The Reinvention of Caja Solidaria and the Uncertain Future of Community Health in the North Carolina Mountains • Enlace Latino NC

Until just a few weeks ago, every Thursday Catalina Noreña loaded her truck with fresh produce—boxes of tomatoes, blueberries, cilantro, beans—and drove the winding roads of Transylvania County. These routes belonged to Caja Solidaria, a community initiative that delivered healthy food—not donations, but medically prescribed groceries—to hundreds of families facing mobility barriers, low incomes, or chronic illness.

That all ended on June 30.

That day, the state officially ended the Healthy Opportunities Pilot (HOP)—a three-year program that enabled organizations like Caja Solidaria to operate as food pharmacies in rural areas via Medicaid.

The funding cut left more than 43,000 people across North Carolina without support—including approximately 10,900 in the western region. It also dis