Development of a National Adult Protective Services Data System: Namrs Pilot Final Report (volume 1). Appendix E. Proposed Agency Component Data Specifications

09/25/2015

E.1. Proposed Agency Component Data Specifications

The Agency Component includes agency information such as agency name, addresses, and contact information. The Agency Component collects information on the policies and practices of each state APS agency as context for understanding the Case Component or the Key Indicators Component submission. While all data elements pertain to the reporting period for the annual data collection, the information in some elements will not change each year. Data topics include the following:

  • Data Sources--sources of information used to submit data.

  • Population Served--characteristics of the population served.

  • Staffing--number of filled investigator and supervisor FTEs.

  • Intake Processes--centralized, local or regional, combination.

  • Referrals--number of reports received; not accepted, or resolved through I&R/I&RA; accepted.

  • Standard of Evidence--legal criteria for substantiating maltreatment.

  • Completion of Investigation--amount of time for APS to complete investigations based on standard.

  • Types of Maltreatment--state definitions or statutory references for definitions.

  • Assessment Tools--uses statewide standardized tools for investigation.

  • Service Gaps--client services that are not available.

  • Perpetrators--whether or not the agency collects person-specific data on perpetrators.

Some data elements have a tiered structure of code values. In such cases the specifications show the tiered structure by indenting the optional, more specific code values.

States can submit additional explanatory information on each item.

TABLE E.1. Agency Component Data Specifications: General Information
Element# Element Name Element Description Required Type Size
Agency1.1 Agency name 1 Department or agency name Yes Alphanumeric 100
Agency1.2 Agency name 2 Branch or unit name No Alphanumeric 100
Agency2.1 Street 1 First line street address of agency physical address Yes Alphanumeric 100
Agency2.2 Street 2 Second line street address of agency physical address No Alphanumeric 100
Agency2.3 City City of agency physical address Yes Alphanumeric 100
Agency2.4 State State of agency physical address Yes Alphanumeric 2
Agency2.5 ZIP ZIP of agency physical address Yes Alphanumeric 10
Agency3.1 Street 1 First line street address of agency mailing address Yes Alphanumeric 100
Agency3.2 Street 2 Second line street address of agency physical address No Alphanumeric 100
Agency3.3 City City of agency physical address Yes Alphanumeric 100
Agency3.4 State State of agency physical address Yes Alphanumeric 2
Agency3.5 ZIP ZIP of agency physical address Yes Alphanumeric 10
Agency4.1 Name Contact name Yes Alphanumeric 100
Agency4.2 Title (per contact name) Contact title Yes Alphanumeric 100
Agency4.3 Email (per contact name) Contact email Yes Alphanumeric 100
Agency4.4 Phone (per contact name) Contact telephone Yes Alphanumeric 50
Agency4.5 Contact's role in agency (per contact name) Contact's role in agency

Code Values:
1 = Manager/director/supervisor
2 = Data coordinator/manager
3 = Training coordinator/specialist
4 = IT/data specialist
5 = Policy specialist
6 = Intake manager/supervisor
7 = Regional supervisor
8 = Field coordinator9 = Investigator
10 = Social worker
11 = Case manager

No Drop down; select 1 NA

 

TABLE E.2. Agency Component Data Specifications: Agency Profile
Element# Element Name Element Description Required Type Size
Agency5 Data sources The sources of information used to submit data this year to NAMRS.

Code Values:
1 = APS agency only
2 = APS and other agencies

No Drop down; select 1 NA
Agency5.1 Comment Provide names of other agencies that provided data. No Text (characters) 5,000
Agency6 Population served Provide a brief description of the characteristics of the population, including age, living arrangement, vulnerability, etc. whom APS is mandated to serve. Provide the citation in state statute or regulation, or agency policy. No Text (characters) 5,000
Agency6.1 Population served: setting If your agency investigates allegations in residential care communities and/or nursing homes, please indicate whether or not your agency would conduct an investigation if the allegation does not pertain to a specific resident, but rather to the residents in general. No Text (characters) 5,000
Agency7 Investigator FTEs filled Number of filled APS FTEs responsible for the hotline and/or conducting investigations. No Numeric 6
Agency7.1 Supervisor FTEs filled Number of filled APS FTEs responsible for supervision. No Numeric 6
Agency7.2 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 (characters) 5,000
Agency8 Intake Centralized or localized intake of APS reports.

Code Values:
1 = Centralized at a statewide hotline or call in number
2 = Local at county or regional hotlines or call in numbers
3 = Combination of both statewide and local hotlines or call in numbers
4 = Other

No Drop down; select 1 NA
Agency8.1 Comment Provide additional information on the definition of intake. No Text (characters) 5,000
Agency9 Reports accepted for investigation Number of reports accepted for investigation during the reporting period. No Numeric 6
Agency9.1 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 I&R/I&RA. No Numeric 6
Agency9.2 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 (characters) 5,000
Agency 10 Response time The length of time from receipt of call or notice of alleged maltreatment to face-to-face contact with the client by the APS worker, based on the standard set by policy or practice. No Numeric 3
Agency 10.1 Comment Provide additional information on the definition of response time to allegations of maltreatment. If different types of allegations are given different priorities in terms of response time, please provide additional information. No Text (characters) 5,000
Agency11 Investigation completion time The length of time from investigation start to investigation completion, based on the standard set by policy or practice. No Numeric 3
Agency11.1 Comment Provide additional information on the definition of start of investigation and completion of an investigation. No Text (characters) 5,000
Agency12 Types of maltreatment Indicate which types of maltreatment are investigated by APS.

Code Values:
10 = Abandonment
20 = Emotional abuse
30 = Exploitation
   31 = Financial exploitation
   32 = Other exploitation
40 = Neglect
50 = Physical abuse
60 = Sexual abuse
70 = Suspicious death
80 = Self-neglect
90 = Other

No Drop down; select 1 or more NA
Agency12.1 Comment Provide citation or URL in state law, regulations, or program guidance for maltreatment types investigated by APS. No Text (characters) 5,000
Agency13 Standard of evidence Standard used for substantiating an allegation of maltreatment.

Code Values:
1 = No state standard
2 = Different standards based on type of perpetrator
3 = Clear and convincing
4 = Preponderance
5 = Credible, reasonable, or probableCause
6 = Other

No Drop down; select 1 NA
Agency13.1 Comment Provide citation or URL of state law, regulations, or program guidance. Include discussion of definitions of perpetrator if relevant. No Text (characters) 5,000
Agency14 Assessment tools Indicate whether APS personnel use standard tools throughout the state for assessing risk or safety of clients.

Code Values:
1 = Yes, use common instrument or tool throughout the state
2 = No, assessment instruments are determined by each county or left to the worker's discretion

No Drop down; select 1 NA
Agency14.1 Comment Provide the name and reference (i.e., URL) for each standardized tool that is used. No Text (characters) 5,000
Agency15 Service gaps Indicate which services are not available or accessible in the state.

Code Values:
1 = Care/case management services
2 = Caregiver support services
3 = Community day services
4 = Education, employment, and training services
5 = Emergency assistance and material aid services
6 = Financial planning services
7 = Housing and relocation services
8 = In-home assistance services
9 = Legal services
10 = Medical and dental services
11 = Medical rehabilitation services
12 = Mental health services
13 = Nutrition
14 = Public assistance benefits
15 =Substance use services
16 = Transportation
17 = Victim services
18 = Other services

No Drop down; select 1 or more NA
Agency15.1 Comment Provide additional information on how gaps in services were identified, if possible. No Text (characters) 5,000
Agency16 Perpetrators Does APS collect person-specific data on persons found to be perpetrators of substantiated maltreatment? Does your information system collect unique IDs and demographic characteristics of such persons? If there is specific state statute or regulation, or agency policy on such data, please provide the citation. No Text (characters) 5,000

E.2. Proposed Case Component Data Specifications

The Case Component includes information pertaining to each report that is screened-in and investigated by the APS agency. The information is specific to the investigation, including the clients, maltreatments, and perpetrators associated with the specific investigation. A case is comprised of an investigation and any ancillary tasks that APS undertakes on behalf of the client. The Case Component collects data on APS cases that were closed during the reporting period.

The Case Component is comprised of five entities. Each entity is comprised of attributes. The key entities for the data submission are:

  • Investigation--each investigation undertaken by APS with a case closure date during the report period.

  • Client--each person subject of an investigation.

  • Maltreatment Allegation--each maltreatment associated with each client, requires the attributes of maltreatment type and maltreatment disposition.

  • Perpetrator--each person determined to be 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, as explained by one or more of the eight possible attributes.

On the following tables, the column “quantifier” indicates if a data element can have multiple values. For example, a client may have received multiple types of benefits, while there can only be one primary reason for case closure.

Some data elements have a tiered structure of code values. For example, the data element race allows the client to be identified as Asian OR as a specific Asian race. In such cases the specifications show the tiered structure by indenting the optional, more specific code values.

Definitions of specific data element values can be found in the NAMRS Definitions of Code Values.

Each reporting period submission may have multiple investigations.

TABLE E.3. Investigation Entity
# Element Name Element Description Required Quantifier Type Size Code Values
Inv1 Investigation ID The unique ID used by the state for each investigation. The ID is assigned to a specific investigation and is only used once. The Investigation ID is encrypted by the state for purposes of data submission. Yes Single A/N 32 Not applicable
Inv2 Report date The month, day, and year the agency was notified of the suspected adult maltreatment. No Single Date 10 Not applicable
Inv3 Report source The role or profession of the person who made the report of the suspected adult maltreatment. Multiple report source code values can be submitted for the client. No Multiple N 2 1 = Substitute decision maker
2 = In-home caregiver
3 = Nursing home staff
4 = Residential care community staff
5 = Education professional
6 = Financial professional
7 = Law enforcement, judicial, or legal professional
8 = Medical or health professional
9 = Mental and behavioral health professional
10 = Social services professional
11 = Other professional
12 = Relative
13 = Neighbor, friend, other non-relative, other non-professional
14 = Self
15 = No role identified
Inv4 State/county FIPS code of investigative agency The FIPS for state (2 digits) and county code (3 digits) of the APS agency. (Primary agency responsible for the determination of the investigation.) No Single N 5 Code is the unique identification number assigned to each state and county under the FIPS guidelines. See http://www.census.gov/geo/www/fips/fips.html.
Inv5 Investigation start date The date the investigation is assigned to an investigation worker. If the agency uses another date to indicate the start of an investigation, that date is used. No Single Date 10 Not applicable
Inv6 Investigation disposition date The date that the agency completed dispositions on the allegations of maltreatment associated with the investigation. No Single Date 10 Not applicable
Inv7 Case closure date The date that the agency completed all activities related to the investigation of the case. Yes Single Date 10 Not applicable

Each investigation may have multiple clients. Each client can be associated with more than one investigation but a separate client entity is required for each investigation.

TABLE E.4. Client Entity
# Element Name Element Description Required Quantifier Type Size Code Values
Clt1 Client ID The unique ID used by the state for each client. The ID is assigned to a specific client and is used identify the same client across investigations and reporting periods. The client ID is encrypted by state for purposes of data submission. Data on multiple clients can be submitted for the investigation. Yes Single A/N 32 Not applicable
Clt2 Maltreatment setting The location where the alleged maltreatment occurred. No Single N 2 10 = Own residence or private residence of relative or caregiver
20 = Residential care community (non-specific)
   21 = Licensed residential care community
   22 = Unlicensed residential care community
30 = Nursing home (non-specific)
   31 = Licensed nursing home
   32 = Unlicensed nursing home
40 = Adult day services center (non-specific)
   41 = Licensed adult day services center
   42 = Unlicensed adult day services center
50 = Place of business or other services
60 = Other
Clt3 State/county FIPS code of client The FIPS for state (2 digits) and county code (3 digits) of the client's residence at the start of the investigation. No Single N 5 Code is the unique identification number assigned to each state and county under the FIPS guidelines. See http://www.census.gov/geo/www/fips/fips.html.
Clt4 Case closure reason The primary reason why the case was closed. No Single N 2 10 = Investigation completed
20 = Investigation completed and protective services case completed
30 = Investigation unable to be completed (non-specific)
   31 = Investigation unable to be completed due to death of client during investigation
   32 =Investigation unable to be completed due to refusal of client
40 = Protective services case opened but not completed (non-specific)
   41 = Protective services case closed due to death of client
   42 = Protective services case closed due to client decision to not continue
50 = Other
Clt5 Age The age of the client in years (at investigation start date). No Single N 2 18,19...74 = Actual age
75 = 75-84
85 = 85 and older
Clt6 Gender identity The actual or perceived gender-related characteristics of the client. No Single N 1 1 = Male
2 = Female
3 = Transgender
Clt7 Sexual orientation The client's enduring pattern of or disposition to experience sexual or romantic desires for, and relationships with, people of one's same sex, the other sex, or both sexes. No Single N 1 1 = Straight
2 = Gay/lesbian
3 = Bisexual
4 = Questioning
5 = Other
Clt8 Race The population(s) or group(s) that the client identifies as being a member. Multiple race code values can be submitted for the client. No Multiple N 2 10 = American Indian or Alaska Native
20 = Asian (non-specific)
   21 = Asian Indian
   22 = Chinese
   23 = Filipino
   24 = Japanese
   25 = Korean
   26 = Vietnamese
   27 = Other Asian
30 = Black or African American
40 = Native Hawaiian or Other Pacific Islander (non-specific)
   41 = Native Hawaiian
   42 = Guamanian or Chamorro
   43 = Samoan
   44 = Other Pacific Islander
50 = White
Clt9 Ethnicity The affiliation of the client as Hispanic or Latino/a or non-Hispanic or Latino/a. Multiple ethnicity code values can be submitted for the client. No Multiple N 2 10 = Yes, Hispanic or Latino/a, or Spanish Origin (non-specific)
   11 = Mexican, Mexican American, Chicano/a
   12 = Puerto Rican
   13 = Cuban
   14 = Other Hispanic, Latino/a, or Spanish Origin
20 = No, not Hispanic or Latino/a, or Spanish Origin
Clt10 Primary language The primary language or method that the client uses for written and verbal communication. No Single N 2 1 = Arabic
2 = Chinese
3 = English
4 = French
5 = German
6 = Korean
7 = Russian
8 = Spanish or Spanish Creole
9 = Tagalog
10 = Vietnamese
11 = Sign language
12 = Assistive technology
13 = Other
Clt11 Marital status The client's status based on state residency laws. No Single N 1 1 = Never married
2 = Married
3 = Domestic partner, including civil union
4 = Divorced
5 = Separated
6 = Widowed
7 = Other
Clt12 Schooling level The highest educational degree attained by the client. No Single N 1 1 = Less than high school
2 = High school diploma or equivalent
3 = Associate's degree or Bachelor's degree
4 = Advanced degree
Clt13 Employment status The involvement of the client in the labor force. No Single N 1 1 = Employed
2 = Unemployed
3 = Not in labor force
4 = Other
Clt14 Income level The level of annual income of the client including all sources of income. No Single N 1 1 = Less than $25,000
2 = $25,000-$49,999
3 = $50,000-$74,999
4 = $75,000-$99,999
5 = $100,000 or more
Clt15 Benefits The federal and state benefits received by the client during the investigation. Multiple benefit code values can be submitted for the client. No Multiple N 1 1 = Medicaid
2 = Medicare
3 = Publicly-subsidized housing
4 = SSDI
5 = Social Security retirement benefits
6 = SSI
7 = TANF
8 = Veterans' disabled benefits
9 = Other
Clt16 Veteran status The client's status related to the U.S. Armed Forces. No Single N 1 1 = Veteran
2 = Non-Veteran
Clt17 Disabilities The client's physical, emotional, and mental health issues that result in limitation in activities and restrictions to fully participate at school, work, or in the community. Multiple disability code values can be submitted for the client. No Multiple N 1 1 = Ambulatory difficulty
2 = Cognitive difficulty
3 = Communication difficulty
4 = Hearing difficulty
5 = Independent living difficulty
6 = Self-care difficulty
7 = Vision difficulty
8 = Other
9 = None
Clt18 ADL score The client's score on the Katz Index of Independence in ADLs. No Single N 1 Permissible values are 0-6
Clt19 IADL score The client's score on the Lawton IADLs. No Single N 1 Permissible values are 0-8
Clt20 Behavioral health screenings or diagnoses The results of assessments on the client, conducted by the APS agency. Multiple behavioral health code values can be submitted for the client. No Multiple N 2 1 = Alcohol use disorder
2 = Anxiety
3 = Bipolar disorder
4 = Dementia
5 = Depression
6 = Schizophrenia and other psychotic disorders
7 = Substance use disorder
8 = Traumatic brain injury
9 = Other
10 = None
Clt21 Living setting at start The primary residential environment of the client at the start of investigation. No Single N 2 10 = Own residence or residence of relative or caregiver
20 = Residential care community (non-specific)
   21 = Licensed residential care community
   22 = Non-licensed residential care community
30 = Nursing home (non-specific)
   31 = Licensed nursing home
   32 = Non-licensed nursing Home
40 = Other
Clt22 Living setting at close The primary residential environment of the client at the time of case closure. No Single N 2 10 = Own residence or residence of relative or caregiver
20 = Residential care community (non-specific)
   21 = Licensed residential care community
   22 = Non-licensed residential care community
30 = Nursing home (non-specific)
   31 = Licensed nursing home
   32 = Non-licensed nursing home
40 = Other
Clt23 Substitute decision makers at start The authorizations that are in effect related to health, personal, or financial decision making for the client at the start of the investigation. Multiple substitute decision maker code values can be submitted for the client. No Multiple N 2 10 = Health care proxy in effect
20 = Financial proxy in effect
30 = Guardianship or conservatorship (non-specific)
   31 = Guardianship or conservatorship of person
   32 = Guardianship or conservatorship of property
40 = Representative payee
50 = None
Clt24 Substitute decision makers at close The authorizations that are in effect related to health, personal, or financial decision making for the client at time of case closure. Multiple substitute decision maker code values can be submitted for the client. No Multiple N 2 10 = Health care proxy in effect
20 = Financial proxy in effect
30 = Guardianship or conservatorship (non-specific)
   31 = Guardianship or conservatorship of person
   32 = Guardianship or conservatorship of property
40 = Representative payee
50 = None
Clt25 Services at start The services known to the agency that the client was already receiving at the start of the investigation. Multiple service code values can be submitted for the client. No Multiple N 2 1 = Care/case management services
2 = Caregiver support services
3 = Community day services
4 = Education, employment, and training services
5 = Emergency assistance and material aid services
6 = Financial planning services
7 = Housing and relocation services
8 = In-home assistance services
9 = Legal services
10 = Medical and dental services
11 = Medical rehabilitation services
12 = Mental health services
13 = Nutrition
14 = Public assistance benefits
15 = Substance use services
16 = Transportation
17 = Victim services
18 = Other services
19 = None
Clt26 Services APS The services that the agency provided on behalf of the client during the investigation or while the agency kept an open case. Multiple service code values can be submitted for the client. No Multiple N 2 1 = Care/case management services
2 = Caregiver support services
3 = Community day services
4 = Education, employment, and training services
5 = Emergency assistance and material aid services
6 = Financial planning services
7 = Housing and relocation services
8 = In-home assistance services
9 = Legal services
10 = Medical and dental services
11 = Medical rehabilitation services
12 = Mental health services
13 = Nutrition
14 = Public assistance benefits
15 = Substance use services
16 = Transportation
17 = Victim services
18 = Other services
19 = None
Clt27 Services referred The services for which the agency referred the client. Multiple services code values can be submitted for the client. No Multiple N 2 1 = Care/case management services
2 = Caregiver support services
3 = Community day services
4 = Education, employment, and training services
5 = Emergency assistance and material aid services
6 = Financial planning services
7 = Housing and relocation services
8 = In-home assistance services
9 = Legal services
10 = Medical and dental services
11 = Medical rehabilitation services
12 = Mental health services
13 = Nutrition
14 = Public assistance benefits
15 = Substance use services
16 = Transportation
17 = Victim services
18 = Other services
19 = None
Clt28 Services at close The services known to the agency that the client was receiving at the time of case closure. Multiple services code values can be submitted for the client. No Multiple N 2 1 = Care/case management services
2 = Caregiver support services
3 = Community day services
4 = Education, employment, and training services
5 = Emergency assistance and material aid services
6 = Financial planning services
7 = Housing and relocation services
8 = In-home assistance services
9 = Legal services
10 = Medical and dental services
11 = Medical rehabilitation services
12 = Mental health services
13 = Nutrition
14 = Public assistance benefits
15 = Substance use services
16 = Transportation
17 = Victim services
18 = Other services
19 = None
Clt29 Interagency coordination The agencies to which the client was referred. Multiple interagency coordination code values can be submitted for the client. No Multiple N 1 1 = Law enforcement or prosecutorial offices
2 = Protection and advocacy or CAP
3 = State licensing agency
4 = State MFCU
5 = Long-term care ombudsman program
6 = Other
7 = None
Clt30 Previous report The indication that the agency has information that the client was the subject of a previous report. No Single N 1 1 = Yes
2 = No

Each client may have multiple maltreatment allegation entities within a specific investigation but only one of a particular maltreatment type. Each maltreatment allegation entity is associated with only one client. Each maltreatment allegation entity must be composed of a maltreatment type and maltreatment disposition.

TABLE E.5. Maltreatment Allegation Entity
# Element Name Element Description Required Quantifier Type Size Code Values
Mal1 Maltreatment type The alleged maltreatments that are investigated. Yes Single (per entity) N 2 10 = Abandonment
20 = Emotional abuse
30 = Exploitation (non-specific)
   31= Financial exploitation
   32= Other exploitation
40 = Neglect
50 = Physical abuse
60 = Sexual abuse
70 = Suspicious death
80 = Self-neglect
90 = Other
Mal2 Maltreatment disposition The disposition of each alleged maltreatment. Yes Single (per entity) N 1 1 = Substantiated
2 = Inconclusive
3 = Unsubstantiated
4 = Other

Each investigation may have zero, one, or more than one perpetrator. A perpetrator must be associated with at least one substantiated maltreatment investigation that is associated with a specific client within the investigation. A perpetrator may be associated with more than one investigation but a separate perpetrator entity is required for each of the associated investigations.

TABLE E.6. Perpetrator Entity
# Element Name Element Description Required Quantifier Type Size Code Values
Per1 Perpetrator ID The unique ID used by the state for the person who is found to be responsible for substantiated maltreatment(s). The ID is assigned to a specific perpetrator and is used to identify the same perpetrator across investigations and reporting periods. The Perpetrator ID is encrypted by the state for purposes of data submission. Yes Single A/N 32 Not applicable
Per2 Age The age of the perpetrator in years (at investigation start date). No Single N 2 18,19...74 = Actual age
75 = 75-84
85 = 85 and older
Per3 Gender identity The actual or perceived gender-related characteristics of the perpetrator. No Single N 1 1 = Male
2 = Female
3 = Transgender
Per4 Race The population(s) or group(s) that the perpetrator identifies as being a member. Multiple race code values can be submitted for the perpetrator. No Multiple N 2 10 = American Indian or Alaska Native
20 = Asian (non-specific)
   21 = Asian Indian
   22 = Chinese
   23 = Filipino
   24 = Japanese
   25 = Korean
   26 = Vietnamese
27 = Other Asian
30 = Black or African American
40 = Native Hawaiian or Other Pacific Islander (non-specific)
   41 = Native Hawaiian
   42 = Guamanian or Chamorro
   43 = Samoan
   44 = Other Pacific Islander
50 = White
Per5 Ethnicity The affiliation of the perpetrator as Hispanic or Latino/a or non-Hispanic or Latino/a. Multiple ethnicity code values can be submitted for the perpetrator. No Multiple N 2 10 = Yes, Hispanic or Latino/a, or Spanish Origin (non-specific)
   11 = Mexican, Mexican American, Chicano/a
   12 = Puerto Rican
   13 = Cuban
   14 = Other Hispanic, Latino/a, or Spanish Origin
20 = No, not Hispanic or Latino/a, or Spanish Origin
Per6 Disabilities The perpetrator's physical, emotional, and mental health issues that result in limitation in activities and restrictions to fully participate at school, work, or in the community. Multiple disability code values can be submitted for the perpetrator. No Multiple N 1 1 = Ambulatory difficulty
2 = Cognitive difficulty
3 = Communication difficulty
4 = Hearing difficulty
5 = Independent living difficulty
6 = Self-care difficulty
7 = Vision difficulty
8 = Other
9 = None
Per7 Behavioral health screenings or diagnoses The results of assessments on the perpetrator, conducted by the APS agency. Multiple behavioral health code values can be submitted for the perpetrator. No Multiple N 2 1 = Alcohol use disorder
2 = Anxiety
3 = Bipolar disorder
4 = Dementia
5 = Depression
6 = Schizophrenia and other psychotic disorders
7 = Substance use disorder
8 = Traumatic brain injury
9 = Other
10 = None

Each client and perpetrator can have a designated relationship if data on one or more of the entity attributes is provided. A client and perpetrator have only one relationship entity within an investigation.

TABLE E.7. Client Perpetrator Relationship Entity
# Element Name Element Description Required Quantifier Type Size Code Values
CPR1 Cohabitation at start The indication if the perpetrator and client are cohabitating at the start of the investigation. No Single N 1 1 = Yes
2 = No
CPR2 Cohabitation at close The indication if the perpetrator and client are cohabitating at the time of case closure. No Single N 1 1 = Yes
2 = No
CPR3 Kinship relationship The indication if the perpetrator is related to the client by affinity (blood, adoption, marriage, etc.). No Single N 2 10 = Yes (non-specific)
   11 = Spouse
   12 = Domestic partner, including civil union
   13 = Parent
   14 = Child
   15 = Sibling
   16 = Grandparent
   17 = Grandchild
   18 = Other relative
20 = None
CPR4 Perpetrator association at start The indication if the perpetrator has a caregiving relationship to the client at the start of the investigation. No Single N 2 10 = Nursing home staff
20 = Residential care community staff
30 = Relative caregiver (non-specific)
   31 = Paid relative caregiver
   32 = Unpaid relative caregiver
40 = Non-relative caregiver (non-specific)
   41 = Paid non-relative caregiver
   42 = Unpaid non-relative caregiver
50 = Other relationship
60 = None
CPR5 Perpetrator association at close The indication whether the perpetrator has a caregiving relationship to the client at time of case closure. No Single N 1 10 = Nursing Home Staff
20 = Residential care community staff
30 = Relative caregiver (non-specific)
   31 = Paid relative caregiver
   32 = Unpaid relative caregiver
40 = Non-relative caregiver (non-specific)
   41 = Paid non-relative caregiver
   42 = Unpaid non-relative caregiver
50 = Other relationship
60 = None
CPR6 Perpetrator substitute decision maker at start Authorizations that the perpetrator has in relation to the client, and that are in effect, related to health, personal or financial decision making at the start of the investigation. Multiple substitute decision maker code values can be submitted for the client-perpetrator relationship. No Multiple N 2 10 = Health care proxy in effect
20 = Financial proxy in effect
30 = Guardianship or conservatorship (non-specific)
   31 = Guardianship or conservatorship of person
   32 = Guardianship or conservatorship of property
40 = Representative payee
50 = None
CPR7 Perpetrator substitute decision maker at close Authorizations that the perpetrator has in relation to the client, and that are in effect, related to health, personal or financial decision making at the time of case closure. Multiple substitute decision maker code values can be submitted for the client-perpetrator relationship. No Multiple N 2 10 = Health care proxy in effect
20 = Financial proxy in effect
30 = Guardianship or conservatorship (non-specific)
   31 = Guardianship or conservatorship of person
   32 = Guardianship or conservatorship of property
40 = Representative payee
50 = None
CPR8 Perpetrator legal remedy The legal remedies that were recommended or sought by the APS agency regarding the status of the perpetrator. Multiple legal remedy code values can be submitted for the client-perpetrator relationship. No Multiple N 1 1 = Recommendation of removal of guardianship rights
2 = Recommendation of restraining order on perpetrator regarding the client
3 = Recommendation of eviction of perpetrator
4 = Recommendation of restitution by perpetrator
5 = Recommendation of other legal remedy
6 = None

E.3. Proposed Key Indicators Component Data Specifications

The Key Indicators Component includes aggregated counts of key statistics related to an investigation, clients, and perpetrators. This component is designed to collect data that are most commonly computed by states on an annual basis. States may need to re-compute these statistics for the pilot test reporting period, which may be different from the standard reporting period used by the state. The Key Indicators Component is submitted only by those states that cannot submit the Case Component.

The Key Indicators Component collects duplicated counts of clients or perpetrators. If a client is involved in multiple investigations, the client is counted multiple times.

The data domains in the Key Indicators Component include the following:

  • Investigations--number completed.

  • Clients--number that received an investigation, that received interagency coordination, and by case closure reason.

  • Victims--clients found to be victims by one or more maltreatments, by demographics, disabilities, behavioral conditions, maltreatment type, and outcomes.

  • Perpetrators--by demographics, kinship relationship, association to victim, and legal remedies.

Some data elements have a tiered structure of code values. In such cases the specifications show the tiered structure by indenting the optional, more specific code values.

States can submit additional explanatory information on each item.

TABLE E.8. Investigations
Element Category/No. Element Name Element Description/Values Required Instructions
Investigations Completed        
K1 Investigations completed Number of investigations completed during the reporting period. Yes Investigation could have been received in previous reporting period, but must have been closed during current reporting period.
K1.1 Comment Provide additional information on the number of investigations completed during the reporting period. No  

 

TABLE E.9. Clients
Element Category/No. Element Name Element Description/Values Required Instructions
Clients Who Received Investigations       Count each client in each investigation. If a client was the subject of 2 investigations, count twice.
K2 Clients who received an investigation Number of clients involved in an investigation that was completed during the reporting period. Yes  
K2.1 Comment Provide additional information on how number of clients was determined. No  
Clients Who Received Interagency Coordination       Count each client once for each investigation in which he/she received 1 or more interagency coordination activities.
K3 Clients who received interagency coordination Number of clients in which an interagency coordination was part of the investigation. No  
K3.1 Comment Provide additional information on how number of clients who received interagency coordination was determined. No  
Clients by Case Closure Reason       This includes the number of clients by case closure reason whose case was closed for a specific reason.A client is counted for each case closure. There can only be 1 primary case closure reason per client per case.
K4.1   Investigation completed. No  
K4.2   Investigation completed and protective services case completed. No  
K4.3   Investigation unable to be completed (non-specific). No  
K4.3.1   Investigation unable to be completed due to death of client during investigation. No  
K4.3.2   Investigation unable to be completed due to refusal of client. No  
K4.4   Protective services case opened but not completed (non-specific). No  
K4.4.1   Protective services case closed due to death of client. No  
K4.4.2   Protective services case closed due to client decision to not continue. No  
K4.5   Other No  
K4.6   Unknown No  
K4.7 Comment Provide additional information on how number of clients by case closure reason was determined. No  

 

TABLE E.10. Victims
Element Category/No. Element Name Element Description/Values Required Instructions
Clients Found to be Victims       A victim is counted once for each investigation in which a maltreatment was substantiated, no matter how many maltreatments were substantiated.
K5 Clients found to be victims Number of victims in which at least 1 maltreatment disposition was substantiated per investigation. Yes  
K5.1 Comment Provide additional information on how number of victims was determined. No  
Victims by Age       The victim age is computed by subtracting the client's date of birth from the investigation start date. An estimated age can be used.The victim's age is counted once per each investigation in which the client was found to be a victim.Age could differ between investigations.
K6.1   18-29 years No  
K6.2   30-39 years No  
K6.3   40-49 years No  
K6.4   50-59 years No  
K6.5   60-69 years No  
K6.6   70-74 years No  
K6.7   75-84 years No  
K6.8   85 and older No  
K6.9   Unknown No  
K6.10 Comment Provide additional information on how age was computed.  No  
Victims by Race       This includes the number of victims by race with victims of multiple races counting as multiracial.
K7.1   American Indian or Alaska Native No  
K7.2   Asian No  
K7.3   Black or African American No  
K7.4   Native Hawaiian or Other Pacific Islander No  
K7.5   White No  
K7.6   Unknown No  
K7.7 Comment Provide additional information on how number of victims by race was determined. No  
Victims by Ethnicity       Count each victim once per investigation.
K8.1   Hispanic, Latino/a, or Spanish No  
K8.2   Not Hispanic, Latino/a, or Spanish No  
K8.3   Unknown No  
K8.4 Comment Provide additional information on how number of victims by ethnicity was determined. No  
Victims by Gender Identity       Count each victim once per investigation.
K9.1   Male No  
K9.2   Female No  
K9.3   Transgender No  
K9.4   Unknown No  
K9.5 Comment Provide additional information on how number of victims by gender was determined. No  
Victims Receiving Benefits       A victim is counted once per investigation in which he/she received 1 or more benefits.
K10 Victims who received 1 or more benefits Number of victims who received 1 or more benefits. No  
K10.1 Comment Provide additional information on how number of victims by receipt of benefits was determined. No  
Victims with Disabilities       A victim is counted once per investigation in which he/she was identified as having 1 or more disabilities.
K11 Victims with 1 or more disabilities Number of victims with 1 or more disabilities. No  
K11.1 Comment Provide additional information on how number of victims with 1 or more disabilities was determined. No  
Victims with Behavioral Conditions       A victim is counted once per investigation in which he/she was screened as having 1 or more behavioral conditions.
K12 Victims with 1 or more screened or diagnosed behavioral conditions Number of victims with 1 or more screened or diagnosed behavioral conditions. No  
K12.1 Comment Provide additional information on how number of victims with a behavioral condition was determined. No  
Victims by Maltreatment Type       A victim is counted each time he/she was substantiated as a victim of a specific maltreatment type.If a person was found to be a victim of neglect in 2 investigations, the count for neglect would be 2 for that victim.
K13.1   Abandonment No  
K13.2   Emotional abuse No  
K13.3   Exploitation (non-specific) No  
K13.3.1   Financial exploitation No  
K13.3.2   Other exploitation No  
K13.4   Neglect No  
K13.5   Physical abuse No  
K13.6   Sexual abuse No  
K13.7   Suspicious death No  
K13.8   Self-neglect No  
K13.9   Other No  
K13.10   Unknown No  
K13.11 Comment Provide additional information on how number of victims by maltreatment type was determined. No  
Victims with Guardian or Conservator       A victim is counted once per investigation in which he/she was screened as having 1 or more guardians or conservators.
K14 Victims with guardian or conservator at start of investigation Number of victims with guardian or conservator at start of investigation. No  
K14.1 Comment Provide additional information on how number of victims by 1 or more guardians or conservators was determined. No  
Victims Who Received or were Referred for Services       A victim is counted once per investigation in which he/she received or was referred for 1 or more services. If a client received multiple services and also was referred for multiple services in 1 investigation, he/she is counted only once.
K15 Victims who received services or were referred for services by APS Number of victims who received services or were referred for services by APS. No  
K15.1 Comment Provide additional information on how number of victims by services was determined. No  

 

TABLE E.11. Perpetrators
Element Category/No. Element Name Element Description/Values Required Instructions
Perpetrators by Age       The perpetrator age is computed by subtracting the person's date of birth from the investigation start date. An estimated age can be used.Count each perpetrator once per client per investigation.If a person was the perpetrator of 2 clients in 1 investigation, the person is counted twice.
K16.1   18-29 years No  
K16.2   30-39 years No  
K16.3   40-49 years No  
K16.4   50-59 years No  
K16.5   60-69 years No  
K16.6   70-74 years No  
K16.7   75-84 years No  
K16.8   85 and older No  
K16.9   Unknown No  
K16.10 Comment Provide additional information on how number of perpetrators by age was determined. No  
Perpetrators by Gender Identity        
K17.1   Male No  
K17.2   Female No  
K17.3   Transgender No  
K17.4   Unknown No  
K17.5 Comment Provide additional information on how number of perpetrators by gender was determined. No  
Perpetrators with Kinship Relationship       Count each perpetrator once per client per investigation.If a person was the perpetrator of 2 clients in 1 investigation and is related to 1 victim and not the second, the perpetrator is counted only once.
K18 Perpetrators who had a kinship relationship to the victim Number of perpetrators related to the victim by affinity (blood, adoption, marriage, etc.). No  
K18.1 Comment Provide additional information on how number of perpetrators by kinship relationship was determined. No  
Perpetrators with Association to Victim       Count each perpetrator once per client per investigation.If a person was the perpetrator of 2 clients in 1 investigation and has 1 or more caregiving relationships to 1 victim and not the second, the perpetrator is counted only once.
K19 Perpetrators who had 1 or more associations to victim Number of perpetrators with 1 or more caregiving relationships to the victim. No  
K19.1 Comment Provide additional information on how number of perpetrators by association to the victim was determined. No  
Perpetrators with Legal Remedies       Count each perpetrator once per client per investigation.If a person was the perpetrator of 2 clients in 1 investigation and had 1 or more legal remedies sought related to 1 victim and none with the second, the perpetrator is counted only once.
K20 Perpetrators for whom 1 or more legal remedies on behalf of the victim were recommended or sought Number of perpetrators for whom at least 1 legal remedy was recommended or sought. No  
K20.1 Comment Provide additional information on how number of perpetrators by legal remedy was determined. No  

E.4. Proposed Code Values and Definitions

The NAMRS Code Values and Definitions serve as a reference to the Agency Component Data Specifications, Case Component Data Specifications, and Key Indicators Data Specifications. It provides definitions of code values found in each data component.

TABLE E.12. Definitions of Code Values
Element Code Value Value Definition
Report Source      
  1 Substitute decision maker Includes health care proxy, financial proxy, guardian or conservator of person or property, representative payee.
  2 In-home caregiver Individuals who have the responsibility for the care of the client, providing in-home monitoring, management, supervision, etc.
  3 Nursing home staff Employees of a nursing home or skilled nursing home, which provide services for residents who require medical or nursing care, or rehabilitative services.
  4 Residential care community staff Employees of a residential care community including those providing room and board of at least 2 meals per day and help with personal care. These places include residential communities identified as assisted living residences, board and care homes, congregate care, enriched housing programs, personal care homes, homes serving primarily persons with disabilities, and homes serving primarily older adults.
  5 Education professional Employees of a public or private educational institution or program; includes teachers, teacher assistants, administrators, and others directly associated with the delivery of educational services.
  6 Financial professional Professionals managing finances or planning for future financial needs. Includes bank officials, financial planners, etc.
  7 Law enforcement, judicial, or legal professional People employed by a local, state, tribal, or federal justice agency. This includes police, courts, district attorney's office, probation or other community corrections agency, and correctional facilities.
  8 Medical or health professional People employed by a medical facility or practice. This includes physicians, physician assistants, nurses, emergency medical technicians, dentists, chiropractors, coroners, and dental assistants and technicians.
  9 Mental and behavioral health professional Persons who offer services for the purpose of improving an individual's mental health or to treat mental illness. Includes psychiatric nurses, clinical psychologists, etc.
  10 Social services professional Employees of public or private social services or social welfare agency, or other social worker or counselor who provides similar services including rehabilitative services.
  11 Other professional Persons who encountered the client as part of their occupation. Includes landlords, housing authorities, clergy, etc.
  12 Relative Persons related by blood, marriage, or adoption. Includes spouse, domestic partner, parent, foster parent, child, in-laws, etc.
  13 Neighbor, friend, other non-relative, other non-professional Other individual who is not a professional or person related to client by blood, marriage, or adoption. Includes friends, neighbors, etc.
  14 Self Person allegedly being maltreated.
  15 No role identified An individual who notifies an APS agency of suspected maltreatment without identifying his or her role.
Maltreatment Setting      
  10 Own residence or private residence of relative or caregiver Client's home or the client's relative or caregiver's home. Includes a house, apartment, mobile home or trailer, group of rooms, etc.
  20 Residential care community (non-specific) Provides room and board of at least 2 meals per day and help with personal care. Includes residential communities identified as assisted living facilities, board and care homes, congregate care, enriched housing programs, personal care homes, homes serving primarily persons with disabilities, and homes serving primarily older adults.
  21 Licensed residential care community Licensed, registered, listed, certified, or otherwise regulated by the state.
  22 Unlicensed residential care community Not licensed, registered, listed, certified, or otherwise regulated by the state.
  30 Nursing home (non-specific) Nursing home or skilled nursing home that provides services for residents who require medical or nursing care, or rehabilitative services.
  31 Licensed nursing home Licensed, registered, listed, certified, or otherwise regulated by the state.
  32 Unlicensed nursing home Not licensed, registered, listed, certified, or otherwise regulated by the state.
  40 Adult day services center (non-specific) Includes adult day care, adult day health services centers. Day care services for adults are those services or activities provided to adults who require care and supervision in a protective setting for a portion of a 24-hour day.
  41 Licensed adult day services center Licensed, registered, listed, certified, or otherwise regulated by the state.
  42 Unlicensed adult day services center Not licensed, registered, listed, certified, or otherwise regulated by the state.
  50 Place of business or other services Includes place of employment, sheltered workshops, hospitals, schools, banks, other offices, shelters, places of worship, etc.
  60 Other A setting not included in categorizations provided, including recreational areas and other public spaces.
Case Closure Reason      
  10 Investigation completed The case was closed after a finding was made on the allegation of maltreatment, the investigation was closed, and no ongoing protective services case was opened.
  20 Investigation completed and protective services case completed The case was closed after the investigation was completed, additional protective services were provided, and the protective services case was closed.
  30 Investigation unable to be completed (non-specific) A finding was not able to be made on the allegations of maltreatment for an unspecified reason and the case was closed.
  31 Investigation unable to be completed due to death of client during investigation The client died during the investigation, the investigation was terminated without a finding, and the case was closed.
  32 Investigation unable to be completed due to refusal of client The client refused to co-operate with the investigation worker, the investigation was terminated without a finding, and the case was closed.
  40 Protective services case opened but not completed (non-specific) The protective services case was terminated prematurely; reason not specified.
  41 Protective services case closed due to death of client The client died during the case and the case was closed.
  42 Protective services case closed due to client decision to not continue The client decided not to continue work with the protective services agency, and the case was closed.
  50 Other Case was closed for a reason not included in the categorizations provided.
Gender Identity      
  1 Male Male gender assigned at birth matches one's gender identity of male.
  2 Female Female gender assigned at birth matches one's gender identity of female.
  3 Transgender Gender identity, gender expression, and biological sex do not all align (e.g., man, masculine, and male).
Sexual Orientation      
  1 Straight Sexual or romantic attractions and behaviors focus exclusively or mainly on members of the other sex.
  2 Gay/lesbian Sexual or romantic attractions and behaviors focus exclusively or mainly on members of the same sex.
  3 Bisexual Sexual or romantic attractions and behaviors are directed at members of both sexes to a significant degree.
  4 Questioning Exploring one's own sexual orientation, investigating influences that may come from family, religious upbringing, and internal motivations.
  5 Other A sexual orientation not included in the categorizations provided.
Race      
  10 American Indian or Alaska Native Having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.
  20 Asian (non-specific) Having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
  21 Asian Indian Having origins of Asian Indian.
  22 Chinese Having origins of Chinese.
  23 Filipino Having origins of Filipino.
  24 Japanese Having origins of Japanese.
  25 Korean Having origins of Korean.
  26 Vietnamese Having origins of Vietnamese.
  27 Other Asian Having Asian origins other than those listed.
  30 Black or African American Having origins in any of the Black racial groups of Africa.
  40 Native Hawaiian or Other Pacific Islander (non-specific) Having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
  41 Native Hawaiian Having origins of Native Hawaiian.
  42 Guamanian or Chamorro Having origins of Guamanian or Chamorro.
  43 Samoan Having origins of Samoan.
  44 Other Pacific Islander Having Pacific Islander origins other than those listed.
  50 White Having origins in any of the original peoples of Europe, the Middle East, or North Africa.
Ethnicity      
  10 Yes, Hispanic or Latino/a, or Spanish origin (non-specific) Of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.
  11 Mexican, Mexican American, Chicano/a Having origins of Mexican, Mexican American, Chicano/a, regardless of race.
  12 Puerto Rican Having origins of Puerto Rican, regardless of race.
  13 Cuban Having origins of Cuban, regardless of race.
  14 Other Hispanic, Latino/a, or Spanish origin Having Hispanic, Latino/a, or Spanish origins other than those listed, regardless of race.
  20 No, not Hispanic or Latino/a, or Spanish origin Not of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.
Primary language      
  1 Arabic Primary language is Arabic.
  2 Chinese Primary language is Chinese.
  3 English Primary language is English.
  4 French Primary language is French.
  5 German Primary language is German.
  6 Korean Primary language is Korean.
  7 Russian Primary language is Russian.
  8 Spanish or Spanish Creole Primary language is Spanish or Spanish Creole.
  9 Tagalog Primary language is Tagalog.
  10 Vietnamese Primary language is Vietnamese.
  11 Sign language Primary language is sign language.
  12 Assistive technology Assistive, adaptive, and rehabilitative devices for people with disabilities.
  13 Other A language not included in the categorizations provided.
Marital status      
  1 Never married Refers to persons who report themselves as never married.
  2 Married Refers to persons who are currently legally married.
  3 Domestic partner, including civil union In a committed relationship with another adult, including both same sex and opposite-sex relationships.
  4 Divorced Refers to those whose marriages were legally dissolved.
  5 Separated A termination of cohabitation of spouses either by mutual agreement or, in the case of judicial separation, under the decree of a court.
  6 Widowed Refers to those whose marriages were terminated through death of their spouse and have not remarried.
  7 Other A marital status not included in the categorizations provided.
Schooling Level      
  1 Less than high school Did not receive a high school diploma or equivalent, such as GED.
  2 High school diploma or equivalent Received high school diploma or equivalent, such as GED.
  3 Associate's degree or Bachelor's degree Associate's degree: granted after a 2-year course of study, especially by a community or junior college. Bachelor's degree: earned for an undergraduate course of study that nominally requires 3-5 years of study, depending on institution and field of study.
  4 Advanced degree A post-graduate degree, such as a Master's degree or a Doctorate.
Employment Status      
  1 Employed Persons who are working or temporarily not working due to illness or other reasons.
  2 Unemployed Persons who are not employed and actively looking for work and available to start a job.
  3 Not in labor force Students, homemakers, retired workers, seasonal workers not looking for work, persons residing in institutions, persons doing only incidental unpaid family work.
  4 Other Employment status not included in the categorizations provided. Includes sheltered workshop participants.
Benefits      
  1 Medicaid The U.S. Medicaid program provides health coverage to persons including eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities.
  2 Medicare The U.S. Medicare program is a health insurance program for people age 65 and older, people under age 65 with certain disabilities, and people of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).
  3 Publicly-subsidized housing Government sponsored economic assistance aimed toward alleviating housing costs and expenses for people in need with low to moderate incomes. Includes direct housing subsidies, non-profit housing, rent supplements, and some forms of co-operative and private sector housing.
  4 SSDI SSDI provides benefits to disabled or blind persons who are "insured" by workers' contributions to the Social Security trust fund.
  5 Social Security retirement benefits Benefits received by retired workers who have paid into the Social Security system during their working years. Paid out on a monthly basis to retired workers and their surviving spouses.
  6 SSI SSI makes cash assistance payments to aged, blind, and disabled persons (including children) who have limited income and resources.
  7 TANF Temporary financial assistance through TANF program, which helps pregnant women and families with 1 or more dependent children pay for food, shelter, utilities, and expenses other than medical.
  8 Veterans' disabled benefits Disability compensation paid to Veterans because of injuries or diseases that were incurred in or aggravated during active duty, active duty training, or inactive duty training.
  9 Other Public benefit other than those specified in the categorizations provided.
Veteran Status      
  1 Veteran Person who has served in the U.S. Armed Forces or is otherwise classified as a Veteran by the U.S. Department of Veteran Affairs.
  2 Non-Veteran Person who has not served in the U.S. Armed Forces or is otherwise not classified as a Veteran by the U.S. Department of Veteran Affairs.
Disabilities      
  1 Ambulatory difficulty Having serious difficulty walking or climbing stairs.
  2 Cognitive difficulty Because of a physical, mental, or emotional problem, having difficulty remembering, concentrating, or making decisions.
  3 Communication difficulty Because of a physical, mental, or emotional problem, having difficulty with speech or language.
  4 Hearing difficulty Deaf or having serious difficulty hearing.
  5 Independent living difficulty Because of a physical, mental, or emotional problem, having difficulty doing errands alone such as visiting a doctor's office or shopping.
  6 Self-care difficulty Having difficulty bathing or dressing.
  7 Vision difficulty Blind or having serious difficulty seeing, even when wearing glasses.
  8 Other Disabilities other than those specified in the categorizations provided.
  9 None Assessed, but no disability determined.
ADL score      
  N Total score Indicates the client's total score on the Katz Index of Independence in ADLs. Permissible values are 0-6.
IADL score      
  N Total score Indicates the client's total score on the Lawton IADLs. Permissible values are 0-8.
Behavioral Health Screenings or Diagnoses      
  1 Alcohol use disorder The consumption of alcohol that impacts the ability to conduct daily activities including quantity and frequency of alcohol consumption as well as feelings of not being able to stop drinking, of remorse about drinking, not being able to remember due to drinking, needing a drink early in the day, etc. Screening tools, such as AUDIT or others, may be used. Diagnosis depends upon clinical training.
  2 Anxiety An affective disorder that makes it difficult to conduct daily activities including feelings of nervousness, not being able to stop or control worrying, worrying too much about different things, being restless so it is hard to sit still, becoming easily annoyed or irritable and feeling afraid. Screening tools, such as the GAD-7 or others, may be used. Diagnosis depends upon clinical training.
  3 Bipolar disorder A mood disorder characterized by alternating moods of mania and depression which can last for long periods of time and which may impact the ability to plan, schedule, and complete daily activities. Screening tools, such as the Mood Disorder Questionnaire or others, may be used. Diagnosis depends upon clinical training.
  4 Dementia The progressive decline of cognitive ability which impacts daily activities. Alzheimer's is 1 type of dementia. Dementia may be associated with memory loss, difficulty performing familiar tasks, problems with language, disorientation to time and place, poor or decreased judgment, problems with abstract thinking, loss of initiative and changes in personality, mood, or behavior. Screening tools, such as the Alzheimer's Association Ten Warning Signs or others, may be used. Diagnosis depends upon clinical training.
  5 Depression A loss of interest in daily activities including feelings of hopelessness, little energy, poor appetite or overeating, feeling bad about oneself, trouble concentrating and thoughts of suicide. Screening tools, such as the PHQ-9 or others, may be used. Diagnosis depends upon clinical training.
  6 Schizophrenia and other psychotic disorders An affective disorder characterized by having delusions and hallucinations that may impact daily activities by causing difficulties in interacting with others. Screening tools, such as STEP1 or others, may be used. Diagnosis depends upon clinical training.
  7 Substance use disorder The use of drugs, including over the counter drugs, prescriptions drugs, cannabis (marijuana, hashish), solvents, tranquilizers, barbiturates, cocaine, stimulants, hallucinogens or narcotics that impact the ability to conduct daily activities including the quantity and frequency of use of such drugs, and feelings of being unable to stop when wanting to, of guilt or being neglectful, of withdrawal symptoms or having blackouts or flashbacks due to drug usage. Screening tools, such as DAST 10 or others, may be used. Diagnosis depends upon clinical training.
  8 Traumatic brain injury The result of a violent blow or injury to the head. Physical damage to the brain may result in long-term complications that impact daily activities due to difficulties in sleeping, dizziness, vision, memory concentration, and mood changes. Screening tool is usually the result of self-reporting of the injury or symptoms. Diagnosis depends upon clinical training.
  9 Other Behavioral conditions not included in the value list of behavioral health that are due to brain damage, disease or unknown causes which impact the ability to conduct daily activities. Examples include amnesia, delirium, behavioral syndromes such as eating disorders, sleep disorders, and other personality disorders. Screening may use a range of tools. Diagnosis depends upon clinical training.
  10 None No behavioral health conditions have been determined.
Living Setting      
  10 Own residence or residence of relative or caregiver Client's home or the client's relative or caregiver's home. Includes a house, apartment, mobile home or trailer, group of rooms, etc.
  20 Residential care community (non-specific) Provides room and board of at least 2 meals per day and help with personal care. Includes residential communities identified as assisted living residences, board and care homes, congregate care, enriched housing programs, personal care homes, homes serving primarily persons with disabilities, and homes serving primarily older adults.
  21 Licensed residential care community Licensed, registered, listed, certified, or otherwise regulated by the state.
  22 Non-licensed residential care community Not licensed, registered, listed, certified, or otherwise regulated by the state.
  30 Nursing home (non-specific) Nursing home or skilled nursing home that provides services for residents who require medical or nursing care, or rehabilitative services.
  31 Licensed nursing home Licensed, registered, listed, certified, or otherwise regulated by the state.
  32 Non-licensed nursing home Not licensed, registered, listed, certified, or otherwise regulated by the state.
  40 Other A setting not included in categorizations provided, including shelters, correctional facilities, or no fixed residence.
Substitute Decision Makers      
  10 Health care proxy in effect The appointment of a person to communicate the clients' wishes as to medical treatment in terminal illness or injury situations and to communicate for them in the event they cannot communicate for themselves. A document also known as a durable power of attorney for health care, medical power of attorney, or appointment of a health care agent, allows an individual to appoint another person (a proxy or agent) to express the individual's wishes and make health care decisions for the individual if he or she cannot speak for him or herself. Depending on the state, these documents are known as living wills, medical directives, health care proxies, or advance health care directives.
  20 Financial proxy in effect Authorization, by a written document, that 1 individual may act in another's place as agent or attorney-in-fact with respect to some or all legal and financial matters. The scope of authority granted is specified in the document and may be limited by state statute. A power of attorney terminates on the death of the person granting the power (unless "coupled with an interest") and may terminate on the subsequent disability of the person granting the power (unless the power is "durable" under the instrument or state law).
  30 Guardianship or conservatorship (non-specific) A relationship created by state law in which a court determines that an adult individual lacks capacity to make decisions about self-care or property, and appoints another individual or entity as a conservator, or by a similar term, as a surrogate decision maker. It becomes the duty and power of that individual to make personal and/or property decisions for another.
  31 Guardianship or conservatorship of person If the individual has a critical need for someone to act on their behalf due to mental or physical disability.
  32 Guardianship or conservatorship of property (Or Estate): if the person is incapable of managing his or her own financial affairs.
  40 Representative payee An individual or organization appointed by SSA to receive Social Security and/or SSI benefits for someone who cannot manage or direct someone else to manage his or her money. The main responsibilities of a payee are to use the benefits to pay for the current and foreseeable needs of the beneficiary and properly save any benefits not needed to meet current needs. A payee must also keep records of expenses. When SSA requests a report, a payee must provide an accounting to SSA of how benefits were used or saved.
  50 None Perpetrator has no authorizations in relation to the client.
Services      
  1 Care/case management services Development and implementation of a service plan to mobilize the formal and informal resources and services identified in the assessment to meet the needs of the client. Includes the development and oversight of a plan to ensure the safety and well-being of the client; developing a safety plan with a person's support network; referring and arranging support services, etc.
  2 Caregiver support services Assistance to family and other informal caregivers to improve or sustain capacity for caring for the older adult or adult with disabilities. Includes counseling, support groups, training, respite, etc.
  3 Community day services Services or activities provided to adults who require care and supervision in a protective setting for a portion of a 24-hour day. Includes out of home supervision, health care, recreation, and/or independent living skills training offered in centers most commonly known as Adult Day, Adult Day Health, Senior Centers, and Disability Day Programs.
  4 Education, employment, and training services Services and activities to assist people in achieving or maintaining economic self-support. Includes training programs, job coaches, supported employment, senior employment programs, and public school individualized education plans.
  5 Emergency assistance and material aid services Providing, arranging for, or facilitating the provision of medical, social service, economic, emergency, or support services. Includes financial assistance or referral for food, clothing, energy/utility assistance, and home repairs/modifications; environmental clean-up of client's home including but not limited to removal of trash, extermination services and cleaning; relocation assistance; urgent medical expenses not typically covered by insurance (eye glasses, dentures); emergency housing/shelter; etc.
  6 Financial planning services Services or activities to assist in managing finances or planning for future financial needs. Includes meeting with bank officials, financial planning, estate planning, money management, and retirement income planning.
  7 Housing and relocation services Services or activities designed to assist in the obtaining of suitable or safe housing and living arrangements. Includes tenant counseling; helping to identify and correct substandard housing conditions; making moving arrangements and minor renovations to personal residence; and relocating to institutional care or facility care.
  8 In-home assistance services Services or activities provided to clients to achieve or maintain self-sufficiency. Includes homemakers and home health aides; visiting and telephone reassurance; chore maintenance; personal care services, etc.
  9 Legal services Legal counsel and representation provided by an attorney to address civil matters such as housing issues and advance care planning, and criminal matters.
  10 Medical and dental services Services and activities designed to assist individuals and families to attain and maintain a favorable condition of health; includes evaluations.
  11 Medical rehabilitation services Services and activities for persons with developmental or physical disabilities, or persons with visual or auditory impairments, are services or activities to maximize the potential of persons with disabilities, help alleviate the effects of physical, mental or emotional disabilities, and to enable these persons to live in the least restrictive environment possible. Includes training in mobility, communication skills, the use of special aids and appliances, self-sufficiency skills for people with disabilities, occupational therapy, physical therapy, speech and language pathology, early intervention and other therapies that help people learn the skills they need to live, learn, work and play in their communities.
  12 Mental health services Services and activities, including commitment, assessment, and evaluations, for people with behavioral health conditions characterized by dysregulation of mood, thought, and/or behavior, as recognized by the DSM-5. Includes services and activities that apply therapeutic processes to personal, family, situational, or occupational problems in order to bring about a positive resolution of the problem or improved individual or family functioning or circumstances.
  13 Nutrition Services and activities, including appeals and applications, to provide food to a client lacking recommended daily nutritional requirements and/or ADLs limitations. Includes home delivered meals, nutritional counseling, congregate meals, senior farmers' market program, etc.
  14 Public assistance benefits Services and assistance to provide a safety net for disadvantaged individuals who lack the resources to provide basic necessities for themselves and their families. Includes such programs as financial aid (TANF), nutrition (SNAP), energy assistance (LIHEAP), health care (Medicaid), etc.
  15 Substance use services Services and activities primarily designed to deter, reduce, or eliminate substance abuse or chemical dependence. Includes a comprehensive range of personal and family counseling methods, methadone treatment for opiate abusers, or detoxification treatment for alcohol abusers. Services and activities may be provided in alternative living arrangements such as institutional settings and community-based halfway houses.
  16 Transportation Services or activities that provide or arrange for the travel, including travel costs, of individuals in order to access services, or obtain medical care or employment.
  17 Victim services Services and activities provided to, or on behalf of, victims at any stage of the criminal justice process, including post sentencing services and support. Includes programs supporting victims of domestic violence, sexual assault, abuse of older women, violence against women, and general crimes which are being handled by the police or prosecutors' offices.
  18 Other services Client receives services and activities not included in the categorizations provided.
  19 None Client receives or was referred to no services.
Interagency Coordination      
  1 Law enforcement or prosecutorial offices Agencies responsible for enforcing laws and maintaining public order and safety, including government units staffed by police, sheriffs, district attorneys, etc.
  2 Protection and Advocacy or CAP Agencies under the Protection and Advocacy for Persons with Mental Illness Act that have the authority to provide legal representation and other advocacy services, under all federal and state laws, to all people with disabilities, along with those agencies that provide information and assistance to individuals seeking or receiving vocational rehabilitation services under the Rehabilitation Act.
  3 State licensing agency Government units responsible for the licensing of facilities and agencies serving older adults and adults with disabilities.
  4 State MFCU State agencies that investigate and prosecute Medicaid fraud as well as patient abuse and neglect in health care facilities.
  5 Long-Term Care Ombudsman Program State program that addresses complaints and advocates for people in the long-term care system.
  6 Other Client was referred to a type of agency not included in the categorizations provided.
  7 None The client was not referred to any other agencies.
Maltreatment Type      
  10 Abandonment The desertion of a person by an individual who has assumed responsibility for providing care for that person, or by an individual with physical custody of another person.
  20 Emotional abuse The infliction of anguish, pain, or distress through verbal or non-verbal acts. This includes but is not limited to verbal assaults, insults, threats, intimidation, humiliation, and harassment.
  30 Exploitation (non-specific) The illegal or improper use of an individual or of an individual's funds, property, or assets for another's profit or advantage.
  31 Financial exploitation The illegal or improper use of an individual's funds, property, or assets for another person's profit or advantage.
  32 Other exploitation The illegal or improper use of an individual for another person's profit or advantage, including exploitation of person, servitude, etc.
  40 Neglect The failure of a caregiver or fiduciary to provide the goods or services necessary to maintain the health or safety of a person. Includes acts of omission and of commission; includes willful deprivation, etc.
  50 Physical abuse The use of force or violence resulting in bodily injury, physical pain, or impairment. Excludes sexual abuse.
  60 Sexual abuse Non-consensual sexual contact of any kind, including sexual contact with any person incapable of giving consent.
  70 Suspicious death An unexpected fatality or 1 in which circumstances or cause are medically or legally unexplained.
  80 Self-neglect A person's inability, due to physical or mental impairment or diminished capacity, to perform essential self-care tasks including obtaining essential food, clothing, shelter, and medical care; obtaining goods and services necessary to maintain physical health, mental health, or general safety; or managing one's own financial affairs. Includes hoarding.
  90 Other A type of maltreatment not included in the categorizations provided.
Maltreatment Disposition      
  1 Substantiated The finding that the allegation of maltreatment is supported under state law and policy.
  2 Inconclusive The finding that there is insufficient information to either support or not support the allegation of maltreatment, but there is a reason to suspect maltreatment.
  3 Unsubstantiated The finding that the allegation of maltreatment is not supported under state law and policy.
  4 Other Disposition not included in categorizations provided. Includes inappropriate allegations that were investigated.
Kinship Relationship      
  10 Yes (non-specific) Kinship relationship exists.
  11 Spouse Partner in a marriage.
  12 Domestic partner, including civil union Adults in a committed relationship with another adult, including both same sex and opposite-sex relationships.
  13 Parent The birth mother or father, adoptive mother or father, or step-mother or step-father of the client.
  14 Child Biological son or daughter, adoptive son or daughter, or step-son or step-daughter.
  15 Sibling Children or offspring have 1 or both parents in common; a brother or sister (by blood, adoption, marriage).
  16 Grandparent Parent of one's father or mother; a grandmother or grandfather (by blood, adoption, marriage).
  17 Grandchild A child of one's son or daughter (by blood, adoption, marriage).
  18 Other relative Another family member, including in-laws and kinship foster parents.
  20 None No kinship relationship, includes non-kinship foster parents.
Perpetrator Association      
  10 Nursing home staff An employee of a nursing home, including a skilled nursing home. Nursing homes primarily provide skilled nursing, rehabilitation, and long-term care.
  20 Residential care community staff An employee of a residential care community including those providing room and board of at least 2 meals per day and help with personal care. These places include residential communities identified as assisted living residences, board and care homes, congregate care, enriched housing programs, personal care homes, homes serving primarily persons with disabilities, and homes serving primarily older adults.
  30 Relative caregiver (non-specific) An individual related to the client by blood, adoption, marriage, etc. who has the responsibility for the care of the client, providing in-home monitoring, management, supervision, etc.
  31 Paid relative caregiver An individual related to the client by blood, adoption, marriage, etc. who has the responsibility for the care of the client, and receives payment for providing in-home monitoring, management, supervision, etc.
  32 Unpaid relative caregiver An individual related to the client by blood, adoption, marriage, etc. who has the responsibility for the care of the client, and does not receive payment for providing in-home monitoring, management, supervision, etc.
  40 Non-relative caregiver (non-specific) An individual not related to the client by blood, adoption, marriage, etc. who has the responsibility for the care of the client, providing in-home monitoring, management, supervision, etc.
  41 Paid non-relative caregiver An individual not related to the client by blood, adoption, marriage, etc. who has the responsibility for the care of the client, and receives payment for providing in-home monitoring, management, supervision, etc.
  42 Unpaid non-relative caregiver An individual not related to the client by blood, adoption, marriage, etc. who has the responsibility for the care of the client, and does not receive payment for providing in-home monitoring, management, supervision, etc.
  50 Other relationship Another trusted person providing care, not included in the categorizations provided.
  60 None The perpetrator has no caregiving association to the client.
Substitute Decision Makers      
  10 Health care proxy in effect The appointment of a person to communicate the clients' wishes as to medical treatment in terminal illness or injury situations and to communicate for them in the event they cannot communicate for themselves. A document also known as a durable power of attorney for health care, medical power of attorney, or appointment of a health care agent, allows an individual to appoint another person (a proxy or agent) to express the individual's wishes and make health care decisions for the individual if he or she cannot speak for him or herself. Depending on the state, these documents are known as living wills, medical directives, health care proxies, or advance health care directives.
  20 Financial proxy in effect Authorization, by a written document, that 1 individual may act in another's place as agent or attorney-in-fact with respect to some or all legal and financial matters. The scope of authority granted is specified in the document and may be limited by state statute. A power of attorney terminates on the death of the person granting the power (unless "coupled with an interest") and may terminate on the subsequent disability of the person granting the power (unless the power is "durable" under the instrument or state law).
  30 Guardianship or conservatorship (non-specific) A relationship created by state law in which a court determines that an adult individual lacks capacity to make decisions about self-care or property, and appoints another individual or entity as a conservator, or by a similar term, as a surrogate decision maker. It becomes the duty and power of that individual to make personal and/or property decisions for another.
  31 Guardianship or conservatorship of person If the individual has a critical need for someone to act on their behalf due to mental or physical disability.
  32 Guardianship or conservatorship of property (Or Estate): if the person is incapable of managing his or her own financial affairs.
  40 Representative payee An individual or organization appointed by SSA to receive Social Security and/or SSI benefits for someone who cannot manage or direct someone else to manage his or her money. The main responsibilities of a payee are to use the benefits to pay for the current and foreseeable needs of the beneficiary and properly save any benefits not needed to meet current needs. A payee must also keep records of expenses. When SSA requests a report, a payee must provide an accounting to SSA of how benefits were used or saved.
  50 None The perpetrator has no authorization in relation to the client.
Legal Remedies      
  1 Recommendation of removal of guardianship rights The termination of a relationship, created by state law and determined by a court, in which an individual or entity acts as a conservator, or by a similar term, as a surrogate decision maker for another person who lacks capacity to make decisions about self-care or property. The individual no longer has duty and power to make personal and/or property decisions for the other.
  2 Recommendation of restraining order on perpetrator regarding the client A court order issued to prohibit an individual from carrying out a particular action, especially approaching or contacting a specified person.
  3 Recommendation of eviction of perpetrator The act of expelling someone, usually a tenant, from a property.
  4 Recommendation of restitution by perpetrator Compensation paid to client by perpetrator for the losses or injuries incurred as a result of a criminal offense.
  5 Recommendation of other legal remedy Legal remedies not included in the categorizations provided.
  6 None No legal remedies were sought on behalf of the client.

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