North Carolina Transitions to Community Living Quality Assurance and Performance Improvement

High-quality, person-centered long-term services and supports are foundational to Medicaid system performance, and necessary to meet state obligations under the Americans with Disabilities Act and the U.S. Supreme Court's 1999 Olmstead Decision. North Carolina’s Transitions to Community Living (TCL) provides long-term housing, community-based services, and supported employment. It promotes community integration for adults living with serious mental illness or serious and persistent mental illness.

North Carolina’s Department of Health and Human Services engaged Mathematica to develop and implement a data-driven quality assurance and performance improvement system for TCL. We began this work by gathering and documenting information about current TCL measurement and reporting, soliciting stakeholder input, and applying frameworks for national quality measures to develop an initial set of performance measures for the TCL system.

In turn, the TCL data analytics platform integrates and transforms information—including Medicaid, state mental health, housing, employment, experience-of-care, and quality-of-life data—from numerous sources, for display in the TCL data dashboard. The dashboard is designed to show measure results and trends to clearly identify areas of success and opportunities for improvement, and to help the state with decision making.