This mixed methods program evaluation evaluated the implementation of the multi-tiered system of support (MTSS) framework in one North Carolina school district. It examined the perceived teacher impact of the program implementation for Tier 3 reading students in first through third grades. The vision for employing the MTSS framework in North Carolina is for all prekindergarten through 12th-grade public education organizations to implement and sustain all areas of an MTSS to ensure students are college-, career-, and community-ready (North Carolina Department of Public Instruction [NCDPI], 2021). I used the study's results to determine how various stakeholders perceive program implementation, how stakeholders were implementing the MTSS framework in first through third grades, how leaders are preparing teachers to implement the program with fidelity, and the perceived impact of the process on student growth. The study looked at first through third-grade classrooms and focused on the MTSS processes for students who need intensive support or Tier 3 program implementation by the program's standards. The study's convergent mixed methods design used interviews, observations, fidelity checks, and a preexisting survey to perform a program evaluation using the CIPP model for evaluation. The CIPP model evaluation concluded that the four sites within the participating district held many strengths in program implementation with a few areas of improvement. The suggested areas of improvement are in program input and program processes. If the district uses the data and results to make necessary changes, there would be greater fidelity to implementation and student achievement growth. I concluded the study with recommendations for practice and future research. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]