HCBS Reports and Surveys

DSDS conducts two annual surveys, categorized by service type, to gather comprehensive data on the direct care workforce and provider operational expenditures. These surveys collect crucial statistics including employee wages, benefits, turnover, vacancy rates, and information on recruitment and retention strategies, along with other vital workforce and operational cost details. The resulting key metrics are essential for informing policy and programmatic strategies, as well as for refining payment methodologies. The two surveys are:

• State of the Workforce – Aging and Disability (So-TW-AD)
  The State of the Workforce—Aging and Disability Survey is a national survey developed by Advancing States in partnership with the Human Services Research Institute.  The survey focuses on agency model (in-home or RCF/ALF) and adult day care providers.

• Consumer Directed Services Operational Survey
  The Consumer Directed Services Operational Survey, developed by DSDS, mirrors many of the measures in the SoTW-AD Survey and extends data collection to Consumer Directed providers not included in the national survey

How to Participate
The annual SoTW-AD survey cycle occurs in the fall, followed by the Consumer Directed survey completion in January and February. While the survey is voluntary providers are highly encouraged to participate and contribute to this essential data. DSDS will issue a one-time value-based payment of $2,000 to eligible providers that complete each survey fully and accurately.

Please send any questions to dsds.surveys@health.mo.gov.

Final Reports
After both surveys are finalized, a comprehensive report is compiled by DSDS to present comparisons across program types and analyze year-over-year trends. 

• Year 3 Report (2025) – COMING SOON
• Year 2 Report (2024)
• Year 1 Report (2023)

Additional national comparisons of the SoTW-AD survey is available here: https://nci-ad.org/sotw-ad/reports/

DSDS participates in the National Core Indicators – Aging and Disabilities (NCI-AD) Consumer Survey, a mandated assessment to evaluate the overall performance and delivery of Home and Community-Based Services (HCBS). The NCI-AD aim to help states measure the quality of programs designed to assist older adults and persons with disabilities. The survey provides valuable data on participants' quality of life, service satisfaction, and outcomes. It fulfills the Centers for Medicare & Medicaid Services (CMS) Access Rule requirements and helps inform legislators and program leaders of program effectiveness.

The Centers for Medicare and Medicaid Services (CMS) mandates a formal review of service rates at least every five years. These rate studies determine whether provider fee schedules are reasonable and appropriate given current market conditions. The information presented here pertains to rate studies for services authorized by the Department of Health and Senior Services.