NAMRS FFY 2016

Background Report

May 5, 2018
Acknowledgements1

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. 





Suggested Citation: 

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

Greene, M., Phillippi, M. (2018). NAMRS FFY2016 Background Report. Administration for 

Community Living, U.S. Department of Health and Human Services: Washington, D.C. 

 

1 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. 
Contents

Executive Summary .................................................................................................... i 

Development of the National Adult Maltreatment Reporting System ...................... 1 

NAMRS Definitions and Data Sources ..................................................................... 1 

Data Submissions ....................................................................................................... 4 

NAMRS Data Reports ............................................................................................... 5 

Limitations ................................................................................................................. 7 

Looking Ahead ........................................................................................................... 7 

Selected Bibliography ................................................................................................ 9 

Works Cited .............................................................................................................12
i

Executive Summary

The idea of a national reporting system for adult abuse, similar to the system for child abuse 

reporting has been discussed for decades, and recommended as a prerequisite to data-driven policy 

development for adult protective services. The absence of national data for research and best 

practice development has been cited by numerous entities, including the Government 

Accountability Office [1], as a significant barrier to improving APS programs. A national reporting 

system provides consistent, accurate national data on the exploitation and abuse of older adults 

and adults with disabilities, as reported to state APS agencies. Policy makers, APS programs, and 

researchers can use the data to evaluate and improve programs.

In 2013, the leadership of HHS Assistant Secretary for Planning and Evaluation (ASPE) and 

Administration for Community Living (ACL) directed the development and piloting of an adult 

abuse reporting system based on data from state APS agency information systems. The project was 

funded by ACL through an interagency agreement with ASPE, and carried out under a contract to 

WRMA, Inc. The project team conducted extensive outreach to gain an understanding of 

information needs. More than 40 state administrators, researchers, service providers, and other 

individuals in the field participated in stakeholder calls. Over 30 state representatives from 25 

states participated in three in-person working sessions to discuss the uses of collected data and the 

key functionalities that should be included in a national system.

The system, called the National Adult Maltreatment Reporting System (NAMRS), was developed 

from September, 2013 through December, 2014. Nine states voluntarily pilot tested NAMARS 

from January, 2015 through May, 2015. Pilot site feedback informed refinements made to the 

system from June, 2015 through September, 2015. A final report of the pilot phase was published 

by ASPE in September 2015.

From October 2015 through February 2017, ACL, through its Adult Protective Services (APS) 

Technical Assistance Resource Center (APS TARC), operated by WRMA, Inc., refined and built 

the final system and provided training and technical assistance to all states in preparation of the 

first NAMRS submission. States, the District of Columbia, and five territories received training 

and assistance in preparation for and during their submission of FFY 2016 information and data. 

The U.S. Office of Management and Budget gave approval for submission of data in March 2017 

(#0985-0054). Fifty-four out of 56 APS reporting jurisdictions, or “states,”2 volunteered to 

participate the first year.

NAMRS is designed as an annual, voluntary system to collect both summary and de-identified, 

case-level data on APS investigations. NAMRS data is a combination of data that most states 

typically collect, along with data elements not historically gathered at the state level, such as caselevel data. The NAMRS pilot and consultations with APS administrators confirmed that states 

would be able to map state data definitions to NAMRS data definitions and, in collaboration with 

 

2

 For NAMRS, a reporting jurisdiction is the officially designated APS office in each state, territory, or district. In 

this report, APS reporting jurisdictions will be referred to as “states” for ease of reading. The term “states” includes 

the District of Columbia and territories.
ii

their local APS programs, to provide many of the data elements. NAMRS consists of three 

components: 

1. Agency Component, comprised of agency information such as state statutes, policies, and 

practices. 

Key Indicator Component, consisting of aggregated data on key statistics of investigations 

and victims, clients, and perpetrators provided by states that are unable to provide caselevel data. 

Case Component, provided by states that have report-level tracking systems, is comprised 

of data on client characteristics, services, and perpetrator characteristics, pertaining to each 

report that is screened-in and investigated by APS. 

2.

3.

States voluntarily submit data to NAMRS in one of the following combinations for the Federal

Fiscal Year reporting period, as illustrated below. 

 Agency Component only; 

Agency Component and Key Indicators; or 

Agency Component and Case Component data. 





NAMRS Data Reports 

NAMRS data reports are presented in four parts, described below. The first report was released 

on August 22, 2017. A re-release of that report, along with the other 3 reports were released in 

April 2018. 

NAMRS FY 2016 Background 

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 of NAMRS. 

NAMRS FY 2016 Report 1.2: Agency 

On August 22, 2017, ACL released NAMRS Report 1, providing highlights of information and 

investigation data submitted for FFY 2016. Since its release, one state has updated FFY 2016 Key 

Indicators data. This resubmission changed the data previously released in Report 1, and those 

updates are reflected in “NAMRS FY 2016 Report 1.2: Agency.”

Agency 

Component

All States

Key Indicators

Option 1

Case 

Component

Option 2
iii

NAMRS FY 2016 Report 2: Key Indicators 

Report 2: 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 

Report 3: 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 substantiated 

maltreatment. 

Looking to the Future 

The primary objective of NAMRS is to collect data to understand the conditions, contributing 

factors, and outcomes of persons who experience abuse, neglect, and exploitation and receive an 

investigation by APS. As reporting to NAMRS grows, especially for case component data, we 

begin to build the information base necessary to improve prevention, interventions, and services 

for those persons. Through technical assistance, training, and other opportunities, ACL will 

continue supporting states as they strive to increase the quality of the data they collect. 

Furthermore, it is anticipated that state information systems will evolve to facilitate reporting a 

larger number of data elements to NAMRS. As experienced in the first year, this evolution is 

happening at a very rapid pace. 

For more information about NAMRS or requesting NAMRS data sets, please direct inquiries to 

ACL Program Officer: Stephanie.WhittierEliason@acl.hhs.gov. 
1

Development of the National Adult Maltreatment Reporting System

The idea of a national reporting system for adult abuse, similar to the system for child abuse 

reporting has been discussed for decades. The absence of national data for research and best 

practice development has been cited by numerous entities, including the Government 

Accountability Office [1]- [2] as a significant barrier to improving APS programs. A national 

reporting system provides consistent, accurate national data on the exploitation and abuse of older 

adults and adults with disabilities, as reported to state APS agencies. Policy makers, APS 

programs, and researchers can use the data to evaluate and improve programs. 

In 2013, the leadership of the HHS Administration for Community Living (ACL) and the Assistant 

Secretary for Planning and Evaluation (ASPE) directed the development and piloting of an adult 

abuse reporting system based on data from state APS agency information systems. The project was 

funded by ACL through an interagency agreement with ASPE. The project team conducted 

extensive outreach to gain an understanding of information needs. More than 40 state 

administrators, researchers, service providers, and other individuals in the field participated in 

stakeholder calls. Over 30 representatives from 25 state APS offices participated in three, inperson working sessions to discuss the uses of collected data and the key functionalities that should 

be included in a national system. ACL contracted with WRMA, Inc. to develop and pilot a system. 

The test version of the NAMRS was piloted in nine (9) states from January through May 2015. 

For more information about the development of NAMRS, please see the final report of the pilot 

phase published by ASPE. 

From October 2015 through February 2017, ACL, with the support of the APS Technical 

Assistance Resource Center (APS TARC) operated by WRMA, Inc., refined and built the final 

system and provided training and technical assistance to states in preparation of the first NAMRS 

submission. All states, the District of Columbia, and the five U.S. territories received training and 

assistance in preparation for and during their submission of FFY 2016 information and data. The 

U.S. Office of Management and Budget gave approval for submission of data in March 2017 

(#0985-0054). 

NAMRS Definitions and Data Sources 

In developing NAMRS, ACL recognized that there were significant variations across state APS

programs, and that definitions for commonly used words and descriptors for the work of APS also

differed. Core issues needing consideration, included: 

 Variability in Who is Served

State statutes establish the criteria for determining eligibility for adult protective services. 

Some state statutes require that all adults 18 years of age and older with reported alleged 

maltreatments will receive an investigation, and if needed, protective services. Other state 

statutes may have more specific parameters for who is served. For example, the age 

threshold for eligibility might be set at 60 years of age and older, or only adults 18 to 59 
2

years old with a developmental disability. Some state statutes might limit APS eligibility 

to adults living in the community, and identify a different entity to handle reports for abuse 

of those living in institutions. 

 Variability in Program Policies and Procedures 

Each state has promulgated their own laws, regulations, policies, and procedures to give 

guidance to staff, and no two states are the same. For example, there are differences across 

the states as to when an investigation should be opened based on alleged reported 

circumstances, the steps that constitute the beginning of an investigation, requirements for 

making contact with or visiting the client, and the number of days for completion of an 

investigation. 

 Variability in Handling Reports 

Many states require that all reports of alleged maltreatments be investigated, and an official 

determination be made as to whether the allegation can be substantiated. A few state 

statutes do not require an investigation in all circumstances. Some states do not require 

that the APS staff enter an official determination of the alleged maltreatment report. Rather, 

in these states APS assesses a person for risk of maltreatment, or need for protective 

services. 

 Variability in Recording Information 

Prior to the creation of NAMRS, there had never been a national reporting system for adult 

maltreatment, nor an attempt to standardize a set of terminology for APS. In this absence, 

states created their own information systems to collect data based on state guidelines and 

definitions. While APS caseworkers collect a great deal of information vital to serving the 

client, most of the reporting requirements at the state level have been for administrative 

data, such as the number of persons served. As a result, methods and policies for collecting, 

retaining, and reporting information and data vary significantly across the states, and often 

within the states from county to county. 

To inform the development of the NAMRS data elements, the project team carried out a number 

of activities. The team reviewed different nomenclatures and similar data elements collected by 

other national reporting systems. For example, seven data collection efforts were examined to 

assist in identifying topics for inclusion in NAMRS and in formulating definitions and key values 

for the data elements: 

 Two efforts were child-specific reporting systems in child welfare: the National Child 

Abuse and Neglect Data System and the National Youth in Transition Database. 

 Three efforts were program performance reporting systems from the field of aging services: 

the National Aging Program Information System State Program Reports, the National 

Ombudsman Reporting System, and the National Aging Program Information System 

Senior Medicare Patrols Project. 

 Two were data collection initiatives addressing services for persons with intellectual 

disabilities: the National Core Indicators program comprised of adult and family surveys 

and
3

 the National Residential Information Systems Project, which collects aggregated data 

through a survey of states and selected state residential facilities serving individuals with 

developmental disabilities. 

General guidance was derived from research studies and papers produced by the U.S. Government 

Accountability Office, Office of Management and Budget, HHS Assistant Secretary for Planning 

and Evaluation, Centers for Disease Control and Prevention, and Department of Justice. At the 

end of this report is a “Selected Bibliography” of resources that informed the development of the 

definitions and values, and a more extensive list is included in Appendix B: Laws, Rules, 

Regulations, and Guidance Sources.

Understanding NAMRS definitions for specific elements is vital to understanding these reports 

As illustration, below is a short list of terms and the definitions used in NAMRS. A full list of 

NAMRS definitions may be found in Appendix A: Data Element and Value Definitions, and the 

reader is encouraged to refer to Appendix A as they read the reports. For NAMRS:

 A client is a person who receives an investigation by APS based on an alleged maltreatment 

report. 

A victim is a client who received an investigation and one or more maltreatment 

substantiations were made by APS.

A perpetrator is the person connected to the substantiated maltreatment of the victim. 

Age groupings were based on several factors. For victims, the population groups served 

by APS are typically 18 years of age and older; 18 to 59 years; 60 and older; or 65 and 

older. Taken into consideration were the age criteria for services provided through funding 

and eligibility criteria of the Older Americans Act, Medicare and Medicaid, and Social 

Security Act, with no further age groupings after age 85, to best protect any possible 

personal identifiable information (PII) being linked to any one victim. For perpetrators, the 

age groupings are the same as victims, except with the addition of age 17 and younger. 

The race and ethnicity demographic data for victims and perpetrators are based upon the 

U.S. Office of Management and Budget’s 1997 approval for these data to be collected by 

U.S. Census Bureau. 

The data element for Victims with Disabilities is premised upon the U.S. Census Bureau’s 

“American Community Survey” descriptions, encompassing hearing, vision, cognition, 

ambulation, self-care, and independent living. 

The Victims Receiving Benefits data element was derived from various U.S. government 

reporting agencies, including the Department of Health and Human Services, Social 

Security Administration, Department of Housing and Urban Development, and Veterans 

Administration. 












4

 The data element Victim with Behavioral Conditions was derived from the American 

Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders.

 The Department of Justice’s Bureau of Justice Statistics and the Elder Justice Act was 

reviewed to inform the data element, Substitute Decision Makers. The American Bar 

Association Commission on Law and Aging’s staff provided input and guidance on the 

data elements pertaining to Victim with Guardian or Conservator and Perpetrator with 

Legal Remedy Recommendation. 

Data Submissions 

NAMRS is designed as an annual, voluntary system to collect both summary and de-identified, 

case-level data on APS investigations. NAMRS receives data from the highest designated APS 

office in the state, territory, or district. For ease of reading, NAMRS data reports refers to these 

entities as “states”. NAMRS data is a combination of data that most states typically collect, along 

with aspirational data not historically gathered at the state-level. The NAMRS pilot and 

consultations with APS administrators confirmed that states would be able to map state data 

definitions to NAMRS data definitions and, in collaboration with their local APS programs, to 

provide many of the data elements. NAMRS consists of three components: 

1. Agency Component, comprised of agency information such as state statutes, policies, and 

practices. 

Key Indicator Component, consists of aggregated data on key statistics of investigations, 

victims, clients, and perpetrators provided by states that are unable to provide case-level 

data. 

Case Component, provided by states that have case-level tracking capability at the statelevel, is comprised of data on client characteristics, services, and perpetrator characteristics 

for each report closed in the NAMRS reporting period (the previous federal fiscal year). 

In order to submit case component data, states have to be able to submit five (5), “required” 

data elements: 

2.

3.

 Unique investigation identifier; 

Case closure date; 

Unique client identifier; 

Maltreatment type; 

Maltreatment disposition; 

Unique perpetrator identifier (if perpetrator information is submitted). 











The FFY 2016 NAMRS Reports series included information derived from the submissions of 

information and data by 48 states, the District of Columbia, and the five territories, totaling 54 

reporting jurisdictions (referred to as “states” in this report). States submit data to NAMRS in one 

of the following combinations for the Federal Fiscal Year reporting period, as illustrated below. 

 Agency Component only;
5

 Agency Component and Key Indicators; or 

 Agency Component and Case Component data.

Figure 1. NAMRS Data Submission Decision Tree 

Agency 

Component

All States

Key Indicators

Option 1

Case 

Component

Option 2

All states that participated in FFY 2016 submitted the Agency Component. States could submit 

Case Component data if their automated information system allowed for extraction of investigation 

specific case-level data. If unable to provide detailed data, states submitted aggregated counts via 

the Key Indicator Component. 

“Exhibit 1. NAMRS Component Response Rates” provides details on the reporting in each of the 

components for FFY 2016. Twenty-four (24) states provided Agency and Case Components. 

Twenty (20) states provided Agency and Key Indicators Component. Ten (10) states provided 

Agency Component only. Two entities elected not to participate. 

Exhibit 1. NAMRS Component Response Rates

Number of States, District, and Territories participated in FFY 2016: 54

Component # of states that

submitted 

% of states 

(56) 

# of States and 

District 

# of 

Territories 

Agency Only 10 17.9% 7 3

Agency and Key Indicators 20 35.7% 18 2

Agency and Case 24 42.9% 24 -

Did not participate 2 3.6% 2 -

NAMRS Data Reports 

NAMRS FY 2016 data reports are presented in four parts, described below. The first report was 

released on August 22, 2017. That report, along with the other 3 reports were released in 2018. 

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 of NAMRS. 
6

NAMRS FY 2016 Report 1.2: Agency 

The Agency Component data is a wealth of information about the uniqueness of each state APS 

program, including state policy and practice information. In addition to the data elements, states 

provided narrative descriptions regarding statutes, policies and procedures, investigative practices, 

data systems, intake processes, staffing, training, and client assessments. 

On August 22, 2017, ACL released NAMRS Report 1, providing highlights of information and 

investigation data submitted for FFY 2016. Since its release, one state has updated FFY 2016 Key 

Indicators data. This resubmission changed the data previously released in Report 1, and those 

updates are reflected in NAMRS Report 1.2: Agency. 

NAMRS FY 2016 Report 2: Key Indicators 

Report 2: Key Indicators Report provides high-level aggregate data on key statistics of 

investigations and victims. The information represents data from 44 states and is 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 data elements. The aggregated data pertains to client, victim, and 

perpetrators. 

NAMRS FY 2016 Report 3: Case Components 

Report 3: 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. For FFY 2016 data was received from 24 states. Report 3: Case Component 

includes data on 56 Case Component data elements, divided across five categories: 

1. Investigation—each investigation undertaken by APS with a case closure date during the 

reporting period 

Client—each person subject of an investigation. The client may have multiple 

investigations in the reporting period. 

Maltreatment Allegation—each maltreatment associated with each client. Maltreatment 

type and maltreatment disposition are required reporting elements.

Perpetrator—each person alleged responsible for one or more maltreatments with a 

disposition of substantiated. 

Client-Perpetrator Relationship—the relationship between the client, who is the victim of 

a substantiated maltreatment, and the perpetrator. 

2.

3.

4.

5.

In addition to the submission data, Report 3: Case Component contains further analyses of data 

pertaining to victims and substantiated maltreatments, and perpetrator characteristics. 
7

Limitations 

In developing NAMRS, stakeholders concurred with ACL to include some aspirational data 

elements in the national reporting system. The project team considered data that already is 

collected routinely at the state-level, as well as data that states could collect in the future to inform 

the growth and evolution of data collected by APS programs. For example, although individual 

APS case workers might gather a great deal of information about alleged victims and perpetrators 

over the course of an investigation, state-level reporting systems collect and report more 

information about victims than information about perpetrators. In later years, the NAMRS 

database will have more information on perpetrators once states are able to add more data elements 

to their state-level information collection systems, and once more staff are trained on collecting 

and reporting of perpetrator data.

The information and data provided in the reports are reflective of the information and data states 

provided for this historical first submission of FFY 2016 data. In this first year of a new, national 

reporting system, care was taken in the writing of these reports to explain how many states were 

able to submit certain types of 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. Also, no two states reported on all of 

the same data elements. However, states were encouraged to provide as much information as 

possible. 

Because 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. 

Differences across states’ statute and policies further contribute to the inability to compare data 

across the NAMRS FY 2016 Reports. For example, it is practice in some states to include multiple 

clients under one investigation, rather than opening a separate case for each client, even if it is one 

investigation. The APS agency may have received one report of alleged abuse for two people 

living in the same household. This could be recorded in two different ways, depending on the 

state. One way is to open one investigation record with two clients. Alternatively, two 

investigation records could be opened, one for each client in the household. 

When possible, we have identified where these differences may appear, such as in the example 

above. However, for these reasons, readers are advised against attempting to compare or combine 

data reported in Agency, Key Indicator, or Case Components. 

Looking Ahead 

The primary objective of NAMRS is to collect data to understand the conditions, contributing 

factors, and outcomes of persons who experience abuse, neglect, and exploitation and receive an 
8

investigation by APS. As reporting to NAMRS grows, especially for case component data, we 

begin to build the information base necessary to improve prevention, interventions, and services 

for those persons. 

ACL is committed to the Office of Management and Budget Information Quality Guidelines 

(2002) for the attributes of data quality—utility, objectivity, and integrity. Given the variation 

among APS agencies, there is a need for careful and methodical mapping of state information 

systems to NAMRS. Through technical assistance, training, and other opportunities, ACL will 

continue supporting states in this process as they strive to increase the quality of the data they 

collect. Furthermore, it is anticipated that state information systems will evolve to facilitate 

reporting a larger number of data elements to NAMRS. As experienced in the first year, this 

evolution is happening at a very rapid pace. 

For more information about NAMRS or requesting NAMRS data sets, please direct inquiries to 

ACL Program Officer: Stephanie.WhittierEliason@acl.hhs.gov. 
9

Selected Bibliography 

Executive Office of the President, Office of Management and Budget. (1997). Revisions to the 

Standards for the Classification of Federal Data on Race and Ethnicity, Federal Register 

Notice October 30, 1997. (OMB Statistical Policy Direction No. 15 revised). Retrieved 

from http://www.whitehouse.gov/omb/fedreg_1997standards/. 

Executive Office of the President, Office of Management and Budget. (2002). Office of 

Management and Budget Information Quality Guidelines. Retrieved from: 

http://www.whitehouse.gov/sites/default/files/omb/inforeg/iqg_oct2002.pdf 

Executive Office of the President, Office of Management and Budget. (2006). Office of 

Management and Budget Standards and Guidelines for Statistical Surveys. Retrieved from: 

http://www.whitehouse.gov/sites/default/files/omb/inforeg/statpolicy/standards_stat_surv

eys.pdf 

Larson, S.A., Salmi, P., Smith, D., Anderson, L., and Hewit, A.S. (2013). Residential Services for 

Persons with Intellectual or Developmental Disabilities: Status and Trends Through 2011. 

Minneapolis: University of Minnesota, Research and Training Center on Community 

Living, Institute on Community Integration. Retrieved from: 

http://rtc.umn.edu/risp/docs/risp2011.pdf 

National Core Indicators. (2012). Using National Core Indicators (NCI) Data for Quality 

Improvement Initiatives. National Association of State Directors of Developmental 

Disabilities Services and Human Services Research Institute. Retrieved from the National 

Core Indicators Website: 

http://www.nationalcoreindicators.org/upload/files/using_nci_data/downloads/using_nati

onalcore_indicators_data.pdf 

National Resource Center for Child Welfare and Technology. (2009). National Youth in Transition 

Database (NYTD) User’s Guide. Retrieved from www.nrccwdt.org. 

U.S. Department of Commerce, United States Census Bureau. (2012). Table B16001 - Language 

Spoken At Home By Ability To Speak English For The Population 5 Years And Over, 

2012 American Community Survey. Retrieved from: 

http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_

12_1YR_B16001&prodType=table. 

U.S. Department of Health and Human Services, Administration on Children, Youth, and Families. 

(2010). Program Instruction, National Youth in Transition Database (NYTD) reporting in 

a statewide child welfare information system (SACWIS) environment (ACYF-CB-PI-10-

04). Retrieved from www.acf.hhs.gov/programs/cb/resource/pi1004.

U.S. Department of Health and Human Services, Administration for Children and Families, 

Administration on Children, Youth and Families, Children’s Bureau. (2013). Child 
10

Maltreatment 2012. Retrieved from http://www.acf.hhs.gov/programs/cb/research-datatechnology/statistics-research/child-maltreatment. 

U.S. Department of Health and Human Services, Administration for Children and Families, 

Administration on Children, Youth and Families, Children’s Bureau. (2013). National 

Child Abuse and Neglect Data System (NCANDS) child file, FFY 2012 version 1, 

NDACAN Dataset Number 178, User’s Guide and Codebook. Retrieved from the National 

Data Archive on Child Abuse and Neglect website, http://www.ndacan.cornell.edu.

U.S. Department of Health and Human Services, Administration on Aging. (n.d.). NAPIS 

Comprehensive Aging Reporting and Data System (CARDS), Retrieved from 

www.aoa.gov/aoaroot/program_results/SPR/docs/NAPIS_CARDS.pdf.

U.S. Department of Health and Human Services, Administration on Aging. (n.d.). NAPIS State 

Reporting Tool Users’ Guide, Retrieved from:

www.aoa.gov/aoaroot/program_results/SPR/docs/NAPIS_user_manual.pdf.

U.S. Department of Health and Human Services, Administration on Aging. (2010). Reporting 

Requirements For Title III and VI, Retrieved from: 

www.aoa.gov/aoaroot/program_results/docs/StateProgramReportForm053110.pdf.

U.S. Department of Health and Human Services, Administration on Aging. (n.d.). Form for the 

State Annual Ombudsman Report to AoA (OMB NO.: 0985-0005), Retrieved from: 

http://www.aoa.gov/aoa_programs/elder_rights/Ombudsman/NORS.aspx. 

U.S. Department of Health and Human Services, Administration on Aging. (n.d.). Instructions for 

Completing the NORS Form (OMB NO.: 0985-0005). Retrieved from: 

http://www.aoa.gov/aoa_programs/elder_rights/Ombudsman/NORS.aspx. 

U.S. Department of Health and Human Services, Administration on Aging. (2013). Long-Term 

Care Ombudsman Program Complaint Codes (OMB NO.: 0985-0005). Retrieved from: 

www.aoa.gov/aoa_programs/elder_rights/Ombudsman/NORS.aspx. 

U.S. Department of Health and Human Services, Administration on Aging. (2006). Senior 

Medicare Patrol (SMP). Retrieved from: 

www.aoa.gov/AoA_programs/Elder_Rights/SMP/index.aspx. 

U.S. Department of Health and Human Services, Administration on Aging. (2013). SMART 

FACTS Manual. Retrieved from: 

www.smpresource.org/Content/NavigationMenu/ResourcesforSMPs/SMARTFACTS/S

MARTFACTSManual/default.htm.

U.S. Department of Justice, Office of Justice Programs, National Information Exchange Model 

(NIEM). (2012). Retrieved from https://www.niem.gov/technical/Pages/version-3.aspx 
11

U.S. Department of Justice, Office of Justice Programs, Office for Victims of Crimes. (2013). 

Vision 21Transforming Victim Services Final Report, May 2013. 

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[1] U.S. Government Accountability Office, "Stronger Federal Leadership Could Enhance National 

Response to Elder Abuse," GAO-11-208, Washington, D.C., March 22, 2011 [Reissue]. 

[2] U.S. Government Accountability Office, "Elder Justice: National Strategy Needed to Effectively 

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[3] U.S. Government Accountability Office, "Elder Justice: More Federal Coordination and Public 

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