national core indicators consumer survey
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National Core Indicators Consumer Survey. Sarah Taub & June Rowe Human Services Research Institute December 9, 2004. Background & Basics. National Core Indicators Started in 1997 Over 22 states participating Importance of consumer perspective - PowerPoint PPT PresentationTRANSCRIPT
National Core Indicators Consumer Survey
Sarah Taub & June Rowe
Human Services Research Institute
December 9, 2004
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Background & Basics
National Core Indicators Started in 1997 Over 22 states participating Importance of consumer perspective Tool designed to measure specific indicators;
not a general satisfaction survey Reports generate national benchmarks for
comparison
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CMS and States are defining quality outcomes
for HCBS services
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Quality Framework: Quality Management System
Design – how services and supports are designed and delivered
Discovery – methods and processes to monitor the quality of services and supports (data collection, analysis for patterns and trends)
Remediation – action to fix problems
Improvement – making sub-state and statewide improvements
Information from NCI used to make improvements in HCBS services
NCI is an important discovery process – quality of services from the individual’s perspective
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New Approach to Quality in HCBS
State build quality and self-direction into the design of their waiver application
State monitors individuals and fixes problems
State collects and analyzes data for trends and patterns across populations
State makes changes to policy, practices and resources based on their analysis
CMS maintains and on “going dialogue” with states and looks for evidence of state over-sight
States report the Quality management (QM) activity and results to CMS and the public
Waiver Application
Waiver Application
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Quality Management:Quality of Waiver services from a variety of perspectives and data sources
Case management monitoring
Incident reporting (e.g., abuse/neglect, major injuries, deaths, medication errors) and risk management
Provider reviews
Consumer surveys!!!!!
Review of claims (e.g., under/over utilization of services)
Assessments and service plans
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Aligning the Quality Framework with the NCI survey
QF Focus Area: Participant-Centered Service Planning & Delivery
NCI: Self-determination & choiceHealth and wellnessService coordinationService delivery
QF Focus Area: Participant Rights & Responsibilities
NCI:Self-advocacyRespect for rightsGuardianship/
advocacy
QF Focus Area: Provider Capacity & Capabilities
NCI:Staff competencies
QF Focus Area: Participant Outcomes & Satisfaction
NCI:Outcomes/Satisfaction (e.g., job,
earnings, home)
QF Focus Area: Participant Safeguards
NCI:MedicationSafety
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NCI provides important information about the overall quality of the state’s waiver services and supports
QF Focus Area: System Performance
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Overview of Survey Tool
Components of the Survey Pre-Survey Form Background Information Section I Section II Interviewer Feedback Sheet
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Purpose To provide interviewers with information
needed for scheduling To determine special accommodations,
communication issues, etc. To obtain familiar names and terms for
ease of conversation (fill in the blanks!) Process varies by state…
Who best to fill out form and where to get the information
Informed consent procedures
Pre-Survey Form
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Key items to review prior to scheduling interviews Does caregiver need to be present? Communication needs? Familiar terms and names
Pre-Survey Form
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Background Information
General Collects demographic and indicator data Very important for data analysis! Unique survey code or identifier must be used Highlighted items are used for Risk Adjustment Some information may come from records; other
information could be provided by staff or family OK to separate this section and have it filled out
during interview
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Background Information
Specific Date of Birth is used to calculate age, then deleted
Do NOT enter other information that would identify the person (e.g., name, SSN)
Behavioral Support Needs section should be filled out by someone other than the person receiving services
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Background Information
Core indicators The proportion of people receiving psychotropic
medications
The proportion of people who have had a physical exam in the past year
The proportion of people who have had a GYN exam in the past year
The proportion of people who have had a routine dental exam in the past six months
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Background Information
Core indicators The proportion of people who maintain healthy
habits in such areas as smoking, weight, and exercise
The proportion of people who are exercising self-determination with regard to the services they receive
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Section I: Direct Interview
Things to keep in mind… Only the person receiving services may respond Conduct interview in private if possible People may skip any question Do not leave any questions blank – record “9” if
necessary Others may provide assistance by interpreting
questions and responses Introduce yourself and make sure people understand
purpose of interview
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Work/Daytime Activities
Core Indicators The proportion of people reporting satisfaction
with their job or day program The proportion of people indicating that most
support staff treat them with respect
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Work/Daytime Activities
For Questions 1-2: include all types of work and daytime activities - paid,
unpaid, community-based jobs, supported employment, facility-based jobs, day programs, volunteer work, non-vocational programs, training facilities, etc.
If respondent has more than one job/day activity, ask how s/he feels in general or “most of the time.”
If respondent works and attends school, ask about work only
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Home
Core indicators The proportion of people who report
satisfaction with where they live The proportion of people who report
satisfaction with the amount of privacy they have
The proportion of people who report that they feel safe in their home and neighborhood
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Home
4. Can you be alone if you want to? (Can you have privacy?)
Here we are looking at privacy (e.g. going in a room and closing the door), not the person's need for supervision (e.g. staying home alone).
__8 NOT APPLICABLE - lives alone
__2 Yes, has enough time alone
__0 No, would like more time alone
__9 Don’t know, no response, unclear response
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Friends and Family
Core Indicators The proportion of people who report having friends
and caring relationships with people other than support staff and family members
The proportion of people who report having a close friend, someone they can talk to about private matters
The proportion of people who are able to see their families and friends when they want
The proportion of people reporting feeling lonely
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Friends and Family
Do you have friends you like to talk to or do things with?
If s/he answers "yes," ask who the friends are and try to determine if they are family, staff, roommates, co-workers, etc. You can use prompts such as: Can you tell me their names? Are these friends staff or your family?
__2 Yes, has friends who are not staff or family
__1 Yes, all friends are staff or family, or cannot determine
__0 No, does not have friends
__9 Don’t know, no response, unclear response
If the person responds "NO" TO BOTH QUESTIONS 10 AND 11, code Questions 12 as "NOT APPLICABLE." Also code Question 47 as “NOT APPLICABLE.”
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Friends and Family
Keep in mind… These questions often elicit emotional responses Questions 12 and 14 are about whether people get
support to see family and friends. Read response options carefully!
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Satisfaction w/Services & Supports
Core Indicators The proportion of people who know their service
coordinators The proportion of people reporting that their service
coordinators help them get what they need The proportion of people reporting that service
coordinators asked about their preferences
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Satisfaction w/Services & Supports
Core indicators The proportion of people who report that they know
their “advocate” or guardian The proportion of people reporting that they receive
support to do or learn new things The proportion of people who are satisfied with their
personal lives The proportion of people who report having adequate
transportation when they want to go somewhere
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Satisfaction w/Services & Supports
15. Do you know your case manager/service coordinator?
PS-3 Do you know _________________________________________________ ?
__8 NOT APPLICABLE – person does not have case manager/service coordinator
__2 Yes, person knows case manager/service coordinator
__1 Maybe, not sure
__0 No, person does not know case manager/service coordinator
__9 Don’t know, no response, unclear response
PS-3
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Self-Determination
Core Indicator: The proportion of people who control their own
budgets
People who are self-directing their services and supports know…
how much is in their budget how it is being spent
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Interviewer Ratings
Indicate whether Section I could be completed Did the person understand questions? Did the person give consistent and valid answers?
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Transition to Section II
If the person was able to provide valid responses, see if a break is needed.
If the person was not able to provide valid responses or does not want to continue, end interview and complete Section II with other respondent.
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Try to interview the person Alternative interviewees…
Family Advocate Staff
Be careful not to overuse the “NA” Indicate who was interviewed for every question
Section II Basics
Indicate respondent: ( ) 1-consumer ( ) 2-other
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Core Indicator:The proportion of people who participate in integrated activities in their communities
Proportion of people who exercise or play sports
Community Inclusion
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Integrated community activities…Shopping (grocery, clothes etc.)Errands/appointments (dentist, bank etc.)Leisure activities (museums, library etc.)Go out to eat Attend religious services and other community
meetings Exercise/play sports (local gym, Y)
Community Inclusion
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Things to bear in mind about the Community Inclusion section:
Community Inclusion
Try to rule out segregated activities just for people with developmental disabilities
People go out to do activities rather than having them brought into the home
If the person answers yes, may ask for an example to verify
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34. Do you (does this person) exercise or play sports? (What kind of exercise? (Examples: jogging, swimming, riding bike, etc.)
__2 Yes, in a community setting__1 Yes, gets exercise but in a non-integrated setting__0 No__9 No response, unclear, don’t know
Community Inclusion Question
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Core indicator:The proportion of people who make choices about important life decisions
The proportion of people reporting they chose what to buy with their own spending money
Choices
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People make choices about… Where they live Who they live with Staff at their home/work Daily schedule Free time Work Spending money Case manager/service coordinator
Choices
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Things to bear in mind about the choices section:
How involved is the person in making decisions
Code “2” if person really made the decision and/or made choices with spouse/partner
Code “1” if had some input
Be careful about “NA” – should avoid using for “not allowed” or “not capable”
Choices
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37. Did you choose (or pick) the people you live with (or did you choose to live by yourself)? (Did anyone ask you who you’d like to live with? Were you given choices, did you get to interview people?)
PS-6 Did you choose to live with __________________ ? (Other respondent – Did this person choose any of the people s/he
lives with? Or: Did this person choose to live alone?)
Choice Question
__8 NOT APPLICABLE – lives with family__2 Yes, chose people s/he lives with, or chose to live alone__1 Chose some people or had some input__0 No, someone else chose__9 Don’t know, no response, unclear response
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Core Indicator:The proportion of people who report that their basic rights are respected by others
The proportion of people who have attended self-advocacy group or other groups that address rights
Rights
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People exercise their rights… Mail Visit with friends alone Use of the phone Self-advocacy
Rights
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46. Do people read your mail without asking you first?
(Other respondent – Does anyone read this person’s mail without permission?)
Rights Question
__8 NOT APPLICABLE - does not get mail__2 [Yes] – mail is read without permission __0 [No] – person reads own mail or others read with permission__9 Don’t know, no response, unclear response
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48. Are you allowed to use the phone when you want to?
If person is unable to use the phone or doesn’t have a phone/TTY, code as “NOT APPLICABLE.”
(Other respondent – is this person allowed to use the phone when s/he wants to?)
Rights Question
__8 NOT APPLICABLE - doesn’t have phone/TTY or unable to use phone__2 Yes, can use anytime, either independently or with assistance, has own phone, or uses email__0 There are rules/restrictions on use of phone __9 Don’t know, no response, unclear response
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Core Indicator:The rate at which people report the “needed” services were not available
Access
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50. Do you get the services you need?
We are asking about services and supports, such as: transportation, job coaching or job development, taking a class, getting medical or dental care, counseling services, finding housing, meeting people, relationship issues, communication technology, environmental modifications, information about benefits or insurance, community involvement, etc.
(Other respondent – Does this person get the services and supports
s/he needs?)
Access
__2 Yes__1 Sometimes, or doesn’t get enough of the services needed__0 No__9 Don’t know, no response, unclear response
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Indicate who you interviewed
for Section II.
Your opinion matters!!!!!
Fill out the “interviewer feedback sheet”
Survey Conclusion Tasks