Which of the following is required for eligibility in the Healthy Opportunities Pilot?

• A. Two health conditions
• B. Evidence of income above the poverty line
• C. Residence outside the target counties
• D. At least one social risk factor and one health condition

Answer: (D)

The key idea being tested is how eligibility for the Healthy Opportunities Pilot is defined in a way that links health needs with social needs. The program targets people whose health is affected by social determinants, so eligibility requires both a social risk factor and a health condition. Think of it as addressing two sides of health: a medical issue (the health condition) and a social barrier that can worsen or sustain that issue (the social risk factor).

For example, someone with diabetes (a health condition) who also experiences food insecurity or housing instability (a social risk factor) would meet eligibility because both elements are present and relevant to the program’s goals. Conversely, a person with a health condition but no social risk factor would not meet the criterion, and a person with a social risk factor but no health condition also would not, since the program is designed to address both aspects together. Being outside designated counties or having income above the poverty line aren’t the defining requirements for eligibility in this program.

So, the best answer is that eligibility requires at least one social risk factor and one health condition.