News

A ‘Godsend for recipients,’ HOP may lose funding

At Interfaith Assistance Ministry employees and volunteers pack and delivery healthy meals as part of the Healthy Opportunities Pilot. [CONTRIBUTED}

By Lightning Reports, Published: May 23, 2025

More than 11,000 at-risk households in Henderson, Transylvania, Polk, Rutherford counties and throughout the rest of Western North Carolina are growing healthier from North Carolina’s Healthy Opportunities Pilot, say HOP providers, who express concern that federal and state funding cuts may jeopardize the pilot.

Children and adults participating in the Medicaid program are receiving prescribed healthy food boxes, assistance with rent for safe housing, nutritious formula, help with power bills, healthy relationship counseling sessions and more are saving the state of North Carolina more than $1,000 per recipient per year in health care costs, the providers say.

In Henderson County, six safety-net nonprofits have already invested millions of dollars back into the community through purchases of fresh produce from local farms, grocery stores and food distributors, payments to local contractors for home repairs and renovations, rent assistance to landlords, utility assistance and more.

Despite the documented success of HOP in its first three years, the $88 million needed to continue HOP funding is not included in either the state Senate’s budget or the draft budget released this week by House leaders. Gov. Josh Stein has included funding for HOP as a priority in his recommended budget.

$313 million at stake

Because the federal government matches 65 percent of state HOP funding — a total of $313 million for rural counties — would be lost, NC Health and Human Services officials said Monday in a briefing to nonprofits participating about HOP.

“We have had incredible success with HOP over the last several years,” said Melanie Bush, assistant secretary for NC Medicaid. It’s important to note the economic impacts HOP has on communities it serves in three regions of the state. “It has also increased the safety net across the state.”

The pilot’s services have been a life-line for area residents hurt by the ravages of Hurricane Helene who have needed help, said Elizabeth Willson Moss, Interfaith Assistance Ministry’s executive director. Known as social determinants of health, assistance with these basic needs, dramatically lower health-care costs by reducing hospital stays and ER visits, HOP has shown.

“HOP has literally been a Godsend for its recipients, especially those hurt by Hurricane Helene,” Moss said. “Low-income, working families who suffered from time lost on the job and loss of their homes have desperately needed HOP’s assistance with housing, nutritious food, utility bills, counseling and other critical services.”

These critical services, provided through North Carolina’s Healthy Opportunities Pilot (HOP) – the first in the nation – are funded through the state Department of Health and Human Services’ budget. HOP’s Medicaid funding pays for non-medical services that have proven to dramatically impact a child or adult’s wellbeing, according to state officials. These non-medical services address the social determinants of health, which data shows affect 80 percent of each of our wellbeing and health.

North Carolina saves $1,020 annually for each Medicaid client who participates in HOP; a savings that is projected to keep growing as the HOP program grows, according to the University of North Carolina’s Sheps Center, which tracks HOP results. In Western North Carolina, HOP health care savings amount to $11.9 million annually, according to Impact Health, WNC’s HOP network lead.

Caja Solidaria, a Hendersonville-based food hub, underscores the significant revenues HOP service organizations have invested back into the communities they serve while improving the health of Medicaid participants.

“In the last three years, we’ve been able to invest $5 million into local farmers, food distributors, and businesses,” said Christina Schnabel, Caja’s co-executive director. “All of the food we purchase is getting to families who need it. We hear every day about how much participants enjoy the fresh, local, and healthy foods.”

HOP ‘paying off in a healthier community’

HOP’s impact through six local safety-net nonprofits includes:

• Caja Solidaria, a Hendersonville-based food sharing hub, provides an average of 350 Medicaid households with healthy food boxes (including fresh local fruit and vegetables) each week and has provided support for utility bill assistance to 120 households, healthy home goods for 124 households, housing navigation for 26 households and housing move-in support for 14 households since joining HOP. Staff employed for HOP: 10.

“All of the food we purchase is getting to families who need it,” Schnebel said. “We hear every day about how much participants enjoy the fresh, local, and healthy foods. All these investments are paying off in a healthier community.”

• Children and Family Resource Center (CFRC), Hendersonville, supports early childhood development and education, quality childcare, healthy parenting and offers family support. CFRC provides healthy baby formula to 43 households across Western North Carolina and provides parenting classes via home visits to 18 families through the HOP program. HOP Staff: 2.5. “The Healthy Opportunities Pilot has enabled CFRC to help families in the 18-county region who are struggling with the high cost of formula,” said Jamie Weiner, CFRC Executive Director. “This initiative ensures they don’t have to worry about affording their child’s next meal. The funding not only helps prevent future health issues by creating programs that address all the social determinants of health while saving taxpayers money in the long run and by providing a sustainable financial path for nonprofits to continue their important work while being reimbursed for their efforts.”

• Housing Assistance Corp. WNC provides safe and affordable housing to local residents with limited income. Through HOP, Housing Assistance assesses homes for safety and health repair needs, shares those findings with client care managers, coordinates with contractors to complete repairs, and ensures those contractors are reimbursed (HOP funding). To date, 192 households have been served and an additional 117 clients are pending for these housing-related services. Staff contributing to HOP services: 9. “Through this program, we’ve been able to serve families with children suffering from asthma, seniors living with COPD, and others whose housing conditions pose serious health risks,” said Margaret Fenton Leback, HAC’s executive director. “HOP has allowed us to address urgent needs for clients who would otherwise fall through the cracks. Without this funding, many of these households will be left without options — and the broader community will feel the impact.”
• IAM, the largest nonprofit provider of crisis assistance in Henderson County, provides an average of 650 Medicaid households with healthy food boxes (including fresh local fruit and vegetables), and has provided 11 families with rent assistance and 148 with utility bill assistance. Staff employed for HOP services: 12. “Through HOP, IAM has helped improve the health of thousands of children and adults prescribed food as medicine while putting more than $3 million back into the local economy,” Moss said. “Our HOP families thank us for giving them a chance to become healthy by eating foods they otherwise could not afford.”
• SAFE Inc. of Transylvania County, is a domestic abuse treatment center in Brevard. It provides interpersonal violence intervention services and case management, transportation assistance, rent and move in assistance, utility bill set-up assistance, short-term post hospitalization housing and help with healthy home goods, to residents of Henderson, Transylvania and other nearby counties. HOP staff: 2.5. “Continued funding for the Healthy Opportunities Pilot is essential to sustaining SAFE’s ability to support survivors of domestic and sexual violence through critical non-medical services like housing, transportation and interpersonal safety planning,” said Melissa Smith, SAFE’s HOP Manager. “These resources are often the bridge between crisis and stability, ensuring survivors not only escape danger but also begin to heal and rebuild their lives in safety and dignity.”
• Safelight, a Henderson County nonprofit that provides support for survivors of interpersonal violence and abuse, has provided 26 individuals with HOP services this year including holistic high intensity enhanced case management, interpersonal violence case management services (IVP), housing move-in support and transportation for Medicaid participants who have experienced violence, abuse or exploitation. Staff for HOP services: 3. “This pilot has been extremely successful addressing the social determinates of health and propelling families out of poverty with wrap-around-resources,” said Lauren Wilkie, Safelight’s executive director. “We have been able to use this tool to help families access us to find safety through our programs offering housing, employment, counseling and other linkages to care.”
• Thrive, a Hendersonville-based mental health and housing assistance nonprofit, provides housing navigation and move-in support, rent assistance, utility assistance, helps with healthy home goods and provides housing inspections for safety and quality. Thrive is currently serving 100 Medicaid members and is managing 130 housing needs related cases. Staff for HOP services: 2.25. Thrive would lose 2 full-time staff if HOP funding is cut, said Melissa Fundukian, HOP program manager. “Thrive would lose the ability to work with and assist members of the community that would not qualify for housing related services otherwise,” Fundukian said. We are proud of the work that we do and the programs we support.”

The 60 HOP service providers throughout Western North Carolina will hopefully help educate their local legislators about the ground-breaking work that’s being done through this national pilot, said Laurie Stradley, CEO of Impact Health, the network organization that oversees HOP in Western North Carolina. They also need to remind legislators that the Centers for Medicare and Medicaid Services approved North Carolina’s second Medicaid waiver request in December 2024, authorizing HOP for another five years.

 “Many states are looking to North Carolina for our leadership because our approach is working,” Stradley said. “People are becoming healthier and reducing their reliance on healthcare.”

 Losing all of the investment, new jobs and healthy outcomes that have occurred because of HOP would be an injustice, local safety net nonprofits agree.

“This program showed how progressive NC is at understanding how to forever change generational poverty,” said Wilkie of Safelight. “We’re leading the way for project other states want to replicate. Sadly, we may be witnessing the first and last of its kind, as it isn’t in the NC budget currently.”

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