By Nicky Smith
June 3, 2025
Candidate for Greensboro City Council
It’s time we approach homelessness in Greensboro with bold, results-driven solutions that treat the whole person, not just their immediate circumstances. One promising model already gaining traction in North Carolina is the Healthy Opportunities Pilot Program (HOPP). This Medicaid-backed initiative takes a groundbreaking approach to addressing the root causes of poor health and homelessness.
Though not yet available in Guilford County, this pilot program is exactly the kind of common-sense, compassionate solution our city should be fighting to bring here. Here’s why.
The Healthy Opportunities Pilot is built on a powerful truth: up to 80% of a person’s health is determined by factors outside the doctor’s office — things like safe housing, nutritious food, transportation, and personal safety. These are the barriers faced by people experiencing homelessness in Greensboro daily.
Rather than treating symptoms after the fact, the HOPP model works upstream — helping prevent the crises that lead to emergency room visits, repeated shelter stays, and cycles of instability.
1. Housing Support Services
From one-time security deposits to housing inspections and repairs, HOPP gives individuals the tools to stabilize their lives. In Greensboro, we could replicate this by funding similar services in partnership with local nonprofits and housing agencies.
2. Whole-Person Care Coordination
Care managers can collaborate with shelters, hospitals, and support networks to ensure people aren’t falling through the cracks — connecting them to mental health care, food access, and transportation.
3. Medical Respite Care
Far too often, unhoused individuals are discharged from hospitals with nowhere safe to recover. HOPP includes funding for medical respite, offering a humane and cost-effective solution that we urgently need here in Greensboro.
4. A Reimbursable Funding Model
What makes this model truly sustainable is its built-in reimbursement system through Medicaid — a game-changer for community-based organizations that are currently underfunded but doing critical work.
Only three pilot regions in North Carolina are eligible for HOPP. Greensboro should be next. As your next City Council member, I will advocate for:
We don’t have to start from scratch. The Healthy Opportunities Pilot offers a proven, Medicaid-backed framework that ties health outcomes directly to housing and life essentials. If we’re serious about reducing homelessness, this is the strategy we must fight for — one rooted in data, dignity, and real results.
Let’s make Greensboro a city that takes care of its own — smartly, compassionately, and effectively.
Additional Reading Resources:
Cost Savings and Health Improvements: An independent evaluation by the Cecil G. Sheps Center for Health Services Research at UNC-Chapel Hill found that HOPP participants experienced reduced emergency department visits and hospitalizations, leading to an average monthly savings of $85 per beneficiary.
Positive Participant Outcomes: Success stories from the program highlight significant improvements in participants’ lives, including securing stable housing, gaining employment, and accessing essential services like childcare and transportation.
What is the Healthy Opportunities Pilot Program? Though HOPP is limited to a few counties, its success shows why Greensboro should pursue a similar model. This approach can effectively tackle homelessness and health disparities in our community by providing housing support, coordinated care, and reducing emergency healthcare costs.
Greensboro Homeless Shelters: This article provides an inside look at the accommodations provided by local shelters, emphasizing the importance of supportive housing services.
Homelessness is a complex challenge, but with innovative, proven strategies like the Healthy Opportunities model, we can take real steps toward lasting change in Greensboro. This isn’t just about shelter; it’s about restoring dignity, health, and opportunity for every community member.
With your support, I can bring this forward-thinking, results-driven leadership to City Hall. Donating to my campaign is an investment in practical solutions and common-sense leadership—the kind our city desperately needs to tackle issues like homelessness head-on.
Let’s build a Greensboro where no one is left behind. Together, we can make it happen.
Please donate to this campaign to bring Nicky Smith’s leadership, wisdom, and common sense to the Greensboro City Council. Make a difference by making a $20 donation today.
