Survey: My Individual Experience

What is this?

This is a survey from the NC Department of Health and Human Services (DHHS). It is for people who are on a Medicaid waiver. The Medicaid waiver pays for many of the services that you get. Your waiver may be called Innovations, CAP/DA or CAP/C.

There is a new rule in the United States. It is about Medicaid waivers. It is called the Community Settings Rule. Providers of Medicaid waivers must follow the new rule. The rule says that Medicaid waiver services must be given in a way that helps you to be a real part of the community.

Some people get Medicaid waiver services in a home that belongs to a provider.  You may be one of these people.  The new rule tells providers what they must do to be sure that the place that you live looks and feels like your home.

DHHS has until March 17, 2023 to be sure that all Medicaid waiver providers in North Carolina are following the new rule. It’s a big job. We need your help.

More information is available about this new rule.

This presentation, My Individual Experience Survey, was developed to provide an overview of the My Individual Experience (MIE) Survey. The survey was developed to measure participant's satisfaction, level of awareness of and access to their rights, privacy requirements and member experience expectations, as outlined in the HCBS requirements. The PowerPoint slides of the presentation are also available by clicking, My Individual Experience Survey (PDF, 411 KB).

In North Carolina, the My Individual Experience Survey Pilot Phase was conducted in the fall of 2016.Pilot Phase findings are available at: MIE Pilot Phase Data Fall 2016. As of January 2017, NC DHHS has requested that LME/MCOs encourage beneficiaries to complete the survey during the beneficiary’s birth month. Doing so, will make it easier in the event the beneficiary requires assistance as the Care Coordinator can assist during the development of the ISP.

 

Why do we need your help?

Your answers will tell us if your waiver services are helping you live the life you want to live. You do not have to fill out this survey but we hope that you will. What you say matters.

 

What do you need to do?

Please fill out this survey. Tell us about your life the way you see it. We will use what you say to make waiver services better.

 

Who can help you with this survey?

A family member, guardian or care coordinator may help you. Your service provider may not help you. Anyone helping you should do all that they can to tell us what YOU think. The way YOU see your life will help us make your waiver services better for you.

 

When do you need to turn in this survey?

LME/MCOs and CAP-DA encourage beneficiaries to complete the survey during the beneficiary’s birth month.Doing so,will make it easier in the event the beneficiary requires assistance as the Care Coordinator can assist during the development of the Individual Support Plan (ISP).However, the survey is available online and can be completed at any time by the beneficiary.

 

Where do you send this survey?

You can fill it out online by selecting the survey below based on the service type you receive.

If you print the form, you can mail it to the appropriate LME-MCO

If you you print the form and are submitting for a CAP/DA, please send it to:

NC Medicaid (Division of Health Benefits)
Clinical Policy and Programs
2501 Mail Service Center
Raleigh, NC 27699-2501
Attention: CAP/DA You can fax the survey to 919-508-0975.

You can email the survey to HCBSTransPlan@dhhs.nc.gov.

 

Survey