Food assistance program likely to be gutted, despite helping WNC residents

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Food assistance program likely to be gutted, despite helping WNC residents

HOP served 13,482 individuals in WNC alone. File photo

Like any parent or guardian, Katie Clubb wants to provide nutritious food for her grandchildren. Clubb, a Canton resident, said with rising grocery prices, SNAP benefits don’t adequately cover healthy options for anyone in her household.

The U.S. Department of Agriculture for fiscal year 2024 reported that the average person received $187.20 in SNAP — Supplemental Nutritional Assistance Program — per participant, per month.

That wouldn’t even cover the USDA low-cost meal plan dietary needs of a 6-year-old receiving five free school lunches per week, and it would only cover the first 11 years of food needs for someone getting free breakfast and free lunch. The benefits are a tight squeeze for anyone over 12 and even children under 12 during school vacation.

But with the Healthy Opportunities Pilot, Clubb said bags of produce were delivered weekly for herself and her grandchildren.

Regularly supplying fresh fruits and vegetables was not the only way the program helped Clubb out.

“[My refrigerator] tore up, so I needed a new refrigerator. Couldn’t afford it. During the storm, lightning struck my stove. I couldn’t afford a new stove,” she recalled.

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HOP provided both appliances for her, she said, along with a new microwave.

“[HOP is] anything that can have a health impact for families who are struggling with a chronic health condition,” including home remediation and non-allergenic bedding and transportation to the grocery store, said HOP Public Information Officer Jennifer Caldwell.

The North Carolina Department of Health and Human Services in late 2018 was granted federal authorization to advance HOP in three target regions — including Western North Carolina, where it has served 13,482 individuals — by expanding Medicaid to cover its services. Now, despite evidence of HOP’s success, the program was suspended July 1, pending passage of the state budget.

The proposed budget, however, would shut it down.

Someone is eligible for HOP if they have Medicaid and one or more chronic conditions — including adverse childhood experiences, which are also determinants of health — explained Caldwell.

Haywood County resident Chris Ulmer said he qualified for the program because of a COPD diagnosis. He and his wife, Robin, were out of work after Helene. The Ulmers decided to start selling barbecue, which Chris said HOP made possible. The program covered food for the couple for the week, enabling them to invest the money they earned through sales back into barbecuing.
The Ulmers are looking to open a brick-and-mortar business.

“I already have my EIN from the IRS … I have my food handlers. I’ve done everything that I have to do, except have a physical trailer,” Chris Ulmer told The Smoky Mountain News.

But “now that we don’t have [HOP], anything we earn is just to get, I mean, mainly milk, because I have stomach problems, and I have some other health issues,” he explained.

When the Ulmers’ truck broke down, it was the last straw. HOP paid for vehicle repairs, Chris said, which they couldn’t afford on their own. The Ulmers’ doctor is in Old Fort, Tennessee, he added, and they have no way of getting there. And without the truck, they can’t tow their camper to another location. “ We have to worry about $200 a week to stay [at this campground],” Robin explained.

In addition to money and resources, the program provided things some might consider less tangible, like spending time with family — or a trip to the park on a summer afternoon, said Christy Mosteller, HOP coordinator for Mountain Projects.

“Those are the moments that life’s about, and when you are so incredibly overwhelmed and consumed by financial stress, health stresses, day-to-day life, an afternoon out like that can be vital to your emotional and mental functioning,” Mosteller said.

HOP facilitated meaningful relationships, too.

”My thing was just being able to talk to Patricia, our case manager, about everything. She was very, very just gentle and kind and willing,” Robin said.

“The whole program was just good … it’s very beneficial and very much needed in every community,” she added.

Caldwell said the Healthy Opportunities Pilot always had huge financial incentives for the state of North Carolina. “The federal government matched, actually two-to-one for every dollar North Carolina put into the program … North Carolina was able to provide $3 worth of services for every Medicaid member for $1,” Caldwell told SMN. As a result, she said, the program was “budgeted four or five years ago without discussion.”

HOP was supposed to run from 2020 until 2025. Then COVID got in the way, and the program didn’t start until March of 2022.

Despite two years of delays, Caldwell said “when it’s all averaged out, it saves about $1,000 per member per year participating in the program.”

Investing upfront in social services, she added, prevented emergency room visits and hospitalizations and medical interventions.

According to Caldwell, the federal government — through the Centers for Medicare and Medicaid Services — saw the data up to December 2024 and granted a five-year permission for the pilot to continue.

“But the state has to put money in. They have to budget for it,” she said. And that hasn’t happened, which “effectively makes [HOP] dead in the water.”

Budget negotiations are ongoing. In other words, HOP “is on legislators’ radar, but we need to keep it on their radar,” Caldwell explained, which can look like calling or emailing state reps about continuing the program.

Ending HOP doesn’t just impact its recipients. A total of 458 WNC farms and growers depend on routine HOP customers — 59 of whom are in Haywood, Jackson, Macon and Swain counties.

Permanently cutting HOP means its former recipients, unable to access preventative care, will be visiting the emergency room more often.

“And that means that you, with your private insurance, are also sitting in that emergency room waiting for care that might be lifesaving … while someone else has a gallbladder issue that could have been addressed,” Caldwell said.

But even if HOP does continue, it’s fundamentally tied to Medicaid, so what happens when federal Medicaid cuts go into effect after the 2026 midterm elections?

According to Caldwell, it’s all in the paperwork.

“[The] administrative burden … will knock people off Medicaid, not being qualified for Medicaid,” she said. “So I would expect to see a lot more grassroots efforts to have Medicaid navigators and ombudsman who just make sure folks get supported in staying enrolled.”

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