[Federal Register Volume 88, Number 32 (Thursday, February 16, 2023)]
[Notices]
[Pages 10118-10121]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-03266]



[[Page 10118]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Community Living


Agency Information Collection Activities; Proposed Collection; 
Comment Request; National Adult Maltreatment Reporting System; OMB# 
0985-0054

AGENCY: Administration for Community Living (ACL), HHS.

ACTION: Notice.

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SUMMARY: The Administration for Community Living is announcing that the 
proposed collection of information listed above has been submitted to 
the Office of Management and Budget (OMB) for review and clearance as 
required under the Paperwork Reduction Act of 1995. This 30-Day notice 
collects comments on the information collection requirements related to 
an extension without change and solicits comments on the information 
collection requirements related to the on the information collection 
requirements relating to the National Adult Maltreatment Reporting 
System (NAMRS).

DATES: Submit written comments on the collection of information by 
March 20, 2023.

ADDRESSES: Submit written comments on the collection of information by:
    (a) Email to: [email protected], Attn: OMB Desk Officer 
for ACL;
    (b) Fax to 202.395.5806, Attn: OMB Desk Officer for ACL; or
    (c) By mail to the Office of Information and Regulatory Affairs, 
OMB, New Executive Office Bldg., 725 17th St. NW, Rm. 10235, 
Washington, DC 20503, Attn: OMB Desk Officer for ACL.

FOR FURTHER INFORMATION CONTACT: Stephanie Whittier Eliason, 
Administration for Community Living, Washington, DC 20201, 202-795-7467 
at [email protected].

SUPPLEMENTARY INFORMATION: In compliance with 44 U.S.C. 3507, ACL has 
submitted the following proposed collection of information to OMB for 
review and clearance. The National Adult Maltreatment Reporting System 
authorized under the Elder Justice Act of 2009, which amends Title XX 
of the Social Security Act [42.U.S.C. 13976 et seq.], requires that the 
Secretary of the U.S. Department of Health and Human Services 
``collects and disseminates data annually relating to the abuse, 
exploitation, and neglect of elders in coordination with the Department 
of Justice'' [Sec. 2041(a)(1)(B)] and ``conducts research related to 
the provision of adult protective services'' [Sec. 2041(a)(1)(D)].
    The Elder Justice Coordinating Council (EJCC) recommended 
development of ``a national adult protective services (APS) system 
based upon standardized data collection and a core set of service 
provision standards and best practices.''
    NAMRS is a voluntary system that has been annually collecting since 
FY 2016 both summary and de-identified case-level data on APS 
investigations submitted by states, and the data does not include any 
personally identifiable information. NAMRS has and will continue to 
consist of three components:
    (1) Descriptive data on state agency and practices from all states 
through the ``Agency Component,'' and
    (2) Case-level, non-identifiable data on persons who receive an 
investigation by APS in response to an allegation of abuse, neglect, or 
exploitation through ``Case Component'', or
    (3) For states that are unable to submit a case-level file through 
the ``Case Component,'' a ``Key Indicators Component'' will be 
available for them to submit data on a smaller set of core items.
    ACL will continue to provide technical assistance to assist in the 
preparation of data submissions by state APS agencies and APS agencies 
in the District of Columbia, Puerto Rico, Guam, Northern Mariana 
Islands, Virgin Islands, and American Samoa (states, hereafter).
    To address gathering necessary and relevant demographic information 
to assess diversity and equity in evidence-based program scaling, 
participation, and advances; \1\ the proposed revisions were compared 
to the Updates on Terminology of Sexual Orientation and Gender Identity 
(SOGI) Survey Measures from the Federal Committee on Statistical 
Methodology that came out after publication of the 60-day notice. 
Several of the changes originally proposed were consistent with SOGI, 
and ACL made additional changes in the 30-day posting to further align 
with the SOGI recommendations. The proposed collection is consistent 
with the SOGI recommendations conceptually and specifically aligns for 
most of the code values for sexual orientation and gender identity. A 
60-day Federal Register notice published on Monday, May 23, 2022, in 
Federal Register Vol. 87, No. 99, page 31243.
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    \1\ Executive Order on Advancing Racial Equity and Support for 
Underserved Communities Through the Federal Government and the 
Executive Order on Advancing Equality for Lesbian, Gay, Bisexual, 
Transgender, Queer, and Intersex Individuals.

[[Page 10119]]



                                        Response to Public Comment Table
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                                                                                       Draft response/notes for
            Name                      Position                    Comment                     discussion
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Shelly Fiebich..............  Director, Bureau of      Case Component 5 & 6: ACL     ACL will align the proposed
                               Adult Services           should enhance the quality    NAMRS code values with the
                               Division of Child        and clarify of information    recent federal Sexual
                               Welfare and Community    collected by adding           Orientation and Gender
                               Services New York        ``declined to answer'' as a   Identity (SOGI)
                               State.                   selection for gender          recommendations.
                                                        identity and sexual          The SOGI recommendations
                                                        orientation.                  use ``prefer not to
                                                       Key Indicator 9: ACL should    answer'' instead of ``X''.
                                                        enhance the quality and       If NYS uses ``X'' as a
                                                        clarity of information        value in its case
                                                        collected by providing an     management system, then it
                                                        option for individuals to     should map ``X'' to the
                                                        mark their gender as ``X''    appropriate category in
                                                        in fields that collect this   NAMRS.
                                                        information. People should   Based on the SOGI
                                                        also have the option to       recommendations, we will
                                                        mark decline to answer in     also add the following
                                                        fields collecting             code values: [If
                                                        information about gender      respondent is AIAN:] Two-
                                                        identity and sexual           Spirit and ``Prefer not to
                                                        orientation. Including        answer''.
                                                        these additional options
                                                        leads to more accurate
                                                        information and affirming
                                                        reporting by individuals.
                                                        It's consistent with the
                                                        Biden administration`s
                                                        efforts to authorize
                                                        individuals to select ``X''
                                                        as their gender marker on
                                                        U.S. passports and other
                                                        federal documents, and in
                                                        alignment with New York
                                                        State`s commitment to
                                                        provide individuals the
                                                        option of marking agenda or
                                                        sex as ``X'' on state
                                                        forms, including a driver
                                                        license, learner permit or
                                                        non-driver identification
                                                        card.
Shelly Fiebich..............  Director, Bureau of      Agency Component 7.1.1: The   No change. FTEs is not a
                               Adult Services           collection of estimated       required data element and
                               Division of Child        FTEs of staff and             if it is considered too
                               Welfare and Community    supervisors devoted only to   costly to collect and
                               Services New York        APS work when staff are       reported by any state they
                               State.                   shared among other programs   do not have to do so. The
                                                        is not feasible in NY         FTE data is important to
                                                        because this information is   understanding the APS
                                                        not collected or tracked at   system workforce and is
                                                        the state level and all       used in various technical
                                                        reporting systems are for     assistance and evaluation
                                                        separate entities. Further,   activities.
                                                        the collection of this
                                                        information does not appear
                                                        necessary for the proper
                                                        performance of ACL
                                                        functions.
                                                       Regarding ACL`s estimated
                                                        program burden, NYSOCFS
                                                        respectfully submits that
                                                        the agency requirement to
                                                        collect FTEs would require
                                                        an annual estimated
                                                        statewide burden of over
                                                        370 hours for the local
                                                        Department of Social
                                                        Services to collect and
                                                        submit that information to
                                                        New York State OCFS.
Shelly Fiebich..............  Director, Bureau of      Agency 10: ACL should         No change. Based on
                               Adult Services           clarify the definition of     responses in NAMRS, almost
                               Division of Child        ``priority level'' to         all states have priority
                               Welfare and Community    provide clarity of            levels and are generally
                               Services New York        information collected.        using this terminology.
                               State.                                                 Each state defines a set
                                                                                      of priority responses
                                                                                      based on its policy. ACL
                                                                                      received no other comments
                                                                                      indicating a need to
                                                                                      define the term. States
                                                                                      are encouraged to use the
                                                                                      comment field to provide
                                                                                      state-specific clarifying
                                                                                      information and a link to
                                                                                      the specific policy.
Shelly Fiebich..............  Director, Bureau of      Agency 21: ACL should         No change. One of the
                               Adult Services           clarify the definition of     defining characteristics
                               Division of Child        and purpose for the request   of the APS system is how
                               Welfare and Community    of collecting the source of   it addresses issues such
                               Services New York        ethical principles and how    as self-determination, so
                               State.                   it relates to the proper      it is important to
                                                        performance of ACL's          understand the source of
                                                        functions.                    each program's ethical
                                                                                      principles. ACL oversees
                                                                                      implementation of the
                                                                                      Elder Justice Act and its
                                                                                      funding, so it is
                                                                                      important to understand
                                                                                      how programs respect
                                                                                      individual rights
                                                                                      consistent with the EJA.
Jay Colbert.................  Data Manager The Polis   I've been looking at your     Agree. Prior to this data
                               Center at IUPUI School   NAMRS reports. If I read      renewal, ACL has not
                               of Informatics and       them right, it's all          shared state specific data
                               Computing.               national data. Is there any   without state permission.
                                                        place to get state-level      Notice was provided in the
                                                        data yet?                     60-day FRN and is
                                                       Please include the need for    addressed again in the
                                                        state-level data reports in   Supporting Statement for
                                                        your NAMRS public comment     this 30 FRN of ACL's
                                                        tracking document.            intent to begin sharing
                                                                                      state-specific data.

[[Page 10120]]

 
Dorian Long.................  Connecticut APS........  Specific ages of perpetrator  No change. The NAMRS age
                                                        may present as a challenge.   ranges were selected to
                                                        Connecticut proposes that     match census categories
                                                        age ranges are added as an    and not the proposed
                                                        option be used to support     categories.
                                                        more opportunities for
                                                        completion of data element.
                                                        Please see below:
                                                       17 and younger..............
                                                       18 to 34 years..............
                                                       35 to 59 years..............
                                                       60 to 74 years..............
                                                       75 years and over...........
Maria Greene................  Consultant.............  While conducting a            No change. While this would
                                                        comprehensive review of       provide useful
                                                        NAMRS, please consider        information, it would add
                                                        adding requirements for a     burden to state responses.
                                                        unique identification         ACL would not want to make
                                                        number for the worker and     this change in the final
                                                        supervisor involved in a      posting without discussion
                                                        case. This is done in the     with stakeholders. ACL
                                                        child maltreatment            will consider its
                                                        reporting system and is       inclusion in the future.
                                                        useful data for analyzing
                                                        staff workload and
                                                        caseloads.
Maria Greene................  Consultant.............  I propose the addition of     Agree. Understanding the
                                                        one question to the NAMRS     case information systems
                                                        Agency Component. In the      used by states will help
                                                        Agency Profile, ask a         ACL provide technical
                                                        question about the            assistance support to APS
                                                        Information System that the   programs in submitting
                                                        state uses to collect data.   data and is important for
                                                                                      understanding and
                                                                                      modernizing the NAMRS
                                                                                      system. The data
                                                                                      collection will include an
                                                                                      additional question in the
                                                                                      Agency Component as
                                                                                      follows:
                                                                                     Select which of the
                                                                                      following describes the
                                                                                      automated system your
                                                                                      state uses to document
                                                                                      case information:
                                                                                      Statewide system
                                                                                      developed by the state
                                                                                      Statewide system
                                                                                      developed by an outside
                                                                                      vendor. (Please use the
                                                                                      comment field to identify
                                                                                      the vendor, the name of
                                                                                      the system, and when you
                                                                                      obtained it.)
                                                                                      Separate systems
                                                                                      for different geographic
                                                                                      areas of the state
                                                                                      Do not have an
                                                                                      automated system.
                                                                                     Comment: If your state has
                                                                                      multiple APS programs,
                                                                                      please provide response to
                                                                                      the above question for
                                                                                      each program. If your
                                                                                      state used a statewide
                                                                                      system developed by an
                                                                                      outside vendor, please use
                                                                                      the comment field to
                                                                                      identify the vendor, the
                                                                                      name of the system, and
                                                                                      when you obtained it.
Mary McGurran...............  Adult Protection         Case Component, Case          No change. While ACL agrees
                               Supervisor [verbar]      Component, Key Indicators;    person-centered
                               Aging and Adult          Use social service            terminology should be used
                               Services, Minnesota      terminology for consistency   whenever possible, the
                               Department of Human      with the ACL definition of    original terms were
                               Services.                adult protective services     selected carefully and
                                                        (APS) as a social service     deliberatively after
                                                        program to maximize client    consultation with state
                                                        safety and independence and   APS programs. ACL would
                                                        for consistency with ACL      not want to make this kind
                                                        values for person-centered    of change in the final
                                                        planning processes.           posting without further
                                                        Suggestions:                  consultation with the
                                                        Investigation:        states. The terminology in
                                                        Assessment..                  NAMRS needs to be
                                                        Victim: Client,       consistent with state law
                                                        Adult, Adult vulnerable to    in across the states and
                                                        maltreatment, Older adult     ACL is not aware to what
                                                        or Adult with a disability..  extent the proposed terms
                                                        Perpetrator: Person   are currently used.
                                                        responsible, or person        Because of the importance
                                                        alleged responsible for       of the issue, the Adult
                                                        maltreatment..                Protective Services
                                                                                      Technical Assistance
                                                                                      Resource Center recently
                                                                                      hosted a discussion of APS
                                                                                      terminology to start such
                                                                                      a dialogue. ACL will
                                                                                      consider changes in
                                                                                      terminology in future
                                                                                      changes.
Mary McGurran...............  Adult Protection         Agency Component Data;        No change in the selections
                               Supervisor [verbar]      Enhance selections on APS     but include ``mental
                               Aging and Adult          use of involuntary            health commitment'' in the
                               Services, Minnesota      interventions.                examples. The current
                               Department of Human     26. Involuntary                selections list does not
                               Services.                Intervention: Add             include specific
                                                        Guardianship and Mental       interventions and
                                                        Health Commitment.            inclusion of them would be
                                                                                      changing the nature of the
                                                                                      data element.

[[Page 10121]]

 
Mary McGurran...............  Adult Protection         Case Component Data; Enhance  No change. The suggested
                               Supervisor [verbar]      data selections to include    code ``Support System
                               Aging and Adult          a service approach            Engaged'' falls under the
                               Services, Minnesota      effective in preventing       definition of current code
                               Department of Human      maltreatment..                value ``Care Case
                               Services.               CLT26: Add code for Support    Management'' and should be
                                                        System Engaged.               mapped and reported to it.
Mary McGurran...............  Adult Protection         NAMRS Annual Report; Enhance  No change. ACL agrees in
                               Supervisor [verbar]      data report to improve        principle with this
                               Aging and Adult          utility for APS program       recommendation. However,
                               Services, Minnesota      evaluation and equity.        it impacts the reporting
                               Department of Human     Add: race/ethnicity; gender    and use of the current
                               Services.                identify; sexual              data and does not require
                                                        orientation; disability       a change in the proposed
                                                        type for clients referred     data elements. The
                                                        and accepted for APS and      suggested demographic
                                                        for voluntary and             categories are all
                                                        involuntary services and      currently part of the data
                                                        interventions.                collection except that
                                                       Add state population rate      referred and accepted data
                                                        for: reports; reports         is collected in the Agency
                                                        accepted; investigation/      Component and is not
                                                        assessment; services;         client specific. After
                                                        involuntary intervention;     this data renewal, as
                                                        client location at APS        noted in the postings, ACL
                                                        start and close.              will begin sharing state
                                                                                      specific data so this
                                                                                      recommendation is timely.
                                                                                      ACL will consider how to
                                                                                      incorporate state
                                                                                      population rates in any
                                                                                      future reports that
                                                                                      include state-specific
                                                                                      data.
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    Estimated Program Burden: ACL estimates the burden associated with 
this collection of information as follows: 59 APS programs will respond 
every year to the Agency Component, with 50 states providing Case 
Component data and 9 states providing Key Indicator data. The total 
annual burden is estimated to be 5,416 hours. The estimates are based 
on the amount of time States have previously reported in completing the 
data collection instruments; continued increase in the number of states 
reporting on Case Component and Key Indicator Component data; one-time 
costs for the changes in the data elements for this renewal; and 
assumption of modest incremental efficiencies by States in reporting 
data to NAMRS every year, including, most significantly, minimal need 
to recode to extract data after the initial year.

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                                                     Number of     Responses per     Hours per     Annual burden
       Respondent/data collection activity          respondents     respondent       response        estimate
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Agency One-Time.................................              59               1            6.20          365.80
Key Indicator One-Time..........................               9               1           30.00          270.00
Case Component One-Time.........................              50               1              83        4,150.00
                                                 ---------------------------------------------------------------
    One-Time Subtotal...........................  ..............  ..............          119.20        4,785.80
Agency Component................................              59               1               4          236.00
Key Indicators Component........................               9               1              20          180.00
Case Component..................................              50               1             100        5,000.00
                                                 ---------------------------------------------------------------
    Recurring Sub-total.........................  ..............  ..............             124        5,416.00
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    Dated: February 11, 2023.
Alison Barkoff,
Acting Administrator and Assistant Secretary for Aging.
[FR Doc. 2023-03266 Filed 2-15-23; 8:45 am]
BILLING CODE 4154-01-P