As Cata Norena shifts her car into park, this week’s fresh food delivery has arrived for the Chavez family. Julian Chavez opens the door and waves to Norena, who has been bringing the family fresh produce in Brevard for almost a year.
Norena’s employer, Caja Solidaria, serves families like the Chavezes through a local food-as-medicine pilot program that helps North Carolina residents facing chronic health problems and food insecurity.
According to Feeding America – a nationwide network of food banks, food pantries and local meal programs – more than 1.4 million individuals are food insecure in North Carolina.
Caja Solidaria, and 57 programs like it in Western North Carolina, are funded through federal health insurance programs to provide families with nutritional, whole foods. Advocates and leaders say the program is already paying off to reduce costly medical expenses associated with unmanaged chronic conditions. However, the approval for funds is set to expire at the end of October. North Carolina state and federal officials are in negotiations to file for a five-year extension, officials told BPR.
Advocates say the program is key to improving accessibility, affordability, and knowledge of nutritional foods – instrumental in reducing health risks and costs.
Chavez has been a participant in the pilot program for close to a year. He explained his family needed financial help badly due to him having surgery and felt like he couldn’t anywhere until Caja. He says the support helps people to not make bad decisions in desperate times.
“People do whatever … especially when you got a family,” Chavez explained on a recent afternoon when BPR tagged along on Caja Solidaria’s route through Transylvania County.
“...Other countries and other places don't have this. I'm just so glad that we have this … it's hard to even get food stamps or anything like that.”
Every week, before Chavez hears the rumbles of the volunteers driving down his dirt driveway, the work begins hours earlier, back at Caja Solidaria’s headquarters in Hendersonville.
Fabiola Lopez helps load three minivans with meats, proteins, fresh fruits, vegetables, grains, and even on occasion, culturally specific food like jalapenos for the Latinx population. Lopez, part of the operations team, helps drivers like Norena prepare for the long day ahead.
The operations team starts by removing food from coolers and dry storage and putting them in baskets. They do quality control to make sure nothing is bruised or moldy – ensuring program participants get the best produce.
On a recent delivery day, Norena had 16 families to deliver to in Transylvania County – and it was already noon.
“We have to make sure we have enough food for everybody. Everybody gets to choose whatever it is that they want for the week to feed their families. This is not a pre-packed food box or anything. People get to shop,” Norena explained.
Caja Solidaria operations team member Larissa Lopez says feels grateful to be able to do this rewarding work.
“I just feel like I can sleep at night with a clean conscience …We really are out here doing our very best for everyone, for all of our participants, for each other.”
WHAT IS HOP?
Healthy Opportunities Pilot (HOP) was developed on March 15, 2022, by the North Carolina Department of Health and Human Services (NCDHHS) and authorized by the Centers for Medicare & Medicaid Services (CMS). It was the nation’s first comprehensive program to test and evaluate the impact of providing select evidence-based, non-medical interventions related to housing, food, transportation, and interpersonal safety and toxic stress to high-needs Medicaid enrollees.
According to a survey from WNC Health Network in 2020, a nonprofit organization that works to improve health and well-being in western North Carolina, 14.8% of households with children were food-insecure, up from 13.9% in 2019.
HOP is a new approach to addressing the social determinants of health problems and reducing the need for clinical interventions. Its main goal is to proactively improve health and help the federal program save millions on treatments.
The federal government authorized up to $650 million in Medicaid funding and North Carolina Medicaid implemented the pilot to run through Oct. 31, 2024.
The pilot program has three network leads, two in eastern NC and one in WNC.
Impact Health Executive Director Laurie Stradley says the 3-year-old non-profit organization was created to launch HOP in Western North Carolina, alongside Medicaid expansion.
“Our relationship is really to make sure that the agencies in Western North Carolina that are part of this work have everything they need to meet the demands of the program,” Stradley said. “And support the members in getting access to the services that they are eligible for and then to try and do our best to mediate the sort of red tape and bureaucracy that goes along with working in a large federal insurance program.”
Stradley highlighted organizations in WNC like Caja Solidaria that are sourcing and delivering nutritious, delicious local food.
Sonya Jones is the executive director of Caja Solidaria (the Solidarity Food Box), a nonprofit in Hendersonville that launched in 2020 as a food-buying co-op. Initially, the organization provided food and emotional support to people living in Henderson and Transylvania counties. Caja was one of the first nonprofits to sign up with HOP.
Caja offers services like Cajacopia, Equitable Community Engagement, Mutual Aid Fund, Mobile Market, and Produce Prescriptions.
For households that don’t qualify for HOP, Caja uses limited funding to supply “solidarity shares” — food from their headquarters. The organization recently received more than $11,000 from Aetna Health for its work in WNC.
In 2022, Caja reported to have reached 300 households, delivered 800 produce-buying cooperative shares, 1000 healthy harvest produce Rx shares, and about 900 super food boxes to participants. They have also invested almost $90,000 in local farms and food businesses.
Demand and interest keep rising.
In May, NCDHHS announced HOP would expand eligibility to include residents in targeted counties who are enrolled in NC Medicaid Direct. The expansion was created to address the non-medical needs of approximately 14,000 additional members.
With the potential expiration of the pilot program, leaders are hopeful they will be able to continue their work.
“I have every confidence that our state is in negotiations right now with CMS ... That they will come to an agreement in the next couple of months and that we will continue on for at least another five years.”
Norena says the work feeds her soul.
“I get energy from the interactions that I have with people,” Noreña explained. “I love that I get to see so many Latin American families. I can connect with them and speak Spanish and talk about all the foods and meet their children and it's just like these people become your friends.”
Norena has seen the rapid growth of the non-profit since she started in October. At first, Caja served around 45 families. Now, the organization helps 260 and has a waitlist for those wanting fresh food deliveries.
“We wish we could serve like every single person that comes to our door,” Norena said. “We are a service that people really do want. We stand out because of the quality of the service, the quality of the food, the dignity that we bring and the respect and the equity and everything that we stand for. “
She also shared that some of the participants have diabetes and have shown improved health progress but it will take time to see the overall impact of the pilot program.
“I have one person, their cholesterol levels are lower, their blood sugar levels are better because she replaced a lot of the snacking with fruit and vegetables and juices and things that she's making for herself now with the food that we bring every week,” Norena explained. “This is gonna take time to really kind of see the overall impact of providing people with really good food. But in just the few months that I have been here, what I have been hearing from people is they are all feeling better.”
Larissa Lopez, who is on the operations team at Caja Solidaria, talked about showing up for people in the most vulnerable times of their lives.
“We had a really hard call from a participant who was in a crisis and we were one of the first calls. They were in distress and just wanting care and we were gonna go see them that day to deliver food…After we went to that house, it was so heavy on our heart and so Sonya and I just drove up this mountain and sat on the side of the mountain and just kind of processed all of it together. That's when I knew that this was deep care work - that we are showing up for people in the most vulnerable times of their lives.”
