[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.
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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.
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Data collection tool(s) Comment ACL response
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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.
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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:
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Number of Responses per Hours per Annual burden
Respondent/data collection activity respondents respondent response hours
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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