Programs to Champion that address local food access and community health

Healthy Opportunity Pilot (HOPs)

The Healthy Opportunities Pilots (HOP) is 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. The federal government has authorized up to $650 million in Medicaid funding for the Pilots over five years (starting in 2022). NC Pilot Region Map Here. 

This working group collectively developed food service operational guidelines and best practices to be used by all stakeholders that are internal and external to the implementation of the Healthy Opportunities Pilot (HOP). All guidance documents included an emphasis on sourcing from local food producers in North Carolina. For example, the Healthy Food Box recommends a minimum of 25% of the food items supporting NC farm and food businesses.

Recent action by the NC General Assembly allocated state funding that is not sufficient enough to make HOP operational, we need to fully fund HOP.

Resources

Local Food Sources for HSOs

Food and Nutrition Access Case Management

Healthy Food Box (for pick-up and delivery)

Healthy Meal (for pick-up and delivery) and Medically Tailored Meals Fruit and Vegetable Prescription

Diabetes Prevention Program

Double Up Bucks North Carolina (DUNC)

In 2023, this working group led the charge to explore strategies to expand Double Up Bucks North Carolina (DUNC) across the entire state of North Carolina. DUNC is a nutrition incentive program that provides a dollar-for-dollar match for SNAP/EBT. The match can be used at farmers markets, food hubs, and direct agricultural retail outlets in North Carolina. A statewide expansion would reach every county, farmers’ market, and farm interested in participating! With DUNC, participants can stretch their purchasing power and make buying local, nutritious foods more affordable. DUNC also grows the economy of rural communities, creating local markets for NC farmeA state and private funded program to support food hubs across North Carolina in purchasing produce from local farms at a competitive market price, assembling food boxes using the farm-fresh food, then partnering with local organizations to distribute those boxes to food insecure households at no cost.rs. So the working group convened diverse stakeholders to understand the current Double Up Bucks programs in North Carolina, including the location, average participants served, funders, and budget. Then the working group developed a draft two-page policy brief to educate decision makers of the impact and benefit of Statewide Double Up Bucks in North Carolina. In 2024, the leadership for the Double Up Bucks statewide advocacy campaign was taken up by partners, North Carolina Farmers Market Network (NCFMN) to lobby for Statewide Double Up Bucks.

NCFMN and partners are actively working to secure state funding and launch Double Up NC. Twenty-six other states have SNAP incentives funding in their state budget — we believe North Carolina is next!

South Carolina - $5 million

Tennessee - $1.1 million

Virginia - $1 million

Council member organization, NCFMN is requesting $2 million in the North Carolina State budget. In 2026, a group of lawmakers agreed to advocate for $11 million in state funding to support local food systems, including the $2 million for DUNC. Ultimately, the funding was eliminated in the final state budget for 2026.

FarmSHARE

An innovative, partnership-based program that improves the livelihoods for small and mid-sized farms and pioneering local food distribution structures that break through the barriers under-resourced communities face in accessing nutritious foods. FarmSHARE is coordinated by council member organization, Carolina Farm Stewardship Association (CFSA) and uses state and private funding to support food hubs across North Carolina in purchasing produce from local farms at a competitive market price, assembling food boxes using the farm-fresh food, and then partnering with local organizations to distribute those boxes to food insecure households at no cost.

2020 - 2024 Impacts

• 78 counties out of 100 counties covered

• $7.9 million paid to 350 local farms and 18 food hubs

• 179,457 food boxes delivered

• 1,400 families served each week

In 2026, CFSA and partners advocated for $5 million in the state budget to secure this program; however, it was ultimately cut in the approved state budget. Programs like these ensure households in need get the high-quality high-nutrition foods they deserve, while supporting local farms.

School Meals for All

School Meals for All is a policy for all public schools in North Carolina to provide lunch and breakfast to students at no cost. School meals help children succeed both in and out of school, avoids the opportunity for a child to experience shame and stigma due to an inability to pay for school meals, builds strong, resilient communities, and produces health and economic benefits for local economies.

Immediate benefits:

• Provides predictable revenue, which helps school districts to:

  • Reduce the pressure to cut food costs

  • Allosws districts to prioritize local sourcing

  • Enter into longer-term purchasing agreements with local farmers

Long-term benefits:

• Strong, consistent demand for environmentally-friendly ingredients and climate-resilient farming practices helps:

  • Maintain productive farmland to prevent land being sold for development

  • Developing generations of students who understand where their food comes from and value local agriculture

At least 8 states have codified universal free school meal policies, let’s make North Carolina next! Council member organization, Alliance for Health is one of the leading advocates for School Meals for All. School Meals for All was not included in the 2026 state budget; however, there was a new mandate included that determined school districts will no longer be able to provide “alternative meals” (which is often less expensive than the daily, regular meal) to students with lunch debt. While this is an excellent move towards student health and well-being, NO FUNDING is provided to cover the additional costs districts will incur to follow the mandate.