OMB Control Number 0985-0054 

Expiration Date: 03/31/2026 

AGENCY COMPONENT DATA 

March 31, 2023 

THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) 

Public reporting burden for this collection of information is estimated to average 4 hours per response, including the time 

for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. 

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 Agency Component data will be entered directly onto an online form on the NAMRS website. Once entered, the state 

can update information annually. The reporting period is the federal fiscal year (October–September). 

Table 1–General Information 

Element No. Element Name Element Description Required Field Entry Format 

Agency 1.1 Agency Name 1 Department or agency name Yes Text - 100 characters 

Agency 1.2 Agency Name 2 Branch or unit name No Text - 100 characters 

Agency 2.1 Street 1 First line street address of agency physical 

address 

Yes Text - 100 characters 

Agency 2.2 Street 2 Second line street address of agency 

physical address 

No Text - 100 characters 

Agency 2.3 City City of agency physical address Yes Text - 100 characters 

Agency 2.4 State State of agency physical address Yes Select from list of 

states/territories 

Agency 2.5 ZIP ZIP of agency physical address Yes ##### or #####-#### 

Agency 3.1 Street 1 First line street address of agency mailing 

address 

Yes Text - 100 characters 

Agency 3.2 Street 2 Second line street address of agency 

physical address 

No Text - 100 characters 

Agency 3.3 City City of agency physical address Yes Text - 100 characters 

Agency 3.4 State State of agency physical address Yes Select from list of 

states/territories 

Agency 3.5 ZIP ZIP of agency physical address Yes ##### or #####-#### 

Agency4.1 Name Enter at least two contacts for the NAMRS 

submission, such as the program 

administrator and the NAMRS lead. 

Contact name 

Yes Text - 100 characters 

Agency 4.2 Title Contact title Yes Text - 100 characters 

Agency 4.3 E-mail Contact e-mail Yes E-mail address 

format 

Agency 4.4 Phone Contact telephone Yes Text - 50 characters 

Agency 4.5 Contact’s role in 

agency 

Contact’s role in agency 

Selection List: 

• Case manager 

• Data coordinator/manager 

• Field coordinator 

• Intake manager/supervisor 

• Investigator 

• IT/data specialist 

• Manager/director/supervisor 

• Policy specialist 

• Regional supervisor 

• Social worker 

• Training coordinator/specialist 

No Select one from list 

A-1 
 

 

 

 

 

 

 

 

 

 

Table 2–Agency Profile 

Element No. Element Name Element Description Required Field Entry Format 

Agency 5 Data Sources The sources of information used to submit 

data this year to NAMRS. 

Selection List: 

• APS agency only 

• APS and other agencies 

No Select one from list 

Agency 5.1 Comment Provide names of other agencies that 

provided data and a brief description of the 

population served. Please indicate if adults 

includes "emancipated minors". 

No Text – 5,000 

characters 

Agency 6 Population 

Served: Age 

Select which of the following population 

groups are served by the APS programs 

submitting data. Vulnerability includes 

criteria such as disability or impairment. 

Selection List: 

• Emancipated minor 

• 18 - 59 with a vulnerability 

• 18 – 64 with vulnerability 

• 18+ with a vulnerability 

• 60+ with a vulnerability 

• 60+ 

• 65+ with a vulnerability 

• 65+ 

• Other 

No Select one or more 

from list 

Agency 6.1 Comment Provide citation or URL of state law, 

regulations, or program guidance and/or 

upload documents in the Agency 

Component attachments. If reporting for 

multiple agencies, indicate which agency 

serves which population group. 

No Text – 5,000 

characters 

Agency 6.2 Population 

served: setting 

Indicate the types of settings in which APS 

is responsible for investigating allegations of 

maltreatment involving facility staff or 

operations in addition to allegations 

involving visitors or resident on resident 

maltreatment. 

Selection List: 

• Own residence or relative or 

caregiver 

• Residential care community (nonspecific) 

• Licensed residential care 

community 

• Non-licensed residential care 

community 

• Nursing home (non-specific) 

• Licensed nursing home 

• Non-licensed nursing home 

No Select one or more 

from list 

A-2 
 

 

 

 

 

 

 

 

Element No. Element Name Element Description Required Field Entry Format 

• Medicaid Home and Community 

Services Waiver Provider 

• Other 

Agency 7 Investigator FTEs 

filled 

Number of filled APS FTEs responsible for 

the hotline and/or conducting investigations. 

If APS staff work in other programs such as 

CPS, make an estimate of FTEs devoted 

only to APS work. 

No Numeric – 10 integers 

Agency 7.1 Supervisor FTEs 

filled 

Number of filled APS FTEs responsible for 

supervision. If APS staff work in other 

programs such as CPS, make an estimate 

of FTEs devoted only to APS work. 

No Numeric – 10 integers 

Agency 7.2 Comment Provide additional information as to whether 

the numbers in 7 and 7.1 were the annual 

total or total for a given day. 

No Text – 5,000 

characters 

Agency 8 Intake Centralized or localized intake of APS 

reports. 

Selection List: 

• Centralized at a statewide hotline or call 

in number 

• Combination of both statewide and local 

hotlines or call in numbers 

• Local at county or regional hotlines or 

call in numbers 

• Other 

No Select one from list 

Agency 8.1 Comment Provide additional information on your 

state’s definition of intake. 

No Text – 5,000 

characters 

Agency 9 Reports 

Accepted for 

Investigation 

Number of reports accepted for 

investigation during the reporting period. 

No Numeric – 10 integers 

Agency 9.1 Reports Not 

Accepted, or 

Resolved 

Through 

I&R/I&RA 

Number of reports that were either not 

accepted by APS for investigation, or were 

resolved through Information & Referral 

(I&R)/Information & Referral Assistance 

(I&RA). 

No Numeric – 10 integers 

Agency 9.2 Comment Please confirm that the sum of 9 and 9.1 is 

the total number of investigations received 

during the reporting period. Please provide 

additional information regarding policy for 

accepting reports and not accepting reports, 

or resolving through I&R/I&RA. 

No Text – 5,000 

characters 

Agency 10 Response Time The length of time (hours), by priority level, 

from receipt of call or notice of alleged 

maltreatment to face-to-face contact with 

the client by the APS worker. Enter the 

number of hours for each priority level as 

set by policy or practice. 

Selection List: 

• Priority 1 length 

• Priority 2 length 

• Priority 3 length 

• Priority 4 length 

No Numeric – 3 integers 

A-3 
 

 

 

 

Element No. Element Name Element Description Required Field Entry Format 

Agency 10.1 Comment Provide additional information on the 

definition of each priority level, including. 

citation or URL of state law, regulations, or 

program guidance and/or upload documents 

in the Agency Component attachments. 

No Text – 5,000 

characters 

Agency 11 Investigation 

Completion Time 

The length of time (days) from investigation 

start to investigation completion, based on 

the standard set by policy or practice. 

No Numeric – 3 integers 

Agency 11.1 Comment Provide additional information on the 

definition of start of investigation and 

completion of an investigation, including 

citation or URL of state law, regulations, or 

program guidance and/or upload documents 

in the Agency Component attachments. 

No Text – 5,000 

characters 

Agency 12 Types of 

Maltreatment 

Indicate which types of maltreatment are 

investigated by APS. 

Selection List: 

• Abandonment 

• Emotional abuse 

• Exploitation (non-specific) 

• Financial exploitation 

• Other exploitation 

• Neglect 

• Physical abuse 

• Sexual abuse 

• Suspicious death 

• Self-neglect 

• Other 

No Select one or more 

from list 

Agency 12.1 Comment Provide citation or URL in state law, 

regulations, or program guidance for 

maltreatment types investigated by APS 

and/or upload documents in the Agency 

Component attachments. 

No Text – 5,000 

characters 

Agency 13 Standard of 

Evidence 

Standard used for substantiating an 

allegation of maltreatment. 

Selection List: 

• Clear and convincing 

• Credible, reasonable, or probable cause 

• Different standards based on type of 

perpetrator 

• No state standard 

• Preponderance 

• Other 

No Select one from list 

Agency 13.1 Comment Provide citation or URL of state law, 

regulations, or program guidance and/or 

upload documents the Agency Component 

attachments. Include discussion of 

definitions of perpetrator if relevant. 

No Text – 5,000 

characters 

Agency14 Assessment 

Tools 

Indicate whether APS personnel use 

standard assessment tools throughout the 

state, such as client safety, at risk factors, 

or behavioral conditions. 

No Select one from list 

A-4 
 

 

 

 

Element No. Element Name Element Description Required Field Entry Format 

Selection List: 

• No, assessment instruments are 

determined by each county or left to the 

worker’s discretion 

• Yes, use common instrument or tool 

throughout the state 

Agency 14.1 Comment Provide the name and reference (i.e., URL) 

for each standardized tool that is used. 

No Text – 5,000 

characters 

Agency 15 Service Gaps Indicate which services are not available or 

accessible in the state. 

Selection List: 

• Care/Case Management Services 

• Caregiver Support Services 

• Community Day Services 

• Education, Employment, and Training 

Services 

• Emergency Assistance and Material Aid 

Services 

• Financial Planning Services 

• Housing and Relocation Services 

• In-home Assistance Services 

• Legal Services 

• Medical and Dental Services 

• Medical Rehabilitation Services 

• Mental Health Services 

• Nutrition 

• Public Assistance Benefits 

• Substance Use Services 

• Transportation 

• Victim Services 

• Other Services 

No Select one or more 

from list 

Agency 15.1 Comment Provide additional information on how gaps 

in services were identified, if possible. 

No Text – 5,000 

characters 

Agency 16 Perpetrators Does APS collect person-specific data on 

persons found to be perpetrators of 

substantiated maltreatment? 

Selection List: 

• Yes 

• No . 

No Select one from list. 

Agency 16.1 Perpetrators Does your information system collect unique 

IDs and demographic characteristics of 

perpetrators? 

Selection List: 

• Yes 

• No 

Select one from list 

Agency 16.2 Comment Provide citation or URL of state law, 

regulations, or program guidance and/or 

upload documents in the Agency 

Component attachments. 

No Text – 5,000 

characters 

A-5 
 

 

 

 

 

 

 

 

Element No. Element Name Element Description Required Field Entry Format 

Agency 17 Policy Change Have there been changes in law, policy, or 

practice that explains changes in the data 

from the previous year? 

Selection List: 

• Yes 

• No 

No Select one from list 

Agency 17.1 Comment Describe the change in law, policy, or 

practice. Provide citation or URL of state 

law, regulations, or program guidance 

and/or upload documents in the Agency 

Component attachments. 

No Text – 5,000 

characters 

Agency 18 Perpetrator 

Registries 

Indicate if APS refers substantiated 

perpetrators to a perpetrator registry. A 

perpetrator registry is a system for 

maintaining the identity of individuals who 

are found to have maltreated adults in the 

community or facilities and meet the 

requirements for referral. This information is 

made available to individuals, agencies, or 

employers authorized to receive the 

information who use it to exclude the 

perpetrator from employment. 

Selection List: 

• There is no perpetrator registry 

• There is a perpetrator registry, but APS 

does not refer to it 

• APS refers all substantiated 

perpetrators to a perpetrator registry 

• APS refers substantiated perpetrators 

that meet selected criteria to the 

perpetrator registry 

No Select one for list. 

Agency 18.1 Comment Provide citation or URL of state law, 

regulations, or program guidance and/or 

upload documents in the Agency 

Component attachments. Include 

description of any additional criteria for 

referral to the registry (e.g., types of 

maltreatment, types of perpetrators). 

No Text – 5,000 

characters 

Agency 19 Multidisciplinary 

Teams 

Indicate APS program participation in 

Multidisciplinary Teams (MDTs). An MDT is 

a group of people, from three or more 

disciplines, who work collaboratively, bound 

by a common purpose, and characterized 

by shared decision-making, partnership, 

interdependency, balanced power, and 

process. MDTs work to ensure victims 

receive the services they need to recover 

from maltreatment and improve the system 

of services. 

Selection List: 

No Select one from the 

list 

A-6 
 

Element No. Element Name Element Description Required Field Entry Format 

• MDTs do not exist in the state 

• APS does not participate in existing 

MDTs 

• Law, rule, or policy requires APS 

participate in multidisciplinary teams 

• APS participates in multidisciplinary 

teams voluntarily without state 

requirement 

Agency 19.1 Comment Provide citation or URL of state law, 

regulations, or program guidance and/or 

upload documents in the Agency 

Component attachments. Include discussion 

of the criteria for participation including state 

requirements and the types of cases. 

No Text – 5,000 

characters 

Agency 20 Confidentiality Indicate if information collected in an APS 

investigation information is shared. 

Selection List: 

• Information is never shared 

• There are no restrictions on sharing 

information 

• Information is shared in circumstances 

defined in law, regulation, or policy 

No Select one from the 

list 

Agency 20.1 Comment Provide citation or URL of state law, 

regulations, or program guidance and/or 

upload documents in the Agency 

Component attachments. Describe the 

circumstances in which information can be 

shared. 

No Text – 5,000 

characters 

Agency 21. Ethical Principles Indicate the source of APS program-specific 

ethical principles or core values that guide 

the program. 

Selection List: 

• Created by program staff from internal 

sources and processes 

• Adapted from National Adult Protective 

Services Association Guiding 

Principles 

• Adapted from other APS program(s) 

• Based on principles or values from 

agency APS is located in or values 

from other state agencies 

• Other 

No Select one from the 

list 

Agency 21.1 Comment Provide citation or URL and/or upload 

documents in the Agency Component 

attachments that describe the key 

principles/core values. 

No Text – 5,000 

characters 

Agency 22 Mandatory 

Reporting 

Indicate if state law requires mandatory 

reporting to APS. 

Selection List: 

No Select one from the 

list 

A-7 
 

 

 

 

 

Element No. Element Name Element Description Required Field Entry Format 

• Yes, universal 

• Yes, targeted groups 

• No 

Agency 22.1 Comment Provide citation or URL of state law, 

regulations, or program guidance and/or 

upload documents in the Agency 

Component attachments. If targeted groups, 

list who they are. 

No Text – 5,000 

characters 

Agency 23 Reporter Identity Indicate the protection state law or policy 

provides for the identity of reporters. 

Selection List: 

• Protected in all cases without 

exceptions 

• General protection but with exceptions 

defined by law, rule, or policy (e.g., law 

enforcement or by court order) 

• Reporter identity is not protected 

No Select one from the 

list 

Agency 23.1 Comment Provide citation or URL of state law, 

regulations, or program guidance and/or 

upload documents in the Agency 

Component attachments. Describe the 

exceptions to reporter identity. 

No Text – 5,000 

characters 

Agency 24 Refuse 

Investigation 

With Decisionmaking Ability 

Indicate the response by APS if a client 

refuses to cooperate with an investigation 

and they appear to have ability to make 

decisions. 

Selection List: 

• APS does not continue the 

investigation 

• APS continues the investigation 

• APS weighs circumstances and 

makes appropriate decision about 

continuing the investigation 

No Select one or more 

from the list 

Agency 24.1 Refuse 

Investigation 

Without Decisionmaking Ability 

Indicate the response by APS if a client 

refuses to cooperate with an investigation 

and they do not appear to have ability to 

make decisions. 

Selection List: 

• APS does not continue the 

investigation 

• APS continues the investigation 

• APS weighs circumstances and 

makes appropriate decision about 

continuing the investigation 

No Select one or more 

from the list 

Agency 24.2 Comment Provide citation or URL of state law, 

regulations, or program guidance and/or 

No Text – 5,000 

characters 

A-8 
 

 

 

 

Element No. Element Name Element Description Required Field Entry Format 

upload documents in the Agency 

Component attachments 

Agency 25 Refuse Services 

with Decisionmaking Ability 

Indicate the response by APS if a client 

refuses services and they appear to have 

ability to make decisions. 

Selection List: 

• APS does not provide services 

through any mechanism 

• APS does not provide purchased 

services 

• APS does not make a referral for 

services 

• APS takes appropriate steps to 

attempt to provide services 

• APS weighs circumstances and 

makes appropriate decision about 

continuing the investigation 

No Select one from the 

list 

Agency 25.1 Refuse Services 

without Decisionmaking Ability 

Indicate the response by APS if a client 

refuses services and they do not appear to 

have ability to make decisions. 

Selection List: 

• APS does not provide services 

through any mechanism 

• APS does not provide purchased 

services 

• APS does not make a referral for 

services 

• APS takes appropriate steps to 

attempt to provide services 

• APS weighs circumstances and 

makes appropriate decision about 

continuing the investigation 

No Select one from the 

list 

Agency 25.2 Comment Provide citation or URL of state law, 

regulations, or program guidance and/or 

upload documents in the Agency 

Component attachments. 

No Text – 5,000 

characters 

Agency 26 Involuntary 

Interventions 

Indicate if APS has the authority to seek 

involuntary interventions - such as 

emergency protective orders and 

emergency placements - for at-risk APS 

clients, 

Selection List: 

• APS does not have the authority to 

seek involuntary interventions in any 

circumstances 

No Select one from the 

list 

A-9 
 

 

Element No. Element Name Element Description Required Field Entry Format 

• APS has the authority to seek 

involuntary interventions regardless of 

client’s decision-making 

• APS has authority to seek involuntary 

interventions only if the client appears 

to lack decision-making ability 

• APS does not have authority to seek 

involuntary interventions if the client 

appears to have decision-making ability 

Agency 26.1 Comment Provide citation or URL of state law, 

regulations, or program guidance and/or 

upload documents in the Agency 

Component attachments. List and define 

types of interventions. 

No Text – 5,000 

characters 

Agency 27 Services To address maltreatment, indicate who APS 

has authority to provide or arrange services 

for. 

Selection List: 

• Substantiated clients (victims) 

• Unsubstantiated (alleged) clients 

• Family members of clients 

• Substantiated perpetrators 

• Unsubstantiated perpetrators 

No Select one or more 

from the list 

Agency 27.1 Comment Provide citation or URL of state law, 

regulations, or program guidance and/or 

upload documents in the Agency 

Component attachments. 

No Text – 5,000 

characters 

Agency 28 Governing 

Principles 

Indicate the mechanisms that APS uses to 

ensure person-centered approaches to 

services (e.g., services in least restrictive 

environment, trauma-informed). 

Selection List: 

• Contained in Guiding Principles or 

Core Values 

• Included in training 

• Required by statute or policy 

• Included in service plan requirements 

• Reviewed in performance measures 

• Reviewed in quality assurance 

process 

• Reviewed by external review teams 

No Select one or more 

from the list 

Agency 28.1 Comment Provide citation or URL of state law, 

regulations, or program guidance and/or 

upload documents in the Agency 

Component attachments. List any additional 

principles. 

No Text – 5,000 

characters 

Agency 29 Purchase of 

Services 

Indicate if APS directly purchases goods 

and services for clients and/or victims. 

No Select one from the 

list 

A-10 
 

 

 

 

 

 

 

 

 

Element No. Element Name Element Description Required Field Entry Format 

Selection List: 

• Yes 

• No 

Agency 29.1 Comment Provide citation or URL of state law, 

regulations, or program guidance and/or 

upload documents in the Agency 

Component attachments. List and define 

types of interventions. 

No Text – 5,000 

characters 

Agency 30 Case Closure Indicate how APS cases are reviewed 

before case closure to ensure their quality. 

Selection List: 

• Caseworker review and judgment only 

• Supervisor review 

• Peer review 

• Review team review 

No Select one or more 

from the list 

Agency 30.1 Comment Provide citation or URL of state law, 

regulations, or program guidance and/or 

upload documents in the Agency 

Component attachments. 

No Text – 5,000 

characters 

Agency 31 Quality 

Assurance 

Indicate the different levels of quality 

assurance mechanisms used to improve 

casework. 

Selection List: 

• Documentation: Law, rule, or policy 

requires standardized case 

documentation 

• Supervisor review: Law, rule, or policy 

requires supervisor review of all or a 

subset of case documentation 

• Peer review: Program practice uses 

peer review of closed cases (e.g., 

“case review staffing”) 

• Independent Review QA Teams: 

Program practice uses review of a 

subset/sample of cases by 

independent case reviewers 

No Select one or more 

from the list 

Agency 31.1 Comment Provide citation or URL of state law, 

regulations, or program guidance and/or 

upload documents in the Agency 

Component attachments. Describe the 

quality assurance activities. 

No Text – 5,000 

characters 

A-11