Cross-System Navigation in a
Managed Care Environment Initiative

Updates & Documents


The Cross-System Navigation in a Managed Care Environment 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.


The i2i Center’s Cross-System Navigation in a Managed Care Environment Initiative is off to a strong start in its first six months. The initiative’s goal is to study the cross-system navigation components (which may pull from case management, care management, and/or community navigator roles and similarly defined roles) that will accompany the State’s Medicaid Transformation plans, assess the options available to individuals with I/DD who are on Medicaid (both the state plan and the Innovations Waiver), and provide recommendations to meet the needs of individuals with I/DD.

To accomplish this, i2i has recruited members for its Cross-System Navigation Advisory Group, ensuring it has a broad representation of perspectives. Members represent various components of the health and human services system, including individuals with lived experience, providers, prepaid health plans, and state government representatives. Since its establishment, the Cross-System Advisory Group has met twice. These meetings featured presentations by subject matter experts, updates on state policy, and ample time for the group to work together to begin identifying cross-system navigation barriers and needs. The Cross-System Navigation Advisory Group will continue to meet quarterly to develop their recommendations, with their next meeting in March.

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.

Lead Staff

Kelly Friedlander, MSW, MPA, Project Director


NC Council on Developmental Disabilities (NCCDD)


Cross-Systems GPS Initiative: Guiding People & Systems Grant Application