Meeting Summary SB109 – November 17, 2015 Attendees (by telephone and Webinar) Lisa began the meeting @ 9:04 She stated that at the end of this meeting we hope to identify those recommendations we have a super majority for, and then get the recommendations drafted either one by one or in a complete report which will be submitted to the committee members to make sure the agreements are clear. The attendees agreed that a single complete document would be preferable. Task Force Members David Ervin, Nancy Sharpe (1st half of meeting), Gini Pingenot (proxy for Nancy Sharpe), Lori Thompson, Randy Kuykendall, Jennifer Kelly, Kasey Daniel, Anne Patton, Lexi Kuznick, Scott Storey, Heidi Haines (proxy for Marijo Reimer), Mindy Kemp (1st half of meeting), Peggy Rogers (proxy for Mindy Kemp), Hanni Raley (proxy for Darla Stuart) SME - Stefanie Norred, TRE Public Attendees: Lisa-Denver County,, Grant Jackson-Mesa county, Jo Booms & Jeanie Benfield, Ann Major-ARC of Adams County Peg’s recent changes not on agenda - requiring vote of the group 1. Sentence added on page 7: is it conveying the wishes of the task group? Unanimously supported 2. Page 9: Is it the task group’s intent that training developed for elders & IDD be added to the police training academy? Heidi believes it should not be added to training academy but required of all officers within first 5 years of employment. Nancy asked where the funding for law enforcement training was coming from, and Peg answered that the group agreed that a $1 million implementation grant be formed. The $150,000 annual training funding for LE to cover training and costs for overtime for officers to attend training. Need $55K for training for DAs/DA investigators. Peg asked if the $625,000 for the public awareness media campaign and 3 FTE for relationship building & facilitated training for mandatory reporters should be part of the funding that would be required by this task group in order to implement SB 109? The task force had agreed that the training for APS & LE and the deficit funding to true up for a 25:1 caseload average must be funded or 109 will not be implemented – but could the public awareness & relationship building be a “nice to have” but not a deal killer? All members voted that the public awareness media campaign and relationship building could be a “soft” request but the facilitated training for mandatory reporters should be required, thus a split solution, except for Honey Raley, proxy for Darla Stuart, who abstained. Lexi had a number of questions and tweaks that she will send to Peg & Mindy 1. Training covers all mandatory reporting, not just IDD, and Lexi and Heidi Hanes felt it should just apply to at-risk elders and IDD (but not other vulnerable adults)

2. Lexi asked for clarification on where the 30% increase comes from – Greg is working on it and it will be provided 3. If No Wrong Door Approach moves forward we need to reopen the conversation about county funding Nancy Sharpe asked for clarification on the LE training piece – more info about what the funding includes/covers. Hanni Raley noted ARC will provide a minority report, and was asked to submit it by end of day 11/18. Definitions discussion: Definitions for mistreatment were fine tuned by Miles Mador, taking out redundant language and re-ordering slightly – anybody have problems with it? None. Exploitation – sample language was inserted to aid the bill writers to avoid having a gap in the definitions. Lexi wants the topic of Incidents included in the narrative. Peg referred to the “Provision of Services” section. It was noted we are putting forward these recommendations about funding, supplemental budget requests, legislative changes, etc. and there will be legislative document drafters/Rep Young taking them forward. Nancy wants the 4th paragraph under Defining the Target Population (“APS has provided services…) – altered to remove “until the legislature expands mandatory reporting to all vulnerable populations…” Provision of Services “Recommendation Related to Provision of Services” Much language added around forming a work group in January to consider: • Definitions of incidents or accidents • Critical incidents already defined in rules, task force believes should stay the same • Work group will consist of… • Investigation-cooperative agreements Task Group members had not received this part of the document and were unwilling to vote until having time to digest the added language…the language herein contains a lot more specificity than they had when voting on Saturday…Lexi suggested the document be sent out right now so members can read it before voting & several ,members agreed. Peg emailed it. Group will take a break to read and discuss/vote after. Current Funding Sources and Possible Sources of Revenue, Recommendation X: Members agreed that 2 possible sources of new revenue to support 109 are Marijuana Taxes and VOCA revenue, but that revenue amounts should be referred to as fixed dollar amounts rather than changeable percentages. Voting on Revenue Sources recommendation: All members yes “No Wrong Door” recommendation (Reporting Abuse, Neglect and Exploitation)

David noted that although he agrees with the intent of the document, he is concerned with the use of the term in a broader health care terminology that may confuse. Peg changed the document to eliminate the NWD terminology. Scott’s problems with this recommendation: APS was very inconsistent with reporting to LE, investigated before reporting to LE, had confidentiality issues (with reporters), self-neglect issue – he disagrees with this document – but says it is working in Jeffco, and if on occasion LE has been reluctant to treat at-risk adult mistreatment as a criminal issue, it is a training matter and it’s getting better. He says SelfNeglect is not a mandatory report. He says LE had nowhere near a 41% increase in reports. MR has only been in force for a year or so! We are trying to instill a “stop the bleeding” response, and this recommendation would set it back seriously. Peg provided the APS perspective: Peg noted that 47% of APS cases involve self-neglect, clearly not a crime. APS also finds that law enforcement is not consistent in notifying APS – so the same problem is occurring both ways. Not a single county reported they are receiving the summary reports from LE. Peg noted that this suggestion works in other states and in child protection. Counties DO report to LE, and that the state oversees such reporting, where there is no oversight mechanism for LE. Lexi agreed that significant additional staffing is needed and would help. Heidi has more trouble with LE reporting to APS, the systems are incompatible & bulky, training is an issue, confidentiality of reporter is a big problem. Hanni noted that streamlining the system is needed and not just increased layers. Lexi referred to the child protection system and the need for additional discussion and work. Nancy was very concerned with going forward with something that is so controversial, and that also requires significant additional funding, and asked if there is a way to leave things the way they are today, and recommend additional work on it. Scott says he is trying to find a way to get LE involved quicker with crimes. David is trying to figure out how to prevent the reporter from calling CCB or APS first – but rather LE. Scott says many times APS doesn’t identify the issue as a crime, until they have conducted their own investigation. So by the time LE gets it all kinds of things happen – evidence lost, etc. etc. So we train mandatory reporters to call LE first. Nancy asked how do we close the loop with LE not sending reports to APS? And CCBs add another layer. Lisa asked what the task force wants to do with this recommendation – that there be a working group considered? That it’s voted on now? Peg asked that it be voted on now and if it is voted down it is just not included in the committee’s report. Lisa suggested the vote now be for 1) Should we vote on it now as is, to change the statute? (If voted down, existing procedure in MandRep bill applies). 2) Just include it in the report as a Parking Lot issue? (Things we want the legislature to be aware of) 3) Formally add the issue to a working group that will be dealing with cooperative agreements going forward The task group agreed to take a break for 20 minutes to read the Provision of Services and will reconvene at 11:50. Lisa reconvened the meeting, asking if there were any questions about the Provision of Services recommendation. Kasey asked for clarification on CDPHE. Lisa asked if there were

any concerns about the current modifications and Scott asked for clarification on the incident/accident definitions – it was agreed this was not going to change any statute language but is a matter for training and the future work group. Kasey suggested including an advocacy group or some rep of consumers to the cooperative agreement work group, and that there be only one work group that deals with definitions of incidents/accidents AND cooperative agreements. Lexi asked if CDPHE is included in work group…David pointed out that by now you’ve got our task group. Why don’t we just say the task force will continue until the work is done…maybe with occasional subgroups…Lexi would only support this if additional county experts are able to participate via public comment …Peg altered the language naming the work group to make it less formal. There then was much discussion about how to avoid a conflict of interest by precluding the CCBs from investigating their own selves or their own service arm, while still allowing CCBs to assist with appropriate (non-conflict-of-interest) investigations. Peg suggested a great deal of this issue could be treated in the cooperative agreement. Lexi asked for additional language clarifying the roles of the different agencies with authority to investigate, as well as raising the question about IDD clients who need services that are not available. Lexi also objected to any agreement that is standard statewide because localities need to develop their own specific agreements. Peg suggested a template for the cooperative agreement for use as a foundation upon which localities could build their own details. Lexi is uncomfortable with the work group developing and imposing a cooperative agreement statewide. Kasey suggested the work group be tasked with exploring and possibly developing the cooperative agreement(s). Lisa asked the group if they are ready to vote on the provision of services recommendation as revised. They were ready to vote and voted a Unanimous yes Time is almost up and we still have parking lot issues and expansion of mandatory reporters. Most members could stay on the call. List of Mandatory Reporters expanded: PASA employees; reworked language to include employees, consultants, of small unlicensed board & care facilities and made clearer it includes long term care facilities and home care/home health agencies; school personnel. Task Group voted on additions to mandatory reporter list. Lexi & Gini abstained. Lori, David, Heidi P, Anne, Scott, Hanni, Peg for Mindy voted yes. (Passed by super majority.) Parking lot items: List of “additional concerns that should be considered” was finalized for the report. Public comment – concern from Jo & Jeanie that no one will report the culture of abuse in IDD facilities – Scott and David said in that case they risk going to jail!