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.

Minnesota Specific Sample

Total Sample Frame: 62425

Total surveys completed: 1148

Overall Margin of Error 2.87%

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)
MN Community Alternative Care (CAC) Waiver Medicaid 1915 (c) Waiver Certified as disabled by the Social Security Administration or the State Medical Review Team, Choose care in the community instead of a hospital , Eligible for Medical Assistance, Have a Community Support Plan, which includes assurances of the health and safety for the person , Require the level of care provided in a hospital , Under the age of 65 years when the waiver is opened 34075 5 4.86% 4.46%
MN Brain Injury (BI) Waiver Medicaid 1915 (c) Waiver Are assessed at Level IV or above on the Rancho Los Amigos Levels of Cognitive Functioning Scale Are certified as disabled by the State Medical Review Team or by the Social Security Administration Are eligible for Medical Assistance Are under the age of 65 years when the waiver is opened Are determined to need the level of care available in a nursing facility or neurobehavioral hospital Choose services in the community instead of services in a nursing facility or neurobehavioral hospital Have a documented diagnosis of traumatic or acquired brain injury or degenerative disease diagnosis where cognitive impairment is present, provided the diagnosis is not congenital Experience significant/severe behavioral and cognitive problems related to the injury or disease 34075 7 4.86% 4.46%
MN Community Access for Disability Inclusion (CADI) Medicaid 1915 (c) Waiver Be eligible for Medical Assistance Be certified disabled by the State Medical Review Team or by the Social Security Administration Be under the age of 65 years when the waiver is opened Be determined to require the level of care provided to individuals in a nursing facility Have an assessed need for supports and services over and above those available under other funding sources Choose care and services in the community instead of a nursing facility 34075 394 4.86% 4.46%
MN State Plan Home Care (Adults age 65+) Medicaid State Plan Adults age 65 and older receiving at least PCA services through a MCO. 1866 82 10.82% 9.92%
MN Alternative Care Program (AC) Medicaid Waiver Adults age 65 and older. The Alternative Care (AC) program provides home-and community-based services to people who need nursing home level of care but choose to live in the community. Alternative Care is for people with low income and assets who are not eligible for Medical Assistance. 1762 74 11.39% 10.44%
MN Elderly Waiver (EW) Medicaid Waiver Adults age 65 and older. The Elderly Waiver (EW) program provides home and community-based services for people who need the level of care provided in a nursing home but who choose to live in the community and qualify for Medical Assistance. 24722 586 4.05% 3.71%

What is included in this report?

This report presents Minnesota 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
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 51.5 406
State Plan Home Care (Adults age 65+) 71.4 79
Alternative Care Program (AC) 77.1 67
Elderly Waiver - Fee For Service (EW-FFS) 78.1 58
Elderly Waiver- Managed Care (EW- MC) 76.6 465
Overall State Average 62.2 1075
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
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 31% 51% 18% 0% 406
State Plan Home Care (Adults age 65+) 0% 0% 96% 4% 82
Alternative Care Program (AC) 0% 0% 91% 9% 74
Elderly Waiver - Fee For Service (EW-FFS) 0% 0% 83% 17% 70
Elderly Waiver- Managed Care (EW- MC) 0% 0% 90% 10% 516
Overall State Average 17% 28% 51% 5% 1148
NCI-AD Weighted Average 8% 27% 58% 6% 13593

Table 4. Gender

Program Male Female Other Don’t know or unclear N
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 44% 56% 0% 0% 406
State Plan Home Care (Adults age 65+) 24% 76% 0% 0% 82
Alternative Care Program (AC) 23% 77% 0% 0% 74
Elderly Waiver - Fee For Service (EW-FFS) 29% 71% 0% 0% 70
Elderly Waiver- Managed Care (EW- MC) 27% 73% 0% 0% 516
Overall State Average 36% 64% 0% 0% 1148
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
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 4% 2% 30% 0% 63% 1% 2% 0% 0% 406
State Plan Home Care (Adults age 65+) 6% 24% 33% 0% 33% 2% 4% 0% 0% 82
Alternative Care Program (AC) 0% 1% 8% 1% 82% 5% 7% 0% 0% 74
Elderly Waiver - Fee For Service (EW-FFS) 6% 9% 9% 1% 69% 6% 7% 0% 0% 70
Elderly Waiver- Managed Care (EW- MC) 2% 12% 9% 0% 74% 11% 4% 0% 0% 516
Overall State Average 3% 7% 21% 0% 67% 5% 3% 0% 0% 1148
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
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 59% 7% 30% 4% 0% 406
State Plan Home Care (Adults age 65+) 28% 10% 40% 22% 0% 82
Alternative Care Program (AC) 16% 9% 42% 33% 0% 69
Elderly Waiver - Fee For Service (EW-FFS) 7% 19% 35% 39% 0% 54
Elderly Waiver- Managed Care (EW- MC) 14% 18% 39% 29% 0% 505
Overall State Average 40% 11% 34% 15% 0% 1116
NCI-AD Weighted Average 28% 15% 27% 25% 4% 13114

Table 7. Preferred Language

Program English Spanish Other Don’t know or unclear N
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 90% 0% 10% 0% 406
State Plan Home Care (Adults age 65+) 70% 0% 30% 0% 82
Alternative Care Program (AC) 96% 1% 3% 0% 74
Elderly Waiver - Fee For Service (EW-FFS) 97% 0% 3% 0% 70
Elderly Waiver- Managed Care (EW- MC) 77% 4% 18% 0% 516
Overall State Average 85% 2% 13% 0% 1148
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
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 80% 7% 5% 7% 406
State Plan Home Care (Adults age 65+) 83% 9% 6% 2% 82
Alternative Care Program (AC) 72% 12% 8% 8% 74
Elderly Waiver - Fee For Service (EW-FFS) 79% 7% 11% 3% 70
Elderly Waiver- Managed Care (EW- MC) 52% 19% 14% 15% 516
Overall State Average 70% 12% 9% 10% 1148
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
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 0% 1% 4% 9% 37% 20% 11% 8% 5% 4% 1% 405
State Plan Home Care (Adults age 65+) 0% 0% 2% 9% 39% 15% 15% 7% 9% 4% 1% 82
Alternative Care Program (AC) 0% 1% 0% 8% 30% 15% 12% 15% 15% 1% 3% 74
Elderly Waiver - Fee For Service (EW-FFS) 0% 0% 0% 10% 20% 16% 17% 19% 9% 9% 1% 70
Elderly Waiver- Managed Care (EW- MC) 0% 1% 1% 9% 40% 21% 13% 6% 4% 3% 2% 515
Overall State Average 0% 1% 3% 9% 37% 20% 12% 8% 5% 4% 2% 1146
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
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 82% 0% 12% 0% 0% 1% 5% 0% 406
State Plan Home Care (Adults age 65+) 90% 4% 2% 0% 0% 0% 0% 4% 82
Alternative Care Program (AC) 70% 19% 3% 4% 1% 0% 1% 1% 73
Elderly Waiver - Fee For Service (EW-FFS) 31% 7% 0% 51% 6% 0% 4% 0% 70
Elderly Waiver- Managed Care (EW- MC) 57% 13% 2% 21% 4% 0% 0% 3% 513
Overall State Average 71% 6% 7% 10% 2% 1% 3% 1% 1144
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
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 47% 11% 25% 4% 2% 16% 0% 398
State Plan Home Care (Adults age 65+) 23% 12% 63% 1% 2% 1% 0% 82
Alternative Care Program (AC) 69% 7% 16% 0% 1% 5% 0% 74
Elderly Waiver - Fee For Service (EW-FFS) 66% 10% 16% 1% 1% 9% 0% 70
Elderly Waiver- Managed Care (EW- MC) 58% 13% 20% 0% 1% 5% 0% 516
Overall State Average 52% 12% 24% 2% 2% 11% 0% 1140
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
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 9% 91% 0% 406
State Plan Home Care (Adults age 65+) 5% 95% 0% 80
Alternative Care Program (AC) 7% 92% 1% 72
Elderly Waiver - Fee For Service (EW-FFS) 10% 90% 0% 69
Elderly Waiver- Managed Care (EW- MC) 7% 93% 0% 500
Overall State Average 8% 92% 0% 1127
NCI-AD Weighted Average 6% 92% 2% 12980
Program No Yes N
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 91% 9% 406
State Plan Home Care (Adults age 65+) 95% 5% 80
Alternative Care Program (AC) 93% 7% 71
Elderly Waiver - Fee For Service (EW-FFS) 90% 10% 69
Elderly Waiver- Managed Care (EW- MC) 93% 7% 499
Overall State Average 92% 8% 1125
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
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 58% 6% 22% 3% 0% 11% 0% 0% 36
Elderly Waiver- Managed Care (EW- MC) 62% 12% 3% 6% 9% 0% 6% 0% 32
Overall State Average 59% 8% 15% 4% 4% 7% 3% 0% 84
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: State Plan Home Care (Adults age 65+), Alternative Care Program (AC), Elderly Waiver - Fee For Service (EW-FFS)

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
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 100% 17% 10% 3% 12% 9% 14% 11% 30% 42%
State Plan Home Care (Adults age 65+) 83% 10% 2% 7% 21% 6% 21% 22% 27% 62%
Alternative Care Program (AC) 27% 7% 0% 7% 31% 25% 23% 15% 44% 73%
Elderly Waiver - Fee For Service (EW-FFS) 60% 7% 0% 7% 38% 13% 21% 22% 22% 59%
Elderly Waiver- Managed Care (EW- MC) 49% 4% 1% 11% 30% 17% 20% 19% 40% 61%
Overall State Average 78% 12% 6% 6% 20% 12% 17% 14% 34% 51%
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
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 80% 20% 0% 406
State Plan Home Care (Adults age 65+) 41% 59% 0% 82
Alternative Care Program (AC) 49% 51% 0% 74
Elderly Waiver - Fee For Service (EW-FFS) 56% 44% 0% 70
Elderly Waiver- Managed Care (EW- MC) 45% 55% 0% 516
Overall State Average 65% 35% 0% 1148
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
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 0% 0% 0% 0% 100% 406
State Plan Home Care (Adults age 65+) 68% 21% 22% 5% 5% 82
Alternative Care Program (AC) 19% 53% 53% 28% 0% 74
Elderly Waiver - Fee For Service (EW-FFS) 40% 39% 39% 21% 0% 70
Elderly Waiver- Managed Care (EW- MC) 28% 53% 53% 18% 0% 516
Overall State Average 14% 23% 23% 8% 55% 1148
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
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 24% 75% 1% 403
State Plan Home Care (Adults age 65+) 19% 81% 0% 79
Alternative Care Program (AC) 15% 85% 0% 72
Elderly Waiver - Fee For Service (EW-FFS) 32% 68% 0% 69
Elderly Waiver- Managed Care (EW- MC) 19% 81% 0% 495
Overall State Average 22% 77% 1% 1118
NCI-AD Weighted Average 28% 70% 1% 12866

Table 18. Receives Medicare

Program Yes No Don’t know or unclear N
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 66% 34% 0% 406
State Plan Home Care (Adults age 65+) 82% 18% 0% 82
Alternative Care Program (AC) 100% 0% 0% 74
Elderly Waiver - Fee For Service (EW-FFS) 96% 4% 0% 70
Elderly Waiver- Managed Care (EW- MC) 96% 4% 0% 516
Overall State Average 79% 21% 0% 1148
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
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 0% 2% 23% 75% 0% 406
State Plan Home Care (Adults age 65+) 9% 16% 45% 30% 0% 82
Alternative Care Program (AC) 14% 8% 39% 34% 5% 74
Elderly Waiver - Fee For Service (EW-FFS) 33% 10% 26% 16% 16% 70
Elderly Waiver- Managed Care (EW- MC) 11% 11% 33% 37% 7% 516
Overall State Average 6% 6% 28% 57% 3% 1148
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
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 64% 36% 357
State Plan Home Care (Adults age 65+) 60% 40% 62
Alternative Care Program (AC) 63% 37% 65
Elderly Waiver - Fee For Service (EW-FFS) 84% 16% 44
Elderly Waiver- Managed Care (EW- MC) 68% 32% 414
Overall State Average 66% 34% 942
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
Community Alternative Care (CAC) Waiver, Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) 70% 7% 22% 362
State Plan Home Care (Adults age 65+) 63% 13% 24% 63
Alternative Care Program (AC) 62% 8% 31% 65
Elderly Waiver - Fee For Service (EW-FFS) 77% 2% 21% 47
Elderly Waiver- Managed Care (EW- MC) 70% 9% 21% 419
Overall State Average 70% 8% 22% 956
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