It’s true! Medicaid will soon be paying for home repairs and other non-clinical services including nutrition counseling, support for victims of domestic violence, and transportation.

This is part of a movement in the health care sector to identify and address Social Determinants of Health (SDOH) or “conditions in the places where people live, learn, work, and play that affect health risks and outcomes.”

For example, a person without reliable transportation may miss doctors’ appointments and a family that lives in a food desert may not have access to fresh fruits and vegetables. Ultimately, these conditions impact their overall health.

Another important SDOH is the condition of one’s home. WARM addresses health risks in two main categories.  

Respiratory Ailments
Indoor air pollution, excessive mold, and contaminants in old carpet may create or worsen respiratory conditions such as COPD and asthma. Research by the Robert Wood Johnson Foundation found that 40% of asthma diagnosed in childhood is caused by conditions in their homes such as poor indoor air quality caused by mold, mildew, and inadequate ventilation.

WARM’s mission improves indoor air quality, and thereby respiratory health, by repairing leaky roofs, replacing water damaged sheetrock, removing old carpet, and repairing heating and air conditioning systems.

This photo from Ms. Mary’s home is typical of what we find in older homes, especially mobile homes. In some cases, homeowners on oxygen discovery they need it less often (or not at all!) after WARM’s work is complete.

Risk of Falls
Dilapidated floors, inadequate or broken railings and stairs, and high tub walls may cause falls, especially as homeowners age-in-place. Falls are the leading cause of injury related deaths among senior citizens. Approximately one in four US residents aged 65 and older report falling each year.  

WARM’s services include wheelchair ramp construction, grab bar and railing installation, safety steps in tubs, and stairs and landing construction.

When WARM managers arrived at the home of Ms. Dorothy for inspection, an ambulance was leaving. We stopped them to ask if Ms. Dorothy was in the ambulance. The driver told us, “No, she falls every week or so, and we come out to pick her up and check her vitals.” After WARM installed railings and grab bars in her home, her home was no longer a danger zone and she didn’t call 911 on a regular basis.

Implications
Health is so greatly impacted by the condition of a patient’s home that every $1.00 spent on home repairs saves $19.00 in Medicare/Medicaid costs, according to studies compiled by the North Carolina Housing Finance Agency.  

Through the NC Department of Health and Human Services (NCDHHS), Medicaid is launching the Healthy Opportunities Pilot program, which will pay for certain non-clinical services that are proven to impact health. The five-year program will take a whole-person centered approach that addresses medical and non-medical drivers of health.

Data from the pilot program will be collected and analyzed to transform Medicaid and address fundamental drivers of health because “research shows up to 80% of a person’s health is determined by social and environmental factors and the behaviors that emerge as a result.”  

WARM has been working with New Hanover Regional Medical Center and other local nonprofits to provide information to NCDHHS for the development of this exciting new pilot program. We like it because we have an opportunity to address the root cause of certain health conditions and prevent the associated suffering and expense.  

If you’d like to know more or get involved, contact us at 910.399.7563.

JC Lyle has served as WARM’s Executive Director since January 2009. Under her leadership, WARM's annual revenue and productivity have more than quadrupled. Prior to working in the nonprofit sector, Lyle worked at McKim & Creed on subdivision design, rezoning and permitting throughout coastal North Carolina. Lyle earned her Master of Business Administration from UNCW's Cameron School of Business and has presented workshops on affordable housing issues and nonprofit management at state-level conferences. Lyle serves on the Planning Commission for the City of Wilmington and the North Carolina Housing Partnership, the board that oversees the state's housing trust fund. In 2012, Lyle was named Wilma Magazine's first Woman to Watch in the Nonprofit Category. In 2014, she accepted WARM's Coastal Entrepreneur Award in the Nonprofit Category, given by the Greater Wilmington Business Journal and UNCW’s Center for Innovation and Entrepreneurship. In 2018, the Association of Fundraising Professionals, Cape Fear Chapter named her Outstanding Fundraiser of the Year.