By Grace Vitaglione and Jaymie Baxley
In 2022, Christina Schnabel was a single mom in Hendersonville barely making ends meet. She lived in public housing and made do with help from services like Medicaid and SNAP. Her son suffered from chronic gastrointestinal symptoms.
That changed after she started volunteering with a local nonprofit called Caja Solidaria. The organization was one of the community partners in the Healthy Opportunities Pilot, a Medicaid program that tackled nonmedical health needs of low-income North Carolinians.
Schnabel was able to participate in HOP. She started getting fresh fruits and vegetables regularly. Before, she could only afford a pint of berries each week.
After receiving food through Healthy Opportunities, her then 6-year-old son’s gastrointestinal symptoms cleared up within three weeks, Schnabel said. She is now the executive director of Caja Solidaria.
“I would not be where I am today if it was not for the Healthy Opportunities Pilot,” she said.
Schnabel and around a hundred others advocating for Healthy Opportunities descended on the legislature June 4 in an all-out effort to persuade legislators to renew funding the program.
Spending plans from the North Carolina House of Representatives and the Senate proposed earlier this spring effectively cut funding for the program. As a result, the Healthy Opportunities Pilot will cease operations July 1, according to an announcement this week.
Even as the two chambers hash out a final budget ahead of the end of the state fiscal year on June 30, the state Medicaid head, Jay Ludlam, informed program partners in a letter June 2 that it would be fiscally irresponsible to continue the program without secured funding.
Staying optimistic
Senate Leader Phil Berger (R-Eden) told reporters in an informal news conference on June 4 that while he supports the idea behind Healthy Opportunities, he’s not sure the program saves the promised amount of money.
Advocates, though, are still hopeful that between now and when the final budget comes out — which could be as late as September or October — they’ll be able to convince lawmakers to keep the program in the budget.
Three agencies facilitated services for program participants in the pilot regions. These organizations — Access East in the northeastern part of the state, Community Care of the Lower Cape Fear in the southeast and Impact Health in the western mountains — coordinated the distribution of goods and services through a network of more than 140 nonprofits and community partners.
Laurie Stradley, CEO of Impact Health, believes lawmakers will ultimately continue funding for the pilot, albeit at a smaller amount than originally requested. In an interview with NC Health News, she noted that support for the program appears to be growing in both chambers of the General Assembly.
“I’m starting to hear more from our leadership — particularly in the Senate but we’re hearing more from their colleagues in the House as well — that [keeping the program] just makes sense,” she said. “So I do have a high degree of optimism that we will come out of this budget process with some version of Healthy Opportunities.”
Still, she acknowledged that the program may be “narrower or more focused” on certain services.
That’s a far cry from earlier this year, when officials from the state Department of Health and Human Services were confident about not only continuing the pilot but potentially expanding it to other counties.
Reducing health care costs
An independent evaluation performed earlier this year showed the pilots have driven down the cost of health care by as much as $1,020 each year for each Medicaid beneficiary who’s participating in the pilot — largely by helping people stay healthy. That’s because program participants were prevented from becoming sicker or from using more expensive kinds of care.
Amy Trees, a respiratory therapist, said she saw that benefit firsthand. She’s part of a care management team through Mission Health Partners that provided services to Healthy Opportunities participants. She’s witnessed patients with respiratory-related illnesses who used to go to the hospital no longer need repeat treatments.
Trees pointed to the example of an 11-year-old boy who rushed to the emergency room with wheezing, shortness of breath and a cough. The team followed up to reinforce the asthma treatment plan and obtained supplies to decrease asthma triggers in his home, such as an air purifier for his room and HVAC filters.
HOP made that process fast and efficient. Without it, optimal care would be delayed, she said.
If the pilot is shuttered, Ludlam said, he fears the positive results it achieved will “begin to degrade.”
“What is the effect of taking or ending a program that does reduce ER visits and inpatient stays?” he said. “I could hypothesize that without healthy food, without access to safe housing or housing that doesn’t have mold, that these impacts are going to come back over time.”
‘Major impact’
In eastern North Carolina, the Green Rural Redevelopment Organization delivers food to 1,000 people each week through HOP, said Henry Crews, executive director. Without the program, those people “won’t get food,” he said.
Kim Gore, chief operations officer of WARM NC, also arrived at the legislature armed with concerns about the program shuttering. Her organization in southeastern NC has provided housing remediation and services like constructing wheelchair ramps for 500 homes over the past two years.
Gore pointed to one of her current projects, a home needing lead abatement where a 3-month-old baby lives.
“This one’s kind of scary for us, because we’re right in the middle of trying to do work, and basically we got a stop order,” she said.
The organization currently has 35 active jobs and a waiting list of over 100 people. Stopping will have a “major impact,” Gore said. The homes currently under construction will now have to be finished in the next three weeks.
“I don’t want to have to Band-Aid something because we don’t have the funds to do it,” she said.
The post They ‘won’t get food’: Healthy Opportunities advocates press lawmakers to reconsider ending funding appeared first on North Carolina Health News.
