Reducing Racial Disparities: Quality Improvement in Developmental Disability System Services

The COVID-19 pandemic has further compounded healthcare disparities faced by people of color and members of the disability community—a fact demonstrated in the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and Human Services Research Institute (HSRI)’s recent COVID-19 bulletin #4, entitled Data on Racial Disparities.

Citing data such as the Centers for Disease Control and Prevention’s report that minority groups are 4 to 5 times more likely to die from the COVID-19 than non-Hispanic white people, the bulletin highlights the disproportionate impact of the virus on communities of color.  Additionally, without current reliable data regarding the effects of the virus on the population with developmental disabilities (DD), the bulletin examines National Core Indicator (NCI) data to highlight the increased vulnerability of minority groups with intellectual and developmental disabilities, who navigate multifaceted obstacles along with the risk of this deadly virus.

Setting Goals that Matter

NCI data is designed to be the voice of the customer—the people who receive healthcare services, their families and their input on those providing the services—and is gathered to help state agencies evaluate, benchmark and improve their own performance over time.  As states build quality management systems and strive for continuous quality improvement, NCI data can be used to inform a state’s decision to implement goals and quality measures related to reducing the gap of racial inequality in care for individuals with intellectual and developmental disabilities.

The NASDDS and HSRI’s bulletin includes key recommendations for how state agencies should “continue to improve the collection of data that track possible racial and ethnic disparities” and “create cultural relevant supports”. When reviewing the bulletin findings of NCI data collected prior to the pandemic, states should closely survey the inequities and gaps in care.  Opportunities to close such gaps for minority groups who receive state DD system services could include:

  • increasing education on vaccination and access to flu shots to prepare for the COVID-19 vaccine;
  • increasing assessment and service planning to support wellness strategies tailored to mental health needs during the pandemic with culturally sensitive providers; and
  • increasing access to COVID-19 information and education, such as written material in languages other than English, as well as augmentative and alternative communication that includes visuals regarding the virus and hygiene.

This pandemic has illustrated the importance of understanding and closely investigating those healthcare inequities and outcomes—particularly for individuals of color receiving DD services.

How States can use National Core Indicators

As a Centers for Medicare and Medicaid Services (CMS)-certified Quality Improvement Organization (QIO-like), Public Consulting Group’s services are dedicated to improving health quality outcomes and increasing patient safety and access to care. We help states administer NCI surveys and measure both performance and outcomes related to individuals’ care needs, health and welfare, and individual rights.

The process for quality improvement begins with identifying the changes states want to make that will improve the lives of those served. Once those goals are implemented, PCG works to identify the NCI measures needed to monitor goals and uses formal quality improvement processes to achieve the outcomes.

If you would like to learn more about how PCG can help your state improve quality of care for its residents, please reach out to Jennifer Martinez at

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