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NCI: A Growing Commitment

NCI: A Growing Commitment. Five Years of Performance Measurement. 127 th Annual AAMR Meeting, Chicago, IL Val Bradley  Human Services Research Institute. Project Beginnings. NASDDDS and HSRI collaboration Launched in 1997 Seven field test states (plus steering committee)

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NCI: A Growing Commitment

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  1. NCI: A Growing Commitment Five Years of Performance Measurement 127th Annual AAMR Meeting, Chicago, IL Val Bradley  Human Services Research Institute

  2. Project Beginnings • NASDDDS and HSRI collaboration • Launched in 1997 • Seven field test states (plus steering committee) • ~60 candidate performance indicators • Development of data collection instruments

  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 21 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. Participating States Phase V WA WA VT VT ME MT MA MA SD WY WY RI RI PA CT CT PA IA IA NE NE IN IN UT IL WV WV DE DE KY KY NC NC AZ AZ OK OK SC Orange Orange County County AL HI HI

  6. 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

  7. 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

  8. 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

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

  10. 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

  11. Frequency of health visits (5 state average) FY00 FY01 FY02 100% 80% 60% 40% Physical exam within the last year GYN exam within the last year Dental check-up within the last six months

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

  13. CM helps get what person needs… (by state) FY00 FY01 FY02 95% 85% 75% 65% CT KY NC PA RI

  14. 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)

  15. 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

  16. Consumer Survey • 7917 surveys completed • 67% of people interviewed were able to respond to Section I

  17. Consumer Survey Phase IVLevel of MR No Label Unknown 3.7% 2.5% Profound 14.9% Mild Severe 38.2% 14.5% Moderate 26.3%

  18. Nursing Facility 0.9 Other 3.7 Apartment Program 4.3 Specialized Facility 8.5 Foster Care or Host Home 9.9 Independent Home or Apt 18.6 Group Home 24.7 Parent or Relative Home 29.1 Consumer Survey Phase IVPlace of Residence 0.0 20.0 40.0

  19. Areas of Strength • 92% report they have enough privacy • over 90% report support staff treat them with respect • 94% satisfied with home • 96% satisfied with work/day program • High community participation (69% to 96%)

  20. Areas for Improvement • 77% report service coordinators get them what they need, compared with 90% in FY2001 • 48% reported “sometimes” or “always” lonely • only 52% of women had a GYN exam in the past year and 7% have never had one

  21. How Are NCI States Using Their Data? • Pennsylvania – Independent monitoring and quality improvement • South Carolina – Core component of external monitoring • Wyoming – Annual reports, CMS review • Massachusetts – Strategic planning • South Dakota – Provider profiles • North Carolina – Health indicators

  22. Rhode Island has formed a Quality Management Group • Arizona advertises reports in their newsletter; sends reports to all families who participated; and shares their information with the Legislature and Governor. • Alabama will use the consumer survey as part of Wyatt settlement

  23. Kentucky included NCI in its ten-year plan. They are expanding their focus on team interviewing techniques to enhance consumer and family participation. • Washington used the NCI data collection protocols to revise their incident reporting and mortality data system • In Indiana, the information from the surveys has been posted on the web site of the Bureau of Quality Improvement Services and notice has gone out to all providers

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

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