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Core
Indicators
Project
An Overview of How ConnecticutIs Using the NCICONSUMER SURVEYFAMILY SUPPORT SURVEYCHILDREN’S SURVEY
State of Connecticut Department of Mental Retardation
Prepared by the DMRSTRATEGIC LEADERSHIP CENTER
July 2003
Use In Connecticut
National Core
Indicators
NCI
CONTENTS
1.Overview of the CIP2.Connecticut’s Participation3.Examples of Data Analysis and
Communication4. Special Issues and Use of NCI
in Quality Review System
NCI
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
NASDDDSNational Association of State Directors of Developmental Disabilities Systems
HSRIHuman Services Research Institute
The National Core Indicators is managed and coordinated by
Information about the NCI, including updatescan be found at:
www.hsri.org
CURRENT Participating States
Connecticut was one of six charter statesin Phase I of the Core Indicators Project
• Alabama • Arizona• Connecticut• Delaware• Hawaii• Illinois• Indiana• Iowa• Kentucky• Massachusetts• (Minnesota)• Montana
22Participating Sates
• Nebraska • North Carolina• Oklahoma• Pennsylvania• Rhode Island• South Carolina• South Dakota• Utah• Vermont• Washington• West Virginia• Wyoming
Plus: Orange County, CA
Orange County
N.C.I. is GROWING year by year.About ½ of the country is now participating! (as of September 2002)
Why is Connecticut Participating?
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.
Children/Family Survey
Random sample of 1000 families of children - receive CM plus one other DMR service
Mailed survey sent to families of children receiving DMR support who live at home. Excludes B3. Completed in 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.
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 SURVEYMAJOR CATEGORIES COVERED IN THE INTERVIEWS
1. HEALTH 2. SERVICES3. INCLUSION4. CHOICE5. RESPECT &
RIGHTS6. PROTECTION &
RIGHTS
7. CASE MANAGEMENT
8. ACCESS9. SAFETY10. SATISFACTION11. RELATIONSHIPS12. ACCEPTABILITY13. STABILITY
QUESTIONS:
Specific Questions on the Survey
CATEGORYCONCERN: Area or issue under assessment
ALL PERCENTAGES REFLECT POSITIVE ORIENTATION
0.0%
20.0%
40.0%
60.0%
80.0%
Pe
rce
nt
Ag
ree
me
nt
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%
Supp Empl
Grp EmplShel
Empl*Non-Voc
DayComm Partic
1/10 5/102/10 1/10 3/10
HIGH Rank of 1, 2 or 3
MIDDLE Rank of 4, 5, 6 or 7
LOW Rank of 8, 9 or 10
Connecticut Ranks
EXAMPLE OF DATAOur display of data includes the following information:
Highest Score for each item
Lowest Score for each item
CT’s Rank out ofTotal StatesReporting DataNote: LOWER number is aBetter (Higher) Rank. 1 isBest and 10 is worst.
CT’s Score for each item
Example:INCLUSION
HIGH Entertainment
MIDDLE Shopping, Errands
LOW Exercise, Eat out, Religious
Services
Connecticut Ranks
CONCERN: People use integrated community services and participate in everyday community activities.
ALL PERCENTAGES REFLECT POSITIVE ORIENTATION
40.0%
60.0%
80.0%
100.0%
Pe
rce
nt
Ag
ree
me
nt
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%
Shopping Errands ExerciseEntertain
mentGo out to
EatReligious
Serv
6/10 6/10 8/10 2/10 8/10 9/10
QUESTIONS: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?
CONCERN: People receive the same respect and protection as others in the community.
Example:PROTECTION & RIGHTS
HIGH
MIDDLE Enter home w/o asking, Enterbedroom, Use phone, Be leftalone when want to
LOW Open mail, Be alone with guests
Connecticut Ranks
ALL PERCENTAGES REFLECT POSITIVE ORIENTATION
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]
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
Pe
rce
nt
Ag
ree
me
nt
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%
Open Mail
Come into
Home
Come into
Bedroo
Use Phone
Alone with
Guests
Be by Self
8/10 5/10 5/10 5/10 8/10 5/10
CHANGES OVER TIME
COMPARISON OF TrendsON THE NCI CONSUMER SURVEY
Since Connecticut has completed the survey for 3 years now, can also look at
Example:CHANGE: Health & Services
50%
60%
70%
80%
90%
100%
1999 91.7% 67.3% 71.8%
2000 87.4% 57.7% 67.8%
Recent Physical Exam
Recent OB/GYN Exam Recent Dental Exam
H
H
H
HH
M
Comparison of 1999 & 2000CIP Consumer Survey for CT
HEALTHSlight decline in all 3 areas. Still rank in highest grouping for OB/GYN and Dental Exams.
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
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%
Case Mngmnt
Asst Tech Clinical Transp Respite HCBS
H
H
H
M
H
L
Comparison of 1999 & 2000CIP Consumer Survey for CT
H
M
M
M
H
M
SERVICESSlight decline in Case Management and Clinical Services. Larger decline in Transportation. Slight improvement in Assistive Technology and Respite.
1999 CIP RESULTS
2000 CIP RESULTS
H 1 2 3M 4 5 6 7L 8 9 10
Rank
KEY FOR READING GRAPHS
• FAMILY SUPPORT SURVEY• FAMILY/GUARDIAN SURVEY• FAMILY/CHILDREN SURVEY
The same type of analyses are also completed for the Family Surveys
ALL PERCENTAGES REFLECT POSITIVE ORIENTATION
HIGH
MIDDLE Receive Information, Easy to Understand, Changes in Staff, Staff Speak Language
LOW Choose Providers, Choose Staff
Connecticut Ranks
INFORMATION, CHOICE & LANGUAGE
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 choose the agencies or providers that work with your
family?4. Do you choose the support staff that work with your family?5. Are frequent changes in support staff a problem for your
family?6. If English is not your first language, are there staff who speak
with you in your preferred language?
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
Pe
rce
nt
Ag
ree
me
nt
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%
Receive Information
Info Easy to Understand
Choose Providers
Choose Staff
Changes in Staff are Problem
Staff Speak Preferred Language
7/11 5/119/115/11 9/11 6.5/11
Example: FAMILY SUPPORT
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?
ALL PERCENTAGES REFLECT POSITIVE ORIENTATION
HIGH
MIDDLE Receive information about services, Receive information about development, Information re: development easy to understand
LOW Enough information to plan,
Got help developing the plan, Information is easy to
understand
Connecticut Ranks
CONCERN: People receive information that is understandable and useful in the planning process.
Example:INFORMATION& PLANNING
20%
30%
40%
50%
60%
70%
80%
90%
Pe
rce
nt
Ag
ree
me
nt
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
Receive Information
Info is Easy To
Understand
Status of Developmen
t
Understand Dev Info
Enough Info to Plan
Help Develop Plan
3/6 5/6 4/6 4/6 5/6 5/6
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.
SPECIAL CONCERNS & FUTURE PLANS
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.
STEP 1 – DATA ANALYSIS• Regional/Provider Data Analysis (including NCIsurvey satisfaction data)
• Provider Organizational Self-Assessment
STEP 2 – SAFETY CHECKLIST PROBES• Emergency Planning• Environmental Safety – Facility/Home
STEP 3 – PERSONAL OUTCOMES REVIEW
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
STEP 4 - SUMMARIZE FINDINGS
STEP 5 - PROVIDE FEEDBACK
STEP 6 - IMPROVEMENT PLANNING Individual/Regional/State
Levels
New Quality Review in CT to include NCI
More Information on theNational Core Indicators can be found at
www.hsri.orgInformation regarding Connecticut’s participation
can be obtained by contacting
The Connecticut State Department of Mental Retardation
[email protected]@po.state.ct.us