NAMRS FFY 2016

Report 1.2: Agency 

Component

May 5, 2018
Suggested Citation:

Acker, D., Aurelien, G., Beatrice, M., Capehart, A., Gassoumis, Z., Ph.D., Gervais Voss, P., 

Greene, M., Phillippi, M. (2018). NAMRS FFY2016 Report 1.2: Agency Component. 

Administration for Community Living, U.S. Department of Health and Human Services: 

Washington, D.C.

Disclaimer:

This project was funded by the Administration for Community Living under contract number 

HHS-P233201500042I to WRMA, Inc. The statements contained in this publication do not 

necessarily reflect the views or policies of the Department of Health and Human Services and 

Administration for Community Living.

Acknowledgements

The Administration for Community Living gratefully acknowledges the voluntary submission of 

data to the National Adult Maltreatment Reporting System (NAMRS) by the States, District of 

Columbia, and Territories. Without the support of the Adult Protective Services staff, supervisors, 

and program administrators’ collection of data and reporting into state systems, it would have been 

impossible to have achieved the historical, first submission of data (FFY 2016) into the National 

Adult Maltreatment Reporting System.

In addition, we applaud the work of the:

 Elder Justice Coordinating Council in making the collection of data regarding adult 

maltreatment a priority issue;

 Department of Health and Human Services’ Assistant Secretary for Planning and 

Evaluation for support of the initial development and piloting of NAMRS; and

 Numerous experts, university faculty, medical researchers, and national organizations 

representing the field of adult maltreatment who provided guidance on NAMRS 

development.
Contents

Acknowledgements ........................................................................................................................ i

Executive Summary..................................................................................................................... iii

Agency Component Data...............................................................................................................1

(AC-1) Agency Component Submission Rates .................................................................. 1

(AC-2) Data Source ............................................................................................................ 1

(AC-3) Staff ........................................................................................................................ 2

(AC-4) Intake Model........................................................................................................... 3

(AC-5) Reports.................................................................................................................... 3

(AC-6) Time (Days)............................................................................................................ 4

(AC-7) Maltreatment Types................................................................................................ 4

(AC-8) Standard of Evidence.............................................................................................. 5

(AC-9) Assessment Tool..................................................................................................... 5

(AC-10) Service Gaps......................................................................................................... 6
iii

Executive Summary

The statistics in this report are based on data submitted to NAMRS, which is a voluntary reporting 

system that was developed by the U.S. Department of Health and Human Services, Administration 

for Community Living. In FFY 2016, 54 APS reporting jurisdictions volunteered to participate 

by providing information and data. For NAMRS, a reporting jurisdiction is the officially 

designated APS office in the state, territory, or district.

The Agency Component report offers an overview of the policies and practices of state APS 

agencies. In addition to submitting the data elements highlighted in this report, states provided 

narratives regarding statutes, policies and procedures, investigative practices, data systems, intake 

processes, staffing, training, and client assessments. Narrative information such as state statutes, 

policies, training, etc. will be used in developing future discussion papers.

Additional information gleaned from the initial year of NAMRS data submissions can be accessed 

in the following reports:

 NAMRS FY 2016 Background Report: This report discusses the development of the 

NAMRS data system, provides an overview of the data elements and the data submission 

process, and discusses the known limitations and future directions of NAMRS.

 NAMRS FY 2016 Report 2: Key Indicators: Key Indicators Report presents data from 44 

states, a combination of data from 20 states that provided aggregate Key Indicator data and 

24 other states that provided case-level data for the same key indicator elements. The 

aggregated data pertains to client, victim, and perpetrators.

 NAMRS FY 2016 Report 3: Case Components: Case Component provides a summary of 

case level information for investigations of maltreatments, clients, victims, services, and 

perpetrators. Additionally, Report 3 presents a review of cross tabulations of certain data 

elements relevant to victims with a substantiated maltreatment type.

A final note on limitations of the FFY 2016 data reports. In this first year of a new, national 

reporting system, care was taken to explain how many states were able to submit information; the 

percentage of individual data elements provided; and to describe limitations discovered when 

reviewing data. For FY 2016, no state could provide all Case Component, nor all Key Indicators, 

data elements, and no two states reported on all of the same data elements. Furthermore, as 

NAMRS was developed to allow maximum flexibility for states to be able to report data in a way

that did not increase burden for the states’ participation, data contained in the exhibit tables will 

not always total 100%. Agency and Key Indicator data have aggregate totals, which contain 

duplicate counts of clients, victims, and perpetrators. The Case Component data, conversely, are 

unique. Case Component data consists of client characteristics, services, and perpetrator 

characteristics, provided by states that have report-level tracking systems. For these reasons, 

readers are cautioned against attempting to compare or combine data reported in Agency, Key 

Indicator, or Case Components.
1

Agency Component Data

The Agency Component report offers information about the uniqueness of each state program. The 

NAMRS Agency Component has 12 data elements that include seven numerical fields and five 

optional narrative fields. The following exhibit reflects response rates for the data elements. The 

optional narrative fields allow states to describe unique state statutes, policies, populations served, 

and method(s) of data collection. The narrative submissions are not included in this report. ACL 

decided that in the initial years of reporting to NAMRS, individual states would not be identified, 

and that the report would reflect national information about the reported maltreatments of adults.

(AC-1) Agency Component Submission Rates

“Exhibit AC-1 Agency Component Submission Rates” lists each of the Agency Component data 

elements. Additionally, the exhibit lists the number of states that submitted each data element; the 

percentage of states out of the possible 56 states that submitted the data elements; and the 

percentage of states out of the possible 54 states which submitted the specific data elements.

Exhibit AC- 1 Agency Component Submission Rates

Data Element

# of states 

that 

submitted

% of states 

(56)

% of states 

that 

submitted 

(54)

Data Source (AC-2) 52 92.9% 96.3%

Investigator FTEs filled (AC-3) 47 83.9% 87.0%

Supervisor FTEs filled (AC-3) 44 78.6% 81.5%

Intake Model(AC-4) 53 94.6% 98.1%

Reports Accepted for Investigation (AC-5) 49 87.5% 90.7%

Reports Not Accepted or I&R/I&RA (AC-5) 42 75.0% 77.8%

Response Time (AC-6) 45 80.4% 83.3%

Completion Time (AC-6) 39 69.6% 72.2%

Maltreatment Types (AC-7) 53 94.6% 98.1%

Standard of Evidence (AC-8) 50 89.3% 92.6%

Assessment Tool (AC-9) 51 91.1% 94.4%

Services Gaps (AC-10) 24 42.9% 44.4%

(AC-2) Data Source

The data source represents the entity from which the data was gathered. Examples of APS and 

Other Agencies include, but is not limited to, agencies responsible for maltreatment investigations, 

licensing and certification agencies, and regulatory authorities. States’ statutory authority varies

for investigations of maltreatments of older adults based upon age, disability, and place of 

residence. For example, investigations of maltreatment reports adults 60 and older may be 
2

investigated by the department of aging services; adults 18 to 59 with a disability may be 

investigated by the department of behavioral health and development disabilities; and adults 18 

and older living in licensed long-term care facilities by the licensing and certification of facilities 

agency. The state point of contact for reporting to NAMRS is the APS program. If the APS

program was able to report adult maltreatment data from other state agencies responsible for 

investigating maltreatments, they worked with the other agencies to submit one state report to 

NAMRS.

“Exhibit AC-2 Data Source” pie chart depicts that 46, or 88.5%, of the states had only one data 

reporting source, which was the APS data system. Six, or 11.5%, of the states submitted data 

gathered from the APS data system and at least one other reporting agency’s system.

(AC-3) Staff

“Exhibit AC-3– Staff” reflects the number of states that were able to provide the number of fulltime equivalent (FTE) positions for investigators and supervisors. Narratives provided by some 

states explained that supervisors also carry an investigative case load.

Exhibit AC- 2 Staff

Staff

# of 

states 

that 

submitted

% of 

states 

(56)

FTE 

Count

Count of 

44 states 

that 

provided 

both

% of 

states 

(44)

Ratio 

Investigators 

to 

Supervisors

Investigator FTEs Filled 47 83.9% 6,079 4,859 80.5% 4 : 1 Supervisor FTEs Filled 44 78.6% 1,180 1,180 19.5%

12%

88%

Exhibit AC- 2 Data Source (N= 52)

APS and Other Agencies

APS Agency Only
3

(AC-4) Intake Model

A centralized intake hotline or call-in number provides a single point of entry for reports of 

maltreatments. Decentralized options include regional or county hotlines or reporting numbers.

In “Exhibit AC-4 Intake Model,” 24, or 45.3%, of the states have a centralized, state-wide system 

for receiving reports. Sixteen, or 30.2%, of states have a combination of both a centralized and 

decentralized (local) reporting system. Eleven, or 20.8%, of states have local systems established 

for reporting of adult maltreatments. Two, or 3.8%, of states have a different arrangement, other 

than state-wide or local systems, for receipts of reports. The two different arrangements were a 

model for intake of reports by law enforcement and another of rotation of responsibility by APS

investigators.

(AC-5) Reports

Reports of maltreatment that APS received were assessed at intake for next steps: either (1) accept 

for investigation and/or assessment for intervention and services; or (2) provide information, 

assistance, and referral to other services. “Exhibit AC-5– Reports” displays how many states could 

report this data; the number of reports accepted for investigation during the FFY 2016; and the 

number of reports not accepted for investigation during the FFY 2016, but instead callers were 

provided information and referral/information and referral assistance.

Whether a state investigates all reports of maltreatment is decided upon by state statutory authority 

and APS program state rules and regulations. States’ statutes may specify populations served, 

adults with certain types of disabilities, or where the adult lives as a basis for investigating the 

allegation or providing information and assistance.

45.3%

30.2%

20.8%

3.8%

Exhibit AC-4 Intake Model (N=53)

Centralized at a statewide

hotline/call number

Combination of both statewide/local

hotlines/call numbers

Local at county or regional

hotlines/call numbers

Other
4

Exhibit AC- 3 Reports

Reports

# of 

states 

that 

submitted

% of 

states 

(56)

Count

Count of 

42 states 

(submitted 

both)

Total 

Count of 

42 states

% of 

states 

(42)

Accepted for Investigation 49 87.5% 728,049 556,730 1,499,043 37.1%

Not Accepted or I&R/I&RA 42 75.0% 942,313 942,313 62.9%

(AC-6) Time (Days)

The response time is the length of time from receipt by APS of an alleged maltreatment to APS 

contact with the client. The completion time is the length of time in days from investigation start 

to investigation completion. “Exhibit AC-6 Time (Days)” displays how many states were able to 

report on the data element and what was the average response and completion times.

Exhibit AC- 4 Time (Days)

Time (Days) # of states that submitted % of states (56) Average Days

Response Time 45 80.4% 4.2

Completion Time 39 69.6% 47.0

(AC-7) Maltreatment Types

Each state has distinct laws and policies defining what types of adult maltreatment the APS 

program will investigate or assess. The NAMRS maltreatment types are listed in “Exhibit AC-7

Maltreatment Types.” Twenty states reported additional maltreatment types, not listed as NAMRS 

data elements. Examples of other maltreatment types submitted by states include abduction, 

confinement/isolation, coercion, and treatment without consent. See definitions of maltreatment 

types in Appendix A: Data Element and Value Definitions.

Exhibit AC- 5 Maltreatment Types

Maltreatment Types # of states that 

selected type

% of 

states (56)

% of states that 

submitted (53)

Abandonment 24 42.9% 45.3%

Emotional Abuse 41 73.2% 77.4%

Exploitation (nonspecific) 28 50.0% 52.8%

Financial Exploitation 44 78.6% 83.0%

Other Exploitation 23 41.1% 43.4%

Neglect 53 94.6% 100.0%
5

Maltreatment Types # of states that 

selected type

% of 

states (56)

% of states that 

submitted (53)

Physical Abuse 51 91.1% 96.2%

Sexual Abuse 47 83.9% 88.7%

Suspicious Death 10 17.9% 18.9%

Self-Neglect 50 89.3% 94.3%

Other Types 20 35.7% 37.7%

(AC-8) Standard of Evidence

States have distinct laws and policies defining what standard of evidence is used for substantiating 

(determining) an allegation of maltreatment. Based on their statute, a few states do not investigate 

or make a substantiation (determination) of alleged maltreatment reports. Instead, staff assess a 

person for risk of maltreatment and need for protective services. “Exhibit AC-8 Standard of 

Evidence” depicts which standard of evidence is followed by states. 

(AC-9) Assessment Tool

Each state has policies defining whether APS personnel use standard assessment tools throughout 

the state, such as client safety, at-risk factors, or behavioral conditions assessment tools. “Unless 

specifically qualified or authorized by state law, an APS worker does not carry out clinical health 

or capacity assessments, but rather screens for indications of impairment, and, as needed, refers 

62%

6%

16%

14%

2%

Exhibit AC- 8 Standard of Evidence (N= 50)

Preponderance

Clear and convincing

Credible, reasonable, or

probable cause

No state standard

Different standards based on

type perpetrator
6

the client on to qualified professionals (physicians, neuropsychologists, etc.) to administer 

thorough evaluations.”1

Thirty-nine, or 76.5%, of the states do have a statewide standard assessment tool used by all staff. 

States may provide an array of approved assessment tools and allow the staff to determine the 

appropriate assessments to use with each client. Twelve, or 23.5%, of the states reporting do not 

have common assessment tools used by all staff. 

(AC-10) Service Gaps

The information provided on client service gaps reflects the APS programs’ efforts to arrange, 

provide, or make referrals for needed services for clients/victims. Service gaps are an indication 

that services are limited or may not be available. Some states provided comments about service 

gaps. Common statements were (1) waiting lists for receipt of services, (2) services available in 

urban areas but not the rural areas of the state, and (3) lack of transportation, especially in rural 

areas, make the services inaccessible. Exhibit AC-10 below lists the service gaps that states 

identified as existing in their areas.

 

1 Administration for Community Living, U.S. Department of Health and Human Services, Final National Voluntary 

Consensus Guidelines for States Adult Protective Services Systems, September 2016.

Yes, use common instrument 

or tool throughout the state

76%

No, assessment instruments are 

determined by each county or 

left to the worker's discretion

24%

Exhibit AC- 9 Assessment Tool (N= 51)
End of NAMRS FFY 2016 Report 1.2: Agency Component

Exhibit AC- 6 Service Gaps (N = 24)

Service Gaps

# of states 

that 

selected 

service

% of 

states 

(56)

% of states 

that 

submitted 

(24)

Care/Case Management Services 10 17.9% 41.7%

Caregiver Support Services 11 19.6% 45.8%

Community Day Services 11 19.6% 45.8%

Education, Employment, and 

Training Services 7 12.5% 29.2%

Emergency Assistance and Material 

Aid Services 11 19.6% 45.8%

Financial Planning Services 13 23.2% 54.2%

Housing and Relocation Services 19 33.9% 79.2%

In-Home Assistance Services 10 17.9% 41.7%

Legal Services 12 21.4% 50.0%

Medical and Dental Services 10 17.9% 41.7%

Medical Rehabilitation Services 8 14.3% 33.3%

Mental Health Services 15 26.8% 62.5%

Nutrition Services 9 16.1% 37.5%

Public Assistance Benefits Services 6 10.7% 25.0%

Substance Use Services 10 17.9% 41.7%

Transportation Services 14 25.0% 58.3%

Victim Services 8 14.3% 33.3%

Other Services 8 14.3% 33.3%