Yancey County

Many opened arms – and plenty of biscuits, fruit and grits – greeted the Extra Miles Tour when we arrived at Reconciliation House in Burnsville. Members of the Blue Cross NC team weren’t the only guests of honor, either. NC Secretary of Health and Human Services Kody Kinsley and Co-Chair of the NC Senate Health Care Committee Jim Burgin had come to this picturesque town in western North Carolina to learn more about Impact Health.

Impact Health is a startup entity created by Dogwood Health Trust to serve as the network lead for the region’s Healthy Opportunities Pilot (HOP) program. Overseeing the region’s growing network of human service organizations (HSOs), last year alone Impact Health coordinated more than 6,500 services. This work has given community members better access to drivers of health resources essential for good health and well-being, with primary areas of focus centered on food, housing and transportation.

North Carolina’s decentralized, community-based approach to HOP programs is relatively unique and allows each region to strategize its approach based on its unique needs and assets. John Miller, director of Reconciliation House, talked about the western region’s challenges with generational poverty, and how the county’s unique geography and limited access to transportation can make it difficult for people to get to vital services. Proximity to Asheville, NC, is driving up housing and rental prices. The shortage of dentists, combined with meth use and excessive consumption of soda throughout the region has undermined oral health and made it difficult for many people to eat apples and other healthy foods.

Food programs are Impact Health’s priority area, and one of the important features of Reconciliation House’s work in this arena (collaborating with TRACTOR Food and Farms, whom we’d met in Mitchell County) is offering an online ordering platform that lets recipients choose which healthy foods they want to receive.

“Choice gives dignity,” Mr. Miller said.

Director of Programs Amanda Bauman talked about how the scope of Impact Health’s work extends far beyond providing food boxes. Countless services include:

• Housing support, such as helping families pull together all of the deposits and fees that make move-in costs prohibitive, inspecting homes for safety issues and making repairs as needed, and helping with utilities when a household experiences unanticipated financial burdens
• A diabetes prevention program, which helps North Carolinians across 18 counties thanks to an innovative online delivery option
• Support with SNAP enrollment
• Training for Mental Health Emergency Response, especially for staff at partnering HSOs

After Impact Health staff provided their overview, the conversation turned to a discussion of where there are gaps, redundancies and opportunities with the HOP program. One of the recurring themes in this portion of the day was how to drive an uptick in usage. Sensitivities and stigma, lack of awareness, lack of trust and lack of time were all identified as major barriers to participation.

This is one reason why Impact Health has identified food security as its top priority.

“Food is the gateway to all other services,” explained Director of Communications Jennifer Caldwell.

She elaborated: Not only do food security programs promote good health, but any nutritional program is also an access point for other critical supports. Whenever a person asks a care manager or an HSO representative for help with food, that’s an opportunity to discuss other areas of need. Furthermore, when people have a positive experience receiving food support – when they are treated with dignity and when the experience directly improves their day-to-day – they will be more receptive to support in other aspects of their lives.

In this same vein, the discussion touched on the importance of engaging more providers and the care managers they work with to serve as hubs, directing patients to these services.

At one point, Secretary Kinsley asked about how the local YMCA (one of the HSOs that collaborates with Impact Health) engages area children. Lauren Wilson, the local YMCA director of funds development, talked about after-school programs that partner with other organizations “to get kids active” and to offer nutrition and cooking courses. Community engagement efforts at local events give children and adults alike opportunities to try vegetables they’ve never had and to raise awareness of food box programs. Then, she talked about examples of true community engagement, where the outreach runs both ways:

“We’ve had kids draw pictures for box deliverers on a weekly basis. We’ve had them pick flowers to give to the people who bring them food,” she described.

That expression of reciprocal commitment embodies what Impact Health is striving toward: Whole person, whole family, whole community well-being.