The produce section of a supermarket.

(The Center Square) — In about a third of North Carolina counties, certain residents on Medicaid are receiving free food and other services with their health coverage through a pilot program funded by the federal government.

And while the effort is helping some struggling with medical issues and rising inflation to feed themselves and their families, other aspects of the six-month-old program have yet to gain traction.

The Healthy Opportunities Pilots is using up to $650 million in Medicaid funding over the next five years to offer "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 the North Carolina Department of Health and Human Services.

The pilot program launched in March with food services for residents in western, southern, and central northeast North Carolina across 33 counties. In May, the program added housing and transportation services and was expected to add "toxic stress and cross-domain services" in June and July, though NC Health News reports some of those services have been delayed.

A Health Opportunities Pilots fee schedule posted on the NCDHHS website in March lists 29 "interventions" covered by the program, which includes everything from up to $1,250 per month in housing move-in support, to $5,000 a year for home remediation services, to $150 for each large Healthy Food Box delivered to those who qualify.

There's also fruit and vegetable prescriptions, medically tailored home delivered meals, reimbursement for health-related public and private transportation, violence intervention services, parenting classes, home visiting services, dyadic therapy and many other services.

The intent of the program is to lower the cost to the state for those on Medicaid by covering non-medical services as preventative care. The pilot is currently run through three Health Opportunities Network Leads that coordinate the work with a variety of community organizations.

Access East, Inc. covers Beaufort, Bertie, Chowan, Edgecombe, Halifax, Hertford, Martin, Northampton, and Pitt counties. Community Care of the Lower Cape Fear covers Bladen, Brunswick, Columbus, New Hanover, Onslow and Pender Counties. Impact Health coordinates services in Avery, Buncombe, Burke, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania and Yancey counties.

Sonya Jones, co-founder of Caja Solidaria — the "solidarity food box" in English — told NC Health News the Medicaid is now paying her to do what she has been doing since 2020: Delivering food boxes sourced from farmers to low-income residents around Henderson and Transylvania counties.

"We have 47 referrals," she told the news site. "We have really strong relationships with health care providers, so people know to talk about it. And then also our participants are talking with each other — they're calling and saying, 'call and figure out how to get on this program.'"

While the healthy food aspect of the program has helped some residents, both physically and emotionally, organizations involved with other aspects told NC Health News the program's referral process and a lack of affordable housing is complicating efforts to roll out other services.

Also, many folks on Medicaid are simply unaware of the program, they said.