Agency Information Collection Activities; Submission for OMB Review; Public Comment Request; Adult Protective Services Client Outcome Study

Published date04 December 2019
Citation84 FR 66426
Record Number2019-26182
SectionNotices
CourtCommunity Living Administration,Health And Human Services Department
Federal Register, Volume 84 Issue 233 (Wednesday, December 4, 2019)
[Federal Register Volume 84, Number 233 (Wednesday, December 4, 2019)]
                [Notices]
                [Pages 66426-66428]
                From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
                [FR Doc No: 2019-26182]
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                DEPARTMENT OF HEALTH AND HUMAN SERVICES
                Administration for Community Living
                [OMB#0985-XXXX]
                Agency Information Collection Activities; Submission for OMB
                Review; Public Comment Request; Adult Protective Services Client
                Outcome Study
                AGENCY: Administration for Community Living, HHS.
                ACTION: Notice.
                -----------------------------------------------------------------------
                SUMMARY: The Administration for Community Living is announcing that the
                proposed collection of information listed above has been submitted to
                the Office of Management and Budget (OMB) for review and clearance as
                required under the Paperwork Reduction Act of 1995. This 30-Day notice
                collects comments on the information collection requirements related to
                the ``Adult Protective Services Client Outcome Study'' (New Data
                Collection [ICR New]).
                DATES: Comments on the collection of information must be submitted
                electronically by 11:59 p.m. (EST) or postmarked by January 3, 2020.
                ADDRESSES: Submit written comments on the collection of information by:
                 (a) email to: [email protected], Attn: OMB Desk Officer
                for ACL;
                 (b) fax to 202.395.5806, Attn: OMB Desk Officer for ACL; or
                 (c) by mail to the Office of Information and Regulatory Affairs,
                OMB, New Executive Office Bldg., 725 17th St. NW, Rm. 10235,
                Washington, DC 20503, Attn: OMB Desk Officer for ACL.
                FOR FURTHER INFORMATION CONTACT: Stephanie Whittier Eliason,
                Administration for Community Living, Washington, DC 20201, (202) 795-
                7467, [email protected].
                SUPPLEMENTARY INFORMATION: In compliance with 44 U.S.C. 3507, ACL has
                submitted the following proposed collection of information to OMB for
                review and clearance.
                 APS programs are provided by state and local governments nationwide
                and serve older adults and adults with disabilities in need of
                assistance due to maltreatment, which can include: Physical, emotional,
                and sexual abuse; financial exploitation; neglect; and self-neglect.
                APS is an important avenue through which maltreatment is reported to
                law enforcement or other agencies.
                 Additionally, APS programs are often the gateway for adults who
                experience
                [[Page 66427]]
                maltreatment to access additional community, social, health, behavioral
                health, and legal services to maintain independence in the settings in
                which they prefer to live. APS programs work closely with clients and a
                wide variety of allied professionals to maximize safety and
                independence, while respecting each client's right to self-
                determination. At this time, there is no single funding stream for APS
                nor a single set of rules and regulations that APS programs must
                follow. Building the evidence-base for APS programs and practices,
                promoting the use of evidence-based and promising practices, and
                developing guiding standards are key needs for the APS field.
                 The proposed new data collection will examine if and how APS
                programs make a difference in the lives of APS clients. Specifically,
                the data collection will help examine (1) what changes clients report
                as a result of receiving APS services; (2) how satisfied clients are
                with the APS services they receive; (3) to what extent clients report
                APS helps them achieve their goals; (4) to what extent clients report
                APS supports their right to self-determination; (5) to what extent APS
                programs affect client safety (risk of maltreatment); (6) how APS
                program intervene to reduce client risk of maltreatment; (7) what
                factors help or hinder APS efforts to reduce risk of maltreatment; (8)
                to what extent APS programs affect client well-being (e.g., quality of
                life, financial, physical health, etc.); (9) how APS programs intervene
                to improve client-well-being; and (10) what factors help or hinder APS
                efforts to improve client well-being. The data collection will be
                conducted with three target populations: (1) APS clients, (2) APS
                caseworkers, and (3) APS leaders. APS leaders will consist of APS state
                and APS county leaders.
                 Data collection with these three target populations will include: A
                brief, anonymous APS client questionnaire, including a de-identified
                client data form; a semi-structured in-person interview with APS
                clients; a semi-structured in-person focus group with APS caseworkers;
                and a semi-structured interview with APS leaders.
                 The APS client questionnaire is designed to be as brief as
                possible, while examining key client outcome areas, identified in
                collaboration with a national expert panel consisting of federal
                experts, researchers, practitioners, and program leaders in APS. The
                outcomes areas focus on: Satisfaction with APS, safety, and well-being,
                and will be assessed with nine questions. The question statements
                examining these areas are designed to be short and easy to understand.
                The first item on the questionnaire provides a simple ``yes/no''
                response option. For the remaining questions, APS clients or a proxy
                (respondents) are asked to rate the extent which they agree with each
                statement using a Likert-type rating scale ranging from `strongly
                disagree' to `strongly agree'. Respondents also have the option of
                sharing anything else about their experience with APS through an open-
                ended question at the end of the form. The questionnaire will be hand-
                delivered to the client or proxy respondent by the APS caseworker at
                case closure. The respondent will complete the questionnaire and mail
                it back to the research team by using a prepaid return envelope.
                 The client data form will be linked to the client questionnaire
                using a pre-populated eight-digit form number. The client data form is
                designed to capture de-identified, basic demographic information and
                additional details about APS clients and their cases.
                 These data points are expected to be among the information about
                clients, and their cases, that caseworkers already collect during
                normal APS processes. The form does not collect any personally
                identifiable information. The form will be completed online by APS
                caseworkers. If an APS program prefers another method of completing the
                form, hard copies can be provided and mailed back to the research team
                using a prepaid return envelope.
                 Individual interviews with APS clients are designed to gain more
                in-depth knowledge about the experiences and needs of APS clients along
                the key outcome areas assessed in the questionnaire. A standardized,
                semi-structured interview guide will be used to guide the interviews
                with clients who provide informed consent.
                 Focus groups with APS caseworkers will be conducted in person,
                using a standardized, semi-structured focus group guide. Individual
                interviews with APS leaders will be conducted either in-person or by
                phone with county and state leaders using a standardized, semi-
                structured, interview guide. Similar to client interviews, focus groups
                with APS caseworkers and interviews with APS leaders will focus on the
                identified outcome areas. Additional questions will be asked to gain
                insight into access and availability of services, collaboration and
                partnerships with other entities in the community, and barriers and
                facilitating factors that affect APS services and client outcomes. The
                interview guide for APS leaders also contains questions related to APS
                policies and procedures.
                Comments in Response to the 60-Day Federal Register Notice
                 A notice was published in the Federal Register on August 20, 2019
                (Vol. 84, Number 161; pp. 43137-43139). ACL received a total of three
                comments in response to the notice. None of the comments raised
                significant concerns about the proposed collection of information. The
                following table lists each comment, by data collection tool, and
                provides ACL's response.
                ------------------------------------------------------------------------
                 Data collection tool(s) Comment ACL response
                ------------------------------------------------------------------------
                Client Data Form............ The status at The level of client
                 closing should engagement item is
                 include an designed to capture
                 additional option: this information.
                 Services knowingly However, the item
                 refused by wording should
                 competent adult. specify engagement
                 with APS, including
                 the investigation
                 and services
                 (specified
                 separately).
                 Competency can be
                 determined using
                 the respondent type
                 item. The following
                 changes are
                 proposed: (1)
                 Revise the item to
                 read: ``Level of
                 Client Engagement
                 with APS:``; (2)
                 Create table
                 (similar to the
                 item for type of
                 maltreatment) or
                 other revised
                 formatting to
                 capture level of
                 client engagement
                 with two separate
                 aspects of APS: (a)
                 the investigation,
                 (b) services. No
                 revisions are
                 proposed to the
                 response options
                 for this item.
                [[Page 66428]]
                
                Client Data Form............ The above initiative ACL recognizes that
                 will be of great APS programs vary
                 benefit to the in terms of the
                 field of APS. Thank criteria used to
                 you for undertaking determine
                 much needed work. eligibility to
                 Your approach is receive APS. ACL
                 sound and we look further believes
                 forward to the that this
                 results of this information is
                 work. My comment meaningful to the
                 regarding APS is of study. The
                 a broad general following change is
                 nature. What is an proposed: (1) Add
                 APS client in the new item to the
                 USA? There is no client data form:
                 unified definition ``How did the
                 on what is a person client qualify to
                 that needs APS receive APS
                 services. Most services (check all
                 states use a that apply)?'' with
                 definition that check boxes for two
                 includes a response options:
                 vulnerability. The ``1) On the basis
                 person is 18+ and of old age''; ``2)
                 due to a permanent On the basis of
                 physical or mental disability/
                 disability is vulnerability/
                 unable to provide etc''.
                 for his or her own
                 care and
                 protection.
                 However, many
                 states (10 to 12 I
                 believe) have an
                 age demarcation on
                 what is an APS
                 client. Anyone 60+
                 or 65+ is an
                 automatic client.
                 This is misleading.
                 As you know, \2/3\
                 of the members of
                 congress are over
                 60 or 65, not to
                 mention our
                 president and many
                 of the democrats
                 running for the
                 presidency. Are
                 those states
                 telling us that
                 just because you
                 are 60 you cannot
                 protect or provide
                 for yourself and
                 you need APS
                 services? These
                 states have laws
                 that go back
                 decades and they
                 have not been
                 updated. This
                 creates an
                 inconsistency in
                 national data on
                 abuse, neglect,
                 exploitation a true
                 vulnerable APS
                 client. APS needs
                 to focus on folks
                 who are vulnerable.
                 Not folks who
                 happen to be 60+
                 and are caught in
                 the pool. The US
                 needs a consistent
                 definition of what
                 is an APS client so
                 that the data can
                 be more meaningful.
                Interview Guide APS Leaders; Below are comments: The APS leader
                 Focus Group Guide APS Applaud ACL interview guide and
                 Caseworkers. for doing this APS caseworker
                 study via a random focus group guide
                 sampling of include an item
                 clients, APS that very closely
                 caseworkers and matches the
                 administrators at recommendation in
                 both the state and the comment. For
                 local level. example, the
                 Questions ``Conclusion''
                 seek to validate if section, item ``A''
                 client autonomy and of the APS leader
                 engagement is interview guide
                 honored (i.e., reads: ``If money
                 client self- and resources were
                 determination unlimited, what
                 recognized by the would you change
                 APS investigator about [name of APS
                 and the need for program] in order
                 APS to balance to do a better job
                 Autonomy with of improving
                 Beneficence and clients' lives?''
                 Nonmaleficence.). This item extends
                 These the focus of the
                 surveys of clients, question beyond
                 APS caseworkers and service delivery to
                 administrators ask client outcomes,
                 open-ended, semi- which is of primary
                 structured interest for this
                 questions around study.
                 domains of client
                 satisfaction,
                 improved safety,
                 and resource
                 access, which is a
                 nice approach.
                 Recommend
                 one additional
                 question for
                 caseworkers and
                 administrators,
                 ``If you had an
                 unlimited budget,
                 what would you give
                 to APS to improve
                 their services
                 delivery?`` Good
                 luck with this
                 important work.
                ------------------------------------------------------------------------
                 The proposed data collection tools may be found on the ACL website
                for review at https://www.acl.gov/about-acl/public-input.
                Estimated Program Burden
                 ACL estimates the burden associated with this collection of
                information as follows:
                ----------------------------------------------------------------------------------------------------------------
                 Number of Responses per Hours per Annual burden
                 Respondent/data collection activity respondents respondent response hours
                ----------------------------------------------------------------------------------------------------------------
                Client Questionnaire........................ 6,000 1 0.167 1,002
                Client Data Form............................ 6,000 1 0.167 1,002
                Client Interview............................ 24 1 0.75 18
                APS Caseworker Focus Group.................. 84 1 1.5 126
                APS Leaders Interview....................... 16 1 1 16
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                 Total................................... 12,124 ............... 3.58 2,164
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                 Dated: November 27, 2019.
                Lance Robertson,
                Administrator and Assistant Secretary for Aging.
                [FR Doc. 2019-26182 Filed 12-3-19; 8:45 am]
                BILLING CODE 4154-01-P
                

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