Title VI COVID Supplemental

OMB No.: 0985-0059

Assessment and Evaluation of the ACL Title VI Programs
Title VI Program Staff Interview – Informed Consent Form
OMB Control: 0985-0059 Expiración Date: xx/xx/2027

Purpose of the Study
The Administration for Community Living (ACL) seeks to gain a deeper understanding of how using
COVID supplemental funds impacted services provided to older adults. The 60-minute interview is
voluntary. ACL will be talking to program leaders, elders, and caregivers to learn how the services in
their communities help to make their lives better. We will also be looking for ideas to share with
programs all over the country. We will roll all of the ideas into a report which talks about the benefits
and the best way to run elder programs.
Description of Participation
You have been asked to participate because you are a program director of an ACL Title VI Programs. The
interview will last 60 minutes.

Here are some things we want you to know about the interview before agreeing and consenting to
participate:

Risk & Benefits
Participating in this interview is unlikely to cause any problems for you in any way. You can choose not to
answer any question for any reason. You can end the interview at any time. Your answers will not give you any
benefits or change any benefits that you currently may be receiving.

Privacy
There are no assurances of confidentiality. Please note, we will be taking notes during the interview about
what is said, but your name and answers will be kept secure to the extent permitted by law. To help with our
notes, we also will audio record the interview. We will keep the notes and audio records in locked files and
only study staff will be allowed to see them. The information that we report will be grouped together with the
results from all Title VI Programs and will not contain any information about you or your community.

Rights Regarding Decision to Participate
Participation in the interview is completely voluntary. You can refuse to participate with no penalty or
negative results. You do not have to answer questions that you do not want to answer. You may choose
to end the interview at any time, for any reason.

OMB No.: 0985-0059

Assessment and Evaluation of the ACL Title VI Programs
Title VI Program Staff Interview – Informed Consent Form
OMB Control: 0985-0059 Expiration Date: xx/xx/2027

Contact Information
If you have any concerns about your participation in this interview or have any questions about the evaluation,
please contact the project manager, Administration for Community Living.

Public Burden Statement: An agency may not conduct or sponsor, and a person is not required to respond to, a
collection of information unless it displays a currently valid OMB control number. The OMB control number for this
Information Collection is 0985-0059. Public reporting burden for this information collection is estimated to
average 60 minutes per respondent, per year, including the time to review instructions. Send comments regarding
this burden estimate or any other aspect of this collection of information, including suggestions for reducing this
burden, to Office of Performance and Evaluation, Center for Policy and Evaluation, 330 C Street, SW, Rm 1229A,
Washington DC, 20201 or evaluation@acl.hhs.gov.

OMB No.: 0985-0059

Assessment and Evaluation of the ACL Title VI Programs – Title VI Program Staff Interview

Use of COVID Supplemental Funds in Title VI Programs: Interview Guide
Welcome and Introduction
Hello and thank you for agreeing to speak with me today.
My name is (XX), and I am from RTI International, a not-for-profit research organization. I am joined by my
colleague (XX), who will be taking notes. We are working on a project funded by the Administration for
Community Living (ACL) to learn more about how using COVID supplemental funds impacted your work and
services to older adults. This work will help ACL better understand and document the impact of these funds,
how service provision changed over time, and what gaps existed despite the additional funding. Themes from
this and interviews with other Title VI Programs will be consolidated and shared in a report that will be made
public.
We are conducting interviews with key staff from ACL Title VI Programs to learn about the approach to spending
and service delivery, impact, and considerations for moving forward.
Informed Consent
Before we start our conversation, I would like to formally ask for your agreement/consent to be interviewed.
Your participation is voluntary. You can choose not to answer any questions. You can end your participation and
stop this phone call at any time. Our conversation should last approximately one hour.
Do you agree to being interviewed today?
Thank you for agreeing.
I would also like to ask you for your permission to record our discussion. The recording will be used
solely to assist us with our notetaking and will not be shared with anyone outside of the RTI team. The
recording will be destroyed upon completion of this project. Do we have your permission to record?
We will not share your comments with anyone in a way that will allow you to be personally identified as an
individual, and all interview responses that we collect will be kept secure and deleted after project completion.
Information gathered during the interviews will be discussed through the lens of themes within and across ACL
Title VI Programs.
Do you have any questions before we begin?
[At this point pause to turn the recording on if participant has agreed to being recorded]

OMB No.: 0985-0059

Interview
A. Introduction
1. Great, why don’t we begin with a bit about your background. Please tell us about your
role with [name of organization] and about how long you have worked with this
organization.
B. Service Delivery
2. We are interested in learning more about OAA-funded programs and services that are
typically provided by Title VI Programs. Specifically, we are interested in hearing about
supportive services, nutrition services, and caregiver services. Can you please provide an
overview of these services?
3. Among the categories of services just discussed (i.e., supportive, nutrition, and caregiver
services) we are interested in learning how service utilization did or did not change as a
result of the pandemic.
a. What supportive services were the most utilized before the pandemic? During
the pandemic? After the pandemic?
b. What supportive services were the least utilized before, during, and after the
pandemic?
c. What nutrition services were the most utilized before the pandemic? During the
pandemic? After the pandemic?
d. What nutrition services were the least utilized before, during, and after the
pandemic?
e. What caregiver services were the most utilized before the pandemic? During the
pandemic? After the pandemic?
f.

What caregiver services were the least utilized before, during, and after the
pandemic?

4. How did the pandemic impact supportive services? What adaptations or innovations
had to be made to allow for continued service delivery?
5. How did the pandemic impact nutrition services? What adaptations or innovations had
to be made to allow for continued service delivery?
6. How did the pandemic impact caregiver services? What adaptations or innovations had
to be made to allow for continued service delivery?
7. Which OAA funded partners, if any, helped the aging network implement programs and
services during the pandemic, and how?

OMB No.: 0985-0059

a. Were any of these new partnerships that were formed as a result of the
pandemic?
C. COVID Supplemental Funding
For the past several years, Title VI Programs have received supplemental funding (e.g., CARES,
FFCRA, ARP, VAC5) and major disaster declaration flexibilities from the federal government in an
attempt to continue or expand services during the pandemic.
8. How did these supplemental funds impact your ability to provide supportive services
during the pandemic? Nutrition services? Caregiver services?
9. How did providing services change over time, from the first days of the pandemic to the
middle stages to now?
a. Were there different priorities during different stages?
10. How did your Title VI Program prioritize which services to provide throughout the
pandemic?
a. How did you assess changing needs?
b. How did you prioritize which types of services you spent money on?
c. How did you prioritize which money you spent?
11. How were supplemental funds used to purchase big items (e.g., capital expenditures
such as kitchen equipment, vehicles, etc.) during the pandemic?
12. What, if any, special considerations were made for targeting services to certain
groups, especially those who were at highest risk or most vulnerable?
D. Successes and Challenges
13. From your perspective, what have been the most notable successes in terms of impact
(for both participation and outcomes) during the pandemic?
a. What has gone well implementing OAA-funded programs/services?
14. What was the most challenging part of service delivery during this time? What
contributed to this challenge?
a. What, if any, challenges existed related to staffing? Are these still challenges
today?

OMB No.: 0985-0059

b. What challenges existed related to reaching different populations (e.g., adults in
remote areas, transportation challenges, cultural competency challenges, etc.)?
Are these still challenges today?
c. What challenges existed related to spending the supplemental funds? Are these
still challenges today?
15. Are there any new programs, services, innovations, or adaptations (for example, hybird
programs) that you began during the pandemic or because of the pandemic that you
still have in place?
a. If yes, do you expect those to continue? Why?
16. Are there any programs, services, innovations, or adaptations that you implemented
during the pandemic or because of the pandemic that you have discontinued?
a. If yes, why did you stop offering them?
E. Close Out
17. As you reflect back on the past several years and consider future emergency planning,
what gaps in planning, relationships, or services still exist to successfully serve older
adults? (What do Title VI Programs need to have in place in order to reach their goals of
serving older adults)?
18. What kinds of services or activities did you wish you could do, but couldn’t, even with
the supplemental funding?
a. What kinds of support and from which agency or partner would have made this
more feasible?
b. If a large influx of funding is available again, what would you do differently?
19. Are there policies or guidance that ACL could provide that would be helpful to Title VI
Programs for future emergencies?
20. Is there anything else that you would like to share with us that we have not talked
about?