; (ii) provides direct assistance to beneficiaries and their families; and (iii) identifies and reports systemic problems to State officials, the public, and the Secretary. (C) Beginning with the 5th fiscal year quarter for which the State is an HCBS program improvement State, and annually thereafter, the State reports on the components of the existing home and community-based services landscape reported in the State HCBS infrastructure improvement plan, including with respect to— (i) the availability and utilization of home and community-based services, disaggregated by disability status, age, income, gender, race, ethnicity, geography, primary language, sexual orientation, gender identity, and type of service setting; (ii) the characteristics of the direct care workforce that provides home and community-based services and the race, ethnicity, and gender of such workforce; (iii) changes in payment rates for home and community-based services; (iv) implementation of the activities to strengthen and expand access to home and community-based services and the direct care workforce that provides such services in accordance with the requirements of subparagraphs (B) and (C) of paragraph (2); (v) if applicable, implementation of the activities described in paragraph (3)