12 CCR 2509-3
7.200 OVERVIEW OF CHILD WELFARE SERVICES - PROGRAM AREAS 4, 5, and 6
7.200.1 CHILD WELFARE SERVICES
Child Welfare Services constitutes a specialized set of services that are intended to strengthen the ability of families to protect and care for their own children, minimize harm to children and youth, and ensure permanency planning. The goal shall be to support the intactness of families, when appropriate, through the provision of services aimed at stabilizing the family situation and strengthening the parents/guardians in fulfilling their parental responsibilities to their children. Intervention shall be guided by respect for the family's integrity, knowledge of the legal base for action, and sound social work practice. The following principles shall underlie the provision of Child Welfare Services:
A. Children and youth shall have the right to be raised in an environment free from abuse or neglect preferably by their families of origin by providing reasonable efforts to maintain the family unit through the provision of in-home services.
B. Placement shall be considered when there is evidence that leaving the child in the home would jeopardize the safety of the child or community. Reasonable efforts shall be made to prevent placement or to reunite the family as soon as safely possible if removal is necessary. In determining reasonable efforts to be made, and in making such reasonable efforts, the child's health and safety shall be the paramount concern. A court may determine that reasonable efforts shall not be required; otherwise, reasonable efforts shall be made to preserve and reunify families.
C. Appropriate and culturally competent services that promote safety shall be provided to families, children, and youth in their own homes and in out-of-home placements.
D. Children and youth who have been removed from the care of their parents shall have the right to have extended family members considered as placement resources, to be placed in a safe environment, to not be moved indiscriminately from one placement to another, and to have the assurance of a permanency plan.
E. Consideration of the child's age, race, ethnicity, culture, language, religion, and other needs shall guide the choice of all services provided, including out-of-home and adoptive placements.
F. Case planning shall involve the parents so that relevant services can be provided to permit timely rehabilitation and reunification.
G. Child Welfare Services shall be provided in collaboration with other community agencies on behalf of children, youth, and their families. Assessment tools or resources available through these community agencies shall be incorporated in the assessment, based on the culture, ethnicity and other needs of the family.
7.200.2 HUMAN IMMUNODEVICIENCY VIRUS (HIV) POLICY
7.200.21 Definitions
A. Acquired Immunodeficiency Syndrome (AIDS): The late stage of the illness triggered by infection with Human Immunodeficiency Virus (HIV). A person receives an AIDS diagnosis when he or she has a CD4 (helper 1-cell) count of less than 200 and/or certain opportunistic infections common with advanced immune deficiency.
B. HIV: The detection by laboratory antibody tests of the presence of the Human Immunodeficiency Virus (HIV) in an individual.
C. Universal Precautions: Measures used to keep a barrier between an person and blood and/or other infectious bodily fluids. The precautions are published by the Centers for Disease Control as accepted methods of preventing the spread of infectious disease and, when used routinely and propely, are sufficient to control the spread of infectious blood borne diseases, including HIV. Following are the universal precautions:
1. Universal precautions apply to blood and to other body fluids containing visible blood. Blood is the single most important source of HIV in a care giving setting.
2. Universal precautions also apply to semen and vaginal secretions. Although both of these fluids have been implicated in the sexual transmission of HIV, they have not been implicated in transmission from client to care providers.
3. Universal precautions do not apply to feces, nasal secretions, sputum, sweat, tears, urine, saliva and vomitus unless they contain visible blood. The risk of transmission of HIV from these fluids, while theoretically possible, is extremely low or nonexistent.
4. In any contact with visible blood, use a barrier such as latex gloves. When these are not immediately available, such as immediate response to a nosebleed or wound, use a barrier such as a towel. If hands are exposed to blood, they must be washed with soap and water immediately after contact.
7.200.22 Testing and Confidentiality
A. For children and youth in the legal custody of the county department of social services, the county department shall recommend to the medical care provider that the child or youth be tested for HIV based on determination of risk including the following considerations:
1. Specific medical reasons for testing related to the well-being of the child or youth.
2. Authority to test based on legal mandates or the informed consent of the client or those authorized to make medical decisions for the client.
3. Mandatory pre and post test counseling shall include age appropriate information regarding the illness, assistance in dealing with psycho social issues, information about safer sex and a risk reduction plan.
4. A plan shall be developed for re-testing based upon risk behaviors.
5. In the event a child refuses to consent to testing for HIV, the medical care provider shall be requested to provide counseling to the child.
B. Confidentiality Section 25-4-1405(6), C.R.S., allows for minors to be examined and treated for HIV infection without the consent of the parent or guardian. Further, if the minor is age 16 or older, the results of the examination or treatment need not be divulged to the minor's parent or guardian, or to any person, unless necessary under reporting requirements of Title 25 or Title 19, C.R.S. In the event that the county becomes aware of positive HIV test results, the county shall develop a plan for confidential management of test results and HIV status. The county's policy may limit access to the test results based on the need to know and must comply with provisions of Title 25, Article 4, Part 14, C.R.S. The need to know shall include, but not be limited to:
1. The care provider, with consideration of his or her capacity to provide appropriate physical and emotional care to a child or youth who is HIV-infected and his or her capacity to appropriately manage confidentiality issues. In the case of residential child care facility, residential treatment center, or child placement agency placement, HIV information shall be provided to the person designated by the facility to coordinate medical care.
2. The caseworker and supervisor for the child or youth, who must manage the case including medical care.
3. Child's biological parents based on the determination of risk to the child. The county department shall include the child's parents in decisions for medical procedures and treatment based on risk to the child, except where parental rights have been terminated.
7.200.23 Service Provisions
7.200.231 Non-Discrimination
The status of being at risk for HIV exposure or being diagnosed with HIV/AIDS shall not be a cause for denial of services.
7.200.232 General Services
The county department shall identify and may refer for medical evaluation children or youth in county custody who are at risk of HIV infection, considering the following factors:
A. Infants born to known HIV infected mothers or mothers with high risk behavior.
B. Children who have been involuntary sexual partners because of sexual assault, rape, incest and/or sexual abuse.
C. Children with hemophilia who were exposed to blood or blood products before 1985 or children or youth who have received blood transfusions before March 1985.
D. Children engaged in injection drug use past or present, including other injection behaviors such as needle sharing.
E. Children engaged in unprotected, oral vaginal, or anal intercourse.
7.200.3 CHILD WELFARE GRIEVANCE RESOLUTION PROCESS
The governing body of each county, and city and county, shall establish a grievance process, including a citizen review panel, as required by Section 19-3-211, C.R.S. The following requirements apply to the grievance process:
A. Definitions Grievance means a complaint regarding the conduct of an employee of a county department of social services in performing his/her duties under Article 3 of the Children's Code. “Grievance” does not include complaints regarding conduct by the courts, attorneys, law enforcement officials, employees of the State, foster parents or other providers of services to children, or other family members.
Citizen Review Panel means an advisory body appointed by the governing body of a county or city and county pursuant to Section 19-3-21.1, C.R.S. The members of such citizen review panel shall be appointed by the governing body without influence from the state department or the county department, be representative of the community, have demonstrable personal or professional knowledge and experience with children, and not be employees or agents of the state department or any county department. At least one member of the citizen review panel in each county and city and county shall be the parent of a minor child at the time of his or her appointrnent to serve on such panel.
Complainant means any person who was the subject of an investigation of a report of child abuse or neglect or any parent, guardian, or legal custodian of a child who is the subject of a report of child abuse or neglect and brings a grievance against a county department in accordance with the provisions of Section 19-3-211, C.R.S. Recommendation means a proposed course of action that may be implemented by a county director to resolve a grievance. These proposed actions may include reassigning a case to a different employee, requinng an employee to receive training, or administenng disciplinary action to an employee, subject to applicable safeguards afforded to the employee through the personnel system under which the employee is employed.
B. Time Frames for Resolving Grievances County department shall attempt to resolve all grievances informally before using the formal grievance process. Any grievance not resolved to the satisfaction of the complainant shall be forwarded to the county director within ten working days after it has been received by the county department.
The county director shall act on the grievance within twenty calendar days after s/he receives it. If the county director is able to resolve the grievance to the complainant's satisfaction, s/he will issue a written decision setting forth the resolution. If the county director is unable to resolve the grievance to the complainant's satisfaction within 20 calendar days, the county director shall immediately refer the grievance to the Citizen Review Panel, together with the county directors proposed resolution of the grievance.
Within thirty calendar days after receipt of the grievance from the county director, the Citizen Review Panel will convene a hearing on the grievance and send a written recommendation regarding the grievance, together with the basis for its recommendation, to the county director and the complainant.
If the county director agrees with the Citizen Review Panel's recommendation, s/he will issue a written decision implementing the recommendation. If the county director or the complainant disagrees with the recommendation, the grievance shall be referred to the governing body. Within thirty calendar days of receiving the grievance, the governing body shall send its written recommendation regarding the grievance, together with the basis for the recommendation, to the complainant, the county director and to any county employee who is the subject of the grievance. The county director shall issue a final decision including his/her plan to implement the governing body's recommendation, and shall send a copy of this report to the complainant and to the county employee who is the subject of the grievance. Within thirty calendar days after issuing this final decision, the county director shall submit a written report to the Citizen Review Panel including a disposition of the grievance, and shall send copies of the report to the complainant and to the county employee who is the subject of the grievance.
C. Citizen Review Panel 1. Access to Information and Confidentiality A Citizen Review Panel shall have access to child abuse or neglect reports and any information from the complete case file that the governing body believes is pertinent to the grievance, which shall be reviewed solely for the purpose of resolving grievances pursuant to the provisions of this section, except that access to identifying information concerning any person who reported child abuse or neglect shall not be provided and no participant in the conflict resolution process shall divulge or make public any confidential information contained in a report of child abuse or neglect or in other case file records to which he or she has been provided access.
2. Informal Testimony Upon the request of the complainant, the county department, or the subject of a grievance, a citizen review panel may receive testimony from experts or other witnesses. Such testimony must be provided voluntanly and without a fee. Further, such testimony will be provided without an oath, will not be subject to objections from parties to the grievance process, and the witness will not be subject to cross examination. Members of the Citizen Review Panel, however, may ask questions of the witness as the panel's procedures permit.
3. Scope of Inquiry and Recommendations The Citizen Review Panel shall only inquire into and make recommendations concerning grievances as presented by a complainant and as defined above. The Citizen Review Panel may not access records or receive testimony unless the record or testimony is directly related to a grievance property referred to the panel. Once the panel has made a recommendation concerning a grievance, or the time for making such a recommendation has expired, the panel may not inquire further into the grievance. The panel may not inquire into the conduct of courts, attorneys, law enforcement officials, employees of the State, foster parents or other providers of services to children, or other family members, nor may the panel inquire into the conduct of a county department employee if no grievance concerning that employee or that conduct has been properly referred to the panel.
D. Annual Reports On or before June 30 of each year, every county or city and county shall submit to the State Department an annual report regarding the resolution of grievances pursuant to this section. At a minimum, this report shall include:
1. The number of grievances received by the County Director, the number of grievances referred to the Citizen Review Panel, the number of grievances referred to the governing board, and the actual time frames for resolving grievances at each level.
2. A brief description of the disposition of the grievances, including the number that were concluded without any action taken, the number which were substantiated, the number resolved by case reassignment, the number resolved by requiring additional training, the number resolved by imposing disciplinary action against a county employee, and the number resolved in other ways.
E. Counties shall publicize:
1. The availability of the process for all dependency and neglect cases through the “Notice of Rights and Remedies” and by informing child welfare clients, guardians, and legal custodians of the process during the initial contacts with parties and periodically throughout the provision of services related to dependency and neglect cases.
2. The rights and remedies for families as specified in Section 7.200.4.
3. Any other information about the process as deemed relevant by the governing body.
7.200.4 REQUIRED NOTICE OF RIGHTS AND REMEDIES
A. All county departments shall utilize the state prescribed “Notice of Rights and Remedies for Families” in cases subject to Article 3 of the Colorado Children's Code, “Dependency and Neglect”.
B. County departments shall add county-specific information to the state prescribed form and supply copies of the notice to all law-enforcement agencies within the county or district.
C. The notice shall be delivered at the time of a child's removal to the parent(s) and family from whom the child is removed by court order or by law enforcement personnel. The notice shall specify the cause of the removal of the child or children.
1. If the removal is an emergency pursuant to Section 19-3-401, C.R.S., a copy of the court order directing the removal of the child or children from the home shall be delivered to the family promptly upon its availability.
2. If the removal of the child or children is not an emergency, a copy of the court order directing the removal shall also be provided to the parents and family at the time of removal.
7.200.5 MANDATORY REPORTING OF CHILD ABUSE OR NEGLECT
All county department staff who have reasonable cause to know or suspect child abuse or neglect as set forth in Section 19-3-304, C.R.S., are mandated to report such information to the appropriate county department staff or local law enforcement.
7.201 PROGRAM AREA 4 - YOUTH IN CONFLICT
7.201.1 DEFINITION OF PROGRAM AREA 4
Program Area 4 services are provided to reduce or eliminate conflicts between youth and their family members or the community when those conflicts affect the youth's well-being, the normal functioning of the family or the well-being of the community. The focus of services shall be on alleviating conflicts, protecting the youth and the community, re-establishing family stability, or assisting the youth to emancipate successfully.
7.201.2 TARGET GROUPS
A. Children and youth who are beyond the control of their parents or guardians.
B. Children and youth whose behavior is such that there is a likelihood they may cause harm to themselves or to others or who have committed acts that could cause them to be adjudicated a delinquent child by the court.
7.201.3 INITIAL ASSESSMENT
A. The county department shall respond, either with a face-to-face intervention or by telephone, when notified by the court appointed detention screener or a law enforcement officer, of a child or youth in the custody of a law enforcement agency who is inappropriate for secure detention but cannot be returned home.
B. The county department shall complete a needs assessment for children or youth who do not require physical restriction but for whom immediate removal from the home appears necessary for his/her protection or the protection of others. The county department shall provide needed services, other than secure detention, such as temporary placement, crisis intervention, or in-home services.
C. A child or youth shall not be removed from the home without police protective custody or hold, a court order, or a signed voluntary placement agreement. Before or at the conclusion of the court- ordered placement (72 hours) or police hold (48 hours), the child or youth shall:
1. Be returned home; or, 2. Remain in court-ordered placement; or, 3. Continue in placement by virtue of a voluntary placement agreement signed by the parents/guardians.
7.202 PROGRAM AREA 5 - CHILDREN IN NEED OF PROTECTION
7.202.1 DEFINITION OF PROGRAM AREA 5
To protect children whose physical, mental or emotional well-being is threatened by the actions or omissions of parents, legal guardians or custodians, or persons responsible for providing out-of-home care, including a foster parent, an employee of a residential child care facility, and a provider of family child care or center-based child care. The county shall provide services targeted to achieve the following:
A. Children are secure and protected from harm;
B. Children have stable permanent and nurturing living environments; and, C. When appropriate, children experience family continuity and community connectedness.
7.202.2 TARGET GROUPS
A. Children whose physical, mental, or emotional well-being has been threatened or harmed due to abuse or neglect.
B. Children who are subjected to circumstances in which there is a reasonable likelihood that they are at risk of harm due to abuse or neglect by their parents or caretakers which shall include children who are alleged to be responsible for the abuse or neglect and are under the age of 10.
7.202.3 DEFINITIONS
A. Child abuse or neglect is defined in Section 19-1-103(1), C.R.S.
B. The following terms shall be defined as:
1. “De novo” means that the issue is reviewed once again as if the appeal were the first review.
2. “Expungement” means the designation of a report or record whereby it is deemed not to have existed for the purpose of employment and background screening. Expungement of a confirmed report of abuse or neglect shall not preclude the county department from maintaining records of the report in the case file or in the State automated system for purposes of future safety and risk assessments.
3. “Good cause” means a legitimate reason why the process set forth herein should be modified. Such reasons may be that it was not possible for a party to meet a specified deadline and there was incapacity of the party or representative, lack of proper notice of the availability of the appeal process, additional time is required to obtain documents which were timely requested but not delivered, or other circumstances beyond the control of the party.
4. “Preponderance of the evidence” means credible evidence, put forth by either party that the claim is more probably true than false.
7.202.4 INITIAL ASSESSMENT
A. The county department shall have staff available 24 hours a day to receive reports of abuse and neglect, conduct initial assessments of such reports and investigate those reports that are appropriate for child protective services. Continuously available means the assignment of a person to be near an operable telephone, beeper system, or to have such arrangements made through agreements with the local law enforcement agencies.
B. The county department shall develop procedures to ensure that those individuals reporting abuse or neglect after-hours are directed to the designated agency for response.
C. The county department shall provide appropriate referral information to the reporting party in those situations in which there are inadequate grounds to constitute a child abuse or neglect referral. Either casework or supervisory staff shall inform, whenever possible and appropriate, the reporting party of the decision not to investigate and the reasons for that decision.
D. The county department shall review all reports and conduct an initial assessment. The initial assessment shall decide the appropriateness of further investigation. It shall include, but not be limited to, the following activities:
1. Checking the State Department's automated system.
2. Reviewing county department files.
3. Obtaining information from collateral sources, such as schools, medical personnel, law enforcement agencies, or other care providers.
E. The county department shall gather and document the following Information:
1. Family members and birth dates.
2. Relationships of individuals in the household.
3. Identified alleged victims, birth dates, and their current location.
4. Reasonable effort to secure the identity of the person alleged to be responsible for the abuse or neglect, as well as the responsible person's date of birth, Social Security Number, and last known address.
5. Presenting problems - specific allegations.
6. Reporter's credibility and name, address, and phone number.
7. Relationship of reporter to family.
8. Other potential witnesses.
9. Collateral agencies and individuals involved with the family.
10. Records check - internal and Central Registry.
11. Date and time intake report received.
12. Risk assessment based upon reporter's information.
13. Referrals made.
14. Decision as to investigation response and caseworker's signature (name).
15. Supervisory approval of the decision and signature.
F. The county department shall accept a report for investigation if it:
1. Contains specific allegations of known or suspected abuse or neglect as defined in statutes and regulations. A “known” incident of abuse or neglect would involve those reports in which a child has been observed being subjected to circumstances or conditions that would reasonably result in abuse or neglect. “Suspected” abuse or neglect would involve those reports that are made based on patterns of behavior, conditions, statements or injuries that would lead to a reasonable belief that abuse or neglect has occurred or that there is a serious threat of harm to the child.
2. Provides sufficient information to locate the alleged victim.
3. Identifies a victim under the age of 18.
4. Meets the conditions of #2 and #3 above, results in a third report of suspected child abuse or neglect within a two year period and the two previous reports were not accepted for investigation. All reports with a child welfare concern occurring in any jurisdiction concerning any child in the family are to be counted towards the three or more reports. Upon completion of the investigation, the next report of suspected abuse or neglect that is not accepted for investigation shall be counted as number one.
G. The county department shall ensure that reports that do not need further investigation after the initial assessment are documented on an assessment/intake form, with the reasons why further investigation was not needed. In those reports in which a full investigation is not going to be conducted the supervisor shall approve that decision.
H. The county department shall use a standardized response assessment process to decide the priority of response to reports needing investigation. At a minimum, those factors that shall be addressed and documented are:
1. Age/vulnerability of the alleged victim.
2. The specific nature and severity of the alleged maltreatment.
3. Prior reports on any family member, child, or alleged perpetrator.
4. Parental level of cooperation.
5. Stressors.
6. Family violence.
“Low Risk” - Factors present indicate that the child's risk of harm is slight. If response assessment information cannot be obtained from the reporting party, the county department shall make an immediate response to determine the child's level of safety.
I. The county department shall assign priority in response time using the following time frames:
1. On all high risk referrals: The safety and protection issues shall be addressed immediately and no later than 24 hours after initial receipt of the report.
2. On all moderate or low risk referrals (in which the child's safety has not been secured): The investigation shall be initiated as soon as possible, but no later than 72 hours after receipt of the report.
3. On low risk referrals in which the child's safety has been secured: The investigation shall occur as soon as possible but no later than four working days after receipt of the report.
7.202.5 INVESTIGATION PROCEDURES
The purposes of the intake investigation are to:
A. Assess and ensure safely;
B. Assess risk, needs, and strengths of children and families;
C. Oversee development and coordination of the initial Family Services Plan; and, D. Obtain appropriate resources for children and their families.
7.202.51 Written Procedures
The county department shall develop written cooperative agreements with law enforcement agencies that include:
A. Protocol for cooperation and notification between parties on child abuse and neglect reports and child maltreatment deaths.
B. Protocol for distributing the Notice of Rights and Remedies when required by Section 19-3- 212, C.R.S., and Section 7.200.3, G, of this staff manual.
C. Joint investigation procedures.
D. Procedures for independent investigation by either party.
E. Procedures for investigation of abuse or neglect in out-of-home-care settings. A law enforcement investigation regarding the criminal aspects of an institutional abuse case shall not relieve the county department of its responsibility to assess the safety of the children in out-of-home care settings.
7.202.52 Investigation Requirements
The investigation of intra-familial, institutional, or third party abuse shall be conducted as set forth in Sections 19-3-308(2), (3), (4) through 19-3-308.5, C.R.S. To the extent that is reasonably possible, this shall occur as soon as possible following the receipt of the referral according to the county's prioritization of the incident.
A. The investigation shall include an interview with or observance of the child who is the subject of a report of abuse or neglect.
B. The interview shall be conducted out of the presence of the suspected person(s) responsible for the abuse or neglect.
C. The investigation shall determine the names and conditions of any children living in the same place as the child who is the subject of the report.
D. The person alleged as responsible for the abuse or neglect shall be advised of the report and given an opportunity to respond.
E. A visit to the child's place of residence or place of custody shall be completed as part of the investigation if:
F. The investigation shall include consideration of ethnic, religious, accepted work-related practices of agricultural communities, and accepted child-rearing practices of the culture in which the child participates.
G. The investigation shall include a safety assessment that identifies the conditions or family actions that may endanger child safety.
H. When safety concerns are identified in the safety assessment, a safety plan shall be completed.
I. Colorado Family Risk Assessment
J. All of the information resulting from the investigation shall be documented in the case file as a summary of investigation findings, along with any specific evidence gathered, such as photographs or videotapes.
K. At the time of a new referral, the county department shall specifically review the case history of any case with four or more reports of abuse/neglect occurring in any jurisdiction concerning any child in a family.
Each report is to be reviewed in terms of actions taken and services provided. The review shall be documented in the file on the investigation summary form. The supervisor is to ensure that the review and the documentation have occurred.
The county department shall have a procedure to identify, track, and record cases with a history of four or more reports of abuse/neglect.
L. Reasonable efforts shall be made to prevent out-of-home placement, unless an emergency exists, and to maintain the family unit. Safety plans other than placement shall be considered, including but not limited to the provision of in-home and Core Services, if appropriate and available; the possibility of removing the maltreating adult from the home rather than the child; the possibility of the non-maltreating parent placing child and self in a safe environment; or the availability of kinship placement.
M. Taking children into custody - See Section 19-3-401, C.R.S.
N. Upon completion of an investigation, the county department shall consider a report confirmed if there is a preponderance of evidence to support that abuse occurred.
O. For purposes of investigation, the interview of the child may be audio or video taped. If audio or video taping is conducted, the following standards shall be followed:
7.202.53 Institutional Abuse or Neglect Investigations
Institutional abuse or neglect investigations shall:
A. Include those reports of child abuse or neglect by staff in any private or public facility that provides out-of-home child care, including 24 hour care and child care homes and centers.
B. Not include abuse or neglect that occurs in public, private, and parochial schools and preschools operated in connection with those schools, except when those schools provide extended day services and abuse or neglect occurs during that time. Those instances shall be considered as institutional abuse and investigated accordingly.
C. Be the responsibility of the county department of social services in which the facility named in the report is located.
D. Be conducted in those cases in which an allegation of abuse or neglect is made. A report of a minor injury resulting from physical restraint shall not, by itself, require a full investigation unless there are surrounding circumstances that would indicate abusive or neglectful behavior by the care provider. Such circumstances include those reports in which someone is specifically alleging the behavior to be abusive or those reports in which there has been a pattern of frequent injuries by the same caretaker or of similar incidents in the same facility.
E. Be conducted by a qualified and disinterested party in those situations in which the county department is the supervisory agency, such as for certified county foster and group homes. Such an investigation shall be arranged for by the responsible county department with either another county department, another agency within the community who accepts delegated responsibility, or a disinterested and qualified staff person within the county department.
F. Be initiated within 24 hours to determine the child/ren's safety. Children must be seen within 24 hours.
G. Include notification within one working day after receipt of the referral to the licensing authority or certifying unit regarding the receipt of a child maltreatment referral in an out-of-home or day care setting.
H. Include in the initial assessment as much of the following information as possible from the reporting party and records:
I. Be investigated in the following manner:
J. Require notification of:
K. Require the submission of a written report by the investigating county within 60 calendar days after the initial receipt of the report of child abuse or neglect:
7.202.54 Third Party Abuse or Neglect Report Requirements
Third party abuse or neglect reports shall:
A. Include any reports of abuse or neglect by a person who is not relating to the child in the contexts described in the previous intrafamilial or institutional abuse sections.
B. Be forwarded immediately by the county department to the appropriate law enforcement agency for screening and investigation in all cases in which the abuse or neglect was by a third party age ten or over.
In those cases in which the person allegedly responsible for an incident of child abuse or neglect is under the age of 10, the county department shall be the agency responsible for the investigation. The investigation shall focus on whether abuse occurred, and if so, identifying the service needs of the victim. In addition, it shall assess whether the person allegedly responsible for child abuse or neglect has been the victim of abuse, and if so, what interventions are necessary to secure safety and address treatment needs.
C. Be followed by receipt by the county department of a copy of the report summarizing the investigation that was conducted by law enforcement. The investigation report shall be the basis upon which the county department enters a confirmed report of child abuse or neglect into the State Department's automated system pursuant to Section 7.202.6.
7.202.55 Conclusion of Investigation
A. An investigation shall be completed within 30 calendar days of date the investigation/assessment was assigned, unless there are circumstances which have prevented this from occurring. Such circumstances shall be documented in the case record.
B. Upon completion of an investigation, the county department shall report the outcome of the investigation on the Department's automated reporting system.
C. Services provided beyond 60 calendar days of the receipt of the report shall be open for services based on either court involvement or the family's agreement to accept services.
D. Regardless of the outcome of the investigation and as allowable by law, the county department shall notify:
1. The involved child's family of the outcome of the investigation;
2. The person alleged to be responsible for the abuse or neglect of the outcome of the investigation; and, 3. Where applicable, its local licensing unit, the director or administrator of the facility, the agency with licensing or certifying authority and the State Department of Human Services' Division of Child Welfare and Division of Child Care, if the abuse or neglect investigation involved a state-licensed or county-certified facility.
7.202.6 REQUIREMENTS CONCERNING COUNTY ENTRY OF CONFIRMED REPORTS OF CHILD
ABUSE AND NEGLECT INTO THE STATE AUTOMATED SYSTEM A. When the county investigation of a report of suspected child abuse or neglect results in a confirmed finding of child abuse or neglect by a preponderance of evidence, the county department shall enter the confirmed report of child abuse or neglect to the State Department's automated system no later than 60 calendar days after receipt of the complaint.
B. The county department shall notify the local law enforcement agency and the District Attorney's Office. No other entity shall receive notification unless otherwise authorized by law.
C. The county department shall notify the person confirmed as responsible for child abuse or neglect of its finding by first-class mail to the responsible person's last known mailing address, using a form approved by the State Department.
The county department shall retain a copy of the notice in the case file reflecting the date the notice was mailed.
At a minimum, the notice shall include the following information:
1. How to access the county's dispute resolution process, pending a State appeal. Counties are authorized to offer a county dispute resolution process to persons alleged to be responsible for an incident of child abuse or neglect.
2. The notice shall include the type and severity level of the of abuse or neglect, date(s) of the incident(s), the date the incident was reported to the county department, which county department filed the report, the date the county confirmed the report in the State Department's automated system, and information concerning persons or agencies that have access to the report.
3. The circumstances under which information contained in the State's automated system will be provided to other individuals or agencies.
4. The right of the person confirmed to request a review of the county's confirmed report and record, and if supported by the county's record, to have the Administrative Law Judge enter an initial decision recommending that the State Department reverse, modify or uphold the county department's confirmed report.
5. The confirmed individual's right to a State level fair hearing before an independent administrative law judge at which the State would bear the burden of proof, if the individual disagrees with the entry of the confirmed report in the State Department's automated system.
6. Notice that the scope of the appeal is limited to disputing the accuracy of the report entered into the State Department's automated system and that the State Department will be responsible for defending that action at the State level fair hearing.
7. A full explanation of all alternatives and deadlines contained in Section 7.202.6, D.
D. The person found to be responsible for child abuse or neglect will have ninety (90) days from the date of the county's notice to request State level review of the county department's decision. Failure to request State review within this ninety-day period without good cause shall be grounds for dismissing the appeal and waiver of further administrative remedies. If the person timely requests State level review, the State Division of Administrative Hearings shall send, within five (5) calendar days, a written request to the county department for copies of all materials that the county secured during the investigation of abuse or neglect that were the basis for the county's decision to confirm the report.
The administrative review and appeal process must be initiated by the person responsible for child abuse or neglect or his/her legal representative. If the individual is a minor child, the appeal may be initiated by his/her parents, legal custodian, or legal representative. The report shall remain confirmed until a final agency decision is rendered.
E. Review by the State Department of Human Services, Office of Appeals of the initial decision of the administrative law judge and the hearing record shall be conducted pursuant to State rules at 9 CCR 2503-1, Sections 3.850.72 and 3.850.73 governing Office of Appeals review of financial assistance programs.
1. Review shall be conducted by a State adjudicator in the Office of Appeals not directly involved in any prior review of the county report or record being appealed.
2. The final agency decision shall advise the appellant/petitioner of his/her right to seek judicial review in the State District Court, City and County of Denver.
F. Upon confirmation of the allegation(s) of abuse, neglect, or sexual abuse, the county department shall use the following definitions when determining the severity of the incidents:
1. Abuse:
Severe - excessive or inappropriate force used resulting in a serious injury which requires medical attention or hospitalization;
Fatal - excessive or inappropriate force used resulting in a child's death.
2. Neglect:
Medium - physical or emotional needs of child are inadequately met resulting in some impairment in the child's functioning;
Severe - physical or emotional needs of child are not met resulting in serious injury or illness;
Fatal - physical or emotional needs of child are not met resulting in death.
3. Sexual abuse:
7.202.601 Confirmed Reports of Child Abuse or Neglect
When the investigation of a report of suspected child abuse or neglect results in a confirmed finding of child abuse or neglect by a preponderance of evidence, the county shall enter the confirmed report to the State Department's automated system.
7.202.602 Definitions Applicable to Confirmed Reports of Abuse and Neglect Entered into the State Department's Automated System In addition to the definitions set forth in Section 7.202.3, the following definitions are applicable to the submission of confirmed reports of abuse and neglect by the county department to the State Department as prescribed herein:
A. “Severity level” means the assessment of the harm to the child victim or the act of abuse or neglect as minor, medium, severe or fatal as defined in these rules. Upon confirmation of the allegation(s) of abuse, neglect, or sexual abuse, the county department shall use the following definitions when determining the severity of the incidents:
7.202.603 Entering Confirmed Reports of Child Abuse or Neglect
When the investigation of a report results in a confirmed finding of child abuse or neglect by a preponderance of evidence, the county department shall enter the confirmed report into the State Department's automated system in a manner prescribed by the State. The county shall enter the confirmed report even if there is a criminal or civil proceeding pending against the person responsible arising out of the same incident. The reported data shall include the following:
A. The name, address, sex, date of birth and race of the child(ren) victim(s);
B. The composition of the victim's immediate family;
C. At a minimum, the name and last known mailing address of the person confirmed to be responsible for the child abuse or neglect, and the date of birth and Social Security Number, if known;
D. The type of abuse or neglect;
E. The severity of the abuse or neglect;
F. Any previous incidents of child abuse or neglect of child or siblings;
G. The name(s) and address(es) of any person(s) responsible for previously confirmed abuse or neglect, if known;
H. The name of the source of the report submitted to the county department, if known;
I. The county department that investigated the report;
J. The date the suspected abuse or neglect was reported to the county department, and the date the county department confirmed the abuse or neglect.
7.202.604 Reports Confirmed Prior to January 1, 2004
In the event that an individual was confirmed by the county department prior to January 1, 2004, as having been responsible for child abuse or neglect, the individual shall be afforded the opportunity to request expungement of the report to the State Department within the time period set forth in the notice, if such time period is different from the period prescribed in these rules for confirmed reports submitted on or after January 1, 2004. The appeal process set forth in this section shall apply to such appeals.
7.202.605 State-Level Appeal Process
A. The grounds for appeal shall consist of the following:
1. The findings are not supported by a preponderance of evidence; or, 2. The actions ultimately found to be abusive or neglectful do not meet the statutory or regulatory definitions of child abuse or neglect by a preponderance of the evidence.
B. The person confirmed to be responsible for committing child abuse or neglect shall have ninety (90) calendar days from the date of the notice of confirmed finding to appeal the finding in writing to the State Department of Personnel and Administration, Division of Administrative Hearings. The written appeal shall include a statement detailing the basis for the appeal. The appellant must specify whether he or she is requesting a record review or fair hearing.
C. If the appeal is filed more than 90 days from the date of the notice of confirmed finding, the appellant must show good cause for not appealing within the prescribed period.
D. The Division of Administrative Hearings shall conduct the appeal in accordance with Section 24-4-105, C.R.S., and the Division's Administrative Hearing policies and procedures (1 CCR 104-1).
E. A telephonic hearing may be conducted as an alternative to a face-to-face hearing unless the appellant (i.e., person appealing the county action) requests a face-to-face hearing in writing. The written request for a face-to-face hearing must be filed with the Division and the other party at least ten (10) calendar days before the scheduled hearing.
F. The appellant shall have the right to appeal and a fair hearing even if a dependency and neglect action or a criminal prosecution for child abuse is pending arising out of the same report.
G. The administrative law judge shall enter an initial decision for review by the State Department of Human Services, Office of Appeals no later than 120 calendar days following receipt of the appeal.
H. Office of Appeal review of the initial decision and hearing record and entry of the final agency decision shall be pursuant to State rules at 9 CCR 2503-1, Sections 3.850.72 - 3.850.73.
I. If the appellant seeks judicial review of the final agency decision, the State Department shall be responsible for defending the final agency decision on judicial review.
J. In any action in any court challenging a county's confirmed report of child abuse or neglect, the State Department will defend the statutes, rules and State-mandated procedures leading up to the confirmation, and will defend all county actions that are consistent with statutes, rules and State- mandated procedures.
The State shall not be responsible for defending the county for actions that are alleged to be in violation of, or inconsistent with, State statutes, State rules or State-mandated procedures.
7.202.606 Confidentiality of Appeal Records
All records submitted by the parties as part of the State level appeal process and all notices, orders, agency notes, final agency decisions, created by or made part of the State Department's agency record shall be confidential and shall not be released or disclosed unless such release or disclosure is permitted by the applicable State statutes or Section 7.000.72 of these rules.
7.202.61 Child Protection Teams
A county department of social services receiving 50 or more reports of child abuse and neglect per year shall have a multi-disciplinary child protection team in accordance with Sections 19-1-103(22) and 19-3- 308(6), C.R.S.
7.202.62 Provision of Ongoing Child Protection Services
A. Ongoing child protection services shall be based on the safety and risk issues identified in the family social history and assessment summary in the Family Services Plan. Services shall be provided to protect the child(ren) from further abuse or neglect and to preserve the family, when this can safely be accomplished. When the family from whom the child(ren) were removed cannot safely be preserved, services shall be provided that preserve the child(ren)'s continuity within the extended family and/or home community when feasible. When the child(ren) cannot safely return to the family from whom they were removed, services shall be provided to achieve an alternative permanent plan.
B. The county department shall complete the safety assessment prior to reunification, prior to case closure, and whenever circumstances indicate. When safety concerns are identified in the safety assessment, the county departments shall assure that there is a current safety plan.
C. The county department shall complete the Colorado family risk reassessment every six months, counted from the date of completion of the Family Services Plan and prior to case closure, on all Program Area 5 cases that have remain home or reunification as the permanency goal identified in the automated system. The Colorado family risk reassessment shall address the following factors:
1. Number of children in household.
2. Age of youngest child in household.
3. Occurrences of a child protection substantiated or inconclusive investigation since the initial risk assessment or most recent reassessment that was not prompted by an investigation.
4. Current use of controlled substances by caretaker(s).
5. Disruptive/volatile relationships in the household.
6. Caregiver ability to provide physical care/supervision to children.
7. Primary caregiver's use of treatment/training programs.
8. Secondary caregiver's use of treatment/training programs.
D. Monthly Contact 1. The county department shall have at least monthly face-to-face or telephone contact with the child(ren) and parent or parent surrogate when children are in their own home, as required by Section 7.001.6, A. This contact must be documented in the case file. If monthly direct client contact is impossible due to particular case circumstances, those circumstances, how contacts shall occur, and how the county department shall monitor progress shall be documented on the Family Services Plan.
2. The county department shall have at least monthly face-to-face contact with children placed out of their own home as required by Section 7.001.6, B. If monthly face-to-face contact with these children is impossible due to the child's location out of state or other particular case circumstances, those circumstances, how contacts shall occur, and how the county department shall monitor progress shall be documented on the alternative agency contact agreement. (See Section 7.001.6, F, for contact exceptions.) E. The county department shall provide courtesy supervision services when requested by another county or state when there is court jurisdiction and such services must continue in order to protect the child. In cases where there is no court jurisdiction, the receiving county shall conduct an assessment to determine if services are needed in order to protect the child. Services shall be provided if indicated.
F. If a child protection service client for whom services are still needed moves to another county or state, the county or state of current residence should be notified within ten days and provided with written appropriate, relevant information. Change in venue procedures as outlined in Section 7.304.4, E, shall be followed. If there is no court order for services, the receiving county shall provide outreach and assessment services up to 60 calendar days. If during the 60 calendar days period it is determined that further services are not indicated or the family is unwilling to accept services, the receiving county shall close the case.
G. All Program Area 5 cases shall remain in that program area as long as the child is at risk for abuse/neglect and the case plan is to reunify the family. Cases on appeal for termination of parent-child legal relationship shall remain in Program Area 5 until the termination is finalized.
7.202.7 SPECIAL CATEGORIES OF INVESTIGATIONS
7.202.71 Investigation of Reports of Medical Neglect of Infants with Disabilities Definitions A. “Withholding of Medically-Indicated Treatment” - means the failure to respond to the infant's life- threatening conditions by providing treatment (including appropriate nutrition, hydration, and medication) that, in the treating physician's reasonable medical judgment, will be most likely to be effective in improving or correcting all such conditions. The term does not include, however, the failure to provide treatment to an infant (other than appropriate nutrition, hydration or medication) when, in the treating physician's (or physicians') reasonable medical judgment any of the following circumstances apply:
1. The infant is chronically and irreversibly comatose;
2. The provision of treatment would merely prolong dying, not be effective in improving or correcting all of the infant's life-threatening conditions, or otherwise be futile in terms of the survival of the infant;
3. The provision of treatment would be virtually futile in terms of the survival of the infant and the treatment itself under such circumstances would be inhumane.
B. “Reasonable Medical Judgment” - is a medical judgment that would be made by a reasonably prudent physician, knowledgeable about the case and the treatment possibilities with respect to the medical conditions involved.
C. “Infant with a Disability” - is a child less than one year of age who was born with a life-threatening condition and who may have additional non-lethal physical or mental disabilities. The definition includes children over the age of one year who have been continuously hospitalized since birth, who were born extremely premature, or who have a long-term disability. These procedures do not imply that treatment should be changed or stopped when an infant reaches one year of age. The primary population to be addressed in these regulations is that of the hospitalized infant. Any other situations involving medical neglect of children will be provided for under the existing protections of the Colorado Children's Code regarding medical care of children.
D. “Designated Hospital Liaison” - is the person named by the hospital or health care facility to act as the contact with the county department in all aspects of cases of suspected withholding of medically- indicated treatment from infants with disabilities and with life-threatening conditions.
E. “Hospital Review Committee (H.R.C.)” - is an entity established to deal with medical and ethical dilemmas arising in the care of patients within a hospital or health care facility. Where they exist, the committee may take many organizational forms, such as an “infant care review committee” or an “institutional-bioethics committee.” The functions for a committee may differ from institution to institution, including the authorization to review and recommend treatment in specific cases.
7.202.72 County Procedures for Investigation of Reports of Medical Neglect of Infants with Disabilities A. The county department responsible for coordinating the investigation of a report of medical neglect shall be the county in which the parents of the hospitalized infant reside. If the parent's residence cannot be determined, the county department in which the hospital is located shall assume responsibility.
B. The county department shall work with medical organizations, hospitals, and health care facilities to implement procedures that ensure a timely response and resolution of reports of medical neglect. To that end, it shall contact each appropriate health care facility in the county to obtain the name, title, and telephone number of the designated hospital liaison. At least annually, this information is to be updated by the county department. The county department also shall be responsible for coordination with any existing hospital review committees, which may have evaluated and recommended treatment in the case under investigation.
C. County department staff assigned to the investigation of a medical neglect report shall make no medical decisions regarding the infant and shall seek an independent medical consultation when indicated.
Should the parent(s) wish to seek a second medical opinion, the county department shall provide referral assistance.
If the county department finds that an independent medical evaluation is necessary to determine the infant's medical prognosis, the county department shall recommend to the parent(s) of an infant with a disability that an independent medical evaluation be done.
D. in all medical neglect reports, the county department shall obtain all relevant medical data concerning the child. The county department shall seek a court order to obtain records if the request for such material is refused.
E. The county department shall advise promptly the State Division of. Child Welfare Services of all medical neglect reports involving infants with disabilities. The contact persons at the State will be the Child Protection Specialists.
7.202.72 County Procedures for Investigation of Reports of Medical Neglect of Infants with Disabilities (continued)
F. If after assessing the medical neglect report there are indications that the report of medical neglect may be founded, the county department shall interview the parent(s).
G. If the county department determines that medically-indicated treatment or palliative care is being or will be withheld, and (1) the child's condition requires an urgent response, or (2) efforts by county department or hospital personnel to obtain parental consent to treatment would be futile or already have failed, then the matter shall be brought to court under a petition. The petition shall be a request to the court to place temporary custody of the child with the county department to ensure proper medical treatment is provided. The county department shall immediately contact the department's attorney when such a court order is required.
H. In cases in which the infant has died before the investigation is completed and the county department has reason to suspect that medically indicated treatment was withheld, the matter shall be referred to the law enforcement agency in the location where the child died. If it is determined that treatment was not medically indicated, or that medically- indicated treatment had not been withheld, then the report shall be deemed unfounded.
7.202.73 Ongoing Services for Cases of Medical Neglect of Infants with Disabilities The county department shall make available the following services:
A. Monitoring Court-Ordered Treatment When either the court has ordered or the parent(s) have agreed upon a course of treatment, the county department shall monitor developments to ensure this treatment is provided. When there is a failure to provide treatment, the county department shall notify the court and immediately petition the court to take appropriate action.
B. Coordinating With Other Resources The county department shall contact agencies that provide services to child/ren with special needs, and help the parents with referrals to appropriate agencies that provide services for infants with similar disabilities and for their families. Referrals shall be made to agencies with financial resources for costs of medical and rehabilitative services. Information shall be provided regarding parental support groups and community educational resources. This information shall be made available, as is deemed appropriate under the circumstances, whether the county department has taken legal action or not.
7.202.74 Investigation of Medical Neglect in Which Religious Considerations are Involved A. The county department shall investigate cases of medical neglect including those cases in which there is a failure to provide medical treatment based upon the parent's, guardian's, or custodian's religious beliefs and there is concern that such failure will result in a threat to the child's health and welfare.
B. The county department shall obtain a medical evaluation if the child's condition presents substantial concern for the child's health and welfare. This evaluation shall be obtained with the consent of the parents, guardians, or legal custodians. If such consent is refused, the county department shall seek a court order to obtain a medical evaluation.
C. In consultation with medical practitioners, the county department shall consider whether the condition is life-threatening or will result in serious disability without professional medical care.
D. If the child's condition is determined to be life-threatening or could result in serious physical impairment, the county department shall seek a court order to ensure the provision of the necessary medical care in the event that such care is refused by the parent, guardian, or legal custodian.
E. Additionally, in those cases in which there is spiritual healing involved, the county department shall follow the guidelines defined in Section 19-3-103(2)(a), (b), C.R.S., to decide whether the method is a “recognized” method of religious healing and whether such healing is considered to be medically effective for the child's condition.
F. If it is determined that the situation is life-threatening or will result in serious disability without professional medical care, the county department shall contact the court for an order providing medical treatment for the child.
G. For purposes of entering confirmed reports of abuse or neglect into the State Department's automated system, reporting to police for criminal investigation, and filing of dependency and neglect petitions, no child who is under treatment by a recognized method of religious healing shall, for that reason alone, be considered to have been neglected or dependent unless the child's parent, legal guardian, or custodian inhibits or interferes with the provision of medical services according to court-ordered medical evaluation or treatment.
If a parent, guardian, or legal custodian inhibits or interferes with the provision of medical evaluation or treatment according to a court order, that act would constitute “neglect” and in such cases a report shall be made to law enforcement and the county department of social services may file a dependency and neglect petition.
7.202.75 Investigation, Reporting, and Review of Child Fatalities
Parameters:
The county department shall investigate child fatalities in intrafamilial and institutional settings in those cases in which:
A. There is reason to know or suspect that abuse/or neglect caused or contributed to the child's death.
B. The death is not explained or cause of death is unknown at the time of the child's death.
C. The history given about the child's death is at variance with the degree or type of injury and subsequent death.
7.202.76 Investigation Procedures
A. The county department shall coordinate with the following agencies: law enforcement, district attorney's office, coroner's office, and hospitals to ensure prompt notification of questionable child fatalities.
B. At a minimum in cases in which there are no surviving siblings, the county department shall provide law enforcement and the coroner with information related to any prior involvement with the child, the family, or the alleged perpetrator.
C. When there are surviving child/ren, the county department shall investigate the condition of those child/ren and shall take the action necessary to ensure their protection.
1. When assessing the condition of surviving child/ren who may be at risk, the investigation shall include the following activities:
2. When there are reasonable grounds to believe that a surviving child is at risk of emotional or physical harm in his/her home environment, the county department shall seek an emergency protective order.
7.202.77 Reporting to the State
A. Within 24 hours (excluding weekends and holidays) of a referral of either a suspicious child fatality or an unexpected fatality of any child currently in the custody of the department, the county department shall call the following information in to the State Department Child Protection Administrator:
1. Name and age of victim.
2. Known circumstances around the death.
3. Description of physical injuries or medical condition of the child/ren at the time of death.
4. Names and ages of surviving child/ren who may be at risk.
5. Brief description of the department's prior involvement with the family/caretaker, if any.
6. Actions taken by the county department to date and future actions to be taken.
7. Involvement of other professionals in the case.
B. The county department shall provide the state department's Child Protection Administrator a completed Child Fatality Report, on a form supplied by the state, within 45 calendar days of notification of the child's death, to the extent possible, and no longer than 60 calendar days without a written request for extension.
In addition to the Child Fatality Report, it shall provide the following information:
1. Copies of any pertinent social, medical, and mental health evaluations of all involved subjects (child/ren, family, caretakers, etc.).
2. Coroner's records, including autopsy report.
3. Police reports of present investigation as well as any prior criminal history of all subjects.
4. A copy of the case record If the county department has had past or current contact with the child prior to the child's death.
5. Report of county department internal review.
7.202.78 Additional Actions when County Department has had Prior/Current Case Services involvement A. When the county department has custody of the child and or protective supervision, it shall take the following actions:
1. Immediately notify the parent/caretaker of the child's death. If the parent/caretaker resides in another county or state, the county department shall coordinate with the county department of parents' or caretakers' residence to provide, whenever possible, personal notification.
2. Immediately notify the county department director of the death of a child in the department's custody, protective supervision, or when the department has had prior case service involvement within the last five years. A complete copy of the child's case record shall be made available to the county director within 24 hours of notification of a child's death.
3. Immediately notify the court, the attorney for the county department, and the Guardian Ad Litem (when one has been assigned) of the death of any child who is under the court's jurisdiction.
B. Upon notification of a child fatality in which the county department has had prior case services involvement with the child, family, or alleged perpetrator, the county department director shall take the following actions:
1. Designate an individual(s) who will be responsible for investigating the child's death. The assigned individual(s) shall not have had prior involvement in the case. In the event of a conflict of interest, the county department shall arrange for the investigation to be conducted by another county department of social services with personnel having appropriate training and skill.
2. Ensure that a complete internal administrative review of the county's involvement in the case before the child's death is conducted. This review shall be referred to as the Department Internal Review and shall be completed whenever the county department has had current or prior case services involvement within the last five years. The Review shall include, at a minimum:
3. Submit a written report of the department internal Review and Child Fatality Report within 45 calendar days of notification of the child's death to the State Department Child Protection Administrator.
C. If another county department also has had prior case services involvement within the five-year period, the State Department shall decide what reviews shall occur in that county department.
7.202.8 FATALITY REVIEWS
When a child fatality occurs, the county shall submit reports for review by the State Department in accordance with Sections 7.202.7 and 7.202.78 of this staff manual, and cooperate with the State Department's review. The State Department shall conduct a review of cases where the county was involved prior to the child's death.
7.203 PROGRAM AREA 6 - CHILDREN IN NEED OF SPECIALIZED SERVICES
7.203.1 DEFINITION OF PROGRAM AREA 6
To provide statutorily authorized services to specified children and families in which the reason for service is not protective services or youth in conflict. These services are limited to children and families in need of subsidized adoption or Medicaid only services, or to children for whom the goal is no longer reunification. The purpose of services in Program Area 6 is to fulfill statutory requirements in the interests of permanency planning for children. Children must meet specific Program requirements to receive services under these target groups.
7.203.2 CHILD WITH SUBSIDIZED ADOPTION
7.203.21 Target Groups
A. Children whose special needs are a barrier to their adoption, are legally free for adoption, and are in the custody of a county department of social services.
B. Children whose special needs are a barrier to their adoption, meet Title IV-E eligibility requirements, and are in the custody of a non-profit licensed adoption agency or living with a relative.
7.203.22 Intake/Assessment
Eligibility Requirements In order for a child to be eligible for subsidized adoption, all the following factors must be present at the time the child is placed for adoption:
A. The goal for the child is adoption and the court has determined that the child cannot or should not be returned to the home of his/her parents and all parent-child legal relationships are terminated.
B. The county department, agency, or relative requesting the adoption subsidy is financially responsible for the care of the child.
C. The county must determine that in each case a reasonable, but unsuccessful, effort to place the child for adoption has been made before providing a subsidy, unless the best interests of the child would not be served by such an effort. Where appropriate, the current foster family will be given priority as the prospective adoptive family. Reasonable effort requires listing with the Colorado Adoption Resource Registry and may include presentation in the media and consultation with the state.
D. Children who are in the custody of licensed non-profit private agencies or who are living with relatives must meet Federal IV-E eligibility requirements.
E. The child is one with “special needs.”
A “special need” is one or more of the following special, unusual, or significant factors that act as a barrier to the child's adoption:
1. Physical disability (such as hearing, vision, or physical impairment; neurological conditions; disfiguring defects; and, heart defects).
2. Mental retardation (such as developmental delay or disability, perceptual or speech/language disability, or a metabolic disorder).
3. Developmental disability resulting in educational delays or significant learning processing difficulties.
4. Educational disability which qualifies for Section 504 of the Rehabilitation Act of 1973 or special educational services.
5. Emotional disturbance.
6. Hereditary factors that have been documented by a physician or psychologist.
7. High risk children (such as HIV-positive, drug-exposed, or alcohol-exposed in utero).
8. Other conditions that act as a serious barrier to the child's adoption. Conditions may include but are not limited to a healthy child over the age of seven or a sibling group that should remain intact and medical conditions likely to require further treatment.
7.203.23 Parameters
A. An adoption subsidy is a payment directly to the adoptive parent or parents to provide for the needs of an eligible adopted child. Case services may be paid directly to the providers of service or to the adoptive parent. A subsidy is intended to help, or remove financial barriers to, the adoption of Colorado children with special needs by providing assistance to the parent or parents in the payment of expenses of caring for and raising the child. Families applying for adoption of a child with special needs should be informed of the subsidized adoption program. The contact requirements in Section 7.001.6 shall be used prior to finalization and contacts shall be documented in the case file.
B. The county department may make subsidy payments at the time of adoptive placement and continue them after the adoption has been finalized.
C. Available public programs and insurance benefits for which the child is eligible shall be used first to address the child's needs before state subsidy payments are used. Subsidy is a program that provides assistance to adoptive parents in certain defined and limited ways for adoptive parents in financial and decision making responsibility and authority for their child.
D. Subsidy benefits may continue through the month of the child's 18th birthday or until age 21, when the county department has determined that the child has a developmental disability or physical disability which warrants continuation of assistance.
E. The county department shall not use state subsidy funds for any child 18 and over attending college.
F. The county department shall not use an income eligibility requirement (income means test) for the prospective adoptive parents in determining eligibility for subsidized adoption.
G. When a child is certified eligible for subsidy, the adoption worker must inform prospective adoptive parents of the availability of subsidy for the child. The amount of the subsidy shall be based on the child's need and the family circumstances.
7.203.24 County Requirements for Subsidized Adoption
A. If current foster home is not an appropriate resource, local adoptive homes should be used or studies should be requested from the counties licensed adoption agencies, in and out of state. If there are no available resources in the state pool, the child shall be registered with the Colorado Adoption Resource Registry (CARR).
B. The county department shall obtain and document the diagnosis and prognosis of the child's special needs that are a barrier to the adoption. The documentation shall include medical, psychological, psychiatric, or other appropriate reports. If the county department determines that the child is one with special needs for whom services will be purchased, it must confirm the special needs by a second opinion of a social worker, doctor, psychologist or mental health specialist who is outside the department.
C. The county department shall determine the child's eligibility for subsidized adoption and sign the subsidized adoption agreement before the adoption is finalized. There are situations after finalization when adoptive parents can request a state level Fair Hearing before an Administrative Law Judge concerning the adopted child's eligibility for Title IV-E Subsidized Adoption benefits or the amount of those benefits. These situations include, but are not limited, to:
1. Relevant facts regarding the child which were known and not presented to the adoptive parents prior to the finalization of the adoption;
2. Denial of assistance based upon a means test of the adoptive family;
3. Erroneous determination that a child is ineligible for adoption assistance; and, 4. Failure by the county department or a non-profit Child Placement Agency to advise adoptive parents about the availability of adoption assistance for children who have been identified with special needs;
5. Decrease in the amount of adoption assistance without the concurrence of the adoptive parents.
6. Denial of a request for a change in payment level due to a change in the adoptive parents' circumstances.
D. If a child is legally free and reunited with the birth parents, the child is not eligible for an adoption subsidy.
E. If the child meets the eligibility requirements the county department responsible for providing the adoption subsidy will approve the CW-SA-1-2 (Child's Application and Summary for Subsidized Adoption) and the CW-SA-3 (Subsidized Adoption Agreement).
7.203.3 CHILD WITH MEDICAID ONLY SERVICES
7.203.31 Target Groups
A. Children in foster care who have been determined IV-E eligible and have moved to Colorado.
B. Children for whom an adoption assistance agreement is in effect and who have moved in or out of Colorado.
C. Children eligible for Home and Community Based Services or Home Health Care Services as defined in Section 8.500 of the Department of Health Care Policy and Financing's Medical Assistance manual (10 CCR 2505-10). Children enrolled in the Home and Community Based- Developmentally Disabled Waiver Program administered through Community Centered Boards and the Department of Human Services, Developmental Disabilities Services, are not eligible for services in this target group.
7.203.32 Intake/Assessment
For children moving to Colorado, the county department shall:
A. Verify from the letter from the other state that the child is eligible for IV-E foster care from the state of origin.
B. Make two copies of the agreement, retaining one for the child's file and forwarding the other to the state department.
C. Complete the state prescribed form and assign a case number, indicating on the form that it is medical only.
D. Complete the Family and Children's Services-100 to obtain a Medicaid Card.
E. Notify the foster care provider using the SS-4 Form that the child is eligible for Medicaid only from Colorado. In addition, advise the provider to notify the county department if foster care is stopped by the originating state or of any change of address.
F. Verify annually from the state of origin that the child is eligible for Medicaid.
7.203.33 Procedures for Children Eligible for Home and Community Based Services or Home Health Care Services A. The county department shall open a case Home and Community Based when an application for Home and Community Based Services (HCBS) or Home Health Care Services is completed. The county department shall provide services as required in Section 8.500 of the Department of Health Care Policy and Financing's Medical Assistance manual (10 CCR 2505-10) for children in Home and Community Based Services or Home Health Care Services Programs.
B. The county department shall close the case on the Department's automated reporting system no later than the end of the month following the month that the child begins to receive services from the case management agency unless the child remains eligible for services under Program Areas 4 or 5.
7.203.4 CHILDREN WHOSE DISPOSITION IS NO LONGER REUNIFICATION WITH FAMILY
Children for whom all efforts at reunification with the family are exhausted. The parent-child legal relationship may or may not be terminated.
7.203.41 Eligibility
A. A child shall be eligible for services in this target group only if he/she has prior eligibility in another target group and has a permanent plan other than reunification.
B. Children in this target group shall receive services as addressed in the placement services, legal guardianship, relinquishment, independent living, and adoption sections of these rules. Contact requirements for these children shall be in accordance with Section 7.001.6. These contacts shall be documented in the case file.
7.203.42 County Department Procedures
A. The county department shall document in the case file all efforts at reunification for the children in this target group.
B. The county department shall ensure that the Family Services Plan contains a plan for permanent placement with a relative, adoption, legal guardianship/ permanent custody, or other planned permanent living arrangement, as appropriate (see Section 7.301.24, M).
C. When the permanent plan is not adoption the county department shall document in the case file why adoption is not appropriate.
7.203.5 YOUNG ADULTS WHO HAVE EMANCIPATED FROM FOSTER CARE
Participation in Independent Living programs is voluntary for this population of emancipated young adults, ages 18 to 21, who were in out-of-home care on their 18th birthday and who are in need of continuing support and services toward becoming self-sufficient.
7.203.51 Eligibility
Emancipated young adults, ages 18 to 21, who were in out-of-home care on their 18th birthday are eligible to receive independent living services to assist them as they continue the transition to adulthood. Services may include independent living assessment, case planning, transitional services, room and board, and other services as identified in the county Title IV-E Independent Living Plan (see Section 7.305).
7.203.52 County Department Procedures
A. The county department of social services shall document in the case file the independent living services provided.
B. The county department of social services shall complete the Independent Living Plan as a part of the Family Services Plan.
C. Minimum contact requirements are to be determined by the participant and caseworker, but shall be quarterly, face-to-face, at a minimum to determine appropriateness of services and continued need of the participant.