ACL contracts with WRMA

Summary

In 2023, the U.S. Department of Health and Human Services (HHS), Administration for Community Living (ACL), Administration on Aging was seeking assistance in piloting programs to effectively serve older adults affected by opioids and other substance use disorders (SUDs) within adult protective services (APS) programs. It chose WRMA to spearhead this initiative, given our extensive knowledge of the older adult population and APS acquired through involvement in the Adult Protective Services Technical Assistance Resource Center (APS TARC) and prior research on the impact of the opioid epidemic on APS.

For this project, WRMA designed, piloted, and evaluated a strategy that state APS programs can implement to more effectively serve clients affected by opioid and other SUDs. Our team accomplished the following:

• Identified feasible and sustainable real-world solutions
• Designed a pilot to test the identified solutions
• Provided technical assistance to pilot sites implementing the solutions
• Evaluated the pilot sites to determine effectiveness, impact, and lessons learned

Details

The opioid epidemic has created new challenges for adult protective services (APS) programs in their mission to support clients. Opioids and other SUDs can lead to self-neglect among older adults, as well as instances of physical and emotional abuse, exploitation, and neglect by family members and caregivers. Addressing the needs of older adults facing neglect due to opioid or other SUDs requires effective strategies within APS systems. Previous research and anecdotal evidence indicate a lack of a clear, replicable model for enhancing services to clients affected by SUDs.

In 2021, through our work with APS TARC, WRMA designed and conducted a qualitative study to identify the challenges and successes when investigating and intervening in cases of opioid-related elder abuse. The study aimed to understand the nature, extent, and challenges APS staff face in providing services to clients affected by opioids.

Building on this knowledge base in 2023, we conducted a literature review, assessed existing ACL opioid grantee projects, and performed an environmental scan that included interviews with APS programs in states with high opioid death rates. This information guided the initial stages of designing a pilot program to test best practices for more effectively and efficiently serving APS clients affected by opioids and other SUDs.

In 2024, three APS program sites were selected to implement the final 12-month pilot. Throughout the year, these pilot sites received coordinated support, guidance, and one-on-one technical assistance, addressing topics related to implementation, data collection, and evaluation processes and procedures. A comprehensive final report, encompassing key findings, challenges, lessons learned, and replication materials will be compiled at the pilot’s conclusion.