A First Look at North Carolina’s Section 1115 Medicaid Waiver’s Healthy Opportunities Pilots

Healthy Opportunities Pilot Services Examples
Housing Tenancy support and sustaining services

  • Assisting with identifying housing preferences, completing housing application and selection process, developing housing support plan, completing reasonable accommodations requests, reducing risk of eviction (conflict resolution etc.)
  • Supports for budgeting and financial literacy and independent living skills
  • Assessing housing/living environment health risks
  • Assisting with moving into stable housing through arranging the move, assessing unit’s readiness for move-in
  • Providing funding for utility set-up and moving costs (provided funding is not available through any other program)

Housing quality and safety improvement services

  • Repairs or remediation for issues such as mold or pest infestation
  • Modifications to improve housing accessibility (e.g., ramps, rails) and safety (e.g., grip bars in bathtubs)

Legal assistance

  • Connecting enrollees with community resources to address legal issues impacting housing

Securing housing payments

  • Providing one-time payments for security deposits and first month’s rent (provided funding is not available through any other program)

Short-term post-hospitalization

  • Housing for short period of time post-hospitalization, not to exceed six months, if individual is at imminent risk of homelessness (provided funding is not available through any other program)
Food Food support services

  • Assisting with SNAP and WIC applications, accessing school-based food programs, and locating food banks or food programs
  • Nutrition counseling and education
  • Funding for meal and food support from food banks or other community-based food programs

Meal delivery services

  • Funding for targeted nutritious food or meal delivery services for individuals with medical or medically-related special dietary needs (provided funding is not available through any other program)
Transportation Non-emergency health-related transportation

  • Transportation services to social services that promote community engagement
  • Providing education assistance in gaining access to public transit
  • Providing payment for public transportation to support ability to access pilot and other community-based and social services
Interpersonal Violence (IPV) / Toxic Stress IPV-related transportation

  • Transportation to/from IPV service providers

IPV and parenting

  • Assistance with linkages to community-based social service and mental health agencies with IPV expertise

Support resources

  • Assistance with linking to child care and after school programs
  • Assistance with linking to programs to increase capacity to participate in community engagement
  • Navigational services that improve safety and health of IPV victims (e.g., obtaining new phone number and mailing address, securing shelter and longer-term housing, connecting enrollees to medical-legal partnerships)

Legal assistance

  • Connecting beneficiary to legal services for IPV related issues

Child-parent support

  • Evidence-based parenting support programs and home-visiting services
  • Dyadic therapy treatment for children/adolescents at risk of attachment disorder

SOURCE: North Carolina’s Medicaid Reform Demonstration, approved October 19, 2018, see Attachment G.

Issue Brief