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Opinion: NC’s HOP program has led to healthier residents, lower medical costs. It needs funding

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Opinion: NC’s HOP program has led to healthier residents, lower medical costs. It needs funding


The best way to lower health care costs is to reduce the need for expensive medical services by preventing illness in the first place. Thanks to the foresight of North Carolina lawmakers, our state tested a pilot program that does just that. In only two years, people are healthier and health care costs are lower. But despite its success, the future of the Healthy Opportunities Pilot is unclear.

As the two most recent secretaries of the North Carolina Department of Health and Human Services, we launched HOP by working with the Republican-led General Assembly and with the first Trump administration, which approved the pilot. North Carolina’s innovation has since become a model for other states and earned national attention for its impact.

HOP is based on a simple idea — it costs less to keep people healthy than to treat them after they get sick. We spend most of our money in this country treating diseases, rather than preventing them. Evidence from HOP has shown that investing in things that impact your health such as food and housing not only prevents disease but also saves money.

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Recent studies show HOP reduces health care costs by $1,020 per participant each year. The savings come from people needing fewer trips to the emergency room and fewer hospital admissions. People are staying healthy because local farmers, nonprofits, and small businesses deliver meals so people have healthy food, make home repairs that get rid of mold and help avoid asthma attacks, and help patients get preventive care and medicine when they need it, not after it becomes an emergency.

In Western North Carolina, families displaced by Tropical Storm Helene faced similar challenges. One mother, whose child suffered from asthma, received support from HOP to make their new home safer by removing mold and other triggers through the Breathe Right program. The result? Fewer ER visits and a healthier future. In the Cape Fear region, a young single mother was struggling with unsafe housing, food insecurity, and her children’s health problems. With support from HOP — including help with housing, food access, and parenting resources — she found stability. She secured full-time work, moved her family into a safe home, and saw their health improve dramatically.

And yet, despite these successes, North Carolina lawmakers have not included specific funding for HOP in either the House or Senate budget proposals. Without funding, millions in federal dollars will be pulled out of our rural communities, emergency department and hospital visits will likely rise again, health care costs will increase, and people’s health will be at risk.

Cutting programs like HOP does not save money. It just shifts costs to emergency rooms, schools, and long-term care facilities — and drives up costs for all of us. It’s why lawmakers funded Healthy Opportunities in the first place. And now that it’s delivered on the promise of saving costs, it’s time to double down on what works. In December of last year, noting the proven success of HOP, the federal government approved expanding the pilots statewide, which could unlock amazing opportunities across all of North Carolina. As North Carolina faces tough budget choices, sustaining and growing programs like HOP is the fiscally responsible decision. It supports healthier families, stronger communities, and a more sustainable health care system.

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With uncertainty at the federal level and no funding included for HOP in either the North Carolina House or Senate budgets, the program’s future hangs in the balance. If it ends, the consequences will be real — lives, jobs, and hurricane recovery efforts will all be at risk. In a time when so much feels uncertain, this is a solution we can agree on. The evidence is clear, the need is urgent, and the stakes are high. Our state must continue to lead the way with common-sense improvements to our health system.

The question is not how we can afford to do this; it is how we cannot?

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Dr. Mandy Cohen and Kody Kinsley are former Secretaries, NC Department of Health and Human Services.



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A town in western North Carolina is returning land to the Eastern Band of Cherokee Indians

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A town in western North Carolina is returning land to the Eastern Band of Cherokee Indians


An important cultural site is close to being returned to the Eastern Band of Cherokee Indians after a city council in North Carolina voted unanimously Monday to return the land.

The Noquisiyi Mound in Franklin, North Carolina, was part of a Cherokee mother town hundreds of years before the founding of the United States, and it is a place of deep spiritual significance to the Cherokee people. But for about 200 years it was either in the hands of private owners or the town.

“When you think about the importance of not just our history but those cultural and traditional areas where we practice all the things we believe in, they should be in the hands of the tribe they belong to,” said Michell Hicks, principal chief of the Eastern Band of Cherokee Indians. “It’s a decision that we’re very thankful to the town of Franklin for understanding.”

Noquisiyi is the largest unexcavated mound in the Southeast, said Elaine Eisenbraun, executive director of Noquisiyi Intitative, the nonprofit that has managed the site since 2019. Eisenbraun, who worked alongside the town’s mayor for several years on the return, said the next step is for the tribal council to agree to take control, which will initiate the legal process of transferring the title.

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CHEROKEE CHIEF SIGNS ORDINANCE FOR FIRST OFFICIAL DEER SEASON ON TRIBAL LANDS

“It’s a big deal for Cherokees to get our piece of our ancestral territory back in general,” said Angelina Jumper, a citizen of the tribe and a Noquisiyi Initiative board member who spoke at Monday’s city council meeting. “But when you talk about a mound site like that, that has so much significance and is still standing as high as it was two or three hundred years ago when it was taken, that kind of just holds a level of gravity that I just have no words for.”

In the 1940s, the town of Franklin raised money to purchase the mound from a private owner. Hicks said the tribe started conversations with the town about transferring ownership in 2012, after a town employee sprayed herbicide on the mound, killing all the grass. In 2019, Franklin and the Eastern Band of Cherokee Indians created a nonprofit to oversee the site, which today it is situated between two roads and several buildings.

“Talking about Land Back, it’s part of a living people. It’s not like it’s a historical artifact,” said Stacey Guffey, Franklin’s mayor, referencing the global movement to return Indigenous homelands through ownership or co-stewardship. “It’s part of a living culture, and if we can’t honor that then we lose the character of who we are as mountain people.”

LUMBEE TRIBE OF NORTH CAROLINA GAINS LONG-SOUGHT FULL FEDERAL RECOGNITION

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Noquisiyi is part of a series of earthen mounds, many of which still exist, that were the heart of the Cherokee civilization. The Eastern Band of Cherokee Indians also owns the Cowee Mound a few miles away, and it is establishing a cultural corridor of important sites that stretches from Georgia to the tribe’s reservation, the Qualla Boundary.

Noquisiyi, which translates to “star place,” is an important religious site that has provided protection to generations of Cherokee people, said Jordan Oocumma, the groundskeeper of the mound. He said he is the first enrolled member of the tribe to caretake the mound since the forced removal.

“It’s also a place where when you need answers, or you want to know something, you can go there and you ask, and it’ll come to you,” he said. “It feels different from being anywhere else in the world when you’re out there.”

The mound will remain publicly accessible, and the tribe plans to open an interpretive center in a building it owns next to the site.



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Former inmate buys NC prison to help others who have served time

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Former inmate buys NC prison to help others who have served time


With the recent purchase of the former Wayne Correctional Center in Goldsboro, Kerwin Pittman is laying claim to an unusual title — he says he’s the first formerly incarcerated person in the U.S. to purchase a prison. Pittman, the founder and executive director of Recidivism Reduction Educational Program Services, Inc. (RREPS), was sent to prison […]



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NC Foundation at center of I-Team Troubleshooter investigation could face contempt charge

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NC Foundation at center of I-Team Troubleshooter investigation could face contempt charge


DURHAM, N.C. (WTVD) — New details in an I-Team investigation into a Durham foundation accused of not paying its employees.

The North Carolina Department of Labor filed a motion in court to try to force the Courtney Jordan Foundation, CJF America, to provide the pay records after the state agency received more than 30 complaints from former employees about not getting paid.

The ABC11 I-Team first told you about CJF and its problems paying employees in July. The foundation ran summer camps in Durham and Raleigh, and at the time, more than a dozen workers said they didn’t get paid, or they got paychecks that bounced. ABC11 also talked to The Chicken Hut, which didn’t get paid for providing meals to CJF Durham’s summer camps, but after Troubleshooter Diane Wilson’s involvement, The Chicken Hut did get paid.

The NC DOL launched their investigation, and according to this motion filed with the courts, since June thirty one former employees of CJF filed complaints with the agency involving pay issues. Court documents state that, despite repeated attempts from the wage and hour bureau requesting pay-related documents from CJF, and specifically Kristen Picot, the registered agent of CJF, CJF failed to comply.

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According to this motion, in October, an investigator with NC DOL was contacted by Picot, and she requested that the Wage and Hour Bureau provide a letter stating that CJF was cooperating with the investigation and that repayment efforts were underway by CJF. Despite several extensions, the motion says Picot repeatedly exhibited a pattern of failing to comply with the Department of Labor’s investigation. The motion even references an ITEAM story on CJFand criminal charges filed against its executives.

The NC DOL has requested that if CJF and Picot fail to produce the requested documentation related to the agency’s investigation, the employer be held in civil contempt for failure to comply. Wilson asked the NC Department of Labor for further comment, and they said, “The motion to compel speaks for itself. As this is an ongoing investigation, we are unable to comment further at this time.”

ABC11 Troubleshooter reached out to Picot and CJF America, but no one has responded. At Picot’s last court appearance on criminal charges she faces for worthless checks, she had no comment then.

Out of all the CJF employees we heard from, only one says he has received partial payment.

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