Developmental Disabilities Service Coordination in Nebraska
The University of Nebraska Public Policy Center conducted a research project to explore the perceptions and experiences of a variety of stakeholders involved in Nebraska’s service coordination system for people with developmental disabilities.
This project began at the request of the Service Coordination Workgroup, created through interim study resolution LR 42, 2003 and coordinated through Senator Dennis Byars’ office. The Workgroup included representatives from the following stakeholder groups: consumers, Service Coordinators, Service Providers, advocates for people with developmental disabilities, and Nebraska Department of Health and Human Services. Although the Department of Health and Human Services was represented on the workgroup, the Department did not sponsor this research project. State employee participation in surveys developed for the project was completely voluntary.
The project focused on the delivery of service coordination in relation to its impact on consumers. From August 2004 through December 2004, the Public Policy Center gathered information from consumers of developmental disability services, their family members or guardians, Service Coordinators, and Service Provider Employees (Provider staff) regarding developmental disability service coordination in Nebraska .
All Service Coordinators and a sample of Service Provider staff were surveyed. Consumers attending the 2004 People First conference were invited to participate in three focus groups. A random sample of family members/guardians was invited to participate in focus groups and individual interviews. This data was supplemented with 2000-2001 National Core Indicators Survey results from surveys of Nebraska consumers.
The goal of the research project was to better understand:
- Stakeholder satisfaction with service coordination
- The roles and responsibilities service coordinators currently are fulfilling
- The importance of various aspects of service coordination
- How service coordination may be improved
Analysis of the quantitative and qualitative data gathered from consumers of developmental disabilities services, consumers’ family members or guardians, Service Coordinators, and Service Provider Employees resulted in the following general observations. Observations are grouped according to the four project goals listed above, with the second and third goals combined. A fifth area, “the working relationship between Service Coordinators and Service Provider Employees,” emerged and has been added as an additional category.
Stakeholder satisfaction with service coordination:
- Many respondents make a distinction between satisfaction with service coordination in general and Service Coordinators.
- Families and consumers generally are pleased and feel Service Coordinators try hard and are helpful and available.
- Families, consumers, and Service Coordinators believe more strongly than do Provider Employees that Service Coordination is beneficial.
- Families of consumers believe Nebraska does not provide the range of service options that many other states provide to consumers of developmental disabilities services.
- Consumers’ family members expressed concerns about supervision and the types of activities offered to consumers at day services.
- Consumers’ family members expressed concerns about frequent turnover in day service employees.
The roles and responsibilities service coordinators currently are fulfilling, and the importance of various aspects of service coordination:
- Consumers and their families generally believe that Service Coordinators help consumers and families in a wide range of ways.
- Both Service Coordinators and Provider staff feel they advocate, ask what is important to consumers, and are familiar with the rights of consumers and their families.
- Both Service Coordinators and Provider staff feel they support consumer self-determination.
- Service Coordinators and Provider Employees indicate that Interdisciplinary Teams function well, but Provider Employees are slightly less positive about Teams.
- Service Coordinators rank tasks associated with their job differently when comparing percent of time spent on the task and importance of the task.
The working relationship between Service Coordinators and Service Provider Employees:
- The relationship between Service Coordinators and Service Provider Employees is tenuous, particularly from the perspective of Provider Employees.
- Service Coordinators believe there is a lack of Provider accountability.
- There is ambiguity between the roles of Service Coordinators and Provider staff.
- Overall, Provider Employees don’t agree as strongly as Service Coordinators that consumers know their Service Coordinator and can talk with their Service Coordinator whenever they want.
How service coordination may be improved:
- Stakeholders want to see increased funding to add more Service Coordinators and reduce caseloads.
- Increase funding for services for people with developmental disabilities.
- Families, consumers, and Service Coordinators believe changes are needed in the process for determining eligibility for hours and types of services.
- Service Coordinators want processes to improve Provider accountability.
- Greater communication and teamwork is needed between Service Coordinators and Provider Staff.
- Service Coordinators and Provider staff may benefit from additional training opportunities.