Headliner Updates

Survey Submission Date Extended to COB Friday, 9/4/2026

Macro-Free Version of Survey Now Available

Self-Direction Survey Now Available

Please See “Provider Resources” and “Self-Direction Wage and Rate Resources” for Additional Information

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Overview

The NC Direct Care Worker Wage and Rate Analysis will establish a strategic direction for ensuring North Carolina has a strong, stable, and sustained direct care workforce capable of meeting the needs of the state’s rapidly growing aging and disability population.

In recognition of NC’s current direct care workforce crisis, the NC Department of Health and Human Services (NCDHHS) is partnering with the NC Center on the Workforce for Health and its vendor, Guidehouse, to conduct a comprehensive analysis of NC’s direct care workforce and related service delivery landscape.

This analysis begins in July 2026 and will continue through 2026. 

This initiative was first recommended in NCDHHS’ and NC Commerce’s joint 2024 report, Investing in North Carolina’s Caregiving Workforce and is made possible with funding from NCDHHS’ Division of Mental Health, Developmental Disabilities and Substance Use Services.

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Thank you, Providers for your participation!

Provider Resources

Self-Direction Wage and Rate Survey Resources

Beneficiaries who are self-directing their services under the NC Medicaid CAP/DA, CAP/C or Innovations waiver are encouraged to contribute data to the Analysis. Thank you!

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Goals of the NC Direct Care Worker Wage & Rate Analysis

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NC’s Direct Care Worker Definition and Services within the Analysis’ Scope

In Spring, 2026, NCDHHS adopted the following definition of direct care worker. The NC Direct Care Worker Wage and Rate Analysis’ scope of services reflect the NC Medicaid and DMHDDSUS-funded services aligned with this definition.

A direct care worker—regardless of title– is an unlicensed, non-supervisory, compensated worker whose primary role is to:

assist older adults and/or people of any age experiencing a disability, chronic health condition, and/or acute illness;

with activities of daily living, instrumental activities of daily living, companionship and/or community participation;

in various settings, including private homes, residential care facilities, day and community-based settings, nursing homes, intermediate care facilities for individuals with intellectual disabilities (ICFs-IID) and inpatient settings.

Services within the Analysis’ Scope

• Community Alternatives Program for Children (CAP C) Waiver (direct care work-affiliated services)
• Community Alternatives Program for Disabled Adults (CAP DA) (direct care work-affiliated services)
• Home Health
• Hospice
• Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID) services
• Innovations waiver (DSP-affiliated services)
• Nursing Facility services
• PACE
• Personal Care Services, In-Home and Setting/Per Diem
• Research-Based Behavioral Health Treatment for Autism Spectrum Disorder
• Traumatic Brain Injury (TBI) waiver
• State Developmental Centers and State Neuromedical Centers
• 1915(i) I/DD and TBI Services
• Corresponding DMHDDSUS –funded services

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Have Questions?

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