National Core Indicators

1. National Core Indicators Sarah Taub Human Services Research Institute

2. NH ME WA VT AK ND MT MA MN OR NY WI SD RI ID MI CT WY PA NJ IA OH DE NE NV IN IL DC WV UT VA MD CO CA MO KS KY NC HI TN SC OK AR AZ NM Orange County MS GA AL LA TX FL PR Participating NCI States ND

3. 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

4. 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

5. 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, <18) • Provider Survey • Staff Stability • Board Representation • System Data • Incidents • Mortality

6. 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

7. 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

8. 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

9. 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

10. Person is satisfied with home… 95% 94.4% 94% 93.6% 92.8% 93% 92% FY00 FY01 FY02

11. 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

12. Person had input in choosing… FY00 FY01 FY02 60% 40% 20% 0% Roommate Home staff Case manager

13. 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)

14. Direct Contact Staff Turnover 52.9% 60% 50% 41.7% 35.2% 40% 45.1% 30% 35.8% 31.2% 20% 10% 0% 1999 2000 2001 day residential

15. 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

16. 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)

17. 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)

18. 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

19. 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

20. 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

21. 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

22. For More Information • Final Reports for Phase IV (FY2002) are available on HSRI’s website: www.hsri.org • Contact: staub@hsri.org