Approved Minutes of March 26, 2025

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MINUTES ORANGE COUNTY BOARD OF HEALTH March 26, 2025 VII. Educational Sessions A. NC Navigator Consortium and Legal Aid NC Sierra Elrahal, Navigator, Judith Rivera, Navigator, and Aaron Bindman, MAT Supervising Attorney, presented on the NC Navigator Consortium and Legal Aid NC programs. Some highlights of their presentation are below: • Ms. Elrahal explained that the NC Navigator Consortium is a grant-funded project within the Legal Aid NC Program that helps provide health insurance options for people living in North Carolina. The program assists North Carolinians with any health insurance option other than Medicare and refers individuals who need assistance with Medicare to State Health Insurance Program (SHIP) counselors. • The program provides education and practical assistance to community members and does a lot of outreach activities, including tabling, flyering, and partnering with community organizations. • Ms. Rivera shared that the Navigator Consortium has been active since the Affordable Care Act (ACA) passed in 2013 and has touched over 7 million North Carolinians with information about health insurance. • Ms. Rivera specifically highlighted the Premium and Copay Assistance Program (PCAP) program, which connects individuals living with HIV with affordable health insurance to cover the cost of their Anti-Retroviral Therapy and other medications. • Mr. Bindman spoke about the NC Legal Aid program, which is a statewide entity providing legal representation to low-income households on topics such as domestic violence defense, eviction defense, fighting for humane housing conditions, defense against foreclosure, debt collection, and repossession, and Medicaid advocacy. Regarding Medicaid advocacy, the program assists those who have been denied or terminated but have reason to believe they are still eligible. They also assist with medical debt relief. Clients are referred to Legal Aid through multiple channels, including the NC Navigator Consortium and the Medicaid Helpline. • Ms. Rivera shared that they have partnered with the UNC Sheps Center to assess the impact of navigators in the community and to determine who hasn't yet been reached by Medicaid expansion. It's estimated that statewide, around 20% of people who are eligible have not enrolled. In response to Commissioner Fowler's question, Ms. Rivera explained that it is likely due to gaps in data collection that many counties have such low estimates of unreached eligible population (that is, >95% of Medicaid-eligible individuals have enrolled), and there is likely more unmet need than the projections indicate. She said that so far, the data analysis has been focusing primarily on clusters, meaning there is less data about trends in more rural areas, and that they are encouraging the Sheps Center to add a qualitative component to paint a more complete picture. • Dr. Stuebe asked what trends navigators are seeing regarding why some populations have waited to enroll, to which Ms. Elrahal said that there are a variety of reasons someone may have waited to enroll, including not knowing that they are eligible, not needing health insurance, and not wanting to work with the Department of Social Services (DSS), often due to a negative experience in the past. Ms. Elrahal added that many people are used to the Health Insurance Marketplace, which is generally set to auto-reenroll each year, meaning newly eligible people may have missed that they are eligible because they did not submit a new application. Ms. Rivera noted that many of the people whom they are now seeing enrolling are burdened on multiple dimensions — for example, they may be both experiencing homelessness and lacking transportation. S:\Managers Working Files\BOH\Agendas &Abstracts\2025 Agenda and Abstracts/ March Page 5