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Headshot of author Andrew CapehartHighlights From the 2020 Adult Maltreatment Report

by Andrew Capehart, APS TARC Team

The latest National Adult Maltreatment Reporting System (NAMRS) report is out in the wild. This year’s report is the fifth annual release. It continues to amaze me that we have so much robust data for a voluntary system (meaning states report data voluntarily and are not required to do so) that hasn’t been around terribly long. This year’s report is similar to past reports but also contains a special focus on the COVID-19 pandemic and the potential impacts it has had on adult protective services (APS) programs.

For those that are unfamiliar with NAMRS, it is a data reporting system established by the Administration for Community Living (ACL) for the purpose of understanding the issue of adult maltreatment in the U.S. Currently, the data submitted is by APS programs. All states, territories, and the District of Columbia provide data. You can read all about it on the NAMRS website, which details the history of NAMRS, how it functions, how states provide data, data reports, and more.

Here are a few key pieces of data from the federal fiscal year (FFY) 2020 Adult Maltreatment Report.

  • There were 8,592 full-time equivalent (FTE) intake or investigative staff in APS programs.

  • There were 1,327,019 referrals of alleged maltreatment received by APS programs.

  • There were 258,389 individuals (victims) that had a substantiated investigation.

  • Self-neglect was the most frequently reported allegation type at 49.2% of allegations.

  • There was a slight decrease in the number of reports, investigations, clients, and victims, which may be attributed to the COVID-19 pandemic. See figure below.

Figure 1 - Year-to-Year Summary Data

Year to year data summary for 2018 through 2020 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 three years listed as follows:
52 states for Reports Accepted; 50 states for Clients; 50 states for Investigations; 49 states for Victims.

APS Programs

NAMRS collects information on APS programs in addition to information on clients, victims and perpetrators. One key piece of information collected is the eligible population by state. There is considerable diversity among states as to the population of adults investigated, depending on factors such as age and disability status.

Figure 2 - APS Eligible Populations by State
Map of the United States shows 2 states older adults only; 2 states older adults with a disability; 13 states adults with a disability and all older adults; 35 states adults with a disability.  Older adult means age 60 and over or age 65 and over depending on the state.

Another interesting data point is the source of reports. Professionals were overwhelmingly the primary report source for FFY 2020, followed by relatives in a distant second place.

Figure 3 – Investigations by Report Source

254,093 by professionals; 60,983 by relatives; 34,016 by other non-professionals; 20,669 self-reported; 18,024 by caregivers or decision makers.

Note: Based on data from 30 states for 426,601 investigations. 
The source was Unknown or Unidentified in 61,235 investigations. Investigations may have more than one report source.

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 rates for FFY 2020.

Figure 4 – Allegations by Disposition and Maltreatment Type

Abandonment: 30.8%25 substantiated; 60.2%25 unsubstantiated; 7.4%25 inconclusive; 1.7%25 other. Emotional abuse: 15.5%25 substantiated; 51.5%25 unsubstantiated; 19.7%25 inconclusive; 13.3%25 other. Exploitation non-specific: 22.9%25 substantiated; 46.6%25 unsubstantiated; 3.2%25 inconclusive; 27.3%25 other. Financial exploitation: 16.0%25 substantiated; 56.9%25 unsubstantiated; 18.0%25 inconclusive; 9.2%25 other. Neglect: 16.1%25 substantiated; 65.9%25 unsubstantiated; 9.6%25 inconclusive; 8.4%25 other. Other: 27.3%25 substantiated; 50.9%25 unsubstantiated; 5.5%25 inconclusive; 16.2%25 other. Other exploitation: 13.4%25 substantiated; 43.3%25 unsubstantiated; 25.8%25 inconclusive; 17.5%25 other. Physical abuse: 16.8%25 substantiated; 58.6%25 unsubstantiated; 15.56%25 inconclusive; 9.2%25 other. Self-neglect: 44.8%25 substantiated; 32.4%25 unsubstantiated; 5.4%25 inconclusive; 17.4%25 other. Sexual abuse: 12.6%25 substantiated; 54.8%25 unsubstantiated; 23.2%25 inconclusive; 9.4%25 other.

Note: Based on data from 35 states for 605,599 allegations.

Potential Impact of COVID-19

The COVID-19 pandemic has had quite an impact on APS programs, from administration to investigation. An APS TARC study in the summer for 2020 indicated that states reported  an initial drop in the number of new reports in the initial months of the pandemic, which was confirmed by NAMRS data.  The latest NAMRS report examined the number of investigations in 2020 compared to those in 2019. The differences are striking.

Figure 5 – Number of Investigations by Month for 2019 and 2020
January: 39,400 in 2019, 39,315 in 2020; February: 34,065 in 2019, 35,820 in 2020; March: 35,978 in 2019, 32,968 in 2020; April: 36,919 in 2019, 27,004 in 2020; May: 33,356 in 2019, 29,320 in 2020; June: 29,856 in 2019, 32,33 in 2020.
Note: Number of investigations is based on NAMRS data submitted by 32 states.

Other more detailed potential impacts of COVID-19 will be discussed on this blog in the coming months.

NAMRS Today and Beyond

The data highlighted here is only a very small piece of what is available in the complete Adult Maltreatment Report 2020. I encourage readers to explore the full report, which provides much greater detail about clients, victims, and perpetrators.
NAMRS is currently undergoing a process to explore potential technology and data changes. Technology, as we all know, moves fast and no data system is immune to the need to improve user experience, update technology, and respond to new security threats. The APS TARC is planning a series of focus groups in December for APS program staff to discuss potential data changes. To learn more about NAMRS, the APS TARC, to be notified when new reports are available, and for opportunities to provide feedback on potential changes, consider signing up for the APS TARC email list.

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 APS TARC team of Leslie McGee, Karl Urban, Brian McBee, 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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