HomeMy WebLinkAbout992327.tiff RESOLUTION
RE: APPROVE VALE GRANT APPLICATION FOR LONG TERM CARE OMBUDSMAN
ADVOCATE/FRIENDLY VISITOR PROGRAM AND AUTHORIZE CHAIR TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with a VALE Grant Application for the Long
Term Care Ombudsman Advocate/Friendly Visitor Program from the County of Weld, State of
Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the
Department of Human Services, Area Agency on Aging, to the Victim's Assistance and Law
Enforcement Board, commencing January 1, 2000, and ending December 31, 2000, with
further terms and conditions being as stated in said application, and
WHEREAS, after review, the Board deems it advisable to approve said application, a
copy of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of
Weld County, Colorado, that the VALE Grant Application for the Long Term Care Ombudsman
Advocate/Friendly Visitor Program from the County of Weld, State of Colorado, by and through
the Board of County Commissioners of Weld County, on behalf of the Department of Human
Services, Area Agency on Aging, to the Victim's Assistance and Law Enforcement Board be,
and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said application.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 20th day of September, A.D., 1999.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
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ATTEST: EXCUSED
.0 a K. Hall, Chair
Weld County Clerk to the :J rd A
°, ;: rbar- J. Kirkmeyer, Pro- em
BY: r
Deputy Clerk to the Bo .® p
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APP D AS TO •
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Glenn Vaat
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HR0070
MEMORANDUM
TO: Dale K. Hall, Chair f�
C
FROM: Walter J. Speckman, Executive Director (i DATE: September
p ember 17, 1999
COLORADO SUBJECT: Victims Assistance Grant Proposal
Enclosed for Board approval is a grant proposal to the Victim's Assistance and Law
Enforcement Board (VALE) for $8,500 to support additional staff time to expand
ombudsman visitations to Weld County nursing homes and personal care boarding homes.
The proposal, if funded, would begin January 1, 2000 and extend through December 31,
2000.
If you have further questions, please call Linda Piper at extension 3320.
992327
Victim's Assistance & Law Enforcement Board
Nineteenth Judicial District
Fiscal Year 2000
GRANT APPLICATION FORM
I. Project Title Weld County Long Term Care Ombudsman Advocate/Friendly
Visitor Program
•
II. Lead Agency/Organization Weld County Area Agency on Aging
Contact Person Linda E. Piper,Director Phone 970-353-3800, Ext. 3320
Address 1551 North 17th Avenue, P.O. Box 1805, Greeley, Colorado 80632
III. Amount Requested $8,500
IV. Non-profit Status X(Government) Yes No In Process
' and of C unty Co missioners
}h UNT RK T T% BOARD
}cur \o\ EPUTY CLERK T THE BOARD
•
Victim's Assistance &
`",• Law Enforcement Board
\ 4.4g Nineteenth Judicial District
?f � : 'F' VICTIM ASSISTANCE AND LAW ENFORCEMENT BOARD
GRANT APPLICANT MEMORANDUM OF UNDERSTANDING
CONCERNING THE RIGHTS AFFORDED TO CRIME VICTIMS
As provided in C.R.S . 24-4 .2-105, (4 .7) , Colorado law requires
the following:
A REQUESTING AGENCY OR PERSON SHALL ACKNOWLEDGE IN WRITING THAT
SUCH AGENCY OR PERSON HAS READ AND UNDERSTANDS THE RIGHTS
AFF2 . 5 AND
THEORDED TO SERVICES CDELINEATED RIME MPURSUANT TO S PURSUANT T SECTION 24-24 . 1-303O SECTION 0 AND 24-
4 . 1-304 . SUCH WRITTEN ACKNOWLEDGEMENT SHALL BE ATTACHED TO
SUCH REQUESTINGGENCY' S
ON.ORTHERBON' S APPLICATION FOR ARD SHALL NOT ACCEPTM YS
FOR
EVALUATION ANY APPLICATION FOR A GRANT OF MONEYS PURSUANT TO
THIS SECTION UNTIL THE REQUESTING AGENCY OR PERSON PROVIDES THE
BOARD WITH SUCH WRITTEN ACKNOWLEDGEMENT.
The prospective grantee certifies to the VALE Board, by
submission of this completed Grant Applicant Memorandum of
Understanding Concerning the Rights Afforded to Crime Victims,
that the agency or person described herein has read and
understands the rights afforded to crime victims as required by
C.R. S. 24-4 . 2-105, (4 .7) .
PROJECT DIRECTOR: Linda E. Piper
PROJECT: Weld County Long Term Care Ombudsman Advocate / Visitor Program
AGENCY: Weld County Area Agency on Aging
ADDRESS : 1551 North 17th Avenue, P.O. Boy IBS, Greeley, CO 80632
SIGNATURE : 1102detiG ( dc• ) DATE: / - /SC7 /
(NOTE: COPIES OF THE STATUTES DESCRIBED ABOVE WILL BE PROVIDED TO
PROSPECTIVE GRANT RECIPIENTS UPON REQUEST. ) WMMVw
Post Office Box 1167 915 Tenth Street•Greeley,CO 80632•(970)356-4010•FAX(970)352-8023
Victim's Assistance &
Law Enforcement Board
t 49 ; Nineteenth judicial District
/876 'x ''
GRANT APPLTCATION FORM
GRANT CYCLE: ,TANTTARY 1, 2000 TO DECFMBER 31, 2000
1 . PLEASE SUBMIT AN ORIGINAL AND EIGHT (8) COPIES OF THE
APPLICATION AND ATTACHMENTS (NINE (9) COPIES TOTALLY) .
2 . PLEASE ADDRESS ALL QUESTIONS LISTED BELOW AND LIMIT THE
NARRATIVE SUMMARY TO SIX (6) PAGES.
I . Project Title
II . Lead Agency/Organization
Project Director Phone
Address
III . Amount Requested
IV. Non-profit Status Yes No In Process
,$RCTTON A: NARRATIVE SUMMARY
1 . Submit a brief summary of the following: a) agency
description, b) project description, c) projected outcomes,
and d) community coordination (including Crime Victim
Compensation Program) .
c rTTON B• PROJECT CONCEPT AND DESIGN
2 . What is the overall problem the project is addressing?
3 . What are the project ' s goals and objectives?
4 . What is your timetable for accomplishing the goals and
objectives?
5 . How will the goals and objectives be accomplished?
6 . What problems do you anticipate in implementing your
program' s goals and objectives, if any?
7 . How will the project ' s effectiveness be evaluated?
8 . How does the project address the victim-service needs
outlined in the V.A.L.E. statute?
Post Office Box 1167 915 Tenth Street•Greeley,CO 80632•(970)356-4010•FAX(970)3524023
,SECTION C: RFRVTCR INFORMATION
9 . What is the population and geographic area targeted for
service through this project .
10 . Provide the following summary information: a) How many people
are in need of these services? b) How many people are
presently being served? c) How many people will be served by
the project during its operation?
11 . Are there other community agencies currently providing like
services to the targeted population?
12 . How will this project diminish or eliminate duplication of
services?
13 . What cost savings will the public experience as a result of
this project?
14 . What is the management plan for the project? (Specifically,
who will be responsible. or accountable for the administration
of the project?)
15 . Who will provide the proposed services? win. volunteers be
utilized? (Include a description of duties, qualifications,
training, etc. )
SECTION D: EFFICIENCY DESCRIPTION
16 . If this is an application for continuing funding, how
successful has this project been in the past in accomplishing
its proposed goals and objectives?
17 . What is the projected cost per client served (cost/benefit
ratio) ?
,GFS'.TION F: BUDGETARY INFORMATION
18 . Complete attached budget page or facsimile.
19 . Explain and justify the project ' s budget and relate the
item(s) budgeted to project activities .
20 . If this is an application for continuing funding, explain any
changes in proposed funding.
21 . How will future funding needs be met?
$RCTTON F: ATTAC'F7MRNTS,
22 . Attach a copy of your agency' s current fiscal-year budget,
including a list of all funding sources .
23 . Include a copy of agency' s most recent audit report . If
agency is not subject to audit, explain how proper management
and disbursement of funds is monitored.
24 . Attach a list of your agency' s Board of Directors, if
applicable.
25 . Include letters of support in this section.
Section A: Summary
The Weld County Long Term Care Ombudsman Program has been a consumer voice for the
elderly residing in nursing homes and personal care boarding homes(assisted living)for more than
twenty(20)years. The authority of the local Ombudsman Program comes from the Older American's
Act, Colorado Revised Statutes 25-11.5 and the Nursing Home Reform Law of 1987. The Weld County
Ombudsman acts as a consumer voice for the concerns of the elderly living in institutions who may have
no one else to speak for them. The Ombudsman also receives and resolves questions, issues,problems
and complaints made by, for, or on behalf of residents of long term care facilities.
Weld County facilities have continued to grow to include six nursing homes and nineteen
personal care boarding homes to respond the increasing number of frail elders affected with chronic
conditions which interfere with their ability to live independently in the community. As estimated last
year,the findings from the 1998 a county wide needs assessment of Weld County's older adults, it was
indicated that approximately 240 older adults anticipate moving either to an assisted living facility or
nursing home. This number does not include the additional seniors moving into the Weld community
already requiring long term care, nor the people who will experience unanticipated changes in their
general health status which will require long term care placement.
The V.A.L.E. grant has allowed the Ombudsman Program to increase staff time to keep up with
the increasing demand for advocacy on behalf of this very vulnerable population. The assistant position
is currently working 12 hours per week in the field,visiting nursing homes and personal care boarding
homes. By maintaining a constant presence in these facilities, the Assistant Ombudsman has built
trusting relationships with residents and staff. The funds have also enabled the program to implement a
successful abuse prevention and awareness program aimed at Certified Nurse Assistants(CNAs). This
has allowed her to educate residents and staff about the Ombudsman Program, abuse issues and resident
rights as well as investigation of complaints of abuse and neglect. The success and popularity for the
abuse prevention program has escalated. As the market continues to grow,the demand for education for
front line staff also increases. Without the V.A.L.E. resource,the program will not be able to continue
these imperative services.
Long term care residents face both physical and psychological barriers when it comes to
expressing and advocating for their needs. This makes residents more likely to be victimized by care
givers. The Ombudsman's role through observation and a frequent presence in the facilities; is to insure
that resident rights are being respected,that quality care is administered, and that abuses do not occur.
Continued funding of the Ombudsman Assistant will make it possible for the Area Agency on Aging
Ombudsman Program to serve the increasing number of vulnerable long term care residents and their
families.
We are requesting a modest amount of V.A.L.E. Board Funds ($8,500) to continue to fund the
Assistant Ombudsman position and to expand its scope to include elder abuse education to additional
target populations. In 2000 the funds will allow the Assistant Ombudsman to increase her presence
from 12 to 16 hours per week. This will increase involvement with the CARTE program and aid in the
recruitment and training of volunteers. We believe that our request for a continuation of funding relates
to the mandate of early crisis intervention and to provide assistance and support to victims and their
families.
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Section B: Project Concept/Design
Overall Issues Being Addressed:
The purpose of the Weld County Long Term Care Ombudsman Program is to assist and empower
consumers of long-term care services by providing information about those services and furnish support
in complaint resolution. These issues or complaints may include,but are not limited to: access to long-
term care services,redress of neglectful or abusive care, and information and assistance with civil and
human rights. The Long Term Care Ombudsman program is a resident/patient/consumer-centered
advocacy program.
Long Term Care Ombudsmen have statutory status under the Older Americans Act of 1965 as
amended and are required by federal and state law to visit every nursing home monthly and every
personal care boarding home quarterly. They also receive, investigate and resolve complaints, identify
needs of long-term care residents and help establish programs to meet those needs. The Ombudsman
also document and report problems of long-term care and help to stimulate and promote improvement of
the system.
Currently,Weld County has the capacity to occupy 869 nursing home residents and 518 assisted
living residents, and the numbers are expected to continuously grow. The recent growth has resulted in
an expansion of assisted living facilities. To meet the demand,the assisted living industry is expanding
into the rural areas as well as continued expansions in the Greeley area. Behive homes have recently
opened a 13 bed facility with the plans to expand to 39 by the third quarter of 2000 and a 17-25 bed
facility in Johnstown in the first quarter of 2000. This growth will increase the Ombudsman
responsibilities, including all education and technical assistance components, all required visitations, all
complaint investigations,and all documentation and reporting. We hope to meet the need by increasing
the Assistant Ombudsman position to .40 FTE,funded by this proposal.
Due to the increased number of long-term care residents Weld County has experienced in the last
two years,the demand for Ombudsman services has also increased. Federal funds,through the Older
Americans Act, are not keeping up with the growing need for long term care advocates. With limited
current resources available to the Area Agency on Aging, it will be impossible to meet the minimum
requirements for a visible presence in all of Weld's long term care facilities. In an effort to keep up with
the visitations,the training and technical assistance to the facilities will be negatively influenced. Such
training is the key to the prevention of practices that diminish the quality of life of residents and in many
cases may border on abuse.
There is continuing evidence from statements made by regulatory agencies that an informed,
educated and empowered community presence in long-term care facilities can help to maintain or
improve the quality of the facility and thus the quality of the resident's lives. In short,the problem we
are trying to resolve is the lack of Ombudsman resources to cover exceptional increases in the growth of
long-term care services in Weld County.
Project Goals:
➢ To enhance the ability of the Weld County Long Term Care Ombudsman Program to act as a
consumer voice for the concerns of the elderly living in nursing homes and personal care
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boarding homes. By visiting nursing homes and personal care boarding homes,there is an
ongoing process of building trust and rapport with the residents and staff so that instances of
mistreatment and elder abuse can be identified and addressed promptly.
➢ • To enhance the ability of the Weld County Long Term Care Ombudsman Program to receive and
resolve questions, issues,problems and complaints on behalf of residents of long-term care
facilities.
➢ To enhance the ability of the Weld County Long Term Care Ombudsman Program to provide
community education regarding issues of elder abuse and quality of life for residents in long-
term care facilities.
➢ To strengthen the ongoing elder abuse training program. The current training being presented is
a program referred to as CARTE,which stands for Coalition of Advocates for the Rights of the
Infirm Elderly. CARIE consists of eight training modules that focus on various aspects of elder
abuse. The training program is used to assist with educating staff,residents, and family
members regarding victimization. (See Attachments E &F) Training and education can be
accomplished through CNA conferences or in-services at nursing homes or personal care
boarding homes.
•
Currently the CARTE program is being offered to CNAs. However, other model programs who
are providing CARTE training have discovered the benefits of offering the training to
administrative and managerial long term care staff. The Ombudsman Program would like to
expand the ongoing CARTE training program to this target population. In addition, the
Ombudsman Program would like to provide the training to the CNA Training Center on a
monthly basis. The students who attend the CNA Training Center frequently work in long term
care facilities and home health care agencies. This will give the Ombudsman Program an
opportunity to reach a wide variety of future nursing assistants.
Project Objectives:
During this grant period we intend to:
➢ Increase Assistant Ombudsman presence from 12 to 16 hours per week in Weld County long
term care facilities for the purpose of providing a consumer voice for the concerns of elderly
living in institutions and to be able to promptly address any instances of mistreatment or abuse.
➢ Continue and expand implementation of the Elder Abuse Prevention Program (CARTE)
➢ Maintain and distend the volunteer program to sustain the current 6 volunteers and to continue to
recruit,train an additional 4 volunteers. Volunteers assist the Ombudsman program for
increased visibility with friendly visits.
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Timetable:
Visit 500 long term care residents and investigate 50 complaints by December 31,2000.
This is a continuation request to proceed with the future CAME training.
• The progression and expansion of the program to include nurse training through AIMS
Community College beginning January, 2000.
The ongoing and enhanced Elder Abuse Prevention Program timetable will be as follows:
Develop advanced training materials by January 15,2000.
• Expand and develop materials for additional trainers by April 1, 1999.
• Implement the enhanced training for management staff into current training program by
April 1, 1999.
• Continuous CAME training to 175 direct line long term care staff along with an increase of
50 administrative and management staff by December 31,2000.
• Establish a set location and schedule for two direct staff sessions a month and one
managerial session a month by January 1,2000.
Heighten volunteer program:
• Recruitment and marketing to continue on a monthly basis from January-December, 2000.
• Screening and orientation of new volunteers to proceed on a monthly or as needed basis from
January-December,2000.
• Training and support to continue on a monthly basis from January-December, 2000.
• Expand role of two volunteers to instruct the CAME training by July,2000.
.How Goals and Objectives Will be Accomplished:
Under the guidance of the Lead Ombudsman the Assistant will continue to be assigned a
specified number of long term care facilities to visit on a regular basis. Sixteen hours per week will be
allotted for visitation and travel time. The average visit per facility will be one hour;however the visit
could take longer if there is a need. During the first three quarters of 1999 the Assistant Ombudsman
made visits to 496 residents of long term care facilities and investigated 68 complaints.
The Elder Abuse Prevention Program is based on a training module called the CAME program.
CAME consists of eight training modules,each focusing on an important aspect of abuse issues
including, identifying and recognizing abuse,the possible causes, understanding the complex issues
surrounding care-giving, cultural and ethnic perspectives,resident/staff dynamics,ethical and legal
issues,how to report abuse and intervention and prevention strategies.
The Assistant Ombudsman will continue to train staff and residents at long term care facilities,
Aims' Nurse Training Center and monthly scheduled sessions regarding victimization and expand into
the nursing programs criteria. The program will continue to be incorporated into the Preceptor Training
Course. The Assistant Ombudsman will obtain a.permanent location and develop a registration schedule,
expanding number of sessions,to meet the increased demand for the training.Abuse issues include
physical, emotional, sexual,financial, abandonment, and neglect. Training individuals about elder abuse
is very important for several reasons.
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Pint, the older adult population is the most vulnerable and frail. Many older adults rely on other
people to take care of their activities of daily living and finances. Second, abuse of older adults is under
reported. Many states including Colorado do not have mandatory reporting of elder abuse. However,
Weld County has experienced an increase in reported incidences. This could be due to education,
awareness, and empowerment on abuse issues, but also could indicate a heightened number of abuse
occurrences. The Assistant Ombudsman will continue to track the reported number of abuse cases.
Third, older adults(especially those 85+)are the fastest growing segment of the population.
Antici ated Problems in Im lementin Goals and Ob'ectives:
Implementing the extension of our current ombudsman program in 1999 did not pose any
problems. The Assistant Ombudsman position met the goals and objectives within the appropriate time
lines. We do not anticipate any problems of reaching the new goals and objectives for 2000. The
Assistant Ombudsman will be able to fulfill the original goals and objectives while enhancing the
Volunteer and CARIE programs
Effectiveness Evaluation:
To evaluate the effectiveness of the CARIE program,
collect data from evaluations that are distributed at the end of the training session.dThe infosm lrl contin mation ue to
gathered will continue to be entered into the data base developed during the third quarter 1999 grant
cycle. (See Attachment G) This data will be utilized to determine if the goals and objectives of the
program are being met. This information will also be used to enhance and modify theprogram if needed.
Evaluation of the Volunteer program will be monitored by the number of additional visits, educational
sessions and volunteer satisfaction surveys will be evaluated and results entered in into a database.
Pro am Goals as Related to the V.A.L.E. Statute:
This program continuation request most relates to 24-4.2-105, Section 2,part a and
addresses provision of service for early crisis intervention. As mentioned earlier,there is evidence that
when there is constant and continuing community part b. Part a
ong term c falities the potential to
improve the quality of life and prevent abuse andexploitation is reduced for the residents We propose
to continue advocate contacts with long term care residents as a preventive move. We know that there
may be many barriers to the elderly,particularly those in long term care facilities,to express their
particular needs without assistance from others. Some of these barriers are physical due to loss of sight,
speech, or hearing. Some barriers are psychological due to a sense of isolation,fear of retaliation, or
disorientation. Barriers to self advocacy can also be because of the lack of information about rights,
alternatives, and legal remedies.
Part b addresses assistance programs for victims and their families. A key role of the long term
care Ombudsman is complaint investigation and complaint resolution. Long term care residents must be
assured that the Ombudsman will be able to follow up on their complaints in a timely and professional
manner. With the continued increase in long term care beds,the ability of the present Ombudsman to
respond appropriately to complaints will be jeopardized. The extension of the friendly visitor/advocate
under this proposal will continue our Ombudsman hours insuring that the Lead Ombudsman will be able
to respond to residents and their families in a timely and appropriate manner.
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•
•
This year the Assistant Ombudsman was referred to a case of a Native American female resident
who resides in an Alzheimer's secured unit of a nursing home. This resident has advanced Alzheimer's
disease,physically in stable condition but is unable to communicate verbally. The facility had called to
inform the Assistant Ombudsman that a resident had been transported to the hospital with numerous
injuries to her genitalia. The nursing facility staff charged this was a self inflicted injury but was
reporting it as a "courtesy"to the resident and family.
The Assistant Ombudsman investigated the report at the facility and contacted the family at the
hospital where the resident had been admitted for an "alleged sexual assault". The hospital, where the
case was investigated, determined that possible abuse/neglect had occurred. The physician and police
indicated the numerous injuries were those consistent with forced sexual assault. This resident incurred
a 4 cm vaginal tear, 2 cm urethral tear and another 3 cm genital tear requiring numerous sutures. A
rape test was conducted and the resident admitted for observation.
The Assistant Ombudsman worked with the hospital staff police,Adult Protection team, State
and Federal regulatory agencies and the nursing facility staff to investigate, coordinate and resolve the
incident. The Assistant Ombudsman worked with other facilities in the area to secure her a safe living
environment after discharge from the hospital. During the numerous contacts with the Assistant
Ombudsman,family members voiced many concerns about the quality of care she was receiving and had
previously suspected abuse and neglect by the nursing home staff. The family had many issues regarding
her quality of care, especially since the resident was non-communicative and unable to voice her own
concerns. The Assistant Ombudsman reviewed policies at all the Weld County facilities to ensure proper
procedures are taken when abuse is suspected so as not to taint any evidence. It was apparent this
facility and the front line staff failed to follow Colorado Public Health and Environment recommended
guidelines for handling a sexual abuse/assault. (See attachment II)
The Assistant Ombudsman continues to work on this case, as a positive semen result ensued from
the rape kit. There continues to be an on-going investigation with the Greeley Police Department, State
Health Department and State Ombudsman Program. The Assistant Ombudsman is currently playing a
crucial role in the investigation, continues reporting and coordination as required and is an imperative
support system to this resident and her family during this critical time of crisis.
The Assistant Ombudsman attends meetings, coordinates information with the Adult Protection
team,police and the State Health Department and continues to be a support system to the family who is
dealing with the devastation of their family member enduring this abuse. The Ombudsman program has
also been involved in the District Attorneys Victims Assistance Program to educate and create empathy
for victims of violent crime, to be a voice and advocate for those who are unable to do so for themselves.
The Assistant Ombudsman continues to educate and monitor the nursing home to insure that this issue is
properly examined and measures are taken to protect the residents remaining in that facility.
Section C: Service Information
Population and geographic area targeted
Population targeted are 60 plus elderly residing in nursing homes and personal care boarding
home located in Weld County.
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Numbers of Persons in Need of These Services:
Approximately, 1,300 Weld County residents live in long term care facilities. All of these
residents receive services through the Ombudsman program either directly with visitations and complaint
resolution or indirectly through training and technical assistance provided to staff to improve the quality
of care. By extension,the program also may represent the concerns of relatives and/or friends of long
term care residents as long as the concern reflects the concerns of the resident.
Continuation of support will make it possible for the Area Agency on Aging Ombudsman
Program to continue to serve all of the long term care residents and their families with the same type and
degree of services that we currently are providing.
Duplication of Services
There is no other program which provides services equivalent to the Ombudsman Program.
Cost Savings
When an advocate visits a long term care facility and discovers issues that affect the direct health
of a resident,the advocate can facilitate and coordinate care with the facility to enhance the resident's
plan of care to help reduce the problem from escalating. There is considerable medical savings to the
taxpayer(most nursing home residents are on Medicaid)when extreme medical procedures can be
avoided.
When long term care patients are restrained, not only is it a violation of individual rights,but an
opportunity is missed to administer therapies which can help the patient become more independent. The
ombudsman, again, can identify these situations and work with the staff to develop alternate
interventions which will respect individual rights and give the patient care that may increase his/her
potential to be independent. Dependence costs society.
Elder abuse education is invaluable to reduce incidences that occur. When a resident is exposed
to an abusive situation the experience can cause not only physical,but also emotional,psychological, and
social damage. The resources used to investigate and monitor these incidences are costly and limited,
the Ombudsman become a valuable resource to assist and prevent abuse in long term care facilities.
Repercussions from abuse result in expensive and time consuming therapies and utilize valuable
resources allocated for the community. The abuse education provided by the funds from this grant help
to raise awareness and allow intervention before abuse situations occur.
Management Plan
The Director of the Weld County Area Agency on Aging will be accountable for the
administration of this project. The part time Ombudsman advocate will be trained and supervised on a
daily basis by the Lead Ombudsman under the supervision of the Long Term Care Coordinator who
reports to the Area Agency on Aging Director.
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Service Providers
Lead and Assistant Ombudsman along with volunteers will provide the proposed services. The
1998 Weld County Needs Assessment determined that four in ten senior respondents volunteer in the
Weld community. Senior Volunteers provide about 17 hours of service a month. Interestingly 19.7 of
the current volunteers indicated they would be interested in increasing the number of hours currently
volunteering. The respondents stated one of the primary reasons for volunteerism is they feel useful
when helping others. In order for the Ombudsman program to continue to meet the needs of the ever
growing long term care population,we must expand the use of volunteers in the program.
The Assistant Ombudsman will take the lead in regard to volunteer recruitment,training and
supervising. The increase of Ombudsman presence in all of the long-term care facilities may allow
intervention to transpire before abuse situations occur.
Section D: Efficiency
Evaluation of Project
The Ombudsman Program maintains files which generate monthly, quarterly, and annual reports.
Data is kept on numbers of visits,complaints,referrals and technical assistance contacts. The
Ombudsman Program developed a database management program in1999 to track the evaluations from
abuse prevention training. (See Attachment I) Data is broken down further to reflect types of
interventions,types of complaints,types of facilities,and actions taken.
This data is analyzed by the state Ombudsman office to assist in determining the efficiency of
the program.At the conclusion of the current grant period,the Ombudsman Program will have provided
CAME training for CNA staff representing all nursing home and a majority of PCBHs in Weld County.
In addition,the Assistant Ombudsman will exceed the targeted project objectives of 1999. This is
evidenced by the number of contacts made by the end of the third quarter-496 residents visited and 68
complaints investigated by the Assistant Ombudsman. This would not have been possible without the
funds from the V.A.L.E. grant.
Cost/Benefit Ratio
Due to the complexity and uniqueness of the program,the current cost benefit ratio is difficult to
determine as we provide a combination of training,technical assistance and direct service to an unlimited
number of residents and family members. However,we do know that early intervention by the
Ombudsman can prevent costly medical costs that may have resulted due to poor quality of care.
Section E: Budget
Future Funding Needs
Future funding needs will correlate with how much growth occurs in long term care beds in
Weld County. The current growth spurt is statewide and is reflective of the rapid increase in numbers of
elderly 75 years of age and older who are frail and in need of some type of long term care. Assisted
living continues to be a fast growing industry in all areas of Colorado and the nation. Area Agencies on
Aging nation—wide are working to bring this to the attention of federal and state governments
emphasizing the need for support of the Ombudsman Program.
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See attached budget
Budget Narrative
We are requesting$8,500. dollars for a .40 FTE advocate/friendly visitor at$8.18 per hour for 16
hours PER week—$6805. for hourly salary and$670. for fringe(taxes and benefits). Travel
reimbursement will be at .27 cents per mile for 1,200 mile or$325. dollars. Mileage records will be kept
by the advocate for documentation. $500. is requested to cover overhead, supplies and operating
expenses. Training is$200. and includes cost to attend ombudsman training sessions in Denver and
other local and state training required by the Area Agency on Aging. This year we are requesting an
additional funds to increase the number of hours for direct service (4 hours per week) and implement a
.32 per hour wage increase from the previous year for a 4%Cost of Living Allowance (COLA) .
Additional funding is being requested to support the expansion of the Elder Abuse Prevention Training.
There is also a decrease for mileage to address the permanent facility for training sessions, requiring
less travel allowance for this postion..
9
_ ATTACHMENT A
VICTIM ASSISTANCE AND LAW ENFORCEMENT BOARD
DETAILED AGENCY BUDGET
16. DETAILED PROTECT BUDGET: Include the estimated cost of all resources needed to undertake the project.
round off figures to the nearest dollar. This budget page must include all monies available. In-kind
services need to be listed sax in the budget narrative, not on this page. CATEGORY
TOTAL TOTAL
a. Personnel (Employees)
(1) Raltries (liar each position with salary rare And nerre}raoa of Wag Aevoted1
I
Eva Jewell i37,855/Ylt 10 -i 3.7Rc I
t
Diana Hutcheson ( 27.212�( 27.212/lai 100 1 27,217 I
Joan Maley I k 6,805,E 100 I fi,AnC
I /YR I a 1 I
i I
I /YR I i I I
I
�Su s 37.802
hrnrai of Personnel t I 7,742
(p) perA. nerlrement. Prinan Aene}inn, err. I
I 45,544 I $ 45,544
Torsi Personnel Costs } I E
•
b. i nn)ice anti Other Oneratina Rxnenses Irnmeoinirarinna. renrn4'rrinn)
Supplies / Operating / Overhead. I •
I750
I 200
Training I
Torsi ,Sxmn7lea an4 Ooarnr.na Rxonnawa
S • 950 150
a 9
c. Travel. (itemize rranennrtattnn and whsisti"nre)
Mileage / Out of Town Travel / Meals I 3.175 I
I I
I Is 3,175
S
:oral Travel testa
d. Anvil-none (itemize)
I I
I
I I
Total Enuiaeent Coats
15 I q -�-
e. profesascsal Services (itemize individuals and oraenizartons) I I
1 1
I I
I 1
IS IIe —0—
Total Professional .4arvirna Gnats I s 49,669
f, TOTAL, PeO,7RrT rOST
g. Total Percent by Source
(1) Federal Funds s 41,169. .:.-311
(2) VALE Funds g 3,500 17k
(3) Other Funds.
g -0- -0- }
TOTAL g 49,669 100 t
4.
Please explain the source of "Other Funds" in the budget narrative.
17. BUDGET NARRATIVE: Explain and justify the project budget and relate the item budgeted to project
tF VAL
activities (use continuation sheets).
• SECTION C: GRANT APPLICATION
Type of Application: 02B-88 FYra9& 2
Grant Award No. egion No.
/_X / Initial • Grant Application Period:
/7_./ Revision of Application
Submitted from 01/01/99. to 12/31/99
TITLE III AWARD REQUEST
Potential Award Transfer Re•uest NOGA Award Request
Admin Carryover
r1"'
Admin New Alloc. $33,797 . .y&r !!. 'ko)k» $33,797
TOTAL ADMIN. $33,797 $33,797
Part B Carryover $19,655 $19,655
$119,204 $119,204
Part B New Alloc •>'
TOTAL PART B $138,859 " $48,677 $187,536
*;. .' -
Part Cl Carryover ,', "ex
Part Cl New Alloc $154,188 ° „< :`;..,c: ac $1
54,188
TOTAL PART C1 $154,188 $154,188
$26,774
Part C2 Carryover $26,744
Pad C2 New Alloc $48,677 :
$48,677
TOTAL PART C2 $75,421 $488,8777 $26,774 _.
)
K - -tirOCC Part D Carryover $6,233
$6,233
4
Part D New Alloc $5298 $5298
TOTAL PART D $11,531 $11,531
Part G Ca over
TOTAL PART G
,fix r�
Part F Carryover $11,089 '_ $11,089
Part F New Alloc $8,749 $8,749
TOTAL PART F $19,838 $19,838
:
Pt OMB Carryover
,
e
TOTAL PART OMB i `
' $63,721
Tot Svc Carryover $63,721
Tot Svc New Alloc $336,116 $336,116
TOTAL SERVICES $399,837 -0- $399,837
Part D,Part G,Part F,and Part OMB are excluded from all transfers. MS 200
\ \ 0
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AI ACHM INT B
FOR FULL COUNTY AUDIT
THE ORIGINAL
CERTIFIEDPUsLIC Le, ACCOUNTANTS
N":3.47PARTNERS
John C.Dollarhide
Michael J. Frick
INDEPENDENT AUDITORS' REPORT Susan A. Gapter
ON COMPLIANCE AND ON INTERNAL CONTROL OVER FINANCIAL Nicholas G.Kosmickl
REPORTING BASED ON AN AUDIT OF FINANCIAL STATEMENTS Marcia L. Siebring
PERFORMED IN ACCORDANCE WITH GOVERNMENT AUDITING STANDARDS
To The Board of County Commissioners
County of Weld, State of Colorado
Greeley, Colorado
We have audited the general purpose financial statements of County of Weld, State of Colorado
as of and for the year ended December 31, 1998, and have issued our report thereon dated
May 5, 1999. We conducted our audit in accordance with generally accepted auditing
standards and the standards applicable to financial audits contained in Government Auditing
Standards, issued by the Comptroller General of the United States.
Compliance
1. As part of obtaining reasonable assurance about whether Weld County's general
purpose financial statements are free of material misstatement, we performed tests of its
compliance with certain provisions of laws, regulations, contracts, and grants,
noncompliance with which could have a direct and material effect on the determination
of financial statement amounts. However, providing an opinion on compliance with
those provisions was not an objective of our audit, and accordingly, we do not express
such an opinion. The results of our tests disclosed no instances of noncompliance that
are required to be reported under Government Auditing Standards.
Internal Control Over Financial Reporting
2. In planning and performing our audit, we considered Weld County's internal control over
financial reporting in order to determine our auditing procedures for the purpose of
expressing our opinion on the general purpose financial statements and not to provide
assurance on the internal control over financial reporting. Our consideration of the
internal control over financial reporting would not necessarily disclose all matters in the
internal control over financial reporting that might be material weaknesses. A material
weakness is a condition in which the design or operation of one or more of the internal
control components does not reduce to a relatively low level the risk that misstatements
in amounts that would be material in relation to the general purpose financial statements
being audited may occur and not be detected within a timely period by employees in the
normal course of performing their assigned functions. We noted no matters involving the
internal control over financial reporting and its operation that we consider to be material
weaknesses. However, we noted other matters involving the internal control over
financial reporting, which we have reported to management of County of Weld, State of
Colorado in a separate letter dated May 5, 1999.
127
1901 56th Avenue, Suite 200 / Greeley, CO 80634-2950 / 970-330-8860 / Denver 303-825-1752 / Fax 970-330-6680
To The Board of County Commissioners
3. This report is intended for the information of the board, management, and federal
awarding agencies and pass-through entities. However, this report is a matter of public
record and its distribution is not limited.
n
May 5, 1999 Xoov.w:. •-• S2a44^ 19;6 * L"-
3'
e
fi
e
•
128 19
CERTIFIED ACCOUNTANTS
PARTNERS
John C.Dollarhide
Michael J. Frick
INDEPENDENT AUDITORS' Susan A. Gapter
Nicholas G.NankinREPORT ON COMPLIANCE WITH REQUIREMENTS Mareta L. siebring
APPLICABLE TO EACH MAJOR PROGRAM AND ON INTERNAL CONTROL
OVER COMPLIANCE IN ACCORDANCE WITH OMB CIRCULAR A-133
To The Board of County Commissioners
County of Weld, State of Colorado
Greeley, Colorado
Compliance
1. We have audited the compliance of County of Weld, State of Colorado with the types of
compliance requirements described in the U.S. Office of Management and Budget (OMB)
Circular A-133 Compliance Supplement that are applicable to each of its major federal
programs for the year ended December 31, 1998. Weld County's major federal programs
are identified in the accompanying schedule of expenditures of federal awards.
Compliance with the requirements of laws, regulations, contracts, and grants applicable to
each of its major federal programs is the responsibility of Weld County's management
Our responsibility is to express an opinion on Weld County's compliance based on our
audit.
2. We conducted our audit of compliance in accordance with generally accepted auditing
standards; the standards applicable to financial audits contained in Government Auditing
Standards, issued by the Comptroller General of the United States; and OMB Circular A-
133, Audits of States, Local Governments, and Non-Profit Organizations. Those
standards and OMB Circular A-133 require that we plan and perform the audit to obtain
reasonable assurance about whether noncompliance with the types of compliance
requirements referred to above that could have a direct and material effect on a major
federal program occurred. An audit includes examining, on a test basis, evidence about ,
Weld County's compliance with those requirements and performing such other
procedures, as we considered necessary in the circumstances. We believe that our audit
provides a reasonable basis for our opinion. Our audit does not provide a legal
determination of Weld County's compliance with those requirements.
3. In our opinion, County of Weld, State of Colorado complied, in all material respects, with
the requirements referred to above that are applicable to each of its major federal
programs for the year ended December 31, 1998.
Internal Control Over Compliance
4. The management of County of Weld, State of Colorado is responsible for establishing and
maintaining effective internal control over compliance with the requirements of laws,
129
1901 56th Avenue, Suite 200 / Greeley, CO 80634-2950 / 970-330-8860 / Denver 303-825-1752 / Fax 970-330-6680
To The Board of County Commissioners
regulations, contracts, and grants applicable to federal programs. In planning and
performing our audit, we considered Weld County's internal control over compliance with
requirements that could have a direct and material effect on a major federal program in
order to determine our auditing procedures for the purpose of expressing our opinion on
compliance and to test and report on internal control over compliance in accordance with
OMB Circular A-133. DE
5. Our consideration of the internal control over compliance would not necessarily disclose D
all matters in the internal control that might be material weaknesses. A material
weakness is a condition in which the design or operation of one or more of the internal F'
control components does not reduce to a relatively low level the risk that noncompliance
with applicable requirements of laws, regulations, contracts, and grants that would be
material in relation to a major federal program being audited may occur and not be
detected within a timely period by employees in the normal course of performing their
assigned functions. We noted no matters involving the internal control over compliance
and its operation that we consider being material weaknesses.
6. We have audited the general purpose financial statements of County of Weld, State of
Colorado as of and for the year ended December 31, 1998, and have issued our report
thereon dated May 5, 1999. Our audit was performed for the purpose of forming an
• opinion on the general purpose financial statements taken as a whole. The IDE
accompanying schedule of expenditures of federal awards is presented for purposes of C
additional analysis as required by OMB Circular A-133 and is not a required part of the
general purpose financial statements. Such information has been subjected to the
auditing procedures applied in the audit of the general purpose financial statements and,
in our opinion, is fairly stated, in all material respects, in relation to the general purpose F
financial statements taken.as a whole.
7. This report is intended for the information of the board, management, and federal
awarding agencies and pass-through entities. However, this report is a matter of public
record and its distribution is not limited.
May 5, 1999 3Coas 4 ad, D?. r. cu LLL
DI
F
130
z
•
rl COUNTY OF WELD
STATE OF COLORADO
Schedule of Expenditures of Federal Awards
2 For the Fiscal Year Ended December 31, 1998
4
ti
Federal Granting Agency/Recipient State Agency Federal
I, Grant Program CFDA# Expenditures
DEPARTMENT OF AGRICULTURE:
r Direct Payment ,
Bank Head Jones Act N/A 37,218
Pass Through Payment from the State of Colorado
Y
Department of Human Services
Food Stamp Program* 10.551 5,112,594
Child Care/Food Program 10.558 183,003
State Administrative Matching Grants 10.561 364,362
for Food Stamp Program*
Commodity Supplemental Food Program* 10.565 927,195
Food Distribution (Cash in lieu of commodities)* 10.550 278,528
Total Department of Agriculture 6,902,900
DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT: ,
Direct Payments:
Section 8 Rental Certificate Program* 14.857 746,535
Section 8 Rental Voucher Program* 14.855 930,380
Pass Through Payments from the State Department of
Housing and Urban Development:
Home Investment in Affordable Housing 14.239 52,069
Pass Through Payment from the State of Colorado
Department of Social Services:
Emergency Shelter Grants Program 14.231 38,028
Emergency Shelter Grants Program 93.034 2,468
Total Department of Housing and Urban Development 1,769,480
DEPARTMENT OF THE JUSTICE:
Pass Throught Payments from the State Division of
Criminal Justice:
Juvenile Justice & Delinquency Prevention- 16.540 50,280
Allocation to States
Crime Victim Assistance 16.575 5,552
Crime Victim Compensation 16.576 59,364
Drug Control & System Improvement 16.579 132,236
Total Department of Justice 247,432
131
COUNTY OF WELD
STATE OF COLORADO
Schedule of Expenditures of Federal Awards
For the Fiscal Year Ended December 31, 1998
Federal Granting Agency/Recipient State Agency Federal
Grant Program CFDA# Expenditures ? _
DEPARTMENT OF LABOR:
Pass Through Payment from the Colorado Department
of Labor.
Employment Service 17.207 215,831
Summer Job Hunt N/A 10,000
Pass Through Payments from the State of Colorado
Governor's Job Training Office:
Employment & Training Assistance/Dislocated Workers 17.246 167,621
Job Training Partnership Act 17.250 600,300
Total Department of Labor 993,752
DEPARTMENT OF TRANSPORTATION:
Pass Through from the Colorado Department of Highways:
Federal Transit Capital & Operating 20.507 45,600
Assistance Formula Grants
Total Department of Transportation 45,600
ENVIRONMENTAL PROTECTION AGENCY
Direct Payments:
• Air Pollution Control Program Support 66.605 42,619
Total Environmental Protection Agency 42,619
DEPARTMENT OF HEALTH AND HUMAN SERVICES:
Direct Payments:
Head Start* 93.600 3,835,161
Pass Through Payments from the State of Colorado
Department of Social Services:
Special Programs for the Aging - Title III 93.044 188,490
Part B - Grants for Supportive Services & Senior Centers
Special Programs for the Aging - Title III 93.045 155,878
Part C - Nutrition Services
Special Programs for the Aging - Title III 93.046 6,424
Part D - In Home Services for Frail Older Individuals
Special Programs for the Aging - Title VII 93.041 194
Part G - Prevention of Abuse, Neglect & Exploitation of
Older Individuals •
Special Programs for the Aging - Title VII
Part A - Long-term Care Ombudsman Services 93.042 178
for Older Individuals 1
Special Programs for the Aging - Title III
Part F - Preventive Health Services 93.043 7,156
Family Preservation 93.556 54,687
132
COUNTY OF WELD
STATE OF COLORADO
Schedule of Expenditures of Federal Awards
For the Fiscal Year Ended December 31, 1998
Federal Granting Agency/Recipient State Agency Federal
Grant Program CFDA # Expenditures
Refugee CRSP 93.566 1,062
Temporary Assistance for Needy Families* 93.558 723,834
Child Support Enforcement* 93.563 1,012,562
Low Income Home Energy Assistance* 93.568 974,667
Independent Living 93.674 11,497
Child Care Mandatory & Matching Funds 93.596 1,955,960
Child Welfare Services - State Grants 93.645 256,606
Title IV-E, Foster Care* 93.658 1,106,626
Adoption Assistance 93.659 245,646
Social Services Block Grant* 93.667 1,720,896
Medical Assistance Program ( Title XIX, Medicaid) 93.778 268,757
Pass Through from the Department of Local Affairs:
Community Services Block Grant 93.031 199,902
Community Services Block Grant N/A 74,826
Pass Through Payments from the State Department
of Health:
TB Control Programs 93.116 51,633
Family Planning 93.217 88,434
Abstinence Education 93.235 20,232
Immunization Program 93.268 169,111
Cancer Control 93.399 56,999
HIV Care Formula Grants 93.917 55,778
Early Detection & Control of Breast Cancer 93.919 30,549
HIV Prevention Program 93.940 30,471
Sexually Transmitted Diseases 93.977 5,296
Diabetes Control Programs 93.988 8,964
Preventive Health & Health Services 93.991 137,173
Maternal & Child Health Services 93.994 286,408
Total Department of Health and Human Services 13,742,057
DEPARTMENT OF ENERGY & CONSERVATION
Direct Payments
OEC Solid Waste Grant 81.041 33,769
Total Department of Energy & Conservation 33,769
TOTAL FEDERAL EXPENDITURES $23,777,609
*Major Program
133
COUNTY OF WELD
STATE OF COLORADO
NOTES TO SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS
Year Ended December 31, 1998
In 1998 the State of Colorado Department of Human Services completed full implementation of Electronic
Benefit Transfer (EBT). The State phased in counties starting in March of 1997, with completion in
February of 1998 and Weld County up in January 1998. Prior to EBT,benefits were issued by the individual •
county and included in the financial statements. With the start of EBT,warrants are no longer issued by the
county, therefore the expenditure is not reflected in the financial statements.
The following is a disclosure of EBT,Social Services expenditures,not included in the financial statements.
State and Federal Programs
Grant Description FAT not on Financial
Food Stamp Program $5,112,594
CHATS-Day Care 3,206,714
CWEST-Foster Care 2,652,267
Low Income Energy Assistance Program 902,395
Colorado Works/TANF 642,525
State Only Programs
(Not on Schedule of Expenditures of Federal Awards)
State Grant FAT not on Financial
Aid to the Needy/Disabled $376,193
Old Age Pension 1,661,052
134
COUNTY OF WELD
STATE OF COLORADO
SCHEDULE OF FINDINGS AND QUESTIONED COSTS
Year Ended December 31, 1998
SUMMARY OF AUDIT RESULTS
1. The auditors' report expresses an unqualified opinion on the general purpose financial state-
ments of County of Weld.
f
2. No instances of noncompliance material to the general purpose financial statements of County
of Weld were disclosed during the audit.
3. The auditors' report on compliance for the major federal award programs for County of Weld
expresses an unqualified opinion on all major federal programs.
4. Audit findings relative to the major federal award programs for County of Weld are reported
in this Schedule.
5. The programs tested as major programs are identified on the Schedule of Expenditures of
Federal Awards.
1
6. The threshold for distinguishing Types A and B programs was $780,000.
7. County of Weld was determined to be a low-risk auditee.
FINDINGS - FINANCIAL STATEMENT AUDIT
None
3
1 FINDINGS AND QUESTIONS COSTS - MAJOR FEDERAL AWARD PROGRAMS AUDIT
None
1
1
i
1
1
i
I
1
135
COUNTY OF WELD
STATE OF COLORADO
SUMMARY SCHEDULE OF PRIOR AUDIT FINDINGS
Year Ended December 31, 1998
Department of Health and Human Services
Head Start Program - CFDA No. 93.600, grant nos. 08CH0019 and 90CM0136/12; grant years
ending June 30, 1997 and 1998
Condition and Criteria: The transportation cost pool allocation included depreciation in excess
of amounts allowed under generally-accepted methods for computing depreciation. No
depreciation may be allowed on any assets that would be considered as fully depreciated.
Recommendation: Procedures should be established to compute depreciation in accordance
with generally-accepted methods, which is consistently applied for all specific asset or class
of assets for all federally-sponsored programs and must result in equitable charges
considering the extent of the use of the assets for the benefit of such programs.
Current Status: The excessive amounts were not noted in such programs in 1998.
— ATTACHMENT C —
Area Agency on Aging Ruth Gartrell Judy Yamaguchi
Board Membership List 20076 Southgate Ave. 13149 WCR 21
LaSalle, CO 80645 Platteville, CO 80651
Mary Lou Batman H: 970-737-2942 H: 970-785-2150
321 5th Street
Box 375 Mike Geile, Commissioner
Pierce, CO 80650 Centennial Complex
H: 970-834-2415 Greeley, CO 80631
W: 356-4000
Don Beierbach
3826 West 8th Street Virgil Harper
Greeley, CO 80634 2507 16th Avenue
970-352-5952 Greeley, CO 80631
H: 970-352-3743
Paula Bernhardt
1130 3rd Avenue Shirley Ianelli
Greeley, CO 80631 7451 Road 49
H: 970-352-3667 Hudson, CO 80642
H: 303-536-9243
John Cruz
130 Sunflower Dr. Mary Jones
Windsor, CO 80550 30887 Road 88
H: 970-686-7312 Ault, CO 80610
H: 970-656-3652
Mary Pat Eastwood
3609 Marigold Street Mary Jane Lang
Evans, CO 80620 P.O. Box 501
W: 970-346-1446 Frederick, CO 80530
H: 970-330-3436 H: 303-833-2836
Mary Ellen Faules John Lee, Manager
746 27th Avenue Transit Division
Greeley, CO 80631 1000 10th Street
H: 970-351-6121 Greeley, CO 80631
W: 350-9280
Don Feldhaus
2038 27th Avenue Ct. #4 Bernie Olivas
Greeley, CO 80631 P.O. Box 18 O; ILESIBOARDIMEMBE
�WPF
H: 970-330-7522 Pierce, CO 80650 O:IWPFMLIST.99
H: 970-834-2793
Mary Fox Revised 03-26-99
327 5th Street Josie Sanchez
P.O. Box 425 PO Box 13
Kersey, CO 80644-0425 Pierce, CO 80650
H: 970- W: 970-351-2829
W: 970-352-8394 H: 970-834-2173
The Legal Center for People ATTACHMENT 3
with Disabilities ir and Older People
Colorado's Protection &Advocacy System
September 7, 1999
Diana Hutcheson, Lead Ombudsman
Weld County Area Agency on Aging
1551 North 17th Avenue
P.O. Box 1805
Greeley, CO 80632
Dear Diana:
I am writing to support your effort to obtain funding from VALE to continue the •
excellent work you have provided on Ensuring An Abuse Free Environment training.
This type of training is critical for not only certified nurses assistants (CNAs) and other
front line staff in long-term care facilities but also for managerial staff. The
evaluations and feedback received from those who have attended the training attest
to both its usefulness and to the quality of the training you have provided.
As State Long-term Care Ombudsman I am well aware of the great need for quality
training of this type and I wish you success in finding funding to continue this
important and needed educational service.
Very truly yours,
Janet Meyers, Esq.
State Long-term Care Ombudsman
•
455 Sherman Street-Suite 130-Denver,Colorado 80203-4403-303-722-0300-PAX 303-722-0720-Toll Free 1-800-288-1376-TDD for Hearing Impaired
2829 North Avenue-Suite 205-Grand Junction,Colorado 81501-1501-970-241-6371-FAX 970-241-5324
Assisted Living
at Life Care Center of .Greeley
September 7, 1999 ,
Dear Vale Grant Committee: `.
This Jotter is in support of the continuation of the Victim's Assistance Law Enforcement WALE)
' grant to the Ombudsman Program of the Weld County Agency on Aging. This grant has allowed
for the training of direct care giving staff to help prevent abuse and neglect in long term care
facilities.
The work that the direct care givers do is difficult and many times underappreciated, this training
recognizes that this work is valuable and gives the care givers tools to do their job more
effectively and deal with difficult situations. I was the Weld County Long Term Care
•
Ombudsman for four years before becoming a provider of assisted living; this experience has
been a basis for my support of the CARIE program as well as the opportunity to read the positiye
comments from staff who have participated and to listen to their personal stories.
Please consider continuing your support of this valuable program. ,
Sincerely, -
t Mindy Rickard
General Manager
R
4750 25th Street • Greeley,CO 80634 • (970) 339-0022 • .FAX (970) 506-9031
Long Term Care
Home Health Community Certified Nurse Aide
Training Program
Hospitals
Higher Education
Consortium Members September 8, 1999
Aims Community College To Whom It May Concern:
Health Occupations Department
The C.A.R.I.E. training, which has been presented at the
Bonell Good Samaritan Center
Centennial Area Health Education Community Certified Nurse Aide Training Center as
Center,Inc. part of our Preceptor Mentor Program, is a valuable
Colorado Home Care tool for our CNA's to help ensure an abuse free
Fairacres Manor,Inc.
environment. The program has received high marks
Kenton Manor
from those who have attended it. Many attendees
LHS Home and Community Care
have indicated the training has helped them to
Life Care Centers of Greeley and The Bridge
recognize and prevent abusive situations.
Mariner Post Acute Network
North Colorado Medical Center I would certainly recommend that this program
Rehabilitation and Visiting Nurse Association continue and be offered more frequently, as it is
The Villa at Greeley,Inc. valuable to all staff serving residents in long-term
University of Northern Colorado care facilities.
Gerontology Program
School of Nursing If you have any questions or would like further
information, please feel free to contact me.
Sincerely, g 4•Teresa L. Masters, RN
Program Coordinator
2319 7th Avenue Greeley, CO 80631 • 970 395 - 1055
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ATTACHMENT G
ENSURING AN ABUSE EtEE ENVIRONMENT
Training Evaluation
We are very interested In having your feedback concerning the training
and would appreciate your time in completing this evaluation form. Thank
you!
1. The length of the training program was:
1 Too long
2 Too short
3 Just right
2. The material presented was:
1 Easily understandable
2 Understandable
3 Somewhat difficult to understand
4 Very difficult to understand
3. Opportunity given to ask questions or make comments was:
1 Not enough
2 Too much
3 Just right
4. How comfortable did you feel discussing the training topics?
1 Very comfortable
2 Somewhat comfortable
3 A little uneasy
4 Very uneasy
5. Could you relate the material covered to your own experience on
the job?
1 Yes
2 No
6. Was the videotape helpful to you?
1 Yes
2 No
7. What is your overall opinion of this training program?
1 Excellent
2 Good
3 Average
4 Inadequate
5 Very poor
8. Would you recommend this training to other nursing home staff?
1 Yes
2 No
9. What did you like BEST about this training?
10. What did you like LEAST about this training?
11. If additional training was offered to CNAs, what topic(s) would be
the most beneficial to YOU?
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RECOMMENDED GUIDELINES FOR REPORTING ABUSE OF ADULTS IN LONG-TERM CARE
ATTACHMENT H
In response to concerns and confusion about the reporting of abuse, a group of State agencies convened and have suggested
the following guidelines. The agencies include:
The Colorado Department of Public Health and Environment
The Colorado Department of Human Services, Adult Protection
The Colorado Department of Regulatory Agencies, Board of Nursing
The Colorado Department of Regulatory Agencies, Complaints and Investigations
Office of the Colorado Attorney General,-Medicaid Fraud Control Unit
The State Ombudsman
Legal Services Developer
Protection and Advocacy System, the Legal Center
Any suspected crime must be reported immediately to law enforcement officials. This does not replace reporting which is
required by other state agencies. The most common examples of crime which must be reported are :
/Assault
/Sexual Assault
/False imprisonment (including unnecessary restraint)
/Suspicious death/Homicide
/Criminal negligence (gross deviation from standard of care)
/Theft of personal belongings
/Theft of personal needs account
The following recommended guidelines may be used to determine whether any suspected abuse, neglect, or
mistreatment should be reported. WHEN IN DOUBT, REPORT!
DEFINITIONS:
PHYSICAL ABUSE - STAFF TO RESIDENT is the infliction of injury or pain - slapping, hitting, kicking, etc. which leaves bruises or
causes pain, including the unauthorized use of physical or chemical restraints.
VERBAL/EMOTIONAL ABUSE includes, but is not limited to demeaning statements, harassment, threats, humiliation, or
intimidation.
SEXUAL ABUSE/ASSAULT is vaginal, anal, or oral intercourse or the touching of a person's genitalia or the female breasts whether
or not it is done under clothing, when the activity is done without permission or with someone who is unable to give informed
consent and for no medical reason.
PHYSICAL ABUSE, EMOTIONAL ABUSE, OR VERBAL ABUSE - REPORTING REQUIREMENTS
Those items starred are mandated by statute or regulation for all types of facilities and
programs. Additional reporting requirements may apply in specific circumstances or
be required by facility policy.
RESPONSIBILITY OF FACILITY OR CARETAKER: TIMEFRAME:
1. Provide medical attention. Immediate / as
necessary
2. Notify local law enforcement in the area where the Immediate
abuse has occurred for cases of physical abuse,
threats, intimidation or harassment. This is a
mandatory requirement where the abuse occurs to a
resident under 16 years of age.
Page 18
�.u«ly ie t,UIUr4UU I.Jt}.JcIuHURL LA ruuuc rieaitn ana tnvironment. By next business say
4. Notify county Department of Human Services. Within 24 hours
5. Notify Community Center Board if abuse occurs in As appropriate
Developmentally Disabled Homes.
6. Notify family or guardian, if one has been appointed Immediate
by a court of law and is evidenced by letters of guardianship.
7. Notify the Medicaid Fraud Control Unit. Within 24 hours
8. Notify local ombudsman. Within 24 hours
9. Notify appropriate licensure board. As required by
regulation
10. Follow internal procedures. Immediate / as
necessary
SEXUAL ABUSE/ASSAULT - REPORTING REQUIREMENTS
1. Provide medical attention. Immediate / as
necessary
Do not bathe resident;
Do not remove clothing unless absolutely necessary;
If removal of the resident's clothing is necessary, preserve the evidence as follows:
Place in paper bag or sack, do not place clothing in plastic bags;
Mark the sack with name of the resident, the date, and the initials of the
person collecting the evidence.
2. Notify local law enforcement; Immediate
Check with local jurisdiction for appropriate procedures.
*3. Notify Colorado Department of Public Health and Environment. By next business day
4. Notify county Department of Human Services. Within 24 hours
5. Notify the Community Center Board if the abuse occurred As appropriate
in a Developmentally Disabled Home.
6. Notify family or guardian, if one has been appointed by a Immediate
court of law and is evidenced by letters of guardianship.
7. Notify the Medicaid Fraud Control Unit. Within 24 hours
8. Notify local ombudsman. Within 24 hours
9. Notify appropriate licensure board. As required by
regulation
10. Follow internal procedures. Immediate / as
necessary
Page 19
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