In 2008, the New Hampshire Department of Health and Human Services Bureau of Elderly and Adult Services (BEAS) and the National Council on Crime and Delinquency (NCCD), with funding provided by the National Institute of Justice (NIJ), collaborated to construct an actuarial risk assessment to classify BEAS clients by their likelihood of elder maltreatment and/or self-neglect in the future. Studies in adult and juvenile corrections and child welfare have demonstrated that active service intervention with high risk clients can reduce criminal recidivism and the recurrence of child maltreatment (Wagner, Hull, & Luttrell, 1995; Eisenberg & Markley, 1987; Baird, Heinz, & Bemus, 1981). The purpose of this research was to examine a large set of individual and referral characteristics, determine their relationship to subsequent elder self-neglect and/or maltreatment, and develop an actuarial risk assessment for BEAS workers to complete at the end of an investigation to inform their case decisions. BEAS and NCCD pursued development of an actuarial risk assessment with the goal of reducing subsequent maltreatment of elderly and vulnerable adults who have been involved in an incident of self-neglect or maltreatment by another person (i.e., abuse, exploitation, or neglect). The actuarial risk assessment described in this report provides BEAS workers with a method to more accurately identify high risk clients and therefore more effectively target service interventions in an effort to protect their most vulnerable clients.