I’ve been fortunate to work on the National Adult Maltreatment Reporting System (NAMRS) for about six years, from pilot project to implementation. National data that captures information about APS clients, victims, and perpetrators has long been a dream of administrators and advocates from the federal to the local level. As each year passes, states are becoming more proficient at submitting the needed data so that APS can tell its “story”.
If you’re not familiar with NAMRS, information about its history, past reports, and frequently asked questions can be found on the NAMRS website. NAMRS was implemented in 2016 and for the federal fiscal year (FFY) 2019 submission period has had 100% participation from states, the District of Columbia, and territories. This is remarkable for a “voluntary” system where no state is required to participate and there is no dedicated funding to assist them in doing so
The most recent data report, the Adult Maltreatment Report 2019, was released this autumn and contains information on FFY 2019 APS data. A few key takeaways from the national data:
- There were 8,070 full-time equivalent (FTE) intake or investigative staff in APS programs.
- There were 1,315,992 reports of maltreatment received by APS programs.
- There were 259,782 victims of substantiated investigations.
- The most frequently submitted allegation was self-neglect at 51% of all allegations.
- Professionals (as opposed to relatives or self-reports) made 63.7% of the reports to APS.
- There was an increase in the number of reports accepted, clients, investigations, and victims over the last three FFYs, as shown below.
Figure 1: Year-to-Year Summary Data
Note: Based on states that submitted these data elements for each of the three years as follows: 51 states for Reports Accepted; 46 states for Clients; 46 states for Investigations; 45 states for Victims.
APS Programs
NAMRS collects information about APS programs in addition to de-identified information about clients, victims, and perpetrators. As referenced earlier, information about number of investigators and supervisors is collected and detailed in the graphic below. In FFY 2019, there were 8,070 full-time hotline or investigator staff and 1,645 supervisors.
Figure 2: APS Program Staff
Intake models vary from state to state. Some states collect reports using a “centralized” state-level phone center and/or web page. In some states, counties collect intakes individually in a “decentralized” structure. Others have a combination where the state collects reports in addition to the counties. The majority of states follow a centralized intake model, at 51%.
Figure 3: APS Intake Models
Note: Based on information from 55 states. “Other” is reported as intakes taken by local law enforcement.
Another data element captures information on the use of assessment tools. Some of these tools are general social work tools, such as screening tools that measure cognition, while others are APS-specific maltreatment assessments. For FFY 2019, 78% of states reported using a common tool statewide.
Investigations and Clients/Victims
NAMRS collects data on multiple types of maltreatment, including self-neglect, neglect, financial exploitation, physical abuse, emotional abuse, and sexual abuse (among others). The graph below breaks down the different types of maltreatment and substantiation status.
Figure 4: Allegations by Disposition and Maltreatment Type
Note: Based on data from 33 states for 576,801 allegations.
NAMRS considers a client as “an individual who has received an investigation regarding a report of alleged maltreatment” and a victim as “an individual who has received an investigation regarding a report of alleged maltreatment and one or more allegations is substantiated.” The largest percentage of both clients and victims by age group was 75-84 years, as shown in the graph below:
Figure 5: APS Clients and Victims by Age
Note: Based on 32 states submitting data for 430,887 clients, and 43 states submitting data for 219,565 victims, age was Unknown for 2.1% of clients and 7.7% of victims.
NAMRS also collects the residence of victims at both the start and the close of the investigation, though not all states are able to provide data on residence at both points in time. For those that can provide data for both, 82% of victims resided in their own home at the start of the investigation, while 71% resided in their own home at the close.
Perpetrators
In NAMRS, a perpetrator is defined as “each person determined to be responsible for one or more maltreatments with a disposition of substantiated.” Not all states collect or are able to provide detailed information about perpetrators.
For FFY 2019, states reported that 41.5% of perpetrators were female, while 36.8% were male (from 27 states). For states that were able to provide data on the relationship of the perpetrator, 33.15% were not related to the victim. The largest age group of perpetrators was in the 50-59 year-old group.
Conclusion
NAMRS data is integral to the future of APS. It is difficult to discuss the importance of APS without knowing the characteristics of the individuals that APS serves. Having demographic information on victims and perpetrators is key to discovering where prevention efforts should be targeted. As states progress in their data collection efforts, more data is provided to the NAMRS system each year, furthering our ability to show the impact of adult maltreatment and the APS system. I encourage everyone to read the full report for a complete picture of the data.
NOTE: While I have written this brief summary on the data from the most recent report, I was not involved in the actual writing of the report itself. The brilliant writing and analysis team of Leslie McGee, Karl Urban, Brian McGee, James Tedrow, Dr. Zach Gassoumis, and others spent many months compiling and analyzing the data. Their efforts, and the hard work of state APS programs in submitting this data, deserve our thanks.
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