Online Survey of State and Local APS Data Collection Pra

Online Survey¹ of State and Local APS Data Collection Practices in 2015

Welcome and Informed Consent²

The Urban Institute, a nonprofit research organization in Washington DC, has been funded by the U.S. Department of Justice, Bureau of Justice Statistics (BJS), to examine how Adult Protective Services (APS) agencies respond to and collect data about elder abuse, neglect, and exploitation (elder abuse). The purpose is to assess the feasibility of using existing APS data to help estimate nationwide statistics about the number of characteristics of reported incidents of elder abuse, neglect, and exploitation.

The survey should take you approximately 30 minutes to complete. We will ask about how your agency responded to suspected elder abuse cases in 2015 and what kinds of data you recorded about those cases. You can complete the survey in more than one session if you cannot complete the whole survey at one time. You may also choose to provide your username to colleagues within your agency, if you feel they can help you to complete the survey.

Your participation in this survey is completely voluntary. You can choose to skip any questions that you are not comfortable answering or stop taking the survey at any time. Reports from this project will help the field’s understanding of elder abuse, neglect, and exploitation.

Thank you very much for participating in this survey. For technical assistance with the survey, please contact Carla Vasquez-Noriega at cvasquez@urban.org (phone: 202-261-5299). For any other questions or concerns, please contact either of the Principal Investigators— Janine Zweig at jzweig@urban.org (phone: 518-791-1058) or Kamala Mallik-Kane at kkane@urban.org (phone: 202-261-5857).

Survey completed by:

Name: ________________

The agency you work for: ________________

Job title: _________________

Telephone number: ____________

Phone Extension: ___________

Email address:______________

A. About your agency’s recordkeeping and data reporting practices

1. Did your agency focus exclusively on elder abuse between January 1 and December 31, 2015? Note: for simplicity, we use the term “elder abuse” to encompass all forms of physical, sexual or psychological abuse against an older adult; neglect or abandonment by others; and exploitation of the elder’s resources. If your agency went through substantial changes in 2015, please report on your practices during the majority of the year.

• Yes, we focused on elder abuse only

• No, we worked on elder abuse AND the abuse of younger vulnerable adults

• No, we worked on elder abuse AND other types of cases (please specify the other case types: ____________)

• No, we rarely received elder abuse cases (please specify the case types you focus on: _____________)

• No, we never received elder abuse cases [END SURVEY IF RESPONDENT INDICATES NEVER RECEIVING ELDER ABUSE CASES: Thank you for your time. This survey is about elder abuse so there is no need for you to continue participating. If you have any questions, concerns, or comments about this project, please contact either of the Principal Investigators: Janine Zweig, at jzweig@urban.org (phone: 518-791-1058) or Kamala Mallik-Kane at kkane@urban.org (phone: 202-261-5857).]

2. In 2015, did your agency typically work with elders when there is no suspected abuse?

• Yes

• No, we only worked with elders when there WAS suspected abuse

A2a. What was your agency’s role in investigating reports of suspected elder abuse in 2015?

• We conducted investigations

• We had oversight of other agencies that conducted investigations

• We did both

This survey focuses exclusively on how your agency handled elder abuse cases in 2015.

If your agency did not investigate cases directly, please answer questions about the investigation process from the perspective of the local office of your agency that directly investigated cases.

Units of count

The next questions ask about how your agency maintained records about elder abuse investigations in 2015 and how your agency reports data or statistics about elder abuse.

3. Which of the following ID numbers did your agency assign when you received a report of elder abuse in 2015?

	[1] Ask for each item. Check one. Did your agency or data system assign this number?		[2] If yes to [1], check one. Following up, when did your agency assign each of these ID numbers?			[3] If yes to [1], check one. Following up once more, did your agency store these ID numbers electronically or on paper?			[D] If [3]=electro-nically, check one. Finally, were these ID numbers stored as a structured data field or as “free text”?
	Yes	No	When report was made	When investi-gation was opened	At both time-points	Electro-nically ONLY	Both electronically and on paper	On paper ONLY	Data field	Text
Did your agency or data system assign a unique number to each investigation opened? For example, if abuse against Jane Doe was investigated on 2 separate occasions (say, in February and in November), 2 different numbers were assigned.										
Did your agency or data system assign a unique number to each report made to your agency? For example, if a neighbor and a family member separately report that Jane Doe was being abused, 2 different numbers were assigned.										
Did your agency or data system assign a unique number to each victim? For example, if abuse was reported against Jane Doe, was she assigned a client number? (If response to column [1] is NO, ask this follow up question: “What information did your agency use to identify victims in your recordkeeping system? Please select all that apply. _Name, _Social security number, _Date of birth, _Other (please specify ______)										
Did your agency or data system assign a unique number to each type of abuse alleged? For example, if it was alleged that Jane Doe was physically abused and financially exploited, 2 different numbers were assigned.										

4. How was information organized in your agency’s recordkeeping system in 2015? At what “level” were data entered and stored in your system? Please check all that apply.

• At a person level (only) – there was one record per client (victim)

• At case or investigation level (only) – there was one record per investigation

• At a report level (only) – there was one record per report

• Multiple levels (i.e., hierarchical or relational tables).

5. [IF MULTIPLE LEVELS] What levels of data were maintained in your agency’s system in 2015? Please check all that apply.

• Client (victim) level

• Case or investigation level

• Report level

• Allegation level

• Other level (s) (please specify: ______________)

6. When your agency reports elder abuse statistics for 2015, would it report on the number of cases or reports or on the number of individuals (regardless of how many reports they were associated with)?

• Cases or reports (for example: if Jane Doe was in 3 cases, we would count this as 3)

• Individuals (for example: we would count Jane Doe only once, even if she was in 3 cases)

• We can report both ways

Data entry and quality assurance

7. Did your agency record elder abuse cases in an electronic database in 2015?

• Yes

• No [SKIP rest of this section]

8. In 2015, was your agency’s electronic database specifically for elder abuse cases, or was it integrated with other case types?

• Elder abuse only

• Elder abuse AND abuse of vulnerable younger adults

• Abuse of younger vulnerable adults only

• Elder and/or vulnerable adult abuse AND other case types

9. Who conducted the data entry into your electronic system in 2015? Please select all that apply.

• The staff person who investigated the case

• Clerical, administrative, or data entry staff

• Other types of staff (please specify: _____)

10. In 2015, was there a time lag between when information was collected on paper, and when it was entered electronically?

• Yes (IF YES: how long was the time lag between when information was collected on paper, and when it was entered electronically? ____________________ days / weeks / months)

• No, we entered the data immediately

• No, we entered the data directly into the electronic system (paperless system)

11. Were paper or electronic records your agency’s official “system of record” in 2015? For example: if you needed to provide records for a civil proceeding or criminal prosecution, would you draw from your paper or electronic records?

• Paper files were the “system of record”

• Electronic database was the “system of record”

12. What quality control procedures were used for the electronic database in 2015? Please check all that apply. [>>SKIP IF ANSWERED NO DATA ENTRY]

• Double data-entry of information from paper forms

• Audits comparing paper and electronic versions of the record

• Assessments of the level of missing data on key elements

• None of the above

13. Since when have reliable records generally been available from your electronic data system? What is the earliest date (i.e., how long ago)? _____ (year) _____ (month, if known)

14. In general, was there a time lag between when data were entered in 2015 and when you could reliably query the database for statistics?

• Yes (if YES: In general, how long was the time lag between when data were entered in 2015 and when your agency could reliably query the database for statistics ____________________ days / weeks / months)

• No

15. When would reliable records for all completed 2015 investigations be available from your agency’s electronic data system? _____ (year) _____ (month, if known)

B. Information gathered about elder abuse reports and investigations

In 2015, did your agency maintain any data from the initial report of abuse before an investigation was opened?

• Yes

• No [Skip all subsequent column 2 questions in section B]

The following questions ask about the types of information your agency collected and recorded in the course of responding to suspected elder abuse, neglect, or exploitation in 2015.  Questions are grouped into broad categories of information such as client demographics or case outcomes.  The first question in each category asks which specific pieces of information your agency gathered, electronically or on paper. Then, for each piece of information you report having gathered, we ask a follow up question about when it was collected.

If you personally do not know the answer to some of these questions, please enlist the help of others in your agency. You may share your survey username and password with others in your agency.

Victim (client) information

1. What pieces of information about victims did your agency gather in the course of an investigation responding to suspected elder abuse in 2015? By “gathering,” we mean collecting and recording information in any form, including on paper, in narrative form, or in a database field. Please respond “yes” to all the items that were available on your data collection forms, even if they were not always consistently filled in.

Case ID and victim demographics Column 1 will be asked for each item. Columns 2 will be asked as a follow-up, for only those characteristics respondents said they record in [1].	[1] Ask for each item. Check one. Did your agency record information on this characteristic, and is it stored electronically?,					[2] If yes to [1], check one. Following up, were any items about victims collected as part of the initial report, before beginning an investigation?
	Yes, electronically in a structured data field	Yes, electronically as free text	Yes, electronically, but don’t know the field type	Yes, but on paper only	No, this was not recorded	Yes	No
Name							
Social Security number							
Date of birth							
Victim/Client ID number assigned by agency							
Age							
Sex							
Race							
Hispanic ethnicity (separate from race, so one could be any race but also report Hispanic ethnicity)							

2. What pieces of information about a victim’s vulnerability did your agency gather in the course of an investigation responding to suspected elder abuse in 2015? By “gathering,” we mean collecting and recording information in any form, including on paper, in narrative form, or in a database field. Please respond “yes” to all the items that were available on your data collection forms, even if they were not always consistently filled in.

Victim’s vulnerability Column 1 will be asked for each item. Columns 2 will be asked as a follow-up, for only those characteristics respondents said they record in [1].	[1] Ask for each item. Check one. Did your agency record information on this characteristic, and was it stored electronically??					[2] If yes to [1], check one. Following up, were any items about a victim’s vulnerability collected as part of the initial report, before beginning an investigation?
	Yes, electronically in a structured data field	Yes, electronically as free text	Yes, electronically, but don’t know the field type	Yes, but on paper only	No, this was not recorded	Yes	No
Disability status
Deaf or has difficulty hearing							
Blind or has difficulty seeing, even when wearing glasses							
Difficulty concentrating, remembering or making decisions							
Difficulty walking or climbing stairs							
Difficulty dressing or bathing							
Difficulty doing errands alone, such as visiting a doctor’s office or shopping							
Dependent on the care of others							
Lacks capacity to make decisions for oneself							
Meets your agency’s definition of vulnerable adult							
Substance use
Has problems with alcohol use							
Has problems with illegal drug use							
Has problems with inappropriate use of prescription drugs							
Has problems with substance use in general (unknown substance type)							
Guardianship status
Had a legal guardian at the time of the incident							

3. What pieces of information about a victim’s housing and living arrangements did your agency gather in the course of an investigation responding to suspected elder abuse in 2015? By “gathering,” we mean collecting and recording information in any form, including on paper, in narrative form, or in a database field. Please respond “yes” to all the items that were available on your data collection forms, even if they were not always consistently filled in.

Victim’s Housing and Living Arrangements Column 1 will be asked for each item. Columns 2 will be asked as a follow-up, for only those characteristics respondents said they record in [1].	[1] Ask for each item. Check one. Did your agency record information on this characteristic, and was it stored electronically?					[2] If yes to [1], check one. Following up, were there any items about a victim’s housing and living arrangements collected as part of the initial report, before beginning an investigation?
	Yes, electronically in a structured data field	Yes, electronically as free text	Yes, electronically, but don’t know the field type	Yes, but on paper only	No, this was not recorded	Yes	No
Victim’s housing type
Housing type at the time of the incident							
Housing type at the time of case closing							
Which of these specific housing type categories were recorded?
Victim’s home							
Family member’s home							
Group home (unlicensed)							
Group home (licensed)							
Assisted living facility							
Skilled nursing facility (e.g., nursing home)							
Other institution for persons with mental illness or developmental disabilities							
Hospital							
Other housing type (please specify: _______)							
Victim’s living arrangements
Whether victim lived with alleged perpetrator at the time of the incident							
Whether victim lived with alleged perpetrator at the time of case closing							

4. What pieces of information about a victim’s history of abuse did your agency gather in the course of an investigation responding to suspected elder abuse in 2015? By “gathering,” we mean collecting and recording information in any form, including on paper, in narrative form, or in a database field. Please respond “yes” to all the items that were available on your data collection forms, even if they were not always consistently filled in.

Victim’s Abuse History Column 1 will be asked for each item. Columns 2 will be asked as a follow-up, for only those characteristics respondents said they record in [1].	[1] Ask for each item. Check one. Did your agency record information on this characteristic, and was it stored electronically?					[2] If yes to [1], check one. Following up, were any items about a victim’s history of abuse collected as part of the initial report, before beginning an investigation?
	Yes, electronically in a structured data field	Yes, electronically as free text	Yes, electronically, but don’t know the field type	Yes, but on paper only	No, this was not recorded	Yes	No
Whether this was the first time this individual was reported to your agency as a victim							
Date of first report to agency as a victim							

Alleged perpetrator information

5. What pieces of information about alleged perpetrators did your agency gather in the course of an investigation responding to suspected elder abuse in 2015? By “gathering,” we mean collecting and recording information in any form, including on paper, in narrative form, or in a database field. Please respond “yes” to all the items that were available on your data collection forms, even if they were not always consistently filled in.

Case ID and alleged perpetrator demographics Column 1 will be asked for each item. Columns 2 will be asked as a follow-up, for only those characteristics respondents said they record in [1].	[1] Ask for each item. Check one. Did your agency record information on this characteristic, and was it stored electronically?					[2] If yes to [1], check one. Following up, were any items about alleged perpetrators collected as part of the initial report, before beginning an investigation?
	Yes, electronically in a structured data field	Yes, electronically as free text	Yes, electronically, but don’t know the field type	Yes, but on paper only	No, this was not recorded	Yes	No
Name							
Social Security number							
Date of birth							
Alleged perpetrator ID number assigned by agency							
Age							
Sex							
Race							
Hispanic ethnicity (separate from race, so one could be any race but also report Hispanic ethnicity)							

6. What pieces of information about the alleged perpetrator’s relationship to the victim did your agency gather in the course of an investigation responding to suspected elder abuse in 2015? By “gathering,” we mean collecting and recording information in any form, including on paper, in narrative form, or in a database field. Please respond “yes” to all the items that were available on your data collection forms, even if they were not always consistently filled in.

Victim-Perpetrator Relationship Column 1 will be asked for each item. Columns 2 will be asked as a follow-up, for only those characteristics respondents said they record in [1].	[1] Ask for each item. Check one. Did your agency record information on this characteristic, and was it stored electronically?					[2] If yes to [1], check one. Following up, were any items about the alleged perpetrator’s relationship to the victim collected as part of the initial report, before beginning an investigation?
	Yes, electronically in a structured data field	Yes, electronically as free text	Yes, electronically, but don’t know the field type	Yes, but on paper only	No, this was not recorded	Yes	No
Regarding how the alleged perpetrator is related to the victim, which of these specific relationship categories were recorded about the alleged perpetrator?
Intimate partner (husband, wife, boyfriend, girlfriend), current or ex- (former)							
Adult child							
Adult grandchild							
Other family member							
Non-family friend or acquaintance							
Paid caregiver							
Healthcare provider							
Other employee of caregiving institution							
Financial professional							
Stranger							
Other							
Whether the alleged perpetrator met your agency’s definition of “abuser” (for example: has position of trust)							
Whether the alleged perpetrator was a caregiver (family or nonfamily, paid or unpaid)?							
Whether the alleged perpetrator was a paid caregiver?							
Whether the alleged perpetrator had guardianship over or power of attorney for the victim?							

7. What pieces of information about the alleged perpetrator’s vulnerability did your agency gather in the course of an investigation responding to suspected elder abuse in 2015? By “gathering,” we mean collecting and recording information in any form, including on paper, in narrative form, or in a database field. Please respond “yes” to all the items that were available on your data collection forms, even if they were not always consistently filled in.

Alleged Perpetrator’s Vulnerability or Disability Status Column 1 will be asked for each item. Columns 2 will be asked as a follow-up, for only those characteristics respondents said they record in [1].	[1] Ask for each item. Check one. Did your agency record information on this characteristic, and was it stored electronically?					[2] If yes to [1], check one. Following up, were any items about the alleged perpetrator’s vulnerability collected as part of the initial report, before beginning an investigation?
	Yes, electronically in a structured data field	Yes, electronically as free text	Yes, electronically, but don’t know the field type	Yes, but on paper only	No, this was not recorded	Yes	No
Whether the alleged perpetrator met your agency’s definition of a vulnerable adult (e.g., has a disability, depends on others for care, lacks capacity to make decisions)							

8. What pieces of information about the alleged perpetrator’s history of committing abuse did your agency gather in the course of an investigation responding to suspected elder abuse in 2015? By “gathering,” we mean collecting and recording information in any form, including on paper, in narrative form, or in a database field. Please respond “yes” to all the items that were available on your data collection forms, even if they were not always consistently filled in.

Alleged Perpetrator’s History of Committing Abuse Column 1 will be asked for each item. Columns 2 will be asked as a follow-up, for only those characteristics respondents said they record in [1].	[1] Ask for each item. Check one. Did your agency record information on this characteristic, and was it stored electronically?					[2] If yes to [1], check one. Following up, were any items about the alleged perpetrator’s history of committing abuse collected as part of the initial report, before beginning an investigation?
	Yes, electronically in a structured data field	Yes, electronically as free text	Yes, electronically, but don’t know the field type	Yes, but on paper only	No, this was not recorded	Yes	No
Whether this was the first time this alleged perpetrator was reported to your agency as an alleged perpetrator							
Date of first report to agency as an alleged perpetrator							
Whether the alleged perpetrator had any criminal history at the time of the incident							
Whether there was a protective order against the alleged perpetrator at the time of the incident							
Whether the alleged perpetrator was on an abuser registry at the time of the incident							
Whether alleged perpetrator was under criminal justice supervision (e.g., parole, probation, pretrial) at the time of the incident							

Reporter Characteristics

9. What pieces of information about the reporter of suspected elder abuse did your agency gather in the course of an investigation responding to suspected elder abuse in 2015? By “gathering,” we mean collecting and recording information in any form, including on paper, in narrative form, or in a database field. Please respond “yes” to all the items that were available on your data collection forms, even if they were not always consistently filled in.

Abuse Reporting Column 1 will be asked for each item. Columns 2 will be asked as a follow-up, for only those characteristics respondents said they record in [1].	[1] Ask for each item. Check one. Did your agency record information on this characteristic, and was it stored electronically?					[2] If yes to [1], check one. Following up, were any items about the reporter of suspected elder abuse collected as part of the initial report, before beginning an investigation?
	Yes, electronically in a structured data field	Yes, electronically as free text	Yes, electronically, but don’t know the field type	Yes, but on paper only	No, this was not recorded	Yes	No
Abuse report
Date of report							
Which of these specific reporter types were recorded?							
Police							
Prosecutor’s office							
Other lawyers or court system representatives							
Guardian							
Victim							
Family member of victim							
Friend or acquaintance of victim							
Healthcare worker							
Other employees of healthcare or long-term care facility							
Social service provider							
Bank employee or other financial professional							
Whether your agency decided to open an abuse investigation							
Reason your agency did not open an abuse investigation							

Incident Characteristics

10. What pieces of information about the abusive incident did your agency gather in the course of an investigation responding to suspected elder abuse in 2015? By “gathering,” we mean collecting and recording information in any form, including on paper, in narrative form, or in a database field. Please respond “yes” to all the items that were available on your data collection forms, even if they were not always consistently filled in.

Time and place of the suspected abuse Column 1 will be asked for each item. Columns 2 will be asked as a follow-up, for only those characteristics respondents said they record in [1].	[1] Ask for each item. Check one. Did your agency record information on this characteristic, and was it stored electronically?					[2] If yes to [1], check one. Following up, were any items about the abusive incident collected as part of the initial report, before beginning an investigation?
	Yes, electronically in a structured data field	Yes, electronically as free text	Yes, electronically, but don’t know the field type	Yes, but on paper only	No, this was not recorded	Yes	No
Date of incident that led to investigation							
Time of incident that led to investigation							
Whether the abuse was a single incident or ongoing pattern							
Regarding the location where the abuse occurred, which of these specific location types were recorded?
Victim’s home							
Family member’s home							
Group home (unlicensed)							
Group home (licensed)							
Assisted living facility							
Skilled nursing facility (e.g., nursing home)							
Other institution for persons with mental illness or developmental disabilities							
Hospital							
Other location (please specify: ______)							

11. What pieces of information about the abusive incident did your agency gather in the course of an investigation responding to suspected elder abuse in 2015? By “gathering,” we mean collecting and recording information in any form, including on paper, in narrative form, or in a database field. Please respond “yes” to all the items that were available on your data collection forms, even if they were not always consistently filled in.

Types of abuse reported or alleged Column 1 will be asked for each item. Columns 2 will be asked as a follow-up, for only those characteristics respondents said they record in [1].	[1] Ask for each item. Check one. Did your agency record information on this characteristic, and was it stored electronically?					[2] If yes to [1], check one. Following up, were any items about the abusive incident collected as part of the initial report, before beginning an investigation?
	Yes, electronically in a structured data field	Yes, electronically as free text	Yes, electronically, but don’t know the field type	Yes, but on paper only	No, this was not recorded	Yes	No
Whether specific abuse types were alleged to have occurred. Which of these specific alleged abuse categories were recorded?3 --
Physical Abuse, meaning “when an elder is injured (e.g., scratched, bitten, slapped, pushed, hit, burned, etc.), assaulted or threatened with a weapon (e.g., knife, gun, or other object), or inappropriately restrained.”							
Sexual Abuse or Abusive Sexual Contact, meaning “any sexual contact against an elder’s will. This includes acts in which the elder is unable to understand the act or is unable to communicate. Abusive sexual contact is defined as intentional touching (either directly or through the clothing), of the genitalia, anus, groin, breast, mouth, inner thigh, or buttocks.”							
Psychological or Emotional Abuse, meaning “when an elder experiences trauma after exposure to threatening acts or coercive tactics. Examples include humiliation or embarrassment; controlling behavior (e.g., prohibiting or limiting access to transportation, telephone, money or other resources); social isolation; disregarding or trivializing needs; or damaging or destroying property.”							
Neglect (by others), meaning “the failure or refusal of a caregiver or other responsible person to provide for an elder’s basic physical, emotional, or social needs, or failure to protect them from harm. Examples include not providing adequate nutrition, hygiene, clothing, shelter, or access to necessary health care; or failure to prevent exposure to unsafe activities and environments.”							
Self-neglect, meaning “when vulnerable elders fail or refuse to address their own basic physical, emotional, or social needs. Examples include self-care tasks such as nourishment, clothing, hygiene, and shelter; proper/appropriate use of medications; and managing or administering one’s finances.							
Financial Abuse or Exploitation, meaning “the unauthorized or improper use of the resources of an elder for monetary or personal benefit, profit, or gain. Examples include forgery, misuse or theft of money or possessions; use of coercion or deception to surrender finances or property; or improper use of guardianship or power of attorney.”							
Abandonment, meaning “the willful desertion of an elderly person by caregiver or other responsible person.”							

12. What pieces of information about specific acts during the abusive incident and resulting injuries did your agency gather in the course of an investigation responding to suspected elder abuse in 2015? By “gathering,” we mean collecting and recording information in any form, including on paper, in narrative form, or in a database field. Please respond “yes” to all the items that were available on your data collection forms, even if they were not always consistently filled in.

Column 1 will be asked for each item. Columns 2 will be asked as a follow-up, for only those characteristics respondents said they record in [1].	[1] Ask for each item. Check one. Did your agency record information on this characteristic, and was it stored electronically?					[2] If yes to [1], check one. Following up, were any items about specific acts during the abusive incident and resulting injuries collected as part of the initial report, before beginning an investigation?
	Yes, electronically in a structured data field	Yes, electronically as free text	Yes, electronically, but don’t know the field type	Yes, but on paper only	No, this was not recorded	Yes	No
Weapon use
Whether a gun was used							
Whether another weapon (e.g., knife) was used							
Whether another type of object was used as a weapon							
Inappropriate use of restraints
Whether victim was inappropriately restrained (with ties, ropes, cords, etc.)							
Whether victim was “chemically restrained,” meaning they were inappropriately sedated with medication or drugs							
Level of completion
Whether the act was threatened, attempted, or completed							
Injury sustained
Whether an injury resulted in bodily injury or impairment (e.g., cuts or lacerations, bruising, dislocated joints, broken bones)							
Whether there was sexual contact against the victim’s will							
Elements of neglect
Whether the victim was “actively” neglected, meaning that things were purposefully withheld							
Whether the victim was “passively” neglected, meaning that there was a failure to provide for him or her without intent							
Regarding the types of things victims lacked access to, which of these specific items ae recorded?:
Adequate food							
Adequate clothing (e.g., clothing appropriate to the season)							
Adequate shelter (e.g., a hygienic and safe environment)							
Access to medicine or healthcare							
Financial loss or impact
Whether there was a loss of personal property							
Whether there was a loss of financial assets							
Whether victim was forced to alter legal documents or beneficiary designations							
Dollar amount of losses sustained (if financial exploitation)							

13. What pieces of information about the severity of injuries sustained did your agency gather in the course of an investigation responding to suspected elder abuse in 2015? By “gathering,” we mean collecting and recording information in any form, including on paper, in narrative form, or in a database field. Please respond “yes” to all the items that were available on your data collection forms, even if they were not always consistently filled in.

Injury severity and need for health care Column 1 will be asked for each item. Columns 2 will be asked as a follow-up, for only those characteristics respondents said they record in [1].	[1] Ask for each item. Check one. Did your agency record information on this characteristic, and was it stored electronically?					[2] If yes to [1], check one. Following up, were any items about the severity of injuries sustained collected as part of the initial report, before beginning an investigation?
	Yes, electronically in a structured data field	Yes, electronically as free text	Yes, electronically, but don’t know the field type	Yes, but on paper only	No, this was not recorded	Yes	No
Whether the victim was seen by a health care provider for the injuries sustained							
Whether the victim was seen by a mental health provider for the injuries sustained							
Whether the victim was hospitalized as a result of injuries sustained							
Duration of hospitalization							
Whether the injury was life-threatening							
Whether the client died from the injuries sustained from this incident of abuse							

Investigation Characteristics and Outcomes

14. What pieces of information did your agency gather about interagency collaborations in the course of an investigation responding to suspected elder abuse in 2015? By “gathering,” we mean collecting and recording information in any form, including on paper, in narrative form, or in a database field. Please respond “yes” to all the items that were available on your data collection forms, even if they were not always consistently filled in.

Agencies involved in the investigation Column 1 will be asked for each item. Columns 2 will be asked as a follow-up, for only those characteristics respondents said they record in [1].	[1] Ask for each item. Check one. Did your agency record information on this characteristic, and was it stored electronically?					[2] If yes to [1], check one. Following up, were any items about interagency collaborations collected as part of the initial report, before beginning an investigation?
	Yes, electronically in a structured data field	Yes, electronically as free text	Yes, electronically, but don’t know the field type	Yes, but on paper only	No, this was not recorded	Yes	No
Whether the police accompanied the APS worker for safety reasons							
Whether case was co-investigated with other agencies							
Name of co-investigative agencies							
Whether case was transferred to other agencies							
Name of agencies case was transferred to							
Police report number, if referred to or from the police (meaning, a number you could use to cross-reference to law enforcement records)							
Court case number, case file number or docket number, if referred to or from prosecutor’s office meaning, a number you could use to cross-reference to the prosecutor’s or court records)							
Case file number, if referred to or from guardianship, conservatorship, or other civil court proceedings (meaning, a number you could use to cross-reference to attorneys’ or court records)							
Case file number, if referred to or from another investigative agency (e.g., regulatory or licensing agency) that you could use to cross-reference that agency’s records.							
Case file number at any other agency, if applicable (If yes in Column 1, ask “Please specify the agency: ______)							

15. What pieces of information about the conclusion of the elder abuse investigation did your agency gather in the course of an investigation responding to suspected elder abuse in 2015? By “gathering,” we mean collecting and recording information in any form, including on paper, in narrative form, or in a database field. Please respond “yes” to all the items that were available on your data collection forms, even if they were not always consistently filled in.

Case outcomes	[1] Ask for each item. Check one. Did your agency record information on this characteristic, and was it stored electronically?
	Yes, electronically in a structured data field	Yes, electronically as free text	Yes, electronically, but don’t know the field type	Yes, but on paper only	No, this was not recorded
Date investigation was opened					
Date investigation closed					
Reason for case closure					
Whether the overall report of abuse was confirmed or substantiated					
Whether specific abuse types4 were substantiated. – Which of these specific abuse categories were recorded?
Physical Abuse, meaning “when an elder is injured (e.g., scratched, bitten, slapped, pushed, hit, burned, etc.), assaulted or threatened with a weapon (e.g., knife, gun, or other object), or inappropriately restrained.”					
Sexual Abuse or Abusive Sexual Contact, meaning “any sexual contact against an elder’s will. This includes acts in which the elder is unable to understand the act or is unable to communicate. Abusive sexual contact is defined as intentional touching (either directly or through the clothing), of the genitalia, anus, groin, breast, mouth, inner thigh, or buttocks.”					
Psychological or Emotional Abuse, meaning “when an elder experiences trauma after exposure to threatening acts or coercive tactics. Examples include humiliation or embarrassment; controlling behavior (e.g., prohibiting or limiting access to transportation, telephone, money or other resources); social isolation; disregarding or trivializing needs; or damaging or destroying property.”					
Neglect (by others), meaning “the failure or refusal of a caregiver or other responsible person to provide for an elder’s basic physical, emotional, or social needs, or failure to protect them from harm. Examples include not providing adequate nutrition, hygiene, clothing, shelter, or access to necessary health care; or failure to prevent exposure to unsafe activities and environments.”					
Self-neglect, meaning “when vulnerable elders fail or refuse to address their own basic physical, emotional, or social needs. Examples include self-care tasks such as nourishment, clothing, hygiene, and shelter; proper/appropriate use of medications; and managing or administering one’s finances.”					
Financial Abuse or Exploitation, meaning “the unauthorized or improper use of the resources of an elder for monetary or personal benefit, profit, or gain. Examples include forgery, misuse or theft of money or possessions; use of coercion or deception to surrender finances or property; or improper use of guardianship or power of attorney.”					
Abandonment, meaning “the willful desertion of an elderly person by caregiver or other responsible person.”					
Whether the victim changed residence since the incident (e.g., as a result of the investigation, at the conclusion of the case)					
Was there a change in guardianship (e.g., initiated guardianship proceedings, place into guardianship, changed guardian) since the incident (e.g., as a result of the investigation, at the conclusion of the case)					
Whether there was a protective order or restraining order issued after the incident (e.g., as a result of the investigation, at the conclusion of the case)					
Regarding non-criminal disciplinary action against the alleged perpetrator, which of these are recorded?
Lost license,					
Added to abuser registry					
Whether there was a referral to the police					
Whether an arrest was made					
Whether there was a referral to criminal prosecution					
Whether criminal charges were filed					
Outcome of the criminal case (e.g., convicted or not)					
Whether jail or prison time was imposed					

C. Elder Abuse Definitions and APS Agency Responsibilities

Screening practices

1. Did your agency’s investigations in 2015 reflect reports that had been screened-in somehow?

• Yes, another agency or unit conducted initial screening to determine that abuse investigation was needed (please specify the other agency: __________)

• Yes, our agency conducted initial screening to determine that abuse investigation was needed.

• No, our agency opens an abuse investigation on all reports received.

2. [IF SCREENED IN] Can you report on the number of reports that were screened out in 2015?

• Yes

• No

3. [IF SCREENED IN] Why were reports screened out? Please check all that apply

• Not in need of protective services (for example: referred to social services)

• Not our agency’s jurisdiction (for example: referred elsewhere for investigation)

• Other reasons (please specify: __________)

C3a. [IF SCREENED IN] What was the primary reason why reports were screened out in 2015?

• Not in need of protective services (for example: referred to social services)

• Not our agency’s jurisdiction (for example: referred elsewhere for investigation)

• Other reasons (please specify: __________)

Types of abuse

4. What types of elder abuse was your agency responsible for investigating in 2015? Please check all that apply.

• Physical abuse

• Sexual abuse

• Emotional or psychological abuse

• Neglect (by others)

• Self-Neglect

• Financial or material exploitation

• Abandonment

• Other (please specify: __________)

5. How did your agency define neglect by others in 2015? Please check all that apply.

• Active neglect (i.e., willful refusal to provide for elder’s needs, such as denying food or medications)

• Passive neglect (i.e., failure to provide for elder’s needs, but no evidence of malicious or punitive intent)

• Other (please specify: __________)

6. a. Did your agency respond to reports of self-neglect in 2015?

• Yes

• No, we didn’t respond ourselves (for example: immediate referral to another agency)

b. [IF YES to A] How did your agency respond to reports of self-neglect in 2015? Please check all that apply.

• We conducted an initial screening to determine jurisdiction before investigating

• We conducted a formal abuse investigation

• We provided services to the elder

• We sometimes provided services to the elder even though another agency investigated the case

• Some other response (please specify: __________)

7. a. In 2015, did your agency respond to reports of financial or material exploitation perpetrated by either an acquaintance or stranger (for example: scams)?  

• Yes

• No, we didn’t respond ourselves (for example: immediate referral to another agency)

b. [IF YES to A] In 2015, how did your agency respond to reports of financial or material exploitation perpetrated by either an acquaintance or stranger (for example: scams)? Please check all that apply.

• We conducted an initial screening to determine jurisdiction before investigating

• We conducted a formal abuse investigation

• We provided services to the elder

• We sometimes provided services to the elder even though another agency investigated the case

• Some other response (please specify: __________)

Vulnerability

8. How did your agency define “vulnerable” in 2015? Please check all that apply.

• Deaf or has difficulty hearing

• Blind or has difficulty seeing, even when wearing glasses

• Difficulty concentrating, remembering or making decisions

• Difficulty walking or climbing stairs

• Difficulty dressing or bathing

• Difficulty doing errands alone, such as visiting a doctor’s office or shopping

• Dependent on the care of others

• Lacks capacity to make decisions for oneself

• Has problems with substance use (alcohol, drugs, or inappropriate use of prescription drugs)

• Has a legal guardian

• Advanced age

• Lives in a long-term care facility

• Receives services from a care agency

• Other (please specify: ______________________)

9. Did your agency distinguish between “elders” and younger vulnerable adults in 2015?

• Yes

• No

10. At what age was someone considered an “elder” by your agency in 2015?

• Age (please specify: _______)

• There was no such definition

11. In 2015, did elderly persons have to demonstrate a specific vulnerability in order for your agency to open an investigation, or was advanced age sufficient?

• Everyone had to demonstrate a specific vulnerability, regardless of age

• Advanced age was enough to open an investigation

12. [IF SELECTED ADVANCED AGE ABOVE] At what age was advanced age, without other demonstrated vulnerabilities, sufficient to open an investigation in 2015? __________

Jurisdiction: Institutions vs. community

13. Which of the following did your agency consider a “facility” or “institution” in 2015? Please check all that apply.

• Licensed group home

• Unlicensed group home

• Assisted living facility

• Nursing home

• State mental illness facility

• State developmental disability facility

• Hospital

• Other (please specify: ________)

14. In 2015, under what circumstances was your agency responsible for investigating elder abuse in a facility or institution?

• We investigated all reports of facility abuse

• We investigated some reports of facility abuse

• We didn’t investigate reports of abuse in a facility or institution

• Some other response (please specify: __________)

15. [IF SOME CHECKED ABOVE] In 2015, what were your agency’s guidelines on when to investigate elder abuse in a facility or institution? Please check all that apply.

• We had jurisdiction to investigate some facility types but not others

• We investigated when the alleged perpetrator was not part of the facility staff (for example: relative of the victim)

• Other (please specify: ____________________________________)

16. a. Did your agency respond to reports of elder abuse in facilities or institutions in 2015?

• Yes

• No, we didn’t respond ourselves (for example: immediate referral to another agency)

b. [IF YES to A] How did your agency respond to reports of elder abuse in facilities or institutions in 2015? Please check all that apply.

• We conducted an initial screening to determine jurisdiction before investigating

• We conducted a formal abuse investigation

• We provided or arranged services for the elder in addition to conducting the abuse investigation

• We sometimes provided or arranged services for the elder even if another agency investigated the case

• Some other response (please specify: __________)

17. a. In 2015, did your agency respond to reports of elder abuse in the community (for example: elder’s home)?

• Yes

• No, we didn’t respond ourselves (for example: immediate referral to another agency)

b. [IF YES to A] In 2015, how did your agency respond to reports of elder abuse in the community (for example: elder’s home)? Please check all that apply.

• We conducted an initial screening to determine jurisdiction before investigating

• We conducted a formal abuse investigation

• We provided or arranged services for the elder in addition to conducting the abuse investigation

• We sometimes provided or arranged services for the elder even if another agency investigated the case

• Some other response (please specify: __________)

Alleged perpetrator relationship

18. Did the relationship between a victim and alleged perpetrator determine whether your agency could open an abuse investigation in 2015?

• Yes

• No

19. [IF YES TO ABOVE] How did your agency define an alleged perpetrator of elder abuse in 2015? Please check all that apply.

• Abuse if committed by a paid caregiver

• Abuse if committed by a family member

• Abuse if committed by facility staff

• Abuse if committed by a medical professional

• Abuse if committed by a financial professional

• Abuse if committed by an acquaintance

• Abuse if committed by a stranger

• Abuse if committed by someone without knowledge of the victim’s vulnerabilities

• Other (please specify: _________________)

Suspicious deaths

20. Did your agency investigate cases posthumously in 2015? For example, were you called to investigate or co-investigate suspicious deaths?

• Yes

• No

21. [IF YES] – In 2015, did your agency record these cases in the same database as other reports or investigations?

• Yes

• No

Referral to law enforcement

22. In 2015, was there a statewide policy to guide when APS should refer or report substantiated cases to law enforcement or to prosecution?

• Yes

• No

23. [IF YES] In 2015, did local areas in your state have different policies about when APS should refer or report substantiated cases to law enforcement or to prosecution?

• Yes

• No

24. In 2015, what was your agency’s policy on referring or reporting substantiated cases (other than self-neglect) to law enforcement or to prosecution?

• All substantiated cases must be reported to the police or the prosecutor’s office

• Substantiated cases that meet certain criteria were referred to police or the prosecutor’s office

• Substantiated cases were referred on an “as needed” basis

25. [IF NOT ALL CASES REFERRED TO POLICE OR PROSECUTOR] In 2015, under what circumstances did your agency refer or report substantiated cases (other than self-neglect) to law enforcement or to prosecution? Please check all that apply.

• Cases were referred if criminal activity was suspected

• All cases with substantiated physical abuse were referred

• All cases with substantiated sexual abuse were referred

• All cases with substantiated psychological or emotional abuse were referred

• All cases with substantiated neglect (by others, not self-neglect) were referred

• All cases with substantiated financial exploitation were referred

• All cases with substantiated abandonment were referred

• Other (please specify: ______________)

26. When your agency referred to cases to the criminal justice system in 2015, who did you contact?

• Police

• Prosecutor’s office

• Either, depending on the circumstances

• Both, the police and the prosecutor’s office

• Other (please specify: ______________)

Conclusion

Thank you very much for participating in this survey. We truly appreciate the time you spent. The results from this survey will be used assess how APS data can be used to augment current knowledge and statistics about elder victimization. If you have any questions, concerns, or comments about this project, please contact either of the Principal Investigators: Janine Zweig, at jzweig@urban.org (phone: 518-791-1058) or Kamala Mallik-Kane at kkane@urban.org (phone: 202-261-5857).

1 Qualtrics software is being used to administer this survey online. In rare cases, project staff will administer the survey by telephone and record responses in the online instrument.

2 Signed hard-copy consent will not be obtained. Rather, this informed consent will be the first page of the online survey. Participants will indicate consent by continuing with the content of the survey. The Urban Institute IRB has approved this method for obtaining informed consent.

3 Definitions of abuse are from the Centers for Disease Control and Prevention, 2014.

4 Definitions of abuse are from the Centers for Disease Control and Prevention, 2014.

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Note: All items will include the following response options in addition to those shown: Not applicable, Decline to answer, and Don’t know.