Transcript Document

NCI
N
Cational
ore
C
ore
Indicators
IPndicators
roject
Use In Connecticut
An Overview of How Connecticut
Is Using the NCI
CONSUMER SURVEY
FAMILY SUPPORT SURVEY
CHILDREN’S SURVEY
State of Connecticut
Prepared by the DMR
STRATEGIC LEADERSHIP CENTER
l
Department of Mental Retardation
July 2003
NCI
CONTENTS
1. Overview of the CIP
2. Connecticut’s Participation
3. Examples of Data Analysis and
Communication
4. Special Issues and Use of NCI in
Quality Review System
Purpose of the Core
Indicators Project
 Develop, field-test, & disseminate a nationally recognized
set of PERFORMANCE INDICATORS that can be
used in any state to gauge the effectiveness of
specialized, publicly-funded DD services and supports.
 Establish corresponding NORMS & STANDARDS as a
basis for assessing and interpreting the indicators.
 Design a CONSUMER SURVEY instrument and
protocol for assessing system performance through the
eyes of individuals who receive and rely on state DD
agency funded services and supports.
 Identify PRACTICAL APPROACHES for collecting,
tracking and reporting the performance data in an
economical and efficient manner.
National Coordinators
The National Core Indicators is
managed and coordinated by
NASDDDS
National Association of State
Directors of Developmental
Disabilities Systems
HSRI
Human Services Research Institute
Information about the NCI, including updates
can be found at:
www.hsri.org
CURRENT Participating
States
Connecticut was one of six charter states
in Phase I of the Core Indicators Project
22
Participating Sates
Orange County
N.C.I. is GROWING year by year.
About ½ of the country is now participating!
• Alabama
• Arizona
• Connecticut
• Delaware
• Hawaii
• Illinois
• Indiana
• Iowa
• Kentucky
• Massachusetts
• (Minnesota)
• Montana
• Nebraska
• North Carolina
• Oklahoma
• Pennsylvania
• Rhode Island
• South Carolina
• South Dakota
• Utah
• Vermont
• Washington
• West Virginia
• Wyoming
Plus: Orange County, CA
(as of September 2002)
Why is Connecticut
Participating?

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
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?
To establish benchmarks for the department’s
performance objectives.
To measure the effectiveness of services and supports
provided over time.
To provide a mechanism for collecting information to be used in
the new Quality Review process
To inform the department’s strategic planning process.
To measure Connecticut's performance nationally and
against states with similar demographics.
To influence the process and assure it is consistent with
Connecticut’s values and service delivery system.
6 MAJOR INFORMATION
COLLECTION ACTIVITIES
METHOD
WHO
Description
Consumer Survey
Random sample of 400+
adults receiving CM plus
one other DMR service
Cross-section of living arrangements.
Personal face-to-face interview conducted
during the late Fall and Winter months.
Family Support
Survey
Random sample of 1000
families – receive CM plus
one other DMR service
Mailed survey sent to families of adults
receiving DMR support who live at home.
Survey usually completed in the Spring.
Family/Guardian
Survey
Random sample of 1000
families – receive
residential services
Mailed survey sent to families of adults
receiving residential support outside of the
home. Completed in Spring.
Children/Family
Survey
Random sample of 1000
Mailed survey sent to families of children
families of children - receive
receiving DMR support who live at home.
CM plus one other DMR service Excludes B3. Completed in Spring.
System Level
Data
DMR System
Demographic and fiscal data. Includes
mortality, injury and unusual incident rates.
Financial/Medicaid data to be coordinated
with Braddock research.
Provider Survey
Private Providers under
contract with DMR
Mailed survey that collects information
about private provider staff retention and
board membership
CONSUMER SURVEY
MAJOR CATEGORIES COVERED IN THE INTERVIEWS
1.
2.
3.
4.
5.
HEALTH
SERVICES
INCLUSION
CHOICE
RESPECT &
RIGHTS
6. PROTECTION &
RIGHTS
7. CASE
MANAGEMENT
8. ACCESS
9. SAFETY
10.SATISFACTION
11.RELATIONSHIPS
12.ACCEPTABILITY
13.STABILITY
EXAMPLE OF DATA
Our display of data includes the following information:
CATEGORY
QUESTIONS:
Specific Questions on the Survey
CONCERN: Area or issue
under assessment
HIGH
Rank of 1, 2 or 3
MIDDLE Rank of 4, 5, 6 or 7
LOW
80.0%for each item
Highest Score
Rank of 8, 9 or 10
CT’s Score
for each item
CT’s Rank out of
Total States
Reporting Data
Note: LOWER number is a
Better (Higher) Rank. 1 is
Best and 10 is worst.
Percent Agreement
Connecticut Ranks
60.0%
Lowest Score
for each item
40.0%
20.0%
1/10
2/10
1/10
3/10
5/10
0.0%
Supp
Empl
Grp Empl
Shel
Empl*
Non-Voc
Day
Comm
Partic
High
35.0%
30.9%
68.3%
48.7%
71.6%
Low
11.2%
3.2%
25.2%
11.5%
37.5%
CT
35.0%
29.8%
25.2%
25.7%
55.2%
ALL PERCENTAGES REFLECT POSITIVE ORIENTATION
CONCERN: People use
integrated community services
and participate in everyday
community activities.
Connecticut Ranks
HIGH
Entertainment
MIDDLE Shopping, Errands
1.
Do you go Shopping?
2.
Do you go out on errands and appointments?
3.
Do you go out to exercise or play sports?
4.
Do you go out for entertainment?
5.
Do you always eat at home-or do you sometimes go out to
eat? (Percent who go out to eat).
6.
Do you go to religious services or events?
100.0%
Percent Agreement
Example:
INCLUSION
QUESTIONS:
80.0%
60.0%
6/10
LOW
6/10
8/10
2/10
Entertain Go out to Religious
m ent
Eat
Serv
40.0%
Exercise, Eat out, Religious
Services
8/10
9/10
Shopping
Errands
Exercise
High
100.0%
100.0%
84.2%
91.2%
94.1%
71.2%
Low
88.3%
92.8%
67.5%
71.4%
86.6%
42.9%
CT
92.8%
95.0%
69.5%
86.8%
88.5%
50.6%
ALL PERCENTAGES REFLECT POSITIVE ORIENTATION
Example:
PROTECTION
& RIGHTS
CONCERN: People receive the
same respect and protection as
others in the community.
QUESTIONS:
1. Does anyone ever open your mail without permission? [% no and
some opened]
2. Does anyone come into your home without asking? [% no}
3. Does anyone come into your bedroom without asking? [% no]
4. Are you allowed to use the phone when you want to? [% yes]
5. When you have guests over, can you be alone with them or does
someone have to be with you? [% yes or not always]
6. Can you be by yourself as much as you want to? [% yes]
Connecticut Ranks
HIGH
MIDDLE Enter home w/o asking, Enter
bedroom, Use phone, Be left
alone when want to
LOW
Open mail, Be alone with
guests
Percent Agreement
100.0%
90.0%
80.0%
70.0%
60.0%
8/10
5/10
5/10
5/10
8/10
5/10
50.0%
Open
Mail
Come
into
Home
Come
into
Bedroo
Use
Phone
Alone
with
Guests
Be by
Self
High
94.2%
94.2%
91.5%
100.0%
97.6%
97.1%
Low
58.7%
67.6%
70.3%
94.7%
86.2%
78.4%
CT
82.3%
82.6%
81.4%
96.7%
86.9%
89.6%
ALL PERCENTAGES REFLECT POSITIVE ORIENTATION
Since Connecticut has completed the
survey for 3 years now, can also look at
CHANGES OVER
TIME
COMPARISON OF Trends
ON THE NCI CONSUMER SURVEY
Example:
CHANGE: Health &
Services
2000 CIP RESULTS
Slight decline in all 3 areas. Still rank
in highest grouping for OB/GYN and
Dental Exams.
H
90%
1999 CIP RESULTS
Rank
H 123
M 4567
L 8 9 10
HEALTH
Comparison of 1999 & 2000
CIP Consumer Survey for CT
100%
KEY FOR READING GRAPHS
M
80%
H
H
70%
H
H
60%
50%
Recent Physical
Exam
Recent OB/GYN Exam Recent Dental Exam
1999
91.7%
67.3%
71.8%
2000
87.4%
57.7%
67.8%
H
100%
90%
SERVICES
Comparison of 1999 & 2000
CIP Consumer Survey for CT
H
L
80%
H
70%
60%
M
H
H
50%
M
40%
30%
20%
H
10%
M
M
M
0%
Case
Mngmnt
Asst Tech
Clinical
Transp
Respite
HCBS
1999
99.4%
16.9%
64.8%
92.3%
21.1%
62.9%
2000
95.5%
17.8%
61.6%
80.4%
23.0%
57.5%
Slight decline in Case Management and
Clinical Services. Larger decline in
Transportation. Slight improvement in
Assistive Technology and Respite.
The same type of analyses are also
completed for the Family Surveys
• FAMILY SUPPORT SURVEY
• FAMILY/GUARDIAN SURVEY
• FAMILY/CHILDREN SURVEY
Example:
FAMILY
SUPPORT
INFORMATION,
CHOICE & LANGUAGE
QUESTIONS:
1.
Do you receive information about services and supports that
are available to your family?
If you receive information, is it easy to understand?
Do you choose the agencies or providers that work with your
family?
Do you choose the support staff that work with your family?
Are frequent changes in support staff a problem for your
family?
If English is not your first language, are there staff who speak
with you in your preferred language?
2.
3.
4.
5.
6.
80.0%
HIGH
70.0%
MIDDLE Receive Information, Easy to
Understand, Changes in Staff, Staff Speak
Language
LOW Choose Providers, Choose Staff
Percent Agreement
Connecticut Ranks
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
7/11
5/11
Receive
Info Easy to
Information Understand
9/11
9/11
Choose
Providers
Choose
Staff
5/11
6.5/11
Changes in Staff Speak
Staff are
Preferred
Problem
Language
High
59.2%
72.7%
67.7%
46.8%
28.4%
69.2%
Low
30.5%
57.4%
31.4%
10.3%
18.6%
29.2%
CT
41.2%
64.8%
51.0%
19.7%
22.4%
50.0%
ALL PERCENTAGES REFLECT POSITIVE ORIENTATION
Example:
INFORMATION
& PLANNING
CONCERN: People receive
information that is
understandable and useful in
the planning process.
QUESTIONS:
1. Do you receive information about services and supports that are
available to your family?
2. If you receive information, is it easy to understand?
3. Do you receive information about the status of your child’s
development?
4. If yes, is this information easy to understand?
5. Do you get enough information to help you participate in planning
services for your child?
6. If your family has a service plan, did you help develop the plan?
Connecticut Ranks
MIDDLE Receive information about
services, Receive information
about development,
Information re: development
easy to understand
LOW
80%
Percent Agreement
HIGH
90%
70%
60%
50%
40%
30%
20%
Enough information to plan,
Got help developing the plan,
Information is easy to
understand
3/6
Receive
Inform ation
5/6
4/6
Info is Easy
Status of
To
Developm en
Understand
t
4/6
Understand
Dev Info
5/6
5/6
Enough Info Help Develop
to Plan
Plan
High
62.1
73.6
55.5
69.5
64.0
82.5
Low
32.1
51.1
26.3
60.3
30.6
54.7
CT
41.8
66.8
30.5
65.3
35.8
59.7
ALL PERCENTAGES REFLECT POSITIVE ORIENTATION
SPECIAL CONCERNS &
FUTURE PLANS
To date, small sample sizes, random selection, and
timeliness of the national analyses have presented
some special challenges for using the NCI as part of a
DMR QA/QI process.
NEW DIRECTION:
The NCI will become an integral component of the new
enhanced QI process within DMR. The Consumer Survey
– with supplemental items – will form the basis for
evaluating personal outcomes. Survey data from families
and guardians will be integrated into a consolidated QI
report for assessing the full DMR system, regions, and
service providers.
New Quality Review in CT
to include NCI
STEP 1 – DATA ANALYSIS
• Regional/Provider Data Analysis (including NCI
survey satisfaction data)
• Provider Organizational Self-Assessment
STEP 2 – SAFETY CHECKLIST PROBES
• Emergency Planning
• Environmental Safety – Facility/Home
STEP 3 – PERSONAL OUTCOMES
REVIEW
STEP 4 - SUMMARIZE FINDINGS
STEP 5 - PROVIDE FEEDBACK
STEP 6 - IMPROVEMENT PLANNING
Individual/Regional/State Levels
FOCUS AREAS
• Planning & Personal
Achievement
• Relationships &
Community Connections
• Choice & Control
• Rights, Respect & Dignity
• Safety
• Health & Wellness
COMPONENTS
• NCI
Consumer
Survey
• Supplementary interview
with the Person
• Interview with Support
Provider
• Observations
• Record Review
More Information on the
National Core Indicators can be found at
www.hsri.org
Information regarding Connecticut’s
participation can be obtained by contacting
The Connecticut State
Department of Mental Retardation
[email protected]
[email protected]