Join Our Network

We at Impact Health want to sincerely thank you for your interest in participating in the Healthy Opportunities Pilot Program. We are grateful for the essential, charitable work you do every day. Together, we can take strides towards improving the health of those who live in our community and make an even bigger impact in Western North Carolina. 

Helpful Application Tips

This application requires detailed information and may take up to an hour to complete. You can save your work at any time as you are working to complete the application and return to it. Before starting your application, please review the FAQ and a model contract. If you have questions or technical difficulties, please contact [email protected]

Key Documents and Application Information

  • Contact information for main and satellite locations 
  • Counties your organization currently serves 
  • Staffing details, including an organizational chart and staff resumes for staff who will be delivering pilot-related services 
  • Board of Directors roster and detailed demographics about Board of Directors
  • Most recent annual report and recent strategic planning documents 
  • Recent financial documents including organizational budget (previous three years), most recent audited financials and financial policies and procedures 
  • Compliance documents including most recent IRS Form 990 and business licensing, accreditation or credentials that you have in order to meet industry standards for applicable pilot program services 
  • Number of clients served (unique individuals) 
  • Cultural competency information including languages spoken, cultural competency and equity policies and practices, annual training and documentation of compliance with non-discrimination state and federal laws, regulations, guidelines and standards 

Application Resources

  • Model contract. Review the contract to find out more about roles, responsibilities and expectations of HSOs in the program.
  • Fee schedule.  The the fee schedule is approved by the Centers for Medicare and Medicaid Service (CMS). It includes a service name, unit of service, service rate and service definition for twenty-nine approved Pilot services. Service definitions provide additional detail on each Pilot service, including a description, anticipated frequency, duration and setting of service delivery, as well as minimum eligibility criteria for receiving the service.
  • HSO contract and instructions. If you are unable to apply via the link above, you can download this .pdf, complete it and email it to [email protected]
  • FAQ. Check out the extensive question and answer section our Resources page.

Thank you for your interest in becoming an HSO with Impact Health. We look forward to reviewing your application. 

For application-specific questions and tech support, contact:
Devon Malloy, Communications Manager, Sevenya
[email protected] 

Ashley Graham, Senior Consultant, Sevenya
[email protected]

For general questions & information contact:
Dionne Greenlee-Jones, MPA, Director of Programs, Impact Health
[email protected]org
Teleworking: 919.638.0088


Information Session Resources

2021 HSO Application Information Session
Food Insecurities – 10/12/21 9am

Application Submission Deadline

October 29, 2021

  • Food Insecurities
  • Transportation
  • Housing
  • Cross-Domain (multiple categories)
To Be Announced
  • Interpersonal Safety & Toxic Stress
 

Have Questions? Attend an Info Session.

Sessions are limited to 100 participants.

Housing

October 15

9am Register Here

5pm Register Here

General Information Session

October 21

Noon Register Here

 

General Information Session

October 26

Noon Register Here

Interpersonal Safety
& Toxic Stress

Coming Soon

Cross-Domain (multiple or inersecting service areas)

October 14

9am Register Here

5pm Register Here

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