The Human Services Research Institute (HSRI) (https://www.hsri.org/who-we-are/) and ADvancing States (https://www.advancingstates.org/) are excited to announce the release of the National Core Indicators – Aging and Disabilities (NCI-AD™) 2024-2025 National Report. For the last ten years, NCI-AD has partnered with states to gather data on the experiences of people using long-term services and supports across the US. NCI-AD is the most comprehensive source of data on older adults and people with physical disabilities using publicly funded supports. In 2024-25, we heard from over 20,000 people in 24 states, including individuals using HCBS waivers, nursing facilities, PACE, and Older Americans Act programs. Some key takeaways from the report are described below.
Access to community: 92% of respondents say they always have transportation to get to medical appointments, while 73% always have transportation to do things they want outside of the home. About 2 in 3 respondents (68%) take part in activities they like to do as much as they want.
Relationships: Nearly all respondents (95%) say they are always able to see or talk to friends or family when they want. At the same time, nearly 1 in 5 (17%) say they often feel lonely.
Health and Access to Health Care: The vast majority of respondents have access to healthy foods (89%), mental health services if they want them (89%), and physical exams/wellness visits in the past year (87%). Nevertheless, 2 in every 5 respondents (42%) went to the emergency room in the past year, and 1 in 4 (26%) stayed overnight in a hospital or rebab/nursing facility in the past year. Overall, just 14% describe their health as excellent or very good.
Workforce: As staffing shortages at provider agencies continue, many LTSS users report using family members to provide support. In fact, 2 in 5 people (40%) say that a paid family member or friend is the person who helps them most often. Further, 22% of respondents say that their paid staff change too often.
Services meet needs: The data suggest that publicly-funded services are making a positive difference, with 89% saying that services and supports help them live the life they want. However, there is still some room for improvement, as 3 in 4 people surveyed (72%) say that their services meet all needs and goals, and among those with unmet needs (such as personal care, home care, and transportation), just over half (55%) say their case manager talked with them about services to help with unmet needs.
You can access the report at the link above, or check out the Data-At-A-Glance.
Data-informed Decision Making
For the last 10 years, state AD agencies have worked tirelessly to measure the quality of their systems, and use NCI-AD data to determine areas for improvement. We urge partners to continue to use these data in conversations with policymakers and community members to inform decisions around Medicaid program quality improvement. HSRI and ADvancing States will continue working closely with state partners to identify opportunities to strengthen service delivery systems and meet the needs of the AD population.
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NCI makes deidentified data available to other researchers for a small fee. Complete this contact form to learn more about our data sharing policies. Do you have other questions about National Core Indicators? Be sure to check out our Frequently Asked Questions.
