“If you make the investment early, people stop going to the emergency room. They stay healthy. You spend less on health care,” said state Health and Human Services Secretary Devdutta Sangvai during his visit to Hendersonville. “And if you cut these programs, people will go hungry.”
With that warning, and a clear message of support, Sangvai toured several cities on June 12. organizations from Western North Carolina participating in the Healthy Opportunities Pilot (HOP), a pioneering program that uses Medicaid funds to cover non-medical needs: foods, temporary housing, transportation, utility assistance, and post-hospital support.
North Carolina is the first state in the country to implement this model, which has reached nearly 30,000 people in three rural regions. Of these, more than 11,000 live in the western part of the state.
The program became an indispensable support for families affected by the Hurricane Helene, as well as for the organizations that execute these funds and rural communities.
However, HOP is on the verge of extinction: unless the North Carolina General Assembly approves a special appropriation, it will cease operations on July 1.
During his visit, and speaking to the press, Sangvai stated that his department continues to advocate with legislators to ensure funding for the program. While he declined to promise a solution, he asserted that "they are listening" and that there is a willingness to find a way forward.
Related: Medical care options in North Carolina for people with and without health insurance
Direct impact on the Latino community
Solidarity Box is one of the organizations that channels HOP funds to ensure access to fresh and healthy food to Medicaid beneficiary families. It is located in Henderson County and serves more than 530 families and 150 individuals per week. Fifty percent are Latino, according to Amy Landers, program director, Enlace Latino NC .
The organization has invested five million dollars in producers and Local Business for the past three years, allowing food grown in Western North Carolina to go directly to the tables of those who need it most.
During the visit of the Secretary of Health, the Caja Solidaria team explained how the program not only improves nutrition, but also creates local employment, strengthens the economy and connects isolated communities.
One of the people who experiences this every day is Diana, a 25-year-old Cuban migrant who arrived with her mother in the western part of the state.
Diana started as a volunteer and now works steadily for the organization. “I'm working, yes, but I'm also supporting people. There are families who wait for the box as if it were a visit from a relative,” she said. “Some tell me, 'You're the only one who knocks on my door all week.'”
From Tuesday to Friday, Diana and other workers run three routes a day, each serving up to 20 households. Most of the families live in remote areas, without access to supermarkets or transportation.
“Once, an elderly lady hugged me and told me that the last time she had eaten fresh fruit was months ago,” she recalled.
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The testimony of the producers
HOP's impact extends to farmers as well. Tommy Riley, who runs Riverview Farm in Henderson County, met with Secretary Sangvai during the visit and was categorical: "If Caja [Solidaria] disappears, three employees disappear."
The program allows organizations like Caja Solidaria to purchase their products. This has been crucial in the wake of the losses caused by Hurricane Helene.
“I would have given up by now,” Riley said. “But seeing the impact it’s had on the community, and the joy of the people who receive it… it’s beautifully orchestrated.”
A model that other states observe
The effectiveness of the program has been documented by the University of North Carolina: the state saves $1,020 for every Medicaid beneficiary participating in HOP. In the West alone, annual health savings are estimated at $11.9 million.
“People are healthier and less dependent on the health care system,” said Laurie Stradley, executive director of Impact Health, one of the entities implementing the pilot in the region. “Many states are looking to North Carolina as a model because our approach is working.”
Melanie Bush, Chief Financial Officer of NCDHHSHe noted that, instead of increasing spending, the model redirects it more efficiently: "We're paying for health, not just for medical interventions. And that means taking care of everything from the environment a person lives in to their access to food and transportation."
The political context
Despite the results, the program's future is uncertain. Governor Josh Stein The U.S. included the $88 million needed to extend HOP in its budget proposal, but neither the House nor the state Senate included it in their drafts. Negotiations are ongoing, but time is running out.
“We're pioneering a model that other states want to replicate. Sadly, we could be facing the first and last of its kind if it's not included in the budget,” warned Lauren Wilkie of Safelight, an organization also participating in the program.
The invisible damage of the hurricane
El Hurricane Helene hit the west of the state eight months ago. Their consecuencias remain latent, particularly among the most vulnerable communities.
Lexie Wilkins, Director of Love and Respect, a barrier-free shelter in the region, sums it up clearly: “Although the storm has passed, the wounds and scars on the mental health “are not visible to the naked eye.”
From September 2024, the Hope4NC program has provided more than 11,300 individual or group emotional support sessions.
Organizations such as Thrive, Interfaith Assistance Ministry, SAFE Inc., and Safelight have also received HOP funding to support individuals with mental health problems, gender violence or housing insecurity.
Secretary Sangvai's visit was his third to the region since taking office. During each visit, he said, he sought to hear firsthand.
“What I've seen in Western North Carolina is admirable. People here have a real community spirit; they want to solve problems, work together, and improve their community. I'm leaving feeling energized,” he told Enlace Latino NC .
Before leaving, he summed up the spirit of the program with a phrase that resonated with listeners: “HOP is health. It's economics, community, personal dignity.”
Unless the North Carolina legislature acts in the coming days, that vision could disappear just when the western part of the state needs it most.
>>If you are looking for support or useful information for you and your family, visit our section Resources available in North Carolina , where you'll find programs, support, and services designed specifically for the Latino and Hispanic community.
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PODCAST
After the storm
A year ago, Hurricane Helene struck western North Carolina. The Latino community responded with something stronger than the storm: solidarity.
🎧 In this episode, learn how Latino organizations transformed crisis into resilience.
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