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HCBS Quality Surveys

The Department of Health Care Policy and Financing (HCPF) participates in the National Core Indicators (NCI) and administers quality surveys to gain deeper insights into the quality gaps within Home and Community Based Services (HCBS) waiver programs. 

Through this participation, members have the opportunity to:

  • Express their level of satisfaction with services and supports they receive
  • Share their experiences within the programs
  • Provide feedback about additional services they may need

HCPF also evaluates staff stability within provider agencies that deliver waiver services to members by surveying both the agencies and direct care workers. These survey results help us to understand the effectiveness of our HCBS programs and improve the delivery of services and supports statewide.

In addition, HCPF conducts research to further understand the root causes of quality gaps in waiver programs and how to strengthen staff stability within the Direct Care Workforce that serves our HCBS members. The goal is to explore innovative approaches and strategies for programmatic and policy adjustments.

This site provides more information about each survey we administer, the research projects conducted, and provides the research and data reports published for public use.
 

What do HCBS Quality Surveys Measure?

  • Member Health, Welfare, and Safety
  • Member Self Determination
  • Member Rights, Choices, and Decision-making
  • Member Service Coordination and Access
  • Member Satisfaction with Services and Supports
  • Member Relationships and Community Inclusion
  • Member Employment Status and Goals
  • Agency Demographics and Structuring, including Agency Size, Number of and Type of Services Provided, and More 
  • Direct Care Worker Wages, Turnover Ratio, Vacancy Rates, Benefits, and More
  • Direct Care Worker Satisfaction with their Job, Training, Wages, Benefits, and More
     

Colorado participates in the following surveys:

The In-Person Survey (IPS, also known as the Intellectual and Developmental Disabilities Survey or IDD) is typically a face-to-face conversation with individuals who are 18 years of age or older and receiving at least one paid service from the state, in addition to case management. Members on the Developmental Disabilities (DD) and Supported Living Services (SLS) waivers are randomly chosen from a list of Colorado residents receiving long-term services and supports to participate.

Colorado has been participating in the survey since 2013. The intent of the survey is to understand demographics and address key areas of concern such as employment, respect/rights, service planning, community inclusion, choice, and health and safety. The data from NCI surveys is used to inform strategic planning, produce legislative reports, and prioritize quality improvement initiatives. The data is also shared with stakeholder groups to help set priorities and establish policy direction.
 

National Reports

State Reports

The National Core Indicators-Aging and Disabilities (NCI-AD) is an initiative designed to support states' interest in assessing the performance of their programs and delivery systems to improve services for older adults and individuals with physical disabilities. NCI-AD's primary aim is to collect and maintain valid and reliable data that give states a broad view of how publicly funded services impact the quality of life and outcomes of service recipients.

State departments and planning groups can utilize the data collected through this survey to make improvements in programs and services, and more effectively meet the needs of older adults and adults with physical disabilities who have significant health care needs.

Members on the Complementary and Integrative Health Waiver (CIH), Brain Injury Waiver (BI), Community Mental Health Supports Waiver (CMHS), and the Elderly, Blind, and Disabled Waiver (EBD) are randomly selected from a list of Colorado residents receiving long-term services and supports to participate.

National Reports

National Report Snapshots

State Reports

 

HCPF has partnered with an independent firm, Vital Research, to assist in the creation and administration of the Children’s Waiver Satisfaction Survey (CWSS). The CWSS expanded NCI’s Children’s Family Survey which primarily focused on Colorado’s Children’s Extensive Services (CES) waiver. The CWSS survey was launched in August 2023 and in January 2025. The Children’s Survey received feedback from families on their services and supports from members enrolled on the four children’s waivers, which included:

2023 Child Waiver Satisfaction Survey Results - September 2024

HCPF partnered with an independent firm, Vital Research, through the American Rescue Plan Act (ARPA) project 1.02 Direct Care Workforce Data Infrastructure to create and conduct a survey of direct care workers to assess their level of satisfaction with their work. The goal of the survey was to collect data on direct care worker's satisfaction with wages, benefits, career advancement, training, work environments, and overall job fulfillment.

The survey was administered in 2022, 2023, and 2024 to provide baseline data on the direct care workforce in Colorado. 

For questions or more information about the Direct Care Workforce Survey, please contact the Direct Care Workforce Team at hcpf_dcworkforce@state.co.us or visit the ARPA project website. 

Direct Care Worker Satisfaction Survey Infographic

Additional Surveys and Research:

Colorado participated in National Core Indicators—Aging and Disabilities (AD) pilot of the State of the Workforce Survey (formerly known as the Staff Stability Survey)-Aging and Physical Disabilities (SSS-AD), due to an increased interest regarding the stability and quality of the workforce supporting older adults and people with physical disabilities. The pilot launched in September and ended November 14, 2022.

Colorado collected data from agencies that provide services such as Adult Day Services, Respite, Homemaker, Personal Care, and more, for the Elderly, Blind and Disabled (EBD), Community Mental Health Supports (CMHS), Complementary & Integrative Health (CIH), and Brain Injury (BI) Waivers. The State of the Workforce Surveys are unique and timely tools for states to assess the status, turnover, recruitment, hourly wages, vacancy rates, demographics, benefits, length of employment, and other pertinent data points related to Direct Care Workers (DCWs). 

Colorado will be able to use SSS-AD in several ways, including supporting workforce initiatives, government partnerships, context for NCI-AD outcomes data, providing baseline data for future analysis, budget projections, policy planning, stakeholder engagement, and quality assurance.

National Reports

National Report Snapshots

State Reports

2022 NCI-AD State of the Workforce Survey: At-a-Glance

The State of the Workforce Survey (formerly known as the Staff Stability Survey) is an online survey of provider agencies supporting adults (age 18 and over) with intellectual and developmental disabilities (IDD) in residential, employment, day services, and other in-home or community inclusion programs. The survey captures data on wages, benefits, turnover rates, and recruitment/retention strategies of the Direct Care Workers (DCWs), who are providing direct supports to adults enrolled on the Developmental Disabilities (DD) or Supported Living Services (SLS) waivers and are employed by the provider agencies surveyed.

Participating in this survey provided Colorado the opportunity for provider agencies, advocates, and researchers to work together to examine workforce challenges, identify areas for further investigation, benchmark workforce data, measure improvements made through policy or programmatic changes, and compare Colorado’s data, to those of other states.

National Reports

National Report Snapshots

State Reports

In response to the national COVID-19 public health emergency, National Core Indicators (NCI) added a state-optional COVID-19 Supplement to all NCI-IDD surveys. The COVID-19 Supplements were created to support the understanding of the experience of people with intellectual and developmental disabilities (IDD) and their families at the beginning of the COVID-19 pandemic, and their interactions with services, provider agencies, and direct service providers. Data were collected between July 1, 2020, and June 30, 2021. Colorado participated in the COVID-19 Supplemental Survey as these survey findings are intended to inform states as they plan for the future.

National Reports

The National Core Indicators (NCI) Child Family Survey (CFS) is mailed to families who have a child (under the age of 18) with an intellectual and/or developmental disability who lives in the family’s home and receives at least one service, in addition to case management.

The intent of the survey is to understand demographics and address key areas of concern such as respect/rights, service planning, community inclusion, choice, and health and safety. The data that result from NCI surveys are often used to inform strategic planning, produce legislative reports, prioritize quality improvement initiatives, and to also share the data with stakeholder groups and use the stakeholder feedback to help set priorities and establish policy direction. 

Colorado discontinued participation after the conclusion of the 2021-2022 survey cycle, and instead has focused on creating a new survey, Children’s Wavier Satisfaction Survey, to include all four children’s waivers.

National Reports

State Reports

State Report Snapshots

NCI Remote Survey Pilot Study Summary Results 2019-20

  • Due to the COVID-19 global pandemic, the declaration of a national public health emergency, and the need to avoid in-person contact, NCI states had to prematurely end the 2019-2020 data collection cycle for the NCI In-Person Survey. Anticipating continued challenges to direct-contact data collection in future cycles, NCI expanded an ongoing pilot study to assess the feasibility of administering the survey through videoconference.
     
  • Colorado participated in this survey and the following results, based on 226 remote surveys, are summarized in this brief report.

Wages are not the only consideration in someone’s decision to work in a certain field. Through the ARPA 1.09 project, HCPF researched innovative opportunities for increasing compensation for the HCBS workforce, with the goal of identifying ways to provide childcare for direct care workers; explore funding for shift differentials; and identify other practices that could better support low-income workers, such as hiring retention specialists or case managers within home care agencies whose job is to support the frontline workers.

For questions or more information about the Workforce Compensation Research, please contact the Direct Care Workforce Team at hcpf_dcworkforce@state.co.us or visit the ARPA project website.

View the Direct Care Workforce Compensation Research Final Report - May 2024

Contacts

For questions or to access older reports, email HCPF_HCBS_Surveys@state.co.us 

 

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