National Core Indicators Overview for the State of Washington Lisa A. Weber, Ph.D. Division of Developmental Disabilities

What has NCI Accomplished? Nationally recognized set of performance and outcome indicators for developmental disabilities service systems Reliable data collection methods & tools (consumer & family surveys, provider survey, system data) Baseline and trend data at the state & national level

Participating NCI States ND AK HI WA OR ID MT WY ND SD NE CA UT NV AZ CO NM KS OK TX MN IA WI IL IN MO AR MI OH KY TN MS LA AL GA FL SC NC VA WV PA NY ME VT NH MD DC DE NJ CT MA RI PR Orange County

NCI Structure Currently 21 states plus Orange County Human Services Research Institute (HSRI) provides technical assistance under subcontract to the National Assoc. of State Directors of Developmental Disabilities Services (NASDDDS) Subcommittees address specific issues Meet with full steering committee annually Funded primarily through state participation fees WA State has used the UW Center for Disability Policy & Research (CDPR) to collect consumer and family data.

Where does NCI fit in? A major component of our state’s Quality Assurance Plan Primary method for obtaining comprehensive and statistically reliable feedback from our providers and a representative sample of the persons we serve Cross-State comparison data Monitor system impacts as we implement service system changes

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

What are the Core Indicators? Consumer Outcomes: Employment (earnings, hours worked) Community Inclusion Choice and Decision-making (personal choices, support-related choices) Self-determination (new) Relationships Satisfaction (with home and job)

What are the Core Indicators? System Performance Service Coordination Family and Individual Participation (on boards of directors) Utilization (types of services provided) Financial Level of Effort Cultural Competence (access to supports) Access (relative to population)

What are the Core Indicators? Health, Welfare, and Rights Safety (mortality, injuries, crimes) Health (routine exams) Medications Wellness (new) Restraints Respect/Rights

What are the Core Indicators? Staff Stability and Competence Staff Stability (turnover and vacancy rates, length of employment) 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

NCI in Washington State Participation since Phase II (2000) Even phases – Consumer Interviews (except Phase VI), Adult Family Survey, Family/Guardian Survey Odd phases – Child/Family Survey Every year – Provider Survey, System Data

Additional Indicators in WA Case Management/Service Coordination Individual Providers Self-Determination Residential and Employment/Day Program Provider Wage/Benefits

What do we do with the data? Results shared with DDD management, external stakeholders and advisory groups A group of DDD employees, including both headquarters and regional staff reviews the results in detail and has put together a series of recommendations for the division director Developmental Disabilities Council (DDC) will do a three-year project to gather groups of people who are the subject of the reports and ask them to make recommendations to the division.

How is NCI data used? Setting goals and strategic planning (e.g., management performance agreements, regionally set goals, quality improvement plans) Budget requests to Governor and legislators (e.g., to illustrate our need for more case managers and service funding, to support requests for provider rate increases) Helps shape data reporting systems (e.g., incidents, mortality)

National Core Indicators Selected Results

Provider Survey: Staff Stability

Board Representation (FY2001)

Employment (earnings, hours worked) --FY2001

Consumers & Families – Areas of Strength Satisfaction with Services Received 92% of consumers are satisfied with where they live 94% of consumers are satisfied with their work/day program Courtesy & Respect 94% report that most day support staff treat them with respect 93% report that most residential support staff treat them with respect 92% of families report that DDD staff are generally respectful and courteous

Consumers & Families -- Potential Areas for Improvement Case Management Only 49% of consumers report that their case manager asks them what’s important 65% of families providing care for the consumer can contact their case manager whenever they want to Access to Services 47% of families get the services and supports they need 28% of consumers report that needed services were not available

Next steps… Complete a baseline report with recommendations. Review internal workgroup and DDC recommendations Develop an action plan and implement selected recommendations Monitor effect of service system changes during future data collection phases

For More Information Reports with cross-state comparison data are available on HSRI’s website: Results for additional indicators added locally can be viewed from reports on the CDPR website at depts.washington.edu/cdpr WA State Updates (select Projects) www1.dshs.wa.gov/ddd Contact: