North Carolina Olmstead Plan
North Carolina
Opportunity
HSRI, along with partners at the Technical Assistance Collaborative (TAC), analyzed data to examine the extent to which North Carolina is providing behavioral health services to the covered target population in adherence with the Olmstead Settlement Agreement. This involved analyzing claims from Medicaid and state-funded services for individuals transitioning from adult care homes to independent living in the community. The analysis examines service utilization and costs.
Approach
Analyzing data from agencies serving people with disabilities
This comprehensive analysis included five target populations: Medicaid-eligible and non-insured individuals of all ages who have intellectual or developmental disabilities (IDD), mental health and/or substance use disorders, Traumatic Brain Injury (TBI), or physical disabilities.
For these target groups, HSRI obtained and analyzed data from the following sources:
- Claim/encounter data for Medicaid-funded services and supports
- Claim/encounter data for services and supports funded by NC DHHS
- Data from the state’s Division of State-Operated Healthcare Facilities (DSOHF)
Synthesizing findings with other secondary data
In addition to analysis of claims data, we identified and synthesized state-level data from publicly available data systems and reports to drive recommendations, including SAMHSA Uniform Reporting System (URS), National Core Indicators, the Residential Information Systems Project (RISP), the NC Division of Vocational Rehabilitation Services, and many others.
Impact
We found variation in service penetration across the LME/MCOs that do not appear to impact the use of state psychiatric beds.
There are disparities in service penetration, with people of color disproportionately represented in state psychiatric hospitals and crisis services.
The findings from our data analysis, in combination with qualitative data collected through key informant interviews and listening sessions, led to the development of detailed recommendations for North Carolina to reduce its reliance on institutional care for people with disabilities.