National Core Indicators

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National Core Indicators

• Sarah Taub
• Human Services Research Institute

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Participating NCI States
ND
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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

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NCI Structure

• Currently 22 states plus Orange County in Phase
  V (FY2003)
• HSRI provides technical assistance under
  subcontract to NASDDDS
• Subcommittees address specific issues
• Meet with full steering committee annually

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What are the data sources?

• Consumer Survey
• Family Survey
• Adult Family Survey (at home, 18)
• Family Guardian Survey (out-of-home)
• Children Family Survey (at home, lt18)
• Provider Survey
• Staff Stability
• Board Representation
• System Data
• Incidents
• Mortality

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Where does NCI fit in?

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

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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

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Trend Analysis

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

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CM helps get what person needs
100
90
88
83
83
90
78
78
80
70
60
50
40
30
20
10
0
5 state average
All state average
FY00
FY01
FY02
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Person is satisfied with home
95
94.4
94
93.6
92.8
93
92
FY00
FY01
FY02
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People report feeling safe
100
95.6
95.6
94.8
95
93.4
90
85
82.8
82.5
80
75
FY00
FY01
FY02
feel safe at home
feel safe in neighborhood
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Person had input in choosing
FY00
FY01
FY02
60
40
20
0
Roommate
Home staff
Case manager
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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)

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Direct Contact Staff Turnover
52.9
60
41.7
50
35.2
40
45.1
30
35.8
31.2
20
10
0
1999
2000
2001
day
residential
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How is NCI data used?

• Setting goals and strategic planning within state
  agencies
• Setting priorities for quality improvement,
  incorporate into Quality Management plans
• Budget requests to Governor and legislators
• Helps 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

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How are results disseminated?

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

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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)

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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

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What areas are states interested in expanding or
developing?

• Additional health and safety indicators
• Questions about self-directed services
• Involvement of self-advocates
• Risk management
• Provider capacity
• Provider performance measures
• Modifications to adapt survey for people with
  different communication styles
• Direct support worker salaries, benefits,
  credentialing
• Crisis services

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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

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What comes next?

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

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For More Information

• Final Reports for Phase IV (FY2002) are available
  on HSRIs website www.hsri.org
• Contact staub_at_hsri.org