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  • Writer's pictureericjcarrig

How to disrupt the cycle of poverty and reduce the negative impact of poor health on society

No food. No way to get to the grocery store. No friends with a working car to get you there or to take your kids to school. That could happen every day to a family on Medicaid.

A family with an asthmatic child can’t replace its carpet with solid flooring. The child misses school and you miss work to take care of him.

A doctor feels futile because she knows that the treatments she recommends likely won’t work because her patient’s basic health needs are not being met.

Photo by Shane Rounce Unsplash

A unique pilot program in Asheville, NC aims to improve people’s lives by supplementing traditional care with offerings like free produce and transportation and investing in affordable housing.

I spoke with Laurie Stradley, Executive Director of Impact Health. She’s leading the Healthy Opportunities Pilot in Western North Carolina that aims to disrupt the cycle of poverty by helping children and adults become more productive, so they can perform better at school and work.

When people aren’t hungry or worried about where their next meal is coming from, paying bills, getting to the doctor, or cleaning their home for their asthmatic child, they can focus on being their best.

The Healthy Opportunities Pilot aims to improve health by providing eligible Medicaid members with choices of 29 service categories, from transportation vouchers and weekly produce boxes to parenting classes and help finding housing.

It is a more effective use of Medicaid funds because it identifies all the supports a family’s needs — not just physical health — and coordinates them.

People who qualify for the program are assigned a care manager, who is typically part of a clinically integrated network (CIN), a physician practice, or employed by one of the five participating private managed care organizations.

The care managers assesses the health care plans provided by the Medicaid members’ doctors and their need for services. During an assessment, care managers ask patients what they need beyond clinical care, and refer them to the most appropriate of the 52 community organizations in the region that can help them.

Once they receive the referral from the care manager, the community service organizations call the members to have them come in to receive the services like transportation, and housing and legal assistance.

In one example, a family with an asthmatic child asked for help replacing the carpet in its home, but a care manager supporting the family also identified needs for meals and assistance navigating the legal system.

In other cases, members may be able to afford a monthly rent payment, but needs assistance with the security deposit or other upfront payments that are required.

Medicaid reimburses the community services organizations for providing their services. They then use that funding — in addition to the grant funding for which they apply — to expand their capabilities as needed.

Impact Health organizes the activities of the community-based organizations in the region, making sure they have the capabilities to serve members. This way, the care managers have the confidence to make referrals to them.

Imagine if Medicaid members STARTED out in life with access to food, transportation, access to education, and a network of supportive people. They may have performed well in society much like people who were born with, or have the means to attain, those supports.

By taking care of basic needs, people have the physical and mental health and time to focus on school or work. More members of our society could be productive, which would likely mean less crime, substance abuse, homelessness, and incarceration, all of which Americans pay for in one way or another.

We also wouldn’t have to increase the overhead of healthcare providers, insurance companies, and government which add staff to manage the patients and use the required technology. Instead they pay for them by passing the costs on to us in higher premiums, prices and taxes.

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