DEPARTMENT OF HUMAN SERVICES State Board of Human Services RULE MANUAL VOLUME 12 SPECIAL PROJECTS 12 CCR 2512-2 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] STATEMENT OF BASIS AND PURPOSE, FISCAL IMPACT AND SPECIFIC STATUTORY AUTHORITY OF REVISIONS MADE TO STAFF MANUAL VOLUME 12 Revisions to Sections 12.500-Concl. - 12.500.12, 12.500 12 - 12.500.14-Concl. were finally adopted following publication at the 5/2/86 State Board meeting, with an effective date of 7/1/86 (Document 7). 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 Section 12.600 was finally adopted following publication at the 2/6/87 State Board meeting, with an effective date of 4/1/87 (Document 8). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Revisions to Section 12.203 were finally adopted following publication at the 5/1/87 State Board meeting, with an effective date of 7/1/87 (Document 11). 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 12.700 - 12.704 was finally adopted following publication at the 11/6/87 State Board meeting, with an effective date of 1/1/88 (Document 2). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Addition of Sections 12.800 - 12.805.12 was finally adopted following publication at the 4/6/90 State Board meeting, with an effective date of 6/1/90 (CSPR# 90-1-24-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Deletion of Section 12.500 was finally adopted following publication at the 11/02/90 State Board meeting, with an effective date of 1/1/91 (CSPR# 90-8-23-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Addition of Section 12.900 was adopted emergency at the 11/2/90 State Board meeting, with an effective date of 11/2/90 (CSPR# 90-9-11-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Addition of Section 12.900 was final adoption of emergency at the 12/7/90 State Board meeting, with an effective date of 11/2/90 (CSPR# 90-9-11-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to Sections 12.200 through 12.203 were finally adopted following publication at the 2/7/91 State Board meeting, with an effective date of 4/1/92 (CSPR# 91-10-24-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Addition of Section 12.500 through 12.515 was adopted emergency at the 2/4/94 State Board meeting, with an effective date of 4/1/94 (CSPR# 93-10-15-1). 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.

Addition of Section 12.500 through 12.515 was adopted emergency and final at the 3/4/94 State Board meeting, with an effective date of 4/1/94 (CSPR# 93-10-15-1). 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 12.500 through 12.515 were final adoption following publication at the 10/7/94 State Board meeting, with an effective date of 12/1/94 (CSPR# 94-6-30-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Addition of Sections 12.100 through 12.111 were final adoption following publication at the 12/6/96 State Board meeting, with an effective date of 2/1/97 (CSPR# 96-9-11-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Sections 12.100 through 12.111 were re-promulgated as final adoption following publication at the 3/7/97 State Board meeting, with an effective date of 5/1/97 (CSPR# 96-9-11-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Addition of Sections 12.400 through 12.480 were adopted as emergency at the 8/4/2000 State Board meeting, with an effective date of 9/1/2000 (CSPR# 00-6-28-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, State Board Administration.

Addition of Sections 12.400 through 12.480 were adopted as emergency and final at the 9/8/2000 State Board meeting, with effective dates of 9/1/2000 and 9/8/2000 (CSPR# 00-6-28-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Office, State Board Administration.

Revisions to Sections 12.440 and 12.470 were final adoption following publication at the 2/2/2001 State Board meeting, with an effective date of 4/1/2001 (CSPR# 00-11-15-1). 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 Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Office, State Board Administration.

Revisions to Section 12.101.1, and addition of Section 12.120-12.120.5 were adopted following publication at the 5/2/2003 State Board meeting, with an effective date of 7/1/2003 (Rule-making# 03-02- 11-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Office, State Board Administration. Revisions to Sections 12.105.2 through 12.105.21 and addition of Section 12.105.22 were adopted as emergency at the 6/6/2003 State Board meeting, with an effective date of 7/1/2003 (Rule-making# 03-02- 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 Office, State Board Administration. Revisions to Sections 12.105.2 through 12.105.21 and addition of Section 12.105.22 were final adoption of emergency rules at the 7/11/2003 State Board meeting, with an effective date of 7/1/2003 (Rule- making# 03-02-13-1). 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 Office, State Board Administration. Deletion of Sections 12.300, 12.600, 12.700, 12.800, and 12.900, et seq., and replacement of Section 12.500, et seq., with a new program, were final adoption following publication at the 5/7/2004 State Board meeting, with an effective date of 7/1/2004 (Rule-making#s 04-2-19-1 and 04-3-5-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Office, State Board Administration.

Revisions to Sections 12.200 through 12.203.6 were final adoption following publication at the 12/2/2005 State Board meeting, with an effective date of 2/1/2006 (Rule-making# 05-08-25-1). 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 Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Office, State Board Administration.

Deletion of Section 12.105.22 was final adoption following publication at the 2/3/2006 State Board meeting, with an effective date of 4/1/2006 (Rule-making# 05-10-25-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Office, State Board Administration.

Revision of Section 12.540 and addition of Section 12.541 were final adoption following publication at the 1/5/2007 State Board meeting, with an effective date of 3/1/2007 (Rule-making# 06-8-24-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Office, State Board Administration.

Revision of Section 12.540 was adopted as emergency and final at the 6/6/2008 State Board meeting, with an effective date of 6/6/2008 (Rule-making# 07-11-13-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Boards and Commissions Division, State Board Administration. Eff. 07/30/2008 Re-write of Sections 12.200 through 12.203.6 were final adoption following publication at the 6/5/2009 State Board meeting, with an effective date of 8/1/2009 (Rule-making# 08-9-12-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Division of Boards and Commissions, State Board Administration. 12.100 COLORADO ELECTRONIC BENEFIT TRANSFER SERVICE (CO/EBTS) 12.100 COLORADO ELECTRONIC BENEFIT TRANSFER SERVICE (CO/EBTS) 12.100.1 AUTHORITY 12.100.11 Authority for the program is contained in Colorado Revised Statutes, Sections 26-2-104 and 26-1-122(2), as amended.

12.100.12 The Colorado Electronic Benefit Transfer Service (CO/EBTS) is intended to provide electronic benefit access, through use of a plastic debit card, to recipients of food assistance and public assistance programs. These programs include, but are not limited to, Food Stamps, Aid to Families with Dependent Children, Old Age Pension, Aid to the Needy Disabled, Aid to the Blind, and the Low-Income Energy Assistance Program. Through CO/EBTS, direct deposit payments will be made to providers of services for the Low-Income Energy Assistance Program, Child Care and Child Welfare (Subsidized Adoption and Foster Care) programs. Voucher payments (e.g., burial) will also be made by direct deposit. Other programs may be added as appropriate. Recipient payments will be made by direct deposit on a voluntary basis. Provision will be made for delivery of recipient payment of direct federal benefits by CO/EBTS. 12.101 GENERAL PROVISIONS 12.101.1 DEFINITIONS A. Automated Teller Machine (ATM)

An "ATM" is a device which dispenses cash and provides benefit inquiries. The equipment is activated by inserting a plastic magnetic stripe card and entering a personal identification number (PIN).

B. Cash Account A "cash account" is an authorization file maintained by the Colorado Department of Human Services on behalf of a cardholder from which withdrawal of cash benefits and purchase transactions are authorized.

C. CO/EBTS Contractor The "CO/EBTS contractor" is a private company hired by the Colorado Department of Human Services. The contractor will be responsible for operation of the CO/EBTS system including, but not limited to, card production, transaction processing, equipment installation/maintenance, customer service, conversion training, and account settlement. D. Correcting Debit A "correcting debit" is an action taken by a retailer to correct a system error. E. CO/EBTS Conversion "CO/EBTS conversion" is the project implementation period during which food stamps and public assistance recipients change over from receiving benefits through food coupons and warrants to accessing their benefits through CO/EBTS debit card transactions at authorized retailers' point-of- sale (POS) terminals and at automated teller (ATM) machines. Also, providers will begin receiving direct deposit payments, electronically transmitted to make accounts, rather than warrants. F. Debit A "debit" is a transaction initiated by the cardholder at a terminal with use of a PIN resulting in a deduction against the balance of the cardholder's account, which has been credited by the value and category of public assistance benefits authorized.

G. Direct Deposit "Direct deposit" is the process by which the Colorado Department of Human Services credits a client's or provider's bank account upon authorization by the Colorado EBTS program. H. Electronic Benefit Transfer Service (EBTS)

"EBTS" is the delivery of government benefits and payments through electronic means and equipment.

I. Food Stamp Account A "food stamp account" is an authorization file maintained by the Colorado Department of Human Services on behalf of a cardholder from which food stamp purchases at approved merchants are authorized.

J. Food Stamp Transaction A "food stamp transaction" is authorized from a food stamp account in which the entire transaction amount is for the purchase of food at an approved merchant in accordance with the Food Stamp Program. A food stamp transaction must not include cash back. K. Encryption "Encryption" is the process which protects PIN data by altering the information to make it unrecognizable. These data are encrypted before transmission over communications lines rendering them unintelligible.

L. Personal Identification Number (PIN)

The "PIN" is a four to six digit secret number or word either selected by the cardholder or randomly assigned by the card processor. The PIN is used by the cardholder to initiate an EBTS transaction.

M. Point of Sale (POS) Terminal "POS" terminals are electronic devices located at retail outlets through which cardholders can conduct EBTS food stamp and cash transactions by swiping their card and entering their PIN on a key pad.

N. Primary Account Number (PAN)

The "PAN" is a number embossed on the front of the debit card, by the card issuer, which identifies the cardholder.

O. Retailer "Retailer" is the commercial location, such as a grocery store or automated teller machine, where the EBT cardholder redeems food or cash benefits.

P. System Error A "system error" is an auditable processing failure at any point in the EBT redemption process that results in the improper crediting or debiting of an account or in the failure to credit or debit an account.

Q. Transaction A "transaction" is an electronic interchange at a point of sale device or ATM resulting in the exchange of financial information concerning a recipient account. 12.102 ACCOUNT SET-UP The county department of social services shall input account set-up data into the various CDHS systems, using state department established file formats and data layouts, to facilitate system transmission of account set-up records to the CO/EBTS contractor. County departments may opt, particularly in emergency cases, to transmit account set-up files on-line directly to the CO/EBTS contractor. 12.103 CARD/ PIN ISSUANCE AND ACCOUNTABILITY The county department of social services shall establish secure procedures for issuance of CO/EBTS debit cards and personal identification numbers. County departments may issue a card at the initial client interview, but under no circumstance shall a card for a non-expedited case be issued later than 30 calendar days after the application date.

12.103.1 OVER-THE COUNTER ISSUANCE 12.103.11 Card Stock Each county department of social services shall maintain the capability to issue cards on-site at its primary location and satellite offices. The CO/EBTS contractor will provide counties with an initial supply of sequentially numbered cards containing pre-embossed primary account numbers; county departments must reorder cards from the CO/EBTS contractor as needed to ensure an adequate supply at all times. 12.103.12 PIN Selection The county department of social services shall issue PINs through encryption devices supplied by the state department. Recipients shall select their own PINs when cards are issued over-the-counter. 12.103.13 Expedited Issuance The county department of social services shall issue CO/EBTS debit cards no later than the sixth day after application for recipients entitled to expedited benefits/payments as defined by specific program rules.

12.103.2 MAIL ISSUANCE The county department of social services shall initiate issuance of cards and PINs through the mail during CO/EBTS conversion by submitting account set-up files to the CO/EBTS contractor. The county department may request mail issuance on a case-by-case basis thereafter by entering a positive mail indicator in the account set-up file transmitted to the CO/EBTS contractor. After conversion, county departments may request mail issuance in those situations where in-person issuance would constitute an inconvenience to the recipient. County departments may also mail cards/PINs to clients residing a distance from the issuance site such that transportation would constitute a hardship.

12.104 REPORTS OF LOST, STOLEN CARDS AND UNAUTHORIZED USE The county department of social services shall facilitate de-activation of CO/EBTS debit cards reported by cardholders to be lost, stolen, or used by unauthorized parties. Upon receiving such a report, the county department may instruct the recipient to phone the CO/EBTS contractor's customer service line to report the incident and request card de-activation. If the recipient cannot or refused to call, the county department shall immediately report the incident and request card de-activation to the CO/EBTS contractor customer service representative on behalf of the recipient. 12.105 CARD REPLACEMENT The county department of social services shall replace CO/EBTS debit cards for eligible recipients when cards are reported to be lost, stolen, or non-functioning. County departments may issue replacement cards over-the-counter or through a transmission to the CO/EBTS contractor requesting mail issuance. 12.105.1 CARD REPLACEMENT TIME LIMIT The county department of social services the recipient. This may be accomplished by either over-the- counter or mail issuance. The shall replace cards within three working days of notification by CO/EBTS contractor is required to deliver replacement cards to the post office no later than 3:00 p.m. the day after a request is received for a mail issued card replacement. 12.105.2 FEES 12.105.21 Card Replacement Fees The county department of social services may charge recipients $2.00 for each over-the-counter card replacement. Counties shall not charge a fee if the replacement is issued by mail, the original card is inoperable due to no fault of the cardholder, or if the recipient is being re-certified for benefits and destroyed, lost, or damaged the original card during the inactive period. The county department shall not collect replacement fees by debiting a recipient's food stamp account. Counties may collect replacement fees by debiting the recipient's cash account through a county POS terminal or by a card holder cash, check or money order payment. The county department shall maintain records of card replacements including the date a new card was requested, the replacement reason, the amount of any fee assessed and the method of collection. The county department shall maintain records of card replacements including the date a new card was requested, the replacement reason, the amount of any fee assessed and the method of collection. [ ] 12.106 PIN REPLACEMENT The county department of social services shall provide cardholders with the opportunity to change PINs. PIN replacements may be issued over-the-counter or by mail through the CO/EBTS contractor. Add eff. 2/1/97 12.107 DIRECT DEPOSIT Eligible recipients, or their designated payees, may elect to receive cash payments through direct deposit to an account at their financial institution. Direct deposit application forms and envelopes will be provided to county offices. The county department of social services shall inform cash assistance recipients of the availability of direct deposit, provide informational materials, and application forms. County offices shall assist recipients or payees in providing bank account information to allow for direct deposit. Add eff. 2/1/97 Counties shall issue a debit card to each new recipient and inform the recipient that he/she will access at least the first payment through the debit card.

12.108 AUTHORIZED REPRESENTATIVES An eligible recipient may designate an authorized representative to receive a CO/EBTS debit card and PIN. Separate cards, primary account numbers, and PINs shall be issued to the eligible recipient and the authorized representative. The authorized representative shall have the ability to access food and/or cash benefits on behalf of the eligible recipient as provided by program regulations. Add eff. 2/1/97 12.109 CLIENT TRAINING The county department of social services may conduct client training through the mail or on-site in local offices. Add eff. 2/1/97 12.109.1 LOCAL OFFICE TRAINING The county department of social shall provide facilities within each food stamp/social services office to conduct on-site CO/EBTS client training. Add eff. 2/1/97 12.109.11 CO/EBTS Trainees The county department of social shall conduct on-site CO/EBTS training in local offices for eligible post- conversion food stamps and cash assistance recipients. Add eff. 2/1/97 12.109.12 Training Content The county department of social services shall conduct training in a manner prescribed by state department procedures. Add eff. 2/1/97 12.109.13 Written Training Materials The county department of social services shall distribute written training materials, produced by the CO/EBTS contractor, to CO/EBTS recipients. These materials will include, but not be limited to, a pamphlet and a fact card. All written training materials will be available in Spanish and English and be at no higher than a fifth grade reading level. Add eff. 2/1/97 12.109.14 Other Client Assistance The county department of social services shall provide other client assistance, which the county department deems necessary, such as orientation classes, question and answer sessions, and “hands- on” card usage instructions. Counties shall identify special needs clients (e.g., blind, illiterate, disabled) and “customize” training to the needs of these individuals. Rev. eff. 5/1/97 12.109.2 MAIL TRAINING 12.109.21 Conversion The county department of social services shall update CDHS automated systems with the most current food stamp recipient, cash assistance recipient, substitute payee, and conservator addresses no later than two months before that county's conversion to CO/EBTS. The CO/EBTS contractor will mail debit cards, PINs, and written training materials to each current recipient one month before conversion. 12.109.22 Ongoing The CO/EBTS contractor will include written training materials with all CO/EBTS card mailings. The county department of social services shall transmit a positive mail indicator to the contractor for any recipient the county wishes to have the CO/EBTS card, PIN, and training materials issued by mail. 12.110 PROVIDER PAYMENTS 12 .110.1 COUNTY RESPONSIBILITIES 12.110.11 Conversion The county department of social services shall update provider information (e.g., name, address, mailing address, and provider tax identification number) contained within the various Human Services automated systems no later than four months prior to CO/EBTS conversion in that county to facilitate transition to direct deposit provider payments.

12.110.12 Ongoing The county department of social services shall enter all provider information into the appropriate automated system immediately upon a provider's approval to deliver program services. The county department shall give each prospective provider a direct deposit form requesting the provider's bank account number and supporting documentation. The provider must then submit the bank account information in order to receive direct deposit payments when and if the provider is approved to deliver services. The county department shall also give the provider written materials explaining the direct deposit payment procedure. County departments must maintain the ability to enter data related to provider bank account numbers into the various Human Services automated systems for transmission to the CO/EBTS contractor.

12.110.2 STATE RESPONSIBILITIES The State Department will transmit provider information through the various Human Services automated systems to the CO/EBTS contractor. Transmissions will take place during conversion and on an ongoing basis as new providers are added.

12.111 EXPUNGED BENEFITS Food stamp benefits will be automatically expunged, or cancelled, after 270 days of no recipient account activity (food purchases or benefit inquiries); cash benefits will be expunged after 90 days of no recipient account activity (purchases, withdrawals, benefit inquiries). County staff may re-start the time period for any recipient in a manner prescribed by the State Department. 12.120 EBT CONTRACTOR ACCOUNT ADJUSTMENTS 12.120.1 EBT CONTRACTOR ACCOUNT ADJUSTMENT AUTHORITY The EBT contractor, on behalf of impacted retailers, may adjust EBT cardholders' food or cash accounts through correcting debits to recoup SYSTEM error funds. 12.120.2 EBT CONTRACTOR NOTIFICATION TO THE COLORADO DEPARTMENT OF HUMAN SERVICES The EBT contractor shall notify the Colorado Department of Human Services, through a claim activity file, of the intention to adjust a recipient's food and/or cash account. 12.120.3 CLIENT NOTICE OF RIGHT TO A FAIR HEARING A. any recipient shall be mailed a notice whose EBT account is to be adjusted by the EBT contractor, advising the recipient of the right to a fair hearing.

B. The notice shall stipulate:

1. The amount to be adjusted;

2. The name of the retailer;

3. The reason for the adjustment;

4. The date of the adjustment;

5. Procedures for requesting a state hearing; and, 6. The timeframe for requesting a hearing.

12.120.4 FAIR HEARING Any request for a State level fair hearing shall be in accordance with State Food Stamp rules, as found in Staff Manual Volume 4B (10 CCR 2506-1), Sections B-4410, B-4410.3, and B-4410.34. 12.120.5 ACCOUNT ADJUSTMENT TIMEFRAMES The EBT contractor may not adjust a recipient's EBT account for fifteen (15) calendar days from the issuance date of the fair hearing notice. If the recipient requests a fair hearing during this 15-day period, the EBT contractor is prohibited from adjusting the account until and unless the fair hearing disposition is rendered in the retailer's favor. After the 15-day noticing period has expired, or after a recipient appeal has been denied, the EBT contractor may adjust a recipient's current month or one future month's benefits. The EBT contractor may take no further adjustment actions if adequate funds are not available in either the month when the recovery action is initiated or in the subsequent month. 12.200 DOMESTIC VIOLENCE PROGRAM (DVP)

12.200 DOMESTIC VIOLENCE PROGRAM (DVP)

12.200.1 MISSION [Rev. eff. 8/1/09] The Colorado Department of Human Services (CDHS), Domestic Violence Program (DVP), is the lead authority for issues pertaining to domestic violence, as defined in Section 18-6- 800.3(1), C.R.S. Within CDHS, the DVP administers funding designated to intervene, prevent, and respond to domestic violence. 12.200.2 DVP ADVISORY AND FUNDING RECOMMENDATION COMMITTEES [Eff. 8/1/09] A. All members of the committees shall be persons knowledgeable in the field of domestic violence and approved by the CDHS Executive Director or designee.

B. No more than half of the membership of each committee shall be representatives of CDHS. C. Membership of the DVP Advisory Committee shall consist of at least one representative from the Colorado Coalition Against Domestic Violence and two funded entities, as defined in Section 12.200.4.

D. Membership of the DVP Funding Recommendation Committee shall consist of at least one representative from the Colorado Coalition Against Domestic Violence. E. Advisory Committee will provide insight, direction, and monitoring to the DVP. Toward this end, the Advisory Committee shall:

1. Guide the overall functioning of the DVP;

2. Advise the DVP regarding domestic violence policy development or legislative initiatives; 3. Advise the DVP on the composition of the Funding Recommendation Committee; 4. Develop processes to review Requests for Applications for funding requests; 5. Review grievances related to funding and contracts as outlined in Section 12.200.4; 6. Review appeals related to findings of non-compliance with DVP rules as outlined in Section 12.200.6 and give recommendations to the DVP;

7. Review formal complaints from concerned citizens regarding services delivered by funded entities as outlined in Section 12.200.7; and, 8. Approve programmatic and administrative standards for funded entities. F. The Advisory Committee shall develop and adopt written policies and procedures to minimally include the:

1. Purpose, as outlined above;

2. Committee structure;

3. Structure, membership, and duties for a DVP Funding Recommendation Committee. G. The Funding Recommendation Committee shall review responses to the Request for Applications and make recommendations for disbursement of funds.

12.200.3 ELIGIBILITY [Rev. eff. 8/1/09] A. Governmental and non-governmental entities, as follows, may be eligible for DVP funding: 1. Counties;

2. Cities and counties;

3. Cities;

4. Towns;

5. Municipalities;

6. Special districts;

7. Private nonprofit organizations or corporations; or, 8. Other community-based or community-oriented entities with a social service mission created for exclusive public use and providing services to victims of domestic violence and their dependants.

B. Eligible entities shall:

1. Develop a mission statement that declares a commitment to work toward the elimination of domestic violence, the provision of domestic violence intervention and prevention services, or educating the community regarding the issue of domestic violence; 2. Comply with the rules in Section 12.201;

3. Offer free and confidential emergency and crisis response services to victims of domestic violence and their dependants on a continuous basis, which shall minimally include one or more of the following:

a. Operation of a crisis telephone number accessible to the local community twenty-four (24) hours per day, seven days per week;

b. Availability of paid staff or volunteers who are able to respond to emergency crisis situations twenty-four (24) hours per day, seven days per week; or, c. Coordination of a or b, above, through a formal memorandum of understanding with one or more entities that also meet all DVP eligibility criteria and rules herein. 4. Develop policies to ensure that victims and their dependants are not required to attend a religious activity or instruction as a requirement to receive domestic violence services;

5. Document appropriate legal status or standing as a nonprofit or nongovernmental agency or corporation as required by Federal or Colorado law; 6. Develop written articles of incorporation and by-laws, as appropriate, to include a functioning board of directors or advisory committee, which provides oversight and governance; and, 7. Document evidence of compliance with applicable Federal, State, and local laws and regulations.

12.200.4 REQUEST FOR APPLICATION (RFA) REQUIREMENTS AND FUNDING AWARDS [Eff. 8/1/09] The DVP administers and distributes funds designated to the Colorado Department of Human Services for community-based programs that intervene, respond, and prevent domestic violence. These funds include, and are not limited to, the Federal Family Violence Prevention and Services Act formula grant, Temporary Assistance to Needy Families block grant, Colorado Domestic Abuse Fund individual state income tax contributions, and may also include other funds received by the Department for purposes of distribution to eligible entities.

A. The DVP will announce availability of funding through a Request for Application (RFA) and solicit responses to an RFA as required by the state.

B. Eligible entities that request funding from the DVP shall complete the RFA in its entirety. C. The RFA and announcement shall state the following:

1. Amount of funding available;

2. Purpose of funding;

3. Sources of funding;

4. Allowable and disallowable expenses;

5. State contracting requirements;

6. Timelines for RFA review process, funding determinations, and contract period; 7. Technical assistance available for the RFA instructions; 8. Funding grievance policy and procedures;

9. Instructions for completing the RFA; and, 10. Criteria used in evaluating RFAs.

D. In distributing funding, no less than seventy-five percent (75%) of funding available through the DVP shall be allocated to non-governmental entities.

E. The DVP staff and the Funding Recommendation Committee shall review all completed RFAs and recommend funding awards using the following criteria:

1. Ability to demonstrate eligibility for DVP funding;

2. Ability to abide by the RFA requirements and instructions; and, 3. Ability to comply with the rules outlined in Section 12.201. F. The DVP reserves the right to deny funding to any entity for failure to complete the RFA and/or adhere to all procedures and timeframes outlined in the RFA instructions. G. Funding award approvals are determined through the following process: 1. The Funding Recommendation Committee provides the recommendations to the DVP Director;

2. The DVP Director reviews and provides preliminary approval; 3. The Executive Director of CDHS or designee provides final review and approval; and, 4. The advisory committee is notified of final awards.

H. The Funding Recommendation Committee, the DVP Director, and the Executive Director of CDHS may reduce award requests based on dollars available.

I. Funding grievances 1. For purposes of these rules, a DVP funding grievance shall be defined as action taken by the DVP, which the griever believes to be unfair and warrants a formal grievance. 2. If an applicant feels that he/she has been incorrectly denied or reduced funding based on the requirements in Section 12.200.4, E, the applicant may file a grievance directly with the DVP director using the process outlined below.

3. Reductions in funding awards based on less available dollars are not grievance circumstances.

4. All grievances shall be submitted in writing within fifteen (15) business days after applicant knows, or should have known, of the facts giving rise thereto. 5. The DVP director shall conduct a preliminary review of the grievance and within ten (10) business days of receipt will issue a formal written response. 6. The preliminary review shall determine whether the alleged grievance meets the requirements for review: a denial or reduction in funding for not meeting one of the requirements in Section 12.200.4, E.

7. If the DVP director determines that the grievance meets the requirements for review, the supervisor for the DVP director, or designee, shall conduct a formal review and issue a formal written response within thirty (30) business days of the preliminary review. A copy of the written formal review shall also be sent to the DVP Advisory Committee. 8. The applicant may request a further review upon receipt of the formal review. The applicant may submit such a request in writing to the DVP Advisory Committee within fourteen (14) business days of the mailing of the formal review by mailing the request to the DVP director.

9. The DVP advisory committee shall review the grievance, the formal review, and any other materials provided by the applicant or the DVP director within sixty (60) business days of the request being received by the department and issue a response. 10. The DVP Advisory Committee shall issue a written opinion on the grievance. The opinion shall be submitted to the Executive Director of the Department or designee for review and approval. If no action is taken, the opinion becomes final within thirty (30) business days of submission to the Executive Director or designee, or the Executive Director or designee may modify, review or overturn the DVP Advisory Committee decision. 12.200.5 CONTRACT AND FUNDING [Rev. eff. 8/1/09] A. CDHS may enter into contracts or agreements for services with any entity eligible that meets the rules in Section 12.201.

B. All contracts shall be in the form prescribed by State Fiscal Rules 2-2 and 3-1 (1 CCR 101-1). C. Entities awarded a contract shall:

1. Agree to all terms and conditions as prescribed by the State Department; 2. Comply with contingencies associated with the contract; 3. Not sub-grant or sub-contract funds;

4. Collect and submit required statistical data and reports; and, 5. Invoice for allowable and approved expenses incurred; preferably monthly, but at least quarterly.

D. The DVP shall reimburse for expenses previously incurred by the funded program in accordance with the terms of the contract.

12.200.6 FUNDED PROGRAM MONITORING [Rev. eff. 8/1/09] A. Funded programs shall agree to comply and cooperate with DVP monitoring including, but not limited to, audits and on-site visits not less than once every four years to minimally include review of compliance with rules in Section 12.201.

B. Funded programs may be subjected to an emergency audit and/or on-site visit should conditions warrant such measures.

C. The DVP shall document all results of audits and on-site visits in a formal report made available to the funded program.

D. The DVP may take one or more of the following actions after an audit or on-site visit: 1. Develop a list of recommendations for programming or administrative improvements; and, 2. Require funded programs to provide updates regarding progress toward reaching recommendations.

E. The DVP may take one or more of the following actions after an audit or on-site visit where the funded program is found to be non-compliant with DVP rules in Section 12.201: 1. Place non-compliant programs on a corrective action plan, which is defined as a written document that establishes steps that a funded program must take to achieve compliance; 2. Temporarily restrict access to funding until compliance issues are remedied; or, 3. Deny further funding including current contract obligations if compliance is not reached, the corrective action plan fails, or DVP receives evidence of criminal wrongdoing. F. Appeals of decisions regarding corrective action plans, restrictions placed upon funding, or denial of funding:

1. For the purposes of these rules, an appeal is defined as an action that a funded program may take if the funded program disagrees with the terms of the corrective action plan. 2. All appeals shall be made in writing within thirty (30) business days of issuance of corrective plan or notification of funding restrictions or denials to the DVP director. 3. The DVP director shall issue a written decision to the program within sixty (60) days of notice of appeal.

4. Funded programs may appeal the DVP director’s decision to the DVP advisory committee within fifteen (15) days of notice of the decision.

5. The DVP Advisory Committee’s written decision shall be submitted to the Executive Director of the Department or designee for review and approval. If no action is taken, the written decision becomes final agency action within thirty (30) business days of submission to the Executive Director or designee, or the Executive Director or designee may modify, revise or overturn the DVP Advisory Committee decision. 12.200.7 REVIEW OF FORMAL COMPLAINTS [Eff. 8/1/09] The DVP shall review formal complaints from concerned citizens regarding the delivery of services from funded entities using the following process:

A. For purposes of these rules, formal complaints are defined as dissatisfaction with services performed by a funded program.

B. All formal complaints shall be made in writing and submitted to the DVP staff no later than sixty (60) days after the incident leading to the complaint arose. C. DVP staff shall review complaints within forty-five (45) days of receipt of the written complaint and develop a written response to the program impacted to include a summary of the complaint and request for the impacted program to respond to the complaint. D. The identity of the concerned citizen bringing forth the complaint shall remain confidential, unless the citizen signs a confidentiality waiver.

E. The impacted program has thirty (30) business days to respond to the DVP staff. F. The DVP Advisory Committee shall review the documentation and issue a written response letter to the complainant within sixty (60) business days of receipt of impacted program’s response, indicating their recommendation to the DVP director. Recommendations could include, but are not limited to, action by the DVP, no action, development of requirements or recommendations to remedy the complaint, a corrective action plan, further investigation, or deem it to be an unfounded allegation.

12.201 PROGRAMMATIC AND ADMINISTRATIVE RULES FOR FUNDED ENTITIES 12.201.1 PURPOSE OF PROGRAMMATIC AND ADMINISTRATIVE RULES [Rev. eff. 8/1/09] These rules, in accordance with Section 26-7.5-104, C.R.S., shall serve as minimum requirements for delivery of free and confidential services to victims of domestic violence and their dependants. Domestic violence programs, as defined in Section 26-7.5-103, C.R.S., that currently do not receive DVP funding should use these rules to begin the process of establishing programs. Programs that currently receive DVP funding shall adhere to these rules to maintain funding from the DVP. 12.201.2 CONFIDENTIALITY REQUIREMENTS [Rev. eff. 8/1/09] A. All staff and volunteers of programs funded wholly or in part by the DVP that provide direct services to victims of domestic violence and their dependants must receive fifteen (15) or more hours of domestic violence-related training, per Section 13-90-107 C.R.S. Training shall minimally address the following topics:

1. Crisis intervention skills;

2. Community resources available to victims of domestic violence and their dependants; 3. The dynamics of abusive relationships;

4. Advocacy and safety planning skills;

5. Domestic violence-related laws;

6. Child abuse reporting; and, 7. Cultural competency.

B. All information pertaining to victims of domestic violence and their dependants shall be confidential, as is prescribed by Section 13-90-107, C.R.S., including, but not limited to, the following types of communications:

1. Client and case file records;

2. Data collection systems;

3. Client meeting notes;

4. Communication logs;

5. Counseling notes;

6. Communications through a translator; or, 7. Any other documents or materials produced by the program containing personally identifying victim information.

C. Funded programs shall develop a written policy regarding confidential communications. The written policy shall minimally include:

1. Use of written, dated, time-limited releases of information to include informed consent; 2. General record keeping policies and procedures including document retention and destruction policies;

3. Victims’ rights to access their individual case records; 4. Staff and volunteer access to client files;

5. Staff, volunteer, and board member confidentiality agreements; and, 6. Notifications of limitations on confidentiality to minimally include reporting of known or suspected child abuse or neglect, or danger to self or others. 12.201.3 STATISTICAL DATA AND RECORD KEEPING REQUIREMENTS [Rev. eff. 8/1/09] All programs funded wholly or in part by the DVP shall: A. Submit reports using the DVP statistical reporting tool(s) and forms; B. Submit narrative reports, including data regarding goals and objectives, outcome measurements and other required information according to the schedule set forth by the DVP; C. Submit data and narrative reports within all timeframes set forth by the DVP; and, D. Keep copies of all reports for a minimum of three (3) years after the end of the grant period. 12.201.4 FISCAL REQUIREMENTS [Rev. eff. 8/1/09] A. Funded programs shall demonstrate sound fiscal management as evidenced by: 1. Implementation of an accounting system in accordance with generally accepted accounting principles;

2. Written fiscal policies and procedures;

3. A board of directors that reviews financial reports on a regular basis (see Section 12.201.5); 4. A board of directors that has oversight of the program’s audit or financial review; 5. Separation of staff and board of directors fiscal responsibilities and duties as appropriate; 6. Staff and board oversight of fiscal matters;

7. Sufficient assurances to protect against theft or embezzlement; 8. A surety bond for employees or contractual services charged with receiving, disbursing, or handling currency or documents with cash value totaling more than twenty-five percent (25%) of the annual revenue of the funded program. A surety bond shall be ten percent (10%) of the maximum value of cash or cash-like items the employee or contractual services has access to during a year;

9. An annual operating budget approved by the board of directors; 10. Monthly financial statements that include actual expenses and income; and, 11. Profit and loss statements.

B. Audits and Financial Reviews 1. Funded programs with an annual operating budget of $500,000.00 or more and/or a contract for funding with the DVP $100,000.00 or greater shall conduct an annual audit by a qualified independent Certified Public Accountant and submit audit results to the DVP as requested.

2. Funded programs with an annual operating budget of $250,000.00 - $499,999.00 shall conduct an annual financial review by a qualified independent Certified Public Accountant and submit review results to the DVP as requested.

3. Funded programs with an annual operating budget of less than $250,000.00 shall conduct a financial review no less than once every two years by a qualified independent Certified Public Accountant and submit review results to the DVP as requested. C. Funded programs shall make fiscal documentation available to the state as requested. 12.201.5 BOARD OF DIRECTORS REQUIREMENTS [Eff. 8/1/09] A. Funded programs that operate directly under the authority of a Board of Directors shall have the following:

1. Written job descriptions for all Board of Directors members and officers; 2. Written policies pertaining to the Board of Directors regarding fiduciary responsibilities; 3. Training for Board members to minimally include how members perform their duties; and, 4. Assurances that the Board of Directors makes every effort to recruit and maintain membership that reflects the racial, ethnic, economic, and social composition of the community or region to be served, including efforts to recruit and maintain participation of former clients of the program and/or persons who have experienced domestic violence. B. Funded programs that operate as part of an umbrella or larger organization with its own Board of Directors shall form an Advisory Board with interests focused only on the funding program component that reflects the racial, ethnic, economic, and social composition of the community or region to be served, including former clients of the program and/or persons who have experienced domestic violence.

12.201.6 ADMINISTRATIVE REQUIREMENTS [Rev. eff. 8/1/09] Funded programs shall demonstrate administrative capacity through the following to minimally include: A. Compliance with all legal requirements pertaining to nonprofit management, reporting, and governance, as prescribed by State and Federal law;

B. Written by-laws;

C. Written mission statement;

D. Written strategic plan;

E. Written plan pertaining to disaster management to minimally include public health emergencies and natural or environmental disasters including documentation of performance of emergency drills; F. Written policy regarding participation in lobbying, political activity, and public demonstrations; G. Procurement of insurance as required by the DVP contract for funding; H. Compliance with health, safety, fire and zoning regulations including posting of approvals/permits in necessary areas; and, I. Written policy regarding actions taken by the funded program to enhance the safety of facilities used by staff, Board members, volunteers, and victims and their dependants. 12.201.7 PERSONNEL REQUIREMENTS [Rev. eff. 8/1/09] Funded programs shall have the following duties and responsibilities related to personnel requirements: A. Written personnel policies;

B. Written volunteer policies;

C. Written job descriptions for employees funded through DVP; D. Written job descriptions for volunteers;

E. Ensure adequate staff coverage during hours of operation to minimally include staffing of the twenty- four (24) hour crisis line;

F. Ensure training is received by paid staff and volunteers prior to the provision of direct services to clients of at least fifteen (15) hours, or as prescribed by Section 13-90-107, C.R.S.; G. Ensure training is received by paid staff and volunteers to include orientation regarding personnel rules, job duties, and agency operational policies and procedures exclusive of the fifteen (15) hours required by Section 13-90-107, C.R.S., and rule Section 12.201.2; H. Ensure that all training provided to staff is documented in staff personnel files; I. Provision of ongoing staff development opportunities; J. Written ethics statement regarding staff relationships with victims and professional conduct; and, K. Written Equal Employment Opportunity or Affirmative Action employment hiring statement. 12.201.8 PROGRAM SERVICES [Rev. eff. 8/1/09 A. Funded programs shall provide all services on a voluntary basis free of charge to victims of domestic violence and their dependants.

B. Funded programs shall establish clearly defined intake policies and procedures that identify who is eligible for services and how those services are accessed. C. Funded programs shall minimally provide the following services by trained staff and volunteers to victims of domestic violence and their dependants:

1. Crisis response to domestic violence twenty-four (24) hours per day, seven days per week as outlined in Section 12.200.4;

2. Referrals and information to minimally include a current up-to-date list of community resources;

3. Individual advocacy services either in-person or via telephone; 4. Group counseling upon request or as feasible;

5. Safety planning;

6. Transportation upon request or as feasible;

7. Community education programs to include prevention activities as feasible; 8. Court advocacy or assistance as feasible; and, 9. Training and technical assistance.

D. Funded programs shall use translators and/or bilingual staff to provide services to victims with limited English proficiency.

E. Funded programs shall develop written policies that state that services shall not discriminate on the basis of age, handicap, sex, race, color, national origin or religion. F. Funded programs may not deny individuals an equal opportunity to receive program benefits for services through the establishment of criteria for receipt of services or participation in programs or activities that screen out or tend to screen out individuals with disabilities including drug and alcohol addiction and mental illness.

G. Funded programs shall not impose an income eligibility standard on individuals receiving assistance or services.

H. Funded programs shall develop formal grievance policies and procedures that afford victims and their dependants an opportunity to resolve grievances with funded programs. I. Funded programs shall establish written protocols for coordination of services for victims and their dependants with other community service providers.

12.201.9 RESIDENTIAL PROGRAM SERVICES [Rev. eff. 8/1/09] “Funded residential programs” are defined as programs that provide short-term or long-term overnight accommodations, to include transitional housing in a facility maintained and operated by the funded program to victims and their dependants. Residential programs shall minimally provide: A. Notification to the DVP of intent to open a new residential facility; B. Shelter and sleeping accommodations for victims and their dependants; C. Clean living conditions free from hazards to health and safety; D. Assessment and intake to evaluate the needs of victims and their dependants; E. Unrestricted functioning telephone access for the purposes of reaching emergency assistance, securing resources, and maintaining social support;

F. ADA compliant accessible accommodations or other arrangements; G. Food, clothing, and other basic needs as feasible or by referral; H. Developmentally appropriate services for children who are exposed to domestic violence to minimally include counseling and recreational opportunities for play; I. Safe accommodations to minimally include:

1. Locking doors and windows;

2. Appropriate lighting; and, 3. Mechanisms or devices for contacting emergency assistance. J. Sheltering or alternative accommodations, or referrals to male dependants of victims, male victims, victims in same sex relationships, transgendered victims, and victims living with disability. K. Written policies made available to victims and their dependants to minimally include: 1. Control of violence in residential facilities;

2. Use of alcohol and non-prescribed drugs;

3. Conduct while residing in the facility;

4. Victim grievance policies and procedures; and, 5. Policies regarding removing victims from the facility. 12.400 COMMUNITY-BASED MANAGEMENT PILOT PROGRAMS 12.410 Definition The purpose of the pilot programs is to provide community-based intensive treatment and management services to eligible juvenile offenders who are charged with or adjudicated for an offense and diagnosed by a mental health professional as having serious mental illness, as defined: a juvenile with a substantial disorder of cognitive, volitional, or emotional processes that impair judgment or capacity to recognize reality or control behavior. These rules are effective September 1, 2000. The pilot programs are repealed, effective July 1, 2007.

12.420 Contractual Authority The Colorado Department of Human Services, Division of Youth Corrections, in consultation with the Judicial Department, is authorized to issue a Request for Proposals on or before October 1, 2000 and to select from among the responding entities one entity in a rural community and one entity in an urban community to operate the community-based management pilot programs beginning on or before January 1, 2001.

12.430 Contract The contract shall be in the form and have content as prescribed by the Colorado Department of Human Services.

12.440 Contract Eligibility Eligibility for application to operate a pilot program is defined as any public or private nonprofit, not-for- profit, or for-profit organization, association, or corporation or any governmental entity. Any eligible entity may apply to the Colorado Department of Human Services for funding under this program. 12.450 Program Eligibility In order to be eligible for the community-based management pilot programs, each juvenile shall be: A. Diagnosed by a mental health professional, as defined in Part 1 of Article 36 of Title 12, C.R.S. or Article 43 of Title 12, C.R.S., as having a serious mental illness; and, B. Less than eighteen years of age and involved in the criminal justice system; or, C. Committed to the Colorado Department of Human Services. D. Excluded if adjudicated for or convicted of a Class 1 felony, or first or second degree sexual assault, as defined in Sections 18-3-402 and 18-3-403, C.R.S., respectively, as they existed prior to July 1, 2000, or sexual assault, as described in Section 18-3-402, C.R.S., as it exists on or after July 1, 2000.

12.460 Program Standards The community-based management pilot programs shall provide high-intensity supervision and treatment services in the community to eligible juvenile offenders. At a minimum, each entity operating a pilot program shall:

A. Provide integrative, cost-effective, family-based treatment to eligible juvenile offenders who reside in the community in which the juvenile offender pilot program operates and who are in the program eligibility population for the juvenile offender pilot program; B. Provide services designed to reduce delinquent activity and other destructive behaviors such as drug and alcohol abuse;

C. Provide psychiatric services, medication supervision, and crisis intervention, as necessary; D. Maintain a low client-to-staff ratio, to be defined in the RFP; E. Support education and vocational skills for eligible juvenile offenders and development of positive social relationships;

F. Provide integrated family-based treatment focused on the juvenile offender, family and peers and educational and vocational performance;

G. Promote the development of neighborhood and community support systems for the juvenile and his or her family;

H. Operate as a collaborative effort among, at a minimum: 1. the District Attorney's Office;

2. the Division of Youth Corrections;

3. the Division of Child Welfare Services;

4. Colorado Judicial branch, Office of Probation Services; 5. Community Corrections;

6. local law enforcement agencies;

7. substance abuse treatment agencies;

8. the county departments of social/human services;

9. community mental health centers; and, 10. any other interested community mental health organizations. I. Establish an agreement between the operating entity and the collaborative agencies, including the structure and operation of the program.

12.470 Expenditure Requirements The entity and collaborative agencies that operate a Community-Based Management Pilot Program must participate together in the cost of the program by allocating, as a group, any moneys available to the entity and the agencies, or by providing services to the program, or by a combination of moneys and services in an amount equal to the amount of State General Fund moneys received to operate the program.

12.480 Monitoring, Evaluation, and Reporting Requirements Each entity operating a program is required to report annually, beginning October 1, 2002, to the Colorado Department of Human Services the following information, at a minimum: A. The number of juveniles participating in the program and an overview of the services provided; B. The number of juveniles participating in the program for whom diversion, parole, probation, or conditional release was revoked and the reasons for each revocation; C. The number of juveniles participating in the program who committed new offenses while receiving services and after receiving services under the program and the number and nature of offenses committed; and, D. The number of juveniles participating in the program who required hospitalization while receiving services and after receiving services under the program and the length of and reason for each hospitalization.

E. The number of juveniles participating in the program who required placement into social services while receiving services and after receiving services under the program, and the length of and reason for each placement.

12.500 COLORADO TRAUMATIC BRAIN INJURY PROGRAM 12.510 INTRODUCTION These rules implement the Colorado Traumatic Brain Injury Program (Program) as defined in Title 26, Article 1, Part 3, C.R.S. Individuals who are eligible for program services do not have an entitlement to services. Program services are subject to available funding. If the demand for and need for services exceeds the available funding, the entity under contract to provide services shall maintain a wait list of eligible persons. Individuals shall receive program services on a first-come, first-served basis. 12.520 DEFINITIONS "Applicant" means an individual for whom an application for services has been completed. "Care Coordination" means a collaborative process that assesses, plans, implements, coordinates, monitors and evaluates the options and services required to meet individual's needs, using communication and available resources to promote quality, cost effective outcomes. Traumatic brain injury care coordination operates with an underlying premise that when individuals reach their optimal level of wellness and functional capability, everyone benefits: the individual and family being served, their community support systems, the healthcare delivery system, and insurance carriers. The primary functions of TBI care coordination are to:

A. Maximize individual and family understanding and participation through education and support. B. Advocate for individual wellness and autonomy through advocacy, communication and identification of service resources.

C. Optimize access to appropriate community services.

D. Integrate and coordinate service delivery by multiple sources and to prevent fragmentation of services. "Care Coordination Plan" means a written plan that identifies the specific services that will be coordinated for the program participant, and that is signed by the program participant or his/her designated personal representative.

"Contractor" means an organization or entity that is under contract with the Department to perform intake and eligibility determination services or to provide services to program participants.

"Designated personal representative" means a parent of a minor, legal guardian or conservator, or other person who has been designated by an applicant or program participant to represent him or her.

"Funding of last resort" means that the individual has no other funding source and that no other funding source is available that covers the program services the individual is requesting. An individual is not required to exhaust all private funds in order to be eligible for program services. "Program" means the Colorado Traumatic Brain Injury Program, as defined in Title 26, Article 1, Part 3, C.R.S.

"Program participant" means an individual for whom an application for program services has been completed, who has been determined to meet all of the program eligibility criteria, and who has been referred to a contactor to receive program services or to be placed on the contractor's wait list for services.

"Protected health information" means any information about an applicant or program participant that is protected under the Health Insurance Portability and Accountability Act of 1996, Public Law Number 104-191, which is incorporated by reference. No later amendments or editions are incorporated. This information will be included in the program application materials and may be obtained by requesting an application for program services. Copies of this material are also available for review by contacting the Traumatic Brain Injury Program Director, Colorado Department of Human Services, 3520 W. Oxford Avenue, Denver, Colorado 80236; or at any State publications depository library.

"Subrogation" means that the individual must reimburse the Program for funded services if he/she recovers expenses from a third party.

"Traumatic Brain Injury (TBI)" means damage to the brain caused by external physical force, including acceleration/deceleration injuries. This does not include brain injury caused by a congenital causation, degenerative diseases, surgical interventions or anoxia. There must be adequate medical or clinical documentation of the injury, and the injury must be of sufficient severity to produce partial or total disability as a result of impaired cognitive ability and/or physical function.

"TBI Board" means the Colorado Traumatic Brain Injury Board created pursuant to Section 26-1- 302, C.R.S.

12.530 ELIGIBILITY Individuals seeking program services or their designated personal representatives shall complete an application form prescribed by the State Department. The applicant must provide his/her social security number for use as a unique client identifier.

Applicants shall be subject to an intake and screening process to determine program eligibility. A contractor shall complete the intake and screening process. As part of the application process, the applicant or his/her designated personal representative must sign a statement attesting to the accuracy of the information provided. Applicants who meet all of the following criteria are eligible to receive program services: A. The applicant has a traumatic brain injury; and, B. The applicant is a legal Colorado resident. This includes legal immigrants but does not include illegal or undocumented aliens residing in the State; and, C. The Colorado Traumatic Brain Injury Program is the funding of last resort for the services the applicant is requesting; and, D. The applicant or his/her designated personal representative agrees to subrogation; and, E. The applicant or his/her designated personal representative agrees to sign an authorization form to release protected health information for the purpose of allowing communication with and between the care coordination agency and all service providers listed in the care coordination plan; and, F. The applicant or his/her designated personal representative agrees to sign an authorization form to obtain protected health information if the contractor performing client intake and eligibility determines that this information is necessary to document the presence of a traumatic brain injury.

12.540 SERVICES All program participants who receive program services shall receive care coordination services. Eff. 07/30/2008 A. Additional client services may be provided as program funds permit. Program services may include, but are not limited to: Eff. 03/02/2007 1. Community residential services; Eff. 03/02/2007 2. Structured day program services; Eff. 03/02/2007 3. Psychological and mental health services for the individual with the traumatic brain injury and the individual's family; Eff. 03/02/2007 4. Prevocational services; Eff. 03/02/2007 5. Supported employment; Eff. 03/02/2007 6. Companion services; Eff. 03/02/2007 7. Respite care; Eff. 03/02/2007 8. Occupational therapy; Eff. 03/02/2007 9. Speech and language therapy; Eff. 03/02/2007 10. Cognitive rehabilitation; Eff. 03/02/2007 11. Physical rehabilitation; and, Eff. 03/02/2007 12. One-time home modifications. Eff. 03/02/2007 B. Program services shall not include institutionalization, hospitalization, or medications. Eff. 03/02/2007 C. Program services shall only be provided, as necessary, for a period of one year from the date services begin. A program participant who wants to receive services beyond one year may submit a new application for program services. Eff. 07/30/2008 D. Contractors shall provide program services. Contractors may sub-contract with service providers, with the approval of the Department. Eff. 07/30/2008 The contractor providing care coordination services shall cooperatively develop a written transition plan with each program participant prior to the termination of the year of services. The transition plan shall identify the participant's needs for further services and support, and the resources that are available in the participant's community to assist in meeting his or her identified needs. Eff. 07/30/2008 12.541 Case Closure [Eff. 3/1/07] Care coordination agencies shall establish and publish written guidelines for closing cases. These guidelines shall respect and accommodate the cognitive and behavioral challenges following traumatic brain injury. Program participants shall be treated sensitively and fairly in any case closure discussions and decisions. Eff. 03/02/2007 A. The Traumatic Brain Injury Board shall approve the written guidelines for closing cases. Eff. 03/02/2007 B. A case may be closed when a program participant: Eff. 03/02/2007 1. Has met his or her goals and elects to discontinue services; Eff. 03/02/2007 2. Has moved out of state; Eff. 03/02/2007 3. Cannot be located by the care coordination agency after at least six attempts have been made over a period of at least two months; Eff. 03/02/2007 4. Has been institutionalized under circumstances which preclude delivery of services for at least six months; Eff. 03/02/2007 5. Has been non-cooperative with, or abusive of, the care coordination agency staff and/or service providers to the extent that services cannot be delivered; or, Eff. 03/02/2007 6. Has died. Eff. 03/02/2007 In the absence of one of the above criteria, a case may not be closed solely because a program participant exhibits behavior that is caused by his or her traumatic brain injury, such as forgetting scheduled appointments or difficulties communicating with the care coordinator. Eff. 03/02/2007 C. When a case is closed, the program participant shall be provided written notification of this action, and of his or her appeal rights and the process of how to appeal. Eff. 03/02/2007 12.550 APPEALS AND GRIEVANCES Applicants and program participants and their designated personal representatives shall have the right to file grievances and appeals.

12.551 Grievance Process A "grievance" is an oral or written complaint or expression of dissatisfaction about any matter other than a decision that may be appealed. A grievance may address issues such as the quality of services provided, the person providing services, the timeliness of services, the accessibility of service locations, or the availability of staff.

A. Applicants and program participants and their designated personal representatives shall have ninety (90) calendar days from the date of the incident to file a grievance expressing a complaint or dissatisfaction with any matter other than a decision that may be appealed. B. The contractor shall accept oral and written grievances, and shall document oral grievances in writing. C. The contractor shall give applicants and program participants reasonable assistance in filing a grievance and completing procedural steps in the grievance process, upon request. D. The contractor shall ensure that the individuals who make decisions on grievances are individuals who are not a subject of the grievance and who were not involved in any previous level of review or decision-making regarding the grievance.

E. The contractor shall provide a reasonable opportunity for the individual making the grievance to present information, in person as well as in writing.

F. The contractor shall resolve each grievance and provide written notice within thirty (30) calendar days from the date the contractor receives the grievance. The notice shall include the contractor's proposed resolution to the grievance, the individual's right to further grieve the contractor's proposed resolution to the Colorado Traumatic Brain Injury Board or its designee, and information on how to contact the Board or its designee.

G. Applicants and program participants and their designated personal representatives shall have ninety (90) calendar days from the date of the contractor's notice to submit their grievance to the Colorado Traumatic Brain Injury Board or its designee.

H. The grievance process shall be an informational dispute resolution process. The decision of the Colorado Traumatic Brain Injury Board or its designee shall be final. 12.552 Appeal Process An "appeal" is a request to review a decision of a contractor to deny or revoke program eligibility or to deny, reduce, suspend or terminate the delivery of program services. A. The contractors performing eligibility determinations and providing program services shall provide written notice to applicants and program participants of decisions adversely impacting the individual's eligibility and program services. The notice shall include the decision the contractor has made, the reasons for the decision, the individual's right to appeal the contractor's decision, and the appeal procedures.

B. Applicants and program participants and their designated personal representatives shall have ninety (90) calendar days to file an appeal from the date of the contractor's notice. C. The contractor shall accept oral and written appeals, and shall document oral appeals in writing. D. The contractor shall give applicants and program participants reasonable assistance in filing an appeal and completing procedural steps in the appeal process, upon request. E. The contractor shall ensure that the individuals who make decisions on appeals are individuals who were not involved in any previous level of review or decision-making regarding the decision under appeal.

F. The contractor shall provide a reasonable opportunity for the individual making the appeal to present information, in person as well as in writing.

G. The contractor shall resolve each appeal and provide written notice within thirty (30) calendar days from the date the contractor receives the appeal. The notice shall include the contractor's decision regarding the appeal, the individual's right to a second level appeal to the Colorado Department of Human Services, Office of Appeals, and information on how to contact the Office of Appeals.

H. Applicants and program participants and their designated personal representatives shall have ninety (90) calendar days from the date of the contractor's notice to file a second-level appeal with the Department of Human Services, Office of Appeals.

I. The Office of Appeals shall have the right to additional information and may request oral argument or a hearing if it deems necessary.

J. The applicant, program participant or designated personal representative may represent himself/herself or use legal counsel or other spokesperson at a hearing. K. The decision of the Office of Appeals shall constitute final agency action. L. The contractor whose decision is under appeal shall participate in the appeals process, provide any documentation required, and implement any decision made by the Office of Appeals. M. The appeal process shall be conducted pursuant to Section 24-4-105 and 106, C.R.S. _____________________________________________________ Editor’s Notes History Section 12.540 emer. Rule eff. 06/06/2008.

Section 12.540 eff. 07/30/2008.

Section 12.200 eff. 08/01/2009.

Annotations Rules 12.540.C. and 12.540.D. (adopted 01/05/2007) were not extended by Senate Bill 08-075 and therefore expired 05/15/2008.