The Healthy Opportunities Pilot program was excluded from North Carolina’s biennial budget for fiscal years 2026 and 2027.
“Both the House and Senate have not included provisions to fund this program for the next two years,” said Parker Chatham-Wolter, executive director of Restoration House WNC.
HOP is the nation’s first comprehensive program designed to test the evidence-based interventions aimed at promoting the health of Medicaid recipients in rural communities while reducing overall healthcare costs. The program was piloted in three regions across the state to include Western North Carolina. HOP provides food, housing, transportation and safety support.
“This past summer, we had the opportunity to engage with Medicaid expansion through the Healthy Opportunities Pilot program,” said Chatham-Wolter. “The Healthy Opportunities Pilot program targets the social determinants of health to create healthier ecosystems for individuals to prevent healthcare costs. That’s the entire premise of the program. If you give someone a healthier environment, they’re more likely to have healthier outcomes. If they have access to a safe home and good food, they’re likely to need health care less.”
According to Chatham-Wolter, the HOP program has proven instrumental in helping the nonprofit fulfill its mission to “empower at-risk populations by providing sustainable solutions that cultivate long-term stability and self-sufficiency.”
“The biggest thing that shocks me is seeing that the legislators are not including this program in the budget when every single bit of research that has come out about the program shows that it saves more money than it spends,” said Chatham-Wolter.
He allowed the invoices and data to speak for itself.
Restoration House launched its HOP program in July of last year. The program serves Swain, Jackson, Graham and Haywood. Six HOP services were provided that month. From July to May, the number of services provided rose to approximately 400. Approximately 280 people were served.
“We are growing at a rate that’s really difficult to keep up with because the need in our community is so high,” he said. “You have to be on Medicaid, present a healthcare need and meet the minimum qualifications for the program. There are many hurdles and we’re still seeing this kind of growth? It shows just how terribly bad the community needs this program.”
The HOP program accepts new clients every day. A total of 1,400 services have been provided to recipients since July.
Chatham-Wolter said the pilot program was successful in preventing DSS interactions.
“Rather than having to submit a DSS report about your family not having food, we just intake you into the HOP program and now you have food every single week,” said Chatham-Wolter. “I just got an email this morning from DSS, stating they are preparing to halt all services the first of next month. That’s 200 clients who are actively receiving services right now and, out of nowhere, will have their lifelines pulled from under their feet. For some of the families we are serving, they are just restabilizing, getting into new housing and out of hardship. Those food boxes are the reason their family eats every day.”
Chatham-Wolter acknowledged that some people might have different views concerning the state’s budget.
“Think of this fiscally,” Chatham-Wolter said. “If one wants to take the viewpoint of not wanting to help a person, think of the disability and nothing else. The research has proven that if we invest in the HOP program, we save more money on Medicaid expenditures than we spent on HOP. So, think of this only as a healthcare savings program if nothing else.”
Chatham-Wolter asked that readers talk to legislatures about funding the HOP program.