Skip To Main content Skip Global Navigation

Photo of Leslie McGee.Highlights from the Adult Maltreatment Report 2021

by Leslie McGee, APS TARC Team

Cover image showing a family hugging and smiling together.What We Saw in the Data from 2021

It has been six years since the Administration for Community Living implemented the National Adult Maltreatment Reporting System (NAMRS), a data reporting system developed for the purpose of better understanding the phenomena of adult maltreatment in the United States. NAMRS collects annual data on adult protective services (APS) investigations, and non-identifying information about the clients, victims (i.e., individuals with a substantiated report of maltreatment) and perpetrators involved in those investigations. Currently, NAMRS data is submitted by adult protective services (APS) programs in all 50 states, the District of Columbia and every U.S. territory. The information is summarized and published in the Adult Maltreatment Report (AMR) each year. This blog discusses some highlights from the Adult Maltreatment Report 2021.

Below are a few of the key data points regarding APS programs and the individuals they served as reported for federal fiscal year (FFY) 2021 (October 1, 2020 to September 30, 2021):

  • APS programs received 1,349,154 referrals of alleged adult maltreatment.
  • There were 8,287 full-time equivalent (FTE) hotline workers and investigators and 1,882 FTE supervisory staff working in APS programs.
  • There were 268,902 victims of adult maltreatment.
  • The most common disabilities for APS clients were cognitive difficulty and independent living difficulty, each at 26% of clients. The most common disability for victims was ambulatory difficulty with 31.9% of victims identified.
  • There were 176,047 victims of self-neglect, which was more than all other maltreatment types combined as shown in the exhibit below from the AMR 2021.

Figure 1 - Victims by Maltreatment Type
Suspicious death 75; abandonment 814; other exploitation 1,440; sexual abuse 1,635; other 4,071; exploitation non-specific 7,678; physical abuse 21,841; emotional abuse 27,399; financial exploitation 37,644; neglect 38,000; self-neglect 176,047.
Note: Based on data from 52 states for 268,902 victims. Victims may have more than one substantiated maltreatment in a single investigation.

A Look at Trends

Because we now have NAMRS data going back to 2016, the APS TARC can now begin to look at trends for several APS data elements. In addition, we looked at the potential impacts of COVID-19 on APS programs, as we did last year.

One area where trend data was compiled looked at the numbers of reports, investigations, clients, and victims.  As shown in the AMR 2021 exhibit below, the numbers for each data element consistently increased every federal fiscal year (October through September) prior to FFY 2020 when there was a decrease across all elements. Although the numbers of accepted reports and victims both increased in FFY 2021 (+1.8% and +4.2%, respectively), there were very slight decreases in the number of investigations (-0.1%) and the number of clients (-0.4%).

Figure 2 - Year-to-Year Summary Data
Year to year data summary for 2016 through 2021 showing bar graph by year for reports accepted, clients, investigations, and victims.
Note: Based on states that submitted these data elements for each of the six years listed as follows: 49 states for Reports Accepted; 44

Gender is another area where looking at data over time showed an interesting trend. Unsurprisingly, the data shows that women have consistently represented more than half of the individuals served by APS programs each year. Something of note that had not been quite so obvious before seeing the trend data is that while the percentage of female victims is lower than the percentage of female clients each year, the opposite is true for men. This is illustrated in the following exhibit from the report.

Figure 3 - Gender Identity by Year
Line graph showign gender identity by year. From the year 2016 to 2021 Female Clients, Female Victims, Male Clients, and Male Victims have not increased or decreased significantly.
Note: Based on 25 states submitting gender data for clients 34 states that submitted gender data for victims each of the six years. Only data for male and female gender is shown due to the small percentage of transgender clients and victims reported each year. There is also a small percentage of clients and victims for whom gender is unknown each year.

The Potential Impact of COVID-19

FFY 2021 data provided a more comprehensive picture of APS data during the height of the COVID-19 pandemic.  Social distancing and other public health protocols were in effect for the much of the federal fiscal year, and APS programs had made adjustments to policies and practices to ensure both worker and client safety. The data reported to NAMRS did not identify clients or victims with COVID-19, so while certain patterns were detectable in the data, it was not possible to establish that the patterns were attributable solely or in part to COVID-19.  That said, in the 2021 report we did look at several NAMRS data elements to identify areas where significant trends in the data aligned with certain time periods during the pandemic.

Data on the number of APS reports accepted and not accepted at intake and the number of investigations over the past three years (2019 – 2021) indicated a drop in both the number accepted and the number of investigations. After seeing a drop in investigations during the initial shutdown months of the pandemic (March – May 2020), the number of APS investigations returned to the usual seasonal patterns and has remained stable as shown in the exhibit below from the report.

Figure 4 - Number of Investigations by Month
Line graph showing number of Investigations by month for the years 2019, 2020, and 2021. showing investigations have not changed drastically over 3 years.
Note: Based on data submitted by the same 32 states. States must have submitted all three FFYs to be included in exhibit.

The trends in data regarding case closures and services was notable and discussed in the AMR 2021. During the shutdown months, there was an increase in case closures due to the reasons "Completed Investigation" and "Client Death." This coincided with increases in the percentages of clients and victims receiving services, although that is not reflected in an increase of case closures with the reason listed as "Investigation and Protective Services Case Completed." Exhibits 5.6 and 5.7 from the report illustrate these trends.

Figure 5 - Case Closure Reason: Percentage of Investigations Completed with Service Case
Percentage of Investigations Completed with Service Case, showing the percentage of clients has stayed around 30 - 34 percent from the years 2018 to 2021. However there was a slight decrease to 30%25 in April of 2021.
Notes: Based on data submitted by 26 states. States must have submitted all three FFYs to be included in exhibit. Unknown responses are excluded from all values to account for variation in states’ reporting capabilities across FFYs. One state was excluded due to program changes during the period.

Figure 6 - Percentage of Clients and Victims Receiving Services by Month
Line graph showing the percentage of clients and victims receiving services by month. Percentage of clients and victims has increased from the year 2018 to 2021.

Notes: Based on data submitted by 18 states for victims and 19 for clients. States must have submitted all three FFYs to be included in exhibit. Unknown responses are excluded from all values to account for variation in states’ reporting capabilities across FFYs. One state was excluded due to program changes during the period.

One final data trend that I would like to highlight involves a look at case durations during the pandemic. In the FFY 2020 data report, it was noted that “… the length of time to complete an investigation and the overall length of time a case is opened (durations) was shorter during April – June 2020 compared to April – June 2019.” A longer term review of the data showed that both durations remained shorter compared to the previous year. The noticeable drop during the early months of the pandemic may reflect case closures during that period when workers were not able to make face-to-face visits and had more time to process cases, however, there is no way to know that for certain. Although the trend appears to be reversing, as shown in the exhibit below from the report, this cannot be fully analyzed without a look at the FFY 2021 cases that remained open beyond the time period included in the exhibit.

Figure 7 - Average Investigation and Case Duration by Month
Line graph showing the average investigation and case duration by month, there was an increase in October 2019, but since then there have been no significant changes from the year 2018 to 2021.
Notes: Based on data submitted by 27 states for investigations and 31 states for cases. States must have submitted all three FFYs to be included in exhibit.

The Journey Continues…

Since 2016, ACL and the APS TARC have continuously worked with states to assist them with collecting and reporting NAMRS data. Increases in the types and amount of data submitted by states each year provides an opportunity to take a more in-depth look into the operations of APS programs and the work they do with and for their clients. Most recently, NAMRS data was instrumental in the APS TARC’s work on the APS process evaluation, which will be publicly available soon. We recognize the value and importance of having a robust and comprehensive data source to increase our understanding of adult maltreatment, and there are plans to use NAMRS data as a foundation for ongoing research and technical assistance to states.
To learn more about NAMRS or the APS TARC, to be notified when new reports are available, and for information about upcoming webinars and other learning opportunities, consider signing up for the APS TARC email list. Thank you to the state APS programs who work diligently every year to collect and submit their NAMRS data, and to my amazing colleagues at the APS TARC and the Learning and Resource Center, who spend many months compiling, analyzing and organizing the data for the report.

What did you think of this blog post? Take our five-question satisfaction survey to let us know!

Safe Exit