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National Core Indicators Performance at the State System Level Val Bradley and Sarah Taub HSRI John Sloyer Pennsylvania OMR February 19, 2003 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 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 NASDDDS Subcommittees address specific issues Meet with full steering committee annually Funded primarily through state participation fees Participating States Phase V WA ME VT MT MA WY SD RI PA IA NE UT IL IN WV DE KY NC AZ OK SC Orange County AL HI CT What are the Core Indicators? Consumer Outcomes: Employment Community Inclusion Choice and Decision-making Relationships System Performance Service Coordination Utilization, Access Financial Level of Effort What are the Core Indicators? Health, Welfare, and Rights Safety Health, Medications, Wellness (new) Respect/Rights Staff Stability and Competence Staff Stability Staff Competence (new) What are the Core Indicators? Family Indicators Information and Planning Choice & Control Access & Support Delivery Community Connections Family Involvement Satisfaction Family Outcomes What are the data sources? Consumer Survey Family Survey Provider Survey Adult Family Survey (at home, 18+) Family Guardian Survey (out-of-home) Children Family Survey (at home, <18) Staff Stability Board Representation System Data Incidents Mortality National Core Indicators Selected Results Consumer Survey 7917 surveys completed 67% of people interviewed were able to respond to Section I Level of MR 65% mild-moderate 29% severe-profound 6% no label or unknown Place of Residence Nursing Facility 0.9 Other 3.7 Apartment Program 4.3 Specialized Facility Foster Care or Host Home Independent Home or Apt 8.5 9.9 18.6 Group Home 24.7 Parent or Relative Home 0.0 29.1 20.0 40.0 Areas of Strength 92% of all respondents report that they have enough privacy over 90% of respondents report that support staff treat them with respect 94% satisfied with home 96% satisfied with work/day program Participation in community activities is generally high, ranging from 69% to 96% Areas for Improvement 77% of all respondents report that service coordinators get them what they need, compared with 90% in FY2001 48% of respondents reported “sometimes” or “always” feeling lonely only 52% of women had a GYN exam in the past year and 7% have never had one Adult Family Survey Surveys of families with an adult family member living at home 5567 total surveys (37% response rate) Average age of respondent = 57 89% of respondents were parents 96% were primary caregivers Adult Family Survey (% shown = “yes” response) Nat’l Avg Family receives information about services 50.7% Family helped develop service plan State staff respect family’s choices and opinions 72.9% State staff are knowledgeable and effective 73.1% 80.3% Adult Family Survey: Choice & Control (% shown = “yes” response) Nat’l Avg Family chooses support workers 39.6% Family has control over hiring & management of workers 36.4% Family wants control over hiring & management of workers 55.9% Family knows how much $$ is spent on behalf of person 31.9% Staff Turnover Rates FY1999 - FY2001 60% 52.9% 50% 40% 41.7% 35.2% 30% 20% 31.2% 45.1% 35.8% residential day 10% 0% 1999 2000 2001 NCI Utilization – Pennsylvania Independent Monitoring “Satisfaction & Quality of Life are Fundamental to an Effective Quality Management System” NCI Utilization – Pennsylvania Independent Monitoring Office of Mental Retardation Planning Advisory Committee Multi-Year Plan Independent Monitoring for Quality (IM4Q) Recommended for System Change Everyday Lives and Principles for the MR System emphasize Outcomes for people and individual/family satisfaction Benefits of Independent Monitoring & NCI Surveys done by consumers, families & citizens NCI Utilization – Pennsylvania Framework for QM Integrating and Linking NCI Information By Quality Domains (Access, Person-Centered Service Planning & Delivery, Safeguards, …) By Business Process (Registration, Service Planning, Support Coordination, Monitoring of Service Provision, Incident Management, Complaint Management, Provider Qualification & Review, …) For System Performance (Program Performance and Impact of Changes, Quality Management Planning, Quality Improvement Activities,…) NCI Utilization – Pennsylvania 2002 Annual Report Overview 2002 Report displayed findings from 2000-2001 (first year all 46 County Programs Participated in IM4Q) NCI Consumer Survey – 1,335 respondents NCI Family Survey – 1,056 respondents NCI Family/Guardian Survey – 938 respondents Results highlighted in the 2002 Annual Report utilized to improve quality in services & supports NCI Utilization – Pennsylvania Continuous Quality Improvement Moving away from Quality Assurance … QI Action Plan developed from 2002 Report Methodology – Plan, Do, Check, Act CQI Steps 1. 2. 3. 4. 5. 6. Identify Opportunities for Improvement Perform a Barrier Analysis Develop Interventions Implement Interventions Track Improvement Return to Step 1 as needed For More Information Final NCI Reports for Phase IV (FY2002) are available on HSRI’s website: www.hsri.org Contact us with questions: [email protected] [email protected] [email protected]