diff --git "a/app.py" "b/app.py"
--- "a/app.py"
+++ "b/app.py"
@@ -1,97452 +1,63 @@
 import gradio as gr
 import faiss
 import numpy as np
+import os
 from sentence_transformers import SentenceTransformer
 from huggingface_hub import InferenceClient
 
 # Load embedding model
 model = SentenceTransformer('all-MiniLM-L6-v2')
 
-# 🔹 PASTE YOUR PDF TEXT HERE
-POLICY_TEXT = """
-CodeofCol
-or
-adoRegul
-at
-i
-ons
-Sec
-r
-et
-ar
-yofSt
-at
-e
-St
-at
-eofCol
-or
-ado
-
-DEPARTMENT OF HUMAN SERVICES
-Behavioral Health
-BEHAVIORAL HEALTH
-2 CCR 502-1
-[Editor’s Notes follow the text of the rules at the end of this CCR Document.]
-
-_________________________________________________________________________
-Statement of Basis and Purpose, Fiscal Impact/Regulatory Analysis and Specific Statutory
-Authority
-Rules regarding the Care and Treatment of the Mentally Ill were originally adopted on 3/21/1977, and
-subsequently amended through April 20, 1993 (effective May 30, 1993), by the Department of Institutions.
-The purpose of the 1991 revision of these rules is to make the regulations easier to locate within the
-document, easier to read and to understand; to incorporate policy statement formerly contained in the
-Division of Mental Health's Procedures Manual; and to add several changes recommended to the
-Department of Institutions by the Mental Health Advisory Board for Service Standards and Regulations.
-These rules were proposed pursuant to Notice of Public Hearing published on November 10, 1991, and
-after proper notice, a public hearing was conducted on Thursday, December 5, 1991. Written and oral
-testimony presented to the Department of Institutions was considered in the determination to adopt these
-rules. The record of the rule-making proceeding demonstrates the need for these regulations; the
-regulations have been clearly and simply stated; and the regulations do not conflict with other provisions
-of law. The effective date for these rules is March 1, 1992.
-Sections 103.2.A.2 and 103.2.A.3, which were adopted after January 1, 1992 and before January 1,
-1993, were not extended by H.B. 93-1131 and therefore expired effective June 1, 1993.
-The entire re-write of these rules were adopted following publication at the 4/2/2004 State Board of
-Human Services meeting, with an effective date of 6/1/2004 (Rule-making #03-5-14-1). Statement of
-Basis and Purpose, fiscal impact, and specific statutory authority for these revisions were incorporated by
-reference into the rule. These materials are available for review by the public during normal working hours
-at the Colorado Department of Human Services, Office of Performance Improvement, Boards and
-Commissions Division, State Board Administration.
-Addition of rules concerning Acute Treatment Units, Sections 19.500 through 19.568.2 were adopted
-following publication at the 9/7/2007 State Board of Human Services meeting, with an effective date of
-11/1/2007 (Rule-making #07-3-22-2). Statement of Basis and Purpose, fiscal impact, and specific
-statutory authority for these revisions were incorporated by reference into the rule. These materials are
-available for review by the public during normal working hours at the Colorado Department of Human
-Services, Office of Performance Improvement, Boards and Commissions Division, State Board
-Administration.
-Revision of Section 19.421.3 was adopted following publication at the 7/12/2013 State Board of Human
-Services meeting, with an effective date of 9/1/2013 (Rule-making# 13-5-14-1). Statement of Basis and
-Purpose, fiscal impact, and specific statutory authority for these revisions were incorporated by reference
-into the rule. These materials are available for review by the public during normal working hours at the
-Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and
-Commissions, State Board Administration.
-
-1
-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-2 CCR 502-1
-
-Rules regarding care and treatment of the mentally ill, as originally found in 2 CCR 502-1 (Rule Vol. 19),
-are repealed in their entirety and rewritten as a consolidation of Behavioral Health rules in 2 CCR 502-1
-(Rule Vol. 21) as adopted following publication at the 9/6/2013 State Board of Human Services meeting,
-with an effective date of 11/1/2013 (Rule-making# 13-3-4-1). Statement of Basis and Purpose, fiscal
-impact, and specific statutory authority for these revisions were incorporated by reference into the rule.
-These materials are available for review by the public during normal working hours at the Colorado
-Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions,
-State Board Administration.
-Revisions to Sections 21.900 through 21.950 were adopted on an emergency basis at the 11/6/2015
-State Board of Human Services meeting, with an effective date of 11/6/2015 (Rule-making# 15-10-20-1).
-Statement of Basis and Purpose, fiscal impact, and specific statutory authority for these revisions were
-incorporated by reference into the rule. These materials are available for review by the public during
-normal working hours at the Colorado Department of Human Services, Office of Strategic
-Communications and Legislative Relations, State Board Administration.
-Revisions to Sections 21.900 through 21.950 were adopted as final (permanent) at the 12/4/2015 State
-Board of Human Services meeting, with an effective date of 2/1/2016 (Rule-making# 15-10-20-1).
-Statement of Basis and Purpose, fiscal impact, and specific statutory authority for these revisions were
-incorporated by reference into the rule. These materials are available for review by the public during
-normal working hours at the Colorado Department of Human Services, Office of Strategic
-Communications and Legislative Relations, State Board Administration.
-Revisions to Sections 21.000 through 21.330 were adopted at the 3/4/2016 State Board of Human
-Services meeting, with an effective date of 5/1/2016 (Rule-making# 15-08-26-1). Statement of Basis and
-Purpose, fiscal impact, and specific statutory authority for these revisions were incorporated by reference
-into the rule. These materials are available for review by the public during normal working hours at the
-Colorado Department of Human Services, Office of Strategic Communications and Legislative Relations,
-State Board Administration.
-Revisions to Sections 21.120.3 and 21.120.31 were adopted at the 9/9/2016 State Board of Human
-Services meeting, with an effective date of 11/1/2016 (Rule-making# 16-5-11-1). Statement of Basis and
-Purpose, fiscal impact, and specific statutory authority for these revisions were incorporated by reference
-into rule. These materials are available for review by the public during normal working hours at the
-Colorado Department of Human Services, Office of Strategic Communications and Legislative Relation,
-State Board Administrator.
-Addition of rules concerning the Behavioral Health Crisis Response System, Sections 21.400 through
-21.400.6 were adopted at the 9/9/2016 State Board of Human Services meeting, with an effective date of
-11/1/2016 (Rule-making# 16-5-11-1). Statement of Basis and Purpose, fiscal impact, and specific
-statutory authority for these additions were incorporated by reference into rule. These materials are
-available for review by the public during normal working hours at the Colorado Department of Human
-Services, Office of Strategic Communications and Legislative Relation, State Board Administrator.
-
-2
-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-2 CCR 502-1
-
-The following Chapters 1 - 11 apply to all agencies that apply for, receive, or renew a Behavioral Health
-Entity license or 27-65 designation on or after January 1, 2024.
-Chapter 1:
-
-General Statutory Authority and Definitions
-
-1.1
-
-Authority and Applicability
-
-A.
-
-The statutory authority for the promulgation of these regulations is set forth in Sections 27-50106, C.R.S., 27-50-107 (3), C.R.S., 27-50-301(5), C.R.S., 27-50-502, C.R.S., 27-65-118, C.R.S.
-and 27-65-128, C.R.S. This regulation is intended to be consistent with the requirements of the
-State Administrative Procedures Act (the “APA”), Section 24-4-101 through -109, C.R.S.
-
-B.
-
-Chapters 1-10 of these rules may be applicable to holders of the following license types or
-designation following approval of an application for a Behavioral Health Entity license or renewal
-of a designation:
-1.
-
-Behavioral Health Entity license by the Colorado Department of Public Health and
-Environment;
-
-2.
-
-Approval or designation by the Office of Behavioral Health, as it existed before the
-effective date of Section 27-60-203(5), C.R.S., or the BHA pursuant to Article 50 of Title
-27, C.R.S. or Article 65 and 66 of Title 27 C.R.S.
-
-C.
-
-On an annual basis, the BHA will review the effectiveness of these rules and produce a written
-report of the results of this review to the State Board of Human Services. This review will include
-engagement with stakeholders and may include, but is not limited to, analysis of grievance data
-and trends in enforcement actions taken by the BHA. The BHA will provide this report annually to
-State Board of Human Services (SBHS) by September 1 starting September 1, 2024. The BHA
-will present information in the report to SBHS at the board's next session following submission of
-the written report unless the board and the BHA agree that presentation of the report occur at a
-different session of the board. If it is determined based on this review that changes to these rules
-are advised, the BHA shall propose these changes to the State Board of Human Services for
-promulgation in accordance with Section 26-1-107, C.R.S.
-
-1.2
-
-General Definitions
-
-“27-65 Designated Facility” means an agency that has applied for and been approved by the Behavioral
-Health Administration (BHA) under these rules to provide mental health services governed by Article 65 of
-Title 27, C.R.S.
-“42 C.F.R. Part 2” means the federal regulations issued by the United States Secretary of Health and
-Human Services found at 42 C.F.R. Part 2 (Jan. 2023), which are hereby incorporated by reference. No
-later editions or amendments are incorporated. These regulations are available at no cost from the U.S.
-Department of Health & Human Services, Substance Abuse & Mental Health Services Administration,
-Office of Communications, 5600 Fishers Lane, Rockville, MD 20857 or at
-https://www.ecfr.gov/current/Title-42. These regulations are also available for public inspection and
-copying at the Behavioral Health Administration, 710 S. Ash Street, Unit C140, Denver, CO 80246, during
-regular business hours.
-
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-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-2 CCR 502-1
-
-“42 C.F.R. Part 441” means the federal regulations issued by the United States Secretary of Health and
-Human Services found at 42 C.F.R. Part 441.151 (Feb.2023), which are hereby incorporated by
-reference. No later editions or amendments are incorporated. These regulations are available at no cost
-from the U.S. Department of Health & Human Services, Substance Abuse & Mental Health Services
-Administration, Office of Communications, 5600 Fishers Lane, Rockville, MD20857 or at
-https://www.ecfr.gov/current/Title-42. These regulations are also available for public inspection and
-copying at the Behavioral Health Administration, 710 S. Ash Street, Unit C140, Denver, CO 80246, during
-regular business hours.
-“72-hour Emergency Rule” means the regulation issued by the Drug Enforcement Administration (DEA)
-found at 21 C.F.R. § 1306.07 (Apr.2022), which is hereby incorporated by reference. No later editions or
-amendments are incorporated. This regulation is available at no cost from the DEA at 8701 Morrissette
-Drive Springfield, VA 22152 or at https://www.ecfr.gov/current/Title-21. This regulation is also available for
-public inspection and copying at the Behavioral Health Administration (BHA), 710 S. Ash Street, Unit
-C140, Denver, CO 80246, during regular business hours.
-“988” means the National Suicide Prevention Lifeline (The Lifeline).
-“Activities of Daily Living (ADLs)” means activities that are oriented toward taking care of one’s own body,
-such as bathing, showering, bowel and bladder management, dressing, eating, feeding, functional
-mobility, personal device care, personal hygiene and grooming, sexual activity, sleep, rest, and toilet
-hygiene.
-“Acute Treatment Unit” (ATU) means an agency or a distinct part of an agency, with an endorsement as
-outlined in Chapter 6 for short-term psychiatric care, which may include treatment for substance use
-disorders, that provides a twenty-four-hour, therapeutically planned and professionally staffed
-environment for individuals who do not require inpatient hospitalization but need more intense and
-individualized services than are available on an outpatient basis, such as crisis management and
-stabilization services.
-“ADDS” means the “Alcohol and Drug Driving Safety” program, established under Section 42-4-1301.3,
-C.R.S., the Judicial Department administers an alcohol and drug driving safety program in each judicial
-district that provides pre-sentence and post-sentence alcohol and drug evaluations on individuals
-convicted of DUI, DUI per se, or DWAI.
-“Administration” means (a) assisting a person in the ingestion, application, inhalation, or, using universal
-precautions, rectal or vaginal insertion of medication, including prescription drugs, (b) doing so in
-accordance with the legibly written or printed directions of the attending physician or other authorized
-practitioner or as written on the prescription label and (c) making a written record thereof with regard to
-each medication administered, including the time and the amount taken, but “administration” does not
-include judgment, evaluation, or assessments. Nor does it include the injection of medication, the
-monitoring of medication, or the self-administration of medication, including prescription drugs and
-including the self-injection of medication by a person.
-“Admission” means that point in an individual’s relationship with an organized treatment service when the
-intake process has been completed and the individual is eligible to receive the services.
-“Admission Summary” means a brief review of assessments and other relevant intake data, including
-screenings, which summarizes an individual’s current status and provides a basis for individualized
-service planning.
-“Adverse Childhood Experiences (ACES)” means traumatic events that occur before the age of eighteen
-(18) years old. Aces can include but are not limited to:
-A.
-
-Abuse, which can be emotional, verbal, physical or sexual;
-
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-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-B.
-
-Neglect, either physical or emotional;
-
-C.
-
-Witnessing or experiencing domestic violence;
-
-D.
-
-Substance misuse by a member of the household;
-
-E.
-
-Divorce or separation of parents and/or caregivers or parental abandonment;
-
-F.
-
-Mental illness of a member of the household;
-
-G.
-
-Loss of a member of the household;
-
-H.
-
-Attempted, or death by, suicide of a member of the household; and,
-
-I.
-
-Incarceration of a member of the household.
-
-2 CCR 502-1
-
-“Affidavit of Enrollment” means the document approved by the Department of Revenue, Division of Motor
-Vehicles pursuant to Section 42-2-132(2)(II)(c), C.R.S. indicating proof of an individual’s current
-enrollment in a Level II Alcohol and Drug Education and Treatment program.
-“Agency” means a behavioral health provider licensed, designated, or approved by the BHA.
-“Aggrieved” means having suffered actual loss or injury or being exposed to potential loss or injury to
-legitimate interests as defined in Section 24-4-102(3.5), C.R.S.
-“Alcohol and Drug Evaluation Specialists” or “ADES,” means persons within the Judicial Department,
-qualified to conduct pre- and post-sentence evaluations on, and provide supervision for, individuals
-convicted of DUI/DWAI.
-“Americans with Disabilities Act”, or “ADA,” means the Federal Americans with Disabilities Act of 1990,
-pub. L. No. 101-336 (1990), codified at 42 U.S.C. § 12101 et seq. (Jan 2017).
-“ASAM Criteria” means the publication from the American Society of Addiction Medicine by Mee-lee, D.,
-Shulman, G.D., Fishman, M.J., Gastfriend, D.R., Miller, M.M., eds Titled the ASAM Criteria: Treatment
-Criteria for Addictive, Substance-related, and Co-occurring Conditions, 3rd ed. Carson City, NV: The
-Change Companies®; 2013, which is hereby incorporated by reference. No later editions or amendments
-are incorporated. The ASAM Criteria is available for a reasonable charge at www.asam.org. It is also
-available for public inspection at the Behavioral Health Administration, 710 S. Ash Street, Unit C140,
-Denver, CO 80246, during regular business hours.
-“Assent” means to agree or approve of something (such as an idea or suggestion) especially after
-thoughtful consideration.
-“Assessment” means a formal and continuous process of collecting and evaluating information about an
-individual for service planning, treatment, and referral. Assessments establish justification for services.
-“Auxiliary Aids or Services” means an aid or service that is used to provide information to an individual
-with a cognitive, developmental, intellectual, neurological, or physical disability, and is available in a
-format or manner that allows the individual to better understand the information.
-“Behavioral Health” has the same meaning as provided in Section 27-50-101(1), C.R.S.
-“Behavioral Health Administration” or “BHA” has the same meaning as provided in 27-50-101(2), C.R.S.
-
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-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-2 CCR 502-1
-
-“Behavioral Health Administration DUI/DWAI legal supplement”, or “legal supplement,” means the
-document available to BHEs providing DUI/DWAI programming, incorporating information about recent
-legal updates to legislation impacting DUI/DWAI-involved individuals (2023 version), which is
-incorporated by reference. No later editions or amendments are incorporated. The legal supplement is
-available for inspection on the BHA website at https://bha.Colorado.gov/behavioral-health/DUI-services
-and at the Behavioral Health Administration headquarters, 710 South Ash Street, Unit C140, Denver, CO
-80246, during regular business hours.
-"Behavioral Health Crisis” means a significant disruption in a person’s mental or emotional stability or
-functioning resulting in an urgent need for immediate assessment and treatment to prevent a serious
-deterioration in the person’s mental or physical health.
-"Behavioral Health Disorder" has the same meaning as provided in Section 27-50-101(3), C.R.S.
-"Behavioral Health Entity" has the same meaning as provided in Section 27-50-101(4), C.R.S.
-“Behavioral Health Provider” has the same meaning as provided in Section 27-50-101(6), C.R.S.
-"Behavioral Health Safety Net Provider" has the same meaning as provided in Section 27-50-101(7),
-C.R.S.
-“Best Practices” are professional procedures, interventions, techniques, and treatment approaches that
-have some quantitative data showing positive treatment outcomes over a period of time but may not have
-enough research or replication to be considered an evidence-based approach.
-“Breath or Blood Testing” has the same meaning as provided in Section 42-4-1301.1(2)(a)(I), C.R.S.
-“Brief Therapeutic Interventions” means interactions that are intended to induce a change in a behavioral
-health-related behavior(s).
-“Care Coordination” means services that support individuals and families and initiate care and navigating
-crisis supports, mental health and substance use disorder assistance, and services that address the
-social determinants of health, and preventive care services.
-“Certificate of Compliance” means an official document issued by the Department of Public Safety,
-Division of Fire Prevention and Control for a building or structure as evidence that materials and products
-meet specified codes and standards, that work has been performed in compliance with approved
-construction documents, and that the provisions of applicable fire and life safety codes and standards
-continue to be appropriately maintained.
-“Chemical Restraint” has the same meaning as provided in 26-20-102(2), C.R.S.
-“Child/Children” means a person under eighteen (18) years of age.
-“Clearance Practice” means the process of identifying specific health needs and conditions that may
-require specialty management in a higher level of care, such as a crisis stabilization unit or an inpatient
-psychiatric hospital. Accepting agencies may have varying requirements prior to accepting a referral.
-“Clinically Managed” means services that are directed by clinical personnel, which may include but are
-not required to be, medical personnel. These services involve on-site behavioral health support to
-address problems related to emotional, behavioral, or cognitive concerns, readiness to change, relapse,
-or recovery environment.
-
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-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-2 CCR 502-1
-
-“Clinically Monitored” means that behavioral health services are accessed in the community, and not
-provided directly on-site by the agency. The agency is responsible for monitoring of the individual’s
-engagement in services and coordinating care, as needed.
-“Colorado Crisis Services” means the statewide behavioral health crisis response system offering
-individuals mental health, substance use, or emotional crisis help, information and referrals.
-“Commissioner” has the same meaning as provided in Section 27-50-101(9), C.R.S.
-“Community-Based” has the same meaning as provided in Section 27-50-101(10), C.R.S.
-“Community-Based Respite Care Services” means services of a temporary or short-term nature provided
-to an individual to temporarily relieve the family or other home providers from the care and maintenance
-of such individual.
-“Comorbid” means the simultaneous presence of two or more diseases or medical conditions in an
-individual.
-“Competent to Proceed” has the same meaning as provided in Section 16-8.5-101(5), C.R.S.
-“Comprehensive Community Behavioral Health Provider” has the same meaning as provided in Section
-27-50-101(11), C.R.S.
-“Continuum of Care” or "Behavioral Health Continuum of Care'' is a model of care that guides and tracks
-patient outcomes through a comprehensive array of health services that include strategies for prevention,
-early intervention, treatment, and recovery from mental health problems and disorders with the goal of
-supporting the individual’s ability to live productively in the community.
-“Controlled Substance” has the same meaning as provided in Section 18-18-102(5), C.R.S.
-“Co-occurring” disorders may include any combination of two or more substance use disorders and
-mental disorders identified in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
-(DSM-5-TR).
-“Crisis Assessment” means a standardized assessment form created by the Behavioral Health
-Administration, available on the BHA website.
-“Crisis Stabilization Services” means services provided in a crisis stabilization unit (CSU).
-“Crisis Stabilization Unit” (CSU) means an agency, endorsed for behavioral health crisis and emergency
-services per Chapter 6 and that provides short-term, bed-based crisis stabilization services in a twentyfour-hour environment for individuals who cannot be served in a less restrictive environment.
-“Critical Incident” means a significant event or condition, which may be of public concern, which
-jeopardizes the health, safety, and/or welfare of personnel and/or individuals.
-“Culturally and Linguistically Appropriate Services (CLAS)” means services that are respectful of and
-responsive to individual cultural health beliefs, practices, preferred languages, health literacy levels and
-communication needs.
-"Danger to the Person’s Self or Others" means:
-A.
-
-A person poses a substantial risk of physical harm to the person’s self as manifested by evidence
-of recent threats of or attempts at suicide or serious bodily harm to the person’s self; or
-
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-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-B.
-
-2 CCR 502-1
-
-A person poses a substantial risk of physical harm to another person or persons, as manifested
-by evidence of recent homicidal or other violent behavior by the person in question, or by
-evidence that others are placed in reasonable fear of violent behavior and serious physical harm
-to them, as evidenced by a recent overt act, attempt, or threat to do serious physical harm by the
-person in question.
-
-“Deficiency” means a failure to fully comply with any statutory and/or regulatory requirements applicable
-to an agency.
-“Designated Representative” means a designated representative of an individual or service provider who
-is a person so authorized in writing or by court order to act on behalf of the individual or service provider.
-In the case of a deceased individual, the personal representative, as defined at Section 15-10-201(39),
-C.R.S., or, if none has been appointed, heirs shall be deemed to be designated representatives of the
-individual.
-“Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision,” or “DSM-5-TR,” is
-published by the American Psychiatric Association (2022), which is hereby incorporated by reference. No
-later editions or amendments are incorporated. A copy may be purchased directly from the American
-Psychiatric Association at https://www.psychiatry.org and/or inspected at the American Psychiatric
-Association, 1000 Wilson boulevard, Arlington, VA 22209-3901. A copy may also be inspected at the
-Behavioral Health Administration, 710 S. Ash Street, Unit C140, Denver, CO 80246, during regular
-business hours.
-“Disaster” means the occurrence or imminent threat of widespread or severe damage, injury, or loss of life
-or property resulting from any natural cause or cause of human origin, including but not limited to fire,
-flood, earthquake, wind, storm, wave action, hazardous substance incident, oil spill or other water
-contamination requiring emergency action to avert danger or damage, volcanic activity, epidemic, air
-pollution, blight, drought, infestation, explosion, civil disturbance, hostile military or paramilitary action, or
-a condition of riot, insurrection, or invasion existing in the state or in any county, city, town, or district in
-the state as defined in Section 24-33.5-703(3), C.R.S.
-“Discharge” means the termination of treatment obligations and/or services between an individual and the
-agency. For agencies that provide concurrent behavioral health services to an individual, “discharge” is
-specific to the discontinued treatment obligation or service and does not impact or apply to an individual’s
-concurrent, active behavioral health service(s).
-“Dispense” means to interpret, evaluate, and implement a prescription drug order or chart order, including
-the preparation of a drug for an individual in a suitable container appropriately labeled for subsequent
-administration or use by an individual.
-“Dispute” means a verbal or written expression of dissatisfaction to a BHE about the care or services
-received or not received by an individual, that cannot be resolved to the satisfaction of the person
-expressing the dispute at the time of submission to BHE personnel. Disputes may be submitted by the
-individual or a personal representative on behalf of the individual.
-“Divert Status” means the period of time in which an agency is unable to accommodate new admissions
-for timely services. This status may be necessary for reasons including but not limited to, the maximum
-number of individuals the agency is able to serve is exhausted, unexpected personnel concerns, and
-safety or environmental concerns.
-“DUI/DWAI” for purposes of this Chapter 10, includes the following impaired offenses:
-A.
-
-“driving under the influence” as defined in Section 42-4-1301(1)(f), C.R.S.;
-
-B.
-
-“driving while ability impaired” as defined in Section 42-4-1301(1)(g), C.R.S.;
-
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-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-2 CCR 502-1
-
-C.
-
-“DUI per se” as defined in Section 42-4-1301(2)(a), C.R.S.;
-
-D.
-
-Operating an aircraft under the influence as defined in Section 41-2-102, C.R.S.;
-
-E.
-
-Operating a vessel while under the influence as defined in Section 33-13-108.1, C.R.S.; and
-
-F.
-
-Underage Drinking and Driving (UDD) as defined in Sections 42-1-102(109.7) C.R.S. and 42-41301, C.R.S.
-1.
-
-For the purpose of this section, UDD applies to individuals that are under twenty-one (21)
-years of age.
-
-2.
-
-Agencies providing UDD services to individuals under eighteen (18) years of age shall
-comply with Chapter 8 of these rules.
-
-“DUI/DWAI Reporting System” or “DRS” is the official document generated from data entered by
-endorsed DUI/DWAI programs into the Treatment Management System (TMS). This document reflects at
-minimum an individual’s education and treatment enrollment, attendance, compliance, and discharge
-status.
-“Early Intervention Services” means:
-A.
-
-Services provided to an individual who is at risk of developing a mental health, substance use, or
-co-occurring disorder which may include screening, brief intervention, referral(s) to treatment
-(SBIRT), and/or education-only services;
-
-B.
-
-Services provided to an individual who is currently diagnosed with a mental health, substance
-use, or co-occurring disorder and is undergoing screening, brief intervention, referral(s) to
-treatment (SBIRT), and/or education-only services.
-
-“Egress Alert Device” means a device that is affixed to a structure or worn by an individual that triggers a
-visual or auditory alarm when an individual leaves the building or grounds. An egress alert device is
-considered restrictive when the device is used to prevent the elopement of an individual.
-“Emergency” means an unexpected event that places life or property in danger and requires an
-immediate response through the use of state and community resources and procedures per Section 2433.5-703(3.5), C.R.S.
-“Emergency Services” means the public organizations that respond to emergencies when they occur.
-This includes, but is not limited to, police, ambulance, and firefighting services. It may also include
-emergency behavioral health services accessed during times of crisis, such as Colorado Crisis Services.
-“Endorsement” means approval for an agency approved, licensed, or designated by the BHA to provide a
-specific service.
-“Essential Behavioral Health Safety Net Provider” has the same meaning as defined in Section 27-50101(13), C.R.S.
-“Evidence-Based” means practices, principles, and programming that uses interventions, techniques, and
-treatment methods that have been tested using scientific methodology and proven to be effective in
-improving outcomes for a specific population.
-
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-
-“External Services” means personal services and protective oversight services provided to an individual
-by family members, or health care professionals who are not personnel of the agency. External service
-providers include, but are not limited to, home health providers, hospice, private pay caregivers, friends,
-and family members.
-“Facility,” as used in the definition of BHE set forth above in part 1.2 of these rules, means a Behavioral
-Health Entity licensed by the Department of Public Health and Environment; a public or private “treatment
-facility” required to meet the approval standards established under Section 27-81-106, C.R.S.; an entity
-providing emergency or crisis behavioral health services; an entity providing behavioral health residential
-services; or an entity providing withdrawal management services.
-"Family Member" means a spouse, partner in a civil union, as defined in Section 14-15-103 (5), C.R.S.,
-parent, adult child, or adult sibling of a person with a mental health disorder.
-“Federally Qualified Health Center” has the same meaning as defined in the federal “Social Security Act”,
-42 U.S.C. Sec. 1395x(aa)(4)(2022).
-“Fentanyl Education” means the fentanyl education program developed by the BHA pursuant to Section
-27-80-1287, C.R.S. This program is accessible publicly and will be required for those individuals that
-have a court order to complete the program as a condition of probation or parole.
-“Follow-Up Services” means services that may include interactions after the initial early intervention
-session and are intended to reassess an individual’s behavioral health status and progress, promote, or
-sustain reduction in symptomology and risk factors for a behavioral health disorder, as defined by the
-DSM-5-TR, and assess an individual’s need for additional referral(s) to services.
-“Full Time Equivalent” (FTE) means the scheduled working hours for personnel divided by the number of
-hours in a full-time workweek for the entity. For example, if the entity considers forty hours to be a fulltime workweek, then personnel working twenty hours per week would have an FTE of 0.5.
-“Gender Identity” means a person’s innate sense of the person’s own gender, which may or may not
-correspond with the person’s sex assigned at birth. Gender identity does not include sexual orientation or
-gender non-conforming expressions.
-“Good Standing” means that a license, certification, registration, or enrollment has not been revoked or
-suspended and against which there are no outstanding disciplinary or adverse actions.
-“Governing Body” means the board of trustees, directors, or other governing body in whom the ultimate
-authority and responsibility for the conduct of the agency is vested.
-“Grievance” means an expression of dissatisfaction made to the BHA about the care or services received
-or not received by an individual, that could not be resolved to the satisfaction of the person expressing the
-grievance at the time of submission to BHE personnel. Grievances may be submitted by an individual or
-entity, including but not limited to, recipients of service, family members of recipients of service,
-authorized representatives of recipients of service, licensed facilities, state departments and members of
-the general public.
-“Harm Reduction” means an approach that emphasizes engaging directly with individuals whose actions
-or behaviors place them at risk for a variety of adverse mental health, substance use disorder or physical
-health outcomes. Harm reduction is a set of practical strategies and ideas aimed at reducing potential
-negative consequences associated with a variety of actions or behaviors. These strategies and
-approaches may include but are not limited to safer drug use, overdose prevention, safer sex, medication
-adherence, managed drug use, abstinence, and addressing environmental conditions along with the
-actions or behaviors themselves.
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-“Health-Related Social Needs (HRSN)” means an individual’s unmet, adverse social conditions (e.g.,
-housing instability, homelessness, nutrition insecurity) that contribute to poor health and are a result of
-underlying social determinants of health.
-“HIPAA” means the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, 110
-Stat. 1936 (1996), codified at 42 U.S.C. § 300gg (2012) and 29 U.S.C. § 1181 et seq. (2012) and 42
-U.S.C. § 1320d et seq. (2012) and the federal regulations issued by the U.S. Department of Health &
-Human Services found at 45 C.F.R. part 160 (2017); 45 C.F.R. part 162 (2017); and, 45 C.F.R. part 164
-(2017), which are hereby incorporated by reference. No later editions or amendments are incorporated.
-These regulations are available at no cost from the U.S. Department of Health & Human Services, Office
-of Civil Rights, 200 Independence Avenue, SW, Room 509f, HHH building, Washington, D.C. 20201 or at
-https://www.ecfr.gov/. These regulations are also available for public inspection and copying at the
-Behavioral Health Administration, 710 S. Ash Street, Unit C140, Denver, CO 80246 during regular
-business hours.
-"Hospitalization" means twenty-four (24) hour out-of-home placement for treatment in a facility for a
-person with a mental health disorder.
-“Incompetent to Proceed” has the same meaning as defined in Section 16-8.5-101(12), C.R.S. for adults
-and in Section 19-2.5-102(25), C.R.S. for youth.
-“Individual” means a person seeking or receiving behavioral health services and includes a respondent,
-as defined by Section 27-65-102(29), C.R.S.
-“Informed Consent” means an informed assent that is freely given. It is always preceded by the following:
-A.
-
-An explanation of the nature and purpose of the recommended treatment or procedure in
-layman's terms and in a form of communication understood by the individual or the individual’s
-designated representative;
-
-B.
-
-An explanation of the risks and benefits of a treatment or procedure, the probability of success,
-mortality risks, and serious side effects;
-
-C.
-
-An explanation of the alternatives with the risks and benefits of these alternatives;
-
-D.
-
-An explanation of the risks and benefits if no treatment is pursued;
-
-E.
-
-An explanation of the recuperative period which includes a discussion of anticipated problems;
-and
-
-F.
-
-An explanation that the individual, or the individual’s designated representative, is free to
-withdraw consent and to discontinue participation in the treatment regimen at any time.
-
-“Initial License” means the licensing of a facility or provider organization by the BHA that is not currently
-licensed by the BHA, as well as a licensure change from one type to another.
-“Inpatient” refers to inpatient hospitalization as well as twenty-four (24) hour residential levels of care.
-“In-Person” means services provided in the same physical location as the individual and agency
-personnel. This may include on-scene crisis responses.
-“Inspection” means a process of review to ensure licensed, approved, or designated entities are operating
-in substantial conformity with applicable licensing, approval, and/or designation rules.
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-“Integrated Care Model” means the systematic coordination of mental health, substance use, and primary
-care services.
-“Intensive Case Management” means community-based services provided to individuals with serious
-behavioral health disorders who are at risk of needing a more intensive 24-hour placement and is
-designed to provide extra support for living in the community. These services include assessment, care
-plan development, multi-system referrals, assistance with wraparound and supportive living services,
-monitoring and follow-up.
-“Intensive Outpatient Program” or “IOP” means a service provided for individuals that require a more
-structured outpatient treatment experience than can be received in standard outpatient services. Program
-may be treatment for mental health, substance-related, and co-occurring disorders.
-“Interlock Enhancement Counseling”, or “IEC,” means the evidence-based intervention curriculum which
-combines cognitive behavioral treatment with motivational interviewing/motivational enhancement as a
-treatment intervention. IEC was developed by Timken, Nandi, and Marques, for DUI/DWAI individuals
-who have alcohol ignition interlock devices installed in their vehicles (July 2012), which is incorporated by
-reference. No later editions or amendments are incorporated. This curriculum is available to providers of
-DUI/DWAI services at no cost through the BHA. A copy of the curriculum is available for inspection at the
-Behavioral Health Administration headquarters, 710 S. Ash Street, Unit C140, Denver, CO 80246, during
-regular business hours.
-“Legal Guardian” is an individual appointed by the court, or by will, to make decisions concerning an
-incapacitated individual's or minor's care, health, and welfare.
-“Legal Representative” means one of the following acting within the scope of their authority:
-A.
-
-The guardian of the individual, as defined in Section 15-14-102, C.R.S., where proof is offered
-that such guardian has been duly appointed by a court of law, acting within the scope of such
-guardianship;
-
-B.
-
-An individual named as the agent in a power of attorney (POA), as defined in Section 15-14500.5, C.R.S., that authorizes the individual to act on the individual's behalf, as enumerated in the
-POA;
-
-C.
-
-An individual selected as a proxy decision-maker pursuant to Section 15-18.5-101 through -105,
-C.R.S., to make medical treatment decisions. For the purposes of these rules, the proxy decisionmaker serves as the individual's legal representative for the purposes of medical treatment
-decisions only; or
-
-D.
-
-A conservator, where proof is offered that such conservator has been duly appointed by a court of
-law, acting within the scope of such conservatorship.
-
-“Lethal Means Restriction” means an approach to suicide prevention that reduces access to a fatal
-method of suicide (e.g., firearms, medications, sharps), thus preventing or reducing the lethality of an
-attempt.
-“Letter of Intent” means the notification provided to the BHA related to an application for an initial BHE
-license or safety net approval.
-“Level I and Level II Alcohol and Drug Education or Treatment” means a BHA endorsed ADDS education
-or treatment program as defined in Section 42-4-1301.3(3)(c)(IV) C.R.S.
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-“Level II Four Plus”, also referred to as “Track F” treatment, is an ADDS program, intended for an
-individual who has four (4) or more alcohol and/or drug impaired driving offenses, as noted in Section 424-1301.3(3)(c)(IV), C.R.S. This includes vehicular homicide and vehicular assault where alcohol or other
-drugs were involved. Only programs endorsed to provide Level II Four Plus treatment may accept
-referrals for this level of service.
-“Level II Four Plus: competencies and phases” means the BHA-approved document available to Level II
-Four Plus programs, providing additional guidance regarding competency and phase completion. It is
-available on the BHA website.
-“Level 3-Withdrawal Management” or “Level 3-WM” means the on-site service offered twenty-four (24)
-hours per day to individuals who are intoxicated and actively withdrawing from the use of one (1) or more
-substances. It includes both Level 3.2-WM and Level 3.7-WM, as defined in part 1.2 of these rules.
-“Living Space Assignment” means the assigned bathroom and sleeping quarters of individuals served by
-the agency.
-“Managed Care Entity” has the same meaning as provided in Section 25.5-5-403(4), C.R.S.
-“Medically Managed” means services that are directly provided and/or managed by licensed medical
-personnel.
-“Mechanical Restraint” means a physical device used to involuntarily restrict the movement of an
-individual or the movement or normal function of a portion of an individual’s body.
-“Medically Monitored” means services that are provided by an interdisciplinary team of personnel
-including nurses, behavioral health professionals, other health care professionals and technical
-personnel, under the direction of a licensed physician. Medical monitoring is provided through a mix of
-direct individual contact, review of records, team meetings, twenty-four (24) hour coverage by a physician,
-and quality assurance programs.
-“Medication/Psychiatric - Only Services” means services dedicated solely to the management of
-medications prescribed to an individual for the management of mental health, substance use, and/or cooccurring behavioral health disorders.
-“Medication-Assisted Treatment,” or “MAT” services, means the use of medications, in combination with
-or without counseling and behavioral therapies, to provide a whole-person approach to the treatment of
-substance use disorders. Medications used in MAT are approved by the United States Food and Drug
-administration (FDA) and MAT programs are clinically driven and tailored to meet each individual’s needs.
-MAT services may include Medications for Opioid Use Disorder (MOUD) services for the specialized
-treatment of Opioid Use Disorder (OUD).
-“Medication Diversion” means the transfer of any controlled substance from a licit to an illicit channel of
-distribution or use.
-“Medication Formulary” means the Required Formulary Psychotropic Medications: 2018, which is
-available at no cost from the Colorado Department of Human Services at
-https://bha.colorado.gov/behavioral-health/medication-consistency. The medication formulary is a list of
-minimum medications, established pursuant to Section 27-70-103, C.R.S., that may be used by service
-providers to increase the likelihood that a broad spectrum of effective medications are available to
-individuals to treat behavioral health disorders, regardless of the setting or service provider. The
-medication formulary may not contain a complete list of medications, and providers may prescribe and/or
-carry any additional medications they deem necessary.
-“Member” means a person or entity with an ownership interest in the limited liability company.
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-"Mental Health Disorder" has the same meaning as provided in Section 27-50-101(15), C.R.S.
-“Mental Health Transitional Living Home” means a community-based residential agency providing
-residential support to individuals who require ongoing support with daily living due to their behavioral
-health diagnosis but whose needs do not rise to the level of hospitalization. There are two levels of
-mental health transition living homes:
-A.
-
-“Level One Mental Health Transitional Living Homes” provide clinically monitored services as
-defined in part 1.2 of these rules.
-
-B.
-
-“Level Two Mental Health Transitional Living Homes” provide clinically managed services as
-defined in part 1.2 of these rules.
-
-“Mental Status Examination '' means a structured assessment of the individual’s behavioral and cognitive
-functioning. The specific cognitive functions of alertness, language, memory, constructional ability, and
-abstract reasoning are the most clinically relevant. The mental status examination can include but is not
-limited to:
-A.
-
-The individual’s appearance and general behavior;
-
-B.
-
-Level of consciousness and attentiveness;
-
-C.
-
-Motor and speech activity;
-
-D.
-
-Mood and affect;
-
-E.
-
-Thought and perception;
-
-F.
-
-Attitude and insight; and
-
-G.
-
-Higher cognitive abilities.
-
-“Milieu” means the shared living space of the agency and includes the living space assignments for
-individuals served.
-“Minor in Possession” (MIP) is an offense committed by an individuals aged twenty-one (21) and younger
-for possession or consumption of ethyl alcohol or possession of two ounces or less or consumption of
-marijuana or possession of marijuana paraphernalia. MIP may result in fines, court-ordered public
-service, a substance use disorder assessment, and/or substance abuse education program per Section
-18-13-122, C.R.S.
-“Monitoring” means the observation, review, and documentation of results when tracking an individual’s
-progress over a period of time related to an event. This may include, but is not limited to, monitoring of
-medication compliance and administration, and monitoring of vital signs while actively withdrawing from
-substances.
-“Motivational Enhancement” means the counseling approach to initiate behavior change by helping an
-individual resolve ambivalence about engaging in treatment services and reducing engagement in
-harmful behavior and activities. This approach employs strategies to evoke rapid and internally motivated
-change in the individual rather than guiding the individual stepwise through the recovery process.
-“Multidisciplinary Team” or “MDT” means a group of personnel, acting within their professional role(s) and
-respective scope(s) of practice, who are members of different professions, working together to provide
-services to individuals.
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-
-“Natural Supports” means the relationships that occur in everyday life. Natural supports typically involve
-family members, friends, co-workers, neighbors, and acquaintances and are self-defined by the individual
-in crisis.
-“No Refusal Requirements” means the requirements found in 27-50-301(4), C.R.S. that establish the
-conditions under which a behavioral health safety net provider cannot refuse to treat an individual.
-“On-Site” means at the location that is licensed, designated, or approved by the BHA for the provision of
-behavioral health services.
-“Opioid Antagonist” has the same meaning provided in Section 17-1-113.4(4)(b), C.R.S.
-“Outreach, Education, and Engagement Services” means services by an agency that have identified
-priority target populations and service needs in the area the agency serves that require higher levels of
-active engagement by the agency to produce positive behavioral health outcomes.
-“Outpatient Competency Restoration” means a community-based program that allows adults and
-juveniles in the criminal justice or juvenile justice system, who are found incompetent to proceed by the
-court, to receive psychoeducation services, case management, and referrals to community-based
-services and supports throughout all of Colorado with the goal of restoring competency.
-“Outpatient Treatment” means behavioral health services provided to an individual in accordance with
-their service plan on a regular basis in a non-overnight setting, which may include, but not be limited to,
-individual, group, or family counseling, peer support professional services, case management, or
-medication management.
-“OWNPATH” is an online directory operated by the Colorado Behavioral Health Administration that allows
-individuals to find behavioral health providers licensed, designated, or approved by the BHA in order to
-access specific services or resources that best meet the individual’s behavioral health needs.
-“Paired Mobile Response” means a mobile crisis response in which two personnel respond, one person
-on scene and the other person on scene or via telehealth. Both members of the paired response should
-be crisis professionals.
-“Partial Hospitalization Program” or “PHP” means a service provided for individuals that require regularly
-scheduled monitoring or management while providing clinical structure in an outpatient setting to treat
-mental health, substance use, or co-occurring needs in addition to providing direct access to medical,
-psychiatric, and laboratory services.
-“Pass” means written permission by an agency for an individual to leave campus grounds.
-“Peer Respite Home” means an agency staffed by peer support professionals that provides temporary
-accommodations to prevent behavioral health-related hospitalizations.
-“Peer Support” means recovery-oriented services provided by peer support professionals that promote
-self-management of psychiatric symptoms, relapse prevention, treatment choices, mutual support,
-enrichment, and rights protection. Peer support also provides social supports and a lifeline for individuals
-who have difficulties developing and maintaining relationships.
-“Persistent Drunk Driver”, or “PDD,” has the same meaning as provided in Section 42-1-102(68.5)(a),
-C.R.S.
-“Personal Services” means those services that an agency and its personnel provide for each individual
-including, but not limited to:
-
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-
-A.
-
-An environment that is sanitary and safe from physical harm;
-
-B.
-
-Individualized social supervision;
-
-C.
-
-Assistance with transportation; and
-
-D.
-
-Assistance with activities of daily living.
-
-2 CCR 502-1
-
-“Person-Centered Care” means individuals participate in the development of treatment goals and services
-provided to the greatest extent possible. Person-centered service planning is strength-based and focuses
-on individual capacities, preferences, and goals. Individuals are core participants in the development of
-the plans and goals of treatment.
-“Pharmacotherapy” means the treatment by an authorized practitioner of an individual’s behavioral health
-condition(s) through medicinal use of pharmaceutical products.
-“Physical Management” means the physical action of placing one’s hands on an individual to gain
-physical control to protect the individual or others from physical harm after all attempts to verbally direct or
-de-escalate the individual have failed. Any attempts at physical management of a child is considered
-restraint.
-“Physical Restraint” means the use of bodily, physical force to involuntarily limit a person's freedom of
-movement, except that “physical restraint” does not include the holding of a child or youth by one adult for
-the purpose of calming or comforting the child.
-“Plan of Action” is a description of how an agency plans to bring into compliance any standards identified
-as out of compliance within a specified time period.
-“Postpartum” means the period of time following the end of a pregnancy or birth of a child up to one year.
-“Primary Complaint” or “Presenting Problem” means the reason, concern, or motivation which prompts an
-individual to seek services or that which the individual’s referral source identifies as the issue which
-requires intervention, usually in the individual’s own words.
-“Priority Populations” has the same meaning as provided in Section 27-50-101(17), C.R.S.
-“Protective Oversight” means guidance of an individual as required by the needs of the individual or legal
-representative or as reasonably requested by the individual including the following:
-A.
-
-Being aware of an individual’s general whereabouts, although the individual may travel
-independently in the facility; and
-
-B.
-
-Monitoring the activities of the individual on the premises to ensure the individual’s health, safety,
-and well-being, including monitoring the individual’s needs and ensuring that they receive the
-services and care necessary to protect health, safety, and well-being.
-
-“Prosocial” means relating to or denoting behavior which is positive (e.g., friendly, expresses empathy to
-or about others, and respects rules as well as the boundaries of others), helpful, and intended to promote
-social acceptance and friendship which is positive, helpful, and intended to promote social acceptance
-and friendship.
-“Protective Factor” means the characteristics associated with a lower likelihood of negative outcomes or
-that reduce a risk factor’s impact. Protective factors are seen as positive countering events. Protective
-factors may include factors such as positive self-image, self-control, or social competence.
-
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-
-“Provider Organization,” as used in the definition of BHE set forth above, means a corporation,
-partnership, limited liability company, business trust, association, or organized group of persons, which is
-in the business of behavioral health care delivery or management and that (a) includes ten (10) or more
-full time equivalent (FTE) fully licensed or certified professionals providing diagnostic, therapeutic, or
-psychological services for behavioral health conditions under the providers’ Professional Practice Act.
-“Psychiatric Advance Directive (PAD)” means a written instruction, created pursuant to Section 15-18.7202, C.R.S. concerning behavioral health treatment, medication, and alternative treatment decisions,
-preferences, and history to be made on behalf of the adult who provided the instruction.
-“Psychotherapy” or “psychotherapy services” has the same meaning as defined in Section 12-245202(14), C.R.S.
-“Readiness to Change” means an individual’s emotional and cognitive awareness of and interest in the
-need to change, coupled with a commitment to change.
-“Real-Time” documentation means that the personnel providing a monitoring activity enters the result in
-the individual’s record at the time of the monitoring activity, allowing necessary information to transition
-seamlessly between shift change. If this process involves delayed entry of results into an electronic health
-record or other tracking system, the documentation reflecting real-time communication must be included
-in the individual’s record.
-“Recovery” means a process of change through which individuals improve their health and wellness and
-ability to live a self-directed life and strive to reach their full potential.
-“Recovery Support Services Organization” (RSSO) has the same meaning as in 27-60-108(2)(c).
-“Residential Child Care Facility (RCCF)” has the same meaning as described in Section 26-6-903(29),
-C.R.S.
-“Residential Services” means the on-site service for individuals whose mental health and/or substance
-use issues and symptoms are severe enough to require a twenty-four (24)-hour per day structured
-program and oversight, but that do not require hospitalization. It includes mental health transitional living
-homes, but does not include residential child care facilities.
-“Restraint” has the same meaning as described in Section 26-20-102(6), C.R.S.
-“Risk Factors” mean the characteristics at the biological, psychological, family, community, or cultural
-level that precede and are associated with a higher likelihood of negative outcomes. Risk factors on an
-individual level may include an individual’s genetic predisposition to addiction or exposure to alcohol or
-other potentially harmful substance(s) prenatally.
-“Risk, Need, Responsivity,” or “RNR,” means the model of evaluating how to best engage an individual
-involved in the criminal justice system. It incorporates the following principles:
-A.
-
-Criminogenic risk: the likelihood that an individual will engage in future illegal behavior in the form
-of a new crime or failure to comply with conditions of probation or parole.
-
-B.
-
-Criminogenic need: dynamic risk factors that increase an individual’s likelihood to engage in
-future illegal behavior in the form of a new crime or failure to comply with conditions of probation
-or parole. This includes, but is not limited to, factors such as lack of employment or livable wages,
-or the presence of a substance use disorder. These factors are malleable and responsive to
-intervention.
-
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-
-C.
-
-2 CCR 502-1
-
-Responsivity: maximizing the potential success of treatment intervention by tailoring the
-intervention to the learning style, secondary needs, motivation, and strengths of the individual.
-
-“SAMHSA” means the Substance Abuse and Mental Health Services Administration overseen by the
-United States Department of Health and Human Services.
-“Screening” means a brief process used to identify current behavioral health or health needs and is
-typically documented through the use of a standardized instrument. Screening is used to determine the
-need for further assessment, referral, or immediate intervention services.
-“Seclusion” has the same meaning as described in Section 26-20-102(7), C.R.S.
-“Self-Administration” means the ability of a person to take medication independently without assistance
-by administration from another person.
-“Sequential Intercept Model (SIM)” means the model of how individuals with behavioral health disorders
-come into contact with and move through the criminal justice system.
-“Service Plan” means a written description of the services to be provided by the agency to meet an
-individual's treatment needs.
-“Session” means a face-to-face, telehealth, or audio-only interaction of the individual and personnel.
-Session may include but is not limited to individual therapy, group therapy, medication-assisted treatment
-education and/or monitoring, family therapy, peer professional services, educational/occupational groups,
-recreational therapy, intake, discharge, service planning, and other therapies.
-“Social Determinants of Health” refers to the conditions in which individuals are born, grow, live, work and
-age. They include factors such as socioeconomic status, education, neighborhood and physical
-environment, employment, and social support networks, as well as access to health care.
-“Stock Medication” means medication that is not labeled for, or intended for, use by a specific individual
-when it leaves the pharmacy but is intended to be stored and ultimately administered by a licensed health
-care professional in accordance with applicable laws and regulations.
-“Sub-Endorsement” means a secondary endorsement for a specific type of service within the broader
-category of an endorsement.
-"Substance Use Disorder" has the same meaning as provided in Section 27-50-101(20), C.R.S.
-“Supervising Entity” means the official employed by probation, parole, or other representative of the
-criminal justice system who is responsible for oversight and supervision of the individual. Other
-representatives may include, but are not limited to, direct employees or contractors of the Department of
-Corrections, the Division of Criminal Justice, The Judicial Department, or the Department of Human
-Services. The supervising entity is often responsible for referring individuals into specific education and/or
-treatment services and reporting compliance with terms of supervision to the courts.
-“Supervision” for the purposes of Chapter 6 only means weekly clinical guidance from a licensee.
-“Telehealth” means delivery of services through telecommunications systems that are compliant with all
-federal and state protections of individual privacy, to facilitate individual assessment, diagnosis,
-consultation, treatment, and/or service planning/case management when the individual and the person
-providing services are not in the same physical location. Telecommunications systems used to provide
-telehealth include information, electronic, and communication technologies. Telehealth may include
-audio-only methods in accordance with state and federal regulation unless noted otherwise.
-
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-
-“Tiered Inspection” means an on-site re-licensure survey that has a reduced scope and reviews fewer
-items for compliance with applicable state regulations than a full re-licensure survey.
-“Transfer” means being able to move from one body position to another. This includes, but is not limited
-to, moving from a bed to a chair or standing up from a chair to grasp adaptive equipment.
-“Trauma-Informed” means an approach to care that realizes the widespread impact of trauma,
-understands potential paths for recovery, recognizes the signs and symptoms of trauma in individuals,
-families, personnel, and others involved in the system, and responds by fully integrating knowledge about
-trauma into policies, procedures, and practices, seeking to actively resist re-traumatization. The six key
-principles of a trauma-informed approach include:
-A.
-
-Safety, trustworthiness and transparency;
-
-B.
-
-Peer support, collaboration and mutuality;
-
-C.
-
-Empowerment, voice and choice;
-
-D.
-
-Cultural issues;
-
-E.
-
-Historical issues; and
-
-F.
-
-Gender issues.
-
-“Treatment Management System,” or “TMS” means the database utilized by endorsed DUI/DWAI
-programs to electronically track and report an individual’s enrollment and status in required DUI/DWAI
-services through the completion of the “DUI/DWAI reporting system,” or “DRS” record.
-“Treatment Type” means the focus of behavioral health services that the agency provides. It may include
-services focused on mental health disorders, substance use disorders, or both, also referred to as “cooccurring” disorders.
-“Triage” means a dynamic process of evaluating and prioritizing urgent needs and intervention options
-based on the nature and severity of the individuals’ presenting situation.
-“Two (2) Generational Approach'' means focusing on both children and parents’ and/or legal guardians
-needs at the same time. This approach focuses on breaking down barriers by strengthening education,
-economic supports, social capital and health and well-being. The core principles of the Two Generational
-Approach are:
-A.
-
-Measure and account for outcomes for both children and their parents and/or legal guardians;
-
-B.
-
-Engage and listen to the voices of families;
-
-C.
-
-Foster innovation and evidence together;
-
-D.
-
-Align and link systems and funding streams; and
-
-E.
-
-Ensure equity.
-
-“Underinsured” means an individual’s insurance plan does not cover the cost of necessary care, either
-medical or behavioral, leaving the individual with out-of-pocket costs they are unable to pay.
-“Understanding the ADDS Evaluation Training” means the mutually developed, webinar-based training
-offered by the BHA and State Court Administrator’s Office.
-
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-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-2 CCR 502-1
-
-“Undue Hardship” means a situation where compliance with a rule creates a substantial, unnecessary
-burden on the applicant or agency’s business operation or the families or community it serves, and which
-reasonable means cannot remedy. An undue hardship does not include the normal cost of operating the
-business.
-"Walk-In Crisis Services" means immediate and confidential, in-person crisis support, information, and
-referrals to any individual in need including to anyone experiencing a self-defined crisis.
-“Warm Handoff” means an approach to care transitions in which a behavioral health care provider uses
-face-to-face or telehealth contact to directly link individuals being treated to other providers or services.
-“Warm Line/Support Line” means a telephonic service where individuals can “opt in” from the statewide
-crisis line to receive individualized screening and resources by peer support professionals.
-“Whole Person Health” means physical, mental, and social wellness which is achieved through integrated
-care and adequately addressing social determinants of health.
-“Withdrawal Management” or “WM” means the services required to assist an individual experiencing
-withdrawal from the use of one (1) or more substances, as identified by the individual’s acute intoxication
-and/or withdrawal potential, also known as the dimension 1 rating, from the ASAM Criteria. Withdrawal
-management is divided into the following levels:
-A.
-
-“Level 1-WM” means ambulatory withdrawal management without extended on-site monitoring
-services. This is an outpatient service that involves medically supervised evaluation, withdrawal
-management, and referral services that are delivered on a regular schedule.
-
-B.
-
-“Level 2-WM'' means ambulatory withdrawal management with extended on-site monitoring. This
-is an outpatient service that involves regularly scheduled sessions of physician approved
-monitoring of withdrawal management protocols.
-
-C.
-
-“Level 3.2-WM” means clinically managed residential withdrawal management. This is an
-organized service delivered in a setting that provides twenty-four (24) hour supervision,
-observation, and support to individuals who are intoxicated and/or experiencing withdrawal. This
-service is characterized by its emphasis on peer and social support rather than medical and/or
-nursing care.
-
-D.
-
-“Level 3.7-WM” means medically monitored inpatient withdrawal management. This is an
-organized service delivered by medical and nursing professionals, which provides for twenty-four
-(24) hour evaluation and withdrawal management in a permanent facility with inpatient beds.
-Services are delivered under a defined set of physician-approved policies and physicianmonitored procedures or clinical protocols.
-
-“Women’s and Maternal Behavioral Health Treatment” means creating an environment and service
-continuum that reflects an understanding of and is grounded in the unique biological, developmental,
-historical, relational, economic and social experiences that shape women's lives, and thus responds
-through factors which include, but are not limited to, site selection; personnel selection and training;
-program development; content; and wrap-around supports that address gender-specific issues in the
-course of prevention, intervention, treatment and recovery services. This was previously known as
-gender-responsive treatment.
-“Youth” means an individual who is under twenty-one (21) years of age.
-
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-Behavioral Health
-
-1.3
-
-2 CCR 502-1
-
-Personnel Definitions
-
-“Administrator” means a person implementing policies and procedures on an agency-wide, endorsement,
-service, or physical location-specific basis, who is responsible for the day-to-day operation of such
-endorsement, service, or location.
-“Advanced Practice Registered Nurse” or “APRN” has the same meaning as provided in Section 12-255104, C.R.S.
-“Approved Restoration Provider” means a comprehensive community behavioral health provider who
-appears on the approved provider list as passing all contract application requirements with the outpatient
-competency restoration services program department within the Office of Civil and Forensic Mental
-Health (OCFMH).
-“Authorized Practitioner” means the person (a) authorized by law to prescribe treatment, medication, or
-medical devices, (b) who holds a current unrestricted license to practice, and (c) is acting within the scope
-of such authority. This includes persons registered with the Drug Enforcement Administration (DEA) to
-prescribe controlled substances. This includes, but is not limited to:
-A.
-
-A physician, psychiatrist, medical doctor, or doctor of osteopathy licensed pursuant to Article 240
-of Title 12, C.R.S.,
-
-B.
-
-A physician assistant licensed pursuant to part 113 of Article 240 of Title 12, C.R.S., and
-
-C.
-
-An advanced practice registered nurse (APRN), licensed pursuant to part 255 of Title 12, C.R.S.
-
-“Candidate” means a person receiving clinical supervision, acting within their scope of practice, and
-seeking licensure through DORA. It includes the following:
-A.
-
-Psychologist candidates, pursuant to Section 12-245-3, C.R.S.;
-
-B.
-
-Clinical social work candidates, pursuant to Section 12-245-4, C.R.S.;
-
-C.
-
-Marriage and family therapist candidates, pursuant to Section 12-245-5, C.R.S.;
-
-D.
-
-Licensed professional counselor candidates, pursuant to Section 12-245-6, C.R.S.; and
-
-E.
-
-Licensed addiction counselor candidates, pursuant to Section 12-245-8, C.R.S.
-
-“Certified Addiction Specialist” or “CAS,” means a person who possesses a valid, unsuspended, and
-unrevoked addiction counseling certificate issued by DORA, authorizing them to practice addiction
-counseling commensurate with their certification level and scope of practice, per Section 12-245-8,
-C.R.S.
-“Certified Addiction Technician” or “CAT” means a person who possesses a valid, unsuspended, and
-unrevoked addiction counseling certificate issued by DORA, authorizing them to practice addiction
-counseling commensurate with their certification level and scope of practice, per Section 12-245-8,
-C.R.S.
-“Clinical Director” means a person responsible for overseeing individual treatment services, including, but
-not limited to ensuring appropriate training and supervision for clinical personnel.
-
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-
-2 CCR 502-1
-
-“Clinical Supervision” means the following:
-A.
-
-Supervision that is received to meet the standard qualifications for clinical supervision as defined
-by a professional practice board and standards in the Colorado Mental Health Practice Act,
-pursuant to Article 245 of Title 12, C.R.S. the delivery, frequency, and specific requirements may
-vary depending upon the credential and the respective skills of the two (2) professionals involved,
-and the population and/or the specific individual being served.
-
-B.
-
-Supervision provided to personnel who are not seeking or not eligible for professional licensure
-but are otherwise qualified to provide services to individuals based on education, training, or other
-credentials implies that the supervisor accepts oversight and responsibility for the services
-provided by this personnel. The supervisor must follow standards in the Colorado Mental Health
-Practice Act, pursuant to Article 245 of Title 12, C.R.S. The nature of the supervisory relationship
-depends on the respective skills of the two professionals involved, the individual population
-and/or the specific individual being served. It is usually ongoing, required, and hierarchical in
-nature.
-
-"Counselor-In-Training" means a person currently in the process of obtaining a professional credential
-pursuant to Article 245 of Title 12, C.R.S. "Counselor-In-Training" does not include candidates as defined
-in this part 1.3.
-“Colorado Department of Regulatory Agencies,” or “DORA” means the division of professions and
-occupations within this state department as created in Section 24-1-122, C.R.S.
-“Crisis Professional” means any person who is receiving or has received crisis professional curriculum
-training approved by the BHA specific to crisis assessment, management, de-escalation, safety planning
-and all relevant laws and provisions such that training is complete, and the person can lead a crisis
-response.
-“Group Living Worker” means a person without a behavioral health credential or license that is adequately
-trained and supervised to recognize and respond to behavioral health concerns. This person may assist
-in twenty-four (24) hour management and oversight of the milieu and, in certain facilities, may also serve
-a correctional or supervision-focused role. This does not include peer support professionals.
-“Intern'' means personnel completing a clinical degree program of study performing duties under the
-direct clinical supervision of degree-corresponding licensed personnel.
-“Licensed Addiction Counselor” or “LAC” means a person who possesses a valid, unsuspended, and
-unrevoked addiction counseling license issued by DORA, authorizing them to practice addiction
-counseling commensurate with their licensure level and scope of practice, per Section 12-245-801
-through -806, C.R.S.
-“Licensed Social Worker” means a person who:
-A.
-
-Is a licensed social worker or licensed clinical social worker; and
-
-B.
-
-Possesses a valid, unsuspended, and unrevoked license issued pursuant to Section 12-245-404,
-C.R.S.
-
-“Licensed Professional Counselor” or “LPC” means a person who is a professional counselor licensed
-pursuant to Section 12-245-601 through -607, C.R.S.
-“Licensee” means a psychologist, social worker, clinical social worker, marriage and family therapist,
-licensed professional counselor, or addiction counselor licensed as defined in 12-245-202(8), C.R.S.
-
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-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-2 CCR 502-1
-
-“Manager” means a person involved in and/or responsible for decisions made on behalf of an agency
-regarding clinical and/or operational policies, procedures, and actions for a physical location,
-endorsement, service type, and/or the agency. This may include administrators or clinical directors,
-depending on the structure and operation of the agency. An agency may have a single manager, or
-multiple managers, as appropriate for the combination of endorsements, services, and locations included
-in the agency license.
-“Marriage and Family Therapist” or “LMFT” means a person who possesses a valid, unsuspended, and
-unrevoked license as a marriage and family therapist pursuant to Section 12-245-504, C.R.S.
-“Nurse” means a person who holds a current unrestricted license to practice pursuant to 12-255-110,
-C.R.S., and is acting within the scope of such authority.
-“Peer Support Professional” means the following persons who meet the qualifications as described in
-Section 27-60-108(3)(a)(III), C.R.S.:
-A.
-
-A peer support specialist;
-
-B.
-
-A recovery coach;
-
-C.
-
-A peer and family recovery support specialist;
-
-D.
-
-A peer mentor;
-
-E.
-
-A family advocate; or
-
-F.
-
-A family systems navigator.
-
-“Personnel” means persons employed by and/or providing services under the direction of an agency,
-including, but not limited to managers, administrators, clinical directors, employees, contractors, students,
-interns, volunteers, or treatment-involved mentors.
-"Professional Person" has the same meaning as described in Section 27-65-102(27), C.R.S.
-“Psychologist” means a person who possesses a valid, unsuspended, and unrevoked license as a
-psychologist licensed pursuant to Section 12-245-304, C.R.S.
-“Qualified Medication Administration Person” or “QMAP” means a person who passed a competency
-evaluation administered by the Department of Public Health and Environment before July 1, 2017, or
-passed a competency evaluation administered by an approved training entity on or after July 1, 2017, and
-whose name appears on the Department of Public Health and Environment’s list of persons who have
-passed the requisite competency evaluation.
-“Qualified Practitioner” means a physician or other person licensed, registered, or otherwise permitted to
-distribute, dispense, or to administer a controlled substance in the course of professional practice.
-Chapter 2:
-
-General Behavioral Health Entity Licensing Standards
-
-2.1
-
-Authority and Applicability
-
-A.
-
-Chapter 2 establishes the conditions that an agency must meet in order to be licensed as a
-Behavioral Health Entity (BHE), and the minimum standards for the operation of a BHE. The
-statutory authority for the promulgation of these regulations is set forth in Sections 27-50107(3)(b), C.R.S. and 27-50-502(1), C.R.S.
-
-23
-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-2 CCR 502-1
-
-B.
-
-As of January 1, 2024, it is unlawful for any person, partnership, association, or corporation, not
-already possessing a valid license to operate a BHE or substance use disorder facility, to conduct
-or maintain a BHE, without having obtained a license from the Behavioral Health Administration
-(BHA) per Section 27-50-501, C.R.S.
-
-C.
-
-Pursuant to Section 27-50-502(1)(g), C.R.S., these rules shall include a timeline for compliance
-with BHE standards that exceed the standards under which a BHE was previously licensed or
-approved. BHEs shall be subject to the following rule compliance timeline:
-1.
-
-Upon these rules going into effect, the BHA shall take immediate action on rule violations
-that impact the health, safety, and welfare of individuals receiving services provided by a
-BHE.
-
-2.
-
-All BHEs, licensed by the BHA, shall be in full compliance of these rules, and any rules
-that apply to any endorsements an entity has elected to obtain, by July 1, 2024.
-
-2.2
-
-License Requirement
-
-A.
-
-Any entity seeking initial licensure as a BHE shall apply for a license from the (BHA) if the entity
-would previously have been licensed or subject to any of the following:
-1.
-
-BHE licensure by the Colorado Department of Public Health and Environment;
-
-2.
-
-Approval or designation by the Office of Behavioral Health, as it existed before the
-effective date of this part, or the BHA pursuant to Article 50 of Title 27, C.R.S. or Article
-66 of Title 27 C.R.S.; or
-
-3.
-
-Approval by the Office of Behavioral Health, as it existed before the effective date of this
-part, or the BHA pursuant to Section 27-81-106, C.R.S. as an approved treatment
-program for substance use disorders. This includes agencies that:
-a.
-
-Are required by statute to be licensed by the BHA;
-
-b.
-
-Receive public funds to provide substance use disorder treatment or substance
-use disorder education;
-
-c.
-
-Provide such treatment to individual populations whose referral sources require
-them to be treated in agencies licensed by the BHA; or
-
-d.
-
-Are acquiring existing agencies or sites licensed by the BHA.
-
-B.
-
-Entities previously licensed as described in part 2.2.A of this Chapter shall seek an initial BHE
-license at least sixty (60) calendar days prior to the expiration of their existing license.
-
-C.
-
-Any entity that meets the definition of a BHE, as defined in these rules, shall be licensed pursuant
-to this Chapter 2.
-
-D.
-
-Hospitals are exempt from BHE licensure as they do not meet the definition of providing
-community-based services.
-
-2.3
-
-General Licensing Requirements
-
-A.
-
-The BHE shall ensure compliance with the following:
-
-24
-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-2 CCR 502-1
-
-1.
-
-The BHE may only provide services for which it holds an endorsement as part of its
-license.
-
-2.
-
-If a BHE has not provided behavioral health services specific to its endorsement for one
-(1) year, the BHA will review the endorsement and may remove the endorsement from
-the BHE’s license.
-
-3.
-
-The following endorsements are considered outpatient service endorsements:
-
-4.
-
-a.
-
-Behavioral Health Outpatient services as described in Chapter 4 of these rules;
-
-b.
-
-Behavioral Health High-Intensity Outpatient services as described in Chapter 4 of
-these rules;
-
-c.
-
-Walk-In Crisis services as described in Chapter 6 of these rules;
-
-d.
-
-Mobile Crisis services as described in Chapter 6 of these rules;
-
-e.
-
-Ambulatory Withdrawal Management without Extended On-Site Monitoring (Level
-1-WM) as described in Chapter 4 of these rules; and
-
-f.
-
-Ambulatory Withdrawal Management with Extended On-Site Monitoring (Level 2WM) as described in Chapter 4 of these rules.
-
-The following endorsements are considered residential/overnight endorsements:
-a.
-
-Residential services as described in Chapter 5 of these rules;
-
-b.
-
-Crisis Stabilization Unit services as described in Chapter 6 of these rules;
-
-c.
-
-Acute Treatment Unit services as described in Chapter 6 of these rules;
-
-d.
-
-Residential Respite services as described in Chapter 6 of these rules;
-
-e.
-
-Clinically Managed Residential Withdrawal Management (Level 3.2-WM) as
-described in Chapter 5 of these rules; and
-
-f.
-
-Medically Monitored Inpatient Withdrawal Management (Level 3.7-WM) as
-described in Chapter 5 of these rules.
-
-5.
-
-The BHE shall ensure all of its operations, locations, and services, including contracted
-services or personnel, comply with laws, regulations, and standards as applicable and
-required by Chapter 2 of these rules, in addition to Chapters specific to any
-endorsements held by the BHE.
-
-6.
-
-The BHE shall meet the requirements in Chapter 2 of these rules, regardless of
-endorsements included as part of its BHE license.
-
-7.
-
-The BHE shall meet endorsement-specific requirements, as applicable to the
-endorsements included as part of the BHE’s license.
-
-8.
-
-The BHE shall have at least one endorsement and shall provide at least one type of
-service for each endorsement held. Endorsement standards are detailed in Chapters 3
-through 10 of these rules.
-
-25
-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-2 CCR 502-1
-
-B.
-
-A BHE may only provide services for which it holds an endorsement, and at locations authorized
-by its license.
-
-C.
-
-A BHE will be issued a single entity-wide license which identifies all physical locations included in
-the license and endorsements for services the BHE is licensed to provide by location. The BHE
-shall display the license, or a copy thereof, in a manner readily visible to individuals at each
-physical location included in the license.
-
-D.
-
-Each physical location of the BHE must meet the standards adopted by the director of the
-Division of Fire Prevention and Control (DFPC), as applicable to the services provided in that
-location.
-
-E.
-
-BHEs are prohibited from engaging in the following actions:
-1.
-
-Making a false statement of material fact about individuals served by the BHE, its
-personnel, capacity, or other operational components verbally to a BHA representative or
-agent or in any public document or in relation to a matter under investigation by the BHA
-or another governmental entity;
-
-2.
-
-Preventing, interfering with, or attempting to impede in any way the work of a
-representative or agent of the BHA in investigating or enforcing the applicable statutes or
-regulations;
-
-3.
-
-Falsely advertising or in any way misrepresenting the BHE’s ability to provide services for
-the individuals served based on its license type or status;
-
-4.
-
-Failing to provide reports and documents required by regulation or statute in a timely and
-complete fashion;
-
-5.
-
-Failing to comply with or complete a plan of action in the time or manner specified;
-
-6
-
-Falsifying records or documents;
-
-7.
-
-Knowingly using or disseminating misleading, deceptive, or false information;
-
-8.
-
-Accepting commissions, rebates, or other forms of remuneration for referrals or other
-treatment decisions; or
-
-9.
-
-Exercising undue influence or coercion over an individual to obtain certain decisions or
-actions or for financial or personal gain. A relationship other than a professional
-relationship, including but not limited to a relationship of a sexual nature, between an
-owner, director, manager, administrator, or other personnel and an individual, shall be
-considered exercise of undue influence or coercion.
-
-2.4
-
-Governance
-
-A.
-
-The BHE shall have a governing body consisting of members who singularly or collectively have
-professional or lived experience sufficient to oversee the types of endorsements, services, and
-number of physical locations included in the BHE’s license.
-
-B
-
-The governing body shall meet at regularly stated intervals at least four (4) times per calendar
-year and maintain records of the meetings.
-
-26
-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-C.
-
-D.
-
-2 CCR 502-1
-
-The governing body shall be responsible for high-level strategy, oversight, and accountability. If
-the BHE has a board of directors as its governing body, the board of directors may delegate
-operations and management responsibilities to an executive hired by the board who shall at the
-executive’s discretion delegate specific operations and management responsibilities including
-those in this part 2.4.C to an executive leadership team. These responsibilities include:
-1.
-
-Ensuring the planning and organization of day-to-day operations.
-
-2.
-
-Defining, in writing, the scope of services provided by the BHE, including services
-provided through arrangements with, or referrals to, other health care service providers.
-
-3.
-
-Ensuring the provision of facilities, personnel, and services in compliance with applicable
-endorsement-specific standards found in Chapters 3 through 10 of these rules.
-
-4.
-
-Establishing organizational structures that clearly delineate personnel positions, lines of
-authority, and supervision.
-
-5.
-
-Ensuring all services and locations operate in compliance with applicable federal, state,
-and local laws and regulations, including but not limited to the rehabilitation act of 1973,
-29 U.S.C. § 794, and the Americans with Disabilities Act, 42 U.S.C. § 12101, et seq.
-
-6.
-
-Ensuring professionally ethical conduct on the part of all personnel providing services,
-whether paid, contracted, or volunteer, and ensuring a system is in place to implement
-corrective measures when needed and monitor such system.
-
-7.
-
-Developing and implementing a quality management program in compliance with the
-requirements of part 2.17 of this Chapter, taking into account each endorsement's
-services and any significant differences in individual populations served.
-
-8.
-
-Ensuring emergency preparedness for the BHE, in accordance with part 2.4.F of this
-Chapter.
-
-9.
-
-Establishing and maintaining a system of financial management and accountability for the
-BHE.
-
-10.
-
-Developing, implementing, and reviewing policies at a minimum once every three years
-or as needed in accordance with part 2.4.D of this Chapter.
-
-11.
-
-Maintaining relationships and agreements with treatment facilities, organizations, and
-services to provide individual transfers, referrals, and transitions of care.
-
-12.
-
-Ensuring all marketing, advertising, or promotional information published or otherwise
-distributed by the BHE is accurate, including, the services the BHE provides.
-
-13.
-
-Considering and documenting the use of individual input in decision-making processes in
-accordance with part 2.4.D.3.i of this Chapter.
-
-The governing body or executive leadership team if so, delegated as described in part 2.4.C shall
-be responsible for ensuring the development and implementation of these policies and
-procedures and must review any changes to policies and procedures for the BHE. The governing
-body or executive leadership must ensure compliance with the policy requirements in this subpart
-and as found elsewhere in this Chapter. Every three (3) years, the governing body or executive
-leadership shall review all policies and procedures.
-
-27
-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-1.
-
-2.
-
-2 CCR 502-1
-
-The BHE must have policies regarding administrative and/or clinical oversight of the
-BHE’s endorsements, services, and/or physical locations that meet oversight
-requirements. Requirements included in part 2.5.A of this Chapter, and shall include, but
-not be limited to:
-a.
-
-Oversight positions within the BHE, such as an administrator or clinical director,
-and whether each position is for the endorsement, specific services, specific
-locations, or a combination thereof.
-
-b.
-
-The authority and responsibilities for each oversight position.
-
-c.
-
-The model or framework for clinical supervision. Such model or framework may
-differ by endorsement, service, or setting.
-
-d.
-
-The procedure for accessing oversight personnel or their delegate when the
-oversight personnel are not on-site, including, but not limited to, methods of
-contact, on-call or other procedures, and required response times.
-
-At a minimum, the BHE shall have policies and procedures that address the following
-items:
-a.
-
-Critical incident and occurrence reporting in accordance with part 2.16 of this
-Chapter.
-
-b.
-
-Individual rights in accordance with part 2.7 of this Chapter.
-
-c.
-
-Individual grievances, including dispute resolution procedures, in accordance
-with part 2.8 of this Chapter.
-
-d.
-
-Infection prevention and control in accordance with part 2.4.E of this Chapter.
-
-e.
-
-Personnel, including a code of ethics for all personnel. This also includes those
-policies and procedures required by part 2.5 of this Chapter, and as required by
-the endorsements of the BHE license. This code of ethics must be made
-available to individuals upon request.
-
-f.
-
-As applicable, screening, admission, assessment/discharge, service plan, and
-care policies as required by parts 2.10, 2.12, and 2.13 of this Chapter.
-
-g.
-
-As applicable, medication administration in accordance with part 2.15 of this
-Chapter.
-
-h.
-
-Defining and preventing conflicts of interest and dual relationships, and where
-such conflicts exist, developing and implementing controls to minimize such
-conflict and ensure decisions are made for the best interest of the individual.
-
-i.
-
-The use of individual input and feedback in governing body decisions, including,
-but not limited to:
-(1)
-
-The formal or informal processes, appropriate for the individuals served
-and the size and complexity of services offered, to be used for collection
-of individual input and feedback.
-
-(2)
-
-How the governing body will document individual input and how that
-feedback has been considered.
-
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-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-E.
-
-F.
-
-2 CCR 502-1
-
-j.
-
-Individual records, including but not limited to confidentiality, access, and
-disposal/destruction of records as required by part 2.11 of this Chapter.
-
-k.
-
-Building safety and security
-(1)
-
-Such policies may be for the agency, an endorsement, or physical
-location.
-
-(2)
-
-Policies must address the needs of the individual population being
-served and/or the services being provided.
-
-(3)
-
-policies may include, but are not limited to, electronic surveillance,
-delayed egress, and/or locked settings as appropriate.
-
-The BHE shall have infection prevention and control policies and procedures that reflect the
-scope and complexity of the services provided across the BHE, including but not limited to:
-1.
-
-Maintenance of a sanitary environment.
-
-2.
-
-Mitigation of risks associated with infections and the prevention of the spread of
-communicable disease, including, but not limited to, hand hygiene, bloodborne and
-airborne pathogens, and respiratory hygiene and cough etiquette for individuals and BHE
-personnel.
-
-3.
-
-Coordination with other federal, state, and local agencies, including but not limited to a
-process for when and how to seek assistance from a medical professional and/or the
-local health department.
-
-4.
-
-For BHEs that administer medications or injections on-site, as well as all agencies
-providing overnight or residential services, a requirement that at least one person trained
-in infection control be employed by or regularly available to the BHE.
-
-The BHE shall be responsible for emergency preparedness policies and procedures, including
-the following:
-1.
-
-Completing a risk assessment of potential hazards and preparedness measures to
-address natural and human-caused crises including, but not limited to, fire, gas
-leaks/explosions, power outages, tornados, flooding, threatened or actual acts of
-violence, and bioterror, pandemic, or disease outbreak events. The governing body shall
-review such risk assessments annually and whenever BHE operations are modified
-through the addition or discontinuation of a physical location, service, or endorsement.
-
-2.
-
-Developing and implementing a written emergency management plan addressing the
-hazards identified in part 2.4.F.1, above, and meeting, at a minimum, the following
-requirements:
-a.
-
-The plan must differentiate between endorsements, physical locations, and
-individual populations served and meet the requirements applicable to any
-endorsements held by the BHE.
-
-b.
-
-The plan must be updated based on changes in the risk assessment conducted
-in accordance with part 2.4.F.1 of these rules, above.
-
-29
-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-3.
-
-2 CCR 502-1
-
-c.
-
-The plan must address interruptions in the normal supply of essentials, including,
-but not limited to water, food, pharmaceuticals, and personal protective
-equipment (PPE), if these are regularly provided or used by BHE personnel or
-individuals.
-
-d.
-
-The plan must ensure continuation of necessary care to all individuals
-immediately following any emergency.
-
-e.
-
-The plan must address the protection and transfer of individual information, as
-needed.
-
-f.
-
-The plan must address the methods and frequency of holding routine drills to
-ensure BHE personnel’s familiarity with emergency procedures, in compliance
-with requirements established by the Department of Public Safety, Division of
-Fire Prevention and Control in 8 CCR 1507-31 (December 15, 2021), which is
-hereby incorporated by reference. No later editions or amendments are
-incorporated. These regulations are available at no cost at
-https://www.coloradosos.gov/CCR/DisplayRule.do?action=ruleinfo&ruleId=3177&
-deptID=17&agencyID=43&deptName=Department%20of%20Public%20Safety&a
-gencyName=Division%20of%20Fire%20Prevention%20and%20Control&seriesN
-um=8%20CCR%20150. These regulations are also available for public
-inspection and copying at the BHA, 710 S. Ash Street, Unit C140, Denver, CO
-80246, during regular business hours.
-
-If the BHE has an automated external defibrillator (AED), personnel must be trained in its
-use, and it must be maintained in accordance with the manufacturer’s specifications.
-
-2.5
-
-Personnel and Contracted Services
-
-A.
-
-The BHE shall ensure administrative and/or clinical oversight of endorsement(s), service(s), and
-physical location(s), in accordance with policies and procedures adopted by the governing body
-under part 2.4.D of these rules, including, as required by those policies:
-1.
-
-An administrator responsible for implementing endorsement and service policies and
-procedures adopted by the governing body, as well as the day-to-day operation of the
-endorsement, services, or location, including, but not limited to:
-a.
-
-Management of business and financial operations.
-
-b.
-
-Ensuring standards in part 2 of this Chapter are met in the endorsement,
-services, and location, including, but not limited to the standards in part 2.15 of
-these rules, medication administration.
-
-c.
-
-Ensuring buildings are properly maintained and building safety/security needs
-are met.
-
-d.
-
-Implementing infection control and emergency preparedness policies and
-procedures, in accordance with governing body policies.
-
-e.
-
-Establishing and maintaining relationships with agencies, services, and
-behavioral health resources within the community.
-
-f.
-
-Identifying personnel to whom administrator responsibilities are delegated during
-periods when the administrator is neither on-site nor available through interactive
-means within thirty (30) minutes.
-
-30
-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-g.
-
-2.
-
-2 CCR 502-1
-
-A BHE may have a single administrator, or multiple administrators for the
-combination of endorsements, services, and locations included in the BHE
-license.
-
-For BHEs providing clinical services, a clinical director, responsible for the overall clinical
-services provided to individuals, including, but not limited to:
-a.
-
-Ensuring training and continuing education for all BHE personnel, relevant to the
-services provided by the personnel.
-
-b.
-
-Ensuring supervision and clinical oversight of BHE personnel in accordance with
-part 2.5.1 of these rules.
-
-c.
-
-Including a method to provide clinical supervision and oversight during periods
-when the clinical director is unable to fulfill their duties within thirty (30) minutes.
-
-d.
-
-Ensuring services provided are appropriate as indicated in screenings and
-assessments.
-
-3.
-
-A BHE may have a single clinical director, or multiple clinical directors, as appropriate for
-the combination of endorsements, services, and locations included in the BHE license.
-
-4.
-
-The minimum qualifications for the administrator and clinical director are set by the BHE’s
-policies and procedures.
-
-5.
-
-An administrator or clinical director may be specific to a physical location or may be
-shared among locations, as appropriate for the services, size, and geographic dispersion
-of the services.
-
-6.
-
-A single person may serve as both the administrator and the clinical director, if that
-person meets qualifications for both, and it is consistent with policies adopted by the
-governing body.
-
-B.
-
-The BHE shall maintain a sufficient number of qualified personnel for each endorsement and at
-each physical location to provide the endorsed services, meet the clinical needs of the
-individuals, and comply with state and federal requirements. The BHE shall ensure personnel are
-only assigned duties they are competent to perform adequately and safely.
-
-C.
-
-All personnel assigned to direct individual care must be qualified through either professional
-credentials, education, training, and/or experience in the principles, policies, procedures, and
-appropriate techniques for providing individual services.
-1.
-
-Personnel providing individual services must be legally authorized to provide the service
-in accordance with applicable federal, state, and local laws.
-
-2.
-
-Licensed, certified, and/or registered personnel must have an active license, certification,
-or registration in the state of Colorado and may only provide services within their scope of
-practice.
-
-3.
-
-The BHE shall verify the license, certification, or registration, and check for any
-disciplinary action against personnel providing individual services, through the Colorado
-department of regulatory agencies or other state or federal agency not more than thirty
-(30) days before official hire date prior to hire.
-
-31
-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-4.
-D.
-
-E.
-
-2 CCR 502-1
-
-The BHE shall create policies and procedures regarding supervision of all personnel
-pursuant to part 2.5.1 of this Chapter.
-
-The BHE shall obtain, prior to hire or contract of new personnel or acceptance of persons for
-volunteer service if that volunteer service involves unsupervised direct contact with individuals
-receiving services, a name-based criminal history record check for each prospective personnel or
-volunteer.
-1.
-
-If the prospective personnel has lived in Colorado for more than three (3) years at the
-time of application, the BHE shall obtain a name-based criminal history report conducted
-by the Colorado Bureau of Investigation (CBI).
-
-2.
-
-If the prospective personnel has lived in Colorado for three (3) years or less at the time of
-application, the BHE shall obtain a name-based criminal history report for each state in
-which the prospective personnel has lived during the past three (3) years, conducted by
-the respective states’ bureaus of investigation or equivalent state-level law enforcement
-agency, or a national criminal history report conducted by the federal bureau of
-investigation.
-
-3.
-
-The BHE shall bear the cost of obtaining such information.
-
-4.
-
-If a BHE contracts with a staffing agency for the provision of services, it shall require that
-the staffing agency meet the requirements of this part 2.5.D.
-
-5.
-
-When determining whether a prospective personnel is eligible for hire or contract, if the
-criminal history record check reveals the person has a conviction or plea of guilty, active
-deferred judgment, or nolo contendere, the BHE shall follow its policy developed in
-accordance with part 2.5.E.3.a of this Chapter.
-
-The BHE shall have written personnel policies developed in accordance with part 2.5.C of this
-Chapter, including, but not limited to:
-1.
-
-Line of authority/management hierarchy of personnel.
-
-2.
-
-Job descriptions/responsibilities.
-
-3.
-
-Written criteria and procedures for evaluating which convictions or complaints make
-prospective personnel unacceptable for hire, or for existing personnel unacceptable for
-retention, including:
-a.
-
-Factors to be considered when determining whether prospective personnel are
-eligible for hire when their criminal history record check reveals a conviction or
-plea of guilty, active deferred judgment, or nolo contendere, including, but not
-limited to:
-(1)
-
-The nature and seriousness of the offense;
-
-(2)
-
-The nature of the position and how the offense relates to or may impact
-the duties of the position. Experience in the criminal justice system is not
-necessarily a disqualifier and, in certain circumstances, a BHE may
-determine that some lived experiences would benefit a particular
-position;
-
-(3)
-
-The length of time since the conviction or plea;
-
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-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-4.
-
-2 CCR 502-1
-
-(4)
-
-Whether such conviction is isolated or part of a pattern; and
-
-(5)
-
-Whether there are mitigating or aggravating circumstances involved.
-
-Conditions of employment, including but not limited to:
-a.
-
-That personnel refrain from sexual or romantic relationships between supervisors
-and supervisees and sexual or romantic relationships with individuals served.
-
-5.
-
-Position qualifications and required credentials.
-
-6.
-
-Orientation, training, and continuing education requirements, for the populations served
-and services provided.
-
-7.
-
-Routine monitoring of personnel credentials and disciplinary actions.
-
-8.
-
-Requirements for self-reporting of new or current investigations, criminal charges,
-indictments, or convictions that may affect the personnel’s ability to carry out their duties
-or functions of the job.
-
-9.
-
-Policies requiring all personnel to be free of communicable disease that can be readily
-transmitted in the BHE.
-a.
-
-All personnel that have direct contact with individuals must be required to have a
-tuberculin skin test prior to direct contact with individuals. In the event of a
-positive reaction to the skin test, evidence of a chest x-ray and other appropriate
-follow-up may be required in accordance with community standards of practice.
-
-F.
-
-The BHE shall ensure that all personnel have access to and know about the BHE’s policies,
-procedures, and state and federal laws and regulations relevant to their respective duties.
-
-G.
-
-The BHE must maintain records on all personnel, including, but not limited to:
-
-H.
-
-1.
-
-Date of hire;
-
-2.
-
-Job description;
-
-3.
-
-Results of criminal history record checks;
-
-4.
-
-Documentation of professional credentials, education, and training;
-
-5.
-
-Documentation of any disciplinary action taken against the person by a credentialing
-body;
-
-6.
-
-Documentation of orientation and training;
-
-7.
-
-Evidence of review of the BHE’s policies, procedures, and state and federal laws and
-regulations relevant to their respective duties; and
-
-8.
-
-Documentation of tuberculosis testing and results, for personnel who have direct contact
-with individuals.
-
-The BHE must ensure that all personnel complete an initial orientation on basic infection
-prevention and control, safety, and emergency preparedness procedures.
-
-33
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-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-I.
-
-2 CCR 502-1
-
-The BHE must ensure that all personnel receive the following training prior to working
-independently with individuals, and on a periodic basis consistent with policies developed in
-accordance with part 2.5.E of this Chapter, above
-1.
-
-Training specific to the particular needs of the populations served, including the provision
-of person-centered, trauma-informed, harm reduction-focused, physically and
-programmatically accessible, and culturally and linguistically responsive services;
-
-2.
-
-Infection control;
-
-3.
-
-Emergency preparedness, including de-escalation of potentially dangerous situations,
-including but not limited to threats of violence, acts of violence, and abuse/mistreatment
-of an individual;
-
-4.
-
-Critical incident reporting;
-
-5.
-
-Suicide prevention;
-
-6.
-
-Individual rights of the population served;
-
-7.
-
-Confidentiality, including individual privacy and records privacy and security;
-
-8.
-
-BHE policies and procedures;
-
-9.
-
-Mandatory reporting requirements for suspected abuse or neglect in accordance with part
-2.8.A.9.a of this Chapter; and
-
-10.
-
-Understanding of basic pharmacology and medications that are relevant to the treatment
-type and population served by the agency, including but not limited to medicationassisted treatment (MAT) services and medications for opioid use disorders (MOUD).
-a.
-
-This training requirement may not be used as reason to hold unqualified
-personnel out as experts in pharmacology. BHEs must not encourage personnel
-to hold themselves out as able to make recommendations that are outside of
-their scope of practice to individuals receiving services. Rather, this training
-requirement is meant to ensure that personnel receive a base knowledge for the
-behavioral health community they service and allow for meaningful, timely, and
-supportive recovery-focused interactions with individuals receiving services.
-
-2.5.1
-
-Clinical Supervision
-
-A.
-
-The BHE must ensure that all personnel providing behavioral health services, with the exception
-of peer support professionals, receive clinical supervision, as defined in part 1.3 of these rules.
-
-B.
-
-The BHE will develop policies and procedures for supervision that address the following:
-1.
-
-Supervisee’s mandatory disclosure statement that clearly states they are under
-supervision and by whom;
-
-2.
-
-Requirements for regular evaluation of the supervisee’s progress with a rubric that is tied
-to the responsibilities assigned;
-
-3.
-
-Documentation and frequency of supervisor reviews and feedback provided;
-
-4.
-
-Maximum number of supervisees a supervisor oversees; and
-
-34
-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-5.
-C.
-
-D.
-
-2 CCR 502-1
-
-How supervision/consultation is covered by personnel with comparable credentials when
-the usual supervisor is not available.
-
-Clinical supervisors must at minimum:
-1.
-
-Meet the standard qualifications for clinical supervision as defined by the supervisor’s
-professional practice board.
-
-2.
-
-Deliver clinical supervision within the supervisor’s professional practice license and
-ethical standards for:
-a.
-
-Those that are licensed or seeking professional licensure; or
-
-b.
-
-When supervising personnel that are not seeking or not eligible for professional
-licensure, such as group living workers, the supervisor must follow standards in
-the Colorado Mental Health Practice Act, as defined in Article 245 of Title 12,
-C.R.S.
-
-3.
-
-Dedicate time between the supervisor and supervisee to instruct, model, and encourage
-self-reflection regarding acquisition of clinical and administrative skills by the supervisees.
-Clinical supervisor will determine skills through observation, evaluation, feedback, and
-mutual problem-solving.
-
-4.
-
-Address ethics and ethical dilemmas as aligned with the appropriate professional practice
-board.
-
-5.
-
-Provide professional direction based on experience, expertise, and/or for ethical or safety
-concerns.
-
-6.
-
-Ensure that safety and crisis management plans are followed and that clinical supervisors
-are available to personnel for assistance in crisis situations and processing of the crisis
-event afterwards.
-
-7.
-
-Document the date, duration, and the content of supervision session for their
-supervisee(s), which may include a professional development plan. All documents
-pertaining to clinical supervision must be provided to the supervisee and the BHA upon
-request.
-
-Personnel-specific clinical supervision requirements
-1.
-
-Licensees will be provided with clinical supervision and/or consultation at minimum upon
-request by the licensee or during times of individual emergency.
-
-2.
-
-Candidates will be provided with clinical supervision at a rate that will meet their licensing
-requirements for the license they are pursuing or at a minimum of one (1) hour every two
-weeks, whichever provides a higher level of clinical supervision.
-
-3.
-
-All clinical documentation completed by a counselor-in-training and/or intern still in pursuit
-of their clinical degree must be reviewed and co-signed by a clinical supervisor able to
-supervise pursuant to their scope of practice.
-
-4.
-
-Personnel not seeking or not eligible for licensure, but that are providing clinical services,
-will be provided clinical supervision at a frequency that ensures treatment to individuals is
-appropriate, safe, and in line with assessment treatment needs and the individual’s
-treatment goals.
-
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-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-2 CCR 502-1
-
-2.6
-
-General Building and Fire Safety Provisions
-
-A.
-
-Each BHE shall be in compliance with all applicable local zoning, housing, fire, and sanitary
-codes and ordinances of the city, city and county, or county where it is situated.
-
-B.
-
-All physical locations of a BHE must be constructed in conformity with the standards adopted by
-the director of the DFPC at the Colorado Department of Public Safety, as applicable.
-
-C.
-
-A BHE that is subject to fire prevention and life safety code requirements, may not provide
-services in areas subject to plan review, except as approved by DFPC.
-
-D.
-
-The BHE shall provide an interior environment that is clean and sanitary, maintained and in good
-repair, and free of hazards to health and safety.
-
-E.
-
-The BHE shall ensure the prominent posting of evacuation routes and exits in each physical
-location.
-
-F.
-
-The BHE shall prominently post the hours of operation at the entrance of each physical location,
-and on the BHE’s website.
-
-2.7
-
-Individual Rights
-
-A.
-
-The BHE shall develop and implement a policy regarding individual rights. The policy must
-ensure that each individual or, when applicable, the individual’s designated representative, has
-the right to:
-1.
-
-Participate in all decisions involving the individual’s care or treatment.
-
-2.
-
-Be informed about whether the BHE is participating in teaching programs, and to provide
-informed consent prior to being included in any clinical trials relating to the individual’s
-care.
-
-3.
-
-Refuse any drug, test, procedure, service, or treatment and to be informed of risks and
-benefits of this action.
-
-4.
-
-Receive care and treatment, in compliance with state statute, that is free from
-discrimination on the basis of physical or mental disability, race, ethnicity, socio-economic
-status, religion, gender expression, gender identity, sex, sexuality, culture, and/or
-languages spoken; and that recognizes an individual's dignity, cultural values and
-religious beliefs; as well as provides for personal privacy to the extent possible during the
-course of treatment.
-
-5.
-
-Be informed of, at a minimum, the first names and credentials of the personnel that are
-providing services to the individual. Full names and qualifications of the service providers
-must be provided upon request to the individual or the individual’s designated
-representative or when required by the department of regulatory agencies.
-
-6.
-
-Receive, upon request:
-a.
-
-Prior to initiation of non-emergent care or treatment, the estimated average
-charge to the individual. This information must be presented to the individual in a
-manner that is consistent with all state and federal laws and regulations.
-
-b.
-
-The BHE’s general billing procedures.
-
-36
-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-c.
-
-7.
-
-2 CCR 502-1
-
-An itemized bill that identifies treatment and services by date. The itemized bill
-must enable individuals or their legal representatives to validate the charges for
-items and services provided and must include contact information, including a
-telephone number, for billing inquiries. The itemized bill must be made available
-either within ten (10) business days of the request, thirty (30) days after
-discharge, or thirty (30) days after the service is rendered – whichever is later.
-
-Give informed consent for all treatment and services. The personnel must obtain
-informed consent for treatment they provide to the individual. Informed consent includes:
-a.
-
-A written agreement executed between the BHE and the individual or the
-individual’s legal representative at the time of admission. The parties may amend
-the agreement if there is written consent of both parties. No agreement will be
-construed to relieve the BHE of any requirement or obligation imposed by law or
-regulation.
-
-b.
-
-Individual consents must include consent to treatment. If the individual is refusing
-treatment or an aspect of treatment, the BHE must have the individual sign a
-form to confirm their refusal.
-
-c.
-
-If the governor or local government declares an emergency or disaster, a BHE
-may obtain documented oral agreements or consents in place of written
-agreements or consents. Documented oral agreements and consents may only
-be used as necessary because of circumstances related to the emergency or
-disaster. The BHE shall send a hard copy or electronic copy of the documented
-agreement or consent to the individual within two (2) business days of the oral
-agreement or consent.
-
-8.
-
-Register disputes with the BHE and grievances with the BHA and to be informed of the
-procedures for registering complaints and grievances including contact information.
-
-9.
-
-Be free of abuse and neglect.
-a.
-
-The BHE must develop and implement policies and procedures that prevent,
-detect, investigate, and respond to incidents of abuse or neglect. This includes
-suspected physical, sexual, or psychological abuse; exploitation and/or caretaker
-neglect; as well as child abuse, neglect and/or child safety issues, which must
-include definitions of abuse and neglect under the Colorado Children’s Code
-(Section 19-1-103, C.R.S.), and that are consistent with the reporting of child
-abuse allowed under federal law. Policies and procedures must also be
-consistent with definitions and mandated reporting requirements for
-mistreatment, abuse, neglect, and exploitation of at-risk adults under the
-Colorado Human Services and Criminal Codes (Sections 26-3.1-101, 26-3.1-102,
-18-6.5-108, C.R.S.).
-(1)
-
-Prevention includes, but is not limited to, adequate staffing to meet the
-needs of the individuals, screening personnel for records of abuse and
-neglect, and protecting individuals from abuse during investigation of
-allegations.
-
-(2)
-
-Detection includes, but is not limited to, establishing a reporting system
-and training personnel regarding identifying, reporting, and intervening in
-incidences of abuse and neglect.
-
-37
-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-b.
-
-2 CCR 502-1
-
-The BHE shall investigate all allegations of abuse or neglect against BHE
-personnel, or made against an individual, when the allegation occurs during
-service provision or on BHE premises. The BHE shall implement corrective
-actions in accordance with such investigations.
-
-10.
-
-Be free from the improper application of restraints or seclusion. Restraints or seclusion
-may only be used in a manner consistent with part 2.14 of this Chapter.
-
-11.
-
-Expect that the BHE in which the individual is admitted can meet the identified and
-reasonably anticipated care, treatment, and service needs of the individual.
-
-12.
-
-Receive care from the BHE in accordance with the individual’s needs.
-
-13.
-
-Have the confidentiality of their individual records maintained.
-a.
-
-A BHE must comply with all applicable state and federal laws and regulations for
-release of information including but not limited to 42 C.F.R. Part 2, Section 2765-123, C.R.S. and HIPAA.
-
-b.
-
-When obtaining informed consent or an authorization for release of information,
-the signed release must state, at a minimum:
-(1)
-
-Persons who may receive the information in the records;
-
-(2)
-
-The purpose for obtaining this information;
-
-(3)
-
-The information to be released;
-
-(4)
-
-That the release may be revoked by the individual, or legal
-representative at any time; and
-
-(5)
-
-That the release of information is only valid for a time period specified
-but such time cannot exceed two (2) years from the date of signature.
-
-14.
-
-Receive care in a safe setting.
-
-15.
-
-Be notified if referrals to other providers are to entities in which the BHE has a direct or
-indirect financial benefit, including a benefit that has financial value, but is not a direct
-monetary payment.
-
-16.
-
-Formulate medical and psychiatric advance directives and have the BHE comply with
-such directives, as applicable, and in compliance with applicable state statute.
-a.
-
-When the BHE is aware that an individual has developed advance directives, the
-BHE shall make good faith efforts to obtain the directives and the directives must
-become part of the individual’s record.
-
-b.
-
-The BHE shall disclose the policy regarding individual rights to the individual or
-the individual’s designated representative prior to treatment or upon admission,
-where possible. For any services requiring multiple individual encounters,
-disclosure provided at the beginning of such care or treatment course must meet
-the intent of the regulations.
-
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-
-2 CCR 502-1
-
-2.8
-
-Dispute and Grievance Resolution
-
-A.
-
-Each BHE shall post a clear and unambiguous notice of dispute and grievance procedures in
-each physical location in an area that is open to the public and on the BHE’s website. The notice
-must also be provided in writing and/or electronically upon admission to services.
-
-B.
-
-1.
-
-The BHE shall establish a uniform procedure for prompt management of disputes brought
-by individuals accessing, receiving, or being evaluated for services and their family
-members. The BHE shall develop policies and procedures for handling disputes.
-
-2.
-
-The BHE shall provide a fair dispute resolution process that allows options for submitting
-both verbal and/or written disputes. The process must provide the individual with a
-response no later than thirty (30) business days from submission of the dispute. If the
-dispute is received verbally, the representative shall create a written documentation of
-the dispute.
-
-As part of the BHE’s resolution process, the BHE must inform persons who have submitted a
-dispute verbally or in writing that they may also submit a grievance to the BHA. The BHE must
-provide information about how to submit a grievance to the BHA.
-1.
-
-The BHE shall designate a representative, who must be available to assist individuals in
-resolving disputes.
-
-2.
-
-The BHE shall educate individuals and their representatives about the mechanisms in
-place for filing disputes. This education must include an explanation of the individual's
-rights; the dispute process and procedures; and the name, contact information, and
-responsibilities of the designated representative within the BHE. Appropriate contacts for
-external appeal must also be provided, which may include, but are not limited to, the
-following: the Colorado Department of Regulatory Agencies; the Colorado Department of
-Public Health and Environment; the Colorado Department of Health care policy and
-financing; or the governor’s designated protection and advocacy system for individuals
-with mental illness. Documentation in the records must include the dated signature of the
-individual receiving the information.
-
-3.
-
-The BHE must post a notice of rights, dispute procedure, and the designated
-representative’s name, office location, responsibilities, and telephone number in
-prominent locations where persons access, receive or are evaluated for services. The
-notice shall be translated into languages commonly used by the populations in the
-service area.
-
-4.
-
-The BHE must maintain a record of submitted disputes, separate from the individual
-records that include the date, the type of dispute, and the outcome of investigation.
-These dispute records must be provided annually to the BHA.
-
-5.
-
-Upon request, the BHE must provide an individual and any interested person with contact
-information for registering complaints with any other state departments.
-
-2.9
-
-Individual Services
-
-A.
-
-The BHE must ensure individuals are provided services in the least restrictive setting that meets
-the individual's needs.
-
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-
-B.
-
-The BHE may use telehealth methods for the provision of services under these regulations
-except for services that specifically require in-person contact. If a service is allowable via
-telehealth according to state and federal regulations, appropriate methods will be noted within the
-applicable endorsement Chapter. If an individual prefers to receive services in-person and the
-BHE does not offer the appropriate service in-person, the BHE shall refer the individual to another
-entity that offers the service in-person.
-1.
-
-C.
-
-2 CCR 502-1
-
-If the BHE uses telehealth methods, it must develop and implement policies and
-procedures regarding telehealth services, including:
-a.
-
-Collection of required signatures;
-
-b.
-
-Training for personnel specific to the modality or manner for determining
-competence with the modality;
-
-c.
-
-Procedure for personnel response if an individual experiences an emergency
-while receiving services via telehealth, including collection of information about
-the individual’s remote location for each session;
-
-d.
-
-Confidentiality protocols designed to protect the individual’s privacy in
-accordance with state and federal law; and
-
-e.
-
-Specification as to whether policies apply to the BHE as a whole, a physical
-location, or a specific endorsement, as appropriate.
-
-2.
-
-Services provided via telehealth methods must be documented in the individual’s record,
-consistent with documentation requirements for in-person services.
-
-3.
-
-Services may be provided through synchronous audio-visual methods but must not
-include text-only methods such as text message or email. Some services may be
-provided through audio-only methods according to state and federal regulations. If audioonly methods are used, the following must be noted in the individual record:
-a.
-
-The reason that audio-visual methods were not utilized.
-
-b.
-
-The clinical determination of appropriateness for service delivery method.
-
-If the BHE uses public community settings for the provision of services, it shall develop and
-implement policies and procedures regarding the delivery of such services, including:
-1.
-
-Collection of required signatures when necessary;
-
-2.
-
-Selection and utilization of public spaces that are safe and accessible to the individuals
-being served;
-
-3.
-
-Procedures for how the BHE will ensure individual privacy and confidentiality in the public
-setting according to state and federal regulations;
-
-4.
-
-Procedure for personnel response if an individual experiences an emergency while
-receiving services in the public setting;
-
-5.
-
-Procedure to promote and monitor personnel safety while providing services in this
-setting; and
-
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-Behavioral Health
-
-6.
-D.
-
-Such policies may apply to the BHE as a whole, a physical location, or a specific
-endorsement, as applicable.
-
-The BHE shall develop and implement policies and procedures regarding behavioral health
-emergency services and methods for addressing individuals or individuals with unexpected high
-acuity and/or urgent behavioral health needs. Such policies and procedures may apply to the
-BHE as a whole, a specific endorsement, or a physical location, as appropriate, and must include,
-but not be limited to:
-1.
-
-The behavioral health emergency services provided by the BHE, if any, and the hours
-during which such behavioral health emergency services are available.
-
-2.
-
-How the BHE ensures access to behavioral health emergency services when not
-provided directly by the BHE, including, but not limited to:
-
-3.
-
-E.
-
-2 CCR 502-1
-
-a.
-
-Criteria used in determining when behavioral health emergency services are
-needed;
-
-b.
-
-Internal protocols for personnel and supervisors in response to behavioral health
-emergency;
-
-c.
-
-Protocols for facilitating transfers to other agencies; and
-
-d.
-
-Methods of providing information to individuals to ensure understanding of how to
-access behavioral health emergency services.
-
-The methods for identifying and responding to and/or mitigating sudden or unpredictable
-high-acuity or increased needs in existing individuals within twenty-four (24) hours of
-notification of increased need
-
-The BHE must develop and implement policies and procedures regarding access to emergency
-medical services. Such policies and procedures may be for the BHE as a whole, a specific
-endorsement, or a physical location, as appropriate, and must include, but are not limited to:
-1.
-
-The medical emergency services provided by the BHE, if any, and the hours during which
-such medical emergency services are available.
-
-2.
-
-How the BHE ensures access to medical emergency services when not provided directly
-by the BHE, including, but not limited to:
-
-3.
-
-a.
-
-Criteria used in determining when medical emergency services are needed;
-
-b.
-
-Internal protocols for personnel in response to a medical emergency; and
-
-c.
-
-Protocols for facilitating transfers of individuals to emergency medical providers
-or facilities.
-
-Methods of providing information to individuals to ensure the individual’s understanding of
-how to access medical emergency services.
-
-F.
-
-The BHE shall inform individuals how to access medical and behavioral health crisis or
-emergency services twenty-four (24) hours per day, seven (7) days per week.
-
-G.
-
-The BHE shall provide care coordination to individuals consistent with the following requirements:
-
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-Behavioral Health
-
-2 CCR 502-1
-
-1.
-
-Care coordination must be carried out in keeping with the individual's needs for care and,
-to the extent possible, in accordance with the individual's expressed preferences. Care
-coordination may involve the individual's family, parent, legal guardian, caregiver, and
-other supports identified by the individual.
-
-2.
-
-Care coordination services may include the following, as appropriate for the needs of the
-individual:
-a.
-
-Screenings to identify the individual’s priorities, goals, strengths, and the barriers
-faced, including those related to health-related social needs.
-
-b.
-
-Supporting the individual in accessing care and services within the health care
-and social service systems and equipping the individual with information to
-navigate and manage their care.
-(1)
-
-c.
-3.
-
-This shall include providing accessible and culturally and linguistically
-meaningful resources and information, including resource directories
-such as OWNPATH.
-
-Conducting application assistance, referrals, and warm hand-offs to access
-appropriate resources and care.
-
-Information sharing
-a.
-
-The BHE shall prioritize information sharing with other providers delivering
-services to the individual for the purpose of care coordination.
-
-b.
-
-Information sharing must occur as clinically indicated, and as approved by the
-individual, throughout an individual’s episode of care.
-
-c.
-
-Information sharing must include obtaining or demonstrated efforts to obtain
-records from previous or existing behavioral health, physical health, and other
-social needs service providers, during the assessment period, and on an ongoing
-basis.
-
-d.
-
-The BHE shall ensure individuals’ preferences for shared information are
-adequately documented in individual records, consistent with the principles of
-person and family-centered care.
-
-e.
-
-The BHE shall obtain authorization for release of information from individuals or
-their legal representative for all care coordination relationships. If the BHE is
-unable, after reasonable attempts, to obtain authorization for any care
-coordination activity as required by this Chapter, the attempts must be
-documented in the individual’s record and revisited periodically, such as during
-transitions of care or when the individual receives a new diagnoses or has a
-change in condition.
-(1)
-
-f.
-
-Information sharing that is permissible under HIPAA without
-authorization from the individual or legal representative is not subject to
-this requirement.
-
-The BHE must maintain the necessary documentation to satisfy the requirements
-of all applicable federal and state privacy laws, including individual privacy
-requirements specific to the care of children.
-
-42
-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-g.
-
-h.
-H.
-
-2 CCR 502-1
-
-A referral must include, in accordance with individual consent and as clinically
-necessary and applicable, information regarding:
-(1)
-
-Health status;
-
-(2)
-
-Active diagnoses;
-
-(3)
-
-Known allergies;
-
-(4)
-
-Test results;
-
-(5)
-
-Lab results;
-
-(6)
-
-Medications list;
-
-(7)
-
-Treatment course, time and detail of modalities used, and response to
-treatment or other recovery supports (status of changes);
-
-(8)
-
-Existing scheduled appointments to include physical health, behavioral
-health and other recovery and supportive services that may be part of
-the care plan;
-
-(9)
-
-Recent history or risks for urgent/acute care (e.g., recent emergency
-department visit, hospitalization, etc.); and
-
-(10)
-
-Reasonable accommodations.
-
-All information sharing must occur in compliance with applicable federal and
-state laws, including but not limited to HIPAA and 42 C.F.R. Part 2.
-
-Medication consistency
-1.
-
-The BHE shall ensure all clinical staff are aware of and have access to the medication
-formulary.
-
-2.
-
-The BHE shall ensure personnel have access to the medications on the medication
-formulary when prescribing medications to treat behavioral health disorders for an
-individual who is or was involved with the criminal or juvenile justice system.
-
-2.10
-
-Admission and Discharge Criteria
-
-A.
-
-For applicable services, the BHE shall develop and implement admission and discharge policies.
-Such policies may be for the BHE as a whole, a particular endorsement, and/or a specific
-physical location, as appropriate, and must include, at a minimum:
-1.
-
-Criteria to ensure the BHE, endorsement, and/or location only treats individuals for whom
-it can provide immediate assessment and treatment based on the individual’s needs.
-
-2.
-
-Admission criteria to ensure treatment in the least restrictive setting based on the
-individual’s level of care needs. The following must not be the sole reason for treatment
-ineligibility:
-a.
-
-Relapse;
-
-43
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-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-2 CCR 502-1
-
-b.
-
-Leaving previous treatment against advice or lack of engagement in previous
-treatment;
-
-c.
-
-Pregnancy;
-
-d.
-
-Drug use;
-
-e.
-
-Involuntary commitment;
-
-f.
-
-Current utilization of any medication-assisted treatment (MAT) or interest in
-beginning MAT services;
-
-g.
-
-Previous or pending disputes, grievances, or appeals; or
-
-h.
-
-Place of residence.
-
-3.
-
-Procedures for transferring an individual from a level of care to a different level of care
-within the BHE.
-
-4.
-
-Procedures for referring an individual to other service providers when the individual
-cannot be admitted to the BHE.
-
-5.
-
-Criteria and procedures for an individual's discharge from treatment, including, but not
-limited to:
-a.
-
-When an individual is being transferred from the BHE to another provider.
-
-b.
-
-Timely discharge of an individual receiving voluntary services upon the
-individual’s request, once appropriate screening and assessment is complete.
-
-c.
-
-Discharge and transfer procedures for an individual receiving services on an
-involuntary basis, if applicable.
-
-d.
-
-Subparts 2.10.A.5.a, 2.10.A.5.b and 2.10.A.5.c of this Chapter must comply with
-the following requirements:
-(1)
-
-At the time of discharge, the BHE must, unless the individual refuses,
-provide support to facilitate a smooth transition to alternate services to
-address any existing service needs.
-
-(2)
-
-If an individual declines support in connecting with additional services at
-the time of discharge, the reason given by the individual shall be
-documented within the record.
-
-(3)
-
-When the individual agrees to BHE support in transitioning providers, the
-BHE must obtain a release of information to communicate with and share
-records with the new provider. The BHE shall ensure that the discharge
-summary meets the requirements set forth in part 2.10.A.6 of this
-Chapter and is provided to the receiving provider no later than fifteen
-(15) days from the date of discharge. The BHE shall make every effort to
-complete and send the discharge summary prior to the individual’s initial
-appointment with the receiving provider.
-
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-Behavioral Health
-
-(4)
-
-e.
-
-When the BHE facilitates the transition of care to a new behavioral health
-provider or alternative resource at the time of discharge, the BHE shall
-inform the individual of the date, time, and location of the scheduled visit
-and/or any other information necessary to access the service or resource
-to which the individual is referred. The BHE shall consider barriers to
-care for the individual and support the individual in connecting with
-necessary resources to promote access to care. If this cannot be
-completed, the BHE shall document the reason within the record as well
-as any attempts made.
-
-Information and documentation to be provided to the individual upon discharge,
-unless clinically contraindicated, including, but not limited to:
-(1)
-
-Medication information, including medication name, dosage, instructions
-for follow-up, and whether the individual was provided with medication
-upon discharge.
-(a)
-
-6.
-
-2 CCR 502-1
-
-The BHE may provide individuals with unused, prescribed
-medications as part of the discharge process, unless it has been
-determined that doing so would pose a risk to the health and
-safety of the individual.
-
-(2)
-
-Detailed information on transitioning care to other providers, including
-referral information, when providing referrals.
-
-(3)
-
-Documentation that the discharge is being made against the advice of
-the provider, as applicable.
-
-(4)
-
-Documentation required when the above information in this subpart
-2.10.A.5.e is not provided to the individual at discharge.
-
-(5)
-
-Written notification of discharge with reason for discharge.
-
-(6)
-
-Written notification of BHE and BHA dispute resolution and grievance
-procedures.
-
-Requirements for a discharge summary to facilitate continuity of individual care,
-including, but not limited to:
-a.
-
-The timeframe for discharge summary completion, which may not be more than
-fifteen (15) calendar days after discharge.
-
-b.
-
-Information to be included in the discharge summary to inform future providers of
-treatment history, including, but not limited to:
-(1)
-
-Demographic information, including, but not limited to, name, date of
-birth, gender identity, emergency contact information, insurance
-information, preferred language, and any cultural factors to consider in
-treatment;
-
-(2)
-
-A brief summary of the episode of care, including, but not limited to, the
-presenting issue, services received, diagnosis assigned or modified, and
-any outstanding needs identified;
-
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-Behavioral Health
-
-c.
-
-2 CCR 502-1
-
-(3)
-
-Information on the individual’s status within the judicial system, including
-any type of behavioral health certification or hold;
-
-(4)
-
-A summary of medications prescribed during treatment, including the
-individual's responses to medications;
-
-(5)
-
-Medications recommended and prescribed at discharge; and
-
-(6)
-
-Documentation of referrals and recommendations for follow-up care.
-
-This discharge information may be in narrative or abbreviated format and must
-be written in a manner that can be readily understood by a receiving provider to
-allow for prompt resumption of services.
-
-2.11
-
-Individual Records
-
-A.
-
-A confidential individual record must be maintained for each individual receiving services from the
-BHE. This record must not contain protected health information pertaining to other individuals
-receiving services.
-
-B.
-
-Each individual record must include at a minimum:
-
-C.
-
-1.
-
-Demographic and medical information, including, but not limited to, individual name,
-address, telephone number, emergency contact information, physician or health provider
-information, and current diagnosis;
-
-2.
-
-Screenings, assessments and reassessments, service plans, documentation of informed
-consent including consent to treatment, releases of information, physician or practitioner
-orders, documentation of services, treatment progress notes and medication, admission
-summary, discharge summary, and any endorsement or service-specific requirements,
-as set by this Chapter;
-
-3.
-
-Medical and psychiatric advance directives when such directives are furnished by the
-individual;
-
-4.
-
-The individual’s medication administration record;
-
-5.
-
-The out-of-state offender questionnaire, if providing substance use disorder (SUD)
-services;
-
-6.
-
-Personal belonging inventories;
-
-7.
-
-Court documents, when such documents are relevant to the individual’s treatment;
-
-8.
-
-Records of required communication with referral sources such as court, probation, child
-welfare, and parole; and
-
-9.
-
-Drug and alcohol testing and monitoring results.
-
-Individual records must be available to an individual or their designated representative through
-the BHE or their designated representative at reasonable times and upon reasonable notice in
-accordance with all applicable state and federal laws, including but not limited to HIPAA and 42
-C.F.R. Part 2.
-
-46
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-Behavioral Health
-
-1.
-
-2 CCR 502-1
-
-If the service provider is deceased or unavailable, the current custodian of the record
-shall designate a substitute service provider for purposes of compliance with these
-regulations.
-
-D.
-
-A statement of the BHE’s procedures for obtaining records, and the right to appeal grievances
-regarding access to records to the BHA must be posted in conspicuous public places on the
-premises and made available to each individual upon admission to the BHE.
-
-E.
-
-An individual, whether currently receiving services or discharged from a BHE, may inspect, or
-obtain a copy of their own record. The BHE must act on the request to review the individual’s
-record within a reasonable time, which must not exceed thirty (30) days except when an
-extension is allowable in accordance with 45 C.F.R. 164.524(b)(2).
-
-F.
-
-BHEs must not charge the individual or designated representative for inspection of the individual
-record.
-
-G.
-
-Records must be kept in accordance with all applicable state and federal laws and regulations.
-
-H.
-
-Access to medical records contained within the individual’s records must be accessed in a
-manner that is consistent with all applicable state and federal laws, including but not limited to the
-Health Insurance Portability and Accountability Act of 1996 (HIPAA).
-
-I.
-
-If there are changes/corrections, deletions, or other modifications to any portion of an individual
-record, the person who is making the changes must note in the record the date, time, nature,
-reason, correction, deletion, or other modification, and their name, to the change, correction,
-deletion, or other modification.
-
-J.
-
-Records must be retained as follows:
-1.
-
-Adult outpatient endorsements as defined in 2.3.A.3 of this Chapter must be retained for
-seven (7) years from the date of discharge from the BHE.
-a.
-
-2.
-
-Adult residential/overnight endorsements as defined in part 2.3.A.4 of this Chapter must
-be retained for ten (10) years from the date of discharge from the BHE.
-a.
-
-K.
-
-Records for individuals who are less than eighteen (18) years old when admitted
-to the BHE must be retained until the individual is twenty-five (25) years old.
-
-Records for individuals who are less than eighteen (18) years old when admitted
-to the BHE must be retained until the individual is twenty-eight (28) years old.
-
-3.
-
-The confidentiality of the individual record, including all medical, behavioral health,
-psychological, and demographic information must be protected in accordance with all
-applicable federal and state laws and regulations, including during record use, storage,
-transportation, transmission, and disposal.
-
-4.
-
-When a BHE closes a physical location and/or discontinues any endorsement, it must
-maintain records of individuals served in accordance with the requirements of this part
-2.11.J.
-
-5.
-
-A BHE that ceases operation must comply with the provisions of part 2.24 of this Chapter
-regarding individual records.
-
-Effect of this part 2.11 on similar rights of an individual
-
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-
-2.12
-
-2 CCR 502-1
-
-1.
-
-Nothing in this part 2.11 may be construed to limit the right of an individual or the
-individual’s designated representative to inspect individual records, including the
-individual’s medical or psychological data pursuant to Section 27-65-123, C.R.S.
-
-2.
-
-Nothing in this part 2.11 may be construed to require a person responsible for the
-diagnosis or treatment of a child for substance use disorder or use of drugs, pursuant to
-Sections 25-4-409 and 13-22-102, C.R.S. to release records of such diagnosis or
-treatment to a parent, guardian, or person other than the minor or their designated
-representative.
-
-3.
-
-Nothing in this part 2.11 may be construed to waive the responsibility of a custodian of
-medical records in the BHE to maintain confidentiality of those records in its possession.
-
-4.
-
-Nothing in this part 2.11 may limit the right of an individual, the individual’s personal
-representative, or a person who requests the medical records upon submission of a
-federal law compliant authorization, a valid subpoena, or a court order to inspect the
-individual’s records.
-
-Screening, Initial Assessment, and Comprehensive Assessment
-
-2.12.1 Screening
-A.
-
-Personnel meeting qualifications under part 2.5.C of this Chapter shall complete a screening and
-triage process to determine urgency of the individual’s needs, including the need for emergency
-or urgent medical or psychiatric services, and whether the BHE can provide the appropriate care
-in light of the individual’s needs.
-
-B.
-
-Screening tools/approaches must be culturally and linguistically appropriate and trauma-informed
-and should accommodate an individual's disability/disabilities (hearing disability, cognitive
-limitations, visual impairment, etc.) As required.
-
-C.
-
-Screenings must collect at least the following information from an individual seeking services:
-1.
-
-Identifying information;
-
-2.
-
-Primary complaint/reason for seeking services;
-
-3.
-
-Current behavioral health symptoms, including severity, duration, mental status, and
-changes or impairments in functioning due to symptoms;
-
-4.
-
-Medical concerns/chronic health issues, including pregnancy and postpartum status; and
-
-5.
-
-Evaluation of imminent risk, including:
-a.
-
-Suicide risk;
-
-b.
-
-Danger to self or others;
-
-c.
-
-Urgent or critical medical conditions, including withdrawal or overdose risk; or
-
-d.
-
-Other immediate risks, including threats from another person.
-
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-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-(1)
-
-6.
-
-2 CCR 502-1
-
-If, at any point in the course of treatment, a screening of imminent risk is
-completed to assess the need for a mental health hold (M1 hold), all
-personnel conducting the screening shall use the BHA designated M1
-screening form notwithstanding any 27-65 designation.
-
-Preliminary determination of level of care needed.
-
-D.
-
-Screenings that identify an imminent risk must be reviewed by a licensee, licensed addiction
-counselor (LAC), a certified addiction specialist (CAS), or a licensure candidate performing within
-the scope of their practice.
-
-E.
-
-Screenings should be conducted in-person unless contraindicated. If contraindicated, screenings
-may be conducted via audio-visual or audio only telehealth. Clinical rationale must be
-documented in the case of a telehealth screening.
-
-F.
-
-To avoid redundant screening, supporting documentation that a screening tool was administered
-within the past six (6) months may be incorporated into an individual’s record in place of similar
-screening requirements, with the exception of screenings for imminent risk as described in part
-2.12.1.C.5 of this Chapter. Screenings for imminent risk as described in 2.12.1.C.5 of this
-Chapter must be completed any time an individual is screened for treatment by a BHE
-notwithstanding any other recent screenings.
-
-G.
-
-Any BHE providing substance use disorder (SUD) services for any level of care shall:
-1.
-
-Screen and register adults with out-of-state offenses in accordance with Section 17-27.1101, C.R.S.
-a.
-
-This does not apply to crisis services found in Chapter 6 of these rules or
-withdrawal management services found in Chapters 4 and 5 of these rules.
-
-2.12.2 Initial Assessment
-A.
-
-An initial assessment must be completed and signed and/or approved by a licensee, licensed
-addiction counselor (LAC), a certified addiction specialist (CAS), or a licensure candidate
-performing within the scope of their practice. BHEs must meet timeline requirements set forth in
-applicable endorsement Chapters. See endorsement Chapters 4 through 10 of these rules for
-additional initial assessment requirements.
-
-B.
-
-The initial assessment, including information gathered as part of the preliminary screening and
-risk assessment, includes, at a minimum:
-1.
-
-Provisional diagnoses;
-
-2.
-
-The source of referral;
-
-3.
-
-The reason for seeking care, as stated by the individual or other referral source(s);
-
-4.
-
-Identification of the individual’s immediate clinical care needs related to the diagnosis for
-mental and substance use disorders;
-
-5.
-
-A list of current prescriptions and prescribing physicians, over-the-counter medications,
-and any other substances the individual may be taking, including doses and frequency;
-
-6.
-
-An assessment of whether the individual is a risk to self or to others, including suicide risk
-factors;
-
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-
-7.
-
-An assessment of whether the individual has other concerns for their safety;
-
-8.
-
-Assessment of need for medical care (with referral and follow-up as required);
-
-9.
-
-A determination of whether the individual presently is or ever has been a member of the
-U.S. Armed Services;
-
-10.
-
-Current health care providers; and
-
-11.
-
-Screening all individuals for current pregnancy status and desire to become pregnant
-within the next year. If not pregnant or desirous of pregnancy in the next twelve (12)
-months, individuals must be asked if they want access to contraceptive/family planning
-care, and the individual must be appropriately referred.
-a.
-
-C.
-
-2 CCR 502-1
-
-Individuals shall be screened and appropriately referred, for past and present risk
-factors associated with behavioral health disorders and that are associated with:
-(1)
-
-Pregnancy complications, including risks to the health of the pregnant
-individual and fetus;
-
-(2)
-
-Acquiring and transmitting Human Immunodeficiency Virus/Acquired
-Immune Deficiency Syndrome (HIV/AIDS), Tuberculosis (TB), Hepatitis
-A, B, or C, and other infectious diseases; and,
-
-(3)
-
-If clinically indicated by the presence of continuing risk factors, screening
-must be conducted at a minimum on a quarterly basis.
-
-As needed, releases of information must be obtained.
-
-2.12.3 Comprehensive Assessment
-A.
-
-The BHE must complete a comprehensive best practices assessment that focuses on personcentered care, which is signed and/or approved by a licensee, licensed addiction counselor
-(LAC), a certified addiction specialist (CAS), or a licensure candidate performing within the scope
-of their practice. BHEs must meet timeline requirements set forth in applicable endorsement
-Chapters. See endorsement Chapters 4 through 10 of these rules for additional requirements.
-
-B.
-
-Information gathered as part of screening and/or the initial assessment may be incorporated into
-the comprehensive assessment.
-
-C.
-
-For BHEs that have or are seeking a SUD sub-endorsement for any level of care, assessments
-must:
-1.
-
-Use the ASAM Criteria as a guide for assessing and placing individuals in the appropriate
-level of care;
-
-2.
-
-Document information gathered on the six (6) dimensions outlined in the ASAM Criteria
-for assessments; and
-
-3.
-
-Utilize the decisional flow process as outlined in the ASAM Criteria to determine and
-document the assessed level of care.
-
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-
-D.
-
-The BHE must conduct assessments throughout the course of treatment, review previous
-assessments and update those assessments whenever there is a change in the person's level of
-care or functioning. The assessments must occur, at minimum, every six (6) months, unless
-otherwise indicated in an endorsement Chapter.
-
-E.
-
-All methods and procedures used to assess and evaluate an individual must be developmentally
-and age appropriate, culturally and linguistically appropriate and trauma informed. All methods
-and procedures used to assess and evaluate an individual must be able to be provided in the
-preferred language and/or communication method of frequently encountered Limited English
-Proficiency (LEP) groups of the BHE.
-
-F.
-
-The assessment must be documented in the individual’s record and, at minimum, include the
-following information, if available and applicable:
-1.
-
-Identification and demographic data;
-
-2.
-
-Primary complaint/reason for seeking services, including onset of symptoms and severity
-of symptoms;
-
-3.
-
-Mental health history, including but not limited to:
-a.
-
-Suicidal risk and ideation, and
-
-b.
-
-Homicidal ideation.
-
-4.
-
-Substance use and substance use withdrawal history;
-
-5.
-
-Physical and dental health status, including but not limited to human immunodeficiency
-virus/acquired immune deficiency syndrome (HIV/AIDS), tuberculosis (TB), hepatitis A, B,
-or C, and other infectious diseases status and risk evaluation;
-
-6.
-
-A diagnosis with sufficient supporting criteria, as well as any subsequent changes in
-diagnosis;
-
-7.
-
-A mental status examination(s) for individuals who receive a diagnosis. When completing
-a mental status exam, personnel must consider other diagnoses or disabilities that may
-impact motor and speech activity;
-
-8.
-
-History of involuntary treatment;
-
-9.
-
-Advance directives, including medical and psychiatric;
-
-10.
-
-Capacity for self-sufficiency and daily functioning;
-
-11.
-
-Cultural factors that may impact treatment, including age, ethnicity,
-linguistic/communication needs, gender, gender identity, sexual orientation, relational
-roles, spiritual beliefs, socio-economic status, personal values, level of acculturation
-and/or assimilation, and coping skills;
-
-12.
-
-Education, vocational training, and military service;
-
-13.
-
-Family and/or social relationships;
-
-14.
-
-Trauma and trauma history;
-
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-15.
-
-Physical and/or sexual abuse or perpetration and current risk;
-
-16.
-
-Legal issues that may impact behavioral health outcomes;
-
-17.
-
-Issues specific to older adults such as hearing loss, vision loss, strength; mobility and
-other aging issues;
-
-18.
-
-Issues specific to children such as growth and development, daily activities, legal
-guardians and need for family involvement and engagement in the child's treatment;
-
-19.
-
-Strengths, abilities, skills, and interests; and
-
-20.
-
-Barriers to treatment.
-
-G.
-
-Assessments must apprise individuals, as applicable, of risk factors associated with acquiring and
-transmitting HIV/AIDS, Tuberculosis (TB), Hepatitis A, B, or C, and other infectious diseases.
-Appropriate testing and pre and post-test counseling must be offered on-site or through referral.
-
-H.
-
-Additional assessment requirements may be required for specific endorsements. See
-endorsement Chapters 4 through 10 of these rules for additional requirements.
-
-2.13
-
-Service Planning
-
-2.13.1 Service plan
-A.
-
-If providing clinical services, the BHE shall ensure the development and review of a written
-service plan for each individual as follows:
-1.
-
-The service plan must be developed as soon as practicable after admission, but no later
-than the timeframes identified in the endorsement-specific Chapters of these rules (i.e.,
-Chapters 4 through 10).
-
-2.
-
-The service plan must be reviewed and revised in writing when there is a change in the
-individual’s level of functioning or service needs, and no later than applicable
-endorsement-specific timeframes. Such revision must include documentation of progress
-made in relation to planned treatment outcomes, changes in treatment focus, and length
-of stay adjustments, as applicable.
-
-3.
-
-The service plan must:
-a.
-
-Meet the developmental and cultural needs of the individual.
-
-b.
-
-Specify goals based on the initial and/or comprehensive assessment in a manner
-understandable to the individual.
-
-c.
-
-Identify the type, frequency, and duration of services.
-
-d.
-
-Be individually directed, including the individual’s strengths and identities.
-
-e.
-
-Include involvement of other identified family and/or supportive individuals, when
-appropriate.
-
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-
-4.
-
-The service plan may include tasks or activities to be performed by the individual, such
-as an individual doing their own laundry or preparing their own meals/snacks, only when
-such tasks are therapeutic. Tasks must not be included in the service plan solely for the
-convenience of the BHE.
-
-5.
-
-The service plan must be signed by all parties involved in the development of the plan,
-including the individual, or the individual’s parent or legal guardian in cases where the
-individual is a child, or the individual has a court-appointed legal guardian and has not
-consented to services without the involvement of the legal guardian. Signatures must
-include at least one of the following: a licensee, licensed addiction counselor (LAC), a
-certified addiction specialist (CAS), or a licensure candidate performing within the scope
-of their practice.
-a.
-
-A copy of the service plan must be offered to the individual, or to the individual’s
-parent or legal guardian, as appropriate.
-
-b.
-
-The BHE must include documentation in the individual record in cases where the
-plan is not signed by the individual or the individual's parent or legal guardian if
-involved in the development of the plan, and in cases where offering the service
-plan to a parent or legal guardian is contraindicated.
-
-2.13.2 Treatment Progress Documentation Requirements
-A.
-
-The individual record must include progress notes, documenting a chronological record of
-treatment, date and type of service, session activity, and progress toward individual-specific
-treatment goals.
-
-B.
-
-The minimum frequency of progress note completion may vary by endorsement. See specific
-endorsement requirements in Chapters 4 through 10 of these rules for details.
-
-C.
-
-Progress notes must include any noted change in physical, behavioral, cognitive, and functional
-condition and action taken by personnel to address the individual’s changing needs.
-
-D.
-
-Progress notes must be signed and dated or electronically approved by personnel, practicing
-within the scope of their practice, at the time they are written, with at least first initial, last name,
-and degree and/or professional credentials.
-
-E.
-
-Verbal orders must be recorded at the time they are given and authenticated as soon as practical.
-
-2.14
-
-Protection of Individuals from Involuntary Restraint or Seclusion
-
-2.14.1 General Provisions
-A.
-
-The following rules covering seclusion, restraint, and physical management apply to all agencies
-that use seclusion, restraint, and/or physical management. If a BHE has decided to use
-seclusion, restraint, and/or physical management, the BHE shall use seclusion, restraint, and/or
-physical management only in accordance with the rules in this part 2.14.
-
-B.
-
-These rules do not supersede any requirements under Sections 26-20-101 through -111, C.R.S.
-
-C.
-
-If any provision of this part 2.14 conflicts with any provision concerning the use of seclusion,
-restraint, and/or physical management on an individual with an intellectual or developmental
-disability as stated in Article 10.5 of Title 27, C.R.S., Article 10 of Title 25.5, C.R.S. or any rule
-adopted pursuant to those Articles, the provisions of those Articles or rules prevail.
-
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-
-D.
-
-Individuals being detained under Sections 27-65-106 through -110, C.R.S., may be secluded or
-restrained involuntarily under the conditions in this part; otherwise, there must be a signed
-informed consent for such an intervention as subject to part 2.11 of this Chapter.
-
-E.
-
-A BHE may only use seclusion, restraint, and/or physical management:
-
-F.
-
-G.
-
-H.
-
-1.
-
-In cases of emergency, as defined at Section 26-20-102(3), C.R.S., to be a serious,
-probable, imminent threat of bodily harm to self or others where there is the present
-ability to affect such bodily harm; and
-
-2.
-
-After the failure of less restrictive alternatives, including but not limited to after all
-attempts to verbally direct or de-escalate the individual have failed; or
-
-3.
-
-After a determination that such alternatives would be inappropriate or ineffective under
-the circumstances.
-
-A BHE that uses seclusion, restraint, and/or physical management pursuant to the provisions of
-part 2.14.1.E, may only use such seclusion, restraint, and/or physical management:
-1.
-
-For the purpose of preventing the continuation or renewal of an emergency;
-
-2.
-
-For the period of time necessary to accomplish its purpose; and
-
-3.
-
-In the case of physical restraint, with no more force than is necessary to limit the
-individual’s freedom of movement.
-
-Seclusion, restraint, and/or physical management must never be used:
-1.
-
-As a punishment or disciplinary sanction;
-
-2.
-
-As a means of coercion;
-
-3.
-
-As part of an involuntary service plan or behavior modification plan;
-
-4.
-
-For convenience;
-
-5.
-
-For the purpose of retaliation; or
-
-6.
-
-For the purpose of protection, unless:
-a.
-
-The restraint or seclusion is ordered by a court; or
-
-b.
-
-In an emergency, as provided for in this part 2.14.1.F.1 above.
-
-Physical management for individuals under the age of eighteen (18) must always be considered
-as restraint and follow the restraint order rules pursuant to part 2.14.13 of this Chapter.
-
-2.14.2 Policies and Procedures Regarding Seclusion, Restraint, and Physical Management
-A.
-
-The BHE shall have and shall implement written policies and procedures that describe the
-situations in which the use of seclusion, restraint, and/or physical management are considered
-appropriate and the personnel who can order their use. The policies and procedures must include
-the requirements in this part 2.14 and Section 26-20-101 through -111, C.R.S. these policies and
-procedures must also include:
-
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-
-1.
-
-For a BHE that does not authorize the use of seclusion, restraint, and/or physical
-management of any type, a policy statement noting the prohibition against the use of
-seclusion, restraint, and/or physical management and the procedures that personnel will
-utilize in lieu of seclusion, restraint, and/or physical management.
-
-2.
-
-For a BHE that utilizes seclusion, restraint, and/or physical management, a policy
-statement regarding the review process for the use of seclusion, restraint, and/or physical
-management. The review process must include a provision for terminating the seclusion,
-restraint, and/or physical management episode when the reviewer does not concur with
-the order for continuation.
-a.
-
-If the reviewer is not an authorized practitioner, then the order must be
-discontinued by an authorized practitioner.
-
-3.
-
-Personnel shall ensure that no individual endures harm or harassment when secluded
-and/or restrained.
-
-4.
-
-A policy statement that a BHE shall ensure that the care and treatment are skillfully and
-humanely administered with full respect for the individual’s dignity, pursuant to Section
-27-65-101(1)(a), C.R.S.
-
-5.
-
-Protocols for when the use of restraint, seclusion, and/or physical management is
-appropriate, which include restrictions on the use of these techniques. A BHE may
-impose more, but not fewer, restrictions on the use of these techniques than is required
-by this Chapter.
-
-6.
-
-Details on the type of physical management interventions that personnel are approved to
-use.
-
-7.
-
-Details on how seclusion, restraint, and/or physical management will be altered to include
-any necessary accommodations the individual may need, including but not limited to
-changing emergency interventions to not restrain hands and ability to communicate for
-those individuals that speak sign language.
-
-8.
-
-If a BHE does not have a 27-65 designation with the BHA and is using seclusion and/or
-restraint interventions, that BHE’s policies and procedures must include details on
-transferring an individual to a 27-65 designated facility if after one (1) hour of seclusion
-and/or restraint interventions have been used and the individual is assessed as continued
-risk, meeting criteria for an emergency hold under 27-65-106, C.R.S., and needing further
-intervention(s).
-
-2.14.3 Personnel Training
-A.
-
-The BHE shall ensure that all personnel involved in utilizing seclusion, restraint, and/or physical
-management are trained in the use of seclusion, restraint, and/or physical management as
-described in this part 2.14.
-
-B.
-
-The BHE shall ensure that personnel are trained to explain, where possible, the use of seclusion,
-restraint, and/or physical management to the individual who is to be secluded, restrained, or
-physically managed and to the individual’s designated representative, if appropriate.
-
-C.
-
-Training must be standardized and evaluated every three (3) years to ensure incorporation of
-evidence-based best practices for seclusion, restraint, and/or physical management.
-
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-
-D.
-
-Training must be provided to personnel within the first month of their orientation period and
-annually thereafter unless training is needed sooner.
-
-E.
-
-Personnel shall obtain certification in cardiopulmonary resuscitation (CPR), including periodic
-recertification as needed to maintain certification.
-
-F.
-
-Training must include at minimum, but is not limited to:
-
-G.
-
-1.
-
-The safe use of seclusion, restraint, and/or physical management including content
-related to the risks of positional asphyxia, aspiration, traumatization, and recognize and
-respond to signs of physical distress of an individual who is secluded, restrained, and/or
-physically managed;
-
-2.
-
-Address concepts related to prevention and non-physical interventions such as deescalation and mediation;
-
-3.
-
-Educate personnel of how their culture, language, biases, values, and perceptions
-influence their response and escalation of person involved; and
-
-4.
-
-Understanding and recognizing underlying behavioral health and physical health
-conditions, medications, and their potential effects as well as how age, developmental
-level, cultural background, language, history of physical or sexual abuse, and prior
-experience with seclusion, restraint, and/or physical management will influence an
-individual’s responses to seclusion, restraint, and physical management.
-
-Personnel must demonstrate knowledge and application of seclusion, restraint, and physical
-management training on an annual basis when working with persons over the age of twenty-one
-(21), and on a semi-annual basis when working with youth twenty (20) years old and younger.
-
-2.14.4 Standards of Care Upon Admission
-A.
-
-At admission, the BHE shall inform both the individual and the individual’s legal representative, as
-applicable, of the BHE’s policy regarding the use of seclusion, restraint, and physical
-management during an emergency behavioral health episode for individuals in a treatment
-program. This must, as is reasonable under the circumstances, be communicated in a language
-and modality accessible to the individual.
-
-B.
-
-Upon an individual’s admission, personnel shall collaborate with the individual and the individual’s
-legal representative, when applicable, to formulate strategies that may minimize the potential for
-a behavioral health emergency event that requires interventions of seclusion, restraint, and/or
-physical management.
-
-C.
-
-A BHE electing to utilize seclusion, restraint, and/or physical management shall assess each
-individual upon admission regarding:
-1.
-
-Assault and trauma history;
-
-2.
-
-Seclusion, restraint, and/or physical management history;
-
-3.
-
-Individual’s risk factors for a behavioral emergency, and individually identified strategies
-to avoid seclusion, restraint, and/or physical management; and
-
-4.
-
-The BHE shall ascertain any applicable behavioral health advance directives.
-
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-
-2.14.5 Use of Physical Management
-A.
-
-Physical management for individuals under the age of eighteen (18) must always be considered
-as restraint and follow the restraint order rules pursuant to this part 2.14.13.
-
-B.
-
-Physical management shall only be used on an emergency basis for a maximum of one (1)
-minute, when the situation places the individual or others at imminent risk of serious physical
-harm after all attempts to verbally direct or de-escalate the person have failed.
-1.
-
-If physical management is used for longer than one (1) minute, the intervention is
-restraint, pursuant to Section 26-20-102(6), C.R.S., and personnel must follow the
-restraint order rules pursuant to part 2.14.7 of this Chapter.
-
-C.
-
-To ensure the safety of each individual and personnel, each BHE shall designate emergency
-physical management techniques to be utilized during emergency situations.
-
-D.
-
-The term “physical management” does not include briefly holding an individual in order to comfort
-them.
-
-E.
-
-The physical management continuum may include:
-1.
-
-Utilizing transitional measures;
-
-2.
-
-Placing one’s hands on an individual to physically guide and/or physically control the
-individual;
-
-3.
-
-Use of an approved restraint method specified in the BHE’s policies and procedures to
-maintain safety of the individual;
-
-4.
-
-Placing an individual into an approved prolonged restraint method specified in the BHE’s
-policies and procedures;
-
-5.
-
-Physical management may be used to move or escort an individual into seclusion.
-a.
-
-F.
-
-Seclusion, in itself, is not a form of physical management.
-
-Physical management must be documented in the clinical record to include the following:
-1.
-
-Documentation of the behavioral necessity for physical management and any deescalation techniques attempted prior to utilizing physical management.
-
-2.
-
-Documentation of the approved physical management method utilized.
-
-2.14.6 Use of Seclusion
-A.
-
-If an order for seclusion is verbal, the verbal order must be received by a registered nurse or
-other trained licensed personnel, such as a licensed practical nurse, while the emergency safety
-intervention is being initiated by personnel or immediately after the emergency safety situation
-begins.
-1.
-
-The physician or other authorized practitioner permitted to order seclusion must verify the
-verbal order in a signed written form in the individual’s record. Signatures must be
-entered into the record no more than twenty-four (24) hours after the event.
-
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-2.
-
-B.
-
-2 CCR 502-1
-
-The physician or other authorized practitioner to order seclusion must be available to
-personnel for consultation, at least by telephone, throughout the period of the emergency
-safety intervention.
-
-Within one (1) hour of the initiation of the original order of seclusion an authorized practitioner,
-such as a registered nurse or physician assistant, trained in the use of emergency safety
-interventions and permitted to assess the physical and psychological well-being of the individual,
-shall conduct a face-to-face assessment of the physical and psychological well-being of the
-individual including but not limited to:
-1.
-
-The individual’s physical and psychological status;
-
-2.
-
-The individual’s behavior;
-
-3.
-
-The appropriateness of the intervention measures; and
-
-4.
-
-Any complications resulting from the intervention.
-
-C.
-
-When the one (1) hour assessment described in this part 2.14.6.B is conducted by a registered
-nurse or a physician assistant, that personnel must consult with the attending physician when the
-assessment is completed.
-
-D.
-
-Results of the one (1) hour assessment must determine if continued emergency interventions
-need to be re-ordered by the authorized practitioner.
-1.
-
-Assessment results and continuation order, if applicable, must be contained in the clinical
-record.
-
-E.
-
-Seclusion occurs any time an individual is placed alone in a room and not allowed to leave.
-
-F.
-
-Seclusion must be used only when other less restrictive methods have failed.
-1.
-
-Documentation of less restrictive methods and the outcome must be contained in the
-clinical record.
-
-G.
-
-Seclusion must not be used for punishment, for the convenience of personnel, or as a substitute
-for a program of care and treatment.
-
-H.
-
-Seclusion rooms must be lighted, clean, safe, and have a window for personnel to observe.
-
-I.
-
-Seclusion rooms must be a minimum of 100 square feet.
-
-J.
-
-Relief periods from seclusion must be offered for reasonable access to toilet facilities.
-
-2.14.7 Use of Restraint
-A.
-
-If an order for restraint is verbal, the verbal order must be received by a registered nurse or other
-trained licensed personnel, such as a licensed practical nurse, while the emergency safety
-intervention is being initiated by personnel or immediately after the emergency safety situation
-begins.
-1.
-
-The physician or other authorized practitioner permitted to order restraint must verify the
-verbal order in a signed written form in the individual’s record. Signatures must be
-entered into the record no more than twenty-four (24) hours after the event.
-
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-2.
-
-2 CCR 502-1
-
-The physician or other authorized practitioner to order restraint must be available to
-personnel for consultation throughout the period of the emergency safety intervention.
-
-B.
-
-An individual in physical restraint must be released from such restraint within fifteen (15) minutes
-after the initiation of physical restraint, except when precluded for safety reasons pursuant to part
-2.14.1 of this section.
-
-C.
-
-Within one (1) hour of the initiation of the original order for the emergency safety intervention, an
-authorized practitioner, such as a registered nurse or physician assistant, trained in the use of
-emergency safety interventions and permitted to assess the physical and psychological wellbeing of the individual, shall conduct a face-to-face assessment of the physical and psychological
-well-being of the individual including but not limited to:
-1.
-
-The individual’s physical and psychological status;
-
-2.
-
-The individual’s behavior;
-
-3.
-
-The appropriateness of the intervention measures; and
-
-4.
-
-Any complications resulting from the intervention.
-
-D.
-
-When the one (1) hour assessment described in this part 2.14.7.C is conducted by a registered
-nurse or a physician assistant, that personnel must consult with the attending physician when the
-assessment is completed.
-
-E.
-
-Results of the one (1) hour assessment must determine if continued emergency interventions
-need to be reordered by the authorized practitioner.
-1.
-
-Assessment results and continuation order, if applicable, must be contained in the clinical
-record.
-
-F.
-
-The decision to restrain must be based on a current clinical assessment and may also be based
-on other reliable information including information that was used to support the decision to take
-the individual into custody for treatment and evaluation. The fact that an individual is being
-evaluated or treated under Sections 27-65-106 through 27-65-111 [effective July 1, 2024], C.R.S.,
-must not be the sole justification for the use of restraint.
-
-G.
-
-Restraint includes chemical restraint, mechanical restraint, and physical restraint.
-
-H.
-
-Mechanical restraints may be used only for the purpose of preventing such bodily movement that
-is likely to result in imminent injury to self or others. Mechanical restraint must not be used solely
-to prevent unauthorized departure.
-
-I.
-
-Restraint of an individual by a chemical spray is not permissible.
-
-J.
-
-The type of restraint must be appropriate to the type of behavior to be controlled, the physical
-condition of the individual, the age of the individual and the type of effect restraint may have upon
-the individual.
-
-K.
-
-Restraint must be applied only if alternative interventions have failed. Justification for immediate
-use of restraint without first attempting alternative interventions must be documented in the
-clinical record; however, alternative techniques are not required if the alternatives would be
-ineffective or unsafe when the individual’s behavior could cause harm to self or others.
-
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-
-L.
-
-The term “restraint” as used in this section, does not include restraints used while the BHE is
-engaged in transporting an individual from one location to another location when it is within the
-scope of that BHE's powers and authority to conduct such transportation pursuant to Section 2620-101 through -111, C.R.S.
-
-M.
-
-No physical or mechanical restraint of an individual may place excess pressure on the chest or
-back of that individual, cover the individual’s face, or inhibit or impede the individual’s ability to
-breathe.
-
-2.14.8 Chemical Restraint
-A.
-
-If an order for chemical restraint is verbal, the verbal order must be received by a registered
-nurse or other trained licensed personnel, such as a licensed practical nurse, while the
-emergency safety intervention is being initiated by personnel or immediately after the emergency
-safety situation begins.
-1.
-
-The physician or other authorized practitioner permitted to order chemical restraint must
-verify the verbal order in a signed written form in the individual’s record. Signatures must
-be entered into the record no more than twenty-four (24) hours after the event.
-
-2.
-
-The physician or other authorized practitioner to order chemical restraint must be
-available to personnel for consultation, throughout the period of the emergency safety
-intervention.
-
-B.
-
-An order for a chemical restraint, along with the reasons for its issuance, must be recorded in
-writing at the time of its issuance;
-
-C.
-
-An order for a chemical restraint must be signed at the time of its issuance by such authorized
-practitioner, who is present at the time of the emergency;
-
-D.
-
-An order for a chemical restraint, if authorized by telephone, must be transcribed, and signed at
-the time of its issuance by personnel with the authority to accept telephone medication orders
-who is present at the time of the emergency.
-
-E.
-
-Personnel trained in the administration of medication shall make notations in the record of the
-individual as to the effect of the chemical restraint and the individual’s response to the chemical
-restraint.
-
-2.14.9 Explanation to Individual in Seclusion/Restraint
-A.
-
-B.
-
-In any situation in which seclusion/restraint is utilized, information must be given to the
-secluded/restrained individual, and the individual’s legal representative when applicable, as soon
-as possible after they have been secluded or restrained. The individual must be given a clear
-explanation of:
-1.
-
-The reasons for use of such intervention;
-
-2.
-
-The observation procedure, the desired effect; and
-
-3.
-
-The circumstances under which the procedure will be terminated.
-
-That the explanation has been given to the individual and the individual’s legal representative,
-when applicable, must be documented in the clinical record.
-
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-C.
-
-2 CCR 502-1
-
-As soon as possible, upon termination of seclusion and/or restraint, personnel shall debrief with
-the individual and assess for any traumatic stress that may have been triggered as a result of
-seclusion/restraint.
-
-2.14.10 Observation & Care of Individuals in Seclusion and/or Restraint
-A.
-
-An individual who is in seclusion/restraint must be observed in-person by trained BHE personnel
-at no more than ten (10) feet physical distance from the individual.
-1.
-
-Such observation, along with the behavior of the individual, must be documented every
-fifteen (15) minutes.
-
-B.
-
-Unless contraindicated by the individual's condition, such observation must include consistent
-efforts to interact personally with the individual throughout the episode.
-
-C.
-
-Ongoing provisions must be made for nursing care, hygiene, diet, and motion of any restrained
-limbs throughout the episode.
-
-D.
-
-BHE personnel must maintain a continuous line-of sight throughout the episode with the
-individual held in mechanical restraints.
-
-E.
-
-For individuals held in mechanical restraints, BHE personnel must observe the individual at least
-every fifteen (15) minutes to ensure that:
-1.
-
-The individual is properly positioned;
-
-2.
-
-The individual’s blood circulation is not restricted;
-
-3.
-
-The individual’s airway is not obstructed; and
-
-4.
-
-The individual’s other physical needs are met, pursuant to this part 2.14.10.
-
-F.
-
-For individuals held in mechanical restraints, the BHE shall offer relief periods of at least ten (10)
-minutes as often as every two (2) hours, so long as relief from the mechanical restraint is
-determined by personnel to be safe pursuant to part 2.14.1 of this section.
-
-G.
-
-Personnel must document relief periods both offered and granted.
-
-H.
-
-The individual must have access to food at least every four (4) hours.
-
-I.
-
-The individual must have access to fluids and toileting upon request or during offered relief
-periods but must at minimum be offered every two (2) hours.
-1.
-
-J.
-
-K.
-
-During such relief periods, personnel shall ensure proper positioning of the individual and
-provide movement of limbs, as necessary.
-
-Personnel must provide assistance for use of necessary toileting methods.
-1.
-
-Appropriate toileting does not include the use of adult diapers if not typically used by the
-individual when not restrained or secluded.
-
-2.
-
-If the individual typically uses adult diapers, they are to be changed immediately if soiled.
-
-Personnel shall maintain the individual’s dignity and safety during relief periods.
-
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-
-L.
-
-Cameras and other electronic monitoring devices must not replace face-to-face observations.
-
-M.
-
-To the extent that the duties specified in Section 26-20-101 through -111, C.R.S. are more
-protective of individual rights or are in conflict with the provisions in this part 2.14, the provisions
-of Section 26-20-101 through -111, C.R.S. shall apply.
-
-2.14.11 Continued Use of Seclusion and/or Restraint
-A.
-
-Personnel must document efforts to assure that the use of seclusion/restraint is as brief as
-possible.
-
-B.
-
-The original order of seclusion/restraint of an individual must not exceed one (1) hour without an
-order for continued seclusion/restraint from an authorized practitioner. A verbal order, including
-telephone or other electronic orders, may be used if followed by a written order from the
-authorized practitioner.
-
-C.
-
-Seclusion/restraint must not be ordered on an “as needed” basis.
-
-D.
-
-A new written order is required every four (4) hours and shall include a documented examination
-by an authorized practitioner.
-
-E.
-
-Continued seclusion/restraint in excess of twenty-four (24) hours shall require an administrative
-review.
-
-F.
-
-1.
-
-The administrative reviewer shall be a different authorized practitioner with the authority
-and knowledge necessary to review clinical information and reach a determination that
-the extension of a seclusion and/or restraint episode beyond twenty- four (24) hours is
-clinically necessary.
-
-2.
-
-If the administrative reviewer does not concur with the order for continuation of
-seclusion/restraint, the order shall be discontinued and the authorized practitioner in
-charge of treatment shall be notified of such discontinuation.
-
-An administrative review must be initiated at the conclusion of each twenty-four (24) hour period
-of continuous use of seclusion/restraint.
-
-2.14.12 Documentation Requirements
-A.
-
-Each BHE must ensure that an appropriate notation of the use of seclusion, restraint and/or
-physical management is documented in the record of the individual who was secluded,
-restrained, and/or physically managed and must be completed before the end of the shift of the
-personnel involved in the seclusion, restraint and/or physical management episode(s). Each BHE
-shall document the following in the individual’s record:
-1.
-
-Specifics of the episode including identified triggers, precipitating events, the individual's
-specific behavior(s) and the nature of the danger;
-
-2.
-
-Type of restraint, if utilized;
-
-3.
-
-Specific date and times of initiation and discontinuation of seclusion, restraint and/or
-physical management and total length of time individual is secluded, restrained, and/or
-physically managed;
-
-4.
-
-A description of specific non-physical and least restrictive interventions that were
-attempted prior and the individual’s response;
-
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-
-B.
-
-C.
-
-2 CCR 502-1
-
-5.
-
-Identification of personnel involved in the initiation and application of the seclusion,
-restraint and/or physical management;
-
-6.
-
-Notification to an authorized practitioner within one (1) hour of the seclusion/restraint
-intervention;
-
-7.
-
-Care provided while individual was secluded, restrained, and/or physically managed,
-including:
-a.
-
-Observations conducted;
-
-b.
-
-Assessments of position, respiration, circulation, and range of motion;
-
-c.
-
-Documentation of ongoing 15-minute observation and care checks, as subject to
-applicable rules, along with relief periods both offered and granted for food, fluid,
-and/or toileting;
-
-d.
-
-Interventions provided to promote comfort and safety as well as expedite release;
-
-e.
-
-The individual’s response to these interventions; and
-
-f.
-
-The effect of the restraint or seclusion on the individual;
-
-8.
-
-Documentation that the individual, and the individual’s legal representative if applicable,
-was given a clear explanation of the reasons for use of such intervention, the observation
-procedure, the desired effect, and the circumstances under which the intervention will be
-terminated including criteria for release and individual understanding of that criteria; and,
-
-9.
-
-Documentation that personnel debriefed the incident with the individual and assessed for
-trauma, processed the traumatic event, and identified triggers.
-
-Any administrative reviewer shall document the clinical justification for the continued use of
-seclusion/restraint in the individual's chart. The justification must include:
-1.
-
-Documentation that the authorized practitioner ordering the continuous use of
-seclusion/restraint in excess of four (4) hours has conducted a face-to-face evaluation of
-the individual within the previous four (4) hours;
-
-2.
-
-Documentation of the ongoing behaviors or findings that warrant the continued use of
-seclusion/restraint and other assessment information as appropriate;
-
-3.
-
-Documentation of a plan for ongoing efforts to actively address the behaviors that
-resulted in the use of seclusion/restraint;
-
-4.
-
-A determination of the clinical appropriateness of the continuation of seclusion/restraint;
-and
-
-5.
-
-A summary of the information considered by the reviewer and the result of the
-administrative review with the date, time and signature of the individual completing the
-review.
-
-Information regarding use of seclusion/restraint must be readily accessible to authorized
-individuals for review. The BHE shall have the ability to gather data as follows:
-
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-1.
-
-2 CCR 502-1
-
-Each seclusion/restraint episode including date and time the episode started and ended,
-specific to each individual over the period of one complete calendar year from January 1
-through December 31.
-
-2.14.13 Additional Procedures and Requirements for Seclusion/Restraint of a Youth
-A.
-
-Procedures for youth must include the following in addition to the requirements found in part 2.14
-of this Chapter, unless otherwise required in this part 2.14.13.
-
-B.
-
-This part 2.14.13 does not apply to adult individuals over the age of 21.
-
-C.
-
-An emergency safety intervention must be performed in a manner that is safe, proportionate, and
-appropriate to the severity of the behavior, and the youth’s chronological and developmental age;
-size; gender; physical, medical, and psychiatric condition; and personal history (including any
-history of physical or sexual abuse).
-1.
-
-D.
-
-Physical management is always considered restraint for an individual under age eighteen
-(18) and must follow the restraint order rules pursuant to this part 2.14 of this Chapter.
-
-Orders for seclusion/restraint must be by an authorized practitioner in the BHE to order
-seclusion/restraint and trained in the use of emergency safety interventions. Federal regulations
-at 42 C.F.R. Part 441, specifically 441.151 require that inpatient psychiatric services for
-individuals under age twenty-one (21) be provided under the direction of a physician.
-1.
-
-If the individual’s treatment team assigned physician is available, only they can order
-seclusion/restraint. If they are not available, then another team physician may make the
-order.
-
-E.
-
-A physician or other authorized practitioner must order the least restrictive emergency safety
-intervention that is most likely to be effective in resolving the emergency safety situation based on
-consultation with personnel.
-
-F.
-
-If the order for seclusion/restraint is verbal, the order must be received by a registered nurse or
-other trained licensed personnel, such as a licensed practical nurse, while the emergency safety
-intervention is being initiated by personnel or immediately after the emergency safety situation
-begins.
-1.
-
-The physician or other authorized practitioner permitted to order restraint or seclusion
-must verify the verbal order in a signed written form in the minor’s record. Signatures
-must be entered into the record no more than twenty-four (24) hours after the event.
-
-2.
-
-The physician or other authorized practitioner to order restraint or seclusion must be
-available to personnel for consultation, at least by telephone, throughout the period of the
-emergency safety intervention.
-
-G.
-
-Each order for seclusion/restraint must be limited to no longer than the duration of the emergency
-safety situation.
-
-H.
-
-Under no circumstances may the total order time exceed:
-1.
-
-Four (4) hours for persons ages eighteen (18) to twenty-one (21);
-
-2.
-
-Two (2) hours for persons ages nine (9) to seventeen (17); or
-
-3.
-
-One (1) hour for persons under the age of nine (9).
-
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-
-I.
-
-2 CCR 502-1
-
-Within one (1) hour of the initiation of the order of the emergency safety intervention, a physician,
-or other authorized practitioner trained in the use of emergency safety interventions and permitted
-to assess the physical and psychological well-being of the youth, must conduct a face - to - face
-assessment of the physical and psychological well-being of the individual including but not limited
-to:
-1.
-
-The youth��s physical and psychological status;
-
-2.
-
-The youth’s behavior;
-
-3.
-
-The appropriateness of the intervention measures; and
-
-4.
-
-Any complications resulting from the intervention.
-
-J.
-
-Results of the one (1) hour assessment must be documented in the individual’s record.
-
-K.
-
-Notification of parent(s) and/or legal guardian(s), when applicable:
-1.
-
-The BHE must notify the parent(s) and/or legal guardian(s) of the individual who has
-been in seclusion or restraint as soon as possible after the initiation of each emergency
-safety intervention.
-
-2.
-
-The BHE shall document in the individual’s record that the parent(s) or legal guardian(s)
-have been notified of the emergency safety intervention, including date and time of the
-notification and the name of personnel providing the notification.
-
-2.15
-
-Medication Administration
-
-A.
-
-The BHE shall ensure that medications are administered only by licensed or certified personnel
-allowed to administer medications under their own scopes of practice, or unlicensed personnel
-who are qualified medication administration persons (QMAPs) acting within their own scope of
-practice.
-
-B.
-
-When using QMAPs to administer medication, the BHE shall ensure compliance with 6 CCR
-1011-1, Chapter 24 (July 19, 2017), which is hereby incorporated by reference. No later editions
-or amendments are incorporated. This Colorado Department of Public Health and Environment
-rule is available at no cost at https://www.sos.state.co.us./CCR/welcome.do. Individuals may
-inspect or obtain a copy of the rule at the BHA, 710 S. Ash Street, Unit C140, Denver, CO 80246,
-during regular business hours.
-
-2.16
-
-Critical Incident Reporting
-
-A.
-
-A critical incident includes but is not limited to the following:
-1.
-
-Breach of confidentiality: any unauthorized disclosure of protected health information as
-described in HIPAA, 42 C.F.R. Part 2, and/or Section 27-65-101 through -131, C.R.S.
-
-2.
-
-Death: including the death of an individual inside of or outside of the BHE’s physical
-location while an individual is receiving services or where an individual has attempted to
-receive services from the BHE within the past thirty (30) calendar days.
-
-3.
-
-Elopement: absconding from a mental health hold, certification, emergency/involuntary
-commitment, or a secure facility where an individual is being held as a result of a court
-order. This includes any unauthorized absence of a child, when a child cannot be
-accounted for or when there is reasonable suspicion to believe the child has absconded.
-
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-
-4.
-
-2 CCR 502-1
-
-Any instance when an individual cannot be located following a search of the BHE, the
-BHE grounds, and the area surrounding the BHE, and:
-a.
-
-There are circumstances that place the individual’s health, safety, or welfare at
-risk; or
-
-b.
-
-The individual has been missing for eight (8) hours.
-
-5.
-
-Medication diversion: any medication diversion as defined in part 1.2 of these rules if the
-diverted drugs are injectable, the BHE shall also report the full name and date of birth of
-any individual who diverted the injectable drugs, if known.
-
-6.
-
-Medication error: medication error that resulted or could have resulted in harm to the
-individual.
-
-7.
-
-Medical emergency: any suicide attempt/self-injury, other form of serious injury, health
-emergency, overdose or serious illness which occurred on BHE premises or in the
-presence of BHE personnel.
-
-8.
-
-Any instance involving physical, sexual, or verbal abuse of an individual, as described in
-Sections 18-3-202, 18-3-203, 18-3-204, 18-3-206, 18-3-402, 18-3-404, 18-3-405, 18-3405.3, 18-3-405.5, and 18-9-111 (exempting however, the phrase “intended to harass”),
-C.R.S. by another individual, personnel, or a visitor to the BHE.
-
-9.
-
-Any instance that results in any of the following serious injuries to an individual:
-a.
-
-Brain or spinal cord injuries;
-
-b.
-
-Life-threatening complications of anesthesia or life-threatening transfusion errors
-or reactions; or,
-
-c.
-
-Second- or third-degree burns involving twenty percent (20%) or more of the
-body surface area of an adult or more than fifteen percent (15%) of the body
-surface area of a child.
-
-10.
-
-Any instance involving caretaker neglect of an individual, as defined in 26-3.1-101(2.3),
-C.R.S. or child abuse or neglect as defined in 19-1-103(1), C.R.S.
-
-11.
-
-Any instance involving misappropriation of an individual’s property, meaning patterns of
-loss or single incidences of deliberately misplacing, exploiting, or wrongfully using, either
-temporarily or permanently, an individual’s belongings or money without the individual’s
-consent.
-
-12.
-
-Any occurrence involving the malfunction or intentional or accidental misuse of care
-equipment that occurs during treatment or diagnosis of an individual and that significantly
-or adversely affects or, if not averted, would have significantly adversely affected an
-individual.
-
-B.
-
-Critical incidents must be reported to the BHA within one (1) business day after the incident.
-Critical incidents must also be reported to the BHA within one (1) business day of when the BHE
-determines that a reportable incident has occurred and the BHA requests such reporting.
-
-C.
-
-The BHA may conduct scheduled or unscheduled site reviews for specific monitoring purposes
-and investigation of critical incidents reports in accordance with:
-
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-2 CCR 502-1
-
-1.
-
-BHA policies and procedures,
-
-2.
-
-Regulations that protect the confidentiality and individual rights in accordance with
-Sections 27-65-101 through -131, C.R.S.; HIPAA; and 42 C.F.R. Part 2,
-
-3.
-
-Controlled Substance Licensing; Section 27-81-113, C.R.S.; Section 27-80-212, C.R.S.,
-and Section 18-18-503, C.R.S.
-
-D.
-
-The BHA shall have access to relevant documentation required to determine compliance with
-these rules.
-
-E.
-
-The BHE must:
-1.
-
-Establish written policies and procedures for reporting and reviewing all critical incidents
-occurring at the BHE;
-
-2.
-
-Submit critical incidents reports to the BHA using state prescribed forms that can be
-obtained from the BHA’s website at https://bha.colorado.gov/for-providers. This is not in
-lieu of other reporting mandated by state statute or federal guidelines;
-
-3.
-
-Make available a report with the investigation findings for review by the BHA, upon
-request; and,
-
-4.
-
-Maintain critical incidents reports for a minimum of three (3) years following the incident
-unless it would violate any other federal or state law.
-
-F.
-
-Nothing in this part shall be construed to limit or modify any statutory or common law right,
-privilege, confidentiality, or immunity.
-
-2.17
-
-Quality Management Program
-
-A.
-
-Every BHE must have a quality management program (QMP) designed to improve individual
-safety and well-being. The individual safety component of the program must implement
-improvements in response to patterns and trends associated with service delivery errors and
-potential for error. The individual well-being component of the QMP must implement
-improvements that are not necessarily tied to errors or potential for error but instead to the
-continuous quality improvement principle that opportunities always exist to enhance service
-delivery.
-
-B.
-
-The BHE must implement the QMP in accordance with a quality management plan that is
-reviewed and approved annually by the governing body. The plan must have the following
-elements:
-1.
-
-Identification of quality management programs
-a.
-
-For the individual safety component of the QMP, the plan must identify:
-(1)
-
-The types of service delivery errors and potential for error that will be
-monitored, which must be based, at minimum, on a review of negative
-individual outcomes that are unanticipated, individual disputes, critical
-incidents, deficiencies cited by regulatory agencies, occurrences and/or
-errors, and potential for errors reported by personnel.
-
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-
-2.
-
-C.
-
-2 CCR 502-1
-
-(2)
-
-A process for personnel to report service delivery error and potential for
-error within a prescribed period of time and a plan for how personnel will
-be trained regarding such reporting.
-
-(3)
-
-The methods used to collect and analyze data to find patterns and
-trends. The plan must also include how the governing body, if applicable,
-and the administrator will be informed of such patterns and trends.
-
-(4)
-
-The method(s) used to select quality management projects.
-
-(5)
-
-The method(s) for selecting the service delivery practice(s) that will be
-reviewed.
-
-Implementation of the individual well-being component
-a.
-
-The plan must include development of improvement strategies. This may include
-identifying the personnel that will be involved in designing the intervention,
-opportunities for individual input, and the administrative approvals needed to
-finalize the intervention design.
-
-b.
-
-The plan must document each improvement strategy including:
-(1)
-
-A description of the intervention design. For individual safety
-improvements, this must include how information about patterns and
-trends will be shared with personnel and how the underlying systemic
-problem(s) that led to the pattern or trend will be addressed.
-
-(2)
-
-How personnel will be allocated and/or trained to implement the strategy.
-
-(3)
-
-How the strategy will be evaluated for effectiveness.
-
-(4)
-
-Timelines for implementation and evaluation of the strategy and how the
-BHE is tracking the meeting of these milestones.
-
-The BHA may audit a BHE’s QMP to determine compliance with part 2.17 of this Chapter.
-1.
-
-If the BHA determines that an investigation of any incident or outcome is necessary, it
-may, unless otherwise prohibited by law, investigate and review documents related to the
-incident or outcome to determine actions taken by the BHE.
-
-2.18
-
-Initial Application Procedure
-
-A.
-
-Any person or business entity seeking a license to operate a BHE shall initially notify the BHA by
-submitting a letter of intent. Upon receipt of a letter of intent, the BHA will open a license
-application file.
-
-B.
-
-The applicant must provide the BHA with a complete application including all information and
-attachments specified in the application form, which is available to access on the BHA’s website,
-and any additional information requested by the BHA. The appropriate non-refundable fee(s) for
-the license category requested must be submitted with the application. Applications must be
-submitted at least ninety (90) calendar days before the anticipated start-up date.
-1.
-
-A license application may be considered abandoned if the applicant fails to complete the
-application within twelve (12) months. The BHA may administratively close the
-application process.
-
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-2.
-
-2 CCR 502-1
-
-After an administrative closure, the applicant may file a new license application along with
-the corresponding initial license fee.
-
-C.
-
-With the submission of an application for a license to operate a BHE, or within ten (10) days after
-a change in ownership or management of a BHE, each owner and manager shall submit a
-complete set of the owner's and manager's fingerprints to the Colorado Bureau of Investigation
-(CBI) for the purpose of conducting a fingerprint-based criminal history record check. The CBI
-shall forward the fingerprints to the Federal Bureau of Investigation (FBI) for the purpose of
-conducting fingerprint-based criminal history record checks. Each owner and each manager shall
-pay the CBI the costs associated with the fingerprint-based criminal history record check. Upon
-completion of the criminal history record check, the CBI shall forward the results to the BHA. The
-BHA may acquire a name-based criminal history record check for an applicant who has twice
-submitted to a fingerprint-based criminal history record check and whose fingerprints are
-unclassifiable.
-
-D.
-
-Each applicant must provide the following information:
-1.
-
-The legal name of the applicant and all other names used by it to provide services. The
-BHE has a continuing duty to submit notification to the BHA for all name changes at least
-thirty (30) calendar days prior to the effective date of the change.
-a.
-
-Applicants for initial licensure must submit a distinctive license name that does
-not need to include the services to be provided, but it may not mislead or confuse
-the public regarding the license or type of services to be provided.
-
-b.
-
-Duplication of an existing name is prohibited except between agencies that are
-affiliated through ownership or controlling interest.
-
-c.
-
-Each BHE shall be identified by this distinctive name on stationery, billing
-materials, and exterior signage that clearly identifies the licensed entity. Exterior
-signage must conform to the applicable local zoning requirements.
-
-d.
-
-If the BHE has a “doing business as” name, it must hold itself out to the public
-using such name, as it appears on the license.
-
-2.
-
-Contact information for the BHE must include a mailing address, telephone number, and
-e-mail addresses. If applicable, the BHE’s website and facsimile number must be
-provided.
-
-3.
-
-The identity, address, and telephone number of all persons and business entities with a
-controlling interest in the BHE, including but not limited to:
-a.
-
-A non-profit corporation shall list the governing body and officers.
-
-b.
-
-A for-profit corporation shall list the names of the officers and stockholders who
-directly or indirectly own or control five percent or more of the shares of the
-corporation.
-
-c.
-
-A sole proprietor shall include proof of lawful presence in the United States.
-
-d.
-
-A partnership shall list the names of all partners.
-
-e.
-
-The chief executive officer of the BHE.
-
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-f.
-
-2 CCR 502-1
-
-If the addresses and telephone numbers provided above are the same as the
-contact information for the BHE itself, the BHE shall also provide an alternate
-address and telephone number for at least one person for use in the event of an
-emergency or closure of the BHE.
-
-4.
-
-Proof of professional liability insurance. BHEs must maintain such coverage for the
-duration of the license term and must notify the BHA of any change in the amount, type,
-or provider of professional liability insurance coverage during the license term.
-
-5.
-
-Articles of incorporation, Articles of organization, partnership agreement, or other
-organizing documents required by the secretary of state to conduct business in Colorado;
-and by-laws or equivalent documents that govern the rights, duties, and capital
-contributions of the business entity.
-
-6.
-
-The address(es) of the physical location(s) where services are delivered, as well as, if
-different, where records are stored for BHA review.
-
-7.
-
-A map for each floor of the BHE’s buildings indicating room layout, services to be
-provided in each of the rooms, the proposed physical extent of the license within each
-building, and all occupancies contiguous to the BHE regardless if services are being
-delivered under the terms of the license.
-a.
-
-If services are delivered in multiple buildings located on a campus, a street map
-of the campus must be submitted that indicates which buildings and floors are
-occupied as part of the license.
-
-b.
-
-Maps must be submitted to the BHA.
-
-8.
-
-A copy of any management agreement pertaining to operation of the entity that sets forth
-the financial and administrative responsibilities of each party.
-
-9.
-
-If an applicant leases one or more building(s) to operate under the license, a copy of the
-lease or leases must be filed with the license application and show clearly in its context
-which party to the agreement is to be held responsible for the physical condition of the
-property.
-
-10.
-
-A statement, on the applicant’s letterhead, if available, signed and dated, submitted with
-the application stating whether any of the actions listed in this part 2.17.D.10.a.(2) of
-these rules have occurred, regardless of whether the action has been stayed in a judicial
-appeal or otherwise settled between the parties. The actions are to be reported if they
-occurred within ten (10) years preceding the date of the application. For initial licensure,
-the BHA may, based upon information received in the statement, request additional
-information from the applicant beyond the ten-year time frame.
-a.
-
-For initial licensure of the BHE, whether one or more individuals or entities
-identified in the response to part 2.18.D.3 of this Chapter has a controlling or
-ownership interest in the BHE and has been the subject or party to any of the
-following:
-(1)
-
-A civil judgment or criminal conviction resulting from conduct or an
-offense in the operation, management or ownership of a BHE or other
-entity related to substandard care or health care fraud. A guilty verdict, a
-plea of guilty, or a plea of nolo contendere (no contest) accepted by the
-court is considered a conviction.
-
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-b.
-
-11.
-
-2 CCR 502-1
-
-(2)
-
-A disciplinary action imposed upon the BHE by a governmental entity in
-another state that registers or licenses agencies including but not limited
-to, a sanction, probation, civil penalty, or a denial, suspension,
-revocation, or modification of a license or registration.
-
-(3)
-
-Limitation, denial, revocation, or suspension by any federal, state, or
-local authorities of any health care related license.
-
-(4)
-
-The refusal to grant or renew a license for operation of a BHE, or
-contract for participation or certification for Medicaid, Medicare, or other
-public health or social services payment program.
-
-For a change of ownership of a BHE, whether any of the new owners have been
-the subject of, or a party to, one of more of the following events:
-(1)
-
-A civil judgment or a criminal conviction in a case brought by the federal,
-state, or local authorities that resulted from the operation, management,
-or ownership of a BHE or other entity related to substandard care or
-health care fraud.
-
-(2)
-
-Limitation, denial, revocation, or suspension of a state license or federal
-certification by another jurisdiction.
-
-Any statement regarding the information requested in 2.18.D.10 of this Chapter must
-include the following, as applicable:
-a.
-
-If the event is an action by a governmental agency, as described in part
-2.18.D.10.b: the name of the agency, its jurisdiction, the case name, and the
-docket proceeding or case number by which the event is designated, and a copy
-of the consent decree, order, or decision.
-
-b.
-
-If the event is a felony conviction or misdemeanor involving moral turpitude: the
-court, its jurisdiction, the case name, the case number, a description of the
-matter or a copy of the indictment or charges, and any plea or verdict entered by
-the court. For the purposes of this rule, “crimes of moral turpitude” include the
-following felony, misdemeanors, or municipal offenses:
-(1)
-
-Any of the offenses against the person set forth in Title 18, Article 3 of
-the Colorado Revised Statutes. Examples of such offenses include, but
-are not limited to, any assault, menacing, or unlawful sexual behavior;
-
-(2)
-
-Any of the offenses against property set forth in Title 18, Article 4 of the
-Colorado Revised Statutes. Examples of such offenses include, but are
-not limited to, any arson, theft, trespass, or criminal mischief;
-
-(3)
-
-Any of the offenses involving fraud set forth in Title 18, Article 5 of the
-Colorado Revised Statutes;
-
-(4)
-
-Computer crime as set forth in Title 18, Article 5.5 of the Colorado
-Revised Statutes;
-
-(5)
-
-Any of the offenses involving the family relations set forth in Title 18,
-Article 6, Part 4 (wrongs to children), when committed intentionally and
-knowingly or recklessly; Part 6 (harboring a minor); or Part 8 (domestic
-violence), of the Colorado Revised Statutes;
-
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-
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-
-(6)
-
-Any of the offenses constituting wrongs to at-risk adults set forth in Title
-18, Article 6.5 of the Colorado Revised Statutes;
-
-(7)
-
-Any of the offenses relating to morals set forth in Title 18, Article 7 of the
-Colorado Revised Statutes. Examples of such offenses include, but are
-not limited to, prostitution, indecent exposure, and criminal invasion of
-privacy;
-
-(8)
-
-Any other offense in any jurisdiction whatsoever that is committed
-intentionally, knowingly, or recklessly, and involves violence, coercion,
-threats, cruelty, fraud, deception, or deprivation of legally recognized
-rights; and,
-
-(9)
-
-Any conspiracy, solicitation, or criminal attempt to commit any of the
-above offenses, or participation as an accessory to any of the above
-offenses.
-
-If the event is a civil action or arbitration proceeding: the court or arbiter, the
-jurisdiction, the case name, the case number, a description of the matter or a
-copy of the complaint, and a copy of the verdict of the court or arbitration
-decision.
-
-E.
-
-The BHA will not issue or renew a BHE license unless it has received a certificate of compliance
-as defined in Chapter 1 of these rules for each physical location where services are provided
-
-F.
-
-Each application must be signed under penalty of perjury by an authorized corporate officer,
-general partner, member, or sole proprietor of the BHE as appropriate.
-
-G.
-
-The BHA shall conduct a preliminary assessment of the application and notify the applicant of any
-application defects.
-1.
-
-H.
-
-The applicant shall respond within fourteen (14) calendar days to written notice of any
-application defect.
-
-License fees must be submitted to the BHA as specified below:
-1.
-
-An applicant for an initial license as a BHE shall submit the following nonrefundable
-fee(s) with the application for licensure, as applicable:
-a.
-
-A base fee of $500, regardless of endorsements or physical locations included as
-part of the application for initial licensure. The base fee includes one physical
-location in which services are to be provided under an outpatient endorsement as
-defined in part 2.3.A.3 of this Chapter.
-
-b.
-
-A fee of $300 for each additional physical location in which services are to be
-provided under an outpatient endorsement as defined in part 2.3.A.3 of this
-Chapter included as part of the application for initial licensure, to be paid only by
-applicants that are seeking licensure that includes endorsement for outpatient
-services.
-
-c.
-
-A fee of $600 for each physical location in which services are to be provided
-under a residential/overnight endorsement as defined in part 2.3.A.4 of this
-Chapter, to be paid only by applicants seeking such endorsement.
-
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-d.
-2.
-
-2 CCR 502-1
-
-Endorsements for services not listed in parts 2.3.A.3 or 2.3.A.4 shall not require a
-fee.
-
-A BHE may apply to add an endorsement to its license at any time with the submission of
-fees outlined in part 2.20.H.1.b and part 2.20.H.1.c.
-
-I.
-
-The duration of the initial license will be one (1) year from the date of issuance.
-
-J.
-
-The BHA will provide written notice to the applicant within thirty (30) calendar days of receipt of a
-complete application.
-
-K.
-
-The BHA will act on an application within thirty (30) calendar days of receipt of the completed
-application.
-
-2.19
-
-Provisional Licenses
-
-A.
-
-Where an applicant for an initial license fails to fully conform to the applicable statutes and
-regulations but the BHA determines the applicant is in substantial compliance with these rules
-and regulations and is temporarily unable to conform to all the minimum standards, a provisional
-license may be granted. No provisional license may be issued to an applicant if the operations
-may adversely affect the health, safety, or welfare of individuals, personnel, or other persons. A
-provisional license will only be issued upon payment of the non-refundable provisional license
-fee.
-1.
-
-A provisional license will be valid for ninety (90) days.
-
-2.
-
-A second provisional license may be issued if the BHA determines that it is likely
-compliance can be achieved by the date of expiration of the second provisional license.
-
-3.
-
-The second provisional license may be issued for the same duration as the first upon
-payment of a second non-refundable provisional license fee. The BHA will not issue a
-third or subsequent provisional license to the applicant.
-
-4.
-
-During the term of the provisional license, the BHA shall conduct any review it deems
-necessary to determine if the applicant meets the requirements for a regular license.
-
-5.
-
-If the BHA determines, prior to expiration of the provisional license, that the applicant is in
-compliance with all applicable rules, it may issue a regular license upon payment of the
-applicable initial license fee. The regular license will be valid for one (1) year from the
-date of issuance of the regular license, unless otherwise acted upon pursuant to part 2.24
-of this Chapter.
-
-2.20
-
-License Renewal
-
-A.
-
-A BHE seeking renewal must provide the BHA with a license application, signed under penalty of
-perjury by an authorized corporate officer, general partner, member, or sole proprietor of the BHE
-as appropriate, and the appropriate fee at least sixty (60) calendar days prior to the expiration of
-the existing license. Renewal applications shall contain the information required in part 2.18.D of
-this Chapter unless the information has been previously submitted and no changes have been
-made to the information currently held by the BHA.
-
-B.
-
-Failure to submit a completed renewal application to the BHA thirty (30) calendar days prior to
-expiration of the existing license will result in assessment of a late fee in an amount equal to the
-renewal fee.
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-
-C.
-
-Failure of the BHE to accurately answer or report any of the information requested by the BHA
-will be considered good cause to deny the license renewal application.
-
-D.
-
-The BHA shall conduct a preliminary assessment of the renewal application and notify the BHE of
-any application defects.
-1.
-
-E.
-
-The BHE shall respond within fourteen (14) calendar days to written notice of any
-application defect.
-
-A BHE submitting a renewal application shall submit the following nonrefundable fees, as
-applicable:
-1.
-
-A base fee of $500, regardless of endorsements or physical locations included as part of
-the application for licensure renewal. The base fee includes one physical location in
-which services are to be provided under an outpatient endorsement as defined in part
-2.3.A.3 of this Chapter.
-
-2.
-
-A fee of $300 for each additional physical location in which services are to be provided
-under an outpatient endorsement as defined in part 2.3.A.3 of this Chapter included as
-part of the application for licensure renewal, to be paid only by applicants that are
-seeking licensure that includes endorsement for outpatient services.
-
-3.
-
-A fee of $600 for each physical location in which services are to be provided under a
-residential/overnight endorsement as defined in part 2.3.A.4 of this Chapter, to be paid
-only by applicants seeking such endorsement.
-
-4.
-
-Endorsements for services not listed in parts 2.3.A.3 or 2.3.A.4 shall not require a fee.
-
-F.
-
-The duration of the renewal license will be one (1) year from issuance.
-
-2.21
-
-Change of Ownership/Management
-
-A.
-
-If a BHE undergoes a change in ownership without following the procedures outlined in this part
-2.21, their existing license may be terminated. Termination of the license may not occur until after
-a hearing and in compliance with the provisions and procedures specified in 24-4-101 through 109, C.R.S.
-
-B.
-
-When a BHE initiates a change of ownership, the BHE must submit notification to the BHA within
-the specified time frame, and the prospective new BHE shall submit an application and
-supporting documentation for change of ownership along with the requisite fees in part 2.21.G of
-this Chapter within the same time frame. The time frame for submission of the notification and the
-application and supporting documentation shall be at least thirty (30) calendar days before a
-change of ownership involving any BHE.
-
-C.
-
-The BHA will consider the following criteria in determining whether there is a change of ownership
-of a BHE that requires a new license. The transfer of fifty percent (50%) of the ownership interest
-referred to in this part 2.21 may occur during the course of one transaction or during a series of
-transactions occurring over a five-year period.
-1.
-
-Sole proprietors:
-a.
-
-The transfer of at least fifty percent (50%) of the ownership interest in a BHE
-from a sole proprietor to another individual, whether or not the transaction affects
-the Title to real property, shall be considered a change of ownership.
-
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-b.
-
-2.
-
-3.
-
-4.
-
-5.
-
-Change of ownership does not include forming a corporation from the sole
-proprietorship with the proprietor as the sole shareholder or forming a limited
-liability company from sole proprietorship with the proprietor as the sole member.
-
-Partnerships:
-a.
-
-Dissolution of the partnership and conversion into any other legal structure shall
-be considered a change of ownership if the conversion also includes a transfer of
-at least fifty percent (50%) of the ownership to one or more new owners.
-
-b.
-
-Change of ownership does not include dissolution of the partnership to form a
-corporation with the same persons retaining ownership in the new corporation.
-
-Corporations:
-a.
-
-Merger of two or more corporations resulting in the creation of a new corporate
-entity will be considered a change of ownership if the consolidation includes a
-transfer of at least fifty percent (50%) of the ownership to one or more new
-owners.
-
-b.
-
-Formation of a corporation from a partnership, a sole proprietorship, or a limited
-liability company will be considered a change of ownership if the change includes
-a transfer of at least fifty percent (50%) of the ownership to one or more new
-owners.
-
-c.
-
-The transfer, purchase, or sale of shares in the corporation such that at least fifty
-percent (50%) of the ownership of the corporation is shifted to one or more new
-owners will be considered a change of ownership.
-
-Limited liability companies:
-a.
-
-The transfer of at least fifty percent (50%) of the ownership interest in the
-company will be considered a change of ownership.
-
-b.
-
-The termination or dissolution of the company and the conversion thereof into
-any other entity will be considered a change of ownership if the conversion also
-includes a transfer of at least fifty percent (50%) of the ownership to one or more
-new owners.
-
-c.
-
-Change of ownership does not include transfers of ownership interest between
-existing members if the transaction does not involve the acquisition of ownership
-interest by a new member.
-
-Non-profits:
-a.
-
-6.
-
-2 CCR 502-1
-
-The transfer of at least fifty percent (50%) of the controlling interest in the
-nonprofit is considered a change of ownership.
-
-Management contracts, leases, or other operational arrangements:
-a.
-
-If the BHE enters into a lease arrangement or management agreement whereby
-the owner retains no authority or responsibility for the operation and
-management of the BHE, the action will be considered a change of ownership
-that requires a new license.
-
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-7.
-
-2 CCR 502-1
-
-Legal structures:
-a.
-
-The conversion of a BHE’s legal structure, or the legal structure of a business
-entity that has an ownership interest in the BHE is a change of ownership if the
-conversion also includes a transfer of at least fifty percent (50%) of the BHE’s
-ownership interest to one or more new owners.
-
-D.
-
-Each BHE undergoing a change of ownership shall submit an application as prescribed in 2.18.B
-through 2.18.F of this Chapter.
-
-E.
-
-The existing BHE is responsible for correcting all rule violations and deficiencies in any current
-plan of action before the change of ownership becomes effective. In the event that such
-corrective actions cannot be accomplished in the time frame specified, the prospective BHE shall
-be responsible for all uncorrected rule violations and deficiencies including any current plan of
-action submitted by the previous BHE unless the prospective BHE submits a revised plan of
-action, approved by the BHA, before the change of ownership becomes effective.
-
-F.
-
-When the BHA issues a license to the new owner, the previous owner must return its license to
-the BHA within five (5) calendar days of the new owner’s receipt of its license.
-
-G.
-
-For a change of ownership, a BHE must submit the following nonrefundable fee(s) with the
-application for licensure, as applicable:
-1.
-
-A base fee of $500, regardless of endorsements or physical locations included as part of
-the application for licensure. The base fee includes one physical location in which
-services are to be provided under an outpatient endorsement as defined in part 2.3.A.3 of
-this Chapter.
-
-2.
-
-A fee of $300 for each additional physical location in which services are to be provided
-under an outpatient endorsement as defined in part 2.3.A.3 of this Chapter included as
-part of the application for licensure, to be paid only by applicants that are seeking
-licensure that includes endorsement for outpatient services.
-
-3.
-
-A fee of $600 for each physical location in which services are to be provided under a
-residential/overnight endorsement as defined in part 2.3.A.4 of this Chapter, to be paid
-only by applicants seeking such endorsement.
-
-4.
-
-Endorsements for services not listed in parts 2.3.A.3 or 2.3.A.4 shall not require a fee.
-
-2.22
-
-Rule Waivers
-
-A.
-
-This part establishes procedures with respect to waiver of regulations relating to BHE licensing.
-
-B.
-
-Any BHE or applicant that has applied for or been issued a license to operate a BHE has the right
-to apply for a waiver of any rule or standard set forth in these rules which, in their opinion, poses
-an undue hardship on the applicant, BHE, or community.
-
-C.
-
-Nothing contained in these provisions abrogates the BHE's obligation to meet minimum
-requirements under local safety, fire, electrical, building, zoning, and similar codes.
-
-D.
-
-Nothing herein authorizes a waiver of any statutory requirement under state or federal law, except
-to the extent permitted therein.
-
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-
-E.
-
-Upon application to the BHA, a waiver may be granted in accordance with this part 2.22. Absent
-the existence of a current waiver issued pursuant to this part, BHEs are expected to comply at all
-times with all applicable regulations except in instances where they are granted a provisional
-license in accordance with part 2.19 of this Chapter. BHEs must comply with all regulations in this
-part as well as all regulations in the endorsement parts of these rules (i.e., Chapters 3 through
-10) that apply to a BHE unless and until a waiver is granted.
-
-F.
-
-Waiver applications must be submitted to the BHA in writing.
-1.
-
-The BHA will only consider one regulation per waiver.
-
-2.
-
-The waiver application must provide the BHA information related to:
-
-3.
-
-G.
-
-a.
-
-The regulation the BHE or applicant is requesting to waive;
-
-b.
-
-The reason why the waiver is being requested;
-
-c.
-
-A proposed alternate compliance plan;
-
-d.
-
-Any other information relevant to the waiver request that would inform the BHA’s
-decision in either granting or denying the waiver.
-
-The waiver application must be signed by an authorized representative of the BHE or
-applicant, who is the primary contact person and the person responsible for ensuring that
-accurate and complete information is provided to the BHA.
-
-In making its determination, the BHA may consider any information it deems relevant, including
-but not limited to:
-1.
-
-Critical incident and complaint investigation reports, licensure or certification survey
-reports, anticipated impact of the waiver on individual safety and quality of care if any,
-and findings of these reports related to the BHE and/or the operator or owner thereof.
-
-2.
-
-When determining whether a waiver should be granted, the BHA shall prioritize
-consideration of the impact of the waiver on the health, safety, and welfare of individuals
-over any alleged undue hardship.
-
-H.
-
-The BHA shall act on a waiver application within ninety (90) calendar days of receipt of the
-completed application. An application will not be deemed complete until the BHE has provided all
-information and documentation requested by the BHA.
-
-I.
-
-The BHA may specify terms and conditions under which any waiver is granted, including which
-terms and conditions must be met in order for the waiver to remain effective. The term for which
-each waiver granted will remain effective must be specified at the time of issuance but may not
-exceed the term of the current license.
-1.
-
-At any time, upon reasonable cause, the BHA may inspect a BHE with an active waiver
-to ensure that the terms and conditions of the waiver are being observed, and/or that the
-continued existence of the waiver is otherwise appropriate.
-
-2.
-
-Within thirty (30) calendar days of the termination, expiration, or revocation of a waiver,
-the BHE shall submit to the BHA an attestation of compliance with the regulation to which
-the waiver pertained.
-
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-J.
-
-K.
-
-2 CCR 502-1
-
-A waiver will automatically terminate upon a change of ownership of the BHE, as defined in part
-2.21 of this Chapter. However, to prevent such automatic termination, the prospective new owner
-may submit a waiver application to the BHA prior to the effective date of the change of ownership.
-Provided the BHA receives the new application by this date, the waiver will be deemed to remain
-effective until such time as the BHA acts on the application.
-1.
-
-Except as otherwise provided in this part 2.22, a waiver may not be granted for a term
-that exceeds the current license term.
-
-2.
-
-If a BHE wishes to maintain a waiver beyond the stated term, it must submit a new waiver
-application to the BHA not less than ninety (90) calendar days prior to the expiration of
-the current term of the waiver or with a license renewal.
-
-Notwithstanding anything in this part 2.22 to the contrary, the BHA may revoke a waiver if it
-determines that:
-1.
-
-The waiver's continuation jeopardizes the health, safety, or welfare of individuals served
-by the BHE;
-
-2.
-
-The waiver application contained false or misleading information;
-
-3.
-
-The terms and conditions of the waiver have not been complied with;
-
-4.
-
-The conditions under which a waiver was granted no longer exist or have changed
-materially; or,
-
-5.
-
-A change in a federal or state statute or regulation prohibits, or is inconsistent with, the
-continuation of the waiver.
-
-L.
-
-Notice of the revocation of a waiver must be provided to the BHE in accordance with the
-Colorado administrative procedures act, Section 24-4-101 through -109, C.R.S.
-
-M.
-
-A BHE may appeal the decision of the BHA regarding a waiver application or revocation, as
-provided in the Colorado administrative procedures act, Section 24-4-101 through -109, C.R.S.
-
-2.23
-
-Continuing Obligations and BHA Oversight
-
-A.
-
-Each BHE must have and maintain electronic business communication tools, including but not
-limited to, internet access and a valid e-mail address. The BHE must use these tools to receive
-and submit information.
-
-B.
-
-The license is only valid while in the possession of the BHE to whom it is issued and may not be
-subject to sale, assignment, or other transfer, voluntary or involuntary, nor is a license valid for
-any premises other than those for which it was originally issued.
-
-C.
-
-The BHE must provide accurate and truthful information to the BHA during inspections,
-investigations, and licensing activities.
-
-D.
-
-When a BHE is subject to inspection, certification, or review by other agencies, accrediting
-organizations, or inspecting companies, the BHE shall provide and/or release to the BHA, upon
-request, any correspondence, reports, or recommendations concerning the BHE that were
-prepared by such organizations.
-
-E.
-
-Each BHE must submit notification to the BHA of any change in the information required by part
-2.18.D of this Chapter from what was contained in the last submitted license application.
-
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-1.
-
-2 CCR 502-1
-
-Changes to the operation of the BHE may not be implemented without prior approval
-from the BHA. A BHE shall, at least thirty (30) calendar days in advance, submit
-notification to the BHA regarding any of the following proposed changes.
-a.
-
-Change in license category or classification.
-
-b.
-
-Change in the scope of services, including the addition or removal of an
-endorsement, a service, or a physical location.
-
-c.
-
-Change in legal name of the BHE and all other names used by it to provide
-services.
-
-F.
-
-The BHA and any duly authorized representatives thereof have the right to enter upon and into
-the premises of any licensed BHE or applicant for a BHE license in order to determine the state of
-compliance with the statutes and regulations and must initially identify themselves to the person
-in charge of the BHE at the time.
-
-G.
-
-Licensure surveys and tiered inspections
-1.
-
-For each BHE that is eligible, the BHA will either extend the standard licensure survey
-cycle up to three (3) years or utilize a tiered licensure inspection system.
-
-2.
-
-To be eligible, the BHE must meet all the following criteria:
-
-3.
-H.
-
-a.
-
-Licensed for at least three (3) years;
-
-b.
-
-No conditions imposed on the license within three (3) years prior to the date of
-the survey;
-
-c.
-
-No patterns of rule violations, which occurs when a BHE commits the same class
-of rule violation three or more times in consecutive inspections, as documented
-in the inspection and survey reports issued by the BHA within the three (3) years
-prior to the date of the inspection; and,
-
-d.
-
-No substantiated complaint resulting in the discovery of significant deficiencies
-that may negatively affect the life, health, or safety of individuals served by the
-BHE within the three (3) years prior to the date of the survey.
-
-The BHA may expand the scope of a tiered inspection to an extended or full survey if the
-BHA finds rule violations during the tiered inspection process.
-
-The BHA may use the following measures to ensure a BHE’s full compliance with the applicable
-statutory and regulatory criteria.
-1.
-
-The BHA may conduct an unscheduled or unannounced review of a current BHE based
-upon, but not limited to, the following criteria:
-a.
-
-Routine compliance inspection;
-
-b.
-
-Reason exists to question the BHE’s continued fitness to conduct or maintain
-licensed operations;
-
-c.
-
-A complaint alleging non-compliance with license requirements;
-
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-2.
-
-2 CCR 502-1
-
-d.
-
-Discovery of previously undisclosed information regarding a BHE or any of its
-owners, officers, managers, or other personnel if such information affects or has
-the potential to affect the BHE’s provision of services; or
-
-e.
-
-The omission of relevant information from documents requested by the BHA or
-indication of false information submitted to the BHA.
-
-Plan of action
-a.
-
-If after review or pursuant to a complaint, it is determined that a BHE is not in
-compliance with these rules, the BHE shall be notified in writing, within thirty (30)
-business days of the specific deficiency/deficiencies.
-
-b.
-
-After any review, the BHA may request a plan of action from a BHE or require a
-BHE’s compliance with a BHA directed plan of action.
-
-c.
-
-If the BHE does not agree with any or all the findings regarding non-compliance,
-the BHE has fourteen (14) business days from the receipt of non-compliance
-notice to dispute the findings by submitting evidence to the BHA.
-
-d.
-
-The BHE shall receive a written response within thirty (30) business days of the
-review of submitted evidence.
-
-e.
-
-If the submitted information is sufficient, the BHE shall be determined in
-compliance with these rules.
-
-f.
-
-If the BHE continues to be found out of compliance with these rules, the BHE
-shall have thirty (30) business days from the date of receipt of the review findings
-to submit a plan of action.
-
-g.
-
-The plan of action must be in the format prescribed by the BHA and included, but
-not be limited to, the following:
-(1)
-
-A description of how the BHE will correct each identified deficiency.
-(a)
-
-h.
-
-If deficient practice was cited for specific personnel, the
-description shall include the measures that will be put in place or
-systemic changes made to ensure that the deficient practice will
-not reoccur for the affected individuals(s) and/or other individuals
-having the potential to be affected.
-
-(2)
-
-A description of how the BHE will monitor the corrective action to ensure
-each deficiency is remedied and will not reoccur, and
-
-(3)
-
-A completion date that is no later than ninety (90) calendar days from the
-issuance of the deficiency list, unless otherwise required or approved by
-the BHA. The completion date is the date that the entity deems it can
-achieve compliance.
-
-A completed plan of action must be:
-(1)
-
-Signed by the BHE’s director, administrator, or manager, and
-
-(2)
-
-Submitted to the BHA within thirty (30) calendar days after the date of
-the BHA’s written notice of deficiencies.
-
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-
-(a)
-
-i.
-
-I.
-
-2 CCR 502-1
-
-If an extension of time is needed to complete the plan of action,
-the BHE shall request an extension in writing from the BHA prior
-to the plan of action due date. The BHA may grant an extension
-of time.
-
-The BHA has discretion to approve, impose, modify, or reject a plan of action.
-(1)
-
-If the plan of action is accepted, the BHA shall notify the BHE by issuing
-a written notice of acceptance.
-
-(2)
-
-If the plan of action is unacceptable, the BHA shall notify the BHE in
-writing, and the BHE shall re-submit the changes within the time frame
-prescribed by the BHA.
-
-(3)
-
-If the BHE fails to comply with the requirements or deadlines for
-submission of a plan or fails to submit requested changes to the plan, the
-BHA may reject the plan of action and impose disciplinary sanctions as
-set forth in part 2.24 of this Chapter.
-
-(4)
-
-If the BHE fails to implement the actions agreed to by the action date in
-the approved plan of action, the BHA may impose enforcement sanctions
-as set forth below.
-
-The BHE must provide, upon request, access to or copies of the following to the BHA for the
-performance of its regulatory oversight responsibilities:
-1.
-
-Individual records.
-
-2.
-
-Reports and information including but not limited to, staffing reports, census data,
-statistical information, and other records, as determined by the BHA.
-
-J.
-
-Oversight and enforcement activities may include review of endorsements and/or separate
-physical locations as necessary for the BHA to ensure the health, safety, and welfare of
-individuals.
-
-2.24
-
-Enforcement and Adverse Actions
-
-2.24.1 License, Designation, or Endorsement Denials
-A.
-
-The BHA may deny an application for an initial or renewal license, or an application for
-endorsement(s) for reasons including but not limited to, the following:
-1.
-
-The BHE has not fully complied with all local, state, and federal laws and regulations
-applicable to that license category, endorsement, or classification;
-
-2.
-
-The application or accompanying documents contain a false statement of material fact;
-
-3.
-
-The BHE fails to respond to BHA requests for additional information in the time frame
-indicated in the request;
-
-4.
-
-The BHE refuses any part of an inspection;
-
-5.
-
-The BHE fails to comply with or successfully complete an acceptable plan of action;
-
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-2 CCR 502-1
-
-6.
-
-The results of the background check reveal a felony or misdemeanor conviction of a
-crime of moral turpitude as described in part 2.18.D.11.b of this Chapter;
-
-7.
-
-The BHE has failed to cooperate with the investigation of any local, state, or federal
-regulatory body or law enforcement agency; or
-
-8.
-
-The BHE is not in compliance with regulatory requirements or has a documented pattern
-of non-compliance that has harmed or has the potential to harm the health or safety of
-the individual(s) served.
-
-B.
-
-If the BHA denies an application for an initial or renewal license, it shall provide the BHE with a
-written notice by mail to the applicant or licensee at the address shown on the application. The
-notice must explain the basis for the denial and afford the BHE the opportunity to respond.
-
-C.
-
-Appeals of licensure denials must be conducted in accordance with the State Administrative
-Procedure Act, Section 24-4-101 through -109, C.R.S. and 26-1-106, C.R.S.
-
-2.24.2 Revocation or Suspension of a License, Designation, or Endorsement
-A.
-
-The BHA may limit, revoke, or suspend an existing license or endorsement if a BHE fails or
-refuses to comply with the statutory and/or regulatory requirements applicable to its license and
-endorsements associated with its license. The BHA may limit the overall BHE license, any
-endorsements or physical locations, or any combination thereof for failure or refusal to comply.
-Failures to comply include, but are not limited to:
-1.
-
-Making a false statement of material fact about individuals served by the BHE, its
-personnel, capacity, or other operational components verbally or in any public document
-or in a matter under investigation by the BHA or another governmental entity,
-
-2.
-
-Preventing, interfering with, or attempting to impede in any way the work of a
-representative or agent of the BHA in investigating or enforcing the applicable statutes or
-regulations,
-
-3.
-
-Falsely advertising or in any way misrepresenting the BHE’s ability to provide services for
-the individuals served based on its license type or status,
-
-4.
-
-Failing to provide reports and documents required by regulation or statute in a timely and
-complete fashion,
-
-5.
-
-Failing to comply with or complete a plan of action in the time or manner specified,
-
-6.
-
-Falsifying records or documents,
-
-7.
-
-Knowingly using or disseminating misleading, deceptive, or false information,
-
-8.
-
-Accepting commissions, rebates, or other forms of remuneration for referrals or other
-treatment decisions, or
-
-9.
-
-Exercising undue influence or coercion over an individual to obtain certain decisions or
-actions or for financial or personal gain. A relationship other than a professional
-relationship, including but not limited to a relationship of a sexual nature, between an
-owner, director, manager, administrator, or other personnel and an individual.
-
-10.
-
-Noncompliance with the requirements of Sections 27-50-501 through 27-50-509, C.R.S.
-and any applicable regulations promulgated pursuant to those statutes.
-
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-B.
-
-C.
-
-2 CCR 502-1
-
-The BHA may revoke or suspend an existing license if one or more individuals or entities
-identified in the response to part 2.18.D.3 of this Chapter has a controlling or ownership interest
-in the BHE and:
-1.
-
-Has been the subject or party to any of the actions described in part 2.18.D.10.a:
-
-2.
-
-Has a felony or misdemeanor conviction of a crime of moral turpitude as described in part
-2.18.D.11.b of this Chapter.
-
-Except in the case of a summary suspension in accordance with 24-4-104(4)(a), C.R.S.,
-suspension or revocation must not occur until after a hearing and in compliance with the
-provisions and procedures specified in Section 24-4-101 through Section -109, C.R.S. and
-Section 27-50-505, C.R.S.
-
-2.24.3 Conditional Licenses
-A.
-
-If a BHE is found to be out of compliance with applicable BHA, state, or federal law or regulations,
-the BHA may impose conditions upon a license prior to issuing an initial or renewal license or
-during an existing license term. If the BHA imposes conditions on a license, the BHE shall
-immediately comply with all conditions until and unless said conditions are overturned or stayed
-on appeal.
-1.
-
-Imposition of conditions on a license does not constitute a modification to the license if
-the BHE agrees to the conditions. If an agreement is not reached, the BHE may appeal in
-accordance with part 2.24.5 of this Chapter, Section 24-4-101 through -109, and Section
-27-50-505, C.R.S.
-
-B.
-
-If conditions are imposed at the same time as an initial or renewal license, the BHE shall pay the
-applicable initial or renewal license fee plus the conditional fee equal to the amount of their initial
-or renewal license fee.
-
-C.
-
-If conditions are imposed during the license term, the BHE shall pay the conditional fee and the
-conditions must run concurrently with the existing license term.
-
-D.
-
-If the conditions are renewed in whole or in part for the next license term, the BHE shall pay the
-applicable renewal fee along with the conditional fee in effect at the time of renewal.
-
-E.
-
-If the BHA imposes conditions of continuing duration that require only minimal administrative
-oversight, it may waive the conditional fee after the BHE has complied with the conditions for a
-full license term.
-
-F.
-
-If a BHE holds a conditional license, it shall post a clearly legible copy of the license conditions in
-a conspicuous public place in the BHE.
-
-2.24.4 Intermediate Restrictions
-A.
-
-The BHA may impose the following intermediate restrictions or conditions on a BHE in
-accordance with Section 27-50-505 (3), C.R.S.:
-1.
-
-Retaining a consultant to address corrective measures including deficient practice
-resulting from systemic failure;
-
-2.
-
-Monitoring by the BHA for a specific period;
-
-3.
-
-Providing additional training to employees, owners, or operators of the BHE;
-
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-B.
-
-2 CCR 502-1
-
-4.
-
-Complying with a directed written plan to correct the violation; or
-
-5.
-
-Paying a civil fine not to exceed two thousand dollars ($2,000) in a calendar year. The
-assessment of these fines shall follow the procedures set forth in Section 26.5.-5-323,
-C.R.S.
-
-The BHE may appeal any intermediate restriction or condition to the BHA in accordance with the
-Colorado Administrative Procedures Act Section 24-4-101 through -109, C.R.S.
-
-2.24.5 Right to Appeal
-A.
-
-Any BHE adversely affected or aggrieved by the BHA’s decisions in regard to implementation of
-these rules, has the right to appeal to the Colorado Department of Personnel and Administration,
-Office of Administrative Courts, and may subsequently seek judicial review of the BHA’s action in
-accordance with Section 24-4-101 through -109, C.R.S.
-
-B.
-
-The following actions may be submitted to an administrative law judge for an evidentiary hearing:
-denial of a license, designation, or endorsement; denial of a renewal; provisional license;
-conditional license; revocation; denial of a waiver; limitation of a license, denial of a modification;
-and imposition of an intermediate restriction or condition.
-
-C.
-
-After written notification from the BHA of intended action, the BHE has twenty-one (21) calendar
-days to submit a written appeal. The appeal must be received by the BHA within twenty-one (21)
-days from the date the written notification of action letter was sent by the BHA.
-
-D.
-
-In all cases except waiver denials, the BHA will file a notice of charges with the office of
-administrative courts to begin the administrative process. In waiver denials, if the applicant for the
-waiver requests an appeal, the request for appeal must be forwarded to the office of
-administrative courts. Once the appellant’s request is forwarded to the office of administrative
-courts, the BHA may file a notice of charges.
-
-E.
-
-Subsequent to an evidentiary hearing at the office of the administrative courts and the issuance of
-a final agency decision, a party may seek to appeal the final agency decision through judicial
-review in accordance with Section 24-4-106, C.R.S.
-
-2.25
-
-BHE Closure
-
-A.
-
-Each license issued by the BHA will become invalid if the BHE fails to timely renew the license,
-ceases operation, or there is final BHA action suspending or revoking the license. The license
-must be returned to the BHA within ten (10) calendar days of the event that invalidated it.
-
-2.25.1 Emergency Closures
-A.
-
-In the event of an emergency affecting the physical space of the BHE that necessitates the
-removal of individuals and personnel from the BHE, a BHE shall provide the BHA with verbal
-notice of the event at the time of removal and a written report within fourteen (14) calendar days
-after the removal explaining the emergent situation and the actions taken by the BHE to provide
-services that meet the health and safety needs of the individuals. Based on the extenuating
-circumstances, the BHA may approve the continuation of the license during the time period that it
-takes to make the physical space appropriate for individuals and personnel to return.
-
-2.25.2 Permanent Closures
-A.
-
-Each BHE that surrenders its license shall accomplish the following with regard to any individual
-records that the entity is legally obligated to maintain:
-
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-2 CCR 502-1
-
-1.
-
-Within ten (10) calendar days prior to closure, inform the BHA in writing of the specific
-plan for storage and retrieval of individual records;
-
-2.
-
-Unless noted otherwise within an endorsement Chapter, within ten (10) calendar days of
-closure, inform all individuals or designated representatives thereof, in writing, how and
-where to obtain their individual records; and
-
-3.
-
-Provide secure storage for any remaining individual records.
-
-B.
-
-In the event of a BHE closure, the BHE shall be responsible for appropriate continuity of care for
-each individual served by the BHE.
-
-2.26
-
-Residential and Overnight Standards
-
-A.
-
-A BHE providing residential and/or overnight services as defined in part 2.3.A.4 of this Chapter
-shall meet the standards in this part 2.26.
-
-B.
-
-Each physical location in which residential and/or overnight services are provided must meet the
-following personnel requirements:
-1.
-
-Each physical location must have appropriate oversight personnel, such as an
-administrator and/or clinical director, or personnel delegated those same responsibilities,
-available twenty-four (24) hours per day, seven (7) days per week.
-a.
-
-2.
-
-C.
-
-D.
-
-Oversight personnel when the administrator and/or clinical director are not
-physically on-site must be in accordance with policies as required at part
-2.2.4.A.6 of this Chapter.
-
-Each physical location must have at least one person trained in cardio-pulmonary
-resuscitation (CPR) and first aid on-site and on-duty at all times when individuals are
-present.
-
-Personnel providing services under the residential/overnight endorsement shall be trained in the
-following:
-1.
-
-The recognition and response to common side effects of medications used for behavioral
-health disorders, and response to emergency drug reactions;
-
-2.
-
-Behavior management and de-escalation techniques, including incidents involving harm
-to self or others, and elopement; and,
-
-3.
-
-Behavioral health and medical emergency response training, consistent with emergency
-services policies required in parts 2.9.D and 2.9.E of this Chapter.
-
-4.
-
-Personnel preparing or serving food shall complete food safety training. At a minimum,
-this must include that personnel overseeing dietary services shall have knowledge of
-foodborne disease prevention, including, but not limited to, hygienic practices and food
-safety techniques pertaining to preparation, food storage, and dishwashing.
-
-The BHE shall have policies and procedures specific to the residential/overnight endorsement,
-services, or physical location, as applicable, including, but not limited to:
-1.
-
-Policies and procedures to be followed in the event of serious illness, injury, or death of
-an individual during their stay, including, but not limited to:
-
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-2 CCR 502-1
-
-a.
-
-Criteria for when an individual's injury or illness warrants medical treatment or an
-in-person medical evaluation.
-
-b.
-
-Requirements for notifying the individual’s emergency contact, including
-immediate notification in the case of an emergency room visit or unscheduled
-hospitalization.
-
-c.
-
-Reporting procedures within the BHE.
-
-2.
-
-BHEs that provide overnight/residential services shall maintain enough food and water on
-hand to provide all individuals with three (3) nutritionally balanced meals for four (4) days.
-
-3.
-
-Written policies and procedures for the management of individuals’ personal funds and
-property, including, but not limited to:
-
-4.
-
-a.
-
-An inventory of all the individual’s personal belongings must be conducted upon
-admission, and documented by at least two (2) individuals, one of which must be
-the individual when the individual is capable and willing to document the
-inventory. Such inventory must be maintained in the individual record.
-
-b.
-
-All inventoried property must be returned to the individual upon discharge, and
-such return must be documented by at least two (2) individuals, one of which
-must be the individual when the individual is capable and willing to document the
-inventory. Such documentation must be included in the individual record.
-
-Infection control policies to address risks associated with housekeeping, dietary services,
-and linen and laundry services, in addition to the requirements at part 2.4.E of this
-Chapter.
-a.
-
-b.
-
-5.
-
-Policies for linen and laundry services must include:
-(1)
-
-Procedures for preventing contamination between soiled linen and clean
-linen through either the use of gloves or hand washing.
-
-(2)
-
-Procedures for soiled linen to be stored separately from clean linen, in
-separate enclosed areas.
-
-Dietary services must be provided using methods that conform to state or local
-food safety standards, including, at a minimum:
-(1)
-
-Food must be prepared, handled, and stored in a sanitary manner, so
-that it is free from spoilage and/or contamination, and must be safe for
-human consumption.
-
-(2)
-
-Reusable equipment, dishes, cutlery, and other wares used for the
-preparation, serving, or storage of food must be washed in a safe and
-sanitary manner, and, in the case of dishwashing machines, in
-accordance with manufacturer’s instructions.
-
-The provision of linen and laundry services, including, but not limited to:
-a.
-
-Individuals must have access to laundry services for personal clothing, which
-may be provided through the use of personal laundry facilities, a centralized
-laundry service, or may be contracted for with an outside provider.
-
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-
-b.
-6.
-
-2 CCR 502-1
-
-A requirement to maintain a sufficient supply of clean linen, including sheets and
-towels.
-
-The provision of dietary services, including but not limited to:
-a.
-
-The BHE must ensure enough food and water on hand to provide all individuals
-with three (3) nutritionally balanced meals for four (4) days.
-
-b.
-
-A BHE responsible for providing meals to individuals must:
-(1)
-
-Provide at least three meals daily, at regular times comparable to normal
-mealtimes in the community, or in accordance with individual needs,
-preferences, and plans of care.
-(a)
-
-Nourishing meal substitutes and between-meal snacks must be
-provided, in accordance with plans of care, to individuals who
-want to eat at non-traditional times or outside of scheduled meal
-service times.
-
-(b)
-
-Meals must include a variety of foods, be nutritionally balanced,
-and sufficient in amount to satisfy appetites of individuals.
-
-(c)
-
-Appealing substitutes of similar nutritive value must be available
-for individuals who choose not to eat food that is initially served
-or who request an alternative meal.
-
-(2)
-
-Offer drinks, including water and other liquids, to individuals with every
-meal and between meals throughout the day.
-
-(3)
-
-Ensure that individuals have independent access to water at all times.
-
-7.
-
-If the population served includes individuals assessed to be at risk of imminent harm to
-self or others, the BHE shall require safety checks be conducted at least every fifteen
-(15) minutes and at every shift change to identify and remedy hazards and shall maintain
-documentation of such checks.
-
-8.
-
-The type of first aid equipment maintained by the BHE, including a requirement that such
-equipment be maintained in a readily accessible location, at each physical location
-providing services under the residential and/or overnight endorsement. First aid
-equipment must include, but not be limited to, an automated external defibrillator (AED).
-a.
-
-9.
-
-First aid supplies and equipment must be kept unexpired and in a reliable
-condition.
-
-Smoking policies applicable to individuals, including, but not limited to any prohibitions on
-smoking, designated areas for smoking, and methods/substances allowed under any
-smoking policy, such as tobacco, electronic cigarettes, vaporizers, etc.
-
-E.
-
-The BHE must ensure there is a minimum of one (1) full bathroom for every six (6) individuals,
-including a toilet, sink, toilet paper dispenser, mirror, tub and/or shower, and towel rack.
-
-F.
-
-Bathrooms must be equipped with soap dispensers, or the BHE shall have a procedure in place
-that prevents individuals from sharing soap.
-
-G.
-
-The BHE shall ensure that individuals have access to basic hygiene supplies.
-
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-
-H.
-
-2 CCR 502-1
-
-In addition to the requirements of part 2.4 of this Chapter, each BHE’s emergency policies must
-address:
-1.
-
-When to evacuate the premises, when to shelter in place, and the procedures for doing
-so;
-
-2.
-
-A predetermined means of communicating with individuals, families, staff and other
-providers;
-
-3.
-
-A plan that ensures the availability of, or access to, emergency power for essential
-functions and all individual required medical devices or auxiliary aids or services;
-
-4.
-
-Storage and preservation of medications; and
-
-5.
-
-In the event relocation of individuals becomes necessary, written agreements with other
-health facilities and/or community agencies.
-
-I.
-
-The BHE shall have readily available a roster of current individuals, their room assignments and
-emergency contact information, along with a facility diagram showing room locations.
-
-J.
-
-Hot water must not measure more than 120 degrees Fahrenheit at taps which are accessible by
-individuals.
-
-K.
-
-A BHE serving both adults and children must ensure management of the living space
-assignments includes physical barriers and personnel oversight of activities to ensure safety. This
-management must include, but is not limited to:
-
-2.27
-
-1.
-
-Physical barriers, such as doors or walls;
-
-2.
-
-Personnel stations that separate living space assignments;
-
-3.
-
-Other practical arrangements that support the safe management of the individuals
-receiving services.
-
-Fentanyl and Other Opioid Use Disorder Education and Treatment
-
-2.27.1 Statutory Authority and Applicability
-A.
-
-Authority to approve BHEs to provide treatment of substance use disorders, including fentanyl
-and other opioid use disorders, is provided by Section 18-1.3-401 and 18-1.3-501, C.R.S.
-
-B.
-
-BHEs providing services for the treatment of substance use disorders including fentanyl and other
-opioid use disorders must exist across all endorsed service types. For this reason, all BHEs shall
-comply with this part 2.27. In addition to this part 2.27, BHEs shall comply with provisions of the
-applicable endorsed services, as noted below:
-1.
-
-BHEs providing outpatient and high-intensity outpatient services shall comply with parts
-4.3, 4.6, and/or 4.7 of these rules.
-
-2.
-
-BHEs providing residential services shall comply with parts 5.1 through 5.4 of these rules
-and the applicable sub-endorsement(s) of residential services (parts 5.6, 5.8, 5.10, and
-5.11 of these rules).
-
-3.
-
-BHEs providing withdrawal management services shall comply with parts 4.5, 4.8, 5.1,
-5.2, 5.3, 5.7, and 5.12 of these rules.
-
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-
-2.27.2 Placement in Services
-A.
-
-Individuals receiving fentanyl and other opioid use disorder treatment must be assessed and
-referred into education and/or treatment by a supervising entity as a condition of probation or
-parole. The BHE is expected to evaluate whether the supervising entity’s recommendation
-matches the individual’s assessed clinical need(s). The BHE is expected to address any
-differences identified with the supervising entity directly and document results in the individual’s
-record.
-
-B.
-
-BHEs shall include a copy of the referral paperwork, demonstrating placement in the fentanyl or
-other opioid-specific treatment services as required by the supervising entity, in the individual’s
-record.
-
-C.
-
-If a BHE is unable to obtain a copy of the court order and/or written documentation of supervising
-entity’s recommendation for education and/or treatment, there must be documentation of
-attempt(s) to obtain the paperwork from the referral source.
-
-D.
-
-Individuals receiving fentanyl and other opioid use disorder treatment are expected to complete
-the required fentanyl education program as part of that process. The BHE must verify that the
-individual completes this requirement when it is clinically appropriate for the individual, prior to
-discharging from services. Documentation of this must be kept in the individual’s record.
-
-2.27.3 Support Systems
-A.
-
-The BHE shall be capable of delivering all necessary medication for opioid use disorder (MOUD)
-services that are clinically indicated for the individual under applicable law. These services may
-be provided through direct service provision or active collaboration with other agencies that are
-able to provide MOUD services.
-
-B.
-
-Opioid antagonists
-1.
-
-2.
-
-Opioid antagonists must:
-a.
-
-Be discussed and provided upon individual request at the initial assessment.
-
-b.
-
-Documentation shall be reflected in the individual record response from individual
-and if dosages were provided for the individual to keep on their person.
-
-BHEs shall:
-a.
-
-Ensure that opioid antagonists are available on-site at all times,
-
-b.
-
-Ensure that opioid antagonists are made available to all individuals being served
-to keep on their person. This may be achieved through providing access to the
-opioid antagonist directly, or through coordination with another resource;
-
-c.
-
-Make reasonable documented attempts and to ensure that all individuals
-receiving treatment know how to administer the opioid antagonist in case of
-emergency, and,
-
-d.
-
-Promote or directly provide information to the individual’s referred support system
-to allow for the administration of opioid antagonists.
-
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-
-2.27.4 Personnel Training and Competencies
-A.
-
-B.
-
-All personnel interacting with individuals receiving fentanyl and other opioid-specific services shall
-be trained in the following:
-1.
-
-Proper use of opioid antagonists, and
-
-2.
-
-Recognition and response to signs and symptoms of drug overdose.
-
-Additionally, all personnel providing treatment and peer support professionals interacting with
-individuals receiving fentanyl and other opioid-specific services shall be trained and demonstrate
-competency in the following topics:
-1.
-
-Substances of misuse and dependence including, but not
-limited to alcohol, tobacco, and other drugs, and
-polysubstance abuse;
-
-2.
-
-Pharmacology of the medications for opioid use disorder (MOUD), including but not
-limited to loss of tolerance to opioids, dangerous drug or alcohol interactions with the
-MOUD, and purpose of the medication’s use;
-
-3.
-
-Culturally and linguistically appropriate services, awareness, and responsiveness to
-current misuse trends for opioid-involved individuals; and
-
-4.
-
-Harm-reduction and trauma-informed practices in the treatment of opioid use disorder.
-
-2.27.5 Collaboration and Termination of Court-Ordered Services
-A.
-
-B.
-
-With written permission from individuals who are required to attend services as a condition of
-probation, agencies shall communicate regular updates to the referring supervising entity for the
-portion of the treatment episode in which fentanyl and other opioid-specific services are
-determined to be clinically necessary. This determination of clinical necessity must be made by:
-1.
-
-A licensee;
-
-2.
-
-A candidate; or
-
-3.
-
-A certified addiction specialist (CAS).
-
-Individuals that no longer meet clinical necessity for fentanyl or other opioid-specific treatment as
-a condition of probation, pursuant to Section 18-1.3-510(3)(a), C.R.S., but may benefit from
-aftercare or continued services to address other relevant behavioral health needs may remain in
-treatment. The BHE is not required to communicate further progress updates to the referring
-supervising entity unless the individual requests and consents to this communication.
-
-Chapter 3:
-
-Behavioral Health Recovery Supports
-
-3.1
-
-Authority and Applicability
-
-A.
-
-Chapter 3 establishes the standards that BHEs must follow when electing to provide mental
-health and substance use recovery supports as part of a recovery supports endorsement. The
-authority to promulgate these service-specific requirements that apply to BHEs electing to provide
-this service comes from Sections 27-50-107(3) and 27-50-502(1), C.R.S.
-
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-
-B.
-
-All agencies providing recovery support services rendered by peer support professionals shall
-meet the standards in this Chapter. If the agency requires a BHE license, the agency must
-comply with Chapter 2.
-
-C.
-
-This Chapter does not apply to licensed recovery support services organizations. Regulations for
-licensed recovery support services organizations are found in Section 21.600.
-
-3.2
-
-Service Provision
-
-A.
-
-Recovery support services include a variety of recovery-focused services and supports for
-individuals with a behavioral health disorder and/or who are in recovery from a behavioral health
-disorder. These services are rendered by peer support professionals. These services must
-include engaging individuals in peer-to-peer relationships that support healing, personal growth,
-life skills development, self-care, and crisis strategy development to help achieve recovery,
-wellness, and life goals. These services include:
-
-B.
-
-1.
-
-Peer support professional-run drop in centers;
-
-2.
-
-Recovery and wellness centers;
-
-3.
-
-Employment services;
-
-4.
-
-Prevention and early intervention activities;
-
-5.
-
-Peer support professional mentoring for children and youth;
-
-6.
-
-Warm lines, as defined in Chapter 1 of these rules;
-
-7.
-
-Advocacy services;
-
-8.
-
-Recovery coaching;
-
-9.
-
-Peer support professional-led support groups;
-
-10.
-
-Navigating services (resources);
-
-11.
-
-Recovery planning services; and
-
-12.
-
-Other activities supporting the recovery experience of an individual.
-
-A peer support professional may provide services in a variety of settings, if permitted access, that
-may include but are not limited to:
-1.
-
-Court-affiliated settings, such as the Department of Corrections, county jails, or
-community correctional placements;
-
-2.
-
-Physical health settings, such as primary care physician offices;
-
-3.
-
-Emergency departments;
-
-4.
-
-Audio-visual or audio-only telehealth;
-
-5.
-
-Agencies serving homeless communities;
-
-6.
-
-Peer respite homes;
-
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-
-C.
-
-2 CCR 502-1
-
-7.
-
-School-based health centers;
-
-8.
-
-Home and community-based settings, including salons and other gathering places; and
-
-9.
-
-Brick and mortar recovery community organizations, including faith based organizations.
-
-Agencies endorsed pursuant to this Chapter 3 must ensure peer support professionals are not
-required to provide services that compromise the dynamic of a peer-to-peer relationship or that
-are outside the scope of providing recovery-focused services. Activities that are outside of the
-scope of a peer support professional include, but are not limited to:
-1.
-
-Performing clinical/diagnostic assessments, service planning, or treatment; and
-
-2.
-
-Drug and/or alcohol testing, monitoring, and/or collection of toxicology samples.
-
-D.
-
-Agencies endorsed pursuant to this Chapter 3 must submit job descriptions of all peer support
-professional positions in accordance with part 2.6.E of these rules.
-
-E.
-
-Peer support professionals must provide individuals with a written disclosure at the time of first
-contact that includes
-1.
-
-Their full name;
-
-2.
-
-Their contact information;
-
-3.
-
-Their qualifications;
-
-4.
-
-Their role in work with the individual;
-
-5.
-
-Their supervisor's name;
-
-6.
-
-Their supervisor's contact information; and
-
-7.
-
-The name of the agency that employs the peer support professional.
-
-3.3
-
-Personnel Qualifications and Training
-
-A.
-
-Peer support professionals providing peer recovery support services must hold a professional
-peer support certification credential or have successfully completed formal training that covers all
-content areas outlined in “core competencies for peer workers in behavioral health services 2018” (December 13, 2018), established by United States Department of Health and Human
-Services, Substance Abuse and Mental Health Services Administration (SAMHSA), which is
-incorporated herein by reference and does not include any later amendments or editions. These
-standards are available at no cost at https://www.samhsa.gov/ and are also available for public
-inspection and copying at the Behavioral Health Administration, 710 S. Ash Street, Unit C140,
-Denver, CO 80246, during regular business hours.
-
-B.
-
-Training or proof of certification must be documented in personnel files.
-
-C.
-
-For peer support professionals with a certification credential, the certification credential must
-include the following requirements:
-
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-
-2 CCR 502-1
-
-1.
-
-At least sixty (60) hours of training, including training covering all content areas in “core
-competencies for peer workers in behavioral health services – 2018” established by
-United States Department of Health and Human Services, Substance Abuse and Mental
-Health Services Administration (SAMHSA), incorporated by reference in subsection A,
-above;
-
-2.
-
-At least 200 hours of experience as a peer support professional; and
-
-3.
-
-Passing a certification exam.
-
-D.
-
-Peer support professionals with a certification credential must be in good standing with their
-certifying body, including compliance with the certifying body’s code of ethics.
-
-3.4
-
-Supervision
-
-A.
-
-Peer support professionals must be supervised on at least a monthly basis for at least an hour by
-a licensee in good standing with their credentialing body and/or an experienced peer support
-professional who meets the criteria set forth in section 3.3 of this Chapter. Supervisors shall
-document supervision date, time, duration, and topics discussed.
-
-B.
-
-Supervisors of peer support professionals must demonstrate to the BHA that they have received
-training in
-1.
-
-The provision of peer support services;
-
-2.
-
-The supervision of peer support professionals; and
-
-3.
-
-The role of peer support professionals.
-
-C.
-
-Supervision of a peer support professional may include co-reflective supervision strategies in
-which supervisors and supervisees engage in a relationship of mutual learning.
-
-3.5
-
-Documentation Requirements
-
-A.
-
-Agencies endorsed to provide recovery supports must maintain records of the services provided
-to individuals by peer support professionals. These records shall include at a minimum the date,
-time, and duration of the service.
-
-Chapter 4:
-
-Behavioral Health Outpatient and High Intensity Outpatient Services
-
-4.1
-
-Authority and Applicability
-
-A.
-
-Chapter 4 establishes the standards for and applies to agencies electing to provide mental health
-and substance use outpatient services and high-intensity outpatient services. The authority to
-promulgate these service-specific requirements that apply to BHEs electing to provide this service
-comes from Sections 27-50-502(1), 27-50-106, 27-50-301(5), and 27-50-107(3)(b), C.R.S.
-
-B.
-
-These rules apply to and are established to create standards for agencies seeking subendorsements to provide behavioral health outpatient services, which includes early intervention,
-outpatient, intensive outpatient, partial hospitalization, and ambulatory withdrawal management
-services. Agencies may also choose to provide optional sub-endorsements of minor in
-possession services, in conjunction with the correlated sub-endorsements in this Chapter.
-
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-2 CCR 502-1
-
-4.2
-
-Early Intervention Services Standards
-
-A.
-
-These rules are established to create standards for agencies seeking sub-endorsements to
-provide early intervention, which includes ASAM Criteria Level 0.5 type services.
-
-B.
-
-Agencies providing early intervention services must meet the standards in part 4.2 of these rules.
-
-4.2.1
-
-Service Delivery and Setting
-
-A.
-
-Early intervention services are generally intended for individuals who are not appropriate for more
-intensive levels of care, are sufficiently stabilized to complete early intervention services prior to
-moving to a different level of care, are attending education-only services, or are being screened in
-a stabilization setting and are provided referrals for appropriate level of care once stabilized.
-
-B.
-
-Early intervention services are appropriate for individuals with mental health, substance use, and
-co-occurring disorders that are of low severity, or are of moderate to high severity, as defined by
-the DSM-5-TR, but have been stabilized and are awaiting entry into a higher level of care.
-
-C.
-
-All services provided must be adapted to the individual’s developmental stage, physical, cultural,
-and comprehensive needs.
-
-D.
-
-Early intervention services may be delivered via telehealth in accordance with the standards set
-in part 2.9 of these rules.
-
-E.
-
-If early intervention services are related to court-ordered DUI/DWAI requirements, services must
-comply with parts 10.1 through 10.9 of these rules, including telehealth provisions.
-
-F.
-
-Treatment groups must not exceed twelve (12) individuals receiving services.
-
-4.2.2
-
-Personnel
-
-A.
-
-The agency must ensure early intervention services are provided by personnel meeting the
-qualifications in parts 1.3 and 2.5 of these rules.
-
-B.
-
-Agencies providing early intervention services must ensure treatment personnel have supervisor
-consultation within twenty-four (24) hours via in-person or telephone to discuss, at minimum,
-psychiatric or medical concerns of individuals receiving services as necessary.
-1.
-
-Personnel must have supervisor consultation available within one (1) hour via in-person
-or by telehealth to discuss, when warranted crisis and/or emergency situations.
-
-4.2.3
-
-Service Provisions
-
-A.
-
-Duration of early intervention services may vary dependent upon individual needs.
-
-B.
-
-Early intervention services must be provided in accordance with individual screening information
-as defined in part 2.12.1 of these rules, or the court ordered education requirements for
-education-only individuals.
-1.
-
-Continued screening will be conducted when symptomology and risk factors for a
-diagnosis of mental health, substance use, and/or co-occurring disorder(s), as defined by
-the DSM-5-TR, are identified by personnel. Referral(s) to match screened treatment
-needs will be provided to the individual and documented pursuant to part 4.2.4 of these
-rules.
-
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-
-2.
-C.
-
-2 CCR 502-1
-
-Referral(s) will be provided in collaboration with the individual.
-
-Early intervention services may include brief therapeutic interventions of individual, group, or
-family counseling, peer support services, medication/psychiatric-only services, follow-up services,
-and/or regulated education groups mandated to the individual by a supervising entity.
-1.
-
-An individual is classified as receiving medication/psychiatric - only services when the
-agency provides a maximum of three (3) services, in addition to services related to
-medications, within a six (6) month period of time.
-
-4.2.4
-
-Documentation and Timeliness
-
-A.
-
-Early intervention agencies must complete appropriate screening in accordance with screening
-guidelines in part 2.12.1 of these rules upon intake of individual into services.
-1.
-
-Other screening may be used in addition for program and/or individual specific needs.
-
-B.
-
-Agencies must complete the screening requirements within two (2) calendar days.
-
-C.
-
-Early intervention level services are exempt from assessment and service plan expectations of
-parts 2.12.2, 2.12.3 and 2.13.1 of these rules, unless the individual attending services is moved to
-a higher level of care within the same agency.
-
-D.
-
-Progress notes must be completed for each early intervention session. Progress notes must be
-completed to standards identified in part 2.13.2 of these rules, and at a minimum frequency of
-one (1) note per session.
-
-E.
-
-Referrals to other services must be documented in the individual’s file including:
-
-F.
-
-1.
-
-Recommendations of care;
-
-2.
-
-Reason for discharge;
-
-3.
-
-Recommended programs for individual to enroll in; and
-
-4.
-
-Follow-up plan including care coordination and documentation needs.
-
-If providing medication/psychiatric-only services, a licensee shall complete and document in the
-individual record at least annually:
-1.
-
-Clinical rationale supporting a medication/psychiatric-only service status;
-
-2.
-
-An updated assessment; and
-
-3.
-
-An updated service plan.
-
-4.3
-
-Outpatient Services Standards
-
-A.
-
-These rules are established to create standards for agencies seeking a sub-endorsement to
-provide outpatient services, which includes ASAM Criteria Level 1.0 type services.
-
-B.
-
-All agencies providing behavioral health outpatient treatment services must meet the standards in
-this part 4.3.
-
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-
-2 CCR 502-1
-
-4.3.1
-
-Service delivery and setting
-
-A.
-
-Outpatient services are generally intended for individuals who are assessed as not appropriate
-for more intensive levels of care. Outpatient services may also be a step-down from a higher level
-of care or offered when an individual is in early stages of change and declines participation in the
-higher level of care indicated by the assessment.
-
-B.
-
-Outpatient services are appropriate for individuals diagnosed with mental health, substancerelated, and co-occurring disorders if the mental health disorders are of moderate severity, or are
-of high severity, as defined by the DSM-5-TR, but have been stabilized.
-
-C.
-
-All services provided must be adapted to the individual’s developmental stage, physical, cultural,
-and comprehensive needs.
-
-D.
-
-Outpatient services may be delivered via in-person, audio-visual telehealth, or audio-only
-telehealth format in accordance with part 2.9 of these rules.
-
-E.
-
-Treatment groups must not exceed twelve (12) individuals receiving services.
-
-4.3.2
-
-Personnel
-
-A.
-
-Treatment personnel, for the purpose of outpatient services, unless otherwise noted, means the
-following behavioral health professionals trained in mental health and/or substance use disorder
-identification and treatment and acting within their scope of practice:
-1.
-
-Authorized practitioners;
-
-2.
-
-Licensees;
-
-3.
-
-Certified addiction specialists (CAS);
-
-4.
-
-Candidates;
-
-5.
-
-Certified addiction technicians (CAT); and
-a.
-
-6.
-
-If utilizing certified addiction technicians (CAT), the agency must ensure that
-CATs do not comprise more than twenty-five (25%) of the agency’s personnel.
-
-Counselors-in-training and/or interns.
-a.
-
-If utilizing counselors-in-training and/or interns, the agency must ensure that all
-clinical documentation is reviewed and co-signed by a clinical agency supervisor
-able to supervise pursuant to their scope of practice. Counselor-in-training and/or
-intern personnel must not comprise more than twenty-five percent (25%) of the
-agency’s personnel.
-
-B.
-
-Outpatient services may include recovery support services rendered by peer support
-professionals in accordance with Chapter 3 of these rules.
-
-C.
-
-Agencies providing outpatient services must ensure treatment personnel have supervisor
-consultation available within twenty-four (24) hours via in-person or by telehealth to discuss,
-when warranted, psychiatric or medical concerns of individuals receiving services.
-1.
-
-Personnel must have supervisor consultation available within one (1) hour via in-person
-or telehealth to discuss, when warranted crisis and/or emergency situations.
-
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-
-2 CCR 502-1
-
-4.3.3
-
-Service Provisions
-
-A.
-
-Outpatient services must be conducted in regularly scheduled sessions of no more than eight (8)
-treatment contact hours per week for adults, and no more than five (5) treatment contact hours
-per week for children.
-1.
-
-Treatment contact hours does not include pro-social activities.
-
-2.
-
-Treatment contact hours may include medication/psychiatric-only services pursuant to
-this part 4.3.3.
-
-B.
-
-Outpatient treatment services must be provided in accordance with the individual’s service plan.
-
-C.
-
-When referral(s) are needed to best meet the individual assessed needs, referral(s) must be
-provided in collaboration with the individual and their choice(s) for referred services.
-
-D.
-
-Medication/psychiatric-only services may be provided when:
-1.
-
-An individual is classified as receiving medication/psychiatric - only services when the
-agency provides a maximum of three (3) services, in addition to services related to
-medications, within a six (6) month period of time.
-
-4.3.4
-
-Documentation and Timeliness
-
-A.
-
-Outpatient service documentation must follow the provisions set forth in parts 2.10, 2.11, 2.12,
-and 2.13 of these rules.
-
-B.
-
-Upon intake into services, preliminary screening and risk assessment must be completed in
-compliance with part 2.12.1 of these rules.
-
-C.
-
-As soon as is practicable upon admission, but no later than ten (10) calendar days from the date
-of preliminary screening and risk assessment, the agency must complete an initial assessment in
-accordance with part 2.12.2 of these rules.
-1.
-
-If the screening and risk assessment identifies an urgent clinical need, clinical services
-must be provided, and the initial assessment must be completed within one (1) calendar
-day of preliminary screening.
-
-D.
-
-As soon as is practicable upon admission, but no later than sixty (60) calendar days from the first
-date of services, the agency must complete a comprehensive assessment in accordance with
-part 2.12.3 of these rules. Completion of the comprehensive assessment does not preclude the
-initiation of services.
-
-E.
-
-The individual service plan must be created, in accordance with part 2.13.1 of these rules, within
-fourteen (14) calendar days after the initial assessment. The service plan must be updated to
-reflect information from the comprehensive assessment. The agency must update the service
-plan throughout the course of treatment, review previous goals, and update those goals
-whenever there is a change in the individual's level of care or functioning, and must occur, at
-minimum, every six (6) months.
-
-F.
-
-Outpatient treatment services must be documented in the individual’s record in accordance with
-part 2.13.2 of these rules, and at a minimum frequency of one (1) note per session.
-
-G.
-
-If providing medication/psychiatric-only services, a licensee shall complete and document in the
-individual record at least every six (6) months:
-
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-
-1.
-
-Clinical rationale supporting a medication/psychiatric-only service status;
-
-2.
-
-An updated assessment; and
-
-3.
-
-An updated service plan.
-
-2 CCR 502-1
-
-4.4
-
-Minor in Possession (MIP): Education and Treatment Services Standards
-
-4.4.1
-
-MIP General Provisions
-
-A.
-
-Agencies providing Minor in Possession education and treatment must comply with this part 4.4.
-
-B.
-
-If providing MIP treatment to individuals under eighteen (18) years of age, agencies must receive
-the Children and Family endorsement and follow the standards of care in Chapter 8 of these
-rules.
-
-C.
-
-Agencies must not place an individual with a MIP citation in DUI/DWAI education or therapy
-groups unless the youth also has a DUI/DWAI offense.
-
-D.
-
-All agency education and treatment personnel must have documented training, supervision and
-experience in youth development and prevention, intervention, and treatment approaches.
-
-E.
-
-Individuals that are sixteen (16) years of age and under must be treated in separate groups than
-those treating individuals seventeen (17) to twenty (20) years old.
-
-F.
-
-Agencies must conduct ongoing assessment of progress in education and/or treatment level of
-care to determine if individuals are in the appropriate service level.
-
-4.4.2
-
-MIP: First Offense Education and Early Intervention
-
-A.
-
-MIP education is for individuals who have received their first MIP citation and must be conducted
-in an outpatient setting and comply with early intervention procedures in part 4.2 of these rules.
-
-B.
-
-MIP education must be at least eight (8) hours, completed over no less than a two (2) day period
-with no more than four (4) hours of education per day.
-
-C.
-
-Education topics must include:
-
-D.
-
-1.
-
-Current legal consequences for additional MIP citations;
-
-2.
-
-Resources or referrals for treatment level services, when indicated;
-
-3.
-
-Developmental impact of early onset substance use and subsequent impact on the
-developing brain;
-
-4.
-
-Physiological effect of alcohol and other drug use;
-
-5.
-
-Refusal skills; and
-
-6.
-
-Avoidance of high-risk situations.
-
-For children, agencies must include and document a minimum of two (2) hours of parental or
-legal guardian involvement, unless contraindicated, and document the determination to not
-include parental or guardian involvement and reasoning for this determination.
-
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-4.4.3
-
-MIP: Second and Subsequent Offense Outpatient Treatment
-
-A.
-
-In addition to the provisions outlined in this part 4.4.3, agencies providing MIP outpatient
-treatment must also comply with part 4.3.
-
-B.
-
-Second offense MIP therapy must be conducted in an outpatient setting, must be a minimum of
-twelve (12) hours in duration over eight (8) weeks, and must not exceed ninety (90) minute
-sessions, excluding breaks and administrative procedures.
-
-C.
-
-Agencies must complete an individualized service plan, with each individual in accordance with
-parts 2.13.1 and 8.5 of these rules.
-
-D.
-
-For children, agencies must include and document a minimum of four (4) hours of parental or
-legal guardian involvement, unless contraindicated, and document the determination to not
-include parental or guardian involvement and reasoning for this determination.
-
-E.
-
-For third and subsequent minor in possession offenses, agencies shall conduct a comprehensive
-assessment to determine substance use disorder treatment needs of the individual.
-
-F.
-
-Third and subsequent MIP outpatient treatment must be conducted at a minimum of twenty (20)
-hours of substance use disorder treatment over a minimum thirteen (13) week period, as
-determined by the assessment. Groups must not exceed ninety (90) minutes in duration.
-
-G.
-
-Additional assessed service offerings and referral(s) must be offered to meet the needs of the
-individual and family members, when determined by the assessment.
-
-4.5
-
-Level 1-Withdrawal Management (Level 1-WM): Ambulatory Withdrawal Management
-Without Extended On-Site Monitoring Standards
-
-A.
-
-This part 4.5 is established to create standards for agencies seeking a sub-endorsement to
-provide outpatient Level 1-Withdrawal Management (Level 1-WM) services in accordance with
-Chapter 6 of the ASAM Criteria.
-
-B.
-
-Agencies providing Level 1-WM services must meet the standards in this part 4.5. Agencies
-providing Level 1-WM services may:
-1.
-
-Also engage in outpatient behavioral health treatment services by meeting the standards
-for the outpatient sub-endorsement(s) selected by the agency, or
-
-2.
-
-Provide only Level 1-WM services and coordinate with other providers for ongoing and
-concurrent outpatient behavioral health treatment services.
-
-4.5.1
-
-Service delivery and setting
-
-A.
-
-Level 1-WM is an outpatient withdrawal management service that complements individualized
-behavioral health treatment services.
-
-B.
-
-Individuals may participate in Level 1-WM for a period of time in which it is determined to be
-medically appropriate. Admission to Level 1-WM services must not hinder the individual’s ability
-to participate in concurrent behavioral health services. This includes the potential process of
-admitting to, and discharging from, such withdrawal management services one (1) or more times
-by the individual.
-
-C.
-
-Level 1-WM services are generally provided in a clinical or addiction-focused treatment office,
-medical health care facility, or home health care-type agency.
-
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-
-D.
-
-Level 1-WM services offered by agencies that do not provide behavioral health services within
-their agency structure must be affiliated with agencies or other behavioral health providers as
-needed to ensure the treatment needs of all individuals served can be met. Documentation of this
-affiliation must be presented to the BHA, upon request. Referral(s) will be provided in
-collaboration with the individual and their choice(s) for referred services.
-
-E.
-
-Support systems
-1.
-
-F.
-
-Agencies must:
-a.
-
-Have the ability to obtain a comprehensive medical history and physical
-examination at the time of admission to Level 1-WM services;
-
-b.
-
-Have twenty-four (24)-hour access to emergency medical consultation services,
-should services become indicated;
-
-c.
-
-Have the ability to provide or assist in accessing transportation services for
-individuals who lack safe transportation; and
-
-d.
-
-Have the ability to coordinate services with behavioral health personnel, within
-the agency or through referral.
-
-Diagnostic criteria
-1.
-
-Individuals participating in Level 1-WM services typically exhibit a mild to moderate
-withdrawal severity rating on standardized withdrawal severity scales as well as
-mild/stable psychiatric symptoms for emotional, behavioral, and cognitive conditions.
-
-2.
-
-Individuals may also present with a higher withdrawal severity rating on standardized
-withdrawal severity scales, with protective factors and other support system(s) in place to
-safely participate in this level of outpatient care.
-
-3.
-
-Due to the safety concerns inherent with withdrawal, the following may not be appropriate
-for Level 1-WM services:
-a.
-
-Individuals who are experiencing withdrawal from more than one class of
-substance.
-
-b.
-
-Individuals with recent complicated withdrawal symptoms as identified by ASAM
-Criteria.
-
-c.
-
-If the medical personnel determines that an individual meeting one or both of the
-above criteria can be safely and effectively served in a Level 1-WM setting, the
-rationale and plan for safe management and services must be documented in the
-individual’s record.
-
-G.
-
-Individuals may be more advanced in their readiness to change and need minimal assistance
-with transportation and other engagement barriers.
-
-H.
-
-Individuals may participate in Level 1-WM services without a formal substance use disorder
-diagnosis if collateral information indicates a high probability of such diagnosis. The agency must
-ensure further evaluation of this probable diagnosis, either completed within the agency or
-through referral to a behavioral health provider.
-
-I.
-
-Agencies must:
-
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-
-1.
-
-Provide safe management and documentation of signs and symptoms of intoxication and
-withdrawal; and
-
-2.
-
-Ensure that discharge planning begins at the time of admission to Level 1-WM services,
-to allow for necessary care coordination and transition into ongoing or concurrent
-treatment services to occur successfully based on screening or assessment of needs.
-
-4.5.2
-
-Personnel
-
-A.
-
-Level 1-WM services are primarily provided by medical professionals who are acting within the
-scope of their practice and are trained in assessing and managing intoxication and states of
-withdrawal. This may include, but is not limited to, authorized practitioners.
-
-4.5.3
-
-Service Provisions
-
-A.
-
-Agencies must develop policies and procedures to address service delivery expectations. These
-policies and procedures must address, but are not limited to the following:
-
-B.
-
-C.
-
-1.
-
-Consultation with specialized clinical and medical professionals for individualized Level 1WM care;
-
-2.
-
-Coordinating an individual’s transition into other levels of care, determined to be
-appropriate through triage, screening, evaluation, and/or assessment processes
-completed during their Level 1-WM services. This may include collaboration with
-emergency behavioral health services, such as Colorado Crisis Services, as appropriate;
-
-3.
-
-Conducting or arranging for laboratory and/or toxicology tests to be completed;
-
-4.
-
-Responding to individuals who are assessed as being a current threat to themselves or
-others, including the appropriate use of law enforcement;
-
-5.
-
-Communication with intoxicated individuals leaving Level 1-WM services against
-personnel recommendations, including the use of emergency commitments; and
-
-6.
-
-Circumstances under which individuals may be discharged from Level 1-WM services,
-other than completing withdrawal management or leaving against personnel
-recommendations.
-
-Admission procedures for Level 1-WM services must include at a minimum:
-1.
-
-Collecting of information regarding the degree of alcohol and/or other drug intoxication as
-evidenced by breathalyzer, urinalysis, self-report, observation or other evidence-based or
-best practices;
-
-2.
-
-A pregnancy screening for pregnancy-capable individuals;
-
-3.
-
-Taking of vital signs; and
-
-4.
-
-Administration of a validated clinical withdrawal assessment tool.
-
-Therapies offered by the agency must include a range of treatment approaches and support
-services based on the screening or assessment of the individual’s treatment needs. Treatment
-services may include but are not limited to:
-1.
-
-Screening;
-
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-2.
-
-Assessment;
-
-3.
-
-Group and individual counseling;
-
-4.
-
-Motivational enhancement;
-
-5.
-
-Family therapy;
-
-6.
-
-Educational groups;
-
-7.
-
-Occupational and recreational therapy;
-
-8.
-
-Addiction pharmacology;
-
-9.
-
-Mental health and physical health pharmacology, as needed;
-
-10.
-
-Medication management;
-
-11.
-
-Peer, social and recovery support;
-
-12.
-
-Care coordination; and
-
-13.
-
-Support for the development of life skills.
-
-2 CCR 502-1
-
-D.
-
-If the agency does not provide a treatment approach or support service necessary to meet the
-individual’s treatment needs, the agency must ensure that care coordination occurs.
-
-E.
-
-Agencies must provide additional service planning for managing individuals with medical
-conditions, suicidal ideation, pregnancy, psychiatric conditions, and other conditions which place
-individuals at additional risk during withdrawal management.
-
-F.
-
-Agencies must provide assessments of individual readiness for treatment and services based on
-the service plan and the assessments and interventions shall be documented in the individual’s
-record.
-
-G.
-
-Medication-assisted treatment (MAT) for withdrawal management
-1.
-
-Agencies must continue individuals on their medication-assisted treatment regimen and
-will only remove individuals from medications treating opioid use disorders at the
-individual’s request or if it is deemed medically appropriate by an authorized practitioner.
-
-2.
-
-Agencies must inform individuals receiving services about access to medication-assisted
-treatment. Upon the individual’s consent, the agency must provide medication-assisted
-treatment directly.
-
-3.
-
-Agencies must obtain a controlled substance license pursuant to section 21.300 of 2
-CCR 502-1 from the BHA if they plan to dispense, compound, or administer a controlled
-substance from stock medication in order to treat a substance use disorder or to treat the
-withdrawal symptoms of a substance use disorder.
-a.
-
-A controlled substance license is not required if the agency intends to provide
-medication-assisted treatment (MAT) services through prescription writing only,
-under an independent prescriber’s license.
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-4.5.4
-
-Documentation and Timeliness
-
-A.
-
-Upon admission to Level 1-WM services, the agency must complete the following requirements,
-keeping documentation of timely completion in the individual’s record:
-1.
-
-Conduct a physical examination of the individual. This may be conducted by an
-authorized practitioner;
-
-2.
-
-Conduct an addiction-focused history of the individual. This may be conducted by an
-authorized practitioner; and
-
-3.
-
-Utilize screening tools in the process of gathering sufficient biopsychosocial and ASAM
-dimensional criteria as outlined in Chapter 6 of the ASAM Criteria, to inform an
-individualized, withdrawal management-focused service plan.
-
-B.
-
-Implementation of the service plan, including any amendments to the service plan and the
-individual’s clinical response to the services provided, must be maintained in the individual’s
-record during the time they remain engaged in Level 1-WM services. This may include withdrawal
-rating scales or flow sheets that are used, as needed.
-
-C.
-
-The service plan and progression tracking may be indicated in progress notes that align with the
-existing medical model for documentation.
-
-D.
-
-Individuals may engage in a pattern of admitting to, and discharging from, Level 1-WM services in
-a repeated and fluid manner throughout a concurrent behavioral health episode of care.
-Documentation specific to these engagement milestones for Level 1-WM services may be
-reflected in the existing medical model documentation and does not require a formal discharge
-summary as detailed in part 2.10.A.5 of these rules.
-
-E.
-
-Considerations for discharge from Level 1-WM services include, but are not limited to:
-1.
-
-Resolution of withdrawal symptoms;
-
-2.
-
-Symptoms that have not improved or have intensified after engaging in Level 1-WM
-services and the individual requires a higher service, such as Level 2-withdrawal
-management (Level 2-WM); or
-
-3.
-
-The individual is unable to participate in Level 1-WM and may require a different support
-system or delivery mechanism.
-
-F.
-
-If a higher level of care is required, the Level 1-WM agency must initiate a referral to the
-appropriate level of care.
-
-4.6
-
-Intensive Outpatient Program (IOP) Services Standards
-
-A.
-
-These rules are established to create standards for agencies seeking a sub-endorsement to
-provide intensive outpatient program (IOP) services, which includes ASAM Criteria Level 2.1 type
-services.
-
-B.
-
-Agencies providing intensive outpatient program services must meet the standards in this part
-4.6.
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-4.6.1
-
-Service Delivery and Setting
-
-A.
-
-Individuals receiving this level of service meet diagnostic criteria of acute state moderate severity
-mental illness, substance use, or co-occurring disorder criteria, as defined in the DSM-5-TR.
-Individuals may also meet high severity, as defined in the DSM-5-TR, but are stabilized and/or
-receiving medication-assisted treatment, as defined in part 1.2 of these rules, or
-pharmacotherapy, as defined in part 1.2 of these rules.
-
-B.
-
-IOP services are intended for individuals who require a higher level of intervention than can be
-provided in standard outpatient services.
-
-C.
-
-All services must be adapted to the individual’s developmental stage and physical and
-comprehensive needs.
-
-D.
-
-Services may be delivered via in-person, audio-visual telehealth, or audio-only telehealth format
-in accordance with telehealth regulations found in part 2.9 of these rules.
-
-E.
-
-Treatment groups must not exceed twelve (12) individuals receiving services.
-
-F.
-
-IOP support systems
-1.
-
-Agencies providing IOP services must have direct affiliation or close coordination through
-referral to more and less intensive levels of care. Agencies must also have a documented
-consultation and/or referral process through internal staff or other affiliation in place for
-medical, psychiatric, and medication-assisted treatment needs.
-a.
-
-Referral(s) will be provided in collaboration with the individual and their choice(s)
-for referred services.
-
-4.6.2
-
-Personnel
-
-A.
-
-Treatment personnel, for the purpose of this Chapter, unless otherwise noted, means the
-following behavioral health professionals trained in mental health, substance use, and/or cooccurring disorder identification and treatment and acting within their scope of practice:
-1.
-
-Authorized practitioners;
-
-2.
-
-Licensees;
-
-3.
-
-Certified addiction specialists (CAS);
-
-4.
-
-Candidates;
-
-5.
-
-Certified addiction technicians (CAT);
-a.
-
-6.
-
-If utilizing certified addiction technicians (CAT), the agency must ensure that
-CATs do not comprise more than twenty-five (25%) of the agency’s personnel.
-
-Counselors-in-training and/or interns.
-a.
-
-If utilizing counselors-in-training and/or interns, the agency must ensure that all
-clinical documentation is reviewed and co-signed by a clinical agency supervisor
-able to supervise pursuant to their scope of practice. Counselor-in-training and/or
-intern personnel must not comprise more than twenty-five percent (25%) of the
-agency’s personnel.
-
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-
-B.
-
-Agencies providing IOP must ensure treatment personnel have supervisor consultation available
-within eight (8) hours via in-person or by telehealth to discuss, when warranted, at minimum,
-psychiatric or medical concerns of individuals receiving services.
-
-C.
-
-Personnel must have supervisor consultation available within one (1) hour via in-person or
-telehealth to discuss, when warranted crisis/emergency situations.
-
-D.
-
-Services may include recovery support services rendered by peer support professionals in
-accordance with Chapter 3 of these rules.
-
-E.
-
-Agencies providing IOP services must provide training appropriate to the treatment-type focus
-and best practice standards.
-1.
-
-Training must include that treatment personnel understand the signs and symptoms of
-mental health, substance use, and co-occurring disorders and the basics of
-psychopharmacology.
-
-4.6.3
-
-Service Provisions
-
-A.
-
-Services must be conducted in regularly scheduled sessions that follow a planned format of
-treatment services of nine (9) to nineteen (19) contact hours per week for adults and six (6) to
-nineteen (19) contact hours per week for children under the age of eighteen (18).
-
-B.
-
-Services may include individual therapy, group therapy, medication-assisted treatment (MAT)
-monitoring and/or education, psychiatric medication education and/or monitoring, family therapy,
-peer professional services, educational/occupational groups, recreational therapy, and other
-therapies as deemed appropriate by assessment of the individual receiving services.
-
-4.6.4
-
-Documentation and Timeliness
-
-A.
-
-Agencies providing IOP services must document services pursuant to the standards set in parts
-2.10, 2.11, 2.12, and 2.13 of these rules.
-
-B.
-
-Upon initiation of services to an individual, preliminary screening and risk assessment must be
-completed in compliance with part 2.12.1 of these rules.
-
-C.
-
-As soon as is practicable upon admission, but no later than ten (10) calendar days from the date
-of preliminary screening and risk assessment, the agency must complete an initial assessment in
-accordance with part 2.12.2 of these rules.
-1.
-
-D.
-
-If the screening and risk assessment identifies an urgent clinical need for treatment of the
-individual, clinical services must be provided immediately, and the initial assessment
-must be completed within one (1) calendar day of preliminary screening.
-
-As soon as is practicable upon admission, but no later than sixty (60) calendar days from the first
-date of services, the agency must complete a comprehensive assessment in accordance with
-part 2.12.3 of these rules. The requirement that the comprehensive assessment be completed
-within sixty (60) days does not preclude the initiation or completion of the comprehensive
-assessment or the provision of treatment during the intervening sixty (60) day period.
-
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-
-E.
-
-Individual service plans must be created, in accordance with part 2.13.1 of these rules, within
-fourteen (14) calendar days after initial assessment. The service plan must be updated to reflect
-information from the completed comprehensive assessment. The agency must update the service
-plan throughout the course of treatment, review previous goals, and update those goals
-whenever there is a change in the person's level of care or functioning, and must occur, at
-minimum, every six (6) months.
-
-F.
-
-IOP services must be documented in the individual’s record in accordance with part 2.11 and
-2.13.2 of these rules and at a minimum frequency of one (1) progress note per session.
-
-4.7
-
-Partial Hospitalization Program (PHP) Services Standards
-
-A.
-
-These rules are established to create standards for agencies seeking a sub-endorsement to
-provide partial hospitalization program (PHP) services, which includes ASAM Criteria Level 2.5
-type services.
-
-B.
-
-Agencies providing partial hospitalization program services must meet the standards in this part
-4.7.
-
-4.7.1
-
-Service Delivery and Setting
-
-A.
-
-PHP services must generally be intended for individuals who require daily monitoring or
-management to treat mental health, substance use, and co-occurring disorders, as defined by the
-DSM-5-TR, that can be provided in a structured outpatient setting. Services include direct access
-to medical, psychiatric, and laboratory services.
-
-B.
-
-PHP service sites for children must include access to educational services and coordination with
-a school system, as appropriate.
-
-C.
-
-PHP services are appropriate for individuals with co-occurring mental health and substance use
-disorders if the disorders are diagnosed as moderate severity or are of higher severity, as defined
-by the DSM-5-TR, but have been stabilized.
-
-D.
-
-All services provided must be adapted to individual’s developmental stage and physical and
-comprehensive needs.
-
-E.
-
-Services may be delivered via in-person, audio-visual telehealth, or audio-only telehealth format
-in accordance with telehealth regulations found in part 2.9 of these rules.
-
-F.
-
-PHP agencies must meet the facility requirements set forth in part 2.6 of these rules or
-requirements in accordance with facility mandates under other regulatory state and federal
-entities for licensure in cases such as a medical facility, school, or other.
-
-G.
-
-Treatment groups must not exceed twelve (12) individuals receiving services.
-
-H.
-
-PHP support systems
-1.
-
-Agencies providing PHP services must inform individuals receiving treatment how to
-access emergency services by telephone twenty-four (24) hours per day, seven (7) days
-per week when the program is not in session. At minimum, agencies must provide
-emergency services information that includes contact information for services provided by
-the behavioral health crisis response system created pursuant to Section 27-60-103,
-C.R.S.
-
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-2.
-
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-
-Agencies providing PHP services must have direct affiliation or close coordination
-through referral to more and less intensive levels of care. Agencies providing PHP
-services must also have a documented consultation and/or referral process through
-internal staff or other affiliation for medical, psychiatric, and medication-assisted
-treatment needs.
-a.
-
-Referral(s) will be provided in collaboration with the individual and their choice(s)
-for referred services.
-
-4.7.2
-
-Personnel
-
-A.
-
-Treatment personnel, for the purpose of PHP services, unless otherwise noted, means the
-following behavioral health professionals trained in mental health and/or substance use disorder
-identification and treatment and acting within their scope of practice:
-1.
-
-Authorized practitioners;
-
-2.
-
-Licensees;
-
-3.
-
-Certified addiction specialists (CAS);
-
-4.
-
-Candidates;
-
-5.
-
-Certified addiction technicians (CAT);
-a.
-
-6.
-
-If utilizing certified addiction technicians (CAT), the agency must ensure that
-CATs do not comprise more than twenty-five (25%) of the agency’s personnel.
-
-Counselors-in-training and/or interns.
-a.
-
-If utilizing counselors-in-training and/or interns, the agency must ensure that all
-clinical documentation is reviewed and co-signed by a clinical agency supervisor
-able to supervise pursuant to their scope of practice. Counselor-in-training and/or
-intern personnel must not comprise more than twenty-five percent (25%) of the
-agency’s personnel.
-
-B.
-
-Services may include recovery support services rendered by peer support professionals in
-accordance with Chapter 3 of these rules.
-
-C.
-
-Agencies providing PHP services must ensure treatment personnel have supervisor consultation
-available within eight (8) hours via in-person or by telehealth and within two (2) calendar days inperson or by telehealth, when warranted, at minimum, to discuss at minimum psychiatric or
-medical concerns of individuals receiving services.
-
-D.
-
-Personnel must have supervisor consultation available within one (1) hour via in-person or
-telehealth to discuss, when warranted crisis and/or emergency situations.
-
-E.
-
-In addition to trainings required as a BHE in part 2.5 of these rules, PHP endorsed agencies must
-provide training appropriate to their treatment-type focus, as well as best practice standards.
-1.
-
-Training for PHP endorsed agencies must include training that treatment personnel
-understand the signs and symptoms of mental health, substance use, and co-occurring
-disorders and the basics of psychopharmacology.
-
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-
-2.
-
-PHP endorsed agencies must ensure that all personnel providing medical services at the
-PHP have completed and maintained any training required by the personnel’s applicable
-government licensing entity in order to work within behavioral health focused services.
-
-4.7.3
-
-Service Provisions
-
-A.
-
-Mental health - only service provisions
-
-B.
-
-2 CCR 502-1
-
-1.
-
-Individuals for this level of treatment meet diagnosed acute state severe and persistent
-mental illness criteria, as defined in the DSM-5-TR, and are not at current risk of harming
-themselves or others.
-
-2.
-
-Services must be provided at a minimum of twenty (20) or more hours a week including a
-minimum of three (3) hours per day and a minimum of four (4) calendar days per week.
-Service frequency and intensity must be modified to meet assessment and service plan
-objectives.
-
-3.
-
-Services may include medical services, individual therapy, group therapy, medication
-management, educational/occupational groups, peer professional services, recreational
-therapy, and other therapies as deemed appropriate by assessment of the individual
-receiving services.
-
-Substance use disorder and co-occurring service provisions (including ASAM Criteria Level 2.5)
-1.
-
-Individuals for this level of treatment meet diagnostic criteria for a substance use related
-disorder as defined in the DSM-5-TR and are at low risk of withdrawal or have minimal
-remaining withdrawal symptoms.
-
-2.
-
-Services must be conducted with a minimum frequency of twenty (20) regularly
-scheduled treatment contact hours per week.
-
-3.
-
-Services may include medical services, individual therapy, group therapy, medication
-management, medication-assisted treatment monitoring/education,
-educational/occupational groups, recreational therapy, peer professional services, and
-other therapies as deemed appropriate by assessment of individual receiving services.
-
-4.7.4
-
-Documentation and Timeliness
-
-A.
-
-All PHP service documentation requirements must follow the requirements set forth in parts 2.10,
-2.11, 2.12, and 2.13 of these rules.
-
-B.
-
-Upon entrance into service, preliminary screening and risk assessment must be completed in
-compliance with part 2.12.1 of these rules.
-
-C.
-
-As soon as practicable upon admission, but no later than ten (10) calendar days from the date of
-preliminary screening and risk assessment, the agency must complete an initial assessment in
-accordance with part 2.12.2 of these rules
-1.
-
-If the screening identifies an urgent need, clinical services are provided, and the initial
-assessment must be completed within one (1) calendar day of preliminary screening.
-
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-
-D.
-
-As soon as practicable upon admission, but no later than sixty (60) calendar days from the first
-date of services, the agency must complete a comprehensive assessment in accordance with
-part 2.12.3 of these rules. The requirement that the comprehensive assessment be completed
-within sixty (60) days does not preclude the initiation or completion of the comprehensive
-assessment or the provision of treatment during the intervening sixty (60) day period.
-
-E.
-
-The individual service plan must be created, in accordance with part 2.13.1 of these rules, within
-fourteen (14) calendar days after initial assessment. The service plan must be updated to reflect
-information from the completed comprehensive assessment. The agency must update the service
-plan throughout the course of treatment, review previous goals and update those goals whenever
-there is a change in the person's level of care or functioning, and must occur, at minimum, every
-fourteen (14) calendar days.
-
-F.
-
-PHP services must be documented in the individual’s record in accordance with part 2.11 and
-2.13.2 of these rules and at a minimum frequency of one (1) progress note per session and one
-(1) progress note per week.
-
-4.8
-
-Level 2-Withdrawal Management (Level 2-WM): Ambulatory Withdrawal Management with
-Extended On-Site Monitoring Services Standards
-
-A.
-
-This part 4.8 is established to create standards for agencies seeking a sub-endorsement to
-provide outpatient Level 2-Withdrawal Management (Level 2-WM) services in accordance with
-Chapter 6 of the ASAM Criteria.
-
-B.
-
-Agencies providing Level 2-WM services must meet the standards in this part 4.8. Agencies
-providing Level 2-WM services may:
-1.
-
-Also engage in outpatient behavioral health services by meeting the standards for the
-outpatient sub-endorsement(s) selected by the agency; or
-
-2.
-
-Provide only Level 2-WM services and coordinate with other providers for ongoing and
-concurrent outpatient behavioral health treatment services.
-
-4.8.1
-
-Service Delivery and Setting
-
-A.
-
-Level 2-WM is an outpatient withdrawal management service that complements individualized
-behavioral health treatment services.
-
-B.
-
-Individuals may participate in Level 2-WM for a period of time in which it is determined to be
-medically appropriate. Admission to Level 2-WM services must not hinder the individual’s ability
-to participate in concurrent behavioral health services. This includes the potential process of
-admitting to, and discharging from, such withdrawal management services one (1) or more times
-by the individual.
-
-C.
-
-Level 2-WM services are generally provided in a day hospital-type setting, general health care
-facility, or an agency providing substance use disorder or mental health treatment.
-
-D.
-
-Level 2-WM services offered by agencies that do not provide behavioral health services within
-their agency structure must be affiliated with BHEs or other necessary providers to ensure the
-treatment needs of all individuals served can be met. Documentation of this affiliation must be
-presented to the BHA, upon request. Referral(s) will be provided in collaboration with the
-individual and their choice(s) for referred services.
-
-E.
-
-Support systems
-
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-1.
-
-F.
-
-Agencies must:
-a.
-
-Have the ability to obtain a comprehensive medical history and physical
-examination at the time of admission to Level 2-WM services;
-
-b.
-
-Have twenty-four (24)-hour access to emergency medical consultation services,
-should emergency services become indicated;
-
-c.
-
-Have the ability to provide or assist in accessing transportation services for
-individuals who lack safe transportation; and
-
-d.
-
-Have the ability to coordinate services with behavioral health personnel, within
-the agency or through referral.
-
-Diagnostic criteria
-1.
-
-Individuals participating in Level 2-WM services typically exhibit a moderate withdrawal
-severity rating on standardized withdrawal severity scales as well as mild/stable
-psychiatric symptoms for emotional, behavioral, and cognitive conditions.
-
-2.
-
-Individuals may also present with a higher withdrawal severity rating on standardized
-withdrawal severity scales or with higher psychiatric symptom requirements, with
-sufficient protective factors and other support system(s) in place to safely participate in
-Level 2-WM services.
-
-3.
-
-Due to the safety concerns inherent with withdrawal, individuals with complicated
-withdrawal severity ratings may not be appropriate for Level 2-WM services.
-a.
-
-G.
-
-2 CCR 502-1
-
-If the medical personnel determines that an individual meeting the above criteria
-can be safely and effectively served in a Level 2-WM setting, the rationale and
-plan for safe management and services must be documented in the individual’s
-record.
-
-4.
-
-Individuals may be more advanced in their readiness to change and may require
-assistance with transportation or other engagement barriers.
-
-5.
-
-Individuals may participate in Level 2-WM services without a formal substance use
-disorder diagnosis if collateral information indicates a high probability of such diagnosis.
-The agency must ensure further evaluation of this probable diagnosis, either completed
-within the agency or through referral to a behavioral health provider.
-
-Agencies must:
-1.
-
-Provide safe management and documentation of signs and symptoms of intoxication and
-withdrawal; and
-
-2.
-
-Ensure that discharge planning begins at the time of admission to Level 2-WM services,
-to allow for necessary care coordination and transition into ongoing or concurrent
-treatment services to occur successfully based on screening or assessment of needs.
-
-4.8.2
-
-Personnel
-
-A.
-
-Level 2-WM services are primarily provided by medical professionals who are acting within the
-scope of their practice and are trained in assessing and managing intoxication and states of
-withdrawal. This may include, but is not limited to:
-
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-
-1.
-
-Authorized practitioners; and
-
-2.
-
-Nurses.
-
-2 CCR 502-1
-
-B.
-
-Level 2-WM is an outpatient service that requires daily monitoring of withdrawal symptoms and
-assessments of progress. This requires medical personnel to be readily accessible and able to
-evaluate an individual’s needs and safe placement in Level 2-WM.
-
-4.8.3
-
-Service Provisions
-
-A.
-
-Agencies must develop policies and procedures to address service delivery expectations. These
-policies and procedures must address, but are not limited to the following:
-
-B.
-
-C.
-
-1.
-
-Consultation with specialized clinical and medical professionals for individualized Level 2WM care;
-
-2.
-
-Coordinating an individual’s transition into other Levels of care determined to be
-appropriate through triage, screening, evaluation, and/or assessment processes
-completed during their Level 2-WM services. This may include collaboration with
-emergency behavioral health services, such as Colorado Crisis Services, as appropriate;
-
-3.
-
-Conducting or arranging for laboratory and/or toxicology tests to be completed;
-
-4.
-
-Responding to individuals who are assessed as being a current threat to themselves or
-others, including the appropriate use of law enforcement;
-
-5.
-
-Communication with intoxicated individuals leaving Level 2-WM services against
-personnel recommendations, including the use of emergency commitments; and
-
-6.
-
-Circumstances under which individuals may be discharged from Level 2-WM services,
-other than completing withdrawal management or leaving against personnel
-recommendations.
-
-Admission procedures for Level 2-WM services must include at a minimum:
-1.
-
-Collection of information regarding the degree of alcohol and/or other drug intoxication as
-evidenced by breathalyzer, urinalysis, self-report, observation, or other evidence-based
-or best practices;
-
-2.
-
-A pregnancy screening for pregnancy-capable individuals;
-
-3.
-
-Taking of vital signs; and
-
-4.
-
-Administration of a validated clinical withdrawal assessment tool.
-
-Therapies offered by the agency must include a range of treatment approaches and support
-services based on the screening or assessment of the individual’s treatment needs. Treatment
-services may include but are not limited to:
-1.
-
-Screening;
-
-2.
-
-Assessment;
-
-3.
-
-Group and individual counseling;
-
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-
-4.
-
-Motivational enhancement;
-
-5.
-
-Family therapy;
-
-6.
-
-Educational groups;
-
-7.
-
-Occupational and recreational therapy;
-
-8.
-
-Addiction pharmacology;
-
-9.
-
-Mental health and physical health pharmacology, as needed;
-
-10.
-
-Medication management;
-
-11.
-
-Peer, social and recovery support;
-
-12.
-
-Care coordination; and
-
-13.
-
-Support for the development of life skills.
-
-2 CCR 502-1
-
-D.
-
-If the agency does not provide a treatment approach or support service necessary to meet the
-individual’s treatment needs, the agency must ensure that care coordination occurs.
-
-E.
-
-Agencies must provide additional service planning for managing individuals with medical
-conditions, suicidal ideation, pregnancy, psychiatric conditions, and other conditions which place
-individuals at additional risk during withdrawal management.
-
-F.
-
-Agencies must provide assessments of individual readiness for treatment and services based on
-the service plan and the assessments and interventions shall be documented in the individual’s
-record.
-
-G.
-
-Medication-assisted treatment (MAT) for withdrawal management
-1.
-
-Agencies must continue individuals on their medication-assisted treatment regimen and
-will only remove individuals from medications treating opioid use disorders at the
-individual’s request or if it is deemed medically appropriate by an authorized practitioner.
-
-2.
-
-Agencies must inform individuals receiving services about access to medication-assisted
-treatment. Upon the individual’s consent, the agency must provide medication-assisted
-treatment directly.
-
-3.
-
-Agencies must obtain a controlled substance license pursuant to section 21.300 of 2
-CCR 502-1 from the BHA if they plan to dispense, compound, or administer a controlled
-substance from stock medication in order to treat a substance use disorder or to treat the
-withdrawal symptoms of a substance use disorder.
-a.
-
-A controlled substance license is not required if the agency intends to provide
-medication-assisted treatment (MAT) services through prescription writing only,
-under an independent prescriber’s license.
-
-4.8.4
-
-Documentation and Timeliness
-
-A.
-
-Upon admission to Level 2-WM services, the agency must complete the following requirements,
-keeping documentation of timely completion in the individual’s record:
-
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-
-2 CCR 502-1
-
-1.
-
-Conduct a physical examination of the individual. This may be conducted by an
-authorized practitioner;
-
-2.
-
-Conduct an addiction-focused history of the individual. This may be conducted by an
-authorized practitioner; and
-
-3.
-
-Utilize screening tools in the process of gathering sufficient biopsychosocial and ASAM
-dimensional criteria as outlined in Chapter 6 of the ASAM Criteria, to inform an
-individualized, withdrawal management-focused service plan.
-
-B.
-
-Implementation of the service plan, including any amendments to the service plan and the
-individual’s clinical response to the services provided, must be maintained in the individual’s
-record during the time they remain engaged in Level 2-WM services. This may include serial
-medical assessments, withdrawal rating scales and/or flow sheets that are conducted, as needed.
-
-C.
-
-The service plan and progression tracking may be indicated in progress notes that align with the
-existing medical model for documentation.
-
-D.
-
-Individuals may engage in a pattern of admitting to, and discharging from, Level 2-WM services in
-a repeated and fluid manner throughout a concurrent behavioral health episode of care.
-Documentation specific to these engagement milestones for Level 2-WM services may be
-reflected in the existing medical model documentation and does not require a formal discharge
-summary as detailed in part 2.10.A.5 and 2.10.A.6 of these rules.
-
-E.
-
-Considerations for discharge from Level 2-WM services include, but are not limited to:
-
-F.
-
-1.
-
-Resolution or diminishing of withdrawal symptoms, that allow the individual to be safely
-served at a lower service level, such as Level 1-WM;
-
-2.
-
-Symptoms that have not improved or have intensified after engaging in Level 2-WM
-services and the individual requires a higher service, such as Level 3-withdrawal
-management (Level 3-WM); or
-
-3.
-
-The individual is unable to participate in Level 2-WM and may require a different support
-system or delivery mechanism.
-
-If a different level of care is required, the agency providing Level 2-WM services must initiate a
-referral to the appropriate level of care.
-
-Chapter 5:
-
-Behavioral Health Residential and Level 3-Withdrawal Management Services
-
-5.1
-
-Authority and Applicability
-
-A.
-
-Chapter 5 establishes the standards for agencies electing to provide behavioral health residential
-and/or Level 3-Withdrawal Management (Level 3-WM) services. The authority to promulgate
-these service-specific requirements that apply to BHEs electing to provide this service comes
-from Sections 27-50-502(1), 27-50-106, 27-50-301(5), 27-71-105(1), and 27-50-107(3)(b), C.R.S.
-
-B.
-
-These rules are established to create standards for agencies seeking an endorsement to provide
-behavioral health residential and/or Level 3-WM.
-
-C.
-
-In addition to the overall endorsement associated with this Chapter 5, agencies must hold the
-relevant sub-endorsement(s) to provide these services, as detailed below. The subendorsements build in alignment with the natural progression of the continuum of care, with parts
-that detail applicability standards as noted in parts 5.4 through 5.11 of this Chapter.
-
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-
-D.
-
-Agencies must elect a treatment type sub-endorsement to provide services to individuals, which
-may include mental health treatment services, substance use disorder treatment services, or
-both.
-
-E.
-
-Agencies are not required to serve all treatment types within their selected sub-endorsement(s). If
-the agency does not provide a service needed by an individual, the agency must ensure that care
-coordination for the needed service occurs.
-
-F.
-
-Agencies providing behavioral health residential services must meet the standards in:
-
-G.
-
-H.
-
-1.
-
-This part 5.1 through part 5.3 of this Chapter; and
-
-2.
-
-The standards required for the sub-endorsement(s) of the agency that are set forth in
-these rules, including treatment type(s) provided.
-
-Agencies providing Level 3-WM services must meet the standards in:
-1.
-
-This part 5.1 through part 5.2 of this Chapter; and
-
-2.
-
-The standards required for the sub-endorsement(s) of Level 3-WM services provided by
-the agency as set forth in part 5.6 and/or part 5.11 of this Chapter.
-
-The continuum of behavioral health residential and Level 3-WM services are set forth in the
-following section of this Chapter:
-1.
-
-Clinically monitored services, part 5.4 of this Chapter, including:
-a.
-
-2.
-
-3.
-
-I.
-
-Level one mental health transitional living homes: part 5.4 of this Chapter.
-
-Clinically managed services, part 5.5 through part 5.9 of this Chapter, including:
-a.
-
-ASAM 3.1-type services: part 5.5 of this Chapter.
-
-b.
-
-Level 3.2-WM services: part 5.6 of this Chapter.
-
-c.
-
-ASAM Level 3.3 services: part 5.7 of this Chapter.
-
-d.
-
-Level two mental health transitional living homes: part 5.8 of this Chapter.
-
-e.
-
-ASAM 3.5-type services: part 5.9 of this Chapter.
-
-Medically monitored services, part 5.10 through 5.11 of this Chapter, including:
-a.
-
-ASAM 3.7-type services, part 5.10 of this Chapter.
-
-b.
-
-Level 3.7-WM services, part 5.11 of this Chapter.
-
-If the agency provides services to both mental health and substance use disorder treatment
-types, they must meet the standards of all relevant sub-endorsement(s) set forth in this Chapter
-as noted above.
-
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-
-5.2
-
-Behavioral Health Residential and Level 3-Withdrawal Management (Level 3-WM) Services
-Standards
-
-A.
-
-This part 5.2 applies to all agencies providing behavioral health residential and/or Level 3Withdrawal Management (Level 3-WM) services.
-
-5.2.1
-
-Service Delivery and Setting
-
-A.
-
-The agency must promote safety and avoid abuse, including psychological abuse, for all
-individuals served by the agency. The agency must prioritize the living space assignment process
-to ensure person-centered and trauma-informed services are received by the individual and
-overall milieu. Factors to be considered in the determination of a safe living space assignment
-may include, but are not limited to:
-
-B.
-
-1.
-
-Age (child, youth or adult);
-
-2.
-
-Gender identity;
-
-3.
-
-Cultural needs identified during the assessment process;
-
-4.
-
-The individual’s sex (male, female, intersex);
-
-5.
-
-Individual’s ability to interact safely with others; and
-
-6.
-
-The individual’s requests.
-
-The agency must have physical barriers such as doors and walls, and personnel oversight of
-activities to ensure safety for all personnel and individuals served. This management may also
-include, but is not limited to:
-1.
-
-Personnel oversight, such as workstations that separate living space assignments;
-
-2.
-
-Video or other monitored oversight that promptly notifies personnel of unexpected
-movement in the milieu; and
-
-3.
-
-Other practical arrangements that support the safe management of the individuals
-receiving services.
-
-5.2.2
-
-Personnel
-
-A.
-
-Agencies providing behavioral health residential and/or Level 3-WM services must have on-site
-personnel twenty-four (24) hours per day, seven (7) days per week.
-1.
-
-This coverage may include a combination of personnel qualified to provide treatment to
-individuals receiving services as well as personnel who are trained to provide milieu
-management services.
-
-2.
-
-Personnel qualified to provide treatment may also provide milieu management, as noted
-below.
-
-3.
-
-On-site personnel must be sufficient to address the needs of the individuals served as
-well as the safety of personnel providing oversight. See the relevant sub-endorsement(s)
-in this Chapter for specific ratios of individuals served to personnel, if applicable.
-
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-2 CCR 502-1
-
-B.
-
-Minimum agency personnel ratios, percentages and requirements are specific to each physical
-location where services are being provided. This includes on-call personnel that may assist the
-site, as needed.
-
-C.
-
-The qualifications and credentialing of personnel providing treatment must be reflective of the
-population(s) receiving services and meet the minimum standards and ratios present in the
-relevant sub-endorsement(s), as applicable.
-
-D.
-
-Treatment personnel
-1.
-
-2.
-
-E.
-
-For agencies providing clinically managed or medically monitored residential and/or Level
-3-WM services, personnel qualified to provide treatment means the following behavioral
-health professionals acting within their scope of practice and trained in mental health
-and/or substance use disorder identification and treatment:
-a.
-
-Authorized practitioners;
-
-b.
-
-Licensees;
-
-c.
-
-Candidates;
-
-d.
-
-Counselors-in-training; and
-
-e.
-
-Interns.
-
-Agencies providing residential substance use disorder, residential co-occurring, and/or
-Level 3-WM services may also utilize the following as treatment personnel, when
-applicable:
-a.
-
-Certified addiction specialists (CAS); and
-
-b.
-
-Certified addiction technicians (CAT).
-
-Milieu management personnel
-1.
-
-In addition to the treatment personnel noted in part 5.2.2.D of this Chapter, agencies
-providing behavioral health residential and/or Level 3-WM services may utilize the
-following personnel for milieu management:
-a.
-
-Peer support professionals, and
-
-b.
-
-Group living workers.
-(1)
-
-If utilizing group living workers for milieu management, these personnel
-must:
-(a)
-
-Be assigned duties and responsibilities that are within their
-training and scope of practice. They must not perform tasks that
-are required to be performed by treatment personnel as outlined
-in part 5.2.2.D; and
-
-(b)
-
-Be assigned to the clinical director or a licensee for training and
-oversight of milieu management services provided.
-
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-
-(c)
-
-2 CCR 502-1
-
-If correctional personnel, such as security or correctional officers,
-are utilized as group living workers within an agency that
-provides services in a correctional setting, they must be
-responsive and accountable to the clinical director or other
-assigned clinical supervisor to ensure the culture of the program
-is supported.
-
-2.
-
-If utilizing peer support professionals for milieu management, the agency must follow
-standards for recovery support services rendered by peer support professionals in
-accordance with Chapter 3 of these rules.
-
-3
-
-Agencies that have shifts without credentialed personnel on-site as a result of utilizing
-cats, counselors-in-training, interns, peer support professionals and/or group living
-workers for milieu management must ensure that consultation with a credentialed person
-is immediately available. This consultation must be provided by the clinical director or a
-licensee.
-a.
-
-Excluding clinically monitored services, this consultation must include an on-site
-response by the credentialed personnel within thirty (30) minutes if needed.
-
-5.2.3
-
-Service Provisions
-
-A.
-
-Agencies providing behavioral health residential and/or Level 3-WM services must offer a range
-of treatment approaches and support services to meet the individual’s treatment needs, as
-determined by the screening and/or assessment process. Services offered may include, but are
-not limited to:
-1.
-
-Screening;
-
-2.
-
-Comprehensive assessment;
-
-3.
-
-Group and individual counseling;
-
-4.
-
-Motivational enhancement;
-
-5.
-
-Family therapy;
-
-6.
-
-Educational groups;
-
-7.
-
-Occupational and recreational therapy;
-
-8.
-
-Behavioral health pharmacology;
-
-9.
-
-Physical health pharmacology;
-
-10.
-
-Medication management;
-
-11.
-
-Peer, social and recovery support;
-
-12.
-
-Care coordination; and
-
-13.
-
-Support for the development of life skills.
-
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-
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-
-B.
-
-If the agency does not provide a treatment approach or support service necessary to meet the
-individual’s treatment needs, the agency must ensure that care coordination for the needed
-service occurs.
-
-5.2.4
-
-Documentation and Timeliness
-
-A.
-
-See the behavioral health residential and/or Level 3-WM services sub-endorsement(s) as set
-forth in this Chapter for relevant documentation and timeliness standards.
-
-5.3
-
-Behavioral Health Residential Services
-
-A.
-
-This part 5.3 applies to all agencies providing behavioral health residential services.
-
-B.
-
-This part 5.3 does not apply to agencies providing only Level 3-WM services.
-
-5.3.1
-
-Service Delivery and Setting
-
-A.
-
-Agencies providing behavioral health residential services must ensure that they can sufficiently
-provide for the behavioral health needs of all individuals served. These services may occur
-through direct service provision by agency personnel or through the coordination of services with
-other agencies endorsed to provide the services an individual requires.
-
-B.
-
-Agencies must prioritize the development of necessary living skills to support the individual’s
-successful integration, or reintegration, into independent or other living situations within their
-community. This may include services developed for participation by all individuals as well as
-services tailored to an individual's assessed needs.
-
-C.
-
-Services offered by the agency must be regularly scheduled and relevant to the treatment type
-and population receiving services.
-
-D.
-
-Agencies providing behavioral health residential services must:
-1.
-
-Have direct affiliation or close coordination through referral to more and less intensive
-levels of behavioral health care;
-
-2.
-
-Have the ability to conduct or arrange for laboratory and/or toxicology tests to be
-completed; and
-
-3.
-
-Develop and maintain house rules as noted in part 5.3.3.C of this Chapter.
-
-5.3.2
-
-Personnel
-
-A.
-
-All personnel must receive training and demonstrate competency in areas relevant to their
-specific duties and responsibilities prior to working independently in the residential setting.
-Training may be provided through formal instruction, self-study courses, or on-the-job training.
-Personnel training must include, but is not limited to the following topics:
-1.
-
-House rules development, implementation, and updating; and
-
-2.
-
-How to access and utilize an individual’s psychiatric advanced directive (PAD), when
-applicable.
-a.
-
-If the individual does not have a PAD completed, personnel must offer to assist in
-PAD completion if the individual is interested and it is clinically appropriate.
-
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-
-5.3.3
-
-General Provisions
-
-A.
-
-Between 10 pm and 6 am, personnel must conduct, and document safety checks of all individuals
-served. The intervals in which safety checks are completed must be sufficient to provide for the
-health and safety of the individuals being served.
-
-B.
-
-The agency must ensure that telephone services available on-site include videophones for
-hearing or speech-impaired individuals served.
-
-C.
-
-House rules
-1.
-
-The agency must establish written house rules and place them in a location where they
-are always available to individuals and visitors.
-
-2.
-
-The agency must develop policies and procedures regarding house rules which includes
-a list of all possible actions which may be taken by the agency if any rule is knowingly
-violated by an individual served, and how the agency will document violations and actions
-taken.
-
-3.
-
-House rules must address, at a minimum, the following items:
-a.
-
-Smoking and tobacco utilization, including the use of electronic cigarettes,
-vaporizers, and chewing tobacco;
-
-b.
-
-Cooking;
-
-c.
-
-Visitors;
-
-d.
-
-Telephone usage, including frequency and duration of calls;
-
-e.
-
-Use of common areas and devices, such as television, radio, and computer;
-
-f.
-
-Consumption of alcohol and marijuana; and
-
-g.
-
-Pets.
-(1)
-
-4.
-
-5.
-D.
-
-Service animals, as determined by the Americans with Disabilities Act
-(ADA), are not classified as pets. House rules must not limit an
-individual’s right to have a service animal while served by the agency.
-
-House rules must not:
-a.
-
-Take the place of, or conflict with, any requirements of these rules; or
-
-b.
-
-Delay, discourage, or prevent an individual’s exercise of their rights.
-
-The agency must revisit and update house rules at least annually and allow for
-collaboration and feedback from individuals.
-
-Court ordered referrals for residential services may require a length of stay that is based on a
-legal requirement and may not be clinically necessary for the duration of that period of time. The
-agency is expected to evaluate if the supervising entity’s recommendation matches the
-individual’s assessed clinical needs. The agency must address any differences identified with the
-supervising entity directly and document the results in the individual’s record.
-
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-
-E.
-
-See the behavioral health residential services sub-endorsement(s) as set forth in this Chapter for
-relevant service provision standards.
-
-5.4
-
-Level One Mental Health Transitional Living Home Services
-
-A.
-
-This part 5.4 applies to agencies operating level one mental health transitional living homes. This
-level of care is defined in Chapter 1 of these rules.
-
-5.4.1
-
-Service Delivery and Setting
-
-A.
-
-Level one mental health transitional living homes shall comply with the requirements of parts 5.1
-through this part 5.4, unless otherwise noted.
-
-5.4.2
-
-Personnel
-
-A.
-
-To determine level of oversight needed to ensure safety, the agency shall consider, at a
-minimum, the following items:
-1.
-
-The acuity and needs of the individuals, and
-
-2.
-
-The services outlined in the service plan of an individual.
-
-B.
-
-Personnel shall be sufficient in number to help individuals needing or potentially needing
-assistance, and to account for the risk of accident, hazards, or other challenging events based on
-the number of individuals in residence.
-
-C.
-
-When determining personnel requirements, the agency must consider the needs of the
-individuals receiving services. Oversight of individuals must include on-site and on-call availability
-of personnel with appropriate training and expertise based on the needs of the individuals.
-
-D.
-
-Personnel must be assigned to complete tasks commensurate with their skills and training.
-Personnel that are not licensed or credentialed shall not complete specialized screenings,
-assessments, therapies, or techniques for which they are not qualified.
-
-E.
-
-Only personnel with the appropriate training and expertise may train personnel on specialized
-techniques beyond general personal care and assistance with activities of daily living as defined
-in these rules. This includes, but is not limited to, transfers requiring specialized equipment, and
-assistance with therapeutic diets. Personnel must be evaluated for proficiency in demonstrating
-the specialized technique before the delivery of a personal service requiring a specialized
-technique.
-1.
-
-Documentation regarding training and proficiency in specialized techniques must be
-included in the personnel files.
-
-F.
-
-A nurse who is employed or contracted by the agency may delegate to other personnel in
-accordance with the Nurse and Nurse Aide Practice Act pursuant to Article 255 of Title 12,
-C.R.S., if the nurse is the supervising nurse for the personnel.
-
-G.
-
-The agency shall ensure that personnel comply with all agency policies and procedures and shall
-not allow personnel to perform any functions which are outside of their job description, scope of
-practice, or an individual's service plan.
-
-H.
-
-Personnel providing non-medical transportation to individuals must meet the following
-requirements:
-
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-
-1.
-
-Must be eighteen (18) years of age or older to render services;
-
-2.
-
-Has at least one year of driving experience;
-
-3.
-
-Possesses a valid driver’s license;
-
-4.
-
-Has provided a copy of their current Colorado motor driving vehicle record, with up to the
-previous seven years of driving history as applicable; and
-
-5.
-
-Has completed a Colorado or national-based criminal history record check.
-
-I.
-
-Vehicles used during the provision of non-medical transportation must be safe and in good
-working order. To ensure the safety and proper functioning of the vehicles, vehicles must pass a
-vehicle safety inspection prior to it being used to render services. Inspection requirements must
-be outlined in the agency’s policies and procedures, and records of such inspections must be
-maintained by the agency.
-
-J.
-
-The agency shall have policies and procedures for determining when personnel are not permitted
-to provide non-medical transportation based on violations presented on the driver’s motor vehicle
-record.
-
-K.
-
-An agency that uses a separate agency, organization, or personnel to provide services for the
-mental health transitional living home or a specific individual shall have a written agreement that
-sets forth the terms of the arrangement. The agreement must specify, at a minimum, the following
-items:
-1.
-
-The specific services to be provided;
-
-2.
-
-The time frame for the provision of such services;
-
-3.
-
-The contractor’s obligation to comply with all applicable agency policies and procedures,
-including personnel qualifications;
-
-4.
-
-How such services will be coordinated and overseen by the agency; and
-
-5.
-
-The procedure for payment of services provided under the contract.
-
-L.
-
-If contract personnel and/or services are used, the agency shall ensure the contractor meets all
-applicable requirements of these regulations.
-
-M.
-
-Notwithstanding the above criteria, the agency shall retain responsibility to ensure the health,
-safety and welfare of the individuals, and the provision of necessary services, including but not
-limited to, the minimum necessary services set forth in part 5.5.1.B.
-
-5.4.3
-
-Service Provisions
-
-A.
-
-The agency shall ensure the provision of accommodations, personnel, and services necessary for
-the welfare and safety of individuals.
-
-B.
-
-The agency shall make available, either directly or indirectly through contracted services, the
-following services, sufficient to meet the needs of the individuals. These services must include but
-are not limited to:
-
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-1.
-
-2 CCR 502-1
-
-A physically safe and sanitary environment that includes, but is not limited to, measures
-to reduce the risk of potential hazards in the physical environment and that accounts for
-the unique characteristics of the resident population;
-a.
-
-When a transitional living home utilizes a delayed egress door at an exit point,
-the exit door must allow full egress in emergencies, and must only be used to
-assist personnel in maintaining supervision and redirecting individuals back into
-the care setting.
-
-b.
-
-Egress alert devices must only be used to assist personnel in redirecting
-individuals back into the mental health transitional living home when personnel
-are alerted to an individual's departure, as opposed to restricting the free
-movement of individuals.
-
-2.
-
-Room and board;
-
-3.
-
-Personnel to assist with personal services;
-
-4.
-
-Assistance with medication;
-
-5
-
-Life skills training;
-
-6.
-
-a.
-
-The agency shall support individuals to maintain and develop skills for
-independent living through regular, structured individual and group engagement
-opportunities.
-
-b.
-
-Training opportunities must include therapeutic and habilitative activities to
-facilitate the development of life skills and promote independent living and must
-support the pursuit of individual’s interests and goals.
-
-c.
-
-The agency shall document in the record the individual’s engagement and
-progress in life skills training and other training opportunities.
-
-d.
-
-If requested, the agency shall assist an individual with identifying and accessing
-outside services and community events.
-
-Intensive case management;
-a.
-
-As appropriate for the needs of the individual, the agency shall:
-(1)
-
-Convene the individual, their legal representative and/or the persons
-involved in the individual’s treatment and care, including medical and
-behavioral health providers, and persons identified by the individual, for
-the purpose of care planning and coordination, in order to facilitate
-wellness, self-management, and recovery of the whole person.
-
-(2)
-
-Provide proactive and intentional outreach and engagement with the
-individual and their identified support persons to build necessary trust
-and support.
-
-(3)
-
-Assess for support needs, risk factors and health related social needs
-and support the individual in accessing care, resources, and services to
-address health related social needs including but not limited to:
-(a)
-
-Food security
-
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-
-b.
-7.
-
-2 CCR 502-1
-
-(b)
-
-Housing stability and security
-
-(c)
-
-Personal safety
-
-(d)
-
-Access to health services including preventative health care
-
-(e)
-
-Physical health concerns for which the individual is not receiving
-adequate treatment
-
-(f)
-
-Ongoing behavioral health care needs
-
-Intensive case management must involve discharge planning in accordance with
-the requirements of part 2.10.A.6 of these rules.
-
-Non-medical transportation and access to the community
-a.
-
-The agency shall provide for community access through non-medical
-transportation services. This includes providing accessible transportation when
-an individual requires adaptive supports.
-
-C.
-
-Agencies will arrange for the individual to receive community-based behavioral health services.
-
-D.
-
-The agency shall assume responsibility for all services it provides, including those provided by
-contract.
-
-E.
-
-Services provided by or coordinated by the agency may be provided via telehealth at the
-discretion of the administrator, to the extent that such services meet the needs of the individual,
-fulfill the requirements set forth in this Chapter, and account for individuals’ preferences for
-service delivery
-
-F.
-
-Admission and discharge
-1.
-
-The agency shall ensure, prior to admission and move-in, that an individual’s needs can
-be fully met either directly or through coordination with additional providers. The agency's
-ability to meet individual needs must be based upon a comprehensive pre-admission
-assessment of an individual's physical, mental, and social needs, which must be
-documented in, and become part of, the individual’s record. The pre-admission
-assessment must also include all screening and initial assessment requirements set forth
-in part 2.12 of these rules.
-
-2.
-
-An agency shall not admit any individual who:
-
-3.
-
-a.
-
-Needs regular 24-hour medical or nursing care,
-
-b.
-
-Has an acute physical illness which cannot be safely managed through
-medication or prescribed therapy
-
-The agency shall arrange for the transfer or transition of care for any individual who has
-an acute physical illness which cannot be safely managed through medication or
-prescribed therapy, or for an individual who develops a need for 24-hour medical or
-nursing care
-
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-
-4.
-
-G.
-
-2 CCR 502-1
-
-Prior to discharging an individual because of increased care needs, which may include,
-but are not limited to, changes in health status or where an individual becomes an
-imminent danger to self or others, the agency shall make documented efforts to meet the
-individual’s needs through other means. The documented efforts must include:
-a.
-
-Taking all measures necessary to protect the individual and others, including
-following agency policies and procedures for behavioral and physical health
-emergencies, as required per parts 2.10.D and 2.10.E of these rules;
-
-b.
-
-Reassessing the individual and revising their service plan to identify the
-individual's current needs and what services the agency will provide or
-coordinate to meet those needs or address newly assessed risks; and
-
-c.
-
-Ensuring all personnel are aware of any revisions to the service plan and are
-properly trained to provide supervision and support consistent with the service
-plan.
-
-5.
-
-The agency shall coordinate a voluntary or involuntary discharge with the individual, the
-individual's legal representative and/or the persons, including medical and behavioral
-health providers, who will be responsible for services provided to the individual per the
-discharge plan.
-
-6.
-
-In the event an individual is transferred to another health care provider for additional care,
-the agency shall arrange to evaluate the individual prior to readmission or shall discharge
-the individual in accordance with the discharge procedures set forth in this Chapter.
-
-7.
-
-When an individual is discharged, it is the responsibility of the agency to develop a
-discharge plan, and provide care coordination to facilitate, to the extent possible, the
-individual's transition to an appropriate level of care. Care coordination efforts must be
-documented and maintained within the individual’s record.
-
-Practitioner assessment
-1.
-
-2.
-
-The agency shall have policies and procedures that are consistent with state and federal
-law for promptly contacting the individual’s authorized practitioner for assessment when:
-a.
-
-The individual experiences a significant change in their baseline status;
-
-b.
-
-The individual has known exposure to a communicable disease;
-
-c.
-
-The individual develops any condition which would have initially precluded
-admission to the agency;
-
-d.
-
-The individual has any observed or reported unfavorable reactions to
-medications;
-
-e.
-
-The individual is affected by a medication error; and/or
-
-f.
-
-The individual engages in a pattern of refusing medications or medical
-recommendations.
-
-The agency shall ensure that any of the events in this part 5.4.3.G of this Chapter are
-documented in the individual’s record.
-
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-
-3.
-
-As applicable, the individual’s legal representative must be promptly notified any time
-assessment is indicated per this part.
-
-5.4.4
-
-Documentation and Timeliness
-
-A.
-
-Comprehensive individual assessment
-
-B.
-
-2 CCR 502-1
-
-1.
-
-Within ten (10) calendar days of admission, the agency shall complete a comprehensive
-assessment that meets the requirements set forth in part 2.12 of these rules as well as
-the requirements of this part 5.4.4.A. The assessment must reflect information requested
-and received from the individual, the individual's representative if requested by the
-individual, and an authorized practitioner. Information from the comprehensive
-assessment must be used to establish an individualized service plan.
-
-2.
-
-The comprehensive assessment must include all the following items:
-a.
-
-Information from the comprehensive pre-admission assessment described in part
-5.4.3.F.1;
-
-b.
-
-Information regarding the individual's overall health and physical functioning
-ability, including supports needed with activities of daily living;
-
-c.
-
-Communication ability and any specific needs to facilitate effective
-communication;
-
-d.
-
-Food and dining preferences, unique dietary needs, allergies, and restrictions;
-
-e.
-
-Reactions to the environment and others, including changes that may occur at
-certain times or in certain circumstances;
-
-f.
-
-Routines and interests;
-
-g.
-
-Safety awareness;
-
-h.
-
-Types of physical, mental, and social support required;
-
-i.
-
-History of or potential risk of harm to self or others, including aggressive
-behaviors, and any known approaches to prevent future occurrences including
-previously developed safety plans.
-
-3.
-
-The comprehensive assessment must be documented in writing and kept in the
-individual's health information record.
-
-4.
-
-The comprehensive assessment must be updated for each individual at least every six
-(6) months and whenever the individual's condition changes from baseline status.
-
-Individual service plan
-1.
-
-An initial service plan, based upon information from the pre-admission assessment
-described in part 5.4.3.G.1 of this Chapter, must be developed within twenty-four (24)
-hours of admission and must address, at a minimum, an individual's daily support needs,
-including assistance with activities of daily living, medication management, behavioral
-and physical health diagnoses, and support needs.
-
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-
-2.
-
-C.
-
-2 CCR 502-1
-
-Within fourteen (14) calendar days of completion of the comprehensive assessment, the
-agency shall develop a comprehensive service plan. In addition to the requirements of
-part 2.13.1 of these rules, the service plan must:
-a.
-
-Be developed with input from the individual and the individual's representative, if
-applicable;
-
-b.
-
-Reflect the most current assessment information;
-
-c.
-
-Promote individual choice, mobility, independence and safety;
-
-d.
-
-Detail specific personal service needs and preferences along with the supports
-necessary to meet those needs; personal service needs must consider:
-(1)
-
-individual prioritized needs for life skills training, and
-
-(2)
-
-medical and therapeutic care needs;
-
-e.
-
-Identify all external service providers along with care coordination arrangements;
-
-f.
-
-Identify engagement opportunities that match the individual's personal choices
-and needs; and
-
-g.
-
-Outline a plan for ensuring the individual’s behavioral health care needs are met,
-which may include access to community-based services.
-
-3.
-
-The agency shall be responsible for the coordination of individual care services with
-external service providers identified in the individual service plan.
-
-4.
-
-The agency shall be responsible for implementing recommendations made by the
-external service providers identified in the individual service plan.
-
-5.
-
-As applicable, the agency shall ensure that an individual receives nursing and therapeutic
-supports prescribed by the individual’s authorized practitioner.
-
-6.
-
-Only personnel employed or contracted by the agency may provide or assist with nursing
-or therapeutic services on behalf of the agency.
-
-7.
-
-If the agency utilizes delayed egress or egress alert devices, it must be noted within the
-individual’s service plan.
-
-8.
-
-The service plan must be updated for each individual at least every six (6) months and
-whenever the individual's condition changes from baseline status.
-
-Records
-1.
-
-In addition to the requirements set forth in part 2.11 of these rules, individual records
-must contain, but not be limited to, the following minimum items:
-a.
-
-Current practitioner orders;
-
-b.
-
-Individualized service plan;
-
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-2 CCR 502-1
-
-c.
-
-Daily progress notes, in accordance with part 2.13.2 of these rules, which must
-include information on individual status, well-being, and engagement, as well as
-documentation regarding any out of the ordinary event or issue that affects an
-individual's physical, behavioral, cognitive and/or functional condition, along with
-the action taken by personnel to address that individual's changing needs; and
-
-d.
-
-Documentation of physical and mental health care services received including
-any on-going services provided by external service providers.
-
-5.5
-
-Clinically Managed Residential Services, Including ASAM 3.1-Type Services
-
-A.
-
-This part 5.5 applies to agencies providing ASAM 3.1-type clinically managed behavioral health
-residential services.
-
-B.
-
-This part 5.5 does not apply to agencies providing only Level 3-WM services.
-
-C.
-
-This part 5.5 does not apply to recovery residences, as defined in BHA rule section 21.500 of 2
-CCR 502-1.
-
-5.5.1
-
-Service Delivery and Setting
-
-A.
-
-These services are intended for individuals who may benefit from twenty-four (24) hour structure
-and supportive services to develop, practice, and integrate coping skills in preparation for
-reintegration into their community of choice. Group homes, community corrections agencies, or
-other supportive living environments that provide twenty-four (24) hour on-site personnel, a focus
-on community re-integration, and treatment services on-site are examples of this level of care.
-
-B.
-
-Agencies must ensure individuals receiving services have at least one (1) of the following
-concerns to address during their residential episode of care:
-1.
-
-A history of mental health, substance use, or co-occurring disorders;
-
-2.
-
-A lack of stable or supportive housing options;
-
-3.
-
-Unemployment or education concerns; and/or
-
-4.
-
-Social or psychological dysfunction that necessitates this twenty-four (24) hour structure.
-
-C.
-
-Agencies must provide services that include (1) motivational enhancement to increase the
-individual’s level of readiness to change and (2) individual monitoring and support to facilitate the
-discovery of the individual’s needs. Services must also prioritize continued engagement in
-treatment services beyond the residential episode of care.
-
-D.
-
-The length of stay allows individuals to remain in residential services for a sufficient period of time
-to familiarize themselves with and integrate the skills obtained into regular use.
-
-E.
-
-Support systems
-1.
-
-Agencies must:
-a.
-
-Ensure the availability of telehealth or on-site consultation with an authorized
-practitioner or nurse twenty-four (24) hours per day, seven (7) days per week;
-
-b.
-
-Ensure the availability of consultation with emergency services twenty-four (24)
-hours per day, seven (7) days per week; and
-
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-
-c.
-
-2 CCR 502-1
-
-Have the capacity to arrange for medication-assisted treatment (MAT) and/or
-psychiatric medications in a timely manner for individuals served.
-(1)
-
-This may include services provided through coordination and referral but
-must not exceed twenty-four (24) hours from the time the need is
-identified to when arrangements are made.
-
-5.5.2
-
-Personnel
-
-A.
-
-Agencies must maintain an individual-to-personnel ratio not exceeding twenty to one (20:1) at all
-times, per physical location. This includes nighttime and weekend hours.
-
-5.5.3
-
-Service Provisions
-
-A.
-
-Services must be regularly scheduled and include a minimum of five (5) hours of planned
-treatment services per week for each individual in care.
-
-5.5.4
-
-Documentation and Timeliness
-
-A.
-
-Agencies must complete and document the following items in the individual’s record within
-twenty-four (24) hours of admission:
-1.
-
-All required demographic, intake and consent paperwork, as specified in part 2.11 of
-these rules;
-
-2.
-
-Screenings, as required in part 2.12.1 of these rules;
-
-3.
-
-The initial assessment as required in part 2.12.2 of these rules; and
-
-4.
-
-The initial service plan, addressing immediate needs and other relevant concerns
-identified in the initial assessment, as required in part 2.13.1 of these rules.
-
-B.
-
-Screenings and assessments conducted in accordance with this part 5.5.4.A must be used to
-determine appropriateness for this level of care.
-
-C.
-
-As soon as possible, but no later than ten (10) calendar days after an individual’s admission, the
-agency must complete and document the comprehensive assessment for the individual, as
-required in part 2.12.3 of these rules.
-
-D.
-
-As soon as possible, but no later than three (3) calendar days after an individual’s comprehensive
-assessment is completed, the agency must complete and document an individualized and
-comprehensive service plan, informed by the comprehensive assessment, as required in part
-2.13.1 of these rules.
-
-E.
-
-If the individual’s comprehensive assessment indicates they may benefit from further evaluation,
-medication, and/or specialty behavioral health care to address mental health, substance usespecific, or co-occurring needs, the agency must ensure their individualized treatment needs are
-addressed during the episode of care. The individual record must contain documentation
-reflecting how these assessed needs were met.
-
-F.
-
-Service plan reviews and revisions must be completed and documented in the individual’s record
-when there is a change in the individual’s level of functioning or service needs, but in no case
-may service plan reviews and revisions occur later than:
-1.
-
-Monthly for the first six (6) months after admission, and
-
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-
-2.
-
-2 CCR 502-1
-
-At least quarterly for the remainder of time that the individual remains in residential
-services.
-
-G.
-
-Progress notes must be present in the individual’s record, in accordance with part 2.13.2 of these
-rules and must be completed at least weekly for this level of care.
-
-5.5.5
-
-Treatment Type Standards for Residential Services, Including ASAM 3.1-Type Services
-
-A.
-
-Agencies that provide mental health-only or co-occurring residential services must ensure that
-individuals served meet at least one (1) of the following criteria:
-
-B.
-
-1.
-
-Are diagnosed with a serious mental illness (SMI) or comorbid diagnoses at a mild to
-moderate level defined in the DSM-5-TR, or
-
-2.
-
-Have sufficient collateral information present that indicates a high probability of a serious
-mental illness or comorbid diagnoses at a mild to moderate level as defined in the DSM5-TR.
-
-Agencies that provide co-occurring or substance use disorder-only residential services at an
-ASAM 3.1-type must ensure the following personnel requirements are met:
-1.
-
-If utilizing certified addiction technicians (CAT), these personnel do not comprise more
-than twenty-five percent (25%) of the agency’s total personnel, and
-
-2.
-
-If utilizing counselors-in-training and/or interns, these personnel do not comprise more
-than twenty-five percent (25%) of the agency’s total personnel.
-
-5.6
-
-Clinically Managed Residential Withdrawal Management (ASAM Level 3.2-WM) Services
-
-A.
-
-This part 5.6 applies to agencies providing withdrawal management services at an ASAM 3.2-WM
-level of care.
-
-B.
-
-This part 5.6 does not apply to agencies providing behavioral health residential services only.
-
-5.6.1
-
-Service Delivery and Setting
-
-A.
-
-Level 3.2-WM services provide a twenty-four (24) hour setting in which individuals may withdraw
-from substances while supervised by personnel, responsible for the implementation of medical
-provider-approved protocols.
-
-B.
-
-Agencies must develop policies and procedures to address service delivery expectations. These
-policies and procedures must address, but are not limited to the following:
-1.
-
-Consultation with specialized clinical and medical professionals for individualized
-withdrawal management care;
-
-2.
-
-Coordinating an individual’s transition into other levels of care, determined to be
-appropriate through triage, screening, evaluation, and/or assessment processes
-completed during the course of Level 3.2-WM services. This may include collaboration
-with emergency behavioral health services, such as Colorado Crisis Services, as
-appropriate;
-
-3.
-
-Conducting or arranging for laboratory and/or toxicology tests to be completed;
-
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-
-C.
-
-4.
-
-Responding to individuals who are assessed as being a current threat to themselves or
-others. This must include appropriate use of law enforcement and monitoring any use of
-individual restraint and/or seclusion in accordance with part 2.14 of these rules;
-
-5.
-
-Communication with intoxicated individuals leaving treatment against personnel
-recommendations, including the use of emergency commitments; and
-
-6.
-
-Circumstances under which individuals must end Level 3.2-WM services, other than
-completing services or leaving against personnel recommendations.
-
-Support systems
-1.
-
-D.
-
-2 CCR 502-1
-
-Agencies must:
-a.
-
-Implement protocols that are developed and supported by a physician
-knowledgeable in addiction medicine;
-
-b.
-
-Have protocols in place to address an individual’s evolving treatment and
-withdrawal needs, including protocols for if the individual’s condition deteriorates
-and requires medical or nursing care services;
-
-c.
-
-Have protocols that clearly determine the nature of medical or nursing care
-required. These protocols must include how to determine when nursing and/or
-physician care is warranted, and/or when transfer to a medically monitored
-facility or acute care hospital is necessary;
-
-d.
-
-Ensure that medical evaluation and consultation is available twenty-four (24)
-hours per/day; and
-
-e.
-
-Ensure that medications that are self-administered, monitored, or dispensed at
-the agency are supervised and documented in accordance with agency policy
-and procedures, state, and federal law.
-
-Diagnostic criteria
-1.
-
-Individuals participating in Level 3.2-WM services are generally intoxicated, under the
-influence, or in any stage of withdrawal from alcohol and/or other drugs.
-
-2.
-
-In addition to the ASAM Criteria guidelines detailed in part 2.12.3.C of these rules,
-individuals participating in Level 3.2-WM services must meet the diagnostic criteria for
-substance withdrawal disorder, as indicated in the DSM-5-TR.
-
-3.
-
-Upon admission to Level 3.2-WM services, the agency must complete the following
-minimum requirements:
-a.
-
-Collect information regarding the degree of alcohol and/or other drug intoxication
-as evidenced by breathalyzer, urinalysis, self-report, observation or other
-evidence-based or best practices;
-
-b.
-
-A pregnancy screening for pregnancy-capable individuals;
-
-c.
-
-Taking of vital signs; and
-
-d.
-
-Administration of a validated clinical withdrawal assessment tool.
-
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-2 CCR 502-1
-
-E.
-
-The agency must conspicuously post procedures for responding to circumstances and events
-that warrant entering a divert status.
-
-5.6.2
-
-Personnel
-
-A.
-
-Personnel must be trained in, and evaluated in knowledge of the following areas before providing
-services independently, if within their scope of practice and job description:
-1.
-
-Withdrawal management process;
-
-2.
-
-Monitoring vital signs;
-
-3.
-
-Conducting assessment and triage, including identifying and properly responding to
-suicidal ideation;
-
-4.
-
-Collecting urine and breath samples; and
-
-5.
-
-Basic counseling and motivational interviewing skills.
-
-B.
-
-Agencies providing Level 3.2-WM must ensure all personnel working with children under the age
-of eighteen (18) are trained and knowledgeable in child development and engaging children in
-states of intoxication and withdrawal management care.
-
-C.
-
-Each work shift at an agency must have a minimum of two (2) personnel, whenever one (1) or
-more individuals are present. At least one (1) of those persons must be treatment personnel as
-listed in part 5.2.2.D of this Chapter.
-
-D.
-
-The individual-to-personnel ratio must not exceed ten to one (10:1).
-
-E.
-
-The agency personnel requirements below are specific to each physical location where Level 3.2WM services are provided. This includes on-call personnel that may assist as needed.
-1.
-
-2.
-
-F.
-
-At least fifty percent (50%) of the agency’s personnel providing Level 3.2-WM services
-must consist of treatment personnel identified in part 5.2.2.D of this Chapter.
-a.
-
-If utilizing counselors-in-training and/or interns, the agency must ensure that all
-clinical documentation is reviewed and co-signed by a clinical agency supervisor
-able to supervise pursuant to their scope of practice. Plans for addiction
-counselor certification must be available for review.
-
-b.
-
-Full-time personnel must obtain at least an addiction technician certification
-within eighteen (18) months of employment.
-
-Uncertified personnel or personnel without a plan for addiction counselor certification
-must not comprise more than fifty percent (50%) of an agency’s total personnel. This
-includes group living workers that may be utilized for milieu management.
-
-The person overseeing day-to-day operations for agencies providing Level 3.2-WM services must
-be one of the following:
-1.
-
-An authorized practitioner,
-
-2.
-
-A licensee; or
-
-3.
-
-A certified addiction specialist (CAS).
-
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-
-5.6.3
-
-Service Provisions
-
-A.
-
-Agencies must:
-
-B.
-
-1.
-
-Provide safe management and documentation of signs and symptoms of intoxication and
-withdrawal;
-
-2.
-
-Ensure that transition planning begins at the time of admission to Level 3.2-WM services,
-to allow for necessary care coordination and transition into ongoing or concurrent
-treatment services to occur successfully;
-
-3.
-
-Provide additional service planning for managing individuals with medical conditions,
-suicidal ideation, pregnancy, psychiatric conditions, and other conditions which place
-individuals at additional risk during withdrawal management; and
-
-4.
-
-Provide assessments of individual readiness for treatment and services based on the
-service plan and the assessments and interventions shall be documented in the
-individual’s record.
-
-Medication-assisted treatment (MAT) for withdrawal management
-1.
-
-Agencies must continue individuals on their medication-assisted treatment regimen and
-will only remove individuals from medications treating opioid use disorders at the
-individual’s request or if it is deemed medically appropriate by an authorized practitioner.
-
-2.
-
-Agencies must inform individuals receiving services about access to medication-assisted
-treatment. Upon the individual’s consent, the agency must provide medication-assisted
-treatment directly.
-
-3.
-
-Agencies must obtain a controlled substance license pursuant to section 21.300 of 2
-CCR 502-1 from the BHA if they plan to dispense, compound, or administer a controlled
-substance from stock medication in order to treat a substance use disorder or to treat the
-withdrawal symptoms of a substance use disorder.
-a.
-
-C.
-
-2 CCR 502-1
-
-A controlled substance license is not required if the agency intends to provide
-medication-assisted treatment (MAT) services through prescription writing only,
-under an independent prescriber’s license.
-
-Discharge from Level 3.2-WM services
-1.
-
-Agencies must ensure referral and care coordination for continued behavioral health
-treatment that occurs at the time of discharge from Level 3.2-WM services. This may be
-made available within the agency’s structure or through referral.
-
-2.
-
-Agencies must provide discharge information as required in part 2.10.A.6 of these rules
-to the individual and document that it was provided.
-
-3.
-
-Agencies must provide the following information to individuals at the time of discharge
-from Level 3.2-WM services:
-a.
-
-Effects of alcohol and other drugs;
-
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-
-2 CCR 502-1
-
-b.
-
-Risk factors associated with alcohol and other drug abuse for acquiring and
-transmitting HIV/AIDS (Human Immunodeficiency Virus/Acquired Immune
-Deficiency Syndrome), Tuberculosis (TB), and other infectious diseases, and for
-pregnancy;
-
-c.
-
-Availability of testing and pre/post-test counseling for HIV/AIDS, TB, Hepatitis C
-and other infectious diseases, and pregnancy; and
-
-d.
-
-Availability of harm-reduction and alcohol and other substance use disorder
-treatment resources.
-
-5.6.4
-
-Documentation and Timeliness
-
-A.
-
-The following must be addressed within three (3) hours of an individual’s arrival at the agency:
-
-B.
-
-C.
-
-1.
-
-Personnel must complete the screening and triage process as indicated in part 2.12.1 of
-these rules to determine the urgency and appropriateness of care within the agency
-including the need for emergency or urgent medical or psychiatric services;
-
-2.
-
-In collaboration with the individual, personnel must develop withdrawal managementfocused initial service plan, tailored to the safe withdrawal of the individual from the
-substance(s) of concern;
-
-3.
-
-In addition to required intake documentation and consents as noted in part 2.11 of these
-rules, the agency must inventory and secure the individual’s personal belongings. This
-must be observed and confirmed through documentation by at least two (2) personnel;
-and
-
-4.
-
-Personnel must monitor and document vitals in real-time.
-
-As soon as clinically feasible, but no later than seventy-two (72) hours following admission of an
-individual to Level 3.2-WM services, the agency must:
-1.
-
-Update or amend any intake paperwork or consents that the individual was not able to
-complete or comprehend due to their state of intoxication upon admission;
-
-2.
-
-Complete at least the initial assessment as indicated in part 2.12.2 of these rules,
-including substance use disorder history and the degree to which the use of substances
-affects personal and social functioning;
-
-3.
-
-Update the individual’s service plan to reflect ongoing treatment needs as identified
-through the assessment; and
-
-4.
-
-Document referral and care coordination activities to support the individual’s transition
-into beginning or resuming behavioral health treatment services.
-
-Observation and monitoring requirements
-1.
-
-Agencies must conduct routine monitoring of physical and mental status of the individual
-throughout their time in Level 3.2-WM services. This must include:
-a.
-
-Vital signs taken and documented in real-time at the following minimum
-frequency:
-
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-
-2 CCR 502-1
-
-(1)
-
-Every two (2) hours until vitals remain at the individual’s baseline for at
-least four (4) consecutive hours,
-
-(2)
-
-Then every eight (8) hours thereafter until discharge.
-(a)
-
-Documentation per shift to include all individual monitoring
-activities.
-
-5.7
-
-Clinically Managed Residential Services, Including ASAM Level 3.3 Services
-
-A.
-
-This part 5.7 applies to agencies providing behavioral health residential services at an ASAM 3.3
-level of care.
-
-B.
-
-This part 5.7 does not apply to agencies providing Level 3-WM services only.
-
-C.
-
-This part 5.7 does not apply to services to children under the age of eighteen (18) seeking
-residential services.
-
-5.7.1
-
-Service Delivery and Setting
-
-A.
-
-These services are intended for individuals who are unlikely to benefit from outpatient services or
-other residential levels of care due to a temporary or permanent cognitive impairment resulting
-from an addictive or co-occurring disorder. Therapeutic rehabilitation facilities or traumatic brain
-injury programs are examples of this level of care.
-
-B.
-
-Agencies shall confirm that individuals served have a history of substance use or co-occurring
-disorders or difficulty with interpersonal relationships, coping skills, or comprehension that
-necessitates this twenty-four (24) hour structured recovery environment, in combination with highintensity clinical services.
-
-C.
-
-If agency personnel determine that an individual served may benefit from deliberately repetitive
-and/or concrete services, those services shall be delivered on a timeline appropriate to the
-individual’s assessed cognitive needs.
-
-D.
-
-The agency must ensure that treatment is focused on preventing relapse, continued problems
-and/or continued use, enhancing readiness to change, and promoting the eventual reintegration
-of the individual into the community.
-
-E.
-
-Individuals with a temporary cognitive impairment may be transferred to another level of care
-after the impairment has resolved. Individuals with chronic cognitive impairment may remain in
-this level of care for a longer duration, if assessed as continuing to meet their individual needs.
-
-F.
-
-Support systems
-1.
-
-Agencies must:
-a.
-
-Ensure the availability of telehealth or on-site consultation with an authorized
-practitioner or nurse twenty-four (24) hours per day, seven (7) days per week;
-
-b.
-
-Ensure the availability of consultation with emergency services twenty-four (24)
-hours per day, seven (7) days per week; and
-
-c.
-
-Have the capacity to arrange for medication-assisted treatment (MAT) and/or
-psychiatric medications in a timely manner for individuals served.
-
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-
-(1)
-
-2 CCR 502-1
-
-This may include services provided through coordination and referral but
-must not exceed twenty-four (24) hours from identifying the need to
-complete.
-
-5.7.2
-
-Personnel
-
-A.
-
-If utilizing certified addiction technicians (CAT), these personnel must not comprise more than
-twenty-five percent (25%) of the agency’s total personnel; and
-
-B.
-
-If utilizing counselors-in-training and/or interns, these personnel must not comprise more than
-twenty-five percent (25%) of the agency’s total personnel.
-
-5.7.3
-
-Service Provisions
-
-A.
-
-Services must be regularly scheduled services and include a minimum of nine (9) hours of
-planned treatment services per week.
-
-B.
-
-Services must be delivered in a manner that is matched to the individual’s functioning. These
-services may be provided in a deliberately repetitive manner or with a timeline appropriate to
-address the cognitive needs of individuals for whom this level of care is considered a medical
-necessity.
-
-5.7.4
-
-Documentation
-
-A.
-
-Agencies must complete and document the following items in the individual’s record within
-twenty-four (24) hours of admission:
-1.
-
-All required demographic, intake and consent paperwork, as specified in part 2.11 of
-these rules;
-
-2.
-
-Screenings, as required in part 2.12.1 of these rules;
-
-3.
-
-The initial assessment as required in part 2.12.2 of these rules; and
-
-4.
-
-The initial service plan, addressing immediate needs and other relevant concerns
-identified in the initial assessment, as required in part 2.13.1 of these rules.
-
-B.
-
-As soon as possible, but no later than ten (10) calendar days after an individual’s admission, the
-agency must complete and document the comprehensive assessment for the individual, as
-required in part 2.12.3 of these rules.
-
-C.
-
-As soon as possible, but no later than three (3) calendar days after an individual’s comprehensive
-assessment is completed, the agency must complete and document an individualized and
-comprehensive service plan, informed by the comprehensive assessment, as required in part
-2.13.1 of these rules.
-
-D.
-
-If the individual’s comprehensive assessment indicates they may benefit from further evaluation,
-medication, and/or specialty behavioral health care to address mental health, substance usespecific, or co-occurring needs, the agency must ensure their individualized treatment needs are
-addressed during the episode of care. The individual record must contain documentation
-reflecting how these assessed needs were met.
-
-E.
-
-Service plan reviews and revisions must be completed and documented in the individual’s record
-when there is a change in the individual’s level of functioning or service needs, but in no case
-may service plan reviews and revisions occur later than:
-
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-
-2 CCR 502-1
-
-1.
-
-Monthly for the first six (6) months after admission, and
-
-2.
-
-At least quarterly for the remainder of time that the individual remains in residential
-services.
-
-F.
-
-Progress notes must be present in the individual’s record, in accordance with part 2.13.2 of these
-rules. Progress notes must be completed at least daily for this level of care.
-
-5.8
-
-Level Two Mental Health Transitional Living Home Services
-
-A.
-
-Level two mental health transitional living homes shall comply with the rules in parts 5.1 through
-5.4 of this Chapter.
-
-B.
-
-Level two mental health transitional living homes shall ensure that 600 minutes (ten hours) of
-planned treatment services are provided to each individual on a weekly basis.
-
-C.
-
-Level two mental health transitional living homes must either:
-1.
-
-Be designated pursuant to part 11.18 of these rules to provide care and treatment to
-individuals on short-term and long-term certifications on an outpatient basis; or
-
-2.
-
-Establish facility agreements with designated facilities in order to treat individuals on
-short-term or long-term certifications on an outpatient basis.
-
-5.9
-
-Clinically Managed Residential Services, Including ASAM 3.5-Type Services
-
-A.
-
-This part 5.9 applies to agencies providing ASAM 3.5-type clinically managed behavioral health
-residential services.
-
-B.
-
-This part 5.9 does not apply to agencies providing only Level 3-WM services.
-
-5.9.1
-
-Service Delivery and Setting
-
-A.
-
-These services are intended for individuals who have multifaceted treatment needs requiring a
-twenty-four (24) hour treatment environment, and who are unable to be properly treated at a
-lower level of residential care. A variable-length therapeutic community or residential treatment
-center are examples of this level of care.
-
-B.
-
-Agencies must confirm that any individuals served have multiple treatment considerations to be
-addressed during the residential episode of care, which may include, but are not limited to the
-following:
-1.
-
-A history of mental health, substance use or co-occurring disorders.
-
-2.
-
-Engagement in behaviors and/or thought processes that contribute to impaired social,
-interpersonal, and/or vocational functioning, necessitating this highly structured twentyfour (24) hour treatment environment.
-
-C.
-
-Services provided by the agency must be directed toward developing and enhancing prosocial
-behaviors, sustaining recovery, reducing relapse risk when applicable, and the promotion of
-successful reintegration into the community.
-
-D.
-
-Support systems
-1.
-
-Agencies providing this clinically managed residential service shall:
-
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-
-2 CCR 502-1
-
-a.
-
-Ensure the availability of telehealth or on-site consultation with an authorized
-practitioner twenty-four (24) hours per day, seven (7) days per week;
-
-b.
-
-Ensure the availability of consultation with emergency services twenty-four (24)
-hours per day, seven (7) days per week; and
-
-c.
-
-Have the capacity to arrange for medication-assisted treatment (MAT) and/or
-psychiatric medications in a timely manner that must not exceed twelve (12)
-hours to complete.
-
-5.9.2
-
-Personnel
-
-A.
-
-Agencies must:
-1.
-
-Ensure that each work shift has a minimum of two (2) personnel on-site, whenever one
-(1) or more individuals are present in the milieu; and
-
-2.
-
-Maintain individual-to-personnel ratios not exceeding twenty to one (20:1) at all times, per
-physical location, unless otherwise noted. This includes nighttime and weekend hours.
-
-5.9.3
-
-Service Provisions
-
-A.
-
-Services for individuals must be regularly scheduled and include a minimum of ten (10) hours of
-planned treatment services per week.
-
-5.9.4
-
-Documentation and Timeliness
-
-A.
-
-Agencies must complete and document the following items in the individual’s record within
-twenty-four (24) hours of admission:
-1.
-
-All required demographic, intake and consent paperwork, as specified in part 2.11 of
-these rules;
-
-2.
-
-Screenings, as required in part 2.12.1 of these rules;
-
-3.
-
-The initial assessment as required in part 2.12.2 of these rules; and
-
-4.
-
-The initial service plan, addressing immediate needs and other relevant concerns
-identified in the initial assessment, as required in part 2.13.1 of these rules.
-
-B.
-
-Screenings and assessments conducted in accordance with 5.9.4.A must be used to determine
-appropriateness for this level of care.
-
-C.
-
-As soon as possible, but no later than ten (10) calendar days after an individual’s admission, the
-agency must complete and document the comprehensive assessment for the individual, as
-required in part 2.12.3 of these rules.
-
-D.
-
-As soon as possible, but no later than three (3) calendar days after an individual’s comprehensive
-assessment is completed, the agency must complete and document an individualized and
-comprehensive service plan, informed by the comprehensive assessment, as required in part
-2.13.1 of these rules.
-
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-
-E.
-
-If the individual’s comprehensive assessment indicates they may benefit from further evaluation,
-medication, and/or specialty behavioral health care to address mental health, substance usespecific, or co-occurring needs, the agency must ensure their individualized treatment needs are
-addressed during the episode of care. The individual record must contain documentation
-reflecting how these assessed needs were met.
-
-F.
-
-Service plan reviews and revisions must be completed and documented in the individual’s record
-when there is a change in the individual’s level of functioning or service needs, but in no case
-may service plan reviews and revisions occur later than:
-
-G.
-
-1.
-
-Monthly for the first six (6) months after admission, and
-
-2.
-
-At least quarterly for the remainder of time that the individual remains in residential
-services.
-
-Progress notes must be present in the individual’s record, in accordance with part 2.13.2 of these
-rules. The minimum frequency of progress note completion for this level of care may vary,
-depending upon the individual’s time in the level of care and/or anticipated length of stay.
-1.
-
-For the first thirty (30) days of the stay, daily progress notes are required.
-
-2.
-
-After the first thirty (30) days where there is an anticipated length of stay of three (3)
-months or less, providers shall continue required daily progress notes.
-
-3.
-
-After the first thirty (30) days when there is an anticipated length of stay of more than
-three (3) months, providers shall complete progress notes at a minimum of weekly.
-
-5.9.5
-
-Treatment Type Standards for Clinically Managed Behavioral Health Residential Services
-and ASAM 3.5-Type Services
-
-A.
-
-Agencies that provide mental health-only or co-occurring residential services must confirm the
-following:
-1.
-
-B.
-
-Individuals served meet at least one (1) of the following criteria:
-a.
-
-Are diagnosed with a serious mental illness (SMI) or comorbid diagnoses at a
-moderate level, per the DSM-5-TR, or
-
-b.
-
-Have sufficient collateral information to indicate there is a high probability that the
-individual has a serious mental illness or comorbid diagnoses at a moderate
-level, as defined in the DSM-5-TR.
-
-Agencies that provide co-occurring or substance use disorder-only residential services at an
-ASAM 3.5-type must ensure the following:
-1.
-
-If utilizing certified addiction technicians (CAT), these personnel do not comprise more
-than twenty-five percent (25%) of the agency’s total personnel, and
-
-2.
-
-If utilizing counselors-in-training and/or interns, these personnel do not comprise more
-than twenty-five percent (25%) of the agency’s total personnel.
-
-5.10
-
-Medically Monitored Residential Services, Including ASAM 3.7-Type Services
-
-A.
-
-This part 5.10 applies to agencies providing ASAM 3.7-Type medically monitored behavioral
-health residential services.
-
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-B.
-
-2 CCR 502-1
-
-This part 5.10 does not apply to agencies providing only ASAM Level 3.7-WM services.
-
-5.10.1 Service Delivery and Setting
-A.
-
-Medically monitored residential services are intended for individuals whose medical, emotional,
-behavioral and/or cognitive problems are severe enough to require twenty-four (24) hour medical
-monitoring, but do not require the full resources of an acute care general hospital or medically
-managed inpatient treatment program. These services may be offered in free-standing buildings
-providing residential services or incorporated into specialty units within general health care or
-psychiatric hospitals.
-
-B.
-
-Agencies must ensure that individuals receiving services receive multiple treatment
-considerations including but not limited to: a history of mental health, substance use or cooccurring disorders, along with medical, cognitive, or complicated withdrawal management needs
-that require the structured regimen of twenty-four (24) hour evaluation, observation, and medical
-monitoring in order to safely provide the necessary behavioral health services.
-
-C.
-
-Agencies must ensure treatment is designed for individuals who have functional limitations in the
-areas of intoxication/withdrawal potential, biomedical conditions, and/or emotional, behavioral, or
-cognitive conditions. This level of care focuses on the monitoring of the individual’s biomedical
-needs to promote physical and psychiatric stabilization and allow for continued engagement in a
-lower level of care once the individual is stabilized.
-
-D.
-
-Support systems
-1.
-
-Agencies must:
-a.
-
-Ensure the availability of telehealth or on-site consultation with an authorized
-practitioner or nurse twenty-four (24) hours per day, seven (7) days per week;
-
-b.
-
-Ensure the availability of consultation with emergency services twenty-four (24)
-hours per day, seven (7) days per week;
-
-c.
-
-Have the capacity to arrange for medication-assisted treatment (MAT) and/or
-psychiatric medications in a timely manner for individuals served. This must not
-exceed eight (8) hours from identifying the need to complete;
-
-d.
-
-Ensure the availability of additional medical specialty consultation, psychological,
-laboratory and toxicology services; and
-(1)
-
-e.
-
-These services may be provided through consultation or referral; and
-
-Ensure that psychiatric services, if not provided, are available on-site through
-consultation or referral within eight (8) hours by telehealth or twenty-four (24)
-hours in-person.
-
-5.10.2 Personnel
-A.
-
-Agencies must:
-1.
-
-Ensure that each work shift has a minimum of two (2) personnel on-site whenever one (1)
-or more individuals are present in the milieu;
-
-2.
-
-Maintain an individual-to-personnel ratio not exceeding twenty to one (20:1) at all times,
-per physical location. This includes nighttime and weekend hours;
-
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-2 CCR 502-1
-
-3.
-
-Utilize an interdisciplinary team that includes physicians, nurses and mental health
-professionals licensed or certified pursuant to Article 245 of Title 12, C.R.S. that provide
-twenty-four (24) hour professionally directed evaluation, care and treatment services
-including administration of prescribed medications, withdrawal management and
-integrated treatment of co-occurring medical, emotional, behavioral or cognitive
-conditions;
-
-4.
-
-Be overseen by a physician licensed pursuant to Article 240 of Title 12, in order to assure
-the quality of care; and
-
-5.
-
-Have a nurse as defined in part 1.3 of these rules, responsible for monitoring the
-individual’s progress and/or medication administration twenty-four (24) hours per day,
-seven (7) days per week.
-
-5.10.3 Service Provisions
-A.
-
-Medically monitored residential services must be regularly scheduled and include a minimum of
-twenty (20) hours of planned treatment services per week.
-
-B.
-
-At the time of admission to the agency, a registered nurse must conduct an alcohol or other drugfocused assessment, if applicable.
-
-C.
-
-As soon as clinically feasible, but no later than twenty-four (24) hours after admission to the
-agency, an authorized practitioner must perform a physical examination of the individual.
-1.
-
-Physical examinations performed by authorized practitioners must be completed as
-necessary for the individual throughout the episode of care.
-
-5.10.4 Documentation and Timeliness
-A.
-
-Agencies must complete and document the following items in the individual’s record within
-twenty-four (24) hours of admission:
-1.
-
-All required demographic, intake and consent paperwork, as specified in part 2.11 of
-these rules;
-
-2.
-
-Screenings, as required in part 2.12.1 of these rules;
-
-3.
-
-The initial assessment as required in part 2.12.2 of these rules; and
-
-4.
-
-The initial service plan, addressing immediate needs and other relevant concerns
-identified in the initial assessment, as required in part 2.13.1 of these rules.
-
-B.
-
-Screenings and assessments conducted in accordance with 5.10.4.A of this Chapter must be
-used to determine appropriateness for this level of care.
-
-C.
-
-As soon as possible, but no later than ten (10) calendar days after an individual’s admission, the
-agency must complete and document the comprehensive assessment for the individual, as
-required in part 2.12.3 of these rules.
-
-D.
-
-As soon as possible, but no later than three (3) calendar days after an individual’s comprehensive
-assessment is completed, the agency must complete and document an individualized and
-comprehensive service plan, informed by the comprehensive assessment, as required in part
-2.13.1 of these rules.
-
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-
-E.
-
-If the individual’s comprehensive assessment indicates they may benefit from further evaluation,
-medication, and/or specialty behavioral health care to address mental health, substance usespecific, or co-occurring needs, the agency must ensure their individualized treatment needs are
-addressed during the episode of care. The individual record must contain documentation
-reflecting how these assessed needs were met.
-
-F.
-
-Service plan reviews and revisions must be completed and documented in the individual’s record
-when there is a change in the individual’s level of functioning or service needs, but in no case
-may service plan reviews and revisions occur later than:
-
-G.
-
-1.
-
-Monthly for the first six (6) months after admission, and
-
-2.
-
-At least quarterly for the remainder of time that the individual remains in residential
-services.
-
-Progress notes must be present in the individual’s record, in accordance with part 2.13.2 of these
-rules. Progress notes must be completed at least daily for this level of care.
-
-5.10.5 Treatment Type Standards for Medically Monitored Behavioral Health Residential Services
-and ASAM 3.7-Type Services
-A.
-
-Agencies that provide mental health-only or co-occurring residential services must ensure the
-following:
-1.
-
-B.
-
-Individuals served meet at least one (1) of the following criteria:
-a.
-
-Are diagnosed with a serious mental illness (SMI) or comorbid diagnoses at a
-severe level, as defined in the DSM-5-TR;
-
-b.
-
-Have sufficient collateral information that indicates a high probability that the
-individual has a serious mental illness or comorbid diagnoses at a severe level,
-as defined in the DSM-5-TR; or
-
-c.
-
-Are diagnosed with a serious mental illness (SMI) or comorbid diagnoses at a
-mild to moderate level, as defined in the DSM-5-TR, with additional biomedical
-needs that require a higher level of medical oversight.
-
-Agencies that provide co-occurring or substance use disorder-only residential services at an
-ASAM 3.7-type must ensure the following:
-1.
-
-If utilizing certified addiction technicians (CAT), these personnel do not comprise more
-than twenty-five percent (25%) of the agency’s total personnel, and
-
-2.
-
-If utilizing counselors-in-training and/or interns, these personnel do not comprise more
-than twenty-five percent (25%) of the agency’s total personnel.
-
-5.11
-
-Medically Monitored Inpatient Withdrawal Management (ASAM Level 3.7-WM) Services
-
-A.
-
-This part 5.11 applies to agencies providing withdrawal management services at an ASAM 3.7WM level of care.
-
-B.
-
-This part 5.11 does not apply to agencies providing behavioral health residential services only.
-
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-
-5.11.1 Service Delivery and Setting
-A.
-
-Level 3.7-WM services are available for individuals who require the oversight of medical and
-nursing professionals in order to complete a safe period of withdrawal. This level of care provides
-a twenty-four (24)-hour service in which individuals have prompt access to medical evaluations as
-needed, as well as an interdisciplinary team available to meet the individual’s needs. Services are
-developed and delivered under the monitoring of a physician. This may be observed as a
-freestanding withdrawal management center or as a step-down service from an acute care
-hospital.
-1.
-
-B.
-
-C.
-
-Services must be provided by licensed medical personnel qualified to supervise
-withdrawal from alcohol and other drugs through the use of medication and/or medical
-procedures in residential settings which possess a controlled substances license in
-compliance with Part 2 of Article 80 of Title 27, C.R.S.
-
-Agencies must develop policies and procedures to address service delivery expectations. These
-policies and procedures must address, but are not limited to the following:
-1.
-
-Consultation with specialized clinical and medical professionals for individualized
-withdrawal management care;
-
-2.
-
-Coordinating an individual’s transition into other levels of care, determined to be
-appropriate through triage, screening, evaluation, and/or assessment processes
-completed during the course of Level 3.7-WM services. This may include collaboration
-with emergency behavioral health services, such as Colorado Crisis Services, as
-appropriate;
-
-3.
-
-Conducting or arranging for laboratory and/or toxicology tests to be completed;
-
-4.
-
-Responding to individuals who are assessed as being a current threat to themselves or
-others. This must include appropriate use of law enforcement and monitoring any use of
-individual restraint and/or seclusion in accordance with part 2.14 of these rules;
-
-5.
-
-Communication with intoxicated individuals leaving treatment against personnel
-recommendations, including the use of emergency commitments; and
-
-6.
-
-Circumstances under which individuals must end Level 3.7-WM services, other than
-completing services or leaving against personnel recommendations.
-
-Support systems
-1.
-
-Agencies must:
-a.
-
-Implement protocols that are developed and approved by a physician
-knowledgeable in addiction medicine.
-
-b.
-
-Develop and implement specific admission protocol detail for which substances,
-including both drugs and alcohol, medical withdrawal management services are
-provided. This protocol must include processes for customary and atypical
-withdrawal management from each drug delineated in the admission protocol,
-and must include at minimum, the following elements:
-(1)
-
-Types of intoxication;
-
-(2)
-
-Tolerance levels for the individual's drug of choice;
-
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-
-D.
-
-2 CCR 502-1
-
-(3)
-
-Degrees of withdrawal;
-
-(4)
-
-Possible withdrawal and/or intoxication complications;
-
-(5)
-
-Other conditions affecting medical withdrawal management procedures;
-
-(6)
-
-Types of medications used;
-
-(7)
-
-Recommended dosage levels;
-
-(8)
-
-Procedures to follow in the event of withdrawal management
-complications;
-
-(9)
-
-Daily assessments including expected improvements as well as potential
-problems; and
-
-(10)
-
-Expected duration of withdrawal management.
-
-c.
-
-Ensure that prompt medical evaluation and consultation is available twenty-four
-(24) hours/day.
-
-d.
-
-Ensure that hourly nurse monitoring of the individual’s progress is available, if
-medically indicated.
-
-e.
-
-Ensure that medications that are self-administered, monitored, or dispensed at
-the facility are supervised and documented in accordance with agency policy and
-procedures, state, and federal law.
-
-f.
-
-Ensure referral and care coordination for continued behavioral health treatment
-occurs. This may be made available within the agency’s structure or through
-referral.
-
-Diagnostic criteria
-1.
-
-Individuals participating in Level 3.7-WM services are generally intoxicated, under the
-influence, or in a severe stage of withdrawal from alcohol and/or other drugs. These
-individuals may have comorbid medical issues that require additional medical oversight.
-
-2.
-
-In addition to the ASAM Criteria guidelines detailed in part 2.12.3.C of these rules,
-individuals receiving Level 3.7-WM services must meet the diagnostic criteria for
-substance withdrawal disorder, as indicated in the DSM-5-TR.
-
-3.
-
-Upon admission to Level 3.7-WM services, the agency must complete the following
-minimum requirements:
-a.
-
-Collect information regarding the degree of alcohol and/or other drug intoxication
-as evidenced by breathalyzer, urinalysis, self-report, observation or other
-evidence-based or best practices;
-
-b.
-
-A pregnancy screening for pregnancy-capable individuals;
-
-c.
-
-Taking of vital signs; and
-
-d.
-
-Administration of a validated clinical withdrawal assessment tool.
-
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-E.
-
-2 CCR 502-1
-
-The agency must conspicuously post procedures for responding to circumstances and events
-that warrant entering a divert status.
-
-5.11.2 Personnel
-A.
-
-Personnel must be trained in, and evaluated in knowledge of the following areas before providing
-services independently:
-1.
-
-Withdrawal management;
-
-2.
-
-Monitoring vital signs;
-
-3.
-
-Conducting assessment and triage, including identifying and properly responding to,
-suicidal ideation;
-
-4.
-
-Collecting urine and breath samples; and
-
-5.
-
-Basic counseling and motivational interviewing skills.
-
-B.
-
-Agencies providing Level 3.7-WM must ensure all personnel working with children under the age
-of eighteen (18) are trained and knowledgeable in child development and engaging children in
-states of intoxication and withdrawal management care.
-
-C.
-
-Each work shift must have a minimum of two (2) personnel, whenever one (1) or more individuals
-are present.
-
-D.
-
-Treatment personnel as defined in part 5.3.2.D must be present at a rate that meets the needs of
-the individuals receiving Level 3.7-WM services.
-
-E.
-
-Agencies must employ, at minimum, the following personnel:
-
-F.
-
-1.
-
-A medical director who is licensed as a physician or medical doctor pursuant to Article
-240 of Title 12, C.R.S.,
-
-2.
-
-A registered nurse or licensed practical nurse with at least one (1) year of withdrawal
-management experience; and
-
-3.
-
-Treatment personnel as defined in part 5.3.2.D of this Chapter.
-
-Personnel oversight
-1.
-
-The person overseeing day-to-day operations for an agency providing Level 3.7-WM
-services must be the medical director.
-
-2.
-
-The medical director’s responsibilities must include, at minimum:
-a.
-
-Quarterly reviews and revisions of drug withdrawal management categories and
-protocols;
-
-b.
-
-Reviews of individual withdrawal management plans;
-
-c.
-
-Reviews of individual prescriptions;
-
-d.
-
-Direct supervision of individual withdrawal management cases that deviate from
-standard protocols and/or the individual experiences complications;
-
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-G.
-
-2 CCR 502-1
-
-e.
-
-Five (5) hours of monthly supervision of and consultation with personnel
-providing withdrawal management services;
-
-f.
-
-Development and implementation of back-up systems for physician coverage
-when medical director(s) are unavailable and/or for emergencies;
-
-g.
-
-Review of critical incidents reported in accordance with part 2.16 of these rules;
-and
-
-h.
-
-Review of admission, medical exclusion, and medical care policies at least
-annually.
-
-Agencies must ensure twenty-four (24) hour access to clinical personnel by telehealth and
-accommodations for unscheduled visits in the event of crises or problem situations.
-
-5.11.3 Service Provisions
-A.
-
-B.
-
-Agencies must:
-1.
-
-Provide safe management and documentation of signs and symptoms of intoxication and
-withdrawal;
-
-2.
-
-Ensure that transition planning begins at the time of admission to Level 3.7-WM services,
-to allow for necessary care coordination and transition into ongoing or concurrent
-treatment services to occur successfully;
-
-3.
-
-Provide additional service planning for managing individuals with medical conditions,
-suicidal ideation, pregnancy, psychiatric conditions, and other conditions which place
-individuals at additional risk during withdrawal management; and
-
-4.
-
-Provide assessments of individual readiness for treatment and services based on the
-service plan and the assessments and interventions shall be documented in the
-individual’s record.
-
-Medication-assisted treatment (MAT) for withdrawal management
-1.
-
-Agencies must continue individuals on their medication-assisted treatment regimen and
-will only remove individuals from medications treating opioid use disorders at the
-individual’s request or if it is deemed medically appropriate by an authorized practitioner.
-
-2.
-
-Agencies must inform individuals receiving services about access to medication-assisted
-treatment. Upon the individual’s consent, the agency must provide medication-assisted
-treatment directly.
-
-3.
-
-Agencies must obtain a controlled substance license pursuant to section 21.300 of 2
-CCR 502-1 from the BHA if they plan to dispense, compound, or administer a controlled
-substance from stock medication in order to treat a substance use disorder or to treat the
-withdrawal symptoms of a substance use disorder.
-a.
-
-C.
-
-A controlled substance license is not required if the agency intends to provide
-medication-assisted treatment (MAT) services through prescription writing only,
-under an independent prescriber’s license.
-
-Discharge from Level 3.7-WM services
-
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-
-D.
-
-E.
-
-2 CCR 502-1
-
-1.
-
-Agencies must ensure referral and care coordination for continued behavioral health
-treatment occurs at the time the individual is discharged from Level 3.7-WM services.
-This may be made available within the agency’s structure or through referral.
-
-2.
-
-Agencies must provide discharge information as required in part 2.11 of these rules to the
-individual and document that it was provided.
-
-3.
-
-In addition to these requirements, agencies must provide the following information to
-individuals at the time of discharge from Level 3.7-WM services:
-a.
-
-Effects of alcohol and other drugs;
-
-b.
-
-Risk factors associated with alcohol and other drug abuse for acquiring and
-transmitting HIV/AIDS (Human Immunodeficiency Virus/Acquired Immune
-Deficiency Syndrome), Tuberculosis (TB), and other infectious diseases, and for
-pregnancy;
-
-c.
-
-Availability of testing and pre/post-test counseling for HIV/AIDS, TB, Hepatitis C
-and other infectious diseases, and pregnancy; and
-
-d.
-
-Availability of harm-reduction and alcohol and other substance use disorder
-treatment resources.
-
-Agencies must provide medical evaluations completed by authorized practitioners. The medical
-evaluations must consist of, at minimum:
-1.
-
-Medical histories including detailed chronologies of substance use disorders;
-
-2.
-
-Identification of current physical addiction including drug types;
-
-3.
-
-Physical examinations to determine appropriateness for outpatient or inpatient medical
-withdrawal management; and
-
-4.
-
-Appropriate laboratory tests and other evaluations, as indicated.
-
-Medication dispensation and administration procedures
-1.
-
-Agencies using stock-controlled substances in order to treat a substance use disorder or
-to treat the withdrawal symptoms of a substance use disorder are required to have a
-controlled substance services license issued by the BHA and comply with the applicable
-portion(s) of section 21.300 of 2 CCR 502-1 that deal with a controlled substance license.
-
-2.
-
-Agencies may utilize buprenorphine for medications for opioid use disorder (MOUD)
-services without requiring an opioid treatment program endorsement. If an agency
-intends to utilize controlled substances other than/in addition to buprenorphine for MOUD
-services, the agency must be endorsed as an opioid treatment program, verified through
-the Drug Enforcement Administration (DEA), and coordinated with the SAMHSA.
-
-3.
-
-Qualified practitioners may prescribe buprenorphine under their own Drug Enforcement
-Administration (DEA) registration number for individuals admitted to this level of care for
-withdrawal management or addiction treatment.
-
-4.
-
-Agencies must develop and implement policies and procedures for dispensing
-medications per standard withdrawal management protocols that are in accordance with
-applicable state and federal statutes and for the following:
-
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-
-a.
-
-Individual prescriptions filled and dispensed by a registered pharmacist at a
-designated pharmacy location;
-
-b.
-
-Individual prescriptions from medical directors that are filled from stock
-quantities; and
-
-c.
-
-Storage and accounting of all medications, including controlled substances.
-
-5.11.4 Documentation and Timeliness
-A.
-
-B.
-
-C.
-
-D.
-
-The following must be addressed within three (3) hours of an individual’s arrival at the agency:
-1.
-
-Personnel must complete the screening and triage process as indicated in part 2.12.1 of
-these rules to determine the urgency and appropriateness of care within the agency
-including the need for emergency or urgent medical or psychiatric services;
-
-2.
-
-In collaboration with the individual, personnel must develop a withdrawal managementfocused initial service plan, tailored to the safe withdrawal of the individual from the
-substance(s) of concern;
-
-3.
-
-In addition to required intake documentation and consents as noted in part 2.11 of these
-rules, the agency must inventory and secure the individual’s personal belongings. This
-must be observed and confirmed through documentation by at least two (2) personnel;
-and
-
-4.
-
-Personnel must monitor and document vitals in real-time.
-
-As soon as clinically feasible, but no later than seventy-two (72) hours following admission of an
-individual into Level 3.7-WM services, the agency must:
-1.
-
-Update or amend any intake paperwork or consents that the individual was not able to
-complete or comprehend due to their state of intoxication upon admission;
-
-2.
-
-Complete at least the initial assessment as indicated in part 2.12.2 of these rules,
-including substance use disorder history and the degree to which the use of substances
-affects personal and social functioning;
-
-3.
-
-Update the individual’s service plan to reflect ongoing treatment needs as identified
-through the assessment; and
-
-4.
-
-Document referral and care coordination activities to support the individual’s transition
-into beginning or resuming behavioral health treatment services.
-
-The individual record must contain informed consent to receive medical withdrawal management
-services that includes at minimum:
-1.
-
-Medications to be used; and
-
-2.
-
-Need to consult with primary care physicians.
-
-Observation and monitoring requirements
-1.
-
-Agencies must conduct routine monitoring of physical and mental status of the individual
-throughout their time in Level 3.7-WM services. This must include:
-
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-
-a.
-
-Vital signs taken and documented in real-time at the following minimum
-frequency:
-(1)
-
-Every two (2) hours until vitals remain at the individual’s baseline for at
-least four (4) consecutive hours,
-
-(2)
-
-Then every eight (8) hours thereafter until discharge.
-(a)
-
-2.
-
-Chapter 6:
-
-2 CCR 502-1
-
-Documentation per shift to include all individual monitoring
-activities.
-
-If medical personnel determine that an individual requires vital signs to be monitored and
-documented in real-time at a frequency that is less than the minimum requirement above,
-the rationale and plan for this variance must be documented in the individual’s record.
-Non-medical personnel must not make or document such a determination.
-Emergency and Crisis Behavioral Health Services
-
-6.1
-
-Authority and Applicability
-
-A.
-
-Chapter 6 establishes the standards for and is applicable to BHEs electing to provide behavioral
-health crisis and emergency services. The authority to promulgate these service-specific
-requirements that apply to BHEs electing to provide these services comes from Sections 27-50502(1), 27-50-106, and 27-50-107(3)(b), C.R.S.
-
-6.2
-
-General Provisions
-
-A.
-
-All agencies providing residential services to individuals shall comply with the residential and
-overnight requirements set forth in part 2.26 of these rules.
-
-B.
-
-Each component within the behavioral health crisis response system must provide services in a
-trauma-informed, culturally responsive manner.
-
-C.
-
-Agencies must incorporate peer support professionals in accordance with Chapter 3 of these
-rules into the services they provide, when clinically appropriate.
-
-6.3
-
-Walk-In Crisis Services
-
-6.3.1
-
-Applicability
-
-A.
-
-These rules set forth in this section 6.3 are established to create standards for and apply to
-agencies with an endorsement to provide walk-in crisis services.
-
-6.3.2
-
-General Provisions
-
-A.
-
-Each walk-in crisis agency must obtain a 27-65 designation and be in compliance with Section
-27-60-104, C.R.S.
-
-B.
-
-All walk-in crisis agencies are required to obtain a Children and Families endorsement pursuant
-to Chapter 8 of these rules.
-
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-
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-
-C.
-
-Walk-in crisis services must be accessible to all individuals throughout the state of Colorado
-twenty-four (24) hours per day, seven (7) days per week, and 365 days per year. Every walk-in
-crisis services agency must have the ability to provide information and referrals to anyone in
-need, and crisis assessment when indicated, including, if appropriate, access and clinically
-appropriate transportation to crisis stabilization in a crisis stabilization unit. Walk-in crisis service
-agencies must collaborate with other agencies endorsed pursuant to this Chapter 6, and
-community-based organizations.
-
-D.
-
-A walk-in crisis agency must have the capacity to:
-1.
-
-Screen and triage every individual who presents at the agency, with any presenting
-problem including acute and chronic substance use and/or intellectual and developmental
-disability;
-
-2.
-
-Coordinate multiple simultaneous requests for services;
-
-3.
-
-Work closely with community partners, family members or caregivers; and
-
-4.
-
-Work with local hospitals to develop accepted clearance practices to divert the individual
-in crisis from emergency departments for purpose of verifying medical stability prior to
-residential or inpatient admission.
-
-E.
-
-Walk-in crisis agencies must employ an integrated care model based on evidence-based
-practices that consider an individual's physical and emotional health.
-
-F.
-
-Walk-in crisis agencies shall manage and prevent elopement of individuals on an emergency
-mental health hold using strategies in conformity with state and federal laws.
-
-G.
-
-Walk-in crisis agencies must develop crisis safety plans in collaboration with the individual in
-crisis and/or their family member(s) or other social supports. Safety plans should include
-psychiatric advanced directives and referrals/warm hand offs to health and social services and
-supports, as needed.
-
-H.
-
-Follow-up services must be provided to every individual and must include:
-1.
-
-Follow-up to each individual and authorized caregiver and/or family member(s) by phone
-or in-person, based on clinical need and individual preferences. The first follow-up must
-be within twenty-four (24) hours after services were provided. Follow-up attempts must
-be documented in the individual’s record. Follow-up communications must be compliance
-with state and federal data protection laws.
-
-2.
-
-Follow-up communication may be conducted face-to-face, via telehealth, or via telephone
-only, based on an individual’s clinical need and preferences.
-
-6.3.3
-
-Service Provisions
-
-A.
-
-Walk-in crisis services must include screening as defined in part 2.12.1 of these rules, triage,
-crisis assessment, and referrals to appropriate resources. Individuals in crisis must be screened
-and triaged within fifteen (15) minutes of arrival.
-1.
-
-Walk-in crisis agencies are exempt from assessment requirements in part 2.12.2 and
-2.12.3 of these rules. Walk-in crisis agencies shall complete a crisis assessment, in full,
-on a BHA-created form that is available on the BHA’s website, if clinically indicated by the
-initial screening in part 2.12.1 of these rules.
-
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-B.
-
-Prior to an individual leaving a walk-in crisis agency, screenings must be reviewed by a crisis
-professional who is licensed or a candidate receiving supervision from a licensee.
-1.
-
-C.
-
-2 CCR 502-1
-
-Walk-in crisis agencies shall refer all individuals seeking crisis services to appropriate
-resources based on the Level of care indicated by the screening or crisis assessment.
-
-Walk-in crisis services must include:
-1.
-
-2.
-
-3.
-
-Brief intervention, stabilization and de-escalation intended to maintain stability in the
-community, whenever possible to include such activities as:
-a.
-
-On-site interventions, including solution-focused crisis counseling, for immediate
-de-escalation of presenting behavioral health issues.
-
-b.
-
-Coordination with other providers involved in the individual’s or individual’s
-family’s care.
-
-c.
-
-Skill development, psychosocial education and initial identification of resources
-needed to stabilize the presenting situation.
-
-d.
-
-Crisis prevention strategies, including resources to cope with presenting
-emotional symptoms, behaviors, and existing circumstances to avoid future
-crises.
-
-e.
-
-Immediate coordination with other crisis providers when needed (e.g., crisis
-stabilization units and respite, psychiatric emergency services).
-
-f.
-
-Prioritization of remaining in the community, especially for children. Prioritize
-crisis response in home and community-based settings, including schools,
-recreational centers, homeless shelters, and other community centers for
-children.
-
-g.
-
-Lethal means restriction.
-
-h.
-
-Peer support to reduce stigma and build connection.
-
-i.
-
-Identifying and engaging natural supports.
-
-Substance use services:
-a.
-
-Walk-in crisis agencies shall provide harm reduction interventions, including the
-administration of opioid receptor antagonists to reverse an overdose, if needed.
-
-b.
-
-Evaluation of withdrawal management needs. Walk-in crisis agencies may offer
-withdrawal management services if endorsed to provide such services.
-
-c.
-
-Evaluation of appropriateness for medication-assisted treatment (MAT) and
-referrals to providers that can initiate treatment as indicated.
-
-Physical health screen, if indicated, to inform crisis planning and/or as part of the
-clearance practice.
-a.
-
-Physical health screens may be provided by qualified walk-in crisis agency
-personnel or through coordination or referral to a medical provider.
-
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-4.
-
-2 CCR 502-1
-
-Referrals:
-a.
-
-Walk-in crisis agency personnel are responsible for referrals and warm hand-offs
-to health and social services and supports, including withdrawal management
-and medication-assisted treatment, as needed.
-
-b.
-
-Walk-in crisis agency personnel must make documented efforts to schedule
-follow-up appointments within seven (7) business days of referral.
-
-6.3.4
-
-Personnel Requirements
-
-A.
-
-A walk-in crisis agency must be staffed twenty-four (24) hours per day, seven (7) days per week,
-and 365 days per year.
-
-B.
-
-A walk-in crisis agency must include a number of trained professionals on their team which may
-include licensees, psychiatrists and other authorized prescribers; peer support professionals;
-case managers; nurses; and other trained crisis personnel.
-
-C.
-
-A walk-in crisis agency must employ sufficient personnel to ensure that the provision of services
-meets the needs of individuals. At minimum, the agency must have two (2) personnel on-site at
-all times.
-
-D.
-
-A walk-in crisis agency must always be staffed by crisis professional licensees or crisis
-professionals receiving supervision from a licensee who can lead the crisis assessment and
-intervention.
-
-E.
-
-A walk-in crisis services agency must have access to a licensee within fifteen (15) minutes via
-telehealth if one is not available onsite.
-
-F.
-
-Every agency endorsed to provide walk-in crisis services must employ or contract with a peer
-support professional who may lead initial engagement and assist with follow-up services. Any
-recovery support services rendered by peer support professionals shall be provided in
-accordance with part 3.1 through 3.5 of these rules.
-
-G.
-
-A walk-in crisis agency must include a personnel member trained in working with children,
-families and their caregivers who experience crisis.
-
-H.
-
-A walk-in crisis agency must develop a training plan for personnel to ensure expertise in
-addressing and responding to individuals with physical or intellectual/developmental disabilities
-(I/DD), traumatic brain injury, severe mental illness, serious emotional disturbance, substance
-use disorders, co-occurring disorders, and other cognitive or neurodiverse needs who are in
-crisis.
-
-I.
-
-A walk-in crisis agency may develop contractual relationships with local providers with expertise
-in working with the populations referenced in part 6.3.4.H of this Chapter above. These providers
-must be engaged during or immediately after initial face-to-face intervention as needed to support
-individuals in crisis who do not already have an existing relationship with a provider. Telehealth
-may be used to secure expertise for individuals served by the mobile crisis response team with a
-physical or I/DD.
-
-J.
-
-Providers seeking crisis professional status must complete training required by the BHA found on
-the BHA website. Status will be tracked on a yearly basis by the BHA.
-
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-
-6.4
-
-Crisis Stabilization Units
-
-6.4.1
-
-Applicability
-
-A.
-
-These rules set forth in this section 6.4 are established to create standards for and apply to
-agencies with an endorsement to operate a crisis stabilization unit (CSU).
-
-6.4.2
-
-Standards for crisis stabilization services
-
-A.
-
-Crisis stabilization services must meet the requirements of part 2.12 of these rules, including, but
-not limited to requirements for screening, initial assessment, and comprehensive assessment,
-with the following additions:
-1.
-
-Comprehensive assessments must be completed within twenty-four (24) hours of
-admission of an individual;
-
-2.
-
-Medical and medication treatment in accordance with parts 11.8 and 11.17.13 of these
-rules and coordination with medical services;
-
-3.
-
-Peer support, in accordance with Chapter 3 of these rules, when clinically appropriate;
-
-4.
-
-Discharge and service planning in accordance with part 2.10 and 2.13 of these rules;
-
-5.
-
-Safety planning:
-
-6.
-B.
-
-a.
-
-Safety planning is required, and safety plans must be developed in collaboration
-with the individual and the individual’s family members and/or other social
-supports, if not clinically contraindicated.
-
-b.
-
-Safety plans must include psychiatric advance directives.
-
-Care coordination and referral services.
-
-Crisis stabilization services must include, at a minimum:
-1.
-
-Medication management; and
-
-2.
-
-Individual and/or group counseling.
-
-C.
-
-The agency shall ensure individuals admitted for crisis stabilization services cannot be
-appropriately treated in a less restrictive setting.
-
-D.
-
-The individual must be assessed for continued appropriateness for treatment in the crisis setting
-at least every three (3) days.
-1.
-
-When an individual’s assessment indicates the individual should be transferred to a
-different setting but placement in that setting is delayed due to lack of availability, the
-agency shall document that in the service plan, and continue reassessing the individual in
-accordance with part 6.5.2.A above.
-
-2.
-
-Assessments for continued stays in the crisis stabilization setting past seven (7) days
-must include consideration regarding whether the individual would be more appropriately
-served, and should be transferred to, a different level of care.
-
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-
-6.4.3
-
-Crisis Stabilization Unit Staffing Requirements
-
-A.
-
-In addition to the walk-in crisis service staffing requirements listed in part 6.3.4 of these rules,
-crisis stabilization units must have:
-1.
-
-Access to an authorized practitioner upon admission; and
-
-2.
-
-At minimum, one (1) on-site personnel member qualified to administer medications.
-
-6.5
-
-Mobile Crisis Services
-
-6.5.1
-
-Applicability
-
-A.
-
-The rules set forth in this section 6.5 are established to create standards for and apply to
-agencies with an endorsement to provide mobile crisis services pursuant to Section 27-60-104,
-C.R.S.
-
-6.5.2
-
-General Provisions
-
-A.
-
-Mobile crisis service agencies are intended to provide a timely paired mobile response as
-described in part 6.5.3.B to a behavioral health crisis in the community. Mobile crisis service
-agencies must provide referrals and facilitate transitions to other crisis agencies, behavioral
-health entities, and community-based services as clinically indicated.
-
-B.
-
-All agencies providing mobile crisis services or responding to crisis calls shall meet critical
-incident reporting procedures in accordance with part 2.16 of these rules.
-
-6.5.3
-
-Service Provisions
-
-A.
-
-Mobile crisis service agencies must have the capacity to:
-
-B.
-
-1.
-
-Intervene where the crisis occurs;
-
-2.
-
-Coordinate multiple simultaneous requests for services;
-
-3.
-
-Work closely with law enforcement, emergency medical services, crisis hotlines, schools,
-and hospital emergency departments; and
-
-4.
-
-Serve priority populations.
-
-An agency’s mobile crisis response teams must arrive at the community-based location where a
-crisis occurs within two (2) hours of accepting a dispatch request for rural and frontier areas as
-defined in Section 23-76.5-101(6), C.R.S. and within one (1) hour of accepting a dispatch request
-for urban areas, including dispatch from the statewide hotline/988 either face-to-face or using
-telehealth operations.
-1.
-
-The mobile crisis service agency shall develop policies for dispatch criteria related to
-serving:
-a.
-
-Populations listed in part 6.5.4.E of this Chapter
-
-b.
-
-Individuals of all ages
-
-c.
-
-Individuals demonstrating aggressive behavior
-
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-2.
-
-2 CCR 502-1
-
-d.
-
-Individuals who are uninsured or unable to pay for services
-
-e.
-
-Individuals who may lack Colorado residency or legal immigration status
-
-If the statewide hotline/988 requests a mobile crisis response, a mobile crisis service
-agency shall immediately accept the request which means to affirm the request from the
-hotline and immediately dispatch the mobile crisis response team. Rejected requests are
-subject to review from the BHA or their designee.
-
-C.
-
-Mobile crisis service agencies must operate twenty-four (24) hours per day, seven (7) days per
-week, and 365 days per year in providing community-based crisis intervention, screening, crisis
-assessment on a BHA created form that is available on the BHA’s website, and referrals to
-appropriate resources.
-
-D.
-
-The mobile crisis service agency must complete screening requirements as defined in part 2.12.1
-of these rules. In addition to these screening requirements, the mobile crisis service agency must
-also attempt to collect the following information:
-1.
-
-Strengths and resources of the individual experiencing the crisis, their family members,
-and other social supports
-
-2.
-
-Recent inpatient hospitalizations and/or any current relationship with a behavioral health
-provider
-
-3.
-
-Medications prescribed, medications taken recently, current prescriber and information
-about the individual’s ongoing medication regimen
-
-E.
-
-The screening process referenced in this section’s subpart D above must also include a rapid
-determination as to whether the crisis warrants medical or law enforcement response.
-
-F.
-
-The mobile crisis service agency must administer a crisis assessment, in full, on a BHA-created
-crisis assessment form that is available on the BHA’s website if clinically indicated by the initial
-screening in part 2.12.1 of these rules.
-
-G.
-
-Mobile crisis service agencies through mobile crisis response teams shall develop crisis safety
-plans in collaboration with individuals in crisis and their authorized family members and/or other
-social supports, unless clinically contraindicated. The safety plan shall be in writing and copies of
-the plan must be offered to the individual, the individual’s caregiver when applicable, and to other
-service providers or social supports when authorized by the individual.
-
-H.
-
-1.
-
-Safety plans must include any psychiatric advance directives in effect.
-
-2.
-
-Safety plans shall also include:
-a.
-
-Short-term strategies for immediate stabilization
-
-b.
-
-Long-term strategies to support a return to the pre-crisis level of functioning
-
-c.
-
-Referrals to services, supports, and resources identified by the mobile crisis
-team.
-
-Mobile crisis teams of a mobile crisis service agency must follow-up with an individual and
-authorized caregiver and/or family member(s) by phone or in-person, based on clinical need and
-individual preferences, within twenty-four (24) hours from when services are provided. Follow-up
-attempts must be documented in the individual’s record.
-
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-I.
-
-2 CCR 502-1
-
-Mobile crisis response teams of a mobile crisis service agency must provide brief intervention,
-stabilization and de-escalation services intended to maintain stability in the community, whenever
-possible. This may include but is not limited to:
-1.
-
-On-site interventions, including solution-focused crisis counseling, for immediate deescalation of presenting behavioral health issues.
-
-2.
-
-Coordination with other providers involved in the individual’s or family’s care.
-
-3.
-
-Skill development, psychosocial education and initial identification of resources needed to
-stabilize the presenting situation.
-
-4.
-
-Crisis prevention strategies and resources to cope with presenting emotional symptoms,
-behaviors and existing circumstances and avoid future crises.
-
-5.
-
-Immediate coordination with other crisis providers, including peer support professional
-services, when needed. Other crisis providers may include walk-in centers, crisis
-stabilization units and respite, psychiatric emergency services.
-
-6.
-
-Prioritization of remaining in the community, especially for children and young people.
-Prioritize crisis response in home and community-based settings, including schools,
-recreational centers, homeless shelters, and other community centers for children.
-
-7.
-
-Provide harm reduction interventions, including the administration of an opioid receptor
-antagonist to reverse an overdose, when needed.
-
-8.
-
-Evaluation of appropriateness for medication-assisted treatment (MAT) and referrals to
-providers that can initiate treatment as indicated.
-
-J.
-
-Mobile crisis response teams of a mobile crisis service agency must provide or coordinate
-clinically appropriate and accessible transportation to an appropriate level of care as needed
-following a response. An agency’s mobile crisis team may only provide transportation directly if
-they are appropriately licensed by their county as a secure transportation provider.
-
-6.5.4
-
-Personnel Requirements
-
-A.
-
-All mobile crisis service agencies must include a mobile crisis response team. Every mobile crisis
-response team must include a licensee or must have a licensee immediately available via
-telehealth. Mobile crisis response teams may also include a number of trained professionals on
-their teams including emergency medical technicians, community paramedics, peer support
-professionals, mobile crisis case managers, nurses, and other trained crisis personnel.
-
-B.
-
-Every mobile crisis response team must include a crisis professional who can lead the crisis
-assessment and intervention.
-
-C.
-
-Every agency endorsed to provide mobile crisis services must employ or contract with a peer
-support professional who can be included in the mobile crisis response team as appropriate and
-available, and who may take the lead on initial engagement and assist with follow-up services.
-1.
-
-D.
-
-A peer support professional must be available for follow-up services within one (1)
-business day of the crisis response.
-
-Every mobile crisis response team must include a personnel member with specific training and
-expertise in serving children and their caregivers who experience crisis.
-
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-
-E.
-
-Personnel on a mobile crisis response team must be trained in responding to individuals with
-physical or intellectual/developmental disabilities (I/DD), traumatic brain injury, severe mental
-illness, serious emotional disturbance, substance use disorders, co-occurring disorders, and
-other cognitive or neurodiverse needs who are in crisis.
-
-F.
-
-Mobile crisis service agencies may develop contractual relationships with local providers with
-expertise working with the populations referenced in 6.4.4.H of this Chapter. These providers
-must be engaged during or immediately after initial face-to-face intervention as needed to support
-individuals in crisis who do not already have an existing relationship with a provider. Telehealth
-may be used to secure expertise for individuals served by the mobile crisis response team with a
-physical disability or I/DD.
-
-G.
-
-Mobile crisis service agencies must develop a training plan to ensure expertise in addressing
-specific population needs as described in part 6.3.4.H of this section. If not utilizing contractual
-relationships to meet requirements in part 6.5.4.F of this section, the plan must address training
-for serving populations described in that part.
-
-6.6
-
-Respite Care Services
-
-6.6.1
-
-Applicability
-
-A.
-
-These rules set forth in this section 6.6 are established to create standards for and apply to
-agencies with an endorsement to provide residential or community-based respite care services.
-
-6.6.2
-
-General Provisions
-
-A.
-
-Residential or community-based respite care services provide temporary or short-term care by a
-licensee, candidate or other personnel based on the level of care being provided and is designed
-for an individual that has experienced a self-defined crisis. Crisis respite is intended to be a
-flexible intervention or set of services based on the presenting concerns of the individual in a selfdefined crisis and must have the capacity to:
-1.
-
-Provide supports necessary to alleviate the conditions leading to the initial crisis; and
-
-2.
-
-Enhance an individuals’ sense of safety and agency in managing their crisis.
-
-B.
-
-Residential or community-based respite care services include a range of short-term services
-twenty-four (24) hours per day, seven (7) days per week, and 365 days per year. Respite care
-services shall be flexible to ensure that the individual’s daily routine is maintained.
-
-C.
-
-Length of stay determinations must be ongoing, transparent to the individual and family to the
-extent allowable under state and federal privacy laws, and jointly determined by the individual,
-family, respite provider, and treatment team.
-
-D.
-
-In order to be eligible for residential or community-based respite services, an individual that has
-experienced a behavioral health crisis must:
-1.
-
-Be referred by personnel within other agencies endorsed pursuant to this Chapter 6;
-
-2.
-
-Agree to residential or community-based respite services;
-
-3.
-
-Not meet emergency procedure criteria outlined in Section 27-65-106, C.R.S., Care and
-Treatment for Persons with Mental Illness;
-
-4.
-
-Present a minimal risk of significant withdrawal complications;
-
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-
-5.
-
-Cooperate with program guidelines; and
-
-6.
-
-Be able and willing to participate, with accommodations if needed, in forming a service
-plan.
-
-6.6.3
-
-Service Provisions
-
-A.
-
-Services must be intended to improve/maintain the condition and functional level of the individual
-and prevent relapse or hospitalization while providing a safe environment to address precipitating
-factors to the crisis. Services must include structure, support, and care coordination, and may
-include but not be limited to the following:
-1.
-
-Comprehensive assessment as described in part 2.12.3 of these rules;
-
-2.
-
-Assistance with monitoring, completing, or prompting of activities of daily living (ADLs);
-
-3.
-
-Assistance with medical and physical health needs, including medication administration
-and monitoring;
-
-4.
-
-Life skills and environmental maintenance;
-
-5.
-
-Assistance/supervision needed by an individual to participate in social, recreational and
-community activities;
-
-6.
-
-Referral to and establishing a stronger connection to community resources;
-
-7.
-
-Relationship building;
-
-8.
-
-Safety planning;
-
-9.
-
-Stigma reduction; and
-
-10.
-
-Monitoring of personal hygiene, nutritional support, safety, and environmental
-maintenance.
-
-6.6.4
-
-Personnel Requirements
-
-A.
-
-Respite agency personnel shall be multidisciplinary, with the intention of subclinical stabilization,
-responsive to the unique needs of the individual. Respite agency personnel shall include
-expertise in meeting the need of children if the agency holds a Children and Families
-endorsement, which includes but is not limited to:
-1.
-
-Child and family peer support providers; psychiatrists, psychiatric nurse practitioners, or
-physicians; and social workers, counselors, and crisis specialists;
-
-2.
-
-Have personnel who can assess physical health needs and deliver care for most minor
-physical health challenges;
-
-3.
-
-Have an identified pathway to transfer the child to more medically staffed services, if
-needed; and
-
-4.
-
-Ensure that personnel have child and family expertise and experience, training in traumaresponsive care and cultural responsiveness.
-
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-B.
-
-Peer support professionals must be utilized in accordance with Chapter 3 of these rules if
-providing residential or community-based respite services.
-
-C.
-
-Every respite agency must include a licensee or must have a licensee immediately available via
-telehealth.
-
-6.6.5
-
-Respite Care Settings
-
-A.
-
-Respite care services may be provided in residential or community-based settings.
-1.
-
-Residential respite care services must comply with residential and overnight
-requirements in accordance with part 2.26 of these rules.
-
-2.
-
-Community-based respite care services may be provided in the individual's home or
-community as a temporary relief from stressful situations or environments, or to provide
-additional support in the individual’s home environment.
-
-6.7
-
-Acute Treatment Services
-
-6.7.1
-
-Applicability
-
-A.
-
-These rules set forth in this section 6.7 are established to create standards for and apply to
-agencies with an endorsement to operate an acute treatment unit (ATU).
-
-6.7.2
-
-Standards for Acute Treatment Services
-
-A.
-
-Agencies providing acute treatment unit services must be designated pursuant to Chapter 11 of
-these rules.
-
-B.
-
-The agency shall ensure the admission/discharge criteria and service planning requirements in
-part 2.10 and 2.13.1 of these rules, as well as assessment requirements in parts 2.12.2 and
-2.12.3 of these rules are met with the following additions:
-1.
-
-The agency shall ensure individuals admitted for acute treatment services are age
-eighteen (18) years or older, in need of psychiatric care, and cannot be appropriately
-treated in a less restrictive setting.
-
-2.
-
-The individual shall be assessed for continued appropriateness for treatment in the acute
-treatment services setting at least every three (3) days. Individual stays may be extended
-when such extension is determined to be the most appropriate course of treatment based
-on an updated individual assessment and service plan, as follows:
-
-3.
-
-a.
-
-When an individual’s assessment indicates the individual should be transferred to
-a different setting but placement in that setting is delayed due to lack of
-availability, the agency shall document that in the service plan, and continue to
-reassess the individual in accordance with part 6.7.2.B.2.
-
-b.
-
-Assessments for continued stays in the acute treatment services setting past ten
-(10) days shall include consideration regarding whether the individual would be
-more appropriately served, and should be transferred to, a different level of care.
-
-An individual may only be admitted into a locked setting if there is no less restrictive
-appropriate alternative and admitting to a locked facility is in compliance with Chapter 11
-of these rules.
-
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-
-4.
-
-An individual may be admitted into a 27-65 designated facility on a voluntary basis, as
-long as the following requirements are met and the individual signs a form that
-documents the following:
-a.
-
-The individual is aware the setting is locked.
-
-b.
-
-The individual has the ability to exit the setting with personnel assistance.
-
-5.
-
-An individual who is an imminent danger to self or others may only be admitted to acute
-treatment services upon completion of the agency’s comprehensive assessment and
-determination that the individual’s safety and the safety of others can be maintained.
-
-6.
-
-If an individual is admitted and personnel subsequently determine the individual’s
-behavior cannot be safely and successfully treated in the acute treatment services
-location, the agency shall make arrangements to transfer the individual to the nearest
-hospital or other appropriate level of care for further assessment and evaluation.
-
-7.
-
-The agency shall have policies that identify when an individual requires a physical health
-assessment by a qualified licensed practitioner, including, but not limited to:
-
-8.
-
-C.
-
-2 CCR 502-1
-
-a.
-
-Within twenty-four (24) hours of admission;
-
-b.
-
-When there is a significant change in the individual’s condition;
-
-c.
-
-When the individual has evidence of a possible infection, such as swelling or
-open sores;
-
-d.
-
-When the individual experiences an injury or accident that might cause a change
-in condition;
-
-e.
-
-When the individual has known exposure to a communicable disease; or
-
-f.
-
-When the individual develops any condition that would have initially precluded
-admission to the acute treatment service setting.
-
-The agency shall ensure the individual’s service plan is created within twenty-four (24)
-hours after admission. Such service plan shall include any special dietary instructions,
-physical or cognitive limitations, and a description of the services which the agency will
-provide to meet the needs identified in the individual’s assessment(s).
-a.
-
-The individual may request a modification of the services identified in the service
-plan at any time.
-
-b.
-
-The service plan shall include goals of the acute treatment services stay and
-standards to be met for discharge.
-
-The agency shall ensure acute treatment services meet personnel training requirements in
-accordance with part 2.14.3 of these rules, with the following additions:
-1.
-
-The agency’s administrator shall have training in assessment skills, nutrition, and
-identifying and dealing with behavioral health crises and behavior management, and be
-responsible for the overall direction and supervision of personnel;
-
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-
-2 CCR 502-1
-
-2.
-
-The agency’s clinical director shall have training in assessment and identifying and
-treating individuals who display behaviors that are common to individuals with severe and
-persistent mental health disorders; and
-
-3.
-
-The agency shall ensure the staffing level in each physical location providing acute
-treatment services is adequate to provide services to meet the needs of the individuals at
-the location, in accordance with the individuals’ service plans.
-
-D.
-
-The agency shall ensure compliance with parts 2.15 and part 11.17.15 of these rules, regarding
-medication administration, storage, handling, and disposal.
-
-E.
-
-The agency shall establish written house rules for the acute treatment services setting which do
-not violate or contradict rules found in this Chapter 6, and which do not restrict an individual’s
-rights. Such house rules shall be provided to the individual upon admission and be prominently
-posted at the location services are provided.
-
-F.
-
-Alternate building standards. The following building standards shall apply only to the physical
-locations in which acute treatment services are provided.
-1.
-
-G.
-
-The interior environment shall be clean and sanitary, free of hazards to health and safety,
-including:
-a.
-
-Layout, finishes, and furnishings must minimize the opportunity for residents to
-injure themselves or others.
-
-b.
-
-Interior areas, finishes, and furnishings must be maintained in good repair and
-promote sanitary conditions. All spaces shall have adequate heat, lighting, and
-ventilation sufficient for its intended use and individual needs.
-
-c.
-
-Windows that can be accessed by individuals must have security glazing or other
-appropriate security features to reduce the possibility of injury or elopement.
-
-d.
-
-Items/substances that could be used for self-harm or harm to others, including,
-but not limited to, sharp knives and cleaning solutions, must be appropriately
-labeled and stored in a safe manner, inaccessible to individuals.
-
-e.
-
-The physical location shall be maintained free of infestations of insects and
-rodents and all openings to the outside must be screened.
-
-f.
-
-An adequate supply of safe, potable water must be available.
-
-g.
-
-Hot water shall not be more than 120 degrees Fahrenheit at taps which are
-accessible by individuals, and there must be a sufficient supply of hot water to
-meet the needs during peak usage.
-
-The agency shall provide a clean, sanitary, and secure exterior environment for the year-round
-use of individuals, free of hazards to health and safety.
-1.
-
-Exterior areas must be maintained to prevent hazardous slopes, holes, or other hazards,
-and must be kept free of high weeds and grass, garbage, and/or rubbish.
-
-2.
-
-Secure outdoor areas shall be fenced or enclosed to prevent elopement and protect the
-safety and security of individuals.
-
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-
-H.
-
-2 CCR 502-1
-
-The agency shall ensure the following standards are met regarding the physical operation of the
-acute treatment services location:
-1.
-
-2.
-
-3.
-
-The agency’s physical operation shall be in compliance with all applicable:
-a.
-
-Local zoning, housing, fire, and sanitary codes and ordinances of the city, city
-and county, or county where the location is situated.
-
-b.
-
-State and local plumbing laws and regulations, including that plumbing must be
-maintained in good repair, free of the possibility of backflow and back siphonage
-through the use of vacuum breakers and fixed air gaps, in accordance with state
-and local codes.
-
-c.
-
-Sewage disposal requirements, including that sewage must be discharged into a
-public sewer system or disposed of in a manner approved by the local health
-department, or local laws if no local health department exists, and the Colorado
-water quality control commission.
-
-The agency shall have common areas adequate to accommodate all individuals,
-including a designated dining area capable of seating all individuals, and meeting the
-following accessibility requirements:
-a.
-
-All common areas and dining areas must be accessible to individuals using an
-auxiliary aid without requiring transfer from a wheelchair to walker or from a
-wheelchair to a regular chair.
-
-b.
-
-Doors to individual accessible rooms shall be at least thirty-two (32) inches wide.
-
-c.
-
-A minimum of two entryways shall be provided for ingress and egress from the
-building by individuals using a wheelchair.
-
-The following requirements must be met for bedrooms:
-a.
-
-No individual may be assigned to any room other than a regularly designated
-bedroom. Temporary occupancy of a room not designated as a bedroom is
-permissible on a limited basis when the use of the assigned bedroom is
-contraindicated due to circumstances related to individual safety or emergent
-issues. Justification for such placement, and the length of placement, shall be
-documented in the individual record.
-
-b.
-
-No more than two (2) individuals shall reside in a bedroom.
-
-c.
-
-Each bedroom for individuals must have at least 100 square feet for a single
-individual, or 120 square feet for two residents. Bathroom areas and closets shall
-not be included in the determination of square footage.
-
-d.
-
-Each individual shall have separate storage facilities adequate for personal
-Articles, such as a closet or locker, available inside their bedroom. Shelves may
-be provided for folded garments in lieu of hanging garments.
-
-e.
-
-Each bedroom must include a comfortable, standard-sized bed with a clean
-mattress, mattress protector, pillow, rollaway-type beds, cots, folding beds, or
-bunk beds are not permitted.
-
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-
-4.
-
-5.
-
-6.
-
-2 CCR 502-1
-
-f.
-
-The bedroom shall have a safe and sanitary method to store the individual’s
-towel, such as a breakaway towel rack.
-
-g.
-
-Extension cords and multiple-use electrical sockets shall be prohibited in
-individual bedrooms.
-
-h.
-
-The bedroom shall include a chair unless contraindicated, in which case alternate
-seating shall be provided in close proximity to the bedroom.
-
-The following standards must be met for bathrooms:
-a.
-
-Each floor with bedrooms must have at least one bathroom which can be
-accessed without entering a bedroom.
-
-b.
-
-The physical location of the agency’s operations must have at least one full
-bathroom accessible to any individual using an auxiliary aid, including properly
-installed grab bars at each tub and/or shower, and adjacent to each toilet.
-
-c.
-
-Bathtubs and shower floors must have non-skid surfaces.
-
-d.
-
-Toilet seats shall be constructed of non-absorbent materials and free of cracks.
-
-e.
-
-Individuals must have individualized personal care Articles and supplies, such as
-soap and towels, and such Articles and supplies shall not be shared.
-
-f.
-
-Toilet paper must be available at all times in each bathroom.
-
-g.
-
-Liquid soap and paper towels must be available at all times in the common
-bathrooms.
-
-The following standards must be met for seclusion rooms:
-a.
-
-The seclusion room must be constructed to prevent an individual from hiding,
-escaping, being injured, or dying by suicide, and must be free of all protrusions,
-sharp corners, hardware, fixtures or other devices, and furnishings which may
-cause injury to the individual.
-
-b.
-
-The seclusion room must maintain a temperature appropriate for the season.
-
-c.
-
-The seclusion room must be located in a manner affording direct observation of
-the individual by personnel.
-
-d.
-
-The seclusion room must have a window that allows someone outside the room
-to see into all of the corners of the room. All windows in the seclusion room must
-be constructed to prevent breakage and otherwise prevent self-harm.
-
-e.
-
-Doors to the seclusion room shall be at least thirty-two (32) inches wide and must
-open outward.
-
-f.
-
-Light fixtures and other electrical outlets in the seclusion room must be limited to
-those required and necessary, must be recessed, and must be constructed to
-prevent self-harm. Such fixtures and outlets must be controlled by labeled on/off
-switches located outside the seclusion room.
-
-The agency shall meet the following requirements regarding linen and laundry:
-
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-
-Chapter 7:
-
-2 CCR 502-1
-
-a.
-
-The agency may have laundry room(s) with residential-style washer(s) and
-dryer(s) in an area with adequate square footage and ventilation for the number
-of washers and/or dryers included in the space.
-
-b.
-
-The laundry room(s) must not be used for storage of soiled or clean linen.
-
-c.
-
-There must be a separate enclosed area for receiving and holding soiled linen
-until ready for pickup or processing, in addition to a separate enclosed area for
-clean linen storage.
-
-d.
-
-There must be hand-washing, or other appropriate hand-sanitizing, facilities in
-each area where unbagged, soiled linen is handled.
-
-Emergency and Involuntary Substance Use Disorder Commitment Services
-
-7.1
-
-Authority and Applicability
-
-A.
-
-Chapter 7 establishes the standards for emergency and involuntary commitment of a person with
-a substance use disorder. The authority to promulgate these rules necessary to carry out the
-BHA’s programs for emergency and involuntary commitment of a person with a substance use
-disorder comes from Section 27-50-107(3), C.R.S. and Section 27-50-502(1), C.R.S. authority for
-BHA administration of these programs is found in Section 27-50-105(1)(pp), C.R.S. and Section
-27-50-105(1)(qq), C.R.S.
-
-B.
-
-These rules are established to create standards for agencies seeking an endorsement to provide
-services to individuals on emergency substance use disorder commitments pursuant to Section
-27-81-111, C.R.S. and Section 27-81-112, C.R.S.
-
-C.
-
-All agencies providing services to individuals on emergency substance use disorder commitments
-shall meet the standards in this Chapter 7. If the agency requires a BHE license, the agency shall
-comply with Chapter 2 of these rules.
-
-7.2
-
-Emergency Substance Use Disorder Commitment Services
-
-A.
-
-Emergency commitment policies and procedures, based on compliance with Section 27-81-111,
-C.R.S., shall be developed and implemented by the licensed and appropriately endorsed agency
-providing withdrawal management services pursuant to Chapter 4 (Outpatient and High Intensity
-Outpatient Services) or Chapter 5 (Residential Services) of these rules. Such policies and
-procedures shall require agency personnel to:
-1.
-
-Ascertain if grounds for commitment exist;
-
-2.
-
-Assure that individuals and their legal representatives receive copies of the application
-for emergency commitment forms and are advised verbally and in writing of the right to
-challenge commitment through the courts; and,
-
-3.
-
-Determine when grounds for emergency commitment no longer exist.
-
-B.
-
-The treatment agency administrator shall designate, in writing, qualified personnel who meet the
-criteria established in part 5.6.2.F of these rules, to assume responsibility for accepting,
-evaluating, informing, and providing treatment to individuals on an emergency commitment.
-
-C.
-
-Applications for emergency commitments must be prepared on BHA designated forms available
-on the BHA website.
-
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-
-2 CCR 502-1
-
-D.
-
-Daily evaluations shall be completed for the continuance of an emergency commitment. Daily
-evaluations shall be documented in the individual record.
-
-E.
-
-If individuals on an emergency commitment require treatment in other licensed and appropriately
-endorsed withdrawal management programs, transfers shall be managed by the programs that
-initially authorized the commitments.
-
-F.
-
-When transferring individuals, withdrawal management programs shall use BHA designated
-transfer forms available on the BHA website. Completed copies shall be given to:
-1.
-
-Individuals and/or their legal representatives; and,
-
-2.
-
-The withdrawal management programs to which individuals are being transferred.
-
-G.
-
-When a child is transferred and/or the child's emergency commitment has been discontinued,
-parents or legal guardians who have given permission for treatment must receive copies of
-transfer form and emergency commitment form.
-
-H.
-
-When it is determined that grounds for an emergency commitment no longer exist, the individual
-must be transferred to voluntary status and the emergency commitment shall be discontinued and
-documented. A copy of the emergency commitment form that specifies discontinuation of the
-emergency commitment must be given to the individual and made part of the individual record as
-described in part 2.11 of these rules.
-
-I.
-
-Discharge summaries, as outlined in part 2.10.A.6 of these rules must be submitted to the BHA,
-the referring source, and to the referral agency in accordance with state and federal
-confidentiality laws and regulations.
-
-7.3
-
-Involuntary Substance Use Disorder Commitment Services
-
-A.
-
-These rules are established to create standards for agencies seeking an endorsement to provide
-services for individuals on involuntary substance use disorder commitments pursuant to Section
-27-81-112, C.R.S.
-
-7.3.1
-
-General Provisions
-
-A.
-
-Involuntary commitment policies and procedures must be developed and implemented based on
-and in compliance with Section 27-81-112, C.R.S.
-
-B.
-
-The BHA may delegate physical custody of individuals involuntarily committed to an appropriate
-approved treatment agency pursuant to Section 27-81-112(5), C.R.S.
-
-C.
-
-Passes may be issued to individuals on involuntary commitments in residential settings only if
-they are directly related to treatment. Passes shall not be issued during the initial thirty (30) days
-of treatment, except in emergencies, as defined in part 1.2 of these rules, and with BHA approval.
-
-D.
-
-The following information shall be reported to the BHA using the process outlined on the BHA
-website:
-1.
-
-Non-compliance with program requirements shall be reported within three (3) business
-days;
-
-2.
-
-Non-compliance with court orders shall be reported within 24 hours;
-
-3.
-
-Failure to appear for admission to treatment shall be reported within 24 hours;
-
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-
-2 CCR 502-1
-
-4.
-
-Leaving treatment in violation of court orders shall be reported within 24 hours;
-
-5.
-
-Failure to return from passes shall be reported within 24 hours; and,
-
-6.
-
-Monthly treatment status reports shall be due by the 15th day of the month.
-
-E.
-
-Discharge summaries, as outlined in part 2.10.A.6 of these rules shall be submitted to the BHA,
-the referring source, and to the referral agency in accordance with state and federal
-confidentiality laws and regulations.
-
-F.
-
-An agency may not grant an individual’s requests for early discharge and/or transfer to other
-treatment programs without first obtaining BHA approval.
-
-7.3.2
-
-Personnel Requirements
-
-A.
-
-Primary counselors for individuals on an involuntary commitment, means the following behavioral
-health professionals trained in substance use disorder identification and treatment and acting
-within their scope of practice:
-1.
-
-Authorized practitioner;
-
-2.
-
-Licensee;
-
-3.
-
-Certified addiction specialist (CAS); or,
-
-4.
-
-Candidate personnel.
-
-B.
-
-All of the personnel noted in part 7.3.2.A above shall complete at least fourteen (14) hours of
-training in interviewing techniques related to engaging individuals in treatment.
-
-C.
-
-Copies of primary counselor credentials and other relevant documentation shall be maintained in
-counselor personnel files as described in part 2.5.G of these rules.
-
-Chapter 8:
-
-Services for Children and Families
-
-8.1
-
-Authority and Applicability
-
-A.
-
-Chapter 8 establishes standards for agencies seeking an endorsement to provide services for
-children and families. Rules include requirements for individual assessment, treatment and
-patient rights. The authority for these standards comes from Section 27-50-502(1)(a)(I), C.R.S.
-authority to promulgate these rules establishing additional competencies related to serving priority
-populations, including children, comes from Section 27-50-502(6) C.R.S., and for children
-Sections 27-50-301(3)(c), C.R.S., 27-50-301(5), C.R.S., and 27-50-107(3), C.R.S.
-
-B.
-
-These rules are established to create standards for agencies seeking an endorsement to provide
-psychotherapy services, as defined in part 1.2 of these rules, and services for children and
-families. Services for children and families include Behavioral Health Early Intervention and
-Outpatient Services as outlined in part 4.1 through 4.4.3 of these rules, Behavioral Health HighIntensity Outpatient Services as outlined in part 4.6 through 4.7.4 of these rules, Behavioral
-Health Residential Services as outlined in part 5.1 through 5.3.3 of these rules and part 5.5
-through part 5.6 of these rules and part 5.9 through 5.9.5 of these rules and Emergency and
-Crisis Behavioral Health Services as outlined in part 6.1 through 6.7.2 of these rules.
-
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-
-2 CCR 502-1
-
-C.
-
-All agencies providing psychotherapy services and children and family services must meet the
-standards in this Chapter 8. If the agency requires a BHE license, the agency shall comply with
-Chapter 2 of these rules.
-
-D.
-
-An agency with a Children and Families endorsement must also have at least one other
-endorsement of these rules.
-
-8.2
-
-Behavioral Health Services for Children
-
-8.2.1
-
-Criminal History Record Check
-
-A.
-
-In addition to criminal background checks required under part 2.6.D of these rules, agencies
-must, prior to hiring or accepting new personnel, submit to the Federal Bureau of Investigation
-(FBI) a complete set of fingerprints taken by a qualified law enforcement agency to obtain any
-criminal record held by the FBI, for each prospective personnel. Payment of the fee for the
-criminal record check is the responsibility of the agency. No direct contact with children may take
-place until the background check is cleared by the FBI.
-
-8.3
-
-Rights of Children
-
-A.
-
-Parents or legal guardians must be contacted without the child’s written or verbal consent, unless
-notifying the parent or legal guardian would be inappropriate or detrimental to the minor’s care
-and treatment, as authorized by Section 12-245-203.5(7), C.R.S., if:
-1.
-
-The child presents or communicates a danger to self or others, including a person who is
-identifiable by the person’s association with a specific location or entity.
-
-B.
-
-Section 27-65-104(1), C.R.S. allows children who are fifteen (15) years of age or older, with or
-without the consent of a parent or legal guardian, to knowingly consent to mental health services,
-which includes the provision of psychotropic medications.
-
-8.3.1
-
-Rights of Children Receiving Outpatient Services
-
-A.
-
-Agencies must obtain parental or legal guardian consent for children under fifteen (15) years of
-age, with the following exception:
-1.
-
-Section 12-245-203.5(2), C.R.S., allows psychotherapy services, as defined in Section
-12-245-202(14)(a), C.R.S., to be provided to a child who is twelve (12) years of age or
-older, with or without the consent of the child’s parent or legal guardian, if the child is
-knowingly and voluntarily seeking such services and the provision of psychotherapy
-services is clinically indicated and necessary to the child’s well-being. The following
-mental health professionals are the only professionals within an agency allowed to
-provide outpatient psychotherapy services in an outpatient setting to a child who is twelve
-(12) years of age or older, without the consent of the child’s parent or legal guardian:
-a.
-
-A professional person as defined in Section 27-65-102(27), C.R.S., which means
-a person licensed to practice medicine in this state, a psychologist licensed to
-practice in this state, or a person licensed and in good standing to practice
-medicine in another state or a psychologist licensed to practice and in good
-standing in another state who is providing medical or clinical services at a
-treatment facility in this state that is operated by the Armed Forces of the United
-States, the United States Public Health Service, or the United States Department
-of Veterans Affairs;
-
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-
-b.
-
-2 CCR 502-1
-
-A mental health professional licensed pursuant to Article 245, of Title 12, C.R.S.,
-which in accordance with Section 12-245-203.5, C.R.S., includes:
-(1)
-
-A licensed psychologist or a psychologist candidate pursuant to Section
-12-245-301 through -309, C.R.S.;
-
-(2)
-
-A licensed clinical social worker or a licensed social worker candidate
-pursuant to Section 12-245-401 through -410, C.R.S.;
-
-(3)
-
-A marriage and family therapist licensed or a licensed marriage and
-family therapist candidate pursuant Section 12-245-501 through -506,
-C.R.S.;
-
-(4)
-
-A licensed professional counselor or a licensed professional counselor
-candidate pursuant to Section 12-245-601 through -607, C.R.S.; and,
-
-(5)
-
-A licensed addiction counselor or an addiction counselor candidate
-licensed pursuant to Section 12-245-801 through -806, C.R.S.
-
-2.
-
-A child may not refuse psychotherapy services when a mental health professional and
-the child’s parent or legal guardian agree psychotherapy services are in the best interest
-of the child.
-
-3.
-
-If the child voluntarily seeks psychotherapy services on their own behalf pursuant to
-Section 12-245-203.5(2)(a), C.R.S.:
-
-4.
-
-a.
-
-The mental health professional may notify the child’s parent or legal guardian of
-the psychotherapy services given or needed, with the child’s consent, unless
-notifying the parent or legal guardian would be inappropriate or detrimental to the
-child’s care and treatment.
-
-b.
-
-The mental health professional shall engage the child in a discussion about the
-importance of involving and notifying the child’s parent or legal guardian and
-shall encourage such notification to help support the child’s care and treatment;
-and,
-
-c.
-
-Notwithstanding the provisions of Section 12-245-203.5(3)(a), C.R.S., a mental
-health professional may notify the child’s parent or legal guardian of the
-psychotherapy services given or needed, without the child’s consent, if, in the
-professional opinion of the mental health professional, the child is unable to
-manage the child’s care or treatment.
-
-A mental health professional shall fully document in the child’s individual record, when
-the mental health professional attempts to contact or notify the child’s parent or legal
-guardian and whether the attempt was successful or unsuccessful, or the reason why, in
-the mental health professional’s opinion, it would be inappropriate to contact or notify the
-child’s parent or legal guardian.
-a.
-
-If the child seeks psychotherapy services on their own behalf pursuant to Section
-12-245-203.5(2)(a), C.R.S., documentation must be included in the child’s
-individual record, along with a written statement signed by the child, indicating
-the child is voluntarily seeking psychotherapy services.
-
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-5.
-
-2 CCR 502-1
-
-In addition to the individual rights specified in part 2.7 of these rules, children who meet
-the requirements of part 8.3.1.A.1, without the consent of a parent or legal guardian, have
-the right to:
-a.
-
-Consent to release of information
-
-8.3.2
-
-Rights of Children in Hospitalization
-
-A.
-
-In addition to the individual rights specified in part 2.7 of these rules, and notwithstanding any
-other provision of law, a child who is fifteen (15) years of age or older, with or without the consent
-of a parent or legal guardian, has the right to consent to receive behavioral health services to be
-rendered by an agency, a professional person, or a mental health professional pursuant to
-Section 27-65-104(1), C.R.S., in any practice setting;
-1.
-
-Consent to voluntary hospitalization for mental health services;
-
-2.
-
-Object to hospitalization and to have that objection reviewed by the court under the
-provision of Section 27-65-104(6), C.R.S.; and
-
-3.
-
-Consent to release of information.
-
-B.
-
-Children who are under the age of fifteen (15), have the right to object to hospitalization and to
-have a guardian ad litem appointed pursuant to Section 27-65-104(6)(b),(c), C.R.S.
-
-8.4
-
-Screening and Assessment of Children
-
-A.
-
-Agencies shall follow screening as required in part 2.12.1 of these rules.
-
-B.
-
-Agencies shall follow the requirements of part 2.12.2 and part 2.12.3 of these rules in addition to
-the following:
-1.
-
-Comprehensive assessments must include an evaluation of the family's, or legal
-guardian’s social determinants of health, as well as needs and strengths that may pertain
-to the child’s treatment. If family or legal guardian basic needs are identified, including,
-but not limited to, food, clothing, shelter and health, this must be addressed in the
-individualized and family-oriented service plan and referral made to the identified services
-and supports, if needed. Such comprehensive assessments will maintain the
-confidentiality of participants records in accordance with applicable state and federal
-laws.
-
-2.
-
-The comprehensive assessment must explore how the identified family members, natural
-supports or legal guardians will be involved in whole person and Two (2) -Generational
-behavioral health services. In the event that any person’s involvement is contraindicated,
-the clinical rationale must be documented.
-
-3.
-
-The comprehensive assessment must also include a trauma assessment specific to
-children, which can include but is not limited to: an ACEs screen, or a pediatric ACEs
-screener. This shall be completed with the child utilizing any standardized screening tool.
-a.
-
-Parent(s) or legal guardian(s) shall be included, unless involvement in the screen
-is contraindicated, then the clinical rationale must be documented in the
-individual record. If completing the aces screen, parent(s) and/or legal
-guardian(s) shall complete this separately.
-
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-b.
-4.
-
-2 CCR 502-1
-
-For clarity and accuracy, a child under the age of twelve (12), must be given the
-option to answer the questions verbally to the provider.
-
-The comprehensive needs and strengths assessment must be incorporated into the
-service plan, reassessment, and discharge plan, when or where appropriate, and assess
-and triage for the needs of a child, who are at least seventeen (17) years of age who is
-expected to require behavioral health services and supports beyond the age of eighteen
-(18). This may include, but is not limited to:
-a.
-
-Housing and/or housing stability;
-
-b.
-
-Insurance or lack of insurance;
-
-c.
-
-Transportation;
-
-d.
-
-Employment and/or education;
-
-e.
-
-Social supports;
-
-f.
-
-Medical/dental needs; and
-
-g.
-
-Food security and/or insecurity
-
-8.5
-
-Service Planning for Children and Families
-
-A.
-
-Agencies shall follow part 2.13 of these rules, service planning and reviews, in addition to the
-following:
-1.
-
-The service plan must be developed in collaboration with the child, and the child’s parent
-or legal guardian and be signed by the child, if the child is over the age of twelve (12),
-and by the parent or legal guardian. In the event that involvement of the parent or legal
-guardian is contraindicated, the rationale shall be documented.
-a.
-
-In all instances where prescription psychiatric medications are to be ordered as a
-part of a mental health treatment program, the following information shall be
-provided, in an accessible manner, to the child and parent(s) or legal guardian(s).
-(1)
-
-The name(s) of the medication being prescribed.
-
-(2)
-
-The usual uses of the medication(s).
-
-(3)
-
-The reasons for ordering the medication(s) for the child.
-
-(4)
-
-A description of the benefits expected.
-
-(5)
-
-The common side effects and common discomforts, if any.
-
-(6)
-
-The major risks, if any.
-
-(7)
-
-The probable consequences of not taking the medication(s).
-
-(8)
-
-Any significant harmful drug or alcohol interactions, or food interactions.
-
-(9)
-
-Appropriate treatment alternatives, if any; and,
-
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-(10)
-
-2 CCR 502-1
-
-That the child may withdraw agreement to take the medication at any
-time.
-
-2.
-
-A copy of the service plan shall be provided, upon request, to the child, if they are over
-the age of twelve (12), and parent or legal guardian. In the event that involvement of the
-parent or legal guardian would be detrimental to the child’s health, safety, or welfare, the
-rationale shall be documented.
-
-3.
-
-The service plan shall be individualized and use a Two (2)- Generational approach to
-include family driven goals and objectives that address the child and family services,
-supports, needs and building on their strengths and natural supports as identified in the
-assessment.
-
-4.
-
-Service plans must be implemented in partnership with children and families. Service
-plans must support planning and transition to another services and/or setting.
-
-Chapter 9:
-
-Women’s and Maternal Behavioral Health Treatment
-
-9.1
-
-Authority and Applicability
-
-A.
-
-Chapter 9 establishes the standards for agencies electing to provide Women’s and Maternal
-Behavioral Health Treatment. Authority to promulgate rules establishing requirements for
-individual assessment, treatment, and patient rights, comes from Sections 27-50-107(3) and 2750-502(1)(a)(b), C.R.S. authority to promulgate these rules establishing additional competencies
-related to serving priority populations comes from Section 27-50-502(6), C.R.S. additionally, the
-BHA has authority to administer the treatment program for high-risk pregnant women created
-pursuant to Sections 27-80-112 and 27-80-113, C.R.S. authority for BHA administration of this
-program is found in Section 27-50-105, C.R.S. authority to promulgate rules required for the
-administration of this program comes from Section 27-50-107(3)(a), C.R.S.
-
-B.
-
-All agencies providing Women’s and Maternal Behavioral Health Treatment services shall meet
-the standards in this Chapter 9. If the agency requires a BHE license, the agency shall comply
-with Chapter 2 of these rules.
-
-C.
-
-An agency with a Women’s and Maternal Behavioral Health Treatment endorsement shall also
-have at least one level of care endorsement to provide substance use disorder treatment
-pursuant to Chapters 4 through 7 of these rules.
-
-9.1.1
-
-General Provisions
-
-A.
-
-Personnel shall have documented training, experience, and access to supervision in womenspecific issues and services. Training and experience may include topics such as:
-1.
-
-Trauma-informed care;
-
-2.
-
-Trauma;
-
-3.
-
-Women’s and/or pregnancy-related health during the reproductive years;
-
-4.
-
-Infertility;
-
-5.
-
-Pregnancy loss;
-
-6.
-
-Infant loss;
-
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-2 CCR 502-1
-
-7.
-
-Perinatal mood and anxiety disorders;
-
-8.
-
-Stigma and substance use disorder among pregnant and parenting women/ individuals
-and perinatal substance exposure;
-
-9.
-
-Body image/disordered eating;
-
-10.
-
-Relationship violence/ healthy relationships;
-
-11.
-
-Dyadic attachment/parenting;
-
-12.
-
-American Society of Addiction Medicine (ASAM) Criteria for parents or prospective
-parents receiving addiction treatment concurrently with their children; and,
-
-13.
-
-Child welfare reporting requirements and alternatives.
-
-B.
-
-Treatment for behavioral health shall be provided to and/or coordinated with family members,
-unless clinically contraindicated. Clinical contraindications to this provision and referrals for
-dyadic and/or family treatment must be documented in the individual record.
-
-C.
-
-Agencies shall make every attempt to offer any pregnant or postpartum women/individuals’
-admission to treatment within forty-eight (48) hours and shall demonstrate compliance with part
-9.1.5.D.
-
-D.
-
-Agencies providing gender specific women’s and/or pregnancy-related behavioral health
-treatment may include the following components:
-1.
-
-Emotional and physical safety of individuals take precedence over all other
-considerations in the delivery of services, as outlined within trauma-informed principles;
-
-2.
-
-Services designed to increase women’s and/or pregnancy-related access to wraparound
-services, and engagement and retention of individuals (such as peer services,
-transportation, childcare);
-
-3.
-
-Women-only therapeutic environments;
-
-4.
-
-Women-specific service needs and topic areas;
-
-5.
-
-Program services shall directly address trauma issues currently manifesting in the
-individual’s life, either through direct service provision or by referral; and,
-
-6.
-
-Multiple modalities that meet the specific needs of women (group and individual therapy,
-case management and opportunities for women to be in treatment with their children
-where possible).
-
-E.
-
-Agency policy and procedures must include the criteria for interventions offered and expected
-outcomes of services delivered.
-
-9.1.2
-
-Screening
-
-A.
-
-In addition to the part 2.12.1 of these rules, screening shall include all the following unless
-clinically contraindicated:
-1.
-
-Screening and documentation of individual’s need for prenatal/postpartum care (where
-applicable), primary medical care and family planning services; and
-
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-2.
-
-2 CCR 502-1
-
-Screening and documentation of child safety issues and/or referrals for children in the
-individual’s home that need behavioral health and/or medical care utilizing an evidencebased instrument or best practice approach.
-
-9.1.3
-
-Treatment
-
-A.
-
-Service plans shall be established in accordance with part 2.13 of these rules and shall address
-each of the need areas identified in part 9.1.3.B and 9.1.3.C.
-
-B.
-
-When not clinically contraindicated the following topic areas shall be addressed in treatment or
-through comprehensive care coordination as outlined in part 2.9.G and the following, when
-applicable:
-
-C.
-
-1.
-
-Reductions or elimination of substance use;
-
-2.
-
-Individual safety;
-
-3.
-
-Child safety;
-
-4.
-
-Trauma;
-
-5.
-
-Parenting, including attachment and co-regulation;
-
-6.
-
-Ways in which behavioral health impacts family and relationships across the lifespan;
-
-7.
-
-Primary care, medical care, lactation, pelvic health, dental health, reproductive health,
-and family planning care;
-
-8.
-
-Mental health, including parental mental health conditions; and
-
-9.
-
-Nutrition assessment in relation to pregnancy, lactation, early childhood, and behavioral
-health.
-
-Any agency that qualifies to provide services pursuant to Sections 25.5-5-202(1)(r), 27-80-112,
-C.R.S. and 27-80-113, C.R.S., in regard to the Treatment Program for High-Risk Pregnant
-Women, shall make available, in addition to substance use and addiction counseling and
-treatment:
-1.
-
-Needs assessment services;
-
-2.
-
-Preventive services;
-
-3.
-
-Rehabilitative services;
-
-4.
-
-Care coordination;
-
-5.
-
-Psychosocial counseling;
-
-6.
-
-Intensive health education;
-
-7.
-
-Home visits;
-
-8.
-
-Transportation;
-
-9.
-
-Development of provider training;
-
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-
-10.
-
-Child care;
-
-11.
-
-Child care navigation; and,
-
-12.
-
-Other necessary components of residential or outpatient treatment or care.
-
-2 CCR 502-1
-
-9.1.4
-
-Services for Pregnant and Postpartum Women/Individuals
-
-A.
-
-Pregnant women/individuals shall be given priority admission and/or care coordination to
-treatment for substance use disorders.
-1.
-
-B.
-
-Agencies cannot deny services to pregnant and postpartum women/individuals due to
-sobriety status.
-
-Agencies shall develop policies and procedures for service delivery to pregnant and postpartum
-women/ individuals, which shall include circumstances under which pregnant and postpartum
-women/individuals may be discharged from treatment.
-1.
-
-Pregnant women/individuals may not be discharged from treatment solely for failure to
-maintain abstinence from substance use.
-
-2.
-
-Every effort shall be made to retain pregnant and postpartum women/individuals in
-treatment for the duration of their pregnancies in order to maintain an optimal period of
-abstinence from substance use.
-
-C.
-
-Every attempt shall be made to admit pregnant women/individuals to treatment within forty-eight
-(48) hours of first contact between the woman/individual and the admitting program.
-
-D.
-
-If a pregnant woman/individual is not admitted to treatment within forty-eight (48) hours of first
-contact, the reason shall be clearly documented in their individual record. If the individual is
-working with a care coordinator through their managed care entity or managed service
-organization, the care coordinator shall be informed. Interim services shall be provided consisting
-of the following at minimum:
-1.
-
-Referral for prenatal care;
-
-2.
-
-Information on the effects of alcohol and drug use on the fetus and perinatal individual;
-
-3.
-
-Daily phone contact with the individual for those seeking residential care; and,
-
-4.
-
-Education regarding the transmission and prevention of communicable diseases such as
-Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS),
-Tuberculosis (TB), and Hepatitis A, B, or C.
-
-E.
-
-Pregnant and postpartum women/individuals shall be linked to prenatal and postpartum care
-immediately and barriers to accessing prenatal and postpartum care including, but not limited to
-transportation to care, must be addressed, and documented in their individual record.
-
-F.
-
-If a pregnant or postpartum woman/individual declines prenatal or postpartum care, this shall be
-documented in the individual record, and offers for care shall continue to be offered at a minimum
-of one attempted contact monthly and documented. If no contact occurs within six (6) months, the
-reason shall be documented, and the agency is no longer required to contact.
-1.
-
-This does not include individuals who have completed their treatment goals or
-disengaged from treatment.
-
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-Chapter 10:
-
-2 CCR 502-1
-
-Services for Criminal Justice-Involved Individuals
-
-10.1
-
-Authority and Applicability
-
-A.
-
-Chapter 10 establishes the standards for and applies to BHEs providing services to criminal
-justice involved individuals, including specific criminal justice programs. The BHA has authority
-for administration of DUI treatment programs pursuant to Article 2 of Title 42, C.R.S., and Alcohol
-and Drug Driving Safety Education or Treatment pursuant to Section 42-4-1301.3, C.R.S. and
-Section 27-50-105(1)(vv)(ww), C.R.S. authority to promulgate rules required for the administration
-of this program comes from Section 27-50-107(3)(a), C.R.S. authority to promulgate rules
-establishing requirements for individual assessment and treatment comes from Section 27-50502(1)(a)(I), C.R.S.
-
-B.
-
-Services for criminal justice-involved individuals must generally be intended for individuals who
-are referred into education and/or treatment services as a result of, or in connection to,
-involvement with the criminal justice system. This does not include juvenile justice system
-services that are regulated by the responsible state agencies as indicated in Section 19-2.5-1401,
-C.R.S.
-
-C.
-
-Services for criminal justice-involved individuals must involve a continuum of education and/or
-treatment options available to individuals as they proceed through the criminal justice system.
-These services must be available across multiple settings, including community-based and
-locked facility-based settings. Services offered must vary depending upon the needs of the
-individual and the specific criminal justice program endorsement.
-
-D.
-
-These rules are established to create standards for BHEs seeking endorsements to provide
-education and/or treatment services, as defined in part 10.1.1 of this Chapter, for individuals
-involved with the criminal justice system. This criminal justice endorsement and all corresponding
-sub-endorsements may not be held alone, but in addition to appropriate corresponding
-endorsement(s) and sub-endorsement(s) for the type of services being provided.
-
-10.1.1 Definitions
-“Contact Hours”, for the purposes of parts 10.5 through 10.9 of this Chapter means the time that an
-individual participates in Level I Education, Level II Therapeutic Education, and/or Level II Treatment.
-“Credit Hours”, for the purposes of parts 10.5 through 10.9 of this Chapter means the time that an
-individual participates in non-DUI/DWAI specific education or treatment. These hours may be granted
-towards education and/or treatment requirements for DUI/DWAI services within the parameters set forth
-in this part 10.5.11.
-“Education and/or Treatment” means the programs developed that are structured in such a manner to
-provide a continuum of education and treatment for each individual as they proceed through the criminal
-justice system and may include but shall not be limited to, attendance at self-help groups, group
-counseling, individual counseling, outpatient treatment, inpatient treatment, day care, or treatment in a
-therapeutic community. Education and treatment are to be accessible by all individuals involved in the
-criminal justice system, pursuant to Section 16-11.5-102, C.R.S.
-“Enhanced Outpatient Services,” or “EOP,” means services in which an individual receives an increased
-number of therapeutic contacts and interactions with personnel, intended to expedite stabilization of
-assessed behavioral health concerns. The goal is to stabilize the individual to allow for more effective
-engagement in education and other treatment services.
-
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-2 CCR 502-1
-
-“Program(s)” for the purpose of this Chapter, means the systems of education and treatment services
-addressing abuse of substances which can be utilized by individuals who are placed on probation,
-incarcerated with the Department of Corrections, placed on parole, or placed in community corrections,
-pursuant to Sections 16-11.5-102(1)(b), C.R.S. and 42-4-1301.3, C.R.S.
-“Telehealth,” in addition to the requirements of part 1.2 and 2.9 of these rules, telehealth services for the
-purpose of this Chapter 10, does not include consistent and regular in-session use of audio-only
-telehealth services.
-10.1.2 Assessment and Placement in Services
-A.
-
-Unless otherwise noted, BHEs endorsed to provide treatment programming to criminal justiceinvolved individuals must receive placement recommendation(s) for each individual served,
-completed by the referring supervising entity. The BHE is expected to evaluate if the supervising
-entity’s recommendation matches the individual’s assessed clinical need(s). The BHE is expected
-to address any differences identified with the supervising entity directly and document results in
-the individual’s record.
-
-B.
-
-The type of placement recommendation(s) from the supervising entity will vary depending upon
-the type of supervising entity and the individual’s type of offense leading to the treatment referral.
-BHEs must include a copy of the referral paperwork, demonstrating treatment in accordance with
-the placement initial assessment and treatment recommendation(s) from the supervising entity, in
-the individual’s record.
-
-C.
-
-If a BHE is unable to obtain a copy of the placement recommendation(s) from the supervising
-entity there must be documentation of attempt(s) to obtain the paperwork from the referral source,
-if applicable.
-
-D.
-
-BHEs must assess for and prioritize the delivery of services that support the individual’s
-placement in the community, including reintegration into the community if incarcerated. This must
-include engagement of the individual’s identified support system throughout the episode of care,
-as permitted by the individual.
-
-10.1.3 Personnel Training
-A.
-
-All BHE personnel providing education and/or treatment services to individuals involved in the
-criminal justice system must:
-1.
-
-Be knowledgeable about the criminal justice system, including the sequential intercept
-model and the processes and phases through which an individual moves in the criminal
-justice system;
-
-2.
-
-Be knowledgeable of the principles of risk, need, and responsivity;
-
-3.
-
-Be knowledgeable about the criminal justice system in the state of Colorado, including
-competency restoration services, as explained in Chapter 12 of these rules, and
-situations involving individuals determined to be not guilty by reason of insanity (NGRI);
-and
-
-4.
-
-Attend at least one (1) training during their active licensing or approval term unique to
-individuals involved in the criminal justice system.
-
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-
-5.
-
-2 CCR 502-1
-
-Personnel providing curriculum-driven education and/or treatment services, including but
-not limited to DUI/DWAI programming, to individuals involved in the criminal justice
-system must be trained in the curriculum and be qualified to provide such services, as
-indicated in parts 10.4 through 10.9 of this Chapter.
-
-B.
-
-The above training requirements may be satisfied by completing the BHA-developed criminal
-justice services curriculum on the statewide Learning Management System (LMS), once
-developed and available in the LMS.
-
-C.
-
-BHEs endorsed to provide programming to DUI/DWAI-involved individuals must maintain proof of
-completion of the training in personnel files and provide verification to the BHA upon request.
-
-10.1.4 Documentation
-A.
-
-In addition to documentation requirements applicable to the BHE’s license and selected
-endorsement(s), individual records must include documentation of intentional collaboration and
-communication with the supervising entity. Collaboration and communication efforts must include,
-but are not limited to:
-1.
-
-Ongoing communication and coordination of care with supervising entities;
-
-2.
-
-Case consultation;
-
-3.
-
-Development of referral processes; and
-
-4.
-
-Incorporation of issues related to criminal justice involvement into ongoing service
-planning processes.
-
-B.
-
-Identified RNR principles must be incorporated in the individual’s record and addressed in
-treatment services, as appropriate.
-
-C.
-
-Documentation in the individual record must reflect and demonstrate personnel’s knowledge of
-the criminal justice system including, for example, the proper use of criminal justice system
-terminology. Documentation must also demonstrate an understanding of how involvement in the
-criminal justice system relates to providing care for the individual.
-
-D.
-
-Documentation in the individual’s record must reflect how, the individual’s identified support
-system is engaged throughout the episode of care.
-1.
-
-If the individual does not permit support system involvement, it is clinically
-contraindicated, or the individual is unable to identify a support system, the record must
-reflect efforts to help the individual build a recovery-focused support system. This may
-include post-treatment referral(s) and peer recovery support services, as applicable.
-
-E.
-
-Individual records must reflect efforts to deliver services necessary based on the individual’s
-assessment and service planning process. This must involve documentation of care coordination
-with other providers, resources, and support systems as necessary.
-
-F.
-
-Documentation in the individual’s record must reflect service delivery that is person-centered,
-trauma-informed, harm reduction focused, physically and programmatically accessible, and
-culturally and linguistically appropriate for all individuals served.
-1.
-
-This may include connecting to referrals, and/or providing translation and/or interpreter
-services for those individuals that need this service to receive treatment.
-
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-
-G.
-
-10.2
-
-2 CCR 502-1
-
-BHEs endorsed to provide programming to criminal justice-involved individuals must provide
-individuals with a complete copy of the participant materials and workbook associated with the
-curriculum being used, when applicable.
-1.
-
-BHEs must supply materials and workbooks associated with curriculum in ways that
-reasonably accommodate the individual’s needs and facilitate access, utilization, and
-understanding of the information.
-
-2.
-
-BHEs must supply youth with age-appropriate materials/workbooks.
-
-Enhanced Outpatient Services (EOP)
-
-10.2.1 Applicability
-A.
-
-BHEs endorsed to provide an EOP level of programming to criminal justice-involved individuals
-must meet all requirements set forth in part 4.3 of these rules in addition to parts 10.1 and 10.2 of
-this Chapter.
-
-B.
-
-BHEs providing EOP level of services must be intended for individuals who are assessed as
-needing increased services for immediate stabilization, but not appropriate for more intensive
-levels of care. EOP services are often utilized by individuals who require stabilization prior to
-engaging in required education or treatment services and a recommendation or referral may be
-received for this level of care from a supervising entity.
-
-C.
-
-BHEs providing EOP level of services are appropriate for individuals with substance-related
-disorders, mental health disorders, or co-occurring disorders if:
-
-D.
-
-1.
-
-The behavioral health disorders are of moderate or high severity, as defined in the DSM5-TR;
-
-2.
-
-Require additional stabilization; and
-
-3.
-
-May be safely managed in this level of care.
-
-BHEs providing EOP level of services must be endorsed by the BHA to provide this level of care.
-If the BHE refers the individual to another provider to address stabilization needs that are
-identified through the assessment and service planning process, the referring BHE must be
-responsible for care coordination and communication of progress updates with the supervising
-entity.
-
-10.2.2 EOP Service Provisions
-A.
-
-BHEs providing EOP level of services must provide between three (3) and eight (8) treatment
-contact hours per week for individuals.
-
-B.
-
-BHEs providing EOP level of services must be conducted over a minimum of two (2) calendar
-days per week.
-
-C.
-
-BHEs providing EOP level of services must be provided by personnel as defined in part 4.3.2 of
-these rules.
-
-D.
-
-The treatment duration in EOP services must be determined by one (1) or more of the following
-treatment personnel, acting within their scope of practice:
-1.
-
-Authorized practitioners;
-
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-
-E.
-
-F.
-
-2.
-
-Licensees;
-
-3.
-
-Certified addiction specialists (CAS); and/or
-
-4.
-
-Candidates.
-
-Determination of treatment duration must be based on the individual’s assessment, continued
-screened/assessed needs while attending services, and documented progress towards treatment
-goals.
-1.
-
-When a supervising entity recommends a treatment duration or a specific number of
-hours in EOP services that is not justified by the individual’s assessment, the BHE must
-address the discrepancy with the supervising entity, provide alternative service
-recommendations to the supervising entity, and document the result of the collaboration
-in the individual’s record.
-
-2.
-
-In the instance where this collaboration does not result in alignment with the assessed
-treatment recommendations, the BHE must follow the supervising entity’s
-recommendation.
-
-Services attended while in EOP level of care must be variable and responsive to the individual’s
-behavioral health needs as identified in the assessment and service plan, unless otherwise
-decided per this part 10.2.2.D.
-1.
-
-10.3
-
-2 CCR 502-1
-
-EOP services attended must not include education related to the originating offense.
-
-Intensive Outpatient Services (IOP)
-
-10.3.1 Applicability
-A.
-
-BHEs endorsed to provide an IOP level of programming to criminal justice-involved individuals
-(including ASAM Criteria Level 2.1) must meet all requirements set forth in part 4.6 of these rules
-in addition to parts 10.1 and 10.3 of this Chapter.
-
-10.3.2 IOP Service Provisions
-A.
-
-B.
-
-The treatment duration in IOP services must be determined by one (1) or more of the following
-treatment personnel, acting within their scope of practice:
-1.
-
-Authorized practitioners;
-
-2.
-
-Licensees;
-
-3.
-
-Certified addiction specialists (CAS); and/or
-
-4.
-
-Candidates.
-
-Determination of treatment duration must be based on the individual’s assessment and
-documented progress towards treatment goals.
-1.
-
-When a supervising entity recommends a treatment duration or a specific number of
-hours in IOP services that is not justified by the individual’s assessment the BHE must
-address the discrepancy with the supervising entity, provide alternative service
-recommendations to the supervising entity, and document the results of the collaboration
-in the individual’s record.
-
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-2.
-
-10.4
-
-2 CCR 502-1
-
-In the instance where this collaboration does not result in alignment with the assessment
-treatment recommendations, the BHE must follow the supervising entity’s
-recommendation.
-
-Criminal Justice Services Programs
-
-10.4.1 Authority and Applicability
-A.
-
-This part 10.4 details standards for and applies to BHEs with an endorsement to provide
-substance use disorder education and treatment for individuals involved in the criminal justice
-system programming, pursuant to Section 16-11.5-102, C.R.S., and
-
-B.
-
-Parts 10.5 through 10.9 of this Chapter detail standards for and apply to BHEs endorsement to
-provide DUI/DWAI Level I and Level II education and treatment programming, pursuant to
-Sections 42-4-1301.3(3)(c), C.R.S. and 27-81-106, C.R.S.
-
-10.4.2 General Provisions
-A.
-
-Individuals convicted of misdemeanor or felony offenses who are assessed as needing substance
-use disorder treatment, as indicated in Section 16-11.5-102, C.R.S. and in accordance with
-current standardized assessment and placement protocol of the referring supervising entity, must
-receive court-ordered education, treatment, and care coordination services.
-
-B.
-
-All BHEs admitting out of state offenders must identify and notify the interstate compact unit for
-adult offender supervision pursuant to Section 17-27.1-101, C.R.S.
-
-C.
-
-Services must be based on the results of current screening and assessments.
-
-D.
-
-BHEs must render treatment to individuals involved in the criminal justice system according to the
-placement recommendation(s) provided by the referring supervising entity.
-
-E.
-
-Education, treatment and care coordination services, as indicated by assessment and included in
-the service plan, must be provided for by the BHE or through referrals.
-
-F.
-
-BHEs must have a written memorandum of understanding with community supports or other
-agencies to provide agreed upon services, as well as any specific data and/or information needed
-for individualized services. Agreements as to disclosure of information must be in compliance with
-state and federal law.
-
-G.
-
-Education and treatment must be a minimum of nine (9) months or as required by the referring
-supervising entity.
-1.
-
-The BHE is expected to address any discrepancies regarding court-ordered length of
-stay in services with the supervising entity and document in the individual’s record.
-
-H.
-
-Frequency and intensity of education and treatment services must be based on assessments and
-at minimum one (1), two (2) hour session per week.
-
-I.
-
-The following content/topics must be presented during treatment:
-1.
-
-Physiological and psychological effects of alcohol, controlled substances, and other
-drugs;
-
-2.
-
-Signs and symptoms of substance use disorders;
-
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-3.
-
-Stress management and substance use disorders;
-
-4.
-
-Anger management and substance use disorders;
-
-5.
-
-Behavioral triggers leading to substance use disorders;
-
-6.
-
-Drugs in the workplace; and
-
-7.
-
-Legal issues and substance use disorders.
-
-2 CCR 502-1
-
-J.
-
-BHEs must implement treatment curricula that are written in manual format and are evidencebased or best practices. These materials must be provided in the language and modality of
-frequently encountered limited English proficiency groups.
-
-K.
-
-Education and treatment sessions must not include administrative procedures or breaks in
-accounting for their duration.
-
-L.
-
-BHE personnel working directly with individuals must have documented qualifications and training
-in forensic populations and criminal justice systems.
-
-M.
-
-Drug and alcohol toxicology collection must be observed by trained personnel when requested by
-the referral source.
-
-N.
-
-Records must contain monthly documentation of communication with the criminal justice referral
-source describing progress toward specific treatment goals. BHEs must be responsible for
-monitoring and reporting to referring courts or their representatives the individual's progress with
-ancillary services.
-
-O.
-
-BHEs must have written documentation in an individual's record that the individual has received
-services to assist in continued community placement, or community reintegration, whichever is
-applicable.
-
-10.5
-
-Driving Under the Influence/Driving While Ability Impaired (DUI/DWAI) Services
-
-10.5.1 Authority and Applicability
-A.
-
-Authority to establish the endorsement of BHEs to provide DUI/DWAI Level I and Level II
-Education and Treatment programming is provided by Sections 42-4-1301.3(3)(c), C.R.S. and 2781-106, C.R.S.
-
-10.5.2 Levels of DUI/DWAI Program Endorsements
-A.
-
-B.
-
-BHEs seeking an endorsement to provide DUI/DWAI education and/or treatment programming in
-Colorado shall identify in their application the level of services they plan to provide. DUI/DWAI
-education and treatment services include:
-1.
-
-Level I Education, part 10.6 of this Chapter, and Level II Therapeutic Education, part 10.7
-of this Chapter;
-
-2.
-
-Level II Treatment (Tracks A - D), part 10.8 of this Chapter; or
-
-3.
-
-Level II Treatment Track F (Level II Four (4) Plus), part 10.9 of this Chapter.
-
-Locked correctional facilities may provide DUI/DWAI education services only.
-
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-
-BHEs shall not provide DUI/DWAI education or treatment services they are not endorsed to
-provide.
-
-10.5.3 General DUI/DWAI Services Provisions
-A.
-
-The following provisions are applicable to all levels of DUI/DWAI services:
-1.
-
-B.
-
-C.
-
-BHEs must develop and implement policies and procedures related to the provision of
-DUI/DWAI services. Personnel must have access to and be knowledgeable about the
-BHEs policies, procedures, and state and federal laws and regulations relevant to their
-respective duties.
-
-All BHEs must have:
-1.
-
-A formalized process for referring individuals to higher or lower levels of care;
-
-2.
-
-A process to ensure individual data is accurate and submitted within seven (7) calendar
-days of service or change in status and entered into the Treatment Management System
-(TMS), unless prohibited by state or federal law;
-
-3.
-
-A process for how the BHE must determine a method of service delivery that best meets
-the needs of the individual. This process must include but not be limited to:
-a.
-
-A plan for regular review, evaluation, and modification of service delivery to
-continue meeting the individual’s needs; and
-
-b.
-
-A referral process to BHEs and/or other agencies that provide alternate methods
-of service delivery, if not available through the current BHE.
-
-4.
-
-A process addressing how concurrent treatment provider(s) may be utilized or engaged
-to ensure coordination of individualized services is available to the individual. This must
-include a plan for data and exchange of information related to the individualized services
-received;
-
-5.
-
-A process for how granting of DUI/DWAI services credit hours, as noted in this part
-10.5.11, must be achieved. This includes providing DUI/DWAI services credit for
-individuals assessed as needing mental health services to address primary treatment
-concerns, and/or referral into non-English-speaking treatment options;
-
-6.
-
-A process for how individuals will be monitored for drug and alcohol use while
-participating in education and/or treatment services must occur. This process must
-include a plan for responding and incorporation of monitoring results into the individual’s
-services.
-
-7.
-
-Groups for ADDS education and treatment services must be restricted to those arrested,
-convicted of or receiving deferred prosecutions, pending prosecution, sentences, or
-judgments for DUI/DWAI.
-
-8.
-
-Individuals with DUI/DWAI must not be treated in offender-specific groups with individuals
-with other offenses unless they need these groups as determined by the assessment and
-supported by the service plan.
-
-Prior to admission of an individual for DUI/DWAI services, the BHE must obtain a current ADDS
-program screening and referral for placement. This screening and referral may be completed by a
-supervising entity as a condition of probation, parole, or pretrial services.
-
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-D.
-
-2 CCR 502-1
-
-1.
-
-If a BHE is unable to obtain a copy of the ADDS or other court paperwork at the time the
-individual is admitted, there must be documentation of attempt(s) to obtain the paperwork
-from referral source, if applicable.
-
-2.
-
-If the court paperwork is unavailable, or the individual is pretrial, the BHE must conduct a
-screening of the individual using an evidence-based or best practices screening process
-and instrument, following track placement guidelines as indicated in the legal
-supplement.
-
-Prior to admission, BHEs must complete a screening for:
-1.
-
-Congruence of level and track assignment with ADDS evaluation, if available. Any
-deviation or discrepancy must be addressed with the referral source prior to engaging the
-individual in DUI/DWAI services;
-
-2.
-
-The individual’s number of DUI/DWAI-related offenses. If the individual is pre-sentenced
-with three or more prior convictions of DUI/DWAI-related offenses, or newly sentenced
-with four or more DUI/DWAI-related offenses, they must be immediately referred to a
-BHE endorsed to provide Level II Four Plus programming, as defined in part 10.9 of this
-Chapter, the referral source must be notified;
-
-3.
-
-Youth status for the individual and clinical appropriateness for placement in DUI/DWAI
-education and/or treatment groups. If the youth is not clinically appropriate for placement
-in a DUI/DWAI education or treatment group with adults, the BHE must develop an age
-and developmentally appropriate intervention for the youth. If the BHE is unable to
-accommodate the youth’s treatment needs, the BHE must refer the youth to another BHE
-endorsed to provide DUI/DWAI programming and the referral source must be notified;
-and
-
-4.
-
-Ability to provide necessary services as identified through the screening or the
-individual’s court order. If the BHE does not provide the necessary services, the BHE
-must:
-a.
-
-Refer the individual back to an ADES with documentation of which service(s) will
-not be provided within the BHE and identified referrals and suggestions for
-alternative services; and
-
-b.
-
-Be responsible for monitoring and reporting to referring courts or their
-representatives the individual's progress with concurrent services.
-
-E.
-
-BHEs must document collaboration with recent or concurrent treatment service providers in
-accordance with all applicable federal and state confidentiality laws and regulations in the
-individual’s record.
-
-F.
-
-Level I Education, Level II Therapeutic Education, and Level II Treatment must not be combined,
-nor must contact hours completed for one count as contact hours completed in another.
-
-G.
-
-Individuals must not be reported as finishing Level I Education or Level II Therapeutic Education
-until all required content/topics have been completed over the minimum required contact hours
-and weeks.
-
-H.
-
-BHEs must provide individuals with an orientation of the DUI/DWAI program requirements and
-anticipated timelines for completion. Documentation of the orientation must be maintained in the
-individual record.
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-10.5.4 DUI/DWAI Reporting and Data Requirements
-A.
-
-BHEs providing Level I Education, Level II Therapeutic Education, and Level II Treatment must
-submit information into the Treatment Management System (TMS), including but not limited to
-DUI/DWAI reporting system (DRS) submissions.
-
-B.
-
-BHEs must maintain access to TMS by submitting approval form(s) annually. These form(s) are
-available on the BHA’s website.
-
-C.
-
-Prior to releasing any treatment information, BHEs shall obtain releases of information in
-accordance with all applicable federal and state confidentiality laws and regulations.
-1.
-
-D.
-
-Identifying information of the judicial district in which an individual committed a DUI/DWAI
-offense shall not be put into TMS and/or the individual’s DRS record without a valid
-release of information for the assigned judicial district. This includes pre-sentenced
-DUI/DWAI individuals.
-
-DRS requirements
-1.
-
-At admission and throughout the duration of treatment:
-a.
-
-A DRS record must be entered into TMS for all individuals enrolled in DUI/DWAI
-education and/or treatment.
-
-b.
-
-The admission date for the DRS must be the date of enrollment with the BHE
-providing DUI/DWAI programming.
-
-c.
-
-If the individual discharges from services and readmits, a new DRS with a current
-date of admission must be input into TMS.
-(1)
-
-E.
-
-F.
-
-Information in the individual’s DRS record must be updated in TMS in a
-timely manner, not to exceed more than seven (7) calendar days after a
-service is provided or a change in status.
-
-Affidavit of enrollment requirements
-1.
-
-BHEs must provide individuals assigned to a Level II Treatment Track, as defined in parts
-10.8, and 10.9 of this Chapter, Track with a Division of Motor Vehicles affidavit of
-enrollment upon request, or by the next scheduled session. This form may be found on
-the BHA’s website.
-
-2.
-
-BHEs must provide proof of enrollment and status in Level II Education and Treatment,
-as defined in parts 10.7 through 10.9 of this Chapter including discharge, to the Colorado
-Department of Revenue, Division of Motor Vehicles via the Treatment Management
-System (TMS), within seven (7) calendar days of the service, in accordance with state
-and federal confidentiality laws, and Sections 42-2-132 and 42-2-114, C.R.S.
-
-At discharge of treatment
-1.
-
-BHEs must provide a copy of the discharge DRS, validated with signature of authorized
-personnel, to individuals and referral sources upon discharge from education and/or
-treatment.
-
-2.
-
-An initial copy of the discharge DRS must be provided to individuals at no charge.
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-
-3.
-
-The discharge DRS shall not be withheld from the individual for any reason including, but
-not limited to, collection of outstanding balances.
-
-4.
-
-The discharge DRS must reflect all DUI/DWAI services the individual completed in a
-given episode of care. This includes any non-DUI/DWAI specific services, or services
-provided by non-DUI/DWAI endorsed programs, reviewed and granted towards
-DUI/DWAI credit hours.
-
-5.
-
-BHEs must obtain a copy of all validated discharge DRS records for individuals who have
-completed any prior DUI/DWAI services for DUI/DWAI treatment requirement.
-
-6.
-
-If the individual successfully completed DUI/DWAI education services while incarcerated
-for the current offense, the community-based BHE endorsed to provide DUI/DWAI
-programming shall not require the individual to repeat the completed education.
-
-7.
-
-If the discharge DRS from a previous treatment episode is not available, the BHE must
-outreach the BHA for a record search.
-
-10.5.5 Training
-A.
-
-Personnel providing DUI/DWAI services must:
-1.
-
-Receive the “Understanding the ADDS Evaluation” training; and,
-
-2.
-
-Be trained in or otherwise knowledgeable of, interlock enhancement counseling (IEC).
-
-B.
-
-All personnel accessing the TMS must receive training by authorized BHA representatives.
-
-C.
-
-BHEs must maintain proof of completion of training in personnel files and provide verification to
-the BHA upon request.
-
-10.5.6 Provision of DUI/DWAI Services
-A.
-
-BHEs must use and adhere to a curriculum written in a manual form that is evidence-based or
-best practices specific to DUI/DWAI, unless otherwise noted.
-
-B.
-
-BHEs must assign individuals to a specific group or individual session, unless clinical reason is
-documented for change in service delivery.
-
-C.
-
-Personnel conducting DUI/DWAI education and treatment must meet the minimum qualifications
-as noted in the specific sub-endorsements for education and treatment in parts 10.6 through 10.9
-of this Chapter.
-
-D.
-
-Hours of attendance must only be granted for education or treatment contacts and must not
-include administrative procedures or breaks.
-
-E.
-
-If telehealth services do not best meet the needs of the individual and the BHE endorsed to
-provide DUI/DWAI programming cannot accommodate in-person services, the BHE must refer
-the individual to a provider that can meet the individual’s needs.
-
-10.5.7 Testing and Monitoring
-A.
-
-BHEs must ensure that testing and/or monitoring of individuals served for alcohol and drug use
-occurs during the course of services. This testing and monitoring may be completed on-site or
-through a third-party testing entity.
-
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-
-1.
-
-If the BHE elects to collect toxicology samples on-site, the BHE must ensure that
-samples will be safely collected, packaged, stored, and transferred to the lab for testing,
-as well as address all points of this part 10.5.8.
-
-2.
-
-Drug and alcohol toxicology collection that occurs on-site must be observed by trained
-personnel.
-
-3.
-
-If testing is completed by a third-party testing entity, there must be documentation of the
-BHE’s effort(s) to obtain test results.
-
-B.
-
-The testing and/or monitoring schedule and method of collection must be determined by the BHE
-endorsed to provide DUI/DWAI programming or in collaboration with the supervising entity.
-
-C.
-
-Method of testing and/or monitoring may include but is not limited to the following:
-
-D.
-
-1.
-
-Urinalysis;
-
-2.
-
-Breath analysis;
-
-3.
-
-Continuous alcohol monitoring;
-
-4.
-
-Mobile/remote breath testing;
-
-5.
-
-Direct and indirect biomarker testing; and
-
-6.
-
-Drug and other testing as appropriate.
-
-With appropriate written consent or assent, the BHE shall coordinate and share testing and/or
-monitoring results with the supervising entity.
-
-10.5.8 Youth DUI/DWAI Education and Treatment
-A.
-
-BHEs endorsed to provide DUI/DWAI education and treatment programming must have the ability
-to provide youth DUI/DWAI education and treatment or assist in direct referral and care
-coordination for the individual to another BHE that is endorsed to provide these DUI/DWAI
-programs for youth.
-
-B.
-
-BHEs providing DUI/DWAI services to youth under the age of eighteen (18) shall obtain a
-Children and Families services endorsement in accordance with Chapter 8 of these rules.
-
-C.
-
-BHEs must hold youth that receive a DUI/DWAI to the same requirements under ADDS education
-and treatment services.
-
-D.
-
-BHEs must use clinical judgment when determining age-appropriate placement of youth in a
-DUI/DWAI group, including but not limited to:
-1.
-
-Providing a separate group for youth, when possible; and
-
-2.
-
-Providing individual sessions to meet the developmental needs of the youth if group
-placement is not clinically indicated or available.
-
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-
-10.5.9 Content of Records for DUI/DWAI Services
-A.
-
-B.
-
-Individual records must be maintained for all levels of DUI/DWAI education and treatment, and in
-addition to the requirements set forth under part 2.11 of these rules, must contain at least the
-following:
-1.
-
-Court documents regarding classification, referral and placement;
-
-2.
-
-Attendance, individualized progress notes, and course completion data;
-
-3.
-
-Descriptions of content and topics covered during each session;
-
-4.
-
-Relevant reports and records of communication with the supervising entity regarding
-participation and termination of the episode of care; and
-
-5.
-
-Copies of discharge DRS.
-
-Additional content of record requirements must be noted within the specific DUI/DWAI
-endorsements in parts 10.6 through 10.9 of this Chapter.
-
-10.5.10 DUI/DWAI Education and Treatment Credit for Specialized Services Attended
-A.
-
-BHEs endorsed to provide DUI/DWAI programming must consider and be authorized to grant
-Level I and Level II Education and Treatment credit for services an individual received at nonDUI/DWAI or out-of-state treatment providers. Services considered may include DUI/DWAIspecific education and treatment, substance use disorder education and treatment, mental health
-or co-occurring disorder services, or other clinically necessary services.
-
-B.
-
-The granting of credit hours must be based on the assessed clinical need for services that
-support reduced engagement in impaired driving behaviors and activities.
-
-C.
-
-Credit toward Level I and Level II Education and Treatment requirements are allowed on an hourfor-hour and week-for-week basis. No more than two (2) clinical contact hours per week must be
-documented for credit. Extra credit hours must not be permitted for individual counseling.
-
-D.
-
-If the DUI/DWAI services credit hours being considered occurred previously, the BHE must:
-
-E.
-
-1.
-
-Complete a new assessment;
-
-2.
-
-If valid written consents or assents in place, obtain and review sufficient documentation of
-prior education and/or treatment, which includes at a minimum:
-a.
-
-Admission and discharge date;
-
-b.
-
-Description of services completed;
-
-c.
-
-Progress on goals;
-
-d.
-
-Discharge status; and
-
-e.
-
-Copy of discharge summary.
-
-If the DUI/DWAI services credit hours being considered are concurrent, the BHE must:
-
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-2 CCR 502-1
-
-1.
-
-If valid written consents or assents in place, refer the individual to an additional treatment
-provider, as indicated by the clinical assessment.
-
-2.
-
-Coordinate between the individual and the concurrent treatment provider.
-
-3.
-
-Document collaboration and care coordination in the individual’s record and service plan.
-
-F.
-
-Credit hours must be assigned only if progress in treatment can be demonstrated in the clinical
-record review.
-
-G.
-
-The granting of any education or treatment credit is subject to the following criteria:
-
-H.
-
-1.
-
-Education or treatment must have occurred after the date of the last DUI/DWAI offense.
-
-2.
-
-Any hours considered must have been completed in-person or through telehealth.
-
-3.
-
-All levels of care are subject to the maximum of two (2) credit hours/week, including
-higher intensity services such as EOP, IOP, partial hospitalization, and residential.
-
-4.
-
-Only partial track credit must be considered for treatment completed exclusively in a noncommunity-based facility, such as while incarcerated.
-
-DUI/DWAI services credit hours must not be granted if:
-1.
-
-I.
-
-The hours were completed in a virtual class and/or webinar format and/or in-person or
-telehealth support group setting that does not include active facilitation and engagement
-with one (1) or more of the following treatment personnel, acting within their scope of
-practice for the behavioral health service being considered for credit hours;
-a.
-
-Authorized practitioners;
-
-b.
-
-Licensees;
-
-c.
-
-Certified addiction specialists (CAS);
-
-d.
-
-Candidates;
-
-e.
-
-Certified addiction technicians (CAT); and
-
-f.
-
-Counselors-in-training and/or interns.
-
-2.
-
-The hours were completed prior to the last date of DUI/DWAI offense;
-
-3.
-
-The individual has a diagnosed substance use disorder and exhibits continued risky
-substance use related to their DUI/DWAI offense. The determination of risky substance
-use may include but is not limited to the following considerations: drug/alcohol
-screening/monitoring, individual self-report, observation by the professional, or another
-manner documented by the professional.
-
-4.
-
-The documented evidence of completed hours or services shows insufficient progress
-towards goals.
-
-Documentation requirements
-
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-1.
-
-Documentation of rationale for granting or denying of credit hours must be included in the
-individual’s record.
-
-2.
-
-All supporting documentation used for consideration in granting or denying of education
-and treatment credit must be maintained in the individual’s record.
-
-3.
-
-The BHE endorsed to provide DUI/DWAI programming shall enter all hours of education
-or treatment credit granted in the individual’s DRS.
-a.
-
-J.
-
-2 CCR 502-1
-
-For DUI/DWAI services credit hours achieved prior to current episode of care
-where a DRS record of that care is not provided, the BHE endorsed to provide
-DUI/DWAI programming must enter hours in a separate DRS record using the
-actual admission and discharge dates from the prior provider.
-
-If treatment credits are not granted pursuant to part 10.5.11.H of this section, the individual must
-complete all the court mandated hours of treatment assigned by the referring supervising entity.
-
-10.5.11 Ignition Interlock Enhancement Counseling (IEC)
-A.
-
-IEC must be made available to all individuals who currently or will have an ignition interlock
-device installed in their vehicle during the episode of care.
-1.
-
-B.
-
-BHEs must ask DUI/DWAI-involved individuals about their ignition interlock requirements upon
-admission and thereafter as needed.
-1.
-
-C.
-
-E.
-
-Participation in IEC is mandatory for DUI/DWAI-involved individuals assigned to Level II
-Four Plus who have an interlock device installed at any time while participating in Level II
-Four Plus services and BHEs endorsed to provide Level II Four Plus programming must
-encourage completion prior to the end of phase 3, as defined in part 10.9.4 of this
-Chapter.
-
-IEC may be completed:
-1.
-
-In-person; or
-
-2.
-
-Utilizing telehealth.
-
-IEC must be provided using a BHA-approved curriculum.
-1.
-
-F.
-
-Documentation of this inquiry must be maintained in the individual’s record.
-
-BHEs must inform all individuals that participation in IEC is voluntary for DUI/DWAI-involved
-individuals assigned to Level II Treatment Tracks B, C, or D, as defined in part 10.8 of this
-Chapter.
-1.
-
-D.
-
-If the BHE endorsed to provide DUI/DWAI programming does not provide IEC services,
-documentation of referral and collaboration with another BHE endorsed to provide
-DUI/DWAI programming that offers IEC services must be maintained in the individual’s
-record.
-
-All BHE personnel providing IEC services must be trained in the curriculum.
-
-Progress notes and service plans must reflect an individual’s participation in IEC, whether offered
-by the BHE or through referral.
-
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-G.
-
-2 CCR 502-1
-
-BHEs must enter ten (10) hours into the individual’s DRS towards Level II Treatment
-requirements upon successful completion of all IEC requirements.
-1.
-
-If referred out for IEC services, DRS record entry is completed by the BHE endorsed to
-provide DUI/DWAI programming that initiated the referral.
-
-2.
-
-BHEs may enroll individuals in IEC concurrent to Level II Therapeutic Education or Level
-II Treatment.
-
-10.6
-
-Level I Education (which includes ASAM Level 0.5)
-
-A.
-
-BHEs endorsed to provide Level I Education programming shall meet the requirements in parts
-10.1 and 10.5, and 4.2 of these rules in addition to this part 10.6.
-
-B.
-
-Level I education may be completed:
-1.
-
-In-person; or
-
-2.
-
-Utilizing telehealth.
-
-C.
-
-Level I Education may be provided by a certified addiction technician (CAT), certified addiction
-specialist (CAS), licensee, or a candidate for a mental health professional license.
-
-D.
-
-BHEs endorsed to provide Level I Education programming must use and adhere to a curriculum
-written in a manual form that is evidence-based or are best practices specific to DUI/DWAI.
-1.
-
-E.
-
-Education about the interlock device and Colorado’s current interlock laws and
-requirements must be a required topic in the legal session of Level I Education groups.
-
-Level I Education must be twelve (12) contact hours of instruction.
-1.
-
-No more than four (4) contact hours must be conducted in one (1) calendar day.
-
-2.
-
-Groups must not exceed twenty (20) individuals receiving services.
-
-3.
-
-Missed groups may be made up by attending another education session that covers the
-missed content.
-
-F.
-
-There are no additional content of record or assessment requirements for this level of care.
-
-10.7
-
-Level II Therapeutic Education (which includes ASAM Level 0.5)
-
-A.
-
-BHEs endorsed to provide Level II Therapeutic Education programming shall meet the
-requirements in parts 10.1 and 10.5 and 4.2 of these rules in addition to this part 10.7.
-
-B.
-
-Level II Therapeutic Education may be completed:
-
-C.
-
-1.
-
-In-person; or
-
-2.
-
-Utilizing telehealth.
-
-Level II Therapeutic Education must be provided by a certified addiction technician (CAT),
-certified addiction specialist (CAS), licensee or a candidate for a mental health professional
-license.
-
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-1.
-
-D.
-
-E.
-
-2 CCR 502-1
-
-If a counselor-in-training and/or intern is involved in the facilitation of Level II Therapeutic
-Education, the group may be co-facilitated and documentation signed by a CAS or
-mental health professional licensed pursuant to Article 245 of Title 12, C.R.S.
-
-BHEs endorsed to provide Level II Therapeutic Education programming must use and adhere to
-a curriculum written in a manual form that is evidence-based or best practices specific to
-DUI/DWAI.
-1.
-
-Education about the interlock device and Colorado’s current interlock laws and
-requirements must be a required topic in the legal session of Level II Therapeutic
-Education groups.
-
-2.
-
-Missed content of the curriculum must be made up in compliance with the requirements
-of curriculum authors.
-
-Level II Therapeutic Education must consist of twenty-four (24) contact hours.
-1.
-
-No more than two (2) contact hours must be granted per week.
-
-2.
-
-Individuals must attend for a minimum of twelve (12) weeks for completion.
-
-3.
-
-Groups must not exceed twelve (12) individuals receiving services.
-
-4.
-
-Must not be combined with Level II Treatment unless clinical rationale is documented.
-The combined time in Level II Therapeutic Education and Level II Treatment must not be
-less than the minimum number of weeks required for the assigned Level II Treatment
-Track.
-
-F.
-
-The BHE must provide the screening(s) required in part 2.12.1 of these rules to DUI/DWAIinvolved individuals assigned to education-only services upon admission. The BHE must arrange
-for care coordination needs of the individual, if clinically indicated in the screening results.
-
-G.
-
-BHEs endorsed to provide Level II Therapeutic Education and Treatment programming are
-subject to the full requirements of Chapter 2 of these rules.
-
-H.
-
-If the individual transitions between BHEs endorsed to provide DUI/DWAI programming during
-the course of services, the discharging BHE must provide the individual with a discharge DRS
-reflecting partial completion of treatment requirements and the supervising entity must be notified.
-
-10.8
-
-Level II DUI/DWAI Outpatient Treatment (which includes ASAM Level 1.0, Treatment Tracks
-A through D)
-
-A.
-
-BHEs endorsed to provide Level II Outpatient Treatment programming shall meet the
-requirements in parts 10.1 and 10.5, and 4.3 of these rules in addition to this part 10.8.
-
-B.
-
-Treatment must be completed:
-
-C.
-
-1.
-
-In-person; or
-
-2.
-
-Utilizing telehealth.
-
-Treatment may be provided by a CAS, licensee or a candidate for a mental health professional
-license.
-
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-1.
-
-D.
-
-E.
-
-2 CCR 502-1
-
-If a CAT, counselor-in-training, and/or intern is involved in facilitation of treatment, the
-group must be co-facilitated and documentation co-signed by a CAS or licensee pursuant
-to Article 245 of Title 12, C.R.S.
-
-Treatment must consist of services that:
-1.
-
-Are evidence-based or best practice curriculum specific to DUI/DWAI;
-
-2.
-
-Are necessary behavioral health services, as determined by the individual’s assessment
-and service plan; or
-
-3.
-
-Are a combination of (1) and (2) noted above.
-
-The BHE endorsed to provide DUI/DWAI programming is responsible for recording clinical
-contact hours in the TMS database.
-1.
-
-A maximum of two (2) clinical contact hours of DUI/DWAI treatment credit may be
-granted per week of participation.
-
-2.
-
-Services provided in any level of care may count towards the individual’s assigned track
-requirement.
-
-3.
-
-Clinical contact hours or weekly requirements must only be assigned in the DRS if
-progress in treatment can be demonstrated in a clinical record review.
-
-4.
-
-Clinical contact hours attended must be conducted over the minimum number of weeks
-associated with the treatment Track assigned.
-
-5.
-
-Make-up sessions for missed treatment sessions are not permitted.
-
-F.
-
-If a Track has not been assigned by an ADES or the BHE is unable to obtain documentation of
-Track placement, the BHE must assign a Track based on the BHA Track placement guidelines
-located within the legal supplement.
-
-G.
-
-Track requirements
-1.
-
-Track A individuals whose breath or blood alcohol content was below the statutorily
-defined PDD level, did not refuse breath or blood testing and who have one (1) offense
-for DUI/DWAI. Track A is a minimum forty-two (42) telehealth or in-person hours of group
-and/or individual treatment conducted over twenty-one (21) or more weeks.
-
-2.
-
-Track B individuals whose breath or blood alcohol content was at or above the statutorily
-defined PDD level or refused breath or blood testing and who have one (1) offense for
-DUI/DWAI. Track B is a minimum of fifty-two (52) telehealth or in-person hours of group
-and/or individual treatment conducted over twenty-six (26) or more weeks.
-
-3.
-
-Track C individuals whose breath or blood alcohol content was below the statutorily
-defined PDD level, did not refuse breath or blood testing, and who have two (2) or more
-offenses for DUI/DWAI. Track C is a minimum of sixty-eight (68) telehealth or in-person
-hours of group and/or individual treatment conducted over thirty-four (34) or more weeks.
-
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-
-4.
-
-Track D individuals whose breath or blood alcohol content was at or above the statutorily
-defined PDD level or refused breath or blood testing, and who have two (2) or more
-offenses for DUI/DWAI. Track D is a minimum of eighty-six (86) telehealth or in-person
-hours of group and/or individual treatment conducted over forty-three (43) or more
-weeks.
-
-5.
-
-Track F; refer to this part 10.9, Level II Four Plus Treatment.
-
-H.
-
-Level II treatment must be conducted only after Level II Therapeutic Education has been
-completed unless there is documented assessment and clinical rationale to do otherwise.
-
-I.
-
-The assessment must be updated at the onset of treatment, and as required in Chapter 2 of
-these rules thereafter.
-
-J.
-
-Using the initial service plan as a basis, a revised service plan and subsequent reviews must be
-developed for individuals in treatment in accordance with part 2.13.1 of these rules.
-
-K.
-
-Treatment group sessions must not be less than two (2) hours of therapeutic contact, and the two
-hours must not include administrative procedures and breaks.
-
-L.
-
-Treatment groups must not exceed twelve (12) individuals receiving treatment.
-
-M.
-
-Individual treatment sessions must not be less than one (1) hour of therapeutic contact, and
-administrative procedures and breaks must not count towards the duration.
-
-N.
-
-Individuals are expected to attend group one (1) time per week. Clinical rationale for any changes
-in frequency of group attendance (fewer or more) must be documented. At minimum, a BHE shall
-require individuals to attend at least one (1) group or individual session per month.
-
-O.
-
-Credit toward clinical contact hours for treatment provided by an agency outside of a BHE
-endorsed to provide DUI/DWAI programming may be granted in accordance with this part
-10.5.11.
-
-10.9
-
-Level II Four Plus Treatment (Track F)
-
-10.9.1 General provisions
-A.
-
-BHEs endorsed to provide Level II Four Plus services shall meet the requirements in part 4.3 of
-these rules and parts 10.1, 10.5 of this Chapter, and this part 10.9.
-
-B.
-
-BHEs endorsed to provide DUI/DWAI Level II Four Plus programming shall:
-
-C.
-
-1.
-
-Have an active BHE license issued by the BHA, pursuant to Chapter 2 of these rules.
-
-2.
-
-Have provided Level II DUI/DWAI treatment services for at least twelve (12) months.
-
-BHEs endorsed to provide DUI/DWAI Level II Four Plus programming must:
-1.
-
-Document active collaboration with referral sources and concurrent treatment entities to
-meet individualized cross-system needs; and
-
-2.
-
-Be able to provide or refer to clinically relevant in-person services.
-
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-
-10.9.2 Training
-A.
-
-In addition to meeting training requirements in part 2.5 of these rules and this part 10.5.6, the
-BHE endorsed to provide Level II Four Plus programming must ensure that personnel involved in
-the provision of Level II Four Plus services attend no less than two (2) BHA-provided sessions
-during their active approval or licensing term that address the provision of Level II Four Plus
-services.
-
-B.
-
-BHEs must maintain documentation of all training sessions attended in personnel records and
-provide verification to the BHA, upon request.
-
-10.9.3 Service Provisions
-A.
-
-Level II Four Plus must be completed as in-person services.
-1.
-
-Telehealth may only be utilized if clinically indicated for the individual, or if the individual
-is unable to attend in-person. Documentation must be present in the individual record
-stating why telehealth was utilized.
-
-B.
-
-There must not be a designated “Level II Four Plus Treatment Group,” as all services must be
-individualized and based on the individual’s assessment.
-
-C.
-
-Length of stay in Level II Four Plus must be determined by competency and phase progression
-with a minimum of one-hundred eighty (180) clinical contact hours received in no less than
-eighteen (18) months.
-1.
-
-The number of clinical contact hours attended will vary throughout an individual’s
-treatment episode, depending upon the current phase and individual’s treatment needs
-and progress.
-
-2.
-
-Contact hours must not include DUI/DWAI education unless clinically indicated for the
-individual.
-
-10.9.4 Level II Four Plus Competencies and Phases
-A.
-
-Level II Four Plus must be structured and provided as follows:
-1.
-
-The individual must demonstrate proficiency in all of the competencies contained within
-each phase prior to progressing into the next (higher) phase.
-
-2.
-
-The BHE endorsed to provide Level II Four Plus programming must document that each
-individual was provided a copy of the phases and competencies as part of the orientation
-phase of treatment.
-
-3.
-
-Individual progress towards Level II Four Plus completion must be a combination of
-treatment and phase competency progress.
-
-4.
-
-The BHE endorsed to provide Level II Four Plus programming must review each
-individual’s phase and competency achievements at a minimum every sixty (60) days in
-collaboration with available members of the individual’s multidisciplinary team.
-
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-a.
-
-B.
-
-2 CCR 502-1
-
-For the purposes of Level II Four (4) Plus Treatment, multidisciplinary team
-means a team consisting of at least the endorsed DUI/DWAI program and the
-supervising entity. The MDT may include other professionals relevant to the
-individual’s assessed treatment needs. Available members of the MDT must be
-consulted by the agency in Level II Four Plus phase progression, service
-planning, changes in levels of treatment, and discharge process.
-
-All individuals in Level II Four Plus who have an interlock device installed in their vehicle must
-complete IEC.
-1.
-
-The BHE endorsed to provide Level II Four Plus programming must make every effort to
-ensure the individual completes IEC prior to the end of phase 3.
-
-10.9.5 Level II Four Plus Care Coordination
-A.
-
-The BHE endorsed to provide Level II Four Plus programming must establish and regularly
-maintain collaborative relationships with other agencies, treatment providers, referral sources, or
-any other entities involved in the individual’s multidisciplinary team.
-
-B.
-
-BHEs endorsed to provide Level II Four Plus treatment must provide care coordination, where
-applicable, to ensure individual service needs are addressed.
-
-10.9.6 Level II Four Plus Assessments
-A.
-
-All Level II Four Plus services must be driven by an evidence-based or best practices
-assessment process and resulting individualized service plan.
-
-B.
-
-Level II Four Plus assessments must include incorporation of standardized screening tools
-specifically designed to evaluate individuals in each of the following areas:
-
-C.
-
-1.
-
-Cognitive functioning;
-
-2.
-
-Traumatic brain injury;
-
-3.
-
-Adverse childhood experiences (ACEs);
-
-4.
-
-Grief and loss;
-
-5.
-
-Co-occurring mental health issues; and
-
-6.
-
-Polysubstance use concerns.
-
-Level II Four Plus assessment must inform the determination of what combination of services the
-individual must complete that are non-DUI/DWAI Therapeutic Education and Treatment
-strategies. These services include, but are not limited to:
-1.
-
-Individual counseling;
-
-2.
-
-Group therapy, unless clinically contraindicated;
-
-3.
-
-Family/other supportive therapy, if applicable;
-
-4.
-
-Medication-assisted treatment, if applicable;
-
-5.
-
-Residential treatment, if applicable;
-
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-
-6.
-
-DUI/DWAI Level II Therapeutic Education or Level II Treatment, if applicable;
-
-7.
-
-Other education or treatment as indicated by the initial and ongoing clinical assessment.
-
-D.
-
-BHEs endorsed to provide Level II Four Plus programming must ensure that personnel
-completing the assessment are properly credentialed and hold a valid certification to use the
-specific assessment instrument. Certification must be attained from entities or professionals
-authorized to provide such training regarding the instrument.
-
-E.
-
-Clinically indicated services may be offered within the BHE or via external referral.
-1.
-
-If at any time during the treatment episode a need is identified that the BHE endorsed to
-provide Level II Four Plus programming does not provide, the program must refer the
-individual to an appropriately licensed and/or credentialed facility or professional.
-
-2.
-
-The BHE endorsed to provide Level II Four Plus programming must document evidence
-of communication with the other agency regarding assessment results, service plans, the
-individual’s participation, and progress.
-
-10.9.7 Level II Four Plus Service Planning and Reviews
-A.
-
-Level II Four Plus service planning and reviews must be administered in accordance with part
-2.13.1 of these rules and this Chapter 10.
-
-B.
-
-BHEs endorsed to provide Level II Four Plus Treatment must conduct service plan, phase, and
-competency reviews at a minimum of every sixty (60) days. Reviews must be conducted in
-collaboration with available members of the individual’s multidisciplinary team, in accordance with
-state and federal confidentiality laws.
-
-C.
-
-All services determined to be necessary for the individual must be incorporated into the service
-plan, whether offered by the BHE endorsed to provide Level II Four Plus programming or another
-provider.
-
-10.9.8 Level II Four Plus Discharge Planning and Process
-A.
-
-Level II Four Plus discharge planning must be administered in accordance with part 2.10 of these
-rules and must include a warm handoff when possible. A validated copy of the discharge DRS
-must be provided to the individual and receiving BHE endorsed to provide Level II Four Plus
-programming, when applicable, and as appropriate under state and federal confidentiality laws.
-
-B.
-
-Consideration must be given to an individual’s needs for post-discharge clinical needs and peer
-recovery support services.
-
-Chapter 11:
-Designation of Facilities for the Care and Treatment of Persons with Mental Health
-Disorders (Title 27, Article 65, C.R.S.)
-11.1
-
-Authority
-
-A.
-
-Chapter 11 establishes standards for and is applicable to facilities that are designated pursuant to
-Article 65 of Title 27, C.R.S. the authority to promulgate these rules establishing minimum
-standards for the Care and Treatment of Persons with Mental Health Disorders comes from
-Sections 27-50-107(3) and 27-65-128, C.R.S.
-
-B.
-
-Facilities designated pursuant to this Chapter 11 shall be subject to the following rule compliance
-timeline:
-
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-2 CCR 502-1
-
-1.
-
-Upon these rules going into effect, the BHA shall take immediate action on rule violations
-that impact the health, safety, and welfare of persons receiving services provided by a
-designated facility.
-
-2.
-
-All designated facilities shall be in full compliance of these rules by July 1, 2024.
-
-C.
-
-On an annual basis, the BHA will review the effectiveness of these rules and produce a written
-report of the results of this review to the state board of human services. This review will include
-engagement with stakeholders and may include, but is not limited to, analysis of grievance data
-and trends in enforcement actions taken by the BHA. The BHA will provide this report annually to
-SBHS by September 1 starting September 1, 2024. The BHA will present information in the report
-to SBHS at the board's next session following submission of the written report unless the board
-and the BHA agree that presentation of the report occur at a different session of the board. If it is
-determined based on this review that changes to these rules are advised, the BHA shall propose
-these changes to the state board of human services for promulgation in accordance with Section
-26-1-107, C.R.S.
-
-11.2
-
-Definitions
-
-“Bedridden” means a form of immobility that can present as the inability to ambulate or move about
-independently or with the assistance of an auxiliary aid, and also requires assistance in turning and
-repositioning in bed. Such immobility may be due to medical orders or due to incapacitation.
-“Behavioral Health Crisis Response Team”, as defined in Section 27-65-102(4), C.R.S., means a mobile
-team that responds to people in the community who are in a behavioral health crisis and includes at least
-one licensed or bachelor-degree-level behavioral health worker. A "Behavioral Health Crisis Response
-Team" includes, but is not limited to, a co-responder model, mobile crisis response unit, or a community
-response team.
-“Certified Peace Officer”, as defined in Section 27-65-102(6), C.R.S., means any certified peace officer as
-described in Section 16-2.5-102, C.R.S.
-“Child”, for the purposes of this Chapter 11, means the same as “Minor”.
-“Colorado Crisis Services” means the statewide behavioral health crisis response system offering
-individuals mental health, substance use or emotional crisis help, information and referrals.
-"Court-Ordered Evaluation" means an evaluation ordered by a court pursuant to Section 27-65-106,
-C.R.S.
-“Discrimination” for the purposes of this Chapter 11, has the same meaning as 27-65-117, C.R.S.
-"Emergency Medical Services Facility" means a general hospital with an emergency department or a
-freestanding emergency department, as defined in Section 25-1.5-114(5), C.R.S.
-“Emergency Medical Service Provider” means a person who holds a valid emergency medical service
-provider certificate or license issued by the Health Department as provided in Article 3.5 of Title 25,
-C.R.S.
-“Emergency Medical Treatment and Labor Act (EMTALA)”, means the federal Emergency Medical
-Treatment and Labor Act of 1986, found at 42 U.S.C. § 1395dd (2020).
-“Facility” for the purposes of this Chapter 11 means:
-
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-
-A.
-
-Pursuant to Section 27-65-102(15), C.R.S., a public hospital or a licensed private hospital,
-Behavioral Health Entity, institution, or residential child care facility that provides treatment for
-persons with mental health disorders.
-
-B.
-
-Any facility, as defined in part 1.2 of these rules, or unit(s) designated by the BHA pursuant to
-Title 27, Article 65, C.R.S. and this Chapter.
-
-“Facility Personnel” or “Community- Based Personnel” means:
-A.
-
-A professional person as defined in this Chapter;
-
-B.
-
-A registered professional nurse as defined in Section 12-255-104(11), C.R.S.;
-
-C.
-
-A licensed marriage and family therapist, as defined in Section 12-245-501(3), C.R.S., licensed
-professional counselor, as defined in Section 12-245-601(2), C.R.S., or licensed addiction
-counselor, as defined in Section 12-245-801(10), C.R.S.; or,
-
-D.
-
-A licensed clinical social worker licensed as defined in Section 12-245-401(7), C.R.S.
-
-“Gravely Disabled” means a condition in which a person, as a result of a mental health disorder, is
-incapable of making informed decisions about or providing for the person’s essential needs without
-significant supervision and assistance from other people. As a result of being incapable of making these
-informed decisions, a person who is gravely disabled is at risk of substantial bodily harm, dangerous
-worsening of any concomitant serious physical illness, significant psychiatric deterioration, or
-mismanagement of the person’s essential needs that could result in substantial bodily harm. A person of
-any age may be “Gravely Disabled”, but the term does not include an person whose decision-making
-capabilities are limited solely by the person’s developmental disability.
-“Immediate Screening” means the determination of whether a person meets criteria for an emergency
-mental health hold.
-“Imminent Danger” means a situation in which a person’s risk status is believed to immediately indicate
-actions that could lead to a person’s harm of self or others.
-“Independent Professional Person” means a professional who evaluates a minor’s condition as an
-independent decision-maker and whose recommendations are based on the standard of what is in the
-best interest of the minor. The professional person may be associated with the admitting facility if the
-professional person is free to independently evaluate the minor’s condition and need for treatment and
-has the authority to refuse admission to any minor who does not satisfy the statutory standards specified
-in Section 27-65-104(2), C.R.S.
-“Individual” for the purposes of this Chapter 11, has the same meaning as respondent as defined in
-Section 27-65-102(29), C.R.S.
-“Intervening Professional”, a person who is statutorily permitted to enact an emergency mental health
-hold, means a person who is of the following:
-A.
-
-A professional person as defined in Section 27-65-102(27), C.R.S.;
-
-B.
-
-A physician assistant licensed pursuant to Section 12-240-113, C.R.S.;
-
-C.
-
-An advanced practice registered nurse, as defined in Section 12-255-104(1), C.R.S.;
-
-D.
-
-A registered professional nurse, as defined in Section 12-255-104(11), C.R.S., who has specific
-mental health training as identified by the BHA;
-
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-
-E.
-
-A clinical social worker licensed pursuant to Part 4 of Article 245 of Title 12, C.R.S.;
-
-F.
-
-A marriage and family therapist licensed pursuant to Part 5 of Article 245 of Title 12, C.R.S.;
-
-G.
-
-A professional counselor licensed pursuant to Part 6 of Article 245 of Title 12, C.R.S.;
-
-H.
-
-An addiction counselor licensed pursuant to Part 8 of Article 245 of Title 12, C.R.S.
-
-“Involuntary Medication” means psychiatric medication administered without a person's consent.
-“Involuntary Transportation Form” means the report and application allowing for immediate transport of a
-person, in need of an immediate screening for treatment, to a clinically appropriate facility.
-“Involuntary Transportation Hold” means the ability to transport a person in need of an immediate
-screening to determine if the person meets criteria for seventy-two (72) hour treatment and evaluation.
-The involuntary transportation hold does not extend or replace the timing or procedures related to a
-seventy-two (72) hour treatment and evaluation hold or a person’s ability to voluntarily apply for mental
-health services.
-"Lay Person" means a person identified by another person who is detained on an involuntary emergency
-mental health hold pursuant to Section 27-65-106, C.R.S., certified for short-term treatment pursuant to
-Section 27-65-109, C.R.S., or certified for long-term care and treatment pursuant to Section 27-65-110,
-C.R.S., who is authorized to participate in activities related to the person’s involuntary emergency mental
-health hold, short-term treatment, or long-term treatment, including court appearances, discharge
-planning, and grievances. The person may rescind the lay person’s authorization at any time.
-"Mental Health Disorder" includes one or more substantial disorders of the cognitive, volitional, or
-emotional processes that grossly impairs judgment or capacity to recognize reality or to control behavior.
-An intellectual or developmental disability is insufficient to either justify or exclude a finding of a mental
-health disorder pursuant to the provisions of Article 65 of Title 27, C.R.S.
-"Minor", for this Chapter 11, means a person under eighteen (18) years of age; except that the term does
-not include a person who is fifteen (15) years of age or older who is living separately and apart from the
-person’s parent or legal guardian and is managing the person’s own financial affairs, regardless of the
-person’s source of income, or who is married and living separately and apart from the person’s parent or
-legal guardian.
-“Objects to Hospitalization” means that a minor, with the necessary assistance of hospital staff, has
-written the minor’s objections to continued hospitalization and has been given an opportunity to affirm or
-disaffirm such objections forty-eight (48) hours after the objections are first written.
-"Patient Representative" means a person designated by a mental health facility to process patient
-complaints or grievances or to represent patients who are minors pursuant to Section 27-65-104(4),
-C.R.S.
-“Petitioner”, pursuant to Section 27-65-102(25), C.R.S., means any person who files any petition in any
-proceeding in the interest of any person who allegedly has a mental health disorder or is allegedly gravely
-disabled.
-"Physician", for the purposes of this Chapter 11, means a person licensed to practice medicine in this
-state pursuant to Article 240 of Title 12, C.R.S.
-
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-
-“Placement Facility” means a public or private behavioral health provider that has a written agreement
-with a designated facility to provide care and treatment to any individual undergoing mental health
-evaluation or treatment by a designated facility. A placement facility may be but is not limited to, a general
-hospital, nursing care facility, adult residential facility or licensed residential child care facility.
-"Professional Person" has the same meaning as described in Section 27-65-102(27), C.R.S.
-“Protection and Advocacy for Individuals with Mental Illness Act (PAIMI Act)”, means the federal
-Protection and Advocacy for Persons with Mental Illness Act of 1986, Pub. L. No. 99-319 (1986).
-“Psychiatric Medication” is a medication being used to treat psychiatric illness for the individual including,
-but not limited to, anti-psychotics, antidepressants, and other medications that may have other medical
-uses but are accepted within the medical profession for psychiatric use as well.
-“Qualified Medication Administration Person” or “QMAP” means a person who passed a competency
-evaluation administered by the Department of Public Health and Environment before July 1, 2017, or
-passed a competency evaluation administered by an approved training entity on or after July 1, 2017, and
-whose name appears on the Department of Public Health and Environment’s list of persons who have
-passed the requisite competency evaluation.
-“Residential Child Care Facility” has the same meaning as set forth in Section 26-6-903(29) C.R.S. a
-residential child care facility may be eligible for designation by the commissioner pursuant to Article 65 of
-Title 27, C.R.S.
-“Respondent”, for the purposes of Chapter 11, has the same meaning as described in Section 27-65102(29), C.R.S.
-"Secure Transportation Provider” means a provider licensed pursuant to Section 25-3.5-310, C.R.S. to
-provide public or private secure transportation services.
-“Secure Treatment Facility” for the purposes of these rules, means the state operated mental health
-hospitals.
-“Subsequent Hold” means additional, up to 72-hour hold, when appropriate placement options could not
-be found during the initial hold period and the person continues to meet criteria for an emergency mental
-health hold.
-“Therapy or Treatments Using Special Procedures” for the purposes of this part 11.10, means a therapy
-that requires informed consent specific to additional requirements of the treatment, including but not
-limited to electroconvulsive therapy, feeding tubes for eating disorder treatment, and behavior
-modifications using transcranial magnetic stimulation.
-“Transitional Measures” means physical guidance, prompting techniques of short duration, or an initial
-temporary approved physical positioning of an individual at the onset or in response to a re-escalation
-during a physical management, for the purpose of quickly and effectively gaining physical control of that
-individual in order to prevent harm to self or others.
-11.3
-
-27-65 Designation Requirement
-
-A.
-
-These rules are established to create standards for agencies seeking a 27-65 designation to
-provide involuntary treatment services pursuant to Article 65 of Title 27, C.R.S.
-
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-
-B.
-
-All agencies providing involuntary treatment services pursuant to Article 65 of Title 27, C.R.S.
-shall meet the standards in this Chapter 11. If the facility requires a BHE license, the facility shall
-also comply with Chapter 2 and the other Chapters specific to any endorsements held by the
-facility. If the facility requires approval as a behavioral health safety net provider, the facility shall
-also comply with Chapter 12.
-
-C.
-
-Any facility licensed by a state agency to include the Colorado Department of Public Health and
-Environment or the division of child welfare within the Colorado Department of Human Services
-providing involuntary mental health services whether inpatient or outpatient, shall seek a 27-65
-designation.
-
-D.
-
-In order to provide involuntary services described in this Chapter 11, a facility, other than an
-emergency medical services facility, must receive a designation based on their compliance with
-the service standards described in this Chapter.
-
-E.
-
-A designated facility must also comply with regulations specific to the involuntary services it
-provides, which may include:
-1.
-
-Involuntary short-term and long-term care and treatment designation (part 11.16 of this
-Chapter); and/or,
-
-2.
-
-Involuntary outpatient care and treatment (part 11.17 of this Chapter).
-
-11.3.1 27-65 Designation General Standards
-A.
-
-The 27-65 designated facility shall only provide services for which it holds/has a 27-65
-designation, approval, and/or another BHA license.
-
-B.
-
-Facility designation applies only to the physical location(s) listed on the 27-65 designation
-certificate from the BHA and not to any other non-designated physical locations operated by the
-facility.
-1.
-
-Psychiatric units within a medical hospital and units that are separate from a main
-building must be designated separately for involuntary services.
-
-C.
-
-The 27-65 designated facility shall ensure all operations, locations, and services, including
-contracted services or personnel, comply with laws, regulations, and standards as required by 2
-CCR 502-1.
-
-D.
-
-Any 27-65 designated facility, must develop, implement, and every three (3) years review the
-following policies and procedures, unless such a facility has an active BHE license or safety net
-approval and has implemented policies and procedures listed below that address 27-65
-designated services:
-1.
-
-The governing body shall have policies and procedures regarding administrative and/or
-clinical oversight of the 27-65 designated services and requirements.
-
-2.
-
-Personnel needed for services and ratios;
-
-3.
-
-Training schedules and demonstration of training for personnel;
-
-4.
-
-Emergency and crisis protocol;
-
-5.
-
-Record protection, sharing, and retention protocol;
-
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-
-E.
-
-2 CCR 502-1
-
-6.
-
-Disclosure of intervention, treatment, and/or medication;
-
-7.
-
-Policies and procedures regarding the use/non-use of seclusion, restraint, and/or
-physical management pursuant to part 11.9 of this Chapter;
-
-8.
-
-Continuity and transfer of care upon admittance and discharge from the facility;
-
-9.
-
-The change to voluntary status process for an individual at the facility;
-
-10.
-
-Communication of rights of individuals;
-
-11.
-
-Facility rules and how they are communicated to individuals receiving services, including
-visitation expectations;
-
-12.
-
-How the facility will manage and maintain the statutory rights individuals have to keep
-and use their own clothes and possessions, including cell phones and money;
-
-13.
-
-Critical incident reporting; and
-
-14.
-
-Facility process for removal and reinstatement of individual rights.
-
-Any additional details regarding applicable policies and procedures in this Chapter must be
-followed in addition to those in this part.
-
-11.3.2 Critical Incident Reporting
-A.
-
-A critical incident includes but is not limited to the following:
-1.
-
-Breach of confidentiality: any unauthorized disclosure of protected health information as
-described in HIPAA, incorporated in part 1.2 of these rules; 42 C.F.R. Part 2, as
-incorporated in part 1.2 of these rules; and/or Sections 27-65-101 through -131, C.R.S.
-
-2.
-
-Death: including the death of an individual inside of or outside of the facility’s physical
-location while an individual is receiving services or where an individual has attempted to
-receive services from the facility within the past thirty (30) calendar days.
-
-3.
-
-Elopement: absconding from a mental health hold, certification, emergency/involuntary
-commitment, or a secure facility where an individual is being held as a result of a court
-order. This includes any unauthorized absence of a minor, when a minor cannot be
-accounted for or when there is reasonable suspicion to believe the minor has absconded.
-
-4.
-
-Any instance in which an individual cannot be located following a search of the facility,
-the facility grounds, and the area surrounding the facility, and:
-a.
-
-There are circumstances that place the individual’s health, safety, or welfare at
-risk; or,
-
-b.
-
-The individual has been missing for eight (8) hours.
-
-5.
-
-Medication diversion: any medication diversion as defined in part 1.2 of these rules. If the
-diverted drugs are injectable, the facility shall also report the full name and date of birth of
-any individual who diverted the injectable drugs, if known.
-
-6.
-
-Medication error: medication error that resulted or could have resulted in harm to the
-individual.
-
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-
-7.
-
-Medical emergency: any suicide attempt/self-injury, other form of serious injury, health
-emergency, overdose or serious illness of an individual which occurred on facility
-premises or in the presence of facility personnel.
-
-8.
-
-Any instance involving physical, sexual, or verbal abuse of an individual, as described in
-Sections 18-3-202, 18-3-203, 18-3-204, 18-3-206, 18-3-402, 18-3-404, or 18-3-405, 18-3405.3, 18-3-405.5, and 18-9-111 (exempting, however, the phrase “intended to harass”),
-C.R.S. by another individual, personnel, or a visitor to the facility.
-
-9.
-
-Any instance that results in any of the following serious injuries to an individual:
-a.
-
-Brain or spinal cord injuries;
-
-b.
-
-Life-threatening complications of anesthesia or life-threatening transfusion errors
-or reactions; or,
-
-c.
-
-Second- or third-degree burns involving twenty percent (20%) of more of the
-body surface area of an adult or more fifteen percent (15%) or more of the body
-surface area of a minor.
-
-10.
-
-Any instance involving caretaker neglect of an individual, as defined in Section 26-3.1101(2.3), C.R.S.
-
-11.
-
-Any instance involving misappropriation of an individual’s property, meaning patterns of
-loss or single incidences of deliberately misplacing, exploiting, or wrongfully using, either
-temporarily or permanently, an individual’s belongings or money without the individual’s
-consent.
-
-12.
-
-Any occurrence involving the malfunction or intentional or accidental misuse of care
-equipment that occurs during treatment or diagnosis of an individual and that significantly
-or adversely affects or, if not averted, would have significantly adversely affected an
-individual.
-
-B.
-
-Critical incidents must be reported to the BHA within one (1) business day after the incident.
-Critical incidents must also be reported to the BHA within one (1) business day of when the
-facility determines that a reportable incident has occurred and the BHA requests such reporting.
-Critical incidents must be reported to the BHA within one (1) business day on a BHA-created form
-posted on the BHA website.
-
-C.
-
-The BHA may conduct scheduled or unscheduled site reviews for specific monitoring purposes
-and investigation of critical incidents reports in accordance with:
-
-D.
-
-1.
-
-BHA policies and procedures,
-
-2.
-
-Regulations that protect the confidentiality and individual rights in accordance with
-Sections 27-65-101 through -131, C.R.S.; HIPAA, as incorporated by reference in part
-1.2 of these rules; and, 42 C.F.R. Part 2, as incorporated by reference in part 1.2 of these
-rules,
-
-3.
-
-Controlled substance licensing, Section 27-81-113, C.R.S., Section 27-80-212, C.R.S.,
-and Section 18-18-503, C.R.S.
-
-The BHA shall have access to relevant documentation required to determine compliance with
-these rules.
-
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-
-E.
-
-2 CCR 502-1
-
-The facility must:
-1.
-
-Establish written policies and procedures for reporting and reviewing all critical incidents
-occurring at the facility;
-
-2.
-
-Submit critical incidents reports to the BHA using state prescribed forms that can be
-obtained from the BHA’s website. This is not in lieu of other reporting mandated by state
-statute or federal guidelines;
-
-3.
-
-Make available a report with the investigation findings for review by the BHA, upon
-request; and,
-
-4.
-
-Maintain critical incidents reports for a minimum of three (3) years following the incident
-unless it would violate any other federal or state law.
-
-F.
-
-Nothing in this part shall be construed to limit or modify any statutory or common law right,
-privilege, confidentiality, or immunity.
-
-11.4
-
-27-65 Designation Approval Procedures
-
-11.4.1 Application Process
-A.
-
-Entities applying for 27-65 designation shall submit an application to the BHA on a state approved
-form, available on the BHA website.
-
-B.
-
-Facilities providing twenty-four (24) hour inpatient or acute crisis care, must apply for a separate
-27-65 designation based on the unique physical address of each site. If two or more buildings or
-units share a physical address, each building or unit must be designated separately for 27-65
-services.
-
-C.
-
-The BHA will provide written notice to the applicant within thirty (30) calendar days of receipt of a
-complete application.
-
-D.
-
-The BHA will act on an application within ninety (90) calendar days of receipt of the completed
-application. The applicant may be approved for 27-65 designation, granted provisional approval,
-or the application may be denied.
-
-E.
-
-An applicant that is found to be in compliance with these rules shall be approved as a facility
-designated to provide mental health services effective for up to a one (1) year period.
-
-F.
-
-A basis for denial of a 27-65 designation application includes a health care or residential child
-care facility’s withdrawal, revocation, loss of its license to operate.
-
-G.
-
-If the application for 27-65 designation is denied, the reason(s) for denial listing deficiencies in the
-application shall be provided in a certified letter to the address of the applicant as shown on the
-application or as subsequently furnished in writing by the applicant. If an applicant disagrees with
-the decision, the applicant, if within sixty (60) days of receiving notice of the decision, may
-request a hearing to review the denial pursuant to Sections 24-4-105 and 24-4-106, C.R.S. (see
-part 2.24.5 of these rules); or upon remedying the noted deficiencies, may re-apply for 27-65
-designation in accordance with this part 11.4.
-
-11.4.2 Provisional 27-65 Designation
-A.
-
-Provisional approval may be granted for a period not to exceed ninety (90) calendar days if, after
-initial inspection and review of an application:
-
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-2 CCR 502-1
-
-1.
-
-The applicant is in substantial compliance with these rules and is temporarily unable to
-conform to all the minimum standards required under these rules. No provisional 27-65
-designation shall be issued to an applicant if the operation of the facility may adversely
-affect individual health, safety, or welfare;
-
-2.
-
-Compliance will be achieved within the ninety (90) day duration of the provisional license;
-and
-
-3.
-
-The applicant has a reasonable plan or schedule in writing for achieving compliance and
-provides a written copy of the plan to the BHA.
-
-B.
-
-The applicant shall provide proof that attempts are being made to conform and comply with
-applicable rules.
-
-C.
-
-A second provisional approval for a period not to exceed ninety (90) calendar days may be
-granted under the same criteria if necessary to achieve compliance.
-
-D.
-
-If the applicant is not able to come into compliance within one hundred and eighty (180) calendar
-days from the date of initial provisional license granted, the application may be denied with a right
-to request a hearing as described in part 11.4.1.G of this rule.
-
-11.4.3 27-65 Re-Designation
-A.
-
-A facility seeking 27-65 designation renewal shall provide the Department with a completed 27-65
-designation application at least sixty (60) calendar days prior to the expiration of the existing 2765 designation.
-
-B.
-
-27-65 designation renewal applications received by the BHA after the current 27-65 designation
-expiration date has passed shall be returned to the facility by certified first class mail and/or
-through electronic means with written notification that the 27-65 designation is no longer in effect.
-Applicants may reapply for an initial 27-65 designation in accordance with part 11.4.1 of these
-rules.
-
-C.
-
-27-65 designation renewal applications that are received by the BHA fewer than sixty (60)
-calendar days prior to the expiration of their existing 27-65 designation is a basis from which the
-BHA may deny the renewal application. If the BHA denies the renewal application for being
-untimely, the BHA will provide the facility with notice of the decision by certified first class mail. If
-the facility disagrees with the decision, it may request a hearing as described in part 11.4.1.G of
-this rule. Alternatively, any facility that submits its renewal application fewer than sixty (60)
-calendar days prior to the expiration of the current 27-65 designation and does not receive a new
-27-65 designation prior to that date and/or notice that the BHA decided to deny the renewal
-application may reapply for an initial 27-65 designation in accordance with part 11.4.1 of these
-rules.
-
-D.
-
-Failure of a facility seeking renewal of a designation to accurately answer or report any
-information requested by the BHA shall be considered good cause to deny the 27-65 designation
-renewal application.
-
-E.
-
-Facilities designated to provide care and treatment to persons with mental health disorders
-pursuant to Section 27-65-101 through -131, C.R.S., shall receive an annual review for
-compliance.
-
-F.
-
-Facilities shall be notified in writing of non-compliance areas and the need for a plan of action as
-outlined in part 2.23.H.2 of these rules. A probationary 27-65 designation may be granted.
-
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-G.
-
-2 CCR 502-1
-
-A facility in compliance with applicable BHA rules and state and federal regulations shall be
-granted 27-65 designation effective through the expiration date, for a period not to exceed one (1)
-year.
-
-11.4.4 Conditional 27-65 Designation
-A.
-
-A conditional 27-65 designation may be granted to a facility out of compliance with applicable
-BHA or state and federal regulations prior to issuance of a renewal designation or during a
-current designation period. The facility will be notified in writing of non-compliance areas and the
-need for a plan of action (see part 2.23.H.2 of these rules).
-
-B.
-
-A conditional 27-65 designation will replace the current 27-65 designation for a period not to
-exceed ninety (90) calendar days.
-
-C.
-
-Administrative and treatment activities may be limited by a conditional 27-65 designation as set
-forth in the conditional designation while the facility addresses corrective actions.
-
-D.
-
-A conditional 27-65 designation may be re-issued for an additional period not to exceed ninety
-(90) calendar days if substantial progress continues to be made and it is likely that compliance
-can be achieved by the date of expiration of the second conditional license.
-
-E.
-
-If the facility fails to comply with or complete a plan of action in the time or manner specified, or is
-unwilling to consent to the conditional 27-65 designation, the modification to a conditional 27-65
-designation shall be treated as a revocation of the 27-65 designation and the facility shall be
-notified by certified mail of the deficiencies and reason for action, the BHA may then institute
-proceedings to effect the revocation per Section 24-4-104(3), C.R.S.
-
-11.4.5 Change in Designation
-A.
-
-If a facility makes a change in its designation status or decides to drop its 27-65 designation, it
-shall notify the BHA in writing no later than thirty (30) calendar days prior to the desired effective
-date. The facility shall submit a written plan for the transfer of care for the persons with mental
-health disorders if the facility will no longer treat those individuals. This plan shall be submitted no
-later than ten (10) business days prior to the effective date.
-
-11.4.6 Rule Waivers
-A.
-
-Rule waivers may be applied for as described in part 2.22 of these rules.
-
-11.4.7 Enforcement and Adverse Actions
-A.
-
-27-65 designated facilities are subject to enforcement measures outlined in part 2.24 of these
-rules and intermediate restrictions as outlined in part 2.24.4 of these rules.
-
-B.
-
-Appeals of adverse actions shall be conducted in accordance with the state administrative
-procedure act, Section 24-4-101 through -109, C.R.S.
-
-11.5
-
-Data Reporting Requirements for All 27-65 Designated Facilities [Effective July 1, 2024]
-
-A.
-
-Each facility designated for 27-65 services by the BHA, pursuant to Article 65 of Title 27, C.R.S.,
-shall file an annual report with the BHA. The report shall be submitted in the format and
-timeframe required by the BHA. This data shall include individuals on emergency mental health
-holds and/or individuals on short-term or long-term certifications that are being treated in
-placement facilities under the auspices of the 27-65 designated facility.
-
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-
-B.
-
-C.
-
-2 CCR 502-1
-
-For each 27-65 designated facility, the annual report shall include:
-1.
-
-Facility name;
-
-2.
-
-County, and address of the facility; and
-
-3.
-
-Type of facility as defined in Section 27-65-102(15), C.R.S.
-
-The facility must maintain confidentiality over the data sets. The reports generated from these
-data sets are also confidential; but the BHA may release aggregated information contained in the
-reports so long as the total number of individuals in any aggregate data group (including county
-or facility name) is greater than thirty (30). If the total number in such a data group is less than or
-equal to thirty (30), the BHA may release this information by redacting such number.
-
-11.5.1 Data Reporting General Standards
-A.
-
-Facilities must submit their annual data report to the BHA by July 1 of each year for the most
-recent, complete calendar year covering January 1 through December 31. The report must meet
-the requirements in this part 11.5 of these rules.
-
-B.
-
-The BHA will annually request from the Department of Public Health and Environment a list of
-licensed facilities that may provide emergency services pursuant to Article 65 of Title 27, C.R.S.
-the facility list shall include, but is not limited to:
-
-C.
-
-1.
-
-General hospitals;
-
-2.
-
-Hospital units;
-
-3.
-
-Psychiatric hospitals; and,
-
-4.
-
-Community clinics.
-
-If a facility on the list provided by the Department of Public Health and Environment does not
-report to the BHA, the BHA will contact the facility to confirm that the facility did not provide
-involuntary care to a person pursuant to Title 27, Article 65, C.R.S. during the reporting cycle.
-1.
-
-If a facility is found to have provided involuntary care to a person pursuant to Title 27,
-Article 65, C.R.S. and did not submit an annual report, an annual report will be requested.
-
-2.
-
-If a facility refuses to provide the statutorily required report, the BHA may submit a
-complaint to the office of the ombudsman for behavioral health access to care.
-
-D.
-
-The facility must maintain confidentiality over the data sets. The reports generated from these
-data sets are also confidential; but the BHA may release aggregated information contained in the
-reports so long as the total number of persons in any aggregate data group (including county or
-facility name) is greater than thirty (30). If the total number in such a data group is less than or
-equal to thirty (30), the BHA may release this information by redacting such number.
-
-E.
-
-The data report requirements, by service type, shall include the following types below in this part
-11.5.
-
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-
-2 CCR 502-1
-
-11.5.2 Seventy-Two (72) Hour Treatment and Evaluation (Emergency Mental Health Holds)
-A.
-
-The facility is required to maintain a data set sufficient to report the following disaggregated
-numbers to the BHA annually by July 1, for the most recent, complete calendar year covering
-January 1 through December 31 and shall include as permitted by HIPAA, as incorporated by
-reference in part 1.2 of these rules; 42 C.F.R. Part 2, as incorporated by reference in part 1.2 of
-these rules ; and Section 27-65-101 through-131, C.R.S.:
-1.
-
-2.
-
-3.
-
-4.
-
-For each individual on an involuntary emergency mental health hold, the facility shall
-report the individual’s:
-a.
-
-Client ID;
-
-b.
-
-Date of birth;
-
-c.
-
-Gender;
-
-d.
-
-Race and ethnicity; and
-
-e.
-
-County of residence.
-
-Who initiated the involuntary emergency mental health hold? (Each hold can only meet
-the requirements of one category listed below):
-a.
-
-Certified peace officer;
-
-b.
-
-Court; or
-
-c.
-
-Intervening professional.
-
-If applicable, what kind of intervening professional initiated the involuntary emergency
-mental health hold?
-a.
-
-Professional person;
-
-b.
-
-Physician assistant;
-
-c.
-
-Advanced practice registered nurse;
-
-d.
-
-Registered professional nurse;
-
-e.
-
-Licensed clinical social worker;
-
-f.
-
-Licensed marriage and family therapist;
-
-g.
-
-Professional counselor; or
-
-h.
-
-Licensed addiction counselor.
-
-The reason(s) for the involuntary emergency mental health hold (each hold can meet the
-requirements of multiple categories listed below):
-a.
-
-Danger to self;
-
-b.
-
-Danger to others; or
-
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-
-c.
-5.
-
-2 CCR 502-1
-
-Gravely disabled.
-
-Disposition of the involuntary emergency mental health hold (each hold can only meet the
-requirements of one category listed below):
-a.
-
-Released without need for further mental health services;
-
-b.
-
-Referred for further mental health care and treatment on a voluntary basis;
-
-c.
-
-Certified for short-term treatment pursuant to Section 27-65-109, C.R.S.;
-
-d.
-
-Transferred to another designated facility while still on the seventy-two (72) hour
-hold; or
-
-e.
-
-Placed on a subsequent hold due to placement issues.
-
-6.
-
-The length of time the individual had to wait for placement in a facility.
-
-7.
-
-The challenges encountered while finding placement for the individual, which may include
-but is not limited to:
-
-8.
-
-9.
-
-a.
-
-Medical complications;
-
-b.
-
-Historical aggression/combativeness;
-
-c.
-
-Intellectual and developmental disorders;
-
-d.
-
-Infectious disease;
-
-e.
-
-No bed available; and/or
-
-f.
-
-Other important barriers to placement.
-
-If applicable, the reason(s) for the subsequent involuntary emergency mental health hold,
-which may include but is not limited to:
-a.
-
-Medical complications;
-
-b.
-
-Historical aggression/combativeness;
-
-c.
-
-Intellectual and developmental disorders;
-
-d.
-
-Infectious disease;
-
-e.
-
-No bed available; and/or
-
-f.
-
-Other circumstances that prompted subsequent involuntary emergency mental
-health hold.
-
-The total number of involuntary transportation holds received by the facility, as well as
-total numbers by outcome of the required screening, including at least:
-a.
-
-Total number of involuntary transportation hold screenings resulting in the
-placement of an involuntary emergency mental health hold;
-
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-
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-
-b.
-
-Total number of involuntary transportation hold screenings resulting in a referral
-for further mental health care and treatment on a voluntary basis; and
-
-c.
-
-Total number of involuntary transportation hold screenings resulting in a release
-without need for further mental health services.
-
-11.5.3 Short and Long-Term Certifications
-A.
-
-The facility is required to maintain a data set sufficient to report the following disaggregate
-numbers to the BHA annually by July 1, for the most recent, complete calendar year covering
-January 1 through December 31 and shall include as permitted by HIPAA, as incorporated by
-reference in part 1.2 of these rules; 42 C.F.R. Part 2, as incorporated by reference in part 1.2 of
-these rules; and Section 27-65-101 through-131, C.R.S.:
-1.
-
-2.
-
-3.
-
-4.
-
-5.
-
-For each individual, who was on a certification, the facility shall report the individual’s:
-a.
-
-Client ID;
-
-b.
-
-Date of birth;
-
-c.
-
-Gender;
-
-d.
-
-Race and ethnicity; and
-
-e.
-
-County of residence.
-
-Type of certification (each certification can only meet the requirements of one category
-listed below):
-a.
-
-Short-term;
-
-b.
-
-Extended short-term;
-
-c.
-
-Long-term; or
-
-d.
-
-Extended long-term.
-
-Status of certification:
-a.
-
-Inpatient; or
-
-b.
-
-Outpatient.
-
-Who initiated the certification (each certification can only meet the requirements of one
-category listed below):
-a.
-
-Court order; or
-
-b.
-
-Professional person.
-
-Reason(s) for the certification (each certification can meet the requirements of multiple
-categories listed below):
-a.
-
-Danger to self;
-
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-
-b.
-
-Danger to others; or
-
-c.
-
-Gravely disabled.
-
-2 CCR 502-1
-
-6.
-
-Start date of certification.
-
-7.
-
-End date of certification.
-
-8.
-
-Start time of certification.
-
-9.
-
-End time of certification.
-
-10.
-
-The services that were provided during the certification.
-
-11.
-
-Outcome of the certification (each certification can only meet the requirements of one
-category listed below):
-
-12.
-
-13.
-
-a.
-
-Certification extended;
-
-b.
-
-Successfully discharged and referred for further mental health care and
-treatment on a voluntary basis;
-
-c.
-
-Voluntarily discharged;
-
-d.
-
-Transferred for continued involuntary treatment;
-
-e.
-
-Unable to locate individual for treatment;
-
-f.
-
-Discontinued with treatment compliance concerns;
-
-g.
-
-Unable to transfer to another facility;
-
-h.
-
-Discontinued due to lack of payment to treatment providers; or
-
-i.
-
-Other circumstances of the outcome of the certification.
-
-Employment status:
-a.
-
-Unemployed;
-
-b.
-
-Employed (full time);
-
-c.
-
-Employed (part time);
-
-d.
-
-Student;
-
-e.
-
-Military service; or
-
-f.
-
-Disability.
-
-Housing status:
-a.
-
-Independent living;
-
-b.
-
-Lives with parent/guardian/caregiver;
-
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-
-c.
-
-Unhoused;
-
-d.
-
-Shelter;
-
-e.
-
-Temporary housing;
-
-f.
-
-Halfway house;
-
-g.
-
-Alternative care facility;
-
-h.
-
-Nursing home;
-
-i.
-
-Group home; or
-
-j.
-
-Residential child care facility.
-
-2 CCR 502-1
-
-11.5.4 Voluntary Individuals
-A.
-
-The facility is required to maintain a data set sufficient to report the following disaggregate
-numbers to the BHA annually by July 1 for the most recent, complete calendar year covering
-January 1 through December 31, a record of each individual who accessed mental health
-treatment voluntarily pursuant to Section 27-65-103, C.R.S., each individual’s record and data
-report shall include as permitted by HIPAA, as incorporated by reference in part 1.2 of these
-rules; 42 C.F.R. Part 2, as incorporated by reference in part 1.2 of these rules; and Section 2765-101 through-131, C.R.S.:
-1.
-
-Client ID;
-
-2.
-
-Date of birth;
-
-3.
-
-Gender;
-
-4.
-
-Race and ethnicity; and
-
-5.
-
-County of residence.
-
-11.5.5 Involuntary Medications
-A.
-
-In addition to the reporting of involuntary medications pursuant to part 11.8.5, the facility is
-required to maintain data sets sufficient to report the following disaggregate numbers to the
-Department annually by July 1 for the most recent, complete calendar year covering January 1
-through December 31, a record of each individual who was given involuntary psychiatric
-medication pursuant to Section 27-65-106, C.R.S., each individual’s record and data report shall
-include as permitted by HIPAA, as incorporated by reference in part 1.2 of these rules; 42 C.F.R.
-Part 2, as incorporated by reference in part 1.2 of these rules; and Section 27-65-101 through131, C.R.S.:
-1.
-
-Client ID;
-
-2.
-
-Date the procedure was initiated;
-
-3.
-
-Date of birth;
-
-4.
-
-Gender;
-
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-
-5.
-
-Race and ethnicity;
-
-6.
-
-Type of order:
-
-7.
-
-a.
-
-Emergency; or
-
-b.
-
-Court-ordered.
-
-2 CCR 502-1
-
-Type of medication (specified use of involuntary medication):
-a.
-
-Antipsychotics - typical;
-
-b.
-
-Antipsychotics - atypical;
-
-c.
-
-Antidepressants;
-
-d.
-
-Mood stabilizers; or
-
-e.
-
-Anxiolytics/hypnotics.
-
-11.5.6 Involuntary Treatment
-A.
-
-The facility is required to maintain data sets sufficient to report the following disaggregate
-numbers to the Department annually by July 1 for the most recent, complete calendar year
-covering January 1 through December 31, a record of each individual who underwent involuntary
-treatments pursuant to Section 27-65-106, C.R.S., each individual’s record and data report shall
-include as permitted by HIPAA, as incorporated by reference in part 1.2 of these rules; 42 C.F.R.
-Part 2, as incorporated by reference in part 1.2 of these rules; and Section 27-65-101 through131, C.R.S.:
-1.
-
-Client ID;
-
-2.
-
-Date of birth;
-
-3.
-
-Gender;
-
-4.
-
-Race and ethnicity; and
-
-5.
-
-Type of treatment:
-
-6.
-
-a.
-
-Seclusion;
-
-b.
-
-Restraint; or
-
-c.
-
-Both seclusion and restraint.
-
-Date, time, and length of seclusion and/or restraint episode per individual.
-
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-
-2 CCR 502-1
-
-11.5.7 Electroconvulsive Therapy (ECT) Procedures
-A.
-
-The facility is required to maintain data sets sufficient to report the following disaggregate
-numbers to the Department annually by July 1 for the most recent, complete calendar year
-covering January 1 through December 31, a record of each individual who underwent
-electroconvulsive therapy, each individual's record and data report shall include as permitted by
-HIPAA, as incorporated by reference in part 1.2 of these rules; 42 C.F.R. Part 2, as incorporated
-by reference in part 1.2 of these rules; and Section 27-65-101 through-131, C.R.S.:
-1.
-
-Client ID;
-
-2.
-
-Date of birth;
-
-3.
-
-Gender;
-
-4.
-
-Race and ethnicity;
-
-5.
-
-Date, time, and length of ECT; and
-
-6.
-
-Status:
-a.
-
-Voluntary ECT; or
-
-b.
-
-Involuntary ECT.
-
-11.5.8 Imposition of Legal Disability or Deprivation of a Right
-A.
-
-The facility is required to maintain data sets sufficient to report the following disaggregate
-numbers to the BHA annually by July 1 for the most recent, complete calendar year covering
-January 1 through December 31, a record of each individual with an imposition of legal disability
-or deprivation of a right during treatment pursuant to Section 27-65-127, C.R.S., each individual’s
-record and data report shall include as permitted by HIPAA, as incorporated by reference in part
-1.2 of these rules; 42 C.F.R. Part 2, as incorporated by reference in part 1.2 of these rules; and
-Section 27-65-101 through-131, C.R.S.:
-1.
-
-Client ID;
-
-2.
-
-Date of birth;
-
-3.
-
-Gender;
-
-4.
-
-Race and ethnicity; and
-
-5.
-
-Specific right deprived.
-
-11.5.9 Data Requirements for Emergency Medical Services Facilities [Effective July 1, 2024]
-A.
-
-The data reporting required in this section is subject to limitations set forth in HIPAA, as
-incorporated by reference in part 1.2 of these rules; 42 C.F.R. Part 2, as incorporated by
-reference in part 1.2 of these rules; and Section 27-65-101 through-131, C.R.S.
-
-B.
-
-An emergency medical services facility, as defined in part 11.2 of these rules, providing care to
-an individual pursuant to Article 65 of Title 27, C.R.S. is required to maintain a data set sufficient
-to report the following disaggregate numbers to the BHA annually pursuant to Section 27-65-
-
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-
-2 CCR 502-1
-
-106(9), C.R.S., in the format and timeframe required by the BHA as provided on the BHA
-website.
-C.
-
-For each facility, the annual report shall include:
-1.
-
-The name, county, and address of each facility site where the service was provided.
-
-2.
-
-Gender;
-
-3.
-
-Race and ethnicity;
-
-4.
-
-County of residence;
-
-5.
-
-If the individual arrived at the facility through an emergency transportation hold;
-
-6.
-
-A record of each individual who had an involuntary emergency mental health hold
-resolved (this includes release without need for further mental health services, referral for
-voluntary treatment, or transferred to from the facility) at the facility;
-
-7.
-
-The outcome of each individual involuntary emergency mental health hold resolved at the
-facility (each hold can only meet the requirements of one category listed below):
-
-8.
-
-9.
-
-11.6
-
-a.
-
-Released without the need for further mental health services;
-
-b.
-
-Referred for voluntary treatment; or
-
-c.
-
-Transferred to a 27-65 designated facility for continued involuntary services.
-
-Who initiated the involuntary emergency mental health hold (each hold can only meet the
-requirements of one category listed below):
-a.
-
-Certified peace officer;
-
-b.
-
-Court; or
-
-c.
-
-Intervening professional.
-
-The reason for the involuntary emergency mental health hold (each hold can meet
-requirements of multiple categories below):
-a.
-
-Dangerous to self;
-
-b.
-
-Dangerous to others; or
-
-c.
-
-Gravely disabled.
-
-Personnel Requirements for 27-65 Designated Facilities
-
-11.6.1 Safety
-A.
-
-Any personnel who are physically or mentally unable to adequately and safely perform duties that
-are essential functions may not be assigned duties as a direct care personnel or volunteer at a
-27-65 designated facility. Facilities shall outline criteria in their policies and procedures for
-determining whether a person is able to safely perform duties in its policies and procedures.
-
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-
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-
-B.
-
-The facility shall not employ or allow any personnel who are under the influence of a controlled
-substance, as defined in Sections 18-18-203 through -207, C.R.S. or who are under the influence
-of alcohol in the workplace. This does not apply to personnel using controlled substances under
-the direction of a physician and in accordance with their health care provider’s instructions, as
-long as it does not pose a safety risk to the person, other personnel, or individuals.
-
-C.
-
-The facility shall employ sufficient personnel to ensure that the provision of services meets the
-needs of individuals. The facility shall:
-1.
-
-Ensure that each shift has a minimum of two (2) personnel, whenever one (1) or more
-individuals are present in the milieu;
-
-2.
-
-Maintain individual-to-personnel ratios not exceeding a one to six (1:6) trained staff
-member(s) to individual ratio at all times; and
-
-3.
-
-Inpatient staffing ratios do not apply to outpatient certification services.
-
-D.
-
-If the facility is a hospital, the facility must comply with staffing requirements pursuant to Section
-25-3-128, C.R.S. in lieu of compliance with part 11.6.1.C.
-
-E.
-
-The facility shall ensure that, at minimum, one of the following qualified personnel is available to
-administer medications at all times:
-1.
-
-Licensed practical nurse, registered nurse, advanced practice registered nurse,
-physician, physician’s assistant, pharmacist, or qualified medication administration
-person (QMAP).
-
-11.6.2 Leadership Personnel Requirements and Responsibilities
-A.
-
-Facility director
-1.
-
-2.
-
-The facility director is responsible for the following:
-a.
-
-Overall direction and responsibility for the individuals, program, facility, and fiscal
-management;
-
-b.
-
-Overall direction and responsibility for supervision of personnel;
-
-c.
-
-The selection and training of a capable personnel member who can assume
-responsibility for management of the facility in the director’s absence; and
-
-d.
-
-The establishment of relationships and maintaining contact with allied facilities,
-services, and mental health resources within the community.
-
-Qualifications of a facility director:
-a.
-
-The facility director shall have, at minimum, received a bachelor’s degree from an
-accredited college or university and have three (3) years of verified experience in
-the human services field, one of which was in a supervisory or administrative
-position; or,
-
-b.
-
-The facility director shall have, at minimum, received a master’s degree from an
-accredited college or university and have two (2) years of verified experience in
-the human services field, one of which was in a supervisory or administrative
-position.
-
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-
-3.
-
-B.
-
-2 CCR 502-1
-
-Assistant or acting facility director:
-a.
-
-In each facility, there shall be a specifically designated personnel member
-capable of acting as a substitute for the facility director during their absence. The
-duties and responsibilities of the acting facility director shall be clearly defined
-within the facility’s policies and procedures in order to avoid confusion and
-conflict among other personnel and individuals.
-
-b.
-
-If the facility director is regularly absent from the facility for more than fifty percent
-(50%) of their working hours, an assistant or acting director shall be appointed
-who meets the qualifications outlined in part 11.6.2.A.2 of this section.
-
-Clinical director
-1.
-
-The clinical director is responsible for assuring that there is adequate training and
-supervision for personnel, that multidisciplinary personnel members are practicing within
-their scope, and that ethical standards are upheld.
-
-2.
-
-Qualifications of a clinical director:
-a.
-
-The clinical director shall possess a master’s degree or doctoral degree in a
-mental health related field or a bachelor’s degree in a mental health related field
-plus five (5) years of related work experience.
-
-b.
-
-The clinical director shall possess a valid clinical license to practice medicine
-and/or behavioral health services in the state of Colorado.
-
-11.6.3 Personnel Training Requirements for 27-65 Designated Facilities
-A.
-
-In addition to trainings identified in part 2.5.I of these rules, facilities designated for 27-65 services
-under these rules shall develop policies and procedures for personnel training curriculum and
-schedules in order to meet the following requirements. Facilities may choose to use an annual
-certification of competency in lieu of training which shall be stored in the personnel file; the facility
-shall develop appropriate policies, procedures and testing to assure and demonstrate personnel
-competency. Training shall be conducted in a trauma-informed, culturally, and linguistically
-competent manner.
-
-B.
-
-All personnel supervising or providing direct care and treatment for individuals with mental health
-disorders shall receive annual training or annual facility certification of competency on the
-provisions of these rules and the requirements of Section 27-65-101 through -131, C.R.S.
-
-C.
-
-All personnel who order or administer involuntary medications (including prescribers, nursing
-personnel, and QMAPs) shall receive annual training or annual facility certification of competency
-on Chapter 11 of these rules and the legal rationale underlying involuntary medication of
-individuals.
-
-D.
-
-All supervisory and direct care personnel shall receive annual training or annual facility
-certification of competency in the recognition and response to common side effects of psychiatric
-medications. These personnel shall be trained to respond to emergency drug reactions in
-accordance with the facility's policies.
-
-E.
-
-All personnel who administer seclusion, restraint, and physical management techniques shall
-receive training and/or certification at minimum pursuant to this part 11.9.3.
-
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-
-2 CCR 502-1
-
-F.
-
-All program administrators and program supervisory personnel shall receive annual training or
-annual facility certification of competency on alternative or representative medical decision
-making, including, but not limited to advance directives, medical durable powers of attorney, and
-proxy decision making, and guardianships.
-
-G.
-
-Specific personnel of placement facilities, as determined by the 27-65 designated facility and its
-policies and procedures, shall receive annual facility training or annual certification of competency
-on the provisions of these rules and the requirements of Section 27-65-101 through-131, C.R.S.
-the 27-65 designated facility is responsible for ensuring that this annual training occurs at
-placement facilities and documenting all relevant placement facility training.
-
-11.7
-
-Individual Records
-
-11.7.1 General Procedures for Individual Records
-A.
-
-The professional person and/or the facility providing an evaluation, care, and/or treatment shall
-keep records detailing all care and treatment received by the individual, and the records must be
-made available, upon the individual’s written authorization, to the individual’s attorney or the
-individuals personal physician in accordance with federal and state laws. The records are
-permanent records and must be retained in accordance with Section 27-65-123(4), C.R.S.
-
-B.
-
-Except as provided in this part 11.7.1.B, all information obtained and records prepared in the
-course of providing any services to any individual pursuant to any provision of Article 65 of Title
-27, C.R.S., are confidential and privileged matter. The information and records may be disclosed
-only:
-1.
-
-In communications between qualified professional personnel in the provision of services
-or appropriate referrals;
-
-2.
-
-When the individual designates other persons to whom information or records may be
-released; but, if an individual is a ward or conservatee and the ward’s or conservatee’s
-guardian or conservator designates, in writing, persons to whom records or information
-may be disclosed, the designation is valid in lieu of the designation by the recipient;
-except that nothing in this section compels a physician, psychologist, social worker,
-nurse, attorney, or other professional personnel to reveal information that has been given
-to the individual in confidence by members of an individual’s family or other informants;
-
-3.
-
-To the extent necessary to make claims on behalf of a recipient of aid, insurance, or
-medical assistance to which recipient may be entitled;
-
-4.
-
-If the BHA has promulgated rules for the conduct of research, such rules must include,
-but are not limited to, the requirement that all researchers must sign an oath of
-confidentiality. All identifying information concerning individuals, including names,
-addresses, telephone numbers, and social security numbers, must not be disclosed for
-research purposes;
-
-5.
-
-To the courts, as necessary for the administration of Article 65 of Title 27, C.R.S.;
-
-6.
-
-To persons authorized by an order of court after notice and opportunity for hearing to the
-individual to whom the record or information pertains and the custodian of the record or
-information pursuant to the Colorado rules of civil procedure;
-
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-
-7.
-
-To family members upon admission of an individual with a mental health disorder for
-inpatient or residential care and treatment. The only information that may be released
-pursuant to this part 11.7.1.B.7 is the location and fact of admission of the person with a
-mental health disorder who is receiving care and treatment. The disclosure of location is
-governed by HIPAA and 42 C.F.R. Part 2 and the procedures in Section 27-65-124,
-C.R.S. and is subject to review pursuant to Section 27-65-124, C.R.S.; and/or,
-
-8.
-
-To family members or a lay person actively participating in the care and treatment of a
-person with a mental health disorder, regardless of the length of the participation. This
-disclosure is governed by HIPAA, as incorporated by reference in part 1.2 of these rules;
-and 42 C.F.R. Part 2, as incorporated by reference in part 1.2 of these rules; and the
-procedures in Section 27-65-124 (2) and is subject to review pursuant to Section 27-65124, C.R.S. The information released pursuant to this subpart is limited to one (1) or
-more of the following:
-
-9.
-
-C.
-
-D.
-
-2 CCR 502-1
-
-a.
-
-The diagnosis;
-
-b.
-
-The prognosis;
-
-c.
-
-The need for hospitalization and anticipated length of stay;
-
-d.
-
-The discharge plan;
-
-e.
-
-The medication administered and side effects of the medication; and
-
-f.
-
-The short-term and long-term treatment goals.
-
-In accordance with state and federal law, to the facility designated pursuant to the federal
-“Protection and Advocacy for Mentally Ill Individuals Act”, 42 U.S.C. Sec. 10801 et seq.,
-and as the governor's protection and advocacy system for Colorado.
-
-Nothing in part 11.7.2 of these rules precludes the release of information to a parent or legal
-guardian concerning the minor.
-1.
-
-Nothing in Article 65 of Title 27, C.R.S., renders privileged or confidential any information,
-except written medical records and information that is privileged pursuant to Section 1390-107, C.R.S., concerning observed behavior that constitutes a criminal offense
-committed upon the premises of any facility providing services pursuant to Article 65 or
-any criminal offense committed against any individual while performing or receiving
-services pursuant to Article 65 of Title 27, C.R.S.
-
-2.
-
-This section does not apply to physicians or psychologists eligible to testify concerning a
-criminal defendant’s mental condition pursuant to Section 16-8-103.6, C.R.S.
-
-All facilities shall maintain and retain permanent records, including all applications as required
-pursuant to Section 27-65-106(3), C.R.S.
-1.
-
-Outpatient or ambulatory care facilities shall retain all records for a minimum of seven (7)
-years after discharge from the facility for individuals who were eighteen (18) years of age
-or older when admitted to the facility, or until twenty-five (25) years of age for individuals
-who were under eighteen (18) years of age when admitted to the facility.
-
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-2 CCR 502-1
-
-2.
-
-Inpatient or hospital care facilities shall retain all records for a minimum of ten (10) years
-after discharge from the facility for individuals who were eighteen (18) years of age or
-older when admitted to the facility, or until twenty-eight (28) years of age for individuals
-who were under eighteen (18) years of age when admitted to the facility.
-
-3.
-
-Nothing in this section prohibits or limits the sharing of information by a state institution of
-higher education police department to authorized university administrators pursuant to
-Section 23-5-141, C.R.S.
-
-11.7.2 Request for Release of Information Procedures
-A.
-
-This section provides for the release of information only and is not deemed to authorize the
-release of the written medical record without authorization by the individual or as otherwise
-provided by law.
-1.
-
-When a family member requests the location and fact of admission of a person with a
-mental health disorder pursuant to Section 27-65-123(1)(g), C.R.S., the treating
-professional person or the professional person’s designee, who must be a professional
-person, shall decide and document the rationale in the individual’s record to whether to
-release or withhold such information. The location must be released if consistent with
-HIPAA, as incorporated by reference in part 1.2 of these rules, and 42 C.F.R. Part 2, as
-incorporated by reference in part 1.2 of these rules, unless the treating professional
-person or the professional person’s designee determines, after an interview with the
-individual, that release of the information to a particular family member would not be in
-the best interests of the individual.
-a.
-
-Any decision to withhold information requested pursuant to Section 27-65-123(1),
-C.R.S., is subject to administrative review pursuant to this section upon request
-of a family member or the individual.
-
-2.
-
-The treating facility shall make a record of the information given to a family member.
-
-3.
-
-For the purposes of request for release of information in this section, an adult person
-having a similar relationship to an individual with a mental health disorder as a spouse,
-lay person, parent, child, or sibling of an individual with a mental health disorder may also
-request the location and fact of admission concerning an individual with a mental health
-disorder.
-
-4.
-
-When a family member requests information concerning an individual with a mental
-health disorder, the treatment professional person or the professional person’s designee,
-shall determine whether the individual is capable of making a rational decision in
-weighing the individual’s confidentiality interests and the care and treatment interests
-implicated by the release of information. The treating professional person or the
-professional person’s designee shall then determine whether the individual consents or
-objects to the release of information.
-
-B.
-
-For purposes of this section, the treating professional person’s designee shall be a professional
-person.
-
-C.
-
-Information must be released or withheld in the following circumstances:
-
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-
-D.
-
-2 CCR 502-1
-
-1.
-
-If the treating professional person or the professional person’s designee makes a finding
-that the individual is capable of making a rational decision concerning the individual’s
-interests and the individual consents to the release of information, the treating
-professional person or the professional person’s designee shall order the release of the
-information unless the professional person or the professional person’s designee
-determines that the release would not be in the best interest of the individual with a
-mental health disorder.
-
-2.
-
-If the treating professional person or the professional person’s designee makes a finding
-that the individual with a mental health disorder is capable of making a rational decision
-concerning the individual’s interests and the individual objects to the release of
-information, the treating professional person or the professional person’s designee shall
-not order the release of information.
-
-3.
-
-If the treating professional person or the professional person’s designee makes a finding
-that the individual with a mental health disorder is not capable of making a rational
-decision concerning the individual’s interests, the treating professional person or the
-professional person’s designee may order the release of the information if the
-professional person or the professional person’s designee determines that the release
-would be in the best interests of the individual.
-
-4.
-
-Any determination of individual capacity:
-a.
-
-Must be used only for the limited purpose of this section.
-
-b.
-
-A decision by a treating professional person or the professional person’s
-designee concerning the capability of an individual with a mental health disorder
-is subject to administrative review upon the request of the individual.
-
-c.
-
-A decision by a treating professional or the professional person’s designee to
-order the release or withholding of information is subject to administrative review
-upon the request of either a family member or the individual with a mental health
-disorder.
-
-d.
-
-The director of the treating facility shall make a record of any information given to
-a family member.
-
-Procedures for administrative and judicial review of information release/withholding when
-requested:
-1.
-
-When administrative review is requested, the director of the facility providing care and
-treatment to an individual with a mental health disorder, shall cause an objective and
-impartial review of the decision to withhold or release information.
-
-2.
-
-The director of the facility shall conduct the review if the director is a professional person.
-a.
-
-If the director is not available or if the director cannot provide an objective and
-impartial review, the review must be conducted by a professional person
-designated by the facility director.
-
-3.
-
-The review must include, but is not limited to, an interview with the individual with a
-mental health disorder.
-
-4.
-
-The facility providing care and treatment shall document the review of the decision
-
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-
-5.
-
-If an individual with a mental health disorder objects to the release or withholding of
-information, the individual and the individual's attorney, if any, must be provided with
-information concerning the procedures for administrative review of a decision to release
-or withhold information. The individual must be informed of any information proposed to
-be withheld or released, and to whom, and be given a reasonable opportunity to initiate
-the administrative review process before information concerning the individual’s care and
-treatment is released.
-
-6.
-
-A family member whose request for information is denied must be provided with
-information concerning the procedures for administrative review of a decision to release
-or withhold information.
-
-7.
-
-An individual with a mental health disorder may file a written request for review by a
-court, under Section 27-65-124, C.R.S., of a decision made upon administrative review to
-release information to a family member requested and proposed to be released.
-
-8.
-
-If judicial review is requested by the individual, under Section 27-65-124, C.R.S., the
-court shall hear the matter within ten (10) days after the request, per Section 27-65-124,
-C.R.S., and the court shall give notice to the individual with a mental health disorder and
-the individual's attorney, the treating professional person, and the person who made the
-decision upon administrative review of the time and place of the hearing.
-a.
-
-The hearing must be conducted in the same manner as other civil proceedings
-before the court per Section 27-65-124, C.R.S.
-
-9.
-
-Unless specifically stated in an order by the court, an individual does not forfeit any legal
-right or suffer legal disability by reason of the provisions of Article 65 of Title 27, C.R.S.
-
-10.
-
-In order to allow an individual with a mental health disorder an opportunity to seek judicial
-review, the treating facility or the treating professional person or the professional person's
-designee shall not release information requested until five (5) days after the
-determination upon administrative review of the director or the director's designee is
-received by the individual.
-
-11.
-
-Once judicial review is requested, the treating facility or the treating professional person
-or the professional person's designee shall not release information except by court order.
-
-12.
-
-If the individual with a mental health disorder indicates an intention not to appeal a
-determination upon administrative review that is adverse to the individual concerning the
-release of information, the information may be released less than five (5) days after the
-determination upon review is received by the individual.
-
-11.7.3 Documentation in Individual Records
-A.
-
-27-65 designated involuntary emergency services facilities shall be exempt from completing a
-comprehensive assessment as described in part 2.12.3 of these rules, an initial assessment as
-described in part 2.12.2 of these rules and a service plan as described in part 2.13.1 of these
-rules.
-
-B.
-
-Screening shall follow requirements as outlined in part 2.12.1 of these rules and must also
-contain the following:
-1.
-
-Substance use in the past 24 hours:
-a.
-
-What, how much, when;
-
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-
-C.
-
-2 CCR 502-1
-
-2.
-
-Current medications; and
-
-3.
-
-Psychiatric advance directives, psychiatric and/or medical assessment documentation.
-
-Crisis assessments must be completed in full on a BHA-created form, available on the BHA
-website, within 24 hours of admission when determining involuntary hold.
-1.
-
-The elements from this form can be integrated into a facility’s electronic health record
-system.
-
-D.
-
-The BHA-created standardized evaluation form pursuant to 27-65-106(6)(b), C.R.S., available on
-the BHA website must be documented in full in the individual record.
-
-E.
-
-If the treating professional person at the designated facility pursues short-term or long-term
-certification of an individual, all corresponding court documents must also be part of the individual
-record.
-
-F.
-
-Safety planning documentation must contain the following:
-
-G.
-
-1.
-
-Emergency services facilities will develop crisis safety plans with individuals who are
-detained or assessed/evaluated and are not placed on emergency mental health holds
-prior to discharge or transfer.
-
-2.
-
-Safety planning must be done in collaboration with the individual in crisis and their family
-members and/or other social supports (if desired by the individual).
-
-Discharge instructions and care coordination instructions must contain the following in both the
-individual’s clinical record and available as instructions for the individual:
-1.
-
-A summary of why the individual was detained or evaluated for an emergency mental
-health hold;
-
-2.
-
-Detailed information as to why the evaluating professional determined the individual no
-longer meets the criteria for an emergency mental health hold pursuant to Section 27-65106, C.R.S. or certification pursuant to Section 27-65-109, C.R.S.;
-
-3.
-
-Whether the individual may receive services on a voluntary basis pursuant to parts
-11.14.2.I through 11.14.2.l of these rules;
-
-4.
-
-If the individual’s medications were changed or the individual was newly prescribed
-medications during the emergency mental health hold, a clinically appropriate supply of
-medications, as determined by the judgment of a licensed health-care provider, for the
-individual until the individual can access another provider or follow-up appointment.
-Facility must assist in care coordination for the follow-up appointment, if needed;
-
-5.
-
-A safety plan for the individual and, if applicable, the individual’s lay person where
-indicated by the individual���s mental health disorder or mental or emotional state;
-
-6.
-
-Notification to the individual’s primary care provider, if applicable and/or known;
-
-7.
-
-A referral to appropriate services, if such services exist in the community, if the individual
-is discharged without food, housing, or economic security. Any referrals and linkages
-must be documented in the individual’s record;
-
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-2 CCR 502-1
-
-8.
-
-The phone number to call or text the Colorado Crisis Services hotline and information on
-the availability of peer support services;
-
-9.
-
-Information on how to establish a psychiatric or medical advance directive if one is not
-presented;
-
-10.
-
-Medications that were changed during the emergency mental health hold, including
-previously prescribed upon admission, and which medications, if any, were changed or
-discontinued at the time of discharge;
-
-11.
-
-A list of any screening or diagnostic tests conducted during the emergency mental health
-hold, if requested;
-
-12.
-
-A summary of therapeutic treatments provided during the emergency mental health hold;
-if requested;
-
-13.
-
-Any laboratory work, including blood samples or imaging that was completed or
-attempted, if requested;
-
-14.
-
-The person’s vital signs upon discharge from the emergency mental health hold, if
-requested;
-
-15.
-
-A copy of any psychiatric advance directive presented to the facility, if applicable; and
-
-16.
-
-How to contact the discharging facility if needed.
-
-H.
-
-The facility shall document in the individual's record whether the individual accepted the
-discharge instructions.
-
-I.
-
-The facility shall provide the discharge instructions to the individual's parent or legal guardian if
-the individual is under eighteen (18) years of age, and to the individual's lay person, when
-possible and if consistent with state and federal law.
-
-J.
-
-Upon discharge, the facility shall discuss with the individual, the individual's parent or legal
-guardian, or the individual's lay person the statewide care coordination infrastructure established
-in Section 27-60-204, C.R.S. to facilitate a follow-up appointment for the individual within seven
-(7) calendar days after the discharge. Facilities shall comply with part 11.7.3.J of this Chapter,
-when the statewide care coordination infrastructure created in Section 27-60-204, C.R.S. is fully
-operational, as determined by the BHA. The BHA shall immediately notify facilities when the
-statewide care coordination infrastructure is available to assist individuals with discharge.
-
-K.
-
-The facility shall, at a minimum, attempt to follow-up with the individual, the individual's parent or
-legal guardian, or the individual's lay person within forty-eight (48) hours after discharge.
-
-L.
-
-The facility is encouraged to utilize peer support professionals, as defined in Section 27-60108(2)(b), C.R.S., when performing follow-up care with individuals and in developing a continuing
-care plan pursuant to this part 11.7.3.G.1 through 3. The facility may facilitate follow-up care
-through contracts with community-based behavioral health providers or the Colorado Behavioral
-Health Crisis Hotline. If the facility facilitates follow-up care through a third-party contract, the
-facility shall obtain authorization from the individual to provide follow-up care, any denial of
-authorization from the individual shall be documented in the individual record.
-
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-2 CCR 502-1
-
-M.
-
-If the individual is enrolled in Medicaid, the facility is not required to meet the requirements of this
-part 11.7.3.J through 11.7.3.M and instead, the facility shall notify the individual's relevant
-Managed Care Entity, as defined in Section 25.5-5-403(4), C.R.S., of the individual's discharge
-and need for ongoing follow-up care prior to the individual's discharge.
-
-N.
-
-If the facility contracts with a Behavioral Health Entity and/or a safety net provider, as defined in
-Section 27-50-101(7), C.R.S., to provide behavioral health services to an individual on or
-following an emergency mental health hold, the facility shall work with the Behavioral Health
-Entity and/or safety net provider in order to meet the requirements of this part 11.7.3.J through
-11.7.3.M.
-
-O.
-
-The facility shall encourage the individual to designate a family member, friend, or other persons
-as a lay person to participate in the individual's discharge planning and shall notify the individual
-that the individual is able to rescind the authorization of a lay person at any time. If the individual
-designates a lay person and has provided necessary authorization, the facility shall attempt to
-involve the lay person in the individual's discharge planning. The facility shall notify the lay person
-that the individual is being discharged or transferred.
-
-P.
-
-Involuntary emergency services facilities must ensure that an individual and authorized caregiver
-and/or family member(s) receive follow-up by phone or telehealth within forty-eight (48) hours,
-conducted by any member of the responding team or by an associated hospital follow-up
-program. Purpose of the follow-up appointment shall be documented in the individual’s clinical
-record.
-
-11.8
-
-Psychiatric Medications
-
-11.8.1 Informed Consent
-A.
-
-In all instances where prescription medications are to be ordered as a part of a mental health
-treatment program, the following information in these part 11.8.1.A through 11.8.1.D shall be
-provided, consistent with federal and state law, to the individual and legal guardian(s) and
-communicated both written and verbally. For individuals, between the ages of fifteen (15) and
-eighteen (18), the following information may be provided to the individuals’ parent(s) or legal
-guardian(s). When an individual has designated another to act concerning medication issues
-pursuant to a medical durable power of attorney, advanced directive, or proxy, the information
-shall be provided to that person also. The facility shall have policies and procedures for
-documenting in the clinical record that the required information was given to the individual,
-parent, or guardian and consent obtained before initial administration of medication(s).
-1.
-
-The name(s) of the medication being prescribed;
-
-2.
-
-The usual uses of the medication(s);
-
-3.
-
-The reasons for ordering the medication(s) for this individual;
-
-4.
-
-A description of the benefits expected;
-
-5.
-
-The common side effects and common discomforts, if any;
-
-6.
-
-The major risks, if any;
-
-7.
-
-The probable consequences of not taking the medication(s);
-
-8.
-
-Any significant harmful drug or alcohol interactions, or food interactions;
-
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-
-2 CCR 502-1
-
-9.
-
-Appropriate treatment alternatives, if any;
-
-10.
-
-That the individual may withdraw agreement to take the medication at any time; and
-
-11.
-
-Ensure that medication will not interfere or negatively interact with any of the individual’s
-other prescribed medication(s).
-
-B.
-
-If an individual has established an advance directive concerning psychiatric medication and the
-advance directive is still in effect, the physician or advanced practice registered nurse shall follow
-the directive unless contraindicated in a psychiatric emergency. The rationale for overriding an
-advance directive shall be clearly documented in the individual’s clinical record.
-
-C.
-
-The provider with prescriptive authority or their designee shall offer to answer inquiries regarding
-the medication(s).
-
-D.
-
-No individual shall be threatened with or subjected to adverse consequences by facility personnel
-solely because of a failure to accept psychiatric medication voluntarily.
-
-11.8.2 Prescribing, Handling, & Administration of Psychiatric Medication(s)
-A.
-
-All psychiatric medication(s) shall be administered on the written order of a professional person
-authorized by statute to order such medications. Verbal medication orders may be given
-according to facility policies.
-
-B.
-
-The facility shall have written policies and procedures regarding part 11.8.1 of these rules for
-informed consent, and the following:
-1.
-
-Documentation of the administration of medication, medication variances/errors, and
-adverse medication reactions related to medication administration;
-
-2.
-
-Notification to a professional person authorized by statute to order such medications in
-case of medication errors and/or medication reactions/events;
-
-3.
-
-Discontinuance of medication;
-
-4.
-
-Disposal of medications;
-
-5.
-
-Acceptance of verbal, fax, or electronically transmitted medication orders; and
-
-6.
-
-Medication shortages and substitutions.
-
-C.
-
-Facilities shall ensure all clinical staff are aware of and have access to the medication formulary.
-
-D.
-
-Facilities shall ensure their providers have access to the medications on the medication formulary
-when prescribing medications to treat behavioral health disorders.
-
-E.
-
-Facilities shall note in the individual’s clinical record all prescription medications administered to
-the individual by a facility including:
-1.
-
-The name and dosage of medication;
-
-2.
-
-The reason for ordering the medication;
-
-3.
-
-The time, date and dosage when medication(s) is administered;
-
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-2 CCR 502-1
-
-4.
-
-The name and credentials of the person who administered the medication;
-
-5.
-
-The name of the prescribing physician or advanced practice registered nurse to order
-such medication; and
-
-6.
-
-If the medication is administered as an emergency medication or a court-ordered
-medication.
-
-11.8.3 Involuntary Psychiatric Medications
-A.
-
-These rules for involuntary psychiatric medications do not apply to refusal of non-psychiatric
-medications or medical emergencies. If an individual refuses medications intended to treat
-general medical conditions and that refusal is likely to cause or precipitates a medical emergency,
-those professionals who are authorized to order and administer medications may take action in
-accordance with generally accepted medical practice in an emergency situation.
-
-B.
-
-Psychiatric emergency conditions: individuals who are detained pursuant to Sections 27-65-106, 107, -108 [effective July 1, 2024], -109, or -110, C.R.S., and refuse psychiatric medication may be
-administered psychiatric medication(s) ordered up to twenty-four (24) hours without consent
-under a psychiatric emergency condition. The least intrusive means should be used to address
-the psychiatric emergency.
-
-C.
-
-An emergency condition exists if:
-1.
-
-The individual is determined to be in immediate and substantial danger of harming self or
-others, as evidenced by symptoms which have in the past reliably predicted
-dangerousness in that particular individual; or,
-
-2.
-
-By a recent overt act, including, but not limited to, a credible threat of bodily harm, an
-assault on another person or self-destructive behavior that demonstrates an immediate
-and substantial threat to self or others.
-
-D.
-
-A reasonable attempt to obtain voluntary acceptance of psychiatric medication shall be made
-prior to the use of involuntary medication.
-
-E.
-
-Continuation of a psychiatric emergency:
-1.
-
-If the psychiatric emergency has abated because of the effect of psychiatric medications
-and the authorized practitioner is of the opinion that psychiatric medication is necessary
-to keep the emergency in abeyance beyond seventy-two (72) hours, then within that
-seventy-two (72) hours the following steps shall be taken:
-a.
-
-The facility shall send a written request for a court hearing for an order to
-administer the medication involuntarily;
-
-b.
-
-A documented concurring consultation with another authorized practitioner shall
-be obtained. The consultation shall include an examination of the individual and a
-review of the clinical record including an assessment as to whether the
-psychiatric emergency condition continues to exist; and
-
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-
-c.
-
-2 CCR 502-1
-
-If a concurring consultation is not obtained within seventy-two (72) hours, then
-emergency psychiatric medication shall be discontinued until such concurring
-consultation is obtained and documented, except in cases where life threatening
-consequences could result from an abrupt medication discontinuation. Under
-these circumstances, the individual shall be safely taken off the medication
-according to standards of medical practice, with corresponding clinical
-documentation.
-
-2.
-
-In no case shall an individual receive emergency psychiatric medication(s) involuntarily
-for a period exceeding ten (10) days without an order from a court of competent
-jurisdiction, including continuation orders from the court.
-
-3.
-
-The individual shall be notified of the right to contact their attorney and/or the court of
-competent jurisdiction at the time the written request for court-ordered medication is
-made. This notification shall be documented in the clinical record. If an individual chooses
-to exercise this right, the 27-65 designated facility shall aid the individual, if necessary, in
-accomplishing the foregoing.
-
-F.
-
-The specific facts outlining behaviors supporting the finding of the emergency condition shall be
-detailed in the clinical record. Every twenty-four (24) hours thereafter until such time a final court
-order is issued, the emergency is resolved, or the individual accepts psychiatric medications
-voluntarily, the facility shall document the behaviors that substantiated the need to continue the
-emergency medication, and the physician shall reorder the psychiatric medications.
-
-G.
-
-During the course of emergency medication administration, the individual shall be offered the
-medication on a voluntary basis each time the medication is given. If the individual voluntarily
-consents to take the medication(s), and the attending physician determines that the individual will
-likely continue to accept the medication on a voluntary basis and no longer requires involuntary
-medications, this shall be documented in the record and the involuntary medication procedures
-shall be terminated.
-
-H.
-
-If the individual again refuses to voluntarily accept medication(s) and their clinical condition
-returns to an emergency situation, pursuant to part 11.8.3.C of these rules, the emergency
-psychiatric medication procedures may be re-instituted.
-
-11.8.4 Non-Emergency Involuntary Medications (Court Ordered Medications)
-A.
-
-In non-emergency situations in which an individual who is detained pursuant to Sections 27-65106, -107, -108 [effective July 1, 2024], -109, -110, or -111 C.R.S., would benefit from the
-administration of a psychiatric medication, but the individual does not consent, the facility shall
-petition the court to obtain permission to administer such medication. The following conditions
-must be documented in the petition:
-1.
-
-The individual is incompetent to effectively participate in the treatment decision;
-
-2.
-
-Treatment by psychiatric medication is necessary to prevent a significant and likely longterm deterioration in the individual's mental condition or to prevent the likelihood of the
-individual causing serious harm to self or others;
-
-3.
-
-A less intrusive appropriate treatment alternative is not available; and
-
-4.
-
-The individual's need for treatment by psychiatric medication is sufficiently compelling to
-override any bonafide and legitimate interest of the individual in refusing treatment.
-
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-
-B.
-
-The petition shall specify what class or name of psychiatric medication is being recommended as
-potentially beneficial to the individual.
-
-C.
-
-No psychiatric medications shall be administered without the individual's consent until a court
-order is received authorizing involuntary use, except under emergency conditions under part 11.8
-of these rules.
-
-11.8.5 Involuntary Medication Data Reporting
-A.
-
-In addition to the involuntary medication data reporting requirements pursuant to 11.5.5, the 2765 designated facility shall maintain a log of all cases where involuntary medications were
-administered.
-
-B.
-
-The record must contain, at a minimum, the following:
-1.
-
-Individual's name and identifying number;
-
-2.
-
-Specified use of involuntary medication;
-
-3.
-
-Physician or other professional authorized by law ordering involuntary medication;
-
-4.
-
-Date/time each involuntary medication was administered and reason for use of
-involuntary medication;
-
-5.
-
-Date/time involuntary medication was discontinued; and
-
-6.
-
-Reason for discontinuation of involuntary medication(s).
-
-C.
-
-If the facility uses a medication administration record or another mechanism which meets the
-criteria listed in this part 11.8.5.B, can correlate this information as required in this part 11.8.5.D,
-and places the information in the clinical record, that mechanism may be used in lieu of a
-separate log.
-
-D.
-
-The facility shall have the ability to determine, at a minimum:
-1.
-
-The aggregate number of individuals receiving emergency and involuntary psychiatric
-medications during a specified period of time; and
-
-2.
-
-The start and stop dates for each individual's involuntary medication treatment.
-
-E.
-
-If the facility is licensed as a BHE, the facility must incorporate the use of this data into the quality
-improvement program in accordance with part 2.17 of these rules.
-
-11.9
-
-Seclusion, Restraint, and Physical Management
-
-11.9.1 General Provisions
-A.
-
-The following rules covering seclusion, restraint, and physical management apply to all facilities
-that use seclusion, restraint, and/or physical management. If a facility has decided to use
-seclusion, restraint, and/or physical management, the facility shall use seclusion, restraint, and/or
-physical management only in accordance with the rules in this part 11.9.
-
-B.
-
-These rules do not supersede any requirements under Section 26-20-101 through-111, C.R.S.
-
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-
-C.
-
-If any provision of this part 11.9 conflicts with any provision concerning the use of seclusion,
-restraint, and/or physical management on an individual with an intellectual or developmental
-disability as stated in Article 10.5 of Title 27, C.R.S., Article 10 of Title 25.5, C.R.S. or any rule
-adopted pursuant to those Articles, the provisions of those Articles or rules prevail.
-
-D.
-
-Individuals being detained under Sections 27-65-106 through -110, C.R.S., may be secluded or
-restrained involuntarily under the conditions in this part; otherwise, there must be a signed
-informed consent for such an intervention as subject to part 2.11 of this rule.
-
-E.
-
-A facility may only use seclusion, restraint, and/or physical management:
-
-F.
-
-1.
-
-In cases of emergency, as defined at Section 26-20-102(3), C.R.S., to be a serious,
-probable, imminent threat of bodily harm to self or others where there is the present
-ability to affect such bodily harm; and,
-
-2.
-
-After less restrictive alternatives, including but not limited to after all attempts to verbally
-direct or de-escalate the individual have failed; or
-
-3.
-
-After a determination that such alternatives would be inappropriate or ineffective under
-the circumstances.
-
-A facility that uses seclusion, restraint, and/or physical management pursuant to the provisions of
-part 11.9.1.E of this section, may only use such seclusion, restraint, and/or physical
-management:
-1.
-
-For the purpose of preventing the continuation or renewal of an emergency;
-
-2.
-
-For the period of time necessary to accomplish its purpose; and
-
-3.
-
-In the case of physical restraint, with no more force than is necessary to limit the
-individual's freedom of movement.
-
-G.
-
-In addition to the circumstances described in this part 11.9.1.F, a facility that is designated by the
-commissioner of the BHA in the State Department to provide treatment pursuant to Sections 2765-106, 27-65-109, or 27-65-110, C.R.S., to an individual with a mental health disorder, as
-defined in Section 27-65-102(22), C.R.S., may use seclusion to restrain an individual with a
-mental health disorder when the seclusion is necessary to eliminate a continuous and serious
-disruption of the treatment environment.
-
-H.
-
-Seclusion, restraint, and/or physical management must never be used:
-1.
-
-As a punishment or disciplinary sanction,
-
-2.
-
-As a means of coercion,
-
-3.
-
-As part of an involuntary service plan or behavior modification plan,
-
-4.
-
-For convenience,
-
-5.
-
-For the purpose of retaliation, or
-
-6.
-
-For the purpose of protection, unless:
-a.
-
-The restraint or seclusion is ordered by a court; or
-
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-b.
-I.
-
-2 CCR 502-1
-
-In an emergency, as provided for in this part 11.9.1.F.1 above.
-
-Physical management for individuals under the age of eighteen (18) must always be considered
-as restraint and follow the restraint order rules pursuant to part 11.9.13 of this Chapter.
-
-11.9.2 Policies and Procedures Regarding Seclusion, Restraint, and Physical Management
-A.
-
-Facilities shall have and shall implement written policies and procedures that describe the
-situations in which the use of seclusion, restraint, and/or physical management are considered
-appropriate in the facilities and personnel who can order their use. The policies and procedures
-must include the requirements in this part 11.9 and Section 26-20-101 through -111, C.R.S. these
-policies and procedures must also include:
-1.
-
-For a facility that does not authorize the use of seclusion, restraint, and/or physical
-management of any type, a policy statement noting the prohibition against the use of
-seclusion, restraint, and/or physical management and the procedures that personnel will
-utilize in lieu of seclusion, restraint, and/or physical management.
-
-2.
-
-For a facility that utilizes seclusion, restraint, and/or physical management, a policy
-statement regarding the review process for the use of seclusion, restraint, and/or physical
-management. The review process must include a provision for terminating the seclusion,
-restraint, and/or physical management episode when the reviewer does not concur with
-the order for continuation.
-a.
-
-If the reviewer is not an authorized practitioner, then the order must be
-discontinued by an authorized practitioner.
-
-3.
-
-Personnel shall ensure that no individual endures harm or harassment when secluded
-and/or restrained.
-
-4.
-
-A policy statement that a facility shall ensure that the care and treatment are skillfully and
-humanely administered with full respect for the individual’s dignity, pursuant to Section
-27-65-101(1)(a), C.R.S.
-
-5.
-
-Protocols for when the use of restraint, seclusion, and/or physical management is
-appropriate, and the restrictions on the use of these techniques, the facility may impose
-more, but not fewer, restrictions on the use of these techniques than is required by this
-Chapter.
-
-6.
-
-Details on the type of physical management interventions that personnel are approved to
-use.
-
-7.
-
-Details on how seclusion, restraint, and/or physical management will be altered to include
-any necessary accommodations the individual may need, including but not limited to,
-changing emergency interventions to not restrain hands and ability to communicate for
-those individuals that speak sign language.
-
-11.9.3 Personnel Training
-A.
-
-The facility shall ensure that all personnel involved in utilizing seclusion, restraint, and/or physical
-management are trained in the use of seclusion, restraint, and/or physical management as
-described in this part 11.9.
-
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-
-B.
-
-The facility shall ensure that personnel are trained to explain, where possible, the use of
-seclusion, restraint, and/or physical management to the individual who is to be secluded,
-restrained, or physically managed and to the individual’s designated representative, if
-appropriate.
-
-C.
-
-Training must be standardized and evaluated every three (3) years to ensure incorporation of
-evidence-based best practices for seclusion, restraint, and/or physical management.
-
-D.
-
-Training must be provided to personnel within the first month of their orientation period and
-annually thereafter unless training is needed sooner.
-
-E.
-
-Personnel shall obtain certification in cardiopulmonary resuscitation (CPR), including periodic
-recertification as needed to maintain certification.
-
-F.
-
-Training must include at minimum, but is not limited to:
-
-G.
-
-1.
-
-The safe use of seclusion, restraint, and/or physical management including content
-related to the risks of positional asphyxia, aspiration, traumatization, and recognize and
-respond to signs of physical distress of an individual who is secluded, restrained, and/or
-physically managed;
-
-2.
-
-Address concepts related to prevention and non-physical interventions such as deescalation and mediation;
-
-3.
-
-Educate personnel of how their culture, language, biases, values, and perceptions
-influence their response and escalation of person involved; and
-
-4.
-
-Understanding and recognizing underlying behavioral health and physical health
-conditions, medications, and their potential effects as well as how age, developmental
-level, cultural background, language, history of physical or sexual abuse, and prior
-experience with seclusion, restraint, and/or physical management will influence an
-individual’s responses to seclusion, restraint, and physical management.
-
-Personnel must demonstrate knowledge and application of seclusion, restraint, and physical
-management training on an annual basis when working with persons over the age of twenty-one
-(21), and on a semi-annual basis when working with youth twenty (20) years old and younger.
-
-11.9.4 Standards of Care Upon Admission
-A.
-
-At admission, the facility shall inform both the individual and the individual’s legal representative,
-as applicable, of the facility’s policy regarding the use of seclusion, restraint, and physical
-management during an emergency behavioral health episode for individuals in a treatment
-program. This must, as is reasonable under the circumstances, be communicated, if feasible, in a
-language and modality accessible to the individual.
-
-B.
-
-Upon an individual’s admission, personnel shall collaborate with the individual and the individual’s
-legal representative, when applicable, to formulate strategies that may minimize the potential for
-a behavioral health emergency event that requires interventions of seclusion, restraint, and/or
-physical management.
-
-C.
-
-A facility electing to utilize seclusion, restraint, and/or physical management shall assess each
-individual upon admission regarding:
-1.
-
-Assault and trauma history;
-
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-
-2.
-
-Seclusion, restraint, and/or physical management history;
-
-3.
-
-Individual’s risk factors for a behavioral emergency, and individually identified strategies
-to avoid seclusion, restraint, and/or physical management; and
-
-4.
-
-The facility shall ascertain any applicable behavioral health advance directives.
-
-11.9.5 Use of Physical Management
-A.
-
-Physical management for individuals under the age of eighteen (18) must always be considered
-as restraint and follow the restraint order rules pursuant to part 11.9.13 of this Chapter.
-
-B.
-
-Physical management shall only be used on an emergency basis for a maximum of one (1)
-minute, when the situation places the individual or others at imminent risk of serious physical
-harm after all attempts to verbally direct or de-escalate the person have failed.
-1.
-
-If physical management is used for longer than one (1) minute, the intervention is
-restraint, pursuant to Section 26-20-102(6), C.R.S., and personnel must follow the
-restraint order rules pursuant to part 11.9.7 of this Chapter.
-
-C.
-
-To ensure the safety of each individual and personnel, each facility shall designate emergency
-physical management techniques to be utilized during emergency situations.
-
-D.
-
-The term “physical management” does not include briefly holding an individual in order to comfort
-them.
-
-E.
-
-The physical management continuum may include:
-1.
-
-Utilizing transitional measures;
-
-2.
-
-Placing one’s hands on an individual to physically guide and/or physically control the
-individual;
-
-3.
-
-Use of an approved restraint method specified in the facility’s policies and procedures to
-maintain safety of the individual;
-
-4.
-
-Placing an individual into an approved prolonged restraint method specified in the
-facility’s policies and procedures; or
-
-5.
-
-Physical management may be used to move or escort an individual into seclusion.
-a.
-
-F.
-
-Seclusion, in itself, is not a form of physical management.
-
-Physical management must be documented in the clinical record to include the following:
-1.
-
-Documentation of the behavioral necessity for physical management and any deescalation techniques attempted prior to utilizing physical management.
-
-2.
-
-Documentation of the approved physical management method utilized.
-
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-11.9.6 Use of Seclusion
-A.
-
-B.
-
-If an order for seclusion is verbal, the verbal order must be received by a registered nurse or
-other trained licensed personnel, such as a licensed practical nurse while the emergency safety
-intervention is being initiated by personnel or immediately after the emergency safety situation
-begins.
-1.
-
-The physician or other authorized practitioner permitted to order seclusion must verify the
-verbal order in a signed written form in the individual’s record. Signatures must be
-entered into the record no more than twenty-four (24) hours after the event.
-
-2.
-
-The physician or other authorized practitioner to order seclusion must be available to
-personnel for consultation, at least by telephone, throughout the period of the emergency
-safety intervention.
-
-Within one (1) hour of the initiation of the original order of seclusion an authorized practitioner,
-such as a registered nurse or physician assistant, trained in the use of emergency safety
-interventions and permitted to assess the physical and psychological well-being of the individual,
-shall conduct a face-to-face assessment of the physical and psychological well-being of the
-individual including but not limited to:
-1.
-
-The individual’s physical and psychological status;
-
-2.
-
-The individual’s behavior;
-
-3.
-
-The appropriateness of the intervention measures; and
-
-4.
-
-Any complications resulting from the intervention.
-
-C.
-
-When the one (1) hour assessment described in this part 11.9.6.B is conducted by a registered
-nurse or a physician assistant, that personnel must consult with the attending physician when the
-assessment is completed.
-
-D.
-
-Results of the one (1) hour assessment must determine if continued emergency interventions
-need to be re-ordered by the authorized practitioner.
-1.
-
-Assessment results and continuation order, if applicable, must be contained in the clinical
-record.
-
-E.
-
-Seclusion occurs any time an individual is placed alone in a room and not allowed to leave.
-
-F.
-
-Seclusion must be used only when other less restrictive methods have failed.
-1.
-
-Documentation of less restrictive methods and the outcome must be contained in the
-clinical record.
-
-G.
-
-Seclusion must not be used for punishment, for the convenience of personnel, or as a substitute
-for a program of care and treatment.
-
-H.
-
-Seclusion rooms must be lighted, clean, safe, and have a window for personnel to observe.
-
-I.
-
-Seclusion rooms must be a minimum of 100 square feet.
-
-J.
-
-Relief periods from seclusion must be offered for reasonable access to toilet facilities.
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-11.9.7 Use of Restraint
-A.
-
-If an order for restraint is verbal, the verbal order must be received by a registered nurse or other
-trained licensed personnel, such as a licensed practical nurse, while the emergency safety
-intervention is being initiated by personnel or immediately after the emergency safety situation
-begins.
-1.
-
-The physician or other authorized practitioner permitted to order restraint must verify the
-verbal order in a signed written form in the individual’s record. Signatures must be
-entered into the record no more than twenty-four (24) hours after the event.
-
-2.
-
-The physician or other authorized practitioner to order restraint must be available to
-personnel for consultation throughout the period of the emergency safety intervention.
-
-B.
-
-An individual in physical restraint must be released from such restraint within fifteen (15) minutes
-after the initiation of physical restraint, except when precluded for safety reasons pursuant to part
-11.9.1 of this section.
-
-C.
-
-Within one (1) hour of the initiation of the original order for the emergency safety intervention, an
-authorized practitioner, such as a registered nurse or physician assistant, trained in the use of
-emergency safety interventions and permitted to assess the physical and psychological wellbeing of the individual, shall conduct a face-to-face assessment of the physical and psychological
-well-being of the individual including but not limited to:
-1.
-
-The individual’s physical and psychological status;
-
-2.
-
-The individual’s behavior;
-
-3.
-
-The appropriateness of the intervention measures; and
-
-4.
-
-Any complications resulting from the intervention.
-
-D.
-
-When the one (1) hour assessment described in this part 11.9.7.C is conducted by a registered
-nurse or a physician assistant, that personnel must consult with the attending physician when the
-assessment is completed.
-
-E.
-
-Results of the one (1) hour assessment must determine if continued emergency interventions
-need to be reordered by the authorized practitioner.
-1.
-
-Assessment results and continuation order, if applicable, must be contained in the clinical
-record.
-
-F.
-
-The decision to restrain must be based on a current clinical assessment and may also be based
-on other reliable information including information that was used to support the decision to take
-the individual into custody for treatment and evaluation. The fact that an individual is being
-evaluated or treated under Sections 27-65-106 through 27-65-111 [effective July 1, 2024], C.R.S.,
-must not be the sole justification for the use of restraint.
-
-G.
-
-Restraint includes chemical restraint, mechanical restraint, and physical restraint.
-
-H.
-
-Mechanical restraints may be used only for the purpose of preventing such bodily movement that
-is likely to result in imminent injury to self or others. Mechanical restraint must not be used solely
-to prevent unauthorized departure.
-
-I.
-
-Restraint of an individual by a chemical spray is not permissible.
-
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-
-J.
-
-The type of restraint must be appropriate to the type of behavior to be controlled, the physical
-condition of the individual, the age of the individual, and the type of effect restraint may have
-upon the individual.
-
-K.
-
-Restraint must be applied only if alternative interventions have failed. Justification for immediate
-use of restraint without first attempting alternative interventions must be documented in the
-clinical record; however, alternative techniques are not required if the alternatives would be
-ineffective or unsafe when the individual’s behavior could cause harm to self or others.
-
-L.
-
-The term “restraint” as used in this section, does not include restraints used while the facility is
-engaged in transporting an individual from one facility location to another facility location when it
-is within the scope of that facility’s powers and authority to conduct such transportation pursuant
-to Section 26-20-101 through -111, C.R.S.
-
-M.
-
-No physical or mechanical restraint of an individual may place excess pressure on the chest or
-back of that individual, cover the individual’s face, or inhibit or impede the individual’s ability to
-breathe.
-
-11.9.8 Chemical Restraint
-A.
-
-If an order for chemical restraint is verbal, the verbal order must be received by a registered
-nurse or other trained licensed personnel, such as a licensed practical nurse, while the
-emergency safety intervention is being initiated by personnel or immediately after the emergency
-safety situation begins.
-1.
-
-The physician or other authorized practitioner permitted to order chemical restraint must
-verify the verbal order in a signed written form in the individual’s record. Signatures must
-be entered into the record no more than twenty-four (24) hours after the event.
-
-2.
-
-The physician or other authorized practitioner to order chemical restraint must be
-available to personnel for consultation, throughout the period of the emergency safety
-intervention.
-
-B.
-
-An order for a chemical restraint, along with the reasons for its issuance, must be recorded in
-writing at the time of its issuance.
-
-C.
-
-An order for a chemical restraint must be signed at the time of its issuance by such authorized
-practitioner, who is present at the time of the emergency.
-
-D.
-
-An order for a chemical restraint, if authorized by telephone, must be transcribed and signed at
-the time of its issuance by personnel with the authority to accept telephone medication orders
-who is present at the time of the emergency.
-
-E.
-
-Personnel trained in the administration of medication shall make notations in the record of the
-individual as to the effect of the chemical restraint and the individual’s response to the chemical
-restraint.
-
-11.9.9 Explanation to Individual in Seclusion/Restraint
-A.
-
-In any situation in which seclusion/restraint is utilized, information must be given to the
-secluded/restrained individual, and the individual’s legal representative when applicable, as soon
-as possible after they have been secluded or restrained. The individual must be given a clear
-explanation of:
-1.
-
-The reasons for use of such intervention;
-
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-2.
-
-The observation procedure, the desired effect; and
-
-3.
-
-The circumstances under which the procedure will be terminated.
-
-2 CCR 502-1
-
-B.
-
-That the explanation has been given to the individual and the individual’s legal representative,
-when applicable, must be documented in the clinical record.
-
-C.
-
-As soon as possible, upon termination of seclusion and/or restraint, personnel shall debrief with
-the individual and assess for any traumatic stress that may have been triggered as a result of
-seclusion/restraint.
-
-11.9.10 Observation & Care of Individuals in Seclusion and/or Restraint
-A.
-
-An individual who is in seclusion/restraint must be observed in-person by trained facility
-personnel at no more than ten (10) feet physical distance from the individual.
-1.
-
-Such observation, along with the behavior of the individual, must be documented every
-fifteen (15) minutes.
-
-B.
-
-Unless contraindicated by the individual's condition, such observation must include consistent
-efforts to interact personally with the individual throughout the episode.
-
-C.
-
-Ongoing provisions must be made for nursing care, hygiene, diet, and motion of any restrained
-limbs throughout the episode.
-
-D.
-
-Facility personnel must maintain a continuous line-of sight throughout the episode with the
-individual held in mechanical restraints.
-
-E.
-
-For individuals held in mechanical restraints, facility personnel must observe the individual at
-least every fifteen (15) minutes to ensure that:
-1.
-
-The individual is properly positioned;
-
-2.
-
-The individual’s blood circulation is not restricted;
-
-3.
-
-The individual’s airway is not obstructed; and
-
-4.
-
-The individual’s other physical needs are met, pursuant to this part 11.9.10.
-
-F.
-
-For individuals held in mechanical restraints, the facility shall offer relief periods of at least ten
-(10) minutes as often as every two (2) hours, so long as relief from the mechanical restraint is
-determined by personnel to be safe pursuant to part 11.9.1 of this section.
-
-G.
-
-Personnel must document relief periods both offered and granted.
-
-H.
-
-The individual must have access to food at least every four (4) hours.
-
-I.
-
-The individual must have access to fluids and toileting upon request or during offered relief
-periods but must at minimum be offered every two (2) hours.
-1.
-
-J.
-
-During such relief periods, personnel shall ensure proper positioning of the individual and
-provide movement of limbs, as necessary.
-
-Personnel must provide assistance for use of necessary toileting methods.
-
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-1.
-
-Appropriate toileting does not include the use of adult diapers if not typically used by the
-individual when not restrained or secluded.
-
-2.
-
-If the individual typically uses adult diapers they are to be changed immediately if soiled.
-
-K.
-
-Personnel shall maintain the individual’s dignity and safety during relief periods.
-
-L.
-
-Cameras and other electronic monitoring devices must not replace face-to-face observations.
-
-M.
-
-To the extent that the duties specified in Section 26-20-101 through -111, C.R.S. are more
-protective of individual’s rights or are in conflict with the provisions in this part 11.9, the provisions
-of Section 26-20-101 through -111, C.R.S. shall apply.
-
-11.9.11 Continued Use of Seclusion and/or Restraint
-A.
-
-Personnel must document efforts to assure that the use of seclusion/restraint are as brief as
-possible.
-
-B.
-
-The original order of seclusion/restraint of an individual must not exceed one (1) hour without an
-order for continued seclusion/restraint from an authorized practitioner. A verbal order, including
-telephone or other electronic orders, may be used if followed by a written order from the
-authorized practitioner.
-
-C.
-
-Seclusion/restraint must not be ordered on an “as needed” basis.
-
-D.
-
-A new written order is required every four (4) hours and shall include a documented examination
-by an authorized practitioner.
-
-E.
-
-Continued seclusion/restraint in excess of twenty-four (24) hours shall require an administrative
-review.
-
-F.
-
-1.
-
-The administrative reviewer shall be a different authorized practitioner with the authority
-and knowledge necessary to review clinical information and reach a determination that
-the extension of a seclusion and/or restraint episode beyond twenty- four (24) hours is
-clinically necessary.
-
-2.
-
-If the administrative reviewer does not concur with the order for continuation of
-seclusion/restraint, the order must be discontinued and the authorized practitioner in
-charge of treatment shall be notified of such discontinuation.
-
-An administrative review must be initiated at the conclusion of each twenty-four (24) hour period
-of continuous use of seclusion/restraint.
-
-11.9.12 Documentation Requirements
-A.
-
-Each facility must ensure that an appropriate notation of the use of seclusion, restraint and/or
-physical management is documented in the record of the individual who was secluded,
-restrained, and/or physically managed and must be completed before the end of the shift of the
-personnel involved in the seclusion, restraint and/or physical management episode(s). Each
-facility shall document the following in the individual’s record:
-1.
-
-Specifics of the episode including identified triggers, precipitating events, the individual's
-specific behavior(s) and the nature of the danger;
-
-2.
-
-Type of restraint, if utilized;
-
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-B.
-
-2 CCR 502-1
-
-3.
-
-Specific date and times of initiation and discontinuation of seclusion, restraint and/or
-physical management and total length of time individual is secluded, restrained, and/or
-physically managed;
-
-4.
-
-A description of specific non-physical and least restrictive interventions that were
-attempted prior and the individual’s response;
-
-5.
-
-Identification of personnel involved in the initiation and application of the seclusion,
-restraint and/or physical management;
-
-6.
-
-Notification to an authorized practitioner within one (1) hour of the seclusion/restraint
-intervention;
-
-7.
-
-Care provided while the individual was secluded, restrained, and/or physically managed,
-including:
-a.
-
-Observations conducted;
-
-b.
-
-Assessments of position, respiration, circulation, and range of motion;
-
-c.
-
-Documentation of ongoing 15-minute observation and care checks, as subject to
-applicable rules, along with relief periods both offered and granted for food, fluid,
-and/or toileting;
-
-d.
-
-Interventions provided to promote comfort and safety as well as expedite release;
-
-e.
-
-The individual’s response to these interventions; and
-
-f.
-
-The effect of the restraint or seclusion on the individual;
-
-8.
-
-Documentation that the individual, and the individual’s legal representative if applicable,
-was given a clear explanation of the reasons for use of such intervention, the observation
-procedure, the desired effect, and the circumstances under which the intervention will be
-terminated including criteria for release and individual understanding of that criteria; and,
-
-9.
-
-Documentation that personnel debriefed the incident with the individual and assessed for
-trauma, processed the traumatic event, and identified triggers.
-
-Any administrative reviewer shall document the clinical justification for the continued use of
-seclusion/restraint in the individual's chart. The justification must include:
-1.
-
-Documentation that the authorized practitioner ordering the continuous use of
-seclusion/restraint in excess of four (4) hours has conducted a face-to-face evaluation of
-the individual within the previous four (4) hours;
-
-2.
-
-Documentation of the ongoing behaviors or findings that warrant the continued use of
-seclusion/restraint and other assessment information as appropriate;
-
-3.
-
-Documentation of a plan for ongoing efforts to actively address the behaviors that
-resulted in the use of seclusion/restraint;
-
-4.
-
-A determination of the clinical appropriateness of the continuation of seclusion/restraint;
-and
-
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-5.
-
-C.
-
-2 CCR 502-1
-
-A summary of the information considered by the reviewer and the result of the
-administrative review with the date, time and signature of the person completing the
-review.
-
-Information regarding use of seclusion/restraint must be readily accessible to authorized persons
-for review. The facility shall have the ability to gather data as follows:
-1.
-
-Each seclusion/restraint episode including date and time the episode started and ended,
-specific to each individual over the period of one complete calendar year from January 1
-through December 31.
-
-11.9.13 Additional Procedures and Requirements for Seclusion/Restraint of a Youth
-A.
-
-Procedures for youth must include the following in addition to the requirements found in this part
-11.9, unless otherwise required in this part 11.9.13.
-
-B.
-
-This part 11.9.13 does not apply to adult individuals over the age of twenty-one (21).
-
-C.
-
-An emergency safety intervention must be performed in a manner that is safe, proportionate, and
-appropriate to the severity of the behavior, and the youth’s chronological and developmental age;
-size; gender; physical, medical, and psychiatric condition; and personal history (including any
-history of physical or sexual abuse).
-1.
-
-D.
-
-Physical management is always considered restraint for an individual under age eighteen
-(18) and must follow the restraint order rules pursuant to this part 11.9 of this Chapter.
-
-Orders for seclusion/restraint must be by an authorized practitioner in the facility to order
-seclusion/restraint and trained in the use of emergency safety interventions. Federal regulations
-at 42 C.F.R. Part 441.151, the federal regulations issued by the United States Secretary of Health
-and Human Services found at 42 C.F.R. Part 441.151 (Feb. 2023), which are hereby incorporated
-by reference. No later editions or amendments are incorporated. These regulations are available
-at no cost from the U.S. Department of Health and Human Services, Substance Abuse and
-Mental Health Services Administration, Office of Communications, 5600 Fishers Lane, Rockville,
-MD 20857 or at https://www.ecfr.gov/current/Title-42. These regulations are also available for
-public inspection and copying at the Behavioral Health Administration, 710 S. Ash Street, Unit
-C140, Denver, CO 80246, during regular business hours. This requires that inpatient psychiatric
-services for individuals under age twenty-one (21) be provided under the direction of a physician.
-1.
-
-If the individual’s treatment team assigned physician is available, only they can order
-seclusion/restraint. If they are not available, then another team physician may make the
-order.
-
-E.
-
-A physician or other authorized practitioner must order the least restrictive emergency safety
-intervention that is most likely to be effective in resolving the emergency safety situation based on
-consultation with personnel.
-
-F.
-
-If the order for seclusion/restraint is verbal, the order must be received by a registered nurse or
-other trained licensed personnel, such as a licensed practical nurse, while the emergency safety
-intervention is being initiated by personnel or immediately after the emergency safety situation
-begins.
-1.
-
-The physician or other authorized practitioner permitted to order restraint or seclusion
-must verify the verbal order in a signed written form in the youth’s record. Signatures
-must be entered into the record no more than twenty-four (24) hours after the event.
-
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-
-2.
-
-2 CCR 502-1
-
-The physician or other authorized practitioner to order restraint or seclusion must be
-available to personnel for consultation, at least by telephone, throughout the period of the
-emergency safety intervention.
-
-G.
-
-Each order for seclusion/restraint must be limited to no longer than the duration of the emergency
-safety situation.
-
-H.
-
-Under no circumstances may the total order time exceed:
-
-I.
-
-1.
-
-Four (4) hours for persons ages eighteen (18) to twenty-one (21);
-
-2.
-
-Two (2) hours for persons ages nine (9) to seventeen (17); or
-
-3.
-
-One (1) hour for persons under the age of nine (9).
-
-Within one (1) hour of the initiation of the order of the emergency safety intervention a physician,
-or other authorized practitioner trained in the use of emergency safety interventions and permitted
-to assess the physical and psychological well-being of the youth, must conduct a face - to - face
-assessment of the physical and psychological well-being of the individual including but not limited
-to:
-1.
-
-The youth’s physical and psychological status;
-
-2.
-
-The youth’s behavior;
-
-3.
-
-The appropriateness of the intervention measures; and
-
-4.
-
-Any complications resulting from the intervention.
-
-J.
-
-Results of the one (1) hour assessment must be documented in the individual’s record.
-
-K.
-
-Notification of parent(s) and/or legal guardian(s), when applicable:
-
-11.10
-
-1.
-
-The facility must notify the parent(s) and/or legal guardian(s) of the individual who has
-been in seclusion or restraint as soon as possible after the initiation of each emergency
-safety intervention.
-
-2.
-
-The facility shall document in the individual’s record that the parent(s) or legal guardian(s)
-have been notified of the emergency safety intervention, including date and time of the
-notification and the name of personnel providing the notification.
-
-Therapy or Treatment Using Special Procedures
-
-11.10.1 Informed Consent for Therapy/Treatment Using Special Procedures
-A.
-
-Therapies using stimuli such as electroconvulsive therapy (ECT), use of feeding tubes for eating
-disorder treatment, and transcranial magnetic stimulation (TMS), require special procedures for
-consent and shall be governed by this part 11.10 of these rules.
-
-B.
-
-Prior to the administration of a therapy listed in part 11.10.1.A of these rules, written informed
-consent shall be obtained and documented in the clinical record reflecting agreement by both the
-individual being treated and their legal guardian, if one has been appointed or alternative decision
-maker if one exists. If the individual’s undergoing treatment using special procedures is a minor,
-the clinical record shall reflect informed consent by both the minor and their guardian(s).
-
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-
-C.
-
-2 CCR 502-1
-
-In the case of electroconvulsive therapy (ECT), a consent form shall be used, and procedures set
-forth in Sections 13-20-401 through 13-20-403, C.R.S. shall be followed. An informed consent for
-ECT means:
-1.
-
-It is freely and knowingly given and expressed in writing.
-
-2.
-
-The consent agreement entered into by the individual or other person(s) shall not include
-exculpatory language through which the individual or other person(s) is made to waive, or
-appear to waive, any of their legal rights, or to release the facility or any other party from
-liability for negligence.
-
-D.
-
-No one under the age of sixteen (16) shall undergo electroconvulsive treatment (ECT).
-
-E.
-
-Electroconvulsive treatment (ECT) requires a concurring consultation by a licensed psychiatrist
-prior to administration of the treatment. Such consultation shall be noted in the clinical record.
-
-F.
-
-The facility shall document that the following has been explained to the individual:
-
-G.
-
-1.
-
-The reason for such treatment information;
-
-2.
-
-The nature of the procedures to be used in such treatment, including their probable
-frequency and duration;
-
-3.
-
-The probable degree and duration of improvement or remission expected with or without
-such treatment;
-
-4.
-
-The nature, degree, duration, and probability of the side effects and significant risks of
-such treatment commonly known by the medical profession, the possible degree and
-duration of memory loss, the possibility of permanent irrevocable memory loss, and the
-remote possibility of death;
-
-5.
-
-The reasonable alternative treatments, if any, and why the professional person is
-recommending the specific treatment;
-
-6.
-
-That the individual has the right to refuse or accept the proposed treatment and has the
-right to revoke their consent for any reason at any time, either orally or in writing;
-
-7.
-
-That there is a difference of opinion within the medical profession on the use of some
-treatments;
-
-8.
-
-An offer to answer any inquiries concerning the recommended special procedures; and
-
-9.
-
-The number of treatments expected over a specified period of time to achieve maximum
-benefit.
-
-Informed consent for the special procedure shall be renewed each time the maximum number of
-treatments determined through clinical assessment have been completed or the specified amount
-of time has expired. No informed consent for special procedures shall be valid for more than thirty
-(30) days.
-
-11.10.2 Involuntary Treatment Using Special Procedures
-A.
-
-In the event the individual or the legal guardian refuses to or cannot consent, treatments
-referenced in part 11.10.1.A of these rules using special procedures shall be administered only
-under the following circumstances:
-
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-
-B.
-
-1.
-
-With a prior court order for the treatments using special procedure; or,
-
-2.
-
-In an emergency in which the life of the individual is in immediate danger because of the
-individual's condition. In an emergency situation in which the individual is unable to grant
-informed consent and sufficient time does not exist to petition the court for an order prior
-to the administration of the specific therapy, the individual's physician, in consultation with
-the director of the facility or their designee, may, after careful and informed deliberation
-and under procedures adopted by the facility, order a special procedure without consent.
-
-Policies and procedures:
-1.
-
-11.11
-
-2 CCR 502-1
-
-Each designated facility shall adopt written policies and procedures for administration of
-special procedures in accordance with these rules and applicable statutes.
-
-Continuity of Care & Transfer of Care
-
-11.11.1 Continuity of Care
-A.
-
-Each facility shall adopt and implement a written policy for continuity of care. The policy shall
-include at a minimum the following:
-1.
-
-Access to all necessary care and services within the facility, and coordination with any
-other current mental health care providers or other systems of care or support as
-appropriate;
-
-2.
-
-Coordination of care with the individual's previous mental health care providers or
-medical providers as appropriate, including retrieval of psychiatric and medical records;
-
-3.
-
-Coordination of the individual's care with family members, guardians, and other
-interested parties as appropriate and in a manner that reflects the individual's culture;
-and/or
-
-4.
-
-The facility shall facilitate access to proper medical care and shall be responsible for
-coordinating mental health treatment with medical treatment provided to the individual.
-
-11.11.2 Transfer of Care: Non-Emergent
-A.
-
-The individual shall only be transferred to another 27-65 designated or placement facility when
-adequate arrangements for care by the receiving facility have been made and documented in the
-clinical record. Transfer coordination shall include at least one discharge planning conference,
-face-to-face or by telephone, with participants from both facilities and the individual and their
-guardian, whenever possible.
-
-B.
-
-At least twenty-four (24) hours advance notice of transfer shall be given to individuals under
-certification, unless knowingly waived in writing by the individual and guardian, if applicable and
-as appropriate, except in cases of a medical emergency. Notice of such transfer shall also be
-provided to the court of competent jurisdiction and the individual's attorney.
-
-C.
-
-The transferring facility shall ask the individual to indicate two (2) persons to whom notification of
-transfer should be given and shall notify such persons within twenty-four (24) hours of notification
-to the individual. Such notification shall be made by the transferring facility with the appropriate
-written authorization. Actions taken under part 11.11 of these rules, shall be documented in the
-clinical record.
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-
-11.12
-
-Requirements for Placement Facilities
-
-A.
-
-Facilities with a 27-65 designation may provide mental health services directly or through the use
-of a placement facility contract. Whenever a placement facility is used there must be a written
-agreement with the 27-65 designated facility. In either case, the 27-65 designated facility is
-responsible for assuring an appropriate treatment setting for individuals and services provided in
-accordance with these rules. Whenever a placement facility is used, the 27-65 designated facility
-shall be responsible for the care provided by the placement facility as well as placement facility
-compliance with these rules. Policies and procedures must be in place outlining the 27-65
-designated facility’s responsibilities and procedures for oversight of placement facilities as
-outlined in this section.
-
-B.
-
-Emergency departments are not eligible to be placement facilities. Only the following Colorado
-licensed facilities are eligible to be placement facilities:
-1.
-
-Nursing homes;
-
-2.
-
-Residential child care facilities providing mental health services;
-
-3.
-
-Non-psychiatric hospitals providing inpatient medical services;
-
-4.
-
-Alternative care facilities; and
-
-5.
-
-Mental health transitional living homes.
-
-C.
-
-All agreements between 27-65 designated facilities and placement facilities and all supplemental
-agreements and amendments shall be submitted in writing to the BHA no later than ten (10)
-business days after the effective date of the agreement or amendment.
-
-D.
-
-Whenever a 27-65 designated facility uses a placement facility, the agreement shall include:
-
-E.
-
-1.
-
-An annual training plan for placement facility personnel that provides at a minimum
-training regarding mental health disorders, these rules, Article 65 of Title 27, C.R.S., and
-appropriate, safe behavioral interventions. The implementation of the training plan shall
-be monitored regularly by the 27-65 designated facility;
-
-2.
-
-A requirement that supervision of direct care personnel be provided by: professional
-persons licensed in Colorado to practice medicine or licensed Colorado psychologists
-employed by or under contract with the designated facility; designated professional
-persons licensed in Colorado to practice medicine; or licensed Colorado psychologists
-employed by the placement facility to be responsible for direct care supervision provided
-that the placement facility and the designated facility are operated by the same corporate
-facility;
-
-3.
-
-A requirement that assures the necessary availability and supervision of placement
-facility personnel in order to carry out the contract; and
-
-4.
-
-A requirement that the placement facility adheres to these rules through the placement
-facility agreement.
-
-Placement facility agreements shall be executed and signed at least every two years and
-submitted to the BHA when the 27-65 designated facility submits its application for continued
-designation.
-
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-2 CCR 502-1
-
-F.
-
-A placement facility can be used by a 27-65 designated facility, at its discretion under the
-provisions of these regulations, in order to provide care to any individual undergoing mental
-health evaluation or treatment. 27-65 designated facilities shall not place individuals in a
-placement facility unless all of the applicable provisions of these rules are met and placement in
-such facilities are appropriate to the clinical needs of each individual. When a placement facility is
-required, the least restrictive facility possible and available must be used, consistent with the
-clinical needs of the individual.
-
-G.
-
-A placement facility shall not provide services beyond the scope of its license.
-
-11.13
-
-Procedures for Involuntary Transportation Holds
-
-A.
-
-This section 11.13 is meant to provide a summary of the obligations and standards set forth in
-Section 27-65-101 through -131, C.R.S., with regard to involuntary transportation holds. This
-section is only enforceable with regard to designated facilities.
-
-B.
-
-An individual may be placed on an involuntary transportation hold pursuant to Section 27-65-107,
-C.R.S. if the certified peace officer or emergency medical services provider believes the individual
-is experiencing a behavioral health crisis or is gravely disabled, and as a result, without
-professional intervention, the individual may be a danger to self or others.
-
-C.
-
-1.
-
-The certified peace officer or emergency medical services provider may then take the
-individual into protective custody and transport the individual to an outpatient mental
-health facility, or a facility designated by the commissioner or other clinically appropriate
-facility designated by the commissioner.
-
-2.
-
-If such a service is not available, the individual may be taken to an emergency medical
-services facility.
-
-The involuntary transportation form to be completed in full (on the BHA provided M 0.51 form
-available on the BHA website) prior to transportation shall include:
-1.
-
-The circumstances under which the individual’s condition was called to the certified
-peace officer’s or emergency medical services (EMS) provider’s attention and further
-stating sufficient facts obtained from personal observations or obtained from others whom
-the certified peace officer or emergency medical services provider reasonably believes to
-be reliable, to establish that the individual is experiencing a behavioral health crisis or is
-gravely disabled and, as a result it is believed that without professional intervention the
-individual may be a danger to the individual’s self or others;
-
-2.
-
-The name of the individual and date and time the individual was placed on the involuntary
-transportation hold;
-
-3.
-
-The name of the facility to which the individual will be transported; and
-
-4.
-
-The signature of the certified peace officer or EMS provider placing the involuntary
-transportation hold.
-
-D.
-
-A copy of the involuntary transportation form must be given to the individual who was placed on
-the involuntary transportation hold.
-
-E.
-
-A copy of the involuntary transportation form must be given to the facility and made part of the
-individual’s medical record.
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-
-F.
-
-An individual may not be placed on a transportation hold if an intervening professional or certified
-peace officer has assessed the individual during the same emergency event and determined the
-individual does not meet the criteria for an emergency mental health hold.
-
-G.
-
-If a behavioral health crisis response team is known to be available in a timely manner, the
-certified peace officer or emergency medical services provider shall access the behavioral health
-crisis response team prior to transporting an individual involuntarily.
-
-H.
-
-Individuals may not be transported involuntarily for longer than six (6) hours.
-
-I.
-
-Once the individual is presented to an outpatient mental health facility or facility designated by the
-commissioner, an intervening professional shall screen the individual immediately. If an
-intervening professional is not immediately available, the individual must be screened within
-immediately, but no more than eight (8) hours pursuant to Section 27-65-107(4)(a)(I), C.R.S.,
-after the individual’s arrival at the facility to determine if the individual meets criteria for an
-emergency mental health hold.
-
-J.
-
-Once the screening is completed and if the individual meets criteria, the intervening professional
-shall first pursue voluntary treatment and evaluation. If the individual refuses or the intervening
-professional has reasonable grounds to believe the individual will not remain voluntarily, the
-intervening professional may place the individual under an emergency mental health hold
-pursuant to Section 27-65-106, C.R.S.
-
-K.
-
-Whenever it appears to the court, by reason of a report by the treating professional person or the
-BHA or any other report satisfactory to the court, that an individual detained for evaluation and
-treatment or certified for short-term treatment should be transferred to another facility for
-treatment and the safety of the individual or the public requires that the individual be transported
-by a secure transportation provider or a law enforcement facility, the court may issue an order
-directing the law enforcement facility where the individual resides or secure transportation
-provider to deliver the individual to the designated facility.
-
-L.
-
-A juvenile, as defined in Chapter one (1) of these rules, committed to the Department of Human
-Services may be transferred temporarily to any state treatment facility for individuals with
-behavioral or mental health disorders or intellectual and developmental disabilities for purposes of
-diagnosis, evaluation, and emergency treatment; except that a juvenile may not be transferred to
-a state treatment facility for individuals with mental health disorders until the juvenile has received
-a mental health hospital placement prescreening resulting in a recommendation that the juvenile
-be placed in a facility for evaluation pursuant to Section 27-65-106, C.R.S.
-
-11.13.1 Individual Rights for Involuntary Transportation
-A.
-
-The following rights must be explained to the individual prior to transporting them involuntarily and
-provided in written form:
-1.
-
-To not be detained under an emergency transportation hold pursuant to this Section for
-longer than fourteen (14) hours, to not be transported for longer than six (6) hours, and to
-receive a screening within eight (8) hours after being presented to the receiving facility.
-Section 27-65-107(4)(a)(I), C.R.S., does not prohibit a facility from holding the individual
-as authorized by state and federal law, including the federal “Emergency Medical
-Treatment and Labor Act,” 42 U.S.C. Sec. 1395dd, or if the treating professional
-determines that the individual's physical or mental health disorder impairs the individual’s
-ability to make an informed decision to refuse care and the provider determines that
-further care is indicated.
-
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-B.
-
-2 CCR 502-1
-
-2.
-
-To request a phone call to an interested party prior to being transported. If the certified
-peace officer or EMS provider believes access to a phone poses a physical danger to the
-individual or someone else, the receiving facility shall make the call on the individual’s
-behalf immediately upon arrival at the receiving facility.
-
-3.
-
-To wear the individual’s own clothes and keep and use personal possessions that the
-individual had in the individual’s possession at the time of detainment. A facility may
-temporarily restrict an individual’s access to personal clothing or personal possessions
-until a safety assessment is completed. If the facility restricts an individual’s access to
-personal clothing or personal possessions, the facility shall have a discussion with the
-individual about why the individual’s personal clothing or personal possessions are being
-restricted. A licensed medical professional or a licensed mental health professional shall
-conduct a safety assessment as soon as possible. The licensed professional shall
-document in the individual’s medical record the specific reasons why it is not safe for the
-individual to possess the individual’s personal clothing or personal possessions.
-
-4.
-
-To keep and use the individual’s cell phone, unless access to the cell phone causes the
-individual to destabilize or creates a danger to the individual’s self or others, as
-determined by a provider, facility personnel, or security personnel involved in the
-individual’s care.
-
-5.
-
-To have appropriate access to adequate water and food and to have the individual’s
-nutritional needs met in a manner that is consistent with recognized dietary practices.
-
-6.
-
-To be treated fairly, with respect and recognition of the individual’s dignity and
-individuality.
-
-7.
-
-To file a grievance with the BHA, the Department of Public Health and Environment
-(CDPHE), or the Office of the Ombudsman for Behavioral Health Access to Care
-established pursuant to Section 27-80-303, C.R.S.
-
-An individual’s rights may only be denied if access to the item, program, or service causes the
-individual to destabilize or creates a danger to the individual’s self or others, as determined by a
-licensed mental health provider or professional person involved in the individual’s care or
-transportation. Denial of any right must be entered into the individual’s treatment record or BHAapproved form, available on the BHA website. Information pertaining to a denial of rights
-contained in the individual’s treatment record must be made available, upon request, to the
-individual, the individuals attorney, or the individual’s lay person.
-
-11.13.2 Individual Rights for Receiving Individuals on Involuntary Transportation Holds
-A.
-
-An individual detained pursuant to this section at an outpatient mental health facility or facility
-designated by the commissioner, must receive a copy of a form with the individual rights
-described in this part 11.13.1 on it if they were not provided a copy of the rights prior to transport.
-1.
-
-B.
-
-If an individual detained pursuant to this part 11.13 is transported to an emergency
-medical services facility, the involuntary transportation hold expires upon the facility
-receiving the person for screening by an intervening professional.
-
-The receiving emergency medical services facility must offer to make a phone call on the
-individual’s behalf if the transporting EMS professional or certified peace officer determined that
-access to a phone prior to transport could pose a physical danger to the individual’s self or
-others.
-
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-
-2 CCR 502-1
-
-C.
-
-A facility may temporarily restrict an individual's access to personal clothing or personal
-possessions until a safety assessment is completed. If the facility restricts an individual's access
-to personal clothing or personal possessions, the facility shall have a discussion with the
-individual about why the individual's personal clothing or personal possessions are being
-restricted and document this in the clinical record.
-
-D.
-
-The individual may keep and use their cell phone, unless access to the cell phone causes the
-individual to destabilize or creates a danger to the individual's self or others, as determined by a
-provider, facility personnel, or security personnel involved in the individual's care. If a cell phone
-is restricted, the reason for this must be explained to the individual and documented in the clinical
-record.
-1.
-
-An individual's rights may only be denied if access to the item, program, or service
-causes the individual to destabilize or creates a danger to the individual's self or others,
-as determined by a licensed provider involved in the individual's care or transportation.
-Denial of any right must be entered into the individual’s treatment record or BHAapproved form, available on the BHA website. Information pertaining to a denial of rights
-contained in the individual's treatment record must be made available, upon request, to
-the individual, the individual's attorney, or the individual's lay person.
-a.
-
-2.
-
-If an individual speaks sign language and their rights to their cell phone has been
-denied, when communicating outside the facility they must have access to
-communication devices that provide written/video/closed caption.
-
-Once the screening is completed and if the individual meets criteria, the intervening
-professional shall first pursue voluntary treatment and evaluation. If the individual refuses
-or the intervening professional has reasonable grounds to believe the individual will not
-remain voluntarily, the intervening professional may place the individual under an
-emergency mental health hold pursuant to Section 27-65-106, C.R.S.
-
-E.
-
-If the individual is placed on an emergency mental health hold, they must be advised of and
-provided with a copy of the associated individual rights as described in part 11.14.3 of this
-Chapter.
-
-11.14
-
-Procedures for Emergency Mental Health Holds
-
-11.14.1 General Procedures
-A.
-
-This section 11.14 is meant to provide a summary of the obligations and standards set forth in
-Section 27-65-101 through -131, C.R.S., with regard to emergency mental health holds. This
-section is only enforceable with regard to designated facilities.
-
-B.
-
-An individual may be placed on an emergency mental health hold for seventy-two (72) hours
-pursuant to Section 27-65-106, C.R.S., if the individual has a mental health disorder and, as a
-result of the mental health disorder, is an imminent danger to the individual’s self or others or is
-gravely disabled.
-1.
-
-The certified peace officer may take the individual into protective custody and transport
-the individual to a facility designated by the commissioner for an emergency mental
-health hold. If such a facility is not available, the certified peace officer may transport the
-individual to an emergency medical services facility. The certified peace officer may
-request assistance from a behavioral health crisis response team for assistance in deescalating and preparing the individual for transportation, or an emergency medical
-services provider in transporting the individual; or,
-
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-
-2.
-
-C.
-
-2 CCR 502-1
-
-When an intervening professional reasonably believes that an individual appears to have
-a mental health disorder and, as a result of the mental health disorder, appears to be an
-imminent danger to the individual's self or others or appears to be gravely disabled, the
-intervening professional may cause the individual to be taken into protective custody and
-transported to a facility designated by the commissioner for an emergency mental health
-hold. If such a facility is not available, the certified peace officer may transport the
-individual to an emergency medical services facility. The intervening professional may
-request assistance from a certified peace officer, a secure transportation provider, or a
-behavioral health crisis response team for assistance in detaining and transporting the
-individual, or assistance from an emergency medical services provider in transporting the
-individual.
-
-The emergency mental health hold form, available on the BHA website, shall be completed by an
-intervening professional or certified peace officer and include the following:
-1.
-
-The circumstances under which the individual’s condition was brought to the attention of
-the intervening professional or certified peace officer;
-
-2.
-
-A description of facts, either through direct observation by the intervening professional or
-peace officer or obtained from others believed to be reliable, establishing that the
-individual has a mental health disorder, and as a result of the mental health disorder, is
-an imminent danger to self or others, is gravely disabled, or is in need of immediate
-evaluation for treatment;
-
-3.
-
-Date/time the individual was placed on the emergency mental health hold; and
-
-4.
-
-Who brought the individual’s condition to the attention of the intervening professional or
-certified peace officer.
-
-D.
-
-A copy of the emergency mental health hold form must be given to the individual who was placed
-on the emergency mental health hold.
-
-E.
-
-A copy of the emergency mental health hold form must be given to the facility and made part of
-the individual’s record.
-
-F.
-
-Once the individual is receiving care and treatment in a designated involuntary short-term
-treatment facility, the individual shall receive treatment and care for the duration of their
-emergency mental health hold.
-
-G.
-
-The individual must be released before seventy-two hours have elapsed if, in the opinion of the
-professional person overseeing treatment, the individual no longer requires evaluation and
-treatment.
-
-H.
-
-At the expiration of the emergency mental health hold, the individual must be:
-1.
-
-Released;
-
-2.
-
-Referred for further care and treatment on a voluntary basis; or
-
-3.
-
-Certified for short-term treatment pursuant to Section 27-65-109, C.R.S.
-
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-
-11.14.2 Court Orders for Screening & Evaluation
-A.
-
-Pursuant to Section 27-65-106(1)(c), C.R.S., any individual may petition the court in the county in
-which the individual resides or is physically present requesting an evaluation of the individual’s
-condition and alleging that the individual appears to have a mental health disorder and, as a
-result of the mental health disorder, appears to be a danger to the individual’s self or others or
-appears to be gravely disabled.
-
-B.
-
-A court may order that an individual be taken into custody and placed in a designated facility for
-seventy-two (72) hour treatment and evaluation.
-
-C.
-
-Pursuant to Section 26-65-106(4)(a), C.R.S., the petition for a court-ordered evaluation must
-contain the following:
-1.
-
-Name and address of the petitioner, and the petitioner’s interest in this case;
-
-2.
-
-Name of the individual for whom evaluation is sought, and if known, the address, age,
-gender, marital status, occupation, and any animals or dependent children in the
-individual’s care;
-
-3.
-
-Allegations of fact indicating the individual may have a mental health disorder and, as a
-result of the mental health disorder, is a danger to self or others or is gravely disabled;
-
-4.
-
-The name and address of every person responsible for the care, support, and
-maintenance of the individual, if available; and
-
-5.
-
-The name, address, and telephone number of the attorney, if any, who has most recently
-represented the individual. If there is not attorney, there shall be a statement as to
-whether, to the best knowledge of the petitioner, the individual meets criteria established
-by the legal aid agency operating in the county or city and county for it to represent the
-individual.
-
-D.
-
-Upon receipt of a petition, the court shall identify a facility designated by the commissioner, an
-intervening professional, or a certified peace officer to provide screening of the individual to
-determine whether probable cause exists to believe the allegations.
-
-E.
-
-Following the screening, the facility, intervening professional, or certified peace officer designated
-by the court shall file a report with the court and may initiate an emergency mental health hold at
-the time of screening. The report must include a recommendation as to whether probable cause
-exists to believe that the individual has a mental health disorder and is a danger to self or others
-or is gravely disabled. The report must also specify whether the individual will voluntarily receive
-evaluation or treatment.
-
-F.
-
-A copy of the confidential screening report must be provided to the individual and the individual’s
-attorney or personal representative.
-
-G.
-
-If the court determines that the individual has a mental health disorder and is a danger to self or
-others or is gravely disabled, and efforts have failed to obtain cooperation from the individual to
-receive treatment voluntarily, the court must issue an order for a certified peace officer or secure
-transportation provider to take the individual into custody and transport the individual to a
-designated facility for seventy-two (72) hour evaluation and treatment.
-
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-
-1.
-
-H.
-
-2 CCR 502-1
-
-At the time the individual is taken into custody, a copy of the petition and the order for
-evaluation must be given to the individual and promptly to the one lay person designated
-by the individual and to the person in charge of the facility named in the order or the
-individual’s lay person designee. If the individual refuses to accept a copy of the petition
-and the order for evaluation, such refusal must be documented in the petition and the
-order for evaluation.
-
-When an individual is transported to an emergency medical services facility or a facility
-designated by the commissioner, the facility may detain the individual under an emergency
-mental health hold for evaluation for a period not to exceed seventy-two (72) hours from the time
-the emergency mental health hold was placed or ordered. Nothing in this section prohibits an
-emergency medical services facility from involuntarily holding the individual in order to stabilize
-the individual as required pursuant to the federal "Emergency Medical Treatment and Labor Act",
-42 U.S.C. Sec. 1395dd, or if the treating professional determines that the individual's physical or
-mental health disorder impairs the individual's ability to make an informed decision to refuse care
-and the provider determines that further care is indicated.
-1.
-
-If, in the opinion of the person in charge of the evaluation, the individual can be properly
-cared for without being detained, the individual shall be provided services on a voluntary
-basis.
-
-2.
-
-If the person in charge of the evaluation determines the individual should be released, the
-person in charge of the evaluation may terminate the emergency mental health hold.
-
-I.
-
-Each individual detained for an emergency mental health hold pursuant to part 11.14 of this
-Chapter, shall receive an evaluation as soon as possible after the individual is presented to the
-facility and shall receive such treatment and care as the individual’s condition requires for the full
-period that the individual is held.
-
-J.
-
-The evaluation may include an assessment to determine if the individual continues to meet the
-criteria for an emergency mental health hold and requires further mental health care in a facility
-designated by the commissioner. The evaluation must state whether the individual should be:
-
-K.
-
-1.
-
-Released;
-
-2.
-
-Referred for further care and treatment on a voluntary basis; or
-
-3.
-
-Certified for short-term treatment pursuant to Section 27-65-109, C.R.S.
-
-Each evaluation must be completed using a standardized form approved by the commissioner
-available on the BHA website (the elements from this form can be integrated into a facility’s
-electronic health record system) and may be completed by a professional person; a licensed
-advanced practice registered nurse with training in psychiatric nursing; or a licensed physician
-assistant, a licensed clinical social worker, a licensed professional counselor, or a licensed
-marriage and family therapist who has two years of experience in behavioral health safety and
-risk assessment working in a health-care setting.
-1.
-
-If the professional person conducting the evaluation does not hold two (2) years’
-experience, they may conduct the evaluation and a professional person that holds the
-required experience must review, provide clinical consultation as needed, and provide
-their signature to the evaluation.
-
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-2 CCR 502-1
-
-L.
-
-If the personnel conducting an evaluation pursuant to part 11.14 of this Chapter is not a
-professional person and the evaluating personnel recommends the detained individual be
-certified for short-term treatment pursuant to Section 27-65-109, C.R.S., the evaluating personnel
-shall notify the facility of the recommendation. A certification may only be initiated by a
-professional person.
-
-M.
-
-If an individual is evaluated at an emergency medical services facility and the evaluating
-professional determines that the individual continues to meet the criteria for an emergency mental
-health hold pursuant to part 11.14 of this Chapter, the emergency medical services facility shall
-immediately notify the BHA if the facility cannot locate appropriate placement. Once notified, the
-BHA shall support the emergency medical services facility in locating an appropriate placement
-option on an inpatient or outpatient basis, whichever is clinically appropriate.
-
-N.
-
-If an appropriate placement option cannot be located pursuant to this part 11.14.2.N and the
-individual continues to meet the criteria for an emergency mental health hold pursuant to part
-11.14 of these rules and the individual has been medically stabilized, the emergency medical
-services facility may place the individual under a subsequent emergency mental health hold.
-1.
-
-If the facility places the individual under a subsequent emergency mental health hold, the
-facility shall immediately notify the BHA, the individual's lay person, and the court, and
-the court shall immediately appoint an attorney to represent the individual.
-
-2.
-
-The facility may notify the court where the individual resides by mail.
-a.
-
-O.
-
-Once the court is notified, the emergency medical services facility is not required
-to take any further action to provide the individual with an attorney unless
-specified in part 11.14.3 of this Chapter.
-
-3.
-
-The emergency medical services facility shall notify the BHA after each emergency
-mental health hold is placed.
-
-4.
-
-If the individual has been recently transferred from an emergency medical services facility
-to a facility designated by the commissioner and the designated facility is able to
-demonstrate that the facility is unable to complete the evaluation before the initial
-emergency mental health hold is set to expire, the designated facility may place the
-individual under a subsequent emergency mental health hold and shall immediately notify
-the BHA and lay person.
-
-The BHA shall maintain data on the characteristics of each individual placed on a subsequent
-emergency mental health hold pursuant to this part 11.14.2. The BHA may contract with facilities
-coordinating care or with providers serving within the safety net system developed pursuant to
-Section 27-63-105, C.R.S., to meet the requirements of this part 11.14.
-
-11.14.3 Individual Rights for Emergency Mental Health Holds
-A.
-
-The following rights apply to anyone receiving evaluation, care, or treatment pursuant to Article
-65 of Title 27, C.R.S. and must be explained to the individual and provided in written form:
-1.
-
-Nothing in Article 65 of Title 27, C.R.S., limits the right of any individual to make a
-voluntary application at any time to any public or private facility or professional person for
-mental health services, including but not limited to evaluation, care, and/or treatment,
-either by direct application in-person or by referral from any other public or private facility
-or professional person.
-
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-
-2 CCR 502-1
-
-a.
-
-Subject to Section 15-14-316(4), C.R.S., a ward, as defined in Section 15-14102(15), C.R.S., may be admitted to a hospital or institutional care and treatment
-for a mental health disorder with the guardian’s consent for as long as the ward
-agrees to such care and treatment. The guardian shall immediately notify in
-writing the court, that appointed the guardian, of the admission.
-
-b.
-
-Medical and legal status of all voluntary individuals receiving treatment for mental
-health disorders in inpatient or custodial facilities must be reviewed at least once
-every six (6) months.
-
-c.
-
-Voluntary individuals are afforded all rights and privileges customarily granted by
-hospitals to individuals they serve.
-
-d.
-
-Any individual receiving an evaluation or treatment pursuant to Article 65 of Title
-27, C.R.S., is entitled to medical and psychiatric care and treatment, with regard
-to services listed in Section 27-65-101, C.R.S., and services listed in rules
-authorized by Section 27-66-102, C.R.S., suited to meet the individual’s specific
-needs, delivered in such a way as to keep the individual in the least restrictive
-environment, and delivered in such a way as to include the opportunity for
-participation of family members in the individuals program of care and treatment
-when appropriate.
-
-2.
-
-To be told the reason for the individual’s detainment and the limitations of the individual’s
-detainment, including a description of the individual’s right to refuse medication, unless
-the individual requires emergency medications, and that the detainment does not mean
-all treatment during detainment is mandatory;
-
-3.
-
-To request a change to voluntary status;
-
-4.
-
-To be treated fairly, with respect and recognition of the individual’s dignity and
-individuality, by all employees of the facility with whom the individual comes in contact;
-
-5.
-
-To not be discriminated against on the basis of age, race, ethnicity, religion, culture,
-spoken language, physical or mental disability, socioeconomic status, sex, sexual
-orientation, gender identity, or gender expression;
-
-6.
-
-To retain and consult with an attorney at any time;
-a.
-
-Except that, unless specified in this part 11.14.2.N of this Chapter, the facility is
-not required to retain an attorney on behalf of the individual but must allow the
-individual to contact an attorney;
-
-7.
-
-To continue the practice of religion;
-
-8.
-
-Within twenty-four (24) hours after the individual's request, to see and receive the
-services of a patient representative who has no direct or indirect clinical, administrative,
-or financial responsibility for the individual;
-
-9.
-
-To have reasonable access to telephones or other communication devices and to make
-and to receive calls or communications in private;
-a.
-
-Facility personnel shall not open, delay, intercept, read, or censor mail or other
-communications or use mail or other communications as a method to enforce
-compliance with facility personnel;
-
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-
-10.
-
-2 CCR 502-1
-
-To wear the individual’s own clothes, keep and use the individual’s own personal
-possessions (including but not limited to personal medical devices and/or auxiliary aids),
-and keep and be allowed to spend a reasonable sum of the individual’s own money.
-a.
-
-A facility may temporarily restrict an individual’s access to personal clothing or
-personal possessions, until a safety assessment is completed.
-
-b.
-
-If the facility restricts an individual’s access to personal clothing or personal
-possessions, the facility shall have a discussion with the individual about why the
-individual’s personal clothing or personal possessions are being restricted.
-
-c.
-
-A licensed medical professional or a licensed mental health professional shall
-conduct a safety assessment as soon as possible. The licensed professional
-shall document in the individual’s medical record the specific reasons why it is
-not safe for the individual to possess the individual’s personal clothing or
-personal possessions.
-
-d.
-
-The facility shall periodically conduct additional safety assessments to determine
-whether the individual may possess the individual's personal clothing or personal
-possessions, with the goal of restoring the individual’s rights established
-pursuant to this section.
-
-11.
-
-To have the individual's information and records disclosed to family members and a lay
-person pursuant to Section 27-65-123, C.R.S.;
-
-12.
-
-To have the individual's treatment records remain confidential, except as required by law;
-
-13.
-
-To not be fingerprinted, unless required by law;
-
-14.
-
-To have appropriate access to adequate water, hygiene products, and food and to have
-the individual's nutritional needs met in a manner that is consistent with recognized
-dietary practices;
-
-15.
-
-To have appropriate access to non-psychiatric medications necessary to maintain an
-individual's health, including but not limited to pain medications that may be controlled
-substances, as ordered and/or overseen by a physician or other authorized medical
-practitioner of record;
-
-16.
-
-To keep and use the individual's cell phone, unless access to the cell phone causes the
-individual to destabilize or creates a danger to the individual's self or others, as
-determined by a provider, facility personnel member, or security personnel involved in the
-individual’s care;
-
-17.
-
-To not be photographed, except upon admission for identification and administrative
-purposes. Any photographs must be confidential and must not be released by the facility
-except pursuant to a court order. Nonmedical photographs must not be taken or used
-without appropriate consent or authorization;
-
-18.
-
-To have personal privacy to the extent possible during the course of treatment;
-
-19.
-
-To have frequent and convenient opportunities to meet with visitors in accordance with
-the facility’s current visitor guidelines. Each individual may see the individual’s attorney,
-clergyperson, or physician at any time;
-
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-2 CCR 502-1
-
-20.
-
-An individual’s rights may only be denied if the item, program, or service causes the
-individual to destabilize or creates a danger to the individual’s self or others, as
-determined by a licensed provider involved in the individual’s care. Denial of any right
-must in all cases be entered into the individual’s treatment record. Information pertaining
-to a denial of rights contained in the individual’s treatment record must be made
-available, upon request, to the individual, or the individual’s attorney; and,
-
-21.
-
-Any person receiving evaluation, care, or treatment pursuant to Article 65 of Title 27,
-C.R.S., must be given the opportunity to exercise the persons right to register and to vote
-in primary and general elections.
-a.
-
-The facility or facility providing evaluation, care, or treatment shall assist the
-individual, upon the individual’s request, to obtain voter registration forms and
-mail ballots and to comply with any other prerequisite for voting.
-
-11.14.4 Additional Considerations
-A.
-
-The facility shall develop written policies that include the procedures for managing individual
-funds or property that include at minimum:
-1.
-
-A written inventory of all personal belongings shall be conducted upon admission. This
-inventory shall be signed and reviewed by facility personnel and the individual and shall
-be maintained in the individual’s clinical record.
-
-2.
-
-A process for storing all inventoried items in a secure location during the individual’s stay
-in the facility.
-
-3.
-
-A process for returning all inventoried property to the individual upon discharge or
-sending the property with the individual if they are transferred to another facility for care
-and treatment. The individual and facility personnel shall sign the inventory form
-indicating that all items were returned or that all items were present in the bag for
-transport.
-
-B.
-
-For the purpose of Article 65 of Title 27, C.R.S., the treatment by prayer in the practice of religion
-of any church that teaches reliance on spiritual means alone for healing is considered a form of
-treatment.
-
-C.
-
-Any individual receiving an evaluation or treatment pursuant to Article 65 of Title 27, C.R.S., may
-petition the court pursuant to Section 13-45-102, C.R.S., for release to a less restrictive setting
-within or without a treating facility or release from a treating facility when adequate medical and
-psychiatric care and treatment are not administered;
-1.
-
-If at any time during an emergency mental health hold of an individual who is confined
-involuntarily the facility personnel requests the individual to sign in voluntarily and the
-individual elects to do so, the following advisement shall be given orally and in writing and
-an appropriate notation shall be made in the individual’s medical record by the
-professional person or the professional person’s designee (this does not apply to an
-individual on an emergency mental health hold in an emergency medical services
-facility):
-
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-
-2 CCR 502-1
-
-“NOTICE
-The decision to sign in voluntarily should be made by you alone and should be free from
-any force or pressure implied or otherwise. If you do not feel that you are able to make a
-truly voluntary decision, you may continue to be held at the hospital involuntarily. As an
-involuntary individual, you will have the right to protest your confinement and request a
-hearing before a judge.”
-11.14.5 Individual Rights for Receiving Individuals on Emergency Mental Health Holds
-A.
-
-Each person receiving evaluation, care, or treatment pursuant to any provision of Article 65 of
-Title 27, C.R.S., has the individual rights specified in part 11.14.3 of this Chapter and shall be
-provided with a written copy and advised of such rights by the facility.
-
-B.
-
-A facility may temporarily restrict an individual's access to personal clothing or personal
-possessions until a safety assessment is completed. If the facility restricts an individual's access
-to personal clothing or personal possessions, the facility shall have a discussion with the
-individual about why the individual's personal clothing or personal possessions are being
-restricted and document this in the chart.
-
-C.
-
-The individual may keep and use their cell phone, unless access to the cell phone causes the
-individual to destabilize or creates a danger to the individual's self or others, as determined by a
-provider, facility personnel member, or security personnel involved in the individual's care. If a cell
-phone is restricted, the reason for this must be explained to the individual and documented in the
-chart.
-
-D.
-
-An individual's rights may only be denied if access to the item, program, or service causes the
-individual to destabilize or creates a danger to the individual's self or others, as determined by a
-licensed provider involved in the individual's care or transportation. Denial of any right must be
-entered into the individual's treatment record or BHA-approved form available on the BHA
-website. Information pertaining to a denial of rights contained in the individual's treatment record
-must be made available, upon request, to the individual, the individual's attorney, or the
-individual's lay person.
-1.
-
-Once the screening is completed and if the individual continues to meet criteria for an
-emergency mental health hold, the intervening professional shall first pursue voluntary
-treatment and evaluation. If the individual refuses or the intervening professional has
-reasonable grounds to believe the individual will not remain voluntarily, the intervening
-professional may keep the individual under an emergency mental health hold pursuant to
-Section 27-65-106, C.R.S.
-
-11.14.6 Procedures for Subsequent Emergency Mental Health Holds
-A.
-
-If the facility places the individual under a subsequent emergency mental health hold, the facility
-shall immediately notify the BHA, the individual's lay person, and the court, and the court shall
-immediately appoint an attorney to represent the individual. The facility may notify the court
-where the individual resides by mail.
-
-11.14.7 Procedures for Individuals Who Meet Criteria for an Emergency Mental Health Hold but
-Require Inpatient Medical Treatment Prior to Placement
-A.
-
-If an individual meets criteria for an emergency mental health hold but requires medical treatment
-prior to being placed psychiatrically, they may receive treatment on a medical unit of the same
-hospital under the following conditions:
-
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-
-1.
-
-Unless the medical unit is designated for 27-65 services by the BHA, the hospital must
-follow the hospital’s policies and procedures for ensuring individual safety while receiving
-medical services.
-
-2.
-
-Reasonable efforts shall be made to ensure ligature risk is minimized in the individual’s
-room on the medical unit; these efforts shall be documented in the individual’s clinical
-record.
-
-11.15
-
-Additional Procedures for Minors
-
-A.
-
-This section 11.15 is meant to provide a summary of the obligations and standards set forth in
-Section 27-65-101 through -131, C.R.S., with regard to minors. This section is only enforceable
-with regard to designated facilities.
-
-11.15.1 Consent and Rights of a Minor
-A.
-
-B.
-
-Notwithstanding any other provision of law, a minor who is fifteen (15) years of age or older,
-whether with or without the consent of a parent or legal guardian, may consent to receive mental
-health services to be rendered by a facility, a professional person, or mental health professional
-licensed pursuant to Parts 3, 4, 5, 6, or 8 of Article 245 of Title 12, C.R.S., in any practice setting.
-1.
-
-Such consent is not subject to disaffirmance because of age.
-
-2.
-
-The professional person or licensed mental health professional rendering mental health
-services to a minor may, with or without the consent of the minor, advise the minor’s
-parent or legal guardian of the services given or needed.
-
-Any individual receiving evaluation or treatment pursuant to any of the provisions of Article 65 of
-Title 27, C.R.S., is entitled to a written copy of all the corresponding designated service
-individual’s rights enumerated and a minor child shall receive written notice of the minor’s rights
-as provided. The list of rights must be prominently posted in all evaluation and treatment facilities.
-Minor’s rights include:
-1.
-
-To refuse to sign the admission consent form; and,
-
-2.
-
-To revoke consent of treatment at a later date;
-a.
-
-If minor’s consent is revoked after admission, a review of the minor’s need for
-hospitalization must be initiated immediately
-
-3.
-
-Nothing in part 11.15 of these rules limits a minor’s right to seek release from the facility
-pursuant to any other provision of law.
-
-4.
-
-Services shall be suited to meet the individual’s needs, delivered in such a way as to
-keep the individual in the least restrictive environment, and delivered in such a way as to
-include the opportunity for participation of family members in the individual’s program of
-care and treatment, when appropriate.
-
-11.15.2 Hospitalization Treatment Procedures for Minors
-A.
-
-The following treatment procedures apply to any minor receiving evaluation, care, or treatment
-pursuant to Article 65 of Title 27, C.R.S. and must be explained to the individual and provided in
-written form:
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-
-1.
-
-A minor who is fifteen (15) years of age or older or a minor’s parent or legal guardian, on
-the minor’s behalf, may make a voluntary application for hospitalization.
-
-2.
-
-An application for hospitalization on behalf of a minor who is under fifteen (15) years of
-age and who is a ward of the Department must not be made unless a guardian ad litem
-has been appointed for the minor or a petition for the same has been filed with the court
-by the facility having custody of the minor; except that such an application for
-hospitalization may be made under emergency circumstances requiring immediate
-hospitalization, in which case the facility shall file:
-a.
-
-A petition for appointment of a guardian ad litem within seventy-two (72) hours
-after application for admission is made,
-
-b.
-
-And the court shall immediately appoint a guardian ad litem.
-
-c.
-
-Procedures for hospitalization of a minor may proceed pursuant to this section
-once a petition for appointment of a guardian ad litem has been filed, if
-necessary.
-
-3.
-
-Whenever an application for hospitalization is made, an independent professional person
-shall interview the minor and conduct a careful investigation into the minor’s background,
-using all available sources, including, but not limited to, the minor’s parents or legal
-guardian, the minor’s school, and any other social service facilities.
-
-4.
-
-Prior to admitting a minor for hospitalization, the independent professional person shall
-make the following findings:
-a.
-
-That the minor has a mental health disorder and is in need of hospitalization;
-
-b.
-
-That a less restrictive treatment alternative is inappropriate or unavailable; and,
-
-c.
-
-That hospitalization is likely to be beneficial, improve condition and/or prevent
-further regression.
-
-5.
-
-An interview and investigation by an independent professional person is not required for
-a minor who is fifteen (15) years of age or older and who, upon the recommendation of
-the minor’s treatment professional person, seeks voluntary hospitalization with the
-consent of the minor’s parent or legal guardian.
-
-6.
-
-A need for voluntary continued hospitalization must be formally reviewed every two (2)
-months and must fulfill the requirements of Section 19-1-115(8), C.R.S., when the minor
-is fifteen (15) years of age or older and consenting to hospitalization.
-a.
-
-Review must be conducted by an independent professional person who is not a
-member of the minor’s treatment team; or if the minor, minor’s physician, and the
-minor’s parent or legal guardian do not object to the need for continued
-hospitalization, the review required may be conducted internally by hospital
-personnel.
-
-b.
-
-The independent professional person shall determine whether the minor
-continues to meet the criteria specified in part 11.15.2.A.1 through part
-11.15.2.A.4 of this Chapter and whether continued hospitalization is appropriate
-and shall, at a minimum, conduct an investigation pursuant to this part
-11.15.2.A.1 through part 11.15.2.A.4 of these rules.
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-
-c.
-
-7.
-
-2 CCR 502-1
-
-Ten (10) days prior to the review, the patient representative at the mental health
-facility shall notify the minor of the date of the review and shall assist the minor in
-articulating to the independent professional person the minor’s wishes
-concerning continued hospitalization.
-
-Every six (6) months the review required pursuant to part 11.15.2.A.6 of this Chapter of
-this section shall be conducted by an independent professional person who is not a
-member of the minor’s treating team and who has not previously reviewed the minor
-pursuant to part 11.15.2.A.6 of this Chapter.
-
-11.15.3 Objection to Hospitalization Process for Minors
-A.
-
-When a minor does not consent to or objects to continued hospitalization, the need for such
-continued hospitalization must, within ten (10) days, be reviewed pursuant to part 11.15.2.A.6 of
-this Chapter by an independent professional person who is not a member of the minor’s
-treatment team and who has not previously reviewed the minor pursuant to part 11.15.3.A of this
-Chapter.
-1.
-
-The minor shall be informed of the results of the review within three (3) days after the
-review’s completion.
-a.
-
-If the conclusion reached by the professional person is that the minor no longer
-meets the standards for hospitalization specified in part 11.15.2.A.1 through part
-11.15.2.A.4 of this Chapter, the minor shall be discharged with clinically indicated
-discharge planning and notice to parent, guardian, or caregiver, as appropriate.
-
-B.
-
-If twenty-four (24) hours after being informed of the results of the review specified in part
-11.15.3.A of this Chapter, a minor continues to affirm the objection to hospitalization, the facility
-director or the director’s duly appointed representative shall advise the minor that the minor has
-the right to retain and consult with an attorney at any time and that the director or the director’s
-duly appointed representative shall file, within three (3) days after the request of the minor, a
-statement requesting an attorney for the minor or, if the minor is under fifteen (15) years of age, a
-guardian ad litem. The minor, the minor’s attorney (if any) and the minor’s parent, legal guardian,
-or guardian ad litem (if any) shall be given written notice that a hearing upon the recommendation
-for continued hospitalization may be had before the court or a jury upon written request directed
-to the court pursuant to part 11.15.3.D of this Chapter.
-
-C.
-
-Whenever the statement requesting an attorney is filed with the court, the court shall ascertain
-whether the minor has retained an attorney, and, if the minor has not, the court shall, within three
-(3) days, appoint an attorney to represent the minor, or if the minor is under fifteen (15) years of
-age, a guardian ad litem. Upon receipt of a petition filed by the guardian ad litem, the court shall
-appoint an attorney to represent the minor under fifteen years of age.
-
-D.
-
-The minor or the minor’s attorney or guardian ad litem may, at any time after the minor has
-continued to affirm the minor’s objection to hospitalization pursuant to part 11.15.3.B of this
-Chapter, file a written request that the recommendation for continued hospitalization be reviewed
-by the court or that the treatment be on an outpatient basis. If review is requested, the court shall
-hear the matter within ten (10) days after the request, and the court shall give notice of the time
-and place of the hearing to the minor; the minor’s attorney (if any), the minor’s parents or legal
-guardian; the minor’s guardian ad litem (if any), the independent professional person, and the
-minor's treatment team. The hearing must be held in accordance with Section 27-65-113, C.R.S.;
-except that the court or jury shall determine that the minor is in need of care and treatment if the
-court or jury makes the following findings:
-1.
-
-That the minor has a mental health disorder and is in need of hospitalization;
-
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-
-2.
-
-That a less restrictive treatment alternative is inappropriate or unavailable; and,
-
-3.
-
-That hospitalization is likely to be beneficial.
-
-E.
-
-At the conclusion of the hearing, the court may enter an order confirming the recommendation for
-continued hospitalization, discharge the minor, or enter any other appropriate order.
-
-F.
-
-A minor may not again object to hospitalization pursuant to this part 11.15.3 until ninety (90) days
-after conclusion of proceedings.
-
-G.
-
-In addition to the rights specified in Section 27-65-119, C.R.S. for individuals receiving evaluation,
-care, or treatment, a written notice specifying the rights of minor children under this section must
-be given to each minor upon admission to hospitalization.
-
-H.
-
-A minor who no longer meets the standards for hospitalization specified in this part 11.15 must be
-discharged.
-
-11.16
-
-Involuntary Short-Term and Long-Term Care and Treatment Designation (Inpatient
-Services)
-
-11.16.1 Applicability
-A.
-
-The involuntary short-term and long-term care and treatment designation allows facilities to
-provide care and treatment to individuals on involuntary mental health holds, short-term
-certifications, and long-term certifications on an inpatient basis.
-
-B.
-
-Facilities designated for involuntary short-term and long-term services must be in compliance with
-the following rules:
-1.
-
-Parts 2.7 through 2.13 and parts 2.23 through 2.25 of these rules with the following
-exception:
-a.
-
-2.
-
-Part 2.7.A.3 of these rules
-
-Parts 11.1 through 11.15 and 11.16 of this Chapter.
-
-C.
-
-Facilities that may become designated to provide involuntary short-term and long-term care and
-treatment include acute treatment units (ATU). Crisis stabilization units (CSU), residential child
-care facilities, and hospitals. ATUs must become designated to meet the requirements of their
-service endorsement.
-
-D.
-
-This section 11.16 is meant, in part, to provide a summary of the obligations and standards set
-forth in Section 27-65-101 through -131, C.R.S., with regard to involuntary short-term care and
-treatment. This section is only enforceable with regard to designated facilities.
-
-11.16.2 Procedures for Emergency Mental Health Holds
-A.
-
-With every emergency mental health hold and petition to court for involuntary treatment resulting
-in a change of legal status, the facility shall advise an individual of their rights set forth in part
-11.16.5 of this Chapter, and there shall be evidence of such advisement in the individual’s clinical
-record.
-
-B.
-
-Procedures for emergency mental health holds may be found in part 11.14 of this Chapter.
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-
-11.16.3 Procedures for Short-Term Certifications on an Inpatient Basis
-A.
-
-An individual may be certified for not more than three (3) months for short-term treatment under
-the following conditions:
-1.
-
-The professional personnel of the facility detaining the individual on an emergency
-mental health hold has evaluated the individual and has found that the individual has a
-mental health disorder and, as a result of the mental health disorder, is a danger to the
-individual’s self or others or is gravely disabled;
-
-2.
-
-The individual has been advised of the availability of, but has not accepted, voluntary
-treatment; but, if reasonable grounds exist to believe that the individual will not remain in
-a voluntary treatment program, the individual’s acceptance of voluntary treatment does
-not preclude certification;
-
-3.
-
-The facility or community provider that will provide short-term treatment has been
-designated by the commissioner to provide such treatment; and,
-
-4.
-
-The individual, the individual’s legal guardian, and the individual’s lay person, if
-applicable, have been advised of the individual’s right to an attorney and right to contest
-the certification for short-term treatment. [effective July 1, 2024]
-
-B.
-
-The facility is responsible for ensuring the individual receive all court paperwork (or ensuring the
-attorney has provided it).
-
-C.
-
-The facility or court shall ask the individual to designate a lay person whom the individual wishes
-to be informed regarding certification. If the individual is incapable of making such a designation
-at the time the certification is delivered, the individual must be asked to designate a lay person as
-soon as the individual is capable.
-
-D.
-
-In addition to the certification, the individual must be given a written notice that a hearing upon the
-individual’s certification for short-term treatment may be had before the court or a jury upon
-written request directed to the court pursuant to Section 27-65-109(6), C.R.S.
-
-E.
-
-The notice of certification must be signed by a professional person who participated in the
-evaluation. The notice of certification must:
-1.
-
-State facts sufficient to establish reasonable grounds to believe that the individual has a
-mental health disorder and, as a result of the mental health disorder, is a danger to the
-individual’s self or others or is gravely disabled;
-
-2.
-
-Be filed with the court within forty-eight (48) hours, excluding Saturdays, Sundays, and
-court holidays, after the date of the certification;
-
-3.
-
-Be filed with the court in the county in which the individual resided or was physically
-present immediately prior to being taken into custody;
-
-4.
-
-Provide recommendations if the certification should take place on an inpatient or
-outpatient basis [effective July 1, 2024]; and
-
-5.
-
-Within twenty-four (24) hours after the date of certification, copies of the certification must
-be personally delivered from the evaluating facility to the individual, the BHA, and a copy
-must be kept by the evaluating facility as part of the individual’s record, if applicable.
-
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-
-F.
-
-Upon certification of the individual, the facility designated for short-term treatment has custody of
-the individual.
-
-G.
-
-The individual or the individual’s attorney may at any time file a written request that the
-certification for short-term treatment or the treatment be reviewed by the court or that the
-treatment be on an outpatient basis.
-1.
-
-If the individual requests the review, the court shall hear the matter within ten (10) days
-after the request, and the court shall give notice to the individual and the individual’s
-attorney and the certifying and treating professional person of the time and place of the
-hearing.
-
-2.
-
-The hearing must be held in accordance with Section 27-65-113, C.R.S.
-
-3.
-
-At the conclusion of the hearing, the court may enter or confirm the certification for shortterm treatment, discharge the individual, or enter any other appropriate order.
-a.
-
-Upon the release of any individual in accordance with Section 27-65-112, C.R.S.,
-the facility shall notify the clerk of the court within five (5) days after the release.
-
-4.
-
-If the professional person in charge of the evaluation and treatment believes that a period
-longer than three (3) months is necessary to treat the individual, the professional person
-shall file with the court an extended certification at least thirty (30) days prior to the
-expiration date of the original certification.
-
-5.
-
-An extended certification for treatment must not be for a period of more than three (3)
-months.
-
-6.
-
-The individual is entitled to a hearing on the extended certification under the same
-conditions as an original certification. The attorney initially representing the individual
-shall continue to represent the individual unless the court appoints another attorney.
-
-H.
-
-An individual certified for short-term treatment may be discharged upon the signature of the
-treating medical professional and the medical director of the facility.
-
-I.
-
-A facility or program shall make the individual’s discharge instructions available to the individual,
-the individual's attorney, and the individual’s legal guardian, if applicable, within seven (7) days
-after discharge, if requested.
-1.
-
-A facility or program that is transferring an individual to a different treatment facility or to
-an outpatient provider shall provide all treatment records to the facility or provider
-accepting the individual at least twenty-four (24) hours prior to the transfer.
-
-11.16.4 Procedures for Long-Term Certifications on an Inpatient Basis
-A.
-
-The facility is responsible for ensuring the individual receives all court paperwork (or ensuring the
-attorney has provided it).
-
-B.
-
-Whenever an individual has received an extended certification for treatment pursuant to Section
-27-65-109(10), C.R.S., the professional person in charge of the certification for short-term
-treatment or the BHA may file a petition with the court at least thirty (30) days prior to the
-expiration date of the extended certification for long-term care and treatment of the individual
-under the following conditions:
-
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-
-C.
-
-2 CCR 502-1
-
-1.
-
-The professional personnel of the facility or facility providing short-term treatment has
-analyzed the individual’s condition and has found that the individual has a mental health
-disorder and, as a result of the mental health disorder, is a danger to the individual’s self
-or others or is gravely disabled;
-
-2.
-
-The individual has been advised of the availability of, but has not accepted, voluntary
-treatment; but, if reasonable grounds exist to believe that the individual will not remain in
-a voluntary treatment program, the individual’s acceptance of voluntary treatment does
-not preclude an order pursuant to this section; and
-
-3.
-
-The facility that will provide long-term care and treatment has been designated by the
-commissioner to provide the care and treatment.
-
-Every petition for long-term care and treatment must include a request for a hearing before the
-court filed thirty (30) calendar days prior to the expiration of six (6) months after the date of
-original certification and provide a recommendation as to whether the certification for long-term
-care and treatment should take place on an inpatient or outpatient basis.
-1.
-
-A copy of the petition must be delivered personally to the individual for whom long-term
-care and treatment is sought and electronically delivered to the individual’s attorney of
-record simultaneously with the filing.
-
-D.
-
-Within ten (10) days after receipt of the petition, the individual or the individual’s attorney may
-request a hearing before the court or a jury trial by filing a written request with the court.
-
-E.
-
-The court or jury shall determine whether the conditions of this part 11.16.4, are met and whether
-the individual has a mental health disorder and, as a result of the mental health disorder, is a
-danger to the individual’s self or others or is gravely disabled.
-
-F.
-
-The court shall issue an order of long-term care and treatment for a term not to exceed six (6)
-months, discharge the individual for whom long-term care and treatment was sought, or enter any
-other appropriate order.
-
-G.
-
-An order for long-term care and treatment must grant physical custody of the individual to the
-BHA for placement with a facility or facility designated by the commissioner to provide long-term
-care and treatment. The BHA may delegate the physical custody of the individual to a facility
-designated by the commissioner and the requirement for the provision of services and care
-coordination.
-
-H.
-
-When a petition contains a request that a specific legal disability be imposed or that a specific
-legal right be deprived, the court may order the disability imposed or the right deprived if the court
-or a jury has determined that the individual has a mental health disorder or is gravely disabled
-and that, as a result, the individual is unable to competently exercise the specific legal right or
-perform the function for which the disability is sought to be imposed.
-1.
-
-I.
-
-Any interested person may ask leave of the court to intervene as a co petitioner for the
-purpose of seeking the imposition of a legal disability or the deprivation of a legal right.
-
-An original order of long-term care and treatment or any extension of such order expires on the
-date specified, unless further extended as provided in this part 11.16.4.
-
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-
-J.
-
-K.
-
-If an extension is being sought, the professional person in charge of the evaluation and treatment
-shall certify to the court at least thirty (30) days prior to the expiration date of the order in force
-that an extension of the order is necessary for the care and treatment of the individual subject to
-the order in force, and a copy of the certification must be simultaneously delivered to the
-individual and electronically delivered to the individual’s attorney of record.
-1.
-
-At least twenty (20) days before the expiration of the order, the court shall give written
-notice to the individual and the individual’s attorney of record that a hearing upon the
-extension may be had before the court or a jury upon written request to the court within
-ten (10) days after receipt of the notice.
-
-2.
-
-If a hearing is not requested by the individual within such time, the court may proceed ex
-parte.
-
-3.
-
-If a hearing is timely requested, the hearing must be held before the expiration date of the
-order in force.
-
-4.
-
-If the court or jury finds that the conditions of this part 11.16 continue to be met and that
-the individual has a mental health disorder and, as a result of the mental health disorder,
-is a danger to others or to the individual’s self or is gravely disabled, the court shall issue
-an extension of the order.
-
-5.
-
-Any extension must not exceed six (6) months, but there may be as many extensions as
-the court orders pursuant to this section.
-
-An individual certified for long-term care and treatment may be discharged from the facility upon
-the signature of the treating professional person and medical director of the facility, and the
-facility shall notify the BHA prior to the individual’s discharge.
-1.
-
-L.
-
-2 CCR 502-1
-
-The facility shall make the individual’s discharge instructions available to the individual,
-the individual’s attorney, the individual’s lay person, and the individual’s legal guardian, if
-applicable, within one (1) week after discharge, if requested.
-
-A facility that is transferring an individual to a different facility or to an outpatient program shall
-provide all treatment records to the facility or provider accepting the individual at least twenty-four
-(24) hours prior to the transfer.
-
-11.16.5 Individual Rights for Short-Term and Long-Term Care Treatment
-A.
-
-The facility shall furnish all persons receiving evaluation, care, or treatment under any provisions
-of Article 65 of Title 27, C.R.S., with a written copy of the rights listed under part 11.14.3 of this
-Chapter (translated into a language or modality accessible that the individual understands if
-feasible) upon admission. If the individual is not able to read the rights, the individual shall be
-read the rights in a language that the individual understands, if feasible, or provided access to a
-modality to assist in understanding. Minors must receive a separate written notice of individual
-rights as outlined in Section 27-65-104, C.R.S.
-
-B.
-
-The facility shall post the following list of rights (in the predominant languages of the community in
-which it operates and explained, if feasible, in a language or modality accessible to the individual)
-in prominent places frequented by individuals and their families receiving services and the facility
-shall assist the individual in exercising the below rights, in addition to the rights found in part
-11.14.3 of this Chapter:
-1.
-
-To meet with or call a personal clinician, spiritual advisor, counselor, crisis hotline, family
-member, workplace, childcare provider, or school at all reasonable times;
-
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-
-2.
-
-To receive and send sealed correspondence, as well as to be given the assistance of
-facility personnel if the individual is unable to write, prepare, or mail correspondence.
-Facility personnel shall not open, delay, intercept, read, or censor mail or other
-communications or use mail or other communications as a method to enforce compliance
-with facility personnel;
-a.
-
-To have access to letter-writing materials, including postage, and to have
-personnel members of the facility assist the individual if the individual is unable to
-write, prepare, and mail correspondence;
-
-3.
-
-To have the individual’s behavioral health orders for scope of treatment or psychiatric
-advance directive reviewed and considered by the court as the preferred treatment option
-for involuntary administration of medications unless, by clear and convincing evidence,
-the individual’s directive does not qualify as effective participation in behavioral health
-decision making;
-
-4.
-
-To have frequent and convenient opportunities to meet with visitors and to see the
-individual’s attorney, clergyperson, or physician at any time;
-a.
-
-The facility may not deny visits by the individual’s attorney, religious
-representative or physician at any reasonable time.
-
-b.
-
-The facility will provide privacy to maintain confidentiality of communication
-between an individual and spouse or significant other, family member(s),
-personnel, attorney, physician, certified public accountant and religious
-representative, except that if disclosure is required by law, then such privacy may
-be terminated;
-
-5.
-
-To have personal privacy to the extent possible during the course of treatment; and,
-
-6.
-
-To have access to a representative within the facility who provides assistance to file a
-grievance.
-
-7.
-
-An individual may be photographed upon admission for identification and the
-administrative purposes of the facility. The photographs are confidential and must not be
-released by the facility except pursuant to court order.
-a.
-
-C.
-
-2 CCR 502-1
-
-Nonmedical photographs shall not be taken or used without appropriate consent
-or authorization.
-
-Facilities providing care and treatment to minors shall post the minor’s rights information of
-section 11.15.1, in addition to the following list of rights (in languages and modality appropriate for
-understanding) in prominent places frequented by individuals and their families receiving
-services.
-
-11.16.6 Individual Rights Restrictions for Short-Term and Long-Term Care Treatment
-A.
-
-As set forth in Section 27-65-119, C.R.S., an individual’s statutory rights, and rights listed in parts
-11.14.3 and 11.16.5 of this Chapter, may be limited or denied if access to the right would
-endanger the safety of the individual or another person in close proximity and may only be denied
-by a person involved in the individual’s care.
-1.
-
-A person involved in the individual’s care means a person that is either providing care
-directly to the individual or directing the care of the individual.”
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-
-B.
-
-Any individual whose rights are denied or violated pursuant to this section has the right to file a
-complaint against the facility with the BHA and the Department of Public Health and Environment.
-
-C.
-
-Except as otherwise provided in part 11.16.6.A of this Chapter, each denial of an individual’s right
-shall be made on a case-by-case basis and the reason for denying the right shall be documented
-in the individual record and shall be made available, upon request, to the individual, the
-individual’s legal guardian, or the individual’s attorney.
-
-D.
-
-Except as otherwise provided in part 11.16.6.A of this Chapter, restrictions on rights in parts
-11.14.3.A.9, 11.14.3.A.10, 11.14.3.A.15, 11.14.3.A.17, and 11.14.3.A.19 and part 11.16.5.B.1 of
-this Chapter, shall be evaluated for therapeutic necessity on an ongoing basis and the rationale
-for continuing the restriction shall be documented at least every seven (7) calendar days.
-
-E.
-
-A facility shall not intentionally retaliate or discriminate against a person or employee for
-contacting or providing information to any official or to an employee or any state protection and
-advocacy facility, or for initiating, participating in, or testifying in a grievance procedure or in an
-action for any remedy authorized pursuant to this this section.
-1.
-
-Under Section 27-65-119(6), C.R.S., any facility that violates this commits an unclassified
-misdemeanor and shall be fined not more than one thousand dollars.
-
-11.16.7 Individual Rights Restrictions in Secure Treatment Facilities
-A.
-
-A facility, through a professional person treating individuals in a secure treatment setting may limit
-or deny rights listed in this Chapter for good cause based upon the safety and security needs of
-the personnel and other individuals in the facility. Safety and security policies applicable to the
-unit shall be incorporated into the individual’s service plan. The following procedures shall be
-adhered to:
-1.
-
-The BHA shall approve of safety and security policies for each facility unit that places any
-limit on the rights set forth in part 11.16 of this Chapter, as well as the policy and criteria
-for placement of an individual committed under Article 65 of Title 27, C.R.S., in secure
-treatment facilities.
-
-2.
-
-The safety and security policies for each facility unit shall be posted in the unit. The
-secure facility personnel shall provide a copy of the unit policy upon an individual’s
-request.
-
-3.
-
-Any good cause restriction of rights based upon the safety and security policy of the
-facility unit shall be noted in the individual’s record. The order for restriction shall be
-signed by the professional person providing care and treatment and shall be reviewed at
-least every thirty (30) days.
-
-4.
-
-No safety or security policy may limit an individual’s ability to send or receive sealed
-correspondence. However, to prevent the introduction of contraband into the secure
-treatment facility, the policy may require that the individual open the correspondence in
-the presence of unit personnel.
-
-5.
-
-No safety or security policy may limit an individual’s right to see their attorney, clergy, or
-physician at reasonable times. However, the safety and security policy may provide that
-advance notice be given to the secure treatment facility for such visits so that the secure
-facility can adequately personnel for the private visit and take any measures necessary to
-ensure the safety of the visit.
-
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-6.
-
-2 CCR 502-1
-
-For the purposes of this rule, placement of individuals in secure treatment facilities on
-units that are locked at night:
-a.
-
-Individuals transferred to a secure treatment facility from the Department of
-Corrections, who are serving sentences in the Department of Corrections, may
-be placed on units in which the bedroom doors are locked during sleeping hours.
-
-b.
-
-Individuals who are newly admitted to a secure treatment facility may be placed
-on units in which the bedroom doors are locked during sleeping hours, for a time
-period not to exceed sixty (60) calendar days. After sixty (60) calendar days,
-these individuals will not be placed on a unit with locked doors during sleeping
-hours unless an individualized assessment is made, and the treatment team
-determines that the individual is imminently dangerous to self or to others; this
-must be documented in the individual’s record.
-
-c.
-
-Sleeping hours shall begin no earlier than 9:00 p.m., end no later than 8:00 a.m.,
-and shall not exceed 8-1/2 hours.
-
-d.
-
-Individuals shall be provided an effective means of calling for assistance when in
-a locked room during sleeping hours. The secure treatment facility shall provide
-personnel to promptly assist an individual with their individual needs including,
-but not limited to, personnel assigned to a day hall where personnel will be able
-to hear and respond to individuals who knock on their room doors. An intercom
-call system may also be used. Personnel shall monitor each individual’s wellbeing through visual observation checks every fifteen (15) minutes.
-
-e.
-
-As set forth in Section 27-65-127, C.R.S., an individual's rights may be limited or
-denied under court order by an imposition of legal disability or deprivation of a
-right.
-
-f.
-
-Information pertaining to the denial of any right shall be made available, upon
-request, to the individual or their attorney.
-
-11.16.8 Admissions Requirements & Disclosures
-A.
-
-The facility shall develop written admission criteria based on the facility’s ability to meet the
-individual’s needs. Admission criteria shall be based upon a comprehensive assessment of the
-individual’s mental health, physical health, substance use, and capacity for self- care. The
-assessment shall determine the level of intervention and supervision required, including
-medication management, behavioral health services and stabilization prior to return to the
-community.
-
-B.
-
-Acute treatment units shall not admit individuals with a mental health disorder into a locked
-setting unless there is no less restrictive alternative and unless they are otherwise in compliance
-with the requirements of Article 65 of Title 27, Colorado Revised Statutes.
-
-C.
-
-Individuals may be admitted to a locked setting as a voluntary or involuntary individual. If
-voluntary, the individual shall sign a form that documents the following information:
-1.
-
-The individual is aware that the facility is locked.
-
-2.
-
-The individual may exit the facility with personnel assistance and/or permission.
-
-3.
-
-The individual may leave the facility at any point in time, unless they present as a danger
-to self or others, or is gravely disabled as defined in Section 27-65-102(17), C.R.S.
-
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-4.
-
-D.
-
-An individual who is imminently suicidal or homicidal shall only be admitted to the locked
-facility, upon completion of the facility’s assessment and the facility’s determination that
-the individual’s safety and the safety of others can be maintained by the facility. If an
-individual is admitted and facility personnel determine that their behavior cannot be safely
-and successfully treated at the ATU, then personnel shall make arrangements to transfer
-the individual to the nearest hospital for further assessment and disposition.
-
-A facility shall not admit or keep any individual who meets the following exclusion criteria:
-1.
-
-Is consistently incontinent unless the individual or personnel is capable of preventing
-such incontinence from becoming a health hazard.
-
-2.
-
-Is under the age of eighteen (18) unless the facility has a separate locked unit dedicated
-to minors.
-
-3.
-
-Is bedridden with limited potential for improvement.
-
-4.
-
-Has a communicable disease or infection that is:
-
-5.
-
-E.
-
-2 CCR 502-1
-
-a.
-
-Reportable under the Department of Public Health and Environment's regulations
-(6 CCR 1009-1 (6/14/2023) and 6 CCR 1009-2 (05/15/2023)) which are hereby
-incorporated by reference. No later editions or amendments are incorporated.
-The rules are available at no cost from the Colorado Secretary of State at
-https://www.sos.state.co.us. Individuals may inspect a copy at the Behavioral
-Health Administration, 710 S. Ash Street, Unit C140, Denver, CO 80246, during
-regular business hours); and
-
-b.
-
-Potentially transmittable in a facility unless the individual is receiving medical or
-drug treatment for the condition and the admission is approved by a physician.
-
-Has acute withdrawal symptoms, is at risk of withdrawal symptoms, or is incapacitated
-due to a substance use disorder and facility does not have appropriate
-capacity/endorsements to address issues of withdrawal.
-
-The facility shall maintain a current list of individuals and their assigned room.
-
-11.16.9 Required Disclosures to Individuals Upon Admission
-A.
-
-There shall be written evidence of consent to treat, and the following upon admission to the
-individual or individual’s legal representative, as appropriate. Acknowledgements shall specify the
-understanding between the parties regarding, at a minimum:
-1.
-
-Charges;
-
-2.
-
-Services included in the rates and charges;
-
-3.
-
-Types of services provided by the facility, those services which are not provided, and
-those which the facility will assist the individual in obtaining;
-
-4.
-
-Transportation services;
-
-5.
-
-Therapeutic diets;
-
-6.
-
-A physically safe and sanitary environment;
-
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-
-7.
-
-Personal services;
-
-8.
-
-Protective oversight;
-
-9.
-
-Presence and purpose of any video monitoring;
-
-10.
-
-Social and recreational activities;
-
-11.
-
-A provision that the facility must give individuals thirty (30) calendar days’ notice of
-closure;
-
-12.
-
-Management of personal funds and property;
-
-13.
-
-Facility rules, established pursuant to part 11.16.11 of this Chapter;
-
-14.
-
-Staffing levels based on individual needs; and
-
-15.
-
-Types of daily activities, including examples of such activities that will be provided.
-
-11.16.10
-
-Environment and Safety
-
-A.
-
-All individuals being treated under these regulations shall receive such treatment in a clean and
-safe environment with opportunities for privacy.
-
-B.
-
-A facility shall only place an individual in a bedroom with video monitoring due to good cause and
-safety or security reasons which must be noted in the individual record. Individuals shall be
-notified in writing when placed in bedrooms with video monitoring capabilities.
-
-C.
-
-Each facility shall maintain reasonable security capabilities to guard against the risk of
-unauthorized departures. The least restrictive method to prevent an unauthorized departure shall
-be used.
-
-D.
-
-An unlocked facility may place an individual in seclusion to prevent an unauthorized departure
-when such departure carries an imminent risk of danger for the individual or for others. Under
-those circumstances, the seclusion procedures in part 11.9 of these rules shall be followed.
-
-11.16.11
-
-Facility rules
-
-A.
-
-The facility shall establish written policies, which shall list all possible actions that may be taken
-by the facility if any policy is knowingly violated by an individual. Facility policies may not violate
-or contravene any rule herein, or in any way discourage or hinder an individual’s rights.
-
-B.
-
-The facility shall prominently post its policies in writing, which shall be available at all times to
-individuals. Such policies shall address at least the following:
-1.
-
-Smoking;
-
-2.
-
-Cooking;
-
-3.
-
-Visitors;
-
-4.
-
-Telephone usage including frequency and duration of calls;
-
-5.
-
-Use of common areas, including the use of television, radio;
-
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-
-6.
-
-Consumption of alcohol and/or illicit drugs;
-
-7.
-
-Dress; and
-
-8.
-
-Pets, which shall not be allowed in the facility; however, in no event shall such rules
-prohibit service or guide animals.
-
-11.16.12
-
-Employment of Individuals Receiving Services in 27-65 Designated Facilities
-
-A.
-
-All labor, employment or jobs involving facility operation and maintenance which are of an
-economic benefit to the facility, shall be treated as work and shall be compensated according to
-applicable minimum wage or prevailing wage rates.
-
-B.
-
-Maintaining a minimum standard of cleanliness and personal hygiene and personal
-housekeeping, such as making one's bed or cleaning one's area, shall not be treated as work and
-shall not be compensated.
-
-C.
-
-Individuals shall not be forced in any way to perform work.
-
-D.
-
-Privileges or release from a designated facility shall not be conditioned upon the performance of
-work.
-
-E.
-
-Vocational programs and training programs must comply with all applicable federal and state
-laws.
-
-F.
-
-Vocational programs are not subject to the provisions in part 11.16.12.A of this section unless the
-program is of economic benefit to the facility.
-
-G.
-
-All work assignments, together with a specific consent form, and the hourly compensation
-received, shall be noted in the individual’s record.
-
-11.16.13
-A.
-
-Medical/Dental Care
-
-The facility shall ensure the availability of emergency medical and dental care to meet the
-individual needs of each individual. The obligation to ensure the availability of emergency medical
-services shall not be construed as the obligation to pay for such services; however, the facility
-shall secure these services regardless of source of payment. The facility shall have and adhere to
-a written plan for providing emergency medical and dental care to include at least:
-1.
-
-A qualified licensed independent practitioner responsible for the completion of physical
-examinations within twenty-four (24) hours of admission. Subsequent physical
-examinations shall be completed at least annually, and as frequently as needed. This
-information shall be included in the clinical record.
-a.
-
-If the individual refuses to complete a physical examination, documentation must
-be held in the clinical record of facility efforts.
-
-2.
-
-The availability of a qualified licensed independent practitioner or emergency medical
-facility on a twenty-four (24) hour, seven (7) days a week basis.
-
-3.
-
-Emergency medical or dental treatment, when indicated, shall be accessed immediately
-upon determination that an emergency exists.
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-4.
-
-2 CCR 502-1
-
-Whenever indicated, an individual shall be referred to an appropriate specialist for either
-further assessment or treatment. The facility shall be responsible for securing an
-appropriate assessment to determine the need for further specialty consultation. This
-information shall be contained in the clinical record.
-
-B.
-
-Each designated facility must maintain a facility placement agreement with one or more medical
-hospitals pursuant to part 11.12 of this Chapter.
-
-C.
-
-If an individual on an emergency mental health hold or certification requires inpatient medical
-care at a hospital, the designated facility shall be responsible for the care and treatment provided
-by the medical hospital per part 11.12 of this Chapter.
-
-D.
-
-The designated facility shall communicate with the hospital upon the individual being admitted to
-the medical unit regarding the individual’s psychiatric treatment needs, safety considerations, and
-managing ligature risk while the individual is hospitalized medically consistent with state and
-federal law.
-
-11.16.14
-A.
-
-Physical Health Assessment Policy
-
-The facility shall develop policies and procedures that identify when a physical health assessment
-by a qualified licensed independent practitioner will be required, including the following indicators:
-1.
-
-Within twenty-four (24) hours of admission;
-
-2.
-
-A significant change in the individual’s condition;
-
-3.
-
-Evidence of possible infection (open sores, etc.);
-
-4.
-
-Injury or accident sustained by the individual that might cause a change in the individual’s
-condition;
-
-5.
-
-Known exposure of the individual to a communicable disease; or
-
-6.
-
-Development of any condition that would have initially precluded admission to the facility.
-
-11.16.15
-
-Medication Storage, Disposition, and Disposal
-
-A.
-
-All personal medication must be surrendered to the facility to be logged in and stored by the
-facility. Individuals are not allowed to self-administer medication in the facility.
-
-B.
-
-Personal medication shall be returned to the individual or individual’s legal representative, upon
-discharge or death, except that return of medication to the individual may be withheld if specified
-in the individual’s service if a physician or other authorized medical practitioner has determined
-that the individual lacks the decisional capacity to possess or administer such medication safely.
-
-C.
-
-Medications shall be labeled with the individual’s full name, pursuant to Article 280 of Title 12,
-C.R.S.
-
-D.
-
-Any medication container that has a detached, excessively soiled, or damaged label shall be
-returned to the issuing pharmacy for re-labeling or disposed of appropriately.
-
-E.
-
-All medication shall be stored in a manner that ensures the safety of all individuals.
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-
-F.
-
-Medication shall be stored in a central location, including refrigerators, and shall be kept under
-lock and shall be stored in separate or compartmentalized packages, containers, or shelves for
-each individual in order to prevent intermingling of medication.
-
-G.
-
-Individuals shall not have access to medication that is kept in a central location.
-
-H.
-
-Medications that require refrigeration shall be stored separately in locked containers in the
-refrigerator. If medication is stored in a refrigerator dedicated to that purpose, and the refrigerator
-is in a locked room, then the medications do not need to be stored in locked containers.
-
-I.
-
-Prescription and over the counter medication shall not be kept in stock or bulk quantities unless
-such medication is administered by a licensed medical practitioner.
-
-J.
-
-Medication disposal procedures include:
-1.
-
-The return of medication shall be documented by the facility.
-
-2.
-
-Medication that has a specific expiration date shall not be administered after that date
-and shall be disposed of appropriately.
-
-11.16.16
-
-Medication Administration
-
-A.
-
-The facility must ensure that medications are administered only by licensed or certified personnel
-allowed to administer medications under their own scopes of practice, or an unlicensed personnel
-who are qualified medication administration persons (QMAPs) acting within their own scope of
-practice.
-
-B.
-
-When using QMAPs to administer medication, the facility shall ensure compliance with 6 CCR
-1011-1 Chapter 24 (July 19, 2017), which is hereby incorporated by reference. No later editions
-or amendments are incorporated. The rule is available at no cost from the Colorado Secretary of
-State at https://www.sos.state.co.us. Individuals may inspect a copy at the Behavioral Health
-Administration, 710 S. Ash Street, Unit C140, Denver, CO 80246, during regular business hours.
-
-C.
-
-Facilities shall follow psychiatric medication standards as outlined in part 11.8.2 of this Chapter
-and the following:
-1.
-
-Only a licensed nurse may accept telephone orders for medication from a physician or
-other authorized practitioner. All telephone orders shall be evidenced by a written and
-signed order and documented in the individual’s record and the facility’s medication
-administration record.
-
-2.
-
-These rules apply to medications and treatment which do not conflict with state law and
-regulations pertaining to acute treatment units and which are within the scope of services
-provided by the facility, as outlined in the individual agreement or the facility rules.
-
-3.
-
-The facility shall be responsible for complying with professional person or advanced
-practice registered nurse orders associated with the administration of medication or
-treatment. The facility shall implement a system that obtains clarification from the
-physician, as necessary and documents that the physician:
-a.
-
-Has been asked whether refusal of the medication or treatment should result in
-physician notification.
-
-b.
-
-Has been notified, where such notification is appropriate.
-
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-11.16.17
-
-2 CCR 502-1
-
-c.
-
-Has provided documentation of such notification shall be made in the individual’s
-clinical record.
-
-d.
-
-Coordinates with external providers or accepts responsibility to perform the care
-using facility personnel.
-
-e.
-
-Trains personnel regarding the parameters of the ordered care as appropriate.
-
-f.
-
-Documents the delivery of the care, including refusal by the individual, of the
-medication or treatment.
-
-Administration of Oxygen
-
-A.
-
-Individuals may administer oxygen, if the individual is able to manage the administration themself
-and personnel shall assist with the administration as needed for safety, when prescribed by a
-physician and if the facility follows appropriate safety requirements regarding oxygen herein.
-
-B.
-
-Oxygen tanks shall be secured upright at all times to prevent falling over and secured in a
-manner to prevent tanks from being dropped or from striking violently against each other.
-
-C.
-
-Tank valves shall be closed except when in use.
-
-D.
-
-Transferring oxygen from one container to another shall be conducted in a well-ventilated room
-with the door shut. Transfer shall be conducted by trained personnel or by the individual for whom
-the oxygen is being transferred, if the individual is capable of performing this task safely. When
-the transfer is being conducted, no person, except for a person conducting such transfer, shall be
-present in the room.
-
-E.
-
-Tanks and other oxygen containers shall not be exposed to electrical sparks, cigarettes, or open
-flames.
-
-F.
-
-Tanks shall not be placed against electrical panels or live electrical cords where the cylinder can
-become part of an electric circuit.
-
-G.
-
-Tanks shall not be rolled on their side or dragged.
-
-H.
-
-Smoking shall be prohibited in rooms where oxygen is used or stored. Rooms in which oxygen is
-used shall be posted with a conspicuous “no smoking” sign.
-
-I.
-
-Tanks shall not be stored near radiators or other heat sources. If stored outdoors, tanks shall be
-protected from weather extremes and damp ground to prevent corrosion.
-
-11.16.18
-
-Serious Illness, Serious Injury, or Death
-
-A.
-
-Facility policy shall describe the procedures to be followed by the facility in the event of serious
-illness, serious injury, or death of individuals receiving services, including incident reporting
-requirements.
-
-B.
-
-The policy shall include a requirement that the facility notify an emergency contact, if one has
-been provided, when the individual’s injury or illness warrants medical treatment or face-to-face
-medical evaluation. In the case of an emergency room visit or unscheduled hospitalization, a
-facility must notify an emergency contact immediately.
-
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-11.16.19
-
-2 CCR 502-1
-
-Service Provisions for Short-Term and Long-Term Care Treatment
-
-A.
-
-Facilities providing short-term and long-term care treatment shall have detailed policies and
-procedures specific to therapeutic programming provided to individuals while in the facility’s care.
-
-B.
-
-Programming shall be trauma-informed, person-centered, and appropriate for the individual’s
-diagnosis.
-
-C.
-
-Programming shall be documented in the individual’s treatment plan.
-
-D.
-
-Programming shall be facilitated by appropriate personnel for the type of therapeutic treatment
-provided.
-
-E.
-
-Programming can include the following, but is not limited to:
-1.
-
-Intensive case management;
-
-2.
-
-Assertive community treatment;
-
-3.
-
-Peer recovery support services;
-
-4.
-
-Individual therapy;
-
-5.
-
-Group therapy;
-
-6.
-
-Therapeutic activities;
-
-7.
-
-Educational and vocational training or activities;
-
-8.
-
-Housing and transportation assistance; and/or
-
-9.
-
-Transitional assistance.
-
-11.16.20
-A.
-
-Content of Records
-
-Records shall be kept in conformity with part 2.11 of these rules, applicable federal and state
-laws, and the following:
-1.
-
-Demographic and medical information;
-
-2.
-
-A cover sheet to contain the following information;
-a.
-
-Individual’s full name, including maiden name if applicable;
-
-b.
-
-Individual’s sex, date of birth, gender identity, marital status and social security
-number, where needed for Medicaid or employment purposes;
-
-c.
-
-Individual’s current address of residence;
-
-d.
-
-Date of admission;
-
-e.
-
-Name, address and telephone number of relatives or legal representative(s), or
-other person(s) to be notified in an emergency;
-
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-2 CCR 502-1
-
-f.
-
-Name, address and telephone number of individual’s primary physician, and
-case manager if applicable, and an indication of religious preference, if any, for
-use in emergency;
-
-g.
-
-Individual’s diagnoses, at the time of admission;
-
-h.
-
-Current record of the individual’s allergies;
-
-3.
-
-Medication administration record; and
-
-4.
-
-Physician’s orders.
-
-B.
-
-Initial and comprehensive assessments shall comply with the requirements of parts 2.12.2 and
-2.12.3 of these rules and must be completed within twenty-four (24) hours of admission.
-
-C.
-
-Service plans shall comply with the requirements of part 2.13.1 of these rules, and the following:
-
-D.
-
-1.
-
-The service plan shall contain specific criteria required for discharge from treatment or to
-progress to less restrictive treatment alternatives.
-
-2.
-
-If an individual is discharged during an emergency mental health hold without certification
-by the facility, and a service plan has not been completed, then pertinent information
-shall be included in the discharge summary.
-
-3.
-
-A physician or other legal prescriber shall be responsible for the component of the plan
-requiring medication management services.
-
-4.
-
-For individuals certified to short-term or long-term treatment, the service plan shall be
-reviewed, and revised, if necessary, at least monthly by the personnel responsible for the
-plan, the treating professional person, any additional personnel involved in care as the
-facility determines is necessary for the review, the individual, and the legal guardian. This
-review shall be documented in the record and include progress toward meeting the
-criteria for termination of treatment and the need for continued involuntary treatment if the
-individual is certified. If the monthly review is delayed, the reason for such delay shall be
-noted in the record and the review shall be completed as promptly as possible.
-
-Treatment progress notes shall include the following:
-1.
-
-Documentation of all treatment procedures including, but not limited to: brief physical
-restraint, seclusion, mechanical restraint, medications voluntary and involuntary, and
-other therapies or interventions.
-
-2.
-
-Information regarding the serious injury of or by the individual and the circumstances and
-outcome.
-
-3.
-
-Documentation of all transfers, whether permanent or temporary, and reasons for
-transfer.
-
-4.
-
-Legal status and all legal documents related to treatment under Section 27-65-101
-through -131, C.R.S.
-
-5.
-
-Consultations and/or case reviews.
-
-6.
-
-Pertinent information from outside facilities or persons or from the individual.
-
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-
-E.
-
-7.
-
-Correspondence to and from relevant facilities and persons.
-
-8.
-
-Consent forms as appropriate for alternative treatments or voluntary treatment.
-
-9.
-
-Use or non-use of psychiatric and medical advance directives.
-
-Discharge information provided to the individual shall include the requirements of part 2.10.A.6.
-Of these rules, and the following:
-1.
-
-F.
-
-a.
-
-At least twenty-four (24) hours in advance of discharge or transfer, in accordance
-with the rules governing the care and treatment of persons with a mental health
-disorder in parts 11.14 and 11.16 of this Chapter.
-
-b.
-
-In cases of a medical or psychiatric emergency, the emergency contact shall be
-notified as soon as possible.
-
-Documentation of discharge coordination with the individual, and, with permission, the
-individual’s family, legal representative, or appropriate facility.
-
-3.
-
-For transfers between facilities, documentation of appropriate clinical information and
-coordination of services between the two facilities, including mode of transportation.
-
-4.
-
-Information if the discharge is being made against the advice of the treating professional
-person.
-Management of Personal Funds and Personal Property
-
-The facility shall comply with part 2.26.D.3 of these rules related to management of personal
-funds and personal property.
-
-11.16.22
-
-Transportation of Individuals
-
-Whenever transportation of an individual is required, the treating personnel of the facility shall
-assess the individual for danger to self or others and potential for escape. Whenever clinically
-and safely appropriate, the individual may be transported by other means such as ambulance,
-care van, private vehicle, and restraints shall not be used, unless consistent with state and
-federal law, authorized as necessary, and ordered by the treating professional person. If the
-treating personnel assesses the individual as dangerous to self or others or as an escape risk,
-the personnel may request transportation by a secure transportation provider or the local sheriff's
-department.
-
-11.16.23
-A.
-
-Documentation that notice of discharge was provided to the individual or individual’s legal
-representatives as follows:
-
-2.
-
-11.16.21
-
-A.
-
-Specific recommendations regarding prevention of re-hospitalization based on the
-individual’s unique challenges and needs.
-
-Discharge summaries shall comply with the requirements of part 2.10.A.6 of these rules, this part
-11.16.20, and the following:
-1.
-
-A.
-
-2 CCR 502-1
-
-Secure Transportation Providers
-
-Facilities may utilize a secure transportation provider.
-
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-
-B.
-
-“Class A” secure transportation services are licensed pursuant to CDPHE regulations to use
-physical restraint during secure transport based on associated regulations.
-
-C.
-
-“Class B” secure transportation services are not licensed pursuant to CDPHE regulations to use
-physical restraint during secure transport.
-
-D.
-
-For individuals receiving involuntary care in a 27-65 designated facility, when transportation to a
-medical appointment outside of the 27-65 designated facility is required, a personnel from the 2765 designated facility who is trained in facility transportation policies and procedures shall
-accompany and remain with the individual for the duration of the appointment at the outside
-facility. The individual may be left in an emergency medical services facility’s care without a
-designated facility personnel only if the individual is in a secure area (such as a psychiatric
-emergency department) and/or if there is trained security personnel present with the individual at
-all times; these provisions for safety/security must be noted in the designated facility’s individual
-chart.
-
-11.16.24
-A.
-
-Secure Transport Requests
-
-Any requests for transportation from the sheriff's department shall be filed with the court of
-appropriate jurisdiction and shall include:
-1.
-
-Statements from the treating Colorado licensed physician or psychologist supporting the
-need for transportation by the sheriff's department;
-
-2.
-
-Recommendations concerning the use of mechanical restraints and the impact that
-handcuffs or shackles would have on the individual;
-
-3.
-
-Recommendations for soft restraints, not handcuffs or shackles, if the findings of the
-assessment support the use of mechanical restraint;
-
-4.
-
-Recommendations concerning the placement and management of the individual during
-the time they will be absent from the 27-65 designated facility due to court hearings;
-
-5.
-
-Recommendations of considerations for management of the individual based on the
-individual's age, physical abilities, culture, medical and psychiatric status and/or stability.
-
-B.
-
-Notice of the request for transportation by the sheriff's department shall be given to the individual
-and their attorney at least twenty-four (24) hours prior to the time it is filed with the court. This
-notice shall not be required during the time an emergency mental health hold is in effect or in an
-emergency situation with an individual under certification or when the individual signs a waiver
-which has been clearly explained.
-
-C.
-
-Requesting transportation by the sheriff's department does not require a finding of danger to self
-or others or an escape risk if the sheriff's department is willing to transport the individual without
-the use of mechanical restraints.
-
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-11.16.25
-
-2 CCR 502-1
-
-Termination of Certification for Short-Term and Long-Term Treatment
-
-A.
-
-Prior to July 1, 2024, an original or extended certification for short-term treatment issues pursuant
-to Section 27-65-109, C.R.S., or an order or extension for certification for long-term care and
-treatment pursuant to Section 27-65-110, C.R.S., terminates as soon as the professional person
-in charge of treatment of the individual determines the individual has received sufficient benefit
-from the treatment for the individual to end involuntary treatment. Beginning July 1, 2024, an
-original or extended certification for short-term treatment issues pursuant to Section 27-65-109,
-C.R.S., or an order or extension for certification for long-term care and treatment pursuant to
-Section 27-65-110, C.R.S., terminates as soon as the professional person in charge of treatment
-of the individual and the BHA determine the individual has received sufficient benefit from the
-treatment for the individual to end involuntary treatment.
-
-B.
-
-Whenever a certification or extended certification is terminated, the professional person in charge
-of providing treatment shall notify the court in writing within five (5) days after the termination.
-
-C.
-
-Before termination, an individual who leaves a facility may be returned to the facility by order of
-the court without a hearing or by the superintendent or director of the facility without a court order.
-
-D.
-
-After termination, an individual may be returned to the facility only in accordance with Article 65 of
-Title 27, C.R.S.
-
-E.
-
-Facilities designated for involuntary care and treatment of individuals are required to notify the
-BHA whenever an individual certification is terminated. 27-65 designated facilities must submit
-required documentation directly to the BHA using the prescribed BHA method available on BHA’s
-website.
-
-11.17
-
-Involuntary Outpatient Care & Treatment Designation
-
-11.17.1 Applicability
-A.
-
-The involuntary outpatient care and treatment designation allows facilities to provide care and
-treatment to individuals on short-term and long-term certifications on an outpatient basis.
-
-B.
-
-Facilities designated for involuntary outpatient care and treatment must be in compliance with the
-following rules:
-1.
-
-Parts 2.7 through 2.13 and parts 2.23 through 2.25 of these rules with the following
-exception
-a.
-
-2.
-C.
-
-Part 2.7.A.3 of these rules
-
-Parts 11.1 through 11.15 and 11.17 of this Chapter.
-
-This section 11.17 is meant, in part, to provide a summary of the obligations and standards set
-forth in Section 27-65-101 through -131, C.R.S., with regard to involuntary outpatient care and
-treatment. This section is only enforceable with regard to designated facilities.
-
-11.17.2 Procedures for Certification to Outpatient Treatment
-A.
-
-An individual who has been treated as an inpatient under a short-term or long-term certification
-for mental health treatment at a designated facility may be treated on an outpatient basis if the
-following conditions are met:
-
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-B.
-
-2 CCR 502-1
-
-1.
-
-A professional person who has evaluated the individual and who is on the personnel of
-the inpatient designated facility determines that while the individual continues to meet the
-requirements for certification, professional judgment is that with appropriate treatment
-modalities in place the individual is unlikely to act dangerously in the community.
-
-2.
-
-Certification on an outpatient basis is the appropriate disposition suited to the individual's
-needs.
-
-3.
-
-The designated facility that will hold the certification on an outpatient basis has
-documentation of the results of a physical examination within the last year, or
-documented attempts to obtain information.
-
-In addition to the requirements in Chapter 4 of these rules, the outpatient treatment provider shall
-develop a service plan for the individual receiving treatment on an outpatient basis with the goal
-of the individual finding and sustaining recovery. The service plan must include measures to keep
-the individual or others safe, as informed by the individual's need for certification. The service
-plan may include, but is not limited to:
-1.
-
-Intensive case management;
-
-2.
-
-Assertive community treatment;
-
-3.
-
-Peer recovery support services;
-
-4.
-
-Individual or group therapy;
-
-5.
-
-Day or partial-day programming activities;
-
-6.
-
-Intensive outpatient programs;
-
-7.
-
-Educational and vocational training or activities; and
-
-8.
-
-Housing and transportation assistance.
-
-C.
-
-The individual, the individual's legal guardian, the individual’s patient representative or the
-individual's lay person, or any party at any court hearing may contest an individual's treatment
-regimen, including court-ordered medications, at any court hearing related to the individual's
-certification for treatment.
-
-D.
-
-Primary oversight of outpatient certifications at designated facilities must be provided by a
-professional person. The professional person assigned to the individual’s case must also be
-available for clinical supervision and/or consultation to personnel providing clinical services to the
-individual at the designated facility in which the individual is receiving outpatient certification
-treatment.
-
-E.
-
-Primary clinical services at the designated facility, including but not limited to individual therapy,
-must be provided by a licensee receiving clinical supervision and/or consultation from the
-assigned professional person.
-
-11.17.3 Enforcement of Outpatient Certification [Effective July 1, 2024]
-A.
-
-The facility responsible for providing services to an individual on a certification on an outpatient
-basis shall proactively reach out to the individual to engage the individual in treatment on a
-weekly basis and including visits to the individual’s known places or residence. Documentation of
-all visits and attempts must be included in the clinical record.
-
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-B.
-
-2 CCR 502-1
-
-If the individual refuses treatment or court-ordered medication and is decompensating
-psychiatrically, the court may order a certified peace officer or secure transportation provider to
-transport the individual to an appropriate, least restrictive designated facility in collaboration with
-the BHA and the provider holding the certification.
-1.
-
-The individual does not need to be imminently dangerous to the individual's self or others
-for the facility to request, and the court to order, transportation to a facility for the
-individual to receive treatment and court-ordered medications.
-
-C.
-
-The facility responsible for providing services to an individual on a certification on an outpatient
-basis shall provide the court information on the facility's proactive outreach to the individual and
-the professional person's and psychiatric advanced practice registered nurse's basis for medical
-opinion.
-
-D.
-
-If an individual is placed in a more restrictive setting, the individual has the right to judicial review
-within ten (10) days after filing a written request.
-
-E.
-
-In addition to any other limitation on liability, an agency or facility providing care to an individual
-placed on short-term or long-term certification on an outpatient basis is only liable for harm
-subsequently caused by or to an individual who:
-1.
-
-Has been terminated from certification despite meeting statutory criteria for certification
-pursuant to Sections 27-65-109 or 27-65-110, C.R.S.; and,
-
-2.
-
-Provided services to the individual not within the scope of the individual's professional
-license or was reckless or grossly negligent in providing services.
-
-3.
-
-A provider is not liable if an individual's certification is terminated, despite meeting criteria
-for certification, if the provider is unable to locate the individual despite proactive and
-reasonable outreach.
-
-F.
-
-An individual certified for short-term treatment on an outpatient basis may be discharged upon the
-signature of the approved professional person overseeing the individual's treatment, and the
-professional person shall notify the BHA prior to the discharge.
-
-G.
-
-A facility or program shall make the individual’s discharge instructions available to the individual,
-the individual's attorney, and the individual’s legal guardian, if applicable, within seven (7) days
-after discharge, if requested.
-1.
-
-H.
-
-A facility or program that is transferring an individual to a different treatment facility or to
-an outpatient provider shall provide all treatment records to the facility or provider
-accepting the individual at least twenty-four (24) hours prior to the transfer.
-
-The individual, their legal guardian, the patient representative or lay person, or any party may
-object to the individual’s treatment, including court-ordered medications, at any court hearing
-related to the individual’s certification to treatment.
-
-11.17.4 Individual Rights for Involuntary Outpatient Treatment [Effective July 1, 2024]
-A.
-
-The facility shall provide all individuals receiving evaluation, care, or treatment on a certified
-outpatient basis, with a written copy of the rights listed under part 11.14.3 of this Chapter, in
-addition to this part 11.17.4.B (translated into a language that the individual understands if
-feasible) upon admission and upon each renewal of certification. If the individual is not able to
-read the rights, the individual shall be read the rights in a language that they understand.
-
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-B.
-
-2 CCR 502-1
-
-The facility shall post the following list of rights (in languages predominantly used by the
-population of individuals served), in addition to those enumerated in part 11.14.3 of this Chapter
-in prominent places frequented by individuals and their families receiving services:
-1.
-
-To request a change to voluntary status. A change to voluntary status may be denied by
-the supervising professional person or an advanced practice registered nurse with
-training in psychiatric nursing responsible for the individual’s treatment if the professional
-person or advanced practice registered nurse with training in psychiatric nursing
-determines reasonable grounds exist to believe that the individual will not remain in a
-voluntary treatment program;
-a.
-
-If a discrepancy exists for the determination of voluntary status between the
-professional person and the advanced practice nurse with training in psychiatric
-nursing, the determination for the individual to change to voluntary status must
-defer to the assessment from the professional person.
-
-2.
-
-To be treated fairly, with respect and recognition of the individual's dignity and
-individuality, by all employees of the treatment facility with whom the individual comes in
-contact;
-
-3.
-
-To appropriate treatment, which must be administered skillfully, safely, and humanely. An
-individual shall receive treatment suited to the individual's needs that must be determined
-in collaboration with the individual;
-
-4.
-
-To not be discriminated against on the basis of age, race, ethnicity, religion, culture,
-spoken language, physical or mental disability, socioeconomic status, sex, sexual
-orientation, gender identity, or gender expression;
-
-5.
-
-To retain and consult with an attorney at any time;
-
-6.
-
-Within forty-eight (48) hours after the individual's request, to see and receive the services
-of a patient representative, including a peer specialist;
-
-7.
-
-To have the individual's behavioral health orders for scope of treatment or psychiatric
-advance directive reviewed and considered by the court as the preferred treatment option
-for involuntary administration of medications unless, by clear and convincing evidence,
-the individual's directive does not qualify as effective participation in behavioral health
-decision-making;
-
-8.
-
-To have the individual's information and records disclosed to adult family members and a
-lay person pursuant to Section 27-65-123, C.R.S.;
-
-9.
-
-To have access to a representative within the facility who provides assistance to file a
-grievance; and
-
-10.
-
-To have the right to file a motion with the court at any time to contest the certification.
-
-c.
-
-As set forth in Section 27-65-127, C.R.S., an individual's rights, as set forth in Section 27-65-101
-through -131, C.R.S. and this Chapter, may be limited or denied under court order by an
-imposition of legal disability or deprivation of a right.
-
-d.
-
-Information pertaining to the denial of any right shall be made available, upon request, to the
-individual or their attorney.
-
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-
-11.17.5 Service Planning [Effective July 1, 2024]
-A.
-
-Service plans shall comply with the requirements of part 2.13.1 of this Chapter, and the following:
-1.
-
-The service plan shall contain specific criteria required for discharge from treatment or to
-progress to less restrictive treatment alternatives;
-
-2.
-
-A physician or other legal prescriber shall be responsible for the component of the plan
-requiring medication management services; and,
-
-3.
-
-For individuals certified to short-term or long-term treatment, the service plan shall be
-reviewed, and revised, if necessary, at least monthly by the personnel responsible for the
-plan, the treating professional person, the individual and the legal guardian. This review
-shall be documented in the record and include progress toward meeting the criteria for
-termination of treatment and the need for continued involuntary treatment if the individual
-is certified. If the monthly review is delayed, the reason for such delay shall be noted in
-the record and the review shall be completed as promptly as possible.
-
-4.
-
-The service plan may include, but is not limited to:
-
-Chapter 12:
-
-a.
-
-Intensive case management services;
-
-b.
-
-Assertive community treatment;
-
-c.
-
-Peer recovery services;
-
-d.
-
-Individual and/or group therapy;
-
-e.
-
-Day or partial-day programming activities;
-
-f.
-
-Intensive outpatient programs;
-
-g.
-
-Educational and/or vocational training and activities; or
-
-h.
-
-Housing and transportation assistance
-
-Behavioral Health Safety Net Provider Approval
-
-12.1
-
-Authority and Applicability
-
-A.
-
-Chapter 12 establishes standards for behavioral health safety net providers, including
-comprehensive community behavioral health providers and essential behavioral health safety net
-providers, and the behavioral health safety net approval process. The statutory authority to
-promulgate these rules is set forth in Sections 27-50-107(3)(c), 27-50-301(5), 27-50-304(7), and
-27-50-502(1) through (5), C.R.S. Chapter 12 additionally establishes standards for additional
-competencies related to serving priority populations where behavioral health safety net providers
-may be eligible for enhanced rates. The statutory authority to promulgate these rules is set forth
-in Section 27-50-502(6), C.R.S.
-
-B.
-
-To be eligible for enhanced service delivery payments set forth in Section 27-50-502(2),(3),
-C.R.S., a behavioral health safety net provider must be approved by the BHA. This approval does
-not guarantee enhanced service delivery payments.
-
-C.
-
-Approved behavioral health safety net providers shall be subject to the following rule compliance
-timeline:
-
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-2 CCR 502-1
-
-1.
-
-Upon these rules going into effect, the BHA shall take immediate action pursuant to
-Section 27-50-505, C.R.S. on rule violations that impact the health, safety, and welfare of
-individuals receiving services provided by an approved safety net provider.
-
-2.
-
-All approved safety net providers shall be in full compliance of these rules by July 1,
-2024.
-
-D.
-
-Provider participation in the behavioral health safety net system is voluntary. The rules in this
-Chapter must be followed, as applicable, by all entities and persons that are seeking to be or are
-approved behavioral health safety net providers to be eligible for public funding as part of the
-state of Colorado’s Behavioral Health Safety Net System created pursuant to Section 27-50-301
-through -304, C.R.S.
-
-12.2
-
-Approval
-
-A.
-
-Approval by the BHA as a behavioral health safety net provider shall be predicated upon the
-following:
-1.
-
-Evidence of current licensure in good standing by the BHA, Department of Public Health
-and Environment, Department of Regulatory Agencies, and/or other state agency where
-applicable, unless otherwise exempt from licensing by state or federal rule or statute.
-a.
-
-2.
-
-12.3
-
-Behavioral health providers, including but not limited to federally qualified health
-centers, that are exempt from licensure but require federal recognition shall
-provide documentation to demonstrate current recognition.
-
-Compliance with the requirements of this Chapter 12.
-a.
-
-Part 12.4 of this Chapter shall apply only to essential behavioral health safety net
-providers.
-
-b.
-
-Part 12.5 of this Chapter shall apply only to comprehensive community
-behavioral health providers.
-
-Safety Net Standards
-
-12.3.1 General Requirements
-A.
-
-The behavioral health safety net provider shall ensure all operations, locations, and services,
-including contracted services and/or personnel, comply with applicable federal and state laws,
-regulations, and standards.
-
-B.
-
-The behavioral health safety net provider shall provide services in conformity with endorsementspecific requirements as found in Chapters 3 through 10 of these rules, for all services delivered
-by the provider as part of the behavioral health safety net provider’s approval. This must include:
-1.
-
-C.
-
-Appropriate personnel, including but not limited to authorized practitioners, licensees,
-peer support professionals, and others, with qualifications, responsibilities and
-experience that correspond to the size and capacity of the provider.
-
-When determining personnel needs, the behavioral health safety net provider must consider how
-they will comply with the no refusal requirements set forth in part 12.4.3.D for essential behavioral
-health safety net providers and part 12.5.3.D. For comprehensive community behavioral health
-providers.
-
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-D.
-
-2 CCR 502-1
-
-The behavioral health safety net provider shall provide services in alignment with the following
-competencies of the behavioral health safety net system:
-1.
-
-Proactively engaging priority populations, with adequate care coordination throughout the
-care continuum;
-
-2.
-
-Incorporating and demonstrating trauma-informed care practices throughout the care
-experience;
-
-3.
-
-Promoting person-centered care and cultural and linguistic competence;
-
-4.
-
-Utilizing evidence-based and evidence-informed programming to promote quality
-services; and
-
-5.
-
-Demonstrating competency in de-escalation techniques.
-
-12.3.2 Policies and Procedures
-A.
-
-The behavioral health safety net provider’s policies and procedures must demonstrate how the
-agency will provide care in alignment with the required competencies of behavioral health safety
-net providers set forth in part 12.3.1 of this Chapter.
-
-B.
-
-The behavioral health safety net provider shall have written policies and procedures that address:
-1.
-
-The rights of individuals seeking or receiving care
-a.
-
-The policy must ensure that each individual or, when applicable, the individual’s
-designated representative, has the right to:
-(1)
-
-Participate in all decisions involving the individual’s care or treatment;
-
-(2)
-
-Be informed about whether the agency is participating in teaching
-programs, and to provide informed consent prior to being included in any
-clinical trials relating to the individual’s care;
-
-(3)
-
-Refuse any drug, test, procedure, service or treatment and to be
-informed of risks and benefits of this action;
-
-(4)
-
-Receive care and treatment, in compliance with state statute, that is free
-from discrimination on the basis of physical or mental disability, race,
-ethnicity, socio-economic status, religion, gender expression, gender
-identity, sexuality, culture, and/or languages spoken; recognizes an
-individual's dignity, cultural values and religious beliefs; as well as
-provides for personal privacy to the extent possible during the course of
-treatment;
-
-(5)
-
-Be informed of, at a minimum, the first names and credentials of the
-personnel that are providing services to the individual. Full names and
-qualifications of the service providers must be provided upon request to
-the individual or the individual’s designated representative or when
-required by DORA;
-
-(6)
-
-Give informed consent for all treatment and services. Personnel must
-obtain informed consent for treatment they provide to the individual;
-
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-2.
-
-2 CCR 502-1
-
-(7)
-
-Register grievances with the agency and the BHA and be informed of the
-procedures for registering these grievances including contact
-information;
-
-(8)
-
-Be free of abuse and neglect;
-
-(9)
-
-Be free from the improper application of restraints or seclusion;
-
-(10)
-
-Expect that the agency in which the individual is admitted can meet the
-identified and reasonably anticipated care, treatment, and service needs
-of the individual;
-
-(11)
-
-Receive care from the agency in accordance with the individual’s needs;
-
-(12)
-
-Have the confidentiality of their individual records maintained as required
-by applicable federal and state law;
-
-(13)
-
-Receive care in a safe setting;
-
-(14)
-
-Be notified if referrals to other providers are to entities in which the
-agency has a direct or indirect financial benefit, including a benefit that
-has financial value, but is not a direct monetary payment;
-
-(15)
-
-Formulate medical and psychiatric advance directives and have the
-agency comply with such directives in compliance with applicable state
-statute.
-
-When admitting, discharging, triaging, and denying services to individuals:
-a.
-
-Essential behavioral health safety net providers must ensure their policies and
-procedures align with the requirements of parts 12.4.2 and 12.4.3 of this Chapter
-
-b.
-
-Comprehensive community behavioral health providers must ensure their
-policies and procedures align with the requirements of parts 12.5.2 and 12.5.3 of
-this Chapter
-
-3.
-
-How an agency will respond in a crisis to promote the safety of individuals, personnel and
-community members, including when an individual demonstrates physical aggression or
-agitation.
-
-4.
-
-How telehealth services are deployed, how individual preference for in-person services
-are addressed, and when based on diagnosis or other need, telehealth services are not
-appropriate.
-
-5
-
-Safety of personnel and individuals when delivering services in-home and in-community.
-
-6.
-
-Personnel training requirements, which must include training in:
-a.
-
-De-escalation techniques;
-
-b.
-
-Culturally and linguistically appropriate service delivery in accordance with the
-requirements of part 12.3.4 of this Chapter;
-
-c.
-
-Trauma-informed care practices and service delivery.
-
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-7.
-
-2 CCR 502-1
-
-Personnel background checks
-a.
-
-The agency must obtain, prior to hire or contract of new personnel, unless the
-personnel is a volunteer whose service does not involve unsupervised direct
-contact with individuals receiving services, a name-based criminal history record
-check for each prospective personnel or volunteer.
-(1)
-
-If the prospective personnel has lived in Colorado for more than three (3)
-years at the time of application, the agency shall obtain a name-based
-criminal history report conducted by the Colorado Bureau of Investigation
-(CBI).
-
-(2)
-
-If the prospective personnel has lived in Colorado for three (3) years or
-less at the time of application, the agency shall obtain a name-based
-criminal history report for each state in which the prospective personnel
-has lived during the past three (3) years, conducted by the respective
-states’ bureaus of investigation or equivalent state-level law enforcement
-agency, or a national criminal history report conducted by the federal
-bureau of investigation.
-
-b.
-
-The agency shall bear the cost of obtaining a name-based criminal history record
-check for each prospective personnel.
-
-c.
-
-If an agency contracts with a staffing agency for the provision of services, it shall
-require that the staffing agency meet the requirements of this part 12.3.2.B.7.
-
-d.
-
-When determining whether a prospective personnel is eligible for hire if the
-criminal history record check reveals the person has a conviction or plea of guilty,
-active deferred judgment, or nolo contendere, the agency shall have a policy that
-includes:
-(1)
-
-Written criteria and procedures for evaluating which convictions or
-complaints make prospective personnel unacceptable for hire, or for
-existing personnel, unacceptable for retention, including:
-(a)
-
-Factors to be considered when determining whether a
-prospective personnel is eligible for hire or contract when their
-name-based criminal history record check reveals a conviction or
-plea of guilty, active deferred judgment, or nolo contendere,
-including, but not limited to:
-1.
-
-The nature and seriousness of the offense;
-
-2.
-
-The nature of the position and how the offense relates to
-or may impact the duties of the position; experience in
-the criminal justice system is not necessarily a
-disqualifier and, in certain circumstances, an agency
-may determine that some lived experiences would
-benefit a particular position;
-
-3.
-
-The length of time since the conviction or plea;
-
-4.
-
-Whether such conviction is isolated or part of a pattern;
-and,
-
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-2 CCR 502-1
-
-5.
-8.
-
-Whether there are mitigating or aggravating
-circumstances involved.
-
-Clinical supervision
-a.
-
-The agency must ensure that all personnel providing behavioral health services,
-with the exception of peer support professionals, receive clinical supervision, as
-defined in this part 12.3.2.B.8.
-
-b.
-
-The agency will develop policies and procedures for supervision that address the
-following:
-
-c.
-
-(1)
-
-Supervisee’s mandatory disclosure statement that clearly states they are
-under supervision and by whom;
-
-(2)
-
-Requirements for regular evaluation of the supervisee’s progress with a
-rubric that is tied to the responsibilities assigned;
-
-(3)
-
-Documentation and frequency of supervisor reviews and feedback
-provided;
-
-(4)
-
-Maximum number of supervisees a supervisor oversees; and
-
-(5)
-
-How supervision/consultation is covered by personnel with comparable
-credentials when the usual supervisor is not available.
-
-Clinical supervisors must at minimum:
-(1)
-
-Meet the standard qualifications for clinical supervision as defined by
-their professional practice board.
-
-(2)
-
-Deliver clinical supervision within the supervisor’s professional practice
-license and ethical standards for:
-(a)
-
-Those that are licensed or seeking professional licensure; or
-
-(b)
-
-When supervising personnel that are not seeking or not eligible
-for professional licensure, such as group living workers, the
-supervisor must follow standards in the Colorado Mental Health
-Practice Act, as defined in Article 245 of Title 12, C.R.S.
-
-(3)
-
-Dedicate time between the supervisor and supervisee to instruct, model,
-and encourage self-reflection by the personnel receiving supervision
-regarding acquisition of clinical and administrative skills. Clinical
-supervisor will determine skills through observation, evaluation,
-feedback, and mutual problem-solving.
-
-(4)
-
-Address ethics and ethical dilemmas as aligned with the appropriate
-professional practice board.
-
-(5)
-
-Provide professional direction based on experience, expertise, and/or for
-ethical or safety concerns.
-
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-d.
-
-9.
-
-2 CCR 502-1
-
-(6)
-
-Ensure that safety and crisis management plans are followed and that
-clinical supervisors are available to personnel for assistance in crisis
-situations and processing of the crisis event afterwards.
-
-(7)
-
-Document date, duration, and the content of supervision session for their
-supervisee(s), which may include a professional development plan. All
-documents pertaining to clinical supervision must be provided to the
-supervisee and the BHA upon request.
-
-Personnel-specific clinical supervision requirements
-(1)
-
-Licensees will be provided with clinical supervision and/or consultation at
-minimum upon request of licensee or at times of individual emergency.
-
-(2)
-
-Candidates will be provided with clinical supervision at a rate that will
-meet their licensing requirements for the license they are pursuing or at a
-minimum of one (1) hour every two (2) weeks, whichever provides a
-higher level of clinical supervision.
-
-(3)
-
-All clinical documentation completed by a counselor-in-training and/or
-intern still in pursuit of their clinical degree must be reviewed and cosigned by a clinical supervisor able to supervise pursuant to their scope
-of practice.
-
-(4)
-
-Personnel not seeking or not eligible for licensure, but that are providing
-clinical services, will be provided clinical supervision at a frequency that
-ensures treatment to individuals is appropriate, safe, and in line with
-assessment treatment needs and the individual’s treatment goals.
-
-Critical incident reporting
-a.
-
-A critical incident includes but is not limited to the following:
-(1)
-
-Breach of confidentiality: any unauthorized disclosure of protected health
-information as described in HIPAA, as incorporated by reference in part
-1.2 of these rules; 42 C.F.R. Part 2, as incorporated by reference in part
-1.2 of these rules, and/or Section 27-65-101 through -131, C.R.S.
-
-(2)
-
-Death: including the death of an individual inside of or outside of the
-agency’s physical location while an individual is receiving services or
-where an individual has attempted to receive services from the agency
-within the past thirty (30) calendar days.
-
-(3)
-
-Elopement: absconding from a mental health hold, certification,
-emergency/involuntary commitment, or a secure facility where an
-individual is being held as a result of a court order. This includes any
-unauthorized absence of a child, when a child cannot be accounted for
-or when there is reasonable suspicion to believe the child has
-absconded.
-
-(4)
-
-Any instance when an individual cannot be located following a search of
-the agency, the agency grounds, and the area surrounding the agency,
-and:
-
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-b.
-
-2 CCR 502-1
-
-(a)
-
-There are circumstances that place the individual’s health,
-safety, or welfare at risk; or
-
-(b)
-
-The individual has been missing for eight (8) hours.
-
-(5)
-
-Medication diversion: any medication diversion as defined in part 1.2 of
-these rules. If the diverted drugs are injectable, the agency shall also
-report the full name and date of birth of any individual who diverted the
-injectable drugs, if known.
-
-(6)
-
-Medication error: medication error that resulted or could have resulted in
-harm to the individual.
-
-(7)
-
-Medical emergency: any suicide attempt/self-injury, other form of serious
-injury, health emergency, overdose, or serious illness which occurred on
-agency premises or in the presence of agency personnel.
-
-(8)
-
-Any instance involving physical, sexual, or verbal abuse of an individual,
-as described in Sections 18-3-202, 18-3-203, 18-3-204, 18-3-206, 18-3402, 18-3-404, 18-3-405, 18-3-405.3, 18-3-405.5, and 18-9-111
-(exempting, however, the phrase “intended to harass”), C.R.S. by
-another individual, personnel, or a visitor to the agency.
-
-(9)
-
-Any instance that results in any of the following serious injuries to an
-individual:
-(a)
-
-Brain or spinal cord injuries;
-
-(b)
-
-Life-threatening complications of anesthesia or life-threatening
-transfusion errors or reactions; or,
-
-(c)
-
-Second- or third-degree burns involving twenty (20%) percent of
-more of the body surface area of an adult or more fifteen (15%)
-percent or more of the body surface area of a child.
-
-(10)
-
-Any instance involving caretaker neglect of an individual, as defined in
-Section 26-3.1-101(2.3), C.R.S.
-
-(11)
-
-Any instance involving misappropriation of an individual’s property,
-meaning patterns of loss or single incidences of deliberately misplacing,
-exploiting, or wrongfully using, either temporarily or permanently, an
-individual’s belongings or money without the individual’s consent.
-
-(12)
-
-Any occurrence involving the malfunction or intentional or accidental
-misuse of care equipment that occurs during treatment or diagnosis of an
-individual and that significantly or adversely affects or, if not averted,
-would have significantly adversely affected an individual.
-
-Critical incidents must be reported to the BHA within one (1) business day after
-the incident. Critical incidents must also be reported to the BHA within one (1)
-business day of when the agency determines that a reportable incident has
-occurred and the BHA requests such reporting.
-
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-c.
-
-2 CCR 502-1
-
-The BHA may conduct scheduled or unscheduled site reviews for specific
-monitoring purposes and investigation of critical incidents reports in accordance
-with:
-(1)
-
-BHA policies and procedures,
-
-(2)
-
-Regulations that protect the confidentiality and individual rights in
-accordance with Section 27-65-101 through -131, C.R.S.; HIPAA; as
-incorporated by reference in part 1.2 of these rules; and, 42 C.F.R. Part
-2, as incorporated by reference in part 1.2 of these rules,
-
-(3)
-
-Controlled substance licensing; Section 27-81-113; Section 27-80-212,
-C.R.S., and Section 18-18-503, C.R.S.
-
-d.
-
-The BHA shall have access to relevant documentation required to determine
-compliance with these rules.
-
-e.
-
-The agency must:
-
-f.
-
-(1)
-
-Establish written policies and procedures for reporting and reviewing all
-critical incidents occurring at the agency;
-
-(2)
-
-Submit critical incident reports to the BHA using state prescribed forms
-available on the BHA website. This is not in lieu of other reporting
-mandated by state statute or federal guidelines;
-
-(3)
-
-Make available a report with the investigation findings for review by the
-BHA, upon request; and,
-
-(4)
-
-Maintain critical incident reports for a minimum of three (3) years
-following the incident.
-
-Nothing in this part shall be construed to limit or modify any statutory or common
-law right, privilege, confidentiality, or immunity.
-
-12.3.3 Care Coordination
-A.
-
-Behavioral health safety net providers shall work with the individual to identify the individual’s
-service and support needs and preferences and shall carry out care coordination as defined in
-part 1.1 of these rules to facilitate access to those services and supports.
-
-B.
-
-Care coordination must, to the extent possible, be carried out in accordance with the individual's
-expressed preferences and with involvement of the individual's family, parent, legal
-representative, advocate, caregiver, and other supports identified by the individual.
-
-C.
-
-Care coordination activities may include, as appropriate for the needs and preferences of the
-individual:
-1.
-
-Development of person and family-centered service plans that:
-a.
-
-Promote integrated whole person care across the spectrum of health services.
-
-b.
-
-Address each individual’s priorities, goals, and the barriers they face.
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-
-c.
-
-2.
-
-Address access to acute and chronic physical and behavioral health care, peer
-support networks, social services including income supports, health insurance,
-housing, educational systems, and employment opportunities as necessary to
-facilitate wellness and recovery of the whole person in alignment with an
-individual’s assessed needs and expressed goals.
-
-Facilitating access to needed resources and services to carry out the service plan. This
-may include, but is not limited to:
-a.
-
-Conducting application assistance, referrals, and warm hand-offs to access
-resources and care;
-
-b.
-
-Providing accessible, culturally and linguistically appropriate resources and
-information, including access to resource directories such as OWNPATH;
-
-c.
-
-Coordinating with partners to provide specialized services, risk stratification,
-discharge planning, transition planning, prior authorization, insurance appeal,
-and medication reconciliation;
-
-d.
-
-Identifying the information, social service, and health care systems that an
-individual will need to access in order to navigate systems, manage their care,
-and achieve whole person health;
-
-e
-
-Equipping the individual with information through means that are accessible and
-appropriate for the individual based on their needs and preferences and as
-required by federal and state statute;
-
-f.
-
-Collaborating with other systems and entities providing care coordination
-services to the individual;
-(1)
-
-g.
-3.
-
-2 CCR 502-1
-
-If care coordination activities necessary to meet the individual’s needs
-and fulfill the service plan are being carried out by an alternate entity, the
-behavioral health safety net provider shall document the responsibilities
-of each entity within the record and update the record in response to
-changes in the individual's needs and/or preferences, and the alternate
-entity’s involvement.
-
-Providing outreach, planning, problem-solving, advocacy, education, and selfmanagement support;
-
-Deliberate and coordinated planning to prevent disengagement from services, identifying
-and mitigating risks for individuals, including identifying and implementing prevention
-strategies to proactively mitigate risk, and connecting individuals to supports to promote
-ongoing maintenance and prevention.
-a.
-
-Risks may include, but are not limited to, risk of grave disability, risk of danger to
-self or others, risk of institutionalization, risk of incarceration, risk of overdose,
-risk of housing and income instability including loss of benefits, and risk for out of
-home placement for a youth.
-
-b.
-
-Risk assessment must involve the individual and their service providers, be done
-on an ongoing basis, and be addressed within the service plan.
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-c.
-
-4.
-
-2 CCR 502-1
-
-When a risk for disengagement is identified, the service plan must address
-prevention of and response to an individual disengaging from services including
-missing appointments.
-
-Monitoring an individual’s progress, engagement, and satisfaction with treatment and
-recovery in alignment with outcomes identified by the individual.
-
-12.3.4 Culturally and Linguistically Appropriate Services
-A.
-
-To ensure the provision of culturally and linguistically appropriate services, the behavioral health
-safety net provider shall:
-1.
-
-Ensure all methods and procedures used to assess and evaluate an individual are able to
-be provided in the preferred language and/or communication method of frequently
-encountered limited English proficiency (LEP) groups.
-
-2.
-
-Develop and maintain general knowledge about the racial, ethnic, and cultural groups in
-the service area, including each group's diverse cultural health beliefs and practices,
-preferred languages, health literacy, and other needs in order to inform the provision of
-culturally and linguistically appropriate services and improve access and quality of
-services for these groups.
-
-3.
-
-Collect and maintain updated information to help understand the composition of the
-communities in the service area, including the primary spoken languages in order to
-inform the provision of culturally and linguistically appropriate services and improve
-access for these communities.
-
-4.
-
-Be able to provide oral and written notice to individuals with limited English proficiency in
-the preferred language and/or communication method of frequently encountered limited
-English proficiency (LEP) groups of the agency to inform them of their right to receive
-language assistance services and how to do so. Language assistance services must be
-free of charge to the individual, be accurate and timely, and protect the privacy and
-independence of the individual receiving services.
-
-5.
-
-Provide documents or messages vital to an individual’s ability to access services (for
-example, registration forms, sliding scale fee discount schedule, after-hours coverage,
-signage) in languages common in the community served, taking account of literacy and
-developmental levels and the need for alternative formats. Such materials shall be
-provided at intake.
-
-6.
-
-Provide interpretation and translation services in a manner that meets the needs of the
-individual.
-a.
-
-In order to ensure complete, accurate, impartial, and confidential communication,
-family, friends, or other individuals shall not be required, suggested, or used as
-interpreters. An individual shall not be required to provide their own interpreter.
-Behavioral health safety net providers shall not rely on an adult accompanying an
-individual with limited English proficiency (LEP) to interpret or choose to facilitate
-communication except:
-(1)
-
-In an emergency involving an imminent threat to the safety or welfare of
-an individual or the public, where there is no qualified interpreter for the
-individual with limited English proficiency immediately available.
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-
-(2)
-
-Where the individual with limited English proficiency specifically requests
-that the accompanying adult interpret or facilitate communication, the
-accompanying adult agrees to provide such assistance, and reliance on
-that adult for such assistance is appropriate under the circumstances.
-(a)
-
-(3)
-
-b.
-
-12.4
-
-2 CCR 502-1
-
-Personnel should suggest that a trained interpreter be present in
-these instances to ensure accurate interpretation and should
-document the offer and declination in the individual’s record.
-
-Minor children must not be used as interpreters, nor be allowed to
-interpret for their parents when the minor is the individual receiving
-services, unless there is an emergency involving an imminent threat to
-the safety or welfare of an individual or the public when no other
-interpreter is available.
-
-To the extent interpreters are used, and an interpreter is not provided by the
-individual, the interpreters must be trained to function in a medical and/or
-behavioral health setting, adhere to accepted interpreter ethics principles,
-including individual confidentiality and be able to interpret effectively, accurately,
-and impartially.
-
-7.
-
-Provide auxiliary aids and services needed for effective communication, that are
-Americans with Disabilities Act (ADA) compliant and responsive to the needs of
-individuals with disabilities (e.g., sign language interpreters, videophones).
-
-8.
-
-Implement strategies to recruit, support, and promote personnel that is representative of
-the demographic characteristics, including primary spoken languages of the communities
-in the agency’s service area.
-
-9.
-
-Behavioral health safety net providers are responsible for training personnel on
-interpretation and translation services available to facilitate services. This includes
-training personnel on the procedures to access and use such services.
-
-Essential Behavioral Health Safety Net Providers
-
-12.4.1 Requirements
-A.
-
-Essential behavioral health safety net providers shall provide at least one of the following
-services.
-1.
-
-Emergency and/or crisis behavioral health services;
-
-2.
-
-Behavioral health outpatient services;
-
-3.
-
-Behavioral health high-intensity outpatient services;
-
-4.
-
-Behavioral health residential services;
-
-5.
-
-Withdrawal management services;
-
-6.
-
-Behavioral health inpatient services;
-
-7.
-
-Integrated care services;
-
-8.
-
-Hospital alternatives; and/or
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-9.
-
-2 CCR 502-1
-
-Additional services that the BHA determines are necessary in a region or throughout the
-state.
-
-B.
-
-For services which a BHA endorsement exists in Chapters 3 through 10 of these rules, services
-shall be provided in conformity with the rules of the endorsement.
-
-C.
-
-When providing services to children and families, essential behavioral health safety net providers
-shall provide services to children and families in conformity with the standards set forth in Chapter
-8 of these rules.
-
-D.
-
-The essential behavioral health safety net provider shall provide clinical services during times that
-ensure accessibility and meet the needs of the individual population to be served, including
-evening and/or weekend hours.
-1.
-
-E.
-
-These extended hours may include services provided via telehealth, if appropriate.
-
-Essential behavioral health safety net providers offering outpatient behavioral health services
-must have in-person service offerings in addition to any telehealth services the agency may elect
-to provide.
-
-12.4.2 Priority Populations
-A.
-
-B.
-
-C.
-
-Essential behavioral health safety net providers must serve all priority populations as defined in
-Section 27-50-101(17), C.R.S., unless:
-1.
-
-The agency’s approval limits the agency’s scope and responsibility to a specific subset of
-priority population(s); and
-
-2.
-
-The provisions in the agency’s contract with the BHA or its designee limit the agency’s
-scope and responsibility to a specific subset of priority populations.
-
-When an essential behavioral health safety net provider is approved to serve a subset of priority
-populations, the agency shall ensure that corresponding admission and exclusion criteria are:
-1.
-
-Outlined in the agency’s policy developed pursuant to part 12.3.2.B.2 of this Chapter;
-
-2.
-
-Approved by the BHA or its designee;
-
-3.
-
-Publicly available on the provider's website; and
-
-4.
-
-Applied uniformly.
-
-The essential behavioral health safety net provider shall have personnel with scope of practice
-and training to meet the needs of priority populations within the scope of the services and priority
-populations that the essential behavioral health safety net provider is approved to provide.
-
-12.4.3 Screening, Triage, and Care Coordination in Alignment with No Refusal Requirements
-A.
-
-When an individual attempts to initiate treatment with an essential behavioral health safety net
-provider, the essential behavioral health safety net provider shall complete an initial screening
-and triage process to identify the needs of the individual, and to determine the urgency and
-appropriateness of care with the essential behavioral health safety net provider.
-
-B.
-
-Screenings must collect at least the following information from an individual seeking services:
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-
-1.
-
-Identifying information;
-
-2.
-
-Primary complaint/reason for seeking services;
-
-3.
-
-Current behavioral health symptoms, including severity, duration, mental status, and
-changes or impairments in functioning due to symptoms;
-
-4.
-
-Medical concerns/chronic health issues, including pregnancy and postpartum status; and,
-
-5.
-
-Evaluation of imminent risk, including:
-a.
-
-Suicide risk;
-
-b.
-
-Danger to self or others;
-
-c.
-
-Urgent or critical medical conditions, including withdrawal or overdose risk; or
-
-d.
-
-Other immediate risks, including threats from another person.
-
-6.
-
-Preliminary determination of level of care needed;
-
-7.
-
-Health-related social needs and associated risk factors related to social determinants of
-health, including but not limited to:
-
-8.
-C.
-
-2 CCR 502-1
-
-a.
-
-Food security;
-
-b.
-
-Housing stability and security;
-
-c.
-
-Personal safety;
-
-d.
-
-Access to health services including preventative health care;
-
-e.
-
-Physical health concerns for which the individual is not receiving adequate
-treatment.
-
-Whether an individual is part of an identified priority population and which one.
-
-The essential behavioral health safety net provider shall use these standard criteria for
-determining whether an agency’s clinical scope of practice or treatment capacity are appropriate
-to meet the needs of the individual, or if the agency will instead provide care coordination to
-support the individual in accessing alternate services. These criteria are:
-1.
-
-The individual’s presenting problem or behavioral health diagnosis is outside the scope of
-practice of the agency and its personnel, including the age range with which the agency
-works, or the modalities and interventions in which personnel are trained in.
-
-2.
-
-The agency is approved pursuant to part 12.4.2 of this Chapter to serve a subset of
-priority populations, and the individual does not fall within the priority population(s).
-
-3.
-
-The individual presents with the need for a level of care the agency does not provide.
-
-4.
-
-The agency cannot provide services within an appropriate time frame per the individual’s
-needs and the agency’s capacity.
-
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-
-D.
-
-In accordance with Section 27-50-301(4), C.R.S., unless it is determined, pursuant to the criteria
-in part 12.4.3.c of this Chapter, that an individual’s needs fall outside the scope and capacity of
-the essential behavioral health safety net provider, the essential behavioral health safety net
-provider shall not refuse to treat an individual based on the individual's:
-1.
-
-Insurance coverage, lack of insurance coverage, or ability to pay;
-
-2.
-
-Clinical acuity level related to the individual's behavioral health condition or conditions,
-including whether the individual has been certified for short-term treatment or long-term
-care and treatment pursuant to Article 65 of Title 27, C.R.S.;
-
-3.
-
-Readiness to transition out of the Colorado Mental Health Hospital at Pueblo, the
-Colorado Mental Health Hospital at Fort Logan, or any other mental health institute or
-licensed facility providing inpatient psychiatric services or acute care hospital providing
-stabilization because the individual no longer requires inpatient care and treatment;
-
-4.
-
-Involvement in the criminal or juvenile justice system;
-
-5.
-
-Current involvement in the child welfare system;
-
-6.
-
-Co-occurring mental health and substance use disorders, physical disability, or
-intellectual or developmental disability, irrespective of primary diagnosis, co-occurring
-conditions, or if an individual requires assistance with activities of daily living or
-instrumental activities of daily living, as defined in Section 12-270-104(6), C.R.S.;
-a.
-
-E.
-
-2 CCR 502-1
-
-Essential behavioral health safety net providers shall not deny services to
-individuals who exhibit inappropriate sexual behaviors.
-
-7.
-
-Displays of aggressive behavior, or history of aggressive behavior, as a symptom of a
-diagnosed mental health disorder or substance use disorder;
-
-8.
-
-Clinical presentation or behavioral presentation in any previous interaction with a
-provider;
-
-9.
-
-Place of residence; or
-
-10.
-
-Disability, age, race, creed, color, sex, sexual orientation, gender identity, gender
-expression, marital status, national origin, ancestry, or tribal affiliation.
-
-If the individual’s needs exceed the treatment capacity or clinical scope of practice needed to
-serve the individual, the essential behavioral health safety net provider shall provide a warm
-handoff to a provider or entity able to provide care for the individual that is within its scope of
-service, which may include the BHA or its designee.
-1.
-
-Essential behavioral health safety net providers must also provide warm handoffs for
-individuals who have health-related social needs that require alternative services outside
-the scope of the behavioral health safety net system, such as services for housing, food
-insecurity, and transportation. The essential behavioral health safety net provider shall
-connect the individual to appropriate resources to initiate those services.
-
-2.
-
-When referring an individual to an alternative provider, entity, or service, geographic
-location and the individual’s ability to access the service location shall be considered.
-
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-
-F.
-
-G.
-
-2 CCR 502-1
-
-The essential behavioral health safety net provider shall track the following information for all
-priority population individuals who were referred to alternative services pursuant to this part. This
-information must be maintained in a single report that must be made available upon request by
-the BHA or its designee. This report shall include:
-1.
-
-Individual demographics, including to which priority population the individual belongs;
-
-2.
-
-Standardized descriptions of the needs of the individual that could not be met and require
-the individual to be referred to another provider;
-
-3.
-
-The outcome and timeliness of the referral, i.e., the date of the referral and response
-from the receiving agency; and
-
-4.
-
-Whether the individual was discharged from a higher level of care to a lower level of care
-and, if so, what level of care the referring provider was seeking to discharge the individual
-from.
-
-These processes must apply at the time of initial screening, and any time reassessment indicates
-the individual’s needs have changed and fall outside of the scope of the agency.
-1.
-
-When an essential behavioral health safety net provider initiates a transition in care for an
-individual or family under the care of the agency, whether the transition is to an alternate
-agency or an alternate level of care within the agency, the essential behavioral health
-safety net provider must notify the individual or family via a live conversation and then
-ensure that appropriate steps are taken to transition the individual or family.
-
-2.
-
-Requirements to not refuse care based on these criteria apply to essential behavioral
-health safety net providers as a whole. Refusal does not include transferring an individual
-to an alternative level of care within an essential behavioral health safety net provider or
-identifying new personnel to support the individual.
-
-12.4.4 Governance
-A.
-
-Overall responsibility for the administration of an essential behavioral health safety net provider
-shall be vested in a director who is a physician or a member of one of the licensed mental health
-professions unless the essential behavioral health safety net provider is only providing recovery
-support services. If the director is not a licensed physician or licensed mental health professional,
-the essential behavioral health safety net provider shall employ or contract with at least one (1)
-authorized practitioner or licensee to advise the director on clinical decisions.
-
-B.
-
-Each essential behavioral health safety net provider from which services may be purchased shall:
-1.
-
-Be under the control and direction of a county or local board of health, a board of
-directors or board of trustees of a corporation, a for-profit or not-for-profit organization, a
-regional mental health board, tribal organization, or a political subdivision of the state;
-
-2.
-
-Enter into a contract developed pursuant to Section 27-50-203, C.R.S. and accept
-publicly funded individuals.
-
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-12.5
-
-2 CCR 502-1
-
-Comprehensive Community Behavioral Health Providers
-
-12.5.1 Requirements
-A.
-
-Comprehensive community behavioral health providers shall, either directly or through formal
-agreement with behavioral health providers in the community or region, ensure the provision of all
-of the following services:
-1.
-
-Emergency and Crisis Behavioral Health Services in conformity with Chapter 6 of these
-rules;
-
-2.
-
-Mental Health and Substance Use Outpatient Services in conformity with Chapter 4 of
-these rules;
-
-3.
-
-Behavioral Health High-Intensity Outpatient Services in conformity with Chapter 4 of
-these rules;
-
-4.
-
-Care Management pursuant to part 12.5.7 of this Chapter;
-
-5.
-
-Outreach, Education, and Engagement Services pursuant to part 12.5.8 of this Chapter;
-
-6.
-
-Mental Health and Substance Use Recovery Supports in conformity with Chapter 3 of
-these rules;
-
-7.
-
-Outpatient Competency Restoration pursuant to part 12.5.9 of this Chapter.
-
-8.
-
-Screening, assessment, and diagnosis, including risk assessment, crisis planning, and
-monitoring to key health indicators, in accordance with endorsement specific
-requirements and part 12.5.3 of this Chapter.
-
-B.
-
-When providing these services directly, the comprehensive community behavioral health provider
-shall provide the services in conformity with endorsement specific requirements for the services,
-found in Chapters 3 through 10 of these rules.
-
-C.
-
-When providing these services through formal agreement with another agency, the
-comprehensive provider shall ensure that the agency providing the services holds the appropriate
-license(s) and accompanying endorsements in good standing for those services, unless the
-agency is otherwise exempt from licensure requirements.
-
-D.
-
-Comprehensive community behavioral health providers shall provide services to children and
-families in conformity with the requirements of Chapter eight (8) of these rules.
-
-E.
-
-In addition to the requirements set forth in the endorsement Chapters three (3) through ten (10),
-comprehensive community behavioral health providers shall comply with the following
-requirements:
-1.
-
-Outpatient requirements
-a.
-
-The comprehensive community behavioral health provider’s requirement to
-provide outpatient services does not include the requirement to provide minor in
-possession (MIP) services.
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-2.
-
-2 CCR 502-1
-
-b.
-
-The comprehensive community behavioral health provider shall provide
-outpatient clinical services during times that ensure accessibility and meet the
-needs of the individual population to be served, including evening and/or
-weekend hours.
-
-c.
-
-As necessary and appropriate for the needs of individuals, comprehensive
-community behavioral health providers shall provide services in the home and
-community and shall utilize telehealth methods to deliver care.
-
-d.
-
-If an individual presents with an emergency or crisis need, appropriate action is
-taken immediately, and subsequent outpatient follow-up is promptly coordinated
-and delivered.
-
-e.
-
-If an individual currently receiving services from a comprehensive community
-behavioral health provider presents with an urgent need, clinical services,
-including medication management, are provided within one (1) business day of
-the time the request is made.
-
-f.
-
-Comprehensive community behavioral health providers must be designated to
-provide services to individuals on involuntary outpatient certifications pursuant to
-part 11.18 of these rules.
-
-Crisis/emergency
-a.
-
-The comprehensive community behavioral health provider shall provide crisis
-management services that are available and accessible 24-hours a day. These
-services may include:
-(1)
-
-Walk-in crisis services;
-
-(2)
-
-Crisis stabilization units;
-
-(3)
-
-Acute treatment units;
-
-(4)
-
-Mobile crisis services;
-
-12.5.2 Priority Populations
-A.
-
-The comprehensive community behavioral health provider shall:
-1.
-
-Serve all priority populations; and
-
-2.
-
-Have personnel with appropriate training and scope of practice to serve all priority
-populations.
-
-12.5.3 Screening, Triage, and Care Coordination in Alignment with No Refusal Requirements
-A.
-
-When an individual attempts to initiate treatment with a comprehensive community behavioral
-health provider, the comprehensive community behavioral health provider shall complete an initial
-screening and triage process to determine urgency and appropriateness of care with the
-comprehensive community behavioral health provider and the service needs of the individual.
-
-B.
-
-Screenings must collect at least the following information from an individual seeking services:
-1.
-
-Identifying information;
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-
-2.
-
-Primary complaint/reason for seeking services;
-
-3.
-
-Current behavioral health symptoms, including severity, duration, mental status, and
-changes or impairments in functioning due to symptoms;
-
-4.
-
-Medical concerns/chronic health issues, including pregnancy and postpartum status; and,
-
-5.
-
-Evaluation of imminent risk, including:
-
-6.
-
-C.
-
-D.
-
-2 CCR 502-1
-
-a.
-
-Suicide risk;
-
-b.
-
-Danger to self or others;
-
-c.
-
-Urgent or critical medical conditions, including withdrawal or overdose risk; or
-
-d.
-
-Other immediate risks, including threats from another person.
-
-Health-related social needs and risk factors related to social determinants of health,
-including but not limited to:
-a.
-
-Food security;
-
-b.
-
-Housing stability and security;
-
-c.
-
-Personal safety;
-
-d.
-
-Access to health services including preventative health care; or
-
-e.
-
-Physical health concerns for which the individual is not receiving adequate
-treatment.
-
-The comprehensive community behavioral health provider shall use these standard criteria for
-determining whether a comprehensive community behavioral health provider clinical scope of
-practice or treatment capacity are appropriate to meet the needs of the individual, or if the
-comprehensive community behavioral health provider will instead provide care coordination to
-support the individual in accessing alternate services in the following circumstances:
-1.
-
-The individual presents with the need for a level of care the comprehensive community
-behavioral health provider does not provide.
-
-2.
-
-The comprehensive community behavioral health provider cannot provide services within
-an appropriate time frame per the individual’s needs and the agency’s capacity.
-
-In accordance with Section 27-50-301(4), C.R.S., unless it is determined, pursuant to the criteria
-in part 12.5.3.C of this Chapter, that an individual’s needs fall outside the scope and capacity of
-the comprehensive community behavioral health provider, the comprehensive community
-behavioral health provider shall not refuse to treat an individual based on the individual's:
-1.
-
-Insurance coverage, lack of insurance coverage, or ability to pay;
-
-2.
-
-Clinical acuity level related to the individual's behavioral health condition or conditions,
-including whether the individual has been certified for short-term treatment or long-term
-care and treatment pursuant to Article 65 of Title 27, C.R.S.;
-
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-
-2 CCR 502-1
-
-3.
-
-Readiness to transition out of the Colorado Mental Health Hospital at Pueblo, the
-Colorado Mental Health Hospital at Fort Logan, or any other mental health institute or
-licensed facility providing inpatient psychiatric services or acute care hospital providing
-stabilization because the individual no longer requires inpatient care and treatment;
-
-4.
-
-Involvement in the criminal or juvenile justice system;
-
-5.
-
-Current involvement in the child welfare system;
-
-6.
-
-Co-occurring mental health and substance use disorders, physical disability, or
-intellectual or developmental disability, irrespective of primary diagnosis, co-occurring
-conditions, or if an individual requires assistance with activities of daily living or
-instrumental activities of daily living, as defined in Section 12-270-104(6), C.R.S.;
-a.
-
-Comprehensive community behavioral health providers shall not deny services to
-individuals who exhibit inappropriate sexual behaviors.
-
-7.
-
-Displays of aggressive behavior, or history of aggressive behavior, as a symptom of a
-diagnosed mental health disorder or substance use disorder;
-
-8.
-
-Clinical presentation or behavioral presentation in any previous interaction with a
-provider;
-
-9.
-
-Place of residence; or
-
-10.
-
-Disability, age, race, creed, color, sex, sexual orientation, gender identity, gender
-expression, marital status, national origin, ancestry, or tribal affiliation.
-
-E.
-
-If the individual's needs exceed the treatment capacity or clinical scope of practice of a
-comprehensive community behavioral health provider, based on the standard criteria in part
-12.5.3.c of this Chapter, the comprehensive community behavioral health provider must ensure
-that the individual has access to interim behavioral health services until the individual is
-connected to the most appropriate agency for ongoing care. This may include use of providers
-within the network of the BHA or its designee, or the regional managed care entity.
-
-F.
-
-The comprehensive community behavioral health provider shall obtain approval from the BHA or
-its designee under which the agency is operating, or the regional managed care entity for
-Medicaid individuals, prior to referring a priority population individual to alternative behavioral
-health treatment services.
-1.
-
-Only an individual assessed to be experiencing a behavioral health crisis may be referred
-to external emergency or crisis services without prior approval from the BHA or its
-designee.
-a.
-
-G.
-
-If an individual is referred to an external provider for crisis or emergency
-behavioral health services, the agency shall work with the receiving provider to
-coordinate follow-up care for the individual upon discharge.
-
-If a referral of a priority population individual is approved by the BHA or its designee, the
-comprehensive behavioral health provider must provide a warm hand off by assisting the client in
-identifying a new provider, which may involve using the state’s care coordination and navigation
-infrastructure.
-
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-2 CCR 502-1
-
-H.
-
-For individuals who have health-related social needs that require alternative services outside the
-scope of the safety net system, such as services for housing, food insecurity, and transportation,
-the comprehensive community behavioral health provider will connect the individual to
-appropriate resources to initiate those services. Approval by the BHA or its designee is not
-required in this instance.
-
-I.
-
-The comprehensive community behavioral health provider shall track the following information for
-all priority population individuals who were referred to external behavioral health services
-pursuant to this part 12.5.3 of this Chapter. This information must be maintained in a single report
-that must be made available upon request by the BHA or it’s designee. This report shall include:
-
-J.
-
-1.
-
-Individual demographics, including to which priority population the individual belongs;
-
-2.
-
-Standardized descriptions of the needs of the individual that could not be met and require
-the individual to be referred to another provider;
-
-3.
-
-The outcome and timeliness of referral, i.e., the date of the referral and response from
-the receiving agency; and
-
-4.
-
-Whether the individual was discharged from a higher level of care to a lower level of care
-and, if so, what level of care the referring provider was seeking to discharge the individual
-from.
-
-These processes must apply at the time of initial screening, and any time reassessment indicates
-the individual’s needs have changed and fall outside of the scope of the agency.
-1.
-
-When an agency initiates a transition in care for an individual or family under the care of
-the agency, whether the transition is to an alternate agency or an alternate level of care
-within the agency, the agency must notify the individual or family face to face, on a
-telephone call, or two-way video conference and then ensure that appropriate steps are
-taken to transition the individual or family.
-
-2.
-
-Requirements to not refuse care based on these criteria apply to the comprehensive
-community behavioral health provider as a whole. Refusal does not include transferring
-an individual to an alternative level of care within the comprehensive community
-behavioral health provider or assigning new personnel to support the individual.
-
-12.5.4 Equity Plan
-A.
-
-Comprehensive community behavioral health providers shall establish an equity plan as part of
-their quality management program.
-
-B.
-
-Equity plans must be designed to improve treatment access and/or outcomes for one (1) or more
-priority populations through an evidenced-based approach.
-
-C.
-
-Comprehensive community behavioral health providers shall implement strategies from the equity
-plan to decrease the disparities in access and outcomes for priority populations.
-
-D.
-
-Development, implementation, and evaluation of the equity plan must include the collection
-and/or analysis of available data related to populations and areas served by the agency to
-evaluate equitable outcomes for priority populations. Goals and outcome measures should be
-identified in conjunction with individuals, families, and advocates who represent the identified
-priority populations. These outcome measures may include but are not limited to:
-
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-
-2 CCR 502-1
-
-1.
-
-Individual or family-reported measures such as satisfaction, achievement of goals, ability
-to thrive, or quality of life;
-
-2.
-
-System-reported outcomes such as access and engagement in care, preventable
-hospitalizations and/or hospital readmission, rate of follow-up with individuals and
-families, level of individual or family engagement, number of substantiated complaints or
-appeals, and timeliness of transitions to appropriate levels of care;
-
-3.
-
-Utilization measures such as number of individuals or families served, characteristics of
-individuals who do not engage in services, number of screenings completed, or number
-of referrals provided.
-
-12.5.5 Governance
-A.
-
-Each comprehensive community behavioral health provider shall:
-1.
-
-Be under the control and direction of a county or local board of health, a board of
-directors or board of trustees of a corporation, a for-profit or not-for-profit organization, a
-regional mental health board, tribal organization, or a political subdivision of the state;
-and
-
-2.
-
-Enter into a contract developed pursuant to Section 27-50-203, C.R.S. and accept
-publicly funded individuals.
-
-B.
-
-Treatment programs of the comprehensive community behavioral health provider must be vested
-in a director who is a physician or a member of one of the licensed mental health professions.
-The director is not required to provide oversight or direction for recovery services. If the director is
-not an authorized practitioner or licensee, the agency shall contract with at least one (1)
-authorized practitioner or licensee to advise the director on clinical decisions.
-
-C.
-
-The governing board of the comprehensive community behavioral health provider must either:
-1.
-
-Be composed of at least 51% voting members that have lived experience with accessing
-services for mental health and/or substance use disorders, which may include parents of
-children with mental health and/or substance use disorders who have supported their
-children in accessing services for mental health and/or substance use disorders; or
-
-2.
-
-Include at least two (2) voting members that have lived experience with accessing
-services for mental health and/or substance use disorders, which may include parents of
-children with mental health and/or substance use disorders who have supported their
-children in accessing services for mental health and/or substance use disorders.
-a.
-
-In addition, the governing body shall demonstrate how it collects, considers, and
-implements input and feedback from individuals and families currently receiving
-services in governing body decisions.
-
-12.5.6 Fee Schedule for Services Provided
-A.
-
-The comprehensive community behavioral health provider shall waive charges or charge for
-services on a sliding scale based on income and require that the agency not restrict access or
-services because of an individual's financial limitations.
-
-B.
-
-The comprehensive community behavioral health provider must ensure no individuals are denied
-behavioral health care services, including but not limited to crisis management services, because
-of an individual’s inability to pay for such service.
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-
-1.
-
-2 CCR 502-1
-
-Any fees or payments required by the comprehensive community behavioral health
-providers for such services must be reduced or waived to enable the comprehensive
-community behavioral health providers if necessary to fulfill this requirement.
-
-C.
-
-The comprehensive community behavioral health provider shall have a published sliding fee
-discount schedule(s) that includes all services the comprehensive community behavioral health
-provider proposes to offer pursuant to these criteria. Such fee schedule must be included on the
-comprehensive community behavioral health provider’s website, posted in the comprehensive
-community behavioral health provider’s waiting room, and readily accessible to individuals and
-families. The sliding fee discount schedule must be communicated in languages/formats and/or
-communication methods of frequently encountered limited English proficiency (LEP) groups of the
-comprehensive community behavioral health provider.
-
-D.
-
-The fee schedules, to the extent relevant, conform to federal and state statutory or administrative
-requirements that may be applicable to existing agencies; absent applicable state or federal
-requirements, the schedule is based on locally prevailing rates or charges and includes
-reasonable costs of operation.
-
-E.
-
-The comprehensive community behavioral health provider has written policies and procedures
-describing eligibility for and implementation of the sliding fee discount schedule. Those policies
-are applied equally to all individuals seeking services.
-
-12.5.7 Care Management
-A.
-
-In addition to the requirements of part 12.3.3, comprehensive community behavioral health
-providers shall be equipped to provide outreach-focused high intensity supports to individuals
-who may have complex needs, be involved in multiple systems, and/or require additional support
-to achieve whole person health.
-
-B.
-
-Care management may include, as necessary to address the assessed needs of an individual,
-and in alignment with the expressed preferences of the individual:
-1.
-
-2.
-
-Convening persons involved in the individual’s services, including health care and
-community-based service providers, family members and other persons identified by the
-individual, to work collaboratively with the individual for the purpose of service planning
-and coordination, in order to facilitate wellness, self-management, and recovery of the
-whole person.
-a.
-
-This must occur when the individual is assessed to be at rising risk of adverse
-outcomes, or when the individual experiences a significant change in status,
-which may include a behavioral health crisis, change in health or housing status,
-etc.
-
-b.
-
-This may include team meetings or other structured discussions.
-
-Facilitating access to necessary services and supports identified within the individual’s
-service plan created pursuant to part 12.3.3 of this Chapter through supports including
-but not limited to:
-a.
-
-Application assistance;
-
-b.
-
-Community-based outreach to the individual;
-
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-2 CCR 502-1
-
-c.
-
-Self-management support including educating the individual about their
-behavioral health conditions and daily living skills including but not limited to
-medication use, personal hygiene, transportation use, shopping, and budgeting;
-
-d.
-
-Accompanying the individual within the community or other setting to access
-services which the individual may not be able to access independently.
-
-3.
-
-Supporting an individual to develop psychiatric advance directives, with the support of
-appropriate medical and behavioral health professionals, so the individual's preferences
-for behavioral health treatment and recovery supports are known in the event of a
-behavioral health crisis.
-
-4.
-
-Providing support and outreach during care transitions.
-a.
-
-The agency shall have policies and procedures in place supporting discharge
-planning and transitions between levels of care, including individuals who have
-presented to or have been treated at an emergency department (ED) or hospital
-for behavioral health needs.
-
-b.
-
-The comprehensive community behavioral health provider shall be proactive in
-identifying impending care transitions and shall implement these procedures any
-time that the comprehensive community behavioral health provider is made
-aware that a care transition is occurring.
-
-c.
-
-Policies and procedures must address how the comprehensive community
-behavioral health provider will provide services to individuals and families to
-support successful care transitions, ensure continuity of services, and minimize
-the time between discharge and follow-up. These services may include:
-(1)
-
-Peer support;
-
-(2)
-
-Medication management including completing medication reconciliation
-and educating individuals, families or persons the individual identifies as
-their caretaker, about changes to the individual’s medications or service
-plan;
-
-(3)
-
-Individual education to support self-management, including education
-regarding warning signs for increasing support needs; and
-
-(4)
-
-Outreach to promote engagement in follow-up care.
-
-d.
-
-Whenever possible, the comprehensive community behavioral health provider
-shall work with the discharging facility ahead of discharge to facilitate a seamless
-transition, in accordance with care coordination requirements in 12.3.3 in this
-Chapter.
-
-e.
-
-The comprehensive community behavioral health provider shall make and
-document reasonable attempts to contact individuals who are discharged from a
-facility within 24 hours of discharge. This may include community-based outreach
-as applicable to the needs of the individual.
-
-f.
-
-Policies and procedures must address transfer of medical records for services
-received as permitted by HIPAA, as incorporated by reference in part 1.2 of
-these rules; 42 C.F.R. Part 2, as incorporated by reference in part 1.2 of these
-rules; and Section 27-65-101 through -131, C.R.S.
-
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-
-C.
-
-Documentation
-1.
-
-Care management provided to an individual pursuant to this part 12.5.7 must be
-documented in the individual’s record.
-
-2.
-
-The service plan must identify person-centered goals related to mitigating risks and
-managing assessed needs. The service plan must identify relevant outcome measures
-and timeframes for assessing progress towards goals.
-a.
-
-D.
-
-2 CCR 502-1
-
-The comprehensive community behavioral health provider must document goal
-progress within the individual’s record.
-
-Personnel and training
-1.
-
-Comprehensive community behavioral health providers shall have written policies and
-procedures outlining the initial and ongoing training for personnel delivering the services
-outlined in this part 12.5.7.
-a.
-
-Training must include training specific to the particular needs of the populations
-served by the personnel, including the provision of person-centered, traumainformed, harm reduction-focused, physically and programmatically accessible,
-and culturally and linguistically appropriate services.
-
-b.
-
-The training requirements of personnel may vary based on the populations
-served by that personnel.
-
-c.
-
-The written policies and procedures must identify the frequency of ongoing
-training.
-
-2.
-
-Comprehensive community behavioral health providers shall clearly document trainings
-in the personnel file and ensure that personnel provide services only to populations for
-which they are properly trained.
-
-3.
-
-Personnel providing care coordination must have clearly defined scopes of work that do
-not exceed their level of training and scope of practice.
-
-12.5.8 Outreach, Education, and Engagement Services
-A.
-
-General service provisions
-1.
-
-Comprehensive community behavioral health providers must complete an assessment of
-the community behavioral health treatment needs of the population they serve.
-
-2.
-
-If the agency is completing, or has completed, a community behavioral health
-assessment for another government entity or project, or through a third-party, those
-assessments may be used for the purpose of this part 12.5.8.A.1.
-
-3.
-
-Assessments of community behavioral health treatment needs of applicable service and
-populations in need by the BHA or a designee of the BHA may be used for the purpose of
-this part 12.5.8.A.1.
-a.
-
-If using previously completed assessment(s) for the purpose of this part
-12.5.8.A.1, community behavioral health needs assessment must not be older
-than three (3) years.
-
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-
-B.
-
-2 CCR 502-1
-
-The community behavioral health treatment needs assessment must include, but is not limited to,
-the following:
-1.
-
-Feedback from community stakeholders that address social determinants of health;
-
-2.
-
-Define the community the agency serves by gathering information including, but not
-limited to, demographics of the community, data on access to care, client grievances and
-complaints, social determinants of health, and priority population data; and
-
-3.
-
-Assess unmet needs in behavioral health treatment levels of care in the community.
-
-C.
-
-Comprehensive community behavioral health providers must re-assess at least once every three
-(3) years to adapt to the changing needs of the community they serve.
-
-D.
-
-Comprehensive community behavioral health providers must develop a strategic plan to provide
-outreach, education, and engagement services. The strategic plan shall include the following:
-1.
-
-Identified priority population(s) and/or treatment needs,
-
-2.
-
-Plans for outreach, education, and engagement services in the community to meet the
-priority population demographic. Plans must include:
-a.
-
-How outreach, education, and engagement services will support efforts toward
-screening, early intervention, and treatment.
-
-b.
-
-Off-site events and intentional engagement with priority populations, that may
-involve but is not limited to:
-(1)
-
-Broad community involvement;
-
-(2)
-
-Community partners that address social determinants of health in serving
-priority populations in assessed area;
-
-(3)
-
-Local law enforcement;
-
-(4)
-
-Local public health departments; and.
-
-(5)
-
-Cultural centers/organizations.
-
-c.
-
-How planned outreach, education, and engagement services can improve
-behavioral health outcomes.
-
-d.
-
-How data will be gathered and analyzed to measure outreach, education, and
-engagement service outcomes as permitted by HIPAA, as incorporated by
-reference in part 1.2 of these rules; 42 C.F.R. Part 2, as incorporated by
-reference in part 1.2 of these rules; and Section 27-65-101 through -131, C.R.S.
-
-E.
-
-Comprehensive community behavioral health providers must engage in outreach, education, and
-engagement services according to the strategic plan developed pursuant to part 12.5.8.D of this
-section.
-
-F.
-
-Comprehensive community behavioral health providers must gather, analyze, and interpret data
-received from efforts to measure outreach, education, and engagement service efforts into an
-outcome report as permitted by HIPAA, 42 C.F.R. Part 2; and Section 27-65-101, et. Seq.
-
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-
-G.
-
-2 CCR 502-1
-
-At the time of license renewal, or at any other additional time requested by the BHA,
-comprehensive community behavioral health providers must submit the outcomes report and an
-updated strategic plan for the following licensure year including a summary of outreach,
-education, and engagement efforts of the previous year and developed goals created from those
-efforts.
-
-12.5.9 Outpatient Competency Restoration Services
-A.
-
-Application process
-1.
-
-B.
-
-C.
-
-12.6
-
-Comprehensive community behavioral health providers must complete the application
-process with outpatient competency restoration services program within the Office of Civil
-and Forensic Mental Health (OCFMH) and appear on the OCFMH approved outpatient
-competency restoration list prior to BHA approval.
-
-Qualification and training
-1.
-
-Comprehensive community behavioral health providers must ensure that all personnel
-providing restoration services meet all qualifications as an approved provider of
-outpatient competency restoration services within OCFMH.
-
-2.
-
-Comprehensive community behavioral health providers must meet all training
-requirements set forth in any contracts between them and OCFMH to provide outpatient
-competency restoration services and must ensure all personnel providing restoration
-services attend any additional trainings as required by OCFMH, via contract, and the
-BHA.
-
-Standards for conducting services
-1.
-
-Comprehensive community behavioral health providers must provide competency
-restoration services in an outpatient setting to adult and juvenile individuals that are
-involved with the criminal justice system and deemed by the court to be incompetent to
-proceed.
-
-2.
-
-An agency must provide care coordination and collaborate with community and state
-partners when referrals are needed to assist in removing barriers to successful
-restoration to competency.
-
-3.
-
-An agency must provide written notice within a minimum of thirty (30) calendar days in
-advance to individuals, OCFMH, and the BHA of intention to no longer provide outpatient
-competency restoration services. Responsibility for continuity of care must remain with
-the agency currently serving the individual until the transfer is complete.
-
-4.
-
-If an agency provider is removed from the approved provider list held by the outpatient
-competency restoration services program within OCFMH, the BHA may take action to
-suspend and/or revoke the safety net approval pursuant to part 12.7 of this Chapter.
-
-Procedures for Approval and BHA Oversight
-
-12.6.1 Initial Approval
-A.
-
-Applicants seeking approval as a behavioral health safety net provider will be approved in
-accordance with the requirements set forth in this section.
-
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-2 CCR 502-1
-
-B.
-
-The applicant shall initially notify the BHA of their intent to seek approval by submitting a letter of
-intent. The letter of intent must indicate the provider’s intent to seek approval as an essential
-behavioral health safety net provider and/or comprehensive community behavioral health provider
-as well as the services the provider intends to provide.
-
-C.
-
-The applicant shall provide the BHA with a complete application including all information and
-attachments specified in the application form available to access on the BHA’s website and any
-additional information requested by the BHA.
-
-D.
-
-1.
-
-An application may be considered abandoned if the applicant fails to complete the
-application within twelve (12) months and fails to respond to the BHA. The BHA may
-administratively close the application process.
-
-2.
-
-After an administrative closure, the applicant may file a new application.
-
-With the submission of an application for approval as a behavioral health safety net provider, or
-within ten (10) days after a change in ownership or management of a behavioral health safety net
-provider, each owner and manager shall submit a complete set of the owner's and manager's
-fingerprints to the Colorado Bureau of Investigation (CBI) for the purpose of conducting a
-fingerprint-based criminal history record check. The CBI shall forward the fingerprints to the
-Federal Bureau of Investigation (FBI) for the purpose of conducting fingerprint-based criminal
-history record checks. Each owner and each manager shall pay the CBI the costs associated with
-the fingerprint-based criminal history record check. Upon completion of the criminal history record
-check, the CBI shall forward the results to the BHA. The BHA may acquire a name-based criminal
-history record check for an applicant who has twice submitted to a fingerprint-based criminal
-history record check and whose fingerprints are unclassifiable.
-1.
-
-E.
-
-An entity that holds a current license to operate from the BHA or CDPHE, and/or is
-currently recognized as a federally qualified health center are exempt from this
-requirement.
-
-The applicant shall provide the following information:
-1.
-
-Evidence of current licensure in good standing by the Department of Public Health and
-Environment, Department of Regulatory Agencies, Department of Human Services, or
-other state agency where applicable, unless otherwise exempt from licensing per
-applicable state or federal rule or statute.
-a.
-
-For applicants, including but not limited to federally qualified health centers, that
-are exempt from licensure but require federal recognition, the applicant shall
-provide documentation to demonstrate current recognition.
-
-b.
-
-Applicants with an existing license from the BHA shall indicate their licensure
-status within the application. Evidence of licensure by the BHA does not need to
-be provided by the applicant for approval.
-
-2.
-
-The legal name of the applicant and all other names used by it to provide services. The
-applicant has a continuing duty to submit notification to the BHA for all name changes at
-least thirty (30) calendar days prior to the effective date of the change.
-
-3.
-
-Contact information for the applicant must include a mailing address, telephone number,
-and e-mail address. If applicable, the applicant’s website and facsimile number are to be
-provided.
-
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-
-4.
-
-2 CCR 502-1
-
-The identity, address, and telephone number of all persons and business entities with a
-controlling interest in the applicant, including but not limited to:
-a.
-
-A non-profit corporation shall list the governing body and officers.
-
-b.
-
-A for-profit corporation shall list the names of the officers and stockholders who
-directly or indirectly own or control five (5) percent or more of the shares of the
-corporation.
-
-c.
-
-A sole proprietor shall include proof of lawful presence in the United States.
-
-d.
-
-A partnership shall list the names of all partners.
-
-e.
-
-The chief executive officer of the facility or agency.
-
-f.
-
-If the addresses and telephone numbers provided above are the same as the
-contact information for the applicant itself, the applicant shall also provide an
-alternate address and telephone number for at least one individual for use in the
-event of an emergency or closure.
-
-5.
-
-Proof of professional liability insurance. Behavioral health safety net providers must
-maintain such coverage for the duration of the approval term and must notify the BHA of
-any change in the amount, type, or provider of professional liability insurance coverage
-during the license term.
-
-6.
-
-Articles of incorporation, Articles of organization, partnership agreement, or other
-organizing documents required by the secretary of state to conduct business in Colorado;
-and by-laws or equivalent documents that govern the rights, duties, and capital
-contributions of the business entity.
-
-7.
-
-The address(es) of the physical location where services are delivered, as well as, if
-different, where records are stored for BHA review.
-
-8.
-
-A copy of any management agreement pertaining to operation of the entity that sets forth
-the financial and administrative responsibilities of each party.
-
-9.
-
-If an applicant leases one (1) or more building(s) to operate under the approval, a copy of
-the lease or leases must be filed with the license application and show clearly in its
-context which party to the agreement is to be held responsible for the physical condition
-of the property.
-
-10.
-
-A statement, on the applicant’s letterhead, if available, signed and dated, submitted with
-the application stating whether any of the actions listed in this part 12.6.1.E.10 of these
-rules have occurred, regardless of whether the action has been stayed in a judicial
-appeal or otherwise settled between the parties. The actions are to be reported if they
-occurred within ten (10) years preceding the date of the application for initial approval.
-The BHA may, based upon information received in the statement, request additional
-information from the applicant beyond the ten-year (10) time frame.
-a.
-
-For initial approval as a behavioral health safety net provider, whether one (1) or
-more individuals or entities identified in the response to part 12.6.1.E.4 has a
-controlling or ownership interest in the business entity and has been the subject
-or party to any of the following:
-
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-
-b.
-
-11.
-
-2 CCR 502-1
-
-(1)
-
-A civil judgment or criminal conviction resulting from conduct or an
-offense in the operation, management, or ownership of an agency or
-other entity related to substandard care or health care fraud. A guilty
-verdict, a plea of guilty, or a plea of nolo contendere (no contest)
-accepted by the court is considered a conviction.
-
-(2)
-
-A disciplinary action imposed by a governmental entity in another state
-that registers or licenses agencies including but not limited to: a sanction,
-probation, civil penalty, or a denial, suspension, revocation, or
-modification of a license or registration.
-
-(3)
-
-Limitation, denial, revocation, or suspension by any federal, state, or
-local authorities of any health care related license.
-
-(4)
-
-The refusal to grant or renew a license for operation of an agency, or
-contract for participation or certification for Medicaid, Medicare, or other
-public health or social services payment program.
-
-For a change of ownership of an agency, whether any of the new owners have
-been the subject of, or a party to, one (1) of more of the following events:
-(1)
-
-A civil judgment or a criminal conviction in a case brought by the federal,
-state, or local authorities that resulted from the operation, management,
-or ownership of an agency or other entity related to substandard care or
-health care fraud.
-
-(2)
-
-Limitation, denial, revocation, or suspension of a state license or federal
-certification by another jurisdiction.
-
-Any statement regarding the information requested in part 12.6.1.E.10 of this Chapter
-must include the following, as applicable:
-a.
-
-If the event is an action by a governmental agency, as described in part
-12.6.1.E.10.b: the name of the agency, its jurisdiction, the case name, and the
-docket proceeding or case number by which the event is designated, and a copy
-of the consent decree, order, or decision.
-
-b.
-
-If the event is a felony conviction or misdemeanor involving moral turpitude: the
-court, its jurisdiction, the case name, the case number, a description of the
-matter or a copy of the indictment or charges, and any plea or verdict entered by
-the court. For the purposes of this rule, “crimes of moral turpitude” include the
-following felony, misdemeanor, or municipal offenses or equivalent out-of-state or
-federal offenses:
-(1)
-
-Any of the offenses against the person set forth in Article 3 of Title 18 of
-the Colorado Revised Statutes. Examples of such offenses include, but
-are not limited to, any assault, menacing, or unlawful sexual behavior;
-
-(2)
-
-Any of the offenses against property set forth in Article 4 of Title 18 of the
-Colorado Revised Statutes. Examples of such offenses include, but are
-not limited to, any arson, theft, trespass, or criminal mischief;
-
-(3)
-
-Any of the offenses involving fraud set forth in Article 5 of Title 18 of the
-Colorado Revised Statutes;
-
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-
-c.
-
-2 CCR 502-1
-
-(4)
-
-Computer crime as set forth in Article 5.5 of Title 18 of the Colorado
-Revised Statutes;
-
-(5)
-
-Any of the offenses involving the family relations set forth in Article 6,
-Part 4 (wrongs to children), when committed intentionally and knowingly
-or recklessly; Part 6 (harboring a minor); or Part 8 (domestic violence) of
-Title 18 of the Colorado Revised Statutes;
-
-(6)
-
-Any of the offenses constituting wrongs to at-risk adults set forth in,
-Article 6.5 of Title 18 of the Colorado Revised Statutes;
-
-(7)
-
-Any of the offenses relating to morals set forth in Article 7 of Title 18 of
-the Colorado Revised Statutes. Examples of such offenses include, but
-are not limited to, prostitution, indecent exposure, and criminal invasion
-of privacy;
-
-(8)
-
-Any other offense in any jurisdiction whatsoever that is committed
-intentionally, knowingly, or recklessly, and involves violence, coercion,
-threats, cruelty, fraud, deception, or deprivation of legally recognized
-rights; and,
-
-(9)
-
-Any conspiracy, solicitation, or criminal attempt to commit any of the
-above offenses, or participation as an accessory to any of the above
-offenses.
-
-If the event is a civil action or arbitration proceeding: the court or arbiter, the
-jurisdiction, the case name, the case number, a description of the matter or a
-copy of the complaint, and a copy of the verdict of the court or arbitration
-decision.
-
-F.
-
-The BHA will not issue or renew an approval unless it has received a certificate of compliance for
-each physical location where services are provided.
-
-G.
-
-Each application must be signed under penalty of perjury by an authorized corporate officer,
-general partner, or sole proprietor of the agency as appropriate.
-
-H.
-
-The BHA shall conduct a preliminary assessment of the application and notify the applicant of any
-application defects.
-1.
-
-The applicant shall respond within fourteen (14) calendar days to written notice of any
-application defect.
-
-I.
-
-The BHA will provide written notice to the applicant within thirty (30) calendar days of receipt of a
-complete application.
-
-J.
-
-The BHA will act on an application within ninety (90) calendar days of receipt of the completed
-application.
-
-K.
-
-The duration of the initial approval will be two (2) years from the date of issuance.
-1.
-
-The BHA may conduct annual inspections during the two (2) year approval duration, in
-addition to any other inspections indicated in section 12.6.6.G.
-
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-2 CCR 502-1
-
-12.6.2 Provisional Approval
-A.
-
-Where an applicant for an initial approval fails to fully conform to the applicable statutes and
-regulations but the BHA determines the applicant is in substantial compliance with these rules
-and regulations and is temporarily unable to conform to all the minimum standards, a provisional
-approval may be granted. No provisional approval may be issued to an applicant if the operations
-may adversely affect individual health, safety, or welfare.
-1.
-
-A provisional approval will be valid for ninety (90) days.
-
-2.
-
-A second provisional approval, for another ninety (90) days, may be issued if the BHA
-determines that it is likely that compliance can be achieved by the date of expiration of
-the second provisional approval.
-
-3.
-
-The second provisional approval may be issued for the same duration as the first. The
-BHA may not issue a third or subsequent provisional approval to the entity.
-
-4.
-
-During the term of the provisional approval, the BHA shall conduct any review it deems
-necessary to determine if the agency meets the requirements for a regular approval.
-
-5.
-
-If the BHA determines, prior to expiration of the provisional approval, that the agency is in
-compliance with all applicable rules, it may issue a regular approval. The regular approval
-will be valid for one (1) year from the date of issuance of the regular approval, unless
-otherwise acted upon pursuant to part 12.7 of this Chapter.
-
-12.6.3 Renewal of Approval
-A.
-
-An agency seeking renewal must provide the BHA with a renewal application, signed under
-penalty of perjury by an authorized corporate officer, general partner, or sole proprietor of the
-agency as appropriate at least sixty (60) calendar days prior to the expiration of the existing
-approval. Renewal applications shall contain the information required in part 12.6.1.E of this
-Chapter unless the information has been previously submitted and no changes have been made
-to the information currently held by the BHA.
-
-B.
-
-Failure of the agency to accurately answer or report any of the information requested by the BHA
-will be considered good cause to deny the renewal application.
-
-C.
-
-The BHA shall conduct a preliminary assessment of the renewal application and notify the agency
-of any application defects.
-1.
-
-D.
-
-The agency shall respond within fourteen (14) calendar days to written notice of any
-application defect.
-
-The duration of the renewal approval will be two (2) years from the date of issuance.
-1.
-
-The BHA may conduct annual inspections during the two (2) year approval duration, in
-addition to any other inspections indicated in section 12.6.6.G.
-
-12.6.4 Change of Ownership/Management
-A.
-
-If an agency undergoes a change in ownership without following the procedures outlined in this
-part 12.6.4, their existing approval will be terminated. Termination of the approval may not occur
-until after a hearing and in compliance with the provisions and procedures specified in Section
-24-4-101 through -109, C.R.S.
-
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-
-2 CCR 502-1
-
-B.
-
-When an agency initiates a change of ownership, the agency must submit notification to inform
-the BHA of the change.
-
-C.
-
-Each agency undergoing a change of ownership shall submit an application, as prescribed in part
-12.6.1 of this Chapter at least thirty (30) calendar days before a change of ownership.
-1.
-
-D.
-
-The application must include supporting documentation for change of ownership.
-
-The BHA will consider the following criteria in determining whether there is a change of ownership
-of an agency that requires a new approval. The transfer of fifty percent (50%) of the ownership
-interest referred to in this part 12.6.4.D may occur during the course of one (1) transaction or
-during a series of transactions occurring over a five (5) year period.
-1.
-
-2.
-
-3.
-
-4.
-
-Sole proprietors:
-a.
-
-The transfer of at least fifty percent (50%) of the ownership interest in an agency
-from a sole proprietor to another individual, whether or not the transaction affects
-the Title to real property, shall be considered a change of ownership.
-
-b.
-
-Change of ownership does not include forming a corporation from the sole
-proprietorship with the proprietor as the sole shareholder or forming a limited
-liability company from sole proprietorship.
-
-Partnerships:
-a.
-
-Dissolution of the partnership and conversion into any other legal structure shall
-be considered a change of ownership if the conversion also includes a transfer of
-at least fifty percent (50%) of the ownership to one (1) or more new owners.
-
-b.
-
-Change of ownership does not include dissolution of the partnership to form a
-corporation with the same persons retaining ownership in the new corporation.
-
-Corporations:
-a.
-
-Merger of two (2) or more corporations resulting in the creation of a new
-corporate entity will be considered a change of ownership if the consolidation
-includes a transfer of at least fifty percent (50%) of the ownership to one or more
-new owners.
-
-b.
-
-Formation of a corporation from a partnership, a sole proprietorship, or a limited
-liability company will be considered a change of ownership if the change includes
-a transfer of at least fifty percent (50%) of the ownership to one (1) or more new
-owners.
-
-c.
-
-The transfer, purchase, or sale of shares in the corporation such that at least fifty
-percent (50%) of the ownership of the corporation is shifted to one (1) or more
-new owners will be considered a change of ownership.
-
-Limited liability companies:
-a.
-
-The transfer of at least fifty percent (50%) of the ownership interest in the
-company will be considered a change of ownership.
-
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-
-5.
-
-b.
-
-The termination or dissolution of the company and the conversion thereof into
-any other entity will be considered a change of ownership if the conversion also
-includes a transfer of at least fifty percent (50%) of the ownership to one (1) or
-more new owners.
-
-c.
-
-Change of ownership does not include transfers of ownership interest between
-existing members if the transaction does not involve the acquisition of ownership
-interest by a new member. For the purposes of this part.
-
-Non-profits:
-a.
-
-6.
-
-The transfer of at least fifty percent (50%) of the controlling interest in the
-nonprofit is considered a change of ownership.
-
-Management contracts, leases, or other operational arrangements:
-a.
-
-7.
-
-2 CCR 502-1
-
-If the agency enters into a lease arrangement or management agreement
-whereby the owner retains no authority or responsibility for the operation and
-management of the agency, the action will be considered a change of ownership
-that requires a new approval.
-
-Legal structures:
-a.
-
-The conversion of an agency’s legal structure, or the legal structure of a business
-entity that has an ownership interest in the agency is a change of ownership if
-the conversion also includes a transfer of at least fifty percent (50%) of the
-agency’s ownership interest to one (1) or more new owners.
-
-E.
-
-The existing agency is responsible for correcting all rule violations and deficiencies in any current
-plan of action before the change of ownership becomes effective. In the event that such
-corrective actions cannot be accomplished in the time frame specified, the prospective agency
-shall be responsible for all uncorrected rule violations and deficiencies including any current plan
-of action submitted by the previous agency unless the prospective agency submits a revised plan
-of action, approved by the BHA, before the change of ownership becomes effective.
-
-F.
-
-When the BHA issues an approval to the new owner, the previous owner must return its approval
-to the BHA within five (5) calendar days of the new owner’s receipt of its approval.
-
-12.6.5 Rule Waivers
-A.
-
-Any agency or applicant that has applied for or been approved as a behavioral health safety net
-provider has the right to apply for a waiver of any rule or standard set forth in these rules which, in
-their opinion, poses an undue hardship on the applicant, agency, or community.
-
-B.
-
-Nothing contained in these provisions abrogates the agency’s obligation to meet minimum
-requirements under local safety, fire, electrical, building, zoning, and similar codes.
-
-C.
-
-Nothing herein authorizes a waiver of any statutory requirement under state or federal law, except
-to the extent permitted therein.
-
-D.
-
-Upon application to the BHA, a waiver may be granted in accordance with this part 12.6.5. Absent
-the existence of a current waiver issued pursuant to this part, behavioral health safety net
-providers are expected to comply at all times with all applicable regulations except in instances
-where they are granted a provisional approval in accordance with part 12.6.2 of this Chapter.
-
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-
-E.
-
-Waiver applications must be submitted to the BHA in writing.
-1.
-
-The BHA will only consider one (1) regulation per waiver application.
-
-2.
-
-The waiver application must provide the BHA information related to:
-
-3.
-
-F.
-
-2 CCR 502-1
-
-a.
-
-The regulation the agency or applicant is requesting to waive;
-
-b.
-
-The reason why the waiver is being requested;
-
-c.
-
-A proposed alternate compliance plan;
-
-d.
-
-Any other information relevant to the waiver request that would inform the BHA’s
-decision in either granting or denying the waiver.
-
-The waiver application must be signed by an authorized representative of the agency or
-applicant, who is the primary contact person and the person responsible for ensuring that
-accurate and complete information is provided to the BHA.
-
-In making its determination, the BHA may consider any information it deems relevant, including
-but not limited to:
-1.
-
-Critical incident and complaint investigation reports, licensure or certification survey
-reports, anticipated impact of the waiver on individual safety and quality of care if any,
-and findings of these reports related to the agency and/or the operator or owner thereof.
-
-2.
-
-When determining whether a waiver should be granted, the BHA shall prioritize the
-impact of the waiver on the health, safety, and welfare of individuals over any alleged
-undue hardship.
-
-G.
-
-The BHA shall act on a waiver application within ninety (90) calendar days of receipt of the
-completed application. An application will not be deemed complete until the applicant has
-provided all information and documentation requested by the BHA.
-
-H.
-
-The BHA may specify terms and conditions under which any waiver is granted, including which
-terms and conditions must be met in order for the waiver to remain effective. The term for which
-each waiver granted will remain effective must be specified at the time of issuance but may not
-exceed the term of the current approval.
-
-I.
-
-1.
-
-At any time, upon reasonable cause, the BHA may inspect an agency with an active
-waiver to ensure that the terms and conditions of the waiver are being observed, and/or
-that the continued existence of the waiver is otherwise appropriate.
-
-2.
-
-Within thirty (30) calendar days of the termination, expiration, or revocation of a waiver,
-the agency shall submit to the BHA an attestation of compliance with the regulation to
-which the waiver pertained.
-
-The BHA will institute termination of a waiver upon a change of ownership of the agency, as
-defined in part 12.7.4. However, to prevent such termination, the prospective new owner may
-submit a waiver application to the BHA prior to the effective date of the change of ownership.
-Provided the BHA receives the new application by prior to the effective date of the change of
-ownership, the waiver will be deemed to remain effective until such time as the BHA acts on the
-application. Termination of the waiver may not occur until after a hearing and in compliance with
-the provisions and procedures specified in Section 24-4-101 through -109, C.R.S.
-
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-J.
-
-K.
-
-2 CCR 502-1
-
-1.
-
-Except as otherwise provided in this part 12.6.5, a waiver may not be granted for a term
-that exceeds the current approval term.
-
-2.
-
-If an agency wishes to maintain a waiver beyond the stated term, it must submit a new
-waiver application to the BHA not less than ninety (90) calendar days prior to the
-expiration of the current term of the waiver or with an approval renewal.
-
-Notwithstanding anything in this part 12.6.5 to the contrary, the BHA may revoke a waiver if it
-determines that:
-1.
-
-The waiver's continuation jeopardizes the health, safety, or welfare of individuals served
-by the agency;
-
-2.
-
-The waiver application contained false or misleading information;
-
-3.
-
-The terms and conditions of the waiver have not been complied with;
-
-4.
-
-The conditions under which a waiver was granted no longer exist or have changed
-materially; or,
-
-5.
-
-A change in a federal or state statute or regulation prohibits, or is inconsistent with, the
-continuation of the waiver.
-
-Notice of the revocation of a waiver must be provided to the agency in accordance with the
-Colorado Administrative Procedures Act and will not be effective until after a hearing in
-compliance with the provisions and procedures specified in Section 24-4-101 through -109,
-C.R.S.
-
-12.6.6 Continuing Obligations and BHA Oversight
-A.
-
-Each agency must have and maintain electronic business communication tools, including but not
-limited to, internet access and a valid e-mail address. The agency must use these tools to receive
-and submit information.
-
-B.
-
-The approval is only valid while in the possession of the agency to whom it is issued and may not
-be subject to sale, assignment, or other transfer, voluntary or involuntary.
-
-C.
-
-The agency must provide accurate and truthful information to the BHA during inspections,
-investigations, applications, and oversight activities.
-
-D.
-
-When an agency is subject to inspection, certification, or review by other agencies, accrediting
-organizations, or inspecting companies, the agency shall provide and/or release to the BHA, upon
-request, any correspondence, reports, or recommendations concerning the agency that were
-prepared by such organizations.
-
-E.
-
-Each agency must submit notification to the BHA regarding any change in the information
-required by part 12.6.1.E of this Chapter from what was contained in the last submitted approval
-application.
-1.
-
-Changes to the operation of the agency may not be implemented without prior approval
-from the BHA. An agency shall, at least thirty (30) calendar days in advance, submit
-notification to the BHA regarding any of the following proposed changes.
-a.
-
-Change in license category or classification.
-
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-
-b.
-
-Change in the scope of services, including the addition or removal of an
-endorsement, a service, or a physical location.
-
-c.
-
-Change in legal name of the agency and all other names used by it to provide
-services.
-
-F.
-
-The BHA and any duly authorized representatives thereof have the right to enter upon and into
-the premises of any approved agency or applicant for an agency approval in order to determine
-the state of compliance with the statutes and regulations and must initially identify themselves to
-the person in charge of the agency at the time.
-
-G.
-
-The BHA may use the following measures to ensure an agency’s full compliance with the
-applicable statutory and regulatory criteria.
-1.
-
-2.
-
-The BHA may conduct an unscheduled or unannounced review of a current agency
-based upon, but not limited to, the following criteria:
-a.
-
-Routine compliance inspection,
-
-b.
-
-Reason exists to question the agency’s continued fitness to conduct or maintain
-operations in accordance with the approval requirements,
-
-c.
-
-A complaint alleging non-compliance with approval requirements,
-
-d.
-
-Discovery of previously undisclosed information regarding an agency or any of its
-owners, officers, managers, or other employees if such information affects or has
-the potential to affect the agency’s provision of services, or
-
-e.
-
-The omission of relevant information from documents requested by the BHA or
-indication of false information submitted to the BHA.
-
-Plan of action
-a.
-
-If after review or pursuant to a complaint, it is determined that an agency is not in
-compliance with these rules, the agency shall be notified in writing, within thirty
-(30) business days of the specific deficiency/deficiencies.
-
-b.
-
-After any review, the BHA may request a plan of action from an agency or
-require an agency’s compliance with a BHA directed plan of action.
-
-c.
-
-If the agency does not agree with any or all of the findings regarding noncompliance, the agency has ten (10) business days from the receipt of noncompliance notice to dispute the findings by submitting evidence to the BHA.
-
-d.
-
-The agency shall receive a written response within thirty (30) business days of
-the review of submitted evidence.
-
-e.
-
-If the submitted information is sufficient, the agency shall be determined in
-compliance with these rules.
-
-f.
-
-If the agency continues to be found out of compliance with these rules, the
-agency shall have thirty (30) business days from the date of receipt of the review
-findings to submit a plan of action.
-
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-g.
-
-The plan of action must be in the format prescribed by the BHA and included, but
-not be limited to, the following:
-(1)
-
-A description of how the agency will correct each identified deficiency.
-(a)
-
-h.
-
-H.
-
-If deficient practice was cited for specific personnel, the
-description shall include the measures that will be put in place or
-systemic changes made to ensure that the deficient practice will
-not reoccur for the affected individuals and/or other individuals
-having the potential to be affected.
-
-(2)
-
-A description of how the agency will monitor the corrective action to
-ensure each deficiency is remedied and will not reoccur, and
-
-(3)
-
-A completion date that is no later than ninety (90) calendar days from the
-issuance of the deficiency list, unless otherwise required or approved by
-the BHA. The completion date is the date that the entity deems it can
-achieve compliance.
-
-A completed plan of action must be:
-(1)
-
-Signed by the agency’s director, administrator, or manager, and
-
-(2)
-
-Submitted to the BHA within thirty (30) calendar days after the date of
-the BHA’s written notice of deficiencies.
-(a)
-
-i.
-
-2 CCR 502-1
-
-If an extension of time is needed to complete the plan of action,
-the agency shall request an extension in writing from the BHA
-prior to the plan of action due date. The BHA may grant an
-extension of time.
-
-The BHA has discretion to approve, impose, modify, or reject a plan of action.
-(1)
-
-If the plan of action is accepted, the BHA shall notify the agency by
-issuing a written notice of acceptance, served either in-person or by firstclass mail.
-
-(2)
-
-If the plan of action is unacceptable, the BHA shall notify the agency in
-writing, and the agency shall re-submit the changes within the time frame
-prescribed by the BHA in the notice.
-
-(3)
-
-If the agency fails to comply with the requirements or deadlines for
-submission of a plan or fails to submit requested changes to the plan, the
-BHA may reject the plan of action and impose disciplinary sanctions as
-set forth in part 12.7 of this Chapter.
-
-(4)
-
-If the agency fails to implement the actions agreed to by the action date
-in the approved plan of action, the BHA may impose enforcement
-sanctions as set forth below in part 12.7.
-
-The agency must provide, upon request, access to or copies of the following to the BHA for the
-performance of its regulatory oversight responsibilities:
-1.
-
-Individual records.
-
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-2.
-
-2 CCR 502-1
-
-Reports and information including but not limited to, staffing reports, census data,
-statistical information, and other records, as determined by the BHA.
-
-I.
-
-Oversight and enforcement activities may include review of endorsements and/or separate
-physical locations as necessary for the BHA to ensure the health, safety, and welfare of
-individuals.
-
-12.7
-
-Enforcement and Adverse Actions
-
-12.7.1 Denial
-A.
-
-The BHA may deny an agency’s approval as a behavioral health safety net provider for reasons
-including but not limited to, the following:
-1.
-
-The agency has not fully complied with all local, state, and federal laws and regulations
-applicable to the approval;
-
-2.
-
-The application or its accompanying documents contain a false statement of material
-fact;
-
-3.
-
-The agency fails to respond to BHA requests for additional information in the time frame
-indicated in the request;
-
-4.
-
-The agency refuses any part of an inspection;
-
-5.
-
-The agency fails to comply with federal financial participation requirements;
-
-6.
-
-The agency fails to comply with state and federal data and financial reporting
-requirements;
-
-7.
-
-The agency has failed to cooperate with the investigation of any local, state, or federal
-regulatory body or law enforcement agency; or
-
-8.
-
-The agency is not in compliance with regulatory requirements or has a documented
-pattern of non-compliance that has harmed or has the potential to harm the health or
-safety of the individual(s) served.
-
-B.
-
-If the BHA denies an application for approval, it shall provide the agency with a written notice,
-served either in-person or by first-class mail, explaining the basis for the denial and affording the
-agency the opportunity to respond and request a hearing.
-
-C.
-
-Appeals of denials must be conducted in accordance with the State Administrative Procedure Act,
-Section 24-4-101 through -109, C.R.S.
-
-12.7.2 Revocation of Approval
-A.
-
-The BHA may revoke an existing approval if an agency fails or refuses to comply with the
-statutory and/or regulatory requirements applicable to its approval. Failures to comply include:
-1.
-
-Making a false statement of material fact about individuals served by the agency, its
-personnel, capacity, or other operational components verbally or in any public document,
-or in a matter under investigation by the BHA or another governmental entity,
-
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-B.
-
-2 CCR 502-1
-
-2.
-
-Preventing, interfering with, or attempting to impede in any way the work of a
-representative or agent of the BHA in investigating or enforcing the applicable statutes or
-regulations,
-
-3.
-
-Falsely advertising or in any way misrepresenting the agency’s ability to provide services
-for the individuals served based on its license type or status,
-
-4.
-
-Failing to provide reports and documents required by regulation or statute in a timely and
-complete fashion,
-
-5.
-
-Failing to comply with or complete a plan of action in the time or manner specified,
-
-6.
-
-Falsifying records or documents,
-
-7.
-
-Knowingly using or disseminating misleading, deceptive, or false information,
-
-8.
-
-Accepting commissions, rebates, or other forms of remuneration for referrals or other
-treatment decisions, or
-
-9.
-
-Exercising undue influence or coercion over an individual to obtain certain decisions or
-actions or for financial or personal gain. A relationship other than a professional
-relationship, including but not limited to a relationship of a sexual nature, between an
-owner, director, manager, administrator, or other personnel and an individual.
-
-Revocation must not occur until after a hearing and in compliance with the provisions and
-procedures specified in Article 4 of Title 24 and in Section 27-50-505, C.R.S.
-
-12.7.3 Intermediate Restrictions
-A.
-
-B.
-
-The BHA may impose the following intermediate restrictions or conditions on an agency that has
-sought enhanced service payments in accordance with Section 27-50-505(3), C.R.S.:
-1.
-
-Retaining a consultant to address corrective measures including deficient practice
-resulting from systemic failure;
-
-2.
-
-Monitoring by the BHA for a specific period;
-
-3.
-
-Providing additional training to personnel, owners, or operators of the agency;
-
-4.
-
-Complying with a directed written plan to correct the violation; or
-
-5.
-
-Paying a civil fine not to exceed two thousand dollars ($2,000) in a calendar year.
-
-The agency may appeal any intermediate restriction or condition to the BHA in accordance with
-the Colorado Administrative Procedures Act Section 24-4-101, et seq., C.R.S.
-
-12.7.4 Right to Appeal
-A.
-
-Any agency adversely affected or aggrieved by these rules or by the BHA’s decisions in regard to
-implementation of these rules, has the right to appeal to the Colorado Department of Personnel
-and Administration, Office of Administrative Courts, and may subsequently seek judicial review of
-the BHA’s action in accordance with Section 24-4-101 through -109, C.R.S.
-
-B.
-
-The following actions may be submitted to an administrative law judge for an evidentiary hearing:
-denial or revocation of an approval.
-
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-
-C.
-
-After written notification from the BHA of intended action, the agency has twenty-one (21)
-calendar days to submit a written appeal. The appeal must be received by the BHA within twentyone (21) days from the date the written notification of action letter was sent by the BHA.
-
-D.
-
-In all cases except waiver denials, the BHA will file a notice of charges with the Office of
-Administrative Courts to begin the administrative process. In waiver denials, if the applicant for
-the waiver requests an appeal, the request for appeal must be forwarded to the Office of
-Administrative Courts. Once the appellant’s request is forwarded to the office of administrative
-courts, the BHA may file a notice of charges.
-
-E.
-
-Subsequent to an evidentiary hearing at the Office of the Administrative Courts and the issuance
-of a final agency decision, a party may seek to appeal the final agency decision through judicial
-review in accordance with Section 24-4-106, C.R.S.
-
-The following sections 21.000 through 21.290.58 and sections 21.400 through 21.400.6 of these rules are
-applicable to agencies approved or designated by the BHA prior to January 1, 2024, pursuant to Section
-27-81-106, C.R.S.; Sections 27-50-101 through 27-50-903; Sections 27-65-101 through 27-65-131; or
-Sections 27-66-101 through 27-66-110, C.R.S. until such time that such agencies’ approval or
-designation expires and/or is up for renewal. Upon renewal, Chapters 1 - 11 above shall apply.
-
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-
-21.000 BEHAVIORAL HEALTH
-21.100 DEFINITIONS
-“42 C.F.R. Part 2” means the federal regulations issued by the Substance Abuse & Mental Health
-Services Administration of the U.S. Department of Health & Human Services found at 42 C.F.R. Part 2
-(Feb. 2018), which are hereby incorporated by reference. No later editions or amendments are
-incorporated. These regulations are available at no cost from the U.S. Department of Health & Human
-Services, Substance Abuse & Mental Health Services Administration, Office of Communications, 5600
-Fishers Lane, Rockville, MD 20857 or at https://www.ecfr.gov/. These regulations are also available for
-public inspection and copying at the Colorado Department of Human Services, Office of Behavioral
-Health, 3824 West Princeton Circle, Denver, Colorado 80236, during regular business hours.
-“Acute Treatment Unit” (ATU) means a designated facility or a distinct part of a facility for short-term
-psychiatric care, which may include substance use disorder treatment. An ATU provides a twenty-four
-(24) hour, therapeutically planned and professionally staffed environment for individuals who do not
-require inpatient hospitalization but need more intense and individualized services, such as crisis
-management and stabilization services, than are available on an outpatient basis, as defined in 27-65102(1), C.R.S.
-“Aggrieved” means having suffered actual loss or injury or being exposed to potential loss or injury to
-legitimate interests as defined in 24-4-102 (3.5), C.R.S.
-“Behavioral Health” for the purposes of these rules, behavioral health includes substance use and mental
-health. “Department” is the Colorado Department of Human Services.
-“Community Mental Health Clinic” means a health institution planned, organized, operated, and
-maintained to provide basic community services for the prevention, diagnosis, and treatment of emotional
-or mental disorders, such services being rendered primarily on an outpatient and consultative basis.
-"Counselor-in-training" means an individual currently in the process of obtaining a professional credential
-pursuant to Part 8 of Article 245 of Title 12, C.R.S. "Counselor-in-training" does not include a psychologist
-candidate; a clinical social worker candidate; a marriage and family therapist candidate; a licensed
-professional counselor candidate; or an addiction counselor candidate.
-“Designated Facility” means an agency has applied for and been approved by the department under
-these rules to provide mental health services.
-“Designated Managed Service Organization” means an organization approved and authorized by the
-Department to manage oversight, quality assurance, and contract compliance of substance use disorder
-treatment providers within one or more of the seven established geographic sub-state planning areas.
-“Disaster” means the occurrence or imminent threat of widespread or severe damage, injury, or loss of life
-or property resulting from any natural cause or cause of human origin, including but not limited to fire,
-flood, earthquake, wind, storm, wave action, hazardous substance incident, oil spill or other water
-contamination requiring emergency action to avert danger or damage, volcanic activity, epidemic, air
-pollution, blight, drought, infestation, explosion, civil disturbance, hostile military or paramilitary action, or
-a condition of riot, insurrection, or invasion existing in the state or in any county, city, town, or district in
-the state as defined in Section 24-33.5-703(3), C.R.S..
-“Emergency” means an unexpected event that places life or property in danger and requires an
-immediate response through the use of state and community resources and procedures Section 24-33.5703(3.5), C.R.S.
-
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-
-“HIPAA” means the Health Insurance Portability and Accountability Act of 1996, pub. l. no. 104-191, 110
-stat. 1936 (1996), codified at 42 U.S.C. § 300GG (2012) and 29 U.S.C. § 1181 et seq. (2012) and 42
-U.S.C. § 1320D et seq. (2012) and the federal regulations issued by the U.S. Department of Health &
-Human Services found at 45 C.F.R. Part 160 (2017); 45 C.F.R. Part 162 (2017); and, 45 C.F.R. Part 164
-(2017), which are hereby incorporated by reference. No later editions or amendments are incorporated.
-These statutes are available for public inspection and copying from the Tenth Circuit Court of Appeals
-Library, Room 430 Byron Rogers Courthouse, 1929 Stout Street, Denver, Colorado 80294, from the
-hours of 8 A.M. TO 4:30 P.M. or at http://uscode.house.gov/. These statutes are also available for public
-inspection and copying at the Colorado Department of Human Services, Office of Behavioral Health, 3824
-West Princeton Circle, Denver, Colorado 80236, during regular business hours. These regulations are
-available at no cost from the U.S. Department of Health & Human Services, Office of Civil Rights, 200
-Independence Avenue, SW, Room 509F, HHH Building, Washington, D.C. 20201 or at
-https://www.ecfr.gov/. These regulations are also available for public inspection and copying at the
-Colorado Department of Human Services, Office of Behavioral Health, 3824 West Princeton Circle,
-Denver, Colorado 80236 during regular business hours.
-“Individual” means a person seeking or receiving services.
-“Inpatient” refers to inpatient hospitalization as well as twenty-four (24) hour residential levels of care.
-“Inspection” means a process of review to ensure licensed or designated entities are operating in
-substantial conformity with applicable licensing and/or designation rules. Inspections may be conducted
-remotely for licensure or designation renewals if the entity has received an on-site visit within three (3)
-years or for entities providing telehealth-only services.
-“Legal Guardian” is an individual appointed by the court, or by will, to make decisions concerning an
-incapacitated individual's or minor's care, health, and welfare.
-“Legal Representative” means one of the following:
-A.
-
-The legal guardian of the individual, where proof is offered that such guardian has been duly
-appointed by a court of law, acting within the scope of such guardianship;
-
-B.
-
-An individual named as the agent in a Power of Attorney (POA) that authorizes the individual to
-act on the individual's behalf, as enumerated in the POA;
-
-C.
-
-An individual selected as a proxy decision-maker pursuant to Section 15-18.5-101, et seq.,
-C.R.S., to make medical treatment decisions. For the purposes of these rules, the proxy decisionmaker serves as the individual's legal representative for the purposes of medical treatment
-decisions only; or,
-
-D.
-
-A conservator, where proof is offered that such conservator has been duly appointed by a court of
-law, acting with the scope of such conservatorship.
-
-“Licensed Agency” means an agency approved and licensed under these rules by the Department to
-provide substance use disorder treatment.
-“Medication formulary” means the Required Formulary Psychotropic Medications: 2018, which is hereby
-incorporated by reference. No later editions or amendments are incorporated. The medication formulary
-is available at no cost from the Colorado Department of Human Services at
-https://www.colorado.gov/pacific/cdhs/behavioral-health-laws-rules. The medication formulary is also
-available for public inspection and copying at the Colorado Department of Human Services, Office of
-Behavioral Health, 3824 West Princeton Circle, Denver, CO 80236, during regular business hours.
-
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-
-The medication formulary is a list of minimum medications, established pursuant to 27-70-103, C.R.S.,
-that may be used by service providers to increase the likelihood that a broad spectrum of effective
-medications are available to individuals to treat behavioral health disorders, regardless of the setting or
-service provider. The medication formulary may not contain a complete list of medications, and providers
-may prescribe and/or carry any additional medications they deem necessary.
-“Office” is the Office of Behavioral Health within the Colorado Department of Human Services.
-“Plan of Action” is a description of how an agency plans to bring into compliance any standards identified
-as out of compliance within a specified time period.
-“Placement facility” means a public or private facility that has a written agreement with a designated
-facility to provide care and treatment to any individual undergoing mental health evaluation or treatment
-by the designated facility. A placement facility may be a general hospital, nursing care facility, or licensed
-residential child care facility.
-“RCCF” means a residential child care facility licensed pursuant to 12 CCR 2509-8, Section 7.705, et
-seq., by the Colorado Department of Human Services, Division of Child Welfare.
-“Short-Term” psychiatric care means the average lengths of services are from three (3) to seven (7) days.
-“The ASAM Criteria” means the publication from the American Society of Addiction Medicine, Mee-Lee,
-D., Shulman, G.D., Fishman, M.J., Gastfriend, D.R., Miller, M.M., EDS. The ASAM Criteria: Treatment
-Criteria for Addictive, Substance-Related, and Co-Occurring Conditions, 3rd ed. Carson City, NV: The
-Change Companies®; 2013, which is hereby incorporated by reference. No later editions or amendments
-are incorporated. Mee-Lee, D., Shulman, G.D., Fishman, M.J., Gastfriend, D.R., Miller, M.M., EDS. The
-ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions, 3rd
-ed. Carson City, NV: The Change Companies®; 2013, is available for a reasonable charge at
-http://www.asam.org/resources/the-asam-criteria. Mee-Lee, D., Shulman, G.D., Fishman, M.J.,
-Gastfriend, D.R., Miller, M.M., EDS. The ASAM Criteria: Treatment Criteria for Addictive, Substance
-Related, and Co-Occurring Conditions, 3rd ed. Carson City, NV: The Change Companies®; 2013, is also
-available for public inspection at the Colorado Department of Human Services, Office of Behavioral
-Health, 3824 West Princeton Circle, Denver, Colorado 80236, during regular business hours.
-21.105 RIGHT TO APPEAL [Eff. 5/1/16]
-Any licensee or designee adversely affected or aggrieved by these rules or by the Department’s decisions
-in regard to implementation of these rules, has the right to appeal to the Colorado Department of
-Personnel and Administration, Office of Administrative Courts, and may subsequently seek judicial review
-of the Department’s action in accordance with Section 24-4-101, et seq., C.R.S.
-A.
-
-The following actions may be submitted to an Administrative Law Judge for an evidentiary
-hearing: denial of a license or designation, provisional license, probationary license, revocation,
-denial of a waiver, limitation of a license, denial of a modification.
-
-B.
-
-After written notification from the Department of intended action, the licensee or designee has
-twenty one (21) calendar days to submit a written appeal. The appeal must be received by the
-Division of Behavioral Health within twenty one (21) days from the date the written notification of
-action letter was sent by the Department.
-
-C.
-
-In all cases except waiver denials, the Department will file a notice of charges with the Office of
-Administrative Courts to begin the administrative process. In waiver denials, the Appellant’s
-request for appeal shall be forwarded to the Office of Administrative Courts. Once the appellant’s
-request is forwarded to the Office of Administrative Courts, the Department may file a notice of
-charges.
-
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-
-D.
-
-An answer to the notice of charges shall be due twenty one (21) calendar days after the date of
-mailing of the notice of charges.
-
-E.
-
-The Office of Administrative Courts shall send out a procedural order directing the course of the
-proceedings and setting the matter for hearing.
-
-F.
-
-Subsequent to an evidentiary hearing at the Office of the Administrative Courts and the issuance
-of a final agency decision, a party may seek to appeal the final agency decision through judicial
-review in accordance with Section 24-4-106, C.R.S.
-
-21.110 GOVERNANCE [Eff. 11/1/13]
-A.
-
-Licensed and or designated entities by the Department shall be recognized by and allowed to do
-business in Colorado.
-
-B.
-
-Governance shall provide for and maintain at minimum:
-1.
-
-Compliance with these rules and applicable federal and state regulations;
-
-2.
-
-Agency operating policies and procedures based on these rules, Department policies and
-procedures, and applicable state and federal regulations;
-
-3.
-
-Organizational structures that clearly delineate staff positions, and lines of authority, and
-supervision;
-
-4.
-
-Adequate financial resources to maintain agency personnel, physical facilities, and
-operations;
-
-5.
-
-Physical facilities that meet all current and applicable local and state health, safety,
-building, plumbing and fire codes and zoning ordinances;
-
-6.
-
-Property liability insurance;
-
-7.
-
-Professional liability (malpractice) insurance;
-
-8.
-
-Accurate, up-to-date individual attendance and payment records; and,
-
-9.
-
-A written emergency plan and procedures that address provisions for dealing with
-medical or natural emergencies. Maps of emergency exits shall be conspicuously posted
-in each site.
-
-21.120 BEHAVIORAL HEALTH LICENSURE AND DESIGNATION
-21.120.1
-
-General Provisions
-
-A.
-
-Any agency licensed and/or designated by the Department shall comply with Sections 21.100
-through 21.190 and all rules applicable to the specific behavioral health services for which it is
-licensed or designated.
-
-B.
-
-The Department will review compliance, at a minimum:
-1.
-
-Licensed agencies once every two (2) years;
-
-2.
-
-Facilities designated to provide mental health services per Title 27, Article 65, C.R.S.,
-annually and all other designated agencies at least once every two (2) years; and,
-
-325
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-Behavioral Health
-
-3.
-
-2 CCR 502-1
-
-When there is reasonable cause to question the agency’s fitness to conduct or maintain a
-license or designation.
-
-C.
-
-Compliance review of sub-contractors and affiliate agencies shall be at the discretion of the
-Department. Review will be limited to those services that are provided pursuant to contract or
-affiliation agreement with the licensed or designated agency.
-
-D.
-
-Based on compliance issues identified through application review and inspection, the agency may
-be issued a provisional or probationary license or designation.
-
-E.
-
-Applicants that are in full compliance shall be granted a Department license to provide substance
-use disorder services and/or designated to provide mental health services for up to two (2)
-consecutive years from the date granted.
-
-F.
-
-Licenses and designations shall be displayed in a prominent, publicly accessible place within
-each agency and or site.
-
-G.
-
-Current licenses and designations shall remain in effect during the approval process when
-completed license and designation applications are received by the Department sixty (60)
-calendar days prior to the existing license or designation expiration date.
-
-H.
-
-An agency whose license or designation is not current shall not indicate in any form or manner
-that it is licensed or designated and shall not provide behavioral health services requiring a
-license or designation.
-
-I.
-
-Any agency site that has not provided behavioral health services specific to its license or
-designation status for two (2) years shall be reviewed for termination of licensure or designation.
-
-J.
-
-Applicants may appeal licensing decisions in accordance with the state Administrative Procedure
-Act, as found in Section 24-4-101, et seq., C.R.S.
-
-21.120.2
-LICENSING PROCEDURES FOR AGENCIES PROVIDING SUBSTANCE USE
-DISORDER SERVICES
-21.120.21
-A.
-
-Criteria [Eff. 11/1/13]
-
-Providers shall obtain a license if:
-1.
-
-Required by statute to be licensed by the Department;
-
-2.
-
-They receive public funds to provide substance use disorder treatment or substance use
-disorder education;
-
-3.
-
-They provide such treatment to individual populations whose referral sources require
-them to be treated in agencies licensed by the Department; or,
-
-4.
-
-They are acquiring existing agencies or sites licensed by the Department.
-
-B.
-
-Licenses for treatment and education services and levels of care are required for each physical
-site.
-
-C.
-
-A license is not transferable from one licensed agency to another, from one treatment site to
-another, or from a licensed agency to an unlicensed organization or individual.
-
-326
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-
-2 CCR 502-1
-
-D.
-
-Hours of education and treatment provided by agencies whose license is not currently in effect
-may not count toward fulfilling individual obligations to courts; probation; parole; Colorado
-Department of Revenue, Motor Vehicle Division; and, other referral sources.
-
-E.
-
-Agencies funded by the Department or a by a designated Managed Service Organization shall be
-licensed to treat individuals involuntarily committed to treatment in accordance with Section
-21.270.
-
-21.120.22
-
-Initial Licenses
-
-A.
-
-Applicants for an initial license to provide substance use disorder services shall submit a
-completed application with required documentation and fees.
-
-B.
-
-An agency may be approved for licensure, granted provisional approval, or have its application
-denied. The applicant shall be advised of the decision in writing within sixty (60) business days of
-the initial inspection.
-
-C.
-
-An applicant not in compliance may have its license application returned by certified mail with
-written summaries of deficiencies and notification that the license application is denied. If an
-applicant disagrees with the decision, s/he may appeal (see Section 21.105); or upon remedying
-the noted deficiencies, may re-apply for an initial license in accordance with Section 21.120.2 of
-these rules. Application fees may not be refunded.
-
-21.120.23
-A.
-
-Provisional Licenses
-
-A provisional license may be granted for a period not to exceed ninety (90) calendar days if after
-initial inspection and review:
-1.
-
-The provider is in substantial compliance with these rules and regulations and is
-temporarily unable to conform to all the minimum standards required under these rules.
-No provisional license shall be issued to a provider if the operations may adversely affect
-individual health, safety, or welfare;
-
-2.
-
-Compliance will be achieved within a reasonable period of time;
-
-3.
-
-The provider has a reasonable written plan or schedule for achieving compliance; and,
-
-4.
-
-The provider shall provide proof that attempts are being made to conform and comply
-with applicable rules.
-
-B.
-
-A second provisional license for a period not to exceed ninety (90) calendar days may be granted
-if substantial progress continues to be made, and it is likely compliance can be achieved by the
-date of expiration of the second provisional license.
-
-C.
-
-During the term of the provisional license, reviews and inspections may be conducted to
-determine if the applicant is in compliance and meets the requirements for a license.
-
-D.
-
-Initial applicants who have completed all provisions and are found to be in compliance prior to the
-expiration of the provisional license shall be granted a license for up to two (2) consecutive years
-from the date the original provisional license was issued.
-
-327
-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-E.
-
-2 CCR 502-1
-
-If the applicant does not come into compliance during the provisional licensing period, the
-application for a two (2) year license shall be denied. A denied application shall be returned by
-certified mail with written summaries of deficiencies and notification that the provisional license is
-no longer in effect as of ten (10) days from the date the letter was mailed. Original application
-fees shall not be refunded. If an applicant disagrees with the decision, s/he may appeal (see
-Section 21.105); or upon remedying the noted deficiencies, may re-apply for an initial license in
-accordance with Section 21.120.2 of these rules.
-
-21.120.24
-
-License Renewal
-
-A.
-
-An agency seeking renewal shall provide the Department with a completed license application
-and the applicable fee at least sixty (60) calendar days prior to the expiration of the existing
-license.
-
-B.
-
-License renewal applications received by the Department after the current license expiration date
-shall be returned by certified mail with written notification that the license is no longer in effect.
-Applicants may reapply for an initial license in accordance with Section 21.120.2 of these rules.
-
-C.
-
-License renewal applications that are received by the Department fewer than sixty (60) calendar
-days prior to the expiration of their existing license may fail to receive their new license prior to
-the expiration of their old license. An agency that submits its renewal application fewer than sixty
-(60) days prior to the expiration of the current license and does not receive a new license prior to
-that date may reapply for an initial license in accordance with Section 21.120.2 of these rules.
-
-D.
-
-Failure of a licensee to accurately answer or report any of the information requested by the
-Department shall be considered good cause to deny the license renewal application.
-
-E.
-
-The agency licensee shall be notified in writing of non-compliance areas and the need for a plan
-of action as outlined in Section 21.120.6. A probationary license may be granted.
-
-F.
-
-An agency in compliance with the applicable Department rules and state and federal regulations
-shall be granted a license renewal effective as of the expiration dates of the current license.
-
-21.120.25
-
-Probationary License [Eff. 11/1/13]
-
-A.
-
-At the Department’s discretion, a probationary license may be granted to an agency out of
-compliance with applicable Department, state or federal regulations prior to issuance of a renewal
-license or during a current license term. The agency will be notified in writing of non-compliance
-areas and the need for a plan of action (see Section 21.120.6).
-
-B.
-
-A probationary license will replace the current license for a period not to exceed ninety (90)
-calendar days.
-
-C.
-
-Administrative and treatment activities may be limited by a probationary license while the agency
-addresses corrective actions.
-
-D.
-
-A probationary license may be re-issued for a period not to exceed ninety (90) calendar days if
-substantial progress continues to be made and it is likely that compliance can be achieved by the
-date of expiration of the second probationary license.
-
-328
-
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-Behavioral Health
-
-E.
-
-If the licensee fails to comply with or complete a plan of action in the time or manner specified, or
-is unwilling to consent to the probationary license, the modification to a probationary license shall
-be treated as a revocation of the licensee and s/he shall be notified by certified mail that the
-probationary license is no longer in effect as of ten (10) days from the date the letter was mailed.
-If an applicant disagrees with the decision, s/he may appeal (see Section 21.105); or upon
-remedying the noted deficiencies, may re-apply for an initial license in accordance with Section
-21.120.2 of these rules.
-
-21.120.26
-A.
-
-2 CCR 502-1
-
-License Modifications
-
-An agency shall submit a license modification application and written documentation
-demonstrating compliance with all applicable Department rules, policies and procedures, a
-minimum of thirty (30) calendar days prior, in the following circumstances:
-1.
-
-Adding, selling, moving or closing agencies, sites, services, or levels of care;
-
-2.
-
-Changing the agency name;
-
-3.
-
-Changing agency governance.
-
-B.
-
-Failure to submit license modification applications and required documentation within thirty (30)
-calendar days may result in the agency, specific sites, and or levels of care not being licensed.
-
-C.
-
-Application fees for a license modification are not required.
-
-D.
-
-Emergency license modification request
-1.
-
-An agency may submit a request to the department for an emergency or disaster
-modification to their license during the timeframe services are disrupted due to a
-statewide emergency or disaster.
-
-2.
-
-An agency shall provide the department information including but not limited to:
-An explanation for the need for an emergency or disaster license modification;
-and,
-
-b.
-
-An explanation or demonstration of compliance with all applicable department
-rules, policies and procedures.
-
-3.
-
-At the department’s discretion, an emergency or disaster license modification may be
-granted to an agency without an on-site inspection by the department.
-
-4.
-
-Upon receiving confirmation of an emergency or disaster license modification, an agency
-may provide services immediately and continue to operate under the modified license for
-up to sixty (60) days after the disaster or emergency has ceased.
-
-5.
-
-To continue to operate beyond sixty (60) days after the emergency or disaster has
-ceased, an agency shall submit a permanent license modification pursuant to
-21.120.26.a.
-
-21.120.27
-A.
-
-a.
-
-Limited License [Eff. 11/1/13]
-
-At the Department’s discretion, a limited license may be issued to an agency to prevent or
-address a perceived conflict of interest and/or a dual relationship within the agency that may
-negatively impact persons receiving services.
-
-329
-
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-Behavioral Health
-
-2 CCR 502-1
-
-The following include, but are not limited to, circumstances where there may be a perceived
-conflict of interest and/or a dual relationship exists within an agency:
-
-B.
-
-C.
-
-1.
-
-The sharing of information across systems that could negatively impact the individual; or,
-
-2.
-
-A financial interest of the agency that may have negative treatment and/or referral
-implications pertaining to the individual; or,
-
-3.
-
-The combining of professional roles within the agency that is incompatible to the best
-interests of the individual(s) receiving treatment.
-
-Limitation of the license may include, but is not limited to:
-1.
-
-Limiting the specific clientele an agency may serve;
-
-2.
-
-Limiting the specific location(s) where an agency may or may not offer services; or,
-
-3.
-
-Limiting the specific level of care that may be provided pursuant to the license.
-
-If an applicant is unwilling to consent to the limitation on the license, the limitation shall be treated
-as a denial and s/he may appeal (see Section 21.105); or upon remedying the noted perceived
-conflict of interest and/or a dual relationship, may re-apply for an initial license in accordance with
-Section 21.120.2 of these rules.
-
-21.120.3
-
-FACILITIES DESIGNATED TO PROVIDE MENTAL HEALTH SERVICES [Eff. 11/1/16]
-
-Facilities designated to provide mental health services may be:
-A.
-
-A general or psychiatric hospital licensed or certified by the Colorado Department of Public Health
-and Environment;
-
-B.
-
-A community mental health center Licensed by the Colorado Department of Public Health and
-Environment or a community mental health clinic;
-
-C.
-
-An acute treatment unit licensed by the Colorado Department of Public Health and Environment;
-
-D.
-
-A crisis stabilization unit, licensed as an acute treatment unit or as a community clinic by the
-Colorado Department of Public Health and Environment; or,
-
-E.
-
-A residential child care facility licensed by the Colorado Department of Human Services, Division
-of Child Welfare.
-
-Applicant facilities shall identify any parent organization ultimately responsible for their operation.
-21.120.31
-
-Application of Rules [Eff. 11/1/16]
-
-A.
-
-Designated facilities that are hospitals, acute treatment units, or crisis stabilization units shall
-comply with all applicable rules including provisions contained in Section 21.280.
-
-B.
-
-Designated facilities that are community mental health centers pursuant to Section 27-66-101,
-C.R.S., shall comply with Sections 21.130 through 21.200.15, where applicable, and Section
-21.280. Treatment provisions, as contained in Sections 21.280.3 through 21. 280.9 shall apply to
-only those individual being treated involuntarily pursuant to Title 27, Article 65, C.R.S.
-
-330
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-Behavioral Health
-
-2 CCR 502-1
-
-C.
-
-Designated facilities that are community mental health clinics shall comply with Sections 21.130
-through 21.200.15 and Sections 21.280.21 through 21.280.22.
-
-D.
-
-Designated facilities that are residential child care facilities (RCCF) shall follow Section 21.120.3
-through 21.120.44 and 21.200 through 21.200.15, where applicable. RCCFs designated to
-provide mental health services pursuant to Title 27, Article 65, C.R.S. shall follow Sections
-21.200, where applicable, and Section 21.280.
-
-E.
-
-Designated managed service organizations (DMSO) shall only comply with 21.120.5 and
-21.120.8.
-
-21.120.32
-Mental Health Services Pursuant to Title 27, Article 65, C.R.S., Care and Treatment
-of Persons with Mental Illness Designations [Eff. 5/1/16]
-A.
-
-B.
-
-A facility meeting the criteria in Section 21.120.3, excluding community mental health clinics, may
-apply to the Department to become designated to provide any or all of the following services:
-1.
-
-Seventy-two (72) hour treatment and evaluation;
-
-2.
-
-Short-term treatment; or,
-
-3.
-
-Long-term treatment.
-
-Facilities designated for seventy-two (72) hour treatment and evaluation, short-term, or long-term
-treatment shall have a person who is licensed in Colorado to practice medicine or a certified
-Colorado psychologist, either employed or under contract, who is responsible for the evaluation
-and treatment of each individual. Hospital staff privileges shall be an acceptable form of
-contractual arrangement. The professional person licensed in Colorado to practice medicine or a
-certified Colorado psychologist may delegate part of his/her duties, except as limited by licensing
-statutes or these rules, but s/he shall remain responsible at all times for the mental health
-treatment administered.
-
-21.120.33
-
-Seventy-Two (72) Hour Treatment and Evaluation Facilities [Eff. 5/1/16]
-
-A.
-
-Facilities that are designated as seventy-two (72) hour treatment and evaluation facilities may
-detain on an involuntary basis persons placed on a seventy-two (72) hour hold for the purpose of
-evaluation and treatment.
-
-B.
-
-ExcIusion of Saturdays, Sundays, and Holidays
-Evaluation shall be completed as soon as possible after admission. The designated treatment
-and evaluation facility may detain a person for seventy-two (72) hour evaluation and treatment for
-a period not to exceed seventy-two (72) hours, excluding Saturdays, Sundays and holidays if
-evaluation and treatment services are not available on those days. For the purposes of these
-rules, evaluation and treatment services are not deemed to be available merely because a
-professional person licensed in Colorado to practice medicine or a certified Colorado psychologist
-is on call during weekends and holidays.
-
-21.120.34
-A.
-
-Short-Term and Long-Term Treatment Facilities [Eff. 5/1/16]
-
-Facilities that are designated as short-term treatment facilities may involuntarily detain individuals
-for short-term (a period of not more than three months) or extended short-term care and
-treatment (a period of not more than an additional three months).
-
-331
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-
-2 CCR 502-1
-
-B.
-
-Facilities that are designated as long-term treatment facilities may involuntarily detain individual
-for long-term care and treatment (a period not to exceed six months) or extended long-term
-treatment (a period of not more than additional six months).
-
-C.
-
-Every person receiving treatment for a mental health disorder by a designated short-term or longterm facility shall upon admission be placed under the care of a person who is licensed in
-Colorado to practice medicine or a certified Colorado psychologist and employed by or under
-contract with the designated facility.
-
-21.120.35
-
-Mental Health Centers and Community Mental Health Clinics [Eff. 5/1/16]
-
-A.
-
-Mental health centers and community mental health clinics shall use membership on the
-governing board or equivalent for soliciting input regarding issues which impact persons receiving
-care. Input shall be solicited from adults, children and adolescents receiving services, and their
-parents or guardians. The input shall be taken into consideration by management or the
-governing board during decision-making processes.
-
-B.
-
-Emergency/crisis services and evaluation under Sections 27-65-105 and 106, C.R.S., shall be
-provided twenty-four (24) hours per day including Saturdays, Sundays and holidays. Initial
-responses to emergencies shall occur either by telephone within fifteen (15) minutes of the call,
-within one (1) hour of contact in urban and suburban areas, or within two (2) hours of contact in
-rural and frontier areas.
-
-21.120.36
-
-Medication Consistency in Designated Facilities
-
-A.
-
-Designated facilities shall ensure all clinical staff are aware of and have access to the medication
-formulary.
-
-B.
-
-Designated facilities shall ensure their providers have access to the medications on the
-medication formulary when prescribing medications to treat behavioral health disorders.
-
-21.120.4
-
-DESIGNATION PROCEDURE
-
-A.
-
-Facilities applying for designation shall submit an application to the Department on a state
-approved form.
-
-B.
-
-Facilities providing twenty-four (24) hour inpatient or acute crisis care, must apply for a separate
-designation based on the unique physical address of each site.
-
-C.
-
-Except in emergency circumstances affecting the facility's ability to provide evaluation and
-treatment services, a facility seeking to exclude Saturdays, Sundays and holidays from the
-seventy-two (72) hour limitation on detaining persons for evaluation and treatment must supply in
-its application for designation or re-designation documentation to establish that it does not have
-evaluation services available on these days due to the limited availability of a professional person
-licensed in Colorado to practice medicine or a certified Colorado psychologist.
-
-D.
-
-Receipt of the application shall be acknowledged in writing and state what additional information
-or documents, if any, are required for review prior to an inspection.
-
-E.
-
-For initial designation applications, the applicant shall be advised in writing within sixty (60)
-calendar days of initial inspection of the decision of the Department. The facility may be approved
-for designation, granted provisional approval, or the application may be denied.
-
-F.
-
-A facility that is found to be in compliance with these rules shall be approved as a facility
-designated to provide mental health services effective for up to a two (2) year period.
-
-332
-
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-
-2 CCR 502-1
-
-G.
-
-Designations shall be automatically revoked or deemed lapsed for any facility whose license to
-operate as a health care or residential child care facility has been withdrawn, revoked or allowed
-to lapse.
-
-H.
-
-If the application for designation is denied, the reason(s) for denial shall be provided in a certified
-letter. If an applicant disagrees with the decision, s/he may appeal (see Section 21.105); or upon
-remedying the noted deficiencies, may re-apply for designation in accordance with Sections
-21.120.3 and 21.120.4 of these rules.
-
-21.120.41
-A.
-
-Provisional Designation [Eff. 11/1/13]
-
-Provisional approval may be granted for a period not to exceed ninety (90) calendar days if, after
-initial inspection and review of a facility:
-1.
-
-The facility is in substantial compliance with these rules, and is temporarily unable to
-conform to all the minimum standards required under these rules. No provisional
-designation shall be issued to a facility if the operation of the facility may adversely affect
-individual health, safety, or welfare;
-
-2.
-
-Compliance will be achieved within a reasonable period of time; and,
-
-3.
-
-The facility has a reasonable plan or schedule in writing for achieving compliance.
-
-B.
-
-The facility shall provide proof that attempts are being made to conform and comply with
-applicable rules.
-
-C.
-
-A second provisional approval for a period not to exceed ninety (90) calendar days may be
-granted under the same criteria if necessary to achieve compliance.
-
-D.
-
-If the facility is not able to come into compliance within one hundred and eighty (180) calendar
-days from date initial provisional license granted, the application may be denied.
-
-21.120.42
-
-Re-Designation
-
-A.
-
-A facility seeking designation renewal shall provide the department with a completed designation
-application at least sixty (60) calendar days prior to the expiration of the existing designation.
-
-B.
-
-Designation renewal applications received by the Department after the current designation
-expiration date shall be returned by certified mail with written notification that the designation is
-no longer in effect. Applicants may reapply for an initial designation in accordance with Section
-21.120.4 of these rules.
-
-C.
-
-Designation renewal applications that are received by the Department fewer than sixty (60)
-calendar days prior to the expiration of their existing designation may fail to receive their new
-designation prior to the expiration of their old designation. An agency that submits its renewal
-application fewer than sixty (60) days prior to the expiration of the current designation and does
-not receive a new designation prior to that date may reapply for an initial designation in
-accordance with section 21.120.2 of these rules.
-
-D.
-
-Failure of a designee to accurately answer or report any of the information requested by the
-Department shall be considered good cause to deny the designation renewal application.
-
-E.
-
-Facilities designated to provide care and treatment to persons with mental health disorders
-pursuant to Section 27-65-101, et seq., C.R.S., shall receive an annual review for compliance. All
-other designated facilities shall be reviewed on-site at least every two (2) years.
-
-333
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-
-2 CCR 502-1
-
-F.
-
-Facilities shall be notified in writing of non-compliance areas and the need for a plan of action as
-outlined in Section 21.120.6. A probationary designation may be granted.
-
-G.
-
-A facility in compliance with applicable Department rules and state and federal regulations shall
-be granted designation effective as of the expiration date for a period not to exceed two (2) years.
-
-21.120.43
-
-Probationary Designation [Eff. 11/1/13]
-
-A.
-
-A probationary designation may be granted to a licensee out of compliance with applicable
-Department or state and federal regulations prior to issuance of a renewal designation or during a
-current designation period. The facility will be notified in writing of non-compliance areas and the
-need for a plan of action (see Section 21.120.6).
-
-B.
-
-A probationary designation will replace the current designation for a period not to exceed ninety
-(90) calendar days.
-
-C.
-
-Administrative and treatment activities may be limited by a probationary designation while the
-facility addresses corrective actions.
-
-D.
-
-A probationary designation may be re-issued for a period not to exceed ninety (90) calendar days
-if substantial progress continues to be made and it is likely that compliance can be achieved by
-the date of expiration of the second probationary license.
-
-E.
-
-If the facility fails to comply with or complete a plan of action in the time or manner specified, or is
-unwilling to consent to the probationary designation, the modification to a probationary
-designation shall be treated as a revocation of the designation and the facility shall be notified by
-certified mail of the deficiencies, reason for action, and that the probationary designation is no
-longer in effect as of ten (10) days from the date the letter was mailed. If the facility disagrees
-with the decision, it may appeal (see Section 21.105); or upon remedying the noted deficiencies,
-may re-apply for a designation in accordance with Sections 21.120.3 and 21.120.4 of these rules.
-
-21.120.44
-
-Change in Designation [Eff. 11/1/13]
-
-If a facility makes a change in its designation status or decides to drop its designation, it shall notify the
-Department in writing not later than thirty (30) calendar days prior to the desired effective date. The facility
-shall submit a written plan for the transfer of care for the individuals with mental health disorders if the
-facility will no longer treat those individuals. This plan shall be submitted no later than ten (10) business
-days prior to the effective date.
-21.120.5
-
-DESIGNATED MANAGED SERVICE ORGANIZATION (DMSO) [Eff. 11/1/13]
-
-A.
-
-The Office of Behavioral Health, within the Department, has the authority pursuant to Section 2780-107, C.R.S., to designate a Managed Service Organization (MSO) responsible for service
-delivery to eligible persons, as described in the annual federal Substance Abuse Prevention and
-Treatment Block Grant application, residing in each of the seven (7) defined geographic regions.
-
-B.
-
-Once designated, each managed service organization shall be reviewed annually for compliance
-pursuant to Section 27-80-107, C.R.S., and Department rules and contract.
-
-C.
-
-MSO’s shall follow all applicable Department rules.
-
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-
-21.120.51
-
-2 CCR 502-1
-
-Role of Designated Managed Service Organizations (DMSO) [Eff. 11/1/13]
-
-A.
-
-Each DMSO will oversee the expenditure of Department funds in providing effective populationspecific substance use disorder treatment and related services to the priority populations
-identified in each applicable contract.
-
-B.
-
-Each DMSO will develop and monitor a network of licensed providers of substance use disorder
-services to deliver a full continuum of care as defined in the Department contract within the
-designated geographic regions of the state.
-
-C.
-
-Each DMSO will ensure the delivery of population-specific services to priority populations as
-defined in the Department contract, to include individuals and families in need of substance use
-disorder treatment and related services.
-
-21.120.52
-
-Reporting Requirements [Eff. 11/1/13]
-
-A.
-
-Each DMSO must maintain a fiscal reporting system that complies with state and federal
-requirements.
-
-B.
-
-Each DMSO must maintain an individual-services reporting system that complies with state and
-federal requirements.
-
-21.120.53
-
-Service Provision [Eff. 11/1/13]
-
-When a DMSO provides substance use disorder treatment or a related service to any individual, it must
-be licensed by the Department and demonstrate compliance with all applicable rules.
-21.120.54
-
-Monitoring and Quality Improvement [Eff. 11/1/13]
-
-A.
-
-Each DMSO must demonstrate ethical, legal, and solvent fiscal practices, and must maintain a
-system for periodic review of its contracts, billing and coding procedures, billing records,
-contractual requirements, and legal requirements.
-
-B.
-
-Each DMSO must maintain a system for periodic review of its contractors to identify any
-intentional or unintentional wrongdoing and to ensure that they are exercising ethical, legal, and
-solvent fiscal practices.
-
-21.120.55
-
-Revocation [Eff. 11/1/13]
-
-A.
-
-Designation shall be revoked for reasons including but not limited to those in Section 21.120.8.
-
-B.
-
-Prior to starting a revocation process, the DMSO shall be notified of the facts or conduct that may
-warrant such action. A plan of action may be required (see Section 21.120.6).
-
-C.
-
-Where there are grounds to find that the DMSO has engaged in deliberate and willful violation or
-that the public health, safety, or welfare requires emergency action, the Department may
-summarily suspend the designation pending proceedings for suspension or revocation.
-
-D.
-
-Written notification of action to revoke a designation shall be sent to the DMSO. Except in cases
-of deliberate and willful violation or of substantial danger to the public health and safety, such
-notice shall be sent at least ten (10) working days before the date such action goes into effect,
-and shall include reasons for the action and rights to the appeal process specified in the State
-Administrative Procedure Act, pursuant to Sections 24-4-105 through 107, C.R.S.
-
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-
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-
-21.120.6
-LICENSE AND DESIGNATION REVIEW PROCESS AND PLANS OF ACTION [Eff.
-11/1/13]
-A.
-
-If after review or pursuant to a complaint, that a licensed or designated agency, contractor, or
-affiliate is not in compliance with these rules, the organization shall be notified in writing, within
-thirty (30) business days, of the specific items found to have been out of compliance.
-
-B.
-
-If the agency does not agree with any or all of the findings regarding non-compliance, the agency
-has ten (10) business days from the receipt of non-compliance notice to dispute the findings by
-submitting evidence to the Department.
-The agency shall receive a written response within thirty (30) business days of the review of
-submitted evidence.
-If the submitted information is sufficient, the agency shall be determined in compliance with these
-rules.
-If the agency continues to be found out of compliance with these rules, the agency shall have
-thirty (30) business days from the date of receipt of the review findings to submit a plan of action.
-The plan shall include anticipated dates for achieving full compliance.
-
-C.
-
-If the agency does not dispute the findings, it shall have thirty (30) business days from the receipt
-of the notice of non-compliance to submit a written plan of action addressing the compliance
-issues. The plan shall include anticipated dates for achieving full compliance within ninety (90)
-business days of the submitted plan.
-
-D.
-
-After reviewing the agency’s plan of action, the Department may take action as follows:
-1.
-
-Approve the proposed plan and schedule for achieving full compliance; or,
-
-2.
-
-Approve a modified plan and schedule for achieving full compliance; or,
-
-3.
-
-Initiate action to revoke, suspend, make probationary, limit, or modify the license or
-designation of the agency as provided in Section 24-4-104, C.R.S.; and,
-
-4.
-
-In cases where a plan of action has been approved, the agency shall remain licensed or
-designated subject to the achievement of the plan of action.
-
-21.120.7
-
-WAIVERS [Eff. 11/1/13]
-
-Every licensed and designated agency shall comply in all respects with applicable rules. Upon application
-to the Department, a waiver of the specific requirements of these rules may be granted in accordance
-with this section, unless the requirements are otherwise required by state or federal law, and individual
-rights shall not be waived.
-A.
-
-Time Period
-A waiver of a specific rule may be granted to a licensed or designated agency, or an agency
-seeking initial application, for a period not to exceed the two year licensing or designation period.
-The waiver may be renewed at the time of re-licensing or designation.
-
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-
-B.
-
-2 CCR 502-1
-
-Compliance with all Other Regulations
-Agencies applying for or granted a waiver shall be in compliance with local, state and federal
-regulations, shall not have outstanding findings with regulatory authorities, and be in good
-standing with meeting any and all contractual requirements related to providing behavioral health
-services.
-
-C.
-
-Grounds for a Waiver
-A waiver may be granted upon a finding that:
-
-D.
-
-1.
-
-The waiver would not adversely affect the health, safety and welfare of the individuals;
-and/or,
-
-2.
-
-Either it would improve care or application of the particular rule would create a
-demonstrated financial hardship on the organization seeking the waiver.
-
-Burden of Proof
-The agency seeking the waiver has the burden of proof. Consideration shall be given as to
-whether the intent of the specific rule has been met.
-
-E.
-
-Placement Facilities
-When a designated agency provides mental health services through a placement facility and a
-waiver is sought for such services, the designated agency and not the placement facility shall
-request the waiver.
-
-F.
-
-Requests for Waivers
-Requests for waivers shall be submitted to the Department on the state prescribed form. The
-request shall include:
-
-G.
-
-1.
-
-A detailed description of the behavioral health services provided by the agency;
-
-2.
-
-The rule section proposed to be waived and the waiver’s effect on the health, safety and
-welfare of the individuals served;
-
-3.
-
-The expected improvement in the care of individuals;
-
-4.
-
-If there would be undue financial hardship on the agency, and to what degree; and,
-
-5.
-
-Signature of the Board President, Director of the agency, or designee.
-
-Decision Process
-Unless additional time is required to make inspections or obtain additional information from the
-agency, the agency shall be notified in writing of the decision within thirty (30) calendar days
-following the date of receipt of the completed waiver application.
-
-H.
-
-Appeal Rights
-An agency may appeal the decision of the Department regarding a waiver application as provided
-by the Colorado Administrative Procedure Act, Sections 24-4-104 and 24-4-105, C.R.S.
-
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-
-21.120.8
-LICENSE AND DESIGNATION REVOCATION, DENIAL, SUSPENSION, LIMITATION
-OR MODIFICATION [Eff. 11/1/13]
-A.
-
-At the Department’s discretion, a license or designation may be revoked, denied, suspended,
-modified or have limited licenses or designation. Written notification of the basis for action shall
-be sent by certified mail to the last known address of the agency, and is effective ten (10) days
-from the date the letter was mailed. If the affected agency disagrees with the decision, it may
-appeal per Section 21.105.
-
-B.
-
-A license or designation may be summarily suspended pending proceedings for suspension or
-revocation in cases of deliberate or willful violation of applicable statutes and regulations or where
-the public health, safety, or welfare requires emergency action.
-
-C.
-
-A license or designation may be revoked, denied, suspended, modified, or limited for reasons
-including, but not limited to, the following:
-1.
-
-Non-compliance with these rules, applicable federal and state laws and regulations, or
-contracting requirements.
-
-2.
-
-Negligence resulting in risk to individuals, staff, public health or safety;
-
-3.
-
-Knowingly using or disseminating misleading, deceptive, or false information about other
-agencies including, but not limited to, advertising;
-
-4.
-
-Exercising undue influence on or otherwise exploiting individuals to obtain or sell
-services, goods, property, or drugs for financial or personal gain;
-
-5.
-
-Accepting commissions, rebates, or other forms of remuneration for referring persons to
-or by the licensed or designated agency;
-
-6.
-
-Evidence of agency fraud or misrepresentation;
-
-7.
-
-Failure to provide persons with information required by these rules and applicable state
-and federal statutes, rules, and regulations;
-
-8.
-
-Failure to submit required data in an accurate and timely manner to the Department or its
-authorized representatives;
-
-9.
-
-Withholding access to clinical, staff, or fiscal records, or administrative information when
-requested by the Department;
-
-10.
-
-Sale, use or distribution of alcohol or illicit drugs, or unauthorized sale or distribution of
-prescription or over-the-counter drugs on treatment premises or during treatment
-activities off premises;
-
-11.
-
-Knowingly using, and/or disseminating false information about these rules, Department
-rules and state or federal regulations, or other information essential to interpreting or
-managing an individual’s status, case management or interagency coordination.
-
-12.
-
-Commits a fraudulent insurance act as defined in Section 10-1-128, C.R.S.
-
-13.
-
-Failure to comply with a written plan of action.
-
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-
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-
-21.130 DATA REQUIREMENTS [Eff. 11/1/13]
-Licensed and designated organizations shall provide accurate and timely submission of required data to
-the Department identified data collection systems or its authorized representatives and retain a copy in
-treatment record.
-21.140 CRITICAL INCIDENT REPORTING
-A critical incident is any significant event or condition that must be reported within twenty-four (24) hours
-to the Department that is of public concern and/or has jeopardized the health, safety and/or welfare of
-individuals or staff.
-A.
-
-The Department may conduct scheduled or unscheduled site reviews for specific monitoring
-purposes and investigation of critical incidents reports in accordance with:
-1.
-
-CDHS policies and procedures;
-
-2.
-
-Regulations that protect the confidentiality and individual rights in accordance with
-Sections 27-65-101, et seq., C.R.S.; HIPAA; AND, 42 C.F.R. Part 2.
-
-3.
-
-Controlled substance licensing, Title 27, Article 82, C.R.S.; Section 27-80-212, C.R.S.,
-and Section 18-18-503, C.R.S.
-
-B.
-
-The Department shall have access to relevant documentation required to determine compliance
-with these rules.
-
-C.
-
-The agency shall:
-
-D.
-
-1.
-
-Establish written policies and procedures for reporting and reviewing all critical incidents
-occurring at the facility;
-
-2.
-
-Submit Critical Incidents reports to the Department according to state prescribed forms.
-This is not in lieu of other reporting mandated by state statute or federal guidelines;
-
-3.
-
-Make available a report with the investigation findings for review by the Department, upon
-request; and,
-
-4.
-
-Maintain critical incidents reports for a minimum of three years following the incident.
-
-Nothing in this section shall be construed to limit or modify any statutory or common law right,
-privilege, confidentiality or immunity.
-
-21.150 QUALITY IMPROVEMENT [Eff. 11/1/13]
-A.
-
-The agencies and programs that the Department contracts with, licenses, or designates, shall
-have a quality improvement program designed to monitor, evaluate, and initiate activities to
-improve the quality and effectiveness of administrative and behavioral health services.
-
-B.
-
-The agency shall adopt and implement a written quality improvement plan that includes, at a
-minimum the following processes:
-1.
-
-Clinical quality measurement of performance.
-
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-
-2 CCR 502-1
-
-2.
-
-Determine the appropriateness and effectiveness of treatment through a clinical review of
-a representative sample of open and closed records at a minimum of every six (6)
-months.
-
-3.
-
-Identify and respond to trends concerning significant events, risks, emergency
-procedures, critical incidents as defined in Section 21.140, and grievances as defined in
-Section 21.180.
-
-4.
-
-Incorporate documented quality improvement findings into clinical and organizational
-planning, decision making, and to develop staff and individual educational programs.
-
-5.
-
-Evaluate annually and update the quality improvement plan as necessary. A copy of the
-annual findings and report shall be available for review.
-
-21.160 PERSONNEL
-21.160.1
-A.
-
-GENERAL PROVISIONS
-
-The organization shall have written personnel policies and procedures that include:
-1.
-
-Personnel (including contracted staff, interns, and volunteers) shall have access to and
-be knowledgeable about the organization’s policies, procedures, and state and federal
-laws and regulations relevant to their respective duties.
-
-2.
-
-Personnel are assigned duties that are commensurate with documented education,
-training, work experience, and professional licenses and certifications. Licensed or
-certified staff shall perform duties in accordance with applicable statutes, rules and
-regulations.
-
-3.
-
-Training
-a.
-
-The organization shall document the evaluation of applicable previous related
-experience for volunteers and for staff, and ensure that these personnel have all
-of the training, including on-the-job training, required in this section.
-
-b.
-
-All staff shall be given on-the-job training or have related experience in the job
-assigned to them. They shall be supervised until they have completed on-the-job
-training appropriate to their duties and responsibilities, or have had previous
-related experience evaluated.
-
-c.
-
-The organization shall maintain records documenting completion of all required
-training, or review of evaluation of previous related experience.
-
-d.
-
-Volunteers having direct individual contact shall receive training appropriate to
-their duties and responsibilities.
-
-e.
-
-Personnel shall receive the following training when first hired and on a periodic
-basis:
-1)
-
-Training specific to the particular needs of the populations served;
-
-2)
-
-Orientation of the physical plant;
-
-3)
-
-Emergency preparedness;
-
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-
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-
-4.
-
-2 CCR 502-1
-
-4)
-
-Individual rights of the population served;
-
-5)
-
-Confidentiality (individual privacy and records privacy and security); and,
-
-6)
-
-Training on needs identified through the quality improvement program.
-
-Personnel (including contracted staff, interns, and volunteers) shall not engage in
-prohibited activities outlined in Section 12-245-224, C.R.S.
-
-B.
-
-Documentation of training, including topics and attendance, shall be maintained in personnel files
-or organization training log.
-
-C.
-
-Personnel files for each staff shall be maintained by the organization.
-1.
-
-Files of current staff shall be available onsite for review by the Department.
-
-2.
-
-Files shall include documentation of:
-
-21.160.2
-A.
-
-B.
-
-a.
-
-Job description that shall detail minimum qualifications, core competencies,
-duties, and supervisory structure;
-
-b.
-
-Education and work experience; and
-
-c.
-
-Background investigations as described in Section 21.160.2.
-
-BACKGROUND CHECKS AND EMPLOYEE VERIFICATION
-
-Pre-employment background investigations:
-1.
-
-Shall be required for all staff, interns and volunteers who have direct contact with
-individuals receiving services.
-
-2.
-
-Take place at submission of an initial Office of Behavioral Health license or designation
-application or take place at pre-employment.
-
-3.
-
-Consist of at least a criminal background check performed by the Colorado Bureau of
-Investigation.
-
-Pre-employment inquiries:
-1.
-
-The agency shall verify license, certification, and a check of disciplinary action through
-the Colorado Department of Regulatory Agencies; and,
-
-2.
-
-Complete a reference check.
-
-C.
-
-Organizations shall maintain evidence of background investigations and employee verification in
-personnel files.
-
-D.
-
-The organization shall have written criteria for evaluating which convictions or complaints make
-an applicant unacceptable for hire or a staff unacceptable for retention.
-
-E.
-
-The organization shall incur the costs of obtaining a criminal history and background check of
-potential employees.
-
-F.
-
-The organization shall develop and implement written criteria for:
-
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-
-2 CCR 502-1
-
-1.
-
-Routine monitoring of employee credentials and disciplinary actions; and,
-
-2.
-
-Reporting requirements of investigations, indictments, or convictions that may affect
-employee’s ability to carry out his/her duties or functions of job.
-
-21.170 RECORDS CARE AND RETENTION
-21.170.1
-
-GENERAL PROVISIONS
-
-A.
-
-Agencies shall assure that all paper and electronic records are maintained to prevent
-unauthorized access in accordance with 42 C.F.R. Part 2 and HIPAA.
-
-B.
-
-For outpatient agencies:
-
-C.
-
-1.
-
-Individual records for adults shall be retained for seven (7) years from date of discharge
-from agency.
-
-2.
-
-For individuals who are under eighteen (18) years of age when admitted to the agency,
-records shall be retained until the individual is twenty five (25) years of age.
-
-For inpatient agencies:
-1.
-
-Individual records for adults shall be retained for ten (10) years from date of discharge
-from agency.
-
-2.
-
-For individuals who are under eighteen (18) years of age when admitted to the agency,
-records shall be retained until the individual is twenty eighty (28) years of age.
-
-D.
-
-All records are to be disposed in accordance with State and Federal confidentiality statutes and
-regulations.
-
-E.
-
-Disposal services commissioned by an agency to dispose of individual records shall sign
-Qualified Service Organization Agreements or Business Associate Agreements.
-
-F.
-
-Staff having access to individual records shall be knowledgeable of state and federal statutes,
-policies, and procedures which protect individual identity and service information from
-unauthorized access and disclosure.
-
-G.
-
-Agencies shall develop policies and procedures that protect individual identity and treatment
-information when transporting electronic and written records.
-
-H.
-
-Agencies shall establish guidelines for reporting breach or potential loss of individual identity and
-service information in accordance with state and federal confidentiality statutes and regulations.
-
-I.
-
-Records shall be accessible to agency staff and the Department.
-
-J.
-
-Agencies that are closing or acquired by another agency shall protect individual identity per state
-and federal regulations.
-
-21.170.2
-A.
-
-CONFIDENTIALITY [Eff. 11/1/13]
-
-The confidentiality of the individual record, including all medical, mental health, substance use,
-psychological and demographic information shall be protected at all times, in accordance with all
-applicable state and federal laws and regulations.
-
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-CODE OF COLORADO REGULATIONS
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-
-B.
-
-2 CCR 502-1
-
-The information in this section shall not be construed to limit the access of duly authorized
-representatives of the Department to confidential material for purposes of assuring compliance
-with these rules. Such duly authorized representatives of the Department are obligated to protect
-the confidentiality of any individual information reviewed.
-
-21.170.3
-
-RELEASE OF INFORMATION
-
-A.
-
-An agency that is licensed or designated by the Department must comply with release of
-information regulations Pursuant to 42 C.F.R. Part 2 and HIPAA.
-
-B.
-
-The signed release of information shall state, at a minimum:
-
-C.
-
-D.
-
-1.
-
-Persons who shall receive the information;
-
-2.
-
-For what purpose;
-
-3.
-
-The information to be released;
-
-4.
-
-That it may be revoked by the individual, parent, or legal guardian at any time;
-
-5.
-
-That the release of information shall be time limited up to two (2) years.
-
-Records shall be released to the staff of the governor’s designated Protection and Advocacy
-System for Individuals with Mental Illness, per Section 27-65-121(1)(i), C.R.S., under the
-following guidelines for all records of:
-1.
-
-Any individual who is an individual of the system or the legal guardian, conservator, or
-other legal representative of such individual has authorized the system to have access;
-
-2.
-
-Any individual with a mental health disorder, who has a legal guardian, conservator, or
-other legal representative, with respect to whom a complaint has been received by the
-system or with respect to whom there is probable cause to believe the health or safety of
-the individual is in serious and immediate jeopardy, whenever:
-a.
-
-Such representative has been contacted by such system upon receipt of the
-name and address of such representative;
-
-b.
-
-Such system has offered assistance to such representative to resolve the
-situation;
-
-c.
-
-Such representative has failed or refused to act on behalf of the individual.
-
-Whenever a family member or other party requesting information, not including the agency,
-requests that information revealed to treating personnel remain confidential, such information
-shall not be released unless otherwise provided by law or court order.
-1.
-
-Whenever confidential information provided by a family member or other party providing
-information is ordered released, attempts shall be made to notify the family member or
-informant of the release of information by the individual who has obtained the court order.
-
-2.
-
-The fact that confidential information is being withheld may be disclosed to individuals
-requesting the information, but if the individual's attorney has requested the information,
-the fact that confidential information is being withheld shall be disclosed.
-
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-
-21.170.4
-
-2 CCR 502-1
-
-CONSENTS
-
-A.
-
-A written agreement shall be executed between the agency and the individual or the individual’s
-legal representative at the time of admission. The parties may amend the agreement provided
-such amendment is evidenced by the written consent of both parties. No agreement shall be
-construed to relieve the organization of any requirement or obligation imposed by law or
-regulation.
-
-B.
-
-Individual consents shall include consent to treatment.
-
-C.
-
-Services shall involve families and significant others with written individual consent, unless
-clinically contraindicated.
-
-D.
-
-For minor's consent, please review Care of Children, Youth, and Families in Section 21.200.13.
-
-E.
-
-For opioid medication assisted treatment consent, see Section 21.320.
-
-F.
-
-If the Governor or local government declares an emergency or disaster an agency may obtain
-documented oral agreements or consents in place of written agreements or consents.
-Documented oral agreements and consents shall only be used as necessary because of
-circumstances related to the emergency or disaster. Agencies shall send a hard copy or
-electronic copy of the documented agreement or consent to the individual within two (2) business
-days of the oral agreement or consent.
-
-21.180 GRIEVANCE [Eff. 11/1/13]
-A.
-
-The agency shall establish a uniform procedure for prompt management of grievances brought by
-individuals accessing, receiving or being evaluated for services and their family members. The
-organization shall develop policies and procedures for handling grievances. A grievance shall
-mean any expression of dissatisfaction about any matter related to provided services, and shall
-be accepted verbally or in writing.
-
-B.
-
-The agency shall provide a fair and accessible grievance resolution process, which shall provide
-the individual with a resolution no later than fifteen (15) business days from submission of the
-grievance. If the grievance is received verbally the representative shall create a written
-documentation of the grievance.
-
-C.
-
-The agency shall designate a representative, who shall be available to assist individuals in
-resolving grievances, and who shall have no involvement in the clinical or regular care of the
-individual.
-
-D.
-
-The agency shall educate service recipients and their representatives about the mechanisms in
-place for filing grievances. This education shall include rights, and internal grievance process and
-procedures, and the name, contact information, and responsibilities of the designated
-representative within the agency. Appropriate contacts for external appeal shall also be provided,
-which may include, but are not limited to, the following: the Colorado Department of Regulatory
-Agencies, the Colorado Department of Public Health and Environment, the Colorado Department
-of Health Care Policy and Financing, or the governor’s designated Protection and Advocacy
-System for Individuals with Mental Illness. Documentation in the records shall include dated
-signature of the individual receiving the information.
-
-E.
-
-A notice of rights, grievance procedure, the representative’s name, office location,
-responsibilities, and telephone number shall be posted within the agency in prominent locations
-where persons access, receive or are evaluated for services.
-
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-
-F.
-
-2 CCR 502-1
-
-The agency shall maintain a record of submitted grievances, separate from the individual records
-that include the date, the type of grievance, and the outcome of investigation. Data shall be
-reported annually to the Department.
-
-21.190 DOCUMENTATION IN INDIVIDUAL RECORDS
-21.190.1
-
-DEFINITIONS [Eff. 5/1/16]
-
-“Admission Summary” is a brief review of assessments and other relevant intake data, including
-screenings, which summarizes the current status and provides a basis for individualized service planning.
-“Assessment” is a formal and continuous process of collecting and evaluating information about an
-individual for service planning, treatment and referral. This information establishes justification for
-services.
-“Best Practices” are interventions, techniques, and treatment approaches that have some quantitative
-data showing positive treatment outcomes over a period of time, but may not have enough research or
-replication to be considered an evidence-based approach.
-“Case Management” means activities that are intended to help individuals gain access to behavioral
-health and supportive services (including social, educational, and medical) that are coordinated and
-appropriate to the changing needs and stated desires of the individual over time. Activities include, but
-are not limited to: service planning, referral, monitoring, follow-up, advocacy, and crisis management.
-“Chief Complaint/Presenting Problem” means the reason/concern/motivation that prompts the client to
-seek services or that their referral source identifies as the issue, which requires intervention, usually in
-the person’s own words. It also includes onset, duration, other symptoms noted, progression of the
-problem, solutions attempted at alleviating the problem, how the person’s life has been impacted, and
-how the person views responsibility for the problem. It can be information from a referral, family or other
-professional.
-“Culture” means the shared patterns of behaviors and interactions, cognitive constructs, and affective
-understanding learned through a process of socialization. These shared patterns identify the members of
-a culture group while also distinguishing those of another group. People within a culture usually interpret
-the meaning of symbols, artifacts, and behaviors in the same or similar ways. Culture includes, but is not
-limited to: race, ethnicity, religion, spirituality, gender, sexual orientation, language and disabilities.
-“Cultural Assessment” means identifying and understanding aspects of an individual's culture and
-linguistic needs in order to incorporate the information into service planning and service delivery. It is
-necessary to incorporate cultural considerations into service delivery in order to best understand and
-address ways in which culture influences an individual's behavioral health issues.
-“Discharge” means the termination of treatment obligations and service between the individual and the
-agency.
-“Evidence-Based” practices, principles, and programming are interventions, techniques, and treatment
-methods that have been tested using scientific methodology and proven to be effective in improving
-outcomes for a specific population.
-“Screening” is a brief process used to determine the identification of current behavioral health or health
-needs and is typically documented through the use of a standardized instrument. Screening is used to
-determine the need for further assessment, referral, or immediate intervention services.
-
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-
-21.190.2
-
-2 CCR 502-1
-
-CONTENT OF RECORDS [Eff. 5/1/16]
-
-A.
-
-A confidential record shall be maintained for each individual. Records shall be dated and legibly
-recorded in ink or in electronic format.
-
-B.
-
-Documents shall include, where applicable:
-
-C.
-
-1.
-
-Consent to treatment;
-
-2.
-
-Consent to release confidential information;
-
-3.
-
-Assessments and screenings;
-
-4.
-
-Admission summary;
-
-5.
-
-Service plan;
-
-6.
-
-Re-assessment(s);
-
-7.
-
-Progress notes;
-
-8.
-
-Medication administration or monitoring record;
-
-9.
-
-Physician's orders;
-
-10.
-
-Documentation of on-going services provided by external services providers;
-
-11.
-
-Advance directives;
-
-12.
-
-Acknowledgements and disclosures;
-
-13.
-
-Legal and court paperwork; and,
-
-14.
-
-Discharge summaries.
-
-See specific program areas for additional content of record requirements.
-
-21.190.3
-A.
-
-ASSESSMENT [Eff. 5/1/16]
-
-A comprehensive best practices assessment shall be completed as soon as is reasonable upon
-admission and no later than seven (7) business days of admission into services with the noted
-exceptions:
-1.
-
-Acute Treatment Unit: within twenty-four (24) hours of admission.
-
-2.
-
-Withdrawal Management units, inpatient hospitalization: within seventy-two (72) hours of
-admission.
-
-B.
-
-Assessment shall continue throughout the course of treatment and shall be reviewed and
-updated when there is a change in the person's level of care or functioning, or, must occur at
-minimum, every six months.
-
-C.
-
-All methods and procedures used to assess and evaluate an individual shall be developmentally
-and age appropriate, culturally responsive, and conducted in the individual's preferred language
-and/or mode of communication.
-
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-
-D.
-
-E.
-
-The assessment shall be documented in the individual record and, at minimum, include the
-following where information is available and applicable:
-1.
-
-Identification and demographic data;
-
-2.
-
-Chief complaint/presenting problem;
-
-3.
-
-Mental health history;
-
-4.
-
-Substance use;
-
-5.
-
-Physical and dental health status;
-
-6.
-
-A diagnosis with sufficient supporting criteria and any subsequent changes in diagnosis;
-
-7.
-
-A mental status examination for each individual who is given a diagnosis;
-
-8.
-
-History of involuntary treatment;
-
-9.
-
-Advance directives.
-
-10.
-
-Capacity for self-sufficiency and daily functioning;
-
-11.
-
-Cultural factors that may impact treatment, including age, ethnicity,
-linguistic/communication needs, gender, sexual orientation, relational roles, spiritual
-beliefs, socio-economic status, personal values, level of acculturation and/or assimilation,
-and coping skills;
-
-12.
-
-Education, vocational training, and military service;
-
-13.
-
-Family and social relationships;
-
-14.
-
-Trauma;
-
-15.
-
-Physical/sexual abuse or perpetration and current risk;
-
-16.
-
-Legal issues;
-
-17.
-
-Issues specific to older adults such as hearing loss, vision loss, strength; mobility and
-other aging issues;
-
-18.
-
-Issues specific to children/adolescents such as growth and development, daily activities,
-legal guardians and need for family involvement and engagement in the child's treatment;
-
-19.
-
-Strengths, abilities, skills, and interests; and,
-
-20.
-
-Barriers to treatment.
-
-See specific program areas for additional assessment requirements.
-
-21.190.4
-
-SERVICE PLANNING AND REVIEWS
-
-21.190.41
-
-Service Planning Requirements [Eff. 5/1/16]
-
-A.
-
-2 CCR 502-1
-
-An individualized, integrated, comprehensive, written service plan will be:
-
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-
-2 CCR 502-1
-
-1.
-
-Collaboratively developed between the individual and service provider or treatment team;
-
-2.
-
-Goal focused;
-
-3.
-
-Written in a manner that fosters an individual's highest possible level of independent
-functioning; and,
-
-4.
-
-Ongoing throughout treatment.
-
-B.
-
-Service planning shall be developed with the individual following an identified assessment(s) and
-shall apply intervention, treatment, recovery oriented services and continuing care strategies to
-the degree indicated by the findings of the assessment(s).
-
-C.
-
-An initial service plan shall be formulated to address the immediate needs of the individual within
-twenty-four (24) hours of assessment.
-
-D.
-
-The service plan shall be developed, by a multidisciplinary team when applicable, as soon as is
-reasonable after admission and no later than:
-
-E.
-
-1.
-
-Acute Treatment Units (ATU): twenty-four (24) hours of admission;
-
-2.
-
-Withdrawal Management: seventy-two (72) hours of admission;
-
-3.
-
-Inpatient Hospitalization: seventy-two (72) hours of admission;
-
-4.
-
-Residential Treatment Facility: ten (10) business days after assessment;
-
-5.
-
-Partial Hospitalization: seven (7) business days after assessment; or,
-
-6.
-
-Outpatient: fourteen (14) business days after assessment.
-
-In addition, services plans shall:
-1.
-
-Specify goals based on the assessment;
-
-2.
-
-Be strength-based, gender appropriate, and individually directed;
-
-3.
-
-Reflect findings of a cultural assessment, to include, but not limited to: gender, sexual
-orientation, socio-economic status, ethnicity, personal values, level of acculturation
-and/or assimilation, spirituality, linguistics, age, family systems, interpretation of trauma
-and coping skills;
-
-4.
-
-Contain specific, measurable, attainable objectives that relate to the goals and have
-realistic expected date(s) of achievement;
-
-5.
-
-Goals and objectives written in a manner understandable to the individual;
-
-6.
-
-Identify the type, frequency and duration of services;
-
-7.
-
-Be developmentally and/or age appropriate; and,
-
-8.
-
-Include involvement of other identified family and supportive individuals, when
-appropriate.
-
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-
-2 CCR 502-1
-
-F.
-
-All parties (the individual, legal guardian, multidisciplinary team members) who participate in the
-development of the plan shall sign the plan. The record shall contain documentation whenever a
-plan is not signed by the individual or participating parties.
-
-G.
-
-There shall be documentation that the individual was offered a copy of the plan.
-
-21.190.42
-A.
-
-B.
-
-Service Plan Revisions and Reviews [Eff. 5/1/16]
-
-Unless otherwise indicated, reviews and any service plan revisions shall be completed and
-documented when there is a change in the individuals' level of functioning or service needs and
-no later than:
-1.
-
-Acute Treatment Units (ATU) and Withdrawal Management: three (3) calendar days;
-
-2.
-
-Inpatient Hospitalization: every seven (7) calendar days for four (4) weeks; after four (4)
-weeks: monthly; and, after six (6) months: quarterly;
-
-3.
-
-Residential Treatment Facility: monthly for six (6) months and quarterly after six (6)
-months;
-
-4.
-
-Partial Hospitalization: every fourteen (14) calendar days;
-
-5.
-
-Opioid Medication Assisted Treatment: every three (3) months; or,
-
-6.
-
-Outpatient: every six (6) months, unless individuals receive medication/psychiatric
-services only as described in Section 21.190.7.
-
-The service plan review shall include documentation of:
-1.
-
-Progress made in relation to planned treatment outcomes;
-
-2.
-
-Any changes in the individual's treatment focus; and,
-
-3.
-
-Adjustments to the plan concerning individual lengths of stay as indicated by on-going
-assessments.
-
-C.
-
-Reviews shall be conducted collaboratively by clinician and individual.
-
-D.
-
-The record shall contain documentation whenever the individual or participating parties do not
-sign a revised plan.
-
-E.
-
-There shall be documentation that the individual was offered a copy of the plan.
-
-21.190.5
-
-TREATMENT PROGRESS DOCUMENTATION REQUIREMENTS [Eff. 5/1/16]
-
-A.
-
-Progress notes are a written chronological record of an individual's progress in relation to planned
-outcomes of services.
-
-B.
-
-Progress notes shall contain the following information unless otherwise noted in specific service
-population sections of these rules:
-1.
-
-Ongoing progress including dates and types of service, adhering to program-specific
-frequency requirements;
-
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-
-2.
-
-2 CCR 502-1
-
-A summary of the activity for the session and progress toward specific treatment goals to
-be completed with minimum frequency of:
-a.
-
-One (1) note per session for outpatient and intensive outpatient,
-
-b.
-
-Daily for inpatient and intensive residential services,
-
-c.
-
-Weekly for partial hospitalization and all other levels of residential treatment;
-
-3.
-
-The individual's response to treatment approaches and information about progress
-toward achieving service plan goals and objectives;
-
-4.
-
-Changes in the service plan with reasons for such changes;
-
-5.
-
-Information regarding support and ancillary services recommended and provided;
-
-6.
-
-Any significant change in physical, behavioral, cognitive and functional condition and
-action taken by staff to address the individual's changing needs; and,
-
-7.
-
-Case management notes reflecting the content of each contact, including ancillary and
-collateral contacts.
-
-C.
-
-Treatment notes shall not include protected health information pertaining to other individuals
-receiving services.
-
-D.
-
-Treatment entries shall be signed and dated by the author at the time they are written, with at
-least first initial, last name, degree and or professional credentials. Telephone orders shall be
-written at the time they are given and authenticated at a later time.
-
-21.190.6
-
-DISCHARGE PLANNING AND SUMMARIES
-
-21.190.61
-
-Discharge Planning Requirements [Eff. 5/1/16]
-
-A.
-
-Discharge planning begins at the time of admission, is updated during the course of services, and
-engages the individual and support systems s/he identifies in the planning process.
-
-B.
-
-Discharge policies and procedures shall include criteria outlining the requirements for an
-individual's discharge from treatment.
-
-C.
-
-Discharge plans shall be concise, complete, and comprehensive to facilitate transition to the next
-level of care when applicable.
-
-D.
-
-Persons receiving services on a voluntary basis shall be discharged from treatment immediately
-at their request unless emergency commitments or emergency mental health holds are in effect.
-
-E.
-
-Documentation of discharge information provided to the individual, where applicable, shall
-include:
-1.
-
-Medications at discharge including, dosages and instructions for follow-up;
-
-2.
-
-Legal status and any other legal restrictions placed upon the individual;
-
-3.
-
-Referrals with details; and,
-
-4.
-
-Information if the discharge is being made against advice of provider.
-
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-
-21.190.62
-
-2 CCR 502-1
-
-Discharge Summary [Eff. 5/1/16]
-
-Discharge summaries shall be completed as soon as possible, no later than thirty (30) calendar days after
-discharge. The agency's policy and procedures shall determine the minimum timeframe for completion.
-Records shall contain a written discharge summary to include, but not limited to, the following information,
-where applicable:
-A.
-
-Reason for admission;
-
-B.
-
-Reason for discharge;
-
-C.
-
-Primary and significant issues identified during course of services;
-
-D.
-
-Diagnoses;
-
-E.
-
-Summary of services, progress made, and outstanding concerns;
-
-F.
-
-Coordination of care with other service providers;
-
-G.
-
-Advance directives developed or initiated during course of services.
-
-H.
-
-Summary of medications prescribed during treatment, including the individual's responses to
-medications;
-
-I.
-
-Medications recommended and prescribed at discharge;
-
-J.
-
-Summary of legal status throughout the course of services and at time of discharge;
-
-K.
-
-Documentation of referrals and recommendations for follow up care;
-
-L.
-
-Documentation of the individual's and/or family's response and attitude regarding discharge; and,
-
-M.
-
-Information regarding the death of the individual.
-
-21.190.7
-MEDICATION/PSYCHIATRIC SERVICES ONLY AT MENTAL HEALTH CENTERS
-AND CLINICS [Eff. 11/1/13]
-A.
-
-A person qualifies to be classified as receiving medication/psychiatric services only when the
-agency provides a maximum of three (3) services, in addition to services related to medications,
-within a six (6) month period of time.
-
-B.
-
-At least annually, a licensed behavioral health professional shall complete and document in the
-clinical record:
-1.
-
-Clinical rationale supporting a medication/psychiatric services only status;
-
-2.
-
-An updated assessment;
-
-3.
-
-An updated service plan; and,
-
-4.
-
-A Colorado Client Assessment Record (CCAR).
-
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-
-2 CCR 502-1
-
-21.200 CARE AND TREATMENT OF CHILDREN, YOUTH AND FAMILIES
-21.200.1
-
-BEHAVIORAL HEALTH SERVICES FOR CHILDREN AND YOUTH
-
-21.200.11
-
-Definitions
-
-A.
-
-“Psychotherapy” or “psychotherapy services” as defined in Section 12-245-202(14), C.R.S.,
-means the treatment, diagnosis, testing, assessment, or counseling in a professional relationship
-to assist individuals or groups to alleviate behavioral and mental health disorders, understand
-unconscious or conscious motivation, resolve emotional, relationship, or attitudinal conflicts, or
-modify behaviors that interfere with effective emotional, social, or intellectual functioning.
-Psychotherapy follows a planned procedure of intervention that takes place on a regular basis,
-over a period of time, or in the cases of testing, assessment, and brief psychotherapy,
-psychotherapy can be a single intervention.
-
-B.
-
-“Youth” in this section means, under the age of twenty-one (21), unless otherwise noted.
-
-21.200.12
-
-General Provisions
-
-A.
-
-In addition to these rules, programs providing behavioral health services to children and
-adolescents must follow provisions made in Sections 21.110 through 21.190.
-
-B.
-
-Residential child care facilities licensed by the Colorado Department of Human Services, Division
-of Child Welfare, shall follow Sections 21.120 and 21.200, where applicable.
-
-21.200.13
-
-Rights of Children and Adolescents
-
-These provisions shall not apply to any youth admitted to a facility designated under Title 27, Article 65,
-C.R.S., Care and Treatment of Persons with Mental Illness, for behavioral health purposes pursuant to
-the Children’s Code, Title 19, C.R.S., when there have been judicial proceedings authorizing the
-placement of the youth into a facility.
-A.
-
-B.
-
-C.
-
-In addition to the individual rights in Section 21.280.26 for adults, youth who are fifteen (15) years
-of age or older, with or without the consent of a parent or legal guardian, have the right to:
-1.
-
-Consent to receive behavioral health services from an agency or a professional person;
-
-2.
-
-Consent to voluntary hospitalization;
-
-3.
-
-Object to hospitalization and to have that objection reviewed by the court under the
-provision of Section 27-65-103, C.R.S.; and
-
-4.
-
-Consent to release of information.
-
-Parents or legal guardians shall be contacted without the youth’s written or verbal consent if:
-1.
-
-The individual presents as a danger to self or others; or,
-
-2.
-
-Essential medical information is necessary for parents or legal guardians to make
-informed medical decisions on behalf of youth.
-
-Behavioral health facilities must obtain parental or legal guardian consent for youth under fifteen
-(15) years of age, with the following exception:
-
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-
-1.
-
-2 CCR 502-1
-
-Section 12-245-203.5(2), C.R.S. allows psychotherapy services, as defined in Section
-12-245-202(14)(a), C.R.S., to be provided to a youth who is twelve (12) years of age or
-older, with or without the consent of the youth’s parent or legal guardian if the youth is
-knowingly and voluntarily seeking such services and the provision of psychotherapy
-services is clinically indicated and necessary to the youth’s well-being. The following
-mental health professionals are the only professionals allowed to provide outpatient
-psychotherapy services in an outpatient setting, to a youth who is twelve (12) years of
-age or older, with or without the consent of the youth’s parent or legal guardian:
-a.
-
-A professional person as defined in Section 27-65-102(17), C.R.S., which means
-a person licensed to practice medicine in this state, a psychologist certified to
-practice in this state, or a person licensed and in good standing to practice
-medicine in another state or a psychologist certified to practice and in good
-standing in another state who is providing medical or clinical services at a
-treatment facility in this state that is operated by the armed forces of the united
-states, the united states public health service, or the united states department of
-veterans affairs;
-
-b.
-
-A mental health professional licensed pursuant to Article 245, of Title 12, C.R.S.,
-which in accordance with Section 12-245-203.5, C.R.S., includes:
-
-c.
-
-1)
-
-A psychologist licensed pursuant to Part 3 of Article 245, of Title 12,
-C.R.S. or a psychologist candidate pursuant to Part 3 of Article 245, of
-Title 12,C.R.S.;
-
-2)
-
-A social worker licensed pursuant to Part 4 of Article 245, of Title 12,
-C.R.S.;
-
-3)
-
-A marriage and family therapist licensed pursuant Part 5 of Article 245,
-of Title 12, C.R.S.;
-
-4)
-
-A professional counselor licensed pursuant to Part 6 of Article 245, of
-Title 12, C.R.S. or a licensed professional counselor candidate pursuant
-to Part 6 of Article 245, of Title 12, C.R.S.;
-
-5)
-
-An addiction counselor licensed pursuant to Part 8 of Article 245, of Title
-12, C.R.S.; or
-
-A school social worker licensed by the Department of Education.
-
-D.
-
-Youth who are under the age of fifteen (15) have the right to object to hospitalization and to have
-a guardian ad litem appointed pursuant to Section 27-65-103, C.R.S.
-
-E.
-
-Appropriate educational programs shall be available for all school age youth who are residents of
-the designated facility in excess of fourteen (14) calendar days. These educational programs may
-be provided by either the local school district or by the designated facility. If provided by the
-designated facility, the educational program shall be approved by the Colorado Department of
-Education.
-
-21.200.14
-
-Assessment of Children and Adolescents [Eff. 5/1/16]
-
-Agencies shall follow Section 21.190.3 and the following:
-
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-
-2 CCR 502-1
-
-A.
-
-Assessments must include an evaluation of the family's, or other supportive adult's, social and
-environmental challenges and strengths that may pertain to the youth's treatment. If family or
-other supportive adults support needs are identified, this shall be addressed in the service plan.
-
-B.
-
-The assessment must explore how the identified family members, supportive individuals or
-significant others will be involved in behavioral health services. In the event that any individual's
-involvement is contraindicated, the clinical rationale must be documented.
-
-C.
-
-An assessment shall address any needs of a youth at least seventeen (17) years of age who is
-expected to require behavioral health services and supports beyond the age of eighteen (18).
-
-21.200.15
-
-Service Planning for Children and Adolescents [Eff. 5/1/16]
-
-Agencies shall follow Section 21.190.4, service planning and reviews, and the following:
-A.
-
-The service plan shall be developed in collaboration with the youth's parent or legal guardian and
-be signed by both. In the event that involvement of the parent or legal guardian is contraindicated,
-the rationale shall be documented.
-
-B.
-
-A copy of the service plan shall be provided to the individual and parent or legal guardian, unless
-contraindicated.
-
-C.
-
-The service plan shall include goals and objectives that address family support needs as
-identified in the assessment.
-
-21.200.2
-LICENSED SUBSTANCE USE DISORDER AGENCIES TREATING YOUTH [Eff.
-5/1/16]
-A.
-
-Agencies providing substance use disorder treatment services to youth shall be licensed by the
-Department to treat youth and comply with Section 21.210.
-
-B.
-
-Agencies shall implement evidence-based screening, assessment instruments, and curricula,
-designed and developed for youth.
-
-C.
-
-Agencies shall provide recovery-oriented services appropriate for youth, when indicated.
-
-D.
-
-Youth shall be informed that non-compliance with treatment programs to which they are
-sentenced shall be reported by the agency to referring courts and/or their agents.
-
-21.200.3
-
-Minor in Possession: Education and Treatment [Eff. 5/1/16]
-
-For the purposes of this section “Minor in Possession” (MIP) is the legal terminology used for an offense
-that is issued to individuals age twenty (20) and younger for underage drinking or possession. MIP may
-result in a revocation of a driver's license, a substance use disorder assessment, and/or alcohol
-education and treatment classes per Section 18-13-122, C.R.S.
-21.200.31
-
-General Provisions [Eff. 5/1/16]
-
-A.
-
-Agencies providing MIP services shall comply with Section 21.200.2.
-
-B.
-
-Agencies shall not place a youth with a MIP citation in DUI/DWAI education or therapy groups
-unless the youth also has a DUI/DWAI offense.
-
-C.
-
-All agency education and treatment staff shall have documented training, supervision and
-experience in adolescent development and prevention, intervention and treatment approaches.
-
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-
-D.
-
-When possible, minors sixteen (16) years of age and under should be treated in separate groups
-than those that are provided to individuals seventeen (17) to twenty (20) years old.
-
-E.
-
-Agencies shall conduct ongoing assessment of progress in education and/or treatment level of
-care to determine if youth are in the appropriate service level.
-
-21.200.32
-
-Minor in Possession: First Offense Education and Intervention [Eff. 5/1/16]
-
-A.
-
-MIP education is for youth who have received their first MIP citation and shall be conducted in an
-outpatient setting.
-
-B.
-
-MIP education shall be at least eight (8) hours, completed over no less than a two (2) day period
-with no more than four (4) hours of education per day.
-
-C.
-
-Education topics shall include:
-
-D.
-
-1.
-
-Current legal consequences for additional MIP citations;
-
-2.
-
-Resources or referrals for treatment level services, when indicated;
-
-3.
-
-Developmental impact of early onset substance use and subsequent impact on
-developing brain;
-
-4.
-
-Physiological effect of alcohol and other drug use;
-
-5.
-
-Refusal skills; and,
-
-6.
-
-Avoidance of high risk situations.
-
-For youth seventeen (17) years old and younger, agencies shall include and document a
-minimum of two (2) hours of parental involvement, unless contraindicated.
-
-21.200.33
-A.
-
-B.
-
-Minor in Possession: Second and Subsequent Offense Treatment [Eff. 5/1/16]
-
-Second Minor in Possession Offense
-1.
-
-Second offense MIP therapy shall be conducted in an outpatient setting, shall be a
-minimum of twelve (12) hours in duration over eight (8) weeks, and shall not exceed
-ninety (90) minute sessions, excluding breaks and administrative procedures.
-
-2.
-
-Agencies shall complete an individualized service plan, with each youth in accordance
-with Sections 21.190.4 and 21.200.15 of these rules.
-
-3.
-
-For youth seventeen (17) years old and younger, agencies shall include and document a
-minimum of four (4) hours of parental involvement, unless contraindicated.
-
-Third and Subsequent Minor in Possession Offenses
-1.
-
-A third MIP results in a Class 2 misdemeanor. Youth shall complete a minimum of twenty
-(20) hours of substance use disorder treatment over a minimum thirteen (13) week
-period, as determined by the assessment. Groups shall not exceed ninety (90) minutes in
-duration.
-
-2.
-
-Multiple levels of care shall be offered to meet the needs of the individual and family
-members, when appropriate.
-
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-3.
-21.200.4
-
-2 CCR 502-1
-
-Agencies shall include and document parental involvement, unless contraindicated,
-throughout the length of treatment.
-CHILDREN AND YOUTH MENTAL HEALTH TREATMENT ACT
-
-These rules are intended to implement the mental health treatment services defined in the Children and
-Youth Mental Health Treatment Act, Sections 27-67-101 through 27-67-109, C.R.S., to ensure the
-maximum use of appropriate least restrictive treatment services and to provide access to the greatest
-number of children. The purpose of the Children and Youth Mental Health Treatment Act is to provide
-access to mental health treatment for eligible children who are Medicaid eligible as well as those who are
-at risk of out-of-home placement, as defined below. These rules are intended to provide a sliding fee
-scale for responsible parties to offset the cost of care not covered by private insurance or the family
-provided under the Children and Youth Mental Health Treatment Act. Appeal procedures for denial of
-Medicaid funded residential services and denial of Children and Youth Mental Health Treatment Act
-funding are established in the rules as well as a dispute resolution process for county departments and
-mental health agencies.
-21.200.41
-
-Definitions
-
-“Ability to Pay” means the amount of income and assets of the legally responsible person(s) available to
-pay for the individual cost of Children and Youth Mental Health Treatment Act funded services.
-“Care Management” means arranging for continuity of care and coordinating the array of service
-necessary for appropriately treating a child or youth; communicating orally or in-person with responsible
-individuals, and funded providers at least every thirty (30) calendar days to assure services are being
-delivered as planned and adequate progress is being made; discharge planning and development; and
-the authority to rescind authorization for any treatment services with proper notice.
-“Child at Risk of Out-of-Home Placement” means a child or youth who meets the following criteria:
-A.
-
-Has been diagnosed as a person with a mental health disorder, as defined in Section 27-65102(11.5), C.R.S.;
-
-B.
-
-Requires a level of care that is provided in a residential child care facility pursuant to Section
-25.5-5-306, C.R.S., or that is provided through community-based programs and who, without
-such care, is at risk of unwarranted child welfare involvement or other system involvement, as
-described in Section 27-67-102, C.R.S., in order to receive funding for treatment;
-
-C.
-
-If determined to be in need of placement in a residential child care facility or psychiatric
-residential treatment facility, a child or youth shall apply for supplemental security income, but any
-determination for supplemental security income must not be a criterion for a child or youth to
-receive funding;
-
-D.
-
-The child or youth is a person for whom there is no pending or current action in dependency or
-neglect pursuant to Article 3 of Title 19, C.R.S.; and,
-
-E.
-
-The child or youth is younger than eighteen years of age at the time of applying, but he or she
-may continue to remain eligible for services until his or her twenty-first birthday.
-
-“Children who are categorically Medicaid eligible” has the same meaning as defined in Section 25.5-5101, C.R.S.
-
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-
-“Community-Based Services” means any intervention that is designed to be an alternative to residential
-or hospital level of care in which the child or youth resides within a non-institutional setting and includes,
-but is not limited to, therapeutic foster care, intensive in-home treatment, intensive case management,
-and day treatment.
-“Community Mental Health Center” has the same meaning as defined in Section 27-66-101(2), C.R.S.
-“Cost of Care” includes residential and community-based services not covered by private insurance, the
-family, or Medicaid.
-“County Department” means the county or district department of human or social services.
-“Dependent” means a person who relies on the responsible person(s) for financial support.
-“Face-to-Face clinical assessment” for this Section 21.200.4, means a formal and continuous process of
-collecting and evaluating information about an individual for service planning, treatment, referral, and
-funding eligibility as outlined in 21.190, and takes place at a minimum upon a request from the
-responsible person for funded services through the Children and Youth Mental Health Treatment Act.
-This information establishes justification for services and Children and Youth Mental Health Treatment
-Act funding. The child or youth must be physically in the same room as the professional person during the
-Face-to-Face clinical assessment. If the child is out of state or otherwise unable to participate in a Faceto-Face assessment, video technology may be used. If the Governor or local government declares an
-emergency or disaster, telephone may be used. Telephone shall only be used as necessary because of
-circumstances related to the disaster or emergency.
-“Family advocate” has the same meaning as provided in Section 27-69-102 (5), C.R.S.
-“Family systems navigator” has the same meaning as provided in Section 27-69-102 (5.5), C.R.S.
-“First-level appeal” means the initial process a Medicaid member is required to enact to contest a benefit,
-service, or eligibility decision made by Medicaid or a Medicaid managed care entity.
-“Licensed Mental Health Professional” means a psychologist licensed pursuant to Section 12-43-301, et
-seq., C.R.S., a psychiatrist licensed pursuant to Section 12-36-101, et seq., C.R.S., a clinical social
-worker licensed pursuant to Section 12-43-401, et seq., C.R.S., a marriage and family therapist licensed
-pursuant to Section 12-43-501, et seq., a professional counselor licensed pursuant to Section 12-43-601,
-et seq., C.R.S., or a social worker licensed by pursuant to Section 12-43-401, et seq., C.R.S., that is
-supervised by a licensed clinical social worker.
-“Medicaid child or youth who is at risk of out-of-home placement” means a child or youth who is
-categorically eligible for Medicaid but who otherwise meets the definition of a child or youth who is at risk
-of out-of-home placement as defined above.
-“Mental Health Agency” means a behavioral health services contractor through the State Department of
-Human Services serving children and youth statewide or in a particular geographic area, including but not
-limited to community mental health centers, and with the ability to meet all expectations of 21.200.4 and
-27-67-101, C.R.S.
-“Plan of Care” is a State Department developed document that at a minimum includes the anticipated
-frequency and costs of services to be provided for the duration of the plan of care. The plan of care is
-also a schedule of the fees to be paid by the responsible person including, but not limited to, the
-estimated amount of Supplemental Security Income payable to the residential facility if awarded to the
-child at risk of out-of-home placement or another provider, and sliding scale fees payable to the
-contractor, if applicable.
-
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-
-“Professional person” means a person licensed to practice medicine in this State, a psychologist certified
-to practice in this State, or a person licensed and in good standing to practice medicine in another state or
-a psychologist certified to practice and in good standing in another state who is providing medical or
-clinical services at a treatment facility in this State that is operated by the Armed Forces of the United
-States, the United States Public Health Service, or the United States Department of Veterans Affairs.
-“Residential Treatment” means services provided by a residential child care facility or psychiatric
-residential treatment facility licensed as a residential child care facility pursuant to Section 26-6-102(8),
-C.R.S., which has been approved by the State Department to provide mental health treatment.
-“Responsible Persons” means parent(s) or legal guardian(s) of a minor.
-“State Department” means the State Department of Human Services.
-21.200.42
-
-Children and Youth Mental Health Treatment Act Program Description
-
-The Children and Youth Mental Health Treatment Act allows parents or guardians to apply to a mental
-health agency on behalf of their minor child for mental health treatment services when the parents or
-guardians believe his or her child is at risk for out-of-home placement, as defined in Section 21.200.41.
-A.
-
-For children who are not categorically eligible for Medicaid at the time services are requested, the
-mental health agency is responsible for clinically assessing the child and providing care
-management and necessary services that may be clinically appropriate for the child’s and family’s
-needs.
-
-B.
-
-The Children and Youth Mental Health Treatment Act provides for an objective third-party review
-by a professional person at the State Department for the responsible person(s) when services are
-denied or terminated for a Medicaid child or youth who is at risk of out-of-home placement or a
-child or youth seeking funding under this Act.
-
-C.
-
-The Children and Youth Mental Health Treatment Act resolves disputes between mental health
-agencies and county departments when a child is seeking or receiving funding through the Child
-and Youth Mental Health Treatment Act.
-
-D.
-
-The Children and Youth Mental Health Treatment Act authorizes funding for services for children
-at risk of out-of-home placement, which are not covered by private insurance, Medicaid, or the
-family.
-
-21.200.43
-
-Application for Funding From the Children and Youth Mental Health Treatment Act
-
-A.
-
-A responsible person may apply to a mental health agency on behalf of his or her minor child for
-mental health treatment.
-
-B.
-
-At any point in applying for, appealing, or receiving Children and Youth Mental Health Treatment
-Act funding the responsible person(s) may request the assistance from a family advocate, family
-system navigator, nonprofit advocacy organization, or county department.
-1.
-
-The mental health agency shall provide the contact information for the organization
-contracted with the State Department to provide these services, free of charge, to the
-responsible person(s) before an initial evaluation.
-
-2.
-
-The State Department is not obligated to pay for any services provided by entities with
-which they do not contract.
-
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-
-C.
-
-The mental health agency shall evaluate the child and clinically assess the child’s need for mental
-health services. When warranted, funding for services will be provided as may be necessary and
-in the best interests of the child and the child’s family.
-
-D.
-
-When completing a face to face clinical assessment for a child or youth, the mental health agency
-shall use one standardized risk stratification tool. The identification of and manner for which the
-standardized risk stratification tool will be used will be determined by the State Department and
-identified in contracts and available on the State Department’s website. Determination of the
-assessment for level of care need and eligibility need will be completed jointly by the mental
-health agency and the State Department.
-
-E.
-
-When evaluating a child or youth for eligibility, the mental health agency shall evaluate all areas
-outlined in 21.190.
-
-F.
-
-The mental health agency shall be responsible for the provision of care management and
-necessary services, including any community-based mental health treatment, residential
-treatment, or any service that may be appropriate for the child’s or family’s needs.
-
-G.
-
-A face to face clinical assessment and eligibility determination shall be completed within the
-following time periods after a request for funding has been made by a responsible person(s).
-1.
-
-Urgent situation, defined as a condition that is likely to escalate to a situation in which the
-child may become a danger to themselves or others and require a clinical assessment
-within twenty-four (24) hours. Urgent situation evaluations shall be completed by the
-mental health agency within twenty-four (24) hours, one business day, of the initial
-assessment request by the responsible person(s). The mental health agency shall
-continue to provide care management while funded services are identified and provided.
-
-2.
-
-Routine situations, defined as all other situations, shall be completed within three (3)
-business days of the initial assessment request.
-
-3.
-
-If the mental health agency requires additional time to make a decision following an
-assessment and the responsible person agrees, then the mental health agency may take
-up to, but no more than, fourteen (14) calendar days to provide a decision. If the
-responsible person does not agree, the notification timelines referenced above remain in
-effect.
-
-H.
-
-The mental health agency’s decision shall be communicated orally and in writing to the
-responsible person(s) within the time allowed for the completion of the evaluation or at least five
-(5) business days before the reduction, increase or termination of funded services. Oral notice
-shall be face to face with the responsible person when possible.
-
-I.
-
-The written decision shall contain the following:
-1.
-
-Notice of the applicable criteria for mental health treatment;
-
-2.
-
-The factual basis for the decision;
-
-3.
-
-The appeals procedures pursuant to the grievance requirements in Section 21.180;
-
-4.
-
-If approved, notice that the responsible person(s) may choose to seek services from the
-provider of their choice, including but not limited to the mental health agency;
-
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-
-5.
-
-Notice that the responsible person(s) may request assistance from a family advocate,
-family system navigator, nonprofit advocacy organization, or county department in
-applying for, receiving, or appealing Children and Youth Mental Health Treatment Act
-funding and applying for supplemental security income;
-
-6.
-
-The contact information for an organization contracted by the State Department to
-perform family advocacy or family system navigation;
-
-7.
-
-Notice that the contracted advocacy provider is not allowed to charge the family a fee;
-
-8.
-
-Notice that the State Department is not obligated to pay for any services provided by
-entities with which they do not contract; and,
-
-9.
-
-A statement for the responsible person to sign, indicating that they agree with the
-decision or that they disagree and wish to file an appeal.
-
-21.200.44
-
-Process of Determining Ability to Pay and Adjusted Charge for Treatment Services
-
-A.
-
-The mental health agency shall determine the cost of care for children and youth that receive
-funding through the Children and Youth Mental Health Treatment Act. All insurance and other
-eligible benefits shall be applied first to the cost of care. A responsible person(s) who fails to
-cooperate in making existing insurance and other benefits available for payment will nevertheless
-be considered as having benefits available for payment;
-
-B.
-
-Per month, the mental health agency shall determine the 7% of the total cost of all Children and
-Youth Mental Health Treatment Act funded services for the responsible person, excluding the
-costs of the initial assessment and all care management;
-
-C.
-
-If the responsible person(s) is unable to pay the 7%, the mental health agency shall consider the
-responsible person(s) total number of dependents, the mental health needs of those dependents,
-all current outstanding medical liabilities, expected length of services, and the education costs for
-the dependents. The mental health agency shall receive approval or denial from the State
-Department for all fee adjustments;
-
-D.
-
-At minimum, the parental fee shall be no less than $50 per calendar month;
-
-E.
-
-Per calendar month, the mental health agency shall collect fees directly from the responsible
-person(s), or monitor that the third-party provider has collected the parental fee;
-
-F.
-
-The funded provider may reserve the right to take any necessary action regarding delinquent
-payments by the responsible person(s);
-
-G.
-
-The responsible person(s) shall sign a financial agreement indicating an understanding of their
-financial responsibilities as described, above, to be eligible for funding through the Children and
-Youth Mental Health Treatment Act;
-
-H.
-
-Within ten (10) business days after the child’s admission to residential treatment, the responsible
-person(s) shall apply for Supplemental Security Income (SSI) on behalf of a child approved for
-funding under the Children and Youth Mental Health Treatment Act;
-
-I.
-
-If awarded Supplemental Security Income; the responsible person(s) shall disclose the award
-amount to the mental health agency as determined by the Social Security Administration
-regulations;
-
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-2 CCR 502-1
-
-J.
-
-If awarded Supplemental Security Income, it is the responsibility of the responsible person(s) to
-notify the Social Security Administration immediately upon the child or youth’s discharge from
-residential services;
-
-K.
-
-If awarded Supplemental Security Income, and awarded Medicaid, Medicaid will be used to fund
-treatment costs while in residential treatment. The parental fee, Supplemental Security Income,
-all other funding sources, and the Child and Youth Mental Health Treatment Act will fund room
-and board;
-
-L.
-
-If denied Supplemental Security Income; the Children and Youth Mental Health Treatment Act will
-fund room and board and behavioral health treatment services that would otherwise have been
-funded by Supplemental Security Income and Medicaid.
-
-21.200.45
-Appeal of the Reduction, Termination, or Denial of Mental Health Services Funded
-By the Children and Youth Mental Health Treatment Act
-A.
-
-Except as provided below, the mental health agency shall follow the formalized notification
-process as defined in Section 21.200.41 through 21.200.43.
-
-B.
-
-A responsible person(s) may request an appeal of a decrease, increase, or denial of Children and
-Youth Mental Health Treatment Act fund services or a recommendation that a child is discharged
-from funded services, and the following shall apply:
-1.
-
-If the responsible person(s) notifies the mental health agency of a desire to appeal a
-decision before termination of services, the State Department and the mental health
-agency shall continue to fund services until the appeal process below has been
-exhausted.
-
-2.
-
-The responsible person(s) shall notify the mental health agency orally or in writing within
-fifteen (15) business days of notice of action of a desire to appeal a decision;
-
-3.
-
-The mental health agency shall have two (2) business days within which to complete an
-internal appeal review process and communicate a decision to the responsible person(s)
-orally and in writing.
-
-4.
-
-The mental health agency’s notice of action shall contain the information required in
-section 21.200.43, e, along with the process for clinical review in Section 21.200.45, C-E
-below.
-
-C.
-
-If the mental health agency requires more than two (2) business days to complete the internal
-review, and the responsible person(s) is in agreement, then the mental health agency may take
-up to but no more than five (5) business days to complete the review.
-
-D.
-
-Within five (5) business days after the mental health agency’s final denial or reduction of
-requested services or recommendation that the child be discharged from treatment, the
-responsible person(s) may request a clinical review of the need for services by an objective thirdparty, at the State Department, who is an independent professional person as that term is defined
-in Section 27-65- 102(11), C.R.S., to review the action of the mental health agency. Such a
-request may be oral or in writing, but if completed orally it must be confirmed in writing, and shall
-be made to the Director of the Office of Behavioral Health or the Office’s consumer and family
-affairs specialist.
-
-E.
-
-Unless waived by the responsible person(s), said clinical review shall include:
-1.
-
-A review of the mental health agency’s denial of services;
-
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-2.
-
-A face to face evaluation of the child so long as the responsible person(s) arranges
-transportation of the child for the evaluation; and,
-
-3.
-
-A review of the evidence provided by the responsible person(s). The responsible
-person(s) shall be advised of the name and credentials of the reviewing professional, as
-well as any mental health agency affiliations of the reviewing professional. The
-responsible person(s) shall have an opportunity to request an alternate reviewing
-professional at the State Department at that time, so long as any delay caused by the
-request is waived by the responsible person(s) as described below.
-
-F.
-
-Within three (3) business days of the receipt of the request for clinical review, a decision shall be
-communicated orally and in writing by the professional person to the responsible person(s), State
-Department, and the mental health agency. The written decision shall include the relevant criteria
-and factual basis. If the clinical review finds residential or community-based services to be
-necessary and that Children and Youth Mental Health Treatment Act funding is necessary, the
-mental health agency shall provide services to the child within twenty-four (24) hours of the said
-decision. If residential treatment is not available within twenty-four hours and placement in
-residential treatment is recommended, the state level review must recommend appropriate
-alternatives including emergency hospitalization, if appropriate, if the child is in need of immediate
-placement out of the home.
-
-G.
-
-If the professional person requires more than three (3) business days to complete the clinical
-review, or if the responsible person(s) requires more time to obtain evidence for the clinical
-review, the responsible person(s) may waive the three day deadline above, so long as said
-waiver is confirmed in writing. In any event, the face to face evaluation and the clinical review
-shall be completed within six (6) business days.
-
-H.
-
-The decision from the objective third-party, at the State Department, who is an independent
-professional person, shall constitute final agency action for funding through the Children and
-Youth Mental Health Treatment Act.
-
-21.200.46
-
-Third-Party Review Process for a Medicaid Child or Youth
-
-A Medicaid child or youth, a responsible person may request an objective third-party clinical review within
-five (5) business days after all first-level Medicaid appeals processes are exhausted (in accordance with
-Section 8.057 or 8.209 of the Colorado Department of Health Care Policy and Financing's Medical
-Assistance Rules [10 CCR 2505-10]). The review must be conducted by a professional person as
-outlined in Section 21.200.45 within three (3) business days of the date of request. This review does not
-obligate funding of services.
-21.200.47
-Dispute Resolution Process between County Departments and Mental Health
-Agencies
-A.
-
-If a dispute exists between a mental health agency and a county department regarding whether
-mental health services should be funded under the Children and Youth Mental Health Treatment
-Act or by the county department, one or both may request the State Department’s Office of
-Behavioral Health, to convene a review panel consisting of family advocates, the State
-Department’s Division of Child Welfare, the State Department’s Office of Behavioral Health, an
-independent mental health agency if available, an independent professional person, and an
-independent county department to provide dispute resolution. The State Department’s Office of
-Behavioral Health shall obtain documentation from independent agencies and individuals that no
-conflict of interest exists pertaining to the specific child being reviewed.
-
-B.
-
-The request to invoke the dispute resolution process shall be in writing and submitted within five
-(5) calendar days of either agency recognizing a dispute exists.
-
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-C.
-
-2 CCR 502-1
-
-The written request for dispute resolution shall include, at a minimum, the following information:
-1.
-
-The county department and mental health agency involved in the dispute, including a
-contact person at each;
-
-2.
-
-The child’s name and age;
-
-3.
-
-The responsible person(s) address, phone number, and e-mail address;
-
-4.
-
-Pertinent information regarding the child including, but not limited to, medical or mental
-health status/assessment;
-
-5.
-
-The reason for the dispute, any efforts to resolve the matter locally, and any pertinent
-information regarding the child;
-
-6.
-
-Information about the child’s mental health status pertaining to the dispute; and,
-
-7.
-
-The responsible person(s) perspective on the matter, if known.
-
-D.
-
-The State Department’s Office of Behavioral Health shall provide notice to both the mental health
-agency and a county department that the State Department’s Office of Behavioral Health will
-convene a review panel to resolve the dispute in writing.
-
-E.
-
-Each side will have an opportunity to present its position to the review panel. Interested parties
-will be allowed to present written or oral testimony at the discretion of the review panel.
-
-F.
-
-The review panel shall have five (5) business days to complete the dispute process and issue its
-determination in writing to the disputing agencies and the responsible person(s). The review
-panel's decision shall constitute final agency action, which binds the agency determined
-responsible for the provision of necessary services.
-
-G.
-
-If the panel deems that neither the mental health agency nor the county department is
-responsible for the provision of funding for the treatment of the child, then the panel shall provide
-a rationale for their determination. The panel shall offer recommendations for other funding
-sources and treatment modalities.
-
-21.200.48
-
-Responsibilities
-
-21.200.481
-
-Responsibilities of Mental Health Agencies
-
-The mental health agency shall provide Children and Youth Mental Health Treatment Act funded services
-to Children and youth who are eligible as defined in Sections 21.200.4.
-A.
-
-Children and Youth Mental Health Treatment Act services include, but are not limited to:
-1.
-
-Clinical behavioral health assessments completed by a licensed mental health
-professional;
-
-2.
-
-Community-based services;
-
-3.
-
-Care management services;
-
-4.
-
-Coordination of residential treatment services; and,
-
-5.
-
-Non-residential mental health transition services for children and youth.
-
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-
-B.
-
-The mental health agency shall provide to the State Department necessary Children and Youth
-Mental Health Treatment Act eligibility, service, and financial information in an agreed upon
-format.
-
-C.
-
-The mental health agency shall submit data to the State Department as required per Section 2767-105, C.R.S.
-
-D.
-
-The mental health agency shall provide or coordinate treatment services in collaboration with the
-child or youth, families, and funded service providers.
-
-E.
-
-The mental health agency shall determine the fee for the responsible person(s) and submit the
-financial agreement to the State Department once signed by the responsible person(s) before
-state approval.
-
-F.
-
-The mental health agency shall submit all eligibility assessments to the State Department before
-funding approval or denial.
-
-G.
-
-If a child has been determined eligible under the Children and Youth Mental Health Treatment
-Act, the mental health agency shall submit a plan of care for approval to the State Department
-before providing services. If necessary services are not immediately available, mental health
-agency shall submit an alternative plan of care and provide interim services as appropriate.
-
-H.
-
-The mental health agency shall maintain a comprehensive clinical record for each child receiving
-services through Children and Youth Mental Health Treatment Act funding consistent with 2 CCR
-502-1. Such records shall be made available for review by the State Department. The
-individualized service plan in the clinical record shall reflect any services provided directly by the
-center, including any care management services provided and relevant documentation submitted
-by a third-party provider. The goal of those care management services may be, at least in part, to
-oversee the delivery of services by third-party providers to assure that adequate progress is
-achieved and may reference the state plan of care and the provider’s clinical service plan.
-
-21.200.482
-
-Responsibilities of the Department
-
-The State Department shall be responsible for administering and regulating the provisions of the Children
-and Youth Mental Health Treatment Act. The responsibilities of the State Department include:
-A.
-
-Ensuring the Children and Youth Mental Health Treatment Act is implemented statewide;
-
-B.
-
-Reviewing requests for funding and making determinations regarding approval of funded
-services;
-
-C.
-
-The provision of technical assistance to Mental health agencies, residential treatment providers,
-families, advocacy organizations, county departments, mental health providers, and other
-stakeholders regarding the technical and financial aspects of the Children and Youth Mental
-Health Treatment Act;
-
-D.
-
-Oversight and monitoring of service delivery for children receiving Children and Youth Mental
-Health Treatment Act funded services;
-
-E.
-
-Oversight of the appropriateness of funded services, service standards, and service expectations
-of Child and Youth Mental Health Treatment Act funded services;
-
-F.
-
-Development and maintenance of the appeal process;
-
-G.
-
-Development and maintenance of dispute resolution processes;
-
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-
-H.
-
-Management of the fiscal aspects of the Children and Youth Mental Health Treatment Act
-program;
-
-I.
-
-Data Collection and public reporting.
-
-21.200.5
-FAMILY ADVOCACY MENTAL HEALTH JUVENILE JUSTICE PROGRAMS [Eff.
-5/1/16]
-These rules and standards implement the Integrated System of Care Family Advocacy Programs for
-Mental Health Juvenile Justice Populations defined in Section 27-69-101, et seq., C.R.S. The rules and
-standards do not apply to other forms of family advocacy provided by persons or organizations, nor do
-they place any requirements or assume authority over such persons or organizations. Families of youth
-with mental health and co-occurring disorders who are in, or at-risk of becoming involved with, the
-juvenile justice system, may choose any form of advocacy and support that best meets their needs and
-are not limited to utilizing entities approved under these rules and standards.
-In order to be eligible for state funding for a family advocacy program as described in Section 27-69-101,
-et seq., C.R.S., and these rules, an entity must be approved by the Department according to the rules
-described herein. Such funding is contingent on available appropriations.
-21.200.51
-
-Definitions [Eff. 5/1/16]
-
-“At-risk of involvement with the juvenile justice system” means a youth who has come into contact with
-law enforcement due to a suspected offense or otherwise exhibits behaviors that will likely result in
-juvenile justice involvement.
-“Family advocacy organization” means an entity governed by individuals who have parented, are
-parenting, or have legal responsibility for a child or youth with a mental health or co-occurring disorder.
-“Family member” means individual who has parented, is parenting, or has legal responsibility for a youth
-with a mental health or co-occurring disorder.
-“Involved in the juvenile justice system” means a youth who has committed a delinquent act as defined at
-Section 19-1-103(36), C.R.S.
-“Partnership” means a relationship between a family advocacy organization and another entity whereby
-the family advocacy organization works directly with another entity for oversight and management of the
-family advocate or family systems navigator and family advocacy demonstration program, and the family
-advocacy organization employs, supervises, mentors, and provides training to the family advocate or
-family systems navigator.
-“System of care” means a spectrum of effective, community-based services and supports for children and
-youth with or at risk for mental health or other challenges and their families, that is organized into a
-coordinated network, builds meaningful partnerships with families and youth, and addresses their cultural
-and linguistic needs, in order to help them to function better at home, in school, in the community, and
-throughout life.
-“Technical assistance and coordination” means linking with resources for the purpose of developing or
-strengthening a family advocacy program.
-“Transition services” include, but are not limited to, assisting a youth and family in accessing services and
-supports necessary for the youth to become a successful adult; developing life skills necessary to
-function in the community; returning to home, community, or school from an out-of-home placement.
-
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-
-“Youth” for the purposes of this section means an individual whose age falls within the jurisdiction of the
-juvenile justice system and is older than ten (10) years of age and under eighteen (18) years of age (see
-Section 19-1-103 (18) for definition of “child”). A young person receiving family advocacy services may
-continue to do so up to twenty one (21) years of age if enrolled in the program between the ages of ten
-(10) and eighteen (18).
-21.200.52
-
-Intent to Become a Family Advocacy Program [Eff. 5/1/16]
-
-A.
-
-A partnership will indicate its intent to become a family advocacy program by completing the
-family advocacy program application and submitting it to the Department.
-
-B.
-
-The partnership will follow all requirements of Section 27-69-101 through 27-69-105, C.R.S. and
-these corresponding rules.
-
-C.
-
-The Department will acknowledge in writing receipt of the letter of application and state which
-documents, if any, are required to be forwarded to the Department for review.
-
-D.
-
-A partnership may request the Department to facilitate technical assistance and coordination, as
-described in Section 21.200.53, needed to complete its application.
-
-21.200.53
-
-Program Standards
-
-A.
-
-Family advocacy programs will consist of a partnership between a family advocacy organization
-providing family advocacy and the system of care, whereby the family advocacy organization
-works with other entities to enable youth and families to access necessary services and supports.
-The family advocacy organization employs or otherwise utilizes, supervises, mentors, and
-provides training to the family advocate or family systems navigator. A community agency may
-employ or otherwise utilize, supervise, mentor, and provide training to the family advocate or
-family systems navigator if there is a written agreement with a family advocacy organization
-describing how this will occur.
-
-B.
-
-The purpose of a family advocacy program is to provide support to families of youth with mental
-health and co-occurring disorders who are in, or at-risk of becoming involved with, the juvenile
-justice system.
-
-C.
-
-The support provided to families and youth will include early intervention, navigation, crisis
-response, integrated planning, transition services, and diversion. These supports will be provided
-in collaboration with community agencies with specific expertise in the area.
-
-D.
-
-Family support will be provided by a family advocate or a family systems navigator as outlined in
-Section 27-69-102(5) and (5.5), C.R.S. The requirements for these roles are as follows:
-1.
-
-2.
-
-Family advocate:
-a.
-
-Training in assisting families in accessing and receiving services and supports,
-and the system of care philosophy;
-
-b.
-
-Experience as a family member of a child or adolescent with a mental health or
-co-occurring disorder; and,
-
-c.
-
-Experience in working with multiple youth-serving agencies and providers.
-
-Family systems navigator:
-
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-
-a.
-
-Training in assisting families in accessing and receiving services and supports,
-and the system of care philosophy;
-
-b.
-
-Skills, experience, and knowledge to work with children and youth with mental
-health or co-occurring disorders; and,
-
-c.
-
-Worked with multiple youth-serving agencies and providers.
-
-E.
-
-A family advocacy program will coordinate its efforts with key service providers to ensure that
-support provided by family advocates and family systems navigators is integrated with services
-provided by community agencies. Where applicable, this coordination will include the local
-Interagency Oversight Group of the Collaborative Management Program, described in Section
-24-1.9-102, C.R.S. and local juvenile services planning committee described in Section 19-2-211,
-C.R.S.
-
-F.
-
-A family advocate or family systems navigator will receive training commensurate with their duties
-and responsibilities. The training will include content on behavioral and co-occurring conditions,
-working with youth-serving systems, ethics, confidentiality and HIPAA, system of care, working
-with families, meeting facilitation, prevention and intervention, and documentation and service
-planning.
-
-G.
-
-A family advocacy program will provide education to the relevant agencies in the system of care,
-describing the roles and responsibilities of family advocates and family systems navigators, and
-the ways in which these positions can benefit youth, families, and agency staff members.
-
-H.
-
-A family advocacy program will ensure that adequate resources are available for program
-operations and evaluation as described in Section 21.200.54.
-
-I.
-
-Family advocates or family systems navigators will receive supervision commensurate with the
-needs of the youth and families. Family advocates or family systems navigators working in
-community agencies will receive supervision consistent with the policies and procedures of the
-host agency.
-
-J.
-
-Any person providing supervision to a family advocate or family systems navigator will have
-demonstrable knowledge about Section 27-69-101, et seq., C.R.S., these rules, and the role and
-function of a family advocacy program.
-
-K.
-
-Family advocacy programs will have policies and procedures concerning the work of family
-advocates and family systems navigators that address:
-1.
-
-Experience and hiring requirements, including a name search through the Colorado
-Bureau of Investigation;
-
-2.
-
-The program's standards of practice and code of ethics;
-
-3.
-
-Training related to providing support to families of youth with a mental health or cooccurring condition;
-
-4.
-
-A description of each aspect of the program, including related staff roles and
-responsibilities;
-
-5.
-
-The handling of grievances and complaints;
-
-6.
-
-Confidentiality, HIPAA, and 42 C.F.R. Part 2; and,
-
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-
-7.
-
-L.
-
-2 CCR 502-1
-
-Methods for recording information concerning each family receiving support including
-demographics, assessment results, needs and strengths, goals and objectives, support
-provided, and other information as needed.
-
-The services and supports provided by a family advocacy program will include, but not be limited
-to, those outlined in Section 27-69-104(3), C.R.S., and the following:
-1.
-
-An assessment of the needs and strengths of the youth and family;
-
-2.
-
-Assisting families with significant transitions in the youth's life;
-
-3.
-
-Coordination with the local community mental health center and other behavioral health
-service, and;
-
-4.
-
-Culturally and linguistically appropriate and responsive services including bilingual family
-advocates and/or family systems navigators, and/or access to translation services for
-families when necessary.
-
-21.200.54
-
-Data Reporting [Eff. 5/1/16]
-
-A.
-
-Family advocacy programs will collect and report data to the Department. This is necessary for
-the program and the Department to determine its effectiveness and what, if any, changes are
-necessary to improve outcomes for youth and families. The results of any data analysis
-conducted by the Department will be shared with the respective family advocacy program.
-
-B.
-
-The data collected and reported to the Department shall include the following:
-
-C.
-
-1.
-
-Types of services and support the youth and families received prior to and during
-involvement in the family advocacy program;
-
-2.
-
-Outcomes of services and supports provided during the youth and family's involvement in
-the family advocacy program;
-
-3.
-
-Indicators of the youth and family's satisfaction with support provided by the family
-advocate or family systems navigator;
-
-4.
-
-Indicators of the effectiveness of the family advocate or family systems navigator;
-
-5.
-
-Indicators of change in the system of care, e.g., interagency agreements, service access
-and utilization, leadership development among youth and families; and shared resources;
-
-6.
-
-Costs of services provided; and,
-
-7.
-
-Types of transition services provided.
-
-Data will be submitted to the Department in an established and standardized format.
-
-21.200.55
-
-Technical Assistance and Coordination [Eff. 5/1/16]
-
-A.
-
-The Department will facilitate the provision of technical assistance and coordination for the
-purpose of developing or strengthening a family advocacy program.
-
-B.
-
-Technical assistance may include linking with written materials, family organizations, and phone
-consultation.
-
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-
-2 CCR 502-1
-
-C.
-
-Technical assistance provided by organizations other than the Department may require a fee paid
-to that organization.
-
-D.
-
-Interested entities will request technical assistance by contacting the Department verbally or in
-writing.
-
-21.210 AGENCIES LICENSED TO PROVIDE SUBSTANCE USE DISORDER SERVICES
-In addition to the rules provided in Sections 21.000 through 21.190, all agencies licensed to provide
-substance use disorder services shall comply with the following rule Sections 21.210.1 through
-21.210.924.
-21.210.1
-
-Agency Staff Qualification and Training
-
-A.
-
-Agencies shall ensure treatment staff are appropriately trained and properly credentialed to
-provide substance use disorder services in Colorado and are in good standing with their
-credentialing body.
-
-B.
-
-Agencies shall ensure treatment staff providing independent treatment services in substance use
-disorder programs within each licensed site are credentialed in accordance with applicable state
-laws and regulations and are providing treatment services allowed within their scope of practice.
-Treatment staff is defined in 21.210.1.E. For clinically managed residential withdrawal
-management staffing requirements, see 21.210.914.
-
-C.
-
-Counselor-in-training staff or certified addiction technician shall not independently counsel, sign
-clinical documentation or carry out other duties relegated solely to the treatment staff identified in
-21.210.1.E. Counselor-in-training staff and certified addiction technicians shall not comprise more
-than twenty-five percent (25%) of total staff.
-
-D.
-
-E.
-
-1.
-
-Counselor-in-training staff must have all clinical documentation reviewed and co-signed
-by their agency clinical supervisor able to supervise pursuant to their scope of practice.
-
-2.
-
-Certified addiction technicians may independently provide services within the statutorily
-defined scope of practice pursuant to Section 12-245-805(3)(a), C.R.S.
-
-Unless otherwise noted, all agencies shall have a designated clinical administrator who shall
-authorize and oversee the clinical practice and supervise the treatment staff defined in
-21.210.1.E. The clinical administrator shall be in good standing with his or her credentialing body
-and properly licensed as a physician or as one of the following mental health professionals:
-1.
-
-Licensed psychologist;
-
-2.
-
-Licensed clinical social worker;
-
-3.
-
-Licensed marriage and family therapist;
-
-4.
-
-Licensed professional counselor; or
-
-5.
-
-Licensed addiction counselor.
-
-Treatment staff, for the purpose of this Section 21.210, unless otherwise noted, means the
-following behavioral health professionals trained in substance use disorder identification and
-treatment and acting within his or her scope of practice:
-1.
-
-Licensed physician;
-
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-2 CCR 502-1
-
-2.
-
-Licensed advanced practice nurse included in the advanced practice registry with a
-population focus in mental health, behavioral health or psychiatry;
-
-3.
-
-Licensed psychologist;
-
-4.
-
-Licensed clinical social worker;
-
-5.
-
-Licensed marriage and family therapist;
-
-6.
-
-Licensed professional counselor;
-
-7.
-
-Licensed addiction counselor;
-
-8.
-
-Certified addiction specialist; or
-
-9.
-
-Candidate status staff receiving supervision to become a licensed or certified mental
-health professional pursuant to Article 245 of Title 12, C.R.S. Candidate level staff shall
-not make up more than fifty percent (50%) of an agency’s treatment staff.
-
-F.
-
-All agencies shall provide and document initial training in methods of preventing and controlling
-infectious diseases and in universal precautions providing protection from possible infection when
-handling blood and other body fluids. Annual refresher training, including updates, shall be
-provided and documented.
-
-G.
-
-Staff collecting samples for drug or alcohol testing shall be knowledgeable of collection, handling,
-recording and storing procedures assuring sample viability for evidentiary and therapeutic
-purposes.
-
-H.
-
-Agencies administering and/or monitoring individual medications shall maintain at least one staff
-person per shift who is currently qualified by certification and/or training to perform those
-functions in accordance with applicable Department rules and state and federal regulations.
-
-I.
-
-Agencies shall document that at least one residential treatment staff person per shift is currently
-certified in cardiopulmonary resuscitation and basic First Aid.
-
-21.210.2
-
-CONTENT OF RECORDS
-
-In addition to 21.190.2, agencies licensed to provide substance use disorder services shall maintain
-individual records to include:
-A.
-
-B.
-
-Individual acknowledgments of:
-1.
-
-42 C.F.R. PART 2;
-
-2.
-
-HIPAA;
-
-3.
-
-Individual rights;
-
-4.
-
-Mandatory disclosure statement;
-
-5.
-
-Chargeable fees and collection procedures; and,
-
-6.
-
-Awareness of agency emergency procedures.
-
-The out-of state offender questionnaire shall be completed and in all clinical records.
-
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-
-C.
-
-Personal belongings inventories, when applicable.
-
-D.
-
-Court documents, when applicable.
-
-E.
-
-Records of required communication with referral sources such as court, probation, child welfare,
-and parole, when applicable.
-
-F.
-
-Drug and alcohol testing and monitoring results, when applicable.
-
-21.210.3
-COUNSELOR AND INDIVIDUALS RECEIVING SERVICES’ SIGNATURES [Eff.
-11/1/13]
-A.
-
-Counselor signatures shall be required on the following treatment documents:
-1.
-
-Screenings;
-
-2.
-
-Assessments;
-
-3.
-
-Admission summaries;
-
-4.
-
-Service plans;
-
-5.
-
-Service plan reviews;
-
-6.
-
-Treatment notes;
-
-7.
-
-Discharge summaries.
-
-B.
-
-Credentialed counselors who counsel independently shall sign treatment documents with at least
-first initial, last name, and Colorado addiction counselor credential, other professional credential,
-or academic degree.
-
-C.
-
-Counselors not credentialed may sign treatment documents if countersigned by supervising
-credentialed counselors.
-
-D.
-
-Signature stamps shall be permissible in lieu of written signatures if initialed by the counselors
-whose signatures they represent. Electronic signatures shall be permissible for computerized
-individual records.
-
-E.
-
-Agencies shall require persons receiving services, or guardians, to sign service plans, service
-plan reviews, and revisions, consents, acknowledgments, and other documents needing
-individual authorization.
-
-21.210.4
-
-PROVISION OF SERVICES
-
-21.210.41
-
-Admission Criteria [Eff. 11/1/13]
-
-A.
-
-The following shall not be the sole reason for treatment ineligibility:
-1.
-
-Relapse;
-
-2.
-
-Leaving previous treatment against advice;
-
-3.
-
-Pregnancy;
-
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-
-B.
-
-4.
-
-Intravenous drug use; or,
-
-5.
-
-Involuntary commitment.
-
-2 CCR 502-1
-
-Restrictions, priorities, or special admission criteria shall be applied equally to all prospective
-persons seeking services.
-
-21.210.42
-
-Screening [Eff. 5/1/16]
-
-A.
-
-Agencies shall screen all female individuals of child bearing age seeking or being referred to
-substance use disorder treatment for pregnancy.
-
-B.
-
-At admission individuals shall be screened for past and present risk factors associated with
-substance use disorders that are associated with:
-1.
-
-Pregnancy complications, including risks to the health of the pregnant woman and fetus;
-
-2.
-
-Acquiring and transmitting Human Immunodeficiency Virus/Acquired Immune Deficiency
-Syndrome (HIV/AIDS), Tuberculosis (TB), Hepatitis A, B, or C, and other infectious
-diseases; and,
-
-3.
-
-If clinically indicated by the presence of continuing risk factors, screening shall be
-conducted at a minimum on a quarterly basis.
-
-C.
-
-Individuals shall be apprised of risk factors associated with acquiring and transmitting HIV/AIDS,
-TB, Hepatitis A, B, C, and other infectious diseases. Appropriate testing and pre and post-test
-counseling shall be offered on-site or through referral.
-
-D.
-
-Criminal justice system referrals for substance use related offenses, such as DUI/DWAI, BUI,
-FUI, and/or controlled substance violations, may be exempt from further substance use disorder
-screening if previously assessed, or evaluated. Supporting documentation from the referring
-agency shall be present in the individual record.
-
-E.
-
-Adults shall be screened for past and present criminal charges in any state. Persons with out-ofstate charges must be registered by the licensed agency with the interstate compact office in
-accordance with Title 17, Article 27.1, Section 101, et seq., C.R.S.
-
-21.210.43
-A.
-
-B.
-
-LEVEL OF CARE GENERAL PROVISIONS
-
-In addition to meeting the requirements established in 21.190, Agencies shall:
-1.
-
-Use the ASAM Criteria as a guide for assessing and placing individuals in the appropriate
-level of care;
-
-2.
-
-Include information gathered on all six (6) dimensions outlined in The ASAM Criteria in
-assessments; and
-
-3.
-
-Utilize the decisional flow process as outlined in The ASAM Criteria to determine level of
-care.
-
-Agencies shall specify the specific level(s) of care services the agency plans to provide, including
-the population(s) the agency plans to serve.
-
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-
-C.
-
-2 CCR 502-1
-
-Each level of care shall offer a range of treatment approaches and support services based on the
-assessment of the individual’s treatment needs. Treatment services may include, but are not
-limited to:
-1.
-
-Assessment;
-
-2.
-
-Group and individual counseling;
-
-3.
-
-Motivational enhancement;
-
-4.
-
-Family therapy;
-
-5.
-
-Educational groups;
-
-6.
-
-Occupational and recreational therapy;
-
-7.
-
-Addiction pharmacology;
-
-8.
-
-Medication management;
-
-9.
-
-Peer, social and recovery support;
-
-10.
-
-Case management or service coordination; and
-
-11.
-
-Support for development of life skills.
-
-D.
-
-In addition to meeting the staff qualification and training requirements established in 21.210,
-agencies shall document that staff are appropriately credentialed and qualified to provide
-treatment services in the levels of care described in this section and to the individual populations
-they serve.
-
-E.
-
-Agencies shall apply sliding fee scales equally to all prospective persons seeking services.
-
-F.
-
-Agencies shall be responsible for monitoring and routinely reporting to referring courts and the
-criminal justice system the individual’s progress within treatment, including any ancillary services.
-
-G.
-
-In addition to meeting the requirements established in 21.200, agencies shall ensure all staff
-working with youth under the age of twenty-one (21) at each level of care are trained and
-knowledgeable of youth development and engaging youth in care.
-
-H.
-
-agencies shall obtain a Controlled Substance License from the Office of Behavioral Health if the
-program plans to dispense, compound, or administer a controlled substance in order to treat a
-substance use disorder or to treat the withdrawal symptoms of a substance use disorder.
-
-I.
-
-Agencies shall continue individuals on their medication-assisted treatment regimen and will only
-detox individuals from medications treating opioid use disorders at the individual’s request or if it
-is deemed medically necessary.
-
-J.
-
-Agencies shall inform individuals receiving services about access to medication-assisted
-treatment. Upon the individual’s consent, agencies shall provide medication-assisted treatment
-directly, if the agency or provider is appropriately licensed to do so. If an agency or provider is not
-licensed to provide medication-assisted treatment and an individual receiving services requests
-medication-assisted treatment, an agency shall refer the individual to an agency that provides
-medication-assisted treatment.
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-21.210.5
-
-2 CCR 502-1
-
-LEVELS OF CARE Specific Requirements
-
-Each level of care is based on a specific level of care outlined in The ASAM Criteria.
-21.210.6
-
-OUTPATIENT SUBSTANCE USE DISORDER SERVICES (Level 1)
-
-A.
-
-Level 1 services shall generally be intended for individuals who are assessed as not appropriate
-for more intensive levels of care. Level 1 may also be a step-down from a higher level of care or
-offered when an individual is in early stages of change and not willing to participate in the higher
-level of care indicated by the assessment.
-
-B.
-
-Level 1 services are appropriate for individuals with co-occurring mental health and substancerelated disorders if the mental health disorders are of moderate severity, or are of high severity
-but have been stabilized.
-
-21.210.61
-
-Level 1 Service Provisions
-
-A.
-
-Level 1 services shall be conducted in regularly scheduled sessions of less than nine (9)
-treatment contact hours per week for adults, and less than six (6) treatment contact hours per
-week for youth under the age of eighteen (18).
-
-B.
-
-Level 1 treatment services shall be provided by treatment staff defined in section 21.210.1.E.
-
-C.
-
-Agencies providing Level 1 services shall inform individuals receiving services how to access
-emergency services by telephone twenty-four (24) hours per day, seven (7) days per week. At
-minimum, emergency services information shall include contact information for services provided
-by the Behavioral Health Crisis Response System created pursuant to § 27-60-103, C.R.S.
-
-D.
-
-Agencies providing Level 1 services shall have direct affiliation or close coordination through
-referral to more intensive levels of care.
-
-E.
-
-Agencies providing Level 1 services shall ensure treatment staff has staff-to-staff consultation
-available within twenty-four (24) hours by telephone to discuss when warranted, at minimum,
-psychiatric or medical concerns of individuals receiving services.
-
-21.210.7
-INTENSIVE OUTPATIENT/PARTIAL HOSPITALIZATION SUBSTANCE USE
-DISORDER SERVICES (Level 2)
-21.210.71
-
-INTENSIVE OUTPATIENT SUBSTANCE USE DISORDER SERVICES (Level 2.1)
-
-A.
-
-Level 2.1 services shall generally be intended for individuals who require a more structured
-substance use disorder outpatient treatment experience than can be received in Level 1
-outpatient treatment.
-
-B.
-
-Level 2.1 services are appropriate for individuals with co-occurring mental health and substancerelated disorders if the disorders are of moderate severity, or are of higher severity but have been
-stabilized.
-
-21.210.711
-
-Level 2.1 Service Provisions
-
-A.
-
-Level 2.1 services shall be conducted in regularly scheduled sessions that follow a planned
-format of treatment services of nine (9) to nineteen (19) contact hours per week for adults and six
-(6) to nineteen (19) contact hours per week for youth under the age of eighteen (18).
-
-B.
-
-Level 2.1 treatment services shall be provided by treatment staff defined in section 21.210.1.E.
-
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-
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-
-C.
-
-Agencies providing Level 2.1 services shall inform individuals receiving services how to access
-emergency services by telephone twenty-four (24) hours per day, seven (7) days per week. At
-minimum, emergency services information shall include contact information for services provided
-by the behavioral health crisis response system created pursuant to § 27-60-103, C.R.S.
-
-D.
-
-Agencies providing Level 2.1 services shall have direct affiliation or close coordination through
-referral to more and less intensive levels of care.
-
-E.
-
-Agencies providing Level 2.1 services shall ensure treatment staff has staff-to-staff consultation
-available within twenty-four (24) hours by telephone and within seventy-two (72) hours in person
-to discuss when warranted, at minimum, psychiatric or medical concerns of individuals receiving
-services.
-
-2.210.72
-
-PARTIAL HOSPITALIZATION SUBSTANCE USE DISORDER SERVICES (Level 2.5)
-
-A.
-
-Level 2.5 services shall generally be intended for individuals who require daily monitoring or
-management to treat substance use disorders that can be provided in a structured outpatient
-setting. Services include direct access to medical, psychiatric, and laboratory services. Level 2.5
-service sites for school aged youth shall include access to educational services and coordination
-with a school system, as appropriate.
-
-B.
-
-Level 2.5 services are appropriate for individuals with co-occurring mental health and substancerelated disorders if the disorders are of moderate severity, or are of higher severity but have been
-stabilized. Staff of Level 2.5 services shall understand the signs and symptoms of mental health
-disorders and the uses of psychotropic medications and their interactions with substance use
-disorders.
-
-21.210.721
-
-Level 2.5 Service Provisions
-
-A.
-
-Level 2.5 services shall be conducted with a minimum frequency of twenty (20) regularly
-scheduled treatment contact hours per week.
-
-B.
-
-Level 2.5 treatment services shall be provided by treatment staff defined in section 21.210.1.E.
-
-C.
-
-Agencies providing Level 2.5 services shall inform individuals receiving services how to access
-emergency services by telephone twenty-four (24) hours per day, seven (7) days per week when
-the program is not in session. At minimum, agencies shall provide emergency services
-information that includes contact information for services provided by the behavioral health crisis
-response system created pursuant to § 27-60-103, C.R.S.
-
-D.
-
-Agencies providing Level 2.5 services shall have direct affiliation or close coordination through
-referral to more and less intensive levels of care.
-
-E.
-
-Agencies providing Level 2.5 services shall ensure treatment staff has staff-to-staff consultation
-available within eight (8) hours by telephone and within forty-eight (48) hours in person to discuss
-when warranted, at minimum, psychiatric or medical concerns of individuals receiving services.
-
-21.210.8
-
-RESIDENTIAL/INPATIENT SUBSTANCE USE DISORDER SERVICES (Level 3)
-
-Agencies providing residential/inpatient substance use disorder services (Level 3) shall construct and
-maintain sound and sight barriers between male and female individuals and between adult and youth
-under the age of eighteen (18) in bathrooms and sleeping quarters.
-
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-
-2 CCR 502-1
-
-21.210.81
-CLINICALLY MANAGED LOW-INTENSITY RESIDENTIAL SUBSTANCE USE
-DISORDER SERVICES (Level 3.1)
-A.
-
-Level 3.1 services shall generally be intended for whose history of chronic substance use
-disorders, lack of supportive living situations, unemployment, levels of social or psychological
-dysfunction and/or lack of housing necessitates twenty-four (24) hour structure and support. Level
-3.1 services are generally provided in settings such as a halfway house, group home or other
-supportive living environment providing twenty-four (24) hour staff and close integration with
-treatment services.
-
-B.
-
-Level 3.1 services shall have staff who are able to identify the signs and symptoms of acute
-psychiatric conditions and understand the signs and symptoms of mental health disorders, the
-uses of psychotropic medication and their interaction with substance use disorders.
-
-C.
-
-Level 3.1 services shall have the capacity to arrange for psychiatric or addiction medications.
-
-21.210.811
-
-Level 3.1 Service Provisions and Staffing
-
-A.
-
-Level 3.1 services shall be regularly scheduled and include a minimum of five (5) hours of
-planned treatment services per week.
-
-B.
-
-Agencies providing Level 3.1 services shall maintain individual to staff ratio not exceeding twenty
-to one (20:1) during nighttime hours, per agency site.
-
-C.
-
-Agencies providing Level 3.1 services shall provide twenty-four (24) hour per day, seven (7) days
-per week on-site staff. Twenty-four (24) hour on-site staff shall be trained and knowledgeable of
-substance use disorders and the treatment of substance use disorders and in addition to
-treatment staff defined in 21.210.1.E may include:
-1.
-
-Peer support specialists as defined in Section 21.400.1; or
-
-2.
-
-Addiction technicians certified pursuant to Part 8 of Article 245 of Title 12, C.R.S. or staff
-in the process of obtaining addiction counselor certification.
-
-D.
-
-Agencies providing Level 3.1 services shall have at least one (1) treatment staff, as defined in
-21.210.1.E, trained and knowledgeable of substance use disorders, the treatment of substance
-use disorders and able to monitor and identify psychiatric conditions available by telephone
-twenty-four (24) hours per day, seven (7) days per week and available to be on-site within thirty
-(30) minutes.
-
-E.
-
-Agencies providing Level 3.1 services shall have direct affiliation or close coordination through
-referral to more and less intensive levels of care.
-
-F.
-
-Agencies providing Level 3.1 services shall ensure staff have telephone or in-person consultation
-with a physician and emergency services available twenty-four (24) hours per day, seven (7) days
-per week.
-
-21.210.82
-CLINICALLY MANAGED POPULATION-SPECIFIC HIGH-INTENSITY RESIDENTIAL
-SUBSTANCE USE DISORDER SERVICES (Level 3.3)
-A.
-
-Level 3.3 services are a structured recovery environment in combination with high-intensity
-clinical services to support recovery from substance-related disorders.
-
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-
-B.
-
-2 CCR 502-1
-
-Level 3.3 is appropriate for individuals who are unable to benefit from outpatient services or
-services in general settings because of cognitive impairments that result in functional limitations.
-Treatment is focused on preventing relapse, continued problems and/or continued use, and
-promoting the eventual reintegration of the individual into the community. Therapeutic
-rehabilitation facilities or traumatic brain injury programs are examples of this level of care.
-
-21.210.821
-
-Level 3.3 Service Provisions and Staffing
-
-A.
-
-Agencies providing Level 3.3 services shall deliver treatment services in a manner that is
-matched to the individual’s functioning and may be provided in a deliberately repetitive fashion to
-address the special cognitive needs of individuals for whom this level of care is considered a
-medical necessity.
-
-B.
-
-Agencies shall provide daily scheduled Level 3.3 services and include a minimum of nine (9)
-hours of planned treatment services per week.
-
-C.
-
-Agencies providing Level 3.3 services shall maintain individual to staff ratios not exceeding
-twenty to one (20:1) during nighttime hours, per agency site. Staff shall include:
-
-D.
-
-1.
-
-At least one (1) treatment staff, as defined in 21.210.1.E, trained and knowledgeable of
-substance use disorders, the treatment of substance use disorders and able to monitor
-and identify psychiatric conditions available by telephone twenty-four (24) hours per day,
-seven (7) days per week and available to be on-site within thirty (30) minutes;
-
-2.
-
-Addiction technicians certified pursuant to Part 8 of Article 245 of Title 12, C.R.S.;
-
-3.
-
-A physician, physician assistant or nurse practitioner available by telephone or in-person
-twenty-four (24) hours per day, seven (7) days per week to provide medical evaluation
-and consultation; and
-
-4.
-
-Peer support specialists as defined in Section 21.400.1.
-
-Agencies providing Level 3.3 services shall have direct affiliation or close coordination through
-referral to more and less intensive levels of care.
-
-21.210.83
-CLINICALLY MANAGED HIGH-INTENSITY RESIDENTIAL SUBSTANCE USE
-DISORDER SERVICES (Level 3.5)
-A.
-
-Level 3.5 services provide a safe and stable living environment with treatment focused on
-promoting skills needed to avoid relapse or continued use. Level 3.5 is appropriate for individuals
-with multiple limitations including criminal activity, psychological problems, and/or impaired social
-and/or vocational functioning.
-
-B.
-
-Treatment is directed toward reducing relapse risk, enhancing prosocial behaviors and
-reintegration into the community. A variable length therapeutic community or residential treatment
-center are examples of this level of care.
-
-21.210.831
-
-Level 3.5 Service Provisions and Staffing
-
-A.
-
-Agencies shall provide daily Level 3.5 services and include a minimum of ten (10) hours of
-planned treatment services per week.
-
-B.
-
-Agencies providing Level 3.5 services shall maintain individual to staff ratios not exceeding
-twenty to one (20:1) during nighttime hours, per agency site, and each shift shall have a minimum
-of two (2) staff members, whenever one (1) or more individuals are present. Staff shall include:
-
-377
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-
-C.
-
-2 CCR 502-1
-
-1.
-
-At least one (1) treatment staff, as defined in 21.210.1.E, trained and knowledgeable of
-substance use disorders, the treatment of substance use disorders and able to monitor
-and identify psychiatric conditions available twenty-four (24) hours per day, seven (7)
-days per week;
-
-2.
-
-Addiction technicians certified pursuant to Part 8 of Article 245 of Title 12, C.R.S. or staff
-in the process of obtaining addiction counselor certification;
-
-3.
-
-a physician, physician assistant or advanced practice nurse available to provide medical
-evaluation and consultation and assess and treat co-occurring biomedical disorders, as
-well as prescribe and monitor the administration of medications; and
-
-4.
-
-Peer support specialists as defined in Section 21.400.1.
-
-Agencies providing Level 3.5 services shall have direct affiliation or close coordination through
-referral to more and less intense levels of care.
-
-21.210.84
-MEDICALLY MONITORED INTENSIVE INPATIENT SUBSTANCE USE DISORDER
-SERVICES (Level 3.7)
-A.
-
-Level 3.7 services provide a planned and structured regimen of twenty-four (24) hour evaluation,
-observation, medical monitoring and addiction treatment.
-
-B.
-
-Level 3.7 services are appropriate for individuals whose medical, emotional, behavioral or
-cognitive problems are so severe that they require twenty-four (24) hour medical monitoring but
-do not need the full resources of an acute care general hospital or medically managed inpatient
-treatment program (Level 4). Treatment is designed for individuals who have functional limitations
-in the areas of intoxication/withdrawal potential; biomedical conditions; or emotional, behavioral or
-cognitive conditions.
-
-21.210.841
-
-Level 3.7 Service Provisions and Staffing
-
-A.
-
-Level 3.7 services shall be scheduled daily and include a minimum of twenty (20) hours of
-planned treatment services per week.
-
-B.
-
-Agencies providing Level 3.7 services shall maintain individual to staff ratios not exceeding
-twenty to one (20:1) during nighttime hours per agency site, and each shift shall have a minimum
-of two (2) staff members, whenever one (1) or more individuals are present.
-
-C.
-
-Level 3.7 services shall be staffed with a team that includes physicians, nurses and mental health
-professionals licensed or certified pursuant to Article 245 of Title 12, C.R.S. that provide twentyfour (24) hour professionally directed evaluation, care and treatment services including
-administration of prescribed medications, withdrawal management and integrated treatment of
-co-occurring medical, emotional, behavioral or cognitive conditions.
-
-D.
-
-A licensed physician shall oversee treatment and assure quality of care in Level 3.7 services. A
-physician, physician assistant or nurse practitioner shall perform physical examinations for all
-individuals admitted. Examinations shall occur within twenty-four (24) hours of admission and
-thereafter as necessary.
-
-E.
-
-A registered nurse shall conduct an alcohol or other drug-focused nursing assessment at the time
-of admission.
-
-F.
-
-A licensed nurse is responsible for monitoring the individual’s progress and/or medication
-administration twenty-four (24) hours per day, seven (7) days per week.
-
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-Behavioral Health
-
-G.
-
-2 CCR 502-1
-
-Additional medical specialty consultation, psychological, laboratory and toxicology services are
-available on-site through consultation or referral. Psychiatric services are available on-site
-through consultation or referral within eight (8) hours by telephone or twenty-four (24) hours in
-person.
-
-21.210.9
-
-WITHDRAWAL MANAGEMENT SERVICES
-
-21.210.91
-WM)
-
-CLINICALLY MANAGED RESIDENTIAL WITHDRAWAL MANAGEMENT (LEVEL 3.2-
-
-A.
-
-Level 3.2-WM programs shall provide twenty-four (24) hour supervised withdrawal from alcohol
-and/or other drugs in a residential setting.
-
-B.
-
-Level 3.2-WM programs shall provide collaboration and coordination with emergency mental
-health services as needed.
-
-C.
-
-Level 3.2-WM programs shall obtain a Controlled Substance License from the Office of
-Behavioral Health if the program plans to dispense, compound, or administer a controlled
-substance in order to treat a substance use disorder or to treat the withdrawal symptoms of a
-substance use disorder.
-
-D.
-
-Level 3.2-WM programs shall develop and implement policies and procedures in accordance with
-federal and state regulations, department rules, and in consultation with medical professionals
-qualified in substance use disorders. Policies and procedures must address but are not limited to:
-1.
-
-Handling individuals who are assessed as being a current threat to themselves or others
-and shall include appropriate uses of law enforcement and monitor any use of individual
-restraint and/or seclusion;
-
-2.
-
-Communication with intoxicated individuals leaving treatment against staff
-recommendations, including the use of emergency commitments; and
-
-3.
-
-Circumstances under which individuals shall be discharged, other than completing
-withdrawal management or leaving against staff recommendations.
-
-21.210.911
-
-Level 3.2-WM Admission and Monitoring
-
-A.
-
-Individuals admitted to level 3.2-WM services shall be intoxicated, under the influence, or in any
-stage of withdrawal from alcohol and/or other drugs.
-
-B.
-
-Level 3.2-WM admission procedures shall include at a minimum:
-1.
-
-Degree of alcohol and other drug intoxication as evidenced by breathalyzer, urinalysis,
-self-report, observation or other evidence-based or best practices;
-
-2.
-
-Initial vital signs;
-
-3.
-
-Need for emergency medical and/or psychiatric services;
-
-4.
-
-Inventorying and securing personal belongings;
-
-5.
-
-Substance use disorder history and the degree to which the use of substance affects
-personal and social functioning, as soon as clinically feasible following admission;
-
-6.
-
-Pregnancy screening; and
-
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-Behavioral Health
-
-7.
-C.
-
-2 CCR 502-1
-
-Administration of a validated clinical withdrawal assessment tool.
-
-Withdrawal management monitoring of individuals shall include:
-1.
-
-Routine monitoring of physical and mental status including observation of individual;
-
-2.
-
-Vital signs taken at least every two (2) hours until they remain at the person's baseline for
-at least four (4) hours, and then taken every eight (8) hours thereafter until discharge;
-and
-
-3.
-
-Documentation per shift to include all individual monitoring activities.
-
-21.210.912
-
-Level 3.2-WM Service Planning
-
-A.
-
-level 3.2-WM programs shall develop and implement service plans in accordance with Section
-21.190.4 and address safe withdrawal, motivational counseling, and referral for treatment.
-
-B.
-
-Level 3.2-WM programs shall provide additional service planning for managing individuals with
-medical conditions, suicidal ideation, pregnancy, psychiatric conditions, and other conditions
-which place individuals at additional risk during withdrawal management.
-
-C.
-
-Level 3.2-WM programs shall provide assessments of individual readiness for treatment and
-interventions based on the service plan and the assessments and interventions shall be
-documented in the individual’s record.
-
-21.210.913
-A.
-
-Level 3.2-WM Discharge
-
-Level 3.2-WM programs shall provide discharge information to individuals and document in the
-individual’s records the requirements established in Section 21.190.6, and:
-1.
-
-Effects of alcohol and other drugs;
-
-2.
-
-Risk factors associated with alcohol and other drug abuse for acquiring and transmitting
-HIV/AIDS (Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome),
-Tuberculosis (TB), and other infectious diseases, and for pregnancy;
-
-3.
-
-Availability of testing and pre/post-test counseling for HIV/AIDS, TB, Hepatitis C and
-other infectious diseases, and pregnancy; and
-
-4.
-
-Availability of alcohol and other drug abuse treatment services.
-
-21.210.914
-
-Level 3.2-WM Staff Requirements
-
-A.
-
-At least fifty percent (50%) of withdrawal management staff including on-call staff shall consist of
-treatment staff as defined in 21.210.1.E, certified addiction technicians or staff in the process of
-obtaining addiction counselor certification. Plans for addiction counselor certification shall be
-available for review. Full-time staff shall obtain at least an addiction technician certification within
-eighteen (18) months of employment.
-
-B.
-
-Uncertified staff or staff without a plan for addiction counselor certification shall not comprise
-more than fifty percent (50%) of total withdrawal management staff.
-
-C.
-
-Level 3.2-WM programs’ individual to staff ratios shall not exceed ten to one (10:1); and
-
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-
-D.
-
-E.
-
-F.
-
-2 CCR 502-1
-
-1.
-
-Procedures for responding to periods of high census and/or emergency situations shall
-be conspicuously posted; and
-
-2.
-
-Each shift shall have a minimum of two (2) staff members, whenever one (1) or more
-individuals are present.
-
-The staff person overseeing day-to-day operations shall be:
-1.
-
-Certified as an addiction specialist or licensed as an addiction counselor pursuant to Part
-8 of Article 245 of Title 12, C.R.S.;
-
-2.
-
-A physician licensed pursuant to Article 240 of Title 12, C.R.S.;
-
-3.
-
-A psychologist licensed pursuant to Part 3 of Article 245 of Title 12, C.R.S.;
-
-4.
-
-An advanced practice nurse licensed pursuant to Section 12-255-111, C.R.S.; or
-
-5.
-
-A licensed clinical social worker, licensed marriage and family therapist, or licensed
-professional counselor licensed under Part 4, 5, or 6 of Article 245 of Title 12, C.R.S.
-
-Level 3.2-WM programs shall provide twenty-four (24) hour per day, seven (7) days per week onsite staff. Twenty-four (24) hour on-site staff shall be trained and knowledgeable of substance use
-disorders and the treatment of substance use disorders and in addition to treatment staff as
-defined in 21.210.1.E, twenty-four (24) hour staff may include:
-1.
-
-Peer support specialists as defined in 21.400.1; or
-
-2.
-
-Addiction technicians certified pursuant to Part 8 of Article 245 of Title 12, C.R.S. or staff
-in the process of obtaining addiction counselor certification.
-
-Programs shall maintain documentation that all direct care staff have training in and evaluated
-knowledge of the following before providing independent services:
-1.
-
-Withdrawal management;
-
-2.
-
-Infectious diseases (AIDS/HIV, Hepatitis C, TB), including universal precautions against
-becoming infected;
-
-3.
-
-Administering cardiopulmonary resuscitation (CPR) and first aid;
-
-4.
-
-Monitoring vital signs;
-
-5.
-
-Conducting assessment and triage, including identifying suicidal ideation;
-
-6.
-
-Emergency procedures and their implementation;
-
-7.
-
-Collecting urine and breath samples;
-
-8.
-
-Cultural factors that impact withdrawal management;
-
-9.
-
-Ethics and confidentiality;
-
-10.
-
-Individual records systems;
-
-11.
-
-De-escalating potentially dangerous situations; and
-
-381
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-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-12.
-21.210.92
-WM)
-
-2 CCR 502-1
-
-Basic counseling and motivational interviewing skills.
-MEDICALLY MONITORED INPATIENT WITHDRAWAL MANAGEMENT (LEVEL 3.7-
-
-Level 3.7-WM services shall be provided by licensed medical staff qualified to supervise withdrawal from
-alcohol and other drugs through use of medication and/or medical procedures in residential settings
-which possess Controlled Substances Licenses in compliance with Part 2 of Article 80 of Title 27, C.R.S.
-21.210.921
-
-Level 3.7-WM Admission and Evaluation
-
-A.
-
-Level 3.7-WM programs shall develop and implement specific admission criteria detail for which
-drugs, including alcohol, medical withdrawal management is provided.
-
-B.
-
-In addition to the consent requirements established in 21.170.4, level 3.7-WM programs shall
-provide informed consent to medical withdrawal management that include:
-
-C.
-
-D.
-
-1.
-
-Medications to be used; and
-
-2.
-
-Need to consult with primary care physicians.
-
-Level 3.7-WM programs shall provide medical evaluations by physicians licensed pursuant to
-Article 240 of Title 12, C.R.S. or authorized health-care professionals under the supervision of
-authorized physicians. The medical evaluations shall consist of, at minimum:
-1.
-
-Medical histories including detailed chronologies of substance use disorders;
-
-2.
-
-Identification of current physical addiction including drug types;
-
-3.
-
-Physical examinations to determine appropriateness for outpatient or inpatient medical
-withdrawal management; and
-
-4.
-
-Appropriate laboratory tests including pregnancy tests, and other evaluations as
-indicated.
-
-Level 3.7-WM service protocols for usual and customary withdrawal management from each drug
-delineated in the admission criteria shall be developed in consultation with licensed physicians
-and other allied health-care professionals and shall be implemented in the form of individualized
-withdrawal management plans under direct supervision of program medical directors. Protocols
-shall include:
-1.
-
-Types of intoxication;
-
-2.
-
-Tolerance levels for the individual's drug of choice;
-
-3.
-
-Degrees of withdrawal;
-
-4.
-
-Possible withdrawal and/or intoxication complications;
-
-5.
-
-Other conditions affecting medical withdrawal management procedures;
-
-6.
-
-Types of medications used;
-
-7.
-
-Recommended dosage levels;
-
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-Behavioral Health
-
-2 CCR 502-1
-
-8.
-
-Frequency of visits (outpatient settings);
-
-9.
-
-Procedures to follow in the event of withdrawal management complications;
-
-10.
-
-Daily assessments including expected improvements as well as potential problems; and
-
-11.
-
-Expected duration of withdrawal management.
-
-E.
-
-Medical withdrawal management programs using any controlled substances are required to have
-Controlled Substance Licenses issued by the Department. Buprenorphine is the only medication
-that can be used for opioid dependent individuals unless the medical withdrawal management
-program is licensed as an opioid treatment program and it has been verified through the program
-and coordinated with the Federal Center for Substance Abuse Treatment.
-
-F.
-
-Authorized physicians may prescribe buprenorphine under his/her own Drug Enforcement
-Administration (DEA) registration number for individuals admitted to the hospital for inpatient
-withdrawal management or addiction treatment.
-
-G.
-
-Withdrawal management programs must continue patients on their medication-assisted treatment
-regimen when available and will only detox individuals from medications treating opioid use
-disorders at the patient’s request or if it is deemed medically necessary.
-
-21.210.922
-A.
-
-B.
-
-C.
-
-Level 3.7-WM Clinical Staff
-
-Level 3.7-WM programs shall provide, at minimum, the following clinical staff:
-1.
-
-One medical director;
-
-2.
-
-One registered nurse or licensed practical nurse (R.N. or L.P.N.) with at least one year of
-withdrawal management experience; and
-
-3.
-
-Treatment staff as defined in 2.210.1.E, staffed at a rate that meets the needs of the
-individuals receiving level 3.7-WM services.
-
-Level 3.7-WM program medical directors' responsibilities shall include, at minimum:
-1.
-
-Quarterly reviews and revisions of drug withdrawal management categories and
-protocols;
-
-2.
-
-Reviews of individual withdrawal management plans;
-
-3.
-
-Reviews of individual prescriptions that deviate from standard withdrawal management
-protocols;
-
-4.
-
-Five (5) hours of monthly supervision of and consultation with staff providing withdrawal
-management services;
-
-5.
-
-Direct supervision of individual withdrawal management cases that deviate from standard
-protocols and/or experience complications; and
-
-6.
-
-Develop and implement back-up systems for physician coverage when medical directors
-are unavailable and/or for emergencies.
-
-level 3.7-WM programs shall ensure twenty-four (24) hour access to clinical staff by telephone
-and accommodation for unscheduled visits for crises or problem situations.
-
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-
-21.210.923
-A.
-
-B.
-
-B.
-
-Level 3.7-WM Treatment Services
-
-Level 3.7-WM programs shall provide the following treatment services in addition to medication
-dosing contacts:
-1.
-
-Motivational counseling and support;
-
-2.
-
-Continuous evaluation and behavioral health intervention; and
-
-3.
-
-Development and monitoring of a service plan per Section 21.190.4.
-
-Level 3.7-WM programs shall ensure a minimum of one (1) daily clinical supportive services
-contact, which shall be documented in individual records.
-
-21.210.924
-A.
-
-2 CCR 502-1
-
-Level 3.7-Wm Dispensing and Administration Procedures
-
-Level 3.7-WM programs shall develop and implement policies and procedures for dispensing
-medications per standard withdrawal management protocols that are in accordance with
-applicable state and federal statutes and for the following:
-1.
-
-Individual prescriptions filled and dispensed by a registered pharmacist at a designated
-pharmacy location; and
-
-2.
-
-Individual prescriptions from medical directors that are filled from stock quantities.
-
-Level 3.7-WM programs shall develop and implement policies and procedures in accordance with
-applicable federal and state statutes for storing and accounting for all drugs including controlled
-substances.
-
-21.220 GENDER-RESPONSIVE WOMEN'S TREATMENT IN SUBSTANCE USE DISORDER
-PROGRAMS [Eff. 11/1/13]
-In addition to Section 21.210, agencies licensed to provide Gender-Responsive Women’s Treatment shall
-be in compliance with Subsections 21.220.1 through 21.220.4.
-21.220.1
-
-GENERAL PROVISIONS [Eff. 11/1/13]
-
-A.
-
-Treatment staff shall have documented training, supervision and experience in women-specific
-issues and services.
-
-B.
-
-Treatment for substance use disorders shall be provided to the family as a whole, unless clinically
-contraindicated. Clinical contraindications to this provision must be documented in the individual
-record.
-
-C.
-
-Agencies shall offer any pregnant woman admission to treatment within forty-eight (48) hours and
-shall demonstrate compliance with Section 21.220.4, D, Services to Pregnant Women.
-
-D.
-
-Agencies providing gender specific women’s treatment shall include the following components:
-1.
-
-Emotional and physical safety of individuals take precedence over all other
-considerations in the delivery of services;
-
-2.
-
-Services designed to increase women’s access to care, and engagement and retention of
-individuals (such as comprehensive case management, transportation, child care);
-
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-
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-
-3.
-
-Women-only therapeutic environments;
-
-4.
-
-Women-specific service needs and topic areas;
-
-5.
-
-Program services shall directly address trauma issues currently manifesting in the
-individual’s life either through direct service provision or by referral; and,
-
-6.
-
-Multiple modalities that meet the specific needs of women (group and individual therapy,
-case management and opportunities for women to be in treatment with their children
-where possible).
-
-E.
-
-Agency policy and procedures shall include the mandatory reporting of suspected child abuse,
-neglect and/or child safety issues, which shall include definitions of abuse and neglect under the
-Colorado Children’s Code (Section 19-1-103, C.R.S.), and which are consistent with the reporting
-of child abuse allowed under federal law.
-
-F.
-
-Agency policy and procedures shall include the criteria for interventions offered and expected
-outcomes of services delivered.
-
-21.220.2
-
-SCREENING [Eff. 11/1/13]
-
-In addition to the Section 21.190.3, screening shall include all of the following unless clinically
-contraindicated:
-A.
-
-Screening and documentation of individual’s need for prenatal care (where applicable), primary
-medical care and family planning services;
-
-B.
-
-Screening for child safety issues utilizing an evidence-based or best practices approved
-instrument.
-
-21.220.3
-
-TREATMENT [Eff. 11/1/13]
-
-A.
-
-Service plans shall be established in accordance with Section 21.190.4 of these rules, and shall
-address each of the need areas identified in Section 21.220.3.
-
-B.
-
-When not clinically contraindicated the following topic areas shall be addressed in treatment or by
-referral when applicable:
-1.
-
-Reductions or elimination of substance use;
-
-2.
-
-Individual safety issues
-
-3.
-
-Child safety issues;
-
-4.
-
-Trauma issues;
-
-5.
-
-Parenting issues;
-
-6.
-
-Ways in which substance use disorders impact and are impacted by family and
-relationships;
-
-7.
-
-Medical and primary health issues;
-
-8.
-
-Mental health issues;
-
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-
-9.
-21.220.4
-
-2 CCR 502-1
-
-Nutrition.
-SERVICES TO PREGNANT WOMEN [Eff. 11/1/13]
-
-A.
-
-Pregnant women shall be given priority admission to treatment for substance use disorders.
-
-B.
-
-Programs shall develop policies and procedures for service delivery to pregnant women, which
-shall include circumstances under which pregnant women may be discharged from treatment.
-1.
-
-Pregnant women may not be discharged from treatment solely for failure to maintain
-abstinence from substance use.
-
-2.
-
-Every effort shall be made to retain pregnant women in treatment for the duration of their
-pregnancies in order to maintain an optimal period of abstinence from substance use.
-
-C.
-
-Every attempt shall be made to admit pregnant women to treatment within forty-eight (48) hours
-of first contact between the woman and the admitting program.
-
-D.
-
-If a pregnant woman is not admitted to treatment within forty-eight (48) hours of first contact, the
-denial shall be clearly documented, the women's treatment coordinator for OBH shall be
-informed, and interim services shall be provided consisting of the following at minimum:
-1.
-
-Referral for pre-natal care;
-
-2.
-
-Information on the effects of alcohol and drug use on the fetus;
-
-3.
-
-Daily phone contact with the individual; and,
-
-4.
-
-Education regarding the transmission and prevention of communicable diseases such as
-HIV, hepatitis.
-
-E.
-
-Pregnant women shall be linked to prenatal care immediately and barriers to accessing prenatal
-care shall be addressed, including transportation to prenatal care.
-
-F.
-
-When a woman refuses to seek prenatal care or fails attempts to link her to care, this shall be
-documented in her record, and there shall be continuing efforts to link her to prenatal care until
-this is accomplished.
-
-21.230 SUBSTANCE USE DISORDER EDUCATION AND TREATMENT FOR PERSONS INVOLVED
-IN THE CRIMINAL JUSTICE SYSTEM
-21.230.1
-
-GENERAL PROVISIONS
-
-A.
-
-Education, treatment, and ancillary services shall be provided to individuals convicted of
-misdemeanors and felonies who are assessed as needing substance use disorder treatment, as
-provided by Title 16, Article 11.5, Part 1, and C.R.S. and in accordance with current standardized
-assessment and placement protocol.
-
-B.
-
-All agencies admitting out of state offenders must identify and notify the Interstate compact unit
-for Adult Offender Supervision per Section 17-27.1-101, C.R.S.
-
-C.
-
-Services shall be based on the results of current screening and assessments.
-
-D.
-
-Agencies shall place individuals involved in the criminal justice system according to the
-standardized offender assessment provided by the referring criminal justice agency.
-
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-
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-
-E.
-
-Education, treatment and ancillary services as indicated by assessment and included in the
-service plan shall be provided for by the agency or through referrals.
-
-F.
-
-Agencies shall have a written memorandum of understanding with ancillary providers to make
-available agreed upon services and require specific data and exchange of information related to
-the individualized services.
-
-G.
-
-Education and treatment shall be a minimum of nine (9) months or as required by the referring
-criminal justice agency.
-
-H.
-
-Frequency and intensity of education and treatment services shall be based on assessments and
-at minimum one two hour session per week.
-
-I.
-
-The following content/topics shall be presented during offender treatment:
-1.
-
-Physiological and psychological effects of alcohol, marijuana and/or marijuana/THC
-infused products, stimulants, and other drugs;
-
-2.
-
-Signs and symptoms of substance use disorders;
-
-3.
-
-Stress management and substance use disorders;
-
-4.
-
-Anger management and substance use disorders;
-
-5.
-
-Behavioral triggers leading to substance use disorders;
-
-6.
-
-Drugs in the work place; and,
-
-7.
-
-Legal issues and substance use disorders.
-
-J.
-
-Agencies shall implement treatment curricula that are written in manual format and are evidencebased or best practices. All agency clinical staff working with the individuals involved in the
-criminal justice system population must be trained on and follow the specific curricula as written.
-
-K.
-
-Individuals will receive a complete copy of the participant materials/workbook associated with the
-approved curriculum. The agency may charge for the curriculum.
-
-L.
-
-Education and treatment sessions shall only consist of face-to-face (as defined in Section
-21.240.1) contact and shall not include administrative procedures or breaks.
-
-M.
-
-Agency staff working directly with individuals shall have documented qualifications and training in
-forensic populations and criminal justice systems.
-
-N.
-
-Drug and alcohol toxicology collection must be observed by trained staff when requested by the
-referral source.
-
-O.
-
-Records shall contain monthly documentation of communication with the criminal justice referral
-source describing progress toward specific treatment goals. Agencies shall be responsible for
-monitoring and reporting to referring courts or their representatives the individual's progress with
-ancillary services.
-
-P.
-
-Agencies shall have written documentation in an individual's record that the individual has
-received services to assist in community reintegration, if applicable.
-
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-2 CCR 502-1
-
-21.230.2
-ENHANCED OUTPATIENT EDUCATION AND TREATMENT SERVICES FOR
-PERSONS INVOLVED IN THE CRIMINAL JUSTICE SYSTEM [Eff. 5/1/16]
-A.
-
-An agency may provide enhanced outpatient services if it:
-1.
-
-Is licensed by the Department for education and treatment services for individuals
-involved in the criminal justice system;
-
-2.
-
-Is in compliance with Section 21.230.1; and,
-
-3.
-
-Provides a minimum of four (4) hours over two (2) group sessions of scheduled treatment
-per week.
-
-B.
-
-Frequency and intensity of treatment activities shall be based on current assessments and
-conducted in at least two (2) sessions per week.
-
-C.
-
-Changes in frequency and intensity of education and treatment activities shall be assessed.
-
-D.
-
-If, upon discharge from enhanced outpatient treatment, the minimum number of months required
-by the referring criminal justice agency have not been met, the agency shall transfer the individual
-to the appropriate level of care where remaining education and treatment requirements can be
-met.
-
-21.240 DUI/DWAI, BUI, AND FUI EDUCATION AND TREATMENT
-21.240.1
-
-DEFINITIONS
-
-“ADDS” is the Alcohol and Drug Driving Safety program, established under Section 42-4-1301.3, C.R.S.
-The Judicial Department administers an Alcohol and Drug Driving Safety program in each judicial district
-that provides pre-sentence and post-sentence alcohol and drug evaluations on all persons convicted of
-Driving, Flying, and Boating Under the Influence (DUI, FUI, BUI) and Driving With Ability Impaired
-(DWAI).
-“Alcohol and Drug Evaluation Specialists” (ADES) are persons within the criminal justice system, qualified
-to conduct pre- and post-sentence evaluations on, and provide supervision for, persons convicted of
-Driving, Flying, and Boating Under the Influence (DUI, FUI, BUI) and Driving With Ability Impaired
-(DWAI).
-“BUI” means Boating Under the Influence.
-“DUI” means Driving Under the Influence.
-“DWAI” means Driving With Ability Impaired.
-“Face-to-Face”, for purposes of this section 21.240, means that the individual is physically in the same
-room as a professional person at an office of a behavioral health licensed or approved site or video
-technology is being utilized.
-“FUI” means Flying Under the Influence.
-“Persistent Drunk Driver” defined in Section 42-1-102(68.5), C.R.S.
-“Level I and Level II Education, Therapy or Treatment” means an approved alcohol and drug driving
-safety education or treatment program as defined in 42-4-1301.3(3)(c)(IV) C.R.S.
-
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-
-21.240.2
-
-2 CCR 502-1
-
-GENERAL PROVISIONS [Eff. 5/1/16]
-
-A.
-
-Agencies providing DUI/DWAI services shall develop and implement policies, procedures, and
-individualized service planning demonstrating recognition of issues and treatment needs unique
-to this individual population.
-
-B.
-
-Alcohol and Drug Driving Safety (ADDS) education and treatment services shall be restricted to
-those arrested, convicted of or receiving deferred prosecutions, sentences, or judgments for
-alcohol/other drug offenses related to driving (Title 42, Article 4, Part 13, C.R.S. and Title 42,
-Article 2, Part 1, C.R.S.), boating (Title 33, Article 13, Part 1, C.R.S.), or flying (Title 41, Article 2,
-Part 1, C.R.S.).
-
-C.
-
-Individuals who are admitted, educated, or treated for Driving Under the Influence (DUI), Driving
-While Ability Impaired (DWAI), Boating Under the Influence (BUI), or Flying Under the Influence
-(FUI) shall be screened, referred and placed in accordance with current ADDS program
-screening, referral, and placement procedures.
-
-D.
-
-1.
-
-If an agency does not have a copy of the ADDS referral paperwork, the agency shall
-conduct a screening of the individual using an evidence-based screening or promising
-practice process and instrument.
-
-2.
-
-If an appropriate level of service has not been determined by the ADDS program
-screening, the agency shall follow guidelines established by the Colorado Department OF
-Human Services, Office of Behavioral Health, to determine the most appropriate level of
-service.
-
-Agencies that do not provide services as identified through the screening or in the individual's
-court order shall:
-1.
-
-Refer the individual back to the Alcohol and Drug Evaluation Specialist with
-documentation of which service(s) will not be provided on site and identified referrals and
-suggestions for alternative services;
-
-2.
-
-Have a written memorandum of understanding or contract with the ancillary provider to
-make available agreed upon services and require specific data and exchange of
-information related to the individualized services; and,
-
-3.
-
-Be responsible for monitoring and reporting to referring courts or their representatives the
-individual's progress with ancillary services.
-
-E.
-
-Individuals with DUI/DWAI shall not be treated in groups with individuals with other offenses
-unless they need these groups as determined by the assessment and supported by the service
-plan.
-
-F.
-
-Agencies providing Level I Education, Level II Therapeutic Education, and Level II Therapy shall
-submit information using reporting formats and data systems approved by the Department when
-appropriate to:
-1.
-
-Sentencing courts;
-
-2.
-
-The Department;
-
-3.
-
-Probation departments;
-
-4.
-
-Alcohol and Drug Evaluation Specialist;
-
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-
-G.
-
-5.
-
-Department of Revenue Hearing Section; and,
-
-6.
-
-Motor Vehicle Division.
-
-2 CCR 502-1
-
-Information released shall be in accordance with federal and state confidentiality regulations and
-shall include:
-1.
-
-Enrollment;
-
-2.
-
-Cooperation;
-
-3.
-
-Attendance, hours and weeks completed;
-
-4.
-
-Treatment status and progress;
-
-5.
-
-Education/treatment levels;
-
-6.
-
-Fee payment;
-
-7.
-
-Compliance with ancillary services; and,
-
-8.
-
-Discharge status.
-
-H.
-
-Agencies shall establish written policies and procedures to ensure that individual data is accurate
-and submitted within seven (7) business days of service or change in status.
-
-I.
-
-Level I education, Level II therapeutic education, and Level II therapy shall not be combined, nor
-shall hours completed for one count as hours completed in another.
-
-J.
-
-Individuals shall not be reported as finishing Level I education, Level II therapeutic education, or
-Level II therapy until all required content/topics have been completed over the minimum required
-hours and weeks.
-
-K.
-
-Agencies shall provide proof of individual enrollment and report individual status in Level II
-education and therapy, including discharge, to the Colorado Department of Revenue, Division of
-Motor Vehicles, within seven (7) business days using Department prescribed reporting formats, in
-accordance with Sections 42-2-132 and 42-2-144, C.R.S.
-
-L.
-
-Agencies shall provide accurate and timely submission of DUI/DWAI referral summaries (DRS)
-and other required data submitted through the Treatment Management System (TMS). Agency
-staff having access to the Treatment Management System shall do so in accordance with federal
-confidentiality laws.
-
-M.
-
-Discharge DUI/DWAI Referral Summary
-Agencies shall provide a copy of the discharge DUI/DWAI referral summary, validated with an
-agency authorized signature, to individuals and referral sources within ten (10) business days
-following discharge from education and/or treatment.
-1.
-
-A copy of the discharge referral summary shall be provided to individuals at no charge;
-
-2.
-
-The discharge referral summary shall not be withheld for any reason including, but not
-limited to, collection of outstanding balances; and,
-
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-
-3.
-N.
-
-2 CCR 502-1
-
-Each discharge referral summary must reflect all DUI/DWAI services the individual
-received in a given treatment episode.
-
-Ignition Interlock
-1.
-
-Agencies shall screen all individuals with DUI/DWAI's for ignition interlock usage and
-requirements in accordance with the Department's interlock rules;
-
-2.
-
-Agencies shall offer interlock counseling to those individuals who have installed, or plan
-to install, an ignition interlock device in accordance with Department rules; and,
-
-3.
-
-Interlock counseling shall be offered on site or by referral to another Department licensed
-agency.
-
-21.240.3
-
-PROVISION OF SERVICES
-
-A.
-
-Agencies shall use and adhere to a curriculum written in a manual form that is evidence-based or
-a best practice specific to DUI/DWAI, and contains content and topic areas as determined by the
-Department.
-
-B.
-
-Agencies shall provide individuals with a complete copy of the participant materials and workbook
-associated with the approved curriculum being used. The agency may charge individuals for the
-curriculum materials.
-
-C.
-
-Agencies shall assign individuals to a specific class, group or individual session throughout the
-treatment episode. Individuals attending DUI/DWAI education may make up sessions missed by
-attending other education sessions that cover the missed content. Make-up groups for DUI/DWAI
-therapy are not allowed.
-
-D.
-
-Staff conducting DUI/DWAI, BUI and FUI education and therapy shall:
-1.
-
-Receive training in the curriculum;
-
-2.
-
-Meet the minimum staff qualifications per Sections 21.160 and 21.210.1, including
-credentialing and competency in group processes; and,
-
-3.
-
-Possess a CAS or LAC.
-
-E.
-
-Hours of attendance shall only be granted for face-to-face contacts and shall not include
-administrative procedures or breaks.
-
-F.
-
-Drug and alcohol toxicology collection must be observed by trained staff when requested by the
-referral source.
-
-21.240.4
-
-YOUTH DUI, DWAI, BUI and FUI EDUCATION AND TREATMENT [Eff. 5/1/16]
-
-Licensed youth DUI/DWAI agencies shall comply with Section 21.200 Behavioral Health Services for
-Children and Adolescents, the adult DUI, DWAI, BUI, FUI rules (21.240) as well as the following:
-A.
-
-Youth under twenty-one (21) years of age that receive a DUI/DWAI are held to the same adult
-requirements under Alcohol and Drug Driving Safety (ADDS) education and treatment services as
-identified in (Title 42, Article 4, Part 13 and Title 42, Article 2, Part 1, C.R.S) boating (Title 33,
-Article 13, Part 1,C.R.S.), or flying (Title 41, Article 2, Part 1, C.R.S.) and includes Section [42-41301.3(3)(c)(IV)] , C.R.S.
-
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-
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-
-B.
-
-Agencies licensed to provide Youth DUI, DWAI, BUI, and FUI education and treatment shall also
-be licensed to provide DUI/DWAI education and treatment.
-
-C.
-
-Whenever possible providers shall hold a separate group for youth.
-1.
-
-Providers shall use clinical judgement when determining age appropriate placement of
-youth under twenty-one (21) years of age in an adult group.
-
-2.
-
-When youth are placed in an adult group, individual sessions shall be offered to meet the
-developmental needs of the youth, when applicable.
-
-D.
-
-Youth under twenty-one (21) years of age shall receive a complete copy, age appropriate
-materials/workbook, associated with the approved curriculum. The agency may charge for the
-curriculum.
-
-E.
-
-Parents, other supportive adults, or significant others, shall participate throughout the length of
-treatment, unless contraindicated.
-
-21.240.5
-
-CONTENT OF RECORDS
-
-Individual records shall be maintained for all levels of education and therapy and follow Section 21.170
-(Records Care and Retention, General Provisions) and include:
-A.
-
-Court documents regarding referral and classification and placement;
-
-B.
-
-Attendance, individualized progress notes, and course completion data;
-
-C.
-
-Descriptions of content and topics covered during each session;
-
-D.
-
-Relevant reports and records of communication;
-
-E.
-
-Copies of Discharge DUI/DWAI Referral Summary;
-
-21.240.6
-
-Level I EDUCATION
-
-A.
-
-Level I education shall be twelve (12) hours of face-to-face instruction; hours may include intake.
-
-B.
-
-No more than four (4) hours shall be conducted in one (1) calendar day.
-
-C.
-
-Level I education shall be conducted in outpatient settings.
-
-21.240.7
-
-Level II THERAPEUTIC EDUCATION [Eff. 5/1/16]
-
-A.
-
-Agencies applying for approval to conduct Level II therapeutic education must also apply for
-approval to conduct Level II therapy and meet the requirements of both.
-
-B.
-
-Provision of Services for Level II therapeutic education shall:
-1.
-
-Be conducted in outpatient settings;
-
-2.
-
-Consist of twelve (12) attended weeks and a total of twenty-four (24) face-to-face contact
-hours; and,
-
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-
-3.
-
-C.
-
-2 CCR 502-1
-
-Not be conducted concurrently with Level II therapy unless clinical rationale is
-documented. The combined time in Level II therapeutic education and Level II therapy
-shall not be less than the minimum number of weeks required for Level II therapy.
-
-Individuals shall not attend more than one (1) session of Level II education per week.
-
-21.240.8
-
-LEVEL II DUI/DWAI THERAPY
-
-21.240.81
-
-LEVEL II Outpatient [Eff. 5/1/16]
-
-A.
-
-Programs applying for approval to conduct Level II therapy must also apply for approval to
-conduct Level II therapeutic education and meet the requirements for both.
-
-B.
-
-Individuals in Level II therapy shall be assigned treatment tracks in accordance with the ADDS
-program placement criteria or Department placement guidelines in the absence of the ADDS
-placement criteria. If a track has not been assigned by the ADDS program, the agency shall
-assign a track based on the Department's track guidelines. The Department track guidelines are
-as follows:
-1.
-
-TRACK A. Individuals whose blood alcohol content was below the statutorily defined
-persistent drunk driving (PDD) level per Section 42- 1-102(68.5), C.R.S, and who have
-one offense for DUI/DWAI, BUI, or FUI. Track A is a minimum forty-two (42) face-to-face
-hours of group and/or individual Level II therapy conducted over twenty-one (21) or more
-weeks.
-
-2.
-
-TRACK B. Individuals whose blood alcohol content was at or above the statutorily
-defined PDD level per Section 42-1-102(68.5), C.R.S., and who have one offense for
-DUI/DWAI, BUI, or FUI. Track B is a minimum of fifty-two (52) face-to-face hours of group
-and/or individual Level II therapy conducted over twenty-six (26) or more weeks.
-
-3.
-
-TRACK C. Individuals whose blood alcohol content was below the statutorily defined
-PDD level per Section 42-1-102(68.5), C.R.S., and who have two or more offenses for
-DUI/DWAI, BUI, or FUI. Track C is a minimum of sixty-eight (68) face-to-face hours of
-group and/ individual Level II therapy conducted over thirty-four (34) or more weeks.
-
-4.
-
-TRACK D. Individuals whose blood alcohol content was at or above the statutorily
-defined PDD level per Section 42-1- 102 (68.5), C.R.S., and who have two or more
-offenses for DUI/DWAI, BUI, or FUI. Track D is a minimum of eighty-six (86) face-to-face
-hours of group and/or individual Level II therapy conducted over forty-three (43) or more
-weeks.
-
-C.
-
-Level II therapy shall be conducted only after Level II therapeutic education has been completed
-unless there is documented assessment and clinical rationale.
-
-D.
-
-Level II therapy group sessions (excluding enhanced or intensive outpatient) shall not be less
-than two (2) hours of therapeutic contact, and shall not include administrative procedures and
-breaks.
-
-E.
-
-Individuals are expected to attend group one (1) time per week. Clinical rationale for any changes
-in frequency of group attendance (fewer or more) shall be documented, and must reflect at least
-one (1) session per month. Therapy hours attended shall be conducted over the minimum
-number of weeks associated with the therapy track assigned.
-
-F.
-
-The assessment shall be updated at the onset of Level II therapy.
-
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-
-G.
-
-Using the initial service plan as a basis, a revised service plan and subsequent reviews shall be
-developed for individuals in Level II therapy in accordance with Section 21.190.4.
-
-21.240.82
-A.
-
-B.
-
-2 CCR 502-1
-
-DUI/DWAI Enhanced Outpatient THERAPY
-
-An agency licensed to provide DUI/DWAI services may qualify to provide enhanced outpatient
-therapy if it:
-1.
-
-Is approved by the Department for Level II therapy;
-
-2.
-
-Meets all the requirements in Sections 21.110 through 21.190, Sections 21.240.2,
-21.240.3, and 21.240.5 and Section 21.240.81; and,
-
-3.
-
-Demonstrates ability to provide eight (8) hours of scheduled treatment activities per
-week.
-
-Level II DUI/DWAI enhanced outpatient therapy shall:
-1.
-
-Be based on assessments;
-
-2.
-
-Include a minimum of three (3) to maximum eight (8) hours of treatment activities;
-
-3.
-
-Be conducted over a minimum of two (2) calendar days per week; and,
-
-4.
-
-Not include Level II education.
-
-C.
-
-DUI/DWAI enhanced outpatient services shall be in addition to any DUI/DWAI level or track
-requirements.
-
-D.
-
-Treatment activities shall be conducted for a minimum of ninety (90) calendar days.
-
-E.
-
-Changes in frequency and intensity of Level II enhanced outpatient treatment shall be driven and
-based on treatment service plan reviews.
-
-21.240.83
-A.
-
-B.
-
-DUI/DWAI Intensive Outpatient THERAPY
-
-An agency licensed to provide DUI/DWAI services may qualify to provide DUI/DWAI intensive
-outpatient therapy if it:
-1.
-
-Is approved by the Department for Level II therapy;
-
-2.
-
-Meets all the requirements in Sections 21.110 through 21.190, Sections 21.240.2,
-21.240.3, and 21.240.5, and Section 21.240.81; and,
-
-3.
-
-Demonstrates ability to provide at least nine (9) hours of scheduled treatment activities
-per week.
-
-DUI/DWAI intensive outpatient treatment therapy shall:
-1.
-
-Be based on assessments;
-
-2.
-
-Include a minimum of nine (9) hours of treatment activities;
-
-3.
-
-Be conducted over a minimum of three (3) calendar days per week; and,
-
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-
-4.
-
-2 CCR 502-1
-
-Not include Level II education.
-
-C.
-
-DUI/DUI intensive outpatient services shall be in addition to any DUI/DWAI level or track
-requirement.
-
-D.
-
-The length of stay in level ii intensive outpatient shall be four (4) to six (6) weeks.
-
-E.
-
-Any changes in frequency and intensity of Level II intensive outpatient treatment shall be based
-on assessments and service plan reviews.
-
-21.240.84
-Partial Hospitalization, Clinically Managed Low Intensity Residential Services,
-Clinically Managed High Intensity Residential Services, and Medically Monitored Intensive
-Residential Treatment [Eff. 5/1/16]
-A.
-
-B.
-
-Partial Hospitalization, Clinically Managed Low Intensity Residential Services, Clinically Managed
-High Intensity Residential Services, and Medically Monitored Intensive Residential Treatment
-may qualify to provide DUI/DWAI therapy if they:
-1.
-
-Meet all requirements under specific level of care in Section 21.210.5;
-
-2.
-
-Meet all requirements in Sections 21.240.2 and 21.240.3; and,
-
-3.
-
-Are affiliated with the Department licensed outpatient DUI/DWAI programs.
-
-In order for individuals to receive DUI/DWAI therapy credit for participation in Partial
-Hospitalization, Clinically Managed Low Intensity Residential Services, Clinically Managed High
-Intensity Residential Services, and Medically Monitored Intensive Residential Treatment, the
-assessed and identified DUI/DWAI treatment areas must be included in the individualized service
-plan.
-
-21.240.85
-
-LEVEL II FOUR PLUS TREATMENT
-
-A.
-
-Level II Four Plus Treatment is an approved alcohol and drug driving safety education or
-treatment program as defined in Section 42-4-1301.3(3)(c)(IV) C.R.S. (2016), intended for
-someone who has four (4) or more alcohol and/or drug impaired driving offenses.
-
-B.
-
-In order to provide Level II Four Plus Treatment an agency must be licensed to provide:
-1.
-
-Level II Therapeutic Education; and,
-
-2.
-
-Level II Therapy.
-
-C.
-
-Level II Four Plus Treatment must consist of not less than eighteen (18) months of attendance
-which includes a minimum of one-hundred eighty (180) hours of treatment.
-
-D.
-
-All Level II Four Plus Treatment shall be driven by the individual’s clinical assessment.
-
-E.
-
-Level II Four Plus Staff Requirements
-1.
-
-Staff providing Level II Four Plus Treatment must meet the requirements in Section
-21.240.3(D), and:
-a.
-
-CAS credentialed staff must be receiving clinical supervision or consultation by a
-CAS or LAC; or,
-
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-
-b.
-
-F.
-
-G.
-
-H.
-
-2 CCR 502-1
-
-Licensed staff must have at least one (1) year of documented addiction
-counseling experience.
-
-2.
-
-Staff providing specialized treatment services must hold current and valid credentials
-and/or licensure in the area of service provision.
-
-3.
-
-Staff providing assessment must hold current and valid credentials and/or licensure in the
-area of service provision.
-
-Level II Four Plus Clinical Assessment(s)
-1.
-
-A full assessment must be administered in accordance with section 21.190.3.
-
-2.
-
-In addition to the requirements in Section 21.190.3(D), the assessment must contain
-information on:
-a.
-
-Cognitive functioning;
-
-b.
-
-Traumatic brain injury;
-
-c.
-
-Adverse childhood experiences (ACES);
-
-d.
-
-Grief and loss; and,
-
-e.
-
-Co-occurring mental health issues.
-
-3.
-
-Agencies shall utilize an assessment tool specifically designed to address co-occurring
-mental health issues in the impaired driver population.
-
-4.
-
-Agencies shall document results and coordinate further services as appropriate.
-
-Level II Four Plus Service Planning and Reviews
-1.
-
-Level II Four Plus service planning and reviews must be administered in accordance with
-Section 21.190.4.
-
-2.
-
-Agencies providing Level II Four Plus Treatment shall conduct service plan reviews at a
-minimum of every sixty (60) days in collaboration with supervising probation officers.
-
-3.
-
-Consideration shall be given to clients’ needs for aftercare and peer recovery support
-services.
-
-Level II Four Plus Discharge Planning
-Level II Four Plus discharge planning must be administered in accordance with Section 21.190.6.
-
-I.
-
-Provision of Level II Four Plus services shall:
-1.
-
-Be determined by the results of the screenings and clinical assessment.
-
-2.
-
-Be a combination of education and treatment strategies that include, but not limited to:
-a.
-
-Individual counseling;
-
-b.
-
-Group therapy, unless clinically contraindicated;
-
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-
-3.
-
-J.
-
-2 CCR 502-1
-
-c.
-
-Family/other supportive adult therapy, if applicable;
-
-d.
-
-Interlock counseling, if the individual has an ignition interlock installed;
-
-e.
-
-DUI Level II Education or Level II Therapy, if applicable;
-
-f.
-
-Education, if applicable;
-
-g.
-
-Medication assisted treatment, if applicable;
-
-h.
-
-Residential treatment, if applicable;
-
-i.
-
-Other treatment as indicated by the initial and ongoing clinical assessment.
-
-Agencies providing Level II Four Plus Treatment shall provide case management
-activities, where applicable, to ensure the coordination of client services and needs, and
-the continuity of care, with other services.
-
-Testing and Monitoring
-1.
-
-All clients shall be tested and/or monitored for alcohol and drug use. Testing and/or
-monitoring may include the following:
-a.
-
-Urinalysis;
-
-b.
-
-Breath analysis;
-
-c.
-
-Continuous alcohol monitoring;
-
-d.
-
-Mobile/remote breath testing;
-
-e.
-
-Direct and indirect biomarker testing;
-
-f.
-
-Drug and other testing as appropriate.
-
-2.
-
-Agency drug and alcohol toxicology collection shall be observed by trained staff.
-
-3.
-
-If testing is not done by the agency, there must be documentation of the efforts to obtain
-test results.
-
-4.
-
-Testing and sharing of results shall be coordinated with probation.
-
-21.240.9
-
-DUI/DWAI BEHAVIORAL HEALTH SERVICES [Eff. 5/1/16]
-
-Some behavioral health service contact hours and weeks may be included and reported as hours of Level
-II therapy. Credit for DUI/DWAI therapy hours may be given if the DUI/DWAI agency conducts a current
-comprehensive assessment and:
-A.
-
-The assessment and service plan support the need for behavioral health services.
-
-B.
-
-Supporting documentation that corresponds to requested hours and weeks of behavioral health
-services from the ancillary provider is requested and documented in the record.
-
-C.
-
-A discharge DUI/DWAI referral summary is completed for the hours and weeks granted.
-
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-2 CCR 502-1
-
-21.250 [Repealed eff. 10/01/2020]
-21.260 ALCOHOL AND DRUG EMERGENCY COMMITMENTS
-A.
-
-Emergency commitment policies and procedures, based on and in compliance with Sections 2781-111 and 27-82-107, C.R.S., and these rules, shall be developed and implemented by the
-licensed withdrawal management programs to:
-1.
-
-Ascertain if grounds for commitment exist;
-
-2.
-
-Assure that individuals and their legal representatives receive copies of the application
-for emergency commitment forms and be advised verbally and in writing of the right to
-challenge commitment through the courts;
-
-3.
-
-Determine when grounds for emergency commitment no longer exist.
-
-B.
-
-The treatment facility administrator shall designate, in writing, qualified staff, who meet the criteria
-established in Section 21.210.914(B), to assume responsibility for accepting, evaluating,
-informing, and providing treatment to individuals on emergency commitment.
-
-C.
-
-Applications for emergency commitments shall be prepared on Department designated forms.
-
-D.
-
-Daily evaluations for emergency commitment continuance shall be documented.
-
-E.
-
-If individuals on an emergency commitment require treatment in other licensed withdrawal
-management programs, transfers may be managed by the programs that initially authorized the
-commitments.
-
-F.
-
-When transferring individuals, withdrawal management programs shall use Department
-designated transfer forms. Completed copies shall be given to:
-1.
-
-Individuals or their legal representatives;
-
-2.
-
-The withdrawal management programs to which individuals are being transferred.
-
-G.
-
-When minors are transferred, parents or legal guardians who have given permission for treatment
-shall receive copies of transfer forms.
-
-H.
-
-When it is determined grounds for emergency commitment no longer exists, the individual shall
-be transferred to voluntary status and the emergency commitment discontinued and documented.
-A copy of the form shall be given to the individual and made part of the treatment record.
-
-21.270 ALCOHOL AND DRUG INVOLUNTARY COMMITMENTS [Eff. 5/1/16]
-A.
-
-All agencies funded by the Department or by a designated Managed Service Organization shall
-be licensed to treat individuals on involuntary commitment in accordance with this section.
-
-B.
-
-Involuntary commitment policies and procedures shall be developed and implemented based on
-and in compliance with Sections 27-81-112 and 27-82-108, C.R.S.
-
-C.
-
-The Department shall be the legal custodian of individuals involuntarily committed to treatment.
-
-D.
-
-Passes shall be issued to individuals on involuntarily commitments in residential settings only if
-they are directly related to treatment. Passes shall not be issued during the initial thirty (30) days
-of treatment except in emergencies and with Department approval.
-
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-
-E.
-
-2 CCR 502-1
-
-The following information shall be reported to the Department:
-1.
-
-Non-compliance with program requirements and/or court orders;
-
-2.
-
-Failure to appear for admission to treatment;
-
-3.
-
-Leaving treatment in violation of court orders;
-
-4.
-
-Failure to return from passes;
-
-5.
-
-Treatment status every thirty (30) days.
-
-F.
-
-Discharge summaries, as outlined in Section 21.190.6 shall be submitted to the Department, the
-referring source, and to the referral treatment or aftercare agency.
-
-G.
-
-Requests for early discharge and/or transfer to other treatment programs shall be submitted to
-the Department for approval.
-
-21.270.1
-A.
-
-B.
-
-STAFF REQUIREMENTS
-
-Primary counselors for individuals on involuntary commitment shall:
-1.
-
-Be Colorado certified addiction specialists; or,
-
-2.
-
-Be Colorado licensed addiction counselors; or,
-
-3.
-
-Possess a clinical master’s degree; and,
-
-4.
-
-Complete fourteen (14) hours of training in interviewing techniques related to engaging
-individuals in treatment.
-
-Copies of course certificates and other relevant documentation shall be retained in counselor
-personnel files.
-
-21.280 CARE AND TREATMENT OF PERSONS WITH A MENTAL HEALTH DISORDER IN A
-DESIGNATED FACILITY
-21.280.1
-
-DEFINITIONS
-
-“Facility” for the purposes of this section means any facility designated by the Department pursuant to
-Title 27, Article 65, C.R.S.
-“Facility or community based personnel” means:
-A.
-
-A professional person;
-
-B.
-
-A registered professional nurse as defined in Section 12-38-103 (11), C.R.S. who by reason of
-postgraduate education and additional nursing preparation has gained knowledge, judgment, and
-skill in psychiatric or mental health nursing;
-
-C.
-
-A licensed marriage and family therapist, licensed professional counselor, or addiction counselor
-licensed under Part 5, 6, or 8 of Article 43 of Title 12, C.R.S., who by reason of postgraduate
-education and additional preparation has gained knowledge, judgment, and skill in psychiatric or
-clinical mental health therapy, forensic psychotherapy, or the evaluation of mental health
-disorders; or,
-
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-
-D.
-
-2 CCR 502-1
-
-A licensed clinical social worker licensed under the provisions of Part 4 of Article 43 of Title 12,
-C.R.S.
-
-“Involuntary Medication” means psychiatric medication administered without an individual's consent.
-“Licensed Independent Practitioner” for the purposes of this section means a practitioner permitted by law
-and by the agency to provide care, treatment, or services, without direction or supervision, within the
-scope of the practitioner license and consistent with assigned clinical responsibilities.
-“Placement facility” means a public or private facility that has a written agreement with a designated
-facility to provide care and treatment to any individual undergoing mental health evaluation or treatment
-by a designated facility. A placement facility may be a general hospital, nursing care facility, or licensed
-residential child care facility.
-“Professional person” means a person licensed to practice medicine in Colorado, a psychologist certified
-to practice in Colorado, or a person licensed and in good standing to practice medicine in another state or
-a psychologist certified to practice and in good standing in another state who is providing medical or
-clinical services at a treatment facility in Colorado that is operated by the armed forces of the United
-States, the United States Public Health Service, or the United States Department of Veterans Affairs.
-“Psychiatric medication” is a medication being used to treat psychiatric illness for the patient including, but
-not limited to, anti-psychotics, antidepressants, and other medications that may have other medical uses
-but are accepted within the medical profession for psychiatric use as well.
-“Secure Treatment Facility” for the purposes of these rules, means the Robert L. Hawkins High Security
-Forensic Institute at the Colorado Mental Health Institute at Pueblo.
-“Therapy or treatments using special procedures” means a therapy that requires an additional, specific
-consent, including electro-therapy treatment (electro-convulsive therapy), and behavior modifications
-using physically painful, aversive, or noxious stimuli.
-“Unduplicated” means an individual is counted only once, no matter how many specific services the
-individual received during the calendar year.
-21.280.2
-
-ORGANIZATIONAL PROVISIONS
-
-21.280.21
-
-Employment of Persons Receiving Services in Designated Facilities [Eff. 11/1/13]
-
-A.
-
-All labor, employment or jobs involving facility operation and maintenance which are of an
-economic benefit to the facility, shall be treated as work and shall be compensated according to
-applicable minimum wage or certified wage rates.
-
-B.
-
-Maintaining a minimum standard of cleanliness and personal hygiene and personal
-housekeeping, such as making one's bed or cleaning one's area, shall not be treated as work and
-shall not be compensated.
-
-C.
-
-Individuals shall not be forced in any way to perform work.
-
-D.
-
-Privileges or release from a designated facility shall not be conditioned upon the performance of
-work.
-
-E.
-
-Vocational programs and training programs must comply with all applicable federal and state
-laws.
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-
-2 CCR 502-1
-
-F.
-
-Vocational programs are not subject to the provisions in Section 21.280.21, A, unless the
-program is of economic benefit to the facility.
-
-G.
-
-All work assignments, together with a specific consent form, and the hourly compensation
-received, shall be noted in the individual’s record.
-
-21.280.22
-
-Environment and Safety [Eff. 11/1/13]
-
-A.
-
-All individuals being treated under these regulations shall receive such treatment in a clean and
-safe environment with opportunities for privacy.
-
-B.
-
-A facility shall only place an individual in a bedroom with video monitoring due to good cause and
-safety or security reasons. Individuals shall be notified when placed in bedrooms with video
-monitoring capabilities.
-
-C.
-
-Each facility shall maintain reasonable security capabilities to guard against the risk of
-unauthorized departures. The least restrictive method to prevent an unauthorized departure shall
-be used.
-
-D.
-
-An unlocked facility may place an individual in seclusion to prevent an unauthorized departure
-when such departure carries an imminent risk of danger for the individual or for others. Under
-those circumstances, the seclusion procedures in Section 21.280.42, Use of Seclusion, shall be
-followed.
-
-E.
-
-Seclusion rooms must be a minimum of 100 square feet.
-
-21.280.23
-Facility Designated Pursuant to Title 27, Article 65, C.R.S., Care and Treatment of
-Persons with Mental Illness Data Requirements
-A.
-
-Each facility designated by the Department, pursuant to Title 27, Article 65 C.R.S, shall file an
-annual report with the Department. The report shall be submitted in the format and timeframe
-required by the Department. This data shall include individuals being treated in placement
-agencies under the auspices of the designated facility.
-
-B.
-
-For each designated facility, the annual report shall include the name, county, and address of the
-facility, as well as facility type as defined in 27-65-102(7), C.R.S.
-
-C.
-
-The data report requirements shall include the following types of information as listed in 1 through
-4:
-1.
-
-Seventy-Two (72) Hour Treatment and Evaluation (Mental Health Holds)
-The facility is required to maintain a data set sufficient to report the following aggregate
-numbers to the Department annually by July 1, for the most recent, complete calendar
-year covering January 1 through December 31:
-a.
-
-The total number of unduplicated individuals, as defined in Section 21.280.1, who
-were on a seventy-two hour hold status, as well as:
-1)
-
-Total number of unduplicated individuals by gender;
-
-2)
-
-Total number of unduplicated individuals by race and ethnicity;
-
-3)
-
-Total number of unduplicated individuals by age; and,
-
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-
-4)
-B.
-
-Total number of unduplicated individuals by county of residence.
-
-The total number of seventy-two hour holds, as well as, the total number of
-seventy-two hour holds grouped by:
-1)
-
-2)
-
-3)
-
-C.
-
-2 CCR 502-1
-
-Who initiated the seventy-two hour hold (each hold can only meet the
-requirements of one category listed below):
-a)
-
-Certified peace officer;
-
-b)
-
-Court; or,
-
-C)
-
-Facility or community based personnel as defined in section
-21.280.1.
-
-The reason(s) for the seventy-two hour hold (each hold can meet the
-requirements of multiple categories listed below):
-a)
-
-Dangerous to self;
-
-b)
-
-Dangerous to others; or,
-
-c)
-
-Gravely disabled.
-
-Disposition of the seventy-two hour hold (each hold can only meet the
-requirements of one category listed below):
-A)
-
-Released without need for further mental health services;
-
-B)
-
-Referred for further mental health care and treatment on a
-voluntary basis;
-
-C)
-
-Certified for treatment pursuant to 27-65-107, C.R.S.; or,
-
-D)
-
-Transferred to another designated facility while still on the
-seventy-two hour hold.
-
-The total number of involuntary transportation holds, as defined in Section
-21.281.1, received by the facility, as well as total numbers by outcome of the
-required screening, including at least:
-1)
-
-Total number of involuntary transportation hold screenings resulting in
-the placement of a seventy-two hour hold;
-
-2)
-
-Total number of involuntary transportation hold screenings resulting in a
-referral for further mental health care and treatment on a voluntary basis:
-and,
-
-3)
-
-Total number of involuntary transportation hold screenings resulting in a
-release without need for further mental health services.
-
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-
-2.
-
-2 CCR 502-1
-
-Short and Long-Term Certifications
-The facility is required to maintain a data set sufficient to report the following aggregate
-numbers to the Department annually by July 1, for the most recent, complete calendar
-year covering January 1 through December 31:
-a.
-
-B.
-
-The total number of unduplicated individuals, as defined in Section 21.280.1, who
-were on a certification, as well as:
-1)
-
-Total number of unduplicated individuals by gender;
-
-2)
-
-Total number of unduplicated individuals by race and ethnicity;
-
-3)
-
-Total number of unduplicated individuals by age; and,
-
-4)
-
-Total number of unduplicated individuals by county of residence.
-
-The total number of certifications, as well as, the total number of certifications
-grouped by:
-1)
-
-2)
-
-3)
-
-Type of certification (each certification can only meet the requirements of
-one category listed below):
-a)
-
-Short-term;
-
-b)
-
-Extended short-term;
-
-c)
-
-Long-term; or,
-
-d)
-
-Extended long-term.
-
-Reason for the certification (each certification can meet the requirements
-of multiple categories listed below):
-a)
-
-Dangerous to self;
-
-b)
-
-Dangerous to others; or,
-
-c)
-
-Gravely disabled.
-
-Outcome of the certification (each certification can only meet the
-requirements of one category listed below):
-A)
-
-Released without need for further mental health services;
-
-B)
-
-Referred for further mental health care and treatment on a
-voluntary basis; or,
-
-c)
-
-Certification extended; or,
-
-d)
-
-Certification transferred.
-
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-
-3.
-
-2 CCR 502-1
-
-Voluntary Individuals
-The facility is required to maintain a data set sufficient to report the following aggregate
-numbers to the Department annually by July 1 for the most recent, complete calendar
-year covering January 1 through December 31, the total number of unduplicated
-individuals, as defined in Section 21.280.1, who accessed mental health treatment
-voluntarily pursuant to 27-65-103, C.R.S., as well as:
-
-4.
-
-A.
-
-Total number of unduplicated individuals by gender;
-
-B.
-
-Total number of unduplicated individuals by race and ethnicity;
-
-C.
-
-Total number of unduplicated individuals by age; and,
-
-D.
-
-Total number of unduplicated individuals by county of residence.
-
-Additional Reporting Requirements
-The facility is required to maintain data sets sufficient to report the following aggregate
-numbers to the Department annually by July 1 for the most recent, complete calendar
-year covering January 1 through December 31.
-a.
-
-Involuntary Medications
-Total number of involuntary psychiatric medication procedures, including type of
-order:
-
-b.
-
-1)
-
-Emergency; or,
-
-2)
-
-Court-ordered.
-
-Involuntary Treatments
-1)
-
-Total number of restraint and/or seclusion episodes.
-
-2)
-
-Total number by type of restraint.
-
-3)
-
-Length of seclusion and/or restraint episode per individual.
-
-c.
-
-Total number of electroconvulsive therapy procedures.
-
-d.
-
-Imposition of Legal Disability or Deprivation of a Right
-Total Number of court orders for:
-
-D.
-
-1)
-
-Imposition of Legal Disability; and,
-
-2)
-
-Deprivation of a Right.
-
-Pursuant to § 27-65-121, C.R.S., and HIPAA, as defined in Section 21.100, the facility must
-maintain confidentiality over the data sets. The reports generated from these data sets are also
-confidential; but the Department may release aggregated information contained in the reports so
-long as the total number of individuals in any aggregate data group (including county or facility
-name) is greater than thirty (30). If the total number in such a data group is less than or equal to
-thirty (30), the Department may release this information by redacting such number.
-
-404
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-Behavioral Health
-
-21.280.24
-
-2 CCR 502-1
-
-Staff Training Requirements [Eff. 11/1/13]
-
-In addition to Section 21.160, facilities designated under these rules shall develop a training curriculum
-and schedule in order to meet the following requirements. Facilities may choose to use a certification of
-competency in lieu of training, and shall develop appropriate policies, procedures and testing to assure
-competency.
-A.
-
-All staff participating in the provision of the care and treatment for individuals with mental health
-disorders shall receive annual training or annual facility certification of competency on the
-provisions of these rules and the requirements of Section 27-65-101, et seq., C.R.S.
-
-B.
-
-All staff who administer involuntary medications shall receive annual training or annual facility
-certification of competency on Section 21.280 of these rules and the legal rationale underlying
-involuntary medication of individuals.
-
-C.
-
-All direct care staff shall receive annual training or annual facility certification of competency in
-the recognition and response to common side effects of psychiatric medications. These staff shall
-be trained to respond to emergency drug reactions in accordance with the facility's policies.
-
-D.
-
-All staff who administer restraint/seclusion techniques shall receive annual facility training or
-annual certification of competency on lower level behavioral interventions and Section 21.280.4 of
-these rules.
-
-E.
-
-All staff involved in the administration of the treatment program shall receive annual training or
-annual facility certification of competency on alternative or representative medical decision
-making, including, but not limited to advance directives, medical durable powers of attorney, and
-proxy decision making, and guardianships.
-
-F.
-
-Specific staff of placement facilities, as determined by the designated facility, shall receive annual
-facility training or annual certification of competency on the provisions of these rules and the
-requirements of Section 27-65-101, et seq., C.R.S.
-
-21.280.25
-
-Placement Facilities [Eff. 5/1/16]
-
-A.
-
-Facilities designated for seventy-two (72) hour evaluation and treatment, short-term, and longterm treatment may provide mental health services directly or through the use of placement
-facility contract. Whenever a placement facility is used there must be a written agreement with the
-designated facility. In either case, the designated facility is responsible for assuring an
-appropriate treatment setting for each individual and services provided in accordance with these
-rules. Whenever a placement facility is used, the designated facility shall be responsible for the
-care provided by the placement facility.
-
-B.
-
-All agreements between designated facilities and placement facilities and all supplemental
-agreements and amendments shall be submitted in writing to the Department no later than ten
-(10) business days after the effective date of the agreement or amendment.
-
-C.
-
-Only the following Colorado licensed facilities are eligible to be a placement facility:
-1.
-
-Nursing homes;
-
-2.
-
-Residential Child Care Facilities providing mental health services;
-
-3.
-
-Non-psychiatric hospitals providing in-patient medical services.
-
-4.
-
-Alternative Care Facilities.
-
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-Behavioral Health
-
-2 CCR 502-1
-
-D.
-
-Emergency departments are not eligible to be, nor are considered placement facilities.
-
-E.
-
-Whenever a designated facility uses a placement facility, the agreement shall include:
-1.
-
-An annual training plan for placement facility staff that provides at a minimum training
-regarding mental health disorders, these rules, Title 27, Article 65, C.R.S., and
-appropriate, safe behavioral interventions. The implementation of the training plan shall
-be monitored by the designated facility;
-
-2.
-
-A requirement that supervision of direct care staff be provided by professional persons
-licensed in Colorado to practice medicine or a certified Colorado psychologist employed
-by or under contract with the designated facility, or designated professional person
-licensed in Colorado to practice medicine or a certified Colorado psychologist employed
-by the placement facility to be responsible for direct care supervision provided that the
-placement facility and the designated facility are operated by the same corporate entity;
-
-3.
-
-A requirement that assures the necessary availability and supervision of placement
-facility staff in order to carry out the contract; and,
-
-4.
-
-A requirement that the placement facility adheres to these rules through the placement
-facility agreement.
-
-F.
-
-Placement facilities agreements shall be executed and signed bi-annually when the designated
-facility submits its application for designation.
-
-G.
-
-A placement facility can be used by a designated facility, at its discretion under the provisions of
-these regulations, in order to provide care to any individual undergoing mental health evaluation
-or treatment. Designated facilities shall not place individuals in a placement facility unless all of
-the applicable provisions of these rules are met and placement in such facility is appropriate to
-the clinical needs of the individual. When a placement facility is required, the least restrictive
-facility possible and available must be used, consistent with the clinical needs of the individual.
-
-H.
-
-A placement facility shall not provide services beyond the scope of its license.
-
-21.280.26
-Individual Rights of Persons Receiving Evaluation Care or Treatment Pursuant to
-Title 27, Article 65, C.R.S. [Eff. 11/1/13]
-A.
-
-Individuals shall be informed they have the same rights as any individual, except as limited by
-law. Among these are the rights to:
-1.
-
-Receive services in the least restrictive setting, subject to available funding.
-
-2.
-
-Have an individualized service plan and the right to participate in the development and
-subsequent changes.
-
-3.
-
-Review the clinical record, as allowed by law.
-
-4.
-
-Designate a representative(s) verbally or in writing, to represent the individual’s interests
-in matters related to grievances.
-
-5.
-
-Have access to a representative within the designated facility who provides assistance to
-file a grievance.
-
-6.
-
-Be informed by the designated facility that there will be no retaliation against an individual
-for exercising his or her rights.
-
-406
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-Behavioral Health
-
-2 CCR 502-1
-
-B.
-
-Facilities shall post individual rights in prominent places frequented by individuals receiving
-services.
-
-C.
-
-For Individuals receiving treatment in facilities designated pursuant to Title 27, Article 65, C.R.S.:
-1.
-
-The facility shall furnish all individuals receiving evaluation, care or treatment under any
-provisions of Title 27, Article 65, C.R.S., with a written copy of the rights listed under
-Subsection 21.280.26, C, 2 (translated into a language that the individual understands)
-upon admission. If the individual is not able to read the rights, the individual shall be read
-the rights in a language that s/he understands. These rules shall be interpreted by the
-Department in accordance with a standard of reasonableness.
-
-2.
-
-The facility shall post the following list of rights (in appropriate languages) in prominent
-places frequented by individuals and their families receiving services:
-a.
-
-To receive and send sealed correspondence. No incoming or outgoing
-correspondence shall be opened, delayed, held or censored by the personnel of
-the facility;
-
-b.
-
-To have access to letter writing materials, including postage, and to have staff
-members of the facility assist him/her if unable to write, prepare and mail
-correspondence;
-
-c.
-
-To have reasonable and frequent access to a telephone, both to make and
-receive calls in privacy;
-
-d.
-
-To have frequent and convenient opportunities to meet with visitors. The facility
-may not deny visits by the individual’s attorney, religious representative or
-physician at any reasonable time. The facility will provide privacy to maintain
-confidentiality of communication between an individual and spouse or significant
-other, family member(s), staff member(s), attorney, physician, certified public
-accountant and religious representative, except that if disclosure is required by
-law, then such privacy may be terminated;
-
-e.
-
-To wear his or her own clothing, keep and use his/her own individual
-possessions within reason and keep and be allowed to spend a reasonable sum
-of his/her own money;
-
-f.
-
-To refuse to take psychiatric medications, unless the individual is an imminent
-danger to self or others or the court has ordered administration of such
-medications;
-
-g.
-
-To not be fingerprinted unless required by law;
-
-h.
-
-To refuse to be photographed except for facility identification and the
-administrative purposes of the facility. Photographs and/or video recordings shall
-be confidential and shall not be released by the facility except pursuant to court
-order. No other non-medical photographs and/or video recordings shall be taken
-or used without appropriate consent or authorization (Section 27-65-117(4),
-C.R.S.).
-
-i.
-
-For individuals who are under certification for care and treatment, to receive
-twenty-four (24) hour notice before being transferred to another designated or
-placement facility unless an emergency exists, and the right to have the
-transferring facility notify someone chosen by the individual about the transfer;
-
-407
-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-2 CCR 502-1
-
-j.
-
-To confidentiality of treatment records except as required by law;
-
-k.
-
-To accept treatment voluntarily, unless reasonable grounds exist to believe the
-individual will not remain in treatment on this basis;
-
-l.
-
-To receive medical and psychiatric care and treatment in the least restrictive
-treatment setting possible, suited to meet the individual's needs and subject to
-available resources;
-
-m.
-
-To request to see his/her clinical record, to see the records at reasonable times,
-and if denied access, to be given the reason upon which the request was denied
-and have documentation of such placed in the individual record;
-
-n.
-
-To retain and consult with an attorney at any reasonable time; and,
-
-o.
-
-Every individual who is eighteen (18) years of age or older shall be given the
-opportunity to exercise his/her right to vote in primary and general elections. The
-staff of the designated or placement facility shall assist each individual in
-obtaining voter registration forms and applications for absentee or mail ballots,
-and in complying with any other prerequisite for voting.
-
-D.
-
-With every mental health hold (M-1) and petition to court for involuntary treatment resulting in a
-change of legal status, the facility shall advise an individual of his or her rights set forth in this
-Section 21.280.26, and there shall be evidence of such advisement in the individual’s clinical
-record.
-
-E.
-
-Individual Rights Restrictions in Facilities Designated Pursuant to 27-65
-1.
-
-2.
-
-As set forth in Section 27-65-117,C.R.S., an individual's statutory rights, Section
-21.280.26, C, 2, a-e may be limited or denied for good cause by the Colorado licensed
-physician or psychologist who is providing treatment, as follows:
-a.
-
-Except as otherwise provided in Section 21.280.26, E, 2, each denial of an
-individual's right shall be made on a case by case basis and the reason for
-denying the right shall be documented in the individual record and shall be made
-available, upon request, to the individual or his/her attorney.
-
-b.
-
-Except as otherwise provided in Section 21.280.26, E, 2, restrictions on rights in
-Section 21.280.26, C, 2, a-e, shall be evaluated for therapeutic necessity on an
-ongoing basis and the rationale for continuing the restriction shall be documented
-at least every seven (7) calendar days.
-
-Secure Treatment Facilities
-A Colorado licensed physician or psychologist treating persons in a secure treatment
-facility may limit or deny rights for good cause based upon the safety and security needs
-of the staff and other individuals in the facility. Safety and security policies applicable to
-the unit shall be incorporated into the individual’s service plan. The following procedures
-shall be adhered to:
-a.
-
-The Department shall approve of safety and security policies for each facility unit
-that places any limit on the rights set forth in Section 21.280.26 as well as the
-policy and criteria for placement of an individual committed under Title 27, Article
-65, C.R.S., in secure treatment facilities.
-
-408
-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-2 CCR 502-1
-
-b.
-
-The safety and security policies for each facility unit shall be posted in the unit.
-The secure facility staff shall provide a copy of the unit policy upon an individual’s
-request.
-
-c.
-
-Any good cause restriction of rights based upon the safety and security policy of
-the facility unit shall be noted in the individual’s record. The order for restriction
-shall be signed by the Colorado licensed physician or psychologist providing care
-and treatment, and shall be reviewed at least every thirty (30) days.
-
-d.
-
-No safety or security policy may limit an individual's ability to send or receive
-sealed correspondence. However, to prevent the introduction of contraband into
-the secure treatment facility, the policy may provide that the individual open the
-correspondence in the presence of unit staff.
-
-e.
-
-No safety or security policy may limit an individual’s right to see his or her
-attorney, clergy, or physician at reasonable times. However, the safety and
-security policy may provide that advance notice be given to the secure treatment
-facility for such visits so that the secure facility can adequately staff for the
-private visit, and take any measures necessary to ensure the safety of the visit.
-
-f.
-
-For the purposes of this rule, placement of individuals in secure treatment
-facilities on units that are locked at night:
-1)
-
-Individuals transferred to a secure treatment facility from the Department
-of Corrections, who are serving a sentence in the Department of
-Corrections, may be placed on units in which the bedroom doors are
-locked during sleeping hours.
-
-2)
-
-All other individuals who are newly admitted to a secure treatment facility
-may be placed on units in which the bedroom doors are locked during
-sleeping hours, for a time period not to exceed sixty (60) calendar days.
-After sixty (60) calendar days, these individuals will not be placed on a
-unit with locked doors during sleeping hours unless an individualized
-assessment is made and the treatment team determines that the
-individual is imminently dangerous to him/herself or to others.
-
-3)
-
-Sleeping hours shall begin no earlier than 9:00 p.m., end no later than
-8:00 a.m., and shall not exceed 8-1/2 hours.
-
-4)
-
-Individuals shall be provided an effective means of calling for assistance
-when in a locked room during sleeping hours. The secure treatment
-facility shall provide staff to promptly assist an individual with his or her
-individual needs including, but not limited to, staff assigned to a day hall
-where staff will be able to hear and respond to individuals who knock on
-their room doors. An intercom call system may also be used. Staff shall
-monitor each individual’s well-being through visual observation checks
-every fifteen (15) minutes.
-
-F.
-
-As set forth in Sections 27-65-104 and 27-65-127, C.R.S., an individual's rights may be limited or
-denied under court order by an imposition of legal disability or deprivation of a right.
-
-G.
-
-Information pertaining to the denial of any right shall be made available, upon request, to the
-individual or his/her attorney.
-
-409
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-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-21.280.3
-
-MEDICAL AND MEDICATION TREATMENT PROVISIONS
-
-21.280.31
-
-Medical/Dental Care [Eff. 11/1/13]
-
-A.
-
-2 CCR 502-1
-
-Seventy-Two (72) Hour Treatment and Evaluation Facilities
-The facility shall ensure the availability of emergency medical care to meet the individual needs of
-each individual. The facility shall have and adhere to a written plan for providing emergency
-medical care to include at least:
-
-B.
-
-1.
-
-A qualified licensed independent practitioner responsible for the completion of physical
-examinations within twenty-four (24) hours of admission.
-
-2.
-
-The availability of a physician or access to an emergency medical facility on a twenty-four
-(24) hour, seven (7) days a week basis.
-
-3.
-
-Emergency medical treatment, when indicated, shall be accessed immediately (within
-one hour) upon determination that an emergency exists.
-
-4.
-
-Whenever indicated, an individual shall be referred to an appropriate specialist for either
-further assessment or treatment. The facility shall be responsible for securing an
-appropriate assessment to determine the need for further specialty consultation. This
-information shall be contained in the clinical record.
-
-Short-Term and Long-Term Treatment Facilities
-The facility shall ensure the availability of medical care and emergency dental care to meet the
-individual needs of each individual. The facility shall have and adhere to a written plan for
-providing medical and emergency dental care to include at least:
-
-C.
-
-1.
-
-A qualified licensed independent practitioner responsible for the completion of physical
-examinations within twenty-four (24) hours of admission. Subsequent physical
-examinations shall be completed annually. This information shall be included in the
-clinical record.
-
-2.
-
-The availability of a qualified licensed independent practitioner or emergency medical
-facility on a twenty-four (24) hour, seven (7) days a week basis.
-
-3.
-
-Emergency medical treatment, when indicated, shall be accessed immediately (within
-one hour) upon determination that an emergency exists.
-
-4.
-
-Whenever indicated, an individual shall be referred to an appropriate specialist for either
-further assessment or treatment. The facility shall be responsible for securing an
-appropriate assessment to determine the need for further specialty consultation. This
-information shall be contained in the clinical record.
-
-5.
-
-Ongoing appraisals of the general health of each individual, including need for
-immunizations in accordance with applicable state and federal law and need for
-corrective and assistive devices such as glasses, hearing aids, prostheses, dentures,
-walkers, etc. This information shall be contained in the clinical record.
-
-The obligation to ensure the availability of emergency medical services shall not be construed as
-the obligation to pay for such services; however, the facility shall secure these services
-regardless of source of payment.
-
-410
-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-21.280.32
-A.
-
-2 CCR 502-1
-
-Psychiatric Medications [Eff. 11/1/13]
-
-In all instances where prescription psychiatric medications are to be ordered as a part of a mental
-health treatment program, the following information shall be provided to the individual and legal
-guardian(s). For children under the age of fifteen (15), the following information shall be provided
-to the child's parent(s) or legal guardian(s). When an individual has designated another to act
-concerning medication issues pursuant to a medical durable power of attorney, advanced
-directive, or proxy, the information shall be provided to that individual also.
-1.
-
-The name(s) of the medication being prescribed.
-
-2.
-
-The usual uses of the medication(s).
-
-3.
-
-The reasons for ordering the medication(s) for this individual.
-
-4.
-
-A description of the benefits expected.
-
-5.
-
-The common side effects and common discomforts, if any.
-
-6.
-
-The major risks, if any.
-
-7.
-
-The probable consequences of not taking the medication(s).
-
-8.
-
-Any significant harmful drug or alcohol interactions, or food interactions.
-
-9.
-
-Appropriate treatment alternatives, if any.
-
-10.
-
-That s/he may withdraw agreement to take the medication at any time.
-
-B.
-
-The facility shall have policies and procedures for documenting in the clinical record that the
-required information was given to the individual, custodian, or guardian and consent obtained
-before administration of medication(s).
-
-C.
-
-The provider with prescriptive authority or his/her designee shall offer to answer inquiries
-regarding the medication(s).
-
-D.
-
-No individual shall be threatened with or subjected to adverse consequences by facility staff
-solely because of a failure to accept psychiatric medication voluntarily.
-
-E.
-
-If an individual has established an advance directive concerning psychiatric medication and the
-advance directive is still in effect, the Colorado licensed physician or psychologist shall follow the
-directive unless contraindicated in a psychiatric emergency.
-
-F.
-
-Prescribing, Handling, Administration of Psychiatric Medication(s)
-All psychiatric medication(s) shall be administered on the written order of a physician or other
-professional authorized by statute to order such medications. Verbal medication orders may be
-given according to facility policies.
-1.
-
-The facility shall have written policies and procedures regarding Section A, above, and
-the following:
-a.
-
-Documentation of the administration of medication, medication variances/errors,
-and adverse medication reactions related to medication administration;
-
-411
-
-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-2.
-
-21.280.33
-
-2 CCR 502-1
-
-b.
-
-Notification to a physician or other professional authorized by statute to order
-such medications in case of medication errors and/or medication
-reactions/events;
-
-c.
-
-Discontinuance of medication;
-
-d.
-
-Disposal of medications; and,
-
-e.
-
-Acceptance of verbal, fax, or electronically transmitted medication orders.
-
-The facility shall note in the individual clinical record all prescription medications
-administered to the individual by the facility including:
-a.
-
-The name and dosage of medication;
-
-b.
-
-The reason for ordering the medication;
-
-c.
-
-The time, date and dosage when medication(s) is administered;
-
-d.
-
-The name and credentials of the individual who administered the medication;
-
-e.
-
-The name of the prescribing professional authorized by statute to order such
-medication; and,
-
-f.
-
-If the medication is administered as an emergency medication or a court-ordered
-medication.
-
-Involuntary Psychiatric Medications [Eff. 11/1/13]
-
-These rules do not apply to refusal of non-psychiatric medications or medical emergencies. If an
-individual refuses medications intended to treat general medical conditions and that refusal is likely to
-cause or precipitates a medical emergency, those professionals who are authorized to order and
-administer medications may take action in accordance with generally accepted medical practice in an
-emergency situation.
-21.280.34
-
-Psychiatric Emergency Conditions [Eff. 11/1/13]
-
-A.
-
-Individuals who are detained pursuant to Sections 27-65-105, 106, 107, 108 or 109, C.R.S., and
-refuse psychiatric medication may be administered psychiatric medication(s) ordered up to
-twenty-four (24) hours without consent under a psychiatric emergency condition.
-
-B.
-
-An emergency condition exists if:
-
-C.
-
-1.
-
-The individual is determined to be in imminent danger of harming herself/himself or
-others, as evidenced by symptoms which have in the past reliably predicted imminent
-dangerousness in that particular individual; or,
-
-2.
-
-By a recent overt act, including, but not limited to, a credible threat of bodily harm, an
-assault on another individual or self-destructive behavior.
-
-A reasonable attempt to obtain voluntary acceptance of psychiatric medication shall be made
-prior to the use of involuntary medication.
-
-412
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-CODE OF COLORADO REGULATIONS
-Behavioral Health
-
-21.280.35
-A.
-
-2 CCR 502-1
-
-Continuation of a Psychiatric Emergency
-
-If the psychiatric emergency has abated because of the effect of psychiatric medications and the
-physician is of the opinion that psychiatric medication is necessary to keep the emergency in
-abeyance beyond seventy-two (72) hours, then within that seventy-two (72) hours the following
-steps shall be taken:
-1.
-
-The facility shall send a written request for a court hearing for an order to administer the
-medication involuntarily; and,
-
-2.
-
-A documented concurring consultation with another physician shall be obtained. The
-consultation shall include an examination of the individual and a review of the clinical
-record including an assessment as to whether the psychiatric emergency condition
-continues to exist.
-
-3.
-
-If a concurring consultation is not obtained within seventy-two (72) hours, then
-emergency psychiatric medication shall be discontinued until such concurring
-consultation is obtained and documented, except in cases where life threatening
-consequences could result from an abrupt medication discontinuation. Under these
-circumstances, the individual shall be safely taken off the medication according to
-standards of medical practice, with corresponding clinical documentation.
-
-4.
-
-In no case shall an individual receive emergency psychiatric medication(s) involuntarily
-for a period exceeding ten (10) days without an order from a court of competent
-jurisdiction, including continuation orders from the court.
-
-5.
-
-The individual shall be notified of the right to contact his or her attorney and/or the court
-of competent jurisdiction at the time the written request for court-ordered medication is
-made. This notification shall be documented in the clinical record. If an individual chooses
-to exercise this right, the designated facility shall aid the individual if necessary, in
-accomplishing the foregoing.
-
-B.
-
-The specific facts outlining behaviors supporting the finding of the emergency condition shall be
-detailed in the clinical record. Every twenty-four (24) hours thereafter until such time a final court
-order is issued, the emergency is resolved, or the individual accepts psychiatric medications
-voluntarily, the facility shall document the behaviors that substantiated the need to continue the
-emergency medication, and the physician shall reorder the psychiatric medications.
-
-C.
-
-During the course of emergency medication administration, the individual shall be offered the
-medication on a voluntary basis each time the medication is given. If the individual voluntarily
-consents to take the medication(s), and the attending physician determines that the individual will
-likely continue to accept the medication on a voluntary basis and no longer requires involuntary
-medications, this shall be documented in the record and the involuntary medication procedures
-shall be terminated.
-
-D.
-
-If the individual again refuses to voluntarily accept medication(s) and his or her clinical condition
-returns to an emergency situation as defined in Section 21.280.34, the emergency psychiatric
-medication procedures may be re-instituted.
-
-21.280.36
-A.
-
-Non-Emergency Involuntary Medications [Eff. 11/1/13]
-
-In non-emergency situations in which an individual who is detained pursuant to Sections 27-65106, 107, 108, or 109, C.R.S., would benefit from the administration of a psychiatric medication,
-but the individual does not consent, the facility shall petition the court to obtain permission to
-administer such medication. The following conditions must be documented in the petition:
-
-413
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-
-2 CCR 502-1
-
-1.
-
-The individual is incompetent to effectively participate in the treatment decision;
-
-2.
-
-Treatment by psychiatric medication is necessary to prevent a significant and likely longterm deterioration in the individual's mental condition or to prevent the likelihood of the
-individual causing serious harm to him/herself or others;
-
-3.
-
-A less intrusive appropriate treatment alternative is not available; and,
-
-4.
-
-The individual's need for treatment by psychiatric medication is sufficiently compelling to
-override any bona fide and legitimate interest of the individual in refusing treatment.
-
-B.
-
-The petition shall specify what class or name of psychiatric medication is being recommended as
-potentially beneficial to the individual.
-
-C.
-
-No psychiatric medications shall be administered without the individual's consent until a court
-order is received authorizing involuntary use, except under emergency conditions under Section
-21.280.34.
-
-21.280.37
-
-Involuntary Medication Data [Eff. 11/1/13]
-
-If the facility uses a medication administration record or another mechanism which meets the criteria
-listed in Section B, below, can correlate this information as required in Section C, below, and places the
-information in the clinical record, that mechanism may be used in lieu of a separate log.
-A.
-
-The designated facility must maintain a log of all cases where involuntary medications were
-administered.
-
-B.
-
-The record shall contain, at a minimum, the following:
-
-C.
-
-1.
-
-Individual's name and identifying number.
-
-2.
-
-Specified use of involuntary medication.
-
-3.
-
-Physician or other professional authorized by law ordering involuntary medication.
-
-4.
-
-Date/time each involuntary medication was administered.
-
-5.
-
-Date/time involuntary medication was discontinued.
-
-6.
-
-Reason for discontinuation of involuntary medication(s).
-
-The facility shall have the ability to determine, at a minimum, the aggregate number of individuals
-receiving emergency and involuntary psychiatric medications during a specified period of time,
-the start and stop dates for each individual's involuntary medication treatment, and shall
-incorporate the use of this data into the quality improvement program.
-
-21.280.4
-SECLUSION, RESTRAINT, AND PHYSICAL MANAGEMENT FOR 27-65
-DESIGNATED FACILITIES [Eff. 11/1/13]
-The following rules covering seclusion and restraint apply to all areas of the designated facility including
-emergency departments and to placement facilities. If a facility is authorized to use physical
-management, restraint or seclusion at the facility, the facility shall use physical management, restraint or
-seclusion only in accordance with the following rules unless the specific rules prohibit, limit or modify the
-requirements placed upon the facility.
-
-414
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-Behavioral Health
-
-2 CCR 502-1
-
-A.
-
-Individuals being detained under Sections 27-65-105 through 109, C.R.S., may be secluded or
-restrained over their objection under the conditions in Section 21.280.4; otherwise, there must be
-a signed informed consent for such an intervention as outlined in Section 21.280.5 of these rules.
-
-B.
-
-These rules do not supersede any requirements under Section 26-20-101, et seq., C.R.S.
-
-C.
-
-Staff shall ensure that no individual will harm or harass an individual who is secluded and/or
-restrained.
-
-D.
-
-These measures may only be used in accordance with a service plan developed in consultation
-with and based on a written order by a Colorado licensed physician or psychologist. The service
-plan, which shall document if less restrictive measures were unsuccessful, shall be evaluated by
-a Colorado licensed physician or psychologist every twenty four (24) hours.
-
-21.280.41
-
-Definitions [Eff. 11/1/13]
-
-“Mechanical Restraint” means a physical device used to involuntarily restrict the movement of an
-individual or the movement or normal function of a portion of his or her body. Types of mechanical
-restraints include, but are not limited to: restraint sheets, camisoles, belts attached to cuffs, leather
-armlets, restraint chairs, and shackles.
-“Physical Management” means the physical action of placing one’s hands on an individual. Physical
-management may be used to gain physical control in order to protect the person or others from harm after
-all attempts to verbally direct or de-escalate the person have failed. Physical management may be utilized
-when an emergency situation exists. The physical management continuum may include:
-A.
-
-Utilizing transitional measures.
-
-B.
-
-Placing one’s hands on a person to physically guide and/or physically control the person.
-
-C.
-
-Use of an approved restraint method to control or contain the person.
-
-D.
-
-Placing of a person into an approved prolonged restraint method.
-
-E.
-
-Physical management may be used to move or escort a person into seclusion. Seclusion, in itself,
-is not a form of physical management.
-
-“Physical Restraint” means the use of bodily, physical force to involuntarily limit a person’s freedom of
-movement, except that “physical restraint” does not include the holding of a child by one adult for the
-purpose of calming or comforting the child.
-“Seclusion” means the confinement of a person alone in a room from which egress is prevented.
-Seclusion does not include the placement of persons, who are assigned to an intake unit in a secure
-treatment facility, in locked rooms during sleeping hours pursuant to Section 21.280.26.E thru G.
-21.280.42
-
-Use of Seclusion [Eff. 11/1/13]
-
-A.
-
-Seclusion may be used only for the purpose of preventing imminent injury to self or others, or to
-eliminate prolonged and serious disruption of the treatment environment. Any time an individual is
-placed alone in a room and not allowed to leave, it shall be construed as seclusion.
-
-B.
-
-An unlocked designated facility may place an individual in seclusion to prevent an unauthorized
-departure when such departure carries an imminent risk of dangerousness for the individual or for
-others. Under those circumstances, the seclusion procedures in this section shall be followed.
-
-415
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-
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-
-C.
-
-Any decision to seclude shall be based on a current clinical assessment, and may also be based
-on other reliable information including information that was used to support the decision to take
-the individual into custody for treatment and evaluation. The fact that an individual is being
-evaluated or treated under Sections 27-65-105 through 27-65-109, C.R.S., shall not be the sole
-justification for the use of seclusion.
-
-D.
-
-Seclusion shall be used only when other less restrictive methods have failed. Documentation of
-less restrictive methods and the outcome shall be contained in the clinical record.
-
-E.
-
-Seclusion rooms shall be lighted, clean, safe, and have a window for staff to observe.
-
-F.
-
-Seclusion shall only be ordered by a Colorado licensed physician or psychologist.
-
-G.
-
-Seclusion shall not be used for punishment, for the convenience of staff, or as a substitute for a
-program of care and treatment.
-
-21.280.43
-
-Use of Restraint [Eff. 11/1/13]
-
-Restraint may be used in emergency circumstances, wherein the individual presents a serious, probable
-imminent threat of bodily harm and has the ability to affect such harm.
-A.
-
-The decision to restrain shall be based on a current clinical assessment, and may also be based
-on other reliable information including information that was used to support the decision to take
-the individual into custody for treatment and evaluation. The fact that an individual is being
-evaluated or treated under Sections 27-65-105 through 27-65-109, C.R.S., shall not be the sole
-justification for the use of restraint.
-
-B.
-
-Mechanical restraints may be used only for the purpose of preventing such bodily movement that
-is likely to result in imminent injury to self or others. Mechanical restraint shall not be used solely
-to prevent unauthorized departure.
-
-C.
-
-Restraint of a single limb is not permitted, unless court-ordered or approved by the
-superintendent and the executive body of the secure treatment facility, utilizing the assessment
-standards set forth in Section 26-20-101, et seq., C.R.S.; Section 21.280.43, A, of these rules;
-and the secure treatment facility’s policies.
-
-D.
-
-Restraint of an individual by a chemical spray is not permissible.
-
-E.
-
-The type of restraint shall be appropriate to the type of behavior to be controlled, the physical
-condition of the individual, the age of the individual and the type of effect restraint may have upon
-the individual.
-
-F.
-
-Restraint shall be applied only if alternative interventions have failed. Alternative interventions
-shall be documented in the clinical record; however, alternative techniques are not required if the
-alternatives would be ineffective or unsafe, when the individual is physically combative or actively
-assaultive or self-destructive.
-
-G.
-
-Justification for immediate use of restraint shall be documented in the clinical record.
-
-H.
-
-Restraint shall only be ordered by a Colorado licensed physician or psychologist.
-
-I.
-
-Restraint shall not be used for punishment, for the convenience of staff, or as a substitute for a
-program of care and treatment.
-
-416
-
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-Behavioral Health
-
-J.
-
-2 CCR 502-1
-
-Restraint does not include restraints used while the facility is engaged in transporting an
-individual from one facility or location to another facility or location within a facility when it is within
-the scope of that facility's powers and authority to effect such transportation pursuant to Section
-26-20-101, et seq., C.R.S.
-
-21.280.44
-
-Explanation to Individual [Eff. 11/1/13]
-
-In any situation, information shall be given to the individual, and guardian when applicable, as soon as
-possible after s/he has been secluded or restrained. The individual shall be given a clear explanation of
-the reasons for use of such intervention, the observation procedure, the desired effect, and the
-circumstances under which the procedure will be terminated. The fact that this explanation has been
-given to the individual shall be documented in the clinical record.
-In an emergency situation, information given to the individual pursuant to this rule regarding the desired
-effect and the circumstances under which the procedure(s) will be terminated may not be as detailed as
-in a non-emergency situation. However, as the individual's condition improves, staff shall promptly
-supplement the information given and this shall be documented in the clinical record.
-21.280.45
-
-Continued Use of Seclusion and/or Restraint [Eff. 11/1/13]
-
-A.
-
-Staff shall document efforts to assure that the use of seclusion/restraint shall be as brief as
-possible.
-
-B.
-
-If the seclusion/restraint episode goes beyond one (1) hour, a Colorado licensed physician or
-psychologist must provide an order. A verbal order, including telephone or other electronic orders,
-may be used if followed by a written order by the Colorado licensed physician or psychologist.
-
-C.
-
-Seclusion and/or restraint shall not be ordered on an “as needed” basis.
-
-D.
-
-If the individual has not been examined by a Colorado licensed physician or psychologist within
-the previous twenty-four (24) hours, seclusion and/or restraint continued in excess of four (4)
-hours will require a face-to-face examination and a new written order by Colorado licensed
-physician or psychologist. If there has been a documented examination by a Colorado licensed
-physician or psychologist within the previous twenty-four (24) hours, seclusion/restraint continued
-in excess of fourteen (14) hours will require a face-to-face examination and a new written order
-by a Colorado licensed physician or psychologist prior to each succeeding twenty-four (24) hours
-of seclusion/restraint to assure that the need for these interventions is still present. The reasons
-for continuation shall be documented in the clinical record by the Colorado licensed physician or
-psychologist.
-
-E.
-
-An episode of seclusion/restraint is terminated when the individual has been out of
-seclusion/restraint for a continuous period of two (2) hours.
-
-F.
-
-Continued seclusion/restraint in excess of twenty-four (24) hours shall require an administrative
-review by the medical/clinical director of the facility or his/her designee, other than the Colorado
-licensed physician or psychologist in charge of treatment. The reviewer shall be an individual with
-the authority and knowledge necessary to review clinical information and reach a determination
-that the extension of a seclusion and/or restraint episode beyond twenty four (24) hours is
-clinically necessary.
-
-G.
-
-If the reviewer does not concur with the order for continuation of seclusion/restraint, the order
-shall be discontinued and the professional person in charge of treatment shall be notified of such
-discontinuation.
-
-417
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-
-H.
-
-An administrative review shall be initiated at the conclusion of each twenty four (24) hour period
-of continuous use of seclusion/restraint, and shall be completed prior to the expiration of each
-twenty four (24) hour period.
-
-21.280.46
-A.
-
-B.
-
-C.
-
-Chart Documentation for the Use of Seclusion and/or Restraint [Eff. 11/1/13]
-
-A staff member shall record each use of seclusion and/or restraint and the clinical justification for
-the use in the individual's chart. The justification shall include:
-1.
-
-The individual's specific behavior(s) and the nature of the danger;
-
-2.
-
-Describe attempts made to control the individual's behavior prior to using seclusion
-and/or restraint;
-
-3.
-
-Describe the circumstances under which seclusion/restraint will be terminated and
-evidence that these criteria were given to the individual; and,
-
-4.
-
-Notification to a Colorado licensed physician or psychologist within one (1) hour of the
-seclusion/restraint intervention.
-
-Administrative review shall document the clinical justification for the continued use of
-seclusion/restraint in the individual's chart. The justification shall include:
-1.
-
-Documentation that the professional person ordering the continuous use of
-seclusion/restraint in excess of twenty-four (24) hours has conducted a face-to-face
-evaluation of the individual within the previous twenty-four (24) hours.
-
-2.
-
-Documentation of the ongoing behaviors or findings that warrant the continued use of
-seclusion/restraint and other assessment information as appropriate.
-
-3.
-
-Documentation of a plan for ongoing efforts to actively address the behaviors that
-resulted in the use of seclusion/restraint.
-
-4.
-
-A determination of the clinical appropriateness of the continuation of seclusion/restraint.
-
-5.
-
-A summary of the information considered by the reviewer and the result of the
-administrative review with the date, time and signature of the individual completing the
-review.
-
-Information regarding use of seclusion/restraint shall be readily accessible to authorized
-individuals for review. Facilities shall have the ability to gather data as follows:
-1.
-
-Each seclusion/restraint episode including date and time the episode started and ended,
-specific to each individual.
-
-2.
-
-Aggregated data to include total number of individuals secluded/restrained and average
-length of time of the episodes over the period of one year.
-
-21.280.47
-A.
-
-2 CCR 502-1
-
-Observation and Care [Eff. 11/1/13]
-
-An individual who is in seclusion/restraint shall be observed in person by staff at least every
-fifteen (15) minutes, and such observation, along with the behavior of the individual, shall be
-recorded each time. Unless contraindicated by the individual's condition, such observation shall
-include efforts to interact personally with the individual.
-
-418
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-
-2 CCR 502-1
-
-B.
-
-Ongoing provisions shall be made for nursing care, hygiene, diet and motion of any restrained
-limbs. For individuals in mechanical restraints, the facility shall provide relief periods, except when
-the individual is sleeping, of at least ten (10) minutes as often as every two hours, so long as
-relief from the mechanical restraint is determined to be safe. Staff shall note in the record relief
-periods granted. The individual shall have access to food at least every four (4) hours and shall
-have access to fluids and toileting upon request or during relief periods, but at least every two (2)
-hours, unless sleeping.
-
-C.
-
-Cameras and other electronic monitoring devices shall not replace the face-to-face observations.
-
-D.
-
-An individual in physical restraint shall be released from such restraint within fifteen (15) minutes
-after the initiation of physical restraint, except when precluded for safety reasons pursuant to
-Section 26-20-101, et seq., C.R.S.
-
-E.
-
-To the extent that the duties specified in Section 26-20-101, et seq., C.R.S. are more protective of
-individual rights, the provisions 26-20-101, et seq., C.R.S. shall apply.
-
-21.280.48
-
-Facility Policies and Procedures for Seclusion/Restraint [Eff. 11/1/13]
-
-The facility shall have and shall implement written policies and procedures that describe the situations in
-which the use of seclusion and/or restraint are considered appropriate within each specific program and
-the staff members who can order their use. The policies and procedures shall include the requirements in
-Section 21.280.4 of these rules and Section 26-20-101, et seq., C.R.S.
-In the event a facility does not authorize the use of seclusion and/or restraint of any type, the policy
-statement shall note the prohibition.
-The policies and procedures shall include implementing administrative review including a process for
-terminating the seclusion and/or restraint episode when the reviewer does not concur with the order for
-continuation. If the reviewer is not a Colorado licensed physician or psychologist, then the order must be
-discontinued by a Colorado licensed physician or psychologist.
-21.280.5
-
-THERAPY OR TREATMENT USING SPECIAL PROCEDURES
-
-21.280.51
-
-Informed Consent [Eff. 11/1/13]
-
-Therapies using stimuli such as electroconvulsive therapy (ECT), and behavior modifications using
-physically painful, aversive or noxious stimuli, require special procedures for consent and shall be
-governed by this rule.
-A.
-
-Prior to the administration of a therapy listed above, written informed consent shall be obtained
-and documented in the clinical record reflecting agreement by both the individual being treated
-and his/her legal guardian, if one has been appointed or alternative decision maker if one exists.
-If the individual undergoing treatment using special procedures is a child age sixteen (16) to
-eighteen (18), the clinical record shall reflect informed consent by both the child and his/her
-guardian(s).
-
-B.
-
-In the case of electroconvulsive therapy, a consent form prescribed by the Department shall be
-used and procedures set forth in Sections 13-20-401through 13-20-403, C.R.S., shall be
-followed. An informed consent means:
-1.
-
-It is freely and knowingly given and expressed in writing.
-
-2.
-
-That the following has been explained to the individual:
-
-419
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-Behavioral Health
-
-2 CCR 502-1
-
-a.
-
-The reason for such treatment information;
-
-b.
-
-The nature of the procedures to be used in such treatment, including their
-probable frequency and duration;
-
-c.
-
-The probable degree and duration of improvement or remission expected with or
-without such treatment;
-
-d.
-
-The nature, degree, duration, and probability of the side effects and significant
-risks of such treatment commonly known by the medical profession, the possible
-degree and duration of memory loss, the possibility of permanent irrevocable
-memory loss, and the remote possibility of death;
-
-e.
-
-The reasonable alternative treatments, if any, and why the Colorado licensed
-physician or psychologist is recommending the specific treatment;
-
-f.
-
-That the individual has the right to refuse or accept the proposed treatment and
-has the right to revoke his consent for any reason at any time, either orally or in
-writing;
-
-g.
-
-That there is a difference of opinion within the medical profession on the use of
-some treatments;
-
-h.
-
-An offer to answer any inquiries concerning the recommended special
-procedures; and,
-
-i.
-
-The number of treatments expected over a specified period of time to achieve
-maximum benefit.
-
-3.
-
-The consent agreement entered into by the individual or other individual(s) shall not
-include exculpatory language through which the individual or other individual(s) is made
-to waive, or appear to waive, any of his/her legal rights, or to release the facility or any
-other party from liability for negligence.
-
-4.
-
-Informed consent for the special procedure shall be renewed each time the maximum
-number of treatments is given or the specified amount of time has expired. No informed
-consent for special procedures shall be valid for more than thirty (30) days.
-
-5.
-
-No one under the age of sixteen (16) shall undergo electroconvulsive treatment.
-
-6.
-
-Electroconvulsive treatment requires a concurring consultation by a licensed psychiatrist
-prior to administration of the treatment. Such consultation shall be noted in the clinical
-record.
-
-7.
-
-All provisions of Sections 13-20-401 through 13-20-403, C.R.S., shall be followed.
-
-21.280.52
-
-Involuntary Treatment Using Special Procedures [Eff. 11/1/13]
-
-In the event the individual or the legal guardian refuses to or cannot consent, treatments referenced in
-Section 21.280.51 using special procedures shall be administered only under the following
-circumstances:
-A.
-
-With a prior court order for the treatments using special procedure; or,
-
-420
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-Behavioral Health
-
-B.
-
-2 CCR 502-1
-
-In an emergency in which the life of the individual is in imminent danger because of the
-individual's condition. In an emergency situation in which the individual is unable to grant
-informed consent and sufficient time does not exist to petition the court for an order prior to the
-administration of the specific therapy, the individual's physician, in consultation with the director of
-the facility or his/her designee, may, after careful and informed deliberation and under procedures
-adopted by the facility, order a special procedure without consent.
-
-21.280.53
-
-Documentation of Special Procedures [Eff. 11/1/13]
-
-Along with the evidence of informed consent as delineated in this section, the reason for the use of any
-special procedure shall be fully documented in the individual’s record. The administration and outcome of
-such special procedure shall also be documented in the clinical record.
-21.280.54
-
-Procedures [Eff. 11/1/13]
-
-Each designated facility shall adopt written procedures for administration of special procedures in
-accordance with these rules and applicable statutes.
-21.280.6
-
-CONTINUITY OF CARE [Eff. 11/1/13]
-
-Each facility shall adopt and implement a written policy for continuity of care. The policy shall include at a
-minimum the following:
-A.
-
-Access to all necessary care and services within the facility, and coordination with any other
-current mental health care providers or other systems of care or support as appropriate.
-
-B.
-
-Coordination of care with the individual's previous mental health care providers or medical
-providers as appropriate, including retrieval of psychiatric and medical records.
-
-C.
-
-Coordination of the individual's care with family members, guardians and other interested parties
-as appropriate and in a manner that reflects the individual's culture and ethnicity.
-
-D.
-
-The facility is not responsible for providing non-psychiatric medical care under these rules, but
-shall facilitate access to proper medical care and shall be responsible for coordinating mental
-health treatment with medical treatment provided to the individual.
-
-21.280.7
-
-TRANSFER OF CARE AND TRANSPORTATION
-
-21.280.71
-
-Transfer of Care [Eff. 11/1/13]
-
-A.
-
-The individual shall only be transferred to another designated or placement facility when
-adequate arrangements for care by the receiving facility have been made and documented in the
-clinical record. Transfer coordination shall include at least one discharge planning conference,
-face-to-face or by telephone, with participants from both facilities and the individual and his/her
-guardian, whenever possible.
-
-B.
-
-At least twenty-four (24) hours advance notice of transfer shall be given to individuals under
-certification, unless knowingly waived in writing by the individual and guardian as appropriate,
-except in cases of a medical emergency. Notice of such transfer shall also be provided to the
-court of competent jurisdiction and the individual's attorney.
-
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-
-C.
-
-2 CCR 502-1
-
-The transferring facility shall ask the individual to indicate two (2) individuals to whom notification
-of transfer should be given and shall notify such individuals within twenty-four (24) hours of
-notification to the individual. Such notification shall be made by the transferring facility with the
-appropriate written authorization. Actions taken under this section shall be documented in the
-clinical record.
-
-21.280.72
-
-Transportation [Eff. 11/1/13]
-
-Whenever transportation of an individual is required, the treating staff of the facility shall assess the
-individual for dangerousness to self or others and potential for escape. Whenever clinically and safely
-appropriate, the individual may be transported by other means such as ambulance, care van, private
-vehicle, and restraints shall not be used, unless authorized as necessary by the treating physician. If the
-treating staff assesses the individual as dangerous to self or others or as an escape risk, the staff may
-request transportation by the local Sheriff's Department.
-A.
-
-A request for transportation from the Sheriff's Department shall be filed with the court of
-appropriate jurisdiction and shall include:
-1.
-
-Statements from the treating Colorado licensed physician or psychologist supporting the
-need for transportation by the Sheriff's Department;
-
-2.
-
-Recommendations concerning the use of mechanical restraints and the impact that
-handcuffs or shackles would have on the individual;
-
-3.
-
-Recommendations for soft restraints, not handcuffs or shackles, if the findings of the
-assessment support the use of mechanical restraint;
-
-4.
-
-Recommendations concerning the placement and management of the individual during
-the time s/he will be absent from the designated facility due to court hearings;
-
-5.
-
-Recommendations of considerations for management of the individual based on the
-individual's age, physical abilities, culture, medical and psychiatric status and/or stability.
-
-B.
-
-Notice of the request for transportation by the Sheriff's Department shall be given to the individual
-and his/her attorney at least twenty-four (24) hours prior to the time it is filed with the court. This
-notice shall not be required during the time a seventy-two hour hold is in effect or in an
-emergency situation with an individual under certification or when the individual signs a waiver
-which has been clearly explained.
-
-C.
-
-Requesting transportation by the Sheriff's Department does not require a finding of
-dangerousness to self or others or an escape risk if the Sheriff's Department is willing to transport
-the individual without the use of mechanical restraints.
-
-21.280.8
-
-CERTIFICATION FOR TREATMENT ON AN OUTPATIENT BASIS [Eff. 11/1/13]
-
-An individual who has been treated as an inpatient under a short-term or long-term certification for mental
-health treatment at a designated facility may be treated on an outpatient basis if the following conditions
-are met:
-A.
-
-A Colorado licensed physician or psychologist who has evaluated the individual and who is on the
-staff of the designated facility which has been treating the individual, determines that while the
-individual continues to meet the requirements for certification, professional judgment is that with
-appropriate treatment modalities in place the individual is unlikely to act dangerously in the
-community.
-
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-
-B.
-
-Certification on an outpatient basis is the appropriate disposition suited to the individual's needs.
-
-C.
-
-The designated facility that will hold the certification on an outpatient basis has documentation of
-the results of a recent physical examination.
-
-D.
-
-Arrangements have been made for the individual to have access to:
-1.
-
-Case management;
-
-2.
-
-Medication management;
-
-3.
-
-Essential food, clothing, shelter; and,
-
-4.
-
-Medical care and emergency dental care.
-
-E.
-
-The service plan shall reflect the outpatient certification status, the arrangements under D, 1-4,
-above, and meet the requirements in Sections 21.190.4 and 21.280.92 Service Planning.
-
-F.
-
-Content of the individual’s outpatient record shall meet the requirements in Sections 21.190 and
-21.280.9, Documentation in Individual Records.
-
-21.280.81
-
-Enforcement of Certification [Eff. 11/1/13]
-
-A.
-
-If the individual on outpatient certification substantially fails to comply with the requirements
-specified in his/her service plan, the Colorado licensed physician or psychologist or staff of the
-designated facility that holds the certification, shall make reasonable efforts, including outreach,
-to obtain the individual's compliance with the plan. As part of these efforts, reasonable attempts
-shall be made to advise the individual that s/he may be picked up and taken into custody for
-appraisal of the individual's need for continued certification and ability to receive treatment on an
-outpatient basis.
-
-B.
-
-If the designated facility's medical director or the treating Colorado licensed physician or
-psychologist reasonably believes that there is a significant risk of deterioration in the individual's
-condition or that the individual may pose a risk of harm to self or the community, and reasonable
-efforts to obtain the individual's compliance with the service plan have been unsuccessful, the
-medical director or the treating professional person shall make arrangements to have the
-individual transported to a designated facility or the emergency room of a hospital. The individual
-shall be assessed for current clinical needs and modifications made in legal status or treatment
-as necessary, including readmission to an inpatient facility.
-
-C.
-
-The individual shall not be physically forced to take prescribed psychiatric medication during this
-appraisal process, unless an emergency situation exists or the individual is court-ordered to do so
-as set forth in Section 21.280.33 through 21.280.36.
-
-D.
-
-Following the assessment, if the individual is not detained, the facility holding the certification
-shall arrange transportation for the individual to return to the individual's residence or other
-reasonable location, if the individual so desires.
-
-21.280.9
-
-DOCUMENTATION IN INDIVIDUAL RECORDS
-
-21.280.91
-
-Assessment [Eff. 11/1/13]
-
-Records shall include:
-A.
-
-Assessment information in accordance with Section 21.190.3.
-
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-
-B.
-
-Evidence of ongoing assessment that at a minimum shall be included in the monthly service plan
-review process.
-
-C.
-
-Evidence of an assessment update for continued certification every six months for individuals
-being treated under an outpatient certification or a long-term certification.
-
-21.280.92
-
-Service Planning Requirements [Eff. 11/1/13]
-
-Service plans shall follow requirements in 21.190.4 (noting the exception in 21.280.92, G, below, of
-monthly service plan reviews), and:
-A.
-
-The service plan shall contain specific criteria required for discharge from treatment or to
-progress to less restrictive treatment alternatives.
-
-B.
-
-For individuals receiving care through outpatient certification, the plan shall assure the individual
-has access to medical and emergency dental care, case management, medication management,
-food, clothing, and shelter.
-
-C.
-
-If an individual is discharged during a seventy-two (72) hour hold without certification by the
-facility, and a service plan has not been completed, then pertinent information shall be included in
-the discharge summary.
-
-D.
-
-The facility shall appoint a clinical staff person to be responsible for the formulation,
-implementation, review, and revision of the service plan. The name of the responsible staff
-person shall be specified in the plan and that individual shall sign the plan. The plan shall also be
-signed by the treating Colorado licensed physician or psychologist, if he or she is not the
-responsible staff person.
-
-E.
-
-A physician or other professional person authorized by law to prescribe the medications shall be
-responsible for the component of the plan requiring medication management services.
-
-F.
-
-Service plans shall be readily identifiable and shall be maintained in a place readily accessible to
-treatment staff.
-
-G.
-
-The service plan shall be reviewed, and revised if necessary, at least monthly by the staff person
-responsible for the plan, the treating Colorado licensed physician or psychologist, the individual
-and the legal guardian. This review shall be documented in the record and include progress
-toward meeting the criteria for termination of treatment and the need for continued involuntary
-treatment if the individual is certified. If the monthly review is delayed, the reason for such delay
-shall be noted in the record and the review shall be completed as promptly as possible.
-
-21.280.93
-
-Treatment Progress and Documentation Requirements [Eff. 11/1/13]
-
-Records shall contain treatment progress notes per Section 21.190.5 and the following:
-A.
-
-Documentation of all treatment procedures including, but not limited to: brief physical restraint,
-seclusion, mechanical restraint, medications voluntary and involuntary, and other therapies or
-interventions.
-
-B.
-
-Information regarding the serious injury of or by the individual and the circumstances and
-outcome.
-
-C.
-
-Documentation of all transfers and reasons for transfer.
-
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-
-D.
-
-Legal status and all legal documents related to treatment under Section 27-65-101, et seq.,
-C.R.S.
-
-E.
-
-Consultations and/or case reviews.
-
-F.
-
-Pertinent information from outside agencies or persons or from the individual.
-
-G.
-
-Correspondence to and from relevant agencies and individuals.
-
-H.
-
-Monthly documentation of the results of a Colorado licensed physician or psychologist’s review of
-certification, effectiveness of mental health treatment, legal status of the individual and
-considerations of less restrictive treatment alternatives.
-
-I.
-
-Consent forms as appropriate for alternative treatments or voluntary treatment.
-
-J.
-
-Use or non-use of advance directives.
-
-21.280.94
-A.
-
-B.
-
-Discharge Planning Requirements [Eff. 11/1/13]
-
-Records shall include documentation that written information has been given to the individual
-upon discharge. This information shall include provision of Section 21.190.6, and:
-1.
-
-If the individual is being transferred to another facility, information regarding that transfer
-and the facility shall be included.
-
-2.
-
-Information if the discharge is being made against the advice of the treating Colorado
-licensed physician or psychologist.
-
-Discharge Summary
-Records shall contain a discharge summary to include the provisions of Section 21.190.62 and
-the following information:
-1.
-
-A summary of treatment received including: involuntary treatments, advance directives,
-progress made, and case management activities.
-
-2.
-
-For transfers between facilities, documentation of appropriate clinical information and
-coordination of services between the two facilities, including mode of transportation.
-
-21.281 INVOLUNTARY TRANSPORTATION FOR IMMEDIATE SCREENING
-21.281.1
-
-DEFINITIONS
-
-“Facility” means any outpatient mental health facility or other clinically appropriate facility designated by
-the office of behavioral health as a seventy-two (72) hour treatment and evaluation facility that has walk-in
-capabilities and provides immediate screenings. If such a facility is not available, an emergency medical
-services facility, as defined in Section 27-65-102(5.5), C.R.S., may be used.
-“Immediate screening” means the determination if an individual meets criteria for seventy-two (72) hour
-treatment and evaluation.
-
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-
-“Intervening professional” as defined in section 27-65-105(1)(a)(II), C.R.S., means a certified peace
-officer; a professional person; a registered professional nurse as defined in section 12-38-103(11), C.R.S.
-who by reason of postgraduate education and additional nursing preparation has gained knowledge,
-judgment, and skill in psychiatric or mental health nursing; a licensed marriage and family therapist,
-licensed professional counselor, or addiction counselor licensed under Part 5, 6, or 8 of Article 43 of Title
-12, C.R.S., who by reason of postgraduate education and additional preparation has gained knowledge,
-judgment, and skill in psychiatric or clinical mental health therapy, forensic psychotherapy, or the
-evaluation of mental health disorders; or a licensed clinical social worker licensed under the provisions of
-Part 4 of Article 43 of Title 12, C.R.S.
-“Involuntary transportation form” means the report and application allowing for immediate transport of an
-individual, in need of an immediate screening for treatment, to a clinically appropriate facility.
-“Involuntary transportation hold” means the ability to transport an individual in need of an immediate
-screening to determine if the individual meets criteria for seventy-two (72) hour treatment and evaluation.
-Pursuant to Section 27-65-105(1)(a)(I.5), C.R.S., an intervening professional may involuntary transport an
-individual in need of an immediate screening from the community to an outpatient mental health facility or
-other clinically appropriate facility. The involuntary transportation hold does not extend or replace the
-timing or procedures related to a seventy-two (72) hour treatment and evaluation hold or an individual’s
-ability to voluntarily apply for mental health services.
-21.281.2
-A.
-
-An individual may be placed on an involuntary transportation hold pursuant to section 27-65105(1)(a)(I.5), C.R.S.
-1.
-
-B.
-
-PROCEDURE
-
-The involuntary transportation form shall be completed by an intervening professional
-and contain:
-a.
-
-The circumstances under which the individual’s condition was called to the
-intervening professional’s attention;
-
-b.
-
-The date and time the individual was placed on the involuntary transportation
-hold;
-
-c.
-
-The name of the facility to which the individual will be transported; and,
-
-d.
-
-The signature of the intervening professional placing the involuntary
-transportation hold.
-
-2.
-
-A copy of the involuntary transportation form must be given to the facility and made part
-of the individual’s medical record.
-
-3.
-
-A copy of the involuntary transportation form must be given to the individual who was
-placed on the involuntary transportation hold.
-
-The involuntary transportation hold expires:
-1.
-
-Six (6) hours after it was placed; or,
-
-2.
-
-Upon the facility receiving the individual for screening; thereby resolving the involuntary
-transportation hold.
-
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-
-C.
-
-2 CCR 502-1
-
-The facility shall ensure that the immediate screening is completed to determine if the individual
-meets criteria for seventy-two (72) hour treatment and evaluation and follow standard procedures
-pursuant to section 27-65-105(1)(A)(I), C.R.S.
-
-21.282 EMERGENCY MEDICAL SERVICES FACILITY DATA REPORTING REQUIREMENTS
-A.
-
-An emergency medical services facility, as defined in 27-65-102(5.5), C.R.S., providing care to an
-individual pursuant to Title 27, Article 65, C.R.S. is required to maintain a data set sufficient to
-report the following aggregate numbers to the Department annually pursuant to 27-65-105(7),
-C.R.S., in the format and timeframe required by the Department.
-
-B.
-
-For each facility, the annual report shall include:
-1.
-
-The name, county, and address of each facility site where the service was provided.
-
-2.
-
-The total number of unduplicated individuals, as defined in Section 21.280.1, who had a
-seventy-two hour hold resolved (this includes release without need for further mental
-health services, or referral for voluntary treatment) at the facility, as well as:
-a.
-
-Total number of unduplicated individuals by gender;
-
-B.
-
-Total number of unduplicated individuals by race and ethnicity;
-
-c.
-
-Total number of unduplicated individuals by age; and,
-
-D.
-
-Total number of unduplicated individuals by county of residence.
-
-3.
-
-The total number of seventy-two hour holds transferred to a designated facility for
-continued involuntary services.
-
-4.
-
-The total number of involuntary transportation holds, as defined in Section 21.281.1,
-received by the facility, as well as total numbers by outcome of the required screening,
-including at least:
-
-5.
-
-A.
-
-Total number of involuntary transportation hold screenings resulting in the
-placement of a seventy-two hour hold;
-
-B.
-
-Total number of involuntary transportation hold screenings resulting in a referral
-for further mental health care and treatment on a voluntary basis: and,
-
-C.
-
-Total number of involuntary transportation hold screenings resulting in a release
-without need for further mental health services.
-
-The total number of seventy-two hour holds where the involuntary status was resolved at
-the facility, as well as, the total number of seventy-two hour holds where the involuntary
-status was resolved at the facility grouped by:
-A.
-
-Who initiated the seventy-two hour hold (each hold can only meet the
-requirements of one category listed below):
-1)
-
-Certified peace officer;
-
-2)
-
-Court; or,
-
-3)
-
-Facility or community based personnel as defined in Section 21.280.1.
-
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-
-B.
-
-C.
-
-C.
-
-D.
-
-2 CCR 502-1
-
-The reason for the seventy-two hour hold (each hold can meet the requirements
-of multiple categories listed below):
-1)
-
-Dangerous to self;
-
-2)
-
-Dangerous to others; or,
-
-3)
-
-Gravely disabled.
-
-Disposition of the seventy-two hour hold (each hold can only meet the
-requirements of one category listed below):
-1)
-
-Released without need for further mental health services; or,
-
-2)
-
-Referred for further mental health care and treatment on a voluntary
-basis.
-
-Process of data reporting
-1.
-
-Facilities must submit their annual data report to the Department by July 1 of each year
-covering the most recent, complete calendar year covering January 1 through December
-31. The report must meet the requirements in section 24-1-136(9), C.R.S.
-
-2.
-
-The Department will annually request from the Department of Public Health and
-Environment a list of licensed facilities that may provide emergency services pursuant to
-Title 27, Article 65, C.R.S. the facility list shall include, but is not limited to: general
-hospitals; hospital units; psychiatric hospitals; and, community clinics.
-
-3.
-
-If a facility on the list provided by the Department of Public Health and Environment does
-not report to the Department, the Department will contact the facility to confirm that the
-facility did not provide involuntary care to an individual pursuant to Title 27, Article 65,
-C.R.S. during the reporting cycle. If a facility is found to have provided involuntary care to
-an individual pursuant to Title 27, Article 65, C.R.S. and did not submit an annual report,
-an annual report will be requested. If a facility refuses to provide the statutorily required
-report, the Department may submit a complaint to the Office of the Ombudsperson for
-Behavioral Health Access to Care.
-
-Pursuant to § 27-65-121, C.R.S. and HIPAA, as defined in Section 21.100, the facility must
-maintain confidentiality over the data sets. The reports generated from these data sets are also
-confidential; but the Department may release aggregated information contained in the reports so
-long as the total number of individuals in any aggregate data group (including county or facility
-name) is greater than thirty (30). If the total number in such a data group is less than or equal to
-thirty (30), the Department may release this information by redacting such number.
-
-21.290 ACUTE TREATMENT UNITS
-21.290.1
-
-DEFINITIONS [Eff. 11/1/13]
-
-“Acute Treatment Unit” (ATU) means a facility or a distinct part of a facility for short-term psychiatric care,
-which may include substance use disorder treatment. An ATU provides a twenty-four (24) hour,
-therapeutically planned and professionally staffed environment for individuals who do not require inpatient
-hospitalization but need more intense and individualized services, such as crisis management and
-stabilization services, than are available on an outpatient basis. The average lengths of services are from
-three (3) to seven (7) days.
-
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-2 CCR 502-1
-
-“Auxiliary Aid” means any device used by individuals to overcome a physical disability and includes, but is
-not limited to, a wheelchair, walker or orthopedic appliance.
-“Bedridden” means an individual who is unable to ambulate or move about independently or with the
-assistance of an auxiliary aid, who also requires assistance in turning and repositioning in bed.
-“Director” means an individual who is responsible for the overall operation and daily administration,
-management, and maintenance of the facility.
-“Emergency Contact” means one of the individuals identified on the face sheet of the individual record to
-be contacted in the case of an emergency.
-“Facility” means an acute treatment unit.
-“Licensee” means the individual or entity to whom a license is issued by the Colorado Department of
-Public Health and Environment pursuant to Section 25-1.5-103(1)(a), C.R.S., and certification as a 27-65
-designated facility has been granted by the Department to operate a facility within the definition herein
-provided.
-“Medical or Nursing Care” means care provided under the direction of a physician and maintained by onsite nursing personnel.
-“Owner” means the entity in whose name the license and designation is issued. The entity is responsible
-for the financial and contractual obligations of the facility. “Entity” means any corporation, Limited Liability
-Corporation, firm, partnership, or other legally formed body, however organized.
-“Personal services” means those services that the director and employees of an acute treatment unit
-provide for each individual including, but not limited to:
-A.
-
-An environment that is sanitary and safe from physical harm;
-
-B.
-
-Assistance with transportation whether by providing transportation or assisting in making
-arrangements for the individual to obtain transportation; and,
-
-C.
-
-Assistance with activities of daily living.
-
-“Protective Oversight” means guidance as required by the needs of the individual or legal representative
-or as reasonably requested by the individual including the following:
-A.
-
-Being aware of an individual’s general whereabouts, although the individual may travel
-independently in the facility; and,
-
-B.
-
-Monitoring the activities of the individual on the premises to ensure the individual’s health, safety,
-and well-being, including monitoring the individual’s needs and ensuring that s/he receives the
-services and care necessary to protect health, safety, and well-being.
-
-“Short-Term Psychiatric Care” means services that average from three to seven (3-7) days provided to
-individuals with mental health disorders in accordance with Title 27, Section 65, C.R.S.
-21.290.2
-
-DESIGNATION OF ACUTE TREATMENT UNITS [Eff. 11/1/13]
-
-Facilities applying for designation as an acute treatment unit (ATU) must be in compliance with Section
-21.280 and the requirements in the following Subsections 21.290.21 through 21.290.58.
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-
-21.290.21
-
-2 CCR 502-1
-
-Director Minimum Education, Training and Experience Requirements [Eff. 11/1/13]
-
-Any individual serving as a director shall meet the minimum education, training, and experience
-requirements in one of the following ways:
-A.
-
-The director shall have received a Bachelor’s degree from an accredited college or university and
-have three years of verified experience in the human services field, one of which was in a
-supervisory or administrative position; or,
-
-B.
-
-The director shall have received a Master’s degree from an accredited college or university and
-have two years of verified experience in the human services field, one of which was in a
-supervisory or administrative position.
-
-C.
-
-Training in the following areas:
-1.
-
-Individual rights;
-
-2.
-
-Environment and fire safety, including emergency procedures and First Aid;
-
-3.
-
-Assessment skills;
-
-4.
-
-Identifying and dealing with difficult situations and behavior management; and,
-
-5.
-
-Nutrition.
-
-21.290.22
-
-Director Responsibilities [Eff. 11/1/13]
-
-The director shall be responsible for the following:
-A.
-
-Overall direction and responsibility for the individuals, program, facility, and fiscal management;
-
-B.
-
-Overall direction and responsibility for supervision of staff;
-
-C.
-
-The selection and training of a capable staff member who can assume responsibility for
-management of the facility in the director’s absence; and,
-
-D.
-
-The establishment of relationships and maintaining contact with allied agencies, services, and
-mental health resources within the community.
-
-21.290.23
-
-Assistant or Acting Director [Eff. 11/1/13]
-
-A.
-
-In each facility, there shall be a specifically designated staff member, age twenty one (21) or over,
-capable of acting as a substitute for the director during his/her absence. The duties and
-responsibilities of the acting director shall be clearly defined in order to avoid confusion and
-conflict among other staff and individuals.
-
-B.
-
-If the director is regularly absent from the facility more than fifty percent (50%) of his/her working
-hours, an assistant director shall be appointed who meets the same qualifications as the director
-found at Sections 21.290.21.
-
-21.290.24
-
-Administrative Coverage [Eff. 11/1/13]
-
-When there is a change in director, or when the director has left the facility permanently without a
-replacement, the facility shall notify the Department in writing, within twenty four (24) hours. When a
-possible change in director is anticipated, the facility shall notify the Department prior to the change.
-
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-2 CCR 502-1
-
-Either the director or assistant or acting director shall be available at all times.
-21.290.25
-
-Clinical Director [Eff. 11/1/13]
-
-A.
-
-The clinical director is responsible for assuring that there is adequate training and supervision for
-staff.
-
-B.
-
-Qualifications of a Clinical Director
-1.
-
-The clinical director shall possess a Master’s degree or Ph.D. in a mental health related
-field or a Bachelor’s degree in a mental health related field and five (5) years of work
-experience.
-
-2.
-
-Additionally, the clinical director shall receive training on:
-a.
-
-Individual rights;
-
-b.
-
-Environment and fire safety, including emergency procedures and First Aid;
-
-c.
-
-Assessment skills; and,
-
-d.
-
-Identifying and treating individuals who have received diagnoses from the most
-current diagnostic and statistical manual of mental disorders and who display
-behaviors that are common to people with severe and persistent mental health
-disorders.
-
-21.290.3
-
-PERSONNEL
-
-21.290.31
-
-Physical or Mental Impairment [Eff. 11/1/13]
-
-Any individual who is physically or mentally unable to adequately and safely perform duties that are
-essential functions may not be assigned duties as a direct care staff member or volunteer at an ATU.
-21.290.32
-
-Alcohol or Substance Use [Eff. 11/1/13]
-
-The facility shall not employ or allow any individual who is under the influence of a controlled substance,
-as defined in Sections 18-18-203, 18-18-204, 18-18-205, 18-18-206, and 18-18-207, C.R.S., or who is
-under the influence of alcohol in the workplace. This does not apply to employees using controlled
-substances under the direction of a physician and in accordance with their health care provider’s
-instructions, as long as it does not pose a safety risk to the employee, other employees, or individuals.
-21.290.33
-A.
-
-Access to Policies and Procedures [Eff. 11/1/13]
-
-The facility shall have a written statement of personnel policies that include:
-1.
-
-Salary range and provisions for increases;
-
-2.
-
-Hours of work and holiday, vacation, sick and other applicable leave information;
-
-3.
-
-Conditions of employment, tenure and promotion;
-
-4.
-
-Employment benefits; including medical/dental/life insurance, workers compensation
-insurance, retirement plan, and any other available benefits;
-
-5.
-
-Employee performance evaluation procedures;
-
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-
-B.
-
-6.
-
-Grievance procedures that may be used by staff; and,
-
-7.
-
-Discipline and/or termination procedures.
-
-A copy of the personnel policy shall be given to each staff member at the time of his/her
-employment.
-
-21.290.34
-A.
-
-B.
-
-2 CCR 502-1
-
-Specialized Training Requirements for ATU [Eff. 11/1/13]
-
-In addition to the personnel training standards in Sections 21.160 and 21.280.24 for designated
-facilities, prior to providing direct care, the facility shall provide training on:
-1.
-
-First Aid and injury response;
-
-2.
-
-The care and services for the current individuals; and,
-
-3.
-
-The recognition and response to common side effects of psychiatric medications, and
-response to emergency drug reactions in accordance with facility policies.
-
-Within one month of the date of hire, the facility shall provide training for staff on each of the
-following topics:
-1.
-
-Assessment skills;
-
-2.
-
-Infection control;
-
-3.
-
-Behavior management and de-escalation techniques, to include incidents involving
-suicide, assault, or elopement.
-
-4.
-
-Health emergency response; and,
-
-5.
-
-Behavioral/psychiatric emergency response training.
-
-21.290.35
-
-Staffing Requirements [Eff. 11/1/13]
-
-A.
-
-The facility shall employ sufficient staff to ensure that the provision of services meets the needs of
-individuals. The facility shall maintain at least a one to six (1:6) trained staff member(s) to
-individual resident ratio at all times.
-
-B.
-
-In determining the staffing levels, the facility shall give consideration to factors including, but not
-limited to:
-1.
-
-Services to meet the individuals’ needs; and,
-
-2.
-
-Services to be provided under the individual service plan.
-
-C.
-
-Each facility shall ensure that, at minimum, an individual qualified as described in Section
-21.290.57 is available to administer medications at all times.
-
-D.
-
-Residents of the facility may volunteer in performing housekeeping duties and other tasks suited
-to the individual’s abilities; however, these persons who provide services for the facility on a
-regular basis may not be included in the facility’s staffing plan in lieu of facility employees.
-
-E.
-
-Volunteers may be utilized in the facility, but may not be included in the facility’s staffing plan in
-lieu of facility employees.
-
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-
-21.290.4
-
-POLICIES AND PROCEDURES FOR ATU
-
-21.290.41
-
-Emergency Plan and Fire Escape Procedures [Eff. 11/1/13]
-
-2 CCR 502-1
-
-A.
-
-Emergency plan: The emergency plan shall include planned responses to fire, gas explosion,
-bomb threat, power outages, and tornado. Such plan shall include provisions for alternate
-housing in the event evacuation is necessary.
-
-B.
-
-Fire escape procedures: The fire escape procedures shall include a diagram developed with local
-fire department officials which shall be posted in a conspicuous place.
-
-C.
-
-Within three (3) days of admission, emergency procedures, including the plan and diagram of fire
-exits, shall be explained to each individual.
-
-21.290.42
-
-Serious Illness, Serious Injury, or Death [Eff. 11/1/13]
-
-A.
-
-The policy shall describe the procedures to be followed by the facility in the event of serious
-illness, serious injury, or death of persons receiving services, including incident reporting
-requirements.
-
-B.
-
-The policy shall include a requirement that the facility notify an emergency contact when the
-individual’s injury or illness warrants medical treatment or face-to-face medical evaluation. In the
-case of an emergency room visit or unscheduled hospitalization, a facility must notify an
-emergency contact immediately.
-
-21.290.43
-
-Physical Health Assessment [Eff. 11/1/13]
-
-The facility shall develop policies and procedures that identify when a physical health assessment by a
-qualified licensed independent practitioner will be required, including the following indicators:
-A.
-
-Within twenty-four (24) hours of admission;
-
-B.
-
-A significant change in the individual’s condition;
-
-C.
-
-Evidence of possible infection (open sores, etc.);
-
-D.
-
-Injury or accident sustained by the individual that might cause a change in the individual’s
-condition;
-
-E.
-
-Known exposure of the individual to a communicable disease; or,
-
-F.
-
-Development of any condition that would have initially precluded admission to the facility.
-
-21.290.44
-
-Smoking [Eff. 11/1/13]
-
-A.
-
-Facilities’ policies for smoking shall address individuals, staff, volunteers and visitors, and shall
-comply with applicable state laws and regulations.
-
-B.
-
-Prior to admission or employment, individuals and staff shall be informed of any prohibitions.
-
-21.290.45
-A.
-
-Discharge [Eff. 11/1/13]
-
-The facility's discharge policy shall include all of the following:
-
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-
-B.
-
-2 CCR 502-1
-
-1.
-
-Circumstances and conditions under which the facility may require the individual to be
-involuntarily transferred or discharged;
-
-2.
-
-An explanation of the notice requirements;
-
-3.
-
-A description of the relocation assistance offered by the facility; and,
-
-4.
-
-The right to call advocates, such as the Governor’s protection and advocacy for
-individuals with mental health disorders, the adult protection services of the appropriate
-county department of social or human services, and/or the Colorado Department of
-Human Services, Office of Behavioral Health.
-
-Disclosure to Individuals
-
-Upon admission, the facility shall document that the individual or legal representative, as appropriate, has
-read or had explained the discharge policy.
-21.290.46
-
-Management of Personal Funds and Personal Property [Eff. 11/1/13]
-
-The facility shall develop written policies that include the procedures for managing individual funds or
-property.
-A.
-
-Upon admission, a written inventory of all personal belongings shall be conducted. This inventory
-shall be signed and reviewed by facility staff and the individual, and shall be maintained in the
-individual’s clinical record.
-
-B.
-
-All inventoried items shall be stored in a secure location during the individual’s stay in the facility.
-
-C.
-
-All inventoried property shall be returned to the individual upon discharge. The individual and
-facility staff shall sign the inventory form indicating that all items were returned.
-
-21.290.5
-
-ADMINISTRATIVE FUNCTIONS
-
-21.290.51
-
-Admissions [Eff. 11/1/13]
-
-A.
-
-The facility shall develop written admission criteria based on the facility’s ability to meet the
-individual’s needs. Admission criteria shall be based upon a comprehensive pre-admission
-assessment of the individual’s mental health, physical health, substance use, and capacity for
-self- care. The assessment shall determine the level of intervention and supervision required,
-including medication management, behavioral health services and stabilization prior to return to
-the community.
-
-B.
-
-Acute treatment units shall not admit individuals with a mental health disorder into a locked
-setting unless there is no less restrictive alternative and unless they are otherwise in compliance
-with the requirements of Title 27, Article 65, Colorado Revised Statutes.
-
-C.
-
-Individuals may be admitted to a locked setting as a voluntary or involuntary individual. If
-voluntary, the individual shall sign a form that documents the following information:
-1.
-
-The individual is aware that the facility is locked.
-
-2.
-
-The individual may exit the facility with staff assistance and/or permission.
-
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-
-3.
-
-2 CCR 502-1
-
-The individual may leave the facility at any point in time, unless he/she presents as a
-danger to self or others, or is gravely disabled as defined in Section 27-65-101, et seq.,
-C.R.S.
-
-D.
-
-An individual who is imminently suicidal or homicidal shall only be admitted to the locked facility,
-upon completion of the facility’s assessment and the facility’s determination that the individual’s
-safety and the safety of others can be maintained by the facility. If an individual is admitted and
-facility staff determine that his/her behavior cannot be safely and successfully treated at the ATU,
-then staff shall make arrangements to transfer the individual to the nearest hospital for further
-assessment and disposition.
-
-E.
-
-A facility shall not admit or keep any individual who meets the following exclusion criteria:
-1.
-
-Is consistently incontinent unless the individual or staff is capable of preventing such
-incontinence from becoming a health hazard.
-
-2.
-
-Is under the age of eighteen (18).
-
-3.
-
-Is bedridden with limited potential for improvement.
-
-4.
-
-Has a communicable disease or infection that is:
-
-5.
-
-a.
-
-Reportable under the Department of Public Health and Environment's regulations
-(6 CCR 1009-1 and 2); and,
-
-b.
-
-Potentially transmittable in a facility, unless the individual is receiving medical or
-drug treatment for the condition and the admission is approved by a physician.
-
-Has acute withdrawal symptoms, is at risk of withdrawal symptoms, or is incapacitated
-due to a substance use disorder.
-
-F.
-
-Facilities shall not admit an individual diagnosed with a developmental disability unless he/she
-has a mental health disorder and has been diagnosed using the most current diagnostic and
-statistical manual of mental disorders, and whose behaviors can be managed and/or modified by
-facility staff during the designated length of stay, and whose behaviors will not endanger the
-safety of the individual, staff or other individuals.
-
-G.
-
-The facility shall maintain a current list of individuals and their assigned room.
-
-21.290.52
-
-Acknowledgements and Disclosures [Eff. 11/1/13]
-
-There shall be written evidence of consent to treat as outlined in Section 21.170.4 and the following upon
-admission to the individual or individual’s legal representative, as appropriate:
-A.
-
-Acknowledgements shall specify the understanding between the parties regarding, at a minimum:
-1.
-
-Charges;
-
-2.
-
-Services included in the rates and charges;
-
-3.
-
-Types of services provided by the facility, those services which are not provided, and
-those which the facility will assist the individual in obtaining;
-
-4.
-
-Transportation services;
-
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-Behavioral Health
-
-B.
-
-2 CCR 502-1
-
-5.
-
-Therapeutic diets;
-
-6.
-
-A physically safe and sanitary environment;
-
-7.
-
-Personal services;
-
-8.
-
-Protective oversight;
-
-9.
-
-Social and recreational activities; and,
-
-10.
-
-A provision that the facility must give individuals thirty (30) calendar days’ notice of
-closure.
-
-Disclosure to individuals shall include:
-1.
-
-Management of personal funds and property;
-
-2.
-
-Facility rules, established pursuant to Section 21.290.53;
-
-3.
-
-Staffing levels based on individual needs;
-
-4.
-
-Types of daily activities, including examples of such activities that will be provided.
-
-21.290.53
-
-Facility Rules [Eff. 11/1/13]
-
-The facility shall establish written policies, which shall list all possible actions that may be taken by the
-facility if any policy is knowingly violated by an individual. Facility policies may not violate or contravene
-any rule herein, or in any way discourage or hinder an individual’s rights.
-The facility shall prominently post its policies in writing, which shall be available at all times to individuals.
-Such policies shall address at least the following:
-A.
-
-Smoking;
-
-B.
-
-Cooking;
-
-C.
-
-Visitors;
-
-D.
-
-Telephone usage including frequency and duration of calls;
-
-E.
-
-Use of common areas, including the use of television, radio;
-
-F.
-
-Consumption of alcohol and/or illicit drugs;
-
-G.
-
-Dress;
-
-H.
-
-Pets, which shall not be allowed in the facility; however, in no event shall such rules prohibit
-service or guide animals.
-
-21.290.54
-
-Content of Record [Eff. 11/1/13]
-
-Records shall include Section 21.190.2, Content of Records, and the following:
-A.
-
-Demographic and medical information;
-
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-
-B.
-
-2 CCR 502-1
-
-A cover sheet to contain the following information:
-1.
-
-Individual’s full name, including maiden name if applicable;
-
-2.
-
-Individual’s sex, date of birth, marital status and social security number, where needed
-for Medicaid or employment purposes;
-
-3.
-
-Individual’s current address of residence;
-
-4.
-
-Date of admission;
-
-5.
-
-Name, address and telephone number of relatives or legal representative(s), or other
-individual(s) to be notified in an emergency;
-
-6.
-
-Name, address and telephone number of individual’s primary physician, and case
-manager if applicable, and an indication of religious preference, if any, for use in
-emergency;
-
-7.
-
-Individual’s diagnoses, at the time of admission;
-
-8.
-
-Current record of the individual’s allergies;
-
-C.
-
-Medication administration record;
-
-D.
-
-Physician’s orders.
-
-21.290.55
-
-Service Planning [Eff. 11/1/13]
-
-The facility shall develop and implement a written service plan in accordance with Section 21.190.4 and
-include the following:
-A.
-
-An initial written safety and stabilization plan for each individual detailing risk issues and the
-stabilization process resulting in discharge shall be completed at the time of admission.
-
-B.
-
-Within twenty four (24) hours of admission, an individualized service plan for each individual shall
-be written and shall include, but not be limited to:
-1.
-
-Special dietary instructions, if any;
-
-2.
-
-Any physical or cognitive limitations; and,
-
-3.
-
-A description of the services which the facility will provide to meet the needs identified in
-the comprehensive assessment.
-
-C.
-
-The individual may request a modification of the services identified in the service plan at any time.
-
-D.
-
-The individual and his/her service plan shall be reassessed on an ongoing basis to address
-significant changes in the individual’s physical, behavioral, cognitive and functional condition, and
-identify the services that the facility shall provide to address the individual’s changing needs. The
-service plan shall be updated to reflect the results of the reassessment.
-
-21.290.56
-A.
-
-Discharge [Eff. 11/1/13]
-
-An individual shall be discharged for one or more of the following reasons:
-
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-Behavioral Health
-
-B.
-
-C.
-
-1.
-
-When the facility cannot protect the individual from harming him or herself or others;
-
-2.
-
-When the facility is no longer able to meet the individual’s identified needs;
-
-3.
-
-When the individual is no longer in need of this level of care; or,
-
-4.
-
-Failure of the individual to comply with facility rules, which contain notice that discharge
-may result from violation of same.
-
-Notice of discharge shall be provided to the individual or individual’s legal representatives as
-follows:
-1.
-
-At least twenty-four (24) hours in advance of discharge or transfer, in accordance with the
-rules governing the care and treatment of persons with a mental health disorder in
-Sections 21.280.7 and 21.280.8.
-
-2.
-
-In cases of a medical or psychiatric emergency, the emergency contact shall be notified
-as soon as possible.
-
-Discharge shall be coordinated with the individual, and, with permission, the individual’s family,
-legal representative, or appropriate agency.
-
-21.290.57
-
-Medication
-
-21.290.571
-
-Storage, Disposition, and Disposal [Eff. 11/1/13]
-
-A.
-
-2 CCR 502-1
-
-Storage and Disposition
-1.
-
-All personal medication must be surrendered to the facility to be logged in and stored by
-the facility. Individuals are not allowed to self-administer medication in the facility.
-
-2.
-
-Personal medication shall be returned to the individual or individual’s legal
-representative, upon discharge or death, except that return of medication to the individual
-may be withheld if specified in the individual’s service if a physician or other authorized
-medical practitioner has determined that the individual lacks the decisional capacity to
-possess or administer such medication safely.
-
-3.
-
-Medications shall be labeled with the individual’s full name, pursuant to Article 42.5 of
-Title 12.
-
-4.
-
-Any medication container that has a detached, excessively soiled or damaged label shall
-be returned to the issuing pharmacy for re-labeling or disposed of appropriately.
-
-5.
-
-All medication shall be stored in a manner that ensures the safety of all individuals.
-
-6.
-
-Medication shall be stored in a central location, including refrigerators, and shall be kept
-under lock and shall be stored in separate or compartmentalized packages, containers,
-or shelves for each individual in order to prevent intermingling of medication.
-
-7.
-
-Individuals shall not have access to medication that is kept in a central location.
-
-8.
-
-Medications that require refrigeration shall be stored separately in locked containers in
-the refrigerator. If medication is stored in a refrigerator dedicated to that purpose, and the
-refrigerator is in a locked room, then the medications do not need to be stored in locked
-containers.
-
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-
-9.
-B.
-
-2 CCR 502-1
-
-Prescription and over the counter medication shall not be kept in stock or bulk quantities,
-unless such medication is administered by a licensed medical practitioner.
-
-Disposal
-1.
-
-The return of medication shall be documented by the facility.
-
-2.
-
-Medication that has a specific expiration date shall not be administered after that date
-and shall be disposed of appropriately.
-
-21.290.572
-
-Administration of Medication [Eff. 11/1/13]
-
-Facilities shall follow psychiatric medication standards as outlined in Section 21.280.32 and the following:
-A.
-
-To be qualified to administer medication, an individual shall be a licensed practical nurse,
-registered nurse, physician, physician’s assistant, or pharmacist.
-
-B.
-
-Only a licensed nurse may accept telephone orders for medication from a physician or other
-authorized practitioner. All telephone orders shall be evidenced by a written and signed order and
-documented in the individual’s record and the facility’s medication administration record.
-
-C.
-
-These rules apply to medications and treatment which do not conflict with state law and
-regulations pertaining to acute treatment units and which are within the scope of services
-provided by the facility, as outlined in the individual agreement or the facility rules.
-
-D.
-
-The facility shall be responsible for complying with physician orders associated with the
-administration of medication or treatment. The facility shall implement a system that obtains
-clarification from the physician, as necessary and documents that the physician:
-1.
-
-Has been asked whether refusal of the medication or treatment should result in physician
-notification.
-
-2.
-
-Has been notified, where such notification is appropriate.
-
-3.
-
-Has provided documentation of such notification shall be made in the individual’s clinical
-record.
-
-4.
-
-Coordinates with external providers or accepts responsibility to perform the care using
-facility staff.
-
-5.
-
-Trains staff regarding the parameters of the ordered care as appropriate.
-
-6.
-
-Documents the delivery of the care, including refusal by the individual, of the medication
-or treatment.
-
-21.290.58
-
-Administration of Oxygen [Eff. 11/1/13]
-
-Individuals may administer oxygen, if the individual is able to manage the administration himself or herself
-and staff shall assist with the administration as needed for safety, when prescribed by a physician and if
-the facility follows appropriate safety requirements regarding oxygen herein.
-A.
-
-Oxygen tanks shall be secured upright at all times to prevent falling over and secured in a
-manner to prevent tanks from being dropped or from striking violently against each other.
-
-B.
-
-Tank valves shall be closed except when in use.
-
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-
-2 CCR 502-1
-
-C.
-
-Transferring oxygen from one container to another shall be conducted in a well-ventilated room
-with the door shut. Transfer shall be conducted by a trained staff member or by the individual for
-whom the oxygen is being transferred, if the individual is capable of performing this task safely.
-When the transfer is being conducted, no individual, except for an individual conducting such
-transfer, shall be present in the room.
-
-D.
-
-Tanks and other oxygen containers shall not be exposed to electrical sparks, cigarettes or open
-flames.
-
-E.
-
-Tanks shall not be placed against electrical panels or live electrical cords where the cylinder can
-become part of an electric circuit.
-
-F.
-
-Tanks shall not be rolled on their side or dragged.
-
-G.
-
-Smoking shall be prohibited in rooms where oxygen is used or stored. Rooms in which oxygen is
-used shall be posted with a conspicuous “no smoking” sign.
-
-H.
-
-Tanks shall not be stored near radiators or other heat sources. If stored outdoors, tanks shall be
-protected from weather extremes and damp ground to prevent corrosion.
-
-21.300 LICENSING OF SUBSTANCE USE DISORDER PROGRAMS USING CONTROLLED
-SUBSTANCES
-21.300.1
-
-DEFINITIONS
-
-“Administer” means the direct application of a controlled substance, whether by injection, inhalation,
-ingestion or any other means to the body of an individual.
-“Approved Private Treatment Facility” means a private agency meeting the definition set forth in Section
-27-81-102(2), C.R.S., and standards prescribed and approved under Section 27-81-106, C.R.S., and
-shall be referred to as “approved treatment facility”.
-“Approved Public Treatment Facility” means an agency operating under the direction and control of or
-approved by the Department and meeting the definition set forth in Section 27-81-102(3), C.R.S., and
-standards prescribed and approved under Section 27-81-106, C.R.S., and shall be referred to as
-“approved treatment facility.”
-“Compound” means to produce or create by combining two or more substances.
-“Controlled Substance” means a drug whose general availability is restricted or any substance that is
-strictly regulated or outlawed because of its potential for abuse or dependence. Controlled substances
-include narcotics, stimulants, depressants, hallucinogens, and cannabis.
-“Corrective Action” means a time limited remedial measure applied to agencies that are out of compliance
-during a two year licensing period.
-“Critical Incident” means a significant event or condition, which may be of public concern, which
-jeopardizes the health, safety, and/or welfare of staff and/or individuals including individual deaths on or
-off agency premises and theft or loss of controlled substances prescribed for individuals and dispensed,
-administered, and/or monitored by licensed agencies.
-
-440
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-CODE OF COLORADO REGULATIONS
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-
-2 CCR 502-1
-
-“DATA 2000 Waiver” means the federal waiver allowing qualified practitioners to use buprenorphine
-products for the treatment of opioid use disorders. The DATA 2000 Waiver is issued pursuant to the
-registration requirements of the Controlled Substance Act found at 21 U.S.C. § 823(g)(2) (November
-2020), which is hereby incorporated by reference. No later editions or amendments are incorporated.
-These regulations are available at no cost from the U.S. Department of Health & Human Services,
-Substance Abuse & Mental Health Services Administration, Office of Communications, 5600 Fishers
-Lane, Rockville, MD 20857 or at https://uscode.house.gov/. These regulations are also available for
-public inspection and copying at the Colorado Department of Human Services, Office of Behavioral
-Health, 3824 West Princeton Circle, Denver, Colorado 80236, during regular business hours.
-“Department” means the Colorado Department of Human Services.
-“Dispense” means to interpret, evaluate, and implement a prescription drug order or chart order, including
-the preparation of a drug for an individual in a suitable container appropriately labeled for subsequent
-administration to or use by an individual.
-“Diversion” means the transfer of any controlled substance from a licit to an illicit channel of distribution or
-use.
-“Individual” means any individual who receives a controlled substance for the purpose of substance use
-disorder treatment or to treat withdrawal symptoms of a substance use disorder.
-“Maintenance Treatment” means the dispensing of a controlled substance, such as methadone or
-buprenorphine, at stable dosage levels for a period in excess of twenty-one (21) days in the supervised
-treatment of an individual for opioid use disorder.
-“Medication Assisted Treatment” means any treatment for a substance use disorder that includes giving a
-controlled substance for medical detoxification or maintenance treatment, which may be combined with
-other treatment services including medical, and shall be combined in all circumstances with psychosocial
-services.
-“Medical Detoxification” means the process through which a person who is physically dependent on
-alcohol, illicit drugs, prescription medications, or a combination of these substances is over a period of
-time withdrawn from the substances of dependence and the process may include the use of controlled
-substances to alleviate the symptoms of withdrawal under the supervision of a licensed practitioner.
-“Office-based opioid treatment” or “OBOT” means the prescribing of buprenorphine products for the
-treatment of opioid use disorders by a federally authorized (DATA 2000 Waiver) primary care or general
-health care provider outside of programs required to be licensed pursuant to 27-80-200, et seq., C.R.S.
-“Physical Dependence” means a state of adaptation that is manifested by a drug class specific withdrawal
-syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the
-drug, and/or administration of an antagonist.
-“Practitioner” means:
-A.
-
-A physician or other person licensed, registered or otherwise permitted to distribute, dispense, or
-to administer a controlled substance in the course of professional practice.
-
-B.
-
-A pharmacy, hospital or other institution licensed, registered, or otherwise permitted to distribute,
-dispense, or to administer a controlled substance in the course of its professional practice in this
-state.
-
-“Substance use disorder” shall have the same meaning as defined in Section 27-80-203(23.3), C.R.S.
-
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-
-2 CCR 502-1
-
-“Ultimate User” means an individual who lawfully possesses a controlled substance for the individual's
-own use or for the use of a member of the individual's household.
-21.300.2
-
-CONTROLLED SUBSTANCE LICENSE REQUIREMENTS
-
-A.
-
-Agencies shall apply for and obtain a controlled substance license if they dispense, compound, or
-administer (pursuant to Section 27-80-204, C.R.S.) a controlled substance in order to treat a
-substance use disorder or to treat the withdrawal symptoms of a substance use disorder. All
-applicants for a controlled substance license shall demonstrate compliance with these rules and
-all applicable state and federal statutes and regulations including, but not limited to those
-pertaining to controlled substances.
-
-B.
-
-An office-based opioid treatment (OBOT) provider that does not dispense, compound, or
-administer a controlled substance on-site is not required to obtain a controlled substance license
-pursuant to this rule section 21.300.2.
-
-21.300.21
-
-Licensing Procedures
-
-Treatment facilities meeting all the requirements of Colorado Revised Statutes Title 12, Article 280, Part
-1; Title 18, Article 18, Part 3; Section 27-81-106, C.R.S.; the requirements of the controlled substance
-license rules; and, all applicable state and federal regulations including those that apply to controlled
-substances shall be issued a controlled substance license.
-A.
-
-A controlled substance license issued by the Department shall be obtained annually for each
-approved treatment facility that dispenses, compounds, or administers a controlled substance to
-treat substance use disorders or the withdrawal symptoms of a substance use disorder.
-
-B.
-
-A separate controlled substance license is required for each approved treatment facility site
-where controlled substances are dispensed, compounded, or administered, in order to treat
-substance use disorders or the withdrawal symptoms of a substance use disorder.
-
-C.
-
-Any approved treatment facility that receives a controlled substance license may dispense,
-compound, or administer controlled substances only to the extent authorized by their license and
-in conformity with Colorado Revised Statutes Title 12, Article 280, Part 1 and Title 18, Article 18.
-
-D.
-
-Routine monitoring: controlled substance licensing visits shall be scheduled and conducted by the
-Department during the approved agencies' normal business hours to the extent possible.
-
-E.
-
-The Department shall conduct unscheduled site visits for specific monitoring purposes and
-investigation of complaints or critical incidents involving approved agencies that have a controlled
-substance license. These unscheduled visits shall be in accordance with the:
-
-F.
-
-1.
-
-Controlled substance license rules;
-
-2.
-
-Department policies and procedures;
-
-3.
-
-Department substance use disorder treatment rules;
-
-4.
-
-Any statutes and regulations that protect the confidentiality of individual identifying
-information.
-
-The Department shall have access to all individual, agency, and staff records and any other
-relevant documentation required to determine compliance with these rules and to coordinate
-individual placement and care.
-
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-
-G.
-
-2 CCR 502-1
-
-A controlled substance license shall not be granted to an agency unless there is documentation
-that the medical director or health care practitioner dispensing, compounding or administering
-controlled substances has not been convicted within the last two (2) years of a willful violation of
-Title 12, Article 280, Part 1 of the Colorado Revised Statutes or any other state or federal law
-regulating controlled substances.
-
-21.300.22
-
-Initial License
-
-Applicants for an initial controlled substance license to dispense, compound, or administer controlled
-substances to treat a substance use disorder or to treat the withdrawal symptoms of a substance use
-disorder shall submit a controlled substance license application that has been affirmed and signed by a
-physician, a copy of current policies and procedures addressing the use of controlled substances to treat
-substance use disorders or withdrawal symptoms of a substance use disorder, and the application fee of
-five hundred dollars ($500).
-A.
-
-No approved treatment facility that is required to be licensed shall engage in any activity for which
-a controlled substance license is required until the facility's application is granted and a license is
-issued to the facility by the Department.
-
-B.
-
-Initial controlled substance license applications received by the Department that are not
-completed according to instructions, do not include the application fee, or do not include the
-required policies and procedures shall be returned to the applicant by certified mail with the
-submitted application fee and a written explanation as to why their application is being returned.
-
-C.
-
-The Department shall review complete initial applications that have the required fee and
-appropriate policies and procedures and the Department shall conduct an on-site inspection to
-determine that the applicant is in compliance with these controlled substance license rules,
-treatment rules, and all state and federal statutes and regulations. If the Governor or local
-government declares an emergency or disaster the Department has discretion to modify the
-requirement for on-site inspections. If the Department modifies the requirement for on-site
-inspections, the requirement shall only be modified as necessary because of circumstances
-related to the disaster or emergency.
-
-D.
-
-Initial applicants that have submitted satisfactory policies and procedures and other required
-documentation shall be granted a six (6) month provisional license.
-
-E.
-
-The Department may conduct a site visit to determine that the provisionally licensed agency is in
-compliance with these controlled substance license rules, treatment rules, and all state and
-federal statutes and regulations. If after the first provisional license an agency has not
-demonstrated full compliance, a second six (6) month provisional license may be granted if
-substantial progress continues to be made, and it is likely compliance can be achieved by the
-date of expiration of the second provisional license. If at the end of the first provisional license an
-agency demonstrates compliance, a full controlled substance license shall be issued.
-
-F.
-
-The Department shall conduct a site visit to determine compliance with all applicable state and
-federal laws and regulations at the end of the second provisional license period. If at the end of
-the second provisional license an agency demonstrates compliance, a full controlled substance
-license shall be issued.
-
-G.
-
-An applicant for licensure pursuant to these rules and regulations shall also be considered an
-applicant for registration pursuant to Section 18-18-302, Colorado Revised Statutes.
-
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-H.
-
-2 CCR 502-1
-
-Initial applicants that are found not to be in full compliance shall have their license applications
-returned by certified mail with a written explanation as to why their application is being returned
-and notification that their controlled substance license application has been denied as of ten (10)
-days from the date the denial letter was mailed. Application fees shall not be refunded. If an
-applicant disagrees with the decision, s/he may appeal (see Section 21.105); or upon remedying
-the noted deficiencies, may re-apply for an initial license in accordance with Section 21.300 of
-these rules.
-
-21.300.23
-
-License Renewal
-
-A controlled substance license shall expire one year from the date the license is granted.
-A.
-
-Agencies wishing to continue their controlled substance license shall submit a license renewal
-application to the Department thirty (30) days prior to the expiration date of their current controlled
-substance license along with the required fee of five hundred dollars ($500). A copy of the
-licensee’s DEA narcotic treatment program registration and SAMHSA accreditation or certification
-as applicable shall also be submitted with each annual renewal application for this program type.
-
-B.
-
-Any treatment facility that currently has a controlled substance license issued by the Department
-may not apply for renewal more than sixty days before the expiration date of the current
-controlled substance license.
-
-C.
-
-A controlled substance license renewal application that is received by the Department fewer than
-thirty (30) calendar days prior to the expiration of their existing license may fail to receive their
-new license prior to the expiration of their existing license. An agency that submits its renewal
-application fewer than thirty (30) days prior to the expiration of the current license and does not
-receive a new license prior to the current license expiration may reapply for an initial license in
-accordance with section 21.300 of these rules.
-
-D.
-
-A controlled substance license renewal application that is received by the Department after the
-current license expiration date shall be returned by certified mail with written notification that the
-license is no longer in effect. Applicants may reapply for an initial license in accordance with
-section 21.300 of these rules.
-
-E.
-
-If the Governor or local government declares an emergency or disaster the Department has
-discretion to modify the requirement for on-site inspections. If the Department modifies the
-requirement for on-site inspections, the requirement shall only be modified as necessary because
-of circumstances related to the disaster or emergency.
-
-F.
-
-A licensee that is in full compliance shall be granted renewal of their annual controlled substance
-license that shall be effective for one year from the prior license’s expiration date.
-
-21.300.24
-
-Probationary License
-
-A.
-
-At the Department’s discretion, a probationary license may be issued to an agency out of
-compliance with applicable Department, state or federal regulations prior to issuance of a renewal
-license or during a current license term. the agency will be notified in writing of non-compliance
-areas and the need for a plan of action (see Section 21.120.6).
-
-B.
-
-A probationary license will replace the current license for a period not to exceed ninety (90)
-calendar days.
-
-C.
-
-Administrative and treatment activities may be limited by a probationary license while the agency
-addresses corrective actions.
-
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-
-D.
-
-A second probationary license may be issued for a period not to exceed ninety (90) calendar
-days if substantial progress continues to be made and it is likely that compliance can be achieved
-by the date of expiration of the second probationary license.
-
-E.
-
-If the licensee fails to comply with or complete a plan of action in the time or manner specified, or
-is unwilling to consent to the probationary license, the Department shall revoke the license and
-the agency shall be notified by certified mail that the agency's license is revoked as of ten (10)
-days from the date the letter was mailed. If an agency disagrees with the decision, the agency
-may appeal (see Section 21.105).
-
-F.
-
-Upon remedying the noted deficiencies, an agency may re-apply for an initial license in
-accordance with Section 21.300.22 of these rules.
-
-21.300.25
-A.
-
-License Denial, Revocation, or Suspension
-
-A controlled substance license may be denied, suspended, or revoked in accordance with
-Section 21.120.8 and upon finding that the licensee:
-1.
-
-Is not in compliance with the controlled substance license rules;
-
-2.
-
-Has violated any provision of Title 12, Article 280, Part 1, and Title 18, Article 18 of the
-Colorado Revised Statutes;
-
-3.
-
-Has failed to implement the Department imposed corrective actions;
-
-4
-
-Has been negligent resulting in risk to individual and/or staff health or safety;
-
-5.
-
-Has failed to provide for adequate supervision of treatment staff as outlined in addiction
-counselor certification and licensure standards (Section 21.330);
-
-6.
-
-Has furnished false or fraudulent information in an application;
-
-7.
-
-Has, as a practitioner, been convicted of, or has had accepted by a court a plea of guilty
-or nolo contendere to a felony under any state or federal law relating to a controlled
-substance;
-
-8.
-
-Has had their federal registration to manufacture, conduct research on, distribute, or
-dispense a controlled substance suspended or revoked.
-
-B.
-
-The Department may limit revocation or suspension of a controlled substance license to the
-particular controlled substance, which was the basis for revocation or suspension.
-
-C.
-
-If the Department denies, suspends or revokes a controlled substance license, all controlled
-substances owned or possessed by the licensee at the time of the denial or suspension or on the
-effective date of the revocation order may be placed under seal. No disposition may be made of
-substances under seal until the time for making an appeal has elapsed or until all appeals have
-concluded unless a court orders otherwise or orders the sale of any perishable controlled
-substances and the deposit of the proceeds with the court. Upon a revocation order’s becoming
-final, all controlled substances may be forfeited to the state.
-
-D.
-
-The Department shall promptly notify the Drug Enforcement Administration and the appropriate
-professional licensing agencies, if any, of all charges and the final disposition thereof and of all
-forfeitures of a controlled substance.
-
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-21.300.3
-A.
-
-2 CCR 502-1
-
-MEDICATION ASSISTED TREATMENT PROVISIONS
-
-Agency Policies and Procedures
-Agencies shall develop and implement policies and procedures, as defined in this section that
-address the use of controlled substances in the treatment of substance use disorders or the
-withdrawal symptoms of a substance use disorder. These policies shall include, but are not
-limited to, how individuals are assessed to be appropriate to receive a controlled substance to
-treat their SUD or the withdrawal symptoms of a substance use disorder. These policies shall
-meet the requirements of all federal, state, and local laws pertaining to controlled substances.
-
-B.
-
-Medication assisted treatment using a controlled substance shall be provided to individuals who
-are physically dependent on alcohol, illicit drugs, prescription medications, or a combination of
-these substances to alleviate the individual’s physical withdrawal symptoms and cravings, to help
-stabilize behavior, to increase productivity, and to reduce the risk of contracting and transmitting
-infectious diseases.
-
-C.
-
-Approved agencies shall only dispense, compound, or administer, controlled substances by or on
-the order of a physician who currently possesses and maintains a license to practice medicine in
-the State of Colorado as provided by Article 240, Title 12, C.R.S. The physician’s medical order
-shall be documented in the individual’s treatment record.
-
-D.
-
-Approved agencies that dispense, compound, or administer, controlled substances must also
-have a current registration from the Drug Enforcement Administration.
-
-E.
-
-All controlled substances shall be dispensed, compounded, or administered, according to
-applicable state and federal statutes, regulations and rules, controlled substance license rules,
-and Department rules.
-
-F.
-
-Controlled substances shall be dispensed, compounded, or administered, in accordance with the
-manufacturer’s specifications found on product labels and/or in printed instructions accompanying
-the product.
-
-G.
-
-Licensees shall maintain an individual dispensing record on each individual that receives
-controlled substances at their facility. The dispensing record shall include:
-
-H.
-
-1.
-
-Complete name of individual receiving the controlled substance;
-
-2.
-
-Name of the controlled substance, strength, and dosage form;
-
-3.
-
-Amount consumed;
-
-4.
-
-Amount dispensed;
-
-5.
-
-Date dispensed;
-
-6.
-
-Amount and dosage form taken home by individual (if applicable);
-
-7.
-
-First initial and last name and the credentials of the individual who dispensed the
-controlled substance medication.
-
-Licensees shall ensure that all personnel are working within their scope of practice and shall only
-allow licensed medical personnel to dispense, compound, or administer, controlled substances.
-
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-
-I.
-
-Each approved treatment facility shall provide formal training and testing on an annual basis to all
-employees on the Department’s rules, the pharmacology of the substances dispensed and state
-and federal requirements regarding controlled substances and confidentiality.
-
-J.
-
-Critical Incident Reporting
-In addition to the provisions of Section 21.140, theft, loss, or diversion of a controlled substance
-shall also be considered a critical incident and the Department critical incident reporting policy
-shall be followed. The Department must be notified verbally within twenty-four (24) hours of the
-critical incident and a written report must be submitted to the Department within three (3)
-business days.
-
-21.300.4
-
-MEDICAL EVALUATIONS
-
-Individuals who wish to receive medication assisted treatment shall have medical evaluations conducted
-by a physician, physician's assistant, or nurse practitioner to determine physical dependence and to
-determine that such individuals are appropriate for treatment with a controlled substance. Evaluations
-shall include, but are not limited to:
-A.
-
-A medical history that includes a detailed and comprehensive account of substance use history
-that includes all substances of abuse;
-
-B.
-
-Evidence of current physiological dependence; and,
-
-C.
-
-A pregnancy screen for females of childbearing age.
-
-21.300.5
-
-INFORMED CONSENT
-
-All individuals receiving medication assisted treatment shall sign informed consent that they are
-voluntarily agreeing to treatment with a controlled substance. The individual shall be informed of what
-controlled substance they are receiving and the expected benefits and risks of medication assisted
-treatment. All individuals receiving controlled substances must also be informed of the risks of using other
-substances in combination with a controlled substance.
-21.300.6
-
-SECURITY CONTROLS AND OPERATING PROCEDURES
-
-All licensees must follow the standards of physical security controls and operating procedures required by
-the federal Drug Enforcement Administration necessary to prevent diversion as outlined in Title 21, Food
-and Drugs, Chapter II, Code of Federal Regulations, Sections 1301.71 through 1301.77 (November
-2020), which are hereby incorporated by reference. No later editions or amendments are incorporated.
-These regulations are available at no cost from the U.S. Department of Justice, Drug Enforcement
-Administration, Office of Diversion Control, 2401 Jefferson Davis Highway, Alexandria, VA 22301; or, the
-Colorado Department of Human Services, Office of Behavioral Health, 3824 West Princeton Circle,
-Denver, Colorado 80236; or at any state publications depository library, during regular business hours.
-21.300.7
-
-RECORD KEEPING
-
-Licensees shall follow the record keeping requirements of the federal Drug Enforcement Administration,
-Code of Federal Regulations (Title 21, Food and Drugs, Part 1304) to ensure compliance with the
-requirements in Title 12, Article 280, Part 1, C.R.S. (November 2020), which are hereby incorporated by
-reference. No later editions or amendments are incorporated. These regulations are available at no cost
-from the U.S. Department of Justice, Drug Enforcement Administration, Office of Diversion Control, 2401
-Jefferson Davis Highway, Alexandria, VA 22301; or the Colorado Department of Human Services, Office
-of Behavioral Health, 3824 West Princeton Circle, Denver, Colorado 80236; or at any state publications
-depository library, during regular business hours.
-
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-
-Licensees shall also keep inventories, records, and reports that are required by any other state or federal
-law or standard regulating controlled substances.
-21.300.8
-
-HANDLING AND STORAGE
-
-All licensees shall have adequate and proper facilities for the handling and storage of controlled
-substances. All licensees must maintain proper control over such controlled substances to ensure against
-their being illegally dispensed or distributed. Access to the storage area shall be restricted to individuals
-specifically authorized to handle controlled substances. This includes restricting the number and
-accessibility of keys or passwords.
-Licensees shall also develop and implement policies on how controlled substances will be obtained,
-stored, and accounted for. These policies shall include, but are not limited to:
-A.
-
-What controlled substance the licensee will be using for the substance use disorder they are
-treating and how these controlled substances will be dispensed, compounded, or administered,
-as well who will be responsible for ordering the controlled substances;
-
-B.
-
-Where the controlled substances will be stored;
-
-C.
-
-How the controlled substances will be accounted for; and,
-
-D.
-
-Who will have access to the controlled substances.
-
-21.300.9
-
-TOXICOLOGY SCREENING REQUIREMENTS
-
-Licensees shall develop and implement toxicology screen policies and procedures that specify a random
-sample collection protocol and these policies shall include, but not be limited to:
-A.
-
-How appropriate and approved samples for drug testing shall be collected and analyzed in
-accordance with applicable state and federal statutes and regulations.
-
-B.
-
-How toxicology screens shall be used to detect the presence of the approved controlled
-substance, that is being dispensed, and its metabolite, for which laboratory analyses are
-available.
-
-C.
-
-How all individuals entering medication assisted treatment shall provide a toxicology screen at
-time of admission and then as clinically indicated throughout the treatment episode.
-
-D.
-
-How a licensee shall address an individual having illicit substances in a toxicology screen,
-including unauthorized prescription medication:
-
-21.310 [Repealed eff. 10/01/2020]
-
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-
-21.320 OPIOID TREATMENT PROGRAMS (OTP)
-21.320.1
-
-DEFINITIONS
-
-“21 C.F.R. Part 1300, 1301, AND 1304” means the federal regulations issued by the Drug Enforcement
-Administration of the U.S. Department of Justice found at 21 C.F.R. Part 1301, 1302, and 1304 (Oct.
-2021), which are hereby incorporated by reference. No later editions or amendments are incorporated.
-These regulations are available at no cost from the U.S. Department of Justice, Drug Enforcement
-Administration, Liaison and Policy Section, 8701 Morrissette Drive, Springfield, VA 22152 or at
-https://www.ecfr.gov/. These regulations are also available for public inspection and copying at the
-Colorado Department of Human Services, Office of Behavioral Health, 3824 West Princeton Circle,
-Denver, Colorado 80236, during regular business hours.
-“Administrative Discharge” means a process where it has been determined that a person in OTP needs to
-be discharged immediately for reasons including but not limited to non-payment of fees, disruptive
-conduct or behavior, violent conduct or threatening behaviors, or incarceration or other confinement that
-does not permit continuation of an individual's medication-assisted treatment. The timeframe for this
-typically involves a taper at a rate set forth by the program.
-“Administrative Transfer” means a process whereby a person in OTP is determined unsafe or has violated
-a behavioral agreement and a program is looking to transfer to another clinic of the person’s choice. This
-person is to be transferred at a time frame that is determined by agreement with the other programs.
-“Authorized OTP practitioner” means a physician or advanced practice registered nurse, nurse
-practitioner, physician assistant, or pharmacist clinician with approval from SAMHSA and the state to
-operate within their scope of practice within an OTP.
-“Dilute Urinalysis” for the purposes of these rules means a creatinine level less than twenty (20)
-milligrams.
-“Guest Dosing” means a process where a person in an OTP may be able to dose at another clinic; either
-in the state, or out of state to maintain the continuity of care for their OTP.
-“Lock In” means a process where a program along with the State authority determine that a person is
-best served clinically at one program. This determines where the person is to go for their OTP.
-“Lock Out” means a process where a program along with the State authority determine that it is in a
-person's best interest to be locked out of a program due to concerns of this person not being safe to
-themselves or others in a program and/or could be a threat to that program due to diversion or other
-items.
-“OTP” means opioid treatment program.
-“Special Exception Requests” are requests that must be sent to the state authority for final approval.
-These requests are for take home bottles above and beyond what is allowed for the person who is on
-Methadone at the time of the request.
-“Take-Home Bottle” is a prescription of individually labeled bottle or bottles of Methadone that is
-determined to be allowed for each particular phase of treatment. Each bottle or bottles is labeled with
-proper required DEA information.
-“Taper” refers to when an individual is being reduced on his/her dose for any reason either of their own
-accord or due to concerns that the medical director raises. Tapers are started with a medical order and
-monitored by the medical staff.
-
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-2 CCR 502-1
-
-“Torsades de Pointes” or simply Torsades, is a French term that literally means “twisting of the spikes.” It
-refers to a specific, rare variety of ventricular tachycardia that exhibits distinct characteristics on the
-electrocardiogram (ECG).
-“Transfer” is when an individual transfers from one program to another without a break in treatment.
-21.320.2
-
-GENERAL PROVISIONS
-
-A.
-
-Opioid Treatment Programs (OTP) shall provide treatment to individuals meeting criteria for
-opioid use disorder according to the American Psychiatric Association’s Diagnostic and Statistical
-Manual of Mental Disorders, Fifth Edition (DSM-5) (2013), which is hereby incorporated by
-reference. No later editions or amendments are incorporated. You may obtain a copy of the
-American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth
-Edition (DSM-5) (2013) from the American Psychiatric Association, 1000 Wilson Boulevard,
-Arlington, VA 22209-3901. You may inspect a copy of the American Psychiatric Association’s
-Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (2013) at the
-Colorado Department of Human Services, Office of Behavioral Health, 3824 W. Princeton Circle,
-Denver, CO 80236, during regular business hours.
-
-B.
-
-Agencies applying to be licensed as an OTP shall have the following:
-1.
-
-Controlled substance license;
-
-2.
-
-Drug Enforcement Administration (DEA) registration;
-
-3.
-
-Substance Use and Mental Health Services Administration (SAMHSA) certification; and,
-
-4.
-
-Federal accreditation, when applicable.
-
-C.
-
-Agencies shall provide admission to pregnant individuals within forty-eight (48) hours of request
-for services or provide interim services until an admit date is available.
-
-D.
-
-Agencies shall not detoxify pregnant individuals receiving methadone or other approved
-controlled substances without the approval of the Office of Behavioral Health.
-
-21.320.21
-
-MOBILE OPIOID TREATMENT UNITS
-
-A.
-
-As used in this rule, “mobile opioid treatment unit” has the same meaning as “mobile narcotic
-treatment program” as used in 21 C.F.R. Part 1300.01.
-
-B.
-
-OTPs utilizing mobile opioid treatment units shall follow all applicable state and federal
-regulations including, 21 C.F.R. Part 1300, 1301, and 1304.
-
-C.
-
-OTPs are not required to obtain a separate substance use disorder license or controlled
-substance license for mobile opioid treatment units.
-
-D.
-
-OTPs shall develop the following plans for mobile opioid treatment units:
-1.
-
-Staffing plan;
-
-2.
-
-Security plan;
-
-3.
-
-Contingency plans for mobile opioid treatment unit closure including but not limited to,
-adverse weather events, human-induced disasters, and unit breakdown; and,
-
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-
-4.
-E.
-
-2 CCR 502-1
-
-Vehicle maintenance plan.
-
-Mobile opioid treatment units shall comply with reporting requirements determined by the
-Department pursuant to Section 21.130.
-
-21.320.3
-
-ADMINISTRATIVE AND MEDICAL RESPONSIBILITY
-
-21.320.31
-
-OTP Sponsors
-
-OTP sponsors are responsible for the following:
-A.
-
-B.
-
-Overall operation of the program including, but not limited to:
-1.
-
-Compliance with all applicable state and federal laws, rules, and regulations;
-
-2.
-
-Medical and counseling personnel are qualified to provide opioid replacement treatment;
-
-3.
-
-Individuals are enrolled on their own volition;
-
-4.
-
-Full disclosure is made to individuals about opioids and their use in treatment.
-
-5.
-
-Written, informed consents for opioid replacement treatment are signed by individuals
-eighteen (18) years of age and older;
-
-6.
-
-Written, informed consents for all aspects of opioid replacement treatment are signed by
-parents, legal guardians or other responsible adults designated by appropriate state
-authorities for individuals under age eighteen (18) years old;
-
-7.
-
-Written (OTP) policies and procedures are developed, implemented and maintained that
-are based on and in compliance with Department rules;
-
-8.
-
-All reasonable and clinically indicated efforts are made to coordinate treatment with other
-healthcare and behavioral health providers. Documentation includes obtaining
-individuals' consent to release information to communicate with those practitioners.
-
-9.
-
-Methadone and other controlled substances are disposed of in accordance with the
-federal regulations.
-
-10.
-
-Printed acknowledgements are signed by patients and kept in patient records stating that
-they have been informed of the United States Department of Transportation regulation
-against the use of OTP prescribed methadone by commercial drivers and the possible
-loss of commercial driver's license if taking methadone for an opioid use disorder is
-discovered.
-
-Training
-1.
-
-Training for new OTP staff is documented in personnel records including, but not limited
-to provisions of Section 21.160.1, A, 3, and:
-a.
-
-Federal opioid treatment program regulations;
-
-b.
-
-OTP treatment rules;
-
-c.
-
-OTP policies and procedures;
-
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-
-d.
-
-e.
-
-2.
-
-21.320.32
-
-2 CCR 502-1
-
-Clinical practices including, but not limited to:
-1)
-
-Protocols around special exception requests;
-
-2)
-
-Phase level requests; and
-
-3)
-
-Any take-home protocol such as holiday dosing, weekend dosing, hold
-doses, hospitalization of individuals, incarceration, nursing home stays,
-and guest dosing.
-
-Pharmacology of methadone including, but not limited to, loss of tolerance to
-opioids, dangerous drug or alcohol interactions, signs and symptoms of
-overdose, purpose of its use.
-
-Annual training for OTP staff including, but not limited to:
-a.
-
-Most current pharmacology of medications used, and clinical practices applicable
-to OTP, including problems with interactions of medications.
-
-b.
-
-Review of federal and state regulations and rules.
-
-c.
-
-Review of current OTP policies and procedures.
-
-d.
-
-Infectious disease risks and screening.
-
-OTP Medical Directors
-
-A.
-
-An OTP shall have designated a medical director who shall authorize and oversee other
-physicians, other appropriately licensed and/or certified medical personnel and all medical
-services provided.
-
-B.
-
-The medical director shall be available to the OTP for service provision or consultation.
-
-C.
-
-The medical director and other medical healthcare providers shall currently possess and maintain
-licenses to practice medicine/nursing in compliance with the credentialing requirements of their
-own profession in Colorado as provided by Article 240, Title 12, C.R.S. OTP medical directors
-shall assure appropriate credentials and training for other OTP physicians and other qualified
-health care providers to dispense, compound or administer a controlled substance in an OTP.
-
-D.
-
-The medical director shall complete an annual review of federal and state guidelines and rules to
-ensure that the OTP agency is in compliance with all state and federal rules and regulations
-regarding medical treatment for opioid use disorder.
-
-E.
-
-The medical director shall sign an acknowledgment of review of all controlled substance licensing
-violations.
-
-F.
-
-OTPs utilizing an authorized OTP practitioner shall have a plan that at minimum:
-1.
-
-Identifies all practitioners with prescriptive authority;
-
-2.
-
-Ensures authorized OTP practitioners with prescriptive authority have a SAMHSA
-approved mid-level exemption (MLE);
-
-3.
-
-Identifies the number of hours practitioners with prescriptive authority are onsite weekly;
-
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-
-G.
-
-H.
-
-2 CCR 502-1
-
-4.
-
-Establishes authorized OTP practitioner supervision requirements; and,
-
-5.
-
-Addresses consultation requirements for when medical directors are not onsite.
-
-OTP medical directors, other OTP physicians and authorized OTP practitioners shall ensure the
-following:
-1.
-
-Medical evaluations are completed, including evidence of current physiological
-dependence and/or history of opioid use or exceptions to admission criteria that are
-documented prior to initial dosing;
-
-2.
-
-These medical evaluations are done at admission prior to initial dose.
-
-3.
-
-The physical examinations and all appropriate laboratory tests are performed and
-reviewed within fourteen (14) calendar days following treatment admission;
-
-4.
-
-All medical professionals shall educate individuals regarding risks and benefits of OTP
-and document that individuals are entering voluntarily.
-
-5.
-
-All medical orders are properly signed or countersigned including initial orders for
-approved controlled substances and other medications, subsequent dose increases or
-decreases, changes in take-home dose privileges, emergency situations and other
-special circumstances by the medical director.
-
-Medical directors and other qualified health care professionals shall utilize the information
-obtained from the Colorado State Board of Pharmacy's electronic Prescription Drug Monitoring
-Program (PDMP), developed pursuant to 12-280-403, C.R.S., as clinically appropriate upon
-intake.
-
-21.320.4
-
-INDIVIDUAL PLACEMENTS
-
-21.320.41
-
-Admission Criteria and Procedures
-
-A.
-
-Agencies shall follow all federal requirements in accordance with 42 CFR Part 8 (2019), which
-are hereby incorporated by reference. No later editions or amendments are incorporated. These
-regulations are available at no cost from the U.S. Department of Health & Human Services,
-Substance Abuse & Mental Health Services Administration, Office of Communications, 5600
-Fishers Lane, Rockville, MD 20857 or at https://www.ecfr.gov/. These regulations are also
-available for public inspection and copying at the Colorado Department of Human Services,
-Office of Behavioral Health, 3824 West Princeton Circle, Denver, Colorado 80236, during regular
-business hours.
-
-B.
-
-Individuals shall be admitted to opioid medication assisted treatment if OTP medical directors or
-authorized OTP practitioners determine, and subsequently document in individual records, that
-such individuals are currently physiologically dependent on opioid drugs or were physiologically
-dependent on opioid drugs, continuously or episodically for most of the year immediately
-preceding admission.
-
-C.
-
-In the case of individuals for whom the exact date on which physiological dependence began
-cannot be ascertained, OTP medical directors or authorized OTP practitioners may, using
-reasonable clinical judgment, admit such individuals to opioid replacement treatment if from the
-evidence presented and recorded in individual records it is reasonable to conclude that such
-individuals were physiologically dependent on opioid drugs approximately one year prior to
-admission.
-
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-
-D.
-
-2 CCR 502-1
-
-OTP medical directors or authorized OTP practitioners may waive the one-year history of opioid
-use requirement, if clinically appropriate, for the following:
-1.
-
-Persons released from penal institutions if admitted to treatment within six (6)
-consecutive months following release;
-
-2.
-
-Pregnant individuals, if OTP physicians certify pregnancy; or
-
-3.
-
-Persons formerly receiving treatment within two (2) consecutive years after discharge.
-
-E.
-
-Persons under age eighteen (18) shall have at least two unsuccessful attempts at short-term
-detoxification or drug-free treatment documented within a twelve-month period.
-
-F.
-
-OTPs offering short-term or long-term detoxification treatment shall follow all applicable state and
-federal laws, rules and regulations regarding admission criteria.
-
-G.
-
-OTPs shall not admit persons for more than two (2) detoxification treatment episodes per year.
-
-H.
-
-At time of admission, individuals shall be oriented to OTP policies and procedures including, but
-not limited to:
-1.
-
-Benefits and risks of opioid replacement treatment.
-
-2.
-
-Fee structure and payment options. This policy shall include written acknowledgement of
-understanding from the individual. The individual will be provided with a copy of this
-document and a copy will be placed in the clinical record.
-
-3.
-
-Conditions for dosing, counseling and toxicology sample collection. The policy shall
-include provisions for holding doses, evaluation of the “impaired” individual, treatment
-stipulations and agreements, “refusal” or “inability” to provide specimens for toxicology
-testing and unacceptable/unsafe behavior that limits the individual's ability to participate
-in OTP.
-
-4.
-
-Take-home dose privilege phase system.
-
-5.
-
-Special privilege exception requests.
-
-6.
-
-Consequences for violating policies; and,
-
-7.
-
-Written procedures and signed acknowledgements around the following shall include, but
-not be limited to:
-a.
-
-Behavioral agreements;
-
-b.
-
-Office treatment lock-in;
-
-c.
-
-Office treatment lock-out;
-
-d.
-
-Reductions in take-home dose privileges;
-
-e.
-
-Administrative discharges;
-
-f.
-
-Administrative transfers;
-
-g.
-
-Guest dosing;
-
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-
-21.320.42
-
-2 CCR 502-1
-
-h.
-
-OTP transfer policy;
-
-i.
-
-Taper protocol for any and all circumstances including inability to pay;
-
-j.
-
-Hospitalization while in OTP instructions including clinic after hours information;
-
-k.
-
-Emergency procedures in case of a natural disaster, human-induced disaster, or
-emergent closing of the clinic;
-
-l.
-
-Use of Prescription Drug Monitoring Program in treatment;
-
-m.
-
-Use of other prescription medications in treatment; and,
-
-n.
-
-Provisions around conditions for dosing.
-
-Other Prescription Medications
-
-A.
-
-Individuals will bring in all personal prescription medications for review to the program.
-
-B.
-
-The program shall assess and document the appropriateness of use of personal medications.
-
-C.
-
-Programs will have a policy for the assessment of all prescription medication that an individual
-may bring in.
-
-D.
-
-Programs will make regular use of the prescription drug monitoring program as evidenced by
-documentation. In addition, they will refer to their policy on the PDMP for clinical decisions.
-
-21.320.5
-PRESCRIBING, DISPENSING, AND ADMINISTERING APPROVED CONTROLLED
-SUBSTANCES
-A.
-
-An OTP medical director or an authorized OTP practitioner shall order approved controlled
-substances and document orders in individual records.
-
-B.
-
-Exceptions to dosing regimens outlined in federal regulations shall require approval by the
-Department prior to dosing.
-
-C.
-
-Approved controlled substances shall be administered by OTPs according to manufacturer's
-specifications found on product labels and/or in printed instructions accompanying the product.
-
-D.
-
-In circumstances where individuals must be administratively withdrawn from methadone due to
-inability or unwillingness to pay treatment fees, OTPs shall provide a safe medical taper if
-necessary. Pregnant individuals shall have the option to defer payment for treatment and
-continue to receive OTP.
-
-21.320.6
-
-EVALUATIONS AND ASSESSMENTS
-
-21.320.61
-
-General Provisions
-
-A.
-
-Individuals re-admitted to treatment following treatment absences of six (6) months or more shall
-undergo medical evaluations, physical examinations, and/or laboratory tests as deemed
-appropriate by an OTP medical director or authorized OTP practitioner.
-
-B.
-
-Other medical concerns shall be addressed by OTPs or referred to other medical agencies when
-appropriate as determined by AN OTP medical director or an authorized OTP practitioner.
-
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-
-21.320.62
-
-2 CCR 502-1
-
-Medical Evaluations
-
-Individuals admitted to OTPs shall have medical evaluations conducted by a medical director, authorized
-OTP practitioner, nurse practitioner, or physician assistant prior to the first dose. Medical evaluations shall
-include, at minimum, the following:
-A.
-
-Past medical history, past substance abuse history including required chronologies of opioid use
-and dependence, choice of opioid and route of administration;
-
-B.
-
-Evidence of current physiological dependence;
-
-C.
-
-Cardiovascular assessment for the risk of Torsades de Pointes; and,
-
-D.
-
-Other co-occurring conditions.
-
-21.320.63
-
-Physical Examinations
-
-A.
-
-Thorough physical examinations shall be conducted, evaluated and documented in individual
-records by medical directors or authorized OTP practitioners practicing within their scope, within
-fourteen (14) consecutive calendar days following treatment admission and every two (2)
-consecutive years from date of admission.
-
-B.
-
-At a minimum, physical examinations shall consist of:
-1.
-
-Examinations of organ systems for possible infectious diseases and pulmonary, liver, and
-cardiac abnormalities;
-
-2.
-
-Checks for dermatologic indication of opioid use;
-
-3.
-
-Vital signs (temperature, pulse, blood pressure and respiratory rate);
-
-4.
-
-Evaluations of individuals' general appearance;
-
-5.
-
-Inspections of head, ears, eyes, nose, throat (thyroid), chest (including heart and lungs),
-abdomen, extremities, and skin (tracks, scarring, abscesses);
-
-6.
-
-Neurological assessments; altered mental status.
-
-21.320.64
-
-Laboratory Tests
-
-A.
-
-Admission laboratory tests shall be conducted either on-site or through referral, and results shall
-be evaluated and documented in individual records within fourteen (14) consecutive calendar
-days following treatment.
-
-B.
-
-Screening for the following shall be documented and laboratory tests shall be completed when
-clinically indicated:
-1.
-
-Serological test for syphilis;
-
-2.
-
-Tuberculin skin test and/or other tests for tuberculosis;
-
-3.
-
-Urine toxicology or other tests to determine current substance use;
-
-4.
-
-Complete blood count and differential;
-
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-
-C.
-
-5.
-
-Routine and microscopic urinalysis;
-
-6.
-
-Liver function tests;
-
-7.
-
-Test for Hepatitis B, C, and Delta;
-
-8.
-
-Test for HIV/AIDS.
-
-The following laboratory tests shall be conducted with consent, every two (2) consecutive years
-from date of admission when clinically indicated.
-1.
-
-Tuberculin skin test and/or other tests for tuberculosis;
-
-2.
-
-Complete blood count and differential;
-
-3.
-
-Liver function profile.
-
-21.320.7
-A.
-
-B.
-
-2 CCR 502-1
-
-TOXICOLOGY SCREENS/URINE DRUG SCREENS
-
-OTPs shall develop and implement policies and procedures that ensure a random sample
-collection protocol that minimizes falsification and limits individuals’ inability or refusal to provide
-specimens for testing.
-1.
-
-Individuals shall have no notification prior to the day they are required to give a sample.
-
-2.
-
-Individuals shall not be allowed to give a sample on days they normally attend the clinic
-unless those days are coincidentally randomly assigned sample days.
-
-OTPs shall develop and implement policies and procedures that establish treatment responses to
-the following:
-1.
-
-Evidence of unauthorized drugs in toxicology screens, including prescription medications;
-
-2.
-
-Lack of OTP-administered controlled substances in toxicology screens, including
-Suboxone;
-
-3.
-
-Dilute urine analysis;
-
-4.
-
-Use of the prescription drug monitoring program.
-
-C.
-
-Procedures for toxicology screens shall be designed and implemented to ensure random sample
-collection in accordance with requirements for each phase of take-home dose privileges.
-
-D.
-
-Toxicology screens shall occur with the following frequencies:
-1.
-
-One (1) toxicology screen at admission;
-
-2.
-
-Minimum of eight (8) annual random toxicology screens;
-
-3.
-
-An initial toxicology screen for individuals undergoing short-term detoxification;
-
-4.
-
-An initial toxicology screen and at least one (1) random toxicology screen per month for
-individuals undergoing long-term detoxification;
-
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-
-5.
-
-2 CCR 502-1
-
-At least one (1) random toxicology screen during thirty (30) day reductions in take-home
-dose privileges.
-
-E.
-
-Refusal to provide samples for toxicology screens shall be considered to be positive toxicology
-screens.
-
-F.
-
-Dilute urinalysis will be reviewed and assessed.
-
-G.
-
-The state authority will monitor drug trends and may require testing for additional substances that
-pose a risk to health and safety of individuals receiving OTP services.
-
-21.320.8
-
-TAKE-HOME DOSE PRIVILEGES
-
-21.320.81
-
-Take-Home Dose Protocols
-
-A.
-
-B.
-
-Individuals may qualify to self-administer methadone doses at locations other than OTPs if they
-meet all the criteria for each of six (6) phases of take-home dose privileges. Individuals shall
-qualify for each phase sequentially and must have the following, at minimum, in addition to length
-of time for each phase:
-1.
-
-Most recent toxicology screen is negative;
-
-2.
-
-Regular clinic attendance;
-
-3.
-
-Compliance with OTP policies and procedures;
-
-4.
-
-No known recent criminal activity;
-
-5.
-
-Competence to safely handle take-home doses;
-
-6.
-
-Absence of serious behavioral problems at the clinic;
-
-7.
-
-Stable living environment;
-
-8.
-
-Stable social relationships;
-
-9.
-
-A clinical determination of a rehabilitative benefit the patient derives from decreasing the
-frequency of clinic attendance outweighs the potential risk of diversion; and,
-
-10.
-
-Prescription drug monitoring shall be used upon transition of each phase and
-documented in the chart.
-
-In addition to items 1-10 above, the following phase requirements must be followed based on
-time in treatment and negative toxicology screens/urine drug screens:
-1.
-
-Phase 1 permits a take-home dose for Sunday and one (1) additional take-home dose
-per week on or after the first ninety (90) consecutive calendar days of treatment.
-
-2.
-
-Phase 2 permits a take-home dose for Sunday and two (2) additional take-home doses
-per week when the individual has completed four (4) or more consecutive months in
-treatment, and the most recent two (2) consecutive toxicology screens/urine drug screens
-are negative. Individuals shall receive no more than two (2) consecutive calendar days of
-take-home doses.
-
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-
-2 CCR 502-1
-
-3.
-
-Phase 3 permits a take-home dose for Sunday and three (3) additional take-home doses
-per week when the individual has completed six (6) or more consecutive months in
-treatment, and the most recent three (3) consecutive toxicology screens/urine drug
-screens are negative. Individuals shall receive no more than two (2) consecutive days of
-take-home doses.
-
-4.
-
-Individuals may qualify for Phase 4 when an individual has completed nine (9) or more
-months in treatment and the most recent four (4) consecutive toxicology screens/urine
-drug screens are negative. Phase 4 permits a take-home dose for Sunday and five (5)
-additional take-home doses per week.
-
-5.
-
-Phase 5 permits thirteen (13) take-home doses per two-week period. Individuals may
-qualify for Phase 5 when the individual has completed one (1) or more years in treatment,
-and the most recent eight (8) consecutive toxicology screens/urine drug screens are
-negative.
-
-6.
-
-Phase 6 permits twenty-eight (28) to thirty (30) take-home doses per month. Individuals
-may qualify for Phase 6 when the individual has completed two (2) or more years in
-treatment, and the most recent eight (8) consecutive toxicology screens/urine drug
-screens are negative.
-
-C.
-
-Individuals transferring from out of state must meet the Colorado state requirements for the takehome phase they are requesting.
-
-D.
-
-All phases must receive special state approval for take-outs beyond their approved week
-schedule.
-
-E.
-
-Take-home doses may be approved by OTPs for days clinics are closed, including Sundays and
-state and federal holidays.
-
-F.
-
-Take-home doses shall not be approved for individuals undergoing short-term detoxification.
-
-G.
-
-Written agreements shall be developed and implemented for individuals approved for take-home
-doses. Agreements shall be part of the service plan and shall explain the rationale for approving
-take-home dose privilege phases, stipulate dose amounts and set consequences for violating
-agreement conditions.
-
-H.
-
-Take-home doses shall be dispensed in medication containers that conform to state and federal
-poison prevention packaging requirements, including childproof lids.
-
-I.
-
-Labels shall be affixed to containers with the following information:
-
-J.
-
-1.
-
-OTP names, addresses, and telephone numbers;
-
-2.
-
-Individual names;
-
-3.
-
-Drug types;
-
-4.
-
-Dose amounts, if not physician-authorized blind doses;
-
-5.
-
-Directions for use.
-
-Take-home doses numbering six (6) or less shall be transported in a discrete and secure manner
-agreed upon by OTPs and individuals.
-
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-
-2 CCR 502-1
-
-K.
-
-Take-home doses numbering seven (7) or more shall be transported in locked containers
-constructed of rigid materials that resist tampering.
-
-L.
-
-Take-home doses shall be securely and discretely stored in a manner that reduces the risk for
-access by children and unauthorized individuals.
-
-M.
-
-OTPs shall submit and obtain Department approval for the following:
-1.
-
-Split doses with the exception of pregnant individuals;
-
-2.
-
-Take-home doses for individual detoxification lasting less than thirty (30) consecutive
-calendar days;
-
-3.
-
-Take-home doses that do not conform to take-home dose phase requirements;
-
-4.
-
-Take-home medication doses for individuals with unacceptable toxicology screen/urine
-drug screen results within the last ninety (90) calendar days;
-
-5.
-
-Take-home doses for OTP individuals admitted to extended health care agencies or
-licensed residential substance use disorder agencies.
-
-N.
-
-Individuals reporting loss or theft of take-home doses shall not be provided replacement doses or
-daily doses, until the day after the last take-home dose would have been taken, unless there are
-extenuating circumstances or medical necessity.
-
-O.
-
-OTPs shall have policies and procedures for transporting methadone or other approved
-controlled substances to individuals in residential treatment or recovery agencies that includes a
-secure plan for storage from the facility.
-
-21.320.82
-
-Reductions in Take-Home Dose Privilege Phases
-
-A.
-
-Illicit positive toxicology screens and unexcused dosing and counseling absences shall result in
-thirty-day reductions in take-home dose privilege phases.
-
-B.
-
-Positive toxicology screens during thirty-day reduction periods shall result in further reductions in
-privilege phases.
-
-C.
-
-Privilege phases for which individuals qualified prior to reductions may be sequentially restored at
-a rate of one (1) phase every thirty (30) consecutive calendar days if toxicology screens remain
-negative and all other requirements are met.
-
-21.320.9
-A.
-
-DIVERSION AND CENTRAL REGISTRY
-
-OTPs shall prevent simultaneous enrollment of individuals in more than one clinic by fully
-participating in the Department Central Registry of opioid individuals, developed pursuant to 2780-215, C.R.S.
-1.
-
-Prior to admitting applicants to treatment, OTPs shall initiate a clearance inquiry to the
-Department's Central Registry of opioid individuals by submitting applicant information in
-Department prescribed formats.
-
-2.
-
-Applicant information shall include:
-a.
-
-Name;
-
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-
-b.
-
-Date of birth;
-
-c.
-
-Proposed date of admission; and
-
-d.
-
-Other information required by the individual clearance procedure.
-
-2 CCR 502-1
-
-3.
-
-Applicants shall not be admitted to treatment when the Department's Central Registry
-shows them as currently enrolled in another OTP.
-
-4.
-
-In the event that the Central Registry is inaccessible, not functioning, or the Department
-is closed, an OTP shall contact other OTPs within their geographic area to verify an
-individual’s enrollment status.
-
-5.
-
-OTPs shall report clinic discharges to the Department's Central Registry within three (3)
-business days or immediately upon transfer.
-
-21.330 ADDICTION COUNSELOR CERTIFICATION AND LICENSURE
-21.330.1
-
-STATUTORY AUTHORITY AND APPLICABILITY
-
-A.
-
-Authority to establish the educational requirements necessary for an individual to pursue
-licensure or certification as an addiction counselor pursuant to Part 8 of Article 245 of Title 12,
-C.R.S. is provided by Sections 12-245-804(3), C.R.S. and 27-80-108(1)(e), C.R.S.
-
-B.
-
-The Department of Regulatory Agencies’ State Board of Addiction Counselor Examiners created
-pursuant to Section 12-245-802, C.R.S. is the entity responsible for issuing a license as an
-addiction counselor (LAC), a certification as an addiction specialist (CAS) or a certification as an
-addiction technician (CAT) granted an applicant meets all applicable statutory and regulatory
-requirements, including the regulatory standards established in section 21.330.
-
-21.330.2
-
-DEFINITIONS
-
-“CAS” for the purpose of this section means a Certified Addiction Specialist.
-“CAT” for the purpose of this section means a Certified Addiction Technician.
-“DORA” means the Department of Regulatory Agencies.
-“LAC” means a Licensed Addiction Counselor.
-21.330.3
-COURSE WORK AND TRAINING REQUIREMENTS FOR INDIVIDUALS PURSUING
-AN ADDICTION COUNSELOR CREDENTIAL
-21.330.31
-A.
-
-Addiction Counseling Course Work and Training
-
-In addition to the statutory requirement listed in Section 12-245-804(3.5)(a), C.R.S., an individual
-must complete nine (9) individual courses or trainings to be eligible for certification as an
-addiction technician (CAT). CAT courses or trainings shall address:
-1.
-
-General counseling theories;
-
-2.
-
-Treatment methods; and,
-
-3.
-
-Addiction counselor competencies.
-
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-
-B.
-
-C.
-
-2 CCR 502-1
-
-In addition to the statutory requirement listed in Section 12-245-804(3.5)(b), C.R.S., an individual
-must complete twenty (20) individual courses or trainings, which includes the nine (9) CAT
-trainings required pursuant to 21.330.31(a), to be eligible for certification as an addiction
-specialist (CAS). CAS courses or trainings shall address:
-1.
-
-General counseling theories;
-
-2.
-
-Treatment methods;
-
-3.
-
-Infectious diseases and substance use/misuse;
-
-4.
-
-Addiction counselor competencies; and,
-
-5.
-
-Clinical supervision.
-
-In addition to the statutory requirement listed in Section 12-245-804(1), C.R.S., an individual must
-complete seven (7) individual courses or trainings to be eligible for licensure as an addiction
-counselor (LAC). LAC courses or trainings shall addressing:
-1.
-
-General counseling theories;
-
-2.
-
-Treatment methods;
-
-3.
-
-Infectious diseases and substance use/misuse;
-
-4.
-
-Addiction counselor professional ethics; and,
-
-5.
-
-Clinical supervision.
-
-21.330.32
-
-Completion of Addiction Counseling Course Work and Training
-
-A.
-
-Addiction counseling course work and training must be completed through an addiction counselor
-clinical training program approved by the Department pursuant to Section 27-80-108(1), C.R.S.
-
-B.
-
-Course work and training competency may also be obtained through academic educational
-equivalency.
-1.
-
-An individual pursuing academic educational equivalency must demonstrate proficiency
-in each of the addiction counseling course work and trainings established in Section
-21.330.31.
-
-2.
-
-Academic educational equivalency may be accomplished by successful completion of
-equivalent department required course work and trainings, obtained from accredited
-institutions of higher education.
-
-3.
-
-Courses in the behavioral health sciences obtained from accredited institutions of higher
-education equivalent to the department required training shall be demonstrated through
-official transcripts and syllabi and/or course descriptions.
-
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-2 CCR 502-1
-
-21.400 BEHAVIORAL HEALTH CRISIS RESPONSE SYSTEM
-21.400.1
-
-DEFINITIONS [Eff. 11/1/16]
-
-“Assessment” means a formal and continuous process of collecting and evaluating information about an
-individual for service planning, treatment and referral. Assessments establish justification for services.
-“Chief complaint/presenting problem” means the reason/concern/motivation which prompts the client to
-seek services or that which their referral source identifies as the issue which requires intervention, usually
-in the person’s own words. Also includes, onset, duration, other symptoms noted, progression of the
-problem, solutions attempted at alleviating the problem, how the person’s life has been impacted and how
-the person views responsibility for the problem. This information can be from a referral source, family
-member or other professional.
-“Crisis stabilization unit” or “CSU” means a facility, utilizing a restrictive egress alert device, which serves
-individuals requiring 24-hour intensive behavioral health crisis intervention for up to five days and cannot
-be accommodated in a less restrictive environment. Crisis stabilization units are licensed by the Colorado
-department of public health and environment as an acute treatment unit, pursuant to 6 CCR 1011-1,
-Chapter 6, or as a Community Clinic, pursuant to 6 CCR 1011-1, chapter 9.
-“Integrated care model” means the systematic coordination of mental health, substance use, and primary
-care services.
-“Licensed mental health professional” means a psychologist licensed pursuant to Section 12-43-301, et
-seq., C.R.S., a psychiatrist licensed pursuant to Section 12-36-101, et seq., C.R.S., a clinical social
-worker licensed pursuant to Section 12-43-401, et seq., C.R.S., a marriage and family therapist licensed
-pursuant to Section 12-43-501, a professional counselor licensed pursuant to Section 12-43-601, et seq.,
-C.R.S., or an addiction counselor licensed pursuant to Section 12-43-801, et seq., C.R.S.
-“Peer specialist,” or peer support specialist, recovery coach, peer and family recovery support specialist,
-peer mentor, family advocate or family systems navigator, means an individual who uses his or her lived
-experience of recovery from mental illness and/or addiction, plus skills learned in formal training, to
-deliver services in behavioral health settings. A family advocate or family systems navigator uses his or
-her lived experience of having a family member with a mental illness or substance use disorder and the
-knowledge of the behavioral health care system gained through navigation and support of that family
-member.
-“Peer support” means recovery-oriented services provided by peer specialists that promote selfmanagement of psychiatric symptoms, relapse prevention, treatment choices, mutual support,
-enrichment, and rights protection. Peer support also provides social supports and a lifeline for individuals
-who have difficulties developing and maintaining relationships.
-“Physician” is defined in Section 27-65-102(16), C.R.S.
-“Restrictive egress alert device” means a device used to prevent the elopement of a resident who is at
-risk if he or she leaves the facility unsupervised. Egress alert devices are not considered restrictive when
-used only to alert staff regarding the ingress and egress of residents, visitors, and others.
-“Screening” means a brief process used to identify current behavioral health needs, including
-assessment, referral, or immediate intervention services, and is typically documented through the use of
-a standardized instrument.
-“Skilled professional” means a person who has a minimum of a master’s degree in a behavioral health
-field, has completed a pre-service training program specific to their modality of service and has clinical
-crisis intervention experience.
-
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-
-“Supervision” means weekly clinical guidance from a licensed mental health professional.
-“Triage” means a dynamic process of evaluating and prioritizing the urgency of crisis intervention needed
-based on the nature and severity of the individuals’ presenting situation.
-“Trauma informed” means being aware of and responsive to the presence of trauma and the potential
-effects of past and current traumatic experiences in an individual’s life.
-“Warm line/support line” means a telephonic service where individuals can “opt in” from the statewide
-crisis line to receive individualized screening and resources by peer specialists.
-21.400.2
-A.
-
-B.
-
-GENERAL PROVISIONS [Eff. 11/1/16]
-
-The Behavioral Health Crisis Response System is based on the following principles, established
-pursuant to Section 27-60-103(1)(a)(I) through (VII), C.R.S.:
-1.
-
-Cultural competence;
-
-2.
-
-Strong community relationships;
-
-3.
-
-The use of peer supports;
-
-4.
-
-The use of evidence based practices;
-
-5.
-
-Building on existing foundations with an eye towards innovation;
-
-6.
-
-Utilization of an integrated system of care; and,
-
-7.
-
-Outreach to students through school-based clinics.
-
-Each component within the behavioral health crisis response system must be capable of serving:
-1.
-
-Children, adolescents, adults and older adults;
-
-2.
-
-Individuals with co-occurring conditions; including:
-a.
-
-Mental health conditions;
-
-b.
-
-Substance use disorders;
-
-c.
-
-Medical needs;
-
-d.
-
-Intellectual/developmental disabilities;
-
-e.
-
-Physical disabilities;
-
-f.
-
-Traumatic brain injuries; and/or,
-
-g.
-
-Dementia.
-
-3.
-
-Individuals demonstrating aggressive behavior;
-
-4.
-
-Individuals who are uninsured or unable to pay for services; and,
-
-5.
-
-Individuals who may lack Colorado residency or legal immigration status.
-
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-
-C.
-
-Each component within the Behavioral Health Crisis Response System must provide services in a
-culturally competent manner.
-
-D.
-
-Each modality of service within the Behavioral Health Crisis Response System must incorporate
-peer support into the services they provide, when clinically appropriate.
-
-21.400.3
-
-TELEPHONE CRISIS SERVICES [Eff. 11/1/16]
-
-The Department shall maintain a comprehensive telephonic system capable of assessing any individual
-experiencing a self-defined crisis situation and making appropriate referrals. Telephone crisis services
-must be accessible to all individuals throughout the state of Colorado 24 hours per day, 7 days per week,
-and 365 days per year.
-A.
-
-The telephone crisis service must provide:
-1.
-
-Screening and triage;
-
-2.
-
-Psycho-social support;
-
-3.
-
-Connection to appropriate resources;
-
-4.
-
-Follow-up capability to callers as clinically appropriate; and,
-
-5.
-
-Access to a support line (also known as a warm line) provided by peer specialists. Peer
-specialists must have the ability to seamlessly transfer individuals to the crisis line when
-urgent clinical intervention is warranted.
-
-B.
-
-The telephone crisis service must be staffed by skilled professionals capable of assessing and
-making culturally competent, appropriate referrals.
-
-C.
-
-The telephone crisis service must use trauma-informed screenings and assessments and
-incorporate this information into safety planning, referrals and follow-up interventions.
-
-D.
-
-The telephone crisis service must initiate mobile crisis services when appropriate and be linked
-with walk-in crisis service facilities.
-
-21.400.4
-
-WALK-IN CRISIS SERVICES [Eff. 11/1/16]
-
-Walk-in crisis services facilities offer confidential, in-person support for anyone experiencing a selfdefined crisis. Every walk-in crisis services facility must have the ability to provide information and
-referrals to anyone in need, including, if appropriate, access and clinically appropriate transportation to
-crisis stabilization for up to five days in a crisis stabilization unit.
-A.
-
-Each walk-in crisis services facility, including crisis stabilization units, must be designated
-pursuant to Title 27, Article 65, C.R.S., Care and Treatment of Persons with Mental Illness, and
-be in compliance with Section 21.280.
-
-B.
-
-Walk-in crisis services must employ an integrated care model based on evidence-based practices
-that consider an individual’s physical and emotional health.
-
-C.
-
-Walk-in crisis services must include screening, assessment, and referrals to appropriate
-resources.
-1.
-
-Screening.
-
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-
-a.
-
-b.
-2.
-
-2 CCR 502-1
-
-Screening must collect at least the following information from an individual
-seeking crisis services:
-1)
-
-Identifying information;
-
-2)
-
-Chief complaint/presenting problem;
-
-3)
-
-Medical concerns/chronic health issues; and,
-
-4)
-
-Current healthcare providers.
-
-Screenings must be reviewed by a skilled professional who is licensed or
-receiving supervision from a licensed mental health professional.
-
-Assessment.
-A full assessment must be administered in accordance with Section 21.190.3, if clinically
-indicated by the initial screening in Section 21.340.4(C)(1).
-
-3.
-
-Referrals.
-The facility shall refer all individuals seeking crisis services to appropriate resources
-based on the level of care indicated by the screening or assessment.
-
-D.
-
-Crisis stabilization units
-1.
-
-Services provided on a crisis stabilization unit must include:
-a.
-
-Full psychiatric evaluation;
-1)
-
-By a physician or other professional authorized by statute to order
-medications; and,
-
-2)
-
-Within 24 hours of admission.
-
-b.
-
-Medical and medication treatment in accordance with Section 21.280.3;
-
-c.
-
-Service planning in accordance with Section 21.190.4;
-
-d.
-
-Peer support, when clinically appropriate;
-
-e.
-
-Treatment, to include:
-1)
-
-Individual counseling; and/or,
-
-2)
-
-Groups.
-
-f.
-
-Coordination with medical services;
-
-g.
-
-Case management;
-
-h.
-
-Service coordination and referral; and,
-
-i.
-
-Discharge planning.
-
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-
-2.
-
-Crisis stabilization unit staffing requirements
-a.
-
-21.400.41
-
-2 CCR 502-1
-
-In addition to the walk-in crisis service staffing requirements listed in 21.400.41,
-crisis stabilization units must have:
-1)
-
-Access to a physician or other professional authorized by statute to order
-medications upon admission; and,
-
-2)
-
-At minimum, one on-site staff member qualified to administer
-medications.
-
-Walk-In Crisis Services Staffing Requirements [Eff. 11/1/16]
-
-A.
-
-A walk-in crisis services facility must be staffed 24 hours per day, 7 days per week, and 365 days
-per year.
-
-B.
-
-A walk-in crisis services facility must employ sufficient staff to ensure that the provision of
-services meets the needs of individuals. At minimum, a facility must have two staff on-site at all
-times.
-
-C.
-
-A walk-in crisis services facility must be staffed by skilled professionals who are licensed or
-receiving supervision from a licensed mental health professional.
-
-D.
-
-If a walk-in crisis services facility is staffed by unlicensed skilled professionals, a licensed mental
-health professional must be on-call and able to respond to the facility within thirty (30) minutes.
-
-E.
-
-A walk-in crisis services facility must have the ability to provide peer support on-site when
-clinically appropriate.
-
-21.400.5
-
-MOBILE CRISIS SERVICES AND UNITS [Eff. 11/1/16]
-
-Mobile crisis services provide a timely in-person response to a behavioral health crisis in the community.
-Mobile crisis services must collaborate with telephone crisis services, walk-in crisis services, and crisis
-residential and in-home respite services.
-A.
-
-B.
-
-A mobile crisis unit must have the capacity to:
-1.
-
-Intervene wherever the crisis occurs;
-
-2.
-
-Serve individuals unknown to the system;
-
-3.
-
-Coordinate multiple simultaneous requests for services; and,
-
-4.
-
-Work closely with police, crisis hotlines, schools, and hospital emergency departments;
-
-A mobile crisis unit must operate 24 hours per day, 7 days per week, and 365 days per year in
-providing community-based crisis intervention, screening, assessment, and referrals to
-appropriate resources.
-1.
-
-In screening the individual in crisis, the mobile crisis unit must collect at least the
-following information:
-a.
-
-Identifying information;
-
-b.
-
-Chief complaint/presenting problem;
-
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-
-2.
-
-c.
-
-Medical concerns/chronic health issues; and,
-
-d.
-
-Current healthcare providers.
-
-2 CCR 502-1
-
-The mobile crisis unit must administer a full assessment in accordance with Section
-21.190.3 if clinically indicated by the initial screening in Section 21.400.5(C)(1).
-
-C.
-
-A mobile crisis unit must be staffed by skilled professionals who are licensed themselves or
-receiving supervision from a licensed mental health professional.
-
-D.
-
-If a mobile crisis staff member is an unlicensed skilled professional, he or she must have, at
-minimum, immediate phone access to a licensed mental health professional.
-
-E.
-
-A mobile crisis unit must utilize peer supports, in conjunction with a skilled professional, in a
-mobile response when clinically appropriate.
-
-21.400.6
-
-RESIDENTIAL AND IN-HOME RESPITE CRISIS SERVICES [Eff. 11/1/16]
-
-Residential and in-home respite crisis services allow an individual experiencing a crisis to stabilize,
-resolve problems, and link with resources for ongoing support in a safe environment.
-A.
-
-Residential and in-home respite services include a range of short-term, not to exceed 14 calendar
-days, services 24 hours per day, 7 days per week, and 365 days per year.
-
-B.
-
-In order to be eligible for residential or in-home respite services, an individual experiencing a
-behavioral health crisis must:
-
-C.
-
-1.
-
-Be referred by a walk-in crisis services professional or a mobile crisis services
-professional;
-
-2.
-
-Agree to residential or in-home respite services;
-
-3.
-
-Not meet emergency procedure criteria outlined in Section 27-65-105, C.R.S., Care and
-Treatment for Persons with Mental Illness;
-
-4.
-
-Present a minimal risk of significant withdrawal complications;
-
-5.
-
-Cooperate with program guidelines; and,
-
-6.
-
-Be able and willing to participate in forming a service plan.
-
-Residential and in-home respite providers will utilize peer specialists to provide support, when
-appropriate.
-
-21.410 COMMUNITY TRANSITION SPECIALIST PROGRAM
-A.
-
-Pursuant to Title 27, Article 66.5, C.R.S. the Community Transition Specialist Program is a
-statewide program that receives referrals from hospitals and withdrawal management facilities
-and coordinates services for individuals prior to their release or discharge to the community.
-
-B.
-
-The Office is responsible for the administration and oversight of the Community Transition
-Specialist Program. Pursuant to § 27-66.5-103(5), C.R.S., the Office may contract with a vendor
-to provide the referral and coordination services required for statewide implementation of the
-Community Transition Specialist Program. The Office shall coordinate the vendor-provided
-services with other relevant state supported programs and services.
-
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-
-C.
-
-2 CCR 502-1
-
-The Community Transition Specialist Program will coordinate services for individuals meeting the
-section 27-66.5-102(3), C.R.S. definition of a “high-risk individual”. “High-risk individual” means a
-person who:
-1.
-
-2.
-
-3.
-
-Is under:
-A.
-
-An emergency procedure for a seventy-two-hour hold pursuant to section 27-65105, C.R.S.;
-
-B.
-
-A certification for short-term treatment or extended short-term treatment pursuant
-to section 27-65-107, C.R.S. or section 27-65-108, C.R.S.;
-
-C.
-
-Long-term care and treatment pursuant to section 27-65-109, C.R.S.;
-
-D.
-
-An emergency commitment pursuant to section 27-81-111, C.R.S. or section 2782-107, C.R.S.; or,
-
-E.
-
-An involuntary commitment pursuant to section 27-81-112, C.R.S. or section 2782-108, C.R.S.;
-
-Has a significant mental health or substance use disorder, which means:
-A.
-
-The individual has had two (2) or more seventy-two hour holds or emergency
-commitments in the previous twelve (12) months;
-
-B.
-
-The individual has been certified for short-term treatment pursuant to section 2765-107, C.R.S., certified for extended short-term treatment pursuant to section
-27-65-108, C.R.S. or, ordered for long-term care and treatment pursuant to
-section 27-65-109, C.R.S. one (1) or more times in the previous twelve (12)
-months; or,
-
-C.
-
-The individual has been arrested or detained two (2) or more times related to an
-alcohol or substance use disorder in the last twelve (12) months and does not
-have a probation or parole officer; and,
-
-Is not currently engaged in consistent behavioral health treatment, which means the
-individual has not received any local or available outpatient behavioral health treatment
-services in the last forty-five (45) calendar days or has been terminated from outpatient
-behavioral health services within the last forty-five (45) calendar days. Outpatient
-behavioral health treatment services do not include crisis services, emergency care,
-withdrawal management services, initial intake appointments, assessments, or inpatient
-hospitalization.
-
-21.500 RECOVERY RESIDENCE CERTIFICATION PROGRAM
-21.500.1
-
-STATUTORY AUTHORITY
-
-The statutory authority to promulgate these rules is set forth in Sections 25-1.5-108.5(4), C.R.S. and 2780-122(4), C.R.S.
-21.500.2
-
-DEFINITIONS
-
-“Recovery residence certifying body” means an entity that has been approved by the office of behavioral
-health to certify recovery residences pursuant to 25-1.5-108.5, C.R.S.
-
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-
-“Recovery residence”, “sober living facility”, or “sober home” as defined in 25-1.5-108.5(1), C.R.S., means
-any premises, place, facility, or building that provides housing accommodation for individuals with a
-primary diagnosis of a substance use disorder that: is free from alcohol and nonprescribed or illicit drugs;
-promotes independent living and life skill development; and provides structured activities and recovery
-support services that are primarily intended to promote recovery from substance use disorders. A
-“recovery residence” does not include: a private residence in which an individual related to the owner of
-the residence by blood, adoption, or marriage is required to abstain from substance use or receive
-behavioral health services for a substance use disorder as a condition of residing in the residence; the
-supportive residential community for individuals who are homeless operated under Section 24-32-724,
-C.R.S. at the Fort Lyon property for the purpose of providing substance abuse supportive services,
-medical care, job training, and skill development for the residents; a facility approved for residential
-treatment by the office of behavioral health in the department of human services; or permanent supportive
-housing units incorporated into affordable housing developments.
-“The NARR Standard” means the National Standard for Recovery Residences Version 3.0 (2018)
-established by the National Alliance of Recovery Residences, which is hereby incorporated by reference.
-No later additions or amendments are incorporated. The National Standard for Recovery Residences
-Version 3.0 (2018) is available at https://narronline.org and is also available for public inspection at the
-Colorado Department of Human Services, Office of Behavioral Health, 3824 West Princeton Circle,
-Denver, Colorado 80236, during regular business hours.
-21.500.3
-A.
-
-Recovery residence certifying body obligations prior to approval
-1.
-
-B.
-
-RECOVERY RESIDENCE CERTIFYING BODY APPROVAL PROGRAM
-
-A recovery residence certifying body applicant must submit an application to the office of
-behavioral health for approval as a recovery residence certifying body. The application
-must contain information on how the recovery residence certifying body applicant will
-meet the standards established in Section 21.500.3(B).
-
-Recovery residence certifying body obligations after approval
-1.
-
-A recovery residence certifying body must ensure that any premises, place, facility, or
-building they certify meets minimum standards that provide safe and healthy housing
-environments that support individuals in achieving and sustaining substance use disorder
-recovery.
-
-2.
-
-A recovery residence certifying body must ensure that each recovery residence that it
-certifies in Colorado, complies with The NARR Standard as defined in 21.500.2 for
-providing the appropriate level of support and housing accommodations for individuals
-with a primary diagnosis of a substance use disorder.
-
-3.
-
-A recovery residence certifying body must ensure recovery residences comply with the
-standards established in 25-1.5-108.5, C.R.S.
-
-4.
-
-A recovery residence certifying body must have written policies and procedures that must
-be posted on the recovery residence certifying body’s website. At minimum, the written
-policies and procedures must include:
-a.
-
-The certification process;
-
-b.
-
-Application submission requirements, including the cost for certification;
-
-c.
-
-How certification fees relate to service delivery and how recovery residences are
-informed about changes to certification fees;
-
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-5.
-
-6.
-
-2 CCR 502-1
-
-d.
-
-The application review process;
-
-e.
-
-The approval, revocation, denial, suspension, limitation, or modification process
-for certification;
-
-f.
-
-The right and process to appeal decisions made by the recovery residence
-certifying body;
-
-g.
-
-Re-application timeframes; and,
-
-h.
-
-How grievances will be managed.
-
-A recovery residence certifying body must maintain a website that contains, at minimum:
-a.
-
-Information on how a recovery residence can apply for certification, as outlined in
-21.500.3(b)(3);
-
-b.
-
-The standards a recovery residence must meet to obtain differing levels of
-certification as defined by The NARR Standard as defined in 21.500.2, including
-the cost of certification for each level.
-
-c.
-
-Board information as outlined in 21.500.3(B)(5);
-
-d.
-
-Contact information for how individuals can submit a grievance to the recovery
-residence certifying body; and,
-
-e.
-
-A list of certified recovery residences to ensure people throughout Colorado have
-access to information and locations of certified recovery residences; and,
-
-f.
-
-The written policies and procedures outlined in 21.500.3(B)(3).
-
-A recovery residence certifying body must have a board that has approval oversight of
-the recovery residence certifying body’s practices, policies, and procedures. At minimum,
-the recovery residence certifying body must ensure:
-a.
-
-A representative from the office of behavioral health is on the board;
-
-b.
-
-A minimum of twenty-five percent (25%) of board members must represent
-recovery residences that are certified and do not otherwise have a conflict of
-interest with the certifying body;
-
-c.
-
-The board includes at least two board members that represent individuals in
-recovery. The representatives for individuals in recovery must not own, volunteer
-at, or be employed by the recovery residence certifying body or a certified
-recovery residence;
-
-d.
-
-That board members disclose any potential conflict of interest and have
-standards for how a conflict of interest is acknowledged, determined, and
-reconciled in regard to the execution of board duties;
-
-e.
-
-That board meetings are open to the public, except as to the portion of the
-meeting that information that is confidential pursuant to state or federal statute is
-being discussed; and,
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-
-f.
-
-7.
-
-2 CCR 502-1
-
-That board information is publicly posted on the recovery residence certifying
-body’s website, including:
-1)
-
-A list of board members, each board member’s representative role on
-the board, and each board member’s term limit;
-
-2)
-
-The board member application and selection process;
-
-3)
-
-Board bylaws;
-
-4)
-
-Board meeting dates, times, and locations posted at least one (1) week
-prior to the board meeting; and,
-
-5)
-
-Board agendas and minutes.
-
-On or before February 1, of each year, a recovery residence certifying body must submit
-an annual report to the Office of Behavioral Health that covers the previous calendar
-year. At minimum, the annual report must include:
-a.
-
-The total number of recovery residences certified in Colorado, as of the previous
-January 1.
-
-b.
-
-The percentage of certified recovery residences which are also members of the
-approved recovery residence certifying body’s association;
-
-c.
-
-The total number of recovery residences which applied for certification in the
-previous calendar year;
-
-d.
-
-The total number of recovery residences which applied for certification and were
-granted certification;
-
-e.
-
-The total number of recovery residences which applied for certification and were
-denied certification, including the reason(s) why each recovery residence was
-denied;
-
-f.
-
-The total number of recovery residences which certification was revoked, denied,
-suspended, or modified, including the reason(s) for the certification change;
-
-g.
-
-The total number of grievances received, including the topic and outcome of
-each grievance;
-
-h.
-
-Increases or decreases in certification fees, including justification for each fee
-change; and,
-
-i.
-
-Any changes to the makeup, structure, and/or duties of the certifying body’s
-board.
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-C.
-
-2 CCR 502-1
-
-An approval from the Office of Behavioral Health as a recovery residence certifying body is not
-time limited, with the exception that at the Office of Behavioral Health’s discretion, an approval as
-a recovery residence certifying body may be revoked, denied, suspended, or modified. Written
-notification of the basis for action must be sent by certified mail to the last known address of the
-recovery residence certifying body. If the affected recovery residence certifying body disagrees
-with the decision, it has the right to appeal to the Colorado Department of Personnel and
-Administration, Office of Administrative Courts in accordance with the regulations set forth at 2
-CCR 502-1 § 21.105, except that the time for answering the notice of charges will be thirty (30)
-days after the mailing of such notice. An affected recovery residence certifying body may
-subsequently seek judicial review of the Office of Behavioral Health’s action in accordance with
-Section 24-4-101, et seq., C.R.S.
-
-21.500.4
-
-RECOVERY RESIDENCE CERTIFICATION GRANT PROGRAM
-
-Subject to available appropriations as established in 27-80-122(3), C.R.S., a recovery residence may be
-eligible for a grant from the Office of Behavioral Health to pay a portion of, or all, application for
-certification and/or membership fees and/or dues required by a recovery residence certifying body.
-21.500.41
-
-RECOVERY RESIDENCE CERTIFICATION GRANT PROGRAM CRITERIA
-
-A.
-
-A recovery residence seeking a recovery residence certification grant must complete, in its
-entirety, the recovery residence certification grant application available on the Colorado
-Department of Human Services website.
-
-B.
-
-A recovery residence certification grant must only be used to pay fees related to gaining
-certification and/or membership from a recovery residence certifying body, which may include the
-payment of membership dues.
-
-C.
-
-A recovery residence certification grant application must be submitted to the Office of Behavioral
-Health by the last business day of each month.
-
-D.
-
-Recovery residence certification grant applications received by the Office of Behavioral Health
-within the time frame established in 21.500.41(C), must be reviewed by the Office of Behavioral
-Health to determine approval or denial. Grants will be awarded in alignment with state fiscal rules
-created pursuant to 24-30-202, C.R.S.
-
-E.
-
-Recovery residence certification grant applications that are not complete, contain inaccurate or
-false information, or express intent to use the recovery residence certification grant money in a
-manner that does not comply with state statutes or regulations, may be denied.
-
-F.
-
-A recovery residence which previously received a recovery residence certification grant must
-submit a new application each time they are seeking another recovery residence certification
-grant.
-
-G.
-
-A recovery residence which applies for a recovery residence certification grant must provide the
-office of behavioral health with documentation of the paid certification fees and/or membership
-dues from the approved recovery residence certifying body. A recovery residence that does not
-provide the required documentation may have their current or any subsequent recovery residence
-certification grant applications denied.
-
-H.
-
-The Office of Behavioral Health’s decision regarding the recovery residence certification grant
-application is a final agency decision. If the affected recovery residence disagrees with the final
-agency decision, it may seek judicial review of the Office of Behavioral Health’s action in
-accordance with Section 24-4-101, et seq., C.R.S.
-
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-
-2 CCR 502-1
-
-21.600 Recovery Support Services Organizations
-21.600.1
-
-Authority for Rulemaking
-
-House Bill 21-1021 provides that it is in the best interest of the State to support the peer support
-professional workforce through the creation of peer-run Recovery Support Services Organizations.
-The general assembly authorized the Colorado Department of Human Services, in collaboration with the
-Department of Health Care Policy and Financing, to promulgate rules establishing minimum standards
-that Recovery Support Services Organizations must meet. § 27-60-108(3)(a), (c) C.R.S.
-21.600.2
-
-Definitions
-
-“Behavioral health” shall have the same definition as in Section 25-27.6-102, C.R.S.
-"Critical incident" shall have the same definition as in 2 CCR 502-1 Section 21.300.1.
-"Department" means the Colorado Department of Human Services.
-"Individual" means any individual who receives services from a Recovery Support Services Organization.
-“Licensed mental health provider” means:
-A.
-
-A mental health professional licensed or certified pursuant to Section 12-245, C.R.S. except for
-unlicensed psychotherapists pursuant to Section 12-245, C.R.S.
-
-B.
-
-Advanced practice registered nurse registered pursuant to Section 12-255-111, C.R.S. with
-training in substance use disorders or mental health
-
-C.
-
-Physician assistant licensed pursuant to Section 12-240-113, C.R.S. with specific training in
-substance use disorders or mental health
-
-D.
-
-Psychiatric technician licensed pursuant to Section 12-295, C.R.S.
-
-E.
-
-Medical doctor or doctor of osteopathy licensed pursuant to Section 12-240, C.R.S.
-
-“Peer support professional” means a peer support specialist, recovery coach, peer and family recovery
-support specialist, peer mentor, family advocate, or family systems navigator who meets the qualifications
-described in Section 27-60-108(3)(a)(iii), C.R.S.
-“Peer support” shall have the same definition as in 2 CCR Section 21.400.1.
-“Recovery Support Services Organization” (RSSO) means an independent entity led and governed by
-representatives of local communities of recovery and approved by the executive director of the
-department
-"Substance use disorder" shall have the same meaning as defined in Section 27-80-203 (23.3), C.R.S.
-“Warm line” means a peer-run telephone hotline that provides early intervention with emotional support
-for the caller.
-21.600.3
-A.
-
-License Requirement
-
-Organizations shall apply for and obtain a Recovery Support Services Organization license if:
-
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-Behavioral Health
-
-B.
-
-2 CCR 502-1
-
-1.
-
-They are a peer-run organization providing peer support to individuals with behavioral
-health disorder, and
-
-2.
-
-The organization is seeking reimbursement through Medicaid.
-
-All applicants for a Recovery Support Services Organization license shall demonstrate
-compliance with these rules and all applicable state and federal regulations and statutes.
-
-21.600.31
-
-Annual License
-
-A.
-
-Each approved Recovery Support Services Organization that provides peer support and seeks
-reimbursement through Medicaid shall obtain a Department-issued Recovery Support Services
-Organization license annually.
-
-B.
-
-Peer-run service providers are not required to seek RSSO licensure to provide services unless
-they seek Medicaid reimbursement for peer support services rendered under a peer-run service
-provider.
-
-21.600.4
-
-General Provisions
-
-21.600.41
-
-Service Provisions
-
-A.
-
-B.
-
-Recovery Support Services Organizations may provide a variety of nonclinical, recovery-focused
-services and supports. These services shall include engaging individuals in peer-to-peer
-relationships that support healing, personal growth, life skills development, self-care, and crisisstrategy development to help achieve recovery, wellness, and life goals. These services may
-include, but are not limited to:
-1.
-
-Peer-run drop in centers
-
-2.
-
-Recovery and wellness centers
-
-3.
-
-Employment services
-
-4.
-
-Prevention and early intervention activities
-
-5.
-
-Peer mentoring for children and adolescents
-
-6.
-
-Warm lines
-
-7.
-
-Advocacy services
-
-A peer support professional may provide services on behalf of a Recovery Support Services
-Organization in a variety of clinical and nonclinical settings, that may include but are not limited
-to:
-1.
-
-Justice-involved settings
-
-2.
-
-Physical health settings, such as pediatrician or obstetric and gynecological health care
-offices
-
-3.
-
-Emergency departments
-
-4.
-
-Services delivered via telehealth
-
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-Behavioral Health
-
-C.
-
-5.
-
-Agencies serving homeless communities
-
-6.
-
-Peer respite homes
-
-7.
-
-School-based health centers
-
-8.
-
-Home and community-based settings
-
-Recovery Support Services Organizations must have an established process by which the
-organization coordinates its services with those rendered by other agencies, including treatment
-agencies, to ensure an uninterrupted continuum of care to persons with behavioral health
-disorders.
-
-21.600.42
-A.
-
-2 CCR 502-1
-
-Staff Requirements and Training
-
-Recovery Support Services Organizations must employ or contract with a licensed mental health
-provider pursuant to §12-245, C.R.S. to administer on-going supervision of peer support
-professionals employed or contracted by Recovery Support Services Organizations. The licensed
-mental health provider must be in good standing with their credentialing body and must
-demonstrate in a manner determined by the Behavioral Health Commissioner having received
-formal training specific to:
-1.
-
-Provision of peer support services
-
-2.
-
-Supervision of peer support professionals
-
-3.
-
-Role of peer support professionals
-
-B.
-
-For peer support professionals with less than 12 months experience, individual supervision by the
-licensed mental health provider of sufficient length to address needs for a minimum of 30
-minutes, two times per month is required. For peer support professionals with more than 12
-months experience, individual supervision by the licensed mental health provider of sufficient
-length to address needs for a minimum of 30 minutes, once per month is required. Supervisors
-shall maintain documentation of all supervisory sessions.
-
-C.
-
-Recovery Support Services Organizations must employ or contract with peer support
-professionals who have successfully completed formal training covering all content areas outlined
-in “Core Competencies for Peer Workers in Behavioral Health Services – 2018” established by
-United States Department of Health and Human Services’ Substance Abuse and Mental Health
-Services Administration (SAMHSA) and does not include any later amendments or editions.
-These regulations are available at no cost at https://www.samhsa.gov/ and are also available for
-public inspection and copying at the Colorado Department of Human Services, Office of
-Behavioral Health, 3824 West Princeton Circle, Denver, Colorado 80236, during regular business
-hours.
-
-D.
-
-Peer support professionals must obtain a certification as a peer support professional and be in
-good standing with their certifying body.
-
-E.
-
-All staff employed or contracted by a Recovery Support Services Organization must comply with
-background checks and employment verification processes outlined in 2 CCR Section 21.160.2.
-and be verified at least annually.
-
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-
-21.600.43
-
-2 CCR 502-1
-
-Documentation Requirements
-
-A.
-
-Recovery Support Services Organizations shall comply with Release of Information requirements
-pursuant to 2 CCR Section 21.170.3.
-
-B.
-
-Recovery Support Services Organizations shall comply with Consent requirements pursuant to 2
-CCR Section 21.170.4.
-
-C.
-
-Recovery Support Services Organizations shall maintain records of the services provided to
-individuals by the RSSOs. The record shall be shared with the Department pursuant to a
-procedure determined by the Behavioral Health Commissioner. For each encounter in which
-services are provided, the record shall contain:
-
-D.
-
-1.
-
-Date of service
-
-2.
-
-Total contact time with person
-
-3.
-
-Session setting/place of service
-
-4.
-
-Reason for the encounter and description of services provided
-
-5.
-
-Provider’s dated signature and relevant qualifying credential.
-
-Recovery Support Services Organizations shall have policies and procedures that address at a
-minimum:
-1.
-
-Experience and hiring requirements for peer support professionals and licensed mental
-health providers
-
-2.
-
-The program's standards of practice and code of ethics
-
-3.
-
-Training for peer support professionals related to providing support services
-
-4.
-
-Training for licensed mental health providers related to the supervision of peers
-
-5.
-
-A description of each aspect of the program, including staff roles and responsibilities and
-how the organization meets the description of “peer run”
-
-6.
-
-The program’s care coordination policy, including referral procedures
-
-7.
-
-The handling of grievances and complaints by individuals receiving services
-
-8.
-
-Reporting and reviewing critical incidents in accordance with 2 CCR Section 21.140.
-
-9.
-
-Compliance with confidentiality, HIPAA, and 42 C.F.R. Part 2
-
-10.
-
-Methods for recording information required by Section 21.600.43(C).
-
-21.600.5
-A.
-
-Site Visits
-
-Routine monitoring: Recovery Support Services Organization licensing visits shall be scheduled
-and conducted by the Department during the RSSO’s normal business hours to the extent
-possible.
-
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-Behavioral Health
-
-B.
-
-2 CCR 502-1
-
-The Department shall conduct unscheduled site visits for specific monitoring purposes and
-investigation of complaints or critical incidents involving approved organizations that have a
-Recovery Support Services Organization license. These unscheduled visits shall be in
-accordance with the:
-1.
-
-Recovery Support Services Organization license rules;
-
-2.
-
-Department policies and procedures;
-
-3.
-
-Any statutes and regulations that protect the confidentiality of individual identifying
-information, including HIPAA and 42 C.F.R. Part 2.
-
-C.
-
-The Department shall have access to all individual, organization, and staff records and any other
-relevant documentation required to determine compliance with these rules and to coordinate
-individual services.
-
-D.
-
-Site inspection may be required at the sole discretion of the Department.
-
-21.600.6
-
-Ethical Standard
-
-Recovery Support Services Organizations shall ensure that peer support professionals adhere to ethical
-standards. Violations of ethical standards include:
-A.
-
-Performing duties outside of the scope of practice of a peer support professional
-
-B.
-
-Any breach of professional boundaries between a peer support professional and an individual
-receiving services, including relationships of a sexual or romantic nature between the peer
-support professional and individual receiving services
-
-C.
-
-Fraudulent activity, including but not limited to misrepresenting credentials and falsifying records
-
-D.
-
-Failure to meet generally accepted standards of peer support professional practice
-
-E.
-
-Any conduct described in 2 CCR Section 21.120.8(C).
-
-21.600.7
-A.
-
-Critical Incident Reporting
-
-Critical incident reporting shall occur in accordance with 2 CCR Section 21.140.
-
-21.600.8
-
-Licensing Procedures
-
-21.600.81
-
-Initial Licenses
-
-A.
-
-Applications for initial licenses for RSSOs shall be submitted and processed according to
-procedures outlined in 2 CCR Section 21.120.22.
-
-B.
-
-The application fee for an RSSO license shall be two hundred dollars ($200).
-
-C.
-
-No initial license shall issue prior to Department inspection per 2 CCR Section 21.100.
-
-21.600.82
-
-Provisional Licenses
-
-Provisional licenses may be granted under the circumstances and through the processes described in 2
-CCR Section 21.120.23.
-
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-
-21.600.83
-
-2 CCR 502-1
-
-License Renewal
-
-License renewal shall be conducted according to processes outlined in 2 CCR Section 21.120.24.
-21.600.84
-
-Probationary License
-
-Probationary licenses may be granted under the circumstances and through the processes described in 2
-CCR Section 21.120.25.
-21.600.85
-
-License Revocation, Denial, Suspension, Limitation or Modification
-
-A.
-
-A license may be revoked, denied, suspended, limited, or modified according to 2 CCR Section
-21.120.8.
-
-B.
-
-A license may be revoked, denied, suspended, limited, or modified if an individual providing
-services under the organization’s auspices violates ethical standards outlined in 2 CCR Section
-21.600.6.
-
-C.
-
-A Recovery Support Services Organization that has a limited, suspended, or modified license will
-maintain that licensure status even if the Recovery Support Services Organization changes its
-name but retains the same supervising licensed mental health provider.
-
-21.600.86
-
-Inactivation or Surrender of a License
-
-No Recovery Support Services Organization license shall be inactivated except with the Department’s
-approval. A Recovery Support Services Organization may request inactivation at any time. Approval to
-inactivate a license will not be unreasonably denied. Inactivation or surrender of a license will not avoid
-discipline if otherwise justified.
-21.600.9
-
-Appeal
-
-Any licensee or designee adversely affected or aggrieved by these rules or by the Department's decisions
-in regard to implementation of these rules has the right to appeal a Department action in accordance with
-2 CCR Section 21.105.
-21.700 (NONE)
-_________________________________________________________________________
-Editor’s Notes
-History
-Rules SB&P, 19.500 eff. 11/01/2007.
-Rules SB&P, 19.421.3 eff. 09/01/2013.
-Entire rule eff. 11/01/2013.
-Rules SB&P, 21.900-21.950 emer. rules eff. 11/06/2015.
-Rules SB&P, 21.900-21.950 eff. 02/01/2016.
-Rules SB&P, 21.000-21.120.35, 21.190-21.210.59, 21.230-21.280.25, 21.330-21.330.2 eff. 05/01/2016.
-Rules SB&P, 21.120.3-21.120.31, 21.400 eff. 11/01/2016.
-Rules 21.240.1, 21.240.85 eff. 07/01/2017.
-Rule 21.281 eff. 06/01/2018.
-Rules 21.100, 21.120.36 eff. 08/01/2018.
-
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-
-2 CCR 502-1
-
-Rules 21.160.2 A.3, 21.200.53 K.1 emer. rules eff. 08/03/2018.
-Rules 21.160.2 A.3, 21.200.53 K.1 emer. rules eff. 11/02/2018.
-Rules 21.100, 21.120.1 G, 21.120.24 A, 21.120.24 C-F, 21.120.42 A-G, 21.140 A.2, 21.170.1 A, 21.170.3
-A, 21.200.53 K.6, 21.210.1 E.1.a, 21.210.2 A.1-2, 21.210.43 A, 21.210.51 D, 21.210.52 C,
-21.210.53 C, 21.210.54 D, 21.210.55, 21.210.56 I, 21.210.57 G, 21.210.58 D, 21.210.59,
-21.230.1 D, 21.240.5 F, 21.240.6 A, 21.240.82 B.5, 21.240.83 B, 21.280.1, 21.280.23, 21.282,
-21.410 eff. 01/01/2019.
-Rules 21.160.2 A.3, 21.200.53 K.1, 21.200.4 eff.02/01/2019.
-Rules 21.160.1 A.4, 21.250.5 C, 21.260 B, 21.500 eff. 12/01/2019.
-Rules 21.100, 21.120.1 D, 21.120.22 B, 21.120.23 C, 21.120.26 D, 21.120.4 D-E, 21.120.42 E, 21.170.4,
-21.200.13 B, 21.200.4, 21.200.41, 21.240.1, 21.280.35 A.4, 21.300.22 C, 21.300.23 D, 21.200.5,
-21.320.31 A.5 emer. rules eff. 04/03/2020.
-Rules 21.100, 21.120.1 D, 21.120.22 B, 21.120.23 C, 21.120.26, 21.120.4 D-E, 21.120.42 E, 21.170.4,
-21.200.13 B, 21.200.4, 21.200.41, 21.240.1, 21.280.35 A.4, 21.300.22 C, 21.300.23 D, 21.200.5,
-21.320.31 A.5 eff. 08/01/2020.
-Rules 21.100, 21.210, 21.210.1 A-E, 21.210.43-21.210.924, 21.260 B eff. 10/01/2020. Rules 21.250,
-21.310 repealed eff. 10/01/2020.
-Rules 21.300.1, 21.300.2, 21.300.21-21.300.23, 21.300.24 A.2, 21.300.3 A, 21.300.3 C, 21.300.3 I-J,
-21.300.6, 21.300.7, 21.300.8 A, 21.320, 21.320.1, 21.320.2, 21.320.31, 21.320.32, 21.320.41,
-21.320.42 D, 21.320.5, 21.320.61, 21.320.62, 21.320.63 A, 21.320.63 B.2, 21.320.7, 21.320.81,
-21.320.9 eff. 03/02/2021.
-Rules 21.100, 21.210.1 C, 21.240.3 D, 21.240.85 E, 21.270.1 A, 21.330-21.331.3 eff. 04/01/2021. Rules
-21.330.3-21.330.92 repealed eff. 04/01/2021.
-Rules 21.120.1 D, 21.120.22 B, 21.120.23 C, 21.120.4 D-e, 21.120.42 E, 21.240.1 emer. rules eff.
-08/06/2021.
-Rules 21.100, 21.120.1 D, 21.120.22 B, 21.120.23 C, 21.120.4 D-E, 21.120.42 E, 21.200.11, 21.200.12,
-21.200.13 C, 21.240.1 eff. 11/01/2021.
-Rules 21.300.1, 21.300.21, 21.300.22 D-F, 21.300.23-21.300.25, 21.300.9, 21.320.1, 21.320.2 A-B,
-21.320.21, 21.320.31, 21.320.32, 21.320.41, 31.320.5 A, 31.320.61, 21.320.62, 21.320.63 A,
-21.320.64, 21.320.7 G, 21.320.81 eff. 02/01/2022.
-Rules 21.330.1, 21.330.31, 21.330.32 eff. 03/02/2022. Rules 21.330.4, 21.331-21.331.3 repealed eff.
-03/02/2022.
-Rules 21.600-21.600.9 eff. 07/01/2022.
-Rules 21.800-21.900 repealed eff. 07/30/2023.
-Rules Chapters 1-12 eff. 01/01/2024.
-
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-DEPARTMENT OF HEALTH CARE POLICY AND FINANCING
-Medical Services Board
-MEDICAL ASSISTANCE - SECTION 8.100 Eligibility, Provider Screening, NPI
-10 CCR 2505-10 8.100
-[Editor’s Notes follow the text of the rules at the end of this CCR Document.]
-
-_______________________________________________________________________________
-8.100
-8.100.1
-
-MEDICAL ASSISTANCE ELIGIBILITY
-Definitions
-
-300% Institutionalized Special Income Group is a Medical Assistance category that provides Long-Term
-Care Services to aged or disabled individuals.
-1619b is section 1619b of the Social Security Act which allows individuals who are eligible for
-Supplemental Security Income (SSI) to continue to be eligible for Medical Assistance coverage after they
-return to work.
-AB - Aid to the Blind is a program which provides financial assistance to low-income blind persons.
-ABD - Aged, Blind and Disabled Medical Assistance is a group of Medical Assistance categories for
-individuals that have been deemed to be aged, blind, or disabled by the Social Security Administration or
-the Department.
-Achieving a Better Life Experience (ABLE) accounts – Special savings accounts that are set up by (or for)
-certain individuals with disabilities in a qualified ABLE program that are exempt for eligibility. They can be
-established by any state’s qualified ABLE Program. Colorado’s ABLE program is administered by the
-Department of Higher Education.
-Adjusted Gross Income (AGI)-means “gross income”, as defined in federal tax rules, minus certain
-adjustments prescribed in the federal tax rules to derive the “Adjusted Gross Income” line on the tax
-return. These adjustments from gross income are taken before the taxpayer takes his or her Schedule A
-deductions or Standard Deduction.
-Adult MAGI Medical Assistance Group provides Medical Assistance to eligible adults from the age of 19
-through the end of the month that the individual turns 65, who do not receive or who are ineligible for
-Medicare.
-AND - Aid to Needy Disabled is a program which provides financial assistance to low-income persons
-over age 18 who have a total disability which is expected to last six months or longer and prevents them
-from working.
-AFDC - Aid to Families with Dependent Children is the Title IV federal assistance program in effect from
-1935 to 1997 which was administered by the United States Department of Health and Human Services.
-This program provided financial assistance to children whose families had low or no income.
-AP-5615 is the form used to determine the patient payment for clients in nursing facilities receiving Long
-Term Care.
-Alien is a person who was not born in the United States and who is not a naturalized citizen.
-
-1
-
-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-10 CCR 2505-10 8.100
-
-Ambulatory Services is any medical care delivered on an outpatient basis.
-Annuity is an investment vehicle whereby an individual establishes a right to receive fixed periodic
-payments, either for life or a term of years.
-Applicant is an individual who is seeking an eligibility determination for Medical Assistance through the
-submission of an application.
-Application Date is the date the application is received and date-stamped by the eligibility site or the date
-the application was received and date-stamped by an Application Assistance site or Presumptive
-Eligibility site. In the absence of a date-stamp, the application date is the date that the application was
-signed by the client.
-Application for Public Assistance is the designated application used to determine eligibility for financial
-assistance. It can also be used to determine eligibility for Medical Assistance.
-Blindness is defined in this volume as the total lack of vision or vision in the better eye of 20/200 or less
-with the use of a correcting lens and/or tunnel vision to the extent that the field of vision is no greater than
-20 degrees.
-Burial Spaces are burial plots, gravesites, crypts, mausoleums, urns, niches and other customary and
-traditional repositories for the deceased's bodily remains provided such spaces are owned by the
-individual or are held for his or her use, including necessary and reasonable improvements or additions to
-or upon such burial spaces such as: vaults, headstones, markers, plaques, or burial containers and
-arrangements for opening and closing the gravesite for burial of the deceased.
-Burial Trusts are irrevocable pre-need funeral agreements with a funeral director or other entity to meet
-the expenses associated with burial for Medical Assistance applicants/recipients. The agreement can
-include burial spaces as well as the services of the funeral director.
-Caretaker Relative is a person who is related to the dependent child or any adult with whom the
-dependent child is living and who assumes responsibility for the dependent child’s care.
-Case Management Services are services provided by community mental health centers, clinics,
-community centered boards, and EPSDT case managers to assist in providing services to Medical
-Assistance clients in gaining access to needed medical, social, educational and other services.
-Cash Surrender Value is the amount the insurer will pay to the owner upon cancellation of the policy
-before the death of the insured or before maturity of the policy.
-Categorically Eligible means persons who are eligible for Medical Assistance due to their eligibility for one
-or more Federal categories of public assistance.
-CBMS - Colorado Benefits Management System is the computer system that determines an applicant’s
-eligibility for public assistance in the state of Colorado.
-CDHS -Colorado Department of Human Services is the state department responsible for administering
-the social service and financial assistance programs for Colorado.
-Children MAGI Medical Assistance group provides Medical Assistance coverage to tax dependents or
-otherwise eligible applicants through the end of the month that the individual turns 19 years old.
-Child Support Services is a CDHS program that assures that all children receive financial and medical
-support from each parent. This is accomplished by locating each parent, establishing paternity and
-support obligations, and enforcing those obligations.
-
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-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-10 CCR 2505-10 8.100
-
-Citizen is a person who was born in the United States or who has been naturalized.
-Client is a person who is eligible for the Medical Assistance Program. “Client” is used interchangeably
-with “recipient” when the person is eligible for the program.
-CMS - Centers for Medicare and Medicaid Services is the Federal agency within the US Department of
-Health and Human Services that partners with the states to administer Medicaid and CHP+ via State
-Plans in effect for each State. Colorado is in Region VIII.
-CHP+ - Child Health Plan Plus is low-cost health insurance for Colorado's uninsured children and
-pregnant women. CHP+ is public health insurance for children and pregnant women who earn too much
-to qualify for The Medical Assistance Program, but cannot afford private health insurance.
-COLA - Cost of Living Adjustment is an annual increase in the dollar value of benefits made automatically
-by the United States Department of Health and Human Services or the state in OASDI, SSI and OAP
-cases to account for rises in the cost of living due to inflation.
-Colorado State Plan is a written statement which describes the purpose, nature, and scope of the
-Colorado’s Medical Assistance Program. The Plan is submitted to the CMS and assures that the program
-is administered consistently within specific requirements set forth in both the Social Security Act and the
-Code of Federal Regulations (CFR) in order for a state to be eligible for Federal Financial Participation
-(FFP).
-Common Law Marriage is legally recognized as a marriage in the State of Colorado under certain
-circumstances even though no legally recognized marriage ceremony is performed or civil marriage
-contract is executed. Individuals declaring or publicly holding themselves out as a married couple through
-verbal or written methods may be recognized as legally married under state law. C.R.S. § 14-2-104(3).
-Community Centered Boards are private non-profit organizations designated in statute as the single entry
-point into the long-term service and support system for persons with developmental disabilities.
-Community Spouse is the spouse of an institutionalized spouse.
-Community Spouse Resource Allowance is the amount of resources that the Medical Assistance
-regulations permit the spouse staying at home to retain.
-Complete Application means an application in which all questions have been answered, which is signed,
-and for which all required verifications have been submitted.
-The Department is defined in this volume as the Colorado Department of Health Care Policy and
-Financing which is responsible for administering the Colorado Medical Assistance Program and Child
-Health Plan Plus programs as well as other State-funded health care programs.
-Dependent Child is a child who lives with a parent, legal guardian, caretaker relative or foster parent and
-is under the age of 18, or, is age 18 and a full-time student, and expected to graduate by age 19.
-Dependent Relative for purposes of this rule is defined as one who is claimed as a dependent by an
-applicant for federal income tax purposes.
-Difficulty of Care Payments is a payment to an applicant or member as compensation for providing live-in
-home care to an individual who qualifies for foster care or Home and Community Based Services (HCBS)
-waiver program and lives in the home of the care recipient. This additional care must be required due to a
-physical, mental, or emotional handicap.
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-Disability means the inability to do any substantial gainful activity (or, in the case of a child, having
-marked and severe functional limitations) by reason of a medically determinable physical or mental
-impairment(s) which can be expected to result in death or which has lasted or can be expected to last for
-a continuous period of l2 months or more.
-Dual Eligible clients are Medicare beneficiaries who are also eligible for Medical Assistance.
-Earned Income is defined for purposes of this volume as any compensation from participation in a
-business, including wages, salary, tips, commissions and bonuses.
-Earned Income Disregards are the allowable deductions and exclusions subtracted from the gross
-earnings. Income disregards vary in amount and type, depending on the category of assistance.
-Electronic Data Source is an interface established with a federal or state agency, commercial entity, or
-other data sources obtained through data sharing agreements to verify data used in determining eligibility.
-The active interfaces are identified in the Department’s verification plan submitted to CMS.
-Eligibility Site is defined in this volume as a location outside of the Department that has been deemed by
-the Department as eligible to accept applications and determine eligibility for applicants.
-Employed means that an individual has earned income and is working part time, full time or is selfemployed, and has proof of employment. Volunteer or in-kind work is not considered employment.
-EPSDT- Early Periodic Screening, Diagnosis and Treatment is the child health component of the Medical
-Assistance Program. It is required in every state and is designed to improve the health of low-income
-children by financing appropriate, medically necessary services and providing outreach and case
-management services for all eligible individuals.
-Equity Value is the fair market value of land or other asset less any encumbrances.
-Ex Parte Review is an administrative review of eligibility during a redetermination period in lieu of
-performing a redetermination from the client. This administrative review is performed by verifying current
-information obtained from another current aid program.
-Face Value of a Life Insurance Policy is the basic death benefit of the policy exclusive of dividend
-additions or additional amounts payable because of accidental death or other special provisions.
-Fair Market Value is the average price a similar property will sell for on the open market to a private
-individual in the particular geographic area involved. Also, the price at which the property would change
-hands between a willing buyer and a willing seller, neither being under any pressure to buy or to sell and
-both having reasonable knowledge of relevant facts.
-FBR - The Federal Benefit Rate is the monthly Supplemental Security Income payment amount for a
-single individual or a couple. The FBR is used by the Aged, Blind and Disabled Medical Assistance
-Programs as the eligibility income limits.
-FFP - Federal Financial Participation as defined in this volume is the amount or percentage of funds
-provided by the Federal Government to administer the Colorado Medical Assistance Program.
-FPL - Federal Poverty Level is a simplified version of the federal poverty thresholds used to determine
-financial eligibility for assistance programs. The thresholds are issued each year in the Federal Register
-by the Department of Health and Human Services (HHS).
-Good Cause is the client’s justification for needing additional time due to extenuating circumstances,
-usually used when extending deadlines for submittal of required documentation.
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-Good Cause for Child Support is the specific process and criteria that can be applied when a client is
-refusing to cooperate in the establishment of paternity or establishment and enforcement of a child
-support order due to extenuating circumstances.
-HCBS are Home and Community Based Services are also referred to as “waiver programs”. HCBS
-provides services beyond those covered by the Medical Assistance Program that enable individuals to
-remain in a community setting rather than being admitted to a Long-Term Care institution.
-In-Kind Income is income a person receives in a form other than money. It may be received in exchange
-for work or service (earned income) or a non-cash gift or contribution (unearned income).
-Inpatient is an individual who has been admitted to a medical institution on recommendation of a
-physician or dentist and who receives room, board and professional services for 24 hours or longer, or is
-expected to receive these services for 24 hours or longer.
-Institution is an establishment that furnishes, in single or multiple facilities, food, shelter and some
-treatment or services to four or more persons unrelated to the proprietor.
-Institutionalization is the commitment of a patient to a health care facility for treatment.
-Institutionalized Individual is a person who is institutionalized in a medical facility, a Long-Term Care
-institution, or applying for or receiving Home and Community Based Services (HCBS) or the Program of
-All Inclusive Care for the Elderly (PACE).
-Institutionalized Spouse is a Medicaid eligible client who begins a stay in a medical institution or nursing
-facility on or after September 30, 1989, or is first enrolled as a Medical Assistance client in the Program of
-All Inclusive Care for the Elderly (PACE) on or after October 10, 1997, or receives Home and Community
-Based Services (HCBS) on or after July 1, 1999; and is married to a spouse who is not in a medical
-institution or nursing facility. An institutionalized spouse does not include any such individual who is not
-likely to be in a medical institution or nursing facility or to receive HCBS or PACE for at least 30
-consecutive days. Irrevocable means that the contract, trust, or other arrangement cannot be terminated,
-and that the funds cannot be used for any purpose other than outlined in the document.
-Insurance Affordability Program (IAP) refers to Medicaid, Child Health Plan Plus (CHP+), and premium
-and cost-sharing assistance for purchasing private health insurance through state insurance marketplace.
-Legal Immigrant is an individual who is not a citizen or national and has been permitted to remain in the
-United States by the United States Citizenship and Immigration Services (USCIS) either temporarily or as
-an actual or prospective permanent resident or whose extended physical presence in the United States is
-known to and allowed by USCIS.
-Legal Immigrant Prenatal is a medical program that provides medical coverage for pregnant legal
-immigrants who have been legal immigrants for less than five years.
-Limited Disability for the Medicaid Buy-In Program for Working Adults with Disabilities means that an
-individual has a disability that would meet the definition of disability under SSA without regard to
-Substantial Gainful Activity (SGA).
-Long-Term Care is Medical Assistance services that provides nursing-home care, home-health care,
-personal or adult day care for individuals aged at least 65 years or with a chronic or disabling condition.
-Long-Term Care Institution means class I nursing facilities, intermediate care facilities for intellectual and
-developmental disabilities (ICF/IDD) and swing bed facilities. Long-Term Care institutions can include
-hospitals.
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-Long-Term Services and Supports Level of Care Eligibility Determination is the determination using the
-state prescribed assessment instrument that an individual does or does not meet institutional level of
-care.
-Long-Term Services and Supports Level of Care Eligibility Determination Screen is a comprehensive
-evaluation with an individual seeking services and appropriate collaterals (such as family members,
-friends, and/or caregivers) to determine the individual’s eligibility for long-term services and supports
-based on their need for institutional level of care as determined using the state prescribed assessment
-instrument.
-Managed care system is a system for providing health care services which integrates both the delivery
-and the financing of health care services in an attempt to provide access to medical services while
-containing the cost and use of medical care.
-Medical Assistance is defined as all medical programs administered by the Department of Health Care
-Policy and Financing. Medical Assistance/Medicaid is the joint state/federal health benefits program for
-individuals and families with low income and resources. It is an entitlement program that is jointly funded
-by the states and federal government and administered by the state. This program provides for payment
-of all or part of the cost of care for medical services.
-Medical Assistance Required Household is defined for purposes of this volume as all parents or caretaker
-relatives, spouses, and dependent children residing in the same home.
-Minimal Verification is defined in this volume as the minimum amount of information needed to process
-an application for benefits. No other verification can be requested from clients unless the information
-provided is questionable or inconsistent.
-Minimum Essential Coverage is the type of coverage one must maintain to be in compliance with the
-Affordable Care Act in order to avoid paying a penalty for being uninsured. Minimum essential coverage
-may include but not limited to: Medicaid; CHP+; private health plans through Connect for Health
-Colorado; Medicare; job-based insurance, and certain other coverage.
-MMMNA - Minimum Monthly Maintenance Needs Allowance is the calculation used to determine the
-amount of institutionalized spouse’s income that the community spouse is allowed to retain to meet their
-monthly living needs.
-MAGI - Modified Adjusted Gross Income refers to the methodology by which income and household
-composition are determined for the MAGI Medical Assistance groups under the Affordable Care Act.
-These MAGI groups include Parents and Caretaker Relatives, Pregnant Women, Children, and Adults.
-For a more complete description of the MAGI categories and pursuant rules, please refer to section
-8.100.4.
-MIA - Monthly Income Allowance is the amount of institutionalized spouse’s income that the community
-spouse is allowed to retain to meet their monthly living needs.
-MSP - Medicare Savings Program is a Medical Assistance Program to assist in the payment of Medicare
-premium, coinsurance and deductible amounts. There are four groups that are eligible for payment or
-part-payment of Medicare premiums, coinsurance and deductibles: Qualified Medicare Beneficiaries
-(QMBs), Specified Low-Income Medicare Beneficiaries (SLIMBs), Qualified Disabled and Working
-Individuals (QDWIs), and Qualifying Individuals – 1 (QI-1s).
-Non-Filer is an individual who neither files a tax return nor is claimed as a tax dependent. For a more
-complete description of how household composition is determined for the MAGI Medical Assistance
-groups, please refer to the MAGI household composition section at 8.100.4.E.
-
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-Nursing Facility is a facility or distinct part of a facility which is maintained primarily for the care and
-treatment of inpatients under the direction of a physician. The patients in such a facility require
-supportive, therapeutic, or compensating services and the availability of a licensed nurse for observation
-or treatment on a twenty-four-hour basis.
-OAP - Old Age Pension is a financial assistance program for low income adults age 60 or older.
-OASDI - Old Age, Survivors and Disability Insurance is the official term Social Security uses for Social
-Security Act Title II benefits including retirement, survivors, and disability. This does not include SSI
-payments.
-Outpatient is a patient who is not hospitalized overnight but who visits a hospital, clinic, or associated
-facility for diagnosis or treatment. Is a patient who does not require admittance to a facility to receive
-medical services.
-PACE - Program of All-inclusive Care for the Elderly is a unique, capitated managed care benefit for the
-frail elderly provided by a not-for-profit or public entity. The PACE program features a comprehensive
-medical and social service delivery system using an interdisciplinary team approach in an adult day
-health center that is supplemented by in-home and referral services in accordance with participants'
-needs.
-Parent and Caretaker Relative is a MAGI Medical Assistance group that provides Medical Assistance to
-adults who are parents or Caretaker Relatives of dependent children.
-Patient is an individual who is receiving needed professional services that are directed by a licensed
-practitioner of the healing arts toward maintenance, improvement, or protection of health, or lessening of
-illness, disability, or pain.
-PEAK – the Colorado Program Eligibility and Application Kit is a web-based portal used to apply for public
-assistance benefits in the State of Colorado, including Medical Assistance.
-PNA - Personal Needs Allowance means moneys received by any person admitted to a nursing care
-facility or Long-Term Care Institution which are received by said person to purchase necessary clothing,
-incidentals, or other personal needs items which are not reimbursed by a Federal or state program.
-Pregnant Women is a MAGI Medical Assistance group that provides Medical Assistance coverage to
-pregnant women whose MAGI-based income calculation is less than 195% FPL, including women who
-are in their 12 months post-partum.
-Premium means the monthly amount an individual pays to participate in a Medicaid Buy-In Program.
-Provider is any person, public or private institution, agency, or business concern enrolled under the state
-Medical Assistance program to provide medical care, services, or goods and holding a current valid
-license or certificate to provide such services or to dispense such goods.
-Psychiatric Facility is a facility that is licensed as a residential care facility or hospital and that provides
-inpatient psychiatric services for individuals under the direction of a licensed physician.
-Public Institution means an institution that is the responsibility of a governmental unit or over which a
-governmental unit exercises administrative control.
-Questionable is defined as inconsistent or contradictory tangible information, statements, documents, or
-file records.
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-Reasonable Compatibility refers to an allowable difference or discrepancy between the income an
-applicant self attests and the amount of income reported by an electronic data source. For a more
-complete description of how reasonable compatibility is used to determine an applicant’s financial
-eligibility for Medical Assistance, please refer to the MAGI Income section at 8.100.4.C
-Reasonable Explanation refers to the opportunity afforded an applicant to explain a discrepancy between
-self-attested income and income as reported by an electronic data source, when the difference is above
-the threshold percentage for reasonable compatibility.
-Recipient is any person who has been determined eligible to receive benefits.
-Resident is any individual who is living within the state and considers the state as their place of residence.
-Residents include any unemancipated child whose parent or other person exercising custody lives within
-the state.
-RRB - Railroad Retirement Benefits is a benefit program under Federal law 45 U.S.C. § 231 et seq that
-became effective in 1935. It provides retirement benefits to retired railroad workers and families from a
-special fund, which is separate from the Social Security fund.
-Secondary School is a school or educational program that provides instruction or training towards a high
-school diploma or an equivalent degree such as a High School Equivalency Diploma (HSED).
-SGA – Substantial Gainful Activity is defined by the Social Security Administration. SGA is the term used
-to describe a level of work activity and earnings. Work is “substantial” if it involves performance of
-significant physical or mental activities or a combination of both, which are productive in nature. For work
-activity to be substantial, it does not need to be performed on a full-time basis. Work activity performed on
-a part-time basis may also be substantial gainful activity. “Gainful” work activity is work performed for pay
-or profit; or work of a nature generally performed for pay or profit; or work intended for profit, whether or
-not a profit is realized.
-Single Entry Point Agency means the organization selected to provide case management functions for
-persons in need of Long-Term Care services within a Single Entry Point District.
-Single Streamlined Application or “SSAp” is the general application for health assistance benefits through
-which applicants will be screened for Medical Assistance programs including Medicaid, CHP+, or
-premium and cost-sharing assistance for purchasing private health insurance through a state insurance
-marketplace.
-SISC- Supplemental Income Status Codes are system codes used to distinguish the different types of
-state supplementary benefits (such as OAP) a recipient may receive. Supplemental Income Status Codes
-determine the FFP for benefits paid on behalf of groups covered under the Medical Assistance program.
-SSA - Social Security Administration is an agency of the United States federal government that
-administers Social Security, a social insurance program consisting of retirement, disability, and survivors'
-benefits.
-SSI - Supplemental Security Income is a Federal income supplement program funded by general tax
-revenues (not Social Security taxes) that provides income to aged, blind or disabled individuals with little
-or no income and resources.
-SSI Eligible means an individual who is eligible to receive Supplemental Security Income under Title XVI
-of the Social Security Act, and may or may not be receiving the monetary payment.
-TANF - Temporary Assistance to Needy Families is the Federal assistance program which provides
-supportive services and federal benefits to families with little or no income or resources. It is the Block
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-Grant that was established under the Personal Responsibility and Work Opportunity Reconciliation Act in
-Title IV of the Social Security Act.
-Tax Dependent is anyone expected to be claimed as a dependent by a Tax-Filer.
-Tax-Filer is an individual, head of household or married couple who is required to and who files a
-personal income tax return.
-Third Party is an individual, institution, corporation, or public or private agency which is or may be liable to
-pay all or any part of the medical cost of an injury, a disease, or the disability of an applicant for or
-recipient of Medical Assistance.
-Title XIX is the portion of the federal Social Security Act which authorizes a joint federal/state Medicaid
-program. Title XIX contains federal regulations governing the Medicaid program.
-TMA - Transitional Medical Assistance is a Medical Assistance category for families that lost Medical
-Assistance coverage due to increased earned income or loss of earned income disregards.
-Unearned Income is the gross amount received in cash or kind that is not earned from employment or
-self-employment.
-VA - Veterans Affairs is The Department of Veterans Affairs which provides patient care and Federal
-benefits to veterans and their dependents.
-8.100.2
-
-Legal Basis
-
-Constitution of Colorado, Article XXIV, Old Age Pensions, section 7, established a health and medical
-care fund for persons who qualify to receive old age pensions.
-Colorado Revised Statutes, Title 25.5, Article 4, Colorado Medical Assistance Act, section 102, provides
-for a program of Medical Assistance for individuals and families, whose income and resources are
-insufficient to meet the costs of necessary medical care and services, to be administered in cooperation
-with the federal government.
-The Social Security Act, Title XIX, Grants to States for Medical Assistance Programs, and the consequent
-Federal regulations, Title 42, CFR (Code of Federal Regulations), Chapter IV, Subchapter C, set forth the
-conditions for states to obtain Federal Financial Participation in Medical Assistance expenditures.
-Under the Colorado Medical Assistance Program, the Medicaid program provides coverage of certain
-groups specified in Title XIX of the Social Security Act. The OAP State Only Medical Assistance Program
-provides coverage to certain old age pension clients entitled to health and medical care under the
-Colorado Constitution.
-The Department of Health Care Policy and Financing is the single State agency designated to administer
-the Colorado Medical Assistance Program under Title XIX of the Social Security Act and Colorado
-statutes. The Office of Medical Assistance of the Department is delegated the duties and responsibilities
-for administration of the Colorado Medical Assistance Program.
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-8.100.3.
-
-Medical Assistance General Eligibility Requirements
-
-8.100.3.A.
-
-Application Requirements
-
-10 CCR 2505-10 8.100
-
-1.
-
-The eligibility site shall advise individuals concerning the benefits of the Medical Assistance
-Program and determine or redetermine eligibility for Medical Assistance in accordance with rules
-and regulations of the Department. A person who is applying for the Medical Assistance Program
-or a client who is determined ineligible for the Medical Assistance Program in one category shall
-be evaluated under all other categories of eligibility. There is no time limit for Medical Assistance
-coverage as long as the client remains categorically eligible.
-
-2.
-
-If the applicant applied for Medical Assistance on the Single Streamlined Application and was
-found ineligible, this application shall be reviewed for all other Medical Assistance eligibility
-programs, the Child Health Plan Plus (CHP+) program and premium and cost-sharing assistance
-for purchasing private health insurance through the state insurance marketplace.
-a.
-
-The application data and verifications shall be automatically transferred to the state
-insurance marketplace through a system interface when applicants are found ineligible
-for Medical Assistance eligibility programs. If an individual is pending for a Non-MAGI
-Medical Assistance eligibility program but has been found financially ineligible for MAGI
-Medical Assistance eligibility programs, the application data and verifications shall be
-transferred to the state insurance marketplace.
-
-3.
-
-Persons applying for assistance need complete only one application form to apply for both
-Medical Assistance and Financial Assistance under the Federal or State Financial Assistance
-Programs administered in the county. The application will be the Application for Public
-Assistance.
-
-4.
-
-If an applicant is found to be ineligible for a particular program, the Application for Public
-Assistance shall be reviewed and processed for other financial programs the household has
-requested on the Application for Public Assistance and all other Medical Assistance Programs.
-Referrals to other community agencies and organizations shall be made for the applicant
-whenever available or requested.
-
-5.
-
-The applicant must sign the application form, give declaration in lieu of a signature by telephone,
-or may opt to use an electronic signature in order to receive Medical Assistance.
-
-6.
-
-A family member, adult in the applicant’s Medical Assistance Required Household or authorized
-representative may submit an application and request assistance on behalf of an applicant.
-
-7.
-
-If the applicant is not able to participate in the completion of the application forms because they
-are a minor (as defined in C.R.S. § 13-22-101) or due to physical or mental incapacity, the
-spouse, other relative, friend, or representative acting responsibly on behalf of the applicant may
-complete the forms. When no such person is available to assist in these situations, the eligibility
-site shall assist the applicant in the completion of the necessary forms. This type of situation
-should be identified clearly in the case record.
-
-8.
-
-For the purpose of Medical Assistance, when an applicant is incompetent or incapacitated and
-unable to sign an application, or in case of death of the applicant, the application shall be signed,
-under penalty of perjury, by someone acting responsibly on behalf of the applicant either:
-a.
-
-A parent, or other specified relative, or legally appointed guardian or conservator, or
-
-b.
-
-For a person in a medical institution for whom none of the above in 8.a. are available, an
-authorized official of the institution may sign the application.
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-9.
-
-Application interviews or requested visits to the eligibility site for Medical Assistance shall not be
-required. All correspondence may occur by mail, email or telephone.
-
-10.
-
-During normal business hours, eligibility sites shall not restrict the hours in which applicants may
-file an application. The eligibility site must afford any individual wishing to do so the opportunity to
-apply for Medical Assistance without delay.
-
-11.
-
-The applicant has the right to withdraw his or her application at any time.
-
-8.100.3.B.
-1.
-
-Individuals shall make application in the county in which they live. Individuals who reside in a
-county but who do not reside in a permanent dwelling nor have a fixed mailing address shall be
-considered eligible for the Medical Assistance Program, provided all other eligibility requirements
-are met. In no instance shall there be a durational residency requirement imposed upon the
-applicant, nor shall there be a requirement for the applicant to reside in a permanent dwelling or
-have a fixed mailing address. If an individual without a permanent dwelling or fixed mailing
-address is hospitalized, the county where the hospital is located shall be responsible for
-processing the application to completion. If the individual moves prior to completion of the
-eligibility determination the origination eligibility site completes the determination and transfers the
-case as applicable.
-a.
-
-2.
-
-3.
-
-Residency Requirements
-
-For applicants in Long Term Care institutions - The county of domicile for all Long Term
-Care clients is the county in which they are physically located and receiving services.
-
-A resident of Colorado is defined as a person that is living within the state of Colorado and
-considers Colorado to be their place of residence at the time of application. For institutionalized
-individuals who are incapable of indicating intent as to their state of residence, the state of
-residence shall be where the institution is located unless that state determines that the individual
-is a resident of another state, by applying the following criteria:
-a.
-
-for any institutionalized individual who is under age 21 or who is age 21 or older and
-incapable of indicating intent before age 21, the state of residence is that of the
-individual's parent(s) or legally appointed guardian at the time of placement;
-
-b.
-
-for any institutionalized individual who became incapable of indicating intent at or after
-age 21, (1) the state of residence is the state in which the person was living when he or
-she became incapable of indicating intent, or (2) if this cannot be determined, the state of
-residence is the state in which the person was living when he or she was first determined
-to be incapable of indicating intent;
-
-c.
-
-upon placement in another state, the new state is the state of residence unless the
-current state of residence is involved in the placement. If a current state arranged for an
-individual to be placed in an institution located in another state, the current state shall be
-the individual's state of residence, irrespective of the individual's indicated intent or ability
-to indicate intent;
-
-d.
-
-in the case of conflicting opinions between states, the state of residence is the state
-where the individual is physically located.
-
-For purposes of this section on establishing an individual's state of residence, an individual is
-considered incapable of indicating intent if:
-a.
-
-the person has an I.Q. of 49 or less or has a mental age of 7 or less, based on
-standardized tests as specified in the persons in medical facilities section of this volume;
-
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-10 CCR 2505-10 8.100
-
-b.
-
-the person is judged legally incompetent; or
-
-c.
-
-medical documentation, or other documentation acceptable to the eligibility site, supports
-a finding that the person is incapable of indicating intent.
-
-4.
-
-Residence shall be retained until abandoned. A person temporarily absent from the state, inside
-or outside the United States, retains Colorado residence. Temporarily absent means that at the
-time he/she leaves, the person intends to return.
-
-5.
-
-A non-resident shall mean a person who considers his/her place of residence to be other than
-Colorado. Any person who enters the state to receive Medical Assistance or for any other reason
-is a non-resident, so long as they consider their permanent place of residence to be outside of the
-state of Colorado.
-
-8.100.3.C.
-
-Transferring Requirements
-
-1.
-
-When a family or individual moves from one county to another within Colorado, the client shall
-report the change of address to the eligibility site responsible for the current active Medical
-Assistance Program case(s). If a household applies in the county in which they live and then
-moves out of that county during the application determination process, the originating eligibility
-site shall complete the processing of that application before transferring the case. The originating
-eligibility site shall electronically transfer the case to the new county of residence in CBMS.
-
-2.
-
-The originating eligibility site must notify the receiving eligibility site of the client's transfer of
-Medical Assistance. The originating eligibility site may notify the receiving eligibility site by
-telephone that a client has moved to the receiving county. If the family or individual wishes to
-apply for other types of assistance, they shall submit a new application to the receiving eligibility
-site.
-
-3.
-
-If the household is transferring the current Medical Assistance case, the receiving eligibility site
-cannot mandate a new application, verification, or an office visit to authorize the transfer. The
-receiving eligibility site can request copies of specific case documents to be forwarded from the
-originating eligibility site to verify the data contained in CBMS.
-
-4.
-
-If the originating eligibility site closes a case for the discontinuation reason of “unable to locate,”
-the applicant shall reapply at the receiving eligibility site for the Medical Assistance Program.
-
-5.
-
-If a case is closed for any other discontinuation reason than “unable to locate” and the client
-provides appropriate information to overturn the discontinuation with the originating eligibility site,
-then, upon transfer, the receiving eligibility site shall reopen the case with case comments in
-CBMS. These actions shall be performed according to timeframes defined by the Department.
-
-6.
-
-When a recipient moves from his/her home to a nursing facility in another county or when a
-recipient moves from one nursing facility to another in a different county:
-a.
-
-the initiating eligibility site will transfer the case electronically in the eligibility system to
-the eligibility site in which the nursing facility is located when the individual is determined
-eligible; and
-
-b.
-
-The following items shall be furnished by the initiating eligibility site to the new eligibility
-site in hard copy format or via electronic transmission:
-i)
-
-5615 that was sent to the nursing facility indicating the case transfer; and
-
-ii)
-
-Identification and citizenship documents; and
-
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-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-iii)
-7.
-
-2.
-
-Long-Term Services and Supports Level of Care Eligibility Determination
-
-When transferring a case, the initiating eligibility site will send an AP-5615 form to the nursing
-facility administrator of the new nursing facility showing the date of case closure and the current
-patient payment at the time of transfer. Should the Medical Assistance Program reimbursement
-be interrupted, the receiving eligibility site will have the responsibility to process the application
-and back date the Medical Assistance eligibility date to cover the period of ineligibility.
-
-8.100.3.D.
-1.
-
-10 CCR 2505-10 8.100
-
-Processing Requirements
-
-The eligibility site shall process a Single Streamlined Application for Medical Assistance Program
-benefits within the following deadlines:
-a.
-
-90 days for persons who apply for the Medical Assistance Program and a disability
-determination is required.
-
-b.
-
-45 days for all other Medical Assistance Program applicants.
-
-c.
-
-The above deadlines cover the period from the date of receipt of a complete application
-to the date the eligibility site mails a notice of its decision to the applicant.
-
-d.
-
-In unusual circumstances, documented in the case record and in CBMS case comments,
-the eligibility site may delay its decision on the application beyond the applicable deadline
-at its discretion. Examples of such unusual circumstances are a delay or failure by the
-applicant or an examining physician to take a required action such as submitting required
-documentation, or an administrative or other emergency beyond the agency's control.
-
-e.
-
-Due to the Coronavirus COVID-19 Public Health Emergency, required through the
-Federal CARES Act for the Maintenance of Effort (MOE), the Department will continue
-eligibility for all Medical Assistance categories, regardless of changes made for a
-redetermination or additional documentation for current Medicaid enrollees. The
-Department will allow these individuals to continue eligibility through the period of the
-COVID-19 pandemic federal emergency declaration. Once the federal emergency
-declaration has concluded, the Department will process eligibility redeterminations and
-/or changes for all members whose eligibility was maintained during the emergency
-declaration. Effective May 11, 2023 the coronavirus COVID-19 pandemic federal
-emergency has been declared to end. To ensure the Department Maintains access to
-State and Federal funding provided by the Federal ‘Families First Coronavirus Response
-Act” Pub.L. 116-127, and the Federal “Consolidated Appropriations Act, 2023”, the
-Department will process eligibility redeterminations and take appropriate action for all
-members whose eligibility was maintained during the emergency declaration. By May
-2024 all members whose eligibility has been maintained due to the Public Health
-Emergency will have completed the renewal process. A member’s eligibility may no
-longer be maintained after May 31, 2023 if they have completed the renewal process
-and/or a change is reported, and they are found ineligible. Members whose eligibility has
-been maintained during the Public Health Emergency and whose renewal is not due yet
-will remain in their current category until their renewal due month, regardless if there is a
-change reported that makes them ineligible.
-
-Upon request, applicants will be given an extension of time within the application processing
-timeframe to submit requested verification. Applicants may request an extension of time beyond
-the application processing timeframe to obtain necessary verification. The extension may be
-granted at the eligibility site's discretion. The amount of time given should be determined on a
-case-by-case basis and should be based on the amount of time the individual needs to obtain the
-required documentation.
-
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-Medical Services Board
-
-10 CCR 2505-10 8.100
-
-3.
-
-The eligibility site shall not use the above timeframes as a waiting period before determining
-eligibility or as a reason for denying eligibility.
-
-4.
-
-For clients who apply for the Medical Assistance Program and a disability determination is
-required, the eligibility site shall send a notice informing the applicant of the reason for a delay
-beyond the applicable deadline, and of the applicant's right to appeal if dissatisfied with the delay.
-The eligibility site shall send this notice no later than 91 days following the application for the
-Medical Assistance Program.
-
-5.
-
-For information regarding continuation of benefits during the pendency of an appeal to the Social
-Security Administration (SSA) based upon termination of disability benefits see section 8.057.5.C.
-
-6.
-
-Eligibility sites at which an individual is able to apply for Medical Assistance benefits shall also
-provide the applicant the opportunity to register to vote.
-
-7.
-
-a.
-
-The eligibility site shall provide to the applicant the prescribed voter registration
-application.
-
-b.
-
-The eligibility site shall not:
-i)
-
-Seek to influence the applicant's political preference or party registration;
-
-ii)
-
-Display any political preference or party allegiance;
-
-iii)
-
-Make any statement to the applicant or take any action, the purpose or effect of
-which is to discourage the applicant from registering to vote; and
-
-iv)
-
-Make any statement to an applicant which is to lead the applicant to believe that
-a decision to register or not to register has any bearing on the availability of
-services or benefits.
-
-c.
-
-The eligibility site shall ensure the confidentiality of individuals registering and declining to
-register to vote.
-
-d.
-
-Records concerning registration and declination to register to vote shall be maintained for
-two years by the eligibility site. These records shall not be part of the public assistance
-case record.
-
-e.
-
-A completed voter registration application shall be transmitted to the county clerk and
-recorder for the county in which the eligibility site is located not later than ten (10) days
-after the date of acceptance; except that if a registration application is accepted within
-five (5) days before the last day for registration to vote in an election, the application shall
-be transmitted to the county clerk and recorder for the county not later than five (5) days
-after the date of acceptance.
-
-Individuals who transfer from one Colorado county to another shall be provided the same
-opportunity to register to vote in the new county of residence. The new county of residence shall
-follow the above procedure. The new county of residence shall notify its county clerk and recorder
-of the client's change in address within five (5) days of receiving the information from the client.
-
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-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-8.100.3.E.
-
-10 CCR 2505-10 8.100
-
-Retroactive Medical Assistance Coverage
-
-1.
-
-An applicant for Medical Assistance shall be provided such assistance any time during the three
-months preceding the date of application, or as of the date the person became eligible for Medical
-Assistance, whichever is later. That person shall have received medical services at any time
-during that period and met all applicable eligibility requirements.
-
-2.
-
-An explanation of the conditions for retroactive Medical Assistance shall be given to all
-applicants. Those applicants who within the three months period prior to the date of application or
-as of the date the person became eligible for Medical Assistance, whichever is later, have
-received medical services which would be a benefit under the Colorado State Plan, can request
-retroactive coverage on the application form. The determination of eligibility for retroactive
-Medical Assistance shall be made as part of the application process. An applicant does not have
-to be eligible in the month of application to be eligible for retroactive Medical Assistance. The
-applicant or client may verbally request retroactive coverage at any time following the completion
-of an application. Verification required to determine Medical Assistance Program eligibility for the
-retroactive period shall be secured by the eligibility site to determine retroactive eligibility. Proof of
-the declared medical service shall not be required.
-
-8.100.3.F.
-1.
-
-Groups Assisted Under the Program
-
-The Medical Assistance Program provides benefits to the following persons who meet the federal
-definition of categorically needy at the time they apply for benefits:
-a.
-
-Parents and Caretaker Relatives, Pregnant Women, Children, Adults, and Family
-Planning Medical Assistance as defined under the Modified Adjusted Gross Income
-(MAGI)Medical Assistance section 8.100.4.
-
-b.
-
-Persons who meet legal immigrant requirements as outlined in this volume, who were or
-would have been eligible for SSI but for their alien status, if such persons meet the
-resource, income and disability requirements for SSI eligibility.
-
-c.
-
-Persons who are receiving financial assistance; and who are eligible for a SISC Code of
-A or B. See section 8.100.3.M for more information on SISC Codes.
-
-d.
-
-Persons who are eligible for financial assistance under Old Age Pension (OAP) and SSI,
-but are not receiving the money payment.
-
-e.
-
-Persons who would be eligible for financial assistance from OAP or SSI, except for the
-receipt of Social Security Cost of Living Adjustment (COLA) increases, or other
-retirement, survivors, or disability benefit increases to their own or a spouse's income.
-This group also includes persons who lost OAP or SSI due to the receipt of Social
-Security Benefits and who would still be eligible for the Medical Assistance Program
-except for the cost of living adjustments (COLA's) received. These populations are
-referenced as Pickle and Disabled Widow(er)s.
-
-f.
-
-Persons who are blind, disabled, or aged individuals residing in the medical institution or
-Long Term Care Institution whose income does not exceed 300% of SSI.
-
-g.
-
-Persons who are blind, disabled or aged receiving HCBS whose income does not exceed
-300% of the SSI benefit level and who, except for the level of their income, would be
-eligible for an SSI payment.
-
-15
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-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-h.
-
-A disabled adult child who is at least 18 years of age and who was receiving SSI as a
-disabled child prior to the age of 22, and for whom SSI was discontinued on or after May
-1, 1987, due to having received of OASDI drawn from a parent(s) Social Security
-Number, and who would continue to be eligible for SSI if the above OASDI and all
-subsequent cost of living adjustments were disregarded. This population is referenced as
-Disabled Adult Child (DAC).
-
-i.
-
-Children age 18 and under who would otherwise require institutionalization in an Long
-Term Care Institution, Nursing Facility (NF), or a hospital but for which it is appropriate to
-provide care outside of an institution as described in 1902(e)(3) of the Act Public Law No.
-97-248 (Section 134).
-
-j.
-
-Persons receiving OAP-A, OAP-B, and OAP Refugees who do not meet SSI eligibility
-criteria but do meet the state eligibility criteria for the OAP State Only Medical Assistance
-Program. These persons qualify for a SISC Code C.
-
-k.
-
-Persons who apply for and meet the criteria for one of the categorical Medical Assistance
-programs, but do not meet the criteria of citizenship shall receive Medical Assistance
-benefits for emergencies only.
-
-l.
-
-Persons with a disability or limited disability who are at least 16, with income less than or
-equal to 450% of FPL after income disregards, regardless of resources, and who are
-employed.
-
-m.
-
-Children with a disability who are age 18 and under, with household income less than or
-equal to 300% of FPL after income disregards, regardless of resources.
-
-n.
-
-Effective March 2020 due to the Coronavirus COVID-19 Public Health Emergency, an
-applicant who is not eligible for Medical Assistance but has been impacted through
-exposure to or potential infection of COVID-19 may be eligible to receive services for
-COVID-19 testing, treatment, or care for complications related to COVID-19. To qualify
-for this limited benefit, the applicant must satisfy residency and immigration-or citizenship
-and not be enrolled in other health insurance. With the expiration of the Covid-19 Public
-Health Emergency declaration effective May 11, 2023 the limited COVID-19 benefit group
-will end. Federal financial participation (FFP) is not available for services after the last
-day of the PHE. The Department will use state-only funds to continue to provide
-coverage for individuals who were enrolled in the limited Covid-19 benefit group on May
-11, 2023 until May 31,2023. After May 11, 2023 individuals will no longer be enrolled in
-the limited Covid-19 benefit group.
-
-8.100.3.G.
-1.
-
-10 CCR 2505-10 8.100
-
-General and Citizenship Eligibility Requirements
-
-To be eligible to receive Medical Assistance, an eligible person shall:
-a.
-
-Be a resident of Colorado;
-
-b.
-
-Meet the following requirements while being an inmate, in-patient or resident of a public
-institution:
-i).
-
-The following individuals, if eligible, may be enrolled for Medical Assistance
-1.
-
-Patients in a public medical institution
-
-2.
-
-Residents of a Long-Term Care Institution
-
-16
-
-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-ii).
-
-10 CCR 2505-10 8.100
-
-3.
-
-Prior inmates who have been paroled
-
-4.
-
-Resident of a publicly operated community residence which serves no
-more than 16 residents
-
-5.
-
-Individuals participating in community corrections programs or residents
-in community corrections facilities (“halfway houses”) who have freedom
-of movement and association which includes individuals who:
-a)
-
-are not precluded from working outside the facility in employment
-available to individuals who are not under justice system
-supervision;
-
-b)
-
-can use community resources (e.g., libraries, grocery stores,
-recreation, and education) at will;
-
-c)
-
-can seek health care treatment in the broader community to the
-same or similar extent as other Medicaid enrollees in the state;
-and/or
-
-d)
-
-are residing at their home, such as house arrest, or another
-location
-
-Inmates who are incarcerated in a correctional institution such as a city, county,
-state or federal prison may be enrolled, if eligible, with benefits limited to an inpatient stay of 24 hours or longer in a medical institution.
-
-c.
-
-Not be a patient in an institution for tuberculosis or mental disease, unless the person is
-under 21 years of age or has attained 65 years of age and is eligible for the Medical
-Assistance Program and is receiving active treatment as an inpatient in a psychiatric
-facility eligible for Medical Assistance reimbursement. See section 8.100.4.H for special
-provisions extending Medical Assistance coverage for certain patients who attain age 21
-while receiving such inpatient psychiatric services;
-
-d.
-
-Meet all financial eligibility requirements of the Medical Assistance Program for which
-application is being made;
-
-e.
-
-Meet the definition of disability or blindness, when applicable. Those definitions appear in
-this volume at 8.100.1 under Definitions;
-
-f.
-
-Meet all other requirements of the Medical Assistance Program for which application is
-being made; and
-
-g.
-
-Fall into one of the following categories:
-i)
-
-Be a citizen or national of the United States, the District of Columbia, Puerto
-Rico, Guam, the Virgin Islands, the Northern Mariana Islands, American Samoa
-or Swain’s Island; or
-
-ii)
-
-Be a lawfully admitted non-citizen who entered the United States prior to August
-22, 1996, or
-
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-
-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-iii)
-
-iv)
-
-10 CCR 2505-10 8.100
-
-Be a non-citizen who entered the United States on or after August 22, 1996 and
-is applying for Medical Assistance benefits to begin no earlier than five years
-after the non-citizen’s date of entry into the United States who falls into one of the
-following categories:
-1)
-
-lawfully admitted for permanent residence under the Immigration and
-Nationality Act (hereafter referred to as the “INA”);
-
-2)
-
-paroled into the United States for at least one year under 8 U.S.C. §
-1182(d)(5); or
-
-3)
-
-granted conditional entry under section 203(a)(7) of the INA, as in effect
-prior to April 1, 1980; or
-
-4)
-
-determined by the eligibility site, in accordance with guidelines issued by
-the U.S. Attorney General, to be a spouse, child, parent of a child, or
-child of a parent who, in circumstances specifically described in 8 U.S.C.
-§1641(c), has been battered or subjected to extreme cruelty which
-necessitates the provision of Medical Assistance (Medicaid); or
-
-Be a non-citizen who arrived in the United States on any date, who falls into one
-of the following categories:
-1)
-
-lawfully residing in Colorado and is an honorably discharged military
-veteran (also includes spouse, unremarried surviving spouse and
-unmarried, dependent children), or
-
-2)
-
-lawfully residing in Colorado and is on active duty (excluding training) in
-the U.S. Armed Forces (also includes spouse, unremarried surviving
-spouse and unmarried, dependent children), or
-
-3)
-
-granted asylum under section 208 of the INA, or
-
-4)
-
-refugee under section 207 of the INA, or
-
-5)
-
-deportation withheld under section 243(h) (as in effect prior to
-September 30, 1996) or section 241(b)(3) (as amended by P.L. 104-208)
-of the INA, or
-
-6)
-
-Cuban or Haitian entrant, as defined in section 501(e) of the Refugee
-Education Assistance Act of 1980, or
-
-7)
-
-an individual who (1) was born in Canada and possesses at least 50
-percent American Indian blood, or is a member of an Indian tribe as
-defined in 25 U.S.C. sec. 5304(e)(2016), or
-
-8)
-
-admitted to the U.S. as an Amerasian immigrant pursuant to section 584
-of the Foreign Operations, Export Financing, and Related Programs
-Appropriations Act of 1988 (as amended by P.L. 100-461), or
-
-9)
-
-lawfully admitted permanent resident who is a Hmong or Highland Lao
-veteran of the Vietnam conflict, or
-
-18
-
-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-10 CCR 2505-10 8.100
-
-10)
-
-a victim of a severe form of trafficking in persons, as defined in section
-103 of the Victims of Trafficking and Violence Protection Act of 2000,
-Pub. L.106-386, as amended (22 U.S.C. § 7105(b) (2016)), or
-
-11)
-
-An alien who arrived in the United States on or after December 26, 2007
-who is an Iraqi special immigrant under section 101(a)(27) of the INA, or
-
-12)
-
-An alien who arrived in the United States on or after December 26, 2007
-who is an Afghan Special Immigrant under section 101(a)(27) of the INA,
-or
-
-13)
-
-Compact of Free Association (COFA) migrants, including citizens of
-Micronesia, the Marshall Islands, and Palau, pursuant to section 208 of
-the Consolidated Appropriations Act of 2021 (in effect December 27,
-2020).
-
-v)
-
-The statutes listed at sections 8.100.3.G.1.g.iii.1-5 and at 8.100.3.G.1.g.iv.3-11
-are incorporated herein by reference. No amendments or later editions are
-incorporated. These regulations are available for public inspection at the
-Colorado Department of Health Care Policy and Financing, 1570 Grant Street,
-Denver, Colorado 80203-1714. Pursuant to C.R.S. 24-4-103(12.5)(b)(2016), the
-agency shall provide certified copies of the material incorporated at cost upon
-request or shall provide the requestor with information on how to obtain a
-certified copy of the material incorporated by reference from the agency of the
-United States, this state, another state, or the organization or association
-originally issuing the code, standard, guideline or rule.
-
-vi)
-
-Be a lawfully admitted non-citizen who is a pregnant women or a child under the
-age of 19 years in the United States who falls into one of the categories listed in
-8.100.3.G.1.g.iii or into one of the following categories listed below. These
-individuals are exempt from the 5-year waiting period:
-1)
-
-granted temporary resident status in accordance with 8 U.S.C. 1160 or
-1255a,or
-
-2)
-
-granted Temporary Protected Status (TPS) in accordance with 8 U.S.C
-1254a and pending applicants for TPS granted employment
-authorization,
-
-3)
-
-granted employment authorization under 8 CFR 274a.12(c),or
-
-4)
-
-Family Unity beneficiary in accordance with section 301 of Pub. L. 101649, as amended.
-
-5)
-
-Deferred Enforced Departure (DED), pursuant to a decision made by the
-President,
-
-6)
-
-granted Deferred Action status (excluding Deferred Action for Childhood
-Arrivals (DACA)) as described in the Secretary of Homeland Security’s
-June 15,2012 memorandum,
-
-7)
-
-granted an administrative stay of removal under 8 CFR 241.6(2016), or
-
-8)
-
-Beneficiary of approved visa petition who has a pending application for
-adjustment of status.
-
-19
-
-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-9)
-
-vii)
-
-viii)
-
-10 CCR 2505-10 8.100
-
-Pending an application for asylum under 8 U.S.C. 1158, or for
-withholding of removal under 8 U.S.C. 1231, or under the Convention
-Against Torture whoa)
-
-as been granted employment authorization; or
-
-b)
-
-Is under the age of 14 and has had an application pending for at
-least 180 days.
-
-10)
-
-granted withholding of removal under the Convention Against Torture,
-
-11)
-
-A child who has a pending application for Special Immigrant Juvenile
-status under 8 U.S.C. 1101(a)(27)(J), or
-
-12)
-
-Citizens of Micronesia, the Marshall Islands, and Palau, or
-
-13)
-
-is lawfully present American Samoa under the immigration of laws of
-American Samoa.
-
-14)
-
-A non-citizen in a valid nonimmigrant status, as defined in 8 U.S.C.
-1101(a)(15) or under 8 U.S.C. 1101(a)(17), or
-
-15)
-
-A non-citizen who has been paroled into the United States for less than
-one year under 8 U.S.C. § 1182(d)(5), except for an individual paroled
-for prosecution, for deferred inspection or pending removal proceedings.
-
-Be an Afghan Humanitarian Parolee who falls into one of the following categories
-listed below, as defined in Section 2502 of the Extending Government Funding
-and Delivering Emergency Assistance Act of 2021 (HR 5305). These individuals
-are exempt from the 5-year waiting period until March 31, 2023, or through the
-termination of their parole period, whichever is later:
-1)
-
-paroled into the United States between July 31, 2021 – September 30,
-2022; or
-
-2)
-
-paroled into the United States after September 30, 2022, and
-a)
-
-is the spouse or child of an individual in subparagraph 1 as
-defined under section 101(b) of the Immigration and Nationality
-Act (8 U.S.C. 4 1101(b)); or
-
-b)
-
-is the parent or legal guardian of an individual in subparagraph 1
-who is determined to be an unaccompanied child under 6
-U.S.C.279(g)(2).
-
-Exception: Criteria set forth at 8.100.3.G.1.g does not apply to persons who
-apply for and meet the criteria for one of the specific Medical Assistance
-programs:
-1)
-
-Persons who are under the age of 19, whose 19th birthday occurred in
-the current month, who are pregnant, or who are within 12 months of the
-beginning of their postpartum period shall not be excluded from the
-following Medical Assistance Categories on the basis of immigration
-status:
-
-20
-
-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-2)
-
-10 CCR 2505-10 8.100
-
-a)
-
-MAGI Children, MAGI Pregnant, Psych <21, Transitional Medical
-Assistance, 4 Month Extended Medical Assistance, MAGI
-Prenatal Presumptive Eligibility, MAGI Child Presumptive
-Eligibility
-
-b)
-
-Medical Buy-In Program for Working Adults with Disabilities
-(including with Home and Community Based Services), Medicaid
-Buy-In Program for Children with Disabilities, and Long-Term
-Care waivers except Program of All Inclusive Care for the Elderly
-(PACE)
-
-Persons requesting limited emergency medical care only and/or
-reproductive care shall not be excluded on the basis of immigration
-status.
-
-For non-qualified non-citizens receiving Medical Assistance emergency only
-benefits, the following medical conditions will be covered:
-An emergency medical condition (including labor and delivery) which manifests
-itself by acute symptoms of sufficient severity (including severe pain) such that
-the absence of immediate medical attention could reasonably be expected to
-result in:
-a)
-
-placing the patient's health in serious jeopardy;
-
-b)
-
-serious impairment of bodily function; or
-
-c)
-
-serious dysfunction of any bodily organ or part.
-
-These persons need not select a primary care physician as they are eligible only
-for emergency medical services and/or reproductive health care services
-Applicants are not required to obtain a written statement by their physician for
-their application to be complete and processed. For emergency care, a physician
-must certify and declare the presence of an emergency medical condition when
-services are provided and shall indicate that services were for a medical
-emergency on the claim form. This will suffice as the physician statement for an
-emergency medical condition when services were provided. Medical Assistance
-coverage for emergency medical care only is limited to care and services that are
-necessary to treat immediate emergency medical conditions. Coverage does not
-include prenatal care or follow-up care. Medical Assistance benefits for
-reproductive health care services are limited to care and services that provide
-reproductive health and/or family planning services only. Once a member has
-been determined eligible for either of these emergency and/or reproductive
-health services, the member will not be required to submit a new application
-before 12 months for any other emergency and/or reproductive health services.
-Members will have the option to advise the Department, at any time, that they no
-longer need the services. Members receiving emergency and/or limited
-reproductive health services will receive a renewal at 12 months to redetermine
-their eligibility.
-3)
-
-The rules on confidentiality indicated under CRS § 24-74-103 prevent the
-Department or eligibility site from reporting to the USCIS persons who
-have applied for or are receiving assistance.
-
-21
-
-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-2.
-
-For determinations of eligibility for Medical Assistance, legal immigration status must be verified.
-This requirement applies to a non-citizen individual who meets the criteria of any category defined
-at 8.100.3.G(1)(g)(ii) (iii) (iv)(vi) or (vii) and has declared that he or she has a legal immigration
-status.
-a.
-
-3.
-
-10 CCR 2505-10 8.100
-
-The Verify Lawful Presence (VLP) interface will be used to verify immigration status. The
-VLP interface connects to the Systematic Alien Verification for Entitlements (SAVE)
-Program to verify legal immigration status.
-i)
-
-If an automated response from VLP confirms that the information submitted is
-consistent with VLP data for immigration status verification requirements, no
-further action is required for the individual and no additional documentation of
-immigration status is required.
-
-ii)
-
-If the VLP cannot automatically confirm the information submitted, the individual
-will be contacted with a request for additional documents and/or information
-needed to verify their legal immigration status through the VLP interface. If a
-response from the VLP interface confirms that the additional documents and/or
-information received from the individual verifies their legal immigration status, no
-further action is required for the individual and no additional documentation of
-immigration status is required.
-
-Reasonable Opportunity Period
-a.
-
-If the verification through the electronic interface is unsuccessful then the applicant will be
-provided a reasonable opportunity period, of 90 days, to submit documents indicating a
-legal immigration status, as listed in 8.100.3.G.1.g. The reasonable opportunity period will
-begin as of the date of the Notice of Action. The required documentation must be
-received within the reasonable opportunity period.
-
-b
-
-If the applicant does not provide the necessary documents within the reasonable
-opportunity period, then the applicant’s Medical Assistance application shall be
-terminated.
-
-c.
-
-The reasonable opportunity period applies to MAGI, Adult and Buy-In Programs.
-i)
-
-For the purpose of this section only, MAGI Programs for persons covered
-pursuant to 8.100.4.G or 8.100.4.I. include the following:
-Commonly Used Program Name
-Children’s Medical Assistance
-Parent and Caretaker Relative Medical Assistance
-Adult Medical Assistance
-Pregnant Women Medical Assistance
-Legal Immigrant Prenatal Medical Assistance
-Transitional Medical Assistance
-
-Rule Citation
-8.100.4.G.2
-8.100.4.G.3
-8.100.4.G.4
-8.100.4.G.5
-8.100.4.G.6
-8.100.4.I.1-5
-
-22
-
-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-ii)
-
-10 CCR 2505-10 8.100
-
-For the purpose of this section only, Adult and Buy-In Programs for persons
-covered pursuant to 8.100.3.F, 8.100.6.P, 8.100.6.Q, or 8.715. include the
-following:
-Commonly Used Program Name
-Old Age Pension A (OAP-A)
-Old Age Pension B (OAP-B)
-Qualified Disabled Widow/Widower
-Pickle
-Long-Term Care
-Medicaid Buy-In Program for Working Adults with Disabilities
-Medicaid Buy-In Program for Children with Disabilities
-Breast and Cervical Cancer Program (BCCP)
-
-8.100.3.H.
-1.
-
-Rule Citation
-8.100.3.F.1.c
-8.100.3.F.1.c
-8.100.3.F.1.e
-8.100.3.F.1.e
-8.100.3.F.1.f-h
-8.100.6.P
-8.100.6.Q
-8.715
-
-Citizenship and Identity Documentation Requirements
-
-For determinations of initial eligibility and redeterminations of eligibility for Medical Assistance
-made on or after July 1, 2006, citizenship or nationality and identity status must be verified unless
-such satisfactory documentary evidence has already been provided, as described in
-8.100.3.H.4.b. This requirement applies to an individual who declares or who has previously
-declared that he or she is a citizen or national of the United States.
-a.
-
-b.
-
-The following electronic interfaces shall be accepted as proof of citizenship and/or
-identity as listed and should be used prior to requesting documentary evidence from
-applicants/clients:
-i)
-
-SSA Interface is an acceptable interface to verify citizenship and identity. An
-automated response from SSA that confirms that the data submitted is consistent
-with SSA data, including citizenship or nationality, meets citizenship and identity
-verification requirements. No further action is required for the individual and no
-additional documentation of either citizenship or identity is required.
-
-ii)
-
-Department of Motor Vehicles (DMV) Interface is an acceptable interface to verify
-identity. An automated response from DMV confirms that the data submitted is
-consistent with DMV data for identity verification requirements. No further action
-is required for the individual and no additional documentation of identity is
-required.
-
-This requirement does not apply to the following groups:
-i)
-
-Individuals who are entitled to or who are enrolled in any part of Medicare.
-
-ii)
-
-Individuals who receive Supplemental Security Income (SSI).
-
-iii)
-
-Individuals who receive child welfare services under Title IV-B of the Social
-Security Act on the basis of being a child in foster care.
-
-iv)
-
-Individuals who receive adoption or foster care assistance under Title IV-E of the
-Social Security Act.
-
-v)
-
-Individuals who receive Social Security Disability Insurance (SSDI).
-
-23
-
-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-vi)
-
-Children born to a woman who has applied for, has been determined eligible, and
-is receiving Medical Assistance on the date of the child's birth, as described in
-8.100.4.G.5. This includes instances where the labor and delivery services were
-provided before the date of application and were covered by the Medical
-Assistance Program as an emergency service based on retroactive eligibility.
-1)
-
-A child meeting the criteria described in 8.100.3.H.1.b.vi shall be deemed
-to have provided satisfactory documentary evidence of citizenship or
-nationality and shall not be required to provide further documentary
-evidence at any time in the future, regardless of any subsequent
-changes in the child’s eligibility for Medical Assistance.
-
-2)
-
-Special Provisions for Retroactive Reversal of a Previous Denial
-a)
-
-2.
-
-10 CCR 2505-10 8.100
-
-If a child described at 8.100.3.H.1.b.vi was previously
-determined to be ineligible for Medical Assistance solely for
-failure to meet the citizenship and identity documentation
-requirements, the denial shall be reversed. Eligibility shall be
-effective retroactively to the date of the child’s birth provided all
-of the following criteria are met:
-(1)
-
-The child was determined to be ineligible for Medical
-Assistance during the period between July 1, 2006 and
-October 1, 2009 solely for failure to meet the citizenship
-and identity documentation requirements as they existed
-during that period;
-
-(2)
-
-The child would have been determined to be eligible for
-Medical Assistance had 8.100.3.H.1.b.vi and/or
-8.100.3.H.1.b.vi.2.a been in effect during the period from
-July 1, 2006 through October 1, 2009; and
-
-(3)
-
-The child’s parent, caretaker relative, or legally
-appointed guardian or conservator requests that the
-denial of eligibility for Medical Assistance be reversed.
-The request may be verbal or in writing.
-
-b)
-
-A child for whom denial of eligibility for Medical Assistance has
-been retroactively reversed shall be subject to the eligibility
-redetermination provisions described at 8.100.3.P.1. Such
-redetermination shall occur twelve months from the retroactive
-eligibility date determined when the denial was reversed
-pursuant to this subsection 1.
-
-c)
-
-A child granted retroactive eligibility for Medical Assistance shall
-be subject to the requirements described at 8.100.4.G.2. for
-continued eligibility.
-
-vii)
-
-Individuals receiving Medical Assistance during a period of presumptive eligibility.
-
-viii)
-
-Individuals qualifying for Medical Assistance under 8.100.3.G.g.viii.
-
-Satisfactory documentary evidence of citizenship or nationality includes the following:
-
-24
-
-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-a.
-
-10 CCR 2505-10 8.100
-
-Stand-alone documents for evidence of citizenship and identity. The following evidence
-shall be accepted as satisfactory documentary evidence of both identity and citizenship:
-i)
-
-A U.S. passport issued by the U.S. Department of State that:
-1)
-
-includes the applicant or recipient, and
-
-2)
-
-was issued without limitation. A passport issued with a limitation may be
-used as proof of identity, as outlined in 8.100.3.H.3.
-
-ii)
-
-A Certificate of Naturalization (DHS Forms N-550 or N-570) issued by the
-Department of Homeland Security (DHS) for naturalized citizens.
-
-iii)
-
-A Certificate of U.S. Citizenship (DHS Forms N-560 or N-561) issued by the
-Department of Homeland Security for individuals who derive citizenship through
-a parent.
-
-iv)
-
-A document issued by a federally recognized Indian tribe, evidencing
-membership or enrollment in, or affiliation with, such tribe (such as a tribal
-enrollment card or certificate of degree of Indian blood).
-1)
-
-Special Provisions for Retroactive Reversal of a Previous Denial
-a)
-
-b)
-
-For a member of a federally recognized Indian tribe who was
-determined to be ineligible for Medical Assistance solely for
-failure to meet the citizenship and identity documentation
-requirements, the denial of eligibility shall be reversed and
-eligibility shall be effective as of the date on which the individual
-was determined to be ineligible provided all of the following
-criteria are met:
-(1)
-
-The individual was determined to be ineligible for
-Medical Assistance on or after July 1, 2006 solely on the
-basis of not meeting the citizenship and identity
-documentation requirements as they existed during that
-period;
-
-(2)
-
-The individual would have been determined to be eligible
-for Medical Assistance had 8.100.3.H.2.a.iv) been in
-effect on or after July 1, 2006; and
-
-(3)
-
-The individual or a legally appointed guardian or
-conservator of the individual requests that the denial of
-eligibility for Medical Assistance be reversed. The
-request may be verbal or in writing.
-
-A member of a federally recognized Indian tribe for whom denial
-of eligibility for Medical Assistance has been retroactively
-reversed shall be subject to the eligibility redetermination
-provisions described at 8.100.3.P.1. Such redetermination shall
-occur twelve months from the retroactive eligibility date
-determined when the denial was reversed as provided in this
-subsection 2.
-
-25
-
-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-b.
-
-10 CCR 2505-10 8.100
-
-Evidence of citizenship. If evidence from the list in 8.100.3.H.2.a. is not provided, an
-applicant or recipient shall provide satisfactory documentary evidence of citizenship from
-the list specified in this section to establish citizenship AND satisfactory documentary
-evidence from the documents listed in section 8.100.3.H. 3. to establish identity.
-Evidence of citizenship includes:
-i)
-
-A U.S. public birth certificate.
-1)
-
-The birth certificate shall show birth in any one of the following:
-a)
-
-One of the 50 States,
-
-b)
-
-The District of Columbia,
-
-c)
-
-Puerto Rico (if born on or after January 13, 1941),
-
-d)
-
-Guam (if born on or after April 10, 1899),
-
-e)
-
-The Virgin Islands of the U.S. (if born on or after January 17,
-1917),
-
-f)
-
-American Samoa,
-
-g)
-
-Swain's Island, or
-
-h)
-
-The Northern Mariana Islands (NMI) (if born after November 4,
-1986 (NMI local time)).
-
-2)
-
-The birth record document shall have been issued by the State,
-Commonwealth, Territory or local jurisdiction.
-
-3)
-
-The birth record document shall have been recorded before the person
-was 5 years of age. A delayed birth record document that is recorded at
-or after 5 years of age is considered fourth level evidence of citizenship,
-as described in 8.100.3.H.2.d.
-
-ii)
-
-A Certification of Report of Birth (DS-1350) issued by the U.S. Department of
-State to U.S. citizens who were born outside the U.S. and acquired U.S.
-citizenship at birth.
-
-iii)
-
-A Report of Birth Abroad of a U.S. Citizen (Form FS-240) issued by the U.S.
-Department of State consular office overseas for children under age 18 at the
-time of issuance. Children born outside the U.S. to U.S. military personnel
-usually have one of these.
-
-iv)
-
-A Certification of birth issued by the U.S. Department of State (Form FS-545 or
-DS-1350) before November 1,1990.
-
-v)
-
-A U.S. Citizen I.D. card issued by the U.S. Immigration and Naturalization
-Services (INS):
-1)
-
-Form I-179 issued from 1960 until 1973, or
-
-2)
-
-Form I-197 issued from 1973 until April 7, 1983.
-
-26
-
-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-10 CCR 2505-10 8.100
-
-vi)
-
-A Northern Mariana Identification Card (I-873) issued by INS to a collectively
-naturalized citizen of the U.S. who was born in the NMI before November 4,
-1986.
-
-vii)
-
-An American Indian Card (I-872) issued by the Department of Homeland Security
-with the classification code “KIC.”
-
-viii)
-
-A final adoption decree that:
-1)
-
-shows the child's name and U.S. place of birth, or
-
-2)
-
-a statement from a State approved adoption agency that shows the
-child's name and U.S. place of birth. The adoption agency must state in
-the certification that the source of the place of birth information is an
-original birth certificate.
-
-ix)
-
-Evidence of U.S. Civil Service employment before June 1, 1976. The document
-shall show employment by the U.S. government before June 1, 1976.
-
-x)
-
-U.S. Military Record that shows a U.S. place of birth such as a DD-214 or similar
-official document showing a U.S. place of birth.
-
-xi)
-
-Data verification with the Systematic Alien Verification for Entitlements (SAVE)
-Program for naturalized citizens.
-
-xii)
-
-Child Citizenship Act. Adopted or biological children born outside the United
-States may establish citizenship obtained automatically under section 320 of the
-Immigration and Nationality Act (8 USC § 1431), as amended by the Child
-Citizenship Act of 2000 (Pub. L. 106-395, enacted on October 30, 2000). section
-320 of the Immigration and Nationality Act (8 USC § 1431), as amended by the
-Child Citizenship Act of 2000 (Pub. L. 106-395, enacted on October 30, 2000) is
-incorporated herein by reference. No amendments or later editions are
-incorporated. Copies are available for inspections from the following person at
-the following address: Custodian of Records, Colorado Department of Health
-Care Policy and Financing, 1570 Grant Street, Denver, CO 80203-1818. Any
-material that has been incorporated by reference in this rule may be examined at
-any state publications repository library.
-Documentary evidence must be provided at any time on or after February 27,
-2001, if the following conditions have been met:
-1)
-
-At least one parent of the child is a United States citizen by either birth or
-naturalization (as verified under the requirements of this part);
-
-2)
-
-The child is under the age of 18;
-
-3)
-
-The child is residing in the United States in the legal and physical
-custody of the U.S. citizen parent;
-
-4)
-
-The child was admitted to the United States for lawful permanent
-residence (as verified through the Systematic Alien Verification for
-Entitlements (SAVE) Program); and
-
-27
-
-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-5)
-
-xiii)
-
-xiv)
-
-xv)
-
-xvi)
-
-10 CCR 2505-10 8.100
-
-If adopted, the child satisfies the requirements of section 101(b)(1) of the
-Immigration and Nationality Act (8 USC § 1101(b)(1)) pertaining to
-international adoptions (admission for lawful permanent residence as IR3 (child adopted outside the United States), or as IR-4 (child coming to
-the United States to be adopted) with final adoption having subsequently
-occurred. 8 USC § 1101(b)(1) is incorporated herein by reference. No
-amendments or later editions are incorporated. Copies are available for
-inspections from the following person at the following address: Custodian
-of Records, Colorado Department of Health Care Policy and Financing,
-1570 Grant Street, Denver, CO 80203-1818. Any material that has been
-incorporated by reference in this rule may be examined at any state
-publications repository library.
-
-Extract of a hospital record on hospital letterhead.
-1)
-
-The record shall have been established at the time of the person's birth;
-
-2)
-
-The record shall have been created at least 5 years before the initial
-application date; and
-
-3)
-
-The record shall indicate a U.S. place of birth;
-
-4)
-
-For children under 16 the document shall have been created near the
-time of birth or at least 5 years before the date of application.
-
-5)
-
-Souvenir “birth certificates” issued by a hospital are not acceptable.
-
-Life, health, or other insurance record.
-1)
-
-The record shall show a U.S. place of birth; and
-
-2)
-
-The record shall have been created at least 5 years before the initial
-application date.
-
-3)
-
-For children under 16 the document must have been created near the
-time of birth or at least 5 years before the date of application.
-
-Religious record.
-1)
-
-The record shall have been recorded in the U.S. within 3 months of the
-date of the individual's birth;
-
-2)
-
-The record shall show that the birth occurred in the U.S.;
-
-3)
-
-The record shall show either the date of birth or the individual's age at
-the time the record was made; and
-
-4)
-
-The record shall be an official record recorded with the religious
-organization.
-
-Early school record that meets the following criteria:
-1)
-
-The school record shows the name of the child;
-
-2)
-
-The school record shows the child's date of admission to the school;
-
-28
-
-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-10 CCR 2505-10 8.100
-
-3)
-
-The school record shows the child's date of birth;
-
-4)
-
-The school record shows a U.S. place of birth for the child; and
-
-5)
-
-The school record shows the name(s) and place(s) of birth of the
-applicant's parents.
-
-xvii)
-
-Federal or State census record showing U.S. citizenship or a U.S. place of birth
-and the applicant's age.
-
-xviii)
-
-One of the following documents that shows a U.S. place of birth and was created
-at least 5 years before the application for The Medical Assistance Program. For
-children under 16 the document must have been created near the time of birth or
-at least 5 years before the date of application.
-1)
-
-Seneca Indian tribal census record;
-
-2)
-
-Bureau of Indian Affairs tribal census records of the Navajo Indians;
-
-3)
-
-U.S. State Vital Statistics official notification of birth registration;
-
-4)
-
-A delayed U.S. public birth record that is recorded more than 5 years
-after the person's birth;
-
-5)
-
-Statement signed by the physician or midwife who was in attendance at
-the time of birth; or
-
-6)
-
-The Roll of Alaska Natives maintained by the Bureau of Indian Affairs.
-
-xix)
-
-Institutional admission papers from a nursing facility, skilled care facility or other
-institution created at least 5 years before the initial application date that indicate
-a U.S. place of birth.
-
-xx)
-
-Medical (clinic, doctor, or hospital) record.
-
-xxi)
-
-1)
-
-The record shall have been created at least 5 years before the initial
-application date; and
-
-2)
-
-The record shall indicate a U.S. place of birth.
-
-3)
-
-An immunization record is not considered a medical record for purposes
-of establishing U.S. citizenship.
-
-4)
-
-For children under 16 the document shall have been created near the
-time of birth or at least 5 years before the date of application.
-
-Written affidavit. Affidavits shall only be used in rare circumstances. They may be
-used by U.S. citizens or nationals born inside or outside the U.S. If
-documentation is by affidavit, the following rules apply:
-1)
-
-There shall be at least two affidavits by two individuals who have
-personal knowledge of the event(s) establishing the applicant's or
-recipient's claim of citizenship (the two affidavits could be combined in a
-joint affidavit);
-
-29
-
-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-c.
-
-10 CCR 2505-10 8.100
-
-2)
-
-At least one of the individuals making the affidavit cannot be related to
-the applicant or recipient. Neither of the two individuals can be the
-applicant or recipient;
-
-3)
-
-In order for the affidavit to be acceptable the persons making them shall
-provide proof of their own U.S. citizenship and identity.
-
-4)
-
-If the individual(s) making the affidavit has (have) information which
-explains why documentary evidence establishing the applicant's claim of
-citizenship does not exist or cannot be readily obtained, the affidavit shall
-contain this information as well;
-
-5)
-
-The applicant/recipient or other knowledgeable individual (guardian or
-representative) shall provide a separate affidavit explaining why the
-evidence does not exist or cannot be obtained; and
-
-6)
-
-The affidavits shall be signed under penalty of perjury pursuant to 18
-U.S.C. §1641 and Title 18 of the Criminal Code article 8 part 5 and need
-not be notarized.
-
-Evidence of citizenship for collectively naturalized individuals. If a document shows the
-individual was born in Puerto Rico, the Virgin Islands of the U.S., or the Northern Mariana
-Islands before these areas became part of the U.S., the individual may be a collectively
-naturalized citizen. A second document from 8.100.3.H.3. to establish identity shall also
-be presented.
-i)
-
-ii)
-
-iii)
-
-Puerto Rico:
-1)
-
-Evidence of birth in Puerto Rico on or after April 11, 1899 and the
-applicant's statement that he or she was residing in the U.S., a U.S.
-possession or Puerto Rico on January 13, 1941; OR
-
-2)
-
-Evidence that the applicant was a Puerto Rican citizen and the
-applicant's statement that he or she was residing in Puerto Rico on
-March 1, 1917 and that he or she did not take an oath of allegiance to
-Spain.
-
-US Virgin Islands:
-1)
-
-Evidence of birth in the U.S. Virgin Islands, and the applicant's statement
-of residence in the U.S., a U.S. possession or the U.S. Virgin Islands on
-February 25, 1927; OR
-
-2)
-
-The applicant's statement indicating residence in the U.S. Virgin Islands
-as a Danish citizen on January 17, 1917 and residence in the U.S., a
-U.S. possession or the U.S. Virgin Islands on February 25, 1927, and
-that he or she did not make a declaration to maintain Danish citizenship;
-OR
-
-3)
-
-Evidence of birth in the U.S. Virgin Islands and the applicant's statement
-indicating residence in the U.S., a U.S. possession or Territory or the
-Canal Zone on June 28, 1932.
-
-Northern Mariana Islands (NMI) (formerly part of the Trust Territory of the Pacific
-Islands (TTPI)):
-
-30
-
-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-d)
-
-1)
-
-Evidence of birth in the NMI, TTPI citizenship and residence in the NMI,
-the U.S., or a U.S. Territory or possession on November 3, 1986 (NMI
-local time) and the applicant's statement that he or she did not owe
-allegiance to a foreign state on November 4, 1986 (NMI local time); OR
-
-2)
-
-Evidence of TTPI citizenship, continuous residence in the NMI since
-before November 3, 1981 (NMI local time), voter registration prior to
-January 1, 1975 and the applicant's statement that he or she did not owe
-allegiance to a foreign state on November 4, 1986 (NMI local time); OR
-
-3)
-
-Evidence of continuous domicile in the NMI since before January 1, 1974
-and the applicant's statement that he or she did not owe allegiance to a
-foreign state on November 4, 1986 (NMI local time).
-
-4)
-
-If a person entered the NMI as a nonimmigrant and lived in the NMI
-since January 1, 1974, this does not constitute continuous domicile, and
-the individual is not a U.S. citizen.
-
-Referrals for Colorado Birth Certificates
-i)
-
-An applicant or client who was born in the State of Colorado who does not
-possess a Colorado birth certificate shall receive a referral to the Department of
-Public Health and Environment by the county department to obtain a birth
-certificate at no charge, pursuant to C.R.S. § 25-2-117(2)(a)(I)(C).
-
-ii)
-
-The referral shall be provided on county department letterhead and shall include
-the following:
-
-iii)
-
-3.
-
-10 CCR 2505-10 8.100
-
-1)
-
-The name and address of the applicant or client;
-
-2)
-
-A statement that the county department requests that the Department of
-Public Health and Environment waive the birth certificate fee, pursuant to
-C.R.S. § 25-2-117(2)(a)(I)(C); and
-
-3)
-
-The name and contact telephone number for the county caseworker
-responsible for the referral.
-
-An applicant or client who has been referred to the Department of Public Health
-and Environment to obtain a birth certificate shall not be required to present a
-birth certificate to satisfy the citizenship documentation requirement at
-8.100.3.H.2. The applicant or client shall have the right to use any of the
-documents listed under 8.100.3.H.2. to satisfy the citizenship documentation
-requirement.
-
-The following documents shall be accepted as proof of identity and shall accompany a document
-establishing citizenship from the groups of documentary evidence outlined in 8.100.3.H.2.b.
-through d.
-a)
-
-A driver's license issued by a State or Territory either with a photograph of the individual
-or other identifying information such as name, age, sex, race, height, weight, or eye color;
-
-b)
-
-School identification card with a photograph of the individual;
-
-c)
-
-U.S. military card or draft record;
-
-31
-
-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-10 CCR 2505-10 8.100
-
-d)
-
-Identification card issued by the Federal, State, or local government with the same
-information included on driver's licenses;
-
-e)
-
-Military dependent's identification card;
-
-f)
-
-U.S. Coast Guard Merchant Mariner card;
-
-g)
-
-Certificate of Degree of Indian Blood, or other U.S. American Indian/Alaska Native Tribal
-document with a photograph or other personal identifying information relating to the
-individual. The document is acceptable if it carries a photograph of the individual or has
-other personal identifying information relating to the individual such as age, weight,
-height, race, sex, and eye color; or
-
-h)
-
-Three or more documents that together reasonably corroborate the identity of an
-individual provided such documents have not been used to establish the individual's
-citizenship and the individual submitted evidence of citizenship listed under
-8.100.3.H.2.b. or 8.100.3.H.2.c. The following requirements must be met:
-
-i)
-
-i)
-
-No other evidence of identity is available to the individual;
-
-ii)
-
-The documents must at a minimum contain the individual's name, plus any
-additional information establishing the individual's identity; and
-
-iii)
-
-All documents used must contain consistent identifying information.
-
-iv)
-
-These documents include, but are not limited to, employer identification cards,
-high school and college diplomas from accredited institutions (including general
-education and high school equivalency diplomas), marriage certificates, divorce
-decrees, and property deeds/titles.
-
-Special identity rules for children. For children under 16, the following records are
-acceptable:
-i)
-
-Clinic, doctor, or hospital records; or
-
-ii)
-
-School records.
-1)
-
-The school record may include nursery or daycare records and report
-cards; and
-
-2)
-
-The school, nursery, or daycare record must be verified with the issuing
-school, nursery, or daycare.
-
-3)
-
-If clinic, doctor, hospital, or school records are not available, an affidavit
-may be used if it meets the following requirements:
-a)
-
-It shall be signed under penalty of perjury by a parent or
-guardian;
-
-b)
-
-It shall state the date and place of birth of the child; and
-
-c)
-
-It cannot be used if an affidavit for citizenship was provided.
-
-d)
-
-The affidavit is not required to be notarized.
-
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-
-e)
-
-j)
-
-1)
-
-It shall be signed under penalty of perjury by a residential care facility
-director or administrator on behalf of an institutionalized individual in the
-facility; and
-
-2)
-
-No other evidence of identity is available to the individual.
-
-3)
-
-The affidavit is not required to be notarized.
-
-Identity documents do not need to be current to be acceptable. An expired
-identity document shall be accepted as long as there is no reason to believe that
-the document does not match the individual.
-
-Referrals for Colorado Identification Cards
-i)
-
-An applicant or client who does not possess a Colorado driver’s license or
-identification card shall be referred to the Department of Revenue Division of
-Motor Vehicles by the county department to obtain an identification card at no
-charge, pursuant to C.R.S. § 42-2-306(1)(a)(II).
-
-ii)
-
-The referral shall be provided on county department letterhead and shall include
-the following:
-
-iii)
-
-4.
-
-An affidavit may be used for disabled individuals in institutional care facilities if
-the following requirements are met:
-
-Expired identity documents.
-i)
-
-l)
-
-An affidavit may be accepted on behalf of a child under the age
-of 18 in instances when school ID cards and drivers' licenses are
-not available to the individual until that age.
-
-Special identity rules for disabled individuals in institutional care facilities.
-i)
-
-k)
-
-10 CCR 2505-10 8.100
-
-1)
-
-The name and address of the applicant or client;
-
-2)
-
-A statement that the county department requests that the Department of
-Revenue Division of Motor Vehicles waive the identification card fee,
-pursuant to C.R.S § 42-2-306(1)(a)(II).; and
-
-3)
-
-The name and contact telephone number for the county caseworker
-responsible for the referral.
-
-An applicant or client who has been referred to the Division of Motor Vehicles to
-obtain an identification card shall not be required to present a Colorado
-identification card to satisfy the identity documentation requirement at
-8.100.3.H.3. The applicant or client shall have the right to use any of the
-documents listed under 8.100.3.H.3. to satisfy the identity documentation
-requirement.
-
-Documentation Requirements
-a.
-
-Citizenship and identity documents may be submitted as originals, certified copies,
-photocopies, facsimiles, scans or other copies.
-
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-
-10 CCR 2505-10 8.100
-
-b.
-
-Individuals who submitted notarized copies of citizenship and identity documents as part
-of an application or redetermination before January 1, 2008 shall not be required to
-submit originals or copies certified by the issuing agency for any application or
-redetermination processed on or after January 1, 2008.
-
-c.
-
-All citizenship and identity documents shall be presumed to be genuine unless the
-authenticity of the document is questionable.
-
-d.
-
-Individuals shall not be required to submit citizenship and identity documentation in
-person. Documents shall be accepted from a Medical Assistance applicant or client or
-from his or her guardian or authorized representative in person or by mail.
-i)
-
-e.
-
-Individuals are strongly encouraged to use alternatives to mailing original
-documents to counties, such as those described in 8.100.3.H.4.e.
-
-Individuals may present original citizenship and identity documents or copies certified by
-the issuing agency to Medical Assistance (MA) sites, School-based Medical Assistance
-sites, Presumptive Eligibility (PE) sites, Federally Qualified Health Centers (FQHCs),
-Disproportionate Share Hospitals (DSHs), or any other location designated by the
-Department by published agency letter.
-i)
-
-Staff at these locations shall make a copy of the original documents and shall
-complete a “Citizenship and Identity Documentation Received” form, stamp the
-copy, or provide other verification that identifies that the documents presented
-were originals. The verification shall include the name, telephone number,
-organization name and address, and signature of the individual who reviewed the
-document(s). This form, stamp, or other verification shall be attached to or
-directly applied to the copy.
-
-ii)
-
-Upon request by the client or eligibility site, the copy of the original document
-with the “Citizenship and Identity Documentation Received” form, stamp, or other
-verification as described in 8.100.3.H.4.e. i) shall be mailed or delivered directly
-to the eligibility site within five business days.
-
-f.
-
-Counties shall accept photocopies of citizenship and identity documents from any
-location described in 8.100.3.H.4.e provided the photocopies include the form, stamp, or
-verification described in 8.100.3.H.4.e.i).
-
-g.
-
-Counties shall develop procedures for handling original citizenship and identity
-documents to ensure that these documents are not lost, damaged, or destroyed.
-i)
-
-Upon receiving the original documents, eligibility site staff shall make a copy of
-the original documents and shall complete a “Citizenship and Identity
-Documentation Received” form, stamp the copy, or provide other verification that
-identifies that the documents presented were originals, as described in
-8.100.3.H.4.e. i). This form, stamp, or other verification shall be attached to or
-directly applied to the copy.
-
-ii)
-
-The original documents shall be sent by mail or returned to the individual in
-person within five business days of the date on which they were received.
-
-iii)
-
-To limit the risk of original documents being lost, damaged, or destroyed,
-counties are strongly encouraged to make copies of documents immediately
-upon receipt and to return original documents to the individual while he or she is
-present.
-
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-
-h.
-
-5.
-
-Later evidence raises a question about the individual's citizenship or identity; or
-
-ii)
-
-There is a gap of more than five years between the ending date of the individual's
-last period of eligibility and a subsequent application for The Medical Assistance
-Program and the eligibility site has not retained the citizenship and identity
-documentation the individual previously provided.
-
-The eligibility site shall retain a paper or electronically scanned copy of an individual's
-citizenship and identity documentation, including any verification described in
-8.100.3.H.4.e.i), for at least five years from the ending date of the individual's last period
-of Medical Assistance eligibility.
-
-An individual who has changed his or her last name for reasons including, but not limited
-to, marriage, divorce, or court order shall not be required to produce any additional
-documentation concerning the name change unless:
-i)
-
-With the exception of the last name, the personal information in the citizenship
-and identity documentation provided by the individual does not match in every
-way;
-
-ii)
-
-In addition to changing his or her last name, the individual also changed his or
-her first name and/or middle name; or
-
-iii)
-
-There is a reasonable basis for questioning whether the citizenship and identity
-documents belong to the same individual.
-
-Reasonable Level of Assistance
-a.
-
-The eligibility site shall provide a reasonable level of assistance to applicants and clients
-in obtaining the required citizenship and identity documentation.
-
-b.
-
-Examples of a reasonable level of assistance include, but are not limited to:
-
-c.
-8.
-
-i)
-
-Name Change Provisions
-a.
-
-7.
-
-Once an individual has provided the required citizenship and identity documentation, he
-or she shall not be required to submit the documentation again unless:
-
-Record Retention Requirements
-a.
-
-6.
-
-10 CCR 2505-10 8.100
-
-i)
-
-Providing contact information for the appropriate agencies that issue the required
-documents;
-
-ii)
-
-Explaining the documentation requirements and how the client or applicant may
-provide the documentation; or
-
-iii)
-
-Referring the applicant or client to other agencies or organizations which may be
-able to provide further assistance.
-
-The eligibility site shall not be required to pay for the cost of obtaining required
-documentation.
-
-Individuals Requiring Additional Assistance
-
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-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-a.
-
-b.
-
-c.
-
-9.
-
-10 CCR 2505-10 8.100
-
-The eligibility site shall provide additional assistance beyond the level described in
-8.100.3.H.7 to applicants and clients in obtaining the required citizenship and identity
-documentation if the client or applicant:
-i)
-
-Is unable to comply with the requirements due to physical or mental impairments
-or homelessness; and
-
-ii)
-
-The individual lacks a guardian or representative who can provide assistance.
-
-Examples of additional assistance include, but are not limited to:
-i)
-
-Contacting any known family members who may have the required
-documentation;
-
-ii)
-
-Contacting any known current or past health care providers who may have the
-required documentation; or
-
-iii)
-
-Contacting other social services agencies that are known to have provided
-assistance to the individual.
-
-The eligibility site shall document its efforts to provide additional assistance to the client
-or applicant. Such documentation shall be subject to the record retention requirements
-described in 8.100.3.H.5.a.
-
-Reasonable Opportunity Period
-a.
-
-If a Medical Assistance applicant does not have the required documentation, he or she
-must be given a reasonable opportunity period to provide the required documentation.
-The reasonable opportunity period will begin as of the date of the Notice of Action. The
-required documentation must be received within the reasonable opportunity period. If the
-applicant does not provide the required documentation within the reasonable opportunity
-period, then the applicant's Medical Assistance benefits shall not be terminated during
-the federal Coronavirus COVID-19 Public Health Emergency. Required documentation
-will be requested during the federal Coronavirus COVID-19 Public Health Emergency.
-When the federal COVID-19 Public Health Emergency has ended, a reasonable
-opportunity period will be given to request proper documentation from the member.
-i)
-
-During the federal Coronavirus COVID-19 Public Health Emergency the
-Department will continue eligibility for all Medical Assistance categories,
-regardless of requested documentation and/or reported change for these
-individuals to ensure continuity of eligibility for Medical Assistance coverage.
-
-Effective May 11, 2023 the Public Health Emergency declaration has ended and continuous
-coverage for individuals who have not provided required documentation by their renewal date will
-be terminated.
-b.
-
-The reasonable opportunity period is 90 calendar days if unable to verify proof of
-citizenship/identity and applies to MAGI, Adult, and Buy-In Programs:
-
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-Medical Services Board
-
-i)
-
-For the purpose of this section only, MAGI Programs for persons covered
-pursuant to 8.100.4.G or 8.100.4.I, include the following:
-Commonly Used Program Name
-Children’s Medical Assistance
-Parent and Caretaker Relative Medical Assistance
-Adult Medical Assistance
-Pregnant Women Medical Assistance
-Transitional Medical Assistance
-
-ii)
-
-Rule Citation
-8.100.4.G.2
-8.100.4.G.3
-8.100.4.G.4
-8.100.4.G.5
-8.100.4.I.1-5
-
-For the purpose of this section only, Adult and Buy-In Programs for persons
-covered pursuant to 8.100.3.F, 8.100.6.P, 8.100.6.Q, or 8.715 include the
-following:
-Commonly Used Program Name
-Old Age Pension A (OAP-A)
-Old Age Pension B (OAP-B)
-Qualified Disabled Widow/Widower
-Pickle
-Long-Term Care
-Medicaid Buy-In Program for Working Adults with
-Disabilities
-Medicaid Buy-In Program for Children with
-Disabilities
-Breast and Cervical Cancer Program (BCCP)
-
-10.
-
-10 CCR 2505-10 8.100
-
-Rule Citation
-8.100.3.F.1.c
-8.100.3.F.1.c
-8.100.3.F.1.e
-8.100.3.F.1.e
-8.100.3.F.1.f-h
-8.100.6.P
-8.100.6.Q
-8.715
-
-Good Faith Effort
-a.
-
-In some cases, a Medical Assistance client or applicant may not be able to obtain the
-required documentation within the applicable reasonable opportunity period. If the client
-or applicant is making a good faith effort to obtain the required documentation, then the
-reasonable opportunity period should be extended. The amount of time given should be
-determined on a case-by-case basis and should be based on the amount of time the
-individual needs to obtain the required documentation.
-Examples of good faith effort include, but are not limited to:
-i)
-
-Providing verbal or written statements describing the individual’s effort at
-obtaining the required documentation;
-
-ii)
-
-Providing copies of emails, letters, applications, checks, receipts, or other
-materials sent or received in connection with a request for documentation; or
-
-iii)
-
-Providing verbal or written statements of the individuals’ efforts at identifying
-people who could attest to the individual’s citizenship or identity, if citizenship
-and/or identity are included in missing documentation.
-
-An individual’s verbal statement describing his or her efforts at securing the required
-documentation should be accepted without further verification unless the accuracy or
-truthfulness of the statement is questionable. The individual’s good faith efforts should be
-documented in the case file and are subject to all record retention requirements.
-
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-CODE OF COLORADO REGULATIONS
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-
-8.100.3.I.
-1.
-
-Additional General Eligibility Requirements
-
-Each person for whom Medical Assistance is being requested shall furnish a Social Security
-Number (SSN); or, if one has not been issued or is unknown, shall apply for the number and
-submit verification of the application, unless an exception below applies. The application for an
-SSN shall be documented in the case record by the eligibility site. Upon receipt of the assigned
-SSN, the client shall provide the number to the eligibility site. This requirement does not apply to
-those individuals who are not requesting Medical Assistance yet appear on the application, nor
-does it apply to individuals applying for emergency medical services, limited reproductive health
-services, or eligible newborns born to a Medical Assistance eligible mother.
-a.
-
-b.
-
-c.
-
-2.
-
-10 CCR 2505-10 8.100
-
-An applicant's or client's refusal to furnish or apply for a Social Security Number affects
-the family's eligibility for assistance as follows:
-i)
-
-that person cannot be determined eligible for the Medical Assistance Program;
-and/or
-
-ii)
-
-if the person with no SSN or proof of application for SSN is the only dependent
-child on whose behalf assistance is requested or received, assistance shall be
-denied or terminated.
-
-Exception: An individual who qualifies for any of the following exceptions must not be
-required to provide an SSN:
-i.)
-
-The individual is not eligible to receive an SSN; or
-
-ii)
-
-The individual does not have an SSN and may only be issued an SSN for a valid
-non-work reason in accordance with 20 CFR 422.104; or
-
-iii)
-
-The individual refuses to obtain an SSN because of a well-established religious
-objection.
-
-Due to the COVID-19 Public Health Emergency, the Department will accept selfattestations for SSN verification. At the end of the COVID-19 Public Health Emergency,
-verification for eligibility criteria will be required as specified prior to the public health
-emergency. Effective May 11, 2023 the Coronavirus COVID-19 Public Health Emergency
-has been declared to end.
-
-A person who is applying for or receiving Medical Assistance shall assign to the State all rights
-against any other person (including but not limited to the sponsor of an alien) for medical support
-or payments for medical expenses paid on the applicant's or client's behalf or on the behalf of any
-other person for whom application is made or assistance is received.
-All appropriate clients of the Medical Assistance Program shall have the option to be referred for
-child support enforcement services using the form as specified by the Department.
-
-3.
-
-A person who is applying for or receiving Medical Assistance shall provide information regarding
-any third party resources available to any member of the assistance unit. Third party resources
-are any health coverage or insurance other than the Medical Assistance Program. A client’s
-refusal to supply information regarding third party resources may result in loss of Medical
-Assistance Program eligibility.
-
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-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-4.
-
-10 CCR 2505-10 8.100
-
-A person who is eligible for Medical Assistance shall be free to choose any qualified and
-approved participating institution, agency, or person offering care and services which are benefits
-of the program unless that person is enrolled in a managed care program operating under
-Federal waiver authority.
-
-8.100.3.J.
-Supplemental Security Income (SSI) And Aid To The Needy Disabled (AND)
-Recipients
-1.
-
-2.
-
-Persons who may be eligible for benefits under either MAGI Medical Assistance or SSI:
-a.
-
-shall be advised of the benefits available under each program;
-
-b.
-
-may apply for a determination of eligibility under either or both programs;
-
-c.
-
-have the option to receive benefits under the program of their choice, but may not receive
-benefits under both programs at the same time; and
-
-d.
-
-may change their selection if their circumstances change or if they decide later that it
-would be more advantageous to receive benefits from the other program.
-
-Any family member who is receiving financial assistance from SSI or OAP-A is not considered a
-member of the Medical Assistance required household, is not counted as a member of the
-household, and the individual's income and resources are disregarded in making the
-determination of need for Medical Assistance.
-a.
-
-3.
-
-An individual receiving Aid to the Needy Disabled (AND) may also receive MAGI Medical
-Assistance, if the recipient meets the eligibility requirements for MAGI Medical Assistance. For
-these individuals, eligibility sites shall not include the applicant’s AND payment when calculating
-income to determine the household’s financial eligibility for MAGI Medical Assistance.
-
-8.100.3.K.
-1.
-
-Consideration of Income
-
-Income or resources of an alien sponsor or an alien sponsor’s spouse shall be countable to the
-sponsored alien effective December 19, 1997. Forms used prior to December 19, 1997, including
-but not limited to forms I-134 or I-136 are legally unenforceable affidavits of support. The
-attribution of the income and resources of the sponsor and the sponsor's spouse to the alien will
-continue until the alien becomes a U.S. citizen or has worked or can be credited with 40
-qualifying quarters of work, provided that an alien crediting the quarters to the applicant/client has
-not received any public benefit during any creditable quarter for any period after December 31,
-1996.
-a.
-
-2.
-
-Exception: For MAGI Medical Assistance a family member who is receiving SSI, when
-appropriate can be counted as a member of the household and their income when
-appropriate can be considered in making the determination of eligibility for MAGI Medical
-Assistance. For treatment of income and household construction for MAGI Medical
-Assistance cases, see section 8.100.4.
-
-Exception: When the sponsored alien is a pregnant woman or a child the income or
-resources of an alien sponsor or an alien sponsor’s spouse will not be countable to the
-sponsored alien.
-
-Income, in general, is the receipt by an individual of a gain or benefit in cash or in kind during a
-calendar month. Income means any cash, payments, wages, in-kind receipt, inheritance, gift,
-prize, rents, dividends, interest, etc., that are received by an individual or family.
-
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-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-10 CCR 2505-10 8.100
-
-3.
-
-Earned income is payment in cash or in kind for services performed as an employee or from selfemployment.
-
-4.
-
-Earned in kind income shall be income produced as a result of the performance of services by the
-applicant/client, for which he/she is compensated in shelter or other items in lieu of wages.
-
-5.
-
-Received means “actually” received or legally becomes available, whichever occurs first; the
-point at which the income first is available to the individual for use. For example, interest income
-on a savings account is counted when it is credited to the account.
-
-6.
-
-All Home Care Allowance (HCA) income paid to a Medical Assistance applicant or member by
-the HCA recipient to provide home care services is countable earned income.
-
-7.
-
-An applicant or member who is a live-In home care provider to a care recipient receiving a
-Difficulty of Care Payment and who is being determined for a MAGI Medical Assistance program,
-must meet the following requirements for Difficulty of Care payments to be excluded as countable
-income:
-a.
-
-The care provider receiving payments for personal care or supportive services provided
-to a care recipient must live full-time in the same home with the care recipient; and
-
-b.
-
-The care recipient must either
-
-c.
-
-8.
-
-9.
-
-i)
-
-receiving personal care or supportive services must be enrolled in Long Term
-Service Supports (LTSS), with additional services through a Home-Based
-Services (HCBS) waiver program; or
-
-ii)
-
-The care recipient must be enrolled in the Buy-In Program for Working Adults
-with Disabilities, and receive additional services through the Home and
-Community Based Services (HCBS) waiver program.
-
-Exception: Difficulty of Care Payments are not excluded if the payments are for more
-than 10 qualified foster individuals under the age of 19 or 5 qualified foster individuals
-who are over the age of 19
-
-Participation in the Workforce Investment Act (WIA) affects eligibility for Medical Assistance as
-follows:
-a.
-
-Wages derived from participation in a program carried out under WIA (work experience or
-on-the-job training) and paid to a caretaker relative is considered countable earned
-income.
-
-b.
-
-Training allowances granted by WIA to a dependent child or a caretaker relative of a
-dependent child to participate in a training program is exempt.
-
-c.
-
-Wages derived from participation in a program carried out the under Workforce
-Investment Act (WIA) and paid to any dependent child who is applying for or receiving
-Medical Assistance are exempt in determining eligibility for a period not to exceed six
-months in each calendar year.
-
-An individual involved in a profit-making activity as a sole proprietor, partner in a partnership,
-independent contractor, or consultant shall be classified as self-employed.
-a.
-
-To determine the net profit of a self-employed applicant/client deduct the cost of doing
-business from the gross income. These business expenses include, but are not limited to:
-
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-
-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-b.
-
-i)
-
-the rent of business premises,
-
-ii)
-
-wholesale cost of merchandise,
-
-iii)
-
-utilities,
-
-iv)
-
-taxes,
-
-v)
-
-labor, and
-
-vi)
-
-upkeep of necessary equipment.
-
-The following are not allowed as business expenses:
-i)
-
-Depreciation of equipment;
-1)
-
-10.
-
-10 CCR 2505-10 8.100
-
-Exception: For the purpose of calculating MAGI-based income,
-depreciation of equipment is an allowable business expense if the
-equipment is not used for capital improvements.
-
-ii)
-
-The cost of and payment on the principal of loans for capital asset or durable
-goods;
-
-iii)
-
-Personal expenses such as personal income tax payments, lunches, and
-transportation to and from work.
-
-c.
-
-Appropriate allowances for cost of doing business for Medical Assistance clients who are
-licensed, certified or approved day care providers are (1) $ 55 for the first child for whom
-day care is provided, and (2) $ 22 for each additional child. If the client can document a
-cost of doing business which is greater than the amounts above set forth, the procedure
-described in A, shall be used.
-
-d.
-
-When determining self-employment expenses and distinguishing personal expenses from
-business expenses it is a requirement to only allow the percentage of the expense that is
-business related.
-
-Self-employment income includes, but is not limited to, the following:
-a.
-
-Farm income - shall be considered as income in the month it is received. When an
-individual ceases to farm the land, the self-employment deductions are no longer
-allowable.
-
-b.
-
-Rental income - shall be considered as self-employment income only if the Medical
-Assistance client actively manages the property at least an average of 20 hours per
-week.
-
-c.
-
-Board (to provide a person with regular meals only) payment shall be considered earned
-income in the month received to the extent that the board payment exceeds the
-maximum food stamp allotment for one-person household per boarder and other
-documentable expenses directly related to the provision of board.
-
-d.
-
-Room (to provide a person with lodging only) payments shall be considered earned
-income in the month received to the extent that the room payment exceeds
-documentable expenses directly related to the provision of the room.
-
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-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-e.
-
-11.
-
-10 CCR 2505-10 8.100
-
-Room and board payments shall be considered earned income in the month received to
-the extent that the payment for room and board exceeds the food stamp allotment for a
-one-person household per room and boarder and documentable expenses directly
-related to the provision of room and board.
-
-Unearned income is the gross amount received in cash or kind that is not earned from
-employment or self-employment. Unearned income includes, but is not limited to, the following:
-a.
-
-Pensions and other period payments, such as:
-i)
-
-Private pensions or disability benefits
-1)
-
-Exception: Refer to section 8.100.4 for treatment of private disability
-benefits for MAGI Medical Assistance.
-
-ii)
-
-Social Security benefits (Retirement, survivors, and disability)
-
-iii)
-
-Workers' Compensation payments
-
-iv)
-
-Railroad retirement annuities
-
-v)
-
-Unemployment insurance payments
-
-vi)
-
-Veterans benefits other than Aid and Attendance (A&A) and Unusual Medical
-Expenses (UME).
-
-vii)
-
-Alimony and support payments
-
-viii)
-
-Interest, dividends and certain royalties on countable resources
-
-12.
-
-For all Medical Assistance categories, the federal Coronavirus Aid, Relief, and Economic Security
-(CARES) Act and American Rescue Plan (ARP) Act Recovery Rebate, known as the COVID-19
-Economic Stimulus, shall be exempt from consideration as income.
-
-13.
-
-Federal Pandemic Unemployment Compensation (FPUC) program, which provides an extra
-$600.00 a week for qualifying individuals, is exempt as countable unearned income for all Medical
-Assistance categories.
-
-14.
-
-Federal Income Tax refunds, Earned Income Tax Credit payments, or Child Tax Credits, are
-exempt from consideration as income.
-
-8.100.3.L
-
-Consideration of Resources
-
-Consideration of Resources
-1.
-
-Resources are counted in determining eligibility for the Aged, Blind and Disabled, and Long-Term
-Care institutionalized and Home and Community Based Services categories of Medical
-Assistance. Resources are not counted in determining eligibility for the MAGI Medical Assistance
-programs, the Medicaid Buy-in Program for Working Adults with Disabilities, or the Medicaid BuyIn Program for Children with Disabilities, See section 8.100.5 for rules regarding consideration of
-resources.
-
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-
-2.
-
-10 CCR 2505-10 8.100
-
-The federal Coronavirus Aid, Relief, and Economic Security (CARES) Act and American Rescue
-Plan (ARP) Act Recovery Rebate known as COVID-19 Economic Stimulus, shall be an exempt
-resource for the first 12 months following the receipt of the Recovery Rebate, after which the
-remaining balance will be considered a countable resource for all Medical Assistance categories
-which include an asset test.
-
-8.100.3.M.
-
-Federal Financial Participation (FFP)
-
-1.
-
-The state is entitled to claim federal financial participation (FFP) for benefits paid on behalf of
-groups covered under the Colorado Medical Assistance Program and also for the Medicare
-supplementary medical insurance benefits (SMIB) premium payments made on behalf of certain
-groups of categorically needy persons.
-
-2.
-
-The SISC codes are as follows:
-
-3.
-
-a.
-
-Code A - for institutionalized persons whose income is under 300% of the SSI benefit
-level and who, except for the level of their income, would be eligible for an SSI payment;
-and non-institutionalized persons receiving Home and Community Based Services,
-whose income does not exceed 300% of the SSI benefit level and who, except for the
-level of their income, would be eligible for an SSI payment; code A signifies that FFP is
-available in expenditures for medical care and services which are benefits of the Medical
-Assistance program but not for SMIB premium payments;
-
-b.
-
-Code B - for persons eligible to receive financial assistance under SSI; persons eligible to
-receive financial assistance under OAP “A” who, except for the level of their income,
-would be eligible for an SSI payment; persons who are receiving mandatory State
-supplementary payments; and persons who continue to be eligible for Medical Assistance
-after disregarding certain Social Security increases; code B signifies that FFP is available
-in expenditures for medical care and services which are benefits of the Medical
-Assistance program and also for SMIB premium payments;
-
-c.
-
-Code C - for persons eligible to receive assistance under OAP “A”, OAP “B”, or OAP
-Refugee Assistance for financial assistance only; who do not receive SSI payment and
-do not otherwise qualify under SISC code B as described in item B. above; code C
-signifies that no FFP is available in Medical Assistance program expenditures.
-
-d.
-
-Code D1 – for persons eligible to receive assistance under AwDC from program
-implementation through 12/31/2013; Code D1 signifies 50% FFP is available in
-expenditures for medical care and services which are benefits of the Medical Assistance
-program.
-
-e.
-
-Code E1 - for persons eligible to receive assistance under the Medicaid Buy-In Program
-for Working Adults with Disabilities and whose annual adjusted gross income, as defined
-under IRS statute, is less than or equal to 450% of FPL – after SSI earned income
-deductions; as well as for children eligible to receive assistance under the Medicaid BuyIn Program for Children with Disabilities and whose household income is less than or
-equal to 300% of FPL after income disregards. Code E1 signifies that FFP is available in
-expenditures for medical care and services which are benefits of the Medical Assistance
-program but not for SMIB premium payments.
-
-Recipients of financial assistance under State AND, State AB, or OAP “C” are not automatically
-eligible for Medical Assistance and the SISC code which shall be entered on the eligibility
-reporting form is C.
-
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-
-8.100.3.N.
-
-10 CCR 2505-10 8.100
-
-Confidentiality
-
-1.
-
-All information obtained by the eligibility site concerning an applicant for or a recipient of Medical
-Assistance is confidential information.
-
-2.
-
-A signature on the Single Streamlined Application and the Application for Public Assistance
-allows an eligibility site worker to consult banks, employers, or any other agency or person to
-obtain information or verification to determine eligibility. The identification of the worker as an
-eligibility site employee will, in itself, disclose that an application for the Medical Assistance
-Program has been made by an individual. In this type of contact, as well as other community
-contacts, the eligibility site should strive to maintain confidentiality. The signature on the Single
-Streamlined Application and the Application for Public Assistance also provides permission for
-the release of the client's medical information to be provided by health care providers to the State
-and its agents for purpose of administration of the Medical Assistance Program.
-
-3.
-
-Eligibility site staff may release a client's Medical Assistance state identification number and
-approval eligibility spans to a Medical Assistance provider for billing purposes.
-Eligibility site staff may inform a Medical Assistance provider that an application has been denied
-but may not inform them of the reason why.
-
-4.
-
-Access to information concerning applicants or recipients must be restricted to persons or agency
-representatives who are subject to standards of confidentiality that are comparable to those of the
-State and the eligibility site.
-
-5.
-
-The eligibility site must obtain permission from a family, individual, or authorized representative,
-whenever possible, before responding to a request for information from an outside source, unless
-the information is to be used to verify income, eligibility and the amount of Medical Assistance
-payment. This permission must be obtained unless the request is from State authorities, federal
-authorities, or State contractors acting within the scope of their contract. If, because of an
-emergency situation, time does not permit obtaining consent before release, the eligibility site
-must notify the family or individual immediately after supplying the information.
-
-6.
-
-The eligibility site policies must apply to all requests for information from outside sources,
-including government bodies, the courts, or law enforcement officials. If a court issues a
-subpoena for a case record or for any eligibility site representative to testify concerning an
-applicant or recipient, the eligibility site must inform the court of the applicable statutory
-provisions, policies, and regulations restricting disclosure of information.
-
-7.
-
-The following types of information are confidential and shall be safeguarded:
-a.
-
-Names and addresses of applicants for and recipients of the Medical Assistance
-Program;
-
-b.
-
-Medical services provided;
-
-c.
-
-Social and economic conditions or circumstances;
-
-d.
-
-Agency evaluation of personal information;
-
-e.
-
-Medical data, including diagnosis and past history of disease or disability;
-
-f.
-
-All information obtained through the Income and Eligibility Verification System (IEVS), the
-Federal Data Services Hub (FDSH), Equifax The Work Number (TWN), Colorado
-Department of Labor and Employment, SSA or Internal Revenue Service;
-
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-
-8.
-
-9.
-
-10 CCR 2505-10 8.100
-
-g.
-
-Any information received in connection with identification of legally liable third party
-resources;
-
-h.
-
-Any information received for verifying income and resources if applicable, or other
-eligibility and the amount of Medical Assistance payments;
-
-i.
-
-Social Security Numbers.
-
-The confidential information listed above may be released to persons outside the eligibility site
-only as follows:
-a.
-
-In response to a valid subpoena or court order;
-
-b.
-
-To State or Federal auditors, investigators or others designated by the Federal or State
-departments on a need-to-know basis;
-
-c.
-
-To individuals executing Income and Eligibility Verification System;
-
-d.
-
-Child Support enforcement officials;
-
-e.
-
-To a recipient or applicant themselves or their designated representative.
-
-f.
-
-To a Long Term Care institution on the AP-5615 form.
-
-The applicant/recipient may give a formal written release for disclosure of information to other
-agencies, such as hospitals, or the permission may be implied by the action of the other agency
-in rendering service to the client. Before information is released, the eligibility site should be
-reasonably certain the confidential nature of information will be preserved, the information will be
-used only for purposes related to the function of the inquiring agency, and the standards of
-protection established by the inquiring agency are equal to those established by the State
-Department. If the standards for protection of information are unknown, a written consent from the
-recipient shall be obtained.
-
-8.100.3.O.
-
-Protection Against Discrimination
-
-1.
-
-Eligibility sites are to administer the Medical Assistance Program in such a manner that no person
-will, on the basis of race, color, sex, age, religion, political belief, national origin, or handicap, be
-excluded from participation, be denied any aid, care, services, or other benefits of, or be
-otherwise subjected to discrimination in such program.
-
-2.
-
-The eligibility site shall not, directly or through contractual or other arrangements, on the grounds
-of race, color, sex, age, religion, political belief, national origin, or handicap:
-a.
-
-Provide aid, care, services, or other benefits to an individual which is different, or
-provided in a different manner, from that of others;
-
-b.
-
-Subject an individual to segregation barriers or separate treatment in any manner related
-to access to or receipt of assistance, care services, or other benefits;
-
-c.
-
-Restrict an individual in any way in the enjoyment or any advantage or privilege enjoyed
-by others receiving aid, care, services, or other benefits provided under the Medical
-Assistance Program;
-
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-
-d.
-
-Treat an individual differently from others in determining whether he/she satisfies any
-eligibility or other requirements or conditions which individuals shall meet in order to
-receive aid, care, services, or other benefits provided under the Medical Assistance
-Programs;
-
-e.
-
-Deny an individual an opportunity to participate in programs of assistance through the
-provision of services or otherwise, or afford him/her an opportunity to do so which is
-different from that afforded others under the Medical Assistance Program.
-
-3.
-
-No distinction on the grounds of race, color, sex, age, religion, political belief, national origin, or
-handicap is permitted in relation to the use of physical facilities, intake and application
-procedures, caseload assignments, determination of eligibility, and the amount and type of
-benefits extended by the eligibility site to Medical Assistance recipients.
-
-4.
-
-An individual who believes he/she is being discriminated against may file a complaint with the
-eligibility site, the Department, or directly with the Federal government. When a complaint is filed
-with the eligibility site, the county director is responsible for an immediate investigation of the
-matter and taking necessary corrective action to eliminate any discriminatory activities found. If
-such activities are not found, the individual is given an explanation. If the person is not satisfied,
-he/she is requested to direct his/her complaint, in writing, to the State Department, Complaint
-Section, which will be responsible for further investigation and other necessary action consistent
-with the provisions of Title VI of the 1963 Civil Rights Act, as amended 42 U.S.C. §2000e et seq.
-and section 504 of the Rehabilitation Act of 1973, as amended 29 U.S.C. §791.
-
-8.100.3.P.
-1.
-
-Redetermination of Eligibility
-
-“Redetermination of eligibility” means a case review and necessary verification to determine
-whether the Medical Assistance Program member continues to be eligible to receive Medical
-Assistance.
-“Reconsideration period” means the 90-day period following termination of eligibility.
-Beginning on the case approval date, a redetermination shall be accomplished at least every 12
-months for Title XIX Medical Assistance only cases. An eligibility site may redetermine eligibility
-through telephone, mail, or online electronically means.
-
-2.
-
-The eligibility site shall promptly redetermine eligibility when:
-a.
-
-it receives and verifies information which indicates a change in a member’s
-circumstances which may affect continued eligibility for Medical Assistance; or
-
-b.
-
-it receives direction to do so from the Department.
-
-The eligibility site shall redetermine eligibility according to timelines defined by the Department.
-3.
-
-Ex Parte Review: A redetermination form will not be sent to the member if all current eligibility
-requirements can be verified by reviewing information from another assistance program or if this
-information can be verified though an electronic verification system – this process is referenced
-as Ex Parte Review. The use of telephonic or electronic redeterminations shall be noted in the
-case record. When applicable, the eligibility site shall redetermine eligibility based solely on
-information already available. If verification or information is available for any of the six months
-prior to the redetermination month, and all other eligibility requirements are met, then an approval
-notice will be sent for all eligible members of the household who are requesting assistance. This
-approval notice shall include directions on how to view the information used to determine
-eligibility.
-
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-
-4.
-
-10 CCR 2505-10 8.100
-
-If all required information is not available and/or the information received does not support a
-finding of eligibility, a redetermination form, and a verification form will be issued to the household
-at least 30 days before the end of the eligibility period. The household will be sent a prepopulated
-redetermination form with the current information on file and a notice of required verifications
-needed to determine eligibility.
-The redetermination form shall direct members to verify that the information provided is accurate
-or to report any changes to the information. Members must complete and return the
-redetermination with the necessary verifications and the signature form. If a member fails to sign
-the signature form or comply with any of these requirements, the member will be terminated from
-the program for failure to complete the redetermination process.
-The following procedures relate to mail-out redetermination:
-a.
-
-A Redetermination Form shall be mailed to the member together with any other forms to
-be completed;
-
-b.
-
-When the member is unable to complete the forms due to physical, mental or emotional
-disabilities, or other good cause, and has no one to help him/her, the eligibility site shall
-either assist the member or refer him/her to a legal or other resource. When initial
-arrangements or a change in arrangements are being made, an extension of up to thirty
-days shall be allowed. The action of the eligibility site in assistance or referral shall be
-recorded in the case record and CBMS case comments.
-
-c.
-
-The redetermination form shall require that a recipient and community spouse of a
-recipient of HCBS, PACE or institutional services disclose a description of any interest
-the individual or community spouse has in an annuity or similar financial instrument
-regardless of whether the annuity is irrevocable or treated as an asset. The
-redetermination form shall include a statement that the Department shall be a remainder
-beneficiary for any annuity or similar financial instrument purchased on or after February
-8, 2006 for the total amount of Medical Assistance provided to the individual.
-
-d.
-
-The eligibility site shall notify in writing the issuer of any annuity or financial instrument
-that the Department is a preferred remainder beneficiary in the annuity or similar financial
-instrument for the total amount of Medical Assistance provided to the individual. This
-notice shall require the issuer to notify the eligibility site when there is a change in the
-amount of income or principal that is being withdrawn from the annuity.
-
-e.
-
-Members who return properly completed redetermination forms and requested
-information during the reconsideration period shall not be required to submit a new
-application for eligibility. If redetermination forms and requested information are not
-returned within 90 days after termination, the member must submit a new application to
-obtain enrollment in the program.
-
-f.
-
-For individuals who are determined to be eligible for Medical Assistance within the
-reconsideration period, the effective date of coverage will be the first day of the month in
-which the redetermination form was returned. If the member has a gap in coverage due
-to submitting the redetermination within the reconsideration period, the member can
-request up to three months in retroactive coverage.
-
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-
-5.
-
-6.
-
-When the redetermination verification information is received by the eligibility site, it shall be date
-stamped. Within fifteen working days, the verification information shall be thoroughly reviewed for
-completeness, accuracy, and consistency. All factors shall be evaluated as to their effect on
-eligibility at that time. Verifications shall be documented in the case file and CBMS case
-comments. The case file shall be used as a checklist in the redetermination process, and shall be
-used to keep track of matters requiring further action. When additional information is needed:
-a.
-
-if incomplete information is provided or a member reports new changes, a worker must
-request required verifications. A form with a letter specifying the items that require
-completion needs to be mailed to the member. The Medical Assistance member shall
-return the completed request form to the eligibility site no later than ten working days.;
-
-b.
-
-if incomplete, inaccurate or inconsistent data is reported, the Medical Assistance member
-shall be contacted by telephone or in writing so that the worker may secure the proper
-information according to timelines defined by the Department.
-
-Due to the federal Coronavirus COVID-19 Public Health Emergency, the Department will continue
-eligibility for all Medical Assistance categories, regardless of a redetermination and/or reported
-change for these individuals to ensure continuity of eligibility for Medical Assistance coverage.
-Effective May 11, 2023 the Coronavirus COVID-19 Public Health Emergency has been declared
-to end. To ensure the Department maintains access to State and Federal funding provided by the
-Federal ‘Families First Coronavirus Response Act” Pub.L. 116-127, and the Federal
-“Consolidated Appropriations Act, 2023”, the Department will process eligibility redeterminations
-and/or changes for all members whose eligibility was maintained during the emergency
-declaration and take appropriate action including termination if no longer meeting eligibility
-criteria. Through the renewal process, a member may be disenrolled or their eligibility category
-may be changed based on information obtained by the state through electronic verifications,
-information provided by the member through the renewal, or the member’s failure to respond to
-the renewal. A member’s eligibility will no longer be maintained as it was during Public Health
-Emergency once their renewal due month has passed, and their renewal has been processed.
-
-8.100.3.Q.
-1.
-
-10 CCR 2505-10 8.100
-
-Continuous Eligibility (CE) for Medical Assistance programs
-
-Continuous eligibility applies to children under age 19, who through an eligibility determination,
-reassessment or redetermination, are found eligible for a Medical Assistance program. The
-continuous eligibility period may last for up to 12 months.
-a.
-
-The continuous eligibility period applies without regard to changes in income or other
-factors that would otherwise cause the child to be ineligible.
-i)
-
-b.
-
-A 14-day no fault period shall begin on the date the child is determined eligible
-for Medical Assistance. During the 14-day period, any changes to income or
-other factors made to the child’s case during the 14-day no fault period may
-change his or her eligibility for Medical Assistance.
-
-Exception: A child’s continuous eligibility period will end effective the earliest possible
-month if any of the following occur:
-i)
-
-Child is deceased
-
-ii)
-
-Becomes an inmate of a public institution
-
-iii)
-
-The child is no longer part of the Medical Assistance required household
-
-iv)
-
-Is no longer a Colorado resident
-
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-
-2.
-
-v)
-
-Is unable to be located based on evidence or reasonable assumption
-
-vi)
-
-Requests to be withdrawn from continuous eligibility
-
-vii)
-
-Fails to provide documentation during a reasonable opportunity period as
-specified in section 8.100.3.G.3 and 8.100.3.H.9
-
-viii)
-
-Fails to provide a reasonable explanation or paper documentation when selfattested income is not reasonably compatible with income information from an
-electronic data source, by the end of the 30-day reasonable opportunity period.
-This exception only applies the first-time income is verified following an initial
-eligibility determination or an annual redetermination.
-
-The continuous eligibility period will begin on the first day of the month the application is received
-or from the date all criteria is met. Continuous eligibility is applicable to children enrolled in the
-following Medical Assistance programs:
-a.
-
-MAGI-Medical Assistance, program as specified in section 8.100.4.G.2
-
-b.
-
-SSI Mandatory, as specified in section 8.100.6.C
-i.)
-
-c.
-
-d.
-
-When a child is no longer eligible for SSI Mandatory they will be categorized as
-eligible within the MAGI-Child category for the remainder of the eligibility period.
-
-Long- Term Care services
-i.)
-
-When a child is no longer eligible for Long-Term Care services they will be
-categorized as eligible within the MAGI- Child category for the remainder of the
-eligibility period.
-
-Medicaid Buy-In program specified in section 8.100.6.Q
-i)
-
-3.
-
-Exception: Enrollment will be discontinued if there is a failure to pay premiums
-
-e.
-
-Pickle
-
-f.
-
-Disabled Adult Child DAC)
-
-Children, under the age of 19, no longer enrolled in Foster Care Medicaid will be eligible for the
-MAGI-Medical Assistance program. The continuous eligibility period will begin the month the child
-is no longer enrolled in Foster Care Medicaid as long as they meet one of the following
-conditions:
-a.
-
-Begin living with other Relatives
-
-b.
-
-Are reunited with Parents
-
-c.
-
-Have received guardianship
-
-8.100.4
-
-MAGI Medical Assistance Eligibility [Eff. 01/01/2014]
-
-8.100.4.A.
-
-MAGI Application Requirements
-
-1.
-
-10 CCR 2505-10 8.100
-
-Persons requesting a MAGI Medical Assistance category need only to complete the Single
-Streamlined Application.
-
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-10 CCR 2505-10 8.100
-
-2.
-
-Parents and Caretaker Relatives, Pregnant Women, Children, and Adults may apply for Medical
-Assistance at sites other than the County Department of Social Services, including eligibility sites
-and Certified Application Assistance Sites (CAAS). The Department shall approve these sites to
-receive and initially process these applications. The application used shall be the Single
-Streamlined Application. The eligibility site shall determine eligibility.
-
-3.
-
-The eligibility sites shall refer Medical Assistance clients who are pregnant and/or age 20 and
-under to EPSDT offices (designated by the Department) by:
-a.
-
-Copying the page of the Single Streamlined Application that includes the EPSDT benefit
-questions. The eligibility site will then forward this page to the EPSDT office within five
-working days from the date of application approval; or by:
-
-b.
-
-Means of secure, electronic data transfer approved by the Department
-
-8.100.4.B.
-1.
-
-MAGI Category Verification Requirements
-
-Minimal Verification – At minimum, applicants seeking Medical Assistance shall provide all of the
-following:
-a.
-
-Social Security Number: Each individual requesting assistance on the application shall
-provide a Social Security Number (SSN), or each shall submit proof of an application to
-obtain an SSN, unless they qualify for an exception listed in 8.100.3.I.1.b. Individuals who
-qualify for an exception must not be required to provide an SSN.
-i)
-
-Due to the COVID-19 Public Health Emergency, at the time of application, selfattestation is acceptable for SSN criteria, with the exception of verification of
-citizenship and immigration status. At the end of the federally declared COVID-19
-Public Health Emergency, verification for SSN eligibility criteria will be required at
-the time of application. Effective May 11, 2023 the Coronavirus COVID-19 Public
-Health Emergency has been declared to end.
-1)
-
-Applicants who meet the criteria for any categorical Medical Assistance
-programs, but do not meet federal and state citizenship and immigration
-status requirements, are only eligible to receive emergency medical
-services.
-
-b.
-
-Verification of citizenship and identity as outlined in section 8.100.3.H under Citizenship
-and Identity Documentation Requirements.
-
-c.
-
-Earned Income: Income -may be self-attested by an applicant or member and verified
-through an electronic data source. Individuals who provide self-attestation of income may provide a SSN for electronic wage verification purposes.
-If the self-attested earned income cannot be verified electronically, due to a missing SSN,
-the applicant must provide documentation of income. Earned income must be verified by
-wage stubs, tax documents, written documentation from the employer stating the
-employee’s gross income or a telephone call to an employer. Applicants may request that
-communication with their employers be made in writing.
-
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-10 CCR 2505-10 8.100
-
-Estimated earned income shall be used to determine eligibility if the applicant/client
-provides less than a full calendar month of wage stubs for the application month. A single
-recent wage stub shall be sufficient if the applicant's income is expected to be the same
-amount for the month of application. Verification of earned income received during the
-month prior to the month of application shall be acceptable if the application month
-verification is not yet available. Actual earned income shall be used to determine eligibility
-if the client provides verification for the full calendar month.
-Due to the Coronavirus COVID -19 Public Health Emergency, the Department will not
-take action on any electronic interfaces that notify that the individual’s income has
-changed for all Medical Assistance programs in which the individual is currently enrolled.
-The Department will take action and require documentation from the individual once the
-federal emergency declaration has concluded. Effective May 11, 2023 the Coronavirus
-COVID-19 Public Health Emergency has been declared to end.
-d.
-
-Unearned income: Unearned income can be self-attested by an applicant. Certain types
-of unearned income, such as unemployment and survivor benefits may be verified
-through electronic data sources. Due to the Coronavirus COVID -19 Public Health
-Emergency, the Department will not take action on any electronic interfaces that notify
-that the individual’s income has changed for all Medical Assistance programs in which
-the individual is currently enrolled. The Department will take action and require
-documentation from the individual once the federal emergency declaration has
-concluded, for all people whose eligibility was maintained during the emergency
-declaration, for these individuals to maintain eligibility. Effective May 11, 2023 the
-Coronavirus COVID-19 Public Health Emergency has been declared to end.
-
-e.
-
-Verification of Legal Immigrant Status: Immigration status may be self-declared by an
-applicant applying for Medical Assistance, to determine eligibility for full Medical
-Assistance benefits. This declaration of legal immigration status will be verified through
-the Verify Lawful Presence (VLP) interface. The VLP interface connects to the
-Systematic Alien Verification for Entitlements (SAVE) program to verify legal immigration
-status. See section 8.100.3.G for a description of the VLP interface. If status cannot be
-verified, or if the applicant does not provide the necessary documents within the
-reasonable opportunity period, then the applicant’s Medical Assistance application shall
-be terminated.
-
-2.
-
-Additional Verification: No other verification shall be required of the client unless information is
-found to be questionable on the basis of fact.
-
-3.
-
-The determination that information is questionable shall be documented in the applicant's case
-file and CBMS case comments.
-
-4.
-
-Information that exists in another case record or in CBMS shall be used by the eligibility site to
-verify those factors that are not subject to change, if the information is reasonably accessible.
-
-5.
-
-The criteria of age and relationship may be declared by the client unless questionable. If
-questionable, these criteria may be established with information provided from:
-
-6.
-
-a.
-
-official papers such as: a birth certificate, order of adoption, marriage license, immigration
-or naturalization papers; or
-
-b.
-
-records or statements from sources such as: a court, school, government agency,
-hospital, or physician.
-
-Establishing that a dependent child meets the eligibility criteria of:
-
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-
-a.
-
-age, if questionable requires (1) viewing the birth certificate or comparably reliable
-document at eligibility site discretion, and (2) documenting the source of verification in the
-case file and CBMS case comments;
-
-b.
-
-living in the home of the caretaker relative, if questionable requires (1) viewing the
-appropriate documents which identify the relationship, (2) documenting these sources of
-verification in the case file and CBMS case comments.
-
-8.100.4.C.
-1.
-
-10 CCR 2505-10 8.100
-
-MAGI Methodology for Income Calculation
-
-For an in depth treatment of gross income, refer to 26 U.S.C. § 61, which is hereby incorporated
-by reference. The incorporation of 26 U.S.C. § 61 (2014) excludes later amendments to, or
-editions of, the referenced material. Pursuant to § 24-4-103(12.5), C.R.S., the Department
-maintains copies of this incorporated text in its entirety, available for public inspection during
-regular business hours at: Colorado Department of Health Care Policy and Financing, 1570 Grant
-Street, Denver CO 80203. Certified copies of incorporated materials are provided at cost upon
-request. Except as otherwise provided, pursuant to 26 U.S.C. § 61 gross income means all
-income from all derived sources, The Modified Adjusted Gross Income calculation for the
-purposes of determining a household’s financial eligibility for Medical Assistance shall consist of,
-but is not limited to, the following:
-a.
-
-b.
-
-Earned Income:
-i)
-
-Wages, salaries, tips;
-
-ii)
-
-Gross income derived from business;
-
-iii)
-
-Gains derived from dealings in property;
-
-iv)
-
-Distributive share of partnership gross income (not a limited partner);
-
-v)
-
-Compensation for services, including fees, commissions, fringe benefits and
-similar items; and
-
-vi)
-
-Taxable private disability income.
-
-Unearned Income:
-i)
-
-Interest (includes tax exempt interest);
-
-ii)
-
-Rents;
-
-iii)
-
-Royalties;
-
-iv)
-
-Dividends;
-
-v)
-
-Alimony received counts as unearned income if the divorce or legal separation is
-executed on or before December 31, 2018. Alimony received will not be
-countable income if the divorce or legal separation is modified or executed on or
-after January 1, 2019;
-
-vi)
-
-Pensions and annuities;
-
-vii)
-
-Income from life insurance and endowment contracts;
-
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-10 CCR 2505-10 8.100
-
-viii)
-
-Income from discharge of indebtedness;
-
-ix)
-
-Income in respect of a decedent;
-
-x)
-
-Income from an interest in an estate or trust;
-
-xi)
-
-Social Security (SSA) income;
-
-xii)
-
-Distributive share of partnership gross income (limited partner);
-
-xiii)
-
-Capital gains;
-
-xiv)
-
-Lottery/Gambling Winnings;
-
-xv)
-
-1)
-
-If less than $79,999 winnings are counted as income in the month
-received.
-
-2)
-
-If over $79,999 but less than $89,999 it is counted as income and it is
-divided equally between two months.
-
-3)
-
-For every additional $10,000 over $89,999, one month is added, and
-divided equally and counted as income for each month.
-
-4)
-
-Lottery/gambling winnings of an individual will continue to count only in
-the month received in determining the eligibility for the members of their
-household.
-
-5)
-
-An applicant/member may request a hardship exemption when an
-application is denied or enrollment is terminated due to Lottery/Gambling
-winnings.
-a.
-
-The applicant/member must demonstrate a severe medical or
-financial hardship.
-
-b.
-
-The applicant/member must provide a written request and
-documentation to their County Department of Human Services,
-within 30 calendar days from the date of their denial or
-termination notice.
-
-Student loan debt that is discharged, forgiven, or cancelled is treated as taxable
-income to the borrower, with certain exceptions.
-1)
-
-This debt will not be considered income for the borrower in the event of
-death or permanent and total disability of the student (the borrower and
-the student may or may not be the same person) if discharged during tax
-years 2018 through 2025.
-
-2)
-
-At the Departments discretion, this debt will not be considered countable
-income for the borrower if discharged, forgiven, or cancelled under
-programs which include, but not limited to:
-a)
-
-Public Service loan forgiveness;
-
-b)
-
-Teacher loan forgiveness;
-
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-
-c.
-
-d.
-
-e.
-
-10 CCR 2505-10 8.100
-
-c)
-
-Healthcare loan forgiveness; and
-
-d)
-
-Closed School discharge.
-
-Additional Income: In addition to the types of income identified in section 8.100.4.C.1.ab., the following income is included in the MAGI calculation.
-i)
-
-Any tax exempt interest income.
-
-ii)
-
-Untaxed foreign wages and salaries.
-
-iii)
-
-Social Security Title II Benefits (Old Age, Disability and Survivor’s benefits).
-
-The following are Income exclusions:
-i)
-
-An amount received as a lump sum is counted as income only in the month
-received;
-
-ii)
-
-Scholarships, awards, or fellowship grants used for educational purposes and not
-for living expenses;
-
-iii)
-
-Child support received;
-
-iv)
-
-Worker’s Compensation;
-
-v)
-
-Supplemental Security Income (SSI);
-
-vi)
-
-Veteran’s Benefits;
-
-vii)
-
-The federal Coronavirus Aid, Relief, and Economic Security (CARES) Act and
-the American Rescue Plan (ARP) Act Recovery Rebate, also known as the
-COVID-19 Economic Stimulus, shall be exempt from consideration as income.
-
-viii)
-
-Federal Pandemic Unemployment Compensation (FPUC) program, which
-provides an extra $600.00 a week for qualified individuals, is exempt as
-countable unearned income.
-
-ix)
-
-American Indian/Alaskan Native income exceptions listed at 42 C.F.R. §
-435.603(e) (2012) is hereby incorporated by reference. The incorporation of 42
-C.F.R. § 435.603(e) (2012) excludes later amendments to, or editions of, the
-referenced material. Pursuant to § 24-4-103(12.5), C.R.S., the Department
-maintains copies of this incorporated text in its entirety, available for public
-inspection during regular business hours at: Colorado Department of Health Care
-Policy and Financing, 1570 Grant Street, Denver, CO 80203. Certified copies of
-incorporated materials are provided at cost upon request.
-
-Allowable Deductions: For an in-depth treatment of allowable deductions from gross
-income, refer to 26 U.S.C. 62, which is hereby incorporated by reference. The
-incorporation of 26 U.S.C. 62 (2014) excludes later amendments to, or editions of, the
-referenced material. Pursuant to § 24-4-103(12.5), C.R.S., the Department maintains
-copies of this incorporated text in its entirety, available for public inspection during regular
-business hours at: Colorado Department of Health Care Policy and Financing, 1570
-Grant Street, Denver CO 80203. Certified copies of incorporated materials are provided
-at cost upon request.
-
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-
-10 CCR 2505-10 8.100
-
-The following deductions may be subtracted from an individual’s taxable gross income, in
-order to calculate the Adjusted Gross Income (AGI) including (but not limited to):
-
-f.
-
-i)
-
-Student loan interest deductions;
-
-ii)
-
-Certain Self- employment expenses SEP, SIMPLE and qualified plans, and
-health insurance deductions;
-
-iii)
-
-Deductible part of self-employment tax;
-
-iv)
-
-Health savings account deduction;
-
-v)
-
-Certain business expenses of reservists, performing artist, and fee-basis
-government officials;
-
-vi)
-
-Reimbursed expenses of employees;
-
-vii)
-
-Moving expenses for active duty military who are moving due to a permanent
-change of station;
-
-viii)
-
-IRA deduction: Regular Individual Retirement Account (IRA) contributions
-claimed on a federal income tax return and which does not exceed the IRA
-contributions limits; (Pre-tax contributions to a 401(k) or 403(b) retirement plan
-are excluded from earned income);
-
-ix)
-
-Penalty on early withdrawal of savings;
-
-x)
-
-Domestic production activities deduction;
-
-xi)
-
-Alimony paid may be deducted only if the divorce or legal separation is executed
-on or before December 31, 2018. It cannot be deducted if the divorce or
-separation is modified or executed on or after January 1, 20019;
-
-xii)
-
-Certain educator expenses;
-
-xiii)
-
-Certain pre-tax contributions;
-
-xiv)
-
-Net operating losses; and
-
-xv)
-
-Capital losses.
-
-Income of children and tax dependents:
-i)
-
-The income of a child who is included in the household of their natural, adopted,
-or step parent will not be included in the household income unless that child has
-income above the tax filing threshold..
-1)
-
-ii)
-
-Income from Title II Social Security benefits and Tier I Railroad benefits
-are excluded when determining if a child is required to file taxes.
-
-The income of a person, other than a child or spouse, who expects to be claimed
-as a tax dependent will not be included in the household income of the taxpayer
-unless that tax dependent has income above the tax filing threshold.
-
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-
-1)
-
-ii)
-
-2.
-
-10 CCR 2505-10 8.100
-
-Income from Title II Social Security benefits and Tier I Railroad benefits
-are excluded when determining if a tax dependent is required to file
-taxes.
-
-The income of a child or tax dependent who does not live with their natural,
-adopted, or step parent will always count towards the determination of their own
-eligibility, even if the child’s or tax dependent’s income is below the tax filing
-threshold.
-
-Income verifications: When discrepancies arise between self-attested income and electronic data
-source results, the applicant shall receive a reasonable opportunity to establish his/her financial
-eligibility through the test for reasonable compatibility, by providing a reasonable explanation of
-the discrepancy, or by providing supporting documentation within the Reasonable Opportunity
-Period of 30 calendar days.
-a.
-
-Income information obtained through an electronic data source shall be considered
-reasonably compatible with income information provided by or on behalf of an applicant
-in the following circumstances:
-i)
-
-If the amount attested by the applicant and the amount reported by an electronic
-data source are both below the applicable MAGI Medical Assistance program
-income standard, that income shall be determined reasonably compatible and
-the applicant shall be determined eligible.
-
-ii)
-
-If the amount attested by the applicant is below the applicable MAGI Medical
-Assistance program income standard, but the amount reported by the electronic
-data source is above, and the difference is within the reasonable compatibility
-threshold percentage of 20%, the income shall be determined reasonably
-compatible and the applicant shall be determined eligible.
-
-iii)
-
-If both amounts are above the applicable MAGI Medical Assistance program
-income standard the income shall be determined reasonably compatible, and the
-applicant shall continue to be determined eligible during the federal Coronavirus
-COVID-19 Public Health Emergency.
-Effective May 11, 2023 the Coronavirus COVID-19 Public Health Emergency has
-been declared to end and the effective policy after May 11,2023 is if both
-amounts are above the applicable income standard for that program, the income
-shall be determined reasonably compatible, and the applicant shall be
-determined ineligible due to income.
-
-b.
-
-If income information provided by or on behalf of an applicant is not determined
-reasonably compatible with income information obtained through an electronic data
-source, a reasonable explanation of the discrepancy shall be requested during the
-federal Coronavirus COVID-19 Public Health Emergency. If the applicant does not
-provide the required documentation within the reasonable opportunity period, then the
-applicant's Medical Assistance benefits shall not be terminated during the federal
-Coronavirus COVID-19 Public Health Emergency. When the federal COVID-19 Public
-Health Emergency has ended, a reasonable opportunity period will be given to request
-proper documentation from the member.
-
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-
-i)
-
-10 CCR 2505-10 8.100
-
-During the federal Coronavirus COVID-19 Public Health Emergency the
-Department may request paper documentation when the Department does not
-find income to be reasonably compatible. If the member does or does not provide
-paper documentation they will remain eligible during the public health emergency
-period.
-Effective May 11, 2023 the Coronavirus COVID-19 Public Health Emergency has
-been declared to end and the effective policy after May 11, 2023 is the
-Department may request paper documentation only if the Department does not
-find income to be reasonably compatible and if the applicant does not provide a
-reasonable explanation or if electronic data are not available.
-
-3.
-
-Self-Employment – If the applicant is self-employed the ledger included in the Single Streamlined
-Application shall be sufficient verification of earnings, unless questionable.
-
-4.
-
-Budget Periods for MAGI-based Income determination – The financial eligibility of applicants for
-Medical Assistance shall be determined based on current or previous monthly household income
-and family size.
-a.
-
-5.
-
-If an applicant does not meet the financial eligibility requirements for Medical Assistance based
-on MAGI, but meets all other eligibility requirements, the applicant shall be found eligible for
-MAGI Medical Assistance if the applicant’s income, as calculated using the methodology for
-determining eligibility for Advanced Premium Tax Credits or Cost Sharing Reductions through the
-marketplace, is below 100% of the federal poverty level.
-
-8.100.4.D.
-1.
-
-Income Disregard
-
-An income disregard equivalent to five percentage points of the Federal Poverty Level for the
-applicable family size will be subtracted from MAGI-based income.
-a.
-
-If an individual’s MAGI-based countable income is above the income threshold for the
-applicable MAGI program under title XIX (Medicaid) or title XXI (CHP+) of the Social
-Security Act, the five percent (5%) disregard will be applied for each qualifying MAGI
-program as the last step to determine eligibility.
-
-b.
-
-If the countable income is below the income threshold for the applicable MAGI program,
-the individual is income eligible and the five percent (5%) disregard will not be applied to
-determine eligibility.
-
-8.100.4.E.
-1.
-
-Applicants who are found financially ineligible based on current or previous monthly
-household income and family size, and whose household has earned income from selfemployment, seasonal employment, and/or commission-based employment, shall have
-their financial eligibility determined using annualized self-employment, seasonal
-employment, and commission-based employment income.
-
-Determining MAGI Household Composition.
-
-MAGI household composition is similar to, but not necessarily the same as a tax household. To
-determine MAGI household composition, the individual’s relationship to the tax filer must be
-established as declared on the Single Streamlined Application.
-a.
-
-In the case of an applicant who expects to file a tax return for the taxable year in which
-an initial determination or renewal of eligibility is being made, and does not expect to be
-claimed as a tax dependent by anyone else, then the applicant’s MAGI household shall
-consist of the following:
-
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-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-b.
-
-c.
-
-d.
-
-10 CCR 2505-10 8.100
-
-i)
-
-The Tax-Filer;
-
-ii)
-
-The Tax-Filer’s spouse if living in the home;
-
-iii)
-
-All persons whom the Tax-Filer expects to claim as a tax dependent on their
-personal income tax return
-
-In the case of an applicant who expects to be claimed as a tax dependent by another
-taxpayer for the taxable year in which an initial determination or renewal of eligibility is
-being made, the applicant’s MAGI household shall be:
-i)
-
-The Tax Dependent;
-
-ii)
-
-The Tax-Filer and their spouse if living in the home;
-
-iii)
-
-The Tax-Filer’s other tax dependents;
-
-iv)
-
-The Tax Dependent’s spouse, if living with the Tax Dependent.
-
-The MAGI household of an applicant who expects to be claimed as a tax dependent is as
-outlined in 8.100.4.E.b above, except in the following circumstances:
-i)
-
-The applicant expects to be claimed as a tax dependent by someone other than
-a spouse, biological, adoptive or step parent.
-
-ii)
-
-The applicant is a child under 19 who is expected to be claimed by one parent as
-a tax dependent and is living with both parents, but the parents do not expect to
-file a joint tax return.
-
-iii)
-
-The applicant is a child under 19 and who expects to be claimed as a tax
-dependent by anon-custodial parent.
-
-If the applicant meets one of the exceptions in 8.100.4.E.c above or is a non-filer,
-household composition shall be determined using the following non-filer rules and the
-applicant’s household shall consist of the following:
-i)
-
-The applicant;
-
-ii)
-
-The applicant’s spouse who lives in the household;
-
-iii)
-
-The applicant’s natural, adopted, and step children under the age of 19, who live
-in the household; and
-
-iv)
-
-In the case of applicants under the age of 19, the applicant’s natural, adoptive,
-and step parents and natural, adoptive, and step siblings under age 19, who live
-in the household.
-
-2.
-
-When a household includes a pregnant woman, regardless of the Medical Assistance category,
-the pregnant woman is counted as herself plus the number of children she is expected to deliver.
-
-3.
-
-When a household includes an individual applying for the limited Family Planning Medical
-Assistance category, the individual is counted as a household of two in addition to any other
-household members.
-
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-
-10 CCR 2505-10 8.100
-
-4.
-
-Married couples living together will each be included in the other’s MAGI household regardless of
-whether or not they expect to file taxes jointly, separately or if one expects to be claimed as a tax
-dependent of the other.
-
-5.
-
-If a child is claimed as a tax dependent by both parents who are married and who will file taxes
-jointly but one parent lives outside of the household due to separation or pending divorce, the
-child’s household composition is determined by non-filer rules. The parent living outside of the
-household will not be counted as part of the household.
-
-6.
-
-An individual who is both a tax dependent and a tax filer will be considered a tax dependent for
-the purpose of determining eligibility for Medical Assistance.
-
-8.100.4.F.
-
-MAGI Category Presumptive Eligibility
-
-1.
-
-A pregnant applicant may apply for presumptive eligibility for ambulatory services through
-Medical Assistance presumptive eligibility sites. A child under the age of 19 may apply or have an
-adult apply on their behalf for presumptive eligibility for State Plan approved medical services
-through presumptive eligibility sites. Presumptive eligibility is available to applicants for limited
-family planning who are not pregnant. There are no restrictions of age or gender under the limited
-family planning presumptive eligibility category.
-
-2.
-
-To be eligible for presumptive eligibility:
-a.
-
-a pregnant woman shall have an attested pregnancy, declare that her household's
-income shall not exceed 195% of the federal poverty level (MAGI-equivalent) and declare
-that she is a United States citizen or a lawfully residing immigrant. Refer to the MAGIMedicaid income guidelines chart available on the Department’s website
-
-b.
-
-a child under the age of 19 shall have a declared household income that does not exceed
-133% of federal poverty level (MAGI-equivalent) and declare that the child is a United
-States citizen or a documented immigrant.
-
-c.
-
-To qualify for limited family planning presumptive eligibility, an applicant must have
-declared household income greater than 133% but not exceeding 260% of the federal
-poverty level. The applicant cannot be eligible for a Medicaid eligibility category that
-provides full coverage. The applicant must declare they are a United States citizen or a
-lawfully residing immigrant. An applicant applying for limited family planning presumptive
-eligibility will be counted individually as a household member of two.
-
-3.
-
-Presumptive eligibility sites shall be certified by the Department to make presumptive eligibility
-determinations. Sites shall be re-certified by the Department every 2 years to remain approved
-presumptive eligibility sites.
-
-4.
-
-The presumptive eligibility site shall forward the application to the county within five business
-days.
-
-5.
-
-The presumptive eligibility period begins on the date the applicant(s) is determined eligible and
-ends with the day an eligibility determination for Medical Assistance is made for the applicant(s)
-
-6.
-
-A presumptive eligible client may not appeal the end of a presumptive eligibility period.
-
-7.
-
-Presumptively eligible women and Medical Assistance clients may appeal the county
-department's failure to act on an application within 45 days from date of application or the denial
-of an application. Appeal procedures are outlined in the State Hearings section of this volume.
-
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-
-8.100.4.G.
-
-10 CCR 2505-10 8.100
-
-MAGI Covered Groups
-
-1.
-
-For MAGI Medical Assistance, any person who is determined to be eligible for Medical
-Assistance based on MAGI at any time during a calendar month shall be eligible for benefits
-during the entire month.
-
-2.
-
-Children applying for Medical Assistance whose total household income does not exceed 142%
-of the federal poverty level shall be determined financially eligible for Medical Assistance. Refer to
-the MAGI-Medicaid income guidelines chart available on the Department’s website.
-a.
-
-3.
-
-Parents and Caretaker Relatives applying for Medical Assistance whose total household income
-does not exceed 68% of the federal poverty level (MAGI-equivalent) shall be determined
-financially eligible for Medical Assistance. Parents or Caretaker Relatives eligible for this category
-shall have a dependent child in the household.
-a.
-
-4.
-
-Children are eligible for Children’s MAGI Medical Assistance through the end of the
-month in which they turn 19 years old. After turning 19, the individual may be eligible for a
-different Medical Assistance category.
-
-A dependent child is considered to be living in the home of the parent or caretaker
-relative as long as the parent or specified relative exercises responsibility for the care and
-control of the child even if:
-i)
-
-The child is under the jurisdiction of the court (for example, receiving probation
-services);
-
-ii)
-
-Legal custody is held by an agency that does not have physical possession of
-the child;
-
-iii)
-
-The child is in regular attendance at a school away from home;
-
-iv)
-
-Either the child or the relative is away from the home to receive medical
-treatment;
-
-v)
-
-Either the child or the relative is temporarily absent from the home;
-
-vi)
-
-The child is in voluntary foster care placement for a period not expected to
-exceed three months. Should the foster care plan change within the three
-months and the placement become court ordered, the child is no longer
-considered to be living in the home as of the time the foster care plan is changed.
-
-Adults applying for Medical Assistance whose total household income does not exceed 133% of
-the federal poverty level shall be determined financially eligible for Medical Assistance. This
-category includes adults who are parents or caretaker relatives of dependent children whose
-income exceeds the income threshold to qualify for the Parents and Caretaker Relatives MAGI
-category and who meet all other eligibility criteria.
-a.
-
-A dependent child living in the household of a parent or caretaker relative shall have
-minimum essential coverage, in order for the parent or caretaker relative to be eligible for
-Medical Assistance under this category. Refer to section 8.100.4.G.3.a on who is
-considered a dependent child.
-
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-
-b.
-
-5.
-
-10 CCR 2505-10 8.100
-
-Due to the COVID-19 Public Health Emergency an applicant who is not eligible for
-Medical Assistance but has been impacted through exposure to or potential infection with
-COVID-19 may be eligible to receive services for COVID-19 testing only. To qualify for
-this limited benefit, the applicant must satisfy residency and immigration or citizenship
-status and not be enrolled in other health insurance.
-
-Pregnant Women whose household income does not exceed 195% of the federal poverty level
-(MAGI-equivalent) are eligible for the Pregnant Women MAGI Medical Assistance program.
-Medical Assistance shall be provided to a pregnant woman for a period beginning with the date of
-application for Medical Assistance through the last day of the 12 th month following the date the
-pregnancy ends. Once eligibility has been approved, Medical Assistance coverage will be
-provided regardless of changes in the woman's financial circumstances once the income
-verification requirements are met.
-a.
-
-A pregnant women’s eligibility period will end effective the earliest possible month, if the
-following occurs:
-i)
-
-Fails to provide a reasonable explanation or paper documentation when selfattested income is not reasonably compatible with income information from an
-electronic data source, by the end of the 30day reasonable opportunity period.
-This exception only applies the first-time income is verified following an initial
-eligibility determination or an annual redetermination.
-
-6.
-
-A lawfully admitted non-citizen who is pregnant and who has been in the United States for less
-than five years is eligible for Medical Assistance if she meets all of the other eligibility
-requirements specified at 8.100.4.G.5 and fits into one of the immigration categories listed in
-8.100.3.G.1.g.iii.1-5 and 8.100.3.G.1.g.vi.1-15. This population is referenced as Legal Immigrant
-Prenatal.
-
-7.
-
-A child whose mother is receiving Medical Assistance at the time of the child's birth is
-continuously eligible for one year. This population is referred to as “Eligible Needy Newborn”. This
-coverage also applies in instances where the mother received Medical Assistance to cover the
-child’s birth through retroactive Medical Assistance. The child is not required to live with the
-mother receiving Medical Assistance to qualify as an Eligible Needy Newborn.
-a.
-
-8.
-
-To receive Medical Assistance under this category, the birth must be reported verbally or
-in writing to the County Department of Human Services or eligibility site. Information
-provided shall include the baby’s name, date of birth, and mother’s name or Medical
-Assistance number. A newborn can be reported at any time by any person. Once
-reported, a newborn meeting the above criteria shall be added to the mother’s Medical
-Assistance case, or his or her own case if the newborn does not reside with the mother,
-according to timelines defined by the Department. If adopted, the newborn’s agent does
-not need to file an application or provide a Social Security Number or proof of application
-for a Social Security Number for the newborn
-
-Applicants applying for Medical Assistance whose total household income is greater than 133%
-but does not exceed 260% of the federal poverty level shall be determined financially eligible for
-limited Family Planning Medical Assistance services. The applicant must satisfy residency and
-immigration or citizenship status to qualify for this limited benefit. The limited family planning
-services eligibility category has no age or gender restriction and is available for those not eligible
-for a Medicaid eligibility category that provides full coverage.
-
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-
-8.100.4.H.
-1.
-
-2.
-
-10 CCR 2505-10 8.100
-
-Needy Persons
-
-Medical Assistance shall be provided to certain needy persons under 21 years of age, including
-the following:
-a.
-
-Those receiving care in a Long Term Care Institution eligible for Medical Assistance
-reimbursement or receiving active treatment as inpatients in a psychiatric facility eligible
-for Medical Assistance reimbursement and whose household income is less than the
-MAGI needs standard for his/her family size when the client applies for assistance.
-Clients that are receiving benefits under this category and are still receiving active
-inpatient treatment in the facility at age 21 shall be eligible to age 22. This population is
-referenced as Psych <21.
-
-b.
-
-Those for whom the Department of Human Services is assuming full or partial financial
-responsibility and who are in foster care, in homes or private institutions or in subsidized
-adoptive homes. A child shall be the responsibility of the county, even if the child may be
-in a medical institution at that time. See Colorado Department of Human Services “Social
-Services Staff Manual” section 7 for specific eligibility requirements (12 CCR § 2509-1).
-12 CCR § 2509-1 (2013) is hereby incorporated by reference. The incorporation of 12
-CCR § 2509-1 excludes later amendments to, or editions of, the referenced material.
-Pursuant to § 24-4-103(12.5), C.R.S., the Department maintains copies of this
-incorporated text in its entirety, available for public inspection during regular business
-hours at: Colorado Department of Health Care Policy and Financing, 1570 Grant Street,
-Denver CO 80203. Certified copies of incorporated materials are provided at cost upon
-request.
-
-c.
-
-Those for whom the Department of Human Services is assuming full or partial financial
-responsibility and who are in independent living situations subsequent to being in foster
-care.
-
-d.
-
-Those for whom the Department of Human Services is assuming full or partial
-responsibility and who are receiving services under the state’s Alternatives to Foster
-Care Program and would be in foster care except for this program and whose household
-income is less than the MAGI needs standard for his/her family size.
-
-e.
-
-Those for whom the Department of Human Services is assuming full or partial
-responsibility and who are removed from their home either with or without (court ordered)
-parental consent, placed in the custody of the county and residing in a county approved
-foster home.
-
-f.
-
-Those for whom the Department of Human Services is assuming full or partial
-responsibility and who are receiving services under the state’s subsidized adoption
-program, including a clause in the subsidized adoption agreement to provide Medical
-Assistance for the child.
-
-g.
-
-Those for whom the Department of Human Services is assuming full or partial financial
-responsibility on their 18th birthday or at the time of emancipation. These individuals also
-must have received foster care maintenance payments or subsidized adoption payments
-from the State of Colorado pursuant to article 7 of title 26, C.R.S. immediately prior to the
-date the individual attained 18 years of age or was emancipated. Eligibility shall be
-extended until the individual’s 21st birthday for these individuals with the exception of
-those receiving subsidized adoption payments.
-
-Medical Assistance shall be extended to certain needy persons until the end of the month of the
-individual’s 26th birthday, including the following:
-
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-
-a.
-
-Those individuals that were formerly in foster care under the responsibility of Colorado or
-Tribe on their 18th, 19th, 20th or up to their 21st birthday and were receiving Medical
-Assistance.
-i)
-
-This extension does not apply to youth that are receiving subsidized adoption
-payments or
-
-ii)
-
-To youth that are enrolled in mandatory Medical Assistance.
-
-iii)
-
-This extension applies to Individuals who were in foster care at the age 18 on or
-after January 1, 2023, and were enrolled in Medicaid in another state, and who
-have become a resident of Colorado.
-
-b)
-
-Former Foster Care youth are not subject to either an income or resource test.
-
-c)
-
-Former Foster Care youth’s newborn shall be considered a needy newborn.
-
-8.100.4.I.
-1.
-
-10 CCR 2505-10 8.100
-
-Transitional Medical Assistance and 4 Month Extended Medical Assistance
-
-Eligibility for Transitional Medical Assistance shall be granted for twelve months (beginning with
-the first month of ineligibility) to individuals who are no longer eligible for the Parent/Caretaker
-Relative category due to a change in income.
-The extension shall be applied to individuals who:
-a.
-
-Were eligible for the Parent/Caretaker Relative category in at least three of the six
-months preceding the month in which the individual would have become ineligible, and
-
-b.
-
-Are no longer eligible for coverage under the Parent/Caretaker Relative category
-because of new or increased income from employment or hours of employment
-i)
-
-2.
-
-3.
-
-At least one Parent/Caretaker Relative must continue to be employed and cannot
-terminate employment without good cause. This does not need to be the same
-person for the whole period the family is receiving Transitional Medical
-Assistance.
-
-Any dependent child or Parent/Caretaker Relative who was or becomes part of the Medical
-Assistance household after the individual has begun receiving Transitional Medical Assistance is
-eligible for the remaining months of Transitional Medical Assistance.
-a.
-
-A dependent child in the household who received Medical Assistance through continuous
-eligibility, but is no longer eligible for Medical Assistance based on a redetermination, is
-eligible for the family’s remaining months of Transitional Medical Assistance.
-
-b.
-
-An individual in the household who received Medical Assistance, but is no longer eligible
-for Medical Assistance based on a redetermination, is eligible for the family’s remaining
-months of Transitional Medical Assistance
-
-To become or remain eligible for Transitional Medical Assistance the household must include a
-dependent child. If it is determined that the household no longer has a child living in the home,
-Transitional Medicaid Assistance shall discontinue at the end of the month in which the
-household does not include a dependent child.
-
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-
-10 CCR 2505-10 8.100
-
-4.
-
-When Transitional Medical Assistance ends the case will be reassessed for all other categories of
-Medical Assistance for which the family members may be eligible. A new application shall not be
-required for this process.
-
-5.
-
-Eligibility for Medical Assistance shall be extended for four months (beginning with the first month
-of ineligibility) for certain families who become ineligible for Medical Assistance due solely or
-partially to the receipt of support income, such as alimony. The extension shall be applied for a
-family which receives assistance under Medical Assistance in at least three of the six months
-immediately preceding the month in which the family becomes ineligible for assistance. To be
-eligible for the four month Medical Assistance extension, the family shall meet all other eligibility
-criteria for Medical Assistance before the alimony income is applied.
-a.
-
-8.100.4.J.
-
-Alimony received will be countable income only if the divorce or legal separation is
-executed on or before December 31, 2018. Alimony will not be countable income if the
-divorce or legal separation is modified or executed on or after January 1, 2019.
-Express Lane Eligibility
-
-Express Lane Eligibility shall allow for automatic initiation of Medical Assistance enrollment by using
-available data and findings from other programs as listed below.
-1.
-
-Free/Reduced Lunch Program
-a.
-
-b.
-
-Recipients of the Free/Reduced Lunch Program who have submitted a Free/Reduced
-Lunch application at a participating school districti)
-
-Families shall be given the option to opt into Medical Assistance coverage for
-their potentially eligible child.
-
-ii)
-
-Children who meet all necessary eligibility requirements as outlined in this
-volume shall be automatically enrolled.
-
-iii)
-
-Children who meet all necessary eligibility requirements except verification of
-U.S. citizenship and identity shall receive 90days of eligibility while awaiting this
-verification.
-
-iv)
-
-Any additionally required verification shall be requested from the client through
-CBMS prior to being automatically enrolled.
-
-v)
-
-Eligibility is based on income declared on the Free/Reduced Lunch application as
-well as eligibility requirements outlined in this volume.
-
-vi)
-
-If it would be found that a child does not satisfy an eligibility requirement for
-Medical Assistance, the child’s eligibility will be evaluated using the Single
-Streamlined Application for Medical Assistance.
-
-Recipients of the Free/Reduced Lunch Program who were not required to submit a
-Free/Reduced Lunch application at a participating school districti)
-
-Families who are automatically enrolled Free/Reduced Lunch recipient children
-shall not be forwarded to the Department for Express Lane Eligibility in
-compliance USDA confidentiality guidelines.
-
-ii)
-
-These families must apply for Medical Assistance in order to give consent for
-request of benefits.
-
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-
-2.
-
-10 CCR 2505-10 8.100
-
-Direct Certification
-a.
-
-Individuals who have submitted a Food Assistance or Colorado Works application
-i)
-
-Families shall be given the option to opt into Medical Assistance coverage for
-their potentially eligible child.
-
-ii)
-
-Children who meet all necessary eligibility requirements as outlined throughout
-8.100.4 shall be automatically enrolled
-
-iii)
-
-Children who meet all necessary eligibility requirements except verification of
-U.S. citizenship and identity will receive 90 days of eligibility while awaiting this
-verification.
-
-iv)
-
-Any additionally required verification shall be requested from the client through
-CBMS prior to being automatically enrolled.
-
-v)
-
-Eligibility is based on income declared on the Food Assistance or Colorado
-Works application as well as eligibility requirements outlined throughout this
-volume.
-
-vi)
-
-If it would be found that a child does not satisfy an eligibility requirement for
-Medical Assistance, the child’s eligibility shall be evaluated using the Single
-Streamlined Application for Medical Assistance.
-
-vii)
-
-Individuals whose eligibility is not determined through Express Lane Eligibility
-can also submit a separate Single Streamlined Application for Medical
-Assistance to determine eligibility.
-
-8.100.5.
-Aged, Blind, and Disabled, Long Term Care, and Medicare Savings Plan Medical
-Assistance General Eligibility
-8.100.5.A.
-1.
-
-Application Requirements
-
-When an individual applies for Medical Assistance on the basis of disability or blindness, the
-eligibility sites shall take the application and determine whether the individual is eligible for Long
-Term Care or any of the Aged, Blind, and Disabled categories of assistance described in section
-8.100.6. If the applicant does not qualify for Medical Assistance on one of those bases, he/she
-shall be referred to the local Social Security office to apply for SSI.
-a.
-
-Applicants who apply for Long-Term Care Medical Assistance on the basis of disability or
-blindness, or who apply for the Medicaid Buy-In Program for Working Adults with
-Disabilities or the Medicaid Buy-In Program for Children with Disabilities without a current
-disability determination, shall complete a Medical Assistance disability determination
-application in addition to the required Single Streamlined Application. The disability
-determination application is not required for individuals that have already been
-determined disabled by the Social Security Administration.
-
-b.
-
-The Medical Assistance disability determination application shall be collected by a
-designated eligibility site representative and shall be forwarded to the state disability
-determination contractor upon completion. The state disability determination contractor
-shall conduct a client disability determination and shall forward the determination to the
-designated eligibility site representative.
-
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-
-2.
-
-c.
-
-For the Medicaid Buy-In Program for Working Adults with Disabilities, if an individual
-does not meet the Social Security Administration definition of disability, the state disability
-determination contractor can review the individual’s circumstances to determine if the
-individual meets limited disability.
-
-d.
-
-Due to the Coronavirus COVID-19 Public Health Emergency, if a person’s existing
-disability determination has expired, the person shall remain enrolled in Medical
-Assistance until the emergency has ended and the state has processed the verification of
-eligibility, unless the individual requests a voluntary termination of eligibility. At the end of
-the Public Health Emergency a disability determination that has expired will require a new
-disability determination to make a proper determination of eligibility. Members whose
-eligibility has been maintained during the Public Health Emergency will remain in their
-current category until their renewal due month and/or their renewal is processed.
-
-Persons requesting Aged, Blind, and Disabled Medical Assistance need only to complete the
-Single Streamlined Application.
-
-8.100.5.B.
-1.
-
-10 CCR 2505-10 8.100
-
-Verification Requirements
-
-The particular circumstances of an applicant will dictate the appropriate documentation needed
-for a complete application. The following items shall be verified for individuals applying for
-Medical Assistance:
-a.
-
-Social Security Number: Each individual requesting assistance on the application shall
-provide a Social Security Number (SSN), or each shall submit proof of an application to
-obtain an SSN, unless they qualify for an exception listed in 8.100.3.I.1.b. Individuals who
-qualify for an exception must not be required to provide an SSN.
-i)
-
-Due to the Coronavirus COVID-19 Public Health Emergency, at application, selfattestation is acceptable for SSN criteria, with the exception of verification of
-citizenship and immigration status. At the end of the COVID-19 Public Health
-Emergency, verification for SSN eligibility criteria will be required. Effective May
-11, 2023 the Coronavirus COVID-19 Public Health Emergency has been
-declared to end. Members whose eligibility has been maintained during the
-Public Health Emergency will remain in their current category until their renewal
-due month and/or their renewal is processed.
-1)
-
-Applicants who meet the criteria for any categorical Medical Assistance
-programs, but do not meet the federal and state criteria of citizenship
-and immigration status are only eligible to receive emergency medical
-services.
-
-b.
-
-Verification of citizenship and identity as outlined in the section 8.100.3.H under
-Citizenship and Identity Documentation Requirements.
-
-c.
-
-Earned income may be self-attested by an applicant or member and verified through an
-electronic data source through the IEVS, FDSH, or the TWN. Individuals who provide
-self-attestation of earned income may also provide a SSN for wage verification purposes.
-If the self-attested earned income cannot be verified electronically due to a missing SSN,
-the applicant must provide documentation of income. Verification of earned income must
-be provided in accordance to the requirements outlined in 8.100.4.B.1.c
-
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-
-10 CCR 2505-10 8.100
-
-When discrepancies arise between self-attested income and electronic data source
-results, the applicant shall receive a reasonable opportunity to establish his/her financial
-eligibility through the test for reasonable compatibility, by providing a reasonable
-explanation of the discrepancy, or by providing paper documentation within the
-Reasonable Opportunity Period (ROP) of 30 calendar days.
-Income information obtained through an electronic data source shall be considered
-reasonably compatible with income information provided by or on behalf of an applicant
-in the following circumstances:
-i)
-
-If the amount attested by the applicant and the amount reported by an electronic
-data source are both below the applicable Medical Assistance program income
-standard, that income shall be determined reasonably compatible and the
-applicant shall be determined eligible.
-
-ii)
-
-If the amount attested by the applicant is below the applicable income standard
-for that program, but the amount reported by the electronic data source is above,
-and the difference is within the reasonable compatibility threshold percentage of
-20%, the income shall be determined reasonably compatible and the applicant
-shall be determined eligible.
-
-iii)
-
-If both amounts are above the applicable income standard for that program, the
-income shall be determined reasonably compatible, and the applicant shall
-continue to be determined eligible during the federal Coronavirus COVID-19
-Public Health Emergency.
-Effective May 11, 2023 the Coronavirus COVID-19 Public Health Emergency has
-been declared to end and the effective policy after May 11, 2023 is if both
-amounts are above the applicable income standard for that program, the income
-shall be determined reasonably compatible, and the applicant shall be
-determined ineligible due to income.
-
-If income information provided by or on behalf of an applicant is not determined
-reasonably compatible with income information obtained through an electronic data
-source, a reasonable explanation of the discrepancy will not be requested during the
-federal COVID-19 Public Health Emergency. If the applicant does not provide the
-required documentation within the reasonable opportunity period, then the applicant's
-Medical Assistance benefits shall not be terminated during the federal Coronavirus
-COVID-19 Public Health Emergency. When the federal Public Health Emergency has
-ended, a reasonable opportunity period will be given to request proper documentation
-from the member.
-iv)
-
-During the federal Coronavirus COVID-19 Public Health Emergency the
-Department may request paper documentation when the Department does not
-find income to be reasonably compatible. If the member does or does not provide
-paper documentation they will remain eligible during the public health emergency
-period.
-Effective May 11, 2023 the Coronavirus COVID-19 Public Health Emergency has
-been declared to end and the effective policy after May 11, 2023 is the
-Department may request paper documentation only if the Department does not
-find income to be reasonably compatible and if the applicant does not provide a
-reasonable explanation or if electronic data are not available.
-
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-10 CCR 2505-10 8.100
-
-If the applicant is self-employed, ledgers are sufficient for verification of earnings, if a
-ledger is not available, receipts are acceptable. The ledger included in the Medical
-Assistance application is sufficient verification of earnings, unless questionable. If an
-individual cannot provide verification through self-declaration, income shall be verified by
-wage stubs, written documentation from the employer stating the employees' gross
-income or a telephone call to an employer. Applicants may request that communication
-with their employers be made in writing.
-As of CBMS implementation, estimated earned income shall be used to determine
-eligibility if the applicant/client provides less than a full calendar month of wage stubs for
-the application month. A single recent wage stub shall be sufficient if the applicant's
-income is expected to be the same amount for the month of application. Written
-documentation from the employer stating the employees' gross income or a telephone
-call to an employer, if the applicant authorizes the telephone call shall also be acceptable
-verification of earned income. Verification of earned income received during the month
-prior to the month of application shall be acceptable if the application month verification is
-not yet available. Actual earned income shall be used to determine eligibility if the client
-provides verification for the full calendar month.
-v)
-
-d.
-
-Verification of all unearned income shall be provided if the unearned income was
-received in the month for which eligibility is being determined or during the previous
-month. If available, information that exists in another case record or verification system
-shall be used to verify unearned income.
-i)
-
-e.
-
-During the federal COVID-19 Public Health Emergency, all earned income and
-self-employment may be reported by self-attestation. The COVID -19 Public
-Health Emergency ended effective May 11, 2023. At the end of the federal
-COVID-19 Public Health Emergency, proof of any unverified income shall be
-provided.
-
-During the federal COVID-19 Public Health Emergency, all unearned income
-may be reported by self-attestation. The COVID -19 Public Health Emergency
-ended effective May 11, 2023. At the end of the federal COVID-19 Public Health
-Emergency, proof of any unverified income shall be provided.
-
-Verification of all resources shall be provided if the resources were available to the
-applicant in the month for which eligibility is being determined.
-Resource information that is verified through an electronic data source, such as the Asset
-Verification Program, shall be a valid verification. Supplemental physical verifications for
-the same resource is not required unless further information is needed for clarification.
-i)
-
-During the federal COVID-19 Public Health Emergency, all resources may be
-reported by self-attestation. The COVID -19 Public Health Emergency ended
-effective May 11, 2023. At the end of the federal COVID-19 Public Health
-Emergency, proof of any unverified resources shall be provided.
-
-f.
-
-Immigrant registration cards or papers, if applicable, to determine if the client is eligible
-for full Medical Assistance benefits. If an applicant does not provide this, he/she shall
-only be eligible for emergency Medical Assistance if they meet all other eligibility
-requirements.
-
-g.
-
-Additional verification-If the requested verification is submitted by the applicant, no other
-additional verification shall be required unless the submitted verification is found to be
-questionable on the basis of fact.
-
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-
-h.
-8.100.5.C.
-1.
-
-10 CCR 2505-10 8.100
-
-The determination that information is questionable shall be documented in the applicant's
-case file and CBMS case comments.
-Effective Date of Eligibility
-
-Eligibility for the Aged, Blind and Disabled categories shall be approved effective on the later of:
-a.
-
-The first day of the month of the Single Streamlined Application for Medical Assistance;
-or
-
-b.
-
-The first day of the month the person becomes eligible for Medical Assistance.
-
-2.
-
-The date that eligibility begins for Long-Term Care Medical Assistance is defined in section
-8.100.7.A and B.
-
-3.
-
-For the Medicaid Buy-In Program for Children with Disabilities, any child who is determined to be
-eligible for Medical Assistance at any time during a calendar month shall be eligible for benefits
-during the entire month.
-
-4.
-
-Clients applying for Medical Assistance under the Aged, Blind and Disabled category shall be
-reviewed for retroactive eligibility as described at 8.100.3.E. When reviewing for retroactive
-eligibility for an individual who is SSI eligible or applied and became SSI eligible in each of the
-retroactive months, the applicant must:
-a.
-
-Be aged at least 65 years; or
-
-b.
-
-Meet the Social Security Administration definition of disability by:
-
-c.
-8.100.5.D.
-1.
-
-i)
-
-Being approved as eligible to receive either SSI or SSDI, on or prior to the date
-of a medical service; or
-
-ii)
-
-Having a disability onset date determined on or prior to the date of a medical
-service; and
-
-Meet the financial requirements as described at 8.100.5.E.
-Medical Assistance Estate Recovery Program
-
-The eligibility site shall provide written information from the Department to the following people
-explaining the provisions of the Medical Assistance Estate Recovery Program and how those
-provisions may pertain to the applicant/client:
-a.
-
-Applicants age 55 and older who are institutionalized.
-
-b.
-
-Applicants/clients who will turn age 55 before their next eligibility re-determination who
-are institutionalized.
-
-c.
-
-Clients age 55 and older who are approved for admittance to an institution
-
-8.100.5.E.
-
-Availability of Resources and Income
-
-Consistent with the legislative declaration outlined at C.R.S. § 25.5-4-300.4, Medicaid should be the
-payer of last resort for payment of medically necessary goods and services furnished to clients. All other
-sources of payment, including an individual’s own countable income and resources, should be utilized to
-the fullest extent possible before Medicaid is accessed.
-
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-
-10 CCR 2505-10 8.100
-
-1.
-
-Income, which includes earned and unearned income, shall be calculated on a monthly basis
-regardless of whether it is received annually, semi-annually, quarterly or weekly.
-
-2.
-
-For married couples, the income and resources of both spouses are counted in determining
-eligibility for either or both spouses. Refer to section 8.100.7.C for exceptions.
-
-3.
-
-Resources and income shall be considered available when actually available; or, shall be
-deemed available when all of the following apply to the resources or income of the individual or
-individual’s spouse:
-a.
-
-has any ownership interest in income or resources or equity value of a resource;
-
-b.
-
-has the right, authority, or power to convert the resource or income to cash or to cause
-the resource or income to be converted to cash; and
-
-c.
-
-is not legally restricted from using the resource or income for his or her support and
-maintenance.
-
-4.
-
-Resources and income shall not be considered unavailable merely because the individual or
-individual’s spouse may need to initiate legal proceedings to access the resources or income.
-
-5.
-
-If the applicant or client demonstrates with clear and convincing evidence that appropriate steps
-are being taken to secure the resources, Medical Assistance shall not be delayed or terminated.
-Verification of efforts to secure the resources must be provided at regular intervals as requested
-by the Eligibility Site.
-
-6.
-
-Resources will be considered available and Medical Assistance shall be denied or terminated if
-the applicant or client refuses or fails to make a reasonable effort to secure potential resources or
-income.
-
-7.
-
-Timely and adequate notice must be given regarding a proposed action to deny, reduce, or
-terminate assistance due to failure to make reasonable efforts to secure resources or income. If
-upon receipt of the prior notice, the individual acts to secure the potential resource, the proposed
-action to deny, reduce, or terminate assistance must be withdrawn, and assistance must be
-approved or continued until the resource or income is, in fact, available.
-
-8.
-
-If the resources or income has been transferred to a trust, the trust shall be submitted for review
-to the Department to determine the effect of the trust on eligibility in accordance with section
-8.100.7.E.
-
-9.
-
-A resource may not necessarily be unavailable by virtue that an individual may be unaware of his
-or her ownership of an asset. The Department will not treat the unknown asset as a resource
-during the period in which the individual was unaware of his/her ownership. However, the value of
-the previously unknown asset, including any monies such as interest that have accumulated on
-the asset through the month of discovery, is evaluated under regular income-counting rules in the
-month of discovery, and the asset is a resource subject to the resource-counting rules following
-the month of discovery.
-a.
-
-The burden is on the individual to prove by clear and convincing evidence that the asset
-was unavailable by virtue of being unknown by the recipient.
-
-b.
-
-Unknown assets shall not be deemed an overpayment pursuant to Section 8.065 of the
-Department’s regulations where the asset was unknown through no fault of the individual.
-
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-
-c.
-8.100.5.F.
-
-10 CCR 2505-10 8.100
-
-If the previously unknown asset causes the individual to be ineligible, the individual may
-repay the Department from the excess resources to retain Medicaid eligibility.
-Income Requirements
-
-1.
-
-This section reviews how income is looked at for the ABD and Long Term Care Medical
-Programs and determining premiums for the Medicaid Buy-In Program for Working Adults with
-Disabilities. For more general income information and income types refer to the Medical
-Assistance General Eligibility Requirements section 8.100.3.
-
-2.
-
-Income for the ABD Medical Programs eligibility is income which is received by an individual or
-family in the month in which they are applying for or receiving Medical Assistance, or the previous
-month if income for the current month is not yet available to determine eligibility.
-
-3.
-
-A self-declared common law spouse retains the same financial responsibility as a legally married
-spouse. Once self-declared as married under the common law, financial responsibility remains
-unless legal separation or divorce occurs. If two persons live together, but are not married to each
-other, neither one has the legal responsibility to support the other. This is not changed by the fact
-that the unmarried individuals may share a common child.
-
-4.
-
-Earned income is countable as income in the month received and a countable resource the
-following month. Earned Income includes the following:
-
-5.
-
-a.
-
-Wages, which include salaries, commissions, bonuses, severance pay, and any other
-special payments received because of employment;
-
-b.
-
-Net earnings from self-employment;
-
-c.
-
-Payments for services performed in a sheltered workshop or work activities center;
-
-d.
-
-Certain Royalties and honoraria.
-
-Unearned income is the gross amount received in cash or kind that is not earned from
-employment or self-employment.
-Unearned income is countable as income in the month received and any unspent amount is a
-countable resource the following month. Unearned income includes, but is not limited to, the
-following:
-a.
-
-Death benefits, reduced by the cost of last illness and burial;
-
-b.
-
-Prizes and awards;
-
-c.
-
-Gifts and inheritances;
-
-d.
-
-Interest payments on promissory notes established on or after March 1, 2007;
-
-e.
-
-Interest or dividend payments received from any resources;
-
-f.
-
-Lump sum payments from workers’ compensation, insurance settlements, etc.
-
-g.
-
-Dividends, royalties or other payments from mineral rights or other resources listed for
-sale within the resource limits
-
-h.
-
-Income from annuities that meet requirements for exclusion as a resource
-
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-
-i
-
-Lottery/Gambling winnings
-1)
-
-j.
-
-k.
-
-6.
-
-10 CCR 2505-10 8.100
-
-An applicant/member may request a hardship exemption when denied/or
-terminated due to Lottery/Gambling winnings.
-a.
-
-The applicant/member must demonstrate a severe medical or financial
-hardship, as determined by the Department.
-
-b.
-
-The applicant/member must provide a written request and
-documentation to their County Department of Human Services, within 30
-calendar days from the date of their denial or termination notice.
-
-Pensions and other period payments, such as:
-i)
-
-Private pensions or disability benefits;
-
-ii)
-
-Social Security benefits (Retirement, survivors, and disability);
-
-iii)
-
-Workers' Compensation payments;
-
-iv)
-
-Railroad retirement annuities;
-
-v)
-
-Unemployment insurance payments;
-
-vi)
-
-Veterans benefits other than Aid and Attendance (A&A) and Unusual Medical
-Expenses (UME);and
-
-vii)
-
-Alimony and support payments.
-
-Support and maintenance in kind - The support and maintenance in kind amount should
-not be greater than one third of the Federal Benefit Rate (FBR). Use the Presumed
-Maximum Value (PMV) of 1/3 of the recipient’s portion of the rent to determine the
-support and maintenance in kind amount. Use one third of the FBR if an amount is not
-declared by the client.
-
-For the purpose of determining eligibility for the Long Term Care and Aged, Blind, and Disabled
-Medical Assistance categories the following shall be exempt from consideration as either income
-or resources:
-a.
-
-A bona fide loan. Bona fide loans are loans, either private or commercial, which have a
-repayment agreement. Declaration of such loans is sufficient verification.
-
-b.
-
-Benefits received under Title VII, Nutrition Program for the Elderly, of the Older
-Americans Act.
-
-c.
-
-Title XVI (SSI) or Title II (Retirement Survivors or Disability Insurance) retroactive
-payments (lump sum) for nine months following receipt and the remainder countable as a
-resource thereafter.
-
-d.
-
-The value of supplemental food assistance received under the special food services
-program for children provided for in the National School Lunch Act and under the Child
-Nutrition Act, including benefits received from the special supplemental food program for
-women, infants and children (WIC).
-
-e.
-
-Home produce utilized for personal consumption.
-
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-
-10 CCR 2505-10 8.100
-
-f.
-
-Payments received under Title II of the Uniform Relocation Assistance and Real Property
-Acquisition Policies Act; relocation payments to a displaced homeowner toward the
-purchase of a replacement dwelling are considered exempt for up to 6 months.
-
-g.
-
-The value of any assistance paid with respect to a dwelling unit is excluded from income
-and resources if paid under:
-i)
-
-Experimental Housing Allowance Program (EHAP) payments made by HUD
-under section 23 of the U.S. Housing Act.
-
-ii)
-
-The United States Housing Act of 1937 (§ 1437 et seq. of 42 U.S.C.);
-
-iii)
-
-The National Housing Act (§ 1701 et seq. of 12 U.S.C.);
-
-iv)
-
-Section 101 of the Housing and Urban Development Act of 1965 (§ 1701s of 12
-U.S.C., § 1451 of 42 U.S.C.);
-
-v)
-
-Title V of the Housing Act of 1949 (§ 1471 et seq. of 42 U.S.C.); or
-
-vi)
-
-Section 202(h) of the Housing Act of 1959.
-
-h.
-
-Payments made from Indian judgment funds and tribal funds held in trust by the
-Secretary of the Interior and/or distributed per capita; and initial purchases made with
-such funds. (Public Law No 98-64 and Public Law No. 97-458).
-
-i.
-
-Distributions from a native corporation formed pursuant to the Alaska Native Claims
-Settlement Act (ANCSA) which are in the form of: cash payments up to an amount not to
-exceed $ 2000 per individual per calendar year; stock; a partnership interest; or an
-interest in a settlement trust. Cash payments, up to $ 2000, received by a client in one
-calendar year which is retained into subsequent years is excluded as income and
-resources; however, cash payments up to $ 2000 received in the subsequent year would
-be excluded from income in the month(s) received but counted as a resource if retained
-beyond that month(s).
-
-j.
-
-Assistance from other agencies and organizations.
-
-k.
-
-Major disaster and emergency assistance provided to individuals and families, and
-comparable disaster assistance provided to states, local governments and disaster
-assistance organizations shall be exempt as income and resources in determining
-eligibility for Medical Assistance.
-
-l.
-
-Payments received for providing foster care.
-
-m.
-
-Payments to volunteers serving as foster grandparents, senior health aids, or senior
-companions, and to persons serving in the Service Corps of Retired Executives (SCORE)
-and Active Corps of Executives (ACE) and any other program under Title I (VISTA) when
-the value of all such payments adjusted to reflect the number of hours such volunteers
-are serving is not equivalent to or greater than the minimum wage, and Title II and Title III
-of the Domestic Volunteer Services Act.
-
-n.
-
-The benefits provided to eligible persons or households through the Low Income Energy
-Assistance (LEAP) Program.
-
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-10 CCR 2505-10 8.100
-
-o.
-
-Training allowances granted by the Workforce Investment Act (WIA) to enable any
-individual whether dependent child or caretaker relative, to participate in a training
-program
-
-p.
-
-Payments received from the youth incentive entitlement pilot projects, the youth
-community conservation and improvement projects, and the youth employment and
-training programs under the Youth Employment and Demonstration Project Act.
-
-q.
-
-Social Security benefit payments and the accrued amount thereof to a client when an
-individual plan for self-care and/or self-support has been developed. In order to disregard
-such income and resources, it shall be determined that (1) SSI permits such disregard
-under such developed plan for self-care-support goal, and (2) assurance exists that the
-funds involved will not be for purposes other than those intended.
-
-r.
-
-Monies received pursuant to the “Civil Liberties Act of 1988” P.L. No. 100-383, (by
-eligible persons of Japanese ancestry or certain specified survivors, and certain eligible
-Aleuts).
-
-s.
-
-Payments made from the Agent Orange Settlement Fund or any fund established
-pursuant to the settlement in the In Re Agent Orange product liability litigation, M.D.L. No
-381 (E.D.N.Y).
-
-t.
-
-A child receiving subsidized adoption funds shall be excluded from the Medical
-Assistance budget unit and his income shall be exempt from consideration in determining
-eligibility, unless such exclusion results in ineligibility for the other members of the
-household.
-
-u.
-
-The Earned Income Tax Credit (EIC). EIC shall also be exempt as resources for the
-month it is received and for the following month.
-
-v.
-
-Any money received from the Radiation Exposure Compensation Trust Fund, Including
-the Energy Employees Occupational Illness Compensation Program Act, pursuant to P.L.
-No. 101-426 as amended by P.L. No. 101-510.
-
-w.
-
-Reimbursement or restoration of out-of-pocket expenses. Out-of-pocket expenses are
-actual expenses for food, housing, medical items, clothing, transportation, or personal
-needs items.
-
-x.
-
-Payments to individuals because of their status as victims of Nazi persecution pursuant
-to Public Law No. 103-286.
-
-y.
-
-General Assistance, SSI, OAP-A and cash assistance under the Temporary Assistance
-to Needy Families (TANF) funds.
-
-z.
-
-All wages paid by the United States Census Bureau for temporary employment related to
-the decennial Census.
-
-aa.
-
-Any grant or loan to an undergraduate student for educational purposes made or insured
-under any programs administered by the Commissioner of Education (Basic Education
-Opportunity Grants, Supplementary Education Opportunity Grants, National Direct
-Student Loans and Guaranteed Student Loans), Pell Grant Program, the PLUS Program,
-the BYRD Honor Scholarship programs and the College Work Study Program.
-
-bb.
-
-Any portion of educational loans and grants obtained and used under conditions that
-preclude their use for current living cost (need-based).
-
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-
-cc.
-
-Financial assistance received under the Carl D. Perkins Vocational and Applied
-Technology Education Act that is made available for attendance cost shall not be
-considered as income or resources. Attendance cost includes tuition, fees, rental or
-purchase of equipment, materials or supplies required of all students in the same course
-of study, books, supplies, transportation, dependent care and miscellaneous personal
-expenses of students attending the institution on at least a half-time basis, as determined
-by the institution.
-
-dd.
-
-The additional unemployment compensation of $25 a week enacted through the
-American Recovery and Reinvestment Act of 2009.
-
-8.100.5.G.
-1.
-
-Deeming Of Income And Resources For The OAP Program
-
-All aliens who apply for OAP on or after April 16, 1988, for three years after the date of admission
-into the United States, shall have the income and resources of their sponsors other than relatives
-deemed for their care. Refer to the Medical Assistance General Eligibility Requirements section
-8.100.3.K for specific information on deeming of income and resources.
-
-8.100.5.H.
-1.
-
-10 CCR 2505-10 8.100
-
-Income Allocations and Disregards
-
-The following income allocations and disregards are only applicable to SSI related, OAP,
-Medicare Savings Programs (MSP), and the Medicaid Buy-In Program for Working Adults with
-Disabilities.
-These allocations and disregards are not applicable to the HCBS waivers or the LTC programs.
-For the Medicaid Buy-In Program for Working Adults with Disabilities, the applicant’s spouse’s
-income does not count toward the applicant.
-
-2.
-
-a.
-
-Income of spouses living together is considered mutually available for SSI related, OAP,
-and Medicare Savings Programs (MSP).
-
-b.
-
-For a person living in the household of another and not paying shelter costs, one third of
-the Federal Benefit Rate (FBR) is counted as in-kind income and is added to the
-countable income. This does not apply to unemancipated children.
-
-For the purposes of this rule, the following definitions apply:
-a.
-
-3.
-
-unemancipated child is:
-i)
-
-a child under age 18 who is living in the same household with a parent or spouse
-of a parent, or
-
-ii)
-
-a child under age 21 who is living in the same household with a parent or spouse
-of a parent, if the child is regularly attending a school, college, or university, or is
-receiving technical training designed to prepare the child for gainful employment.
-
-b.
-
-Ineligible child is a child who is not applying or eligible for SSI.
-
-c.
-
-Ineligible parent/spouse is a parent or spouse who is not applying or eligible for SSI.
-
-Countable income is calculated by reducing the gross income by the following allocations and
-disregards.
-
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-
-a.
-
-10 CCR 2505-10 8.100
-
-Income allocations are the part of the gross income that is allocated to individuals in the
-home who are not eligible for Supplemental Security Income or Old Age Pension. The
-allocation reduces the gross income that is deemed available to the applicant/client. The
-allocation is deducted from the gross income prior to applying the other disregards.
-
-The allocations are:
-
-b.
-
-4.
-
-i)
-
-An Ineligible Child Allocation is an amount equal to one half the current year’s
-SSI FBR that is disregarded from the ineligible parents’ gross income. This
-allocation is used to meet the needs of ineligible children in the household. This
-allocation is available for each ineligible child in the home. The amount of the
-allocation is reduced by any of the ineligible child’s own income.
-
-ii)
-
-An Ineligible Parent(s) Allocation is an amount equal to the current year’s SSI
-FBR for a single individual or a couple, as applicable. This amount is used to
-meet the needs of the ineligible parent(s) in the home with an applicant/client
-child.
-
-iii)
-
-No allocations are allowed for applicant/recipient spouses who do not have
-children in the home.
-
-Allocations are applied to the income in the following manner:
-i)
-
-Allocation disregards are deducted from unearned income before earned income.
-
-ii)
-
-Ineligible child allocation disregards are deducted from parents’ income before
-any standard disregards are applied.
-
-iii)
-
-Ineligible parent(s) allocation disregards are deducted after any ineligible child
-allocation disregards and after the standard income disregards.
-
-Income disregards
-a.
-
-$20 General Income Disregard
-If there is unearned income left after the Ineligible Child and Parent(s) Allocation
-Disregards are applied, a General Income Disregard of $20 shall be applied as follows:
-
-b.
-
-i)
-
-The first $20 of total available unearned income (except for SSI income) must be
-disregarded. The remaining amount of unearned income is countable.
-
-ii)
-
-If the client has less than $20 of unearned income, the difference between the
-gross unearned income and the $20 deduction shall be applied as an earned
-income disregard, if applicable.
-
-iii)
-
-Only one $20 general income disregard is allowed per couple and is divided
-between the two spouses. If one of the spouses has no income the other spouse
-shall get the full $20 disregard.
-
-$65 Plus One Half Remainder Earned Income Disregard
-i)
-
-If there is earned income left after the Ineligible Child and Parent(s) Allocation
-Disregards are applied:
-1)
-
-Deduct the first $65 of all earned income.
-
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-10 CCR 2505-10 8.100
-
-2)
-
-Divide the remaining income in half.
-
-3)
-
-The result is the amount of earned income used for determining
-eligibility.
-
-c.
-
-Child support received by an applicant/recipient child is reduced by one third of the total
-child support payment. This reduction does not apply to ineligible children when
-calculating the ineligible child allocation disregard.
-
-d.
-
-The first $400 of the gross monthly earned income is exempt for a blind or disabled child
-who is a student that is regularly attending school. The exemption cannot exceed $1,620
-in a calendar year.
-
-e.
-
-Title 20 of the Code of Federal Regulations, § 416.1112 (2012) is hereby incorporated by
-reference into this rule. Such incorporation, however, excludes later amendments to or
-editions of the referenced material. These regulations are available for public inspection
-at the Department of Health Care Policy and Financing, 1570 Grant Street, Denver, CO
-80203. Certified copies of incorporated materials are provided at cost upon request.
-
-8.100.5.I.
-
-Determining Ownership of Income
-
-1.
-
-If payment is made solely to one individual, the income shall be considered available income to
-that individual.
-
-2.
-
-If payment is made to more than one individual, the income shall be considered available to each
-individual in proportion to their interests.
-
-3.
-
-In case of a married couple in which there is no document establishing specific ownership
-interests, one-half of the income shall be considered available to each spouse.
-
-4.
-
-Income from the Community Spouse's Monthly Income Allowance, as defined in the spousal
-protection rules in this volume at 8.100.7.R, is income to the community spouse.
-
-8.100.5.J.
-1.
-
-Income-Producing Property
-
-Net rental income from an exempt home or a life estate interest in an exempt home is countable
-after the following allowable deductions:
-a.
-
-Property taxes and insurance
-
-b.
-
-Necessary reasonable routine maintenance expenses
-
-c.
-
-Reasonable management fee for a professional property manager.
-
-2.
-
-Non-business property that is necessary to produce goods or services essential to self- support is
-excluded up to $6,000.
-
-3.
-
-Property used in a trade or business which is essential to self-support is excluded up to a limit of
-$6,000 if it produces 6% return of the $6,000 excluded value.
-
-8.100.5.K.
-
-Department of Veterans Affairs (VA) Payments
-
-The portion of the pension payments for Aid and Attendance (A&A) and Unusual Medical Expenses
-(UME), as determined by the VA, shall not be considered as income when determining eligibility.
-
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-
-1.
-
-2.
-
-10 CCR 2505-10 8.100
-
-The portion of the pension payments for Aid and Attendance (A&A) and Unusual Medical
-Expenses (UME), as determined by the VA, shall not be used as patient payment to the medical
-facility:
-a.
-
-for a veteran or surviving spouse of a veteran in a medical facility other than State
-Veterans Home; or
-
-b.
-
-for a veteran or surviving spouse of a veteran in a State Veterans Home with
-dependents.
-
-For a veteran or surviving spouse of a veteran in a State Veterans Home with no dependents the
-portion of the pension payments for Aid and Attendance (A&A) and Unusual Medical Expenses
-(UME), as determined by the VA, shall be used as patient payment to the medical facility.
-
-8.100.5.L.
-
-Reverse Mortgages
-
-1.
-
-In accordance with C.R.S. § 11-38-110, reverse mortgages payments made to a borrower shall
-not be treated as income for eligibility purposes.
-
-2.
-
-Funds remaining the following month after the payment is made will be countable as a resource.
-
-3.
-
-Any payments from a reverse mortgage that are transferred to another individual without fair
-consideration shall be analyzed in accordance with the rules on transfers without fair
-consideration in the Long-Term Care section and may result in a penalty period of ineligibility.
-
-8.100.5.M.
-
-Resource Requirements
-
-1.
-
-Consideration of resources: Resources are defined as cash or other assets or any real or
-personal property that an individual or spouse owns. The resource limit for an individual is
-$2,000. For a married couple, the resource limit is $3,000. If one spouse is institutionalized, refer
-to Spousal Protection-Treatment of Income and Resources for Institutionalized Spouses.
-Effective January 1, 2011, the resource limits for the Qualified Medicare Beneficiaries (QMB),
-Specified Low Income Medicare Beneficiaries (SLMB), and Qualified Individuals 1 (QI-1)
-programs are $8,180 for a single individual and $13,020 for a married individual living with a
-spouse and no other dependents. The resource limits for the QMB, SLMB, and QI programs shall
-be adjusted annually by the Centers for Medicare and Medicaid Services on January 1 of each
-year. These resource limits are based upon the change in the annual consumer price index (CPI)
-as of September of the previous year. Resources are not counted for the Medicaid Buy-In
-Program for Working Adults with Disabilities or the Medicaid Buy-In Program for Children with
-Disabilities.
-
-2.
-
-The following resources are exempt in determining eligibility:
-a.
-
-A home, which is any property in which an individual or spouse of an individual has an
-ownership interest and which serves as the individual’s principal place of residence. The
-property includes the shelter in which an individual resides, the land on which the shelter
-is located and related outbuildings.
-i)
-
-Only one principal place of residence is excluded for a single individual or a
-married couple.
-
-ii)
-
-The individual’s ownership interest in the home must have an equity value that:
-1)
-
-From January 1, 2006 thru December 31, 2010 is $500,000 or less, or;
-
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-
-2)
-
-10 CCR 2505-10 8.100
-
-Is less than the amount that results from the year to year percentage
-increase to the $500,000 limit. The increase is based upon the consumer
-price index for all urban consumers (all items; United States city
-average), rounded to the nearest $1,000.
-
-iii)
-
-If an individual or spouse of an individual owns a home of any value located
-outside Colorado, and if the individual intends to return to that home, then the
-individual does not meet the residency requirement for Colorado Medicaid
-eligibility.
-
-iv)
-
-If an individual or spouse of an individual owns a home of any value located
-outside Colorado, and if the individual does not intend to return to that home,
-then the home is a countable resource unless the individual’s spouse or
-dependent relative lives in the home.
-
-v)
-
-If an individual or spouse of an individual owns a home located inside Colorado
-with an equity value lower than the limit in subparagraph (1), above, and if the
-individual intends to return to that home, then the home is considered an exempt
-resource if:
-1)
-
-The individual is institutionalized; and
-
-2)
-
-The intent to return home is documented in writing.
-
-vi)
-
-If an individual or spouse of an individual owns a home with an equity value
-greater than the limit that is located inside Colorado, and if the individual intends
-to return to that home, then the home is considered to be a countable resource
-unless spouse or dependent relative lives in the home.
-
-vii)
-
-If an individual or spouse of an individual owns a home of any value located
-inside Colorado, and if the individual does not intend to return to that home, then
-the home is a countable resource unless spouse or dependent relative lives in
-the home.
-
-viii)
-
-If an individual or spouse moves out of his or her home without the intent to
-return, the home becomes a countable resource because it is no longer the
-individual's principal place of residence.
-
-ix)
-
-If an individual leaves his or her home to live in an institution, the home shall still
-be considered the principal place of residence, irrespective of the individual's
-intent to return as long as the individual's spouse or dependent relative continues
-to live there.
-
-x)
-
-The individual's equity in the former home becomes a countable resource
-effective with the first day of the month following the month it is no longer his or
-her principal place of residence.
-
-xi)
-
-The intent to return home applies to the home in which the individual or spouse
-of the individual was living prior to being institutionalized or to a replacement
-home as long as the individual’s spouse or dependent relative continues to live in
-the home.
-
-xii)
-
-The intent to return home also applies if the individual is living in an assisted
-living facility or alternative care facility and receives HCBS while in that facility or
-transfers into a Long-Term Care institution to receive services.
-
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-
-xiii)
-
-For an individual in a Long-Term Care institution, receiving HCBS, or enrolled in
-PACE, the exemption for the principal place of residence does not apply to a
-residence which has been transferred to a trust or other entity, such as a
-partnership or corporation.
-1)
-
-xiv)
-
-10 CCR 2505-10 8.100
-
-The exemption shall be regained if the residence is transferred back into
-the name of the individual.
-
-The principal place of residence, which is subject to estate recovery, becomes a
-countable resource upon the execution and recording of a beneficiary deed.
-The exemption can be regained if a revocation of the beneficiary deed is
-executed and recorded.
-
-b.
-
-Excess property will not be included in countable resources as long as reasonable efforts
-to sell it have been unsuccessful. Reasonable efforts to sell means:
-i.)
-
-The property is listed with a professional such as a real estate agent, broker,
-dealer, auction house, etc., at current market value.
-
-ii)
-
-If owner listed, the property must be for sale at current market value, advertised
-and shown to the public.
-
-iii)
-
-Any reasonable offer must be accepted.
-
-iv)
-
-If an offer is received that is at least two-thirds of the current market value, that
-offer is presumed reasonable.
-
-v)
-
-The client must continue reasonable efforts to sell and must submit verification of
-these efforts to the Eligibility Site on a quarterly basis. Reasonable effort is at
-Eligibility Site discretion.
-
-vi)
-
-If the exemption is used to become eligible under the Spousal Protection rules,
-the property shall continue to be viewed according to 8.100.7.L while efforts to
-sell it are being made.
-
-vii)
-
-Eligibility under this exemption is conditional. Once the property sells, the client
-shall be ineligible until the resources are below the prescribed limit.
-
-c.
-
-One automobile is totally excluded regardless of its value if it is used for transportation for
-the individual or a member of the individual's household. An automobile includes, in
-addition to passenger cars, other vehicles used to provide necessary transportation.
-
-d.
-
-Household goods are not counted as a resource to an individual (and spouse, if any) if
-they are:
-i)
-
-Items of personal property, found in or near the home, that are used on a regular
-basis; or
-
-ii)
-
-Items needed by the household for maintenance, use and occupancy of the
-premises as a home.
-
-iii)
-
-Such items include but are not limited to: furniture, appliances, electronic
-equipment such as personal computers and television sets, carpets, cooking and
-eating utensils, and dishes.
-
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-
-e.
-
-10 CCR 2505-10 8.100
-
-Personal effects are not counted as a resource to an individual (and spouse, if any) if
-they are:
-i)
-
-Items of personal property ordinarily worn or carried by the individual; or
-
-ii)
-
-Articles otherwise having an intimate relation to the individual.
-
-iii)
-
-Such items include but are not limited to: personal jewelry including wedding and
-engagement rings, personal care items, prosthetic devices, and educational or
-recreational items such as books or musical instruments.
-
-iv)
-
-Items of cultural or religious significance to the individual and items required
-because of an individual’s impairment are also not counted as a resource.
-
-f.
-
-The cash surrender value of all life insurance policies owned by an individual and
-spouse, if any, is exempt if the total face value of all life insurance policies does not
-exceed $1,500 on any person. If the total face value of all the life insurance policies
-exceeds $1,500 on one person, the cash surrender value of those policies will be
-counted.
-
-g.
-
-Term life insurance having no cash surrender value, and burial insurance, the proceeds
-of which can be used only for burial expenses, are not countable toward the resource
-limit.
-
-h.
-
-The total value of burial spaces for the applicant/recipient, his/her spouse and any other
-members of his/her immediate family is exempt as a resource. If any interest is earned on
-the value of an agreement for the purchase of a burial space, such interest is also
-exempt.
-
-i.
-
-An applicant or recipient may own burial funds through an irrevocable trust or other
-irrevocable arrangement which are available for burial and are held in an irrevocable
-burial contract, an irrevocable burial trust, or in an irrevocable trust which is specifically
-identified as available for burial expenses without such funds affecting the person's
-eligibility for assistance.
-
-j.
-
-An applicant or recipient may also own up to $1,500 in burial funds through a revocable
-account, trust, or other arrangement for burial expenses, without such funds affecting the
-person's eligibility for assistance. This exclusion only applies if the funds set aside for
-burial expenses are kept separate from all other resources not intended for burial of the
-individual or spouse's burial expenses. Interest on the burial funds is also excluded if left
-to accumulate in the burial fund. For a married couple, a separate $1,500 exemption
-applies to each spouse.
-The $1,500 exemption is reduced by:
-
-k.
-3.
-
-i)
-
-the amount of any irrevocable burial funds such as are described in the
-preceding subparagraph, and
-
-ii)
-
-the face value of any life insurance policy whose cash surrender value is exempt.
-
-Achieving a Better Life Experience (ABLE) Accounts.
-
-Countable resources include the following:
-a.
-
-Cash;
-
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-
-b.
-
-Funds held by a financial institution in a checking or savings account, certificate of
-deposit or money market account;
-
-c.
-
-Current market value of stocks, bonds, and mutual funds;
-
-d.
-
-All funds in a joint account are presumed to be a resource of the applicant or client. If
-there is more than one applicant or client account holder, it is presumed that the funds in
-the account belong to those individuals in equal shares. To rebut this presumption,
-evidence must be furnished that proves that some or all of the funds in a jointly held
-account do not belong to him or her. To rebut the sole ownership presumption, the
-following procedure must be followed:
-i)
-
-Submit statements from all of the account holders regarding who owns the funds,
-why there is a joint account, who has made deposits and withdrawals, and how
-withdrawals have been spent.
-
-ii)
-
-Submit account records showing deposits, withdrawals and interest in the
-months for which ownership of funds is at issue.
-
-iii)
-
-Correct the account title and submit revised account records showing that the
-applicant or client is no longer an account holder or separate the funds to show
-they are solely owned by the individual within 45 days.
-
-e.
-
-Any real property that is subject to a recorded beneficiary deed and on which an estate
-recovery claim can be made.
-
-f.
-
-For applications filed on or after January 1, 2006, an individual’s home if the individual’s
-equity interest in the home exceeds the equity value limit described at 8.100.5.M.2.a.i)1).
-
-g.
-
-Real property not exempt as the principal place of residence and not exempt as income
-producing property with a value of $6,000 or less, as described at 8.100.5.J.
-
-h.
-
-When the applicant alleges that the sale of real property would cause undue hardship to
-the co-owner due to loss of housing, all of the following information must be obtained:
-
-i.
-
-i)
-
-The applicant or client's signed statement to that effect.
-
-ii)
-
-Verification of joint ownership.
-
-iii)
-
-A statement from the co-owner verifying the following:
-1)
-
-The property is used as his principal place of residence.
-
-2)
-
-The co-owner would have to move if the property were sold.
-
-3)
-
-The co-owner would be unable to buy the applicant or client's interest in
-the property.
-
-4)
-
-There is no other readily available residence because there is no other
-affordable housing available or no other housing with the necessary
-modifications for the co-owner if he is a person with disabilities.
-
-Personal property such as a mobile home or trailer or the like, that is not exempt as a
-principal place of residence or that is not income producing.
-
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-10 CCR 2505-10 8.100
-
-j.
-
-Personal effects acquired or held for their value or as an investment. Such items can
-include but are not limited to: gems, jewelry that is not worn or held for family
-significance, or collectibles.
-
-k.
-
-The equity value of all automobiles that are in addition to one exempt vehicle.
-
-l.
-
-The cash surrender value of all life insurance policies owned by an individual and spouse
-is counted if the total face value of all the policies combined exceeds $1,500 on any
-person.
-
-m.
-
-Promissory notes established before April 1, 2006 are treated as follows:
-
-n.
-
-i)
-
-The fair market value of a promissory note, mortgage, installment contract or
-similar instrument is an available countable resource.
-
-ii)
-
-In order to determine the fair market value, the applicant shall obtain three
-estimates of fair market value from a private note broker, who is engaged in the
-business of purchasing such notes. In order to obtain the estimates and locate
-willing buyers, the note shall be advertised in a newspaper with state wide
-circulation under business or investment opportunities.
-
-iii)
-
-A note or similar instrument which transferred funds or assets for less than fair
-consideration shall be considered as a transfer for less than fair consideration
-and a period of ineligibility shall be imposed.
-
-Promissory notes established on or after April 1, 2006 and before March 1, 2007 are
-treated as follows:
-i)
-
-ii)
-
-o.
-
-The value of a promissory note, loan or mortgage is an available countable
-resource unless the note, loan or mortgage:
-1)
-
-Has a repayment term that is actuarially sound based on the individual’s
-life expectancy, found in the tables at 8.100.7.J, for annuities purchased
-on or after February 8, 2006;
-
-2)
-
-Provides for payments to be made in equal amounts during the term of
-the loan, with no deferral and no balloon payments made; and
-
-3)
-
-Prohibits the cancellation of the balance upon the death of the lender.
-
-The value of a promissory note, loan or mortgage which does not meet the
-criteria in outlined in 8.100.5.M.3.n.i)1)-3) is the outstanding balance due as of
-the date of the individual’s application for HCBS, PACE or institutional services
-and is subject to the transfer of assets without fair consideration provisions as
-outlined in section 8.100.7.F.
-
-Promissory notes established on or after March 1, 2007 are treated as follows:
-i)
-
-The value of a promissory note, loan or mortgage is the outstanding balance due
-as of the date of the individual’s application for HCBS, PACE or institutional
-services and is an available countable resource, and
-
-ii)
-
-A promissory note, loan or mortgage which does not meet the following criteria
-shall be considered to be a transfer without fair consideration and shall be
-subject to the provisions outlined at 8.100.7.F.
-
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-
-p.
-
-8.100.5.N.
-
-10 CCR 2505-10 8.100
-
-1)
-
-Has a repayment term that is actuarially sound based on the individual’s
-life expectancy as found in the tables in section 8.100.7.J for annuities
-purchased on or after February 8, 2006;
-
-2)
-
-Provides for payments to be made in equal amounts during the term of
-the loan, with no deferral and no balloon payments made; and
-
-3)
-
-Prohibits the cancellation of the balance upon the death of the lender.
-
-Mineral rights represent ownership interest in natural resources such as coal, oil, or
-natural gas, which normally are extracted from the ground.
-i)
-
-Ownership of land and mineral rights. If the individual owns the land to which the
-mineral rights pertain, the current market value of the land generally includes the
-value of the mineral rights.
-
-ii)
-
-If the individual does not own the land to which the mineral rights pertain, the
-individual should obtain a current market value estimate from a knowledgeable
-source. Such sources may include:
-1)
-
-any mining company that holds leases;
-
-2)
-
-the Bureau of Land Management;
-
-3)
-
-the U.S. Geological Survey.
-
-Treatment of Self-Funded Retirement Accounts
-
-1.
-
-The following regulations apply to self-funded retirement accounts such as an Individual
-Retirement Account (IRA), Keogh Plan, 401(k), 403(b) and any other self-funded retirement
-account.
-
-2.
-
-Self-funded retirement accounts in the name of the applicant are countable as a resource to the
-applicant.
-
-3.
-
-Self-funded retirement accounts in the name of the applicant's spouse who is living with the
-applicant are exempt in determining eligibility for the applicant, except as set forth in 4. below.
-
-4.
-
-Self-funded retirement accounts in the name of a community spouse who is married to an
-applicant who is applying for Long Term Care in a Long Term Care institution, HCBS or PACE,
-are countable as a resource to the applicant and may be included in the Community Spouse
-Resource Allowance (CSRA) up to the maximum amount allowable. The terms community
-spouse and CSRA are further defined in the regulations on Spousal Protection in this volume.
-
-5.
-
-The value of a self-funded retirement account is determined as follows:
-a.
-
-The gross value of the account, less any taxes due, is the amount that is countable as a
-resource, regardless of whether any monthly income is being received from the account.
-
-b.
-
-If the applicant is not able to provide the amount of taxes that are due, the value shall be
-determined by deducting 20% from the gross value of the account.
-
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-
-8.100.5.O.
-
-10 CCR 2505-10 8.100
-
-Treatment of Inheritances
-
-1.
-
-An inheritance is cash, other liquid resources, non-cash items, or any right in real or personal
-property received at the death of another.
-
-2.
-
-If an Individual or individual’s spouse is the beneficiary of a will, the inheritance is presumed to be
-available at the conclusion of the probate process or within 6 months if the estate is not in
-probate.
-
-3.
-
-If an individual or individual’s spouse is eligible for a family allowance in a probate proceeding,
-that allowance will be considered available three months after death or when actually available,
-whichever is sooner.
-
-4.
-
-Evidence demonstrating that the inheritance is not available due to probate or other legal
-restrictions must be provided to rebut the presumption.
-
-8.100.5.P.
-
-Treatment of Proceeds from Disposition of Resources
-
-Treatment of proceeds from disposition of resources is determined as follows:
-1.
-
-The net proceeds from the sale of exempt or non-exempt resources are considered available
-resources.
-
-2.
-
-The net proceeds are the selling price less any valid encumbrances and costs of sale.
-
-3.
-
-After deducting any amount necessary to raise the individual's and spouse's resources to the
-applicable limits, the balance of the net proceeds, in excess of the resource limits, shall be
-considered available resources. In lieu of terminating eligibility due to excess resources, the client
-may request that the proceeds be used to reimburse the Medical Assistance Program for
-previous payments for Medical Assistance.
-
-4.
-
-The proceeds from the sale of an exempt home will be excluded to the extent they are intended
-to be used and are, in fact, used to purchase another home in which the individual, a spouse or
-dependent child resides, within three months of the date of the sale of the home.
-
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-8.100.6
-
-Aged, Blind, and Disabled Medical Assistance Eligibility
-
-8.100.6.A.
-
-Aged, Blind, and Disabled (ABD) General Information
-
-1.
-
-10 CCR 2505-10 8.100
-
-Medical Assistance for ABD includes SSI eligible individuals, OAP recipients, and the Medicare
-Savings Program (MSP) individuals. Refer to section 8.100.5 of this volume for income and
-resource criteria for these categories of assistance.
-
-8.100.6.B.
-
-Disability Determinations
-
-1.
-
-Beginning on July 1, 2001, the Department or its contractor shall determine whether the client is
-disabled or blind in accordance with the requirements and procedures set forth elsewhere in this
-volume and according to Federal regulations regarding disability determinations.
-
-2.
-
-A client who disagrees with the decision on disability or blindness shall have the right to appeal
-that decision to a state-level fair hearing in accordance with the procedures at 8.057.
-
-8.100.6.C.
-1.
-
-SSI Eligibles
-
-Benefits of the Colorado Medical Assistance Program must be provided to the following:
-a.
-
-persons receiving financial assistance under SSI;
-
-b.
-
-persons who are eligible for financial assistance under SSI, but are not receiving SSI;
-
-c.
-
-persons receiving SSI payments based on presumptive eligibility for SSI pending final
-determination of disability or blindness; and persons receiving SSI payments based on
-conditional eligibility for SSI pending disposal of excess resources.
-
-2.
-
-The Department has entered into an agreement with SSA in which SSA shall determine Medical
-Assistance for all SSI applicants. Medical Assistance shall be provided to all individuals receiving
-SSI benefits as determined by SSA to be eligible for Medical Assistance.
-
-3.
-
-The eligibility sites shall have access to a weekly unmatched listing of all individuals newly
-approved and a weekly SSI-Cases Denied or Discontinued listing. These lists shall include the
-necessary information for the eligibility site to authorize Medical Assistance.
-
-4.
-
-Medical Assistance shall not be delayed due to the necessity to contact the SSI recipient and
-obtain third party medical resources.
-
-5.
-
-Notification shall be sent to the SSI recipient advising him/her of the approval of Medical
-Assistance.
-
-6.
-
-The SISC Code for this type of assistance is B.
-
-7.
-
-Denied or terminated Medical Assistance based on a denial or termination of SSI which is later
-overturned, must be approved from the original SSI eligibility date.
-
-8.
-
-Individuals who remain eligible as SSI recipients but are not receiving SSI payments shall receive
-Medical Assistance benefits. This group includes persons whose SSI payments are being
-withheld as a means of recovering an overpayment, whose checks are undeliverable due to
-change of address or representative payee, and persons who lost SSI financial assistance due to
-earned income.
-
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-10 CCR 2505-10 8.100
-
-9.
-
-If the eligibility site obtains information affecting the eligibility of these SSI recipients, they shall
-forward such information to the local Social Security office.
-
-10.
-
-For individuals under 21 years of age who are eligible for or who are receiving SSI, the effective
-date of Medicaid eligibility shall be the date on which the individual applied for SSI or the date on
-which the individual became eligible for SSI, whichever is later.
-a.
-
-Special Provisions for Infants
-i)
-
-8.100.6.D.
-
-For an infant who is eligible for or who is receiving SSI, the effective date of
-Medicaid eligibility shall be the infant’s date of birth if:
-1)
-
-the infant was born in a hospital;
-
-2)
-
-the disability onset date, as reported by the Social Security
-Administration, occurred during the infant’s hospital stay; and
-
-3)
-
-the infant’s date of birth is within three (3) months of the date on which
-the infant became eligible for SSI
-
-Pickle Amendment
-
-1.
-
-Beginning July 1977, Medical Assistance must be provided to an individual if their countable
-income is below the current years SSI standard after a cost of living adjustment (COLA) disregard
-is applied to their OASDI (excluding Railroad Retirement Benefits) and they meet all other
-eligibility criteria. This is referred to as Pickle Disregard.
-
-2.
-
-The Pickle Disregard applies to an individual who:
-a.
-
-lost SSI and/or OAP because of a cost of living adjustment to his/her own OASDI
-benefits.
-
-b.
-
-lost SSI and/or OAP because a cost of living adjustment to OASDI income deemed from
-a parent or spouse.
-
-c.
-
-lost OAP and/or SSI due to the receipt of, or increase to, OASDI, and would be eligible
-for OAP and/or SSI if all COLA’S on the amount that caused them to lose eligibility is
-disregarded from their current OASDI amount.
-
-8.100.6.E.
-1.
-
-Pickle Determination
-
-To determine eligibility of Medical Assistance recipients to whom the Pickle disregards apply, the
-eligibility site must:
-a.
-
-establish whether the person was eligible for SSI or OAP and, for the same month, was
-entitled to OASDI;
-
-b.
-
-determine the previous amount of the OASDI that caused them to lose SSI and/or OAP;
-
-c.
-
-determine the current OASDI income;
-
-d.
-
-subtract the previous OASDI income from the current OASDI income to find the
-cumulative OASDI COLAs since SSI and/or OAP was lost. This is the Pickle Disregard
-amount;
-
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-
-e.
-
-10 CCR 2505-10 8.100
-
-subtract the Pickle Disregard amount from the current OASDI income to get the
-countable OASDI income.
-
-2.
-
-If the countable OASDI income and all other countable income is less than the current SSI or
-OAP standard, and the individual meets all other eligibility criteria then medical eligibility must
-continue or be reinstated.
-
-3.
-
-This disregard must also be applied to any OASDI cost of living increases paid to any financially
-responsible individual such as a parent or spouse whose income is considered in determining the
-person's continued eligibility for Medical Assistance.
-
-4.
-
-The cost of living increase disregard specified in the preceding action must continue to be applied
-at each eligibility redetermination.
-
-5.
-
-An SSI medical only individual who loses SSI due to an OASDI cost-of-living increase shall be
-contacted by the eligibility site to determine if the individual would continue to remain eligible for
-Medical Assistance under the provisions for SSI related cases. The individual must complete an
-application for assistance to continue receiving benefits.
-
-8.100.6.F.
-
-1972 Disregard Individuals
-
-1.
-
-Medical Assistance must be provided to a person who was receiving financial assistance under
-AND or Aid to the Blind (AB) for August 1972 and who – except for the October 1972 Social
-Security (includes RRB) 20% increase amount would currently be eligible for financial assistance.
-This disregard must also be applied to a person receiving Medical Assistance in August 1972
-who was eligible for financial assistance but was not receiving the money payment and to a
-person receiving Medical Assistance as a resident in a medical institution in August 1972.
-
-2.
-
-To redetermine the eligibility of Medical Assistance recipients to whom the 1972 disregard
-applies, the eligibility site must:
-a.
-
-review the case against the current applicable program definitions and requirements;
-
-b.
-
-apply the resource and income criteria specified in section 8.100.5;
-
-c.
-
-subtract the 1972 disregard amount from the income;
-
-d.
-
-consider the remainder against the current appropriate SSI benefit level.
-
-8.100.6.G.
-
-Individuals Eligible in 1973
-
-1.
-
-Medical Assistance must be provided to ABD persons who are receiving mandatory state
-supplementary payments (SSP). Such persons are those with income below their December
-1973 minimum income level (MIL).
-
-2.
-
-Medical Assistance must be provided to a person who was eligible for Medical Assistance in
-December 1973 as an inpatient of a medical facility, who continues to meet the December 1973
-eligibility criteria for institutionalized persons and who remains institutionalized.
-
-3.
-
-Medical Assistance must be provided to a person who was eligible for Medical Assistance in
-December 1973 as an “essential spouse” of an AND or AB financial assistance recipient, and
-who continues to be in the grant and continues to meet the December 1973 eligibility criteria.
-Except for such persons who were grandfathered-in for continued assistance, essential spouses
-included in assistance grants after December 1973 are not eligible for Medical Assistance.
-
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-CODE OF COLORADO REGULATIONS
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-
-8.100.6.H.
-1.
-
-10 CCR 2505-10 8.100
-
-Eligibility for Certain Disabled Widow(er)s
-
-Medical Assistance shall be provided retroactive to July 1, 1986, to qualified disabled widow(er)s
-who lost SSI and/or state supplementation due to the 1983 change in the actuarial reduction
-formula prescribed in section 134 of P.L. No. 98 21.
-In order for these widow(er)s to qualify, these individuals must:
-a.
-
-have been continuously entitled to Title II benefits since December 1983;
-
-b.
-
-have been disabled widow(er)s in January 1984;
-
-c.
-
-have established entitlement to Title II benefits prior to age 60;
-
-d.
-
-have been eligible for SSI/SSP benefits prior to application of the revised actuarial
-reduction formula;
-
-e.
-
-have subsequently lost eligibility for SSI/SSP as a result of the change in the actuarial
-table; and
-
-f.
-
-reapply for assistance prior to July 1, 1987.
-
-8.100.6.I.
-1.
-
-Eligibility for Disabled Widow(er)s
-
-Effective January 1, 1991, Medical Assistance shall be provided to disabled widow(er)s age 50
-through 64 who lost SSI and/or OAP due to the receipt of Social Security benefits as a disabled
-widow(er). The individual shall remain eligible for Medical Assistance until he/she becomes
-eligible for Part A of Medicare (hospital insurance).
-To qualify these individuals must:
-a.
-
-be a widow(er);
-
-b.
-
-have received SSI in the past;
-
-c.
-
-be at least 50 years old but not 65 years old;
-
-d.
-
-no longer receive SSI payments because of Social Security payments;
-
-e.
-
-not have hospital insurance under Medicare; and,
-
-f.
-
-meet all other Medical Assistance requirements.
-
-8.100.6.J.
-1.
-
-Disabled Adult Children
-
-Medical Assistance shall be provided to an individual aged 18 or older who loses SSI due to the
-receipt of OASDI drawn from his/her parents' Social Security Number; and:
-a.
-
-who was determined disabled prior to the age of 22; and
-
-b.
-
-who is currently receiving OASDI income as a Disabled Adult Child; and
-
-c.
-
-who would continue to be eligible for SSI if:
-i)
-
-the current OASDI income of the applicant is disregarded; and
-
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-
-2.
-
-10 CCR 2505-10 8.100
-
-ii)
-
-the resources are below the applicable limit as listed at 8.100.5.M; and
-
-iii)
-
-other countable income is below the current years SSI FBR.
-
-Disabled Adult Children are identified by the OASDI Beneficiary Identification Code (BIC) of “C”.
-
-8.100.6.K.
-
-Old Age Pension (OAP) Eligibles
-
-1.
-
-Individuals that are 65 and over are defined as the OAP-A category. Individuals who attain the
-age of 60 but not yet 65 are defined as the OAP-B category.
-
-2.
-
-Medical Assistance must be provided to persons receiving OAP-A or OAP-B and SSI (SISC B).
-
-3.
-
-Medical Assistance must be provided to all OAP-A and OAP-B persons who also meet SSI
-eligibility criteria but are not receiving a money payment (SISC-B).
-
-4.
-
-Medical Assistance must be provided to all OAP-A and OAP-B persons who also meet SSI
-eligibility criteria except for the level of their income (SISC-B).
-
-5.
-
-Medical Assistance must be provided to persons in a facility eligible for Medical Assistance
-reimbursement whose income is under 300% of the SSI benefit level and who, but for the level of
-their income, would be eligible for OAP “A” or OAP “B” and SSI financial assistance. This group
-includes persons 65 years of age or older receiving active treatment as inpatients in a psychiatric
-facility eligible for Medical Assistance reimbursement (SISC A). This population is referenced as
-Psych >65.
-
-6.
-
-The OAP B individual included in AFDC assistance unit shall receive Medical Assistance as a
-member of the AFDC household (SISC B).
-
-7.
-
-The OAP State Only Medical Assistance Program provides Medical Assistance to OAP-A, OAP-B
-or OAP Refugees who lost their OAP financial assistance because of a cost of living adjustment
-other than OASDI. Examples of other sources of income are VA, RRB, PERA, etc. (SISC C).
-
-8.
-
-For the purpose of identifying the proper SISC code for persons receiving assistance under OAP
-“A” or OAP “B”, if the person:
-a.
-
-receives an SSI payment (SISC B);
-
-b.
-
-does not receive an SSI payment but is receiving assistance under OAP “A”, a second
-evaluation of resources must be made using the same resource criteria as specified in
-section 8.100.5.M for those who meet this criteria the SISC code is B for money payment
-and “disregard” case, A for institutional cases;
-
-c.
-
-does not receive an SSI payment and does not otherwise qualify under SISC code B or A
-as described in item b. above (SISC C).
-
-8.100.6.L.
-
-Qualified Medicare Beneficiaries (QMB)
-
-1.
-
-Medical Assistance coverage for QMB clients is payment of Medicare part B premiums, coinsurance and deductibles.
-
-2.
-
-Effective July 1, 1989, a Qualified Medicare Beneficiary is an individual who:
-a.
-
-is entitled to Part A Medicare; and
-
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-
-b.
-
-resources may not exceed the standard for an individual or couple who have resources,
-as described in section 8.100.5.M; and
-
-c.
-
-has income at or below the percentage of the federal poverty level for the size family as
-mandated for QMB by federal regulations. Poverty level is established by the Executive
-Office of Management and Budget.
-
-3.
-
-For QMB purposes, couples shall have their income compared against the federal poverty level
-couples income maximum. This procedure shall be applied whether one or both members apply
-for QMB.
-
-4.
-
-For QMB purposes, income of the applicant and/or the spouse shall be determined as described
-under Income Requirements in section 8.100.5. If two or more individuals have earned income,
-the income of all the individuals shall be added together and the $65 plus one half remainder
-earned income disregard shall be applied to the total amount of earned income.
-
-5.
-
-Medicare cost sharing expenses must be provided to qualified Medicare beneficiaries. This
-limited Medical Assistance package of Medicare cost sharing expenses only includes:
-a.
-
-payment of Part A Medicare premiums where applicable;
-
-b.
-
-payment of Part B Medicare premiums; and
-
-c.
-
-payment of coinsurance and deductibles for Medicare services whether or not a benefit of
-Medical Assistance up to the full Medicare rate or reasonable rates as established in the
-State Plan.
-
-6.
-
-Individuals may be QMB recipients only or the individual may be classified as a dual eligible. A
-dual eligible is a Medicare recipient who is otherwise eligible for Medical Assistance.
-
-7.
-
-A QMB-only recipient is an individual who is not eligible for other categorical assistance program
-due to their income and/or resources but who meets the eligibility criteria for QMB described
-above.
-
-8.
-
-Individuals who apply for QMB assistance have the right to have their eligibility determined under
-all categories of assistance for which they may qualify.
-
-9.
-
-All other general non-financial requirements or conditions of eligibility must also be met such as
-age, citizenship, residency requirements as well as reporting and redetermination requirements.
-These criteria are defined in section 8.100.3 of this volume.
-
-10.
-
-Eligibility for QMB benefits shall be effective the month following the month of determination.
-Beneficiaries who submit and complete an application within the 45-day standard shall be eligible
-for benefits no later than the first of the month following the 45th day of application. Administrative
-delays shall not postpone the effective date of eligibility.
-
-11.
-
-QMB benefits are not retroactive and the three month retroactive Medical Assistance rule does
-not apply to QMB benefits.
-
-12.
-
-Clients who would lose their QMB entitlement due to annual social security COLA will remain
-eligible for QMB coverage under Medical Assistance, as income disregard cases, until the next
-year's federal poverty guidelines are published.
-
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-8.100.6.M.
-
-10 CCR 2505-10 8.100
-
-Specified Low Income Medicare Beneficiaries
-
-1.
-
-Medical Assistance coverage for SLMB clients is limited to payment of monthly Medicare Part B
-(Supplemental Medical Insurance Benefits) premiums.
-
-2.
-
-Effective January 1, 1993, a Specified Low Income Medicare Beneficiary (SLMB) is an individual
-who:
-a.
-
-is entitled to Medicare Part A;
-
-b.
-
-resources may not exceed the standard for an individual or couple who has resources as
-described in section 8.100.5.M of this volume.
-
-c.
-
-has income at or below a percentage of the federal poverty level for the family size as
-mandated by federal regulations for SLMB. Income limits have been defined through CY
-1995, as follows: CY 1993 and 1994 100-110% of FPL, CY 1995 100-120% of FPL.
-
-3.
-
-For SLMB purposes, couples shall have their income compared against the federal poverty level
-couples income maximum. This procedure shall be applied whether one or both members apply
-for SLMB.
-
-4.
-
-For SLMB purposes, income of the applicant and/or the spouse shall be determined as described
-under Income Requirements in section 8.100.5. If two or more individuals have earned income,
-the income of all the individuals shall be added together and the $65 plus one half remainder
-earned income disregard shall be applied to the total amount of earned income.
-
-5.
-
-SLMB eligibility starts on the date of application or up to three month prior to the application date
-for retroactive Medical Assistance.
-
-6.
-
-Eligibility may be made retroactive up to 90 days, but may not be effective prior to 1/1/93.
-
-7.
-
-Clients who would lose their SLMB entitlement due to annual SSA COLA will remain eligible for
-SLMB coverage, as income disregard cases, through the month following the month in which the
-annual federal poverty levels (FPL) update is published.
-
-8.100.6.N.
-
-Medicare Qualifying Individuals 1 (QI1)
-
-1.
-
-Medical Assistance coverage is limited to monthly payment of Medicare Part B premiums.
-Payment of the premium shall be made by the Department on behalf of the individual.
-
-2.
-
-Eligibility for this benefit is limited by the availability of the allocation set by CMS. Once the state
-allocation is met, no further benefits under this category shall be paid and a waiting list of eligible
-individuals shall be maintained.
-
-3.
-
-Eligibility for QI1 benefits shall be effective the month in which application is made and the
-individual is eligible for benefits. Eligibility may be retroactive up to three months from the date of
-application, but not prior to January 1, 1998.
-
-4.
-
-In order to qualify as a Medicare Qualifying Individual 1, the individual must meet the following:
-a.
-
-be entitled to Part A of Medicare,
-
-b.
-
-income of at least 120%, but less than 135% of the FPL.
-
-c.
-
-resources may not exceed the standard as described in section 8.100.5.M, and
-
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-
-10 CCR 2505-10 8.100
-
-he/she cannot otherwise be eligible for Medical Assistance.
-
-5.
-
-For QI1 purposes, income of the applicant and/or the spouse shall be determined as described
-under Income Requirements in section 8.100.5. If two or more individuals have earned income,
-the income of all the individuals shall be added together and the $65 plus one half remainder
-earned income disregard shall be applied to the total amount of earned income.
-
-6.
-
-Clients who would lose QI-1 entitlement due to annual social security COLA will remain eligible
-for QI-1 coverage under Medical Assistance, as an income disregard case, until the next year’s
-federal poverty guidelines are published.
-
-8.100.6.O.
-
-Qualified Disabled And Working Individuals
-
-1.
-
-Medical Assistance coverage is limited to monthly payment of Medicare Part A premiums, and
-any other Medicare cost sharing expenses determined necessary by CMS.
-
-2.
-
-Effective July 1, 1990, a Qualified Disabled and Working Individual (QDWI) is an individual who:
-a.
-
-was a recipient of federal Social Security Disability Insurance (SSDI) benefits, who
-continues to be disabled but lost SSDI entitlement due to earned income in excess of the
-Social Security Administration's Substantial Gainful Activity (SGA) threshold, and;
-
-b.
-
-has exhausted SSA's allowed extension of “premium free” Medicare Part A coverage
-under SSDI, and;
-
-c.
-
-has resources at or below twice the SSI resource limit as described in section 8.100.5.,
-and;
-
-d.
-
-has income less than 200% of FPL.
-
-3.
-
-For QDWI purposes, income of the applicant and/or the spouse shall be determined as described
-under Income Requirements in section 8.100.5. If two or more individuals have earned income,
-the income of all the individuals shall be added together and the $65 plus one half remainder
-earned income disregard shall be applied to the total amount of earned income.
-
-4.
-
-An individual may be eligible under this section only if he/she is not otherwise eligible under
-another Medical Assistance category of eligibility.
-
-5.
-
-Eligibility for QDWI benefits shall be effective the month of determination of entitlement.
-
-6.
-
-Eligibility may be retroactive only to the date as of which SSA approves an individual's application
-for coverage as a “Qualified Disabled and Working Individual”. However, eligibility may not begin
-prior to 07/01/90.
-
-8.100.6.P.
-1.
-
-Medicaid Buy-In Program for Working Adults with Disabilities.
-
-To be eligible for the Medicaid Buy-In Program for Working Adults with Disabilities:
-a.
-
-Applicants must be at least age 16.
-
-b.
-
-Income must be less than or equal to 450% of FPL after income allocations and
-disregards. See 8.100.5.F for Income Requirements and 8.100.5.H for Income allocations
-and disregards. Only the applicant’s income will be considered.
-
-c.
-
-Resources are not counted in determining eligibility.
-
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-
-d.
-
-Individuals must have a disability as defined by Social Security Administration medical
-listing or a limited disability as determined by a state contractor.
-
-e.
-
-Individuals must be employed. Please see Verification Requirements at 8.100.5.B.1.c.
-i)
-
-f.
-
-Due to the federal COVID-19 Public Health Emergency, and required by the
-Federal CARES Act for the Maintenance of Effort (MOE), members who had a
-loss of employment will remain in the Buy-In program until the end of the federal
-Public Health Emergency. At the end of the federal Public Health Emergency
-effective May 11, 2023, members will be redetermined based on their current
-employment status and be required to be employed to be eligible for the
-program. New applicants enrolled will still need to meet the work requirement.
-
-Individuals will be required to pay monthly premiums on a sliding scale based on income.
-i)
-
-The amount of premiums cannot exceed 7.5% of the individual’s income.
-
-ii)
-
-Premiums are charged beginning the month after determination of eligibility. Any
-premiums for the months prior to the determination of eligibility will be waived.
-
-iii)
-
-Premium amounts are as follows:
-1)
-
-There is no monthly premium for individuals with income at or below 40%
-FPL.
-
-2)
-
-A monthly premium of $25 is applied to individuals with income above
-40% of FPL but at or below 133% of FPL.
-
-3)
-
-A monthly premium of $90 is applied to individuals with income above
-133% of FPL but at or below 200% of FPL.
-
-4)
-
-A monthly premium of $130 is applied to individuals with income above
-200% of FPL but at or below 300% of FPL.
-
-5)
-
-A monthly premium of $200 is applied to individuals with income above
-300% of FPL but at or below 450% of FPL.
-
-iv)
-
-The premium amounts will be updated at the beginning of each State fiscal year
-based on the annually revised FPL if the revised FPL would cause the premium
-amount (based on percentage of income) to increase by $10 or more.
-
-v)
-
-A change in a member’s net income may impact the monthly premium amount
-due. Failure to pay premium payments in full within 60 days from the premium
-due date will result in the member’s assistance being terminated prospectively.
-The effective date of the termination will be the last day of the month following
-the 60 days from the date on which the premium became past due. The
-Department will waive premiums for the Medicaid Buy-In for Working Adults with
-Disability Program for member’s who are within their 12 months postpartum
-period.
-
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-vi)
-
-10 CCR 2505-10 8.100
-
-Due to the federal COVID-19 Public Health Emergency, the Department waived
-premiums for the Medicaid Buy-In for Working Adults with Disability Program
-during the federal COVID-19 emergency declaration. The Department will
-continue to waive premiums past the end of the emergency declaration and until
-further notice. The Department will notify all members as to when required
-premiums will resume.
-
-2.
-
-Retroactive coverage is available according to 8.100.3.E, however is not available prior to
-program implementation
-
-3.
-
-Individuals have the option to request to be disenrolled if they have been enrolled into the
-Medicaid Buy-In Program for Working Adults with Disabilities. This is also called “opt out.”
-
-8.100.6.Q.
-1.
-
-Medicaid Buy-In Program for Children with Disabilities
-
-To be eligible for the Medicaid Buy-In Program for Children with Disabilities:
-a.
-
-Applicants must be age 18 or younger.
-
-b.
-
-Household income will be considered and must be less than or equal to 300% of FPL
-after income disregards. The following rules apply:
-i)
-
-8.100.4.E - MAGI Household Requirements
-
-ii)
-
-8.100.5.F - Income Requirements
-
-iii)
-
-8.100.5.F.6 - Income Exemptions
-
-iv)
-
-An earned income of $90 shall be disregarded from the gross wages of each
-individual who is employed
-
-v)
-
-A disregard of a 33% (.3333) reduction will be applied to the household’s net
-income.
-
-c.
-
-Resources are not counted in determining eligibility.
-
-d.
-
-Individuals must have a disability as defined by Social Security Administration medical
-listing.
-
-e.
-
-Children age 16 through 18 cannot be employed. If employed, children age 16 through 18
-shall be determined for eligibility through the Medicaid Buy-In Program for Working Adults
-with Disabilities.
-
-f.
-
-Families will be required to pay monthly premiums on a sliding scale based on household
-size and income.
-i)
-
-For families whose income does not exceed 200% of FPL, the amount of
-premiums and cost-sharing charges cannot exceed 5% of the family’s adjusted
-gross income. For families whose income exceeds 200% of FPL but does not
-exceed 300% of FPL, the amount of premiums and cost-sharing charges cannot
-exceed 7.5% of the family’s adjusted gross income.
-
-ii)
-
-Premiums are charged beginning the month after determination of eligibility. Any
-premiums for the months prior to the determination of eligibility will be waived.
-
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-
-iii)
-
-For households with two or more children eligible for the Medicaid Buy-In
-Program for Children with Disabilities, the total premium shall be the amount due
-for one eligible child.
-
-iv)
-
-Premium amounts are as follows:
-1)
-
-There is no monthly premium for households with income at or below
-133% of FPL.
-
-2)
-
-A monthly premium of $70 is applied to households with income above
-133% of FPL but at or below 185% of FPL.
-
-3)
-
-A monthly premium of $90 is applied to individuals with income above
-185% of FPL but at or below 250% of FPL.
-
-4)
-
-A monthly premium of $120 is applied to individuals with income above
-250% of FPL but at or below 300% of FPL.
-
-v)
-
-The premium amounts will be updated at the beginning of each State fiscal year
-based on the annually revised FPL if the revised FPL would cause the premium
-amount (based on percentage of income) to increase by $10 or more.
-
-vi)
-
-A change in household net income may impact the monthly premium amount
-due. Failure to pay premium payments in full within 60 days from the premium
-due date will result in a member’s assistance being terminated prospectively. The
-effective date of the termination will be the last day of the month following the 60
-days from the date on which the premium became past due. The Department will
-waive premiums for the Children with Disabilities Program members who are
-within their 12 months postpartum period.
-
-vii)
-
-Due to the federal COVID-19 Public Health Emergency, the Department waived
-premiums for the Children with Disabilities Program during the federal COVID-19
-emergency declaration. The Department will continue to waive premiums past
-the end of the emergency declaration and until further notice. The Department
-will notify all members as to when required premiums will resume.
-
-2.
-
-Retroactive coverage is available according to 8.100.3.E, however is not available prior to
-program implementation.
-
-3.
-
-Verification requirements will follow the MAGI Category Verification Requirements found at
-8.100.4.B.
-
-4,
-
-Individuals have the option to request to be disenrolled if they have been enrolled into the
-Medicaid Buy-In Program for Children with Disabilities. This is also called “opt out.”
-
-8.100.7
-
-Long-Term Care Medical Assistance Eligibility
-
-8.100.7.A.
-
-Persons in Long-Term Care Institutions or Other Residential Placement
-
-1.
-
-For Long-Term Care services to be covered in a Long-Term Care institution, a client must be
-determined eligible under the 300% Institutionalized Special Income category. If the client is
-already Medicaid eligible, a new application is not required but the client must be determined to
-meet the eligibility criteria.
-
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-
-For a client entering a Long-Term Care Institution from the community, the Eligibility Site must
-notify the Single Entry Point/Case Management Agency, upon receipt of the application or client
-request, to schedule the Long-Term Services and Supports Level of Care Eligibility Determination
-Screen. This is not applicable to a client being discharged from a hospital, nursing facility or
-Long-Term Home Health.
-For purposes of applying the special income standard for the aged, disabled or blind persons in
-Long-Term Care Institutions, gross income means income before application of deductions,
-exemptions or disregards appropriate to the SSI program.
-Medical Assistance will be provided beginning the first day of the month following the month
-during which a child under the age of 18 ceases to live with his or her parent(s). Once determined
-to meet the institutional requirement, parental income and resources will cease to be deemed
-available to the child because the child is institutionalized and not living in the parents' home.
-2.
-
-Eligibility under the 300% Institutionalized Special Income category will be provided to applicants
-who:
-a.
-
-Have attained the age of 65 years or;
-
-b.
-
-Have met the requirements according to the definition of disability or blindness applicable
-to the Social Security Disability Insurance (SSDI) and Supplemental Security Income
-(SSI)
-
-c.
-
-Have been institutionalized for at least 30 consecutive full days in a Long-Term Care
-institution. The 30 consecutive full day stay may be a combination of days in a hospital,
-Long-Term Care institution, or receiving services from a Home and Community Based
-Services (HCBS) program or Program of All Inclusive Care for the Elderly (PACE).
-Supporting documentation must be provided which verifies the 30 consecutive full days.
-This documentation shall include the Long-Term Services and Supports Level of Care
-Eligibility Determination and/or medical records which must be verified by a physician or
-case manager.
-If a client dies prior to the 30th consecutive full day, the client shall be determined to have
-met the 30 consecutive full day requirement if:
-i)
-
-There is a statement from a physician, or case manager that declares if the client
-had not died, he/she would have been institutionalized for 30 consecutive full
-days, and;
-
-ii)
-
-The statement is verified by supporting documentation from the beginning of the
-institutionalized period, which is the first 15 days, or prior to the death of the
-client, whichever is earliest.
-
-iii)
-
-Once the 30 consecutive days of institutionalization requirement has been met,
-Medical Assistance benefits start as of the first day when institutionalization
-began if all other eligibility requirements were met as of that date.
-
-d.
-
-Are in a facility eligible for Medical Assistance Program reimbursement if the individual is
-in a hospital or Long-Term Care institution; and
-
-e.
-
-Have gross income that does not exceed 300% of the current individual SSI benefit level
-or;
-
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-
-Are in a Long-Term Care institution (excluding hospital) whose gross income exceeds the
-300% level and who establishes an income trust in accordance with the rules on income
-trusts in section 8.100.7 of this volume;
-i)
-
-3.
-
-This special income standard must be applied for:
-1)
-
-A person 65 years of age or older, or disabled or blind receiving care in a
-hospital, nursing facility; or
-
-2)
-
-A person who is not SSI eligible needing Long-Term Care from HCBS or
-PACE; or
-
-3)
-
-A person 65 years of age or older receiving active treatment as an
-inpatient in a psychiatric facility eligible for Medical Assistance
-reimbursement; and
-
-f.
-
-Have resources that conform with the regulations regarding resource limits and
-exemptions set forth in section 8.100.5 of this volume; and
-
-g.
-
-If married, Income and resources conform to rules set forth at 8.100.7.C and 8.100.7.K;
-and
-
-h.
-
-Have not transferred assets without fair consideration on or after the look-back date
-defined in section 8.100.7.F.2.d. which would incur a penalty period of ineligibility in
-accordance with the regulations on transfers without fair consideration in section 8.100.7
-of this volume; and
-
-i.
-
-Have submitted trust documents to the Department if the individual or the individual's
-spouse has transferred assets into a trust or is a beneficiary of trust. The Department
-shall determine the effect of the trust on Medical Assistance Program eligibility.
-
-j.
-
-Have submitted documents verifying that an annuity conforms to the regulations
-regarding Annuities at 8.100.7.I.
-
-An appeal process is available to children identified by C.R.S. 27-10.3-101 to 108, The Child
-Mental Health Treatment Act, who are denied residential treatment. The appeal process is
-outlined in the Income Maintenance Staff Manual of the Department of Human Services (9 CCR
-2503-1). A determination made in connection with this appeal shall not be the final agency action
-with regard to Medical Assistance eligibility
-
-8.100.7.B.
-Persons Requesting Long-term Care through Home and Community Based
-Services (HCBS) or the Program of All Inclusive Care for the Elderly (PACE)
-1.
-
-HCBS or PACE shall be provided to persons who have been assessed by the Single Entry
-Point/Case Management Agency to have met the institutional level of care and will remain in the
-community by receiving HCBS or PACE; and
-a.
-
-are SSI (including 1619b) or OAP Medicaid eligible; or
-
-b.
-
-are eligible under the Institutionalized 300% Special Income category described at
-8.100.7.A; or
-
-c.
-
-are eligible under the Medicaid Buy-In Program for Working Adults with Disabilities
-described at 8.100.6.P. For this group, access to HCBS:
-
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-
-2.
-
-i)
-
-Is limited to the Elderly, Blind and Disabled (EBD), Community Mental Health
-Supports (CMHS), Brain Injury (BI), Spinal Cord Injury (SCI), Supported Living
-Services (SLS), and Developmental Disabilities waivers; and
-
-ii)
-
-Is contingent on the Department receiving all necessary federal approval for the
-waiver amendments that extend access to HCBS to the Working Adults with
-Disabilities population described at 8.100.6.P.
-
-A client who is already Medicaid eligible does not need to submit a new application. The client
-must request the need for Long-Term Care services and the Eligibility Site must redetermine the
-client’s eligibility.
-a.
-
-3.
-
-10 CCR 2505-10 8.100
-
-All individuals applying for or requesting Long-Term Care services must disclose and
-provide documentation of:
-i)
-
-any transfer of assets without fair consideration as described at 8.100.7.F; and
-
-ii)
-
-any interest in an annuity as described at 8.100.7.I; and
-
-iii)
-
-any interest in a trust as described at 8.100.7.E.
-
-b.
-
-Failure to disclose and provide documentation of the assets described at 8.100.7.B.2.a
-may result in the denial of Long-Term Care services.
-
-c.
-
-The requirements at 8.100.7.B.2.a and 8.100.7.B.2.b do not apply to individuals who
-have been determined eligible under the Medicaid Buy-In Program for Working Adults
-with Disabilities described at 8.100.6.P.
-
-For individuals served in Alternative Care Facilities (ACF), income in excess of the personal
-needs allowance and room and board amount for the ACF shall be applied to the Medical
-Assistance charges for ACF services. The total amount allowed for personal need and room and
-board cannot exceed the State's Old Age Pension Standard.
-
-8.100.7.C.
-
-Treatment of Income and Resources for Married Couples
-
-1.
-
-The income of a community spouse is not deemed to the institutionalized spouse in determining
-eligibility. If both spouses are institutionalized, their individual income is counted in determining
-their own eligibility. The income of one institutionalized spouse is not deemed to the other
-institutionalized spouse when determining eligibility.
-
-2.
-
-The income and resources of both spouses are counted in determining eligibility for either or both
-spouses with the following exceptions:
-a.
-
-If spouses share the same room in an institution, the income of the individual spouse is
-counted in determining his or her eligibility, and each spouse is allowed the $2000 limit
-for resources.
-
-b.
-
-Beginning the first month following the month the couple ceases to live together, only the
-income of the individual spouse is counted in determining his or her eligibility.
-
-c.
-
-If one spouse is applying for Long-Term Care in a Long-Term Care institution or Home
-and Community Based Services (HCBS), refer to the rules on Treatment of Income and
-Resources for Institutionalized Spouses.
-
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-
-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-10 CCR 2505-10 8.100
-
-3.
-
-Long term care insurance benefits are not countable as income, but are payable as part of the
-patient payment to the Long-Term Care institution.
-
-4.
-
-For living expense purposes, income and resources of spouses living in the same household for a
-full calendar month or more must be considered as available to each other, whether or not they
-are actually contributed, and must be evaluated in accordance with rules contained in 8.100.7.Q.
-
-Long-Term Care
-8.100.7.D.
-Other Medical Assistance Clients Requesting Long-Term Care in an Institution or
-through HCBS or PACE
-Clients who need Long-Term Care services who are eligible for the State Only Health Care Program shall
-submit an application because they are not already Medicaid eligible.
-8.100.7.E
-1.
-
-Trusts established before August 11, 1993:
-a.
-
-2.
-
-Consideration of Trusts in Determining Medical Assistance Eligibility
-
-Medical Assistance Qualifying Trust (MQT)
-i)
-
-In the case of a Medical Assistance qualifying trust, as defined in 42 U.S.C. Sec.
-1396a(k), the amount of the trust property that is considered available to the
-applicant/recipient who established the trust (or whose spouse established the
-trust) is the maximum amount that the trustee(s) is permitted under the trust to
-distribute to the individual assuming the full exercise of discretion by the
-trustee(s) for the distribution of the maximum amount to the applicant/recipient.
-This amount of property is deemed available resources to the individual, whether
-or not is actually received.
-
-ii)
-
-42 U.S.C. Sec. 1396a(k) was repealed in 1993 and is reprinted here exclusively
-for purposes of trusts established before August 11, 1993. 42 U.S.C. Sec.
-1396a(k) defines a Medical Assistance qualifying trust as “a trust, or similar legal
-device, established (other than by will) by an individual (or an individual's spouse)
-under which the individual may be the beneficiary of all or part of the payments
-from the trust and the distribution of such payments is determined by one or
-more trustees who are permitted to exercise any discretion with respect to the
-distribution to the individual.”
-
-b.
-
-This provision does not apply to any trust or initial decrees established before April 7,
-1986, solely for the benefit of a developmentally disabled individual who resides in an
-Long Term Care Institution for the developmentally disabled.
-
-c.
-
-This provision does not apply to individuals who are receiving SSI.
-
-Trusts established on or after July 1, 1994:
-Assets include all income and resources of the individual and the individual's spouse, including all
-income and resources which the individual or the individual's spouse is entitled to but does not
-receive because of action by any of the following:
-a.
-
-The individual or the individual's spouse,
-
-b.
-
-A person, including a court or administrative body, with legal authority to act in place of or
-on behalf of the individual or the individual’s spouse, or
-
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-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-c.
-3.
-
-5.
-
-Any person court or administrative body acting at the direction of or upon the request of
-the individual or the individual's spouse.
-
-In determining an individual's eligibility for Medical Assistance, the following regulations apply to a
-trust established by an individual:
-a.
-
-4.
-
-10 CCR 2505-10 8.100
-
-An individual shall be considered to have established a trust if assets of the individual
-were used to form all or part of the corpus of the trust, and if any of the following
-individuals established the trust, other than by will:
-i)
-
-The individual or the individual's spouse
-
-ii)
-
-A person, including a court or administrative body, with legal authority to act in
-place of, or on the behalf of, the individual or the individual's spouse;
-
-iii)
-
-A person, including a court or administrative body acting at the direction or upon
-the request of the individual or the individual's spouse.
-
-b.
-
-In the case of a trust, the corpus of which includes assets of an individual and the assets
-of any other person(s), this regulation shall apply to the portion of the trust attributable to
-the assets of the individual.
-
-c.
-
-These regulations apply without regard to the following:
-i)
-
-The purposes for which a trust is established;
-
-ii)
-
-Whether the trustees have or exercise any discretion under the trust;
-
-iii)
-
-Any restrictions on when or whether distributions may be made from the trust; or
-
-iv)
-
-Any restrictions on the use of distributions from the trust.
-
-Revocable Trusts are considered as follows:
-a.
-
-The corpus of the trust shall be considered resources available to the individual.
-
-b.
-
-Payments from the trust to or for the benefit of the individual shall be considered income
-to the individual, and
-
-c.
-
-Any other payments from the trust shall be considered assets transferred by the
-individual for less than fair market value and are subject to a 60 month look back period
-and a penalty period of ineligibility as set forth in the regulations on transfers without fair
-consideration in this volume.
-
-Irrevocable Trusts
-If there are any circumstances under which payments from the trust could be made to or for the
-benefit of the individual, the following shall apply:
-a)
-
-The portion of the corpus of the trust, or the income on the corpus, from which payment
-to the individual could be made, shall be considered as resources available to the
-individual.
-
-b)
-
-Payments from that portion of the corpus, or income to or for the benefit of the individual,
-shall be considered income to the individual.
-
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-
-6.
-
-10 CCR 2505-10 8.100
-
-c)
-
-Payments from that portion of the corpus or income for any other purpose shall be
-considered as a transfer of assets by the individual for less than fair market value and are
-subject to a 60 month look back period and a penalty period of ineligibility as set forth in
-the regulations on transfers without fair consideration in this volume.
-
-d)
-
-Any portion of the trust from which, or any income on the corpus from which no payment
-could be made to the individual under any circumstances, shall be considered as a
-transfer of assets for less than fair market value and shall be subject to a 60 month look
-back period and penalty period of ineligibility as set forth in the regulations on transfers
-without fair consideration in this volume. The transfer will be effective as of the date of the
-establishment of the trust, or the date on which payment to the individual from the trust
-was foreclosed, if later. The value of the trust shall be determined by including the
-amount of any payments made from such portion of the trust after such date.
-
-The preceding regulations for trusts established on or after July 1, 1994, do not apply to the
-following:
-a.
-
-Income Trusts
-i)
-
-A trust consisting only of the individual's pension income, social security income
-and other monthly income that is established for the purpose of establishing
-income eligibility for Long Term Care institution care or Home and Community
-Based Services (HCBS). To be valid, the trust must meet the following criteria:
-a)
-
-The individual's gross monthly income must be above the 300%-SSI limit
-but below the average cost of private Long Term Care institution care in
-the geographic region in which the individual resides and intends to
-remain. The Colorado Department of Health Care Policy and Financing
-shall calculate the average rates for such regions on an annual,
-calendar-year basis. The geographic regions which are used for
-calculating the average private pay rate for Long Term Care institution
-care shall be based on the Bureau of Economic Analysis Regions and
-consist of the following counties:
-REGION I: (Adams, Arapahoe, Boulder, Broomfield, Denver, Jefferson)
-REGION II: (Cheyenne, Clear Creek, Douglas, Elbert, Gilpin, Grand,
-Jackson, Kit Carson, Larimer, Logan, Morgan, Park, Phillips,
-Sedgwick, Summit, Washington, Weld, Yuma)
-REGION III: (Alamosa, Baca, Bent, Chaffee, Conejos, Costilla, Crowley,
-Custer, El Paso, Fremont, Huerfano, Kiowa, Lake, Las Animas,
-Lincoln, Mineral, Otero, Prowers, Pueblo, Rio Grande,
-Saguache, Teller)
-REGION IV: (Archuleta, Delta, Dolores, Eagle, Garfield, Gunnison,
-Hinsdale, La Plata, Mesa, Moffat, Montezuma, Montrose, Ouray,
-Pitkin, Rio Blanco, Routt, San Juan, San Miguel)
-
-b)
-
-For Long Term Care institution clients, each month the trustee shall
-distribute the entire amount of income which is transferred into the trust.
-An amount not to exceed $20.00 may be retained for trust expenses
-such as bank charges if such charges are expected to be incurred by the
-trust.
-
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-
-c)
-
-10 CCR 2505-10 8.100
-
-The only deductions from the monthly trust distribution to the Long Term
-Care institution are the allowable deductions which are permitted for
-Medical Assistance-eligible persons who do not have income trusts.
-Allowable deductions include only the following:
-i)
-
-Personal need allowance
-
-ii)
-
-Spousal income payments
-
-iii)
-
-Approved PETI payments
-
-d)
-
-Any funds remaining after the allowable deductions shall be paid solely
-to the cost of the Long Term Care institution care in an amount not to
-exceed the Medical Assistance reimbursement rate. Any excess income
-which is not distributed shall accumulate in the trust.
-
-e)
-
-No other deductions or expenses may be paid from the trust. Expenses
-which cannot be paid from the trust include, but are not limited to, trustee
-fees, attorney fees and costs (including attorney fees and costs incurred
-in establishing the trust), accountant fees, court fees and costs, fees for
-guardians ad litem, funeral expenses, past-due medical bills and other
-debts. Trustee fees which were ordered prior to April 1, 1996 may
-continue until the trust terminates.
-
-f)
-
-For HCBS clients, the amount distributed each month shall be limited to
-the 300% of the SSI limit. Any monthly income above that amount shall
-remain in the trust. An amount not to exceed $20.00 may be retained for
-trust expenses such as bank charges if such charges are expected to be
-incurred by the trust. No other trust expenses or deductions may be paid
-from the trust. For the purpose of calculating Individual Cost
-Containment or client payment (PETI), the client's monthly income will be
-300% of the SSI limit. Upon termination, the funds which have
-accumulated in the trust shall be paid to the Department up to the total
-amount of Medical Assistance paid on behalf of the individual.
-
-g)
-
-For a court-approved trust, notice of the time and place of the hearing,
-with the petition and trust attached, shall be given to the eligibility site
-and the Department in the manner prescribed by law.
-
-h)
-
-The sole beneficiaries of the trust are the individual for whose benefit the
-trust is established and the Department. The trust terminates upon the
-death of the individual or if the trust is not required for Medical
-Assistance eligibility in Colorado.
-
-i)
-
-The trust must provide that upon the death of the individual or
-termination of the trust, whichever occurs sooner, the Department shall
-receive all amounts remaining in the trust up to the total amount of
-Medical Assistance paid on behalf of the individual.
-
-j)
-
-The trust must include the name and mailing address of the trustee. The
-trustee must notify the Department of any trustee address changes or
-change of trustee(s) within 30 calendar days.
-
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-
-b.
-
-10 CCR 2505-10 8.100
-
-k)
-
-The trust must provide that an annual accounting of trust income and
-expenditures and an annual statement of trust assets shall be submitted
-to the eligibility site or to the Department upon reasonable request or
-upon any change of trustee.
-
-l)
-
-The amount remaining in the trust and an accounting of the trust shall be
-due to the Department within three months after the death of the
-individual or termination of the trust, whichever is sooner. An extension
-of time may be granted by the Department if a written request is
-submitted within two months of the termination of the trust.
-
-m)
-
-The regulations in this section for income trusts shall also apply to
-income trusts established after January 1, 1992, under the undue
-hardship provisions in 26-4-506.3(3),C.R.S. and 15-14-412.5,C.R.S.
-
-Disability Trusts
-i)
-
-A trust that is established solely for the benefit of a disabled individual under the
-age of 65, which consists of the assets of the individual, and is established for
-the purpose or with the effect of establishing or maintaining the individual's
-resource eligibility for Medical Assistance and which meets the following criteria:
-a)
-
-The individual for whom the trust is established must meet the disability
-criteria of Social Security.
-
-b)
-
-[Removed and Reserved]
-
-c)
-
-The trust is established solely for the benefit of the disabled individual by
-the individual, the individual’s parent, the individual’s grandparent, the
-individual’s legal guardian, or by the court.
-
-d)
-
-The sole lifetime beneficiaries of the trust are the individual for whose
-benefit the trust is established, the Colorado Department of Health Care
-Policy and Financing, and any other state that provides medical
-assistance to the individual under such state’s Medicaid program.
-
-e)
-
-The trust terminates upon the death of the individual or if the trust is no
-longer required for Medical Assistance eligibility.
-i)
-
-If the individual becomes ineligible for Medical Assistance in
-Colorado or any other state due to a change in residency, then
-the trust shall terminate unless the Department receives proof
-that: (1) the individual is receiving medical assistance under
-another state’s Medicaid program; and (2) the trust is required
-for the individual to receive those medical assistance benefits.
-The trustee must submit the required proof no later than sixty
-(60) calendar days from the date the trustee acquires knowledge
-of the change in residency. An extension of time may be granted
-upon submission of a written request to the Department by the
-trustee.
-
-ii)
-
-The trustee must provide the Department with notice of the
-individual’s death, loss of Medicaid eligibility, or change in
-residency no later than sixty (60) calendar days from the date the
-trustee acquires knowledge of such event.
-
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-
-10 CCR 2505-10 8.100
-
-f)
-
-Any statutory lien pursuant to section 25.5-4-301(5), C.R.S. must be
-satisfied prior to funding of the trust and approval of the trust.
-
-g)
-
-If the trust is funded with an annuity or other periodic payments, the trust
-shall be named on the contract or settlement as the remainder
-beneficiary or the Department and any other state that provided medical
-assistance to the individual under such state’s Medicaid program may be
-named as remainder beneficiary up to the amount of Medical Assistance
-paid on behalf of the individual.
-
-h)
-
-The trust shall provide that, upon the death of the beneficiary or
-termination of the trust, the Department and any other state that provided
-medical assistance to the individual under such state’s Medicaid program
-shall receive all amounts remaining in the trust up to the amount of total
-medical assistance paid on behalf of the individual. If the trust does not
-have sufficient funds to reimburse each state in full, the amount
-remaining in the trust shall be distributed based on each state's
-proportionate share of the total amount of medical assistance benefits
-paid by all of the states on the individual’s behalf.
-
-i)
-
-No expenditures may be made after the death of the beneficiary, except
-for federal and state taxes. However, prior to the death of the individual
-beneficiary, trust funds may be used to purchase a burial fund for the
-beneficiary.
-
-j)
-
-The amount remaining in the trust and an accounting of the trust shall be
-due to the Department within three months after the death of the
-individual or termination of the trust, whichever is sooner. An extension
-of time may be granted by the Department if a written request is
-submitted within two months of the termination of the trust.
-
-k)
-
-The trust fund shall not be considered as a countable resource in
-determining eligibility for Medical Assistance.
-
-l)
-
-[Rule 8.110.52 B 5. b. 1) l), adopted or amended on or after November 1,
-2000 and before November 1, 2001 was not extended by HB 02-1203,
-and therefore expired May 15, 2002.]
-
-m)
-
-Distributions from the trust may be made only to or for the benefit of the
-individual beneficiary. Cash distributions from the trust shall be
-considered income to the individual. Distributions for food or shelter are
-considered in-kind income and are countable toward income eligibility.
-
-n)
-
-If exempt resources are purchased with trust funds, those resources
-continue to be exempt. If non-exempt resources are purchased, those
-resources are countable toward eligibility.
-
-o)
-
-The trust must include the name and mailing address of the trustee. The
-Department must be notified of any trustee address changes or change
-of trustee(s) within 30 calendar days.
-
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-
-c.
-
-10 CCR 2505-10 8.100
-
-p)
-
-The trust must provide that an accounting of trust income and
-expenditures and statement of trust assets shall be submitted to the
-eligibility site and to the Department on an annual basis and upon
-reasonable request or any change of trustee. Further, the trust must
-provide that the trustee is required to give the Department notice of any
-distribution in excess of $5,000 no later than thirty (30) days after such
-distribution. The Department shall acknowledge receipt within thirty (30)
-days of receiving the notice.
-
-q)
-
-Prior to the establishment or funding of a disability trust, the trust shall be
-submitted for review to the Department, along with proof that the
-individual beneficiary is disabled according to Social Security criteria. No
-disability trust shall be valid unless the Department has reviewed the
-trust and determined that the trust conforms to the requirements of 1514-412.8,C.R.S., as amended, and any rules adopted by the Medical
-Services Board..
-
-Pooled Trusts
-i)
-
-A trust consisting of individual accounts established for disabled individuals for
-the purpose of establishing resource eligibility for Medical Assistance. A valid
-pooled trust shall meet the following criteria:
-a)
-
-The individual for whom the trust is established must meet the disability
-criteria of Social Security.
-
-b)
-
-The trust is established and managed by a non-profit association which
-has been approved by the Internal Revenue Service.
-
-c)
-
-A separate account is maintained for each beneficiary; however, the trust
-pools the accounts for the purposes of investment and management of
-the funds.
-
-d)
-
-The sole lifetime beneficiaries of each trust account are the individual for
-whom the trust is established and the Department.
-
-e)
-
-If the trust is funded with an annuity or other periodic payments, the
-Department or the pooled trust shall be named as remainder beneficiary.
-
-f)
-
-The trust account shall be established by the disabled individual, parent,
-grandparent, legal guardian, or the court.
-
-g)
-
-The only assets used to fund each trust account are (1) the proceeds
-from any personal injury case brought on behalf of the disabled
-individual, or (2) retroactive payments of SSI benefits under Sullivan v.
-Zeblev . (This provision is applicable to pooled trusts established from
-July 1, 1994 to December 31, 2000.)
-
-h)
-
-Any statutory lien pursuant to section 25.5-4-301(5), C.R.S. must be
-satisfied prior to funding of the individual's trust account and approval of
-the joinder agreement.
-
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-
-d.
-
-10 CCR 2505-10 8.100
-
-i)
-
-Following the disabled individual's death or termination of the trust
-account, whichever occurs sooner, to the extent that the remaining funds
-in the trust account are not retained by the pooled trust, the Department
-shall receive any amount remaining in the individual's trust account up to
-the total amount of Medical Assistance paid on behalf of the individual.
-
-j)
-
-The pooled trust account shall not be considered as a countable
-resource in determining Medical Assistance eligibility.
-
-k)
-
-Distributions from the trust account may be made only to or for the
-benefit of the individual. Cash distributions to the individual from the trust
-shall be considered as income to the individual. Distributions for food or
-shelter are considered in-kind income and are countable toward income
-eligibility.
-
-l)
-
-If exempt resources are purchased with trust funds, those resources
-continue to be exempt. If non-exempt resources are purchased, those
-resources are countable toward resource eligibility.
-
-ii)
-
-If an institutionalized individual for whom a pooled trust is established is 65 years
-of age or older, the transfer of assets into the pooled trust creates a rebuttable
-resumption that the assets were transferred without fair consideration and shall
-be analyzed in accordance with the rules on transfers without fair consideration
-in this volume. This regulation is effective for transfers to pooled trusts after
-January 1, 2001.
-
-iii)
-
-When the individual beneficiary of an income, disability or pooled trust dies or the
-trust is terminated, the trustee shall promptly notify the eligibility site and the
-Department. To the extent required by these rules the trustee shall promptly
-forward the remainder of the trust property to the Department, up to the amount
-of Medical Assistance paid on behalf of the individual beneficiary.
-
-Third Party Trusts
-i)
-
-Third party trusts are trusts which are established with assets which are
-contributed by individuals other than the applicant or the applicant's spouse for
-the benefit of an applicant or client
-
-ii)
-
-The terms of the trust will determine whether the trust fund is countable as a
-resource or income for Medical Assistance eligibility.
-
-iii)
-
-Trusts which limit distributions to non-support or supplemental needs will not be
-considered as a countable resource. If distributions are made for income or
-resources, such distributions are countable as such for eligibility.
-
-iv)
-
-If the trust requires income distributions, the amount of the income shall be
-countable as income in determining eligibility.
-
-v)
-
-If the trust requires principal distributions, that amount shall be considered as a
-countable resource.
-
-vi)
-
-If the trustee may exercise discretion in distributing income or resources, the
-income or resources are not countable in determining eligibility. If distributions
-are made for income or resources, such distributions are countable as such for
-eligibility.
-
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-
-e.
-
-7.
-
-Federally Approved Trusts
-i)
-
-If an SSI recipient has a trust which has been approved by the Social Security
-Administration, eligibility for Medical Assistance cannot be delayed or denied.
-Individuals on SSI are automatically eligible for Medical Assistance despite the
-existence of a federally approved trust.
-
-ii)
-
-If the eligibility site has a copy of a federally approved trust, the eligibility site
-must send a copy to the Department.
-
-Submission of Trust Documents and Records
-a.
-
-The trustee of a trust which was established by or which benefits a Medical Assistance
-Applicant or client shall submit trust documents and records to the eligibility site and to
-the Department.
-
-b.
-
-This requirement includes documents and records for income trusts, disability trusts and
-the joinder agreement for each pooled trust account.
-
-c.
-
-The eligibility site shall submit any trust which is submitted with an application or at
-redetermination to The Department. The eligibility site shall determine Medical
-Assistance eligibility based on the determination of The Department as to the effect of the
-trust on eligibility.
-
-8.100.7.F.
-1.
-
-10 CCR 2505-10 8.100
-
-Transfers of Assets Without Fair Consideration
-
-Definitions. The following definitions apply to transfers of assets without fair considerations:
-a.
-
-“Assets” include all income and resources of the individual and such individual's spouse,
-including any interest in income or a resource as well as all income or resources which
-the individual or such individual's spouse is entitled to but does not receive because of
-action by any of the following:
-i)
-
-The individual or such individual's spouse,
-
-ii)
-
-A person, a court, or administrative body with legal authority to act on behalf of
-the individual or such individual's spouse, or
-
-iii)
-
-Any person, court or administrative body acting at the direction of or upon the
-request of the individual or such individual's spouse.
-
-b.
-
-“Fair market value” is the value of the asset if sold at the prevailing price at the time it
-was transferred.
-
-c.
-
-“Fair consideration” is the amount the individual receives in exchange for the asset that is
-transferred, which is equal to or greater than the value of the transferred asset.
-
-d.
-
-“Look-back period” means the number of months prior to the month of application for
-long-term care services that the Department will consider for transfer of assets.
-
-e.
-
-“Penalty period” means a period of time for which an applicant or client will not be eligible
-to receive long-term care services.
-
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-
-2.
-
-10 CCR 2505-10 8.100
-
-f.
-
-“Uncompensated value” shall mean the fair market value of an asset at the time of the
-transfer minus the value of compensation the individual receives in exchange for the
-asset.
-
-g.
-
-“Valuable consideration” shall mean what an individual receives in exchange for his or
-her right or interest in an asset which has a tangible and/or intrinsic value to the individual
-that is equivalent to or greater than the value of the transferred asset.
-
-General Provisions
-If an institutionalized individual or the spouse of such individual disposes of assets without fair
-consideration on or after the look-back period, the individual shall be subject to a period of
-ineligibility for Long-Term Care services, including Long-Term Care institution care, Home and
-Community Based Services (HCBS), and the Program of All Inclusive Care for the Elderly
-(PACE).
-a.
-
-For transfers made before February 8, 2006, the look-back period is 36 months prior to
-the date of application. For transfers made on or after February 8, 2006, the look-back
-date is 60 months prior to the date of application.
-
-b.
-
-An institutionalized individual is one who is institutionalized in a medical facility, a LongTerm Care institution, or applying for or receiving Home and Community Based Services
-(HCBS) or the Program of All Inclusive Care for the Elderly (PACE).
-
-c.
-
-If an institutionalized individual or such individual's spouse transfers assets without fair
-consideration on or after the look-back period, the transfer shall be evaluated as follows:
-i)
-
-The fair market value of the transferred asset, less the actual amount received, if
-any, shall be divided by the average of the regions, defined at 8.100.7.E, monthly
-private pay cost for Long-Term Care institution care in the state of Colorado at
-the time of application.
-
-ii)
-
-The resulting number is the number of months that the individual shall be
-ineligible for Medical Assistance. For transfers made before February 8, 2006,
-the period of ineligibility shall begin with the first day of the month following the
-month in which the transfer occurred. For transfers made on or after February 8,
-2006, the period of ineligibility shall begin on the later of the following dates:
-a)
-
-The first day of the month following the month in which the transfer
-occurred or is discovered. For transfers discovered after the date the
-transfer occurred, the date of transfer shall be the discovery date.
-Or;
-
-b)
-
-The date on which the individual would initially be eligible for HCBS,
-PACE or institutional services based on an approved application for such
-assistance that were it not for the imposition of the penalty period, would
-be covered by Medical Assistance;
-And;
-
-c)
-
-Which does not occur during any other period of ineligibility for services
-by reason of a transfer of assets penalty.
-
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-
-10 CCR 2505-10 8.100
-
-d.
-
-The period of ineligibility shall also include partial months, which shall be calculated by
-multiplying 30 days by the decimal fractional share of the partial month. The result is the
-number of days of ineligibility. For transfers occurring on or after April 1, 2006, the result
-shall be rounded up to the nearest whole number.
-
-e.
-
-There is no maximum period of ineligibility.
-
-f.
-
-For transfers prior to February 8, 2006, the total amount of all of the transfers are added
-together and the period of ineligibility begins the first day of the month following the
-month in which the resources are transferred.
-
-g.
-
-i)
-
-If the previous penalty period has completely expired, the transfers are not added
-together.
-
-ii)
-
-If the previous penalty period has not completely expired and the first day of the
-month following the month in which the resources are transferred is part of a prior
-penalty period, the new penalty period begins the first day after the prior penalty
-period expires.
-
-For transfers on or after February 8, 2006, the total amounts of all of the transfers are
-added together and the penalty period is assessed as outlined in section 8.100.7.F.2.cdabove.
-i)
-
-If the previous penalty period has completely expired, the transfers are not added
-together.
-
-ii)
-
-If the previous penalty period has not completely expired and the first day of the
-month following the month in which the resources are transferred is part of a prior
-penalty period, the new penalty period begins the first day after the prior penalty
-period expires.
-
-h.
-
-The institutionalized individual may continue to be eligible for Supplemental Security
-Income (SSI) and basic Medical Assistance services, but shall not be eligible for Medical
-Assistance for Long-Term Care institution services, Home and Community Based
-Services or the Program of All Inclusive Care for the Elderly due to the transfer without
-fair consideration.
-
-i.
-
-If a transfer without fair consideration is made during a period of eligibility, a period of
-ineligibility shall be assessed in the same manner as stated above.
-
-j.
-
-Actions that prevent income or resources from being received, or reduce an individual’s
-ownership, right or interest in an asset such that the individual does not receive valuable
-consideration as set forth on the following list, which is not exclusive, shall create a
-rebuttable presumption that the transfer was without fair consideration:
-i)
-
-Waiving pension income.
-
-ii)
-
-Waiving a right to receive an inheritance.
-
-iii)
-
-Preventing access to assets to which an individual is entitled by diverting them to
-a trust or similar device. This is not applicable to valid income trusts, disability
-trusts and pooled trusts for individuals under the age of 65 years.
-
-iv)
-
-Failure of a surviving spouse to elect a share of a spouse's estate or failure to
-open an estate within 6 months after a spouse’s death.
-
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-
-8.100.7.G.
-1.
-
-v)
-
-Failure to obtain a family allowance or exempt property allowance from an estate
-of a deceased spouse or parent. Such allowances are presumed to be available
-3 months after death.
-
-vi)
-
-Not accepting or accessing a personal injury settlement.
-
-vii)
-
-Transferring assets into an irrevocable private annuity which was not purchased
-from a commercial company.
-
-viii)
-
-Transferring assets into an irrevocable entity such as a Family Limited
-Partnership which eliminates or restricts the individual's access to the assets.
-
-ix)
-
-Refusal to take legal action to obtain a court ordered payment that is not being
-paid, such as child support or alimony, if the benefit outweighs the cost.
-
-x)
-
-Failure to exercise rights in a Dissolution of Marriage case, which insure an
-equitable distribution of marital property and income.
-
-xi)
-
-Purchasing a single-premium life insurance policy, endowment policy or similar
-instrument within the look-back period, which has no cash value, and for which
-the individual receives no valuable consideration shall be considered an
-uncompensated transfer. The total amount of the purchase price shall be
-considered a transfer without fair consideration.
-
-Treatment of Certain Assets as Transfers Without Fair Consideration
-
-Promissory notes established before April 1, 2006:
-a.
-
-The fair market value of promissory notes is a countable resource and must be evaluated
-in accordance with the regulations on consideration of resources in this volume.
-
-b.
-
-Promissory notes with one or more of the following provisions, indicating they have little
-or no market value, shall create a rebuttable presumption of a transfer without fair
-consideration:
-
-c.
-2.
-
-10 CCR 2505-10 8.100
-
-i)
-
-An interest rate lower than the prevailing market rate.
-
-ii)
-
-A term for repayment longer than the life expectancy of the holder of the note, as
-determined by the tables at 8.100.7.J.for annuities purchased on or after
-February 8, 2006.
-
-iii)
-
-Low payments.
-
-iv)
-
-Cancellation at the death of the note holder.
-
-Promissory notes which have been appraised by a note broker as having little or no value
-shall create a rebuttable presumption of a transfer without fair consideration.
-
-Promissory notes established on or after April 1, 2006 but before March 1, 2007
-a.
-
-Subject to the look-back date described in section 8.100.7.F.2.b for the purpose of
-calculating the penalty period of ineligibility for a transfer without fair consideration, the
-value of a promissory note, loan or mortgage which does not meet the criteria in section
-8.100.5.M.3.n. is the outstanding balance due as of the date of the individual’s application
-for Medical Assistance for services, described in section 8.100.7.F.2.c.
-
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-
-3.
-
-Promissory notes established on or after March 1, 2007
-a.
-
-4.
-
-10 CCR 2505-10 8.100
-
-Subject to the look-back date described in section 8.100.7.F.2.b, for the purpose of
-calculating the penalty period of ineligibility for a transfer without fair consideration, the
-value of a promissory note, loan or mortgage which does not meet the criteria in section
-8.100.5.M.3.o. is the outstanding balance due as of the date of the individual’s application
-for Medical Assistance for services, described in section 8.100.7.F.2.c..
-
-Personal care services
-a.
-
-b.
-
-Effective for agreements that were signed and notarized prior to March 1, 2007, family
-members who provide assistance or services are presumed to do so for love and
-affection, and compensation for past assistance or services shall create a rebuttable
-presumption of a transfer without fair consideration unless the compensation is in
-accordance with the following:
-i)
-
-A written agreement must be executed prior to the delivery of services.
-
-ii)
-
-The agreement must be signed by the applicant, or a legally authorized
-representative, such as agent under a power of attorney, guardian, or
-conservator. If the agreement is signed by a representative, that representative
-may not be a beneficiary of the agreement.
-
-iii)
-
-The agreement must be dated and the signature must be notarized; and
-
-iv)
-
-Compensation for services rendered must be comparable to what is received in
-the open market.
-
-Effective for agreements that are signed and notarized on or after March 1, 2007,
-compensation under personal service agreements will be deemed to be a transfer without
-fair consideration unless the following requirements are met:
-i)
-
-ii)
-
-A written agreement was executed prior to the delivery of services; and
-a)
-
-The agreement must be signed by the applicant, or a legally authorized
-representative, such as agent under a power of attorney, guardian, or
-conservator. If the agreement is signed by a representative, that
-representative may not be a beneficiary of the agreement; and
-
-b)
-
-The legally authorized representative, agent, guardian, conservator, or
-other representative of the applicant’s estate may not be a beneficiary of
-a care agreement; and
-
-c)
-
-The agreement specifies the type, frequency and time to be spent
-providing the services agreed to in exchange for the payment or
-transferred item; and
-
-d)
-
-The agreement provides for payment of services on a regular basis, no
-less frequently than monthly, while the services are being provided; and
-
-Compensation for services rendered must be comparable to what is received in
-the open market. The burden is on the applicant to prove that the compensation
-is reasonable and comparable; and
-
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-
-iii)
-
-5.
-
-A record or log is provided which details the actual services rendered. The
-services cannot be services that duplicate services that another party is being
-paid to provide or which another party is responsible to provide.
-
-c.
-
-Payment for services, which were rendered previously and for which no compensation
-was made, shall be considered as a transfer without fair consideration.
-
-d.
-
-Assets transferred in exchange for a contract for personal services for future assistance
-after the date of application are considered available resources.
-
-e.
-
-A care agreement must be entered into, signed, and notarized prior to providing any
-services for which a beneficiary will be compensated.
-
-Transfers of real property into joint tenancy without fair consideration
-a.
-
-b.
-
-6.
-
-10 CCR 2505-10 8.100
-
-If real property is transferred into joint tenancy with right of survivorship with one or more
-joint tenants, the amount transferred depends on the number of joint tenants to whom the
-property is transferred. The following are examples:
-i)
-
-If the transfer is to one joint tenant, the amount transferred is equal to one-half of
-the value of the property at the time of the transfer.
-
-ii)
-
-If the transfer is to two joint tenants, the amount transferred is equal to two-thirds
-of the value.
-
-iii)
-
-If the transfer is to three joint tenants, the amount transferred is equal to threefourths of the value of the property at the time of the transfer.
-
-If the transfer is completed with two deeds or transactions, the first of which transfers a
-fractional share of the property into tenancy in common, and the second into joint
-tenancy, the amount transferred shall be determined in the same manner as set forth
-above.
-
-No period of ineligibility will be imposed if the individual transferred the assets under any of
-following circumstances:
-a.
-
-The asset transferred was a home and title to the home was transferred to:
-i)
-
-The spouse of such individual;
-
-ii)
-
-A child of such individual who is either
-
-iii)
-
-iv)
-
-1)
-
-Under the age of 21 years, or
-
-2)
-
-Is blind or totally and permanently disabled as determined by the Social
-Security Administration.
-
-A brother or sister
-1)
-
-Who has an equity interest in the home and
-
-2)
-
-Who was residing in such individual's home for at least one year
-immediately before the date that the individual becomes institutionalized.
-
-A son or a daughter of such individual
-
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-
-b.
-
-c.
-
-10 CCR 2505-10 8.100
-
-1)
-
-Who was residing in the home for a period of at least two years
-immediately before the date the individual becomes institutionalized and
-
-2)
-
-Who provided care to such individual by objective evidence, that
-permitted such individual to reside at home rather than in an institution.
-
-3)
-
-Documentation shall be submitted proving that the son or daughter's sole
-residence was the home of the parent. The parent's attending
-physician(s) or professional health provider(s) during the past two years
-must substantiate in writing that the care was provided, and that the care
-prevented the parent from requiring placement in a Long-Term Care
-institution.
-
-The assets were transferred:
-i)
-
-To the individual's spouse or to another for the sole benefit of the individual's
-spouse.
-
-ii)
-
-From the individual's spouse to another for the sole benefit of the individual's
-spouse.
-
-iii)
-
-To a trust which is established solely for benefit of the individual's child who is
-determined to be blind or totally disabled by the Social Security Administration or
-to that child directly for the sole benefit of the child.
-
-iv)
-
-To a trust established solely for the benefit of an individual under 65 years of age
-who is determined to be blind or totally disabled by the Social Security
-Administration.
-
-Definition of the term “for the sole benefit of,” as used in the preceding exceptions to the
-transfer penalty rules:
-i).
-
-A transfer or a trust is considered to be for the sole benefit of the spouse, blind or
-disabled child, or a disabled individual if the transfer is arranged in such a way
-that no individual or entity except the spouse, blind or disabled child, or disabled
-individual can benefit from the assets transferred in any way, whether at the time
-of the transfer or at any time in the future.
-
-ii).
-
-To insure that the asset transferred is for the sole benefit of the spouse, blind or
-disabled child or disabled individual, the following criteria must be met:
-1)
-
-2)
-
-The transfer must be accomplished by a written instrument which legally
-binds the parties to a specified course of action and sets forth:
-a)
-
-The conditions under which the transfer was made, and
-
-b)
-
-A statement as to whom can benefit from the transfer.
-
-The written instrument must provide for the spending of funds or use of
-the transferred assets for the benefit of the individual on a basis that is
-actuarially sound based on the life expectancy of the individual.
-
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-
-7.
-
-10 CCR 2505-10 8.100
-
-3)
-
-Disability trusts and income trusts, which designate the Colorado
-Department of Health Care Policy and Financing as the remainder
-beneficiary up to the amount of Medical Assistance paid on behalf of the
-individual, are exempt from this requirement.
-
-4)
-
-A community spouse to whom a Community Spouse Resource
-Allowance has been transferred does not have to provide a written
-document or comply with the requirement that the transfer is actuarially
-sound. However, the Community Spouse Resource Allowance must be
-for the sole benefit of the community spouse to whom it is transferred.
-Upon the death of the community spouse, those resources shall be
-made available to the surviving spouse, at least up to the amount of the
-elective share of the augmented estate, the family allowance and the
-exempt property allowance.
-
-There is a rebuttable presumption the transfer without fair consideration was made for purposes
-of Medical Assistance eligibility or avoiding the medical assistance estate recovery program.
-a.
-
-The presumption that an asset was transferred to establish or maintain Medicaid eligibility
-or to avoid the medical assistance estate recovery program is rebutted only if the
-individual or individual’s spouse demonstrates by providing convincing evidence that the
-asset was transferred exclusively for some other purpose and the reason for the transfer
-did not include Medical Assistance eligibility or avoidance of medical assistance estate
-recovery..
-
-b.
-
-A subjective statement of intent or ignorance of the transfer penalty or verbal assurances
-that the individual was not considering Medical Assistance eligibility when the transfer
-was made are not sufficient.
-
-c.
-
-There is a rebuttable presumption that transfers without fair consideration were made for
-the purpose of Medical Assistance eligibility in the following cases:
-i)
-
-In any case in which the individual's assets and the assets of the individual's
-spouse remaining after the transfer total an amount insufficient to meet all living
-expenses and medical expenses reasonably expected to be incurred by the
-individual or the individual's spouse in the sixty (60) months following the
-transfer. Medical expenses include the cost of Long-Term Care unless the future
-necessity of such care could have been absolutely precluded because of the
-particular circumstances.
-
-ii)
-
-In any case where:
-1)
-
-the transfer was made on behalf of the individual or the individual's
-spouse;
-
-2)
-
-the transfer was made by:
-a)
-
-the individual or individual’s spouse
-
-b)
-
-a guardian,
-
-c)
-
-a conservator, or
-
-d)
-
-agent under a power of attorney; and
-
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-
-3)
-
-d.
-
-8.
-
-10 CCR 2505-10 8.100
-
-the transfer was made to:
-a)
-
-anyone related to the individual or individual’s spouse by birth,
-adoption or marriage, other than between the individual and the
-individual’s spouse; or to
-
-b)
-
-anyone related to the guardian, conservator, or agent under a
-power of attorney by birth, adoption or marriage.
-
-Convincing evidence may include, but is not limited to, verification which establishes:
-i)
-
-That at the time of the transfer the individual could not have anticipated needing
-long term Medical Assistance due to the existence of other circumstances which
-would have precluded the need.
-
-ii)
-
-Other assets were available at the time of the transfer to meet current and future
-needs of the individual, including the cost of Long-Term Care institution or other
-institutionalized care for a period of sixty (60) months.
-
-iii)
-
-The specific purpose for which the assets were transferred and the reason the
-transfer was necessary and the reason there was no alternative but to transfer
-the assets without fair consideration.
-
-Apportionment of penalty period between spouses
-a.
-
-If a transfer results in a period of ineligibility for an individual, and the individual's spouse
-becomes institutionalized and is otherwise eligible for Medical Assistance, the period of
-ineligibility shall be apportioned equally between the spouses.
-
-b.
-
-If one spouse dies or is no longer institutionalized, any months remaining in the period of
-ineligibility shall be assigned to the spouse who remains institutionalized.
-
-9.
-
-If the individual or the individual's spouse has transferred assets into a trust or is a beneficiary of
-a trust, the trust document shall be submitted to the Colorado Department of Health Care Policy
-and Financing to determine the effect of the trust on Medical Assistance eligibility.
-
-10.
-
-Notice
-
-11.
-
-a.
-
-The Colorado Department of Health Care Policy and Financing is an interested person
-according to 15-14-406, C.R.S. or a successor statute.
-
-b.
-
-As an interested party, the department shall be given notice of a hearing in cases in
-which Medical Assistance planning or Medical Assistance eligibility is set forth in the
-petition as a factor for requesting court authority to transfer property.
-
-Undue Hardship
-a.
-
-The period of ineligibility resulting from the imposition of the transfer or the trust
-provisions may be waived if denial of eligibility would create an undue hardship for an
-individual who is otherwise eligible. Undue hardship can be established if application of
-the transfer penalty would:
-i)
-
-deprive the individual of medical care such that the individual’s health or life
-would be endangered; or
-
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-
-ii)
-
-10 CCR 2505-10 8.100
-
-deprive the individual of food, clothing, shelter or other necessities of life.
-
-b.
-
-Undue hardship shall not exist when the application of the trust or transfer rules merely
-causes the individual inconvenience or when such application might restrict his or her
-lifestyle but would not put him or her at risk of serious deprivation.
-
-c.
-
-Notice of an undue hardship exception shall be given to the applicant or client. The
-Eligibility Site shall make a determination on the request within 15 working days from
-when the request is received. The Eligibility Site shall issue a notice of action on the
-determination of hardship. An adverse determination may be appealed in accordance
-with the appeal process as described at Section 8.057 of this volume.
-
-d.
-
-The facility in which an institutionalized individual is residing may file an undue hardship
-waiver application on behalf of the individual with the individual's or his or her personal
-representative's consent. Where the individual is unable to give consent and where the
-personal representative of the individual has a conflict of interest concerning the
-particular circumstance giving rise to the period of ineligibility, the facility may request an
-undue hardship on behalf of the individual. An example of such a conflict of interest
-would be a situation where the personal representative who is also an agent under a
-power of attorney transfers property to himself or herself. The facility shall submit the
-undue hardship request to the Eligibility Site and give sufficient detail of the circumstance
-surrounding the conflict of interest and the information required below to the Eligibility
-Site. These provisions are not intended to change the Department’s requirements under
-Section 8.057 of the Department’s regulations as to who has standing to file an appeal.
-
-e.
-
-An individual or representative may request that the Eligibility Site waive a transfer
-penalty on the basis of undue hardship. The request shall be made in writing to the
-applicant’s or client’s Eligibility Site case worker. The individual making the request has
-the burden of proof and must provide clear and convincing evidence to substantiate the
-circumstances surrounding the transfer, attempts to recover the assets, and the impact of
-the denial of Medicaid payments for Long-Term Care services. The request and
-documentation shall include all of the following:
-
-f.
-
-i)
-
-the reason(s) for the transfer including the individual’s participation in the transfer
-or grant of legal authority to another that gave rise to the transfer, and the
-relationship between the transferor and transferee;
-
-ii)
-
-evidence to prove that the assets have been irretrievably lost and that all
-reasonable attempts made to recover the asset(s), including any legal actions
-and the results of the attempts, including but not limited to a request for an adult
-protection investigation (such as in a case of financial exploitation), filing a police
-report, or filing a civil action have been exhausted or have been or are being
-pursued; and,
-
-iii)
-
-documentation such as a notice of discharge or pending discharge from the
-facility and a physician’s statement detailing how the inability to receive nursing
-facility or community based services would result in the individual’s inability to
-obtain life-sustaining medical care or that the individual would not be able to
-obtain food, clothing or shelter.
-
-To the extent that the transferred assets are recovered pursuant to the attempts in (e)(ii)
-above, the individual shall reimburse Medicaid for the funds expended as a result of an
-approved undue hardship request.
-
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-
-g.
-
-12.
-
-2.
-
-If the transferee and the transferor of the assets for which the transfer penalty is being
-imposed are related parties there shall be a rebuttable presumption that the transferred
-assets are not irretrievably lost as required under (e)(ii) above. Related parties are
-described in Section 8.100.7.G.7.c.ii of these regulations.
-
-No period of ineligibility shall be assessed in any of the following circumstances:
-a.
-
-Convincing and objective evidence is provided that the individual intended to dispose of
-the resources either at fair market value or for other fair consideration.
-
-b.
-
-Convincing and objective evidence is presented proving that the resources were
-transferred exclusively for a purpose other than to qualify or remain eligible for Medical
-Assistance.
-
-c.
-
-All of the resources transferred without fair consideration have been returned to the
-individual.
-
-d.
-
-For assets transferred before February 8, 2006, the assets were transferred more than
-36 months prior to the date of application.
-
-e.
-
-For assets transferred before February 8, 2006, the penalty period has expired based on
-the following formula: The fair market value of the transferred asset is divided by the
-average cost of Long Term Care institution care in the state at the time of application and
-the resulting number of months of ineligibility has ended prior to the date of application.
-
-8.100.7.H.
-1.
-
-10 CCR 2505-10 8.100
-
-Life Estates
-
-Definitions
-a.
-
-“Fair Market Value” means the amount for which a property or interest in a property could
-reasonably be expected to sell on the open market.
-
-b.
-
-“Life Estate.” A life estate conveys upon a grantee certain rights in property measured by
-the life of the life estate holder or of some other person. The owner of a life estate has the
-right to possess the property, the right to use the property, the right to obtain profits from
-the property, and the right to sell the life estate interest in the property. The establishment
-of a life estate on a property results in the creation of two interests: a life estate interest
-and a remainder interest.
-
-c.
-
-“Remainder Interest” means an interest in property created at the time a life estate is
-established which gives the holder of the interest the right to ownership of the property
-upon the death of the life estate holder. An individual holding a remainder interest is free
-to sell his or her interest in the property unless the sale is restricted by the terms of the
-instrument which established the remainder interest.
-
-General Provisions
-a.
-
-Life Estates Established before July 1, 1995
-i)
-
-Transfer without fair consideration Treatment
-1)
-
-The establishment of a life estate before July 1, 1995 by an individual or
-individual’s spouse shall not be considered a transfer without fair
-consideration.
-
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-
-ii)
-
-Resource Treatment
-1)
-
-A life estate owned by an individual or individual’s spouse that was
-established on exempt property shall be considered to be an exempt
-resource.
-
-2)
-
-A life estate owned by an individual or individual’s spouse that was
-established on countable property shall be considered a countable
-resource.
-i)
-
-The value of the life estate shall be determined by using the
-methodology described at 8.100.7.H.3.
-
-3)
-
-A remainder interest held by an individual or individual’s spouse on
-exempt property shall be considered an exempt resource.
-
-4)
-
-A remainder interest held by an individual or individual’s spouse on
-countable property shall be considered a countable resource
-i)
-
-b.
-
-10 CCR 2505-10 8.100
-
-The value of the remainder interest shall be determined by using
-the methodology described at 8.100.7.H.4.a.
-
-Life Estates Established on or after July 1, 1995
-i)
-
-Transfer without fair consideration Treatment
-1)
-
-The establishment of a life estate on or after July 1, 1995 on property
-owned by an individual or individual’s spouse shall be considered a
-transfer without fair consideration if the life estate was established within
-the look-back period described at 8.100.7.F.2.b.
-a)
-
-2)
-
-For the purpose of determining the transfer without fair
-consideration penalty period, the amount of the transfer shall be
-based on the value of the remainder interest, as calculated using
-the methodology described at 8.100.7.H.4.a.
-
-The purchase of a life estate interest in a home not owned by an
-individual or individual’s spouse on or after April 1, 2006 within the lookback period described at 8.100.7.F.2.b. shall be considered a transfer
-without fair consideration unless the purchaser lives in the home for a
-period of at least twelve (12) consecutive months after the date of the
-purchase.
-a)
-
-For the purpose of determining the transfer without fair
-consideration penalty period, the amount of the transfer shall be
-the entire amount used to purchase the life estate.
-
-b)
-
-If the payment for the life estate exceeds the value of the life
-estate, as calculated using the methodology described at
-8.100.7.H.3, then the difference between the amount paid and
-the value of the life estate shall be considered to be a transfer
-without fair consideration.
-
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-
-ii)
-
-Resource Treatment
-1)
-
-A life estate owned by an individual or individual’s spouse that was
-established on exempt property shall be considered an exempt resource.
-
-2)
-
-A life estate owned by an individual or individual’s spouse that was
-established on countable property shall be considered a countable
-resource.
-a)
-
-A remainder interest held by an individual or individual’s spouse on
-exempt property shall be considered an exempt resource.
-
-5)
-
-A remainder interest held by an individual or individual’s spouse on
-countable property shall be considered a countable resource
-The value of the remainder interest shall be determined by using
-the methodology described at 8.100.7.H.4.
-
-Determining the Value of a Life Estate
-a.
-
-b.
-4.
-
-The value of the life estate shall be determined by using the
-methodology described at 8.100.7.H.3.a.
-
-3)
-
-a)
-3.
-
-10 CCR 2505-10 8.100
-
-The value of a life estate interest is calculated using the following method:
-i)
-
-Determine the fair market value of the property on which the life estate was
-established. The fair market value shall be obtained by using the most recent
-actual value reported by the county assessor or from the most recent property
-assessment notice. If the actual value is not shown on the property assessment
-notice, the assessed value shall be divided by the appropriate property
-assessment rate to obtain the market value.
-
-ii)
-
-Multiply the fair market value of the property by the “Life Estate” factor in Column
-1 from the Life Estate Table at 8.100.7.H.5, in this section, that corresponds to
-the life estate holder’s age as of his or her last birthday. The result is the value of
-the life estate interest.
-
-If a life estate was established on property held by spouses in joint tenancy, then the age
-of the youngest individual shall be used to calculate the value of the life estate.
-
-Determining the Value of a Remainder Interest
-a.
-
-The value of a remainder interest is calculated using the following method:
-i)
-
-Determine the fair market value of the property on which the remainder interest
-was established. The fair market value shall be obtained by using the most
-recent actual value reported by the county assessor or from the most recent
-property assessment notice. If the market value is not shown on the property
-assessment notice, the assessed value shall be divided by the appropriate
-property assessment rate to obtain the market value.
-
-ii)
-
-Multiply the fair market value of the property by the “Remainder” factor in Column
-2 from the Life Estate Table at 8.100.7.H.5, in this section, that corresponds to
-the life estate holder’s age as of his or her last birthday. The result is the value of
-the remainder interest.
-
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-
-b.
-5.
-
-10 CCR 2505-10 8.100
-
-If a life estate was established on property held by spouses in joint tenancy, then the age
-of the youngest individual shall be used to calculate the value of the remainder interest.
-
-Life Estate Table
-This rule incorporates by reference the Social Security life estate and remainder interest table
-effective April 1999 to the present. The incorporation of the table excludes later amendments, or
-editions of, the referenced material.
-The Social Security life estate and remainder interest tables are available at
-http://policy.ssa.gov/poms.nsf/lnx/0501140120
-Pursuant to § 24-4-103 (12.5), C.R.S., the Department maintains copies of the incorporated text
-in its entirety, available for public inspection during regular business hours at: Colorado
-Department of Health Care Policy and Financing, 1570 Grant Street, Denver, CO 80203. Certified
-copies of incorporated materials are provided at cost upon request.
-
-8.100.7.I.
-1.
-
-Annuities
-
-DEFINITIONS
-a.
-
-“Annuity” means a contract between an individual and a commercial company in which
-the individual invests funds and in return receives installments for life or for a specified
-number of years.
-
-b.
-
-“Annuitant” means an individual who is entitled to receive payments from an annuity.
-
-c.
-
-“Annuitization Period” means the period of time during which an annuity makes payments
-to an annuitant.
-
-d.
-
-“Annuitized” means an annuity that has become irrevocable and is making payments to
-an annuitant.
-
-e.
-
-“Assignable” means an annuity that can have its owner and/or annuitant changed.
-
-f.
-
-“Balloon Payment” means a lump sum equal to the initial annuity premium less any
-distributions paid out before the end of an annuitization period.
-
-g.
-
-“Beneficiary” means an individual or individuals entitled to receive any remaining
-payments from an annuity upon the death of the annuitant.
-
-h.
-
-“Department” means the Department of Health Care Policy and Financing, its
-successor(s), or its designee(s).
-
-i.
-
-“Irrevocable” means an annuity that cannot be canceled, revoked, terminated, or
-surrendered under any circumstances.
-
-j.
-
-“Non-assignable” means an annuity that cannot have its owner and/or annuitant changed
-under any circumstances.
-
-k.
-
-“Owner” means the person who may exercise the rights provided in an annuity contract
-during the life of the annuitant. An owner can generally name himself or herself or
-another person as the annuitant.
-
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-2.
-
-l.
-
-“Revocable” means an annuity that can be canceled, revoked, terminated, or
-surrendered.
-
-m.
-
-“Transaction” means:
-i)
-
-The purchase of an annuity;
-
-ii)
-
-The addition of principal to an annuity;
-
-iii)
-
-Elective withdrawals from an annuity;
-
-iv)
-
-Requests to change the distributions from an annuity;
-
-v)
-
-Elections to annuitize an annuity contract; or
-
-vi)
-
-Any other action taken by an individual that changes the course of payments
-made by an annuity or the treatment of income or principal of an annuity.
-
-Annuities purchased on or before June 30, 1995
-a.
-
-A revocable or irrevocable annuity established on or before June 30, 1995 is not a
-countable resource if it is annuitized and regular returns are being received by the
-annuitant.
-i)
-
-b.
-3.
-
-10 CCR 2505-10 8.100
-
-Payments from the annuity to the individual or individual’s spouse are income in
-the month received.
-
-A revocable or irrevocable annuity established on or before June 30, 1995 is a countable
-resource if it has not been annuitized.
-
-Annuities Established on or after July 1, 1995 but before February 8, 2006
-a.
-
-b.
-
-The purchase of an annuity shall be considered to be a transfer without fair consideration
-unless the following criteria are met:
-i)
-
-The annuity is purchased from a life insurance company or other commercial
-company that sells annuities as part of its normal course of business;
-
-ii)
-
-The annuity is annuitized for the individual or individual’s spouse;
-
-iii)
-
-The annuity is purchased on the life of the individual or individual’s spouse; and
-
-iv)
-
-The annuity provides payments for a period not exceeding the annuitant’s
-projected life expectancy based on life expectancy tables described at 8.100.7.J.
-
-To determine if a transfer without fair consideration has occurred in the purchase of an
-annuity, the Eligibility Site shall:
-i)
-
-Determine the date on which the annuity was purchased;
-
-ii)
-
-Determine the amount of money used to purchase the annuity and the length of
-the annuitization period;
-
-iii)
-
-Determine the age of the annuitant at the time the annuity was purchased; and
-
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-
-iv)
-
-4.
-
-Determine the life expectancy of the annuitant at the time the annuity was
-purchased using the appropriate life expectancy table described at 8.100.7.J.
-1)
-
-If the length of the annuitization period exceeds the annuitant’s life
-expectancy, then a transfer without fair consideration exists for the
-portion of the annuitization period that exceeds the annuitant’s life
-expectancy.
-
-2)
-
-If the total value of the annuity’s payments during the annuitization period
-is less than the original purchase price of the annuity, then the difference
-shall be considered to be a transfer without fair consideration.
-
-3)
-
-If the total value of the annuity’s payments during the annuitization period
-is equal to or greater than the original purchase price of the annuity, then
-the purchase of the annuity shall not be considered to be a transfer
-without fair consideration. However, any payments made by the annuity
-shall be considered to be countable income in the month received.
-
-4)
-
-If the annuity was purchased more than 36 months before the date of
-application for Medicaid, then there is no transfer without fair
-consideration penalty period. However, any payments made by the
-annuity shall be considered to be countable income in the month
-received.
-
-Annuities Established on or after April 1, 1998 but before February 8, 2006
-a.
-
-The Eligibility Site shall determine the Minimum Monthly Maintenance Needs Allowance
-(MMMNA) of the community spouse, if applicable.
-i)
-
-b.
-
-c.
-
-If the monthly payment amount provided by the annuity to the community spouse
-exceeds the MMMNA, then the amount of the annuity which causes the monthly
-annuity payment to exceed the MMMNA shall be considered to be a transfer
-without fair consideration in determining the institutionalized spouse’s eligibility.
-This applies only to the extent that the transferred amount causes the
-Community Spouse Resource Allowance to exceed the maximum.
-
-The Eligibility Site shall determine if the Individual is receiving substantially equal
-installments from the annuity for the annuitization period of the annuity.
-i)
-
-If the annuity is not paid in substantially equal installments, then the original
-purchase price of the annuity shall be considered to be a transfer without fair
-consideration.
-
-If the annuity was purchased more than 36 months before the date of application for
-Medicaid, then there is no transfer without fair consideration penalty period.
-i)
-
-5.
-
-10 CCR 2505-10 8.100
-
-Any payments made by the annuity shall be considered to be countable income
-in the month received.
-
-Annuities Purchased on or after February 8, 2006
-a.
-
-As a condition of Medicaid eligibility, at the time of application or redetermination, an
-applicant or his or her spouse for Medicaid Long-Term Care services shall disclose any
-interest that the Medicaid applicant or his or her spouse has in an annuity.
-
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-i)
-b.
-
-10 CCR 2505-10 8.100
-
-A complete copy of the annuity contract, including the most recent beneficiary
-designation, shall be provided to the eligibility site.
-
-By providing Medicaid Long-Term Care services, the Department shall be a remainder
-beneficiary of any annuity in which an individual or individual’s spouse has an interest.
-The purchase of the annuity shall not be considered to be a transfer without fair
-consideration if:
-i)
-
-The Department is named as the remainder beneficiary in the first position for the
-total amount of medical assistance paid on behalf of the individual; or
-
-ii)
-
-The Department is named as the remainder beneficiary in the next position after
-the community spouse or minor or disabled child.
-
-iii)
-
-This provision shall not apply to annuities that are revocable and/or assignable.
-
-c.
-
-The Eligibility Site shall notify the issuer of the annuity that the Department is a preferred
-remainder beneficiary in the annuity for medical assistance provided to the
-institutionalized individual. This notice shall include a statement requiring the issuer to
-notify the Eligibility Site of any changes in the amount of income or principal that is being
-withdrawn from the annuity or any other transactions, as defined at 8.100.7.I.1.,
-regardless of when the annuity was purchased.
-
-d.
-
-If the Department is not named on the annuity as a remainder beneficiary, then the value
-of funds used to purchase the annuity shall be deemed a transfer without fair
-consideration and shall be subject to the penalty period provisions described at
-8.100.7.F.
-i)
-
-e.
-
-This provision shall not apply to annuities that are revocable and/or assignable.
-
-Revocable Annuities
-i)
-
-A revocable annuity is a countable resource. The value of the annuity is the total
-value of the annuity principal plus any accumulated interest.
-a)
-
-ii)
-f.
-
-If the annuity includes a surrender charge or other financial penalty
-(other than tax withholding or a tax penalty) for withdrawing funds from
-the annuity, then the value of the annuity is the net amount the individual
-would receive upon full surrender of the annuity.
-
-Payments from a revocable annuity are not countable as income.
-
-Irrevocable Assignable Annuities
-i)
-
-An irrevocable assignable annuity is a countable resource. The value of the
-annuity is presumed to be the total value of the annuity principal plus any
-accumulated interest.
-a)
-
-An individual or individual’s spouse can rebut the presumption by
-providing documented offers from at least three companies who are
-active in the market for buying and selling annuities an annuity income
-streams. The value of the annuity shall then be the highest of the offers.
-
-b)
-
-Any payments from an irrevocable assignable annuity that is considered
-to be a countable resource are not considered to be countable income.
-
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-ii)
-
-An individual or individual’s spouse can rebut the presumption that an irrevocable
-assignable annuity is not a countable resource by providing documented offers
-from at least three companies who are active in the market for buying and selling
-annuities and annuity income streams stating their unwillingness or inability to
-purchase the annuity or annuity income stream.
-a)
-
-g.
-
-10 CCR 2505-10 8.100
-
-Any payments from an irrevocable assignable annuity that is not
-considered to be a countable resource are considered to be countable
-income in the month received.
-
-Irrevocable Non-Assignable Annuities
-i)
-
-An irrevocable non-assignable annuity is not considered to be a countable
-resource.
-
-ii)
-
-Payments from an irrevocable non-assignable annuity are considered countable
-income in the month received.
-
-iii)
-
-An irrevocable non-assignable annuity purchased by or for the benefit of a
-community spouse shall not be considered to be a transfer without fair
-consideration if:
-
-iv)
-
-v)
-
-1)
-
-The Department is named as the remainder beneficiary in the first
-position for the total amount of medical assistance paid on behalf of the
-institutionalized individual; or
-
-2)
-
-The Department is named as the remainder beneficiary in the second
-position after the community spouse or minor or disabled child and is
-named in the first position if such spouse or a representative of such
-child disposes of any such remainder without fair consideration.
-
-An irrevocable non-assignable annuity purchased by or for the benefit of an
-institutionalized individual shall not be considered to be a transfer without fair
-consideration if:
-1)
-
-The Department is named as the remainder beneficiary in the first
-position for the total amount of medical assistance paid on behalf of the
-institutionalized individual; or
-
-2)
-
-The Department is named as the remainder beneficiary in the second
-position after the community spouse or minor or disabled child and is
-named in the first position if such spouse or a representative of such
-child disposes of any such remainder without fair consideration.
-
-In addition to the requirements listed at 8.100.7.I.5.g.iv) for naming the
-Department as remainder beneficiary, an irrevocable non-assignable annuity
-purchased by or for the benefit of an institutionalized individual shall not be
-considered to be a transfer without fair consideration if the annuity meets any
-one of the following conditions:
-1)
-
-The annuity is considered either:
-a)
-
-An Individual Retirement Annuity as described in Section 408(b)
-of the Internal Revenue Code of 1986; or
-
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-
-b)
-
-2)
-
-3)
-
-vi)
-
-h.
-
-10 CCR 2505-10 8.100
-
-A deemed Individual Retirement Account under a qualified
-employer plan described in Section 408(q) of the Internal
-Revenue Code of 1986; or
-
-The annuity is purchased with proceeds from one of the following:
-a)
-
-An Individual Retirement Account as described in Section 408(a)
-of the Internal Revenue Code of 1986; or
-
-b)
-
-An account established by an employer or association of
-employers as described in Section 408(c) of the Internal
-Revenue Code of 1986; or
-
-c)
-
-A simple retirement account as described in Section 408(p) of
-the Internal Revenue Code of 1986; or
-
-d)
-
-A simplified employee pension plan as described in Section
-408(k) of the Internal Revenue Code of 1986; or
-
-e)
-
-A Roth IRA as described in Section 408A of the Internal
-Revenue Code of 1986; or
-
-The annuity meets all of the following requirements:
-a)
-
-The annuity is irrevocable and non-assignable; and
-
-b)
-
-The annuity is actuarially sound based on the life expectancy
-tables described at 8.100.7.J.; and
-
-c)
-
-The annuity provides for payments in equal amounts during the
-term of the annuity with no deferral and no balloon payments
-made.
-
-If an irrevocable non-assignable annuity is considered to be a transfer without fair
-consideration, then, for the purpose of calculating the transfer without fair
-consideration penalty period, the value that was transferred shall be the amount
-of funds used to purchase the annuity.
-
-Annuity Transactions
-i)
-
-If an Individual or individual’s spouse undertakes any transaction, as defined at
-8.100.7.I.1. which has the effect of changing the course of payments to be made
-by an annuity or the treatment of income or principal of the annuity, such a
-transaction shall be deemed to be a transfer without fair consideration,
-regardless of when the annuity was originally purchased. For the purpose of
-calculating the transfer without fair consideration penalty period, the value that
-was transferred shall be the amount used to purchase the annuity.
-a)
-
-Routine changes such as a notification of an address change or death or
-divorce of a remainder beneficiary are excluded from treatment as a
-transfer without fair consideration.
-
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-8.100.7.J.
-
-10 CCR 2505-10 8.100
-
-b)
-
-Changes which occur based on the terms of the annuity which existed
-before February 8, 2006 and which do not require a decision, election, or
-action to take effect are excluded from treatment as a transfer without
-fair consideration.
-
-c)
-
-Changes which are beyond the control of the individual, such as a
-change in law, a change in the policies of the annuity issuer, or a change
-in terms based on other factors, such as the annuity issuer’s financial
-condition, are excluded from treatment as a transfer without fair
-consideration.
-
-Life Expectancy Tables
-
-This rule incorporates by reference the Social Security Office of the Chief Actuary Period Life
-Table 2011 for both males and females. The incorporation of the table excludes later
-amendments, or editions of, the referenced material.
-The Social Security Office of the Chief Actuary Period Life Table 2011 is available at
-www.ssa.gov/oact/STATS/table4c6.html.
-Pursuant to § 24-4-103 (12.5), C.R.S., the Department maintains copies of the incorporated text
-in its entirety, available for public inspection during regular business hours at: Colorado
-Department of Health Care Policy and Financing, 1570 Grant Street, Denver, CO 80203. Certified
-copies of incorporated materials are provided at cost upon request.
-8.100.7.K.
-Spousal Protection - Treatment of Income and Resources for Institutionalized
-Spouses
-1.
-
-The spousal protection regulations apply to married couples where one spouse is institutionalized
-or likely to be institutionalized for at least 30 consecutive days and the other spouse remains in
-the community. Being a community spouse does not prohibit Medicaid eligibility if all criteria are
-met. The community spouse resource allowance does not supersede the Medicaid eligibility
-criteria.
-
-2.
-
-For purposes of spousal protection, an institutionalized spouse is an individual who:
-
-3.
-
-a.
-
-Begins a stay in a medical institution or nursing facility on or after September 30, 1989, or
-
-b.
-
-Is first enrolled as a Medical Assistance client in the Program of All Inclusive Care for the
-Elderly (PACE) on or after October 10, 1997, or
-
-c.
-
-Receives Home and Community Based Services on or after July 1, 1999; and
-
-d.
-
-Is married to a spouse who is not in a medical institution or nursing facility; but does not
-include any such individual who is not likely to meet the requirements of subparagraphs
-8.100.7.K.2.a thru c for at least 30 consecutive days.
-
-A community spouse is defined as the spouse of an institutionalized spouse.
-
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-8.100.7.L.
-
-10 CCR 2505-10 8.100
-
-Assessment and Documentation of The Couple's Resources
-
-An assessment of the total value of the couple’s resources shall be completed at the time of initial
-Medical Assistance application or when requested by either spouse of a married couple. All nonexempt resources owned by a married couple are counted, whether owned jointly or individually.
-There are no exceptions for legal separation, pre-nuptial, or post-nuptial agreements. Once the
-applicant is approved, the Community Spouses’ resources are not reviewed again unless the
-Community Spouse applies for Medical Assistance.
-8.100.7.M.
-1.
-
-Calculation of the Community Spouse Resource Allowance
-
-A Community Spouse Resource Allowance (CSRA) shall be allocated based on the total
-resources owned by the couple as of the time of Medical Assistance application. The CSRA is
-established at intake only, and; once approved the community spouse’s resources are not
-considered again until the community spouse applies for Medical Assistance. This is true even if
-the community spouse becomes institutionalized but does not apply for Medical Assistance. In
-calculating the amount of the CSRA, resources shall not be attributed to the community spouse
-based upon state laws relating to community property or the division of marital property.
-For persons whose Medical Assistance application is for an individual who meets the definition of
-an institutionalized spouse, the CSRA is the largest of the following amounts:
-a.
-
-The total resources of the couple but no more than the current maximum allowance
-which, changes each year beginning January 1st.; or
-
-b.
-
-The increased CSRA calculated pursuant to section 8.100.7.S; or
-
-c.
-
-The amount a court has ordered the institutionalized spouse to transfer to the community
-spouse for monthly support of the community spouse or a dependent family member.
-
-2.
-
-The resources allotted to the community spouse as the CSRA shall be transferred into the name
-of the community spouse and shall not be considered available to the institutionalized spouse.
-After the transfer of the CSRA to the community spouse, the income from these resources shall
-be attributed to the community spouse.
-
-3.
-
-The transfer of the CSRA shall be completed as soon as possible, but no later than the next
-redetermination when the community spouse becomes institutionalizes; whichever is earlier. If the
-transfer is not completed within this time period, the resources shall be attributed to the
-institutionalized spouse and shall affect his/her Medical Assistance eligibility. Verification of the
-transfer of assets to the community spouse shall be provided to the eligibility site.
-The institutionalized spouse may transfer the resources allotted to the community spouse as the
-CSRA to another person for the sole benefit of the community spouse.
-
-4.
-
-If the community spouse is in control of resources attributed to the institutionalized spouse, but
-fails to make such resources available for his/her cost of care, this fact shall not make the
-institutionalized spouse ineligible for Medical Assistance, where:
-a.
-
-The institutionalized spouse has assigned The Department any rights to support from the
-community spouse; or
-
-b.
-
-The institutionalized spouse lacks the ability to execute an assignment due to physical or
-mental impairment but The Department has the right to bring a support proceeding
-against the community spouse without such assignment; or
-
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-
-c.
-
-8.100.7.N.
-
-10 CCR 2505-10 8.100
-
-The eligibility site determines that the denial of eligibility would work an undue hardship
-upon the institutionalized spouse. For the purposes of this subparagraph, undue hardship
-means that an institutionalized spouse, who meets all the Medical Assistance eligibility
-criteria except for resource eligibility, has no alternative living arrangement other than the
-medical institution or Long Term Care institution.
-Treatment of the Home and Other Exempt Resources
-
-The CSRA shall not include the value of exempt resources including the home. It is not necessary for the
-home to be transferred to the community spouse. The rules regarding countable and exempt resources
-can be found in the section 8.100.5. However, for Spousal Protection there is no limit to the value of
-household goods and personal effects and one automobile.
-8.100.7.O.
-
-Determination of the Institutionalized Spouse’s Income and Resource Eligibility
-
-1.
-
-The institutionalized spouse is resource eligible for Medical Assistance when the total resources
-owned by the couple are at or below the amount of the Community Spouse Resource Allowance
-plus the Medical Assistance resource allowance for an individual of $2,000.
-
-2.
-
-The eligibility site shall determine whether the institutionalized spouse is income eligible for
-Medical Assistance. The institutionalized spouse shall be income eligible if his/her gross income
-is at or below the Medical Assistance income limit for recipients of long-term care. If an income
-trust is used the trust must be established before the MIA is calculated.
-
-8.100.7.P.
-
-Attribution of Income
-
-During any month in which a spouse is institutionalized, the income of the community spouse shall not be
-deemed available to the institutionalized spouse except as follows:
-1.
-
-If payment of income from resources is made solely in the name of either the institutionalized
-spouse or the community spouse, the income shall be considered available only to the named
-spouse.
-
-2.
-
-If payment of income from resources is made in the names of both the institutionalized spouse
-and the community spouse, one-half of the income shall be considered available to each spouse.
-
-3.
-
-If payment of income is made in the names of the institutionalized spouse or the community
-spouse, or both, and to another person or persons, the income shall be considered available to
-each spouse in proportion to the spouse’s interest.
-
-4.
-
-The above regulations of attribution of income are superseded if the institutionalized spouse can
-establish by a preponderance of the evidence that the ownership interests in the income are other
-than that provided in the regulations.
-
-8.100.7.Q.
-1.
-
-Calculating the Community Spouse’s Monthly Income Needs
-
-The community spouse's total minimum monthly needs shall be determined as follows:
-a.
-
-The current minimum monthly maintenance needs allowance (MMMNA), which is equal
-to 150% of the federal poverty level for a family of two and is adjusted in July of each
-year;
-
-b.
-
-An excess shelter allowance, in cases where the community spouse's expenses for
-shelter exceed 30% of the MMMNA. The excess shelter allowance is computed by
-adding (a) and (b) together:
-
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-
-2.
-
-10 CCR 2505-10 8.100
-
-i)
-
-The community spouse’s expenses for rent or mortgage payment including
-principal and interest, taxes and insurance, and, in the case of a condominium or
-cooperative, any required maintenance fee, for the community spouse’s principal
-residence; and
-
-ii)
-
-The larger of the following amounts: the standard utility allowance used by
-Colorado under U.S.C. 2014(e) of Title 7; or the community spouse’s actual,
-verified, utility expenses. A utility allowance shall not be allowed if the utility
-expenses are included in the rent or maintenance charge, which is paid by the
-community spouse.
-
-iii)
-
-The excess shelter allowance is the amount, if any, that exceeds 30% of the
-MMMNA.
-
-An additional amount may be approved for the following expenses:
-a.
-
-b.
-
-Medical expenses of the community spouse or dependent family member for necessary
-medical or remedial care. Each medical or remedial care expense claimed for deduction
-must be documented in a manner that describes the service, the date of the service, the
-amount of the cost incurred, and the name of the service provider. An expense may be
-deducted only if it is:
-i)
-
-Provided by a medical practitioner licensed to furnish the care;
-
-ii)
-
-Not subject to payment by any third party, including Medical Assistance and
-Medicare;
-
-The cost of Medicare, Long Term Care insurance, and health insurance premiums. A
-health insurance premium may be allowed in the month the premium is paid or may be
-prorated and allowed for the months the premium covers. This allowance does not
-include payments made for coverage which is:
-i)
-
-Limited to disability or income protection coverage;
-
-ii)
-
-Automobile medical payment coverage;
-
-iii)
-
-Supplemental to liability insurance;
-
-iv)
-
-Designed solely to provide payments on a per diem basis, daily indemnity or nonexpense-incurred basis; or
-
-v)
-
-Credit life and/or accident and health insurance.
-
-3.
-
-If either spouse establishes that the community spouse needs income above the level provided
-by the minimum monthly maintenance needs allowance due to exceptional circumstances, which
-result in significant financial duress, such as loss of home and possessions due to fire, flood, or
-tornado, an additional amount may be substituted for the MMMNA if established through a fair
-hearing.
-
-4.
-
-The total that results from adding the current MMMNA and the excess shelter allowance shall not
-exceed the current maximum MMMNA which is $2,175.00 for the year 2001 and is adjusted by
-the Health Care Financing Administration in January of each year.
-
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-
-10 CCR 2505-10 8.100
-
-8.100.7.R.
-Calculating the Amount of Income to be Contributed by the Institutionalized
-Spouse for the Community Spouse's Monthly Needs
-1.
-
-The Monthly Income Allowance (MIA) is the amount of money necessary to raise the community
-spouse's income to the level of his/her monthly needs, and shall be obtained from the monthly
-income of the institutionalized spouse. For individuals who become institutionalized on or after
-February 8, 2006, all income of the institutionalized spouse that could be made available to the
-community spouse must be considered to have been made available to the community spouse
-before an MIA is allocated to the community spouse.
-
-2.
-
-The MIA shall be the amount by which the community spouse's minimum monthly needs, which is
-the MMMNA, exceed his/her income from sources other than the institutionalized spouse. The
-community spouse’s income shall be calculated by using the gross income less mandatory
-deduct ions for FICA and Medicare tax.
-
-3.
-
-If a court has entered an order against the institutionalized spouse for monthly support of the
-community spouse, the MIA shall not be less than the monthly amount ordered by the court.
-
-4.
-
-The eligibility site shall make adjustments to the MMMNA and/or the MIA on a monthly basis for
-any continuing change in circumstances that exceeds $50 a month. Continuing changes of less
-than $50 in a month, and any infrequent or irregular changes, shall be considered at
-redetermination.
-
-8.100.7.S.
-1.
-
-Increasing the Community Spouse Resource Allowance
-
-The CSRA shall be increased above the maximum amount if additional resources are needed to
-raise the community spouse's monthly income to the level of the Minimum Monthly Maintenance
-Needs Allowance (MMMNA). In making this determination the items listed below are calculated in
-the following order:
-a.
-
-The community spouse's MMMNA;
-
-b.
-
-The community spouse’s own income; and
-
-c.
-
-The Monthly Income Allowance (MIA) contribution that the community spouse is eligible
-to receive from the institutionalized spouse.
-
-d.
-
-If the community spouse’s own income, and the Monthly Income Allowance contribution
-from the institutionalized spouse’s income is less than the Minimum Monthly Maintenance
-Needs Allowance, additional available resources shall be shifted to the community
-spouse to bring his/her income up to the level of the MMMNA. The additional resources
-necessary to raise the community spouse’s monthly income to the level of the MMMNA
-shall be based upon the cost of a single-premium lifetime annuity with monthly payments
-equal to the difference between the MMMNA and the community spouse’s income. The
-following steps shall be followed to determine the amount of resources to be shifted:
-i)
-
-The applicant shall obtain three estimates of the cost of an annuity that would
-generate enough income to make up the difference between the MMMNA and
-the combined community spouse’s income as described above.
-
-ii)
-
-The amount of the lowest estimate shall be used as the amount of resources to
-increase the CSRA.
-
-iii)
-
-The applicant shall not be required to purchase the annuity in order to have the
-CSRA increased.
-
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-
-e.
-8.100.7.T.
-1.
-
-2.
-
-The CSRA shall not be increased if the institutionalized spouse refuses to make the
-monthly income allowance (MIA) available to the community spouse.
-Deductions from Monthly Income of the Institutionalized Spouse
-
-During each month after the institutionalized spouse becomes Medical Assistance eligible,
-deductions shall be made from the institutionalized spouse's monthly income in the following
-order.
-a.
-
-A personal needs allowance or the client maintenance allowance as allowed by program
-eligibility.
-
-b.
-
-A Monthly Income Allowance (MIA) for the community spouse, but only to the extent that
-income of the institutionalized spouse is actually made available to, or for the benefit of,
-the community spouse;
-
-c.
-
-A family allowance for each dependent family member who lives with the community
-spouse.
-i)
-
-The allowance for each dependent family member shall be equal to one third of
-the amount of the MMMNA and shall be reduced by the monthly income of that
-family member.
-
-ii)
-
-Family member means dependent children (minor or adult), dependent parents
-or dependent siblings of either spouse that are residing with the community
-spouse and can be claimed by either the institutionalized or community spouse
-as a dependent for federal income tax purposes.
-
-d.
-
-Allowable deductions identified in section 8.100.7.V.
-
-e.
-
-If the institutionalized spouse fails to make his/her income available to the community
-spouse or eligible dependent family members in accordance with these regulations, that
-income shall be applied to the cost of care for the institutionalized spouse.
-
-f.
-
-No other deductions shall be allowed.
-
-8.100.7.U.
-1.
-
-10 CCR 2505-10 8.100
-
-Right to Appeal
-
-Both spouses shall be informed of the following:
-a.
-
-The amount and method by which the eligibility site calculated the community spouse
-resource allowance (CSRA), community spouse monthly income allowance (MIA), and
-any family allowance;
-
-b.
-
-The spouses' right to a fair hearing concerning these calculations;
-
-c.
-
-The eligibility site conclusions with respect to the spouses' ownership and availability of
-income and resources, and the spouses' right to a fair hearing concerning these
-conclusions.
-
-If either spouse establishes that the community spouse needs income above the level provided
-by the minimum monthly maintenance needs allowance due to exceptional circumstances, which
-result in significant financial duress, such as loss of home and possessions due to fire, flood, or
-tornado, an additional amount may be substituted for the MMMNA if established through a fair
-hearing.
-
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-
-3.
-
-Appeals from decisions made by the eligibility site shall be governed by the provisions under
-Recipient Appeals Protocols/Process at 8.058.
-
-8.100.7.V.
-1.
-
-10 CCR 2505-10 8.100
-
-Long-Term Care Institution Recipient Income
-
-Determination of Income and Communication between the Long-Term Care institution and the
-Eligibility Site Using the AP-5615 Form for Patient Payment
-a.
-
-Sections I, II and IV of the AP-5615 form are to be completed by the Long-Term Care
-institution for all admissions, readmissions, transfers to and from another payer source,
-including private pay and Medicare, discharges, deaths, changes in income and/or
-patient payment, medical leaves of absence and non-medical/programmatic leave in
-excess of 42 days combined per calendar year.
-
-b.
-
-The initial determination of resident income for patient payment shall be made by the
-Eligibility Site. The Eligibility Site shall notify the Long-Term Care institution of current
-resident income.
-
-c.
-
-On receipt of AP-5615 form, the Eligibility Site will, within five working days:
-i)
-
-d.
-
-e.
-
-For an admission, a readmission or a transfer from/to private pay, Medicare, or
-another payer source:
-1)
-
-Verify and correct, if necessary, data entered by the Long-Term Care
-institution.
-
-2)
-
-List and/or verify the resident's monthly income adjustments and/or
-Long-Term Care Insurance benefit payments; and compute patient
-payment. Provide the completed AP-5615 to the Long-Term Care
-institution.
-
-3)
-
-Correct the automated system to indicate the Long-Term Care institution
-name and provider number and to reflect the current distribution of
-income. Submit the AP-5615 form to the Department.
-
-For change in patient payment with respect to changes in resident income:
-i)
-
-Verify changes in resident income, and correct if necessary. All such corrections
-must be initialed,
-
-ii)
-
-Compute patient payment and provide the completed AP-5615 to the Long-Term
-Care institution.
-
-For change in patient payment with respect to the post-eligibility treatment of income, the
-Eligibility Site shall:
-i)
-
-Review the AP-5615 form for Medicare part B premium deduction allowances for
-the first two months of admission.
-
-ii)
-
-If client is already on the Medicare Buy-In program for Medicare part B, do not
-adjust patient payment on AP-5615 form for the Medicare premium deduction. If
-client is not on the Buy-In program, adjust AP-5615 form for the Medicare
-premium deduction for the first two months of Long-Term Care institution
-eligibility.
-
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-
-iii)
-
-f.
-
-g.
-
-h.
-
-i.
-
-10 CCR 2505-10 8.100
-
-If the client has a Medicare D premium, the Eligibility Site shall use the amount
-as an income adjustment/deduction in the patient payment calculation and
-complete the AP-5615 form.
-
-For resident leave of absence:
-i)
-
-Non-Medical/Programmatic Leave. When combined non-medical/programmatic
-days in excess of 42 days are reported, verify adherence to the restrictions and
-conditions of section 8.482.44.
-
-ii)
-
-Medical Leave/Hospitalization. Verify that the patient payment is apportioned
-correctly between the nursing facility and the hospital so that no Medicaid
-payment is requested for the period. See also section 8.482.43.
-
-iii)
-
-The nursing facility may wait until the end of the month to complete the AP-5615
-form for an ongoing hospitalization.
-
-For change in payer status:
-i)
-
-If Medicare or insurance is a primary payer during the month, verify the nursing
-facility’s calculation of the patient payment.
-
-ii)
-
-Complete and provide the AP-5615 to the nursing facility.
-
-For discharge or death of resident:
-i)
-
-Verify the date of death or discharge, and verify the correct patient payment
-including the resident's monthly income for the discharged month, and the
-amount calculated by per diem. All corrections must be initialed.
-
-ii)
-
-Note if the resident entered another Long-Term Care institution and, if so, enter
-the name of the new Long-Term Care institution in the system.
-
-iii)
-
-In the event the resident may return to the same facility, the AP-5615 form may
-be completed at the end of the month for discharges due to hospitalization.
-
-For discontinuation of Long-Term Care eligibility:
-i)
-
-Initiate and send an AP-5615 form to the Long-Term Care institution within 5
-working days of the date of determination that the client’s eligibility will be
-discontinued. Indicate the date the discontinuation will be effective.
-
-j.
-
-Failure to provide a correct and timely AP-5615 to the Long-Term Care institution may
-result in the refusal of the Department to reimburse such Long-Term Care institution care.
-The AP-5615 form is required in order for a Prior Authorization Request (PAR) to be
-issued for Long-Term Care institution claim reimbursement.
-
-k.
-
-General Instructions:
-i)
-
-The AP-5615 form must be verified and a signed AP-5615 form returned to the
-Long-Term Care institution.
-
-ii)
-
-The AP-5615 form must be signed and dated by the director of the Eligibility Site
-or by his/her designee.
-
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-
-iii)
-
-l.
-
-2.
-
-3.
-
-10 CCR 2505-10 8.100
-
-AP-5615 forms may be initiated by either the Long-Term Care institution or
-Eligibility Site. If the Eligibility Site is aware of information requiring a change in
-financial arrangements of a resident, and a new AP-5615 form is not forthcoming
-from the Long-Term Care institution, the Eligibility Site may initiate the revision to
-the AP-5615 form. In such case, one copy of the AP-5615 form showing the
-changes will be sent to the Long-Term Care institution.
-
-The Department may deduct excess payments from the Eligibility Site administrative
-reimbursement as stated in the Colorado Department of Human Services Finance Staff
-Manual, Volume 5 if the Eligibility Site fails to:
-i)
-
-Perform the duties as detailed in this section; or
-
-ii)
-
-Adhere to the limitations on a reduced patient payment; as detailed in section
-8.100.7.V.4; or
-
-iii)
-
-Notify the Long-Term Care institution within 5 working days of any changes in
-resident income, provided the Long-Term Care institution is not authorized to
-receive the resident's income; and excessive Medicaid funds are paid to the
-Long-Term Care institution as a result of this negligence.
-
-Collection of Patient Payment
-a.
-
-It shall be the responsibility of the Long-Term Care institution to collect from the client, or
-from the client's family, conservator or administrator, the patient payment, which is to be
-applied to the cost of client care. The Department is not responsible for any deficiency in
-patient payment accounts, due to failure of the Long-Term Care institution to collect such
-income.
-
-b.
-
-If, however, the Long-Term Care institution is unable to collect such funds, through
-refusal of the resident or the resident's family, conservator, administrator or responsible
-party to release such income, the Long-Term Care institution shall immediately notify the
-Eligibility Site.
-
-c.
-
-When notified by the Long-Term Care institution of the refusal of the client or the client's
-family, conservator administrator or responsible party to pay the patient payment due, the
-Eligibility Site shall immediately contact the refusing party. If, after such contact, the party
-still refuses to release such income, the action shall be deemed a failure to cooperate,
-and the Eligibility Site shall proceed to discontinue Medicaid benefits for the resident.
-
-Calculation of Patient Payment
-a.
-
-Specific instructions for computing the patient payment amount are contained in this
-volume under The “Status of Long-Term Care institution Care” Form, AP-5615
-
-b.
-
-Once an applicant for Nursing Facility Medical Assistance has been determined eligible
-for Medical Assistance, the Eligibility Site shall determine the patient payment due to the
-Nursing Facility which is to be applied to the Medicaid reimbursement for the cost of care.
-That patient payment is calculated by:
-i)
-
-Determining all applicable income of the recipient
-
-ii)
-
-Deducting all applicable allowable monthly income adjustments, which include:
-1)
-
-Personal Needs Allowance
-
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-
-c.
-
-10 CCR 2505-10 8.100
-
-2)
-
-If applicable, Monthly Income Allowance for the community spouse.
-
-3)
-
-If applicable, Family Dependent Allowance
-
-4)
-
-If applicable, Home Maintenance Allowance
-
-5)
-
-If applicable, Trustee/Maintenance Fees: actual fees, with a maximum of
-$20 per month
-
-6)
-
-If applicable, Mandatory Income Tax Withheld
-
-7)
-
-Mandatory garnishments repaying Federal assistance overpayment
-
-8)
-
-Medical or remedial care expenses that are not subject to payment by a
-third party:
-a)
-
-Medicare Part B Premium expenses, if applicable, are deductible
-only for the first and second month in the Nursing Facility.
-
-b)
-
-Medicare Part D Premium expenses, if applicable, are ongoing
-deductions.
-
-c)
-
-Other medical and remedial expenses covered under the
-Nursing Facility PETI (NF PETI) program are not deductible. NF
-PETI-approved expenses are allowed only for residents with a
-patient payment, but do not change the patient payment amount.
-For NF PETI, see the Section 8.482.33 in this volume “Post
-Eligibility Treatment of Income”.
-
-Long-Term Care Insurance
-Long-Term Care insurance payments are not counted as income for eligibility purposes.
-However, they are income available for a patient payment. The patient payment shall
-include the client’s income after the allowable deductions and any Long-Term Care
-insurance payments for the month. In the event that the patient payment is greater than
-the cost of care, the Long-Term Care insurance payment shall be applied before the
-client’s income.
-i)
-
-If Long-Term Care insurance is received for the month, and:
-1)
-
-d.
-
-If, after all deductions, the client has income available for a patient
-payment, add this to the amount of the Long-Term Care insurance to
-determine the total patient payment.
-a)
-
-If the total amount is greater that the allowable cost of care, the
-Long-Term Care insurance is applied before the client’s income,
-or;
-
-b
-
-If after all deductions, the client does not have income available
-for the patient payment, only the Long-Term Care insurance
-payment is used.
-
-Personal Needs Allowances
-i)
-
-Non-Veteran related personal needs allowance
-
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-
-1)
-
-Prior to January 1, 2015 the personal needs allowance base amount is
-$50 per month.
-
-2)
-
-Effective January 1, 2015 the personal needs allowance base amount is
-$75 per month and will be adjusted annually at the same rate as the
-statewide average of the nursing facility per diem rate net of patient
-payment pursuant to C.R.S. § 25.5-6-202(9)(b)(I). Each yearly
-adjustment will set a new base amount.
-a)
-
-ii)
-
-10 CCR 2505-10 8.100
-
-The first annual rate adjustment to the new $75 base amount will
-occur on January 1, 2015.
-
-Veterans-related personal needs allowance
-Effective 07/01/91, the personal needs allowance shall be $90 per month for a
-veteran in a Long-Term Care institution who has no spouse or dependent child
-and who receives a non-service connected disability pension from the U.S.
-Veterans Administration. The personal needs allowance shall also be $90 per
-month for the widow(er) of a veteran with no dependent children.
-
-iii)
-
-1)
-
-Public Law requires that a veteran, without a spouse or dependent child,
-who enters a Long-Term Care institution have their veteran’s pension
-reduced to $90 which is to be reserved for their personal needs. This
-reduction in pension is not applicable to veteran’s who reside in a State
-Veteran’s Nursing facility. If a veteran, who does not reside in a State
-Veteran’s Nursing facility, receives a pension reduction of $90 he/she is
-allowed to apply this $90 to his/her personal needs allowance. It is not
-considered income toward the patient payment. The same regulation
-applies to a widow of a veteran without any dependent children.
-
-2)
-
-To verify if those veterans residing in State Veteran’s Nursing facilities
-are receiving a non-service connected pension you may request their
-award letter from the Department of Veterans Affairs or call the
-Department of Veterans Affairs and verify through contact. If they are
-receiving any amount in a non-service connected pension they are
-entitled to a $90 personal needs allowance so long as they do not have a
-spouse or dependent child. The same regulation applies to a widow of a
-veteran without any dependent children.
-
-For aged, disabled, or blind Long-Term Care institution recipients engaged in
-income-producing activities, an additional amount of $65 per month plus one-half
-of the remaining gross income may be retained by the individual.
-
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-
-iv)
-
-e.
-
-f.
-
-10 CCR 2505-10 8.100
-
-Effective September 15, 1994, aged, disabled, or blind Long-Term Care
-institution residents, HCBS or PACE recipients with mandatory withholdings from
-earned or unearned income to cover federal state, and local taxes may have an
-additional amount included as a deduction from the patient payment. The patient
-payment deduction must be for a specific accounting period when the taxes are
-owed and expected to be withheld from income or paid by the individual in the
-accounting period. The Eligibility Site must verify that the taxes were withheld. If
-the taxes are not paid, the Eligibility Site must establish a recovery. The
-deduction is also applicable for any Federal pensions with mandated tax
-withholdings from unearned income despite the individual earner being
-institutionalized. All other pensions will discontinue the tax withholding once
-notified that the recipient is receiving institutionalized care through Medicaid, thus
-signifying that the withholding was not mandatory. This deduction does not apply
-to individuals who have elected to have taxes withheld from their earnings as a
-means to receiving a greater tax refund.
-
-The reserve specified in section 8.100.7.V.3.d.iii. of this volume shall apply to Long-Term
-Care institution residents who are engaged in income-producing activities on a regular
-basis. Types of income-producing activities include:
-i)
-
-work in a sheltered workshop or work activity center;
-
-ii)
-
-“protected employment” which means the employer gives special privileges to
-the individual;
-
-iii)
-
-an activity that produced income in connection with a course of vocational
-rehabilitation;
-
-iv)
-
-employment training sessions;
-
-v)
-
-activities within the facility such as crafts products and facility employment.
-
-In determining the personal needs reserve amount for Long-Term Care institution
-residents engaged in income-producing activities:
-i)
-
-The personal needs allowance is reserved from earned income only when the
-person has insufficient unearned income to meet this need;
-
-ii)
-
-In determining countable earned income of a Long-Term Care institution
-resident, the following rules shall apply:
-
-iii)
-
-1)
-
-$65 shall be subtracted from the gross earned income.
-
-2)
-
-The result shall be divided in half.
-
-3)
-
-The remaining income is the countable earned income and shall be
-considered in determining the patient payment.
-
-When the personal needs allowance is reserved from unearned income, the
-additional reserve is computed based on the total gross earned income.
-
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-CODE OF COLORADO REGULATIONS
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-
-g.
-
-10 CCR 2505-10 8.100
-
-Other Deductions Reserved from Recipient's Income:
-i)
-
-In the case of a married, long-term care recipient who is institutionalized in a
-Long-Term Care institution and who has a spouse (and, in some cases, other
-dependent family members) living in the community, there are “spousal
-protection” rules which permit the contribution of the institutionalized spouse's
-income toward their living expenses. See section 8.100.7.K.
-
-ii)
-
-For a Long-Term Care institution recipient with no family at home, an amount in
-addition to the personal needs allowance may be reserved for maintenance of
-the recipient's home for a temporary period, not to exceed 6 months, if a
-physician has certified that the person is likely to return to his/her home within
-that period.
-This additional reserve from recipient income is referred to as Home
-Maintenance Allowance and the amount of the deduction must be based on
-actual and verified shelter expenses such as mortgage payments, taxes, utilities
-to prevent freeze, etc.
-The Home Maintenance Allowance:
-1)
-
-Prior to July 1, 2018 shall not exceed the total of the current shelter and
-utilities components of the applicable standard of assistance (OAP for
-aged recipients; AND/SSI-CS or AB/SSI-CS for disabled or blind
-recipients).
-
-2)
-
-Beginning July 1, 2018
-a)
-
-The Home Maintenance Allowance shall not exceed the Home
-Maintenance Allowance Maximum described in this section.
-Claimable utility costs will be limited to the lessor of the following
-amounts:
-The standard utility allowance used by Colorado under 7 U.S.C.
-2014(e) (2018), which is hereby incorporated by reference.
-The incorporation of 7 U.S.C. 2014(e) (2018) excludes later
-amendments to, or editions of, the referenced material. Pursuant
-to § 24-4-103(12.5), C.R.S., the Department maintains copies of
-this incorporated text in its entirety, available for public inspection
-during regular business hours at: Colorado Department of Health
-Care Policy and Financing, 1570 Grant Street, Denver CO
-80203. Certified copies of incorporated materials are provided at
-cost upon request.
-Or;
-The individual’s actual, verified, utility expenses.
-
-b)
-
-The Maximum Home Maintenance Allowance is The Individual
-Needs Standard minus 105% Federal Poverty Limit (FPL) for a
-household of 1, rounded to the nearest whole dollar, and is
-determined as follows:
-
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-(1)
-
-The Department will calculate the Individual Needs
-Standard by dividing the Federal Minimum Monthly
-Maintenance Needs Allowance maximum by the Federal
-Minimum Monthly Maintenance Needs Allowance
-(MMMNA), described at 8.100.7.Q, which is in place on
-January 1st of each calendar year. The result of this
-division will be multiplied by 150% of FPL for a
-household of 1.
-
-(2)
-
-The Home Maintenance Maximum is determined by
-subtracting 150% FPL for a household of 1 from the
-Individual Needs Standard and adding 30% of 150%
-FPL for a household of 1. The result will be rounded to
-the nearest whole dollar.
-
-h.
-
-The necessity for the deduction from a recipient's income specified in section 8.100.7.V.3
-shall be fully explained in the case record. Such additional reserve amount must be
-entered on the eligibility reporting form.
-
-i.
-
-As of July 1, 1988, an SSI cash recipient may continue to receive SSI benefits when
-he/she is expected to be institutionalized for three months or less. This provision is
-intended to allow temporarily institutionalized recipients to pay the necessary expenses to
-maintain the principal place of residence.
-
-j.
-
-4.
-
-10 CCR 2505-10 8.100
-
-i)
-
-Payments made under this continued benefit provision are not considered overpayments of SSI benefits if the recipient's stay is more than 90 days.
-
-ii)
-
-The amount of Supplemental Security Income (SSI) benefit paid to an
-institutionalized individual is deducted from gross income when computing the
-patient payment.
-
-When a nursing facility resident’s SSI is reduced due to institutionalization, the difference
-between the reduced SSI payment and the personal needs allowance amount shall be
-provided through the Adult Financial program so that the resident receives the full
-personal needs allowance.
-
-Reduction of the Patient Payment
-a.
-
-Patient payment may be reduced only under the following conditions:
-i)
-
-A resident's income is equal to or less than the personal needs allowance and
-there is no long term care insurance payment, in which case the patient payment
-is zero; or
-
-ii)
-
-A resident's income is equal to or less than the sum of all allowable and
-appropriate deductions, and there is no long term care insurance payment; or
-
-iii)
-
-A resident is admitted to the Long Term Care institution from his/her home and
-the resident's funds are committed elsewhere for that month; or
-
-iv)
-
-The resident is admitted from his/her home, where his/her funds were previously
-committed, to the hospital, and subsequently to the Long Term Care institution, in
-the same calendar month; or
-
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-b.
-
-5.
-
-6.
-
-10 CCR 2505-10 8.100
-
-v)
-
-The resident is discharged to his/her home, and the Eligibility Site determines
-that the income is necessary for living expenses; or
-
-vi)
-
-The resident is admitted from another Long Term Care institution or from private
-pay within the facility and has committed the entire patient payment for the month
-for payment of care already provided in the month of admission.
-
-vii)
-
-Medicare assesses a co-insurance payment for a QMB recipient; the recipient’s
-patient payment cannot be used for payment of Medicare co-insurance.
-
-Patient payment may not be waived in the following instances:
-i)
-
-Transfers between nursing facilities, except that the patient payment for the
-receiving facility may be waived if the patient payment has already been
-committed to the former nursing facility; or
-
-ii)
-
-Discharges from nursing facility to a hospital or other medical institution when
-Medicaid is paying for services in the medical institution; or
-
-iii)
-
-Changes from private pay within the facility and the patient payment is not
-already committed for care provided under private pay status; or
-
-iv)
-
-The death of the resident.
-
-c.
-
-The Eligibility Site shall verify and approve partial month patient payments due to
-transfers, discharges or death when calculated by the nursing facility based upon the
-nursing facility’s per diem rate.
-
-d.
-
-The amount of SSI benefits received by a person who is institutionalized is not
-considered when calculating patient payment.
-
-Responsibilities of the Eligibility Site Regarding the Personal Needs Fund
-a.
-
-It shall be the responsibility of the Eligibility Site to explain to the resident the various
-options for handling the personal needs monies, as well as the resident's rights to such
-funds. The resident has the option to allow the Long Term Care institution to hold such
-funds in trust.
-
-b.
-
-It shall be the responsibility of the Eligibility Site to assure that the Long Term Care
-institution properly transfers or disposes of the resident's personal needs funds within 30
-days of discharge from the Long Term Care institution, or transfer to another Long Term
-Care institution.
-
-c.
-
-The Eligibility Site shall notify the State Department if they become aware that a Long
-Term Care institution has retained personal needs funds more than 30 days after the
-death of a resident.
-
-For rules regarding post eligibility treatment of income, see the section in this volume titled “Post
-Eligibility Treatment of Income”
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-8.125
-
-10 CCR 2505-10 8.100
-
-PROVIDER SCREENING
-
-8.125.1
-
-DEFINITIONS.
-
-Managed Care Entity is defined at 42 CFR § 455.101.
-Ownership interest is defined at 42 CFR § 455.101.
-Person with an ownership or control interest is defined at 42 CFR § 455.101.
-Enrollment is defined as the process by which an individual or entity not currently enrolled as a Colorado
-Medicaid provider submits a provider application, undergoes any applicable screening, pays an
-application fee, as appropriate for the provider type, and is approved by the Department for participation
-in the Medicaid program. Entities that have never previously enrolled as Medicaid providers or whose
-enrollment was previously terminated and are not currently enrolled are required to enroll. The date of
-enrollment shall be considered the date that is communicated to the provider in communication from the
-Department or its fiscal agent verifying the provider’s enrollment in Medicaid.
-Revalidation is defined as the process by which an individual or entity actively enrolled as a Colorado
-Medicaid provider resubmits a provider application, undergoes a state-defined screening process, pays
-an application fee, as appropriate for the provider type, and is approved by the Department to continue
-participation in the Medicaid program.
-Disclosing Entity and Other Disclosing Entity are defined at 42 CFR § 455.101.
-8.125.2
-TYPES
-
-PROVIDERS DESIGNATED AS LIMITED CATEGORICAL RISK AND NEW PROVIDER
-
-8.125.2.A.
-Except as provided for in Section 8.125.2.B, provider types not designated as moderate
-or high categorical risk at Sections 8.125.3 or 8.125.4 shall be considered limited risk.
-8.125.2.B.
-The risk category for each provider type designated by CMS shall be the risk category for
-purposes of this rule regardless of whether a provider type may be listed in Sections 8.125.3 or
-8.125.4.
-8.125.3
-
-PROVIDERS DESIGNATED AS MODERATE CATEGORICAL RISK
-
-8.125.3.A.
-
-Emergency Transportation including ambulance service suppliers
-
-8.125.3.B.
-
-Community Mental Health Center
-
-8.125.3.C.
-
-Hospice
-
-8.125.3.D.
-
-Independent Laboratory
-
-8.125.3.E.
-
-Comprehensive Outpatient Rehabilitation Facility
-
-8.125.3.F.
-
-Physical Therapists, both individuals and group practices
-
-8.125.3.G.
-
-X-Ray Facilities
-
-8.125.3.H.
-
-Revalidating Home Health agencies
-
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-
-8.125.3.I.
-Revalidating Durable Medical equipment suppliers, including revalidating pharmacies that
-supply Durable Medical Equipment
-8.125.3.J.
-
-Revalidating Personal Care Agencies under the state plan
-
-8.125.3.K.
-
-Providers of the following services for HCBS waiver members:
-
-1.
-
-Alternative Care Facility
-
-2.
-
-Adult Day Services
-
-3.
-
-Assistive Technology, if the provider is revalidating
-
-4.
-
-Behavioral Programing
-
-5.
-
-Behavioral Therapies
-
-6.
-
-Behavioral Health Supports
-
-7.
-
-Behavioral Services
-
-8.
-
-Care Giver Education
-
-9.
-
-Children’s Case Management
-
-10.
-
-Children’s Habilitation Residential Program (CHRP)
-
-11.
-
-Community Connector
-
-12.
-
-Community Mental Health Services
-
-13.
-
-Community Transition Services
-
-14.
-
-Complementary and Integrative Health
-
-15.
-
-Day Habilitation
-
-16.
-
-Day Treatment
-
-17.
-
-Expressive Therapy
-
-18.
-
-Home Delivered Meals
-
-19.
-
-Home Modifications/Adaptations/Accessibility
-
-20.
-
-Independent Living Skills Training
-
-21.
-
-In-Home Support Services, if the provider is revalidating
-
-22.
-
-Intensive Case Management
-
-23.
-
-Massage Therapy
-
-24.
-
-Mentorship
-
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-10 CCR 2505-10 8.100
-
-25.
-
-Non-Medical Transportation
-
-26.
-
-Palliative/Supportive Care Skilled
-
-27.
-
-Peer Mentorship
-
-28.
-
-Personal Care/Homemaker Services, if the provider is revalidating
-
-29.
-
-Personal Emergency Response System/Medication Reminder/Electronic Monitoring
-
-30.
-
-Prevocational Services
-
-31.
-
-Professional Services
-
-32.
-
-Residential Habilitation Services
-
-33.
-
-Respite
-
-34.
-
-Specialized Day Rehabilitation Services
-
-35.
-
-Specialized Medical Equipment and Supplies, if the provider is revalidating
-
-36.
-
-Substance Abuse Counseling
-
-37.
-
-Supported Employment
-
-38.
-
-Supported Living Program
-
-39.
-
-Therapy and Counseling
-
-40.
-
-Transitional Living Program
-
-41.
-
-Youth Day Services
-
-8.125.3.L.
-
-Medicare Only Providers
-
-1.
-
-Independent Diagnostic Testing Facility
-
-2.
-
-Revalidating Medicare Diabetes Prevention Program Supplier
-
-3.
-
-Newly enrolling Opioid Treatment Program that has been fully and continuously certified
-by Substance Abuse and Mental Health Services Administration (SAMHSA) since
-October 24, 2018.
-
-4.
-
-Revalidating Opioid Treatment Program
-
-8.125.4
-
-PROVIDERS DESIGNATED AS HIGH CATEGORICAL RISK
-
-8.125.4.A.
-
-Enrolling DME Suppliers
-
-8.125.4.B.
-
-Enrolling Home Health Agencies
-
-8.125.4.C.
-
-Enrolling Personal Care Agencies providing services under the state plan
-
-8.125.4.D.
-
-Enrolling providers of the following services for HCBS waiver members:
-
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-
-1.
-
-Assistive Technology
-
-2.
-
-Personal Care/Homemaker Services
-
-3
-
-Specialized Medical Equipment and Supplies
-
-4
-
-In-Home Support Services
-
-8.125.4.E.
-
-Non-Emergent Medical Transportation
-
-8.125.4.F.
-
-Medicare Only Providers
-
-10 CCR 2505-10 8.100
-
-1.
-
-Enrolling Medicare Diabetes Prevention Program Supplier
-
-2.
-
-Enrolling Opioid Treatment Program that has not been fully and continuously certified by
-SAMHSA since October 24, 2018.
-
-8.125.4.G.
-Enrolling and revalidating providers for which the Department has suspended payments
-during an investigation of a credible allegation of fraud, for the duration of the suspension of
-payments.
-8.125.4.H.
-Enrolling and revalidating providers which have a delinquent debt owed to the State
-arising out of Medicare, Colorado Medical Assistance or other programs administered by the
-Department, not including providers which are current under a settlement or repayment
-agreement with the State.
-8.125.4.I.
-Providers that were excluded by the HHS Office of Inspector General or had their
-provider agreement terminated for cause by the Department, its contractors or agents or another
-State's Medicaid program at any time within the previous 10 years.
-8.125.4.J.
-Providers applying for enrollment within six (6) months from the time that the Department
-or CMS lifts a temporary enrollment moratorium on the provider’s enrollment type.
-8.125.5
-
-PROVIDERS WITH MULTIPLE RISK LEVELS
-
-8.125.5.A
-Providers shall be screened at the highest applicable risk level for which a provider meets
-the criteria. Providers shall only pay one application fee per location.
-8.125.6
-
-PROVIDERS WITH MULTIPLE LOCATIONS
-
-8.125.6.A.
-Providers must enroll separately each location from which they provide services. Only
-claims for services provided at locations that are enrolled are eligible for reimbursement.
-8.125.6.B.
-Each provider site will be screened separately and must pay a separate application fee.
-Providers shall only pay one application fee per location.
-8.125.7
-
-ENROLLMENT AND SCREENING OF PROVIDERS
-
-8.125.7.A.
-All enrolling and revalidating providers must be screened in accordance with
-requirements appropriate to their categorical risk level.
-8.125.7.B.
-Notwithstanding any other provision of the Colorado Code of Regulations, providers who
-provide services to Medicaid members as part of a managed care entity’s provider network who
-would have to enroll in order to participate in fee-for-service Medicaid must enroll with the
-Department and be screened as Medicaid providers.
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-
-8.125.7.C.
-Nothing in Section 8.125.7.B shall require a provider who provides services to Medicaid
-members as part of a managed care entity’s provider network to participate in fee-for-service
-Medicaid.
-8.125.7.D.
-All physicians or other professionals who order, prescribe, or refer services or items for
-Medicaid members, whether as part of fee-for-service Medicaid or as part of a managed care
-entity’s provider network under either the state plan, the Children’s Health Insurance Program, or
-a waiver, must be enrolled in order for claims submitted for those ordered, referred, or prescribed
-services or items to be reimbursed or accepted for the calculation of managed care rates by the
-Department.
-8.125.7.E.
-The Department may exempt certain providers from all or part of the screening
-requirements when certain providers have been screened, approved and enrolled or revalidated:
-1.
-
-By Medicare within the last 5 years, or
-
-2.
-
-By another state’s Medicaid program within the last 5 years, provided the Department
-has determined that the state in which the provider was enrolled or revalidated has
-screening requirements at least as comprehensive and stringent as those for Colorado
-Medicaid.
-
-8.125.7.F.
-The Department may deny a Provider’s enrollment or terminate a Provider agreement for
-failure to comply with screening requirements.
-8.125.7.G.
-The Department may terminate a Provider agreement or deny the Provider's enrollment if
-CMS or the Department determines that the provider has falsified any information provided on the
-application or cannot verify the identity of any provider applicant.
-8.125.8
-
-NATIONAL PROVIDER IDENTIFIER FOR ORDERING, PRESCRIBING, REFERRING
-
-8.125.8.A.
-As a condition of reimbursement, any claim submitted for a service or item that was
-ordered, referred, or prescribed for a Medicaid member must contain the National Provider
-Identifier (NPI) of the ordering, prescribing or referring physician or other professional.
-8.125.9
-
-VERIFICATION OF PROVIDER LICENSES
-
-8.125.9.A.
-If a provider is required to possess a license or certification in order to provide services or
-supplies in the State of Colorado, then that provider must be so licensed as a condition of
-enrollment as a Medicaid provider.
-8.125.9.B.
-Required licenses must be kept current and active without any current limitations
-throughout the term of the agreement.
-8.125.10
-
-REVALIDATION
-
-8.125.10.A.
-Actively enrolled providers must complete all requirements for revalidation at least every
-5 years as established by the Department, or upon request from the Department for an off cycle
-review.
-8.125.10.B.
-The date of revalidation shall be considered the date that the provider’s application was
-initially approved plus 5 years, or by an off-cycle request from the Department.
-
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-8.125.10.C.
-If a provider fails to comply with any requirement for revalidation by the deadlines
-established by Sections 8.125.10.A. or 8.125.10.B., the provider agreement may be terminated.
-In the event that the provider agreement is terminated pursuant to this section, any claims for
-dates of service submitted after deadlines established by Sections 8.125.10.A. or 8.125.10.B., are
-not reimbursable beginning on the day after the date indicated by Section 8.125.10.B.
-8.125.11
-
-SITE VISITS
-
-8.125.11.A.
-All providers designated as “moderate” or “high” categorical risks to the Medicaid
-program must consent to and pass a site visit before they may be enrolled or re-validated as
-Colorado Medicaid providers. The purpose of the site visit is to verify that the information
-submitted to the state department is accurate and to determine compliance with federal and state
-enrollment requirements.
-8.125.11.B.
-All enrolled providers who are designated as “moderate” or “high” categorical risks must
-consent to and pass an additional site visit after enrollment or revalidation. The purpose of the
-site visit is to verify that the information submitted to the state department is accurate and to
-determine compliance with federal and state enrollment requirements. Post-enrollment or postrevalidation site visits may occur anytime during the five-year period after enrollment or
-revalidation.
-8.125.11.C.
-All providers enrolled in the Colorado Medicaid program must permit CMS, its agents, its
-designated contractors, the State Attorney General’s Medicaid Fraud Control Unit or the
-Department to conduct unannounced on-site inspections of any and all provider locations
-8.125.11.D.
-
-All site visits shall verify the following information:
-
-1.
-
-Basic Information including business name, address, phone number, on-site contact
-person, National Provider Identification number and Employer Identification Number,
-business license, provider type, owner’s name(s), and owner’s interest in other medical
-businesses.
-
-2.
-
-Location including appropriate signage, utilities that are turned on, the presence of
-furniture and applicable equipment, and disability access where applicable and where
-clients are served at the business location.
-
-3.
-
-Employees with relevant training, designated employees who are trained to handle
-Medicaid billing, where applicable, and resources the provider uses to train employees in
-Medicaid billing where applicable.
-
-4.
-
-Appropriate inventory necessary to provide services for specific provider type.
-
-5.
-
-Other information as designated by the Department.
-
-8.125.11.E.
-The Department shall give the provider a report detailing the discrepancies or
-insufficiencies in the information disclosed by the provider and the criteria the provider failed to
-meet during the site visit.
-8.125.11.F.
-Providers that are found in full compliance shall be recommended for approval of
-enrollment or revalidation, subject to other enrollment or revalidation requirements.
-8.125.11.G.
-Providers who meet the vast majority of criteria in 8.125.11.D but have small number of
-minor discrepancies or insufficiencies shall have 60 days from the date of the issuance of the
-report in 8.125.11.E to submit documentation to the Department attesting that the provider has
-corrected the issues identified during the site visit.
-
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-
-1.
-
-If the provider submits attestation within the 60 day timeframe and has met requirements,
-then the provider shall be recommended for enrollment or revalidation, subject to the
-verification of other enrollment or revalidation requirements.
-
-2.
-
-If the provider fails to submit the attestation in 8.125.11.G.1 within the 60 day deadline,
-the Department may deny the provider’s application for enrollment or revalidation.
-
-3.
-
-If the provider submits an attestation within 60 days indicating that the provider is not fully
-compliant with criteria in 8.125.11.D, then the Department may,
-a.
-
-For existing providers, suspend the provider, until the provider demonstrates
-compliance in a subsequent site visit, conducted at the provider’s expense; or
-
-b.
-
-For new providers, deny the application and require the provider to restart the
-enrollment process.
-
-8.125.11.H.
-When site visits reveal major discrepancies or insufficiencies in the information provided
-in the enrollment application or a majority of the criteria described in 8.125.11.D are not met, the
-Department shall allow for an additional site visit for the provider.
-1.
-
-Additional site visits shall be conducted at the provider’s expense.
-
-2.
-
-The provider shall have 14 days from the date of the issuance of the report listed in
-8.125.11.E above to request an additional site visit.
-
-3.
-
-The Department shall deny or terminate enrollment or revalidation of any provider subject
-to 8.125.11.G who does not request an additional site visit within 14 days.
-
-4.
-
-If the Department determines that a provider is not in full compliance upon the additional
-site visit:
-a.
-
-for a revalidating provider, the Department shall immediately suspend the
-provider until a subsequent site visit demonstrates provider is in compliance.
-
-b.
-
-for an enrolling provider, deny the application and require the provider to restart
-the enrollment process.
-
-8.125.11.I.
-The Department shall deny or terminate enrollment or revalidation of any provider who
-refuses to allow a site visit, unless the Department determines the provider or the provider’s staff
-refused the on-site inspection in error. The provider must provide credible evidence to the
-Department that it refused the on-site inspection in error within in 7 days of the date of the
-issuance of the report in 8.125.11.E. Any provider who does not provide credible evidence to the
-Department that it refused the on-site inspection in error shall be denied or terminated from
-enrollment or revalidation.
-8.125.11.J.
-The Department shall deny an application or terminate a provider’s enrollment when an
-on-site inspection provides credible evidence that the provider has committed Medicaid fraud.
-8.125.11.K.
-
-The Department shall refer providers in 8.125.11.J to the State Attorney General.
-
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-8.125.12
-
-10 CCR 2505-10 8.100
-
-CRIMINAL BACKGROUND CHECKS AND FINGERPRINTING
-
-8.125.12.A.
-As a condition of provider enrollment, any person with an ownership or control interest in
-a provider designated as “high” categorical risk to the Medicaid program, must consent to criminal
-background checks and submit a set of fingerprints, in a form and manner to be determined by
-the Department.
-8.125.12.B.
-Any provider, and any person with an ownership or control interest in the provider, must
-consent to criminal background checks and submit a set of fingerprints, in a form and manner
-designated by the Department, within 30 days upon request from CMS, the Department, the
-Department’s agents, or the Department’s designated contractors.
-8.125.13
-
-APPLICATION FEE
-
-8.125.13.A.
-Except when exempted in Sections 8.125.13.C and 8.125.13.D, enrolling and revalidating providers must submit an application fee or a formal request for a hardship exemption
-with their application.
-8.125.13.B.
-The amount of the application fee is the amount calculated by CMS in accordance with
-42 CFR § 424.514(d).
-8.125.13.C.
-
-Application fees shall apply to all providers except:
-
-1.
-
-Individual practitioners
-
-2.
-
-Providers who have enrolled or re-validated in Medicare and paid an application fee
-within the last 12 months
-
-3.
-
-Providers who have enrolled or re-validated in another State’s Medicaid or Children’s
-Health Insurance Program and paid an application fee within the last 12 months provided
-that the Department has determined that the screening procedures in the state in which
-the provider is enrolled are at least as comprehensive and stringent as the screening
-procedures required for enrollment in Colorado Medicaid.
-
-8.125.13.D.
-The Department may exempt a provider, or group of providers, from paying the
-applicable application fee, through a hardship exemption request or categorical fee waiver, if:
-1.
-
-The Department determines that requiring a provider to pay an application fee would
-negatively impact access to care for Medicaid clients, and
-
-2.
-
-The Department receives approval from the Centers for Medicare and Medicaid Services
-to exempt the application fee.
-
-8.125.13.E.
-A provider may not be enrolled or revalidated unless the provider has either paid any
-applicable application fee or obtained an exemption described at Section 8.125.13.D.
-8.125.13.F.
-
-The application fee is non-refundable, except if submitted with one of the following:
-
-1.
-
-A request for hardship exemption described at Section 8.125.13.D, that is subsequently
-approved;
-
-2.
-
-An application that is rejected prior to initiation of screening processes;
-
-3.
-
-An application that is subsequently denied as a result of the imposition of a temporary
-moratorium as described at Section 8.125.14.
-
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-8.125.14
-
-10 CCR 2505-10 8.100
-
-TEMPORARY MORATORIA
-
-8.125.14.A.
-In consultation with CMS and HHS, the Department may impose temporary moratoria on
-the enrollment of new providers or provider types, or impose numerical caps or other limits on
-providers that the Department and the Secretary of HHS identify as being a significant potential
-risk for fraud, waste, or abuse, unless the Department determines that such an action would
-adversely impact Medicaid members’ access to medical assistance.
-8.125.14.B.
-Before imposing any moratoria, caps, or other limits on provider enrollment, the
-Department shall notify the Secretary of HHS in writing and include all details of the moratoria.
-8.125.14.C.
-The Department shall obtain the Secretary of HHS's concurrence with imposition of the
-moratoria, caps, or other limits on provider enrollment, before such limits shall take effect.
-8.125.15
-DISCLOSURES BY MEDICAID PROVIDERS, MANAGED CARE ENTITIES,
-MEDICARE PROVIDERS AND FISCAL AGENTS
-8.125.15.A.
-All providers, disclosing entities, fiscal agents, and managed care entities must provide
-the following federally required disclosures to the Department:
-1.
-
-The name and address of any entity (individual or corporation) with an ownership or
-control interest in the disclosing entity, fiscal agent, or managed care entity having direct
-or indirect ownership of 5 percent or more. The address for corporate entities must
-include, as applicable, primary business address, every business location, and P.O. Box
-address.
-
-2.
-
-For individuals: Date of birth and Social Security number
-
-3.
-
-For business entities: Other tax identification number for any entity with an ownership or
-control interest in the disclosing entity (or fiscal agent or managed care entity) or in any
-subcontractor in which the disclosing entity (or fiscal agent or managed care entity) has a
-5 percent or more interest.
-
-4.
-
-Whether the entity (individual or corporation) with an ownership or control interest in the
-disclosing entity (or fiscal agent or managed care entity) is related to another person with
-ownership or control interest in the disclosing entity as a spouse, parent, child, or sibling;
-or whether the entity (individual or corporation) with an ownership or control interest in
-any subcontractor in which the disclosing entity (or fiscal agent or managed care entity)
-has a 5 percent or more interest is related to another person with ownership or control
-interest in the disclosing entity as a spouse, parent, child, or sibling.
-
-5.
-
-The name of any other disclosing entity (or fiscal agent or managed care entity) in which
-an owner of the disclosing entity (or fiscal agent or managed care entity) has an
-ownership or control interest.
-
-6.
-
-The name, address, date of birth, and Social Security Number of any managing
-employee of the disclosing entity (or fiscal agent or managed care entity).
-
-7.
-
-The identity of any person who has an ownership or control interest in the provider, or is
-an agent or managing employee of the provider who has been convicted of a criminal
-offense related to that person’s involvement in any program under Medicare, Medicaid,
-Children’s Health Insurance Program or the Title XX services since the inception of these
-programs.
-
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-
-8.
-
-Full and complete information about the ownership of any subcontractor with whom the
-provider has had business transactions totaling more than $25,000 during the 12 month
-period ending on the date of the request; and any significant business transactions
-between the provider and any wholly owned supplier, or between the provider and any
-subcontractor, during the 5-year period ending on the date of the request.
-
-8.125.15.B.
-
-Disclosures from any provider or disclosing entity are due at any of the following times:
-
-1.
-
-Upon the provider or disclosing entity submitting the provider application.
-
-2.
-
-Upon the provider or disclosing entity executing the provider agreement.
-
-3.
-
-Upon request of the Department during revalidation.
-
-4.
-
-Within 35 days after any change in ownership of the disclosing entity.
-
-8.125.15.C.
-
-Disclosures from fiscal agents are due at any of the following times:
-
-1.
-
-Upon the fiscal agent submitting its proposal in accordance with the State's procurement
-process.
-
-2.
-
-Upon the fiscal agent executing a contract with the State.
-
-3.
-
-Upon renewal or extension of the contract.
-
-4.
-
-Within 35 days after any change in ownership of the fiscal agent.
-
-8.125.15.D.
-
-Disclosures from managed care entities are due at any of the following times:
-
-1.
-
-Upon the managed care entity submitting its proposal in accordance with the State's
-procurement process.
-
-2.
-
-Upon the managed care entity executing a contract with the State.
-
-3.
-
-Upon renewal or extension of the contract.
-
-4.
-
-Within 35 days after any change in ownership of the managed care entity.
-
-8.125.15.E.
-The Department will not reimburse any claim from any provider or entity or make any
-payment to an entity that fails to disclose ownership or control information as required by 42 CFR
-§ 455.104. The Department will not reimburse any claim from any provider or entity or make any
-payment to an entity that fails to disclose information related to business transactions as required
-by 42 CFR § 455.105 beginning on the day following the date the information was due and
-ending on the day before the date on which the information was supplied. Any payment made to
-a provider or entity that is not reimbursable in accordance with this section shall be considered an
-overpayment.
-8.125.15.F.
-The Department may terminate the agreement of any provider or entity or deny
-enrollment of any provider that fails to disclose information when requested or required by 42
-CFR § 455.100-106.
-
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-8.126
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-
-COLORADO NPI RULE
-
-8.126.1 Definitions
-A.
-
-Billing Provider Field means the data field on a Claim that reflects the Health Care Provider to
-which the payer issues payment.
-
-B.
-
-Campus means the physical area immediately adjacent to the Hospital’s main buildings, other
-areas and structures that are not strictly contiguous to the main buildings but are located within
-250 yards of the main buildings, and any other areas determined on an individual case basis by
-the Centers of Medicare and Medicaid Services to be part of the provider's campus.
-
-C.
-
-Claim means a request for payment for the delivery of medical care, services, or goods
-authorized under the Medical Assistance Program, submitted to the Department through its fiscal
-agent by a Health Care Provider. Claim includes the transmission of encounter information for the
-purpose of reporting the delivery of medical care, services, or goods.
-
-D.
-
-Health Care Provider means any person or organization that furnishes, bills for, or is paid for
-medical care, services, or goods to one or more Medical Assistance Program members.
-1.
-
-A Health Care Provider includes an Organization Health Care Provider, Subpart of an
-Organization Health Care Provider, Off Campus Location, and a Site of an Organization
-Health Care Provider.
-
-2.
-
-Unless specified otherwise in Subsection 8.126.1, a Health Care Provider may include a
-Health Care Provider located outside the state of Colorado (out-of-state provider) that is
-licensed and/or certified pursuant to their state laws.
-
-E.
-
-Hospital means an Organization Health Care Provider that is enrolled in the Medical Assistance
-Program under the Provider Type of “Hospital - General” as defined in this Subsection 8.126.1.
-
-F.
-
-Medical Assistance Program means the programs authorized under Articles 4, 5, 6, 8, and 10 of
-Title 25.5.
-
-G.
-
-National Provider Identifier (NPI) means the standard, unique health identifier for Health Care
-Providers or Organization Health Care Providers that is used by the National Plan and Provider
-Enumeration System (NPPES) in accordance with 45 C.F.R. pt. 162.
-
-H.
-
-Off-Campus Location means a facility that:
-1.
-
-Has operations that are directly or indirectly owned or controlled by, in whole or in part, or
-affiliated with, a Hospital, regardless of whether the operations are under the same
-governing body as the Hospital;
-
-2.
-
-Is not on the Hospital’s Campus;
-
-3.
-
-Provides services that are organizationally and functionally integrated with the Hospital;
-
-4.
-
-Is an outpatient facility providing preventive, diagnostic, treatment, or emergency
-services; and
-
-5.
-
-Is identified on the Hospital’s State License Addendum issued by the Colorado
-Department of Public Health and Environment or, for Hospitals licensed outside of
-Colorado, documentation demonstrating direct or indirect ownership or control of the OffCampus Location.
-
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-
-I.
-
-Organization Health Care Provider means a Health Care Provider that is not an individual.
-
-J.
-
-Provider Type means a classification of Health Care Provider or Organization Health Care
-Provider to which the payer issues payment for services provided to individuals enrolled in the
-Medical Assistance Program, according to the Provider Type license, accreditation, certification,
-and/or service provided. The Provider Types recognized by the Department are as follows:
-1.
-
-Administrative Services Organization (ASO) is an entity that has entered into a valid,
-active contract to provide ASO services with the Colorado Department of Health Care
-Policy and Financing.
-
-2.
-
-Ambulatory Surgical Center (ASC) means a health care entity that is:
-a.
-
-Licensed by the Colorado Department of Public Health and Environment as an
-Ambulatory Surgical Center; and
-
-b.
-
-Certified by the Centers for Medicare and Medicaid Services to participate in the
-Medicare program as an Ambulatory Surgical Center.
-
-3.
-
-Audiologist means an individual licensed as an audiologist by the Division of Professions
-and Occupations within the Colorado Department of Regulatory Agencies.
-
-4.
-
-Behavioral Therapy Clinic means any group practice that has at least one affiliated
-Behavioral Therapy Individual. The affiliated Behavioral Therapy Individual must be
-enrolled in the Colorado Medical Assistance Program.
-
-5.
-
-Behavioral Therapy Individual means an individual that:
-a.
-
-Is nationally certified as a Board-Certified Behavioral Analyst (BCBA); or
-
-b.
-
-Meets one of the following:
-(1)
-
-Has a doctoral degree with a specialty in psychiatry, medicine, or clinical
-psychology and is actively licensed by the State Board of Examiners;
-and has completed 400 hours of training; and/or has direct supervised
-experience in behavioral therapies that are consistent with best practice
-and research on effectiveness for people with autism or other
-developmental disabilities; or
-
-(2)
-
-Has a doctoral degree in one of the behavioral or health sciences; and
-has completed 800 hours of specific training; and/or has experience in
-behavioral therapies that are consistent with best practice and research
-on effectiveness for people with autism or other developmental
-disabilities; or
-
-(3)
-
-Is nationally certified as a BCBA; or
-
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-
-(4)
-
-10 CCR 2505-10 8.100
-
-Has a master’s degree or higher in behavioral or health sciences; and is
-a licensed teacher with an endorsement of school psychologist; or is a
-licensed teacher with an endorsement of special education or early
-childhood special education; or is credentialed as a related services
-provider (Physical Therapist, Occupational Therapist, or Speech
-Therapist); and has completed 1,000 hours of direct supervised training
-or has experience in behavioral therapies that are consistent with best
-practice and research on effectiveness for people with autism or other
-developmental disabilities.
-
-6.
-
-Birthing Center means a health care entity licensed as a Birth Center by the Colorado
-Department of Public Health and Environment. Out-of-state providers are not eligible for
-enrollment.
-
-7.
-
-Case Management Agency (CMA) means a public or private not-for-profit or for-profit
-agency that meets all applicable state and federal requirements and is certified by the
-Department to provide case management services for Home and Community Based
-Services waivers.
-
-8.
-
-Certified Registered Nurse Anesthetist (CRNA) means an individual who is:
-
-9.
-
-a.
-
-Licensed as a registered nurse by the State Board of Nursing within the Colorado
-Department of Regulatory Agencies; and
-
-b.
-
-Included within the advanced practice registry as a CRNA.
-
-Clinic – Dental means any group practice that has at least one affiliated, licensed dentist
-or dental hygienist.
-a.
-
-The affiliated dentist or dental hygienist must be enrolled in the Colorado Medical
-Assistance Program; and
-
-b.
-
-A dental practice or clinic must be owned by a licensed dentist except if the
-dental practice or clinic is a non-profit organization defined as a community
-health center (also known as an FQHC) or having 50% or more patients
-determined as low income, or a political subdivision (i.e. city, county, state, etc.);
-and
-
-c.
-
-A dental hygiene practice or clinic must be owned by a licensed dentist or
-licensed dental hygienist except if the dental hygiene practice or clinic is a nonprofit organization defined as a community health center (also known as an
-FQHC) or having 50% or more patients determined as low income, or a political
-subdivision (i.e. city, county, state, etc.)
-
-10.
-
-Clinic – Practitioner means any group practice that has at least one affiliated, licensed
-physician, osteopath, or podiatrist. The affiliated practitioner must be enrolled in the
-Colorado Medical Assistance Program.
-
-11.
-
-Community Clinic means a health care entity that is:
-a.
-
-Licensed as a Community Clinic or Freestanding Emergency Department (FSED)
-by the Colorado Department of Public Health and Environment;
-
-b.
-
-Certified by the Centers for Medicare and Medicaid Services to participate in the
-Medicare program; and
-
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-
-c.
-12.
-
-10 CCR 2505-10 8.100
-
-Owned by a Medicare participating hospital.
-
-Community Mental Health Center (CMHC) means a health care entity that:
-a.
-
-Is licensed as a Community Mental Health Center by the Colorado Department of
-Public Health and Environment;
-
-b.
-
-Has program approval to operate as a CMHC from the Colorado Department of
-Human Services; and
-
-c.
-
-If the CMHC delivers substance use disorder services, shall have Substance Use
-Disorder program approval from Colorado Department of Human Services.
-
-13.
-
-Dental Hygienist means an individual who is licensed as a Dental Hygienist by the
-Colorado Dental Board within the Colorado Department of Regulatory Agencies.
-
-14.
-
-Dentist means an individual who is licensed as a Dentist by the Colorado Dental Board
-within the Colorado Department of Regulatory Agencies.
-
-15.
-
-Dialysis Treatment Clinic [Formerly Known as Dialysis Center] means a health care entity
-that is:
-a.
-
-Licensed as a Dialysis Treatment Clinic by the Colorado Department of Public
-Health and Environment; and
-
-b.
-
-Certified by Centers for Medicare and Medicaid Services to participate in the
-Medicare program as an End-Stage Renal Dialysis Facility (ESRD).
-
-16.
-
-Federally Qualified Health Center (FQHC) means a health care entity that has been
-awarded a Section 330 Grant from the Health Resources and Services Administration. A
-health care entity that has been designated as a “look-alike” is also eligible to be enrolled
-as an FQHC.
-
-17.
-
-Foreign Teaching Physician means an individual who is licensed as a distinguished
-foreign teaching physician by the Colorado Medical Board within the Colorado
-Department of Regulatory Agencies.
-
-18.
-
-Home and Community Based Services (HCBS) means Health First Colorado (Colorado’s
-Medicaid Program)’s community-based care alternatives to institutional, Long-Term care.
-Providers enrolling as an HCBS provider shall meet all applicable state and federal
-requirements to provide HCBS by waiver and specialty type.
-
-19.
-
-Home Health Agency means a health care entity that:
-
-20.
-
-a.
-
-Has a Class A Home Care Agency license from the Colorado Department of
-Public Health and Environment; and
-
-b.
-
-Is certified by the Centers for Medicare and Medicaid Services to participate in
-the Medicare program as Home Health Agency.
-
-Hospice means a health care entity that is:
-a.
-
-Licensed as a Hospice by the Colorado Department of Public Health and
-Environment; and
-
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-
-b.
-21.
-
-22.
-
-23.
-
-24.
-
-10 CCR 2505-10 8.100
-
-Certified by the Centers for Medicare and Medicaid Services to participate in the
-Medicare program as a Hospice.
-
-Hospital – General means a health care entity that is:
-a.
-
-Licensed as a General Hospital by the Colorado Department of Public Health and
-Environment; and
-
-b.
-
-Certified by the Centers for Medicare and Medicaid Services to participate in the
-Medicare program as a Hospital.
-
-Hospital – Psychiatric [Formerly Known as Hospital - Mental] means a health care entity
-that is:
-a.
-
-Licensed as a Psychiatric Hospital by the Colorado Department of Public Health
-and Environment; and
-
-b.
-
-Certified by the Centers for Medicare and Medicaid Services to participate in the
-Medicare program as a Psychiatric Hospital.
-
-Independent Laboratory means a laboratory that:
-a.
-
-Has a current and valid Clinical Laboratory Improvement Amendments (CLIA)
-certification; and
-
-b.
-
-Is certified through the Centers for Medicare and Medicaid Services as a
-laboratory.
-
-Indian Health Service – Federally Qualified Health Center (FQHC) means a health care
-entity that:
-a.
-
-Is treated by the Centers for Medicare and Medicaid Services as a
-comprehensive Federally funded health center; and
-
-b.
-
-Includes an outpatient health program or facility operated by a tribe or tribal
-organization under the Indian Self-Determination Act or by an urban Indian
-organization receiving funds under Title V of the Indian Health Care Improvement
-Act for the provision of primary health services.
-
-25.
-
-Indian Health Service – Pharmacy means a health care entity that has evidence of
-participation in the Indian Health Service.
-
-26.
-
-Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) [Formerly
-Known as Nursing Facility – ICF/IID] means a health care entity that is:
-
-27.
-
-a.
-
-Licensed as an Intermediate Care Facility for Individuals with Intellectual
-Disabilities through the Colorado Department of Public Health and Environment;
-and
-
-b.
-
-Certified by the Centers for Medicare and Medicaid Services or the Colorado
-Department of Health Care Policy and Financing to participate in the Medicaid
-program as an ICF/IID.
-
-Licensed Behavioral Health Clinician means an individual that is licensed by the Colorado
-Department of Regulatory Agencies as either:
-
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-
-a.
-
-A Licensed Clinical Social Worker;
-
-b.
-
-A Licensed Professional Counselor;
-
-c.
-
-A Licensed Marriage and Family Therapist; or
-
-d.
-
-A Licensed Addiction Counselor.
-
-10 CCR 2505-10 8.100
-
-28.
-
-Licensed Psychologist means an individual who is licensed as a psychologist by the
-State Board of Psychologist Examiners within the Colorado Department of Regulatory
-Agencies.
-
-29.
-
-Managed Care Entity [Formerly Known as Health Maintenance Organization (HMO)]
-means an entity that has a valid and comprehensive or all-inclusive risk contract with the
-Colorado Department of Health Care Policy and Financing.
-
-30.
-
-Medicare Only Providers means a provider enrolled in the Medical Assistance Program
-for purposes of Medicare cost-sharing only, pursuant to 42 CFR §455.410(d).
-
-31.
-
-Non-Physician Practitioner Group means any group practice consisting of any of the
-following:
-a.
-
-Licensed Nurse Practitioners;
-
-b.
-
-Licensed Audiologists;
-
-c.
-
-Licensed Occupational Therapists;
-
-d.
-
-Licensed Behavioral Health Clinicians;
-
-e.
-
-Licensed Psychologists;
-
-f.
-
-Licensed Speech Therapists; and/or
-
-g.
-
-Licensed Physical Therapists.
-
-32.
-
-Non-Physician Practitioner Individual means a registered nurse, which means an
-individual licensed as a Registered Nurse by the State Board of Nursing within the
-Colorado Department of Regulatory Agencies.
-
-33.
-
-Nurse Midwife means an individual who is:
-
-34.
-
-35.
-
-a.
-
-Licensed as a registered nurse by the State Board of Nursing within the Colorado
-Department of Regulatory Agencies; and
-
-b.
-
-Included within the advanced practice registry as a Nurse Midwife.
-
-Nurse Practitioner means an individual who is:
-a.
-
-Licensed as a registered nurse by the State Board of Nursing within the Colorado
-Department of Regulatory Agencies; and
-
-b.
-
-Included within the advanced practice registry as a Nurse Practitioner.
-
-Nursing Facility means a health care entity that is:
-
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-
-a.
-
-Licensed as a Nursing Care Facility through the Colorado Department of Public
-Health and Environment; and
-
-b.
-
-Certified by the Centers for Medicare and Medicaid Services or the Colorado
-Department of Health Care Policy and Financing to participate in the Medicaid
-program as a Skilled Nursing Care Facility.
-
-36.
-
-Occupational Therapist means an individual who is licensed as an Occupational
-Therapist by the Director of the Division of Professions and Occupations within the
-Colorado Department of Regulatory Agencies.
-
-37.
-
-Optical Outlet means a health care supplier that is qualified to make and supply
-eyeglasses and contact lenses for the correction of vision. If, in the performance of its
-duties, the Optical Outlet requires laboratory services, the laboratory is required to have a
-current and valid CLIA certification.
-
-38.
-
-Optometrist means an individual who is licensed as an Optometrist by the State Board of
-Optometry within the Colorado Department of Regulatory Agencies.
-
-39.
-
-Osteopath means an individual who holds a degree of “doctor of osteopathy,” and who is
-licensed as a physician by the Colorado Medical Board within the Colorado Department
-of Regulatory Agencies.
-
-40.
-
-Personal Care Agency means a health care entity that has a Class A or Class B Home
-Care Agency license from the Colorado Department of Public Health and Environment.
-
-41.
-
-Pharmacist means an individual who is licensed as a Pharmacist by the State Board of
-Pharmacy within the Colorado Department of Regulatory Agencies.
-
-42.
-
-Pharmacy means a pharmacy, pharmacy outlet, or prescription drug outlet registered by
-the Board of Pharmacy within the Colorado Department of Regulatory Agencies.
-
-43.
-
-Physical Therapist means an individual who is licensed as a Physical Therapist by the
-Physical Therapy Board within the Colorado Department of Regulatory Agencies.
-
-44.
-
-Physician means an individual who is licensed as a physician by the Colorado Medical
-Board within the Colorado Department of Regulatory Agencies.
-
-45.
-
-Physician Assistant means an individual who is licensed as a physician assistant by the
-Colorado Medical Board within the Colorado Department of Regulatory Agencies.
-
-46.
-
-Podiatrist means an individual licensed as a podiatrist by the Colorado Podiatry Board
-within the Colorado Department of Regulatory Agencies.
-
-47.
-
-Psychiatric Residential Treatment Facility (PRTF) means a health care entity that:
-a.
-
-Is licensed by the Colorado Department of Human Services as a Residential
-Child Care Facility and a PRTF; and
-
-b.
-
-Is certified as a qualified residential provider by the Department of Public Health
-and Environment; and
-
-c.
-
-Is accredited by the Joint Commission, the Commission on Accreditation of
-Rehabilitation Facilities, or the Council on Accreditation of Services for Families
-and Children; and
-
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-
-d.
-
-10 CCR 2505-10 8.100
-
-Has provided an attestation to the Department that the PRTF is in compliance
-with the conditions of participation as required by Colorado Department of
-Human Services and the Centers for Medicare and Medicaid Services.
-
-48.
-
-Qualified Medicare Beneficiary (QMB) Benefits Only means the provider type designation
-used for Chiropractors who participate under the QMB Program. Chiropractor means an
-individual licensed as a chiropractor by the Board of Chiropractic Examiners within the
-Colorado Department of Regulatory Agencies. QMB Benefits Only providers must also be
-certified as QMB Benefits Only providers through the Centers for Medicare and Medicaid
-Services.
-
-49.
-
-Regional Accountable Entity (RAE) means an entity that has entered into a valid, existing
-contract with the Colorado Department of Health Care Policy and Financing to be a
-Regional Accountable Entity.
-
-50.
-
-Rehabilitation Agency means a group practice that requires at least one affiliated and
-licensed professional enrolled in the Colorado Medical Assistance Program.
-
-51.
-
-Residential Child Care Facility (RCCF) means a health care entity that is:
-a.
-
-Designated by the Colorado Department of Human Services to provide Medicaidreimbursable mental health services as an RCCF; and
-
-b.
-
-Licensed by Colorado Department of Human Services as an RCCF.
-
-52.
-
-Rural Health Clinic (RHC) means a clinic that is certified by the Centers for Medicare and
-Medicaid Services as a Rural Health Clinic.
-
-53.
-
-School Health Services means a school district or Board of Cooperative Educational
-Services that has a valid, active contract with the Colorado Department of Health Care
-Policy and Financing to participate in the Colorado School Health Services Program.
-a.
-
-The Site at which an Organization Health Care Provider delivers medical care,
-services, or goods authorized under the Medical Assistance Program enrolled
-under the Provider Type of School Health Services is a school district.
-
-54.
-
-Speech Therapist is an individual certified as a Speech Language Pathologist by the
-Director of the Divisions of Professions and Occupations within the Colorado Department
-of Regulatory Agencies.
-
-55.
-
-Substance Use Disorder (SUD) – Clinic means a health care entity that:
-
-56.
-
-a.
-
-Is licensed as a SUD Provider by the Colorado Department of Human Services;
-
-b.
-
-Has program approval to operate as a SUD – Clinic from Colorado Department
-of Human Services; and
-
-c.
-
-Has at least one affiliated advanced practice nurse, physician/psychiatrist,
-physician assistant, or behavioral health clinician who is certified in addiction
-medicine.
-
-Supply means a Durable Medical Equipment, Prosthetic, Orthotic and Supplies
-(DMEPOS) provider that meets one or both of the following definitions:
-
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-
-a.
-
-b.
-
-57.
-
-Complex Rehabilitation Technology (CRT) Supplier means a health care supplier
-that meets all the requirements of Section 8.590.5.D, and that:
-(1)
-
-Has a Sales Tax Certificate or Tax-Exempt Certificate;
-
-(2)
-
-Has CRT Professional Certification; and
-
-(3)
-
-Is accredited by the Centers for Medicare and Medicaid Services to
-provide DMEPOS and CRT.
-
-Durable Medical Equipment (DME) means a health care supplier that meets the
-requirements of Sections 8.590.5.A and B, and that:
-(1)
-
-Has a Sales Tax Certificate or Tax-Exempt Certificate; and
-
-(2)
-
-Is accredited by the Centers for Medicare and Medicaid Services to
-provide DMEPOS.
-
-Transportation means a provider that meets one or both of the following definitions:
-a.
-
-Emergency Medical Transportation (EMT) [Formerly Known as Emergency
-Medical Transportation and Air Ambulance] means providers that:
-(1)
-
-Meet all provider screening requirements in Section 8.125.
-
-(2)
-
-Comply with commercial liability insurance requirements.
-
-(3)
-
-Maintain the appropriate licensure for:
-
-(4)
-b.
-
-58.
-
-10 CCR 2505-10 8.100
-
-(a)
-
-Ground ambulance license as required by Colorado Department
-of Public Health and Environment; and
-
-(b)
-
-Air ambulance license as required by Colorado Department of
-Public Health and Environment.
-
-License, operate, and equip ground and air ambulances in accordance
-with federal and state regulations.
-
-Non-Emergent Medical Transportation (NEMT) means a provider that:
-(1)
-
-Has a Public Utilities Commission (PUC) common carrier certificate as a
-taxicab; or
-
-(2)
-
-Has a PUC Medicaid Client Transport (MCT) Permit as required by the
-PUC; or
-
-(3)
-
-Has a ground ambulance license as required by Department of Public
-Health and Environment; or
-
-(4)
-
-Has an Air Ambulance license as required by Colorado Department of
-Public Health and Environment; or
-
-(5)
-
-Is exempt from licensure requirements in accordance with the PUC.
-
-X-Ray Facility means an imaging center that:
-
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-
-a.
-
-Has an X-Ray Facility and Machine Registration Report certified by the Colorado
-Department of Public Health and Environment; and
-
-b.
-
-Is certified by the Centers for Medicare and Medicaid Services to participate in
-Medicare as an X-Ray facility.
-
-K.
-
-Service Facility Location Field means the physical location specifically where services were
-rendered as identified on the Claim.
-
-L.
-
-Site means the physical location by street address, including suite number, where goods and/or
-services are provided. The term Site when involving a Health Care Provider that voluntarily
-contracts with a RAE as a Primary Care Medical Provider (PCMP) to participate in the
-Department’s Accountable Care Collaborative (ACC) as a medical home, also includes the
-following requirements:
-1.
-
-PCMP services must be identifiable from other goods and/or services, including services
-provided by specialists provided by the Health Care Provider in the same physical
-location through a separate and unique NPI.
-
-2.
-
-PCMP services provided at a Campus or Off-Campus Location must be identifiable from
-other goods and/or services, including services provided by specialists, provided by the
-Health Care Provider on the same Campus or Off-Campus Location through a separate
-and unique NPI.
-
-M.
-
-Subpart means a component or separate physical location of an Organization Health Care
-Provider that may be separately licensed or certified. This definition is intended to be consistent
-with the use of the term “Subpart” as defined in 45 C.F.R. pt. 162.
-
-N.
-
-The definitions in Subsection 8.126.1 apply only to Section 8.126.
-
-8.126.2 Enrollment of Health Care Providers
-A.
-
-Health Care Providers must enroll in the Medical Assistance Program through the Department’s
-Fiscal Agent, if they:
-1.
-
-deliver medical care, services, or goods authorized under the Medical Assistance
-Program; and
-
-2.
-
-are required to submit a Claim.
-
-8.126.3 Health Care Provider Requirements to Obtain and Use an NPI
-A.
-
-A Health Care Provider that is required or eligible to obtain an NPI pursuant to 45 C.F.R. §
-162.410 must:
-1.
-
-Enroll with a unique NPI that identifies the Health Care Provider that delivers medical
-care, services, or goods authorized under the Medical Assistance Program; and
-
-2.
-
-Utilize the Health Care Provider’s unique NPI for all Claims.
-a.
-
-A Health Care Provider that is not enrolled as of January 1, 2020, must submit
-every Claim using the unique NPI used for enrollment that identifies both the
-Provider Type and Site effective for date-of-services on or after January 1, 2020.
-
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-
-b.
-
-All Off Campus Locations must submit every Claim using the unique NPI used for
-enrollment that identifies both the Provider Type and Site effective for date-ofservices on or after January 1, 2020.
-
-c.
-
-All Health Care Providers must submit every Claim using the unique NPI used for
-enrollment that identifies both the Provider Type and Site effective for date-ofservices on or after January 1, 2021.
-
-d.
-
-On every Claim, including Coordination of Benefits Agreement (COBA) automatic
-crossover Claims, the Organization Health Care Provider shall use the Service
-Facility Location Field to represent the most specific Site with an NPI where the
-services are rendered unless the Billing Provider Field represents the most
-specific Site with an NPI where the services are rendered.
-
-8.126.4 Organization Health Care Provider Requirements to Obtain and Use an NPI
-A.
-
-Each Organization Health Care Provider and each Subpart of an Organization Health Care
-Provider that is required or eligible to obtain an NPI pursuant to 45 C.F.R. § 162.410 must enroll
-using a unique NPI.
-1.
-
-Each Organization Health Care Provider must enroll using its unique NPI for each Site at
-which the Organization Health Care Provider delivers medical care, services, or goods
-authorized under the Medical Assistance Program.
-a.
-
-2.
-
-(1)
-
-Its Campus; and
-
-(2)
-
-Each Off-Campus Location.
-
-Each Organization Health Care Provider must enroll in the Medical Assistance Program
-using a unique NPI for each Provider Type at each Site from which the Organization
-Health Care Provider delivers medical care, services, or goods authorized under the
-Medical Assistance Program.
-a.
-
-3.
-
-A Hospital must enroll in the Medical Assistance Program with a unique NPI for:
-
-A Hospital must enroll with a unique NPI for each Provider Type at each Site at
-its Campus and at each Off-Campus Location at which it delivers medical care,
-services, or goods authorized under the Medical Assistance Program.
-
-An Organization Health Care Provider that is a School Health Services provider type
-must enroll once per School District and not each individual Site.
-
-8.126.5 Health Care Provider Requirements Not Eligible to Receive an NPI
-A.
-
-A Health Care Provider that is not eligible pursuant to 45 C.F.R. § 162.410 to receive an NPI
-shall:
-1.
-
-Enroll without submitting an NPI. The Health Care Provider must obtain a unique
-identification number assigned by the Department through its Fiscal Agent, that identifies
-both the unique Provider Type at each Site at which the Health Care Provider delivers
-medical care, services or goods authorized under the Medical Assistance Program; and
-
-2.
-
-Use the unique identification number assigned by the Department through its Fiscal
-Agent on every Claim.
-
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-
-a.
-
-A Health Care Provider that is not eligible to obtain an NPI that is not enrolled as
-of January 1, 2020, must submit every Claim using the unique identification
-number used for enrollment that identifies both the Provider Type and Site,
-effective January 1, 2020.
-
-b.
-
-All Health Care Providers that are not eligible to obtain an NPI must submit every
-Claim using the unique identification number used for enrollment that identifies
-both the Provider Type and Site, effective January 1, 2021.
-
-8.126.6 New Providers as of January 1, 2020
-A.
-
-A Health Care Provider that is not enrolled as of January 1, 2020, shall not apply to be enrolled to
-deliver medical care, services, or goods authorized under the Medical Assistance Program unless
-the Health Care Provider complies with Section 8.126.
-
-8.126.7 Existing Providers as of January 1, 2021
-A.
-
-A Health Care Provider that is enrolled as of January 1, 2021, shall not apply to have their
-enrollment revalidated to deliver medical care, services, or goods authorized under the Medical
-Assistance Program, as required under 42 C.F.R. § 455.414, unless the Health Care Provider
-complies with Section 8.126.
-
-8.130
-
-PROVIDER PARTICIPATION
-
-Providers will not discriminate on the basis of race, color, ethnic or national origin, ancestry, age, sex,
-gender, sexual orientation, gender identity and expression, religion, creed, political beliefs, or disability.
-8.130.1
-
-DEFINITIONS
-
-A.
-
-“Advanced Directive” means a written instruction, such as a Living Will or Durable Power of
-Attorney for health care, recognized under state law, whether statutory or as recognized by the
-courts of the state, that relates to the provision of medical care when the individual is
-incapacitated.
-
-B.
-
-"Agent" means any person who has been delegated the authority to obligate or act on behalf of a
-Provider.
-
-C.
-
-“Change of Information” means any change in information contained in the Provider’s current
-enrollment record with the Department, including, but not limited to, any change to a person or
-entity who holds a direct or indirect ownership interest in the Provider exceeding five percent and
-any change to the Provider’s licensure, certification registration status, accreditation, bankruptcy
-status, address (including any change to location(s) where good and services are rendered),
-contact person, telephone number, email address, or criminal conviction disclosures within the
-scope of 42 CFR § 455.106.
-
-D
-
-“Change of Ownership” means that a Provider has been issued a new tax identification number.
-
-E.
-
-“Colorado Department of Health Care Policy and Financing” or “Department” means the Colorado
-State governmental agency responsible for the administration of the Medical Assistance Program,
-, Child Health Plan Plus, the old age pension health and medical care program, and the
-supplemental old age pension health and medical care program pursuant to Title XIX of the
-Social Security Act and Title 25.5 of the Colorado Revised Statutes.
-
-F.
-
-“Inactivation” means a Provider’s billing privileges have been stopped but can be restored upon
-resolution of the basis of inactivation.
-
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-
-G.
-
-“Provider” means any person, public or private institution, agency, or business concern enrolled
-under the state Medical Assistance Program to provide medical care, services, or goods, and
-holding, where applicable, a current valid license or certificate to provide such services or to
-dispense such goods.
-
-H.
-
-“Requesting Agency” means the US Department of Health and Human Services or its designees,
-the Department or its designees, the Colorado Department of Human Services or its designees,
-or the Medicaid Fraud Control Unit or its designees, acting through their representatives who
-have written or other authorization to act on behalf of these agencies.
-
-8.130.2
-A.
-
-MAINTENANCE OF RECORDS
-Each Provider shall:
-1.
-
-2.
-
-Maintain legible, complete, and accurate records necessary to establish that conditions of
-payment for Medical Assistance Program covered goods and services have been met,
-and to fully disclose the basis for the type, frequency, extent, duration, and delivery of
-goods and/or services provided to Medical Assistance Program members, including but
-not limited to:
-a.
-
-Billings,
-
-b.
-
-Prior authorization requests,
-
-c.
-
-All medical records, service reports, and orders prescribing treatment plans,
-
-d.
-
-Records of goods prescribed, ordered for, or furnished to, members, and
-unaltered copies of original invoices for such items,
-
-e.
-
-Records of all payments received from the Medical Assistance Program, and
-
-f.
-
-Records required elsewhere in Section 8.000 et seq.
-
-The records shall be created at the time the goods or services are provided.
-
-B.
-
-Records of Providers shall include employment records, including but not limited to shift
-schedules, payroll records, and time-cards of employees.
-
-C.
-
-Providers who issue prescriptions shall keep in the patient's record, the date of each prescription
-and the name, strength, and quantity of the item prescribed.
-
-D.
-
-Records must be maintained for seven (7) years unless an additional retention period is required
-elsewhere in Section 8.000 et seq., or in an individual Provider participation agreement.
-
-E.
-
-Each Provider shall retain any other records created in the regular operation of business that
-relate to the type and extent of goods and/or services provided (for example, superbills). All
-records must be legible, verifiable, and must comply with generally accepted accounting
-principles, auditing standards, and all applicable state and federal laws, rules, and regulations.
-
-F.
-
-Each entry in a medical record must be signed and dated by the individual providing the medical
-service or good. Stamped signatures are not acceptable.
-
-G.
-
-Providers utilizing electronic record-keeping may apply computerized signatures and dates to a
-medical record if their record-keeping systems guarantee the following security measures:
-
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-
-H.
-
-1.
-
-Restrict application of an electronic signature to the specific individual identified by the
-signature. System security must prevent one person from signing another person's name.
-
-2.
-
-Prevent alterations to authenticated (signed and dated) records. If the Provider chooses
-to supplement a previous entry, the system must only allow a new entry that explains the
-supplement. The Provider must not be allowed to change the initial entry.
-
-3.
-
-Printed or displayed electronic records must note that signatures and dates have been
-applied electronically.
-
-At the discretion of the Requesting Agency, record verification may include, but will not be limited
-to, interviews with Providers, employees of Providers, billing services that bill on behalf of
-Providers, and any member of a corporate structure that includes the Provider as a member.
-
-8.130.3
-A.
-
-B.
-
-C.
-
-10 CCR 2505-10 8.100
-
-ADVANCE DIRECTIVES
-Providers shall provide adult Medical Assistance Program members with written information
-about the individual's rights under state law to accept or refuse medical treatment, the right to
-formulate advance directives, and the Providers' policies regarding the implementation of such
-rights as follows:
-1.
-
-Hospitals, at the time of the individual's admission as an inpatient.
-
-2.
-
-Nursing facilities, at the time of the individual's admission as a resident.
-
-3.
-
-Providers of home health care or personal care services, in advance of the individual
-coming under the care of the Provider.
-
-4.
-
-Hospice programs, at the time of initial receipt of hospice care by the individual from the
-program.
-
-5.
-
-Health maintenance organizations, at the time of enrollment of the individual with the
-organization.
-
-The Provider shall maintain written policies and procedures with respect to all adult individuals
-receiving medical or personal care by or through the Provider, which shall include:
-1.
-
-Documentation in the individual's medical records indicating whether the individual has
-executed an advance directive.
-
-2.
-
-Documentation that the individual will not be discriminated against, nor will the provision
-of care be conditioned on whether he/she has executed an advance directive.
-
-3.
-
-Documentation ensuring compliance with requirements of state law respecting advanced
-directives.
-
-4.
-
-Documentation in the individual's medical record substantiating the Provider's reason(s)
-for non-compliance with an advance directive based on conscience or professional
-ethics.
-
-Providers shall provide education for staff and the patient/member community on issues
-concerning advance directives.
-
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-8.130.35
-A.
-
-SCREENING FOR EXCLUDED EMPLOYEES AND CONTRACTORS
-
-As a condition of enrollment and participation in the Medical Assistance Program, each Provider
-shall comply with the following requirements for screening for employees and contractors who
-have been excluded from participation in Medicaid and Medicare by the US Department of Health
-& Human Services Office of Inspector General:
-1.
-
-Each Provider shall utilize the US Department of Health & Human Services Office of
-Inspector General’s List of Excluded Individuals/Entities (www.oig.hhs.gov) to determine
-if a prospective employee or newly signed contractor has been excluded from
-participation in a Medical Assistance Program.
-a.
-
-B.
-
-Each Provider shall screen its employees and contractors against the List of Excluded
-Individuals/Entities at least monthly to capture any exclusions or reinstatements that have
-occurred since the last search of the database.
-
-3.
-
-If a Provider determines that an employee or contractor of the Provider has been
-excluded, then the Provider shall report this to the Department within five (5) business
-days of the date of discovery.
-
-4.
-
-Each screening must be documented in a manner that can be provided to the
-Department upon request.
-
-Except as otherwise provided in federal law, if the Medical Assistance Program pays for any
-goods or services furnished, ordered, or prescribed by an excluded individual or entity that is
-employed by or has contracted with a Provider, such payment shall constitute an overpayment
-and shall be subject to overpayment recovery, pursuant to Section 8.076. Such Provider may also
-be subject to sanctions by the Department, including the termination of the Provider agreement,
-as described at 8.076.5., if the Provider knew or should have known of the exclusion. The
-Provider may also be subject to civil and monetary penalties imposed by the US Department of
-Health and Human Services.
-To the extent that such amount can be traced, the amount of the overpayment shall
-include any funds expended by the Medical Assistance Program to pay the excluded
-individual’s or contractor’s salary, expenses, or fringe benefits.
-
-Subject to federal law and the Department’s discretion, failure of a Provider to comply with the
-screening requirements listed at Section 8.130.35.A. may constitute good cause sufficient to
-justify termination of the Provider agreement, as described at 8.076.5.
-
-8.130.40
-A.
-
-Such screening should be performed within five (5) business days of the date on
-which the new employee was hired or new contract was signed.
-
-2.
-
-1.
-
-C.
-
-10 CCR 2505-10 8.100
-
-PROVIDER EMPLOYEE OR CONTRACTOR LICENSE VERIFICATION
-
-As a condition of participation in the Medical Assistance program, any Provider who provides or
-who has employees or contractors who provide services or supplies must ensure that, at the time
-services or supplies are provided, the Provider, the employee, or the contractor possesses the
-license, certification, or credential that is required in the State of Colorado to provide such
-services or supplies.
-
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-8.130.45
-
-10 CCR 2505-10 8.100
-
-REPORTING CHANGES
-
-A.
-
-Within thirty-five (35) calendar days, Provider shall update the provider portal of the Department’s
-Medicaid Management Information System (MMIS) with any Change of Information or Change in
-Ownership.
-
-B.
-
-Failure by the Provider to notify the Department of any Change of Information or Change in
-Ownership in accordance with section 8.130.45.A.:
-1.
-
-May result in the denial, suspension, inactivation, or termination of the Provider
-agreement or contract.
-
-2.
-
-Does not exempt a Medical Assistance Program Provider from compliance with 10 CCR
-2505-3 and 10 CCR 2505-10.
-
-8.130.50
-
-REQUIREMENT TO VERIFY ENROLLMENT OF MEMBER AT TIME OF SERVICE
-
-A.
-
-A Provider shall verify and document that the member is enrolled in the applicable Medical
-Assistance Program at the time the service is rendered.
-
-B.
-
-A Provider shall verify that payments received are for medically necessary goods and services
-that were actually rendered, and that claims and encounters submitted for payment are true and
-correct.
-
-8.130.60
-A.
-
-PROVIDERS ARE RESPONSIBLE FOR ALL CLAIMS SUBMITTED
-
-A Provider shall accept full legal responsibility for all claims submitted under the Provider’s
-Medical Assistance Program ID number to the Medical Assistance Program, whether submitted
-by the Provider or submitted on the Provider’s behalf.
-1.
-
-A Provider shall comply with all federal and state civil and criminal statutes, regulations,
-and rules relating to the delivery of goods and services to eligible individuals, and to the
-submission of claims for such goods and services. A Provider’s non-compliance may
-result in no payment for goods and services rendered.
-
-B.
-
-A Provider shall furnish to the Department its National Provider Identifier (NPI) (if eligible for an
-NPI) and include the NPI on all claims submitted pursuant to Sections 8.125.8 and 8.126.3.
-
-C.
-
-A Provider shall request payment only for those goods and services which are medically
-necessary, as such term is defined in Section 8.076.1.8. and in any other subsection of these
-rules defining medical necessity, and which are rendered personally by the Provider or rendered
-by qualified personnel under the Provider’s direct and personal supervision.
-
-D.
-
-1.
-
-A Provider shall submit claims only for those goods and services provided by health care
-personnel who meet the professional qualifications established by the State.
-
-2.
-
-Any misrepresentation or falsification of a claim submitted by a Provider, or on a
-Provider’s behalf, may subject the Provider to fines and/or imprisonment under state or
-federal law.
-
-If at any time the Department determines that a Provider has failed to maintain compliance with
-any state or federal laws, rules, or regulations, the Provider may be suspended from participation
-in the Medical Assistance Program, and may be subject to administrative actions authorized by
-federal or state law or regulation, criminal investigation, and/or prosecution.
-
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-8.130.70
-
-10 CCR 2505-10 8.100
-
-COMPLIANCE WITH GUIDANCE
-
-A.
-
-Providers must comply with all state and federal statutes, rules, regulations, and guidance.
-
-B.
-
-Guidance includes, but is not limited to:
-
-C.
-
-1.
-
-Department Billing Manual
-
-2.
-
-Department Provider Bulletins
-
-3.
-
-Department Memo Series
-
-4.
-
-Uniform Service Coding Standards
-
-5.
-
-Current Procedural Terminology (CPT) code set
-
-6.
-
-Current Healthcare Common Procedure Coding System (HCPCS)
-
-7.
-
-Current International Classification of Diseases (ICD))
-
-Failure to comply may subject the Provider to authorized administrative actions, civil investigation,
-and criminal investigation.
-
-8.130.80
-A.
-
-B.
-
-C.
-
-INACTIVATING PROVIDER AGREEMENTS
-
-A Provider may have its Provider Participation Agreement inactivated and will no longer be able
-to bill for goods and services if any of the following occur:
-1.
-
-The Provider’s license, certification, or accreditation has expired or is subject to
-conditions or restrictions.
-
-2.
-
-The Provider has failed to complete Provider revalidation.
-
-3.
-
-The Provider is no longer eligible to participate as a Medical Assistance Program
-Provider or breaches the Provider agreement.
-
-4.
-
-There is a Change of Ownership.
-
-5.
-
-The Provider’s business closes, or the business is nonoperational.
-
-6.
-
-The Provider is deceased or retired.
-
-7.
-
-The Provider is inactive and has not submitted any claims activity for 24 months.
-
-The Provider will be sent written notice thirty (30) days prior to the inactivation, unless otherwise
-required by federal or state statute, regulation, or rule.
-1.
-
-The notice will detail the reason for the inactivation.
-
-2.
-
-The notice will give the Provider the opportunity to dispute the inactivation.
-
-If the Provider elects to dispute the inactivation, the Department must receive the Provider’s
-written request to dispute the inactivation within thirty (30) calendar days of the date of the
-inactivation notice.
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-
-D.
-
-The Department will review the request and issue a determination on the inactivation which will
-include the Provider’s right to file an appeal in accordance with Section 8.050.
-
-E.
-
-The effective date of the inactivation may be backdated to the date of the occurrence described in
-Section 8.130.80.A.
-
-8.170
-
-STATE IDENTIFICATION NUMBER
-
-.10
-
-As medical assistance is administered on an individual recipient basis, rather than on a
-household basis, the individual recipient is uniquely identified. A state assigned number is used
-for this purpose. This state identification number consists of an alpha (letter) prefix, followed by a
-six-digit number. When an individual is approved for medical assistance, the state identification
-number is assigned. This number is transmitted to the county department via the automated
-system.
-
-.20
-
-The State Identification Number is the only numeric designation medical assistance providers will
-have, other than the name, to identify individuals. This number is required to be entered on all
-billing transactions.
-In order to carry out this responsibility for facilitating provision of medical benefits to recipients, to
-properly respond to inquiries from providers, to secure benefits of medical resources other than
-Medicaid (see 8.061 et seq.), and for other administrative purposes, county departments are to
-maintain cross reference files of household and medical identification numbers.
-
-8.180
-
-MEDICAL IDENTIFICATION CARDS AND DURATION OF ELIGIBILITY
-
-8.181
-
-IDENTIFICATION
-
-.10
-
-The state department will issue identification cards directly to clients who are eligible for benefits
-under a medical assistance program.
-
-.20
-
-The providers of benefits in the Department's medical assistance programs are instructed to use
-the identifying information to access an automated eligibility database to obtain the client's
-current or previous eligibility for medical assistance for a given date of service.
-
-8.182
-
-MEDICAL IDENTIFICATION CARD
-
-Each eligible client shall have a medical identification card issued from the state department's office to
-obtain medical services.
-8.183
-
-INSTRUCTIONS FOR HANDLING UNDELIVERED MEDICAL IDENTIFICATION CARDS
-
-The Post Office returns all undelivered Medical Identification Cards to the county departments when
-recipients are deceased, no longer at that address, etc. The following steps will be taken to assure
-delivery of cards to the recipient.
-A.
-
-If the address shown in the envelope window is incorrect or no longer valid, the county
-departments are not to make the address change for remailing on the returned envelope.
-Counties are to open the envelope, paste a white sticker over the incorrect address, type
-in the correct address, use a separate envelope with the corrected address, insert the
-Medical Identification Card Mailer, and remail the card and its carrier to the client's new
-(correct) address. (This includes out-of-state moves if the client remains eligible.)
-
-B.
-
-Counties shall immediately correct the address on the automated system.
-
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-CODE OF COLORADO REGULATIONS
-Medical Services Board
-
-C.
-8.190
-
-10 CCR 2505-10 8.100
-
-If the recipient is deceased, the county shall destroy the identification card and make
-appropriate change in the eligibility system.
-
-ACUTE MEDICAL BENEFITS DETERMINATION
-
-8.190.1 A client or provider may request a coverage determination for new acute medical benefits or
-services by submitting a written request to the Department.
-8.190.1.A.
-Written requests shall include documentation on all the following criteria regarding the
-benefit or service:
-
-8.190.2
-
-1.
-
-Prescribed by a doctor of medicine or osteopathy, or an optometrist, dentist or podiatrist
-acting within the scope of their respective licenses;
-
-2.
-
-A reasonable, appropriate and effective method for meeting the medical need;
-
-3.
-
-The expected use is in accordance with current medical standards or practices;
-
-4.
-
-Proven cost effective method of treatment;
-
-5.
-
-Does not result in an unsafe environment or situation;
-
-6.
-
-Not experimental, investigational and is accepted by the medical community as standard
-practice;
-
-7.
-
-Primary purpose is not to enhance personal comfort or convenience; and
-
-8.
-
-Considered to be medically necessary for the diagnosis.
-
-The requestor shall be notified in writing of the Department's decision regarding
-coverage.
-
-_________________________________________________________________________
-Editor’s Notes
-10 CCR 2505-10 has been divided into smaller sections for ease of use. Versions prior to 03/04/2007,
-Statements of Basis and Purpose, and rule history are located in the first section, 10 CCR 2505-10. Prior
-versions can be accessed from the All Versions list on the rule's current version page. To view versions
-effective on or after 03/04/2007, select the desired section of the rule, for example 10 CCR 2505-10
-8.100, or 10 CCR 2505-10 8.500.
-History
-[For history of this section, see Editor’s Notes in the first section, 10 CCR 2505-10]
-
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-DEPARTMENT OF HUMAN SERVICES
-Supplemental Nutrition Assistance Program (SNAP)
-RULE MANUAL VOLUME 4, SNAP
-10 CCR 2506-1
-[Editor’s Notes follow the text of the rules at the end of this CCR Document.]
-
-_________________________________________________________________________
-4.000
-
-SNAP
-
-4.000.1 SNAP DEFINITIONS
-“Able-Bodied Adult Without Dependents (ABAWD)” means an individual aged eighteen (18) through the
-age of fifty-four (54) without a physical or mental disability who lives in a household with no one under the
-age of eighteen (18).
-“Administrative disqualification hearing (ADH)” means a disqualification hearing against an individual
-accused of wrongfully obtaining or attempting to obtain SNAP benefits.
-“Administrative law judge (ALJ)” means a person that may preside over state-level fair hearings and
-administrative disqualification hearings.
-“Administrative adjudicator” means a person who presides over state-level fair hearings and
-administrative disqualification hearings.
-“Adverse action” means any action taken by a local office that causes a household’s SNAP benefits to be
-reduced, suspended, terminated, or denied.
-“Adverse action period” means the period of time during the certification period prior to the adverse action
-becoming effective.
-���Agency error claim” means that a debt has been established for the household to repay due to an overissuance of SNAP benefits that was issued to the household resulting from an error made by the local
-office.
-“Allotment” means the total amount of SNAP benefits a household is authorized to receive in a particular
-month.
-“Appeal” means a request made by a household to have a decision about its case reviewed by an
-impartial third party to determine whether the decision was correct. The term appeal includes state level
-fair hearings and local-level dispute resolution conferences.
-“Application” means a request on a state-approved form for public assistance which can include the
-electronic state-prescribed form.
-“Application filing date” means the date an application for public assistance is received by the county
-office.
-“Application for recertification” means an application submitted prior to the last month of the certification
-period to determine a household’s continued eligibility for the next certification period.
-
-1
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-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-“Application process” means the required process a household must complete for purposes of
-determining eligibility for SNAP benefits at application or application for recertification.
-“Authorized representative” means an individual who has been designated in writing by a responsible
-member of the household to act on behalf of or assist the household with the application process,
-obtaining SNAP benefits, and/or in using SNAP benefits at authorized retailers.
-“Automated Child Support Enforcement System (ACSES)” means the automated computer system used
-by the state department’s child support services to record child support payments.
-“Basic Categorical Eligibility (BCE)” means the status granted to any household that is not eligible for
-Expanded Categorical Eligibility and contains only members who receive, or are eligible to receive,
-benefits from Colorado Works, Supplemental Security Income (SSI), Old Age Pension, Aid to the Needy
-and Disabled, Aid to the Blind, or a combination of these programs.
-“Basic Utility Allowance (BUA)” means a fixed deduction applied to a household that does not pay for
-heating or cooling and incurs at least two (2) non-heating or non-cooling utility costs, such as electricity,
-water, sewer, trash, cooking fuel, or telephone.
-“Bifurcated appeal” means an appeal that involves more than one benefit program area and where the
-administrative adjudicator determines to divide the appeal so that a SNAP appeal is reviewed separate
-from the appeal of a different benefit program area appeal.
-“Boarder” means an individual residing with others and paying reasonable compensation to others for
-lodging and meals.
-“Boarding house” means an establishment that is licensed as a commercial enterprise and which offers
-meals and lodging for compensation, as described in 7 C.F.R 273.1(b)(3)(i), herein incorporated by
-reference. No later editions or amendments are incorporated. The regulation is available at no cost at the
-FNS, 3101 Park Center Dr., #906, Alexandria, VA 22302 or at https://www.ecfr.gov. This regulation is
-also available for public inspection and copying at the Food and Energy Assistance Division Director,
-Colorado Department of Human Services, 1575 Sherman Street, 3rd Floor, Denver, Colorado 80203.
-“Case record” means a combination of the physical case file that contains documents pertinent to a
-household’s case; similar documents maintained in an electronic database; and information about the
-household that is contained within the statewide automated system.
-“Certification period” means the period of time for which a household has been certified to receive
-benefits.
-“Civil union” means a legally binding partnership between two individuals without the legal recognition of
-these individuals as spouses.
-“Claim” means a debt resulting from an over-issuance of SNAP benefits that a household is obligated to
-repay.
-“Clear and convincing evidence” means evidence which is stronger than a preponderance of evidence
-and which is unmistakable and free from serious or substantial doubt.
-“Client” means a current or past applicant or a current or past recipient of SNAP.
-“Collateral contact” means a verbal or written confirmation of a household's circumstances by a person
-outside the household who has first-hand knowledge of the information, made either in person,
-electronically submitted, or by telephone.
-
-2
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-“Colorado Department Of Human Services (CDHS)” means the same as defined in section 26-1-105,
-C.R.S., which is incorporated by reference. No later editions or amendments are incorporated. This
-regulation is available for public inspection and copying at The Food and Energy Assistance Division
-Director, Colorado Department of Human Services, 1575 Sherman Street, 3rd Floor, Denver, Colorado
-80203.
-“Colorado Electronic Benefit Transfer System (CO/EBTS)” means the electronic system that enables
-SNAP participants or their authorized representatives to redeem their SNAP benefits at point-of-sale
-terminals.
-“Colorado Unemployment Benefits System (CUBS)” means the electronic system by which
-Unemployment Insurance Benefits (UIB) are determined by the Colorado Department of Labor and
-Employment.
-“Combined appeal” means an appeal that involves both a SNAP appeal and an appeal concerning any
-other benefit program area (ex. A SNAP appeal plus a Colorado Works appeal that are filed as one
-appeal). Combined appeals will be bifurcated to allow the SNAP portion of the appeal to move on a faster
-track to comply with federal SNAP timeliness requirements.
-“Communal dining facility” means an establishment approved by FNS that prepares and serves meals for
-persons aged sixty (60) and older, or for Supplemental Security Income (SSI) recipients, and their
-spouses. This also includes federally subsidized housing for persons aged sixty (60) and older at which
-meals are prepared for and served to the residents. It also includes private establishments that contract
-with an appropriate state or local agency to offer meals at concessional prices to persons aged sixty (60)
-and older or SSI recipients, and their spouses.
-“Compromise” means a local office’s decision to reduce the amount of a claim that is owed by a
-household.
-“Countable month” means a month in which an ABAWD received a full SNAP allotment but did not meet
-work requirements or have an exemption from those requirements.
-“Demand letter”, see “notice of overpayment.”
-“Disaster Supplemental Nutrition Assistance Program (D-SNAP)” means the assistance provided to the
-affected areas when a Presidential disaster declaration for individual assistance is declared and the
-decision to implement this program after a Presidential declaration shall be at the affected county’s
-discretion in coordination with the state SNAP office and FNS.
-“Dispute Resolution Conference (DRC)” means an informal meeting between a household and the local
-office to review an action taken on a case and the relevant facts pertaining to such action.
-“Disqualification Consent Agreement (DCA)” means the form that allows the individual(s) suspected of
-Intentional Program Violation/fraud to consent to his/her disqualification in cases of deferred adjudication,
-as described in 7 C.F.R. 273.169(h), which is herein incorporated by reference. No later editions or
-amendments are incorporated. The regulation is available at no cost at the FNS, 3101 Park Center Dr.,
-#906, Alexandria, VA 22302, or at https://www.ecfr.gov. This regulation is also available for public
-inspection and copying at the Food and Energy Assistance Division Director, Colorado Department of
-Human Services, 1575 Sherman Street, 3rd Floor, Denver, Colorado 80203.
-
-3
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-“Disqualified individuals” means any individual who is ineligible to receive SNAP benefits due to having
-been disqualified for an Intentional Program Violation/fraud, failure to provide or obtain a SSN, ineligible
-non-citizens, individuals disqualified for failure to cooperate with work requirements, individuals
-disqualified for failure to cooperate with the state quality assurance division, and ABAWDs who already
-received three countable months of SNAP within thirty-six (36) months without meeting an exemption or
-ABAWD work requirements.
-“Documentary evidence” means written information used to verify the income, expenses, and other
-circumstances of a household.
-“Documentation” means the collection of documentary evidence, verification, case notes, and other
-information related to a household’s case upon which eligibility determinations and other decisions are
-based.
-“Drug and Alcohol Treatment Center (DAA)” means any residential facility run by a private, nonprofit
-organization or institution, or a publicly operated community mental health center, under Part B of Title
-XIX of the Public Health Service Act (42 U.S.C 300x-1 through 300x-13) that provides rehabilitative
-treatment to persons participating in a drug or alcohol treatment program.
-“Dual participation” means the receipt of SNAP benefits in more than one SNAP household or state in the
-same calendar month.
-“EBT account” means the account linked to the EBT card where the state department deposits SNAP
-benefits.
-“EBT card” means the card issued to persons authorized to receive SNAP to which the household’s
-allotment is credited. Used for SNAP purposes to purchase eligible foods at approved retailers.
-“Eligibility has been determined” means a required interview was completed and all required verifications
-were received for a valid SNAP application and a determination of eligibility or ineligibility was made with
-a resulting notice of action.
-“Employment and Training Program” means a program operated by the Department of Human Services
-consisting of work, training, education, work experience, and/or job search activities designed to help
-clients obtain gainful employment.
-“Employment First (EF)” means Colorado’s Employment and Training Program.
-“Energy Electronic Benefit Transfer (E-EBT)” means the fuel assistance payment to eligible SNAP
-households of at least $20.01 that qualifies those households for the heating and cooling standard utility
-allowance.
-“Evidence” includes but is not limited to an item, document, photograph, video recording, testimony, or
-other tangible object presented to an administrative adjudicator, administrative law judge, and/or during a
-dispute resolution conference to make the existence of a fact more or less valid.”
-“Excess medical deduction” means a deduction from a household's total gross income applied when a
-person with a disability or a person aged sixty (60) and older has medical expenses over a specified
-monthly amount.
-“Exempt income” means income that is exempt from consideration when determining eligibility for SNAP.
-“Expanded Categorical Eligibility (ECE)” means households that are exempt from having resources
-considered when determining eligibility for SNAP.
-
-4
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-“Expedited service” means the method by which an application for SNAP is processed to ensure that the
-neediest households have access to benefits no later than the seventh (7th) calendar day following the
-date of application.
-“Fair hearing” or “State-level fair hearing” means a hearing conducted in person or on the telephone by an
-administrative adjudicator to provide an impartial decision on a household’s appeal of a local office’s
-decision or action.
-“Final agency decision” means a decision issued by the Office of Appeals after reviewing the initial
-decision issued by an administrative adjudicator.
-“Financial criteria” means the set of rules governing gross and net income and resource standards and
-the proper methods for computing a household’s income and resources.
-“Fleeing felon” means an individual who is fleeing to avoid prosecution or custody for a crime, or an
-attempt to commit a crime, that would be classified as a felony under a state or federal law.
-“FNS” means the Food and Nutrition Service of the U.S. Department of Agriculture.
-“Fraud” means the same as described in section 26-2-305(1)(a), C.R.S.
-“Full-time student” means a person who has a school schedule equivalent to a full-time curriculum as
-defined by the institution of higher education the person is attending.
-“G-845” means the U.S. Citizenship and Immigration Services (USCIS) form submitted by SNAP to the
-USCIS to request immigration status verification for a SNAP client. Form G-845 was last modified on April
-8, 2021 and is incorporated by reference. No later editions or amendments are incorporated. The form is
-available at no cost at https://www.uscis.gov/g-845. The form is also available for public inspection and
-copying at the Food and Energy Assistance Division Director, Colorado Department of Human Services,
-1575 Sherman Street, 3rd Floor, Denver, Colorado 80203.
-“Good cause” except as defined in 4.308.1, means a waiver granted to a person or household a)
-excusing them from complying with a specific eligibility requirement because compliance could cause
-adverse consequences to the person or household, or b) providing the household with more time to
-comply with a specific eligibility requirement.
-“Gross income” means the total of all non-exempt earned and unearned income added together before
-any deduction or disregard is considered.
-“Group Living Arrangement (GLA)” means a public or private non-profit facility certified under Section
-1616(e) of the Social Security Act which serves no more than sixteen (16) people.
-“Head of Household (HOH)” means the person who is generally regarded as the person with the most
-knowledge of the household’s circumstances. The head of household is the person to whom the local
-office addresses correspondence and notices about the household’s case. This person is generally the
-individual who completes the application process and is responsible for obtaining and using the
-household’s EBT card.
-“Heating/Cooling Utility Allowance (HCUA)” means a fixed deduction applied to any household that incurs
-a heating or cooling expense.
-“Homeless meal provider” means:
-1.
-
-A public or private nonprofit establishment that feeds persons experiencing
-homelessness; or,
-
-5
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-2.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-A restaurant which contracts with an appropriate state agency to offer meals at
-concessional (low or reduced) prices to persons experiencing homelessness.
-
-“Household” means a group of individuals who live together and customarily purchase and prepare food
-together for home consumption.
-“Household income” means all earned and unearned income received or anticipated to be received by the
-household from all sources, unless specifically exempted for SNAP eligibility purposes.
-“Inadvertent Household Error Claim (IHE)” means a debt that has been established for the household to
-repay due to an over-issuance of benefits that was issued to a household based on a misunderstanding
-or unintentional error on the part of the household.
-“Income and Eligibility Verification System (IEVS)” means a system used to match client’s Social Security
-Numbers with the Social Security Administration, Internal Revenue Service, and the Department of Labor
-and Employment to obtain information about household income.
-“Indigent non-citizen” means a sponsored non-citizen who, after considering all income and contributions
-provided by the sponsor and other sources in conjunction with the non-citizen’s own income, is unable to
-obtain food and shelter amounting to one hundred thirty percent (130%) of the federal poverty level (FPL),
-as defined in section 4.401.1, for the non-citizen’s household size. When a non-citizen is declared
-indigent, only the amount provided by the sponsor shall be deemed for the non-citizen. A declaration of
-indigence may last up to twelve (12) months but may be renewed at the end of such a period, if
-necessary. The local office must notify the U.S. Attorney General of each indigence determination,
-including the name of the sponsor and the sponsored non-citizen.
-“Initial decision” means a decision issued by an administrative adjudicator after a state-level fair hearing.
-“Initial application” means a household’s first application for assistance or an application for assistance
-that is received after the household has been off the program for any period following the end of a
-certification period.
-“Initial month of application” means the first month for which the household is certified for participation in
-the program for those who have not received SNAP benefits in the state previously or following any break
-after the end of the certification period where the household was not certified for participation. If the
-household applies for recertification prior to the expiration of its certification period and is found eligible for
-the first month following the end of the certification period, that month shall not be an initial month.
-“Institution of higher education” means institutions that normally require a high school diploma or
-equivalency certificate for a student to enroll, such as colleges, universities, and vocational or technical
-schools.
-“Intentional” means a false representation of a material fact with knowledge of that falsity or omission of a
-material fact with knowledge of that omission.
-“Intentional Program Violation (IPV)” means when an individual has intentionally made a false or
-misleading statement or misrepresented, concealed, or withheld facts, or committed or intended to
-commit any act that constitutes a violation of the federal SNAP program operated under the Food and
-Nutrition Act of 2008, the federal SNAP regulations, or any state statute relating to the use, presentation,
-transfer, acquisition, receipt, or possession of SNAP benefits or EBT cards.
-“IPV hearing”, see “Administrative disqualification hearing.”
-“IPV hearing waiver”, see “Waiver of administrative disqualification hearing.”
-
-6
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-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-“Issuance month” means the calendar month for which a benefit allotment is issued.
-“Lawful Permanent Resident” means a non-citizen legally admitted into the United States to reside on a
-permanent basis.
-“Level sanction” means a specified period of ineligibility imposed against an individual who failed to take a
-required action as part of his or her eligibility for SNAP.
-“Liquid resources” means assets such as cash on hand or assets that can be easily converted to cash
-such as money in checking or savings accounts, saving certificates, or stocks and bonds.
-“Live-in attendants” means individuals who reside with a household to provide medical, housekeeping,
-child-care, or other personal services.
-“Local office” means the county Department of Social/Human Services that is responsible for
-administering SNAP. In those counties that have more than one office that administers SNAP, “local
-office” shall be inclusive of all local offices within the county that administer the program.
-“Local-level dispute resolution conference”, see “Dispute resolution conference.”
-“Low-Income Home Energy Assistance Program (LEAP)” means the Colorado program designed to help
-low-income clients pay a portion of their winter heating costs.
-“Management Evaluation (ME) reviews” means state or federal reviews of each county’s administration of
-SNAP to determine each county’s adherence to federal- and state-mandated requirements. Such reviews
-are mandated by the Food and Nutrition Service of the USDA.
-“Mass update” means a change in data or policy that affects the entire state-wide caseload or a portion of
-the caseload.
-“Material fact” means information to which a reasonable person would attach importance when
-determining a course of action.
-“Migrant farm worker” means a person who travels away from home on a regular basis to follow the flow
-of seasonal agricultural work.
-“Minimum benefit” means the minimum amount of benefits issued to one- and two-person households
-that are eligible for assistance, but whose issuance calculates to less than the federally prescribed
-minimum allotment.
-“Net income test” means the one hundred percent (100%) federal poverty level (FPL), as defined in
-section 4.401.2, under which a household’s income must fall after all allowable deductions are considered
-in order to be considered eligible. This level is specific to the household size as defined by FNS.
-“Non-financial criteria” means the set of rules governing SNAP eligibility elements not related to a
-household’s gross and net income and resource standards.
-“Non-liquid resources” means assets which cannot be easily converted into cash such as vehicles and
-real property.
-“Notice of Action (NOA)” means the state-prescribed form sent to a household every time a local office
-increases or takes an adverse action impacting a household’s SNAP benefits. This form describes the
-action taken upon a household’s case and the resulting effect.
-
-7
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-“Notice of Overpayment” means a notice sent to a household upon the establishment of a claim against
-the household for an overpayment of benefits.
-“Office of Administrative Courts (OAC)” means the office within The Colorado Department of Personnel
-and Administration that The Colorado Department of Human Services may designate to hear state-level
-fair hearings as needed and as agreed to by The Office of Administrative Courts.
-“Office of Appeals (OOA)” is an office within The Colorado Department of Human Services that issues
-final agency decisions on behalf of The Colorado Department of Human Services.
-“On-the-job training (OJT)” means training provided to an employee after he or she is hired. Such training
-is designed for individuals who do not have the necessary work experience required for the job.
-“One Utility Allowance (OUA)” means a fixed deduction given to any household that is not eligible to
-receive the HCUA or BUA and incurs only one (1) non-heating or non-cooling utility expense, such as
-electricity, water, sewer, trash, or cooking fuel. The OUA is not allowed if the household’s only utility
-expense is a telephone.
-“Outdated” means information that is older than sixty (60) days from the point of eligibility determination or
-is no longer representative of a household’s circumstances.
-“Over-issuance” means the amount of SNAP benefits issued to a household that exceeds the
-household’s correct allotment.
-“PA households” means households that contain only persons who receive TANF/Colorado Works or
-Adult Financial cash grants.
-“Parolee” means a non-citizen allowed into the United States for urgent humanitarian reasons or when
-the non-citizens entry is determined to be for significant public benefit as described in 8 U.S.C 1182(d)(5)
-and in 8 C.F.R. 212.5 (2019), herein incorporated by reference. No later editions or amendments are
-incorporated. The regulation is available at no cost at the U.S. Department of Homeland Security, 3801
-Nebraska Avenue NW, Washington D.C., 20016 or at https://www.ecfr.gov. This regulation is also
-available for public inspection and copying at the Food and Energy Assistance Division Director, Colorado
-Department of Human Services, 1575 Sherman Street, 3rd Floor, Denver, Colorado 80203. Parole does
-not constitute a formal admission to the United States and confers temporary status only, requiring
-parolees to leave when the conditions supporting their parole cease to exist.
-“Payment Error Rate (PER)” means the sum of the overpayment error rate and the underpayment error
-rate, which is the value of all over and underpaid allotments expressed as a percentage of all allotments
-issued to the cases reviewed, excluding those cases processed by Social Security Administration (SSA)
-personnel or participating in certain demonstration projects designated by FNS.
-“Period of ineligibility” means the period of time a person is ineligible to receive SNAP benefits as a result
-of a failure to cooperate with either a state or federal QA review.
-“Periodic Report Form (PRF)” means the report that must be submitted by the household during the
-twelfth (12th) month of a twenty-four (24) month certification period. The purpose of this form is to allow
-the household to report any changes that occurred during the first half of the twenty-four (24) month
-certification period and for the local office to determine the household’s continued eligibility for the
-remaining twelve (12) months of the household’s certification period.
-
-8
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-“Person experiencing homelessness” means an individual who lacks a fixed and regular nighttime
-residence or whose primary residence is: a supervised shelter designed for temporary accommodations;
-a halfway house or similar facility that provides temporary residence; a place not designed for or ordinarily
-used as regular sleeping accommodations for human beings; or a temporary accommodation in the
-residence of another individual for ninety (90) days or less.
-“Person with disabilities” means a person who:
-1.
-
-Receives Supplemental Security Income (SSI) benefits under Title XVI of the Social
-Security Act, or the Colorado Supplement, or Aid to the Needy and DisabledSupplemental Security Income- Colorado Supplement (AND-SSI-CS), or Aid to the BlindSupplemental Security Income- Colorado Supplement (AB-SSI-CS); or Disability or
-Blindness Payments under Title I, II, X, or IXV of the Social Security Act;
-
-2.
-
-Is a veteran with a service-connected disability rated or paid as a total disability under
-Title 38 of the United States Code or is a veteran receiving a pension for a non-service
-connected disability;
-
-3.
-
-Is a veteran considered by the Veterans Affairs (VA) to be in need of regular aid and
-attendance or permanently housebound under Title 38 of the United States Code;
-
-4.
-
-Is a surviving spouse of a veteran and considered in need of aid and attendance or
-permanently housebound or a surviving child of a veteran and considered by the VA to
-be permanently incapable of self-support under Title 38 of the United States Code;
-
-5.
-
-Is a surviving spouse or child of a veteran and considered by the VA to be entitled to
-compensation for a service-connected death or pension benefits for a non-serviceconnected death under Title 38 of the United States Code and has a disability considered
-permanent under Section 221(i) of the Social Security Act. “Entitled”, as used in this
-definition, refers to those veterans’ surviving spouses and children who are receiving the
-compensation or benefits or have been approved for such benefits but are not yet
-receiving them;
-
-6.
-
-Has a disability considered permanent under Section 221(i) of the Social Security Act and
-receives a federal, state, or local public disability retirement pension;
-
-7.
-
-Receives an annuity for disability from the railroad retirement board who is considered as
-a disabled person with disabilities by the SSA or who qualifies for Medicare as
-determined by the railroad retirement board; or
-
-8.
-
-Is a recipient of interim assistance benefits pending the receipt of the Supplemental
-Security Income (SSI), disability-related medical assistance under Title XIX of the Social
-Security Act, or disability-based state assistance benefits provided that the eligibility to
-receive these benefits is based on disability or blindness criteria which are at least as
-stringent as those used under Title XVI of the Social Security Act.
-
-“Post high school education” means colleges, universities, and post-high school level technical and
-vocational schools.
-“Preliminary determination” means an administrative adjudicator has determined in writing and at a
-hearing that the sole issue is one of federal law or regulation and that the household’s claim that the local
-office improperly calculated benefits, and/or misinterpreted or misapplied such law or regulation is invalid.
-
-9
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-“Preponderance of evidence” means the legal burden of proof to show that the evidence is more likely to
-be true than not. Preponderance of evidence is a lesser burden of proof than that of clear and convincing
-evidence.
-“Prospective budgeting” means the method of computing a household’s monthly allotment by using
-current circumstances and reasonably anticipated income for the month in which the allotment will be
-issued.
-“Prudent Person Principle (PPP)” means a technician’s discretion to apply reasonable judgment when
-determining the proper course of action in specific situations in order to make an eligibility determination.
-“Public assistance (PA)” means the same as section 26-2-103(7), C.R.S.
-“Quality assurance (QA)” means the division of the Colorado Department of Human Services (CDHS)
-responsible for reviewing SNAP cases to determine if the proper eligibility determination was made and if
-the correct allotment was issued to a household in a given month.
-“QA active case” means cases where a household was certified prior to or during the sample month and
-issued SNAP benefits for the sample month.
-“QA negative case” means cases where a household was denied certification to receive SNAP benefits in
-the sample month or which had its participation in the program terminated during a certification period
-effective for the sample month.
-“Qualified non-citizen” means an individual who meets the specific definition of “qualified alien” as defined
-by the Food and Nutrition Service, United States Department of Agriculture, in 7 C.F.R. 273.4(a)(5), (6)(1)
-(2019), and is herein incorporated by reference. No later editions or amendments are incorporated. The
-regulation is available at no cost at the FNS, 3101 Park Center Dr., #906, Alexandria, VA 22302, or at
-https://www.ecfr.gov. This regulation is also available for public inspection and copying at the Food and
-Energy Assistance Division Director, Colorado Department of Human Services, 1575 Sherman Street, 3rd
-Floor, Denver, Colorado 80203. Qualified non-citizen for purposes of SNAP includes lawful permanent
-residents, asylees, refugees, parolees, individuals granted withholding of deportation or removal,
-conditional entrants, Cuban or Haitian entrants, battered immigrants and non-citizen victims of a severe
-form of trafficking. This term is not itself an immigration status, but rather includes a collection of
-immigration statuses. It is a term used solely for federal SNAP purposes. Qualified non-citizens are not
-automatically eligible for assistance, but rather must meet all other eligibility requirements.
-“Quality control review” means a review conducted by CDHS of a statistically valid sample of active and
-negative cases to determine the extent to which households are receiving snap allotments to which they
-are entitled, and to determine the extent to which decisions to deny, suspend, or terminate cases are
-correct.
-“Quest card” means Colorado’s specific version of the EBT card.
-“Questionable” means inconsistent or contradictory information, statements, documents, or case
-documentation that requires verification from the household to determine eligibility.
-“Recoupment” means the withholding of a portion of a household’s monthly allotment to pay back an
-over-issuance.
-“Repayment agreement” means the state department form sent to a household upon the establishment of
-a claim that outlines the household’s responsibility and options for repayment.
-“Restoration” means a payment of benefits made to a household who was eligible to receive the amount
-in a past month but did not receive the payment.
-
-10
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-“Roomer” means an individual to whom a household furnishes lodging, but not meals, for compensation.
-“Sanction” means a specified period of ineligibility imposed against an individual who failed to take a
-required action as part of his or her eligibility for either SNAP or Colorado Works.
-“Self-employment” means a situation where some or all income is received from a self-operated business
-or enterprise in which the individual retains control over work or services offered and assumes the
-necessary business risks and expenses connected with the operation of the business.
-“Shelter for battered women and children” means a public or private nonprofit residential facility that
-serves battered women and their children. If such a facility serves other individuals, a portion of the facility
-must be set aside on a long-term basis to serve only battered women and children.
-“Simplified reporting” means SNAP households are required to report mid-certification changes that
-cause the household’s combined gross income to rise above one hundred thirty percent (130%) of the
-federal poverty level (FPL) as defined in section 4.401.1 for the applicable household size, when a
-member of the household wins substantial lottery or gambling winnings, and if an ABAWD’s
-work/volunteer hours fall below twenty (20) hours per week.
-“SNAP” means Supplemental Nutrition Assistance Program, formerly known as the Food Assistance
-program, administered by the state department in Colorado.
-“SNAP fair hearings unit” means the unit within the Office of Appeals at the Colorado Department of
-Human Services that may be designated by the Colorado Department of Human Services to hear SNAP
-appeals, the SNAP portion of a bifurcated appeal, combined appeals, and administrative disqualification
-hearings. The SNAP fair hearings unit generally operates under the supervision of the chief adjudicator of
-the Office of Appeals but acts independently and in a fair and impartial manner concerning the fair
-hearings process and the issuance of initial decisions.
-“Sponsor” means any person(s) who executed an affidavit of support (USCIS form I-864A (March 6,
-2018)) or another form deemed legally binding by the Department of Homeland Security on behalf of a
-non-citizen as a condition of the non-citizen’s date of entry or admission into the United States as a
-permanent resident. These forms are herein incorporated by reference. This rule does not contain any
-later amendments or editions. These forms are available at no cost from https://www.uscis.gov/forms.
-These forms are also available for public inspection and copying at the Colorado Department of Human
-Services, Director of the Employment and Benefits Division, 1575 Sherman Street, Denver, Colorado,
-80203, or at any state publications library during regular business hours.
-“Sponsored non-citizen” means those non-citizens lawfully admitted for permanent residence into the
-United States who have been sponsored by an individual for entry into the country.
-“Standard Eligibility (SE)” means the set of rules applicable to households that do not fall under
-“Expanded Categorical Eligibility” or “Basic Categorical Eligibility.” Households considered under
-Standard Eligibility rules are subject to resource limits as a condition of eligibility.
-“State department” means the office/division within the Colorado Department of Human Services that
-administers SNAP. Currently, this is the Food and Energy Assistance Division within the Office of
-Economic Security.
-“State-level fair hearing” or “Fair hearing” means a review (hearing) requested by a client which is held
-before an administrative adjudicator to establish whether an adverse action or eligibility determination
-taken was correct.
-
-11
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-“Striker” or “striking member” means an individual who is involved in a strike or other concerted stoppage
-of work by employees, including a stoppage by reason of the expiration of a collective bargaining
-agreement and any concerted slowdown or other concerted interruption of operations by employees.
-“Substantial lottery or gambling winnings” is a cash prize won in a single game, before taxes or other
-amounts are withheld, that is equal to or greater than the resource limit for persons aged sixty (60) and
-older and persons with disabilities.
-“Supplement” means a payment of additional allowable SNAP benefits made for the current issuance
-month.
-“Supplemental Security Income (SSI)” means monthly cash payments made under the authority of: (1)
-Title XVI of the Social Security Act, as amended, to the aged, blind and disabled; (2) Section 1616(a) of
-the Social Security Act; or (3) Section 212(a) of Pub. L. 93-66.
-“Systematic Alien Verification for Entitlements (SAVE)” means the system allowing for the validation of
-immigration statuses of non-citizen clients through access to centralized U.S. Citizenship and Immigration
-Service (USCIS) data.
-“Telephone allowance” means a fixed deduction given to any household not incurring utility expenses
-other than the expense for a telephone.
-“Temporary Assistance for Needy Families (TANF) or Colorado Works (CW)” means the cash assistance
-program also known as Title IV-a of the Social Security Act.
-“Temporary emergency” means an emergency caused by any natural or human-caused disaster, other
-than a major disaster declared by the President of the United States under the Disaster Relief Act of
-1974, which is determined by FNS to have disrupted commercial channels of food distribution.
-“Thrifty food plan” means the diet required to feed a family of four (4) persons, as defined by the FNS, as
-consisting of a man and a woman twenty (20) through fifty (50) years of age, a child six (6) through eight
-(8) years of age, and a child nine (9) through eleven (11) years of age, determined in accordance with the
-U.S. Department of Agriculture. The cost of such a diet shall be the basis for uniform allotments for all
-households regardless of their actual composition.
-“Trafficking” means the same as defined in section 26-2-306, C.R.S. and 7 C.F.R. 271.2 (2019), which is
-incorporated by reference. No later editions or amendments are incorporated. The regulation is available
-at no cost at the FNS, 3101 Park Center Dr., #906, Alexandria, VA 22302, or at https://www.ecfr.gov. This
-regulation is also available for public inspection and copying at the Food and Energy Assistance Division
-Director, Colorado Department of Human Services, 1575 Sherman Street, 3rd Floor, Denver, Colorado
-80203.
-“Unclear information” means unverified information that is known to the agency and requires verification,
-or information that is verified but the local office needs additional information to determine SNAP
-eligibility.
-“Under-issuance” means the difference between the allotment the household was eligible to receive and
-the allotment the household received, which was lower than what the household was eligible to receive.
-“Valid application” means a state-prescribed public assistance benefits form completed with name,
-address, and signature.
-“Vendor payments” means money payments that are not payable directly to a household but are paid to a
-third party for a household expense.
-
-12
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-“Verification” means confirmation of a household’s statements through written, verbal, or electronic
-means
-“Verified upon receipt (VUR)” means information that is provided directly from the primary source and
-which is not questionable.
-“Voluntary quit” means when a SNAP client voluntarily quit a job of 30 or more hours a week or reduced
-work effort to less than 30 hours a week without good cause.
-“Voluntary work registrant” means an individual who chooses to participate in the program and is not
-mandated to participate by the state or federal regulations.
-“Waiver of administrative disqualification hearing” means a waiver sent to individuals suspected of IPV
-which presents the individual with the option of waiving his or her right to an administrative hearing,
-accepting the appropriate disqualification without necessarily admitting the violation.
-
-13
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-4.100
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-SNAP INTRODUCTION
-
-This material sets forth rules, policies, and procedures concerned with eligibility determination and
-certification of persons who apply to participate in SNAP, and, if determined eligible, the requirements
-concerning the use of SNAP benefits. The rules and regulations herein are promulgated in accordance
-with Program regulations of the United States Department of Agriculture (USDA), 7 C.F.R. 271–274
-(2021), as amended, which are incorporated by reference, and the State Plan of Operation. No later
-amendments or editions of the regulations are incorporated. Copies of the regulations are available at no
-cost at the FNS, 3101 Park Center Dr., #906, Alexandria, VA 22302, or at https://www.ecfr.gov. These
-regulations are also available for public inspection and copying at the Food and Energy Assistance
-Division Director, Colorado Department of Human Services, 1575 Sherman Street, 3rd Floor, Denver,
-Colorado.
-4.110
-
-USE OF THE SNAP MANUAL
-
-Below is a summary of the information contained in each section:
-Section 4.000 contains SNAP specific definitions.
-Section 4.100 contains general program information, confidentiality requirements, and complaint
-procedures (including complaints regarding alleged discrimination).
-Section 4.200 sets forth policies and procedures for the application and recertification processes.
-Information contained in this section includes the process of filing an application and recertification,
-interview requirements, timely processing standards, determination of certification periods, and initial
-month allotment proration.
-Section 4.300 outlines the non-financial criteria a household must meet to be eligible for SNAP. Nonfinancial criteria include identity of clients, Social Security Number (SSN) requirement, residency,
-household composition, citizenship and non-citizenship status, and work program requirements.
-Section 4.400 sets forth the financial criteria a household must meet to be eligible for SNAP. Financial
-criteria include gross and net income standards, resource standards, and deductions from income.
-Section 4.500 sets forth policies and procedures regarding the verification and documentation of a
-household’s circumstances.
-Section 4.600 outlines a household’s obligation to report changes during the certification period, and how
-certain changes are handled by the local office.
-Section 4.700 sets forth policies and procedures for issuing SNAP benefits, including restoration and
-replacement of issuances.
-Section 4.800 outlines the rules and processes regarding claims, appeals, and fraud.
-Section 4.900 outlines state and county administrative requirements.
-4.120
-
-PURPOSE OF SNAP
-
-The purpose of SNAP is expressed by the United States Congress in Section 2 of the Food and Nutrition
-Act of 2008, Public Law No. 110-246 (codified at 7 USC 2011).
-SNAP is designed to promote the general welfare and to safeguard the health and well-being of the
-nation’s population by raising the levels of nutrition among low-income households.
-
-14
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-4.130
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-USING SNAP BENEFITS
-
-SNAP benefits received by an eligible household may be used at any time by the household or other
-persons whom the household selects to purchase eligible food for the household. SNAP benefits are
-issued through an Electronic Benefit Transfer (EBT) system in which benefit allotments are stored on an
-electronic benefit transfer card and used to purchase authorized items at a point-of-sale (POS) terminal.
-EBT cards shall be presented only to retailers authorized by USDA/FNS to accept food benefit payment
-for food purchases.
-SNAP benefits must be used to pay for food currently purchased and cannot be used to pay for foods
-previously or subsequently secured or to pay back bills owed the grocer. The only exceptions are that
-SNAP benefits may be used to pay for food items such as milk or bakery goods that are delivered to the
-home on a regular basis, or for advance payment to a non-profit cooperative food venture when food
-purchased is to be delivered later.
-A.
-
-Expungement
-1.
-
-Upon approval of benefits, SNAP recipients are provided information in writing that any
-SNAP benefits issued to the EBT card that are unused after nine (9) months (274 days)
-will be expunged and removed from the account.
-
-2.
-
-Upon approval of benefits, SNAP recipients are provided information in writing that if the
-EBT account goes inactive (no food purchases or returns) after nine (9) months (274
-days), the inactive SNAP benefits will be considered expunged and removed from the
-account.
-
-4.130.1 WHERE HOUSEHOLDS CAN USE SNAP BENEFITS
-A.
-
-B.
-
-Specified persons may use their SNAP benefits to purchase meals from the following:
-1.
-
-A meal delivery service approved by the USDA, Food and Nutrition Service (FNS);
-
-2.
-
-A communal dining facility for persons aged sixty (60) years and older and/or SSI
-households;
-
-3.
-
-An authorized drug or alcoholic treatment and rehabilitation center;
-
-4.
-
-An authorized public or private, nonprofit group living arrangement facility; and
-
-5.
-
-A shelter for battered women and children.
-
-Households containing persons experiencing homelessness shall be permitted to use their
-benefits to purchase prepared meals from an authorized public or private nonprofit provider for
-persons experiencing homelessness. A meal provider for persons experiencing homelessness
-means a public or private non-profit establishment, including, but not limited to, soup kitchens and
-temporary shelters which feed persons experiencing homelessness. To be considered a meal
-provider to persons experiencing homelessness, the meal provider must be approved as such by
-the USDA, FNS.
-Households containing persons experiencing homelessness may also purchase meals from
-restaurants if the restaurant offers discounts to or serves food to households containing persons
-experiencing homelessness at concessional (reduced) prices, and the restaurant is authorized by
-the USDA, FNS as a retailer.
-
-15
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.130.2 ELIGIBLE FOODS
-Households can only purchase eligible foods with SNAP benefits. Eligible foods include:
-A.
-
-Any food or food product intended for human consumption, except for alcoholic beverages,
-tobacco, and hot food, including hot food products prepared by the retailer and sold at above
-room temperature for immediate consumption.
-
-B.
-
-Seeds and plants to grow foods for personal consumption by eligible household members.
-
-4.140
-
-CONFIDENTIALITY
-
-A.
-
-If there is a written request by a responsible member of the household, the current authorized
-representative, or a person acting on behalf of the household to review materials contained in the
-case record, the material and information contained in the case record shall be made available to
-the requestor.
-1.
-
-B.
-
-The local office shall withhold confidential information, such as the names of persons who
-have disclosed information about the household without the household’s knowledge, or
-the nature or status of pending criminal investigations or prosecutions.
-
-Use or disclosure of information obtained from a SNAP household or from any State or Federal
-agency included in the Income and Eligibility Verification System (IEVS), including the Internal
-Revenue Service (IRS), Social Security Administration (SSA) and Colorado Department of Labor
-and Employment (DOLE) exclusively for SNAP, shall be restricted to the following persons, as
-described in 7 C.F.R 272.1(C)(1). Incorporated by reference in section 4.100:
-1.
-
-Persons directly connected with the administration or enforcement of the provisions of the
-Food Stamp Act or regulations, other Federal assistance programs, federally- assisted
-State programs providing assistance on a means-tested basis to low-income individuals,
-or general assistance programs which are subject to the joint processing requirements in
-section 4.202.1.
-
-2.
-
-Employees of the Comptroller General's office of the United States for audit examination
-authorized by any other provision of law;
-
-3.
-
-Local, State or Federal law enforcement officials, upon their written request, for the
-purpose of investigating an alleged violation of the Food Stamp Act or regulations. The
-written request shall include the identity of the individual requesting the information and
-his/her authority to do so, the violation being investigated, and the identity of the person
-about whom the information is requested;
-Local, State, or Federal law enforcement officers acting in their official capacity, upon
-written request by such law enforcement officers that includes the name of the household
-member being sought, for the purpose of obtaining the address, social security number,
-and, if available, photograph of the household member, if the member is fleeing to avoid
-prosecution or custody for a crime, or an attempt to commit a crime, that would be
-classified as a felony (or a high misdemeanor in New Jersey), or is violating a condition of
-probation or parole imposed under a Federal or State law. The agency shall provide
-information regarding a household member, upon written request of a law enforcement
-officer acting in his or her official capacity that includes the name of the person being
-sought, if the other household member has information necessary for the apprehension
-or investigation of the other household member who is fleeing to avoid prosecution or
-custody for a felony or has violated a condition of probation or parole imposed under
-Federal or State law.
-
-16
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-The agency must accept any document that reasonably establishes the identity of the
-household member being sought by law enforcement authorities. If a law enforcement
-officer provides documentation indicating that a household member is fleeing to avoid
-prosecution or custody for a felony, or has violated a condition of probation or parole, the
-agency shall follow the procedures in 4.304.4 to determine whether the member's
-eligibility in the SNAP program should be terminated. A determination and request for
-information that does not comply with the terms and procedures in 4.304.4 is not
-sufficient to terminate the member's participation. The agency shall disclose only such
-information as is necessary to comply with a specific written request of a law enforcement
-agency authorized by this paragraph.
-4.
-
-Persons connected with the Parent Locator Service. Information made available to the
-Parent Locator Service must be restricted to the client’s most recent address and place of
-employment;
-
-5.
-
-Persons directly connected with the administration of the Child Support Program under
-part D, title IV of the Social Security Act, in order to assist in the administration of their
-program, and employees of the Secretary of Health and Human Services as necessary to
-assist in establishing or verifying eligibility or benefits under Titles II and XVI of the Social
-Security Act;
-
-6.
-
-Persons directly connected with the verification of immigration status of non-citizen SNAP
-clients through the Systematic Alien Verification for Entitlements (SAVE) system, to the
-extent the information is necessary to identify the individual for verification purposes;
-
-7.
-
-School authorities for the purpose of determining which children are from families who
-participate in SNAP. This information is used to determine eligibility for meals under the
-National School Lunch or Breakfast Program; and,
-
-8.
-
-Persons directly connected with the administration or enforcement of programs included
-in the Income and Eligibility Verification System (IEVS). Information obtained through the
-IEVS will be stored and processed so that no unauthorized personnel may acquire or
-retrieve the information for unauthorized purposes. All persons with access to information
-obtained pursuant to the IEVS requirements will be advised of the circumstances under
-which access is permitted and the sanctions imposed for illegal use or disclosure of the
-information.
-
-C.
-
-SNAP is subject to the confidentiality requirements of section 26-1-114, C.R.S. to the extent the
-provisions of that section are not preempted by Federal law.
-
-4.150
-
-RIGHT AND OPPORTUNITY TO REGISTER TO VOTE
-
-A client for SNAP benefits shall be provided the opportunity to register to vote. The local office shall
-provide to all clients the prescribed voter registration application.
-The local office shall not:
-A.
-
-Seek to influence the applicant's political preference or party registration.
-
-B.
-
-Display any political preference or party allegiance.
-
-C.
-
-Make any statement to an applicant or take any action, the purpose or effect of which is to
-discourage the applicant from registering to vote.
-
-17
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-D.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Make any statement to an applicant or take any action, the purpose or effect of which is to lead
-the applicant to believe that a decision to register or not to register has any bearing on the
-availability of services or benefits.
-
-4.150.1 Transmittal of Voter Registration Records
-A completed voter registration application shall be transmitted to the county clerk and recorder for the
-county in which the local office is located not later than ten (10) calendar days after the date of
-acceptance; except that, if a registration application is accepted within five (5) calendar days before the
-last day for registration to vote in an election, the application shall be transmitted to the county clerk and
-recorder for the county not later than five (5) calendar days after the date of acceptance.
-4.150.2 Confidentiality of Voter Registration Records
-Records concerning voter registration and declination to register to vote shall be maintained for two years
-by the local office, and these records shall not be a part of the SNAP case record and are not subject to
-subpoena. The local office shall ensure the confidentiality of individuals registering or declining to register
-to vote. A voter registration application completed at the local office is not to be used for any purpose
-other than voter registration.
-4.160
-
-COMPLAINT REQUIREMENTS
-
-The local office shall be required to comply with complaint-reporting procedures set forth by the State
-Department. In addition, the local office shall advise any household wishing to file a complaint of the
-complaint procedure and assist in filing a complaint, as appropriate.
-The State Department shall ensure that information concerning the complaint system, including the
-procedure for filing a complaint at the state or county level, is made available to client and any other
-interested parties. Such information shall be made available to clients and other interested parties
-through written materials and posters, including the relevant USDA “And Justice for All” poster. These
-materials shall be prominently displayed in all certification and issuance offices.
-The local office shall make every effort to resolve all complaints, excluding complaints of discrimination,
-brought to their attention at the local level. All complainants shall be informed they have the right to
-contact the State Department if they are not satisfied with the action taken at the local level.
-4.160.1 State Department and Local Office Responsibility
-A.
-
-The State Department shall maintain records of complaints received. These records shall be
-obtained via submission from local offices on a frequency set forth by the State Department.
-These records will be reviewed on an office-by-office basis at least annually. The local office shall
-analyze complaint records for any potential or actual patterns of deficiencies and shall include
-descriptions of those patterns with its submitted materials.
-Complaints lodged directly with the State Department shall be triaged by the Department.
-Appropriate complaints shall be referred to the relevant local office for resolution.
-
-B.
-
-When requested by the State Department, the local office shall be responsible to respond to any
-complaint no later than the response date specified by the Department in the forwarded
-complaint. “Respond to” refers not only to acknowledgement of receipt, but also the successful
-completion of the resolution criteria outlined by the Department in the complaint.
-
-C.
-
-The State-level complaint system shall include notification to the complainant, either verbally or in
-writing, of the action taken in resolving the complaint. Notification to the complainant shall be
-accomplished within the following time frames:
-
-18
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-D.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-1.
-
-Complaints involving expedited services shall be investigated and a response provided to
-the complainant no later than three (3) business days following the date the complaint
-was received by the State Department.
-
-2.
-
-All other complaints shall be investigated, and a response provided to the complainant no
-later than thirty (30) calendar days following the date the complaint was received by the
-State Department.
-
-If a complaint can be resolved through the fair hearing process, the State Department shall
-advise the complainant of the process for requesting a fair hearing and offer the complainant
-assistance to request a fair hearing. The State Department may require the local office to provide
-the same offer of assistance to the complainant.
-
-4.160.2 Non-Discrimination Complaint Requirements
-State and local offices shall not discriminate against any applicant or participant in any aspect of program
-administration, including, but not limited to, the certification of households, the issuance of benefits, the
-conduct of fair hearings, or the conduct of any other program service for reasons of age, race, color, sex,
-disability, religious creed, national origin, political beliefs, or reprisal or retaliation for prior civil rights
-activity in any program or activity funded by the USDA. Discrimination in any aspect of program
-administration is prohibited. Local offices shall ensure that the nondiscrimination poster provided by FNS
-is prominently displayed. Posters may be obtained through the State Department.
-The local office shall explain complaint procedures to each person expressing an interest in filing a
-discrimination complaint and shall advise the individual of the right to file a complaint under this
-procedure. Such information shall be made available within ten (10) calendar days from the date of
-request.
-4.160.21
-A.
-
-Discrimination Complaint Procedure
-
-Individuals who believe they have been subject to discrimination may file a written complaint with
-the USDA, FNS national office, the local office, and/or the State Department. All complaints of
-alleged discrimination shall be made in writing and shall be submitted to the FNS national office.
-If allegations of discrimination are made verbally, and if the complainant is unable or unwilling to
-put the allegations in writing, the State or county employee to whom the allegation is made shall
-document the complaint in writing. The person accepting the complaint shall make every effort to
-secure the information specified in Subsection C, below.
-
-B.
-
-The complainant shall be advised that a complaint may be submitted to the State Department,
-FNS or both, and that a complaint shall not be investigated unless information specified in items
-C, 2, through C, 4, below, is provided. In addition, the complainant shall be advised that a
-complaint must be filed no later than one hundred eighty (180) calendar days from the date of the
-alleged discrimination. The local office shall date stamp or otherwise note the date the complaint
-is received by the office.
-1.
-
-Complaints directed to the FNS national office shall be addressed to: U.S. Department of
-Agriculture, Director, Office of the Assistant Secretary for Civil Rights, 1400
-Independence Avenue, S.W., Washington, D.C. 20250-9410; Fax: (202) 690-7442;
-Email: program.intake@usda.gov.
-
-2.
-
-Complaints directed to the State Department shall be addressed to: Colorado
-Department of Human Services, SNAP, 1575 Sherman St., Denver, CO 80203.
-
-19
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-The complaint shall include the following information to facilitate investigations to be considered
-complete:
-1.
-
-The name, address, and telephone number or other means of contacting the person
-alleging discrimination;
-
-2.
-
-The location and name of the office which is accused of discriminatory practices;
-
-3.
-
-The nature of the incident or action, or the aspect of Program administration that led the
-person to allege discrimination;
-
-4.
-
-The reason for the alleged discrimination;
-
-5.
-
-The name(s) and title(s), if appropriate, of person(s) who may have knowledge of the
-alleged discriminatory act; and
-
-6.
-
-The date(s) on which the alleged discriminatory action(s) occurred.
-
-4.160.22
-
-Disposition of Discrimination Complaints
-
-When the local office receives a complaint of alleged discrimination and obtains a complete discrimination
-complaint, it shall transmit a copy of the complaint to the FNS national office and/or the State Department
-within five (5) working days. The State Department shall file the complaint with the FNS national office on
-behalf of the complainant if the local office does not file the complaint with the FNS national office.
-4.200
-
-APPLICATIONS AND RECERTIFICATIONS
-
-This section specifically discusses processing of initial applications and applications for recertification.
-4.201
-
-APPLICATION PROCESSING
-
-A.
-
-Local offices shall not apply additional conditions or processing requirements that are beyond
-those prescribed by State SNAP rules. The application process includes the filing and completion
-of an application form, being interviewed, and verifying certain information. Signs shall be posted
-in certification offices that explain the application processing standards and the right to file an
-application on the day of initial contact. Similar information about same-day filing shall be
-included in outreach materials and on the application form.
-
-B.
-
-The local office shall act promptly on all applications and provide SNAP benefits retroactive to the
-month of application to those households that have completed the application process and have
-been determined to be eligible.
-
-C.
-
-Applications will be screened as they are filed, or as individuals come in to apply, to determine
-eligibility for expedited service or for normal processing. Applicants entitled to expedited service
-shall be informed immediately and given a same-day interview, whenever possible. Those eligible
-for expedited processing shall be served in accordance with Sections 4.205.1 and 4.205.11 while
-those eligible for normal processing shall be served in accordance with Section 4.205.2. Local
-offices shall not conduct any pre-eligibility screening process prior to securing the date of
-application.
-
-20
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-D.
-
-The household may voluntarily withdraw its application at any time prior to a determination of
-eligibility. Once a determination of eligibility is made, the household may voluntarily terminate its
-participation. Any reason given by the household for withdrawal or termination shall be
-documented in the case file. A Notice of Action form, indicating voluntary withdrawal of
-application or voluntary termination of participation, shall be sent to the household within ten (10)
-calendar days of the decision, to confirm the action taken. The household shall be advised of its
-right to reapply at any time after withdrawal.
-
-E.
-
-No household shall have its SNAP benefits denied solely based on its application to participate in
-another program being denied or its benefits under another program being terminated, without a
-separate determination by the local office that a household failed to satisfy a SNAP eligibility
-requirement.
-
-F.
-
-Households denied SNAP that have an SSI application pending shall be informed on the notice of
-denial of the possibility of categorical eligibility if they become SSI recipients. Residents of public
-institutions who apply jointly for SSI and SNAP benefits prior to their release from the institution
-shall not be eligible for SNAP until the individual has been released from the public institution.
-
-G.
-
-Local offices shall record in the automated system racial and ethnic data provided by an applicant
-household. The purpose of obtaining this information is not to affect the eligibility or the level of
-benefits, but rather to ensure that SNAP benefits are distributed without regard to race, color, or
-national origin. Households that do not declare race and/or ethnicity information shall not be
-subject to additional observation or questioning to obtain such information. Under no
-circumstance should an eligibility technician challenge or change a self-declaration made by a
-household member.
-
-4.202
-
-FILING AN APPLICATION
-
-A.
-
-Regardless of what type of application system is used, the local office must provide a means for
-applicants to immediately begin the application process. The household shall be advised it may
-file an incomplete application form if the form contains a name, address, and is signed by a
-responsible household member or the household's authorized representative. Signatures include
-handwritten signatures, electronic signature techniques, recorded telephonic signatures, or
-documented gestured signatures. A valid handwritten signature includes a designation of an X.
-Local offices shall accept applications for SNAP during normal business hours and shall not be
-restricted to a certain day or time of day. The household shall be advised that it need not be
-interviewed before filing an application. The local office shall inform applicants that receiving
-SNAP will have no bearing on any other program's time limits that may apply to the household.
-
-B.
-
-Persons who request information for SNAP must be advised of expedited service provisions and
-encouraged to apply so that eligibility processing can begin. County local offices shall encourage
-the filing of an application form on the same day the household or its representative contacts the
-local office in person or by telephone and expresses interest in obtaining SNAP, or indicates the
-household is without food or the means to obtain food.
-
-C.
-
-Local offices shall make application forms readily accessible to applicant households, as well as
-to groups and organizations, and shall also provide an application form to anyone who requests
-the form. If a household contacting the local office by telephone does not wish to come to the
-appropriate office to file the application that same day and instead prefers receiving an
-application through the mail, the local office shall mail an application form to the household on the
-same day the telephone request is received. An application shall also be mailed on the same day
-a written request for SNAP is received.
-Application forms shall be made available in Spanish, or other appropriate languages for use in
-those counties where it has been determined in conjunction with the State local office that there
-are a significant number of households without an adult member fluent in English.
-
-21
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-D.
-
-The state or local office shall annotate the application form by recording the date the form was
-received. All valid applications which are paper, transmitted by fax or other electronic
-transmissions, are acceptable. When an application is submitted through such means outside of
-business hours, the application filing date shall be recorded as the next business day.
-
-E.
-
-Households must file applications by submitting the forms in person, through an authorized
-representative, by fax or other electronic transmission, by mail, or by completing an online
-electronic application. The local office must inform the applicant that they can obtain a copy of
-their application and provide the household with a copy of their completed application upon the
-request of the client. A copy of a completed application can be a copy of the information provided
-by the client that was used or will be used to determine a household’s eligibility and benefit
-allotment. At the option of the household, this may be provided in an electronic format.
-
-F.
-
-Applications are valid for a period of sixty (60) calendar days or until eligibility has been
-determined, whichever is sooner. Once eligibility has been determined, households must submit
-a new application if the household:
-
-G.
-
-1.
-
-Failed to attend an interview in the first thirty (30) days of the application, or
-
-2.
-
-Was determined ineligible due to household circumstances.
-
-Local offices shall record in the automated system racial and ethnic data provided by an applicant
-household. The purpose of obtaining this information is not to affect the eligibility or the level of
-benefits, but rather to ensure that SNAP benefits are distributed without regard to race, color, or
-national origin. In those instances when the information is not provided voluntarily by the
-household on the application form, the local office shall use alternative means of collecting the
-ethnic and racial data on households, such as by observation during the interview. Under no
-circumstance should an eligibility technician challenge or change a self-declaration made by a
-household member.
-
-4.202.1 Public Assistance (PA) Applications and Processing
-A.
-
-Households applying for PA shall be notified of their right to apply for SNAP at the same time and
-shall be allowed to apply for SNAP at the same time they apply for PA benefits.
-
-B.
-
-The local office shall provide benefits using the original application and any other pertinent
-information occurring after that application for any household filing a joint application for SNAP
-and PA benefits. The original application and relevant subsequent information shall also be used
-for households that are categorically eligible when they are determined eligible to receive PA after
-being denied for SNAP. The local office shall not re-interview the household but shall use mail or
-telephone contact to obtain information about any changes.
-
-C.
-
-Households whose PA applications are denied shall not be required to file a new SNAP
-application. The household shall have its SNAP eligibility determined or continued based on the
-applications filed jointly for PA and SNAP purposes and any other documented information
-obtained after the application that may have been used in the PA determination.
-
-4.202.2 Application Filing by Ineligible Individuals
-The ineligibility of certain individuals for SNAP benefits will not prohibit the remaining household members
-from applying for and receiving SNAP. Ineligible individuals living in an applicant household shall not be
-considered eligible household members for SNAP purposes; however, the ineligible individual’s income
-and resources are considered in the household’s eligibility determination and benefit allotment.
-
-22
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-When the eligible members of a household are all unemancipated minors and the only adult is an
-ineligible individual, the ineligible individual may apply on behalf of the eligible minors without being
-considered as having applied for themself. However, if there is any other eligible adult in the household,
-even though they would not normally be considered the head of household, that eligible person should file
-an application as the head of household.
-4.202.3 SSI Households Submitting SNAP Applications to the Social Security Administration
-(SSA)
-A.
-
-Whenever a member of a household consisting only of SSI clients transacts business at an SSA
-office, the member has a right to apply for SNAP at the SSA office or the local office. The SSA
-office is not required to accept applications for SSI clients who are not members in a household
-consisting entirely of SSI clients unless a county has out stationed an eligibility technician at the
-SSA office. The SSA office will refer non-SSI households to the correct local office. An SSI client
-shall be informed at the SSA office of the availability of SNAP benefits and the availability of the
-SNAP application at the SSA office. The SSA office shall also complete joint SSI and SNAP
-applications for residents of public institutions who apply for SSI prior to their release from the
-institutions. The clients shall be permitted to apply for SNAP while they apply for SSI.
-
-B.
-
-The SSA office will accept and complete SNAP applications from SSI households and forward
-them, within one working day after receipt of a signed application, to the appropriate local office.
-The SSA will use the SNAP application. The application will be transmitted to the local office with
-documentation of verification obtained. When an SSA office sends a SNAP application and
-supporting documentation to an incorrect local office, the application and documentation shall be
-sent to the correct office within one working day.
-
-C.
-
-The SSA office is required to prescreen all SNAP applications for entitlement to expedited service
-and shall mark “expedited processing” on the first page of all applications of households that
-appear to be entitled to such processing. The SSA will inform households which appear to meet
-the criteria for expedited service that benefits may be issued a few days sooner if the household
-applies directly at the local office. The household may take the application from the SSA office to
-a local office for screening, interviewing, and processing of the application. Each local office shall
-furnish the SSA office(s) serving its geographical area with a street map and/or map defining its
-boundaries together with the addresses of the local offices in the project area.
-
-D.
-
-The local office shall prescreen all applications received from the SSA office for entitlement to
-expedited service on the day the application is received at the correct local office. All households
-entitled to expedited service shall be certified in accordance with Sections 4.205.1 and 4.205.11,
-except that the expedited processing time standard shall begin on the date the application is
-received at a local office in the correct county. To prevent duplication, the local office shall
-develop and implement a method to determine if members of SSI households whose applications
-are forwarded by the SSA office are currently participating in SNAP.
-
-4.202.31
-
-SSI Telephone Applications and Recertifications Completed by the SSA
-
-A.
-
-If an SSA office takes an SSI application or recertification on the telephone from a household
-consisting only of SSI clients, a SNAP application shall also be completed during the telephone
-interview and shall be mailed by the SSA office to the client for signature for return to the SSA
-office or to the local office. The SSA office shall then forward any SNAP applications it receives to
-the local office. The local office shall not require the household to be interviewed again. The local
-office may contact the household further to obtain additional information for the eligibility
-determination.
-
-B.
-
-The SSA office shall mail information of the client’s right to file a SNAP application at the SSA
-office if all members or their household are SSI clients, or at their local office, and their right to an
-interview to be performed by the local office.
-
-23
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-C.
-
-For households consisting entirely of SSI clients who apply for SNAP certification at an SSA
-office, the application shall be considered filed for normal processing purposes when the
-application is received by the SSA.
-
-4.202.32
-A.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-SSI and SNAP Joint Processing
-
-In those instances where an application has been completed at the SSA office, the local office
-shall ensure that information required by Section 4.502 is verified prior to certification for
-households initially applying, and households entitled to expedited certification services shall be
-processed in accordance with Sections 4.205.1 and 4.205.11. In those cases where the SSI
-household submits its SNAP application to the local office rather than through the SSA office, all
-verification, including that pertaining to SSA program benefits, shall be provided by the
-household, by State Data Exchange (SDX) or Beneficiary Data Exchange (BENDEX), or obtained
-by the local office rather than being provided by the SSA.
-For those cases in which SSI and SNAP are being processed simultaneously, the local office
-shall question the household and/or use SDX listings to obtain information on SSI determinations.
-If the information cannot be obtained through SDX listings and/or questioning the households, a
-written inquiry may be made to the SSA office to obtain information of the status of SSI
-determinations. Within ten (10) calendar days of learning of the determination of the SSI
-application, the local office shall act in accordance with Section 4.604.
-
-B.
-
-The expedited processing time standard for clients who filed prior to the release from a public
-institution will begin on the date that the individual is released from the public institution. The SSA
-shall notify the local office of the date of release of the client from the institution. Benefits shall be
-restored back to the date of a client’s release from a public institution if, while in the institution, the
-client jointly applied for SSI and SNAP, but the local office was not notified on a timely basis of
-the client’s release.
-
-4.202.33
-
-Out Stationing Eligibility Technicians in SSA Offices
-
-If the local office, with the approval of the State Department, chooses to outstation eligibility technicians at
-SSA offices, with SSA's concurrence, the following actions shall be completed:
-A.
-
-SSA will provide adequate space for SNAP eligibility technician in SSA offices;
-
-B.
-
-The local office shall have at least one out stationed technician on duty at all time periods during
-which households will be referred for SNAP application processing. In most cases, this would
-require the availability of an out stationed technician throughout normal SSA business hours;
-
-C.
-
-The following households shall be entitled to file SNAP applications with, and be interviewed by,
-an out stationed eligibility technician:
-
-D.
-
-1.
-
-Households containing an SSI client.
-
-2.
-
-Households which do not have an SSI client but which contain an applicant for or
-recipient of benefits under Title II of the Social Security Act, if the county and the SSA
-have an agreement to allow the processing of such households at SSA offices.
-
-Households shall be interviewed for SNAP on the day of application unless there is insufficient
-time to conduct an interview. The county shall arrange for the out stationed technician to interview
-clients as soon as possible;
-
-24
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-E.
-
-The out stationed eligibility technician(s) shall not refuse to provide service to a client because
-they do not reside in the county or project area in which the SSA office is located, if they reside
-within the jurisdiction served by the SSA office and the State. The county is not required to
-process the applications of persons who are not residing within the SSA office’s jurisdiction but
-who do reside within the county's jurisdiction, other than to forward the forms to the correct local
-offices;
-
-F.
-
-The county may permit the eligibility technician out stationed at the SSA office to determine the
-eligibility of households, or may require that completed applications be forwarded elsewhere for
-the eligibility determination;
-
-G.
-
-Applications from households entitled to joint processing through an out stationed eligibility
-technician shall be considered filed on the date they are submitted to that technician. Both the
-normal and expedited service time standards shall begin on that date; and,
-
-H.
-
-Households not entitled to joint processing shall be entitled to obtain and submit applications at
-the SSA office. The out stationed eligibility technician need not process these applications except
-to forward them to correct local office where they shall be considered filed upon receipt. Both the
-normal and expedited service time standards shall begin on that date.
-
-4.203
-
-HEAD OF HOUSEHOLD AND AUTHORIZED REPRESENTATIVES
-
-Application for participation shall be made in the name of the household, by the head of the household,
-the spouse, another household member, or an authorized representative.
-4.203.1 Designating a Head of Household
-A.
-
-The local office shall allow a household to select an adult parent of children (of any age) living in
-the household, or an adult who has parental control over children (under 18 years of age) living in
-the household, as the head of household provided that all adult members agree to the selection.
-The household may make this designation each time the household is certified for participation
-but may not change the designation during a certification period unless there is a change in the
-composition of the household.
-
-B.
-
-The local office shall not use the head of household designation to impose special requirements
-on the household, such as requiring that the head of household, rather than another responsible
-member of the household, appear at the local office to apply for benefits. If the household is not
-able to select its head of household, or an eligible household does not choose to select its head
-of household, the local office may make a reasonable determination of the head of household
-with an understanding that the head of household is usually the household member who has the
-most knowledge of the household's financial circumstances. If the only adult living in the home is
-not eligible for SNAP nor required to be included in the household, they can be designated as the
-head of household and apply on behalf of the unemancipated minors in the home.
-
-4.203.2 Designating Authorized Representatives
-A.
-
-The head of the household, spouse, or any other responsible household member may designate
-in writing someone to act on behalf of the household to apply, obtain an EBT card, and/or use the
-EBT card to purchase food for the household. In instances where a household needs an
-authorized representative but is unable to obtain one, the local office will assist such a household
-in finding one. The local office will assure that authorized representatives are properly
-designated; that is, the name of the authorized representative and the justification for appointing a
-person outside the household shall be maintained as part of the household's permanent case
-record.
-
-25
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-1.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Submitting an Application
-The authorized representative must be a person who is sufficiently aware of relevant
-household circumstances. Whenever possible, the head of the household or spouse
-should prepare or review the application even though another household member or an
-authorized representative is the person interviewed.
-The local office shall inform the household that the household will be held liable for any
-over-issuance which results from erroneous information given by the authorized
-representative.
-
-2.
-
-Obtaining an EBT Card
-An authorized representative may be designated to obtain an EBT card for the household
-at the time the household applies for participation. The authorized representative
-responsible for obtaining an EBT card may be the same individual designated to apply for
-the household or may be another individual. Even if a household member can apply and
-obtain an EBT card, the household should be encouraged to name an authorized
-representative responsible for obtaining an EBT card in case of illness or other
-circumstances which might result in an inability to obtain SNAP benefits.
-
-3.
-
-Using an EBT Card
-The authorized representative may use the household’s EBT card to purchase food for
-the household's consumption provided the authorized representative is acting with the full
-knowledge and consent of the household.
-
-4.
-
-Restrictions
-An authorized representative may act on behalf of more than one household and limits
-shall not be placed on the number of households an authorized representative may
-represent, but such an arrangement should be approved only if there is a bona fide need.
-In determining such need, consideration shall be given to the proximity of the households
-to one another, the distance to the certification or issuance office, the availability of
-transportation, and the health of the household members involved. In the event
-employers, such as those that employ migrants, are designated as authorized
-representatives or that a single authorized representative has access to multiple EBT
-cards, the certification office should make certain that:
-
-B.
-
-a.
-
-The household has freely requested the assistance of the authorized
-representative;
-
-b
-
-The household's circumstances are correctly stated and the household is
-receiving the correct amount of benefits; and,
-
-c.
-
-The authorized representative is properly using the EBT card.
-
-In the event the only adult living with a household is classified as a non-household member, that
-individual may be the authorized representative for the minor household members.
-
-4.203.21
-
-Individuals Who Cannot Be an Authorized Representative
-
-The following individuals cannot be an authorized representative unless otherwise stated:
-
-26
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-A.
-
-Local office employees who are involved in Program eligibility determination and/or issuance
-processes, or the supervisors of such workers, unless the local office determines that no other
-representative is available.
-
-B.
-
-Employees of FNS-authorized retailers and meal services that are authorized to accept SNAP
-benefits, unless the local office determines that no other representative is available.
-
-C.
-
-An individual disqualified for IPV/fraud shall not be an authorized representative during the period
-of disqualification unless the individual is the only adult in the household and the office is unable
-to arrange for another authorized representative. Local offices shall determine whether these
-disqualified individuals are needed to apply on behalf of the household, to obtain SNAP benefits
-for the household, and to use the household's SNAP benefits to purchase food.
-
-D.
-
-In no event may an authorized meal provider for persons experiencing homeless act as an
-authorized representative.
-
-4.203.22
-
-Disqualification of an Authorized Representative
-
-An authorized or emergency authorized representative (section 4.203.3, below) may be disqualified from
-representing a household in SNAP for up to one (1) year if the local office has obtained evidence that the
-representative has misrepresented a household's circumstances and has knowingly provided false
-information pertaining to the household or has made improper use of SNAP benefits. The local office shall
-send written notification to the affected household(s) and to the representative thirty (30) calendar days
-prior to the date of disqualification. The notification shall include the proposed action, the reason for the
-proposed action, the household's right to request a fair hearing, the telephone number of the office, and, if
-possible, the name of the person to contact for additional information.
-This provision is not applicable in the case of drug and alcohol treatment centers or to the heads of group
-living arrangements that act as authorized representatives for their residents. However, drug and alcohol
-treatment centers and the heads of group living arrangements that act as authorized representatives for
-their residents, and that intentionally misrepresent households' circumstances, may be prosecuted under
-applicable state fraud statutes for their acts.
-4.203.3 Emergency Authorized Representatives
-The household may designate an emergency authorized representative during the certification period
-should the need arise. Such a person obtains the EBT Card for the household when neither a household
-member nor the previously designated authorized representative is able to obtain the EBT Card because
-of unforeseen circumstances. An emergency authorized representative must be designated in writing by
-the head of the household, spouse, or other responsible household member.
-Local offices shall develop a system by which a household may designate an emergency authorized
-representative to obtain the household's benefits for a particular month. Households shall not be required
-to travel to a local office to designate an emergency authorized representative.
-4.204
-
-Interviews
-
-A.
-
-Interview Requirements
-All applicant households shall undergo a phone or face-to-face interview with a qualified eligibility
-technician prior to initial certification and at least once every twelve (12) months. The State
-Department recommends phone interviews as the default option with face-to-face interviews only
-scheduled upon client request. If an individual does not list a working phone number on the
-application, then the local office must provide a number for the client to call the local office.
-
-27
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-A household certified for twenty-four (24) months is not required to complete an interview at the
-12-month Periodic Report Form (PRF) or at twenty-four (24) month recertification, unless the
-household either requests an interview, is potentially going to be denied for SNAP (24-month
-households only) or has any outstanding issues or questions about the recertification process.
-The applicant may include any person(s) they choose for the interview. The individual interviewed
-may be the head of the household, spouse, or any other responsible member of the household,
-or an authorized representative.
-A face-to-face interview may be conducted at the local office or a mutually acceptable location,
-including the household's residence upon household request. If the interview is to be conducted
-at the residence, it must be scheduled in advance. The interview shall be conducted as an official
-and confidential discussion of household circumstances. The applicant's right to privacy shall be
-protected during the interview. Facilities shall be adequate to preserve the privacy and
-confidentiality of the interview.
-The eligibility technician shall not simply review the information entered on the application but
-shall explore and resolve with the household unclear and incomplete information. Households
-shall be advised of their rights and responsibilities during the interview, including the appropriate
-application processing standard and the household's responsibility to report changes. The
-interviewer must advise households that are applying for other PA programs that any time limits
-and other requirements for the receipt of other PA do not apply to the receipt of SNAP.
-Households may still qualify for SNAP if they have reached a time limit, begun working, or lost
-benefits from another PA program for another reason.
-Upon determination that a person should be referred to an Employment First Unit, the local office
-shall explain to the applicant the pertinent work requirements, the rights and responsibilities of
-work-registered household members, and the consequences of failure to comply. The local office
-shall provide a written statement of these requirements to each work registrant in the household
-and to each previously exempt or new household member when that person becomes subject to
-the work registration and at recertification.
-B.
-
-Scheduling Interviews
-The local office must schedule an interview for all applicant households who are not interviewed
-on the same day they apply to the local office. Interviews shall be scheduled for a specific date
-and time and an appointment letter must be provided to the client at the address on file. All
-interviews, including the date and time of the interview, shall be documented in the case record.
-When scheduling interviews, the interview shall be scheduled as promptly as possible to ensure
-that eligible applicant households receive an opportunity to participate within SNAP’s processing
-guidelines, as outlined in Section 4.205. When the interview is scheduled, the client shall be
-notified that if it a responsible member of the household or its authorized representative fails to
-attend the interview, the household will be responsible for rescheduling and attending an
-interview within thirty (30) days from the date of application and that failure to do so shall result in
-the denial of the application.
-If the local office schedules an interview with the household before the thirtieth (30th) day from
-the application date and no later than the sixtieth (60th) day, the original application can be used,
-and benefits are issued from the original date of application.
-If the household requests an interview date after the thirtieth (30th) day, the local office will deny
-the application on the thirtieth (30th) day and the household must file a new application.
-
-28
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Missed Interviews
-If the household fails to attend its scheduled interview, the local office shall mail the household a
-notice of missed interview, informing the household that it missed the scheduled interview and
-that the household is responsible for rescheduling the interview. If the household does not
-schedule a subsequent interview for a date within thirty (30) calendar days after the application is
-filed, the application shall be denied by the local office on the thirtieth (30th) day following the
-date of application. The application shall not be denied before the thirtieth (30th) day.
-If a household misses its first interview, the household forfeits its right to expedited service,
-unless the second interview is rescheduled for a date within seven (7) days following the date of
-application.
-
-D.
-
-Interviews for PA Households
-If a household is applying for both PA and SNAP, the local office shall conduct a single interview
-at initial application for both PA and SNAP purposes. The applicant household shall complete the
-combined application for PA and SNAP. Following the single interview, the application may be
-processed by separate workers to determine eligibility and benefit levels for SNAP and PA. A
-household's eligibility for an out-of-office interview for SNAP purposes does not relieve the
-household of any responsibility for a face-to-face interview for PA purposes. Except for
-households which may be eligible under basic categorical eligibility, the household's SNAP
-eligibility and benefit level shall be based solely on SNAP eligibility criteria, and all households
-shall be certified in accordance with the noticing, procedural, and timeliness requirements of the
-SNAP regulations. The PA applicant household shall indicate on the single purpose application if
-it does not wish to apply for SNAP.
-
-E.
-
-Interviews for SSI Households
-Households in which all members are SSI clients and are applying and being interviewed for
-SNAP by SSA, will not be required to see a SNAP eligibility technician or otherwise be subjected
-to an additional certification interview. The local office shall accept SSA documentation and shall
-not contact the household to obtain additional information for the eligibility determination unless
-the application is improperly completed, mandatory verification required by Section 4.502 is
-missing, or the local office determines that certain information on the application is questionable.
-In no event shall the client be required to appear at the local office to finalize the eligibility
-determination. Further contact made in accordance with this paragraph shall not constitute a
-second SNAP interview.
-
-4.205
-
-Application Processing Standards
-
-All newly certified households, except those that are given expedited service, shall be given an
-opportunity to participate no later than thirty (30) calendar days following the date the application was
-filed. Households entitled to expedited service shall have benefits available no later than the seventh
-calendar day following the date of application. For application processing purposes, day “one” (1) is the
-first calendar day after the application is received by a local office in the correct county.
-If the local office does not determine a household’s eligibility and provide an opportunity to participate
-within thirty (30) calendar days following the date the application was filed, the office shall determine
-whether the delay was caused by failure to act on the part of the household or on the part of the local
-office as outlined in Sections 4.205.3 through 4.205.4.
-4.205.1 Processing Standards for Expedited Service
-A.
-
-The following households are entitled to expedited service:
-
-29
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-B.
-
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-1.
-
-Migrant or seasonal farm worker households whose liquid resources do not exceed one
-hundred dollars ($100) and who are destitute of income as defined in Section 4.406.
-
-2.
-
-Households whose liquid resources do not exceed one hundred dollars ($100) and who
-reasonably expect to have less than one hundred fifty dollars ($150) of gross monthly
-income in the calendar month of application.
-
-3.
-
-Eligible households whose combined monthly gross income and liquid resources are less
-than the household's anticipated monthly rent/mortgage and utilities. The appropriate
-utility standard, as defined in Section 4.407.31, shall be utilized when determining a
-household’s utility costs.
-
-Households eligible for expedited service shall be able to access EBT benefits no later than the
-seventh (7th) calendar day following the date of application.
-1.
-
-If a household is entitled to expedited service the local office shall conduct the interview,
-unless the household cannot be reached, and complete the application process within
-seven (7) calendar days.
-
-2.
-
-Households entitled to expedited service shall complete an interview prior to any
-determination of eligibility. If a household fails to complete the required interview within
-seven (7) calendar days following the date the application for assistance was filed, the
-household is no longer entitled to expedited benefits by the seventh (7th) day following
-the date of application.
-
-Households that apply for initial benefits after the fifteenth (15 th) of the month under the expedited
-service procedures, which have completed the application and provided all verification within the
-expedited timeframe and have been determined eligible to receive benefits for the initial month
-and the subsequent month, shall receive the application month’s prorated allotment and the next
-full month's allotment at the same time.
-Households applying for initial benefits after the fifteenth (15th) of the month for which verification
-has been postponed shall have the second month's benefits and the prorated allotment available
-on the seventh (7th) calendar day. The household must provide all postponed verification before
-the third month's benefits can be issued.
-
-D.
-
-Households not initially screened as requiring expedited service, but subsequently determined to
-be entitled to such service, shall be entitled to the expedited processing timeframes from the date
-such a determination was made.
-
-E.
-
-If Program benefits are reduced, suspended, or cancelled in accordance with Section 4.904.4,
-households eligible for expedited service shall receive expedited service in accordance with the
-following procedures:
-1.
-
-Those households that receive expedited service in the month(s) in which reductions are
-in effect and are determined to be eligible shall be issued allotments that are reduced in
-accordance with the reduction in effect. These reduced allotments shall be made
-available to the households within the timeframes specified in this section.
-
-2.
-
-Those households that receive expedited service in month(s) in which suspensions are in
-effect and are determined to be eligible shall have benefits issued to them within the
-timeframes specified in this section. However, if the suspension is still in effect at the time
-issuance is to be made, the issuance shall be postponed until the suspension is ended.
-
-30
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-3.
-
-4.205.11
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Households eligible to receive expedited processing and who apply for Program benefits
-during months in which cancellations are in effect shall receive expedited service.
-However, the deadline for completing the processing of such cases shall be five (5)
-calendar days or the end of the month of application, whichever date is later. All other
-rules pertaining to expedited service contained in this section shall be applicable to these
-cases.
-Special Provisions for Expedite Service
-
-A.
-
-Households requesting, but not entitled to, expedited service shall have their applications
-processed according to normal processing standards.
-
-B.
-
-The local office shall use the following procedures for expediting service:
-1.
-
-Prior to certification, the identity of the applicant shall be verified.
-
-2.
-
-Prior to certification of expedited benefits, all reasonable efforts shall be made to verify
-residency, income, or lack thereof, and other factors of eligibility. However, verification
-shall be postponed if it cannot be obtained in sufficient time to meet the expedited
-processing standards. If verification is postponed, the household shall be certified for
-expedited benefits, if determined eligible, for the month of application or, for those
-households applying after the fifteenth (15th) of the month, the month of application and
-the subsequent month.
-a.
-
-Except for migrant households applying after the fifteenth (15th) of a month, when
-a household is certified for expedited benefits for an initial month of application
-and the subsequent month and verification is postponed, a request for
-verification form shall be annotated to indicate what verification is required in
-order for further benefits to be issued.
-
-b.
-
-When households that apply for benefits on or before the fifteenth (15th) of the
-month provide the required postponed verification, the local office shall issue the
-second month's benefits within five working days from receipt of the verification
-or the first of the second month, whichever is later.
-Households that apply after the fifteenth (15th) of the month and provide the
-postponed verification shall be issued the third month's benefits within five
-working days from receipt of verification, or the first of the third month, whichever
-is later.
-Except for migrant households needing out-of-state verification, when the
-postponed verification is not completed within thirty (30) calendar days from the
-date of application, the local office shall terminate the household's participation
-on the thirtieth (30th) calendar day without providing a notice of adverse action.
-
-31
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-c.
-
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Migrants shall be entitled to a postponement of out-of-state verification only once
-each season. If a migrant household requesting expedited service has already
-received this exception during the current season, the local office shall grant a
-postponement of out-of-state verification only for the initial month's issuance and
-not for the second (2nd) month's issuance. Migrant households eligible for
-expedited service and applying after the fifteenth (15th) of a month which are
-assigned certification periods of longer than one month shall be issued a request
-for verification notifying them that they shall provide postponed verification from
-sources within the state before a second month's benefits are issued and shall
-provide all verification from out-of-state sources before being issued benefits for
-the third month. The notice shall also advise the household that if verification
-results in changes in the household's eligibility or level of benefits, such changes
-shall be acted on without providing an advance notice of adverse action.
-
-There is no limit to the number of times a household can be certified under expedited procedures,
-as long as prior to each expedited certification, the household either completes the verification
-requirements that were postponed at the last expedited certification or the household was
-certified under normal processing standards since the last expedited certification.
-
-4.205.2 Normal Processing Standards
-A.
-
-The local office shall process applications as expeditiously as possible and provide eligible
-households a written notification of their eligibility. The applicant household must receive a Notice
-of Action form, which will indicate the household's period of eligibility and SNAP allotment.
-Eligible households shall be provided an opportunity to obtain benefits as soon as possible, but
-no later than thirty (30) calendar days following the date the application was filed. An application
-shall be considered filed the day a local office in the correct county receives a valid application
-containing the applicant's name, address, and signature.
-
-B.
-
-In cases where verification is incomplete, the local office shall provide the household with a
-statement of required verification on the state-prescribed notice form and offer to assist the
-household in obtaining the required verification. The office shall allow the household ten (10)
-calendar days to provide the missing verifications unless the household missed the first
-appointment. If the household misses the first appointment and the interview cannot otherwise be
-rescheduled until after the twentieth (20th) day but before the thirtieth (30th) day following the
-date the application was filed, the household must appear for the interview, bring verification, and
-register members for work by the thirtieth (30th) day. A household can be found ineligible or
-eligible for the month of application and for the following month based on one (1) application if
-sufficient information for such determination is available. The state-prescribed Notice of Action
-form shall reflect specific months of eligibility and ineligibility.
-
-4.205.3 Delays in Processing Beyond Thirty (30) Days
-If the local office does not determine a household's eligibility and provide an opportunity to participate
-within thirty (30) calendar days following the date the application was filed, the office shall determine
-whether the delay was caused by failure to act on the part of the household or on the part of the local
-office. The following shall be used to determine causes of delay beyond thirty (30) calendar days in the
-application process:
-A.
-
-If a household has failed to complete a SNAP application form even though the local office
-offered to assist the client in its completion, the household shall be at fault. If the local office failed
-to assist the household, the local office is at fault. If the local office offered the household
-assistance in completing the application but the household failed to cooperate or failed to
-complete the application process, the local office shall document in the case record its attempt to
-assist the household.
-
-32
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-B.
-
-If a nonexempt household member failed to register for work even though the local office
-informed the household of the work requirements, the household shall be at fault unless
-paragraph D of this section applies. If the local office did not give the client at least ten (10)
-calendar days to supply information, the local office is at fault.
-
-C.
-
-If requested verification is missing even though the local office offered assistance and a written
-notice of needed verification was provided and the household was allowed ten (10) calendar days
-to supply necessary verification, the household shall be considered at fault unless paragraph D of
-this section applies. If the local office did not request necessary verification through a written
-notice, or assist the client as required by these regulations, or give the client time to provide
-information, then the local office is at fault.
-
-D.
-
-If the household failed to appear for the first (1st) interview, failed to schedule a second (2nd)
-interview and/or requested to postpone the interview until after the thirtieth (30th) day following
-the date of application, the delay shall be the household's fault.
-
-E.
-
-If the household missed both scheduled interviews and requests another interview, the delay
-shall be the fault of the household.
-
-F.
-
-If the local office failed to notify the household to schedule a second interview or failed to
-schedule a second interview within the thirty (30) calendar days following the date the application
-was filed or failed to request verification or other necessary action at the interview, the local office
-is at fault.
-
-4.205.31
-
-Delays Caused by the Household
-
-Any time the household requests a postponement which delays the thirty (30) calendar day processing, it
-shall be the household’s fault.
-If the household provides requested verification after the thirtieth (30 th) day and on or before the sixtieth
-(60th) day from the date of application, the local office shall reopen the case without requiring a new
-application and benefits will be prorated from the date the requested verification is provided. Any changes
-in the household situation must be considered for determining eligibility.
-4.205.32
-
-Delays Caused by the Local Office
-
-Delays that are the fault of the local office include, but are not limited to, those cases in which the office
-has failed to take any of the actions listed in Section 4.205.3. Whenever a delay in the initial thirty (30)
-day period is the fault of the local office, the local office shall take immediate corrective action to complete
-the application process. The local office shall not deny the application if the local office caused the delay,
-but shall instead notify the household if there is any action the household must take to complete the
-application process.
-Benefits retroactive to the month of application and prorated for an initial month of application in
-accordance with Section 4.207.2 shall be provided to the household if it is found to be eligible during the
-second thirty (30) day period. If the household is found to be ineligible, the application shall be denied and
-the household shall be sent a notice of action form when the eligibility determination is made.
-
-33
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.205.4 Delays in Processing Beyond Sixty (60) Days
-A.
-
-If the local office is at fault for not completing the application process by the end of the second
-thirty (30) day period, and the case record is otherwise complete, the office shall continue to
-process the original application until an eligibility determination is made. If the household is found
-to be eligible, and the local office was also at fault for the delay in the initial thirty (30) days,
-benefits retroactive to the month of application shall be provided to the household. However, if the
-delay during the initial thirty days was the household's fault, benefits shall only be provided back
-to the month following the month of application (see Section 4.207.2).
-
-B.
-
-If the local office is at fault for not completing the application by the end of the second thirty (30)
-day period, but the case record is insufficiently complete to make an eligibility determination, the
-office shall deny the case and request the household to file a new application, if desired.
-
-C.
-
-If the household is at fault for not completing the application process by the end of the second
-thirty (30) day period, the application shall be denied and a new application required if the
-household wishes to participate. The household shall not be entitled to any lost benefits even if
-the delay in the initial thirty day period was the fault of the local office.
-
-4.206
-
-CATEGORIES OF ELIGIBILITY
-
-A.
-
-Households applying for SNAP must be determined eligible using one of the following categories
-of eligibility: Basic Categorical Eligibility (BCE), Expanded Categorical Eligibility (ECE) or
-Standard Eligibility (SE).
-
-B.
-
-SNAP households that are applying for or receiving benefits from other PA programs in addition
-to SNAP are still required to meet the resource limits and follow the reporting and verification
-requirements of the other PA program(s). Requests for information and verification to determine
-eligibility for other PA programs shall not affect or delay the determination of SNAP eligibility.
-
-C.
-
-Eligibility
-1.
-
-Basic Categorical Eligibility (BCE)
-a.
-
-BCE households are:
-1)
-
-Households in which all members receive, or are authorized to receive,
-SSI, Colorado Works (CW), Old Age Pension (OAP), Aid to the Needy
-Disabled (AND), Aid to the Blind (AB) or a combination of these benefits.
-The CW, SSI, OAP, and/or AB program(s) need only to authorize
-benefits for the household to be considered for BCE. Clients who are
-authorized to receive a benefit from one or more of these programs, but
-who are not paid such benefits because the grant is less than a minimum
-benefit or the benefits are suspended or are being recouped, are still
-considered eligible under BCE rules.
-Households not receiving, or authorized to receive, TANF, Title IV-A or
-SSI benefits, who are entitled to Medicaid only, shall not be considered
-SSI or Title IV-A participants.
-
-2)
-
-A household in which at least one (1) member receives services from the
-Family Preservation Program. This determination must be documented
-in the case record.
-
-34
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-b.
-
-c.
-
-d.
-2.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Households eligible under BCE have been deemed to have met the income and
-resource requirements of the program that confers eligibility; therefore, no further
-verification is required beyond that gathered by the program that confers
-eligibility. However, the local office must collect and verify eligibility factors, if
-these factors are not already collected and verified by the other program, are
-considered questionable, or are unavailable to SNAP. This includes:
-1)
-
-Net income;
-
-2)
-
-Gross income;
-
-3)
-
-Resources;
-
-4)
-
-Residency;
-
-5)
-
-Social Security Number; and
-
-6)
-
-Sponsored non-citizen information.
-
-A household cannot be considered under BCE rules if, at the time of application:
-1)
-
-Any member is disqualified for a SNAP IPV.
-
-2)
-
-Any member has been convicted of a drug-related felony where SNAP
-benefits were used to purchase drugs. Drug-related felony means the
-same as in 7 C.F.R. 273.11(m), which is incorporated by reference in
-section 4.100, above.
-
-Households that are ineligible for SNAP benefits under BCE rules shall have their
-eligibility determined under ECE or SE rules.
-
-Expanded Categorical Eligibility (ECE)
-a.
-
-b.
-
-ECE households are:
-1)
-
-Households with a combined gross income at or below two hundred
-(200%) of the federal poverty level as defined in section 4.401.1; and
-
-2)
-
-Households who have been authorized to receive non-cash Temporary
-Assistance to Needy Families/Maintenance of Effort (TANF/MOE) funded
-service designed to further TANF Purpose Four (4) by “encouraging the
-formation and maintenance of two-parent families.” Language regarding
-the non-cash TANF/MOE funded program shall be provided on the
-application, application for recertification, periodic report form, and/or the
-statement of facts.
-
-Households eligible under ECE have been deemed to have met the income and
-resource requirements of the program that confers eligibility; therefore, no further
-verification is required beyond that gathered by the program that confers
-eligibility. However, the agency must collect and verify eligibility factors, if these
-factors are not already collected and verified by the other program, are
-considered questionable, or are unavailable to SNAP. This includes:
-1)
-
-Net income;
-
-35
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-c.
-
-d.
-3.
-
-2)
-
-Gross income;
-
-3)
-
-Resources;
-
-4)
-
-Residency;
-
-5)
-
-Social Security Number; and
-
-6)
-
-Sponsored non-citizen information
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-A household’s eligibility cannot be determined using ECE rules if, at the time of
-application:
-1)
-
-Any member is disqualified for a SNAP IPV.
-
-2)
-
-Any member has been convicted of a drug-related felony where SNAP
-benefits were used to purchase drugs. Drug-related felony means the
-same as in 7 C.F.R. 273.11(m), which is incorporated by reference in
-section 4.100, above.
-
-Households that are ineligible for SNAP benefits under ECE rules shall have their
-eligibility determined under SE rules.
-
-Standard Eligibility (SE)
-a.
-
-b.
-
-SE rules shall only be applied to the following households:
-1)
-
-Households that include a member who is serving a disqualification for
-an IPV or a fraud conviction;
-
-2)
-
-Households that include a member who has been convicted of a drug
-related felony where SNAP benefits were used to purchase drugs. Drugrelated felony means the same as in 7 C.F.R. 273.11(m), which is
-incorporated by reference in section 4.100, above;
-
-3)
-
-Households that do not meet the criteria to be considered under BCE or
-ECE rules.
-
-Households having their eligibility reviewed under SE rules must meet the
-following criteria:
-1)
-
-Households that include a member who is aged sixty (60) and older or a
-person with a disability must have a combined net income, after all
-applicable deductions, at or below one hundred percent (100%) of the
-federal poverty level. The household must have resources below the limit
-prescribed in Section 4.408; or
-
-2)
-
-Households that do not include a member who is aged sixty (60) and
-older or a person with a disability must have a combined gross income at
-or below one hundred thirty percent (130%) of the federal poverty level.
-After all applicable deductions, the household’s net income must be at or
-below one hundred percent (100%) of the federal poverty level as
-defined in section 4.401.2. The household must have resources below
-the limit prescribed in Section 4.408; or
-
-36
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-3)
-c.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Households must also meet nonfinancial eligibility criteria set out in
-Section 4.300.
-
-Households, as defined in Section 4.304, that are found ineligible under SE rules
-shall be considered ineligible for participation in SNAP.
-
-D.
-
-If the circumstances which allowed the household to meet the criteria to be considered under
-BCE or ECE rules change during the certification period or at the time of recertification or periodic
-report, the household’s eligibility must be re-evaluated according to the appropriate category. If
-there is insufficient documentation to make an eligibility determination based on the new category
-of eligibility, the agency shall send the household a request for verification in accordance with
-Sections 4.604, Action on Reported Changes, and 4.604.1, Verification of Reported Changes.
-
-E.
-
-Substantial lottery or gambling winnings from an individual will disqualify the entire SNAP
-household from eligibility in the month the winnings are received. The next time such a household
-reapplies and is certified for SNAP after losing eligibility, the household must be considered under
-Standard Eligibility (SE) guidelines. After receiving SNAP as a SE household, the SNAP
-household will be re-evaluated for categorical eligibility at the next eligible certification period.
-
-4.207
-
-AUTHORIZING BENEFITS
-
-4.207.1 Newly-Certified and Ongoing Households
-A.
-
-All households shall be placed on an issuance schedule so that they receive their benefits on or
-about the same date each month. The date on which a household receives its initial allotment
-after certification need not be the date that the household must receive any subsequent
-allotments.
-
-B.
-
-All newly certified households shall be given an opportunity to participate no later than thirty (30)
-calendar days following the date the application was filed. Households eligible for expedited
-service shall be given an opportunity to participate no later than seven (7) calendar days following
-the date the application was filed. Day one (1) is the first calendar day after the application is
-received by a local office in the correct county. An opportunity to participate consists of providing
-households with an active EBT card and PIN, posting benefits to the household’s EBT account,
-and making benefits available for spending.
-Local offices shall utilize a mailing system to mail EBT cards and PINs, if applicable, by the
-twenty-eighth (28th) day to ensure that the benefits can be spent by the thirty (30) day standard.
-Local offices shall, at a minimum, use first class mail to send EBT cards to households.
-
-C.
-
-Households that apply for initial month's benefits after the fifteenth (15 th) day of the month, that
-fulfill eligibility requirements, and are determined eligible to receive benefits for the initial month of
-application and the next subsequent month, shall receive their prorated allotment for the initial
-month of application and their first full month's allotment at the same time. Expedited households
-applying for initial benefits after the fifteenth (15th) of the month for which verification has been
-postponed shall be entitled to a combined first (1st) and second (2nd) months' benefits in the same
-timeframes as above. The postponed verification shall be provided prior to the third calendar
-month or the application shall be denied.
-
-D.
-
-An eligible household shall have an opportunity to receive its benefits prior to the end of the
-period of intended use. The period of intended use is defined as the month in which benefits are
-issued. For households certified after the twentieth (20th) of the month, the period of intended use
-is the balance of the month for which benefits are authorized through the last day of the following
-month.
-
-37
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.207.2 Initial Month Allotment Prorating
-A.
-
-The household benefit level for the initial month of application shall be based on the day of the
-month it applies for benefits. Benefits for the initial month shall be prorated from the date of
-application to the end of the month. Applicant households consisting of residents of a public
-institution who apply jointly for SSI and SNAP prior to release from an institution will have their
-eligibility determined for the month in which the applicant household was released from the
-institution. The benefit level for the initial month of certification shall be based on the date of the
-month the household is released from the institution and the household shall receive benefits
-from the date of the household's release through the end of the month. Eligible households are
-entitled to a full month allotment for all months except an initial month of application.
-
-B.
-
-The only exception to the proration policy shall be migrant and seasonal farm worker households
-who are in the job stream and the break in participation does not exceed thirty (30) days. These
-households are entitled to a full month allotment.
-
-C.
-
-The state automated system will utilize the exact number of days in the calendar month to
-determine the proration of benefits. The following formula shall be used to determine the amount
-of prorated benefits:
-1.
-
-Number of days in month plus one;
-
-2.
-
-Subtract the date of application;
-
-3.
-
-Multiply by the full month's benefits the household is eligible to receive;
-
-4.
-
-Divide by the number of days in the application month.
-
-4.207.3 Benefit Allotment
-A.
-
-B.
-
-After eligibility has been established, the monthly SNAP benefit allotment will be determined. The
-state automated system will compute the household’s allotment. The following formula shall be
-used to determine a household’s benefit allotment.
-1.
-
-Multiply the net monthly income by thirty percent (30%)
-
-2.
-
-Subtract the result from the maximum benefit allowed for the appropriate household size,
-as shown in D below.
-
-3.
-
-Round the result down to the nearest dollar.
-
-If the calculation of benefits for an initial month yields an allotment of less than the federal
-minimum allotment referenced in 4.207.3(D), no benefits shall be issued to the household for the
-initial month.
-For eligible households that are entitled to no benefits in their initial month of application, but are
-entitled to benefits in subsequent months, the local office shall certify the household for a
-certification period beginning with the month of application.
-Except for households that are eligible under BCE or ECE, households with three or more
-members who are entitled to zero benefits shall have their SNAP application denied. This
-provision does not apply if zero benefits are due to the pro-ration requirements or due to the initial
-month's allotment being less than the federal minimum allotment referenced in 4.207.3(D).
-
-38
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-C.
-
-Except for an initial month, if the allotment for a one- or two-person household is less than the
-federal minimum allotment referenced in 4.207.3 D, round the allotment up to the minimum
-benefit allowed for a one- or two-person household.
-
-D.
-
-The SNAP maximum and minimum monthly benefit allotment tables will be adjusted as
-announced by the USDA, FNS.
-Household Size
-1
-2
-3
-4
-5
-6
-7
-8
-Each additional person
-
-Maximum Monthly Allotment Effective October 1, 2024
-$292
-$536
-$768
-$975
-$1,158
-$1,390
-$1,536
-$1,756
-+$220
-
-Household Size
-1-2
-
-Minimum Monthly Allotment Effective October 1, 2024
-$23
-
-4.208
-
-CERTIFICATION PERIODS
-
-A.
-
-Certification periods shall conform to calendar months. Households shall be assigned the longest
-certification period possible based on the predictability of the household's anticipated income and
-other circumstances. At the expiration of each certification period, entitlement to SNAP benefits
-ends. Further eligibility shall only be established on a newly completed application for
-recertification. Under no circumstances shall benefits be continued beyond the end of a
-certification period without a new determination of eligibility. The State-prescribed Notice of Action
-form provided to the applicant household shall indicate the period of certification if the household
-is determined to be eligible for benefits.
-
-B.
-
-Upon approval at the time of recertification, a household need not be assigned the same
-certification period as formerly but should be assigned a period of time based on a new review of
-the household’s circumstances.
-
-C.
-
-A delinquent PA recertification shall not delay the SNAP recertification beyond the date of the
-household's SNAP certification period ending date.
-
-4.208.1 Certification Period Guidelines [Rev. eff. 4/1/16]
-Households will be assigned a six (6) month, or twenty-four (24) month certification period as follows:
-A.
-
-Twenty-Four (24) Month Certification Period
-1.
-
-A twenty-four month (24) certification period shall be assigned to households that contain
-only members who are aged 60 and older and/or have a disability and have no earned
-income, as defined in Section 4.403 at the time of certification.
-
-39
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-2.
-
-B.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Households that are assigned a twenty-four (24) month certification period must complete
-a periodic report form at the twelfth (12th) month interval to report any changes that have
-occurred or to report that no changes have occurred since the most recent certification.
-The form shall be returned, or the case will be closed following the notice of adverse
-action period. The notice will state the reason for ending the certification period and that
-the certification period will end following the adverse action period.
-
-Six (6) Month Certification Period
-1.
-
-A household not assigned a twenty-four month certification period as outlined in
-subsection A of this section shall be assigned a six month certification period.
-
-4.208.2 Classification of Households as PA or Non-PA
-A.
-
-PA Households
-PA households are those SNAP households that contain only persons who receive the following:
-
-B.
-
-1.
-
-CW Basic Cash Assistance grant or any type of TANF payment or services under the CW
-Program. The household will be considered a PA household if one (1) member received
-cash assistance or services, but the entire household benefits from the receipt of this
-cash or services, such as when one (1) individual in a household is authorized for family
-preservation; or,
-
-2.
-
-A State Grant (OAP-A, OAP-B, AND/AB); or,
-
-3.
-
-Colorado Supplement to the SSI Grant
-
-Non-PA Households
-All other households are classified as Non-PA households.
-County General Assistance (GA), SSI with no Colorado Supplemental payment, and medical-only
-programs are not considered PA benefits.
-
-4.209
-
-RECERTIFICATION PROCESS REQUIREMENTS
-
-A.
-
-In order to enable timely receipt of an application for recertification, the local office shall provide
-each household with a notice that its certification is about to expire. Benefits will not be continued
-beyond the end of the certification period unless the household is recertified.
-A notice of expiration, as prescribed by the State Department, shall be used by offices to advise
-households that their certification period is ending and that a new application must be filed.
-
-B.
-
-A household shall receive the notice of expiration not less than thirty (30) calendar days and not
-more than sixty (60) calendar days prior to expiration of its current certification period. If mailed,
-the notice shall be sent for the same timely receipt, allowing two (2) extra days for delivery delay.
-All households that file on or before the fifteenth (15th) of the last month of their certification
-period will have timely reapplied. Notices which are mailed must specify a date that allows at
-least two (2) days mail time and still gives the household fifteen (15) calendar days to respond.
-Households that submit an application for recertification by the date specified on their notice of
-expiration shall be considered to have timely reapplied to prevent an interruption in SNAP
-benefits.
-
-40
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-The local office shall conduct an interview with an adult member of the household or its
-authorized representative a minimum of once every twelve (12) months for households certified
-for six (6) months or less. The local office may choose not to interview the household at each
-recertification provided the household has completed an interview within the previous twelve (12)
-months.
-The local office shall schedule the interview so that the household has at least ten (10) calendar
-days to provide verification before the certification period ends. If an interview is required and the
-household fails to attend the scheduled interview, the local office must mail the household a
-notice of missed interview and a notice of denial at the same time.
-The local office may schedule an interview prior to the last month of the certification period or
-prior to the date the application is timely filed, but the household cannot be denied for failing or
-refusing to appear for such an interview. Rather, the local office shall send notice to the
-household in order to reschedule an appointment for an interview on or after the date the
-application is timely filed.
-
-D.
-
-The recertification process must elicit from the household sufficient information that, when
-combined with information in the case record, will ensure an accurate determination of eligibility.
-The local office shall provide the household with a notice of required verification and the date by
-which the verification must be provided.
-
-4.209.1 Recertification Processing Standards and Timeframes
-A.
-
-B.
-
-Timely Applications for Recertification
-1.
-
-Households that file an application for recertification on or before the fifteenth (15th) of
-the last month of their certification period will have reapplied timely. A timely application
-for recertification shall be approved or denied prior to the end of the household's current
-certification period and shall provide eligible households with an opportunity to obtain
-their benefits by their normal issuance day of the month following the expiration of their
-certification period.
-
-2.
-
-Households which have reapplied timely, but because of local office error are not
-determined eligible in sufficient time to permit normal issuance to the household in the
-following month, shall receive an immediate opportunity to participate upon being
-determined eligible. Such households shall be entitled to participate and receive a full
-month's allotment for the month following the expiration of the certification period.
-
-Untimely Applications for Recertification
-1.
-
-Households which file an application for recertification anytime between the sixteenth
-(16th) and the last day of the last month of the certification period shall not be considered
-as having timely reapplied. For households that have not timely reapplied, but have been
-found eligible, benefits may be delayed past the household’s normal issuance day. The
-household shall be notified of approval or denial on a notice of action form within thirty
-(30) calendar days of when the application for recertification was submitted to the local
-office.
-
-41
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-C.
-
-Late Applications for Recertification
-1.
-
-D.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-If a household files an application form within thirty (30) calendar days after the end of the
-certification period, the application shall be considered and processed as an application
-for recertification and shall have the allotment for the initial month of application prorated
-from the day of application to the end of the month, unless the local office was at fault for
-the delay. For applications received within thirty (30) calendar days after the expiration of
-the certification period, verification requirements shall remain consistent with the
-verification requirements for applications that were filed prior to the expiration of the
-certification period as outlined in Section 4.502, B.
-
-If an application for recertification is denied for a failure of the household to take a required action,
-the local office shall reopen the case if the required action is taken by the end of the certification
-period and provide benefits for the first month of the new certification period.
-If the household takes the required action after the end of the certification period, but within the
-next thirty (30) calendar days, the local office shall reopen the case and provide benefits
-retroactive to the date that the action was taken by the household.
-
-E.
-
-A household shall lose its right to uninterrupted benefits if one of the following occurs after the
-fifteenth (15th) day of the last month of the household’s certification period:
-1.
-
-A household fails to timely apply for recertification in accordance with Section 4.209.1, A;
-or,
-
-2.
-
-A household timely files an application for recertification but fails to appear for a
-scheduled interview; or,
-
-3.
-
-A household fails to submit all necessary verification by the date specified on the request
-for such verification. The request for verification shall allow the household no less than
-ten (10) days to provide the verification to prevent an interruption in benefits.
-If the household is eligible after providing such verification(s), the county/district shall
-provide benefits within thirty (30) calendar days after the application was filed. If the local
-office is unable to provide benefits within thirty (30) calendar days due to the time allowed
-for providing verification, the office shall provide benefits within five (5) calendar days
-after the household supplies the missing verification. Households that refuse to cooperate
-in providing required information or taking the required actions to determine eligibility
-shall be denied.
-
-4.210
-
-PERIODIC REPORTING REQUIREMENTS
-
-A.
-
-A household consisting solely of members who are persons with a disability and/or members who
-are aged sixty (60) years and older with no earned income can be certified for twenty-four (24)
-months. For households certified for twenty-four months, no interview during the certification
-period shall be required. Households with a twenty-four (24) month certification period are
-required to report changes at the twelve (12) month interim reporting period.
-
-42
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-B.
-
-A PRF shall be mailed to the household during the eleventh (11th) month of the certification
-period for the household to report all changes. If the PRF is not submitted to the local office by
-the fifth (5th) day of the twelfth (12th) month of the certification period, a reminder notice shall be
-sent advising the household that it has ten (10) calendar days plus one (1) calendar day for
-mailing to return the completed report. Households participating in ACP shall be afforded five (5)
-days mailing time. If the household has not submitted the completed form by the extended due
-date on the reminder notice, the SNAP case shall be terminated effective the first day of the
-thirteenth (13th) month and a termination letter shall be mailed to the household. If the household
-submits a PRF or reports changes for any other PA program within thirty (30) calendar days
-following the effective date of the termination notice and provides all required verification, benefits
-shall be issued without proration from the beginning of the thirteenth (13th) month.
-
-C.
-
-The local office must act on all changes reported by those households filing a PRF. If the
-household files a complete PRF that results in a reduction or termination of benefits, the agency
-shall send an adequate notice. The adequate notice must be mailed at least two (2) business
-days prior to the date that benefits are normally received by the household. If the household fails
-to provide sufficient information or verification regarding a deductible expense, the county local
-office shall not terminate the household but shall instead determine the household’s benefits
-without allowing the deduction.
-
-D.
-
-The household shall report changes in circumstances to the following items on the periodic
-report:
-1.
-
-A change of more than $100 in the amount of unearned income.
-
-2.
-
-A change in the source of income, including starting a job.
-
-3.
-
-All changes in household composition, such as the addition or loss of a household
-member.
-
-4.
-
-Changes in home address and any resulting changes in shelter costs.
-
-5.
-
-Acquisition of a licensed vehicle that is not fully excludable.
-
-6.
-
-A change in liquid resources, such as cash, stocks, bonds, and bank accounts that reach
-or exceed the resource limits for elderly or disabled households and for all other
-households, unless these assets are excluded.
-
-7.
-
-Changes in the legal obligation to pay child support.
-
-8.
-
-Whenever a member of the household wins substantial lottery or gambling winnings.
-
-E.
-
-If allowable medical expenses are reported and verified, the change should be acted upon for the
-remainder of the certification period but only if the change results in an increase in benefits.
-
-4.300
-
-NON-FINANCIAL ELIGIBILITY CRITERIA
-
-Non-financial criteria for eligibility shall apply to all households (including those receiving PA) and shall be
-considered prospectively for the issuance month based on the eligibility technician’s anticipation of
-circumstances at the time of application and when changes are made known to the local office. Nonfinancial criteria shall consist of:
-A.
-
-Identity of applicant; and
-
-B.
-
-Residency; and
-
-43
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-C.
-
-Social Security Number; and
-
-D.
-
-Citizenship and non-citizenship status; and
-
-E.
-
-Household composition, including student and striker eligibility; and
-
-F.
-
-Work registration and employment requirements.
-
-4.301
-
-IDENTITY OF APPLICANT
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-The identity of the person submitting an application shall be verified either through interfaces, collateral
-contact, or client provided verification. When an authorized representative applies on behalf of a
-household, the identity of both the authorized representative and the head of household shall be verified.
-4.302
-
-SOCIAL SECURITY NUMBER REQUIREMENT
-
-A.
-
-General Requirements
-1.
-
-As a condition of SNAP eligibility, each member of a household participating in or
-applying for participation in SNAP shall provide a Social Security Number (SSN), or proof
-that an application for an SSN has been submitted to the SSA. The local office shall not
-require any household member to submit a Social Security card or other official
-documents as a means of verifying an SSN. Household members who provide an SSN
-shall not be denied benefits for failure or inability to present a Social Security card or
-other official documentation. If individuals have more than one SSN, all numbers shall be
-required.
-
-2.
-
-The local office shall explain that a member is not required to provide an SSN, but the
-failure to provide one shall result in disqualification of the individual(s) for whom the
-number is not provided. The member who does not provide an SSN shall still be required
-to provide other eligibility information such as income and resources that will affect
-eligibility of other members. The local office shall advise individuals that any SSN that is
-provided voluntarily will be used in the same manner as SSNs of eligible household
-members. The SSNs will be matched against federal and state databases to verify
-information. SSNs will be used for the initial application matching for duplicate
-participation.
-
-3.
-
-If the household member required to provide an SSN either refuses to supply their SSN
-at the time of application or fails to provide the local office with a form or letter as proof of
-application for a SSN without good cause, they shall be ineligible to participate in SNAP.
-The disqualification applies to the individual(s) who refused to cooperate with the
-application process to obtain the SSN and not the entire household. The household
-member(s) disqualified may become eligible by providing the local office with an SSN, or
-by providing verification that an application for an SSN has been submitted to the SSA.
-
-44
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-B.
-
-Individuals and Newborns Without an SSN
-1.
-
-2.
-
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Those household members who do not have the required SSN shall obtain proof of
-application for an SSN prior to being certified as a member of the household unless the
-member is a newborn child. The applicant/recipient shall be instructed to obtain from the
-SSA proof that they have completed an application for an SSN and that the SSA has
-received that application. A specifically addressed letter from the SSA verifying that
-application for an SSN has been made is also acceptable proof of application for an SSN.
-The applicant/recipient shall be instructed to return the completed form as soon as
-possible to the eligibility technician. A copy of the form shall be maintained in the case
-record.
-a.
-
-If the household is unable to provide proof of application for an SSN for a
-newborn, the household shall provide the SSN or proof of application at its next
-recertification within six (6) months following the baby's birth. The local office
-shall determine if the good cause provisions are applicable at the recertification.
-
-b.
-
-If a participating household's benefits are reduced or terminated within the
-certification period because one or more of its members are required to provide a
-SSN is disqualified for failure to meet the SSN requirement, the local office shall
-issue a Notice of Adverse Action form. The notice shall inform the household that
-the non-cooperating individual(s) without an SSN is being disqualified and show
-the current eligibility and benefit level of the remaining members, as well as a
-statement that the disqualified member(s) may end disqualification by providing
-an SSN.
-
-Household members who provide the eligibility technician with a copy of a form or a letter
-from SSA, or who demonstrate good cause for not providing the proof from SSA (e.g.,
-difficulty in obtaining birth certificates) shall be allowed to continue to participate in SNAP
-as follows:
-a.
-
-When an SSA form or letter is received by the local office or good cause for not
-providing proof is demonstrated, the household member in need of a SSN shall
-be allowed to participate so long as the household is not at fault for not providing
-proof of application with the SSA.
-
-b.
-
-If the required SSNs are provided by the household, or it is demonstrated that
-good cause exists for not having applied for a SSN, the household member(s)
-without an SSN(s) shall remain eligible to participate. If the local office
-determines that the household is at fault for not having proof of application for the
-SSN(s), the member(s) without proof of application shall be disqualified and
-income shall be handled in accordance with Section 4.411.1.
-
-Determining Good Cause for Not Providing an SSN
-1.
-
-In determining good cause, the local office shall consider information received from the
-household member and/or the SSA. Documentary evidence or collateral information that
-the household has applied for the number or made every effort to supply the SSA with
-the necessary information shall be considered good cause. If the household member can
-show good cause why an application has not been completed in a timely manner, that
-person shall be allowed to participate until good cause is no longer applicable or until the
-household’s next recertification. If the household member(s) applying for an SSN has
-been unable to obtain the documents required by the SSA, the eligibility technician
-should assist the individual(s) in obtaining these documents.
-
-45
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-2.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-If an individual refuses to provide an SSN based on a sincere religious objection, all
-members of the household may participate in SNAP, if otherwise eligible. In these
-situations, the local office may check with the SSA to see if the household members
-already have SSNs and may use any existing SSNs for verification and matching
-purposes without further notice to the household.
-
-4.303
-
-RESIDENCY REQUIREMENT
-
-A.
-
-Applicants shall live in the county or district in which they make application for the Program
-unless the local office has made arrangements to allow particular households to file an
-application in a nearby specified county/district office.
-
-B.
-
-Individuals may not participate in more than one (1) household in the same month unless they are
-a resident of a shelter for battered women and children, nor may a household participate in more
-than one (1) county or district in any month unless all household members are residents of a
-shelter for battered women and children.
-Households on Indian reservations participating in the Commodity Food Distribution Program for
-a particular period shall not be allowed to participate in SNAP during the same period.
-Participation shall be limited to participation in the Commodity Food Distribution Program or
-SNAP.
-
-C.
-
-Applicants who maintain a residence in the county or district for any purpose other than a
-vacation, regardless of the length of time they have resided in the county or district, shall be
-considered eligible for the Program, provided other eligibility requirements are met.
-
-D.
-
-Applicants who reside in a county, without residing in a permanent dwelling nor having a fixed
-mailing address, shall be considered eligible for the Program, provided other eligibility
-requirements are met. Migrant campsites satisfy the residency requirement, as do shelters for the
-homeless. Homeless persons satisfy the residency requirement as long as dual participation in
-any month of eligibility is not allowed.
-
-E.
-
-In no instance shall there be a durational residency requirement imposed upon the applicant.
-Intent to permanently remain in the state shall not be a condition of eligibility.
-
-F.
-
-The application contains spaces for both a physical address and a mailing address. If the
-household has a mailing address that is different than the household’s physical address, the
-certification worker should ensure that both addresses are given. For households residing in a
-permanent dwelling, a mailing address only, such as post office box or rural route, will not be
-sufficient, as it does not indicate the household resides in the county. In such cases, information
-should be given that can identify the location of the home. An exception to the requirement for
-physical location may be granted for residents of shelters for battered women and children and
-those that lack a permanent dwelling.
-
-4.304
-
-HOUSEHOLD COMPOSITION
-
-A.
-
-Determining Household Composition
-It is possible for more than one SNAP household to live under the same roof, on the same
-property, or at the same address.
-1.
-
-A household is a group of individuals who live together and customarily purchase and
-prepare food together for home consumption.
-
-46
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-2.
-
-Each household may apply as a separate household if they are not mandatory household
-members due to their relationships or financial responsibility.
-A.
-
-3.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Individuals experiencing homelessness can be determined as a separate
-household under this provision.
-
-If the client is currently purchasing and preparing with other individuals but upon approval
-of SNAP benefits intends to purchase and prepare separately, separate household status
-can be granted.
-
-4.304.1 MANDATORY HOUSEHOLD MEMBERS
-All mandatory household members who live together must be considered in the same household, even if
-the mandatory individuals declare they do not customarily purchase and prepare their food together for
-home consumption.
-A.
-
-Parents and Children
-1.
-
-A person aged twenty-one (21) years and younger living with their natural or adoptive
-parent(s) or stepparent(s).
-A.
-
-2.
-
-A child (other than a foster child) under eighteen (18) years of age who is living with and
-is under the parental control of a household member other than their parent.
-A.
-
-B.
-
-A child under eighteen (18) years of age is considered to be under parental
-control of an individual if the child is financially or otherwise dependent on that
-individual member of the household unless emancipated as defined by state law.
-
-Spouses
-1.
-
-2.
-
-C.
-
-If the child lives in the same home with both parents, regardless of marital status
-or whether or not the parents purchase and prepare their food together, both
-parents must be included in the SNAP household.
-
-Spouses refer to:
-A.
-
-Persons defined as married to each other under state law.
-
-B.
-
-Persons living together who are free to marry and are representing themselves
-as spouses to relatives, friends, neighbors, or the larger community.
-
-In situations where a spouse is in an established residence elsewhere but still contributes
-financially to the household, the value of the financial contribution will be counted as
-unearned income to the household in determining eligibility. Please refer to section
-4.304.4 for more information.
-
-Persons aged sixty (60) and older experiencing a disability who live with others whose income
-exceeds 165% of the Federal Poverty Line (FPL)
-1.
-
-Persons aged sixty (60) and older who are also experiencing a disability who are unable
-to purchase and prepare their own meals and are residing with other individuals whose
-income exceeds 165% of the FPL must be in the same household.
-
-47
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-2.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-When applying the 165% limit test, the spouse of an elderly person with disabilities is not
-to be considered a member of their household unless the spouse is the person
-purchasing and preparing meals. If the spouse is not a member of the household, the
-spouse’s income and resources are excluded in calculating the household’s eligibility.
-
-4.304.2 Children in Shared Custody Arrangements
-A.
-
-In instances when different households apply for the same child, the household that applies for
-benefits for the child second must establish that it has majority custody and/or provide a majority
-of the child’s meals.
-
-B.
-
-If the second requesting household provides verification that indicates that household possesses
-majority custody and provides the majority of meals, this constitutes unclear information as to the
-first household under which the child is currently receiving benefits.
-1.
-
-A.
-
-A request for contact (RFC) must be initiated on the first case if verification was not
-previously provided to establish majority custody and/or that the majority of meals are
-being provided. The confidentiality rules described in Section 4.140 must be followed
-when making this request.
-
-If the two different households applying for the same child cannot agree in which household the
-child shall receive benefits the household that provides the majority of meals to the child(ren) in
-question shall include the child(ren) in their household. Depending on the document being used
-to establish majority custody and majority of meals, the eligibility technician must ensure that they
-are considering a period of time of sufficient length to accurately capture the custody
-arrangement, taking into account disruptions to established arrangements such as holidays and
-school breaks. Eligibility technicians may have to look at a longer period of time than just the last
-calendar month.
-2.
-
-If the second requesting household provides verification that conclusively proves it has
-majority custody of the child and provides majority of meals as of the request to include
-the child(ren) in its household, the child(ren) should be removed from the first case and
-added to the second case as detailed in Section 4.604.G to avoid dual participation.
-
-3.
-
-If the two households provide an equal number of meals to the child(ren), then the SNAP
-household currently receiving benefits or who applied first shall receive benefits for the
-child(ren).
-
-4.
-
-If one household fails to provide verification of the percentage of meals they provide to
-the child(ren), the child(ren) shall remain in the household in which they first began
-receiving SNAP benefits.
-
-4.304.3 Optional Household Members
-The following individuals residing with a household shall not be considered household members in
-determining the household's eligibility or allotment, unless otherwise stated:
-A.
-
-Persons aged sixty (60) and older experiencing a disability who live with others whose income
-does not exceed 165% Federal Poverty Level (FPL).
-1.
-
-Persons aged sixty (60) and older who are also persons with disabilities who are unable
-to purchase and prepare their own meals and are residing with other individuals whose
-income does not exceed 165% of the FPL can be in a separate household.
-
-48
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-2.
-
-B.
-
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-When applying the 165% limit test, a person aged sixty (60) and older with disabilities’
-spouse is not to be considered a member of the household unless the spouse is the
-person purchasing and preparing meals. If the spouse is not a member of the household,
-the spouse’s income and resources are excluded in calculating the household’s eligibility.
-
-Foster children
-1.
-
-If a foster parent chooses not to include a foster child in their SNAP household, the foster
-child not included will not have their income, resources/assets, or needs included in the
-eligibility determination for the SNAP household.
-
-2.
-
-If the foster parent chooses to include the foster child in their SNAP household, the foster
-child's income, and resources/assets, as well as their needs, are considered in the
-eligibility determination.
-
-3.
-
-The foster child, including a child and/or spouse of the foster child, may not apply for
-benefits separately from the foster family unless they are over eighteen (18) and no
-longer under the parental control of the foster parents.
-
-Boarders
-1.
-
-Boarders are only considered members of a client’s SNAP household if the household
-requests that they be considered household members.
-
-2.
-
-If a boarder is not considered a SNAP household member, the boarder’s income and
-resources shall not be considered available to the household.
-A.
-
-The amount of payment that a boarder gives to a household for lodging and
-meals shall be treated as self-employment income to the SNAP household.
-
-3.
-
-If the SNAP household requests to include the boarder as a household member, the
-boarder's income and resources/assets shall be considered available to the SNAP
-household and used in determining eligibility and allotment.
-
-4.
-
-Persons who only work and provide no monetary compensation in exchange for meals or
-who make payments to a third party on the household’s behalf in exchange for meals
-would not be classified as boarders.
-
-5.
-
-Boarder status shall not be granted to individuals paying less than a reasonable monthly
-payment for meals. An individual not paying a reasonable monthly payment for meals will
-be considered a member of the household which provides the meals and lodging.
-A.
-
-B.
-
-A reasonable monthly payment is one of the following:
-1)
-
-Boarders, whose board arrangement is for more than two (2) meals per
-day, shall pay an amount that equals or exceeds the maximum SNAP
-allotment for the number of persons in the boarder SNAP household.
-
-2)
-
-Boarders, whose board arrangement is for two (2) meals or fewer per
-day, shall pay an amount that equals or exceeds two-thirds of the
-maximum allotment for the number of persons in the boarder household.
-
-When the boarder's payments for a room are distinguishable from their payments
-for meals, only the amount paid for meals will be considered in determining if
-reasonable compensation is being paid for meals.
-
-49
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-4.304.31
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Non-Household Members
-
-The following individuals residing with a household shall not be considered household members in
-determining the household’s eligibility or allotment unless otherwise stated in 4.304.3:
-A.
-
-Boarders
-Boarders are individuals residing with others and paying reasonable compensation for lodging
-and meals.
-Boarders cannot participate in SNAP as separate households.
-
-B.
-
-Roomers
-Roomers are individuals to whom a household furnishes lodging, but not meals, for
-compensation.
-Roomers who are otherwise eligible may participate in SNAP as separate households.
-
-C.
-
-Live-in Attendant
-Live-in attendants are individuals who live with a household to provide medical, housekeeping,
-childcare, or other similar personal services.
-Live-in attendants, who are otherwise eligible may, participate in SNAP as separate households.
-
-4.304.32
-
-Established Residence Separate and Apart
-
-Mandatory household members who live together must be included in the same household unless one of
-the mandatory individuals has established a residence separate and apart from the other mandatory
-household members.
-A residence shall only be considered established as separate and apart from mandatory SNAP
-household members when the individual pays shelter expenses, supports the maintenance of the other
-residence, or has provided that separate address to other governmental organizations or an employer as
-their primary residence. Supporting the maintenance of another residence can be demonstrated through
-paying rent/mortgage, paying utilities, paying insurance, or other charges necessary to maintain the
-residence.
-When it is determined that a person who would normally be considered a mandatory household member
-has established a residence separate and apart and is not required to be considered part of the SNAP
-household, any monies that person provides to the SNAP household should be considered as unearned
-income.
-Examples include, but are not limited to:
-A.
-
-A truck driver who is away from the household, returns at the end of each trip, and has not
-established a residence separate and apart must be considered a household member.
-
-B.
-
-A spouse in the armed forces may be considered a non-household member if the spouse is away
-on assignment for a calendar month or longer and has established a residence separate and
-apart.
-
-50
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Oil field workers living on-site while working away from the primary residence may be considered
-a non-household member if the spouse is away on assignment for a calendar month or longer
-and has established a residence separate and apart.
-
-4.304.4 Persons Disqualified or Ineligible to Participate in SNAP
-A.
-
-B.
-
-Disqualified individuals shall not be allowed to participate in SNAP as separate households.
-“Disqualified individuals” are individuals disqualified for:
-1.
-
-IPV/fraud;
-
-2.
-
-Failure to either provide or obtain an SSN;
-
-3.
-
-Being an ineligible non-citizen;
-
-4.
-
-Failure to comply with work requirements;
-
-5.
-
-Being an ABAWD who has been disqualified after receiving three (3) months of SNAP
-benefits within a period of thirty-six (36) months; or,
-
-6.
-
-Being a person with a felony conviction who is not in compliance with the terms of their
-sentence and was convicted as an adult for conduct that occurred after February 7, 2014
-for any of the following crimes:
-a.
-
-Aggravated sexual abuse under Section 2241 of Title 18, United States Code;
-
-b.
-
-Murder under Section 1111 of Title 18, United States Code;
-
-c.
-
-An offense under Chapter 110 of Title 18, United States Code;
-
-d.
-
-A federal or state offense involving sexual assault, as defined in Section
-40002(a) of the Violence Against Women Act of 1994 (42 U.S.C. 13925(a)); or
-
-e.
-
-An offense under state law determined by the attorney general to be substantially
-similar to an offense described in clause (a), (b), or (c).
-
-Individuals who are fleeing to avoid prosecution or custody for a crime, or an attempt to commit a
-crime, that would be classified as a felony shall not be considered eligible household members. If
-an individual is suspected of being a fleeing felon, either by their own admission or based on a
-report from law enforcement, the fleeing status must be verified in to determine if the client is
-eligible for SNAP.
-The following four-part test must be used to determine if the individual would be considered a
-fleeing felon for SNAP:
-1.
-
-There is an outstanding felony warrant for the individual by a Federal, State, or local law
-enforcement agency and the underlying cause for the warrant is for committing, or
-attempting to commit, a crime that is a felony under the law of the place from which the
-individual is fleeing or is a high misdemeanor under the law of New Jersey; and
-
-2.
-
-The individual is aware of, or should reasonably have been able to expect that, the felony
-warrant has already or would have been issued; and
-
-3
-
-The individual has taken some action to avoid being arrested or jailed; and
-
-51
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-4.
-C.
-
-The Federal, State, or local law enforcement agency is actively seeking the individual as
-provided in 4.304.4, C, 1.
-
-Individuals who are determined to be a parole or probation violator shall not be an eligible
-household member. To be considered a probation or parole violator, an impartial party, as
-designated by the agency, must determine that the individual violated a condition of his or her
-probation or parole imposed under Federal or State law, and that Federal, State, or local law
-enforcement authorities are actively seeking the individual to enforce the conditions of the
-probation or parole as outlined below.
-1.
-
-D.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-For the purposes of this provision, actively seeking is defined as follows:
-a.
-
-A Federal, State, or local law enforcement agency informs the local office that it
-intends to enforce an outstanding felony warrant or to arrest an individual for a
-probation or parole violation within twenty (20) days of submitting a request for
-information about the individual to the local office; or,
-
-b.
-
-A Federal, State, or local law enforcement agency presents a felony arrest
-warrant as provided in 4.304.4, B, 1; or,
-
-c.
-
-A Federal, State, or local law enforcement agency states that it intends to
-enforce an outstanding felony warrant or to arrest an individual for a probation or
-parole violation within thirty (30) days of the date of a request from a local office
-about a specific outstanding felony warrant or probation or parole violation.
-
-Residents of commercial and noncommercial boarding houses and institutions are not eligible to
-participate in the Program unless exempt in Section 4.304.41.
-1.
-
-The household of the proprietor of a boarding house may participate in the Program
-separate and apart from the residents of the boarding house if that household meets all
-eligibility requirements for Program participation.
-
-2.
-
-An institution is a place which has not been authorized by FNS to accept SNAP benefits,
-but which provides its residents with more than fifty percent (50%) of their daily meals as
-a part of its normal services. Residents of a halfway house for persons with a disability
-are residents of an institution if they are provided meals as part of their regular service.
-
-3.
-
-Students who purchase meal plans through an institution of higher education shall be
-considered residents of an institution if the meal plan provides the student more than fifty
-percent (50%) of his/her meals, unless the individual is otherwise exempt from the
-institution provisions as provided in Section 4.304.41.
-
-4.304.41
-
-EXEMPTIONS FROM THE BOARDING HOUSE AND INSTITUTION PROHIBITIONS
-
-A.
-
-An individual who is a resident of federally subsidized housing for persons aged sixty (60) and
-older under 12 U.S.C. 1701Q or 12 U.S.C. 1715Z-1.
-
-B.
-
-Narcotic addicts or alcoholics and their children, who, for purposes of regular participation in a
-drug or alcoholic treatment and rehabilitation program, reside at a facility or treatment center.
-
-C.
-
-Residents of a public or private nonprofit group living arrangement facility, who are blind or a
-person with disabilities.
-
-D.
-
-Women or women and their children who are temporarily residing in a public or private nonprofit
-shelter for battered women and children.
-
-52
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-E.
-
-Residents of public or private nonprofit shelters for homeless persons.
-
-4.305
-
-CITIZENSHIP AND NON-CITIZENSHIP STATUS
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Citizens of the United States are potentially eligible for participation in SNAP, provided they meet other
-eligibility requirements. Most non-citizens must be in a qualified non-citizen status and meet one (1)
-additional condition to be eligible for participation in the Program. Some classes of non-citizens are
-eligible for participation without having to meet an additional condition.
-A.
-
-Citizens and Non-Citizen Nationals
-1.
-
-2.
-
-B.
-
-The following individuals are considered United States citizens:
-a.
-
-A person born in the United States or in the District of Columbia, Puerto Rico,
-Guam, the U.S. Virgin Islands or the Mariana Islands;
-
-b.
-
-A person who has become a citizen through the naturalization process;
-
-c.
-
-A person born outside of the United States to at least one (1) U.S. citizen parent;
-and
-
-d.
-
-A child under eighteen (18) years of age adopted or born outside the U.S. with a
-parent who is a U. S. citizen, who has been admitted as a lawful permanent
-resident, and is in the legal and physical custody of a parent who is a U.S.
-citizen.
-
-Although not considered U.S. citizens, non-citizen nationals have the same potential
-eligibility for SNAP as U.S. citizens. Non-citizen nationals are those individuals born in an
-outlying possession of the United States (either American Samoa or Swain’s Island) on or
-after the date the U.S. acquired the possession, or a person whose parents are U.S. noncitizen nationals.
-
-Non-Citizens
-Qualified non-citizens and certain groups of non-citizens who are not qualified are eligible for
-participation under certain conditions.
-Some qualified non-citizens must also meet an additional condition, as outlined in Section 4.305,
-B, 3, to be eligible for participation. Each of the following categories of qualified non-citizens
-stands alone for the purposes of determining eligibility. If eligibility expires under one (1) eligible
-category, the local office shall determine if eligibility exists under another category.
-1.
-
-Qualified Non-Citizen Status
-The following classes of non-citizens, based on the immigration status of an individual,
-are defined as a qualified non-citizen. The non-citizen shall be qualified as listed below at
-the time the non-citizen applies for, receives, or attempts to receive SNAP benefits.
-A non-citizen under the age of eighteen (18) that is in a qualified alien status, as outlined
-in paragraphs A and B of this subsection, shall be eligible for participation in the program
-without having to meet an additional requirement. Once the non-citizen turns eighteen
-(18), the eligibility of the non-citizen shall be reviewed.
-
-53
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-a.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-A non-citizen in one (1) of the following qualified non-citizen statuses is not
-required to meet an additional condition to be eligible for participation in the
-Program and is eligible for participation indefinitely from the date the non-citizen
-obtains qualified non-citizen status or enters the U.S. in a qualifying status.
-1)
-
-A refugee who is admitted to the United States under 8 U.S.C. 1157.
-
-2)
-
-Victims of trafficking, under the Trafficking Victims Protection Act of
-2000, as amended, certified by the U.S. Department of Health and
-Human Services Office of Refugee Resettlement (ORR). This person
-shall have a certification letter.
-a)
-
-ORR issues a letter of eligibility for adults and children under the
-age of eighteen (18). A trafficked minor shall have either an
-interim assistance letter or an eligibility letter from ORR to be
-eligible for SNAP. The local office shall accept these letters in
-place of Department of Homeland Security documentation.
-
-b)
-
-Certification letters and eligibility letters do not expire; however,
-interim assistance letters that are provided to children are valid
-for ninety (90) calendar days from the effective date of the letter.
-ORR may extend the interim eligibility an additional thirty (30)
-calendar days. Children with an interim assistance letter can only
-receive SNAP benefits until the expiration of the period
-established in the interim letter.
-
-c)
-
-The local office can verify the status of these individuals through
-SAVE.
-
-3)
-
-Asylees granted asylum under Section 208 of the INA, which is codified
-throughout Title 8 of the United States Code. The U.S. Code does not
-include any later amendments to or editions of the incorporated material.
-Copies of the federal laws are available for inspection as defined in
-4.000.
-
-4)
-
-A non-citizen whose deportation is being withheld under 8 U.S.C.
-1224(H) as in effect prior to April 1, 1997, or whose removal is withheld
-under 8 U.S.C. 1231(B)(3).
-
-5)
-
-Retroactive to August 22, 1996, Cuban or Haitian entrants under 8
-U.S.C. 1522(E).
-
-6)
-
-Retroactive to August 22, 1996, Amerasians under 8 U.S.C 1612..
-
-7)
-
-Iraqi and Afghan Special Immigrants (SIV)
-Special immigrant status under 8 U.S.C. 1101(A)(27) may be granted to
-Iraqi and Afghan nationals who have worked on behalf of the U.S.
-Government in Iraq or Afghanistan. The Department of Defense
-Appropriations Act of 2010 (DODAA), P.L. 111-118, Section 8120
-enacted on December 19, 2009 provides that SIVs are eligible for all
-benefits to the same extent and the same period as refugees.
-
-54
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-b.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Non-citizens in one (1) of the following qualified non-citizen statuses are required
-to meet an additional condition (see Section 4.305, B, 3) to be eligible for
-participation in the Program.
-1)
-
-Lawfully Admitted for Permanent Residence (LPRs) under the
-Immigration and Nationality Act (INA). LPRs are holders of Green Cards.
-If a non-citizen is in a qualified non-citizen status as outlined in
-paragraph a. of this section and later adjusts to LPR status, the noncitizen does not have to meet an additional condition to be eligible for
-participation and shall remain eligible based on the previous qualified
-status.
-
-2)
-
-Paroled into the United States under 8 U.S.C. 1182(d)(5) for at least one
-(1) year.
-
-3)
-
-Granted conditional entry pursuant to 8 U.S.C. 1153(a)(7) as in effect
-before April 1, 1980.
-
-4)
-
-A non-citizen who has been battered or subjected to extreme cruelty in
-the U.S. by a family member with whom the non-citizen resides, such as
-by a spouse, a parent, or a member of the spouse or parent's family.
-This qualified alien status also extends to a non-citizen whose child has
-been battered or subjected to battery or cruelty or to a non-citizen child
-whose parent has been battered.
-To establish eligibility, the local office shall determine that the non-citizen
-has satisfied three (3) requirements. Spouses and children who have
-applied for or have been granted protection under the Violence Against
-Women Act will meet these requirements.
-a)
-
-The battered non-citizen(s) shall show that he/he has an
-approved or pending petition which makes a prima facie case for
-immigration status in one (1) of the following categories:
-i)
-
-United States Citizenship and Immigration Services
-(USCIS) Form I-130, last modified July 20, 2021, petition
-for alien relative, filed by their spouse or the child’s
-parent, which is incorporated by reference. No later
-editions or amendments are incorporated. This form is
-available at no cost from the USCIS at
-https://www.USCIS.gov/I-130. The form is also available
-for public inspection and copying at the Food and
-Energy Assistance Division Director, Colorado
-Department of Human Services, 1575 Sherman Street,
-3rd Floor, Denver, Colorado 80203;
-
-ii)
-
-Form I-130, as incorporated by reference above, petition
-as a widow(er) of a U.S. citizen;
-
-55
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-2.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-iii)
-
-Self-petition under the Violence Against Women Act
-(including those filed by a parent on behalf of an abused
-child), USCIS Form I-360, last modified June 9, 2020,
-which is incorporated by reference. No later editions or
-amendments are incorporated. This form is available at
-no cost from the USCIS at https://www.USCIS.gov/I-360.
-The form is also available for public inspection and
-copying at the Food and Energy Assistance Division
-Director, Colorado Department of Human Services, 1575
-Sherman Street, 3rd Floor, Denver, Colorado, 80203; or,
-
-iv)
-
-An application for cancellation of removal or suspension
-of deportation filed as a victim of domestic violence.
-
-b)
-
-There is substantial connection between the battery or extreme cruelty and the
-need for SNAP benefits; and
-
-c)
-
-The battered non-citizen, child, or parent no longer resides in the same home as
-the abuser.
-
-Eligible Non-Citizens Not in a Qualified Status:
-The following classes of non-citizens are not defined as having a qualified status but are
-potentially eligible for participation in SNAP without having to meet an additional condition
-(see Section 4.305, B, 3). All other classes of non-citizens that are not in a qualified
-status are not eligible for participation in SNAP.
-a.
-
-Certain American Indians Born Abroad
-American Indians born abroad in Canada living in the U.S. under Section 289 of
-the INA or non-citizen members of a federally recognized Indian tribe under
-Section 4(e) of the Indian Self-Determination and Education Assistance Act (25
-U.S.C. 450(B)(E) who are recognized as eligible for the special programs and
-services provided by the U.S. to Indians because of their status as Indians.
-This provision was intended to cover Native Americans who are entitled to cross
-the U.S. border between Canada and/or Mexico. It was intended to include but is
-not limited to the St. Regis Band of the Mohawk in New York State, the Micmac
-(also known as Mi’kmaq) in Maine, the Abenaki in Vermont, and the Kickapoo in
-Texas.
-
-b.
-
-Hmong or Highland Laotian Tribal Members
-An individual lawfully residing in the U.S. who was a member of a Hmong or
-Highland Laotian tribe that rendered assistance to U.S. personnel by taking part
-in a military or rescue operation during the Vietnam era (August 5, 1964 – May 7,
-1975). This category includes:
-1)
-
-Spouse or surviving spouse of a deceased Hmong or Highland Laotian
-Tribal Member who is not remarried; and/or,
-
-2)
-
-Unmarried dependent child of Hmong or Highland Laotian Tribal Member
-who is: under the age of eighteen (18) or a full-time student under the
-age of twenty-two (22);
-
-56
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-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-3)
-
-Unmarried child under the age of eighteen (18) or a full-time student
-under the age of twenty-two (22) of a deceased Hmong or Highland
-Laotian Tribal Member, provided the child was dependent upon them at
-the time of the Hmong or Highland Laotian tribal member’s death; or,
-
-4)
-
-Unmarried child with disabilities age eighteen (18) or older if the child
-with disabilities had a disability and was dependent on the person prior to
-the child's eighteenth (18th) birthday.
-A)
-
-3.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-For purposes of this paragraph, “child” means the legally
-adopted or biological child of the person described in this section
-as a Hmong or Highland Laotian Tribal Member.
-
-Additional Conditions
-Non-citizens in a qualified status as outlined in subsection 4.305, B, 1, are required to
-meet one additional condition to be eligible for participation in the Program. At the time
-the non-citizen applies for SNAP, they need only satisfy one of the following conditions to
-be eligible:
-a.
-
-Five (5) Years of Residence
-The non-citizen has lived in the U.S. in a qualified non-citizen status for five (5)
-years. The five (5) year waiting period begins on the date the non-citizen obtains
-status as a qualified non-citizen or enters the U.S. in a qualifying status.
-
-b.
-
-Forty (40) Qualifying Work Quarters
-A person shall have satisfied this additional condition if they are lawfully admitted
-for permanent residence while already possessing credit for forty (40) qualifying
-work quarters as defined under Title II of the Social Security Act. In some cases,
-an applicant may have work from employment that is not covered by Title II of the
-Social Security Act, but which is countable toward the forty (40) quarters test,
-and there are also cases in which SSA records do not show current year’s
-earnings. Such quarters are still countable for the forty (40) quarter test, but the
-individual non-citizen shall be responsible for providing evidence needed to verify
-the quarters.
-1)
-
-The sum of work quarters can include:
-a)
-
-Quarters the non-citizen worked;
-
-b)
-
-Quarters credited from the work of a parent of such a non-citizen
-while the non-citizen was under eighteen (18), which includes
-quarters worked before the non-citizen was born or adopted; or
-
-c)
-
-Quarters credited from the work of the non-citizen’s spouse.
-Quarters are only creditable to the non-citizen for work
-performed by his or her spouse if the couple is still legally
-married, or if the spouse becomes deceased while married to the
-non-citizen, and the work being credited to the non-citizen was
-performed after the marriage began.
-
-57
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-If a couple divorces prior to determination of SNAP eligibility, a
-spouse may not get credit for quarters of their spouse. However,
-if the local office determines eligibility of a non-citizen based on
-the quarters of the spouse, and then the couple divorces, the
-non-citizen's eligibility continues until the next re-certification. At
-that time, the local office shall determine the non-citizen's
-eligibility without crediting the non-citizen with the former
-spouse's quarters of coverage.
-2)
-
-c.
-
-The sum of work quarters cannot include:
-a)
-
-Quarters in which not enough income was earned to qualify, or,
-
-b)
-
-Quarters earned after December 31, 1996, cannot be counted if
-the non-citizen, during the quarter, received SNAP or any other
-federal means-tested public benefits, such as Medicaid, SSI,
-TANF, or state Children’s Health Insurance Program.
-
-Children Under Eighteen (18)
-A non-citizen under eighteen (18) years of age in a qualified non-citizen status
-who lawfully resides in the U.S. When the non-citizen turns eighteen (18), noncitizen eligibility shall be reviewed.
-
-d.
-
-Blind or Person with Disabilities
-A non-citizen who is blind or a person with a disability if the non-citizen is
-receiving benefits or assistance for their condition regardless of entry date.
-
-e.
-
-Born on or before August 22, 1931 who lawfully resided in the U.S. on August 22,
-1996.
-
-f.
-
-Military Connection
-1)
-
-Qualified non-citizens with a military connection, including an individual
-who is lawfully residing in a state and is on active duty, other than
-training, in the military, excluding national guard; or,
-
-2)
-
-An honorably discharged veteran, as defined in Section 101 of Title 38,
-U.S.C, whose discharge is not because of immigration status, who fulfills
-the minimum active-duty service requirements. This includes an
-individual who died in active military duty, naval or air service. This
-provision extends to the spouse, un-remarried surviving spouse, and
-unmarried dependent children. A discharge “under honorable
-conditions,” which is not the same as an honorable discharge, does not
-meet this requirement.
-
-3)
-
-The definition of “veteran” shall also include:
-a.
-
-An individual who served before July 1, 1946, in the organized
-military forces of the Commonwealth of the Philippines while
-such forces were in the service of the Armed Forces of the U.S.
-or in the Philippine Scouts; or,
-
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-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-b.
-
-An individual who is on active duty (other than active duty for
-training) in the Armed Forces of the United States, or the spouse
-of such a person; or,
-
-c.
-
-The spouse of a veteran who served at least twenty-four (24)
-months in the Armed Forces. This includes the spouse of a
-deceased veteran, provided the marriage fulfilled the
-requirements of 38 U.S.C. 1304, and the spouse has not
-remarried; or
-
-d.
-
-An unmarried dependent child of a veteran who is under the age
-of eighteen (18) or, if a full-time student, under the age of twentytwo (22); or,
-
-e.
-
-Unmarried dependent child of a deceased veteran provided such
-child was dependent upon the veteran at the time of the
-veteran's death; or an unmarried child with disabilities age
-eighteen (18) or older if the child with disabilities was disabled
-and dependent upon the deceased veteran prior to the child's
-eighteenth (18th) birthday.
-1.
-
-For purposes of this provision, “child” means the legally
-adopted or biological child of the veteran.
-
-4.305.1 Non-Citizens Ineligible for Participation in SNAP
-The following non-citizens are not eligible to participate in SNAP as a member of any household.
-A.
-
-Non-citizens who are lawfully present in the U.S. but not in a qualified status, such as students
-and H-1B Visa workers;
-
-B.
-
-Undocumented non-citizens (e.g., individuals who entered the country as temporary residents
-and overstayed their visas or who entered without a visa);
-
-C.
-
-Non-citizen visitors;
-
-D.
-
-Tourists;
-
-E.
-
-Diplomats;
-
-F.
-
-Students who enter the U.S. temporarily with no intention of abandoning their residence in a
-foreign country;
-
-G.
-
-Individuals granted temporary protection status (TPS), unless in some other qualifying status;
-
-H.
-
-Citizens of nations under Compact of Free Association agreements (Palau, Micronesia, and the
-Marshall Islands) who have been admitted under those agreements are not qualified non-citizens.
-These individuals may otherwise reside, work, and study in the U.S.; and,
-
-I.
-
-Individuals with U Visas, including minor children under the age of eighteen (18), are ineligible as
-they have temporary status and are not considered qualified non-citizens. However, if the
-individual adjusts to qualified non-citizen status, such as LPR or battered immigrant status, then
-the individual’s non-citizen eligibility shall be reviewed under the new status.
-
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-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-4.305.2
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Households Containing a Sponsored Non-Citizen Member
-
-A.
-
-The provisions of this section apply only to those non-citizens for whom a sponsor has executed
-an affidavit of support (INS Form I-864 or I-864A) on behalf of the non-citizen pursuant to Section
-213A of the Immigration and Nationality Act (INA) on or after December 19, 1997. Prior to this
-time, affidavits of supports, known as I-134s, were not legally binding; therefore, the sponsor
-could not be legally compelled to support the non-citizen based on an affidavit of support signed
-prior to December 19, 1997.
-
-B.
-
-Definition of a Sponsor
-1.
-
-Sponsored non-citizens are those non-citizens lawfully admitted for permanent residence
-into the United States who have been sponsored by an individual for entry into the
-country.
-
-2.
-
-A sponsor is a person who executed an affidavit(s) of support (INS Form I-864 or I-864A)
-or another form deemed legally binding by the Department of Homeland Security on
-behalf of a non-citizen as a condition of the non-citizen's entry or admission to the United
-States as a permanent resident. Date of entry or admission means the date established
-by the Immigration and Naturalization Service (INS) as the date the sponsored noncitizen was admitted for permanent residence.
-
-C.
-
-Only when a sponsored non-citizen is an eligible non-citizen will the local office consider the
-income and resources of the sponsor and sponsor's spouse available to the household. For
-purposes of determining eligibility and benefit level of a household of which an eligible sponsored
-non-citizen is a member, the local office shall deem the income and resources of the sponsor and
-the sponsor's spouse, if they have executed USCIS Form I-864 or I-864A, as the unearned
-income and resources of the sponsored non-citizen.
-
-D.
-
-Calculating Sponsor Income
-1.
-
-The total gross income and resources of a sponsor and sponsor's spouse shall be
-considered as unearned income and resources of a sponsored non-citizen for a period
-until the person’s citizenship is obtained; or until the non-citizen has worked or can
-receive credit for forty (40) work quarters under Title II of the Social Security Act; or the
-sponsor dies.
-The spouse's income and resources shall be counted even if the sponsor and spouse
-were married after the signing of the agreement.
-
-2.
-
-The monthly income of the sponsor and the sponsor's spouse to be considered toward
-the non-citizen shall be the total monthly earned and unearned income of the sponsor
-and spouse at the time the household containing the sponsored non-citizen member
-applies for or is recertified for Program participation and shall be calculated as follows:
-a.
-
-Reduced by an amount equal to twenty percent (20%) of the earned income of
-the sponsor and the sponsor's spouse; and,
-
-b.
-
-An amount equal to the SNAP monthly gross income eligibility limit for a
-household equal in size to the sponsor, the sponsor's spouse, and any other
-person who is claimed or could be claimed by the sponsor or the sponsor's
-spouse as a dependent for federal income tax purposes; and,
-
-60
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-c.
-
-E.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-If a sponsored non-citizen can demonstrate to the local office's satisfaction that
-his or her sponsor is the sponsor of other non-citizens, the local office shall divide
-the deemed income and resources of the sponsor and the sponsor's spouse by
-the number of such sponsored non-citizens.
-
-3.
-
-If the sponsored non-citizen has already reported gross income information on his/her
-sponsor in compliance with the sponsored non-citizen rules of another state assistance
-program, and the local office is aware of the amounts that income amount shall be used
-for SNAP deeming purposes. However, the local office shall limit allowable reductions to
-the total gross income of the sponsor and the sponsor's spouse prior to attributing an
-income amount to the non-citizen. The only reduction will be twenty percent (20%)
-earned income amount for that portion of the income determined as earned income of the
-sponsor and the sponsor's spouse and an amount equal to the SNAP monthly gross
-income eligibility limit for a household equal in size to the sponsor, the sponsor's spouse,
-and any other person who is claimed or could be claimed by the sponsor or the sponsor's
-spouse as a dependent for federal income tax purposes.
-
-4.
-
-Actual money paid to the non-citizen by the sponsor or the sponsor's spouse shall not be
-considered as income to the non-citizen unless the amount paid exceeds the amount
-already considered as income as above. Only the portion that exceeds the income
-already considered shall be added to that income.
-
-5.
-
-If the non-citizen changes sponsors during the certification period, a change shall be
-processed to consider the new sponsor's income and resources toward the non-citizen
-as soon as possible after the information is verified. The previous sponsor's income and
-resources shall be used until such determination; however, should any present sponsor
-become deceased, that sponsor's income and resources shall not be attributed to the
-non-citizen.
-
-6.
-
-Total resources of the sponsor and the sponsor's spouse shall be considered as
-resources to the non-citizen reduced by one thousand five hundred dollars ($1,500).
-
-The counting of a sponsor’s income and resource provisions do not apply to a non-citizen who is:
-1.
-
-A member of his or her sponsor's SNAP household;
-
-2.
-
-Sponsored by an organization or group as opposed to an individual;
-
-3.
-
-Not required to have a sponsor under the Immigration and Nationality Act (INA), such as
-a refugee, a parolee, an asylee, or a Cuban or Haitian entrant;
-
-4.
-
-Considered as an “indigent” non-citizen;
-An indigent non-citizen is a non-citizen who has been determined to be unable to obtain
-food and shelter which totals to an amount exceeding one hundred thirty percent (130%)
-of the federal poverty level, as defined in section 4.401.1. A non-citizen who is receiving
-in-kind benefits that exceed the gross income level for the household size shall not be
-considered indigent. The noncitizen's own income plus any cash, food, housing, or other
-assistance provided by other individuals, including the sponsor, will be counted in making
-this determination.
-
-61
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-For purposes of this provision, the sum of the eligible sponsored non-citizen household's
-own income, the cash contributions of the sponsor and others, and the value of any inkind assistance from the sponsor and others, shall not exceed one hundred thirty percent
-(130%) of the poverty income guideline for the household's size. The local office shall
-determine the amount of income and other assistance provided in the month of
-application. If the non-citizen is below one hundred thirty percent (130%) of the federal
-poverty level, the only amount that the local office shall consider deemed to such a noncitizen will be the amount provided by the sponsor for a period beginning on the date of
-such determination and ending twelve (12) months after such date. Each determination is
-renewable for additional twelve (12) month periods. The local office shall notify the U.S.
-attorney general of each such determination, including the names of the sponsor and the
-sponsored non-citizen involved.
-
-F.
-
-5.
-
-A child of a battered parent is exempt from the provision of sponsorship. A battered noncitizen spouse, non-citizen parent of a battered child, or child of a battered non-citizen will
-not have sponsor's income and resources counted during a twelve (12) month period
-after the local office determines that the battering is substantially connected to the need
-for benefits, and the battered individual does not live with the batterer. After twelve (12)
-months, the local office shall not deem the batterer's income and resources if the battery
-is recognized by a court or the INS and has a substantial connection to the need for
-benefits, and the non-citizen does not live with the batterer;
-
-6.
-
-Had been sponsored but has since obtained citizenship;
-
-7.
-
-A person whose sponsor has died; or,
-
-8.
-
-Who has worked or can receive credit for a total of forty (40) work quarters under Title II
-of the Social Security Act.
-
-Verification Requirements
-The local office shall verify the following information at the time of initial application and
-recertification:
-
-G.
-
-1.
-
-The income and resources of the non-citizen's sponsor and the sponsor's spouse (if the
-spouse is living with the sponsor) at the time of the non-citizen's application for SNAP.
-
-2.
-
-The names (and alien registration numbers) of other non-citizens for whom the sponsor
-has signed an affidavit of support or similar agreement.
-
-3.
-
-The number of dependents who are eligible to be claimed for federal income tax
-purposes by the sponsor and the sponsor's spouse.
-
-4.
-
-The name, address, and phone number of the non-citizen's sponsor.
-
-Awaiting Verification
-1.
-
-Until the non-citizen provides information or verification necessary to determine eligibility,
-the sponsored non-citizen shall be ineligible. When such verification is provided, the local
-office shall act on the information as a reported change in household circumstances. The
-eligibility of any remaining household members shall be determined. The income and
-resources of the ineligible non-citizen (excluding the attributed income and resources of
-the non-citizen's sponsor and sponsor's spouse) shall be treated in the same manner as
-a disqualified member as set forth in Section 4.411.1 and considered available in
-determining the eligibility and benefit level of the remaining household members.
-
-62
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-2.
-
-H.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-If the sponsored non-citizen refuses to cooperate in providing and/or verifying needed
-information, other adult members of the non-citizen's household shall be responsible for
-providing and/or verifying the information. If the information or verification is subsequently
-received, the local office shall act on the information as a reported change. If the same
-sponsor is responsible for the entire household, the entire household is ineligible until
-such time as the needed information is provided and/or verified. The local office shall
-assist the non-citizen in obtaining verification provided the household is cooperating with
-the local office.
-
-Sponsored Non-Citizen’s Responsibility
-1.
-
-During the period the sponsored non-citizen is subject to deeming, the eligible sponsored
-non-citizen shall be responsible for obtaining the cooperation of their sponsor, for
-providing the local office, at the time of application and/or recertification, the information
-and/or documentation necessary to calculate income and resources attributable to the
-non-citizen's household. The eligible sponsored non-citizen shall be responsible for
-providing the names (or other identifying factors) of other non-citizens for whom the noncitizen's sponsor has signed an agreement to support. The local office shall attribute the
-entire amount of income and resources to the eligible sponsored non-citizen until they
-provide the information required.
-
-2.
-
-The local office will determine how many of such non-citizens are SNAP applicants or
-participants and initiate appropriate proration. The eligible sponsored non-citizen shall
-also be responsible for reporting the required information about the sponsor and
-sponsor's spouse should the non-citizen obtain a different sponsor during the certification
-period. The eligible sponsored non-citizen shall report changes in income should the
-sponsor or sponsor's spouse change or lose employment or become deceased during
-the certification period. The local office shall act on the information as a reported change
-in household circumstances as set forth in Section 4.604.
-
-4.305.3 Reporting Undocumented Non-Citizens
-A.
-
-The local office shall immediately inform the local USCIS office whenever personnel responsible
-for the certification or recertification of households determine that any member of a household is
-ineligible to receive SNAP because the member is present in the United States in violation of
-immigration laws.
-
-B.
-
-In determining whether the member is present in the United States in violation of immigration
-laws, caution shall be exercised to ensure that the determination is not made merely on the noncitizen's inability or unwillingness to provide documentation of non-citizen status. When a person
-indicates an inability or unwillingness to provide documentation of non-citizen status, the local
-office shall not continue efforts to obtain documentation other than that necessary to obtain
-information on the income and resources to be made available to remaining members of the
-household.
-
-C.
-
-Because many non-citizens who are legally present in the United States are not eligible for
-SNAP, eligibility technicians are cautioned that a determination that a person is an ineligible noncitizen is not equivalent to a determination that a person is a non-citizen present in the United
-States in violation of immigration laws.
-
-D.
-
-When and if a SNAP eligibility technician is able, based on information that becomes available to
-him/her in the process of reviewing a household's eligibility for SNAP, to determine that a
-member or members of that household are in fact non-citizens present in the United States in
-violation of the immigration laws, the eligibility technician will report the determination to their
-supervisor. The report to USCIS, if made, shall be in writing.
-
-63
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-This rule does not permit the reporting to USCIS on mere suspicion or prejudice. Firm evidence
-that a household is illegally in the U.S. would be required. A person known to be a non-citizen in
-the United States in violation of the Immigration and Nationality Act is only known to have such
-status when they are found in this country and are known to have a final order of deportation
-outstanding against them. An outstanding order of deportation is final when it is not subject to
-appeal because the relevant statutory appeal period of ten (10) days has expired or because
-there are no lawful grounds upon which an appeal may be based or because the available
-administrative and/or judicial appeals have been exhausted, and the order is not subject to review
-under the limited standards of reopening for consideration.
-E.
-
-The failure to report a non-citizen illegally present in the United States in violation of immigration
-laws to USCIS will not be considered a quality assurance error or assessed as an administrative
-deficiency.
-
-4.306
-
-STUDENT ELIGIBILITY
-
-A.
-
-Any person who is age eighteen (18) through forty-nine (49) and enrolled at least half time in an
-institution of higher education shall not be eligible to participate in the SNAP unless the person
-meets one of the exemption criteria outlined at 4.306.1.
-
-B.
-
-The following individuals are not considered under student eligibility criteria:
-
-C.
-
-1.
-
-Persons aged seventeen (17) or under;
-
-2.
-
-Persons aged fifty (50) or over;
-
-3.
-
-Persons enrolled less than half time;
-
-4.
-
-Persons enrolled full time in schools and training programs that are not institutions of
-higher education;
-
-5.
-
-Persons attending high school;
-
-6.
-
-Persons participating in an on-the-job training program. On-the-job training is defined as
-training in an employment environment and does not include an internship, field work, or
-practical experience associated with a course of higher education.
-
-The enrollment status of a student shall begin on the first day of the school term of the institution
-of higher education. Once a student enrolls in an institution of higher education, such enrollment
-shall be deemed continuous through normal periods of class attendance, vacation, and recess
-unless the student graduates, is suspended or expelled, drops out or does not intend to register
-for the next normal school term (excluding summer session). It is possible for a student to enroll
-prior to the beginning of the school term. However, for eligibility purposes, enrollment starts when
-the student starts classes.
-
-4.306.1 Student Exemption Criteria
-To be eligible to participate in SNAP, a student must meet at least one (1) of the following exemptions:
-A.
-
-Be physically or mentally unfit for employment (including students participating through or in a
-vocational rehabilitation program).
-
-64
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-If mental or physical unfitness for employment is claimed and the unfitness is not evident to the
-local office, verification may be required. Appropriate verification may consist of receipt of
-temporary or permanent disability benefits or a statement from a physician or licensed
-psychologist.
-B.
-
-The student is employed for an average of twenty (20) hours per week and is paid for such
-employment. The student shall be employed an average of twenty (20) hours each week,
-regardless of wages received.
-If the student is self-employed, the student shall work an average of twenty (20) hours a week
-and have earnings after allowable business expenses are deducted equal to at least the federal
-minimum wage multiplied by twenty (20) hours.
-The weekly employment of twenty (20) hours may be based on an average number of hours
-worked per month, so long as the student is employed for eighty (80) hours per month.
-
-C.
-
-The student is participating in a state or federally financed work-study program. The student shall
-be approved for a work-study program at the time of application for SNAP. The work-study shall
-be approved for the school term and the student shall anticipate working during that time. The
-student qualifies for this exemption the month the school term in which the work-study will occur
-begins or the month work-study is approved, whichever is later. The exemption will continue until
-the end of the school term or until it becomes known that the student has refused an assignment.
-The exemption shall not continue between terms when there is a break of one (1) full month or
-longer unless the student is participating in work-study during the break.
-
-D.
-
-The student is responsible for more than half of the physical care of a dependent household
-member under the age of six (6), or a full-time student who is a single parent with responsibility
-for the care of a dependent child under age twelve (12). The single parent provision applies in
-those situations where only one natural, adoptive, or stepparent regardless of marital status is in
-the same SNAP household as the child. A full-time student in the same SNAP household with a
-child who is under their parental control may qualify if they do not reside with their spouse.
-
-E.
-
-The student is responsible for more than half of the physical care of a dependent household
-member who has reached the age of six (6) but is under the age of twelve (12) where the local
-office has determined that adequate childcare is not available to enable the individual to attend
-class and satisfy the requirement of item B or item C, above.
-
-F.
-
-The student is receiving a Title IV-A TANF cash grant. The student’s needs shall be included in
-the grant to be eligible under this provision. Family Preservation is not considered a TANF cash
-grant.
-
-G.
-
-The student is assigned to or placed in an institution of higher education through a program under
-the Workforce Innovation and Opportunity Act (WIOA), Employment First (EF), a program under
-Section 236 of the Trade Act of 1974 (19 U.S.C. 2296), another program for the purpose of
-employment and training operated by the state or local government (program shall have at least
-one (1) component equivalent to the SNAP EF Program), or as a result of participating in the
-JOBS program under Title IV of the Social Security Act.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Self-initiated placement during the period the person is enrolled in one of these employment and
-training programs shall comply with the requirements of the employment and training program in
-which the person is enrolled. This placement is considered in compliance provided that the
-Employment and Training program has a component for enrollment in an institution of higher
-education and that the Employment and Training program accepts the placement. Persons who
-voluntarily participate in one of these employment and training programs and are placed in an
-institution of higher education through or in compliance with the requirements of the Employment
-and Training program shall also qualify for the exemption.
-H.
-
-The student is participating in an on-the-job training program. A person is participating in an onthe-job training program only during the period the person is being trained by an employer.
-
-4.307
-
-STRIKER ELIGIBILITY
-
-A.
-
-Households containing a striking member, as defined in section 4.000.1, shall not be eligible for
-SNAP unless the household was eligible for the Program the day before the strike and are
-otherwise eligible at time of the strike. Households where the striking member was exempt from
-work registration the day before the strike shall not be subject to these provisions and shall be
-certified if otherwise eligible unless the exemption was based on the employment.
-
-B.
-
-Pre-strike eligibility is determined by considering the day prior to the strike as the day of
-application and assuming the strike was not occurring. Eligibility at the time of application shall be
-determined by comparing the striking member's income as of the day before the strike to the
-striking member's current income and adding the higher of the two (2) to the current income of
-the non-striking household members during the month of application. The higher income will be
-used in determining benefits.
-
-4.307.1 Households Not Affected by the Striker Provisions
-A.
-
-Employees whose work place is closed by an employer (i.e., lockout),
-
-B.
-
-Employees unable to work as a result of other striking employees (e.g., a paper strike closes
-operations at a printing company; therefore, pressmen are out of work),
-
-C.
-
-Employees not wanting to cross a picket line due to fear of personal injury or death (this does not
-include persons sympathetic to the strike who refuse to cross the picket line),
-
-D.
-
-Persons who were exempt from work registration the day before the strike such as the caretaker
-of a child under six (6) years of age (other than those exempt solely on the ground that they were
-employed).
-
-4.308
-
-VOLUNTARY QUIT
-
-A.
-
-No individual who quit his or her most recent job without good cause or reduces work effort and,
-after the reduction, is working less than thirty (30) hours each week, without good cause, or
-earning less than the federal minimum wage multiplied by thirty (30) hours, shall be eligible for
-participation in SNAP. At the time of application, the eligibility technician shall explain to the
-applicant the potential penalties if a household member quits his or her job or reduced hours or
-wages without good cause or if another member joins the household if that individual has
-voluntarily quit employment.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-B.
-
-When a household files an application, or when a participating household reports the loss of a
-source of income or reduction in hours, the local office shall determine whether any household
-member voluntarily quit or reduced his or her hours or income. Benefits shall not be delayed
-pending the outcome of this determination. A sanction shall be imposed if the quit or reduction in
-hours or wages occurred within sixty (60) calendar days prior to the date of application or anytime
-thereafter, and the quit or reduction was without good cause. An employee of the federal
-government, or of a state or local government who participates in a strike against such
-government and is dismissed from his or her job because of participation in the strike, shall be
-considered to have voluntarily quit his or her job without good cause. If an individual quits a job,
-secures new employment at comparable wages or hours, and, through no fault of his or her own
-loses the new job, the earlier quit shall not be a basis for disqualification.
-
-C.
-
-In the case of an applicant household, the local office shall determine whether any currently
-unemployed household member who is required to register for work or was exempt from
-registration for being employed has voluntarily quit his or her most recent job within the last sixty
-(60) days. If the local office learns that a household has lost a source of income after the date of
-application but before the household is certified, the local office shall determine whether a
-voluntary quit occurred.
-The nonexempt individual who quit or reduced work hours will be ineligible to participate for the
-sanction period if the household is determined eligible for SNAP. The individual will be required to
-comply with EF following the sanction period unless the individual becomes exempt from work
-requirements.
-
-D.
-
-In the case of the participating household, the local office shall determine whether any household
-member voluntarily quit his or her job while participating in the Program. If a household is already
-participating when a quit that occurred prior to certification is discovered, the household shall be
-regarded as a participating household.
-
-E.
-
-Upon a determination that the individual voluntarily quit employment, reduced work hours below
-thirty (30) hours, or reduced wages to the point at which the person is earning less than the
-federal minimum wage multiplied by thirty (30) hours, the local office shall determine if the
-voluntary quit was with good cause.
-If an individual voluntarily quits or reduces work hours/wages without good cause, the individual
-will be disqualified in the same manner as individuals failing to comply with work registration or
-EF requirements.
-
-F.
-
-If the local office determines that the individual voluntarily quit his or her job or reduced his or her
-work hours without good cause while participating in SNAP, the local office shall provide the
-household with a Notice of Adverse Action within ten (10) calendar days after the determination of
-a voluntary quit is made. The notice shall contain the act of noncompliance, the proposed period
-of disqualification, the action to be taken at the end of the disqualification and shall specify that
-the individual may be included in the household after the disqualification period if the individual
-meets other work requirements.
-
-G.
-
-Individuals have the right to a fair hearing to appeal a disqualification due to a determination that
-the individual quit his or her job without good cause or reduced his or her work hours without
-good cause. If a participating household requests a fair hearing and the local office determination
-is upheld, the disqualification period shall begin the first of the month after the hearing decision is
-rendered.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.308.1 Good Cause for Quitting or Reducing Work Hours
-Upon a determination that the individual voluntarily quit employment, the local office shall determine if
-there was good cause which shall include, but not be limited to, any of the following:
-A.
-
-Discrimination by an employer based on age, race, sex, color, handicap, religious beliefs, national
-origin, or political beliefs;
-
-B.
-
-Work demands or conditions that render continued employment unreasonable such as working
-without being paid on schedule;
-
-C.
-
-Acceptance by the individual of employment; or enrollment of at least half-time in any recognized
-school, training program, or institution of higher education, that requires the individual to leave
-employment;
-
-D.
-
-Acceptance by any other household member of employment or enrollment at least half-time in
-any recognized school, training program, or institution of higher education in another county or
-political sub-division which requires the household to move and thereby requires the individual to
-leave employment;
-
-E.
-
-Resignations by persons under the age of sixty (60) that are recognized by the employer as
-retirement;
-
-F.
-
-Resignation from employment that does not meet suitable criteria specified in Section 4.310.7;
-
-G.
-
-Because of circumstances beyond the control of the individual, accepted full time employment
-subsequently either does not materialize or results in employment of less than thirty (30) hours a
-week or weekly earnings of less than the federal minimum wage multiplied by thirty (30) hours;
-
-H.
-
-Leaving a job in connection with patterns of employment in which workers frequently move from
-one employer to another, such as migrant farm labor or construction work, even though
-employment at the new site has not actually begun;
-
-I.
-
-Illness of the head of household;
-
-J.
-
-Illness of another household member requiring the presence of the head of household;
-
-K.
-
-A household emergency;
-
-L.
-
-The unavailability of transportation; or,
-
-M.
-
-Employer demands a reduction in participant's work effort or salary through no fault of the
-employee.
-
-N.
-
-Lack of adequate child care for children who have reached age 6 but are under age 12.
-
-4.309
-
-HOUSEHOLDS WITH SPECIAL CIRCUMSTANCES
-
-The following sections explain the application of SNAP criteria and certification procedures to the
-eligibility determinations for households with special circumstances pertaining to:
-A.
-
-Dining Facilities and Homeless Meal Providers;
-
-B.
-
-Shelters for Battered Women and Children;
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-C.
-
-Drug and Alcohol Treatment and Rehabilitation Centers;
-
-D.
-
-Residents of Group Living Arrangements.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.309.1 Dining Facilities and Homeless Meal Providers
-Households with special circumstances, such as a person with disabilities, persons aged sixty (60) and
-older, or group living arrangements, may be authorized to use SNAP benefits to buy food from authorized
-communal dining facilities, meals on wheels, drug and alcohol treatment and rehabilitation centers, and
-shelters for battered women and children.
-Households experiencing homelessness may also use SNAP benefits to purchase prepared meals from
-approved restaurants. SNAP households experiencing homelessness may use food benefits for meals
-prepared for and served by an authorized provider (for example, a soup kitchen or temporary shelter) that
-feeds persons experiencing homelessness.
-4.309.2 Shelters for Battered Women and Children
-There are no restrictions on how long a center shall be in operation or on the number of residents served
-by the shelter. The local office shall determine a shelter's status as a shelter for battered women and
-children and shall document the basis for their determination. The rules within this subsection apply
-specifically to centers which provide meals to their residents. Centers which do not provide meals are not
-to be considered institutions and their residents' eligibility will be determined using the standard rules for
-eligibility.
-4.309.21
-
-Residents of Shelters for Battered Women and Children
-
-Women or women with their children who are temporarily residing in a shelter for battered women and
-children (which serves over fifty percent (50%) of their meals) shall be considered exempt from the
-prohibition against residents of institutions.
-A.
-
-They shall be allowed to apply and be considered for eligibility as individual (parent/child) units,
-rather than considered as part of a household consisting of all shelter residents.
-
-B.
-
-In many instances battered women and their children who were previously certified in the
-household of an abuser may not have access to their allotment. Therefore, these individuals shall
-be allowed to participate in one (1) additional project area and/or household so long as one of the
-two households with which they are participating contains the individual who abused them. These
-persons may receive an additional allotment only once in a month.
-
-C.
-
-The local office should act promptly to reflect the changes in household composition and shall act
-on the change to reduce or terminate benefits to the applicant's former household as appropriate.
-
-D.
-
-Shelter residents who apply as separate households shall be certified solely on the basis of their
-income and resources and the expenses for which they are responsible. They shall be certified
-without regard to the income, resources, and/or expenses of their former household. Jointly held
-resources shall be considered inaccessible to the household if access to such resources is
-dependent upon the agreement of a joint owner who still resides in the former household.
-
-69
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.309.3 Drug and Alcohol Treatment and Rehabilitation Centers (Center)
-A.
-
-Residents of publicly operated community mental health centers or private non-profit
-organizations or institutions, operating a residential drug or alcohol treatment or rehabilitation
-program, are eligible to participate in SNAP. Applications shall be made through an authorized
-representative who is employed by the drug or alcohol treatment or rehabilitation facility and
-designated by the facility for that purpose. Individuals residing in a for-profit facility are considered
-residents of an institution per Section 4.304.4(E), above.
-
-B.
-
-The center shall be approved by the Colorado Department of Human Services (CDHS), Office of
-Behavioral Health (OBH) before its residents are eligible for SNAP participation. The OBH will
-ensure that the center is providing treatment that can lead to the rehabilitation of drug or alcohol
-addiction.
-Before the certification of residents can be accomplished, the local office shall verify that the
-center has been approved by FNS as a retailer and is certified by the OBH. Proof of OBH
-certification may be provided in the form of a license or an approval letter issued to the center by
-that agency, or proof that the center is funded under Part B of Title XIX of the Public Health
-Service Act (42 U.S.C. 300x-1 through 300x-13).
-
-C.
-
-Residents and their children residing in a certified center must voluntarily elect to participate in
-SNAP. Residents shall have their eligibility determined as one-person households unless children
-are residing with them at the center. Children of the residents in a center who live with their
-parents in the treatment center will qualify for SNAP. Meals served to the children are eligible for
-purchase with SNAP benefits. The local office shall certify residents of centers by using the same
-provisions that apply to other applicant households.
-
-D.
-
-Residents of centers may be receiving public assistance or SSI benefits or may be destitute of
-income and resources and eligible for expedited service. Residents who qualify for expedited
-service shall have benefits available for spending no later than seven (7) calendar days following
-the date the application was filed.
-
-E.
-
-Any applicant household containing a member who regularly participates in a drug and alcohol
-treatment program on a non-resident basis shall include this member when having its eligibility
-determined. The household must complete the application process through the head of
-household or through an authorized representative and shall meet all financial and non-financial
-criteria unless specifically exempt. Such households may use any part of their SNAP benefits to
-purchase food prepared for or served to the individual during the program, provided the program
-has been authorized by FNS for such purposes.
-
-4.309.31
-
-Responsibilities of the Center
-
-Drug or alcohol treatment and rehabilitation centers will be responsible for the following:
-A.
-
-The drug or alcohol treatment center employee designated to serve as an authorized
-representative shall be responsible for obtaining their own Electronic Benefit Transfer (EBT) card
-and Personal Identification Number (PIN) with which to access benefits from the resident’s
-account while the resident remains a resident of the facility.
-The resident’s EBT card shall be stored in a secure area while the resident receives treatment at
-the facility. The drug or alcohol treatment center shall not have access to, or knowledge of, the
-PIN for the resident’s own EBT card.
-
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-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-B.
-
-Each treatment and rehabilitation center shall provide the certification office with a certified list of
-currently participating residents and their children residing with them in the center. The
-certification office shall require the list on a monthly or semimonthly basis. In addition, the
-certification office shall conduct periodic, random, onsite visits to the center to ensure the
-accuracy of the listings and that the local office's records are consistent and up-to-date. The
-frequency of periodic visits is left to the discretion of the local office but once each year is
-recommended.
-
-C.
-
-The center shall also report when the resident leaves the center. The center shall return to the
-issuing office any benefits received after the household has left the center.
-The center shall provide the residents with their EBT card when the household leaves the
-treatment and rehabilitation program. Once the household leaves the center, the center is no
-longer allowed to act as that household's authorized representative. The departing resident shall
-receive his/her full allotment if already issued and if no benefits have been spent on his/her
-behalf.
-If benefits have been issued and any portion has been spent on his/her behalf and the resident
-leaves prior to the sixteenth (16th) of the month, the center shall provide the resident with one
-half of his/her monthly allotment; on or after the sixteenth (16th), if benefits have already been
-used, the resident shall not receive any benefits.
-Under no circumstances shall the center pull benefits from an EBT card after the resident has left
-the facility. The center shall return the authorized representative EBT card, and the resident’s
-card if it was left behind, to the issuing office within five (5) calendar days of the resident’s
-departure.
-The center shall provide the household with a change report form as soon as it has knowledge
-the household plans to leave the facility and advise the household to return the form to the local
-office within ten (10) days of any change the household is required to report.
-
-D.
-
-The center shall be responsible for any misrepresentation or fraud, which it knowingly commits in
-the certification of center residents. The organization or institution shall be knowledgeable about
-household circumstances when serving as an authorized representative. The organization or
-institution should carefully review those circumstances with residents prior to applying on their
-behalf.
-
-E.
-
-The center may be penalized or disqualified if it is determined administratively or judicially that
-benefits were misappropriated or used for purchases that did not contribute to a certified
-household's meals. The local office shall promptly notify the state department when it has reason
-to believe that a center is misusing SNAP benefits in its possession. However, no action shall be
-taken against the center prior to an FNS investigation. The local office shall establish a claim for
-over-issuance of SNAP benefits held on behalf of center residents if any over-issuances are
-discovered because of an FNS investigation or hearing. If FNS disqualifies a center as an
-authorized drug and alcohol rehabilitation and treatment center, the local office shall suspend its
-authorized representative status for the same period.
-
-71
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.309.4 Residents of Group Living Arrangements
-A.
-
-Group living arrangements are residential settings that are considered alternatives to institutional
-living. Institutional settings are not included in this provision. To be eligible as residents of a group
-living arrangement, the person must be a person with disabilities. In addition, the local office shall
-verify that the group living arrangement is a public or private nonprofit facility with no more than
-sixteen (16) residents and is certified as a group living arrangement by the Colorado Department
-of Public Health and Environment and the state department under Section 1616(e) of the Social
-Security Act (codified at 42 U.S.C. 1382e(e)). FNS may also certify under standards determined
-by the USDA that are comparable to standards implemented by the state under 1616(e) of the
-Social Security Act. Individuals residing in a for-profit facility are considered residents of an
-institution per Section 4.304.4(E).
-
-B.
-
-Residents of group living arrangements must voluntarily elect to participate in SNAP.
-Residents shall either apply and be certified through an authorized representative, who is
-employed and designated by the group living arrangement or apply and be certified on their own
-behalf or through an authorized representative of their own choice. The group living arrangement
-shall determine if any resident may apply for SNAP on his/her own behalf; the determination shall
-be based on the resident's physical and mental capability to handle his/her own affairs.
-1.
-
-C.
-
-If residents apply using the group living facility's authorized representative, eligibility shall
-be determined as a one-person household. The group living arrangement may either:
-a)
-
-Receive and spend the allotment on food prepared by and/or served to the
-eligible resident, or
-
-b)
-
-Allow the eligible resident to use all or any portion of the allotment on his/her own
-behalf.
-
-2.
-
-The group living facility employee designated to serve as an authorized representative
-shall be responsible for obtaining their own Electronic Benefit Transfer (EBT) card and
-Personal Identification Number (PIN) with which to access benefits from the resident’s
-account while the resident remains a resident of the facility.
-
-3.
-
-The resident’s EBT card shall be stored in a secure area while the resident resides in the
-group living facility. The group living facility shall not have access to, or knowledge of, the
-PIN for the resident’s personal EBT card.
-
-4.
-
-If the residents apply on their own behalf, the applications shall be accepted for any
-individual applying as a one-person household or for any grouping of residents applying
-as a household. If residents are certified on their own behalf, the allotment may be
-returned to the facility to be used to purchase food for meals served either communally or
-individually to eligible residents, used by eligible residents to purchase and prepare food
-for their own consumption, and/or to purchase meals prepared and served by the group
-living arrangement.
-
-Applications for residents of group living arrangements shall be processed using the same
-standards that apply to all other SNAP households including that residents entitled to expedited
-service shall have benefits available for spending no later than seven (7) calendar days following
-the date the application was filed. Required verification shall be obtained prior to further benefits
-being issued.
-
-72
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-Supplemental Nutrition Assistance Program (SNAP)
-
-D.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-The local office shall process changes in household circumstances and recertifications by using
-the same standards that apply to all other SNAP households, and resident households shall be
-afforded the same rights all other SNAP households enjoy, including the right to notices of
-adverse action, fair hearings, and entitlement to lost benefits.
-
-4.309.41
-
-Responsibilities of Group Living Arrangements
-
-A.
-
-Each group living arrangement shall provide the local office with a list of currently participating
-residents. The local office shall require the list on either a monthly or semimonthly basis and the
-list shall be signed by a responsible center official attesting to the validity of the list. In addition,
-the local office shall conduct periodic random onsite visits to ensure the accuracy of the list and
-that the local office's records are consistent and up to date.
-
-B.
-
-If the resident has applied on his/her own behalf, the household is responsible for reporting
-changes to the local office in accordance with Section 4.603. If the group living arrangement is
-acting in the capacity of an authorized representative, the group living arrangement shall notify
-the local office of changes in the household's income or other household circumstances and
-when the individual leaves the group living arrangement.
-
-C.
-
-When the household leaves the group living facility, the group living arrangement, either acting as
-an authorized representative or retaining use of the benefits on behalf of the residents (regardless
-of the method of application), shall provide residents with their EBT card. The household, not the
-group living arrangement, shall be allowed to receive his/her authorized issuance. Also, the
-departing household shall receive its full allotment if no benefits have been spent on behalf of that
-individual household. These procedures are applicable any time during the month.
-However, if the benefits have already been issued and any portion spent on behalf of the
-individual and the household leaves the group living arrangement prior to the sixteenth (16th) of
-the month, the facility shall provide the resident with one half of his/her monthly allotment. If the
-household leaves on or after the sixteenth (16th) of the month and the benefits have already been
-issued and used, the household does not receive any benefits.
-Once the resident leaves, the group living arrangement no longer acts as his/her authorized
-representative. Under no circumstances shall the group living arrangement pull benefits from an
-EBT card after the resident or group of residents have left the group living facility. The facility
-shall return the authorized representative EBT card, and the resident’s card if it was left behind, to
-the issuing office within five (5) calendar days of the resident’s departure.
-The group living arrangement shall provide the household with a change report form as soon as it
-has knowledge of the household plan to leave the facility and advise the household to return the
-form to the local office within ten (10) days of any change the household is required to report.
-
-D.
-
-When acting as the authorized representative, a group living arrangement shall be responsible for
-any misrepresentation or fraud, which it knowingly commits in the certification of group living
-facility residents. The facility shall be knowledgeable about household circumstances as an
-authorized representative and should carefully review those circumstances with residents prior to
-applying on their behalf. The facility shall be strictly liable for all losses or misuse of benefits held
-on behalf of resident households and for all over-issuances that occur while the households are
-residents of the group living facility. However, the resident applying on his/her own behalf shall be
-responsible for over-issuance as would any other household.
-
-73
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-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-E.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-The group living arrangement may purchase and prepare food to be consumed by eligible
-residents on a group basis if residents normally obtain their meals at a central location as part of
-the group living arrangement services, or if meals are prepared at a central location for delivery to
-the individual residents. If residents purchase and/or prepare food for individual consumption, as
-opposed to communal dining, the group living arrangement shall ensure that each resident’s
-SNAP benefits are used for meals intended for that resident. If the resident retains use of their
-own allotment, they may either use the benefits to purchase meals prepared for them by the
-facility or to purchase food to prepare meals for their own consumption.
-
-4.309.42
-
-Disqualification of the Group Living Arrangements
-
-A group living arrangement facility authorized by FNS may be penalized or disqualified if it is determined
-administratively or judicially that benefits were misappropriated or used for purchases that did not
-contribute to a certified household's meals. The local office shall promptly notify the state department
-when it has reason to believe that a facility is misusing benefits. However, the local office shall take no
-action prior to FNS action against the facility. The local office shall establish a claim for over-issuances of
-SNAP benefits held on behalf of resident clients if any over-issuances are discovered during an
-investigation or hearing procedure for redemption violations.
-If the group living facility loses its authorization from FNS to accept SNAP benefits or is no longer certified
-by the Colorado Department of Public Health and Environment as a group living arrangement, residents
-using the facility as an authorized representative shall no longer be able to participate. The residents are
-not entitled to a Notice of Adverse Action but shall receive a written notice explaining the termination and
-when it shall become effective.
-Residents applying on their own behalf shall still be able to participate, if otherwise eligible.
-4.310
-
-GENERAL WORK REQUIREMENTS
-
-As a condition of eligibility for SNAP, each household member not determined to be exempt must comply
-with the following work requirements:
-A.
-
-Register for work at the time of initial application and at every recertification by signing the
-application for assistance or recertification. The application must be signed by the member
-required to register, an authorized representative, or by another adult household member; and
-
-B.
-
-Provide the eligibility techncian with sufficient information regarding employment status or
-availability for work; and
-
-C.
-
-Cannot commit an act of voluntary quit; and
-
-D.
-
-Accept an offer of suitable employment; and
-
-E.
-
-Report to an employer if referred by the local office if the potential employment is suitable
-employment.
-
-4.310.1 Work Requirements and Verification
-Client statements are considered acceptable verification unless questionable.
-If verification is requested from the client because client statement is considered questionable, case
-documentation must thoroughly explain why the original client statement was considered questionable.
-A.
-
-Examples of verification that can be obtained to resolve questionable information can include but
-is not limited to:
-
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-
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-Effective Date: 10/01/2024
-
-1.
-
-Receipt of temporary or permanent disability benefits issued by government or private
-sources; or
-
-2.
-
-Persons may provide a statement from a physician, physician’s assistance, nurse, nurse
-practitioner, designated representative of the physician’s office, or a licensed or certified
-psychologist. A county agency may determine other licensed medical personnel
-appropriate to provide verification that a work registrant is physically or mentally unfit for
-employment; or
-
-3.
-
-A statement from a licensed social worker or a social worker employed by or acting on
-behalf of a 501(C)(3) non-profit organization or government entity.
-
-4.310.2 Informing the Household of General Work Requirements
-At the point of initial application and recertification, when an interview is required, SNAP households must
-receive from the eligibility technician a written notice and a verbal explanation of:
-A.
-
-The SNAP general work requirements;
-
-B.
-
-The rights and responsibilities of household members subject to work requirements;
-
-C.
-
-The consequences of failure to comply with these work requirements; and
-
-D.
-
-The availability of additional employment and training programs and services, outside of
-Employment First (EF), within their community.
-
-When an interview is not required at recertification, the written statement of these requirements to the
-work registrants in the household is sufficient.
-4.310.3 General Work Requirement Exemptions
-At all determinations of eligibility including initial, ongoing, and recertification, eligibility technicians must
-explore if the household member meets an exemption rather than placing the burden solely on the
-household member to self-report.
-General work requirement exemptions include:
-A.
-
-A person 15 years of age or younger or a person 60 years of age or older;
-1.
-
-A person age 16 or 17 who is not the head of a household, or who is attending school, or
-is enrolled in an employment training program, on at least a half-time basis, is also
-exempt.
-
-B.
-
-A parent or other household member responsible for the care of a dependent child under 6 or an
-incapacitated person;
-
-C.
-
-A person physically or mentally unfit for employment;
-Examples of being physically or mentally unfit for employment can include but are not limited to:
-1.
-
-Persons experiencing homelessness, as defined in 4.000.1
-
-2.
-
-Recently released from an institution
-
-3.
-
-Person with disabilities as defined in 4.100 and includes but is not limited to:
-
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-
-D.
-
-E.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-a.
-
-Persons with self-declared temporary conditions that would prevent successful
-participation in work activities
-
-b.
-
-Persons receiving temporary or permanent disability benefits issued by
-government or private sources
-
-c.
-
-Persons participating in vocational rehabilitation
-
-d.
-
-Persons applying for and/or appealing SSI benefits
-
-4.
-
-Persons unable to maintain employment
-
-5.
-
-Persons impacted by domestic violence
-
-A student enrolled at least half-time, as defined by the educational facility, in any accredited
-school, training program, or institution of higher education;
-1.
-
-A student who is enrolled in an institute of higher education must meet student eligibility
-requirements to receive SNAP.
-
-2.
-
-Students who are eligible for SNAP remain exempt from work requirements during
-normal periods of class attendance and school breaks.
-
-3.
-
-Persons who are not enrolled at least half-time or who experience a break in their
-enrollment status due to graduation, expulsion, suspension, or who drop out or otherwise
-do not intend to register for the next normal school term (other than summer), shall not be
-eligible for this exemption.
-
-Employed or self-employed individuals who are working a minimum of thirty (30) hours per week
-or receiving weekly earnings at least equal to the federal minimum wage multiplied by thirty (30)
-hours;
-1.
-
-This shall include migrant and seasonal farm workers who are under contract or similar
-agreement with an employer or crew chief to begin employment within thirty (30) days.
-
-2.
-
-Persons working in action programs, including VISTA, are exempt from work
-requirements if they work at least thirty (30) hours per week even if the compensation is
-not consistent with prevailing community wage, since an employer-employee relationship
-can be documented.
-
-F.
-
-A person applying for or receiving Unemployment Insurance Benefits (UIB). The local office shall
-verify application for or receipt of UIB, if questionable. A person who has been denied UIB and
-who is appealing the decision is exempt;
-
-G.
-
-A regular participant in drug or alcohol treatment or rehabilitation program;
-
-H.
-
-A person subject to and complying with CW or the Colorado Refugee Services Program (CRSP)
-work programs.
-
-4.310.4 Changes in Exemption Status
-Individuals exempt from work requirements are not required to report changes in their exemption status
-during their certification period. At recertification, all individuals subject to work requirements will be
-reassessed for work requirement exemptions.
-
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-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-If an individual loses their exemption status during their certification period, they shall retain their original
-work requirement exemption through their certification period unless they are considered an ABAWD.
-4.310.5 Voluntary Quit
-A.
-
-When a household files an initial application or recertification, the local office must determine if
-any household member who is not exempt from work requirements voluntarily quit his or her job
-of 30 or more hours a week or reduced his or her work effort to be less than 30 hours a week
-without good cause. Benefits must not be delayed beyond the normal processing times pending
-the determination of voluntary quit.
-
-B.
-
-A level sanction as described in section 4.3108, below, will be imposed if voluntary quit occurred
-within sixty (60) calendar days prior to the date of application or after the date of application but
-prior to eligibility determination and the voluntary quit was without good cause as defined in
-section 4.308.1.
-1.
-
-C.
-
-Individuals who voluntary quit are ineligible to participate in SNAP and shall be treated as
-a disqualified member. If the disqualified member joins another household, the ABAWD
-disqualification period for that individual shall continue until the ABAWD disqualification
-period is completed.
-
-An employee of the federal, state, or local government who participates in a strike against such a
-government and is dismissed from his or her job because of participation in the strike, will be
-considered to have voluntarily quit his or her job without good cause.
-If an individual quits a job, secures new employment at comparable wages or hours, and, through
-no fault of his or her own loses the new job, the prior voluntary quit will not be a basis for
-disqualification.
-
-4.310.6 Suitable Employment
-Employment will be considered suitable, unless any of the following apply:
-A.
-
-The wages offered are less than the higher of:
-1.
-
-The applicable federal or state minimum wage.
-
-2.
-
-Eighty percent (80%) of the federal minimum wage if neither the federal or state minimum
-wage is applicable.
-
-B.
-
-The employment offered is on a piece-rate and the average hourly yield the employee can
-reasonably be expected to earn is less than the applicable hourly wage specified above.
-
-C.
-
-The household member, as a condition of employment, is required to join, resign from, or refrain
-from joining any legitimate labor organization.
-
-D.
-
-The work offered is at a site subject to a strike or lockout at the time of the offer unless the strike
-has been enjoined under the Labor Management Relations or the Railway Labor Act.
-
-E.
-
-The household member that can demonstrate or the local office becomes aware that:
-1.
-
-The degree of risk to the health and safety is unreasonable.
-
-2.
-
-The client is physically or mentally unfit to perform the employment as established by
-documentary medical evidence or reliable information obtained from other sources.
-
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-
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-Effective Date: 10/01/2024
-
-3.
-
-The employment offered is not in his/her major field experience unless, after a period of
-thirty (30) calendar days from registration, job opportunities in his/her major field have not
-been offered.
-
-4.
-
-The distance from the member’s home to the place of employment is unreasonable
-considering the expected wage and the time and cost of commuting.
-
-5.
-
-The daily commuting time exceeds two (2) hours per day, not including the transporting
-of a child or children to and from a child care facility.
-
-6.
-
-The distance to the place of employment prohibits walking and neither public nor private
-transportation is available to transport the member to the job site.
-
-7.
-
-The working hours or nature of the employment interferes with the member’s religious
-observances, convictions, or beliefs.
-
-4.310.7 Good Cause for Voluntary Quit and Suitable Employment
-The local office is responsible for determining good cause when a non-exempt individual appears to have
-voluntarily quit or failed to accept an offer of suitable employment. Good cause and/or lack of good cause
-must be clearly documented in the case file.
-Good cause for voluntary quit includes circumstances beyond the household member’s control, such as,
-but not limited to:
-A.
-
-Discrimination by an employer based on age, race, sex, color, handicap, religious beliefs, national
-origin or political beliefs;
-
-B.
-
-Work demands or conditions that render continued employment unreasonable, such as working
-without being paid on schedule;
-
-C.
-
-Acceptance by the individual of employment; or enrollment of at least half-time in any recognized
-school, training program, or institution of higher education, that requires the individual to leave
-employment;
-
-D.
-
-Acceptance by any other household member of employment or enrollment at least half-time in
-any recognized school, training program, or institution of higher education in another county or
-political subdivision which requires the household to move and thereby requires the individual to
-leave employment;
-
-E.
-
-Resignations by persons under the age of sixty (60) that are recognized by the employer as
-retirement;
-
-F.
-
-Resignation from employment that does not meet suitable employment;
-
-G.
-
-Because of circumstances beyond the control of the individual, accepted full time employment
-subsequently either does not materialize or results in employment of less than thirty (30) hours a
-week or weekly earning of less than the federal minimum wage multiplied by thirty (30) hours;
-
-H.
-
-Leaving a job in connection with patterns of employment in which workers frequently move from
-one employer to another, such as migrant farm labor or construction work, even though
-employment at the new site has not actually begun;
-
-I.
-
-Illness of the individual;
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-J.
-
-Illness of another household member requiring the presence of the individual;
-
-K.
-
-A household emergency;
-
-L.
-
-Unavailability of transportation;
-
-M.
-
-Employer demands a reduction in participant’s work effort or salary through no fault of the
-employee; and
-
-N.
-
-Lack of adequate child care for children who have reached age 6 but are under age 12.
-
-4.310.8 Level Sanction Periods
-A.
-
-If the local office determines that an individual has voluntarily quit or failed to accept suitable
-employment without good cause, that individual shall be ineligible to participate in SNAP and
-shall be treated as a disqualified member. If the disqualified member joins another household, the
-disqualification period for that individual shall continue until the disqualification period is
-completed.
-1.
-
-The first (1st) time, the individual shall be disqualified for a period of one (1) month after
-the date the individual became ineligible.
-
-2.
-
-The second (2nd) time an individual fails without good cause to comply with work
-requirements, the individual shall be disqualified for a period of three (3) months after the
-date the individual became ineligible.
-
-3.
-
-The third (3rd) or subsequent time an individual fails without good cause to comply with
-work requirements, the individual shall be disqualified for a period of six (6) months after
-the date the individual became ineligible.
-
-B.
-
-The disqualification period shall begin the month following the expiration of the Notice of Adverse
-Action unless a fair hearing is requested.
-
-C.
-
-If the level sanction disqualified individual is the sole member of the SNAP household and then
-becomes exempt, the newly exempt individual can reapply for benefits. The newly exempt
-individual will be eligible based on the date of the application or if in the case of reinstatement, the
-date exemption information was provided to the local office.
-
-D.
-
-If the level sanction disqualified individual is in a SNAP household with other eligible members
-and then becomes exempt, the newly exempt individual will be eligible based on the date
-exemption information was provided to the local office.
-
-4.311
-
-ABAWD WORK REQUIREMENTS
-
-ABAWDs must fulfill an ABAWD work requirement in addition to the general work requirements. For the
-remainder of this section, client statement is considered acceptable verification unless questionable. If
-verification is requested from the client, case documentation must thoroughly explain why the original
-client statement was considered questionable.
-A.
-
-The following individuals are not considered ABAWDs and are therefore not subject to the
-ABAWD work requirement:
-1.
-
-Aged seventeen (17) or younger.
-
-2.
-
-Aged fifty-five (55) or older.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-3.
-
-4.
-
-B.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Determined to be medically certified as physically or mentally unfit for employment. An
-individual is medically certified as physically or mentally unfit for employment if they:
-A.
-
-Are receiving temporary or permanent disability benefits issued by governmental
-or private sources;
-
-B.
-
-Are obviously mentally or physically unfit for employment as determined by the
-local office; or
-
-C.
-
-Provide a statement from a physician, physician’s assistant, nurse, nurse
-practitioner, designated representative of the physician’s office, a licensed or
-certified psychologist, a social worker, or any other qualified health professional
-as defined in 12-200-101 through 12-315-126, C.R.S., that the client is physically
-or mentally unfit for employment.
-
-Residing in the same physical household with an individual who is under the age of
-eighteen (18). The minor individual does not have to be included in the same SNAP
-household for this exclusion to apply.
-
-To fulfill the ABAWD work requirement, the ABAWD must be:
-1.
-
-Working 20 hours per week or averaged monthly for a total of 80 hours a month; or
-a.
-
-2.
-
-Working includes:
-i.
-
-Work completed in exchange for money (compensated work); or
-
-ii.
-
-Work completed in exchange for goods or services (in-kind work); or
-
-iii.
-
-Unpaid work verified by the provider of the unpaid work; or
-
-iv.
-
-Any combination of compensated work, unpaid work, or in-kind work.
-
-Participating in and complying with the requirements of a work program 20 hours per
-week or averaged monthly for a total of 80 hours a month; or
-a.
-
-A work program includes:
-i.
-
-A program of employment and training operated or supervised by the
-CDHS program other than a job search program or a job search training
-program;
-
-ii.
-
-A program under the Workforce Innovation and Opportunity Act (WIOA);
-
-iii.
-
-A program under Section 236 of the Trade Act of 1974 (19 USC 2296,
-“Trade Adjustment Assistance”).
-
-3.
-
-In any combination of working and participating in a work program for a total of 20 hours
-per week or averaged monthly for a total of 80 hours a month; or
-
-4.
-
-Participating in and complying with the Colorado Workfare program.
-
-Failure to meet the ABAWD work requirement will result in the ABAWD losing eligibility if they accrue
-three countable months within a thirty-six (36) calendar month period.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.311.1 ABAWD Exemptions
-Any individual who meets the definition of an ABAWD can be exempt from the ABAWD work requirement
-by meeting one of the follow exemptions:
-A.
-
-Exempt from the general work requirements;
-
-B.
-
-Pregnancy;
-
-C.
-
-A person experiencing homelessness, as defined in Section 4.000.1;
-
-D.
-
-Veterans;
-
-E.
-
-Aged twenty-four (24) years and younger and in Foster Care on their eighteenth (18th) birthday;
-
-F.
-
-Exempt under a waiver approved by the USDA, FNS; or
-
-G.
-
-Exempt using Colorado defined state exemptions as identified in the current SNAP Employment
-and Training State Plan.
-
-4.311.2 Changes in ABAWD Exemption Status
-ABAWDs are not required to report changes in their exemption status during a certification period.
-However, if the ABAWD loses their exemption status during a certification period, the months the ABAWD
-was not exempt will count toward their three countable months in a thirty-six (36) calendar month period.
-Any remaining months of benefits received during that certification period are not considered overissuances and claims will not be established.
-4.311.3 ABAWD Time Limits
-ABAWDs are not eligible to participate in SNAP if they have received SNAP benefits for more than three
-countable months during a thirty-six (36) month period.
-However, ABAWDs may be eligible for up to three additional consecutive months after regaining eligibility
-in accordance with paragraph (C) of this section.
-A.
-
-Countable months
-1.
-
-2.
-
-B.
-
-Countable months are accrued when an ABAWD received SNAP benefits for the full
-benefit month but did not:
-A.
-
-Meet an exemption; or
-
-B.
-
-Fulfill their work requirements.
-
-When an individual turns eighteen years old (18) and enters ABAWD status, they do not
-accrue a countable month in the month they turn eighteen (18). If they do not meet an
-ABAWD exemption, they will begin to accrue countable months in the month after the
-month in which they turn eighteen (18).
-
-Good cause for countable months
-If an ABAWD would have worked an average of twenty (20) hours per week but missed some
-work for good cause, the ABAWD shall be considered to have me the work requirement if the
-absence from work is temporary and the individual retains work.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Good cause for countable months shall include circumstances beyond the individual’s control,
-such as, but not limited to, illness, illness of another household member requiring the presence of
-the member, a household emergency, or the unavailability of transportation.
-C.
-
-D.
-
-The ABAWD time limit clock:
-1.
-
-Counts accrued countable months for all ABAWDs who are not in compliance with work
-requirements and do not have an exemption; and
-
-2.
-
-Resets accrued countable months and ABAWD disqualifications, regardless of start date,
-for all ABAWDs every thirty-six (36) calendar months starting July 1, 2023.
-
-Regaining Eligibility
-1.
-
-4.312
-
-An individual who is denied eligibility under this provision can regain eligibility if in a thirty
-(30) calendar day period, the individual:
-a.
-
-Worked eighty (80) or more hours;
-
-b.
-
-Participates in and complies with the requirements of a work program for eighty
-(80) or more hours;
-
-c.
-
-Participates and complies with the Workfare Program as described in section
-4.313; or
-
-d.
-
-Becomes exempt.
-
-2.
-
-The individual will be reinstated if otherwise eligible and will continue to be eligible if the
-individual continues to meet the work requirement or is exempt.
-
-3.
-
-If an individual regains eligibility but then fails to continue meeting these requirements,
-the individual shall remain eligible for a consecutive three-month period after the
-individual notifies the local office. The individual can only have this provision applied for a
-single three-month period in the thirty-six (36) calendar month period.
-
-Employment First (EF)
-
-In Colorado, the Employment and Training program is called EF. The purpose of the program is to assist
-members of households participating in SNAP in gaining skills, training, work, or experience that will
-increase their ability to obtain employment.
-CDHS must submit an annual Employment and Training State Plan for approval by the USDA, Food and
-Nutrition Service. A copy of the CDHS Employment and Training plan is available at
-https://cdhs.colorado.gov/benefits-assistance/employment-assistance/colorado-employment-first.
-The EF program is a voluntary work program for SNAP applicants and recipients. Failure to participate
-with the EF program will not result in a work requirement disqualification.
-4.312.1 County Administration Requirements for EF
-Local offices choosing to administer an EF program shall submit a county plan as prescribed by CDHS
-and shall operate their EF program in alignment with the CDHS Employment and Training plan. Failure to
-adhere to the requirements as described in the CDHS Employment and Training plan will result in a
-Corrective Action Plan (CAP).
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Local offices may enter into a contractual agreement for all or any part of the EF program service delivery.
-These contractual agreements shall be reviewed by CDHS for adherence to the program requirements
-before implementation.
-A.
-
-Every EF program must monitor ABAWDs who choose to use EF to meet their ABAWD work
-requirement to ensure they are meeting ABAWD work requirements. This monitoring may include
-obtaining employment or volunteer working hours information and/or ensuring the ABAWD is
-participating in an allowable Employment First component as set forth in the annual CDHS
-Employment and Training plan and the specific county EF plan.
-
-B.
-
-The EF provider shall:
-
-4.313
-
-1.
-
-Deliver case management services as prescribed in the CDHS EF State Plan;
-
-2.
-
-Compile data and submit required reports within prescribed timeframes;
-
-3.
-
-Coordinate program operations with the state EF staff, in accordance with the annual
-CDHS Employment and Training plan as well as the specific county EF plan;
-
-4.
-
-Ensure that participants receive the appropriate reimbursement for participation, such as
-actual costs of transportation or other costs as outlined in the CDHS Employment and
-Training plan;
-
-5.
-
-Utilize required forms as prescribed or approved by the state;
-
-6.
-
-Attend scheduled EF program meetings and training as required;
-
-7.
-
-Ensure that all funds expended are allowable program costs per the annual CDHS
-Employment and Training plan;
-
-8.
-
-Ensure program services are not suspended for longer than fourteen (14) consecutive
-days for any reason;
-
-9.
-
-Ensure that any exemptions discovered through working with participants are
-communicated to county eligibility
-
-Colorado Workfare Program
-
-In Colorado, the Section 20 Workfare Program of the Food and Nutrition Act of 20018 (codified at 7 USC
-2029) is called the Colorado Workfare Program.
-CDHS must submit an annual Section 20 Workfare State Plan for approval by the USDA, FNS. A copy of
-the CDHS Section 20 Workfare plan is available at https://cdhs.colorado.gov/benefitsassistance/employment-assistance/colorado-employment-first.
-4.313.1 County Administration Requirements for Workfare
-Local offices choosing to administer a Colorado Workfare program shall submit a county plan as
-prescribed by CDHS and shall operate their Workfare program in alignment with the CDHS Section 20
-Workfare plan. Failure to adhere to the requirements as described in the CDHS Section 20 Workfare plan
-will result in a Correct Action Plan (CAP).
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-4.400
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-FINANCIAL ELIGIBILITY CRITERIA
-
-Income shall be considered prospectively for the issuance month based on the eligibility technician’s
-determination of the household's reasonably anticipated monthly income, and for households eligible
-under Standard Eligibility as outlined in Section 4.206, the value of its resources is considered.
-4.401
-
-Income Eligibility Standards
-
-A.
-
-Income eligibility is determined based on the composition of the household. A household shall
-meet the gross and net monthly income eligibility standards as outlined in this section. See
-section 4.401.1 and 4.401.2 for the gross and net percentages of the Federal Poverty Levels.
-1.
-
-ECE households must have gross income below two hundred percent (200%) of the
-federal poverty level.
-
-2.
-
-BCE households shall be deemed as having met gross and net income limits.
-
-3.
-
-Households that are not considered ECE or BCE and are instead subject to SE rules
-shall meet income eligibility standards as follows:
-
-4.
-
-B.
-
-a.
-
-Households that do not include a member who is aged sixty (60) and older or a
-person with a disability shall have gross income at or below one hundred thirty
-percent (130%) of the federal poverty level and have a net income at or below
-one hundred percent (100%) of the federal poverty level.
-
-b.
-
-Households that include a member who is aged sixty (60) and older or a person
-with a disability shall have a net income at or below one hundred percent (100%)
-of the federal poverty level.
-
-For household members who are persons that are aged sixty (60) and older and/or have
-a disability, who are unable to purchase and prepare meals because they suffer from a
-disability considered permanent under the Social Security Act, or a non-disease related,
-severe, permanent disability, may be considered, together with his or her spouse if the
-spouse is living in the same home, a separate household from the others with whom the
-individual lives. The combined income of the others with whom the individual who is aged
-sixty (60) and older and a person with disabilities resides (excluding the income of the
-individual who is aged sixty (60) and older and a person with disabilities and his or her
-spouse) must not exceed one hundred sixty-five percent (165%) of the poverty level.
-
-Ineligible students and household members who are ineligible due to citizenship status,
-intentional program violation, failure to cooperate with work programs, or failure to provide or
-apply for a Social Security Number, shall be excluded when determining the household size and
-the appropriate income eligibility maximum and/or level of benefits.
-
-4.401.1 Gross Income Limits
-Effective October 1, 2024, the gross income levels for one hundred thirty percent (130%), two hundred
-percent (200%), and one hundred sixty-five percent (165%) of the federal poverty level for the
-corresponding household size are as follows:
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-Household
-Size
-
-1
-2
-3
-4
-5
-6
-7
-8
-Each additional
-person
-
-130% Gross Income
-Level
-$1,632
-$2,215
-$2,798
-$3,380
-$3,963
-$4,546
-$5,129
-$5,712
-+$583
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-200% Gross Income
-Level
-$2,510
-$3,408
-$4,304
-$5,200
-$6,098
-$6,994
-$7,890
-$8,788
-+$898
-
-165% Gross Income
-Level
-$2,071
-$2,811
-$3,551
-$4,290
-$5,030
-$5,770
-$6,510
-$5,712
-+$740
-
-4.401.2 Net Income Levels
-Effective October 1, 2024, the net income level of one hundred percent (100%) of the federal poverty
-level for the corresponding household size is as follows:
-Household Size
-1
-2
-3
-4
-5
-6
-7
-8
-Each additional person
-4.402
-
-HOUSEHOLD INCOME ELIGIBILITY
-
-A.
-
-Determining Income
-
-100% Net Income Level
-$1,255
-$1,704
-$2,152
-$2,600
-$3,049
-$3,497
-$3,945
-$4,394
-+$449
-
-1.
-
-Income eligibility shall be determined prospectively based on the eligibility technician’s
-anticipation of income at the time of application and when changes are made known to
-the local office.
-
-2.
-
-When determining if a household is eligible under gross and/or net income limits,
-households shall have income converted to a monthly amount by using a conversion as
-specified below. When a full month's income is anticipated any cents in the gross weekly
-or biweekly earnings shall be used in converting income to a monthly amount.
-Pay Frequency
-Weekly
-Bi-Weekly (Every Two Weeks)
-Semi-Monthly (Twice a Month)
-Every Other Month
-Quarterly
-Twice a Year
-Annual
-
-Conversion
-Multiply Weekly Average by 4.3.
-Multiply Bi-Weekly Average by 2.15.
-Multiply Semi-Monthly Average by 2.
-Multiply Average by 0.5.
-Multiply Average by 0.333333.
-Multiply Average by 0.166666.
-Multiply Average by .083.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-3.
-
-B.
-
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Household income shall mean all earned and unearned income received or anticipated to
-be received by household members from whatever source, unless specifically exempted
-for Food Assistance eligibility and budgeting purposes, per Section 4.405. Income of
-household members, including the amount of the disqualified person's income attributed
-to the household, shall be counted as income in the month received or the month it
-becomes available, unless the income is averaged over the certification period.
-
-Variations in Date of Pay
-1.
-
-Regular ongoing earned income that is received early or late by a household due to a
-holiday, a weekend, or pay dates being changed will have income counted based on the
-regular pay schedule instead of the actual date of pay.
-
-2.
-
-Households receiving monthly benefits such as public assistance or social security
-payments shall not have their monthly income varied merely because mailing cycles
-resulted in two (2) payments in one month and none in the next month.
-
-3.
-
-Households containing a member of the Armed Services of the United States shall not
-have their monthly income varied merely because the first day of the month falls on a
-holiday or weekend which resulted in two (2) payments in the month and none in the
-subsequent month.
-
-Wage Data
-1.
-
-With respect to income or resource information originating with the Internal Revenue
-Service (IRS) and provided through the income and eligibility verification system (IEVS),
-as well as wage data obtained through the DOLE or IEVS, the local office must verify
-such information from another source and must verify applicant/participant access to that
-income/resource. The local office may not take adverse action on such information until
-independent verification is obtained, or until the applicant has been found to have failed
-to cooperate in providing the required verification. The information must also be verified
-prior to establishing a claim for an over-issuance of benefits.
-
-4.402.1 Prospective Budgeting
-A.
-
-Prospective budgeting is the process of computing a household's allotment based on anticipated
-income and circumstances during the issuance month. All SNAP households and all situations
-require prospective budgeting determinations, including Public Assistance (PA) households under
-the TANF /Colorado Works Program.
-
-B.
-
-If the date of receipt or the amount of any anticipated income is uncertain, such as a new job or a
-PA application, that portion of income shall not be considered. Only the portion of income which
-can be anticipated with reasonable certainty concerning the amount and month in which monies
-will be received shall be counted as income.
-
-C.
-
-Income received within the past thirty (30) days may be used as an indication of the income that
-will be received in the issuance month unless changes in income have occurred or can be
-anticipated which require proper adjustment. Income used to determine prospective eligibility
-shall be representative of the household’s current circumstances.
-
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-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-If the verified income does not provide an accurate indication of anticipated income, a longer
-period of past time may be used if it will provide a more accurate indication of anticipated income.
-If a household's income fluctuates seasonally, it may be appropriate to use the last season rather
-than the last thirty (30) days, although precaution must be taken to account for possible
-fluctuations or new circumstances. Except for eligible strikers, no household shall have the
-amount of any past income automatically attributed to it.
-4.402.2 Averaging Income
-To obtain a household's average monthly income, income intended to cover a specific period of time is
-divided by the number of months the income is intended to cover.
-A.
-
-Income shall be averaged for:
-1.
-
-Households who derive their annual income from self-employment. These households
-shall have their income annualized over a twelve (12) month period even if the income is
-received within a shorter period of time.
-
-2.
-
-Households who derive their annual income from contract income shall have that income
-averaged over a twelve (12) month period. (This requirement is not applied to income
-from a contract received on an hourly or piecework basis.)
-
-3.
-
-Households receiving educational income as defined in Section 4.404, D. The income is
-prorated over the period of time it was intended to cover.
-
-4.
-
-Other households not previously mentioned, such as migrant or seasonal workers, may
-elect to have their fluctuating income averaged over the period of time the income is
-intended to cover.
-Self-employment income, contract income, and fluctuating income intended to cover a
-specific period of time shall not be averaged or annualized for migrant households that
-are destitute of income as defined in Section 4.406.
-
-B.
-
-The types of households listed above shall have their self-employment income, contract income,
-or educational monies annualized or prorated, and added to other household income to
-determine monthly income for SNAP.
-
-C.
-
-To average income prospectively, the eligibility technician shall use the household's anticipation
-of income, considering fluctuations, to obtain a monthly average amount for the period of
-certification. The number of months used to arrive at the average income need not be the same
-as the number of months in the certification period, such as the known income from two (2)
-previous months may be averaged and projected for each month of a certification period that is
-longer than two (2) months. Refer to Section 4.403.11 for more information on computing selfemployment income.
-Fluctuating income that has been averaged may be adjusted if verification of a change in
-circumstances is received.
-
-4.403
-
-COUNTABLE EARNED INCOME
-
-The following shall be considered as earned income:
-A.
-
-Wages and Salaries
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-1.
-
-All payments for services as an employee, including garnishments, or money payments
-legally obligated to the employee and diverted to a third party for the employee's
-household expenses. Countable income from employment received by students in
-institutions of higher education while participating in state work-study programs or a
-fellowship with a work requirement shall not be considered earned income.
-
-2.
-
-Earned income includes government payments from Agricultural Stabilization and
-Conservation Service and wages of AmeriCorps Volunteers in Service to America
-(VISTA) workers. VISTA payments are excluded if the client was receiving SNAP benefits
-when they joined VISTA. If the client was not receiving SNAP benefits when they joined
-VISTA, the VISTA payments shall count as earned income. Temporary interruptions in
-SNAP participation shall not alter the exclusion once an initial determination has been
-made (see Section 4.405.2, A, 3). Temporary interruptions shall be defined as a period
-where a household or individual missed a full month of benefits, excluding instances
-where the lapse in benefits is due to the local office not taking timely action in accordance
-with the processing standards outlined in Sections 4.604, 4.205, or 4.209.1.
-
-3.
-
-Wages held at the request of the employee shall be considered income to the household
-in the month the wages would otherwise have been paid by the employer. Advances on
-wages shall count as income in the month received, if reasonably anticipated. However,
-wages held by the employer as a general practice shall not be counted as income unless
-the household anticipates that it will receive income from such wages previously withheld
-by the employer.
-When an advance on wages is subsequently repaid from current wages, only the wages
-received is considered as income. The amount of repayment is disregarded, even if the
-wage-earner was not a SNAP participant at the time of the advance.
-
-4.
-B.
-
-C.
-
-Payment for sick leave, vacation pay, and bonus pay shall be considered as earned
-income, if the person was still employed while receiving the pay.
-
-Training Allowances
-1.
-
-Payments from vocational and rehabilitation programs recognized by federal, state, or
-local governments, such as the Job Opportunities and Basic Skills (JOBS) Program, to
-the extent they are not a reimbursement, except for allowances paid under the Workforce
-Innovation and Opportunity Act (WIOA).
-
-2.
-
-Earned income will include earnings to individuals who are participating in the on-the-job
-training under Section 204(5), Title II, of the Workforce Innovation and Opportunity Act
-(WIOA). This provision does not apply to household members under nineteen (19) years
-of age who are under the parental control of another adult member. Earnings include
-monies paid by the Workforce Innovation and Opportunity Act (WIOA) and monies paid
-by an employer.
-
-Title I Monies
-Payments received under Title I (VISTA-University Year of Action) of the Domestic Volunteer
-Service Act of 1973 shall be considered earned income and subject to the earned income
-deduction, excluding payments made to those households specified in Section 4.405.2.
-
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-
-D.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Income of Strikers
-Pre-strike eligibility is determined by considering the day prior to the strike as the day of
-application and assuming the strike was not occurring. Eligibility at the time of application shall be
-determined by comparing the striking member's income as of the day before the strike to the
-striking member's current income and adding the higher of the two to the current income of the
-non-striking household members during the month of application.
-
-E.
-
-Self-Employment
-The method of ascertaining the self-employment income to be considered for SNAP purposes is
-often difficult and the guidelines set forth in Sections 4.403.1–4.403.12 are meant to clarify and
-aid the process.
-In determining gross self-employment income, all income received by the self-employment
-household must be considered. Self-employment income includes:
-1.
-
-Monies received from rental or lease of self-employment property. Rental property shall
-be considered a self-employment enterprise. However, the income will be considered as
-earned income only if the household member (or disqualified person) actively manages
-the property at least an average of twenty (20) hours per week.
-
-2.
-
-Monies received from the sale of capital goods, services, and property connected to the
-self-employment enterprise. Proceeds of sales from capital goods or equipment are to be
-treated as income rather than as capital gains.
-The term “capital gains”, as used by the Internal Revenue Service (IRS), describes the
-handling of the profit from the sale of capital assets such as, but not limited to, computers
-and other electronic devices, office furniture, vehicles, and equipment used in a selfemployment enterprise; or securities, real estate, or other real property held as an
-investment for a set time period. For SNAP purposes, the total amount received from the
-sale of capital goods shall be counted as income to the household.
-
-F.
-
-Owners of Limited Liability Corporations (LLC) and S-Corporations
-For SNAP purposes, owners of LLCs or S-Corporations are considered employees of the
-corporation and, therefore, cannot be considered self-employed. The income from these types of
-corporations should be treated as regular earned income, not self-employment income.
-If the owner of the LLC or S-Corporation takes a draw, the total business income minus all
-expenses will count as earned income for the client. If the owner receives a salary, we count all
-payments for services as an employee as regular earned income. There are situations where the
-owner of an LLC or S-Corporation may receive a salary and a draw, so both sources of income
-must be counted.
-Client statement of LLC and S-Corporation income is acceptable, unless questionable. If the
-income meets the SNAP definition of questionable, verification can be provided in the form of pay
-stubs, bank records, the LLC or S-Corporation owner’s individual form 1040, or any other
-document that sufficiently establishes countable earned income for the owner.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-G.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Boarder Income
-The income of boarders shall include all direct payments to the household for room and meals,
-including contributions to the household for shelter expenses. Shelter expenses paid directly by
-boarders to someone outside of the household shall not be counted as income to the household.
-See Section 4.403.2 regarding calculating income from a boarder.
-
-4.403.1 Self-Employment
-See Section 4.403, E, for a description of what is considered self-employment income.
-A.
-
-Self-employment is defined as a situation where some or all income is received from a selfoperated business or enterprise in which the individual retains control over work or services
-offered, and assumes the necessary business risks and expenses connected with the operation
-of the business.
-Households in which one or more members are engaged in an enterprise for gain either as an
-independent contractor, franchise holder, or owner-operator must be considered as selfemployed, provided that the members are actively engaged in the enterprise on a day-to-day
-basis. In instances where the members hire or contract for another person or firm to handle the
-day-to-day activities of such enterprise, the members will have self-employment income but will
-not be considered as self-employed for purposes of work registration. The self-employed
-individual need not own one hundred percent (100%) of the company to be considered selfemployed.
-
-B.
-
-The receipt of income from self-employment, which may constitute all or only a portion of the
-income of the household, does not automatically exempt the members from the work registration
-requirement. This determination will be made based on the assessment of the eligibility
-technician and the household’s declaration that the self-employment enterprise requires thirty
-(30) hours of work per week or averages annually thirty (30) hours per week.
-
-4.403.11
-
-Determining Monthly Income from Self-Employment
-
-The amount of income considered from self-employment in the month of application shall be the gross
-amount of anticipated income plus capital gains less anticipated costs of doing business.
-A.
-
-To determine average income from self-employment, the worker first must determine the gross
-amount of income, actual or anticipated, including capital gains, for the period of time over which
-the self-employment income is being considered. The allowable costs of producing the selfemployment income are excluded and the net income divided by the number of months over
-which the income is intended to cover. For federal income tax purposes, only fifty percent (50%)
-of the proceeds from the sale of capital goods is taxed. Therefore, if income tax forms are used to
-determine household income, the eligibility technician must be aware that the full amount of the
-capital gains is counted as income.
-
-B.
-
-Allowable costs of doing business include, but are not limited to: identifiable costs of labor; stock;
-raw materials; seed; fertilizer; payments on the principal of the purchase price of income
-producing real estate; capital assets, equipment, machinery and other durable goods; interest
-paid to purchase income-producing property; insurance premiums; taxes paid on incomeproducing property; and, other similar items that are necessary costs of doing business.
-
-C.
-
-The following shall not be allowed as a deduction for business costs:
-1.
-
-Any amount that exceeds the payment a household receives from a boarder for lodging
-and meals is not allowable as a cost of doing business.
-
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-
-D.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-2.
-
-Any amount claimed as a net loss sustained in any prior period.
-
-3.
-
-Federal, state, and local income taxes, money set aside for retirement purposes, and
-other work-related personal expenses (such as meals). These expenses are accounted
-for by the earned income deduction. However, any taxes paid by the business for
-employees (such as the business share of social security taxes) are allowed as a
-business deduction.
-
-Anticipating Capital Gains and Other Self-Employment Income
-When self-employment income is calculated on an anticipated basis, any capital gains that the
-household anticipates receiving in the next twelve (12) months, beginning with the date the
-application is filed, are added, and divided by twelve (12). This amount is used in successive
-certification periods over the next twelve months unless a change occurs. A new average monthly
-amount must be calculated over this twelve-month period if the anticipated amount of capital
-gains changes. The anticipated monthly amount of capital gains and the anticipated monthly selfemployment income then are added and the anticipated cost of producing the income deducted.
-The cost is calculated by anticipating the monthly allowable costs of producing the selfemployment income.
-The monthly net self-employment income will be added to any other earned and unearned
-income received by the household to determine eligibility of self-employed SNAP applicants.
-For those households with self-employment income, which is not annualized, the eligibility
-technician shall anticipate income. Any anticipated proceeds from the sale of capital gains shall
-be used as income in the month the proceeds are anticipated to be received.
-
-4.403.12
-
-Averaging Self-Employment Income
-
-Self-employment income must be averaged over the period for which the income is intended to cover, as
-outlined below:
-A.
-
-Self-Employment as Primary Annual Support
-When a household receives its annual support from self-employment income, such income is to
-be averaged over twelve (12) months to determine the household's average monthly income from
-this source. This policy applies even if the income is received in only a short period of time or the
-household receives income from other sources in addition to the self-employment income.
-However, if the averaged, annualized amount does not accurately reflect the household's actual
-circumstances because the household has experienced a substantial increase or decrease in
-business, the worker must calculate the self-employment income on anticipated earnings and not
-on the basis of prior income.
-
-B.
-
-Self-Employment as Partial Support
-Households may receive income from self-employment that represents only a part of their annual
-income. Such self-employment income must be averaged over the self-employment months
-rather than over a twelve (12) month period.
-
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-
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Self-Employment Income Received Monthly
-Self-employment income received on a monthly basis and representing a household's annual
-support normally will be averaged over twelve (12) months. If the monthly average does not
-accurately reflect the household's actual financial situation because of a substantial increase or
-decrease in business, the worker must calculate self-employment income based on the
-household's anticipated earnings.
-
-D.
-
-Self-Employment Income from a New Source
-Income from a self-employment enterprise that has been in business less than a year is to be
-averaged over the period of time the business has been in operation and the monthly amount
-projected for the coming year.
-
-E.
-
-Self-Employment Income of a Farmer
-1.
-
-If after deducting all allowable business expenses from gross income received from selfemployment as a farmer, the costs of producing the income exceed the income derived,
-such losses shall be offset against other income received by the household. Steps to take
-in offsetting the loss shall be as noted below. The net losses shall be prorated over the
-period intended and the monthly prorated amount deducted from other monthly income.
-
-2.
-
-For purposes of applying this rule, an individual shall be considered a self-employed
-farmer if they receive or expect to receive gross annual income of one thousand dollars
-($1,000) or more from the farm enterprise. In addition, the following steps shall be taken
-when determining eligibility and benefits levels of the self-employed farmer.
-a.
-
-The monthly prorated loss shall be deducted first from any other “selfemployment” income.
-
-b.
-
-Any remaining loss will then be deducted from other earned income into the
-household. This total shall be the figure from which the earned income deduction
-shall be calculated.
-
-c.
-
-Finally, any other income shall be added, and this total shall be the amount used
-to compare the household's gross income to income eligibility standards for the
-appropriate-sized household.
-
-4.403.2 Boarder Income
-Persons paying a reasonable amount for room and board shall be excluded from the household when
-determining the household's eligibility and benefit level. The income of households owning and operating
-a commercial boarding house shall be handled as described in Section 4.403.11. For all other
-households, payments from the boarder shall be treated as self-employment income and the household's
-eligibility determined as follows:
-A.
-
-The income from boarders shall include all direct payments to the household for room and meals,
-including contributions to the household for shelter expenses. Shelter expenses paid directly by
-boarders to someone outside of the household shall not be counted as income to the household.
-
-B.
-
-After determining the income received from the boarders, the local office shall exclude that
-portion of the boarder payment which is the cost of doing business. The cost of doing business
-shall be equal to either of the following costs, provided that the amount allowed as a cost of doing
-business shall not exceed the payment the household received from the boarder for lodging and
-meals.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-1.
-
-The value of the maximum allotment for the household size that is equal to the number of
-boarders;
-
-2.
-
-The actual documented cost of providing room and meals if the actual cost exceeds the
-appropriate maximum allotment. If actual costs are used, only separate and identifiable
-costs of providing room and meals to boarders shall be allowed as a cost of doing
-business; or,
-
-3.
-
-If the boarder income received is from foster care payments, the entire amount of the
-payment will be disregarded as a cost of doing business.
-
-C.
-
-The monthly net income (after subtracting costs of doing business) from self-employment shall be
-added to other monthly earned income and the twenty percent (20%) earned income deduction
-shall be applied to the total dollar amount.
-
-D.
-
-Shelter costs the household actually incurs, even if the boarder contributes to the household for
-part of the household's shelter expenses, shall be computed to determine if the household will
-receive a shelter deduction. However, the shelter costs shall not include any shelter expenses
-paid directly by the boarder to a third party, such as to the landlord or the utility company.
-
-4.403.3 School Employee Income
-The provisions of this section are intended to apply primarily to teachers and other school employees.
-A.
-
-Households with members who receive income other than that which is paid on an hourly piecework basis from employment under a contract which is renewable on an annual basis will have
-such income averaged over a twelve (12) month period to determine household eligibility.
-
-B.
-
-Such members will be considered to be receiving compensation for an entire year, even though
-predetermined non-work periods are involved or actual compensation is scheduled for payment
-during work periods only. The renewal process may involve a signing of a new contract each
-year, be automatically renewable, or, as in cases of school tenure, rehire rights may be implied
-and thus preclude the use of a written contract altogether. The fact that such a contract is in effect
-for an entire year does not necessarily mean that the contract will stipulate work every month of
-the year. Rather, there may be certain predictable non-work periods or vacations, such as the
-summer break between school years.
-
-C.
-
-Income from such a contract will be considered as compensation for a full year, regardless of the
-frequency of compensation as stipulated in the terms of the contract, as determined at the
-convenience of the employer, or as determined at the wish of the employee.
-
-D.
-
-The annual income household members receive from contractual employment described above
-shall be averaged over a twelve (12) month period to determine the member's average monthly
-income. To determine household eligibility all other monthly income from other household
-members will be added to this average monthly income.
-
-4.404
-
-Countable Unearned Income
-
-Unearned income shall include, but not be limited to, the following:
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-A.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Assistance Payments
-Payment from federal or federally aided public assistance programs, such as Supplemental
-Security Income (SSI), or Colorado Works/Temporary Assistance to Needy Families (TANF)/Title
-IV-A, or other assistance programs based on need, including payments from programs which
-require, as a condition of eligibility, the actual performance of work without compensation other
-than the assistance payments themselves.
-
-B.
-
-Retirement and Disability Payments
-Payments from annuities; pensions; retirement; veterans or disability benefits; workmen's or
-unemployment compensation; old age, survivors, or Social Security benefits; and strike benefits.
-
-C.
-
-Support and Alimony Payments
-Support and alimony payments made directly to the household from non-household members for
-normal living expenses.
-
-D.
-
-Rental Income
-Rental income is total income, less the cost of doing business, from rental property in which a
-household member (or disqualified individual) is not actively managing the property an average of
-at least twenty (20) hours a week.
-
-E.
-
-Income of Non-Citizen Sponsors
-Income of non-citizen sponsors shall be considered as unearned income to households
-containing sponsored non-citizens.
-
-F.
-
-Vacation Pay, Sick Pay, and Bonus Pay
-If vacation pay, sick pay, or bonus pay is received in installment payments after a person has
-terminated employment, it is considered unearned income. If the pay is received in a lump sum, it
-shall be considered as a resource in the month received.
-
-G.
-
-Gifts
-Gifts from nonprofit organizations that exceed three hundred dollars ($300) in a quarter or gifts
-from other sources of any amount, if they can be anticipated.
-
-H.
-
-Other Gain or Benefits
-Dividends, interest, royalties, and all other nonexempt direct money payments from any source
-that can be construed to be a gain or benefit.
-Monies withdrawn from trust funds are income in the month received. Dividends that the
-household has the option of either receiving as income or reinvesting in the trust must be
-considered as income in the month they are available to the household.
-
-I.
-
-Substantial Lottery or Gambling Winnings
-Substantial lottery or gambling winnings as defined in section 4.000.1 will be counted as
-unearned income in the month received. If multiple individuals shared in the purchase of a ticket,
-hand, or similar bet, then only the portion of the winnings allocated to the member of the SNAP
-household would be counted in the eligibility determination.
-
-94
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-Supplemental Nutrition Assistance Program (SNAP)
-
-4.405
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Exempt Income
-
-Income from certain sources will be excluded for SNAP eligibility purposes under mandate of law. Only
-the following will not be considered as income:
-A.
-
-Irregular Income
-Any income in the certification period that is received too infrequently or irregularly to be
-reasonably anticipated, but not in excess of thirty dollars ($30) in three (3) months.
-
-B.
-
-Monies Intended for Non-Household Members
-Monies received and used for the care and maintenance of a third-party beneficiary who is not a
-household member. If the intended beneficiaries of a single payment are both household and
-non-household members, any identifiable portion of the payment intended and used for the care
-and maintenance of the non-household member shall be excluded. If the non-household
-member's portion cannot be readily identified, the payment shall be evenly prorated among the
-intended beneficiaries and the exclusion applied to the non-household member's pro rata share
-or the amount actually used for the non-household member's care and maintenance, whichever is
-less.
-
-C.
-
-Earnings of Children
-The earned income of children who are under eighteen (18) years of age, who live with their
-natural parent, adoptive parent, stepparent, or are under the parental control of another
-household member other than a parent and are students at least half-time in elementary school,
-high school, or classes to obtain a General Equivalency Diploma (GED), will be considered
-exempt income.
-If the student becomes eighteen (18) years of age in the month of application, the income shall be
-excluded for the month of application and counted the following month. If the student turns
-eighteen (18) during the certification period, their income shall be excluded until the month
-following the month in which the student turns eighteen (18).
-
-D.
-
-Recoupments
-The following recoupments or repayments from any nonexempt income source shall be exempt
-as income as follows:
-1.
-
-Monies withheld from an assistance payment, earned income, or monies received from
-any nonexempt income source that is voluntarily or involuntarily returned to repay a prior
-overpayment received from that income source. Only the net income received from these
-sources shall be considered countable income. However, monies withheld from a federal,
-state, or local means-tested program (such as Title IV-A, State Old Age Pension), for
-purposes of recouping an overpayment which resulted from the household's intentional
-failure to comply with that program's requirements, shall not be exempted as income, and
-the gross income received from these sources shall be considered countable income.
-See Section 4.705 for specific instructions.
-
-2.
-
-Child support payments received by Title IV-A participants that the household must
-transfer to the agency administering Title IV-D of the Social Security Act, in order to
-maintain their Title IV-A eligibility.
-
-95
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-E.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Non-recurring Lump Sum Payments
-Money received in the form of non-recurring lump sum payments, includes, but is not limited to,
-income tax refunds, rebates, or credits; retroactive lump-sum Social Security, SSI, public
-assistance, railroad retirement benefits or other payments; or retroactive lump-sum insurance
-settlements; or any money an inmate receives upon release from prison, including earnings from
-work performed while incarcerated and accumulated over the length of the incarceration.
-State and county diversion payments under Colorado Works shall be excluded as a non-recurring
-lump sum payment if the payment does not cover more than ninety (90) days of expenses and is
-not expected to occur again in a twelve (12) month period.
-Non-recurring lump sum payments shall be counted as resources in the month received, unless
-specifically excluded from consideration as a resource by other federal laws. Any funds remaining
-in subsequent months shall be considered a resource.
-
-F.
-
-G.
-
-Loans
-1.
-
-All loans from private individuals as well as commercial institutions shall not be
-considered as income, including educational loans.
-
-2.
-
-Monies received from a Reverse Annuity Mortgage (RAM) loan program should be
-treated as a loan and excluded from income. These loans meet the accepted definition of
-a loan since there is a verifiable agreement to repay with interest.
-
-In-Kind Benefits
-An in-kind benefit is any gain or benefit received by the household that is not in the form of money
-such as meals, clothing, public housing, or produce from a garden.
-
-H.
-
-Vendor Payments
-A payment made on behalf of a household shall be considered a vendor payment whenever a
-person or organization outside of the household uses its own funds to make a direct payment to
-either the household's creditors or a person or organization providing a service to the household.
-Vendor payments are excludable as follows:
-1.
-
-Such payments include subsidies paid to the households and legally obligated to the
-landlord, rent or mortgage payments made directly to landlords or mortgagees by the
-Department of Housing and Urban Development (HUD), or payments by a government
-agency to a child-care institution to provide day care for a household member are also
-excluded as vendor payments.
-
-2.
-
-Monies that are legally obligated and otherwise payable to the household, but which are
-diverted by the provider of the payment to a third party for household expense, shall be
-counted as income and not excluded as a vendor payment. The distinction is whether the
-person or organization making the payment on behalf of a household is using funds that
-otherwise would need to be paid to the household.
-
-3.
-
-Any emergency Public Assistance (PA) or General Assistance (GA) payment that is
-provided to a third party on behalf of the migrant or seasonal farm worker household,
-while the household is in the job stream, shall be excluded as income and considered as
-a vendor payment. These payments would normally be considered as income since the
-payment is legally obligated to the household.
-
-96
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.
-
-Wages earned by a household member that are garnished or diverted by an employer
-and paid to a third party for a household's expenses, such as rent, shall be considered as
-income. However, if the employer pays a household's rent directly to the landlord in
-addition to paying the household its regular wages, this rent payment shall be excluded
-as a vendor payment. In addition, if the employer provides housing to an employee, the
-value of the housing shall not be counted as income.
-
-5.
-
-Assistance provided to a third party on behalf of a household by the state or local
-program shall be considered money payable directly to the household if the assistance is
-provided in lieu of:
-a.
-
-A regular benefit payable to the household for living expenses under a program
-funded under Part A of the Social Security Act; or,
-
-b.
-
-A benefit payable to the household for housing expenses under a state or local
-general assistance program or other assistance program comparable to general
-assistance.
-
-6.
-
-Assistance payments made to a third party for medical, child-care, or emergency/special
-assistance would be excluded as a vendor payment. Assistance payments provided by a
-state or local housing authority would also be excluded as income.
-
-7.
-
-Energy assistance payments, other than for the Low-Income Energy Assistance Program
-(LEAP) or a one-time payment under federal or state law for weatherization or to
-repair/replace an inoperative furnace or other heating or cooling device, that are made
-under a state or local program shall be counted as income. The exclusion will still apply if
-a down payment is made and is followed by a final payment upon completion of work. If a
-state law prohibits the household from receiving a cash payment under state or local
-general assistance (or comparable program), the assistance would be excluded. This
-applies to either an energy assistance payment or other type of payment.
-Energy assistance payments for an expense paid on behalf of the household under a
-state law shall be considered an out-of-pocket expense incurred and paid by the
-household. Energy assistance payments made under Part A of Title IV of the Social
-Security Act (42 U.S.C. 601 through 42 U.S.C. 619) are included as income.
-
-I.
-
-8.
-
-Vendor payments which would normally be excluded as income but are converted in
-whole or in part to a direct cash payment under the approval of a federally authorized
-demonstration project (including demonstration projects created by a waiver of the
-provisions of federal law) shall be excluded from income.
-
-9.
-
-Monies from alimony or a court-ordered child support payment which are required by a
-court order (or other legally binding agreement) to be paid to a third party rather than to
-the household shall be excluded from income as a vendor payment, even if the
-household agrees to the arrangement.
-
-10.
-
-Payments more than the amount specified in a court order (or other legally binding
-agreement) which are paid to a third party in addition to a court-ordered vendor payment
-shall also be treated as a vendor payment.
-
-Reimbursements
-1.
-
-Reimbursement for past or future expenses, to the extent they do not exceed actual
-expenses, and do not represent a gain or benefit to the household shall not be
-considered income.
-
-97
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-To be excluded, the reimbursement must be provided specifically and used for an
-identified expense, other than normal living expenses, and used for the purpose
-intended. When a reimbursement, including a flat allowance, covers multiple expenses,
-each expense does not have to be separately identified as long as none of the
-reimbursement covers normal living expenses. Reimbursements for normal household
-living expenses such as rent or mortgage, personal clothing, or food eaten at home are a
-gain or benefit and, therefore, are not exempt.
-
-J.
-
-2.
-
-No portion of benefits provided under Title IV-A of the Social Security Act, to the extent
-such benefit is attributed to an adjustment for work related or child care expenses, except
-for payment or reimbursement for such expenses made under an education,
-employment, or training program initiated under such Title after September 18, 1988,
-shall be considered exempt under this provision.
-
-3.
-
-The amount by which a reimbursement exceeds the actual incurred expense shall be
-counted as income. However, reimbursements shall not be considered to exceed actual
-expenses unless the provider or the household indicates the amount is excessive.
-
-4.
-
-Types of reimbursement for expenses include:
-a.
-
-Reimbursement or flat allowances for job or training related expenses, such as
-travel, per diem, uniforms, and transportation to and from the job or training site
-including migrant travel.
-
-b.
-
-Reimbursements for out of pocket expenses of volunteers incurred in the course
-of their work.
-
-c.
-
-Medical or dependent care reimbursements.
-
-d.
-
-Reimbursements received by households to pay for services provided by Title XX
-of the Social Security Act.
-
-e.
-
-Reimbursements made to the household for expenses necessary for participation
-in an education component under the Employment First program.
-
-Verification
-Documentation of exempt income may explain a household's ability to maintain itself. Verification
-of exempt income is necessary only if the income is questionable. For example, when it is
-questionable that money received is a loan, a simple statement signed by both parties must be
-obtained which states that the money is a loan and that a repayment is being made or will be
-made.
-If the household receives payments on a regular basis from the same source but claims that
-payments are loans, it may be required that the provider of the loan sign an affidavit stating that
-repayments are being made or will be made in accordance with an established repayment
-schedule.
-
-4.405.1 Loans and Reimbursements to Students
-All education assistance including grants, scholarships, fellowships, work-study, veteran's educational
-benefits, and any other money received specifically for educational expenses are exempt from
-consideration as income.
-
-98
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.405.2 Income Excluded by Other Federal Statutes
-The following government payments are received for a specific purpose and are excluded as income.
-A.
-
-General
-1.
-
-P.L. No. 89-642, Section 11(b) of the Child Nutrition Act of 1966, as amended, excludes
-the value of assistance to children under this Act.
-
-2.
-
-Reimbursement from the Uniform Relocation Assistance and Real Property Acquisition
-Policy Act of 1970, as amended, (P.L. No. 91-646, Section 216).
-
-3.
-
-Any payment to volunteers under Title II (RSVP, Foster Grandparents and others) of the
-Domestic Volunteer Services Act of 1972, as amended, (P.L. No. 93-113).
-Payments under Title I (AmeriCorps Volunteers in the Service of America/VISTA including University Year for Action and Urban Crime Prevention Program) to volunteers
-shall be excluded for those individuals receiving SNAP or PA at the time they joined the
-Title I Program, except that households which are receiving an income exclusion for a
-VISTA or other Title I Subsistence Allowance at the time of conversion to the Food
-Assistance Act of 1977 shall continue to receive an income exclusion for VISTA for the
-length of their volunteer contract in effect at the time of conversion. Temporary
-interruptions in SNAP participation shall not alter the exclusion once an initial
-determination has been made. New applicants who are not receiving PA or SNAP at the
-time they joined VISTA shall have these volunteer payments included as earned income.
-
-4.
-
-P.L. No. 101-610, Section 17(d), 11/16/90, National and Community Service Act (NCSA)
-of 1990, as amended, provides that Section 142(b) of the Job Training Partnership Act
-(JTPA) applies to projects conducted under Title I of the NCSA as if such projects were
-conducted under the JTPA. Title I includes three Acts:
-a.
-
-Serve-America: the Community Service, Schools and Service-Learning Act of
-1990, as amended.
-
-b.
-
-American Conservation and Youth Service Corps Act of 1990, as amended.
-
-c.
-
-NCSA, as amended.
-
-There are approximately forty-seven (47) different NCSA programs and they vary by
-state. Most of the payments are made as a weekly stipend or for educational assistance.
-The Higher Education Service-Learning program and the AmeriCorps umbrella program
-come under this title. The National Civilian Community Corps (NCCC) is a federally
-managed AmeriCorps program. The Summer for Safety program is an AmeriCorps
-program under which participants earn a stipend and a one thousand dollar ($1,000)
-post-service educational award. The National and Community Service Trust Act of 1993
-(P.L. No. 103-82) amended the NCSA but did not change the exclusion.
-P.L. No. 93-288, Section 312(d), the Disaster Relief Act of 1974, as amended by P.L. No.
-100-707, Section 105(i), the Disaster Relief and Emergency Assistance Amendments of
-1988. Payments precipitated by an emergency or major disaster as defined in this Act, as
-amended, are not counted as income for SNAP purposes. This exclusion applies to
-Federal assistance provided to persons directly affected and to comparable disaster
-assistance provided by states, local governments, and disaster assistance organizations.
-
-99
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-A major disaster is any natural catastrophe such as a hurricane or drought, or, regardless
-of cause, any fire, flood, or explosion, which the President determines causes damage of
-sufficient severity and magnitude to warrant major disaster assistance to supplement the
-efforts and available resources of states, local governments, and disaster relief
-organizations in alleviating the damage, loss, hardship, or suffering caused thereby.
-An emergency is any occasion or instance for which the President determines that
-Federal assistance is needed to supplant state and local efforts and capabilities to save
-lives and to protect property and public health and safety, or to lessen or avert the threat
-of a catastrophe.
-Payments made to homeless people with funds from Federal Emergency Management
-Assistance (FEMA) to pay for rent, mortgage, food, and utility assistance when there is
-no major disaster or emergency are not excluded under this provision.
-6.
-
-Payments, allowances and earnings under the Workforce Innovation and Opportunity Act
-(WIOA) are excluded as income. Earnings paid for on-the-job training are still counted for
-SNAP. On-the-job training payments for members under nineteen (19) years of age who
-are participating in WIOA Programs and are under the parental control of an adult
-member of the household shall be excluded as income. The exclusion shall apply
-regardless of school attendance and/or enrollment as outlined in Section 4.405, C. Onthe-job training payments under the Summer Youth Employment and Training Program
-are excluded from income.
-
-7.
-
-P.L. No. 99-425, Section(e), the Low-Income Home Energy Assistance Act, 1986.
-Payments or allowances made under any federal laws for the purpose of energy
-assistance. P.L. No. 104-193 states that any payment or allowances made for the
-purpose of providing energy assistance under a federal law other than Part A of Title IV
-of the Social Security Act (42 U.S.C. 601 through 42 U.S.C. 619), or a one-time payment,
-or allowance made under federal or state law for the cost of weatherization, or
-emergency repair or replacement of an unsafe or inoperative furnace or other heating or
-cooling device is excluded from income.
-
-8.
-
-Payments received from the Youth Incentive Entitlement Pilot Projects, the Youth
-Community Conservation and Improvement Projects, and under the Title IV of the
-Comprehensive Employment and Training Act Amendments of 1978 (P.L. No. 95-524).
-
-9.
-
-P.L. No. 100-175, Section 166, Older Americans Act. Funds received by persons fiftyfive (55) years of age and older under the Senior Community Service Employment
-Program under Title V of the Older Americans Act are excluded from income. State
-agencies and eight organizations receive funding under Title V. The eight organizations
-are: Green Thumb, National Council on Aging, National Council of Senior Citizens,
-American Association of Retired Persons, U.S. Forest Service, National Association for
-Spanish Speaking Elderly, National Urban League, National Council on Black Aging.
-
-10.
-
-Payments in cash donations, based upon need, from one or more private, nonprofit
-charitable organizations, but not exceeding three hundred dollars ($300) in the
-aggregate, per fiscal quarter (P.L. No. 100-232).
-
-11.
-
-The portion of a military retirement payment, which goes to an ex-spouse under a divorce
-decree property settlement, is not counted as income to the retiree. (P.L. No. 97-252,
-Uniform Service Former Spouse Protection Act.) These payments are excluded as
-vendor payments.
-
-100
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-12.
-
-Military combat payments received by a member of the United States Armed Forces
-deployed to a designated combat zone shall be excluded from the household income for
-the duration of the member’s deployment as long as the additional payment was not
-received immediately prior to serving in a combat zone.
-
-13.
-
-Mandatory deductions from military pay for education purposes while the individual is
-enlisted. (P.L. No. 99-576, Veterans' Benefits Improvement and Health-Care
-Authorization Act of 1986, Section 303(a) (1)). Section 216 of P.L. No. 99-576 authorizes
-stipends for participation in study of Vietnam-Era veterans' psychological problems which
-are not excluded from income.
-
-14.
-
-Payments to U.S. citizens of Japanese ancestry and resident Japanese non-citizens of
-up to twenty thousand dollars ($20,000) each and payments to certain eligible Aleuts of
-up to twelve thousand dollars ($12,000) each (P.L. No. 100-383, Civil Liberties Act of
-1988).
-
-15.
-
-Emergency assistance payments made by a state or local agency for migrants or
-seasonal farm-workers in the job stream (P.L. No. 100-387).
-
-16.
-
-Benefits received from the special supplemental food program for women, infants and
-children (WIC), including benefits that can be exchanged for food at farmers' markets or
-part of a WIC demonstration project (P.L. No. 92-443). This payment is excluded as an
-in-kind benefit (P.L. No. 100-435, Section 501, amended, Child Nutrition Act).
-
-17.
-
-P.L. No. 100-485, Section 301, the Family Support Act, 10/31/88 which amended Section
-402(g)(1)(E) of the Social Security Act. The value of any child-care payments made
-under Title IV-A of the Social Security Act, including transitional child-care payments, are
-excluded from income.
-
-18.
-
-Payments made from the Agent Orange Settlement Fund (P.L. No. 101-201). All
-payments from the Agent Orange Settlement fund or any other fund established pursuant
-to the settlement in the Agent Orange product liability litigation are excluded from income
-retroactive to January 1, 1989.
-The veteran with disabilities will receive yearly payments. Survivors of deceased veterans
-with disabilities will receive a lump-sum payment. These payments were disbursed by the
-AETNA insurance company.
-P.L. No. 102-4, Agent Orange Act of 1991, 2/6/91, authorized veterans' benefits to some
-veterans with service-connected disabilities resulting from exposure to Agent Orange.
-These VA payments are not excluded by law.
-
-19.
-
-P.L. No. 101-508, Section 5801, which amended Section 402(i) of the Social Security
-Act, 11/5/90. At-risk block grant child care payments made under section 5801 are
-excluded from being counted as income for SNAP purposes and no deduction may be
-allowed for any expense covered by such payments.
-
-20.
-
-P.L. No. 101-508, the Omnibus Budget Reconciliation Act of 1990, Title XI Revenue
-Provisions, Section 11111, Modifications of Earned Income Tax Credit, subsection (b)
-provides that any earned income tax credit shall not be treated as income. This provision
-is effective with taxable years beginning after December 31, 1990.
-
-101
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-21.
-
-Any payment made to an Employment First participant for costs that are reasonably
-necessary and directly related to participation in the Employment First Program. These
-costs include, but are not limited to, dependent care costs, transportation, other expenses
-related to work, training or education, such as uniforms, personal safety items, or other
-necessary equipment, and books or training manuals. These costs shall not include the
-cost of meals away from home. Also, the value of any dependent care services provided
-for or arranged by the Employment First Unit is excluded.
-
-22.
-
-Amounts necessary for the fulfillment of a Plan for Achieving Self-Support (PASS) under
-Title XVI of the Social Security Act (P.L. No. 102-237). This money may be spent in
-accordance with an approved PASS or deposited into a PASS savings account for future
-use.
-
-23.
-
-Any money received from the Radiation Exposure Compensation Trust Fund pursuant to
-P.L. No. 101-426 as amended by P.L. No. 101-510.
-
-24.
-
-P.L. No. 102-586, Section 8, amended the Child Care and Development Block Grant Act
-Amendments of 1992 by adding a new Section 658S to exclude the value of any childcare provided or arranged, or any amount received as payment for such care or
-reimbursement for costs incurred for such care from income for purposes of any other
-federal or federally assisted program that bases eligibility, or the amount of benefits, on
-need.
-
-25.
-
-P.L. No. 101-625, Section 22(i), Cranston-Gonzales National Affordable Housing Act, (42
-U.S.C.S. 1437t(i)), provides that no service provided to a public housing resident under
-this section (Family Investment Centers) may be treated as income for purposes of any
-other program or provision of state or federal law.
-This exclusion applies to services such as child-care employment training and
-counseling, literacy training, computer skills training, assistance in the attainment of
-certificates of high school equivalency, and other services. The exclusion does not apply
-to wages or stipends.
-P.L. No. 101-625, Section 522(i)(4), excludes most increases in the earned income of a
-family residing in certain housing while participating in HUD demonstration projects
-authorized by P.L. No. 101-625. Demonstration projects are authorized by P.L. No. 101625 for Chicago, Illinois, and three other locations. The affected offices will be contacted
-individually regarding these projects.
-
-26.
-
-P.L. No. 103-286, Section 1(a), Section 1(a), provides in part that payments made to
-individuals because of their status as victims of Nazi persecution shall be disregarded in
-determining eligibility for and the amount of benefits or services to be provided under any
-federal or federally assisted program which provides benefits or services based, in whole
-or in part, on need.
-
-27.
-
-Amendments to Section 1403 of the Crime Act of 1984 (42 U.S.C. 10602) provides in
-part that, notwithstanding any other law, if the compensation paid by an eligible crime
-victim compensation program would cover costs that a federal program or a federally
-financed state or local program would otherwise pay:
-a.
-
-Such crime victim compensation program shall not pay that compensation.
-
-b.
-
-The other program shall make its payments without regard to the existence of the
-crime victim compensation program.
-
-102
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Based on this language, payments received under this Program must be
-excluded from income for SNAP purposes.
-28.
-B.
-
-P.L. No. 104-204, requires that allowances paid under this law to children of Vietnam
-veterans who were born with spina bifida be excluded from income.
-
-American Indian or Alaska Native
-Usually a law will specify payments to members of a tribe or band, and the law will apply to the
-members enrolled in the tribe or band wherever they live. The individuals should have
-documentation showing where the payments originate.
-1.
-
-P.L. No. 92-203, section 29, dated 1/2/76, the Alaska Native Claims Settlement Act, and
-Section 15 of P.L. No. 100-241, 2/3/88, the Alaska Native Claims Settlement Act
-Amendments of 1987 - All compensation, including cash, stock, partnership interest,
-land, interest in land, and other benefits, received under this Act are excluded.
-
-2.
-
-P.L. No. 93-134, the Judgment Award Authorization Act, as amended by P.L. No. No. 97458, Section 1407, 11/12/83 and P.L. No. 98-64, 8/2/83, the Per Capita Distribution Act.
-P.L. No. 97-458 required the exclusion of per capita Payments under the Indian
-Judgment Fund Act (judgment awards) of two thousand dollars ($2,000) or less from
-income. The exclusion applies to each payment made to each individual. P.L. No. 98-64
-extended the exclusion to cover per capita payments from funds which are held in trust
-by the Secretary of Interior (trust fund distributions).
-P.L. No. 93-134, the Indian Tribal Judgment Fund Use or Distribution Act, Section 8,
-10/19/73, as amended by P.L. No. 103-66, Section 13736, 10/7/93, provides that interest
-of individual Indians in trust or restricted lands up to two thousand dollars ($2,000) per
-year received by individual Indians that is derived from such interests shall not be
-considered income in determining eligibility for assistance under the Social Security Act
-or any other federal or federally assisted program. The two thousand dollar ($2,000) limit
-is based on calendar years from January through December.
-
-3.
-
-P.L. No. 93-531, section 22 - Relocation assistance payments to members of the Navajo
-and Hopi Tribes are excluded from income and resources.
-
-4.
-
-P.L. No. 94-114, section 6, 10/17/75 - Income derived from certain sub-marginal land
-held in trust for certain Indian tribes is excluded from income. The tribes that shall benefit
-are:
-a.
-
-Bad River Band of the Lake Superior Tribe of Chippewa
-
-b.
-
-Indians of Wisconsin
-
-c.
-
-Blackfeet Tribe
-
-d.
-
-Cherokee Nation of Oklahoma
-
-e.
-
-Cheyenne River Sioux Tribe
-
-f.
-
-Crow Creek Sioux Tribe
-
-g.
-
-Lower Brule Sioux Tribe
-
-h.
-
-Devils Lake Sioux Tribe
-
-103
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-i.
-
-Fort Belknap Indian Community
-
-j.
-
-Assiniboine and Sioux Tribes
-
-k.
-
-Lac Courte Oreilles Band of Lake Superior Chippewa Indians
-
-l.
-
-Keweenaw Bay Indian Community
-
-m.
-
-Minnesota Chippewa Tribe
-
-n.
-
-Navajo Tribe
-
-o.
-
-Oglala Sioux Tribe
-
-p.
-
-Rosebud Sioux Tribe
-
-q.
-
-Shoshone-Bannock Tribes
-
-r.
-
-Standing Rock Sioux Tribe
-
-5.
-
-P.L. No. 94-189, Section 6, 12/31/75 - Funds distributed per capita to the Sac and Fox
-Indians or held in trust are excluded from income. The funds are divided between
-members of the Sac and Fox Tribe of Oklahoma and the Sac and Fox Tribe of the
-Mississippi in Iowa. The judgments were awarded in Indian Claims Commission dockets
-numbered 219, 153, 135, 158, 231, 83, and 95.
-
-6.
-
-P.L. No. 94-540 - Payments from the disposition of funds to the Grand River Band of
-Ottawa Indians are excluded from income.
-
-7.
-
-P.L. No. 95-433, section 2 - Indian Claims Commission payments made pursuant to this
-Public Law to the Confederated Tribes and Bands of the Yakima Indian Nation and the
-Apache Tribe of the Mescalero Reservation are excluded from income.
-
-8.
-
-P.L. No. 96-420, section 9(c), 10/10/80, Maine Indian Claims Settlement Act of 1980 Payments made to the Passamaquoddy Tribe, the Penobscot Nation, and the Houlton
-Band of Maliseet are excluded from income.
-
-9.
-
-P.L. No. 97-403 - Payments to the Turtle Mountain Band of Chippewas, Arizona, are
-excluded from income.
-
-10.
-
-P.L. No. 97-408 - Payments to the Blackfeet, Grosventre, and Assiniboine tribes,
-Montana, and the Papago, Arizona, are excluded from income.
-
-11.
-
-P.L. No. 98-123, Section 3, 10/13/83 - Funds distributed to members of the Red Lake
-Band of Chippewa Indians are excluded from income. Funds were awarded in docket
-number 15-72 of the United States Court of Claims.
-
-12.
-
-P.L. No. 98-124, Section 5 - Per capita and interest payments made to members of the
-Assiniboine Tribe of the Fort Belknap Indian Community, Montana, and the Assiniboine
-Tribe of the Fort Peck Indian Reservation, Montana, under this Act are excluded from
-income. Funds were awarded in docket 10-81L.
-
-104
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-13.
-
-P.L. No. 98-500, Section 8, Old Age Assistance Claims Settlement Act, provides that
-funds made to heirs of deceased Indians under this Act shall not be considered as
-income nor otherwise used to reduce or deny SNAP benefits except for per capita shares
-more than two thousand dollars ($2,000). The first two thousand dollars ($2,000) of each
-payment is excluded.
-
-14.
-
-P.L. No. 99-146, Section 6(b), 11/11/85 - Funds distributed per capita or held in trust for
-members of the Chippewas of Lake Superior are excluded from income. Judgments were
-awarded in Dockets Numbered 18-S, 18-U, 18-C, and 18-T.
-a.
-
-b.
-
-Dockets 18-S and 18-U are divided among the following reservations:
-1)
-
-Wisconsin
-
-2)
-
-Bad River Reservation
-
-3)
-
-Lac du Flambeau Reservation
-
-4)
-
-Lac Courte Oreilles Reservation
-
-5)
-
-Sokaogon Chippewa Community
-
-6)
-
-Red Cliff Reservation
-
-7)
-
-St. Croix Reservation
-
-8)
-
-Michigan
-
-9)
-
-Keweenaw Bay Indian Community (L'Anse, Lac Vieux Desert, and
-Ontonagon Bands)
-
-10)
-
-Minnesota
-
-11)
-
-Fond du Lac Reservation
-
-12)
-
-Grand Portage Reservation
-
-13)
-
-Nett Lake Reservation (including Vermillion Lake and Deer Creek)
-
-14)
-
-White Earth Reservation
-
-Under dockets 18-C and 18-T funds are given to the Lac Courte Oreilles Band of
-the Lake Superior Bands of Chippewa Indians of the Lac Courte Oreilles
-Reservation of Wisconsin, the Bad River Band of the Lake Superior Tribe of
-Chippewa Indians of the Bad River Reservation, the Sokaogon Chippewa
-Community of the Mole Lake Band of Chippewa Indians, and the St. Croix
-Chippewa Indians of Wisconsin.
-
-15.
-
-P.L. No. 99-264, White Earth Reservation Land Settlement Act of 1985, 3/24/86, Section
-16 excludes moneys paid from income. This exclusion involves members of the White
-Earth Band of Chippewa Indians in Minnesota.
-
-16.
-
-P.L. No. 99-346, Section 6(b) (2) - Payments to the Saginaw Chippewa Indian Tribe of
-Michigan are excluded from income.
-
-105
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-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-4.406
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-17.
-
-P.L. No. 99-377, Section 4(b), 8/8/86, - Funds distributed per capita to the Chippewas of
-the Mississippi or held in trust under this Act are excluded from income. The judgments
-were awarded in Docket Number 18-S. The funds are divided by reservation affiliation for
-the Mille Lac Reservation, Minnesota; White Earth Reservation, Minnesota; and Leech
-Lake Reservation, Minnesota.
-
-18.
-
-P.L. No. 101-41, 6/21/89, the Puyallup Tribe of Indians Settlement Act of 1989, Section
-10 (b) provides that nothing in this Act shall affect the eligibility of the Tribe or any of its
-members for any Federal program. Section 10(c) provides that none of the funds, assets,
-or income from the trust fund established in section 6(b) shall at any time be used as a
-basis for denying or reducing funds to the tribe or its members under any Federal, State,
-or local program. (The Puyallup Tribe is located in the State of Washington.)
-
-19.
-
-P.L. No. 101-277, 4/30/90, funds appropriated in satisfaction of judgments awarded to the
-Seminole Indians in dockets 73, 151, and 73-A of the Indian Claims Commission are
-excluded from income except for per capita payments in excess of two thousand dollars
-($2,000). Payments were allocated to the Seminole Nation of Oklahoma, the Seminole
-Tribe of Florida, the Miccosukee Tribe of Indians of Florida, and the independent
-Seminole Indians of Florida.
-
-20.
-
-P.L. No. 101-503, Section 8(b), Seneca Nation Settlement Act of 1990, dated November
-3, 1990, provides that none of the payments, funds, or distributions authorized,
-established, or directed by this Act, and none of the income derived therefrom shall affect
-the eligibility of the Seneca Nation or its members for, or be used as a basis for denying
-or reducing funds under, any federal program.
-
-21.
-
-P.L. No. 103-436, 11/2/94, Confederated Tribes of the Colville Reservation Grand Coulee
-Dam Settlement Act, Section 7(b) provides that payments made pursuant to the Act are
-totally excluded from income.
-
-HOUSEHOLDS DESTITUTE OF INCOME
-
-Migrant or seasonal farm worker households may be considered destitute of income upon initial
-certification or recertification, but only for the first month of each certification period.
-A.
-
-Migrant or seasonal farm worker households may have little or no income at the time of
-application even though they receive income at some time during the month of application. Such
-households will be considered destitute and thereby entitled to expedited application processing if
-their only income is from a terminated and/or new source under the following circumstances:
-1.
-
-The household's only income for the month of application was received from a terminated
-source prior to the date of application.
-a.
-
-Income is considered to be from a terminated source if it is normally received on
-a monthly or more frequent basis and is not expected to be received again from
-the same source during either the remainder of the month of application or the
-month following (i.e., migrant work ended with one grower).
-
-b.
-
-Income that is normally received less often than monthly is considered to be from
-a terminated source if it is not anticipated to be received during the month in
-which it would normally be received (i.e., quarterly income not received in the
-normal third month).
-
-106
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-2.
-
-3.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-The household's only income for the month of application is more than twenty-five dollars
-($25) from a new source and it will not be received by the tenth (10th) calendar day after
-the filing date of an application for initial certification, or by the tenth calendar day after
-the household's normal issuance cycle if the application is for recertification.
-a.
-
-Income is considered to be from a new source if the income of more than twentyfive dollars ($25) is normally received on a monthly or more frequent basis but
-has not been received from that source within thirty (30) calendar days prior to
-the filing date of application.
-
-b.
-
-Income is considered to be from a new source if the income of more than twentyfive dollars ($25) is normally received less often than monthly but was not
-received within the last normal interval between payments.
-
-The household's only income is a combination of that received from a terminated source
-prior to date of application and income of more than twenty-five dollars ($25) received in
-the month of application from a new source, which will not be received by the tenth (10th)
-calendar day after the date of initial application, or by the tenth (10th) calendar day after
-the household's normal issuance cycle if application is for recertification.
-
-B.
-
-A migrant farm worker's source of income shall be considered to be the particular grower, and not
-the crew chief. A migrant who moves from one grower to another shall be considered to have
-moved from a terminated source to a new source.
-
-C.
-
-There is no limit on the number of times a household can be considered destitute of income
-provided that before each subsequent expedited certification, the household either has completed
-the verification requirements that were postponed at the last expedited certification or the
-household was certified under normal processing standards since the last expedited certification.
-
-4.406.1 Income Calculation When Destitute of Income
-A.
-
-Destitute households shall have their eligibility and level of benefits calculated for the month of
-application by considering only that income received between the first of the month and the date
-of application. It if is an initial month application, the first application or an application received
-after the household's last certification period expired, the allotment for the initial month shall be
-prorated to cover days from date of application to the end of the month.
-
-B.
-
-If income of more than twenty-five dollars ($25) from a new source has not been received or is
-not anticipated within ten (10) calendar days from the date of initial application or within ten (10)
-calendar days after the household's normal issuance cycle if applying for recertification, it shall be
-disregarded.
-
-C.
-
-Travel advances provided by an employer to reimburse travel costs of relocation of a new
-employee is exempt income and does not affect the destitute status of a household. If the travel
-advance is, by written contract, an advance of wages that will be subtracted from wages later
-earned by the employee, the money is considered as income but shall not affect the
-determination of whether subsequent payments from the employer are from a new source of
-income nor whether the household shall be considered destitute.
-
-4.407
-
-DEDUCTIONS AND EXCLUSIONS FROM INCOME
-
-A.
-
-Allowable deductions are subtracted from total monthly gross income to determine the
-household's monthly net SNAP income.
-
-107
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Allowable expenses will not be deductible if covered by vendor payments such as HUD, or
-reimbursements, such as insurance. An expense which is covered by an excluded vendor
-payment that has been converted to a direct cash payment under a federally authorized
-demonstration project shall not be deductible.
-B.
-
-Households may elect to have fluctuating monthly expenses averaged over the certification
-period. Also, households have the option of having expenses that are billed less often than
-monthly averaged over the period the expense is intended to cover. Households may elect to
-have medical expenses averaged as described in Sections 4.407.6 and 4.407.61. Expenses that
-have been averaged are subject to the reporting requirements contained in Section 4.603.
-
-C.
-
-Actual or averaged expenses that result in deductions for medical, dependent care, and shelter
-costs shall be anticipated. Households who expect changes cannot have their expenses
-averaged solely on the basis of the last several bills. Expenses that are billed on a weekly or
-biweekly basis shall be converted to a monthly figure utilizing the conversion outlined in Section
-4.402.
-
-D.
-
-Legally obligated child support is considered an income exclusion.
-
-E.
-
-The following subsections contain the only deductions allowed from a household's monthly
-income. The deductions are as follows:
-1.
-
-Standard deduction
-
-2.
-
-Earned income deduction
-
-3.
-
-Excess shelter deduction
-
-4.
-
-Dependent care deduction
-
-5.
-
-Excess medical deduction
-
-4.407.1 Standard Deduction
-A standard deduction of 8.31% of the federal poverty income guidelines for the household size as
-described in Section 4.401.2 will be used to calculate the amount that is allowed to all households. The
-established standard amount will be adjusted annually as announced by FNS, USDA. The calculation of
-8.31% of the federal poverty income guidelines for eligible members will be used for all households up to
-the household size of six (6). All households with six (6) or more eligible members will use the six (6)
-person standard deduction.
-Standard Deduction Amount
-Household Size
-1-3
-4
-Effective October 1, 2024
-$204
-$217
-
-5
-$254
-
-6+
-$291
-
-4.407.2 Earned Income Deduction
-A.
-
-A household with earned income shall receive a deduction of twenty percent (20%) of its gross
-nonexempt earned income. The twenty percent (20%) deduction shall also apply to prorated
-income earned by the disqualified member and attributed to the household.
-
-B.
-
-The earned income deduction will not be applied to any portion of income earned under a work
-supplementation or work support program that is attributable to a federal, state, or local public
-assistance program.
-
-108
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-An Inadvertent Household Error (IHE) claim that is due to earned income being reported in an
-untimely manner will be calculated without allowing the twenty percent (20%) earned income
-deduction
-4.407.3 Excess Shelter Deduction
-A.
-
-Households shall receive a deduction for the allowable monthly shelter costs that are in excess of
-fifty percent (50%) of the household's income after all other deductions. Shelter expenses are
-allowed as billed to a household member or as paid or billed to a disqualified individual. Shelter
-costs that are paid by or billed to a person disqualified for fraud shall be allowed as a deduction
-for eligible members in their entirety. Shelter costs, paid or billed to a person disqualified for being
-an ineligible non-citizen or for failure to provide a Social Security Number shall be divided evenly
-among all household members and the disqualified individual. All except the disqualified person's
-pro rata share is counted as a shelter cost of the household.
-
-B.
-
-A shelter deduction cap, as specified below, applies to households that do not contain a person
-who is aged sixty (60) and older or a person with a disability as defined in Section 4.000.1. Those
-households containing a person who is aged sixty (60) and older and/or a person with a disability
-shall receive an excess shelter deduction for the monthly cost of shelter that exceeds fifty percent
-(50%) of the household's monthly income after all other applicable deductions.
-Shelter Deduction Cap
-Effective October 1, 2024
-
-C.
-
-$712
-
-Households in which all individuals are experiencing homelessness and are not receiving free
-shelter throughout the calendar month shall be entitled to use a standard estimate of shelter
-expenses.
-The FNS, USDA, provides an update of this estimated figure annually when the shelter cap for
-other households is adjusted. The Homeless Shelter Deduction is as follows:
-Homeless Shelter Deduction
-Effective October 1, 2024
-$190.30
-All households experiencing homelessness that incur, or reasonably expect to incur, shelter costs
-during a month shall be eligible for the estimate, unless higher shelter costs are verified, at which
-point the household may use actual shelter costs rather than the estimate.
-Households experiencing homelessness that incur no shelter costs during the month shall not be
-eligible for the homeless shelter deduction.
-If a household experiencing homelessness has difficulty in obtaining traditional types of
-verification of shelter costs, the eligibility technician shall use the prudent person principle in
-determining if verification obtained is adequate.
-
-D.
-
-A household may claim both the costs of its actual residence and those for a home that is not
-occupied by the household because of: employment or training away from home; illness; or
-abandonment caused by a natural disaster or casualty loss.
-For costs of a home vacated by the household to be included in the household's shelter costs, the
-household must intend to return to the home; the current occupants of the home, if any, must not
-be claiming the shelter costs for SNAP purposes; and the home must not be leased or rented
-during the absence of the household.
-
-109
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-E.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Allowable shelter costs shall include only the following:
-1.
-
-Continuing charges for the shelter, including rent, mortgages, condo, and association
-fees or other continuing charges leading to the ownership of the shelter such as loan
-repayments for the purchase of a mobile home, including interest on such payments.
-a.
-
-If a homeowner has drawn money down in a reverse mortgage and now wants to
-make monthly payments to repay some of the amount drawn, the repayment
-shall be considered a charge leading to the ownership of a home, such as a loan
-repayment. To be deductible, the charge must be continuing. If the household
-expects to make monthly payments, the client’s charges are considered to be
-continuing, and the repayments shall be allowed as a shelter cost. If the
-repayment is not continuing, it does not meet the requirement and the payments
-shall not be allowed as a shelter deduction.
-
-b.
-
-Payments on loans secured by a lien placed on the property by the lending
-institution, such as a second mortgage or home equity loan, shall be considered
-a continuing charge for shelter. Payments on unsecured loans or personal loans
-are not considered shelter costs.
-
-c.
-
-Expenses incurred to keep a pet that are billed separately from the household’s
-rent are not allowable as shelter deductions.
-
-2.
-
-Property taxes, state and local assessments, and insurance on the structure itself, but not
-separate costs for insuring furniture or personal belongings.
-
-3.
-
-Charges to repair or rebuild a home substantially damaged or destroyed due to a natural
-disaster such as a fire or flood. Allowable expenses are those that have not been, and
-will not be, reimbursed by private or public relief agencies, insurance companies, or any
-other source.
-
-4.
-
-Utility costs which include charges for heating and cooking fuel; water and sewer; well
-installation and maintenance; septic tank installation and maintenance; garbage and
-trash collection fees; and, fees charged by the utility provider for initial installation of the
-utility.
-
-5.
-
-A telephone allowance for one telephone or the cost of telephone service that is
-associated with a specific device, which includes land-line service or cellular service,
-including disposable cell phones, and voice over internet protocol (VOIP). Households
-are not allowed to deduct the cost of pay phones and of phone cards that are not
-associated with a specific device. One-time deposits shall not be included as shelter
-costs. With regard to VOIP, only the cost of VOIP is deductible; other charges such as
-Internet connectivity fees and monthly cable/internet fees are not deductible.
-
-4.407.31
-
-Four-Tiered Mandatory Standard Utility Allowance
-
-Effective October 1, 2008, a four-tiered mandatory standard utility allowance deduction was implemented
-in determining a household’s excess shelter deduction. Households cannot claim actual utility expenses
-and are only entitled to one (1) of the four (4) utility allowances. The four (4) utility allowances shall be
-reviewed annually and adjusted each year, based on federal approval, to reflect Colorado's cost of
-utilities. No utility expenses can be allowed as an income exclusion for self-employed households when a
-mandatory utility allowance is given to the household.
-When determining expedited eligibility, the appropriate utility allowance shall be applied when
-establishing the household’s shelter costs.
-
-110
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-The four (4) allowances are as follows:
-A.
-
-Heating and Cooling Utility Allowance (HCUA)
-1.
-
-“Cooling costs” are defined as utility costs relating to the operation of air conditioning
-systems, room air conditioners, swamp coolers, or evaporative coolers. Fans are not an
-allowable cooling cost. A heating and cooling utility allowance (HCUA) is available only to
-households which:
-a.
-
-Incur or anticipate heating or cooling costs separate and apart from their rent or
-mortgage;
-
-b.
-
-Received a Low-Income Energy Assistance Program (LEAP) or an Energy
-Electronic Benefit Transfer (E-EBT) payment within the previous twelve (12)
-month period, regardless of whether the individual is still residing at the address
-for which they received the LEAP or E-EBT payment;
-
-c.
-
-Live in private rental housing and are billed by their landlords on the basis of
-individual usage or charged a flat rate separately from their rent for heating and
-cooling;
-
-d.
-
-Share a residence and incur at least a portion of the heating or cooling cost, in
-which case each household will be entitled to the full HCUA; or,
-
-e.
-
-Live in public housing and are responsible for excess heating and/or cooling
-costs.
-
-2.
-
-A SNAP household, which incurs or anticipates heating or cooling costs on an irregular
-basis, may continue to receive the HCUA between billing periods.
-
-3.
-
-Operation of a space heater, electric blanket, heat lamp, cooking stove and the like when
-used as a supplemental heating source are allowable costs when determining eligibility
-for the basic utility allowance (BUA), but do not qualify a household for the HCUA.
-
-4.
-
-The HCUA standard is as follows:
-HCUA Standard
-Effective October 1, 2024
-
-B.
-
-$578
-
-Basic Utility Allowance (BUA)
-1.
-
-The Basic Utility Allowance (BUA) is mandated for any households that are not entitled to
-the HCUA and that incur at least two (2) non-heating or non-cooling utility costs, such as
-electricity, water, sewer, trash, cooking fuel, or telephone.
-
-2.
-
-If more than one SNAP household shares in paying non-heating or non-cooling utility
-costs of the dwelling, the full BUA will be allowed for each assistance group sharing in the
-utility costs.
-
-3.
-
-The BUA standard is as follows:
-BUA Standard
-Effective October 1, 2024
-
-$367
-
-111
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-C.
-
-One Utility Allowance (OUA)
-1.
-
-The OUA is mandated for any household that is not entitled to the HCUA or BUA but is
-responsible for only one (1) non-heating or one (1) non-cooling utility expense. The OUA
-is not allowed if the household’s only utility expense is a telephone.
-
-2.
-
-If more than one (1) SNAP household shares in paying one (1) non-heating or one (1)
-non-cooling utility cost of the dwelling, the full OUA will be allowed for each assistance
-group sharing in the utility cost.
-
-3.
-
-The OUA standard is as follows:
-OUA Standard
-Effective October 1, 2024
-
-D.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-$69
-
-Telephone allowance
-1.
-
-The telephone allowance is available to households whose only utility cost is for a
-telephone. If more than one SNAP household shares in paying the telephone costs and
-that is the only utility costs of the dwelling, the full phone standard will be allowed for
-each assistance group sharing in the telephone costs.
-
-2.
-
-The telephone allowance is as follows:
-Telephone Standard
-Effective October 1, 2024
-
-$94
-
-4.407.4 Dependent Care Deduction
-Refer to Section 4.407.6 if the attendant care is for a household member who is age sixty (60) or older or
-who receives SSI or Social Security disability payments. The attendant costs, including meals provided,
-shall be considered as a medical expense.
-A.
-
-Dependent care expenses, as billed to a household member or as paid by or billed to a person
-disqualified for being an ineligible non-citizen or failure to provide or apply for a SSN, for the care
-of a child or dependent with disabilities shall be considered when the dependent care expenses
-are necessary for a household member to accept or continue employment, seek employment, or
-attend training or pursue education which is preparatory to employment. Dependent care
-expenses that are paid by or billed to the disqualified person shall be divided equally among all
-household members and the disqualified person. All except the disqualified member's pro rata
-share is considered for a deduction.
-The dependent care deduction that is paid by or billed to individuals disqualified for intentional
-Program violation/fraud will be allowed in its entirety.
-Allowable dependent care costs include:
-1.
-
-The cost of care given by an individual care provider or care facility;
-
-2.
-
-Transportation costs to and from the care facility. Mileage expenses must be calculated
-based on the prevailing Internal Revenue Service (IRS) business rate published annually
-at https://www.irs.gov/tax-professionals/standard-mileage-rates; and
-
-3.
-
-Activity or other fees associated with the care provided to the dependent that are
-necessary for the household to participate in the care.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-B.
-
-The total dollar amount that the household is responsible to pay for dependent care expenses is
-deductible.
-
-C.
-
-Only direct monetary payments to an agency or a person outside of the household will be
-allowable. The value of in-kind benefits paid to an attendant, such as meals, is not considered for
-a dependent care deduction.
-
-D.
-
-A child care expense which is reimbursed or paid for by the JOBS program under Title IV-F of the
-Social Security Act or the Transitional Child Care (TCC) program shall not be a deductible
-expense.
-
-4.407.5 Child Support Expense Exclusion
-A.
-
-A household shall receive an exclusion from income for legally binding child support payments
-made to or for non-household members. The child support exclusion will be made from the
-household's total countable gross income and prior to any gross income test to determine
-eligibility. The court-ordered amount and the most recent amounts that have been paid must be
-verified by the household. Legally obligated child support paid by a household member under the
-age of eighteen (18) shall be an allowable exclusion, even if the income of the child is considered
-exempt under Section 4.405, C.
-
-B.
-
-If the noncustodial parent makes child support payments to a third party non-household member
-(e.g., a landlord, utility company, or health insurance organization) in accordance with the support
-order, the payment shall be included in the child support exclusion.
-
-C.
-
-A deduction for amounts paid toward arrearage will be allowed. Alimony payments will not be
-allowed as an exclusion.
-
-D.
-
-Households with a history of three (3) or more months of paying child support shall have the
-support payments averaged taking into account any anticipated changes in the legal obligation
-and shall use that average as the household's support exclusion.
-
-E.
-
-For households with less than a three (3) month record, the local office shall estimate the
-anticipated payments and use that estimate as the household's support exclusion.
-
-F.
-
-If the household does not report and verify its monthly child support payment or a change in its
-legal obligation, the child support exclusion shall not be allowed.
-
-4.407.6 Excess Medical Deduction
-A household shall receive a deduction for total medical expenses more than thirty-five dollars ($35) per
-month, incurred by any household member(s) who is aged sixty (60) and older or a person with
-disabilities. Other household members who are not aged sixty (60) and older or a person with disabilities,
-including spouses and dependents, cannot claim costs of their medical treatment and services.
-A.
-
-The following medical costs, less the cost of reimbursements from another source, are allowable:
-1.
-
-Medical and dental care including psychotherapy and rehabilitation services provided by
-a licensed practitioner or other qualified health professional as defined in 12-200-101
-through 12-315-126, C.R.S.
-
-2.
-
-Hospitalization or outpatient treatment, nursing care, and nursing home care including
-payments by the household for an individual who was a household member immediately
-prior to entering a hospital or nursing home provided by a facility recognized by the
-Colorado Department of Public Health and Environment.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-3.
-
-Prescription drugs when prescribed by a licensed practitioner authorized under state law
-and other over-the-counter medication (including insulin) when approved by a licensed
-practitioner or other qualified health professional. Costs of medical supplies, sickroom
-equipment (including rental), or other prescribed equipment may also be allowable.
-
-4.
-
-Health and hospitalization insurance policy premiums, Medicare premiums, and any costsharing expenses incurred by medical recipients.
-
-5.
-
-Dentures, hearing aids, prosthetics, and eyeglasses prescribed by a physician skilled in
-eye disease or by an optometrist.
-
-6.
-
-Securing and maintaining a service animal, such as a seeing eye or hearing dog,
-including cost of food and veterinarian fees. The costs of caring for these animals may be
-deducted only when the animal has received special training to provide a service to the
-client.
-
-7.
-
-Reasonable transportation and lodging to obtain medical treatment or services. Mileage
-expenses shall be calculated based on the prevailing Internal Revenue Service (IRS)
-commercial mileage rate.
-
-8.
-
-Wages to an attendant, homemaker, home health aide, child-care services, or a
-housekeeper necessary due to age, infirmity, or illness. In addition, an amount equal to
-the maximum allotment for one (1) person is allowed if the household furnishes the
-majority of the attendant's meals. The allotment shall be the one in effect at the time of
-certification with an appropriate adjustment at the next certification.
-If attendant care costs qualify under both medical and dependent care deduction, the
-costs shall be allowed as a medical expense.
-In cases when the household claims a deduction for billed medical expenses and the
-household is unable to verify whether any reimbursement will be received, no medical
-expense deduction shall be allowed until the household either receives reimbursement
-for all or part of the expense or is able to verify that reimbursement will not be provided.
-When such reimbursement is received and/or verified, the non-reimbursed portion of the
-claimed medical expense is allowed.
-
-B.
-
-Non-allowable medical costs include, but are not limited to:
-1.
-
-Special diet expenses;
-
-2.
-
-Premiums for health and accident policies, such as those payable in lump sum
-settlements for death or dismemberment, or policies for income maintenance such as
-those that continue mortgage or loan payments while the beneficiary is a person with
-disabilities;
-
-3.
-
-Medical expenses that are reimbursable by insurance or other public or private sources;
-
-4.
-
-Medical marijuana;
-
-5.
-
-Vitamins and supplements unless prescribed by a physician; and
-
-6.
-
-Medical expenses carried forward from past billing periods unless one (1) of the following
-conditions is met:
-a.
-
-The amount is being carried forward pending reimbursement information; or,
-
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-
-4.407.61
-A.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-b.
-
-The household has arranged to make monthly installments on the past due bills.
-The past due amount must be due to missed payments under a previous
-repayment agreement with the medical provider, and the payment plan is now
-being renegotiated with the provider. The negotiation of a payment plan with a
-collection agency will not be accepted as a renegotiated payment plan; or,
-
-c.
-
-Households that become categorically eligible for SNAP by reason of becoming a
-pure SSI household shall be entitled to excess medical expenses for the period
-for which they are authorized to receive SSI or from the date of the SNAP
-application, whichever is later. Restored benefits shall be issued if appropriate;
-or,
-
-d.
-
-Medical expenses that occur after the application filing date and reported at the
-subsequent application for recertification or periodic report shall be considered if
-the medical expense has not previously been reported and allowed as a medical
-deduction. If at recertification the household provides previously unreported
-medical expenses that occurred prior to the last certification period that are past
-due, the local office shall review the medical expenses under provisions a
-through c of this subsection.
-
-Determining Monthly Medical Expenses
-
-A household that contains a member who is eligible for a medical expense deduction is eligible
-for a deduction using either the Standard Medical Expense Deduction (SMED) or using actual
-medical expenses. Beginning October 1, 2016, the SMED is one hundred sixty-five dollars
-($165).
-The SMED is used if the total verified medical expenses are greater than thirty-five dollars ($35)
-and less than or equal to the SMED. The household may claim actual expenses if the total
-verified expenses, after deducting the first thirty-five dollars ($35), exceed the SMED.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-At ...
-
-Then allow ...
-
-And verify ...
-
-Application, if the household has medical
-expenses greater than $35 and less than
-or equal to the SMED,
-Application, if the household has monthly
-medical expenses greater than the SMED
-after subtracting the first $35,
-
-The SMED,
-
-The household has medical expenses
-greater than $35.verification must be
-received to allow the SMED.
-
-Recertification, if:
-• The household already has actual
-medical expenses greater than $35
-and less than or equal to the SMED,
-and
-• There is no change, or there is a
-change in the amount but the monthly
-medical expense is still greater than
-$35 and is less than or equal to the
-SMED,
-
-The SMED,
-
-No verification is required unless the
-household’s declaration is
-questionable.
-
-Recertification, if the household does not
-already have the SMED allowed and the
-household states an eligible member has
-medical expenses greater than $35 and
-less than or equal to the SMED,
-
-The SMED,
-
-The household has medical expenses
-greater than $35. Verification must be
-received to allow the SMED.
-
-Recertification, if the household does not
-already have actual medical expenses
-budgeted and the household states an
-eligible member has medical expenses
-greater than the SMED after subtracting
-the first $35,
-
-Actual medical expenses,
-
-Recertification, if:
-• The household has actual medical
-expenses greater than the SMED
-already allowed, and
-• There is a change in the monthly
-amount of more than twenty-five
-dollars ($25),
-
-•
-
-The actual monthly medical
-expense(s). If the household chooses
-not to provide verification of expenses
-exceeding the SMED, then allow the
-SMED instead of actual expenses. The
-household must provide proof of
-expenses exceeding $35 to receive the
-SMED.
-
-B.
-
-Actual medical expenses,
-
-•
-
-The SMED if the new
-total is greater than
-$35 and less than or
-equal to the SMED, or
-Actual medical
-expenses if the new
-total exceeds the
-SMED after deducting
-the first $35
-
-The actual monthly medical
-expense(s). If the household chooses
-not to provide verification of expenses
-exceeding the SMED, then allow the
-SMED instead of actual expenses.
-Verification of expenses exceeding
-$35 must be received to allow the
-SMED.
-
-The change in medical expenses.
-
-Expenses incurred weekly or biweekly shall be converted to a monthly amount using exact dollars
-and cents and the conversion method outlined in Section 4.402, A. The excess over thirty-five
-dollars ($35) per month is allowed as a monthly deduction.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-At the time of application and recertification, the household may elect to have one-time-only costs
-deducted in one month as a lump sum or averaged over the certification period to obtain a
-monthly amount. If the household elects to average the expenses over the certification period, the
-thirty-five dollar ($35) deduction shall be taken for each month of the certification period.
-When a one-time-only medical expense is reported during a certification period, the amount may
-be deducted in a lump sum or averaged over the remainder of the certification period. Averaging
-would begin the month the change would be effective. If the household elects to average the
-expenses over the remainder of the certification period, the thirty-five dollar ($35) deduction shall
-be taken for each remaining month of the certification period.
-When averaging the medical expenses, the SMED is allowed for each month of the certification
-period, as long as the household’s allowable averaged monthly medical expense is greater than
-$35. If the expense recurs monthly or more often, and the medical expense exceeds $35 and is
-less than or equal to the SMED each month, the SMED is allowed for each month of the
-certification period. When allowable medical expenses for the household exceed the SMED after
-deducting the first $35, the actual medical expenses are budgeted. The following chart is used to
-determine when to allow the SMED or actual medical expenses.
-If the expense ...
-
-THEN ALLOW THE ...
-
-Recurs less often than monthly and the amount
-averaged for each month is less than or equal to
-$35,
-
-Actual amount of verified actual medical expense
-in the month billed, or use the SMED in the month
-billed if the medical expense is greater than $35
-and less than or equal to the SMED.
-
-Recurs less often than monthly and the amount
-averaged for each month is greater than $35 and
-less than or equal to the SMED each month,
-
-SMED for each month of the certification period.
-
-Recurs less often than monthly and the amount
-averaged for each month is greater than the
-SMED,
-
-Averaged amount of actual verified medical
-expenses for each month. Allow the SMED only if
-the household chooses to use the SMED or fails to
-provide enough verification to qualify for actual
-medical expenses.
-
-Occurs one time and the amount averaged over
-the certification period is less than or equal to
-$35 a month,
-
-Actual amount of verified medical expenses in the
-month billed, or use the SMED in the month billed if
-the medical expense is greater than $35 and is
-less than or equal to the SMED.
-
-Occurs one time and the amount averaged over
-the certification period is greater than $35 and
-less than or equal to the SMED each month,
-
-SMED for each month of the certification period.
-
-Occurs one time and the amount averaged over
-the certification period is greater than the SMED
-each month,
-
-Averaged amount of the actual medical expenses
-for each month. Allow the SMED only if the
-household chooses to use the SMED or fails to
-provide enough verification to qualify for actual
-medical expenses.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.408
-
-RESOURCE ELIGIBILITY STANDARDS
-
-A.
-
-The local office shall consider households eligible under either expanded or basic categorical
-eligibility exempt from the resource eligibility criteria of this section.
-
-B.
-
-Households that do not meet expanded or basic categorical eligibility criteria shall have their
-nonexempt resources, as anticipated to be available in the issuance month, used to determine
-household eligibility.
-The resources of a sponsor and spouse considered toward a non-citizen household shall be the
-sponsor's total resources less two thousand dollars ($2,000).
-
-C.
-
-The value of liquid resources, as declared by the household, shall be utilized in the determination
-of expedited eligibility for all applicant households.
-
-D.
-
-As a result of the Food, Conservation and Energy Act of 2008, adjustments to the SNAP resource
-limit will be subject to change annually according to the Consumer Price Index. There are
-currently two (2) resource limits:
-
-E.
-
-1.
-
-One established for households that do contain a member who is aged sixty (60) and
-older and/or a person with a disability; and,
-
-2.
-
-Another established for households that do not contain a member who is aged sixty (60)
-and older and/or a person with a disability.
-
-The resource limits are as follows:
-Effective October 1, 2024, the resource limit for households that include a member who is aged
-sixty (60) and older and/or a person with a disability is four thousand and five hundred dollars
-($4,500). The resource limit for households that do not include a member who is aged sixty (60)
-and older and/or a person with a disability is three thousand dollars ($3,000).
-
-4.408.1 Determining the Value of Resources
-The value of nonexempt household resources at the application filing date must be determined from
-applicant statements, documents, and/or from collateral contacts when household assessment is
-uncertain or questionable.
-A.
-
-Valuation of Liquid Resources
-The value of liquid resources is the current redemption rate less encumbrances.
-
-B.
-
-Valuation of Non-Liquid Resources
-Except for real property, non-exempt non-liquid resources shall have a fair market value as
-determined from the best source available (such as, but not limited to, blue book, local dealer, or
-equivalent verifiable Internet web site) less verified encumbrances. If warranted, the eligibility
-technician worker should adjust the market value for poor or unusable condition of the property
-before assigning a resource value. The eligibility technician worker shall annotate the case record
-to show source and computation used to determine resource value.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-The value of real property, such as buildings, land, or vacation property, unless exempt as
-income producing, may be obtained by using the actual value reported by a county assessor or, if
-not reported, the current assessed valuation, accomplished in accordance with state law, and
-dividing the value by the appropriate percentage rate of assessment for real property to derive fair
-market value and subtracting the amount the household currently owes on the property.
-4.408.2 Transfer of Resources
-At the time of application, households not eligible under expanded or basic categorical eligibility rules
-shall be asked to provide information regarding any resources which any household member, ineligible
-non-citizen, or disqualified person whose resources are being considered available to the household has
-transferred within the three (3) month period immediately preceding the date of application. Households
-that have transferred resources knowingly for the purpose of qualifying or attempting to qualify for SNAP
-benefits shall be disqualified from participation in the program for up to one (1) year from the date of
-discovery of the transfer. This disqualification period shall be applied if the resources are transferred
-knowingly in the three (3) month period prior to application, or if they are transferred knowingly after the
-household is determined eligible for benefits.
-A.
-
-B.
-
-Eligibility for the program shall not be affected by the following transfers:
-1.
-
-Resources that would not otherwise affect eligibility, such as resources consisting of
-excluded person property such as furniture, or of money that when added to other
-household resources, totaled less at the time of the transfer than the allowable resource
-limits.
-
-2.
-
-Resources that are sold or traded at, or near, fair market value.
-
-3.
-
-Resources that are transferred between members of the same household including
-ineligible non-citizens or disqualified individuals whose resources are being considered
-available to the household.
-
-4.
-
-Resources that are transferred for reasons other than qualifying or attempting to qualify
-for SNAP benefits, for example a parent placing funds into an educational trust fund.
-
-In the event the local office establishes that an applicant household knowingly transferred
-resources for the purpose of qualifying or attempting to qualify for SNAP, the household shall be
-sent a notice of denial explaining the reason for and length of disqualification. The period of
-disqualification shall begin in the month of application. If the household is participating at the time
-of the discovery of the transfer, a notice of adverse action explaining the reason for and the
-length of disqualification shall be sent. The period of disqualification shall be made effective with
-the first allotment to be issued after the notice of adverse action has expired unless the
-household has requested a fair hearing and continued benefits.
-The length of the disqualification period shall be based on the amount by which nonexempt
-transferred resources, when added to other countable resources, exceed the allowable resource
-limits.
-
-C.
-
-The following chart shall be used to determine the period of disqualification for transfer of
-resources.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Amount in Excess of the Resource Limit
-
-Period of Disqualification
-
-$1 to $249
-
-1 month
-
-$250 to $999
-
-3 months
-
-$1,000 to $2,999
-
-6 months
-
-$3,000 to $4,999
-
-9 months
-
-$5,000
-
-12 months
-
-4.409
-
-COUNTABLE RESOURCES
-
-A.
-
-Liquid Resources
-Liquid resources are assets such as cash on hand, money in checking or savings accounts,
-saving certificates stocks or bonds, or lump sum payments as specified in Section 4.405, F.
-
-B.
-
-Non-Liquid Resources
-A non-liquid resource is any tangible real property such as buildings, land, and vacation homes.
-The value of non-liquid resources, unless exempt under Section 4.410 or specified under Section
-4.408.1 shall be the equity value. The equity value is the fair market value minus the verified
-amount owed.
-
-C.
-
-Jointly Owned Resources
-Nonexempt liquid and non-liquid resources owned jointly by separate households shall be
-considered available in their entirety to each household, unless it can be demonstrated by the
-applicant household that it does not have access to such resources. If only a portion of the
-resource is accessible, that portion which is available to the household is considered as a
-resource. The resource shall be considered totally inaccessible to the household if the resource
-cannot practically be subdivided and the household's access to the value of the resource is
-dependent on the agreement of a joint owner who refuses to comply. For the purpose of this
-provision, ineligible non-citizens or disqualified individuals residing with the household shall be
-considered household members.
-
-D.
-
-Co-Mingled Resources
-Exempt monies that are kept in a separate account and that are not commingled in an account
-with non-excluded funds shall retain their resource exclusion for an unlimited period of time.
-Those excluded shall retain their exemption for six (6) months from the date they are
-commingled. After six (6) months from the date of commingling, all funds in the commingled
-account shall be counted as a resource.
-
-4.410
-
-EXEMPT RESOURCES
-
-In determining the resources for a household, the following shall be excluded from consideration.
-A.
-
-Vehicles
-All of a household's licensed and unlicensed automobiles, motorcycles and vehicles, including
-recreational vehicles and seasonal vehicles, shall be totally exempt as a resource.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-B.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Home and Property
-The home and surrounding property, which is not separate from the home by intervening property
-owned by others, will be an exempt resource. Public rights of way, such as roads that run through
-the surrounding property and separate it from the home, will not affect the exemption of the
-property. The home and surrounding property shall remain exempt when temporarily unoccupied
-for reasons of employment, training for future employment, illness, or not habitable as a result of
-casualty or natural disaster, if the household intends to return. The property owned or being
-purchased by households that currently do not own a home and on which the household intends
-to build or is building a permanent home shall be exempt.
-
-C.
-
-Prorated Income
-Monies that have been prorated and considered as income for eligibility purposes will be an
-exempt resource. Prorated student and self-employment income is exempt as a resource as long
-as a portion is still being counted as income.
-
-D.
-
-Household Goods, Personal Effects, and Retirement Accounts
-1.
-
-Household goods, personal effects, including one burial plot per household member, the
-cash value of life insurance policies, and livestock not excluded as income producing
-property are exempt resources.
-
-2.
-
-All retirement accounts with Federal tax preferred retirement status are exempt
-resources. The following retirement accounts are exempt:
-
-3.
-
-a.
-
-Pension or traditional defined benefit plan;
-
-b.
-
-401(K) plan and simple 401(K);
-
-c.
-
-501C(18);
-
-d.
-
-403(A) and 403(B) plans;
-
-e.
-
-408 plans including traditional individual retirement accounts (Roth IRA, SIMPLE
-IRA, and myRA), traditional Individual Retirement Annuities
-
-f.
-
-457 plan;
-
-g.
-
-Federal employee thrift savings plan;
-
-h.
-
-Keogh plan;
-
-i.
-
-529A funds including funds in a qualified ABLE program
-
-j.
-
-Simplified employer plan;
-
-k.
-
-Profit sharing plan; and,
-
-l.
-
-Cash balance plans.
-
-All tax deferred education accounts are exempt resources. The two types of tax deferred
-education savings accounts are:
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-4.
-
-E.
-
-F.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-a.
-
-Section 529 qualified tuition programs, which allow owners to prepay a student’s
-education expenses or to contribute to an account to pay those expenses.
-
-b.
-
-Coverdell education savings accounts and IRA type of account designed to pay a
-student’s education expense.
-
-One bona fide pre-purchased funeral agreement per household member, which may
-include one burial plot per household member, shall be excluded provided that the
-agreement does not exceed one thousand five hundred dollars ($1,500) in equity value;
-the equity value over one thousand five hundred dollars ($1,500) is counted as a
-resource. If a burial plot is included in the agreement, the burial plot portion will be
-exempted prior to determining the equity value of the funeral agreement.
-
-Income-Producing Property, Including Vehicles
-1.
-
-Any property that is producing an annual income consistent with its fair market value in
-the community, even if it is used only on a seasonal basis, shall be an exempt resource.
-Such property includes farmland and rental homes, or work- related equipment, such as
-the tools of a tradesman or the machinery of a farmer, and vehicles which are essential to
-the employment or self-employment of a household member such as semi-tractor/trailer,
-boat, motor home, utility trailer, or seasonal or recreation vehicles used for incomeproducing purposes. Such property also includes livestock.
-
-2.
-
-Installment contracts for the sale of land or buildings if the contract or agreement is
-producing income consistent with its fair market value shall be an exempt resource. The
-exclusion shall also apply to the value of the property sold under the installment contract
-or held as security in exchange for a purchase price consistent with the fair market value
-of that property retained by the seller.
-
-3.
-
-Income-producing vehicles such as, but not limited to, a taxi, tractor, fishing boat, a
-vehicle used for deliveries, motor home, snowmobile, or camper is an exempt resource if
-it annually produces income consistent with its fair market value, even if only used on a
-seasonal basis. The exemption will apply when the vehicle is not in use because of
-temporary unemployment. This exemption also applies to ineligible non-citizens or
-disqualified persons whose resources are being considered available to the household.
-
-4.
-
-Property essential to the self-employment of a household member engaged in farming
-(including land, machinery, equipment, and supplies) shall be excluded for one (1) year
-from the date the household member terminates his or her self-employment from farming.
-
-Inaccessible Resources
-1.
-
-Resources having a cash value which is not accessible to the household include, but are
-not limited to, irrevocable trust funds, property in probate, or property prohibited from sale
-by a creditor holding a lien, and real property which the household is making a good faith
-effort to sell at a reasonable price, and which has not been sold. In such cases, the local
-office shall establish that the property is for sale and that the household will accept a
-reasonable offer.
-
-2.
-
-Non-exempt, non-liquid resource, as defined in Section 4.408.1, B, that would have a net
-return of one thousand five hundred dollars ($1,500) or less if sold, shall be considered
-an inaccessible resource. The equity value shall be used to determine this amount. The
-equity value is fair market value less verified encumbrances (amount owed).
-
-122
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-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-3.
-
-G.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Any funds in a trust or transferred to a trust, and the income produced by that trust shall
-be considered inaccessible to the household if:
-a.
-
-The trust arrangement will not likely cease during the certification period, and no
-household member has the power to revoke the trust arrangement or change the
-name of the beneficiary during the certification period; or
-
-b.
-
-The trustee administering the funds is either a court, an institution, corporation, or
-organization which is not under the direction or leadership of any household
-member; or an individual appointed by the court who has court-imposed limitation
-placed on his/her use of funds which meet requirements of this section; or
-
-c.
-
-The trust investments made on behalf of the trust do not directly involve or assist
-any business or corporation under the control, direction, or influence of a
-household member; or
-
-d.
-
-The funds held in irrevocable trust are either established from household's own
-funds and are used solely to make investments on behalf of the trust or to pay
-educational or medical expenses of persons named by the household creating
-the trust; or established from non-household funds by a non-household member;
-or
-
-e.
-
-Monies which are withdrawn from trust and dividends that are or could be
-received by the household shall be considered as income.
-
-Resources with No Significant Return
-Resources that, as a practical matter, the household is unlikely to be able to sell for any
-significant return because the household's interest is relatively slight or because the cost of
-selling the household's interest would be relatively great and shall be considered inaccessible. A
-resource shall be so identified if its sale or other disposition is unlikely to produce any significant
-amount of funds for the support of the household. Verification of the value of a resource to be
-excluded shall not be required unless the eligibility worker determines that the information
-provided by the household is insufficient to permit a determination of the resource value or the
-technician believes that the information is questionable.
-This provision regarding no significant return does not apply to negotiable financial instruments
-(as defined in C.R.S section 4-3-104). A significant return or a significant amount of funds shall be
-any return/funds after estimated costs of sale or disposition and considering the ownership
-interest of the household. A significant return or a significant amount of funds is an amount that is
-estimated to be more than one thousand five hundred dollars ($1,500).
-
-H.
-
-Resources of Battered Women in Shelters
-Residents of shelters for battered women and children may not have been able to retain access
-to all the resources of their former household. Therefore, in cases where access to a resource,
-such as jointly held bank accounts requiring both signatures, vehicles, and property, is dependent
-upon the agreement of a person who still resides in the household where the woman was
-abused, the resource shall be considered inaccessible to the applicant.
-
-I.
-
-Resources Used by Household Members
-Where an exclusion applies because of use of a resource by or for a household member, the
-exclusion shall also apply when the resource is being used by or for an ineligible non-citizen or
-disqualified person whose resources are being counted as part of the household's resources.
-
-123
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-Supplemental Nutrition Assistance Program (SNAP)
-
-J.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Government Payments
-The following government payments are received for a specific purpose or services and shall be
-excluded as a resource for SNAP eligibility.
-1.
-
-P.L. No. 89-642. Section (11b) of the Child Nutrition Act of 1966 excludes the value of
-assistance to children under this Act from resources for SNAP purposes.
-
-2.
-
-Payments received from the youth incentive entitlement pilot projects, the youth
-community conservation and improvement projects, and the youth employment and
-training programs under Youth Employment and Demonstration Act of 1977 (P.L. No. 9593) and extended under Title IV of the Comprehensive Employment and Training
-Amendments of 1978 (P.L. No. 95-524). (Note: Does not include other payments under
-the Comprehensive Employment and Training Act (CETA) or payments under the Youth
-Adults Conservation Corps.)
-
-3.
-
-Any governmental payments which are designated for the restoration of a home
-damaged in a disaster, if the household is subject to a legal sanction if the funds are not
-used as intended: for example, payments made by the Department of Housing and Urban
-Development through the individual and family grant program or disaster loans or grants
-made by the Small Business Administration, Section 312(d) of Disaster Relief Act of
-1974.
-The Disaster Relief Act of 1974. P.L. No 93-288 as amended by P.L. No. 100-707,
-Section 105(i). the Disaster Relief and Emergency Assistance Amendments of 1988.
-Payments precipitated by an emergency or major disaster as defined in this Act, as
-amended, are not counted as income or resources for SNAP purposes. This exclusion
-applies to Federal assistance provided to persons directly affected and to comparable
-disaster assistance provided by states, local governments, and disaster assistance
-organizations.
-
-4.
-
-Reimbursements from the Uniform Relocation Assistance and Real Property Acquisition
-Policy Act of 1970 (P.L. No. 91-646. section 216).
-
-5.
-
-Benefits received from the special supplemental food program for women, infants and
-children (WIC) (P.L. No. 92-443). This payment is excluded as an in-kind benefit.
-
-6.
-
-Payments or allowances made under any federal laws for the purpose of energy
-assistance, other than Part A of Title IV of the Social Security Act (42 U.S.C. 601 through
-42 U.S.C. 619), or a one-time payment or allowance made under federal or state law for
-the cost of weatherization or emergency repair or replacement of an unsafe or
-inoperative furnace or other heating or cooling device is exempt as a resource.
-
-7.
-
-HUD rental refund payments made pursuant to settlement of a series of class action
-lawsuits such as Underwood v. Harris, originally brought in the District of Columbia
-Federal District Court, are excluded in the month received and the following month.
-
-8.
-
-Mandatory deductions from military pay for educational purposes while the participant is
-enlisted. (P.L. No. 99-576, Veterans' Benefits Improvement and Health-Care
-Authorization Act of 1986, Section 303(a) (1)) Section 216 of P.L. No. 99-576 authorizes
-stipends for participation in study of Vietnam-Era veterans’ psychological problems that
-are not excluded from income.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-9.
-
-Payments to U.S. citizens of Japanese ancestry and resident Japanese non-citizens for
-up to twenty thousand dollars ($20,000) each and payments to certain eligible Aleuts of
-up to twelve thousand dollars ($12,000) each. P.L. No. 100-383. Section 105(f)(2) Civil
-Liberties Act of 1988.
-
-10.
-
-P.L. No. 100-435, Section 501, amended Child Nutrition Act to allow under WIC
-demonstration projects, benefits that may be exchanged for food at farmers' markets.
-
-11.
-
-Payments made from the Agent Orange Settlement Fund (P.L. No. 101-201). All
-payments from the Agent Orange Settlement fund or any other fund established pursuant
-to the settlement in the Agent Orange product liability litigation are excluded from income
-retroactive to January 1, 1989. The veteran with disabilities will receive yearly payments.
-Survivors of deceased veterans with disabilities will receive a lump-sum payment. These
-payments were disbursed by the AETNA insurance company.
-
-12.
-
-A federal earned income tax credit received either as a lump sum or as payments under
-Section 3507 of the Internal Revenue code for the month of receipt and the following
-month for the individual and that individual's spouse (P.L. No. 101-508).
-A federal, state, or local Earned Income Tax Credit (EITC) would be exempted for twelve
-(12) months from receipt for any household member if the individual receiving the EITC
-was participating in SNAP when the EITC was received and participation continues for
-twelve (12) months. Temporary non-participation due to administrative reasons, such as
-a delayed recertification, shall not affect the twelfth (12th) month participation
-requirement (P.L. No. 103-66, Mickey Leland Childhood Hunger Relief Act of 1993).
-
-13.
-
-Any money received from the Radiation Exposure Compensation Trust Fund, pursuant to
-P.L. No. 101-426 as amended by P.L. No. 101-510.
-
-14.
-
-P.L. No. 103-286, Section 1(a) provides, in part, that payments made to individuals
-because of their status as victims of Nazi persecution shall be disregarded in determining
-eligibility for, and the amount of, benefits or services to be provided under any federal or
-federally assisted program which provides benefits or services based, in whole or in part,
-on need.
-
-15.
-
-Amendments to Section 1403 of the Crime Act of 1984 (42 U.S.C. 10602) provide in part
-that, notwithstanding any other law, if the compensation paid by an eligible crime victim
-compensation program would cover costs that a federal program or a federally financed
-state or local program would otherwise pay:
-a.
-
-Such crime victim compensation program shall not pay that compensation;
-
-b.
-
-The other program shall make its payments without regard to the existence of the
-crime victim compensation program.
-
-Based on this language, payments received under this program must be excluded from
-income for SNAP purposes.
-16.
-
-P.L. No. 104-204 requires that allowances paid under this law to children of Vietnam
-veterans who were born with spina bifida be excluded from resources.
-
-17.
-
-P.L. No. 111-312 and The American Taxpayer Relief Act of 2012 requires that Federal
-income tax refunds received beginning January 1, 2010 must be disregarded as a
-resource for twelve (12) months from the date of receipt by the client.
-
-125
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.411 TREATMENT OF INCOME AND RESOURCES OF DISQUALIFIED, SANCTIONED, AND NONHOUSEHOLD MEMBERS
-4.411.1 Treatment of Income and Resources of Disqualified and/or Sanctioned Members
-A.
-
-Individual household members may be disqualified for being ineligible non-citizens, for failure or
-refusal to obtain or provide a Social Security Number (SSN), for Intentional Program Violation
-(IPV)/fraud, for being a fleeing felon, for failing to comply with a work requirement, or for being a
-sanctioned ABAWD (Able Bodied Adult Without Dependents) who has received three (3) months
-of SNAP benefits within a thirty-six (36) month period.
-
-B.
-
-During the period in which a household member is disqualified, the eligibility and benefit level of
-any remaining members shall be determined as follows:
-1.
-
-Households containing members disqualified for IPV or fraud, or a work requirement
-sanction, or classified as a fleeing felon:
-a.
-
-Income, Resources, and Deductible Expenses
-The income and resources of the disqualified household member(s) shall be
-counted in their entirety. Resources shall only be considered if the household is
-required to meet the resource standard. The allowable earned income, standard,
-medical, dependent care, and shelter deductions shall be allowed in their
-entirety.
-
-b.
-
-Eligibility and Benefit Level
-The disqualified member shall not be included when determining the household's
-size for purposes of assigning a benefit level to the household. The disqualified
-household member will not be included when determining the household size for
-comparison against any eligibility standard; this includes the gross income and
-net income eligibility limits, or the resource eligibility limits.
-
-2.
-
-Households containing members disqualified for being an ineligible non-citizen, for failure
-or refusal to obtain or provide a SSN, or sanctioned as an ABAWD who has received
-three (3) months of SNAP benefits in a thirty-six (36) month period:
-a.
-
-Resources
-The resources of the disqualified and/or sanctioned member(s) shall be counted
-in their entirety to the remaining household members if the household is required
-to meet the resource standard.
-
-b.
-
-Income
-A pro rata share of the nonexempt income of the disqualified and/or sanctioned
-member(s) shall be counted as income to the remaining members. This pro rata
-share is calculated by dividing the income evenly among the household
-members, including the disqualified member. All but the disqualified member's
-share is counted as income to the remaining household members. If an ineligible
-non-citizen is also an ineligible student and purchases and prepares food with
-the household, the individual’s income shall be prorated under the ineligible noncitizen provisions.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-c.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Deductible Expenses
-The earned income deduction shall apply to the prorated income earned by the
-disqualified and/or sanctioned member that is attributed to the household. That
-portion of the household's allowable shelter and dependent care expenses which
-are either paid by or billed to the disqualified member shall be divided evenly
-among the household members, including the disqualified member. Legally
-obligated child support payments are deducted before prorating income. The
-shelter expense will be prorated except for the standard utility allowance (SUA).
-The full SUA will be added to the other prorated shelter components if the
-household qualifies for the SUA. All but the disqualified member's share is
-counted as a deductible expense for the remaining household members.
-
-d.
-
-Eligibility and Benefit Level
-The disqualified and/or sanctioned member shall not be included when
-determining the household's size for purposes of assigning a benefit level to the
-household. The disqualified or sanctioned household member will not be
-included when determining the household size for comparison against any
-eligibility standard, which includes the gross income, the net income eligibility
-limits, and the resource eligibility limits.
-
-4.411.2 Treatment of Income and Resources of Other Non-Household Members
-A.
-
-For those non-household members that have not been disqualified, such as live-in attendants and
-ineligible students, the income and resources of the non-household member shall not be
-considered available to the household. Cash payments from the non-household member to the
-household will be considered as income to the household. Vendor payments, as defined in
-Sections 4.405, H and 4.405, I, shall be excluded as income. Except for the mandatory telephone
-allowance, if the household shares deductible expenses with the non-household member, only
-the amount actually paid or contributed by the household shall be deducted as a household
-expense. If the payments or contributions cannot be differentiated, the expenses shall be
-prorated evenly among persons actually paying or contributing to the expenses and only the
-household's pro rata share deducted.
-If an ineligible non-citizen is also an ineligible student and purchases and prepares food with the
-household, the individual’s income shall be prorated under the ineligible non-citizen provisions.
-
-B.
-
-C.
-
-When the earned income of one or more household members and the earned income of a nonhousehold member are combined into one wage, the income of the household members shall be
-determined as follows:
-1.
-
-If the household's share can be identified, the local office shall count that portion due to
-the household as earned income.
-
-2.
-
-If the household's share cannot be identified, the local office shall prorate the earned
-income among all those whom it was intended to cover and count that prorated portion to
-the household.
-
-A person who is an ineligible student for SNAP purposes shall be treated as a non-household
-member. The other members of a household containing the ineligible student may be certified.
-The income and resources of the ineligible student shall not be considered available to the other
-household members for determining the household's income resources and deductions nor shall
-the student be considered in determining the household's allotment.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.500
-
-VERIFICATION AND DOCUMENTATION
-
-A.
-
-Verification is the use of documentary evidence or a contact with a third party to confirm
-information and to establish the accuracy of statements provided by the household.
-
-B.
-
-The case record shall consist of statements and documentation regarding the sources and results
-of verification used to determine a household’s eligibility. Such statements must be sufficiently
-detailed to support the determination of eligibility or ineligibility and to permit a reviewer to
-determine the reasonableness of the eligibility technician’s determination. When ineligibility is
-determined, the case record must clearly indicate the reason for denial or termination of SNAP
-benefits and the verification used in making the decision. If information is considered
-questionable or if an alternate source of verification was requested, the reason for additional
-verification shall be documented in the case record.
-The case record shall also contain all correspondence pertaining to fair hearings and
-administrative disqualification hearings (ADH).
-Information to retain in the case record for fair hearings shall include, at a minimum, the
-household’s request for a fair hearing, the scheduling notice with the hearing date and time, all
-decisions pertaining to the fair hearing, an any formal objections to the court’s ruling (known as
-exceptions) filed by the local office or the household.
-Information to retain in the case record for an ADH shall include, at a minimum, the notice to the
-individual of the alleged intentional program violation (IPV)/fraud, any notice given to the
-household waiving the household’s right to an ADH, the scheduling notice of the ADH if the
-waiver is not signed and returned, all decisions issued regarding the outcome of the ADH
-hearing, and the disqualification notice sent to the household notifying the individual of the
-disqualification period.
-
-C.
-
-The local office shall provide each household at the time of application for initial certification,
-recertification, and periodic report form with a notice that informs the household of verification
-requirements that the household must meet as part of the application, recertification, or periodic
-report process. The notice will inform the household that the local office will assist the household
-in obtaining verification, provided the household is cooperating with the office. The notice shall be
-written in clear and simple language and shall meet bilingual requirements.
-
-D.
-
-The household has the primary responsibility for providing documentary evidence for required
-verification and to resolve questionable information. The local office shall assist the household to
-obtain the necessary documentation provided the household is cooperating with the local office.
-
-E.
-
-The household shall also be determined ineligible if it refused to cooperate in any subsequent
-review of its eligibility, including reviews generated by reported changes, recertifications, or as
-part of a quality control review.
-
-4.501
-
-Prudent Person Principle
-
-The rules contained herein are intended to be sufficiently flexible to allow the eligibility technician to
-exercise reasonable judgment, also known as PPP, in executing his/her responsibilities when determining
-SNAP eligibility.
-In making an eligibility decision, the eligibility technician should consider whether their judgment is
-reasonable, based on their experience with and knowledge of SNAP.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.502 VERIFICATION REQUIREMENTS AT APPLICATION, RECERTIFICATION, AND PERIODIC
-REPORT
-A.
-
-Verification Requirements at Application
-1.
-
-Expedited Service Requirements
-Only verification of the identity of the head of household is required. When an authorized
-representative applies on behalf of a household, the identity of both the authorized
-representative and the head of household shall be verified. No requirement for a specific
-document may be imposed. Client declaration of Social Security Number(s) (SSNS) and
-residency shall be accepted. Client declaration of other household circumstances shall be
-accepted when determining eligibility for expedited service, and verification of any clientdeclared information shall be postponed and verified prior to certification.
-
-2.
-
-3.
-
-The following information shall be verified prior to certification:
-a.
-
-Identity of the head of household;
-
-b.
-
-Household's gross nonexempt income;
-
-c.
-
-Information available through IEVS, including SSNs for all household members;
-
-d.
-
-Non-citizen status of persons identified as non-citizens on the application;
-
-e.
-
-Residency, except for homeless households, or households newly arrived in the
-state or county for whom third-party verification cannot reasonably be obtained.
-
-The household shall be given a reasonable opportunity to submit verification of certain
-expenses to receive expense deductions and exclusions.
-If a deductible expense must be verified and obtaining verification may delay the
-household's certification, the local office shall advise the household that the household's
-eligibility and benefit level will be determined without providing a deduction or exclusion
-for the claimed but unverified expense.
-If the expense cannot be verified within thirty (30) calendar days of the date of
-application, the local office shall determine the household's eligibility and benefit level
-without providing a deduction or exclusion for the unverified expense. These expenses
-are:
-a.
-
-Allowable medical expenses less reimbursement;
-
-b.
-
-Legally obligated child support payments;
-
-c.
-
-Dependet care expenses; and,
-
-d.
-
-Shelter expenses, if questionable and verification has been requested.
-
-129
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-B.
-
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.
-
-For households eligible under basic or expanded categorical eligibility rules, verification
-of resources, gross and net income, SSN information, sponsored non-citizen information,
-and residency beyond that gathered by the Public Assistance (PA) program that confers
-eligibility shall not be required unless these eligibility factors are not already collected and
-verified by the other PA program, are considered questionable, or are unavailable to
-SNAP. The local office shall verify that each member receives benefits or services from
-the program that confers basic or expanded categorical eligibility.
-
-5.
-
-For households subject to an asset test, the household's written declaration of resources
-that declares more than the resource limit is an acceptable form of verification.
-
-Verification Requirements at Recertification
-1.
-
-Eligibility factors not verified by the Income and Eligibility Verification System (IEVS)
-should be verified at recertification only if they are incomplete, inaccurate, questionable,
-inconsistent, or outdated and would affect a household's eligibility or benefit level.
-Unchanged information shall not be verified unless the information is outdated.
-
-2
-
-A change in total monthly income of fifty ($50) or more for each member must be verified
-at recertification. If the source of income has not changed and if the amount is
-unchanged or has changed by fifty dollars ($50) or less, verification is not required unless
-the information is unclear, questionable, or outdated.
-
-3.
-
-At recertification, all households shall verify the following information if the source has
-changed, or the amount has changed by more than twenty-five dollars ($25) since the
-last time they were verified:
-a.
-
-Dependent care expenses; and
-
-b.
-
-Allowable medical expenses; and
-
-c.
-
-Legally obligated child support.
-
-4.
-
-A reported SSN not verified at initial certification and newly obtained SSNs shall be
-verified through the IEVS or State On-Line Query Internet (SOLQ-I).
-
-5.
-
-For households subject to an asset test, the household's written declaration of resources
-that declares more than the resource limit is an acceptable form of verification.
-
-6.
-
-If there has been a change in a deductible expense that must be verified and obtaining
-verification delays the household's redetermination processing, the local office shall
-advise the household that the household's eligibility and benefit level will be determined
-without providing a deduction for the claimed but unverified expense.
-
-Verification Requirements at Periodic Report
-1.
-
-The household shall verify the following changes in circumstances at the time of periodic
-report:
-a.
-
-A change of more than $100 in the amount of unearned income.
-
-b.
-
-A change in the source of income, including starting a job.
-
-c.
-
-Acquisition of a licensed vehicle that is not fully excludable, if resource limits
-apply.
-
-130
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-2.
-
-4.503
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-d.
-
-A change in liquid resources, unless excluded, if resource limits apply.
-
-e.
-
-Changes in the legal obligation to pay child support.
-
-f.
-
-If a member of the household won substantial lottery or gambling winnings.
-
-g.
-
-Allowable medical expenses to receive an increase in the allowed expense or
-add a medical expense.
-
-Previously reported medical and shelter expenses used to establish the twenty-four (24)
-month certification should continue through the end of twenty-four (24) month certification
-period unless:
-a.
-
-An increase in medical expenses is verified, or
-
-b.
-
-An increase in shelter expenses is reported.
-
-Case Documentation
-
-The case record shall consist of statements and documentation regarding the sources and results of
-verification used to determine eligibility and ineligibility. Such statements shall be entered into a physical
-case file and/or the statewide automated system. Such statements must be sufficiently detailed to support
-the determination of eligibility or ineligibility and to permit a reviewer to determine the reasonableness of
-the eligibility technician’s determination. When ineligibility is determined, the case record must clearly
-indicate the reason for denial or termination and the verification used in making the decision. If
-information is considered questionable or if an alternate source of verification was requested, the reason
-for additional verification shall be documented in the case record.
-The case record shall show the names of the employers and others contacted; the dates and amounts of
-wage stubs and statements; the figures used to arrive at monthly gross income; the household’s
-responsibility to pay utilities; and the method of verifying other information, including non-citizen status, if
-applicable.
-A notation shall be made to indicate which household members completed work registration forms and
-the date completed.
-4.504
-
-Sources of Verification
-
-The local office shall accept any pertinent documentary evidence provided by the household and shall be
-primarily concerned with how adequately the verification proves the statements on the application, during
-recertification, in the PRF, or in any reported changes. Local offices shall accept the minimum verification
-requirements outlined throughout this document, unless questionable. If written verification cannot be
-obtained, the eligibility technician shall substitute an acceptable collateral contact.
-4.504.1 Documentary Evidence
-Documentary evidence consists of written confirmation of a household’s circumstances. Households may
-supply documentary evidence in person, through the mail, by facsimile or other electronic device, or
-through an authorized representative. The local office shall not require the household to present
-verification in person at the office.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.504.2 Collateral Contacts
-A.
-
-A collateral contact is a verbal confirmation of a household's circumstances by a person outside
-the household, made either in person, in writing, or by telephone. Acceptable collateral contacts
-include, but are not limited to: employers, landlords, social/migrant service agencies, and
-neighbors of the household who can be expected to provide accurate third-party verification. The
-name of the individual contacted, the individual’s contact information, and the information
-provided shall be documented in the case record.
-
-B.
-
-Confidentiality shall be maintained when talking with collateral contacts. The local office shall
-disclose only the information that is necessary to get information being sought. When talking with
-collateral contacts, the local office must not state that an individual or household has applied for
-SNAP.
-
-C.
-
-If the household fails to provide a collateral contact or provides a contact that is unacceptable to
-the eligibility technician, the technician may select a collateral contact that can provide
-information that is needed.
-
-D.
-
-The local office shall not determine the household to be ineligible when a person outside the
-household fails to cooperate with a request for verification. Household members who are
-disqualified or in an ineligible status shall not be considered individuals outside the household.
-
-E.
-
-In cases in which the information from another source contradicts statements made by the
-household, the household shall be afforded a reasonable opportunity to resolve the discrepancy
-prior to an eligibility determination.
-
-4.504.3 Home Visits
-For the purposes of determining eligibility, home visits shall be used as verification only if documentary
-evidence cannot be obtained and the visit is scheduled in advance with the household. Home visits are to
-be used on a case-by-case basis where the supplied documentation or verification is insufficient.
-4.504.4 Systematic Alien Verification Entitlement (SAVE)
-The U.S. Citizenship and Immigration Service (USCIS), Systematic Alien Verification for Entitlement
-(SAVE) system will verify the alien status of applicant non-citizens. The use of SAVE shall be
-documented in the case record. The record will contain the date the primary or secondary request was
-submitted, along with a copy of the Form G-845 when applicable, and any response to the request for
-verification.
-4.504.5 Colorado Income Eligibility Verification System (IEVS)
-A.
-
-The Colorado Income and Eligibility Verification System (IEVS) provides for the exchange of
-information on SNAP clients with the Social Security Administration (SSA), Internal Revenue
-Service (IRS), and the Colorado Department of Labor and Employment (DOLE).
-
-B.
-
-At initial certification and recertification, all applicants for SNAP shall be notified through a written
-statement provided on or with the application form that contains the following information:
-1.
-
-Information available through the IEVS will be requested and verified through collateral
-sources when discrepancies are found by the local office.
-
-2.
-
-Information available through the IEVS shall be used and that such information will be
-used and may affect the household’s eligibility and level of benefits.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-C.
-
-With respect to all household members, including any excluded household members for whom a
-Social Security Number (SSN) is available, the agency shall be responsible for requesting
-verification through the IEVS or directly from locally accessed automated information. All such
-information shall be requested at the first available opportunity after the date of application.
-
-D.
-
-The local office shall at a minimum, prior to approval of benefits at initial application,
-recertification, and periodic report, verify potential earnings or unemployment benefits through the
-DOLE for all applicants.
-
-E.
-
-Determination of a household's eligibility and benefit level shall not be delayed past the
-application processing time standards if verification of information is not available nor shall
-determination be delayed awaiting verification from the IEVS.
-
-F.
-
-The local office is required to act upon information received from IEVS within forty-five (45)
-calendar days of the receipt of that information, except for UIB information received from the
-DOLE, which must be acted upon in accordance with Section 4.604.
-
-G.
-
-Some information received through the IEVS is not considered verified and is subject to
-independent verification by the local office. Benefits shall not be delayed pending receipt of
-verification from a collateral source, such as an employer, when independently verifying
-information received from the IEVS. Such verification of IEVS information may include contacting
-the household in writing informing them of the information received from the IEVS data source
-and requesting a response within ten (10) calendar days, or by appropriate collateral contact. The
-following Information received through the IEVS shall be treated as not verified and subject to
-independent verification by the local office:
-
-H.
-
-1.
-
-Wage data from the Colorado Department of Labor and Employment.
-
-2.
-
-Internal Revenue Service unearned income information.
-
-Through the IEVS, participant SSNs will be matched with source agency records on a regular
-basis to identify potential earned and unearned income and resources and assets from the
-following sources:
-1.
-
-Social Security Administration (SSA)
-Information received from the Social Security Administration includes:
-
-2.
-
-a.
-
-Wages, payments of retirement income, Title II Social Security benefits, Title XVI
-Social Security benefits, pensions, and federal employee earnings maintained by
-the SSA.
-
-b.
-
-Federal retirement, survivors disability, SSI, and related information available
-from SSA through BENDEX (Beneficiary Data Exchange) and SDX (State Data
-Exchange).
-
-State Data Exchange (SDX) and Beneficiary Data Exchange (BENDEX)
-Death information, SSI benefit amounts, and social security benefit information may be
-obtained verified through SDX AND BENDEX. See Section 4.504.6, E, for what
-information from SSA is considered verified upon receipt.
-
-3.
-
-Colorado Department of Labor and Employment (DOLE)
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-4.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-a.
-
-Information received from the DOLE includes wage and unemployment
-insurance benefits (UIB). Wage data received from the DOLE shall not be
-considered as verified upon receipt and shall be subject to independent
-verification. Unemployment information reported through the IEVS shall be
-verified through the DOLE or by the household. Verification of unemployment
-compensation insurance benefits, including beginning dates, duration of
-payments and amount of payments can be obtained from the Colorado
-Department of Labor and Employment.
-
-b.
-
-The local office shall at a minimum, prior to approval of benefits at initial
-application, recertification, and periodic report, verify potential earnings or
-unemployment benefits through the DOLE for all applicants, including ineligible
-and disqualified members’ SSNs. With respect to all members of a participant
-household, the local office shall use UIB information received through the Income
-and Eligibility Verification System (IEVS). Participant SSNs will be matched at
-least monthly with the DOLE, UIB records.
-
-Internal Revenue Service (IRS)
-Unearned income information received from the IRS includes, but is not limited to,
-interest on checking and savings accounts, dividends, royalties, winnings from betting
-establishments, and capital gains. Unearned income information from the IRS that is
-reported through the IEVS shall not be considered as verified upon receipt and shall be
-subject to independent verification.
-
-4.504.6 Information Considered Verified Upon Receipt
-A.
-
-Verified upon receipt (VUR) is a term given to a state-prescribed list of specific information that
-comes directly from the primary source of the information and is free from question.
-
-B.
-
-Information that is considered VUR shall be acted upon for all households. Information
-considered VUR shall be acted on at the time of application, recertification, periodic report, and
-during a household’s certification period if the information causes a change in the SNAP benefit
-amount. A household shall not be convicted of fraud for not reporting a change in the information
-it is not required to report.
-
-C.
-
-Information considered VUR shall be considered verified unless the office has reason to believe
-that the information may be inaccurate. Advance notice of adverse action shall be given when
-acting on information that is considered VUR, except as noted in Section 4.608.1.
-
-D.
-
-The local office shall consider only the following information as VUR:
-1.
-
-Social Security and SSI benefit amounts obtained from SSA.
-SSI and benefit amounts obtained from the SSA are considered reported and verified on
-the day the information is first known to the agency, either through the IEVS, SDX,
-BENDEX or another automated interface of information, whichever is sooner.
-
-2.
-
-Death information received from the Burial Assistance program.
-Death information received from the Burial Assistance program is considered reported
-and verified on the day the information is first known to the agency.
-
-3.
-
-Unemployment insurance benefits (UIB) that are reported through the IEVS and obtained
-through the Department of Labor and Employment (DOLE).
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-The UIB information shall be considered reported and verified on the date of the IEVS
-notification. Advance notice of adverse action shall be given when acting on the change
-in information.
-4.
-
-PA benefit amounts (Colorado Works, Aid to the Needy Disabled (AND) program
-consisting of AND-State Only (AND-SO) and AND-Colorado Supplement (AND-CS),
-Home Care Allowance (HCA), and Old Age Pension (OAP), obtained from the State
-Department.
-
-5.
-
-Information that is reported and verified to a PA program which results in a change to the
-PA benefit amount and that meets SNAP verification requirements.
-Such information shall be considered reported and verified on the day the PA program
-processes the change and authorizes the new PA benefit amount.
-
-6.
-
-Child support income and expense amounts obtained through the ACSES.
-Such information is considered reported and verified on the day the information is
-reported through an automated interface with ACSES.
-
-7.
-
-Non-compliance information obtained from EF agencies of the failure of an ABAWD to
-meet work requirements.
-
-8.
-
-Colorado IPVs.
-
-9.
-
-Information obtained from the SAVE system regarding non-citizen status.
-
-10.
-
-Changes in household composition that are reported and verified and result in one (1) or
-more members being removed from one (1) SNAP household and added to a new or
-existing SNAP household.
-Duplicate benefits shall not be issued for a particular individual when removing that
-individual from one SNAP household and adding them to a new SNAP household.
-
-11.
-
-Changes in household composition that are reported and verified by child welfare
-agencies and result in a child being removed from one SNAP household and added to a
-new or existing SNAP household.
-
-12.
-
-The disqualification of a household member who is determined to be a fleeing felon.
-
-4.504.61
-
-Information Not Considered Verified Upon Receipt (VUR)
-
-A.
-
-Some information received from sources other than the household are not considered VUR. Such
-information shall be subject to independent verification prior to taking adverse action against a
-household’s SNAP benefits during the certification period.
-
-B.
-
-The following sources of information shall not be considered as VUR:
-1.
-
-Death information received from a source other than the Burial Assistance program.
-
-2.
-
-Veterans Assistance (VA) benefit amounts obtained through the IEVS.
-
-3.
-
-Wage data obtained through the IEVS and the DOLE.
-
-4.
-
-IRS income and asset information obtained through the IEVS.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-5.
-
-Information regarding railroad retirement benefits obtained through the IEVS.
-
-6.
-
-Information received from the Public Assistance Reporting and Information System
-(PARIS).
-
-7.
-
-Prisoner information received during the certification period.
-
-8.
-
-Information received from the National Directory of New Hires (NDNH).
-
-9.
-
-Social Security benefit amounts reported via an award letter given by the household.
-
-10.
-
-IPV/disqualification data from another state as reported through the disqualified recipient
-database.
-
-4.505
-
-VERIFICATION OF NON-FINANCIAL INFORMATION
-
-A.
-
-Some information received from sources other than the household are not considered verified.
-Such information shall be subject to independent verification prior to taking adverse action
-against a household’s SNAP benefits during the certification period.
-
-4.505.1 Verification of Identity
-A.
-
-The identity of the person making an application shall be verified. When an authorized
-representative applies on behalf of a household, the identity of both the authorized representative
-and the head of household shall be verified.
-
-B.
-
-Identity may be verified through readily available documentary evidence, or if this is unavailable,
-through a collateral contact or through electronic information received from the Colorado
-Department of Revenue, Division of Motor Vehicles (DMV). Acceptable documentary evidence
-that the applicant may provide includes, but is not limited to, a driver's license, a work or school
-ID, an ID for health benefits or for another assistance or social services program, a voter
-registration card, wage stubs, or a birth certificate. No requirement for a specific type of
-document, such as a birth certificate or picture ID, may be imposed.
-
-C.
-
-When obtaining an Electronic Benefit Transfer (EBT) card, a household shall not be required to
-provide verification beyond what was utilized to establish identity when determining SNAP
-eligibility. This includes verification through a collateral contact.
-
-4.505.2 Verification of Social Security Numbers (SSN)
-A.
-
-All SSNs provided by the household, including multiple SSNs issued by the Social Security
-Administration (SSA), shall be verified through the SSA in accordance with the Income and
-Eligibility Verification System (IEVS) procedures established by the State Department. The State
-On-Line Query Internet (SOLQ-I) may also be utilized to verify an SSN. Certification of an
-otherwise eligible household member shall not be delayed verifying the SSN provided by the
-client. Household members who provide an SSN shall not be denied benefits for failure or inability
-to present a social security card or other official documentation. Eligibility determinations and
-benefits will not be delayed to otherwise eligible households while awaiting a response from the
-IEVS. For basic categorically eligible clients, the local office shall accept SSNs as verified by the
-categorically eligible programs.
-
-B.
-
-When the local office receives notification through the IEVS that a participant's SSN cannot be
-verified or is otherwise discrepant, such as the name or number does not match SSA records, the
-local office shall:
-
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-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-1.
-
-Conduct a case record review to confirm that the SSN in the case record matches the
-SSN submitted to the SSA for verification. If an error occurred in the original submittal,
-such as digits transposed or an incorrect name submitted, the local office shall correct
-the error and the SSN will be resubmitted through the IEVS for verification.
-
-2.
-
-If no error is identified as outlined in 1, above, the local office shall advise the household
-in writing that a member's SSN could not be verified and instruct the household to contact
-the local office to resolve the discrepancy. This notice shall not constitute advance notice
-of adverse action.
-
-3.
-
-The local office shall make every effort to assist the household in resolving the
-discrepancy, including referral to the appropriate SSA office and assisting the household
-in obtaining documents available to the local office which may be required by the SSA.
-
-4.
-
-Should the household or participant fail or refuse to cooperate in resolving the
-discrepancy, the individual whose SSN cannot be verified may be disqualified as having
-failed to provide an SSN until such time as the household/participant cooperates, unless
-good cause exists. Disqualification shall be effective the month following the expiration of
-the notice of adverse action.
-
-4.505.3 Verification of Residency
-A.
-
-Except for basic categorically eligible households, residency shall be verified prior to certification,
-except in unusual cases when verification cannot reasonably be accomplished, such as for
-homeless households, some migrant farm worker households, or households newly arrived to an
-area. Verification of residency should be accomplished to the extent possible when verifying other
-information, such as identity or income. Any documents or collateral contacts which reasonably
-establish the applicant’s residency must be accepted and no requirement for a specific type of
-verification may be imposed.
-
-A.
-
-If the eligibility technician and client have made reasonable efforts to verify residency and it has
-proved impossible, the household may be certified, if otherwise eligible. If an individual’s county
-residency cannot be verified, but the individual’s Colorado residency is not questionable, then the
-individual shall be certified if otherwise eligible and not participating in another SNAP household.
-
-C.
-
-The client may supply the verification through driver's license, rent receipt, utility or other recently
-received bill, voter registration, or similar means. If the client is unable to supply documentary
-evidence, information may be obtained from a telephone or city directory or detailed area map. If
-documentary evidence is not available, a collateral contact, such as a landlord or neighbor, may
-provide verification. In the absence of documentary evidence or collateral contact, a scheduled
-home visit may be feasible.
-
-4.505.4 Verification of Household Composition
-A.
-
-Local offices shall accept the household’s statement, without requiring verification, regarding
-household composition unless the statement is questionable or there is unclear information, as
-defined in section 4.000.1.
-
-B.
-
-Persons aged sixty (60) and older experiencing a disability as described in Section 4.304.3.A,
-declaring separate household status from others in the household shall be responsible for
-providing necessary income information of other household members and medical statements
-that the individual(s) cannot purchase and prepare their own meals if questionable and requested
-by the local office.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-A household that requests benefits for a child that is already receiving benefits in another
-household is responsible for verifying that they provide the child with the majority of his or her
-meals prior to receiving benefits for that child as described in Section 4.304.1.B.
-
-4.505.5 Verification of U.S. Citizenship
-A.
-
-B.
-
-If questionable, U.S. citizenship may be verified by one of the following:
-1.
-
-A U.S. birth certificate;
-
-2.
-
-Possession of a U.S. passport;
-
-3.
-
-A certificate of U.S. citizenship (INS form N-560 or N-561);
-
-4.
-
-A certificate of naturalization (INS form N-550 or N-570);
-
-5.
-
-A certificate of birth abroad of a citizen of the United States (Department of State forms
-FS-545 or DS-1350);
-
-6.
-
-Identification Cards for U.S. citizens (INS-I-179 or INS-I-197); or,
-
-7.
-
-Information obtained through the Colorado Vital Information System (COVIS).
-
-If the above forms of verification cannot be obtained and the household can provide a reasonable
-explanation as to why verification is not available, the local office shall accept a signed statement
-from a third party having personal knowledge of the person's status and who declares, under
-penalty of perjury, that the member in question is a U.S. citizen. The signed statement shall
-contain a warning of the penalties for helping someone commit fraud.
-
-4.505.51
-A.
-
-Verification of Questionable Citizenship
-
-The following guidelines shall be used in considering whether a client’s statement of citizenship is
-questionable:
-1.
-
-The claim of citizenship is inconsistent with statements made by the client.
-
-2.
-
-The claim of citizenship is inconsistent with information received from another source.
-
-B.
-
-Application of the above criteria by the eligibility technician must not result in discrimination based
-on race, religion, ethnic background or national origin, and groups such as migrant farm workers
-or American Indians shall not be targeted for special verification. The eligibility technician shall
-not rely on a surname, accent or appearance that seems foreign to find a claim to citizenship
-questionable. Nor shall the eligibility technician rely on a lack of English speaking, reading, or
-writing ability as grounds to question a claim to citizenship.
-
-C.
-
-The member whose citizenship is in question shall be ineligible to participate until proof of
-citizenship is obtained, except as provided in Section 4.505.6, E. Until proof of citizenship is
-obtained, the member whose citizenship is in question shall have his or her income, less a
-prorated share, and all of his or her resources considered available to any remaining household
-members.
-
-D.
-
-The method used to document verification of citizenship and the result of the verification shall be
-included in the case record.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.505.6 Verification of Non-citizen Status
-A.
-
-All SNAP clients shall be notified on the application form that the non-citizen status of any
-household member will be subject to verification by the U.S. Citizenship and Immigration Service
-(USCIS) through the submission of information from the application to the USCIS. The
-information received from the USCIS may affect the household's eligibility and level of benefits.
-The application shall contain a statement signed by an adult representative from each household
-which attests, under penalty of perjury, to citizenship or non-citizen status of each member.
-
-B.
-
-The local office shall verify the eligibility status of non-citizens by submitting the noncitizen
-registration number through the USCIS Systematic Alien Verification for Entitlement (SAVE)
-system. The office shall use the information from USCIS SAVE to determine eligibility for benefits.
-The use of SAVE shall be documented in the case record. If a non-citizen does not wish the office
-to verify his or her immigration status, the local office shall give the household the option of
-withdrawing its application or participating without that member.
-
-C.
-
-The SAVE system will verify the alien status of non-citizens. The use of SAVE shall be
-documented in the case record. The record will contain the date that the primary or secondary
-request was submitted, along with a copy of the Form G-845, as incorporated by reference in
-section 4.000.1, when applicable, and any response to the request for verification.
-1.
-
-If the non-citizen status is not verified in the primary SAVE verification process, a USCIS
-Form G-845 will be submitted with a photocopy of the non-citizen's document to the
-Colorado Refugee Service Program (CRSP).
-
-2.
-
-If the proper USCIS documentation is not available, the non-citizen may state the reason
-and submit other conclusive verification. The local office shall accept other forms of
-documentation or corroboration from the USCIS that the non-citizen is classified pursuant
-to Section 207 (8 U.S.C. 1157), Section 208 (8 U.S.C. 1158), or Section 243(h) (8 U.S.C.
-1253(h)) of the Immigration and Nationality Act, or other conclusive evidence such as a
-court order stating that deportation has been withheld pursuant to Section 243(h) of the
-Immigration and Nationality Act.
-
-D.
-
-If a non-citizen is unable to provide any USCIS document, such as an INS form I-94, the local
-office has no authority or responsibility to contact the USCIS.
-
-E.
-
-The local office shall provide an applicant non-citizen up to the thirtieth (30th) calendar day
-following the date of application to submit acceptable documentation of their non-citizen status or
-at least ten (10) calendar days from the date of the local office's request for an acceptable
-document.
-
-F.
-
-A non-citizen who has been given a reasonable opportunity to submit acceptable documentation
-and has not done so within the normal processing time shall not be certified for benefits until
-acceptable documentation is available, except as provided below. However, when the local office
-fails to provide a non-citizen applicant with a reasonable opportunity as of the thirtieth (30th)
-calendar day following the date of application, the local office must provide the household with
-benefits back to the date of application, provided the household is otherwise eligible. A noncitizen is ineligible to participate until acceptable documentation is provided, except as provided
-below:
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-G.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-1.
-
-The local office has submitted a copy of a document provided by the household to the
-USCIS or other federal agency for verification that bears on the individual’s eligible alien
-status. In such instances, the local office must certify the individual for up to six (6)
-months from the date of the original request for verification pending the results of the
-investigation. Pending such verification, the individual's benefits will not be delayed,
-denied, reduced or terminated based on the individual's immigration status while awaiting
-a response to the request for verification.
-
-2.
-
-The local office has submitted a request to the SSA for information regarding the number
-of quarters of work that can be credited to the individual; or SSA has responded that the
-individual has fewer than forty (40) quarters, and the individual provides documentation
-from the SSA that the SSA is conducting an investigation to determine if more quarters
-can be credited. If the SSA indicated that the number of qualifying quarters that can be
-credited is under investigation, the local office shall certify the individual, pending the
-results of the investigation, for up to six (6) months from the date of the original
-determination of insufficient quarters.
-
-If the office determines that the documentation presented by the household is questionable or the
-documents that are used to determine eligibility are not issued by the USCIS, the office will use a
-secondary SAVE process. The secondary verification process will also be used when primary
-verification is not available through SAVE.
-The secondary verification process will consist of submitting a photocopy of the documentary
-evidence presented, with form G-845, to the U.S. Citizenship and Immigration Service.
-
-H.
-
-If the local office determines, after complying with the requirements of this section, that the noncitizen is not in an eligible alien status, the office shall take action, including sending proper
-notices to the household, to terminate, deny or reduce benefits. The household will have the
-opportunity to request a fair hearing prior to any adverse action taking effect.
-
-I.
-
-If verification of eligible non-citizen status is not provided on a timely basis, the household has the
-option of withdrawing its application or requesting that the eligibility of the remaining household
-members be determined. The income and resources of the individual whose non-citizen status is
-unverified shall be considered available in determining the eligibility of the remaining household
-members. If verification of eligible non-citizen status is subsequently received the local office shall
-act on the information as a reported change in household membership in accordance with
-timeliness standards. The non-citizen shall not be entitled to retroactive benefits.
-
-J.
-
-When any person in a household indicates inability or unwillingness to provide documentary
-evidence of non-citizen status, either for themselves or any other household member, the
-household has the option of withdrawing its application or participating with the member in
-question classified as an ineligible non-citizen. In such cases the local office shall not continue
-efforts to obtain that documentary evidence.
-
-4.505.61
-
-Verification of SSA Forty (40) Work Quarters
-
-The SSA Quarters of Coverage History System (QCHS) is available for purposes of verifying whether a
-lawful permanent resident has earned or can receive credit for forty (40) qualifying quarters. If the
-individual does not have documentation, they cannot participate until verification of forty (40) quarters of
-work is received from either the SSA or the individual.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-If the SSA determines that its existing records do not verify that an individual claiming forty (40) credits or
-quarters has the forty (40) credits or quarters and the individual believes the SSA records are not correct,
-the SSA will work with the individual to determine whether the additional credits or quarters can be
-established. The individual should be advised that they have the option of working with the SSA and that
-if they exercise this option and obtain a statement from the SSA indicating that the number of credits or
-quarters is under review, they can continue to receive SNAP benefits for up to six (6) additional months
-from the date of the original determination of insufficient quarters.
-A.
-
-No such qualifying quarter of coverage that is creditable under Title II of the Social Security Act
-for any period beginning after December 31, 1996, may be credited to a non-citizen if the noncitizen, parent of the non-citizen, or spouse of such non-citizen received any federal meanstested public benefit during the period for which such qualifying quarter of coverage is so
-credited.
-
-B.
-
-The local office must evaluate quarters of coverage and receipt of federal means-tested public
-benefits on a calendar year basis. The local office must first determine the number of quarters
-creditable in a calendar year, then identify those quarters in which the non-citizen (or the
-parent(s) or spouse of the non-citizen) received federal means-tested public benefits and then
-remove those quarters from the number of quarters of coverage earned or credited to the
-noncitizen in that calendar year. However, if the non-citizen earns the fortieth (40th) quarter of
-coverage prior to applying for SNAP or any other federal means-tested public benefit in that same
-quarter, the local office must allow that quarter toward the forty (40) qualifying quarters total.
-
-C.
-
-Receipt of federal means-tested public benefit shall not include the following:
-1.
-
-Medical assistance under Title XIX of the Social Security Act (or any successor program
-to such Title) for care and services that are necessary for the treatment of an emergency
-medical condition (as defined in Section 1903(v)(3) of such Act) of the non-citizen
-involved and are not related to an organ transplant procedure, if the non-citizen involved
-otherwise meets the eligibility requirement for medical assistance under the State Plan
-approved under such Title (other than the requirement of the receipt of aid or assistance
-under Title IV of such Act, supplemental security income benefits under Title XVI of such
-Act, or a state supplementary payment)
-
-2.
-
-Short-term non-cash, in-kind emergency disaster relief.
-
-3.
-
-Assistance or benefits under the National School Lunch Act.
-
-4.
-
-Assistance or benefits under the Child Nutrition Act of 1966.
-
-5.
-
-Public health assistance (not including any assistance under Title XIX of the Social
-Security Act) for immunizations with respect to immunizable diseases and for testing and
-treatment of symptoms of communicable diseases whether or not such symptoms are
-caused by a communicable disease.
-
-6.
-
-Payments for foster care and adoption assistance under Parts B and E of Title IV of the
-Social Security Act for a parent or a child who would, in the absence of Subsection (q),
-be eligible to have such payments made on the child's behalf under such part, but only if
-the foster or adoptive parent (or parents) of such child is a qualified alien (as defined in
-Section 431 of the Social Security Act).
-
-7.
-
-Programs, services, or assistance (such as soup kitchens, crises counseling and
-intervention, and short-term shelter) specified by the U.S. Attorney General, in the
-Attorney General's sole and unreviewable discretion after consultation with appropriate
-federal agencies and departments, that:
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-a.
-
-Deliver in-kind services at the community level, including through public or
-private nonprofit agencies,
-
-b.
-
-Do not condition the provision of assistance, the amount of assistance provided,
-or the cost of assistance provided on the individual recipient's income or
-resources, and,
-
-c.
-
-Are necessary for the protection of life or safety.
-
-8.
-
-Programs of student assistance under Titles IV, V, IX, and X of the Higher Education Act
-of 1965.
-
-9.
-
-Means-tested programs under the Elementary and Secondary Education Act of 1965.
-
-10.
-
-Benefits under the Head Start Act.
-
-11.
-
-Benefits under the Workforce Investment Act.
-
-4.505.7 Verification of Non-citizen Sponsorship
-A.
-
-The local office shall verify the following information at the time of initial application and
-recertification:
-1.
-
-The income and resources of the non-citizen’s sponsor and the sponsor's spouse (if
-living with the sponsor) at the time of the non-citizen’s application for SNAP.
-
-2.
-
-The names and alien registration numbers of other non-citizens for whom the sponsor
-has signed an affidavit of support or similar agreement.
-
-3.
-
-The number of dependents who are claimed or who could be claimed for federal income
-tax purposes of the sponsor and the sponsor's spouse.
-
-4.
-
-The name, address, and phone number of the non-citizen’s sponsor.
-
-B.
-
-Until the non-citizen provides information or verification necessary to determine eligibility, the
-sponsored non-citizen shall be ineligible. When such verification is provided, the local office shall
-act on the information as a reported change in household circumstances.
-
-C.
-
-The eligibility of any remaining household members shall be determined. The income and
-resources of the ineligible non-citizen, excluding the attributed income and resources of the noncitizen’s sponsor and sponsor's spouse, shall be considered available in determining the eligibility
-and benefit level of the remaining household members.
-If the sponsored non-citizen refuses to cooperate in providing and/or verifying needed
-information, other adult members of the non-citizen’s household shall be responsible for providing
-and/or verifying the information. If the information or verification is subsequently received, the
-local office shall act on the information as a reported change. If the same sponsor is responsible
-for the entire household, the entire household is ineligible until such time as the needed
-information is verified. The local office must assist the non-citizen in obtaining verification
-provided the household is cooperating with the local office.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.505.8 Verification of Disqualified Member Data
-At the time of application and when adding a new member to a SNAP household, the office shall verify
-data with the national IPV/disqualification database for all household members aged eighteen (18) or
-older to determine if any members have an active IPV / disqualification from another state which requires
-a portion, or the entirety of, the disqualification period to be served in Colorado. Application processing
-shall not be delayed while awaiting verification from another state.
-The local office shall ensure that:
-A.
-
-Disqualifications from another state due to a drug-related felony, as defined in 7 C.F.R.
-273.11(m), which is incorporated by reference in section 4.100, above, or any other
-disqualification that is not pursued in Colorado due to a waiver or state statute shall not be acted
-upon;
-
-B.
-
-IPVs/disqualifications from another state must be independently verified with the originating state
-prior to taking any adverse action against a household’s SNAP benefits, if the client is unable to
-attest to the accuracy of the disqualification;
-
-C.
-
-States shall be given twenty (20) calendar days to respond to a request for verification. If
-verification cannot be provided by the other state, then the disqualification shall not be acted
-upon. Local offices shall be given twenty (20) calendar days to respond to another state’s request
-of obtaining verification of a Colorado IPV. If the local office cannot provide verification, then
-steps shall be taken to remove the IPV from the national database.
-
-D.
-
-Once independent verification is received, advance notice of adverse action shall be granted prior
-to benefits being reduced, suspended, denied, or terminated; and,
-
-E.
-
-The disqualified individual shall be provided an opportunity to appeal any adverse action.
-If benefits are issued by the local office to an individual while awaiting verification of an IPV
-disqualification, the benefits issued while awaiting such verification may be reclaimed by the local
-office if it is determined that the individual was disqualified from the program at the time the
-benefits were issued.
-
-4.506
-
-VERIFICATION OF INCOME
-
-Monthly, gross nonexempt income shall be verified prior to initial certification, unless the household is
-entitled to expedited service and postponed verification for one month. Income is also verified at
-recertification when a household reports that the amount of income has changed more than fifty dollars
-($50), or the source of income has changed.
-A.
-
-Responsibility
-1.
-
-Clients are primarily responsible for furnishing income verification documents, a collateral
-contact, or the authorization needed to secure sufficient information to allow written or
-verbal verification by the eligibility technician. For PA recipients, the PA case record will
-normally be used as the source of verification.
-
-2.
-
-Means of income verification include pension award letters, check stubs, employer
-letters, and collateral contacts with employers, agencies, or other persons having
-knowledge of the household’s circumstances.
-
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-
-B.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-3.
-
-When a collateral contact designated by the household cannot be expected to provide
-accurate third-party verification, the local office shall ask the household to designate an
-acceptable collateral contact, provide an alternative form of verification, or substitute a
-home visit.
-
-4.
-
-In some instances, however, all attempts to verify income may be unsuccessful because
-the person or organization has failed to cooperate with the household. A cooperating
-client shall not be denied solely because a third-party refuses to provide verification. The
-eligibility technician shall, in consultation with the client or other sources, arrive at a figure
-to be used for certification purposes and annotate the household’s case record with
-information used to make an eligibility determination.
-
-Continuing Employment
-When the client has continuing employment, the previous month's income is the best indication
-and source of verification of the amount of income the household may expect to receive. If
-information, such as probable salary raise, overtime pay, or layoff supplied by the household or
-collateral contact reveals that future income will differ substantially from the previous month's
-income, a reasonable estimate of income shall be made based on information obtained from the
-household members and/or collateral contacts. The method of determining and computing
-income shall be fully annotated in the case record.
-
-C.
-
-Self-Employment
-A household’s statement of self-employment income shall be accepted unless questionable.
-Should verification be requested, no specific verification shall be required. Self-employment
-verification may consist of tax documents, self-employment ledgers maintained by the household,
-receipts, or other documents used for verifying and documenting the household’s selfemployment income and expenses. If at the time of initial certification, a household is recently
-self-employed or does not have adequate documentation of the household’s self-employment
-income and expenses, the eligibility technician shall use the best information available to
-determine the household’s monthly income. The household shall be encouraged to keep records
-of income and expenses for subsequent certifications.
-
-D.
-
-Educational Assistance
-
-All educational income and financial aid are considered exempt income and does not require verification
-to determine a household’s monthly income.
-E.
-
-Verification of Terminated Employment
-1.
-
-If information regarding the termination of employment is questionable, verification is
-necessary. The primary responsibility for providing verification rests with the household. If
-it is difficult or impossible for the household to obtain documentary evidence in a timely
-manner, the local office shall offer assistance.
-
-2
-
-Acceptable sources of verification include, but are not limited to, the previous employer,
-employee associations, union representatives and grievance committees, and the
-Colorado Department of Labor and Employment (DOLE). Whenever documentary
-evidence is not available, a collateral contact shall be used.
-
-3.
-
-If the household and the local office are unable to obtain verification for a questionable
-claim of resignation from employment due to discrimination practices or unreasonable
-demands by an employer because an employer cannot be located, the household shall
-not be denied.
-
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-
-F.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Cases of No Reported Income
-
-The existence of resources, unpaid bills, and/or credit might be an explanation of how the household
-exists with no income or income so low as to place them at the maximum benefit level without
-consideration of deductible expenses. The client’s statement of no income is acceptable, unless
-otherwise questionable.
-4.507
-
-VERIFICATION OF EXPENSES
-
-A.
-
-Verification of Dependent Care
-Verification of dependent and child care expenses is required to grant a deduction.
-
-B.
-
-C.
-
-Verification of Shelter and Utility Costs
-1.
-
-A household’s declaration of its responsibility to pay shelter and utility costs, as well as
-the amount the household is responsible to pay, shall be considered an acceptable
-source of verification, unless questionable, to grant the household a deduction for the
-amount the household declares it is responsible for paying.
-
-2.
-
-Households that wish to claim shelter costs for a home that is unoccupied because of
-employment or training away from the home, illness or abandonment caused by a natural
-disaster or casualty loss must provide verification of actual utility costs if the costs would
-result in a deduction. These households are also responsible for providing verification of
-any other shelter costs if the cost is questionable and it would result in a deduction. The
-local office is not required to assist households in obtaining verification of this expense if
-the verification needs to be obtained from a source outside the county.
-
-3.
-
-If shelter expense is questionable and verification cannot be verified within thirty (30)
-calendar days from the date of application, the local office shall determine the
-household's eligibility and benefit level without providing a deduction for the unverified
-expense.
-
-4.
-
-If the household subsequently provides the missing verification for questionable shelter
-costs, the information will be handled as a reported change. The household shall be
-entitled to restoration of any lost benefits as a result of the disallowance of the expense
-which could not be verified within the thirty (30) day period, only if the client was not given
-at least ten (10) calendar days to provide verification or less than ten (10) calendar days
-if a necessary second interview could only be scheduled between the twentieth (20th)
-and thirtieth (30th) day of the processing period.
-
-Verification of Medical Expenses
-1.
-
-The amount of medical bills and the portion that is reimbursable shall be verified prior to
-initial certification. At recertification, total medical expenses shall be verified if the source
-has changed or the total amount has changed more than twenty-five dollars ($25) since
-the last time they were verified, or the information is incomplete, inaccurate, inconsistent,
-or outdated.
-
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-
-D.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-2.
-
-The household's monthly medical deduction for the certification period shall be based on
-the information reported and verified by the household, any anticipated changes in the
-household's medical expenses that can be reasonably expected to occur during the
-certification period based on available information about the recipient's medical condition
-public or private insurance coverage and current verified medical expenses. If the change
-cannot be reasonably anticipated, the household shall have the non-reimbursable portion
-of the medical expense considered at the time the amount of the expense or
-reimbursement is reported and verified.
-
-3.
-
-If the household reports a change in its medical expenses, the local office shall verify the
-change and act on the change during the certification period if it will result in an increase
-to the household’s benefit allotment. The household shall not be contacted to verify a
-change discovered through another source.
-
-4.
-
-Households certified for twenty-four (24) months that incurred a one-time medical
-expense during the first twelve (12) months shall have the option of deducting the
-expense for one month, averaging the expense over the remainder of the first twelve (12)
-months of the certification period, or averaging the expense over the remainder of the
-certification period. One-time expenses reported after the twelfth (12th) month of the
-certification period will be deducted as a one-time monthly expense or averaged over the
-remaining months in the certification period, at the household's option.
-
-Verification of Child Support Expenses
-1.
-
-The local office shall accept any document that verifies the household's legal obligation to
-pay child support, such as a court or administrative order or legally enforceable
-separation agreement.
-
-2.
-
-The local office shall accept documentation verifying a household's actual payment of
-child support including, but not limited to, cancelled checks, wage withholding
-statements, verification of withholding from unemployment compensation and statements
-from the custodial parent regarding direct payments or third party payments that the
-noncustodial parent pays or expects to pay on behalf of the custodial parent.
-
-3.
-
-Documents that are accepted as verification of the household's legal obligation to pay
-child support shall not be accepted as verification of the household's actual monthly child
-support payments.
-
-4.
-
-In addition to requiring verification from the household, the local office shall be
-responsible for obtaining verification of the household's child support payments if the
-payments are made to the child support services agency. The local office shall give the
-household an opportunity to resolve any discrepancy between household verification and
-the verification received from the child support services agency.
-
-5.
-
-At recertification or periodic report, the local office shall require the household to re-verify
-the amount of legally obligated child support that a household member pays to a nonhousehold member and the actual monthly child support payments made.
-
-4.601
-
-GENERAL REQUIREMENTS FOR REPORTING CHANGES
-
-A.
-
-Households are only required to report and verify if the household’s combined gross income
-exceeds one hundred thirty percent (130%) of the Federal Poverty Level (FPL) for its household
-size.
-
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-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-B.
-
-Households shall be required to report any increase in income no later than ten (10) calendar
-days from the end of the calendar month in which the change occurred.
-
-C.
-
-The household shall be allowed to report changes in person, by telephone, in writing, or through
-the online system.
-
-4.602
-
-WHEN CHANGES ARE CONSIDERED REPORTED
-
-A.
-
-A change shall be considered to be reported as of the date the local office is notified of the
-change, if the required verification is received within ten (10) calendar days from the date the
-change is considered reported.
-If verification is obtained after the ten (10) calendar day timeframe, or during the adverse action
-period, the office shall consider the change reported on the day the verification is received.
-
-4.603
-
-HOUSEHOLD RESPONSIBILITY TO REPORT CHANGES
-
-A.
-
-Households shall report all changes related to their SNAP eligibility and benefits at the
-certification interview, including any changes that occurred between the date an application is
-submitted and the date of the interview. If a change is reported in an initial month and the
-application has not yet been processed, the local office shall act on the most current information.
-
-B.
-
-Households are required to report all changes in household circumstances when filing a
-recertification and periodic report.
-
-C.
-
-Able-Bodied Adults Without Dependents (ABAWD), as defined in Section 4.100, that do not meet
-an exemption, as outlined in Section 4.310.3, are required to report any changes in work hours
-that bring the individual below twenty (20) hours per week, averaged monthly.
-
-D.
-
-Households who have no gross income threshold or who are eligible to be certified with a gross
-income level of up to two hundred percent (200%) of the federal poverty level, as applicable to
-the household size, who are initially certified with income above one hundred thirty percent
-(130%) FPL shall not be required to report increases in the household’s combined gross income
-during the certification period.
-
-E.
-
-Households who have no gross income threshold or who are eligible to be certified with a gross
-income level of up to two hundred percent (200%) of the FPL, as applicable to the household
-size, who are initially certified with income below 130% FPL are required to report when the
-household’s combined gross income exceeds one hundred thirty percent (130%) FPL applicable
-to the household size. After the household reports its first increase in income above one hundred
-thirty percent (130%) FPL, the household shall not be required to report further increases in the
-household’s combined gross income for the remainder of the certification period.
-
-F.
-
-When a household submits a recertification or periodic report form and an interview is not
-conducted because one has been completed in the previous twelve month period, any changes
-that occur after the recertification or periodic report form was submitted are not required to be
-reported unless the change causes the household to exceed one hundred thirty percent (130%)
-FPL applicable to the household size. If an interview is scheduled with the household, then the
-household is required to report any changes that occur between the time the household
-submitted the recertification application or periodic report form and the date of the interview.
-
-G.
-
-Upon benefit approval at initial application, recertification and periodic change report, the
-household shall be provided with a notice of the gross income level that applies to its household
-size.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-H.
-
-All applicant and ongoing SNAP households are responsible to report whenever a member of the
-SNAP household wins substantial lottery or gambling winnings.
-
-4.604
-
-ACTION ON REPORTED CHANGES
-
-Changes shall be acted on in accordance with the following guidelines:
-A.
-
-General Requirements
-Changes to a household’s circumstances shall be acted on prospectively and processed within
-ten (10) calendar days from the date the change is reported. Changes reported by households
-shall be documented in the SNAP case record to indicate the change and the date that the
-change was reported. If the reported change causes a change to the household’s allotment, a
-notice of action form shall be issued to inform the household of a new basis of issuance and/or a
-supplemental allotment. If a supplemental allotment is to be issued, the amount of the
-supplemental allotment shall be the difference between the allotment the household is eligible to
-receive, due to the reported change, and the allotment the household received for the current
-month. The household's total monthly allotment shall be increased for all subsequent months of
-the certification period that are affected by the change.
-
-B.
-
-Changes Reported at Recertification and Periodic Report
-The local office shall act on all changes reported by households filing a recertification or periodic
-report. When a household reports information during the certification period that it was not
-required to report, the local office shall document the information in the case record. If the
-information is not acted upon because it would cause a reduction in benefits, and it does not meet
-the criteria outlined in D below, the local office shall review the information at the time of the
-household’s subsequent certification, or at the twelve (12) month periodic report for those
-households certified for twenty-four (24) months, to determine if the change should be acted upon
-when processing the recertification or periodic report.
-
-C.
-
-Changes Resulting In an Increase
-1.
-
-The local office shall act on any change reported by the household that will increase
-benefits. The increased allotment shall be made no later than the first allotment issued
-ten (10) or more calendar days after the change is reported. Any increase in benefits
-resulting from a change shall take effect the month following the month the change is
-considered reported. Therefore, if such a change is reported after the twentieth (20th) of
-a month, and it is not possible to adjust the following month's allotment before the
-household's next normal issuance day, a supplemental allotment (in addition to the
-previously authorized monthly allotment) must be issued within ten (10) calendar days
-from the date the change was reported. A supplemental allotment shall not be issued for
-the month in which the change occurred.
-
-2.
-
-Changes that result in increased SNAP benefits for a household must be verified by the
-household within ten (10) calendar days from the date the change is reported. If the
-household fails to provide verification, benefits shall remain at the original level until
-verification is obtained. Changes that result in increased SNAP benefits for a household
-must be verified prior to adjusting the household’s allotment.
-
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-
-D.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Changes Resulting in Allotment Decreases
-Changes that result in a decreased allotment shall be processed within ten (10) calendar days
-from the date the change is considered reported and made effective on the last day of the month
-in which the advance Notice of Adverse Action (NOAA) expires. The NOAA expires eleven (11)
-calendar days from the date it is issued or fifteen (15) calendar days for households participating
-in the address confidentiality program (ACP).
-The county local office shall not act on changes during the certification period that would
-decrease benefits, unless:
-
-E.
-
-1.
-
-The head of household requests that their case be closed;
-
-2.
-
-The head of household requests that any member be removed;
-
-3.
-
-An adult member requests to be removed from the case;
-
-4.
-
-An adult member requests themselves and their children be removed from the case;
-
-5.
-
-The agency has information about the household’s circumstances considered verified
-upon receipt;
-
-6.
-
-There has been a change in the household’s public assistance grant;
-
-7.
-
-The agency is acting on a mass change;
-
-8.
-
-A household who has no gross income threshold or who is eligible to be certified with a
-gross income level up to two hundred percent (200%) FPL as applicable to the household
-size, which is initially certified with income below one hundred thirty percent (130%) FPL
-has a change in income that causes the household’s combined gross monthly income
-during the certification period to exceed one hundred thirty percent (130%) FPL; or
-
-9.
-
-The agency has received information from the Prisoner Verification System or the
-Deceased Matching System that a household member is no longer residing in the home
-and the household has failed to respond to the notice of match, provided insufficient
-evidence to the contrary, or has confirmed the match.
-
-Changes Resulting in Ineligibility
-Changes that result in the household becoming ineligible shall be processed within ten (10)
-calendar days from the date the change is considered reported unless the change does not
-require adverse action. Changes resulting in ineligibility shall be made effective on the last day of
-the month in which the Notice of Adverse Action expires.
-
-F.
-
-Changes in Categorical Eligibility
-When a household reports a change during the certification period that results in it no longer
-meeting the criteria of the categorical eligibility tier for which it was originally certified, the
-household’s eligibility must be re-evaluated using the next appropriate category. If the reported
-change has not been verified, or is considered questionable, and it cannot be determined whether
-basic categorical eligibility, expanded categorical eligibility, or standard eligibility criteria should be
-used, a request for verification shall be initiated.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-G.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Changes in Household Composition
-1.
-
-Changes in household composition shall be acted on prospectively for the following
-month when the local office is able to affect the change prior to the determination of the
-household’s allotment for that month. Anticipated income, deductions and other financial
-and non-financial criteria of the new member shall be considered in the prospective
-determination. The anticipated income, deductions, and other financial and non-financial
-criteria of a removed member shall no longer be considered when determining the
-household’s eligibility.
-
-2.
-
-Individuals Disqualified During the Certification Period
-When an individual is disqualified during the household's certification period, the local
-office shall determine the eligibility or ineligibility of the remaining household members
-based on information contained in the case record. If information in the case record is
-insufficient, additional information shall be obtained as needed.
-
-H.
-
-a.
-
-If a household's benefits are reduced or terminated within the certification period
-because one or more of its members was disqualified for intentional program
-violation/fraud, the local office shall notify the remaining members of their
-eligibility and benefit level at the same time the disqualified member(s) is notified
-of his or her disqualification.
-
-b.
-
-If a household's benefits are reduced or terminated within the certification period
-because one or more of its members is disqualified for being an ineligible
-noncitizen, noncompliance with a work requirement, or for failure or refusal to
-obtain or provide a Social Security Number, the local office shall send a Notice of
-Adverse Action which informs the household of the disqualification, the reason
-for the disqualification, the eligibility and benefit level of the remaining members,
-and the actions the disqualified member must take to end the disqualification.
-
-Changes Reported During the Certification Period That the Household Is Not Required To Report
-When a household reports information during the certification period that it was not required to
-report, the local office shall document the information in the case record. If the information is not
-acted upon because it would cause a reduction in a household’s benefit allotment and it does not
-meet the criteria outlined in D above, the local office shall review the information at the time of the
-household’s subsequent certification, or at the twelve (12) month periodic report for those
-households certified for twenty-four (24) months to determine if the change should be acted upon
-at that time.
-
-4.604.1 Verification of Reported Changes
-Before action is taken on reported changes and to determine the effect on benefits, additional verification
-is required in the following instances:
-A.
-
-Unclear Information
-1.
-
-If the local office receives information about changes in a household's circumstances but
-cannot determine if or how the change will affect the household's benefits and the
-unclear information is:
-a.
-
-Fewer than sixty (60) days old relative to the current month of participation; and
-
-b.
-
-Was required to have been reported per simplified reporting rules; or
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-c.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Appears to present significantly conflicting information about the household’s
-circumstances from that used by the local office at the time of certification,
-including changes to the household’s categorical eligibility tier, then:
-
-The local office shall send a verification request notice requesting the household to
-provide the specific information or verification within ten (10) calendar days plus one (1)
-additional calendar day for mailing. Households participating in the Address
-Confidentiality Program (ACP) shall receive five (5) additional calendar days for mailing
-time. The local office shall assist the client in obtaining the verification if the household
-cannot obtain the information.
-If the household fails or refuses to provide the verification or to request assistance with
-obtaining the verification within the ten (10) calendar days plus one (1) additional
-calendar day for mailing timeframe, or five (5) additional calendar days mailing time for
-ACP households, the process for closing the case shall be initiated. The Notice of Action
-Form shall advise the household that a change occurred that could not be acted upon,
-that the case is being closed, and that the household must provide the needed
-verification if it wishes to continue participation in the program. The household may be
-required to reapply if the household takes the required action after a break in benefits of
-more than thirty (30) calendar days.
-
-B.
-
-2.
-
-If the information is more than sixty (60) days old relative to the current month of
-participation, was not required to be reported, or does not present significantly conflicting
-information from that used by the agency at the time of certification, the local office shall
-not act on this information or require the household to provide the information until the
-household’s next recertification or periodic report.
-
-3.
-
-Changes which result in increased SNAP benefits for a household shall be verified prior
-to adjusting the household’s allotment. If the household fails to provide verification,
-benefits shall remain at the original level until verification is obtained.
-
-Computer Matches Not Considered Verified Upon Receipt
-When information is received from a Prisoner Verification System indicating an individual is
-currently being held in a federal, state, or local detention or correctional institution for more than
-thirty (30) days or information is received from a Deceased Matching System indicating a
-household member has recently died, a notice of match shall be sent to the affected household
-prior to taking action to adjust or terminate the household’s benefits.
-The notice of match shall explain what information is needed to challenge the match and the
-consequences of failing to respond. The notice shall provide the household with ten (10) calendar
-days plus one (1) additional calendar day for mailing time to respond. Households participating in
-the ACP shall be provided five (5) additional calendar days for mailing time.
-If the household substantiates the match, fails to respond to the notice, or fails to provide
-sufficient verification to challenge the match results, the local office shall remove the subject
-individual from the SNAP household and adjust benefits accordingly following the procedures
-outlined in Section 4.604.
-If the household provides sufficient verification that the match is invalid, no further action shall be
-taken to remove the subject individual or adjust the household’s benefits. The case record shall
-be documented accordingly.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-4.605
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-FAILURE TO REPORT CHANGES
-
-If SNAP benefits are over-issued because a household fails to timely report changes as required, a claim
-shall be established. Upon the establishment of a claim, a notice of overpayment, a detailed explanation
-of why the claim was established, and a repayment agreement will be mailed to the household. If the
-discovery is made within the certification period, the household must be given advance notice of adverse
-action if its benefits are to be reduced.
-4.606
-
-PUBLIC ASSISTANCE (PA) HOUSEHOLD CHANGES
-
-A.
-
-Households that receive PA benefits which report a change in circumstances to the PA technician
-shall be considered to have reported the change for SNAP purposes. Information that is reported
-and verified to a PA program which results in a change to the PA benefit amount and that meets
-the SNAP rules for verification shall be considered VUR. The date the change is considered
-reported and verified is the date the PA program processes the change and authorizes the new
-PA benefit amount. When acting on information considered verified upon receipt (VUR), advance
-Notice of Adverse Action is required, except as noted in Section 4.608.1.
-
-B.
-
-When there is a change in a PA case and the local office has sufficient information to make the
-corresponding SNAP adjustment, the local office shall follow the guidelines listed below.
-1.
-
-2.
-
-If the change in household circumstances requires a reduction or termination of both PA
-and SNAP, the following action will be required:
-a.
-
-Send Notices of Action for both programs simultaneously with both notices
-bearing the same effective date.
-
-b.
-
-If a household requests a fair hearing any time prior to the effective date of the
-Notice of Adverse Action, and its certification period has not expired, the
-household's participation in the program shall be continued on the basis
-authorized immediately prior to the Notice of Adverse Action, unless the
-household specifically waives continuation of benefits. Continued benefits shall
-not be issued for a period beyond the end of the current certification period.
-
-c.
-
-If the household appeals only a PA adverse action and is granted interim relief,
-SNAP benefits authorized prior to the adverse action shall continue or be
-restored. However, the household must reapply if the SNAP certification period
-expires before the hearing process is completed.
-
-d.
-
-If the household does not appeal the adverse action to decrease the PA or SNAP
-benefits within the adverse action period, the changes shall be made in
-accordance with timeframes outlined in Section 4.603.
-
-If the change requires a reduction or termination of PA benefits and/or increases in SNAP
-benefits, the following action will be required:
-a.
-
-A PA Notice of Adverse Action shall be issued to the household and SNAP
-benefits shall not be increased until the adverse action period expires. If the
-household does not appeal, the increase shall be effective in accordance with
-Section 4.604. The time limit for taking the action to increase SNAP benefits shall
-be calculated from the date the PA Notice of Adverse Action expires. The Notice
-of Adverse Action expires eleven (11) calendar days from the date it is issued or
-fifteen (15) calendar days for households participating in the address
-confidentiality program (ACP).
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-b.
-
-3.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-If the household requests a PA appeal and is granted interim relief, the
-household is entitled only to SNAP benefits that were authorized immediately
-prior to the PA adverse action and action must be taken to correct the current
-basis of issuance. A SNAP claim must be made against the household if there
-was an over-issuance for the period pending the appeal decision.
-
-When there is a change in a PA case which results in a termination of PA but there is
-insufficient information to determine SNAP eligibility, the local office shall follow the
-guidelines listed below:
-a.
-
-The PA Advance Notice of Adverse Action and a verification request notice are
-issued simultaneously. The PA notice makes the action effective on the last day
-of the month the notice is sent (or the last day of the following month, as
-appropriate, to allow for the required advance notice period). The routine
-extension on SNAP notices allows the household time to reapply for benefits at
-the appropriate local office.
-The verification request notice shall advise the household of the information that
-needs to be verified for the household to continue to receive SNAP benefits. The
-eligibility technician shall not take any further action until the PA Notice of
-Adverse Action period expires or until the household requests an appeal. If the
-household does not appeal the PA action and request a continuation of benefits,
-the agency may resume action on the reported change.
-Depending on the response or non-response to the verification request, the
-eligibility technician shall adjust the household's benefits if the verification of the
-household circumstances is received, or issue a Notice of Adverse Action to
-close the household's case if the household does not respond or refuses to
-provide information.
-
-4.
-
-C.
-
-b.
-
-Households requesting a SNAP appeal may be entitled to continued benefits.
-
-c.
-
-If the household requests only a PA state appeal and is granted interim relief,
-SNAP benefits authorized immediately prior to the adverse action will continue or
-be restored.
-
-If the situation does not require a PA Notice of Adverse Action, the local office shall act
-based on the normal change reporting processing time frames and provide proper
-noticing as described in this section.
-
-Local offices shall ensure that there is no increase in SNAP benefits to households as the result
-of a penalty being imposed for an IPV or failure to comply with program requirements for a
-federal, state, or local means-tested program that distributes publicly funded benefits.
-The local office shall calculate the SNAP allotment using the benefit amount that would be issued
-by the federal, state, or local means-tested program if no penalty had been imposed to reduce the
-benefit amount. A situation where benefits of the other program are being frozen at the current
-level shall not constitute a penalty subject to these provisions. Changes in household
-circumstances that are not related to the penalty and result in an increase in SNAP benefits shall
-also not be affected by these provisions.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-4.607
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-MASS CHANGES
-
-There are certain changes that occur which are not caused by the household, and which affect a mass
-portion of the SNAP caseload simultaneously. Such adjustments go into effect for all households at a
-specific point in time, and the local office will have full prior knowledge of the change. Such changes are
-generally initiated because of a change in state or federal regulations. When such changes occur, the
-local office shall be responsible for making the appropriate adjustments in the household's eligibility or
-allotment as directed by the State Department and noticing the client as outlined below:
-A.
-
-Federal adjustments to eligibility standards, allotments, and deductions; state adjustments to the
-Standard Utility Allowance; and any federal reduction, cancellation, or suspension of SNAP
-benefits.
-These mass changes shall not require Advance Notice of Adverse Action to affected households;
-however, households shall be notified of such changes through the news media; posters in
-certification or issuance offices, or other locations frequented by participating households; or
-general notices mailed to participating households. Adjustments to federal standards and state
-adjustments to utility standards shall be implemented prospectively.
-
-B.
-
-Mass changes in PA grants, such as state-only OAP and AND; and Cost of Living Adjustments
-(COLA), increases in federal Retirement, Survivors, and Disability Insurance (RSDI), SSI benefits
-(Title XVI), and amendments to the Social Security Act (Title II).
-These mass changes shall require a Notice of Adverse Action when SNAP benefits are
-decreased or terminated. Such Notice for these mass changes shall be provided to the household
-as much before the household's scheduled issuance date as reasonably possible, although the
-Notice need not be given any earlier than the time required for advance Notice of Adverse Action,
-per Section 4.608. Mass changes shall be processed prospectively for all households.
-1.
-
-At a minimum, affected households shall be informed of:
-a.
-
-The general nature of the change;
-
-b.
-
-Examples of the change's effect on household's allotments;
-
-c.
-
-The month in which the change will take effect;
-
-d.
-
-The household's right to a fair hearing;
-
-e.
-
-The household's right to receive a continuation of benefits if the following criteria
-are met:
-1.
-
-The household has not specifically waived its right to a continuation of
-benefits;
-
-2.
-
-The household requests a fair and the request for a hearing is based
-upon improper computation of SNAP eligibility or benefits, or upon
-misapplication or misinterpretation of state rules, or federal law or
-regulation.
-
-f.
-
-The household's liability for any over-issued benefits if the hearing decision is
-adverse to the household
-
-g.
-
-General information on whom to contact for additional information.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-2.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Processing Mass Changes in PA
-PA grant cost-of-living increases and Social Security Act/SSI cost-of-living increases are
-treated as mass changes in SNAP. Mass changes shall be processed prospectively for
-all households. SNAP benefits shall be recalculated, and the change shall be effective in
-the same month as the change in the PA grant. If the local office has at least thirty (30)
-calendar days’ advance knowledge of the amount of the PA adjustment, the SNAP
-benefits shall be recalculated, and the change shall be effective in the same month as the
-change in the PA grant. In cases where the local office does not have thirty (30) calendar
-days’ advance notice, the SNAP change shall be made effective no later than the month
-following the month in which the PA grant was changed.
-
-4.608
-
-ADVANCE NOTICE OF ADVERSE ACTION
-
-A.
-
-The local office shall notify a household of any change from its prior benefit level, the reason for
-the action and the date the action becomes effective on the Notice of Action form except as
-specified in Section 4.608.1. The Notice of Overpayment form is used as the Notice of Adverse
-Action for claims and the resulting recoupment for failure to respond.
-
-B.
-
-Households shall receive advance Notice of Adverse Action, giving at least ten (10) calendar
-days advance notice, plus one additional calendar day for mailing time, before any adverse
-action, such as a benefit reduction, suspension, termination or denial, becomes effective during
-the certification period, except as specified in Section 4.608.1. Households participating in the
-address confidentiality program (ACP) shall receive five (5) additional calendar days for mailing
-time.
-When acting on a change, if the ten (10) calendar day advance notice period, plus the additional
-calendar day(s) for mailing time, can be given in the month the Notice of Adverse Action is sent,
-the notice shall be effective on the last day of the month the notice is sent.
-If the ten (10) calendar day advance notice period, plus the additional calendar day(s) for mailing,
-extends into the following month, the notice shall be effective on the last day of the month the
-notice expires. The notice of adverse action expires eleven (11) calendar days from the date it is
-issued or fifteen (15) calendar days for households participating in the ACP. The notice shall
-explain the reason for the proposed action and the date the action becomes effective.
-If the advance notice period ends on a weekend or holiday and a request for a fair hearing and
-continuation of benefits are received the business day after the weekend or holiday, the request
-shall be considered timely received.
-For changes that result in a decreased allotment or ineligibility, the local office shall issue a notice
-of adverse action within ten (10) calendar days of the date the change is considered reported,
-which will affect the next regularly scheduled allotment after the month in which the advance
-Notice of Adverse Action period expires.
-
-C.
-
-Prior to the effective date of the Notice of Adverse Action, a participant household may request a
-conference with the staff of the certification office responsible for the decision to take the adverse
-action, or the household may file an appeal of such action.
-
-D.
-
-The participant household may also, prior to the effective date of the Notice of Adverse Action,
-either before or after the conference, appeal the proposed action. Households that timely request
-a hearing may be entitled to continued benefits. The eligibility technician shall explain to the
-household that a demand will be made for any benefits determined by the hearing officer to have
-been over-issued.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.608.1 Changes Not Requiring Advance Notice of Adverse Action
-Advance Notice of Adverse Action may be given, but is not required in the following situations:
-A.
-
-The state department initiates mass changes outlined in Section 4.607, A. Such changes must be
-publicized in advance. Announcements may be handed out or mailed to affected participant
-households.
-
-B.
-
-The local office determines based on reliable information that meets verification requirements that
-all members of a household have died.
-
-C.
-
-The local office determines based on reliable information that meets verification requirements that
-the household has moved from the project area.
-
-D.
-
-The household has been receiving an increased allotment to restore lost benefits, the restoration
-is complete, and the household was previously notified in writing of when the increased allotment
-would terminate.
-
-E.
-
-The household's allotment varies from month to month within the certification period to consider
-changes that were anticipated at the time of certification, and the household was notified at the
-time of certification.
-
-F.
-
-The household applied for PA and SNAP jointly and has been receiving SNAP benefits pending
-the approval of the PA grant and was notified at the time of certification that SNAP benefits would
-be reduced upon approval of the PA grant.
-
-G.
-
-The certification office has elected to assign a longer certification period to a household certified
-on an expedited basis and for whom verification was postponed provided the household has
-received prior written notice that verification may result in a reduction in benefits.
-
-H.
-
-As a result of the facility's loss of state or USDA/FNS authorization, the local office terminates
-eligibility of those residents in a drug or alcohol treatment center or group living arrangement, who
-are certified with the facility acting as authorized representative.
-
-I.
-
-A household member is disqualified for an IPV/fraud or the benefits of the remaining household
-members are reduced or terminated to reflect the disqualification of that household member.
-
-J.
-
-Converting a household from cash and/or SNAP repayment for claims to allotment reduction
-because of a failure to make agreed-on repayments.
-
-K.
-
-The household was issued a repayment agreement for a claim and failed to respond. For
-households participating in the program that do not respond to the repayment agreement, benefit
-recoupment will be initiated.
-
-L.
-
-A change that is reported at recertification for a household certified for six (6) months, or at
-periodic report for a household certified for twenty-four (24) months, which results in a decrease
-to the household’s SNAP allotment.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-4.609
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-TRANSITIONAL SNAP (T-SNAP)
-
-4.609.1 GENERAL ELIGIBILITY GUIDELINES
-A.
-
-Households that receive SNAP and Colorado Works (CW) basic cash assistance that become
-ineligible for continued receipt of CW basic cash assistance because of changes in household
-income are eligible to receive T-SNAP, as provided for within this section. CW diversion
-payments are not considered basic cash assistance. CW basic cash assistance is defined in
-CDHS regulations at 9 CCR 2503-6.
-
-B.
-
-Households that are eligible to receive T-SNAP will have the SNAP allotment continued for five
-(5) months. The household’s SNAP allotment will be continued in an amount based on what the
-household received prior to when the household’s income made them ineligible for CW basic
-cash assistance. Only the following four (4) changes will be acted upon when determining the
-SNAP allotment that is to be continued.
-1.
-
-The loss of the CW cash grant;
-
-2.
-
-Changes in household composition that result in a household member leaving and
-applying for SNAP in another household;
-
-3.
-
-Updates to the SNAP eligibility standards that change each October 1 because of the
-annual cost-of-living adjustments (see Section 4.607); and,
-
-4.
-
-Imposing an IPV disqualification.
-
-C.
-
-When the SNAP allotment is continued, the household’s existing certification period shall end,
-and the household shall be assigned a new five (5) month certification period. The recertification
-requirements that would normally apply when the household's certification period ends must be
-postponed until the end of the five (5) month transitional certification period.
-
-D.
-
-Households who are denied or not eligible for T-SNAP must have continued eligibility and benefit
-level determined in accordance with Section 4.604.
-
-E.
-
-The following households are not eligible to receive T-SNAP:
-1.
-
-Households leaving the CW program due to a CW sanction; or,
-
-2.
-
-Households that are ineligible to receive SNAP because all individuals in the household
-meet one of the following criteria:
-a.
-
-Disqualified for IPV;
-
-b.
-
-Ineligible for failure to comply with a work requirement;
-
-c.
-
-Ineligible student;
-
-d.
-
-Ineligible non-citizen;
-
-e.
-
-Disqualified for failing to provide information necessary for making a
-determination of eligibility or for completing any subsequent review of its
-eligibility;
-
-f.
-
-Disqualified for receiving SNAP benefits in more than one household in the same
-month;
-
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-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-g.
-
-Disqualified for being a fleeing felon; or
-
-h.
-
-ABAWDs who fail to comply with the requirements of Section 4.310.
-
-4.609.2 HOUSEHOLD CHANGES DURING THE TRANSITIONAL PERIOD [Rev. eff. 2/1/16]
-A.
-
-The household is not required to report any changes during the five (5) month transitional period,
-including changes that put the household over one hundred thirty percent (130%) of the Federal
-Poverty Level (FPL).
-
-4.609.3 CLOSING THE TRANSITIONAL PERIOD [Rev. eff. 2/1/16]
-In the final month of the transitional period, the household must undergo the recertification process to
-determine the household’s continued eligibility and benefit amount.
-4.609.4 HOUSEHOLDS WHO RETURN TO COLORADO WORKS (CW) DURING THE TRANSITIONAL
-PERIOD
-If a household receiving T-SNAP returns to CW during the transitional period, the local office shall
-complete the recertification process for SNAP to determine the household’s continued eligibility and
-benefit amount. If the household remains eligible for SNAP, the household shall be assigned a new
-certification period.
-4.609.5 HOUSEHOLDS WHO REAPPLY FOR SNAP DURING THE TRANSITIONAL PERIOD [Rev. eff.
-2/1/16]
-A.
-
-B.
-
-At any time during the transitional period, the household may apply for recertification to determine
-if the household is eligible for a higher SNAP allotment. In determining if the household is eligible
-for a higher allotment, all changes in household circumstances shall be acted upon.
-1.
-
-If the household is determined eligible for a benefit lower than its transitional benefit, the
-local office shall encourage the household to withdraw its application for recertification
-and continue to receive transitional benefits. If the household chooses not to withdraw its
-application, the local office shall deny the application and allow the transitional period to
-run its course.
-
-2.
-
-If the household is eligible for benefits higher than its transitional benefit amount, the
-increased benefits shall take effect with the first day of the month following the month in
-which the reapplication was received. The transitional certification period shall be ended,
-and the household shall be assigned a new certification period that begins with the first
-day of the month following the month in which the household submitted the application for
-recertification.
-
-If a household applies for recertification during its transitional period, the local office shall observe
-the following procedures:
-1.
-
-The local office must schedule and complete an interview if one has not been completed
-within the previous 12 months.
-
-2.
-
-The local office must provide the household with a notice of required verification and
-provide the household a minimum of ten (10) calendar days to provide the required
-verification.
-
-3.
-
-Households shall be notified of their eligibility or ineligibility as soon as possible, but no
-later than thirty (30) calendar days following the date the application was filed.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-a.
-
-If the local office does not determine a household's eligibility within thirty (30)
-calendar days following the application date, then the local office shall continue
-processing the application while continuing the household's transitional benefits.
-
-b.
-
-If the application process cannot be completed because the household failed to
-take a required action, the local office may deny the application at that time or at
-the end of the thirty (30) calendar days.
-
-c.
-
-If the household is determined to be ineligible, the local office shall deny the
-household's application for recertification and continue the household's
-transitional benefits to the end of the transitional benefit period, at which time the
-local office shall recertify the household in accordance with Section 4.209.
-
-4.609.6 TRANSITIONAL NOTICE REQUIREMENTS
-When a household is approved for T-SNAP, the household shall be notified of the following information:
-A.
-
-A statement informing the household that it will be receiving transitional benefits and the length of
-its transitional period;
-
-B.
-
-A statement informing the household that it has the option of applying for recertification at any
-time during the transitional period. The household must be informed that if it does not apply for
-recertification during the transitional period, then at the end of the transitional period the
-household must undergo the recertification process;
-
-C.
-
-A statement that if the household returns to CW during its T-SNAP period, the household must
-undergo the recertification process to determine the household’s continued eligibility and new
-SNAP allotment;
-
-D.
-
-A statement explaining any changes in the household's benefit amount due to the loss of
-Colorado Works basic cash assistance or due to changes outlined in Section 4.609.1, B and C;
-
-E.
-
-A statement informing the household that it is not required to report and provide verification for
-any changes in household circumstances until the household completes the recertification
-process; and,
-
-F.
-
-A statement informing the household that the local office will not act on changes that the
-household reports during the transitional period and that if the household experiences a decrease
-in income or an increase in expenses or household size prior to that deadline, the household
-should apply for recertification.
-
-4.610
-
-REINSTATEMENT OF BENEFITS
-
-A household may be eligible for a reinstatement of benefits, without filing a new application, during the
-remaining month(s) of the certification period if the reason for the original closure has been resolved and
-eligibility may be reestablished.
-The local office may reinstate the household if the household reports and verifies a reported change in
-circumstances that reestablishes the household’s eligibility within 30 calendar days following the date of
-ineligibility. Within standard processing timeframes, the local office will review the case to determine if the
-household continues to meet all other eligibility requirements.
-If eligible for reinstatement, the local office will prorate SNAP benefits from the date the household took all
-required action(s) to reestablish eligibility.
-
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-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-If the certification period has already ended or will end during the month the household is attempting to
-reestablish eligibility, a new application is needed.
-4.700
-
-SNAP BENEFIT ISSUANCE
-
-CO/EBTS will allow electronic debiting of benefits onto an EBT card for certified eligible households.
-Every household must be informed of the issuance accommodations that are available.
-Local offices must provide an adequate number of issuance locations and hours of operation to allow all
-eligible households to receive their EBT) cards.
-As SNAP is a national program, benefits issued to eligible households may be used for the purchase of
-eligible food in every state.
-4.701
-
-PROVIDING BENEFITS TO PARTICIPANTS
-
-A.
-
-Local offices are responsible for the timely and accurate issuance of benefits to certified eligible
-households. All newly certified households, except those that are given expedited service, shall
-be given an opportunity to participate no later than thirty (30) calendar days following the date the
-application was filed. Day one (1) is the first calendar day after the application is received by a
-local office in the household’s county of residence. An opportunity to participate consists of
-providing households with an active EBT card and Personal Identification Number (PIN), posting
-benefits to the household’s EBT account, and having benefits available for spending. Local
-offices utilizing a mailing system must mail EBT cards and pins, if applicable, in time to assure
-that the benefits can be spent after they are received but before the thirty (30) day standard if the
-EBT card or pin is mailed on the twenty-ninth (29th) or thirtieth (30th) day. For households
-entitled to expedited service, the local office shall make benefits available to the household not
-later than the seventh (7th) calendar day following the date of application, and for mail card
-issuance, the EBT card shall be mailed no later than the end of the fifth (5TH) calendar day. Local
-offices that issue EBT cards by mail shall, at a minimum, use first-class mail and sturdy nonforwarding envelopes or packages to send EBT cards to households, and the EBT card and PIN
-must be mailed separately from one another.
-
-B.
-
-Those households composed of persons who are: aged sixty (60) and older; or persons with a
-disability who have difficulty reaching issuance offices, as described in section 4.707, D;
-households which do not reside in a permanent dwelling or have a fixed mailing address; and
-those in remote, rural areas shall be given assistance in obtaining their EBT card. The local office
-shall assist these households by arranging for the mail issuance of EBT cards to them, by
-assisting them in finding authorized representatives who can act on their behalf, or by using other
-appropriate means.
-
-C.
-
-The eligibility technician shall be sufficiently familiar with issuance operations to answer any
-questions the household may have about when, where, and how to access one’s benefits from
-the EBT card.
-
-4.701.2 EBT Cards
-A.
-
-Certification units of local offices shall issue a Colorado Electronic Benefits Transfer System
-(CO/EBTS) debit card to each certified household. All cards shall be issued under the Social
-Security Number or client ID number of the household member or authorized representative who
-is authorized to receive the household's issuance as designated by the household.
-
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-
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-Effective Date: 10/01/2024
-
-B.
-
-The household, or the authorized representative, shall present the household's Colorado
-Electronic Benefits Transfer System (CO/EBTS) debit card at issuance points, retail outlets, or
-meal services in order to transact the allotment authorization or when exchanging benefits for
-eligible food.
-
-C.
-
-The EBT card shall contain a space for the name and signature of the household member to
-whom the allotment is to be issued or for any authorized representatives designated by the
-household.
-
-D.
-
-The local office shall limit issuance of EBT cards to the time of initial certification, with
-replacements made only in instances when the EBT card is lost, mutilated, destroyed, or if there
-are changes in the person authorized to obtain benefits, or when the local office determines that a
-new EBT card is needed. Whenever possible, the local office shall collect the EBT card that it is
-replacing. The issuance unit must be notified of a replacement EBT card to assure that only the
-most recently issued EBT card is used for benefit issuance.
-
-E.
-
-EBT cards can be used in the following circumstances:
-1.
-
-Eligible household members sixty (60) years of age or over or members who are
-housebound, physically handicapped, or otherwise a person with disabilities to the extent
-that they are unable to adequately prepare all their meals, and their spouses, may use
-benefits to purchase meals prepared for and delivered to them by a nonprofit meal
-delivery service authorized by USDA/FNS.
-
-2.
-
-Eligible household members sixty (60) years of age or over and their spouses may use
-benefits issued to them to purchase meals prepared especially for them at communal
-dining facilities authorized by USDA/FNS for that purpose.
-
-F.
-
-EBT cards shall be kept in secure storage with access limited to authorized personnel only.
-
-4.702
-
-RESTORATION OF LOST BENEFITS
-
-4.702.1 Eligibility for Restoration of Lost Benefits
-A.
-
-To be eligible for restored benefits, the household must have had its SNAP benefits wrongfully
-delayed, denied, or terminated. Delay shall mean that an eligibility determination was not
-accomplished within processing timeframe standards.
-
-B.
-
-A restoration of benefits is warranted when a household has received fewer benefits than it was
-eligible to receive due to:
-
-C.
-
-1.
-
-An error by the local office;
-
-2.
-
-A court decision overturning or reversing a disqualification for IPV; or
-
-3.
-
-A determination by a court that the household should have received more benefits than it
-received during a given issuance period.
-
-In the event that a restoration is warranted, benefits shall be restored for not more than twelve
-(12) months prior to whichever of the following occurred first:
-1.
-
-The date the local office was notified, in writing or orally, by the household or by another
-person or agency that a household received fewer benefits than it was eligible to receive;
-
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-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-2.
-
-The date the local office discovers through the normal course of business that an error
-occurred which lead to the loss of benefits for a specific household; or,
-
-3.
-
-The date the household requested a fair hearing to contest the adverse action that
-resulted in the loss.
-When determining the months for which a household may be entitled to restorations,
-month one (1) shall be the month prior to the month in which the error was discovered.
-
-D.
-
-If the restoration is the result of a judicial action, the amount to be restored shall be determined as
-follows:
-1.
-
-If the judicial action is the first action the household has taken to obtain a restoration of
-lost benefits, then benefits shall be restored for a period of not more than twelve (12)
-months prior to the date the court action was initiated.
-
-2.
-
-If the judicial action is a review of an action taken by the local office, the benefits shall be
-restored for a period of no more than twelve (12) months prior to the first of either:
-a.
-
-The date the local office was notified by the household or by another person or
-agency in writing, or orally, of the possible loss to the household, or,
-
-b.
-
-The date the household requested a fair hearing.
-
-E.
-
-In no case shall benefits be restored for more than twelve (12) months prior to the date the local
-office is notified of, or discovers, the loss. Benefits shall be restored even if the household is
-currently ineligible.
-
-F.
-
-In the event that the State orders a reduction or cancellation of benefits, those households whose
-allotments are reduced or cancelled as a result of the enactment of those procedures are not
-entitled to restoration of lost benefits. If the Secretary of Agriculture directs the State to restore
-reduced or cancelled benefits, the local office shall work promptly to issue such benefits.
-
-4.702.2 Disputed Benefits
-A.
-
-If a household does not agree with any action taken by the local office to restore lost benefits or
-the amount of benefits determined to have been lost, the household may request a fair hearing
-within ninety (90) calendar days of the notice to the household of entitlement to a restoration. If
-such a request is made before or during the time period for which lost benefits are being restored,
-the local office will continue to issue the under-issued benefits pending the decision of the fair
-hearing. Once a final decision is reached, the local office shall restore benefits in accordance with
-the decision.
-
-B.
-
-If the household requests a fair hearing to dispute the local office’s determination that the
-household is not eligible for restored benefits, restored benefits for the period in question shall not
-be issued to the household while awaiting the final agency decision.
-
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-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.702.3 Lost Benefits Due to Fraud Reversal
-Individuals disqualified for intentional Program violation/fraud are not entitled to a restoration of any
-benefits lost during the months they were disqualified unless the decision which resulted in
-disqualification is subsequently reversed. For each month the individual was disqualified, not to exceed
-twelve (12) months, the amount to be restored, if any, shall be determined by comparing the allotment the
-household received with the allotment the household would have received had the disqualified member
-been allowed to participate. If the household received a smaller allotment than it should have received,
-the difference equals the amount to be restored.
-Participation in an administrative disqualification hearing (state or local) or referral for prosecution in
-which a person contests the local office's assertion that the individual committed an intentional program
-violation/fraud will be considered a request for restored benefits. If such a person is found to have
-committed intentional program violation by the State Department final agency decision and this decision
-is subsequently overturned by a court of law, the restoration of benefits shall be calculated for a period
-not to exceed twelve (12) months prior to the date of the original administrative hearing.
-4.702.4 Errors by the SSA Office
-The local office shall restore to the household any benefits lost as the result of an error by the local office
-or by the SSA through joint processing.
-Benefits shall be restored back to the date of a client’s release from a public institution if, while in the
-institution, the client jointly applied for SSI and SNAP, but the local office was not notified on a timely
-basis of the client’s release.
-4.703
-
-CALCULATING LOST BENEFITS
-
-After correcting the loss for future months and excluding those months which occurred prior to the twelve
-(12) month restriction, the following method will be used to calculate the amount of benefits to be
-restored:
-A.
-
-B.
-
-If the household was eligible but received an incorrect allotment, the loss of benefits shall be
-calculated only for those months the household participated. If the loss was caused by an
-incorrect delay, denial, or termination of benefits, the month the loss initially occurred will be
-calculated as follows:
-1.
-
-If an eligible household's application was erroneously denied, the month the loss initially
-occurred shall be the month of application or for an eligible household filing a timely
-reapplication, the first month of the new certification period.
-
-2.
-
-If an eligible household's application was delayed, the months for which benefits may be
-lost shall be calculated.
-
-3.
-
-If a household's benefits were erroneously terminated, the month the loss initially
-occurred shall be the first month benefits were not received as a result of the erroneous
-action.
-
-After computing the date the loss initially occurred, the loss shall be calculated for each month
-subsequent to that date until either the first month the error is corrected or the first month the
-household is found ineligible, not to exceed twelve (12) months prior to the date the loss was
-discovered.
-
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-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.704
-
-METHOD OF RESTORATION
-
-A.
-
-Regardless of whether a household is currently eligible or ineligible, the local office shall restore
-lost benefits to a household by issuing an allotment equal to the amount of benefits that were lost.
-The amount restored shall be issued in addition to the allotment currently eligible households are
-entitled to receive for the next month.
-
-B.
-
-Whenever lost benefits are due to a household and the household's membership has changed,
-the local office shall restore the lost benefits to the household containing a majority of the
-individuals who were household members at the time the loss occurred. If the local office cannot
-locate or determine the household which contains a majority of household members, the local
-office shall restore the lost benefits to the household containing the person who was the head of
-the household at the time the loss occurred.
-
-C.
-
-Each local office shall be responsible for maintaining an accounting system for documenting a
-household's entitlement to the restoration of lost benefits and for recording the balance of lost
-benefits that must be restored to the household. Each local office shall, at minimum, document
-how the amount to be restored was calculated and the reason lost benefits must be restored. The
-accounting system shall be designed to readily identify those situations where a claim against a
-household can be used to offset the amount to be restored.
-
-4.705
-
-WHEN AN INCREASE TO SNAP BENEFITS SHOULD NOT BE ISSUED
-
-A.
-
-Local offices shall ensure that there is no increase in SNAP benefits to households as the result
-of a penalty being imposed for an IPV, or for failure to comply with work requirements, or for
-failure to comply with another program requirement for a federal, state, or local means-tested
-program that distributes publicly funded benefits.
-
-B.
-
-To determine the SNAP allotment when there is such a decrease, the local office shall calculate
-the allotment using the benefit amount which would be issued by that program if no penalty had
-been imposed to reduce the benefit amount. A situation where benefits of the other program are
-being frozen at the current level shall not constitute a penalty subject to these provisions.
-Changes in household circumstances that are not related to the penalty and result in an increase
-in SNAP benefits shall also not be affected by these provisions.
-
-4.706
-
-REPLACEMENT ISSUANCES TO HOUSEHOLDS DUE TO MISFORTUNE
-
-A.
-
-A household may request a replacement issuance if food purchased with program benefits was
-destroyed in a household misfortune, such as, but not limited to, fire or flood. Replacement
-issuances shall be provided in the amount of the loss to the household, not to exceed one
-month's allotment, unless the issuance includes restored benefits that shall be replaced up to
-their full value. To qualify for a replacement, the household shall report the destruction to the local
-office within ten (10) calendar days of the incident.
-The household shall sign and return a statement or an Affidavit for Food Destroyed in Misfortune
-to the local office within ten (10) calendar days of the date of the report, or benefits shall not be
-replaced. If the tenth (10th) day falls on a weekend or holiday, and the statement or Affidavit for
-Food Destroyed in Misfortune is received the day after the weekend or holiday, the local office
-shall consider the statement or affidavit timely received.
-The statement or affidavit shall:
-1.
-
-Attest to the destruction of the food purchased with the household's SNAP benefits;
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-2.
-B.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-State that the household is aware of the penalties for intentional misrepresentation of the
-facts.
-
-Upon receiving a request for replacement of SNAP benefits for food reported as destroyed in an
-individual household misfortune, the local office shall:
-1.
-
-Verify the disaster through either a collateral contact, documentation from a community
-agency including, but not limited to, the fire department or the Red Cross, or a home visit;
-
-2.
-
-Issue replacement benefits within ten (10) calendar days of the report of loss, provided a
-signed statement of loss or an Affidavit for Food Destroyed in Misfortune is received. If
-the statement of loss is received on the ninth (9th) or tenth (10th) day after the report of
-loss, the issuance must be replaced within two (2) business days; and,
-
-3.
-
-Document in the case record the date and reason that a replacement has been provided.
-This provision shall apply in cases of an individual household misfortune, such as a fire,
-as well as in natural disasters affecting more than one (1) household. No limit on the
-number of replacements shall be placed on food purchased with SNAP benefits that were
-subsequently destroyed in a household misfortune.
-
-4.706.1 Disaster and Replacement Allotments
-Where USDA/FNS has issued a disaster declaration of individual assistance, individuals in a household
-who are eligible for emergency SNAP benefits shall not receive both the disaster allotment and a
-replacement allotment.
-4.706.2 Replacement of EBT Cards Lost in the Mail or Stolen Prior to Receipt by the Household
-Local offices shall comply with the following procedures in replacing EBT cards reported lost in the mail or
-stolen from the mail prior to receipt by the household.
-A.
-
-Determine if the EBT card was mailed, if sufficient time has elapsed for delivery, or if the card
-was returned in the mail to the local office.
-
-B.
-
-Issue a replacement EBT card and new PIN.
-
-C.
-
-Take other action, such as correcting the address on the master issuance file by updating the
-households mailing and/or home address within the automated system.
-
-4.706.3 Request for Replacement Issuances after Receipt of EBT Card
-Households cannot receive a replacement allotment of SNAP benefits that have been reported as stolen
-and used from the EBT card by someone without the household’s knowledge and consent. An EBT card
-received by a household and subsequently mutilated or found to be improperly manufactured shall be
-replaced.
-4.706.4 Authorized Number of Replacement Issuances
-No limit on the number of replacements shall be placed on the replacement of benefits if the food
-purchased with SNAP benefits was destroyed in a household misfortune.
-The local office shall deny or delay replacement issuances in cases in which available documentation
-indicates that the household's request for replacement appears to be fraudulent.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-When a local office intends to deny or delay a replacement of SNAP benefits for any reason, the local
-office shall notify the household of the delay or denial through use of a Notice of Action form. The
-household shall be informed of its right to a county dispute resolution conference or state-level fair
-hearing to contest the denial or delay of a replacement issuance. Replacement shall not be made while
-the denial or delay is being appealed.
-Replacement issuances shall be provided to households within ten (10) calendar days after report of loss
-(fifteen (15) days if issuance was by certified or registered mail) or within two (2) working days of
-receiving the signed household statement, whichever date is later.
-When a request for replacement is made late in an issuance month, the replacement will be issued in the
-month after the month in which the original allotment was issued. All replacements shall be posted and
-reconciled to the month of issuance of the replacement.
-4.707
-
-SNAP ISSUANCE AND ACCOUNTABILITY
-
-A.
-
-Local offices shall establish issuance and accountability systems to comply with these rules and
-to ensure that: only certified eligible households receive benefits; EBT cards are accepted,
-stored, and protected after delivery to receiving points; benefits are timely distributed in the
-correct amounts; and that benefit issuance and reconciliation are properly conducted and
-accurately reported.
-
-B.
-
-Electronic benefit issuance shall be handled through the state department, and at designated
-contractor sites through the Colorado Electronic Benefit Transfer System (CO/EBTS).
-
-C.
-
-Local offices shall assure a separation of certification functions from issuance functions and
-thereby provide for internal controls and prevention of fraud. Certification functions include
-determining eligibility for a household and ensuring that the eligibility is current and accurate.
-Eligibility shall be updated and maintained in the automated system. It shall be the responsibility
-of the certification unit to complete all necessary actions in the automated system to authorize the
-issuance of benefits. Data entry of case information may be completed by either the certification
-unit or a separate data entry unit, but not by the issuance unit.
-
-D.
-
-Issuance offices are responsible for the timely and accurate issuance of SNAP benefits to eligible
-participant households. An approved accountability and benefit issuance delivery system shall be
-established to ensure that eligibility information is data entered, that the automated system has
-an issuance available, and only certified households receive benefits.
-
-4.707.1 Security Procedures
-The electronic benefit issuance area shall be physically separated, such as, but not limited to, the cage,
-counter, and railing, from both clients and other employees of the office who are not responsible for
-benefit issuance and accountability. Persons not specifically responsible for benefit issuance
-accountability shall also be barred from the electronic benefit card storage area.
-Local offices, including contract issuers, shall take all precautions necessary to avoid acceptance,
-transfer, negotiation, or use of counterfeit SNAP benefits and to avoid any unauthorized use, transfer,
-acquisition, alteration, or possession of SNAP benefits. EBT cards shall be safeguarded from theft,
-embezzlement, loss, damage, or destruction.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Issuance supervisors shall give each cashier a daily supply of blank EBT cards from the bulk card
-inventory. On high volume issuance days, the cashier's supply may need to be replenished during
-issuance hours from an office vault. The vault containing bulk card inventory shall remain locked unless
-opened to withdraw cards. Keys and lock combinations shall be controlled and restricted to as few
-individuals as possible. Combinations and locks should be changed whenever an individual who has
-received them leaves the employ of the office.
-EBT cards must be removed from public view and reach. It is required that each cashier operate from a
-card drawer rather than from sources on top of the counter. The EBT cards must be locked in the drawer
-whenever the cashier leaves the issuance area for any reason. In small offices where it is not possible for
-each cashier to have a separate supply of EBT cards, the number of EBT cards shall be counted
-whenever one cashier assumes duties of another cashier at the issuance counter, and transferred to that
-cashier's responsibility.
-The office shall never be left unattended during hours of issuance, such as during breaks or lunch, unless
-the building is secured as it would be after business hours.
-4.707.2 Security Program and Types of Prevention of Theft
-The goal of a security program is to safeguard issuance personnel, EBT cards, and other valuables. In
-the event of a robbery, a planned security program will prevent panic that could endanger the lives of the
-people in the office.
-A major element in an effective security program is the designation of a security officer who would
-continually review office facilities and procedures to improve office security and deter loss. She/he shall
-acquaint fellow employees with the security measures including precautions during issuance, night
-security, and safety of persons and EBT cards while they are in transit between the issuance office and
-bulk storage area.
-In addition to a security officer, each office shall distribute written instructions to all employees concerning
-appropriate behavior in the event of a robbery attempt and procedures for reporting the theft to law
-enforcement authorities and the state department.
-A.
-
-Burglary
-Bulk EBT supplies shall be stored in a secure facility, preferably a bank or courthouse vault. If
-possible, all EBT cards should be returned daily to the secure storage facility. If EBT cards must
-be kept in the issuance office overnight, the amount shall be strictly limited to a one- or two-day
-supply.
-If EBT cards are being stored in the office overnight, doors and windows that could afford access
-to the building shall be secured. Doors shall be equipped with double-cylinder dead bolt locks or
-locks of equivalent security. Any glass in doors and windows shall be barred or otherwise
-protected against breakage. Doors connecting with other offices or buildings shall be locked as
-securely as exterior doors. All doors and windows shall be checked to make certain they are
-locked before closing the office.
-Issuance office EBT supplies shall be kept in a safe rather than a desk or file cabinet. The safe
-shall be immovable and in a part of the office not visible to the outside.
-
-B.
-
-Robbery
-To minimize the temptation for robbery, the amount of EBT cards in the issuance office shall be
-limited to a one- or two-day supply. The cashier's supply shall be out of public view and issued
-from a cashier's drawer out of reach of clients.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-The county social services director or office supervisor will inform local law enforcement officials
-of the issuing office operation and advise them of the maximum amounts of EBT cards handled.
-If EBT cards are returned to the bank at the end of the day and/or EBT card mailings are
-delivered to the post office by issuance personnel, an escort shall be provided. EBT card
-deliveries shall not be made by only one person, especially at night.
-Offices that use itinerant issuance points shall take additional precautions to protect EBT cards in
-transit and during issuance. An escort shall be provided to and from the itinerant point and shall
-be present during issuance hours.
-C.
-
-Embezzlement
-To prevent embezzlement, there shall be a division of issuance responsibilities. The supervisor
-must verify issuance records and resolve or document any discrepancies in daily reconciliation.
-At a minimum, supervisory personnel must take a monthly physical count of all EBT cards in the
-bulk EBT card storage points and EBT cards in each cashier's working stock. The end-of-themonth physical inventory must be accomplished after the close of business on the last issuance
-day of the reporting month or prior to the opening of business on the first issuance day of the
-following month. The actual inventory count is reported on Form FNS-250 (EBT Card
-Accountability Report). The supervisor must verify the accuracy of the FNS-250 report.
-
-4.707.21
-
-Reporting a Robbery or Burglary
-
-The local law enforcement agency shall be notified immediately by one of the persons at the issuance
-office who have been designated to carry out the reporting of a robbery or burglary. The state department
-shall also be notified immediately and will be responsible for informing USDA/FNS.
-The office shall be protected to ensure that evidence is not destroyed. Any articles touched by the
-robbers (papers, furniture, counter tops) should not be touched by employees or other persons until law
-enforcement officers arrive.
-The names of persons other than employees in the office at the time of the robbery shall be obtained if
-they insist on leaving prior to the arrival of law enforcement officers.
-Each employee shall write down all pertinent information about the robbery. They should be told it is
-important to record their own impressions and observations prior to any discussion of them with other
-employees.
-After law enforcement officers have made their examinations and with their approval, an immediate
-reconciliation of EBT cards shall be made to determine the amount of any loss. Stolen EBT cards will be
-identified by serial numbers.
-4.707.3 EBT
-
-Requisition
-
-Issuance offices shall maintain EBT card inventory at proper levels as determined by volume of issuance,
-availability of adequate storage facilities and insurance coverage. EBT card inventory levels shall not
-exceed a six-month supply, including EBT cards on hand and those on order.
-The security of issuance offices shall be continually monitored to ensure that adequate safeguards and
-insurance coverage are provided for the EBT card inventory on hand.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Arrangements have been made for issuance offices with sufficient issuance volume to receive shipments
-of EBT cards directly from USDA/FNS. Offices with low issuance volume will receive EBT card shipments
-from the state department storage vault by fully insured registered mail.
-It is advised that issuance offices that receive direct shipments should check EBT cards after monthly
-reconciliation and order EBT cards according to USDA/FNS instructions. USDA/FNS will assess the
-reasonableness of EBT card requisitions based on prior inventory change. The requisitioning issuance
-office will be notified prior to any adjustment made to requisitions.
-Those issuance offices which receive their EBT card supply from the state department storage vault shall
-requisition EBT cards in accordance with the instructions from the state department. The instructions will
-advise of procedures for ordering from the contractual EBT card provider.
-4.707.4 Designated Personnel and Receiving Locations
-A.
-
-B.
-
-Local offices ordering EBT cards shall designate at least two persons who are authorized to
-receive EBT cards (receiving agent). The state department shall be notified by letter of the
-following:
-1.
-
-Names of authorized personnel;
-
-2.
-
-Complete address of EBT card receiving location; and
-
-3.
-
-Hours in which EBT card delivery will be accepted.
-
-Verification of Shipments
-Issuance offices and bulk storage points shall promptly verify and acknowledge, in writing, the
-contents of EBT card shipments received, and shall be responsive for the control and storage of
-EBT cards. Cartons of blank EBT cards are usually numbered consecutively, and serial numbers
-should be verified upon receipt of shipment. The receiving agent shall ensure that the indicated
-number of cartons is received before signing the receipt form.
-
-C.
-
-Receipt of EBT Cards from USDA, FNS
-When a shipment of EBT cards is received from USDA/FNS, an original and three (3) copies of
-Form FNS 261 (Advice of Shipment) are mailed to the receiving agent. If the shipment is in order,
-the receiving agent shall complete Form FNS 261. If the shipment is not in order, immediately
-notify the State Department. The receiving agent will then be instructed to annotate Form FNS261, describing the EBT card discrepancy or damaged condition of the EBT cards. Form FNS
-261 must be signed, dated, and submitted in the normal manner.
-
-D.
-
-Receipt of EBT Cards from the State Department
-When a shipment is received from the State Department, Form FNS-300 (Advice of Transfer) is
-mailed to the receiving agent in the original and three (3) copies. If the shipment is in order, the
-original and all copies of Form FNS-300 are signed and dated by the receiving agent. If the
-shipment is not in order, immediately notify the state department.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.707.5 Inventory Records
-A.
-
-Shortage/Overage of EBT Cards in Shipment
-Prior to issuance, each carton and box of EBT cards shall be examined. When there is a shortage
-or overage of EBT cards, Form FNS-471 must be completed and signed by two witnesses. In the
-case of a shortage, show the amount of shortage on Line 13 of Form FNS-250 as credits. In the
-case of an overage, show the amount on Line 9 of Form FNS-250 (Shipments Received from
-USDA/FCS) regardless of where shipment originated.
-
-B.
-
-Improperly Manufactured or Mutilated EBT Cards in Shipment
-If EBT cards are improperly manufactured or mutilated, Form FNS-471 shall be completed. The
-EBT cards are cancelled immediately and destroyed at the end of the month in accordance with
-Section 4.708.5.
-If one or more boxes of EBT cards were improperly manufactured, local offices shall contact the
-state department, who will contact USDA/FNS on the instructions for disposition of the
-destructible EBT cards. EBT cards must be destroyed within thirty (30) calendar days from the
-close of the month in which the EBT cards were received. For disposition of mutilated EBT cards
-returned by participants, refer to Section 4.708.5.
-
-C.
-
-Out-of-Sequence EBT Card Serial Numbers
-There will be occasional instances where an EBT card will be substituted for an EBT card
-damaged in manufacturing. Out-of-sequence serial numbered EBT cards in the box present no
-problem as long as the correct number of EBT cards are contained in the box, and shall be
-issued in the normal manner.
-
-4.707.6 Benefit Issuance Locations and Storage Facilities
-A.
-
-Issuance locations shall be established by every local office to accomplish the issuance of EBT
-cards to certified SNAP households.
-
-B.
-
-The state department shall be notified of all issuance locations and EBT card shipment receiving
-points that are created, changed, or terminated at least thirty (30) calendar days prior to THE
-effective date of action.
-
-C.
-
-Whenever an issuance office or bulk storage point is terminated, the state department will
-complete a closeout accountability audit within thirty (30) calendar days of the termination. The
-findings of the audit shall be forwarded to USDA/FNS immediately. The state department shall
-perform a count of EBT cards on hand and transfer the inventory to another issuance office or
-bulk storage point preferably within the same project area. The actual inventory and transfer shall
-be properly documented and reported on Form FNS-250.
-
-D.
-
-At least thirty (30) calendar days prior to closure of an issuance location, SNAP participants shall
-be notified of the impending closure. Notification shall include alternative issuance locations and
-information concerning available public transportation. A notice of closure shall also be
-prominently displayed in the issuance office. All necessary action shall be taken to maintain
-participant service without interruption.
-
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-
-E.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-The transfer of EBT cards between project areas is allowed only in emergency situations and only
-when authorized by the state department. The transferring office initiates Form FNS-300, retains
-copy 4, and forwards all other parts to the receiving office with the EBT card shipment. On
-verification of shipment, Form FNS-300 is dated and signed by the receiving office and copy 3 is
-returned to the transferring office. The counties involved in “transferring out” and “transferring in''
-must properly document the transaction on Form FNS-250, which is submitted at the end of the
-month.
-
-4.707.61
-
-Contracting or Delegating Issuance Responsibilities
-
-Local assistance offices may legally contract with other parties such as banks, savings and loan
-associations, the U.S. Postal Service, community action and migrant service agencies, and other
-commercial businesses, the responsibility of issuance and storage of EBT cards. Contractors may be
-permitted to subcontract assigned issuance responsibilities with the approval of the local office.
-Any delegation of issuance and EBT card security must clearly delineate the responsibilities of both
-parties. Local offices remain responsible regardless of any agreements to the contrary for ensuring that
-assigned duties are carried out in accordance with the regulations. Local offices are still liable to
-USDA/FNS for all losses of EBT cards regardless of the actual responsibility for duties.
-If an issuance office/agent or bulk storage point is being closed for noncompliance with contractual
-agreements, the local assistance office shall perform weekly reconciliation until alternative issuance or
-storage points are obtained.
-4.707.7 Monitoring of EBT Card Issuers
-The state department shall conduct an onsite review of each EBT issuance office and bulk storage point
-at least once every three (3) years. All offices or units of an EBT issuance office are subject to this review
-requirement. The state department shall base each review on the specific activities performed by each
-EBT card issuer or bulk storage point. A physical inventory of EBT cards shall be taken at each location,
-and count compared with perpetual inventory records and the monthly reports of the EBT card issuer or
-bulk storage point. This review may be conducted at branch sites as well as the main offices of each
-issuer and bulk storage point that operates in more than one office.
-4.707.8 Division of Issuance Responsibilities
-Over the counter and mail issuance responsibilities shall be divided between a cashier and another
-issuance employee.
-A.
-
-It is not always feasible for the duties of the cashier to be performed by separate employees
-because of a low issuance volume at an issuance office. Therefore, any local office that can
-justify deviation from the requirement, and is willing to assume the additional risk, may obtain
-permission for one-person issuance through written request to the state department (refer to
-Section 4.707).
-
-B.
-
-If mail issuance functions are performed by only one person, a second-party review shall be
-necessary to verify EBT card inventory each day and reconcile the number of certified
-households who were issued EBT cards and the number of mailings prepared on a biweekly
-basis.
-
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-
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Cashier Responsibility
-1.
-
-The cashier requests Form FS-5 (Identification Card) from the over-the-counter
-participant and compares the names on EBT card with the household names or
-authorized representative. For mail issuance the participant does not present an ID card
-for comparison.
-
-2.
-
-When satisfied with the identification of the participant (not necessary for mail issuance)
-the cashier shall issue the EBT card and, enter the issuance information and authorized
-allotment on the issuance log. The cashier shall also post Form FS-52 (Daily Issuance
-Log) or Form FS-11 (Daily Tally Sheet of Individual Transactions) if either is used by the
-issuance office to record household participation.
-
-3.
-
-The cashier may enter any remarks, (such as serial numbers) concerning EBT cards to
-be issued on either Form FS-52 or Form FS-11. For the over-the-counter issuances the
-cashier shall also obtain the participant's signature on Form FS-52 (Daily Issuance Log)
-and compare the signature with that on the ID card to assure that the signatures agree.
-For mail issuance, there is no participant signature required. The cashier shall enter the
-date that the EBT card is mailed on Form FS-52 or Form FS-11.
-
-4.707.81
-
-Issuance of EBT Cards
-
-The cashier shall use Form FS-10 (Daily Report of Books Issued) each issuance day to record his/her
-beginning EBT card inventory to show the amount of EBT cards received to replenish the cashier's card
-stock supply, to show returns to inventory, and to enter total amount of EBT cards on hand by physical
-count at the end of the issuance-day. The cashier's actual issuance totals must be reconciled with Form
-FS-52, Form FS-11 or other authorizing documents each issuance day.
-4.707.82
-
-Issuance Reconciliation
-
-EBT cards shall be maintained in a secure location with access limited to authorized personnel. The
-issuance supervisor shall establish proper tracking and accounting methods to replenish each cashier's
-EBT card stock supply as needed.
-In all issuance systems, EBT card issuers shall reconcile their issuance daily using daily tally sheets,
-cashiers' daily reports, tapes or printouts.
-The daily total of issuances is recorded for printouts by the automated system, and shall also be
-reconciled with the cashiers' daily total of actual issuance of EBT cards determined by physical count.
-Any unresolved discrepancy must be verified daily and on the cashiers' Form FS-10.
-4.707.83
-
-Issuance Record Retention and Forms Security
-
-The local office shall maintain issuance and reconciliation records for a period of three (3) years from the
-month of origination. This period may be extended with the written approval of USDA/FNS. Issuance and
-reconciliation records shall include, at a minimum, reports regarding Notices of Action, Notices of Change,
-and inventory record. Forms FNS-250, FNS-259, FNS-46 and substantiating documents, cashiers' daily
-reports, cashiers' daily tally sheets, master issuance files, the records for issuance for each month and
-any rosters or lists produced by the automated system. In lieu of the records themselves, easily
-retrievable microfilm, microfiche, or computer tapes that contain the required information may be
-maintained.
-
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-
-4.707.84
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Control of Issuance Documents
-
-Local offices shall control all issuance documents that establish household eligibility while the documents
-are transferred and processed within the local office. The local office shall use numbers, batching,
-inventory control logs, or similar controls from the point of initial receipt through the issuance and
-reconciliation process. Access to all Notices of Action that initiate or terminate the master issuance file
-and blank EBT cards shall be limited to authorized personnel.
-4.707.9 Issuance Methods
-The issuance office shall mail EBT cards to all eligible households if the household does not utilize any
-available in person pick up option. Certified households must be issued EBT cards by the end of the
-month except when benefits are suspended, cancelled, or reduced.
-If benefits have been suspended, and the local office receives a directive to resume issuance of benefits,
-the issuance of mailed or over the counter EBT cards will be staggered through the end of the month or
-over a five-day period following the resumption of issuance. This could result in benefits being issued
-after the end of the month in which the suspension occurred.
-4.707.91
-A.
-
-Mail Issuance
-
-Prevention of Mail Issuance Losses
-All EBT cards shall be mailed as first-class mail, in sturdy non-forwarding envelopes.
-
-B.
-
-Liability for EBT Cards Lost in the Mail
-USDA/FCS will assume financial liability for all properly issued EBT cards lost in the mail except
-losses in excess of three tenths of a percent (0.3%) of the state total quarterly mail issuance loss.
-Each local office that has a mail loss during a quarter will be assessed a percentage of the state
-total penalty when a penalty is assessed against the state by the USDA/FNS.
-
-C.
-
-SNAP Mail Issuance Report
-Form FNS-259 reports shall be submitted by local offices for each unit using a mail issuance
-system. Local offices shall submit Form FNS-259 reports so that they are received by the fifteenth
-(15th) day of the next month.
-
-4.708
-
-INVENTORY VERIFICATION
-
-The issuance supervisor is responsible for taking a physical count of EBT cards on hand after the last
-issuance day of the month. There must be an actual count of all EBT cards in bulk storage facilities and in
-each cashier's working card stock in order to validate EBT card inventories reported on Form FS-13 and
-Form FNS-250.
-4.708.1 EBT Card Responsibility and Liability
-Local offices shall be liable to USDA/FNS for the face value of EBT card loss that occurs because of
-thefts, embezzlements, and cashier error, unless the investigation was reported directly to USDA/FNS
-prior to the loss and unexplained causes. The local offices shall not be liable for the value of EBT cards
-issued for those duplicate issuances in the correct amount that are the result of authorized replacement
-issuances.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.708.2 Inventory Reporting to The State Department
-Form FNS-250 (EBT Card Accountability Report), as incorporated by reference in section 4.707.6, C,
-above, shall be executed monthly by EBT card issuers and bulk storage points. The FNS-250 shall be
-signed by the EBT card issuer or appropriate official, certifying that the information is true and correct to
-the best of that person's knowledge and belief.
-FNS-250 is an automated report available through an automated system and needs to be data entered by
-the 15th of the month. Supporting documentation to Form FNS-250 shall be submitted to the state
-department which will verify the monthly report. Documentation shall consist of documents supporting
-EBT card shipments (FNS-261, as incorporated by reference in section 4.707.4, C, above), EBT card
-transfers (FNS-300, as incorporated by reference in section 4.707.4, D, above), and destruction of EBT
-cards (FNS-135 and FNS-471, as incorporated by reference in section 4.707.5, A, above).
-4.708.3 State Monthly EBT Card Accountability
-The state department shall establish an accounting system to review Form FNS-250, as incorporated by
-reference in section 4.707.66, C, above, completed by all local offices and determine the propriety and
-reasonableness of EBT card inventories, issuance activities, and reconciliation records. All records of
-EBT card requisition, EBT card receipt, returned mail EBT card issuances, replacements of EBT cards
-lost in the mail or improperly manufactured, or mutilated as well as the supporting remarks and
-documentation for monthly over-issuance and under-issuance shall be used to assure the accuracy of
-monthly reports.
-4.708.4 Issuance Reconciliation Reporting
-Form FNS-46 (Issuance Reconciliation Report) shall be submitted by each local office operating an
-issuance system. The report shall be prepared at the level where the actual reconciliation of the record for
-issuance and master file occurs.
-Local offices shall identify and report the number and value of all issuances that do not reconcile with the
-record-for-issuance and master issuance file.
-In addition to the above requirement, local offices will continue to reconcile inventory levels against
-issuances each month on Form FNS-250 (SNAP Accountability Report, as incorporated by reference in
-section 4.707.6, C, above) and attach Form FNS259 (SNAP Mail Issuance Report, as incorporated by
-reference in section 4.707.91, E, above) for reconciliation.
-4.708.5 Destruction of Unusable EBT Cards Returned by Households
-Unusable EBT cards shall be destroyed by the local office provided that the destruction is accomplished
-by burning, shredding, or tearing and two (2) persons witness the EBT card destruction.
-Form FNS-471 (EBT Card and Destruction Report, as incorporated by reference in section 4.707.5, A,
-above) shall be completed and signed by the required witnesses and mailed to the state department.
-Form FNS-135 (Affidavit for Return or Exchange of EBT Cards, as incorporated by reference in section
-4.708.2, above) completed for the return of unusable EBT cards by clients or for claims payments and
-Form FNS-471 completed on destruction of unusable EBT cards improperly manufactured or mutilated in
-shipments are supporting documents for necessary EBT card destruction.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Local offices must report the destruction of improperly manufactured or mutilated EBT cards on Form
-FNS-471 and submit it with Form FNS-250, as incorporated by reference in section 4.707.6, C, above, for
-the appropriate month. For EBT cards received from recipients, the original copy of Form FNS-135 must
-be attached to a copy of Form FNS-471 and retained in the office for future review and audit purposes.
-The destruction of EBT cards received from claims collections that are the result of payment of household
-claims must be reported on Form FNS-471.
-Form FNS-135 will act as a receipt on exchange of unusable EBT cards returned by clients or returned
-for claim payments.
-4.708.6 Undeliverable or Returned EBT Cards
-Local offices shall exercise the following security and controls for EBT cards that are undeliverable or
-returned during the valid issuance period. Forms FNS-471, as incorporated by reference in section
-4.707.5, A, above, and FNS-135, as incorporated by reference in section 4.708.2, above, shall be
-completed by the local office as appropriate.
-EBT cards shall be returned to inventory and noted as such on the issuance log and Form FNS-250, as
-incorporated by reference in section 4.707.6, C, above.
-4.708.7 EBT Cards Returned Because of Involuntary Termination or Death
-EBT Cards will be accounted for on Form FNS-135 (Affidavit for Return or Exchange of Food Coupons)
-and destroyed under procedures pertaining to Form FNS-471 (EBT Card and Destruction Report). A copy
-of Form FNS-135 will be retained in the household's case file for audit purposes.
-4.708.8 State EBT Card Issuance and Participation Reporting
-The state department shall make estimations with data from the automated system on Benefit Issuance
-and Participation Estimates.
-4.709
-
-COLORADO ELECTRONIC BENEFIT TRANSFER SYSTEM (CO/EBTS) AND PROCESSING
-
-CO/EBTS shall maintain a composite of data for all certified households and provide complete information
-on participating households for review sampling purposes, statistical summary, and reporting
-requirements. The automated system is a direct-access system that allows online issuance access to the
-master issuance file. The automated system provides for an online issuance system.
-CO/EBTS will provide access to SNAP benefits by issuing a plastic debit card to clients receiving SNAP
-and/or PA benefits. The overall rules for CO/EBTS are in the Colorado Department of Human Services
-Special Projects rule manual at 12 CCR 2512-2.
-Eligibility determinations in the automated system will be processed nightly to make SNAP benefits
-available the following day for initial certification. Ongoing cases will have benefits posted during a ten
-(10) calendar day cycle with the Social Security Number (SSN) as the basis. The ending number of the
-SSN will indicate the date for the posting of benefits. An SSN ending with one (1) will be posted on the
-first day of the month, two (2) on the second day of the month, etc. AN SSN ending with zero (0) will be
-posted on the tenth (10th) day of the month.
-4.709.1 Card/PIN Issuance Accountability
-A.
-
-Local offices will establish procedures for issuance of CO/EBTS debit cards and Personal
-Identification Numbers (PINs). The household will be issued a debit card within seven (7)
-calendar days from the date of application for expedited cases and within thirty (30) calendar
-days for non-expedited cases.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-B.
-
-Local offices shall maintain debit cards on site at its primary location and satellite offices. The
-EBTS contractor will provide counties with an initial supply of sequentially numbered cards with
-pre-embossed primary account numbers. Local offices must reorder cards to always ensure an
-adequate supply. The cards will be secured and accounted for through appropriate inventory and
-distribution forms.
-
-C.
-
-The household PIN will be issued through encryption devices supplied by the state department.
-
-4.709.2 EBT Card Replacement
-A.
-
-CO/EBTS debit cards for eligible recipients will be replaced when reported lost, stolen, or nonfunctioning. Replacement of cards will occur within three (3) business days of notification by the
-recipient.
-
-B.
-
-Local offices may have replacement cards over the counter or through a transmission to the
-CO/EBTS contractor requesting mail issuance. Local offices shall not charge a fee if the
-replacement is issued by mail or the original card is inoperable due to no fault of the client. Local
-offices shall not charge a fee if the client is being recertified, and if, during the period of nonparticipation, the client has destroyed, lost, or damaged the original card.
-
-C.
-
-Local offices shall not collect replacement fees by debiting a recipient's SNAP account.
-
-4.800
-
-CLAIMS, APPEAL PROCESS, AND FRAUD
-
-Pursuant to Section 15(d) of the Food Stamp Act, benefits are an obligation of the United States within
-the meaning of 18 United States Code (USC), Chapter 15. The provisions of Title 18 of the United States
-Code, “Crimes and Criminal Procedure, Relative to Counterfeiting, Misuse and Alteration of Obligations of
-the United States” are applicable to SNAP benefits.
-Any unauthorized issuance, use, transfer, acquisition, alteration, possession, or presentation of SNAP
-benefits may subject an individual, partnership, corporation, or other legal entity to prosecution under
-federal law and/or section 26-2-305, C.R.S. and accompanying Colorado criminal statutes.
-4.801
-
-CLAIMS AGAINST HOUSEHOLDS
-
-A claim shall be established when a household is over-issued benefits. An over-issuance means the
-amount by which SNAP benefits issued to a household exceeds the SNAP allotment.
-4.801.1 Classification of Claims
-Claims shall be classified as follows:
-A.
-
-“Agency Error Claims” - A claim shall be handled as an agency error claim if the over-issuance is
-caused by an error on the part of the local office. Instances that may result in an agency error
-claim include, but are not limited to, the following:
-1.
-
-The local office failed to take prompt action on a change reported by the household;
-
-2.
-
-The local office incorrectly computed the household's income or deductions, or otherwise
-assigned an incorrect allotment;
-
-3.
-
-The local office continued to provide a household SNAP benefits after its certification
-period expired without a recertification of eligibility.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-4.
-B.
-
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-The local office failed to provide a household a reduced level of SNAP benefits when its
-PA grant changed.
-
-“Inadvertent Household Error Claims” - A claim shall be handled as an inadvertent household
-error claim if the over-issuance was caused by a misunderstanding or unintentional error on the
-part of the household. Instances that may result in an inadvertent household error claim include,
-but are not limited to, the following:
-1.
-
-The household unintentionally failed to provide the local office with correct or complete
-information.
-
-2.
-
-The household unintentionally failed to report changes in its household circumstances.
-
-3.
-
-The household unintentionally received benefits or more benefits than it was entitled to
-receive pending a fair hearing decision because the household requested a continuation
-of benefits based on the mistaken belief that it was entitled to such benefits.
-
-4.
-
-The household was receiving SNAP solely because of basic categorical eligibility and the
-household was subsequently determined ineligible for Colorado Works (CW) or Social
-Security Income (SSI) during the time that the benefits were being received. The claim
-must be based on a change in net income and/or household size.
-
-5.
-
-The SSA failed to take action that resulted in the household's basic categorical eligibility
-and improper receipt of SSI. The claim must be based on change in net income and/or
-household size.
-
-“Intentional Program Violation (IPV) /Fraud Claims” - A claim shall be handled as an IPV/fraud
-claim only if:
-1.
-
-An administrative disqualification hearing (ADH) official or a court of appropriate
-jurisdiction has found a household member has committed an IPV or fraud; or,
-
-2.
-
-A signed waiver of ADH is received; or
-
-3.
-
-A signed disqualification consent agreement has been obtained.
-Prior to a waiver or consent agreement being signed or the determination of IPV/fraud,
-the claim against the household shall be handled as an inadvertent household error
-claim.
-
-4.801.2 Establishing Claims Against Households
-A.
-
-Establishing a claim
-1.
-
-The local office shall establish claims in accordance with the thresholds outlined below.
-a.
-
-For participating households, the local office shall not establish a claim for
-overpayment due to Administrative Error (AE) or Inadvertent Household Error
-(IHE), except in the following circumstances:
-1.
-
-When the amount of the claim is greater than $200; or
-
-2.
-
-When the over-issuance is identified through a federal or state level
-quality control review; or,
-
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-
-3.
-b.
-
-2.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-When the IHE claim is being pursued as an IPV, except that if the IHE
-claim does not result in an IPV, collection shall not be pursued.
-
-For households not participating in SNAP, the local office shall not establish a
-claim for over-issuance except in the following circumstances:
-1.
-
-When the amount of the AE claim is greater than $400;
-
-2.
-
-When the amount of the claim is due to an IHE and is greater than $200;
-or
-
-3.
-
-When the over-issuance is identified through a federal or state level
-quality control review.
-
-4.
-
-When an IHE claim is being pursued as an IPV, except that if the IHE
-claim does not result in an IPV, collection shall not be pursued.
-
-An AE or IHE claim shall not be established for a period of more than twelve (12) months
-from the date the local office was notified, in writing or orally, or discovered through the
-normal course of business, that an error occurred which led to the household receiving
-more benefits than it was entitled to receive.
-A claim associated with an IPV must be calculated back to the month the act of IPV first
-occurred and cannot be established for a period more than six (6) years from the date the
-local office was notified, in writing or orally, or discovered through the normal course of
-business, that an error occurred which led to the household receiving more benefits than
-it was entitled to receive.
-
-B.
-
-3.
-
-Claims shall be established for benefits that are trafficked. The trafficking of benefits
-means the same as described in 26-2-306, C.R.S. and 7 C.F.R. 271.2, which is
-incorporated by reference in section 4.000.1, above.
-
-4.
-
-Claims shall be established against the following individuals:
-a.
-
-All adult household members aged eighteen (18) years of age or older at the time
-the over-issuance occurred, even if one or more of the adult household members
-are participating in another SNAP household at the time the claim is established;
-and
-
-b.
-
-A person connected to the household, such as an authorized representative, who
-traffics SNAP benefits or otherwise causes an over-issuance to occur.
-
-Timeframe to Establish a Claim
-Local offices shall establish all claims before the last day of the quarter following the quarter in
-which the over-issuance or trafficking incident was discovered.
-1.
-
-The discovery date for AE claims is the date that the local office was notified, in writing or
-orally, or discovered through the normal course of business that an agency error
-occurred that caused the household to receive more benefits than it was entitled to
-receive.
-
-2.
-
-The discovery date for IHE and IPV non-trafficking claims shall be the date that
-verification used to calculate the over-issuance is obtained.
-
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-
-3.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-The discovery date for claims resulting from trafficking is the date of the court decision or
-the date the household signed a waiver of administrative disqualification hearing form or
-a disqualification consent agreement.
-
-4.801.3 Calculating the Amount of a Claim
-A.
-
-Compromising Claims
-If the full amount or remaining amount of an AE or IHE claim cannot be liquidated in three (3)
-years, the local office may compromise the claim by reducing it to an amount that will allow the
-household to pay the claim in three (3) years. IPV claims shall not be compromised, unless
-specified in a court decision. The local office may use the full amount of the claim, including any
-amount compromised, to offset lost benefits. Decisions regarding compromises shall be
-documented in the case record.
-A payment plan on a claim that has been compromised may be renegotiated if necessary. Claims
-that are already reduced by either an administrative or district court order are considered
-compromised claims, and thus are not eligible for additional compromise.
-Local offices shall review the household’s circumstances and determine if a compromise would
-be appropriate. Local offices do not have the option of refusing to consider compromising claims.
-Local offices cannot institute a policy of never compromising claims
-Claims should be compromised if the household demonstrates need, such as the inability to
-repay the claim within three (3) years, or if the household proves that financial, physical, or
-mental hardship would exist if forced to pay the full amount of the original claim. Some
-circumstances include, but are not limited to, medical hardships, high shelter costs, loan
-payments, and other extraordinary expenses. A compromise based on hardship may be applied
-to a SNAP case regardless of whether the household is still receiving SNAP benefits.
-Consideration should be given to the future earning potential of the household over the next three
-(3) years to pay back the claim based on age, disability, and other household factors.
-
-B.
-
-Claims Resulting from Trafficking
-The value of claims resulting from trafficking related offenses is the value of the trafficked benefits
-as determined by the individual's admission, through adjudication, or the documentation that
-forms the basis for the trafficking determination. Documentation could include such items as
-notarized statements or printouts from the EBT systems.
-
-C.
-
-Agency Error and Inadvertent Household Error Claims
-1.
-
-If the household received a larger allotment than it was entitled to receive, the local office
-shall establish a claim against the household that is equal to the difference between the
-allotment that the household received and the actual allotment it should have received.
-Benefits authorized under Colorado Electronic Benefits Transfer System (CO/EBTS) shall
-be used to calculate the claim. After calculating the amount of a claim and establishing
-claims, the local office must offset the amount of the claim against any amounts which
-have not yet been restored to the household. Expungements and any return of benefits
-that occur must be used to offset the amount of the claim.
-
-2.
-
-The claim must also be offset against restored benefits owed to:
-a.
-
-Any household that contains a member who was an adult member of the original
-household;
-
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-
-3.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-b.
-
-Any household that contains an authorized representative that caused the overissuance or trafficking.
-
-c.
-
-In no circumstance may the local office collect more than the amount of the
-claim.
-
-For households eligible under BCE, a claim shall only be determined when it can be
-calculated because of changed household net income and/or household size. A claim
-shall not be established if there was not a change in net income and/or household size.
-If a household receives both TANF and SNAP and mis-reports information to TANF in
-accordance with the TANF reporting requirements, and the mis-report of information to
-TANF resulted in the household being over-issued TANF or ineligible for TANF, any
-resulting SNAP claim should be based on the actual TANF issued.
-
-4.
-
-The correct allotment shall be calculated using the same methods applied to certification.
-The twenty percent (20%) earned income deduction shall not be applied to that part of
-any earned income that the household failed to report in a timely manner when this act is
-the basis for the claim; therefore, any portion of the claim that is due to earned income
-being reported in an untimely manner will be calculated without allowing the twenty
-percent (20%) earned income deduction. The circumstances of the household shall be
-used to calculate the claim. In instances when a claim is caused by the household’s
-failure to report information as required, the amount of the claim is based on the allotment
-difference from what the household received compared to what the household would
-have received if the household would have reported the information as required. For
-example, if a simplified reporting household did not report income at initial application as
-required, the income used to calculate the over-issuance would be the income that the
-household received in the month of application, as this would have been used to
-determine the household’s ongoing monthly amount. Actual income received each
-subsequent month is not required to calculate each month of the claim, as any fluctuation
-in monthly income that was received by the household after the initial month of
-application was not required to be reported by the household. If the household failed to
-report a change in household circumstances that would have resulted in an increase in
-benefits during the period of the claim, the local office shall act on the change in
-information as of the date the change was reported to the local office.
-
-5.
-
-When a household certified below 130% FPL, as defined in section 4.401.1, above fails
-to report an increase in household income over 130% FPL. The local office shall
-establish the claim for each month in which an over-issuance of SNAP has occurred.
-a.
-
-In cases involving household failure to report an increase in income within the
-required timeframes, the first (1st) month affected by the household's failure to
-report shall be the first (1st) month in which the change would have been
-effective had it been timely reported. However, in no event shall the
-determination of the first (1st) month in which the change would have been
-effective be any later than two (2) months from the month in which the change
-occurred. For purposes of calculating the claim, the local office shall assume that
-the change would have been reported properly and timely acted upon by the
-local office.
-
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-
-b.
-
-D.
-
-E.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-If the household timely reported an increase in income but the local office failed
-to act on the change within the required timeframes, the first (1st) month affected
-by the local office's failure to act shall be the first (1st) month the office would
-have made the change effective had it acted timely. If a Notice of Adverse Action
-was required, the local office shall assume, for the purpose of calculating the
-claim, that the Notice of Adverse Action period would have expired without the
-household requesting a fair hearing.
-
-IPV Claims
-1.
-
-Prior to a waiver of ADH or consent agreement being signed or the determination of
-IPV/fraud, the claim being pursued as an IPV claim shall be pursued as an IHE claim.
-
-2.
-
-For each month that a household received an over-issuance due to an act of IPV/fraud,
-the local office shall determine the correct amount of SNAP benefits, if any, the
-household was entitled to receive. If the household member is determined to have
-intentionally failed to report a change in its household's circumstances, the claim shall be
-established for each month in which the failure to report would have affected the
-household's SNAP allotment.
-
-3.
-
-Once the amount of the IPV claim is established, the local office shall offset the claim
-against any amount of lost benefits that have not yet been restored to the household.
-
-Court Actions
-In cases where a household member was found guilty of fraud by a court of appropriate
-jurisdiction, the local office should request that the matter of restitution be brought before the
-court or addressed in the agreement reached between the prosecutor and individual.
-
-4.801.4 Collecting Payments on Claims
-A.
-
-Claim Liability
-1.
-
-Liable Individuals
-All adult household members aged eighteen (18) years or older at the time the overissuance occurred, sponsors, or other persons, such as an authorized representative
-who trafficked or otherwise caused an over-issuance or trafficking to occur, that are
-connected with the household shall be jointly and severally liable for the value of any
-over-issuance of benefits to the household.
-
-2.
-
-Initiating Collection Action
-a.
-
-Local offices shall initiate collection action against all adult members or persons
-connected to the household at the time an over-issuance occurred. Under no
-circumstances shall the office collect more than the amount of the claim.
-
-b.
-
-The local office may pursue collection action against any household that has a
-member that was connected to the household that received or created an overissuance.
-
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-
-c.
-
-B.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-The local office shall initiate collection action for an unpaid or partially paid IPV
-claim even if collection action was previously initiated against the household
-while the claim was being handled as an IHE claim. Collection action shall be
-initiated unless the household has already repaid the over-issuance because of
-an IHE demand letter described in section 4.801.4, C, 1, below, or the local office
-has documentation that shows the household cannot be located.
-
-Postponing Collection Action
-Collection action on IHE claims may be postponed in cases where an over-issuance is being
-referred to an ADH or a court of appropriate jurisdiction, and the local office determines that
-collection action will prejudice the case. For cases in which the household is appealing an AE or
-IHE claim, collection action shall be suspended pending a final decision. A household’s appeal
-may include, but not be limited to, the establishment of the claim, the amount of the claim, and/or
-the household’s liability to repay the claim.
-
-C.
-
-Notifying a Household of a Claim
-1.
-
-Notice of Over-Issuance and Repayment Agreement
-Local offices shall initiate collection action on agency error and inadvertent household
-error claims by sending the household a State-prescribed written demand letter for the
-over-issuance. The letter shall inform the household of its rights and responsibilities
-concerning repayment of the claim as well as providing information on the availability of
-free legal services. All households that owe a claim shall be sent a demand letter. If the
-claim or the amount of the claim was not established at a fair hearing, the state agency
-must provide the household with a one-time Notice of Adverse Action. If the hearing
-official determines that a claim does, in fact, exist against the household, the household
-must be re-notified of the claim. The demand for payment may be combined with the
-notice of the hearing decision. Delinquency must be based on the due date of this
-subsequent notice and not on the initial pre-hearing demand letter sent to the household.
-
-2.
-
-Calculation of Claim
-The local office shall mail the household an explanation of how the claim was calculated,
-showing each individual month and the cause for the claim. The State-prescribed form
-shall be used to determine and calculate the amount of the claim and to notify the
-household of the calculation. The form shall be mailed on a schedule that coincides with
-the mailing of the demand letter.
-
-D.
-
-Negotiating Payment Plans
-Households participating in the program are subject to allotment reduction in accordance with
-Section 4.801.41. B, unless the claim is being collected at a higher amount, per agreement with
-the household. Allotment reduction must begin with the first allotment issued ten (10) calendar
-days after the demand letter is mailed.
-When a household is subject to allotment reduction, then a repayment agreement is not
-necessary unless the household wants to make voluntary payments in addition to the allotment
-reduction or elects to make monthly payments in amount greater than what would be repaid
-through allotment reduction.
-If a household is not participating in the program, then the local office shall negotiate a payment
-schedule with the household for repayment of any amounts of the claim not repaid through a
-lump sum payment.
-
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-
-1.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Establishing a Payment Plan
-The local office shall negotiate a payment schedule with the household for repayment of
-any amounts of the claim not repaid through a lump sum payment or through allotment
-reduction. Payments shall be accepted in regular installments. The household may use
-SNAP benefits as full or partial payment of any installment. The local office shall ensure
-that the negotiated amount of any payment schedule to be repaid each month through
-installment payments is not less than the amount that could be recovered through an
-allotment reduction. Once negotiated, the amount to be repaid each month through
-installment payments shall remain unchanged regardless of subsequent changes in the
-household's monthly allotment. However, both the local office and the household shall
-have the option to initiate renegotiation of the payment schedule if they believe that the
-household's economic circumstances have changes enough to warrant such action.
-
-2.
-
-Household’s Failure to Respond to the Repayment Agreement
-If the household is not participating in the program when collection action for claim is
-initiated or if collection action has been initiated for repayment of a claim and no
-response is made to the first (1st) demand letter, additional demand letters shall be sent
-at reasonable Intervals, such as thirty (30) calendar days apart. The demand letters shall
-be sent until the household responds by paying or agreeing to pay the claim, until the
-criteria for suspending collection has been met or until the local office initiates ether
-collection actions.
-
-E.
-
-Determining Delinquency
-1.
-
-2.
-
-Claims shall be considered delinquent under the following circumstances:
-a.
-
-If a claim has not been paid by the due date on the demand letter or a
-satisfactory payment arrangement has not been made. The claim shall remain
-delinquent until payment is received in full, an allotment reduction is invoked, or a
-new repayment schedule is negotiated. The date of delinquency for such claims
-is the due date on the initial demand letter.
-
-b.
-
-If a satisfactory payment arrangement has been made for a claim and payment
-has not been received by the due date specified in the established repayment
-schedule, the date of delinquency for such claims is the due date of the missed
-installment payment, unless the claim was delinquent prior to entering into a
-repayment agreement, in which case the due date will be the due date on the
-initial demand letter. The claim will remain delinquent until payment is received in
-full, allotment reduction is invoked, or once the local office resumes or
-renegotiates the repayment schedule.
-
-c.
-
-For purposes of the Federal Treasury Offset Program (TOP), a delinquent claim
-is one which is past due more than one hundred twenty (120) calendar days.
-
-Claims shall not be considered delinquent under the following circumstances:
-a.
-
-If another SNAP claim for the same household is currently being paid, either
-through an installment agreement or an allotment reduction, and the local office
-expects to begin collection on the claim once the prior claim(s) is settled;
-
-b.
-
-If collection is coordinated through the court system and the local office has
-limited control over collection action; and
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-c.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-If a household timely requests a fair hearing on the existence or amount of the
-claim and the local office suspends collection action pending a final agency
-decision. A claim awaiting a fair hearing decision shall not be considered
-delinquent.
-If the hearing officer determines that a claim does in fact exist against the
-household, the household shall be sent another demand letter. Delinquency shall
-be based on the due date of this subsequent demand letter and not on the initial
-pre-hearing demand letter sent to the household. If the hearing officer determines
-that a claim does not exist, the claim is deleted and shall be terminated, and all
-collection activity ceased.
-
-F.
-
-Joint Collections Received for a Combination SNAP and PA Claim
-An unspecified joint collection is when funds are received in response to correspondence or a
-referral that contained both the SNAP and other program claims, and the debtor does not specify
-to which program to apply the payment. The local office shall ensure that unspecified joint
-collections are pro-rated among the programs involved. When an unspecified joint collection is
-received for a combined PA and SNAP claim, each program shall receive its prorated share of
-the amount collected.
-
-4.801.41
-
-Methods of Collecting Payment on Claims
-
-The local office shall collect claims through one of the following methods:
-A.
-
-Lump Sum
-The local office shall collect payments for total or partial payments of a claim in one lump sum if
-the household is financially able to pay the claim; however, the household shall not be required to
-liquidate all of its resources to make this repayment. If the household requests to make a lump
-sum cash and/or food benefit payment as full or partial payment of the claim, the local office shall
-accept this method of payment.
-
-B.
-
-SNAP Allotment Reduction
-1.
-
-The local office shall collect payments for claims from households currently participating
-in the Program by reducing the household's SNAP allotment. For claims where there is a
-court-ordered judgment for repayment, allotment reduction shall not occur.
-Prior to reduction, the local office shall inform the household of:
-
-2.
-
-a.
-
-The appropriate formula for determining the amount of SNAP to be recovered
-each month;
-
-b.
-
-The amount of SNAP the local office expects will be recovered each month; and,
-
-c.
-
-The availability of other methods of repayment.
-
-The household's allotment will be reduced based on the recoupment amounts for each
-type of claim unless a payment schedule has been negotiated with the household.
-The local office may collect on a claim by invoking benefit allotment reduction on two (2)
-separate households for the same claim. However, the local office is not required to
-perform this simultaneous reduction.
-
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-
-3.
-
-4.
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-The amount of SNAP to be recovered each month through allotment reduction shall be
-determined as follows:
-a.
-
-For AE claims and IHE claims, the amount of SNAP to be recovered each month
-from a household shall either be ten percent (10%) of the household's monthly
-allotment or ten dollars ($10) each month, whichever is greater.
-
-b.
-
-For IPV claims, the amount of SNAP benefit reduction shall either be twenty
-percent (20%) of the household's monthly allotment or twenty dollars ($20) per
-month, whichever is greater.
-
-Benefits authorized for an initial month will not be reduced to offset a claim. Ongoing
-benefits will be recouped based on the above criteria.
-
-Benefits from an EBT Account
-1.
-
-A household may pay all or a portion of the claim by using benefits from its EBT account.
-The local office shall obtain written permission from the household to deduct benefits
-from the EBT account to pay a claim. The written agreement shall be obtained prior to
-removing benefits from the EBT account and shall include:
-
-D.
-
-a.
-
-A statement that this collection activity is strictly voluntary;
-
-b.
-
-The amount of the payment;
-
-c.
-
-The frequency of the payments (i.e., whether monthly or one (1) time);
-
-d.
-
-The length of the agreement; and
-
-e.
-
-A statement that the household may revoke this agreement at any time.
-
-2.
-
-If the household provides oral permission, the local office can make a one- time
-deduction from an active EBT account for a one (1)-time reduction. The county shall
-provide the household with a written receipt within ten (10) business days. The receipt
-shall contain the information used for an active EBT account and indicate that this is a
-one-time reduction.
-
-3.
-
-When a local office pursues payment on a claim by applying SNAP benefits from the
-household’s stale EBT account, prior written notice shall be given to the household of the
-existing stale EBT account that may be applied to an outstanding claim. The county shall
-notify the household that the benefits will be applied to the claim unless the household
-objects to this offset. The household must be given ten (10) calendar days to object
-before the benefits can be applied as a payment to the claim. A stale EBT account
-means an account that has benefits but has not been accessed for at least three (3)
-consecutive calendar months.
-
-Offset Against Taxpayer's State Income Tax Refund
-1.
-
-The state department and local office may recover over-issuances of PA benefits through
-the offset (intercept) of a taxpayer's state income tax refund. Rent rebates are subject to
-the offset procedure. This method may be used to recover over-issuances that have
-been:
-a.
-
-Determined by final agency action;
-
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-
-2.
-
-b.
-
-Ordered by a court as restitution; or,
-
-c.
-
-Reduced to judgment.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Pre-Offset Notice
-Prior to certifying the taxpayer's name and other information to the Department of
-Revenue, the state department shall notify the taxpayer in writing at his or her last known
-address that the state intends to use the tax refund offset to recover the over-issuance.
-The pre-offset notice shall include the name of the local office claiming the over-issuance,
-a reference to SNAP as the source of the over-issuance, and the current balance owed.
-
-3.
-
-Household Objection to Pre-Offset Notice
-The taxpayer is entitled to object to the offset by filing a request for a DRC or state-level
-hearing within thirty (30) calendar days from the date the state department mails the preoffset notice to the taxpayer. At the hearing on the offset, the local office or administrative
-adjudicator shall not consider whether an over-issuance has occurred, but may consider,
-if raised by the taxpayer in his or her request for a hearing, whether:
-
-E.
-
-a.
-
-The taxpayer was properly notified of the over-issuance ;
-
-b.
-
-The taxpayer is the person who owes the over-issuance ;
-
-c.
-
-The amount of the over-issuance has been paid or is incorrect;
-
-d.
-
-The debt created by the over-issuance has been discharged through bankruptcy;
-
-e.
-
-Other special circumstances exist as described in Section 4.801.42.
-
-Federal Treasury Offset Program (TOP)
-The TOP, including the Federal Salary Offset Program (FSOP), is a mandatory government-wide
-delinquent debt matching and payment offset system in which Colorado SNAP participates.
-The TOP allows collection of delinquent debts by intercepting any allowable payment from the
-federal government. Federal payments eligible for offset include federal income tax refunds,
-federal employee salary, federal retirement payments (including military), contractor or vendor
-payments, and federal benefits such as Social Security and railroad retirement.
-1.
-
-Claims Submitted for Offset
-a.
-
-A delinquent claim may be submitted to the USDA, FNS for the TOP. To submit a
-claim to the TOP, the claim must be determined to be past due and legally
-enforceable. To determine that a claim is past due and legally enforceable, it
-must be determined that notification and collection attempts have taken place.
-
-b.
-
-For purposes of the TOP, a delinquent claim is one which is past due more than
-one hundred twenty (120) calendar days.
-
-c.
-
-A claim is not considered delinquent if a fair hearing is pending concerning the
-claim; or the claim has either been discharged by bankruptcy or is subject to the
-automatic stay of the bankruptcy; or the claim is not considered delinquent as
-described within Section 4.801.4, E, 2.
-
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-
-2.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Processing Fee
-TOP, including the FSOP, is authorized to apply a processing fee each time a successful
-offset for collection occurs. Federal payroll offices participating in the TOP process may
-add another separate processing fee. The delinquent SNAP debtor is responsible for the
-fee each time it is applied. A TOP offset taken in error and later refunded will have the
-processing fee refunded, except for partially refunded offsets.
-
-3.
-
-Notifying a Household of the TOP
-At the time delinquent debts are sent to be certified to the FNS for intercept by the TOP,
-all delinquent debts for every individual are sent at one time. Prior to a claim being
-certified to the FNS as a debt owed to the local office, the individual shall be mailed an
-offset notice. The notice shall provide the following information:
-a.
-
-The local office has documentation that the individual identified with his or her
-Social Security Number (SSN) is liable for the specified unpaid balance of the
-claim;
-
-b.
-
-The individual has been notified about the claim and prior collection efforts have
-been made. The claim is past due and legally enforceable. All adults are liable for
-the over-issuance of SNAP if they were household members when the SNAP
-benefits were over-issued. False statements concerning such liability may
-subject individuals to legal action (see Section 4.801.4, A);
-
-c.
-
-Debts over one hundred twenty (120) days delinquent to be referred to the
-Treasury for an administrative offset. The local office intends to refer the claim
-within sixty (60) days of the date of the notice unless the individual makes other
-repayment arrangements acceptable to the local office;
-
-d.
-
-Instructions on how to pay the claim, including the name, address, and telephone
-number of a person in the county who can discuss the claim and the intended
-offset with the individual;
-
-e.
-
-The individual is entitled to request a review of the debt’s eligibility for referral to
-TOP. Individual review requests must be honored, regardless of whether they are
-received after the deadline requested. Claims that are currently under review will
-not be referred for the tax intercept; and
-
-f.
-
-All claims for the household that are to be certified to TOP.
-
-4.
-
-The individual may document any legitimate reason that the claim is not past due or
-legally enforceable.
-
-5.
-
-The individual should contact the local office if they believe that a bankruptcy proceeding
-prevents the collection of the claim or if the claim has been discharged in bankruptcy.
-
-6.
-
-In some circumstances, the married individual may want to contact the IRS before filing
-his/her income tax return. This is true if the individual is filing a joint return and his or her
-spouse is not responsible for the SNAP claim and has income and withholding and/or
-estimated federal income tax payments. In such cases, the spouse may receive his or
-her portion of any joint return based on procedures prescribed by the IRS.
-
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-
-7.
-
-A federal employee may have his or her net disposable pay subject to garnishment under
-the offset. The Treasury may garnish up to fifteen percent (15%) of the net disposable
-pay. A federal employee may petition for a hearing only at the federal level to dispute the
-existence or the amount of the claim. The hearing occurs after the review period at the
-state-level and the subsequent submission to the Treasury as a valid offset.
-
-8.
-
-An OOA adjudicator within CDHS will review the proposed offset and issue only a final
-agency decision. The OOA shall find that the claim is past due and legally enforceable
-unless the household can provide documentation to show one (1) of the following:
-
-9.
-
-a.
-
-The claim is not delinquent or was already paid, and the individual provides proof
-of payment.
-
-b.
-
-The individual is not the person that is liable for the claim.
-
-c.
-
-A bankruptcy action prohibits collection of the claim because the automatic stay
-under Section 362 of the Bankruptcy Code is in effect with respect to the
-individual or his or her spouse, or that the claim was discharged by a bankruptcy
-proceeding.
-
-d.
-
-There is some other reason that the claim is not delinquent or is not legally
-enforceable.
-
-The final agency decision by the OOA regarding the paper review will be issued by
-means of written findings. No oral argument is permitted. The written findings shall
-include the following:
-a.
-
-F.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-If the OOA determines that the claim is past due and legally enforceable:
-1.
-
-The individual shall be notified that the claim will continue to be referred
-for the offset; and,
-
-2.
-
-The individual is entitled to have the FNS review the OOA’s decision.
-FNS must receive a request to do so within thirty (30) calendar days after
-the date of the state agency's notice of review decision. A request for
-FNS review shall include the individual's SSN. The notice shall also
-provide the address of the regional office including the phrase “Tax
-Offset Review” in the address.
-
-b.
-
-If the OOA determines that the claim is not past due or legally enforceable, it
-shall notify the individual and the local office that the claim will not be referred for
-the offset.
-
-c.
-
-While the OOA or FNS is conducting a review of the debt, the debt is not eligible
-for referral to TOP.
-
-Pursuing Other Collection Activities
-1.
-
-Local offices may pursue other collection actions, as appropriate, to obtain restitution of a
-claim against any household which fails to respond to a written demand letter for
-repayment of an agency error or inadvertent household error claim. In cases where a
-household member was found guilty of fraud by a court of appropriate jurisdiction, the
-local office may request that the matter of restitution be brought before the court or
-addressed in the agreement reached between the prosecutor and individual.
-
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-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-2.
-
-Other collection actions that the local office may pursue include the use of a collection
-agent, civil action, or criminal filing.
-
-3.
-
-If the local office chooses to pursue other collection actions and the household pays the
-claim, payments shall be submitted to the Colorado Department of Human Services as
-required by Section 4.801.8. The local office's retention of recoveries shall be based on
-the actual amount collected from the household through such collections actions.
-
-4.
-
-The local office shall not use other, involuntary collection methods against individuals in a
-household that is already having its benefit reduced.
-
-4.801.42
-
-Criteria for Suspending Collection Action [Rev. eff. 1/1/16]
-
-The provisions within this section apply to Agency Error (AE) claims, Inadvertent Household Error (IHE)
-claims, and intentional Program violation (IPV) claims, unless otherwise stated.
-A.
-
-The local office shall document the reason for suspending collection action. Suspended claims
-may be reactivated to offset a restoration of lost benefits or to pursue collection should collection
-action become feasible.
-
-B.
-
-Collection action on a claim shall be suspended only under the following circumstances:
-1.
-
-2.
-
-3.
-
-4.801.43
-
-A claim may be suspended if no collection action was initiated because of one of the
-following conditions:
-a.
-
-The local office has documentation that shows the household cannot be located;
-or,
-
-b.
-
-A court decision postpones collection activity for a period of time.
-
-If collection action was initiated and at least one (1) demand letter was sent, further
-collection action against an agency error claim or an inadvertent household error claim
-for a non-participating household may be suspended when:
-a.
-
-The household cannot be located.
-
-b.
-
-The cost of further collection action is likely to exceed the amount that can be
-recovered.
-
-c.
-
-The household is determined to be financially unable to pay the claim.
-
-d.
-
-If the local office can document that an individual found guilty of intentional
-program violation/fraud cannot be located, collection action shall be suspended.
-
-Collection action may be suspended on any claim for a non-participating household after
-six (6) months of no response. The local office should be alert to other methods of pursuit
-of the claim (see Section 4.801.41, F).
-Criteria for Terminating Collection Action [Rev. eff. 1/1/16]
-
-The provisions within this section apply to Agency Error (AE) claims, Inadvertent Household Error (IHE)
-claims, and intentional Program violation (IPV) claims.
-
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-
-A.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-A terminated claim is a claim in which all collection activity has ceased. A terminated claim is no
-longer considered a receivable subject for continued state and federal agency collection and
-reporting requirements unless otherwise stated.
-Voluntary payments from a household on a terminated claim do not reactivate the claim. A
-terminated claim cannot be reactivated to pursue collection.
-
-B.
-
-Collection action on a claim shall be terminated only in the following situations:
-1.
-
-A claim may be determined uncollectible after the collection action has been suspended
-for three (3) years. Prior to terminating such a claim, the local office may submit the claim
-for state or federal offset or pursue other collection actions. A terminated claim may not
-be reactivated to offset restoration of lost benefits.
-
-2.
-
-A claim may be terminated if it has been delinquent for a period of three (3) years. Prior
-to terminating such claim, the local office may submit the claim for state or federal offset
-or pursue other collection actions.
-
-3.
-
-A claim shall be terminated if found to be invalid by an administrative fair hearing decision
-or a court determination.
-
-4.
-
-A claim shall be terminated if all adult members are deceased and the agency is not
-pursuing collection from the estate.
-
-5.
-
-A claim that is twenty-five dollars ($25) or less and delinquent for ninety (90) calendar
-days may be terminated.
-
-4.801.5 Claims Discharged Through Bankruptcy
-A.
-
-IPV claims tied to an actual determination of fraud through either an ADH or a court hearing
-cannot be discharged through bankruptcy. If an individual signs an ADH waiver and admits to
-committing fraud or guilt when accepting the disqualification, the IPV claims cannot be discharged
-through bankruptcy. If the individual signs the ADH waiver without admitting to fraud or guilt, there
-is no actual determination of fraud and the IPV claim may potentially be dischargeable through
-bankruptcy.
-
-B.
-
-Local offices shall act on behalf of, and as an agent of, FNS in any bankruptcy proceedings
-against bankrupt households owing SNAP claims. Local offices shall possess any rights,
-priorities, liens, and privileges and shall participate in any distribution of assets, to the same
-extent as FNS. Acting as FNS, local offices shall have the power and authority to file objections to
-discharge proof of claims, exceptions to discharge, petition for revocation of discharge, and any
-other documents, motions, or objections which FNS might have filed.
-
-4.801.6 Interstate Claims Collection
-In cases where a household moves out of the state, the local office that last handled the case involving a
-claim may initiate or continue collection action against the household for any over-issuance that occurred
-while the household was under that local office's jurisdiction. Counties may transfer a claim to another
-state or Colorado county if the other state or Colorado county accepts the transfer.
-Counties are not obligated to accept the transfer of a claim from another state or Colorado county but
-have the option of accepting the claim and pursuing collection on that claim. Counties that accept the
-transfer of a claim shall pursue collection activities and retain appropriate incentives for the collection.
-
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-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.801.7 County Retention of Recoveries
-Counties may retain twenty percent (20%) of collections from inadvertent household error claims and
-thirty-five percent (35%) of collections from intentional Program violation/fraud claims. The total amount of
-collections from agency error claims is retained by the USDA, Food and Nutrition Service.
-4.801.8 Submission of Claim Payment Activity to USDA, FNS
-The FNS-209 Report (Status of Claims against Households) is an automated report and is run quarterly.
-The report is utilized to reflect all claims activities during a quarter and reflects all the payments made
-during the quarter. SNAP benefits received as a claim payment shall be recorded in the automated
-system and any corrections that need to be made to payments are made through the automated system.
-The report is available for review from the first of the month immediately following the end of the quarter
-and continues to be available through the last working day of the quarter. A consolidated final report is
-available to be printed by local offices following the last working day of the quarter.
-This FS-209 report is run quarterly even if the local office has not collected any payments or other claims
-activities. The local office shall not be required to submit Form FS-209 if the material on the automated
-system FS-209 is accurate and complete for that local office.
-4.802
-
-APPEAL PROCESS
-
-Any household that is aggrieved by any action of the local office affecting the household's participation in
-SNAP may appeal by requesting a local-level dispute resolution conference (DRC) and/or a state-level
-fair hearing.
-The right of a household to a DRC and state-level hearing is primarily to ensure that a proposed eligibility
-determination or action is valid, to protect the person against an erroneous action concerning benefits,
-and to ensure reasonable promptness of local office action. The individual may choose to request a DRC
-or bypass the DRC and appeal directly to the Colorado Department of Human Services (CDHS) for a
-state-level fair hearing.
-CDHS may deny fair hearings to those households that are disputing a mass change, or the fact that a
-statewide reduction, cancellation, or suspension was ordered. In such instances, CDHS is not required to
-hold a fair hearing unless the request is based on the household's belief that the rules were misapplied.
-If the household has a combined appeal, the appeal will be bifurcated. The SNAP fair hearings unit will
-process and hear the SNAP appeal, and the Office of Administrative Courts (OAC) will process and hear
-the other benefits program appeal(s). The SNAP fair hearings unit will provide the parties with any
-necessary instructions and/or procedures related to combined appeals.
-4.802.1 Time Period for Requesting an Appeal
-A.
-
-A household shall be allowed to request a DRC or state-level fair hearing on the following:
-1.
-
-Any action by the local office that occurred in the previous ninety (90) calendar days.
-
-2.
-
-A loss of benefits that occurred in the previous ninety (90) calendar days. Such SNAP
-action shall include a denial of a request for restoration of benefits lost more than ninety
-(90) calendar days, but less than a year prior to the request.
-
-3.
-
-At any time during a certification period a household may request a fair hearing to dispute
-its current level of benefits.
-
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-
-B.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-An aggrieved household shall be advised that the use of a DRC is optional, and it shall in no way
-delay or replace the state-level fair hearing process. If the household does not want a DRC but
-desires to have the disputed matter considered only at a state-level hearing, this fact should be
-indicated in the case record. In these cases, the request for an appeal shall be forwarded to the
-SNAP fair hearings unit.
-
-4.802.2 Continuation of Benefits Pending Final Agency Decision
-A.
-
-Eligibility for Continuation of Benefits
-1.
-
-If a household requests a state-level fair hearing or local-level dispute resolution
-conference any time prior to the effective date of the Notice of Adverse Action and its
-certification period has not expired, the household's participation in the program shall be
-continued on the basis authorized immediately prior to the Notice of Adverse Action
-unless the household specifically waives continuation of benefits.
-Households which were not given a ten (10) day advance notice period plus one (1)
-additional calendar day for mailing time, or five (5) additional calendar days for mailing for
-households participating in the address confidentiality program (ACP), prior to the
-effective date of the Notice of Adverse Action shall be given ten (10) calendar days after
-the date the notice is mailed to appeal and receive continued benefits unless the
-household specifically waives continuation of benefits.
-
-B.
-
-2.
-
-If a request for an appeal is not made within the times specified above, benefits shall be
-reduced or terminated as provided in the Notice of Adverse Action. However, if the
-household established that its failure to make the request within the established
-timeframe was for circumstances beyond the individual’s control, the local office shall
-reinstate the household’s benefits on the basis authorized immediately prior to the Notice
-of Adverse Action, unless the household indicates it has waived continuation of benefits.
-Such circumstances are: illness, illness of another household member requiring the
-presence of the member, a household emergency, the unavailability of transportation, or
-other circumstances that would preclude the individual from taking the required action.
-
-3.
-
-When benefits are reduced or terminated because of a mass change, participation on the
-prior basis shall be reinstated only if the issue being contested is that SNAP eligibility or
-benefits were improperly computed or that federal regulations or state rules were
-misapplied or misinterpreted by the local office.
-
-4.
-
-Households appealing a decision based on information reported as part of the
-recertification process are not eligible for continued benefits. The benefit allotment that a
-household is certified to receive shall not be issued beyond the end of the household’s
-assigned certification period without a new determination of eligibility. The household’s
-benefit allotment beginning with the new certification period shall be based on the new
-review of eligibility.
-
-Household’s Requirement to Request a Continuation of Benefits
-If the letter or form requesting an appeal does not positively indicate that the household has
-waived continuation of benefits, the local office shall assume that continuation of benefits is
-desired, and the benefits shall be issued accordingly.
-
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-
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Establishing a Claim on Benefits That Were Continued
-If the local office action is upheld by the hearing decision, a claim shall be established against the
-household for all over-issuances. This includes over-issuances due to the household receiving a
-continuation of benefits that the household was determined not eligible to receive. Such claims
-shall be classified as an inadvertent household error claim.
-
-D.
-
-The certification office shall promptly inform the household in writing if the benefits are reduced or
-terminated pending the final agency decision. Once benefits are continued or reinstated, benefits
-shall not be reduced or terminated prior to the receipt of the final agency decision unless:
-1.
-
-The certification period expires. The household may reapply and may be determined
-eligible for a new certification period with a benefit amount as determined by the local
-office.
-
-2.
-
-The administrative adjudicator makes a preliminary determination, in writing and at the
-hearing, that the sole issue is one of federal law or regulation and that the household's
-claim that the local office improperly computed the benefits or misinterpreted or
-misapplied such law or regulation is invalid.
-
-3.
-
-A change affecting the household's eligibility or basis of issuance occurs while the final
-agency decision is pending, and the household fails to request a hearing after the
-subsequent Notice of Adverse Action.
-
-4.
-
-A mass change affecting the household's eligibility or basis of issuance occurs while the
-final agency decision is pending. During the fair hearing period, the local office shall
-adjust allotments to consider reported changes, information considered verified upon
-receipt, and mass changes, but not the factors on which the fair hearing is based.
-
-4.802.21
-
-Households Disputing Restoration of Lost Benefits
-
-A.
-
-The household has the right to appeal through the fair hearing process if the household disagrees
-with any action taken to grant or restore lost benefits.
-
-B.
-
-If the local office has determined that a household is entitled to restoration of lost benefits but the
-household is appealing some action in calculating or restoring the lost benefits, the household
-shall receive the lost benefits as determined by the local office, pending the hearing results. Once
-a final agency decision is reached, the local office shall comply with that decision.
-
-C.
-
-To be eligible for restored benefits, the household shall have had its SNAP benefits wrongfully
-delayed, denied, or terminated. The term denial shall include the situation where, through
-certification office error, the net income was larger than required under proper determination, and
-because of this improperly set net income, the household was unable to get the full allotment for
-which it was eligible. Delay shall mean that eligibility determination was not accomplished within
-the prescribed time limits set forth in Section 4.205.2.
-
-4.802.3 Rights During an Appeal
-A.
-
-A household is entitled to the following:
-1.
-
-Be represented by an authorized representative, such as legal counsel, relative, friend, or
-other spokesman, or they may represent themselves at the DRC or state-level fair
-hearing.
-
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-
-2.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Adequate opportunity to examine the case file and all documents and records used by
-the local office in making its decision and all documents and records that are to be used
-at the hearing at a reasonable time before the date of the hearing as well as during the
-hearing.
-The contents of the case file including the application form and documents of verification
-used by the local office to establish the household's eligibility and allotment shall be
-made available, provided that confidential information, such as the names of individuals
-who have disclosed information about the household without its knowledge; or the nature
-or status of pending criminal prosecutions; or confidential informants; or privileged
-communications between the local office and its attorney is protected from disclosure.
-If requested by the household or its representative, the local office shall provide a free
-copy of the portions of the case file that are relevant to the hearing. Confidential
-information that is protected from release and other documents or records which the
-household will not otherwise have an opportunity to contest, or challenge shall not be
-introduced at the hearing nor affect the hearing officer's decision.
-
-3.
-B.
-
-Present new information or documentation to support reversal or modification of the
-proposed adverse action.
-
-The household, its representative, and the local office shall be entitled to:
-1.
-
-Present the case or have it presented by a legal counsel or other person.
-
-2.
-
-Bring witnesses.
-
-3.
-
-Advance arguments without undue interference.
-
-4.
-
-Question or refute any testimony or evidence, including an opportunity to confront and
-cross-examine adverse witnesses.
-
-5.
-
-Submit evidence to establish all pertinent facts and circumstances in the case.
-
-4.802.4 Local Office Responsibility During an Appeal
-A.
-
-Upon request, the local office shall make available without charge the specific materials
-necessary for a household or its representative to determine whether a hearing should be
-requested or to prepare for a hearing. If the individual making the request communicates in a
-language other than English, the local office is required to provide bilingual staff or an interpreter
-who can effectively translate between the client’s language and English. The local office shall
-ensure that the hearing procedures are verbally explained in that language, upon request. The
-local office shall also help a household with its hearing process. Households shall be advised of
-any legal services available that can provide representation at the hearing.
-
-B.
-
-The local office shall expedite hearing requests from households, such as migrant farm workers,
-that plan to move from the jurisdiction of the hearing officer before the hearing decision would
-normally be reached. Hearing requests from these households shall be processed faster than
-others, if necessary, to enable them to receive a decision before they leave the area.
-
-C.
-
-The local office shall have the burden of proof, by a preponderance of the evidence, to establish
-the basis of the issue being appealed whether the appeal is at a state-level fair hearing or at a
-local-level DRC. This burden of proof applies to all matters other than IPV, which is outlined in
-sections 4.803.2, C and 4.803.2, E.
-
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-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.802.5 Local-Level Dispute Resolution Conferences (DRC)
-A.
-
-Before taking action to deny, terminate, reduce, or recover SNAP benefits, the local office shall
-provide the household an opportunity for a DRC. The individual may choose to bypass the DRC
-process and appeal directly to the SNAP fair hearings unit for a state-level fair hearing.
-
-B.
-
-If the household requests a DRC, the local office shall arrange one to attempt to resolve the
-disputed action. The household may be represented by legal counsel or have other persons
-present to aid the household in the DRC.
-
-C.
-
-Failure of the client to request a DRC within the prior notice period or failure to appear at the time
-of the scheduled DRC without making a timely request for postponement shall constitute
-abandonment of the right to a DRC, unless the client can show good cause for their failure to
-appear. “Good cause” includes, but is not limited to:
-
-D.
-
-1.
-
-Death or incapacity of a client, or a member of his or her immediate family, or the
-representative;
-
-2.
-
-Any other health or medical condition of an emergency nature; or
-
-3.
-
-Other circumstances beyond the control of the client, and which would prevent a
-reasonable person from making a timely request for a DRC or postponement of a
-scheduled DRC.
-
-The local office may consolidate the SNAP DRC with disputes regarding other assistance
-payments programs, the Colorado Works (CW) Program, or disputes concerning Medicaid
-eligibility if the facts are similar and consolidation will facilitate the resolution of all disputes.
-
-4.802.51
-A.
-
-Management of Local-Level Dispute Resolution Conference (DRC)
-
-General Requirements
-The DRC shall be conducted on an informal basis. Every effort shall be made to ensure that the
-household understands the local office’s specific reasons for the proposed action and the
-applicable State Department's rules. The local office shall have available at the DRC all pertinent
-documents and records in the case file relevant to the specific action in dispute.
-
-B.
-
-Scheduling
-1.
-
-To the extent possible, the DRC shall be scheduled and conducted within the prior notice
-period. If the local office cannot conduct the DRC within this period, for whatever reason,
-the adverse action in dispute shall be delayed until a DRC can be held, unless the
-household waives continuation of benefits.
-
-2.
-
-If a DRC is requested to attempt to resolve a contested denial of expedited service, it
-shall be scheduled within two (2) working days of the receipt of the request for a DRC
-unless the household requests that it be held later. Prior notice is not required.
-
-3.
-
-The local office shall provide reasonable notice to the household of the scheduled time
-and location for the DRC, or the time of the scheduled telephone conference. Notice shall
-be in writing; however, verbal notice may be given to facilitate the DRC process.
-
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-
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Location
-The DRC shall be held in the local office where the proposed decision is pending and before a
-person who was not directly involved in the initial determination of the action in question. The
-DRC may be conducted either in person or by telephone. If a telephonic conference is requested,
-it shall be agreed upon by the client. In the event the household does not speak English or is
-visually or hearing impaired, an interpreter or translator shall be provided by the local office.
-
-D.
-
-County Representatives
-The individual who initiated the action in dispute shall not conduct the DRC. The individual who
-initiated the action in dispute shall attend the DRC and present the factual basis for the disputed
-action. The person designated to conduct the DRC shall be in a position which, based on
-knowledge, experience, and training, would enable them to determine if the proposed action is
-valid.
-
-E.
-
-Joint Dispute Resolution Processes
-Two (2) or more local offices may establish a joint DRC process. If two or more counties establish
-a joint process, the location of the DRC need not be held in the county or agency taking the
-action, but the DRC location shall be convenient to the client.
-
-F.
-
-Notice of DRC Decision
-1.
-
-If the additional information presented in the DRC proves that the adverse action is not
-warranted, the case record shall be documented, and the Notice of Adverse Action
-cancelled.
-
-2.
-
-At the conclusion of the DRC, the person presiding shall reduce to writing the agreement
-entered by the parties. Such agreement shall be signed by the parties and/or their
-representatives and shall be binding upon the parties. A copy of the written decision shall
-immediately be provided to the client and/or his or her representative. The local office
-shall also forward a copy of the decision to the State Department, within five (5) working
-days of the hearing, regardless of whether the client agrees with the outcome.
-
-3.
-
-In the event the dispute is not resolved, the person presiding shall prepare a written
-statement indicating that the dispute was not resolved. The decision shall include:
-a.
-
-A statement explaining the client’s right to request a state-level fair hearing;
-
-b.
-
-The time limit for requesting a state-level hearing; and,
-
-c.
-
-If appropriate, a statement that the household’s previous benefit amount will
-continue pending a final state decision in accordance with Section 4.802.2, if
-appealed to the state within the appeal timeframe provided on the original Notice
-of Action cooresponding to the disputed action.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.802.6 STATE-LEVEL FAIR HEARINGS
-4.802.61
-A.
-
-Scheduling
-1.
-
-B.
-
-MANAGEMENT OF STATE-LEVEL HEARINGS
-
-The SNAP fair hearings unit at the Colorado Department of Human Services (CDHS) or
-the Office of Administrative Courts (OAC), if so designated by CDHS, shall arrange the
-time, date, and place of the state-level fair hearing so that the hearing is accessible to the
-household. At least ten (10) calendar days prior to the hearing, advance written notice
-shall be provided to all parties involved to permit adequate preparation of the case. The
-household, however, may request less advanced notice to expedite the scheduling of the
-hearing. The notice shall:
-a.
-
-Advise the household or its representative of the name, address, and phone
-number of the person to notify in the event it is not possible for the household to
-attend the scheduled hearing.
-
-b.
-
-Specify that the household's hearing request will be dismissed if the household or
-its representative fails to appear for the hearing without good cause.
-
-c.
-
-Include a copy of the information outlining CDHS’ state-level fair hearing
-procedures.
-
-d.
-
-Explain that the household may examine the case file prior to the hearing.
-
-2.
-
-Hearing requests for households that plan to move from the area, such as migrant farm
-workers, shall be processed faster than others, if necessary, to enable them to receive a
-decision and any appropriate restoration of benefits before they leave the area.
-
-3.
-
-The administrative adjudicator shall complete the hearing no more than twenty-five (25)
-calendar days from when the SNAP fair hearings unit received the notice of appeal. The
-household may request and is entitled to receive a postponement (also referred to as a
-continuance) of the scheduled hearing. The postponement shall not exceed 30 days and
-the time limit for action on the final agency decision may be extended for as many days
-as the hearing is postponed. A county may not request and is not entitled to receive a
-postponement.
-
-4.
-
-The administrative adjudicator may respond to a series of individual requests for hearings
-by conducting a single group hearing related to SNAP appeals. The snap fair hearings
-unit may consolidate only SNAP related cases where individual issues of fact are not
-disputed and where related issues of state and/or federal law, regulation, or policy are the
-sole issues being raised. In all group hearings, the regulations governing individual
-hearings shall be followed. Each individual household shall be permitted to present its
-own case or have its case presented by a representative.
-
-Hearings Conducted by Phone
-The hearing may be conducted by telephone using conference call techniques or by video
-conference unless one of the parties objects to either of these methods. If a hearing is held by
-telephone using conference call techniques or by video conference, the rules of procedure
-(including a recording of the hearing) shall be the same as a face-to-face hearing.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Attendance
-The hearing shall be attended by a representative of the local office and by the household and/or
-its representative. The hearing may also be attended by friends or relatives of the household if
-the household so chooses. The administrative adjudicator shall have the authority to limit the
-number of persons in attendance at the hearing if space limitations exist.
-
-D.
-
-Administrative Adjudicator
-The administrative adjudicator shall:
-1.
-
-Administer all oaths or affirmations as required by the State;
-
-2.
-
-Ensure all relevant issues are considered;
-
-3.
-
-Request, receive, and make part of the record all evidence determined necessary to
-decide the issues being raised;
-
-4.
-
-Regulate the conduct and course of the hearing consistent with due process to ensure an
-orderly hearing;
-
-5.
-
-Order, where relevant and useful, an independent medical assessment or professional
-evaluation from a source mutually satisfactory to the household and the local office;
-
-6.
-
-Provide a hearing record and prepare and file an initial hearing decision with the Office of
-Appeals (OOA) which shall serve each party with a copy of the initial decision.
-
-4.802.62
-A.
-
-Hearing Denials or Dismissals
-
-CDHS shall not deny or dismiss a request for a hearing unless:
-1.
-
-The request is not received within the time period specified in Section 4.802.1.
-
-2.
-
-The request is withdrawn in writing by the household or its representative; or,
-
-3.
-
-The household or its representative fails, without good cause, to appear at the scheduled
-hearing.
-
-B.
-
-The administrative adjudicator shall not enter a default against any party for failure to file a written
-answer to the notice of hearing but shall base the initial decision upon the evidence presented at
-the hearing.
-
-C.
-
-When the administrative adjudicator dismisses an appeal for reasons other than failure to appear,
-the decision of the administrative adjudicator shall be an initial decision, which shall not be
-implemented pending review by the Office of Appeals and entry of a final agency decision.
-
-D.
-
-When an appellant fails to appear at a duly scheduled hearing, having been given proper notice,
-and without having given timely advance notice to the administrative adjudicator of acceptable
-good cause for inability to appear at the hearing at the time, date and place specified in the notice
-of hearing, then the appeal shall be considered abandoned, and an order of dismissal shall be
-entered by the administrative adjudicator and served upon the parties by the Office of Appeals
-(OOA). The order of dismissal for failure to appear shall not be implemented pending review by
-the OOA and entry of a final agency decision.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-The appellant, however, shall be afforded a period of ten (10) calendar days from the date the
-order of dismissal was mailed, during which the appellant may explain in a letter to the
-administrative adjudicator the reason for his or her failure to appear. If the administrative
-adjudicator, then finds that there was acceptable good cause for the appellant not appearing, the
-administrative adjudicator shall vacate the order dismissing the appeal and reschedule another
-hearing date.
-If the appellant does not submit a letter seeking to show good cause within a period of ten (10)
-calendar days, the order of dismissal shall be filed with the OOA. The OOA shall confirm the
-dismissal of the appeal by an agency decision, which shall be served upon the parties and the
-interested division of the State Department. Within three (3) working days after the effective date
-of the decision, the local office shall implement necessary actions to provide benefits in the
-correct amount, terminate benefits, recover benefits incorrectly paid, and/or other appropriate
-actions in accordance with the rules.
-If the appellant submits a letter seeking to show good cause and the administrative adjudicator
-finds that the stated facts do not constitute good cause, the administrative adjudicator shall enter
-an initial decision confirming the dismissal.
-4.802.63
-A.
-
-State-Level Hearing Decisions
-
-Decisions of the administrative adjudicator shall not run counter to Federal law, State Department
-rule, or state statute, and shall be based on the hearing record.
-The exclusive record for an initial decision by the administrative adjudicator shall constitute the
-verbatim transcript or recording of testimony and exhibits, or an official report containing the
-substance of what transpired at the hearing, together with all papers and requests filed in the
-proceedings. This record shall be retained in accordance with normal retention periods. This
-record shall also be available to the household or its representative at any reasonable time for
-copying and inspection.
-
-B.
-
-Following the conclusion of the state hearing, the administrative adjudicator shall promptly
-prepare and issue an initial decision and file it with the OOA.
-
-C.
-
-Initial Decision
-1.
-
-The administrative adjudicator shall render an initial decision within ten (10) calendar
-days of the hearing date. However, if the head of the household or the household’s
-representative requests a delay in the proceedings, the time limit for action on the
-decision may be extended for as many days as the hearing is delayed, up to thirty (30)
-calendar days.
-
-2.
-
-The initial decision shall make an initial determination whether the county or the Colorado
-Department of Human Services (CDHS) or its agent acted in accordance with, and/or
-properly interpreted, the rules of the State Department. The administrative adjudicator
-may determine whether statutes were properly interpreted and applied only when no
-implementing state rules exist. The administrative adjudicator has no jurisdiction or
-authority to determine issues of constitutionality or legality of departmental rules.
-
-3.
-
-The initial decision shall advise the household that failure to file exceptions to provisions
-of the initial decision will waive the right to seek judicial review of a final agency decision
-affirming those provisions.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-D.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.
-
-The Office of Appeals shall promptly serve the initial decision upon each party by first
-class mail and shall transmit a copy of the decision to the divisions of the State
-Department that administer the program(s) pertinent to the appeal.
-
-5.
-
-The initial decision by the administrative adjudicator shall summarize the facts of the
-case, specify the reasons for the initial decision, and identify the supporting evidence and
-the pertinent rules.
-
-6.
-
-The Office of Appeals at CDHS, as the designee of the Executive Director, shall review
-the initial decision of the administrative adjudicator and shall enter a final agency decision
-affirming, modifying, or reversing the initial decision. The Office of Appeals may issue an
-order of remand upon receipt of the initial decision and identification of an issue that
-warrants a remand before the initial decision is sent to the parties. Additionally, the Office
-of Appeals may issue an order of remand at the time of the substantive review of an initial
-decision for final agency decision. An order of remand is not a final agency decision that
-is subject to judicial review. The initial decision shall not be implemented pending review
-by the Office of Appeals and entry of a final agency decision. While review of the initial
-decision is pending before the Office of Appeals, the record on review, including any
-transcript or tape of testimony filed with the Office of Appeals, shall be available for
-examination by any party at the Office of Appeals during regular business hours.
-
-Exceptions to the Initial Decision
-1.
-
-Any party seeking a final agency decision that reverses, modifies, or remands the initial
-decision of the administrative adjudicator must file a written notice of intent to file
-exceptions to the decision with the OOA within five (5) calendar days - plus three (3)
-calendar days for mailing - from the date the initial decision is mailed to the parties. If the
-party has filed such a notice of intent, the party will have fifteen (15) calendar days, plus
-three (3) calendar days for mailing from the date the initial decision is mailed to the
-parties to file its written exceptions with the OOA. Exceptions shall state specific grounds
-for reversal, modification, or remand of the initial decision. Exceptions that fail to state
-specific grounds for reversal, modification, or remand of the initial decision shall be
-considered as only arguments of general dissatisfaction.
-
-2.
-
-If any party asserts that the administrative adjudicator findings of fact are not supported
-by the weight of the evidence, the OOA will request the SNAP fair hearings unit provide
-an audio recording of the hearing to the OOA. If the local office asserts that the
-administrative adjudicator’s findings of fact are not supported by the weight of the
-evidence, the local office shall provide a hearing transcript to the OOA on or before the
-deadline for the filing of exceptions. If the local office’s yearly budget is not sufficient to
-pay the cost of a hearing transcript, the local office may request that the OOA review an
-audio recording of the hearing in lieu of a hearing transcript. Such requests must be
-mailed or emailed to the OOA at least five (5) calendar days before the deadline for the
-filing of exceptions. Additionally, the letter must indicate the insufficiency of the local
-office’s budget to pay for a hearing transcript and the letter must be signed by the county
-department’s director. The OOA shall issue an order regarding the request, and if
-granted, the OOA shall request the audio recording from the SNAP fair hearings unit. If
-the division(s) of the State Department responsible for administering the program(s)
-relevant to the appeal assert(s) that the administrative adjudicator’s findings of fact are
-not supported by the weight of the evidence, it shall simultaneously with, or prior to the
-filing of exceptions, file a hearing transcript with the OOA on or before the deadline for
-filing exceptions.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-E.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-3.
-
-Considering the federal timeliness requirements for SNAP cases, a party may not request
-an extension of time to file exceptions unless a party is able to show sufficient good
-cause as to why an extension of time should be granted. The determination of good
-cause is within the sole discretion of the OOA. When an extension of time is granted by
-the OOA, the extension shall not be for more than five (5) calendar days after the original
-exceptions filing deadline. Local offices or the State Department will need to immediately
-review initial decisions to assess any need to request an audio recording from the SNAP
-fair hearings unit to receive the audio recording and expedite the transcription of the
-audio recording through whatever transcription service it chooses. Any party requesting
-transcription services shall be fully responsible for the cost of such.
-
-4.
-
-If the exceptions do not challenge the findings of fact, but instead assert only that the
-administrative adjudicator improperly interpreted or applied state rules or relevant
-statutes, no transcript review or audio recording review is required.
-
-5.
-
-The OOA shall serve a copy of the exceptions on each party by first class mail and by
-electronic mail if the party has consented to receiving communications by electronic mail.
-Each party shall be limited to ten (10) calendar days from the date exceptions are mailed
-to the parties in which to file a written response to such exceptions. The OOA shall not
-permit oral argument.
-
-6.
-
-The OOA shall not consider evidence that was not part of the record before the
-administrative adjudicator. However, the case may be remanded to the administrative
-adjudicator for rehearing if a party establishes in its exceptions that material evidence has
-been discovered that the party could not with reasonable diligence have produced at the
-hearing.
-
-7.
-
-The division(s) of the State Department responsible for administering the program(s)
-relevant to the appeal may file exceptions to the initial decision, or respond to exceptions
-filed by a party, even though the Division has not previously appeared as a party to the
-appeal. The Division's exceptions shall be filed in compliance with the requirements of
-section 4.802.63, D, 1 and 2, above. Exceptions filed by a Division that did not appear as
-a party at the hearing shall be treated as requesting a review of the initial decision upon
-the State Department's own motion.
-
-Final Agency Decisions
-1.
-
-The OOA shall enter a final agency decision resolving the appeal within sixty (60)
-calendar days after the request for appeal was received by the SNAP fair hearings unit.
-
-2.
-
-In the absence of exceptions filed by any party or by a division of the State Department,
-or when exceptions are filed, the OOA shall review the initial decision and may review the
-hearing file of the administrative adjudicator and/or the taped testimony of witnesses
-before entering a final agency decision. Review by the OOA shall determine whether the
-initial decision properly interprets and applies the rules of the State Department or
-relevant statutes and whether the findings of fact and conclusions of law support the
-decision. If a party or Division of the State Department objects to the final agency
-decision entered upon review by the OOA, the party or Division may seek
-reconsideration.
-
-3.
-
-The OOA shall mail copies of the final agency decision to all parties by first class mail.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-4.
-
-F.
-
-For purposes of requesting judicial review, the effective date of the final agency decision
-shall be the third (3rd) day after the date the decision is mailed to the parties, even if the
-third day falls on Saturday, Sunday, or a legal holiday. The parties shall be advised of this
-in the final agency decision.
-
-Motion for Reconsideration of a Final Agency Decision
-1.
-
-G.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-A motion for reconsideration of a final agency decision may be granted by the OOA for
-the following reasons:
-a.
-
-Upon a showing of good cause for failure to file exceptions to the initial decision
-within the fifteen (15) calendar day period; or,
-
-b.
-
-Upon a showing that the final agency decision is based upon a clear or plain
-error of fact or law. An error of law means failure by the OOA to follow a rule,
-statute, or court decision that controls the outcome of the appeal.
-
-2.
-
-No motion for reconsideration shall be granted unless it is filed in writing with the OOA
-within fifteen (15) calendar days of the date that the final agency decision is mailed to the
-parties. The motion shall state specific grounds for reconsideration of the agency
-decision.
-
-3.
-
-The OOA shall mail a copy of the motion for reconsideration to each party of record and
-to the appropriate Division of the State Department.
-
-Acting on Decisions
-1.
-
-Initial decisions shall not be implemented pending review by the OOA and entry of a final
-agency decision.
-
-2.
-
-The State Department or local office shall initiate action to comply with the final agency
-decision within three (3) working days after the effective date. The acting
-department/office shall comply with the decision, even if reconsideration is requested,
-unless the effective date of the agency decision is postponed by order of the OOA or a
-reviewing court.
-
-3.
-
-If it is ruled that the household had its SNAP benefits wrongfully delayed, denied, or
-terminated, the local office shall provide retroactive benefits. If it is decided that benefits
-were over-issued before and during the pendency of the determination of final agency
-action, a claim for over-issued benefits will be prepared.
-
-4.
-
-Final agency decisions which result in an increase in household benefits shall be
-reflected in the benefit allotment within ten (10) days of the receipt of the decision, even if
-the local office is obligated to provide a supplementary allotment or otherwise provide the
-household with the opportunity to obtain the allotment outside of the normal cycle.
-However, the local office may take longer than ten (10) days if it elects to make the
-decision effective in the household's normal issuance cycle, provided that the issuance
-will occur within sixty (60) days from the household's request for the hearing.
-
-5.
-
-Final agency decisions which result in a decrease in household benefits shall be reflected
-in the next scheduled issuance following receipt of the decision unless the decision is
-stayed by the OOA upon a showing of irreparable harm.
-
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-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.803
-
-IPV AND FRAUD [Rev. eff. 1/1/16]
-
-A.
-
-Local offices shall be responsible for investigating any case of alleged intentional program
-violation/fraud and insuring that appropriate cases are acted upon either through administrative
-hearings; by referral to a court of appropriate jurisdiction; by obtaining a waiver of administrative
-hearing; or by obtaining a signed disqualification consent agreement.
-
-B.
-
-Local offices are encouraged to refer for prosecution under state fraud statutes those individuals
-suspected of committing fraud, particularly if large amounts of benefits are suspected of being
-fraudulently obtained or the individual is suspected of committing more than one (1) fraudulent
-act. The local office shall confer with its legal representative to determine the types of cases that
-will be accepted for possible prosecution.
-Local offices are also encouraged to enter into prosecution agreements with their district court.
-Agreements should include information on how, and under what circumstances, cases will be
-accepted for possible prosecution and any other criteria set by the court for accepting cases for
-prosecution, such as a minimum amount of over-issuance that resulted from the intentional
-program violation.
-
-C.
-
-Administrative disqualification procedures or referral for prosecution should be initiated by the
-local office anytime it has sufficient documentary evidence to substantiate that an individual has
-committed one or more acts of intentional program violation/fraud. If administrative
-disqualification procedures or referral for prosecution is not initiated for a case involving an overissuance caused by a suspected act of intentional program violation/fraud, an inadvertent
-household error claim shall be established against the household.
-
-D.
-
-In cases where the determination of fraud is reversed by a court of appropriate jurisdiction or by a
-final agency decision, the local office shall reinstate the individual in the Program if the household
-is otherwise eligible. The local office shall restore any benefits that were lost as a result of the
-disqualification.
-
-E.
-
-The local office shall inform the household in writing of disqualification penalties for IPV each time
-it applies for SNAP benefits. The penalty warning will appear in clear, boldface lettering on the
-SNAP application forms and shall serve as notification to the household.
-
-4.803.1 Documenting and Reporting IPV/Fraud to the State Department
-Local offices shall enter into the automated system individuals disqualified for intentional program
-violation/fraud prior to the second (2nd) to the last working day of the month. In addition, local offices shall
-prepare quarterly a form FS-36A, Investigation/Intentional Program Violation/Fraud Report. The
-completed report shall be due fifteen (15) calendar days after the end of the quarter to the State
-Department.
-4.803.2 Determination of an IPV /Fraud
-A.
-
-An intentional program violation shall be established only if an administrative disqualification
-hearing official or a court of appropriate jurisdiction has found a household member has
-committed an intentional program violation or fraud or if a signed waiver of administrative hearing
-or a signed disqualification consent agreement has been obtained.
-
-B.
-
-For purposes of determining, through administrative disqualification hearings, whether a person
-has committed an IPV, the determination shall be based upon whether the person intentionally:
-1.
-
-Made a false or misleading statement, or misrepresented, concealed, or withheld facts;
-or,
-
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-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-2.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Committed any act that constitutes a violation of the Food and Nutrition Act of 2008, as
-amended, these SNAP rules, Federal SNAP regulations, or any state statute for the
-purpose of using, presenting, transferring, acquiring, receiving, possessing, or trafficking
-of SNAP benefits, authorization cards or reusable documents as part of an automated
-benefit delivery system access device.
-“Intentionally” means a false representation of a material fact with knowledge of that
-falsity, or omission of a material fact with knowledge of that omission.
-
-C.
-
-The determination of IPV/fraud shall be based upon clear and convincing evidence that
-demonstrates that the household member(s) committed and intended to commit IPV. “Clear and
-convincing” means evidence which is stronger than a “preponderance of evidence” and which is
-unmistakable and free from serious or substantial doubt.
-
-D.
-
-The same act of IPV/fraud repeated over a period of time shall not be separated so that separate
-disqualification periods can be imposed.
-
-E.
-
-The burden of proving IPV/fraud is with the local office.
-
-F.
-
-Disqualification periods shall be imposed based on the following:
-1.
-
-Administrative Disqualification Hearing (ADH)
-If an IPV/fraud is determined through an ADH, the individual must be notified in writing
-once it is determined that they are to be disqualified. The disqualification period shall
-begin no later than the second month which follows the date the individual receives
-written notice of the disqualification.
-
-2.
-
-Waiver of an ADH
-If an IPV/fraud is determined through the client signing a waiver of an administrative
-disqualification hearing form, then the period of disqualification shall begin with the first
-month which follows the date the household member receives written notification of the
-disqualification.
-
-3.
-
-Court Decisions
-If an individual is determined through a court to be disqualified for an IPV/fraud, but the
-date for initiating the disqualification period is not specified, the local office shall initiate
-the disqualification period for currently eligible individuals within forty-five (45) calendar
-days of the date the disqualification was ordered. Any other court-imposed
-disqualification shall begin within forty-five (45) calendar days of the date the court found
-a currently eligible individual guilty of civil or criminal misrepresentation or fraud.
-
-4.
-
-Disqualification Consent Agreements
-Unless contrary to the court order, the period of disqualification shall begin within fortyfive (45) calendar days from the date the household member signed the disqualification
-consent agreement. However, if the court imposes a disqualification period or specifies
-the date for initiating the disqualification period, the state department shall disqualify the
-household member in accordance with the court order.
-
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-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.803.3 Time Period and Types of Disqualifications [Rev. eff. 1/1/16]
-A.
-
-IPV
-Individuals who have waived a hearing for IPV or who have been found to have committed an IPV
-through a local-level or state administrative IPV decision shall be ineligible to participate in SNAP
-for twelve (12) months for the first (1st) IPV; twenty-four (24) months for the second (2nd) IPV;
-and permanently for the third (3rd) IPV/fraud.
-
-B.
-
-Receiving Duplicate Benefits
-Individuals who misrepresent their identity or residency to receive duplicate benefits shall be
-ineligible to participate in SNAP for a period of ten (10) years. Receiving duplicate benefits is
-considered an attempt to receive or the receipt of more than one original allotment of benefits
-during a calendar month. A permanent disqualification for a third (3rd) offense would override the
-disqualification period for duplicate benefits.
-
-C.
-
-D.
-
-Trafficking Benefits
-1.
-
-The penalties for trafficking SNAP benefits are outlined in Section 26-2-306(2), C.R.S.
-
-2.
-
-An individual convicted through a court of law of trafficking in SNAP of five hundred
-dollars ($500) or more will be disqualified permanently.
-
-Drug Convictions
-An individual shall not be ineligible due to a drug conviction unless misuse of SNAP benefits is
-part of the court findings. An individual found guilty of purchasing controlled substances, as
-defined in Section 18-18-102 (5), C.R.S., with SNAP benefits will be disqualified for twenty-four
-(24) months on the first (1st) conviction by a court of law and permanently disqualified on a
-second (2nd) conviction by a court of law. The disqualification periods shall also apply to
-individuals with a felony conviction entered on or after July 1, 1997, for possession, use, or
-distribution of controlled substances only if the conviction is directly related to the misuse of
-SNAP benefits.
-
-E.
-
-An individual found guilty in a court of law of trading or purchasing firearms, ammunition, or
-explosives with SNAP benefits will be permanently disqualified on the first (1st) conviction. An
-individual will be disqualified even in the cases of deferred adjudication.
-
-4.803.4 Pursuing Disqualifications for IPV/Fraud [Rev. eff. 1/1/16]
-A.
-
-The provisions of these rules concerned with state-level fair hearings at Sections 4.802.6 and at
-4.802.3 are also applicable for state and local administrative disqualification hearings.
-
-B.
-
-Whenever the local office has accumulated evidence to substantiate that a person has committed
-one or more acts of intentional program violation as defined above, the establishment of an
-intentional program violation shall be determined via:
-1.
-
-An administrative disqualification hearing; or,
-
-2.
-
-A signed waiver of administrative hearing; or,
-
-3.
-
-For cases referred to a court of appropriate jurisdiction, through a signed disqualification
-consent agreement for plea bargained cases or cases of deferred adjudication.
-
-205
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-The local office may conduct a local-level administrative disqualification hearing for intentional
-Program violation or may use the Office of Administrative Courts of the Colorado Department of
-Personnel and Administration to conduct a state-level administrative disqualification hearing. The
-local office may also initiate court action by referring an intentional program violation under state
-fraud statutes to a court of appropriate jurisdiction.
-C.
-
-If the local office determines that there is evidence to substantiate that a person has committed
-an IPV/fraud, the local office shall, prior to initiating an administrative disqualification hearing,
-allow that person the opportunity to waive his or her right to an administrative disqualification
-hearing or, for cases referred to a court of appropriate jurisdiction, to sign a disqualification
-consent agreement for plea bargained cases or cases of deferred adjudication. However, prior to
-providing the request for waiver, there shall be a review of the evidence against the household
-member by a staff member who was not involved in the investigation of the household and who
-has a thorough enough understanding of SNAP policy to ensure that policy is being correctly
-applied and that the evidence meets the “clear and convincing” criteria (see Section 4.803.2, C)
-necessary to warrant the pursuit of an IPV/fraud determination.
-
-D.
-
-An administrative disqualification hearing may be initiated regardless of the current eligibility of
-the individual charged. An administrative hearing should be initiated under the following
-circumstances:
-1.
-
-Whenever the facts of the individual case do not warrant civil or criminal prosecution
-through the appropriate court system; or,
-
-2.
-
-In cases that were previously referred for prosecution and were declined by appropriate
-legal authority; or,
-
-3.
-
-In previously referred cases where no action was taken within a reasonable period of
-time and which were formally withdrawn by the local office.
-
-E.
-
-Administrative hearings shall not be requested against an accused individual whose case is
-currently being referred for prosecution or subsequent to any action taken against the accused
-individual by the prosecutor or court of appropriate jurisdiction, if the factual issues of the case
-arise out of the same or related circumstances.
-
-F.
-
-To request a state or local-level administrative hearing for intentional program violation, the local
-office shall submit a request to the Colorado Department of Personnel and Administration, Office
-of Administrative Courts. To request a local-level administrative hearing, the local office shall
-submit a request to the local-level hearing officer. When initiating an administrative
-disqualification hearing for intentional program violation/fraud, the Notice of Hearing form shall be
-sent to the household member at least thirty (30) calendar days in advance of the scheduled local
-hearing. At the time of the hearing, the local office will have the opportunity to present the full
-body of evidence.
-
-G.
-
-The Department of General Support Services, Division of Administrative Hearings, may combine
-a fair hearing and an administrative disqualification hearing into a single hearing if the factual
-issues arise out of the same or related circumstances and the household receives prior notice
-that the hearings will be combined. The amount of the claim will be contained on the notice of
-confirmation. If the intentional program violation hearings and fair hearings are combined, the
-Office of Administrative Courts (OAC) will follow the timeliness standards for conducting
-intentional program violation hearings. If the hearings are combined for the purpose of settling the
-amount of the claim and determining whether or not intentional program violation has occurred,
-the household shall lose its right to a subsequent fair hearing on the amount of the claim.
-However, OAC shall, upon request of the household, allow the household to waive the thirty (30)
-day advance notice period required in Section 4.803.43 when the intentional program violation
-hearing and fair hearing are combined.
-
-206
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-4.803.41
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Waiver of Administrative Disqualification Hearing [Rev. eff. 1/1/16]
-
-A.
-
-Households mailed a request for waiver of the administrative disqualification hearing shall be
-provided a copy of the statement of rights. The household shall be notified that it has fifteen (15)
-days from the date the waiver of administrative disqualification hearing was dated and mailed to
-respond by returning a completed waiver.
-
-B.
-
-The completion of the waiver of the administrative disqualification hearing for intentional program
-violation is voluntary and the local office shall not require its completion nor by its actions appear
-to require the completion of the waiver.
-
-C.
-
-If the household member suspected of intentional program violation signs the waiver of the
-administrative disqualification hearing and returns the waiver to the local office within fifteen (15)
-days from the date it is dated and mailed by the local office, that person and the head of
-household shall be provided with a notice of disqualification for waived hearing of intentional
-program violation
-
-D.
-
-The disqualification shall begin with the first (1st) month following the month the notice of
-disqualification is received by the household member.
-
-E.
-
-No further administrative appeal procedure exists after an individual voluntarily waives his/her
-right to an administrative disqualification hearing for intentional program violation. The
-disqualification penalty cannot be changed by a subsequent fair hearing decision. However, the
-household member is entitled to seek relief in a court having appropriate jurisdiction. The period
-of disqualification may be subject to stay by a court of appropriate jurisdiction or other injunctive
-remedy.
-
-F.
-
-If the waiver is not returned, the local offices that conduct local-level administrative
-disqualification hearings shall, within five (5) working days after the deadline for receipt of the
-waiver of administrative hearing, mail to the household a Notice of Intentional Program Violation
-Hearing together with a copy of the hearing procedure.
-
-4.803.42
-A.
-
-Scheduling an Administrative Disqualification Hearing for IPV
-
-The time and place of the state or local-level administrative disqualification hearing shall be
-arranged so that the hearing is accessible to the household member suspected of intentional
-program violation.
-The state-level hearing may be conducted by telephone using conference call techniques unless
-one of the parties objects to this method. If a hearing is held by telephone, the rules of procedure,
-including recording of the hearing, shall be the same as a face-to-face hearing. The household
-member charged with intentional program violation has the right to request a face-to-face hearing
-at any time, including up to and during the telephonic hearing, but not once the telephonic hearing
-is concluded.
-
-B.
-
-Persons that have been charged with intentional program violation and notified that a local-level
-administrative disqualification hearing has been scheduled have the right to request that their
-case be heard by a state-level Administrative Law Judge in the Office of Administrative Courts
-within (10) calendar days of being notified of a local-level hearing. If a state-level hearing is
-requested, the local office shall forward the request to the Office of Administrative Courts no later
-than three (3) working days from receipt of the request. No local-level administrative
-disqualification hearing shall be held if the accused requests a state-level hearing within these
-specified guidelines.
-
-207
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-C.
-
-If the household member or representative cannot be located or fails to appear at a hearing
-initiated by the local office without good cause, the hearing shall be conducted without the
-household member represented. However, the household member may subsequently appeal a
-disqualification from a decision on the basis of not being notified in accordance with Section
-4.803.43. If the household provides a statement of non-receipt and the county or the office of
-administrative courts cannot document receipt of the notice, a re-hearing of the evidence shall be
-scheduled and the previous decision shall no longer be valid. If the household member is not
-represented, the hearing official shall carefully consider the evidence and determine if the
-individual intended to commit an act of intentional program violation.
-
-D.
-
-If the household member is found to have committed intentional program violation but the State
-Department or a local hearing official later determines that the household member or
-representative had good cause for not appearing at a hearing initiated by the local office, the
-previous decision shall no longer remain valid and the Office of Administrative Courts or locallevel hearing officer shall conduct a new hearing. The hearing official who originally ruled on the
-case may conduct the new hearing. The household member who has received notice has a
-period of ten (10) calendar days from the date of the hearing to present reasons indicating a good
-cause for failure to appear. A hearing official shall enter the good cause into the record.
-
-4.803.43
-
-Notifying a Household of an IPV Administrative Disqualification Hearing
-
-A.
-
-The administrative adjudicator shall provide written notice to the household member suspected of
-intentional program violation at least thirty (30) calendar days in advance of the date an
-administrative disqualification hearing initiated by the local office has been scheduled.
-
-B.
-
-The notice shall be mailed by Certified Mail, Return Receipt Requested, or by first class mail or
-the notice may be served on the individual by any other reliable method, such as personal
-delivery by a SNAP worker or other employee, affidavit of service, Federal Express, etc. If no
-proof of receipt is obtained, a statement of non-receipt by the household member shall be
-considered as good cause for not appearing at the hearing. The notice shall contain at a
-minimum:
-1.
-
-The date, time, and place of the hearing;
-
-2.
-
-The charge(s) against the household member;
-
-3.
-
-A summary of the evidence and how and where the evidence can be examined;
-
-4.
-
-A warning that the decision will be based solely on information provided by the local
-office if the household member fails to appear at the hearing;
-
-5.
-
-A statement that the household member or representative will have ten (10) calendar
-days from the date of the scheduled hearing to present good cause for failure to appear
-in order to receive a new hearing;
-
-6.
-
-A warning that the disqualification penalties for fraud under SNAP that could be imposed
-and a statement of which penalty the hearing officer believes is applicable to the case
-scheduled for hearing. The disqualification penalties for fraud are as follows:
-a.
-
-Twelve (12) month disqualification for the first (1st) violation, twenty-four month
-disqualification for the second (2nd) violation, and permanently for the third (3rd)
-violation, except as provided for in paragraphs b, c, d, and e, of this section;
-
-208
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-b.
-
-Individuals found to have made a fraudulent statement or representation with
-respect to the identity or place of residence of the individual in order to receive
-multiple food stamp benefits simultaneously shall be ineligible to participate in the
-Program for a period of ten (10) years, except if the client has received his/her
-3rd violation. In such cases, the individual shall be disqualified permanently.
-
-c.
-
-Individuals found guilty of purchasing controlled substances, as defined in
-section 18-18-102(5), C.R.S., with SNAP benefits by a court of law shall be
-ineligible to participate in the program:
-1.
-
-For a period of twenty-four (24) months upon the first occasion of such
-violation; and,
-
-2.
-
-Permanently upon the second occasion of such violation.
-
-d.
-
-Individuals found by a federal, state, or local court to have used or received
-benefits in a transaction involving the sale of firearms, ammunition or explosives
-shall be permanently ineligible to participate in the program upon the first
-occasion of such violation.
-
-e.
-
-An individual convicted by a federal, state, or local court of having trafficked
-benefits for an aggregate amount of five hundred dollars ($500) or more shall be
-permanently ineligible to participate in the program upon the first occasion of
-such violation.
-
-f.
-
-The penalties in paragraphs c and d of this section shall also apply in cases of
-deferred adjudication as described in Section 4.804, where the court makes a
-finding that the individual engaged in the conduct described in paragraph c and
-d, of this section.
-
-g.
-
-If a court fails to impose a disqualification or a disqualification period for any IPV,
-the state department shall impose the appropriate disqualification penalty
-specified within this section, unless it is contrary to the court order.
-
-7.
-
-A statement of which penalty the hearing officer believes is applicable to the case
-scheduled for the hearing.
-
-8.
-
-A statement that the hearing does not preclude the state or federal government from
-prosecuting the household member for fraud in a civil or criminal court action or from
-collecting the over-issuance.
-
-9.
-
-The name and telephone number of the agency that the individual can call to obtain free
-legal advice.
-
-10.
-
-For local offices conducting a local-level ADH, the notice shall inform the client that they
-may request to have a state-level ADH rather than a local-level ADH.
-
-C.
-
-A copy of the local-level hearing procedures, and the demand letter for over-issuance (if not sent
-previously) shall be attached to the thirty (30) day advance notice for the local-level hearing. The
-Administrative Law Judge shall provide a copy of the state hearing procedures with the thirty (30)
-day advance notice.
-
-D.
-
-The Administrative Law Judge shall not enter a default against the household member for failure
-to file a written answer to the notice of hearing but shall base the initial decision upon the
-evidence introduced at the hearing.
-
-209
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-4.803.44
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Participation While Awaiting an Administrative Disqualification Hearing
-
-A pending state or local-level administrative disqualification hearing shall not affect the individual's or the
-household's right to be certified and to participate in the program. Since the local office cannot disqualify a
-household member for intentional program violation until it obtains a signed waiver of administrative
-hearing or until the local hearing official or State Department finds that the individual has committed
-intentional program violation, the local office shall determine eligibility and benefit level of the household
-in the same manner it would be determined for any other household.
-A.
-
-If the action for which the household member is suspected of intentional program violation does
-not affect the household's current circumstances, the household would continue to receive its
-allotment based on the latest certification action or be recertified based on a new application and
-its current circumstances.
-
-B.
-
-The household's benefits shall be terminated if the certification period has expired and the
-household, after receiving its notice of expiration, fails to reapply.
-
-C.
-
-The local office shall also reduce or terminate the household's benefits if the local office has
-documentation which substantiates that the household is ineligible or eligible for fewer benefits
-(even if these facts led to the suspicion of intentional program violation and resultant hearing) and
-the household fails to request a fair hearing after receipt of a Notice of Adverse Action.
-
-4.803.45
-
-Administrative Disqualification Hearing (ADH) Procedures
-
-A.
-
-At the ADH, the Administrative Law Judge (ALJ) or local hearing officer shall advise the
-household member or representative that they may refuse to answer questions during the
-hearing.
-
-B.
-
-A hearing decision and notification to the parties shall occur within ninety (90) calendar days from
-the date the household member is notified in writing that a state or local-level hearing requested
-by the local office has been scheduled.
-
-C.
-
-Following the conclusion of the hearing at the state-level, the ALJ shall prepare and issue an
-initial decision that shall contain a determination of whether the county or State Department acted
-in accordance with, and properly interpreted the rules and regulations of the State Department.
-For the purpose of the decision, material issues of law shall be defined. The ALJ has no
-jurisdiction or authority to determine issues of constitutionality or legality of departmental rules or
-regulations. This decision is prepared and filed with the Colorado Department of Human Services
-for service to each party.
-In the case of a hearing before the Administrative Law Judge (ALJ), this determination shall be an
-initial decision to be reviewed by the Office of Appeals. The initial decision shall not be
-implemented pending review by the Office of Appeals and entry of a final agency decision. The
-initial decision shall advise the household that failure to file exceptions to provisions of the initial
-decision will waive the right to seek judicial review of a final agency decision affirming those
-provisions.
-
-D.
-
-A local-level hearing officer shall meet the ninety (90) calendar day timeframe, issue the decision
-to the client, and forward a copy to the state department.
-
-E.
-
-The household member or his/her representative is entitled to a postponement of up to thirty (30)
-calendar days if the request for postponement is made at least ten (10) calendar days prior to the
-scheduled hearing date, unless good cause can be shown for failure to request postponement
-within the required timeframe. If the hearing is postponed, the above limits shall be extended for
-as many days as the hearing is postponed.
-
-210
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-F.
-
-The local office shall make the hearing procedures in this staff manual available to any interested
-party.
-
-G.
-
-A verbatim transcript or recording of testimony and exhibits shall be made. This transcript or
-recording together with all papers and requests filed in the proceeding shall be retained by the
-local office for a period of three (3) years from the initiation of the action and shall be available to
-the household or its representatives during business hours for copying and inspection.
-
-4.803.5 Local-Level IPV Hearings
-A.
-
-Local-Level Hearing Official
-1.
-
-2.
-
-B.
-
-The individual who acts as a local-level hearing officer for the local office shall meet the
-following requirements:
-a.
-
-They shall be an impartial individual who does not have a personal stake or
-involvement in the case;
-
-b.
-
-They cannot have been directly involved in the initial determination of the action
-which is being contested and was not the immediate supervisor of the eligibility
-technician who initiated the IPV action;
-
-c.
-
-The individual shall be:
-1.
-
-An employee of the county;
-
-2.
-
-An individual under contract with the county; or
-
-3.
-
-An employee of another public agency, statutory board, or other legal
-entity designated by the county to conduct hearings.
-
-The individual who acts as a local-level hearing officer is required to carefully consider
-the evidence and determine, based on clear and convincing evidence, if the individual
-intended to commit an IPV.
-
-Notice of Local-Level Hearing Decision
-1.
-
-If the local-level administrative disqualification hearing finds the household member did
-not commit an IPV, the local-level hearing officer shall provide a written notice that
-informs the household, the local office, and the State Department of the decision.
-
-2.
-
-The decision shall contain the reasons for the hearing officer's decision and a response
-to client presented arguments and identify the evidence presented by both client and the
-local office.
-
-3.
-
-If a local-level hearing officer determines that an IPV occurred, the household shall be
-notified in accordance with Section 4.803.7 and accompanying the decision shall be an
-Appeal Request for the household to appeal the decision to a state-level administrative
-disqualification hearing.
-
-4.
-
-If mailed, the notice shall be sent by either first class mail or certified mail (return receipt
-requested), or the notice may be served on the individual(s) by any other reliable method.
-If no proof of receipt is obtained, a statement of non-receipt by the household member
-shall be considered good cause for not appearing at the hearing
-
-211
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-5.
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-A copy of the local-level hearing decision shall be forwarded to the state department for
-review at the same time the decision is mailed to the client.
-
-Appeal of Local-Level Decision
-1.
-
-The household may appeal the decision of the local-level administrative disqualification
-hearing to the Office of Administrative Courts. An appeal must be received by the local
-office or by the Office of Administrative Courts within fifteen (15) calendar days of the
-date of household receipt of the local-level decision. The household shall be allowed to
-participate as described in Section 4.803.44.
-
-2.
-
-If the household member appeals a local-level hearing to a state-level hearing, the Office
-of Administrative Courts shall provide a written notice to that household member at least
-ten (10) calendar days in advance of the scheduled hearing. The ten (10) calendar day
-advance notice shall contain at a minimum:
-
-3.
-
-a.
-
-The date, time, and place of the hearing.
-
-b.
-
-A statement that the Office of Administrative Courts will dismiss the hearing
-request and the household member will be disqualified in accordance with the
-local hearing decision if the household member or its representative fails to
-appear for the hearing without good cause.
-
-c.
-
-A statement that the hearing does not preclude civil or criminal prosecution, or
-from collecting the over-issuance.
-
-d.
-
-A listing of the household members' rights.
-
-e.
-
-A copy of the Office of Administrative Courts hearing procedures shall be
-attached to the ten (10) calendar day advance notice.
-
-If the household member fails to appear for the administrative disqualification hearing
-appeal, the Office of Administrative Courts (OAC) shall dismiss the hearing request. The
-Administrative Law Judge shall promptly serve copies of the order on the household
-member and the local office. The order shall inform the household member that they will
-continue to be disqualified in accordance with the local-level hearing decision. The
-household member will be afforded a ten (10) calendar day period from the date the
-order of dismissal was mailed to explain in a letter to the OAC the reason for failing to
-appear. If the OAC determines that the household member or its representative has good
-cause for not appearing, the Administrative Law Judge shall reschedule another hearing
-date.
-If the appellant does not submit a letter seeking to show good cause within the ten (10)
-calendar day period, the order of dismissal shall be filed with the Office of Appeals of the
-State Department. The Office of Appeals shall confirm the dismissal of the appeal by an
-agency decision, which shall be served on the parties and the interested Division of the
-State Department. Within three (3) working days after the effective date of the decision,
-the local office shall implement necessary actions to provide benefits in the correct
-amount, to terminate benefits, to recover benefits incorrectly paid, and/or other
-appropriate actions in accordance with the rules. If the appellant submits a letter seeking
-to show good cause and the Administrative Law Judge (ALJ) finds that the stated facts
-do not constitute good cause, the ALJ shall enter an initial decision confirming the
-dismissal. The appellant may file exceptions to the initial decision pursuant to Section
-4.802.63, D.
-
-212
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.803.6 State-Level Administrative Disqualification Hearing
-A.
-
-B.
-
-Initial Decisions
-1.
-
-The State Administrative Law Judge (ALJ) will forward the initial decision to the Colorado
-Department of Human Services, Office of Appeals. The Office of Appeals shall promptly
-serve a copy of the initial decision upon each party by first class mail.
-
-2.
-
-Any party, or the Divisions of the State Department responsible for administering
-programs relevant to the appeal, if seeking an agency decision which reverses, modifies
-or remands the initial decision, may file exceptions to the initial decision as set forth in
-Section 4.802.63, D. The parties and the Division may also request reconsideration of the
-agency decision pursuant to Section 4.802.63, F.
-
-Final Decisions
-1.
-
-The Office of Appeals shall review the initial decision of the Administrative Law Judge
-and shall enter a final agency decision affirming, modifying, reversing, or remanding the
-initial decision, pursuant to Section 4.802.63, E.
-
-2.
-
-For purposes of requesting judicial review, the effective date of the final agency decision
-shall be the third (3rd) day after the date the decision is mailed to the parties, even if the
-third (3rd) day falls on Saturday, Sunday, or a legal holiday. The parties shall be advised
-of this in the agency decision.
-
-3.
-
-The state department or local office shall initiate action to comply with the final agency
-decision within three (3) working days after the effective date. The department shall
-comply with the decision even if reconsideration is requested unless the effective date of
-the agency decision is postponed by order of the Office of Appeals or a reviewing court.
-
-4.
-
-If the household member has committed IPV, that member shall be disqualified in
-accordance with the disqualification periods specified in Section 4.803.3. The same act of
-IPV shall not be separated so that separate penalties can be imposed.
-
-4.803.7 Notification of Final Administrative Disqualification Hearing Decision
-Once the local-level hearing decision or a final state-level decision has been made, written notice, prior to
-disqualification, will be provided to the household member, to the local office, and to the state department
-containing:
-A.
-
-The decision;
-
-B.
-
-The reason for the decision including pertinent regulations and a response to client presented
-arguments;
-
-C.
-
-The disqualification period, including the date the disqualification will take effect. For local-level
-hearing decisions, the decision shall notify the individual that the disqualification period will take
-effect, unless a state-level hearing is requested. If the individual is no longer participating, the
-notice shall inform them that the period of disqualification shall take effect in accordance with
-Section 4.803.2, F;
-
-D.
-
-For local-level administrative hearings, if the household member is not satisfied with the decision
-given in a local-level administrative disqualification hearing (see Section 4.803.5, C), they may
-request a hearing through the Office of Administrative Courts; and
-
-213
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-E.
-
-For state-level administrative hearings, if the household member is not satisfied with the final
-state agency decision of a state-level administrative hearing, they may seek judicial review
-pursuant to Section 24-4-106, C.R.S.
-
-4.804
-
-COURT ACTION
-
-A.
-
-Local offices are encouraged to refer for prosecution under state fraud statutes those individuals
-suspected of committing fraud, particularly if large amounts of benefits are suspected of being
-fraudulently obtained or the individual is suspected of committing more than one (1) fraudulent
-act. The local office shall confer with its legal representative to determine the types of cases that
-will be accepted for possible prosecution.
-
-B.
-
-An individual must be found guilty of fraud through criminal court in order for the local office to
-impose a disqualification penalty. However, when a determination of guilt is not obtained because
-of a case involving court-deferred adjudication or plea-bargaining, a disqualification penalty may
-be imposed if a signed consent agreement is obtained from the individual.
-
-C.
-
-A summary or copy of a referral for prosecution shall, together with the date of the referral, be
-forwarded to the state department.
-
-D.
-
-Local offices shall disqualify an individual found guilty of fraud or the length of time specified by
-the court. If the court fails to impose a disqualification period, the local office shall impose an
-appropriate disqualification in accordance with Section 4.803.3, unless imposing a disqualification
-would be contrary to the court order.
-
-E.
-
-If disqualification is ordered but a date for initiating the disqualification period is not specified, the
-local office shall initiate the disqualification period for individuals within forty-five (45) calendar
-days from the date the disqualification was ordered. Any other court-imposed disqualification shall
-begin within forty-five (45) calendar days from the date the court found an individual guilty of civil
-or criminal misrepresentation or fraud.
-
-F.
-
-Once a disqualification period has been imposed against a currently participating household
-member, the period of disqualification shall continue uninterrupted until completed regardless of
-the eligibility of the disqualified member's household.
-
-G.
-
-If the court finds that the individual committed fraud, the county shall mail to the household, prior
-to the disqualification whenever possible, a notice informing the household of the disqualification
-and the date the disqualification will take effect, and shall advise the remaining household
-members of the allotment they will receive during the period of disqualification or that they must
-reapply because the certification period has expired.
-
-4.804.1 Disqualification Consent Agreement (DCA)
-A.
-
-Criteria for DCA
-If county prosecutors pursue a DCA, the agreement shall provide the household advance
-notification of the consequences of consenting to the disqualification. The consent agreement
-shall contain the following:
-1.
-
-A statement for the accused individual to sign that they understand the consequences of
-consenting to disqualification.
-
-2.
-
-A signature block for the accused individual;
-
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-
-B.
-
-C.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-3.
-
-A statement that the head of household must also sign the consent agreement if the
-accused individual is not the head of household;
-
-4.
-
-A signature block for the head of household;
-
-5.
-
-A statement that consenting to disqualification will result in disqualification and a
-reduction in benefits for the period of disqualification, even though the accused individual
-was not found guilty of civil or criminal misrepresentation or fraud;
-
-6.
-
-A warning that the disqualification penalties for fraud under SNAP that could be imposed
-and a statement of which penalty the hearing office believes is applicable to the case
-scheduled for the hearing; and
-
-7.
-
-A statement of the fact that the remaining household members, if any, will be held
-responsible for repayment of the resulting claim, unless the accused individual has
-already repaid the claim as a result of meeting the terms of the agreement with the
-prosecutor or the court order.
-
-Imposing Disqualifications When Consent Agreements are Obtained
-1.
-
-If the household member suspected of fraud signs the disqualification consent
-agreement, the household member shall be disqualified in accordance with the
-disqualification periods specified in Section 4.803.2, F, unless contrary to the court order.
-
-2.
-
-Once a disqualification penalty has been imposed against a currently participating
-household member, the period of disqualification shall continue uninterrupted until
-completed, regardless of the eligibility of the disqualified member's household. However,
-the disqualified member's household shall continue to be responsible for repayment of
-the over-issuance that resulted from the disqualified member's suspected fraudulent act,
-regardless of its eligibility for Program benefits.
-
-Notification to Household of Disqualification
-1.
-
-If the household member suspected of fraud signs the disqualification consent
-agreement, the local office shall provide written notice to the household member. The
-notice shall be provided prior to disqualification. The notice shall inform the household
-member of the disqualification and the date the disqualification will take effect.
-
-2.
-
-The local office shall also provide to the remaining household members, if any, the
-allotment they will receive during the period of disqualification or notice that they must
-reapply because the certification period has expired. The procedures for handling the
-income and resources of the disqualified member are described in Section 4.411.1.
-
-4.900
-
-ADMINISTRATIVE PROCEDURES
-
-4.901
-
-ADMINISTRATION OF SNAP
-
-A.
-
-SNAP shall be administered in every county of the state in accordance with the regulations
-promulgated by the Colorado Department of Human Services and these rules.
-
-B.
-
-SNAP shall be administered by the local offices of social/human services unless the State
-Department enters into a written agreement with a particular county to have a state-administered
-program in that county. As a condition for receiving grant-in-aid from the state for PA and welfare
-activities, each county must bear the proportion of the total administrative and program costs for
-all assistance payments and social services activities as required by Section 26-1-122, C.R.S.
-
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-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-C.
-
-Local offices of social/human services shall comply with all requirements concerning security and
-case processing for the automated system.
-
-D.
-
-Counties shall receive approval from the State Department, prior to using any county-developed
-forms in the administration of SNAP.
-
-4.901.1 Compliance with State Department
-If a county does not comply with the rules of the State Department that govern the administration of
-SNAP, which require the establishment of a SNAP Program in each county and the payment of the
-county's share of the cost of the program, the State Department may do one or more of the following:
-A.
-
-Utilize the remedies described in Section 26-1-109(4) (a)-(e), C.R.S.
-
-B.
-
-Recover all or part of the county share of the cost of SNAP by reducing any other grant-in-aid to
-the county for PA or welfare purposes by a corresponding amount.
-
-C.
-
-If the county does not comply, judicial enforcement may be pursued under Section 24-4-106(3)
-C.R.S.
-
-D.
-
-Take any other appropriate action to enforce compliance with the rules governing SNAP.
-
-4.902
-
-COUNTY ADMINISTRATION REQUIREMENTS
-
-4.902.1 Local SNAP Office
-Local offices shall ensure that adequate locations and hours of operation exist to meet the needs of
-SNAP clients in their areas. Each location shall have ample availability for parking and shall be accessible
-to persons with disabilities. Hours of operation shall be sufficient to ensure the timely processing of
-applications and issuance of EBT cards according to existing guidelines. Counties must establish
-procedures for the operation of the local office that best serves households within that county. Local
-offices shall establish procedures to assist households with special needs including, but not limited to:
-households containing persons who are aged sixty (60) and older or persons with disabilities; households
-in rural areas with low-income members; households experiencing homelessness; households containing
-adult members who are not proficient in English; and households containing working persons.
-A household must apply for SNAP in its county of residence. A local office that receives an application
-that belongs to another county may secure the application date, process the application to completion,
-issue the household an EBT card, and then transfer the case to the correct county once the final eligibility
-decision is made. If a household is determined eligible for participation, it may request and be designated
-to receive SNAP from a local office that is more accessible. It is possible for an issuance unit in one local
-office to determine eligibility, authorize SNAP benefits, and issue EBT cards to an eligible household that
-resides in another county in Colorado.
-Local offices may also transfer certification and/or EBT card issuance duties for those households only
-receiving SNAP that live closer to the local office in a neighboring county than the county of residence.
-4.902.2 Phone Directory Listings
-A.
-
-Each local office telephone number available to the public shall be listed under each of the
-following two alphabetical listings:
-1.
-
-SNAP certification and issuance office, street address, phone number. If there are
-separate certification and issuance offices in the county, they may be listed in this
-manner: local office (certification only) or (issuance only), street address, phone number.
-
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-
-2.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-(Name of the county) Department of Human/Social Services, local office (certification
-only) or (issuance only), street address, phone number.
-
-B.
-
-Each local office shall provide a toll-free number or a number where collect calls will be accepted
-for households outside the local calling area.
-
-C.
-
-The listings above are not to restrict any other listings that may be provided within the telephone
-directory, but only to standardize the availability of SNAP to the public.
-
-4.902.3 Certification Personnel and Facilities Requirements
-A.
-
-County employees assigned to certify households for participation in SNAP shall be employed in
-accordance with the current standards for a merit system personnel administration that is guided
-by a set of six broad merit principles outlined in the Intergovernmental Personnel Act of 1970 (42
-U.S.C. 4728), as amended. The principles cover recruiting, compensation, training, retention,
-equal employment opportunity, and guidance on political activity. Only such qualified employees
-shall interview SNAP households and determine household eligibility or ineligibility and the level
-of benefits.
-
-B.
-
-Every local office must utilize an appropriate amount of the staff allocated to it and utilize effective
-and efficient practices in administering SNAP. Facilities must, within available state legislative
-appropriations and federal and required county matching funds, be of adequate size and layout to
-assure the privacy necessary to allow workers to conduct confidential interviews and perform
-other office duties efficiently and effectively. Any persons or organizations who are parties to a
-strike or lockout shall not be permitted to interview or certify households or to secure verification
-required of such households. However, such individuals may be used as a source of verification
-for information provided by applicant households if, under normal circumstances, they could be
-expected to be the best verification source. An eligibility technician who is the spouse of a striker
-is not considered party to a strike but shall not certify his or her household.
-
-4.902.31
-
-Bilingual Staff, Interpreter, and Translator Requirements
-
-A.
-
-Local offices determined by the State Department to have a significant population of Limited
-English Proficiency (LEP) households shall provide sufficient bilingual staff and/or translators for
-the timely processing of applications. Local office staff shall be trained and familiar with these
-procedures.
-
-B.
-
-During those periods when there is a significant influx of seasonal or migrant farmworkers, local
-offices shall provide sufficient bilingual staff and/or translators for the timely processing of such
-applicants.
-
-C.
-
-If translators or interpreters are utilized, the local office shall ensure that the translators or
-interpreters are readily available to assist in pre-screening clients for expedited processing
-standards and completing the interview and other activities necessary to determine the eligibility
-of the applicant household. The local office shall not require the client to provide a translator or
-interpreter, or to in any way imply that an interpreter is required, as a condition for being prescreened or interviewed by the local office, nor shall the local office postpone or in any way delay
-the pre-screening process or appointments because of the unavailability of bilingual staff or
-translators/interpreters.
-
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-
-4.902.32
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Restrictions on Staff
-
-A.
-
-Volunteers or other personnel who do not meet the criteria outlined in Section 4.902.3 may not be
-allowed to interview or certify households but may be used for pre-screening, assistance in the
-completion of applications, obtaining verifications to support statements made on the application,
-and the transportation of clients. In certain situations, volunteers may act as authorized
-representatives for households unable to come to the local office.
-
-B.
-
-Volunteers may also be used as translators or interpreters when necessary to pre-screen clients
-and to complete the interview. If volunteers are utilized, the local office shall ensure that
-volunteers are available, as necessary, for the timely processing of applications. Such volunteers
-utilized to pre-screen clients or to translate/interpret during the interview shall be educated on
-confidentiality requirements.
-
-C.
-
-Any persons or organizations who are parties to a strike or lockout shall not be permitted to
-interview or certify households or to secure verification required of such households. However,
-such individuals may be used as a source of verification for information provided by households
-if, under normal circumstances, they could be expected to be the best verification source. An
-eligibility technician who is the spouse of a striker is not considered party to a strike but shall not
-certify his or her household.
-The facilities of persons or organizations who are parties to a strike or lockout may not be used in
-the certification process or as a site for certification interviews.
-
-4.902.4 Local Office Case Review Responsibilities
-Local offices shall establish a documented method to review a random sample of current SNAP
-determinations (certifications, denials, and terminations) to determine the correctness of eligibility
-determinations accomplished. A record of the cases reviewed must be kept for management
-evaluation/audit purposes. Local offices must be able to demonstrate to the satisfaction of the State
-Department that the frequency and scope of the reviews are adequate to ensure the integrity of both the
-program and clients. Additionally, local offices must demonstrate a consistent process for tracking error
-trends, correcting case records timely, and providing eligibility technicians an opportunity to improve their
-program knowledge.
-4.902.5 Retention of Case Records
-Each local office shall retain all program records in an orderly fashion for audit and review purposes for
-no less than three (3) years from the month of origin of each record. In addition:
-A.
-
-The local office shall retain fiscal records and accountable documents for three (3) years from the
-date of fiscal or administrative closure. Fiscal closure means that obligations for or against the
-federal government have been liquidated. Administrative closure means that the state agency has
-determined and documented that no further action to liquidate the obligation is appropriate. Fiscal
-records and accountable documents include, but are not limited to, claims and documentation of
-lost benefits.
-
-B.
-
-Case records relating to intentional program violation (IPV) disqualifications and related notices to
-the household shall be retained indefinitely until the local office obtains reliable information that
-the individual who was disqualified has died or until the information is received from the national
-disqualified recipient database system that all records associated with a particular individual,
-including the disqualified client database record, may be permanently removed from the database
-because of the individual's eightieth (80th) birthday.
-
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-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-4.902.6 Non-Discrimination Complaint Requirements
-Both state and local offices shall ensure that all local office staff responsible for the administration,
-issuance, review, and eligibility determination of SNAP are knowledgeable about civil rights procedures
-and are able to assist clients with the filing of civil rights complaints. Local office staff must undergo stateprescribed training on civil rights procedures annually.
-4.903
-
-STATE ADMINISTRATION RESPONSIBILITIES
-
-4.903.1 Information Available to the Public
-A.
-
-Federal regulations, federal procedures embodied in Food and Nutrition Service (FNS) notices
-and policy memos, the SNAP rules, and State Plans of Operation (including specific planning
-documents such as corrective action plans) shall be available upon request for examination by
-members of the public during office hours at the State Department. Copies of materials are
-available to recipient organizations, action centers, and other individuals for a minimal printing
-charge.
-
-B.
-
-The SNAP rules shall be available for examination upon request at each local office within each
-county. They are also available online through the Secretary of State’s official publication of State
-Agency rules in the Colorado Code of Regulations, accessible at:
-https://www.sos.state.co.us/CCR/Welcome.do.
-
-4.903.2 Reporting Lawsuits
-FNS regulations require prompt notification from the State Department of any lawsuits involving the
-administration of SNAP.
-As SNAP is administered under the supervision of the State Department, it is mandatory that all legal
-proceedings involving SNAP be brought to the attention of the State Department immediately for
-notification to the FNS.
-4.903.3 Management Evaluations (ME)
-The State Department is responsible for supervising the administration of SNAP. To ensure compliance
-with program requirements, the State Department is responsible for conducting ME reviews to measure
-compliance with the provisions of these rules. The objectives of the ME review system are to:
-A.
-
-Provide a systematic method of monitoring and assessing program operations in the counties;
-
-B.
-
-Provide a basis for counties to improve and strengthen program operations by identifying and
-correcting deficiencies;
-
-C.
-
-Provide a continuous flow of information between the counties, the State Department, and FNS to
-develop solutions to problems in SNAP policy and procedures; and,
-
-D.
-
-Provide a review of target program areas as identified by USDA, FNS.
-
-4.903.31
-
-Frequency of ME Reviews
-
-The State Department shall conduct an ME review of all SNAP operations:
-A.
-
-At least once annually on each large project area containing more than twenty-five thousand and
-one (25,001) participating households;
-
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-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-B.
-
-At least once every two (2) years on each medium project area containing five thousand (5,000)
-to twenty-five thousand (25,000) participating households; and,
-
-C.
-
-At least once every three (3) years on each small project area containing four thousand nine
-hundred and ninety-nine (4,999) or fewer participating households.
-
-The State Department may conduct ME reviews on an alternative schedule with the written approval of
-the USDA, FNS. The State Department may also perform reviews of specific local offices or program
-elements. The USDA, FNS, or the State Department, may identify the need for a special review, or the
-local office may request a special review.
-Reviews will generally include all aspects of program administration in the large project areas. The
-reviews may be more limited in scope in the medium and small project areas. The USDA, FNS, generally
-identifies target program areas that it requires for review each fiscal year.
-The State Department will complete the ME report for all counties that are reviewed and will be
-responsible for monitoring the county responses to any findings.
-The county shall be responsible for submitting any factual corrections to the ME review within twenty (20)
-state working days and shall submit a final plan to correct all other cited deficiencies within twenty (20)
-state working days of receiving the review. The response shall include specific actions, persons
-responsible for implementation, and the date for completion. When the review identifies ongoing problems
-in critical areas, the county response shall also include a method for monitoring implementation of the
-plan and reporting progress to the state department on at least a quarterly basis.
-4.903.32
-
-Compliance Action for ME Reviews
-
-The State Department is the designated entity responsible for ensuring that corrective action is taken at
-the state and/or county level on the deficiencies found by the ME Reviews.
-The state may impose fiscal sanctions on counties that do not make good-faith efforts to address ongoing
-problems in critical areas. Fiscal sanctions may be imposed in accordance with Section 4.901.1, which
-requires local offices to operate the program in accordance with state rules.
-4.903.4 Quality Assurance (QA) Reviews
-QA reviews are conducted during the annual federal QA review period, which is the twelve (12) month
-period from October 1 of each calendar year through September 30 of the following calendar year.
-A.
-
-QA reviews are federally mandated to provide:
-1.
-
-A systematic method of measuring the validity of the SNAP caseload;
-
-2.
-
-A basis for determining error rates;
-
-3.
-
-A timely and continuous flow of information on which to base corrective action at all levels
-of administration; and,
-
-4.
-
-A basis for establishing liability for errors that exceed the federal error rate target and the
-State's eligibility for an increased share of federal administrative funding and/or federal
-high-performance bonuses.
-
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-
-CODE OF COLORADO REGULATIONS
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-
-B.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Reviews are conducted on:
-1.
-
-Active cases to determine if the household is eligible and, if eligible, whether the
-household is receiving the correct SNAP benefits.
-
-2.
-
-Negative cases to determine if households that were denied or terminated were, in fact,
-not eligible to participate in SNAP and that the household received an accurate, timely
-notice as defined in sections 4.205.2, 4.209.1, and 4.608. The review of a negative case
-includes:
-
-4.903.41
-
-a.
-
-A household case record review;
-
-b.
-
-An error analysis;
-
-c.
-
-Client notification; and,
-
-d.
-
-The reporting of review findings.
-
-QA Review Procedures
-
-A.
-
-Each month a statistically random sample of active and negative cases is selected for QA review.
-The sampling of both active and negative cases is accomplished through the master file from the
-automated system.
-
-B.
-
-Case records for the monthly selected sample may be reviewed by QA in the local office, or the
-local office may be requested to forward the case recrods to the appropriate state QA office for
-review prior to the field reviews and verification of eligibility factors. Local offices shall make case
-records available for review no later than seven (7) business days from the date that the request
-is received by the local office.
-
-C.
-
-When the local office receives a request for one or more cases for QA review, the following steps
-shall be taken in preparing the case record:
-
-D.
-
-1.
-
-All documents and notes supporting eligibility decisions and/or basis of issuance related
-to the case and actions taken by the local office that apply to the sample/review month
-shall be included in the case record.
-
-2.
-
-Accomplishment of the objectives of QA depends upon the successful operation of all
-aspects of the sampling system, including the elimination of bias to prevent bias, the local
-office shall not take any action that might alter the findings or misrepresent the
-household’s circumstance including, but not limited to:
-a.
-
-Making changes that would affect eligibility and payment;
-
-b.
-
-Adding or removing documentation/verification from the official case record; or,
-
-c.
-
-Contacting the household sampled, the QA reviewer, or making collateral
-contacts to obtain additional information to clarify the household’s circumstances,
-obtain statements or coerce the household into saying or doing anything that
-might alter the findings or misrepresent the household’s circumstances for the
-review month.
-
-These provisions do not apply to routine case management such as acting on reported changes,
-completing recertifications, or issuing a notice of expiration.
-
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-
-4.903.42
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Refusal to Cooperate with QA Review
-
-Households selected for review are required to cooperate with federal and state QA review processes.
-Households that refuse to cooperate in a QA review shall be declared ineligible for SNAP benefits in this
-section. The state QA reviewer shall notify the local office of the household's refusal to cooperate in the
-review process, including everyone who refused, and the local office shall document the refusal to
-cooperate in the statewide automated system.
-A.
-
-B.
-
-Within ten (10) calendar days from the date of receipt of QA's notification of the household's
-refusal to cooperate, the local office shall take action to disqualify or terminate the entire
-household from participation in SNAP and each household member who refused to cooperate
-shall be entered into the automated system to initiate a period of ineligibility. The period of
-ineligibility is as follows:
-1.
-
-For refusal to cooperate with a state QA review, the period of ineligibility shall exist for the
-remainder of the current federal fiscal year plus one hundred twenty-five (125) days and
-shall expire on February 2 of that federal fiscal year.
-
-2.
-
-For refusal to cooperate with a federal QA review, the period of ineligibility shall exist for
-the remainder of the current federal fiscal year plus nine (9) months and shall expire on
-June 30 of that federal fiscal year.
-
-If a member or members who refused to cooperate with a QA review leaves the household, the
-ineligibility period shall follow the household member(s) who refused to cooperate.
-If a household is disqualified or terminated for refusal to cooperate with a QA review, the
-household may reapply. The household cannot be determined eligible until it cooperates with the
-QA review and provides verification of all eligibility factors.
-
-C.
-
-If a household that has refused to cooperate with a state QA review reapplies more than one
-hundred twenty-five (125) days after the end of the annual federal QA review period, or refused to
-cooperate with a federal review and reapplies more than nine (9) months from the end of the
-annual federal QA review period, the household shall not be determined ineligible for its refusal to
-cooperate and is required to provide verification of all eligibility factors before it can be approved
-for benefits.
-
-4.903.43
-
-QA Findings and Required Responses
-
-QA shall notify local offices on State-prescribed forms of the review findings for each sampled active and
-negative case. Brief descriptions of the review findings shall be given with references to applicable rule
-sections.
-A.
-
-When the review findings document no error and/or only other observations have been noted, a
-response is not required by the local office; however, any observation that affects the payment
-accuracy must be corrected and a claim or restoration established in accordance with Sections
-4.801.2 and 4.702. The report of review findings shall be retained in the case record.
-
-B.
-
-When the review findings document that an error resulted in ineligibility, over-issuance, underissuance, or an incorrect negative action, the local office shall take action to correct any errors
-discovered within ten (10) calendar days.
-If the local office disagrees with a review finding then a response should be sent to the State
-Department for further review.
-
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-
-C.
-
-D.
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Upon receiving the local office's response to the QA review findings, the State Department shall
-review the action taken by the local office and either concur with the QA findings; concur with the
-local office rebuttal; or concur/disagree with the corrective action taken by the local office.
-1.
-
-The local office shall be notified of the final QA review findings.
-
-2.
-
-Upon receipt of final notification of the results of the findings, the local office must take
-corrective action to terminate ineligible households within ten (10) calendar days, restore
-lost benefits, or establish a claim in accordance with Sections 4.801.2 and 4.702.
-
-Local offices are required by the State Department to report twice a year to the State Department
-the status of all QA review findings that required case corrections.
-
-4.903.44
-
-Federal QA Reviews
-
-For purposes of validating the State's QA findings, the FNS Regional Office will conduct a sub-sample rereview of the State QA sample. As part of this re-review process, the Federal Regional Office will conduct
-case record reviews to the extent necessary to determine the accuracy of state QA findings. The FNS
-Regional Office may request case records and/or verify any aspects of state QA findings. The local
-offices shall forward case records in their entirety as outlined in Section 4.903.41 that are selected for
-FNS regional office review within ten (10) calendar days of the request.
-4.904
-
-OUTREACH
-
-Outreach activities performed by state and local personnel shall be ineligible for federal matching funds.
-Although activities to recruit participation in SNAP are prohibited, all local offices shall perform program
-informational activities. Program informational activities are those activities that convey information about
-SNAP, including household rights and responsibilities to households through means such as publications,
-telephone hotlines, and face-to-face contacts.
-All program informational material shall be available in languages other than English and shall include a
-statement that the program is available to all without regard to race, color, sex, age, mental or physical
-disability, religious creed, national origin, or political belief.
-4.905
-
-D-SNAP
-
-D-SNAP, or the Disaster Supplemental Nutritional Assistance Program, may be implemented because of
-a “major disaster” or “temporary emergency” to provide temporary assistance to households affected by
-these misfortunes. A Presidential disaster declaration for individual assistance must be declared for the
-affected areas to be eligible for D-SNAP.
-A “major disaster” is any hurricane, tornado, storm, flood, high water, wind-driven water, tidal wave,
-earthquake, drought, fire, or other catastrophe that is determined to be a major disaster by the President
-pursuant to the Disaster Relief Act of 1974, Section 302(a). A similar definition is provided under State
-law in 24-33.5-703, C.R.S.
-A “temporary emergency” means an emergency caused by any disaster, resulting from either natural or
-human causes, other than a major disaster as declared by the President under the Disaster Relief Act of
-1974, Section 302(a), which is determined by FNS to have disrupted commercial channels of food
-distribution.
-
-223
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-In such Presidentially declared disasters, emergency SNAP allotments can be authorized by the USDA,
-FNS. In Colorado, the Governor can accept such federal assistance on behalf of the state if they
-determine and declare a major disaster. When authorized by the Governor and FNS, the state
-department may authorize those counties, within which all or part of the disaster area lies, to distribute
-emergency SNAP allotments in those areas.
-The State Department shall provide special certification material and forms designed for certification of
-disaster victims. Certification shall be done for households that are victims of a disaster that disrupts
-commercial channels of food distribution; if such households need temporary SNAP and if commercial
-channels of food distribution have again become available to meet the temporary food needs of those
-households.
-
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-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-_________________________________________________________________________
-Editor’s Notes
-History
-Rules SB&P, R-4010, R-4011, R-4100, R-4220, R-4222, R-4223, R-4224, R-4225, R-4230, R-4242 emer.
-rule eff. 10/01/2008.
-Rules SB&P, R-4010, R-4011, R-4100, R-4220, R-4222, R-4223, R-4224, R-4225, R-4230, R-4242 eff.
-12/01/2008.
-Rules SB&P, 4010.11, 4230 emer. rules eff. 04/01/2009; expired eff. 06/06/2009.
-Rules SB&P, 4010.11, 4230 eff. 07/01/2009.
-Rules SB&P, B-4242, B-4242.1, B-4242.12, B-4242.13 eff. 03/02/2010.
-Rules SB&P, B-4011.1-4011.11, B-4011.131-B-4011.136, B-4011.22-B-4011.3, B-4220-B-4220.12, B4224, B-4230.1, B-4242.11-B-4242.13, B-4430.2-B-4430.22(B) eff. 02/01/2011.
-Rules SB&P, B-4222.8, B-4223, B-4225.7.A.17 emer. rules eff. 06/10/2011.
-Rules SB&P, B-4222.8, B-4223, B-4225.7.A.17 eff. 09/01/2011.
-Rules SB&P, B-4224(A-C) emer. rules eff. 10/01/2011.
-Rules SB&P, B-4224(A-C) eff. 01/01/2012.
-Rules SB&P, B-4221.312, B-4230.11-B-4230.12, B-4240, B-4242.34-B-4242.36, B-4315, B-4317.4-B4317.6, B-4600-B-4611, B-4640-B-4653, B-4695.1, B-4730-B-4800.3 eff. 05/01/2012.
-Rules SB&P, B-4430.22.D-G, B-4430.32.B-H eff. 07/01/2012.
-Rules SB&P, B-4010.42 eff. 08/01/2012.
-Rules SB&P, B-4011.31-B-4011.32, B-4110.1-B-4110.2 eff. 11/01/2012.
-Rules SB&P, B-4224 eff. 04/01/2013.
-Rules SB&P, B-4100-B-4100.D, B-4220.11-B-4220.12, B-4223.1, B-4223.5-B-4223.5.B, B-4223.51 emer.
-rules eff. 10/01/2013.
-Rules B-4010.12, B-4230-B-4230.1, B-4430.4 emer. rules eff. 11/01/2013.
-Rules SB&P, B-4100-B-4100.D, B-4220.11-B-4220.12, B-4223.1, B-4223.5-B-4223.5.B, B-4223.51 eff.
-12/01/2013.
-Rules SB&P, B-4010.12, B-4230-B-4230.1, B-4430.4 eff. 01/01/2014.
-Entire rule eff. 09/01/2014.
-Rules SB&P, 4.207.3, 4.401.1-4.401.2, 4.407.1, 4.407.3-4.407.31 emer. rules eff. 10/01/2014.
-Rules SB&P, 4.207.3, 4.401.1-4.401.2, 4.407.1, 4.407.3-4.407.31 eff. 12/01/2014.
-Rules SB&P, 4.207.3, 4.401.1-4.401.2, 4.407.1, 4.407.3.A-B, 4.407.31 emer. rules eff. 10/02/2015.
-Rules SB&P, 4.207.3, 4.401.1-4.401.2, 4.407.1, 4.407.3.A-B, 4.407.31, 4.801.2-4.801.43, 4.8034.803.41, 4.803.43, 4.803.5, 4.803.7, 4.804.1 eff. 01/01/2016. Rule 4.704.1 repealed eff.
-01/01/2016.
-Rules SB&P, 4.609 eff. 02/01/2016.
-Rule 4.609.1 emer. rule eff. 02/05/2016.
-Rules SB&P, 4.208.1, 4.603.A eff. 04/01/2016.
-Rules SB&P, 4.609.1 eff. 05/01/2016.
-Rule 4.609.1.A emer. rule eff. 05/06/2016.
-Rule 4.609.1.A eff. 09/01/2016.
-Rules 4.207.3.C, 4.401.1.C, 4.401.2.D, 4.407.1, 4.407.3.B, 4.407.31.A.4, 4.407.31.B.3, 4.407.31.C.3,
-4.407.31.D.2 emer. rules eff. 09/09/2016.
-Rules 4.407.6, 4.502 B.3.b eff. 10/01/2016.
-
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-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Rules 4.403.A.1, 4.404.D, 4.405.G.1, 4.405.1, 4.506.D, 4.604.D-E, 4.606.B.2.a, 4.608.B, 4.802.2.A.1 eff.
-11/01/2016.
-Rules 4.207.3.C, 4.401.1.C, 4.401.2.D, 4.407.1, 4.407.3.A-B, 4.407.31.A-D eff. 01/01/2017.
-Rules 4.050, 4.070, 4.070.2, 4.070.22, 4.304.4 A-C, 4.402 A, 4.405 F, 4.504.6 E, 4.504.61 B.1, 4.802.1
-A.1, 4.903.31 eff. 07/01/2017.
-Rules 4.100, 4.306.1, 4.310, 4.403, 4.405.2 eff. 10/01/2017. Rules 4.100, 4.207.3, 4.401.1, 4.401.2,
-4.407.1, 4.407.3, 4.407.31, 4.408 emer. rules eff. 10/01/2017; expired 12/30/2017.
-Rules 4.100, 4.207.3, 4.404.1, 4.401.2, 4.407.1, 4.407.3, 4.407.31, 4.408, eff. 01/01/2018.
-Rules 4.206, 4.400, 4.401.1, 4.401.2, 4.408 A, 4.502 A.4, 4.603, 4.604 emer. rules eff. 06/01/2018.
-Rules 4.206, 4.207.2, 4.207.3, 4.210 B, 4.309.3, 4.309.31, 4.309.4, 4.309.41, 4.400, 4.401.1, 4.401.2,
-4.407.4 A, 4.408 A, 4.410 D.2, 4.502 A.4, 4.603, 4.604, 4.604.1 eff. 09/01/2018.
-Rules 4.207.3, 4.401.1, 4.401.2, 4.407.1, 4.407.3 A-B, 4.407.31 emer. rules eff. 09/07/2018.
-Rules 4.207.3, 4.401.1, 4.401.2, 4.407.1, 4.407.3 A-B, 4.407.31 emer. rules eff. 12/07/2018.
-Rules 4.207.3, 4.401.1, 4.401.2, 4.407.1, 4.407.3 A-B, 4.407.31 eff. 02/01/2019.
-Rules 4.070, 4.070.2-4.070.21, 4.100, 4.200-4.202, 4.202.2-4.202.32, 4.203-4.203.2, 4.204 A, 4.2054.205.2, 4.205.4, 4.206, 4.208-4.208.1, 4.209, 4.301-4.303, 4.304.2-4.304.3, 4.304.41, 4.305.2,
-4.306, 4.307, 4.308-4.308.1, 4.309.21, 4.309.31-4.309.4, 4.401-4.402.1, 4.403-4.403.1, 4.4044.405.1, 4.406, 4.407, 4.407.5-4.407.6, 4.408-4.408.2, 4.410, 4.411.1, 4.500-4.502, 4.504,
-4.504.6-4.504.61, 4.505.2, 4.505.51-4.505.6, 4.505.7, 4.506-4.507, 4.601-4.609.6, 4.702.14.702.2, 4.702.4, 4.703, 4.801-4.801-41, 4.802, 4.802.2-4.802.21, 4.802.51, 4.802.61-4.802.62,
-4.803, 4.803.2, 4.803.43, 4.803.45, 4.803.5, 4.804.1 eff. 03/15/2019. Rules 4.204.1, 4.209.11,
-4.505.62, 4.600 repealed eff. 03/15/2019.
-Rule 4.802.63 D.1 emer. rule eff. 07/02/2019.
-Rules 4.100, 4.304 B, 4.304.41 C, 4.305 B, 4.309.1, 4.309.31, 4.309.4 A, 4.309.41, 4.401 A, 4.401.1,
-4.401.2, 4.405.2, 4.405.2 A.18, 4.407.4 A, 4.407.6, 4.407.6 B.2, 4.410 B, 4.410 J.11, 4.610,
-4.701 B, 4.701.2 E.1, 4.801.4 E, 4.801.41 E, 4.802.61-4.802.63, 4.902.1 eff. 10/01/2019.
-Rules 4.100, 4.206 E, 4.207.3, 4.304.4 A, 4.401.1, 4.401.2, 4.404 I, 4.407.1, 4.407.3 B-C,
-4.407.31 A.4, 4.407.31 B.3, 4.407.31 C.3, 4.407.31 D.2, 4.603 H, 4.604 E emer. rules eff.
-10/01/2019.
-Rules 4.309.31 C, 4.309.41 C emer. rules eff. 11/08/2019.
-Rules 4.100, 4.206 E, 4.207.3, 4.304.4 A, 4.401.1, 4.401.2, 4.404 I, 4.407.1, 4.407.3 B-C, 4.407.31 A.4,
-4.407.31 B.3, 4.407.31 C.3, 4.407.31 D.2, 4.603 H, 4.604 E eff.12/30/2019.
-Rules 4.309.31 C, 4.309.41 C eff. 01/30/2020.
-Rules 4.100, 4.310-4.313, 4.504.6, 4.801.2-4.801.5 emer. rules eff. 02/07/2020.
-Rules 4.100, 4.310-4.313, 4.504.6, 4.801.2-4.801.5 eff. 04/30/2020.
-Rules 4.100, 4.204 A, 4.207.3 D, 4.311, 4.311.3 B, 4.311.3 D.1, 4.312.1, 4.401.1, 4.401.2, 4.407.1,
-4.407.3 B-C, 4.407.31 A.4 emer. rules eff. 10/01/2020.
-Rules 4.100, 4.204 A, 4.207.3 D, 4.311, 4.311.3 B, 4.311.3 D.1, 4.312.1, 4.401.1, 4.401.2, 4.407.1,
-4.407.3 B-C, 4.407.31 A.4 eff. 11/30/2020.
-Rules 4.207.3 D, 4.401.1, 4.401.2, 4.407.1, 4.407.3 B, 4.407.3 C, 4.407.31 A.4, 4.407.31 B.3, 4.407.31
-C.3, 4.407.31 D.2, 4.408 E emer. rules eff. 10/01/2021.
-Rules 4.207.3 D, 4.401.1, 4.401.2, 4.407.1, 4.407.3 B, 4.407.3 C, 4.407.31 A.4, 4.407.31 B.3, 4.407.31
-C.3, 4.407.31 D.2, 4.408 E eff. 11/30/2021.
-Entire rule eff. 03/30/2022.
-Rules 4.000.1, 4.207.3 D, 4.310.3 C.1, 4.401.1, 4.401.2, 4.407.1, 4.407.3 B-C, 4.407.31 A.4, 4.407.31
-B.3, 4.407.31 C.3, 4.407.31 D.2, 4.408 E, 4.801.41 D.3, 4.801.41 E.8-9, 4.801.43 A-B.1, 4.802,
-4.802.1, 4.802.2 D, 4.802.3 A.1, 4.802.5, 4.802.51, 4.802.61-4.802.63, 4.803.43 A emer. rules
-eff. 10/01/2022.
-Rules 4.901, 4.902.1, 4.902.3, 4.901.31, 4.902.32, 4.902.4, 4.902.5, 4.902.6, 4.903.1, 4.903.2, 4.903.3,
-4.903.31, 4.903.32, 4.903.4, 4.903.41, 4.903.42, 4.903.43, 4.903.44 eff. 11/01/2022.
-
-226
-
-CODE OF COLORADO REGULATIONS
-Supplemental Nutrition Assistance Program (SNAP)
-
-10 CCR 2506-1
-Effective Date: 10/01/2024
-
-Rules 4.000.1, 4.207.3 D, 4.310.3 C.1, 4.401.1, 4.401.2, 4.407.1, 4.407.3 B-C, 4.407.31 A.4, 4.407.31
-B.3, 4.407.31 C.3, 4.407.31 D.2, 4.408 E, 4.801.41 D.3, 4.801.41 E.8-9, 4.801.43 A-B.1, 4.802,
-4.802.1, 4.802.2 D, 4.802.3 A.1, 4.802.5, 4.802.51, 4.802.61-4.802.63, 4.803.43 A eff.
-11/30/2022.
-Rules 4.000.1, 4.202.2, 4.204 A, 4.206 E, 4.207.3 A, 4.209.1 C.1, 4.302 A.3,B.1, 4.304 B.4, 4.304.1 A-C,
-4.304.3 B, 4.305 B.2-3, 4.305.2 C,H, 4.305.3 D, 4.306 A-B, 4.306.1, 4.308.1 F, 4.309.41 E,
-4.310.3, 4.310.4, 4.310.5 A, 4.310.6 E.2, 4.311.1, 4.311.3 A, 4.401 A, 4.401.1, 4.403 A.1-2,
-4.403.12 E.2, 4.405 C, 4.407.31 A.1.b, 4.407.61 A, 4.408 A, 4.500 C, 4.502 B, 4.504, 4.504.5
-D,H.3.b, 4.504.6 D.10, 4.504.61 B, repealed 4.505 B, 4.505.6 J, 4.505.61, 4.506, 4.506 C, 4.603
-C,G, 4.604 D, 4.609, 4.609.1, 4.609.4, 4.609.6, 4.701, repealed 4.801.4 D.3, 4.801.41 E.3,5,
-4.802.2 A.4, 4.802.4 C, 4.803.2 F.1, 4.803.43 B,B.10, 4.803.45 A, 4.803.5 A,C, 4.803.7 C-E,
-4.804.1 A, 4.905 eff. 09/30/2023.
-Rules 4.000.1, 4.207.3 D, 4.311, 4.311.1, 4.401.1, 4.401.2, 4.407.1, 4.407.3, 4.407.31, 4.408 E emer.
-rules eff. 10/01/2023.
-Rules 4.000.1, 4.207.3 D, 4.311, 4.311.1, 4.401.1, 4.401.2, 4.407.1, 4.407.3, 4.407.31, 4.408 E eff.
-11/30/2023.
-Rules 4.000.1, 4.140 A, 4.201 G, 4.207.1 B, 4.207.3 A.3, 4.304-4.304.32, 4.311.3 C.2, 4.402 A.2, 4.403
-F, 4.403.2 C, 4.407 A, 4.407.2 A, 4.407.4 A.2, 4.505.4, 4.707.9, 4.707.91 eff. 08/30/2024.
-Rules 4.000.1, 4.207.3 D, 4.311 A.2, 4.401.1, 4.401.2, 4.407.1, 4.407.3 B-C, 4.407.31, 4.408 E emer.
-rules eff. 10/01/2024.
-Rules 4.000.1, 4.207.3 D, 4.311 A.2, 4.401.1, 4.401.2, 4.407.1, 4.407.3 B-C, 4.407.31, 4.408 E eff.
-11/30/2024.
-
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-CodeofCol
-or
-adoRegul
-at
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-
-DEPARTMENT OF LABOR AND EMPLOYMENT
-Division of Unemployment Insurance
-REGULATIONS CONCERNING EMPLOYMENT SECURITY
-7 CCR 1101-2
-[Editor’s Notes follow the text of the rules at the end of this CCR Document.]
-
-_________________________________________________________________________
-PART I GENERAL PROVISIONS
-1.1
-
-PREAMBLE
-
-Pursuant to the provisions of 8-72-102, C.R.S., and other provisions of the Colorado Employment
-Security Act, the industrial commission of Colorado, ex officio, unemployment compensation commission
-of Colorado hereby adopts and promulgates the following regulations.
-1.2
-
-PURPOSE AND SCOPE
-
-The purpose of these regulations effective March 3, 1980, is to implement the procedural and substantive
-provisions of the Colorado Employment Security Act.
-1.2.1
-
-Basis and Purpose for the 1983 Amendments. - The amendments and reenactments and
-renumbering of the regulations effective August 30, 1983, are caused by requirements of
-legislative enactments that require conformity in the implementing regulations, and the
-necessities for clarifications and elaborations in the regulations to ensure continuing fairness in
-administration and adjudication of claims for benefits and appeals from adjudications; and in just
-determination of appeals and petitions at a reasonable expense to parties and the administering
-agencies.
-
-1.2.2
-
-Basis and Purpose for the 1984 Amendments. - The amendments effective October 30, 1984,
-are promulgated by the commission pursuant to 8-72-102 and 24-4-103, C.R.S., for the purpose
-of clarifying and defining more fully the procedural rights and duties of claimants for
-unemployment benefits, employers, and other interested parties, and are calculated to implement
-the Colorado Employment Security Act, C.R.S. title 8, articles 70 to 82 as amended, more fairly
-and efficiently, and to further its stated purposes; and to implement the purpose of harmony in
-state administration with federal statutes and regulations; and the requirements for effective
-appeals or petitions for review of administrative determinations; and the duties and liabilities of
-parties in communications with the administrative authorities in matters of claims for benefits and
-notices and determinations related thereto.
-These amendments to rules and regulations result from recent legislative enactments upon
-employment security; from a public hearing held in accordance with 24-4-103, C.R.S., and the
-entire record connected thereto; and from comments and advice offered during proceedings of
-the legal affairs committee within the Colorado Department of Labor and Employment that is
-concerned, as is the commission, with just and efficient administrative practices and response to
-the needs for changes and prospective improvements in procedure, including the areas of claims,
-hearing, and appeals.
-
-1
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-1.2.3
-
-Basis and Purpose for the 1985 Amendments. - The amendments effective September 30,
-1985, are adopted pursuant to 8-72-102, C.R.S., for the purpose of conformity with new
-legislation, clarification of the substantive and procedural rights and responsibilities of interested
-parties, and increased efficiency and effectiveness in the fair administration of the Colorado
-Employment Security Act, including the appeal process.
-
-1.2.4
-
-Basis and Purpose for the 1987 Amendments. - The amendments effective January 1, 1988,
-are adopted pursuant to 8-72-102, C.R.S., for the purpose of conformity with new legislation,
-clarification of the substantive and procedural rights and responsibilities of interested parties, and
-increased efficiency and effectiveness in the fair administration of the Colorado Employment
-Security Act, including the appeal process.
-
-1.2.5
-
-Basis and Purpose for the 1991 Amendments. - The amendments effective October 1, 1991,
-are adopted pursuant to 8-72-102, C.R.S., for the purposes of conformity with new legislation,
-facilitating the reorganization of the division and its operations, and removing obsolete language
-from the regulations.
-
-1.2.6
-
-Basis and Purpose for the 1992 Amendments. - The amendments effective August 3, 1992,
-are adopted pursuant to 8-72-102, C.R.S., for the purpose of transferring to the industrial claim
-appeals office certain procedural responsibilities concerning appeals from referees' decisions, to
-facilitate increased efficiency and effectiveness in the administration of the appeals process, and
-to effectuate the 1992 amendments to 8-74-104(3), C.R.S., and enactment of 8-74-104 (4),
-C.R.S.
-
-1.2.7
-
-Basis and Purpose for the 1994 Amendments. - The amendments effective July 1, 1994, are
-adopted pursuant to 8-72-102, C.R.S., for the purpose of more fully describing claim-filing
-requirements, clarifying administrative-appeals procedures, and removing obsolete provisions
-from the regulations.
-
-1.2.8
-
-Effective Date for the 1994 Amendments. - The rules adopted on May 4, 1994, are effective on
-July 1, 1994.
-
-1.2.9
-
-Basis and Purpose for the 1997 Amendments. - The amendments effective January 1, 1998,
-are adopted pursuant to 8-72-102, C.R.S., for the purpose of modifying statutory citations,
-clarifying eligibility requirements, removing obsolete provisions concerning the Head Start
-Program, conforming quarterly tax and wage reporting to federal-law requirements, modifying
-hearing-document exchange and good-cause provisions, and outlining criteria for the write-off of
-recovery and the waiver of recovery of benefit overpayments.
-
-1.2.10 Effective Date for the 1997 Amendments. - The rules adopted on November 6, 1997, are
-effective on January 1, 1998.
-1.2.11 Basis and Purpose for the 1998 Amendments. - The amendments effective January 1, 1999,
-are adopted pursuant to 8-72-102, C.R.S., for the purpose of making technical corrections,
-modifying provisions concerning claims for benefits, promoting increased effectiveness in the
-administration of the appeals process, and conforming interstate provisions to arrangements with
-other states.
-1.2.12 Effective Date for the 1998 Amendments. - The rules adopted on November 6, 1998, are
-effective on January 1, 1999.
-1.2.13 Basis and Purpose for the 2000 Amendments. - The amendments effective January 1, 2001,
-are adopted pursuant to 8-72-102, C.R.S., for the purpose of modifying provisions concerning
-approved training and improving clarity and uniformity in the regulations.
-
-2
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-1.2.14 Effective date for the 2000 Amendments. - The rules adopted on November 1, 2000, are
-effective on January 1, 2001.
-1.2.15 Basis and Purpose for the 2002 Amendments. - The amendments effective January 1, 2003,
-are adopted pursuant to 8-72-102, C.R.S., for the purpose of expanding the methods for the
-division, the panel, and their customers to conduct business through use of technology and
-harmonizing the regulations with the provisions of 8-76-101(3), C.R.S., concerning quarterly taxes
-due that are less than five dollars.
-1.2.16 Effective Date for the 2002 Amendments. - The rules adopted on October 30, 2002, are
-effective on January 1, 2003.
-1.2.17 Basis and Purpose for the 2008 Amendments. - The amendments effective February 1, 2009,
-are adopted pursuant to 8-72-102, C.R.S., for the purpose of modifying provisions required by
-legislative enactments to facilitate increased efficiency and effectiveness in the administration of
-the appeals process, to include the employee -leasing company requirements, and to remove
-obsolete language from the regulations concerning employment security.
-1.2.18 Effective Date for the 2008 Amendments. - The rules adopted on November 12, 2008, are
-effective on February 1, 2009.
-1.2.19 Effective Date for the 2009 Amendments. - The rules adopted on August 14, 2009, are
-effective on October 30, 2009.
-1.2.20 Basis and Purpose for the 2009 Amendments. - The amendments effective October 30, 2009,
-are adopted pursuant to 8-72-102, C.R.S, to:
-.1
-
-Reflect the changes in the reporting requirements for employee-leasing companies in
-part xvi.
-
-.2
-
-Create processes related to employee misclassification by adding new Part XVII.
-
-.3
-
-Modify provisions required by legislative enactments to add a definition for remuneration
-in part I.
-
-.4
-
-Reflect statutory amendments in part ii, by allowing for a work-search waiver for an
-individual who has a qualifying job separation under 8-73-108 (4) (t) C.R.S, and;
-
-.5
-
-Extend the waiver of the requirements to register for work and report to an employment
-office as a condition of being eligible to receive unemployment insurance benefits for a
-claimant who is job-attached.
-
-1.2.21 Effective Date for the 2009 Amendments. The rules adopted on October 30, 2009, are effective
-on December 30, 2009.
-1.2.22 Basis and Purpose for the 2009 Amendments. The amendments effective December 30, 2009,
-are adopted pursuant to 8-72-102, C.R.S., for the purpose of modifying provisions required by
-legislative enactments to facilitate increased efficiency and effectiveness in the administration of
-the appeals process, and to include House Bill 09-1363, Unemployment Compensation
-Enterprise requirements to the Regulations Concerning Employment Security.
-1.2.23 Basis and Purpose of the 2011 Amendments. - The rules adopted on November 14, 2011, are
-effective January 1, 2012 for the purpose of:
-
-3
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-.1
-
-Improving communication with claimants in regards to what defines an active work
-search.
-
-.2
-
-Amending the rules related to actively seeking work to add clear definitions of what
-represents a work search. Additionally, adding further explanation that a tangible record
-of contacts is required, what a tangible record is, and the length of time the record must
-be maintained by a claimant.
-
-.3
-
-Adding new rules allowing the Division to issue a formal warning, at its discretion, to a
-claimant who unintentionally fails to meet the work-search requirements.
-
-1.2.24 Basis and Purpose of the 2012 Amendments. - The rules adopted on November 22, 2011, are
-effective April 1, 2012 for the purpose of:
-.1
-
-Amending the rules related to unemployment insurance appeals and redeterminations for
-clarity.
-
-.2
-
-Amending the rules related to good cause for clarity.
-
-.3
-
-Adopting rules allowing the Division to fine an employer who is found to have willfully
-disregarded the law when misclassifying an employee as an independent contractor.
-
-1.2.25 Basis and Purpose of the 2012 Amendments. - The rules adopted on January 18, 2012, are
-effective April 1, 2012 for the purpose of:
-.1
-
-Amend the rules regarding employer reports, specifically a wage or separation report on
-a specific worker to include a statement that good cause is automatically found when the
-separation report is received after the deadline but before a decision is issued. As
-appropriate, add the new reference on good cause to other rules within this Part.
-
-.2
-
-Repeal a portion of the rule regarding a decision of the hearing officer that no longer
-applies.
-
-.3
-
-Amend the rules regarding good cause procedure to allow Unemployment Insurance
-Appeals to make a determination of good cause without specifically requesting a goodcause statement from the appellant if the file material contains the necessary information.
-
-1.2.26 Basis and Purpose of the May 2012 Amendments. – The rules adopted on April 2, 2012, are
-effective May 30, 2012 for the purpose of amending the rules to allow the Division to take the
-postmark date into account when determining the timeliness of the receipt of a premium payment
-and quarterly report.
-1.2.27 Basis and Purpose of the May 2012 Amendments. – The rules adopted on June 4, 2012 are
-effective July 30, 2012. The Division of Unemployment Insurance reviewed all rules currently in
-effect. The review found rules that are redundant to statute and/or outdated. The following
-amendments are proposed to simplify the Division’s rules:
-.1
-
-Repeal rules that repeat statute and renumber the remaining Definitions in Part I.
-
-.2
-
-Amend rules to clarify that an employer is not required to pay premiums that are less than
-$5 as long as the quarterly reports are submitted timely in Part VI, Premiums and
-Assessments.
-
-.3
-
-Repeal reporting methods that cannot be accepted for employer quarterly reports in Part
-VII, Employer Records and Reports.
-
-4
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-.4
-
-Repeal a portion of the employee-leasing companies rules that is no longer applicable in
-Part XVI, Employee-Leasing Companies.
-
-.5
-
-Repeal rules that repeat statute and renumber the remaining rules in Part XVII, Work
-Share.
-
-1.2.28 The rules adopted on July 18, 2012, are effective September 14, 2012. The Division of
-Unemployment Insurance amended the following rules to address legislative changes made
-during the 2012 Colorado General Assembly.
-.1
-
-Amend references to the Unemployment Insurance Program to be the Division.
-
-.2
-
-Amend the definition of the division to conform to statute creating the Division of
-Unemployment Insurance.
-
-.3
-
-Amend references to the Unemployment Insurance Program to be the Division and
-extend the date by which enhanced benefits can be paid to June 30, 2014, to conform to
-the law.
-
-.4
-
-Amend rules on the application of delinquent payments to include nonprincipal-related
-bond payments.
-
-1.2.29 The rules adopted on March 13, 2013, are effective May 15, 2013. The Unemployment Insurance
-Division reviewed all rules currently in effect. The review found rules that are redundant to statute
-and/or outdated. The following amendments are proposed to simplify the Unemployment
-Insurance Program’s rules.
-
-1.3
-
-1.
-
-Repeal rules regarding emergency rules that were later promulgated into permanent
-rules, and the effective date of the permanent rules are included in the details of that
-promulgation.
-
-2.
-
-Repeal a rule that is no longer applicable, and clarify income derived from investmentinterest payments.
-
-3.
-
-Clarify that a spousal relationship is defined by Colorado law.
-
-4.
-
-Amend rules regarding the timelines for requesting redeterminations to extend the time
-from fifteen (15) days to twenty (20) days.
-
-5.
-
-Amend rules for clarity, and repeal sections that are no longer applicable. Renumber
-remaining sections.
-
-6.
-
-Repeal a rule that is no longer applicable.
-
-DEFINITIONS
-
-As used in these regulations, the following words shall have the following meanings:
-.1
-
-Commission. - The word “commission” shall mean the Industrial Commission of Colorado, ex
-officio, Unemployment Compensation Commission of Colorado as it existed prior to July 1, 1986.
-
-.2
-
-Division. - The word “division” shall mean the Division of Unemployment Insurance of the
-Department of Labor and Employment of the State of Colorado.
-
-5
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-.3
-
-Act. - The word “act” shall mean the Colorado Employment Security Act, articles 70 to 82 of title
-8, C.R.S., unless the context clearly indicates otherwise.
-
-.4
-
-Benefits. - The word “benefits” shall mean unemployment compensation benefits payable to
-claimants under the act.
-
-.5
-
-Calendar Week. - The term “calendar week” shall mean a period of seven consecutive days
-beginning at 12:01 a.m. on Sunday and ending at midnight on the following Saturday.
-
-.6
-
-Public Employment Office. - The term “public employment office” shall mean any workforce
-center, itinerant service point, or representative thereof.
-
-.7
-
-Panel. - The word “panel” shall mean the industrial claim appeals panel that conducts
-administrative appellate review of any decision entered pursuant to article 74 of title 8, C.R.S.
-
-.8
-
-Examiner. - The word “examiner” shall mean one of the industrial claim appeals examiners
-appointed to the panel.
-
-.9
-
-Attendance. - The term “attendance” shall mean participation in hearings before a hearing officer
-by telephonic means or in person.
-
-.10
-
-Written, in Writing. - The terms “written” and “in writing” shall mean:
-.1
-
-Decisions, determinations, notices, account statements, and documents provided by the
-division or the panel to an interested party, or their authorized representative, if any, in
-person, by mail, by facsimile machine, or by electronic means.
-
-.2
-
-Appeals, applications, documents, elections, forms, notices, protests, reports, and
-requests submitted to the division or the panel by an interested party, or their authorized
-representative, if any, when handwritten or typed, transmitted using division-approved
-electronic means and formats, or panel-approved electronic means, or provided using a
-division interactive voice response system when this method is expressly permitted by
-regulation.
-
-.11
-
-Signed, Signature. - When information submitted to the division is required to be signed, the
-personal identification number (PIN) shall be considered the same as a signature when a
-claimant, an employer, or authorized representative thereof uses division-approved electronic
-means or uses a division interactive voice response system.
-
-.12
-
-Personal Identification Number (PIN). - The term “personal identification number (PIN)” shall
-mean a confidential number or other electronic method of verification unique to a claimant, an
-employer, or authorized representative thereof that shall be required for such persons to perform
-certain transactions with the division by electronic means or by a division interactive voice
-response system.
-
-.13
-
-Electronic. - The term “electronic” shall have the meaning set forth in 8-70-103 (8.5), C.R.S.,
-and, for purposes of these regulations, said meaning shall include the Internet and any other
-technology the division in its discretion may approve, or when appropriate, the panel may
-approve.
-
-.14
-
-Facsimile Machine. - The term “facsimile machine” shall mean a device that electronically or
-telephonically receives and transmits reproductions or facsimiles of documents.
-
-6
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-.15
-
-Transmit. - The term “transmit,” or any derivative thereof, shall mean by facsimile machine, by
-electronic means, or by a division interactive voice response system unless the context clearly
-indicates otherwise.
-
-.16
-
-Mail. - The term “mail” shall mean delivery through the United States Postal Service or by other
-commercial carrier, but not by electronic or telephonic means.
-
-.17
-
-Interactive Voice Response System. - The term “interactive voice response system” means the
-division's automated interface between a caller using a telephone and a division computer.
-
-.18
-
-By Telephone. - The term “by telephone” means verbal communication using a telephone
-instrument or communication using a telephone device for the deaf (TDD). Said term does not
-include information transmitted by “electronic” means pursuant to regulation 1.3.14 or information
-transmitted using an “interactive voice response system” pursuant to regulation 1.3.18.
-
-.19
-
-Corrected Decision. - The term “corrected decision” shall refer to a decision issued by a deputy
-or a hearing officer or the panel, within 30 days subsequent to the date of his decision, to correct
-typographical or clerical or other minor errors. A “corrected decision” is not a reconsidered
-decision as provided by 8-74-105, C.R.S. Notice of a corrected decision shall promptly be given
-to all interested parties.
-
-.20
-
-The term “remuneration,” - as used in §8-73-110, C.R.S., shall mean any payment the
-individual receives from the employer which the individual would not have received had he or she
-not separated from employment.
-
-.21
-
-Negative Excess Employer. - The term “negative excess employer” shall mean an employer
-who has more in unemployment benefits charged to his or her account as compared to
-unemployment premiums paid and credited to his or her account.
-
-.22
-
-Fringe Benefits. - The term “fringe benefits” shall mean health insurance, retirement benefits
-received under a pension plan, paid vacation days, paid holidays, paid sick leave, and any other
-similar employee benefit that is provided by an employer.
-
-.23
-
-Work Share Benefits. - The term “work share benefits” shall mean the unemployment benefits
-payable to employees in an affected unit under an approved work share plan as distinguished
-from the unemployment benefits otherwise payable under the conventional unemployment
-compensation provisions of the Colorado Employment Security Act.
-
-.24
-
-Participating Employer. - The term “participating employer” shall mean an employer who has a
-work share plan in effect.
-
-.25
-
-Participating Employee. - The term “participating employee” shall mean an employee who
-works a reduced number of hours under a work share plan.
-
-.26
-
-“Federal Program” means any federal- and state-extended benefits program under federal law
-that provides benefits to exhaustees of regular benefits during times of high unemployment or
-economic downturn and any program that pays benefits under federal law, including but not
-limited to, Disaster Unemployment Assistance.
-
-1.4
-
-USE OF PRONOUNS
-
-As used in these regulations, “he,” “his,” and “him” shall refer to individuals of either gender, and also,
-where appropriate, to entities and organizations.
-
-7
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-1.5
-
-7 CCR 1101-2
-
-REPEAL
-
-All rules and regulations enacted previous to March 3, 1980, relating to employment security are hereby
-repealed.
-1.6
-
-SUBSTITUTION OF THE WORD “PREMIUM” FOR THE WORD “TAX”.
-
-Wherever the word “tax(es)” appears in these rules said word(s) shall be replaced by the word
-“premium(s)”.
-1.7
-AMENDMENT OF REGULATIONS CONCERNING EMPLOYMENT SECURITY BY
-EMERGENCY RULE MADE PERMANENT
-1.7.1
-
-Statement of Basis and Purpose as to Emergency Rule Made Permanent. - The emergency
-rule, adding a new subsubsection .11 to regulation 11.2.15 of part XI of the Regulations
-Concerning Employment Security, was promulgated and made permanent to comply with 8-74104(1), C.R.S. (1985 Cum. Supp.), that required the commission to promulgate a rule regarding
-briefing schedules on first appeal to the commission. The rule establishes a simultaneous briefing
-schedule for such appeals and codifies existing division procedure for processing such appeals.
-
-1.7.2
-
-Authority. - The emergency rule was promulgated effective January 2, 1986, pursuant to the
-industrial commission's authority in 8-72-102 and 24-4-103(6), C.R.S., having to do with
-promulgation of emergency rules. The commission found that said adoption and promulgation as
-an emergency rule was imperatively necessary for the preservation of health, safety, and welfare,
-and of substantive and procedural rights of parties to unemployment compensation appeals, and
-that compliance with the ordinary provisions and requirements for notice and prior public hearing,
-as provided by 24-4-103, C.R.S., would be contrary to the public interest; and such finding by the
-commission has been duly set forth in the commission resolution adopting the emergency rule
-dated January 2, 1986.
-
-1.7.3
-
-Permanency of Emergency Rule. - The commission, pursuant to said section 24-4-103, C.R.S.,
-and after duly published notice and public hearing, now promulgates said rule as a permanent
-rule, adding a new subsubsection .11 to existing regulation 11.2.15 of existing part XI of the
-Regulations Concerning Employment Security, 7 C.C.R. 1101-2.
-
-1.7.4
-
-Effective Date of Rule. - This rule shall be effective 20 days after publication.
-
-1.7.5
-
-Repealed
-
-1.8
-
-DATE OF FILING.
-
-Where part II, part V, part VI, part VII, part X, part XI, part XII, part XIII, or part XV of these regulations
-provides for the filing of documents, the date of filing shall be the date received, if mailed or filed in
-person, the receipt date encoded on a facsimile document, or the receipt date recorded by the division's
-automated systems if filed using division-approved electronic means or a division interactive voice
-response system unless the regulation specifically provides otherwise.
-1.9
-
-DIVISION OR PANEL COMMUNICATIONS.
-
-The division or panel may request information from an interested party and their authorized
-representative, if any, by personal delivery, by mail to their last known address as shown in the division’s
-or panel’s records, by telephone, by facsimile machine, or by division approved electronic means. Any
-decision, determination, notice, or statement that conveys protest or appeal rights shall be provided in
-accordance with articles 70 to 82 of title 8, C.R.S., and these regulations.
-
-8
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-1.10
-
-7 CCR 1101-2
-
-USE OF PERSONAL IDENTIFICATION NUMBER (PIN).
-
-It is the responsibility of a claimant, an employer, or authorized representative thereof who uses a PIN to
-keep that information confidential. Use of said PIN by any third party to obtain, increase, delay, prevent,
-or reduce benefit payments shall be subject to the provisions of 8-81-101, C.R.S., and the regulations
-pursuant thereto.
-1.11
-
-MAILING ADDRESS OF PARTIES.
-
-It is the responsibility of a claimant, an employer, or authorized representative thereof to keep the division
-promptly and directly informed of the party’s current and correct mailing address. Parties may notify the
-division of a change of address by providing a written, signed statement in person, by mail, by facsimile
-machine, by division-approved electronic means, or via cubline, the division's interactive voice response
-system.
-PART II
-
-CLAIMS FOR BENEFITS
-
-2.1
-
-REGISTRATION AND FILING CLAIMS
-
-2.1.1
-
-Statutory References. 8-70-111 (2)(a), 8-70-112, 8-73-107 (1)(a)(b)(e)(h), and 8-74-101 (1),
-C.R.S.
-
-2.1.2
-
-Work Registration. To qualify for benefits, an unemployed worker must register for work when
-instructed by the division. Failure to register for work when so instructed may result in a
-disallowance of benefits pursuant to regulation 2.1.67.
-
-2.1.3
-
-Filing an Initial, Additional, or Reopened Claim. The claimant may file an initial, additional, or
-reopened claim by division-approved electronic means, by telephone, by mail, or in person at the
-discretion of the division. Unless otherwise determined by the division, filing claims by divisionapproved electronic means and by telephone shall be the preferred methods of filing.
-.1
-
-If the division determines that the claimant's interests would be better served by an
-alternative method of claim filing, an individual may be permitted to file a claim by mail or
-in person. The division shall determine which alternative method of claims filing the
-claimant may use.
-
-.2
-
-If the division determines that an individual may file by mail, the following criteria shall be
-used in addition to the criteria contained in regulation 2.3.5 in determining the effective
-date of the claim:
-.1
-
-The claimant must fill out the prescribed claim form completely and correctly in
-order to establish a valid claim.
-
-.2
-
-The effective date of the claim may not be established until the claim form is
-correctly completed by the claimant and received by the division. If the
-information on the form is not complete, it may be returned to the claimant for
-correction. The time the corrected claim is received by the division may establish
-the effective date.
-
-9
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-.3
-
-7 CCR 1101-2
-
-to establish the validity of an initial, additional or reopened claim, the division may require
-the claimant to provide documentation or other evidence to establish their identity. failure
-to provide such information shall result in a disallowance of benefits. such information
-must be provided by the claimant by methods prescribed by the division director which
-may include the submission of the information through a third party administrator. failure
-to submit such information by the method prescribed by the division director shall be
-considered in the same manner and shall be subject to the same disallowance of benefits
-as if the claimant had failed to submit the information.
-.1
-
-no claim for benefits shall be considered valid as defined in 8-70-111(2)(a) until
-this requirement has been met to the satisfaction of the division.
-
-.2
-
-an individual’s identity may not be established by any method other than those
-prescribed by the division director.
-
-2.1.4
-
-Completion of the Required Forms. After filing an initial, additional, or reopened claim, the
-claimant will be issued the necessary forms that must be completed and returned to the division.
-At the discretion of the division, completed forms may be returned to the division in person, by
-mail, by facsimile machine, or by division-approved electronic means. Failure to return the
-completed forms could result in a disallowance of benefits.
-
-2.1.5
-
-Reporting in Person. The division may, at its discretion, require a claimant to report in person to
-a public employment office to comply with such requirements as deemed necessary to
-demonstrate eligibility for benefits.
-
-2.1.6
-
-Failure to Report. Failure by the claimant to comply with a request to report in person, by
-telephone, by mail, by facsimile machine, or by division-approved electronic means as directed by
-the division or to provide the division with necessary information or documentation when so
-requested could result in a disallowance of benefits, unless good cause is shown.
-2.1.6.1 [Emergency rule expired 08/12/2020]
-
-2.1.7
-
-Filing a Continued Claim. A continued claim is a request filed for waiting-period credit or payment
-for one or more weeks of unemployment. Claimants must file for continued claims by interactive
-voice response system or by division-approved electronic means. the division may permit a
-claimant to file a continued claim by mail or in person if filing by interactive voice response system
-or by division-approved electronic means would cause undue hardship for an individual.
-.1
-
-filing period. continued claims must be filed on a weekly basis, as directed by the division,
-and must be filed no later than the seventh day after the last day of the week for which
-the claimant is requesting a benefit payment.
-
-.2
-
-continued Claims Filed by Interactive Voice Response System. The term “interactive
-voice response system” means the division's automated interface between a caller using
-a telephone and a division computer.
-
-.3
-
-continued Claims Filed by Division-Approved Electronic Means. Division approved
-electronic means include the internet and any other technology the division in its
-discretion, may approve, or when appropriate, the panel may approve. The transmittal
-date recorded by the division’s automated systems shall determine the date of filing.
-
-10
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-.4
-
-continued Claims Filed by Mail. “mail” means delivery through the united states postal
-service or by other commercial carrier, but not by electronic or telephonic means. in the
-event that the division permits filing a continued claim by mail, the claimant must
-complete and sign the document. the division must receive the document at the central
-office of the division no later than the last day of the filing period.
-
-.5
-
-continued claims filed in person. in the event that the division permits filing an in-person
-continued claim, he or she must file in person, a completed claim form, signed by the
-claimant at a public employment office or at the central office of the division. the claimant
-must complete this action no later than the last day of the filing period.
-
-2.1.8
-
-Temporary Absence From State. Claimants who reside in Colorado and temporarily leave the
-state to seek employment and, while absent from the state, satisfy the eligibility requirements set
-forth in 8-73-107, C.R.S., and the regulations pursuant thereto will be allowed to file continued
-claims from out-of-state. Upon a claimant's relocation to another state, the provisions of
-regulation 13.1 shall apply.
-
-2.1.9
-
-Nonreceipt of Forms. If prescribed continued-claim forms are not received by the claimant by
-mail, the claimant must request such forms from the division.
-
-2.1.10 Exceptions to Time Limits. Acts under this section 2.1 may be permitted out of time only under
-limited circumstances, but regardless of whether an individual has met the requirements of this
-section 2.1.10, no act under this section 2.1 shall be permitted more than 180 days beyond the
-last day of the applicable time period. Exceptions for untimely act that occur within the allotted
-180 days may be granted only if the following standards apply.
-.1
-
-Work Registration and Requested Reports. The division may, for good cause shown,
-permit an individual to register for work or provide requested reports to the division
-outside the required time period without loss of eligibility. For the purposes of this
-subsection, good cause shall have the meaning set forth in regulation 12.1.8.
-
-2.1.10.2
-Continued Claims. The division may permit filing a continued claim out of time as
-set forth in regulation 2.1.7 only if the individual establishes to the satisfaction of the
-division that he or she exercised no control over the circumstances of the untimely filing.
-Being unaware of the need to timely file is not considered a factor outside an individual’s
-control.
-.3
-
-Initial, Additional, Reopened Claims. When an initial, additional, or reopen claim is
-filed, the first week of that claim shall be determined in accordance with regulation 2.3.5.
-The division may permit a change in the first week of an initial, additional, or reopened
-claim only if the individual establishes to the satisfaction of the division that he or she
-exercised no control over the circumstances of the untimely filing. Being unaware of the
-need to timely file shall not be considered a factor outside the individual’s control.
-
-2.1.11 Cancellation of Initial Claim. When a benefit year is established as a result of a valid initial
-claim, such claim may be cancelled only when:
-.1
-
-Part XIII of the regulations concerning interstate and combined-wage claimants applies,
-or
-
-.2
-
-The claimant requests cancellation in person, by mail, by facsimile machine, by divisionapproved electronic means, or by telephone within twelve calendar days from the date of
-such filing. Requests to cancel a valid initial claim made after the twelve-day period shall
-be denied without consideration of good cause or whether the individual exercised any
-control over the circumstances of the untimely request.
-
-11
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-2.1.12 Tax-Withholding Option for Federal Programs. Claimants may choose a tax-withholding option
-upon initially applying for a federal program, as defined in Regulation 1.3.31, for which claimants
-receive a notice of monetary determination.
-2.2
-
-BENEFITS RIGHTS OF PART-TIME WORKERS
-
-2.2.1
-
-Statutory References: 8-73-103, 8-73-104 (1), 8-73-105, 8-73-106 (1), and 8-73-107, C.R.S.
-
-2.2.2
-
-Eligibility. An unemployed part-time worker as defined in 8-73-105 (1), C.R.S., who worked parttime for the majority of weeks of work in his or her base period for one or more employers and
-whose availability is restricted to part-time work shall be eligible for benefits pursuant to this
-section.
-
-2.2.3
-
-Able, Available, and Actively Seeking Work. Any unemployed part-time worker shall be
-deemed to have met the requirements of 8-73-107 (1)(c) and (g), C.R.S., if:
-.1
-
-Said worker is able to work, available for work, and actively seeking his or her customary
-part-time work or other part-time work for which he or she is qualified; and
-
-.2
-
-Such part-time work exists in the labor-market area.
-
-2.2.4
-
-Totally Unemployed Part-Time Seasonal Worker. Benefit rights of an unemployed part-time
-worker who is also a seasonal worker shall be determined pursuant to 8-73-104 (1), C.R.S.
-
-2.2.5
-
-Partially Unemployed Part-Time Worker. Benefit rights of partially unemployed part-time
-workers who meet the requirements of regulation 2.2.2 and who receive a reduction in customary
-work hours shall be determined in accordance with 8-73-103, C.R.S.
-
-2.2.6
-
-Regular Part-Time Worker. Regular part-time employment is defined to be that part-time baseperiod employment from which a claimant has not separated at the time of filing a valid initial
-claim and that was present with other full-time or part-time base-period employment. Benefits are
-not payable with respect to wages from regular part-time employment until a claimant becomes
-separated from such employment and then only for those weeks occurring after said separation.
-
-2.3
-
-WEEK OF UNEMPLOYMENT
-
-2.3.1
-
-Statutory References: 8-70-103 (19)(28)(30), 8-70-112, 8-73-107 (1)(d)(f)(h), 8-73-108 and 874-101, C.R.S.
-
-2.3.2
-
-Week of Unemployment. Except as provided in regulations 2.3.4 and 2.3.5, a week of
-unemployment shall be the calendar week in which the individual files an initial, additional, or
-reopened claim with the division and each calendar week immediately following any such week
-for which said individual has filed a continued claim as provided by regulation or has failed to do
-so and has established to the satisfaction of the division that he or she exercised no control over
-that failure. However, no week is a week of unemployment unless the individual has worked less
-than thirty-two hours during such week, earned less than his or her weekly benefit amount, and
-has filed an initial, additional, or reopened claim not later than Wednesday of that week or has
-filed a continued claim pursuant to regulation 2.1.7.
-
-12
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-2.3.3
-
-Area Served by Itinerant Service Point. A week of unemployment for an individual who resides
-in an area served only by an itinerant service point of the division shall be the calendar week in
-which such individual became unemployed, if such individual files an initial, additional, or
-reopened claim at such itinerant service point at the first opportunity thereafter, and each
-calendar week immediately following such week for which such individual has filed a continued
-claim as provided by regulation or has failed to do so and has established to the satisfaction of
-the division that he or she exercised no control over that failure. However, no week shall be
-considered a week of unemployment unless the individual has worked less than thirty-two hours
-during such week and earned less than his or her weekly benefit amount.
-
-2.3.4
-
-Failure to Meet Requirements. A week of unemployment for an individual who has failed to
-timely file an initial, additional, or reopened claim for benefits as provided in these regulations
-shall be the earliest calendar week in which the individual established to the satisfaction of the
-division that he or she exercised no control over the circumstances of the failure to act timely.
-Thereafter, weeks of unemployment shall be the calendar weeks immediately following any such
-week for which the individual has filed a continued claim as provided by regulation, or has failed
-to do so and has established to the satisfaction of the division that he or she exercised no control
-over that failure. However, no week shall be considered a week of unemployment unless the
-individual has worked less than thirty-two hours during such week and earned less than his or her
-weekly benefit amount.
-
-2.3.5
-
-First Week for Claims. To begin a claims series by reason of an initial, additional, or reopened
-claim, an individual's first week in the claims series shall be determined as follows:
-.1
-
-If the individual files a claim on Monday, Tuesday, or Wednesday, the first day of the first
-week in the claims series shall begin on the Sunday immediately preceding the day on
-which said claim was filed.
-
-.2
-
-If the individual files a claim on Thursday, Friday, or Saturday, the first day of the first
-week in the claims series shall begin on the Sunday immediately following the day on
-which said claim was filed.
-
-2.4
-
-JOB ATTACHMENT.
-
-2.4.1
-
-Statutory References: - 8-73-107 and 8-73-108 (5)(a)(b)(c), C.R.S.
-
-2.4.2
-
-Job Attachment to an Employer. - A claimant is considered to be job-attached and is presumed
-to be following a course of action reasonably designed to result in prompt reemployment in
-suitable work, as contemplated by 8-73-107 (1)(g), C.R.S., when an understanding exists
-between the claimant and his or her employer that the claimant will return to his or her old job or
-other suitable work with such employer within the period set forth in regulation 2.4.5 and the
-requirements of this section 2.4 of the regulations are met. This presumption may be rebutted by
-competent evidence in an individual case. Job attachment to an employer shall commence with
-the week in which the claimant last separated from said employer.
-
-2.4.3
-
-Job Attachment by Virtue of Union Hiring Hall. - A claimant who is properly registered for
-employment through a union hiring hall is presumed to be following a course of action reasonably
-designed to result in prompt reemployment in suitable work, as contemplated by 8-73-107 (1)(g),
-C.R.S., and shall be considered job-attached to the extent permitted by regulation 2.4.5. This
-presumption may be rebutted by competent evidence in an individual case. Job attachment shall
-commence with the effective date of a valid initial, additional, or reopened claim filing.
-
-13
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-2.4.4
-
-Job Attachment by Promise of New Work. - A claimant who has an assurance of new work
-shall be considered job-attached to the extent permitted by regulation 2.4.5, and such period shall
-commence with the week in which the offer of new work was accepted. “New work” for the
-purposes of this section 2.4 shall mean a job offer that has no known termination date made by
-any employer other than the employer from whom the claimant most recently separated.
-
-2.4.5
-
-Duration of Job Attachment. - Claimants who are job-attached to an employer or who are jobattached by virtue of a union hiring hall arrangement will be presumed to meet the requirements
-of 8-73-107 (1)(g), C.R.S., for a period of up to sixteen weeks unless it can be shown that said
-job-attached status is not reasonably designed to result in prompt reemployment in suitable work.
-Job-attached status may be granted for a period of no more than two weeks to a claimant with a
-promise of new work.
-.1
-
-The division, at its discretion during times of economic recession, may extend the period
-of job attachment for up to twenty-six weeks for claimants who are job-attached to an
-employer or who are job-attached by virtue of a union hiring hall arrangement.
-
-2.4.6
-
-Duties of Claimant. - During the period of job attachment set forth in regulation 2.4.5, a jobattached claimant must be able to work and be available for suitable work with the employer to
-whom he or she is job-attached or be able to work and be available for referral to a job by his or
-her hiring hall. The claimant shall not be required to search for work elsewhere and shall, by
-means of his or her job attachment, be presumed to have met these requirements. Nothing in this
-regulation 2.4 shall permit a claimant to refuse an offer of suitable work as defined in 8-73-108
-(5)(b), C.R.S.
-
-2.4.7
-
-Expiration of Job Attachment. - When the job-attached period set forth in regulation 2.4.5 has
-expired or when a claimant's understanding with the employer as provided in regulation 2.4.2 no
-longer exists or when a claimant's registration with a union hiring hall ceases or when an offer of
-new work is withdrawn or if, in the judgement of the division, job-attached status is not reasonably
-designed to result in prompt reemployment in suitable work, the claimant must comply with the
-provisions of 8-73-107, C.R.S., or his or her compensability shall cease.
-
-2.5
-
-SELF-EMPLOYMENT
-
-2.5.1
-
-Statutory Reference: 8-73-107, C.R.S.
-
-2.5.2
-
-Effect of Self-Employment Activities. A claimant may be disqualified from receipt of benefits
-due to self-employment activities where such activities result in the claimant restricting his or her
-availability for work or limiting his or her search for work.
-
-2.5.3
-
-Self-Employment Activities. For the purposes of this section, “self-employment activities” shall
-include all activities of a claimant that relate to the formulation, development, or operation of any
-business or income-producing undertaking.
-
-2.5.4
-
-Matters to be Considered. In determining whether or not a claimant's availability for suitable
-work is restricted or a claimant's search for work is limited by means of his or her selfemployment activities, the division may consider, in addition to other relevant factors, the
-following:
-.1
-
-The nature of the claimant's self-employment activities;
-
-.2
-
-The nature of the claimant's previous employment;
-
-.3
-
-The amount of time required for the claimant's self-employment activities;
-
-14
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-.4
-
-Whether the claimant's self-employment activities occur at the normal time the claimant
-would be employed or seeking employment;
-
-.5
-
-Whether the nature of the claimant's self-employment activities require regular hours of
-work;
-
-.6
-
-Whether the nature of the claimant's previous employment required regular hours of
-work;
-
-.7
-
-The extent to which the claimant's self-employment activities coexisted with the
-claimant's previous employment;
-
-.8
-
-The extent of the claimant's financial commitment to the self-employment activities;
-
-.9
-
-Whether the claimant has rented or purchased space to be used for self-employment
-activities;
-
-.10
-
-Whether the claimant has arranged for or obtained a business telephone;
-
-.11
-
-Whether the claimant has obtained any required licenses or permits;
-
-.12
-
-Whether the claimant has advertised for customers;
-
-.13
-
-The extent to which the claimant's self-employment activities required him or her to
-supervise or direct other individuals.
-
-2.5.5
-
-All Requirements Must be Met. Notwithstanding any provision of this section, a self-employed
-claimant, in order to qualify for benefits, must satisfy all of the eligibility conditions enumerated in
-8-73-107, C.R.S.
-
-2.5.6
-
-Reporting Earnings. A self-employed claimant must report all monies earned during the week(s)
-for which benefits are claimed regardless of whether or not such earnings have been received.
-Where earnings have not been received, the claimant must provide an estimate of monies earned
-and, thereafter, must report actual earnings, when received, if the estimate was incorrect.
-
-2.6
-
-APPROVED-TRAINING COURSE
-
-2.6.1
-
-Statutory Reference: 8-73-107 (4), C.R.S.
-
-2.6.2
-
-Approved Training. The claimant must produce evidence of continued attendance and
-satisfactory progress in an approved-training course when requested by the division. In
-determining whether or not a training course will be approved for an individual claiming benefits
-under the provisions of 8-73-107 (4), C.R.S., the division shall consider, among other factors, the
-following:
-.1
-
-Whether the claimant's skills are such that reasonable employment opportunities do not
-exist or have substantially diminished in the labor-market area of the claimant to the
-extent that, in the judgement of the division, the individual has little or no prospect of
-obtaining suitable employment;
-
-.2
-
-Whether the claimant possesses the qualifications and aptitudes to successfully complete
-the program of training;
-
-.3
-
-Whether there is a reasonable expectation that the claimant will complete the training
-course;
-
-15
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-.4
-
-Whether the training relates to an occupation or skill for which there are, or are expected
-to be, reasonable employment opportunities for the claimant; and
-
-.5
-
-Whether the training course is reasonably designed to result in the claimant's prompt
-reemployment in suitable work.
-
-2.6.3
-
-Effect of Participation in Approved Training. With respect to any week in which a claimant is
-participating in a training program with the approval of the division and meets the requirements of
-this section, he or she shall not be denied benefits for the reason that he or she is not actively
-searching for work or that he or she has failed to apply for or refused to accept suitable work.
-
-2.6.4
-
-Enhanced Unemployment Insurance Compensation Benefits. (Repealed)
-
-2.6.5
-
-Approved Training for Industries In Crisis. In the event of a localized or state-wide downturn in
-a particular industry, such as unexpected mass layoffs or other triggers that threaten the
-economic stability of the regional or state economy, the division may, at the discretion of the
-division director, waive consideration of any of the factors set forth in regulation 2.6.2.
-
-2.7
-
-(RESERVED)
-
-2.8
-
-ELIGIBILITY REQUIREMENTS
-
-2.8.1
-
-Statutory References: - 8-73-107, 8-73-108 (5)(a)(b)(c), and 8-73-113, C.R.S.
-
-2.8.2
-
-Able to Work. - In general, a claimant must be physically and mentally capable of performing the
-usual duties of his or her customary occupation or the usual duties of other suitable work for
-which he or she is reasonably qualified. The burden of establishing ability to work is on the
-claimant. However, there shall be no presumption that the claimant is not able to work. In
-determining whether the claimant is able to work, the division shall consider the relevant facts and
-circumstances of the claimant's individual situation.
-
-2.8.3
-
-.1
-
-The division may request the claimant to furnish, at his or her own expense, a competent
-written statement from a licensed practicing physician or a licensed mental-health-care
-professional when the claimant's ability to work is in doubt.
-
-.2
-
-The claimant must be able to work all shifts that are customary for his or her usual
-occupation or be able to perform other suitable work for which he or she is reasonably
-qualified.
-
-.3
-
-A part-time worker's ability to work shall be determined in accordance with regulation 2.2.
-
-.4
-
-A claimant engaged in self-employment activities shall have his or her ability to work
-determined in accordance with regulation 2.5.
-
-Available for Work. - In general, a claimant shall be considered available for work only if he or
-she is ready and willing to accept suitable work. There must be no restrictions, either selfimposed or created by other circumstances, that prevent accepting suitable work. The claimant
-must accept referral to suitable work or accept an offer of suitable work to avoid being disqualified
-from receiving benefits in accordance with 8-73-108 (5), C.R.S.
-.1
-
-Labor-Market Area. A claimant must offer his or her services without restriction to the
-labor-market area to be considered available for work. For the purposes of this regulation
-2.8, the term “labor-market area” shall mean the geographic area where the claimant can
-reasonably be expected to seek and find employment.
-
-16
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-.2
-
-Absence From State. A claimant who is temporarily absent from the state for reasons
-other than to seek work pursuant to regulation 2.1.8 is presumed to be not available for
-work. This presumption may be rebutted by competent evidence in an individual case.
-
-.3
-
-Change of Labor-Market Area. A claimant who relocates to a new labor-market area
-may be required to expand his or her work search to include other occupations for which
-he or she is reasonably qualified when, in the opinion of the division, opportunities for
-securing work in his or her customary occupation are significantly limited.
-
-.4
-
-Referral to Job Opening. A claimant who cannot be reached for referral to a job
-opening, after reasonable efforts to contact the person have been made, shall be
-considered unavailable for work unless good cause for failure to be reachable is shown.
-For purposes of this regulation 2.8, good cause shall have the meaning set forth in
-regulation 12.1.8.
-
-.5
-
-Length of Unemployment. As a claimant's duration of unemployment lengthens,
-prospects for obtaining employment in his or her customary occupation or other work in a
-reasonable time may change. Therefore, work that is unsuitable at one point in time may
-become suitable at another point. To be available for work, a claimant must be ready and
-willing to accept other work that becomes suitable as his or her prospects for customary
-work change. Thus, a claimant may be required to broaden the geographic area where
-he or she will accept work, accept counseling for possible retraining or change in
-occupation, or seek and accept employment at the prevailing wage in a new occupation.
-
-.6
-
-Incarceration. A claimant who is incarcerated and unable to accept employment under a
-work-release program is not available for work.
-
-.7
-
-Seasonal Worker. A seasonal worker who, outside the seasonal period, is not willing to
-accept suitable work in a nonseasonal occupation is not available for work.
-
-.8
-
-Self-Employment. A claimant engaged in self-employment activities shall have his or her
-availability determined in accordance with regulation 2.5.
-
-.9
-
-Time or Shift Restriction. A claimant who is unwilling to work the hours of the day or the
-days of the week that are customary for his or her usual occupation or other suitable work
-for which he or she is reasonably qualified is not available for work.
-
-.10
-
-Transportation. Transportation is the responsibility of the worker. A claimant who is
-unable to seek or accept suitable work in the labor-market area due to a lack of
-transportation is not available for work.
-
-.11
-
-Dependent Care. A claimant who elects not to seek or accept suitable work because he
-or she must care for a dependent person is not available for work.
-
-.12
-
-School or Training. Except as provided by 8-73-107 (4)(a) and 8-73-113, C.R.S., and
-regulation 2.6, a claimant who elects not to seek or accept suitable work because of
-participation in or attendance at school or training is not available for work.
-
-.13
-
-Wage Restriction. A claimant who is unwilling to accept the prevailing wage for the type
-of work he or she is seeking in the labor-market area is not available for work.
-
-.14
-
-Part-Time Worker. A part-time worker's availability for work shall be determined in
-accordance with regulation 2.2.
-
-17
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-2.8.4
-
-7 CCR 1101-2
-
-Actively Seeking Work. In general, a claimant shall be considered to be actively seeking work if
-he or she is following a course of action reasonably designed to result in prompt reemployment in
-suitable work. Failure to establish to the satisfaction of the Division that the work-search activities
-in which the claimant engages are reasonably designed to result in prompt reemployment may
-result in a disallowance of benefits.
-.1
-
-Evidence Of Work Search. A claimant shall, upon request by the Division, provide
-verifiable information of his or her work-search activities. Such activities may include, but
-are not limited to:
-1.
-
-Applying for a job for which the claimant is reasonably qualified.
-
-2.
-
-Interviewing for a job for which the claimant is reasonably qualified.
-
-3.
-
-Taking an exam required as part of the application process for a new job for
-which the claimant is reasonably qualified.
-
-4.
-
-Contacting an employer, who the claimant reasonably believes may have
-available suitable work, to inquire as to whether the employer is hiring.
-
-5.
-
-Being referred to a job by a state workforce center or other entity which provides
-similar services.
-
-6.
-
-Adding a resume to an online job board.
-
-7.
-
-Engaging in documented use of online career tools.
-
-8.
-
-Participation in reemployment services at a state workforce center or other
-location where such similar services are provided.
-
-9.
-
-Participation in state-sponsored or other professional job-related education or
-skills development.
-
-10.
-
-Creating a user profile on a professional networking website.
-
-11.
-
-Participating in networking events related to a job or occupation for which the
-claimant is reasonably qualified.
-
-12.
-
-Timely reporting to a union hiring hall when you are a registered member of that
-union.
-
-.2
-
-Number of Work-Search Activities. The acceptable number of work-search activities
-that the claimant engages in each week shall be determined by the Division or the
-Division’s designee.
-
-.3
-
-Reasonably Designed to Result in Prompt Reemployment. In determining the
-adequacy of an individual’s work-search activities, the Division shall consider the totality
-of the efforts made by the claimant to become reemployed. In addition, the Division, or
-the Division’s designee shall consider, but not be limited to, the employment opportunities
-in the claimant’s labor market area, the skills and qualifications of the claimant, and the
-normal practices and customary methods for obtaining work.
-
-18
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-.4
-
-Warning Letter. The Director or the Director’s designee, at his or her discretion, may
-elect to issue a warning letter to any claimant who has failed to meet the work-search
-requirements. This authority shall, in no way, limit the authority of the Division to issue a
-disallowance of benefits when it is determined that a claimant has not met the worksearch requirements. If a claimant has been issued a warning letter for failing to meet the
-work-search requirements and is again determined to have failed to meet the
-requirements, another warning letter shall not be issued. Instead, a disallowance of
-benefits shall be issued for the weeks in which a second and any subsequent failure
-occurred unless the circumstances of that failure were outside the claimant’s control.
-.1
-
-.5
-
-7 CCR 1101-2
-
-Penalties. If a claimant is issued a warning letter, pursuant to this section, it shall
-be considered in determining whether a claimant made a false representation or
-willfully failed to disclose a material fact for the purpose of determining whether
-monetary or weekly penalties should be imposed pursuant to 8-81-101 (4)(a)(II),
-C.R.S.
-
-Verifiable Information. Verifiable information, as used in section 2.8.4.1, is the date an
-activity is completed and may include:
-1.
-
-Employer contact information, including business name, address, phone number,
-email address
-
-2.
-
-Name and title of person contacted
-
-3.
-
-Documentation of use of an online career tool
-
-4.
-
-Confirmation of an online job board submission
-
-5.
-
-Networking event name and location
-
-6.
-
-Specifics of job-related education or other skills development activity
-
-7.
-
-Reemployment service in which you participated
-
-.6
-
-Seasonal Worker. A claimant who is seasonally employed is not relieved of the
-responsibility to engage in work-search activities.
-
-.7
-
-Incarcerated Worker. A claimant who is incarcerated and who is unable to seek work is
-not actively seeking work.
-
-.8
-
-Limited Job Opportunities. If, due to economic conditions within the labor-market area,
-the division determines that any effort to search for work would be fruitless for the
-claimant and burdensome to employers, then registering for work as directed by the
-division shall constitute an active search for work.
-
-.9
-
-Part-Time Worker. Whether a part-time worker is actively seeking work shall be
-determined in accordance with regulation 2.2.
-
-.10
-
-Self-Employment. Whether an individual engaged in self-employment activities is
-actively seeking work shall be determined in accordance with regulation 2.5.
-
-.11
-
-[Repealed eff. 10/30/2020]
-
-19
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-.13
-
-under circumstances in which provisions have been made for the payment of benefits to
-individuals separated from work not classified as employment under article 70 of this title
-8, and when such individuals are required to comply with the requirements of section 873-107(1)(g)(i) regarding an active work search.
-.1
-
-.2
-
-.4a
-2.8.5
-
-7 CCR 1101-2
-
-the following actions by the individual shall be considered in determining whether
-the individual has followed a course of action designed to result in a prompt
-return to work. consideration of the following work-search activities shall not
-preclude the division from also considering other relevant activities or factors.
-1.
-
-documented efforts to obtain new or additional clients for the individual’s
-business;
-
-2.
-
-documented efforts to expand the individual’s business beyond the
-services typically performed;
-
-3.
-
-documented efforts to market the individual’s business to new,
-reasonably available customers;
-
-4.
-
-if the individual performs work for an online platform, establishing an
-account with another similar online platform for the purpose of seeking
-work with that platform;
-
-5.
-
-if the individual performs work for an online platform, seeking work with
-another online platform for which the individual may reasonably be
-qualified;
-
-6.
-
-any activity which demonstrates an active search for covered
-employment including, but not limited to, the activities listed in section
-2.8.4.1.
-
-a determination under this section shall be applicable only to the eligibility of the
-individual claiming benefits and shall not prevent the division from later
-determining that the individual was engaged in covered employment pursuant to
-article 70 of title 8 of the act.
-
-Repealed
-
-Reemployment Services. - A claimant who fails to participate in reemployment services, after
-having been determined likely to exhaust regular benefits and to need such services pursuant to
-a profiling system established by the director of the division, shall be ineligible to receive benefits
-with respect to any week unless it is determined that:
-.1
-
-The individual has completed such services; or
-
-.2
-
-There is justifiable cause for the claimant's failure to participate in such services.
-
-2.8.6
-
-The Waiting Week. Any unemployed individual shall be eligible to receive benefits with respect
-to any week only if the division finds that the individual has been either totally or partially
-unemployed for a waiting period of one week.
-
-2.9
-
-DISQUALIFYING PAYMENTS
-
-2.9.1
-
-Statutory References: 8-70-103 (28), 8-73-102 (4), 8-73-107 (1) and (4), and 8-73-110 (1),
-C.R.S.
-
-20
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-2.9.2
-
-7 CCR 1101-2
-
-Gross Wages/Earnings Reportable During a Week of Unemployment. For the purposes of
-determining weekly benefits, “wages/earnings” is defined as any income or remuneration
-received in exchange for services performed, including amounts that have been deducted under
-a plan for tax exemption or deferral.
-.1
-
-Wages/earnings do not include payments for reimbursements for out-of-pocket expenses
-by volunteer workers.
-
-.2
-
-Wages/earnings do not include income derived from investment-interest payments,
-dividend payments, or rent receipts from rental property, except if the income is earned
-through a business owned or operated by the individual requesting payment for a week of
-unemployment.
-
-PART III
-
-WAGES
-
-3.1
-
-REMUNERATION PAYABLE IN ANY MEDIUM OTHER THAN CASH
-
-3.1.1
-
-Statutory References: 8-70-141, 8-70-142, 8-73-102, and 8-76-102 (2), C.R.S.
-
-3.1.2
-
-Value of Remuneration. If board, lodging, payments in kind, and/or other benefits are given as
-compensation for services performed by employees, and where a cash value of such benefits is
-agreed upon in a contract of hire or otherwise, the amounts agreed upon shall be deemed a
-reasonable value of such benefits. The division may, after investigation, determine in individual
-cases the amounts to be included as reasonable value of all such remuneration payable in any
-medium other than cash for the purpose of computing contributions due under the act.
-
-3.2
-
-TIPS, GRATUITIES, AND SERVICE CHARGES
-
-3.2.1
-
-Statutory References: 8-70-141, 8-73-102, and 8-76-102 (1), C.R.S.
-
-3.2.2
-
-Tips, Gratuities, and Service Charges as Wages. Tips, gratuities, and service charges shall be
-considered to be wages for the purposes of the act when the employer exercises significant
-control over the amount and distribution of money received by an employee as a tip, gratuity, or
-service charge.
-
-3.2.3
-
-Significant Control. An employer is considered to have significant control over tips, gratuities, or
-service charges when they are collected by the employer and then redistributed to employees.
-
-3.2.4
-
-Minimum-Wage Requirements. Notwithstanding any other provision of this section, any tips,
-gratuities, and service charges that are used by the employer in order to conform to the minimumwage requirements of federal or state law shall be deemed to be wages for the purposes of the
-act, to the extent of such use.
-
-3.2.5
-
-Use of Credit Card. For the purposes of this section, the inclusion, for the convenience of the
-customer, of a tip or gratuity in an amount charged by a customer through the use of a credit card
-shall not, by itself, be deemed to constitute significant control.
-
-3.2.6
-
-Requirement to Report Tips. For the purposes of this section, a requirement by an employer
-that an employee report or account for tips and gratuities shall not, by itself, be deemed to
-constitute significant control.
-
-3.2.7
-
-Tips Reported to Employer. In addition to the foregoing provisions of this section, on and after
-January 1, 1986, wages shall also include tips that are received while performing services that
-constitute employment and that are made known to the employer through a written statement
-furnished by the employee.
-
-21
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-PART IV
-
-7 CCR 1101-2
-
-JOB SEPARATIONS
-
-4.1
-
-SEPARATIONS RELATED TO RELOCATION
-
-4.1.1
-
-STATUTORY REFERENCE: 8-73-108 (4), C.R.S
-
-4.1.2
-
-SPOUSE’S EMPLOYMENT LOCATION CHANGED. If a claimant separates from his or her
-employment due to a change in location of the employment of the claimant’s spouse, the Division
-shall consider in determining benefit entitlement whether the claimant has demonstrated all the
-required elements of 8-73-108 (4)(s) or 8-73-108 (4)(u), C.R.S. The Division may, at its discretion,
-request from the claimant additional documentation related to any or all of the following:
-.1
-
-The claimant has established a spousal relationship, as defined under Colorado law, with
-the individual whose employment necessitates a new place of residence.
-
-.2
-
-The claimant has established that his or her spouse secured employment prior to the
-claimant separating from his or her job.
-
-.3
-
-The claimant has established that the change in his or her spouse’s employment requires
-a new place of residence.
-
-.4
-
-The claimant has established that it is impractical to commute to his or her place of
-employment from the new place of residence.
-
-.5
-
-The claimant has established that, upon arrival to the new location, he or she is available
-for suitable work as described in section 8-73-108(5)(b) C.R.S.
-
-4.2
-
-Separations Related To Domestic Violence
-
-4.2.1
-
-Statutory Reference: 8-73-108 (4)(r), c.r.s
-
-4.2.2
-
-Domestic Violence. “Domestic violence” means an act or threatened act of violence, or any
-other act of aggression, abuse, coercion, or intimidation committed against the worker or a
-member of the worker’s immediate family, as defined in § 8-73-108 (4)(r)(v), by a person with
-whom the worker or immediate family member is or has been involved in an intimate relationship,
-and that would cause a reasonable worker to believe his or her continued employment would
-jeopardize the safety of the worker or an immediate family member.
-
-4.2.3
-
-.1
-
-“Intimate relationship” means a relationship between past or present spouses, past or
-present unmarried couples, past or present household members, or parents of the same
-child, regardless of whether they have been married or have lived together.
-
-.2
-
-“Separating from a job” as used in § 8-73-108(4)(r)(I) C.R.S includes a partial separation.
-
-In determining whether a worker reasonably believes that their continued employment would
-jeopardize the safety of the worker or any member of the worker’s immediate family, the Division
-may consider whether it is reasonably necessary for the worker to refrain from working to engage
-in certain activities necessary to ensure their own safety or the safety of their immediate family
-member, including but not limited to:
-1.
-
-Making arrangements for alternative housing or transportation.
-
-2.
-
-Appearance in scheduled court proceedings related to the domestic violence.
-
-3.
-
-Medical appointments reasonably related to the domestic violence.
-
-22
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-4.
-
-Meeting with an attorney and/or law enforcement officer related to ensuring the safety of
-the worker or the worker’s immediate family.
-
-5.
-
-Any other activity which, as determined by the division, is necessary to ensure the safety
-of the worker or the worker’s immediate family.
-
-PART V
-
-BENEFIT CHARGING
-
-5.1
-
-BENEFIT CHARGE-BACKS IN CASES OF TWO OR MORE EMPLOYERS
-
-5.1.1
-
-Statutory Reference: 8-76-103 (1), C.R.S.
-
-5.1.2
-
-Benefit Charge-Backs. In the event it is administratively impracticable for the division to
-determine the chronological order of employment because two or more employers have
-submitted wage reports covering the same calendar quarter, periods of employment within such
-calendar quarter shall be chargeable without regard to chronological order by the division in a
-manner determined to be fair and equitable for all affected employers. The order of charges shall
-stand unless an affected employer makes a timely request for redetermination pursuant to
-regulation 11.1.
-
-PART VI
-
-PREMIUMS AND ASSESSMENTS
-
-6.1
-
-EMPLOYER PREMIUMS
-
-6.1.1
-
-Statutory References: 8-76-101 (1) (3), 8-76-102, 8-79-101, 8-79-102, 8-79-104, and 8-79-107,
-C.R.S.
-
-6.1.2
-
-Due Date of Premiums. Except as otherwise provided by this rule 6.1, premiums shall become
-due and be paid no later than the last day of the month immediately following the end of the
-calendar quarter for which the premiums have accrued. For purposes of this rule 6.1, payment
-will be considered timely if postmarked or received in person or electronically on or before the
-due date. If the due date of premiums falls on a Saturday, Sunday, or legal holiday, payment will
-be considered timely if postmarked or received in person or electronically on the next business
-day that is not a Saturday, Sunday, or legal holiday.
-.1
-
-Quarterly payment shall not be required when the total amount of any premiums due,
-including any penalties and interest accrued for an untimely or incorrect report, is less
-than five dollars.
-
-6.1.3
-
-Payment to Another Jurisdiction. An employer who has erroneously paid to another jurisdiction
-an amount as premiums properly payable to Colorado shall not be delinquent if premiums
-properly payable to Colorado are paid within thirty days of the date on which the division
-determines that such premiums are payable to Colorado.
-
-6.1.4
-
-Erroneous Rate Notice. If, as a result of an incorrect notification or computation of rate by the
-division, an employer is required to make an additional payment of premiums, such additional
-payment shall not accrue interest until thirty days after notification by the division that such
-additional payments are due.
-
-6.1.5
-
-Payments. Quarterly payments shall include all premiums with respect to wages paid for
-employment in all payroll periods that end within the quarter.
-.1
-
-Quarterly payment shall not be required when the total amount of any premiums due,
-including any penalties and interest accrued for an untimely or incorrect report, is less
-than five dollars.
-
-23
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-6.1.6
-
-First Payment of New Employer. The first premium payment of any employing unit that
-becomes an employer at any time during a calendar year shall become due and be paid on or
-before the last day of the month immediately following the calendar quarter in which such
-employing unit becomes an employer. Said payment shall include premiums with respect to
-wages paid for employment occurring on and from the first day of the calendar year through all
-payroll periods that end within the calendar quarter in which the employing unit becomes an
-employer.
-
-6.1.7
-
-Application of Payments on Delinquent Accounts. Whenever a delinquency exists in the
-account of an employer and payment is submitted to the division upon said account, the division
-shall apply such payment in the following order of priority:
-.1
-
-Unpaid interest assessments from federal trust fund advances, starting with the earliest
-quarter in which premiums are due;
-
-.2
-
-Unpaid nonprincipal-related bond repayment assessments, starting with the earliest
-quarter in which premiums are due
-
-.3
-
-Penalties owed, starting with the earliest quarter in which such penalty was incurred;
-
-.4
-
-Interest already charged, commencing with the earliest quarter in which such interest is
-due;
-
-.5
-
-Interest accrued on unpaid premiums as of the date of the payment, commencing with
-the earliest quarter in which premiums are due;
-
-.6
-
-Unpaid premiums or unpaid regular unemployment insurance benefits charged, starting
-with the earliest quarter in which premiums or reimbursements are due.
-
-.7
-
-Unpaid reimbursements for extended benefits charged, starting with the earliest quarter
-in which amounts are due.
-
-6.2
-
-ASSESSMENTS AND RECOMPUTATIONS
-
-6.2.1
-
-Statutory References: 8-72-101 (1), 8-72-108, 8-79-104, and 8-79-107, C.R.S.
-
-6.2.2
-
-Obtaining Information. If, in the judgment of the division or upon its information and knowledge,
-the report of wages included in an employer’s report is incomplete or in error, the division may
-require a further report, examine the employer’s relevant books and records, or use other
-reasonable measures to the extent necessary to obtain an accurate report.
-
-6.2.3
-
-Summary Methods. If a contributing employer is delinquent in filing a wage report within the time
-prescribed by the division or if a reimbursing employer whose records are needed to make a
-proper determination of an amount of indebtedness or other matter declines to make its records
-available, the division may, in its discretion:
-.1
-
-Use the information and knowledge available to the division to estimate the amount of
-chargeable wages paid by a contributing employer during the premium period or periods.
-The amount of chargeable wages so determined shall be deemed to have been paid by
-the employer and shall be used to determine the annual payroll;
-
-.2
-
-Assess the employer for premiums calculated on the basis of the estimated wages; and
-
-.3
-
-Issue a subpoena duces tecum to compel an employer to release books and records to
-the division for use in obtaining the required information.
-
-24
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-6.2.4
-
-Notification. A contributing employer who is delinquent in filing reports or paying premiums shall
-be promptly notified of the assessment computed under rule 6.2.3.
-
-6.2.5
-
-Recomputations. Notwithstanding the provisions of rule 11.1, the division may correct errors of
-computation whenever such erroneous computations are found or brought to the division's
-attention.
-
-6.2.6
-
-Notice of Recomputation. Every interested party shall be promptly notified of any recomputation
-made hereunder that affects an employer's liability for premiums.
-
-6.2.7
-
-Recomputation Not a Redetermination. An initial recomputation issued hereunder shall not be
-deemed to be a redetermination decision under rule 11.1.
-
-6.2.8
-
-Redetermination Rights. Assessments and recomputations made hereunder are subject to
-redetermination pursuant to the provisions of rule 11.1.
-
-PART VII
-
-EMPLOYER RECORDS AND REPORTS
-
-7.1
-
-RECORDS
-
-7.1.1
-
-Statutory Reference: 8-72-107(1), C.R.S.
-
-7.1.2
-
-Work Records. Each employing unit shall keep true and accurate work records in accordance
-with the requirements of this section.
-
-7.1.3
-
-Payroll Information. For each payroll period, the employing unit's records shall show:
-
-7.1.4
-
-.1
-
-Beginning and ending dates.
-
-.2
-
-Total wages payable for employment during such period and the date on which such
-wages were paid.
-
-.3
-
-The date in each calendar week on which the largest number of workers was employed
-and the number of such workers.
-
-.4
-
-A reporting pay period of not to exceed one month, if any established payroll period be
-longer than one month.
-
-Employee Information. For each worker, the employing unit's records shall show:
-.1
-
-Name.
-
-.2
-
-State of residence.
-
-.3
-
-Social security account number. If a worker has no account number, the employer shall
-require the worker to produce a receipt of application therefor within seven days of
-entering upon employment.
-
-.4
-
-Date of hire, rehire, or return to work after temporary layoff.
-
-.5
-
-Date and reason separated from employment.
-
-.6
-
-State or states where services are performed.
-
-25
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-.7
-
-If services are performed outside of Colorado, the worker's base of operations, and, if
-there is no base of operations, then the place from which such services are directed or
-controlled.
-
-.8
-
-If such worker is paid:
-
-.9
-
-.10
-
-.1
-
-On a salary basis, the wage rate and period covered.
-
-.2
-
-On a fixed hourly basis, the hourly rate and the customary scheduled days per
-week prevailing in the establishment for the occupation.
-
-.3
-
-On a fixed daily basis, the daily rate and the customary scheduled days per week
-in the establishment for the occupation.
-
-.4
-
-On a piece rate or other variable pay basis, the method by which the wages are
-computed.
-
-.5
-
-By tips, gratuities, or service charges as defined in regulation 3.2, whether in
-whole or in part.
-
-If, during any payroll period, such worker shall work less than his or her customary fulltime hours:
-.1
-
-The specific amount of time lost; and
-
-.2
-
-The specific reason or reasons, including his or her nonavailability for work, and,
-if there be more than one reason, the amount of time attributable to each.
-
-Wages paid during each payroll period and the date of payment thereof, with separate
-entries for:
-.1
-
-Money wages;
-
-.2
-
-The reasonable cash value of wages paid in any medium other than money as
-defined in regulation 3.1;
-
-.3
-
-Amounts paid to a worker that exceed travel and other business expenses
-actually incurred or accounted for; and
-
-.4
-
-Tips, gratuities, and service charges that meet the requirements of regulation 3.2.
-
-7.2
-
-REPORTS
-
-7.2.1
-
-Statutory References: 8-70-103 (17), 8-72-101 (1), 8-73-107 (1) (h), 8-74-102 (1), 8-76-104
-(3)(g), 8-76-106 (4), 8-79-103 (1), and 8-79-104, C.R.S.
-
-7.2.2
-
-Duty to Submit Reports. Each employing unit shall make such reports as required by the
-division using such reporting methods as the division allows.
-
-7.2.3
-
-Social Security Number and Worker Name. An employer shall include a worker's social
-security number and name in all reports required by the division with respect to such worker. If
-the worker has no social security number, the employer shall report the date of issue of the
-application receipt therefor, its termination date, the address of the issuing Social Security
-Administration office, and the name and address of the worker as shown on the receipt.
-
-26
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7.2.4
-
-7 CCR 1101-2
-
-Unemployment Insurance Quarterly Reports. Every employer subject to the act shall furnish to
-the division a quarterly report of total covered wages paid and a report of covered wages paid to
-all workers in his or her employ, except that no such reports shall be required with respect to an
-employee of a state or local agency performing intelligence or counterintelligence functions if the
-head of such agency has determined that filing such reports could endanger the safety of the
-employee or compromise an ongoing investigation or intelligence mission. These reports are due,
-and any premiums due thereon are payable no later than the last day of the month immediately
-following the end of each calendar quarter, regardless of whether covered wages were paid
-during such quarter, and shall be filed in accordance with the methods specified in rule 7.2.5.
-Quarterly wage reports will be considered timely if received electronically on or before the due
-date. If an employer has received a waiver of the requirement to file quarterly reports by
-electronic means, the report shall be considered timely if it is postmarked or received prior to the
-due date. If the due date for filing timely quarterly wage reports falls on a Saturday, Sunday, or
-legal holiday, the due date will be extended to the next business day that is not a Saturday,
-Sunday, or legal holiday.
-Must include the report period, Colorado employer account number assigned by the division,
-employer's current name and address, worker's social security number, worker's name and total
-quarterly covered wages paid.
-
-7.2.5
-
-Reporting Methods. Quarterly reports of wages paid to workers must be submitted by divisionapproved electronic means unless a waiver to submit such reports in person, by mail, or by
-facsimile machine has been granted by the division.
-.1
-
-Waiver of the requirement to file quarterly reports of wages paid to workers by divisionapproved electronic means will be granted only if the employer can demonstrate to the
-satisfaction of the division that such a means of reporting creates an undue burden on
-the employer.
-
-.2
-
-Waiver of the requirement to file quarterly reports of wages paid to workers by divisionapproved electronic means will be valid only for a one-year period commencing with the
-date of issue of said waiver.
-
-7.2.6
-
-Request for Report. The division may request a wage and/or separation report concerning a
-particular worker for the purpose of confirming a report previously submitted or obtaining
-information necessary to enable the division to make a determination of benefit rights. Such
-report shall be furnished to the division by division approved electronic means except that the
-Division, at its discretion, may waive this requirement. The report shall be received by the division
-within seven calendar days after the date on which the division requests such information, except
-that the division may accept information out of time if it determines good cause exists for the
-untimely action, as referenced in 7.2.8 or 12.1.8. If the initial report is not provided within the
-required seven days, the Division may make a follow up request by telephone or electronic
-means. A response to such a follow up request must be received within the time period provided
-by the Division at the time the request is made. In the event that the requested report is received
-late but before the initial adjudication of the matter for which the report was requested, there is a
-presumptive showing of good cause.
-
-7.2.7
-
-Cessation or Transfer of Business. Any employer that ceases doing business, that in any
-manner transfers all or part of the trade and business, or that changes the trade name or address
-of said business shall:
-.1
-
-Within ten days thereof, give notice in writing to the division in accordance with rule
-1.3.11; and
-
-27
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-.2
-
-7.2.8
-
-7.2.9
-
-7 CCR 1101-2
-
-In accordance with rule 1.3.11 and rule 7.2.4, file with the division a final Employer's
-Unemployment Insurance Quarterly Report and Report of Worker's Wages when due for
-the calendar quarter in which the change or cessation occurred and for any quarter for
-which a report was due but not previously filed.
-
-Loss of Right to Protest. An employer who fails to comply with the provisions of the preceding
-paragraphs of this section 7.2 without good cause as referenced in 7.2.6 or 12.1.8 shall be
-deemed not to be an interested party as defined in 8-70-103 (17) and 8-73-107 (1)(h), C.R.S.,
-and shall be barred from protesting either:
-.1
-
-The payment of benefits to workers for whom wage and separation information was not
-furnished within the required time; or
-
-.2
-
-The charging of the employer's account for experience-rating purposes with benefits paid
-such workers or the amount due as payments in lieu of contributions for benefits paid
-such workers.
-
-Incorrect or Incomplete Report or failure to follow approved method of submission of
-report. An incorrect or incomplete report not in substantial compliance with the provisions of this
-part VII of the rules or the failure to submit a report by the approved electronic method of
-submission, pursuant to 7.2.6 may, at the division's discretion, be considered in the same manner
-and subject to the same penalties and loss of rights as if the employer had failed to submit a
-report. For the purposes of this paragraph, the Report of worker's wages required by rule.
-
-7.2.10 Labor Dispute. When workers become unemployed or separated from an employer because of a
-labor dispute, the employer shall furnish the division with such relevant information about each
-worker as the division may require.
-7.2.11 Penalties Remain in Force. Nothing contained in these rules shall be construed as reason to
-relieve an employer from:
-.1
-
-The responsibility for the submission of quarterly wage reports or from the liability for
-payment of penalties incurred for failure to timely submit such reports, as provided by 879-104 (1), C.R.S., or
-
-.2
-
-The responsibility to provide separation reports or the liability for the payment of penalties
-incurred for failure to timely submit such information as provided by 8-73-107(1)(h),
-C.R.S., unless
-
-.3
-
-The division finds that the employer had good cause, as defined at rule 12.1.8, for failing
-to timely submit required documents.
-
-7.2.12 [Emergency rule expired 08/12/2020]
-7.3
-
-POSTING NOTICES TO WORKERS
-
-7.3.1
-
-Statutory References: 8-72-101(1) and 8-74-101(2), C.R.S.
-
-7.3.2
-
-Posting Notices. Every employer shall post and maintain notices that inform employees that the
-employer is subject to the act and has been so registered by the division.
-.1
-
-Posted Notice To Workers Of Availability Of Unemployment Insurance. Every
-employer shall post and maintain notices that inform workers of the availability of
-unemployment insurance.
-
-28
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-.2
-
-7 CCR 1101-2
-
-Notice Provided To Employee Upon Separation. The employer must also provide such
-notice to every worker upon separation from employment. This notice must include:
-.1
-
-A statement that unemployment insurance benefits are available to unemployed
-workers who meet the eligibility requirements of colorado law;
-
-.2
-
-Contact information to file a claim;
-
-.3
-
-Information the worker will need to file a claim;
-
-.4
-
-Contact information to inquire about the status of their claim after it is filed.
-
-7.3.3
-
-Form and Design. Such notices shall be of such form and design and posted in such numbers
-as the division may determine to be necessary.
-
-7.3.4
-
-Post in Work Locations. Such notices shall be conspicuously posted at or near work locations.
-
-7.3.5
-
-Assignment of Account Number. An employer shall not be required to post notices until an
-employer's account number has been assigned by the division.
-
-7.3.6
-
-[Emergency rule expired 08/12/2020]
-
-7.4
-
-PATTERN OF FAILING TO RESPOND
-
-7.4.1
-
-Statutory References: 8-79-102(5)(a), C.R.S.
-
-7.4.2
-
-Definitions
-
-7.4.3
-
-.1
-
-TIMELY. As used in this section means, those acts completed by the employer within the
-time period permitted by law.
-
-.2
-
-ADEQUATE. As used in the section, refers to that information provided by an employer
-to a division request which is sufficient to support a determination on the issue.
-
-.3
-
-Fault. As used in §8-79-102(5)(a)(i), C.R.S., an employer shall not be considered at fault
-for failing to respond timely or adequately to a request of the division for information if
-that failure occurred for any reason outside the employer’s control such as administrative
-error by the division or a natural or other such similar disaster.
-
-Pattern of Failing to Respond. A “pattern of failing to respond timely or adequately” as
-referenced under §8-79-102(5)(A)(II) C.R.S. refers to a repeated, documented failure on the part
-of the employer or the agent of the employer to respond timely or adequately to initial requests for
-information from the division, taking into consideration the number of instances of failure in
-relation to the total volume of requests. The determination of whether such a pattern has been
-shown shall be at the discretion of the division except that:
-.1
-
-An employer or its agent shall not be determined to have engaged in a “pattern of failing
-to respond timely or adequately” if the number of such failures during the year prior to
-such request is fewer than three or less than three percent of such requests, whichever is
-greater.
-
-.2
-
-An agent, representing two or more employers, shall not be determined to have engaged
-in a pattern of failing to respond timely or adequately in relation to the total volume of
-requests collectively sent to the agent. Instead, each specific employer account shall be
-subject to the determination..
-
-29
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7.4.4
-
-7 CCR 1101-2
-
-APPEALS. Determinations by the division under this section shall be subject to appeal in the
-same manner as other determinations of the division.
-
-PART VIII
-
-EMPLOYER BOND REQUIREMENTS
-
-8.1
-
-BONDING REQUIREMENTS
-
-8.1.1
-
-Statutory Reference: 8-70-114 and 8-76-110, C.R.S.
-
-8.1.2
-
-Bond Requirements. A surety bond, deposit of money, or securities, specified in 8-70-114
-(2)(g)(III) AND 8-76-110 (4), C.R.S., shall be required only if the amount of the bond, deposit of
-money, or securities computed as provided in said sections is one hundred dollars or more.
-
-8.1.3
-
-Bond Calculation, Employee Leasing. The bond calculation required in section 8-70-114
-(2)(g)(III)(a), shall be based on the total premiums assessed under the employee-leasing
-company’s unemployment insurance account, including premiums assessed for work-site
-employers required to report under the employee-leasing company’s account. If in the prior year,
-the work-site employer reported under a separate unemployment insurance account, the
-premiums assessed for the work-site employer in the separate account shall be included in the
-bond calculation for the current year.
-
-PART IX
-
-COVERED EMPLOYMENT (RESERVED)
-
-PART X
-
-SEASONAL INDUSTRY
-
-10.1
-
-SEASONAL DETERMINATIONS
-
-10.1.1 Statutory References: 8-73-104(1), 8-73-106, and 8-76-113, C.R.S.
-10.1.2 Seasonal Periods Considered. As used in 8-73-106(1), C.R.S., the words “a regularly recurring
-period or periods of less than twenty-six weeks in a calendar year” are deemed to include periods
-in those years during which an employing unit was not subject to the provisions of the act, or
-during which a predecessor employer was subject to the act, and records of such predecessor
-are available to support such periods.
-10.1.3 Seasonal Operation. No industry or functionally distinct occupation within an industry shall be
-deemed a seasonal industry as defined in 8-73-106 (1), C.R.S., unless the employer certifies in
-the application for seasonal determination required by regulation 10.1.5 that the employer will
-fulfill the requirements set forth in regulation 10.1.4 and certifies such other information as may be
-required by the division to determine eligibility for designation as a seasonal employer under this
-part X of the regulations.
-10.1.4 Seasonal Employer. An employer shall be determined to be a seasonal employer as to a
-particular industry or functionally-distinct occupation within an industry only if:
-.1
-
-The employer customarily employs workers in such industry or functionally-distinct
-occupation only during a regularly-recurring period or period of less than twenty-six
-weeks in a calendar year, and
-
-.2
-
-The employer does not employ more than twenty-five percent of the total number of
-workers in such functionally-distinct occupation outside the seasonal period that were
-employed in such occupation during the previous seasonal period, and
-
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-Division of Unemployment Insurance
-
-.3
-
-7 CCR 1101-2
-
-The employer does not employ any workers in such functionally-distinct occupation for a
-period of forty-five consecutive days following the seasonal period. For the purposes of
-this part X of the regulations, no employment shall be determined to be a functionallydistinct occupation unless its assigned duties or activities, as a whole, are identifiably
-distinct under the usual and customary practice of the industry.
-
-10.1.5 Application for Determination. An employer who wishes designation as a seasonal employer or
-determination or redetermination of a seasonal period or periods shall make application with the
-division upon such forms and using such filing methods as may be prescribed by the division.
-10.1.6 Notice of Application. The division shall require the employer to post a Notice of Application for
-Seasonal Status on such forms as the division may require and shall require the employer to
-notify the unions representing any of its workers that an application for seasonal status has been
-filed.
-10.1.7 Seasonal Determination. Upon review of the matters set forth in the application and such other
-information as it may require, the division shall issue a determination as to the employer's
-seasonal status, the seasonal period, the functionally-distinct occupations determined to be
-seasonal, and the functionally-distinct occupations determined to be nonseasonal.
-10.1.8 Seasonal Workers. A worker may not be determined to be a seasonal worker if:
-.1
-
-The worker performs services for a seasonal employer outside the employer's designated
-seasonal period or periods; or
-
-.2
-
-The worker performs services for a seasonal employer for twenty-six weeks or more in a
-calendar year.
-
-10.1.9 Appeal From Determination. Any employer who wishes to protest a determination made under
-the provisions of this part X of the regulations shall file a notice of appeal with the division. Such
-notice of appeal must be received by the division within twenty calendar days after the date the
-seasonal determination was mailed. A hearing may be obtained in accordance with 8-76-113,
-C.R.S., and regulation 11.2.
-10.1.10 Notice of Operation Outside Season. Each seasonal employer shall give written notice, in
-accordance with regulation 1.3.11, to the division within thirty days when the seasonal industry or
-functionally-distinct occupation is operated for twenty-six weeks or more in a calendar year and,
-for a functionally-distinct occupation, when more than twenty-five percent of the total number of
-workers who were employed in any such functionally-distinct occupation during the designated
-season are employed in such occupation outside the seasonal period or there is not a forty-five
-consecutive-day period outside the seasonal period, during which no workers are employed in
-such functionally-distinct occupation.
-10.1.11 Annual Report. In addition to the notice required in regulation 10.1.10, every employer who has
-been designated a seasonal employer must file a written report on prescribed forms and using
-such filing methods as may be prescribed by the division on or before the last day of February,
-which report shall inform the division of the beginning and ending dates of the previous calendar
-year's seasonal operations and such other information as may be required by the division to show
-compliance with this part X of the regulations.
-10.1.12 Notification. Each seasonal employer shall notify each seasonal worker in writing at the time of
-hire of the worker's seasonal status and the beginning and ending dates of the seasonal period
-for which the worker is to be employed.
-
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-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-10.1.13 Loss of Seasonal Status. If an employer, subsequent to the date on which he or she was
-designated as a seasonal employer, fails to fulfill the requirements of regulation 10.1.4 or fails,
-without good cause, to comply with the reporting or notification requirements of this part X of the
-regulations during a calendar year, such employer shall lose his or her seasonal status. Any
-determination by the division that an employer has lost his or her seasonal status shall be made
-in writing and provided to the employer in accordance with regulation 1.3.11.1. Said determination
-shall be subject to appeal pursuant to regulation 10.1.9.
-10.1.14 Reinstatement of Seasonal Status.
-.1
-
-An employer who has lost his or her designation as a seasonal employer, and who
-wishes reinstatement as such, may make application with the division for reinstatement in
-any calendar year subsequent to the year in which the employer lost the designation as a
-seasonal employer, provided such employer has met the requirements of regulation
-10.1.4 in the calendar year immediately preceding application for reinstatement.
-
-.2
-
-A worker who has performed services for a seasonal employer outside the employer's
-designated seasonal period or periods, and thereby lost his or her status as a seasonal
-worker, shall regain his or her status as a seasonal worker if he or she is not thereafter
-employed by such employer between any two following designated seasonal periods and
-he or she is subsequently reemployed by the employer in a seasonal industry or
-occupation.
-
-10.1.15 Filing Methods. For purposes of this part X of the regulations, applications, notices, and reports
-may be made in person, by mail, by facsimile machine, by division-approved electronic means, or
-by a division interactive voice response system.
-PART XI
-11.1
-
-REDETERMINATIONS AND APPEALS
-
-REDETERMINATIONS
-
-11.1.1 Statutory References: 8-73-102 (3), 8-74-102 (2), 8-76-103 (4), 8-76-110 (3) (e), and 8-76-113,
-C.R.S.
-11.1.2 Redetermination of Assessments. An employer who wishes to protest a notice of assessment
-of premiums shall file a written request for redetermination of said assessment or to file a correct
-report of chargeable wages paid during the premium period or periods. The written request for
-redetermination must be received by the Division within twenty calendar days of the date the
-assessment was issued.
-11.1.3 Redetermination of Quarterly Statement of Benefits Charged to Employer's Account. An
-employer who wishes to protest a quarterly statement of benefits charged to his or her account
-shall have sixty calendar days after the date notification was provided to file a written notice for
-redetermination of the accuracy of the statement.
-11.1.4 Redetermination of Premium Rates. An employer who wishes to protest a notice of his or her
-premium rate shall file a written request for redetermination of the premium rate. The written
-request for redetermination must be received by the Division within twenty calendar days of the
-date the rate notice was issued.
-11.1.5 Redetermination of Recomputations. Any interested party who wishes to protest a
-recomputation made by the division shall file a written request for redetermination of the matters
-corrected. The written request for redetermination must be received by the Division within twenty
-calendar days of the date the recomputation was issued.
-
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-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-11.1.6 Monetary Determinations. Any interested party who wishes to protest a monetary determination
-made by the division on a claim for benefits shall file a written request for redetermination with the
-division within the benefit year or extended-benefit period for such claim.
-11.1.7 Reimbursement Bill. Any employer who wishes to protest a bill for payments in lieu of premiums
-shall file a written request for redetermination of the amount due. The written request for
-redetermination must be received by the Division within twenty calendar days of the date the bill
-was issued.
-11.1.8 Timeliness of Request for Review. Any determination made by the division that is subject to
-redetermination under this section shall be deemed final, and any information contained in any
-document or notice issued by the division that is subject to redetermination under this section
-shall be deemed correct unless the party files a timely request for redetermination in accordance
-with this regulation or establishes to the satisfaction of the division that said party had good cause
-for the failure to do so. Good cause for failure to file a timely request for redetermination shall
-have the meaning set forth in regulation 12.1.8.
-11.1.9 Form of Request. Each request for redetermination filed pursuant to this section shall specify in
-detail the errors, omissions, or other grounds upon which the party relies.
-11.1.10 Redetermination Decision. Upon receipt of a request for redetermination, the division shall
-review the request, investigate the matters specified, and give the parties notice of its
-redetermination decision in accordance with regulation 1.3.11.1.
-11.1.11 Appeals From Redeterminations. Any party who wishes to appeal from a redetermination
-decision shall file a written notice of appeal with the division in accordance with regulation 11.2.
-Such notice of appeal must be received by the division within twenty calendar days of the date
-the redetermination decision was mailed. Appeals shall be filed and heard pursuant to 8-74-103
-to 8-74-109 and 8-76-113, C.R.S., and regulation 11.2.
-11.1.12 Benefit Claims Not Covered. Except for monetary eligibility questions subject to redetermination
-pursuant to regulation 11.1.6, this regulation 11.1 does not authorize the adjudication in the
-redetermination process of the merits of claims for benefits, which are subject to the appeal
-process established in 8-74-101 to 8-74-109, C.R.S., and regulation 11.2.
-11.1.13 Limitation on Review. Review and redetermination by the division under this section shall be
-limited to the matters covered by the document protested. No protest by an employer under rule
-11.1.4 of a notice of the employer's premium rate shall permit inquiry into the validity of any
-assessment of premiums subject to review and redetermination under rule 11.1.2 nor of any
-benefit charge to the employer's account subject to review and redetermination under rule 11.1.3,
-unless the employer has first protested the assessment or charge pursuant to rules 11.1.2 or
-11.1.3.
-11.1.14 Written Notices, Reports, and Requests. For purposes of this regulation 11.1, written notices,
-reports, and requests shall have the meaning set forth in regulation 1.3.11.1.
-11.2
-
-APPEALS PROCEDURE
-
-11.2.1 Statutory References: 8-72-108, 8-74-101 to 8-74-109, 8-76-103 (4), 8-76-113, and 8-80-102,
-C.R.S.
-
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-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-11.2.2 Scope of Section. The procedures described herein deal with appeals on disputed claims under
-8-74-101, et. seq., C.R.S.; appeals from determinations of liability, determinations of coverage,
-and seasonality determinations under 8-76-113 (1), C.R.S.; appeals from redeterminations
-regarding quarterly statements of benefits charged to an employer's account under 8-76-103 (4),
-C.R.S.; appeals from redeterminations as to an assessment of taxes, rate of tax, recomputation
-of rate, or correction of any such matter under 8-76-113 (2), C.R.S.; redeterminations of
-reimbursement billings under 8-76-110 (3)(e), C.R.S.; appeals from redeterminations of monetary
-eligibility under 8-74-102 (2), C.R.S.; and appeals from eligibility determinations regarding
-enhanced unemployment insurance compensation under 8-73-114, C.R.S., as defined in
-regulation 2.6.4.
-11.2.3 Procedure for Filing Appeals to Hearing Officer. Appeals from decisions of a deputy on a
-claim for benefits, from premium liability and coverage determinations, from seasonality
-determinations, and from redeterminations shall be by written notice of appeal that should state
-specific reasons. However, any written statement expressing disagreement with a determination
-or the party’s desire for review shall be accepted as an appeal. An appeal that does not state
-specific reasons must be supplemented prior to the appeal hearing and provided to the other
-interested parties in time to be received before the date of the hearing, as required by rule
-11.2.9.4, or the specific factual issues may be excluded from the hearing. An appeal shall be filed
-by mail at the address designated in the notice of decision, or may be filed in person, by facsimile
-machine, or by division-approved electronic means. For purposes of this rule 11.2.3, the term
-“written” shall have the meaning set forth in rule 1.3.11. The notices of appeal in matters involving
-a disputed claim may also be filed with a public employment office. The division shall provide a
-copy of such notice of appeal to each interested party. When an appeal of a deputy’s decision on
-a claim for benefits is received, the division shall provide to interested parties and their authorized
-representatives, if any, copies of relevant separation information in the claim file submitted by the
-parties. The division shall also provide to interested parties and their authorized representatives,
-if any, a copy of the form(s) used to document additional fact-finding information and to reflect
-those issues considered in rendering the decision.
-11.2.4 Notice of Hearing. Notices specifying the time and date of the hearing as well as instructions for
-the proper method of participation shall be mailed, transmitted by facsimile machine, or
-transmitted by electronic means to each party to the appeal at least ten calendar days before the
-scheduled hearing date. If participants are required to register for their hearing, the notice shall
-contain instructions regarding the method of registration.
-11.2.5 Disqualification of a Hearing Officer. Challenges to the interest of a hearing officer in an appeal
-scheduled to be heard by said hearing officer shall be heard and decided by that hearing officer
-or, in his or her discretion, referred to the panel.
-11.2.6 Prehearing Conference. The chief hearing officer or designee may, upon the application of any
-party or on his or her own motion, convene a prehearing conference to discuss the issues on
-appeal, the evidence to be presented, and any other relevant matters that may simplify further
-proceedings.
-11.2.7 Prehearing Discovery in Premium Cases. In cases arising under 8-76-110 (3)(e) and 8-76-113,
-C.R.S., the chief hearing officer or designee may permit the parties to engage in prehearing
-discovery, insofar as practicable, in accordance with the Colorado Rules of Civil Procedure and,
-in connection therewith, shorten or extend any applicable response time.
-11.2.8 Limitation on Discovery. No party to an appeal proceeding may seek discovery without having
-first obtained an order of the chief hearing officer or designee and only upon a showing of
-necessity for such discovery.
-
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-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-11.2.9 Conduct of Hearing. Hearings shall be conducted informally with as few technical requirements
-as possible. The hearing officer shall control the evidence taken during a hearing in a manner
-best suited to develop, fully and fairly the relevant evidence, safeguard the rights of all parties,
-and ascertain the substantive rights of the parties based on the merits of the issue(s) to be
-decided. The appealing party shall be required to present evidence that supports the party’s
-position on the issues raised by the appeal. Parties to the appeal may present any relevant
-evidence. However, the hearing officer is charged with ensuring that the record is fully developed
-to the extent practicable based on the evidence reasonably available at the time of the hearing,
-whether or not a party is represented. Therefore, the hearing officer should oversee the
-development of the evidence and participate in the interrogation process to the extent necessary
-to fully develop the record.
-.1
-
-Parties and witnesses shall ordinarily participate by telephone. However, based on the
-individual circumstances of a case or if a party would be disadvantaged by telephone
-participation, the chief hearing officer or designee shall have the discretion to determine
-another method of participation and to order the parties to participate in that manner to
-best achieve the purposes of this rule 11.2.
-
-.2
-
-Parties may be required to register for their hearing prior to the scheduled date and time
-of the hearing. Registration shall be considered part of the hearing process and failure to
-register for a scheduled hearing shall constitute a failure to appear pursuant to regulation
-11.2.13.
-
-.3
-
-An interested party to a hearing must submit to the hearing officer any documents,
-subpoenaed documents, and any physical exhibits that can be reproduced that he or she
-intends to introduce at the hearing. Such materials must be submitted in time to ensure
-that the hearing officer receives them before the date of the scheduled hearing. Such
-party must also provide copies of all documents and physical exhibits sent to the hearing
-officer to any other interested party to the hearing or to that interested party's
-representative as shown on the hearing notice, in time to ensure the materials are
-received prior to the date of the scheduled hearing. Failure to timely submit such
-materials to the hearing officer, or to timely send the materials to the opposing party or
-such party’s representative may result in their exclusion from the record. However, if a
-party has made a good faith effort to provide documents or physical exhibits in time to be
-received prior to the hearing, such materials shall not be excluded due to the failure of
-the hearing officer, the other interested party, or an interested party’s representative to
-receive the materials. In any appropriate case where documents have been timely sent
-but not received in advance, an adjournment of the hearing may be permitted by the
-hearing officer pursuant to rule 11.2.11 unless waived on the record by both parties.
-
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-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-.4
-
-Hearing Procedure. Prior to taking evidence, the hearing officer shall state the issues and
-the order in which evidence will be received. The hearing officer also shall inform the
-parties of any written documents or other tangible materials that have been received and
-explain the procedure for introducing the materials and offering them into evidence. The
-sequence of receiving testimony shall be in the hearing officer’s discretion. Computer
-records of the division concerning continued weeks claimed or payment for continued
-weeks claimed are admissible as evidence and may be filed in the record as evidence
-without formal identification if relevant to the issues raised by the appeal. The hearing
-officer also may consider any other relevant division file documents without a formal
-request or identification. However, parties shall be advised during the hearing of the
-division records and documents to be considered. All physical materials offered into the
-record shall be clearly identified and marked. Further, materials admitted shall be
-expressly received for the record. The hearing officer shall permit the parties to testify on
-their own behalf and present witnesses, and opposing parties may cross-examine each
-other and the others’ witnesses. The hearing officer shall examine the parties and
-witnesses as necessary and, after notice to the parties, may hear such additional
-evidence as deemed necessary. All testimony shall be presented under oath and the
-hearing shall be timed. At the conclusion of the hearing, the hearing officer shall inform
-the parties of the time consumed by the hearing and the approximate cost of the
-preparation of the transcript of the hearing, if any, and shall instruct the parties that a
-decision will be promptly issued as to the issues brought forth at the hearing. The hearing
-officer shall also instruct the parties that such decision may be appealed and, if
-applicable, that the appellant must bear the cost of preparation of a transcript. The sum
-paid may, be reimbursed at a later date by the panel without interest, if such appeal
-results in a decision favorable to the appellant. It shall also be stated to the parties that
-the cost of preparation of the transcript may be waived pursuant to rule 11.2.15.
-
-.5
-
-New Issues. Parties are entitled to advance notice of the factual issues that may be
-considered at a hearing. The hearing officer shall not permit an interested party to
-present factual issues at a hearing that have not been disclosed to the other interested
-party(ies) in writing, as shown by the claim file. If good cause, as set forth in rule 12.1.8,
-is found for a party not providing proper notice of the factual issues it intends to present,
-the hearing officer may adjourn the hearing. If good cause is not found, the hearing shall
-proceed as scheduled, and those new factual issues raised shall not be considered. In
-determining whether there is good cause for permitting a new factual issue, the hearing
-officer shall give substantial weight to an absence of prejudice to the other interested
-party and to the overall interests of an accurate and fair resolution. An interested party, at
-the hearing, may waive the requirement that they be provided with proper notice.
-
-11.2.10 Stipulations of Fact. With the consent of the hearing officer, parties to an appeal may stipulate
-to the facts in writing. Parties may also stipulate to facts on the record at the hearing before the
-hearing officer. The hearing officer may decide the case on the facts stipulated or, in his or her
-discretion, set the appeal for hearing and take such additional evidence as is deemed necessary.
-11.2.11 Adjournment of Hearings. The hearing officer may grant requests for further hearing when, in
-his or her own best judgment, such further hearing will result in adducing all necessary evidence
-and be equitable to the parties.
-11.2.12 Postponements of Hearings. Postponements of hearings shall not be granted without the
-showing of necessity therefor by the requesting party.
-
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-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-11.2.13 Failure to Appear.
-.1
-
-Appealing Party. If the appealing party fails to register for their hearing of fails to
-participate in the hearing after registering, the appeal shall be dismissed and the decision
-that was the subject of the appeal shall become final. Written notice that the appeal has
-been dismissed shall be provided to the interested parties named in the caption. The
-appealing party may request that the appeal be reinstated and the hearing be
-rescheduled pursuant to the procedures set forth in part XII of the regulations. The
-request must be received by the division within twenty calendar days after the date the
-dismissal notice was mailed by the division. An untimely request that a hearing be
-rescheduled may be permitted by the division for good cause shown, pursuant to the
-procedure set forth in part XII of the regulations.
-
-.2
-
-Nonappealing Party. If any other interested party fails to register for their hearing of fails
-to participate in the hearing, and a decision is issued by a hearing officer on the merits of
-the appeal, the party who failed to participate as directed may request that a new hearing
-be scheduled either by filing a written request with the panel or filing a written appeal
-from the hearing officer's decision. The written statement shall include details, pursuant
-to part XII of the regulations, to establish that he or she had good cause for the failure to
-participate in the appeal hearing. The request for a new hearing shall be filed with the
-panel in person, by mail, by facsimile machine, by panel-approved electronic means, or
-at a public employment office, the central office of the division, the office where the
-hearing officer is located, or by division-approved electronic means and shall be received
-by the panel within twenty calendar days after the date mailed on the hearing officer’s
-decision. An untimely request for a new hearing may be permitted by the panel for good
-cause shown, pursuant to the procedure set forth in part XII of the regulations. If it is
-determined that the party has shown good cause for the failure to participate, the hearing
-officer's decision that was issued on the merits of the appeal shall be vacated and a new
-hearing scheduled forthwith.
-
-.3
-
-Representative of a Party. When an interested party's attorney or other designated
-representative appears for and participates in the scheduled hearing on the party's
-behalf, the party shall be deemed to have appeared for the hearing, for the purposes of
-this part XI of the regulations.
-
-11.2.14 Decision of the Hearing Officer. The hearing officer shall announce, in written form, findings of
-fact, decision, and reasons therefor, as soon as practicable after a hearing, and a copy thereof
-shall be provided to all parties to the appeal.
-11.2.15 Procedure for Appeal to the Panel.
-.1
-
-An appeal from a decision of a hearing officer shall be by written notice of appeal that
-shall be in any form that signifies an intent to appeal and shall be filed with the panel in
-person, by mail, by facsimile machine or by panel-approved electronic means, or at a
-public employment office or the central office of the division or the office where the
-hearing officer is located or by division-approved electronic means. An appeal from a
-decision of a hearing officer shall be filed within the time limits provided by 8-74-104 (1),
-C.R.S., and regulation 1.8. When an appeal has been received, the appeal file and
-record shall be transmitted to the panel. The panel shall notify the interested parties
-named in the caption of the hearing officer's decision that an appeal has been filed and
-shall provide a copy of the written appeal to the other-named parties.
-
-37
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-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-2
-
-The appeal shall be filed in the manner provided by 8-74-106 (1), C.R.S. The panel shall
-provide each interested party or the party's representative with an audio copy of the
-recorded hearing testimony or, at the panel’s discretion, a written transcript. Any
-interested party may obtain a transcript of the hearing testimony for purposes of the
-appeal by tendering payment for the approximate cost of the transcript. If a transcript is
-reasonably necessary for an interested party or the party's representative for purposes of
-the appeal due to a disability of the party or the representative, the party or
-representative may provide a written statement of disability on a form prescribed by the
-panel, requesting that the transcript cost be waived. In determining whether a transcript is
-reasonably necessary to accommodate a disability, the panel may require the requesting
-party to provide written documentation of the disability from a treating health-care
-professional. If a transcript is reasonably necessary for an interested party or the party's
-representative for other reasons and the party is unable to pay the cost of the transcript
-due to financial hardship, the party may provide a written statement of necessity and
-indigency on a form prescribed by the panel, requesting that such cost be waived. The
-appealing party shall submit the payment or completed waiver request form with the
-appeal. Any other interested party shall submit the payment or completed waiver request
-form within ten business days of the date the notice of appeal is issued. In determining
-whether payment would cause undue financial hardship, any relevant factors may be
-considered, including but not limited to the party's household income and available
-money and existing expenses; the approximate cost of the transcript; and whether
-payment of this cost would deprive the party or his or her family of basic necessities. If
-any interested party or representative receives a transcript of the hearing testimony, the
-panel shall provide a copy of the transcript to the other interested party or the party's
-representative.
-
-.3
-
-The panel shall issue a written procedural decision on a completed waiver request, based
-upon the information contained in the statement of indigency, written documentation from
-a treating health-care professional, or other relevant information contained in the record,
-within fifteen calendar days after the completed prescribed request has been received by
-the panel.
-
-.4
-
-In ruling on a waiver request, the panel shall have the discretion to request or accept
-additional reliable evidence by such means as shall be deemed appropriate for resolution
-of the issue. If the panel requests additional information, the time period for issuing a
-decision on the waiver request shall be tolled until the information is received by the
-panel or the time limit imposed for providing the information has expired, whichever
-occurs sooner.
-
-.5
-
-The cost of the preparation of the transcript of a hearing that occurs as a result of a
-remand order by the panel may be assigned to be borne by the division, if expressly so
-assigned by panel order, but otherwise shall be borne by the appealing party as provided
-in these regulations.
-
-.6
-
-If the payment of the approximate cost of the transcript tendered by the requesting party
-exceeds the actual cost of the transcript, the excess payment shall be refunded without
-interest to the payer. If the actual cost of the transcript exceeds the payment received,
-the requesting party shall be assessed a charge for such excess cost that must be paid
-within fifteen days after the date notice of such charge was provided to the party by the
-panel. If this charge for excess cost is not timely paid, the appeal shall proceed with
-audio copies of the testimony and the division shall retain all monies previously submitted
-by the requesting party unless the time for payment is extended for good cause shown as
-provided in rule 12.1.
-
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-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-.7
-
-If a party withdraws his or her appeal after the panel has received payment or payments
-for the transcript, the panel may retain such payments in whole or in part according to the
-panel's assessment of its own costs in administrative time and expense in preparation of
-the transcript.
-
-.8
-
-Any act required by this regulation 11.2.15, except regulation 11.2.15.5, may be
-permitted outside the time periods set forth herein for good cause shown.
-
-.9
-
-Briefing Schedule. A “brief” for purposes of this rule, shall be any document apparently
-intended by an interested party to be a written argument. Copies of the audio recording or
-the transcript of the hearing testimony shall be provided to the interested parties named
-in the caption of the hearing officer's decision with a notice that the parties may submit a
-brief. Each named interested party may submit one brief within twelve calendar days after
-the date the notice was provided to the party by the panel. The panel may, in its
-discretion, permit the non-appealing party to file a brief in response to the brief filed by
-the appealing party. Such response brief must be filed with the panel within ten calendar
-days of the date of the panel's notification, which shall be accompanied by a copy of the
-appealing party's brief. Requests for extensions of time for the filing of briefs must be in
-writing as defined in rule 1.3.11.2 and will be granted only on a specific showing of
-inability to submit a brief within the time limits set forth herein. When a party files an
-appeal of a hearing officer's decision in circumstances in which no hearing has been
-held, the appealing party shall submit its written argument, if any, with the appeal.
-
-11.2.16 Decision of the Panel. The panel may affirm, modify, reverse, or set aside a hearing officer’s
-decision on the basis of the evidence in the record previously submitted in the case, which shall
-include any relevant materials in the case file at the time of the hearing. In addition, the majority
-of the members of entire panel may remand a case for the taking of further evidence where there
-has been a compelling demonstration that such evidence, if credited, would establish that a
-miscarriage of justice has occurred. Prior to determining whether such a remand is appropriate,
-the panel shall provide written notice of the issue to the interested parties and afford them at least
-seven (7) calendar days to provide a written response. In determining the issue, the panel
-members shall consider the following factors: whether the party offering the additional evidence
-knew or should have known of the existence of the evidence at the time of the hearing; whether
-the party requested the hearing officer to continue the hearing to allow additional evidence and
-the hearing officer denied the party’s request; whether there is a substantial likelihood that the
-offer of proof pertaining to the additional evidence would have compelled a substantially different
-decision by the hearing officer; and whether there is a substantial likelihood that the additional
-evidence would show that the evidence presented at the hearing was false and that the false
-evidence had an effect on the outcome of the hearing. The neglect or error of a party’s
-designated representative shall be imputed to the party and shall not constitute a basis for a
-remand to consider additional evidence under this section. Decisions shall identify those
-members of the panel who consider an appeal and copies thereof shall be provided to all
-interested parties or their representatives of record. The decision of the majority shall control,
-provided, however, that a dissent stating reasons therefor may be filed by the minority.
-.1
-
-Precedential Decisions. Upon a unanimous vote of the members of the entire panel, a
-panel decision may be designated as precedential to be followed by the hearing officers
-and deputies of the division. Precedential decisions shall meet at least one of the
-following criteria: 1) The decision interprets a statute, rule, or 2) The decision resolves an
-apparent conflict of authority. Precedential decisions shall be promptly provided to the
-hearing officers and deputies of the division. In addition, precedential decisions shall be
-published and made available to the public in a manner that does not reveal confidential
-identifying information prohibited by 8-72-107(1), C.R.S.
-
-11.2.17 Disqualification of Examiner. Challenges to the interest of an examiner shall be heard and
-decided by the panel.
-
-39
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-11.2.18 Evidence From Another State. The division may, after notice to the parties, request an agency
-that administers the employment security law for another state to take evidence in that state for
-use by the division. Such agency, after notice to the parties, may follow the procedure prescribed
-by the law and regulations of that state for conducting hearings.
-11.2.19 Subpoenas. The division may issue subpoenas to compel attendance of witnesses and
-production of records for a hearing before a hearing officer. A subpoena shall be served by
-delivering a copy of the subpoena to the person named therein no later than forty-eight hours
-before the time for appearance set forth in said subpoena. A subpoena may be served by an
-interested party, and proof of service shall be made by affidavit setting forth the date, place, and
-manner of service.
-.1
-
-.2
-
-.3
-
-A party that submits a request for a subpoena shall show:
-.1
-
-The name of the witness and the address where the witness can be served the
-subpoena;
-
-.2
-
-That the testimony of the witness is material; and
-
-.3
-
-That the testimony of the witness is not repetitive.
-
-If the requesting party wishes the witness to produce books, records, documents, or other
-physical evidence, the party shall also show:
-.1
-
-The name or a detailed description of the specific books, records, documents, or
-other physical evidence the witness should bring to the hearing;
-
-.2
-
-That such evidence is material;
-
-.3
-
-That such evidence is not repetitive; and
-
-.4
-
-That such evidence does not cause an undue burden on the party to whom it is
-directed.
-
-If the subpoena or subpoena duces tecum is denied, the aggrieved party may object at
-the hearing. The hearing officer will consider all objections and responses and supporting
-evidence, if any, and will grant or deny the request for issuance of the subpoena. If
-denied, the hearing will proceed on the merits of the issue in dispute. If granted, the
-hearing shall be adjourned pursuant to regulation 11.2.11.
-
-11.2.20 Appearance of Parties. In a proceeding before a hearing officer or the panel, an individual may
-appear for himself or herself; a partnership may be represented by any partner or a duly
-authorized representative; and a corporation or association may be represented by an officer or
-duly authorized representative.
-11.2.21 Designation of Representative. In addition to representatives under regulation 11.2.20, any
-party may designate another person as an authorized representative in an appeal proceeding
-before the division or panel.
-11.2.22 Preserving Records of Decisions. Decisions of hearing officers and the panel shall be kept in
-such format as may be determined by the division in the main administrative office of the division
-in Denver, Colorado for a period of two years after the last decision. Copies of such decisions
-may be obtained by the interested parties upon written request and the payment of a reasonable
-fee therefor.
-
-40
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-PART XII
-12.1
-
-7 CCR 1101-2
-
-GOOD CAUSE
-
-DETERMINATION OF GOOD CAUSE
-
-12.1.1 Statutory References: 8-73-107 (1)(h), 8-73-108 (5)(e)(XVIII)(XIX), 8-74-102, 8-74-106, 8-76110 (2)(g), 8-76-110 (4)(e), 8-76-113, and 8-79-104 (1)(d), C.R.S.
-12.1.2 Purpose. The purpose of this part XII of the regulations is to provide procedures and substantive
-guidelines for the determination of good cause only when a particular section of the act or
-regulations other than this part XII of the regulations specifically permits an untimely action or
-excuses the failure to act as required for good cause shown.
-12.1.3 Procedure.
-.1
-
-Whenever an interested party files an untimely appeal from a deputy’s decision, a
-rebuttable presumption of good cause shall be established and a hearing shall be
-scheduled unless the appeal was received more than 180 days beyond the expiration of
-the timely filing period. The notice of hearing shall contain a statement indicating that the
-appeal was filed beyond the expiration of the timely filing period and that the
-nonappealing party may object to the hearing being granted at the time of the new
-hearing. If the nonappealing party fails at the time of the hearing to object to the hearing
-proceeding, that party waives the opportunity to object to the hearing going forward. If the
-nonappealing party objects at the time of the hearing to the matter being scheduled, the
-hearing officer shall determine whether good cause has been shown, pursuant to section
-12.1.8, for permitting the untimely appeal. If the hearing officer determines that good
-cause has been shown for permitting the untimely appeal, the hearing shall proceed. If
-the hearing officer determines that good cause has not been shown for permitting the
-untimely appeal, the appeal shall be dismissed.
-
-.2
-
-In the event an interested party files an untimely appeal from a deputy’s decision or
-makes a request for a new hearing and the appeal or hearing request is received more
-than 180 days beyond the expiration of the timely filing period, good cause may not be
-established, a hearing shall not be scheduled, the appeal shall be dismissed, and the
-deputy’s decision shall become final.
-
-.3
-
-Whenever an interested party files an untimely appeal from a hearing officer’s decision,
-or fails to participate as directed in a hearing held on an appeal from a deputy’s decision
-and has filed a request for a new hearing, the panel shall determine if good cause has
-been shown, pursuant to section 12.1.8, for permitting the untimely appeal or excusing
-the failure to participate in the hearing as directed. The panel shall make a determination
-of good cause only if the untimely appeal or request for new hearing contains a statement
-of the reasons for which the party failed to act in a timely manner or if information within
-the appeal file supports a determination of good cause. If the party’s untimely appeal or
-request for a new hearing does not establish good cause, the panel may request an
-explanation in writing, by postal mail, by approved electronic means, or by telephone.
-The party shall respond to any such request within ten days.
-
-41
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-.4
-
-Whenever an appeal from a deputy’s decision has been dismissed because the
-appealing party failed to participate as directed in a scheduled hearing before a hearing
-officer and the appealing party requests that a new hearing be scheduled, a rebuttable
-presumption of good cause shall be established and a new hearing shall be scheduled.
-The notice of the new hearing shall contain a statement indicating that the hearing is
-being rescheduled because the appealing party did not participate in the prior hearing as
-directed and that the nonappealing party may object at the beginning of the new hearing
-to the matter being rescheduled. If, at the time of the new hearing, the nonappealing
-party objects to the matter being rescheduled, the hearing officer shall determine whether
-good cause has been shown, pursuant to section 12.1.8, to excuse the failure to
-participate in the hearing as directed. If, at the time of the hearing, the nonappealing party
-fails to object to the hearing proceeding, that party waives the opportunity to object to the
-hearing going forward. If the hearing officer determines that good cause has been shown
-to excuse the failure to participate in the hearing as directed, the hearing on the deputy’s
-decision shall proceed. If the hearing officer determines that good cause has not been
-shown to excuse the failure to participate in the hearing as directed, the appeal shall be
-dismissed.
-
-.5
-
-Notwithstanding these provisions, good cause may not be established for the failure of an
-appealing party to participate in a second hearing as directed which was set because that
-party failed to participate as directed in the first hearing. In the event that the appealing
-party fails to participate as directed in the first setting of a hearing on a deputy’s decision
-and then subsequently fails to participate as directed in the second setting of a hearing,
-the appeal shall be dismissed and the deputy’s decision shall become final. Under such
-circumstances, the division shall issue a notice to all interested parties that the appeal
-has been dismissed and that no further rescheduled hearings shall be granted.
-
-12.1.4 Written Statement. All statements provided for the purpose of part XII of these regulations shall
-be in writing and identify the person submitting the statement. The statement may be submitted in
-person, by postal mail, by facsimile machine, by telephone, by division-approved electronic
-means, or if submitted to the panel, by panel-approved electronic means.
-12.1.5 Determination by Panel. Upon receipt of the statement, the panel shall determine whether good
-cause has been shown for permitting an untimely appeal from a hearing officer's decision or for
-excusing the failure of a nonappealing party to appear for a hearing. Such determination shall be
-in writing with supporting findings of fact and shall be provided to all interested parties in person,
-by mail, by facsimile machine, or by electronic means. If the panel determines that good cause
-exists for permitting a late appeal, the decision shall contain a written notification that the othernamed interested parties may object to the good-cause determination by raising their objections
-in their written arguments as permitted by regulation 12.1.3. The panel shall consider any
-objections and conduct further appropriate proceedings to reconsider the good-cause
-determination.
-12.1.6 Additional Evidence. In making a determination of whether good cause has been shown for
-permitting an untimely appeal from a hearing officer's decision or for excusing the failure to
-appear for a hearing, the panel may request or accept additional written evidence, may obtain
-additional evidence by other reliable means as shall be deemed appropriate, or may order that a
-hearing be conducted by a hearing officer to obtain such evidence and to make findings of fact
-deemed necessary to resolve this issue.
-12.1.7 Appeals. If any interested party objects to a determination of the chief hearing officer or designee
-that a rebuttable presumption of good cause exists for an untimely appeal from a deputy's
-decision; or objects to a determination of the panel based solely on written documents that there
-is good cause for an untimely appeal, that excuses the failure to appear for a hearing or
-determines that good cause exists for an untimely request for a new hearing, that interested party
-may present its objections at the hearing scheduled on the issues in dispute.
-
-42
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-.1
-
-The hearing officer shall consider all information in support of or in opposition to the good
-cause determination presented by the interested parties, including all objections and
-responses and supporting evidence. The hearing officer shall determine if good cause
-exists for permitting the untimely appeal or excusing the failure to appear or excusing the
-untimely request for a new hearing based on the evidence presented.
-
-.2
-
-However, if the hearing officer does not find the facts to be different than those already
-considered, the hearing officer shall not disturb the prior determination of good cause,
-and the hearing will proceed on the merits of the issues in dispute. If good cause is
-overturned, the hearing will be terminated and any previously vacated hearing officer's
-decision on the merits of the appeal shall be reinstated.
-
-12.1.8 Substantive Guidelines. In determining whether good cause has been shown for permitting an
-untimely action or excusing the failure to act as required, the division or the panel consider:
-.1
-
-whether the party acted in the manner that a reasonably prudent individual would have
-acted under the same or similar circumstances;
-
-.2
-
-whether there was administrative error by the division;
-
-.3
-
-whether the party exercised control over the untimely action, except that the acts and
-omissions of a party's authorized representative are considered the acts and omissions
-of the party and are not considered to be a factor outside the party's control as intended
-by this rule;
-
-.4
-
-the length of time the action was untimely;
-
-.5
-
-whether any other interested party has been prejudiced by the failure to act or untimely
-action, “prejudiced,” as used in this section, means that an interested party will be
-prevented from presenting of substantially hindered from presenting probative evidence
-in support of the interested party’s position or in the ability to refute the position of the
-opposing party; and
-
-.6
-
-whether denying good cause would lead to a result that in inconsistent with the law.
-
-.7
-
-Good cause cannot be established to accept or permit an untimely action or to excuse
-the failure to act, as required, that was caused by the party's failure to keep the division
-directly and promptly informed by a written, signed statement of his or her current and
-correct mailing address in person, by mail, by facsimile machine, or by other divisionapproved electronic means. This provision shall not apply if the party establishes that he
-or she reasonably believed that the division would not have any need for his or her new
-address under the circumstances.
-
-.8
-
-A written decision concerning the existence of good cause need not contain findings of
-fact on every relevant factor, but the basis for the decision must be apparent from the
-order.
-
-.9
-
-Unless otherwise provided by law, no act subject to this section shall be permitted more
-than 180 days beyond the applicable timely date.
-
-43
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-PART XIII
-13.1
-
-7 CCR 1101-2
-
-INTERSTATE ARRANGEMENTS
-
-PAYMENT OF BENEFITS TO INTERSTATE CLAIMANTS
-
-13.1.1 Statutory References: 8-72-109 and 8-72-110, C.R.S.
-13.1.2 Cooperation With Other States. This section of the regulations shall govern the division in its
-administrative cooperation with other states that adopt similar regulations for the payment of
-benefits to interstate claimants.
-13.1.3 Definitions. The following definitions shall apply to this section unless the context clearly requires
-otherwise.
-.1
-
-Interstate Benefit Payment Plan. The plan approved by the Interstate Conference of
-Employment Security Agencies (ICESA) under which benefits shall be payable to
-unemployed individuals absent from the state or states in which benefit credits have been
-accumulated.
-
-.2
-
-Interstate Claimant. An individual who claims benefits under the unemployment
-insurance law of one or more liable states through the facilities of an agent state or
-directly with the liable state. The term shall not include an individual who customarily
-commutes from a residence in any agent state to work in a liable state unless the division
-determines that such an exclusion would create undue hardship upon claimants in
-designated areas.
-
-.3
-
-State. Any state of the United States, the District of Columbia, Puerto Rico, the Virgin
-Islands, and the provinces of Canada.
-
-.4
-
-Agent State. Any state from or through which an individual files a claim for benefits
-against another state.
-
-.5
-
-Liable State. Any state against which an individual files, from or through another state, a
-claim for benefits.
-
-.6
-
-Benefits. The unemployment compensation payable to an individual under the
-unemployment insurance law of any state.
-
-.7
-
-Week of Unemployment. Any week of unemployment as defined in the law of the liable
-state from which benefits with respect to such week are claimed.
-
-13.1.4 Registration for Work.
-.1
-
-Each interstate claimant who files through the agent state or directly with the liable state
-shall register for work as required by the law, regulations, and procedures of the agent
-state. Such registration shall be deemed to meet the registration requirements of the
-liable state.
-
-.2
-
-The agent state shall duly report to the liable state each interstate claimant who fails to
-meet the registration or reemployment-assistance-reporting requirements of the agent
-state.
-
-44
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-13.1.5 Benefit Rights of Interstate Claimants. If an interstate claimant files a claim against a state and
-such state determines that benefit credits are available to the claimant in that state, claims may
-be filed only against that state and no other state so long as such benefit credits are available.
-Thereafter, the claimant may file claims against any other state in which he or she has available
-benefit credits. Benefit credits, for the purposes of this section, shall be deemed to be unavailable
-whenever benefits are affected by the application of a seasonal restriction or have been
-exhausted, terminated, or postponed for an indefinite period or for the entire period during which
-benefits would otherwise be payable.
-13.1.6 Claims for Benefits.
-.1
-
-Interstate claims for benefits and waiting periods filed by interstate claimants through the
-agent state shall be filed in compliance with the uniform procedures developed pursuant
-to the Interstate Benefit Payment Plan. Such claims filed directly with the liable state shall
-be filed in accordance with the liable state's procedures. Claims shall be filed to conform
-to the type of week in effect in the agent state. The liable state shall make required
-adjustments on the basis of consecutive claims.
-
-.2
-
-Agent-state regulations for filing intrastate claims with public employment offices or
-itinerant service points or representative therefor or by mail or by telephone shall apply to
-interstate claims.
-
-.3
-
-With respect to weeks of unemployment during which an individual is attached to his or
-her regular employer, the liable state shall accept as timely any claim that is filed through
-the agent state within the time limit applicable to such claims under the law of the agent
-state.
-
-13.1.7 Determination of Claims.
-.1
-
-When an interstate claim is filed, the agent state shall identify to the liable state any
-potential issue relating to the claimant's availability for work and eligibility for benefits
-detected by the agent state.
-
-.2
-
-The agent state's authority and responsibility with respect to the determination of
-interstate claims shall be limited to the identification of potential issues identified in
-connection with initial claims or weeks claimed that are filed through the agent state and
-to the reporting of relevant facts pertaining to the claimant's failure to register for work or
-report for reemployment assistance as required by the agent state.
-
-.3
-
-The agent state shall not refuse to accept an interstate claim.
-
-13.1.8 Providing Assistance to Interstate Claimants. Each agent state, upon request by an interstate
-claimant, shall assist the individual with the understanding and filing of necessary notices and
-documents. The liable state shall provide interstate claimants with access to information
-concerning the status of their claims during normal business hours.
-13.1.9 Eligibility Review Program. The liable state may schedule and conduct eligibility-review
-interviews for interstate claimants.
-13.1.10 Notification of Interstate Claim. The liable state shall notify the agent state of each initial claim,
-reopened claim, claim transferred to interstate status, and each week claimed filed from the agent
-state using uniform procedures and record formats pursuant to the Interstate Benefit Payment
-Plan.
-
-45
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-13.1.11 Appellate Procedure.
-
-13.2
-
-.1
-
-The agent state shall give all reasonable cooperation in conducting hearings and taking
-evidence in connection with disputed benefit determinations when so requested by a
-liable state.
-
-.2
-
-The time limit imposed by the liable state for filing an appeal in connection with a
-disputed benefit determination shall control, provided, however, that a claimant's appeal
-shall be deemed to have been made and communicated to the liable state on the date on
-which it is received by an employee of the agent state.
-
-.3
-
-The liable state shall conduct hearings in connection with appealed interstate benefit
-claims. The liable state may contact the agent state for assistance in special
-circumstances.
-
-COMBINING EMPLOYMENT AND WAGES
-
-13.2.1 Statutory Reference: 8-72-110 (2), C.R.S.
-13.2.2 Purpose of Arrangement. This arrangement is approved by the Secretary of Labor of the United
-States (Secretary) under the provisions of section 3304 (a)(9)(B) of the Federal Unemployment
-Tax Act to establish a system whereby an unemployed worker, with covered employment or
-wages in more than one state, may combine all such employment and wages in one state, in
-order to qualify for benefits or to receive more benefits.
-13.2.3 Consultation With the State Agencies. As required by section 3304 (a)(9)(B) of the Federal
-Unemployment Tax Act, this arrangement has been developed in consultation with the state
-unemployment compensation agencies. For purposes of such consultation, in its formulation and
-any future amendment, the Secretary recognizes, as agents of the state agencies, the duly
-designated representatives of the Interstate Conference of Employment Security Agencies
-(ICESA).
-13.2.4 Interstate Cooperation. Each state agency will cooperate with every other state agency by
-implementing such rules, regulations, and procedures as may be prescribed for the operation of
-this arrangement. Each state agency shall identify the paying and the transferring state with
-respect to combined-wage claims filed in its state.
-13.2.5 Rules, Regulations, Procedures, Forms - Resolution of Disagreements. All state agencies
-shall operate in accordance with such rules, regulations, and procedures and shall use such
-forms as shall be prescribed by the Secretary in consultation with the state unemployment
-compensation agencies. All rules, regulations, and standards prescribed by the Secretary with
-respect to intrastate claims will apply to claims filed under this arrangement unless they are
-clearly inconsistent with the arrangement. The Secretary will resolve any disagreement between
-state agencies concerning the operation of the arrangement, with the advice of the duly
-designated representatives of the state agencies.
-13.2.6 Effective Date. This arrangement shall apply to all new claims (to establish a benefit year) filed
-under it after December 31, 1971.
-13.2.7 Definitions. These definitions apply for the purpose of this arrangement and the procedures
-issued to effectuate it.
-.1
-
-State. “State” includes the states of the United States, the District of Columbia, the
-Commonwealth of Puerto Rico, and the Virgin Islands.
-
-46
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-.2
-
-State Agency. The agency that administers the unemployment compensation law of a
-state.
-
-.3
-
-Combined-Wage Claim. A claim filed under this arrangement.
-
-.4
-
-Combined-Wage Claimant. A claimant who has covered wages under the
-unemployment compensation law of more than one state and who has filed a claim under
-this arrangement.
-
-.5
-
-Paying State.
-.1
-
-The state where a combined-wage claimant files a combined-wage claim, if the
-claimant qualifies for unemployment benefits in that state on the basis of
-combined employment and wages.
-
-.2
-
-If the state where a combined-wage claimant files a combined-wage claim is not
-the paying state under the criterion set forth in regulation 13.2.7.5.1, or if the
-combined-wage claim is filed in Canada, then the paying state shall be that state
-where the combined-wage claimant was last employed in covered employment
-among the states where the claimant qualifies for unemployment benefits on the
-basis of combined employment and wages.
-
-.6
-
-Transferring State. A state where a combined-wage claimant had covered employment
-and wages in the base period of a paying state and that transfers such employment and
-wages to the paying state for its use in determining the benefit rights of such claimant
-under its law.
-
-.7
-
-Employment and Wages. “Employment” refers to all services that are covered under the
-unemployment compensation law of a state, whether expressed in terms of weeks or
-work or otherwise. “Wages” refers to all remuneration for such employment.
-
-.8
-
-Secretary. The Secretary of Labor of the United States.
-
-.9
-
-Base Period and Benefit Year. The base period and benefit year applicable under the
-unemployment compensation law of the paying state.
-
-13.2.8 Election to File a Combined-Wage Claim.
-.1
-
-.2
-
-Any unemployed individual who has had employment covered under the unemployment
-compensation law of two or more states, whether or not he or she is monetarily qualified
-under one or more of them, may elect to file a combined-wage claim. Said individual may
-not so elect, however, if he or she has established a benefit year under any state or
-federal unemployment compensation law and:
-.1
-
-The benefit year has not ended; and
-
-.2
-
-He or she still has unused benefit rights based on such benefit year.
-
-For the purpose of this arrangement, a claimant will not be considered to have unused
-benefit rights based on a benefit year that he or she has established under a state or
-federal unemployment compensation law if:
-.1
-
-The claimant has exhausted his or her rights to all benefits based on such benefit
-year; or
-
-47
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-.2
-
-The claimant's rights to such benefits have been postponed for an indefinite
-period or for the entire period in which benefits would otherwise be payable; or
-
-.3
-
-Benefits are affected by the application of a seasonal restriction.
-
-.3
-
-If an individual elects to file a combined-wage claim, all employment and wages in all
-states in which he or she worked during the base period of the paying state must be
-included in such combining, except employment and wages that are not transferable
-under the provisions of regulation 13.2.10.2.
-
-.4
-
-A combined-wage claimant may withdraw his or her combined-wage claim within the
-period prescribed by the law of the paying state for filing an appeal, protest, or request for
-redetermination (as the case may be) from the monetary determination of the combinedwage claim, provided the claimant either:
-
-.5
-
-.1
-
-Repays in full any benefits paid to him or her thereunder; or
-
-.2
-
-Authorizes the state(s) against which he or she files a substitute claim(s) for
-benefits to withhold and forward to the paying state a sum sufficient to repay
-such benefits.
-
-If the combined-wage claimant files his or her claim in a state other than the paying state,
-he or she shall do so pursuant to the Interstate Benefit Payment Plan.
-
-13.2.9 Responsibilities of the Paying State.
-.1
-
-Transfer of Employment and Wages - Payment of Benefits. The paying state shall
-request the transfer of a combined-wage claimant's employment and wages in all states
-during its base period and shall determine his or her entitlement to benefits (including
-additional benefits, extended benefits, and dependents' allowances, when applicable)
-under the provisions of its law based on employment and wages in the paying state, if
-any, and all such employment and wages transferred to it hereunder. The paying state
-shall apply all the provisions of its law to each determination made hereunder, even if the
-combined-wage claimant has no earnings in covered employment in that state, except
-that the paying state may not determine an issue that has previously been adjudicated by
-a transferring state. Such exception shall not apply, however, if the transferring state's
-determination of the issue resulted in making the combined-wage claim possible under
-regulation 13.2.8.2.2. If the paying state fails to establish a benefit year for the combinedwage claimant, or if the claimant withdraws his or her claim as provided herein, the
-paying state shall return to each transferring state all employment and wages thus
-unused.
-
-.2
-
-Notices of Determination. The paying state shall give to the claimant a notice of each of
-its determinations on his or her combined-wage claim that he or she is required to receive
-under the Secretary's claim-determinations standard, and the contents of such notice
-shall meet such standard. When the claimant is filing his or her combined-wage claims in
-a state other than the paying state, the paying state shall send a copy of each such
-notice to the local office where the claimant filed such claims.
-
-.3
-
-Redeterminations. Redeterminations may be made by the paying state in accordance
-with its law based on additional or corrected information received from any source,
-including a transferring state, except that such information shall not be used as a basis
-for charging the paying state if benefits have been paid under the combined-wage claim.
-
-48
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-.4
-
-7 CCR 1101-2
-
-Appeals.
-.1
-
-Except as provided in regulation 13.2.9.4.3 where the claimant files his or her
-combined-wage claim in the paying state, any protest, request for
-redetermination, or appeal shall be in accordance with the law of such state.
-
-.2
-
-Where the claimant files his or her combined-wage claim in a state other than the
-paying state or under the circumstances described in regulation 13.2.9.4.3, any
-protest, request for redetermination, or appeal shall be in accordance with the
-Interstate Benefit Payment Plan.
-
-.3
-
-To the extent that any protest, request for redetermination, or appeal involves a
-dispute as to the coverage of the employing unit or services in a transferring
-state or otherwise involves the amount of employment and wages subject to
-transfer, the protest, request for redetermination, or appeal shall be decided by
-the transferring state in accordance with its law.
-
-.5
-
-Recovery of Prior Overpayments. If there is an overpayment outstanding in a transferring
-state and such transferring state so requests, the overpayment shall be deducted from
-any benefits the paying state would otherwise pay to the claimant on his or her
-combined-wage claim, except to the extent prohibited by the law of the paying state. The
-paying state shall transmit the amount deducted to the transferring state or credit the
-deduction against the transferring state's required reimbursement under this
-arrangement. This subsection shall apply to overpayments only if the transferring state
-certifies to the paying state that the determination of overpayment was made within three
-years before the combined-wage claim was filed and that repayment by the claimant is
-legally required and enforceable against the claimant under the law of the transferring
-state.
-
-.6
-
-Statement of Benefit Charges.
-.1
-
-At the close of each calendar quarter, the paying state shall send each
-transferring state a statement of benefits charged during such quarter to such
-state for each combined wage claimant.
-
-.2
-
-Each such charge shall bear the same ratio to the total benefits paid to the
-combined-wage claimant by the paying state as his or her wages transferred by
-the transferring state bear to the total wages used in such determination. The
-paying state shall express the ratio as a percentage, of three or more decimal
-places.
-
-.3
-
-With respect to new claims establishing a benefit year effective on and after July
-1, 1977, the United States shall be charged directly by the paying state in the
-same manner as provided in regulations 13.2.9.6.1 and 13.2.9.6.2 of this section
-13.2 in regard to federal-civilian service and wages and federal-military service
-and wages assigned or transferred to the paying state and included in combinedwage claims in accordance with the Code of Federal Regulations, 20 C.F.R.,
-parts 609, 614, and 616.
-
-49
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-13.2.10 Responsibilities of Transferring States.
-.1
-
-Transfer of Employment and Wages. Each transferring state shall promptly transfer to
-the paying state the employment and wages the combined-wage claimant had in covered
-employment during the base period of the paying state. Any employment and wages so
-transferred shall be transferred without restriction as to their use for determination and
-benefit payments under the provisions of the paying state's law.
-
-.2
-
-Employment and Wages Not Transferable. Employment and wages transferred to the
-paying state by a transferring state shall not include:
-
-.3
-
-.1
-
-Any employment and wages that have been transferred to any other paying state
-and not returned unused or that have been used in the transferring state as the
-basis of a monetary determination that established a benefit year.
-
-.2
-
-Any employment and wages that have been canceled or are otherwise
-unavailable to the claimant as a result of a determination by the transferring state
-made prior to its receipt of the request for transfer, if such determination has
-become final or is in the process of appeal but is still pending. If the appeal is
-finally decided in favor of the combined-wage claimant, any employment and
-wages involved in the appeal shall forthwith be transferred to the paying state,
-and any necessary redetermination shall be made by such paying state.
-
-.3
-
-Any employment and wages that would be canceled under the law of the
-transferring state, if its law does not permit noncharging of benefits paid thereon,
-except that this subsection shall not apply to requests for transfer made after
-June 30, 1973, or after amendment of the law to provide for noncharging,
-whichever is earlier.
-
-Reimbursement of Paying State. Each transferring state shall, as soon as practicable
-after receipt of a quarterly statement of charges described herein, reimburse the paying
-state accordingly.
-
-13.2.11 Reuse of Employment and Wages. Employment and wages that have been used under this
-arrangement for a determination of benefits that establishes a benefit year shall not thereafter be
-used by any state as the basis for another monetary determination of benefits.
-13.2.12 Amendment of Arrangement. Periodically, the Secretary shall review the operation of this
-arrangement and shall propose such amendments to the arrangement as he or she believes are
-necessary or appropriate. Any state unemployment compensation agency or the ICESA may
-propose amendments to the arrangement. Any proposal shall constitute an amendment to the
-arrangement upon approval by the Secretary in consultation with the state unemployment
-compensation agencies. Any such amendment shall specify when the change shall take effect
-and to which claims it shall apply.
-13.3
-EMPLOYER ELECTIONS TO COVER WORKERS PERFORMING SERVICES IN MORE THAN
-ONE STATE
-13.3.1 Statutory Reference: 8-72-110(3), C.R.S.
-13.3.2 Definitions. The following definitions shall apply to this section unless the context otherwise
-clearly requires:
-.1
-
-Arrangement. The Interstate Reciprocal Coverage Arrangement.
-
-50
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-.2
-
-Jurisdiction. Any state of the United States, the District of Columbia, Puerto Rico, the
-Virgin Islands, and Canada or the federal government, with respect to coverage under a
-federal unemployment compensation law.
-
-.3
-
-Participating Jurisdiction. A jurisdiction whose agency has subscribed to and has not
-terminated participation in the arrangement.
-
-.4
-
-Agency. Any officer, board, commission, or other authority charged with the
-administration of the unemployment compensation law of a participating jurisdiction.
-
-.5
-
-Electing Unit. An employing unit that requests that the services customarily performed
-for it by any individual in more than one participating jurisdiction be covered under the law
-of a single participating jurisdiction.
-
-.6
-
-Election. The request of an electing unit for permission to cover under the law of a single
-participating jurisdiction all of the services customarily performed for such unit by any
-individual who customarily works in more than one participating jurisdiction.
-
-.7
-
-Elected Jurisdiction. The participating jurisdiction selected by an employing unit to
-cover under its law any individual who customarily performs services for such unit in
-more than one participating jurisdiction.
-
-.8
-
-Interested Jurisdiction. Any participating jurisdiction where the elected jurisdiction
-submits an election for approval.
-
-.9
-
-Interested Agency. The agency of the interested jurisdiction.
-
-.10
-
-Services Customarily Performed. Services performed by an individual over a
-reasonable period of time, the nature of which is such that it can be expected that they
-will continue in more than one jurisdiction; services required or expected to be performed
-in more than one jurisdiction.
-
-.11
-
-Multistate Worker. An individual who customarily performs services for the same
-employing unit in more than one jurisdiction.
-
-13.3.3 Procedure.
-.1
-
-An electing unit shall use the prescribed form (Form RC-1) or other methods as may be
-permitted or required by the Interstate Benefit Payment Plan to file an election to cover
-multistate workers under the unemployment compensation law of a participating
-jurisdiction.
-
-.2
-
-An election may be filed with any participating jurisdiction where:
-
-.3
-
-.1
-
-Any part of an individual's services are performed.
-
-.2
-
-An individual maintains his or her residence.
-
-.3
-
-The employing unit maintains a place of business to which the individual's
-services bear a reasonable relation.
-
-The agency of the elected jurisdiction shall approve or disapprove the election. If such
-election is approved, the agency shall forward a copy thereof to each interested agency
-(as specified on the election form) under whose unemployment compensation law the
-electing unit's employee might be covered in the absence of such election.
-
-51
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-.4
-
-Each interested agency shall approve or disapprove such election, as soon as
-practicable, and notify the elected jurisdiction. If the law of the interested jurisdiction so
-requires, an interested agency may, before taking action, require the electing unit to
-furnish satisfactory evidence that it has notified affected employees of the election and
-they have agreed thereto.
-
-.5
-
-If the agency of the elected jurisdiction disapproves the election, the agency shall notify
-the electing unit stating reasons therefor.
-
-.6
-
-An interested agency that disapproves the election shall notify the elected jurisdiction and
-electing unit, stating reasons therefor.
-
-.7
-
-The election shall become effective only upon approval of the agency of the elected
-jurisdiction and one or more interested agencies.
-
-.8
-
-An interested agency that disapproves the election shall not be bound by such election.
-
-.9
-
-If the election is not approved by the agencies of all participating jurisdictions, the electing
-unit may withdraw such election within ten days of notification thereof.
-
-.10
-
-If the services for which an employer is requesting reciprocal coverage is determined to
-be employment as defined in the Colorado Employment Security Act, such request shall
-not be granted.
-
-13.3.4 Effective Period.
-.1
-
-An election, duly approved under this regulation, shall become effective at the beginning
-of the calendar quarter during which such election is submitted unless such election, as
-approved, specifies a different calendar quarter. An electing unit may request an effective
-date for a calendar quarter earlier than the calendar quarter during which the election is
-submitted, provided, however, that such earlier date may be approved solely as to those
-interested jurisdictions in which the electing unit had no liability to pay contributions
-during such earlier calendar quarter.
-
-.2
-
-The application of an election to an individual shall terminate if the agency of the elected
-jurisdiction finds that the services of such individual are no longer performed in more than
-one participating jurisdiction. The termination date shall be the last day of the calendar
-quarter in which notice of termination is mailed to all affected parties. Except as provided
-in the forgoing paragraph, each election approved under this section shall be in effect
-through the end of the calendar year in which such election was filed and, thereafter,
-through the end of the calendar quarter during which the electing unit gives written notice
-of termination to the agencies of the elected and interested jurisdictions.
-
-.3
-
-The electing unit shall notify each affected individual when an election under this section
-ceases to apply to that individual.
-
-13.3.5 Required Reports and Notices.
-.1
-
-The electing unit shall promptly notify each affected individual when an election is
-approved. Prescribed form Notice to Employee as to Unemployment Compensation
-Coverage (Form RC-2) shall be used, and a copy thereof shall be forwarded to the
-elected jurisdiction.
-
-52
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-13.4
-
-7 CCR 1101-2
-
-.2
-
-Whenever an individual affected by an election is separated from employment with the
-electing unit, such unit shall forthwith again notify said individual of the elected jurisdiction
-under whose law his or her services have been covered. If the individual is not in the
-elected jurisdiction when he or she is separated from his or her employment, the electing
-unit shall give the individual information concerning procedures to follow in filing interstate
-claims.
-
-.3
-
-The electing unit shall immediately notify the elected jurisdiction of any changes that are
-applicable to and affect its election, as when an individual's services will no longer be
-customarily performed in more than one participating jurisdiction or when a change in an
-individual's work assignment requires him or her customarily to perform services in an
-additional participating jurisdiction.
-
-.4
-
-Notification to the elected jurisdiction pursuant to this regulation 13.3.5 shall be made as
-permitted or required by the Interstate Benefit Payment Plan.
-
-INTERSTATE RECIPROCAL OVERPAYMENT RECOVERY
-
-13.4.1 Statutory References: 8-72-109(1), 8-72-110, and 8-79-102(1), C.R.S.
-13.4.2 Definitions. The following definitions shall apply to this section unless the context clearly requires
-otherwise.
-.1
-
-State. Any state of the United States, the District of Columbia, Puerto Rico, and the
-Virgin Islands.
-
-.2
-
-Offset. The withholding of the overpaid amount against benefits that would otherwise be
-payable for a compensable week of unemployment.
-
-.3
-
-Overpayment. An improper payment of benefits from a state or federal unemployment
-compensation fund that has been determined recoverable under the requesting state's
-law.
-
-.4
-
-Participating State. A state that has subscribed to the interstate reciprocal overpayment
-arrangement.
-
-.5
-
-Paying State. The state under whose law a claim for unemployment benefits has been
-established on the basis of combining wages and employment covered in more than one
-state.
-
-.6
-
-Recovering State. The state that has received a request for assistance from a
-requesting state.
-
-.7
-
-Requesting State. The state that has issued a final determination of overpayment and is
-requesting another state to assist it in recovering the outstanding balance from the
-overpaid individual.
-
-.8
-
-Transferring State. A state in which a combined-wage claimant had covered
-employment and wages in the base period of a paying state and that transfers such
-employment and wages to the paying state for its use in determining the benefit rights of
-such claimant under its law.
-
-.9
-
-Liable State. Any state against which an individual files, through another state, a claim
-for benefits.
-
-53
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-13.4.3 Recovery of State or Federal Benefit Overpayments.
-.1
-
-.2
-
-Duties of Requesting State. The requesting state shall:
-.1
-
-Send the recovering state a written request for overpayment-recovery assistance
-that includes certification that the overpayment is legally collectable under the
-requesting state's law, certification that the determination is final and that any
-rights to postponement of recoupment have been exhausted or have expired, a
-statement as to whether the state is participating in cross-program offset by
-agreement with the U.S. Secretary of Labor, a copy of the initial overpayment
-determination, and a statement of the outstanding balance;
-
-.2
-
-Send notice of the request to the claimant; and
-
-.3
-
-Send to the recovering state a new outstanding overpayment balance whenever
-the requesting state receives any amount of repayment from a source other than
-the recovering state such as by interception of tax refund.
-
-Duties of Recovering State. The recovering state shall:
-.1
-
-Issue to the claimant an overpayment-recovery determination that includes the
-statutory authority for the offset, the name of the state requesting recoupment,
-the date of the original overpayment determination, the type of overpayment
-(fraud or nonfraud), program type, total amount to be offset, the amount to be
-offset weekly, and the right to request determination and appeal of the
-determination to recover the overpayment by offset.
-
-.2
-
-Offset benefits payable for each week claimed in the amount determined under
-state law.
-
-.3
-
-Provide the claimant with a notice of the amount offset.
-
-.4
-
-Prepare and forward, no less than once a month, payment representing the
-amount recovered made payable to the requesting state except as provided in
-regulation 13.4.4.1.2.
-
-.5
-
-Retain a record of the overpayment balance no later than the exhaustion of
-benefits, end of the benefit year, exhaustion or end of an additional or extended
-benefits period, or other extensions of benefits, whichever is latest.
-
-.6
-
-Not redetermine the original overpayment determination.
-
-13.4.4 Combined-Wage Claims.
-.1
-
-Recovery of Outstanding Overpayment in Transferring State. The paying state shall:
-.1
-
-Offset any outstanding overpayment in a transferring state(s) prior to honoring a
-request from any other participating state.
-
-.2
-
-Credit the deductions against the statement of benefits paid to combined-wage
-claimants, Form IB-6, or forward payment to the transferring state as described in
-regulation 13.4.3.2.4.
-
-54
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-.2
-
-.3
-
-7 CCR 1101-2
-
-Withdrawal of Combined-Wage Claim After Benefits Have Been Paid.
-.1
-
-Withdrawal of a combined-wage claim after benefits have been paid shall be
-honored only if the combined-wage claimant has repaid any benefits paid or
-authorizes the new liable state to offset the overpayment pursuant to regulation
-13.2.8.4.
-
-.2
-
-The paying state shall issue an overpayment determination and forward a copy,
-with an overpayment-recovery request and an authorization to offset, with the
-initial claim to the liable state.
-
-The recovering state shall:
-.1
-
-Offset the total amount of any overpayment resulting from the withdrawal of a
-combined-wage claim prior to the release of any payments to the claimant;
-
-.2
-
-Offset the total amount of any overpayment resulting from the withdrawal of a
-combined-wage claim prior to honoring a request from any other participating
-state;
-
-.3
-
-Provide the claimant with a notice for the amount offset; and
-
-.4
-
-Prepare and forward payment representing the amount recovered to the
-requesting state as described in regulation 13.4.3.2.4.
-
-13.4.5 Cross-Program Offset. The recovering state shall offset benefits payable under a state
-unemployment compensation program to recover any benefits overpaid under a federal
-unemployment compensation program, as described in the recovering state's agreement with the
-U.S. Secretary of Labor, and vice versa, in the same manner as required under regulation 13.4.3
-and regulation 13.4.4 when both the recovering state and requesting state have entered into an
-agreement with the U.S. Secretary of Labor to implement section 303(a) of the federal Social
-Security Act.
-PART XIV
-
-(RESERVED)
-
-PART XV
-
-BENEFIT OVERPAYMENTS
-
-15.0
-
-Coordination of benefits.
-
-15.0.1 Statutory References: 8-70-101 et seq., and 8-13.3-513, C.R.S.
-15.0.2 Concurrency of Benefits.
-1.
-
-15.1
-
-Benefits under the FAMLI Act and its implementing regulations do not run concurrently
-with benefits under the Colorado Employment Security Act, C.R.S. § 8-70-101 et seq. or
-its implementing regulations (“CESA”), including Workshare.
-
-WRITE-OFF OF RECOVERY
-
-15.1.1 Statutory References: 8-74-109, 8-79-102, and 8-81-101(4)(b)(c)(d), C.R.S.
-15.1.2 Purpose. The division may write off the recovery of all or part of the amount of overpaid benefits
-that it finds non-collectible or the recovery of which it finds to be administratively impracticable.
-
-55
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-15.1.3 Criteria for Write-Off. In determining whether overpaid benefits are non-collectible or whether the
-recovery of such benefits would be administratively impracticable, the division shall consider all
-relevant factors including, but not limited to, the following:
-
-15.2
-
-.1
-
-That the claimant has died.
-
-.2
-
-That the claimant is totally and permanently disabled.
-
-.3
-
-That the claimant has retired from the labor force, including consideration of the
-claimant's age, the likelihood of the claimant's reentering the labor force, the claimant's
-physical condition, and the claimant's financial status.
-
-.4
-
-That the claimant has been adjudicated bankrupt.
-
-.5
-
-That the division determines the costs of collection to exceed the amount of
-overpayment.
-
-.6
-
-That the overpaid amount, if not due to false representation or willful failure to disclose a
-material fact, has remained uncollected for more than five years.
-
-.7
-
-That the overpaid amount, if due to false representation or willful failure to disclose a
-material fact, has remained uncollected for more than seven years.
-
-WAIVER OF RECOVERY
-
-15.2.1 Statutory References: 8-79-102, 8-81-101 (4)(a)(I)(II), and 8-81-101 (4)(c)(d)(e), C.R.S.
-15.2.2 Request for Waiver. When a determination establishing an overpayment is final, the overpaid
-claimant shall be notified of the overpayment and advised that a written request for waiver of
-recovery may be submitted to the division. Such request shall be submitted in accordance with
-regulation 1.3.11. Upon receipt of such request, the division shall suspend recovery of the
-overpayment until the waiver determination is final.
-.1
-
-If the final waiver determination denies said request, subsequent requests for waiver may
-be submitted upon a showing by the claimant of a significant change in financial
-conditions affecting his or her ability to repay the overpaid amount, such as catastrophic
-illness or loss of employment.
-
-.2
-
-A final determination that approves a waiver request shall apply only to the overpaid
-balance at the time the request was made, as evidenced by the date received, if mailed
-or filed in person, the receipt date encoded on a facsimile document, or the receipt date
-recorded by the division's automated systems if filed using division-approved electronic
-means and shall not be retroactive to any part of the overpaid amount already recovered.
-except that, if the division has failed to timely notify the individual of the right to request a
-waiver as required, the waiver shall then be retroactive to the date of the overpayment
-determination.
-
-15.2.3 Requests for Information by the Division. Financial and other relevant information that, in the
-opinion of the division, is necessary to render a waiver determination may be requested from the
-claimant by the division in writing. Failure by the claimant to provide the requested information, in
-writing, to the division within fifteen calendar days of said request shall cause the claimant's
-request for waiver to be determined based on available information. Information may be
-submitted to the division in person, by mail, by facsimile machine, or by division approved
-electronic means.
-
-56
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-15.2.4 Criteria for Waiver. A person who is overpaid any amount of benefits is liable for the amount
-overpaid. The division may waive the recovery of all or any part of an overpaid amount only
-when:
-.1
-
-The overpayment did not result from false representation or willful failure to disclose a
-material fact by the claimant; and
-
-.2
-
-Requiring repayment would be inequitable.
-
-15.2.5 False Representation. For purposes of part XV of the regulations, the term “false representation”
-means any representation made by an individual that he or she knew to be false or any
-representation made by an individual with an awareness that he or she did not know whether the
-representation was true or false.
-15.2.6 Willful Failure to Disclose a Material Fact. For purposes of part XV of the regulations, the term
-“willful failure to disclose a material fact” means knowingly withholding material information from
-the division.
-15.3
-
-FRAUDULENT CLAIMS
-
-15.3.1 Statutory References: 8-81-101(1)(a), 8-81-101(4)(a)(I) AND (II) C.R.S.
-15.3.2 False Statements. The terms “false statement” and “false representation” include, but are not
-limited to, the following actions:
-.1
-
-Filing a claim for benefits knowingly using a social security number or other identifying
-information belonging to another or which is otherwise not properly assigned to the
-individual filing the claim for the purpose of improperly obtaining unemployment benefits.
-
-.2
-
-Accessing the benefit claim of another by knowingly using the social security number or
-other identifying information properly belonging to that other individual for the purpose of
-improperly obtaining unemployment benefits.
-
-.3
-
-Knowingly using false or fictitious employer information to either establish a false
-employer account or add fictitious wages to an employer account for the purpose of
-improperly obtaining unemployment benefits.
-
-15.3.3 A claim filed by using such false statements or false representations is not a valid claim.
-15.3.4 Any benefits obtained using such methods are overpaid and shall be repaid to the Division.
-15.3.5 Nothing in this section shall be construed to infringe upon the rights of any individual who, as
-determined by the Division, is properly making a claim for benefits using their own social security
-number or other identifying information properly belonging to that individual.
-PART XVI
-16.1
-
-EMPLOYEE-LEASING COMPANIES
-
-EMPLOYEE-LEASING COMPANY CERTIFICATIONS
-
-16.1.1 Statutory Reference: 8-70-114, C.R.S.
-16.1.2 Employee-Leasing Company Certification Considered. An employer who meets the definition
-of an employee-leasing company as described in 8-70-114 (2)(a)(V), C.R.S., shall be certified
-only if:
-
-57
-
-CODE OF COLORADO REGULATIONS
-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-.1
-
-The employer completes and submits an initial and annual employee-leasing company
-application and work-site employer and employee list as required by regulation 16.1.3.,
-and
-
-.2
-
-Upon filing the application and work-site employer and employee list, the employer
-submits a nonrefundable fee of $500, and
-
-.3
-
-In conjunction with the application, the employer provides evidence of securitization of
-unemployment premiums as set forth in 8-70-114 (2)(g)(III) and rules part VIII, and
-
-.4
-
-The employer completes and submits a quarterly report of all terminated and activated
-employee-leasing company contracts in the previous calendar quarter using such filing
-methods as may be prescribed by the division. Quarterly reports are to be submitted no
-later than the last day of the month following the completion of a calendar quarter.
-
-16.1.3 Application for Certification. An employer seeking to be a certified employee-leasing company
-shall make application with the division upon such forms and using such filing methods as may be
-prescribed by the division. Such application shall include a complete list of all coemployer clients
-as follows:
-.1
-
-A list of all work-site employers with whom a coemployment relationship exists that shall
-include name of each business, the work-site address(es) for each business, actual
-initiation dates and termination dates of each employee-leasing company contract, gross
-wages for each business per quarter, the federal employer identification number of each
-business, and the name, social security number, and quarterly wages of each employee
-performing work for each coemployer client.
-
-16.1.4 [Emergency Rule expired 05/06/2009].
-16.1.5 Certification Determination. Upon review of the matters set forth in the application and such
-other information as it may require, the division shall issue a determination as to the employeeleasing company’s certification. Such certification shall be valid until the end of the state’s first
-fiscal year that is more than one year after the effective date of the initial certification.
-16.1.6 Appeal From Determination. Any employer who wishes to protest a determination made under
-the provisions of 8-70-114, C.R.S, or this part XVI of the regulations shall file a notice of appeal
-with the division. Such notice of appeal must be received by the division within twenty calendar
-days after the date the certification determination was mailed. A hearing may be obtained in
-accordance with 8-73-113, C.R.S., and regulation 11.2.
-16.1.7 Annual Certification. Subsequent to the initial certification, every employer who has been
-certified as an employee-leasing company shall file a certification on prescribed forms and using
-such filing methods as may be prescribed by the division on or before the last day of June of each
-year, except as set forth in regulation 16.1.4. An employee-leasing company shall retain its
-certification only if all requirements defined in 16.1.2 are met.
-16.1.8 Notification. An employee-leasing company or the work-site employer shall notify each covered
-employee in writing at the time of hire of the coemployment relationship. The employee-leasing
-company contract shall specify whether the responsibility for making written notice belongs to the
-employee-leasing company or the work-site employer.
-
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-
-7 CCR 1101-2
-
-16.1.9 Loss of Employee-Leasing Company Certification. If an employer, subsequent to the date on
-which he or she was designated as an employee-leasing company, fails to fulfill the requirements
-of 8-70-114, C.R.S, or this part XVI of the regulations without good cause, such employer shall
-lose his or her employee-leasing company certification. Any determination by the division that an
-employer has lost his or her employee-leasing company certification shall be made in writing and
-provided to the employer in accordance with regulation 1.3.11.1 said determination shall be
-subject to appeal pursuant to regulation 16.1.6.
-16.2
-
-EMPLOYEE-LEASING COMPANY STATUS
-
-16.2.1 Statutory Reference: 8-70-114
-16.2.2 Employee-Leasing Company Reporting Election. At the time of application for certification, an
-employee-leasing company shall elect to report and pay unemployment insurance taxes under its
-own account or under the respective work-site employer’s account.
-16.2.3 Effect of Agency Relationship Upon Status as Employee Leasing Company. - If an entity, or
-any portion of its business, meets the requirements under section 8-70-114 (2) C.R.S., that entity
-shall be determined to be an employee leasing company and not an agent, for the purposes of
-section 8-70-114 C.R.S.
-16.3
-
-PROVISION OF BOND OR OTHER SECURITY.
-
-16.3.1 Statutory Reference: 8-70-114 (2)(g)(III), C.R.S.
-16.3.2 Holding a Deposit of Money or Security. Any deposit of money or securities in accordance with
-section 8-70-114 (2)(g)(III)(A) C.R.S. shall be retained by the division in an escrow account until
-liability under section 8-70-114 C.R.S. is terminated, at which time it shall be returned to the
-organization, less any deductions pursuant to regulation 16.3.3.
-16.3.3 Deduction From a Deposit Of Money or Security. The division may deduct from the money
-deposited by an employee-leasing company pursuant to rule 16.3.2 or sell the securities an
-employee-leasing company has so deposited to the extent necessary to satisfy any due and
-unpaid premiums and any applicable interest and penalties.
-16.4
-
-QUALIFIED ASSURANCE ORGANIZATION
-
-16.4.1 Statutory Reference: 8-70-114 (2)(g)(III)
-16.4.2 Application to be an Approved Assurance Organization. Any assurance organization seeking
-to be an approved, qualified assurance organization in accordance with 8-70-114 (2)(g)(III)(C),
-C.R.S., shall make application with the division using such filing methods as may be prescribed
-by the division. Such application shall include evidence of securitization of unemployment
-premiums as set forth in 8-70-114 (2)(g)(III), C.R.S.
-16.4.3 Assurance-Organization Approval. Upon approval, each assurance organization shall receive
-written notification from the division director. Such approval shall be valid for three years unless
-the assurance organization fails to comply with any provision of the law.
-16.4.4 Subsequent Approval. An approved assurance organization shall make subsequent application
-with the division at least ninety days prior to the expiration date specified in the written approval
-notice.
-
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-Division of Unemployment Insurance
-
-PART XVII
-17.1
-
-7 CCR 1101-2
-
-WORKER CLASSIFICATION
-
-CLASSIFICATION GUIDANCE AND CLARIFICATION
-
-17.1.1 Statutory Reference: 8-70-115, C.R.S.
-17.1.2 Factors to Consider. In determining whether a worker is an employee or independent
-contractor, the Deputy, Hearing Officer, or Panel considers the nine factors enumerated under §
-8-70-115, C.R.S., as well as any other relevant factors, including but not limited to:
-.1
-
-The relationship between the company for whom services are performed and the worker.
-
-.2
-
-The totality of the circumstances of the relationship between the company for whom
-services are performed and the worker.
-
-.3
-
-The degree of direction and control exercised by the company over the worker
-performing the service, except the division will not consider direction and control
-exercised pursuant to the requirements of any state or federal statute or regulation.
-
-17.1.3 Customarily Engaged in an Independent Trade, Occupation, Profession, or Business.
-Whether a worker is customarily engaged in an independent trade, occupation, profession or
-business is dependent upon whether the worker engages in a business that is separate and
-distinct from the company for whom services are performed. Whether a worker could or does
-perform services for multiple businesses may be considered in the Division’s determination
-regarding the worker as an employee or an independent contractor, but it is not solely dispositive
-in that determination.
-In reaching its determination, the Division considers each working relationship individually. The
-Division does not rely on any single factor, but rather the totality of the circumstances and all
-relevant factors in accordance with applicable law. While these factors may represent
-consideration as to the status of the working relationship, the circumstances differ from case to
-case and additional factors not listed may be considered. No single set of factors is exclusive.
-When determining whether an employment relationship exists under the Colorado Employment
-Security Act, the Division considers factors, which may include but are not limited to:
-.1
-
-The date the worker’s business started and whether the company required the worker to
-start the business in order to perform services for the company.
-
-.2
-
-If the worker markets his or her own business and the means used for marketing.
-
-.3
-
-If the worker has a business that is viable beyond the scope of the agreement between
-the worker and the company for whom the services are currently being performed,
-including whether:
-.1
-
-The worker is economically independent from or is substantially dependent upon
-continued work with the company for whom services are performed.
-
-.2
-
-There is a permanent or continuous working relationship between the worker and
-the company, and any industry-specific conditions relevant to the permanency.
-
-.4
-
-If the worker has a business investment such that there is a risk of suffering a loss on the
-project.
-
-.5
-
-If the company for whom services are performed provides tools to the worker, except as
-allowed by 8-70-115 (1)(c)(VI), while on the project.
-
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-
-7 CCR 1101-2
-
-.6
-
-If the rate and method of payment is negotiated by the parties, is established by the
-worker, is established by the company for whom services are performed, or is
-established as part of a contract awarded through a bidding process.
-
-.7
-
-If the worker may employ or does employ others to complete the work.
-
-.8
-
-If the worker carries his or her own liability insurance, as well as other types of insurance
-relevant to sustaining the worker’s business.
-
-.9
-
-The number of hours per week that the worker performs services for the company.
-
-.10
-
-If the worker seeks other work for the worker’s own business in the same field as he or
-she performs for the company.
-
-.11
-
-If the worker has the ability to accept or reject work being offered.
-
-.12
-
-If the service provided by the worker is an integral part of the company’s business.
-
-17.1.4 Worker-Business Relationship.
-.1
-
-The evidence and circumstances must demonstrate that the worker in question is an
-independent contractor.
-
-.2
-
-A worker could still be determined to be in covered employment, even if the worker signs
-a contract or an agreement, if the facts of the relationship establish that an employment
-relationship exists.
-
-.3
-
-The existence of an agreement between the worker and the company for the workers’
-compensation coverage is not determinative of the worker-business relationship for
-unemployment insurance purposes.
-
-17.1.5 Burden of Proof. The company for whom services are performed has the burden of establishing,
-by a preponderance of the evidence, that a worker is, in fact, free from control and direction in the
-performance of the work and is customarily engaged in an independent trade, occupation, or
-profession related to that work. A written document may establish a rebuttable presumption of
-independent contractor status only if it includes the applicable factors set forth in § 8-70-115
-(1)(c), C.R.S., and the disclosure set forth in § 8-70-115 (2), C.R.S. While an agreement that
-meets the requirements of § 8-70-115 (1) (c) may shift the burden of proof to the worker or the
-Division, such an agreement is not, in itself, conclusive of whether the worker is, in fact, an
-employee or an independent contractor.
-17.1.6 Compliance Assistance. A business may request that the Division provide educational
-information as it relates to proper worker classification. A business has further opportunity to
-request a nonbinding advisory opinion in accordance with Regulation 17.2.
-17.1.7. Industry-Specific Guidelines. The Division may adopt industry-specific guidance in collaboration
-with industry representatives to address unique factors and situations in that industry. When
-applicable, the Division considers such guidance, in addition to the applicable law and the
-regulations in this Part XVII when determining whether an individual is an employee or an
-independent contractor.
-
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-
-17.2
-
-7 CCR 1101-2
-
-NONBINDING ADVISORY OPINION
-
-17.2.1 Statutory Reference: 8-72-114 (4), C.R.S.
-17.2.2 Issuance of Advisory Opinion. An advisory opinion, described in 8-72-114 (4)(a), C.R.S., shall
-be issued only if:
-.1
-
-The employer completes and submits a request for a written advisory opinion using such
-filing methods as may be prescribed by the division; and
-
-.2
-
-Upon submitting the request for a written advisory opinion, the employer must submit a
-nonrefundable fee of $100; and
-
-.3
-
-In conjunction with the request, as solicited by the division, the employer must provide
-information and evidence as described in 8-70-115, C.R.S.
-
-17.2.3 The Director shall not use an advisory opinion previously issued pursuant to section 8-72-114 (4),
-C.R.S. for the purposes of initiating an unemployment insurance audit.
-17.3
-
-WORKER CLASSIFICATION INVESTIGATIONS AND FINES
-
-17.3.1 Statutory Reference: 8-72-114 (3), C.R.S.
-17.3.2 Written Order. Upon conclusion of a requested investigation of misclassification, the division
-shall issue a written order in conjunction with an audit report including any determination of the
-existence of an employment relationship.
-17.3.3 Appeal From Determination. Any employer who wishes to appeal a determination made under
-the provisions of this part XVII of the regulations shall file a notice of appeal with the division. A
-hearing may be obtained in accordance with 8-76- 113, C.R.S., and regulation 11.2.
-17.3.4 The Division, prior to committing department resources to a full audit under the provision of this
-article, shall take into consideration whether the purported acts of misclassification are
-inconsistent with section 8-70-115 (1) (b), C.R.S.
-17.3.5 Fine. As described in 8-72-114 (3)(e)(III), C.R.S., a fine may be imposed on an employer who
-misclassified an employee with willful disregard for the law. Such fine shall be imposed in the
-following manner:
-.1
-
-For the first instance of such misclassification, an employer shall be fined a minimum of
-one hundred dollars or one hundred dollars for each day that an employee was
-misclassified, whichever is greater, but the fine shall not exceed five thousand dollars per
-misclassified employee.
-
-.2
-
-For the second and any subsequent instance of such misclassification, an employer shall
-be fined a minimum of one thousand dollars or five hundred dollars for each day that an
-employee was misclassified, whichever is greater, but the fine shall not exceed twentyfive thousand dollars per misclassified employee.
-
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-Division of Unemployment Insurance
-
-PART XVIII
-18.1
-
-7 CCR 1101-2
-
-SPECIAL PROGRAMS
-
-WORK SHARE
-
-18.1.1 STATUTORY REFERENCE: 8-75-203, C.R.S.
-18.1.2 criteria for work share plan
-.1
-
-The director shall deny a work share plan if the employer has seasonal status with the
-division and any portion of the work share period is during the employer’s off-season.
-
-.2
-
-The provisions of section 8-75-203 (1)(b)(i) notwithstanding, the division, at its discretion
-during an economic crisis or declared state of emergency, may accept a work share plan
-submitted by a negative excess employer.
-
-.3
-
-an employer who has been approved for a workshare plan must reduce hours and
-earnings for the employees identified on the work share plan by at least ten percent and
-no more than 50 percent of the employees' regular work hours. any reduction in pay
-under this section must be proportional to the reduction in hours."
-
-18.1.3.1
-work share plan modification an employer can submit a plan modification for a maximum
-of one new modification every 7 days or no earlier than 7 days after the submission of a plan or
-plan modification
-18.1.4 Work Share Plan Revocation. The director may revoke approval of a work share plan for good
-cause. A decision of revocation is final and the employer’s re-enrollment is subject to a waiting
-period pursuant to 18.1.4.1. The revocation order shall be in writing and shall specify the date the
-revocation is effective and the reasons. Good cause shall include, but not be limited to, violation
-of any criteria upon which approval of the plan was based, unreasonable revision of productivity
-standards for the affected unit, or other conduct by the employer that may compromise the
-purpose, intent, and effective operation of the plan.
-18.1.4.1
-Waiting Period After Revocation. An employer that has had a Workshare plan
-revoked for an affected unit under an approved Workshare plan may not reapply for a
-new Workshare plan for the affected unit or any employee included in that affected unit
-for a period of six weeks from the effective date of such revocation.
-18.1.4.2
-Early Termination of Workshare Plan. An employer that terminates a
-Workshare plan for any employment unit under an approved Workshare plan shall not be
-eligible to reapply for a new Workshare plan for the affected unit or to include any
-employee of that unit for a period of six weeks following the Division’s receipt of the
-employers notice of intent to terminate the Workshare plan.
-18.1.6 Employee Eligibility Under The Work Share Plan
-.1
-
-An individual who has received all of the work share benefits and regular unemployment
-compensation benefits available to him or her in a benefit year is an exhaustee for
-purposes of 8-75-101 C.R.S. and is entitled to receive extended benefits under such
-sections, provided the claimant is otherwise eligible for such benefits.
-
-.2
-
-If an individual who is eligible to receive work share benefits has a prior overpayment,
-which is still outstanding, the director shall offset such overpayment from work share
-benefits in accordance with 8-81-101 C.R.S
-
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-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-.3
-
-If an individual who is eligible to receive work share benefits has been identified as
-having outstanding child support obligations, the director shall reduce the work share
-benefits in accordance with 8-73-102 C.R.S.
-
-.4
-
-Wages earned from other part-time work will not reduce benefits and are not reportable.
-
-.5
-
-No individual shall be eligible to receive a work share benefit payment for a given week if
-their work hours in that week are such that their overall reduction in hours from normal
-would be less than ten percent. In no case shall an individual be eligible to receive a work
-share benefit payment for a week if their hours of work in that week exceeds thirty-six.
-
-18.1.7 Work Share Program Administration. The administration of the work share program shall be as
-follows:
-.1
-
-A work share plan shall be effective on the date it is approved by the director or the first
-week specified by the employer, whichever is later.
-
-.2
-
-A work share plan shall expire twelve months or less after the effective date of the plan.
-
-.3
-
-An employer’s chargeability under a work share plan is subject to the provisions of 8-73108 (3)(e)(i) C.R.S.
-
-.4
-
-An individual who does not work during a week for the work share employer and who is
-otherwise eligible for benefits shall be paid regular unemployment benefits and the week
-shall not be counted as a week for which work share benefits were received.
-
-PART XIX
-19.1
-
-OPERATIONS DURING OTHER THAN NORMAL CONDITIONS
-
-ECONOMIC CRISIS OR DECLARED STATE OF EMERGENCY
-
-19.1.2 Statutory References. 8-70-102, 8-72-109 (1)(A), 8-72-109(2), AND 8-74-101, C.R.S.
-19.1.3 Definitions.
-.1
-
-Executive Orders. The president or the governor or both may use executive orders to
-trigger emergency powers during natural disasters, energy crises, and other emergency
-situations requiring immediate attention.
-
-.2
-
-Emergency Declarations. The president or the governor or both may declare an
-emergency in anticipation of or in the event of a natural or man-made disaster; an
-epidemic, pandemic, or other health emergency; or other emergency situation.
-
-19.1.4 Actions. Notwithstanding other sections of colorado law that may require otherwise, this part XIX
-shall be implemented at the discretion of the division director in accordance with federal law
-allowances or at the direction of the governor pursuant to an executive order or in the event of a
-declared state of emergency as described in section 19.1.3, with the direction being consistent
-with federal law, the division may:
-1
-
-Waive the waiting week as described in regulation 2.8.6.
-
-2
-
-Expand the definition of when an individual is able to work as described by regulation
-2.8.2 to comply with orders of an emergency declaration as described in this section
-19.1.3.
-
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-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-3
-
-Expand the definition of when an individual is available to work as described by
-regulation 2.8.3 to comply with orders of an emergency declaration as described in this
-section 19.1.3.
-
-4
-
-Waive, modify, or broaden the work-search requirement as described in 2.8.4.
-
-5
-
-Require that a claimant register for work with the online job database as described by
-regulation 2.1.2 and 13.1.4 when the work-search requirement is waived.
-
-6
-
-Extend the period of job attachment as described by regulation 2.4 to a period no longer
-than the closure required by the crisis or emergency order or declaration.
-
-7
-
-Waive any charges to an employer’s account and experience rate; instead, charge the
-unemployment insurance compensation fund or another fund established for the purpose
-of paying benefits for the period of the crisis or emergency.
-
-8
-
-Extend reporting deadlines for employer’s quarterly reports and premium payments when
-businesses are unable to meet those because:
-1
-
-A declared emergency, as described in this section 19.1.3, caused the employer
-to close their place of business or severely curtail operations.
-
-2
-
-The employer or an immediate family member received a request from a medical
-professional, local official, or state department to be isolated or quarantined or
-relocated because of a declared emergency as described in this section 19.1.3.
-
-9
-
-Require a claimant or an employer to submit reports or other correspondence in a
-preferred manner as dictated by the nature of the crisis or emergency.
-
-10
-
-Extend the protest period for employer’s quarterly statement of benefits charged as
-described by regulation 11.1.3.
-
-11
-
-Extend the protest period for employer’s notice of premium rate as described by
-regulation 11.1.4
-
-12
-
-Extend the protest period for employer’s quarterly bill for benefits charged as described
-by regulation 11.1.7.
-
-_________________________________________________________________________
-Editor’s Notes
-History
-Rules 1.2, 1.3, 1.9, 2.1., 7.2, 8, 10.1, 11.1, 11.2.13, 11.2.15, 12.1, 16 eff. 02/01/2009.
-Rule 16.1.4 emer. rule eff. 02/06/2009; expired 05/06/2009.
-Rules 2.4.5(.1), 2.8.4, 2.8.4(.8) emer. rules eff. 05/29/2009.
-Rules 2.4.5(.1), 2.8.4, 2.8.4(.8) emer. rules eff. 08/27/2009.
-Rule 2.2.2 eff. 08/30/2009.
-Rules 1.2.19-1.2.20, 1.3.22, 1.7.5, 2.4.5.1, 2.8.4, 2.8.4.8, 16.2.2, XVII eff. 10/30/2009.
-Rules 1.2.19-1.2.20, 1.6, 1.11, VI, 7.2, VIII, XI, XII, XVI eff. 12/30/2009.
-Rules 2.6; IV; 11.2.2 emer. rules eff. 12/31/2009; expired 03/31/2010.
-Rules 2.6; IV; 11.2.2 emer. rules eff. 04/02/2010.
-Rules 1.2.21-1.2.22; 2.6, IV, 11.2.2, 17.1.4-17.1.5 eff. 05/31/2010.
-
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-Division of Unemployment Insurance
-
-7 CCR 1101-2
-
-Rules 1.3.23-1.3.30; Part XVIII emer. rules eff. 06/09/2010.
-Rules 1.3.23-1.3.30; Part XVIII eff. 09/30/2010.
-Rules 1.3.31, 2.1.12, 6.1.7 emer. rules eff. 11/30/2010.
-Rules 1.3.31, 1.8, 2.1.12, 6.1.2, 6.1.7, 7.2.4, 15.2.2 eff. 03/31/2011.
-Rules 1.2.23, 2.8.4 eff. 01/01/2012.
-Rules 6.1.2, 7.2.4 emer. rules eff. 01/25/2012; expired 05/24/2012.
-Rules 1.2.24, 1.2.25, 7.2.6, 7.2.8, 7.2.11, 11.2.9, 11.2.14, 11.2.15, 12.1.3, 12.1.7, 12.1.8, 17 eff.
-04/01/2012.
-Rules 1.2.26, 6.1.2, 7.2.4 eff. 05/30/2012.
-Rules 1.2.27, 1.3.10-1.3.26, 6.1.2, 6.1.5, 7.2.5, 16.2.2, 18.1 eff. 07/30/2012.
-Rules 1.2.23-1.2.24, 1.2.26, 1.2.28, 1.3.2, 2.6.4, 6.1.7 eff. 09/14/2012.
-Rules 1.2.29, 2.9, 4.1.2, 11.1, 11.2.9, 11.2.15 eff. 05/15/2013. Rules 1.7.5, 15.2.7.7 repealed eff.
-05/15/2013.
-Rules 4.2, 15.2.7.7 eff. 08/01/2014.
-Rule 2.8.4.4 a emer. rule eff. 01/19/2016.
-Rule 2.8.4.4 a eff. 05/15/2016.
-Rule 2.6.5 emer. rule eff. 09/01/2016.
-Rules 2.1.10-2.1.11, 2.3.2-2.3.4, 2.6.1, 2.6.5 eff. 12/15/2016. Rule 2.6.4 repealed eff. 12/15/2016.
-Rules 17.1, 17.3 emer. rules eff. 01/09/2017; expired 05/09/2017.
-Part XVII eff. 07/01/2017.
-Rules 11.2.13, 12.1.3-12.1.6 emer. rules eff. 09/05/2017; expired 12/12/2017.
-Rules 11.2.13, 12.1.3-12.1.7 eff. 12/30/2017.
-Rule 2.8.4 eff. 06/03/2018.
-Rules 2.1.10, 7.2.4, 7.2.5, 7.4, 12.1.7, 12.1.8 eff. 09/14/2018.
-Rules 2.3.2.1, 2.3.2.2, 2.9.3, 15.3 emer. rules eff. 01/17/2019; expired 05/17/2019.
-Rules 11.2.9, 11.2.13, 12.1.3 eff. 04/15/2019.
-Rules 2.1.7.5, 2.4.5.2, 2.8.4.12, 2.8.5, 4.3, 6.1.2.2, 7.2.4.2 emer. rules eff. 03/20/2020.
-Rules 1.9, 7.2.6, 11.2.4, 11.2.9, 11.2.13, 12.1.7, 13.2.9.6 eff. 04/14/2020. Rules 2.1.6.1, 7.2.12, 7.3.6,
-18.1.1, 18.1.2.2, 18.1.3, 18.1.7.2-.3,.5 emer. rules eff. 04/14/2020; expired 08/12/2020.
-Rule 4.3.2 emer. rule eff. 04/27/2020.
-Rules 4.3.2.1.4, 4.4.1-4.4.3.2.2 emer. rules eff. 05/06/2020; expired 09/03/2020.
-Rule 18.1.7 emer. rule eff. 05/08/2020.
-Rules 2.1.7.5, 2.4.5.2, 2.8.4.12, 2.8.4.13, 2.8.6, 4.3, 4.3.1.2, 4.3.1.3, 6.1.2.2, 7.2.4.2 emer. rules eff.
-06/03/2020; expired 10/01/2020.
-Rules 18.1.1, 18.1.2, 18.1.3.1, 18.1.6.4-.6, 18.1.7.2-.3 emer. rules eff. 09/15/2020.
-Rules 2.8.6, 7.3.2, 7.4.2.3, Part XIX eff. 10/30/2020. Rule 2.8.4.11 repealed eff. 10/30/2020.
-Rules 18.1.1, 18.1.2, 18.1.3.1, 18.1.6.4-.6, 18.1.7.2-.3 emer. rules eff. 01/05/2021; expired 05/05/2021.
-Rules 1.3.27, 2.10 emer. rules eff. 05/04/2021; expired 09/01/2021.
-Rules 2.8.4.13, 18.1.1, 18.1.2, 18.1.3.1, 18.1.6.4-.6, 18.1.7.2-.3, 19.1.4.4, 19.1.4.10-.12 eff. 06/30/2021.
-Rules 2.1.7, 2.1.10.2, 2.3.2, 6.2.2, 6.2.3, 7.2.4-7.2.6, 7.2.11, 13.2.9.5, 15.1, 15.2, 18.1.2.3, 18.1.3.1,
-18.1.7 eff. 10/01/2023. Rules 15.2.7, 18.1.6.6 repealed eff. 10/01/2023.
-Rules 4.2.2, 4.2.3, 7.2.4, 7.2.6, 7.2.9, 7.4.3, 15.0-15.02, 15.3-15.3.5, 18.1.4, 18.1.4.1, 18.1.4.2 eff.
-09/30/2024. Rule 18.1.5 repealed eff. 09/30/2024.
-Rules 2.1.1-2.1.3.3.2 emer. rules eff. 01/25/2025.
-
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-DEPARTMENT OF HUMAN SERVICES
-Child Support Services
-RULE MANUAL VOLUME 6, CHILD SUPPORT SERVICES RULES
-9 CCR 2504-1
-[Editor’s Notes follow the text of the rules at the end of this CCR Document.]
-
-_______________________________________________________________________________
-STATEMENT OF BASIS AND PURPOSE, AND, SPECIFIC STATUTORY AUTHORITY OF REVISIONS
-MADE TO THE CHILD SUPPORT SERVICES STAFF MANUAL
-A rewrite of staff manual Volume 6, (Child Support Enforcement) was finally adopted at the 11/1/85 State
-Board meeting, with an effective date of 1/1/86. Statement of Basis and Purpose, Fiscal Impact, and
-specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Office of the State
-Board Administrator, Department of Social Services.
-Revisions to section 6.201.2 - 6.210.4 were finally adopted following publication at the 9/11/87 State
-Board meeting, with an effective date of 11/1/87 (Document 17). Statement of Basis and Purpose, Fiscal
-Impact, and specific statutory authority for these revisions were incorporated by reference into the rule.
-These materials are available for review by the public during normal working hours at the Office of the
-State Board Administrator, Department of Social Services.
-Revisions to section 6.201.2 were finally adopted following publication at the 12/4/87 State Board
-meeting, with an effective date of 2/1/88 (Document 3). Statement of Basis and Purpose, Fiscal Impact,
-and specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Office of the State
-Board Administrator, Department of Social Services.
-Revisions to sections 6.200 - 6.201 were finally adopted following publication at the 1/8/88 State Board
-meeting, with an effective date of 3/1/88 (Document 5). Statement of Basis and Purpose, Fiscal Impact,
-and specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Office of the State
-Board Administrator, Department of Social Services.
-Revisions to sections 6.101 - 6.102 and 6.240 - 6.260 were emergency adopted at the 7/8/88 State Board
-meeting, with an effective date of 8/22/88 (CSPR# 88-4-25-1). Statement of Basis and Purpose and
-specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Office of the State
-Board Liaison, Department of Social Services.
-Revisions to sections 6.101 - 6.102 and 6.240 - 6.260 were finally adopted emergency at the 8/5/88 State
-Board meeting, with an effective date of 8/22/88 (CSPR# 88-4-25-1). Statement of Basis and Purpose
-and specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Office of the State
-Board Liaison, Department of Social Services.
-
-1
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-Revisions to sections 6.000 - 6.002, 6.200 - 6.210, and 6.260 - 6.270 were emergency adopted at the
-9/9/88 State Board meeting, with an effective date of 10/1/88 (CSPR# 88-6-7-1). Statement of Basis and
-Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.
-These materials are available for review by the public during normal working hours at the Office of the
-State Board Liaison, Department of Social Services.
-Revisions to sections 6.000 - 6.002, 6.200 - 6.210, and 6.260 - 6.270 were final adoption of emergency at
-the 10/7/88 State Board meeting, with an effective date of 10/1/88 (CSPR# 88-6-7-1). Statement of Basis
-and Purpose and specific statutory authority for these revisions were incorporated by reference into the
-rule. These materials are available for review by the public during normal working hours at the Office of
-the State Board Liaison, Department of Social Services.
-Revisions to sections 6.700 - 6.802 and 6.803 - 6.902 were finally adopted following publication at the
-10/7/88 State Board meeting, with an effective date of 12/1/88 (CSPR# 88-8-12-3). Statement of Basis
-and Purpose and specific statutory authority for these revisions were incorporated by reference into the
-rule. These materials are available for review by the public during normal working hours at the Office of
-the State Board Liaison, Department of Social Services.
-Revisions to sections 6.000 - 6.002, 6.201 - 6.210, and 6.260 - 6.270 were finally adopted following
-publication at the 11/4/88 State Board meeting, with an effective date of 1/1/89 (CSPR#'s 88-6-28-3, and
-88-8-17-1). Statement of Basis and Purpose and specific statutory authority for these revisions were
-incorporated by reference into the rule. These materials are available for review by the public during
-normal working hours at the Office of the State Board Liaison, Department of Social Services.
-Revisions to sections 6.100 - 6.102, 6.260 - 6.300, 6.500 - 6.600 and 6.804 - 6.805 were finally adopted
-following publication at the 2/3/89 State Board meeting, with an effective date of 4/1/89 (CSPR#'s 88-830-1, 88-10-6-1 and 88-10-14-1). Statement of Basis and Purpose and specific statutory authority for
-these revisions were incorporated by reference into the rule. These materials are available for review by
-the public during normal working hours at the Office of the State Board Liaison, Department of Social
-Services.
-Revisions to sections 6.000, 6.102, 6.200 - 6.201, 6.240 - 6.270, 6.400, 6.700 - 6.802, 6.803 - 6.804 and
-6.805 - 6.902 were finally adopted following publication at the 3/3/89 State Board meeting, with an
-effective date of 5/1/89 (CSPR#'s 88-9-13-1, 88-11-18-1 and 88-11-18-2). Statement of Basis and
-Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.
-These materials are available for review by the public during normal working hours at the Office of the
-State Board Liaison, Department of Social Services.
-Revisions to sections 6.260 - 6.270 were emergency adopted at the 4/7/89 State Board meeting, with an
-effective date of 5/1/89 (CSPR# 88-10-25-1). Statement of Basis and Purpose and specific statutory
-authority for these revisions were incorporated by reference into the rule. These materials are available
-for review by the public during normal working hours at the Office of the State Board Liaison, Department
-of Social Services.
-Revisions to sections 6.260 - 6.270 were final adoption of emergency at the 5/5/89 State Board meeting,
-with an effective date of 5/1/89 (CSPR# 88-10-25-1). Statement of Basis and Purpose and specific
-statutory authority for these revisions were incorporated by reference into the rule. These materials are
-available for review by the public during normal working hours at the Office of the State Board Liaison,
-Department of Social Services.
-Revisions and additions to sections 6.000 - 6.002, 6.201 - 6.210, and 6.260 were finally adopted following
-publication at the 6/2/89 State Board meeting, with an effective date of 8/1/89 (CSPR# 89-3-13-1).
-Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by
-reference into the rule. These materials are available for review by the public during normal working hours
-at the Office of the State Board Liaison, Department of Social Services.
-
-2
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-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-Revisions to sections 6.120 - 6.140 and 6.805 - 6.902 were finally adopted following publication at the
-7/7/89 State Board meeting, with an effective date of 9/1/89 (CSPR#'s 89-1-11-1 and 89-2-17-1).
-Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by
-reference into the rule. These materials are available for review by the public during normal working hours
-at the Office of the State Board Liaison, Department of Social Services.
-Revisions to section 6.200 - 6.201.2 were finally adopted following publication at the 8/4/89 State Board
-meeting, with an effective date of 10/1/89 (CSPR# 89-5-17-1). Statement of Basis and Purpose and
-specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Office of the State
-Board Liaison, Department of Social Services.
-Revisions to sections 6.100 - 6.102, 6.803 - 6.804, and 6.900 - 6.902 were adopted emergency at the
-8/4/89 State Board meeting, with an effective date of 8/4/89 (CSPR# 89-6-9-1). Statement of Basis and
-Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.
-These materials are available for review by the public during normal working hours at the Office of the
-State Board Liaison, Department of Social Services.
-Revisions to sections 6.100 - 6.102, 6.803 - 6.804, and 6.900 - 6.902 were final adoption of emergency at
-the 9/8/89 State Board meeting, with an effective date of 8/4/89 (CSPR# 89-6-9-1). Statement of Basis
-and Purpose and specific statutory authority for these revisions were incorporated by reference into the
-rule. These materials are available for review by the public during normal working hours at the Office of
-the State Board Liaison, Department of Social Services.
-Addition of sections 6.701 through 6.715.3 were final adoption following publication at the 2/2/90 State
-Board meeting, with an effective date of 4/1/90 (CSPR# 89-9-25-1). Statement of Basis and Purpose and
-specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Office of the State
-Board Liaison, Department of Social Services.
-Revisions to sections 6.000 - 6.002 and 6.250 - 6.260 were adopted emergency at the 6/1/90 State Board
-meeting, with an effective date of 6/1/90 (CSPR# 90-5-15-1). Statement of Basis and Purpose and
-specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Office of the State
-Board Liaison, Department of Social Services.
-Revisions to sections 6.000 - 6.002 and 6.250 - 6.260 were final adoption of emergency at the 7/6/90
-State Board meeting, with an effective date of 6/1/90 (CSPR# 90-5-15-1). Statement of Basis and
-Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.
-These materials are available for review by the public during normal working hours at the Office of the
-State Board Liaison, Department of Social Services.
-Revisions to sections 6.701 - 6.715 and 6.804 - 6.805 were adopted emergency at the 7/6/90 State Board
-meeting, with an effective date of 7/6/90 (CSPR#'s 90-6-4-1a and 90-6-6-1). Statement of Basis and
-Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.
-These materials are available for review by the public during normal working hours at the Office of the
-State Board Liaison, Department of Social Services.
-Revisions to sections 6.000 - 6.101, 6.120 - 6.130, 6.200 - 6.201, 6.240 - 6.260, 6.270 - 6.300, 6.400 6.700, 6.800 - 6.803, and 6.804 - 6.902 were final adoption following publication at the 8/3/90 State Board
-meeting, with an effective date of 10/1/90 (CSPR#'s 90-3-15-2, 90-3-20-2, and 90-3-23-1). Statement of
-Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into
-the rule. These materials are available for review by the public during normal working hours at the Office
-of the State Board Liaison, Department of Social Services.
-
-3
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-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-Revisions to sections 6.701 - 6.715 and 6.804 - 6.805 were adopted emergency and final at the 8/3/90
-State Board meeting, with an effectives date of 7/6/90 and 8/3/90 (CSPR#'s 90-6-4-1a and 90-6-6-1).
-Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by
-reference into the rule. These materials are available for review by the public during normal working hours
-at the Office of the State Board Liaison, Department of Social Services.
-Revisions to sections 6.201, 6.260, and 6.600 - 6.700 were adopted emergency at the 10/5/90 State
-Board meeting, with an effective date of 10/5/90 (CSPR#'s 90-6-27-1 and 90-8-13-1). Statement of Basis
-and Purpose and specific statutory authority for these revisions were incorporated by reference into the
-rule. These materials are available for review by the public during normal working hours at the Office of
-the State Board Liaison, Department of Social Services.
-Revisions to sections 6.201 and 6.600 - 6.700 were final adoption of emergency at the 11/2/90 State
-Board meeting, with an effective date of 10/5/90 (CSPR# 90-6-27-1). Revisions to section 6.260 were
-adopted emergency and final at the 11/2/90 State Board meeting, with effective dates of 10/5/90 and
-11/2/90 (CSPR# 90-8-13-1).Statement of Basis and Purpose and specific statutory authority for these
-revisions were incorporated by reference into the rule. These materials are available for review by the
-public during normal working hours at the Office of the State Board Liaison, Department of Social
-Services.
-Revisions to section 6.260 were adopted emergency at the 1/4/91 State Board meeting, with an effective
-date of 1/4/91 (CSPR# 90-11-29-1). Statement of Basis and Purpose and specific statutory authority for
-these revisions were incorporated by reference into the rule. These materials are available for review by
-the public during normal working hours at the Office of the State Board Liaison, Department of Social
-Services.
-Revisions to section 6.260 were final adoption of emergency at the 2/1/91 State Board meeting, with an
-effective date of 1/4/91 (CSPR# 90-11-29-1). Statement of Basis and Purpose and specific statutory
-authority for these revisions were incorporated by reference into the rule. These materials are available
-for review by the public during normal working hours at the Office of the State Board Liaison, Department
-of Social Services.
-Revisions to sections 6.120 through 6.140 and 6.270 through 6.300 were final adoption following
-publication at the 2/1/91 State Board meeting, with an effective date of 4/1/91 (CSPR# 90-11-9-1).
-Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by
-reference into the rule. These materials are available for review by the public during normal working hours
-at the Office of the State Board Liaison, Department of Social Services.
-Revisions to sections 6.260, 6.701 - 6.707, 6.710 - 6.711, and 6.713 - 6.715 were final adoption following
-publication at the 5/3/91 State Board meeting, with an effective date of 7/1/91 (CSPR# 91-1-22-1).
-Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by
-reference into the rule. These materials are available for review by the public during normal working hours
-at the Office of the State Board Liaison, Department of Social Services.
-Revisions to sections 6.102 through 6.110 were final adoption following publication at the 8/2/91 State
-Board meeting, with an effective date of 10/1/91 (CSPR# 91-4-23-2). Statement of Basis and Purpose
-and specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Office of the State
-Board Liaison, Department of Social Services.
-Revisions to sections 6.000 - 6.102, 6.803 and 6.805 were adopted emergency at the 1/10/92 State
-Board meeting, with an effective date of 1/10/92 (CSPR# 91-12-4-1). Statement of Basis and Purpose
-and specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Office of the State
-Board Liaison, Department of Social Services.
-
-4
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-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-Revisions to sections 6.120 - 6.140 and 6.270 - 6.300 were final adoption following publication at the
-1/10/92 State Board meeting, with an effective date of 3/1/92 (CSPR#'s 91-7-10-2, and 91-10-7-1).
-Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by
-reference into the rule. These materials are available for review by the public during normal working hours
-at the Office of the State Board Liaison, Department of Social Services.
-Revisions to sections 6.000 - 6.102, 6.803 and 6.805 were adopted emergency and final at the 1/10/92
-State Board meeting, with effective dates of 1/10/92 and 2/7/92 (CSPR# 91-12-4-1). Statement of Basis
-and Purpose and specific statutory authority for these revisions were incorporated by reference into the
-rule. These materials are available for review by the public during normal working hours at the Office of
-the State Board Liaison, Department of Social Services.
-Revisions to sections 6.600 through 6.603 and 6.711 through 6.715 were adopted emergency at the
-7/10/92 State Board meeting, with an effective date of 8/1/92 (CSPR# 92-5-28-1). Statement of Basis and
-Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.
-These materials are available for review by the public during normal working hours at the Office of the
-State Board Liaison, Department of Social Services.
-Revisions to sections 6.600 through 6.603 and 6.711 through 6.715 were final adoption of emergency at
-the 8/7/92 State Board meeting, with an effective date of 8/1/92 (CSPR# 92-5-28-1). Statement of Basis
-and Purpose and specific statutory authority for these revisions were incorporated by reference into the
-rule. These materials are available for review by the public during normal working hours at the Office of
-the State Board Liaison, Department of Social Services.
-Revisions to sections 6.002, 6.102, 6.200 - 6.201, 6.230, 6.260, 6.400 - 6.706, 6.800 - 6.803, 6.804,
-6.805 and 6.903 were final adoption following publication at the 8/7/92 State Board meeting, with an
-effective date of 10/1/92 (CSPR# 91-12-3-1). Statement of Basis and Purpose and specific statutory
-authority for these revisions were incorporated by reference into the rule. These materials are available
-for review by the public during normal working hours at the Office of the State Board Liaison, Department
-of Social Services.
-Revisions to sections 6.710 - 6.711, 6.713 - 6.715, 6.804, and 6.805 were adopted emergency at the
-8/7/92 State Board meeting, with effective dates of 8/1/92 and 8/7/92 (CSPR#'s 92-6-12-1 and 92-6-171). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated
-by reference into the rule. These materials are available for review by the public during normal working
-hours at the Office of the State Board Liaison, Department of Social Services.
-Revisions to sections 6.710 - 6.711, 6.713 - 6.715, 6.804, and 6.805 were final adoption of emergency at
-the 9/4/92 State Board meeting, with effective dates of 8/1/92 and 8/7/92 (CSPR#'s 92-6-12-1 and 92-617-1, respectively). Statement of Basis and Purpose and specific statutory authority for these revisions
-were incorporated by reference into the rule. These materials are available for review by the public during
-normal working hours at the Office of the State Board Liaison, Department of Social Services.
-Revisions to sections 6.102 and 6.803 were adopted emergency at the 10/2/92 State Board meeting, with
-an effective date of 10/2/92 (CSPR# 92-8-7-1). Statement of Basis and Purpose and specific statutory
-authority for these revisions were incorporated by reference into the rule. These materials are available
-for review by the public during normal working hours at the Office of the State Board Liaison, Department
-of Social Services.
-Revisions to sections 6.102 and 6.803 were final adoption of emergency at the 11/6/92 State Board
-meeting, with an effective date of 10/2/92 (CSPR# 92-8-7-1). Statement of Basis and Purpose and
-specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Office of the State
-Board Liaison, Department of Social Services.
-
-5
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-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-Revisions to sections 6.002, 6.500 - 6.506, 6.710 - 6.711, 6.805, and 6.900 - 6.902 were adopted
-emergency at the 11/6/92 State Board meeting, with an effective date of 11/6/92 (CSPR# 92-9-16-1 and
-92-9-30-1). Statement of Basis and Purpose and specific statutory authority for these revisions were
-incorporated by reference into the rule. These materials are available for review by the public during
-normal working hours at the Office of the State Board Liaison, Department of Social Services.
-Revisions to sections 6.002, 6.500 - 6.506, 6.710 - 6.711, 6.805, and 6.900 - 6.902 were final adoption of
-emergency at the 12/4/92 State Board meeting, with an effective date of 11/6/92 (CSPR# 92-9-16-1 and
-92-9-30-1). Statement of Basis and Purpose and specific statutory authority for these revisions were
-incorporated by reference into the rule. These materials are available for review by the public during
-normal working hours at the Office of the State Board Liaison, Department of Social Services.
-Revisions to section 6.803 were final adoption following publication at the 2/5/93 State Board meeting,
-with an effective date of 4/1/93 (CSPR# 92-11-13-1). Statement of Basis and Purpose and specific
-statutory authority for these revisions were incorporated by reference into the rule. These materials are
-available for review by the public during normal working hours at the Office of the State Board Liaison,
-Department of Social Services.
-Revisions to sections 6.710 - 6.715 and 6.900 - 6.902 were adopted emergency at the 4/2/93 State Board
-meeting, with an effective date of 4/2/93 (CSPR# 93-2-23-2). Statement of Basis and Purpose and
-specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Office of the State
-Board Liaison, Department of Social Services.
-Revisions to sections 6.710 - 6.715 and 6.900 - 6.902 were final adoption of emergency at the 5/7/93
-State Board meeting, with an effective date of 4/2/93 (CSPR# 93-2-23-2). Statement of Basis and
-Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.
-These materials are available for review by the public during normal working hours at the Office of the
-State Board Liaison, Department of Social Services.
-Revisions to sections 6.000 - 6.002, 6.240 - 6.260 and 6.712 - 6.715 were final adoption following
-publication at the 5/7/93 State Board meeting, with an effective date of 7/1/93 (CSPR# 92-12-17-1).
-Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by
-reference into the rule. These materials are available for review by the public during normal working hours
-at the Office of the State Board Liaison, Department of Social Services.
-Revisions to section 6.700 were adopted emergency and final at the 7/9/93 State Board meeting, with an
-effective date of 7/9/93 (CSPR# 93-4-26-1). Statement of Basis and Purpose and specific statutory
-authority for these revisions were incorporated by reference into the rule. These materials are available
-for review by the public during normal working hours at the Office of the State Board Liaison, Department
-of Social Services.
-Revisions to sections 6.110, 6.201, 6.230, and 6.600 - 6.603 were final adoption following publication at
-the 10/1/93 State Board meeting, with an effective date of 12/1/93 (CSPR# 93-7-9-1). Statement of Basis
-and Purpose and specific statutory authority for these revisions were incorporated by reference into the
-rule. These materials are available for review by the public during normal working hours at the Office of
-the State Board Liaison, Department of Social Services.
-Revisions to sections 6.260, 6.701 - 6.702 and 6.711 - 6.715 were final adoption following publication at
-the 12/3/93 State Board meeting, with an effective date of 2/1/94 (CSPR# 93-9-2-1). Statement of Basis
-and Purpose and specific statutory authority for these revisions were incorporated by reference into the
-rule. These materials are available for review by the public during normal working hours at the Office of
-the State Board Liaison, Department of Social Services.
-
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-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-Revisions to section 6.210 were adopted emergency at the 1/7/94 State Board meeting, with an effective
-date of 1/7/94 (CSPR# 93-10-26-2). Statement of Basis and Purpose and specific statutory authority for
-these revisions were incorporated by reference into the rule. These materials are available for review by
-the public during normal working hours at the Office of the State Board Liaison, Department of Social
-Services.
-Revisions to section 6.210 were final adoption of emergency at the 2/4/94 State Board meeting, with an
-effective date of 1/7/94 (CSPR# 93-10-26-2). Statement of Basis and Purpose and specific statutory
-authority for these revisions were incorporated by reference into the rule. These materials are available
-for review by the public during normal working hours at the Office of the State Board Liaison, Department
-of Social Services.
-Revisions to sections 6.205 - 6.207 and 6.240 - 6.260 were final adoption following publication at the
-6/3/94 State Board meeting, with an effective date of 8/1/94 (CSPR# 93-12-28-1). Statement of Basis and
-Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.
-These materials are available for review by the public during normal working hours at the Office of the
-State Board Liaison, Department of Social Services.
-Revisions to sections 6.000 - 6.102, 6.230 - 6.250, 6.261, 6.600 - 6.702, and 6.712 - 6.715 were adopted
-emergency at the 7/8/94 State Board meeting, with an effective date of 7/1/94 (CSPR# 94-5-23-1).
-Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by
-reference into the rule. These materials are available for review by the public during normal working hours
-at the Office of External Affairs, Department of Human Services.
-Revisions to sections 6.000 - 6.102, 6.230 - 6.250, 6.261, 6.600 - 6.702, and 6.712 - 6.715 were final
-adoption of emergency at the 8/5/94 State Board meeting, with an effective date of 7/1/94 (CSPR# 94-523-1). Statement of Basis and Purpose and specific statutory authority for these revisions were
-incorporated by reference into the rule. These materials are available for review by the public during
-normal working hours at the Office of External Affairs, Department of Human Services.
-Revisions to sections 6.000 - 6.002, 6.110 - 6.260, 6.261 - 6.603, 6.707 - 6.715, 6.804 - 6.805, and 6.903
-were final adoption following publication at the 8/5/94 State Board meeting, with an effective date of
-10/1/94 (CSPR# 94-3-3-1). Statement of Basis and Purpose and specific statutory authority for these
-revisions were incorporated by reference into the rule. These materials are available for review by the
-public during normal working hours at the Office of External Affairs, Department of Human Services.
-Revisions to sections 6.230 and 6.261 were final adoption following publication at the 12/2/94 State Board
-meeting, with an effective date of 2/1/95 (CSPR# 94-9-7-2). Statement of Basis and Purpose and specific
-statutory authority for these revisions were incorporated by reference into the rule. These materials are
-available for review by the public during normal working hours at the Office of External Affairs,
-Department of Human Services.
-Revisions to sections 6.002, 6.201, 6.220, 6.600 - 6.700, 6.707 - 6.710, and 6.711 - 6.715 were final
-adoption following publication at the 3/3/95 State Board meeting, with an effective date of 5/1/95 (CSPR#
-94-12-20-1). Statement of Basis and Purpose and specific statutory authority for these revisions were
-incorporated by reference into the rule. These materials are available for review by the public during
-normal working hours at the Office of External Affairs, Department of Human Services.
-Revisions to sections 6.803 and 6.805 were adopted emergency at the 3/3/95 State Board meeting, with
-an effective date of 4/7/95 (CSPR# 95-2-15-1). Statement of Basis and Purpose and specific statutory
-authority for these revisions were incorporated by reference into the rule. These materials are available
-for review by the public during normal working hours at the Office of External Affairs, Department of
-Human Services.
-
-7
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-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-Revisions to sections 6.803 and 6.805 were final adoption of emergency at the 5/5/95 State Board
-meeting, with an effective date of 4/7/95 (CSPR# 95-2-15-1). Statement of Basis and Purpose and
-specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Office of External
-Affairs, Department of Human Services.
-Revisions to sections 6.002 - 6.101, 6.110, 6.201, 6.205, 6.240 - 6.250, 6.261, and 6.701 - 6.715 were
-final adoption following publication at the 5/5/95 State Board meeting, with an effective date of 7/1/95
-(CSPR# 95-2-17-1). Statement of Basis and Purpose and specific statutory authority for these revisions
-were incorporated by reference into the rule. These materials are available for review by the public during
-normal working hours at the Office of External Affairs, Department of Human Services.
-Revisions to sections 6.600 through 6.700 were adopted emergency at the 6/2/95 State Board meeting,
-with an effective date of 6/2/95 (CSPR# 95-4-21-1). Statement of Basis and Purpose and specific
-statutory authority for these revisions were incorporated by reference into the rule. These materials are
-available for review by the public during normal working hours at the Office of External Affairs,
-Department of Human Services.
-Revisions to sections 6.600 through 6.700 were adopted emergency and final at the 7/7/95 State Board
-meeting, with effective dates of 6/2/95 and 7/7/95 (CSPR# 95-4-21-1). Statement of Basis and Purpose
-and specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Office of External
-Affairs, Department of Human Services.
-Revisions to sections 6.002, 6.220, 6.261, 6.707 - 6.711, and 6.712 - 6.715 were final adoption following
-publication at the 10/6/95 State Board meeting, with an effective date of 12/1/95 (CSPR# 95-7-11-2).
-Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by
-reference into the rule. These materials are available for review by the public during normal working hours
-at the Office of External Affairs, Department of Human Services.
-Revisions to sections 6.002, 6.101, 6.700 - 6.702, and 6.802 - 6.803 were final adoption following
-publication at the 11/3/95 State Board meeting, with an effective date of 1/1/96 (CSPR#'s 95-4-12-1 and
-95-8-25-1). Statement of Basis and Purpose and specific statutory authority for these revisions were
-incorporated by reference into the rule. These materials are available for review by the public during
-normal working hours at the Office of External Affairs, Department of Human Services.
-Revisions to sections 6.110 and 6.600 - 6.603 were final adoption following publication at the 12/1/95
-State Board meeting, with an effective date of 2/1/96 (CSPR# 95-9-14-1). Statement of Basis and
-Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.
-These materials are available for review by the public during normal working hours at the Office of
-External Affairs, Department of Human Services.
-Revisions to the Table of Contents and sections 6.002, 6.260, and 6.600 - 6.700 were final adoption
-following publication at the 1/5/96 State Board meeting, with an effective date of 3/1/96 (CSPR# 95-10-51). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated
-by reference into the rule. These materials are available for review by the public during normal working
-hours at the Office of External Affairs, Department of Human Services.
-Revisions to the Table of Contents and sections 6.210 - 6.220 and 6.700 were final adoption following
-publication at the 2/2/96 State Board meeting, with an effective date of 4/1/96 (CSPR#'s 95-9-22-1 and
-95-11-20-1). Statement of Basis and Purpose and specific statutory authority for these revisions were
-incorporated by reference into the rule. These materials are available for review by the public during
-normal working hours at the Office of External Affairs, Department of Human Services.
-
-8
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-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-Revisions to the sections 6.100 - 6.102, 6.210, and 6.805 were final adoption following publication at the
-6/7/96 State Board meeting, with an effective date of 8/1/96 (CSPR# 96-3-20-1). Statement of Basis and
-Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.
-These materials are available for review by the public during normal working hours at the Office of
-External Affairs, Department of Human Services.
-Revisions to the sections 6.002, 6.101 - 6.102, 6.110, 6.201 - 6.205, 6.210 - 6.220, 6.261, 6.700, 6.707 6.715, 6.805, and 6.900 - 6.903 were adopted emergency at the 6/7/96 State Board meeting, with an
-effective date of 7/1/96 (CSPR# 96-5-8-1). Statement of Basis and Purpose and specific statutory
-authority for these revisions were incorporated by reference into the rule. These materials are available
-for review by the public during normal working hours at the Office of External Affairs, Department of
-Human Services.
-Revisions to the sections 6.002, 6.101 - 6.102, 6.110, 6.201 - 6.205, 6.210 - 6.220, 6.261, 6.700, 6.707 6.715, 6.805, and 6.900 - 6.903 were final adoption of emergency at the 7/12/96 State Board meeting,
-with an effective date of 7/1/96 (CSPR# 96-5-8-1). Statement of Basis and Purpose and specific statutory
-authority for these revisions were incorporated by reference into the rule. These materials are available
-for review by the public during normal working hours at the Office of External Affairs, Department of
-Human Services.
-Revisions to the sections 6.000 - 6.002, 6.110, 6.201 - 6.205, 6.230 - 6.250, 6.260 - 6.261, 6.270 - 6.400,
-6.600 - 6.710, and 6.711 - 6.715 were final adoption following publication at the 8/2/96 State Board
-meeting, with an effective date of 10/1/96 (CSPR# 96-4-11-2). Statement of Basis and Purpose and
-specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Office of External
-Affairs, Department of Human Services.
-Revisions to the sections 6.002, 6.110, 6.210 - 6.220, 6.261, 6.700, 6.710 - 6.712, and 6.903 were final
-adoption following publication at the 12/6/96 State Board meeting, with an effective date of 2/1/97
-(CSPR# 96-9-16-1). Statement of Basis and Purpose and specific statutory authority for these revisions
-were incorporated by reference into the rule. These materials are available for review by the public during
-normal working hours at the Office of External Affairs, Department of Human Services.
-Revisions to the sections 6.002, 6.110, 6.210 - 6.220, 6.261, 6.700, 6.710 - 6.712, and 6.903 were
-repromulgated final adoption following publication at the 3/7/97 State Board meeting, with an effective
-date of 5/1/97 (CSPR# 96-9-16-1). Statement of Basis and Purpose and specific statutory authority for
-these revisions were incorporated by reference into the rule. These materials are available for review by
-the public during normal working hours at the Office of External Affairs, Department of Human Services.
-Revisions to the sections 6.200 through 6.201, 6.230, and 6.260, 6.261, 6.400 through 6.702, 6.900
-through 6.902, and 6.903 were final adoption following publication at the 5/2/97 State Board meeting, with
-an effective date of 7/1/97 (CSPR# 97-2-24-2). Statement of Basis and Purpose and specific statutory
-authority for these revisions were incorporated by reference into the rule. These materials are available
-for review by the public during normal working hours at the Office of External Affairs, Department of
-Human Services.
-Revisions to the sections 6.600 through 6.603 and 6.710 through 6.715 were adopted emergency and
-final at the 6/6/97 State Board meeting, with an effective date of 7/1/97 (CSPR# 97-2-24-1). Statement of
-Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into
-the rule. These materials are available for review by the public during normal working hours at the Office
-of External Affairs, Department of Human Services.
-
-9
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-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-Revisions to the sections 6.800 through 6.802 and 6.805 were adopted emergency at the 6/6/97 State
-Board meeting, with an effective date of 7/1/97 (CSPR# 97-5-19-1). Statement of Basis and Purpose and
-specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Office of External
-Affairs, Department of Human Services.
-Rewrite of the entire Child Support Enforcement manual was final adoption following publication at the
-10/3/97 State Board meeting, with an effective date of 12/1/97 (CSPR# 97-6-5-1). Statement of Basis and
-Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.
-These materials are available for review by the public during normal working hours at the Office of
-External Affairs, Department of Human Services.
-Revisions of sections 6.270 and 6.903 were final adoption following publication at the 3/6/98 State Board
-meeting, with an effective date of 5/1/98 (CSPR#'s 97-12-22-1 and 97-12-23-1). Statement of Basis and
-Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.
-These materials are available for review by the public during normal working hours at the Office of
-External Affairs, Department of Human Services.
-Revisions of sections 6.000 - 6.002, 6.800 - 6.802, and 6.805 were final adoption following publication at
-the 9/4/98 State Board meeting, with an effective date of 11/1/98 (CSPR# 98-6-22-1). Statement of Basis
-and Purpose and specific statutory authority for these revisions were incorporated by reference into the
-rule. These materials are available for review by the public during normal working hours at the Office of
-External Affairs, Department of Human Services.
-Revisions of sections 6.002 through 6.102, 6.205 through 6.230, 6.261, 6.500 through 6.505, 6.600
-through 6.603, 6.700, 6.706 through 6.708, 6.711 through 6.712, and 6.805 were final adoption following
-publication at the 11/6/98 State Board meeting, with an effective date of 1/1/99 (CSPR# 98-8-11-1).
-Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by
-reference into the rule. These materials are available for review by the public during normal working hours
-at the Office of External Affairs, Department of Human Services.
-Revisions of sections 6.260, 6.300 through 6.400, and 6.601 through 6.700 were final adoption following
-publication at the 12/4/98 State Board meeting, with an effective date of 2/1/99 (CSPR# 98-9-16-1).
-Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by
-reference into the rule. These materials are available for review by the public during normal working hours
-at the Office of External Affairs, Department of Human Services.
-Revisions of sections 6.261, 6.700 - 6.715 and 6.903 were final adoption following publication at the
-5/7/99 State Board meeting, with an effective date of 7/1/99 (CSPR# 99-2-8-1). Statement of Basis and
-Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.
-These materials are available for review by the public during normal working hours at the Office of
-External Affairs, Department of Human Services.
-Revisions of section 6.260 were adopted emergency at the 5/7/99 State Board meeting, with an effective
-date of 5/7/99 (CSPR# 99-3-24-2). Statement of Basis and Purpose and specific statutory authority for
-these revisions were incorporated by reference into the rule. These materials are available for review by
-the public during normal working hours at the Office of External Affairs, Department of Human Services.
-Revisions of section 6.260 were final adoption of emergency at the 6/4/99 State Board meeting, with an
-effective date of 5/7/99 (CSPR# 99-3-24-2). Statement of Basis and Purpose and specific statutory
-authority for these revisions were incorporated by reference into the rule. These materials are available
-for review by the public during normal working hours at the Office of External Affairs, Department of
-Human Services.
-
-10
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-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-Revisions of sections 6.002, 6.803, and 6.902 were final adoption following publication at the 6/4/99 State
-Board meeting, with an effective date of 8/1/99 (CSPR#'s 98-12-21-1 and 99-3-30-1). Statement of Basis
-and Purpose and specific statutory authority for these revisions were incorporated by reference into the
-rule. These materials are available for review by the public during normal working hours at the Office of
-External Affairs, Department of Human Services.
-Revisions of sections 6.002 and 6.210 were final adoption following publication at the 7/9/99 State Board
-meeting, with an effective date of 9/1/99 (CSPR# 99-4-6-1). Statement of Basis and Purpose and specific
-statutory authority for these revisions were incorporated by reference into the rule. These materials are
-available for review by the public during normal working hours at the Office of External Affairs,
-Department of Human Services.
-Revisions of sections 6.002 and 6.805 were final adoption following publication at the 8/6/99 State Board
-meeting, with an effective date of 10/1/99 (CSPR# 99-5-20-1). Statement of Basis and Purpose and
-specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Office of External
-Affairs, Department of Human Services.
-Revisions to the manual's Table of Contents and section 6.804 were final adoption following publication at
-the 11/5/99 State Board meeting, with an effective date of 1/1/2000 (CSPR# 99-8-19-1). Statement of
-Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into
-the rule. These materials are available for review by the public during normal working hours at the Office
-of External Affairs, Department of Human Services.
-Addition of Section 6.905 was final adoption following publication at the 04/07/2000 State Board meeting,
-with an effective date of 6/1/2000 (CSPR# 99-10-12-1). Statement of Basis and Purpose and specific
-statutory authority for these revisions were incorporated by reference into the rule. These materials are
-available for review by the public during normal working hours at the Office of Public Affairs, Department
-of Human Services.
-Revisions to Sections 6.002, 6.210, 6.240, 6.261, 6.601, 6.700, and 6.902 were final adoption following
-publication at the 5/5/2000 State Board meeting, with an effective date of 7/1/2000 (CSPR# 00-2-8-1).
-Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by
-reference into the rule. These materials are available for review by the public during normal working hours
-at the Office of Public Affairs, Department of Human Services.
-Revisions to Sections 6.902 and 6.904 were final adoption following publication at the 6/2/2000 State
-Board meeting, with an effective date of 8/1/2000 (CSPR# 00-2-9-1). Statement of Basis and Purpose
-and specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Office of Public Affairs,
-Department of Human Services.
-Revisions to Sections 6.002, 6.101, 6.261, 6.710, - 6.712, and 6.902 - 6.903 were final adoption following
-publication at the 8/4/2000 State Board meeting, with an effective date of 10/1/2000 (CSPR#s 00-5-16-1
-and 00-5-16-2). Statement of Basis and Purpose and specific statutory authority for these revisions were
-incorporated by reference into the rule. These materials are available for review by the public during
-normal working hours at the Colorado Department of Human Services, Office of Performance
-Improvement, Boards and Commissions Division, State Board Administration.
-Revisions to Sections 6.002, 6.110, 6.210, 6.805, and 6.905 were final adoption following publication at
-the 9/8/2000 State Board meeting, with an effective date of 11/1/2000 (CSPR#s 00-6-26-1, 6-27-1 and
-00-7-7-1). Statement of Basis and Purpose and specific statutory authority for these revisions were
-incorporated by reference into the rule. These materials are available for review by the public during
-normal working hours at the Colorado Department of Human Services, Office of Performance
-Improvement, Boards and Commissions Division, State Board Administration.
-
-11
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-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-Revisions to Section 6.906 were adopted as emergency at the 12/1/2000 State Board meeting, with an
-effective date of 12/1/2000 (CSPR# 00-10-23-2). Statement of Basis and Purpose and specific statutory
-authority for these revisions were incorporated by reference into the rule. These materials are available
-for review by the public during normal working hours at the Colorado Department of Human Services,
-Office of Performance Improvement, Boards and Commissions Division, State Board Administration.
-Revisions to Section 6.906 were final adoption of emergency at the 1/5/2001 State Board meeting, with
-an effective date of 12/1/2000 (CSPR# 00-10-23-2). Statement of Basis and Purpose and specific
-statutory authority for these revisions were incorporated by reference into the rule. These materials are
-available for review by the public during normal working hours at the Colorado Department of Human
-Services, Office of Performance Improvement, Boards and Commissions Division, State Board
-Administration.
-Revisions to Section 6.902 and 6.906 were final adoption following publication at the 1/5/2001 State
-Board meeting, with an effective date of 3/1/2001 (CSPR#'s 00-8-23-1 and 00-10-13-1). Statement of
-Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into
-the rule. These materials are available for review by the public during normal working hours at the
-Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions
-Division, State Board Administration.
-Revisions to Sections 6.261, 6.603 - 6.700, 6.709 - 6.710, 6.711 - 6.712, and 6.900 - 6.904 were final
-adoption following publication at the 4/6/2001 State Board meeting, with an effective date of 6/1/2001
-(CSPR# 01-1-10-1). Statement of Basis and Purpose and specific statutory authority for these revisions
-were incorporated by reference into the rule. These materials are available for review by the public during
-normal working hours at the Colorado Department of Human Services, Office of Performance
-Improvement, Boards and Commissions Division, State Board Administration.
-Revisions to Sections 6.260, 6.702, 6.712, 6.905, and 6.906 were final adoption following publication at
-the 2/1/2002 State Board meeting, with an effective date of 4/1/2002 (CSPR# 01-11-14-1). Statement of
-Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into
-the rule. These materials are available for review by the public during normal working hours at the
-Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions
-Division, State Board Administration.
-Revisions to Sections 6.710.17, 6.711.6, 6.712.4, 6.712.9, 6.902.15, and 6.903.11 were adopted
-emergency at the 7/12/2002 State Board meeting, with an effective date of 7/1/2002 (CSPR# 02-4-5-1).
-Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by
-reference into the rule. These materials are available for review by the public during normal working hours
-at the Colorado Department of Human Services, Office of Performance Improvement, Boards and
-Commissions Division, State Board Administration.
-Revisions to Sections 6.710.17, 6.711.6, 6.712.4, 6.712.9, 6.902.15, and 6.903.11 were final adoption of
-emergency at the 8/2/2002 State Board meeting, with an effective date of 7/1/2002 (CSPR# 02-4-5-1).
-Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by
-reference into the rule. These materials are available for review by the public during normal working hours
-at the Colorado Department of Human Services, Office of Performance Improvement, Boards and
-Commissions Division, State Board Administration.
-Revisions to Sections 6.261 through 6.261.9, were adoption following publication at the 11/1/2002 State
-Board meeting, with an effective date of 1/1/2003 (CSPR# 02-8-21-1). Statement of Basis and Purpose
-and specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Colorado Department
-of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board
-Administration.
-
-12
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-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-Revisions to Sections 6.002, 6.805, 6.805.31 through 6.805.34, and 6.805.9 through 6.805.97 were
-adoption following publication at the 1/3/2003 State Board meeting, with an effective date of 3/1/2003
-(Rule-making# 02-10-21-1). Statement of Basis and Purpose and specific statutory authority for these
-revisions were incorporated by reference into the rule. These materials are available for review by the
-public during normal working hours at the Colorado Department of Human Services, Office of
-Performance Improvement, Boards and Commissions Division, State Board Administration.
-Revisions to Sections 6.102.2, 6.205.1-6.205.11, 6.261.8, 6.710.17, 6.711.6, 6.712.4, 6.712.9, 6.902.126.902.13, and 6.903.11, and addition of Section 6.604-6.604.5, were adopted following publication at the
-4/4/2003 State Board meeting, with an effective date of 6/1/2003 (Rule-making #s 02-11-6-1 and 03-1-81). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated
-by reference into the rule. These materials are available for review by the public during normal working
-hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and
-Commissions Division, State Board Administration.
-Revisions to Sections 6.002, 6.805 and 6.805.1 were adopted following publication at the 11/7/2003 State
-Board meeting, with an effective date of 1/1/2004 (Rule-making #03-8-1-1). Statement of Basis and
-Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.
-These materials are available for review by the public during normal working hours at the Colorado
-Department of Human Services, Office of Performance Improvement, Boards and Commissions Division,
-State Board Administration.
-Revisions to Sections 6.805.4 and addition of Sections 6.908-6.908.6 were adopted following publication
-at the 12/5/2003 State Board meeting, with an effective date of 2/1/2004 (Rule- making #03-9-24-1).
-Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by
-reference into the rule. These materials are available for review by the public during normal working hours
-at the Colorado Department of Human Services, Office of Performance Improvement, Boards and
-Commissions Division, State Board Administration.
-Revisions to Sections 6.002, 6.201.1, 6.230.16, 6.260.22-6.260.23, 6.261.7-6.261.8, 6.604-6.604.4,
-6.902.12-6.902.13, and 6.903.11 were adopted following publication at the 4/2/2004 State Board meeting,
-with an effective date of 6/1/2004 (Rule-making #03-12-29-1). Statement of Basis and Purpose and
-specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Colorado Department
-of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board
-Administration.
-Revisions to Sections 6.205.23, 6.205.3, 6.250.11 - 6.250.12, 6.250.27, 6.260.51-6.260.52, 6.601.1,
-6.702.1, and 6.906 - 6.906.6 were adopted following publication at the 5/7/2004 State Board meeting,
-with an effective date of 7/1/2004 (Rule-making #04-2-24-1). Statement of Basis and Purpose and
-specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Colorado Department
-of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board
-Administration.
-Revisions to Sections 6.001.11-6.001.12, 6.102.21, 6.201.2, 6.201.5, 6.206, 6.230.1, 6.230.16, 6.230.3 6.230.7, 6.260.23, and 6.260.51 - 6.260.52 were adopted following publication at the 8/6/2004 State
-Board meeting, with an effective date of 10/1/2004 (Rule-making #04-5-4-1). Statement of Basis and
-Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.
-These materials are available for review by the public during normal working hours at the Colorado
-Department of Human Services, Office of Performance Improvement, Boards and Commissions Division,
-State Board Administration.
-
-13
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-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-Revisions to Sections 6.002, 6.260.53, 6.260.55, 6.803.11-6.803.15, 6.803.2-6.803.23, 6.803.31,
-6.803.33, 6.803.46-6.803.47, 6.805.11, 6.805.13, 6.805.15, 6.805.35, 6.905.1, 6.906-6.906.1, 6.906.21 6.906.22, 6.906.3, 6.906.4, 6.906.5, 6.906.6, and 6.907.1 were adopted following publication at the
-9/9/2005 State Board meeting, with an effective date of 11/1/2005 (Rule-making #05-5-9-1). Statement of
-Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into
-the rule. These materials are available for review by the public during normal working hours at the
-Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions
-Division, State Board Administration.
-Revisions to Sections 6.700.31 through 6.700.32, and 6.700.37 through 6.700.38 were adopted following
-publication at the 12/2/2005 State Board meeting, with an effective date of 2/1/2006 (Rule-making #05-89-1);and a technical correction to 6.906 (TL# VI-05-1/Rule-making #05-5-9-1) is being republished.
-Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by
-reference into the rule. These materials are available for review by the public during normal working hours
-at the Colorado Department of Human Services, Office of Performance Improvement, Boards and
-Commissions Division, State Board Administration.
-Revisions to Section 6.902.3 (formerly 6.902.24) were adopted following publication at the 1/5/2007 State
-Board meeting, with an effective date of 3/1/2007 (Rule-making #06-10-20-1). Statement of Basis and
-Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.
-These materials are available for review by the public during normal working hours at the Colorado
-Department of Human Services, Office of Performance Improvement, Boards and Commissions Division,
-State Board Administration.
-Revisions to Sections 6.002, 6.210.13-6.210.15, 6.700.33, 6.805.32-6.805.35, 6.901-6.902.3, addition of
-Sections 6.210.7 and 6.902.4, and revisions to Sections 6.905.1-6.905.3, 6.906-6.908.6 were adopted
-following publication at the 3/9/2007 State Board meeting, with an effective date of 5/1/2007 (Rule-making
-#'s 06-12-7-1 and 06-12-18-1). Statement of Basis and Purpose and specific statutory authority for these
-revisions were incorporated by reference into the rule. These materials are available for review by the
-public during normal working hours at the Colorado Department of Human Services, Office of
-Performance Improvement, Boards and Commissions Division, State Board Administration.
-Revisions to Sections 6.002, 6.101.2, 6.201.2, 6.261.3, 6.805, 6.805.2, and 6.903.11 were adopted as
-emergency at the 9/7/2007 State Board meeting, with an effective date of 10/1/2007 (Rule-making#07-61-1). Statement of Basis and Purpose and specific statutory authority for these revisions were
-incorporated by reference into the rule. These materials are available for review by the public during
-normal working hours at the Colorado Department of Human Services, Office of Performance
-Improvement, Boards and Commissions Division, State Board Administration.
-Revisions to Sections 6.002, 6.101.2, 6.201.2, 6.261.3, 6.805, 6.805.2, and 6.903.11 were final
-(permanent) adoption of emergency rules at the 10/5/2007 State Board meeting, with an effective date of
-10/1/2007 based on the prior emergency rules (Rule-making#07-6-1-1). Statement of Basis and Purpose
-and specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Colorado Department
-of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board
-Administration.
-Revisions to Sections 6.905-6.905.1 and 6.905.4-6.906 were final adoption following publication on
-11/2/2007 and re-adopted following public notice and hearing at the 12/7/07 State Board meeting, with an
-effective date of 2/1/2008 (Rule-making#07-7-13-1). Statement of Basis and Purpose and specific
-statutory authority for these revisions were incorporated by reference into the rule. These materials are
-available for review by the public during normal working hours at the Colorado Department of Human
-Services, Office of Performance Improvement, Boards and Commissions Division, State Board
-Administration.
-
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-
-9 CCR 2504-1
-
-Revisions to Sections 6.001.1-6.001.22, 6.002, 6.201.2-6.201.3, 6.201.6, 6.261.1-6.261.5, 6.261.76.261.9, 6.700.31-6.700.32, 6.709.4, 6.710.14, 6.803.1-6.803.12, 6.803.14-6.803.21, and 6.903.11 were
-final adoption following publication at the 5/2/2008 State Board meeting, with an effective date of 7/1/2008
-(Rule-making# 08-2-19-1). Statement of Basis and Purpose and specific statutory authority for these
-revisions were incorporated by reference into the rule. These materials are available for review by the
-public during normal working hours at the Colorado Department of Human Services, Boards and
-Commissions Division, State Board Administration.
-Revisions to Sections 6.210.12-6.210.13, 6.803.45-6.803.48, 6.804.1-6.804.2, 6.804.5-6.804.61, and
-6.804.8 were adopted on an emergency basis at the 7/11/2008 State Board meeting, with an effective
-date of 7/11/2008 (Rule-making# 08-5-14-1). Statement of Basis and Purpose and specific statutory
-authority for these revisions were incorporated by reference into the rule. These materials are available
-for review by the public during normal working hours at the Colorado Department of Human Services,
-Boards and Commissions Division, State Board Administration.
-Revisions to Sections 6.210.12-6.210.13, 6.803.45-6.803.48, 6.804.1-6.804.2, 6.804.5-6.804.61, and
-6.804.8 were final adoption (permanent) of emergency rules at the 8/1/2008 State Board meeting, with an
-effective date of 10/1/2008 (Rule-making# 08-5-14-1). Statement of Basis and Purpose and specific
-statutory authority for these revisions were incorporated by reference into the rule. These materials are
-available for review by the public during normal working hours at the Colorado Department of Human
-Services, Boards and Commissions Division, State Board Administration.
-Revisions to Sections 6.002, 6.201.3-6.201.6, 6.240.12-6.240.18, 6.250.27, 6.260.54, 6.400.17-6.400.19,
-6.500-6.501, 6.602.2, 6.603.2, 6.700.22-6.700.24, 6.700.31, 6.700.35, 6.700.38, 6.702.2, 6.709.1,
-6.713.1-6.714.2, 6.801.15-6.801.18, 6.805, 6.805.2, 6.805.31, 6.805.5, 6.902.1-6.902.12, and 6.902.14
-were final adoption following publication at the 8/7/2009 State Board meeting, with an effective date of
-10/1/2009 (Rule-making# 09-4-20-1). Statement of Basis and Purpose and specific statutory authority for
-these revisions were incorporated by reference into the rule. These materials are available for review by
-the public during normal working hours at the Colorado Department of Human Services, Division of
-Boards and Commissions, State Board Administration.
-Deletion of Sections 6.110 through 6.110.72 and revisions to Sections 6.102.21, 6.201.2, 6.601.32,
-6.702.1, 6.902.17, 6.905.2, 6.906.1, 6.906.22, 6.906.4, 6.906.6, 6.907.1-6.907.2, and 6.908.3-6.908.6
-were final adoption following publication at the 1/8/2010 State Board meeting, with an effective date of
-3/2/2010 (Rule-making# 09-9-11-1). Statement of Basis and Purpose and specific statutory authority for
-these revisions were incorporated by reference into the rule. These materials are available for review by
-the public during normal working hours at the Colorado Department of Human Services, Division of
-Boards and Commissions, State Board Administration.
-Revisions to Sections 6.207-6.207.4, 6.250.18, 6.250.25-6.250.26, 6.250.3, 6.260.51, 6.600.11, 6.600.13,
-6.601.2-6.601.32, 6.602.1, 6.603.1, 6.603.3, and 6.714.1-6.714.4 were adopted on an emergency basis
-at the 7/8/2011 State Board meeting, with an effective date of 8/10/2011 (Rule-making# 11-4-8-2).
-Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by
-reference into the rule. These materials are available for review by the public during normal working hours
-at the Colorado Department of Human Services, Division of Boards and Commissions, State Board
-Administration.
-Revisions to Sections 6.207-6.207.4, 6.250.18, 6.250.25-6.250.26, 6.250.3, 6.260.51, 6.600.11, 6.600.13,
-6.601.2-6.601.32, 6.602.1, 6.603.1, 6.603.3, and 6.714.1-6.714.4 were final (permanent) adoption at the
-8/5/2011 State Board meeting, with an effective date of 10/1/2011 (Rule-making# 11-4-8-2). Statement of
-Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into
-the rule. These materials are available for review by the public during normal working hours at the
-Colorado Department of Human Services, Division of Boards and Commissions, State Board
-Administration.
-
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-
-Revisions to Sections 6.101-6.101.2, 6.102.3-6.102.32, 6.130-6.140.1, 6.205.21-6.205.23, 6.2406.240.20, 6.250.18-6.250.291, 6.270-6.280.1, 6.300-6.300.23, 6.503-6.506.4, 6.700.33-6.700.38, 6.702.4,
-6.715-6.715.3, 6.801-6.801.19, 6.806.5-6.805.7, and 6.805.82 were final adoption following publication at
-the 1/6/2012 State Board meeting, with an effective date of 3/1/2012 (Rule-making# 11-9-2-1). Statement
-of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference
-into the rule. These materials are available for review by the public during normal working hours at the
-Colorado Department of Human Services, Division of Boards and Commissions, State Board
-Administration.
-Revisions to Sections 6.260.22-6.260.23 and 6.800 through 6.809.6 were final adoption following
-publication at the 7/13/2012 State Board meeting, with an effective date of 9/15/2012 (Rule-making# 119-2-3). Statement of Basis and Purpose and specific statutory authority for these revisions were
-incorporated by reference into the rule. These materials are available for review by the public during
-normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships,
-Division of Boards and Commissions, State Board Administration.
-Revisions to Sections 6.102.2-6.102.21, 6.210.13-6.210.15, 6.261-6.261.1, 6.261.3-6.261.8, 6.600-6.606,
-6.700-6.715.1, 6.804.4, 6.902-6.902.11, 6.902.14-6.902.175, 6.902.23, 6.902.3-6.902.4, 6.903.11, 6.906,
-and 6.906.21; and, addition of Sections 6.240-6.240.2 were final adoption following publication at the
-2/1/2013 State Board meeting, with an effective date of 4/1/2013 (Rule-making# 11-9-2-5). Statement of
-Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into
-the rule. These materials are available for review by the public during normal working hours at the
-Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and
-Commissions, State Board Administration.
-Revisions to Sections 6.250 through 6.250.3, 6.260.51, and 6.806 were adopted on an emergency basis
-at the 4/5/2013 State Board meeting, with an effective date of 4/5/2013 (Rule-making# 13-2-8-1).
-Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by
-reference into the rule. These materials are available for review by the public during normal working hours
-at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and
-Commissions, State Board Administration.
-Revisions to Sections 6.250 through 6.250.3, 6.260.51, and 6.806 were final (permanent) adoption at the
-5/3/2013 State Board meeting, with an effective date of 7/1/2013 (Rule-making# 13-2-8-1). Statement of
-Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into
-the rule. These materials are available for review by the public during normal working hours at the
-Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and
-Commissions, State Board Administration.
-Revisions to Sections 6.002, 6.205 and 6.205.1, 6.205.13, 6.205.2, 6.210.12, 6.210.13, 6.210.2, 6.210.3,
-6.210.42, 6.210.5, 6.210.6 through 6.210.67, 6.220, 6.260.23, 6.260.3 through 6.260.31, 6.400, 6.400.1,
-and 6.500 through 6.503 were final adoption following publication at the 9/6/2013 State Board meeting,
-with an effective date of 11/1/2013 (Rule-making# 13-4-3-1). Statement of Basis and Purpose and
-specific statutory authority for these revisions were incorporated by reference into the rule. These
-materials are available for review by the public during normal working hours at the Colorado Department
-of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board
-Administration.
-
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-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-6.000
-
-CHILD SUPPORT SERVICES PROGRAM
-
-6.001
-
-INTRODUCTION
-
-9 CCR 2504-1
-
-6.001.1 PURPOSE
-The Colorado Child Support Services (CSS) Program is established to collect support, to reimburse, in
-part or whole, Title IV-A grants paid to families, help remove IV-A recipients from the IV-A program by
-assuring continuing support payments, and assist persons who do not receive IV-A or IV-E foster care to
-remain financially independent. Such purpose is achieved by: locating noncustodial parents, establishing
-the parentage of children born out of wedlock, establishing child support obligations and health insurance,
-reviewing the order for a possible adjustment, and enforcing and collecting support. Although this
-program must be closely coordinated with the IV-A, Medicaid, and foster care programs, it is a separate
-and distinct program with defined functions, which must be performed by a distinct administrative unit.
-This manual sets forth the policies and rules by which the Colorado Child Support Services (CSS)
-program must be administered and describes the coordination that must take place with the IV-A and
-foster care programs. IV-A and IV-E foster care cases in these rules are also referred to as public
-assistance (PA) cases. Cases that do not contain IV-A or IV-E recipients and cases receiving continued
-services are referred to as non-public assistance (Non-PA; NPA) cases. Non-IV-E foster care and
-Medicaid cases are also included in NPA cases. The policies and rules for the IV-A, Medicaid, and foster
-care programs are set forth in the respective staff manuals.
-6.002
-
-DEFINITIONS
-
-“Abandoned Collections Account” - the state IV-D account into which undeliverable collections are
-transferred once a determination has been made that the payment cannot be disbursed. This account is
-used to reimburse state expenditures.
-“ACSES” - the acronym for the Automated Child Support Enforcement system, a comprehensive
-statewide online computer system providing case management, financial management, reports, statistics
-and an extensive cross-reference system.
-“Adjustment” or “Modification” - is a legal action to change the amount of the child support or foster care
-fee order, which can increase or decrease based upon application of the state's presumptive guideline; or
-to add a provision for medical support or to change the party ordered to provide medical support.
-“Administrative Costs” - the amount of court ordered costs that must be repaid to the Child Support
-Services Unit such as genetic tests, service of process fees, or attorney's costs.
-“Administrative Lien and Attachment” - a notice to withhold child support, child support arrearages, child
-support debt, or retroactive support due from a noncustodial parent's workers' compensation benefits that
-is issued to any person, insurance company, or agency providing such benefits.
-“Administrative Process Action (APA)” - determination of parentage and/or support obligations through a
-non-judicial process.
-“Administrative Review” - a county or state level review of the following four issues only: the payments
-made, the arrearage amounts, the distribution of amounts collected, or a mistake in the identity of the
-person who owes the child support.
-“Alleged Parent” - a person who has been identified as the possible biological parent of a child and/or
-who may be the legal parent of a child.
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-
-“Allocation” - the process of apportionment of a collection to a specific noncustodial parent's obligation
-based on the legal order for support to satisfy the various classes of the noncustodial parent's
-receivables.
-“APA – Petitioner” – The party who has applied or been mandatorily referred for Child Support Services.
-“APA – Respondent” – The party that did not apply for Child Support Services and was not mandatorily
-referred for Child Support Services.
-“APA Stipulated Order” – An order that is agreed to and signed by both the APA-Petitioner and the APARespondent or an order that is agreed to and signed by the APA-Respondent in the absence of the APAPetitioner.
-“APA Temporary Order” – An order that establishes a monthly support obligation only and that is entered
-when the APA-Petitioner and/or the APA-Respondent does not agree with the terms of the proposed
-stipulated order.
-“APA Default Order” – An order that is entered when the APA-Respondent (1) fails to attend the currently
-scheduled negotiation conference, (2) fails to sign and deliver to the county delegate child support
-enforcement unit at or prior to the time of the currently scheduled negotiation conference the stipulated
-order, or (3) fails to appear for or cooperate with a genetic testing appointment.
-“Application” - the state prescribed form which indicates that the individual is applying for Child Support
-Services. The application is signed by the individual applying for services and an application fee is
-assessed.
-“Application Fee” - A fee assessed upon receipt of an application as required by Federal Regulation, to be
-paid out of State funds in the amount of 10 cents ($0.10).
-“Arrearages” - the total amount of the court ordered support obligations that are past due and unpaid.
-Such amount is calculated by multiplying the amount of the support obligation (including any modification
-thereto) by the number of months that have elapsed since the inception of the order and subtracting from
-the product the amount of support paid by the noncustodial parent, through the court, directly to the
-obligee, Child Support Services Unit, or Family Support Registry (FSR).
-“Assignment of Support Rights” - the determination that a family is eligible for IV-A benefits automatically
-invokes a state law (Section 26-2-111(3), C.R.S., as amended) that assigns to the State Department all
-rights that the applicant may have to support from any other person on their own behalf or on behalf of
-any other family member for whom application is made. The assignment is effective for both current
-support and support that accrues as arrears during the period that the family receives assistance. The
-assignment is limited by the total amount of IV-A assistance received. When a child is placed in foster
-care, all rights to current and accrued child support for the benefit of the child are assigned to the State
-Department pursuant to Section 26-13-113, C.R.S.
-“Automated Child Support Enforcement System (ACSES)” - the statewide computer program used by
-Child Support Services for daily operations.
-“Caretaker” - a person who is related to the dependent child by blood or by law, or who lives with the child
-and who exercises parental responsibility (care, control and supervision) of the child in the absence of the
-child's parent.
-“Case Category” - category of a case identifies the type of IV-D case. Case categories must be
-maintained on the automated child support system as prescribed by the State Department.
-“Cash Medical Support” - see definition of “specific dollar amount for medical purposes”.
-
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-
-“Challenge” - when either party disagrees in writing with the review results because the guideline
-calculation contained an alleged mathematical or factual error. The parties' right to challenge is included
-in the Post Review Notice or the Administrative Process, Notice of Financial Responsibility for
-Modification.
-“Child Support Services (CSS) Unit”- the county unit administering or supervising the contract for another
-private or public entity to administer the Child Support Services (CSS) Program.
-“Colorado Central Registry” - the unit within the Colorado Division of Child Support Services which
-receives and distributes responding cases and has oversight responsibility for intergovernmental IV-D
-cases.
-“Colorado Date of Receipt” (CDOR) - the date the child support payment is first received by the Child
-Support Services program, either the Family Support Registry or the Child Support Services Unit.
-“Commencement Date” – a day within the month in which a new or modified monthly support obligation
-begins.
-“Confidential” - privileged information of individuals which is private and not for release, disclosure, or
-distribution unless specifically authorized in statute, regulation, or rule.
-“Consumer Credit Reporting Agency” - any person who, for monetary fees, dues, or on a cooperative
-nonprofit basis, regularly engages in whole or in part, in the practice of assembling or evaluating
-consumer credit information or other information on consumers for the purpose of furnishing consumer
-reports to third parties, and which uses any means or facility of interstate commerce for the purpose of
-preparing or furnishing consumer reports.
-“Continued Services Cases” – non-public assistance Child Support Services cases in which the Child
-Support Services Unit continues to provide services after IV-A financial or IV-E foster care eligibility
-ceases unless notified by the custodial party that continued services are not desired.
-“Cost Effectiveness Ratio” - the ratio of total child support collections to total administrative costs.
-“County Department” - a county department of social services, human services, housing and human
-services, or health and human services. “C.R.S.” - Colorado Revised Statutes.
-“CSS Case” - a child support case in which services are provided to establish, modify, and enforce
-support and medical obligations pursuant to the state IV-D plan.
-“Currently Scheduled Negotiation Conference” – The date and time of the APA negotiation conference as
-scheduled in the notice of financial responsibility or the date and time of a continued negotiation
-conference whichever date is later.
-“Custodial Party” - the legally responsible parent, blood relative, adoptive relative, adult who exercises
-responsibility for a dependent child(ren), or agency. Also known as the caretaker relative, custodial
-relative, custodian, government agency (for foster care cases) or, on ACSES, as the recipient/applicant
-and abbreviated as R/A.
-“Date of Withholding” - the date the employer withheld the child support from the employee's wages.
-“Deliver” – Delivery of a document or documents includes delivery by hand (in person), by first-class mail,
-or by electronic means if mutually agreed upon.
-“Discharge From Custody” - As defined in title 17 of the Colorado Revised Statutes.17-22.5-402(1)
-
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-Child Support Services
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-9 CCR 2504-1
-
-“Disbursement” - processing of the payable to payees other than the Department of Human Services.
-“DISH” –The acronym for the Data Information Sharing System of the Colorado Judicial Department. It is
-also the process of electronically transmitting information on a case or data on an order by and between
-the county CSS unit and the court clerk.
-“Disposition” - the date on which a support order is officially established and/or recorded or the action is
-dismissed.
-“Distribution” - application of the allocated collection to the IV-D retained and/or payable accounts
-according to federal regulations based on assignment of rights to support, continued services, and
-application for services.
-“EFPLS” - Expanded Federal Parent Locator Service
-“Enforcing County” - Colorado county responsible for processing the case and providing Child Support
-Services.
-“Erroneous Disbursement” - see “Unfunded Disbursement”.
-“Excess Pass Through Amount” – means an assigned child support collection (applied to current support)
-that the state elects to pay to the family rather than retain to reimburse for assistance provided to the
-family over the Pass Through Amount.
-“Expedited Processes” - administrative or expedited judicial processes or both which increase
-effectiveness and meet specified processing time frames and under which the presiding officer is not a
-judge of the court. Actions to establish or enforce support obligations in IV-D cases must be completed
-within the time frames specified in federal regulations.
-“Family Support Registry (FSR)” - the contracted fiscal agent responsible for processing all child support
-payments.
-“FFP” - Federal Financial Participation.
-“Federal Tax Information (FTI)” - any information contained in, or derived from, a federal tax return.
-“Financial Institution Data Match (FIDM)” - Federal mandate requiring the state to do a periodic match of
-noncustodial parents who owe arrearages to accounts maintained at financial institutions.
-“Financial Institution Data Match Lien and Levy” - a notice generated by the Colorado Department of
-Human Services, Division of Child Support Services, to freeze and seize assets contained in financial
-accounts. The notice is issued to any financial institution or state entity maintaining accounts for obligors
-with child support arrearages, child support debt or retroactive support.
-“FIPS” - Federal Information Processing Standard - a code number assigned to each state and county
-within the United States.
-“Former Arrears Due (FAD) Case” - any IV-D case in which the custodial party or the child(ren) formerly
-received IV-A cash assistance or IV-E maintenance but no longer receives CSS services and where there
-are still assigned arrears due.
-“Former Assistance Case” - any IV-D case in which the custodial party or the child(ren) formerly received
-IV-A cash assistance or IV-E maintenance.
-
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-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-“Foster Care Fee Debt” - the amount of support due in a foster care case from the placing parent for the
-time period between the date the child was placed in out-of-home placement to the date the fee order
-was established.
-“Foster Care Fee Order” - a monthly amount assessed by application of the Colorado Child Support
-guidelines, which are found under 14-10-115(7), C.R.S., to the legally responsible person(s) whose
-child(ren) are receiving substitute care through a foster care placement as ordered by a court or through
-administrative process by a county Child Support Services Unit. These orders may be reinstated without
-further action of the court, upon the child returning to placement for a new decree.
-“FPLS” - Federal Parent Locator Service.
-“Genetic Testing” - a scientific test that shows the probability of biological parentage of a child which can
-lead to the establishment of parentage.
-“Health Care Coverage/Health Insurance” – Fee for service, health maintenance organization, preferred
-provider organization, and other types of private health insurance and public health care coverage under
-which medical services could be provided to the dependent child(ren).
-“HHS” - the U.S. Department of Health and Human Services.
-“High Volume Automated Administrative Enforcement in Interstate Cases” - the use of automated data
-processing on interstate cases to search various state databases and seize identified assets of delinquent
-obligors, using the same techniques as used in intrastate cases upon request of another state.
-“Income Assignment” - the process whereby an obligor’s child support payments are taken directly from
-the obligor’s income and forwarded to the FSR through a notice to the employer, trustee, or other payor of
-funds.
-“Initial Date of Receipt” (IDOR) - the date on which the support collection is initially received by the Title
-IV-D agency or the legal entity of any state or political subdivision actually making the collection or, if
-made via income assignment, the date of withholding, whichever is earliest.\
-“Initiating State/Jurisdiction” A.
-
-The state/jurisdiction which requests CSS services from the state/jurisdiction where the
-noncustodial parent resides, has property, or derives income; or,
-
-B.
-
-The state where the custodial party resides if a modification has been requested and it is
-appropriate for that state to review the order.
-
-“Inmate” - As defined in title 17 of the Colorado Revised Statutes.17-1-102(6.5)
-“Intergovernmental Case” - a CSS services case which involves more than one state, country or tribe.
-“In-State Case” - a case being worked in Colorado with no other jurisdiction involved.
-“IV-A Cash Assistance” - payments paid to or on behalf of families with children pursuant to Title IV-A of
-the Social Security Act.
-“IV-A Case” - a case referred from the IV-A Unit to the CSS office for child support services when the
-family has been approved for IV-A financial benefits and/or medical benefits.
-“IV-A Unit” - the county unit administering the IV-A cash assistance program.
-
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-CODE OF COLORADO REGULATIONS
-Child Support Services
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-9 CCR 2504-1
-
-“IV-D Program” - Child Support Services Program pursuant to Title IV-D of the Social Security Act.
-“IV-E Foster Care Case” - a case with a child(ren) who qualifies for public assistance under Title IV-E of
-the Social Security Act. These cases are mandatory referrals to the CSS Unit.
-“IV-E Payment” - payment made on behalf of a child for the child’s foster care maintenance in accordance
-with Title IV-E of the Social Security Act.
-“Judgment” - by operation of law, a child support payment becomes a final money judgment when it is
-due and not paid. A missed payment, or a series of missed payments, may also be reduced into a single
-judgment by the court.
-“Legal Parent” - see “Parentage”.
-“Locate” - information concerning the physical whereabouts of the noncustodial parent or the noncustodial
-parent's employer(s), other sources of income, or assets, as appropriate, which is sufficient to take the
-next appropriate action in a case.
-“Medicaid Referral Cases” - cases in which families, with a noncustodial parent, receive Medicaid and are
-referred to CSS from a Medicaid agency for CSS services if the Medicaid recipient voluntarily wants CSS
-services.
-“Medical Coverage” - any health coverage provided for a child(ren), including: 1) private health insurance;
-2) publicly-funded health coverage; 3) cash medical support; or 4) payment of medical bills, including
-dental or vision.
-“Medical Support” - a subset of medical coverage which includes health coverage provided for a
-child(ren) in a IV-D case in which there is a medical support order. This includes: 1) private health
-insurance; 2) publicly-funded health coverage, if a parent is ordered by a court or administrative process
-to provide cash medical support payments to help pay the cost of Medicaid or State Child Health
-Insurance Program (SCHIP); 3) cash medical support, including payment of health insurance premiums;
-and 4) payment of medical bills, including dental or vision. Indian health service and Tricare are
-acceptable forms of medical support.
-“Modification” - see “Adjustment”.
-“Monthly Amount Due” - the monthly amount the obligor is expected to pay toward the arrearages.
-“Monthly Payment Due” - the monthly amount that the obligor is expected to pay each month; the amount
-includes the court ordered current support and the monthly amount due towards any arrears.
-“Monthly Support Obligation (MSO)” - the monthly obligation amount ordered by a court or through
-administrative process by a IV-D agency to be paid on behalf of (a) child(ren) or (b) child(ren) and former
-spouse, if established in the same court order and if the former spouse is living with the child(ren).
-“National Medical Support Notice (NMSN)” - a federally mandated notice sent to employers by the
-delegate CSS Units. The NMSN requires an employer to enroll a child(ren) in the employer’s health
-insurance plan if it is available, the employee is eligible, and it is reasonable in cost.
-“Non-IV-E Foster Care Case” - a case with a child(ren) receiving Title IV-B foster care services who does
-not qualify for IV-E public assistance. These cases are classified by the State CSS Division on the
-automated child support system as a Non-PA case, but are treated like public assistance cases because
-they originate within Child Welfare Services and, pursuant to statute, contain an automatic assignment of
-support.
-
-22
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-“Non-Public Assistance (Non-PA) Case” - a IV-D case in which the family currently does not receive
-public assistance. Non-PA cases include Medicaid referral cases.
-“Noncustodial Parent (NCP)” - the legally responsible parent, adoptive parent, or alleged parent who is
-not living with the dependent children. Also known on ACSES as the absent parent and abbreviated as
-“A/P”.
-“Not in Child's Best Interest” - order would not be reviewed based on a good cause determination in
-cases with an assignment of rights as defined in Section 6.230.1.
-“Notice of Collection” - a periodic report of Child Support collection information which is sent by the Child
-Support Services Unit to current and former Colorado Works Program recipients who have assigned their
-rights to support.
-“Obligee” - the party to whom an obligation of support is owed.
-“Obligor” - the party bound by a court or administrative order to provide support. This may or may not be
-the party with the least number of overnights with the child for the purposes of calculating child support
-guidelines.
-“OCSE” - Office of Child Support Enforcement. The Health and Human Services agency responsible for
-the supervision of state child support enforcement programs pursuant to Title IV-D of the Social Security
-Act.
-“Original Order” - means the first support order that orders a parent to pay support for a child.
-“Parole” - As defined in title 17 of the Colorado Revised Statutes.17-2-207(3)
-“Parties to the Action” - those individuals or entities named in a petition, motion, or administrative process
-notice of financial responsibility and joined, or to be joined, in a legal action.
-“Pass Through Amount” – means an assigned child support collection (applied to current support) that the
-state elects to pay to the family rather than retain to reimburse for assistance provided to the family. In
-current-assistance cases, the federal share will be waived for up to $100 per month for TANF families
-with one child and up to $200 per month for families with two or more children, as long as both the federal
-and state share of the Pass Through are paid to the family and are disregarded in determining the TANF
-Basic Cash amount of assistance provided to the family.
-“Parentage” - is the legal establishment of maternity or paternity, for a child, either by court determination,
-administrative process, or voluntary acknowledgment.
-"Past-Due Support" - the amount of a delinquency, determined and/or accrued under a court order, or an
-order of an administrative process established under state law, for support and maintenance of a child
-(whether or not a minor), or of a child (whether or not a minor) and the parent with whom the child is
-living. Expenses owed between the parties, such as extracurricular expenses, post-secondary education,
-and attorney fees do not meet the definition of past-due support.
-“Permanently Assigned Arrears” - arrears which accrued under a court or administrative order and were
-assigned prior to October 1, 1997, plus all arrears which accrue while a family is receiving public
-assistance after October 1, 1997.
-“Placing Parent” - the legally responsible parent who the child(ren) was living with prior to foster care
-placement.
-
-23
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-“Post Assistance Arrears” - the arrears that accrue under a court or administrative order on a continued
-services case after the obligee discontinues IV-A services.
-“Pre-Assistance Arrears” - the arrears that accrued from October 1, 1997, forward, under a court or
-administrative order before the obligee started receiving IV-A assistance.
-“Pre-Offset Notice” - a notice generated yearly by the state Office of Child Support Services notifying
-noncustodial parents of the enforcement remedies that may be applied to their cases and advising of their
-right(s) to request an administrative review.
-“Pre-Review Screening” - an assessment of the IV-D case to determine the appropriateness for review.
-Presumed Parent” - a person who is more likely than not to be the legal parent of a child because certain
-facts exist.
-“Primary Contact County” - the county that the obligee will contact to resolve issues concerning an
-unfunded disbursement balance.
-“Procedure” - processes developed by county Child Support Services Units and/or the State Department
-to implement state policy and rules.
-“Public Assistance” - assistance payments provided to or on behalf of eligible recipients through programs
-administered or supervised by the State Department under Titles IV-A or IV-E of the Social Security Act or
-under Child Welfare Services.
-“Public Assistance (PA) Case” - a case that has met established criteria by the IV-A or IV-E divisions to
-be referred to the CSS Unit for child support services.
-“Responding State/Jurisdiction” - the state/jurisdiction where the obligor resides, has property, or derives
-income, which provides Child Support Services Unit services upon request from another state/
-jurisdiction.
-“Retroactive Support Due” - the amount of support due for a time period prior to the entry of an order
-establishing parentage and/or support.
-“Review” - an evaluation of the parties’ income information to determine the child support order amount
-and whether a medical support provision needs to be added to the child support order or if the party
-ordered to provide medical support needs to change.
-“Sentence” - Means the post-conviction stage of the criminal justice process, in which the defendant is
-brought before the court for the imposition of a penalty. Sentences can vary in the way they are
-implemented or carried out. A sentence can be concurrent, meaning it is served at the same time as any
-other sentences imposed; or, consecutive meaning there is a conviction on several counts and the
-sentences are added to each other so each sentence begins immediately upon the expiration of the
-previous one. In the case of the conviction of a sexual offense, Colorado may also impose an
-indeterminate sentence of “not more than” or “not less than” a certain period of time.
-“Service Fee” – the annual fee charged to an obligee who has never received cash public assistance.
-“Specific Dollar Amount for Medical Purposes or Cash Medical Support” - an amount ordered to be paid
-toward the cost of health insurance provided by a public entity or by another party through employment or
-otherwise, or for other medical costs not covered by insurance.
-“SPLS” - the State Parent Locator Service.
-
-24
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-“State Department” - the Colorado Department of Human Services.
-“State Plan” - the comprehensive statement submitted by the State Department to the Department of
-Health and Human Services describing the nature and scope of its Child Support Services Program and
-giving assurance that it will be administered in conformity with the specific requirements stipulated in Title
-IV-D of the Social Security Act and other official issuances of Health and Human Services.
-“Support” - a medical support order and/or financial amount ordered by a court or through administrative
-process by a county Child Support Services Unit on behalf of (a) child(ren) or (b) child(ren) and former
-spouse, if established in the same court order and if the former spouse is living with the child(ren).
-“Termination of Review and Adjustment” - the review/adjustment activity ceases based on specific criteria
-which are set forth in Section 6.261.5.
-“Total Program Expenditures” - the total amount of costs associated with the Child Support Services
-program billed to the federal government for reimbursement.
-“UIFSA” - Uniform Interstate Family Support Act, Title 14, Article 5, Colorado Revised Statutes (C.R.S.)
-which governs interstate case processing.
-“UMP” - Unreimbursed Maintenance Payments. The amount of IV-E foster care maintenance payments
-which have not been reimbursed by child support collections or other recoveries.
-“Unassigned Arrears” - any arrears that are not assigned to the state, either because the obligee never
-received public assistance or because, for an obligee who is or was receiving public assistance, the
-arrears accrued during a time period when the obligee was not receiving public assistance.
-“Unfunded Disbursement” - a disbursement that is paid but subsequently found to contain an error or
-found to have insufficient funds to pay the disbursement.
-“UPA” - Unreimbursed Public Assistance. The amount of IV-A payments which have not been reimbursed
-by child and spousal support collections or reduced by IV-A established recoveries.
-“URESA” or “RURESA” - The Revised Uniform Reciprocal Enforcement of Support Act, Title 14, Article 5,
-C.R.S., as amended. Repealed in Colorado on January 1, 1995, the effective date of Uniform Interstate
-Family Support Act.
-“Unenforceable” - A case is determined unenforceable when there is no collection on a case for two years
-and all administrative or legal remedies have been attempted and determined to be ineffective. Ineffective
-has three elements: 1. The obligor is unable to pay, 2. The obligor has no known income or assets, 3.
-There is no reasonable prospect that the obligor will be able to pay in the foreseeable future; or, there is
-nothing to enforce on the case as benefits were paid but uncollectable due to the fact the recipient does
-not have custody of the children or there is shared custody.
-“Unsworn Declaration” - A statement or document that is not notarized but is made under the penalty of
-perjury under the law of Colorado that it is true and correct. An unsworn declaration may be used in lieu
-of an affidavit.
-6.100
-
-ADMINISTRATION OF THE COLORADO CHILD SUPPORT SERVICES PROGRAM
-
-6.101
-
-STATE DEPARTMENT OF HUMAN SERVICES
-
-The State Department of Human Services is responsible for statewide supervision or administration and,
-as provided in these rules, direct administrative activities concerning the Child Support Services Program
-as required by the federal government under its provisions for financial participation.
-
-25
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-6.102
-
-9 CCR 2504-1
-
-County Departments Of Social Services
-
-6.102.1 County departments shall strictly administer the Child Support Services Program in
-accordance with the rules set forth in this manual.
-6.102.2 Duties Of The County Department
-6.102.21
-The duties of the county department or its delegate shall include the following:
-A.
-
-Establishing, maintaining, and implementing specific written procedures for the operation of the
-Child Support Services Program in accordance with these rules;
-
-B.
-
-Maintaining the Child Support Services staff manual, required state forms, and copies of county
-letters;
-
-C.
-
-Establishing and monitoring agreements with local law enforcement officials, legal services
-providers and other organizations for the provision of services in support of the Colorado Child
-Support Services Program;
-
-D.
-
-Securing compliance with the requirements of the Colorado Child Support Services Program in
-operations delegated under any agreement;
-
-E.
-
-Implementing and utilizing a statewide, comprehensive automated child support system, as
-prescribed by the state department;
-
-F.
-
-Certifying delinquent cases to the state department for the interception of Internal Revenue
-Service refunds and for interception of state income tax refunds;
-
-G.
-
-Ensure the accuracy and integrity of the automated child support system;
-
-H.
-
-Conduct an administrative review at the request of the obligee as a result of the notice of
-collections mailed to the obligee or posted to the CSS website by the state department. the
-county will review its files prior to or at the administrative review as provided for in state
-regulations at Section 6.805.41. The notice will be generated for current and former IV-A
-recipients with support obligations who have assigned their rights to support and shall contain:
-1.
-
-Explanation of the assignment of support rights,
-
-2.
-
-Name of the noncustodial parent from whom the support is collected,
-
-3.
-
-The starting date of the period reported,
-
-4.
-
-The ending date of the period reported,
-
-5.
-
-A separate listing of payments collected from each noncustodial parent when more than
-one noncustodial parent owes support,
-
-6.
-
-Amount collected from each noncustodial parent which was retained to reimburse public
-assistance,
-
-7.
-
-Amount collected from each noncustodial parent which was paid to the family in the form
-of excess collections,
-
-26
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-I.
-
-Periodically, not less than annually, publicizing the availability of Child Support Services, including
-address and telephone number of the county Child Support Services Unit;
-
-J.
-
-Establishing an order for either party to provide medical support in new or modified court or
-administrative orders for child support, and enforcing the medical support provision when health
-insurance is accessible and available at reasonable cost to the obligor;
-
-K.
-
-Obtaining information regarding the health insurance available through the custodial party and/or
-noncustodial parent when a change in circumstance occurs that would warrant a change in the
-health insurance status and reporting such information on the automated child support system.
-The automated child support system will generate a report to the state Medicaid Third Party
-Resource Section;
-
-L.
-
-Conducting administrative reviews of contested arrears;
-
-M.
-
-Using diligent efforts to complete all actions appropriately and within the time frames required by
-the applicable federal regulations, statute or rule. Diligent efforts shall include the following:
-1.
-
-Initiating a task within the required time period;
-
-2.
-
-Completion of the task, including any follow up activities within the required time period;
-
-3.
-
-Taking the necessary actions in response to receipt of information that indicates that the
-task may not be on track to be completed within the required time frame.
-
-6.102.3 Establishment of the County Department Child Support Services Unit
-Allocation of Staff: Sufficient staff shall be assigned to the Child Support Services Unit to provide the
-following child support services functions: intake, locate, legal determination of parentage, establishment
-of the legal obligation, collection, enforcement, investigation and reporting as prescribed by these rules.
-6.103
-
-CERTIFICATION REQUIREMENTS FOR CHILD SUPPORT SERVICES EMPLOYEES
-
-6.103.1 ADMINISTRATIVE PROCESS ACTION (APA) CERTIFICATION
-A.
-
-B.
-
-APA Certification by the State Division of Child Support Services is required for:
-1.
-
-Child Support Services Unit employees that conduct APAs as described in sections 6.261
-and 6.700.
-
-2.
-
-County employees that supervise employees that conduct APAs, unless the direct
-supervisor of an employee conducting APAs is the county human or social services
-director and the director has designated another individual to review and sign APA
-default orders as required by sections 6.710.1(c), 6.711.1(c), and 6.714.1(a), below.
-
-3.
-
-Supervisors, administrators, or attorneys that have been designated, in writing, by the
-county human or social services director to review and sign APA default orders, pursuant
-to section 26-13.5-106 C.R.S. and required by sections 6.710.1(c), 6.711.1(c), and
-6.714.1(a), below.
-
-APA recertification must occur every three (3) years. A certified employee may transfer his or her
-certified status from one county to another if the transfer is requested within ninety (90) days of
-terminating employment with the first county.
-
-27
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-C.
-
-The county Child Support Services Unit must ensure that employees fulfill all certification and
-recertification training and testing requirements prior to conducting or continuing to conduct
-APAs.
-
-D.
-
-The county director or their authorized designee must determine and authorize, in writing, which
-Child Support Services Unit employees may conduct APA and negotiation conferences based
-upon the employee's APA certification status, classification, and experience. The county director
-or their authorized designee must ensure that only those employees with adequate skills,
-knowledge and training conduct negotiation conferences.
-
-E.
-
-In the event that a county does not have an APA certified supervisor, administrator, attorney, or
-county director, due solely to temporary staffing changes, the county shall notify the State
-Division of Child Support Services and coordinate with another county that has agreed to provide
-coverage for continuity of services, as identified in the annual program plan.
-
-6.103.2 AUTOMATED ENFORCEMENT CERTIFICATION
-A.
-
-Certification by the State Division of Child Support Services is required for Child Support Services
-Unit employees that perform, or supervise employees that perform, any enforcement actions
-associated with the following automated enforcement remedies:
-1.
-
-Administrative Offset
-
-2.
-
-Child Support Lien Network (CSLN)
-
-3.
-
-Credit Reporting (CRA)
-
-4.
-
-Department Of Corrections (DOC)
-
-5.
-
-Driver's License Suspension (DLS)
-
-6.
-
-Federal Tax Offset (IRS)
-
-7.
-
-Financial Institution Data Match (FIDM)
-
-8.
-
-Gambling (GAM)
-
-9.
-
-Lottery (LOT)
-
-10.
-
-Passport Denial
-
-11.
-
-Professional/Occupational License Suspension (POLS)
-
-12.
-
-Recreational License Suspension (RLS)
-
-13.
-
-State Revenue Offset (REV)
-
-14.
-
-Unclaimed Property Offset (UPO)
-
-15.
-
-Unemployment Compensation Benefits (UCB)
-
-16.
-
-Vendor Offset (VO)
-
-17.
-
-Worker's Compensation (WC)
-
-28
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-18.
-
-9 CCR 2504-1
-
-Automated Enforcement of Interstate Cases (AEI)
-
-B.
-
-Recertification must occur every three (3) years. A certified employee may transfer his or her
-certified status from one county to another if the transfer is requested within ninety (90) days of
-terminating employment with the first county.
-
-C.
-
-The county Child Support Services Unit must ensure that employees fulfill all certification and
-recertification training and testing requirements prior to performing or continuing to perform the
-enforcement actions described in this section.
-
-D.
-
-The county director or their authorized designee must determine and authorize, in writing, which
-Child Support Services Unit employees may perform the enforcement actions described in this
-section based upon the employee's certification status, classification, and experience. The county
-director or their authorized designee must ensure that only those employees with adequate skills,
-knowledge and training perform these actions.
-
-6.104 - 6.110 (None)
-6.120
-
-REIMBURSEMENT OF EXPENDITURES
-
-6.120.1
-The state department shall pass through to county departments of social services federal matching funds
-as prescribed by the state department for necessary expenditures for child support services and activities
-provided to PA recipients and NPA families in accordance with these rules.
-6.120.2 Federal matching funds will not be passed through to county departments of social
-services for:
-21
-
-Activities not related to the Child Support Services Program;
-
-22
-
-Construction or major renovations;
-
-23
-
-Purchases of child support services which are not secured in accordance with these rules and
-regulations;
-
-24
-
-Education and training programs and educational services except the direct costs of approved
-short-term training, as defined and approved by the state department;
-
-25
-
-Activities related to investigation or prosecution of fraud except for referring the discovery of same
-to the appropriate program;
-
-26
-
-Activities that are beyond the scope of these rules as determined by the state department;
-
-27
-
-Activities performed pursuant to an agreement that has expired and has not been renewed in
-accordance with these rules; and
-
-28
-
-The amount of any fees, costs, or interest on child support collections deposited in a financial
-institution and collected by the CSS Unit that have not been used to reduce county CSS program
-expenditures.
-
-29
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-6.130
-
-9 CCR 2504-1
-
-STATE DEPARTMENT TO SUPERVISE CSS PROGRAM
-
-The Colorado Department of Human Services is responsible for statewide supervision and direct
-administrative activities concerning the CSS program as required by the Federal government under its
-provisions for financial participation.
-County departments shall strictly administer the CSS program in accordance with the requirements of
-Title IV-D of the Social Security Act, and the federal and state rules and regulations which govern the
-operations of the CSS program.
-6.140
-
-PENALTY FOR FAILURE TO COMPLY WITH STATE AND FEDERAL REGULATIONS
-
-If a county fails to comply with the requirements of Title IV-D of the Social Security Act, and the federal
-and state rules and regulations which govern the operations of the CSS program, the State Department
-may reduce or withhold incentive payments or take other actions as provided for in state statute or
-Department rules referenced in Colorado Department of Human Services' rule manual Volume 1 (9 CCR
-2501-1).
-6.200
-
-GENERAL PROVISIONS
-
-6.201
-
-Application Requirements
-
-County CSS Units shall establish procedures to ensure that all appropriate functions and activities
-regarding applications and information on available services are undertaken and completed within the
-time frames specified and that all activities are documented on ACSES.
-6.201.1 Public Assistance (PA) Cases
-A.
-
-Public assistance cases shall be provided full support services as required by the Child Support
-Services program upon referral without an application requirement. Referral is defined as the
-Colorado Benefits Management System (CBMS) generated automated referral and the State
-prescribed Social Services Single Purposes Application (SSSPA) form or another county form
-containing, at a minimum, the information found in the State prescribed form.
-
-B.
-
-The following information shall be provided to PA clients on the appropriate state prescribed form:
-
-C.
-
-1.
-
-The assignment of rights to support payments;
-
-2.
-
-Available services;
-
-3.
-
-The individual's rights and responsibilities;
-
-4.
-
-Fees, cost-recovery and distribution policies;
-
-5.
-
-Case categorization and the information necessary to change the category;
-
-6.
-
-The requirement, in appropriate cases, for good cause exemption from referral to the
-CSS Unit to be granted by the county director or the designate IV-A staff; and
-
-7.
-
-The lack of an attorney-client relationship.
-
-Counties must document in the case record the date of referral, which is the date the recipient
-received the program information.
-
-30
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-6.201.2 NON-PUBLIC ASSISTANCE (NPA) CASES
-A.
-
-Continued Services Cases
-1.
-
-The Child Support Services Unit shall provide to the person whose IV-A grant or IV-E
-foster care eligibility is discontinued, continued CSS services, without a formal application
-unless the CSS agency is notified to the contrary by the person whose IV-A grant or IV-E
-foster care eligibility is discontinued.
-
-2.
-
-The Notice of Action and the CSE 34 Notice are notices that inform the recipient of public
-assistance, when they have discontinued temporary aid to needy families (TANF) that
-their child support case will remain open unless they request that the county close their
-case. These notices will be generated and mailed to the recipient ten (10) days prior to
-the effective date of the discontinuation.
-
-3.
-
-Form SS-4, Notice of Social Service Action, will be completed by the county services
-worker and mailed to recipients when a person(s) is discontinued from IV-E foster care.
-The form will be sent to the recipient five (5) days prior to the effective date of the
-discontinuation.
-The Notice Of Action, the CSE 34 Notice, and the Notice of Social Service Action (SS-4)
-shall:
-a.
-
-Notify the person whose IV-A grant or IV-E foster care has been discontinued,
-that the CSS Unit shall continue to provide CSS services unless the CSS Unit is
-notified by the former IV-A or IV-E foster care recipient to the contrary;
-
-b.
-
-Specify the CSS services that are available;
-
-c.
-
-Inform the person that the quality of information provided will affect the category
-of the case;
-
-d.
-
-Specify the name of the person whose IV-A grant and/or IV-E foster care has
-been discontinued; and,
-
-e.
-
-Specify the household number;
-
-f.
-
-Specify the unique case identifiers;
-
-g.
-
-Require the signature of the person discontinued who wishes to terminate CSS
-services;
-
-h.
-
-Specify the CSS unit will collect overdue support to repay past IV-A or IV-E foster
-care maintenance.
-
-i.
-
-Contain any other information deemed appropriate by the State Department.
-
-31
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-B.
-
-9 CCR 2504-1
-
-Application Cases
-1.
-
-Persons who do not receive public assistance or continued CSS services may apply for
-full CSS services by completing the Application for Child Support Services, as prescribed
-by the State Department. Applications for child support services shall be readily
-accessible to the public. Applications will not be accepted if all of the children associated
-with a specific obligee and obligor are emancipated, as defined in the existing child
-support order and the laws of the state where the child support order was entered. This
-same requirement applies to new interstate referrals sent to Colorado from another
-initiating state or jurisdiction. In a responding intergovernmental case, if the case was
-opened in the other state prior to emancipation and/or has state debt due, the application
-shall be accepted.
-
-2.
-
-Upon application, the services established for IV-A recipients to locate, establish
-parentage of a child (or children), establish court orders for child support, review and
-modify orders for child support, and secure support from noncustodial and/or alleged
-parents shall also be made available on behalf of children who are or were deprived of
-parental support due to the absence of a parent or parents, but, for other reasons, are not
-recipients of IV-A, including those children who are receiving foster care services from
-funds other than Title IV-E of the Social Security Act.
-
-3.
-
-The application on behalf of the child for child support services may be made by either of
-the child's parents (custodial or noncustodial), an alleged parent, legal guardian, or other
-person or agency.
-
-4.
-
-When the applicant is not a parent of the child, an application for child support services
-must be obtained for each noncustodial parent.
-
-5.
-
-Requests for Application
-
-6.
-
-a.
-
-When an individual requests an application or CSS services in person, the CSS
-Unit shall provide an application on the day requested.
-
-b.
-
-When an individual requests an application by phone or in writing, the application
-shall be sent by the county CSS Unit within no more than five (5) business days
-from the date of request.
-
-c.
-
-The application shall include the following information:
-1)
-
-available services;
-
-2)
-
-the individual's rights and responsibilities;
-
-3)
-
-fees, cost recovery and distribution policies;
-
-4)
-
-case categorization and the information necessary to change the
-category; and
-
-5)
-
-the lack of an attorney-client relationship.
-
-The application for non-PA CSS services shall be made on the Application for Child
-Support Services, as prescribed by the state department. The standard Application for
-Child Support Services shall include the following elements:
-a.
-
-The full name of the noncustodial parent;
-
-32
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-7.
-
-9 CCR 2504-1
-
-b.
-
-The full name, date of birth, place of birth, sex and social security number of
-each child for whom support is sought;
-
-c.
-
-The signature, address, telephone number, date of birth and social security
-number of the applicant and date of application.
-
-Acceptance of Applications
-a.
-
-An application may be filed in any CSS office. If there is an existing case in
-another county, then the application shall be forwarded to the appropriate
-enforcing county within two (2) working days of receipt in the original county.
-
-b.
-
-An application shall be accepted as filed on the date it is received in the CSS
-office, if one or more of the children associated with a specific obligee and obligor
-are not emancipated as defined in the child support order and the laws of the
-state where the child support order was entered, and it includes the following
-information:
-
-c.
-
-1)
-
-applicant's name, address and social security number;
-
-2)
-
-the name of the noncustodial parent(s), if known;
-
-3)
-
-name, birth date, sex, place of birth and social security number, if
-available, for each child;
-
-4)
-
-applicant's signature, either handwritten or electronic.
-
-Acceptance of an application involves recording the date of receipt on the
-application. The application must be entered into the ACSES for the application
-fee to be assessed..
-
-8.
-
-County CSS Units may collect costs incurred in excess of fees. These costs shall be
-determined on a case by case basis and shall be used to reduce CSS program
-expenditures.
-
-9.
-
-Non-PA obligees shall be charged an annual twenty-five dollar ($25) certification fee for
-collection of IRS tax refunds only if an actual intercept occurs. The fee shall be deducted
-from the tax refund intercept. The certification fee must be used to reduce CSS program
-expenditures.
-If there is more than one tax refund intercept for a case, the twenty-five dollar ($25)
-certification fee will be charged only once, regardless of the number of obligors, and will
-be deducted from the first intercept(s) that occurs. If the total amount of all tax refunds for
-a case is less than twenty-five dollars ($25), the amount of refunds will satisfy the
-certification fee.
-
-10.
-
-Non-PA obligees shall be charged an annual thirty-five dollar ($35) service fee once five
-hundred and fifty dollars ($550) has been disbursed to the family.
-The service fee will be reported to the federal government as program income, and will
-be shared between the federal, state, and county governments.
-The service fee will be collected for each case set in all intrastate in-state and initiating
-intergovernmental cases on the ACSES if the $550 disbursement threshold is reached.
-
-33
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-C.
-
-9 CCR 2504-1
-
-Locate Only Cases
-Persons who request only noncustodial parent locator service may complete the Request for
-Parent Locator Service. The Colorado State Parent Locator Service shall provide such caretaker
-with instructions for completing the form and fees to be paid by the caretaker. A non-PA
-application form is not required.
-
-6.201.3 FOSTER CARE CASES
-A.
-
-Appropriately referred IV-E or non-IV-E foster care cases pursuant to the CDHS Social Services
-staff manual (12 CCR 2509-1) shall be provided the full range of services as required by the Child
-Support Services program upon referral. Cases that are not appropriate for referral shall not be
-initiated.
-
-B.
-
-Referral is defined as receipt of the referral packet from the county child welfare agency or the
-date the case appears in the county’s on-line referral list. If the referral is manual, counties must
-document the date received by the CSS Unit as the referral date on the ACSES.
-
-C.
-
-Child support services applications are not required for IV-E foster care cases. An application for
-child support services, as prescribed by the State Department, shall be completed by the county
-department having custody of the child(ren) for all non-IV-E foster care cases.
-
-6.201.4 MEDICAID REFERRAL CASES
-Appropriately referred Medicaid cases shall be provided the full range of services required by the Child
-Support Services (CSS) program without an application requirement. “Appropriately referred” means that
-the Medicaid applicant requested CSS services.
-6.202 - 6.204
-6.205
-
-(None)
-
-ENFORCING COUNTY
-
-Designation of the county responsible for accepting the Child Support Services application or processing
-the case, or both, provides for centralized legal and financial activities and prevents duplication of effort
-and establishment of unnecessary orders for support when an order exists.
-Provisions pertaining to enforcing county designation and responsibilities shall apply to all new Child
-Support Services cases and for existing cases where there is a dispute regarding an enforcing county
-issue.
-A.
-
-The enforcing county is the county responsible for processing a case for Child Support Services,
-including locating the noncustodial parent, establishment of parentage, establishment and
-modification of a support order and enforcement of a support order. Enforcing county means the
-enforcing county on the automated child support system. The enforcing county is responsible for
-financial management of the case.
-The enforcing county is also the county responsible for the case for audit purposes. When the
-noncustodial parent resides outside of Colorado, the enforcing county is the county responsible
-for initiating an intergovernmental action or appropriate instate action for CSS services. If the
-noncustodial parent is the only party in the case residing in Colorado and there is no existing
-court order and no public assistance has been paid in Colorado, the enforcing county will be
-considered the county where the noncustodial parent resides.
-
-34
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-B.
-
-For all cases, the enforcing county for a Colorado Child Support Services case is the first county
-where a Child Support Services application or referral was made.
-
-C.
-
-When there is a new application or referral in a county other than the enforcing county, the county
-of the new application or referral shall assist in the completion of the application and any
-intergovernmental or other necessary documents. The county of the new application or referral
-shall forward the application and documents to the enforcing county, as appropriate, utilizing the
-form as prescribed by the State Department. Unless the CSS Units in the interested counties
-agree or there is enforcing county resolution to change enforcing county designation, the
-enforcing county remains the enforcing county until the case is closed in accordance with this
-manual. The enforcing county does not change when the parties in the case relocate.
-
-D.
-
-When a IV-D unit requests enforcing county designation and the interested CSS Units cannot
-agree, within five (5) calendar days, upon which county should be the enforcing county, the
-county directors, or their designees, in the counties will resolve the issue. If agreement cannot be
-reached, the CSS office shall refer the matter to the State Division of Child Support Services for
-resolution in accordance with the state procedure and prescribed form. The state decision is final
-and binding on the interested counties.
-
-6.205.1 ENFORCEMENT OF ORDER AND FINANCIAL MANAGEMENT
-A.
-
-The enforcing county shall enforce the original order and any subsequent modifications, and
-modify, as appropriate. Copies of all legal actions, such as modifications, and judgments shall be
-filed into the original order.
-
-B.
-
-When IV-A or foster care placement costs (maintenance and services) have been expended in
-another Colorado county or counties, the enforcing county must contact all such counties and,
-within ten (10) working days, such counties shall provide the amount of unreimbursed public
-assistance or the costs for foster care placement to be included in the establishment of an order
-or to modify an order for UPA or foster care costs reimbursement. The enforcing county is
-responsible for coordinating arrearage balances of all interested counties.
-
-C.
-
-The enforcing county shall enforce the existing order to the extent possible even if the order was
-issued by another county. If a court hearing is necessary, the enforcing county may request the
-IV-D unit in the county of the existing order to have its CSS attorney appear on behalf of the
-enforcing county. When requested, the CSS attorney in the order-issuing county shall appear on
-behalf of the enforcing county and represent the case as if it were their own county's case.
-
-D.
-
-In cases in which the obligor has now become the obligee, known as role reversal, the county
-enforcing the existing order shall initiate the role reversal case and modify the existing court order
-to reflect the new change in circumstance, or initiate a reciprocal action to another jurisdiction, if
-appropriate, whether the role reversal occurred prior to or after the IV-D referral or application.
-
-6.205.11
-
-Change of Venue
-
-Change of venue shall not be initiated for purposes of having the attorney for the order county take court
-action or to change the enforcing county for the case. A change of venue may be completed when the
-court determines it is in the best interests of the custodian, child, or non-custodial parent. Change of
-venue does not change the enforcing county, except upon agreement of the counties involved.
-6.205.12
-
-Controlling Order
-
-In cases with multiple actions or orders, the enforcing county will determine the controlling order pursuant
-to Section 14-5-207, C.R.S., et seq.
-
-35
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-6.205.13
-
-9 CCR 2504-1
-
-Registration Of Order
-
-In intergovernmental cases, the enforcing county may register a foreign order or enforce administratively,
-when enforcement is requested by the initiating agency.
-There shall be no registration of Colorado orders.
-6.205.2 INTERGOVERNMENTAL ENFORCING COUNTY
-Responding intergovernmental cases are cases received from a jurisdiction outside Colorado requesting
-Child Support Services because the noncustodial parent resides, is employed or derives income in
-Colorado. The county that shall work the responding intergovernmental case is determined as follows:
-A.
-
-If there is an existing open cases, a responding intergovernmental action shall be forwarded to
-the existing enforcing county.
-
-B.
-
-If there is no open enforcing county designation, the responding intergovernmental action will be
-forwarded to the county where a Colorado order has been entered or a foreign order registered
-that involves the same obligor and children.
-
-C.
-
-If there is no open enforcing county designation and no previous Colorado order or registration of
-a foreign order, a responding intergovernmental action will be forwarded to the county of the
-noncustodial parent's place of residence.
-
-D.
-
-If there is no open enforcing county designation, no previous Colorado order or registration of a
-foreign order, and a noncustodial parent's residential location cannot be identified or verified, a
-responding intergovernmental action will be forwarded to the county of the noncustodial parent's
-place of employment.
-
-E.
-
-If there is no open enforcing county designation, no previous Colorado order or registration of a
-foreign order, and a noncustodial parent's residential and employment location cannot be
-identified or verified, a responding intergovernmental action will be put into sixty (60) day closure
-by the Interstate Unit. It will be returned to the initiating state if the obligor’s residence or
-employment cannot be verified in Colorado within that time frame. However, if the
-intergovernmental action was received from a foreign country, it will be forwarded to the county of
-the noncustodial parent's last known place of residence, if one was provided, or county of last
-known employment.
-
-F.
-
-If the responding case is the enforcing case and is closed by the other state, the current in-state
-case must take enforcing county designation. If there is more than one current case, the rules for
-determining the enforcing county shall be followed.
-
-6.206 - 6.209
-6.210
-
-(None)
-
-Safeguarding And Protecting Confidential Information
-
-All information contained in electronic or paper case files of the Child Support Services program
-concerning the name(s) or identifying information of custodial parties, noncustodial parents, or children
-shall be considered confidential and shall be protected, except when otherwise provided for in this
-section.
-
-36
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-6.210.1 Release Of Information
-6.210.11
-Before any information is released and before any discussion is held with any individual or entity
-concerning an individual case, the requestor’s identity must be verified and the purpose of the contact or
-request must be confirmed. If the request is made by fax, phone or Internet, information shall not be
-released until the requestor’s identity has been verified by requiring the requestor to provide unique
-identifying information such as Social Security Number, dates of birth for self or child(ren), court case
-number, child support case number, or Family Support Registry account number.
-6.210.12
-Child Support Services workers shall release the name, mailing and/or residential address, Social
-Security Number, place of employment, day care amount, income, health insurance information, and date
-of birth of custodial parties, noncustodial parents or children, and establishment or enforcement
-information concerning the legal obligation for support only in the following circumstances:
-A.
-
-When clarification of information is required to provide the next appropriate Child Support
-Services Unit service authorized in Colorado law and described in the Child Support Services
-state plan. For example, if a worker from a clerk and recorder’s office calls to clarify information
-contained in a Child Support Services Unit’s request for a lien to be placed on real property, the
-child support worker may confirm what action is being requested of the clerk and recorder.
-
-B.
-
-In the administration of the plan or any program approved under Part A (Temporary Assistance to
-Needy Families), Part B (Child Welfare), Part D (Child Support Enforcement), Part E (Foster
-Care) or Part F (Child Care Services) or Titles XIX (Medicaid) or XXI (State Children’s Health
-Insurance Program) of the Social Security Act, and the Supplemental Nutrition Assistance
-Program, including data which is necessary for fraud investigation or audit.
-1.
-
-To assist any investigation, prosecution, or criminal or civil proceeding conducted in
-connection with the administration of any such state plans or programs.
-
-2.
-
-To report to the appropriate state or county department staff information that has been
-reported, to a Child Support Services worker, of suspected mental or physical injury,
-sexual abuse or exploitation, or negligent treatment or maltreatment of a child who is the
-subject of a child support services activity under circumstances which indicate that the
-child’s health or welfare is threatened.
-
-C.
-
-In response to a request received from a party to the action or the party’s attorney of record, the
-requester can receive information specific to themself only, and not the other party. Each party
-may verify the accuracy of the information related to themself only that is in the possession of the
-Child Support Services Unit. If the requestor is shown as a child on the case action, even if the
-child has since reached the age of emancipation, that requestor is not a party to the action and
-the information shall not be released except upon issuance of a court order.
-
-D.
-
-To provide statutorily required information to the court on child support orders and other
-documents that are completed by the CSS Unit and then filed with the court, unless there has
-been a court order of non-disclosure entered to suppress such information on that particular
-party.
-
-E.
-
-To inform the parties of information regarding the amount of public assistance benefits paid to the
-family which could be used in an administrative or court proceeding to establish or enforce an
-order for the past assistance.
-
-37
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-6.210.13
-
-9 CCR 2504-1
-
-Disclosure
-
-Disclosure of any Child Support Services case information is prohibited in the following circumstances:
-A.
-
-At the request of all private collection agencies, unless the requesting agency is a state or county
-contractor and bonded as required by state or federal statute.
-
-B.
-
-In response to a written complaint from the party (constituent) received by a legislator. Child
-Support Services Units may provide only information which indicates what progress is being
-made on the case or what action has or will be taken to move the case forward.
-
-C.
-
-At the request of any attorney who is not the attorney of record as reflected on the automated
-child support system or in the court files.
-
-D.
-
-At the request of a current spouse or other individual even if that person has a notarized
-statement from the noncustodial parent.
-
-E.
-
-Any information received from the Internal Revenue Service that has not been verified by an
-independent source. Such information can only be released to the taxpayer.
-
-F.
-
-Information obtained through the State Income and Eligibility Verification System (IEVS) shall not
-be disclosed to anyone. The information shall be used exclusively by the Child Support Services
-program.
-
-G.
-
-Disclosure to any committee or legislative body (federal, state, or local) of any information that
-identifies any party to the action by name or address.
-
-H.
-
-Genetic test results can only be released to the parties of the action. Pursuant to Sections 19-1308 and 25-1-122.5, Colorado Revised Statutes, the parties are prohibited from disclosing the
-information to anyone else.
-
-I.
-
-The information obtained from the access of records using the Social Security Number, pursuant
-to Section 14-14-113, C.R.S., shall only be used for the purposes of establishing parentage or
-child support ordered, modifying or enforcing child support orders.
-
-J.
-
-Upon receipt of a non-disclosure affidavit and required documentation from either party, the
-county child support services worker shall create the affidavit of non-disclosure and the affidavit
-shall be forwarded to the court of jurisdiction. In this instance an individual’s identity or location
-can be released only upon receipt of a court order requiring the override of the non-disclosure.
-The county child support worker shall update the non-disclosure indicator on the automated child
-support system within five working days of the date of receipt of the affidavit. Interjurisdictional
-cases will be handled as follows:
-
-K.
-
-1.
-
-Initiating Interjurisdictional Cases: Treated the same as an in-state case with the
-exception that the affidavit will be sent to the responding jurisdiction along with the other
-required intergovernmental forms.
-
-2.
-
-Responding Interjurisdictional Cases: If the initiating jurisdiction indicates that there is a
-nondisclosure granted in that jurisdiction, the county child support worker shall update the
-non-disclosure indicator on the automated child support system within five working days
-of the date of receipt of the intergovernmental request.
-
-No Financial Institution Data Match information or Federal Tax information from the Internal
-Revenue Service may be disclosed outside of the administration of the Title IV-D program.
-
-38
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-L.
-
-9 CCR 2504-1
-
-No information from the National Directory of New Hires or the Federal Case Registry may be
-disclosed outside of the administration of the Title IV-D program except:
-1.
-
-In the administration of the plan or any program approved under Part B and Part E of the
-Social Security Act to locate parents and putative parents for the purpose of establishing
-parentage or establishing parental rights with respect to a child.
-
-2.
-
-In the administration of the plan or any program approved under Part A, Part B, Part D,
-and Part E of the Social Security Act, which is incorporated by reference; no
-amendments or editions are included. They may be examined during regular business
-hours by contacting the Colorado Department of Human Services, Director of the Division
-of Child Support Services, 1575 Sherman Street, Denver, Colorado 80203; or at any
-State Publications Depository Library. The Social Security Act is also available on-line at:
-http://www.ssa.gov/op_home/ssact/ssact.htm.
-
-6.210.2 PAYMENT RECORDS
-Child support payment records that do not identify the source of the payments are considered public
-records and may be released upon request of any person pursuant to Section 24-72-202, C.R.S. No
-federal tax information, address or any other location information shall be included in the documents
-provided to the requestor or included for use in any court.
-6.210.3 CONFLICT OF INTEREST
-Child Support Services Units shall establish processes in which certain case files are worked only by a
-supervisor or in a manner that provides limited access to case information. An example of these files:
-employee files or court ordered “sealed” files. Any employee with a personal interest in a case, including
-but not limited to the employee’s own case or a case of a relative or friend, shall not engage in any Child
-Support Services activity related to that case and may not view any case information maintained on the
-automated child support system for that case.
-6.210.4 RECORDS
-6.210.41
-
-Taxpayer Records
-
-Federal tax return information obtained from the Internal Revenue Service shall be safeguarded to
-comply with Internal Revenue Service safeguarding standards, which include storing information in a
-locked cabinet or by shredding the information. Disclosure of, or access to, unverified data shall be
-restricted to individuals directly involved in the administration of the Child Support Services program.
-“Unverified” means information which has not been independently verified with the taxpayer or through a
-third party collateral source. While obtaining verification of locate information, the Child Support Services
-worker shall not divulge the source of the data being requested for verification.
-6.210.42
-
-Financial Records
-
-Financial records of an individual are to remain confidential, unless they are part of an action to establish
-a child support order or to complete a review and adjustment of an existing child support order, in which
-case, supporting financial documentation used to calculate the monthly support obligation shall be
-provided to both parties. Any person disclosing financial information inappropriately could face civil
-damages.
-
-39
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-6.210.5 ADOPTION INFORMATION
-Adoption information such as adoptive parents’ names, biological parents’ names, or other identifying
-information shall not be data entered on the automated child support system. The date of adoption or
-relinquishment shall be documented in the case file to indicate that any prior arrears owed could be
-assigned to the state.
-6.210.6 ACCESS TO INFORMATION
-A.
-
-No online computer access to electronic records through the automated child support system or
-other systems or databases will be provided to parties or non-parties.
-
-B.
-
-Access to the automated child support system or other systems or databases for any personal
-reason is prohibited. Access is restricted to business use only and can only be accessed in the
-usual course of business.
-
-C.
-
-County directors of social services or their written designee shall establish written processes to
-assure that system access is only provided to employees which corresponds to each workers'
-case assignment.
-
-D.
-
-No other division within the state department shall have access to the automated child support
-system without specific approval from the state Division of Child Support Services. Child Support
-Services information will be released by granting access to specific automated child support
-system data elements or by making an extract file of case information available, at the state level,
-for other programs to access.
-
-E.
-
-County directors or their written designees must request from the state Child Support Services
-Unit access to the automated child support system, for companies or individuals who have
-entered into contracts or agreements with state and/or county Child Support Services Units, by
-including the request to access case information in the contract or agreement.
-
-F.
-
-State and county Child Support Services Units must perform a background check on all
-employees prior to authorizing access to Child Support Services information. Employees shall
-have their fingerprints taken by a local law enforcement agency or any third party approved by the
-Colorado Bureau of Investigation to obtain a fingerprint-based criminal history record check.
-Additionally, the background check must include a Colorado Civil Court record check to obtain
-any child support case history of the employee.
-
-G.
-
-All information eligible for release to related agencies (such as Internal Revenue Service, lottery,
-Department of Labor, credit reporting agencies, Department of Revenue, Motor Vehicle, Workers'
-Compensation, financial institutions, state regulatory agencies, the state controller, and Social
-Security) will be made available at the state level.
-
-6.210.7 Access to Electronic Vital Records Maintained by the Colorado Department of Public
-Health and Environment (CDPHE)
-A.
-
-In order to be granted access to the electronic vital records system maintained by the Colorado
-Department of Public Health and Environment (CDPHE), an employee of a county delegate Child
-Support Services Unit must complete and provide to CDPHE a criminal background check and all
-required forms.
-
-B.
-
-Each county delegate Child Support Services Unit must complete a safeguard assessment for
-each location where employees will be accessing the electronic vital records system using the
-form prescribed by CDPHE. The safeguard assessment will be completed on a yearly basis
-thereafter.
-
-40
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-C.
-
-Each county delegate Child Support Services Unit shall ensure that its employees access the
-electronic vital records system maintained by CDPHE only for child support services purposes.
-
-D.
-
-If a current or former child support services employee’s access to the electronic records system
-maintained by CDPHE is terminated or needs to be terminated due to a change of employment or
-job duties, the county delegate Child Support Services Unit shall notify CDPHE and the Colorado
-Department of Human Services, Division of Child Support Services, within two (2) business days.
-The county delegate Child Support Services Unit shall request that access to the electronic vital
-records system be terminated when an employee no longer needs access for child support
-enforcement purposes. However, if there is an emergency situation involving a security breach,
-the county delegate Child Support Services Unit shall notify CDPHE of the need to terminate
-access, at least on a temporary basis, by the end of the next business day following discovery of
-the breach. A security breach is defined in the access agreement signed by county delegate child
-support services staff.
-
-E.
-
-If a county delegate Child Support Services Unit determines that the electronic vital records
-system has been accessed or may have been accessed for non-child support services purposes
-or accessed by anyone not authorized to do so, it shall report this to CDPHE and the Colorado
-Department of Human Services, Division of Child Support Services, by the end of the next
-business day following discovery.
-
-F.
-
-A county delegate Child Support Services Unit shall cooperate with any investigation into a
-security breach relating to the electronic vital records system, including providing any
-documentation requested to CDPHE and the Colorado Department of Human Services, Division
-of Child Support Services.
-
-6.220
-
-FEDERAL TAX INFORMATION
-
-A.
-
-Federal Tax Information is not to be viewed, either on a computer screen or on a printout of a
-computer screen, by anyone other than Child Support Services (CSS) staff, CSS contract staff, or
-CSS attorneys. If an unauthorized person inspects or discloses Federal Tax Information, county
-CSS staff must report this violation to the State Child Support Services Internal Revenue
-Service’s point of contact.
-
-B.
-
-Federal Tax Information is not to be printed from the automated child support system except if
-that Federal Tax Information was originally provided by the taxpayer, unless the screen print is
-appropriately logged and either filed with secure storage controls or appropriately destroyed. The
-log must contain the following information:
-
-C.
-
-1.
-
-Which screen was printed;
-
-2.
-
-Who printed the screen;
-
-3.
-
-Who had access to the screen print;
-
-4.
-
-The name of the obligor;
-
-5.
-
-The IV-D case number;
-
-6.
-
-The storage location of the screen print; and,
-
-7.
-
-The date, method of destruction, and person who destroyed the screen print.
-
-CSS Units are prohibited from transmitting Federal Tax Information via a facsimile device or via
-any form of electronic mail.
-
-41
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-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-D.
-
-Only an agency-owned computer and/or other device shall be used to remotely connect and gain
-access to the automated child support system.
-
-E.
-
-If a county uses a visitor’s log in its CSS Unit, the log must include the following items:
-
-6.230
-
-1.
-
-Date;
-
-2.
-
-Visitor’s name;
-
-3.
-
-Visitor’s place of business;
-
-4.
-
-Driver’s license number, state, and expiration date;
-
-5.
-
-The purpose of the visit;
-
-6.
-
-The person who escorted the visitor; and,
-
-7.
-
-The time the visitor came into the building and the time the visitor left the building.
-
-COOPERATION BY CUSTODIAL PARTY
-
-6.230.1 Good Cause
-Good cause is defined as circumstances under which cooperation with the Child Support Services Unit
-may not be “in the best interests of the child.” In the case of a IV-A referral, the county director or the
-designate IV-A staff shall make the determination of good cause exemption from referral of a custodial
-party to the Child Support Services Unit. The Child Support Services Unit may provide information or
-participate with the county director or designate IV-A staff, as appropriate, to make the determination of
-good cause exemption.
-6.230.11
-
-Cooperation Requirements
-
-The custodial party is required to cooperate with the county Child Support Services Unit in:
-A.
-
-Providing sufficient, verifiable information about the identity and location of the noncustodial
-parent(s) of the child(ren). Information is sufficient if it includes:
-1.
-
-Noncustodial parent's full name and Social Security Number; or,
-
-2.
-
-Noncustodial parent's full name and at least two of the following items:
-a.
-
-Noncustodial parent's date of birth;
-
-b.
-
-Noncustodial parent's address;
-
-c.
-
-Noncustodial parent's telephone number;
-
-d.
-
-Noncustodial parent's employer's name and address;
-
-e.
-
-The names of the parents of the noncustodial parent;
-
-f.
-
-Noncustodial parent's vehicle information (manufacturer, model and license);
-
-g.
-
-Noncustodial parent's prison record;
-
-42
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-h.
-3.
-B.
-
-9 CCR 2504-1
-
-Noncustodial parent's military record; or,
-
-Noncustodial parent's full name and additional information which leads to the location of
-the noncustodial parent, or if unable to comply with any of the above.
-
-Provide all of the following that the custodial party has or can reasonably obtain that may lead to
-the identity of noncustodial parent:
-1.
-
-If parentage has not been established, provide a sworn statement of conception;
-
-2.
-
-Statements as to the identity or location of noncustodial parent from other individuals;
-
-3.
-
-Records or information as to the whereabouts of records, from specific agencies;
-
-4.
-
-Utility bills, parking tickets, credit card receipts, etc., that contain information about
-noncustodial parent;
-
-5.
-
-Telephone numbers or addresses of others who knew the noncustodial parent;
-
-6.
-
-Sworn statement documenting efforts taken by custodial party and obstacles
-encountered by custodial party in pursuit of information about the noncustodial parent;
-
-7.
-
-Any other information that may assist the CSS Unit in identifying or locating the
-noncustodial parent.
-
-C.
-
-Establishing parentage of children for whom parentage has not been legally established or is in
-dispute and for whom assistance or foster care services is requested or provided.
-
-D.
-
-Establishing orders for financial and medical support and obtaining medical support for each
-child, when available to either party, as ordered by the court.
-
-E.
-
-Obtaining support payments for the recipient/applicant and for each child for whom assistance or
-foster care services is requested or provided, and to which the department is entitled to collect
-pursuant to the assignment of support rights.
-
-F.
-
-Obtaining any other payments or property to which the custodial party and/or each child for whom
-assistance is provided may be entitled, and to which the department is entitled to collect,
-pursuant to the assignment of support rights.
-
-6.230.13
-
-Cooperation in Foster Care Cases
-
-As a condition of continuing eligibility for assistance or to comply with part of the foster care treatment
-plan, unless exempted for good cause, the custodial party is required to make a good faith effort to
-provide information about the noncustodial parent(s) of the child(ren) to the Child Support Services Unit.
-6.230.2 Cooperation Defined
-“Cooperation”, as used in this context, is defined as, but not limited to:
-A.
-
-Appearing at the county department of social services office or other related agency to provide
-verbal and/or written information, or documentary evidence that is known by, in the possession of,
-or reasonably obtainable by the individual and which is relevant and necessary;
-
-B.
-
-Appearing as a witness in court or other relevant hearing or proceeding;
-
-43
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-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-C.
-
-Providing information or attesting to the lack of information requested, under penalty of perjury;
-
-D.
-
-Submitting to genetic tests during an administrative or court proceeding conducted to determine
-parentage;
-
-E.
-
-Paying to the CSS Unit of the county department of social services all child support payments
-received from an obligor or a court after being determined eligible for IV- A or foster care
-services; and,
-
-F.
-
-Signing legal documents, as appropriate.
-
-6.230.3 Cooperation Determination
-The county IV-D administrator, or a designee, is responsible for making the determination of whether a
-public assistance or foster care recipient has cooperated with the CSS Unit for the purposes of
-establishing and enforcing child or medical support.
-6.230.4 Notification
-The county CSS Unit shall notify immediately the IV-A unit, foster care unit, or Medicaid unit of any IV-A
-recipient, foster care placing parent, or Medicaid referral case recipient who fails to fulfill the cooperation
-requirements of this section. The notification shall describe the circumstances of the non-cooperation and
-the date(s) upon which it occurred.
-The county CSS Unit will not attempt to establish parentage and support or collect support or third party
-information for medical support in those cases where the custodial party is determined to have good
-cause for refusing to cooperate.
-6.230.5 Custodial Party Cooperates
-After the CSS Unit has notified the IV-A or foster care units of the custodial party's failure to cooperate,
-the custodial party may decide to cooperate rather than face penalties with the assistance grant or foster
-care treatment plan. Should this occur, the CSS Unit shall provide notification to the IV-A or foster care
-units that the custodial party is now cooperating. The CSS Unit shall provide the notification to the IV-A or
-foster care units within two (2) working days from the date the custodial party cooperated with the CSS
-Unit.
-6.230.6 Request for Review Through Title IV-A
-When the custodial party requests a review through IV-A of the determination that they have failed to
-cooperate with the CSS Unit, the county IV-D administrator, or a designee, shall appear at the IV-A
-dispute resolution conference and/or state level hearings to provide information concerning the basis for
-the determination that the custodial party has failed to cooperate with the CSS Unit.
-6.240
-
-MEDICAL SUPPORT ESTABLISHMENT AND ENFORCEMENT
-
-6.240.1 MEDICAL SUPPORT ESTABLISHMENT
-For all cases in which current child support is being sought (including zero dollar orders), the Child
-Support Services Unit shall include a provision for either parent to provide health care coverage for the
-child(ren).
-
-44
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-Child Support Services
-
-9 CCR 2504-1
-
-6.240.2 MEDICAL SUPPORT ENFORCEMENT
-Unless the child(ren) are receiving public health care coverage, the National Medical Support Notice
-(NMSN) must be sent to the obligor’s employer if the obligor is ordered to provide health insurance, the
-obligor is eligible for health insurance, the health insurance is accessible to the child(ren), and the
-monthly premiums are reasonable in cost.
-A.
-
-A notice must be sent to the obligor, informing the obligor that the NMSN was sent to their
-employer and describing the rights and conditions regarding the issuance of the NMSN. The
-obligor has ten (10) calendar days from the date of the mailing to object with the Child Support
-Services Unit if the obligor believes there is a mistake in identity and they are not the obligor,
-there is no order for the obligor to provide health insurance, the health insurance is not accessible
-to the children, or the monthly premiums are not reasonable in cost.
-1.
-
-Health insurance is considered not accessible to the child(ren) if the child(ren) resides
-outside the geographic area of coverage.
-
-2.
-
-A premium amount is considered reasonable in cost if the premium payments
-(child(ren)’s portion) are less than five percent (5%) of the paying parent’s gross income
-or application of the premium payment (child(ren)’s portion) on the guidelines does not
-result in a Monthly Support Obligation of fifty dollars($50) or less.
-
-B.
-
-The Child Support Services Unit will have ten (10) calendar days from the date the objection is
-mailed to determine if the objection is valid. If the obligor objects to the enforcement of the NMSN
-claiming it exceeds the reasonable cost standard, the Child Support Services Unit must
-determine if the premium amount is five percent (5%) or more of the obligor’s gross monthly
-income.
-
-C.
-
-If the obligor’s objection is valid, the Child Support Services Unit must send a notice of
-termination to the obligor’s employer with a copy to the obligor. If the obligor’s objection is not
-valid, the Child Support Services Unit must notify the obligor that the NMSN will remain in effect
-and that the obligor has the right to object with the court.
-
-D.
-
-In subsidized adoption cases, CSS units have the option of enforcing medical support through a
-NMSN. Verification of the subsidized adoption is required if the Child Support Services Unit
-chooses not to enforce.
-
-6.250
-
-PROVISION OF SERVICES IN INTERGOVERNMENTAL IV-D CASES BY CHILD SUPPORT
-SERVICES (CSS) UNITS
-
-6.250.1 INITIATING STATE/JURISDICTION RESPONSIBILITIES
-County CSS Units shall ensure management of the initiating intergovernmental CSS caseload to ensure
-provision of necessary services, including maintenance of case records and periodic review of program
-performance on interstate cases.
-A.
-
-When applicable, use long arm statutes to establish parentage or support. Also, determine if
-enforcement action can be completed through an instate action such as direct income withholding
-to the noncustodial parent's out of state source of income.
-
-B.
-
-Within twenty (20) calendar days of locating the noncustodial parent in another state, Tribe or
-country, determine if the filing of an intergovernmental action is appropriate and refer the
-intergovernmental filing to the Interstate Central Registry of the appropriate state, to the Tribal IVD program, or to the central authority of the foreign country, or take the next appropriate action.
-
-45
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-C.
-
-Ask the appropriate intrastate tribunal or refer the case to the appropriate responding state IV-D
-agency for a determination of the controlling order and a reconciliation of arrearages, if such a
-determination is necessary.
-
-D.
-
-The twenty (20) day time frame begins on the date the obligor’s location is verified and/or
-necessary documentation to process the case is received, whichever date is later. UIFSA
-petitions are to be sent directly to the Interstate Central Registry of the appropriate state, to the
-Tribal IV-D program, or to the central authority of the foreign country.
-
-E.
-
-Provide sufficient and accurate information on appropriate standardized interstate forms with
-each action referred to enable the responding agency to take action. The Intergovernmental Child
-Support Enforcement Transmittal form and other standardized interstate forms, as prescribed by
-the state, shall be used for each intergovernmental action request.
-
-F.
-
-Request that the responding state include health insurance in all new and modified orders for
-support.
-
-G.
-
-Within thirty (30) calendar days of request, provide additional information and any order and
-payment record information requested by a state IV-D agency for a controlling order
-determination and reconciliation of arrearages, or notify the requesting office when information
-will be provided.
-
-H.
-
-Within ten (10) working days of receipt of new case information, submit information to the CSS
-office in the responding agency. New information includes case status change or any new
-information that could assist the other agency in processing the case.
-
-I.
-
-Instruct the responding agency to close its intergovernmental case and to stop any withholding
-order or withholding notice that the responding agency has sent to an employer, before
-transmitting a withholding order or withholding notice, with respect to the same case, to the same
-or another employer, unless an alternative agreement is reached with the responding agency
-regarding how to proceed.
-
-J.
-
-Notify the responding agency within ten (10) working days when a case is closed and the reason
-for closure.
-
-K.
-
-The CSS Unit may provide any documentation, notification, or information through any electronic
-means, as long as the electronic transaction is appropriately documented in the case record.
-
-L.
-
-If the initiating agency has closed its case pursuant to Section 6.260.5 and has not notified the
-responding agency to close its corresponding case, the initiating agency must make a diligent
-effort to locate the obligee, including use of the Federal Parent Locator Service and the State
-Parent Locator Service, and accept, distribute, and disburse any payment received from a
-responding agency.
-
-6.250.2 RESPONDING STATE/JURISDICTION RESPONSIBILITIES
-County CSS Units shall ensure management of the interstate CSS caseload to ensure provision of
-necessary services, including maintenance of case records and periodic review of program performance
-on interstate cases.
-A.
-
-Ensure that organizational structure and staff are adequate to provide services in
-intergovernmental CSS cases.
-
-46
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-B.
-
-County CSS Units must initiate any electronic or manual referral from the Colorado Central
-Registry within twenty (20) calendar days of the date of referral as found on the ACSES
-responding interstate recently referred list.
-
-C.
-
-If the noncustodial parent is located in another county within ten (10) working days of receipt of
-the intergovernmental case, the case shall be moved to the county of the noncustodial parent's
-residence unless:
-1.
-
-The county was the open enforcing county prior to the intergovernmental referral; or,
-
-2.
-
-The county has registered a foreign order; or,
-
-3.
-
-The county is the county of the original order.
-If the case does need to be moved, the county shall contact the Colorado Central
-Registry to move the case to the county of the noncustodial parent's residence.
-
-D.
-
-Within ten (10) working days of locating the noncustodial parent in another state or country, the
-CSS Unit will notify the initiating state of the new address. At the direction of the initiating agency,
-the case may be closed or the case may be forwarded to the appropriate Central Registry, to the
-Tribal IV-D program, or to the central authority of the foreign country in which the noncustodial
-parent now resides.
-
-6.250.21
-
-Provide Necessary CSS Services as In state Title IV-D Cases
-
-Provide all necessary CSS services as would be provided in instate IV-D cases by:
-A.
-
-Establishing parentage and attempting to obtain a judgment for costs if parentage is established;
-if parentage has been determined by another state, whether it was established through voluntary
-acknowledgment, administrative process or judicial process, it shall be enforced and otherwise
-treated in the same manner as an order of this state;
-
-B.
-
-Establishing child support obligations;
-
-C.
-
-Establishing an order for either party to provide medical support in all new or modified orders for
-child support, if not addressed in the original order;
-
-D.
-
-Processing and enforcing orders referred by another agency, pursuant to the UIFSA or other
-legal processes;
-
-E.
-
-Enforcing medical support if there is evidence that health insurance is accessible and available to
-the obligor at a reasonable cost;
-
-F.
-
-Collecting and monitoring support payments for the initiating agency and forwarding payments to
-the location specified by the initiating CSS office within two business days of the Colorado date of
-receipt;
-
-G.
-
-If a determination of controlling order has been requested, file the request as defined by Section
-14-5-207, C.R.S., with the appropriate tribunal within thirty (30) calendar days of receipt of the
-request or location of the noncustodial parent, whichever occurs later. Notify the initiating agency,
-the controlling order state, and any state, country, or Tribe where a support order in the case was
-issued or registered of the controlling order determination and any reconciled arrearages within
-thirty (30) calendar days of receipt of the determination from the tribunal.
-
-47
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-H.
-
-Provide timely notice to the CSS office in the initiating agency of any formal hearing regarding
-establishment or modification of an order. Respond to inquiries regarding intergovernmental case
-activity within five (5) working days.
-
-I.
-
-Respond to inquiries regarding intergovernmental case activity within five (5) working days.
-
-J.
-
-Within ten working days of receipt of new information on a case, submit information to the
-initiating agency. New information includes case status change or any new information that could
-assist the other agency in processing the case.
-
-K.
-
-Notify the initiating state within ten (10) working days of the case closure when a case is closed.
-
-6.250.3 PAYMENT AND RECOVERY OF COSTS IN INTERSTATE IV-D CASES
-The responding agency is responsible for payment of genetic tests for establishing parentage. The
-responding agency is responsible for attempting to obtain judgment for genetic test costs.
-The responding agency is responsible for payment of all costs it incurs in the processing of an interstate
-case.
-The responding agency may not recover costs from a Foreign Reciprocating Country (FRC) or from a
-foreign obligee in that FRC, when providing services under Sections 454(32) and 459A of the Social
-Security Act. The documents are incorporated by reference; no amendments or editions are included.
-They may be examined during regular business hours at the Colorado Department of Human Services,
-Director of the Division of Child Support Services, 1575 Sherman Street, Denver, Colorado 80203; or at
-any state publications depository library. The Social Security Act is also available on-line at:
-http://www.ssa.gov/OP_Home/ssact/ssact.htm.
-6.260
-
-Case Management
-
-6.260.1 CSS Case Definition
-A CSS case is defined as a noncustodial parent who has a duty, or has been alleged to have a duty, of
-support (not necessarily a court order) whether or not there has been a collection of support. If the
-noncustodial parent is responsible for the support of children in more than one family, the noncustodial
-parent is considered as a separate case with respect to each separate family.
-6.260.2 Case Records
-6.260.21
-
-Case Record Procedures
-
-County CSS Units shall establish procedures to ensure that all appropriate functions and activities related
-to opening a case record are undertaken and completed within the time frames specified. The time
-frames begin on the date of referral or acceptance of an application and end when the case is ready for
-the next appropriate activity, e.g. locate, establishment of parentage, establishment of a support order, or
-enforcement. All activities must be documented on ACSES within five working days.
-6.260.22
-
-Opening a Case
-
-Within twenty (20) calendar days of receipt of an application or referral of a case, the Child Support
-Services (CSS) Unit must:
-A.
-
-Open a case by initiating a case record on the State approved automated child support system by
-following established procedures.
-
-48
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-B.
-
-For Title IV-A inter-county transfer cases, the new county must initiate the case on the automated
-child support system within five (5) working days of referral from IV-A in the new county.
-
-C.
-
-Determine necessary action needed.
-
-D.
-
-Solicit necessary information from the custodial party or other sources.
-
-E.
-
-Initiate verification of information.
-
-F.
-
-If location information is inadequate, refer the case for further location.
-
-G.
-
-Initiate an automated ledger if an order for support exists, including posting Monthly Support
-Obligation to the correct class and initiating any arrears balances, if such information is known. If
-order information is unknown when the case is initiated, the ledger must be initiated within twenty
-(20) days of when the order information becomes available to the Child Support Services Unit.
-
-6.260.23
-A.
-
-Maintenance of Records
-
-For all cases, the Child Support Services Unit shall maintain an electronic or physical case record
-for each noncustodial or alleged parent which contains all information collected pertaining to the
-case. Such information shall include, but is not limited to the following:
-1.
-
-A chronological listing of information maintained on the State approved automated child
-support system. Such information shall include:
-a.
-
-Any contacts with the recipient of IV-A or foster care placing parent who is
-required to cooperate with the Child Support Services Unit, the date and reason,
-and the results of such contact;
-
-b.
-
-Any contacts with the non-PA custodial party for Child Support Services, the date
-and reason, and the results of such contact;
-
-c.
-
-Any contacts with the noncustodial parent, the date and reason therefore, and
-the results of such contact;
-
-d.
-
-Any contact with any other agency involved in the case.
-
-e.
-
-Actions taken to establish or modify a support obligation, establish child support
-debt, establish parentage, or enforce a support obligation, the dates and results;
-
-f.
-
-Identification of the reason for and date of case closure; and
-
-g.
-
-Any other significant actions taken regarding the case as deemed necessary for
-caseload documentation and management.
-
-2.
-
-The referral document received from the IV-A or foster care units, or the Application for
-Child Support Enforcement Services form;
-
-3.
-
-The written request from the recipient/applicant or the initiating jurisdiction in a
-responding intergovernmental case to terminate Child Support Services;
-
-4.
-
-Information Concerning Noncustodial Parent form, as prescribed by the State
-Department or similar county created form;
-
-49
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-B.
-
-9 CCR 2504-1
-
-5.
-
-A record of efforts to utilize local locate resources and the dates and results of these
-efforts;
-
-6.
-
-A copy of the court or administrative order;
-
-7.
-
-A copy of communications to and from the IV-A or the foster care program;
-
-8.
-
-A copy of communications to and from the State Department;
-
-9.
-
-A copy of communications to and from other Child Support Services Units or agencies;
-
-10.
-
-A record of case categories and priorities assigned and reassigned to the case, the date
-of such determination, and identification of the individual who made the determination;
-
-11.
-
-A copy of notices to the noncustodial parent and decisions concerning contested arrears.
-
-12.
-
-An accurate and updated automated system ledger, including posting the court ordered
-Monthly Support Obligation and an accurate arrears balance.
-
-Child Support Services staff shall change case categories as prescribed by the state immediately
-on the automated child support system when the case is ready for the next activity in order to
-provide documentation that the time frames have been met.
-
-6.260.3 CATEGORIZATION OF WORKLOAD
-6.260.31
-The CSS Unit shall provide equal services to all cases in the caseload.
-6.260.32
-shall:
-
-The CSS Unit may utilize a case assessment and category system. Such system
-
-A.
-
-Include all cases in the system.
-
-B.
-
-Ensure that no service including location, establishment of parentage, establishment and
-enforcement of support obligation is systematically excluded by the system.
-
-C.
-
-Provide for notice to the custodial party that the information provided to the CSS Unit, either
-initially or subsequently, may affect the relative category of the case.
-
-D.
-
-Provide that case assessment and category setting shall occur only after the intake information
-has been reviewed for accuracy and completeness and an attempt has been made to obtain the
-missing information.
-
-E.
-
-Provide for periodic review of cases and notification to the custodial party in those cases that new
-information may result in a category change for the case.
-
-6.260.33
-
-The CSS Unit shall modify the category of cases as case conditions change.
-
-6.260.4 (None)
-
-50
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-Child Support Services
-
-9 CCR 2504-1
-
-6.260.5 CLOSURE OF CASES
-6.260.51
-
-Notice and Reasons for Closure
-
-Unless otherwise noted, case closure requires a sixty (60) day advance notice of closure to the custodial
-party. For closure reasons that require notice, the Child Support Services Unit must notify the custodial
-party of the unit's intent to close the case by sending a notice of closure on the form prescribed by the
-State Department either by paper or electronic notification sixty (60) calendar days prior to closing a
-public assistance or non-public assistance case. The case must be left open if the custodial party or
-initiating agency supplies information in response to the notice which could lead to the establishment of
-parentage or a support order or enforcement of an order. If the case is a responding interstate case, the
-notice shall be sent to the initiating agency. Responding intergovernmental cases can only be closed
-using closure reasons “H” or “I” of this section. If the case is a foster care case, the notice of closure is not
-required because the custodial party (county department) initiated the request for closure based on the
-child(ren)'s termination from foster care placement. All records of closed cases must be retained for a
-minimum of three years. All documentation concerning the closure must remain in the case file.
-Public assistance and non-public assistance cases may be closed for one or more of the reasons listed
-below or in Section 6.260.52 or 6.260.53.
-A.
-
-B.
-
-C.
-
-There is no longer a current support order and,
-1.
-
-All arrearages in the case are assigned to the state or;
-
-2.
-
-The arrearages are under $500.
-
-The noncustodial parent or putative parent is deceased and the death has been verified through
-sources such as:
-1.
-
-A newspaper obituary;
-
-2.
-
-A death certificate;
-
-3.
-
-Contact with the funeral home;
-
-4.
-
-The custodial party's statement has been recorded in the case record; or,
-
-5.
-
-The Social Security Death Index, and no further action, including a levy against the
-estate, can be taken.
-
-The Child Support Services Unit determines that parentage cannot be established because:
-1.
-
-The child is at least 18 years old and the action is barred by a statute of limitations;
-
-2.
-
-The results of genetic testing have excluded the alleged parent as the parent of the child;
-
-3.
-
-A court or administrative process has excluded the alleged parent;
-
-4.
-
-The Child Support Services Unit determines it is not in the best interest of the child to
-establish parentage in a case involving incest, rape, or in any case where legal
-proceedings for adoption are pending;
-
-5.
-
-The identity of the biological, alleged, putative, or presumed parent is unknown and
-cannot be identified after diligent efforts, including at least one interview by the Child
-Support Services Unit with the custodial party; or,
-
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-
-6.
-D.
-
-9 CCR 2504-1
-
-The child(ren) in the case has had their adoption(s) finalized.
-
-The noncustodial parent's location is unknown and the Child Support Services Unit has made
-diligent efforts using multiple sources, pursuant to Section 6.500, all of which have been
-unsuccessful in locating the noncustodial parent:
-1.
-
-Over a two-year period when there is sufficient information to initiate an automated locate
-effort; or,
-
-2.
-
-Over a one-year period when there is not sufficient information to initiate an automated
-locate effort. Sufficient information is defined as a name and Social Security Number
-and/or Individual Tax Identification Number (ITIN).
-
-3.
-
-After a one-year period when there is sufficient information to initiate an automated locate
-effort, but locate interfaces are unable to verify a Social Security Number.
-All cases in the Child Support Services caseload will be transmitted from the state case
-registry to the federal case registry. One step in the transmission will be to submit the
-case to the Enumeration Verification System (EVS) which will assist in identifying and
-verifying a Social Security Number.
-
-E.
-
-The noncustodial parent cannot pay support for the duration of the child's minority (or the child
-has reached the age of majority), because the parent has been institutionalized in a psychiatric
-facility, is incarcerated with no chance for parole, or has a medically verified total and permanent
-disability with no evidence of support potential above the subsistence level, which is defined as
-the federal poverty level. The Child Support Services Unit must determine that no income or
-assets are available to the noncustodial parent which could be levied or attached for support.
-
-F.
-
-The noncustodial parent’s sole income is from Supplemental Security Income (SSI) payments, or
-both SSI payments and Social Security Disability Insurance (SSDI). This closure criterion does
-not apply when the parent is receiving only SSDI benefits. parentage and support must be
-established in order to use this closure criterion.
-
-G.
-
-The noncustodial parent is a citizen of, and lives in, a foreign country, and does not work for the
-United States government or a company which has its headquarters or offices in the United
-States and the noncustodial parent has no reachable domestic income or assets and the federal
-office and the state have been unable to establish reciprocity with the foreign country.
-
-H.
-
-The initiating jurisdiction has requested in writing that the interstate case be closed. The sixty (60)
-day advance notice of closure is not required for these cases. Any income withholding order must
-be terminated and the responding case closed within ten (10) working days of the request from
-the initiating agency unless an alternative agreement is reached with that agency.
-
-I.
-
-The Child Support Services Unit documents failure by the initiating agency to take action which is
-essential for the next step in providing services.
-
-J.
-
-If a case was closed and then subsequently reopened to process child support payments
-received after case closure, the case should be closed once payment processing is completed.
-The sixty (60) day advance notice of closure is not required for these cases.
-
-K.
-
-There has been a change in legal custody in the case.
-
-L.
-
-The custodial parent is deceased.
-
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-
-M.
-
-The responding jurisdiction does not have statutory authority to take the next appropriate action in
-the case.
-
-N.
-
-Unenforceable as defined in section 6.002.
-
-6.260.52
-
-Closure of Non-Public Assistance Cases
-
-Non-public assistance cases may be closed for one of the following reasons or the closure reasons in
-Section 6.260.51. Unless otherwise noted, case closure requires a 60-day advance notice of closure to
-the custodial party.
-A.
-
-The Child Support Services Unit is unable to contact the custodial party within a 60 calendar day
-period despite a good faith effort to contact the recipient through at least two different methods:
-mail, electronic, or telephone. If contact is reestablished with the custodial party in response to
-the notice which could lead to the establishment of parentage or support, or enforcement of an
-order, the case must be kept open. After a notice of case closure has been sent, if the custodial
-party reports a change in circumstances within the 60 days contained in the advance notice of
-closure, the case shall remain open.
-
-B.
-
-The Child Support Services Unit documents non-cooperation of the custodial party and that
-cooperation of the custodial party is essential for the next step in providing support enforcement
-services. The notice shall include the basis of the recipient's failure to cooperate and the dates on
-which it occurred. The applicant requests closure of the case in writing and there are no arrears
-owed to the State. The 60 day advance notice of closure is not required for these cases.
-
-C.
-
-The Child Support Services Unit has provided location only services as requested. The 60 day
-advance notice of closure is not required for these cases.
-
-D.
-
-The status of the case has changed from non-public assistance to public assistance. The 60 day
-advance notice is not required for these cases.
-
-E.
-
-The children have reached the age of majority, the noncustodial parent is entering or has entered
-long-term care arrangements (such as a residential care facility or home health care), and the
-noncustodial parent has no income or assets available above the subsistence level that could be
-levied or attached for support.
-
-F.
-
-The noncustodial parent is living with the minor child (as the primary caregiver or in an intact two
-parent household), and the IV-D agency has determined that services are not appropriate or are
-no longer appropriate.
-
-6.260.53
-
-Closure of Public Assistance Cases
-
-Public assistance cases may be closed for one of the following reasons or the closure reasons in Section
-6.260.51. Unless otherwise noted, case closure requires a 60 day advance of closure to the custodial
-party.
-A.
-
-The 60 day advance notice of closure is not required for these cases. There has been a finding
-by the county director or designated IV-A staff of good cause or other exceptions to cooperation
-with the Child Support Services Unit and the county has determined that support enforcement
-may not proceed without risk of harm to the child or caretaker relative.
-
-B.
-
-The public assistance case has been closed and all possible assigned arrearages have been
-collected. The Child Support Services Unit is no longer providing services for the current monthly
-support obligation. The 60 day advance notice of closure is not required for these cases.
-
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-
-C.
-
-The public assistance case has been closed, the obligor owes no public assistance arrearages,
-and a case has been subsequently opened as a Child Support Services non-public assistance
-case. The 60 day advance notice of closure is not required for these cases.
-
-D.
-
-The public assistance case has been closed, there is no order for child support, child support
-debt, medical coverage, foster care fees, and where, pre 1984, the custodial parent did not
-request continued child support services (by signing the CSE-34), or post-1984, the obligee
-requested closure of their child support case in writing. The 60 day advance notice of closure is
-not required.
-
-E.
-
-The children have reached the age of majority, the noncustodial parent is entering or has entered
-long-term care arrangements (such as a residential care facility or home health care), and the
-noncustodial parent has no income or assets available above the subsistence level that could be
-levied or attached for support.
-
-F.
-
-The noncustodial parent is living with the minor child (as the primary caregiver or in an intact two
-parent household), and the IV-D agency has determined that services are not appropriate or are
-no longer appropriate.
-
-6.260.54
-A.
-
-B.
-
-Closure of Foster Care Cases
-
-In addition to the same closure reasons as public assistance cases under Section 6.260.53,
-foster care fee cases may also be closed because:
-1.
-
-The child(ren)'s foster care placement has been terminated; and,
-
-2.
-
-There is no longer a current support order; and,
-
-3.
-
-Either no arrears are owed or arrearages are under $500 or unenforceable under state
-law.
-
-If the child(ren) is in foster care placement, a foster care fee or foster care child support case may
-be closed:
-1.
-
-If there is an order terminating parental rights; and,
-
-2.
-
-There is no longer a current support order; and,
-
-3.
-
-Either no arrears are owed or arrearages are under $500 or unenforceable under state
-law.
-
-A sixty day advance notice of closure is required to close a foster care child support case, but is not
-required to close a foster care fee case.
-6.260.55
-
-Closure of Caretaker Relative Cases
-
-Child support staff shall not close, at the request of the caretaker relative, one of the two cases against
-biological parents in caretaker relative cases where each of the biological parents have child support
-cases.
-6.260.56 Tribal Closure
-Tribal closure codes will be used by the County Child Support Services Unit when dealing with Tribal IV-D
-programs. These codes will designate the different closure requests made by the tribal nations.
-
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-
-6.260.6 IMAGING
-Certified forms of the imaging of the case records may be substituted for the original case records upon
-prior written approval by the State Department.
-Such approval may be granted when the Child Support Services Unit provides the State Department with
-the methods and procedures that conform to federal standards for the imaging of records.
-6.260.7 EXPEDITED PROCESSES FOR CHILD SUPPORT ESTABLISHMENT AND ENFORCEMENT
-ACTIONS
-County child support units must develop, have in effect, and use procedures for all cases which ensure
-compliance with expedited process requirements. The procedures must include meeting the expedited
-process time frames for processing CSS actions based upon the following criteria:
-A.
-
-Actions to establish an order for support (and parentage, if not previously established) must be
-completed from the date of service of process to the time of disposition within the following time
-frames:
-1.
-
-Seventy five percent (75%) in six (6) months; and,
-
-2.
-
-Ninety percent (90%) in twelve (12) months.
-
-B.
-
-When an order is established using long arm jurisdiction and disposition occurs within twelve (12)
-months of service of process on the alleged parent or noncustodial parent, the case may be
-counted as a success within the six-month tier of the expedited process time frame, regardless of
-when disposition actually occurs within those twelve (12) months.
-
-6.261
-
-REVIEW AND ADJUSTMENT OF CHILD SUPPORT ORDERS
-
-The Child Support Services Unit is responsible for the following functions in sub-sections 6.261.2 through
-6.261.8 regarding the review and adjustment of child support orders for all cases.
-6.261.1 (NONE)
-6.261.2 NOTICE OF RIGHT TO REQUEST REVIEW
-Both parties or their attorney(s) of record, if any, subject to an order must be notified of their right to
-request a review.
-A.
-
-The obligee shall receive notification of the right to request a review on the Social Services Single
-Purpose Application (SSSPA), the Child Support Services application for services, and/or on the
-Administrative Process Orders or Judicial Order forms for cases having a support order
-established or modified by the Child Support Services Unit. At least every thirty-six (36) months,
-the obligee or the obligee’s attorney of record shall receive notification of the right to request a
-review via the right to request notice which is automatically generated when a residence or
-mailing address exists on the obligee's personal record and the order date or the notice date is
-thirty-six (36) months or older.
-
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-
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-
-B.
-
-The obligor or the obligor’s attorney of record shall receive notification of the right to request a
-review via the right to request notice which is automatically generated when a residence or
-mailing address exists on the obligor's personal record and the order date or the notice date is
-thirty-six (36) months or older, whichever is later. The right to request notice generated by the
-Automated Child Support Enforcement System document generation will automatically be
-documented in chronology. The obligor or the obligor’s attorney of record shall also receive
-notification on the administrative process orders or judicial order forms for cases having a support
-order established or modified by the Child Support Services Unit.
-
-C.
-
-The enforcing county delegate Child Support Services Unit must respond to the Automated Child
-Support Enforcement System's calendar review message indicating the automatic generation of
-the right to request review notice of each party or their attorney of record. The calendar review
-alerts the worker when a child(ren) has reached the age of emancipation. Within five (5) business
-days of receiving the calendar review message and the generation of the right to request review
-notices, the worker must read the active order and determine if the child(ren) included in the order
-is emancipated pursuant to Section 14-10-115, Colorado Revised Statutes. If the child(ren) is
-emancipated and is not the last or only child on the order, the worker shall mail a right to request
-review notice to each party or their attorney of record.
-
-D.
-
-The obligee or the obligee’s attorney of record and the obligor or the obligor’s attorney of record
-shall receive notification of the right to request a review via the right to request notice which is
-automatically generated within fifteen (15) business days of when incarceration information is
-populated as verified indicating incarceration for more than one hundred and eighty (180) days on
-the obligor’s personal record. The right to request notice generated by the Automated Child
-Support Enforcement System document generation program will automatically be documented in
-chronology.
-
-E.
-
-Upon reinstatement of a foster care fee order, if it has been greater than six (6) months since
-enforcing the monthly support obligation, the county child support services unit shall notify the
-obligor or the obligor’s attorney of record of the right to request a review by generating and
-mailing the right to request notice within five (5) business days of reinstatement.
-
-6.261.3 CASES SUBJECT TO REVIEW AND ADJUSTMENT
-A.
-
-Either party in cases with an active order may request a review of the order. The request shall
-include the financial information from the requesting party necessary to conduct a calculation
-pursuant to the Colorado Child Support guidelines. The requesting party shall provide his or her
-financial information on the form required by the Division of Child Support Services.
-If the requestor fails to provide the necessary financial information with their request, the review
-process shall be denied.
-
-B.
-
-The delegate Child Support Services Unit may initiate a review of a current child support order
-upon its own request.
-
-C.
-
-In cases containing an active assignment of rights, the Child Support Services Unit shall review
-the order at least once every thirty six (36) months to determine if an adjustment of the order is
-appropriate.
-In the case of an automatic review with an active assignment of rights, both parties are
-considered non-requestors and have twenty days from the date of the review notice to provide
-the necessary financial information.
-
-D.
-
-Only the enforcing county delegate Child Support Services Unit shall assess a request for review
-of a child support order and deny it or grant it and initiate a review.
-
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-
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-
-E.
-
-If the current county receives the written request for review, the request must be forwarded to the
-enforcing county within five calendar days of receipt of the request.
-
-F.
-
-Within fifteen (15) business days of receipt of a written request for review, the worker shall
-determine whether Colorado or another jurisdiction has authority (Continuing, Exclusive
-Jurisdiction (CEJ)) to conduct the review and modify the child support order. If Colorado has CEJ,
-the worker will make the assessment as to whether the request for review will be granted or
-denied pursuant to the standards set forth in paragraph H, below.
-
-G.
-
-If another jurisdiction has CEJ:
-
-H.
-
-1.
-
-The Child Support Services worker shall determine whether or not a full UIFSA action is
-needed. If this is needed, the worker shall initiate the reciprocal and generate the general
-testimony and the uniform support petition. If not, the worker shall generate the last two
-pages of the Interstate Income and Expense Affidavit. The appropriate forms shall be
-sent to the requester within five (5) business days of the determination.
-
-2.
-
-The forms generated from the automated child support system document generation will
-automatically be documented in chronology.
-
-3.
-
-The requester shall return the last two pages of the Income and Expense Affidavit to the
-enforcing county within twenty (20) calendar days.
-
-4.
-
-If the requester fails to return the requested documentation within twenty (20) calendar
-days, the process stops.
-
-5.
-
-Within twenty (20) calendar days of receipt of the information from the requester, the
-Child Support Services worker shall send it to the other state that is to conduct the
-review.
-
-If Colorado has CEJ, and:
-1.
-
-It has been thirty-six (36) months or more since the last review or adjustment of the
-support order, the child support services worker must begin the review process following
-the procedures set forth in Section 6.261.4, unless:
-a.
-
-It is a request for review of a spousal maintenance order;
-
-b.
-
-It is a request for the emancipation of a child who has not emancipated in
-accordance with Section 14-10-115, C.R.S.;
-
-c.
-
-There is a pending administrative process action, court action for modification or
-a pending “add-a-child action”;
-
-d.
-
-It is a request for a change in the allocation of parental responsibility or parenting
-time;
-
-e.
-
-The IV-D case is closed; if so, the requester will be advised in writing that s/he
-may apply for services;
-
-f.
-
-The delegate county Child Support Services Unit is enforcing only arrearages; or,
-
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-
-g.
-
-2.
-
-9 CCR 2504-1
-
-The last or only child is within one year of the legal age of emancipation and the
-modification process may not be able to be completed before the child reaches
-the legal age of emancipation; the requesting party must be informed of the right
-to request a modification through court.
-
-It has been fewer than thirty-six (36) months since the last review or adjustment of the
-support order, the child support services worker will begin the review process following
-the procedures set forth in Section 6.261.4, unless:
-a.
-
-The requester has not provided a reason for such review or the reason for review
-arises from the circumstances of the requesting party and the requesting party
-fails to provide supporting documentation or otherwise fails to demonstrate that
-there has been a substantial and continuing change in circumstances as set forth
-in Section 14-10-122, C.R.S., with their request;
-
-b.
-
-It is a request for review of a spousal maintenance order;
-
-c.
-
-It is a request for the emancipation of a child who has not emancipated in
-accordance with Section 14-10-115, C.R.S.;
-
-d.
-
-It is a request for a change in the allocation of parental responsibility or parenting
-time;
-
-e.
-
-There is a pending administrative process action or court action for modification
-or a pending add-a-child action;
-
-f.
-
-The IV-D case is closed, if so the requester will be advised in writing that s/he
-may apply for services;
-
-g.
-
-The delegate county Child Support Services Unit is enforcing only arrearages; or,
-
-h.
-
-The last or only child is within one year of the legal age of emancipation and the
-modification process may not be able to be completed before the child reaches
-the legal age of emancipation; the requesting party will be informed of the right to
-request a modification through court.
-
-I.
-
-If a request for review of a child support order is denied pursuant to paragraph H, the worker shall
-inform the requesting party in writing within five (5) business days of receipt of the request. The
-worker shall also document the date of the request and the reason for the denial in the
-Automated Child Support Enforcement System. If the request is granted the worker shall initiate
-the review process within five (5) business days pursuant to Section 6.261.4.
-
-J.
-
-If a county delegate CSS unit who is enforcing a current monthly support obligation receives a
-request for review of a child support order, which does not contain medical support provisions or
-which contains a request to change the party ordered to provide medical support, the request
-shall be granted and the review conducted, including a review of the MSO, regardless of the date
-of the last review or adjustment. The modified order shall state that “either” party, “respondent” or
-“petitioner” party shall provide medical support unless it is a caretaker or foster care fee order.
-
-K.
-
-Within fourteen (14) days of information and confirmation that the Obligor is incarcerated and has
-been sentenced to one hundred-eighty (180) days or greater, the delegate county child support
-services unit shall initiate a review of the order if the current monthly support obligation is not
-already a minimum order amount.
-
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-
-9 CCR 2504-1
-
-6.261.4 CONDUCTING THE REVIEW
-A.
-
-The Child Support Services worker shall send the following documents to the requesting party or
-their attorney of record, except in foster care cases where the requesting party is the county
-department, at least thirty (30) calendar days prior to commencement of the review:
-1.
-
-The Review Notice; and,
-
-2.
-
-At county option, the county may choose to send the Administrative Subpoena to obtain
-additional income/financial information.
-
-The forms generated from the automated child support system document generation will
-automatically be documented in chronology.
-B.
-
-The Child Support Services worker shall send the following documents to the non-requesting
-party or their attorney of record, except in foster care cases where the non-requesting party is the
-county department, thirty (30) calendar days prior to commencement of the review. In
-interjurisdictional cases, a copy shall also be sent to the other agency involved in the case:
-1.
-
-The Review Notice; and,
-
-2.
-
-The Income and Expense Affidavit.
-
-The forms generated from the automated child support system document generation will
-automatically be documented in chronology.
-C.
-
-The Child Support Services worker shall conduct the review on or before the thirtieth calendar
-day following the date the Review Notice is sent to the parties using income information from
-each party's Income and Expense Affidavit and/or the Department of Labor and Employment
-records and/or other reliable financial/wage information. The review may be conducted in person
-at the Child Support Services office, via United States mail, or via an electronic communication
-method.
-
-D.
-
-The delegate Child Support Services Unit may grant a continuance of the review for good cause.
-The continuance shall be for a reasonable period of time and shall not exceed thirty (30) calendar
-days.
-
-E.
-
-When conducting the review, the Child Support Services worker shall apply the child support
-guidelines to determine any inconsistencies between the existing child support award amount and
-the amount resulting from application of the child support guidelines.
-
-F.
-
-If the non-requesting party or their attorney of record fails to provide financial or wage information,
-the Child Support Services worker shall use income information which is available to the Child
-Support Services Unit through Colorado Department of Labor and Employment records and/or
-other verified sources such as the State Parent Locator Service, the Expanded Federal Parent
-Locator Service, and the State Employment Security Administration. Information from the other
-party/parent or from a prior review or establishment action may also be used.
-
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-
-G.
-
-If the Child Support Services Unit determines that a parent is voluntarily unemployed or
-underemployed or in the absence of reliable information, the Child Support Services Unit shall
-then determine, and document for the record, the parent’s potential income. In determining
-potential income, the Child Support Services Unit shall consider the specific circumstances of the
-parent to the extent known, including consideration of the following when said information is
-available: the parent’s assets, residence, employment and earnings history, job skills, educational
-attainment, literacy, age, health, criminal record and other employment barriers, and record of
-seeking work, as well as the local job market, the availability of employers willing to hire the
-parent, prevailing earnings level in the local community, and other relevant background factors in
-the case. All steps taken to obtain financial information must be documented.
-
-H.
-
-In conducting the review, the Child Support Services worker shall examine the existing order to
-determine if a medical support provision needs to be added or modified.
-
-6.261.5 TERMINATION OF REVIEW
-If the applicant for services or continued services party requests case closure after a review of the order
-has been initiated, the county CSS shall complete the review (and modification, if appropriate) before the
-IV-D case is closed. If the results of the review indicate a post-order change of physical care, the review
-and modification shall be completed and then the case closed, if appropriate.
-6.261.6 (Reserved for Future Use)
-6.261.7 REVIEW RESULTS, NO ADJUSTMENT REQUIRED
-Judicial and Administrative Process Orders: After completion of the review, the child support services
-worker may determine that there is no adjustment required in the ordered child support amount because
-the guideline calculation does not indicate at least a ten percent change in the ordered child support
-amount and/or the provision for medical support is already a part of the order.
-Within five (5) business days of completing the review, the Child Support Services worker shall provide to
-each party or their attorney of record, including the foster care agency and other child support agencies:
-A.
-
-The Post Review Notice stating that a “substantial and continuing change of circumstances” has
-not been shown but that a party may file his or her own motion to modify with the court.
-
-B.
-
-The Guideline Calculation Worksheets.
-
-C.
-
-The forms generated by the automated child support system document generation will
-automatically be documented in chronology.
-
-6.261.8 REVIEW RESULTS, ADJUSTMENT REQUIRED
-A.
-
-Judicial Orders: After completion of the review, the Child Support Services worker may determine
-an adjustment is necessary because the guideline calculation indicates at least a ten percent
-change in the ordered child support amount and/or a change in or addition of medical support
-provision is needed.
-1.
-
-Within five (5) business days of completing the review and determining that an
-adjustment is required, the Child Support Services worker shall provide to the obligor and
-obligee or their attorney of record and to the other agency involved in interjurisdictional
-cases:
-a.
-
-The Post Review notice;
-
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-
-2.
-
-3.
-
-9 CCR 2504-1
-
-b.
-
-The guideline calculation worksheets;
-
-c.
-
-All supporting financial documentation used to calculate the monthly support
-obligation; and,
-
-d.
-
-The order/stipulation.
-
-Either party may file a challenge to the review results based on the post review notice or
-the proposed order:
-a.
-
-The challenge must be received no later than the fifteenth day following the Post
-Review Notice date.
-
-b.
-
-The challenge must be in writing.
-
-c.
-
-The challenge must be based on alleged mathematical or factual error in the
-calculation of the monthly support obligation.
-
-d.
-
-The delegate Child Support Services Unit may grant an extension of up to fifteen
-(15) calendar days to challenge the review results based upon a showing of good
-cause.
-
-e.
-
-The delegate Child Support Services Unit shall have fifteen (15) calendar days
-from the date of receipt of the challenge to respond to the challenge.
-
-f.
-
-If a challenge results in a change in the monthly support obligation, the delegate
-Child Support Services Unit shall provide an amended notice of review and a
-new order/stipulation to the parties.
-
-g.
-
-Both parties are then given fifteen (15) calendar days from the date of the
-amended notice of review to challenge the results of any subsequent review.
-
-Within five (5) business days of determining that a review indicates that a change to the
-monthly support obligation is appropriate, and the review is not challenged or all
-challenges have been addressed, the delegate Child Support Services Unit shall file with
-the court:
-a.
-
-A Motion to Modify; and,
-
-b.
-
-The order/stipulation.
-
-4.
-
-Upon receipt of the order/stipulation from the court, the Child Support Services worker
-shall send copies to the parties or their attorneys of record and to the other agency
-involved in interjurisdictional cases. The Child Support Services worker shall document
-the automated child support system chronology with this activity.
-
-5.
-
-Within five (5) business days of determining that a challenge cannot be resolved, the
-Child Support Services worker shall file with the court:
-a.
-
-A Motion to Modify;
-
-b.
-
-The order/stipulation;
-
-c.
-
-The Guideline Calculation Worksheets; and,
-
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-
-B.
-
-9 CCR 2504-1
-
-d.
-
-The Imputing Potential Income Checklist, with comments made in the Guideline
-Worksheet, if applicable,
-
-e.
-
-Income and Expense Affidavits of the parties.
-
-6.
-
-Within eighteen (18) days of determining that a challenge cannot be resolved, the Child
-Support Services worker shall check for the court’s signature on the order; if the court
-has not signed the order, set a hearing pursuant to local court rules.
-
-7.
-
-After a hearing has been set, the Child Support Services worker shall send copies of the
-notice of hearing to the parties or their attorneys of record and to the other agency
-involved in interjurisdictional cases and document the automated child support system’s
-chronology with this activity.
-
-8.
-
-If the obligor’s employer’s address is known, the delegate Child Support Services Unit
-shall, unless another agency is enforcing an interjurisdictional case or the case meets
-one of the good cause criteria specified in Section 14-14-111.5(3)(a)(II)(A), C.R.S.:
-a.
-
-Send a notice to withhold income for support within fifteen (15) calendar days of
-the date the modified order is entered;
-
-b.
-
-Send a notice to withhold income for support to the obligor’s employer within two
-(2) business days from the report of the obligor’s employment through the state
-directory of new hires;
-
-c.
-
-Send a National Medical Support Notice to initiate health insurance coverage
-within fifteen (15) calendar days of the date the modified order is entered or
-within two (2) business days from the report of the obligor’s employment through
-the state directory of new hires, if the obligor is the party ordered to provide
-health insurance and the employer has health insurance available at reasonable
-cost, as defined in Section 6.240.2, A, 2.
-
-Administrative Process Orders: After completion of the review the Child Support Services worker
-may determine an adjustment is necessary because the guideline calculation indicates at least a
-ten percent change in the ordered child support amount and/or a change to or an addition of a
-medical support provision is needed.
-1.
-
-Within five (5) business days of completing the review and determining that a
-modification is required, the Child Support Services worker shall provide to the obligor
-and obligee or their attorney of record and to the other agency involved in
-interjurisdictional cases:
-a.
-
-The Administrative Process Notice of Financial Responsibility for Modification
-form, which schedules a negotiation conference fifteen (15) days from the review
-date,
-
-b.
-
-The Guideline Calculation Worksheets,
-
-c.
-
-All supporting financial documentation used to calculate the monthly support
-obligation; and,
-
-d.
-
-The Administrative Process Modified Order of Financial Responsibility.
-
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-
-2.
-
-3.
-
-9 CCR 2504-1
-
-Either party may file a challenge to the review results based on the Administrative
-Process Notice of Financial Responsibility for Modification or the Administrative Process
-Modified Order of Financial Responsibility:
-a.
-
-The challenge must be received no later than the fifteenth (15th) day following
-the date of the review results or date of the negotiation conference.
-
-b.
-
-The challenge must be based on alleged mathematical or factual error in the
-calculation of the monthly support obligation.
-
-c.
-
-The delegate Child Support Services Unit may grant an extension of up to fifteen
-(15) calendar days to challenge the review results based upon a showing of good
-cause.
-
-d.
-
-The delegate Child Support Services Unit shall have fifteen (15) calendar days
-from the date of receipts of the challenge to respond to the challenge.
-
-e.
-
-If a challenge results in a change in the monthly support obligation, the delegate
-Child Support Services Unit shall deliver, as defined in 6.002 -definitions, an
-amended notice of review and a new Notice Of Financial Responsibility For
-Modification to the parties or their attorney of record and to the other agency
-involved in interjurisdictional cases. The notice must include a date and time for
-the negotiation conference.
-
-f.
-
-Both parties are then given fifteen (15) calendar days from the date of the
-amended notice of review to challenge the results of any subsequent review.
-
-If the APA-Petitioner and APA-Respondent sign the Administrative Process Modified
-Order of Financial Responsibility at the negotiation conference or returns it in the mail
-prior to the negotiation conference date, then the county director or APA certified county
-CSS staff member signs the Administrative Process Modified Order of Financial
-Responsibility. The Child Support Services worker shall, within five (5) business days, file
-with the court:
-a.
-
-The Administrative Process Notice of Financial Responsibility for Modification;
-
-b.
-
-Income and Expense Affidavits of the parties;
-
-c.
-
-The Guideline Calculation Worksheets; and,
-
-d.
-
-The Imputing Potential Income Checklist, with comments made in the Guideline
-Worksheet, if applicable, and,
-
-e.
-
-The Administrative Process Modified Order of Financial Responsibility.
-
-4.
-
-The Administrative Process Modified Order of Financial Responsibility shall also be
-provided to the parties and to the other agency involved in interjurisdictional cases on the
-same date it is filed with the court.
-
-5.
-
-If the APA-Petitioner and APA-Respondent does not sign and return the Administrative
-Process Modified Order of Financial Responsibility, but:
-a.
-
-A party appears at the negotiation conference and does not agree, the Child
-Support Services worker within five (5) business days shall file with the court:
-
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-
-9 CCR 2504-1
-
-1)
-
-The Administrative Process Notice of Financial Responsibility for
-Modification;
-
-2)
-
-The Guideline Calculation Worksheet;
-
-3)
-
-The Imputing Potential Income Checklist and affidavit, if any;
-
-4)
-
-The delegate Child Support Services Unit's request for court hearing;
-and,
-
-5)
-
-Income and Expense Affidavits of the parties.
-
-After a hearing is set, the Child Support Services worker shall file a Notice of
-Hearing with the court and send copies of the Notice of Hearing to the parties or
-their attorneys of record and to the other agency involved in interjurisdictional
-cases.
-b.
-
-6.
-
-If the APA-Petitioner and the APA-Respondent does not appear at the
-negotiation conference, the Child Support Services worker, within five (5)
-business days shall file with the court:
-1)
-
-The Administrative Process Notice of Financial Responsibility for
-Modification;
-
-2)
-
-Income and Expense Affidavits of the parties;
-
-3)
-
-The Guideline Calculation Worksheets;
-
-4)
-
-The Affidavit of Non-Appearance for modification; and,
-
-5)
-
-The Administrative Process Default Order of Financial Responsibility
-(modified).
-
-c.
-
-Upon receipt of a copy of the default order with signed approval by the judge or
-magistrate, the Child Support Services worker shall send copies to the parties or
-their attorneys of record and to the other agency involved in interjurisdictional
-cases.
-
-d.
-
-The Child Support Services worker shall document this activity on the automated
-child support system.
-
-If the obligor’s employer’s address is known, the delegate Child Support Services Unit
-shall, unless another agency is enforcing an interjurisdictional case or the case meets
-one of the good cause criteria specified in Section 14-14-111.5(3)(a)(II)(A), C.R.S.:
-a.
-
-Send a notice to withhold income for support within fifteen (15) calendar days of
-the date the modified order is entered;
-
-b.
-
-Send a notice to withhold income for support to the obligor’s employer within two
-(2) business days from the report of the obligor’s employment through the state
-directory of new hires,
-
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-
-c.
-
-9 CCR 2504-1
-
-Send a National Medical Support Notice to initiate health insurance coverage
-within fifteen (15) calendar days of the date the modified order is entered or
-within two (2) business days from the report of the obligor’s employment through
-the state directory of new hires, if the obligor is the party ordered to provide
-health insurance and the employer has health insurance available at reasonable
-cost, as defined in Section 6.240.2, A, 2.
-
-6.262
-
-POST-ORDER CHANGE OF PHYSICAL CARE
-
-A.
-
-If it is alleged that there has been a post-order change of physical care the enforcing county CSS
-shall initiate a review of the order. If a change in physical care is indicated, the enforcing county
-CSS shall pursue a judicial modification of the order.
-
-B.
-
-If the child’s residence has changed to a caretaker, who is currently not a party to the case, the
-CSS shall also file a motion and order to join that person as a party to the case, if their identity
-and location is known. In the motion to modify the existing order, the enforcing county shall also
-request the establishment of an order against the parent who previously had custody. The order
-of modification shall modify the existing order and establish the new order against the parent who
-previously had custody all in the same action under the same docket number. This shall be
-completed even if the new caretaker does not want child support services. The modification shall
-be completed and the IV-D case closed, if appropriate, after entry of the order of modification.
-
-6.270
-
-CHILD SUPPORT SERVICES PROGRAM PLAN
-
-Each county department shall forward its CSS County Program Plan for the next calendar year to the
-State Department by December 31 of each year. The plan shall be submitted to the State Department on
-prescribed State form. If the plan is disapproved, the county department will negotiate mutually
-acceptable goals with the State Department. If agreement cannot be reached, counties may request
-reconsideration by the Executive Director or a designee of the Colorado Department of Human Services.
-The county department will be bound by the decision of the Executive Director or designee. Satisfactory
-completion of this process is required to ensure the county department receives continued federal
-financial participation.
-6.270.3
-Each county's program plan must set county goals in order to meet annual statewide goals set by the
-State Division of Child Support Services.
-A.
-
-If a county fails to:
-1.
-
-Submit an annual county program plan; revised annual county program plan as required
-by the state office; or
-
-2.
-
-Submit a plan which establishes goals consistent with statewide goals,
-
-B.
-
-Then the State Division will take appropriate corrective action to ensure that a satisfactory county
-program plan is submitted and approved.
-
-6.280
-
-REPORTING
-
-County departments shall provide the State Department with reports and fiscal information as deemed
-necessary by the State Department.
-6.300
-
-(None)
-
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-
-6.400
-
-9 CCR 2504-1
-
-INTAKE
-
-County Child Support Services Units shall establish procedures to ensure that all activities regarding
-intake are undertaken and completed within the time frames, along with appropriate and specified
-functions pursuant to Section 6.260.22. The time frames begin when the application or referral is received
-and end when the case is ready for the next appropriate activity, e.g., locate, parentage establishment,
-establishment of a support order, or enforcement. All activities must be documented on the automated
-child support system.
-6.400.1 INTAKE FUNCTIONS
-The following functions are the responsibility of the Child Support Services Unit with regard to intake of
-child support services cases:
-A.
-
-The Child Support Services Unit shall assure that for each noncustodial or alleged parent of
-children for whom Child Support Services are sought for non-public assistance cases, a Form
-CSS-6 shall be completed by the applicant; however, an application is not required in a
-responding intergovernmental case. The Child Support Services Unit shall provide an application
-to the applicant pursuant to Section 6.201.2.
-
-B.
-
-The Child Support Services Unit shall assure that for all cases for which IV-A and/or foster care is
-being provided that the custodial party cooperate, unless a finding of good cause exemption from
-referral to the Child Support Services Unit has been granted by the county director or designee,
-in:
-1.
-
-Location of noncustodial or alleged parents;
-
-2.
-
-Determination of parentage;
-
-3.
-
-Establishment and modification of support orders, both financial and medical; and,
-
-4.
-
-Enforcement of support orders.
-
-C.
-
-Upon receipt of a good cause determination from the county director or designee, the Child
-Support Services Unit shall close the Child Support Services case.
-
-D.
-
-The Child Support Services Unit shall assure that written explanations about Child Support
-Services and custodial party rights and responsibilities are provided to public assistance
-recipients receiving Child Support Services pursuant to Section 6.201.1
-
-E.
-
-Within twenty (20) calendar days of receipt of an application or referral, the Child Support
-Services Unit must open a case and take appropriate action pursuant to Section 6.260.22. When
-CSS is enforcing an existing order, the county must send the state prescribed documents
-regarding payment options and possible enforcement remedies to the parties in the case.
-
-F.
-
-The Child Support Services Unit shall assure that Form CSS-7 be forwarded to the IV-A unit or
-that other written notice be sent to the foster care unit within five (5) working days of failure to
-cooperate by the custodial party of a child receiving IV-A or by the placing parent of a child in
-foster care placement, unless good cause exemption from referral to the Child Support Services
-Unit has been granted by the county director or designee.
-
-G.
-
-The Child Support Services Unit shall assure that for each noncustodial or alleged parent, a
-unique case number is established to identify the case.
-
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-
-9 CCR 2504-1
-
-H.
-
-The Child Support Services Unit shall assure that all cases are categorized as set forth in these
-rules.
-
-I.
-
-The Child Support Services Unit shall assure that case records and financial records be
-established for each child support services case according to these rules and procedures
-prescribed by the State Department.
-
-6.500
-
-LOCATE
-
-Attempts to determine the physical whereabouts of noncustodial parents, placing parents, or the
-noncustodial or placing parents' employer(s), other sources of income or assets, as appropriate, for
-parentage establishment, establishment or modification of a child support order or enforcement of an
-order are a required service of the Child Support Services program. Locate activity is provided for all
-cases.
-6.501
-
-LOCATE PROCEDURES
-
-County Child Support Services Units shall establish procedures to ensure that all appropriate locate
-activities are undertaken and completed within the time frames specified. The time frames begin when it
-is determined that location of the noncustodial or placing parent is necessary and end when the
-noncustodial or placing parent is located and the case is ready for the next appropriate activity, e.g.
-establishment of parentage, establishment or modification of a support order or foster care fee order, or
-enforcement. All locate activities must be documented by source (Division of Motor Vehicles, Department
-of Labor and Employment, no hit, etc.) on the automated child support system.
-6.502
-
-LOCATE FUNCTIONS
-
-Within seventy-five calendar days of determining that location is necessary, the Child Support Services
-Unit must access all appropriate locate sources including transmitting appropriate cases to the Expanded
-Federal Parent Locator Service and ensuring that information is sufficient to take the next appropriate
-action in a case. In intergovernmental cases, it is the responsibility of the initiating agency, rather than the
-responding state, to access the Expanded Federal Parent Locator Service when appropriate, and provide
-new locate information to the responding agency. However, if the initiating agency is a foreign country,
-the responding agency should access the expanded Federal Parent Locator Service.
-6.502.1
-The Child Support Services Unit must assess each locate case to determine appropriate locate sources.
-Available locate sources include:
-A.
-
-State locate sources such as the Department of Labor and Employment and the Division of Motor
-Vehicle, Workers' Compensation and state directory of new hires;
-
-B.
-
-Current or past employers;
-
-C.
-
-Local telephone company, United States Postal Service, financial references, unions, fraternal
-organizations, parole and probation records and police records;
-
-D.
-
-Expanded Federal Parent Locator Service and other state parent locators;
-
-E.
-
-Local offices administering public assistance, general assistance, medical assistance, food
-assistance, and social services;
-
-F.
-
-Custodial party, friends, and relatives of noncustodial parents;
-
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-
-G.
-
-9 CCR 2504-1
-
-Credit reporting agencies.
-1.
-
-A full credit report may be obtained only if a child support order exists, except as provided
-in Section 6.709.3.
-
-2.
-
-If a child support order does not exist, an inquiry using the Social Security Number will
-provide residential and employment information, if available.
-
-6.502.2
-A Child Support Services Unit may obtain information from public utilities through the utilization of an
-administrative subpoena. The Child Support Services Unit must submit a request for administrative
-subpoena to the State parent locator by documenting in the chronology of the case the following:
-A.
-
-All locate resources have been accessed.
-
-B.
-
-No location information has been obtained.
-
-6.503
-
-LOCATION IN INTERGOVERNMENTAL CASES
-
-The initiating agency must forward a State Parent Locate Service (SPLS) request through manual or
-electronic means to the IV-D agency of any other jurisdiction within twenty (20) calendar days of receiving
-information that the noncustodial or alleged parent may be in another jurisdiction. However, if the initiating
-agency is a foreign country, the responding agency should access the expanded Federal Parent Locator
-Service.
-Upon receipt of information regarding the noncustodial or alleged parent, all appropriate follow up must
-be completed by the Child Support Services Unit to verify the location information received.
-6.504
-
-REPEATED LOCATION ATTEMPTS
-
-Location attempts, except for Federal Parent Locater Service (FPLS), shall be repeated quarterly or
-immediately upon receipt of new information when adequate identifying and other information exists
-which may aid in location, whichever occurs sooner.
-A.
-
-Quarterly attempts may be limited to automated sources, but must include accessing the
-Department of Labor and Employment files.
-
-B.
-
-When repeated location attempts are necessary because of new information, all appropriate
-locate sources must be accessed within seventy-five (75) calendar days.
-
-6.600
-
-ESTABLISHMENT OF PARENTAGE
-
-6.600.1 STATUTE OF LIMITATIONS
-In a IV-D case involving a child for whom parentage has not been legally established, the Child Support
-Services Unit shall attempt to establish the parentage of such child if the action can be brought prior to
-the child’s eighteenth birthday:
-A.
-
-Unless a good cause exemption on a mandatory referral to the Child Support Services Unit has
-been determined by the county director or designated staff.
-
-B.
-
-If the statute of limitations in effect at the time of the child's birth was less than eighteen years,
-the county Child Support Services Unit may bring an action on behalf of the child at any time prior
-to the child's twenty-first birthday.
-
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-
-C.
-
-An action brought solely to establish parentage is not a CSS function.
-
-6.601
-
-PARENTAGE ESTABLISHMENT TIME FRAMES
-
-9 CCR 2504-1
-
-County Child Support Services Units shall establish procedures to ensure that all appropriate parentage
-establishment activities are undertaken and completed within the timeframes specified. In judicial cases
-the timeframes begin when the alleged or presumed parent is located. For APA cases, it begins when the
-APA-Respondent is located and ends when parentage and a support obligation are established or the
-alleged or presumed parent is excluded. All parentage establishment activities must be documented on
-the automated child support system.
-A.
-
-B.
-
-Within ninety (90) calendar days of locating the alleged parent or when the APA-Respondent is
-located, the Child Support Services Unit must:
-1.
-
-Document unsuccessful attempts to serve process, or,
-
-2.
-
-Complete service of process, establish parentage, and establish an order for support.
-
-Repeated unsuccessful service of process attempts are not a valid reason for not meeting the
-time frames. If service of process is unsuccessful because of a poor address, the case shall be
-referred back to the locate function.
-
-6.601.1 GOOD CAUSE
-If good cause exemption has not been established and the custodial party or placing parent fails to
-cooperate with the Child Support Services Unit, the Child Support Services Unit shall complete a Notice
-of Non-Cooperation of Caretaker and forward the notice to the county IV-A unit, or the Division of Child
-Welfare.
-6.602
-
-DETERMINATION OF PARENTAGE STATUS
-
-A.
-
-Before initiating a judicial or APA case, the CSS shall conduct parentage and order research to
-determine if parentage of the child has been established by a judicial or APA order or determined
-pursuant to the laws of Colorado or another state.
-
-B.
-
-For all Colorado births, the CSS Unit shall research the Colorado Vital Information System
-(COVIS) to determine if the parents’ names are listed on the child’s birth certificate and the
-method/grounds used to list a non-birthing parent, if any. The CSS shall determine if, for any
-listed non-birthing parent:
-
-C.
-
-1.
-
-A presumption of parentage based on marriage or a civil union exists,
-
-2.
-
-A court or APA order establishing parentage exists, or
-
-3.
-
-A voluntary acknowledgment of parentage has been filed.
-
-The CSS Unit shall examine the child’s birth certificate, if obtained and the COVIS record for the
-parents and child to determine if the parents’ names are listed on the certificate according to law.
-If not, the CSS shall notify Colorado vital records of any inconsistency or error and take other
-appropriate actions to correct the error or omission.
-
-6.602.1 ESTABLISHMENT OF PARENTAGE
-A.
-
-If parentage has not been established or determined for the child, the CSS Unit shall pursue the
-establishment of parentage.
-
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-
-B.
-
-9 CCR 2504-1
-
-If parentage has been established or determined for the child, the CSS Unit shall not pursue the
-establishment of parentage but shall pursue the establishment of child support actions as
-appropriate.
-
-6.602.2 PRESUMPTION OF PARENTAGE
-A.
-
-The CSS Unit shall determine if a presumption of parentage exists pursuant to Section 19-4-105,
-C.R.S. or 14- 15-101, et seq., C.R.S. as to one or more alleged or presumed parents of the child.
-
-B.
-
-The CSS Unit shall only use the judicial process to establish parentage if multiple
-alleged/presumed birthing parents or multiple alleged/presumed non-birthing parents of a child
-exist.
-
-6.603
-
-VOLUNTARY ACKNOWLEDGEMENT OF PARENTAGE
-
-County Child Support Services Units shall provide all parents who are applying for services with or are
-referred to the Child Support Services Unit with the opportunity to voluntarily acknowledge parentage at
-the Child Support Services office. The Child Support Services Unit shall provide to parents the voluntary
-acknowledgment form prescribed and furnished by the state registrar and oral and written state
-prescribed standardized notices stating the alternatives to, the legal consequences of, and the rights and
-responsibilities that arise from signing the acknowledgment. Either the Child Support Services Unit or a
-party of the case shall forward the completed acknowledgement of parentage form to the Department of
-Public Health and Environment, the Division of Health Statistics and Vital Records, according to the
-instructions provided on the form.
-6.603.1 RESCISSION AND CONTEST OF A VOLUNTARY ACKNOWLEDGEMENT OF PARENTAGE
-A.
-
-B.
-
-A signed voluntary parentage acknowledgment is considered a legal finding of parentage, subject
-to the right of either party who signed the acknowledgment to rescind the acknowledgment within
-the earlier of:
-1.
-
-Sixty (60) calendar days from the date signed; or,
-
-2.
-
-The date of a prior administrative or judicial proceeding relating to the child in which the
-person who signed the parentage acknowledgment is a party.
-
-When a party in a IV-D case notifies the Child Support Services Unit of their desire to rescind
-their signature on a voluntary acknowledgement of parentage or to contest parentage based on a
-voluntary acknowledgement of parentage and the voluntary acknowledgement of parentage was
-filed with the Colorado Department of Public Health and Environment, Division of Health Statistics
-and Vital Records, and parentage has not been established by or pursuant to the laws of
-Colorado or another state, the Child Support Services Unit shall, through administrative process,
-if appropriate, pursue the establishment of parentage and support and order genetic testing.
-1.
-
-If the results of the genetic testing establish a threshold of probability of parentage of
-ninety-seven percent (97%) or higher and the party continues to contest parentage, the
-Child Support Services Unit shall proceed with administrative process procedures to
-establish a temporary support order and request a court hearing to obtain a court finding
-and order.
-
-2.
-
-If the results of the genetic testing establish a threshold of probability of parentage of
-ninety-seven percent (97%) or higher and the party does not continue to contest
-parentage, the Child Support Services Unit shall proceed with administrative process
-procedures to establish an appropriate administrative process parentage and support
-order.
-
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-Child Support Services
-
-9 CCR 2504-1
-
-3.
-
-If the results of the genetic testing do not establish a threshold of probability of parentage
-of at least ninety-seven percent (97%), the Child Support Services Unit may dismiss the
-action or take such other appropriate action as allowed by law, including filing a request
-for court hearing.
-
-4.
-
-If the court finds that the parent who signed the voluntary acknowledgment of parentage
-is not the legal parent of the child and orders that such parent’s name be removed from
-that child’s birth certificate, the Child Support Services Unit shall notify the Department of
-Public Health and Environment, Division of Health Statistics and Vital Records, and
-request that they remove the party's name from the child's birth certificate. The
-notification shall be either a certified copy of the court order or a modified report of
-paternity determination, as prescribed by the Division of Health Statistics and Vital
-Records.
-
-6.603.2 CONTESTING PARENTAGE ESTABLISHED BY A VOLUNTARY ACKNOWLEDGEMENT OF
-PARENTAGE
-A.
-
-When a party in a IV-D case notifies the county Child Support Services Unit of the desire to
-rescind their signature on or contests parentage established by a voluntary acknowledgement of
-parentage and there has been a prior administrative process or judicial proceeding involving the
-party concerning the support of the child, the party shall be advised to contact the court for
-resolution.
-
-B.
-
-When a party in a IV-D case notifies the county Child Support Services Unit of the desire to
-rescind their signature on or contests parentage established by a voluntary acknowledgement of
-parentage and there has been no prior administrative process or judicial proceeding involving the
-party concerning the parentage or support of the child, and the current proceeding is being
-conducted through an administrative process action and it has been sixty or more calendar days
-since the acknowledgment was signed and the parent's name is on the child(ren)’s birth
-certificate, and parentage has not been established by or pursuant to the laws of Colorado or
-another state, the Child Support Services Unit shall:
-
-C.
-
-1.
-
-Enter an administrative process order for genetic testing, then
-
-2.
-
-Establish an administrative process temporary order of financial responsibility and
-request a court hearing to obtain a permanent court finding and order if the genetic
-testing results show a ninety seven percent (97%) or greater probability of parentage and
-the party continues to contest parentage, or
-
-3.
-
-If the genetic testing results show a less than ninety-seven percent (97%) probability of
-parentage, the county Child Support Services Unit may dismiss the action or take such
-other appropriate action as allowed by law.
-
-If the party withdraws their contest of parentage at any time, even after genetic testing has been
-done and the parent's name is on the child’s birth certificate, the delegate Child Support Services
-Unit shall enter the appropriate administrative process order if the genetic testing results do show
-a ninety-seven percent (97%) or greater probability of parentage.
-
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-6.604
-
-9 CCR 2504-1
-
-CONTESTING PARENTAGE BASED ON OTHER PRESUMPTIONS OF PARENTAGE
-
-Whether or not a parent's name is listed on a child’s birth certificate, if one or more presumptions of
-parentage of a child exist pursuant to Section 19-4-105, C.R.S., including the execution of a voluntary
-acknowledgment of PARENTAGE for one or more possible birthing parents or one or more possible nonbirthing parents, the delegate Child Support Services Unit shall pursue the establishment of parentage
-and support for that child judicially and all alleged and/or presumed parents shall be joined as parties in
-the case, if possible, pursuant to Section 19-4-110, C.R.S.
-However, if child support or parentage has already been established against a parent by an
-administrative or judicial order or parentage has been established pursuant to the laws of another state, a
-support only order shall be pursued against such parent.
-6.604.1 CONTESTING PARENTAGE – NON IV-D CASE
-Parties who do not have a IV-D case and request the Child Support Services Unit to assist them in
-rescinding a voluntary acknowledgment of parentage, and it has been less than sixty (60) days since the
-voluntary acknowledgment of parentage was signed, and there has been no prior administrative process
-or judicial proceeding involving the party concerning the support of the child, shall be advised that they
-may apply for full child support services, or may contact the court for assistance. If it has been more than
-sixty (60) days since the voluntary acknowledgment of parentage was signed, or there has been a prior
-administrative process or judicial proceeding involving the party concerning the support of the child, or the
-party wants to disestablish parentage, the party shall be referred to the court.
-6.605
-
-GENETIC TESTING
-
-A.
-
-County Child Support Services Units shall require that the child and all other parties in a
-contested parentage case submit to genetic testing, upon the request of any party, except in
-cases:
-1.
-
-Where good cause has been determined; or,
-
-2.
-
-Where parentage has been determined by or pursuant to the laws of another state; or,
-
-3.
-
-Where parentage has been established by a Colorado administrative process or judicial
-order.
-
-B.
-
-The parties are required to use the genetic testing laboratory designated by the Child Support
-Services Unit.
-
-C.
-
-Counties, or the state Division of Child Support Services on behalf of counties, shall competitively
-procure, according to county or state procedures, services from genetic testing laboratories which
-have been accredited. The state Division of Child Support Services shall provide a list of genetic
-testing laboratories which have been accredited to the county Child Support Services Units.
-Genetic testing laboratories procured by the counties must perform, at reasonable cost, legally
-and medically acceptable genetic tests to identify the parent or exclude the alleged parent. Proof
-of competitive procurement may be requested by the Colorado Department of Human Services at
-any time.
-
-D.
-
-County Child Support Services Units shall pay the costs of the genetic testing for all parties for
-instate cases, including long-arm establishment of parentage. For interstate cases, the
-responding state is responsible for the genetic testing costs, as stated in Section 6.605.2.
-
-E.
-
-Genetic testing services may only be provided on open IV-D cases.
-
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-
-F.
-
-9 CCR 2504-1
-
-If genetic testing results excluding the alleged parent are obtained in an APA case, the results
-shall be filed:
-1.
-
-In the county and in the court case where an action relating to support is pending,
-
-2.
-
-In the court where an order has been entered but is silent as to child support, or
-
-3.
-
-In the county where the APA case was conducted.
-
-6.605.1 OBJECTION TO GENETIC TESTING RESULTS
-Any objection to the genetic testing results shall be made in writing at least fifteen (15) days before the
-hearing where the results may be introduced, or fifteen (15) days after the Motion for Summary Judgment
-is served. If, however, the results were not received at least fifteen days before the hearing, the objection
-to the genetic testing results shall be made at least twenty-four (24) hours prior to the hearing. In APA
-cases, the objection must be made at or before the currently scheduled negotiation conference. If no
-objection is made, the test results shall be entered as evidence of parentage in a parentage action
-without the need for proof of authenticity or accuracy.
-Upon receipt of an objection to the genetic testing results, the delegate Child Support Services Unit will
-take the following action:
-A.
-
-If the case is an Administrative Process case, establish a temporary order if appropriate, and file
-a Child Support Services Unit Request for Court Hearing as required in Section 6.713.
-
-B.
-
-If the case has been filed through the Judicial process, request the court to set a hearing to
-resolve the objection and decide the issue of parentage and child support.
-
-C.
-
-The Notice of Hearing must be sent to the parties by the delegate Child Support Services Unit.
-
-6.605.2 GENETIC TESTING COSTS
-In all cases, when parentage is adjudicated, the county Child Support Services Units may attempt to enter
-a judgment for the costs of genetic testing for full payment or prorated payment with a specified monthly
-amount due to liquidate those costs. In intergovernmental cases, the responding jurisdiction is
-responsible for the cost of initial genetic testing.
-6.606
-
-REPORTING THE DETERMINATION OF PARENTAGE TO THE COLORADO DEPARTMENT
-OF PUBLIC HEALTH AND ENVIRONMENT, DIVISION OF HEALTH STATISTICS AND VITAL
-RECORDS
-
-A.
-
-After a child's parentage has been established, either judicially or administratively, the Child
-Support Services Unit shall complete and file the State prescribed forms with the Colorado
-Department of Public Health and Environment, Division of Health Statistics and Vital Records, or
-with comparable respective agencies in other jurisdictions, to ensure that the parent's name is
-added to the child's birth record. These documents shall be filed with the Division of Health
-Statistics and Vital Records within ten (10) days of the judicial or administrative order establishing
-parentage.
-
-B.
-
-The Child Support Services Unit shall document in the Automated Child Support Enforcement
-System the date on which the State prescribed forms are sent to the Colorado Department of
-Public Health and Environment, Division of Health Statistics and Vital Records or with
-comparable respective agencies in other jurisdictions
-
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-
-C.
-
-Within forty-five (45) days after the State prescribed forms are sent to the Colorado Department
-of Public Health and Environment, Division of Health Statistics and Vital Records, or with
-comparable respective agencies in other jurisdictions, the Child Support Services Unit shall
-attempt to determine whether or not the parent's name has been added to the child's birth record.
-If the Child Support Services Unit determines that the parent's name has not been added to the
-child's birth certificate, they shall attempt to determine why the name has not been added and
-take all reasonable steps to correct the situation including requesting assistance from the State
-Division of Child Support Services where appropriate.
-
-D.
-
-If the Child Support Services Unit has contact with the Colorado Department of Public Health and
-Environment, Division of Health Statistics and Vital Records or with comparable respective
-agencies in other jurisdictions, about corrections needed to the State prescribed forms, the
-worker shall take all steps reasonably necessary and within their ability to resolve the issue so
-that the parent's name can be added to the child's birth record. This may include requesting
-assistance from the State Division of Child Support Services where appropriate.
-
-E.
-
-The Child Support Services Unit shall document in the automated child support system the date
-on which the parent's name has been verified to be on the child's birth record.
-
-6.700
-
-ESTABLISHMENT OF SUPPORT OBLIGATIONS
-
-The following functions are the responsibility of the Child Support Services Unit with regard to the
-establishment of child support obligations for all Child Support Services cases.
-6.700.1 EXPEDITED PROCESS
-A.
-
-County Child Support Services Units shall establish procedures to ensure that all appropriate
-functions and activities to establish support obligations are undertaken and completed within the
-time frames specified. The time frames begin when the APA-Respondent is located and end
-when a temporary or permanent order is established or service of process is unsuccessful. All
-support activities must be documented on the automated child support system.
-
-B.
-
-Within ninety (90) calendar days of locating the alleged parent or noncustodial parent in judicial
-cases or the APA-Respondent in APA cases, the Child Support Services Unit must check to
-ensure that the child(ren) has not reached the age of emancipation; and,
-1.
-
-Document unsuccessful attempts to serve process, or
-
-2.
-
-Complete service of process (or obtain a waiver of service) and establish an order for
-support (and parentage, if not already established or determined).
-
-C.
-
-Actions subject to expedited process must be completed from the time of successful service of
-process (or obtaining a waiver of service) to the time of disposition within the required time
-frames.
-
-D.
-
-Repeated unsuccessful service of process attempts are not a valid reason for not meeting the
-time frames. If service of process is unsuccessful because of a poor address, the case shall be
-referred back to the locate function.
-
-6.701
-
-ESTABLISHING SUPPORT OBLIGATIONS
-
-A.
-
-All child support obligations must be established using the Colorado child support guidelines as
-found in Section 14-10-115, C.R.S., to determine the amount to be ordered. Child Support
-Services staff shall not deviate from the guidelines. Child Support Services Units shall refer to
-Section 6.707 for rules on how to determine income to use in the guideline calculation.
-
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-
-9 CCR 2504-1
-
-B.
-
-In the instance of an adoption subsidy paid for a child, the case shall be handled judicially and
-when establishing an order against the adoptive parents, the amount of the monthly support order
-established against the adoptive parent(s) receiving the monthly adoption assistance payments
-cannot exceed the amount of the monthly adoption assistance payment. If the calculated
-guideline amount for the monthly support order exceeds the amount of the monthly adoption
-assistance payment, the Child Support Services Unit must treat this as a deviation and request a
-court hearing pursuant to Section 6.713 to request the court to accept the adoption assistance
-payment amount as the order.
-
-C.
-
-In all cases, the Child Support Services Unit shall attempt to establish child support obligations
-and medical support from any person who is legally liable for support of a child.
-1.
-
-In a foster care referral case, the county Child Support Services Unit shall attempt to
-establish a foster care fee obligation.
-
-2.
-
-In public assistance and foster care referral cases, the Child Support Services Unit shall
-not pursue the establishment of a child support obligation, child support debt, retroactive
-support or medical support if good cause exemption has been determined by the county
-director or designee.
-
-D.
-
-Establishing the legal obligation to provide child support includes activities related to establishing
-the amount of retroactive support due, determining the ability of both parents to provide support,
-and determining the amount of the support obligation.
-
-E.
-
-If the applicant for services or continued services party requests case closure after process has
-issued in an APA case or a petition has been filed with the court on a judicial case, the county
-CSS shall complete the establishment case and establish an order (if appropriate) before the IVD case is closed.
-
-F.
-
-In APA establishment cases, including add-a-child actions, the CSS unit shall establish a
-commencement date of the monthly support obligation as follows:
-
-G.
-
-1.
-
-If the order was submitted to the court between the 1st and the 15th of the month, the 1st
-of the next month,
-
-2.
-
-if the order was submitted to the court between the 16th and the last day of the month,
-the 1st of the month two months in the future, and
-
-3.
-
-if a default order is submitted to the court, the 1st of the month two months in the future.
-
-In judicial establishment cases, including add-a-child actions, the CSS Unit shall establish a
-commencement date of the monthly support obligation as follows:
-1.
-
-If the order was established between the 1st and the 15th of the month, the 1st of the
-next month,
-
-2.
-
-If the order was established between the 16th and the last day of the month, the 1st of
-the month two months in the future, and
-
-3.
-
-If a default order is established, the 1st of the month two months in the future.
-
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-
-9 CCR 2504-1
-
-6.701.1 HEALTH INSURANCE
-For all cases in which current child support is being sought, including zero dollar MSO orders, the Child
-Support Services Unit shall include a provision for either parent to provide health insurance for their
-children.
-6.702
-
-ESTABLISHING DEBT OR RETROACTIVE SUPPORT
-
-The Child Support Services Unit has the discretion to establish an obligation for Temporary Assistance
-For Needy Families (TANF) debt, foster care fee debt, and/or retroactive support due based on the
-county’s procedure.
-6.702.1 DEBT
-Action taken to establish debt must be pursued in accordance with Section 14-14-104, C.R.S. Debt may
-be established on public assistance and foster care referral cases.
-A.
-
-A CSS may establish a debt-only order in APA or judicial cases if public assistance paid for the
-child(ren) terminates before an order is established and the person who received the public
-assistance does not want continued services.
-
-B.
-
-If additional child support obligations need to be established subsequent to the establishment of a
-debt only order, the CSS shall use the establishment process, referenced in 6.701(c), including
-new service of process.
-
-C.
-
-If not already established, parentage shall be established in a debt only action and a judgment for
-costs may also be established.
-
-D.
-
-Debt shall not be established for months in which a good cause exemption from referral was in
-place or months in which the county child welfare department determined that a referral is not
-appropriate.
-
-6.702.2 RETROACTIVE SUPPORT
-A.
-
-An order for a reasonable amount of retroactive support due may be included in any action,
-except a debt-only action, if requested by a custodial party, if there is a time period which
-occurred prior to or after the receipt of public assistance benefits for which such support can be
-established.
-
-B.
-
-The custodial party shall be required to complete an “Affidavit of Retroactive Support” and return
-it to the Child Support Services Unit before the initiation of any judicial or administrative action to
-establish retroactive support. A Child Support Services Unit shall not establish an order for
-retroactive support unless an “Affidavit for Retroactive Support” has been received from the
-custodial party. The county Child Support Services Unit shall use the State prescribed “Affidavit of
-Retroactive Support”.
-
-C.
-
-If the custodial party is waiving the right to retroactive support, this shall be reflected in the
-support order. If the Child Support Services Unit does not establish retroactive support on behalf
-of custodial parties, the order shall contain a statement to this effect and also an advisement to
-the noncustodial parent that the custodial party may pursue the establishment of retroactive
-support separately.
-
-D.
-
-Retroactive support shall not be established for:
-1.
-
-Any months for which the custodial party received public assistance.
-
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-
-9 CCR 2504-1
-
-2.
-
-Any months in which a good cause exemption from referral was in place.
-
-3.
-
-Any months in which the county child welfare department determined that a referral is not
-appropriate.
-
-4.
-
-Any months for which the children did not reside with the custodial party, including
-months in which the child(ren) were in out of home placement.
-
-5.
-
-Any months when the custodial party, noncustodial parent, and the child(ren) lived in the
-same household.
-
-6.
-
-If the retroactive support is being established in a divorce or legal separation action, the
-amount of retroactive support will be based upon the number of months after the date of
-physical separation of the parents, the filing date of the action, or the date of service upon
-the respondent, whichever date is latest.
-
-6.702.3 CALCULATING RETROACTIVE SUPPORT AND CHILD SUPPORT DEBT
-A.
-
-If action is taken to establish debt in a public assistance case, including Title IV-A, Title IV-E
-foster care, and non-IV-E foster care referral cases, because no order for a monthly support
-obligation existed at the time public assistance was paid, the Child Support Services Unit shall
-use the current monthly support order amount determined by using the Colorado Child Support
-Guidelines times the number of months that the custodial party received public assistance or the
-total amount of public assistance paid, whichever amount is lower as the initial basis for the
-amount of child support debt owed by the noncustodial parent.
-1.
-
-In a IV-E foster care case, the amount of the foster care fee debt is limited by the total of
-the unreimbursed maintenance payments for that child(ren).
-
-2.
-
-In a non-IV-E foster care case, the amount of the foster care fee debt is limited by the
-total cost of placement for that child(ren).
-
-B.
-
-If action is taken to establish retroactive support, the Child Support Services Unit shall use the
-current monthly support order amount determined by using the Colorado child support guidelines
-times the number of months that the children lived in the custodial party’s home without the
-presence of the noncustodial parent as the initial basis for the amount of retroactive support owed
-by the noncustodial parent.
-
-C.
-
-If either the custodial or noncustodial parent does not agree to the proposed amount of
-retroactive support, a temporary order, according to Section 6.712, must be established and the
-case referred for a court hearing. The temporary order may not include any amount for child
-support debt or retroactive support.
-
-6.703
-
-DISMISSAL
-
-If the court or administrative authority dismisses a party or a case for a support order without prejudice,
-the Child Support Services Unit shall, at the time of dismissal, examine the reasons for dismissal and
-determine when it would be appropriate to seek an order in the future, and seek a support order at that
-time. This shall be documented on automated child support system chronology and a review date set.
-6.703.1 WITHDRAWAL
-When a IV-D case is closed, the CSS shall file with the court a notice of withdrawal in the case.
-
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-
-9 CCR 2504-1
-
-6.703.2 IMAGING DOCUMENTS
-A.
-
-A CSS may maintain APA and judicial case orders and documents electronically (imaging).
-
-B.
-
-Upon confirmation by a supervisor or IV-D administrator of the CSS, that a true, correct and
-complete electronic copy of a document has been made, the CSS may shred the original paper.
-This confirmation shall be recorded in CSES chronology on the IV-D case.
-
-C.
-
-When a IV-D case is closed or APA is no longer appropriate, the CSS shall print a complete copy
-of the imaged case order and other documents and file them with the court.
-
-6.703.3 ATTORNEY OF RECORD IN APA CASES
-A.
-
-If a party retains an attorney to represent him or her in an APA case, the party must deliver to the
-CSS a written notice of representation, signed by the party and the attorney, to the CSS for the
-notice to be effective.
-
-B.
-
-The notice shall state the name of the party, the name, address and telephone number of the
-attorney and state that the attorney is representing the party/client in the APA case.
-
-C.
-
-An entry of appearance or filing a document with a court in a court case is not sufficient.
-
-D.
-
-A party must notify the CSS in writing if a party terminates the attorney-client relationship and
-representation in the APA case.
-
-E.
-
-Upon receipt of a notice of representation, the CSS shall deliver a copy of all APA documents to
-the parties’ attorney of record.
-
-F.
-
-Once an attorney withdraws as attorney of record or the attorney-client relationship is terminated
-by the party, the CSS shall cease further communication with that attorney about the APA case.
-
-G.
-
-An attorney of record may not sign a stipulated order on behalf of his or her client, the party must
-sign the order as well.
-
-6.704
-
-ADMINISTRATIVE PROCEDURES TO ESTABLISH CHILD SUPPORT AND PARENTAGE
-
-Pursuant to Article 13.5 of Title 26, C.R.S., the delegate Child Support Services Unit is authorized to
-establish certain parentage and child support obligations through administrative procedures.
-6.704.1 CASES SUBJECT TO ADMINISTRATIVE PROCESS
-A.
-
-Administrative procedures to establish a monthly support obligation, foster care fee order, child
-support debt, foster care debt, medical support and/or retroactive support, or to modify an order
-established by administrative process shall be used by the delegate Child Support Services Unit
-in all cases to establish these obligations as appropriate, unless:
-1.
-
-A court order exists that was issued in this or any other state, tribe, or reciprocating
-country, which establishes any child support obligation; or,
-
-2.
-
-An order for the obligation already exists but excluding appropriate administrative
-process, add-a-child actions; or,
-
-3.
-
-The case requires parentage establishment and the case involves multiple presumed
-and/or alleged parent(s); or,
-
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-
-9 CCR 2504-1
-
-4.
-
-One or both of the parents in the case is under age eighteen (18); or,
-
-5.
-
-A hearing has been scheduled by the court or a request for hearing has been filed with
-the court by any party on the issue of child support; or,
-
-6.
-
-Another state’s order was entered judicially and a modification must be conducted.
-
-7.
-
-The court has exercised jurisdiction over a child support issue; or,
-
-8.
-
-A court’s parentage only order is not silent as to a child support obligation. If the judicial
-parentage only order is silent as to child support APA may be used.
-
-B.
-
-Administrative process shall be utilized in cases in which a divorce decree is silent on the issue of
-child support and service in the divorce was by publication. In these cases, the administrative
-process action (APA) will be filed under a new court number.
-
-C.
-
-In cases in which there is a pending court action relating to child support, the Child Support
-Services Unit shall proceed to utilize administrative process as set forth in these rules. Copies of
-all documents, including the APA order, shall be filed by the Child Support Services Unit in the
-existing court case, utilizing the case number of the existing court case.
-
-6.704.2 ESTABLISHING AN ORDER FOR WORK ACTIVITIES
-A delegate Child Support Services Unit may establish an administrative order for a noncustodial parent
-who is unemployed, not incapacitated, and has an obligation of support to a child receiving assistance.
-The order would require the noncustodial parent to enter into one or more of the following work activities:
-private or public employment, job search activities, community service, vocational training, or any other
-employment related activities available to that particular individual.
-6.704.3 ENFORCING COUNTY APPLICATION TO ADMINISTRATIVE PROCESS
-Only the enforcing county delegate Child Support Services Unit may initiate an administrative process
-action (APA). The enforcing county must close an open APA on ACSES before the enforcing county
-designation can be changed.
-6.705
-
-NOTICE OF FINANCIAL RESPONSIBILITY, NOTICE OF FINANCIAL RESPONSIBILITYPARENTAGE ACTION OR AMENDED NOTICE OF FINANCIAL RESPONSIBILITY
-
-A.
-
-A Notice of Financial Responsibility or amended Notice of Financial Responsibility for add a child
-cases, as prescribed by the State Department, shall be issued in all establishment cases subject
-to administrative procedure within twenty-one (21) days of locating the APA-Respondent by the
-enforcing county delegate Child Support Services Unit.
-
-B.
-
-“Issued” shall be defined to mean the date the Notice of Financial Responsibility or amended
-Notice of Financial Responsibility is delivered to: the United States mail for service by certified
-mail, or the delegate Child Support Services Unit employee authorized to serve the process, or
-the delegate Child Support Services Unit's contractual process server, or the U.S. mail for service
-by first class mail only in an action to modify an existing administrative order.
-
-C.
-
-The Notice of Financial Responsibility or amended Notice of Financial Responsibility shall be
-signed by the county director or an employee of the delegate Child Support Services Unit
-designated in writing by the county director.
-
-D.
-
-The delegate Child Support Services Unit issuing a Notice of Financial Responsibility or amended
-Notice of Financial Responsibility shall:
-
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-
-1.
-
-Check on the automated child support system, R/A Financial History, and the Colorado
-Benefits Management System (CBMS) to determine all amounts of public assistance
-expended for the children's benefit by all Colorado counties and include the total amount
-on the Certification of Official Record.
-
-2.
-
-Check the automated child support system to determine the total unreimbursed
-maintenance payments for Title IV-E foster care cases and with the foster care unit to
-determine the total unreimbursed costs of foster care placement for non-IV-E foster care
-cases and include the total amount on the Foster Care Arrearage/Unreimbursed
-Maintenance Payment Calculation or similar form used by the county Child Support
-Services Unit.
-
-3.
-
-Schedule a negotiation conference date on the Notice of Financial Responsibility or
-amended Notice of Financial Responsibility thirty-five (35) calendar days from the date
-the Notice or amended Notice is issued, and
-
-4.
-
-Data enter the issuance date and negotiation conference date on the automated child
-support system within five (5) working days of issuing the Notice or amended notice of
-Financial Responsibility.
-
-In any instance in which the thirty-fifth (35th) day would fall on a Saturday, Sunday or holiday, the
-Child Support Services Unit shall set the negotiation conference on the next working day
-immediately following.
-6.705.1 SUBPOENA TO PRODUCE
-A.
-
-A Subpoena to Produce, as prescribed by the State Department, shall be served on the APARespondent with every Notice of Financial Responsibility or amended Notice of Financial
-Responsibility.
-
-B.
-
-The CSS may issue a subpoena to produce to the APA–Petitioner or any third party, person or
-entity having information and or documents regarding a party that is relevant to any issue in a
-case.
-
-6.705.2 INCOME AND EXPENSE AFFIDAVIT
-The delegate Child Support Services Unit shall include an income and expense affidavit as prescribed by
-the State Department with every Notice or amended Notice of Financial Responsibility issued.
-6.705.3 SERVICE OF THE NOTICE OF FINANCIAL RESPONSIBILITY
-A.
-
-The delegate Child Support Services Unit shall serve the Notice or amended Notice of Financial
-Responsibility on the APA-Respondent at least fifteen (15) calendar days prior to the date stated
-in the Notice or amended Notice for the negotiation conference.
-
-B.
-
-The following forms shall be included in the packet served on the APA-Respondent.
-1.
-
-Notice or amended Notice of Financial Responsibility,
-
-2.
-
-Subpoena to Produce, and
-
-3.
-
-Income and Expense Affidavit.
-
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-C.
-
-Either a Return of Service or a Waiver of Service must be obtained in all cases. Within five (5)
-working days of receipt of a Return of Service or a Waiver of Service, the delegate Child Support
-Services Unit shall data enter the date of service or the waiver on the automated child support
-system and send notice of the negotiation conference to all parties or their attorney of record and
-the other state, if appropriate.
-
-D.
-
-If service was by certified mail restricted delivery, the return receipt shall be attached to the return
-of service. If service was effected by the county director or delegate Child Support Services Unit
-employee designated in writing by the county director, the director or designated employee shall
-complete the return of service within five (5) working days of effecting service of process and
-attach the “green card”.
-
-E.
-
-The notice shall be delivered, as defined in section 6.002 – definitions, to the APA-Petitioner at
-least fifteen (15) calendar days prior to the date stated in the notice or amended notice for the
-negotiation conference.
-
-6.705.4 DELIVERY OF NOTICES AND OTHER DOCUMENTS
-A.
-
-Except for service of process on the APA-Respondent, any order, notice of other document may
-be delivered to a party or his or her attorney of record by:
-1.
-
-Hand delivery (including FedEx, UPS etc.) ,
-
-2.
-
-First class U.S. mail or
-
-3.
-
-Fax, e-mail or other form of electronic delivery if consented to by the party/attorney in
-writing.
-
-B.
-
-The written consent for electronic delivery shall state the method of delivery, the phone number,
-e-mail address and/or any other information necessary to effect delivery and must be agreed to
-by the CSS.
-
-C.
-
-If a preferred method of delivery fails, the CSS may use another authorized form of delivery.
-
-D.
-
-Genetic testing information and results are confidential. If mailing, the CSS shall mark the
-envelope “confidential”. If sending electronically, the communication shall be marked
-“confidential” and encrypted, if possible.
-
-6.705.5 ADD A CHILD
-A.
-
-Add-a-child is an establishment action and the CSS shall follow the procedures stated in 26-13.5103.5, C.R.S.
-
-B.
-
-The CSS unit must ensure the caption in an APA add-a-child case includes the names of all
-subsequent child(ren) in all documents in the add-a-child case. CSS does not and is not required
-to file a motion and order with a court to amend a caption in an APA add-a-child case.
-
-6.705.6 COSTS OF COLLECTION
-A.
-
-A judgment for child support costs may be entered against the APA-Petitioner and/or the APARespondent in an APA case or judicially by the court.
-
-B.
-
-A judgment for the same costs shall not be entered against both parties.
-
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-
-6.706
-
-NEGOTIATION CONFERENCE
-
-a.
-
-Child Support Services Unit employees must be certified by the State Division of Child Support
-Services to conduct APA and negotiation conferences. Certification requirements are found in
-section 6.103.1.
-
-B.
-
-The negotiation conference date is originally scheduled in the notice or amended notice. This
-date can be continued and the “currently scheduled” date is the date of the notice or amended
-notice or, if continued, the date in the notice of continuance, whichever date is later.
-
-C.
-
-The negotiation conference will be conducted in-person (face-to-face) or if requested by the party,
-the conference may be conducted by telephone, computer program, e-mail, fax or by mail.
-However, the party that requested an alternative to an in-person negotiation conference will be
-responsible for signing and delivering a copy of the signed order to the CSS at the time the
-conference concludes.
-
-D.
-
-A copy of any document used by the CSS to calculate the MSO shall be provided to the parties
-with a copy of the order.
-
-E.
-
-Prior to concluding the negotiation conference, the child support specialist must review the order
-commencement date, payment options and possible enforcement remedies with the parties as
-provided by a state prescribed document.
-
-F.
-
-If a default order is issued, the county must send the state prescribed documents regarding
-payment options and possible enforcement remedies with a copy of the order to the parties of the
-case.
-
-6.706.1 STANDARD CONTINUANCES
-A.
-
-Upon request of the APA-Petitioner or the APA-Respondent, the negotiation conference shall be
-continued once per party, not to exceed seven (7) calendar days from the currently scheduled
-date.
-
-B.
-
-If a continuance is requested by a party, the delegate Child Support Services Unit shall issue and
-deliver a Notice of Continuance of the Negotiation Conference to parties, or their attorneys of
-record and the other state if appropriate. The notice shall contain the rescheduled date.
-
-C.
-
-If a continuance is requested by a party, the delegate Child Support Services Unit shall data enter
-the type and reason for the continuance and the date for the rescheduled negotiation conference
-on the automated child support system.
-
-6.706.2 CONTINUANCES FOR GOOD CAUSE
-A.
-
-More than one continuance and for any number of days may be granted only for good cause as
-defined in Section 6.706.2(E).
-
-B.
-
-Continuances for good cause may be granted only by the county director or delegate Child
-Support Services employee designated in writing by the county director.
-
-C.
-
-If a continuance for good cause is granted, the delegate Child Support Services Unit shall issue a
-Notice of Continuance of Negotiation Conference to the noncustodial parent, the custodial party,
-or their attorney of record and the other state if appropriate. The notice shall contain the
-rescheduled date and will be provided by first class mail or hand delivery.
-
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-
-D.
-
-If a continuance for good cause is granted, the delegate Child Support Services Unit shall data
-enter the type and reason for the continuance and the date for the rescheduled negotiation
-conference on the automated child support system.
-
-E.
-
-A finding of good cause may be made for the following reasons:
-1.
-
-The case involves a parentage determination and genetic tests results are needed to
-proceed; or,
-
-2.
-
-A valid contest of parentage is made and parentage has not been established pursuant to
-the laws of another state; or,
-
-3.
-
-Additional time is needed to verify income or other information necessary to calculate a
-child support order pursuant to the Colorado Child Support Guidelines, Section 14 10
-115, C.R.S. as amended; or,
-
-4.
-
-An allegation of fraud and referral for investigation; or,
-
-5.
-
-A party or their attorney, is unable to appear at the negotiation conference due to a
-sudden severe illness, an accident, or other particular occurrence which, by its
-emergency nature and drastic effect, prevents a party or their attorney's appearance at
-the negotiation conference, the burden of proof to show cause of this type shall be upon
-the party; or,
-
-6.
-
-No Child Support Services Unit employee authorized to conduct negotiation conferences
-is able to attend the negotiation conference due to a sudden severe illness, an accident,
-or other particular occurrence which, by is emergency nature and drastic effect, prevents
-an authorized Child Support Services Unit employee from attending the negotiation
-conference.
-
-6.706.3 POSSIBLE RESULTS OF A NEGOTIATION CONFERENCE – ESTABLISHMENT CASES
-A.
-
-If both parties appear for the negotiation conference and agree with the order and/or sign a
-stipulated order prior to or at the negotiation conference, the CSS Unit shall enter a stipulated
-order if appropriate,
-
-B.
-
-If neither party appears for the negotiation conference, the CSS Unit shall enter a default order if
-appropriate,
-
-C.
-
-If both parties appear and one appearing party does not agree with the proposed order, the CSS
-Unit shall enter a temporary order, if appropriate,
-
-D.
-
-If the APA-Respondent appears and agrees with the order, but the APA-Petitioner does not
-appear, the CSS Unit shall enter a stipulated order if appropriate,
-
-E.
-
-If the APA-Respondent does not appear the CSS Unit shall enter a default order if appropriate.
-
-6.707
-
-CALCULATING THE MONTHLY CHILD SUPPORT OBLIGATION
-
-A.
-
-In any order for financial responsibility, the delegate Child Support Services Unit shall calculate
-the monthly child support obligation pursuant to the Colorado Child Support Guidelines, Section
-14-10-115, C.R.S. The delegate Child Support Services Unit shall not deviate from the amount
-calculated pursuant to Section 14-10-115, C.R.S.
-
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-B.
-
-9 CCR 2504-1
-
-In the instance of adoption assistance services, when establishing an order against the adoptive
-parents, the amount of the monthly support order established against the adoptive parent(s)
-receiving the monthly adoption assistance payments cannot exceed the amount of the monthly
-adoption assistance payment. If the calculated guideline amount for the monthly support order
-exceeds the amount of the monthly adoption assistance payment, the Child Support Services
-Unit must treat this as a deviation and request a court hearing pursuant to Section 6.713 to
-request the court to accept the adoption assistance payment amount as the order.
-
-6.707.1 DETERMINING INCOME
-A.
-
-B.
-
-The delegate Child Support Services Unit shall calculate the monthly support obligation using
-reliable information concerning the parents’ actual and/or potential income, as appropriate, which
-may include, but is not limited to, the following:
-1.
-
-Wage statements;
-
-2.
-
-Wage information obtained from the Department of Labor and Employment;
-
-3.
-
-Tax records;
-
-4.
-
-Verified statement by the obligee, as prescribed by the State Department;
-
-5.
-
-Income and Expense Affidavit, as prescribed by the State Department; or
-
-6.
-
-Information from a consumer credit reporting agency.
-
-If the Child Support Services Unit determines that a parent is voluntarily unemployed or
-underemployed or in the absence of reliable information, the Child Support Services Unit shall
-then determine, and document for the record, the parent’s potential income. In determining
-potential income, the Child Support Services Unit shall consider the specific circumstances of the
-parent to the extent known, including consideration of the following when said information is
-available: the parent’s assets, residence, employment and earnings history, job skills, educational
-attainment, literacy, age, health, criminal record and other employment barriers, and record of
-seeking work, as well as the local job market, the availability of employers willing to hire the
-parent, prevailing earnings level in the local community, and other relevant background factors in
-the case. All steps taken to obtain financial information must be documented.
-
-6.707.2 NEGOTIATE DEBT AMOUNT
-The delegate CSS Unit shall not negotiate the amount of child support or foster care debt unless:
-A.
-
-No other county or state has unreimbursed public assistance or unreimbursed maintenance
-payments or unreimbursed costs of foster care placement; or,
-
-B.
-
-All other counties and states with UPA or UMP or unreimbursed costs of foster care placement
-have agreed to the negotiated amount in writing; and,
-
-C.
-
-Automated child support system chronology is updated by the enforcing county delegate Child
-Support Services Unit to document the agreed upon negotiation.
-
-6.708
-
-ISSUANCE OF APA ORDER OF FINANCIAL RESPONSIBILITY
-
-A.
-
-If a stipulation is agreed upon at the negotiation conference, the delegate Child Support Services
-Unit shall prepare and issue an Order of Financial Responsibility, as prescribed by the State
-Department.
-
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-
-B.
-
-The order shall be signed by the APA-Respondent and the APA Petitioner, if appropriate and by
-the county director or employee of the delegate Child Support Services Unit designated in writing
-by the county director.
-
-C.
-
-The order shall specify that the noncustodial parent send all payments to the Family Support
-Registry.
-
-D.
-
-The order shall be prepared and signed at the conclusion of the negotiation conference. The
-order shall advise the noncustodial parent that the unpaid child support balance is entered as
-judgment.
-
-E.
-
-The original order and one copy shall be filed with the clerk of the district court in the county
-which issued the notice of financial responsibility or in the district court where an action relating to
-child support is pending or an order exists but is silent on the issue of child support within five (5)
-business days of the negotiation conference.
-
-F.
-
-The following documents shall be filed with the order:
-
-G.
-
-1.
-
-Notice or amended Notice of Financial Responsibility;
-
-2.
-
-Return of Service or Waiver of Service: if service was by certified mail, the return receipt
-must be attached to the Return of Service;
-
-3.
-
-Guidelines worksheets;
-
-4.
-
-Income and Expense Affidavit for noncustodial parent and custodial party;
-
-5.
-
-Imputing Potential Income Checklist with comments made in the Guideline Worksheet, if
-applicable;
-
-6.
-
-Subpoena to Produce; and
-
-7.
-
-Retroactive support affidavit, if the action is for support of the child(ren) prior to entry of
-the support order.
-
-Upon receipt of a copy of the order with a docket number assigned by the court or upon
-confirmation of receipt from the court clerk through DISH pursuant to Section 6.715, the delegate
-Child Support Services Unit shall within five (5) working days:
-1.
-
-Update automated child support system with court order and initiate a ledger; and,
-
-2.
-
-Send a copy of the order to the noncustodial parent, or their attorney of record, and to the
-custodial party of the child by first class mail.
-
-3.
-
-For intergovernmental cases, send a copy to the initiating agency.
-
-6.708.1 NOTICE TO WITHHOLD INCOME
-If the obligor’s employer’s address is known, the delegate Child Support Services Unit shall, unless the
-case meets one of the good cause criteria specified in Section 14-14-111.5(3)(a)(II)(A), C.R.S.:
-A.
-
-Send a notice to withhold income for support within fifteen (15) calendar days of the date the
-order is entered;
-
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-
-B.
-
-Send a notice to withhold income for support to the obligor’s employer within two (2) business
-days from the report of the obligor’s employment through the state directory of new hires;
-
-C.
-
-Send a National Medical Support Notice to initiate health insurance coverage within fifteen (15)
-calendar days of the date the order is entered or within two (2) business days from the report of
-the obligor’s employment through the state directory of new hires, if the obligor is the party
-ordered to provide health insurance and the employer has health insurance available at
-reasonable cost, as defined in Section 6.240.2, A, 2.
-
-6.709
-
-ISSUANCE OF ORDER ESTABLISHING PARENTAGE AND FINANCIAL RESPONSIBILITY
-
-A.
-
-The delegate Child Support Services Unit shall issue an order establishing parentage and
-financial responsibility after a negotiation conference if:
-1.
-
-Neither the custodial party nor the noncustodial parent is contesting the issue of
-parentage, and
-
-2.
-
-A parent's Parentage Advisement and Admission, as prescribed by the State
-Department, is provided to and signed by the custodial and noncustodial parent.
-
-A.
-
-The order shall be signed, electronically or by hand, by APA-Respondent and APA-Petitioner, if
-appropriate and by the county director or the employee of the delegate Child Support Services
-Unit designated in writing by the county director.
-
-B.
-
-The order shall be prepared and signed at the conclusion of the negotiation conference. The
-order shall advise the obligor that the unpaid child support balance is entered as judgment.
-
-6.709.1 CONTESTING PARENTAGE
-A.
-
-If any party contests parentage, the delegate Child Support Services Unit shall issue an Order for
-Genetic Testing unless parentage has already been established or determined pursuant to the
-laws of another state. The negotiation conference may be continued in accordance with the
-provision of Section 6.706.2.
-
-B.
-
-A finding of good cause to reschedule genetic testing may be made for the following reasons:
-1.
-
-A parent is unable to appear at the appointed time or place for genetic testing due to a
-sudden severe illness, an accident, or other particular occurrence which, by its
-emergency nature and drastic effect, prevents their appearance at the time or place for
-genetic testing.
-The burden of proof to show good cause of this type shall be upon the parent.
-
-2.
-
-Any other reason beyond a party’s control (i.e., if the person authorized to collect the
-genetic testing sample is unable to appear or fails to appear at the time and place for
-genetic testing).
-
-C.
-
-Rescheduling of the time and place for genetic testing may be granted only by the county director
-or delegate Child Support Services employee designated in writing by the county director.
-
-D.
-
-If rescheduling for good cause is granted, the delegate Child Support Services Unit shall issue an
-Order for Genetic Testing to the parties with the new date for the genetic testing which shall be
-delivered to the parties.
-
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-E.
-
-9 CCR 2504-1
-
-If the birthing parent or caretaker, and child(ren) fail to appear for or submit to genetic testing, the
-case shall be set for hearing pursuant to Section 6.713. Upon receipt of the test results, if a
-stipulation is not reached, the case shall be set for hearing pursuant to Section 6.713.
-
-6.709.2 REQUEST FOR COURT HEARING WHEN PARENTAGE IS AT ISSUE]
-If no stipulation is agreed upon at the negotiation conference because a party contests the issue of
-parentage, the delegate Child Support Services Unit shall file the Notice or amended Notice of Financial
-Responsibility, genetic testing results, if any, the appropriate APA order, if any and proof of service with
-the clerk of the court, and shall request the court set a hearing in accordance with Section 6.713.
-6.709.3 FILING THE ORDER
-The original order and one copy shall be filed with the clerk of the district court in the county which issued
-the notice of financial responsibility or in the district court where an action relating to child support is
-pending or an order exists but is silent on the issue of child support within five (5) working days of the
-negotiation conference.
-A.
-
-B.
-
-C.
-
-The following documents shall be filed with the order:
-1.
-
-Notice or amended Notice of Financial Responsibility (Parentage Action);
-
-2.
-
-Return of Service or Waiver of Service: if service was by certified mail, the return receipt
-must be attached to the Return of Service.
-
-3.
-
-Parentage Advisement and Admission;
-
-4.
-
-Guideline Worksheets;
-
-5.
-
-Income and Expense Affidavits;
-
-6.
-
-Subpoena to Produce;
-
-7.
-
-Retroactive support affidavit, if the action is for support of the child(ren) prior to the entry
-of the order establishing parentage;
-
-8.
-
-Imputing Potential Income Checklist with comments made in the Guideline Worksheet, if
-applicable; and
-
-9.
-
-Genetic testing results, if any.
-
-Upon receipt of a copy of the order with a docket number assigned by the court, the delegate
-Child Support Services Unit shall within five (5) working days:
-1.
-
-Update automated child support system with parentage, court order and initiate a ledger,
-and
-
-2.
-
-Send a copy of the order to the noncustodial parent, the custodial party, or their attorney,
-and the initiating agency, if appropriate, by first class mail.
-
-If the obligor’s employer’s address is known, the delegate child support Services unit shall, unless
-the case meets one of the good cause criteria specified in Section 14-14-111.5(3)(a)(ii)(a),
-C.R.S.:
-
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-
-1.
-
-Send a notice to withhold income for support within fifteen (15) calendar days of the date
-the order is entered;
-
-2.
-
-Send a notice to withhold income for support to the obligor’s employer within two (2)
-business days from the report of the obligor’s employment through the state directory of
-new hires.
-
-D.
-
-Send a National Medical Support Notice to initiate health insurance coverage within fifteen (15)
-calendar days of the date the order is entered or within two (2) business days from the report of
-the obligor’s employment through the state directory of new hires, if the obligor is the party
-ordered to provide health insurance and the employer has health insurance available at
-reasonable cost, as defined in Section 6.240.2, A, 2.
-
-E.
-
-The order shall specify that the noncustodial parent send all payments to the Family Support
-Registry.
-
-6.710
-
-ISSUANCE OF DEFAULT ORDER OF FINANCIAL RESPONSIBILITY
-
-A.
-
-After service pursuant to Section 6.705.3, if the noncustodial parent fails to appear for the
-negotiation conference as stated in the Notice or amended Notice of Financial Responsibility, and
-fails to reschedule the negotiation conference prior to the date and time stated in the Notice or
-amended Notice of Financial Responsibility, or fails to appear for a rescheduled negotiation
-conference, the delegate Child Support Services Unit shall:
-1.
-
-Within five (5) working days of the date of the negotiation conference; or,
-
-2.
-
-Within fifteen (15) calendar days of the negotiation conference if the delegate Child
-Support Services Unit has mailed the noncustodial parent a stipulated order and it has
-not been signed and returned by the noncustodial parent or a rescheduled negotiation
-conference has not been conducted within the fifteen (15) days.
-File an original Order of Default, as prescribed by the State Department, and one copy
-with the clerk of the district court in the county in which the Notice of Financial
-Responsibility was issued, or in the district court where an action relating to child support
-is pending or an order exists but is silent on the issue of child support.
-
-B.
-
-A Default Order of Financial Responsibility will not be issued when the noncustodial parent is
-incarcerated and fails to appear for the negotiation conference or the rescheduled negotiation
-conference. In these circumstances, the delegate Child Support Services Unit's worker shall
-close the administrative process action for the reason that a hearing has been requested. The
-delegate Child Support Services Unit's worker shall follow the process for requesting a court
-hearing pursuant to Section 6.713.
-
-6.710.1 FILING THE ORDER OF DEFAULT
-A.
-
-The following documents shall be filed with the Order of Default:
-1.
-
-Return of Service or Waiver of Service and, if service was by certified mail, the return
-receipt must be attached to the Return of Service;
-
-2.
-
-Affidavit of Non-Appearance as prescribed by the State Department;
-
-3.
-
-Notice or amended Notice of Financial Responsibility;
-
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-4.
-
-Verified Statement of Obligee, as prescribed by the State Department, used to set the
-monthly support obligation, or other documentation supporting the guideline calculation of
-the monthly support obligation such as wage information obtained from the Department
-of Labor and Employment;
-
-5.
-
-Affidavit and Certification of Official Record or Foster Care Arrearage/Unreimbursed
-Maintenance Payment Calculation as prescribed by the State Department, or
-documentation supporting the calculation of child support debt such as public assistance
-payment records, foster care payment records, or arrears calculation information, if
-appropriate;
-
-6.
-
-Guidelines worksheets;
-
-7.
-
-Subpoena to Produce;
-
-8.
-
-Income and Expense Affidavit for each parent, if available;
-
-9.
-
-Imputing Potential Income Checklist with comments made in the Guideline Worksheet, if
-applicable; and
-
-10.
-
-Retroactive Support Affidavit, if any.
-
-B.
-
-The default order shall be signed by the county director or employee of the delegate Child
-Support Services Unit designated in writing by the county director.
-
-C.
-
-The order and accompanying documents shall be reviewed by the county director, IV-D
-administrator, IV-D attorney or supervisor of the APA certified employee of the delegate Child
-Support Services Unit designated entering the order before the order is filed with the court. The
-reviewer shall sign the order confirming that the review has been conducted.
-
-D.
-
-The delegate Child Support Services Unit shall not take any action to enforce the default order
-until a copy signed by the court approving the default order is received.
-
-E.
-
-If the court has not approved or denied approval of the default order within thirty-six (36) days
-after filing with the court, the delegate Child Support Services Unit must notify the court that the
-deadline for approval or denial is in seven (7) days on the forty-second (42nd) day.
-
-F.
-
-If the obligor’s employer’s address is known, the delegate Child Support Services Unit shall,
-unless the case meets one of the good cause criteria specified in Section 14-14-111.5(3)(a)(ii)(A),
-C.R.S.:
-
-G.
-
-1.
-
-Send a Notice to Withhold Income for Support within fifteen (15) calendar days of the
-date the order is entered;
-
-2.
-
-Send a Notice to Withhold Income for Support to the obligor’s employer within two (2)
-business days from the report of the obligor’s employment through the state directory of
-new hires;
-
-3.
-
-Send a National Medical Support Notice to initiate health insurance coverage within
-fifteen (15) calendar days of the date the order is entered or within two (2) business days
-from the report of the obligor’s employment through the state directory of new hires, if the
-obligor is the party ordered to provide health insurance and the employer has health
-insurance available at reasonable cost, as defined in Section 6.240.2, A, 2.
-
-The order shall specify that the obligor send all payments through the Family Support Registry.
-
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-
-H.
-
-The effective date of the default order shall be the date signed by the court approving the default
-order.
-
-I.
-
-If the default order is returned to the Child Support Services Unit by the court as not approved,
-the delegate Child Support Services Unit shall take appropriate action to cure the defect stated by
-the court as grounds for disapproval.
-
-6.710.2 RECEIPT OF THE ORDER OF DEFAULT
-Upon receipt of a copy of the default order approved by the court, the delegate Child Support Services
-Unit shall within five (5) working days:
-A.
-
-Update automated child support system with court order and initiate a ledger, and
-
-B.
-
-Send a copy of the order to the noncustodial parent, the custodial party, or their attorney, and to
-the initiating agency, if appropriate, by first class mail.
-
-6.711
-
-ISSUANCE OF DEFAULT ORDER ESTABLISHING PARENTAGE AND FINANCIAL
-RESPONSIBILITY
-
-A.
-
-A default order may be issued in cases where parentage is at issue if, after service pursuant to
-Section 6.705.2:
-1.
-
-The alleged parent fails to appear for the initial negotiation conference as scheduled in
-the Notice of Financial Responsibility and fails to reschedule a negotiation conference
-prior to the date and time stated in the Notice of Financial Responsibility or fails to appear
-for a rescheduled negotiation conference;
-
-2.
-
-The alleged parent fails to take or appear for a genetic test and a finding of good cause
-as described in Section 6.709.1 has not been made; or,
-
-3.
-
-The genetic test results, if any, show a ninety-seven percent (97%) or greater probability
-that the alleged parent is the parent of the child(ren), and the parent fails to appear at the
-negotiation conference and fails to reschedule the negotiation conference.
-
-B.
-
-The delegate Child Support Services Unit shall within five (5) working days of the date of the
-negotiation conference, or the date of the scheduled genetic test, or within fifteen (15) calendar
-days of the negotiation conference if the delegate Child Support Services Unit has mailed the
-noncustodial parent a stipulated order and it has not been signed and returned by the
-noncustodial parent or a rescheduled negotiation conference has not been conducted within the
-fifteen (15) days, file an original Order of Default, as prescribed by the State Department, and one
-copy with the clerk of the District Court in the county in which the Notice or amended Notice of
-Financial Responsibility-Parentage Action was issued, or in the District Court where an action
-relating to parentage and child support is pending.
-
-C.
-
-A Default Order Establishing Parentage and Financial Responsibility will not be issued when the
-noncustodial parent is incarcerated and fails to appear for the negotiation conference or the
-rescheduled negotiation conference. In these circumstances, the delegate Child Support Services
-Unit's worker shall close the administrative process action for the reason that a hearing has been
-requested. The delegate Child Support Services Unit's worker shall follow the process for
-requesting a court hearing pursuant to Section 6.713.
-
-6.711.1 FILING THE ORDER OF DEFAULT
-A.
-
-The following documents shall be filed with the Order of Default:
-
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-
-1.
-
-Return of Service or Waiver of Service: if service was by certified mail, the return receipt
-must be attached to the Return of Service;
-
-2.
-
-Affidavit of Non-Appearance as prescribed by the State Department;
-
-3.
-
-Notice or amended Notice of Financial Responsibility (Parentage Action);
-
-4.
-
-Verified Affidavit of Obligee as prescribed by the State Department, regarding parentage
-and genetic tests, if any;
-
-5.
-
-Other documentation supporting the guideline calculation of the monthly support
-obligation such as wage information obtained from the Department of Labor and
-Employment;
-
-6.
-
-Affidavit and Certification of Official Record or foster care arrearage/unreimbursed
-maintenance payment calculation, as prescribed by the State Department, or
-documentation supporting the calculation of child support debt such as public assistance
-payment records, foster care payment records, or arrears calculation information, if
-appropriate;
-
-7.
-
-Guidelines worksheets;
-
-8.
-
-Subpoena to Produce;
-
-9.
-
-Income and Expense Affidavit for each parent if available;
-
-10.
-
-Retroactive Support Affidavit, if any; and,
-
-11.
-
-Genetic testing results, if any;
-
-12.
-
-Imputing Potential Income Checklist with comments made in the Guideline Worksheet, if
-applicable;
-
-13.
-
-Statement Of Parentage; and,
-
-B.
-
-The default order shall be signed by the county director or employee of the delegate Child
-Support Services Unit designated in writing by the county director.
-
-C.
-
-The order and accompanying documents shall be reviewed by the county director, IV-D
-administrator, IV-D attorney or supervisor of the APA certified employee of the delegate Child
-Support Services Unit designated entering the order before the order is filed with the court. the
-reviewer shall sign the order confirming that the review has been conducted.
-
-D.
-
-The delegate Child Support Services Unit shall not take any action to enforce the default order
-until a copy signed by the court approving the default order is received.
-
-E.
-
-If the court has not approved or denied approval of the default order within thirty-six (36) days
-after filing with the court, the delegate child support services unit must notify the court that the
-deadline for approval or denial is in seven days (7) on the forty-second (42nd) day.
-
-F.
-
-If the obligor’s employer’s address is known, the delegate Child Support Services Unit shall,
-unless the case meets one of the good cause criteria specified in Section 14-14-111.5(3)(a)(ii)(A),
-C.R.S.:
-
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-
-1.
-
-Send a Notice to Withhold Income for Support within fifteen (15) calendar days of the
-date the order is entered;
-
-2.
-
-Send a Notice to Withhold Income for Support to the obligor’s employer within two (2)
-business days from the report of the obligor’s employment through the state directory of
-new hires;
-
-3.
-
-Send a National Medical Support Notice to initiate health insurance coverage within
-fifteen (15) calendar days of the date the order is entered or within two (2) business days
-from the report of the obligor’s employment through the state directory of new hires, if the
-obligor is the party ordered to provide health insurance and the employer has health
-insurance available at reasonable cost, as defined in Section 6.240.2, A, 2.
-
-G.
-
-The court shall specify that the noncustodial parent send all payments through the Family
-Support Registry.
-
-H.
-
-The effective date of the default order shall be the date signed by the court approving the default
-order.
-
-I.
-
-If the default order is returned to the Child Support Services Unit by the court as not approved,
-the delegate Child Support Services Unit shall take appropriate action to cure the defect stated by
-the court as grounds for disapproval.
-
-J.
-
-Upon receipt of a copy of the default order approved by the court, the delegate Child Support
-Services Unit shall within five (5) working days:
-
-6.712
-
-1.
-
-Update automated child support system with court order, parentage information and
-initiate a ledger, and
-
-2.
-
-Send a copy of the order to the noncustodial parent or his attorney of record to the
-custodial party and the initiating agency, if appropriate, by first class mail.
-
-ISSUANCE OF A TEMPORARY ORDER IF NO STIPULATION IS REACHED
-
-If no stipulation is agreed upon at the negotiation conference and parentage is not an issue, or if any
-party contests parentage and the genetic test results are ninety-seven percent (97%) or higher probability
-of parentage has previously been determined by another state, the delegate Child Support Services Unit
-shall issue temporary orders for current child support, arrears, foster care, maintenance, medical support
-and reasonable support for a time period prior to the entry of the order for support. The Notice or
-amended Notice of Financial Responsibility and proof of service shall be filed with the clerk of the court.
-The Child Support Services Unit shall file a request for hearing in accordance with Section 6.713.
-6.713
-
-REQUEST FOR COURT HEARING
-
-A.
-
-A request for a court hearing is made when:
-1.
-
-No stipulation is agreed upon at a negotiation conference and a temporary order is
-completed; or,
-
-2.
-
-the APA-Respondent is incarcerated and does not participate in a negotiation conference
-or sign a stipulated order, or
-
-3.
-
-An alleged or presumed parent is excluded by genetic testing results but facts exist that
-the person may be a psychological parent, or
-
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-
-B.
-
-9 CCR 2504-1
-
-4.
-
-The APA-Respondent, after valid service of process or execution of a waiver of service,
-“opts-out” of APA by delivering a written request for court hearing prior to the
-commencement of the negotiation conference, or
-
-5.
-
-A case is referred to court without entry of an administrative order because adoption
-subsidy payments are being made for a child; or,
-
-6.
-
-An order needs to be established but for other reasons cannot be established at the
-negotiation conference.
-
-No judicial complaint or new service of process is necessary for the transfer of subject matter
-jurisdiction to the court in these situations, however, the CSS shall issue and file with the court
-and deliver to all parties a notice of hearing. In these instances, a hearing shall be held and
-appropriate permanent orders shall be entered without the necessity of a complaint being issued
-or served on the parties. The delegate Child Support Services Unit shall request the court to set a
-hearing in the matter by:
-1.
-
-Filing a Child Support Services Unit Request for Court Hearing, as prescribed by the
-State Department, with the clerk of the district court in the county in which the Notice of
-Financial Responsibility was issued or in the district court where an action relating to child
-support is pending or an order exists but is silent on the issue of child support.
-
-2.
-
-Attaching to the Child Support Services Unit Request for Court Hearing the following:
-a.
-
-Notice of Hearing, as prescribed by the State Department;
-
-b.
-
-Notice of Financial Responsibility;
-
-c.
-
-Return of Service or Waiver of Service: if service was by certified mail, the return
-receipt must be attached to the Return of Service;
-
-d.
-
-Income and Expense Affidavits of each parent, if available;
-
-e.
-
-Temporary Order of Financial Responsibility;
-
-f.
-
-Adoption Assistance Agreement, if applicable.
-
-C.
-
-The delegate Child Support Services Unit shall file a request for hearing within ninety (90) days of
-service of the Notice of Financial Responsibility or Notice of Financial Responsibility-Parentage
-Action on the APA-Respondent or within five (5) of determining that APA is no longer appropriate
-and that the case must be referred to court, whichever date is earlier.
-
-D.
-
-The Notice of Hearing must be sent to the noncustodial parent or the noncustodial parent's
-attorney and the custodial party and other agency, if appropriate, by the delegate Child Support
-Services Unit if delegated and authorized by the court in writing.
-
-E.
-
-The delegate Child Support Services Unit is responsible for notifying the court of the last day for a
-hearing to be held in order to decide the issue of child support within ninety days after receipt of
-notice, commencing on the date the service of the Notice or amended Notice of Financial
-Responsibility is accomplished. This is the date on the return receipt if service is by certified mail
-or the date on the return of service, if through personal services.
-
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-
-6.714
-
-MODIFICATION OF ADMINISTRATIVE ORDERS
-
-A.
-
-If the current order was established or modified using administrative process and APA is still
-appropriate, the CSS Unit shall use APA to modify the order.
-
-B.
-
-The CSS Unit shall follow the provisions of Sections 26-13-121, 26-13.5-112, and 14-10-122,
-C.R.S. and Sections 6.261.4 through 6.261.8 and this section of these rules in conducting the
-review and any modification of the current APA order.
-
-C.
-
-At the negotiation conference, the CSS Unit shall enter an order as follows:
-1.
-
-If both parties appear and agree to the terms of the proposed order, enter a stipulated
-order of modification,
-
-2.
-
-If neither party appears for the negotiation conference, enter a default order of
-modification,
-
-3.
-
-If one or both parties appear and one or both do not agree to the terms of the proposed
-order, the CSS Unit shall not enter an APA order of modification but shall request a court
-hearing on the modification and continue to enforce the current order until modified by the
-court.
-
-6.714.1 DEFAULT ORDER OF MODIFICATION
-If a default order of modification is entered:
-A.
-
-The order and accompanying documents shall be signed by the APA certified employee of the
-county CSS or county director and be reviewed by the county director, IV-D administrator, IV-D
-attorney or supervisor of the APA certified employee of the delegate Child Support Services Unit
-designated entering the order before the order is filed with the court. The reviewer shall sign the
-order confirming that the review has been conducted.
-
-B.
-
-The following documents shall be filed with the court:
-
-C.
-
-1.
-
-Affidavit of Non-Appearance;
-
-2.
-
-Default Order of Modification;
-
-3.
-
-Notice of Financial Responsibility – Modification
-
-4.
-
-Guidelines Worksheet(s);
-
-5.
-
-Imputing Potential Income Checklist with comments made in the Guideline Worksheet, if
-applicable;
-
-6.
-
-Subpoena to Produce;
-
-7.
-
-Income and Expense Affidavit, if any; and
-
-8.
-
-Documentation supporting the guidelines calculation, if any.
-
-If the court has not approve or denied approval of the default order within the thirty-six (36) days
-after filing with the court, the delegate child support services unit must notify the court that the
-deadline for approval or denial is in seven (7) days on the forty-second (42nd) day.
-
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-D.
-
-The effective date of the order shall be the date the order is approved by the court.
-
-6.715
-
-DATA INFORMATION SHARING (DISH) AND CUSTODIAN OF THE RECORD (COR)
-
-A.
-
-If an APA stipulated order establishing or modifying child support obligations is entered, the CSS
-shall use the DISH process for transmitting data elements of the order to the court clerk in lieu of
-filing the paper order and other documents with the court unless:
-1.
-
-The order is to be filed in a pending court case relating to child support,
-
-2
-
-The order is to be filed in a county other than the county where APA was conducted, or
-
-3.
-
-Non-Disclosure of Information (NDI) is indicated on the IV-D case.
-
-B.
-
-CSS shall request the court clerk send a dish transmission back to the CSS confirming receipt of
-the required data elements of the order upon which the order becomes effective, valid and
-enforceable.
-
-C.
-
-When DISH procedures are used in lieu of filing the paper order with the court, the CSS becomes
-the Custodian of the Record (COR) of the original order and other APA documents in the case.
-As the COR, the CSS shall maintain the original order and documents until they are filed with the
-court. Upon request of parties or other CSS agencies entitled to such orders, the CSS shall
-provide certified copies of the order.
-
-D.
-
-When a IV-D case is closed or APA is no longer appropriate, the CSS shall file the original order
-and other APA documents with the court thereby transferring the COR designation and duties to
-the court clerk.
-
-6.716
-
-SURVIVABILITY OF AN APA ORDER
-
-A.
-
-If the parents of a child marry each other after an APA order is established, the order survives the
-marriage of the parties and remains in full force and effect except for provisions of the order that:
-1.
-
-Establish an MSO payable between the parents only,
-
-2.
-
-Establish a judgment for retroactive support between the parents only, or
-
-3.
-
-Result in arrears due between the parents.
-
-B.
-
-If an APA order is filed into a pending court case relating to child support (the “parent case”) and
-the parent case is subsequently dismissed by the court, the APA shall survive such dismissal and
-remain in full force and effect unless the court specifically states in the order of dismissal that the
-APA order is also dismissed.
-
-C.
-
-The CSS need take no action in these situations.
-
-6.800
-
-COLLECTION
-
-6.801
-
-PROCESSING COLLECTIONS
-
-6.801.1 Family Support Registry
-A.
-
-All support collections shall be receipted timely by the Family Support Registry and the county
-department of social services as prescribed by the state.
-
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-B.
-
-9 CCR 2504-1
-
-All child support collections receipted in the Family Support Registry or the county department of
-social services shall be processed on the automated child support system.
-
-6.801.2 Colorado Date of Receipt
-Collections shall be entered on the automated child support system screens using the Colorado Date of
-Receipt.
-6.801.3 County Processes
-The county department shall assure that procedures for processing the flow of support payments be
-established and maintained, including the following functions:
-A.
-
-Establish, maintain, and employ procedures which assure that persons responsible for handling
-cash receipts of support payments are not responsible for accounting functions of processing and
-monitoring such payments;
-
-B.
-
-Ensure that only collections received by the Child Support Services Unit or the Family Support
-Registry are recorded as IV-D payments on the Automated Child Support Enforcement System
-(ACSES) ledger or the Automated Child Support Enforcement System and reported to the state
-office as child support Services collections;
-
-C.
-
-Establish, maintain, and employ procedures which assure that all support payments received are
-accounted for in the financial records; and,
-
-D.
-
-Establish, maintain, and employ procedures which provide for the allocation, distribution, and
-disbursement of child and spousal support payments and/or specific medical dollar order
-amounts.
-
-6.801.4 Information on Automated Systems
-Amounts allocated, distributed, and disbursed according to the information available on the automated
-child support system, the Colorado Benefits Management System, and Trails regarding the public
-assistance or placement status of a child(ren) during an eligible month shall remain as such even if the
-eligibility or placement status of the child changes in the current or a later month.
-6.802
-
-ALLOCATION
-
-A.
-
-The court-ordered Monthly Support Obligation (MSO) shall be posted each month on all IV-D
-ledgers where a current obligation is due for the current accounting month. The monthly support
-obligation shall be retroactively posted for each month that it was due for which the CSS Unit was
-responsible for enforcing the MSO that month, but it was previously not posted.
-
-B.
-
-If there is a Monthly Medical Obligation (MMO) due, the entire monthly support obligation,
-monthly medical obligation, and arrears balances shall be posted on a manual ledger for all IV-D
-cases where a current medical obligation is due for the current accounting month.
-
-C.
-
-Allocations shall be made at a child level.
-
-D.
-
-All collections shall be allocated within two (2) business days after being receipted in the Family
-Support Registry or the Child Support Services Unit.
-
-E.
-
-All manual overrides of allocation on the automated child support system shall be documented in
-the automated child support system case chronology.
-
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-
-F.
-
-Allocation to multiple arrears obligations on the same ledger shall prorate to class of balances as
-listed below under Section 6.802.2, “Collections on Cases with Support Orders”.
-
-G.
-
-Allocation to multiple arrears obligations on the same ledger shall satisfy the most recent
-obligation first based on the beginning accrual date of the obligation.
-
-6.802.1 Voluntary Collections on Cases With No Support Orders
-If collections are received on a case that has no support order established yet, the county will first initiate
-a voluntary ledger. The collections shall then be allocated to the ledger in the following order:
-A.
-
-The collection will first satisfy any noncustodial parent erroneous disbursement ledger balance.
-
-B.
-
-If there is any remaining amount, the user shall first post the Monthly Support Obligation to zero
-and then shall allocate the payment to the Monthly Support Obligation.
-
-6.802.2 Collections on Cases With Support Orders
-All collections, except those from a federal income tax intercept or designated as a judgment payment,
-shall be allocated to the ledger as follows:
-A.
-
-First, to the Monthly Support Obligation (MSO) where the Monthly Support Obligation has been
-posted for the current accounting month, prorated among each class of Monthly Support
-Obligation posted on the ledger.
-
-B.
-
-Second, to A Monthly Medical Obligation (MMO) when there is a specific dollar amount ordered.
-
-C.
-
-Third, to non-assigned arrears balances. Arrears payments are allocated in the following order to
-the various types of balances due. Within those types of balances due, an arrears payment will
-allocate to: 1) non-IV-A, either never assistance or post assistance, ordered specific dollar
-amounts for medical, non-IV-E foster care, or non-IV-D, and 2) IV-A unassigned pre-assistance,
-and shall be prorated across ledger balances.
-1.
-
-In-state current delinquency.
-
-2.
-
-In-state non-judgment obligations.
-
-3.
-
-In-state judgment obligations.
-
-4.
-
-Out-of-state current delinquency.
-
-5.
-
-Out-of-state non-judgment obligations.
-
-6.
-
-Out-of-state judgment obligations.
-
-D.
-
-Fourth, to obligor erroneous disbursement ledger balances.
-
-E.
-
-Fifth, to costs due, in the following order:
-1.
-
-Judgment costs due the county.
-
-2.
-
-In-state costs due the Child Support Services Unit that incurred the cost.
-
-3.
-
-Out-of-state costs due another state.
-
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-4.
-F.
-
-9 CCR 2504-1
-
-Costs due to the custodial party.
-
-Sixth, to Title IV-A or Title IV-E assigned arrears balances. Arrears payments are allocated in the
-following order to the various types of balances due, and shall be prorated across ledger
-balances:
-1.
-
-In-state current delinquency.
-
-2.
-
-In-state non-judgment obligations.
-
-3.
-
-In-state judgment obligations.
-
-4.
-
-Out-of-state current delinquency.
-
-5.
-
-Out-of-state non-judgment obligations.
-
-6.
-
-Out-of-state judgment obligations.
-
-If there is a balance for IV-A assigned pre-assistance arrears for an accounting period prior to
-October 1, 2009, these arrears will be paid before permanently assigned arrears.
-G.
-
-Seventh, to prepay if an ongoing monthly support obligation exists. Counties must research the
-ledger to ensure that the payments should be considered prepay payments.
-
-H.
-
-Eighth, to obligor over collect, if no obligation or arrears balance exists on the ledger. Counties
-must research the ledger to ensure that the payments should be considered over collect
-payments prior to disbursing to the obligor.
-
-6.802.3 IRS Collections
-Collections made via an IRS refund shall be allocated to the ledger as follows:
-A.
-
-First, to any pre-assistance arrears owed to the state.
-
-B.
-
-Second, to title IV-A, Title IV-E, or medical assigned arrears balances. Arrears payments are
-allocated in the following order to the various types of balances due and shall be prorated across
-ledger balances:
-
-C.
-
-1.
-
-In-state current delinquency.
-
-2.
-
-In-state non-judgment obligations.
-
-3.
-
-In-state judgment obligations.
-
-4.
-
-Out-of-state current delinquency.
-
-5.
-
-Out-of-state non-judgment obligations.
-
-6.
-
-Out-of-state judgment obligations.
-
-Third, to non-assigned arrears balances, including non-IV-A post, non-IV-A never, or non-IV-E.
-Arrears payments are allocated in the following order to the various types of balances due and
-shall be prorated across ledger balances:
-1.
-
-In-state current delinquency.
-
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-
-D.
-
-2.
-
-In-state non-judgment obligations.
-
-3.
-
-In-state judgment obligations.
-
-4.
-
-Out-of-state current delinquency.
-
-5.
-
-Out-of-state non-judgment obligations.
-
-6.
-
-Out-of-state judgment obligations.
-
-9 CCR 2504-1
-
-Fourth, to obligor over collect, and shall be refunded to the noncustodial parent. If the intercepted
-collection was based on a joint tax return, the over collect refund will be issued in both joint filers'
-names.
-
-6.802.4 Judgment Collections
-Collections made specifically for a judgment arrears balance shall be allocated to the ledger as follows:
-A.
-
-First, to the Monthly Support Obligation (MSO) where the Monthly Support Obligation has been
-posted for the current accounting month, prorated among each class of Monthly Support
-Obligation posted on the ledger.
-
-B.
-
-Second, to a Monthly Medical Obligation (MMO) when there is a specified dollar amount ordered.
-
-C.
-
-Third, to non-assigned judgment balances, pro-rated across ledger balances.
-
-D.
-
-Fourth, to judgment costs due the department.
-
-E.
-
-Fifth, to Title IV-A, Title IV-E, or medical assigned judgment balances, prorated across balances.
-Any assigned pre-assistance balance for an accounting period prior to October 1, 2009, shall be
-paid before a permanently assigned balance.
-
-F.
-
-Sixth, to noncustodial parent over collect, if no obligation or arrears balance exists on the ledger.
-Counties must research the ledger to ensure that the payments should be considered over collect
-payments prior to disbursing to the obligor.
-
-6.803
-
-DISTRIBUTION OF SUPPORT COLLECTIONS
-
-6.803.1 Distribution from a Title IV-A Allocation
-The Pass Through of current child support collections is dependent upon legislative funding availability.
-When Pass Through is funded, the Deficit Reduction Act (DRA) distribution rules shall apply. When Pass
-Through is not funded, standard distribution rules shall apply.
-DRA Distribution of collections from a Title IV-A allocation shall be as follows:
-A.
-
-Amounts applied to the monthly support obligation (MSO) shall be applied in the following order:
-1.
-
-B.
-
-First towards any unfunded disbursement balance according to the agreement with the
-obligee, up to 10% of the payment received or $10.00, whichever is greater, from current
-support; to the family if there is no unfunded disbursement balance.
-
-Amounts applied to a IV-A arrears balance shall first apply towards any obligee unfunded
-disbursement balance and then toward any unreimbursed public assistance and/or unreimbursed
-specific medical dollar order amounts.
-
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-
-1.
-
-Unreimbursed public assistance will be satisfied first in the enforcing county for all
-periods of public assistance, then Last In First Out (LIFO) for all other counties for all
-periods of public assistance for each county until all IV-A assigned arrears are collected.
-Payments to other counties will be made by means of an inter-county transfer of funds as
-prescribed by the state.
-
-2.
-
-In the event no other county has such monetary interest in the case, excess over
-unreimbursed public assistance will be paid to the obligee.
-
-Standard Distribution of collections from a Title IV-A allocation shall be as follows:
-A.
-
-B.
-
-Amounts applied to the monthly support obligation (MSO):
-1.
-
-Shall apply towards any obligee unfunded disbursement balance.
-
-2.
-
-Shall be used to reimburse the total unreimbursed public assistance (UPA) provided to
-the family.
-
-3.
-
-Shall be sent to the family as excess over unreimbursed public assistance if there is no
-unreimbursed public assistance (UPA) balance.
-
-Amounts applied to a IV-A arrears balance shall first apply towards any obligee unfunded
-disbursement balance, and are then used to reimburse unreimbursed public assistance and/or
-unreimbursed specific medical dollar order amounts.
-1.
-
-Unreimbursed public assistance will be satisfied first in the enforcing county for all
-periods of public assistance, and then Last in First Out (LIFO) for all other counties for all
-periods of public assistance for each county until all IV-A assigned arrears are collected.
-Payments to other counties will be made by means of an inter-county transfer of funds as
-prescribed by the state.
-
-2.
-
-In the event no other county has such monetary interest in the case, excess over
-unreimbursed public assistance will be paid to the obligee.
-
-6.803.2 Distribution From a Title IV-E Allocation
-Distribution of collections from a Title IV-E allocation shall be as follows:
-A.
-
-B.
-
-Amounts applied to the monthly support obligation (MSO):
-1.
-
-Shall be used to reimburse the foster care maintenance payment for the month in which
-the maintenance payment was made.
-
-2.
-
-Shall be forwarded to the county business office to be applied according to the state’s
-reporting and accounting procedures, if the amounts applied to the monthly support
-obligation exceed the foster care maintenance payment.
-
-3.
-
-Amounts of the foster care maintenance payment that exceed the monthly support
-collection are added to the balance of unreimbursed maintenance payments (UMP).
-
-Amounts applied to Title IV-E assigned arrears balances:
-1.
-
-Shall be used to reimburse unreimbursed maintenance payments.
-
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-2.
-
-9 CCR 2504-1
-
-Shall be used to reimburse unreimbursed public assistance, if any exists on the case and
-there is no unreimbursed maintenance payments balance. Any remaining collections are
-paid to other counties that have a monetary interest in the case.
-Unreimbursed public assistance and/or unreimbursed maintenance payments will be
-satisfied first in the enforcing county for all periods of public assistance, then Last in First
-Out (LIFO) for all other counties for all periods of public assistance for each county until
-all IV-A OR IV-E assigned arrears are collected. Payments to other counties will be made
-by means of an inter-county transfer of funds as prescribed by the state.
-
-3.
-
-In the event no other county has such monetary interest in the case:
-a.
-
-Any remaining collections are forwarded to the county business office if the child
-is actively in placement at the time the payment was allocated; or,
-
-b.
-
-Forwarded to the obligee if the child is not actively in placement at the time the
-payment was allocated.
-
-6.803.3 Distribution From a Non-IV-A Allocation
-Distribution of collections from a non-IV-A allocation shall be as follows:
-A.
-
-B.
-
-Amounts applied to the monthly support obligation (MSO) or any arrears balance:
-1.
-
-Shall first apply towards any unfunded disbursement balance according to the agreement
-with the obligee.
-
-2.
-
-Shall then be applied to any non-PA service fee still owed by the obligee, whether or not
-such fee has already been reported to the federal government.
-
-3.
-
-Shall be paid to the family.
-
-4.
-
-Amounts that represent payment on the required support obligation for future months
-shall be applied to those future months and shall be paid to the family.
-
-Non IV-A applicants shall be charged a twenty-five dollar ($25) certification fee only if an actual
-federal tax intercept occurs. The certification fee shall be deducted yearly from the first Federal
-Income Tax refund intercept that occurs, regardless of the number of obligors. If the total yearly
-amount of all tax refunds for a case is less than twenty-five dollars ($25), that amount will satisfy
-the certification fee.
-
-6.803.4 Distribution From a Non-IV-E Allocation
-Distribution of collections from a non-IV-E allocation shall be as follows:
-All payments allocated to the current monthly amount due or to any arrears balances shall be forwarded
-to the county business office.
-6.804
-
-DISBURSEMENT OF SUPPORT COLLECTIONS
-
-Any disbursement to a family shall be made to the resident parent, legal guardian, or caretaker relative
-having custody of or responsibility for the child(ren), judicially-appointed conservator with a legal and
-fiduciary duty to the custodial parent and the child, or alternate caretaker designated in a record by the
-custodial parent. An alternate caretaker is a nonrelative caretaker who is designated in a record by the
-custodial parent to take care of the children for a temporary time period.
-
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-
-6.804.1 Disbursement from a Title IV-A Allocation
-Disbursement of collections from a title IV-A allocation shall be as follows:
-A.
-
-Disbursements of Pass Through or Excess Pass Through amounts shall be paid to the family
-within two (2) business days from the Colorado date of receipt if sufficient information identifying
-the payee is provided.
-
-B.
-
-Disbursements to excess over UPA shall be paid to the family within two (2) business days of the
-end of the month in which the collection was received if sufficient information identifying the
-payee is provided.
-
-C.
-
-If the collection was received from a federal income tax return, the excess over unreimbursed
-public assistance payment must be sent to the family within thirty (30) calendar days of the
-Colorado date of receipt unless based on a joint tax return (see Section 6.804.6).
-
-6.804.2 Disbursement From a Title IV-E Allocation
-Disbursement of collections from a Title IV-E allocation shall be as follows:
-A.
-
-Disbursements to the IV-E agency shall be forwarded to the business office within fifteen (15)
-business days of the end of the month in which the collection was received.
-
-B.
-
-Disbursements to excess over UMP which are due to the obligee and not child welfare shall be
-paid to the obligee within two (2) business days of the end of the month in which the collection
-was received if sufficient information identifying the payee is provided.
-
-C.
-
-If the collection was received from a federal income tax return, the collection must be forwarded
-to the IV-E agency or to the family as appropriate, within thirty (30) calendar days of the Colorado
-initial date of receipt unless based on a joint tax return (see Section 6.804.6).
-
-6.804.3 Disbursement from a Non-IV-A Allocation
-Disbursement of collections from a non-IV-A allocation shall be as follows:
-A.
-
-If any moneys are owed for the non-PA service fee, those moneys will be held from any
-disbursement being sent to the obligee, whether from the current monthly support obligation or
-from an arrears or judgment disbursement.
-
-B.
-
-All disbursements for the monthly support amount and arrears amounts shall be paid to the family
-within two (2) business days from the Colorado initial date of receipt if sufficient information
-identifying the payee is provided unless the collection was received from a federal IRS tax return
-(see Section 6.804.6).
-
-6.804.4 DISBURSEMENT FROM A NON-IV-E ALLOCATION
-Disbursement of collections from a non-IV-E allocation shall be as follows:
-A.
-
-Disbursements to child welfare shall be paid within fifteen (15) business days of the end of the
-month in which the collection was received.
-
-B.
-
-If the collection was received from a federal income tax return, the collection must be forwarded
-to child welfare within thirty (30) calendar days of the Colorado initial date of receipt unless based
-on a joint tax return (see Section 6.804.6).
-
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-
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-
-6.804.5 Disbursement in Intergovernmental Cases
-Disbursement of collections on intergovernmental cases shall be as follows:
-A.
-
-In responding intergovernmental cases, for which collections are made on behalf of another child
-support Services agency, the payment must be forwarded to the location specified by the
-initiating child support Services agency. Collections must be forwarded to the initiating child
-support Services agency within two (2) business days of the Colorado date of receipt if sufficient
-information identifying the payee is provided and within thirty (30) calendar days of the date the
-payment is received from tax offset collections.
-
-B.
-
-In transmitting collections, the responding child support Services agency must provide the
-initiating child support Services agency with sufficient information to identify the case, the initial
-date of receipt, and the responding agency’s FIPS code.
-
-6.804.6 Disbursements From Federal Income Tax Return Allocations
-Disbursements of collections from federal income tax return allocations must be sent to the family within
-thirty (30) calendar days of the Colorado initial date of receipt, except if a disbursement is from a joint
-federal income tax refund, the county Child Support Services Unit may delay disbursement to the family
-until:
-A.
-
-The Child Support Services Unit is notified that the unobligated spouse’s proper share of the
-refund has been paid; or,
-
-B.
-
-For a period not to exceed six months from notification of offset, whichever date is earlier.
-
-C.
-
-A disbursement to obligor over-collect must be sent within a reasonable time period.
-
-6.804.7 Erroneous Intercept Collection
-When an intercept collection is identified as an erroneous certification intercept collection such as the
-amount was not owed at the time of certification or the wrong person was intercepted, the Child Support
-Services Unit shall refund the collection within two (2) working days from the time the erroneously
-intercepted person provides notice of intercept. This payment shall be disbursed even if the erroneous
-intercept collection has not been received by the county Child Support Services Unit. The County Child
-Support Services Unit must submit the state prescribed notice to the State Child Support Services
-Division when an erroneous intercept occurs.
-6.804.8 Erroneous Collection From an Enforcement Remedy
-When a collection from any enforcement remedy is identified as an erroneous withholding, the Child
-Support Services Unit shall refund the withheld monies within two (2) working days from the date the
-obligor provides notice of erroneous withholding. This payment shall be disbursed to the obligor even if
-the erroneous withholding was not retained by the Child Support Services Unit. The County Child Support
-Services Unit must submit the state prescribed notice to the State Child Support Services Division when
-an erroneous collection is received due to an enforcement remedy action.
-
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-6.805
-
-9 CCR 2504-1
-
-ADMINISTRATIVE REVIEW OF CONTESTED ARREARS
-
-6.805.1 COUNTY LEVEL REVIEW
-A.
-
-The county department shall establish procedures for reviewing arrearage amounts that are to be
-reported to a consumer credit reporting agency or have been certified for the administrative offset
-program, administrative lien and levy, tax offset, lottery intercept, workers’ compensation
-attachment, state vendor offset program, gambling intercept, license suspension, or
-administrative lien and attachment of insurance claim payments, awards, and settlements.
-
-B.
-
-Upon written request for an administrative review, within the time frame specified on the advance
-notice for reporting arrears to a consumer credit reporting agency, the pre offset notice for tax
-purposes, the notice of intercept of lottery winnings, the Administrative Lien and Attachment for
-workers’ compensation benefits, the notice for license suspension, The Notice of License Denial,
-the notice of administrative lien and levy, the notice for state vendor offset program, the notice of
-intercept of gambling winnings, the notice for federal administrative offset program, or the notice
-of administrative lien and attachment of insurance claim payments, awards, and settlements, the
-county Child Support Services Unit shall:
-1.
-
-Schedule and advise the obligor, and the obligee in a non-public assistance case, of the
-date, time and place of the review and initiate administrative review information on the
-administrative review tracking system screen in the automated child support system.
-
-2.
-
-Request from the obligor copies of any modifications of the support order.
-
-3.
-
-Request from the obligor records of payments made by the obligor.
-
-4.
-
-Advise the obligor this review is a review of the records only and not a judicial
-determination.
-
-5.
-
-Request proof from the obligor if they have contested being the obligor.
-
-6.
-
-Advise the obligor that a decision will be rendered within thirty (30) days of the request for
-a review.
-
-C.
-
-The county department shall notify the obligor that an administrative review will only be held if the
-request for an administrative review concerns an issue of mistaken identity of the obligor or the
-amount of arrearages specified on the advance notice for reporting to a consumer credit reporting
-agency, the pre-offset notice for tax offset, the notice for lottery intercept, administrative lien and
-attachment for workers’ compensation benefits, the notice of license suspension, the notice for
-federal administrative offset program, the notice for state vendor offset program, the notice of
-intercept of gambling winnings, the notice for administrative lien and levy, or the notice of
-administrative lien and attachment of insurance claim payments, awards, and settlements.
-
-D.
-
-On the date established, the county department shall review the child support case record and
-the documents submitted by the obligor and determine the arrears.
-
-E.
-
-Within ten (10) calendar days of the decision rendered, the county department shall update the
-automated child support system, take any additional action appropriate to reflect the decision,
-notify the obligor, and the obligee in a non-public assistance case, of the decision rendered. The
-written decision shall include the time frames reviewed, balance due for that time frame, court
-orders reviewed including the child support terms of those orders, payment records reviewed, and
-amounts credited based on those records.
-
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-F.
-
-9 CCR 2504-1
-
-The county department shall notify the obligor of the right to request a further review by the State
-Department. The obligor must be advised that the request must be made in writing and be
-received by the state office within thirty (30) calendar days of the mailing of the county decision to
-the obligor.
-
-6.805.2 STATE LEVEL REVIEW
-Upon written request from the obligor to the State Department for review of arrearage amounts, that are
-to be reported to a consumer credit reporting agency, or have been certified for tax offset, for lottery
-intercept, for workers’ compensation benefits attachment, license suspension, license denial, federal
-administrative offset program, state vendor offset program, gambling intercept, administrative lien and
-levy, and administrative lien and attachment of insurance claim payments, awards, and settlements, the
-State Department shall
-A.
-
-B.
-
-C.
-
-Determine if a county level administrative review occurred.
-1.
-
-If not and the obligor is within the time frame specified on the notice, forward the request
-to the appropriate county and ensure that the county conducts an administrative review
-within thirty (30) calendar days of receiving the request from the State Department.
-
-2.
-
-If not and the obligor is outside of the time frame specified on the notice, the obligor has
-lost the right to contest the arrears through the administrative review process.
-
-3.
-
-If yes, set a date, time, and place for the review, which shall be within thirty (30) calendar
-days from the date the written request for review was received by the State Department.
-
-Provide a written notice to the obligor, and the obligee in a non-public assistance case, of the
-date, time, and place of the review. This notice shall contain a statement which advises the
-parties:
-1.
-
-The only issues to be reviewed are a mistake in the identity of the obligor or a
-disagreement of the amount of arrears.
-
-2.
-
-The review is a review of the records only and not a judicial determination.
-
-3.
-
-The obligor must provide all records of support payments made.
-
-4.
-
-That a decision will be rendered within thirty (30) days of the review.
-
-Request that the county provide:
-1.
-
-The records that established the arrearages; and,
-
-2.
-
-A copy of its decision if not previously provided by the noncustodial parent.
-
-D.
-
-On the date established for the review, the State Department shall review the records and
-determine the arrears. If more time is required to review the records or render a decision, the
-State Department may extend the time for rendering a decision by an additional thirty (30) days.
-
-E.
-
-Within ten (10) calendar days of the decision rendered, the State Department shall notify, in
-writing, the obligor, the obligee in a non-public assistance case, and the county Child Support
-Services Unit of the decision rendered. Any party shall have the right to appeal the decision. The
-written decision shall include the time frames reviewed, balance due for those time frames, court
-orders reviewed including the child support terms of those orders, payment records reviewed, and
-amount credited based on those records.
-
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-
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-
-F.
-
-Update the Automated Child Support Enforcement system to reflect the administrative review.
-
-G.
-
-A decision will be rendered within thirty (30) calendar days of the receipt of the written request for
-review unless the parties fail to provide the required information.
-
-H.
-
-Advise the parties of their right to appeal the state decision by filing an action for judicial review
-with the State District Court within thirty-five (35) calendar days of the effective date of the state
-decision. The state decision is effective on the date of the decision.
-
-6.805.21
-
-Reflect Decision Rendered
-
-The county department, upon receiving the decisions rendered by the State Department after a state level
-review, shall, within ten (10) calendar days, adjust the Automated Child Support Enforcement System
-records to reflect the decision rendered and take any additional action appropriate.
-6.805.3 Intergovernmental Review
-Procedure for Reviewing arrearage amounts that have been certified and submitted for a federal income
-tax refund offset on an intergovernmental case.
-A.
-
-Within ten (10) calendar days of the receipt of a written request for an administrative review
-where Colorado is the submitting state and the requester has requested that the order-issuing
-state conduct the review or Colorado, as the submitting state, cannot resolve the matter, the
-county CSS Unit shall notify the order-issuing state and send all necessary information which was
-considered in the decision of an arrearage amount. Colorado, as the submitting state, shall be
-bound by the decision of the order-issuing state.
-
-B.
-
-Within ten (10) calendar days of the receipt of a written request for an administrative review
-where Colorado is the order-issuing state and the requester has requested that the order-issuing
-state conduct the review or the submitting state cannot resolve the matter, the county Child
-Support Services Unit shall:
-1.
-
-Schedule and advise the obligor, and the obligee in a non-public assistance case, and
-the other state, of the date, time, and place of the administrative review.
-
-2.
-
-Advise the obligor, and the obligee in a non-public assistance case and the other state
-that a decision will be rendered within forty five (45) calendar days of the receipt of the
-submitting state's request and information.
-
-3.
-
-On the date established, the order-issuing state shall review the child support case
-record, and the documents submitted by the requester and forwarded by the submitting
-state, and determine the arrears.
-
-4.
-
-Within ten (10) calendar days of the decision rendered, the order-issuing state shall notify
-in writing, the obligor, the obligee, and the submitting state of the decision rendered. The
-written decision shall include the time frames reviewed, balance due for those time
-frames, court orders reviewed including the child support terms of those orders, payment
-records reviewed, and amounts credited based on those records.
-
-5.
-
-The county department shall notify the obligor of the right to request a further review by
-the State Department. The obligor must be advised that the request must be made in
-writing and be received by the state office within thirty (30) calendar days of the mailing of
-the county decision to the obligor.
-
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-
-6.
-
-9 CCR 2504-1
-
-The county department, upon receiving the decisions rendered by the other state shall,
-within ten (10) calendar days, adjust the Automated Child Support Enforcement System
-records to reflect the decision rendered and take any additional appropriate action.
-
-6.805.4 Administrative Review of Contested Distribution of Amounts Collected
-6.805.41
-
-County Responsibility
-
-A.
-
-Following verbal or written contact from an obligee regarding questions or disagreement about
-distribution of amounts collected, the CSS unit shall review the distribution and respond verbally
-or in writing. The obligee must be advised that if there is still disagreement, the obligee must
-submit a written request for an administrative review by the Child Support Services Unit.
-
-B.
-
-Within ten (10) calendar days of the receipt of a written request for an administrative review, the
-Child Support Services unit shall:
-1.
-
-Schedule and advise the obligee of the date, time and place of the review;
-
-2.
-
-Request from the obligee copies of any modification of the support order that have not
-been previously provided to the Child Support Services Unit;
-
-3.
-
-Request from the obligee records of any payments made directly to the family from the
-obligor;
-
-4.
-
-Advise the obligee that a written decision will be rendered within thirty (30) days of the
-date of the review;
-
-5.
-
-Request from the obligee any other information to support the contention that the
-collections were distributed in error.
-
-C.
-
-If the request for an administrative review concerns an issue other than the distribution of current
-support and/or arrearage payments, the Child Support Services unit shall notify the obligee that a
-review will not be held.
-
-D.
-
-On the date established for the administrative review, the Child Support Services unit shall review
-the child support case record and any information submitted by the obligee and determine if the
-distribution of the amounts collected was correct.
-
-E.
-
-The Child Support Services unit shall promptly notify the obligee in writing of the decision
-rendered and will provide a copy of the decision to the State Department within five (5) days of
-the date the decision is rendered.
-
-F.
-
-The Child Support Services Unit shall notify the obligee in writing of the right to request a further
-review by the State Department. The obligee will be advised that the written request must be
-received by the state office within thirty (30) calendar days of the mailing of the county decision to
-the obligee.
-
-G.
-
-The Child Support Services Unit, upon receiving the decision rendered by the State Department
-after a state level review shall, within ten (10) calendar days, adjust the automated child support
-enforcement system records to reflect the decision rendered and take any additional action as
-appropriate.
-
-6.805.42
-
-State Responsibilities
-
-Upon written request for further administrative review, the State Department shall:
-
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-
-A.
-
-9 CCR 2504-1
-
-Provide notice to the obligee, which shall contain:
-1.
-
-A statement that the only issue to be reviewed is the distribution of current support and/or
-arrearage payments collected;
-
-2.
-
-A statement that the review is a review of the records only and not a judicial
-determination and that the review will be limited to the documentation in the CSS file and
-any written material the obligee wishes to present.
-
-B.
-
-Request from the CSS Unit or obtain from the automated child support system, the records used
-for the distribution;
-
-C.
-
-Request from the CSS Unit a copy of its decision;
-
-D.
-
-Request from the county records of support payment paid directly to the family which were
-provided by the obligee during the administrative review;
-
-E.
-
-Advise the obligee that a written decision will be made within thirty (30) calendar days of the
-receipt of the request;
-
-F.
-
-Advise the obligee of the right to appeal the state decision by filing an action for judicial review
-with the State District Court within thirty-five (35) calendar days of the effective date of the state
-decision. The state decision is effective on the date of the decision.
-
-6.805.43
-
-Notify of Decision Rendered
-
-The State Department shall, within thirty days of the date of the state level review, promptly notify in
-writing the obligee and the county CSS Unit of the decision rendered.
-6.805.5 Appeal of Joint Account Collection From FIDM
-When a FIDM notice of lien and levy is made on a joint or shared ownership account, as defined at
-Section 15-15-201(5), C.R.S., the non-debtor account holder may appeal the seizure of his or her share
-of the funds (see Section 6.906.5), first through the Colorado Department of Human Services, Division of
-Child Support Services, and then, if still disputed, judicially. If the appeal is approved, the Colorado
-Department of Human Services, Division of Child Support Services, shall release all or part of the lien and
-levy within two (2) working days from the date the appeal decision is made by the Colorado Department
-of Human Services, Division of Child Support Services, or within two working days of the receipt of the
-judicial order approving the appeal. In the event that the financial institution has already remitted payment
-to the Family Support Registry at the time of the appeal ruling, the payment shall be refunded to the nondebtor account holder pursuant to the appeal ruling.
-6.806
-
-INTEREST
-
-Collection of interest is optional for county Child Support Services Units. If a county chooses to collect
-interest, the following rules shall apply.
-A.
-
-Interest on support collections that are deposited in a financial institution in interest bearing
-accounts shall be used to reduce administrative costs as prescribed by the State Department.
-
-B.
-
-Interest collected through support arrears/debt shall be considered a support collection and shall
-be used to reduce the UPA/UMP balances or, for non IV-A cases, paid to the family.
-
-108
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-1.
-
-In order to collect interest on a Colorado order, the interest rate will be calculated as
-prescribed by the State Department on the balance past due at the current interest rate in
-effect as set forth in Sections 5-12-101 and 14-14-106, C.R.S.
-
-2.
-
-Interest on arrears balances will be calculated for a specific amount of arrearages/debt
-covering a specific period of time. The amount of interest will be listed separately from
-the amount listed for child support arrears/debt and shall be added to the IV-D ledger on
-the automated child support enforcement system using the appropriate interest
-adjustment reason codes. The two figures will be added together to show the total
-amount of judgment or non-judgment balances.
-
-3.
-
-A county may charge interest on a Colorado child support order according to statute. If a
-county intends to calculate interest, it must:
-a.
-
-Send a written notice to the obligor or the obligor’s attorney of record, if one
-exists, that interest will be assessed on the order.
-
-b.
-
-Only assess interest beginning with the date of the notice referenced in
-paragraph a, of this section.
-
-c.
-
-Complete an updated interest calculation every six (6) months for all cases
-where notice, in paragraph “a” of this section, was provided and shall provide
-written notification of the amount of interest assessed to the obligor or the
-obligor’s attorney of record, if one exists.
-
-d.
-
-Notify the responding agency in an initiating reciprocal action, at least annually,
-and upon request in an individual case, of interest charges, if any, owed on
-overdue support.
-
-4.
-
-The county Child Support Services Unit may waive the collection of interest if it wishes to
-use interest as a negotiating tool to reach a payment settlement on both public
-assistance and non-public assistance cases.
-
-5.
-
-Counties must collect interest on interjurisdictional cases if they are enforcing another
-jurisdiction’s order and the jurisdiction requests collection of interest.
-
-6.807
-
-DISBURSEMENTS ON HOLD
-
-A.
-
-If a disbursement returns as undeliverable mail, if there is no existing address on the automated
-child support system, or if a disbursement has been reported as lost or stolen, the user shall put
-all disbursements for that ledger on hold until the issue is resolved.
-
-B.
-
-Child Support Services Units shall ensure that procedures are established in the county to work
-the scheduled disbursements daily.
-
-C.
-
-The county Child Support Services Unit shall utilize all appropriate local, state, and federal
-sources to determine the location of the payee.
-
-D.
-
-If the obligee cannot be located within ninety (90) calendar days of the original warrant issue date
-of the disbursement to the obligee, the Child Support Services worker shall allocate the
-payment(s) first to any obligor erroneous disbursement balance and second to any assigned
-arrears balance.
-
-E.
-
-If there are no obligor erroneous disbursement or assigned arrears balances, the Child Support
-Services worker shall allocate the payment to obligor over collect and disburse to the obligor.
-
-109
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-F.
-
-9 CCR 2504-1
-
-If the obligor cannot be located within ninety (90) calendar days of the original warrant issue date
-of the disbursement to the obligor, the Child Support Services worker shall, by the ninety-first
-(91ST) calendar day, mark the collection to transfer to the abandoned collections account on the
-disbursement record on the automated child support enforcement system.
-The automated child support enforcement system will automatically reimburse any obligee
-unfunded disbursement balance on the ledger before the payment is transferred to the
-abandoned collections account.
-
-G.
-
-If the payee requests payment of the disbursement once it has been transferred to the
-abandoned collections account, the transfer will be reversed through a problem log to the state
-office, and the disbursement will be scheduled.
-
-6.808
-
-UNFUNDED DISBURSEMENTS
-
-A.
-
-The county Child Support Services Unit shall make every reasonable effort to recover unfunded
-disbursements.
-
-B.
-
-If the payment was allocated to the wrong account, the county Child Support Services Unit shall
-allocate and disburse the payment to the correct account within five (5) working days of
-discovering the error, even if the county has not received a recovery from the payee who received
-the original disbursement.
-
-6.808.1 Notification
-A.
-
-The county Child Support Services Unit must ensure that the obligee or the initiating jurisdiction
-has received notification of the unfunded disbursement prior to automatic recovery of the
-unfunded disbursement amount. This notification may occur through the application for Colorado
-Works, Child Support Services, or through the automated child support system noticing process.
-
-B.
-
-The county Child Support Services Unit must have an agreement with the obligee in order to
-recover the unfunded disbursement. If the obligee does not agree to the unfunded disbursement
-recovery, county Child Support Services Units may pursue recovery through civil means or may
-write off the unfunded disbursement amount.
-
-C.
-
-The notice of the unfunded disbursement amount will inform the obligee or the initiating
-jurisdiction of her/his responsibility to repay the balance and will state that failure to respond to
-the notice constitutes an agreement of her/his part.
-
-6.808.2 Recovery
-A.
-
-The primary contact county shall be responsible for any negotiations with the obligee and for
-ensuring that the statewide unfunded disbursement balance is paid. The automated child support
-enforcement system will determine the primary county.
-
-B.
-
-Any county CSS Unit can accept a cash payment from the obligee to recover the unfunded
-disbursement amount.
-
-C.
-
-The automated process will recover one hundred percent (100%) of any Title IV-A distribution.
-County CSS staff can negotiate a percent or amount of recovery with the obligee on a non-IV-A
-distribution but the automated child support system will automatically recover at least ten percent
-(10%) of the payment or ten dollars ($10), whichever is greater.
-
-110
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-6.808.3 Balance Statement
-The county Child Support Services Unit must send an unfunded disbursement balance statement to the
-obligee if one is requested. Balance statements requested on intergovernmental cases will be sent to the
-other agency.
-6.808.4 Balance Write-Off
-The Automated Child Support Enforcement System will automatically write off unfunded disbursement
-balances for obligees who have no open cases anywhere in Colorado and with no financial history activity
-throughout the State for seven years.
-6.809
-
-CHILD SUPPORT INCENTIVE PAYMENTS
-
-A.
-
-Child support incentives distributed to counties shall be the total amount of the federal incentives
-paid to the state, excluding amounts described in paragraph B of this section, plus no less than
-50% of the state share of retained collections. However, beginning 01/01/2020 if the Federal
-Medical Assistance Percentages (FMAP) rate is greater than 50%; then the share of retained
-collections distributed to the counties will default to the share percentage remaining after the
-federal government is reimbursed based on the current FMAP rate. Reimbursement pursuant to
-the FMAP rate might result in counties receiving less than 50% of the retained collections. The
-share of retained collections paid to the counties shall never exceed 50%. In the event that the
-share of retained collections to be distributed to the counties is less than 50%, the state division
-of child support services must issue notice to the counties within 91 days of the determination that
-the share of retained collections is less than 50%. Child support incentives shall be paid to
-counties quarterly. The federal and state share incentives shall be calculated separately but using
-the same formula.
-
-B.
-
-Beginning in federal fiscal year 2024, a percentage of the federal incentives received by the state
-may be retained for the purposes of information technology enhancements to the ACSES, if
-approved by majority vote by the Policy Advisory Committee.
-1.
-
-Beginning in federal fiscal year 2024, the State Division of Child Support Services shall
-annually submit a proposal to the Policy Advisory Committee containing:
-a.
-
-The dollar amount of federal incentives available to be retained, pursuant to
-section 26-13-112.5, C.R.S.;
-
-b.
-
-The recommendation of the IV-D Task Force regarding technology
-enhancements to be funded with federal incentives; and
-
-c.
-
-A cost estimate of each recommended enhancement.
-
-111
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-6.809.1 Incentive Formula
-The following formula to calculate incentives is used at the federal level to calculate incentives to
-distribute to states and shall be used in Colorado to calculate incentives to distribute to counties.
-A.
-
-Two (2) X (collections for current and former IV- A =
-and IV-E cases) + collections for non-PA and
-non-IV-E cases
-
-“Collections Base”
-
-B.
-
-Total “collections base” X the weight for each
-performance measure
-Convert each actual performance ratio using the
-conversion table
-Each county’s “unadjusted incentive amount” ÷
-state total of “unadjusted incentive amounts”
-Each county’s percent of the “unadjusted
-incentive amount” X the statewide incentive to be
-distributed for each performance measure
-Sum of the “county incentive” for each
-performance measure
-
-=
-
-County “collections base amount” for each
-performance measure
-“Performance incentive factor” for each
-performance measure
-Each county’s percent of the state
-“unadjusted incentive amount”
-“County incentive” for each performance
-measure
-
-Sum of county quarterly federal and state share
-incentives
-
-=
-
-C.
-E.
-F.
-G.
-H.
-
-=
-=
-=
-=
-
-Total “county quarterly federal
-incentive payment” or “county quarterly state
-share incentive payment”
-Total “county quarterly incentive payment”
-
-6.809.2 Performance Measures
-Incentives distributed to counties will be based on five (5) performance measures. Each performance
-measure will be calculated at the end of the quarter for each county.
-A.
-
-Paternity establishment percentage (PEP) is:
-The total number of children born out of wedlock in the IV-D caseload with paternity established
-as of the end of the present month divided by the total number of children born out of wedlock in
-the IV-D caseload as of the end of the corresponding month of the previous year.
-
-B.
-
-The percent of caseload with support orders is:
-The total number of cases with an order for support as of the end of the present month divided by
-the total number of cases in the caseload as of the end of the present month.
-
-C.
-
-The percent of current support paid is:
-The total dollar amount of child support payments made to current monthly support obligations
-from the beginning of the year to the present time divided by the total dollar amount of current
-monthly support obligations due from the beginning of the year to the present time.
-
-D.
-
-The percent of arrears cases with a payment is:
-The total number of cases with a payment made to an arrears obligation or current delinquency
-balance during the previous 12 months divided by the total number of cases with an arrears
-obligation or current delinquency owed as of the end of the present month.
-
-112
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-E.
-
-9 CCR 2504-1
-
-The cost effectiveness ratio is:
-The total county combined collections divided by the total county administrative costs.
-The paternity establishment percentage, the percent of caseload with orders, and the percent of
-current support paid shall have a weight of one hundred percent (100%). The percent of arrears
-cases with a payment and the cost effectiveness ratio shall have a weight of seventy-five percent
-(75%).
-
-6.809.3 “Statewide Incentive Amount” for Each Performance Measure
-The total amount of incentives to be distributed shall be the quarterly estimated incentive amount
-received from the federal government plus the state share incentive, excluding amounts described in
-section 6.809.B.
-6.809.4 Conversion Tables
-Each performance measure has a bottom threshold; no incentives will be paid for performance ratios
-below the bottom threshold. The bottom threshold is fifty percent (50%) for the paternity establishment
-percentage and the percent of caseload with orders. The bottom threshold of the table is forty percent
-(40%) for the percent of current support paid and the percent of arrears cases with a payment.
-Each performance ratio, except for the cost effectiveness ratio, converts, by means of the following table,
-to a performance incentive factor.
-If the
-performance
-ratio is at least
-80%
-79%
-78%
-77%
-76%
-75%
-74%
-73%
-72%
-71%
-70%
-69%
-68%
-67%
-66%
-65%
-64%
-63%
-62%
-61%
-60%
-
-But is
-less
-than
-80%
-79%
-78%
-77%
-76%
-75%
-74%
-73%
-72%
-71%
-70%
-69%
-68%
-67%
-66%
-65%
-64%
-63%
-62%
-61%
-
-The performance
-incentive factor
-equals:
-100%
-98%
-96%
-94%
-92%
-90%
-88%
-86%
-84%
-82%
-80%
-79%
-78%
-77%
-76%
-75%
-74%
-73%
-72%
-71%
-70%
-
-If the
-performance
-ratio is at least
-59%
-58%
-57%
-56%
-55%
-54%
-53%
-52%
-51%
-50%
-49%
-48%
-47%
-46%
-45%
-44%
-43%
-42%
-41%
-40%
-
-But is
-less
-than
-60%
-59%
-58%
-57%
-56%
-55%
-54%
-53%
-52%
-51%
-50%
-49%
-48%
-47%
-46%
-45%
-44%
-43%
-42%
-41%
-
-The performance
-incentive factor
-equals:
-69%
-68%
-67%
-66%
-65%
-64%
-63%
-62%
-61%
-60%
-59%
-58%
-57%
-56%
-55%
-54%
-53%
-52%
-51%
-50%
-
-113
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-9 CCR 2504-1
-
-The cost effectiveness ratio converts, by means of the following table, to a performance incentive factor.
-No incentives will be paid for a cost effectiveness ratio under two dollars ($2.00).
-If the CER is at least
-But is less than
-The performance incentive factor equals:
-$5.00
--100%
-$4.50
-$4.99
-90%
-$4.00
-$4.49
-80%
-$3.50
-$3.99
-70%
-$3.00
-$3.49
-60%
-$2.50
-$2.99
-50%
-$2.00
-$2.49
-40%
-6.809.5 Adjustment
-An annual adjustment will be done at the end of the federal fiscal year, replacing the estimated state
-incentive with the actual statewide incentive payment received from the federal Office of Child Support
-Enforcement, excluding amounts described in section 6.809.B. The adjustment is done in the quarter
-following the date the state office receives the adjustment letter from the federal office. The adjusted
-amounts are incorporated into the current quarter’s incentive payments. If there are counties that have a
-negative incentive amount in the adjusted quarter, they will be billed for this amount by the state Division
-of Accounting.
-6.809.6 Reinvestment
-A.
-
-Federal regulations require that all federal incentives received be reinvested into the child support
-program to ensure continued improvement, adequate resources, and maintenance of a high
-performance level for the child support services program.
-
-B.
-
-When a county’s federal incentives for a calendar year exceed the county thirty-four percent
-(34%) share of county administrative expenditures, the county shall demonstrate to the state
-Child Support Services Unit how the excess federal incentives are reinvested in the child support
-program. Counties shall report this information to the state Child Support Services Unit within two
-calendar years of receipt of the federal incentives, or if counties are unable or unwilling to reinvest
-the federal incentives in the child support program, they shall return that amount to the state
-office.
-
-C.
-
-Counties must gain state approval of any plan to reinvest federal incentives that exceed their
-thirty-four percent (34%) share of county administrative expenditures by presenting to the state
-Child Support Services Unit a written proposal of their plan. The reinvestment can be made
-directly into the Child Support Services program or can be made to a program not approved for
-IV-D federal participation of expenditures, as long as the county can demonstrate to the state
-office how the proposed program will benefit the Child Support Services program. The cost
-effectiveness ratio converts, by means of the following table, to a performance incentive factor.
-No incentives will be paid for a cost effectiveness ratio under two dollars ($2.00).
-
-6.900
-
-ENFORCEMENT
-
-Child Support Services Unit employees must be certified by the State Division of Child Support Services
-to perform functions associated with the automated enforcement remedies described in section 6.103.2.
-
-114
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-6.901
-
-9 CCR 2504-1
-
-ENFORCEMENT PROCEDURES
-
-The county Child Support Services Units shall establish procedures to ensure that the full range of
-enforcement activities are undertaken and completed within the time frames specified. The time frames
-begin when the obligor is located or on the date the obligor fails to make a payment or when other
-support related non-compliance occurs. The time frames end when enforcement action is taken. All
-enforcement activities must be documented in the automated child support system.
-6.902
-
-ENFORCEMENT FUNCTIONS
-
-6.902.1
-The following functions are the responsibility of the Child Support Services Unit with regard to the
-enforcement of child support obligations for all CSS cases.
-6.902.11
-
-County Procedures
-
-Within thirty (30) calendar days of identifying a delinquency or other non-compliance with the order, or
-location of the obligor, whichever occurs later, the Child Support Services Unit must take appropriate
-enforcement action. The Child Support Services Unit must assess each enforcement case to determine
-appropriate enforcement actions pursuant to Section 6.903.11.
-A.
-
-When an obligor fails to make full payment in the month the payment is due, appropriate
-enforcement action shall be taken.
-
-B.
-
-Income Assignment
-1.
-
-For support orders subject to the immediate activation of an income assignment, the
-Notice to Withhold Income for Support must be sent within two (2) business days after
-receipt of an income source.
-
-2.
-
-For support orders not subject to the immediate activation of an income assignment, the
-Advance Notice of Activation of Income Assignment must be filed with the court and
-mailed to the obligor within two (2) business days after receipt of an income source. If the
-obligor does not file an objection to the activation of the income assignment, the Notice to
-Withhold Income for Support must be sent within two (2) business days of the end of the
-fourteen (14) day objection period.
-
-3.
-
-A copy of the Notice to Withhold Income for Support shall be provided to the obligor by
-the employer.
-
-4.
-
-If an automated income assignment cannot be issued due to an exception, the
-automated child support system will electronically generate a message to the enforcing
-county and the county child support services worker shall complete the following within
-two (2) working days of the date of the receipt of the message:
-a.
-
-Research the case to determine whether the exception is valid and correct the
-exception data if possible;
-
-b.
-
-Document the findings and the actions taken to correct the exception in the
-automated child support system;
-
-c.
-
-Issue the income assignment to the employer, if appropriate.
-
-115
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-C.
-
-9 CCR 2504-1
-
-Service of Process
-1.
-
-If service of process is necessary, service must be completed and enforcement action
-taken within sixty (60) calendar days of identifying a delinquency or of locating the
-obligor, whichever occurs later.
-
-2.
-
-Repeated unsuccessful service of process attempts are not a valid reason for not
-meeting the time frames. If service of process is unsuccessful because of a poor
-address, the case shall be referred back to the locate function.
-
-6.902.12
-
-Public Assistance Cases
-
-In public assistance and foster care cases, the Child Support Services Unit shall enforce court-ordered
-child support obligations from any person who is legally liable for such support until such obligations are
-satisfied, including assigned arrearages, unless good cause exemption from referral to the Child Support
-Services Unit has been determined to exist by the county director or designee. Spousal maintenance
-must also be enforced if established in the same court action and if the child(ren) is living with the obligee
-of child support and spousal maintenance.
-6.902.13
-
-Non-Public Assistance Cases
-
-In non-public assistance cases, the Child Support Services Unit shall enforce court-ordered child support
-obligations from any person who is legally liable for such support until such obligations are satisfied or
-services are no longer requested. Spousal maintenance must also be enforced if established in the same
-court action and if the child(ren) is living with the obligee of child support and spousal maintenance. When
-the current support order and/or the child support arrears are no longer being enforced, the Child Support
-Services Unit shall cease enforcement of spousal maintenance.
-6.902.14
-
-Arrears Calculation
-
-For cases where the date of the order is prior to the date of referral, application, or request from an
-initiating state/jurisdiction, the Child Support Services Unit shall calculate arrearages from the date the
-child support order is entered to determine the beginning arrears balance.
-A.
-
-The Child Support Services Unit shall provide notice of the arrears by providing the arrears
-calculation and any supporting documentation to the obligor and obligee or initiating
-state/jurisdiction. Notice is only required when an arrears balance has been determined and there
-was no existing arrears balance on the ledger.
-1.
-
-Parties are allowed fourteen (14) days to respond to the calculation.
-
-2.
-
-Any determined arrearages may not be added to the case ledger until the fifteenth (15th)
-day.
-
-3.
-
-If the parties disagree with the arrears calculation, the county shall refer the case to the
-court with jurisdiction for an arrears determination.
-a.
-
-The county shall collect current support while the court determines the arrears.
-
-b.
-
-If the court determines that arrears are owed, the county must amend the income
-withholding order to include all monthly payments due.
-
-116
-
-CODE OF COLORADO REGULATIONS
-Child Support Services
-
-6.902.15
-
-9 CCR 2504-1
-
-National Medical Support Notice
-
-The Child Support Services Unit shall enforce a medical support order when health insurance for the
-child(ren) is no longer being provided, by issuance of the National Medical Support Notice to the obligor's
-employer, when such an employer is known, or unless the court or administrative order contains
-alternative health care coverage.
-6.902.16
-
-Notice of Emancipation of a Child
-
-The enforcing Child Support Services Unit must respond to the automated child support system's
-electronic message indicating the automatic generation of the right to request review notice for each party
-or their attorney of record. The electronic message alerts the worker when a child(ren) has reached the
-age of emancipation. Within five working days of receiving the electronic message and the generation of
-the right to request review notices, the worker must read the active order and determine if the child(ren)
-included in the order is emancipated pursuant to Section 14-10-115, Colorado Revised Statutes. If the
-child(ren) is emancipated and is not the youngest child on the order, the worker shall mail a right to
-request review notice to each party or their attorney of record.
-6.902.17
-
-Credit Reporting (CRA)
-
-6.902.171
-
-Selection
-
-Obligors shall be selected for referral on all of their court orders when the following two conditions exist in
-the same accounting period on at least one court order: 1) current balance exceeds five hundred dollars
-($500) and 2) there is an amount that is at least sixty calendar days past due. The Colorado Department
-of Human Services, Division of Child Support Services, will generate a report which displays the orders
-that have been selected for credit reporting. The Child Support Services Units shall take the following
-actions within thirty calendar days of the generation date of the credit reporting agency notification list:
-A.
-
-Ensure that the monthly support obligation, monthly amount due, monthly payment due and
-current balance are correct; and,
-
-B.
-
-Ensure that the arrears in the inactive ledgers are not a duplication of those in the active ledgers;
-and,
-
-C.
-
-Ensure that the Social Security Number is correct; and,
-
-D.
-
-Clear any financial holds; and,
-
-E.
-
-Electronically send a request for suppression of the court order to the “SEU CRA” mailbox if
-selection has been made on an incorrect person.
-
-F.
-
-Document in the automated child support system all changes or other actions taken.
-
-6.902.172
-
-Notice
-
-The Colorado Department of Human Services, Division of Child Support Services, generates the prereferral notice, thirty calendar days after the case is selected for credit bureau reporting. The obligor has
-thirty calendar days from the date of the pre-referral notice to pay the past-due obligation, pay a lump
-sum toward the current balance or submit a written request for an administrative review. If a written
-request for administrative review is received, the county child support enforcement worker shall follow
-Section 6.805.
-Once sixty (60) calendar days have lapsed, the child support data will be submitted to the credit reporting
-agencies.
-
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-
-6.902.173
-
-9 CCR 2504-1
-
-Disputes
-
-If, during the monthly referral to the credit reporting agencies, the obligor contacts the county child
-support enforcement worker to dispute the information contained in their credit report, the county child
-support enforcement worker shall:
-A.
-
-Enter the dispute code in the automated child support system within one working day of contact.
-
-B.
-
-Research the case to determine if the information is correct or incorrect. If incorrect, the
-necessary changes must be made to the child support case. The changes will be reflected in the
-next monthly update to the credit reporting agencies.
-
-C.
-
-Document in the automated child support system all changes or other actions taken.
-
-The county Child Support Services Units shall respond to requests from the Division of Child Support
-Services within two working days for payoff amounts and status information and within six working days
-for information needed to complete the investigation of a consumer credit dispute. If the Child Support
-Services Unit receives a request for information from a lender, credit reporting agency or obligor, it shall
-follow Section 6.902.174.
-6.902.174
-
-Limited Point of Contact
-
-The Fair Credit Reporting Act, which governs credit reporting agencies, requires a limited point of contact
-between credit reporting agencies and users of credit information. When a Child Support Services Unit
-receives a request for credit status information from a lender, an underwriter, a mortgage company, a
-credit verifier, an obligor or from a credit reporting agency, the request shall be forwarded to the Colorado
-Department of Human Services, Division of Child Support Services, which shall respond to the request for
-information or to the request for confirmation or clarification of information submitted to credit reporting
-agencies by the Child Support Services program. All requests for credit reporting status letters shall be
-forwarded to the Colorado Department of Human Services, Division of Child Support Services.
-6.902.175
-
-Arrears or Payoff Requests
-
-If the Colorado Department of Human Services, Division of Child Support Services, requests arrears or
-payoff information as referenced in Section 6.902.174, the Child Support Services Unit shall provide the
-information within two (2) working days, as required at Section 6.902.173.
-6.902.2 SELECTION FOR DRIVER'S LICENSE SUSPENSION PROCESS
-The obligor's court orders will be selected for the drivers' license suspension process if the monthly
-support obligation is not paid in full each month.
-The Colorado Department of Human Services, Division of Child Support Services, is the single point of
-contact between Child Support Services and the Colorado Department of Revenue, Division of Motor
-Vehicles.
-6.902.21
-A.
-
-Reports
-
-A report is generated by the Colorado Department of Human Services, Division of Child Support
-Services, indicating any cases that have changed status with regards to driver's license
-suspension. County Child Support Enforcement workers shall take the following actions within
-thirty calendar days of the generation date of the EM-008, County License Suspension Action
-Report:
-
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-
-B.
-
-9 CCR 2504-1
-
-1.
-
-Suppress driver's license suspension action, if appropriate. A suppression may be
-entered at the court order level by the county child support enforcement worker or the
-technician may request a suppression at the person level, by electronically sending a
-request to the “SEU DLS” mailbox.
-
-2.
-
-Document in the automated child support system all changes or other actions taken.
-
-A report is generated by the Colorado Department of Human Services, Division of Child Support
-Services, indicating cases that have been suppressed from the driver's license suspension
-process. County child support enforcement workers shall review the case within thirty calendar
-days of the generation date of the combined suppression report and take the following actions:
-1.
-
-If appropriate, remove the court case level suppression or request a release of the
-suppression at the obligor level, by electronically sending a release request to the “SEU
-DLS” mailbox.
-
-2.
-
-Document in the automated child support system all changes or other actions taken.
-
-6.902.22
-
-Notices
-
-The following notices are generated by the state office based on the specifics of each case.
-A.
-
-The obligor has thirty calendar days from the notice of noncompliance date to meet the paying
-criteria, pay the past due obligation, negotiate a payment plan or request, in writing, an
-administrative review. If a written request for an administrative review is received, the county child
-support enforcement worker shall follow Section 6.805.
-
-B.
-
-If a new payment plan is reached with the obligor, the county child support enforcement worker
-shall enter the new payment plan on the automated child support system pursuant to Section
-6.902.3.
-
-C.
-
-If the obligor has not paid the past due obligation, negotiated a new payment plan, requested an
-administrative review or met the paying criteria after the notice of noncompliance is issued, and at
-least thirty calendar days have lapsed, the automated child support system will electronically
-send an initial notice of failure to comply to the Colorado Department of Revenue, Division of
-Motor Vehicles, to suspend the license. A paper copy of the initial notice of failure to comply is
-sent to the obligor at the same time.
-
-D.
-
-If the obligor complies and is sent a notice of compliance after the initial notice of failure to comply
-and then subsequently fails to meet the paying criteria, the automated child support system will
-electronically send a subsequent notice of failure to comply to the Colorado Department of
-Revenue, Division of Motor Vehicles, asking that the license be suspended. A paper copy of the
-subsequent notice of failure to comply is sent to the obligor at the same time.
-
-E.
-
-When a manual notice of compliance is needed to stop a suspension, the county child support
-services worker shall electronically request a manual notice of compliance from the Colorado
-Department of Human Services, Division of Child Support Services, which will determine if the
-request is warranted. If the request is approved, within one working day from the date of the
-decision, Colorado Department of Human Services, Division of Child Support Services, shall fax a
-manual notice of compliance to the Colorado Department of Revenue, Division of Motor Vehicles.
-
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-
-6.902.23
-
-9 CCR 2504-1
-
-Rescission
-
-A.
-
-Within one working day of the discovery that an erroneous suspension of an obligor's driver’s
-license has occurred due to a county or state Child Support Services office error only, the county
-child support services worker shall electronically notify the Colorado Department of Human
-Services, Division of Child Support Services, via the “SEU DLS” mailbox. The message shall
-contain the date of the erroneous suspension, the specific error that caused the erroneous
-suspension, and any other relevant facts.
-
-B.
-
-Within two working days from the receipt of the electronic message, the Colorado Department of
-Human Services, Division of Child Support Services, shall review the case to verify whether an
-error occurred and whether the error is documented in the automated child support system:
-1.
-
-If the Colorado Department of Human Services, Division of Child Support Services,
-determines that the suspension occurred erroneously, the Colorado Department of
-Revenue, Division of Motor Vehicles, shall be notified that the erroneous suspension
-must be rescinded.
-
-2.
-
-If the Colorado Department of Human Services, Division of Child Support Services,
-determines that the suspension was not erroneous, the county child support services
-worker shall be electronically notified within two working days of the determination.
-
-6.902.3 PAYMENT PLAN
-The payment plan displays the monthly payment due. The monthly payment due consists of the Monthly
-Support Obligation (MSO) and Monthly Amount Due (MAD) on the arrears.
-A.
-
-If the obligor has a court ordered MAD on the arrears balance, the county child support worker
-must enter this amount and the correct code on the court ordered screen in the automated child
-support system. The code and amount must be removed when the court ordered MAD is no
-longer valid.
-
-B.
-
-If the obligor has a MAD previously set by a county child support worker, the obligor may request
-the worker reduce the MAD. Upon a request for a reduction by the obligor, the county child
-support worker must consider information relevant to the determination of the MAD, including but
-not limited to, the arrears balance, obligor’s current income, and other child support obligations.
-The county child support worker shall document any changes to the MAD in chronology.
-When the pay plan amounts change, the county child support worker shall issue an amended
-order/notice to withhold income for support to reflect the new pay plan amount.
-
-C.
-
-If the obligor has a MAD set by the child support system that is not a previously technician set
-MAD, the county shall review the case and ensure the default MAD amount is appropriate and
-document findings in chronology.
-
-6.902.4 UNEMPLOYMENT COMPENSATION BENEFITS (UCB)
-Automated, electronic income assignments are sent to the Colorado Department of Labor and
-Employment, Division of Unemployment Benefits (UCB), to attach an obligor’s unemployment
-compensation benefits.
-The Colorado Department of Human Services, Division of Child Support Services, is the single point of
-contact between Child Support Services and the Colorado Department of Labor and Employment,
-Division of Unemployment Compensation Benefits.
-
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-
-9 CCR 2504-1
-
-When a case is unable to attach to a valid unemployment compensation claim, the county child support
-services worker shall take the following actions as appropriate within two working days of being
-electronically notified:
-A.
-
-Name mismatch – research the case to determine whether the correct name is entered and make
-any necessary corrections.
-
-B.
-
-Exclusion – research the case to determine whether the exclusion is valid and make any
-necessary corrections.
-
-C.
-
-All changes or other actions taken to resolve the exclusions shall be documented in the
-automated child support system by the county child support services worker.
-
-6.903
-
-ENFORCEMENT ACTIVITIES
-
-6.903.1
-The county department shall assure that the full range of enforcement activities are utilized, as applicable,
-for all CSS cases pursuant to CSS caseload categorization requirements as contained in these rules and
-consistent with cost-benefit caseload management.
-6.903.11
-
-Enforcement Remedies
-
-The following enforcement remedies shall be utilized as appropriate:
-A.
-
-One of two processes of assignment from any type of income through a Notice to Withhold
-Income for Support:
-1.
-
-Immediate income assignment - the process whereby the income assignment is ordered
-in the original or modified court or administrative order or where the original or modified
-support order was issued after a certain date and takes effect immediately without any
-further notice to the obligor;
-
-2.
-
-Other income assignment - the process whereby the order for income assignment is not
-part of the original order or the original order was issued before a certain date and the
-obligor is afforded due process through advance notification.
-
-B.
-
-Immediate health insurance premium withholding through a National Medical Support Notice
-(NMSN) - notice of health insurance premium withholding shall be included in the original or
-modified court or administrative order and take effect immediately without any further notice to the
-parties. The NMSN shall be issued in accordance with Section 6.240.
-
-C.
-
-Judgment for arrearages - the process of filing with the court of record a verified entry of
-judgment or motion and order for judgment for the amount of arrearages owed by the
-noncustodial parent. All Verified Entries of Judgement must be provided to all parties in a case.
-
-D.
-
-Post Judgment remedies - the execution of legal remedies that are available in state law and
-procedure that are used to satisfy judgment. Such remedies include, but are not limited to:
-1.
-
-Garnishment of earnings;
-
-2.
-
-Garnishment of assets;
-
-3.
-
-Liens upon real property;
-
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-
-E.
-
-4.
-
-Liens upon personal property;
-
-5.
-
-Forced sale of real or personal property;
-
-6.
-
-Liens upon motor vehicles.
-
-9 CCR 2504-1
-
-Intercept Program Participation - the participation in state and federal intercept programs which
-includes:
--
-
-IRS income tax refunds,
-
--
-
-State lottery winnings,
-
--
-
-Unemployment Compensation Benefits,
-
--
-
-State income tax refunds,
-
--
-
-Gambling intercepts;
-
--
-
-Federal administrative offset, and
-
--
-
-State vendor offset.
-
-F.
-
-Billings and delinquency notices - the process of billing noncustodial parents or noticing
-delinquent noncustodial parents as a reminder of support obligations due and past due.
-
-G.
-
-Contempt Actions - the process of demonstrating to the court of record at a court hearing that the
-noncustodial parent has failed to comply with a court order and therefore should be held in
-contempt of court;
-
-H.
-
-Criminal Non-Support Actions - the process of demonstrating to the court of record at a court
-hearing that the noncustodial parent should be held criminally liable for the failure to support their
-family;
-
-I.
-
-Payment Guarantee Action - request to the court to order the obligor to post security, bond, or
-other form of guarantee to secure payment of the child support order;
-
-J.
-
-Contact with the noncustodial parent - the process of obtaining a support collection by contacting
-the noncustodial parent by telephone or in writing;
-
-K.
-
-Internal Revenue Service full collection service - levy by Internal Revenue Service against
-noncustodial parent's income or assets;
-
-L.
-
-Denial, Revocation, or Limitation of Passports - certifying to the United States Secretary of Health
-and Human Services the names of noncustodial parents that have failed to comply with a court
-order to pay child support and who owe the amount of federally mandated arrears for the purpose
-of denying, revoking, or limiting their passports;
-
-M.
-
-Fraudulent Transfers - a petition to the court to void transfers of property by an noncustodial
-parent to another party;
-
-N.
-
-Refer case for prosecution under the Federal Child Support Recovery Act;
-
-O.
-
-Administrative Lien and Attachment - form used to attach noncustodial parent's Department of
-Corrections inmate accounts.
-
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-
-9 CCR 2504-1
-
-6.903.2 PRIORITY OF OBLIGATION ENFORCEMENT
-6.903.21
-The county Child Support Services Units shall utilize enforcement activities based upon the type of
-obligation and the results to be achieved. The order of effectiveness of obligation enforcement is as
-follows:
-A.
-
-Enforcement activities that will result in regular collections to satisfy the monthly support
-obligation for public assistance and non-public assistance cases.
-
-B.
-
-Enforcement activities that will result in the collection of arrearages insofar as such enforcement
-does not interrupt the regular payment of the monthly support obligation by affecting the
-noncustodial parent's wages.
-
-C.
-
-Enforcement activities that will result in the collection of court-ordered costs due to the county
-department.
-
-6.903.31
-
-Civil Contempt Actions
-
-The county Child Support Services Unit may file civil contempt actions with the local court. The CSS Unit
-must:
-A.
-
-Screen the case for information regarding the noncustodial parent’s ability to pay or otherwise
-comply with the order;
-
-B.
-
-Provide the court with such information regarding the noncustodial parent’s ability to pay or
-otherwise comply with the order, which may assist the court in making a factual determination
-regarding the noncustodial parent’s ability to pay the purge amount or comply with purge
-conditions; and
-
-C.
-
-Provide clear notice to the noncustodial parent that his or her ability to pay constitutes the critical
-question in the civil contempt action.
-
-6.904
-
-ADMINISTRATIVE LIEN AND ATTACHMENT OF INSURANCE CLAIM PAYMENTS,
-AWARDS, AND SETTLEMENTS
-
-The Colorado Department of Human Services, Division of Child Support Services, shall attach the
-insurance claim payments, awards, or settlements due to an obligor who is responsible for the payment of
-past-due child support obligations or past-due maintenance or maintenance when combined with child
-support obligations.
-6.904.1 SELECTION
-A.
-
-The State Child Support Services Unit shall attach claim payments, awards, or settlements or
-obligors who owe more than $500.00, across all court orders, in past-due child support, past-due
-maintenance or a combination thereof.
-
-B.
-
-Pursuant to Section 26-13-122.7, C.R.S., for purposes of this section 6.904, an insurance claim
-payment, award, or settlement is defined as an individual’s receipt of moneys in excess of
-$1,000.00 after making a claim for payment under an insurance policy for:
-1.
-
-Personal injury under a policy for liability;
-
-2.
-
-Wrongful death; or
-
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-
-3.
-
-9 CCR 2504-1
-
-Workers’ compensation.
-
-C.
-
-Such insurance claim payment, award, or settlement only includes the portion payable to the
-obligor or the obligor’s representative, and does not include any monies payable as attorney fees
-or litigation expenses, documented unpaid medical expenses, or payment for damage or loss to
-real or personal property.
-
-D.
-
-The State Child Support Services Unit shall recover any fees assessed from the monies collected
-under the administrative lien. If it chooses not to pursue collection under the administrative lien,
-the county Child Support Services Unit is still responsible for fees assessed by the State
-Department related to the lien, including a data match fee.
-
-6.904.2 NOTICES
-The State Child Support Services Unit shall send a notice of administrative lien and attachment to the
-insurance company, and send to the obligor a copy of the notice of administrative lien and attachment
-along with notice of the obligor’s right to request an administrative review. The notices shall be sent via
-first class mail or electronically, if mutually agreed upon. The obligor has thirty (30) calendar days from
-the date on the notice to request, in writing, an administrative review. When a written request is timely
-received, the county Child Support Services worker shall follow section 6.805.
-6.904.3 POINT OF CONTACT
-The Colorado Department of Human Services, Division of Child Support Services, is the single point of
-contact between Child Support Services and the Child Support Lien Network, or similar program, and the
-insurance companies.
-6.905
-
-PROFESSIONAL OCCUPATIONAL LICENSE SUSPENSION PROCESS – DEPARTMENT OF
-REGULATORY AGENCIES
-
-Referral will be made to the appropriate licensing board to suspend the professional or occupational
-license of obligors who:
-A.
-
-Meet the selection criteria;
-
-B.
-
-Have been sent the required notices; and,
-
-C.
-
-Have failed to comply with a support order.
-
-6.905.1 SELECTION
-Obligors will be selected for the professional occupational license process if they owe more than six
-months' gross dollar amount of child support and are paying less than fifty percent (50%) of their current,
-monthly child support obligation.
-6.905.12
-
-REPORTS
-
-The reports that are generated by the Colorado Department of Human Services, Division of Child Support
-Services, and used by county CSS Units to process professional occupational license suspension cases
-must be worked within thirty (30) days of receipt and all changes or other actions taken must be
-documented in the automated child support enforcement system.
-
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-
-6.905.13
-
-9 CCR 2504-1
-
-NOTICES
-
-A.
-
-The obligor has thirty calendar days from the notice of noncompliance date to pay the past-due
-obligation, to negotiate a new payment plan or to request, in writing, an Administrative Review.
-When a written request is received, the county child support services worker shall follow Section
-6.805.
-
-B.
-
-When a new payment plan is negotiated with the obligor, the county child support services worker
-shall enter the new payment plan into the automated child support system pursuant to Section
-6.902.3.
-
-C.
-
-If the obligor has not paid the past-due obligation, negotiated a new payment plan, requested an
-Administrative Review or met the paying criteria after the notice of noncompliance, an initial
-notice of failure to comply shall be electronically sent to the licensing board asking the licensing
-board to suspend the license. A paper copy shall be sent to the obligor.
-
-D.
-
-If the obligor is issued a notice of compliance after the initial notice of failure to comply, but has
-again become delinquent, a subsequent notice of failure to comply shall be electronically sent to
-the licensing board asking the licensing board to suspend the license. A paper copy shall be sent
-to the obligor.
-
-E.
-
-When a notice of compliance is needed in less than twenty-four hours to stop the license
-suspension, the county child support services worker shall electronically request a manual notice
-of compliance from the Colorado Department of Human Services, Division of Child Support
-Services, which will fax a notice of compliance to the licensing agency.
-
-F.
-
-All changes or other actions taken shall be documented in the automated child support system by
-the county child support services worker.
-
-6.905.14
-
-POINT OF CONTACT
-
-The Colorado Department of Human Services, Division of Child Support Services, is the single point of
-contact between child support services and the Department of Regulatory Agencies representing the
-licensing boards. County child support services workers shall contact the Division of Child Support
-Services for assistance with questions or concerns through the automated child support system. The
-Division of Child Support Services shall resolve the questions or concerns with the Department of
-Regulatory Agencies and communicate the resolution to the county child support services worker through
-the automated child support system.
-6.905.2 PROFESSIONAL OCCUPATIONAL LICENSE SUSPENSION PROCESS – DEPARTMENT OF
-REVENUE
-Referral will be made to the appropriate licensing board to suspend the professional or occupational
-license of obligors who:
-A.
-
-Meet the selection criteria;
-
-B.
-
-Have been sent the required notices; and,
-
-C.
-
-Have failed to comply with a support order.
-
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-
-6.905.21
-
-9 CCR 2504-1
-
-SELECTION
-
-Obligors will be selected for the professional occupational license process if they owe more than six
-months' gross dollar amount of child support and are paying less than fifty percent (50%) of their current
-monthly child support obligation and have paid less than 90% in the previous and prior accounting
-periods.
-6.905.22
-
-NOTICE
-
-A.
-
-The obligor must pay the past due obligation in full, pay a one-time lump sum amount and
-negotiate a new payment plan if arrears are due or request, in writing, an administrative review.
-When a written request is received, the county child support worker shall follow section 6.803.
-
-B.
-
-Upon contact from the obligor regarding the DOR license, the county child support worker shall
-collect a lump sum payment from the obligor and negotiate a payment plan for any arrears due.
-
-C.
-
-If a new payment plan is negotiated with the obligor, the county child support worker shall enter
-the new payment plan on the automated child support system pursuant to section 6.902.3.
-
-D.
-
-All changes or other actions taken shall be documented in the automated child support system by
-the county child support worker.
-
-6.905.23
-
-POINT OF CONTACT
-
-The Colorado Department of Human Services, Division of Child Support Services, is the single point of
-contact between child support services and the Department of Revenue Enforcement representing the
-licensing boards. County child support services workers shall contact the Division of Child Support
-Services for assistance with questions or concerns through the automated child support system. The
-Division of Child Support Services shall resolve the questions or concerns with the Department of
-Revenue Enforcement and communicate the resolution to the county child support services worker
-through the automated child support system.
-6.906
-
-SELECTION FOR FINANCIAL INSTITUTION DATA MATCH (FIDM)
-
-The Colorado Department of Human Services, Division of Child Support Services, is the single point of
-contact between Child Support Services and the financial institutions.
-Obligors shall be selected for Financial Institution Data Match on all of their court orders after they have
-been advised of their due process rights by the issuance of the annual pre-offset notice and the following
-selection criteria:
-A.
-
-Arrears balance is $1,000.00 or greater; and,
-
-B.
-
-Full monthly support obligation is not paid each month.
-
-The Colorado Department of Human Services, Division of Child Support Services, shall exclude
-partnership, custodial, and commercial accounts or accounts otherwise precluded by law. Pursuant to
-Section 26-13-128, C.R.S., and the “Uniform Transfers to Minors Act” and trust accounts of monies held
-in trust by a third party shall not be attached, encumbered or surrendered.
-
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-
-9 CCR 2504-1
-
-6.906.1 REVIEW OF SELECTED CASES
-Within seven (7) calendar days of the date the electronic notification is generated from the automated
-child support system, the county child support services worker shall review the accepted match to ensure
-that the ledger is accurate and to ensure that issuing a lien and levy against the obligor's financial account
-is appropriate.
-All changes or other actions taken shall be documented in the automated child support system by the
-county child support services worker.
-6.906.2 SUPPRESSION
-6.906.21
-
-Temporary Suppression
-
-The county Child Support Services worker may, within the allotted seven (7) calendar days, suppress the
-accepted court order match on a temporary basis by updating the suppression code on the automated
-child support system.
-6.906.22
-
-Indefinite Suppression
-
-The request for an indefinite suppression shall be submitted to the “SEU FIDM” mailbox electronically by
-the administrator of the Child Support Services Unit.
-6.906.3 CREATION OF THE LIEN AND LEVY
-If the court order match has not been suppressed, the automated child support system will create a lien
-and levy document on the eighth calendar day after the accepted match. The Colorado Department of
-Human Services, Division of Child Support Services, will submit the lien and levy to the financial
-institution.
-Seven calendar days after the lien and levy document has been sent to the financial institution, the
-Colorado Department of Human Services, Division of Child Support Services, will notify the obligor and
-any non-debtor account holders of the lien and levy of the account along with the exception/exemption
-policy and/or the appeal policy.
-6.906.4 EXCEPTION OR EXEMPTION CLAIM
-A.
-
-Within twenty (20) calendar days from the date of the lien, the obligor may request an exception
-claim per State policy from the Colorado Department of Human Services, Division of Child
-Support Services, if there is terminal illness of the obligor or the obligor’s biological or adopted
-child.
-
-B.
-
-Within 20 calendar days from the date of the lien, the obligor may request an exemption claim per
-State statute from the Colorado Department of Human Services, Division of Child Support
-Services, if there is:
-1.
-
-Misidentification; or,
-
-2.
-
-A custodial account created pursuant to the “Colorado Uniform Transfers to Minors Act”,
-Article 50 of Title 11, C.R.S., or a trust account of moneys held in trust for a third party;
-or,
-
-3.
-
-An account held with a corporate tax identification number; or,
-
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-Child Support Services
-
-9 CCR 2504-1
-
-4.
-
-An account used to receive deposits of Supplemental Security Income benefits, Social
-Security survivors benefits, or any combination of these funds, Veterans Administration
-disability benefits, child support payments, public assistance benefits, or federal or state
-income tax refunds attributed to an earned income or child tax credit as a refundable tax
-credit or as a nonrefundable reduction in tax; or,
-
-5.
-
-An account used to receive “earnings” as defined in Section 13-54-104, C.R.S. The
-maximum percentage amount of the account balance that can be seized will be
-determined based upon the documentation provided by the obligor. Documentation
-requirements are specified on the notice that the obligor receives.
-
-The obligor is responsible for providing the Colorado Department of Human Services, Division of Child
-Support Services, documentation in support of the above situations.
-The Colorado Department of Human Services, Division of Child Support Services, shall review the claim
-and document its decision whether to approve or deny the claim. The claim shall be reviewed within three
-business days of receipt based upon the documentation outlined in the lien and levy exception/exemption
-policy that is included with the Notice of Lien and Levy. If the claim is approved, the Colorado Department
-of Human Services, Division of Child Support Services, will issue a release of lien and levy to the financial
-institution. If the claim is denied, the lien and levy will remain in effect. The Colorado Department of
-Human Services, Division of Child Support Services, shall notify the obligor and the county child support
-services worker of the claim decision.
-6.906.5 APPEAL PROCESS FOR JOINT ACCOUNTS
-The lien placed on any and all types of joint account(s) shall require the financial institution to freeze one
-hundred percent (100%) of the assets on deposit as of the date of the lien. “Joint accounts” means
-multiple party accounts as defined in Section 15-15-201(5), C.R.S. The Colorado Department of Human
-Services, Division of Child Support Services, shall take the following actions:
-A.
-
-The non-debtor account holders are noticed that they have twenty (20) calendar days from the
-date of the lien to request an appeal of the frozen funds on the basis that there is proof of
-contribution of the funds on deposit up to one hundred percent (100%) as of the date of the lien
-as governed by Section 15-15-211, C.R.S.
-
-B.
-
-The request for appeal and the required documentation shall be reviewed by the Division of Child
-Support Services within three working days of receipt.
-1.
-
-If the appeal is approved, the Colorado Department of Human Services, Division of Child
-Support Services, will issue a release of lien and levy to the financial institution releasing
-the contribution of the non-debtor account holder.
-
-2.
-
-If the appeal is denied, the lien and levy will remain in effect as to the amount frozen at
-the time of the lien.
-
-3.
-
-The Colorado Department of Human Services, Division of Child Support Services, shall
-notify the non-debtor account holder and the county child support services worker of the
-appeal decision.
-
-6.906.6 ALLOCATION OF FUNDS
-The levied funds are sent to the Family Support Registry and are allocated according to the obligor's court
-orders that were included on the FIDM lien and levy.
-
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-
-6.907
-
-9 CCR 2504-1
-
-VENDOR OFFSET
-
-This enforcement remedy allows the State Controller’s Office to intercept monies from
-vendors/contractors who perform work for the State of Colorado and owe child support arrearages.
-The Colorado Department of Human Services, Division of Child Support Services, is the single point of
-contact between Child Support Services and the State Controller's Office.
-6.907.1 SELECTION AND REFERRAL TO VENDOR OFFSET
-Obligors shall be selected for referral on their court order when the monthly support obligation is not paid
-in full.
-The selection criteria is applied to each court order and subsequent court orders for the obligor. When a
-match is made between the obligor record and the vendor offset table, the county child support services
-worker will be notified electronically through the automated child support system. The vendor offset table
-is maintained by the controller’s office and lists all vendors used by the State of Colorado.
-6.907.2 REVIEW OF SELECTED CASES
-When the county child support services worker is notified that the case has been selected for vendor
-offset, the worker shall review the case to ensure that the ledger balances are correct. If the county child
-support services worker determines that vendor offset is not appropriate for the case, an electronic
-message must be sent through the automated child support system to the “SEU VO” mailbox to request
-suppression. The case will remain suppressed until the county child support services worker electronically
-requests the Colorado Department of Human Services, Division of Child Support Services, lift the
-suppression.
-6.907.3 NOTICE
-The Colorado Department of Human Services, Division of Child Support Services, generates a Notice of
-State Vendor Payment Offset when there is a match with the obligor with the vendor table and the match
-is not suppressed by the county Child Support Services Unit. The obligor has thirty calendar days from
-the generation date of the Notice of State Vendor Payment Offset to take one of the following actions to
-stop the intercept of the vendor payment:
-A.
-
-Contact the county child support services worker and enter into a payment plan and pay the
-monthly payment due (MPD). If a payment plan is reached with the obligor, the county child
-support services worker shall update the payment plan on the automated child support system
-pursuant to Section 6.902.3 concerning maintenance of the payment plan; or,
-
-B.
-
-Pay the total amount due on the court order; or,
-
-C.
-
-Submit a written request for an administrative review. If an administrative review is received, the
-county Child Support Services worker shall follow Section 6.805.
-
-All changes or other actions taken shall be documented in the automated child support system by the
-county child support Services worker.
-6.908
-
-RECREATIONAL LICENSE SUSPENSION
-
-Referral will be made to the Colorado Department of Natural Resources, Parks and Wildlife, to suspend
-the recreational license of obligors who:
-A.
-
-Meet the selection criteria;
-
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-Child Support Services
-
-B.
-
-Have been sent the required notices; and,
-
-C.
-
-Have failed to comply with a support order.
-
-9 CCR 2504-1
-
-6.908.1 SELECTION
-Obligors will be selected for the recreational license suspension process if they owe more than six
-months’ gross dollar amount of child support and are paying less than fifty percent of their current monthly
-child support obligation.
-6.908.2 NOTICES
-A.
-
-The obligor has thirty calendar days from the notice of the noncompliance date to pay the pastdue obligation, to enter into a payment plan and begin paying the required amount within the 30
-days or to request, in writing, an administrative review. If a written request is received, the county
-child support services worker shall follow Section 6.805.
-
-B.
-
-If the obligor enters into a payment plan, the county child support services worker must enter the
-payment plan on the automated child support system pursuant to Section 6.902.3.
-
-C.
-
-All changes or other actions taken shall be documented in the automated child support system by
-the county child support services worker.
-
-D.
-
-The automated child support system will electronically send a failure notice to the Department of
-Natural Resources, Parks and Wildlife to suspend the license privilege and shall send a paper
-copy to the obligor in the following circumstances:
-1.
-
-Obligor has not paid the past-due obligation;
-
-2.
-
-Obligor entered into a new payment plan but failed to make a payment within 30 days of
-the pay plan; or,
-
-3.
-
-Obligor failed to request an administrative review.
-
-6.908.3 REPORT
-The reports that are generated by the Colorado Department of Human Services, Division of Child Support
-Services, and used by county CSS units to process recreational license suspension cases must be
-worked within thirty days of receipt and all changes or other action taken must be documented in the
-automated child support enforcement system.
-6.908.4 POINT OF CONTACT
-The Colorado Department of Human Services, Division of Child Support Services, is the only point of
-contact with the Department of Natural Resources, Parks and Wildlife. County child support Services
-workers shall electronically contact the Colorado Department of Human Services, Division of Child
-Support Services, with any questions or concerns through the automated child support system. The
-Colorado Department of Human Services, Division of Child Support Services, shall resolve child support
-enforcement issues with the Department of Natural Resources, Parks and Wildlife and electronically
-communicate the resolution to the county child support Services worker through the automated child
-support system.
-
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-
-9 CCR 2504-1
-
-6.908.5 MISTAKEN IDENTITY
-In cases of mistaken identity, the county child support Services worker shall notify the Colorado
-Department of Human Services, Division of Child Support Services, through the automated child support
-system of the error. The county child support Services worker shall not enter the name of the innocent
-party into the alias screen in the automated child support system. The Colorado Department of Human
-Services, Division of Child Support Services, shall notify the Colorado Department of Natural Resources,
-Parks and Wildlife, to resolve the error.
-6.909
-
-INCARCERATED OBLIGORS
-
-6.909.1 Confirmation of Sentencing and/or Incarceration of Obligor
-Upon receipt of information and confirmation that an Obligor has been sentenced to one hundred-eighty
-(180) days or greater, the delegate County Child Support Services Unit must initiate a review and follow
-guidance in 6.909.2 and 6.909.3 related to suppression of the driver’s license suspension and
-professional occupational license suspension enforcement remedies.
-6.909.2 Suppression of Driver’s License Suspension Enforcement Remedy for Incarcerated
-Obligors
-The delegate County Child Support Services Unit shall review the Obligor's driver's license status. If the
-Obligor's driver's license is in compliance with child support services, the delegate County Child Support
-Services Unit shall suppress the driver's license suspension remedy. All actions must be documented in
-the Automated Child Support Enforcement System.
-6.909.3 Suppression of Professional Occupational License Suspension Enforcement Remedy for
-Incarcerated Obligors
-The delegate County Child Support Services Unit shall review the Obligor's professional/occupational
-license status. If the Obligor's professional/occupational license is in compliance with child support
-services, the delegate County Child Support Services Unit shall suppress the professional/occupational
-license suspension remedy. All actions must be documented in the Automated Child Support
-Enforcement System.
-6.909.4 Administrative Lien and Attachment of Inmate Bank Accounts
-The Colorado Department of Human Services, Division of Child Support Services, shall attach the inmate
-bank account held by the Colorado Department of Corrections for an Obligor who is responsible for the
-payment of current monthly child support, current maintenance, current maintenance when combined with
-child support, past due child support, past due maintenance, when combined with child support, child
-support debt, retroactive child support, or medical support.
-6.909.5 Notices
-A.
-
-The delegate County Child Support Services Unit shall generate a right to request notice through
-the automated system for Obligors who have been sentenced to one hundred-eighty (180) days
-or greater in a Federal, State, or County Corrections Facility. The confirmation of the sentencing
-may be through a manual or automated match.
-
-B.
-
-This notice sets forth the Obligor’s right to request an administrative review. The Obligor has thirty
-(30) calendar days from the date on the notice to request, in writing, an administrative review.
-When a written request is timely received, the delegate County Child Support Services worker
-shall follow section 6.805
-
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-
-9 CCR 2504-1
-
-6.909.6 Reports
-A monthly report is generated that identifies all Obligors in the Colorado Department of Corrections. The
-County Child Support Services Unit shall confirm the length of sentence and follow 6.261(k) within 14
-days if the obligor is sentenced for 180 days or greater. All actions must be documented in the Automated
-Child Support Enforcement System.
-6.909.7 Point of Contact
-The Colorado Department of Human Services, Division of Child Support Services, is the single point of
-contact between Child Support Services and the Colorado Department of Corrections Inmate Banking.
-County child support services workers shall contact the State Division of Child Support Services for
-assistance with questions or concerns with administrative lien and attachment of inmate bank accounts
-through the automated child support system.
-_________________________________________________________________________
-Editor’s Notes
-History
-Rules B&P, 6.002, 6.210, 6.700, 6.805, 6.901, 6.902, 6.905, 6.906, 6.907, 6.908 eff. 05/01/2007.
-Rules 6.002, 6.101.2, 6.201.2, 6.261.3, 6.805, 6.805.2, 6.903.11 emer. rule eff. 10/01/2007.
-Rules 6.002, 6.101.2, 6.201.2, 6.261.3, 6.805, 6.805.2, 6.903.11 eff. 11/30/2007.
-Rules 6.905, 6.906 eff. 02/01/2008.
-Rules 6.001.1 - 6.002, 6.201.2, 6.201.3, 6.201.6, 6.261.1, 6.700.3, 6.709.4, 6.710.1, 6.803.1 - 6.803.2,
-6.903.11 eff. 07/01/2008.
-Rules B&P, 6.210.12, 6.210.13, 6.803.45 - 6.804.2, 6.804.5 - 6.804.81 emer. rule eff. 07/11/2008.
-Rules B&P, 6.210.12, 6.210.13, 6.803.45 - 6.804.2, 6.804.5 - 6.804.81 eff. 10/01/2008.
-Rules B&P, 6.002, 6.201.3 - 6.201.6, 6.240.12 - 6.240.18, 6.250.27, 6.260.54, 6.400.17 - 6.400.19, 6.500
-- 6.501, 6.602.2, 6.603.2, 6.700.22 - 6.700.24, 6.700.31, 6.700.35, 6.700.38, 6.702.2, 6.709.1,
-6.713.1 - 6.714.2, 6.801.15 - 6.801.18, 6.805, 6.805.2, 6.805.31, 6.805.5, 6.902.1 - 6.902.12,
-6.902.14 eff. 10/01/2009.
-Rules B&P, 6.102.21, 6.110, 6.201.2, 6.601.32, 6.702.1, 6.902.17, 6.905.2, 6.906.1, 6.906.22, 6.906.4,
-6.906.6, 6.907.1, 6.907.2, 6.908.3, 6.908.4 eff. 03/02/2010.
-Rules SB&P, 6.207, 6.250.18, 6.250.25 – 6.250.26, 6.250.3, 6.260.51, 6.600.11, 6.600.13, 6.601.2 –
-6.601.31, 6.601.32. – 6.601.32.B, 6.602.1, 6.603.1, 6.603.3, 6.714 emer. rule eff. 08/10/2011.
-Rules SB&P, 6.207, 6.250.18, 6.250.25 – 6.250.26, 6.250.3, 6.260.51, 6.600.11, 6.600.13, 6.601.2 –
-6.601.31, 6.601.32 – 6.601.32.B, 6.602.1, 6.603.1, 6.603.3, 6.714 eff. 10/01/2011.
-Rules SB&P, 6.101, 6.102.3, 6.130 - 6.140, 6.205.21 - 6.205.22, 6.240, 6.250.18 - 6.250.19, 6.250.2,
-6.270, 6.300.2, 6.503 - 6.504, 6.700.33 - 6.700.37, 6.715, 6.801, 6.805.5 - 6.805.7, 6.805.82 eff.
-03/01/2012.
-Rules SB&P, 6.001.1, 6.002, 6.201.2, 6.201.3, 6.205 - 6.209, 6.230.1, 6.230.11, 6.230.13, 6.230.2 6.230.5, 6.260.22 - 6.260.23, 6.260.6 - 6.260.7, 6.400, 6.903.11 eff. 04/01/2012.
-Rules SB&P, 6.260.22 – 6.260.23, 6.800 eff. 09/15/2012.
-Rules SB&P, 6.102.21, 6.210.13, 6.210.13.J, 6.240 – 6.240.2, 6.261 – 6.261.1, 6.261.3 – 6.6261.8, 6.600
-– 6.714, 6.804.4, 6.902.1 – 6.902.175, 6.902.23, 6.902.3, 6.902.3.C, 6.902.4 – 6.903.11, 6.906,
-6.906.21 eff. 04/01/2013.
-Rules SB&P, 6.250, 6.260.51, 6.806 emer. rules eff. 04/05/2013.
-Rules SB&P, 6.250, 6.260.51, 6.806 eff. 07/01/2013.
-Rules SB&P, 6.002, 6.205, 6.210.12 – 6.210.6, 6.220, 6.260.23 – 6.260.23.A, 6.260.31, 6.400 –
-6.400.1.A, 6.500 – 6.503 eff. 11/01/2013.
-
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-
-9 CCR 2504-1
-
-Rules 6.240.2, 6.805, 6.904 eff. 01/01/2017.
-Rules 6.002, 6.803.1, 6.804.1 eff. 04/01/2017.
-Entire rule eff. 12/01/2017.
-Entire rule eff. 07/01/2019.
-Rules 6.809 A-B emer. rules eff. 06/12/2020.
-Rules 6.809 A-B eff. 09/30/2020.
-Rules 6.002, 6.260.51 A.2, 6.260.51 N, 6.260.55, 6.261.3 K, 6.261.5, 6.262 B, 6.502.1, 6.502.2, 6.701 EF, 6.712, 6.903.11 C, 6.906.4 B.4, 6.909 eff. 12/01/2020.
-Rules 6.002, 6.201.2 A.1-3, 6.201.2 B.7-9, 6.201.3 C, 6.205 C, 6.260.52 eff. 01/01/2022.
-Rules 6.103, 6.706 A, 6.900 eff. 03/01/2022.
-Entire rule eff. 07/01/2023.
-Rules 6.809 A-B, 6.809.2, 6.809.3, 6.809.5 eff. 10/01/2023.
-
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-DEPARTMENT OF HUMAN SERVICES
-Income Maintenance (Volume 3)
-COLORADO WORKS PROGRAM
-9 CCR 2503-6
-[Editor’s Notes follow the text of the rules at the end of this CCR Document.]
-
-_________________________________________________________________________
-3.600
-
-COLORADO WORKS PROGRAM [Rev. eff. 3/1/2022]
-
-3.600.1 Performance Contract
-County departments shall enter into a performance contract with the State Department, which may be
-called a memorandum of understanding (MOU), regarding the delivery of Colorado Works programming.
-This contract will outline performance measures that the county department is required to meet.
-3.600.2 County Policies
-County departments shall submit the following county policies to the State Department for review and
-approval. The State Department is responsible for reviewing and approving county policies, assuring that
-all counties are complying with all federal and State statutes and regulations. After approval by the State
-Department, the county department shall have their State approved policies signed by their county board
-of commissioners or the board’s designee and provide a signed copy back to the State Department. The
-State Department will communicate, in advance, when a change to the list of required policies is made.
-Counties that do not provide signed county policies within the timeframe required by the State
-Department will operate under these broad State rules and default to the State defined policies.
-The following policies are required:
-A.
-
-Diversion
-
-B.
-
-County Approved Settings
-
-C.
-
-Workforce Requirements and Employment Outcomes
-
-D.
-
-Disaster Assistance
-
-E.
-
-Domestic Violence
-
-F.
-
-Assistance and Supportive Payments
-
-G.
-
-Substance Abuse (only required if practiced)
-
-County departments should regularly review their Colorado Works policies to ensure alignment with
-current county practice.
-
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-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-9 CCR 2503-6
-
-3.600.3 Contracting
-3.600.31
-
-Private Contracting
-
-The Board of County Commissioners may contract all or part of the Colorado Works program operation to
-private or public providers. They may also choose to contract out the provision of goods or services to
-Colorado Works (CW) eligible persons/families.
-A.
-
-B.
-
-Prior to initiating a contract with a provider, the county shall:
-1.
-
-Verify that the provider has not been debarred or suspended or otherwise found to be
-ineligible for participation in federal assistance programs by consulting the ineligible
-parties list at http://www.epls.gov.
-
-2.
-
-Determine if the provider is acting as a sub-recipient and is therefore subject to OMB
-Circular A-133 (2003) and expanded auditing and oversight requirements. No later
-editions or amendments are incorporated. This circular is available at no cost from the
-U.S. Government Publishing Office at 732 North Capitol St., N.W., Washington, D.C.
-20002, or at
-https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/circulars/a133/a133.pdf.
-These regulations are also available for public inspection and copying at the Colorado
-Department of Human Services, Office of Economic Security, 1575 Sherman St., Denver,
-CO 80203, during regular business hours.
-
-All contracts shall:
-1.
-
-Specify the Temporary Assistance for Needy Families (TANF) purpose(s) that is served
-and/or supported, as outlined in the Code of Federal Regulations at 45 CFR 260.20
-(2021). No later editions or amendments are incorporated. These regulations are
-available at no cost from the U.S. Department of Health and Human Services at 200
-Independence Ave., S.W., Washington D.C. 20201, or at https://www.ecfr.gov/. These
-regulations are also available for public inspection and copying at the Colorado
-Department of Human Services, Office of Economic Security, 1575 Sherman St., Denver,
-CO 80203, during regular business hours.
-
-2.
-
-Approximate, with reasonable certainty, the number of CW eligible persons to be served
-and include the method used to calculate this number. This number and the calculation
-used must be documented and made available upon request by the State Department for
-audit purposes.
-
-3.
-
-Outline the provider's eligibility verification process to ensure that goods and services are
-provided to CW eligible persons/families.
-
-4.
-
-Explain how the costs for the goods/services are calculated.
-
-5.
-
-Prohibit supplantation.
-
-6.
-
-Include a regular accounting of activities and costs at least twice a year.
-
-7.
-
-Clarify that all expenditures for goods, services, or start-up funds be documented with a
-purchasing document.
-
-8.
-
-Ensure that the agency has the ability to clearly identify CW eligible individuals from
-others in situations where an agency receives funding from multiple sources.
-
-2
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-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-C.
-
-9 CCR 2503-6
-
-9.
-
-Outline specific and measurable performance goals for the contract.
-
-10.
-
-Require, if the county chooses to, that a client apply for CW, sign a written agreement, or
-complete an Individualized Plan.
-
-11.
-
-Ensure that a HIPPA agreement is signed and on-file in instances where the provider will
-obtain protected health information. All other contracts must ensure reasonable
-expectations for the provider to keep client information confidential and secure.
-
-12.
-
-Complete an audit in instances where the county is contracting $750,000 or more in CW
-funds during the fiscal year, in compliance with OMB Circular A-133, as incorporated by
-reference in section 3.600.31.a.2.
-
-Some contracts may be classified as a community resource investment contract pursuant to
-Section 26-2-707.5(1), C.R.S. These contracts do not require clients to complete an application, a
-written agreement, or Individualized Plan, though the county may continue to require such
-documentation per their own individual contracting procedures.
-Community resource investment contracts shall meet all contract requirements as outlined above
-in section 3.600.31 and shall:
-1.
-
-Include the purpose of the contract and investment in the community.
-
-2.
-
-Specify the income eligibility standards that are used.
-
-3.
-
-Outline the county’s dispute resolution process if it differs from that outlined in section
-3.609.6.
-
-3.600.32
-
-County Contract with Religious Organizations
-
-Counties may contract with religious organizations for the payment of cash assistance or provision of
-services. If the individual objects to being served by the religious organization chosen as a contractor, the
-county must provide alternative means for the individual or family to receive benefits, assistance, or
-services. Contract agencies providing services to individuals must have the ability to provide services that
-are equitable and make all services available offered to every client.
-3.600.4 State Flexibility for Pilot Programs
-Nothing in these rules prohibits the State Department from piloting programs to serve the TANF
-population within the bounds of federal regulations for the program. Pilot programs may be offered at the
-State level or in partnership with one or more county departments. Pilot programs may be designed to
-serve a subset of clients based on broad-based eligibility factors and may have different eligibility criteria
-than listed in this rule volume.
-3.600.5 Program Review and Oversight
-County department supervisory personnel and/or quality assurance staff shall review eligibility
-determinations (certifications, denials, and/or pending cases) monthly. Supervisory personnel and/or
-quality assurance staff shall:
-A.
-
-Review a minimum number of cases, including specific programs and/or actions, per month as
-outlined annually by the State Department based on the county department’s Colorado Works
-caseload size. The State Department will notify the county of the minimum number of cases to be
-reviewed.
-
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-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-9 CCR 2503-6
-
-The county may elect to:
-1.
-
-Create a plan to pull a random sample that includes at least the minimum number of
-Colorado Works cases set forth by the State Department and submit that plan to the
-State for approval.
-
-2.
-
-Use the State prescribed random sample.
-
-B.
-
-Determine the correctness of eligibility determinations;
-
-C.
-
-Ensure correction of any errors within ten (10) business days or the time frame specified within
-the approved review plan;
-
-D.
-
-Maintain a record of the cases reviewed for audit purposes, including audit results and any
-required actions taken by the county. County departments must keep case file reviews for a
-minimum of three (3) years; and;
-
-E.
-
-Report these results and actions to the State on a monthly basis via the state prescribed process.
-
-3.601
-
-Program Definitions
-
-“Adequate” (related to notice) means a written notice sent to the client which details any determination of
-eligibility, as well as a change or discontinuation of grant payments and the reason for that change.
-“Administrative Disqualification Hearing” (ADH) means a disqualification hearing against an individual
-accused of wrongfully obtaining or attempting to obtain assistance.
-“Administrative error claim” means a client was overpaid and a claim validated based on an error on the
-part of the county department of human services.
-“Administrative Law Judge” (ALJ) means an Administrative Law Judge appointed pursuant to Section 2430-1003, C.R.S.
-“Adverse action” means a county action to reduce grant payments or to deny an application. A reduction
-may be the result of a sanction, a demonstrable evidence closure, or ineligibility based on income or
-household changes.
-“Affidavit” means a State prescribed form wherein a client attests, subject to the penalties of perjury, that
-he or she is lawfully present in the United States. An affidavit need not be notarized.
-“Applicant” means any individual or family who individually or through an authorized representative or
-someone acting responsibly for him or her has applied for benefits under the programs of public
-assistance administered or supervised by the State Department pursuant to Title 26, Article 2, C.R.S., as
-defined at Section 26-2-103(1), C.R.S.
-“Application” means an initial or redetermination request on State approved forms (paper or electronic) for
-a grant payment and/or services.
-“Approval” means assistance is authorized by the county department.
-“Assessed need” means any identified need of a client or family receiving Colorado Works grant
-payments beyond ordinary, routine living expenses that is designed to deal with a specific crisis situation
-or episode of need, is not intended to meet recurrent or ongoing needs, and will not extend beyond four
-(4) months without a new assessment.
-
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-9 CCR 2503-6
-
-“Assistance unit” means individuals who live together and who are receiving grant payments as one
-household.
-“Authorized representative” means someone acting reasonably for the client with the authority to make
-decisions on behalf of the client and who has taken responsibility for the case, including but not limited to,
-signing documents and speaking with county departments. The authorization must be in writing and
-signed by the client.
-“Basic cash assistance” means a recurrent cash payment intending to meet ongoing needs.
-“Budgetary unit” means those people whose income is considered in the determination of eligibility and
-grant payment calculation because they are considered financially responsible for members of an
-assistance unit. Members of the budgetary unit can be in the assistance unit or outside of the assistance
-unit.
-“Caretaker” means a person who exercises the responsibility for a child.
-“Certification period” means the time period for which a CW client is approved to receive grant payments
-before a redetermination is required.
-“Claim” means an overpayment of a grant payment, diversion, or supportive payment that needs to be
-researched and validated by the county department.
-“Clear and convincing” evidence is stronger than “a preponderance of evidence” and is unmistakable and
-free from serious or substantial doubt.
-“Client” means a current or past applicant or a current or past recipient of a Colorado Works grant
-payment.
-“Client error claim” means a client was overpaid and a claim was validated based on unintentional or
-willful withholding of information on the part of the client.
-“Collateral contact” means a person outside the client’s household (excluding sponsor(s) and landlord
-who also live in the home) who has first-hand knowledge of the client’s circumstance and provides a
-verbal or written confirmation thereof. This confirmation may be made either in person, in writing,
-electronically submitted, or by telephone. Acceptable collateral contacts include but are not limited to:
-employers, landlords, social/migrant service agencies, and medical providers who can be expected to
-provide accurate third-party verification. The name/title of the collateral contact as well as the information
-obtained must be documented in the statewide automated system.
-“Colorado Works” is the Temporary Assistance for Needy Families (TANF) program in Colorado.
-“Countable income” means income considered available to the individual after the application of valid
-exemptions, disregards, and deductions.
-“County department” means the county department of human/social services.
-“County policy(ies)” means the written county policies governing the Colorado Works program as
-approved by the State Department and county board of commissioners or their designee.
-“County worker” means an employee or designated representative of the county department.
-“County approved setting” means a living arrangement evaluated and deemed appropriate by the county
-department according to county policy.
-
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-
-“Demonstrable evidence” means evidence that a Colorado Works client has refused to comply with the
-workforce program.
-“Denial” means that a Colorado Works application was denied because the client was not eligible for a
-grant payment upon application.
-“Dependent child(ren)” means a person who resides with a parent or non-parent caretaker and who is:
-A.
-
-Under eighteen (18) years of age; or,
-
-B.
-
-Between the ages of eighteen (18) and nineteen (19) and a full-time student in a secondary
-school or in the equivalent level of vocational or technical training (including seeking to obtain
-high school equivalency) and expected to complete the program before age nineteen (19).
-
-“Discontinuation” means that a client who is currently receiving a grant payment is no longer eligible and
-his or her grant payment will be stopped.
-“Disqualified person” means a person who would be a member of the assistance unit but is ineligible due
-to program prohibitions.
-“Diversion” means a short-term cash payment (not to extend beyond four (4) months) intended to meet an
-episode of need.
-“Domestic violence” (also known as family violence) means a pattern of coercive control one individual
-inflicts upon another in the context of familial, household, or intimate partner (current or former)
-relationships including marriage and dating. Violence may be inflicted through a variety of means
-including, but not limited to:
-A.
-
-Physical acts threatening or resulting in physical injury to the individual, including hitting,
-punching, slapping or biting;
-
-B.
-
-Intimidation resulting in fear of imminent bodily harm through the use of gestures, displays of
-weapons, or destruction of property, including pets;
-
-C.
-
-Threats of or attempts at physical or sexual abuse or other means of coercion and control,
-including harm to or threats to harm children, other family members, or pets;
-
-D.
-
-Sexual abuse or threats to inflict nonconsensual sexual acts, including sexual activity with a
-minor;
-
-E.
-
-Mental, emotional, or psychological abuse including degradation, constant put-downs, or
-humiliation that results in a reduced ability to engage in daily activities;
-
-F.
-
-Isolation from friends, family, or any type of emotional support system;
-
-G.
-
-Neglect or deprivation of medical care;
-
-H.
-
-Stalking;
-
-I.
-
-Economic abuse or control of finances through withholding money or sabotaging attempts to
-attain economic self-sufficiency; and/or,
-
-J.
-
-Child molestation, incest.
-
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-
-“Domestic violence survivor” means any person who has experienced or is experiencing domestic
-violence as defined above.
-“Earned income” means payment in cash or in-kind received by an individual for services performed as
-an employee or as a result of being engaged in self-employment.
-“Effective date of eligibility” means the first date a client is eligible for the public assistance program.
-“Eligibility requirements” means criteria used to determine individuals eligible or ineligible to receive grant
-payments and/or services.
-“Eligible client” means a client whose countable income is below the grant standard and who meets all
-non-financial eligibility criteria.
-“Emancipated juvenile” means the same as in Section 19-1-103(45), C.R.S.
-“Exceptional disengagement” means a pattern of documented non-compliance with the Individualized
-Plan over a span of time without reporting good cause. The pattern must clearly demonstrate repetitive
-disengagement from the program over a span of not more than two (2) months, such as three (3)
-consecutive times in one (1) month or four (4) times in two (2) months. Exceptional disengagement does
-not exist when a client has demonstrated an unmet need for transportation or childcare or when domestic
-violence or a disability impact a client. Exceptional disengagement is reported to the State Department via
-a State prescribed review process.
-“Excluded person” means a person who is not included in the assistance unit or budgetary unit.
-“Exempt income” means any income that is not countable income for the purpose of eligibility.
-"Federal Poverty Guidelines" also called Federal Poverty Level (FPL) means the income level for a
-household as set forth in the Federal Register 86 FR 7732, 7732-7734, as of February 1, 2021. This rule
-does not contain any later amendments or editions. These guidelines are available for no cost at
-https://www.federalregister.gov/. These guidelines are also available for public inspection and copying at
-the Colorado Department of Human Services, Director of the Division of Economic and Workforce
-Support, 1575 Sherman Street, Denver, Colorado, 80203, or at any state publications library during
-regular business hours.
-“Fleeing felon” means a person fleeing to avoid prosecution or custody or confinement after conviction for
-a felony.
-“Fraud” means the same as in Section 26-1-127(1), C.R.S.
-“Family violence option (FVO) trained worker” means a county worker or contract staff who has
-participated in the State prescribed FVO training.
-
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-9 CCR 2503-6
-
-“Good cause” means circumstances beyond the control of the client. Good cause includes, but is not
-limited to, medical emergencies or hospitalization; a client who has a disability or other medical
-condition(s) requiring additional time and/or assistance; a delayed appointment with the Social Security
-Administration beyond the client's control; a client who is experiencing domestic violence, a child-only
-case, and a client who is the head of a single-parent household who has a child under one (1) year of
-age, or other good cause determined reasonable by the county department using the prudent person
-principle, including the reasons outlined in 3.608.3. Related to the appeal process, the following
-circumstances do not constitute good cause: an excessive workload of a party or his or her representative
-or attorney; when a party obtains legal representation in an untimely manner; a party or his or her
-representative or attorney’s failure to either receive or timely receive, a timely mailed initial decision, or
-other timely mailed correspondence from the Office of Administrative Courts, the Office of Appeals, or the
-county department; when a party or his or her representative or attorney has failed to advise the Office of
-Administrative Courts, the county department, or the Office of Appeals of a change of address or failed to
-provide a correct address; or any other circumstance which was foreseeable or preventable.
-“Grant payment” means the Colorado Works program payment that can either be basic cash assistance
-or diversion. Grant payments may also be referred to as the benefit.
-“Grant standard” means the maximum Colorado Works grant payment that can be provided to a client
-based on the household composition, not including diversion or assessed need.
-“Guardian” means the same as in Section 26-2-703(10.2), C.R.S.
-“Immediate family member” means spouses, child(ren), parents, siblings, and the spouses of those
-persons.
-“Income” means any financial gain by means of money payment or in-kind payment. Payments made
-directly to a vendor are not income.
-“Income reporting standard” means the amount of income which requires an assistance unit to report an
-increase in earnings during a certification period.
-“In-kind” means something of value received for the benefit of a client or sponsor(s) of a client and is
-considered either earned or unearned income. Examples of this are food or shelter that the client
-received for free or at fair market value or less.
-“Intent” and/or “intentionally” means the same as in Section 18-1-501(5), C.R.S.
-“Intentional program violation” (IPV) occurs when an individual makes a false or misleading statement or
-fails to disclose by misrepresentation or concealment of facts, or acts in a way that is intended to mislead
-or conceal any eligibility factor on any application or other written and/or electronic communication for the
-purpose of establishing or maintaining eligibility to:
-A.
-
-Receive a grant payment for which the client is not eligible; or,
-
-B.
-
-Increase a grant payment for which the client is not eligible; or,
-
-C.
-
-Prevent a denial, reduction or termination of a grant payment.
-
-“Investigation’s Conclusion” means the investigation into an IPV has concluded and the amount of
-overpayment has been determined.
-“Irregular” (related to income) means income which an individual cannot reasonably expect to receive on
-a monthly basis.
-
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-CODE OF COLORADO REGULATIONS
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-
-9 CCR 2503-6
-
-“Liable individual” means a person financially responsible for an overpayment including the client,
-sponsor(s) of a client, a payee, parents of dependent children, and/or other persons determined to be
-financially liable by a court.
-“Medical services” means services that are allowable or reimbursable under Title XIX of the Social
-Security Act.
-“Minor” means a person who is under the age of eighteen (18).
-“Noncustodial parent” means an individual who, at the time he or she requests and receives program
-services:
-A.
-
-Is a parent of a minor child; and,
-
-B.
-
-Is a resident of Colorado; and,
-
-C.
-
-Does not live in the same household as the minor child.
-
-"Overpayment” means a payment was made in excess of the amount a client was eligible for.
-“Parent” means an adoptive or natural/biological parent, including an expectant parent.
-“Periodic payments” means payments that are irregular or a one-time payment.
-“Potential income” means a benefit or payment to which the client or sponsor(s) of a client may be entitled
-and could secure, such as spousal support, annuities, pensions, retirement or disability benefits, veterans
-compensation and pensions, workers' compensation, Social Security retirement or disability benefits,
-Supplemental Security Income (SSI) benefits, and unemployment compensation.
-“Produce” means to provide for inspection either: 1) an original or 2) a true and complete copy of the
-original document. A document may be produced either in person, electronically, or by mail.
-“Program prohibitions” means any of the following that prevents a required member of the assistance unit
-from participating in the Colorado Works program.
-A.
-
-The individual has misrepresented his or her residence to receive TANF benefits or services
-simultaneously in two or more states;
-
-B.
-
-The individual is a fugitive or fleeing felon;
-
-C.
-
-The individual is a non-citizen who does not meet the definition of an eligible qualified non-citizen;
-
-D.
-
-The individual has been convicted of welfare fraud under the laws of this State as described in
-Section 26-1-127, C.R.S., any other state, or the federal government. The individual convicted of
-fraud shall not be permitted to receive grant payments but may receive services as deemed
-necessary; or,
-
-E.
-
-The individual lacks or failed to provide a Social Security Number (SSN) or proof of application for
-a SSN.
-
-“Prudent person principle” means that, based on experience and knowledge of the program, the county
-department exercises a degree of discretion, care, judiciousness, and circumspection, as would a
-reasonable person, in a given case.
-
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-CODE OF COLORADO REGULATIONS
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-
-9 CCR 2503-6
-
-“Qualified non-citizen” is the same as “qualified alien” in 8 U.S.C. 1641(b) and the language, including all
-notes, in 8 U.S.C. § 1101 and may also be referred to as a legal immigrant.
-“Questionable” means the information provided is unclear, conflicting information has been provided, or
-the county has reason to believe facts presented are contrary to the information provided by the client.
-“Received” (for the purpose of income) means the date on which the income is actually received or legally
-becomes available for use, whichever occurs first, whether reported timely by the client or not.
-“Received” (as it applies to receipt of verification, documentary evidence, and reported changes in
-circumstances) means the date the verification, documentary evidence, and reported changes were
-received by the county department.
-“Recovery” means the collection of a valid claim to repay grant payments to which a client was not
-entitled.
-“Redetermination” means a case review/determination of necessary information and verifications to
-determine ongoing eligibility and may also be called renewal.
-“Responsibility/exercising responsibility” means the accountability for and obligation to make decisions on
-behalf of a child(ren).
-“Sanction” means a reduction in Colorado Works grant payments for an established period of time as a
-result of not participating in the Workforce Development program.
-“Scheduled appointment” or “scheduled interview” means an appointment or interview set using a State
-prescribed or State approved appointment notice provided to the client.
-“Self-employment” means work that is performed at the client's discretion either informally, as an
-independent contractor or as the owner of a business and not for an employer. Self-employment does not
-include S-Corps or Limited Liability Companies (LLC).
-“Signature” means handwritten signatures, electronic signature techniques, recorded telephonic
-signatures, or documented gestured signatures. A valid handwritten signature includes a designation of
-an x. For Individualized Plans and conditions agreements, a verbal agreement is an acceptable signature
-and must be substantiated with an electronic, recorded telephonic, or written agreement of the terms.
-“Sponsor” means any person(s) who executed an affidavit of support (USCIS form I-864 or I-864a (March
-6, 2018)) or another form deemed legally binding by the Department of Homeland Security on behalf of a
-non-citizen as a condition of the non-citizen's date of entry or admission into the United States as a
-permanent resident. These forms are herein incorporated by reference. This rule does not contain any
-later amendments or editions. These forms are available at no cost from https://www.uscis.gov/forms.
-These forms are also available for public inspection and copying at the Colorado Department of Human
-Services, Director of the Division of Economic and Workforce Support, 1575 Sherman Street, Denver,
-Colorado, 80203, or at any state publications library during regular business hours.
-“State Department” or “the Department” means the Colorado Department of Human Services.
-“Statewide automated system” means the electronic platform used to calculate public assistance program
-benefits and grant payments.
-“Supplantation” means the replacement of county funds serving Colorado Works clients with block grant
-funds and the use of those county fund savings for purposes other than the Colorado Works program.
-
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-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-9 CCR 2503-6
-
-“Supportive payment” means a payment and/or service in addition to basic cash assistance or diversion
-that is based on an assessed need.
-“Termination” means that the client who is currently receiving Colorado Works program grant payments is
-no longer eligible and his or her grant payments will be stopped.
-“Timely notice” means the county shall generate a notice to the client at least eleven (11) calendar days
-prior to the initiation of any adverse action. This shall be sent to his or her last address known to the
-county department.
-“Unearned income” means any income received by a client or sponsor(s) of a client that is not earned
-through employment or self-employment.
-“Unintentional” or “without intent” means an act, or something done or performed that was not voluntary
-or intended.
-“Verification” or “verify” means confirming statements, application information, and other case information
-by obtaining written, audio, or other evidence or information that proves such fact or statement to be true.
-“Verified upon receipt” means information that is provided directly from the primary source and is not
-questionable and no additional verification is required.
-“Willful” means the same as in in Section 18-1-501(6), C.R.S.
-“Willful withholding of information” includes:
-A.
-
-Willful misstatement including understatement, overstatement, or omission, whether verbal or
-written, made by a client in response to verbal or written questions from the county department;
-and/or,
-
-B.
-
-Willful failure by a client to report changes in income or other circumstances which may affect the
-amount of grant payment.
-
-“Withdraw” or “withdrawal” means an application is not processed because the client who submitted the
-application withdraws his or her request for assistance prior to eligibility determination, or requests his or
-her grant payment be discontinued.
-“Workforce Development (WD)” means the program provided to clients determined to be work eligible as
-described in section 3.607.
-3.602
-
-Applications for Colorado Works
-
-3.602.1 Applications
-A.
-
-An individual shall have the opportunity to apply for Colorado Works assistance without delay.
-When an individual is unable to make an application in person at the county department, the
-county department, upon request of the applicant, shall mail the State Department’s prescribed
-public assistance application form or assist the individual in applying for assistance utilizing other
-forms of the State Department’s prescribed application.
-1.
-
-County departments shall not require any pre-eligibility screening process designed to
-deter individuals from applying for Colorado Works benefits, services, and/or payment. All
-applications shall be accepted by the county department and entered into the statewide
-automated system to determine the applicants’ eligibility for the program.
-
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-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-B.
-
-9 CCR 2503-6
-
-2.
-
-County departments shall accept applications for Colorado Works during normal
-business hours. They shall not be restricted to a certain day or time of day. County
-departments shall not refer applicants to community resource providers in place of
-allowing them to apply for Colorado Works benefits or otherwise limiting opportunities to
-apply for Colorado Works. In addition, county departments shall accept applications at all
-Human/Social Services departments for public assistance locations. The application date
-shall be the date that the application is received in the public assistance office.
-
-3.
-
-If the applicant wishes to terminate the process before the application is completed, it
-shall be treated as an “inquiry” and the application will not be acted upon for a
-determination of eligibility. An inquiry is a request of information about eligibility
-requirements for public assistance. If the applicant wishes to terminate the process after
-the application is submitted, it shall be treated as a “withdrawal/denial.”
-
-4.
-
-An applicant may choose to withdraw his or her application anytime during the application
-process or after a grant payment is determined. A decision by the applicant to withdraw
-shall be treated as a denial by the county department. The applicant shall be notified of
-the action of the county department on the State-approved Notice of Action form.
-
-5.
-
-County departments shall simplify the requirements relating to determination and
-verification of eligibility criteria, such as accepting the simplist form of eligibility verification
-possible. County departments may use other public assistance program’s eligibility forms
-and processes when redetermining and verifying eligibility.
-
-Administrative Review
-All Colorado Works clients whose benefits have been denied, reduced or terminated shall receive
-timely and adequate notice of the denial or change in benefits in accordance with section 3.609.1.
-In addition, the client shall have the right to appeal a county department’s action in accordance
-with State rules pursuant to Section 3.609.7. A Colorado Works client receiving basic cash
-assistance shall have benefits continued if an appeal is filed timely in accordance with rules at
-Section 3.609.1.E.2.
-
-C.
-
-General information concerning public assistance programs shall be provided to all persons
-seeking information. This shall be provided in writing by the county department. In addition, verbal
-notice shall be provided to all persons seeking information when requested. Available information
-shall include:
-1.
-
-Information about the Colorado Works Program;
-
-2.
-
-Conditions of eligibility;
-
-3.
-
-Scope of benefits;
-
-4.
-
-Time limits;
-
-5.
-
-Related services available;
-
-6.
-
-Domestic violence waivers; and,
-
-7.
-
-Rights and responsibilities of clients.
-
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-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-D.
-
-9 CCR 2503-6
-
-The county department shall ensure that no information concerning a client is released without
-authorization except as outlined in E.2.i below. In circumstances when a client needs assistance
-with the application process, information shall not be released by the county department to the
-assisting individual(s) unless the individual is accompanied by the client, or is the client’s
-authorized representative, or a written authorization to release information is obtained from the
-client. Upon request, the county department shall provide assistance in completing the application
-form.
-When a client is a person with disabilities and is unable to complete the forms the spouse, other
-relative, friend, or authorized representative may complete the forms. When no such person is
-available to assist in these situations, the county department must assist the client in the
-completion of the necessary forms. The county department also may refer the client to a legal or
-other resource. The county shall provide reasonable accommodations under the Americans with
-Disabilities Act for disabled clients. The county department shall make referral to the Social
-Security Administration (SSA) office for all aged, disabled, or blind clients that may be eligible to
-receive SSA benefits. However, this shall not negate the county department’s responsibility to
-obtain and process the application. In the event that a client needs assistance in submitting and
-completing an application, the individual providing this assistance is not considered to be the
-authorized representative unless the required prescribed or approved State form has been signed
-indicating such authority for the individual to be the authorized representative on the case.
-Applications for clients in special situations shall be handled as follows:
-
-E.
-
-1.
-
-Clients who cannot write their names shall make a mark, and such mark shall be
-witnessed by the signature of at least one witness. The printed name and address of
-such witness shall follow the signature. County workers may act as witnesses if not
-related to the client.
-
-2.
-
-A client receiving medical treatment in a medical facility shall submit an application to the
-county department in which the facility is located. When a county department receives an
-application for a client whose place of residence is in another county, the application shall
-be forwarded to that county department for processing. When a client has no
-determinable county of residence, the county department in which the facility is located
-shall process the application.
-
-3.
-
-An application for a client in a public institution shall be processed by the county
-department where the client has established residence or the county in which the court is
-located which issued a confinement order. When the application process is completed,
-the case shall become the responsibility of the county department in which the institution
-is located.
-
-4.
-
-All clients’ rights shall be preserved. The signed release of information form/authorization
-to release information form may be used only for the entities/agencies for which it is
-intended. No subset of that agency or legal entity attached to that agency shall be
-included in the authorization to release information unless specified by the client.
-
-Receiving Applications for Colorado Works Benefits
-1.
-
-When receiving applications for benefits, county workers shall:
-a.
-
-Record the date the signed application was received by the county department.
-
-b.
-
-Review applications for completeness and determine eligibility for assistance;
-
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-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-c.
-
-Schedule an interview with the client if the interview is not taking place
-immediately.
-1)
-
-The client shall be offered an in-person interview at redetermination. if
-the client does not elect an in-person interview, the county shall schedule
-and conduct a phone interview.
-
-2)
-
-The client shall be provided written notice of the interview at least four (4)
-calendar days of the scheduled interview. The client may provide a
-written or verbal waiver that written notice of the scheduled interview is
-not necessary when the county department is able to conduct the
-interview during application processing. Notice shall include:
-
-3)
-
-2.
-
-9 CCR 2503-6
-
-a)
-
-The date and time for the interview;
-
-b)
-
-Identification of any documentation that may be needed;
-
-c)
-
-The opportunity to reschedule the appointment or make other
-arrangements in the event of good cause.
-
-When the client does not keep the interview appointment and does not
-request an alternate time or arrangement, as described in this section,
-grant payments will be denied.
-
-d.
-
-Make a home visit when required by county policy to determine a county
-approved setting for a minor client; and,
-
-e.
-
-Refer the client to other services when appropriate. Applications that have been
-approved for refugees shall be referred to the Colorado Refugee Services
-Program for other ongoing case management and services offered through
-Colorado Works.
-
-The application process shall consist of all activity from the date the application is
-received from the client until a determination concerning eligibility is made. Language
-translation via interpreter shall be provided by the county department of residence as
-needed. The major steps in the application process shall include:
-a.
-
-The application shall be date stamped by the county department to secure the
-application date for the client;
-
-b.
-
-An explanation shall be provided to the client of the various benefit options;
-
-c.
-
-An explanation shall be provided to the client of the eligibility factors;
-
-d.
-
-An explanation shall be provided to the client of the client’s responsibility to
-accurately and fully complete the application, provide documents to substantiate
-or verify eligibility factors, and that the client may use friends, relatives, or other
-persons to assist in the completion of the application;
-
-e.
-
-An assurance shall be provided to the client of the county worker's availability to
-assist in the completion of the application and to secure needed documentation
-which the client is unable to otherwise secure;
-
-f.
-
-An explanation shall be provided to the client of the process to determine
-eligibility;
-
-14
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-9 CCR 2503-6
-
-g.
-
-An explanation shall be provided to the applicant of the client’s rights and
-responsibilities including confidentiality of records and information, the right to
-non-discrimination provisions, the right to a county dispute resolution process,
-the right to a State-level appeal, the right to apply for another category of
-assistance and that a determination of the client’s eligibility for such other
-assistance will be made;
-
-h.
-
-An explanation shall be provided to the client that the client may withdraw from
-the application process at any time.
-
-i.
-
-The agency shall inform all clients in writing at the time of application that the
-agency will use all Social Security Numbers (SSN) of required household
-members to obtain information available through state identified sources. One
-interface includes, but is not limited to, the Income and Eligibility Verification
-System (IEVS) used to obtain information of income, eligibility, and the correct
-amount of assistance payments. Information gathered through State identified
-sources may be shared with other assistance programs, other states, the Social
-Security Administration, the Department of Labor and Employment, and the Child
-Support Services Program as permitted by Section 26-1-114, C.R.S.; and,
-
-j.
-
-An explanation shall be provided to the client of all Colorado Works program
-benefits and requirements applicable to the family members in the household.
-The county department shall, when appropriate, provide the information verbally
-and in written form.
-
-k.
-
-An explanation provided regarding the process of utilizing the Electronic Benefit
-Transfer (EBT) card. This explanation shall include:
-1)
-
-Identification of the following establishments as described in Section 262-104(2), C.R.S.in which clients shall not be allowed to access cash
-benefits through the Electronic Benefits Transfer services from
-automated teller machines and point of sale (POS) devices:
-a)
-
-Licensed gaming establishments as defined in Section 44-30103(18), C.R.S.;
-
-b)
-
-In-state simulcast facilities as defined in 44-32-102(11), C.R.S.;
-
-c)
-
-Tracks for racing as defined in Section 44-32-102(24), C.R.S.;
-
-d)
-
-Commercial bingo facilities as defined in Section 24-21-602(11);
-
-e)
-
-Stores or establishments in which the principal business is the
-sale of firearms;
-
-f)
-
-Retail establishment licensed to sell malt, vinous, or spirituous
-liquors except for liquor-licensed drug stores as defined in
-Section 44-3-410, C.R.S.;
-
-g)
-
-Establishments licensed to sell medical marijuana or medical
-marijuana-infused products, or retail marijuana or retail
-marijuana products; and,
-
-15
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-h)
-
-2)
-
-F.
-
-G.
-
-9 CCR 2503-6
-
-Establishments that provide adult-oriented entertainment in
-which performers disrobe or perform in an unclothed state for
-entertainment.
-
-An explanation that the cash portion issued on the EBT card may be
-suspended with identified misuse of the EBT card at the above prohibited
-locations.
-
-3.
-
-An application has been made when the county department receives the signed public
-assistance application forms meeting the criteria identified in Section 3.602.1.F. An
-application is different from an inquiry.
-
-4.
-
-An application must be accepted by any county department; however, it is the
-responsibility of the county of residence to determine eligibility. The county department
-that received the application incorrectly shall forward the application to the county of
-residence promptly.
-
-5.
-
-An application may be submitted by the client or by an individual acting on the client’s
-behalf when the client is unable to submit an application.
-
-6.
-
-To be accepted, applications for Colorado Works can only be made by a caretaker with
-whom a dependent child(ren) is living.
-
-Minimum Application Requirements
-1.
-
-The county department shall require a written application, signed under penalty of
-perjury, using the State Department's prescribed public assistance form.
-
-2.
-
-The application form shall be used as the primary source of information. To be
-considered complete, the application shall contain, at a minimum, the name of the client,
-signature of the client or authorized representative, and an address for the client which
-can include general delivery or a county office. If an address is not provided, another
-means of contact such as phone number or email address must be utilized to obtain an
-address.
-
-3.
-
-The date of application shall be the first working day the county department receives a
-signed application form, which indicates the client’s desire to receive public assistance.
-The application must be date stamped with the date the county department receives the
-signed application to secure the application date.
-
-Information Sharing
-There are public assistance programs that are to be jointly administered by county departments.
-This requires sharing of information to the extent permitted by Section 26-1-114, C.R.S.
-Communications from one division to the other shall be formalized so that they serve a purpose,
-and there is a record of that purpose.
-
-H.
-
-Confidentiality
-Information regarding families shall remain confidential and available only for the purposes
-authorized by federal or State law as described in Section 3.609.73, Protections to the Individual.
-
-16
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-I.
-
-9 CCR 2503-6
-
-Processing Standard
-The county department shall process applications as expeditiously as possible but no later than
-forty-five (45) calendar days following the application date as described in Section 3.602.1.F.3.
-1.
-
-The county department shall consider an application for Colorado Works to be an
-application for all programs of public assistance, except for child welfare services, for
-which the client has requested assistance. County departments shall make clients aware
-of other services and assistance under other public assistance programs that they may
-be eligible.
-
-2.
-
-The determination should be followed by a written notification of eligibility status to the
-client. Clients who refuse to cooperate in completing the application processes shall be
-denied based upon timely noticing in accordance to Section 3.609.1. In cases where
-verification is incomplete, the county department shall provide the client with a statement
-of required verification on the State prescribed notice form and offer to assist the client in
-obtaining the required verification. The county department shall allow the client eleven
-(11) calendar days to provide the missing verifications, unless the client can provide good
-cause or the verification falls under the programs verification at an individual level
-described in Section 3.604.3 . If good cause is provided, the client shall have until the
-twentieth (20th) calendar day following the date of application to provide the necessary
-verification. The State prescribed notice form shall reflect specific months of eligibility and
-ineligibility.
-
-3.
-
-Following a determination of ineligibility, applications remain valid for a period of thirty
-(30) calendar days.
-
-4.
-
-a.
-
-If the client has good cause and notifies the county department that he/she is
-requesting benefits within thirty (30) calendar days of the denial, the county
-department shall reschedule the interview if not already completed, and the
-current application date shall be used.
-
-b.
-
-If the client does not have good cause and notifies the county department that
-he/she is requesting benefits, and the request is made within thirty (30) calendar
-days of the current application, that application can be used, but the date of
-application shall be the most recent date the client requested benefits.
-
-c.
-
-If the continued application results in a denial for any reason and the client
-makes a subsequent request for Colorado Works without good cause, a new
-application shall be required.
-
-d.
-
-If the client requests benefits more than thirty (30) days from the date of the
-denial, they must submit a new application.
-
-County departments shall require no more than one interview for a Colorado Works
-client. When an interview is conducted, the county worker shall review the application for
-completeness and secure, if necessary, signed copies of the Authorization for Release of
-Information form, and any other forms or documentation necessary to determine
-eligibility.
-
-17
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-J.
-
-9 CCR 2503-6
-
-Information Concerning Immunizations
-At the time of application, the county department shall provide information concerning
-immunizations to all clients seeking benefits through the Colorado Works program. The
-information shall include parent education of vaccines, information concerning where to access
-vaccines in the local community, and the exemptions listed in Section 25-4-903, C.R.S. The
-Department of Public Health and Environment or the County or District Public Health Agency
-shall provide the immunization information to the county department for this purpose.
-
-K.
-
-Reporting Case Actions
-1.
-
-2.
-
-“Denied,” is the action that the county shall take when the client fails to meet the eligibility
-requirements of the category of assistance desired. A denial also may be on the basis of
-such factors as, but not limited to:
-a.
-
-The client refuses to furnish information necessary to determine eligibility;
-
-b.
-
-The client is unwilling to have the county department contact a collateral source
-to secure information, and the client refuses to sign the State-approved
-Authorization for Release of Information form;
-
-c.
-
-The client does not supply information or otherwise fails to cooperate with the
-county department within ten (10) calendar days of the request for information
-unless good cause is granted and after having received notification of the reason
-for delay;
-
-d.
-
-The client moves to an unknown address before determination of eligibility has
-been completed;
-
-e.
-
-A third-party refuses to provide documentation of essential verifications and the
-client is unwilling to cooperate in obtaining such information personally.
-1)
-
-Authorization of the release of such information alone does not constitute
-cooperation if the county department requests further assistance from
-the client. Documentation of lack of cooperation must be entered by the
-county in the case record.
-
-2)
-
-However, if the client is willing to cooperate but unable to obtain the
-information, no denial or delayed determination of eligibility shall occur.
-The county shall assist the client in gaining the information required to
-make a determination of eligibility.
-
-A decision by the client to “withdraw,” shall be treated as a denial by the county
-department.
-
-3.602.2 Right and Opportunity to Register to Vote
-A client for public assistance shall be provided the opportunity to register to vote. The county department
-shall provide public assistance clients the prescribed voter registration application at application and
-redetermination for public benefits.
-
-18
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-3.603
-
-9 CCR 2503-6
-
-Case File Maintenance
-
-3.603.1 Purpose and Use of Case File Records
-A.
-
-Preparation of Case Record
-Preparation of the case record shall begin at the point of initial application with the client and case
-maintenance shall continue as long as the case is open for assistance.
-
-B.
-
-Purpose
-The major purposes of a case record shall be:
-
-C.
-
-1.
-
-To assist the county worker in reaching a valid decision concerning eligibility or case
-action, and the amount of payment and type of assistance;
-
-2.
-
-To ensure assistance is based on factual information and verifications received;
-
-3.
-
-To provide for continuity of assistance when a worker is absent, when a case is
-reopened, and when a case is transferred from one county worker/department to another;
-
-4.
-
-To ensure valid administration of the county department in keeping with its function and
-purposes;
-
-5.
-
-To serve as a valuable basis for research, for interpretation of the work of the county
-department, and as a basis for development and evaluation of policy and procedure.
-
-Case Numbering
-A case number shall be assigned to the client at the time of application for assistance.
-
-D.
-
-The county department shall document all case actions in case comments. This information shall
-include actions taken by the county department, the basis of such actions, and the result or
-outcome of the action taken on the case, and must also include:
-1.
-
-All case decisions related to the prudent person principle;
-
-2.
-
-All decisions related to the disposition of claims;
-
-3.
-
-Any interactions with the client;
-
-4.
-
-Actions related to a county conference and/or state level fair hearing;
-
-5.
-
-Cause of untimely processing of the application or redetermination;
-
-6.
-
-Other information that would be critical to document county department actions and/or
-would be necessary to justify case decisions during a case review, audit, appeal, or
-lawsuit; and,
-
-7.
-
-Information pertaining to eligibility, verifications, collateral contacts, program participation,
-and associated expenditures.
-
-19
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-E.
-
-9 CCR 2503-6
-
-Documentation
-The county department shall document all income and non-financial eligibility information into the
-statewide automated system.
-
-F.
-
-1.
-
-The county department shall not omit case information from the statewide automated
-system based on the assumption that the information is unnecessary for eligibility
-determination.
-
-2.
-
-All case information used to determine eligibility and changes in basic biographical
-information shall be updated at the time of redetermination.
-
-Arrangement of Case Record and Content of the Case Record
-All case files, including electronic files, shall contain all documents necessary to determine the
-eligibility and participation in program requirements. All case files, including electronic files, at a
-minimum shall be:
-
-G.
-
-1.
-
-Labeled clearly, and,
-
-2.
-
-Easily accessible for state reviews and/or audit purposes.
-
-Storing County Records
-The county department shall be responsible for the provision of a safe place for storage of case
-records and other confidential material to prevent disclosure by accident or as a result of curiosity
-of persons other than those involved in the administration of the programs. Data of any form shall
-be retained for the current year, plus three previous years unless:
-
-H.
-
-1.
-
-There is a written statutory requirement, rule, or regulation available from a county (i.e., a
-broader county policy), State or federal agency requiring a longer retention period; or,
-
-2.
-
-There has been a claim, audit, negotiation, litigation or other action started before the
-expiration of the three-year period. If any such action has been started, the county must
-maintain the case record for the duration of the action. If a county department shares
-building space with other county offices, locked files to store case material shall be used.
-Facility and other maintenance personnel shall be instructed concerning the confidential
-nature of information.
-
-Removal of Case Records
-Case records are the property of the State Department and shall be restricted to use by the State
-Department and county department.
-
-3.604
-
-Eligibility Criteria for Colorado Works Payments and Services
-
-3.604.1 Eligibility Criteria
-To receive a Colorado Works grant payment, a client must:
-A.
-
-Be a resident of Colorado.
-1.
-
-There shall be no durational residency requirement and a client who establishes intent to
-remain in Colorado shall be considered a resident.
-
-20
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-B.
-
-9 CCR 2503-6
-
-2.
-
-Residence shall be retained until abandoned.
-
-3.
-
-Persons receiving TANF benefits from another state shall not be eligible for Colorado
-Works grant payments during any month a payment was made by the other state.
-
-Be lawfully present in the United States as:
-1.
-
-A citizen of the United States (including persons born in the United States, Puerto Rico,
-Guam, Virgin Islands (U.S.), American Samoa, or Swain's Island; persons who have
-become citizens through the naturalization process; persons born to U/S. citizens outside
-the United States with appropriate documentation); or,
-
-2.
-
-A qualified legal non-citizen who entered the United States prior to August 22, 1996; or,
-
-3.
-
-A qualified legal non-citizen who entered the United States on or after August 22, 1996,
-who has been in a qualified non-citizen status for a period of five years, unless they meet
-one of the exceptions to the five-year bar consistent with 8 U.S.C. 1613(b).
-
-C.
-
-Be a member of an assistance unit who meets income eligibility requirements and has provided
-required verifications or be a noncustodial parent (noncustodial parents may receive services, but
-not basic cash assistance).
-
-D.
-
-Not be admitted to an institution as a patient for tuberculosis or mental disease, unless the person
-is a child and receiving “under 21” psychiatric care under Medicaid benefits.
-
-E.
-
-Not be in the custody of or confined in a county, state, or federal correction facility or institution as
-an inmate, which is one who is confined or serving time imposed by a court, except as a patient in
-a public medical institution. Those considered to not be an inmate also include, but are not limited
-to, those on a work release or court monitoring system.
-
-F.
-
-Not be a temporary resident or non-citizen in one of the following situations:
-1.
-
-Non-citizens with no status verification from the United States Citizenship and
-Immigration Service (USCIS);
-
-2.
-
-Non-citizens granted a specific voluntary departure date;
-
-3.
-
-Non-citizens applying for a status; or,
-
-4.
-
-Citizens of foreign nations residing temporarily in the United States on the basis of visas
-issued to permit employment, education, or a visit.
-
-3.604.2 Household Composition
-A.
-
-A Colorado Works household consists of clients who are part of the assistance unit and/or
-budgetary unit.
-1.
-
-The assistance unit consists of individuals who live together and who must apply for and
-receive Colorado Works grant payments as a single household.
-Members of the same assistance unit who meet the requirements of the Colorado Works
-program shall receive basic cash assistance or shall be considered when determining
-diversion grant amounts.
-
-21
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-9 CCR 2503-6
-
-Persons not required to be in one assistance unit, but residing in the same household,
-shall have the option of applying for Colorado Works as separate units. Each assistance
-unit shall be budgeted using the appropriate need standard for the unit.
-2.
-
-The budgetary unit consists of individuals who are part of the assistance unit as well as
-individuals who are outside of the assistance unit but considered financially responsible
-for members of the assistance unit.
-
-3.
-
-Clients must provide any information or verification needed to determine who must be in
-the assistance unit and budgetary unit.
-
-B.
-
-Two parent household cases will be paid with county maintenance of effort (MOE) funds. All other
-single parent and child only cases will be paid with county TANF block grant funds.
-
-C.
-
-Members of the Assistance Unit
-1.
-
-2.
-
-The following individuals must be included in the assistance unit when living in the home:
-a.
-
-Dependent child(ren) who live in the home of a caretaker.
-
-b.
-
-Parents of dependent child(ren) who live in the home unless the child is a minor
-parent who is requesting assistance for their own child or responsibility is
-established with another caretaker through court order, child welfare, or adoption.
-
-c.
-
-Siblings of dependent child(ren) who live in the home and are legally in the care
-of the requesting caretaker.
-
-d.
-
-Half siblings of the dependent child(ren) who live in the home that do not receive
-child support payments.
-
-e.
-
-The spouse of a pregnant parent.
-
-The following individuals are optional members of the assistance unit. These individuals
-are included in the assistance unit when living in the home and requesting assistance:
-a.
-
-The spouse of a parent who is not themselves a parent of dependent child(ren)
-who live in the home.
-
-b.
-
-A non-parent caretaker.
-
-c.
-
-The spouse of a non-parent caretaker.
-
-d.
-
-Half siblings of the dependent child(ren) who live in the home and are receiving
-child support. The parent or non-parent caretaker of the half sibling receiving
-child support shall decide whether to include such half sibling receiving child
-support in the assistance unit.
-
-e.
-
-Siblings of the dependent child(ren) who live in the home but are not in the legal
-custody of the requesting caretaker due to an established court order, child
-welfare involvement or an adoption.
-
-f.
-
-A parent who lives in the home of another caretaker and no longer has legal
-custody of the dependent child(ren) who live in the home.
-
-g.
-
-Parent(s) of a minor parent who is requesting assistance for their own child.
-
-22
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-3.
-
-D.
-
-2.
-
-F.
-
-The following individuals are excluded from the assistance unit.
-a.
-
-Individuals receiving SSI payments.
-
-b.
-
-Individuals who receive other Title IV benefits such as foster care, adoption
-subsidy or Title IV kinship payments.
-
-Members of the Budgetary Unit
-1.
-
-E.
-
-9 CCR 2503-6
-
-The following individuals must be included in the budgetary unit:
-a.
-
-Any individual who is part of the assistance unit (to include optional members of
-the assistance unit who requested assistance) regardless of whether or not the
-individual is eligible to receive assistance.
-
-b.
-
-The spouse of a parent or non-parent caretaker who requested assistance,
-regardless of whether or not the spouse has requested assistance for
-themselves.
-
-c.
-
-The unborn child of a pregnant parent.
-
-d.
-
-The non-recipient parent(s) of a minor parent.
-
-e.
-
-The sponsor of a non-citizen who is part of the assistance unit (whether or not
-the non-citizen is themselves eligible to receive Colorado Works grant
-payments).
-
-The following individuals are excluded from the budgetary unit:
-a.
-
-An optional member of the assistance unit who chooses not to receive
-assistance for himself or herself.
-
-b.
-
-Individuals who are excluded from the assistance unit as identified in Section
-3.604.2.C.3.
-
-A dependent child is considered to be living in the home of a caretaker as long as the caretaker
-exercises the responsibility for the care of the child even if the following occurs:
-1.
-
-The child or the caretaker is temporarily absent from the home to receive medical
-treatment;
-
-2.
-
-The child is under the jurisdiction of the court;
-
-3.
-
-Legal custody is held by an agency that does not have physical custody of the child;
-
-4.
-
-The child is in regular attendance at a school away from home.
-
-School-aged, dependent children must be in school, home school, pursuing a GED, or attending
-online courses to obtain a high school diploma or GED. A dependent child is still considered to be
-a student in regular attendance during official school or training program vacation periods,
-absences due to illness, convalescence or family emergencies. County departments must work
-with families to enroll children not enrolled in and attending school.
-
-23
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-G.
-
-H.
-
-I.
-
-J.
-
-9 CCR 2503-6
-
-Assistance units may remain eligible and payment for the child shall continue for Colorado Works
-when children are absent from the home for a period greater than forty-five (45) consecutive
-calendar days for the following reasons:
-1.
-
-Child(ren) receiving medical care or education that requires him or her to live away from
-the home; or,
-
-2.
-
-Child(ren) visiting a noncustodial parent, as specified in a parenting plan entered by the
-court or a parenting plan signed by both parties, the visit not exceeding six (6) months
-unless otherwise specified; or,
-
-3.
-
-Child(ren) residing in voluntary foster care placement for a period not expected to exceed
-three (3) months. Should the foster care plan change within three months and the
-placement become court-ordered, the child is not longer considered to be living in the
-home as of the time the foster care plan is changed.
-
-When more than one caretaker exercises responsibility for a child, the following hierarchy shall be
-followed. A caretaker:
-1.
-
-Is a parent; or,
-
-2.
-
-Is a relative by blood, marriage, or adoption who is within the fifth degree of kinship to the
-dependent child (not to be separated due to death or divorce); or is appointed by the
-court to be the legal guardian or legal custodian of the dependent child; or,
-
-3.
-
-If those identified in a-b above are not available, is a person who exercises responsibility
-for a dependent child within the person’s home and provides verification of such
-responsibility such as a court order, school or medical records listing the individual as the
-child’s contact, collateral contact with child welfare, or another document acceptable to
-the county department. the prudent person principle may be used to determine that a
-non-parent caretaker other than a guardian, legal custodian, or a relative exercises
-responsibility for a child. The individual who exercises responsibility and is highest in the
-above hierarchy list shall be deemed the caretaker for the assistance unit.
-
-A parent or non-parent caretaker is considered to be living in the home and may continue as a
-member of the assistance unit/ family needs unit if the individual is temporarily away from home if
-one of the following occurs:
-1.
-
-Is on active duty in the uniformed service of the United States.
-
-2.
-
-Is temporarily absent from the home to receive medical treatment.
-
-3.
-
-Is temporarily absent from the home for less than forty-five (45) calendar days and has
-established an intent to return.
-
-Indian Tribe Eligibility
-Members of an Indian Tribe not eligible for assistance under a Tribal Family Assistance Plan are
-eligible for Colorado Works.
-
-24
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-K.
-
-9 CCR 2503-6
-
-Assistance for Eligible Refugees
-Refugees are qualified non-citizens exempt from the five-year bar. Those refugees eligible for
-assistance through TANF/Colorado Works shall submit an application to their county of
-residence. Those applications that have been approved shall be referred to the Colorado
-Refugee Services Program (CRSP) for other ongoing case management and services offered
-through the TANF/Colorado Works program.
-1.
-
-The CRSP is responsible for performing the eligibility assessment as required by section
-3.607.3 for all refugees referred to them by county departments and will apply uniform
-guidelines that apply to all county departments regarding the assessment of refugees.
-
-2.
-
-Based on the assessment of the refugee, CRSP will make recommendations to the
-county departments and will apply uniform guidelines that apply to all county departments
-regarding the assessment of refugees. These recommendations shall include, at a
-minimum:
-
-3.
-L.
-
-a.
-
-Whether the refugee is determined to be ready to work.
-
-b.
-
-The type(s) of activities that will be most beneficial to the refugee; and,
-
-c.
-
-The amount and duration of supportive services and other assistance payments
-necessary to achieve self-sufficiency for the refugee.
-
-The county department shall consider the recommendations of CRSP and the
-recommended supportive payments within the county policy.
-
-Individuals Ineligible for Colorado Works Program
-The following individuals shall not be eligible under Colorado Works:
-
-M.
-
-1.
-
-Fugitives or fleeing felons;
-
-2.
-
-Assistance units with an adult participating in a strike;
-
-3.
-
-Qualified legal non-citizens or those who are not federally exempt, who entered the
-United States on or after August 22, 1996, are ineligible for cash assistance for five (5)
-years from the date of entry into the United States.
-
-Penalties for Disqualified or Ineligible Persons
-Persons who are required members of the assistance unit, but who are disqualified from receiving
-or are ineligible to receive Colorado Works basic cash assistance or diversion due to program
-prohibitions or violations, shall be removed from the assistance unit for the purposes of
-determining the assistance unit size. Disqualified individuals income must be considered when
-determining eligibility without applying income disregards.
-The following disqualified or ineligible individuals shall have such month counted as a month of
-participation in the calculation of their overall sixty-month (60) lifetime maximum as referenced in
-section 3.606.6 when a grant payment is received for others in the assistance unit.
-1.
-
-Individuals convicted by a court or whose disqualification was obtained through an
-intentional program violation (IPV) waiver for misrepresenting their residence in order to
-obtain assistance in two states at the same time shall have their Colorado Works
-assistance denied for ten (10) years.
-
-25
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-N.
-
-9 CCR 2503-6
-
-2.
-
-Individuals who have committed fraud as determined by a court or determination of an
-IPV by administrative hearing shall result in the disqualified caretaker being removed
-from the grant for a twelve (12) month period for the first offense, twenty-four (24) months
-for the second offense, and lifetime for the third offense. An IPV from another state shall
-be used to determine eligibility for an individual. The level of the IPV established by the
-Administrative Law Judge from the other state shall be used to determine the level of the
-IPV for Colorado Works. The timeframes established herein shall be used; the timeframe
-established from the other state shall no longer be valid.
-
-3.
-
-Individuals who are fleeing felons for the time that that person meets the definition of
-fleeing felon as described in 3.601.
-
-4.
-
-Individuals who have failed to apply for a Social Security Number unless a federally
-allowable reason, as listed in 20 CFR § 422.107 (2023), exists for not attempting to
-obtain a social security number. No later editions or amendments are incorporated.
-These regulations are available at no cost from the U.S. social security administration,
-1500 Champa Street, Suite 200, Denver, CO 80202, or at https://www.ecfr.gov/. These
-regulations are also available for public inspection and copying at the Colorado
-Department of Human Services, Office of Economic Security, 1575 Sherman Street,
-Denver, CO 80203, during regular business hours. Once that person has taken action to
-apply for a Social Security Number, they may become eligible.
-
-6.
-
-Individuals who are non-citizens and do not meet the definition of a qualified non-citizen,
-those who fail to prove citizenship or fail to provide proof that they are otherwise possess
-a qualified non-citizen status and/or proof of lawful presence.
-
-Minor Parent Applicants/Participants
-A minor who is also a parent may apply for Colorado Works.
-1.
-
-When a minor parent is not emancipated and has a marital status of single, grant
-payments may not be approved unless the minor parent resides with another adult
-caretaker or the minor parent resides in another setting which the county has determined
-is an appropriate setting.
-a.
-
-Counties shall assist minor parents who are otherwise eligible and are not living
-in a county approved setting according to the county’s policy to find an
-appropriate living arrangement.
-
-b.
-
-Counties shall assist assistance units which include an unmarried minor
-parent(s) who has a child at least twelve (12) weeks of age, who has not
-completed his or her high school education or GED, and who is not participating
-in educational activities or an approved training program, in participating in such
-programs within sixty (60) calendar days from the date the initial assessment is
-completed for those sixteen (16) or older or within sixty (60) calendar days from
-the date the eligibility interview takes place for those under the age of sixteen
-(16). Participation means enrollment, attendance, or an action otherwise
-specified by the county department. Failure to participate without good cause will
-result in the termination or discontinuation of Colorado Works basic cash
-assistance.
-
-26
-
-CODE OF COLORADO REGULATIONS
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-
-2.
-
-3.
-
-O.
-
-9 CCR 2503-6
-
-When a minor parent does not live in the home of another caretaker:
-a.
-
-The minor parent may not receive benefits until deemed to be in a county
-approved setting by the county department unless the minor is emancipated, has
-a marital status other than single, or resides with an adult relative.
-
-b.
-
-A minor parent who is emancipated or has a marital status other than single is
-not considered to be living in the home of a caretaker even if they are living in the
-home of their parent.
-
-c.
-
-A minor who is a parent and does not live in the home of a caretaker will receive
-assistance as an adult if approved.
-
-Minor Parents and Caretakers
-a.
-
-If the minor parent lives with an unrelated non-parent caretaker who chooses not
-to be a member of the assistance unit, the minor must be in a county approved
-setting.
-
-b.
-
-If the minor parent lives with an unrelated non-parent caretaker who chooses to
-be a member of the assistance unit, the county department may choose if it is
-necessary to approve the setting before grant payments are provided per county
-policy.
-
-c.
-
-If the minor parent lives with his or her parent, the county department does not
-need to approve a setting even if the minor’s parent chooses not to be a member
-of the assistance unit.
-
-d.
-
-A minor parent who is the dependent child of a caretaker will receive assistance
-as a child if approved even if the caretaker is not included in the assistance unit.
-
-Out of the Home
-1.
-
-For Colorado Works purposes, a client who is out of State temporarily shall be provided
-assistance on the same basis as one who is in the state as long as the individual has
-established intent to return. The client’s temporarily out of the State status shall not
-exceed ninety (90) consecutive days.
-
-2.
-
-A client who is a resident of an institution is not considered to be in the home. A client
-shall be considered a resident in an institution when the recipient's stay is at least thirty
-(30) consecutive days. Institutions include general medical and surgical hospitals, nursing
-homes, assisted living residences, and mental institutions. Residents of an institution who
-continue to have the responsibility of a dependent child may receive Colorado Works if
-the dependent child also resides in the institution or continues to be cared for in the
-home, unless individual needs are provided for through other state.
-
-27
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-CODE OF COLORADO REGULATIONS
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-
-9 CCR 2503-6
-
-3.604.3 Program Verifications
-A.
-
-The county department shall not require any documentary evidence (verification) and/or written
-statements for eligibility determination until the county department receives a signed and dated
-application. The client has the primary responsibility for providing documentary evidence for
-required verification and the responsibility to resolve questionable information. The county worker
-shall assist the client in obtaining the necessary documentation if the client is cooperating with
-county workers. The client may supply documentary evidence in person, through mail, by
-facsimile, through an electronic device, or through an authorized representative. The county
-worker shall accept all pertinent documentary evidence provided by the client and shall be
-primarily concerned with how adequately the verification proves the statements on the application
-and/or program participation, if applicable. If written verification cannot be obtained, county
-workers shall substitute an acceptable “collateral contact” if available, as defined in section 3.601
-program definitions and E-F of this section.
-If the client is missing any verification, the county department shall request additional and/or
-required verifications from the client. the request shall include:
-1.
-
-A specific list of verifications necessary to determine eligibility;
-
-2.
-
-The due date for when the verifications must be returned, which shall be eleven (11)
-calendar days from the date the verification was requested in writing; and,
-
-3.
-
-Notification that if the client fails to return the verifications by the due date, the county
-department shall process the application without those verifications, which may lead to a
-denial of grant payments.
-
-If proper verification is not received and a collateral contact is unavailable, the client will be
-noticed (in writing or verbally) with information that the county worker will assist with obtaining
-verification, provided that he or she is cooperating with the county department.
-Verification is an eligibility requirement. Failure to provide requested verification may result in the
-case and/or client being denied, closed, terminated, or discontinued. The verification process
-shall begin the date the application is date stamped by the county and shall continue throughout
-the life of the case, including program participation and applicable verifications for ongoing
-redeterminations of eligibility.
-B.
-
-Required Primary Verifications
-1.
-
-All information received through the Income and Eligibility Verification (IEVS) System
-shall be reviewed and verified. Assistance shall not be denied, delayed, or discontinued
-pending receipt of information requested through IEVS, if other evidence establishes the
-client's eligibility for assistance.
-
-2.
-
-All participating clients shall provide to the county the following information:
-a.
-
-Verification of lawful presence in the United States; section 3.604.3.I.
-
-b.
-
-Verification of citizenship or qualified non-citizenship status; section 3.604.I-J.
-
-28
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-CODE OF COLORADO REGULATIONS
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-
-c.
-
-9 CCR 2503-6
-
-A Social Security Number (SSN) for each client applying for benefits or proof that
-an application for a SSN has been made. Proof of application is only valid for up
-to eight (8) months without good cause. The agency shall explain to the client
-that refusal or failure without good cause to provide a SSN or a receipt of a SSN
-application will result in ineligibility for the client for whom an SSN or receipt is
-not obtained. Only the client for whom the SSN or receipt is not provided will be
-ineligible, and not the entire assistance unit.
-1)
-
-For clients that made application for a SSN at initial eligibility
-determination, verification of the SSN must be received prior to the next
-recertification.
-
-2)
-
-For clients added to the assistance unit within sixty (60) days of the
-certification period expiring, verification of the SSN must be received by
-the following recertification.
-
-3)
-
-The county department shall verify the SSNs provided by the assistance
-unit with the Social Security Administration (SSA) in accordance with
-procedures established by the state department for the State On Line
-Query (SOLQ) system.
-
-4)
-
-The county department shall accept as verified a Social Security Number
-that has been verified by any program agency participating in SOLQ
-system.
-
-d.
-
-Verification of a caretaker’s responsibility for the child(ren) must be provided,
-unless the caretaker is the child(ren)’s parent. Verification may include, but is not
-limited to, verbal or written confirmation from the child’s parent, a court order,
-school or medical records listing the individual as the child’s contact, or collateral
-contact with child welfare. The prudent person principle may be used to
-determine that a non-parent caretaker other than a guardian, legal custodian, or
-a relative exercises responsibility for a child.
-
-e.
-
-Verification of income of any member of the assistance unit or other household
-member whose income is used to determine eligibility and payment.
-
-f.
-
-Verification of Colorado residency.
-
-3.
-
-Counties may require further verification of any information that is received that is
-determined to be questionable or inconsistent. Such a determination must be
-documented in the applicant's case file.
-
-4.
-
-An applicant may request an extension of time beyond the forty-five (45) day maximum to
-process an application for Colorado Works benefits in order to obtain necessary
-verification. The extension may be provided at county discretion. The worker must
-document the reason for the extension in the statewide automated system and/or case
-file.
-
-5.
-
-All immigrants shall have non-citizen status verified through the Systematic Alien
-Verification for Entitlements (SAVE) system. Assistance shall not be delayed or
-discontinued pending this verification.
-
-29
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-C.
-
-9 CCR 2503-6
-
-Secondary Verifications
-When applicable, secondary verifications for eligibility and program participation, may include, but
-are not limited to:
-
-D.
-
-1.
-
-Verification of relationship of a dependent child to other household members;
-
-2.
-
-Verification of good cause, to include good cause for a delay in providing verifications for
-assistance, good cause for not cooperating with child support services, and good cause
-for not participating in work activities;
-
-3.
-
-Verification of child support, to include information of the noncustodial parent and/or child
-support income/expenses as specified in section 3.606;
-
-4.
-
-Verification of school attendance for all school-aged children included in the assistance
-unit, including home school, GED, and online attendance;
-
-5.
-
-Verification of work participation;
-
-6.
-
-Verification establishing allowable absences of an adult or child in the assistance unit if
-leaving the state/home and requesting to continue benefits; and/or,
-
-7.
-
-Verification of pregnancy, when no children are in the assistance unit.
-
-Sources of Verification
-Counties may use collateral contacts, interfaces, prudent person principle, documentary
-evidence, and in some cases, client statement as sources of verification.
-
-E.
-
-Use of a Collateral Contact, Review, and Follow-up
-Applications shall be reviewed and any necessary follow-up activities such as collateral contacts,
-verifications, etc., shall be initiated within five (5) calendar days of when the county department
-obtains information containing the collateral contacts information from the client. Priority shall be
-given to those applications where critical and emergent need is apparent.
-
-F.
-
-Requirements for Collateral Contact to Make a Determination of Eligibility
-1.
-
-The client shall be given the opportunity to provide documentation necessary to
-determine eligibility. When necessary, the county department shall assist the client to
-secure documentation. If documentation that is necessary to determine eligibility is not
-received, a notice shall be sent to the client to advise him or her of the proposed action to
-deny or discontinue the case. The notice to the client shall also include a specific
-description of the documentation necessary to determine eligibility.
-In general, the county department shall rely on the client to provide the documentation
-necessary to determine eligibility.
-
-2.
-
-A collateral contact is an oral or written confirmation of a household's circumstances by a
-person outside of the household. The signature on the application shall be considered
-consent for the use of collateral contacts. The county department may rely on members
-of the household to provide the name of any collateral contact. If the individual provides
-an unacceptable collateral contact who cannot be expected to provide accurate
-verification, the county department shall:
-
-30
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-3.
-
-9 CCR 2503-6
-
-a.
-
-Request the name of another collateral contact; or,
-
-b.
-
-Ask for alternative forms of verification; or,
-
-c.
-
-Substitute a home visit to establish a county approved setting when applicable.
-
-Confidentiality shall be maintained when talking with collateral contacts. The county
-department shall disclose only the information that is absolutely necessary to obtain
-information being sought. If the client fails to provide a collateral contact or provides a
-contact that is unacceptable to the eligibility worker, the county worker may select a
-collateral contact that can provide information that is needed. Except for contacts to verify
-information provided through IEVS, the collateral contact selected by the county worker
-shall not be contacted without first obtaining the prior written or verbal approval of an
-adult household member or the authorized representative. Collateral contacts for IEVS do
-not require household designation or prior contact approval. The notice of proposed
-action shall advise the household that they have the option to consent to the collateral
-contact, to provide acceptable verification in another form, or to withdraw the application.
-If the household refuses to choose one of the above options, the application shall be
-denied.
-The case file shall be documented to support action taken by the county department. The
-county department shall not determine the household to be ineligible when a person
-outside the household refuses to provide information required for the client to resolve a
-request for verification (i.e. a former employer will not provide verification of employment
-termination and does not respond to attempts for a collateral contact by the county
-department). In such scenarios, the prudent person principle must be used to determine
-eligibility without the unavailable verification.
-Household members who are disqualified or in an ineligible status are not considered
-individuals outside the household.
-
-4.
-
-G.
-
-In cases in which the information from another source contradicts statements made by
-the household, the household shall be afforded a reasonable opportunity to resolve the
-discrepancy prior to an eligibility determination.
-
-The rules contained herein are intended to be sufficiently flexible to allow the eligibility worker to
-exercise reasonable judgment to determine when a request for verification is unnecessary
-because the facts of the case are clear. In making a certification decision, the eligibility worker
-should ask whether his or her judgment is reasonable, based on experience and knowledge of
-the program.
-The prudent person principle may not be used to waive the requirement to verify lawful presence
-for clients over the age of eighteen (18).
-The prudent person principle may not be used to verify that a SSN application has been
-submitted for a newborn unless the pregnancy was previously verified or the newborn was born in
-a colorado hospital.
-The prudent person principle may be used to determine that a non-parent caretaker other than a
-guardian, legal custodian, or a relative exercises responsibility for a child and/or when
-determining good cause for non-cooperation with the workforce development program activities
-or child support services.
-All case decisions related to the prudent person principle must be documented in case
-comments.
-
-31
-
-CODE OF COLORADO REGULATIONS
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-
-H.
-
-9 CCR 2503-6
-
-Interfaces are acceptable verification sources for Colorado Works.
-1.
-
-Income and Eligibility Verification System (IEVS)
-IEVS provides for the exchange of information for Colorado Works with the SSA and the
-Colorado Department of Labor and Employment (DOLE). The county department shall
-act on all information received through IEVS. The county department shall, at a minimum,
-prior to approval of benefits, verify potential earnings and unemployment benefits through
-DOLE for all applicants, except institutionalized applicants. Benefits shall not be delayed
-pending receipt of verification from a collateral contact (e.g., employers). In cases where
-the county department has information that an institutionalized or group home recipient is
-working, wage and unemployment insurance benefits matches are required at
-application. All other matches will be initiated through IEVS upon approval of benefits.
-Through IEVS, recipient SSNs will be matched with source agency records on a regular
-basis to identify potential earned and unearned income, resources and assets, including:
-a.
-
-The following data shall be considered verified when entered into the statewide
-automated system:
-1)
-
-SSA (Beneficiary and Earnings Data Exchange/Bendex, State Data
-Exchange/SDX) Social Security benefits, SSI, pensions, selfemployment earnings, federal employee earnings; and,
-
-2)
-
-Unemployment Insurance Benefits (UIB).
-
-b.
-
-DOLE wage data shall not be considered verified upon receipt. Additional
-verification must be obtained to verify wage information.
-
-c.
-
-At initial application and at redetermination, a client of Colorado Works shall be
-notified through a written statement provided on or with the application form that
-the information available through IEVS: will be requested and used for eligibility
-determinations; shall be verified through sources, such as collateral contacts with
-the client, when discrepancies are found by the county department; and may
-affect the assistance unit’s eligibility and level of payment.
-
-d.
-
-1)
-
-All verification types obtained by a collateral contact to validate or
-invalidate the IEVS discrepancy shall be documented; and,
-
-2)
-
-Case documentation shall be available in the case file or statewide
-automated system documenting the action taken on the case within fortyfive (45) calendar days of initial receipt. Case documentation must
-include the purpose of the review, the action taken on the case, and how
-the determination was made that supported the action taken by the
-county department.
-
-The county department shall review and process IEVS within forty-five (45) days.
-No more than twenty (20) percent of the IEVS reviewed may remain
-unprocessed beyond forty-five (45) days when:
-1)
-
-The reason that the action cannot be completed within forty-five (45)
-days is the non-receipt of requested third-party verification; and,
-
-32
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-2)
-
-2.
-
-9 CCR 2503-6
-
-Action is completed promptly, when third-party verification is received or
-at the next time eligibility is redetermined, whichever is earlier. If action is
-completed when eligibility is redetermined and third-party verification has
-not been received, the county department shall make its decision based
-on information provided by the recipient and any other information in its
-possession.
-
-Public Assistance Reporting Information System (PARIS)
-The county department shall query PARIS at initial application and at redetermination to
-determine whether the client is receiving benefits in another state, veterans’ benefits, or
-military wages or allotments.
-
-3.
-
-Systematic Alien Verification for Entitlements (SAVE)
-The county department shall query SAVE at initial application and at redetermination to:
-
-4.
-
-a.
-
-Determine whether a qualified non-citizen has a sponsor(s);
-
-b.
-
-Verify the non-citizen registration number provided by the client and, if the
-number and name submitted do not match, take prompt action to terminate
-assistance to the client; and
-
-c.
-
-Determine if there has been a change in the non-citizen’s status.
-
-Colorado Department of Revenue, Division of Motor Vehicles (DMV)
-The Colorado DMV may be used by the county department to verify lawful presence and
-identity.
-
-I.
-
-Verification of Citizenship and Lawful Presence
-1.
-
-Verification of citizenship in the United States
-Citizenship may be verified by a birth certificate, possession of a U.S. passport, a
-Certificate of U.S. Citizenship (USCIS form N-560 or NH-561), a Certificate of
-Naturalization (USCIS form N-550 or N-570), a Certificate of Birth Abroad of a Citizen of
-The United States (Department of State Forms FS-545 or DS-1350), or identification
-cards for U.S. citizens (USCIS-I-179 or USCIS-I-197). Documents that are acceptable as
-verification of citizenship can be found in the Department of Revenue rules at 1 CCR
-204-30, Rule 5, Appendix A and B (Mar. 2, 2021), no later editions or amendment are
-incorporated. These regulations are available at no cost form the Colorado Department of
-Revenue, 1881 Pierce St., Lakewood, CO 80214 or at https://www.sos.state.co.us/ccr.
-These regulations are also available for public inspection and copying at the Colorado
-Department of Human Services, Office of Economic Security, 1575 Sherman St., Denver,
-CO 80203, during regular business hours.
-
-2.
-
-Verification of questionable citizenship information
-The following guidelines shall be used in considering questionable statement(s) of
-citizenship from a client:
-a.
-
-The claim of citizenship is inconsistent with statements made by the client, or
-with other information on the application, or on previous applications.
-
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-
-CODE OF COLORADO REGULATIONS
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-
-9 CCR 2503-6
-
-b.
-
-The claim of citizenship is inconsistent with information received from another
-source.
-
-c.
-
-The claim of citizenship is inconsistent with the documentation provided by the
-client.
-
-Application of the above criteria by the eligibility worker must not result in discrimination
-based on race, religion, ethnic background or national origin, and groups such as migrant
-farm workers or Native Americans shall not be targeted for special verification. The
-eligibility worker shall not rely on a surname, accent, or appearance that seems foreign to
-find a claim to citizenship questionable. Nor shall the eligibility worker rely on a lack of
-English speaking, reading, or writing ability as grounds to question a claim to citizenship.
-3.
-
-The client whose citizenship is in question shall be ineligible to participate until proof of
-citizenship is obtained. If a non-citizen is unable to provide any USCIS document at all,
-there is no responsibility to offer to contact USCIS on the non-citizen's behalf.
-Responsibility exists only when the non-citizen has a USCIS document that does not
-clearly indicate eligible or ineligible non-citizen status. The county department shall
-contact the State Department, not the USCIS, to obtain information about the noncitizen's correct status. The method used to document verification of citizenship and the
-result of that verification shall be contained in the case file.
-
-4.
-
-All persons eighteen years of age or older must establish lawful presence in the United
-States prior to receiving Colorado Works with the exception of those exempt in the list
-provided in this section. The requirements of this section do not apply to clients under the
-age of eighteen (18).
-a.
-
-In order to verify his or her lawful presence in the United States, a client must:
-1)
-
-b.
-
-Produce and provide to the county department:
-a)
-
-A valid Colorado driver’s license or a Colorado identification card
-issued pursuant to article 2 of title 42, C.R.S.; or,
-
-b)
-
-A United States military card or military dependent’s identification
-card; or,
-
-c)
-
-A United States coast guard merchant mariner card; or,
-
-d)
-
-A Native American tribal document; or,
-
-e)
-
-Any other document authorized by rules adopted by the
-Department of Revenue (1 CCR 2204-30, Rule 5, Appendix A,
-as incorporated by reference in section 3.604.3.I.1 of these
-rules).
-
-The requirements of this section do not apply to the following clients, programs
-and services:
-1)
-
-For any purpose for which lawful presence in the United States is not
-required by law, ordinance, or rule;
-
-2)
-
-For obtaining health care items and services that are necessary for the
-treatment of an emergency medical condition of the person involved and
-are not related to an organ transplant procedure;
-
-34
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-5.
-
-6.
-
-J.
-
-3)
-
-For short-term, non-cash, in-kind emergency disaster relief;
-
-4)
-
-For programs, services, or assistance such as soup kitchens, crisis
-counseling and intervention, and short-term shelter specified by federal
-law or regulation that:
-a)
-
-Deliver in-kind services at the community level, including
-services through public or private non-profit agencies;
-
-b)
-
-Do not condition the provision of assistance provided on the
-individual recipient’s income or resources; and,
-
-c)
-
-Are necessary for the protection of life or safety;
-
-5)
-
-Pregnant women;
-
-6)
-
-For individuals over the age of eighteen years of age and under the age
-of nineteen years who continue to be eligible for medical assistance
-programs after their eighteenth birthday.
-
-A non-citizen considered a legal immigrant will normally possess one of the following
-forms provided by the citizenship and immigration services (USCIS) as verification:
-a.
-
-I-94 arrival/departure record.
-
-b.
-
-I-551 resident alien card (I-551).
-
-c.
-
-Forms I-688b or I-766 employment authorization document.
-
-d.
-
-A letter from USCIS indicating a person's status.
-
-e.
-
-Letter from the U.S. Department of Health and Human Services (HHS) certifying
-a person's status as a victim of a severe form of trafficking.
-
-f.
-
-Iraqi and Afghan individuals who have been admitted as Special Immigrants (SI).
-
-g.
-
-Any of the documents permitted by the Colorado Department of Revenue rules
-for evidence of lawful presence (1 CCR 204-30, appendix B, as incorporated by
-reference in section 3.604.3.I.1 of these rules).
-
-Legal immigrants applying for public assistance must present documentation from USCIS
-showing the applicant's status. All documents must be verified through SAVE to
-determine the validity of the document. Benefits shall not be delayed, denied or
-discontinued awaiting the SAVE verification.
-
-Verification required from non-citizens
-1.
-
-K.
-
-9 CCR 2503-6
-
-As a condition of eligibility for financial assistance, when a sponsored non-citizen is
-included in the assistance unit or budgetary unit, the client must provide income
-information about the non-citizen's sponsor(s).
-
-When a client is unable to provide verification for citizenship, qualified non-citizenship status,
-lawful presence, identity, and/or their social security number, the county department shall grant
-thirty (30) calendar days to the client to provide the verification. If the verification is provided in the
-allotted time, the same application may be used to determine eligibility and benefits provided.
-
-35
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-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-9 CCR 2503-6
-
-Verification shall be provided for each individual requesting/receiving payments at the time of
-application and redetermination. In addition, supportive services, special needs payments and
-assistance in obtaining verifications shall be provided.
-Individuals unable to provide this verification will not receive payment for themselves and their
-income will be used to determine eligibility for the household.
-3.604.4 Colorado Works and Child Support Services
-A.
-
-As a condition of continued eligibility, clients for Colorado Works are statutorily required to assign
-all rights to child support on their own behalf or on behalf of any other member of the assistance
-unit for whom the application is made. A client's failure to sign and date the application form to
-avoid assignment of support rights precludes eligibility for the assistance unit. Failure to
-cooperate with Child Support Services at application and/or while receiving basic cash
-assistance, without good cause, will result in the termination or discontinuation of the Colorado
-Works basic cash assistance.
-This assignment is effective for child support due and owed during the period of time the person
-is receiving public assistance. The assignment takes effect upon a determination of eligibility for
-Colorado Works cash assistance. The assignment remains in effect with respect to the amount of
-any unpaid support obligation accrued and owed prior to the termination of Colorado Works cash
-assistance to the client. The application form shall contain acknowledgement of these provisions
-and shall be signed and dated by the client.
-1.
-
-B.
-
-Clients may request that their case not be referred to child support services based upon
-good cause. Claims found to be valid are:
-a.
-
-Potential physical or emotional harm to a child(ren).
-
-b.
-
-Potential physical or emotional harm to a parent or caretaker.
-
-c.
-
-Pregnancy or birth of a child related to incest or forcible rape.
-
-d.
-
-Legal adoption before court or a parent receiving pre-adoption services.
-
-e.
-
-Other reasons documented by the county department.
-
-f.
-
-Reasons considered to be in the best interest of the child.
-
-g.
-
-Other court order.
-
-2.
-
-Every client shall be given notice and the opportunity to claim that his or her case should
-not be referred to Child Support Services based upon good cause.
-
-3.
-
-Determination of such good cause must be in writing and documented in the case file by
-the county director or designee of the county director.
-
-4.
-
-Each case not referred based upon good cause shall be reviewed by the county director
-or designee at least yearly.
-
-Basic cash assistance shall be considered part of the Unreimbursed Public Assistance (UPA) as
-defined in the Child Support Services Rule Manual at 9 CCR 2504-1 section 6.002.
-
-36
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-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-C.
-
-9 CCR 2503-6
-
-If a family is ineligible for Colorado Works basic cash assistance due to child support income and
-the income received from child support is either not received or is less than the family need
-standard, the family may request to be reinstated for assistance in that month. The income from
-the current month will be used to determine eligibility and payment prospectively.
-
-3.604.5 Family Violence Option (FVO) Waiver
-The federal government allows state Temporary Assistance for Needy Family (TANF) programs to
-participate in the option to waive certain program requirements for individuals who have been identified as
-survivors of family (domestic) violence.
-A.
-
-Waiver provisions
-1.
-
-2.
-B.
-
-The FVO waiver allows a county to exempt Colorado Works clients from the following
-standard program elements if it is determined that participation in these elements would
-unfairly endanger or penalize an individual or their child(ren) as a result of their
-experience of family violence:
-a.
-
-Work activities
-
-b.
-
-TANF time clock. Assistance received while the FVO waiver is in effect does not
-prevent the TANF time clock from advancing, but is an allowable reason to
-extend assistance beyond the sixtieth (60th) month.
-
-c.
-
-Child support services
-
-The county department shall involve the client when choosing to invoke a FVO waiver.
-The individual at their discretion may accept or refuse any waiver offered.
-
-Requirements for FVO waivers:
-When a county department and client invoke the FVO waiver the following are required:
-1.
-
-Implement county written policies which at a minimum address:
-a.
-
-Domestic violence and FVO;
-
-b.
-
-How counties intend to provide information about the FVO waiver, related
-benefits, domestic violence services, and options provided by Colorado Works
-and others to all clients on an ongoing basis.
-This information should be provided in accordance with section 3.602.1 and at a
-minimum shall include (1) procedures for voluntarily and confidentially selfidentifying as a survivor of domestic violence and how self-disclosed information
-will be used and (2) benefits of and procedures for applying for waivers from any
-program requirements and extension of time limits;
-
-c.
-2.
-
-The process for screening and assessing domestic violence continually.
-
-Training and case actions for county staff.
-
-37
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-3.
-
-9 CCR 2503-6
-
-a.
-
-The core FVO/domestic violence training shall be mandatory for all staff who play
-a role in determining, modifying, or granting FVO waivers, including intake,
-assessment, case management, or Workforce Development staff. This training
-must be completed prior to contact with Colorado Works clients. CDHS strongly
-recommends that all county staff, including experienced staff, supervisors, and/or
-managers, attend the core FVO training at least once every five (5) years, and
-attend ongoing and specific training offered or recommended by Colorado Works
-and local agencies that address domestic violence issues.
-
-b.
-
-County staff who have participated in the core FVO training shall be the only staff
-who shall provide information about and screen for domestic violence, assess for
-domestic violence waiver eligibility, make waiver determinations, review waivers
-and extensions, consider sanctions, and/or develop and modify an Individualized
-Plan of a client who has a waiver.
-
-Follow certain processes with regard to all Colorado Works clients including:
-a.
-
-Screen Colorado Works clients by identifying those who are or have been
-survivors of domestic violence by using the State Department domestic violence
-screening form.
-
-b.
-
-Assess Colorado Works clients who are identified as a survivor of domestic
-violence by:
-
-c.
-
-1.
-
-The nature and extent to which the individual may engage in work
-activities;
-
-2.
-
-The resources and services needed to assist the individual in obtaining
-safety and self-sufficiency; and,
-
-3.
-
-A plan to increase the client’s safety and self-sufficiency.
-
-Domestic violence exemptions (or waivers) of certain Colorado Works
-requirements may be granted for good cause based on circumstances that
-warrant non-participation in program work requirements described in this section,
-non-cooperation with Child Support Services as defined in section 3.604.4,A.1, or
-a program extension. Good cause may also be determined through the use of
-the prudent person principle as specified in section 3.604.3.G. And defined in
-section 3.601.
-1.
-
-Good cause for granting an FVO waiver of work activities and/or the sixty
-(60)-month time limit extension is defined as anything that would
-potentially endanger or unfairly penalize a client or the client’s family if
-he/she participated in work activity requirements or grant payments were
-discontinued.
-
-2.
-
-Good cause for granting a waiver of the Child Support Services
-cooperation requirement is defined as anything in section 3.604.4.A.1,
-including circumstances that are not in the best interest of the child, e.g.,
-potentially endangering or unfairly penalizing the client or child if the
-individual cooperated with Child Support Services.
-
-38
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-4.
-
-C.
-
-9 CCR 2503-6
-
-Provide certain resources to all Colorado Works clients and survivors of domestic
-violence. Counties are to make immediate referrals to appropriate services, including:
-domestic violence services, legal services, health care, emergency shelter, child
-protection, and law enforcement. Such referrals are to be documented in the client’s case
-file.
-
-FVO provisions
-1.
-
-2.
-
-3.
-
-Screening clients includes:
-a.
-
-All clients are to be screened continually for domestic violence by trained
-workers.
-
-b.
-
-At any point in Colorado works program participation, a client may be identified or
-may self-identify as a survivor of domestic violence.
-
-c.
-
-Workers are to use sensitivity and discretion in selecting the appropriate setting
-for domestic violence screening. The screening and any information related to
-the client’s domestic violence shall remain confidential in accordance with section
-3.609.73.
-
-Waiver provisions, case documentation, and the Individualized Plan (IP)
-a.
-
-The county shall use only FVO-trained workers to work with survivors of
-domestic violence throughout the application, screening, waiver/IP development,
-and case management processes, and when implementing, modifying, and
-monitoring sanctions for a domestic violence survivor.
-
-b.
-
-Workers shall use the prudent person principle in determining what FVO
-waiver(s) will most benefit the individual. The IP shall be developed with a priority
-on safety and self-sufficiency for the individual and the individual’s child(ren).
-
-c.
-
-Waivers shall be based on need, and may be granted as long as need is
-demonstrated. This can be accomplished at application or throughout the life of
-the case.
-
-d.
-
-Waivers shall be documented in the statewide automated system describing and
-taking into account:
-1)
-
-The past, present, and ongoing impact of domestic violence on the
-individual and the family;
-
-2)
-
-The individual’s available resources;
-
-3)
-
-The maximized safety of the individual and the individual’s family while
-leading to self-sufficiency;
-
-4)
-
-Identification of specific program/work activities requirements being
-required and/or waived;
-
-5)
-
-Prioritization of work, excepting those cases where work would lead to
-greater risk of family violence; re-assessment should occur every six (6)
-months, at minimum.
-
-Appeal of a waiver denial
-
-39
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-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-a.
-
-9 CCR 2503-6
-
-If a waiver is denied, and the client wishes to dispute this decision, he or she may
-appeal through the State Employment and Benefits Division. The Division will
-review and make decisions on the appeal. If the State Employment and Benefits
-Division denies the client’s appeal, he or she has the right to appeal further
-through the judicial review process in section 24-4-106, C.R.S.
-The appellant shall be granted all requested waivers and continue to receive
-benefits through the appeal process.
-
-b.
-3.605
-
-Any individual may reapply for a waiver at any time.
-
-Income
-
-3.605.1 Income
-A.
-
-For Colorado Works grant payments, all countable gross income that members of the assistance
-unit and budgetary unit have received or expect to receive shall be used to determine eligibility.
-1.
-
-Consideration of income - for purpose of determining need, all countable gross income
-received in the month prior to, if available, and in the month of application shall be used
-to determine eligibility of members of the assistance unit.
-
-2.
-
-Availability of income - income shall be countable when actually available, when the client
-has a legal interest in a sum, and has the legal ability to make such sum available for
-support and maintenance. Income, in general, is the receipt by a client of a gain or
-benefit in cash or in-kind during a calendar month. Received means the date on which
-the income becomes legally available.
-
-3.
-
-Securing potential income - a client must make every reasonable effort to secure
-potential income.
-
-4.
-
-a.
-
-The time required to make income available shall not be used as a basis for
-delaying the processing of an application.
-
-b.
-
-When the client is taking appropriate action to secure potential income, the
-assistance unit shall continue without adjustment until the income is available.
-
-c.
-
-If the client refuses to make a reasonable effort to secure potential income, such
-income must be considered as if available. Timely and adequate notice must be
-given to the assistance unit regarding a proposed action to deny, reduce, or
-terminate assistance, based on the availability of the income.
-
-d.
-
-If, upon the receipt of the prior notice, the client acts to secure the potential
-income, the proposed action to deny, reduce, or terminate assistance shall be
-withdrawn and assistance must be approved and/or continued without
-adjustment until the income is, in fact, available.
-
-Income of a non-participant stepparent and a non-participant parent of an unmarried
-minor parent
-a.
-
-A stepparent’s countable income is considered available to stepchildren included
-in the assistance unit as dependent children. The countable income of a nonparticipant parent(s) of an unmarried minor parent who is living in the same home
-as the minor parent, shall also be deemed to the assistance unit.
-
-40
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-9 CCR 2503-6
-
-The countable income equals gross earned income minus the employment
-disregard of $90, minus the maintenance or child support paid to others outside
-the assistance unit, minus the amounts actually paid by the individual to other
-individuals not living in the home and who could be claimed by the individual for
-federal income tax purposes, plus any unearned income received by the
-stepparent or non-participant parent. The needs of the stepparent or parent of
-the minor parent, and the needs of individuals living in the home for whom the
-stepparent or parent are responsible shall be deducted from the result to
-determine the amount attributed to the assistance unit.
-b.
-5.
-
-Income of parents living in the same home as the unmarried minor parent shall
-be attributed to the assistance unit of the minor parent.
-
-Sponsored non-citizens
-a.
-
-It shall be presumed that an affidavit of support demonstrates the sponsor's
-ability to make income available to a non-citizen whom he or she sponsors at a
-minimum of one hundred twenty-five percent (125%) of the Federal Poverty
-Level. Therefore, the net income of a non-citizen’s sponsor and the sponsor's
-spouse shall be deemed to the assistance unit.
-
-b.
-
-Sponsor net income equals gross earned income minus twenty percent (20%) or
-$175, whichever is less, minus support paid to dependents not living in the
-sponsor's home, plus any unearned income. The remaining income shall be
-considered available as unearned income to the non-citizen for the purpose of
-establishing eligibility and payment for Colorado Works.
-The client may rebut the county department's determination that the income of
-the sponsor is available. If such a determination is made, the sponsor’s income
-will not be deemed to the assistance unit.
-
-c.
-
-The income of the sponsor will not be deemed to the assistance unit if any of the
-following are true:
-1)
-
-The non-citizen is a qualified non-citizen who is not a legal permanent
-resident (i.e. refugees, asylees, parolees and Cuban and Haitian
-entrants).
-
-2)
-
-The non-citizen adjusted their status to legal permanent resident from
-refugee or asylee status.
-
-3)
-
-The non-citizen’s sponsor signed the sponsorship agreement prior to
-December 19, 1997.
-
-4)
-
-The non-citizen is a victim of battery or extreme cruelty.
-
-5)
-
-The total income of the non-citizen and non-citizen’s spouse, together
-with the total income of the sponsor and the sponsor’s spouse (who is
-also a sponsor) is less than one hundred twenty-five percent (125%) of
-the Federal Poverty Guidelines for the household size of both the noncitizen and the sponsor.
-
-6)
-
-The non-citizen earned or can be credited with forty (40) qualifying
-quarters of coverage as defined under Title II of the Social Security Act.
-
-41
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-7)
-
-d.
-
-9 CCR 2503-6
-
-The non-citizen was sponsored on an affidavit of support other than the
-I-864. Or the non-citizen entered in a nonfamily or employment
-classification that did not require the sponsor to sign form I-864.
-
-If it is determined that the legal immigrant received financial assistance benefits
-that were the responsibility of the sponsor, the State Department or county
-department may recover such funds from the sponsor or the legal immigrant via
-the following:
-1)
-
-Income assignments;
-
-2)
-
-State income tax refund offset;
-
-3)
-
-State lottery winnings offset; and,
-
-4)
-
-Administrative lien and attachment.
-
-Enforcement of duties under affidavit of support shall be the responsibility of the
-sponsored immigrant.
-6.
-
-B.
-
-Net income of persons who are required to be included in the assistance unit, but who
-are disqualified due to failure to meet citizenship, non-citizen status, lawful presence or
-Social Security Number requirements, or are ineligible as defined in section 3.604.2.C,
-shall be deemed to the assistance unit. Net income equals gross earned income minus
-employment disregards and employment incentives plus any unearned income.
-
-Countable Income
-All countable income, including earned and unearned income received, or unearned income an
-assistance unit expects to receive in the application month and any month following shall be used
-to determine eligibility for the assistance unit.
-
-3.605.2 Earned Income
-A.
-
-Earned In-kind Income
-Earned in-kind income shall be income resulting from the performance of services by the client for
-which he or she is compensated in shelter or other items in lieu of wages.
-
-B.
-
-Consideration of Earned Income
-“Earned Income” is still considered when:
-1.
-
-Money payments obligated to the employee are diverted to a third-party for the
-employee’s household or other expenses;
-
-2.
-
-Wages are being garnished by a court order.
-
-With the exception of contract employment, wages that are paid to an employee for a period for
-which services were rendered are considered available when paid rather than when earned,
-except that wages held at the request of the employee are considered income in the month they
-would otherwise have been paid.
-
-42
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-C.
-
-9 CCR 2503-6
-
-Income from Short-Term Employment
-Income received from short-term employment such as temporary employment (ninety days or
-less) and subsidized employment shall not be considered to determine eligibility as long as the
-client has not been terminated or has terminated the employment due to a fault of their own. This
-employment may be documented in the Individualized Plan.
-
-D.
-
-Countable Earned Income
-1.
-
-Consideration of Earned Income Against the Program Income Standard
-Unless otherwise specified, any earned income is countable and the applicable earned
-income must be considered against the applicable needs standard.
-
-2.
-
-Determining Earned Income
-The amount of wages, salaries, or commissions available to the client after the applicable
-disregards is considered the net earned income.
-
-3.
-
-Wages for Providing Home Care Allowance Services
-When a client is the care provider to another client for whom a Home Care Allowance
-(HCA) payment is made, the HCA payment is considered earned income to the client
-who is the care provider.
-
-4.
-
-Earned Income of a Dependent Child not in School
-All earned income of dependent children who are not students or making satisfactory
-progress in an equivalent activity shall be considered in determining eligibility for
-Colorado Works.
-
-E.
-
-Self-Employment Income
-1.
-
-A client who is self-employed shall have the following applied to their income:
-a.
-
-To determine the net profit of a self-employed client, deduct the cost of doing
-business from the gross income.
-1)
-
-These expenses include, but are not limited to, the rent of business
-premises (if working out of the home, the cost of the room used when
-doing business shall be used to determine the amount of the expense),
-wholesale cost of merchandise, utilities, interest, taxes, labor, and
-upkeep of necessary equipment.
-
-2)
-
-Depreciation of equipment shall not be considered as a business
-expense.
-
-3)
-
-The cost of and payments on the principal of loans for capital assets or
-durable goods shall not be considered as a business expense.
-
-4)
-
-Personal expenses such as personal income tax payments, lunches, and
-transportation to and from work are not business expenses, and are
-included in the applicable earned income disregards computation.
-
-43
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-b.
-
-2.
-
-9 CCR 2503-6
-
-Appropriate allowances for the cost of doing business for clients who are
-licensed, certified, or approved day care providers are:
-1)
-
-For the first child for whom day care is provided, deduct $55, and
-
-2)
-
-For each additional child deduct $22. If the client can document a cost of
-doing business that is greater than the amounts above, the procedure
-described in (a), above, shall be used.
-
-c.
-
-The result net profit amount, secured after the appropriate deductions described
-above, shall be treated as described in section 3.605.2.D, concerning earned
-income.
-
-d.
-
-An allowable form of verification for self-employment is a client’s ledger of
-income and expenses.
-
-Income Received From Self-Employment
-All self-employment income that is received regularly shall be considered income in the
-month it is received.
-
-3.
-
-Irregular Receipt of Self-Employment Income
-If receipt of self-employment income is irregular or varies significantly from month to
-month, it shall be averaged over a twelve-month period.
-
-4.
-
-Other Types of Self-Employment Income
-Some different types of self-employment income and how they are considered include,
-but are not limited to, the following:
-
-F.
-
-a.
-
-Self-employment income earned by the owner of a farm – shall be considered in
-the month it is received.
-
-b.
-
-Rental income – shall be considered as self-employment income only if the client
-actively manages the property for an average of twenty (20) hours per week or
-more.
-
-c.
-
-Board (to provide a person with regular meals only) payments shall be
-considered earned income in the month received to the extent that the board
-payment exceeds the maximum Food Assistance allotment for a one-person
-household per boarder and other documented expenses directly related to the
-provision of board.
-
-d.
-
-Room (to provide a person with lodging only) payments shall be considered
-earned income in the month received to the extent that the room payment
-exceeds other documented expenses directly related to the provision of room.
-
-e.
-
-Room and board payments shall be considered earned income in the month
-received to the extent that the payment for room and board exceeds the Food
-Assistance allotment for a one-person household per room and boarder and
-other documented expenses directly related to the provision of room and board.
-
-In-Kind Countable Earned Income
-
-44
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-1.
-
-2.
-
-3.
-
-G.
-
-9 CCR 2503-6
-
-Donated in-kind earned income is countable when it:
-a.
-
-Is regular and for a specific time period;
-
-b.
-
-Is a necessary service; and,
-
-c.
-
-If not performed by the client, someone would have to be hired to perform the
-service.
-
-If donated services meet these requirements, the value of these services is determined
-by:
-a.
-
-The going rate in the community; or
-
-b.
-
-From two employers of like services.
-
-The client shall be informed that the continuation of donation of services will result in an
-income deduction from the assistance grant after all applicable earned income disregards
-have been applied.
-
-In-Kind Income In Exchange For Employment
-In-kind income received in exchange for employment is employment income and shall have the
-appropriate earned income disregards applied to the total value of the income. The amount
-considered as earned income when a client is paid in-kind is the value of the item supplied. The
-current market value of the item is used if the value of the item is not provided.
-
-3.605.3 Countable Unearned Income
-Unless otherwise specified, any unearned income is countable and together with all other countable
-income of the client it must be considered against the applicable assistance program need and/or grant
-standards specified in the regulations covering the different programs.
-A.
-
-Countable Unearned Income
-Countable unearned income includes, but is not limited to the following, as well as other
-payments from any source, which can be construed to be a gain or benefit to the client and which
-are not earned income:
-1.
-
-Veteran’s Compensation and pension.
-
-2.
-
-Income from rental property is considered as unearned income where the client is not
-actively managing the property on an average of at least twenty (20) hours a week.
-Rental income is countable to the extent it exceeds allowable expenses. Allowable
-expenses are maintenance, taxes, management fees, interest on mortgage, and utilities
-paid. This shall not include the purchase of the rental property and payments on the
-principal of loans for rental property.
-
-3.
-
-Current spousal maintenance (also referred to as alimony).
-
-4.
-
-U.S. Department of Veterans Affairs (VA) educational assistance (G.I. Bill) payments or
-any other benefits which are conditional upon school attendance are income to the extent
-that they exceed expenses necessary for school attendance.
-
-45
-
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-Income Maintenance (Volume 3)
-
-B.
-
-9 CCR 2503-6
-
-5.
-
-Proceeds of a life insurance policy to the extent that they exceed the amount expended
-by the beneficiary for the purpose of the insured recipient's last illness and burial which
-are not covered by other benefits.
-
-6.
-
-Proceeds of a health insurance policy or personal injury lawsuit to the extent that they
-exceed the amount to be expended or required to be expended for medical care.
-
-7.
-
-Strike benefits.
-
-8.
-
-Income from jointly owned property - in a percentage at least equal to the percentage of
-ownership or, if receiving more than percentage of ownership, the actual amount
-received.
-
-9.
-
-Lease bonuses (oil or mineral) received by the lessor as an inducement to lease land for
-exploration are income in the month received.
-
-10.
-
-Oil or mineral royalties received by the lessor are income in the month received.
-
-11.
-
-Stepparent and non-citizens' sponsors' attributable income for Colorado Works cases.
-
-12.
-
-Amounts withheld from unearned income because of a garnishment are countable as
-unearned income.
-
-13.
-
-Loans or inheritances.
-
-14.
-
-Gifts or prizes.
-
-15.
-
-Dividends and interest received on savings bonds, leases, etc.
-
-16.
-
-Annuities, pensions, or retirements payments.
-
-17.
-
-Disability or survivor's benefits.
-
-18.
-
-Worker's Compensation payments.
-
-19.
-
-Unemployment Compensation.
-
-20.
-
-Social Security benefits.
-
-Periodic Payments
-The following types of periodic payments are countable unearned income:
-1.
-
-Annuities - payments calculated on an annual basis which are in the nature of returns on
-prior payments or services; they may be received from any source;
-
-2.
-
-Pension or retirement payments - payments to a client following retirement from
-employment, such payments made by a former employer or from any insurance or other
-public or private fund;
-
-3.
-
-Disability or survivor's benefits - payment to a client who has suffered injury or
-impairment, or to such client’s dependents or survivors; such payments may be made by
-an employer or from any insurance or other public or private fund;
-
-46
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-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-9 CCR 2503-6
-
-4.
-
-Worker's Compensation payments - payments awarded under federal and state law to an
-injured employee or to such employee's dependents; amounts included in such awards
-for medical, legal, or related expenses incurred by a client in connection with such claim
-are deducted in determining the amount of countable unearned income;
-
-5.
-
-Veteran compensation and pension - payments based on service in the armed forces;
-such payments may be made by the VA, another country, a state or local government, or
-other organization. Any portion of a VA pension that is paid to a veteran for support of a
-dependent shall be considered countable unearned income to the dependent rather than
-the veteran.
-
-6.
-
-Unemployment Compensation - payments in the nature of insurance for which one
-qualifies by reason of having been employed and which are financed by contributions
-made to a fund during periods of employment;
-
-7.
-
-Railroad retirement payments - payments, such as sick pay, annuities, pensions, and
-unemployment insurance benefits, which are paid by the Railroad Retirement Board
-(RRB) to a client who is or was a railroad worker, or to such worker's dependents or
-survivors;
-
-8.
-
-Social Security benefits - old age (or retirement), survivors, dependent, and disability
-insurance payments (OASDI or RSDI) made by the Social Security Administration; also
-included are special payments at age seventy-two (72) (Prouty Benefits and Black Lung
-benefits);
-
-9.
-
-Supplementary Medical Insurance Benefits (SMIB)- Social Security “Medicare”
-supplementary medical insurance benefit is a voluntary program, therefore the full Social
-Security award amount is counted as income to determine Colorado Works eligibility and
-to determine the amount of financial assistance to the client. The lump sum SMIB refund
-received by the “buy-in” recipient is exempt income as the client has previously been
-charged with that income.
-
-10.
-
-Military Allotment- A military allotment received on behalf of a client for those individuals
-included in the budget unit shall be considered as income in the month received. The
-military allotment received by the non-recipient spouse, parent, or stepparent on behalf of
-individuals not in the assistance unit shall be considered as income in the month received
-to the extent that such income exceeds the need standard concerning those persons not
-in the budget unit.
-
-3.605.4 Exempt Unearned Income
-A.
-
-For the purpose of determining eligibility for Colorado Works, the following shall be exempt from
-consideration as income:
-1.
-
-2.
-
-Income Tax refunds.
-a.
-
-The Earned Income Tax Credit (EITC) shall also be exempt for the month in
-which the EITC payment is received and for the following month.
-
-b.
-
-County departments shall provide assistance to help clients apply for and receive
-the federal and State EITC.
-
-Third-Party Payments- The value of any third-party payment for medical care or social
-services paid on behalf of a client.
-
-47
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-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-B.
-
-9 CCR 2503-6
-
-3.
-
-Emergency Assistance- Emergency Assistance received on a one-time basis in cash or
-in kind from other agencies and organizations.
-
-4.
-
-Energy Assistance- Home energy assistance granted to a client by a private non-profit
-organization or home energy supplier, whether in kind, by voucher, or vendor payment.
-
-5.
-
-Personal Care and Home Care- Personal care or home care allowances paid to a
-recipient or non-recipient spouse, parent, stepparent, or child, from a federal, state, or
-local government program for in-home supportive services (attendant, chore,
-housekeeping) shall be exempt as income in determining the amount of attributable nonrecipient spouse, non-recipient parent, or non-recipient stepparent income. However, it
-shall be classified as employment income in determining the attendant's own eligibility for
-assistance.
-
-6.
-
-VA Aid and Attendance- VA Aid and Attendance may be paid to qualified veterans in
-addition to their regular VA benefit. VA Aid and Attendance is exempt income to the
-applicant or recipient to determine eligibility for public assistance in the applicant's or
-recipient's own home, if the VA Aid and Attendance is used for medical supplies and
-medical or attendant care not covered by Medicare or Medicaid, or other health insurance
-programs. The remainder is deducted from the assistance grant. (Amounts for attendant
-care are treated in the same manner as specified in the preceding paragraph.)
-
-7.
-
-General Assistance- General Assistance granted to a client by the county department
-prior to or as a supplement to categorical assistance.
-
-8.
-
-Crime Victims Compensation Act.
-
-General Income Exemptions – Exemptions from Consideration as Income
-For the purpose of determining eligibility for Colorado Works, the following shall be exempt from
-consideration as income:
-1.
-
-A bona fide loan. Bona fide loans are loans, either private or commercial, which have a
-repayment agreement.
-
-2.
-
-Benefits received under the Older Americans Act, Nutrition Program for the Elderly.
-
-3.
-
-The value of supplemental food assistance received under the special food services
-program for children provided for in the National School Lunch Act and under the Child
-Nutrition Act, including benefits received from the special supplemental food program for
-Women, Infants and Children (WIC).
-
-4.
-
-Home produce utilized for personal consumption.
-
-5.
-
-Payments received under Title II of the Uniform Reconciliation Act and Real Property
-Acquisition Policies Act; relocation payments to a displaced homeowner toward the
-purchase of a replacement dwelling are considered exempt for up to six (6) months.
-
-6.
-
-Experimental Housing Allowance Program (EHAP) payments made by HUD under
-Section 23 of the U.S. Housing Act.
-
-7.
-
-Payments from Indian judgment funds and tribal funds held in trust by the Secretary of
-the Interior and/or distributed per capita; and the initial purchase made with such funds.
-
-48
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-9 CCR 2503-6
-
-8.
-
-Distributions from a native corporation formed pursuant to the Alaska Native Claims
-Settlement Act (ANCSA) which are in the form of: cash payments up to an amount not to
-exceed $2,000 per individual per calendar year; stock; a partnership interest; or an
-interest in a settlement trust. Cash payments, up to $2,000, received by a client in one
-calendar year is excluded as income.
-
-9.
-
-Assistance from other agencies or organizations that are provided for items not included
-in the need standard or do not duplicate a component of the need standard in total.
-
-10.
-
-Major disaster and emergency assistance provided to clients, and comparable disaster
-assistance provided to states, local governments, and disaster assistance organizations.
-
-11.
-
-A child receiving foster care or kinship care funds under Title IV of the Social Security Act
-shall be excluded from the assistance unit and his or her income shall be exempt from
-consideration for Colorado Works eligibility and payment.
-
-12.
-
-Payments to volunteers serving as foster grandparents, senior health aids, or senior
-companions, and to persons serving in the Service Corps of Retired Executives (SCORE)
-and Active Corps of Executives (ACE) and any other program under Title I (AmeriCorps
-VISTA) when the value of all such payments adjusted to reflect the number of hours such
-volunteers are serving is not equivalent to or greater than the minimum wage, and Title II
-and Title III of the Domestic Volunteer Services Act.
-
-13.
-
-Training allowances or training scholarships granted by Workforce Innovation and
-Opportunity (WIOA)or other programs to enable any individual to participate in a training
-program is exempt.
-
-14.
-
-Payments received from the Youth Incentive Entitlement Pilot Projects (YIEPP), the
-Youth Community Conservation and Improvement Projects (YCCIP), and the Youth
-Employment and Training Programs (YETP) under the Youth Employment and
-Demonstration Project Act (YEDPA).
-
-15.
-
-Social Security benefit payments and the accrued amount thereof paid to a client when
-an individual plan for self-care and/or self-support has been developed under the
-following conditions:
-a.
-
-Supplemental Security Income (SSI) permits such disregard under such
-developed plan for self-care-support goal, and
-
-b.
-
-Assurance exists that the funds involved will not be for purposes other than those
-intended.
-
-16.
-
-Income received through the Workforce Innovation and Opportunity Act, including
-supportive services through that program.
-
-17.
-
-Money received from the Radiation Exposure Compensation Trust Fund, P.L. No. 101426 as amended by P.L. No. 101-510.
-
-18.
-
-Reimbursement of out-of-pocket expenses.
-
-19.
-
-Payments received by clients because of their status as victims of Nazi persecution
-pursuant to P.L. No. 103-286.
-
-20.
-
-Individual Development Accounts (IDAs).
-
-49
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-9 CCR 2503-6
-
-21.
-
-Distributions from retirement savings accounts.
-
-22.
-
-Distributions from health care savings accounts.
-
-23.
-
-Income paid to children of Vietnam veterans who were born with spina bifida pursuant to
-P. L. No. 104-204.
-
-24.
-
-Income of A client who is attending school (student in a secondary education or
-undergraduate degree program) shall be considered as follows:
-a.
-
-Income received from a college work-study program grant shall be exempt.
-
-b.
-
-All earned income, including earned income from WIOA, that is received by a
-dependent child who is a full-time student or a part-time student who is not a
-fulltime employee shall be disregarded.
-
-25.
-
-Educational savings accounts.
-
-26.
-
-Educational grants, loans, stipends, and/or scholarships.
-
-27.
-
-A client receiving SSI payments shall be excluded from the assistance unit and his or her
-income shall be exempt from consideration for Colorado works eligibility and payment.
-
-28.
-
-Refugee resettlement funds and reception and placement money.
-
-29.
-
-Interim Cash Payment received through the Colorado Refugee Services Program.
-
-30.
-
-Life or disability insurance policies that may have a cash value taken.
-
-31.
-
-The benefits provided from the Low-Income Energy Assistance Program (LEAP).
-
-32.
-
-A child receiving subsidized adoption funds shall be excluded from the assistance unit
-and his or her income shall be exempt from consideration for Colorado Works eligibility
-and payment.
-
-33.
-
-Income that is exempt shall also be exempt if received as a lump sum or excluded if
-designated or legally obligated for legal fees related to obtaining the lump sum payment,
-medical bills, funeral and burial expenses, or income taxes.
-
-34.
-
-Income tax credits when identified as exempt by the state or federal government.
-
-35.
-
-Wages earned through subsidized employment programs including employment,
-apprenticeships, on-the-job training, and transitional jobs.
-
-3.605.5 Child Support Income
-A.
-
-At initial application, current child support payments received by the assistance unit shall be
-considered income and counted against the need standard to determine eligibility.
-
-B.
-
-Once found eligible, child support income is excluded in the basic cash assistance grant
-calculation.
-
-C.
-
-For purposes of redetermination (RRR):
-
-50
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-9 CCR 2503-6
-
-1.
-
-Inconsistent child support payments are not countable. Child support payments are
-considered consistent when received in all six (6) of the six (6) previous months.
-
-2.
-
-Once consistency of payments has been established, current child support is averaged
-over the previous six (6) months. If that averaged amount is $500 or less for the
-household, the child support income is disregarded for both eligibility and grant
-calculation. If that amount is over $500 for the household, it is counted, in combination
-with other income, against the need standard to determine continued eligibility.
-
-3.
-
-If found eligible, the child support income is disregarded for basic cash assistance grant
-calculation.
-
-D.
-
-Child support arrears are exempt income and are not used for eligibility or grant calculation.
-
-3.606
-
-Colorado Works Certification and Benefit Calculation
-
-3.606.1 Basic Cash Assistance
-A.
-
-Payment of Basic Cash Assistance (BCA) Grants
-Counties or groups of county departments shall not reduce the BCA grant, restrict eligibility, or
-impose sanctions that are inconsistent with state and federal laws or the rules of this Section
-3.606.1.
-
-B.
-
-Unreimbursed Public Assistance
-The BCA grant shall be considered part of the Unreimbursed Public Assistance (UPA) as defined
-in the Child Support Services rule manual at 9 CCR 2504-1 Section 6.002.
-
-C.
-
-Recipient's Right to Decide
-In accordance with the principle of the unrestricted money payment, a client shall have the right to
-decide how any payment received shall be spent.
-
-D.
-
-Vendor Payments for client Protection
-The county may pay the basic cash assistance grant to vendors on behalf of the client with the
-client's voluntary agreement. In all other situations the payment shall be made to the client.
-
-E.
-
-Considering Income for Eligibility and Payment
-Applications received will be certified for six (6) consecutive months beginning the first month the
-assistance unit is found eligible for basic cash assistance. The certification period consists of the
-calendar months beginning with the first day of the budget month (day/month the application is
-received and the assistance unit is found eligible) and ending with the last day of the sixth (6th)
-month (unless found ineligible) in which financial assistance is provided and that is intended to
-cover the ongoing basic needs of the assistance unit.
-For eligibility and payment, income shall be considered in the month of application and
-throughout the certification period. This is also true for redetermination and establishing a new
-certification period going forward. The following calculation shall be used: countable earned
-income minus applicable earned income disregards, plus countable unearned income.
-
-F.
-
-Determining Eligibility for Basic Cash Assistance Grant Based on the Need Standard
-
-51
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-Income Maintenance (Volume 3)
-
-9 CCR 2503-6
-
-The State department shall annually review and as necessary update the need standard to reflect
-the current economic situations in the state.
-The basic cash assistance grant shall be determined based upon income using the following
-need standard. If the client has zero income the following cash payment shall be received based
-upon those included in the assistance unit:
-COLORADO WORKS STANDARDS OF ASSISTANCE CHART
-Number of
-Children
-No Caretaker
-
-One Caretaker
-
-Two Caretakers
-
-G.
-
-0
-
-1
-
-2
-
-3
-
-4
-
-5
-
-6
-
-7
-
-8
-
-9
-
-10
-
-Each
-Additional
-Child
-
-Need
-Standard
-
-0
-
-117
-
-245
-
-368
-
-490
-
-587
-
-678
-
-755
-
-830
-
-904
-
-977
-
-67
-
-Grant
-Standard
-
-0
-
-165
-
-345
-
-518
-
-691
-
-829
-
-957
-
-1066
-
-1170
-
-1276
-
-1393
-
-86
-
-Need
-Standard
-
-253
-
-331
-
-421
-
-510
-
-605
-
-697
-
-770
-
-844
-
-920
-
-992
-
-1065
-
-67
-
-Grant
-Standard
-
-357
-
-466
-
-592
-
-719
-
-853
-
-984
-
-1086
-
-1191
-
-1297
-
-1400
-
-1502
-
-86
-
-Need
-Standard
-
-357
-
-439
-
-533
-
-628
-
-716
-
-787
-
-861
-
-937
-
-1009
-
-1082
-
-1155
-
-67
-
-Grant
-Standard
-
-503
-
-619
-
-752
-
-885
-
-1009
-
-1110
-
-1215
-
-1323
-
-1424
-
-1525
-
-1629
-
-86
-
-Pregnancy Allowance
-Pregnant parents are eligible for the basic cash assistance grant plus a ten-dollar ($10.00)
-pregnancy allowance. The client is eligible for the pregnancy allowance through the month in
-which the pregnancy ends.
-
-H.
-
-Gross Income
-To be eligible for Colorado Works basic cash assistance, the countable gross earned and
-unearned income together shall not exceed the need standard for the household size after
-disregards have been applied in accordance with section 3.606.2.
-
-I.
-
-Calculation of the Basic Cash Assistance Grant for an Eligible Assistance Unit
-To calculate the basic cash assistance amount for an eligible assistance unit:
-
-J.
-
-1.
-
-Deduct the earned income disregard(s) from the gross earned income, received or
-expected to be received by members of the assistance unit, in the month of application;
-
-2.
-
-Add to the result from step 1, above, the unearned income received or expected to be
-received by members of the assistance unit;
-
-3.
-
-Deduct the total from step 2, above, from the grant amount for the household size.
-
-Reporting of Earned Income
-When the assistance unit reports earned income:
-1.
-
-Apply the appropriate earned income disregards to the gross earned income of each
-employed member of the budgetary unit as described in Section 3.606.2; and,
-
-52
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-K.
-
-9 CCR 2503-6
-
-2.
-
-Add the unearned income received by each member of the budgetary unit; and,
-
-3.
-
-Compare the total to the need standard for the household size.
-
-4.
-
-If the net countable income equals or exceeds the need standard, the assistance unit is
-not eligible for Colorado Works basic cash assistance.
-
-Calculation of an Eligible Assistance Unit
-To calculate the basic cash assistance grant amount for an eligible assistance unit:
-1.
-
-Deduct the net countable income from the grant amount for the assistance unit; and,
-
-2.
-
-Drop the cents, and the remainder is the authorized grant.
-
-3.606.2 Earned Income Disregards
-For all cases with eligible members that have earned income (not including disqualified individuals),
-payment and eligibility will be determined using the income disregards as described below. All payments
-shall be calculated by using applicable disregards.
-A.
-
-Earned Income Disregards Calculations
-The following earned income disregards shall be applied to gross wages for clients:
-1.
-
-At application, the gross earned income minus the ninety dollar ($90.00) earned income
-disregard, plus any countable unearned income received or expected to be received by
-members of the assistance unit, shall not exceed the need standard for the household
-size and shall be applied. If income does not exceed the need standard for the household
-size, a one hundred percent (100%) disregard shall be applied to earned income for the
-first certification period to determine the payment amount. after the first certification
-period, a sixty seven percent (67%) disregard shall be applied to determine the payment
-amount.
-
-2.
-
-For an assistance unit currently receiving basic cash assistance:
-a.
-
-A new source of earned income shall receive a one hundred percent (100%)
-earned income disregard for the first certification period that the income impacts
-according to section 3.606.3.
-
-b.
-
-A current source of earned income shall receive the sixty seven (67%) disregard.
-
-3.606.3 Changes and Reporting Requirements
-Colorado Works clients shall report information concerning income, household composition, and
-residency. The income reporting standard for an assistance unit is provided on the change report form
-and in noticing. Information on such changes may be reported to the county of residence by use of a
-change report form, the client’s redetermination packet, and/or by making the county aware of the
-change. Changes shall be reported by the tenth (10th) of the month following the month the change
-occurred. The county must act on all changes reported within ten (10) calendar days of the report by
-entering the change into the statewide automated system. By acting on changes, the county department
-shall determine eligibility.
-A.
-
-Negative and positive changes during the certification period
-
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-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-9 CCR 2503-6
-
-1.
-
-If the assistance unit will receive an increase in grant payments as indicated by the total
-net change of all changes in the month, the increase will affect the case the month
-following the date the change is reported and verified.
-
-2.
-
-If the assistance unit will receive a decrease in grant payments, the grant payment
-amount will remain the same until redetermination when a new payment amount will be
-set for the upcoming certification period or the case discontinues.
-The only decreases that occur during the certification period are identified in section
-3.606.3.C below. These changes take effect after timely noticing is applied.
-
-B.
-
-Limited reporting standard
-A recipient with an established certification period must report certain changes in household
-circumstances by the tenth (10th) day of the month following the month in which the change
-occurred. The client will be notified in writing of the changes they are required to report. The
-county worker must act on reported changes within ten (10) calendar days from the date the
-change is reported by entering the change into the statewide automated system. The following
-changes must be reported during the certification period:
-1.
-
-C.
-
-When the income of the assistance unit exceeds the income reporting standard for that
-assistance unit.
-a.
-
-The reporting standard for earned income is a reflection of the amount of earned
-income the household could receive and still be eligible for Colorado Works after
-applicable disregards are applied (calculated by dividing the need standard for
-the household by .33).
-
-b.
-
-The reporting standard for unearned income is the need standard for the
-household, as identified in 3.606.1.F.
-
-2.
-
-When the assistance unit receives earned or unearned income from a new source.
-
-3.
-
-When a change to the number of people living in the home occurs.
-
-4.
-
-When the assistance unit no longer resides at the address previously reported to the
-county department.
-
-Ongoing eligibility and the effect of negative and positive changes to the certification period
-The certification period does not guarantee ongoing eligibility. To remain eligible, the primary
-eligibility criteria must still be met, including remaining below the need standard. All changes are
-compared against the assistance unit size and grant amount.
-1.
-
-A negative change may result in the reduction of payment or case closure before the end
-of the certification period. When a negative change occurs, the reduction of payment or
-closure shall take place after the appropriate noticing timeframe as identified in 3.609.1.
-A negative change shall include, but is not limited to:
-a.
-
-An increase in income in which the budgetary unit’s total countable income is
-over the need standard after applicable income disregards are applied.
-
-b.
-
-Income is received from a new source which results in the exclusion of a member
-of the assistance unit.
-
-54
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-c.
-
-9 CCR 2503-6
-
-A member leaves the household.
-1)
-
-If the member leaving the home is the only dependent child on the case.
-
-2)
-
-If a pregnancy ends.
-
-3)
-
-When a government agency provides information that a dependent child
-is no longer in the household and the child’s new household is in need of
-services from another program (such as child support) with a different
-caretaker or parent.
-
-4)
-
-When a member leaves the home and applies for assistance and/or
-someone is requesting assistance for that member during the original
-assistance unit’s certification period:
-
-5)
-
-a)
-
-A new assistance unit may apply for the member as he/she
-leaves the original assistance unit but the member shall not
-receive a portion of the new assistance unit’s basic cash
-assistance grant until benefits have been terminated for that
-member in the original assistance unit.
-
-b)
-
-The individual is considered to be a part of the original
-assistance and budgetary units during the noticing period. After
-the noticing period, the grant amount for the original assistance
-unit will be recalculated using the new household size and
-benefits will continue as long as eligibility continues for that
-assistance unit until the certification period ends.
-
-When a member requests assistance to stop for him or herself, or a
-caretaker who remains a part of the original assistance unit requests that
-they stop receiving benefits for another member who has left the home.
-when a member of the assistance unit or budgetary unit leaves the
-home, the individual’s income shall be excluded beginning the first day of
-the month following the month the individual reported they left the home
-and the basic cash assistance grant adjusted accordingly.
-
-2.
-
-d.
-
-An eighteen-year-old who is the only dependent child graduates from high school
-or stops attending school.
-
-e.
-
-Death of a client.
-
-f.
-
-Imposing sanctions.
-
-g.
-
-Imposing actual intentional program violation (IPV) penalties.
-
-A positive change results in a payment increase and shall be effective the month
-following the month the change is reported and verified. Payments shall be adjusted
-accordingly and provided to the recipient timely. A positive change shall include, but is
-not limited to:
-a.
-
-Termination of or decrease in income.
-
-b.
-
-Adding a member to the assistance unit.
-
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-
-3.
-
-D.
-
-9 CCR 2503-6
-
-1)
-
-The initial application for Colorado Works is sufficient to cover all
-members who join the assistance unit after initial application. Verification
-is still needed to establish eligibility for the member joining the assistance
-unit.
-
-2)
-
-A new member(s) who is added to an existing assistance unit shall be
-added effective the first day of the following month that the assistance
-unit reported the change and provided any necessary verifications.
-a)
-
-If the new member has income, it will be considered income to
-the assistance unit in the month that the new member joined the
-household. The income shall be used to determine eligibility and
-payment according to the negative and positive change rules in
-section 3.606.34.a.
-
-b)
-
-If the new member is a newborn, the newborn shall be added
-effective the first day of the month of birth and documentation
-shall consist of the birth date and a Social Security Number
-(SSN) or an SSN application. No other documentation is
-required to add a baby to the assistance unit after the birth is
-reported unless there is questionable information regarding the
-relationship to a parent(s), citizenship, or qualified noncitizenship status.
-
-c)
-
-Adding a pregnancy.
-
-d.
-
-Providing individual level verification.
-
-e.
-
-A member who was previously ineligible becomes eligible.
-
-Positive and negative changes may occur at the same time. All changes will be taken into
-consideration and the net result of the change will be compared to the client’s base
-eligibility determination. The comparison will be used to determine if there is a negative
-change, positive change, or complete ineligibility to the assistance unit’s basic cash
-assistance grant.
-
-At any time while receiving basic cash assistance, if there is questionable information regarding
-the circumstances of a household, the county worker can request verification of the questionable
-information. If the client fails to submit verification of the questionable information, grant payments
-may be discontinued.
-
-3.606.4 Redetermination of Eligibility
-A.
-
-Filing a redetermination (RRR) to continue benefits
-Colorado Works clients shall file their RRR with the county by the 15th of the month as specified
-in the RRR packet. A client’s failure to file a RRR timely may delay the determination of benefits.
-All RRR forms must be entered into the statewide automated system within two (2) business
-days. Complete forms received timely must be acted upon by the county department by the last
-day of the month in which the forms were due. Complete forms received between the 16th and
-the last day of the month the RRR is due must be approved as soon as possible. The county
-department will have ten (10) days to act on such redeterminations, to include scheduling and
-conducting the interview and requesting any necessary verification. The county must make an
-eligibility decision on redetermination forms received between the 16th and the last day of the
-month within thirty (30) days from receipt of such RRR.
-
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-9 CCR 2503-6
-
-An interview for Colorado Works basic cash assistance cases shall take place annually and
-necessary verifications must be requested and obtained at each RRR to determine whether the
-client continues to be eligible for Colorado Works.
-B.
-
-Redetermination procedures- mail out
-Forms that the client is required to complete shall be mailed to the client at least thirty (30)
-calendar days prior to the first of the month in which eligibility redetermination is due. This is
-considered the prior notice period. The following procedures relate to mail-out redetermination:
-
-C.
-
-1.
-
-An RRR packet shall be mailed to the client which identifies the RRR due date and the
-date when Colorado Works grant payments will stop if the RRR packet is not returned;
-
-2.
-
-The RRR packet shall be completed, signed by the client, and returned to the county
-department no later than the 15th of the month in which the client’s existing certification
-ends; and,
-
-3.
-
-When the client is unable to complete the RRR packet due to physical, mental, or
-emotional disabilities, and has no one to help, the county department shall either assist
-the client or refer the client to a legal or other resource.
-
-4.
-
-When initial arrangements or a change in arrangements are being made, an extension of
-up to thirty (30) days may be allowed. The assistance and/or referral action of the county
-department shall be recorded in the case record.
-
-Complete RRR packet
-A complete RRR packet has all questions applicable to Colorado Works and/or specific to the
-household’s circumstances completed by the client and is signed by the client or authorized
-representative.
-
-D.
-
-Redetermination process
-The redetermination process shall consist of all activity from the date the RRR is received from
-the client until a determination concerning eligibility is made.
-During the redetermination process, the county worker shall:
-1.
-
-Date the RRR packet to record the date of receipt by the county department.
-
-2.
-
-Enter the RRR into the statewide automated system within two (2) business days.
-
-3.
-
-Schedule and conduct an interview when required. The client shall be provided with
-written notice of a scheduled interview in accordance with section 3.602.1.E.1.c. When
-the client does not keep the appointment and does not request an alternate time or
-arrangement, as described in section 3.602.1.E.1.c, grant payments will be terminated at
-the end of the current certification period.
-
-4.
-
-Explain the purpose of the interview and the use of the information supplied by the client
-on the RRR form and any additional required forms.
-
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-E.
-
-9 CCR 2503-6
-
-5.
-
-Inform all clients in writing at the eligibility redetermination that Social Security Numbers
-for all clients will be used to request and exchange information with other agencies as
-part of the eligibility process, including the Department of Labor and Employment (State
-Wage And Unemployment Data), Social Security Administration, and Internal Revenue
-Service (unearned income). IEVS information may also be exchanged with other state or
-federal agencies administering public assistance programs, including the Department of
-Labor and Employment, Child Support Services, and the Social Security Administration.
-
-6.
-
-Have the client complete the forms or complete the form on behalf of the client.
-
-7.
-
-Explain the appeal rights to the client.
-
-8.
-
-Witness the signature of the client and sign as a person who helped complete the forms,
-when applicable.
-
-9.
-
-Review documents, verifications, and any other information supplied by the client with the
-client in order to obtain clarification if needed. Information requested shall include:
-a.
-
-Income.
-
-b.
-
-Other eligibility factors to be verified unless satisfactory documentation is in the
-case record.
-
-Redetermination not returned
-When the RRR packet is not returned by the 15th of the RRR due month, discontinuation of
-benefits shall occur at the end of the RRR due month. This action to discontinue shall not be
-taken, however, if the completed and signed forms are returned between the 16th and the end of
-the RRR due month as defined in section 3.606.4.A. If no response is received by the end of the
-RRR due month, the case shall be discontinued upon the effective date of the notice sent to the
-client with the RRR packet.
-
-F.
-
-Incomplete redetermination packets
-If the RRR packet is received by the first filing deadline, but it is incomplete, a correction notice
-shall be sent to the client advising the client that the RRR packet is incomplete and must be
-corrected by the correction deadline to avoid termination and/or the county department shall work
-with the client to complete the packet.
-
-G.
-
-Termination of benefits and adequate notice
-When the information provided in the RRR packet, or otherwise provided by the client, is the
-basis for reduction in the amount of assistance or in termination of assistance, such actions shall
-be taken after adequate notice, as defined in section 3.601 and described in 3.609.1,C and D, is
-given.
-
-H.
-
-Termination of benefits and adequate notice redetermination requirements
-A redetermination of eligibility shall be complete for Colorado Works when:
-1.
-
-All necessary forms concerning the redetermination are completed and have been
-reviewed;
-
-2.
-
-Requested verification is obtained and recorded in the case file;
-
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-Income Maintenance (Volume 3)
-
-I.
-
-9 CCR 2503-6
-
-3.
-
-All factors are evaluated and decisions on continued eligibility and amount of money
-payment have been reached; and
-
-4.
-
-Notice of change in payment, if applicable, is completed and mailed to the client. A stateapproved notice of proposed action form shall be used for positive actions and for
-negative or adverse actions.
-
-Reopening and reinstatements
-Cases may be reopened prior to the effective date of closure with good cause and may be
-reinstated if closed within thirty (30) calendar days or less.
-1.
-
-2.
-
-Reinstatement in lieu of an application- when a request is made for the category of
-assistance from which the client was discontinued within thirty (30) calendar days
-following the effective date of discontinuation, the following procedures shall be followed:
-a.
-
-A RRR packet or current application shall be in the case file or completed and
-signed by the client;
-
-b.
-
-Income shall be verified;
-
-c.
-
-Other eligibility factors shall be verified unless satisfactory documentation is in
-the case record;
-
-d.
-
-Eligibility determination shall be completed and appropriate actions shall be
-taken.
-
-Reopening in lieu of an application- when a client requests assistance prior to the
-effective date of the client’s discontinuation from assistance, the following procedures
-shall be followed:
-a.
-
-A RRR packet or current application form shall be in the case file or completed
-and signed by the client;
-
-b.
-
-Income shall be verified;
-
-c.
-
-Other eligibility factors shall be verified unless satisfactory documentation is in
-the case record;
-
-d.
-
-Eligibility determination shall be completed and appropriate actions shall be
-taken;
-
-e.
-
-If reopened, child support services and other appropriate units shall be so
-advised.
-
-3.606.5 Clients Moving to a New County of Residence
-A.
-
-Colorado Works clients transferring from one county to another shall remain eligible for the basic
-cash assistance and shall continue to be eligible. For work required individuals, the client remains
-eligible until assessed by the new county, in accordance with the timeframes outlined in
-3.608.1.A. The benefits shall continue without interruption.
-
-B.
-
-Clients who are transferring to another county are required to continue to report changes and the
-transferring county shall continue to process the client's changes during the period in which the
-transfer to another county is in process.
-
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-Income Maintenance (Volume 3)
-
-9 CCR 2503-6
-
-1.
-
-Clients shall continue to report changes by the tenth (10th) of the month following the
-month in which the change occurred and complete redeterminations as required by the
-paying county; and,
-
-2.
-
-The paying county shall continue its activities; and,
-
-3.
-
-The paying county shall resolve all issues concerning the client’s continuing eligibility or
-termination before the transfer is completed; and,
-
-4.
-
-The paying county shall assure that the case is updated in a timely way to enable
-acceptance by the county of residence.
-
-3.606.6 Time Limits and Extensions
-A.
-
-Time Limits
-Each month for which a basic cash assistance grant is received shall be counted toward the time
-limits of adult members who are part of the assistance unit regardless of whether or not the adult
-is eligible to receive assistance. Any assistance unit containing an adult may receive Federal
-TANF grant payments for up to sixty (60) cumulative months.
-
-B.
-
-Time Limits and Sanction Periods
-Months in which a partial Colorado Works payment was made due to a sanction shall be counted
-toward the time limit.
-
-C.
-
-Extensions
-An assistance unit containing an individual who has received Federal TANF assistance in
-Colorado or another state as an adult for sixty (60) or more cumulative months shall not be
-eligible for Colorado Works assistance in Colorado unless the household demonstrates good
-cause as defined in section 3.601 and outlined in 3.608.3. The county department must reference
-criteria in the state prescribed extension determination form to approve or deny an extension
-request for a client who is requesting to receive TANF beyond sixty (60) months. Assistance units
-that contain disqualified members shall not be eligible for consideration of an extension.
-1.
-
-The State Department shall send a notification to clients who are approaching the sixty
-(60) month time limit on Federal TANF assistance. The county department shall make all
-reasonable efforts to contact these clients by phone or in person to explain the extension
-process and to accept a request for an extension.
-
-2.
-
-All clients shall have the opportunity to request an extension. Requests for an extension
-of Colorado Works shall be made in the county of residence and may be made
-electronically, in person, by phone, or in writing. County departments must enter the
-client’s request, and the good cause reason for the extension request, into CBMS within
-ten (10) calendar days.
-
-3.
-
-The county department shall have (30) calendar days after the receipt of a request for an
-extension to make a decision whether to grant or deny the extension in accordance with
-the criteria in the state prescribed form. The county shall send a notice to the client
-concerning the decision by the thirtieth (30th)) calendar day of receiving the request.
-
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-Income Maintenance (Volume 3)
-
-D.
-
-9 CCR 2503-6
-
-4.
-
-If the request for an extension is denied, the notice shall include the reason for the denial
-and the right to appeal the decision per Section 3.609.6. A client who has been granted
-an extension may request an additional extension prior to the end of the current
-extension period. If a timely request is not made, the county department may grant an
-extension if the client is able to demonstrate good cause. Good cause shall be
-determined by the county department and cannot be appealed.
-
-5.
-
-An extension may be granted for up to six (6) months. A client who has been granted an
-extension may request additional extensions, but the request must be made prior to the
-end of the current extension period.
-
-6.
-
-Nothing in these rules shall be construed to prohibit a former client from requesting a
-hardship or domestic violence extension, after the lapse of the sixty (60) month lifetime
-limit, when new hardship or domestic violence factors occur, to the extent permissible
-under State and federal law.
-
-7.
-
-The client receiving an extension shall meet with the county worker on a regular basis to
-address specific needs and to identify assistance in an Individualized Plan.
-
-Hardship
-A household may be considered to be experiencing a hardship if one or more of the following
-prevents the adult member(s) of the assistance unit from securing or maintaining employment:
-
-E.
-
-1.
-
-Disability of the caretaker, his or her spouse, the dependent child(ren) or immediate
-relative for whom the caretaker is the primary caregiver, pursuant to the definition of
-“persons with disabilities” at Section 3.604.3; or,
-
-2.
-
-Involvement in the judicial system because a member of the assistance unit has an
-existing case; or,
-
-3.
-
-Family instability which may include a caretaker with the proven inability to maintain
-stable employment or inability of the caretaker to care for the children in his or her own
-home or in the home of a relative; or,
-
-4.
-
-Inadequate or unavailable:
-a.
-
-Child care,
-
-b.
-
-Housing,
-
-c.
-
-Transportation,
-
-d.
-
-Employment opportunities, or,
-
-e.
-
-Other hardship reasons listed on the state prescribed extension determination
-form.
-
-Hardship Due to Domestic Violence
-Domestic violence extension may be granted when domestic violence problems, as defined at
-Section 3.604.5 prevent the adult member(s) from participating in work activities or securing
-employment.
-
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-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-F.
-
-9 CCR 2503-6
-
-Exemptions From the 60-Month Time Limit
-Any month of receipt of assistance by an adult while living in Indian Country, or a Native Alaskan
-village where at least fifty percent (50%) of the adults were not employed, shall not be counted
-toward the sixty (60) cumulative months of Federal TANF assistance. Indian Country is defined in
-18 U.S.C. Section 1151.
-
-G.
-
-Twenty Percent (20%) Allocation of Extensions
-Up to twenty percent (20%) of the Statewide caseload receiving Colorado Works may be granted
-an extension beyond the sixty (60) month time limit due to hardship or domestic violence. At any
-point that records indicate that the State will exceed the twenty percent (20%) maximum on the
-number of Colorado Works extensions granted to assistance units, the State shall determine if
-this is due to the provision of federally recognized good cause domestic violence waivers. If the
-records support this determination, as allowed by federal law, the State shall provide information
-to the federal government to demonstrate that the reason for exceeding the twenty percent (20%)
-maximum was due to granting federally recognized good cause domestic violence waivers. The
-State Department has the sole responsibility of monitoring this federal limit. County departments
-are not restricted to a certain number of extensions unless the Statewide limit is reached.
-
-3.606.7 Funeral, Burial, and Cremation Expenses
-A.
-
-B.
-
-Death Reimbursement
-1.
-
-A death reimbursement benefit shall in some circumstances be available to assist in
-paying for the funeral, burial, and cremation expenses of a deceased client. Death
-reimbursement benefits paid for the disposition of a deceased client under these rules
-are not entitlements. Benefit levels for such dispositions shall be adjusted by the State
-Department in order to contain expenditures within the available legislative appropriation.
-
-2.
-
-The total amount of death reimbursement benefit paid by the county department pursuant
-to this section shall not exceed one thousand five hundred dollars ($1,500). To be eligible
-for a state contribution, the total combined reasonable charges (including those paid by
-the deceased client’s estate, family, State Department funds, or any other source) for
-services, property, and supplies shall not exceed two thousand five hundred dollars
-($2,500).
-
-3.
-
-A birth certificate and death certificate shall not be required for a burial in the
-circumstances of a stillborn child or a pregnancy ended by miscarriage. Documentation
-from a medical provider and/or a collateral contact shall take the place of the birth and
-death certificate.
-
-When State Funds may be Contributed
-A death reimbursement benefit covering reasonable funeral expenses or reasonable cremation or
-burial expenses or any combination thereof shall be paid by the State Department for a deceased
-client, subject to state appropriations, as follows:
-1.
-
-The expenses are incurred for the disposition of a deceased client who received
-Colorado Works while alive; and,
-
-2.
-
-The deceased client’s estate is insufficient to pay all or part of such expenses (a
-deceased client’s estate is defined as property of any kind that the deceased client
-owned at the time of death); and,
-
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-Income Maintenance (Volume 3)
-
-C.
-
-9 CCR 2503-6
-
-3.
-
-The county department shall issue a written authorization and itemization of the services,
-property, and supplies for which the State Department funds shall be contributed. The
-total charge and amount of State Department funds authorized for each item shall be
-included in this authorization; and,
-
-4.
-
-The total combined reasonable charges (including those paid by the deceased client’s
-estate, family, State Department funds, or any other source) for services, property, and
-supplies which have been authorized by the county department shall not exceed two
-thousand five hundred dollars ($2,500).
-
-Disposition by Funeral, Burial, and Cremation
-In those cases where disposition of a deceased client is by funeral/memorial service and burial or
-cremation, the county department may authorize that State Department funds shall be contributed
-toward the expenses for the following:
-1.
-
-Transportation of the deceased client’s body from the place of death to a funeral home or
-other storage facility;
-
-2.
-
-Storage of the body during the time prior to final disposition;
-
-3.
-
-Embalming, where necessary for preservation of the body;
-
-4.
-
-Funeral or memorial service;
-
-5.
-
-Purchase of casket;
-
-6.
-
-Preparation of body for placement in casket;
-
-7.
-
-Transportation of body and casket to site of funeral/memorial service and/or cemetery;
-
-8.
-
-Purchase of gravesite;
-
-9.
-
-Purchase of vault (liner), when required by the cemetery;
-
-10.
-
-Opening and closing of grave;
-
-11.
-
-Purchase and placement of grave marker;
-
-12.
-
-Perpetual care of gravesite by owner of cemetery;
-
-13.
-
-Cremation of body;
-
-14.
-
-Purchase of an urn or other receptacle for the cremated remains of the decedent;
-
-15.
-
-Burial of the cremated remains of the decedent, including purchase of gravesite, vault
-(liner) if required by the cemetery, opening and closing of grave, purchase and placement
-of grave marker, and perpetual care of gravesite;
-
-16.
-
-Storage of the cremated remains for no more than one hundred twenty (120) days, in
-those cases where they are not buried and are not claimed by the decedent's family or
-friend; and/or,
-
-17.
-
-Any other items that are incidental to the funeral/memorial service and burial/cremation.
-
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-
-D.
-
-9 CCR 2503-6
-
-Arranging for Details of Disposition
-Even though State Department funds may be contributed toward the expenses for the items listed
-in the preceding sections, some of those items will not be requested, necessary, or affordable in
-some situations (e.g., in the case of a direct burial with or without graveside service, or immediate
-cremation with no burial). In the course of contacting relatives of the deceased client in order to
-arrange for disposition, the county department and any provider which is involved (e.g., a funeral
-home or cemetery) should consult with the family members about the applicable regulatory
-provisions, the resources of the decedent's estate and family/friends, and the relative costs of the
-various types of disposition.
-In those cases where the client or family has requested that the disposition include items which
-cannot be provided within the limitations of these regulatory provisions, and where the family is
-unable or unwilling to make separate financial arrangements without a State Department
-contribution, the county department shall make arrangements for disposition of the client’s body
-in a reasonable, dignified manner which approximates the wishes and the religious and cultural
-preferences of the client or family.
-
-E.
-
-Limitation of Total Charges for Disposition
-Regardless of the manner of disposition, State Department funds shall not be contributed if the
-total charges (including those paid by the deceased client’s estate, family, state funds, or any
-other source) for services, property, and supplies related to the disposition exceed two thousand
-five hundred dollars ($2,500).
-
-F.
-
-Procedures to be Followed by County Departments
-The county department in which the deceased client’s case is active shall be responsible for
-determining whether and in what amounts State Department funds may be contributed for the
-disposition of the deceased client’s body.
-1.
-
-When assistance for funeral, burial, or cremation services is requested on behalf of a
-deceased client, the county department shall obtain a completed application for
-funeral/burial/cremation assistance as prescribed by the State Department. This form is
-used to make a determination of eligibility for State Department funds for such services.
-The county department shall ensure that a choice of disposition by the client or a family
-member is made in writing. The choice of disposition may be made in the client’s will, on
-the application for funeral/burial/cremation assistance, or by any other document that the
-county department deems to be credible. When a choice of disposition between burial
-and cremation was made by the client in writing, and the client is determined to be
-eligible for burial assistance, the choice shall be honored by the county department within
-the limits of costs and reimbursement available.
-If a choice of disposition was not previously made by the client, the county department
-shall request a family member (spouse, adult children, parents, or siblings) to make the
-choice. The application form provides a section to be used by the family to make a written
-choice of disposition. Once the choice of disposition is determined, the appropriate
-providers shall be contacted to obtain signed proposals of items and charges for
-disposition. The Provider's Proposed Charges for Funeral/Burial/Cremation of Deceased
-Recipient of Assistance form shall be used for this purpose. If more than one provider is
-involved, a separate form for each provider MUST be used.
-Once the application and proposals from providers are received, the county department
-will be able to determine if a State Department funded death reimbursement is
-appropriate.
-
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-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-9 CCR 2503-6
-
-If the combined charges from the providers exceed two thousand five hundred dollars
-($2,500), no death reimbursement shall be paid from State Department funds.
-Providers may seek contributions from non-responsible persons only to the extent that
-monies are available from such parties.
-2.
-
-In determining the extent of the State Department funded contribution, if any, toward the
-expenses of disposition, the county department shall proceed in accordance with the
-following steps:
-a.
-
-If the client did not make a written choice between burial and cremation, the
-county department shall determine whether the client’S family has any
-preference. The county department shall encourage such relatives, in making a
-choice of disposition, to consider the relatives' ability to contribute to the costs of
-the available options.
-
-b.
-
-After determining the method of disposition for the deceased client, the county
-department shall next determine whether any funds for disposition are available
-from the deceased client’s estate using the guidelines in section 26-2-129(6), or
-from those individuals legally responsible, as defined in section 26-2-129(2)(E),
-C.R.S., for the deceased client’s support. The county department shall also
-inquire about the availability of such funds from persons who appear to be
-interested in the manner of the deceased client’s disposition, even if such
-persons are not legally responsible for the deceased client’s support.
-
-c.
-
-The county department shall require the legally responsible person to financially
-participate towards the charges for funeral, burial, or cremation unless their
-resources are less than the Supplemental Security Income (SSI) resource limit
-which is $2,000 for an individual and $3,000 for a couple as described in C.R.S.
-26-2-129(5). The amount of resources over the SSI limit shall be used to reduce
-the State Department funded Death Reimbursement payment. Money voluntarily
-contributed by the responsible party towards the burial, funeral, or cremation
-costs by the responsible party is also used to reduce the Death Reimbursement
-Benefit.
-
-d.
-
-The value of a prepaid burial plot of two thousand dollars ($2,000) or less when
-purchased is exempt and not counted toward the total funeral, cemetery, or burial
-expenses. If the final resting place was purchased by someone other than the
-decedent and donated to the deceased client, it shall not be counted as personal
-resource of the deceased client or legally responsible person.
-
-e.
-
-Social Security lump sum death benefits payable to a legally responsible person
-shall not be used in reducing the maximum Death Reimbursement Benefit.
-
-f.
-
-Funds disbursed from any insurance policy of the deceased client to a legally
-responsible person or non-responsible person who is named as beneficiary or a
-joint beneficiary of the deceased client’s policy, are counted as available and
-shall be used to reduce the maximum Death Reimbursement. Providers may
-seek contributions from non-responsible persons to the extent that monies are
-available from such parties.
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-
-3.
-
-G.
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-
-Contributions made by non-responsible parties shall not reduce the Death
-Reimbursement Benefit. These funds are used to offset the maximum combined
-charges to the providers. The county department shall make every reasonable
-effort to minimize the contribution of State Department funds for a deceased
-client’s disposition. The State Department may limit the maximum State
-Department contribution to a figure lower than one thousand five hundred dollars
-($1,500) in order to contain total State Department expenditures within the
-available legislative appropriation. The State prescribed form shall be used to
-inform the county department accounting office of itemized total charges and the
-total State Department contribution.
-
-The county department shall use the following procedures in cases where the county
-department becomes aware of a deceased client, and a family member cannot be
-located:
-a.
-
-If a family member has not been located within twenty-four hours after the client
-dies, the county department shall have the deceased client’s body refrigerated or
-embalmed.
-
-b.
-
-If a family member has not been located within seven days, the county
-department shall make the determination to bury or cremate the deceased client
-based on the best option available.
-
-c.
-
-The county department shall complete and send the State required form,
-Authorization of Cremation, to the appropriate funeral home/crematorium to
-authorize the cremation.
-
-d.
-
-The county department may authorize payment for funeral, burial, and cremation
-expenses up to one year after the death of the client. Those persons who made
-arrangements for the disposition of the deceased recipient's body must provide
-all necessary information to enable the county department to determine whether
-and to what extent a contribution of State Department funds is appropriate.
-
-Provider Agreement
-The county department shall have a statement of agreement between the providers that sets forth
-the charges and the amounts of any disbursement of funds by the county department. The
-agreement shall assure that the distributions of death reimbursement benefits are equitable. All
-vendor(s) who are providing the services must sign the agreement. The form must be approved
-and signed by the county department before death reimbursement is provided. Payment shall be
-made pursuant to the agreement.
-
-3.606.8 Diversion, Other Assistance, and Family Needs Payments
-A.
-
-A Colorado Works client may receive a diversion payment to address a specific crisis situation or
-episode of need. Such payments are not designed to meet clients’ basic ongoing needs. A
-diversion payment may address needs over a period of no more than four (4) months. In addition
-to a diversion payment, a client who is eligible for diversion may receive supportive payments
-based on a defined need.
-A Colorado Works client may receive a diversion payment (diversion grant) under the following
-terms and conditions:
-1.
-
-The client does not need long-term cash assistance or basic cash assistance as
-determined by the assessment.
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-2.
-
-The client demonstrates a need for a specific item or type of assistance, including but not
-limited to, cash, housing, or transportation. Such assistance may be provided in the form
-of cash payment, vendor payments, or in-kind services.
-
-3.
-
-The client enters into a written or verbal agreement with the county department. The
-agreement shall be documented in the statewide automated system and shall:
-a.
-
-Document the reason why the client does not need basic cash assistance; and,
-
-b.
-
-Define the expectations and the terms of the diversion payment; and,
-
-c.
-
-Specify the need(s) for and the specific type(s) of non-recurring cash payment.
-
-4.
-
-The client shall agree not to receive any further Colorado Works assistance in the county
-where he or she received the diversion payment or any other county for a period of time
-to be established by the county that issued the diversion payment. This Period of
-Ineligibility (POI) shall start in the month that the payment is provided and shall not be
-longer than the equivalent maximum grant payment for the household size over the same
-period of time.
-
-5.
-
-If the client is unable to sustain the agreement because of circumstances beyond his or
-her control, he or she may apply for and the county may grant basic cash assistance or
-another diversion payment prior to the end of the POI. The county department can end
-the POI before it expires if good cause exists and is granted by the county department.
-
-6.
-
-A diversion payment is a needs-based, cash or cash-equivalent payment made to a client
-who is eligible for basic cash assistance, or, at county option, and based on the county’s
-policy, a higher income limit not to exceed the maximum criteria established in the State
-plan for non-recurrent short-term benefits. All diversion clients who receive a one-time
-cash payment are not required to assign child support rights, and receipt of such
-payment does not count toward their Federal TANF assistance time limit.
-
-7.
-
-Two Payments of Assistance in the Same Month
-A client shall not receive a diversion grant for any month in which he/she receives basic
-cash assistance.
-
-B.
-
-Supportive payments and referrals
-1.
-
-Counties shall provide referrals for all families and assess non-work eligible families for
-supportive payments at each eligibility interview, at minimum. Work eligible clients must
-be assessed for supportive payments according to 3.608.1, at minimum. To receive
-supportive payments while receiving Colorado Works grant payments, clients must have
-an assessed need as defined in section 3.601. Supportive payments can also be issued
-as incentives for gaining or maintaining employment, participation in the workforce
-development program, or other achievements.
-
-2.
-
-County departments shall take action on all supportive payment requests within ten (10)
-calendar days from the date of request by the client. All requests for and decisions to
-approve or deny supportive payments must be documented in the statewide automated
-system. Clients shall receive notice of supportive payment decisions as defined in section
-3.609.7.
-
-3.
-
-Supportive payments may include anything but the following:
-
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-a.
-
-Medical services, except for family planning;
-
-b.
-
-Title IV of the Social Security Act funding that supports children in foster care;
-
-c.
-
-Supports to children under 18 who are not in the home;
-
-d.
-
-Any juvenile justice purposes; and
-
-e.
-
-Capital assets over $5,000.
-
-Family Preservation Eligibility
-To receive Family Preservation Services as provided in the Social Services rule manual, 12 CCR
-2509-4 Section 7.304.21 under “Title IV-A Emergency Assistance,” a family's income and
-resources must meet all of the following guidelines:
-
-D.
-
-1.
-
-The family income must be under $75,000 yearly; and,
-
-2.
-
-The child must meet out-of-home placement criteria; and,
-
-3.
-
-The child lived with a specified relative within the last six months.
-
-Other assistance
-Counties may provide assistance to clients meeting the following broad based Colorado Works
-eligibility criteria:
-
-E.
-
-1.
-
-At least one dependent child or pregnancy in the home;
-
-2.
-
-Lawfully present; and
-
-3.
-
-Household income under $75,000 yearly.
-
-County Department's Right to Decide
-The county department may provide, by means of its own funds, items which are needed by a
-client and which are not included in the standards of assistance. Such provisions for “unmet
-need” shall not be deducted as income in the budgeting process.
-
-3.607
-
-Initial Workforce Development (WD)
-
-3.607.1 Work Eligible
-A.
-
-B.
-
-The following are work eligible clients, unless excluded by subsection B below:
-1.
-
-An adult, minor child head-of-household, or spouse of a minor child head-of-household
-receiving assistance.
-
-2.
-
-A parent who is not receiving assistance that is living with their child who is receiving
-assistance.
-
-The following are not mandatory for the Workforce Development program:
-1.
-
-A minor parent who is not a head-of-household or who is not a spouse of a head-of
-household.
-
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-2.
-
-A non-citizen who is ineligible to receive assistance due to his or her immigration status
-based on criteria established in 3.604.1.
-
-3.
-
-Anyone receiving supplemental security income.
-
-The following work eligible clients are mandatory for the workforce development program.
-however, good cause or hardship may impact the client’s program participation.
-1.
-
-Work eligible clients who are included in subsection a but report hardship or good cause
-based on criteria in 3.601.
-
-2.
-
-For clients with hardship or good cause, county departments must engage the client in
-activities that address hardship or good cause.
-
-3.607.2 Workforce Development Screening
-All work eligible clients will have a Workforce Development Screening completed within thirty (30)
-calendar days from the date of application as defined in section 26-2-708, C.R.S. Benefits shall not be
-delayed or postponed for any Workforce Development requirement.
-The Workforce Development Screening shall consist of an evaluation of basic skills, past employment,
-and employability for a client who is 18 years of age or older, or who is 16 years of age or older, but is not
-yet 18 years old and is not attending high school or a high school equivalency program and has not
-completed high school or obtained a certificate of high school equivalency.
-3.607.3 Workforce Development Assessment
-Once referred to Workforce Development, all work eligible clients must have the State prescribed
-Workforce Development Assessment completed at their initial Workforce Development appointment.
-A.
-
-The Workforce Development Assessment must be completed prior to and shall be utilized to
-inform the development of the first and subsequent Individualized Plans (see section 3.608.1.A).
-
-B.
-
-The Workforce Development Assessment shall be documented in case comments in the
-statewide automated system.
-
-C.
-
-The Workforce Development Assessment shall also be utilized to determine the issuance of
-supportive payments.
-
-3.607.4 Condition Agreement
-All counties shall use the State prescribed Condition Agreement that clearly outlines the expectations of
-the county and the client. The county worker shall review the Condition Agreement with the client within
-thirty (30) calendar days from the date of the Workforce Development Screening as defined in section 262-708, C.R.S.
-The client shall sign the Condition Agreement, using a valid form of signature, one time per application.
-3.607.5 Individualized Plan
-The Individualized Plan shall be developed collaboratively between the county worker and the client,
-addressing the family’s needs, goals, and supports. The Individualized Plan shall be comprehensive
-including matters relating to securing and maintaining training, education, or work. No abbreviations or
-acronyms shall be used. The Individualized Plan shall identify goals and determine manageable action
-steps for satisfying the objectives.
-
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-The first Individualized Plan shall be developed at the same time the county worker and client review the
-Condition Agreement (within thirty (30) calendar days from the date of the Workforce Development
-Screening).
-The county worker shall ensure the client understands the terms of the Individualized Plan, including
-reasons the client might not need to engage in work activities and good cause as outlined in the reengagement section 3.608.3. The client shall indicate by a valid form of signature as defined in 3.601 and
-date that they agree with the Individualized Plan. If the client does not agree with the Individualized Plan,
-the client may follow the steps outlined in section 3.609.7 regarding due process.
-If a client does not participate in the Workforce Development program prior to signing the first
-Individualized Plan, this shall be considered Demonstrable Evidence, as defined in 3.601, and will result
-in the closure of the grant payment. Once an Individualized Plan is signed, clients that do not participate
-in the Workforce Development program are subject to re-engagement according to 3.608.3.
-3.608
-
-Ongoing Workforce Development
-
-3.608.1 Ongoing Case Management
-The Workforce Development worker will have contact with the client at least once every ninety (90) days.
-This contact may include an update to the Individualized Plan if needed and shall include an assessment
-for supportive payments as outlined in section 3.606.8.
-A.
-
-Ongoing Workforce Development Assessment
-The State prescribed Workforce Development Assessment shall be completed at least once
-every six (6) months and must be documented in case comments in the Statewide Automated
-System. in addition, the State prescribed Workforce Development Assessment must be
-completed by the new county of record within thirty (30) days of a county transfer.
-
-B.
-
-Individualized Plan Modification
-Either a client or a county department may request a modification of the Individualized Plan. Any
-modification made will result in a new Individualized Plan that must have a valid form of signature
-as defined in 3.601 and date by the client. If the client does not agree with the modification, they
-may request due process as defined in section 3.609.7. In addition, an updated Individualized
-Plan must be completed by the new county of record within thirty (30) days of a county transfer.
-
-3.608.2 Work Activities
-A.
-
-Engaged in Work Activities
-Work eligible clients are required to engage in the Workforce Development program, once
-determined eligible for Colorado Works. All activities in the Individualized Plan shall relate to the
-outcome of both initial and ongoing assessments. The statewide automated system shall
-accurately reflect all activities that a client is participating in, regardless if that activity is included
-in the Individualized Plan.
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-
-9 CCR 2503-6
-
-Allowable Work Activities
-Work activities are defined in greater detail in Colorado’s federally approved Work Verification
-Plan (2020); no later amendments or editions are incorporated. The Work Verification Plan can
-be found at https://drive.google.com/open?id=0b9eaxw7_92zsvnnhexz4u3hzdue. Copies are also
-available for public inspection and copying by contacting the Colorado Department of Human
-Services, Director of the Employment and Benefits Division, 1575 Sherman Street, Denver,
-Colorado, 80203 or at any State publications library during regular business hours.
-The State of Colorado will seek public comment on any changes to the Work Verification Plan by
-posting such changes for comment on the publicly accessible Colorado Department of Human
-Services website, at least thirty (30) days prior to implementing the change.
-County defined work activities are listed in county policy which can be reviewed at the county
-department or copies are also available for public inspection and copying by contacting the
-Colorado Department of Human Services, Director of the Employment and Benefits Division,
-1575 Sherman Street, Denver, Colorado, 80203 during normal business hours.
-Allowable work activities include:
-
-C.
-
-1.
-
-Employment, such as full-time or part-time employment, subsidized employment, on the
-job training, and temporary employment.
-
-2.
-
-Education, such as pursuing a degree, high school equivalency, job skills training, english
-as a second language courses, or pursuing a certificate.
-
-3.
-
-Volunteer work, such as community service, work experience programs, and unpaid
-internships.
-
-4.
-
-Search for work, such as applying for jobs, interviewing, attending job fairs, and attending
-hiring events.
-
-5.
-
-Job readiness activities, such as interpreting labor market information, identifying
-references, building job search skills, building cultural competencies, substance abuse
-and mental health treatment, mitigating the effects of domestic violence, and
-rehabilitation activities.
-
-Work Activity Outlined in the Individualized Plan
-For purposes of participating in the work activities requirements of this section, a Colorado Works
-client shall be considered to be engaged in work program requirements if they are participating in
-the work activities listed in section 3.608.2.B or in the Work Verification Plan incorporated in
-section 3.608.2.B, or in any other work activities designed to lead to self-sufficiency as
-determined by the county department and as outlined in their Individualized Plan.
-
-D.
-
-Clients in paid work experience shall be entitled to the same wages and benefits, including but
-not limited to, sick leave, holiday and vacation pay, as are offered to employees who are not
-clients and who have similar training or experience performing the same or similar work at a
-specific workplace. Clients in unpaid work experience are entitled to all rules under the Fair Labor
-Standards Act as indicated in the Work Verification Plan.
-
-3.608.3 Re-engagement and Good Cause
-Counties should make every reasonable effort to ensure Individualized Plans are appropriate, achievable,
-and the most likely strategy to support a client’s long-term economic well-being goals.
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-Good cause for not engaging in Workforce Development can be reported at any time during the current
-application period and verification is not required to be provided by the client. The county worker shall use
-the Prudent Person Principle to determine good cause which may be reported by the client in person,
-virtually, telephonically, or electronically. County workers must enter good cause in the State Benefit
-Management System within five (5) calendar days.
-A.
-
-There may be instances where a client is unable to comply, such as:
-1.
-
-Missing a scheduled meeting; or
-
-2.
-
-Not participating with the Individualized Plan.
-In these instances, the county shall send a request to the client to report good cause and
-provide the client with eleven (11) calendar days to report good cause.
-
-B.
-
-In general, the Prudent Person Principle is used to determine good cause. At a minimum, good
-cause for the client may include, but is not limited to:
-1.
-
-Breakdown in child care arrangements
-
-2.
-
-A lack of available and appropriate child care pursuant to a county department's written
-policy. Colorado Works clients who are caring for a child should be granted good cause
-if:
-a.
-
-There is not appropriate child care within a reasonable distance from the client's
-home or work site.
-
-b.
-
-There is no available or suitable child care.
-
-c.
-
-There is not appropriate and affordable child care arrangements within the rate
-structure defined in the approved county child care rate plan.
-
-3.
-
-Remotely located without transportation
-
-4.
-
-Breakdown in transportation arrangements with no feasible alternative
-
-5.
-
-School obligations that frequently necessitate a parent’s or caretaker’s attendance
-
-6.
-
-Loss of housing or a housing crisis that might result in homelessness or eviction
-
-7.
-
-Medical emergencies, including mental health, substance abuse, or crisis, involving
-anyone in the household
-
-8.
-
-Physical or mental disability or illness of the client or an individual in the client’s care
-
-9.
-
-Legal proceedings for the client or other immediate family members
-
-10.
-
-Employment issues when layoffs occur, wages are below applicable federal and state
-minimum wage standards, working conditions present a risk to health or safety, or
-workers’ compensation protection does not exist
-
-11.
-
-Client’s incarceration
-
-12.
-
-Jury duty
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-13.
-
-Death of an immediate family member or authorized representative
-
-14.
-
-Other situations as determined by the county
-
-9 CCR 2503-6
-
-C.
-
-If a client reports good cause criteria for not participating in the Workforce Development program,
-a sanction or closure will not be imposed. Once good cause is determined, the re-engagement
-process ends. County departments must follow the state prescribed process for re-engagement
-to include good cause, re-engagement, sanctioning, and closing a case.
-
-D.
-
-At the time of the good cause request, a re-engagement appointment shall be sent through the
-Statewide Automated System and the client shall be provided written notice of the appointment at
-least four (4) calendar days, but no more than eleven (11) calendar days in advance. The client
-may provide a written or verbal waiver that written notice of the scheduled appointment is not
-necessary when the county department is able to conduct the appointment during communication
-with the client.
-Notice shall include:
-1.
-
-The date and time for the appointment
-
-2.
-
-The opportunity to reschedule the appointment or make other arrangements in the event
-of good cause
-
-E.
-
-If the county department makes contact with the client and good cause is provided, the reengagement process stops. The Workforce Development worker shall enter a case comment
-including the date and type of contact into the Statewide Automated System.
-
-F.
-
-Clients may reschedule their re-engagement appointment prior to the re-engagement
-appointment. The rescheduled appointment cannot exceed fifteen (15) calendar days from the
-original re-engagement appointment.
-
-G.
-
-Timeframes for rescheduling the re-engagement appointment include:
-
-H.
-
-1.
-
-The Workforce Development worker shall schedule the new re-engagement appointment
-within four (4) calendar days of the client’s request to reschedule.
-
-2.
-
-The client shall be provided written notice of the rescheduled appointment at least four
-(4) calendar days, but no more than fifteen (15) calendar days in advance. The client may
-provide a written or verbal waiver that written notice of the scheduled appointment is not
-necessary when the county department is able to conduct the appointment during
-communication with the client.
-
-If the client attends the re-engagement appointment but does not provide good cause, a sanction
-will not be imposed, except as outlined below. Once the client attends the re-engagement
-appointment, the re-engagement process ends. The county or client may request modification of
-the Individualized Plan as outlined in section 3.608.1.B.
-When a county determines that there has been exceptional dis-engagement by the client, as
-evidenced by repetitive or cumulative attendance at re-engagement appointments without
-reporting good cause, a sanction, as defined in section 3.608.4 may be applied to the grant
-payment based on state department review.
-
-I.
-
-If the client misses the re-engagement appointment, there are no attempts to reschedule prior to
-the scheduled appointment, and the client does not provide good cause, a sanction, as defined in
-section 3.608.4 will be applied to the grant payment. The following process shall occur:
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-1.
-
-The unsuccessful outcome of the re-engagement attempts shall be documented in the
-statewide automated system within five (5) working days of the determination by the
-county worker.
-
-2.
-
-A notice of grant payment reduction based on the sanction will be sent according to
-section 3.609.7.
-
-3.
-
-If good cause is provided after the unsuccessful outcome of the re-engagement attempts
-is entered into the Statewide Automated System, the sanction shall be reversed.
-
-3.608.4 Sanction
-A.
-
-Sanctions from other counties
-All sanctions shall be served when a client moves from one county to another. The new county
-may become aware of good cause for previous non-participation and may reverse the sanction if
-appropriate.
-
-B.
-
-Sanctions issued in other states will not be recognized in the State of Colorado.
-
-C.
-
-Effect of a sanction on the Colorado Works grant payment
-The Colorado Works grant payment for the entire household shall be reduced due to a sanction
-imposed against a member of the assistance unit as follows:
-1.
-
-First, Second, and Third level sanctions
-The reduction for the first level sanction shall be one dollar ($1.00), second and third
-instance of sanction shall be twenty five percent (25%) of an assistance unit’s grant
-payment.The sanction shall be in effect for one month for each level sanction. A first,
-second, or third instance of sanction shall progress to the next level of sanction if the
-client does not re-engage in the Workforce Development program as defined in
-subsection G. Below by the end of the month that the sanction is being served.
-
-2.
-
-Fourth level sanction
-The reduction for a fourth instance of sanction is 100% and shall result in case closure of
-the Colorado Works grant payment. The closure shall be in effect for one month. A new
-application for Colorado Works grant payments is required according to section 3.602.1.
-
-D.
-
-Serving a sanction
-All sanctions imposed by a county must be served by the client. If a client has had a break in
-grant payment for one month or more, the sanction shall be considered served. If a client
-reapplies for benefits anytime within the calendar month that they are serving a sanction, the
-client must serve the sanction by having a reduction in benefits according to the first, second, or
-third level sanctions, or by having a case closed for a fourth level sanction.
-
-E.
-
-Sanctioning a client that has been sanctioned previously
-Once a sanction is served, all subsequent occurrences shall be in accordance with the level
-following the sanction previously served as outlined in 3.608.4.C. and D.
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-Sanctioning more than one client in an assistance unit
-Each Colorado Works case can experience no more than one sanction level in a month. If
-multiple clients in the same assistance unit have sanctions, the sanctions will be served
-simultaneously and at the higher sanction level when multiple levels exist.
-
-G.
-
-Re-engagement following a sanction
-When a client who is serving a sanction contacts the county worker and indicates an interest in
-participating in the Workforce Development program, an Individualized Plan will be developed.
-Once the Individualized Plan is signed, the sanction will not progress to the next sanction level
-unless a new instance of non-compliance occurs. The county worker will enter the reengagement date into the Statewide Automated System and resume ongoing case management.
-When a client is serving a sanction based on exceptional dis-engagement defined in section
-3.601 and outlined in 3.608.3.H, the client is considered re-engaged based on their attendance at
-the most recent re-engagement appointment.
-
-3.608.5 Appeal of a Sanction
-A Colorado Works client has the right to appeal the county department’s action to sanction. The client can
-utilize the local level dispute resolution process and/or a state level hearing process per section 3.609.9.
-The appeal period for proposed sanctions for Colorado Works begins with the mailing of a notice of
-sanction that lists the proposed action and the client's appeal rights.
-A notice of proposed action shall not be issued by the county department for proposed Colorado Works
-sanctions until the re-engagement process has been completed.
-3.609
-
-Colorado Works Notice, Payments, Overpayment, Intentional Program Violations and
-Fraud, Dispute Resolution, Appeal and State Level Fair Hearing
-
-3.609.1 Notice
-A.
-
-Each client of Colorado Works shall receive prior written notice of any agency action affecting his
-or her eligibility for or receipt of grant payments.
-1.
-
-2.
-
-The client shall be notified in writing of county department approval of:
-a.
-
-An application for Colorado Works.
-
-b.
-
-Any change in the amount of grant payment.
-
-c.
-
-The right to a county conference and/or state level fair hearing if the client is
-dissatisfied with the effective date of eligibility, or the amount or type of
-assistance authorized.
-
-A client shall be given notice of any action by the county department, or any person or
-agency acting on its behalf, which adversely affects the client’s eligibility for, or right to
-grant payments authorized under the Colorado Works program. Failure to give notice of
-an adverse action shall be grounds for setting aside the action on appeal. The notice
-must meet the following standards:
-a.
-
-The notice must be in writing; and,
-
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-b.
-
-It must describe clearly and in plain language the action to be taken and the
-reason(s) for the action; and,
-
-c.
-
-It must refer by number to the section(s) of the state department's rules that
-require or permit the action being taken, or cite the specific changes in federal or
-state law requiring the action; and,
-
-d.
-
-It must state the effective date of the proposed action; and,
-
-e.
-
-It must explain the client’s right to request a county conference and/or state level
-fair hearing, the time period for requesting a conference or hearing, and the steps
-which must be taken to obtain a conference or hearing; and,
-
-f.
-
-It must explain the client's right to continued grant payments and the obligation to
-repay if it is determined that the client was not eligible to receive them; and,
-
-g.
-
-It must inform the client of his or her right to be represented or assisted by legal
-counsel, a relative, a friend, or a spokesperson of his or her choosing; and,
-
-h.
-
-To the extent practicable, notice shall be in his or her primary language. If he or
-she is illiterate, the action shall also be explained verbally.
-
-B.
-
-The county department shall notify a client of any change from his or her prior grant payment
-amount, the reason for the action, and the date the action becomes effective in writing.
-
-C.
-
-Clients shall receive written timely notice, giving at least eleven (11) calendar days advance
-notice before any adverse action taken during the certification period, becomes effective, except
-as specified in section 3.609.7.C. The notice shall explain the reason for the proposed action and
-the date the action becomes effective.
-1.
-
-When acting on a change, if the eleven (11) calendar day timely notice period can be
-given within the month the written timely notice is sent, the change will become effective
-the first day of the following month.
-
-2.
-
-If the 11 calendar day timely notice period concludes in the following month, the change
-shall become effective the first day of the month after which the timely notice period
-concluded.
-
-3.
-
-If the timely notice period ends on a weekend or holiday and a request for a state level
-fair hearing and continuation of grant payments is received the first business day after the
-timely notice period, the request shall be considered timely received.
-
-4.
-
-Colorado Works grant payments must be discontinued or reduced after thirty-one (31)
-calendar days in the following situations:
-a.
-
-The client’s income exceeds the grant standard, after application of disregards.
-
-b.
-
-All eligible dependent children in the assistance unit no longer meet the definition
-of living in the home.
-
-c.
-
-A dependent child(ren) in the assistance unit no longer meet the definition of
-living in the home and Colorado Works is requested for the child(ren) by another
-caretaker.
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-d.
-
-An adult member of the assistance unit leaves the home and requests assistance
-in a new assistance unit.
-
-e.
-
-All members of the assistance unit leave the state of Colorado to reside in
-another state or country.
-
-f.
-
-An eighteen-year-old who is the only dependent child graduates from high school
-or stops attending school.
-
-The thirty-one (31) day count begins on the first day of the month following the month in
-which the change occurred. Colorado Works benefits will be discontinued on the first day
-of the month following the month in which the thirty-first (31st) day falls.
-An individual may be removed from the assistance unit according to D below, and prior to
-thirty-one (31) calendar days, when the change described in this section occurs
-simultaneously with a change in which adequate notice, not timely notice, is required.
-D.
-
-E.
-
-Adequate notice, not timely notice, is required in the following situations:
-1.
-
-When facts indicate an overpayment because of probable fraud or an intentional program
-violation and such facts have been verified to the extent possible, prior notice shall be
-mailed at least five (5) calendar days before the proposed effective date.
-
-2.
-
-The client has died.
-
-3.
-
-An adult member of the assistance unit formally requests for benefits to stop for
-themselves in their original assistance unit, or a caretaker who remains a part of the
-original assistance unit requests that they stop receiving benefits for another member
-who has left the home.
-
-4.
-
-When an adult member of the assistance unit who is not the head of household requests
-for benefits to stop for themselves and their child(ren) when that adult makes a
-declaration that they have left the home due to domestic violence.
-
-5.
-
-The client begins receiving Title-IV of the Social Security Act funds from another source
-such as foster care/ Title-IV kinship/adoption subsidies.
-
-6.
-
-The client begins receiving benefits under another public assistance program which may
-not be received concurrently with a Colorado Works grant, such as Supplemental
-Security Income or Adult Financial programs.
-
-7.
-
-At application or redetermination, when a certification period has not yet been set.
-
-8.
-
-An adult member of the assistance unit has already received sixty months of assistance
-and a hardship extension has not been granted.
-
-If the client’s change in circumstances requires a reduction or termination of grant payments, the
-following action will be required:
-1.
-
-Send a written timely or adequate notice, according to subsections C. and D., above.
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-2.
-
-If a client requests a county conference, conduct the county conference as specified in
-section 3.609.6. If a client is dissatisfied with the results of the county conference and
-requests a state level fair hearing before an Administrative Law Judge, such a request
-shall be in accordance with section 3.609.7. If a client does not request a county
-conference and only requests a state level fair hearing any time prior to the effective date
-of the timely notice, and the certification period has not expired, the client's grant
-payments shall be continued on the basis authorized immediately prior to the timely
-notice. Continued grant payments shall not be issued for a period beyond the end of the
-current certification period. Grant payments shall be continued until a final decision has
-been made by the Office Of Appeals or until the certification period ends, whichever
-occurs first. The county department shall explain to the client that repayment will be
-required for the amount of any grant payments determined by the hearing officer to have
-been overpaid or the continued grant payments to which the client was not eligible to
-receive.
-
-3.
-
-If the certification period expires before the hearing process is completed, the client may
-reapply for benefits.
-
-4.
-
-If the client does not appeal the timely notice to decrease or terminate grant payments
-within the timely notice period, the changes shall be made in accordance with timeframes
-outlined in section 3.609.1.
-
-3.609.2 Payments
-A.
-
-A client shall be placed on an issuance schedule so that he or she receives grant payments on or
-about the same date each month once a certification period is established. Due to the effective
-date of eligibility, the date on which a client receives his or her initial payment need not be the
-date that the client must receive any subsequent payments.
-1.
-
-Initial payment
-The initial payment to eligible clients shall include assistance beginning with the date of
-application. Should the assistance unit be ineligible on the date of application, but
-become eligible prior to the time that a determination of eligibility is made, the initial
-payment shall include assistance beginning with the date on which the assistance unit
-became eligible.
-To calculate partial month payments:
-a.
-
-Determine the grant amount based on the size and composition of the assistance
-unit;
-
-b.
-
-Deduct the total net countable income – this is the authorized grant amount for
-the entire month;
-
-c.
-
-Determine the number of days for which payment is made and based on the
-table in subsection E. Below, find the decimal figure corresponding to the number
-of days of eligibility;
-
-d.
-
-Multiply the authorized grant amount for the entire month by such decimal figure
-to determine the authorized grant amount for the partial month;
-
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-Subtract from authorized grant amount for the partial month any appropriate
-deductions, unless the authorized grant for the partial month is less than $10, in
-which case no payment is made. However, if the deductions from the authorized
-grant amount for the partial month results in an amount less than $10, such
-lesser amount shall be paid except when the amount is less than $1.00.
-To calculate the partial month payments, the following table shall be used:
-Days
-1
-2
-3
-4
-5
-6
-7
-8
-9
-10
-
-2.
-
-Standard
-.03288
-.06575
-.09863
-.13151
-.16439
-.19726
-.23014
-.26302
-.29590
-.32876
-
-Days
-11
-12
-13
-14
-15
-16
-17
-18
-19
-20
-
-Standard
-.36164
-.39452
-.42739
-.46027
-.49315
-.52603
-.55890
-.59178
-.62466
-.65754
-
-Days
-21
-22
-23
-24
-25
-26
-27
-28
-29
-30
-
-Standard
-.69041
-.72329
-.75617
-.78904
-.82192
-.85480
-.88768
-.92054
-.95342
-.9863
-
-Payment determination
-For the certification period, eligibility and payment shall be determined prospectively.
-
-B.
-
-When the county department determines that a client was ineligible for all or a part of a payment
-that the client has already received, the county department shall, subject to notice as described in
-3.609.1 and these recovery rules, establish a claim, and if valid, initiate recovery.
-
-C.
-
-If a client dies, payments to the client shall be treated as follows:
-1.
-
-A client’s eligibility shall end on the date of his or her death.
-
-2.
-
-If a client dies before 12:00 a.m. on the first day of a month, no eligibility for a grant
-payment for the following month exists.
-
-3.
-
-If a client dies on or after 12:00 a.m. on the first day of a month, any payment to which
-the person was eligible shall be maintained for release to the client’s personal
-representative as defined in section 15-10-201(39), C.R.S., for a maximum of three (3)
-months. The following rules apply when a personal representative requests to receive a
-deceased client’s last grant payment:
-a.
-
-The individual claiming to be the personal representative of the deceased client
-must provide the court-issued letters described in section 15-12-103, C.R.S. to
-the county department in order to receive the deceased client’s last grant
-payment; or
-
-b.
-
-If the personal representative with court-issued letters presents a court order
-ordering the county department to pay the deceased client’s last grant payment
-to a specific person or entity, the county department shall make the last grant
-payment payable to the person named in the order.
-
-D.
-
-All payments, including partial payments, shall have any cents dropped to the nearest dollar.
-
-E.
-
-The client has the right to decide how to use his or her grant payment. The county department
-shall not:
-
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-
-G.
-
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-
-1.
-
-Impose any restriction, either direct or implied, on a client’s use of his or her grant
-payment including, but not limited to, requesting a client to provide receipts or proof of
-how the money has been spent; or
-
-2.
-
-Require the client to account for the use of the grant payment, except for the Electronic
-Benefits Transfer (EBT) card point of sale limitations listed in 26-2-104(2), C.R.S.; or,
-
-3.
-
-Give assistance to creditors in the collection of the client’s debts.
-
-County departments shall not hold or delay the client’s grant payment beyond the regular
-issuance date except when:
-1.
-
-A final agency decision has been made authorizing the action;
-
-2.
-
-In cases where a corrected payment is to be issued, the corrected payment shall be
-issued by the effective date of the original warrant and the incorrect payment shall be
-cancelled.
-
-3.
-
-When the county department receives reliable information that the client no longer
-resides at the last known address and attempts to locate the person through the post
-office, relatives, friends, etc., have been unsuccessful, the client’s grant payment shall be
-discontinued. Discontinuing the grant payment is an adverse action and notice shall be
-given following the policies outlined in section 3.609.1.C. If the client contacts the county
-department before grant payments are discontinued and provides the client’s current
-address and all other eligibility criterion have been met, the client shall receive the grant
-payments they are eligible for;
-
-4.
-
-Any grant payments issued to an Electronic Benefits Transfer (EBT) card and not
-accessed within two hundred seventy-four (274) days of issuance shall be expunged.
-The county shall reissue grant payments within 90 days of the expungement if requested
-by the client verbally, electronically, in person, or in writing. The county may reissue up to
-twelve (12) months of expunged grant payments.
-
-The county department shall take prompt action to correct underpayments to clients of Colorado
-Works grant payments. There are two types of underpayments: 1) grant payment(s) received by
-or for a client that is less than the amount which the client should have received but not a denial
-or termination, or 2) the failure of the county department to issue a grant payment to an eligible
-client when such payment should have been issued (i.e., denials or termination of Colorado
-Works grant payments).
-1.
-
-When a county department becomes aware of a potential underpayment, the county
-department shall:
-a.
-
-Determine if an underpayment occurred; and,
-
-b.
-
-Record the facts and basis of its determination in the case record.
-
-2.
-
-A county shall correct any underpayments by the month following the discovery of such
-underpayments.
-
-3.
-
-Underpayments shall be used to pay any validated claims against the client unless the
-county department has determined this action will cause an undue hardship to the client
-as determined on a case-by-case basis. Underpayments will be applied to claims using
-the following hierarchy:
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-
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-a.
-
-Fraud or intentional program violation (IPV) claims first (undue hardship cannot
-be granted);
-
-b.
-
-Client error claims second; and
-
-c.
-
-Administrative error claims last. Instances that may result in an administrative
-error claim include, but are not limited to, the following:
-1)
-
-The county failed to take timely action on a change reported by the
-client.
-
-2)
-
-The county incorrectly computed the client’s income or other information,
-or otherwise gave an incorrect grant payment.
-
-3)
-
-Any other situation not caused by willful withholding of information on the
-part of the client and/or their authorized representative.
-
-4)
-
-If an underpayment is discovered by the county department, the county
-department shall inform the client in writing of its determination of the
-underpayment.
-
-5)
-
-Prompt action shall be taken to correct underpayments that occurred
-within the past twelve (12) months from the discovery date by issuing a
-retroactive payment. Retroactive payments shall not be made unless the
-amount is one dollar ($1.00) or more.
-
-The county department shall reissue a lost or stolen payment if the loss or theft is not
-questionable and the county determines that such loss was beyond the client's control.
-A loss will be considered within the client’s control when:
-
-J.
-
-1.
-
-The client has shared the EBT pin number or written the pin number on the EBT card
-itself, or
-
-2.
-
-The client has given his or her card to another person for that person’s use.
-
-A client is prohibited from using or allowing the use of his or her EBT card at automated teller
-machines (ATMs) and point of sale (POS) devices located in establishments as described in
-section 3.602.1.E.2.k.
-A client’s transactions shall be monitored quarterly. Clients who use prohibited ATMs or POS
-devices (misuse) shall be contacted by the county department. Misuse shall result in:
-1.
-
-A written warning that the use of the EBT card in prohibited establishments will result in
-the card being disabled. The county department shall provide education about
-appropriate use, access, and alternatives;
-
-2.
-
-If continued misuse occurs (identified on the usage report after a warning has occurred),
-the cash portion of his or her EBT card shall be disabled for one month, requiring the
-county to inform the client of additional options for receipt of payment (direct deposit or
-county warrant) as well as notification of the dispute resolution process in accordance
-with state rules pursuant to section 3.609.6;
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-3.
-
-If misuse continues, the county department shall deny or discontinue the cash benefit for
-one month. The county shall require the client to complete a new application after the
-one-month time period if the client requests assistance. The county department shall not
-accept a new application from the client until the one-month denial or discontinuance
-expires. The county department shall follow the dispute resolution process pursuant to
-section 3.609.6; and,
-
-4.
-
-After the one-month case closure for continued misuse, if/when the client reapplies, any
-future EBT card usage at prohibited establishments shall be considered continued
-misuse. Such subsequent violations will result in the one-month denial/discontinuance
-and reapplication process referred to in subsection 3, above.
-
-3.609.3 Overpayments
-The county department shall establish a claim on an overpayment before the last day of the quarter
-following the quarter in which the overpayment was discovered.
-A.
-
-B.
-
-An overpayment claim shall be adjusted if there is a record of any underpayment(s) for a prior
-period. Any underpayment must be applied to the overpayments in the following hierarchy:
-1.
-
-Fraud or IPV claims first,
-
-2.
-
-Client error claims second; and,
-
-3.
-
-Administrative error claims last.
-
-Liability for an overpayment must be legally established. Methods for legally establishing an
-overpayment include but are not limited to:
-1.
-
-An executed promissory note;
-
-2.
-
-A court judgment;
-
-3.
-
-A final agency action; or
-
-4.
-
-A signed public assistance repayment agreement form.
-
-The state department’s public assistance repayment agreement form shall be provided to the
-client once an overpayment claim is established.
-C.
-
-Failure to sign the public assistance repayment agreement form shall be handled as follows:
-1.
-
-If the client against whom a recovery has been initiated is currently participating in the
-Colorado Works program and does not respond to the public assistance repayment
-agreement form within eleven (11) calendar days of the date the notice containing the
-public assistance repayment form is mailed, grant payment reduction shall begin with the
-first month following the timely noticing period without further notice.
-
-2.
-
-If the client against whom a recovery has been initiated is not participating in the program
-when a recovery for a claim is initiated or if a recovery has been initiated for repayment of
-a claim and no response is made to the public assistance repayment agreement form
-within eleven (11) calendar days of the date the notice is mailed, the county department
-shall pursue all legal recovery methods in order to recover the overpayment. Legal
-remedies include, but are not limited to, judgments, garnishments, claims on estates and
-the state income tax refund intercept process.
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-D.
-
-The amount of the overpayments involving income shall be calculated to allow for income
-disregards described in section 3.606.2.
-
-E.
-
-All earned and unearned income received by the client are taken into consideration in the
-computation.
-In the instances where the overpayment is the direct result of actions tied to the determination of
-IPV and/or fraud, which resulted in receipt of grant payments in error, or grant payments received
-that the client was not eligible to receive, the overpaid grant payments shall be recovered from
-the client and/or a liable individual.
-
-F.
-
-The calculation of overpayment shall begin in the month that the overpayment occurred.
-1.
-
-Start with the amount issued to the client;
-
-2.
-
-Determine the correct payment;
-
-3.
-
-Compare the amount issued to the client to the correct payment amount.
-
-4.
-
-G.
-
-a.
-
-If the amount issued to the client is greater than the correct payment amount, the
-difference is the overpayment amount.
-
-b.
-
-If the amount issued to the client is less than the correct payment amount, the
-difference is the underpayment amount; follow the procedures for underpayment
-in section 3.609.2.G.
-
-If a client does not meet the non-financial eligibility requirements in any month, the client
-is totally ineligible for the month. Any payment received in such month(s) is an
-overpayment.
-
-When the county department has determined that a client has received an overpayment, the
-department shall:
-1.
-
-Take action to research the overpayment and determine the amount of the overpayment.
-
-2.
-
-Determine if the overpayment is to be recovered.
-
-3.
-
-Document the facts and situation that produced the overpayment. Document whether the
-overpayment is to be recovered. Retain all associated documentation and notices until
-the overpayment is repaid in full.
-
-4.
-
-Determine whether there was willful withholding of information, fraud, or IPV.
-
-5.
-
-Provide the client with timely or adequate notice as required by section 3.609.1 of the
-amount due and the reason for the recovery including:
-a.
-
-The liable individual(s) responsible for the repayment;
-
-b.
-
-The amount of the claim;
-
-c.
-
-The period the claim is for;
-
-d.
-
-The reason for the overpayment including whether the overpayment is a result of
-fraud/IPV, client error, or administrative error;
-
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-6.
-
-e.
-
-The client’s rights and responsibilities;
-
-f.
-
-The method of repayment;
-
-g.
-
-How to obtain free legal assistance;
-
-h.
-
-The applicable rules concerning the overpayment; and
-
-i.
-
-Provide the public assistance repayment form.
-
-9 CCR 2503-6
-
-Send quarterly statements with the balance due.
-
-3.609.4 Recovery
-A.
-
-The recovery of valid overpayments is required regardless of when the overpayment occurred.
-Overpayments may be recovered from the client who was overpaid or who fraudulently received
-the assistance payment or another liable individual.
-If a client is deceased, overpayments shall be recovered from the deceased client's estate.
-
-B.
-
-The following rules for recovery do not apply in instances where the state or county department
-seeks recovery in a case that was transferred to the district attorney and prosecuted through the
-courts:
-1.
-
-The client shall be notified of the recovery action to be taken, using the notice rules found
-at section 3.609.1.
-
-2.
-
-When the overpayment is caused by an unintentional error, the client's willful withholding
-or an administrative error, such overpayment shall be deducted, after notice has been
-given, from subsequent grant payments while the client is actively receiving Colorado
-Works grant payments.
-a.
-
-The client may choose to repay the county department the entire amount of the
-overpayment at one time. The client shall work with the county department to
-determine how a lump sum repayment can be made.
-
-b.
-
-When the recovery amount is not to be repaid in a single payment per subsection
-a above, and the case remains active, the county department shall establish a
-monthly recovery deduction from subsequent grant payments. The monthly rate
-of recovery shall be ten dollars or ten percent of the assistance payment,
-whichever is higher.
-The following procedure shall be used to arrive at the monthly recovery
-deduction amount:
-1)
-
-If the error is a result of an agency error and the client does not meet
-criteria set forth in section 3.609.4.L, compute ten percent (10%) of the
-Colorado Works grant payment amount. If the resulting percentage
-amount is less than ten dollars ($10), the deduction from the grant
-payment amount shall be ten dollars ($10).
-
-2)
-
-Deduct the percentage amount or ten dollars ($10), whichever is higher,
-from the grant payment. The result shall be rounded to the next lower
-whole dollar amount, if not already a whole dollar amount. This rounded
-amount is the final payment amount.
-
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-c.
-
-3.
-
-9 CCR 2503-6
-
-3)
-
-When the authorized payment amount is less than ten dollars ($10), the
-case is considered a “no payment” case and no deduction shall be
-made.
-
-4)
-
-When the recovery is due to a fraudulent action on the part of the client
-and interest may be added thereto, the interest amount shall not be
-included in the grant payment deduction unless the client agrees to such
-inclusion. If the client does not so agree, the interest amount shall be
-collected separately.
-
-5)
-
-The amount of the grant payment deduction for recovery shall be
-recorded in the client's case file and collected via the statewide
-automated system.
-
-The county department shall not establish a claim unless the amount of the claim
-is greater than $200, except in the following circumstances:
-1)
-
-The overpayment is identified through a federal or state level quality
-control review; or,
-
-2)
-
-The claim is being pursued as and results in an IPV.
-
-When the overpayment is caused by an unintentional error, the client’s willful withholding
-of information or an administrative error, and the Colorado Works case is no longer
-active, recovery of such overpayment shall be based upon the public assistance
-repayment agreement form or other methods of recovery.
-a.
-
-The county shall establish a monthly repayment agreement with a former client.
-The repayment agreement shall not exceed twenty-five percent (25%) of
-available monthly income. Determination of the repayment amount must be
-clearly documented in the electronic case file.
-
-b.
-
-The client may choose to repay the county department the entire amount of the
-overpayment at one time. The client shall work with the county department to
-determine how a lump sum repayment can be made.
-
-c.
-
-The county department may write-off unpaid valid claims as follows:
-1)
-
-Valid administrative error claims less than one hundred twenty-five
-dollars ($125.00) can be written off ninety (90) days after the termination
-of Colorado Works.
-
-2)
-
-Valid claims for client error, fraud, and IPV less than three hundred
-dollars ($300.00).
-
-3)
-
-Any unpaid valid claim of one hundred twenty-five dollars ($125.00) or
-more for an individual who was not convicted of an IPV or fraud specific
-to the overpayment, is no longer receiving public assistance from
-Colorado Works, Adult Financial, or SNAP, and the overpayment was
-established six (6) or more years ago, and the county department has
-determined that it is no longer cost effective to pursue collection.
-
-4)
-
-Once written off, a claim is not subject to recovery.
-
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-d.
-
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-
-If the client begins to receive Colorado Works grant payments again after the
-overpayment has been established and still has a claim balance, the deduction of
-grant payments shall occur as described in section 3.609.5.
-
-C.
-
-The client may issue the state a refund of any overpayments from his or her existing balance of
-Colorado Works grant payments on his or her electronic benefits transfer (EBT) card by
-contacting the county department. This requires a written statement from the client.
-
-D.
-
-Clients are not entitled to payments that were paid in error or mistakenly provided to the client
-based on a data entry error into the statewide automated system or an error resulting from the
-statewide automated system. The county shall create a claim and may retrieve the payments
-from the client’s EBT card within twenty-four (24) hours of the issuance without prior written
-authorization by the client. The client shall have no appeal rights in relation to this payment
-because he or she was not eligible for the initial receipt of the payment(s) in the first instance.
-When payments issued in error are not retrieved from the client’s EBT card within twenty-four
-(24) hours, funds shall not be taken from the card using this method unless permission is granted
-from the client in writing using the state prescribed form. If permission is not granted, the county
-department shall pursue other methods of recovery.
-
-E.
-
-The client may request voluntary deductions be applied to the overpayment. These are
-considered to be an amount in addition to the deduction from the grant payment as established
-through the recovery calculations. The client shall be provided written confirmation of the amount
-to be deducted and that he or she has the right to stop the voluntary deduction at any time by
-written request.
-
-F.
-
-A claim may be filed against the estate of a client for overpayment. This includes cases where
-overpayments were made and not recovered. The county department's legal advisor must be
-consulted in determining the amount of assistance payments for which a claim is to be filed.
-
-G.
-
-In accordance with sections 26-2-133 and 39-21-108, C.R.S., the State and county departments
-may recover overpayments of public or medical assistance benefits through the offset (intercept)
-of a taxpayer's state income tax refund. Tax refunds shall not be offset in instances where the
-taxpayer is making regular, ongoing payments as agreed to in the public assistance repayment
-agreement and/or based on arrangements between the taxpayer and the county(ies). Unless
-agreed to by the client, the county shall not offset tax refunds during the same month the client
-makes a payment on a claim if the payment agreement was established prior to the offset. Rent
-rebates are subject to the offset procedure.
-The offset of the taxpayer state income tax refund and/or rent rebate may be used to recover
-overpayments that have been:
-
-H.
-
-1.
-
-Determined by final agency action; or,
-
-2.
-
-Ordered by a court as restitution; or,
-
-3.
-
-Reduced to judgment.
-
-Prior to certifying the taxpayer's name and other information to the Colorado Department of
-Revenue, the Colorado Department of Human Services shall notify the taxpayer, in writing at his
-or her last-known address, that the State intends to use the tax refund offset to recover the
-overpayment. In addition to the requirements of section 26-2-133(2), C.R.S., the pre-offset notice
-shall include the name of the county department claiming the overpayment, the program that
-made the overpayment, and the current balance owed.
-
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-
-9 CCR 2503-6
-
-Effective August 1, 1991, the taxpayer is entitled to object to the offset by filing a request for a
-county conference or state level fair hearing within thirty (30) calendar days from the date that the
-state department mails its pre-offset notice to the taxpayer. In all other respects, the procedures
-applicable to such hearings shall be those that are stated in section 3.609.7. At the hearing on the
-offset, the county department or ALJ shall not consider whether an overpayment has occurred
-because overpayment has already been otherwise legally established, but may consider the
-following issues if raised by the taxpayer in his or her request for a hearing:
-1.
-
-Whether the taxpayer was properly notified of the overpayment;
-
-2.
-
-Whether the taxpayer is the person who owes the overpayment;
-
-3.
-
-Whether the amount of the overpayment has been paid or is incorrect;
-
-4.
-
-Whether the debt created by the overpayment has been discharged through bankruptcy;
-or,
-
-5.
-
-Whether other special circumstances exist, (i.e., facts that show that the taxpayer was
-without fault in creating the overpayment and will incur financial hardship if the income
-tax refund is offset).
-
-J.
-
-If a tax refund offset is established, an overpayment shall not be recovered using another method
-in the month the offset occurs unless prior authorization is received from the individual making the
-recovery payments.
-
-K.
-
-The county department is required to pursue collection of the overpayment from the
-client/responsible payee who managed and administered the Colorado Works funds. The county
-department shall pursue all available overpayment recovery options to collect the overpayment
-from the client/responsible payee first and then any other liable individuals legally responsible for
-overpayments, unless otherwise specified.
-1.
-
-2.
-
-In instances where a trustee has used a client's trust income or property in a manner
-contrary to the terms of the trust, the county department shall:
-a.
-
-Determine whether an overpayment has occurred as a result of the client’s loss
-of income based on the trustee’s improper actions;
-
-b.
-
-Consult with the county attorney or other legal resource to determine how to
-pursue action against a trust/trustee;
-
-c.
-
-Advise the trustee of the overpayment circumstances; and
-
-d.
-
-If the trustee disagrees with such circumstances and overpayment, pursue the
-recovery establishment and collection through appropriate legal means; or
-
-e.
-
-Take appropriate steps to secure repayment with the cooperation of the trustee;
-or,
-
-f.
-
-Report such behavior or action by the trustee to the county protective services to
-ensure the protection of the client’s rights in the trust.
-
-In instances where a power of attorney has used his or her legal authority for purposes
-other than for the benefit of the client, the county department shall:
-
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-L.
-
-M.
-
-9 CCR 2503-6
-
-a.
-
-Determine whether an overpayment has occurred as a result of the power of
-attorney’s improper actions;
-
-b.
-
-Consult with the county attorney or other legal resource to determine how to
-pursue action against a power of attorney;
-
-c.
-
-Advise the holder of the power of attorney of the overpayment circumstances;
-and,
-
-d.
-
-If the holder of the power of attorney disagrees with such circumstances and
-overpayment, pursue the recovery establishment and collection through
-appropriate legal means; or
-
-e.
-
-Take appropriate steps to secure repayment with the cooperation of the holder of
-the power of attorney; or
-
-f.
-
-Report such behavior or action by the trustee to the county protective services to
-ensure the protection of the client’s rights and benefits.
-
-In any case in which an overpayment has been made, there shall be no recovery from any
-person:
-1.
-
-Who is without fault in the creation of the overpayment; and,
-
-2.
-
-Who has reported any increase in income or other circumstances affecting the client's
-eligibility within the timely reporting requirements for the program; and,
-
-3.
-
-Who would be deprived of income required for ordinary and necessary living expenses
-such that it would be against equity and good conscience to seek recovery. The fact that
-the client is receiving public assistance shall not be the only factor in making a
-determination that the person would be deprived of income required for ordinary and
-necessary living expenses and that equity and good conscience exist.
-a.
-
-If a client has ten (10) percent or more of income remaining after necessary living
-expenses, he or she shall not be considered deprived of income.
-
-b.
-
-If a client’s expenses exceed his or her income, additional questions must be
-asked to determine how he or she is meeting expenses to ascertain if other
-income (i.e. gift, in-kind) needs to be included in the income calculation.
-
-When the overpayment recovery is not pursued, such fact, together with the reason, shall be
-documented in the statewide automated system. All information pertaining to the reason,
-establishment, and collection of claims shall be retained in the case record until the claim is
-written off or paid in full.
-
-3.609.5 Intentional Program Violation (IPV) and Fraud
-A.
-
-All clients must be provided with their rights in relation to IPV as follows:
-1.
-
-The client has the right to an administrative disqualification hearing (ADH) before an
-administrative law judge (ALJ).
-
-2.
-
-The county department may offer an ADH at the county. This does not preclude the client
-from requesting the initial ADH or a second ADH be held before an ALJ under
-subsections M and O.
-
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-9 CCR 2503-6
-
-3.
-
-A client may waive the right to an ADH, either before an ALJ or with the county
-department, by signing a waiver of ADH form. Clients have a right to look at all the
-evidence that would be used at an ADH before deciding whether to waive the right to an
-ADH.
-
-4.
-
-If a client chooses to appear at the ADH he or she has the right to represent him or
-herself or to be represented by an attorney at his or her expense.
-
-5.
-
-The client may choose to be represented by any other person he or she chooses
-pursuant to section 26-2-127(1)(a)(IV), C.R.S.
-
-6.
-
-A client and/or his or her representative, upon providing a signed release, may look at his
-or her case file, including all the evidence that will be used at the ADH. The client and/or
-his or her representative has the right to look at his or her case file before and during the
-ADH.
-
-7.
-
-The county department shall provide a free copy of the evidence to be utilized during the
-ADH to the client at least fifteen (15) days prior to an ADH heard by the county. Upon
-request, the county department will provide a free copy of any other parts of the case file
-that the client determines is needed at the ADH.
-
-8.
-
-A client may bring witnesses to speak on his or her behalf at the ADH.
-
-9.
-
-The client and or his or her representative has the right to question or deny any evidence
-or statements made against him or her at the ADH. This includes the right to ask
-questions of persons testifying against him or her.
-
-10.
-
-The client has the right to present any evidence that he or she feels is important to prove
-his or her case.
-
-B.
-
-All Colorado Works clients must be provided with a written notice of the penalties for an IPV on
-the application form. All Colorado Works clients shall be notified of the penalties for an IPV when
-reporting changes on the redetermination form.
-
-C.
-
-A county department is required to refer the investigation to the appropriate investigatory agency
-for any client or representative payee whenever there is an allegation or reason to believe that
-individual has committed an IPV as described below.
-When conducting an interview for IPV and/or fraud, the county department investigator or
-representative has the responsibility to ensure the following:
-1.
-
-That an explanation was given to the individual regarding the reason the interview is
-taking place; and,
-
-2.
-
-That the individual’s rights have been provided to him or her (section 3.609.6.A); and,
-
-3.
-
-That the individual’s rights and responsibilities including confidentiality of records and
-information, the right to non-discrimination provisions, the right to a county conference,
-and the right to a state level fair hearing have been provided to him or her; and,
-
-4.
-
-That the rights and responsibilities presented in the “what I should know” section of the
-application that the client acknowledged when he or she signed the application form have
-not been violated; and,
-
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-5.
-
-9 CCR 2503-6
-
-That the county and/or representative of the county shall not threaten the individual or
-engage in any other intimidation tactics toward the client.
-
-D.
-
-If the county receives questionable information that is necessary for determining a client’s
-eligibility and the verification requested by the county department is not supplied by the client as
-required by the county department’s verification request timeframes (section 3.604.3), grant
-payments may be reduced and/or the case closed and grant payments terminated for a client’s
-failure to prove eligibility following the notice policies outlined in section 3.609.1. These actions
-and notification shall not be used as an intimidation tactic or threat.
-
-E.
-
-Following an investigation, the county must take action on cases where documented evidence
-exists to show a client has committed one or more acts of IPV. The county must take action
-through:
-1.
-
-Obtaining a “waiver of administrative disqualification hearing”; or,
-
-2.
-
-Proceeding with an ADH, either at the county department or in front of an ALJ, or both as
-described in subsections M. and O. below; or,
-
-3.
-
-Referring the case for civil or criminal action in a county or district court; or,
-
-4.
-
-Documenting in the case file the county department’s decision to take no action to pursue
-IPV using documented evidence to support the decision.
-
-5.
-
-Establishing a claim based on the IPV, if appropriate.
-
-F.
-
-In proceeding against a client who is alleged to have committed an IPV, the county department
-must coordinate any action with actions taken under the food assistance program where the
-factual issues are the same or related.
-
-G.
-
-Overpayment actions shall be initiated in the statewide automated system within ten (10)
-calendar days of the investigation’s conclusion, unless otherwise specified in the case file. This is
-required in all cases even if ADH procedures or referral for prosecution is not initiated, except in
-instances where notification of overpayments may prejudice the ongoing criminal case or
-investigation. In these instances, the county department may make the determination to postpone
-notification of claims to the client if the overpayment is being referred to a court of appropriate
-jurisdiction. The determination to postpone notification must be clearly documented in the case
-file.
-
-H.
-
-The state department will not condone any actions of the county department that could be
-determined to be a violation of state or federal law. Any actions taken by a county department
-that is determined to be in violation of state or federal law may be subject to corrective action per
-9 C.C.R. 2501-1 section 1.150.
-
-I.
-
-These rules apply to all clients who commit an IPV who are recipients or representative payees of
-grant payments and/or services. The determination of IPV shall be based on clear and convincing
-evidence that demonstrates intent to commit IPV.
-
-J.
-
-Supporting evidence warranting the pursuit of an IPV disqualification must be documented and
-reviewed by a supervisor. If the county department determines there is evidence to substantiate
-that a person has committed an IPV, the person has a right to an ADH. However, the county
-department shall allow that person the opportunity to waive the right to an ADH.
-
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-K.
-
-9 CCR 2503-6
-
-1.
-
-The State approved IPV forms shall be provided to the individual suspected of an IPV.
-These may be offered to the individual during the investigation or mailed once it has been
-suspected an IPV has occurred, but there is no plan to pursue criminal charges.
-
-2.
-
-One of the state approved forms affords the individual the right to waive the ADH. If the
-individual chooses to waive his or her right to an ADH, the individual shall have fifteen
-(15) calendar days from the date the IPV forms are hand-delivered or mailed by the
-county to return the waiver. If the form is not returned, the county department shall
-pursue an ADH.
-
-3.
-
-The completion of the waiver is voluntary and the county department may not require, nor
-by its actions appear to require, the completion of the waiver.
-
-An IPV ADH must be requested whenever:
-1.
-
-The facts of the case do not warrant civil or criminal prosecution;
-
-2.
-
-Documentary evidence exists to show an individual has committed one or more acts of
-IPV; and
-
-3.
-
-The individual has failed to sign and return the waiver of ADH form.
-
-L.
-
-An ADH may be requested against an accused individual whose case is currently being referred
-for prosecution on a civil or criminal action in county or district court.
-
-M.
-
-A county department may conduct an ADH or may use the Office of Administrative Courts (OAC)
-to conduct the ADH.
-1.
-
-The individual may request verbally, in writing, electronically, or in person that the OAC
-conduct the ADH in lieu of a county ADH. Such an ADH must be requested ten (10)
-calendar days before the scheduled date of the county ADH.
-
-2.
-
-The OAC or the county department must mail by certified mail, return receipt requested,
-a notice of the date of the ADH on the form prescribed by the state department, to the
-individual alleged to have committed an IPV. The notice must be mailed at least thirty
-(30) calendar days prior to the ADH date, to the individual’s last known address. The
-notice form shall include a statement that the individual may waive the right to appear at
-an ADH.
-
-3.
-
-The ALJ or ADH officer shall not enter a default judgment against the individual for failure
-to file a written answer to the notice of hearing or failure to appear at the ADH, but shall
-base the initial decision upon the evidence introduced at the ADH.
-
-4.
-
-The ADH must be continued at the accused individual's request if good cause is shown.
-The request for continuance must be received by the presiding ALJ or ADH officer at
-least ten (10) calendar days prior to the ADH.
-The ADH shall not be continued for more than a total of thirty (30) calendar days from the
-original ADH date. One additional continuance is permitted at the ADH officer or ALJ's
-discretion. If the ADH officer or ALJ considers it necessary, a medical assessment may
-be ordered to substantiate or disprove a good cause statement of an accused individual.
-Such assessment shall be obtained at the agency’s expense and made part of the
-record.
-
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-5.
-
-N.
-
-O.
-
-9 CCR 2503-6
-
-In the event that the ADH was heard by the county, the client may request an ADH to be
-heard by the OAC within fifteen (15) calendar days of the date the county department
-mails the local ADH decision to the client.
-
-Disqualification for IPV shall be as follows:
-1.
-
-If the individual signs and returns the request for waiver of ADH within fifteen (15)
-calendar days from the date the waiver is sent, that person shall be provided with a
-notice of the period of disqualification.
-
-2.
-
-The disqualification period shall begin no later than the first day of the following month
-from the date determined through the ADH process or, if the individual signed an ADH
-waiver, the date he or she signed the waiver.
-a.
-
-Once the disqualification is imposed it shall continue without interruption. To
-consider a disqualification period served, the client shall have a break in grant
-payments totaling the time period of the disqualification. The disqualification
-period shall remain in effect unless and until the finding is reversed by the Office
-of Appeals or a court of appropriate jurisdiction or until the period of
-disqualification is served per section c below.
-
-b.
-
-The disqualification may be in addition to any other penalties which may be
-imposed by a court of law for the same offenses (i.e. criminal or civil sanctions).
-
-c.
-
-The disqualification shall be in effect for twelve (12) months upon the first
-occasion of any such offense; twenty-four (24) months upon the second occasion
-of any such offense and permanently upon the third such offense, pursuant to
-section 26-2-128(1), C.R.S. all disqualifications imposed shall run and be served
-consecutively.
-
-3.
-
-The disqualification penalizes only the individual(s) found to have committed an IPV. If a
-client’s spouse and/or sponsor(s) have received an IPV on his or her own case(s), the
-spouse’s and/or sponsor(s)’ income and resources, when applicable, will be considered
-available to the client and used for determining eligibility.
-
-4.
-
-An IPV disqualification in one county is valid and effective in all other Colorado counties.
-A county department shall consider a disqualification imposed by another county
-department when determining the appropriate disqualification penalty for the disqualified
-individual without an additional ADH or further right to appeal.
-
-If, as a result of the ADH, the county ADH officer or ALJ finds the individual has committed an
-IPV, a written notice shall be provided to notify the individual of the decision. The county hearing
-decision notice shall be a state prescribed form, which includes a statement that a state ADH at
-the OAC may be requested.
-1.
-
-In the event that the ADH was heard by the county, the client may appeal the decision of
-the county ADH to the OAC. An appeal must be received by the county department or by
-the OAC within fifteen (15) calendar days of the date the county department mails the
-local ADH decision to the client. See section 3.609.7 for rules regulating the appeal
-process.
-
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-9 CCR 2503-6
-
-2.
-
-A copy of the county ADH decision shall be forwarded to the state department’s
-employment and benefits division for review at the same time the decision is mailed to
-the client. If the client does not appeal the county ADH decision to the OAC, it becomes
-an initial decision and if no response is sent by the employment and benefits division to
-the county department, the county’s decision becomes a final decision. If the employment
-and benefits division disagrees with the county department decision, they may: remand
-the decision to the county department or require the county to send the ADH request to
-OAC for determination of IPV, as described in M.5 above.
-
-3.
-
-In an ADH before an ALJ, the determination of IPV shall be an initial decision, which shall
-not be implemented while pending state department review and a final agency decision.
-The initial decision shall advise the client that failure to file exceptions to findings of the
-initial decision will waive the right to seek judicial review of a final agency decision under
-section 24-4-106, C.R.S. affirming the initial decision.
-
-4.
-
-When an individual waives his or her right to an ADH, a written notice of the
-disqualification penalty shall be mailed to the individual. This notice shall be on a state
-prescribed notice form.
-
-P.
-
-When the county department determines that it has paid a client a grant payment as a result of
-fraud, the facts used in the determination shall be reviewed with the department’s legal counsel
-within the attorney general’s office and/or a representative from the district attorney’s office. If
-suspected fraud is substantiated by the available evidence, the case shall be referred to the
-district attorney. All referrals to the district attorney shall be made in writing and shall include the
-amount of assistance fraudulently received by the client.
-
-Q.
-
-If any deduction is being made from the client’s assistance payment it must be consistent with
-any court order resulting from a prosecution by the district attorney. If the individual being
-prosecuted is not a Colorado Works program client, another method of recovery shall be used to
-collect amounts due to the department.
-
-R.
-
-1.
-
-Interest shall be charged from the month in which the overpayment was received until the
-date the overpayment is recovered. Interest shall be calculated at the legal rate.
-
-2.
-
-The client may choose to repay the county department the entire amount of the
-overpayment at one time or establish a repayment plan. In either instance, the fraud
-charge should be discussed with the district attorney or appropriate investigative
-authority.
-
-If the district attorney declines to prosecute, the amount of overpayment due, as established by
-the department, will continue to be recovered by deduction from subsequent grant payments or
-other method of recovery if the individual is not a current client of Colorado Works grant
-payments.
-
-3.609.6 Dispute Resolution
-The dispute resolution process is available for disputes concerning county department actions related to
-eligibility, reduction of grant payment amounts, redetermination procedures, and other county actions that
-do not involve allegations of fraud or IPV on the part of the client. If there is a dispute regarding fraud or
-IPV, that dispute must be handled according to sections 3.609.1 and 3.609.5 regarding IPVs and fraud. In
-order to resolve disputes between county departments and clients, county departments shall adopt
-procedures for the resolution of disputes consistent with this section. The procedures shall be designed to
-establish a simple, non-adversarial format for the informal resolution of disputes.
-
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-Income Maintenance (Volume 3)
-
-A.
-
-B.
-
-9 CCR 2503-6
-
-The county department, prior to taking action to deny, terminate, recover, initiate vendor
-payments, or modify financial assistance provided under the Colorado Works program to a client,
-shall, at a minimum, provide the client an opportunity for a county conference.
-1.
-
-The right of a client to a county conference is primarily to ensure that the proposed action
-is valid, to protect the client against an erroneous action concerning grant payments, and
-to ensure reasonable promptness of county action. The client may choose, however, to
-bypass the county conference and appeal directly to the state office of administrative
-courts, pursuant to section 3.609.7.
-
-2.
-
-The client is entitled to:
-a.
-
-Representation by an authorized representative retained at his or her own
-expense, such as legal counsel, relative, friend, or another spokesperson, or he
-or she may represent himself or herself;
-
-b.
-
-Examine the contents of the case file and all documents and records used by the
-county department or agency in making its decision. Examination of the file is
-available at a reasonable time before the conference and during the conference.
-However, the file shall not include names of confidential informants, privileged
-communications between the county department and its attorney, or the nature
-and status of pending criminal prosecutions and any other information that is
-confidential or privileged under state or federal law; and
-
-c.
-
-Present new information or documentation to support reversal or modification of
-the proposed adverse action.
-
-3.
-
-Failure of the client to request a county conference within ninety (90) calendar days from
-the date timely notice of the proposed action was mailed, absent the client requesting a
-postponement within that same ninety (90) days, shall constitute abandonment of the
-right to a conference. The client does not lose the right to appeal directly to the OAC
-pursuant to section 3.609.7.
-
-4.
-
-Failure of the client to appear at the scheduled county conference without making a
-request for postponement prior to the scheduled date of the conference shall constitute
-abandonment of the right to a conference unless the client can show good cause for his
-or her failure to appear. The client does not lose the right to appeal directly to the OAC
-pursuant to section 3.609.7.
-
-The county conference shall be held before a person who was not directly involved in the initial
-determination of the action in question. The county worker or contractor who initiated the action in
-dispute shall not conduct the county conference.
-1.
-
-The person designated to conduct the conference shall be in a position which, based on
-knowledge, experience, and training, would enable him or her to determine if the
-proposed action is valid. This could include, but is not limited to, a supervisor, quality
-assurance personnel, or a manager with no previous knowledge of the case.
-
-2.
-
-Two or more county departments may schedule a joint county conference related to the
-same client. If two or more counties schedule a joint county conference, the location of
-the conference need not be held in the county taking the action, and the conference
-location shall be convenient to the client.
-
-3.
-
-The county conference may be conducted either in person, by telephone, or by video
-conference. A telephonic or video conference must be agreed to by the client.
-
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-C.
-
-9 CCR 2503-6
-
-4.
-
-The county/agency worker or other county or department employee or contractor shall
-attend the county conference and present the factual basis for the disputed action.
-
-5.
-
-The county conference shall be conducted on an informal basis. The county
-department/agency must provide specific reasons for the proposed action, and the
-applicable state department's rules or county policy. In the event the client does not
-speak English or other language services are needed, an interpreter shall be provided by
-the county department/agency.
-
-6.
-
-The county/agency shall have available at the conference all pertinent documents and
-records in the case file relevant to the specific action in dispute.
-
-7.
-
-To the extent possible, the county conference shall be scheduled and conducted prior to
-grant payments being reduced or terminated.
-
-8.
-
-The county department shall provide notice to the client at least four (4) days prior to the
-scheduled time and location for the conference, or the time of the scheduled telephone or
-video conference. Notice should be in writing. The client may provide a written or verbal
-waiver that written notice of the scheduled conference is not necessary when the county
-department is able to conduct the conference within four (4) days.
-
-9.
-
-The county department may consolidate a client’s disputes regarding the Colorado Works
-program, the food assistance program, or any other public assistance program if the facts
-are similar and consolidation would facilitate resolution of all disputes.
-
-10.
-
-The goal of the county conference is to reach an agreement between the client and the
-county department.
-
-At the conclusion of the conference, the person presiding shall summarize the discussion in
-writing. The summary shall include whether the issue was resolved and include the client’s
-appeal rights as described in section 3.609.7. A copy of the written summary shall be provided to
-the client and/or his or her representative within eleven (11) calendar days. A copy of the
-summary will also be maintained in the client’s case file.
-
-3.609.7 Appeal and State Level Fair Hearing
-A.
-
-These rules apply to all state-level fair hearings of county department actions concerning
-assistance payments and actions taken pursuant to state rules or official county policies
-governing the Colorado Works program. An affected client who is dissatisfied with a county
-department action or the result of a county conference or failure to act concerning grant payments
-may appeal to the Office of Administrative Courts (OAC) for a fair hearing before an independent
-Administrative Law Judge (ALJ). This will be a full evidentiary hearing of all relevant and pertinent
-facts to review the decision of the county department. The time limitations for submitting a
-request for an appeal are:
-1.
-
-When the client elects to avail himself of a county conference, but is dissatisfied with that
-decision, the request must be submitted in writing and mailed or hand-delivered as
-described in subsection 3 below, within the ninety (90) day period specified in 2, below;
-
-2.
-
-When the client elects not to avail himself of a county dispute resolution conference but
-wishes to appeal directly to the state, a written request for an appeal must be mailed or
-hand-delivered as described in 3 below no later than ninety (90) calendar days from the
-date the notice of the proposed action was mailed to the client;
-
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-3.
-
-B.
-
-C.
-
-D.
-
-9 CCR 2503-6
-
-A request for an appeal must be mailed or hand-delivered to the office of administrative
-courts. If the request is sent to or mailed to the county department, the county shall
-forward such request to the OAC.
-
-Requests for state hearings may result from such reasons as:
-1.
-
-The opportunity to make application or reapplication has been denied;
-
-2.
-
-An application for assistance or services has not been acted upon within the maximum
-time period for the category of assistance;
-
-3.
-
-The application for assistance has been denied, the grant payment has been modified or
-discontinued, vendor payments have been initiated, requested reconsideration or a grant
-payment amount deemed incorrect has been refused or delayed, payment has been
-delayed through the holding of payments, the county department is demanding
-repayment for any part of a grant payment which the client does not believe is justified, or
-the client disagrees with the type or level of benefits or services provided.
-
-The basic objectives and purposes of the appeal and state hearing process are:
-1.
-
-To safeguard the interests of the client;
-
-2.
-
-To provide a practical means by which the client is afforded a protection against incorrect
-action on the part of the county department;
-
-3.
-
-To bring to the attention of the state department and county department information that
-may indicate need for clarification or revision of state and county policies and procedures;
-
-4.
-
-To assure equitable treatment through the administrative process without resort to legal
-action in the courts.
-
-Any clear expression verbally or in writing by the client or his or her representative, that the client
-wants an opportunity to have a specific action of a county department reviewed by the state
-department is considered a request for a state level fair hearing. The county department shall,
-when asked, aid the person in preparation of a request for a hearing. If the request for a hearing
-is made verbally, the county department shall prepare a written request within ten (10) calendar
-days for the client or his or her representative’s signature or have the client prepare such request,
-specifying the action he or she would like to appeal and the reason for appealing that action.
-1.
-
-The client is entitled to:
-a.
-
-Representation by any person he or she chooses pursuant to section 26-2127(1)(a)(iv), C.R.S., legal counsel retained at the client’s own expense, or he or
-she may represent him or herself;
-
-b.
-
-Examine the complete case file and any other documents, records, or pertinent
-material to be used by the county at the state level fair hearing, including the
-hearing packet as described in section 3.609.711.D.3, before the date of hearing
-as well as during the hearing. However, the file shall not include the names of
-confidential informants, privileged communications between the county
-departments and its attorney, the nature and status of pending criminal
-prosecutions, and any other information that is confidential or privileged under
-state or federal law.
-
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-2.
-
-9 CCR 2503-6
-
-The client and staff of the county department are entitled to:
-a.
-
-Present witnesses;
-
-b.
-
-Establish all facts and circumstances pertinent to the decision being appealed;
-
-c.
-
-Advance any arguments without undue interference;
-
-d.
-
-Question or refute any testimony or evidence, including opportunity to confront
-and cross-examine adverse witnesses.
-
-3.609.71
-
-Hearing Procedures
-
-3.609.711
-
-State Level Fair Hearing Procedures
-
-The procedures in this section apply to all hearings in front of the OAC. One or more persons from the
-Colorado Department of Personnel and Administration, Office of Administrative Courts (OAC), are
-appointed to serve as ALJs for the state department.
-All hearings described in this section shall be conducted in accordance with section 24-4-105, C.R.S.
-A.
-
-The State Administrative Law Judge shall, in preparation for the hearing, review the reasons for
-the decision under appeal and be prepared to interpret applicable Departmental rules and/or
-official written county policies governing the Colorado Works program and pertaining to the issue
-under appeal.
-
-B.
-
-The county department shall forward copies of its applicable Colorado Works policies and any
-subsequent amendments, including effective dates, to the OAC. Clients appealing a county action
-shall be provided reasonable opportunity to examine the county's policies.
-
-C.
-
-When legal counsel does not represent the client and/or the department, the ALJ shall assist in
-bringing forth all relevant evidence and issues relating to the appeal.
-
-D.
-
-Upon receipt by the OAC of an appeal request, OAC assigns a case number. The OAC sets a
-hearing date at least ten (10) days from the date the appeal was requested, and sends a letter by
-first class or certified mail, or by email through the electronic filing system to the appellant and the
-county department notifying them of the date, time, and place of the hearing.
-1.
-
-The appellant is told that if these arrangements are not satisfactory, he or she must notify
-the OAC. An ALJ will decide if good cause exists, and whether the date, time, and/or
-place of the hearing will be changed.
-
-2.
-
-An information sheet shall be enclosed to explain the hearing procedures to the
-appellant. The information sheet informs the appellant that: he or she has the right to
-representation retained at his or her own expense, such as legal counsel, a relative, a
-friend, or another spokesperson, or he or she may represent himself or herself under
-section 26-2-127(1)(a)(iv), C.R.S.; the appellant or his or her representative has the right
-to examine all materials to be used at the hearing, before and during the hearing.
-
-3.
-
-For all hearings except IPV ADH hearings, the information sheet shall also include a
-notice that failure to appear at the hearing as scheduled, without having secured a proper
-extension in advance, or without having shown good cause for failure to appear, shall
-constitute abandonment of the appeal and cause a dismissal thereof. Pursuant to section
-3.609.5.M.2-3., failure to appear does not result in a dismissal of an ADH hearing.
-
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-4.
-
-E.
-
-9 CCR 2503-6
-
-If OAC sets the hearing forty-five (45) days or more from the date of the notice of hearing,
-the county department/agency shall, within fifteen (15) days but no later than thirty (30)
-days prior to the hearing, prepare and mail a hearing packet to the appellant with a copy
-to OAC. If the hearing is set less than 45 days from the date of the notice of hearing, the
-county department/agency shall, within five (5) days but no later than ten (10) days prior
-to the hearing, prepare and mail the hearing packet. The hearing packet shall contain the
-following information:
-a.
-
-The reasons for the decision of the county department and a specific explanation
-of each factor involved, such as the amount of excess income or residence
-factors;
-
-b.
-
-The specific state rules governing the Colorado Works program or county policy
-on which the decision is based with a numeric reference to each such rule,
-including the appropriate Code of Colorado Regulations (C.C.R.) cites;
-
-c.
-
-Notice that the county department will assist him or her by providing relevant
-documents from the case file for his or her claim, if he or she so desires, and that
-he or she has the opportunity to examine rules and other materials to be used at
-the hearing concerning the basis of the county decision.
-
-5.
-
-Information that the appellant or his or her representative does not have an opportunity to
-see shall not be made available as a part of the hearing record or used in a decision on
-an appeal. No material made available for review by the ALJ may be withheld from
-review by the appellant or his or her representative.
-
-6.
-
-In Colorado Works program appeals, the ALJ has twenty (20) calendar days from the
-hearing date to arrive at an initial decision. Once an initial decision is rendered, the OAC
-immediately sends the case and the initial decision to the State Department, Office of
-Appeals. The Office of Appeals serves the initial decision on the parties via first class
-mail and provides for an opportunity for the parties to file exceptions to the initial decision
-prior to the Office of Appeals issuing a final agency decision.
-
-7.
-
-The initial decision shall not be implemented pending review by the Office of Appeals and
-entry of a final agency decision. All final agency decisions on these appeals shall be
-made within ninety (90) calendar days from the date the request for hearing is received.
-
-When the client has had a county conference and wishes to appeal the county department's
-action to the OAC, the following procedures shall be followed:
-1.
-
-As part of the local conference the client is informed that if he or she wishes to appeal to
-the OAC for a hearing, the county department shall provide relevant documents from the
-case file for the client’s claim, if he or she so desires, and that he or she may have the
-opportunity to examine materials as described in the section 3.609.
-
-2.
-
-The county department shall forward a copy of the decision being appealed and a copy of
-the written notification given to the client to the OAC.
-
-3.
-
-A copy of the OAC’s notice to the client setting a date for the hearing is forwarded to the
-county department. The county department shall provide the client with a hearing packet
-in accordance with section 3.609.711.D.3.
-
-4.
-
-If the client indicates to the county department that he or she desires to withdraw the
-appeal, the county shall attempt to obtain a statement to that effect in writing and forward
-it to the OAC.
-
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-
-5.
-
-If a client has legal counsel or another authorized representative for the appeal, the
-county department will not discuss the merits of the appeal or the question of whether or
-not to proceed with it with the client unless the discussion is in the presence of, or with
-the permission of, such counsel or such other authorized representative.
-
-6.
-
-If the county department learns that legal counsel will represent the client, the county
-department shall make every effort to ensure that it, too, is represented by an attorney at
-the hearing. The county department may be represented by an attorney in any appeal
-that it considers such representation desirable.
-
-7.
-
-If the appellant needs interpretation services, the county department shall arrange to
-have present at the hearing a certified interpreter who will be sworn to translate correctly.
-
-8.
-
-The fact that an appellant and the county department have been notified that a hearing
-will be held does not prevent the county department from reviewing the case and
-considering any new factors which might change the status of the case, or taking such
-action as may be indicated to reverse its decision or otherwise settle the issue. Any
-change, which results in a voiding of the cause of appeal, shall be immediately reported
-to the OAC.
-
-9.
-
-Upon receipt of notice of a state hearing on an appeal, the county department shall
-arrange for a suitable hearing room appropriate to accommodate the number of persons,
-including witnesses, who are expected to be in attendance, taking into consideration such
-factors as privacy; absence of distracting noise; and the need for table, chairs, electrical
-outlets, adequate lighting and ventilation, and conference telephone facilities.
-
-F.
-
-Telephonic hearings may be conducted as an alternative to in-person hearings unless otherwise
-requested by any of the parties. All applicable provisions of the in-person hearing procedures will
-apply, such as the right to be represented by counsel, the right to examine and cross-examine
-witnesses, the right to examine the contents of the case file, and the right to have the hearing
-conducted at a reasonable time and date.
-
-G.
-
-The county department shall have the burden of proof, by a preponderance of the evidence, to
-establish the basis of the ruling being appealed. Every party to the proceeding shall have the right
-to present his or her case or defense by verbal and documentary evidence, to submit rebuttal
-evidence, and to conduct such cross-examination as may be required for a full and true
-disclosure of the facts. Subject to these rights and requirements, where a hearing is expedited
-and the interests of the parties will not be subsequently prejudiced thereby, the ALJ may receive
-all or part of the evidence in written form or by verbal stipulations.
-
-H.
-
-The following provisions govern the procedure at state hearings before the ALJ:
-1.
-
-The hearing is closed to the public however, any person or persons whom the appellant
-wishes to appear for or with him or her may be present, and, if requested by the appellant
-and in the record, such hearing may be public;
-
-2.
-
-The purpose of the hearing is to determine the pertinent facts in order to arrive at a fair
-and equitable decision in accordance with the rules of the state department. In arriving at
-a decision, only the evidence and testimony introduced at the hearing is considered by
-the ALJ. However, in circumstances when it is shown at the hearing that medical or other
-evidence could not, for good cause, be obtained in time for the hearing, the ALJ may
-permit the introduction of such evidence after the hearing. The opposing party must also
-be furnished with a copy of this new evidence and must have the opportunity to
-controvert or otherwise respond to it. Delays in rendering the initial decision will be
-attributed to the party requesting that the ALJ hear additional evidence after the hearing;
-
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-
-3.
-
-Although the hearing is conducted on an informal basis and an effort is made to place all
-the parties at ease, it is essential that the evidence be presented in an orderly manner so
-as to result in an adequate record;
-
-4.
-
-When an ALJ makes a decision regarding the merits of the case, or the dismissal of the
-appeal, that decision is called an initial decision.
-
-5.
-
-A complete and exact record of the proceedings shall be made by electronic or other
-means. When requested by the party, the OAC shall cause the proceedings to be
-transcribed.
-
-6.
-
-When the ALJ dismisses an appeal for reasons other than failure to appear, the decision
-of the ALJ shall be an initial decision, which shall not be implemented until the Office of
-Appeals completes its review and enters a final decision.
-
-7.
-
-The ALJ shall not enter a default against any party for failure to file a written answer in
-response to the notice of hearing, but shall base the initial decision upon the evidence
-introduced at the hearing. However, an appellant may be granted a postponement of the
-hearing if the county department has failed to provide the hearing packet required by
-section 3.609.711, and the appellant has therefore been unable to prepare for the
-hearing.
-
-8.
-
-When OAC has notified the appellant of the time, date, and place of the OAC hearing and
-the appellant fails to appear at the hearing, without giving notice to the ALJ of acceptable
-good cause for his or her inability to appear at the hearing, then the appeal shall be
-considered abandoned. The ALJ shall enter an order of dismissal and the OAC shall
-serve it upon the parties. The dismissal order shall not be implemented pending review
-by the Office of Appeals and entry of an agency decision.
-However, the appellant shall have ten (10) calendar days from the date the order of
-dismissal was mailed to draft and send a letter to the ALJ explaining the reason for his or
-her failure to appear. If the ALJ then finds that there was good cause for the appellant not
-appearing, the ALJ shall vacate the order dismissing the appeal and reschedule the
-hearing date.
-If the appellant does not submit a letter seeking to show good cause within the ten (10)
-day period, the order of dismissal shall be filed with the Office of Appeals of the state
-department. The Office of Appeals shall review the dismissal of the appeal and give the
-appellant time to file exceptions before issuing a final agency decision in accordance with
-the procedures in section 3.609.72.
-After the final agency decision is served on the parties, the county department shall carry
-out the necessary actions within ten (10) calendar days of the final agency decision
-becoming effective. The actions may be: to provide assistance or services in the correct
-amount, to terminate assistance or services, to recover assistance incorrectly paid,
-and/or other appropriate actions in accordance with the rules. Pursuant to section 24-4106(5), C.R.S., the effective date of the final agency decision may be postponed if the
-appellant makes a request for postponement due to irreparable injury to the state
-department or the court reviewing the final agency action on judicial review.
-
-3.609.72
-A.
-
-Decision and Notification
-
-Following the conclusion of the state level fair hearing, the ALJ shall promptly prepare and issue
-an initial decision and file it with the State Department, Office of Appeals.
-
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-
-The Office of Appeals of The State Department is the designee of the State Department’s
-executive director for reviewing the initial decision of the ALJ. The Office of Appeals enters a final
-agency decision on behalf of the executive director affirming, modifying, or reversing the initial
-decision.
-
-B.
-
-1.
-
-The initial decision shall make an initial determination whether the county or state
-department or its agent acted in accordance with, and/or properly interpreted, the rules of
-the state department and/or the county policies governing the Colorado Works program.
-
-2.
-
-The ALJ has no jurisdiction or authority to determine issues of constitutionality or legality
-of Colorado Statute, departmental rules, or county policy(ies) governing the Colorado
-Works program.
-
-3.
-
-The initial decision shall advise the client who brought the appeal that failure to file
-exceptions to the initial decision will waive the right to seek judicial review under section
-24-4-106, C.R.S. of a final agency decision that affirms the initial decision.
-
-4.
-
-The Office of Appeals shall promptly serve the initial decision upon each party by first
-class mail, and shall transmit a copy of the decision either electronically or by mail to the
-division of the state department that administers the program(s) pertinent to the appeal.
-
-5.
-
-The initial decision shall not be implemented pending review by the Office of Appeals and
-entry of an agency decision.
-
-Upon receiving the initial decision, the Office of Appeals may issue an order of remand based on
-an issue that warrants an immediate remand before the initial decision is even mailed to the
-parties.
-Additionally, the Office of Appeals may issue an order of remand after its substantive review of an
-initial decision, and prior to issuing a final agency decision, based on the need for further
-clarification, findings, conclusions of law, and/or further proceedings. An order of remand is not a
-final agency decision that is subject to judicial review under section 24-4-106, C.R.S.
-
-C.
-
-Any party seeking final agency decision which reverses, modifies, or remands the initial decision
-of the ALJ shall file exceptions to the decision with the Office of Appeals, within fifteen (15) days
-(plus three days for mailing) from the date the initial decision is mailed to the parties. If that date
-falls on a weekend or State holiday, the due date shall be moved to the next business day.
-Exceptions must state specific grounds for reversal, modification or remand of the initial decision.
-1.
-
-If the party asserts that the ALJ’s findings of fact are not supported by the weight of the
-evidence, the party shall, simultaneously with, or prior to, the filing of exceptions request
-the OAC create a transcript of all or a portion of the hearing and file it with the Office of
-Appeals. No transcript is required if the review is limited to a pure question of law.
-Similarly, if the exceptions assert only that the ALJ improperly interpreted or applied State
-rules or statutes, the party filing exceptions is not required to provide a transcript or
-recording to the Office of Appeals.
-If applicable, the exceptions shall state that a transcript has been requested. Within five
-(5) days of the request for transcript, the party requesting it shall advance the cost
-therefore to the transcriber designated by the OAC unless the transcriber waives prior
-payment.
-
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-9 CCR 2503-6
-
-2.
-
-A party who is indigent and unable to pay the cost of a transcript may file a written
-request, which need not be sworn, with the Office of Appeals for permission to submit a
-copy of the hearing recording instead of the transcript. If submission of a recording is
-permitted, the party filing exceptions must promptly request a copy of the recording from
-the OAC and deliver it to the Office of Appeals. Payment in advance shall be required for
-the preparation of a copy of the recording.
-
-3.
-
-The Office of Appeals shall serve a copy of the exceptions on each party by first class
-mail. Each party shall be limited to ten (10) calendar days from the date exceptions are
-mailed to the parties in which to file a written response to such exceptions. The Office of
-Appeals shall not permit oral argument.
-
-4.
-
-The Office of Appeals shall not consider evidence that was not part of the record before
-the ALJ. However, the case may be remanded to the ALJ for rehearing if a party
-establishes in its exceptions that material evidence has been discovered which the party
-could not with reasonable diligence have produced at the hearing.
-
-5.
-
-While review of the initial decision is pending before the Office of Appeals, the record on
-review, including any transcript or recording of testimony filed with the Office of Appeals,
-shall be available for examination by any party at the Office of Appeals during regular
-business hours.
-
-6.
-
-The state department’s division(s) responsible for administering the program(s) relevant
-to the appeal may file exceptions to the initial decision, or respond to exceptions filed by
-a party, even though the division has not previously appeared as a party to the appeal.
-The division's exceptions or responses must be filed in compliance with the requirements
-of this section exceptions filed by a division that did not appear as a party at the hearing
-shall be treated as requesting review of the initial decision upon the state department's
-own motion.
-
-7.
-
-In the absence of exceptions filed by any party or by a division of the state department,
-the Office of Appeals shall review the initial decision, and may review the hearing file of
-the ALJ and/or the recorded testimony of witnesses, before entering a final agency
-decision. Review by the Office of Appeals shall determine whether the decision properly
-interprets and applies the rules of the state department and/or relevant statutes, and
-whether the findings of fact and conclusions of law support the decision. If a party or
-division of the state department objects to the final agency decision entered upon review
-by the Office of Appeals, the party or division may seek reconsideration of the final
-agency decision pursuant to subsection c, below.
-
-8.
-
-The Office of Appeals shall mail copies of the final agency decision to all parties by first
-class mail.
-
-9.
-
-For purposes of requesting judicial review under section 24-4-106, C.R.S., the effective
-date of the final agency decision shall be the third day after the date the decision is
-mailed to the parties, even if the third day falls on Saturday, Sunday, or a legal holiday.
-The parties shall be advised of this in the final agency decision.
-
-10.
-
-The State or county department shall initiate action to comply with the final agency
-decision within three (3) business days after the effective date. The department shall
-comply with the decision even if reconsideration is requested, unless the effective date of
-the agency decision is postponed by order of the Office of Appeals or a reviewing court
-pursuant to section 24-4-106(5), C.R.S.
-
-102
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-D.
-
-9 CCR 2503-6
-
-No motion for reconsideration shall be granted unless it is filed in writing with the Office of
-Appeals within fifteen (15) days of the date that the final agency decision is mailed to the parties.
-The motion must state specific grounds for reconsideration of the final agency decision.
-The Office of Appeals shall mail a copy of the motion for reconsideration to each party of record
-and transmit electronically or in writing to the appropriate division of the state department.
-A motion for reconsideration of a final agency decision may be granted by the Office of Appeals
-for the following reasons:
-1.
-
-A showing of good cause for failure to file exceptions to the initial decision within the
-fifteen (15) day period allowed by section 3.609.7; or,
-
-2.
-
-A showing that the agency decision is based upon a clear or plain error of fact or law. An
-error of law means failure by the Office of Appeals to follow a rule, statute, or court
-decision, which controls the outcome of the appeal.
-
-E.
-
-When a final agency decision concludes that an action of the county or state department was not
-in accordance with rules of the department, or when the county or state department determines
-that its action was not supported by the state department’s rules after the client makes a request
-for a hearing, the adjustment or corrective payment is made retroactively to the date of the
-incorrect action.
-
-F.
-
-The client is to be fully informed by the final agency decision of his or her further right to apply for
-judicial review of the agency decision. Judicial review can be started by filing an action for review
-in the appropriate state district court. Any such action must be filed in accordance with section 244-106, C.R.S. and with the Colorado Rules of Civil Procedure within thirty-five (35) days after the
-final agency decision becomes effective.
-
-G.
-
-The state department will establish and maintain a method for informing, in summary and
-depersonalized form, all county departments and other interested persons concerning the issues
-raised and decisions made on appeals.
-
-3.609.73
-A.
-
-Protections to the Individual
-
-Confidentiality
-All information obtained by the county department concerning a client of Colorado Works is
-confidential information.
-1.
-
-The county department shall inform county officials and other persons who have dealings
-with the department as to the confidential nature of information, which may come into
-their possession through transaction of department business.
-When a county worker consults a bank, current/former employer of a client, another
-social agency, etc., to obtain information or eligibility verification information, the
-identification of the county worker as an employee of the county department will, in itself,
-disclose that an application for assistance has been made by a client. In this type of
-contact, as well as other community contacts, the department shall strive to maintain
-confidentiality whenever possible.
-
-103
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-B.
-
-9 CCR 2503-6
-
-2.
-
-Ensuring privacy while interviewing and the continuous confidentiality of information are
-essential. This involves both office facilities and county worker discretion. Office
-procedures and facilities should be such that information is not inadvertently revealed to
-persons not concerned with the affairs of a particular client. The county worker must also
-use discretion in mentioning department business outside the office.
-
-3.
-
-The county or state department may share information across systems so that a client is
-efficiently served by programs using other systems to determine eligibility/maintain
-information to the extent allowable under section 26-1-114, C.R.S.
-
-Confidentiality must be treated as follows:
-1.
-
-Aggregated information not identified with any client, such as caseload statistics and
-analysis, is not confidential and may be released for any purpose.
-
-2.
-
-Information secured by the county department for the purpose of determining eligibility
-and need is confidential.
-
-3.
-
-Unless disclosure is specifically permitted by the state department, the following types of
-information are the exclusive property of, and are restricted to use by, the state and
-county departments:
-
-4.
-
-a.
-
-Names and addresses of Colorado Works clients, and/or the grant payment
-amount;
-
-b.
-
-Information contained in applications, reports of medical examinations,
-correspondence, and other information concerning any person from whom, or
-about whom, information is obtained by the county department;
-
-c.
-
-Records of state or county departmental evaluations of the above information.
-
-d.
-
-All information obtained through the Income and Eligibility Verification System
-(IEVS).
-
-No one outside the state or county department shall have access to records of the
-department except for the following individuals: those executing the Income and Eligibility
-Verification System (IEVS); child support services officials; the SSA; and federal and
-State auditors and private auditors for the county these individuals shall have access only
-for purposes necessary for the administration of the program.
-a.
-
-Client records may be used as exhibits for administrative, civil and/or criminal
-proceedings when the proceedings relate directly to the receipt of Colorado
-Works Programs.
-
-b.
-
-Additional individuals shall have access to the client’s records as long as the
-client is notified and his or her prior permission for release of information is
-obtained, unless the information is to be used to verify income or eligibility under
-administration of the IEVS.
-
-104
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-5.
-
-9 CCR 2503-6
-
-c.
-
-If the information is needed to provide benefits to a client in an emergency
-situation, and the client is physically or mentally incapacitated to the extent that
-he or she cannot sign the release form, and time does not permit obtaining the
-client’s consent prior to release of information, the county department must notify
-the client within eleven (11) calendar days after supplying the information. If the
-applicant or client does not have a telephone or cannot be personally contacted
-within eleven (11) days, the county department must send written notification
-containing the required information. The verbal or written notification shall include
-the name and address of the agency that requested the information, the reason
-the information was requested and a summary of the information released.
-
-d.
-
-The release of records is strictly conditioned upon the information being used
-solely for the purpose authorized and the person requesting the information must
-certify the use to be made of the information and that it will not be disclosed or
-used for any other purpose.
-
-The district attorney or county human services board member, shall have access to the
-records of the department, excluding IEVS information, if the following identified consent
-or notice conditions are met.
-a.
-
-A district attorney upon presentation of a written request accompanied by
-evidence that fraud is the reason for the request
-
-b.
-
-A county human services board member, as described in section 26-1-116,
-C.R.S. if the board member has an obligation to perform Colorado Works duties
-per county business processes or county policies approved by the state
-department as described in section 3.600.2.
-
-When a county board member or a district attorney who has met the above conditions
-needs information about a client that is not in the possession of the county department,
-the requestor, with the aid of the county department, may contact the state department to
-inquire as to the appropriate methods of securing it.
-6.
-
-County departments shall not release information regarding clients to law enforcement
-agencies unless a valid search warrant is received by the county or state department,
-except as provided in section 3.609.73.B.4.
-
-7.
-
-Upon request to the state department by the Colorado Bureau of Investigation, with the
-responsibility for location and apprehension of a person with an outstanding felony arrest
-warrant, the addresses of a fleeing felon who is a client of Colorado Works programs
-shall be released pursuant to section 26-1-114(3)(a)(iii) C.R.S.
-
-8.
-
-The client shall have an opportunity to examine such pertinent records concerning him or
-her as constitutes a basis for adverse action and in the case of a county conference or a
-state level fair hearing. Other requests for information by the client shall be honored only
-when the client makes the request in person and his or her identity is verified or the
-request is in the form of a written and signed statement.
-The client may designate an individual, firm, or agency to represent him or her at
-conferences and hearings. The client must put the designation of such representative in
-writing. The representative shall have access to all pertinent records.
-
-105
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-9 CCR 2503-6
-
-9.
-
-The client may give a formal written release for disclosure of information to other
-agencies, such as hospitals or advocate agencies. If the client is not present, or the
-opportunity to agree or object to the use or disclosure cannot practicably be provided
-because of the client’s incapacity or an emergency circumstance, the department may, in
-the exercise of professional judgment, determine whether the disclosure is in the best
-interests of the client and, if so, disclose only the minimum confidential information
-necessary that is directly relevant to the client’s care.
-
-10.
-
-Information provided to agencies and/ or individuals must be limited to the specific
-information required to determine eligibility, conduct ongoing case management, or
-otherwise necessary for the administration of the Colorado Works program. Information
-obtained through IEVS will be stored and processed so that no unauthorized personnel
-can acquire or retrieve the information. County departments are responsible for limiting
-IEVS data to only those individuals requiring access to determine eligibility or otherwise
-administer the programs.
-All persons with access to information obtained pursuant to the income and eligibility
-verification requirements will be advised of the circumstances under which access is
-permitted, how data will be utilized, confidentiality of data, and the sanctions imposed for
-illegal use or disclosure of the information.
-
-3.609.74
-
-Protection Against Discrimination
-
-County departments are to administer Colorado Works in such a manner that no client will, on the basis
-of race, color, religion, creed, national origin, ancestry, sex/gender (including transgender status),
-pregnancy, age, sexual orientation, gender identity, political affiliation, or physical or mental disability, or
-any other protected groups as described in the state department’s anti-discrimination policy, be excluded
-from participation, be denied any aid, care, or services, or other benefits of, or be otherwise subjected to
-discrimination in his or her interactions with the Colorado Works program.
-A.
-
-The references to “aid” includes all forms of assistance, including direct and vendor payments,
-work programs and information and referral services.
-
-B.
-
-The county department shall not, directly or through contractual or other arrangements, on the
-grounds of race, color, religion, creed, national origin, ancestry, sex/gender (including
-transgender status), pregnancy, age, sexual orientation, gender identity, political affiliation, or
-physical or mental disability, or any other protected status: :
-1.
-
-Provide any aid to an individual which is different, or is provided in a different manner,
-from that provided to others;
-
-2.
-
-Subject a client to segregation barriers or separate treatment in any manner related to
-access to or receipt of assistance, care services, or other benefits;
-
-3.
-
-Restrict a client in any way in the enjoyment or any advantage or privilege enjoyed by
-others receiving aid, care, services, or other benefits provided under assistance
-programs;
-
-4.
-
-Treat a client differently from others in determining whether he or she satisfies any
-eligibility or other requirements or conditions which must be met in order to receive aid,
-care, services, or other benefits provided under the Colorado Works program;
-
-5.
-
-Deny a client an opportunity to participate in assistance programs through the provision
-of services or otherwise, or afford him or her an opportunity to do so which is different
-from that afforded others under programs of assistance.
-
-106
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-6.
-
-9 CCR 2503-6
-
-Deny a client the opportunity to participate as a member of a planning or advisory body
-that is an integral part of the program.
-
-C.
-
-No distinction is permitted in relation to the use of physical facilities, intake and application
-procedures, caseload assignments, determination of eligibility, and the amount and type of
-benefits extended by the county department to clients.
-
-D.
-
-The county department shall ensure that other non-federal agencies, persons, contractors and
-other entities with which it contracts business are in compliance with the above prohibition of
-discrimination requirements on a continuing basis. The county department staff is responsible for
-being alert to any discriminatory activity of other agencies and for notifying the state department
-concerning the situation.
-
-E.
-
-The State department, through its various contacts with agencies, persons, and referral sources,
-will be continuously alert to discriminatory activity and will take appropriate action to assure
-compliance with these prohibitions against discrimination the county department, on notification
-by the state department, will also terminate payments to the offender or association with any
-agency, person, or resource being used which has been found by the state department or the
-Colorado Civil Rights Division to continue discriminatory activity against clients.
-
-F.
-
-A client who believes he or she is being discriminated against may file a complaint with the
-county department, the state department, the Colorado Civil Rights Division or directly with the
-federal government. When a complaint is filed with the county department, the county director is
-responsible for an immediate investigation of the matter and taking necessary corrective action to
-eliminate any discriminatory activities found. If such activities are not found, the client is given a
-written explanation of the outcome. If the client is not satisfied, he or she is requested to direct his
-or her complaint, in writing, to the state department, client services section, which will be
-responsible for further investigation and other necessary action. The client services section can
-be reached by email at cdhs_clientservices@state.co.us.]
-
-3.609.75
-
-Additional Programs and Services
-
-3.609.751
-
-Optional Noncustodial Parent Programs
-
-A county may provide services under the Colorado Works program to a noncustodial parent (as defined in
-section 3.601), in accordance with the county’s policy. A noncustodial parent shall not be eligible to
-receive basic cash assistance under the program.
-A.
-
-Such services provided to a noncustodial parent shall be intended to promote the sustainable
-employment of the noncustodial parent and enable such parent to pay child support.
-
-B.
-
-Provision of such services shall not negatively impact the custodial parent’s eligibility for benefits
-or services.
-
-C.
-
-Any services offered to a noncustodial parent shall be based on the county’s review of:
-1.
-
-The noncustodial parent’s request for services; and,
-
-2.
-
-The county’s assessment of the noncustodial parent’s needs.
-
-D.
-
-All services offered to a noncustodial parent shall be outlined in an Individualized Plan entered
-into by the county and the noncustodial parent.
-
-E.
-
-Services may include, but are not limited to, parenting skills, mediation, workforce development,
-job training activities, and job search.
-
-107
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-9 CCR 2503-6
-
-_________________________________________________________________________
-Editor’s Notes
-Primary sections of 9 CCR 2503-1 have been recodified effective 09/15/2012. See list below. Versions
-and rule history prior to 09/15/2012 can be found in 9 CCR 2503-1. Prior versions can be accessed from
-the All Versions list on the current rule page.
-Rule section 3.100, et seq. has been recodified as 9 CCR 2503-1, (Reserved for Future Use).
-Rule section 3.200, et seq. has been recodified as 9 CCR 2503-2, (Reserved for Future Use).
-Rule section 3.300, et seq. has been recodified as 9 CCR 2503-3, COLORADO REFUGEE SERVICES
-PROGRAM (CRSP).
-Rule section 3.400, et seq. has been recodified as 9 CCR 2503-4, (Reserved for Future Use).
-Rule section 3.500, et seq. has been recodified as 9 CCR 2503-5, ADULT FINANCIAL PROGRAMS.
-Rule section 3.600, et seq. has been recodified as 9 CCR 2503-6, COLORADO WORKS PROGRAM.
-Rule section 3.700, et seq. has been recodified as 9 CCR 2503-7, LOW-INCOME ENERGY
-ASSISTANCE PROGRAMS (LEAP).
-Rule section 3.800, et seq. has been recodified as 9 CCR 2503-8, ADMINISTRATIVE PROCEDURES
-FOR THE COLORADO CHILD CARE ASSISTANCE PROGRAM.
-Rule section 3.900, et seq. has been recodified as 9 CCR 2503-9, COLORADO CHILD CARE
-ASSISTANCE PROGRAM.
-History
-Rules 3.600-3.609 eff. 09/15/2012. Rules 3.610-3.638 repealed eff. 09/15/2012.
-Rules 3.600.1, 3.604.1, 3.605.3, 3.606.6, 3.608.4, 3.609.95 eff. 04/01/2013.
-Rules 3.602.1.E, 3.602.1.I, 3.604.2, 3.605.3.D, 3.605.3.E.1, 3.605.3.E.2, 3.606.1-3.606.3, 3.606.4.A,
-3.606.4.B, 3.606.4.F-G, 3.606.4.L, 3.608.4.H.1-3.608.4.H.4, 3.608.4.I-3.608.4.J, 3.609.1.A.13.609.1.A.2 eff. 07/01/2013.
-Rule 3.606.4.B eff. 08/07/2013.
-Rules 3.602.1-3.602.1.E emer. rule eff. 07/11/2014.
-Rules 3.602.1-3.602.1.E eff. 10/01/2014.
-Rule 3.602.1 emer. rule eff. 06/05/2015.
-Rules 3.600.31, 3.601, 3.602.1, 3.604.1, 3.604.2, 3.605.2, 3.606.6, 3.606.8, 3.607.2, 3.608.1, 3.608.3,
-3.608.4, 3.609.961-3.609.962 eff. 07/01/2015.
-Rule 3.602.1 emer. rule eff. 06/05/2015.
-Rule 3.602.1 eff. 09/01/2015.
-Rules 3.602.1-3.602.1.E, 3.609.3-3.609.3.J eff. 01/01/2016.
-Rules 3.605.2.F, 3.605.3.A.1, 3.605.3.D.24.a eff. 11/01/2016.
-Rules 3.602.1.E.2.i, 3.604.1.C.2, 3.604.1.G, 3.604.1.N.5.d.18), 3.604.2 O, 3.604.2.V.2.a.3), 3.604.2.V.3.c,
-3.605.3 A, 3.605.3.E, 3.606.1 A, 3.606.2 A, B, 3.606.4 B, L, 3.606.8.D, 3.609.4.F, 3.609.4.G.1.c,
-3.609.94.D.1 eff. 04/01/2017.
-Rules 3.601, 3.604.2 eff. 10/01/2017.
-Rule 3.605.3.D eff. 01/01/2018.
-Rule 3.606.2 F eff. 09/01/2018.
-Rules 3.609.5 E, 3.609.92 B eff. 01/30/2020.
-Rules 3.607.1 B, 3.608.1 B, 3.608.2 A-C, 3.608.3 eff. 08/01/2020.
-Rules 3.609.4 E, 3.609.4 G.2.b eff. 01/01/2021.
-Rules 3.601, 3.604.1 N.7.f, 3.604.1 N.11, 3.604.2 L.2.c emer. rules eff. 12/03/2021.
-Entire rule eff. 03/01/2022. Rules 3.601, 3.604.1 B.3, 3.604.3 I.5.f emer. rules eff. 03/01/2022.
-
-108
-
-CODE OF COLORADO REGULATIONS
-Income Maintenance (Volume 3)
-
-9 CCR 2503-6
-
-Rules 3.601, 3.604.1 B.3, 3.604.3 I.5.f eff. 03/02/2022.
-Rule 3.606.1 F emer. rule eff. 06/03/2022.
-Rule 3.606.1 F eff. 08/30/2022.
-Rules 3.600.2, 3.601, 3.602.1 A.5, 3.602.1 B, 3.602.1 I.3.C-D, 3.604.2 C.3.b, 3.604.2 K, 3.604.2 K.3,
-3.604.2 L, 3.604.2 M.4, 3.604.3 C.7, 3.604.3 G, 3.606.1 F-G, 3.606.2 A, 3.606.3 C.1.c.3), 3.606.3
-C.2.b.2), 3.606.6 C, 3.606.6 D.4, 3.606.8 A, 3.607.1 B, 3.607.1 C, 3.607.5, 3.608.3 C, 3.608.4
-C.1, 3.609.4 B.3.c, 3.609.6 B eff. 06/01/2023.
-Rule 3.604.3 J.2 repealed emer. rule eff. 08/07/2023.
-Rule 3.604.3 J.2 repealed eff. 10/30/2023.
-Rule 3.606.1 F eff. 07/01/2024.
-Rules 3.601, 3.604.3 I.4, 3.609.2 B, 3.609.4 C,D,K eff. 11/01/2024.
-
-Annotations
-Rule 3.602.1 E. 2.k. (adopted 08/08/2014) was not extended by Senate Bill 15-100 and therefore expired
-05/15/2015.
-
-109
-
-
-
-"""
-
-# 🔹 Split into chunks for FAISS indexing
+# File paths
+TEXT_FILE = "combined_text_documents.txt"
+EMBEDDINGS_FILE = "policy_embeddings.npy"
+INDEX_FILE = "faiss_index.bin"
+
+# Load policy text from the file
+if os.path.exists(TEXT_FILE):
+    with open(TEXT_FILE, "r", encoding="utf-8") as f:
+        POLICY_TEXT = f.read()
+    print("✅ Loaded policy text from combined_text_documents.txt")
+else:
+    print("❌ ERROR: combined_text_documents.txt not found! Ensure it's uploaded.")
+    POLICY_TEXT = ""
+
+# Split text into chunks
 chunk_size = 500
-chunks = [POLICY_TEXT[i:i+chunk_size] for i in range(0, len(POLICY_TEXT), chunk_size)]
-
-# 🔹 Generate embeddings
-embeddings = np.array([model.encode(chunk) for chunk in chunks])
-
-# 🔹 Create FAISS index
-index = faiss.IndexFlatL2(embeddings.shape[1])
-index.add(embeddings)
+chunks = [POLICY_TEXT[i:i+chunk_size] for i in range(0, len(POLICY_TEXT), chunk_size)] if POLICY_TEXT else []
+
+# Check if precomputed embeddings and FAISS index exist
+if os.path.exists(EMBEDDINGS_FILE) and os.path.exists(INDEX_FILE):
+    print("✅ Loading precomputed FAISS index and embeddings...")
+    embeddings = np.load(EMBEDDINGS_FILE)
+    index = faiss.read_index(INDEX_FILE)
+else:
+    print("🚀 Generating embeddings and FAISS index (First-time setup)...")
+    if chunks:
+        embeddings = np.array([model.encode(chunk) for chunk in chunks])
+        np.save(EMBEDDINGS_FILE, embeddings)  # Save for future runs
+
+        # Use FAISS optimized index for faster lookup
+        d = embeddings.shape[1]
+        nlist = 10  # Number of clusters
+        index = faiss.IndexIVFFlat(faiss.IndexFlatL2(d), d, nlist)
+        index.train(embeddings)
+        index.add(embeddings)
+        index.nprobe = 2  # Speed optimization
+        faiss.write_index(index, INDEX_FILE)  # Save FAISS index
+        print("✅ FAISS index created and saved.")
+    else:
+        print("❌ ERROR: No text to index. Check combined_text_documents.txt.")
+        index = None
 
 # 🔹 Function to search FAISS
 def search_policy(query, top_k=3):
+    if index is None:
+        return "Error: FAISS index is not available."
+
     query_embedding = model.encode(query).reshape(1, -1)
     distances, indices = index.search(query_embedding, top_k)
-    
+
     return "\n\n".join([chunks[i] for i in indices[0] if i < len(chunks)])
 
 # 🔹 Hugging Face LLM Client
@@ -97468,7 +79,7 @@ def respond(
         if val[1]:
             messages.append({"role": "assistant", "content": val[1]})
 
-    # 🔹 Search the pasted policy text for relevant information
+    # 🔹 Search policy text efficiently
     policy_context = search_policy(message)
     if policy_context:
         messages.append({"role": "system", "content": f"Relevant Policy Info:\n{policy_context}"})
@@ -97487,12 +98,12 @@ def respond(
         response += token
         yield response
 
-# 🔹 Gradio Chat Interface with Your System Message
+# 🔹 Gradio Chat Interface
 demo = gr.ChatInterface(
     respond,
     additional_inputs=[
         gr.Textbox(
-            value="You are a knowledgeable and professional chatbot designed to assist Colorado case workers in determining eligibility for public assistance programs. Your primary role is to provide accurate, up-to-date as recent as 2025, and policy-compliant information on Medicaid, SNAP, TANF, CHP+, and other state and federal assistance programs. Responses should be clear, concise, and structured based on eligibility criteria, income limits, deductions, federal poverty level guidelines, and program-specific requirements.",
+            value="You are a knowledgeable and professional chatbot designed to assist Colorado case workers in determining eligibility for public assistance programs. Your primary role is to provide accurate, up-to-date, and policy-compliant information on Medicaid, SNAP, TANF, CHP+, and other state and federal assistance programs. Responses should be clear, concise, and structured based on eligibility criteria, income limits, deductions, federal poverty level guidelines, and program-specific requirements.",
             label="System message"
         ),
         gr.Slider(minimum=1, maximum=2048, value=512, step=1, label="Max new tokens"),
@@ -97502,4 +113,4 @@ demo = gr.ChatInterface(
 )
 
 if __name__ == "__main__":
-    demo.launch()
\ No newline at end of file
+    demo.launch()