Phase I Phase I State Administrator Interview

PHASE I: APS Administrator Interview Questions
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regarding the burden estimate or any other aspect of this collection of information, including suggestions
for reducing this burden, to the Administration for Community Living, U.S. Department of Health and
Human Services, 330 C Street, SW, Washington, DC 20201-0008, Attention Stephanie Whittier Eliason, or
email [email protected].

Interviewee Name: ________________________________
Title: ___________________________________________
State: ___________________________________________
Date of interview: _________________________________

Introduction: Hello, My name is xxx. I am part of a study team that was contracted by the Administration
for Community Living under the U.S. Department of Health and Human Services. We are conducting a
study of how opioid misuse affects older adults as well as APS in its attempts to help them.
The purpose of this interview is to understand your state’s perspectives concerning cases involving
opioids. We are conducting these interviews at the state level with several states. This interview should
take about 45 minutes.
During the interview, I will refer to the word “abuse” by surrogate decision makers and by this, I mean
any types of abuse, neglect or exploitation of a victim by another person, that your agency investigates.
I’m just using “abuse” for short.
With your permission, our conversation will be tape recorded so that we will be able to capture correctly
your input and ideas. Is that all right with you?
I expect you would be careful about this anyway, but, once we turn the recording on as we discuss, let’s
avoid referring to anyone by name, be it the victim or any other individual.
If any of my questions are unclear to you, please stop me and ask for clarification.

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1. Roughly, how many cases of abuse involving opioids would you say that your state has handled in
the past year?
Probe: suggest they just identify whether it is probably less than 5, 10, 20, 30 or over 30?

2. Did the number increase, decrease, or are they about the same in the last year, before COVID-19?
Why do you think so??
2a. How about from the previous 5 years? Why do you think so?
3. In these cases, was it most likely that the victim is misusing opioids, or was the perpetrator
misusing, or were both the victim and perpetrator misusing opioids?

4. What are some characteristics of these opioid cases?
Probe: Type of ANE? Characteristics of client, perpetrator? How about living circumstances?
Any other conditions or circumstances?
Probe: Of those characteristics, do you see any that are more common? Less common?
4a. Any characteristics that you think were related to COVID-19 – for example, economic
circumstances, isolation or lack of services?

5. Does your state have a policy or set of procedures to follow when cases involve opioids? If yes,
please describe. If no, please describe how your staff respond to opioid cases?
5a. What deviations did you make due to COVID-19?
6. What are the challenges encountered in investigating the allegations of abuse of these cases
involving opioids?
6a. Any challenges related to COVID-19?
7. Was your APS program able to provide any intervention(s) that assisted these clients to achieve
increased safety and relief from continued abuse?
7b. If yes, please describe intervention(s) provided and specifically how intervention(s) assisted
the victims.
Probe: Did this enable the victims to become safe? Please explain.
7b. If no, what barriers blocked efforts to assist the victims? Any barriers specific to COVID-19?
8. Overall, do you find that substantiated cases of abuse involving opioids are generally more, less,
or equally as difficult to intervene as other types of allegations?
Probes: Why?
8a. What impact did COVID-19 have?
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9. Is it easier or harder to substantiate these cases?
Probes: Why?
10. When opioids are involved, is abuse, neglect, or exploitation easier or harder to miss than abuse,
neglect, or exploitation when opioids are not involved?
Probe: Why? In what ways?
11. Are there ways that APS and other agencies should be working cases differently when opioids are
involved?
12. Do you have recommendations regarding how suspected victims of abuse involving opioids can
be better served? That is, how can these cases better handled?
13. What are ways to improve prevention of the abuse of older people when opioids are involved?
14. Are there any other comments you would like to make about cases of abuse involving opioids in
general?
15. Do you have any recommendations for further research on abuse involving opioids?

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