EVALUATION OF THE ACL TITLE VI PROGRAMS

YEAR 3 INTERIM REPORT

January 2020
1

BACKGROUND

WHAT IS TITLE VI?

In 1965, the Older Americans Act (OAA) was 

authorized to protect the well-being of older 

Americans. The OAA promotes community and 

home-based services to support independent 

living, physical and mental health, suitable housing, 

restorative services for those requiring institutional 

care, and retirement in “health, honor, and dignity” 

(OAA Title I, Sec. 101: 42 U.S.C. 3001).

In 1978, the OAA was amended to include homeand community-based supportive services for older 

American Indian, Alaska Native, and Native Hawaiian 

(AI/AN/NH) populations. This amendment, Title VI, 

recognizes that older AI/AN/NHs are a “vital resource 

entitled to all benefits and services available” (OAA 

Title VI, Sec. 602: 42 U.S.C. 3057a).

Title VI provides nutrition and supportive services 

for elders, including congregate and home-delivered 

meals, information referral services, transportation, 

and other services. The program also provides 

caregiver services for individuals providing care for 

elders or for elders raising grandchildren or caring 

for adult children with disabilities. Services include 

information and outreach, respite care, and other 

related services.

The Administration for Community Living (ACL), 

Administration on Aging (AoA), administers the Title 

VI Programs. In fiscal year 2016, ACL awarded 3-year 

grants for the following:

▶ 270 grants for Nutrition and Supportive Services 

▶ 233 grants for the Caregiver Support Program 

ICF has been contracted to conduct the Evaluation 

of ACL’s AI/AN/NH Programs (OAA Title VI) Title VI 

Grant Program under ACL contract #1600197A. This 

report presents a summary and findings from year 3 

of the evaluation.

IMPLEMENTATION STUDY: The purpose 

of this study is to understand the context 

of the Title VI Programs, including barriers 

and facilitators to program implementation.

OUTCOMES STUDY: This study assesses 

the impact of the Title VI Programs, 

particularly on elders and the community.

SUPPORTING ELDERS AND CAREGIVERS

Title VI provides services through three programs: 

Part A (Indian Program), Part B (Native Hawaiian 

Program), and Part C (Native American Caregiver 

Support Program).

NUTRITION AND SUPPORTIVE SERVICES FOR ELDERS

Part A—Serves 

federally recognized 

tribes with at least 

50 members ages 60 

years and older.

▶ Congregate and

 home-delivered meals

▶ Information and 

assistance

▶ Case management

▶ Transportation

▶ Health promotion

▶ Other supportive 

services (e.g., 

homemaker, personal 

care, legal assistance) 

Part B—Serves 

public or nonprofit 

organizations that 

serve Native Hawaiians 

and represent at least 

50 individuals ages 60 

years and older.

CAREGIVER SUPPORT SERVICES

Part C—Serves all 

programs with Parts 

A or B, providing 

support to caregivers 

of elders, elders caring 

for adult children 

with disabilities, and 

grandparents raising 

grandchildren.

▶ Information and 

outreach

▶ Access assistance

▶ Counseling, training, 

and support groups

▶ Respite services

▶ Other supplemental 

services

WHAT IS THE EVALUATION OF THE ACL TITLE VI PROGRAMS?

The Evaluation of the ACL Title VI Programs is an 

opportunity to understand the impact of the Title VI 

Programs on stakeholders, including elder program 

participants, caregivers of elders, and program staff. 

The evaluation consists of an implementation study and 

an outcomes study.

The evaluation uses a mix of information that grantees 

already collect (secondary data), as well as new 

sources of information (primary data) to describe the 

implementation and outcomes across nutrition services, 

supportive services, and caregiver support services. 
2

With the help of a stakeholder advisory committee (Steering Committee) representing tribal, local, state, and 

national partners to the ACL Title VI Programs, the evaluation is grounded by a medicine wheel representing the 

four quadrants of indigenous practice: spiritual, mental, emotional, and physical (see Appendix A). Each quadrant 

of the medicine wheel reflects the expected outcomes of the Title VI Programs on program participants.

EVALUATION GRANTEES

Twelve Title VI grantees representing 5 Title VI regions and 6 states are participating in the Evaluation of the 

ACL Title VI Programs. Each grantee identified two to three people from its Title VI Program, including the Title 

VI program director, to serve on the Evaluation Working Group (EWG). The EWG guides and informs all stages 

of the evaluation, including data collection instruments, recruiting participants to take part in focus groups and 

interviews, and local data collection and technical assistance needs.

EVALUATION TIMELINE

The third year of the evaluation focused both on data collection to better understand the implementation of the 

Part C Caregiver Support Services and training and technical assistance (TTA) to support evaluation grantees in 

using their program data. 

1. How do tribes operate their 

Title VI Programs?

2. What is the effect of Title VI 

Programs on elders in the 

community? Are there differences 

nationally or by tribe/tribal groups?

3. Do Title VI Programs that rely only on 

Title VI funds have a different impact 

than programs that have money from 

other programs or agencies?

TWO STUDIES: 

IMPLEMENTATION 

& OUTCOMES

EVALUATION 

QUESTIONS

REPORTING & 

DISSEMINATION

Primary Data

• Staff, Caregiver, Elder Focus Groups

• Staff, Elder Interviews

Secondary Data

• Title VI Needs Assessment

• n4a Survey

• Program Performance Reports

• Title VI Applications

SNAPSHOT OF THE EVALUATION OF THE ACL TITLE VI PROGRAMS
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2019

ICF hosted a webinar for the ACL Title VI 

Evaluation Steering Committee, 

An Update on the ACL Title VI Evaluation. 

January 29

ICF staff conducted site visits to all 

evaluation grantees. Site visits included 

focus groups and interviews with caregivers, 

an evaluation needs assessment, and a 

caregiver program assessment.

March 19–May 21

ICF staff conducted quarterly evaluation 

calls with Title VI Evaluation grantees. 

June

ICF staff developed the Title VI 

Evaluation Tool and User Guide and the 

Title VI Infographic and User Guide.

July

ICF hosted a meeting with the ACL Title 

VI Evaluation Steering Committee during 

the National Title VI Training and 

Technical Assistance Conference. 

August 15

ICF hosted a webinar for the EWG, Using 

the Title VI Evaluation Tool and Infographic. 

October 30

The ICF Institutional Review Board (IRB) 

approved the Continuing Review of the 

Evaluation of the ACL Title VI Programs.

ICF staff conducted quarterly evaluation 

calls with Title VI Evaluation grantees.

October

ICF staff shared a fall e-letter update with the 

ACL Title VI Evaluation Steering Committee.

November 26

ICF hosted a webinar for the EWG, 

Preparing for Your Second Site Visit.

February 27

ICF staff conducted quarterly evaluation 

calls with Title VI Evaluation grantees.

March

ICF staff shared a summer e-letter 

update with the ACL Title VI Evaluation 

Steering Committee.

June 17

ICF hosted an in-person, full-day training 

with the EWG in conjunction with the 

National Title VI Training and Technical 

Assistance Conference.

August 12

KEY ACHIEVEMENTS IN YEAR 3 OF THE 

EVALUATION OF ACL TITLE VI PROGRAMS
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TITLE VI EVALUATION 

TOOL AND USER GUIDE

“Appreciate the development of the 

various tools and products! They are all 

very useful and will definitely be used 

and implemented with our program.” 

—Title VI grantee

The Title VI Evaluation Tool and User Guide 

is a ready-to-use resource for Title VI 

program staff. The tool includes:

▶ Two Surveys (Part A/B, Nutrition and 

Supportive Services, and Part C, 

Caregiver Support Services)—to assess 

elder and caregiver use and satisfaction 

with program services.

▶ Survey Response Spreadsheet—to help 

program staff analyze survey responses 

through use of data visualizations (e.g., 

tables and charts).

▶ User Guide—to help program staff review 

and use evaluation findings with support 

of step-by-step guidance from planning to 

data collection. 

TITLE VI INFOGRAPHIC 

AND USER GUIDE

“The infographic ... will help me paint 

a picture for leadership. Data such as 

numbers, raw data, is good but to have 

visualizations for them to relate to is 

awesome.” —Title VI grantee

The Title VI Infographic and User Guide 

is designed to help Title VI program staff 

summarize and share their program data 

in a visual and engaging way. The Title 

VI Infographic brings together program 

data that Title VI grantees already collect, 

including their Program Performance 

and Reporting (PPR) data as well as data 

from their Elder Needs Assessment. The 

infographic includes four core sections:

▶ Overview of the Title VI Program—

includes a description of services provided.

▶ Elder Profile—summarizes health 

characteristics of elders in the community.

▶ Program Delivery and Participation—

summarizes the number of units and 

clients served for each Title VI service. 

▶ Program Improvement—summarizes 

program quality improvement practices, 

including trainings and evaluation.

TRAINING AND TECHNICAL 

ASSISTANCE

As part of the evaluation, the ICF evaluation team 

provides TTA to the EWG to ensure understanding 

and use of program data for program monitoring 

and improvement. The TTA includes skill-building 

resources and tools, such as one-page guidance 

documents on using focus groups and interviews 

to better understand elders’ and caregivers’ needs 

and satisfaction with program services. Through 

evaluation TTA, evaluation grantees have learned 

how to identify themes within their program data 

and use these findings to inform their programming.

During this year’s site visits, the evaluation team 

worked with program staff to understand their local 

evaluation needs. Across the evaluation grantees, 

program staff shared a common need to understand 

whether and how their program services are 

meeting the needs of elders and caregivers, as well 

as a need to showcase the depth and breadth of 

their local Title VI program. To address these needs, 

the evaluation team developed two resources to 

support grantees in conducting local program 

evaluation and engaging stakeholders. The Title VI 

Evaluation Tool and the Title VI Infographic were 

shared with the EWG in August. As the EWG uses 

the tools, their feedback will be compiled and used 

to refine the tools before they are shared with the 

broader Title VI community.

TRAINING & 

TECHNICAL 

ASSISTANCE

EWG Trainings 

(in-person and virtual)

Quarterly 

Liaison Calls

Evaluation 

Tools and 

Resources

Annual Site Visits

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Respite—Provides temporary support to 

give caregivers a break from caregiving.

Supplemental Services—Offered on a 

limited basis, these may include home 

modifications (e.g., handrails), assistive 

technologies, or consumable supplies 

(e.g., gloves and adult diapers).

Information—Provides information to 

caregivers on available services. It is 

often provided through public service 

announcements, health fairs, and 

program brochures. 

Assistance—Includes hands-on support 

to help caregivers access services. 

Assistance includes one-on-one support 

and case management.

Counseling, Support Groups, and 

Training—Supports caregivers in 

decision making and problem solving 

related to their role as caregivers. 

Trainings often focus on stress relief and 

financial literacy.

The Evaluation of the ACL Title VI Programs uses mixed methods, including quantitative and 

qualitative data sources to answer the Title VI evaluation questions.

WHAT IS PART C?

The Native American Caregiver Support Program (Part C) supports unpaid family caregivers in caring for an elder 

family member, a grandchild, or an adult with disabilities. The Older Americans Act authorizes grantees to provide 

caregiver support services including: Information; Assistance; Counseling, Support Groups, and Training; Respite; 

and Supplemental Services.

WHAT WE’VE LEARNED

2019 EVALUATION DATA SOURCES

▶ Caregiver Focus Groups and Interviews

▶ Caregiver Program Assessment 

▶ National Resource Center on Native 

American Aging/University of North Dakota’s 

Identifying Our Needs: A Survey of Elders 

(Elder Needs Assessment)

▶ n4a Title VI Survey

This year, the evaluation team focused on 

understanding the Title VI Part C, Native American 

Caregiver Support Program, from the perspective of 

caregivers. The evaluation team analyzed multiple 

data sources, including interviews and focus 

groups with informal (unpaid) caregivers, in order to 

understand the implementation and impact of the 

Pact C Caregiver Support Program (see Appendix B: 

Methods). The following sections include a summary 

of emerging themes from the evaluation based on 

data collection and analysis in 2019. These themes 

include the variability of Part C caregiver support 

services across Title VI grantees and caregivers’ met 

and unmet needs.

While the OAA defines Part C as 

delivery of all five of these services, not 

all Title VI grantees are implementing 

these services.

5
6

More elders report that they would use caregiver and 

respite services than are actually using those services. 

Service Delivery

The range of Part C Caregiver Support Services 

provided varies across the evaluation grantees. 

The majority of the evaluation grantees provide 

information, outreach, and assistance in accessing 

services to caregivers. Counseling, support groups, 

and training are less frequently provided. 

13caregivers served, on average, in 2019, by the 

evaluation grantees that maintain a roster of caregivers.

Program Monitoring and Evaluation

The majority of the evaluation grantees do not 

have a systematic process in place for using Part C 

program data (e.g., PPR or elder needs assessments) 

to inform program planning. Instead, program 

planning is informed by staff observation of available 

resources to meet caregivers’ needs. 

Staffing and Resources

Caregiver services have been funded under Part C for 

varying lengths of time across the evaluation grantees. 

The range of caregiver services provided did not 

depend on the length of time grantees had been 

receiving Part C funding. 

To meet the needs of caregivers and their families, 

elder programs rely on a mix of funding sources. 

While half of the evaluation grantees’ caregiver 

support services are funded fully by Title VI funds, the 

remaining evaluation grantees receive supplemental 

funding to support their caregiver programs. 

The staffing structure for the caregiver program 

varies by grantee. More than one-third of the 

evaluation grantees (34%) have a designated staff 

coordinator for their caregiver program. For others, 

caregiver program duties are spread across the 

program director, assistants, and other staff. In 

addition, many programs have experienced recent 

staff turnover. One-third of the evaluation grantees 

have new program directors or staff as of this year. 

PROGRAM CONTEXT AND DELIVERY

Half of the evaluation grantees 

have received Part C funding for 

more than 10 years.

The other half have received 

Part C funding for 5 years or less.

Across the evaluation grantees and all Title 

VI grantees, reporting for the Part C PPR is 

inconsistent. This may be due to a lack of 

clear definitions and guidance by ACL.

PART C SERVICES PROVIDED BY 

EVALUATION GRANTEES

Data Source: Caregiver Program Assessment

PROGRAM PARTICIPANTS

One in 3 elders have family caregivers. 

One in 10 elders are a grandparent raising 

grandchildren.

One in 15 elders reported that they use caregiver 

services.

Less than 1 in 30 elders reported using respite care.

PERCENTAGE OF ELDERS 

CURRENTLY USING VERSUS WOULD USE

CAREGIVER AND RESPITE SERVICES

 

Data Source: Elder Needs Assessment

of evaluation 

grantees have 

a designated 

caregiver program 34%

coordinator.

Data Source: Elder Needs Assessment
7

WHAT IS WORKING

Caregivers who receive caregiver support services shared that the services helped them in important ways, 

particularly by providing relief from the stress of caregiving and helping to improve their overall quality of life.

Respite

For the programs that offer respite services, 

caregivers described that this service provided them 

an opportunity to take a needed break from the 

challenging work of caregiving and attend to other 

aspects of their lives.

“I know as a caregiver, I need time for myself. It’s 

hard to take care of somebody else and not take 

care of yourself. How do you be strong for them 

when you can’t even take care of your own self? 

With mom, it’s good that somebody else comes 

in. And, that I take time out for me, and I go do 

what I need to do.”*

“My mom liked to argue, especially when her 

dementia got worse, and [the respite] gave me 

a little bit of a break from her. I hate to say that.”*

Supplemental Services

A few caregivers described that the Title VI program 

provided equipment for them, such as wheelchairs or 

walkers. This was a simple but critical resource that 

helped them support their care recipient to remain as 

independent as possible. 

“This last week, she needed a walker. They 

provided that ASAP, and we didn’t have to 

worry about spending our own money, having 

to run around town and find it. ... That walker 

enables her to be independent instead of having 

to rely on somebody to help carry her to the 

bathroom.”*

PROGRAM STAFF PERSPECTIVE

One-third of evaluation grantees believe 

they are meeting caregivers’ needs for 

respite services.

PROGRAM STAFF PERSPECTIVE

Several programs shared that collaboration 

with other tribal or community organizations 

to support lending closet supplies has 

increased over time. 

ACL RESPONDS

After learning of grantee confusion around 

the Part C program, ACL has begun 

developing clear guidelines to better support 

Title VI grantees.

Information and Assistance

Caregivers appreciate that local program staff are 

there to support them. Staff share useful resources 

and information about available caregiver services 

and provide referrals to ensure better care for them 

and their family members. 

“They’ve got tons of information. Anything you 

want to know, they bend over backwards and get 

it for you. If they aren’t able to have somebody 

come in for you, they give you information to 

rural resources or things like that.”*

The staff member “is so caring, and she always 

gets right back with you. That’s important 

because you’re already frustrated or lacking 

sleep, and she always tries to find a resource for 

you. That’s what I like about her. And she comes 

out to visit. She checks up on the person that 

needs the care and the providers, as well, to see 

if there’s anything she could help out with.”* 

Counseling/Support Groups/Training

Of the programs that offer caregiver support groups, 

caregivers shared that this resource helped them to 

manage the stress of caregiving. The support groups 

helped them learn from other caregivers who face 

similar issues and gave them renewed strength to 

continue providing care. 

“It’s most helpful for us as caregivers to take 

time away from our home, away from our clients 

or patients that we care for. I’m a 24/7 caregiver 

and to just get away for those few minutes over 

here and then to share our difficulties amongst 

ourselves. And as a caregiver, how to survive 

and take care of our self.”* 

“So I thoroughly appreciate coming [to the 

caregiver group]. Because ... of course, 

everything that we share amongst each other 

and all that stays here. And leaves that here for 

us to again kind of begin to be whole and start 

our journey again.”*

* Title VI Caregiver
8

Many caregivers shared that they do not consider themselves to be a “caregiver.” They 

view caregiving as a natural extension of their responsibility to their family. As a result, 

caregivers may not consider themselves to be eligible for caregiver services or support.

“I think, number one, the caregivers don’t really know that they’re caregivers in the community. They’re just 

so used to taking care of somebody that they don’t consider themselves to be that precious to that individual. 

So they need to be identified, I think.”*

Many caregivers also described falling into the role of being a caregiver without any training or knowledge to 

support them in the role. As a result, they struggled when faced with issues such as how to safely lift and move 

a family member with a disability, administer medical care at home, navigate medical or insurance processes, or 

recognize the signs of depression in a loved one suffering from chronic illness.

WHO IS A CAREGIVER?

CAREGIVERS ARE FAMILY

Many caregivers described that “family takes 

care of family.” Caregivers shared that they work 

hard to meet the needs of family members with 

an illness or disability to avoid placing loved 

ones in a care facility.

“If we don’t take care of our husbands, they 

go in a nursing home, so we do everything. 

We change them when it’s the end of their 

time, and we do everything ... change their 

bed all the time, we bathe them. Otherwise, 

if we don’t, then they go in a nursing home. 

So we keep going no matter what.”* 

“All of us kids and grandkids, we just kind of 

pull together, and my older sister got a group 

going where, ‘whose taking care of mom this 

day,’ ‘whose with mom in the evening.’”*

CAREGIVERS ARE ELDERS

In many cases, caregivers are themselves 

elders caring for other elders (e.g., spouse, 

siblings, or cousins) as well as grandparents 

raising grandchildren.

“I think a lot of the problem is people are 

living too long now, and now it’s people like 

us that are actually old that are taking care 

of people that are older.”*

“Well, my baby is 35 so it’s been that long 

since I raised a baby and ... I had to learn ... 

I’ve had both of them since they were infants 

and one is already a 9th grader in high 

school ... it’s hard, I say it’s very hard. Me 

and my husband, we’ll see other elders come 

out of places, no worries. You know, they’re 

just by themselves. I said, we should be like 

that. ... But we have to rush home because 

she’s coming home on the bus. ... You know, 

it kind of robs us of our livelihood.”*

* Title VI Caregiver
9

PHYSICALLY

Caregiving can be physically 

exhausting as caregivers 

attempt to handle the routine 

duties of their lives while also 

providing care. Many described 

depriving themselves of sleep or 

other self-care. 

“I drive back and forth to take 

my husband three times a week 

[to dialysis treatment]. And, his 

chair time starts at 3:00 a.m., 

so we leave home ... at midnight 

to get out to dialysis, and he’s 

done about 7:30, 8:00 a.m., and 

then I drive him back home. 

You know, it’s not only enduring 

the treatment time, but it’s the 

6-hour commute time.”*

FINANCIALLY

Caregiving can be expensive. 

Many caregivers face travelrelated costs driving to 

frequent medical appointments, 

sometimes requiring overnight 

stays in a motel. Caregivers also 

struggle with whether to leave a 

job or reduce to part-time in order 

to care for their family member. 

“I had to leave my job about 4 

years ago when my husband’s 

kidney failed and he’s now in 

dialysis. So I’ve been a 24/7 

caregiver for him. I left my job 

and everything ... and I left it 

to take care of my husband 

because he lost one side of his 

eyesight, and the other side is 

slowly diminishing.”*

EMOTIONALLY

Caregiving can be emotionally 

overwhelming. Caregivers often 

worry about the recipient of 

care as well as their caregiving 

duties. Some experience 

tension between family 

members regarding caregiving 

decisions. All caregivers 

experienced the need for, and 

lack of, personal breaks. 

“I was doing this from the time 

I was 17 until I was 22. And the 

amount of stress I was under 

during those times was just 

insane. And even when I was at 

home at night I couldn’t really 

rest because I was so worried 

about my grandma.”*

GRANDPARENTS RAISING 

GRANDCHILDREN

For grandparents raising grandchildren, many 

are “starting all over”—taking on the role and 

responsibility of being a parent when they are often 

in need of greater support themselves. Grandparents 

described the time required to care for and raise 

a child; the related expense, when most are now 

retired; and that managing the many tasks needed to 

raise a child requires energy and mobility. 

“Well, my own children have been

out of school for 7 years, and 

starting all over, it feels like ... 

It’s challenging at times, but we’re 

doing the best we can.”*

CAREGIVING: A REWARDING 

BUT CHALLENGING EXPERIENCE

CARING FOR ELDERS 

WITH DEMENTIA

Caregiving for family members with dementia 

presents its own challenges. Caregivers described 

ongoing tension with the elder, whose illness may 

result in confusion, anger, and resistance to care. 

“It’s hard to reason with somebody who is adamant 

that she puts something there, and 10 minutes later, 

it’s not there. She can’t help it, she’s sick.”* 

“For people that have relatives with dementia ... 

you know a lot of them suffer the sun 

downers, and that was just ... really 

stressful to have to be up all night 

and work all day and take care of 

your own family and household. 

So that was a challenge.”*

* Title VI Caregiver

* Title VI Caregiver
OPPORTUNITIES FOR GROWTH 

While grantees are working to support the caregivers 

in their communities, caregivers and program staff 

each identified the need to increase caregivers’ 

awareness of existing services as well as to expand 

the services provided. For some grantees, this may 

mean expanding their services to include all of the 

five required Part C services.

Information and Assistance

Many caregivers were interested to learn more about 

the types of caregiver services available and how to 

access them. Caregivers also expressed a need for 

information on the signs and symptoms of mental 

and physical illnesses and how to care for others 

with conditions such as dementia or depression. 

“At some point in time, I will be using that 

[caregiver] service and I need to find out what’s 

available and how to go about getting it.”*

“It’d be helpful to learn some stuff about the one 

you’re caring for, signs to look for to be aware of. 

That would be nice.”* 

Counseling/Support Groups/Training

Many caregivers spoke about the need for 

counseling and caregiver support groups that 

would provide an opportunity for them to share 

experiences and learn from one another. 

“So I think it’s just offering these sessions to 

the families going through these situations and 

letting them know that it’s normal to feel this 

way. But offering them the support and the tools 

they need to not, at the end of the day, break 

when it comes to these situations.”* 

“And I love my grandkids, he’s my grandkid, the 

little one. And, I have four other ones too. But ... 

I really need to talk to somebody, yeah, get my 

stuff out. And, I just need somebody to listen to 

and at least give me a little bit of advice, where 

to go or who to talk to.”*

Respite 

Many caregivers described respite as a crucial 

resource. For those caregivers currently receiving 

respite, they expressed a need for additional hours 

of respite, available over a longer period of time.

PROGRAM STAFF PERSPECTIVE

Program staff reported a lack of awareness 

among caregivers about available services. 

Some program staff shared that they have 

increased outreach as a result.

PROGRAM STAFF PERSPECTIVE

Program staff shared that, in some cases, 

their tribal clearance process (e.g., 

background checks) for respite providers 

delays the availability of these services to 

caregivers in need.

PROGRAM STAFF PERSPECTIVE

The majority of program staff expressed they 

did not understand the required elements of 

the Part C program.

PROGRAM STAFF PERSPECTIVE

One grantee shared that services have 

decreased over time due to a decrease in tribal 

support that supplemented their Part C funding.

* Title VI Caregiver

1/3 of the evaluation 

grantees do not provide 

respite services.

Supplemental Services

Caregivers also described a need for supplemental 

services and supplies including hygiene, 

incontinence, and first aid supplies. 

“It’s kind of hard when you get low [on supplies]. 

... Because I’m taking care of two of them ... I 

really need a mask and the gloves.”*

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FOR MORE INFORMATION, CONTACT:

Kristen (Krissy) Hudgins, PhD

Social Science Analyst, Office of Performance and 

Evaluation

Administration for Community Living 

Telephone: 202-795-7732 

Email: Kristen.Hudgins@acl.hhs.gov

Gretchen Clarke, MPH

Manager, Title VI Evaluation

ICF

Telephone: 907-747-7124 

Email: Gretchen.Clarke@icf.com

WHAT’S NEXT?

The fourth year of the evaluation marks the third and final year of data collection with the 

evaluation grantees. During year 4, ICF will conduct a third site visit with the evaluation 

grantees to collect program data and provide evaluation TTA. Following the site visits, ICF 

will begin synthesizing all data gathered across the three years of data collection with the 

evaluation grantees. Year 4 evaluation activities will include the following:

Final Site Visits

ICF staff will work with grantees to schedule a one-day site visit in the spring of 2020. The site 

visits will be an opportunity for:

▶ One-on-one TTA with grantees

▶ Conducting small group interviews with program staff

Evaluation Tools Dissemination

Using feedback from the EWG, ICF staff will refine the Title VI Evaluation Tool and the Title VI 

Infographic to better meet the needs of Title VI grantees. The revised tools will be shared with 

all Title VI grantees to enhance the ability of all Title VI programs to conduct local program 

evaluation for program monitoring and improvement.

Summative Analysis

The evaluation team will synthesize and summarize all data gathered through the three years of 

data collection, using it to address and answer the questions that have guided this evaluation.

Briefings With Stakeholders

The ICF evaluation team will brief stakeholders on findings from the evaluation. The briefings, 

delivered virtually, in-person, and through written posts, will be an opportunity to share what 

has been learned through the evaluation and gather feedback as to what it may mean from the 

local program perspective.