National Core Indicators: How Does Orange County Compare Phase IV 20012002 Results

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National Core Indicators How Does Orange County
Compare? Phase IV (2001-2002) Results
Val Bradley and Sarah Taub Human Services
Research Institute November 2002
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Project Beginnings

• NASDDDS and HSRI collaboration
• Launched in 1997
• Seven field test states 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
• Benchmarks of performance
• Trend data at the state national level
• Reliable data collection methods tools

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What are the Core Indicators?

• Consumer Outcomes
• Satisfaction, choice, employment
• Provider Agency/Workforce Stability
• Staff turnover
• System Performance
• Cost/Utilization
• Access
• Protection of Health and Safety
• Incidents, Mortality, Restraints

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Recent Developments

• Currently 22 states plus Orange in Phase V of
  data collection
• Mobilization of subcommittees to address specific
  issues
• Governing structure will continue
• Staff will continue to seek other sources of
  funding (e.g., Kennedy Foundation)
• Next meeting will be in late July

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Specific Recommendations

• States want to continue to work on comparability
  of health and welfare indicators
• Until then states will receive information on
  whether or not their particular trend line has
  changed (e.g., with respect to restraints)
• Wellness items will be added to consumer survey
  (i.e., obesity, smoking, and exercise)

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Specific Recommendations

• Family support indicators have been added to
  indicator list
• New states will be mentored by veteran states
• Should pursue a quality consortium when new
  Real Choice grants are announced
• Name change to National Core Indicators (NCI)

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Participating States Phase V
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What Are State Doing With the Data?

• Pennsylvania External monitoring and quality
  improvement
• South Carolina Core of external monitoring
• Wyoming Annual reports
• Massachusetts Strategic planning
• Maine and South Dakota Provider profiles
• North Carolina Health indicators

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National Core Indicators

• Selected Results
• Orange County andNational Benchmarks

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Provider Survey

• Measures Staff Stability and Board Representation
• 38 agencies reported data
• 21 of agencies reporting provide both
  residential and day supports
• 5 NCI states collected provider survey data in
  Phase IV

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Staff Turnover Rates FY1999-FY2001
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Provider Survey Staff Stability
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Consumer and Family Representation on Agency
Boards of Directors (FY2001)
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Areas of Strength

• Staff stability Orange Countys turnover rate
  was the second lowest out of 5 NCI states
  reporting
• Board representation Orange County reported the
  highest percentage of consumers who were voting
  members on agency boards of directors

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Adult Family Survey

• Surveys of families with an adult family member
  living at home
• 881 surveys returned (out of about 2900)
• Average age of respondent 59
• 90 of respondents were parents
• Most common supports received
• transportation (61)
• day services (61)
• financial (40)
• out-of-home respite (27)
• in-home support (21)

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Adult Family Survey
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Adult Family Survey
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Adult Family Survey
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Adult Family Survey
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Adult Family Survey
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Adult Family Survey
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Areas of Strength

• Provision of informational material to families
• Cultural competence (providing materials and
  assistance in native languages)
• Respectful, knowledgeable staff
• Process for filing and resolving grievances
• Provision of needed services

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Potential Areas for Improvement

• Choice of support providers
• Involvement of families in decision-making
• Information about and control over budgets

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Consumer Survey

• 456 surveys completed
• 81 were able to respond to Section I (compared
  with average 67 across other NCI states, this
  was the highest response rate out of all 16
  states)
• 11 spoke primary language other than English
  (0.3 across all states)

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Level of MR - National Sample
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Place of Residence National Sample
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Consumer Survey Analysis

• Four scales were created to combine sets of
  related items
• Scales are considered to be reliable if alpha
  .70
• Service Coordination (.80)
• Community Inclusion (.89)
• Support-Related Choices (.92)
• Personal Choices (.95)

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Consumer Survey Analysis

• Service Coordination Scale
• Person knows service coordinator
• Service coordinator helps people get what they
  need
• Service coordinator asks people what is
  important to them

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Consumer Survey Service Coordination Scale
Results

• Orange Countys score 0.83
• 90 know who their service coordinator is
• 80 said that the service coordinator helps them
  to get what they need
• 71 said that the service coordinator asked them
  what was important to them
• Average for other 15 states 0.81
• No significant difference

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Consumer Survey Analysis

• Community Inclusion Scale
• Goes shopping
• Goes on errands or appointments
• Plays sports or exercises
• Goes out to eat
• Attends religious services
• Belongs to clubs or communityorganizations
• Goes out for entertainment

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Consumer Survey Community Inclusion Scale
Results

• Orange Countys score 0.81
• Average for other 15 states 0.78
• Orange County scored significantly above average

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Consumer Survey Analysis

• Support Related Choices Scale
• Chose job or day activity
• Chooses support staff at home
• Chooses support staff at job/day activity
• Chose service coordinator
• Chose residence

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Consumer Survey Supports Related Choices Scale
Results

• Orange Countys score 0.65
• Average for other 15 states 0.61
• Orange County scored significantly above average

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Consumer Survey Analysis

• Personal Choices Scale
• Chose roommate
• Chooses daily schedule
• Chooses what to do in free time
• Chooses what to buy with spending money

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Consumer Survey Personal Choices Scale Results

• Orange Countys score 0.80
• Average for other 15 states 0.75
• Orange County scored significantly above average

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Consumer Survey Relationships
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Areas of Strength

• Supporting participation in community activities
• Supporting individuals to make decisions,
  offering choices

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Potential Areas for Improvement

• Aim for better than average scores on service
  coordination indicators (keeping in mind that
  caseloads are high in CA)
• Increase focus on self-determination,
  opportunities for individuals (and families) to
  exercise control overtheir own supports (hiring
  staff, etc.)

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What Do You Do With the Information?

• Include at your web site
• Prepare annual reports
• Develop provider profiles
• Use with sister agencies
• Use in allocation decisions
• Use to spot red flags

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For More Information

• Final Reports for Phase IV will be available on
  HSRIs website by the end of the November
  www.hsri.org