An experimental program in North Carolina striving to shift health care’s focus on wellness instead of sickness is in full swing in Haywood.
The Healthy Opportunities Pilot program provides nonmedical services for select Medicaid recipients that many believe can enhance health. In the long run, addressing the so-called social detriments of health could reduce medical bills paid by Medicaid.
“I’m really excited about this program serving folks in our community with services they really need to address social determinants of health,” said Brooke Smith, assistant director at Mountain Projects. “If they go home and they’re hungry or can’t connect with their community or the power turns off, those affect your physical health.”
Impact Health is spearheading the effort in Western North Carolina and has contracted with 50 providers across 18 counties to provide the services since the pilot launched last May, said Jennifer Caldwell, the communication manager for Impact Health. (See accompanying story.)
The nonprofits and service providers sign contracts to care for select Medicaid clients through the federally funded pilot program. The community partners not only get funding for overhead, but also for direct costs of services provided to clients.
Here’s an overview of services contract holders offer in Haywood.
Food, housing, transit help
As one of the contracted community partners, Mountain Projects provides transportation, food boxes and housing assistance to eligible Medicaid recipients through the HOP program. Patsy Davis, executive director of Mountain Projects, said it has revolutionized what services fall under the umbrella of healthcare.
“Before, we could take someone for a medical appointment, but had no authorization to stop at pharmacy or grocery store, so wrapping services around people is wonderful,” Davis said. “I love the HOP program. If you’re sick, you can’t get better if you don’t have healthy food or medicine.”
Housing services can include moving, paying security deposits and the first month’s rent, along with utility assistance for those whose power has been disconnected, Smith said.
For now, the agency makes food deliveries two days a week, but is on the cusp of adding a third day to meet the growing need.
“The food program is for folks experiencing food insecurity,” she said. “We send out healthy food boxes and healthy frozen meals. People can get both. We prepare breakfasts, lunches and dinners in our commercial kitchen, and provide bread and milk to go with the frozen meals.”
The healthy food boxes have 10 pounds of top quality fresh produce ordered through US Foods and themed boxes include items for meals such as chili, spaghetti, tacos or fajitas, she said. The boxes also include recipes.
“We try to make it a user-friendly product,” she said.
Mountain Projects also assists with transportation through Haywood Public Transit.
Smith cited a case where the HOP program was able to provide transportation for students who needed rides to Haywood Community Learning Center two days each week — an alternative high school that doesn’t offer transportation.
“I think this is helping in ways the state didn’t ever intend having positive effects,” Smith said. “I’m so proud of North Carolina for being a pioneer and leader in the country and am so glad Mountain Projects is a part of this.”
So far Mountain Projects serves about 100 clients in the seven western counties, most of whom live in Haywood.
Mandy Haithcox, executive director of the Haywood Pathways Center, said so far about half a dozen clients have been eligible for the HOP program.
“We’ve used it solely for housing navigation for people staying at Pathways who qualify and are eligible,” she said. “We’ve not had very many so far.”
Part of the issue is limited staffing at the center that slows down work with Pathways residents on their Medicaid eligibility, she said.
“We’re trying to put our processes in place to better identify people as they come in to see what kind of Medicaid they have and if they are eligible to apply. Not everyone who stays here has the right kind of Medicaid,” Haithcox said.
The lack of affordable housing remains a barrier to helping those at the Pathways Center move beyond the homeless shelter, Haithcox said. For instance, one man who has a full-time job and has saved up $8,000 is ready to move into an apartment, but the cheapest one he can find is $1,000 a month.
“He’s been here over a year, and he’s nervous about paying that much for rent,” Haithcox said.
She’s hopeful as that as the HOP program gains traction, it will make a difference in the community.
“It’s a brilliant plan to try to address social determinants of health and to expand coverage of services to people who might not otherwise receive them,” Haithcox said.
Food, shelter upgrades
Haywood Christian Ministry provides both food and housing services for its 35 HOP clients. The food program is simply an extension of the nonprofit’s already robust program to offer food free of charge.
Housing services are mostly referrals to clients who can’t find a suitable place to live, as well as a home inspection service that assesses basic safety issues in a home, said Blake Hart, the executive director of the organization.
If a home is found in need of something like an accessible ramp, basic home improvements like grab bars in the bathroom, floor repairs to prevent slips and falls or even insulation to improve energy efficiency, HOP funds can be used to hire a contractor or for modifications installed by volunteers, Hart said.
HIGHTS, a nonprofit that provides services for at-risk youth ages 12-24, is another HOP contractor serving Haywood clients and oversees a portion of the transportation assistance.
Paul Heckert, the chief financial officer of HIGHTS, said eligible clients can seek mileage reimbursement in a number of circumstances, including travel to work, parks or fitness centers, church or school.
“It’s pretty broad and covers wellness activities — pretty much everything except medical trips,” he said.
Those who are accepted for the service fill out a mileage form and are reimbursed at 31 cents a mile.
HIGHTS also is under contract in the region to provide healthy food boxes, but since there are two other Haywood organizations doing that, Heckert said his organization was asked to focus on clients in Jackson and west where there are fewer providers.
“This is the first pilot in the nation where Medicaid funds can be used for these type of services,” Heckert said. “It’s a very cool program.”
Coming next: Stayed tuned for a future story on a Waynesville church offering a unique “full circle” program between farmers, consumers and retailers.
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