Assisting Consumers with I/DD and Families with NC Managed Care Cross System Navigation

The Cross-Systems GPS: Guiding People & Systems initiative’s goal is to develop recommendations for the North Carolina Department of Health and Human Services (DHHS) about how individuals with I/DD and their families can best be supported to effectively navigate across various service systems (cross-system navigation) as DHHS moves toward implementation of Medicaid Transformation (managed care to improve and integrate behavioral and I/DD healthcare and physical healthcare services).

North Carolina’s existing I/DD system of navigation services will be examined, and recommendations will be made for adjustments necessary for the system to be more effective in meeting the needs of individuals with I/DD and their families. This project is a grant from the NC Council on Developmental Disabilities (NCCDD) for its Cross-System Navigation in a Managed Care Environment initiative and is a renewable multi-year grant.

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In June 2018, i2i Center hired Kelly Friedlander, MSW, MPA, to serve as Project Director. She is currently consulting with the DD Council to ensure that the membership of the Advisory group meets grant guidelines and is preparing initial informational documents.

In September 2018, the Cross-System Advisory Group held its first meeting in Raleigh, NC from 10 am – 3 pm. The meeting began with introductions and a brief background about the i2i Center from Mary Hooper, Executive Director of the i2i Center. Next Erika Hagensen, Policy Consultant for the NCCDD, provided a State of the State presentation, providing an overview of recent happenings regarding Medicaid Transformation. Next Kelly Friedlander provided an overview of the initiative, including the goals, scope of work, and answering questions. After lunch, Barbara Brent, Director of State Policy at National Association of State Directors of Developmental Disabilities Services (NASDDDS) gave a presentation “The National Landscape: Navigating with Voice & Choice Across Systems”. During her presentation, she reviewed national trends regarding Managed Long-Term Services & Supports (MLTSS), challenges states have faced, challenges of serving people with I/DD in what has (until recently) been a medical based model, and CMS rules and regulations that are affecting states as they transition to managed care. After Ms. Brent’s discussion, the group engaged in a dialogue to outline priorities and strategies for the Advisory Group moving forward. This discussion will inform the groups effort for the next meeting.   The Cross-System Navigation Advisory Group will continue to meet quarterly to develop their recommendations, with their next meeting in March, 2019.

In 2019, in addition to the continuing work of the Cross-System Advisory Group, the initiative is focusing on additional activities to help educate the general public and dissimilate initiative findings. We will be developing and hosting a Medicaid Transformation 101 Webinar in the Spring, to help inform people with I/DD and their families about Medicaid Transformation.  The initiative will also produce a Workforce White Paper that will make relevant workforce development recommendations to DHHS, state policymakers, LME-MCO leadership, and provider leadership. These recommendations will focus on ensuring that individuals whose job it is to function as case managers, care coordinators, and/or community navigators to assist people with I/DD in accessing services shall have the appropriate education, training, and knowledge, including familiarity with different systems of services, to interact appropriately with people with I/DD and their families and effectively guide them to the needed services in the most efficient manner possible.

To learn more about the Cross-System Navigation Initiative, visit our website, This website serves as a place to provide information about the initiative and share resources, such as the recorded webinar, recommendation report, and white papers.

Lead Staff

Kelly Friedlander, MSW, MPA, Project Director


White Paper – A Guide to Care Management in North Carolina: Context & Recommendations for Care Coordination under the North Carolina Tailored Plan 

Webinar: Connecting Expertise to Communities to Support Comprehensive Care for People with I/DD: Building on North Carolina’s Assets


NC Council on Developmental Disabilities (NCCDD)