National Core Indicators

Sarah Taub

Human Services Research Institute

Participating NCI States

NDAK

HI

WA

OR

ID

MT

WY

ND

SD

NE

CAUT

NV

AZ

CO

NM

KS

OK

TX

MN

IA

WI

IL IN

MO

AR

MI

OH

KY

TN

MS

LA

AL GA

FL

SC

NC

VAWV

PA

NY

MEVTNH

MD

DC

DE

NJCT

MA

RI

PR

Orange County

What has NCI Accomplished?

Nationally recognized set of performance and outcome indicators for developmental disabilities service systems

Reliable data collection methods & tools

Baseline and trend data at the state & national level

Benchmarks of performance

NCI Structure

Currently 22 states plus Orange County in Phase V (FY2003)HSRI provides technical assistance under subcontract to NASDDDSSubcommittees address specific issuesMeet with full steering committee annually

What are the data sources?

Consumer SurveyFamily Survey Adult Family Survey (at home, 18+) Family Guardian Survey (out-of-home) Children Family Survey (at home, <18)

Provider Survey Staff Stability Board Representation

System Data Incidents Mortality

Where does NCI fit in?

NCI is one core component of state Quality Management systemsMain process for measuring consumer and family satisfactionIntegration of information is the key (many QA systems are fragmented)Increasing interest in using NCI to measure provider performance

Pennsylvania and NCI

Founding member – original field test state

Served on Technical Advisory Committee for development and testing of surveys

Co-Chair of Steering Committee

Represented on Subcommittees

One of core states in 5-year longitudinal analysis of Consumer Survey data

Trend Analysis

Beginning to look at trends over past three yearsFive states collected Consumer Survey data annually for three years Connecticut Kentucky North Carolina Pennsylvania Rhode Island

CM helps get what person needs…

90% 88%83% 83%

78% 78%

0%10%20%30%40%50%60%70%80%90%

100%

5 state average All state average

FY00 FY01 FY02

92.8%

93.6%

94.4%

92%

93%

94%

95%

FY00 FY01 FY02

Person is satisfied with home…

95.6 95.6

82.5

94.8

82.8

93.4

75%

80%

85%

90%

95%

100%

FY00 FY01 FY02

% feel safe at home % feel safe in neighborhood

People report feeling safe…

0%

20%

40%

60%FY00 FY01 FY02

Roommate Home staff Case manager

Person had input in choosing…

Staff Stability

Rising trend in staff turnover over past three years

Turnover is higher in residential settings vs. day settings

In FY2002, turnover rates ranged from 33% (Hawaii) to 54% (Indiana)

Direct Contact Staff Turnover

35.2%

41.7%

52.9%

35.8%

45.1%

31.2%

0%

10%

20%

30%

40%

50%

60%

1999 2000 2001

residential day

How is NCI data used?

Setting goals and strategic planning within state agenciesSetting priorities for quality improvement, incorporate into Quality Management plansBudget requests to Governor and legislatorsHelps to shape data reporting systems (e.g., incidents, mortality)Stakeholder advisory committees (Quality Councils) being formed to review results and make recommendations to state agencies

How are results disseminated?

Many states compile reports of state results vs. national results and post on websitesSome states beginning to look at provider by provider results, share with providersSummaries shared with families who filled out surveys (AZ)Simplified version of Consumer Survey report for self-advocates (VT)

What have other states added?

Family survey questions: Fair hearing/complaint process (RCOC) Service coordinator turnover (RCOC) Early start (0-3) survey (RCOC) Support needs and future planning (CT)

Consumer survey questions: Assistive technology (DE) Case management supplement (WA, HI, MA, IN, WY) Person-centered planning, additional health data (HI) Modified for people with chronic mental illness (IA) Health status supplement (NC)

Other state project activities

Kentucky Training videos Team interviewing pilot General population comparison study

Washington State DD Council 3-year project asking stakeholders

to make recommendations to state based on NCI reports

What areas are states interested in expanding or developing?

Additional health and safety indicatorsQuestions about self-directed servicesInvolvement of self-advocatesRisk managementProvider capacityProvider performance measuresModifications to adapt survey for people with different communication stylesDirect support worker salaries, benefits, credentialingCrisis services

What comes next?

Expansion is in the works… Two states (MT, ND) plus District of Columbia

are proposing NCI participation in grant applications (Real Choices, Family Support)

California considering participation after one-year ramp up period

What comes next?

Major overhaul of NCI website – expected to be completed by last week of JulyWill include a section with links to other states’ websites, reports, presentations, etc.Development of Core Health Status Supplement, pending CDC grant awardSurvey revisions will be completed by beginning of calendar year

For More Information

Final Reports for Phase IV (FY2002) are available on HSRI’s website: www.hsri.org

Contact: staub@hsri.org