North Carolina

In 2005 CMS funded a national evaluation by a consortium led by the RAND Corporation to study the implementation and outcomes of ten funded initiatives. These initiatives were meant to improve the recruitment and retention of the Direct Service Community Workforce. Review the report and listen to a recorded webinar where the author's present their findings.

The CMS website has been updated with the new 508 compliant MSIS Medicaid eligibility and claims tables for federal fiscal years 2005 through 2008 for 31 states. Individual or groups of tables may be selected using the identified dynamic list options. The standard MSIS fiscal year tables will be updated periodically as additional states submit their data for the full fiscal year.

The purpose of this report is fourfold: 1) to present a brief overview of the results of the Systems Change grants awarded from FY 2001 through FY 2004, 2) to describe the remaining challenges to community living that Grantees identified, 3) to provide Grantees’ recommendations for actions needed at the state and federal level to further improve their long-term care systems, and 4) to discuss the key lessons learned regarding factors that are needed to improve states’ long-term care systems.

CMS awarded the fourth round of 3-year grants for RCSC in Sept 2004. Three categories of grants were awarded: Research and Demonstration grants (40), Technical Assistance grants (10), and Feasibility Study and Development grants (2). This report focuses on the outcomes and Enduring Systems Improvements in Housing, Comprehensive Systems Reform, Mental Health Systems Transformation, Quality, Rebalancing, and Family to Family Grantees.

This updated resource provides a state-by-state look at wages and wage trends for PHCAs, the second fastest growing occupation in the country, and a key job title within the direct-care workforce. Review wages over a 9-year period. Prepared as a resource guide on wages for advocates and policymakers concerned with the direct-care workforce, the data underscore the problem of low and declining real wages for PHCAs, factors which contribute to workforce.

This issue brief examines the early successes and challenges of MFP. A 2008 survey of 29 states receiving MFP grants turned up several key findings, including that several hundred people have moved from institutional to community settings; that states are providing a broad range of services to facilitate transition; that housing issues for MFP participants are a major challenge for states; and that the severe economic downturn had not yet prompted states to scale back their efforts.

RTI is preparing a series of reports to document outcomes from the Systems Change grants. Divided into six parts, the first four provide an overview of the enduring improvements, continuing challenges, lessons learned, and recommendations of the 48 Research & Demonstration Grantees, organized by the four types of grants: CPASS, MFP, IP, & QA/QI. Part 5 provides summaries of the FTF Grants. Part 6 reviews the Respite for Adults and Children and Community-Based Treatment Alternatives for Children.

In September 2004 CMS provided $3.6 million to fund MHST grants to encourage states to develop mental health systems infrastructure to implement and sustain evidence-based and recovery-oriented practices. Grants were awarded to 12 states under the Systems Change grants program. This report describes the initiatives with a focus on implementation issues and challenges and how they addressed them. Four Grantees focused solely on evidence-based practices, six on recovery practices, and two on both.

In each issue of HCBS.org NewsCLIPS we examine a topic related to home and community-based care by providing an overview of recent papers and publications. This issue of NewsCLIPS highlights Housing. Access to affordable, accessible and integrated housing is a component critical to the efficacy of home and community based services. The NCB Capital Impact team of experts helped gather examples and promising practices on affordable, community based housing options.

The first in a series on a system change, this report is a collaborative with state developmental disability agencies. In each various location, the goal has been consistent, to create person centered systems that support person directed services. What follows is a brief overview of central ideas including: learning what is and is not working, using value-based skills to drive change, improve quality of life with skills, quality management and organizational development tools.