NAMRS Agency Component

OMB Control Number 0985-0054
Expiration Date: 02/29/2020

AGENCY COMPONENT DATA
PRA Public Burden Statement:
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of
information unless such collection displays a valid OMB control number (OMB 0985-0054). Public
reporting burden for this collection of information is estimated to average per response as follows for each
component of the collection: Agency Component – 7 hours; Key Indicator Component – 32 hours; Case
Component – 125 hours. These estimates include the time for gathering and maintaining the data needed and
completing and reviewing the collection of information. The obligation to respond to this collection is
voluntary. Send comments regarding the burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to the Administration for Community Living,
U.S. Department of Health and Human Services, 330 C Street, SW, Washington, DC 20201-0008, Attention:
Stephanie Whittier Eliason, at 202.795.7467 and [email protected]

The Agency Component data will be entered directly onto an online form on the NAMRS website. Once entered,
the state can update information annually. The reporting period is the federal fiscal year (October–September).
Table 1–General Information
Element No.

Element Name

Element Description

Required

Field Entry Format

Agency 1.1
Agency 1.2
Agency 2.1
Agency 2.2

Agency Name 1
Agency Name 2
Street 1
Street 2

Yes
No
Yes
No

Text - 100 characters
Text - 100 characters
Text - 100 characters
Text - 100 characters

Agency 2.3
Agency 2.4

City
State

Department or agency name
Branch or unit name
First line street address of agency physical address
Second line street address of agency physical
address
City of agency physical address
State of agency physical address

Yes
Yes

Agency 2.5
Agency 3.1
Agency 3.2

ZIP
Street 1
Street 2

Yes
Yes
No

Agency 3.3
Agency 3.4

City
State

ZIP of agency physical address
First line street address of agency mailing address
Second line street address of agency physical
address
City of agency physical address
State of agency physical address

Text - 100 characters
Select from list of
states/territories
##### or #####-####
Text - 100 characters
Text - 100 characters

Agency 3.5
ZIP
ZIP of agency physical address
Multiple contact names and associated information can be entered.
Agency4.1
Name
Contact name
Agency 4.2
Title
Contact title
Agency 4.3
E-mail
Contact e-mail
Agency 4.4
Phone
Contact telephone
Agency 4.5
Contact’s role in
Contact’s role in agency
agency
Selection List:
• Case manager
• Data coordinator/manager
• Field coordinator
• Intake manager/supervisor
• Investigator
• IT/data specialist
• Manager/director/supervisor
• Policy specialist
• Regional supervisor
• Social worker
• Training coordinator/specialist

Yes
Yes
Yes

Text - 100 characters
Select from list of
states/territories
##### or #####-####

Yes
Yes
Yes
Yes
No

Text - 100 characters
Text - 100 characters
E-mail address format
Text - 50 characters
Select one from list

A-1

Table 2–Agency Profile
Element No.

Element Name

Element Description

Required

Field Entry Format

Agency 5

Data Sources

The sources of information used to submit data this
year to NAMRS.

No

Select one from list

No

Text – 5,000 characters

No

Text – 5,000 characters

No

Text – 5,000 characters

No

Numeric – 10 integers

No

Numeric – 10 integers

No

Text – 5,000 characters

No

Select one from list

No

Text – 5,000 characters

No

Numeric – 10 integers

No

Numeric – 10 integers

No

Text – 5,000 characters

No

Numeric – 3 integers

Agency 5.1

Comment

Agency 6

Population Served

Agency 6.1

Population served:
setting

Agency 7

Agency 7.2

Investigator FTEs
filled
Supervisor FTEs
filled
Comment

Agency 8

Intake

Agency 7.1

Agency 8.1

Comment

Agency 9

Agency 9.2

Reports Accepted for
Investigation
Reports Not
Accepted, or
Resolved Through
I&R/I&RA
Comment

Agency 10

Response Time

Agency 9.1

Selection List:
• APS agency only
• APS and other agencies
Provide names of other agencies that provided data.
Provide the citation in state statute or regulation, or
agency policy, regarding the population your APS
agency is mandated to serve.
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.
Number of filled APS FTEs responsible for the hotline
and/or conducting investigations.
Number of filled APS FTEs responsible for
supervision.
Provide additional information as to whether the
numbers in 7 and 7.1 were the annual total or total for
a given day.
Centralized or localized intake of APS reports.
Selection List:
• Centralized at a statewide hotline or call in
number
• Combination of both statewide and local hotlines
or call in numbers
• Local at county or regional hotlines or call in
numbers
• Other
Provide additional information on your state’s
definition of intake.
Number of reports accepted for investigation during
the reporting period.
Number of reports that were either not accepted by
APS for investigation, or were resolved through
Information & Referral (I&R)/Information & Referral
Assistance (I&RA).
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.
The length of time (hours) 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.

A-2

Element No.

Element Name

Element Description

Required

Field Entry Format

Agency 10.1

Comment

No

Text – 5,000 characters

Agency 11

Investigation
Completion Time

No

Numeric – 3 integers

Agency 11.1

Comment

No

Text – 5,000 characters

Agency 12

Types of
Maltreatment

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.
The length of time (days) from investigation start to
investigation completion, based on the standard set
by policy or practice.
Provide additional information on the definition of start
of investigation and completion of an investigation.
Indicate which types of maltreatment are investigated
by APS.

No

Select one or more from list

No

Text – 5,000 characters

No

Select one from list

No

Text – 5,000 characters

No

Select one from list

No

Text – 5,000 characters

Agency 12.1

Comment

Agency 13

Standard of Evidence

Agency 13.1

Comment

Agency14

Assessment Tools

Agency 14.1

Comment

Selection List:
• Abandonment
• Emotional abuse
• Exploitation (non-specific)
• Financial exploitation
• Other exploitation
• Neglect
• Physical abuse
• Sexual abuse
• Suspicious death
• Self-neglect
• Other
Provide citation or URL in state law, regulations, or
program guidance for maltreatment types investigated
by APS.
Standard used for substantiating an allegation of
maltreatment.
Selection List:
• Clear and convincing
• Credible, reasonable, or probable cause
• Different standards based on type of perpetrator
• No state standard
• Preponderance
• Other
Provide citation or URL of state law, regulations, or
program guidance. Include discussion of definitions of
perpetrator if relevant.
Indicate whether APS personnel use standard
assessment tools throughout the state, such as client
safety, at risk factors, or behavioral conditions.
Selection List:
• No, assessment instruments are determined by
each county or left to the worker’s discretion
• Yes, use common instrument or tool throughout
the state
Provide the name and reference (i.e., URL) for each
standardized tool that is used.

A-3

Element No.

Element Name

Element Description

Required

Field Entry Format

Agency 15

Service Gaps

Indicate which services are not available or
accessible in the state.

No

Select one or more from list

No

Text – 5,000 characters

No

Text – 5,000 characters

Agency 15.1

Comment

Agency 16

Perpetrators

Selection List:
• Care/Case Management Services
• Caregiver Support Services
• Community Day Services
• Education, Employment, and Training Services
• Emergency Assistance and Material Aid Services
• Financial Planning Services
• Housing and Relocation Services
• In-home Assistance Services
• Legal Services
• Medical and Dental Services
• Medical Rehabilitation Services
• Mental Health Services
• Nutrition
• Public Assistance Benefits
• Substance Use Services
• Transportation
• Victim Services
• Other Services
Provide additional information on how gaps in
services were identified, if possible.
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.

A-4