nci: a growing commitment five years of performance measurement 127 th annual aamr meeting, chicago,...
TRANSCRIPT
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NCI: A Growing Commitment
Five Years of Performance Measurement
127th Annual AAMR Meeting, Chicago, ILVal Bradley Human Services Research Institute
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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
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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 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
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Participating States Phase V
WA
IN
AZ
UT
NC
IL
IA
OK
VT
WV
KY
PA
MA
DE
RI
CT
MT
WY
NE
HI
Orange County
WA
IN
AZ
NC
IA
OK
VT
WV
KY
PA
MA
DE
RI
CT
WY
NE
HI
Orange County
AL
SD
SC
ME
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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, <18)
Provider Survey Staff Stability Board Representation
System Data Incidents Mortality
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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…
90% 88%83% 83%
78% 78%
0%10%20%30%40%50%60%70%80%90%
100%
5 state average All state average
FY00 FY01 FY02
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92.8%
93.6%
94.4%
92%
93%
94%
95%
FY00 FY01 FY02
Person is satisfied with home…
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95.6 95.6
82.5
94.8
82.8
93.4
75%
80%
85%
90%
95%
100%
FY00 FY01 FY02
% feel safe at home % feel safe in neighborhood
People report feeling safe…
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40%
60%
80%
100%
FY00 FY01 FY02
Physical exam within the last yearGYN exam within the last yearDental check-up within the last six months
Frequency of health visits (5 state average)
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0%
20%
40%
60%FY00 FY01 FY02
Roommate Home staff Case manager
Person had input in choosing…
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65%
75%
85%
95%
FY00 FY01 FY02
CT KY NC PA RI
CM helps get what person needs… (by state)
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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
35.2%
41.7%
52.9%
35.8%
45.1%
31.2%
0%
10%
20%
30%
40%
50%
60%
1999 2000 2001
residential day
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Consumer Survey
7917 surveys completed 67% of people interviewed were able to
respond to Section I
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Consumer Survey Phase IVLevel of MR
Severe14.5%
Moderate 26.3%
Unknown
2.5%
No Label3.7%
Profound 14.9%
Mild38.2%
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Consumer Survey Phase IVPlace of Residence
0.0 20.0 40.0
0.9Nursing Facility
3.7Other
4.3Apartment Program
8.5Specialized Facility
9.9Foster Care or Host Home
18.6Independent Home or Apt
24.7Group Home
29.1Parent or Relative Home
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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%)
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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
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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
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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
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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
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For More Information
Final Reports for Phase IV (FY2002) are available on HSRI’s website: www.hsri.org
Contact: [email protected] [email protected]