About Adult Protective Services
The Colorado Adult Protective Services (APS) program was established in statute in 1983, and rules detail how the APS program must be implemented. APS investigates allegations of physical and sexual abuse, caretaker neglect, exploitation and harmful acts (collectively referred to as "mistreatment") and self-neglect of at-risk adults. APS offers protective services to improve the health, safety, and welfare of at-risk adult experiencing mistreatment or self-neglect. APS uses community-based services and resources, health care services, family and friends when appropriate, and other support systems while protecting the at-risk adult's right to confidentiality, self-determination, and least-restrictive intervention.
The APS program will be presenting a proposed change to the rules to the State Board of Human Services on May 7, 2021. You can read about the proposed changes here. If you have comments or feedback about the rules, please email email@example.com. You can find information about attending the State Board meeting and providing public comment here.
- Learn more about Colorado's system
Colorado operates as a state supervised, county administered system. County departments of human services’ Adult Protective Services (APS) programs provide for the safety and protection of at-risk adults who are, or are suspected to be, victims of mistreatment. The county department APS programs:
- Receive reports of mistreatment, which includes physical abuse, sexual abuse, caretaker neglect, exploitation, other harmful acts, and self-neglect;
- Investigate allegations and conduct an assessment of the client's strengths and needs; and
- Arrange for needed services to reduce risk and improve safety.
Who are at-risk adults?
At-risk adults are persons age 18 and older who are unable to provide or obtain services necessary for their health, safety, and welfare OR who lack the capacity to make or understand responsible decisions. Conditions that increase risk include dementia, physical or medical frailty, developmental disabilities, brain injury, behavioral disorders, and mental illness. Approximately 51% of at-risk adults served by APS have multiple conditions.
Mistreatment and self-neglect
APS receives more than 25,000 reports of suspected mistreatment or self-neglect in Colorado each year. Mistreatment includes physical abuse, sexual abuse, caretaker neglect, exploitation, and other harmful acts committed by another person against an at-risk adult. Self-neglect occurs when the at-risk adult substantially endangers their health, safety, and welfare because they are not meeting their essential human needs.
- Learn more about mistreatment and self-neglect
“Abuse,” pursuant to Section 26-3.1-101(1), C.R.S., means any of the following acts or omissions committed against an at-risk adult:
- The non-accidental infliction of physical pain or injury, as demonstrated by, but not limited to, substantial or multiple skin bruising, bleeding, malnutrition, dehydration, burns, bone fractures, poisoning, subdural hematoma, soft tissue swelling, or suffocation;
- Confinement or restraint that is unreasonable under generally accepted caretaking standards; or,
- Unlawful sexual behavior as defined in Section 16-22-102(9), C.R.S.
"Caretaker neglect," pursuant to Section 26-3.1-101(2.3)(a), C.R.S., means neglect that occurs when adequate food, clothing, shelter, psychological care, physical care, medical care, habilitation, supervision, or other treatment necessary for the health, safety, or welfare of the at-risk adult is not secured for an at-risk adult or is not provided by a caretaker in a timely manner and with the degree of care that a reasonable person in the same situation would exercise, or when a caretaker knowingly uses harassment, undue influence, or intimidation to create a hostile or fearful environment for an at-risk adult. However, the withholding, withdrawing, or refusing of any medication, any medical procedure or device, or any treatment, including but not limited to resuscitation, cardiac pacing, mechanical ventilation, dialysis, artificial nutrition and hydration, any medication or medical procedure or device, in accordance with any valid medical directive or order, or as described in a palliative plan of care, is not deemed caretaker neglect. In addition to those exceptions identified above, access to Medical Aid in Dying, pursuant to Title 25, Article 48, C.R.S., shall not be considered caretaker neglect.
"Caretaker," pursuant to Section 26-3.1-101(2), C.R.S., means a person who:
- Is responsible for the care of an at-risk adult as a result of a legal relationship; or
- Has assumed responsibility for the care of an at-risk adult; or,
- Is paid to provide care, services, or oversight of services to an at-risk adult.
"Exploitation" means an act or omission that:
- Uses deception, harassment, intimidation, or undue influence to permanently or temporarily deprive an at-risk adult of the use, benefit, or possession of anything of value; or,
- Employs the services of a third party for the profit or advantage of the person or another person to the detriment of the at-risk adult; or,
- Forces, compels, coerces, or entices an at-risk adult to perform services for the profit or advantage of the person or another person against the will of the at-risk adult; or,
- Misuses the property of an at-risk adult in a manner that adversely affects the at-risk adult’s ability to receive health care or health care benefits or to pay bills for basic needs or obligations.
“Harmful act” means an act committed against an at-risk adult by a person with a relationship to the at-risk adult when such act is not defined as abuse, caretaker neglect, or exploitation but causes harm to the health, safety, or welfare of an at-risk adult.
"Self-neglect," pursuant to Section 26-3.1-101(10), C.R.S., means an act or failure to act whereby an at-risk adult substantially endangers his or her health, safety, welfare, or life by not seeking or obtaining services necessary to meet the adult's essential human needs. Choice of lifestyle or living arrangements shall not, by itself, be evidence of self-neglect. Refusal of medical treatment, medications, devices, or procedures by an adult or on behalf of an adult by a duly authorized surrogate medical decision maker or in accordance with a valid medical directive or order, or as described in a palliative plan of care, shall not be deemed self-neglect. Refusal of food and water in the context of a life-limiting illness shall not, by itself, be evidence of self-neglect. "medical directive or order" includes, but is not limited to, a Medical Durable Power of Attorney, a Declaration as to Medical Treatment executed pursuant to Section 15-18-104, C.R.S., a Medical Orders for Scope of Treatment Form executed pursuant to Article 18.7 of Title 15, C.R.S., and a CPR Directive executed pursuant to Article 18.6 of Title 15, C.R.S. In addition to those exceptions identified above, access to Medical Aid in Dying, pursuant to Title 25, Article 48, C.R.S., shall not be considered self-neglect.
Reporting to APS
If you suspect an at-risk adult may be experiencing mistreatment or is self-neglecting his or her basic needs, call the county department where the at-risk adult lives to make a report. It’s OK to report even if you just suspect something is wrong as long as you make the report in good faith. If you knowingly make a false report it is a class 3 misdemeanor and if you are charged and convicted, you could receive a fine of up to $750, six months in jail, or both.
Please note: If you are a mandatory reporter (CRS 18-6.5-108) and suspect an at-risk elder (a person age 70 or older) or at-risk adult with intellectual and developmental disabilities is being abused, neglected or exploited, you must contact the law enforcement agency where the client resides to make a report. You can find more information about mandatory reporting and an online training here.
- Learn more about reporting to APS
Below is helpful information when making a report but, even if you don't have all this information and you think an at-risk adult is being mistreated, you should still make a report.
- What prompted the call today? Did something happen?
- How is the adult being mistreated? When did you last see the adult?
- Does the adult have any medical or physical conditions that impair the adult's ability to provide for day-to-day needs?
- Does the adult have a diagnosed mental illness or show signs of a mental illness?
- Does the adult have any problems with memory, decision making, or understanding how to care for him/herself?
- Does the adult have any developmental, intellectual, or cognitive disability that is impairing the ability for self-care?
- Has there been any decline in the adult's ability to adequately do cooking, shopping, using available transportation, managing medications, or mobility?
- Is the adult working with any service providers to address his/her needs? Any friends or family who are supportive?
- Have any actions been taken yet that address your concerns?
- Can you think of anyone else who might have additional information that we could contact?
If your call is about caretaker neglect:
- Remember that a caretaker can be paid or unpaid, family, a home health provider, spouse, child, neighbor, friend, or facility staff.
- Does the caretaker misuse drugs or alcohol?
- Does the caretaker isolate or prevent outside contact with the adult?
- Does the adult demonstrate fear of the caretaker?
- Is the caretaker financially dependent on the adult?
- Is the caretaker depriving the adult of basic necessities?
If your call is about exploitation:
- Is anyone using the adult's money for their own personal needs without the adult's knowledge?
- Has the adult's bank account been depleted?
- Is there an unexplained disappearance of funds or valuables?
- Has there been questionable transfer of assets or real estate?
If your call is about physical abuse or sexual abuse:
- Does the adult have any current injuries?
- Does the alleged abuser have access to the adult?
- Does the adult demonstrate any fear of the alleged abuser?
- Has the adult experienced any pain as a result of the abuse?
If your call is about self-neglect:
- Is the adult malnourished or dehydrated as a result of self-neglect?
- Is the adult's hygiene poor resulting in health hazards?
- Is the adult hoarding and as a result the living situation is unsafe?
- Does the adult have any untreated medical or mental health needs?
- Is the adult homeless?
- Is the adult aware of his/her needs?
- Is the adult able to provide for his/her own basic needs?
Responsibilities, limitations and ethical principles
In Colorado, APS report and case information is confidential and, except in limited circumstances established in statute, cannot be shared without a court order for good cause. APS must also adhere to several ethical principles, including the at-risk adult’s right to self-determination, consent to services, and APS should provide protective services that are the least restrictive services that will meet the adult’s health and safety needs.
- Learn more about responsibilities, limitations and ethical principles
Colorado statute requires that all reports to APS and all subsequent case information remain confidential unless a court orders a release of information for good cause, with a few exceptions outlined in statute. These same restrictions limit the information APS can provide to the reporting party. Therefore, the reporting party is not entitled to any follow up or further information once they have made the report, unless it's necessary to provide protective services. Any person who violates the confidentiality provisions in the APS statute is guilty of a crime and may be prosecuted.
Self-determination and consent
Self-determination is the right of an adult to choose his or her own course of action and/or outcomes without compulsion. The APS caseworker is required by statute and through the ethical principle of self-determination to get consent from the adult prior to providing any services. Unless there is a law, code, or ordinance prohibiting or limiting a choice, the at-risk adult has the right to make lifestyle choices that others feel are objectionable or even dangerous, such as:
- Refusing medical treatment;
- Refusing to take necessary medications;
- Choosing to abuse alcohol or drugs;
- Living in a dirty or cluttered home;
- Continuing to live with the perpetrator;
- Keeping large numbers of pets; or
- Engaging in other behaviors that may not be safe.
Self-determination means that the at-risk adult has the right to refuse services. If the adult refuses APS assistance and appears capable of understanding the consequences of doing so, he or she cannot be forced to accept any services. For example, a caseworker may determine that an adult would benefit from meal preparation services and home health care. The adult agrees to meal services but refuses home health care. Even after consenting to services, an at-risk adult may refuse to allow access to records or persons that could aid in providing those services, such as obtaining medical or bank records or working with family to establish a care plan.
When an at-risk adult consents to services, the APS caseworker has an ethical and statutory requirement to arrange services that constitute the least-restrictive intervention. These are services implemented for the shortest duration and to the minimum extent necessary to meet the needs of the at-risk adult. Examples of least-restrictive intervention include:
- A day program or in-home services instead of placement in an assisted living facility; or
- A move to an assisted living facility instead of to a nursing home.
Data and resources
You can find additional information and data on the APS program in our FY 2019-20 Annual Report. The Colorado Adult Protective Services Annual Report provides details regarding the APS program and the at-risk adults served by the APS program.
Contact the Colorado APS Office at firstname.lastname@example.org with further questions. Do not report mistreatment and self-neglect to email@example.com; doing so could result in a delayed response and does not meet your obligation under the law.