What is NCI-AD?

Establish in 2015, National Core Indicators—Aging and Disabilities™ (NCI-AD™) is a voluntary effort by state aging and physical disability agencies to measure and track their performance using a standardized set of nationally validated measures. The effort is coordinated by Advancing States and Human Services Research Institute (HSRI). Learn more about our history here.

In 2021-22 a total of 19 states participated in NCI-AD. Not all participating states do all surveys every year.

What is the NCI-AD
Adult Consumer Survey?

The NCI-AD Adult Consumer Survey (ACS), is standardized survey conducted with a person receiving long term services and supports (LTSS) through state aging and physical disability systems. Surveys are conducted by trained surveyors through in-person, secure video meeting, or over-the-phone conversations with service participants. The main part of the survey contains subjective questions about how well services are supporting the person; these can only be answered by the person themselves. A subset of more objective questions may be answered by a proxy respondent if needed. In addition to the questions for service participants, the survey also collects background information on the person –demographic and service-related data – mainly from service agency records. In 2021-22, the survey included two state-optional modules:

Person-Centered Planning Module. This is a series of questions that ask about the person-centered planning process, including the person’s experience developing the service plan and the service planning meeting. The following states conducted the Person-Centered Planning Module: CO, DE, GA, IN, KS, MI, MN, MO, NJ, OK, TX, WA, WI.

COVID-19 Supplement. This included a series of questions of the person’s experience with services during COVID-19 and the overall impact of the pandemic on the person’s life. The following states conducted the COVID-19 Supplement: CO, DE, GA, IN, KS, MI, MN, MO, NJ, OK, TX, WA, WI.

Sampling

There is considerable variation in how states’ long-term services and supports (LTSS) programs serving older adults and adults with physical disabilities are organized, funded, and administered. The NCI-AD program allows states to include programs funded through Medicaid, the Older Americans Act, Program of All-Inclusive Care for the Elderly (PACE), state-only funds, and/or other state- and federal-blended funds. The NCI-AD project team works closely with each participating NCI-AD state to advise and track which LTSS program populations and sub-populations are included in the state’s sampling strategy, how that sample is designed and how many surveys are targeted for completion. See detailed information on state sample frames here.

Delaware Specific Sample

Total Sample Frame: 10333

Total surveys completed: 781

Overall Margin of Error 3.37%

Program Category

Table 1. Classification of 2021-22 State programs

STATE Program Funding Source Description of Program Total Population Eligible for NCI-AD Total Usable Surveys Collected MoE (95%Confidence, 0.5 Distribution) MoE (95%Confidence, 0.7 Distribution)
DE Home and Community Based Services (DMMA) Medicaid administrative funds and state Medicaid funds Sample drawn from a population of Medicaid-enrolled HCBS recipients and stratified by two MCOs — AmeriHealth and Highmark. 7175 311 5.56% 5.09%
DE Nursing Facility (DMMA) Medicaid administrative Sample drawn from a population of Medicaid-enrolled skilled nursing facility recipients and stratified by two MCOs — AmeriHealth and Highmark. 2456 325 5.44% 4.98%
DE Home Community Based Services Program (DSAAPD) OAA, State, Social Services Block Grant (SSBG) Non-Medicaid enrolled who are low income and either over 60 years (OAA) or under 60 years (SSBG and State). 702 145 8.14% 7.46%

What is included in this report?

This report presents Delaware 2021-22 ACS demographics and outcomes results. Data are shown for the overall statewide average, broken out by program sampled, and include the weighted NCI-AD Average.

Please note: Extreme caution should be used when interpreting results where the number of valid responses is small. Each program’s valid number of responses (valid Ns) is shown in every chart and table in this report.

To protect people’s privacy we do not show the data when 20 or fewer people from a state or within a program responded to a question, however their data are included in the overall state average.

Presentation of Data

Data may be viewed as bar charts or in tables by clicking the appropriate tab for each outcome. Data presented in charts are “collapsed” meaning that data grouped by response options to what is considered to reflect a positive outcome and all other responses. Tables represent the un-collapsed data outcomes.

All NCI-AD data are collapsed “yes” responses only, unless otherwise noted.

All state and NCI-AD averages throughout this report are “weighted” to account for any non-proportional sampling of programs and to “rebalance” the states’ sample sizes according to their populations of survey-eligible service recipients. See more details on weighting in Part II of this report.

Results

Demographics

Table 2. Average age (reported for those under 90 years old)

Program Age N
Amerihealth Home and Community Based Services (DMMA) 58.2 150
Highmark Home and Community Based Services (DMMA) 55.5 156
Amerihealth Nursing Facility (DMMA) 71.6 148
Highmark Nursing Facility (DMMA) 71.1 157
Home Community Based Services Program (DSAAPD) 67.5 140
Overall State Average 60.9 751
NCI-AD Weighted Average 66.8 12847

Table 3. Age Category (including those 90 and older)

Program 18-44 45-64 65-89 90+ N
Amerihealth Home and Community Based Services (DMMA) 20% 41% 37% 2% 153
Highmark Home and Community Based Services (DMMA) 22% 44% 33% 1% 158
Amerihealth Nursing Facility (DMMA) 4% 18% 71% 6% 158
Highmark Nursing Facility (DMMA) 2% 20% 71% 6% 167
Home Community Based Services Program (DSAAPD) 8% 30% 59% 3% 145
Overall State Average 16% 36% 45% 3% 781
NCI-AD Weighted Average 8% 27% 58% 6% 13593

Table 4. Gender

Program Male Female Other Don’t know or unclear N
Amerihealth Home and Community Based Services (DMMA) 35% 65% 0% 0% 153
Highmark Home and Community Based Services (DMMA) 41% 59% 0% 0% 158
Amerihealth Nursing Facility (DMMA) 44% 56% 0% 0% 158
Highmark Nursing Facility (DMMA) 33% 67% 0% 0% 167
Home Community Based Services Program (DSAAPD) 33% 67% 0% 0% 145
Overall State Average 37% 63% 0% 0% 781
NCI-AD Weighted Average 32% 68% 0% 0% 13595

Table 5. Race and ethnicity

Program American Indian or Alaska Native Asian Black or African American Pacific Islander White Hispanic or Latino Other Don’t know Unclear/Refused/No Response N
Amerihealth Home and Community Based Services (DMMA) 0% 2% 44% 2% 52% 7% 0% 0% 0% 153
Highmark Home and Community Based Services (DMMA) 1% 3% 41% 1% 54% 8% 0% 0% 0% 158
Amerihealth Nursing Facility (DMMA) 0% 1% 25% 3% 72% 3% 0% 0% 0% 158
Highmark Nursing Facility (DMMA) 0% 1% 19% 5% 76% 4% 0% 0% 0% 167
Home Community Based Services Program (DSAAPD) 1% 0% 46% 0% 51% 2% 1% 0% 0% 145
Overall State Average 0% 2% 38% 2% 58% 6% 0% 0% 0% 781
NCI-AD Weighted Average 2% 5% 23% 0% 60% 9% 2% 3% 2% 13134

Table 6. Marital Status

Program Single, never married Married or in domestic partnership Separated or divorced Widowed Don’t know or unclear N
Amerihealth Home and Community Based Services (DMMA) 42% 11% 27% 19% 1% 149
Highmark Home and Community Based Services (DMMA) 43% 18% 19% 20% 1% 157
Amerihealth Nursing Facility (DMMA) 24% 11% 22% 38% 6% 152
Highmark Nursing Facility (DMMA) 23% 14% 23% 37% 3% 159
Home Community Based Services Program (DSAAPD) 23% 30% 18% 29% 0% 141
Overall State Average 37% 15% 22% 24% 1% 758
NCI-AD Weighted Average 28% 15% 27% 25% 4% 13114

Table 7. Preferred Language

Program English Spanish Other Don’t know or unclear N
Amerihealth Home and Community Based Services (DMMA) 99% 1% 0% 0% 153
Highmark Home and Community Based Services (DMMA) 97% 3% 0% 0% 158
Amerihealth Nursing Facility (DMMA) 99% 1% 0% 0% 158
Highmark Nursing Facility (DMMA) 100% 0% 0% 0% 167
Home Community Based Services Program (DSAAPD) 99% 1% 0% 0% 142
Overall State Average 98% 2% 0% 0% 778
NCI-AD Weighted Average 89% 4% 7% 0% 13409

Table 8. Residential Designation

Categories created using zip codes and corresponding RUCA codes

Program Metropolitan Micropolitan Rural Small Town N
Amerihealth Home and Community Based Services (DMMA) 91% 8% 0% 1% 153
Highmark Home and Community Based Services (DMMA) 92% 8% 0% 0% 158
Amerihealth Nursing Facility (DMMA) 91% 8% 0% 1% 158
Highmark Nursing Facility (DMMA) 86% 10% 0% 4% 167
Home Community Based Services Program (DSAAPD) 86% 14% 0% 1% 145
Overall State Average 90% 9% 0% 1% 781
NCI-AD Weighted Average 72% 14% 6% 9% 13085

Table 9. Median Income (based on zip code)

Newly reported in 2021-2022

Program $0- $9,999 $10,000- $19,999 $20,000- $29,999 $30,000- $39,999 $40,000- $49,999 $50,000- $59,999 $60,000- $69,999 $70,000- $79,999 $80,000- $89,999 $90,000- $99,999 $100,000 and over N
Amerihealth Home and Community Based Services (DMMA) 0% 0% 4% 5% 24% 33% 3% 27% 3% 0% 1% 153
Highmark Home and Community Based Services (DMMA) 0% 0% 9% 6% 27% 30% 2% 20% 4% 1% 1% 158
Amerihealth Nursing Facility (DMMA) 0% 0% 0% 0% 18% 32% 1% 27% 13% 5% 4% 158
Highmark Nursing Facility (DMMA) 0% 0% 0% 1% 26% 32% 2% 25% 12% 1% 2% 167
Home Community Based Services Program (DSAAPD) 0% 0% 2% 6% 24% 47% 3% 13% 6% 0% 0% 144
Overall State Average 0% 0% 5% 4% 25% 33% 2% 23% 6% 1% 1% 780
NCI-AD Weighted Average 0% 1% 9% 27% 27% 16% 9% 5% 3% 1% 1% 12977

Table 10. Type of Residence

Program Own or family house or apartment Senior living apartment or complex Group home, adult family home, foster home, host home Assisted living facility, residential care facility Nursing facility, nursing home Homeless or temporary shelter Other Don’t know or unclear N
Amerihealth Home and Community Based Services (DMMA) 72% 8% 1% 14% 5% 1% 0% 0% 151
Highmark Home and Community Based Services (DMMA) 82% 4% 2% 10% 2% 0% 1% 0% 158
Amerihealth Nursing Facility (DMMA) 0% 0% 0% 0% 100% 0% 0% 0% 158
Highmark Nursing Facility (DMMA) 0% 0% 0% 0% 100% 0% 0% 0% 167
Home Community Based Services Program (DSAAPD) 97% 1% 1% 1% 0% 0% 1% 0% 142
Overall State Average 60% 4% 1% 8% 26% 0% 0% 0% 776
NCI-AD Weighted Average 76% 7% 2% 7% 6% 0% 2% 1% 13448

Table 11. Who the person lives with

Program No One – Lives Alone Spouse or Partner Other Family Friend(s) Live-in PCA Others Don’t know or unclear N
Amerihealth Home and Community Based Services (DMMA) 31% 13% 47% 1% 2% 12% 0% 150
Highmark Home and Community Based Services (DMMA) 32% 13% 53% 1% 2% 6% 1% 158
Amerihealth Nursing Facility (DMMA) 0% 0% 0% 0% 0% 100% 0% 158
Highmark Nursing Facility (DMMA) 0% 0% 0% 0% 0% 100% 0% 167
Home Community Based Services Program (DSAAPD) 31% 32% 41% 2% 1% 3% 0% 142
Overall State Average 24% 11% 37% 1% 1% 30% 0% 775
NCI-AD Weighted Average 47% 13% 28% 2% 2% 9% 1% 13355

Table 12. Address Change

Program Yes No Don’t know or unclear N
Amerihealth Home and Community Based Services (DMMA) 6% 94% 0% 150
Highmark Home and Community Based Services (DMMA) 6% 94% 0% 158
Amerihealth Nursing Facility (DMMA) 3% 97% 1% 154
Highmark Nursing Facility (DMMA) 3% 97% 0% 160
Home Community Based Services Program (DSAAPD) 5% 95% 0% 142
Overall State Average 5% 95% 0% 764
NCI-AD Weighted Average 6% 92% 2% 12980
Program No Yes N
Amerihealth Home and Community Based Services (DMMA) 94% 6% 150
Highmark Home and Community Based Services (DMMA) 94% 6% 158
Amerihealth Nursing Facility (DMMA) 97% 3% 153
Highmark Nursing Facility (DMMA) 97% 3% 160
Home Community Based Services Program (DSAAPD) 95% 5% 142
Overall State Average 95% 5% 763
NCI-AD Weighted Average 94% 6% 12752

Table 13. Where people moved from (if moved in the last 6 months)

Program Own or family house or apartment Senior living apartment or complex Group home, adult family home, foster home, host home Assisted living facility, residential care facility Nursing facility, nursing home Homeless or temporary shelter Other Don’t know or unclear N
Overall State Average 58% 9% 4% 13% 1% 0% 13% 0% 34
NCI-AD Weighted Average 63% 5% 4% 5% 5% 3% 14% 1% 689
* The following programs had an N of less than 20 and were not shown: Amerihealth Home and Community Based Services (DMMA), Highmark Home and Community Based Services (DMMA), Amerihealth Nursing Facility (DMMA), Highmark Nursing Facility (DMMA), Home Community Based Services Program (DSAAPD)

Table 14. Diagnoses

All categories except ‘physical disability’, ‘intellectual or other developmental disability’, and ’Alzheimer’s disease or other dementia are new in 2021-22. Categories are not mutually exclusive; therefore, N is not shown.

Program Physical Disability Traumatic brain injury or other acquired brain injury Intellectual or other developmental disability Alzheimer’s disease or dementia Heart Disease Cancer Chronic Obstructive pulmonary disease (COPD) Stroke Diabetes Hypertension (or high blood pressure
Amerihealth Home and Community Based Services (DMMA) 61% 12% 11% 5% 22% 6% 21% 18% 37% 56%
Highmark Home and Community Based Services (DMMA) 55% 14% 11% 6% 23% 9% 20% 18% 44% 61%
Amerihealth Nursing Facility (DMMA) 54% 7% 5% 14% 19% 12% 14% 23% 29% 45%
Highmark Nursing Facility (DMMA) 47% 1% 4% 18% 28% 9% 12% 32% 30% 50%
Home Community Based Services Program (DSAAPD) 56% 9% 8% 9% 30% 13% 14% 31% 39% 71%
Overall State Average 56% 11% 9% 9% 23% 9% 18% 21% 38% 57%
NCI-AD Weighted Average 70% 11% 8% 11% 33% 12% 23% 20% 37% 60%

Table 15. Person has chronic psychiatric or mental health diagnosis

Program Yes No Don’t know or unclear N
Amerihealth Home and Community Based Services (DMMA) 16% 83% 1% 146
Highmark Home and Community Based Services (DMMA) 24% 74% 3% 157
Amerihealth Nursing Facility (DMMA) 21% 71% 8% 154
Highmark Nursing Facility (DMMA) 20% 72% 8% 158
Home Community Based Services Program (DSAAPD) 17% 83% 0% 142
Overall State Average 20% 77% 3% 757
NCI-AD Weighted Average 35% 61% 3% 12828

Table 16. Level of Mobility

Categories are not mutually exclusive (except ‘Don’t know or unclear or unclear’).

Program Non-Ambulatory Moves self with wheelchair Moves self with other aids Moves self without aids Don’t know or unclear N
Amerihealth Home and Community Based Services (DMMA) 7% 34% 60% 33% 0% 149
Highmark Home and Community Based Services (DMMA) 7% 30% 63% 42% 0% 158
Amerihealth Nursing Facility (DMMA) 14% 57% 35% 16% 0% 155
Highmark Nursing Facility (DMMA) 14% 62% 37% 16% 0% 161
Home Community Based Services Program (DSAAPD) 4% 32% 68% 34% 0% 142
Overall State Average 8% 39% 56% 32% 0% 765
NCI-AD Weighted Average 8% 21% 53% 27% 8% 13086

Table 17. Has history of frequent falls (more than two falls in a six-month period)

Program Yes No Don’t know or unclear N
Amerihealth Home and Community Based Services (DMMA) 19% 80% 1% 147
Highmark Home and Community Based Services (DMMA) 18% 81% 1% 158
Amerihealth Nursing Facility (DMMA) 17% 80% 3% 153
Highmark Nursing Facility (DMMA) 18% 81% 1% 159
Home Community Based Services Program (DSAAPD) 25% 75% 0% 142
Overall State Average 19% 80% 1% 759
NCI-AD Weighted Average 28% 70% 1% 12866

Table 18. Receives Medicare

Program Yes No Don’t know or unclear N
Amerihealth Home and Community Based Services (DMMA) * 78% 22% 0% 101
Highmark Home and Community Based Services (DMMA) 69% 31% 0% 140
Amerihealth Nursing Facility (DMMA) 92% 8% 0% 158
Highmark Nursing Facility (DMMA) 95% 5% 0% 167
Home Community Based Services Program (DSAAPD) 90% 9% 1% 141
Overall State Average 80% 20% 0% 707
NCI-AD Weighted Average 79% 18% 3% 12473

Table 19. Length of time receiving LTSS services in current program

Program 0 - 5 months 6 months – less than 1 year 1 year – less than 3 years 3 or more years Don’t know or unclear N
Amerihealth Home and Community Based Services (DMMA) 3% 8% 49% 41% 0% 153
Highmark Home and Community Based Services (DMMA) 1% 1% 34% 64% 1% 158
Amerihealth Nursing Facility (DMMA) 1% 7% 54% 38% 0% 158
Highmark Nursing Facility (DMMA) 0% 1% 25% 74% 1% 167
Home Community Based Services Program (DSAAPD) 2% 6% 45% 46% 1% 145
Overall State Average 1% 4% 41% 53% 0% 781
NCI-AD Weighted Average 7% 6% 28% 54% 5% 11942

Outcome Tables and
Comparisons across Programs

Community Participation

Table 21. Gets to do things outside of their home as much as they want to

Bar chart

Table

Program Yes No N
Amerihealth Home and Community Based Services (DMMA) 69% 31% 122
Highmark Home and Community Based Services (DMMA) 71% 29% 138
Amerihealth Nursing Facility (DMMA) 44% 56% 117
Highmark Nursing Facility (DMMA) 46% 54% 128
Home Community Based Services Program (DSAAPD) 61% 39% 128
Overall State Average 64% 36% 633
NCI-AD Weighted Average 62% 38% 9950

Table 22. Takes part in activities with others as much as they want to (in-person or virtually)

Question changed in 2021-22

Bar chart

Table

Program Yes Sometimes No N
Amerihealth Home and Community Based Services (DMMA) 62% 10% 28% 121
Highmark Home and Community Based Services (DMMA) 59% 7% 34% 135
Amerihealth Nursing Facility (DMMA) 52% 15% 34% 116
Highmark Nursing Facility (DMMA) 57% 12% 31% 129
Home Community Based Services Program (DSAAPD) 54% 9% 38% 128
Overall State Average 58% 10% 32% 629
NCI-AD Weighted Average 58% 11% 31% 9904

Table 23. Reasons cannot always take part in activities with others as much as they want to (in-person or virtually)

Bar chart