Pulse development · 4 cited sources · September 15, 2026
North Carolina's Community-Living Exit Has a Continuity Test
North Carolina and DOJ seek to end settlement oversight after a compliance finding. The practical question is whether community supports stay usable if the court's role ends.
North Carolina and the U.S. Department of Justice have asked a federal district court to end oversight of the Transition to Community Living settlement. The joint motion follows DOJ's finding that the state had met major requirements of the agreement. Since 2012, North Carolina's health department has implemented the settlement through investments to support people with serious and persistent or severe mental illness. Its Transition to Community Living program helps eligible adults move from state psychiatric hospitals and adult care homes into community living. The department says its commitment to community living is not contingent on the settlement.
That proposed exit arrives after a June DOJ legal opinion said federal disability-rights laws do not require states to provide services that let people remain in their homes rather than institutions, according to KFF Health News. KFF reported the opinion does not change existing law and that advocates worry HHS and DOJ could rescind integration guidance and regulations.
In Outagamie County, Wisconsin, officials plan to end Supportive Home Care on Dec. 31 and move participants to other service plans. The county says it is changing the funding stream, not eliminating in-home support, yet a participant said the alternatives listed by the county looked expensive and that she would leave the program if the change goes forward because she does not believe she needs services such as bathing assistance. In Arkansas, the Community and Employment Services Medicaid waiver had a waitlist of 2,268 people as of July 1; people at the top had been waiting for three years. They show why a compliance finding or funding arrangement is only the start of the caregiver question: will community support be usable when a person needs it?
Evidence
Each statement shown below is a verified claim this source supports.
- North Carolina and the U.S. Department of Justice filed a joint motion asking a federal district court to terminate oversight of the Transition to Community Living settlement.
- The joint motion follows DOJ's finding that North Carolina had met major requirements of the settlement agreement.
- Since 2012, NCDHHS has overseen implementation of the settlement through investments supporting people with serious and persistent or severe mental illness.
- Transition to Community Living helps eligible adults transition from state psychiatric hospitals and adult care homes to community living.
- NCDHHS says its commitment to community living is not contingent on the settlement agreement.
- A June DOJ legal opinion said federal disability-rights laws do not require states to provide services that let people remain in their homes rather than institutions.
- The DOJ legal opinion does not change existing law.
- Advocacy groups worry that HHS and DOJ could rescind integration guidance and regulations.
- Outagamie County plans to end Supportive Home Care on Dec. 31.
- Outagamie County plans to transition Supportive Home Care participants to different service plans.
- Beth Roberts said the change uses a different funding stream to cover the same services.
- Beth Roberts said the change is not intended to eliminate in-home support.
- Maryann Janeiro said replacement-provider costs were expensive.
- Maryann Janeiro said she would leave the program if the county's change goes forward.
- Maryann Janeiro said she does not believe she needs services such as bathing assistance.
- Maryann Janeiro said she would leave the program because she does not believe she needs services such as bathing assistance.
- As of July 1, 2,268 Arkansans were on the Community and Employment Services Medicaid waiver waitlist, and people at the top had waited three years.
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