Statement of Basis and Purpose and Specific Statutory Authority of Revisions Made to Rule Manual Volume 10 Volume 10 was rewritten and reissued when finally adopted following publication at the 8/2/85 State Board meeting, with an effective date of 10/1/85. 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.

Addition of sections 10.500 - 10.515, and revision of section 10.900 were finally adopted following publication at the 10/2/87 State Board meeting, with an effective date of 12/1/87 (Document 9). 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 of sections 10.100 - 10.202, 10.207 - 10.280, 10.300 - 10.427, and 10.455 - 10.485 were finally adopted following publication at the 12/2/88 State Board meeting, with an effective date of 2/1/89 (CSPR# 88-8-18-1). 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 Office of the State Board Liaison, Department of Social Services. Revisions of sections 10.100 - 10.405, 10.411 - 10.415, 10.470 - 10.472, 10.478 - 10.485, and 10.802 - 10.815 were finally adopted following publication at the 12/6/90 State Board meeting, with an effective date of 2/1/91 (CSPR# 90-8-15-2). 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 of sections 10.305, 10.310, and 10.335 - 10.345 were finally adopted following publication at the 5/3/91 State Board meeting, with an effective date of 7/1/91 (CSPR# 91-3-11-1). 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 the State Board Liaison, Department of Social Services. Revisions of sections 10.125 - 10.135, 10.300 - 10.305, 10.413 - 10.415 and 10.802 - 10.805 were adopted emergency at the 7/12/91 State Board meeting, with an effective date of 7/12/91 (CSPR# 91-5- 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 10.125 - 10.135, 10.300 - 10.305, 10.413 - 10.415 and 10.802 - 10.805 were adopted emergency and final at the 8/2/91 State Board meeting, with effective dates of 7/12/91 and 8/2/91 (CSPR# 91-5-15-1). 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 10.100 - 10.220, 10.305, 10.400 through 10.402, 10.407 through 10.415 and 10.470 through 10.472 were adopted emergency at the 9/6/91 State Board meeting, with an effective date of 9/6/91 (CSPR# 91-3-11-2). 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 the State Board Liaison, Department of Social Services.

Revisions to sections 10.100 - 10.220, 10.305, 10.400 through 10.402, 10.407 through 10.415 and 10.470 through 10.472 were adopted emergency and final at the 10/4/91 State Board meeting, with effective dates of 9/6/91 and 10/4/91 (CSPR# 91-3-11-2). 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 the State Board Liaison, Department of Social Services.

Revisions to section 10.235 were adopted emergency and final at the 12/6/91 State Board meeting, with an effective date of 1/1/92 (CSPR# 91-7-19-2). 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 10.305, 10.320, 10.400 through 10.412, and 10.470 were adopted emergency at the 3/5/93 State Board meeting, with an effective date of 3/5/93 (CSPR# 93-2-9-2). 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 10.305, 10.320, 10.400 through 10.412, and 10.470 were final adoption of emergency at the 4/2/93 State Board meeting, with an effective date of 3/5/93 (CSPR# 93-2-9-2). 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 10.110 - 10.120, 10.220 - 10.235, 10.300 - 10.305, 10.320 - 10.330, 10.400 - 10.405, 10.411 - 10.412, 10.416 - 10.427, and 10.470 - 10.472 were final adoption following publication at the 9/10/93 State Board meeting, with an effective date of 11/1/93 (CSPR# 93-6-22-1). 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 the State Board Liaison, Department of Social Services. Revisions to sections 10.100 - 10.105, 10.400 - 10.402, and 10.410 were adopted emergency at the 9/10/93 State Board meeting, with an effective date of 9/30/93 (CSPR# 93-8-11-2). 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 the State Board Liaison, Department of Social Services. Revisions to sections 10.100 - 10.105, 10.400 - 10.402, and 10.410 were final adoption of emergency at the 10/1/93 State Board meeting, with an effective date of 9/30/93 (CSPR# 93-8-11-2). 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 the State Board Liaison, Department of Social Services. Revisions/additions to sections 10.100 - 10.120, 10.400 - 10.402, 10.410 and 10.700 were adopted emergency at the 1/7/94 State Board meeting, with an effective date of 1/1/94 (CSPR# 93-12-7-1). 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/additions to sections 10.100 - 10.120, 10.400 - 10.402, 10.410 and 10.700 were final adoption of emergency at the 2/4/94 State Board meeting, with an effective date of 1/1/94 (CSPR# 93-12-7-1). 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 10.305 and 10.470 were final adoption following publication at the 4/1/94 State Board meeting, with an effective date of 6/1/94 (CSPR# 93-12-10-1). 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 Office of the State Board Liaison, Department of Social Services.

Revisions and additions to sections 10.100, 10.700 - 10.710, and 10.713 - 10.714 were adopted emergency at the 9/9/94 State Board meeting, with an effective date of 9/1/94 (CSPR# 94-8-2-1). 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 External Affairs, Department of Human Services. Revisions and additions to sections 10.100, 10.700 - 10.710, and 10.713 - 10.714 were final adoption of emergency at the 10/7/94 State Board meeting, with an effective date of 9/1/94 (CSPR# 94-8-2-1). 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 External Affairs, Department of Human Services. Revisions to sections 10.100 - 10.120 and 10.400 - 10.405 were adopted emergency at the 9/8/95 State Board meeting, with an effective date of 9/8/95 (CSPR# 95-7-25-1). 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 10.100 - 10.120 and 10.400 - 10.405 were adopted emergency and final at the 10/6/95 State Board meeting, with an effective date of 9/8/95 (CSPR# 95-7-25-1). 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 section 10.401 were adopted as emergency at the 7/9/99 State Board meeting, with an effective date of 7/9/99 (CSPR# 99-6-16-1). 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 section 10.401 were final adoption of an emergency rule at the 8/6/99 State Board meeting, with an effective date of 7/9/99 (CSPR# 99-6-16-1). 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 sections 10.140 and 10.401 were final adoption following publication at the 4/6/2001 State Board meeting, with an effective date of 6/1/2001 (CSPR# 00-12-13-1). 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.

This Rule Manual Volume 10 concerning Older Americans Act programs was rewritten in its entirety and adopted following publication at the 2/4/2005 State Board meeting, with an effective date of 4/1/2005 (Rule-making# 03-12-1-1). 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 10.620.1, 10.630.1, 10.640, and 10.640.5 were adopted following publication at the 4/7/2006 State Board meeting, with an effective date of 6/1/2006 (Rule-making# 06-1-3-1). 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 Performance Improvement, Boards and Commissions Division, State Board Administration.

10.100 OLDER AMERICANS ACT PROGRAMS, ELIGIBILITY, TARGETING, CONFIDENTIALITY, DEFINITIONS 10.110 INTRODUCTION A. The Colorado Department of Human Services (CDHS), pursuant to the Older Americans Act of 1965 (Public Law No. 89-73) shall encourage and assist State agencies and area agencies to: 1. Concentrate resources to develop greater capacity;

2. Foster development and implementation of comprehensive and coordinated systems to serve older individuals;

3. Secure and maintain maximum independence and dignity in a home environment for older individuals capable of self care with appropriate supportive services; 4. Remove individual and social barriers to economic and personal independence for older individuals;

5. Provide a continuum of care for vulnerable older individuals; and, 6. Secure the opportunity for older individuals to receive managed in-home and community– based long-term care services.

B. Pursuant to the Older Americans Act, the State shall concentrate resources to develop greater capacity and foster the development and implementation of comprehensive and coordinated systems. To accomplish this, the State shall enter into new and cooperative arrangements with the following:

1. Area Agencies on Aging (AAA);

2. Other state agencies including agencies that administer home and community care programs; 3. Indian tribes, tribal organizations, and Native Hawaiian organizations; 4. Providers, including voluntary organizations or other private sector organizations, of supportive services, nutrition services, and multipurpose senior centers; and, 5. Organizations representing or employing older individuals or their families. C. The Older Coloradans Act (Section 26-11-100 through 26-11-207, C.R.S., incorporates the provisions of the Older Americans Act programs.

D. Authorized Programs and Services under the Older Americans Act 1. Title III, Part B authorizes:

a. Senior centers;

b. Access services, such as transportation, outreach, information and assistance, and case management;

c. In-home services; and d. Community services, such as adult day care and legal assistance. 2. Title III, Parts C-1 and C-2 authorize nutrition services, including nutrition outreach, nutrition screening, nutrition education, nutrition counseling, and congregate meal and home- delivered meal services.

3. Title III, Part D authorizes disease prevention and health promotion services. 4. Title III, Part E authorizes the National Family Caregiver Support Program (NFCSP). 5. Title IV funds training, research, and discretionary projects and programs. 6. Title V authorizes the Senior Community Services Employment Program (SCSEP). 7. Title VI authorizes grants for Native Americans, including programs for Indians, Native Hawaiians, and the Native American Caregiver Support Program. 8. Title VII authorizes Vulnerable Elder Rights Protection Activities, including long-term care ombudsman programs; prevention of elder abuse, neglect, and exploitation programs; and legal assistance development programs.

10.120 CONSUMER ELIGIBILITY CRITERIA 10.121 Title III, Parts B, C, D, E, and Title VII Eligibility Requirements A. All individuals age 60 and older shall be eligible for services. B. All targeting factors shall be considered to prioritize access to services. 10.122 Title III, Part C-1 and Part C-2 Eligibility Requirements A. Congregate Meal Service Eligibility [Title III, Part C-1] 1. Congregate meal consumers shall be:

a. Individuals age 60 and over as described at Section 10.121; or, b. The spouse of an eligible congregate consumer, regardless of age. 2. In accordance with procedures established by the Area Agency on Aging (AAA), the following may have the option to receive meals on the same basis as meals are provided to participating older persons, if such an opportunity does not deprive any other older individual from receiving congregate meals: a. Physically or mentally disabled or blind individuals, aged 18 through 59, who reside in a housing facility primarily occupied by older individuals and which has a congregate meal site funded by the Older Americans Act; b. Individuals providing volunteer services at the congregate sites during the meal hours;

c. Individuals with physical and/or mental disabilities who reside with and accompany older individuals eligible under the Older Americans Act, to the congregate meal site; and, d. Volunteer caregivers, volunteer respite workers, or other volunteer escorts who accompany an older person who is homebound or otherwise unable to attend meal service at the congregate site.

B. Home-Delivered Meal Eligibility [Title III, Part C-2] 1. In addition to general eligibility requirements for Title III, Part C, a person receiving home-delivered meals shall be homebound.

2. If included in the AAA Area Plan and policies for nutrition service providers, home- delivered meals may be made available to older individuals who are geographically isolated when a congregate site is not reasonably available as an alternative including:

a. Homebound, disabled dependents under sixty (60) years of age, residing with a homebound or geographically isolated older individual. The dependent must be assessed as homebound; and, b. Spouses, volunteer caregivers, or volunteer in-home respite providers of homebound or geographically isolated individuals, as defined by the AAA in its plan.

10.123 In-Home Services Eligibility Under Title III, Part-B To be eligible for in-home services, the consumer shall meet the eligibility requirements as described in Section 10.121 in addition to the eligibility requirements for the services listed below: A. Personal Care Services To be eligible for Personal Care services, the consumer shall be determined to meet the criteria of a “frail individual” based on:

1. The inability to perform at least two (2) activities of daily living without substantial human assistance, including verbal reminding, physical cueing, or supervision; or, 2. A cognitive or other mental impairment, requiring substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to self or others.

B. Home Health Aide Services To be eligible for Home Health Aide services, the consumer shall be determined to meet the criteria of a frail individual as described at Section 10.123, A, 1 and 2, and demonstrate a need for skilled services based on orders by a licensed physician. C. Homemaker Services Eligibility To be eligible for homemaker services, the consumer shall be determined to be unable to complete at least two (2) instrumental activities of daily living (IADLs). D. Chore Services Eligibility To be eligible for chore services, the consumer shall meet the eligibility requirements as described in Section 10.121 and shall be determined to be unable to complete the task that the service provides due to physical and/or cognitive limitations. 10.124 Title III, Part E Eligibility Under the National Family Caregiver Support Program A. Under the National Family Caregiver Support Program (NFCSP), Area Agencies on Aging (AAA) and/or the service providers with whom the AAAs contracts with, shall provide multifaceted systems of support services to:

1. Family caregivers as defined at Section 10.510.1; and, 2. Grandparent or relative caregivers as defined at Section 10.510.1. B. Priority for services shall be given to:

1. Caregivers of older individuals with greatest social and/or greatest economic need, with particular attention to low-income minority, and individuals residing in rural areas; and, 2. Older individuals providing care and support to persons with mental retardation and related developmental disabilities.

C. Respite Care and Supplemental Services Eligibility In the case of a family caregiver of an older individual, respite care and supplemental services under the National Family Caregiver Support Program shall be provided only if the care recipient is determined frail as defined at 10.123, A, 1 and 2. 10.125 Title V Eligibility Requirements Potential participants in the Senior Community Services Employment Program (SCSEP) shall meet age, income, and place of residence criteria for initial enrollment in the program. A. Eligible participants shall be at least age 55.

B. The income of the participant or the participant’s family shall not exceed 125% of the poverty level established by the United States Department of Health and Human Services. The participant’s income level shall be determined by whichever of the following is more beneficial to the applicant:

1. Annualizing the preceding six (6) months income; or, 2. Considering the actual income for the preceding twelve (12) months. C. The individual shall have a place of residence within the State of Colorado. There is no minimum length of residency requirement.

D. Individuals who are 60 years of age or older shall have priority for work opportunities provided under the SCSEP.

E. No additional eligibility requirements shall be imposed. 10.130 TARGETING OF SERVICES Preference and priority in the delivery of services shall be given to older persons with the greatest social or economic need with particular attention to low income minority individuals and individuals who are frail, homebound by reason of illness or incapacitating disability or otherwise isolated as defined below: A. The need caused by non-economic factors which include physical and mental disabilities, language barriers, and cultural, social, or geographical (rural) isolation including that caused by racial or ethnic status which restricts an individual's ability to perform normal daily tasks or which threatens such individual's capacity to live independently. B. The need resulting from an income level at or below the Federal poverty levels. 10.140 CONSUMER CONFIDENTIALITY All AAAs and service providers shall maintain the confidentiality of protected health information, including the consumer’s individually identifiable health information, and ensure that no information about an eligible consumer is disclosed by the agency or provider without the informed written consent of the consumer.

10.150 DEFINITIONS “Activities of daily living skills (ADLs)” shall be defined as activities that are regularly necessary for personal care. These activities include: transfers in and out of a bed or chair, toileting, walking, dressing, bathing, hygiene, and eating.

“Administration” shall be defined as the Administration on Aging (AoA) of the United States Department of Health and Human Services.

“Applicant Agency” shall be defined as an entity that is applying for an annual grant or other funding, or for designation or consideration as an Area Agency on Aging. “Area Agency on Aging (AAA)” shall be defined as a private nonprofit or public agency designated by the State Unit on Aging (SUA) to administer the Older Americans Act and related programs within a Planning and Service Area (PSA) in the State of Colorado “Area Agency on Aging Advisory Council” shall be defined as a representative body of laypersons and service providers, designated by the AAA to represent the interests of older persons within the boundaries of a Planning and Service Area.

“Area Plan” shall be defined as a document submitted by the AAA to the SUA every four years in a format specified by the State, which includes goals and measurable objectives; and identifies planning, coordination, administration, supportive, and nutrition services, as well as evaluation activities to be undertaken.

“Carry-Over” shall be defined as the estimated or actual portion of the funds made available to a grantee for a budget year which are not expended during that budget year, and which may be available for use (carried over) during a subsequent budget year.

“Case management” shall be defined as assistance, either in the form of access or care coordination, in circumstances where the older person and/or their caregivers are experiencing diminished functioning capacities, personal conditions, or other characteristics which require the provision of services by formal service providers. Activities of case management shall include: assessing needs, developing care plans, authorizing services, arranging services, coordinating the provision of services among providers, follow- up, and reassessment, as required.

“Cash Match” shall be defined as local cash received from non-Federal and non-State sources, passing to the control of the grantee or sub-grantee or contract agencies, which is used for the payment of allowable costs charged to the grant, and for the satisfaction of requirements for non-Federal/non-State share of program expenses.

“Cash welfare payment" shall be defined as public assistance through Federal, State or local government cash payments for which eligibility is determined by a need or income test. “Child” shall be defined as an individual who is less than 18 years of age. “Colorado Commission on Aging” (CCOA) shall be defined as an advisory board, appointed by the governor and confirmed by the state senate, to advise the State Unit on Aging on matters concerning older persons and monitor the implementation of the Older Americans Act. The Commission reviews existing programs for the aging and makes recommendations to the governor and the General Assembly for improvements in such programs.

“Colorado Long-Term Care Ombudsman” (CLTCO) shall be defined as an entity with expertise and experience in the fields of long-term care and advocacy, serving on a full-time basis to carry out the functions identified in the Older Americans Act of 1965, as amended. “Commodities” shall be defined as agricultural food stuffs of United States origin which are distributed to eligible entities and individuals through the Nutrition Services Incentive Program (NSIP) and the Food Assistance Program of the Colorado Department of Human Services. “Community focal point” shall be defined as a facility established to encourage the maximum collocation and coordination of services for older individuals.

“Comprehensive and coordinated service delivery system” shall be defined as a system for providing all necessary supportive services, including nutrition services, in a manner designed to: A. Facilitate the accessibility and use of interrelated social, supportive, and nutrition services provided to meet the needs of older persons in a Planning and Service Area; B. Develop and make the most effective use of supportive services and nutrition services in meeting the needs of older individuals;

C. Use resources efficiently and with a minimum of duplication; and, D. Encourage and assist public and private entities that have unrealized potential for meeting the service needs of older individuals to provide such assistance on a voluntary basis. “Conflict of Interest” shall be defined as a direct official action on a matter in which the AAA, provider, Council member, or other interested party has the opportunity for substantial financial, contractual, or employment gain.

“Congregate meals” shall be defined as the provision of a meal that meets all requirements as specified at Section 10.413.2 and Section 10.413.3 to an eligible individual at a nutrition site, senior center or some other congregate setting.

“Construction,” with respect to multipurpose senior centers, shall be defined as building a new facility, including the costs of land acquisition and architectural and engineering fees, or making modifications to or in connection with an existing facility which are in excess of double the square footage of the original facility and all physical improvements.

“Contract” shall be defined as an agreement, allowable and enforceable by law, between two or more competent parties, for a legal consideration. More specifically, in regard to these rules, it is a legal written agreement between agencies or other entities to provide, supply, or perform on the one part, and remunerate on the other part, a particular service, goods, or materials, in (a) particular time frame(s) and location(s).

“Contractor” shall be defined as an organization or person that provides goods, materials, and/or services for remuneration under the stipulations of a contract.

“Coordination” shall be defined as a formal or informal arrangement through which the SUA, AAA, or another entity or coalition brings together the planning and service resources of two (2) or more public and private agencies in Colorado for the purpose of expanding or strengthening services for older persons. Coordination refers to cooperative efforts, in support of common objectives, directed toward joint planning and resource development, increased quality and quantity of services, and the improvement of services to achieve a more effective and efficient comprehensive system. “Developmental disability” shall be defined as disability that is manifested before the person reaches twenty-two (22) years of age, which constitutes a substantial disability to the affected individual, and is attributable to mental retardation or related conditions which include cerebral palsy, epilepsy, autism, or other neurological conditions when such conditions result in impairment of general intellectual functioning or adaptive behavior similar to that of a person with mental retardation (27-10-102 C.R.S.). “Dietary supplement” shall be defined as a product intended to supplement the diet that bears or contains one or more of the following ingredients:

A. A vitamin;

B. A mineral;

C. An herb or other botanical;

D. An amino acid;

E. A dietary substance for use by man to supplement the diet by increasing the total dietary intake; or, F. A concentrate, metabolic, constituent, extract, or any combination of the above ingredients. “Education and training service” shall be defined as a supportive service designed to assist older individuals to better cope with their economic, health, and personal needs through services such as consumer education, continuing education, health education, pre-retirement education, financial planning, and other education and training services which advances the objectives of the Older Americans Act. “Elder abuse, neglect, and exploitation” shall be defined as abuse, neglect, or exploitation, of an older individual.

“Employability plan” shall be defined as a document developed with the enrollee's input that takes into consideration the individual's work history, work preference, skills, aptitudes, and barriers to employment resulting in planned service actions to achieve an agreed upon occupational goal. “Enrollee” shall be defined as an individual who is eligible for the Title V Senior Community Services Employment Program, and receives services and paid wages as a result of participating in program activities and/or community service employment under Title V. “Evaluation” shall be defined as a review completed of the direction, appropriateness, efficiency and effectiveness of a program or part of a program.

“Family caregiver” shall be defined as an adult family member or other individual, who is an informal provider of in-home, and community care to an older individual (60 years of age or older) who is “frail” and determined to be functionally impaired because of:

A. An inability to perform at least two activities of daily living without substantial human assistance, including verbal reminding, physical cueing, or supervision; or, B. Due to cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to others.

“Funding Letter” shall be defined as a unilateral contracting document that allows a State agency to increase or decrease the amount of funding for a specific sub-grantee based upon the funding available to the State agency.

“Frail” shall be defined as an older individual who is determined to be functionally impaired due to: A. Inability to perform at least two (2) activities of daily living without substantial human assistance, including verbal reminding, physical cueing, or supervision; or, B. A cognitive or other mental impairment, requiring substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to self or others.

“Grant” shall be defined as money, or property provided in lieu of money, paid or furnished by the SUA to an eligible agency for programs administered under the Older Americans Act. The funds subject to these regulations include Older Americans Act Federal funds, State matching funds, local matching funds and program income. A grant differs from a contract as follows: A. A contract provides reimbursement for specific services, goods, or materials provided according to a given standard, at a specific time and place. The amount of reimbursement may be specified as payable to the unit of service delivered, provided, or supplied, as vouchered or billed; or may be payable upon completion of other contractually specified obligations;

B. A grant designates an entity to act as a provider of a particular service under specific conditions, and includes a line item budget and assurances of performance and meeting of standards; and, C. The contractor is required to furnish evidence of specific performance to receive payment for services.

“Grantee” shall be defined as an organization which receives a grant and is accountable to the granting agency for the use of funds provided.

“Greatest economic need” shall be defined as the need resulting from an income level at or below the poverty threshold established by the United States Bureau of the Census. “Hazard Analysis Critical Control Point (HACCP)” shall be defined as a proactive, comprehensive, science-based, food safety system, approved by the CDPHE that allows nutrition project operators to continuously monitor their establishments and reduce the risk of foodborne illness. “Health Insurance Portability and Accountability Act” creates national standards to protect individuals’ medical records and other personal health information.

“Health oversight agency” shall be defined as an agency or authority of the United States, a State, a territory, a political subdivision of a State or territory, or an Indian tribe, or a person or entity acting under a grant of authority from or contract with such public agency, including the employees or agents of such public agency or its contractors or persons or entities to whom it has granted authority, that is government programs in which health information is necessary to determine eligibility or compliance, or to enforce civil rights laws for which health information is relevant.

“Health promotion” shall be defined as programs that promote health and well-being, such as programs for multigenerational participation that may include art therapy, dance therapy, music therapy, dental, hearing, immunization, medication management screening and education, insurance counseling, physical fitness, and vision.

“High-risk of malnutrition” shall be defined as the condition of a consumer scoring six (6) or more on the State Unit on Aging’s prescribed Colorado Nutrition Screening Tool. “Homebound” shall be defined as an individual who is assessed as unable to leave his or her home without human assistance, due to a disabling physical or emotional condition or an environmental condition which may have a health related impact.

“Home-delivered meal” shall be defined as the provision of a meal that meets all requirements as described at Section 10.413.2 and Section 10.413.4, to an eligible individual at that person’s home. “Home health aide services” shall be defined as activities which provide basic health services to older individuals who can be cared for at home.

“Homemaker services” shall be defined as providing assistance to persons who meet the eligibility requirements for in-home services and who are unable to perform two or more of the following instrumental activities of daily living: preparing meals, shopping for personal items, managing money, using the telephone, or doing light housework.

“Home modification” shall be defined as specific adaptations, repairs, maintenance, renovation, modifications, or improvements in a consumer’s existing home setting. “Host agency” shall be defined as a public or private nonprofit organization, other than a political party, exempt by law from taxation, that provides a worksite and supervision for an enrollee under the Title V, Senior Community Services Employment Program.

“Indian Tribe,” except for the purposes of Title VI of the Act, shall be defined as any tribe, band, nation, or other organized group or community of Indians, which is: A. Recognized as eligible for special programs and services provided by the United States to Indians because of their status as Indians; or, B. Located on, or in proximity to, a Federal or State reservation or rancheria. “In-Kind Match” shall be defined as services, goods, or property donated by a grantee or third party, which are allowable costs of the grant, and for which no cash reimbursement is required, and which are applied to a requirement for the non-Federal/non-State share of program expenses. “Internal Control” shall be defined as processes designed to provide reasonable assurance regarding the achievement of objectives in the following categories:

A. Effectiveness and efficiency of operations;

B. Reliability of financial reporting; and, C. Compliance with applicable laws and regulations.

“Instrumental activities of daily living skills (IADLS)” shall be defined as activities necessary for independent living including: meal preparation, shopping, medication management, housework, laundry, appointment management, money management, access resources, transportation, and telephone “Legal assistance” shall be defined as legal advice, counseling, and representation provided by an attorney or other person acting under the supervision of an attorney. "Local ombudsman" means an individual trained and designated as qualified by the state long-term care ombudsman to act as a representative of the Office of the State Long-Term Care Ombudsman, Section 26-11.5-103(2), C.R.S.

“Long-Term Care (LTC) facility” shall be defined as:

A. A nursing facility as defined at Section 24-6-103(11), C.R.S.; B. An assisted living residence as defined at Section 25-27-102(8), C.R.S.; or, C. An extended care facility with any swing bed.

“Long-Term Care Ombudsman Complaint” shall be defined as an alleged problem or issue, verbal or written, in which the Colorado or Local Long-Term Care (LTC) Ombudsman takes direct action or suggests action at the request of residents, family, or other interested persons. Such action is taken in order to identify issues, resolve problems, or alter the outcome of situations. Complaints may be specific to individual residents or may involve general issues affecting many residents. “Long-Term Care Ombudsman education” shall be defined as provision of information and/or training to residents and staff of LTC facilities and communities, regarding resident’s rights, the ombudsman program, and other related issues.

“Long-Term Care Ombudsman services” shall be defined as actions taken to identify, investigate, or seek to resolve complaints made by or on behalf of an older individual who resides in a long-term care facility, relating to actions, inactions, or decisions of providers or public agencies that may adversely affect the health, safety, welfare, and rights of the residents.

“Low-income” shall be defined as incomes below the federal poverty level. “Material aid” shall be defined as aid in the form of goods or food such as direct distribution of commodities, surplus food, and distribution of clothing, smoke detectors, eyeglasses, hearing aids, dentures, security devices, and medication reminder boxes. “Means test” shall be defined as the use of an older person’s income or resources to determine that person’s eligibility pursuant to these rules.

“Medical food” shall be defined as a food formulated to be consumed or administered entirely under supervision of a physician, and intended for the specific dietary management of a disease or condition for which distinctive nutritional requirements, based on recognized scientific principles, are established by medical evaluation.

“Monitoring” shall be defined as a review by the grantor or contractor agency of one or more grant activities, that may include on-site visits to the grantee or contractor agency; and/or data collection activities of grantees, contractors, sub-grantees, and subcontractors, for the purpose of assuring that the grant or contract is being administered in accordance with the Older Americans Act programs, and that the purposes of the grant or contract are being met.

“Multigenerational” shall be defined as activities intended to promote interaction among generations, and may include opportunities for older persons to serve as mentors or advisors in child care, youth day care, educational assistance, at-risk youth intervention, juvenile delinquency treatment, and family support programs.

“Multipurpose senior center” shall be defined as a community facility for the organization and provision of a broad spectrum of services for elder persons, including provision of mental and physical health services; social, nutritional, and educational services; and the provision of facilities for recreational activities for older individuals.

“Native American” shall be defined as an Indian or as a Native Hawaiian. “Native Hawaiian” shall be defined as any individual whose ancestors were natives of the area which consists of the Hawaiian Islands prior to 1778.

“Needs assessment” shall be defined as the process of evaluating an older person’s status and needs, to identify the service or combination of services required to maintain the consumer’s ability to live independently.

“Nonprofit,” as applied to any agency, institution, or organization, shall be defined as an agency, institution, or organization owned and/or operated by, one or more corporations or associations whose profits must be used exclusively for the charitable, educational or scientific purpose for which it was formed.

“Notice of Grant Award (NOGA)” shall be defined as written notification that an applicant agency has received a grant award.

“Nutrition counseling” shall be defined as the provision of individualized advice and guidance, by a registered dietitian in accordance with State law and/or policy, to individuals or their caregivers, for those individuals at nutritional risk because of their health or nutritional history, dietary intake, medication use, or chronic illnesses.

“Nutrition education” shall be defined as a program to promote better health by providing accurate and culturally sensitive nutrition, physical fitness, or health (as it relates to nutrition) information and instruction to consumers or consumers and caregivers in a group or individual setting overseen by a dietitian or individual of comparable expertise.

“Nutrition outreach” shall be defined as an activity designed to seek out and identify the maximum number of individuals in greatest need of nutrition and supporting social services, such as those hard to reach, isolated, withdrawn, low-income, or a minority.

“Nutrition screening” shall be defined as the process of identifying older individuals at nutritional risk or with malnutrition.

“Nutrition services” shall be defined as services and activities intended to provide older persons with assistance in maintaining a well-balanced diet, including congregate and home-delivered meals, nutrition counseling and nutrition education.

“Nutrition Services Incentive Program (NSIP)” shall be defined as a program carried out by the United States. Department of Health and Human Services to allot cash, commodities, or a combination of cash and commodities to States and grantees providing nutrition program to older individuals. “Nutrition site” shall be defined as a location where congregate meals are provided, and may include, senior centers, community buildings, elderly housing complexes, and public schools. “Older American,” “older individual,” or “older person” shall be defined as a person who is 60 years of age or older.

“Older Americans Act funds” are Federal funds authorized under the Older Americans Act. “One-Year Grant Application” shall be defined as the documentation submitted annually by each AAA to the SUA, in a format prescribed that includes updated budgetary information. “Personal care” shall be defined as providing personal assistance, stand-by assistance, supervision or cues for persons age 60 and over, who meet the eligibility requirements for in-home services. “Personal representative” shall be defined as an individual who, under applicable law has authority to act on behalf of an individual who is an adult or an emancipated minor in making decisions related to health care.

“Place of residence” shall be defined as a permanent declared dwelling place. “Planning and Management Region (PMR)” shall be defined as a geographic region established by an executive order of the governor of Colorado on November 17, 1972, consisting of two or more counties; or for the purposes of these rules, any planning and service area in existence on October 1, 1985. “Planning and Service Area (PSA)” shall be defined as a geographic area of the state, designated by the State Unit on Aging for purposes of planning, development, delivery, and overall administration of services under an area plan.

“Poverty level” shall be based on the Federal poverty guidelines. “Program” shall be defined as a particular set of services/activities authorized and funded under a specific Title and Part of the Older Americans Act of 1965, as amended. “Program development” shall be defined as activities directly related to either the establishment of a new service or the improvement, expansion, or integration of existing services. “Program income” shall be defined as any income generated by a grantee from activities, part or all of the cost of which is borne by the grant.

“Project area” shall be defined as the geographic area for which a single nutrition project is designed. “Public transportation vehicle” shall be defined as a bus, train, light-rail vehicle, or any other mode of transportation used by a public transportation entity to provide transportation services to the general public.

“Reassurance” shall be defined as the process of contacting a consumer on a regular basis in order to provide comfort and/or help.

“Representative payee” shall be defined as a person who is appointed by a governmental entity to receive, on behalf of an older individual who is unable to manage funds by reason of a physical or mental incapacity, any funds owed to the individual by the entity. “Resident” shall be defined as any individual who is 60 years of age or older, who is a current, prospective, or former patient or consumer of any long-term care facility. “Rural” shall be defined as any area that is not defined as urban. “Single Entry Point” (SEP) shall be defined as the availability of a single access or entry point within a local area where a current or potential long-term care consumer may obtain long-term care information, screening, assessment of need, and referral to appropriate long-term care programs and case management services.

“State Unit on Aging” (SUA) shall be defined as the unit in the State agency designated by the Executive Director to administer the Colorado State Plan on Aging and Adult Services, including Older Americans Act programs. In Colorado, this agency is the Colorado Department of Human Services, Division of Aging and Adult Services.

“Subgrant” shall be defined the same as “grant” , except that subgrants are awarded by Area Agencies on Aging. An agency to which a grant is made by the AAA to provide services pursuant to the Older Americans Act requirements is a subgrantee.

“Sub-project sponsor” shall be defined as a public or private nonprofit organization awarded funds and positions by the SUA to administer Title V, Senior Community Services Employment Program within an agreed upon geographic area. It is used interchangeably with the terms sub-project and sub-grantee under Title V.

“Supportive services” shall be defined as those services as described in these rules and as included in the State Plan on Aging and Adult Services.

“Swing bed” shall be defined as hospital beds that can be used as either skilled nursing facility (SNF) or hospital inpatient levels of care on an as needed basis. The facility must receive approval from Medicare to provide post-hospital SNF care.

“Transportation” (one-way trip) shall be defined as a means of going from one location to another in a vehicle. It does not include any other activity.

“Tribal organization” , except for purposes of Title VI of the Older Americans Act, shall be defined as the recognized governing body of any Indian tribe, or any legally established organization of Indians, which is controlled, sanctioned, or chartered, by such governing body. “Urban Area” means a central place and its adjacent densely settled territories with a combined minimum population of 50,000 or an incorporated place or a census designated place with 20,000 or more inhabitants.

10.200 PROGRAM ADMINISTRATION 10.210 CONFLICT OF INTEREST 10.211 Prohibition of Conflict of Interest A. No officer, employee, or other representative of the SUA, Colorado Long Term Care Ombudsman (CLTCO) or an AAA shall give the appearance of a conflict of interest under the Older Americans Act (OAA) or the Older Coloradans Act (OCA); B. Staff members of the SUA shall not serve on a policy board or advisory council of an AAA or other organization, which receives OAA or the OCA funds, or has submitted a grant application or contract proposal for such funds.

C. Members of AAA Advisory Councils, who are also employees, board members, or serve on subcommittees of agencies that have submitted grant applications or contract proposals to the Area Agency on Aging shall not take part in the process of evaluating applications or proposals in the service category in which the proposal was submitted, and shall abstain from voting to approve or disapprove of the application or proposal, as well all proposals in the service category in which the proposal was submitted. 10.220 COLORADO LEGAL ASSISTANCE DEVELOPMENT (CLAD) PROGRAM A legal assistance developer shall be assigned to provide State leadership in developing the Colorado legal assistance programs for older persons throughout the State, including: A. Offering advice and technical assistance to AAAs.

B. Supporting training for legal assistance through coordination with the Colorado Coalition of Legal Services programs, the Colorado Bar Association, and other organizations involved with the coordination and promotion of legal assistance to older individuals; C. Ensuring:

1. Statewide leadership in securing and maintaining the legal rights of older individuals; 2. Statewide coordination of the provision of legal assistance; 3. Provision of technical assistance, training, and other supportive functions to Area Agencies on Aging, legal assistance providers, Long-Term Care Ombudsmen, and other persons, as appropriate;

4. Encouragement of financial management services to older individuals at risk of conservatorship;

5. Assistance to older individuals in understanding their rights, exercising choices, benefiting from services and opportunities authorized by law, and maintaining the rights of older individuals at risk of guardianship;

6. Statewide improvement in the quality and quantity of legal services provided to older individuals.

10.230 PLANNING AND SERVICE AREA DESIGNATION OR MODIFICATION A. Planning and Service Areas shall be designated after considering the following: 1. Geographical distribution of individuals age 60 and over in the State; 2. Incidence of need for supportive services, nutrition services, multipurpose senior centers, and legal assistance;

3. Distribution of older individuals who have the greatest economic need (with particular attention to low-income minority individuals and older individuals residing in rural areas);

4. Distribution of older individuals who have the greatest social need (with particular attention to low-income minority individuals and older individuals residing in rural areas);

5. Distribution of older individuals who are Indians residing in the area; 6. Distribution of resources available to provide such services or centers; 7. Boundaries of existing areas within the State which were drawn for the planning or administration of supportive services programs;

8. Location of units of general purpose local government within the State. B. Application for Designation or Modification of a PSA 1. An application for design or modification of an existing PSA may be made by: a. Any unit of general purpose local government which has a population of 100,000 or more;

b. A region within the State that is recognized for area-wide planning; c. A metropolitan area;

d. An Indian reservation;

e. An Area Agency on Aging; or, f. The State Unit on Aging.

C. The designation process for a PSA shall automatically open to new applicants when: 1. More than 50% of the counties in the PSA request the SUA to open the designation for AAA to new applicants; or 2. The PSA served by the AAA has been modified; or, 3. The existing AAA designation is withdrawn.

D. The applicant shall include an assessment of the distribution of older individuals and other factors as outlined in the proposed PSA, including the impact of the proposed change on these same factors in the existing PSAs that would remain if the application is approved. E. The applicant, the SUA, or any other affected PSA, may submit documentation concerning the effect of the proposed change on current delivery systems for consideration by the SUA. F. An Area Agency on Aging shall be designated for each Planning and Service Area. G. Right of First Refusal 1. When the State designates a new Area Agency on Aging, the right of first refusal shall be given to a unit of general purpose local government if the designated agency meets the following criteria:

a. An established office of aging which is operating within a planning and service area designated under Section 10.230;

b. Any office or agency of a unit of general purpose local government, which is designated to function only for the purpose of serving as an area agency by the chief elected official of such unit; or, c. Any office or agency designated by the appropriate chief elected officials of any combination of units of general purpose local government to act only on behalf of such combination for such purpose.

2. If the unit of general-purpose local government chooses not to exercise the right of first refusal, preference shall be given to an established Area Agency on Aging. H. Designated Agency Requirements A designated area agency shall be:

1. An established AAA operating within a Planning and Service Area; 2. Any office or agency of a unit of general purpose local government which is designated to function only for the purpose of serving as an AAA by the chief elected official of the unit;

3. Any office or agency designated by the appropriate chief elected officials of any combination of units of general purpose local government to act only on behalf of the SUA, which can and will engage only in the planning or provision of a broad range of supportive services, or nutritional services within the PSA; or, 4. Any public or private nonprofit agency in a PSA or any separate organizational unit within such an agency, which is under the supervision or direction of the SUA, which can and will engage only in the planning or provision of a broad range of supportive services or nutrition services within the PSA. I. Withdrawal of AAA Designation 1. An Area Agency on Aging designation may be withdrawn when: a. The AAA has consistently failed to carry out the mandates of State and Federal laws and regulations as specified in the OAA and in these rules; or, b. The AAA fails to submit an Area Plan or One-Year Grant Application; or, c. The SUA has disapproved the Area Plan or One-Year Grant Application and the AAA refuses to modify its plan to comply with existing mandates; or, d. The AAA voluntarily terminates its grant or resigns as an Area Agency on Aging.

2. The Area Agency on Aging shall have the right to appeal the decision of the withdrawal of designation through the appeals process as described at Section 10.950.2.

10.240 AREA AGENCIES ON AGING The Area Agency on Aging engages in community planning, coordination, and program development, and provides a broad array of social and nutritional services for eligible consumers. 10.240.1 AAA Role and Responsibilities 10.240.11 General Responsibilities A. The responsibilities of the AAA shall include the following: 1. Developing and maintaining an organizational structure and capacity to effectively administer OAA programs and responsibilities;

2. Developing an Area Plan for providing a comprehensive and coordinated system of programs, consistent with the state plan, to meet the needs of the older persons in the PSA;

3. Revising and updating the Area Plan annually as required; 4. Developing and implementing a plan to assist potential direct service providers to develop capacity to efficiently and effectively provide services under the Area Plan. If applicable, an update of progress in developing potential direct service providers shall be included in the One-Year Grant Application; 5. Administering the plan in accordance with fiscal and programmatic requirements stated in the Older Americans Act, in these rules, and the AAA policy and procedures manual;

6. Identifying needs and targeting of services to individuals; 7. Selecting a local agency, program, or person(s) to be designated as the Local Long- Term Care Ombudsman and to serve as an official and identifiable link to the Colorado Long-Term Care Ombudsman, including designation of a “lead” Local LTC ombudsman;

8. Ensuring that criminal background checks are conducted for all employees, volunteers, and contractors who have direct contact with elderly consumers; 9. Providing services or contracting with local providers to provide services under the Caregiver Support Programs;

10. Ensuring that all for-profit contracts shall be submitted to the SUA for approval; 11. Ensuring that funds made available under the Act shall not be used for lobbying activities, as described at Section 24-6-301, C.R.S., including, but not limited to, any activities intended to influence any decision or activity by any non-judicial Federal, State or local individual or body.

12. Ensuring that Federal funds are not used to supplant non-Federal funds, and that efforts to obtain support from private sources and other public organizations continue;

13. Providing leadership and advocacy for older persons within the PSA, including monitoring and evaluating factors and issues affecting older individuals within the PSA;

14. Establishing and maintaining a uniform system compatible with State systems for collection and exchange of required data and information that accurately reflects the project and financial operations; and, 15. Completing reports in formats as required by the AAA or SUA. B. Priority Services The AAA shall ensure that the adequate amounts, as developed by the SUA and with stakeholders’ input, of Title III, Part B funding are expended for the following priority services:

1. Access services;

2. In-home services ;

3. Legal assistance.

C. Public Hearings The AAA shall conduct public hearings when it plans to submit, amend, or seek a waiver for any part of the Area Plan, to provide an opportunity for the general public, officials of local units of general-purpose government, service providers, and other interested parties to comment on the Area Plan or One-Year Grant Application. 10.240.2 Nutrition Services Programs The AAAs shall comply with nutrition services as prescribed by the SUA. A. Modified Diets The AAAs shall provide modified diets in accordance with Section 339 of the Older Americans Act.

Modified diets shall include:

1. Medical nutritional food as a supplement a. Nutrition supplement prescribed by a physician and monitored by a registered dietitian to determine if the prescription is feasible and appropriate. b. Medical nutritional food as a supplement shall not be eligible for reimbursement under Nutrition Service Incentive Program (NSIP), Title III C-1, or C-2.

2. Medical nutritional food as a meal replacement a. Prescribed by a physician as necessary to treat a diagnosed medical condition and meet primary nutritional needs. A registered dietitian shall monitor the nutrient content, feasibility and appropriateness, and referrals to insurance coverage and other resources.

b. Medical nutritional food as a meal replacement shall be eligible for reimbursement under NSIP if the meal replacement meets the 33-1/3% Recommended Dietary Allowances/ Dietary Reference Intakes (RDA/DRI) nutrient requirements by volume.

3. Texture or Nutrient Modified Diets shall be:

a. Prescribed by a physician; and, b. Monitored by a registered dietitian; and, c. Determined if feasible and appropriate by the registered dietitian and nutrition provider.

B. Home-Delivered Meals 1. The AAA shall establish and operate nutrition projects which, five (5) days or more a week, provide at least one home-delivered hot, cold, frozen, dried, canned, or supplemental foods (with a satisfactory storage life) meal per day and any additional meals which the nutrition project may elect to provide except when the State Unit on Aging approves a lesser frequency.

2. The AAA shall ensure that all individuals requesting home-delivered meals are assessed, and that only those who have been determined to be homebound as defined at Section 10.150, or who are geographically isolated as described at Section 10.122, B, shall be eligible for a home-delivered meal. 3. The AAA shall develop eligibility criteria in conjunction with the nutrition service provider in making a determination as to whether home-delivered meals should be provided to the spouse of a homebound or geographically isolated individual. C. Food Assistance Program If an AAA elects to participate in the Food Assistance Program, The AAA shall develop guidelines for participation in this program.

10.240.3 Community Focal Points A. The AAA shall ensure that:

1. Services funded under the Older Americans Act are based at, linked to, or coordinated with, the designated community focal point; when applicable, and, 2. Older persons within the PSA have information regarding access, including transportation, to designated community focal points and OAA programs. B. The AAA shall work with other appropriate service agencies within the community to achieve maximum coordination and access to services and opportunities from community focal points.

10.240.4 Senior Centers Construction and Renovation In making awards for the construction or renovation of senior centers, the AAA shall ensure that: A. The facility complies with state and local health, fire, safety, building, zoning, and sanitation laws, ordinances or codes; and, B. The technical adequacy of any proposed alteration or renovation of a senior center that affects the load bearing members of the facility.

10.240.5 Coordination Coordination shall include planning, development, and use of community-based resources to create effective service delivery systems that delay or prevent institutionalization of older persons, including:

A. Coordination with:

1. The Single Entry Point Agency(ies) in the PSA, as well as, 2. Other long-term care services and adult protection.

B. Developing relationships with other service organizations, including local public and nonprofit agencies providing services to older individuals within the PSA. C. Pooling of resources within the PSA.

D. Participating on the Single Entry Point Community Advisory Committee and the Single Entry Point Resource Development Committee if feasible.

10.240.6 Program Development A. Program development activities shall include establishment of a new service; or improvement, expansion, or integration of existing services.

B. Program development services shall meet the following criteria to be funded with Title III-B supportive services funds:

1. Activities intended to achieve a specific service(s) goal or objective; and, 2. Activities occurring during a specifically defined and limited period of time. 10.240.7 Legal Assistance Area Agencies on Aging shall:

A. Enter into contracts with providers of legal assistance who can demonstrate the experience or capacity to deliver legal assistance as required by Federal regulations and State rules. B. Involve the private bar, where possible, in legal assistance activities under Title III, including groups within the private bar furnishing services to older individuals on a pro bono and/or reduced fee basis.

10.240.8 One-Year Grant Application On an annual basis, using a format specified by the SUA, the AAA shall complete a one-year grant application to make fiscal and programmatic adjustments to the four-year plan including the submission of an annual budget.

10.240.81 Area Plan and One-Year Grant Application Review The AAA shall conduct at least one public hearing on the Area Plan to provide an opportunity for the general public, officials of county and other local governments, and other interested parties to comment on the four-year Area Plan and One-Year Grant Application. A. A summary of the comments, including resulting changes to the proposal plan(s), shall be submitted to the SUA with the four-year plan and annual updates. B. Records of the public meetings shall be on file at the AAA and shall be available for review upon request.

10.240.9 Data Collection, Performance Evaluation and Monitoring A. Data Collection and Reporting The AAA shall ensure that data and reports submitted to the SUA shall be in a format compatible with State systems, and that data submitted to the SUA can be manipulated without manual re-entry of data by SUA staff.

B. Evaluation Each Area Agency on Aging shall evaluate the costs/benefits, quality, accessibility, utilization, priority, targeting, and overall effectiveness of all programs, services, and activities for which it provides funding at least yearly. C. Monitoring 1. The AAA shall monitor the performance of all service providers awarded a grant or contract at least every six (6) months.

2. On-site Assessments The AAA shall conduct a comprehensive on-site assessment of each new service provider within 90 calendar days of the date the sub-grantee or contractor begins providing services to older individuals or their caregivers under the OAA and annually thereafter.

10.250 ADVISORY COUNCILS 10.250.1 Area Agency on Aging Advisory Council A. Each AAA shall establish and support an Advisory Council. B. In selecting the membership of the Advisory Council, the AAA shall ensure that any potential conflicts of interest are identified and corrected.

10.260 SERVICE PROVIDERS AAAs shall assure that services authorized under the Older Americans Act are delivered through a network of local service providers under grant or contract with the SUA or the AAA. Failure to comply with the requirements of these rules by any service provider including grantees, sub-grantees, contractors, or subcontractors, shall be grounds for termination of the grant, subgrant, contract, or subcontract. As a condition for receipt of funds under the OAA, all service providers, including grantees, sub-grantees, and contractors, shall:

A. Provide the AAA, within required timeframes, statistical and other information which the AAA requires to meet its planning, coordination, evaluation, and reporting requirements established by the SUA;

B. Specify how the provider intends to satisfy the service needs of low-income minority individuals and older persons residing in rural areas of the area served, including attempting to provide services to low-income minority individuals at least in proportion to the number of low-income minority older persons in the population served by the provider;

C. Provide consumers with an opportunity to contribute to the cost of the service in accordance with Section 10.260.42, E;

D. With the consent of the older person, or his or her legal representative, bring to the attention of appropriate officials for follow-up, conditions or circumstances which place the older person, or the household of the older person, in imminent danger; E. Where feasible and appropriate, make arrangements for the availability of services to older persons in weather related emergencies or other emergency situations; F. Assist consumers in taking advantage of benefits under other programs; G. Establish complaint and appeals procedures and inform consumers of their right to complain and receive a written response at the provider level;

H. Establish a waiting list for services;

I. Inform consumers/customers of their grievance rights and their right to request and receive an informal hearing at the provider level.

10.260.2 Access Service Provider Responsibilities/Requirements 10.260.21 Information and assistance Information and assistance providers shall:

A. Maintain current information about opportunities, benefits, and services available to older persons and their caregivers;

B. Refer older persons and their caregivers to services using most current information; C. Employ, where feasible, specially trained staff to assess the needs of older persons and their caregivers, provide information and assist in utilization of opportunities and services; and, D. In an area where a predominate number of older individuals speak a language other than English as their principal language, information and assistance service shall also be provided in that language.

10.260.22 Outreach The outreach service shall:

A. In an area where a predominate number of older individuals speak a language other than English as their principal language, outreach shall also be provided in that language. B. Establish outreach activities to assure that the maximum numbers of eligible individuals are informed of, and have an opportunity to participate in, services funded through the Older Americans Act, including low-income minority older individuals and older individuals living in rural areas.

C. Establish communication with the local news media to inform the public of available services and opportunities to contribute to the planning and implementation of services. 10.260.23 Transportation A. Except private vehicles, all transportation providers rendering services to OAA consumers shall have all licenses, approvals, or certifications required by Federal, State, and local law or regulation.

B. All transportation providers not requiring licensure by the PUC shall ensure that their drivers, vehicles, and auxiliary equipment meet all applicable regulations and standards for passenger and vehicle safety, as well as all applicable safety inspection and maintenance requirements, and shall be in compliance with the State’s mandated minimum insurance coverage.

10.260.3 In-home service providers General Responsibilities and Requirements In-home providers shall comply with Federal, State, and local regulations and standards for specific services provided to consumer under the OAA program and shall: A. Develop written policies and procedures for the following: 1. Recruiting, selecting, retaining, and terminating employees; 2. Access to, duplication, and dissemination of information from the consumer’s records in accordance with State statutes on Confidentiality of Information at Section 26- 1-114, C.R.S.;

3. Protecting and promoting consumer’s rights as described at Section 10.412.1; 4. Emergency procedures; and, 5. Handling and reporting of critical incidents, including accidents, suspicion of abuse, neglect or exploitation, and criminal activity.

B. Establish documentation requirements for:

1. Maintaining a log of all complaints and critical incidents, which shall include documentation of the resolution of the problem;

2. Documenting changes in the consumer’s conditions or needs, as well as documentation of appropriate reporting and actions taken as a result. C. Target consumers 1. Ensure that older persons with the greatest economic or social needs, low-income minority individuals, and older persons residing in rural areas, are given priority for services; and, 2. Ensure that no person applying for or receiving service under the OAA shall be discriminated against based on age, sex, religion, race, sexual orientation, political belief, handicap, or disability.

D. In-home service providers receiving funding under Title III shall coordinate with other agencies to ensure there is no duplication of services.

10.260.31 Homemaker Service A. Homemaker service providers shall conform to all rules for in-home service providers in Section 10.260.3;

B. Homemaker provider agencies shall document that all homemakers have received a minimum of eight (8) hours of training or have passed a skills validation test conducted by the provider prior to delivery of services in the provision of homemaker services; C. A person who, at a minimum, has received the training or passed the skills validation test required of homemakers shall be qualified to supervise homemakers. D. Supervisory visits shall be made to the consumer’s home at least every six months or more often as necessary for problem resolution, skills validation of staff, observation of the home’s condition, and assessment of consumer’s satisfaction with services. 10.260.32 Personal Care Service Personal care provider agencies shall conform to the rules for in-home service providers in Section 10.260.3. In addition, personal care provider agencies shall meet the following personal care requirements:

A. Supervisory visits shall be made to the consumer’s home at least every three (3) months or more often as necessary for problem resolution, skills validation of staff, consumer specific or procedure-specific training of staff, observation of the consumer’s condition and care, and assessment of satisfaction with services. At least one of the assigned personal staff shall be present at supervisory visits.

B. Staff rendering personal care services to older individuals shall receive at least 20 hours of training related to performing personal care tasks, or pass a skills validation test prior to service.

10.280.33 Home Modification A. Home modification providers shall meet the rules for in-home service providers identified at Section 10.260.3.

B. All home modification shall be provided in accordance with State laws and regulations and all local building codes.

C. Home modifications requiring a permit shall be inspected and approved by a qualified individual as follows:

1. Local/county building inspector; and/or, 2. A licensed engineer, architect, contractor, or any other person as agreed upon by the AAA.

10.260.34 Additional In-Home Services A. Telephone reassurance service providers shall:

1. Establish emergency procedures to be used when a consumer does not call or answer as arranged.

2. Ensure that individuals serving as reassurance callers shall have training. B. Chore maintenance providers shall protect and promote older individuals’ rights as described at Section 10.412.1.

C. Consumer Directed Services shall allow the consumer to choose a qualified provider to provide services.

1. The AAA shall establish qualification requirements for each service type and maintain documentation for each consumer.

2. Background checks for Consumer directed services shall comply with the requirements at 10.240.11, A, 8.

10.260.35 Home Health Aide Home Health Aide providers shall conform to the rules for in-home service providers in Section 10.260.3. In addition, Home Health Aide providers shall meet the following Home Health Aide requirements:

A. The Home Health Aide provider must operate and furnish services in compliance with all applicable Federal, State, and local laws and regulations. B. The Home Health Aide providers must comply with accepted professional standards and principles that apply to professionals furnishing services as a Home Health Aide provider. C. The Home Health provider must ensure that aides have completed a course of training and received a nurse’s aide certification, conducted by an educational or health care institution which implements the basic nurse aide curriculum prescribed and approved by the State Board of Nursing.

D. Home Health Aide providers shall comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) regarding privacy of records. 10.260.4 Nutrition Providers Responsibilities and Requirements 10.260.41 General Responsibilities and Requirements Nutrition service providers shall comply with all service and quality standards as described at Section 10.413.

10.260.42 Regulatory Compliance A. Nutrition service providers shall comply with the applicable provisions of State or local laws regarding the safe and sanitary handling of food, equipment, and supplies used in the storage, preparation, service and delivery of meals to older individuals, including but not limited to, the following:

1. The Colorado Department of Public Health and Environment’s (CDPHE’s) “Colorado Retail Food Establishments Rules and Regulations” (6 CCR 1010-2). 2. Nutrition service providers shall comply with health, fire, and safety codes and regulations; building codes; purchasing regulations; licensure requirements; and any other State or local requirements as may be applicable. B. Current food permits shall be posted at the nutrition site. C. Inspection reports issued by the CDPHE shall be on file at the site and available for review. D. If a nutrition project requests a variance from the CDPHE, the nutrition project shall send copies of both the variance request and the approval or denial from the CDPHE to the SUA and to the AAA.

E. Contribution Policy 1. The provider shall establish a mechanism so that each eligible meal consumer as described at Section 10.122, A, 2, shall be afforded an opportunity to contribute voluntarily and anonymously.

2. No eligible meal consumer shall be denied service because of a decision not to contribute.

10.260.43 Nutrition Program Requirements 10.260.44 Minimum Dietary Requirements Nutrition Service Providers shall provide meals that:

A. Comply with the Dietary Guidelines for Americans, published by the Secretary of Health and Human Services and the Secretary of Agriculture;

B. Provide each participating older individual:

1. A minimum of 33-1/3 percent of the medically recognized daily recommended dietary allowances or references for dietary intake if only one meal per day is provided. 2. A minimum of 66-2/3 percent of the allowances if two (2) meals per day are provided; and, 3. A minimum of 100 percent of the allowances if three (3) meals per day are provided. C. Are adjusted, to the maximum extent practical, to meet any special dietary needs of program consumers including, special health, religious, or ethnic requirements; and, D. Have been specially modified and approved by a registered dietitian to meet therapeutic, religious, or ethnic requirements, but may not meet the minimum dietary requirements. 10.260.45 Menu Cycles and Analysis A. Nutrition providers shall maintain an approved copy of the menu cycles and analyses on file at the nutrition site(s), and available for review by the AAA or SUA at any time. B. Menus and recipes shall be analyzed using a nutrient software package to ensure compliance with the Dietary Guidelines for Americans, Recommended Daily Allowances, and Dietary Reference Intakes, and approved by a registered dietitian, a registered dietetic technician, or a nutritionist.

C. Only tested quality recipes, adjusted to yield the number of servings needed, shall be used. D. Substitutions or deviations from the approved menu(s) shall be documented. E. Menu cycles and nutrient analysis shall be maintained for a minimum of three (3) years for audit purposes unless disposition is authorized by the grantor agency. 10.260.46 Home-Delivered Meal Provider Responsibilities and Requirements In addition to the requirements at Section 10.260.4, home-delivered meal providers shall: A. Establish a nutritional screening procedure for determining individual needs and resources; B. Verify that all consumers in the home-delivered meal program meet the homebound or geographically isolated eligibility requirements as specified at Section 10.122, B; and, C. Maintain documentation of the consumer’s nutritional screen. 10.260.47 Additional Meal Policy Nutrition providers may serve a second or third meal to older persons identified through nutrition screening to be at nutritional risk and/or socially or economically in need, if included as an objective in the Area Plan.

10.260.48 Nutrition Screening, Counseling, Education Nutrition service providers shall:

A. Provide for nutrition screening of all consumers as described at Section 10.413,D; and, B. Nutrition education and counseling shall be offered in accordance with the requirements at Section 10.413.1, E.

10.260.49 Food Assistance Program A. The nutrition service provider shall provide information and assistance about the Food Assistance Program to consumers who may be eligible for such benefits. B. The nutrition service provider shall inform older consumers if the nutrition program accepts the Food Assistance Program.

C. Congregate sites accepting food stamps shall display Food Assistance Program posters at the site.

D. Older individuals receiving home-delivered meals, who are unable to apply in person, shall be informed of their right to have a proxy apply for assistance on their behalf as an authorized representative.

E. A nutrition service provider receiving funds under the Older Americans Act shall not act as an authorized representative for a consumer in making an application for the Food Assistance Program.

10.260.5 Legal Assistance Provider Responsibilities and Requirements The following provisions and restrictions apply only to legal assistance providers, and only if they are providing legal assistance under the Older Americans Act: A. Legal assistance service providers shall comply with the standards described in the Statewide Standards for Title III-B Legal Assistance in Colorado , published by the Office of the Colorado Legal Assistance Developer as required by the Older Americans Act; no later amendments or editions are incorporated. Copies of these materials are available for public inspection by contacting the Colorado Department of Human Services, Division of Aging and Adult Services, Section Manager, Aging Services Unit, 1575 Sherman Street, Denver, Colorado 80203, or any State Publications Depository Library. B. None of the funds made available under the Act may be used to pay dues exceeding $100.00 per recipient per annum to any organization (other than a bar association), a purpose or function of which is to engage in activities prohibited under these rules. 10.260.6 Other Optional Service Provider Responsibilities and Requirements A. Adult Day Care 1. All providers of adult day care shall operate in full compliance with all applicable Federal, State, and local fire, health, safety, sanitation, and other standards prescribed in law or regulations.

2. Adult day care centers shall provide a safe environment for all consumers, including consumers exhibiting behavioral problems, wandering behavior, or limitations in mental/cognitive function.

3. Adult day care providers shall keep such records and information as necessary to document the services provided to consumers receiving adult day care. 4. All adult day care centers shall maintain a minimum staff to consumer ratio of 1 to 8 to provide for the needs of the population served.

5. Adult day service centers providing medication administration as a service shall have qualified persons on staff trained in accordance with applicable State laws. B. Case Management 1. Case managers shall have a background in human services, and shall be responsible for arranging and monitoring a package of long-term care services for a consumer.

2. Case management activities shall include, at a minimum, the following: a. Initial screening to determine that each applicant meets pre-established criteria prior to the conduct of a comprehensive assessment; b. Comprehensive assessment to identify each applicant’s problems, resources, and needs, and to confirm eligibility;

c. Care planning to specify the types and amounts of care that shall be provided to meet the identified needs of the consumer;

d. Service arrangement to implement the plan of care through formal and informal services;

e. Ongoing monitoring to assure services are appropriately delivered and to ensure the quality of those services; and, f. Formalized reassessment conducted at periodic intervals to adjust care plans to the consumer’s changing needs.

3. Each case management project shall have written policies and/or procedures to monitor the development, implementation, and management of case files. 4. Each case management provider shall maintain comprehensive and complete case files.

10.270 TRIBAL ORGANIZATIONS Services provided under Title III shall be coordinated, when appropriate, with the services provided under Title VI of the Act.

A. The SUA shall not have responsibility for tribal organizations and reservations served by Title VI of the Older Americans Act.

B. Geographic areas served under Title VI shall not be included within any PSAs and are not required to meet the AAA designation criteria defined at Section 10.230. 10.300 FISCAL ADMINISTRATION AND MANAGEMENT 10.310 ALLOTMENT OF FUNDS FOR TITLE III and Title VII SERVICES The allocation formula for all Title III and Title VII services shall be developed with input from stakeholders and approved by the Colorado Commission on Aging.

10.311 State and Local Match 10.311.1 General Match Requirements To be acceptable, all matching contributions, including cash and in-kind contributions, shall meet the following criteria:

A. Verifiable from grantee or sub-grantee records; and, B. Not included as contributions (match) for any other Federally assisted project or program; and, C. Reasonable and necessary for proper and efficient accomplishment of project or program objectives; and, D. Allowable under applicable cost principles; and, E. Not paid by the Federal government under another award, except where authorized by Federal statute to be used for matching; and, F. Provided for in the approved budget; and, G. Conforms to Federal matching requirements in accordance with the Older Americans Act and the Office of Management and Budget (OMB) fiscal rules. 10.311.2 Administrative Match A. The non-Federal share of the cost of administering the Area Plan shall not be less than 25% of the total costs incurred for Area Plan administration during the grant period. B. The non-Federal share shall be from local (non-state) sources and may be cash or in-kind contributions.

10.311.3 Title III, Parts B, C, and D Title III, Parts B, C, and D require a 15% match.

A. The State shall match at least five cents ($0.05 ) for every eighty-five cents ($0.85 ) of Federal funding.

B. The local match requirement shall be 10% of the combined State and Federal funds (in cash or in-kind).

C. The SUA shall not require that every sub-grantee or contractor meet the minimum 10% local match requirement.

1. The net costs of supportive and nutrition services provided under the Area Plan during the grant period shall contain a local match component of not less than 10%. 2. The AAA shall have flexibility to determine individual match requirements for its grantees and contractors in meeting this 10% requirement. 10.311.4 Title III, Part E - National Family Caregiver Support A. Title III, Part E funds shall require a 25% match, including: 1. Appropriations from the Colorado General Assembly; and, 2. Local resources available to AAAs in the form of cash and in-kind. B. Expenditures used to satisfy the non-Federal share requirement shall be related to the purposes of Title III, Part E, and may not be used to meet the non-Federal share requirements of other Federal programs, including other sections of Title III. 10.311.5 Title VII AAAs shall meet the allocation of Title VII funds with a 25% local match (in cash or in-kind contribution).

10.311.6 In-Kind Contributions A. In-kind contributions include, but are not limited to, the following: 1. Personal services provided by volunteers or other unpaid staff for which the grantee or contractor would otherwise have to pay, when the service is an integral and necessary part of the project. These services shall be valued at rates consistent with those ordinarily paid for similar work in the same labor market and may include fringe benefits.

2. Donated goods, including expendable property such as office supplies, laboratory supplies, or workshop and classroom supplies shall be valued at fair market value at the time of donation.

3. If approved by the SUA, donated buildings, space, land, or equipment shall be valued at:

a. Fair rental value of the equipment or space if the donor retains ownership; or, b. Fair market value at the time ownership of the building, space, land, or equipment is transferred to the grantee, if the granting agency approves the match.

c. Depreciation or use allowance may be counted as match. B. In-kind contributions shall be documented to identify the in-kind contribution and the methodology for determining the value placed on the in-kind contribution. C. The value of donated goods or services shall not be reimbursable as a direct or indirect cost of the grant.

D. Neither the cost nor the value of in-kind contributions shall be counted toward satisfying a cost-sharing (match) requirement of an OAA grant, if counted towards satisfying a cost- sharing or matching requirement for another Federal grant, a Federal procurement contract, or any other award of Federal funds.

10.312 Grants, Contracts, and Awards 10.312.1 Area Plan/Grant Application and Approval A. Direct grantees or contractors of the SUA shall apply for Older Americans Act funds at a time and in the format designated by the SUA.

B. Grantees or contractors shall be notified in writing by the SUA of approval, conditional approval, or disapproval of the application.

C. Issuance of the signed NOGA or Funding Letter constitutes spending authority for the grantee or contractor, and approval of the Area Plan and/or grant application. D. The project period shall be stipulated in the NOGA or Funding Letter issued by the SUA and shall be the period from the start date of the grant or contract to the end date of the grant or contract.

E. The project period shall not extend beyond the end of the grant or contract unless a later date is specifically authorized in writing by the SUA or specified in the grant application or contract approved by the SUA.

F. Submission of a request for reimbursement after the issuance of a NOGA, Funding Letter, or revised NOGA or Funding Letter is issued, constitutes acceptance of all grant or contract conditions, unless a written appeal is filed by the AAA. 10.312.2 Awarding of Funds A. The Federal government awards funds to the SUA for the purpose of distributing such funds throughout Colorado according to the guidelines established under the Older Americans Act and the approved State Plan.

B. The AAAs shall have a formal award agreement or contract with service providers to provide services under the Area Plan.

C. Preference in awarding funds or contracts for Title III services shall be given to minority organizations if, in the judgment of the awarding agency and all other requirements being equal, the award or contract:

1. Facilitates meeting the requirement of giving preference to older persons with greatest social or economic need; and, 2. Results in particular attention to low-income minority persons and older persons living in rural areas.

10.312.3 Conditions of Award or Contract Program activities conducted with a Title III award or contract shall comply with the following: A. The Older Americans Act;

B. Clarifications or guidance issued by the United States Department of Health and Human Services;

C. Colorado Department of Human Services’ Older Americans Act Program rules (12 CCR 2510- 1);

D. Any conditions attached to the NOGA or Funding Letter issued to Area Agencies, sub- grantees, or contractors; and, E. Requirements found at 45 CFR, Part 1321; 45 CFR, Part 74; 45 CFR, Part 92; and 45 CFR, Part 95. These shall not include any later amendments to or editions of the incorporated material. Copies of these materials are available for public inspection by contacting the Colorado Department of Human Services, Division of Aging and Adult Services, Section Manager, Aging Services Unit, 1575 Sherman Street, Denver, Colorado 80203, or any State Publications Depository Library.

10.312.4 Cash Advances on Awards The SUA may provide cash advances to a AAA for cash flow purposes during the reimbursement period.

10.312.5 Interest on Cash Advances A. Nonprofit grantees, sub-grantees, and contractors shall maintain advances of Federal funds in interest-bearing bank accounts. This shall include cash advances as described at Section 10.312.4.

B. Interest earned on these cash advances of Federal funds shall not be considered “local” income.

C. Interest amounts up to $250.00 per year, may be retained for administrative expenses. D. Interest amounts in excess of $250.00 shall be remitted annually to the SUA. 10.312.6 Enforcement, Suspension or Termination of a Grant A. The granting agency (SUA or AAA) shall take one or more enforcement actions, if the grant recipient:

1. Fails to comply with these rules; or, 2. Has materially failed to comply with the terms of the grant; or, 3. Fails to carry out required corrective action by the dates specified by the granting agency.

B. Enforcement actions may include:

1. Temporarily withholding cash payments pending correction of the deficiency by the grantee or sub-grantee;

2. Disallowance (denial of use of funds and any applicable matching credit) for all or part of the cost of the activity or action not in compliance; 3. Total or partial suspension of the current award;

4. Termination of the current award; and, 5. Other remedies as may be legally available.

C. Non-compliance shall be documented by the granting agency. D. The granting agency shall notify the grantee in writing of the required corrective actions and dates by which corrective action shall be due.

E. Notification shall include the grantee or sub-grantees rights to a hearing, appeal or other administrative action.

F. The grantee or sub-grantee shall not incur new obligations against the grant during the period of suspension unless expressly authorized to do so by the granting agency. G. If the grantee remains in suspension until the end of the grant period recorded in the NOGA or Funding Letter, the grant shall be automatically terminated. H. If a grant to an AAA is suspended or terminated by the SUA, agency acting on its behalf may administer the Area Plan as described at Section 10.230. I. Termination of a grant shall occur on other grounds if: 1. The granting agency and the grantee agree upon the termination conditions; or, 2. The grantee notifies the granting agency in writing of the termination, the effective date and, in case of partial termination, the portion of the grant to be terminated. J. In the case of partial termination, the granting agency shall determine whether the remaining portion of the grant will accomplish the purposes for which it was awarded. If not, the granting agency may terminate the grant in its entirety. K. If a grant is terminated:

1. The grantee shall not incur new obligations after the effective date of the termination; 2. The grantee shall cancel outstanding obligations; and, 3. The granting agency shall allow full credit to the grantee for obligations properly incurred prior to termination that cannot be cancelled. 10.313 Multipurpose Senior Center Federal Reversionary Interest The Administration on Aging (AOA) retains a Federal reversionary interest to recover funds at a percentage of the current market value of the multipurpose senior center, equal to the percentage of AOA funds contributed to the cost of the facility.

10.314 Transfers of Funds A. The OAA provides authority for the State to transfer funds, within specific limits, among its allotments for supportive services and senior centers, congregate meals and home- delivered meals.

B. The OAA does not provide authority for the State to transfer funds in or out of the allotments for Preventive Health Services/Disease Prevention, the Long-Term Care Ombudsman Program or the National Family Caregiver Support Program. C. The AAA may transfer up to 40% of funds between Title III Part C-1 (congregate meals) and Part C-2 (home-delivered meals).

D. The AAA may transfer up to 30% of its allotment between Title III, Part B and the Nutrition Programs under Title III, Part C.

E. If the AAA requests a transfer that exceeds the maximum percentage, a waiver justifying the additional amount shall be submitted to the SUA.

10.315 Restrictions on Fund Use A. Program development and coordination activities shall not be funded as a cost of supportive services for Area Plan administration until the SUA has spent 10% of its Title III allotments on administration of area plans.

B. Title III Program Income Program income generated by Title III shall not be used for AAA administration. C. Title III, Part E – National Family Caregiver Support Program 1. Area Agencies on Aging providing caregiver services to consumers and/or their families prior to enactment of the Title III, Part E shall: a. Use these funds only to increase the level of services provided; and, b. Not supplant other Federal, State or local funds used for this purpose with funds from Title III, Part E.

2. Area Agencies on Aging shall not expend more than 10% of Title III, Part E, Federal funds to provide support services for grandparent caregivers. 10.316 Carry-Over Funds Area Agencies on Aging shall expend OAA funds during the budget year for which the funds are granted. Carry-over funds are funds that are not expended during the budget year and may be available during the next budget year. The SUA may reallocate carry-over funds or carry-over funds may revert to the SUA.

10.317 Payment Grantees and contractors shall submit requests for reimbursement in the format and time period required by the SUA.

10.318 Consumer Contributions and Guest Fees A. Voluntary contributions shall be allowed and may be solicited for all services for which funds are received under Title III.

B. Methods of solicitation for voluntary contributions shall be non-coercive. C. The AAA shall provide service providers with policy and guidelines for accepting voluntary contributions and guest fees from non-eligible consumers. 1. The AAA shall establish and maintain procedures to protect the privacy of the client’s decision to contribute or not contribute toward the service rendered. 2. Eligible consumers shall not be denied service(s) provided under Title III because the consumer’s decision not to contribute.

3. Service providers shall determine the costs of services provided and display a suggested contribution schedule as well as required guest fees for services at the entry point of the service premises.

D. The AAA and service providers shall not perform a means test for any service for which contributions are accepted, or deny services to any eligible consumer who does not contribute to the cost of the service.

10.319 Accounting 10.319.1 General Requirements A. Agencies which are grantees or contractors of the SUA shall utilize double-entry accounting systems including, but not limited to: a general ledger, cash receipts journal, cash disbursements journal, in-kind receipts, disbursements journal, and general journal. Additionally, individual payroll records shall be maintained. B. Area Agencies on Aging, sub-grantees, and contractors shall have qualified accounting personnel available to perform accounting functions.

10.319.2 Internal Control Procedures State grantees shall ensure that internal controls are established and maintained for itself and its subgrantees in accordance with State policies and procedures. At a minimum, agencies shall develop and maintain a fiscal policy and procedures manual which shall establish minimum fiscal requirements in accordance with federal, state, and local statutes, regulations, and procedures. The local advisory council shall review the fiscal policy and procedures manual. If the agency is an area agency the fiscal policy and procedures manual shall be approved by the agency's governing board. The fiscal policy and procedures manual shall include but not be limited to: A. Cash control procedures including requirements for the collection of consumer contributions and guest fees, recording of cash receipts and expenditures, depositing of cash, separation of cash handling from record-keeping responsibilities and periodic reconciliation of all cash funds including bank accounts. B. A plan to equitably distribute on a timely basis the State's cash advance by the area agency to its subgrantees.

C. Bidding, purchasing, and contracting procedures in accordance with federal, state and local requirements.

D. Requirements for bid guarantees, performance bonds, and payment bonds for bids and contracts for construction and facility improvement.

E. A procedure for distributing joint costs among projects or grants in accordance with the section on cost distribution methods in this staff manual.

F. In-state and out-of-state travel policies including specification of required signatures and documentation.

10.320 INCOME 10.320.1 Title III Income A. Program Income 1. Program income shall include all income earned by a grantee, sub-grantee, contractor, or subcontractor that is directly generated by supported activities, the cost of which is borne by the grant whether in part or in full. 2. All program income shall be used in accordance with the additional costs alternative and shall be added to funds committed to the project or program, and used to further eligible project or program objectives.

3. All income, including interest earned on program income accounts, earnings, and expenditures of program income, shall be reported monthly in accordance with the format and time period required by the SUA.

4. Carry-over (unexpended program income or “balance on hand” ) shall be reported as required by the SUA.

5. The AAAs or service providers with programs for services to both older individuals under the OAA, and other non-aging programs, are prohibited from maintaining one interest-bearing account to serve all programs.

B. Part C-1 and Part C-2 Program Income 1. All program income earned under Title III, Part C-1 and Part C-2 awards shall be used to accomplish one or more of the following:

a. Increase the number of meals served by the nutrition project; b. Facilitate access to meals by providing supportive services such as outreach or transportation to meal sites; or, c. Provide other supportive services directly related to nutrition services. 2. Part C-1 and Part C-2 program income shall be accounted for separately and deposited into separate interest bearing accounts.

3. If the service provider operates both C-1 and C-2 programs, the grantor agency may authorize the provider to deposit the program income from each into one joint interest bearing account if grant accounting principles are used and/or the funds are accounted for separately.

4. Program income from Part C-1 and Part C-2 collected during the last 30 calendar days of the grant period shall be reported, but need not be expended if it cannot be effectively used in the grant period in which it was received. The income may be carried over and expended in a subsequent grant period. 5. When a C-1 or C-2 grant, subgrant, or contract expires and is not renewed, or is suspended or terminated, any unexpended program income funds shall revert or be transferred to the awarding agency and subsequently transferred to the successor nutrition provider.

6. All purchase of service contracts shall contain a provision that unexpended program income funds on hand at the date the contract is terminated shall revert to the awarding agency, unless the contracting provider agency is awarded a purchase of services nutrition contract or grant for the succeeding grant period. 7. If program income is transferred to a AAA following expiration, suspension, or termination of a provider grant or contract, the AAA may withhold all or part of the transferred program income to fund access and other supportive services directly related to nutrition services through a provider agency other than the nutrition project grantee or contractor.

C. Guest Fees Guest fees are required charges to persons who are not eligible consumers of the program but are receiving services. Minimum fees for congregate meals, home- delivered meals, and supportive services shall be determined using guidelines and procedures established by the SUA.

D. Usage Fees Usage fees include charges for the use of equipment or other fixed assets acquired with OAA funds. The minimum usage fee shall be charged when such assets are used for non-grant purposes.

If nutrition project grantees or sub-grantees use equipment purchased with Title III funds to produce meals sold to other organizations:

1. The compensation shall be directly credited to the cost of goods or services provided under the current grant, if the equipment was acquired under the current year’s grant.

2. If the equipment was acquired with a prior year’s grant, the compensation shall be recorded as program income.

E. Sales of Equipment and Supplies Proceeds from sale of equipment or supplies not used for replacement equipment shall be accounted for as program income.

F. Program income earned after grant support has ended shall be subject to the terms of the grant or subgrant. If this category of income is not specifically detailed in the grant document, the agency may dispose of the income as it chooses. 10.320.2 Third Party Payments A. Payments from Medicare, insurance companies, or other third party sources shall be credited directly to the cost of goods or services provided.

B. If Medicaid funds are used to purchase services, no additional funds shall be used for those services.

C. Refunds for defective or unused merchandise or manufacturer rebates or discounts shall be credited directly to the cost of the goods or services provided. D. Donations unrelated to the receipt of services are not program income and may be used to meet local matching requirements.

E. Fund Raising Activities The use of goods and property, and the value of staff personnel time used in fund raising activities, shall be fully compensated.

10.320.3 Nutrition Services Incentive Program (NSIP)

A. Funds received from the AoA shall be distributed by SUA. B. The AAA allocation shall be based on the percentage of the number of eligible meals served each year by the AAA/nutrition service project to the total number of meals served under Colorado Nutrition projects.

C. The SUA shall have discretion in receiving:

1. Cash; or, 2. A combination of cash and commodities.

D. If the SUA chooses a combination of cash and commodities, nutrition providers that choose to receive a combination of cash and commodities shall complete documentation as directed by the SUA.

E. All meals shall be reported to the SUA on a regular basis in the format required by the SUA. F. NSIP cash funds shall only be used to purchase United States agricultural commodities and other raw foods for the nutrition program, and shall be used to increase the number of meals served.

G. NSIP cash funds shall not be applied to the costs of the nutrition project, except as stated above.

10.321 Fixed Assets, Supplies, and Capital Expenditures 10.321.1 Fixed Asset Requirements A. Fixed assets are:

1. Real property (land, buildings, and building improvements); 2. Leasehold improvements (remodeling or redecorating of rented or leased spaces); and, 3. Tangible personal property (office furniture, kitchen equipment and vehicles) with a useful life of more than one (1) year.

B. Fixed assets may be acquired by purchase or by donations. 1. Prior approval of the granting agency shall be obtained prior to purchase of a fixed asset with a value in excess of $5,000.00. Issuance of a NOGA or Funding Letter shall constitute approval if the proposed purchase and its justification have been included in the fiscal section of the grant application. 2. Donations of fixed assets shall be used as in-kind match if they further the purposes of the grant. The cost shall be recorded at fair market value and all requirements for fixed assets shall apply.

C. The AAA or sub-grantee shall maintain, at a minimum, insurance coverage adequate to cover the replacement value of all fixed assets.

D. Fixed assets funded in whole or in part by grant funds may be used on a part-time basis for non-grant purposes by:

1. Nonprofit agencies, provided that:

a. A minimum usage fee is charged in accordance with Program Income requirements at Section 10.320.1D; and, b. The part-time usage does not conflict with the use of the equipment for the purposes of the grant.

2. Profit-making organizations provided that:

a. A usage fee equal to or greater than the prescribed minimum is charged; b. Usage does not conflict with the use of the equipment for purposes of the grant; and, c. Prior approval has been obtained from the grantor agency. 10.322 Fiscal and Performance Reporting Requirements A. At the end of each reporting period, performance and fiscal reports shall be submitted to the SUA in a format and time period specified by the SUA.

B. Area Agencies on Aging failing to meet SUA requirements to provide accurate and timely reports may be subject to further corrective action, including 1. Suspension of reimbursement payments; and, 2. Withholding of grant applications for funding.

10.323 Documentation and Record Retention Requirements Each AAA shall ensure that record keeping and documentation requirements are met as required by the SUA.

A. Documentation Documentation including, but not limited to, consumer files, accounting records, deposit slips, cancelled checks, bank statements, monthly bank reconciliation, invoices, receiving report, etc., shall be maintained and clearly documented with supporting information and references.

B. Retention of Records 1. Grantees and sub-grantees shall retain fiscal and programmatic records until formal written notice permitting disposal of the records is received from the grantor agency.

2. The SUA shall transmit written notice to its grantees within six (6) months of the date retention of the records is no longer required by Federal regulations. 3. Within three (3) months after receiving the notice, the AAA shall notify its sub-grantees in writing that retention of the records is no longer required. 10.324 Fiscal Audits A. Frequency of Audits 1. An independent auditor shall audit all AAAs at least every two (2) years. If conducted every two (2) years, the audit shall include both years. 2. Each direct grantee of the SUA and each sub-grantee shall be audited at least every two (2) years in accordance with Federal requirements for audits of states, local governments and nonprofit organizations, and as directed by the SUA. If conducted on a two (2) year basis, the audit shall include both years. 3. Direct grantees, including AAAs, of the SUA shall be responsible for scheduling audits of their agency and shall budget for the use of an independent registered certified public accountant to carry out the audit.

4. The AAAs shall ensure that their grantees receiving financial assistance awards whether the grant instrument used is a NOGA or a contract, are audited in accordance with Section 10.324, A, 2.

5. The audit of an AAA shall include a representative sample of the transactions under subgrants that are less than lower limits established by the Federal Office of Management and Budget for such audits, if the aggregate of the subgrants is material according to the auditor’s judgment.

B. Scope of Audit Audits of grantees and sub-grantees shall be conducted in accordance with Federal requirements for audits of states, local governments and nonprofit organizations and as directed by the SUA.

C. Allowable Audit Costs Audit costs may be charged to the grant if the audit meets all requirements at Section 10.324. If multiple funding sources are covered by the audit, an equitable portion of the audit costs may be charged to the grant.

10.400 DIRECT SERVICES AND SERVICE STANDARDS 10.410 DIRECT SERVICE PROHIBITIONS AND WAIVERS 10.410.1 Prohibition of Direct Services A. The Area Agency on Aging (AAA) shall not directly provide supportive services, nutrition services, in-home services, or disease prevention and health promotion services unless, in the judgment of the State Unit on Aging (SUA):

1. Provision of the services by the AAA is necessary to assure an adequate supply of services; or, 2. The services are directly related to AAA administrative functions; or, 3. Services of comparable quality can be provided more economically by the AAA. B. Services and activities directly related to AAA administrative functions shall include, but not be limited to:

1. Advocacy;

2. Coordination;

3. Program development;

4. Information and assistance services;

5. Outreach;

6. Needs assessment;

7. Long-Term Care Ombudsman;

8. Training; and, 9. Case Management.

C. Except for the services described above, or where a waiver is granted by the SUA, AAAs shall award funds by grant or contract to community service provider agencies and organizations.

10.410.2 Direct Service Waiver 10.410.21 Waiver Application An AAA shall request a direct service waiver from the SUA in the Area Plan, One-Year Grant Application, or whenever the AAA is applying for a waiver to directly provide a service not previously approved by the SUA.

10.410.22 Approval/Denial of Direct Services Waiver Application A. The AAA shall be notified in writing of the approval, conditional approval or denial of the requested waiver as described at Section 10.312.1, B.

B. If the waiver is denied, the AAA shall be informed of its right to appeal the determination. 10.411 Access Services 10.411.1 Information and Assistance A. Information and assistance providers shall meet the requirements at Section 10.260.21. B. Information and assistance includes one-on-one contacts between an information and assistance provider and consumer or the consumer’s caregiver. C. In an area where a predominate number of older individuals speak a language other than English as their principal language, the outreach service shall also be provided in that language.

10.411.2 Outreach A. Outreach providers shall meet the requirements at Section 10.260.22. B. Outreach includes one-on-one interventions with older individuals and/or their caregivers for the purpose of identifying potential consumers and encouraging the older individuals or caregivers’ use of existing services and benefits.

C. Outreach efforts shall be conducted throughout the PSA to identify older individuals and their caregivers, and inform them of the availability of services. D. In an area where a predominate number of older individuals speak a language other than English as their principal language, the outreach service shall also be provided in that language.

E. Special outreach activities shall be conducted for Native American elders and their caregivers in an area where Native Americans comprise at least:

1. One percent (1%) of the PSA’s population age 60 and over; or, 2. Five percent (5%) or more of the State’s 60 and over Native American population resides within a PSA.

10.411.3 Transportation A. Transportation and assisted transportation are available under the Older Americans Act (OAA) to enable older persons to travel to and from congregate meal sites, community facilities, and other resources for the purposes of applying for or receiving services, reducing isolation, and promoting independent living.

B. Priority shall be given to:

1. Older individuals who lack the ability to transport themselves or lack other means of transportation; and, 2. Older individuals in greatest economic need or greatest social need with preference given to low-income minority older individuals and older persons residing in rural or geographically isolated areas.

C. The provider determines the type of transportation services, available within the area, that most effectively meet the older individuals’ needs, and any special assistance (e.g., escort) the older individual requires.

D. Transportation providers shall meet the requirements described at Section 10.260.23. E. OAA funds shall not be used to pay for transportation or assisted transportation if such transportation is offered or covered through other Federal or State programs for which the older individual is receiving.

10.412 In-Home Services 10.412.1 Rights Relating to In-Home Services for Older Individuals Older individuals receiving in-home services under the OAA shall have the following rights: A. To be fully informed in advance about each in-home service provided under the OAA, and about any change in services that may affect the well-being of the older individual; B. To participate in planning and changing an in-home service provided under the OAA, unless the older individual is judicially determined to be incompetent; C. To voice a grievance with respect to a service that is provided or fails to be provided, without discrimination or reprisal as a result of voicing the grievance; D. To have their property treated with respect; and, E. To be fully informed (orally and in writing) of these rights under the OAA before receiving an in-home service.

10.412.2 Available Services A. In-home services shall be made available to older individuals, including individuals with Alzheimer’s disease and related disorders or with neurological and organic brain dysfunction, and their families.

B. Services provided shall be designed to capitalize on the older individual’s strengths; lessen the burden of impairment; reduce the degree of stress or burden on caregivers; and assist and enable the consumers to remain in their own homes and communities with the maximum degree of independence.

C. The following in-home services may be provided:

1. Homemakers (Section 10.412.4);

2. Personal care services (Section 10.412.5);

3. Visiting and telephone reassurance (Section 10.260.34); 4. Chore maintenance (Section 10.412.62);

5. Minor home modifications necessary to facilitate the ability of older individuals to remain at home and not available under other Federal or State programs for which the older individual may be eligible (Section 10.412.61); 6. In-home respite care (Section 10.510.51);

7. Adult day care as a respite service for families (Section 10.510.52); 8. Other in-home services as defined by the State and approved in the Area Plan. D. OAA funds shall not be used to pay for in-home services offered or covered through other Federal or State programs for which the older individual is receiving. 10.412.3 Assessments An assessment shall be completed for each older individual prior to the delivery of in-home services using the assessment tool approved by the SUA. 10.412.4 Homemaker Services A. Homemaker service providers shall meet all requirements as specified at Section 10.260.31. B. Homemaker services shall be for the benefit of the older individual, and not for the sole benefit of other persons living in the home.

C. Family members shall not be reimbursed under Title III for providing homemaker services to an older relative. For purposes of this section, family shall be defined as all persons related to the consumer by virtue of blood, marriage, adoption or common law. 10.412.5 Personal Care Services A. Personal care service providers shall meet the requirements described at Section 10.260.32. B. Personal care services are unskilled services provided to eligible consumers to meet physical, maintenance, and supportive needs.

C. Personal care services shall include direct assistance, stand-by assistance, supervision or cues of the following activities:

1. Bathing, when no skilled services are required in conjunction with the bathing; 2. Skin care, including application of lotions or solutions that are not medicated and/or do not require a physician’s prescription;

3. Hair care, including shampooing with shampoo that is not medicated or does not require a physician’s prescription, drying, combing, and styling of hair; 4. Nail care including soaking of the nails, pushing back cuticles, and trimming and filing of nails;

5. Mouth care including denture care and basic oral hygiene; 6. Shaving when done with an electric razor;

7. Dressing assistance, including application of support stockings that can be purchased without a physician’s order, and orthopedic devices such as splints, braces or artificial limbs if the older individual has been fully trained in the use of the device or limb and is able to instruct the personal care staff; 8. Feeding when the consumer is able to eat by mouth, using common eating utensils, such as forks, knives, spoons, and straws;

9. Assistance with ambulation, including transfers, if the older individual does not require skilled supervision, has been fully trained in the use of adaptive equipment, including gait belts, walkers, canes, and wheelchairs, and is able to instruct the personal care staff;

10. Assistance with exercise when the exercises are not prescribed by a licensed medical professional;

11. Assistance with transfers when the consumer has sufficient balance and strength to assist with the transfer:

a. Adaptive equipment other than Hoyer lifts may be used if the consumer is fully trained in the use of the equipment and can direct the transfer step by step.

b. Adaptive equipment may include gait belts, wheel chairs, tub seats, and grab bars.

12. Positioning to assist the consumer in changing position or alignment in a bed, wheelchair, or other furniture;

13. Bowel and bladder care to include assisting the older individual to and from the bathroom, assistance with bed pans, urinals, and commodes; changing of clothing and pads used for incontinence:

a. Emptying of Foley catheter bags or suprapubic catheter bags if the personal care staff has been trained to understand what constitutes disruption of the closed system and is able to ensure that such a disruption does not occur; and, b. Emptying of ostomy bags and assistance with other consumer-directed ostomy care if there is no need for skilled skin care or observation and reporting to a nurse.

14. Medication reminding if the medications have been pre-selected by the older individual, the older individual’s family or caregiver, a nurse, or a pharmacist, and are stored in containers other than prescription bottles, such as medication minders.

a. Medication reminding includes only:

1) Inquiries as to whether a medication has been taken; 2) Verbal prompting to take medications;

3) Providing the proper liquid and utensil with which to take medications; 4) Handing the appropriately marked medication minder to the older individual; and, 5) Opening the appropriately marked prescription minder container for the older individual if the older individual is physically unable to open the container.

b. Medication reminding shall not include taking the medication out of the container.

15. Respiratory care services shall include only cleaning or changing tubing for oxygen equipment, refilling the distilled water reservoir, and temporarily removing and replacing the cannula or mask from the older individual’s face for purposes of shaving or washing the consumer’s face.

16. Accompanying the consumer to medical appointments, banking errands, basic household errands, clothes shopping, and grocery shopping to the extent necessary and specified in the consumer’s service plan. a. Personal care for accompanying the consumer shall only be approved when a personal care provider is needed during the trip to provide one or more unskilled personal care services.

b. Accompanying the consumer to provide companionship is not a covered benefit.

10.412.6 Additional In-Home Services 10.412.61 Home Modification A. Home modification providers shall meet the requirements at Section 10.260.33. B. Home modification services include repairs, maintenance, renovation, adaptations, and modifications or improvements in the older individual’s home setting which: 1. Are necessary to ensure the health, welfare, and safety of the individual; and, 2. Enable the older individual to function with greater independence in his or her home; and, 3. Prevent institutionalization of the older individual. C. Home modification services shall not exceed the amount established by the SUA. D. Services may include:

1. Installation of ramps;

2. Installation of grab-bars and other durable medical equipment if approved by the AAA and not a covered benefit of the individual’s health plan or health insurance; 3. Widening of doorways;

4. Modification of bathroom facilities; and, 5. Electrical and plumbing repairs or installation of specialized electric and plumbing systems, which are necessary to accommodate medical equipment and supplies necessary for the welfare of the consumer.

E. The following home modifications shall not be reimbursable with Older Americans Act funds: 1. Major repairs of houses and/or furnishings to include replacement of a furnace, roof, floor or foundation, or installation of central air conditioning; 2. Remodeling of bare rooms;

3. Construction of a second ramp if a first ramp is available, safe, and usable; 4. Construction, repair or maintenance of outbuildings such as garages, carports, animal shelters or greenhouses;

5. Installation, repair or maintenance of nonessential appliances (e.g., decorative light fixtures or television sets); and, 6. New construction or beautification of property or activities strictly for cosmetic purposes such as landscaping, planting a garden, purchase of gardening equipment, a complete paint job, ornamental shutters or trim, fancy porch supports, carpeting, patio, and/or mending fences unless directly essential to the older individual’s safety.

F. Home modification services, as described in this section, shall not be reimbursed or reported as chore maintenance services or material aid.

G. Home modification services may be provided to older individuals residing in rental properties if a determination is made that the modifications are not the responsibility of the landlord, management company or public housing authority, according to a valid lease agreement. H. Older Americans Act funds shall not be used to pay for home modifications if such modifications are offered or covered through other Federal or State programs for which the older individual is receiving.

10.412.62 Chore Services A. Chore services are those services designed to increase the safety of the individual(s) living at home such as assistance with heavy housework, yard work or sidewalk maintenance, and may include:

1. Cleaning appliances, including ovens, and defrosting and cleaning refrigerators; 2. Cleaning and securing carpets and rugs;

3. Cleaning and waxing wood or tile floors;

4. Washing windows or walls;

5. Moving or rearranging furniture to provide safe entry, mobility, and egress; 6. Turning mattresses;

7. Cleaning closets and drawers;

8. Cleaning attics, basements, porches, and outbuildings to remove fire and health hazards;

9. Cleaning exterior surfaces, such as removing mildew from siding or decking; 10. Installing or removing existing screens, storm doors, or windows; 11. Replacing fuses, light bulbs, repairing electric plugs, or frayed cords; 12. Grass cutting and leaf raking;

13. Clearing walkways of ice, snow, and leaves;

14. Clearing interior and exterior debris following natural disasters; 15. Trimming overhanging tree branches; and, 16. Changing batteries in smoke or carbon monoxide detectors. B. Chore services shall not include services described under home modifications at Section 10.412.61 or material aid at Section 10.417, D.

C. Chore service activities are one-time, seasonal or occasional in nature, and shall be planned with input from the older individual based on an evaluation of the consumer’s strengths and needs, and the degree of physical and/or cognitive impairment of the consumer. D. Chore services may be provided to older individuals residing in rental properties if a determination is made that the modifications are not the responsibility of the landlord, management company, or public housing authority according to a valid lease agreement. 10.412.63 Home Health Aide A. Home Health Aide service providers shall meet the requirements described at Section 10.260.35.

B. Home Health Aide services are provided to eligible consumers to meet physical needs. C. Home Health Aide services shall include direct assistance with the following activities: 1. Basic medical care procedures, including vital sign monitoring, catheter care, digital stimulations, enemas, oral suctioning and simple skin care routines; and, 2. Skilled personal care procedures; and, 3. Skilled grooming; and, 4. Skilled bowel and bladder care; and, 5. Assistance with skilled mobility and transfers.

D. Home Health Aide services shall not duplicate services that can be provided by personal care or homemaker services.

E. Consumers who receive Home Health Aide services through Medicaid, Medicare or Private insurance shall not be qualified to receive Home Health Aide services through Older Americans Act or State funding.

10.413 Nutrition Programs Nutrition services shall be provided to older individuals, particularly those in the greatest economic or greatest social need, with particular attention to low-income minorities and older individuals residing in rural areas. Nutrition services shall include access and outreach services to encourage the use of nutrition services, nutrition screening, nutrition education, nutrition counseling, and nutritionally balanced meals, to promote better health through improved diet. 10.413.1 Nutrition Services Each nutrition project shall include the following services consistent with the Area Plan and approved by the AAA.

A. Congregate Meals Nutrition projects shall provide at least one hot or other appropriate meal per day, five (5) days or more per week, except in rural areas where such frequency is not feasible and a lesser frequency is approved by the SUA, and any additional meals the project, in consultation with the AAA, may elect to provide.

B. Home-delivered Meals The AAA shall establish and operate nutrition projects which, five (5) days or more a week, provide at least one home-delivered hot, cold, frozen, dried, canned, or supplemental foods (with a satisfactory storage life) meal per day and any additional meals which the nutrition project may elect to provide except when the State Unit on Aging approves a lesser frequency.

C. Modified Diets Modified diets or special menus shall be provided, where feasible, to meet the particular dietary needs arising from health or religious requirements, or ethnic backgrounds of eligible individuals. The nutrition provider and a registered dietician shall determine feasibility and appropriateness of modified diets.

D. Nutrition Screening All older individuals shall receive nutrition screening when participating in: 1. Congregate meal programs; or 2. Home-delivered meal programs; or 3. Nutrition counseling; and/or, 4. Case management.

E. Nutrition Education Nutrition education services shall be conducted on an ongoing basis and documented for congregate and home-delivered meal consumers, and shall include presentations or learning activities at congregate sites with content approved by a registered dietitian, registered dietetic technician, or nutritionist, and presented by a person knowledgeable in nutrition.

10.413.2 General Nutrition Service Standards Nutrition service providers of congregate and home-delivered meals shall comply with requirements described at Section 10.260.4 through 10.260.49 and the State laws and regulations for retail food establishments.

10.413.3 Congregate Meal Service Standards A. Eligibility for nutrition and nutrition support services shall be as defined at Section 10.121. B. If resources are not available to serve all eligible individuals requesting the service, preference shall be given to those of greatest social or economic need, with particular attention to low-income and older individuals residing in rural areas. 10.413.4 Home-Delivered Meal Service Standards A. Eligibility 1. Eligibility for nutrition and nutrition support services shall be as defined at Section 10.121.

2. Services shall be provided to those of greatest social or economic need, with particular attention to low-income minority individuals and older individuals residing in rural areas.

3. Individuals requesting home-delivered meals shall be assessed. Only those determined to be homebound or geographically isolated shall be eligible for a home-delivered meal.

4. Priority shall be given to emergency requests for older individuals who are newly homebound or temporarily incapacitated.

B. Homebound Assessment Homebound status shall be documented at the nutrition project level. Based on the consumer’s condition, homebound status shall be re-evaluated at least every six (6) months.

10.413.5 Nutrition Screening Service Standards A. All older individuals participating in nutrition programs for the elderly, whether congregate or home-delivered meal programs, shall be requested to complete the Colorado nutrition screening tool required by the SUA.

B. If an older individual refuses to complete the screening form, he or she shall not be denied a meal.

10.413.6 Nutrition Education Service Standards A. If a consumer is determined to be at high nutritional risk, nutrition education shall be offered to the consumer or his/her caregiver.

B. Congregate sites shall provide food safety information and nutrition education for nutrition project consumers to include proper storage and heating of the meal if not immediately consumed.

C. Consumers and/or caregivers of consumers in the home-delivered meal program shall receive instruction on the handling and use of meals when the home-delivered meal service is implemented, and as a reminder at each reassessment or more frequently if necessary. 10.413.7 Nutrition Program Support Service Standards If the provisions of Section 10.320.1, Title III Program Income are met, nutrition project income may be used to fund nutritional program services and support services directly related to nutrition services as described at Section 10.413.1.

10.414 Legal Assistance A. Legal assistance providers shall meet the requirements as described at Section 10.260.5. B. Legal assistance services may include legal advice and representation provided by an attorney to older individuals in the following categories: 1. Public benefits, institutions, and alternatives to institutions; 2. Estate planning;

3. Wills and trusts;

4. Guardianship/conservatorship;

5. Health law including quality of care, living wills, medical, and general durable power of attorney, long-term care;

5. Pensions;

7. Remedies for abuse, neglect, and exploitation;

8. Consumer;

9. Landlord/tenant;

10. Probate; and, 11. Age discrimination in employment.

10.415 Disease Prevention and Health Promotion A. Disease Prevention and Health Promotion include, but are not limited to, the following services:

1. Health risk assessments;

2. Routine health screening, including hypertension, glaucoma, cholesterol, cancer, vision, hearing, diabetes, bone density, and nutrition screening; 3. Nutritional counseling and educational services for older individuals and the caregivers with primary responsibility for their care, if applicable; 4. Health promotion programs, including programs relating to prevention and reduction of effects of chronic disabling conditions (including osteoporosis and cardiovascular disease), alcohol and substance abuse reduction, smoking cessation, weight loss and control, and stress management;

5. Programs regarding physical fitness, group exercise, and music therapy, art therapy, and dance-movement therapy, including programs for multigenerational participation that are provided by:

a. An institution of higher education;

b. A local educational agency described by appropriate Federal regulations; or, c. A community-based organization.

6. Home injury control services, including screening of high-risk home environments and provision of educational programs on injury prevention (including fall and fracture prevention) in the home environment;

7. Screening for the prevention of depression, coordination of community mental health services, provision of educational activities, and referral to psychiatric and psychological services;

8. Educational programs on the availability, benefits, and appropriate use of preventive health services;

9. Medication management screening and education to prevent incorrect medication and adverse drug reactions;

10. Information concerning diagnosis, prevention, treatment, and rehabilitation concerning age-related diseases and chronic disabling conditions, including osteoporosis, cardiovascular diseases, diabetes, and Alzheimer’s disease and related disorders with neurological and organic brain dysfunction; 11. Gerontological counseling; and, 12. Counseling regarding social services and follow-up health services based on any of the services described in items 1 through 11 of this section. B. Disease Prevention and Health Promotion services and information shall be provided at multipurpose senior centers, congregate meal sites, through home-delivered meal programs or other appropriate sites.

10.416 Medication Management A. Medication management, screening, and education to prevent incorrect medication use and adverse drug reactions shall be included as one of the categories of service activities authorized in Disease Prevention and Health Promotion activities under the OAA. B. Services include, but are not limited to:

1. Information and education to assist older individuals in understanding how to take prescription, over-the-counter, and herbal medications in a safe and appropriate manner, including following a regimen provided by their physician or pharmacist; 2. Information on potential food and drug interactions; 3. The use of devices (e.g., pill boxes, pill cutters, timers, etc.) to assist older individuals in taking their medication properly;

4. Referral of older individuals to a physician or pharmacist for information and assistance with their medications;

5. Provision of information to older individuals about prescription, over-the-counter, and herbal medications including common side effects, the dangers of mixing medications, and other issues related to medication management and screening; 6. Development of brochures, videos, or other materials and resources to provide information about, or assistance with, appropriate management of medications; 7. Provision of information to older individuals and/or their caregivers about applying to drug companies that participate in prescription assistance programs; and 8. Additional education, screening, and assistance as identified by the AAA. C. Services, including information and training may be provided directly to older individuals or to their spouses, family members, or caregivers.

10.417 Optional Services A. Introduction Additional services may be funded by the AAA to provide resources for older individuals to access existing services, or assist in filling known gaps in the service continuum described in the Area Plan. These optional support services may include: 1. Services provided in the community such as advocacy, counseling, and assistance to address such concerns as:

a. Taxes and financial problems;

b. Benefits, food stamps, and the use of facilities and services; c. Pre-retirement or second career concerns;

d. Services designed for the unique needs of the disabled; e. Emergency services employment;

f. Physical fitness and recreational services;

g. Adequate housing; and, h. Alteration, renovation, acquisition, and construction of facilities to be used as multi-purpose senior centers.

2. Services provided to residents of care providing facilities including long-term care facilities, emergency shelters, adult foster care, alternative care facilities, and other congregate living arrangements include:

a. Case management;

b. Counseling;

c. Placement and relocation assistance;

d. Group services;

e. Legal assistance;

f. Advocacy and visiting.

B. Consumer Representation 1. Consumer representation services includes such non-legal services as: a. Medical insurance claims filing;

b. Tax preparation; and, c. Program eligibility.

2. Service provider staff shall be knowledgeable and/or trained to provide the specific representation services offered to the older individual. C. Counseling Individuals providing counseling services to assist older individuals in resolving concerns or making decisions, whether paid staff or volunteers, shall be knowledgeable or trained to provide the specific type of counseling services that is being offered to the older individual.

D. Material Aid 1. Material aid shall include food or goods including the direct distribution of commodities, surplus food, clothing, smoke detectors, eye glasses, hearing aids, dentures, security devices, and medication boxes.

2. Material aid shall not include:

a. Chore services or home modifications; or, b. Vouchers for the purchase of groceries.

E. Health Screening 1. Health screening services may include the following: a. Completing individual or group health screening;

b. Providing the older individual with an opportunity to learn more about his/her health status;

c. Performing standard examinations, procedures, or tests to gather information about the older individual’s health or medical status;

d. Assisting the older individual in following up on screening results, if necessary; and, e. Referring the older individual to a physician or treatment facility if medical attention is required.

2. Health screenings shall be conducted by qualified and appropriately certified and/or licensed health care professionals.

F. Employment Services 1. The employment services program shall include the following minimum services: a. Current information about employment and training opportunities; b. Job counseling;

c. Resume development;

d. Job development; and, e. Job placement.

2. Employment services shall be coordinated with the local Workforce Investment Board, Job Service, Community College and Occupational Education System, Title V of the Older Americans Act and any other organizations in the PSA offering employment resources to older individuals.

10.418 Disaster Relief A. The OAA provides for potential reimbursement to any state on behalf of AAAs in the state for delivery of supportive services and related supplies during any major disaster declared by the President in accordance with the Disaster Relief and Emergency Assistance Act. B. Disaster relief funds provide expense reimbursement with no matching requirement for Title III services provided above those normally expected by the AAA as a result of a declared disaster in their PSA.

C. Eligibility for services is based on OAA eligibility. D. Disasters for which services may be provided include tornados, floods, earthquakes, drought, blizzards, pestilence, famine, fire, building collapse, transportation accidents, or other situations that the victims of such a disaster cannot alleviate without assistance. E. Disaster relief services shall include the following: 1. Disaster Advocacy and Outreach - One-on-one services designed to assure older persons, in both the short and the long-term, have access to the knowledge and assistance necessary to obtain the services and benefits they need to help maintain their independence and well-being following a disaster; 2. Gap-filling services – Services that are provided when required services are not available, or when the needed services are in limited supply or cannot be provided. Gap-filling services during and following a disaster may include chore, homemaker, transportation, nutrition, and legal services; and, 3. Related supplies – Disposable items such as home-delivered meal containers, bottled water, rubber gloves, and cleaning supplies.

F. Priority in the use of funds during a disaster shall be given to Disaster Advocacy and Outreach services. Once these services are adequately funded, gap-filling services may be considered.

10.500 CAREGIVER SUPPORT PROGRAMS 10.510 NATIONAL FAMILY CAREGIVER SUPPORT PROGRAM (NFCSP) 10.510.1 Eligibility for Services A. Area Agencies on Aging (AAA) and/or the service providers with whom the AAAs contract shall provide support services to caregivers who are:

1. Grandparents or older individuals who are a relative caregiver of a child by blood or marriage, who is 60 years of age or older, and who:

a. Lives with the child; and, b. Is the primary caregiver of the child because the biological or adoptive parents are unable or unwilling to serve as the primary caregiver of the child; or, c. Has a legal relationship to the child, such as legal custody or guardianship, or is raising the child informally.

2. Family caregivers who are adult family members or other individuals, providing informal in-home, and community care to an older individual (60 years of age or older) who is “frail” and determined to be functionally impaired because of: a. An inability to perform at least two activities of daily living without substantial human assistance, including verbal reminding, physical cueing, or supervision; or, b. Due to cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to others.

B. Priority for services shall be given to:

1. Caregivers of older individuals with greatest social and/or greatest economic need (with particular attention to low-income minority, and individuals residing in rural areas); and, 2. Older individuals providing care and support to persons with mental retardation and related developmental disabilities.

C. Eligibility for Respite Care and Supplemental Services In the case of a family caregiver of an older individual, respite care and supplemental services under the National Family Caregiver Support Program shall be provided only if the care recipient is functionally impaired and meets either of the following conditions: 1. Unable to perform at least two (2) activities of daily living without substantial human assistance, including verbal reminding, physical cueing, or supervision; or, 2. Due to a cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to himself or herself or another individual.

10.510.2 Registration All older individuals and/or their family caregivers receiving services, other than information as described at Section 10.510.4, A, 1, under the NFCSP, shall have a registration completed as prescribed by the State Unit on Aging (SUA).

10.510.3 Assessment An assessment, prescribed by the SUA, shall be completed for older individuals if the older individual or his/her caregiver requests supplemental services or respite care assistance. A. The assessment shall include, but not be limited to: 1. A caregiver profile;

2. An evaluation of the informal support systems available to, and used, by the caregiver; 3. A care receiver profile and evaluation of the strengths and needs of the older individual; and, 4. Determination of the formal support services and resources available to the caregiver within the community.

B. An assessment or reassessment shall be completed using the format and timeframes prescribed by the SUA.

10.510.4 Services A. Support Services provided by the AAA under the NFCSP shall be described in the AAA Area Plan including:

1. Information to caregivers about available services, including outreach, community education, and access to information;

2. Assistance to caregivers in accessing services including case management, care planning, and information and assistance;

3. Individual counseling, organization of support groups, and caregiver training to assist the caregiver in making decisions and solving problems related to the caregiver role, including supportive intervention/guidance counseling, peer counseling, and caregiver training;

4. Respite care to temporarily relieve caregivers from their caregiving responsibilities, including in-home respite care, adult day care, and institutional respite care; and 5. Supplemental services, on a limited basis, to complement the care provided by family caregivers.

B. Coordination of Services The AAA or contracted service provider shall coordinate its activities with the activities of the Single Entry Point Agency(ies) in the Planning and Service Area (PSA), as well as other community agencies and voluntary organizations providing the same types of services listed at Section 10.510.4, A.

C. Language Assistance 1. In an area where a predominate number of older individuals speak a language other than English as their principal language, the outreach service shall also be provided in that language.

2. Information and assistance, and outreach activities shall be conducted in the principle language spoken in areas where Native American elders comprise at least: a. One percent (1%) of a PSA’s population age 60 and over; or, b. Five percent (5%) or more of the State’s age 60 and older Native American population residing within a PSA.

D. Direct Payments to Family Members Direct payments to family caregivers residing with the care recipient for services to family members are not permitted.

10.510.5 Respite Care A. Respite care services include the following activities: 1. In-home services, including services provided by volunteers or in-home service providers;

2. Adult day care services; and, 3. Institutional respite care.

B. Respite care services shall be provided in the most appropriate way that meet the needs of the elder and the family caregiver.

C. Older Americans Act (OAA) funds shall not be used to pay for respite care services if such services are offered through other Federal or State programs for which the older individual is receiving.

10.510.51 In-Home Respite Services A. Volunteer In-home Respite Services If volunteer in-home respite services are provided by the AAA or a contracted agency, the AAA shall be responsible to ensure that the volunteer providing respite services receives the information, training, and ongoing supervision necessary to safely and effectively provide respite care.

B. Non-Volunteer In-Home Respite Services 1. In-home service provider staff, including homemakers or personal care service providers, may be used to provide brief in-home respite services for caregivers if appropriate to the older individual’s needs.

2. In-home service provider staff shall meet all of the requirements as described at Section 10.260.3 through Section 10.260.32 of these rules. 10.510.52 Adult Day Care A. Older individuals receiving adult day care services as respite care shall meet all of the eligibility requirements. as specified at Section 10.124, D, and Section 10.510.1, C. B. Adult day care providers shall meet the requirements at Section 10.260.6, A. C. Adult day care providers shall accept only consumers whose needs can be met by the adult day care center within its certification category and according to its admission criteria. 10.510.53 Institutional Respite Care A. Institutional respite care includes services provided on a short-term basis (i.e. less than thirty (30) consecutive days) in an assisted living residence or nursing facility. B. Only those portions of facilities that are licensed as nursing facilities or assisted living residences shall be used for respite consumers.

10.510.531 Assisted Living Residence (ALR) Respite Care An individual utilizing an Assisted Living Residence for short-term respite must be able to be provided adequate services in the ALR.

10.510.532 Nursing Care Facility Respite Care A. For each respite consumer, the facility shall provide an initial assessment as described at 10.260.6, B, 2, which shall serve as the plan of care; obtain physicians treatment plan and diet orders; and have a chart for the consumer.

The chart shall identify the individual as a respite consumer. B. Admission to a nursing facility for respite care shall not require the same forms as required for a routine nursing facility admission.

C. The nursing facility shall have written policies and procedures available to staff regarding respite care consumers.

10.510.6 Title III, Part E Funding Allocations A. Funds for the National Family Caregiver Support Program shall be distributed according to the state allocation formula described at Section 10.310.1, C. B. Funding for supplemental services and support services for grandparents and other family caregivers shall be according to the requirements of the Older Americans Act. C. Services provided under the National Family Caregiver Support Program shall supplement, and not supplant, funding from other Federal, State, or local funds for services described at Section 10.510.4.

10.510.7 Data and Records The AAA shall collect data and maintain records related to the National Family Caregiver Support Program in the format mandated by the SUA. Data and records shall be used to monitor program administration and compliance and to evaluate the effectiveness of AAA programs. 10.520 COLORADO FAMILY CAREGIVER SUPPORT PROGRAM A. The Colorado General Assembly has created the Colorado Family Caregiver Support Program, administered by the SUA and the AAAs.

B. The Colorado Family Caregiver Support Program shall follow the intent and guidelines established under the National Family Caregiver Support Program and the requirements of these rules.

C. This program is subject to available appropriations. 10.530 NATIVE AMERICAN NATIONAL FAMILY CAREGIVER SUPPORT PROGRAM A. Tribal organizations may apply for grants from the AoA to carry out multifaceted systems of support services for caregivers as described under the National Family Caregiver Support Program.

B. In Planning and Service Areas, which border areas served by Tribal Organizations, the AAA for the PSA shall coordinate their service activities with those provided by the Tribal Organization.

10.600 SENIOR COMMUNITY SERVICES EMPLOYMENT PROGRAM (SCSEP) A. The Senior Community Services Employment Program (SCSEP), administered by the United States Department of Labor, is a Federally sponsored job creation program targeted to low-income older Americans, subsidizing part-time community service jobs for low- income persons age 55 and older who have poor employment prospects. B. The SCSEP provisions of the Older Americans Act are designed to: 1. Enhance employment and training opportunities for seniors by reinforcing connections with the broader workforce investment system, including government agencies, community service organizations, and nonprofit organizations approved under Section 501(c)(3) of the Internal Revenue Code;

2. Establish an enhanced performance accountability system to hold each grantee or contractor accountable for attaining quality levels of performance with respect to core measures;

3. Improve the ability of states to coordinate services by providing for the broad participation of stakeholders in the development of an annual plan to ensure an equitable distribution of projects within the State;

4. Strengthen the administrative procedures and fiscal accountability provisions similar of other Federal work programs; and, 5. Revise the distribution of funding.

C. SCSEP Services Services available through the SCSEP shall include the following: 1. Enrollee wages and fringe benefits (including a physical examination); 2. Enrollee training, provided prior or subsequent to placement, including the payment of reasonable costs of instructors, classroom rental, training supplies, materials, equipment, and tuition;

3. Job placement assistance, including job development and job search assistance; 4. Enrollee supportive services; and, 5. Outreach, recruitment and selection, intake, orientation, and assessments. 6. On The Job Experience (OJE) – Training and employment opportunities through public or private employers not associated with community service. 10.610 PROCUREMENT A. The State Unit on Aging (SUA) shall award Title V funds to prospective sub-project sponsors using a competitive bidding process pursuant to the Colorado Procurement Code (Section 24-103-202, C.R.S., “Competitive Sealed Bidding” ). B. Contracts shall be awarded for a defined period and may be renewed for additional option years at the sole discretion of the SUA, contingent upon: 1. Appropriation and budgeting of funding; and, 2. The sub-project sponsors successful satisfaction of contractual requirements, if applicable.

10.620 PROGRAM MONITORING AND REPORTING A. The Colorado Department of Human Services, Division of Aging and Adult Services, is the State Unit of Aging with designated responsibility for administering the SCSEP funded under Title V, including all program activities prescribed by the Older Americans Act, the grant agreement, and other United States Department of Labor bulletins and regulations. B. The SUA conducts ongoing monitoring of performance, based on specific performance indicators and achievement of established program goals and objectives as indicated in the contractual agreement.

10.620.1 Performance Measures [Rev. eff. 6/1/06] A. All sub-project sponsors shall be evaluated on the performance measures established by the Secretary of HHS and the SUA as a requirement for application, and as a condition of, all grants or contracts received under Title V. The performance measures include, but are not limited to:

1. Number of enrollees placed in unsubsidized employment by each sub-project during the program year shall be authorized through the State Unit on Aging. 2. Completion of customer satisfaction surveys of host agency employers, unsubsidized employers, and participants.

3. Data collection shall be timely and accurate. Quarterly progress reports shall be submitted via the Federal Data Collection System.

B. Levels of performance may be adjusted with approval from the SUA only with respect to the following:

1. High rates of unemployment, poverty, or welfare recipiency in areas served by a sub- project relative to other areas of the State;

2. Significant numbers or proportions of enrollees with one or more barriers to employment served by a sub-project relative to sub-projects serving other areas of the State; or, 3. Significant downturns in the areas served by the sub-project or in the national economy.

10.620.2 Non-Compliance with Performance Measures A. If a sub-project fails to meet its performance measures for a year the sub-project is required to submit an action plan identifying:

1. The specific performance measure(s) that were not met; 2. Reasons why the sub-project was unable to meet the performance measure(s); and, 3. A plan for implementing changes and steps the sub-project will take to meet the standard(s).

B. An action plan shall be submitted in the time period specified by the State. C. If the sub-project fails to meet performance measures for a second year, the State shall conduct a competition to transfer up to 25% of the services to another sub-project sponsor (minimizing to the extent possible, disruption of services provided to enrollees). D. If the sub-project fails to meet performance measures during the third year, the SUA shall conduct a competition to award all of the funds to another sub-project sponsor. The sub- project that has failed to meet its performance measures shall not be included in the competition award process.

10.630 ENROLLMENT POLICIES 10.630.1 Eligibility [Rev. eff. 6/1/06] A. Potential enrollees in the SCSEP shall meet eligibility criteria as described in Section 516(2) of the OAA.

B. Enrollees shall be eligible to remain in the program for a maximum of two (2) years, including time away. If the enrollee completes the program and is successful in obtaining non- subsidized employment, the enrollee may be considered eligible for SCSEP for another two (2) years if the non-subsidized employment ceases.

C. Enrollees shall re-certify income eligibility at least once every twelve (12) months. Participants that become ineligible due to changes in income shall be given a written notice of termination within thirty (30) days and terminated after thirty days from receipt of written notice. The enrollee shall be referred to the one-stop delivery system or other partner programs.

10.630.2 Priority for Placement A. Vacant authorized positions shall be filled according to the following order of priorities: 1. Veteran age 60 years and older;

2. Eligible spouse of a veteran age 60 years and older; 3. Eligible individuals age 60 years and older;

4. Eligible individuals seeking re-enrollment after termination due to an illness or placement in private or other unsubsidized employment, provided re-enrollment is requested within one (1) year of employment;

5. Eligible individuals who are enrolled in temporary positions; and, 6. Other eligible individuals who are most economically disadvantaged. B. Eligible individuals determined most in need shall be provided enrollment preference within these priorities.

10.630.3 Enrollee Recruitment and Selection A. Sub-projects shall implement recruitment and selection methods to ensure the maximum number of eligible individuals have an opportunity to participate in the SCSEP and vacant positions are kept to a minimum as directed in the sub-project's policy and procedures manual.

B. Sub-project sponsors shall ensure that recruitment efforts are targeted toward eligible minority individuals, limited English-speaking individuals, Native American individuals, and individuals with the greatest economic need, at least in proportion to their numbers in the sub-project area, and taking into consideration their rates of poverty and unemployment. C. Selection of enrollees for enrollment shall be according to the priorities defined at Section 10.630.2.

10.630.4 Enrollment Sub-projects shall document and verify the accuracy of information concerning an applicant’s eligibility and ensure compliance with related Federal and State regulations, using the policy procedures related to application, recertification, denials, and termination process. 10.630.5 Terminations 10.630.51 Administrative Terminations A. Enrollees may be terminated immediately for cause.

B. If the enrollee is terminated for cause, a 30-day notice is not required. C. Reasons for administrative termination may include:

1. Refusal to cooperate in establishing eligibility;

2. Inability and/or unwillingness to perform assigned duties; 3. Refusal to accept a different community service assignment; 4. Frequent tardiness or unauthorized absences;

5. Falsification of time sheets or other official records; 6. Insubordination;

7. Non-compliance with substance abuse policy; or, 8. Inappropriate failure to cooperate with project and/or host agency staff. D. Behaviors that may lead to administrative termination shall be documented and included in project records.

E. The personnel policies and procedures of each sub-project shall include the reasons for administrative termination.

10.630.52 Employability Plan Termination (Individual Development Plan) A. Failure to participate in the Employability Plan process may be cause for corrective actions, up to and including termination as a last resort.

B. Repeated refusal by the employee to perform specific actions as agreed upon may lead to termination.

C. The personnel policies and procedures of each project shall include description of the enrollee’s responsibilities and obligations if included in the employability plan, and actions that may be taken by the sub-project sponsor if the enrollee fails to meet his/her obligations.

10.630.53 Termination Notices Termination notices shall include:

A. The effective date of the termination;

B. Reason(s) for the termination;

C. Appeal rights of the enrollee; and, D. Procedures for appealing the determination as provided by the sub-project sponsor. 10.630.6 Title V Adverse Actions and Appeals A. If an adverse action is taken against an enrollee, the enrollee shall receive written notice stating the reasons for the determination, the enrollee’s right to appeal, and the appropriate appeal procedures.

B. Sub-project sponsors shall develop complaint procedures and an appeal process to resolve issues arising between the host agency and an enrollee or applicant. C. The enrollee shall be provided a copy of the complaint resolution process. Unresolved complaints alleging violations of law other than discrimination shall be filed with the appropriate office of the U.S. Department of Labor at:

U.S. Department of Labor200 Constitution Avenue NWWashington, D.C. 20210 D. Unresolved complaints alleging discrimination due to race, color, religion, gender, sexual orientation, national origin, disability, or age (except where age is a valid consideration under SCSEP) shall be filed with the Director, Office of Civil Rights at: Colorado Civil Rights Division Commission1560 Broadway, Room 1050Denver, CO 80202-5143 10.640 SUB-PROJECT RESPONSIBILITIES [Rev. eff. 6/1/06] A. Sub-project sponsors shall provide assistance to each enrollee to obtain unsubsidized employment in private or public sector jobs as soon as practicable to provide additional opportunities for other eligible individuals with the funds available. B. Sub-project sponsors shall develop job opportunities for job-ready enrollees. C. Sub-project sponsors shall follow-up with each enrollee within 90 calendar days following placement in unsubsidized employment or into job-training programs. 1. Enrollees who are found to be unemployed shall be considered for re-enrollment in a project.

2. Results of the follow-up shall be documented in the enrollee file. D. Sub-projects shall maintain adequate staffing and dedicate sufficient resources to ensure fulfillment of all program responsibilities, including enrollment at Section 10.630.4. E. Sub-project sponsors shall retain enrollee records for a period of three (3) years. Hard copy files shall be held in locked file cabinets and electronic files shall be accessible to sub- project staff through secure passwords.

10.640.5 Community Service Employment [Rev. eff. 6/1/06] A. Enrollees shall be assigned to useful part-time community service employment as soon as possible after the physical exam, orientation and pre-job training. A physical examination shall be offered to the enrollee and, if the physical is refused, it must be noted in the enrollee's file.

B. Host agency assignment shall not exceed one year without prior written approval of the SUA. Written approval shall be requested two (2) months prior to the end of the one year period, unless directed otherwise by the SUA.

C. At the end of the maximum two (2) year placement period, if unsubsidized employment is not found, the enrollee shall exit from the program, unless the sub-project sponsor submits a request for extension, in writing, and is granted approval by the SUA. D. Hours worked by each enrollee, include paid hours of orientation, pre-job training, job related training, voluntary training, sick leave, and vacation during each program year. 1. Sub-project sponsors shall not require an enrollee to work more than 40 hours per week, nor offer an enrollee less than 20 hours of paid participation per week, on average, unless approved by the SUA and agreed to in writing by the enrollee. 2. Enrollee’s community service employment shall be during normal working hours unless otherwise agreed upon by the enrollee.

E. Enrollees shall be placed with host agencies in their own county of residence and shall be assigned to community service employment in or near the communities in which they reside.

F. Enrollees shall be assigned to community service employment positions that contribute to the general welfare of the community, such as social, health, welfare, library, education, conservation, maintenance or restoration of natural resources, economic development, and any other services essential and necessary to the community. G. Enrollees shall be given first consideration for positions in the operation of sub-projects where assignments are congruent with the skills and interests of the enrollee. H. Enrollees employed in community service employment positions funded under Title V shall not be considered Federal or State employees.

I. Wages and Fringe Benefits 1. The pay rate for enrollees for active participation, including orientation and pre-job training shall be whichever of the following is higher: a. The Federal minimum wage; or, b. The State or local minimum wage for that employment or the most nearly comparable employment covered under the State or local minimum wage laws.

2. Fringe benefits shall be administered by sub-project sponsors uniformly to all enrollees, including those in temporary positions.

a. State sponsored enrollees shall receive the same benefits afforded to national sponsored enrollees, where both state and national grants are administered by the sub-project.

b. Benefits may include, but are not limited to:

1) Sick, vacation, and holiday leave;2) Health insurance;3) Workers Compensation; and,4) Other benefits as approved by the SUA. 3. Enrollees not covered by state workers’ compensation laws shall be provided with workers’ compensation benefits through a recognized carrier or by self- insurance, as authorized by State law, equal to that provided by law for covered employment.

J. Supportive Services 1. Supportive services shall be provided to assist enrollees in successful participation in community service employment and to assist in transition to unsubsidized employment.

2. Supportive services shall include the following:

a. Personal and job related counseling;

b. Reimbursement for items such as work shoes, badges, uniforms, tools, safety glasses, and other items required for participation in subsidized or unsubsidized employment; and, c. Transportation when accomplished in the direct performance of employment or employment-related activities, or from central pickup points to work sites in cases where public transportation is inadequate. 3. Public transportation or transportation of no cost to the project shall be used whenever possible.

K. Other Training 1. Sub-project sponsors may provide additional training to enrollees that provides or enhances skills required to perform community service employment or to obtain unsubsidized employment.

2. Training may be classified as job-related or voluntary, and includes: a. Skill training;

b. Job seeking skills;

c. Training in preparation for obtaining unsubsidized employment; and, d. Resume writing and interviewing skills.

3. “ Job-related training” is training which provides or enhances skills necessary for successful participation in community service employment. a. Required training shall be reasonable and consistent with the enrollee’s assignment.

b. Enrollees shall be paid the established wage rate of the sub-project sponsor during training.

4. “ Voluntary training ” provides or enhances skills necessary to obtain unsubsidized employment.

a. Voluntary training may be provided during subsidized employment participation and the enrollee need not be compensated for the hours of training.

b. If training is provided during subsidized employment participation, uncompensated hours shall not apply to the 1,300 hour participation guideline.

5. Sub-projects shall develop training opportunities through other employment and training programs, including the Colorado Workforce Development Career Centers or other sources at no cost or reduced cost to the program whenever possible.

L. Temporary Positions 1. Sub-project sponsors may enroll up to one hundred twenty percent (120%) of the total authorized positions in temporary positions to serve as many individuals as possible and to expend authorized funds with maximum efficiency. 2. Sub-projects shall notify temporary enrollees of their status in writing and file a copy of the notification in the enrollee’s permanent file.

M. Title V Federal funds shall not be expended in excess of the authorized grant amount. 10.640.6 Host Agency Selection A. Sub-project sponsors shall develop community service employment positions with local, State, Federal or other publicly owned and operated facilities and projects that contribute to the general welfare of the community or projects sponsored by organizations, other than political parties, that are exempt from taxation pursuant to the provisions the Internal Revenue Code.

B. Host agencies shall sign a host agency agreement with the sub-project sponsor, which shall become a part of the contractor’s permanent record.

C. Host agency responsibilities shall include, but are not limited to providing: 1. Adequate supervision of the enrollee at least equal to supervision provided employees in similar positions; and, 2. Adequate orientation and instruction regarding the enrollee’s job responsibilities, duties, and job safety; and, 3. A sanitary and safe working environment that provides fair and impartial treatment of the enrollee; and, 4. First consideration to the enrollee for an unsubsidized position within the host agency when a vacancy occurs for which the enrollee has the qualifications and required experience; and, 5. Cooperation and access to enrollee records to the sub-project sponsor and SUA for the purposes of on-site monitoring; and, 6. Training that is job-related and enhances the individual’s potential for unsubsidized employment; and, 7. Time off to attend training during work hours as approved and required by the sub- project sponsor.

D. Training positions at the host agency shall meet the maintenance of effort provisions required under Federal regulations as follows:

1. Training positions shall result in an increase in employment opportunities over and above those already available;

2. Training positions shall not result in the displacement of current employees including partial displacement such as the reduction of regular hours, wages or benefits. E. No host agency may be a work site for a person in an administrative capacity, staff position, or community service employment position under Title V, if a member of that person’s immediate family is in an administrative capacity or a board member for the host agency. F. In the context of Title V, immediate family includes wife, husband, son, mother, father, daughter, brother, brother-in-law, sister, sister-in-law, son-in-law, daughter-in-law, mother- in-law, father-in-law, aunt, uncle, niece, nephew, stepparent, stepchild, grandparent or grandchild.

10.650 ON THE JOB EXPERIENCE Sub-project sponsors shall develop relationships with other employment and training programs providing services to the elderly and other agencies in the area to provide the most comprehensive employment and training services to eligible individuals.

A. Sub-project sponsors shall maintain cooperation with the Colorado Workforce Development Career Centers in their area for assistance:

1. In recruitment of eligible individuals, especially economically and socially disadvantaged individuals, minorities, limited English-speaking, and Native Americans; and, 2. Obtaining unsubsidized employment for the job-ready individual. 3. To increase training and employment opportunities for eligible enrollees. B. Sub-projects shall develop and maintain relationships with the AAAs for a source of supportive services for the older worker and to provide a work site for community service employment for eligible enrollees.

C. Sub-projects shall develop cooperation with all local, State, and Federal agencies as potential host agency sites, to:

1. Provide a variety of work assignments for enrollees; and, 2. Produce a variety of services to the community that would otherwise not be available. D. Sub-projects shall initiate close cooperation with private employers in the area to: 1. Determine their needs and provide education on the benefits of hiring the elderly; 2. Identify techniques that would increase opportunities for the elderly; and, 3. Provide an employment source for enrollees ready to assume unsubsidized employment.

E. Sub-projects shall maintain close cooperation and communication with other SCSEP sponsors in the area to assure equitable distribution of available Title V positions in the sub-project sponsor’s service delivery area.

10.660 NON-DISCRIMINATION A. Sub-project contracts and grant awards shall include assurances concerning non- discrimination in all activities related to the administration of the program. B. No sub-project or staff person of the sub-project shall discriminate, exclude from participation, or deny benefits to eligible individuals because of the individual’s race, color, religion, gender, sexual orientation, national origin, handicap, political beliefs, or age, except where age is a valid consideration as described in these rules. 10.670 DOCUMENTATION AND REPORTING REQUIREMENTS A. Sub-project sponsors shall maintain documentation that is sufficient to permit the preparation of reports as mandated by the Older Americans Act or as required by the U.S. Department of Labor or the SUA, and to permit the tracking of funds to a level of expenditure adequate to ensure funds have not been spent unlawfully. B. Documentation shall be completed based on the sub-project's policy and procedures manual. 10.680 POLITICAL ACTIVITIES A. No political activity is allowed under a SCSEP project or sub-project. B. No enrollee or staff person shall engage in partisan or non-partisan political activities during the hours compensated by Title V funds, or represent himself/herself as a spokesperson for the SCSEP while engaging in partisan political activity at any time. C. Enrollees and staff persons of a project or sub-project are further restricted from political activity as required by Federal rules and regulations.

D. Each enrollee under Title V shall be given a written explanation clarifying the law with respect to allowable and unallowable political activities.

E. Enrollees shall not be employed in the office of a member of Congress, a State or local legislator, or on the staff of a legislative committee. F. Assignments to offices of any other local or State elected officials where the duties are of a non-political nature may be allowed only with prior approval of the SUA and documented assurances that political activities shall not be engaged in by the enrollee. G. No funds, provided under Title V shall be directly provided to influence a member of Congress, State or local legislator.

10.700 LONG-TERM CARE (LTC) OMBUDSMAN PROGRAMS The Colorado Department of Human Services, Division of Aging and Adult Services, is the State Unit on Aging (SUA) authorized under Title VII of the Older Americans Act (OAA) and Section 25-11.5-104, C.R.S., to establish and operate the Colorado Long-Term Care Ombudsman (CLTCO) office and Local Long-Term Care (LTC) ombudsman offices throughout the State. 10.710 COLORADO LONG-TERM CARE OMBUDSMAN PROGRAM 10.710.1 Selection and Designation of the Colorado Long-Term Care Ombudsman A. The SUA may provide the CLTCO services directly or by contract or grant with a public agency or private non-profit organization.

B. The agency, program, or person(s) selected to serve as the CLTCO shall have demonstrated expertise and experience in the fields of long-term care and advocacy. C. The office of the CLTCO shall not be administered by any agency or organization: 1. Responsible for licensing or certifying long-term care services in the State; or, 2. An association or an affiliate of such an association of long-term care facilities, or of any other residential facilities for older individuals. 10.710.2 Requirements of the Colorado LTC Ombudsman Program The CLTCO shall serve on a full-time basis and shall, personally or through representatives of the Office, perform the following duties and responsibilities in implementing a statewide Long-Term Care Ombudsman program:

A. Establish and publish a manual containing statewide policies and procedures for operating the Long-Term Care Ombudsman program in collaboration with the SUA, AAAs, and Local LTC Ombudsman offices. This shall include procedures to identify, investigate, and resolve complaints that are:

1. Made by, or on behalf of, elderly residents; and, 2. Related to actions, inactions, or decisions that may adversely affect the health, safety, welfare, or rights of the resident, including the welfare or rights of the residents with respect to the appointment and activities of guardians and representative payees, by:

a. Providers, or representatives of providers, of long-term care services; b. Public agencies, including the Colorado Department of Human Services; or, c. Health and social service agencies, including County Department(s) of Social or Human Services.

B. Provide services to assist residents in protecting the health, safety, welfare, and rights of the residents;

C. Represent the interests of residents before governmental agencies; D. Seek administrative, legal, and other remedies to protect the health, safety, welfare, and rights of residents;

E. Inform residents about means of obtaining services from providers or agencies; F. Ensure that residents have regular and timely access to services provided through the CLTCO and residents and complainants receive timely responses from representatives of the CLTCO to complaints as described at Section 10.720.2, E-F; G. Establish procedures to analyze, monitor, and comment on the development and implementation of Federal, State, and local laws and regulations, and other governmental policies and actions, pertaining to the health, safety, welfare, and rights of residents, with respect to the adequacy of long-term care facilities and services in Colorado; H. Provide information to public and private agencies, legislators and others, as deemed necessary by the CLTCO, regarding the problems and concerns of older individuals residing in long-term care facilities;

I. Recommend changes in laws, regulations, policies, and other actions as appropriate; J. Facilitate public comment on laws, regulations, policies, and actions; K. Provide administrative and technical assistance to local LTC ombudsman offices; L. Promote the development of citizen organizations to participate in the program; M. Provide technical support for the development of resident and family councils to protect the well-being and rights of residents;

N. Provide training as required for representatives of the CLTCO, including unpaid volunteers, as described at Section 10.730.2;

O. Prohibit any representative (other than the CLTCO) from carrying out any activities on behalf of the CLTCO unless the representative:

1. Has received the required training; and, 2. Has been certified by the CLTCO as qualified to carry out activity on behalf of the CLTCO.

P. Coordinate LTC ombudsman services with the protection and advocacy systems for individuals with developmental disabilities and mental illness established under State and Federal laws;

Q. In conjunction with the AAA and SUA, designate a Local LTC Ombudsman entity to serve each Planning and Service Area (PSA) of the State;

R. Prepare a notice informing residents of long-term care ombudsman services for display at long-term care facilities to include the following:

1. Name, address, and toll-free phone number of the CLTCO; and, 2. Name, address, and phone number of the nearest Local LTC Ombudsman program. S. Pursue administrative, legal, or other appropriate remedies on behalf of residents for the purpose of effectively carrying out Section 10.710.2, A; T. Coordinate, to the greatest extent possible, LTC ombudsman services with legal assistance services through adoption of Memoranda of Understanding or other means; U. Coordinate services with State and local law enforcement agencies and courts of competent jurisdiction;

V. Prepare an annual report:

1. Describing the activities carried out by the CLTCO in the year for which the report is being prepared;

2. Containing and analyzing data collected as described at Section 10.730.4; 3. Evaluating the issues or problems experienced by, and the complaints made by, or on behalf of, residents;

4. Analyzing the success of the program including success in providing services to residents in facilities as described at Section 10.720.2, L; 5. Identifying of barriers that prevent optimal operation of the program; and, 6. Providing policy, regulatory, and legislative recommendations to: a. Solve identified problems; and, b. Resolve complaints; and, c. Improve the quality of care and life for residents; and, d. Protect the health, safety, welfare, and rights of residents; and, e. Remove barriers to optimal operation of the program and to improve the quality of care and life in long-term care facilities.

7. Providing recommendations of program or policy changes. W. Make the annual report available to the public and submit copies to the Assistant Secretary of HHS, the governor, the State legislature, the State agency responsible for licensing or certifying long-term care facilities, the SUA, the AAA, Local LTC Ombudsman, and other appropriate governmental entities; and, X. Any other duties and functions assigned to the CLTCO by the SUA. 10.720 Local Long-Term Care (LTC) Ombudsman Program 10.720.1 Selection/Designation of Local LTC Ombudsman A. In conjunction with the CLTCO office and the SUA, each AAA shall select a local agency, program, or person(s) to serve as a Local LTC Ombudsman program. 1. The entity selected shall be designated as the Local LTC Ombudsman upon recommendation of the CLTCO and approval by the SUA.

2. The Local LTC Ombudsman shall serve as an official and identifiable link to the CLTCO program.

3. The designated agency, program, or person(s) shall be identified and its functions described in the AAA Area Plan, including the name of the Local LTC Ombudsman lead representative.

B. To be eligible for designation as a Local LTC Ombudsman, an agency, program, or person shall:

1. Have demonstrated capability to carry out the responsibilities of the CLTCO at the local level;

2. Be free of any conflict of interest as described at Section 10.730.1; 3. Not stand to gain financially through an action or potential action brought on behalf of individuals served by the Local LTC Ombudsman;

4. Be a public or non-profit private entity; and, 5. Meet additional requirements as the CLTCO may specify. 10.720.2 Requirements of Local LTC Ombudsman The Local LTC Ombudsman shall:

A. Carry a valid identification card issued annually and signed by the CLTCO and, present the card to obtain access to residents and the facilities records; B. Follow the rules and regulations of these rules and the policies and procedures established by the CLTCO;

C. Provide services to protect the health, safety, welfare, and rights of residents; D. Ensure residents in the service area of the Local LTC Ombudsman have timely access to representatives of the program, and timely responses to complaints and requests for assistance;

E. Receive, investigate, and resolve complaints:

1. Made by or on behalf of residents that relate to actions, inactions or decisions that may adversely affect the health, safety, welfare, or rights of the residents; or, 2. Referred to the CLTCO, in accordance with the OAA, these rules, and the policies and procedures established by the CLTCO.

F. Respond to complaints:

1. Within five (5) working days for routine complaints; or, 2. Within one (1) working day in emergency situations where the long-term care ombudsman representative believes the resident is in imminent danger. G. Represent the interests of residents before government agencies and seek administrative, legal, and other remedies to protect the health, safety, welfare, and rights of the residents;

H. Review and, if necessary, comment on any existing and proposed laws, regulations, and other government policies and actions that pertain to the rights and well-being of residents; I. Facilitate the ability of the public to comment on the laws, regulations, policies, and actions; J. Assist with the development of resident and family councils; K. Establish linkages with at least the following community agencies: 1. County department(s) of social or human services;

2. Mental health centers;

3. Local health departments;

4. Case management agencies; and, 5. Senior services agencies.

L. Visit, within the region it services:

1. At least monthly, all nursing care facilities (i.e. nursing homes) where persons who are age 60 or over reside and which are licensed or certified, including certified swing bed facilities, as defined at 10.150, offering extended care services; 2. At least quarterly, all assisted living residences providing services to persons who are age 60 or older, which are licensed or certified.

3. “Visit” shall be defined as the on-site:

a. Provision of information about LTC ombudsman services and residents’ rights to residents and, if possible, the resident’s family; and/or, b. Investigation of complaints.

M. Compliance:

1. The CLTCO and SUA shall monitor these visit requirements for compliance. 2. If a Local LTC Ombudsman program is found to be out of compliance with these requirements:

a. The Local LTC Ombudsman program and the AAA shall submit a written plan of action to the SUA and the CLTCO, signed by the AAA director, indicating steps to bring the program into full compliance. b. The SUA may withhold reimbursement for expenditures for services until the program comes into full compliance.

10.730 OMBUDSMAN POLICIES AND PROCEDURES 10.730.1 Conflict of Interest A. A conflict of interest occurs when an officer or employee of the CLTCO or its representatives, including the Local LTC Ombudsman entity, or a member of the immediate family of the officer, employee or representative:

1. Has direct involvement in licensing and/or certifying long-term care facilities; 2. Is a provider of a long-term care service;

3. Has ownership or investment interest in a long-term care facility; 4. Has ownership or investment interest in a long-term care service; 5. Is employed by and/or manages a long-term care facility or association of long-term care facilities; or, 6. Receives or has the right to receive, directly or indirectly, remuneration under a compensation arrangement with an owner or operator of a long-term care facility or service.

B. No individual or member of the immediate family, involved in the designation of the CLTCO or Local LTC Ombudsman shall be subject to a conflict of interest. 10.730.2 LTC Ombudsman Training A. The CLTCO, in collaboration with the SUA, shall establish procedures for the training of representatives of the office, including unpaid volunteers. B. The training procedures shall:

1. Specify a minimum number of hours of initial training; 2. Specify the content of the training including, but not limited to: a. Federal, State, and local laws, regulations, and policies with respect to long- term care facilities in Colorado; and, b. Investigative techniques; and, c. Other matters as the CLTCO, in collaboration with the SUA, deems appropriate.

3. Specify an annual number of hours of in-service training for all designated or certified representatives.

C. The CLTCO shall prohibit any representative, including employees or volunteers of Local LTC Ombudsman programs, from carrying out activities described at Section 10.710.2, A - I, unless the representative:

1. Has received the training required by the CLTCO policy and procedures manual; and, 2. Has been certified by the CLTCO as qualified to carry out the activity on behalf of the CLTCO.

10.730.3 Access Representatives of the CLTCO, including Local LTC ombudsmen, shall have access to: A. Long-term care facilities and residents, including the following: 1. Nursing care facilities;

2. Skilled nursing facilities;

3. Assisted living residences; and, 4. Swing beds in extended care facilities.

B. The medical and social records of a long-term care resident, if: 1. The long-term care ombudsman has the permission of the resident, or the legal representative of the resident; or, 2. The resident is unable to consent to the review and has no legal representative; or, 3. Access to the records is necessary to investigate a complaint if: a. A legal guardian of the resident refuses to give permission; and, b. The long-term care ombudsman has reasonable cause to believe the guardian is not acting in the best interests of the resident; and, c. The long-term care ombudsman obtains the approval of the CLTCO. C. The administrative records, policies, and documents of long-term care facilities, to which the residents or the general public has access; and, D. Upon request, copies of all licensing and certification records maintained by the State with respect to any long-term care facility.

10.730.4 Reporting A. Through the AAA, Local LTC Ombudsman programs shall: 1. Generate and analyze data from activities;

2. Compare results to the previous time period;

3. Identify trends and resolve discrepancies;

4. Provide recommendations for improvement or change; and, 5. Submit their reports to the Colorado Long-Term Care Ombudsman and/or the SUA at the time periods specified by the SUA.

B. The CLTCO shall:

1. Collect and analyze data relating to complaints and conditions in long-term care facilities and to residents;

2. Identify and assist in resolving significant problems using the automated data system required by the SUA; and, 3. Evaluate compliance with standards for complaint resolution and visit standards. C. The data shall be submitted to the SUA at time periods specified by the SUA and to: 1. The agency of the State responsible for licensing or certifying long-term care facilities in the State;

2. Other State and Federal entities that the SUA determines to be appropriate; 3. The Assistant Secretary of the Department of Health and Human Services; and, 4. The National Long-Term Care Ombudsman Resource Center. 10.730.5 Liability According to Section 26-11.5-110, C.R.S., the CLTCO and its representatives, including Local LTC ombudsmen, acting in good faith within the scope of its duties and functions as described at Sections 26-11.5-105, C.R.S. through 26-11.5-106, C.R.S., shall be immune from civil or criminal liability.

10.730.6 Legal Representation A. Adequate legal counsel shall be available to the CLTCO and able, without conflict of interest, to:

1. Provide advice and consultation needed to protect the health, safety, welfare, and rights of residents; and, 2. Assist the CLTCO and its representatives, including Local LTC Ombudsman entities, in the performance of official duties.

B. Adequate legal counsel shall be available to any representative of the CLTCO for legal representation of a Long-Term Care Ombudsman against whom legal action is brought in connection with the performance of long-term care ombudsman duties and functions as described at Sections 26-11.5-101, C.R.S. through 26-11.5-108, C.R.S., the Colorado Long-Term Care Ombudsman Program.

10.730.7 Interference with Long-Term Care Ombudsman A. Willful interference with representatives of the CLTCO is prohibited under the Older Americans Act, Section 712(j) and Section 26-11.5-109, C.R.S.

B. Discriminatory, disciplinary, or retaliatory actions and reprisals shall not be taken by a long- term care facility or other entity against any of the following individuals for filing a complaint with, providing information to, or otherwise cooperating with any representative of the CLTCO:

1. Any resident eligible for LTC Ombudsman services under the OAA; or, 2. Any officer or employee of a facility or governmental agency providing services to residents of long-term care facilities eligible for long-term care ombudsman services under the OAA.

C. Any person listed at Section 10.730.7, B, or any person acting on such a person’s behalf, including the CLTCO or its representatives, may file a complaint with the SUA against any individual or entity violating Section 10.730.7, A or B. D. Upon receipt of a complaint regarding interference with a LTC Ombudsman in the course of his/her duties, or a complaint regarding discriminatory, disciplinary, or retaliatory action against any individual, the SUA shall:

1. Conduct an investigation of the complaint;

2. Determine if the complaint is substantiated;

3. Provide a written notice regarding the nature of the violation and the amount of the fine to the violator:

a. If the complaint involves interference with an ombudsman in the course of his/her duties, the SUA shall assess and collect the fine of $2,500.00 per violation;

b. If the complaint involves discriminatory, disciplinary, or retaliatory action against any individual, the SUA shall assess and collect a fine of $5,000.00 per violation.

4. If the penalized person disagrees with the SUA findings, he/she may request an Administrative Law Judge (ALJ) hearing in accordance with Section 24-4-105, C.R.S., as described at Section 10.950.

5. If the penalized person is dissatisfied with the results of the ALJ hearing process, the person may request a judicial appeal in accordance with Section 24-4-106, C.R.S, as described at Section 10.960.

E. All fines collected by the SUA as a result of the complaint investigation process shall be transmitted to the State Treasurer.

10.730.8 Disclosure A. The SUA, in collaboration with the CLTCO, shall establish procedures for disclosure by the CLTCO and Local LTC Ombudsman of files maintained by the program, including records described at Section 10.730.3 and Section 10.730.4.

B. Such files and records shall be disclosed only at the discretion of the CLTCO (or the person designated by the CLTCO to disclose the files and records). C. The disclosure of the identity of any complainant or resident with respect to whom the CLTCO maintains such files or records shall be prohibited unless: 1. The complainant or resident, or his/her legal representative, consents to the disclosure and the disclosure is given in writing;

2. The complainant or resident gives consent orally and the consent is documented contemporaneously in a writing made by a representative of the CLTCO in accordance with requirements established by the SUA; or, 3. The disclosure is required by court order.

D. Disclosure of protected health information by the CLTCO to other entities and written authorizations of disclosure shall meet all of the requirements of Section 10.140 of these rules and any CLTCO policies and procedures.

10.740 PROGRAMS FOR PREVENTION OF ELDER ABUSE, NEGLECT, AND EXPLOITATION A. The SUA may carry out programs and activities described in this section directly or designate another State agency to serve as its representative.

B. The SUA or its designee, in consultation with AAAs, shall develop and enhance programs for the prevention of elder abuse, neglect, and exploitation. C. The SUA or its designee, and AAAs shall use a comprehensive approach to identify and assist older individuals who are subject to abuse, neglect, and exploitation, including older individuals living in State licensed facilities, unlicensed facilities, or domestic or community-based settings.

D. Funds authorized for this program shall be used to carry out activities to develop, strengthen, and carry out programs for the prevention and treatment of elder abuse, neglect, and exploitation (including financial exploitation) including at a minimum: 1. Providing for public education and outreach to identify and prevent elder abuse, neglect and exploitation;

2. Ensuring coordination of the services with those of other State and local programs and services for the protection of vulnerable older individuals, including the following: a. Area Agencies on Aging;

b. Adult protective service programs;

c. CLTCO and Local LTC Ombudsman;

d. Protection and advocacy programs;

e. Facility and long-term care provider licensure and certification programs; f. Medicaid fraud and abuse services, including services provided by the Colorado Medicaid fraud control unit;

g. Victim assistance programs;

h. Consumer protection and State and local law enforcement programs; i. Courts of competent jurisdiction; and, j. Other services provided by agencies and local programs to identify and assist vulnerable older individuals.

3. Promoting the development of information and data systems, including elder abuse reporting systems, to quantify the extent of elder abuse, neglect, and exploitation in Colorado;

4. Conducting analyses of statewide information, concerning abuse, neglect, and exploitation and identifying unmet service, enforcement or intervention needs; 5. Conducting training for individuals, including caregivers described at Section 10.510.1, A, professionals, and paraprofessionals in relevant fields on the identification, prevention, and treatment of elder abuse, neglect, and exploitation, with particular focus on prevention and enhancement of self-determination and autonomy;

6. Providing technical assistance to programs that provide or have the potential to provide services for victims of elder abuse, neglect, and exploitation, and for family members of the victims;

7. Conducting special and on-going training, of individuals involved in serving victims of elder abuse, neglect and exploitation on the following topics: a. Self-determination;b. Individual rights;c. State and Federal requirements concerning confidentiality; and,d. Other topics determined by the SUA. E. Upon receipt of known or suspected instances of elder abuse, neglect, or exploitation, the SUA or it’s designee shall promptly:

1. Initiate an investigation to substantiate the accuracy of the report; and, 2. Take appropriate action, including referral to protect the health and welfare of the abused, neglected, or exploited older individual.

F. All information obtained in the course of receiving a report or making a referral shall remain confidential unless:

1. All parties to the complaint or report consent in writing to the release of such information as described at Section 10.140; or, 2. The release of such information is to a law enforcement agency, public protective service agency, licensing or certification agency, the CLTCO or its representatives, or a protection or advocacy system; or, 3. Upon court order.

G. Involuntary or coerced participation in programs for elder abuse, neglect, or exploitation by alleged victims, abusers, or members of their household is prohibited. H. The SUA or its designee shall make all reasonable efforts to resolve any conflicts with other public agencies with respect to confidentiality of the information described at Section 10.740, E, by entering into Memoranda of Understanding that narrowly limit disclosure of information consistent with the requirements of Section 10.740, F. 10.750 ADULT PROTECTION PROGRAM (PROTECTIVE SERVICES)

A. AAAs shall assist in carrying out an abuse prevention program: 1. Consistent with relevant state laws;

2. Coordinated with state adult protective service activities; and, 3. Developed in cooperation with local law enforcement agencies, county departments' adult protective services and local ombudsmen within the region. B. Program activities include the following:

1. Public education on how to identify abuse, neglect, and exploitation of older individuals;

2. Active participation of older individuals participating in programs under the OAA through outreach and conferences;

3. Referral of older individuals to other social service agencies or sources of assistance where appropriate and consented to by the individuals to be referred; 4. Receiving reports of abuse of older individuals;

5. Referral of complaints and cases of suspected abuse, neglect, or exploitation to the county department of human/social services' adult protection unit, the Local LTC Ombudsman, or to a local law enforcement agency;

6. Arranging for the provision of training to service providers on the indicators of abuse, exploitation, or neglect of at-risk adults, and the procedures for making referrals, as appropriate; and, 7. Assisting in the formation of and/or participating on community adult protection task forces.

C. Involuntary or coerced participation in the program of adult protective services by alleged victims, abusers or their households is prohibited.

D. All information gathered in the course of receiving reports and making referrals shall remain confidential except as described at Section 10.740.

E. Services provided under Title III shall be in addition to and shall not be used to supplant any funds that are or would be expended under any other Federal, State or local program. 10.800 STATE FUNDED PROGRAMS FOR SENIORS (SFPS) INTRODUCTION A. The State Funded Programs for Seniors (SFPS) include both the Older Coloradans Program (OCP) and State Funding for Senior Services (SFSS).

B. The Older Coloradans Act (Section 26-11-205.5, C.R.S.) established the Older Coloradans Program.

C. State funding for Senior Services (SFSS) is appropriated by the Colorado General Assembly in the Long Bill. Funding for SFPS is dependent upon appropriations by the Colorado General Assembly.

D. The purpose of these funding sources is to provide community based services to persons sixty-years of age or older to assist such persons to live in their own homes and communities for as long as possible.

E. The Colorado Department of Human Services, Division of Aging and Adult Services, is the State Unit on Aging (SUA) designated by Section 26-11-205.5, C.R.S., with responsibility for administering the OCP and SFSS within the limits of available funding. 10.810 AAA RESPONSIBILITIES A. State Grant Application 1. The AAA shall submit information about the proposed use of SFPS funds in the State Grant Application.

2. The purpose of the State Grant Application shall be to allow the AAA to articulate to the SUA and to the local community, a plan for what will be accomplished during the State fiscal year with available funding.

3. The AAA Advisory Council shall:

a. Review the plan to ensure that it is in accordance with the requirements of the State Grant Application; and, b. Make recommendations for the plan.

4. The governing board of the AAA shall review the plan. Approval by this board requires the signature of the executive director or chairperson of the governing board. 5. Approval by the SUA shall follow the requirements for approval of the Area Plan and One-Year Grant Application as described in these rules. B. The AAA shall award grants or contracts to service providers using SFPS funds. 1. Grants or contracts awarded by the AAA may cover a multi-year period, but shall not exceed four years.

2. Funds shall be awarded on the State fiscal year.

3. Award of funds for subsequent years shall be contingent on the availability of funds and acceptable performance of the grant or contract as determined by the AAA. 4. AAAs may provide direct service only with approval of the SUA as part of the AAAs Area Plan or SUA approval of a direct service waiver as described at Section 10.410.2.

C. The AAA shall monitor and evaluate provider performance in accordance with the requirements of this staff manual for OAA programs.

10.820 STATE FUNDED PROGRAMS FOR SENIORS SERVICES A. Services shall include one or more of the following: 1. Nutrition services, including congregate and home-delivered meals; 2. Outreach, information, and assistance services;

3. Transportation services;

4. In-home services;

5. Long-Term Care Ombudsman services;

6. Legal assistance services;

7. Disease prevention and health promotion services;

8. Caregiver support services;

9. Elder abuse prevention services; and, 10. Other services as described in the OAA or as approved by the SUA. B. Eligibility for services shall be as described at Section 10.120. C. All service providers receiving SFPS funds to render services under the program shall meet the service provider requirements described at Sections 10.260 – 10.260.6. D. All services provided shall meet the service standards described at Sections 10.412 -10.419. 10.830 FUNDING A. The fiscal year shall be the State fiscal year.

B. Funding shall be allocated and spent on a State fiscal year. C. The SUA shall distribute SFPS funds using the same intrastate formula used to distribute funds available under Title III of the Older Americans Act as described at Section 10.310. D. SFPS funds shall be allocated as a whole.

E. Fiscal accounting and management of SFPS funds shall be completed in accordance with the procedures and requirements established at Section 10.319 to Section 10.321, unless a one-time waiver for program income is requested and approved by the SUA. Waivers shall be valid for a period of only one year.

F. The AAA may use ten percent (10%) of the funds received from the OCP for administrative expenses as described at Section 26-11-205.5, C.R.S.

G. SFSS may be used for administrative expenses as determined by the SUA. H. SFPS shall be used to supplement existing services and cannot be used to meet match requirements.

I. Documentation and record retention requirements shall be as described at Section 10.323. 10.900 COMPLAINTS, APPEALS AND HEARINGS A. All service providers, including Area Agencies on Aging (AAA), contractors, and grantees receiving Older Americans Act (OAA) funds to provide services to older individuals, shall develop policies and procedures for the resolution of complaints and appeals as described at Section 10.260, G.

B. A complaint, in the context of this rule, is an expression of dissatisfaction by: 1. An older individual receiving services under the Older Americans Act (OAA) or State Funded Programs for Seniors (SFPS), or his/her representative or caregiver; 2. An applicant for services under the OAA or SFPS, or his/her representative or caregiver, or, 3. A service provider.

C. Older individuals receiving services, applicants for services, or their representatives or caregivers may file a complaint related to the following: 1. Any action or failure to act which impacts the older individual’s experience with programs and services funded by the OAA or SFPS;

2. Dissatisfaction with services including issues related to quality and quantity of services;

3. Dissatisfaction with service providers; or, 4. Other issues related to OAA or SFPS programs raised by the older individual or his/her representative or caregiver.

D. Consumer complaints may initially be verbal or written. 1. If a verbal complaint is made in person, the agency staff or volunteer receiving the complaint shall assist the older individual in recording the complaint. a. The narrative of the complaint shall be read back to the older individual to ensure that the individual’s complaint is accurately documented and the older individual shall be asked to sign the complaint. The staff member shall sign and date the document to verify this step.

b. The older individual shall not be required to sign the complaint if he/she refuses or is unable to sign.

2. Complaints received by phone shall be documented by the agency staff/ volunteer receiving the complaint.

3. Complaints shall be forwarded to the appropriate agency for follow-up and resolution. E. Service providers may file written complaints for issues related to: 1. Reimbursement; or, 2. Matters pertaining to the contractual relationship between the service provider and the contracting or granting agency.

F. Service provider complaints shall not include issues related to withdrawal of designation as an AAA, or PSA modification (see Section 10.950. - State Hearings). G. Long-Term Care Ombudsman Complaints 1. Complaints made to a local LTC ombudsman or the Colorado Long-Term Care Ombudsman (CLTCO) shall be resolved according to Section 10.720.2, E. 2. Complaints made by the CLTCO or its representatives related to interference with LTC ombudsman activities shall be resolved according to Section 10.730.7. 3. Complaints about actions or inactions of the Local LTC Ombudsman program representatives shall be resolved according to Section 10.930. 4. Complaints about actions or inactions of the Colorado Long-Term Care Ombudsman shall be resolved according to Section 10.940.

H. Complaint procedures for enrollees in the Senior Community Service Employment Program are located at Section 10.640.6.

10.910 CONSUMER COMPLAINTS AND APPEALS A. Complaints (including consumer complaints and complaints by their representatives or caregivers), and complaints by applicants for services (or their representatives or caregivers) shall be resolved at the lowest possible level. B. If the complaint cannot be resolved at the local level, it may be appealed to the SUA. 10.910.1 Consumer Complaint A. Consumer complaints shall be filed in writing with the direct service provider within 30 calendar days of the complaint.

B. The direct service provider receiving the complaint shall investigate and resolve the complaint. The direct service provider may be the AAA, the SUA, or a contractor or grantee of the AAA or SUA.

C. Written notice of the resolution shall be sent to the complainant within 15 working days. This notice shall include:

1. A summary of the concern or issue;

2. The results of the investigation into the complaint and the service provider’s resolution of the concern; and, 3. Notification to the complainant of his/her right to appeal the service provider’s decision if he/she is dissatisfied with the resolution, and instructions for filing such an appeal.

D. The provider shall maintain complaint files that include: 1. The consumer’s complaint;

2. Investigative notes and findings;

3. The resolution of the complaint including any actions taken; and, 4. A copy of the written response to the consumer.

10.910.2 Consumer Appeal A. If the complainant is dissatisfied with the complaint resolution, a written appeal may be filed with the SUA Director within 10 calendar days of receipt of the decision. B. The SUA Director or designee shall complete a review of the complaint and resolution to that complaint, including all pertinent documentation or new information that may be available. C. The SUA Director will provide a written response to the complainant within 30 calendar days of receipt of the appeal.

D. This written response shall include notification of the complainant’s rights to an Administrative Law Judge hearing as described at Section 10.960, if he/she is dissatisfied with the resolution of the appeal, and instructions for requesting such a hearing. 10.920 SERVICE PROVIDER COMPLAINTS AND APPEALS 10.920.1 Service Provider Complaint A. Service provider complaints shall be filed in writing directly with the service provider’s contracting or granting agency (i.e., the AAA or SUA) within 30 calendar days of the date the incident occurred.

B. The AAA or SUA receiving the complaint shall investigate and resolve the complaint within 15 working days from the time the agency receives the complaint. C. If the service provider is a contractor or grantee of the AAA, the complaint shall be investigated and resolved by the AAA director.

D. If the service provider is a contractor or grantee of the SUA, the complaint shall be investigated and resolved by a designated SUA staff person. E. Written notice of the resolution shall be sent to the service provider complainant. This notice shall include:

1. A summary of the concern or issue;

2. The results of the investigation into the complaint and the resolution of the concern; and, 3. Notification to the complainant of his/her right to appeal the decision if he/she is dissatisfied with the resolution, and instructions for filing such an appeal. 10.920.2 Service Provider Appeal A. If the service provider, contractor, or grantee is dissatisfied with the resolution of the complaint, a written appeal may be filed with the SUA Director within 10 calendar days of the receipt of the initial decision.

B. The appeal shall be investigated and resolved by the SUA Director or designee. If a designee is selected, the appeal shall be resolved by a supervisory level designee in the SUA not involved in the original complaint resolution.

C. The SUA Director or designee shall complete a review of the complaint and complaint resolution, including all pertinent documentation or new information that may be available, and provide a written response to the complainant within 15 working days of receipt of the appeal.

D. This written response shall include notification of the complainant’s rights to an Administrative Law Judge hearing as described at Section 10.960, if he/she is dissatisfied with the resolution of the appeal, and instructions for requesting such a hearing. 10.930 LOCAL LONG-TERM CARE (LTC) OMBUDSMAN COMPLAINTS AND APPEALS 10.930.1 Local Long-Term Care Ombudsman Complaints A. Complaints made involving actions or inactions by a Local LTC Ombudsman shall be filed with the appropriate AAA within 30 calendar days of the date of the incident. B. The AAA Director shall investigate and resolve the complaint. C. The complainant shall be notified, in writing, by the AAA Director of the resolution within 15 working days of receipt of the complaint. This notice shall include: 1. A summary of the concern or issue;

2. The results of the investigation into the complaint and the resolution of the concern; and, 3. Notification to the complainant of his/her right to appeal the decision if he/she is dissatisfied with the resolution, and instructions for making such an appeal. 10.930.2 Local Long-Term Care Ombudsman Complaints Appeal A. If the complainant is dissatisfied with the complaint resolution by the AAA, a written appeal may be filed with the SUA Director within 10 calendar days of the decision. B. The SUA Director or designee shall complete a review of the complaint and complaint resolution, including all pertinent documentation or new information that may be available, and provide a written response to the complainant within 15 working days of receipt of the appeal.

C. This written response shall include notification of the complainant’s rights to an Administrative Law Judge hearing as described at Section 10.960, if he/she is dissatisfied with the resolution of the appeal, and instructions for requesting such a hearing. 10.940 COLORADO LONG-TERM CARE OMBUDSMAN (CLTCO) COMPLAINTS AND APPEALS 10.940.1 Colorado Long-Term Care Ombudsman Complaints A. Complaints made involving actions or inactions by the CLTCO shall be filed with SUA within 30 calendar days of adverse action.

B. The SUA shall investigate and resolve the complaint. C. The complainant shall be notified in writing of the resolution within 15 working days. This notice shall include:

1. A summary of the concern or issue;

2. The results of the investigation into the complaint and the resolution of the concern; and, 3. Notification to the complainant of his/her right to appeal the decision if he/she is dissatisfied with the resolution, and instructions for making such an appeal. 10.940.2 Colorado Long-Term Care Ombudsman Appeal A. If the complainant is dissatisfied with the complaint resolution by the SUA, a written appeal may be filed with the SUA Director within 10 calendar days of the decision. B. The appeal shall be investigated and resolved by the SUA Director or designee. If a designee is selected, the appeal shall be resolved by a supervisory level designee in the SUA not involved in the original complaint resolution.

C. The SUA Director or designee shall complete a review of the complaint and complaint resolution, including all pertinent documentation or new information that may be available, and provide a written response to the complainant within 15 working days of receipt of the appeal.

D. This written response shall include notification of the complainant’s rights to an Administrative Law Judge hearing as described at Section 10.960, if he/she is dissatisfied with the resolution of the appeal, and instructions for requesting such a hearing. 10.950 STATE HEARINGS A. Applicants for area agency designation, including units of general-purpose local government, may request a state hearing.

B. The AAAs may request a hearing at the SUA in the following circumstances: 1. Withdrawal of AAA designation resulting from:

a. Termination of the grant;

b. Disapproval by the SUA of the Area Plan, the One-Year Grant Application or revisions to the plan;

c. Non-compliance with the terms of the grant, State regulations, Federal regulations or applicable laws;

d. Failure to apply or submit the Area Plan, the One-Year Grant Application or revisions to the plan; or, e. Voluntary termination of the grant by the AAA.

2. Modification of planning and service areas when:

a. The applicant is denied a PSA modification; or, b. An existing AAA is affected by an approved application for modification of a PSA.

C. Individuals or entities penalized as a result of an investigation into complaints of interference with an ombudsman in the course of his/her duties, or a complaint regarding discriminatory, disciplinary or retaliatory action as described at Section 10.730.7, B, may request an Administrative Law Judge (ALJ) hearing.

10.950.1 Conduct of State Hearings A. Requests for SUA appeal hearings shall be filed with the SUA within 30 calendar days of receipt of the initial decision.

B. A hearing may be terminated at any time if the appellant and the respondent negotiate a written agreement resolving the issue(s) in question.

C. Upon receipt of a request for a hearing, the SUA shall: 1. Appoint a three member impartial hearing board.

2. Schedule a hearing within 30 calendar days of the request unless: a. Consent for delay is obtained from all parties; or, b. In the opinion of the SUA and at its option, there is good and sufficient reason to delay the hearing at the request of one of the parties. 3. Notify all parties involved in the appeal of the time and place for the hearing. D. The SUA hearing board shall regulate the hearing, rules of evidence, testimony and other pertinent procedures including, but not limited to the following: 1. Ruling upon offers of proof and receive evidence;

2. Regulating the course of the hearing;

3. Setting the time and place for continued hearings;

4. Setting the time for filing of briefs and other documents; 5. Directing the parties involved in the appeal to confer and consider simplification of issues, admissions of fact, or of documents to avoid unnecessary proof; and, 6. Issuing orders to control subsequent course of the proceeding. E. The SUA hearing board shall hear the case in accordance with Section 24-4-105, C.R.S. F. The SUA hearing board may consider information not available at the time the decision in question was made. If the hearing board determines that the new information is pertinent to the decision under review, it shall recommend that the matter be remanded back to the appropriate decision level for reconsideration of the decision. G. The SUA hearing board shall render its findings and recommendations to the SUA Director within 15 working days of the close of the hearing.

H. The SUA Director or his/her designee shall review the findings and recommendations of the hearing board and shall render a written decision within 15 working days of receipt of the hearing board’s recommendations.

10.950.2 AAA Designation or Withdrawal of Designation Hearings SUA hearings related to AAA designation or withdrawal of designation as an AAA shall be conducted as described at Section 10.950.1.

A. If the decision is in favor of the appellant, the SUA Director may, at his/her option: 1. Remand the matter to the SUA for reconsideration of the decision with specific notation of the errors which shall be corrected and any other instructions or actions that may be deemed appropriate; or, 2. Revise or rescind the decision in question.

B. The written decision shall be mailed by first class mail to the appellant and to the respondents in the appeal.

C. If the decision is not in favor of the appellant, the written decision shall include information about the appellant’s right to appeal to the Assistant Secretary of HHS in accordance with the OAA, and Federal rules and regulations.

10.950.3 State Hearings Related to PSA Modification SUA hearings related to PSA modification shall be conducted as described at Section 10.950.1. A. If the decision is in favor of the appellant, the SUA Director may, at his/her option: 1. Remand the matter to the SUA for reconsideration of the decision with specific notation of the errors which shall be corrected and any other instructions or actions that may be deemed appropriate; or, 2. Revise or rescind the decision in question.

B. The written decision shall be mailed by first class mail to the appellant and to the respondents in the appeal.

C. If the decision is not in favor of the appellant, the written decision shall include information about the appellant’s right to appeal to the Assistant Secretary of HHS in accordance with the OAA, and Federal rules and regulations.

10.960 STATE ADMINISTRATIVE LAW JUDGE (ALJ)

A. The purpose of an ALJ hearing shall be to determine the pertinent facts to arrive at a fair and equitable decision.

B. ALJ hearings shall be conducted in accordance with Section 24-4-105, C.R.S. 10.960.1 Notification of Decision A. Following conclusion of the hearing, the ALJ shall prepare and file a decision in accordance with the provisions of Section 24-4-105, C.R.S.

B. The decision shall include a statement of findings and conclusions upon all the material issues of fact, law or discretion presented by the record and the appropriate order, sanction, relief or denial thereof.

C. The decision shall include a determination as to whether the respondent acted in accordance with, or properly interpreted, applicable State policies and regulations. D. The decision shall be sent to each party involved in the hearing and shall include the date upon which the decision becomes final and binding to all parties. E. The decision shall be mailed by first class mail.

10.960.2 Additional Appeals A. If the ALJ hearing is the result of a complaint or appeal by a consumer or service provider as described at Section 10.910 and Section 10.920, the decision of the ALJ is final. B. If the ALJ hearing is an appeal of a finding by the State hearing board related to withdrawal of an AAA designation, as described at Section 10.950.2, the appellant may commence an action for further judicial review as described at Section 10.970. 10.970 JUDICIAL APPEALS A. Review of ALJ determinations may be initiated by the filing of an action for review in the district court in accordance with Section 24-4-106(4), C.R.S. B. The Division of Administrative Hearings shall advise the appellant of its decision concerning these rights.

C. Appellants may avail themselves of their rights in district court following the hearing and appeal process to ensure fairness in the administration of the Older Americans Act.