A DSP Wage Investment, an HB 437 Override Countdown, and What NC Providers Should Watch This Month
Your monthly briefing on Aging, Intellectual and Developmental Disabilities, and Homeless Management Information Systems for North Carolina
THIS MONTH IN NORTH CAROLINA
$21.3 Million in New DSP Wages, and 21,000 North Carolinians Still on the Innovations Waiver Waitlist
Governor Josh Stein signed the state budget on July 7, delivering $21.3 million in recurring funding for Direct Support Professional (DSP) wages and $70.8 million to raise personal care service rates from about $23.84 to $30 per hour. With the federal Medicaid match, the total impact climbs past $250 million. What did not change: the almost 21,000 North Carolinians still on the Innovations Waiver waiting list. For provider organizations, this month is about deciding how to translate one of the largest recurring workforce investments in years into retention that actually sticks.
What's in This Month's Issue:
Featured Story: What the DSP Wage Investment Means for NC Providers
Aging in NC: Updated Standard Plan Care Management Rate for State Fiscal Year 2027
Intellectual and Developmental Disabilities (IDD): October 1 Accreditation Deadline for 251S00000X Providers
Homelessness and HMIS: HB 437 Override Countdown and Wake at Home
Where the Verticals Meet: Aging Populations, Workforce Investment, and Housing
Case Study Spotlight: Monarch and Tailored Care Management
More to Read This Month
Quick Poll: What Is Your Biggest DSP Retention Challenge?
FEATURED STORY
What the DSP Wage Investment Means for NC Providers
The state budget signed July 7 delivers the biggest recurring workforce investment for the Intellectual and Developmental Disabilities (IDD) sector in years. Three takeaways worth carrying into your operating plan:
The numbers, in plain terms. $21.3 million in recurring funding raises Direct Support Professional (DSP) wages, and $70.8 million lifts personal care service rates from about $23.84 to $30 per hour for programs like the Community Alternatives Program for Disabled Adults (CAP/DA). With the roughly 2-to-1 federal Medicaid match, the total recurring impact is closer to $257 million per year, per the NC Council on Developmental Disabilities (NCCDD).
Accountability is baked in. The legislation requires providers to demonstrate the new funding is spent on wages, benefits, or other payroll costs. Agencies should stand up documentation now for how the DSP raise flows through payroll, including how you will report it back if asked. Waiting until year-end reconciliation is not the play.
The waitlist did not move. Almost 21,000 North Carolinians remain on the Innovations Waiver waiting list. Governor Stein's budget proposal included 200 additional slots at $9.3 million; the final budget did not add new dollars to that line. Talley Wells, Executive Director of NCCDD, described the DSP investment as a needed step while pointing to the waitlist as the other half of the story.
Read CaseWorthy's guide to Person-Centered Planning templates and best practices, a practical companion for Innovations Waiver providers documenting the impact of the new DSP investment.
Updated Standard Plan Care Management Rate Takes Effect for SFY 2027
NC Medicaid updated its Standard Plan capitation rates for State Fiscal Year (SFY) 2027, effective July 1. The rates now build in $11.34 Per Member Per Month (PMPM) as the expected average cost of whole-person care management activities across Standard Plan populations, whether the care management sits with the health plan or an Advanced Medical Home (AMH) Tier 3 practice. For aging providers coordinating with health plans on Community Alternatives Program for Disabled Adults (CAP/DA) and other Home and Community-Based Services (HCBS), that figure sets expectations for care management capacity and reimbursement as the Tailored Plans transition continues.Read the NC Medicaid rate update.
Intellectual and Developmental Disabilities (IDD)
October 1 Accreditation Deadline for 251S00000X Providers
NC Medicaid has extended the deadline to October 1, 2026 for organizational providers enrolled with taxonomy code 251S00000X who have not yet selected at least one Service Type and Service on the Provider Permission Matrix. The bulletin, issued July 10, replaces the timelines from the April 16 Post-Enrollment National Accreditation Update. Providers who fail to act by October 1 risk termination of the taxonomy and potentially the service location and provider record. Provider organizations should confirm accreditor status with the Council on Quality and Leadership (CQL), the Commission on Accreditation of Rehabilitation Facilities (CARF), or another approved body before the fall deadline, and update their taxonomy record in NCTracks. Read the NC Medicaid deadline extension.
Homelessness and Homeless Management Information Systems (HMIS)
HB 437 Override Countdown as House Returns Week of August 3
Governor Josh Stein vetoed HB 437, the drug-free zones and unauthorized public camping bill, on July 8. The House passed it 73-40 on June 30 with five Democrats and two unaffiliated members crossing over, leaving Republicans one vote short of the 72 needed for an override without Democratic help. A spokesperson for Speaker Destin Hall said the chamber plans to attempt an override when lawmakers return. The House is holding no-vote sessions until the week of August 3, so the arithmetic will turn on attendance. For NC providers, plan for the bill to become law and start scoping the local ordinances, coordinated-entry updates, and outreach protocols that would follow.Read Port City Daily’s coverage.
Wake County Launches a $22 Million Initiative to Move 400 People Out of Encampments
Wake at Home, led by the Wake Continuum of Care (CoC), is a new 18-month, $22 million effort announced in mid-July. Phase 1 aims to connect 400 people living outside to housing and supportive services by December 2027, and to help another 1,000 people experiencing homelessness for the first time get back into housing through financial assistance, including security deposits, temporary rental support, and reunification with family. Funding combines Wake County tax dollars, private assistance, and current or planned financing from local governments. For HMIS teams, this is a live case for tight coordinated-entry documentation, encampment-decommissioning workflows, and outcome tracking that other NC CoCs will study.Read WUNC’s coverage.
Where the Verticals Meet
Aging Populations, Workforce Investment, and Housing
The Pew Charitable Trusts’ July issue brief on how an aging population is reshaping state revenue, spending, and service demand puts the NC budget in national context. Pew notes that older adults now make up almost half of the U.S. homeless population and that Pew-funded research projects the number of older adult households with low incomes will reach 32.6 million by 2040, up from 22.8 million in 2020, representing 61 percent of older adult households. Rising housing cost burdens on older homeowners with mortgages add to that pressure. The $21.3 million DSP wage bump and $70.8 million personal care service investment help address the workforce side of that equation, but the practical takeaway for NC providers is that aging services capacity, workforce retention, and homeless-response funding are increasingly the same policy conversation, and none of them are solved by a single line item. Read the Pew brief.
CASE STUDY SPOTLIGHT
Monarch and Tailored Care Management in 19 NC Counties
Monarch is an NC Care Management Agency serving 2,500+ members across 19 counties, coordinating physical health, behavioral health, IDD services, and health-related resource needs. When the Tailored Care Management (TCM) program launched in December 2022, Monarch chose MediSked by CaseWorthy because the platform demonstrated IDD from the start rather than bolting it on. Automated workflows pull assessment needs directly into the care plan. Care managers can see engagement status at a glance and act on hospital alerts quickly. Reporting comes back in minutes, not days. As Monarch’s Anna Marshall put it, “Our program has seen real efficiency gains in assessment, care planning, and ongoing care coordination thanks to the automated workflows in MediSked.” For NC agencies preparing for the next phase of the Tailored Plans transition, Monarch is a live example of what person-centered TCM looks like at scale.
Clean Data In, Trustworthy AI Out: Why Data Quality Decides Everything
AUGUST 13 • 3 PM ET
The AI conversation is loud, and most of it is about the model. In human services, the model is the easy part. The hard part is the data it stands on: assessments, case notes, services, and outcomes scattered across programs, spreadsheets, and free-text fields.
In this session on Thursday, August 13 at 3 pm ET,David Lewis, VP of Industry Leadership at CaseWorthy, revisits the six-question framework from Beyond the Buzzwords and focuses on the one that sits beneath all the others: is your data trustworthy? You will leave with a clearer picture of what AI-ready data actually means, questions to ask vendors about how their AI is grounded, and a practical 90-day plan for evaluating your own data foundation.
NC Health News on counties absorbing $52 million in new SNAP costs. Read at NC Health News, July 10. A clear breakdown of how federal Supplemental Nutrition Assistance Program (SNAP) changes taking effect October 1 will land on county budgets and food-insecure households across NC.
WRAL on the surge in NC 211 housing calls. Read at WRAL, July 22. Nearly 10,000 people called the 211 hotline in the Triangle in the first six months of 2026, roughly 30 percent higher than 2023, useful context for coordinated-entry capacity planning.
Spectrum News on the Point-in-Time (PIT) counts behind the numbers. Read at Spectrum News, July 7. Five-year PIT trend data for Greensboro/High Point (+265), Charlotte/Mecklenburg (+170), and Raleigh/Wake (+215).
NCDHHS on the new statewide Traumatic Brain Injury (TBI) plan. Read at NCDHHS, July 22. A cross-agency plan to improve access to TBI services, relevant for IDD, aging, and homeless-response providers whose caseloads overlap.
Disability Scoop on the Department of Justice’s Olmstead guidance rescission. Read at Disability Scoop, July 20. The DOJ Civil Rights Division declared major Olmstead sub-regulatory guidance “not enforceable,” a signal worth tracking as states, including NC, work through community-integration commitments.
QUICK POLL
What is your biggest Direct Support Professional retention challenge?
A. Wages, even with the new state investment
B. Scheduling flexibility and predictable hours
C. Training, career pathways, and internal mobility
D. Documentation burden pulling staff off direct support
Reply with A, B, C, or D. We will share the results next month.
Questions or feedback? Questions or feedback? Please reach out to us! Thanks for the work you do across North Carolina.
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