NC Medicaid Update: Additional Healthy Opportunities Services Now Available

Update from NC Medicaid:

Healthy Opportunities is a groundbreaking pilot program that works in conjunction with the state’s transition to NC Medicaid Managed Care to test and evaluate the use of Medicaid to pay for a select set of evidence-based interventions designed to address non-medical factors that drive health outcomes and costs.  

Qualifying Medicaid Standard Plan members in Healthy Opportunities Pilot regions may receive Evidence-Based Parenting Classes or Home Visiting Services as part of the pilots program that addresses toxic stress and Medical Respite which addresses multiple non-medical needs.

The following new services are:

• Evidence-Based Parenting Classes, including the Incredible Years curriculum, which provide group and one-on-one instruction, often in a classroom setting, over 18-20 sessions by a trained facilitator 
• Home Visiting Services, including the Parents as Teachers curriculum, which provide families one-on-one observation, instruction, and support from a trained case manager who may be a licensed clinician, and typically involve at least 12-24 home visits annually depending on the family’s need.
• Medical Respite, which addresses multiple non-medical needs, is a short-term, specialized program focused on individuals who are homeless or imminently homeless, have recently been discharged from a hospital setting and require continuous access to medical care. Services include comprehensive residential care that provides the enrollee the opportunity to rest in a stable setting while enabling access to hospital, medical, and non-medical services that assist in completing their recuperation. Medical respite services should include, at a minimum, short-term post-hospitalization housing, medically-tailored meals and transportation services.

Healthy Opportunities Pilot services are available in three regions of the state on the following timelines, overseen by the following Network Lead organizations:

1. Access East Inc.: Beaufort, Bertie, Chowan, Edgecombe, Halifax, Hertford, Martin, Northampton, Pitt

• All services available by July 26.

2. Community Care of the Lower Cape Fear: Bladen, Brunswick, Columbus, New Hanover, Onslow, Pender
   • Evidence-Based Parenting Classes and Home Visiting Services available by June 20.
   • Medical Respite will be available by July 11, 2022.
3. Impact Health/Dogwood Health Trust: Avery, Buncombe, Burke, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Yancey
   • All services are available as of June 15.

For more information, please see Medicaid bulletin article Additional Healthy Opportunities Services Now Available.