Outcomes & Expectations

The NC Stakeholders Engagement Group was an initiative funded by the North Carolina Council on Developmental Disabilities from 2013 - 2016. The initiative is no longer active, but the website is being maintained as a resource to the general public. If you have questions, email info@cb-cg.com.

Entrance into the System

  • Utilize only one application to get all public services.
  • Employ a person who helps with enrollment and has nothing to gain from the choice of services.
  • Maintain a similar array of services across the state.
  • Allow individuals to move from one part of the state to another and keep services

Waiting Lists

  • Provide everyone with the service they need, at the right amount, at the right time and in the right place.
  • Serve everyone – no individual waits for services.
  • Move people from the waiting list based on urgency and severity of need.


  • Guide but do not predict what services are received.
  • Build on what is important to person and is working in their life.
  • Utilize a whole person approach that addresses individual life needs.
  • Implement process for ongoing review and development as person will change and grow.
  • Require consistent process and tools across the state and MCOs.


  • Individual control and flexibility of funds to meet needs with services within an allowable budget.
  • Educate person and providers about self-direction and support them to use it.
  • Provide financial and business management supports.

Person-Centered Planning

  • Drive plan by the personal goals and desired outcomes as indicated by the individual
  • Create an on-going living document that changes as person changes – not just paper
  • Involve team that is valued and is selected by the person to include family, support professionals planners, and any others.
  • Allow the plan to drive the authorization of services –the authorizers do not drive the plan.

Support Coordination

  • Develop a personal and consistent relationship between the person and the support coordinator.
  • Require coordinators to have a working (best practice) knowledge of local resources and how to connect people to communities.
  • Advocate for individual rights, responsibilities, and choices in an independent appeals process.


  • Promote independence and community inclusion through all services.
  • Make employment and careers the preferred outcome of all education and services (“Employment First”).
  • Pay for the desired outcomes, not just units of service.
  • Allow flexibility to meet the unique needs of each person and family.
  • Make outcome expectations and service access consistent across the state.


  • Focus the Comprehensive Quality Strategy on the valued outcomes versus the quality of the process.
  • Involve participants and their families in independent oversight.
  • Communicate the results of the oversight process in a timely, accurate, and is easily accessible and understood formats.
  • Evaluate success in all areas of a person’s life through meaningful outcome measures.
  • Enforce requirements and maintain standards statewide.

Qualified Providers

  • Provide participant choice by having multiple providers in each specialty area of service.
  • Require provider to be qualified, trained and monitored to achieve outcomes for people they support.
  • Recruit and retain providers by paying for the actual costs and rewarding good performance.
  • Encourage certification and recognition of direct support workers.

Payment Structure

  • Move from fee-for-service to incentive payments for outcomes; assist providers to change business models.
  • Allow flexibility to better match services with individual needs.
  • Share costs of services and the outcomes providers report with consumers.
  • Provide timely payments for approved services and outcomes to all providers.

System Transition

  • Involve cross disability consumers and families in all levels of strategy development and implementation through recognized advisory boards; provide sufficient time for review of concepts and proposals.
  • Determine readiness of the state; managed care entities; providers, consumers, families for new management structures. Readiness includes enough staff, the right skills competencies, the right values.
  • Implement and standardize operational and IT systems across the state to assure continuity of service.
  • Communicate information to enrolled participants and families – and to those not yet enrolled – about the new program, their rights and responsibilities.
  • Develop a process for transferring participants to new system to prevent gaps in service; plan for rapid identification and resolution of problems.

Participant Protections

  • Educate individuals, families and support providers about participants’ rights and responsibilities.
  • Assure safety and support for individuals and families when reporting concerns or making claims.
  • Investigate, track, and provide prompt follow up on critical incidents (including abuse, neglect and exploitation) and make results clear to all.