Kentucky recognizes the increasing emphasis on outcomes and performance assessment is more than merely a change in measurement approaches. It represents a change in the assumptions about what “quality” is and reflects a larger shift in the field of human services — specifically from program-oriented, formulaic models of care to individually tailored supports based on individual choices and preferences. As a result, the adoption of performance indicators as a quality assurance technique is both a consequence of the change in expectations as well as a method for maintaining a focus on person-centered outcomes. As supports become more individualized, strict input and process measures become problematic since prescriptive standards constrain the flexibility and creativity needed to individually tailor supports to people’s unique capabilities and preferences. Further, the growth of continuous quality improvement and total quality management initiatives have contributed to the prominence of indicators linked to observable performance.
The National Core Indicators is a logical outgrowth of the increasing emphasis on outcomes, concerns about the consistency of performance with state missions, and an intensified commitment to ensure that services and supports are accountable to people with developmental disabilities, their families, and the taxpayer. In the consumer survey activity, a standard interview/survey instrument developed in conjunction with the Human Services Research Institute (HSRI) is administered. The consumer interview tool has gone through five rounds of development and testing and has been shown to be a reliable data collection instrument. Interviewers trained through the Interdisciplinary Human Development Institute at the University of Kentucky conduct face to face surveys with the consumer who is receiving state funded services through the Kentucky Division of Developmental and Intellectual Disabilities and his or her family and caregivers. Consumers are randomly identified by the state data system.
During this, our twenty-first year of participation, Kentucky’s National Core Indicators seeks to conduct a minimum of 400 consumer interviews. In the most recently completed data cycle ending June 30, 2019, Kentucky submitted 431 consumer surveys to HSRI for statewide and longitudinal analysis. We have begun the interview process to include updated interviewer training in our current data cycle, which ends June 30, 2020. We also reconvened the NCI Quality Improvement Committee, consisting of members from KY National Core Indicators, KY DDID, and consumers receiving services and their families in summer, 2019, to review the latest NCI results, and make follow up recommendations that assess changes since the committee provided its initial recommendation report to Kentucky’s Division of Developmental and Intellectual Disabilities in October, 2010.