EAMN Attachments with Table of Contents

Attachments
Table of contents
Attachment A – Initial Invitation Letter
Attachment B – Project Description
Attachment C – Summary of Background Research (example)
Attachment D – Semi-structured telephone interview guide for state APS representatives
Attachment E – Letter of Project Approval from Urban IRB

Telephone Interviews with State APS Representatives
Introductory Email

SUBJECT: Requesting information for BJS-sponsored elder abuse study

Dear ___,

I am writing to request no more than 30 minutes of your time to conduct a
telephone interview for a research study on the feasibility of using existing APS data
to help estimate the prevalence of reported incidents of elder abuse, mistreatment,
and neglect nationwide. My name is _______, and I am a research associate with the
Urban Institute in Washington, DC. This study is sponsored by the federal Bureau
of Justice Statistics (BJS), a part of the U.S. Department of Justice.
This fall, we will conduct an online survey of state and local APS agencies to learn
whether they routinely collect a common set of case information that could be used
to develop national statistics on reported elder abuse. The attached 1-page project
description contains more information about our research approach.
In preparation for the online survey, we would like to speak with you to verify our
understanding of the APS response in your state. Attached is a summary of
background information we have compiled, including information from NAPSA’s
2012 survey of state APS agencies. Additionally, we would like your input on the
appropriate points of contact for our online survey in the fall.
Please let me know your availability for approximately a 30-minute telephone
interview on one of the following days: LIST POSSIBILITIES.
Thank you for your consideration.
Sincerely,
________________

For more information about the Urban Institute, please go to www.urban.org

URBAN INSTITUTE

Justice Policy Center

PROJECT DESCRIPTION

Assessment of Administrative Data on
Elder Abuse, Mistreatment, and Neglect (EAMN)
Problem Statement
Elder Abuse, Mistreatment, and Neglect (EAMN) is a growing concern as the
population of elderly persons increases within the United States. Yet uniform and
comparative statistics on incidents reported to Adult Protective Services (APS) agencies
and related responses are not available nationwide due to widespread variation in states’
legal definitions of elder abuse and reporting mechanisms for tracking cases. This lack
of uniform data has impeded policymakers’ abilities to adequately estimate and track
the prevalence of EAMN reported to APS agencies, make comparisons across
jurisdictions, and evaluate the effectiveness of responses to EAMN.

Project Purpose
This project is a first, exploratory step toward the creation of a nationwide statistical
reporting system that would uniformly track the prevalence of EAMN that has been
reported to APS agencies and responses to reported cases.
The Bureau of Justice Statistics (BJS)—through its grantee, the Urban Institute’s
Justice Policy Center—is assessing the feasibility of using existing data from APS
agencies as the basis of a nationwide EAMN statistical reporting system. This project
examines the extent to which APS agencies collect and maintain a common set of
information about EAMN cases, as well as agency capacity to report statistical
information about these cases.

Project Activities
 An online survey of state and local APS agencies is scheduled for the fall of
2013 and collects information on:
o The specific scope of abuse reports that APS agencies respond to;
o What types of individual-level case records APS agencies maintain
(e.g., reports of suspected abuse, case investigations, case outcomes);
o Victim-, perpetrator- and case-level characteristics that are maintained
within APS agencies’ record-keeping systems; and
o Technical assistance and resources needed to participate in a
nationwide statistical data collection.
 In preparation for the online survey, we are conducting telephone interviews
with state APS representatives to verify our background research.

Project Results
The study’s final report, scheduled for December 2014, will provide an overview of
APS agencies’ practices on detecting, reporting, and collecting data on EAMN.
Specifically, the report will:
 Describe current data collection practices across states, including the processes
by which EAMN cases are reported and types of data collected by APS
agencies;
 Identify commonalities in reporting practices and data availability across states,
as well as highlight gaps in key information; and
 Give recommendations to BJS on the feasibility and challenges of
implementing a national EAMN data reporting system.

Funded by the
Bureau of Justice
Statistics (BJS)
2010-MU-MU-K072
Erica L. Smith
Program Officer
[email protected]
(202) 616-3491

Urban Institute
Project Staff
Janine M. Zweig
Co-Principal Investigator
[email protected]
(518) 791-1058
Kamala Mallik-Kane
Co-Principal Investigator
[email protected]
(202) 261-5857
Darakshan Raja
[email protected]
(202) 261-5350
Miriam Becker-Cohen
[email protected]
(202) 261-5514
David McClure
[email protected]
(202) 261-5358
The Urban Institute is a
nonprofit, nonpartisan policy
research and educational
organization that examines the
social, economic, and
governance challenges facing
the nation. It provides
information, analyses, and
perspectives to public and
private decision-makers to
help them address these
problems and strives to deepen
citizens' understanding of the
issues and trade-offs that
policymakers face.

2100 M Street, NW
Washington, D.C 20037
www.urban.org

Summary of Background Research
for Verification with State APS 
A. Background Information 
State Name 
Number of Counties
State APS Contact 
Name
Title
Phone
Email
Department Name
Website

California
57
Charissa Miguelino
Adult Programs Policy & Operations Bureau Chief 
(916) 653‐1871
[email protected]
California Department of Social Services
http://www.cdss.ca.gov/agedblinddisabled/PG1298.htm

B. APS Organizational Structure
Reported APS Level of 
County
Administration
Reported State Oversight if  No
County Administered

C. Data on initial reports of suspected elder abuse, mistreatment or neglect (EAMN)
Citizens report suspected  County
EAMN to which level APS 
agency:
Individual records of initial  State
reports maintained by 
(highest level):

D. Scope of APS investigations & extent of within‐state variation
APS investigations 
conducted by which level 
agency:
Age of clients served by 
APS:
Does APS investigate 
routinely self‐neglect?
What settings does APS 
routinely investigate? 
Uniform elder abuse case 
opening criteria applied 
throughout the state?

County

Other
Yes
Community‐ and Facility‐based abuse
Yes

E. Data on APS investigations opened
Individual records of 
investigations opened 
maintained by (highest 
level):

State

Page 1 of 2

Summary of Background Research
for Verification with State APS 
F. Data on APS investigative outcomes
Individual records of 
investigative outcomes 
maintained by (highest 
level):

State

F. Recommendations for fall 2013 online survey
Recommended number of  58
surveys (state + local):
Recommended unit of 
County
analysis
Urban Institute Reviewer  County APS agencies operate their own hotlines and conduct abuse 
Summary (draft)
investigations.  Although all counties operate per statute and statewide 
regulations, each county manages its own staffing requirements and caseload 
practices. State APS does NOT monitor APS services; it has regulatory oversight 
and provides common form for initial reports of alleged abuse (SOC 341). This 
form describes the types of abuse alleged and the agency assignment.  Counties 
are responsible for investigating community based abuse; ombudsmen (through 
state Department of Aging) have responsibility for facility based abuse 
investigations.  State has (and collects from counties [and ombudsmen?]) a 
common reporting form for alleged abuse (SOC 341).   It is uncertain who keeps 
the data on investigative results and outcomes, though the state APS agency did 
report on substantiated cases to the 2012 NAPSA survey.

State contact for online survey
Name
Charissa Miguelino
Title
Adult Programs Policy & Operations Bureau Chief 
Phone
(916) 653‐1871
Email
[email protected]
Department Name
California Department of Social Services
Local contacts for online survey (if needed)
Contact Information for 
http://www.cdss.ca.gov/agedblinddisabled/PG1298.htm
Local/Area Agencies

Page 2 of 2

Wave 1 Semi-Structured Interviews with State APS Reps
DRAFT Telephone Protocol, 9/12/13

Study Introduction and Informed Consent
My name is _______ and I am a research associate at the Urban Institute in Washington, DC.
We are asking for your help in preparation for an online survey of APS agencies that will be
launched this fall. This work is funded by the federal Bureau of Justice Statistics, within the
U.S. Department of Justice, and they are part of a larger federal interagency working group on
elder abuse. BJS is conducting a feasibility study to develop a national data system recording
reports to APS agencies on elder abuse, mistreatment, and neglect. The goal is for this reporting
system to include a combination of aggregate statistics and de-identified individual level data.
The Urban Institute, as BJS’ grantee, will be launching an online survey this fall to learn about
APS agencies’ data collection and reporting capabilities at the state and local levels. We are
asking for your help today to identify the correct APS agencies and individuals to include in that
online survey.
This interview should take no more than 30 minutes. I have a set list of questions to go through,
but, essentially, I’d like to confirm the information on the summary PDF I emailed you earlier
and ask a few follow-up questions. Do you have that handy? [resend if needed]. You’ll see that
we’re interested in understanding how APS is organized in your state, what kinds of cases APS
investigates, and how this relates to 3 different types of data that your agency may maintain.
Thank you again for taking the time to talk. Before we begin, I need to tell you that participating
is completely voluntary. You can choose to skip any questions or stop participating at any time.
Your responses will be used to describe the scope of APS data collection in your state and
identify respondents for our fall 2013 online survey of APS data collection practices and
capabilities.
Record Interview Date: __________________
Record Interview Start Time: __________________
Record Interviewer Name: __________________

p. 1 of 13

A. Background Information
Before we begin, is the contact information listed on your state’s summary form correct?
(Information on the state summary form will already populate the responses below. Briefly
review the information to confirm its accuracy and modify as necessary.)
Question
Items marked REVIEW are from the
summary of background research. Our data
entry form will already be populated and the
information briefly confirmed.
1. REVIEW Name
2.
3.
4.
5.

REVIEW Title
REVIEW Phone number
REVIEW Email address
REVIEW Department name

If a Second person is included in the
interview then gather their contact
information
6. Name
7. Title
8. Phone number
9. Email address
10. Department name

Response Categories

•
•
•
•
•
•

First name
Last name
Text
Text
Text
Text

Response Categories
•
•
•
•
•
•

First name
Last name
Text
Text
Text
Text

p. 2 of 13

B. APS Organizational Structure
Let’s start with a review of the information about your state’s APS organizational structure on
the summary sheet. This comes from NAPSA’s survey of APS agencies last year. Is this
accurate, or have things changed? Could you give me a 1-2 minute introduction to how APS is
organized and operates in your state? (Information on the state summary form will already
populate the responses below. Briefly review the information to confirm its accuracy and modify
as necessary.)
Question
Items marked REVIEW are from the
summary of background research. Our data
entry form will already be populated and the
information briefly confirmed.
11. Respondent’s overview of how APS is
organized. Could you give me a 1-2
minute introduction to how APS is
organized and operates in your state?
Record details about case processing,
tracking, and data, if offered.
12. REVIEW Reported level of APS
organization: Is it accurate to say that it
your program is administered?
If other, ask respondents to specify
what the level of organization is (e.g.,
area agencies on aging)
13. If state administered:
a. How many local APS offices are
there within your agency?
b. Is there another organizational level
between the state and local
agencies?
c. How many are there?
Example: there may be 20 local
APS offices in 3 regions.
14. If county administered REVIEW:
How many county APS agencies are there?
Is it ?
Note: APS may be consolidated into a
single agency across some small
counties.
15. If other administered:
How many APS agencies are
there? (e.g., 6 regional APS agencies)

Response Categories

•

Text

•
•
•
.

State
County
Other (specify______)

•

Number of local APS offices under
state agency
Other organizational level
(specify________)
Number of the other organizational
level

•
•

•

Number of county APS agencies

•

Number of other level APS agencies

p. 3 of 13

Question
Items marked REVIEW are from the
summary of background research. Our data
entry form will already be populated and the
information briefly confirmed.
16. REVIEW Reported state oversight if
county administered
Probe: What does the state oversee?
Data? Does state set policy, provide
training, or monitor local APS?
17. If other administered:
Does the state agency have oversight
responsibility?
Probe: What does the state oversee?
Data? Does state set policy, provide
training, or monitor local APS?

Response Categories

•
•

Yes (specify over what, esp. data___)
No

•
•

Yes (specify over what, esp. data___)
No

p. 4 of 13

C. Data on initial reports of suspected EAMN
The next questions are about how initial reports of suspected abuse, neglect, or exploitation are
made, and where that information is recorded. Again, let’s start by confirming the information
from your state’s summary sheet. (Information on the state summary form will already populate
some responses below. Briefly review the information to confirm its accuracy and modify as
necessary.)
Question
Items marked REVIEW are from the
summary of background research. Our data
entry form will already be populated and the
information briefly confirmed.
18. REVIEW From our background research,
we gathered that a
level agency receives the initial reports of
suspected abuse. Would you say that’s
correct?
Note: County , regional, or local
offices of a state agency should be
classified as state.
Probe: Are the staff employees of
the state, county, or another other
organization?
19. To clarify, when a concerned citizen wants
to report suspected abuse, neglect or
exploitation, is that who they contact? Is
there anyone else?
If the response is law enforcement,
probe further: Is it a particular law
enforcement agency (to distinguish
local agency from state)? Who does
law enforcement contact?
20. Also to clarify, when a mandatory reporter
or a professional such as a paid caregiver,
healthcare provider, or bank employee
wants to report suspected abuse, neglect or
exploitation, is that also who they contact?
Is there anyone else?
If the response is law enforcement,
probe further: Is it a particular law
enforcement agency (to distinguish
local agency from state)? Who does
law enforcement contact?

Response Categories

•
•
•
•
•

State
County
Other (specify___)
Multiple agency types (specify___)
Notes field for detailed description of
how cases are reported and recorded, if
offered.

•
•

Enter text
Update #18 if needed

•
•

Enter text
Update #18 if needed

p. 5 of 13

Question
Items marked REVIEW are from the
summary of background research. Our data
entry form will already be populated and the
information briefly confirmed.
21. Are law enforcement officers like police or
sheriffs required to make a report to APS
when they find out about possible
vulnerable adult abuse? For example,
when someone calls the police or when
police respond to a call for service.
22. Are prosecutors required to make a report
to APS when they find out about possible
abuse? For example, when a prosecutor is
asked to investigate fraud, exploitation,
neglect or abuse.
23. Is that initial report of suspected abuse
recorded in an electronic database?
24. If yes, is the initial data entry into a state,
county, or other database?

25. REVIEW. What is the highest level
agency where those individual reports get
submitted to, regardless of whether they are
paper or electronic records? What’s the
name of the agency/division that houses
those records?
Note: County , regional, or local offices
of a state agency should be classified as
state.
Probe: Are the staff employees of the
state, county, or another organization?
26. How many agencies would we need to
contact to obtain full statewide data about
initial reports of suspected abuse?
27. Are you the best, central point of contact to
speak with about the specific types of
information collected in these initial
reports?
28. If no, please suggest another contact person

Response Categories

•
•
•

Yes
No
Notes field for any details offered.

•
•
•

Yes
No
Notes field for any details offered.

•
•
•
•
•
•
•
•
•
•
•

Yes
No
Notes field for any details offered.
State
County
Other (specify ________)
Notes field for any details offered
State (agency name _______)
County (agency name _________)
Other (agency name _________)
Notes field for any additional detail
offered by respondent.

•

Enter number (1 if a single state
agency, more if counties or other
entities involved)
Yes
No

•
•
•
•
•

Name
Title
Agency (confirm if same agency as
where the data are housed)

p. 6 of 13

Question
Items marked REVIEW are from the
summary of background research. Our data
entry form will already be populated and the
information briefly confirmed.
29. If multiple agencies (e.g., counties or
regions) where can I get contact
information for each agency?

Response Categories

•

Enter text

p. 7 of 13

D. Scope of APS investigations & extent of within-state
variation
Now I would like to ask about the scope of cases that APS agencies in your state investigate,
starting with the information on your state’s summary sheet. (Information on the state summary
form will already populate the responses below. Briefly review the information to confirm its
accuracy and modify as necessary.)
Question
Items marked REVIEW are from the
summary of background research. Our data
entry form will already be populated and the
information briefly confirmed.
30. REVIEW What agency
conducts APS investigations? Note:
County , regional, or local offices of a
state agency should be classified as
state.
Probe: Are the investigators employees
of the state, county, or other agency?
31. REVIEW Confirm or ask (if other): What’s
the age range of clients served by APS?
32. REVIEW From looking at state legislation,
it seemed to us that APS does/does not
routinely investigate self-neglect. Is that
correct?

Response Categories

•
•
•

State
County
Other (specify _______)

•

Text

•
•
•

APS investigates self-neglect
No
Notes field for any clarification offered
(e.g., if APS investigates some but not
all self-neglect cases)
APS investigates facilities
No
Notes field for any clarification offered
(e.g., if APS co-investigates with
another agency, or if a subset of
facilities are investigated by another
agency)
APS investigates all types of abuse
Some types of abuse are exclusively
investigated by other agencies

33. REVIEW From the NAPSA survey, we
gathered that APS does/does not routinely
investigate facility-based abuse. Is that
correct?

•
•
•

34. What types of abuse are exclusively
investigated by agencies other than APS?

•
•

p. 8 of 13

Question
Items marked REVIEW are from the
summary of background research. Our data
entry form will already be populated and the
information briefly confirmed.
35. Please specify the other agencies and the
types of cases they investigate.

36. At what level are the criteria for opening an
APS investigation set?
37. How does APS decide which reports to
investigate?
38. REVIEW. How much discretion do local
areas have to decide which reports will
have an investigation opened? For
example, would the same set of
circumstances result in a case being opened
in two completely different parts of the
state?
Probe if yes, uniform criteria: Do you
mean that the statutory criteria are the
same across the state? Do local areas
have discretion within those
parameters? Do some local areas use
wider or narrower case opening
criteria than others?
39. Is it fair to say there are potentially ###
sets of criteria for opening an APS
investigation in your state?

Response Categories

For each non-APS agency or case type:
• Name of the non-APS agency
• Whether it is a state, county or other
type of agency (specify)
• The purview of its investigations (may
include some predefined categories
such as institutions or financial abuse)
For example, Department of Health =
state agency = investigates abuse in
licensed facilities
• State
• County
• Other (Specify ________)
• Enter text
•
•

Same criteria across state
Local areas have discretion within
statutory parameters

•

Enter number (1 if uniform criteria are
used throughout the state, more if there
are different sets of criteria. Use
maximum number of local units if each
one can make its own case selection
rules. )

p. 9 of 13

E. Data on APS investigations opened
The next questions focus on data about the investigations that APS opens. (Information on the
state summary form will already populate the responses below. Briefly review the information to
confirm its accuracy and modify as necessary.)
Question
Items marked REVIEW are from the
summary of background research. Our data
entry form will already be populated and the
information briefly confirmed.
40. When APS opens an investigation, is that
recorded in an electronic database?

Response Categories

•
•
•

41. If yes, is the initial data entry into a state,
county or other database?
Note: County , regional, or local offices
of a state agency should be classified as
state.
Probe: Are the staff employees of the
state, county, or another other
organization?
42. REVIEW. What is the highest level
agency that those individual records on
new APS investigations get submitted to?
What’s the name of the agency/division
that houses those records?
Note: County , regional, or local offices
of a state agency should be classified as
state.
Probe: Are the staff employees of the
state, county, or another organization?
43. How many agencies would we need to
contact to obtain full statewide data about
investigations opened by APS?
44. Are you the best, central point of contact to
speak with about the specific types of
information recorded about APS
investigations?
45. If no, please suggest another contact person

•
•
•
•

46. If multiple agencies (e.g., counties or
regions) where can I get contact
information for each agency?

•

Yes
No
Notes field to record any additional
detail offered by respondent.
State
County
Other (specify _______)
Notes field for any other detail offered
by respondent.

•
•
•
•

State (agency name _______)
County (agency name _________)
Other (agency name _________)
Notes _________
(e.g., if respondent specifies that state
receives a subset of fields collected
locally)

•

Enter number (1 if a single state
agency, more if counties or other
entities involved)
Yes
No

•
•
•
•
•

Name
Title
Agency (confirm if same agency as
where the data are housed)
Enter text

p. 10 of 13

Question
Items marked REVIEW are from the
summary of background research. Our data
entry form will already be populated and the
information briefly confirmed.
47. How often do law enforcement officers,
like police or sheriffs’ deputies, participate
in or continue an APS investigation
(beyond accompanying an APS worker for
safety reasons). Read choices aloud.

Response Categories

•
•
•
•
•

Rarely or almost never
Less than half the time
About half the time
More than half the time
Almost always

48. Are there particular types of cases when
this happens? Probes: What types of cases
require such involvement?
49. How often do prosecutors participate in or
follow up on an APS investigation. For
example, by launching a criminal
investigation and/or pressing charges.
Read choices aloud.

•

Notes field for added description

•
•
•
•
•

Rarely or almost never
Less than half the time
About half the time
More than half the time
Almost always

50. Are there particular types of cases when
this happens? Probes: What types of cases
require such involvement?

•

Notes field for added description

p. 11 of 13

F. Data on APS investigative outcomes
This next to last set of questions is about when APS makes a finding or otherwise concludes a
case. (Information on the state summary form will already populate the responses below.
Briefly review the information to confirm its accuracy and modify as necessary.)
Question
Response Categories
Items marked REVIEW are from the
summary of background research. Our data
entry form will already be populated and the
information briefly confirmed.
51. When APS closes an investigation, are the
• Yes
date and findings recorded in an electronic
• No
database?
• Notes field for any other detail offered
52. If yes, is that initial data entry into a state,
• State
county or other database?
• County
Note: County , regional, or local offices
• Other (specify _______)
of a state agency should be classified as
• Notes field for any other detail offered
state.
Probe: Are the staff employees of the
state, county, or another other
organization?
53. REVIEW. What is the highest level
• State (agency name _______)
agency that those individual records with
• County (agency name _________)
APS determinations and case outcomes
• Other (agency name _________)
get submitted to? What’s the name of the
• Notes _________
agency/division that houses those records?
(e.g., if respondent specifies that state
Note: County , regional, or local offices
receives a subset of fields collected
of a state agency should be classified as
locally)
state.
Probe: Are the staff employees of the
state, county, or another organization?
54. How many agencies would we need to
• Enter number (1 if a single state
contact to obtain full statewide data about
agency, more if counties or other
the determinations or outcomes of APS
entities involved)
investigations?
55. Are you the best, central point of contact to
• Yes
speak with about the specific types of
• No
information recorded about APS
determinations?
56. If no, please suggest another contact person
• Name
• Title
• Agency (confirm if same agency as
where the data are housed)
57. If multiple agencies (e.g., counties or
• Enter text
regions) where can I get contact
information for each agency?
p. 12 of 13

G. Recap & recommendations for fall 2013 online survey
Thank you. We’re just about done. I’d like to do a final review of what I’ve learned.
Question
Items marked REVIEW are from the summary
of background research. Our data entry form
will already be populated and the information
briefly confirmed.
58. REVIEW. Please review the summary on
the background information sheet. Is that
generally accurate? What needs to be
corrected?
59. REVIEW. Based on what we discussed, it
sounds like our initial estimate of APS
agencies to survey was right/wrong.
Would you agree that surveying the state
plus ## counties / regions / localities would
get at the full range of how decisions are
made to open cases, and where data are
housed.
Recap #13-15, 23-24, 40-41 and 47-48
60. REVIEW. Would you be the most
appropriate person at the state level to
participate in our online survey about data
capabilities? If not, please suggest an
alternate contact person.
61. REVIEW. If local surveys are needed:
What is the best place to find out contact
information for the local agencies?

Response Categories

•

Enter text

•
•
•

Enter number 1 for state agency
Enter 0-## localities and specify unit of
analysis
Auto-calculate total number of surveys

•
•
•

Name of state contact
Title of state contact
Agency of state contact

•

Enter local area contacts

This has been very informative. Thank you again for your time. I’m going to send you a
summary of my call notes within the next day or two, so you have an opportunity to review this
and point out any inaccuracies. Please do not hesitate to contact me if you have any follow up
questions or concerns. Again, my name is _________, and you can reach me at or .
Record Interview End Time: __________________

p. 13 of 13

lil
II

THE URBAN INSTITUTE

2100 M Street N.W.

INSTMUTIONAL REVTEW BOARD NOTICE

Otr'

-

Washinston, D.C. 20037

APPROVAL

(Federalwide Assurance Number #0189)

Kamala Mallik-Kane and Janine Zweig

PROJECT DIRECTOR:

"Assessment of Administrative Data on Eldcr Abuse, Mistreatment, and Neglect

TITLE:

SPONSORAGENCY: USDOJ PROTOCOLDATE:
UI PROJECT NUMBER: 08585-000-00
NATI]RE OF RDVIEW:

(Cheek0ne)

FULL

"

Aus'11- rev. Aor'12: Jun'12: Aus'13
PROPOSAL ITIUMBER: N/A

EXPEDITED

X

EXEMPT

MEETINGDATE: N/A
TYPE OFAPPROVAL

X

PRELIMINARY
FULL IMPLEMENTATION
RENEWAL
AMENDMENT: Modification to stakeholder interview protocol and suspension of data collection from
APS.

Please note the following requirements:

PROBLEMS OR ADVERSE REACTIONS: If any problems in treatment of human sulrjects or unexpected
adverse reactions occur as a result of this study, you must notify the IRB Chairperson immediately.
CHANGES IN PROTOCOL: If there are significant changes in procedures or study protocol, you must notify
the IRB Chairperson before they are implemented.

RENEWAL: You are rcquired to apply for renewal of approval at least annually for
active. Your next review date should be on or

before 81412014

.

August 5. 20

Date

Copy: PI

E:\I{E\tr IRB\08585-000-00 EXPEDITED REYIEW3.DOC

I3

as long as the study is