USDA’s “Expanded” Access to School Meals Falls Short

Sep 28, 2023

Position Title: Health Access Manager

Reports To: Executive Director

Status: Full-time, exempt

Location: North Carolina: hybrid/remote with statewide travel

Hiring Salary Range: $62,000–$68,000

Supervisory responsibilities: None currently

About the North Carolina Alliance for Health

The North Carolina Alliance for Health brings together community voices, bipartisan leaders, businesses, and partners across the state to advance practical policy solutions grounded in local experience and designed for statewide impact. Together, we improve health outcomes while reducing long-term healthcare costs, expanding access to care, strengthening the workforce, and helping communities thrive. 

About the Role

As federal funding cuts and policy shifts threaten public health and Medicaid coverage, the North Carolina Alliance for Health (NCAH) is committed to fighting for North Carolinians’ continued access to affordable care. In alignment with NCAH’s commitment to public health and ensuring health access for all, the Health Access Manager will lead and coordinate Keeping NC Medicaid Strong – a statewide coalition focused on protecting and advancing Medicaid in North Carolina.

This role requires strong skills in coalition management, stakeholder communications, and policy analysis. The ideal candidate is a strategic thinker, a skilled communicator, and committed to access to care in North Carolina.

Key Responsibilities

  • Coalition Management & Leadership

    • Manage NCAH’s health access portfolio, with a primary focus on Medicaid policy and related public health issues. 
    • Convene and grow a diverse coalition of organizations, advocates, and community partners.
    • Facilitate Keeping NC Medicaid Strong coalition meetings by setting agendas, supporting discussions, and ensuring follow-through on action items.
    • Work with the Executive Director to build and maintain relationships with key stakeholders, including advocacy groups and community leaders.
    • Manage project timelines, budgets, deliverables, and grant requirements; identify risks and recommend adjustments to keep work on track. 
    • Engage Medicaid beneficiaries, grassroots organizations, and communities most affected by health access barriers in campaign planning, messaging, and advocacy. 

 

  • Policy & Legislative Work

    • Monitor and analyze federal and state policy developments affecting Medicaid and health access; advise leadership on emerging opportunities and threats.
    • Draft policy briefs, talking points, and testimony targeted to a variety of audiences.
    • Represent the coalition with media and relevant public forums.
    • Work closely with the Executive Director to influence policy outcomes.

  • Advocacy & Campaigns

    • Implement advocacy campaigns, including grassroots mobilization and digital outreach.
    • Prepare coalition members for legislative meetings, press events, and other advocacy opportunities.
    • Track campaign progress and report on outcomes to the coalition and funders.

  • Communications & External Relations

    • Serve as a representative for NCAH’s healthcare access work in meetings with key stakeholders, funders, and the media, providing timely updates, reporting recent developments, and sharing relevant information.
    • Translate complex Medicaid and healthcare policy issues into clear, compelling messages for diverse audiences.
    • Collaborate with the communications team to draft fact sheets, advocacy toolkits, talking points, and digital content.
    • Support coalition members in amplifying unified messaging.

  • Organizational Management

    • Work with the Executive Director to support Medicaid-related grants, including budget tracking, deliverable management, and funder reporting.
    • Ensure projects are executed effectively, on time, and in alignment with NCAH’s strategic goals.
    • Contribute to funding proposals, funder cultivation, grant reports, and sustainability planning for NCAH’s health access portfolio. 
    • Develop annual goals, strategies, work plans, and performance measures for NCAH’s health access portfolio in collaboration with the full team.
    • Establish and track campaign goals, performance indicators, partner engagement, policy progress, and outcomes; use findings to improve strategy and support funder reporting.
  • Team Participation & Collaboration
  • Work closely with NCAH staff, consultants, and coalition partners to align strategies and coordinate communications.

    • Uphold NCAH's mission, vision, and values in your daily work.
    • Foster a collaborative, inclusive team culture that values diverse perspectives and lived experiences.
    • Support colleagues across projects by contributing expertise in policy, advocacy, and coalition management.

 

Qualifications

  • Minimum two to four years of health policy advocacy or NC Medicaid program experience.
  • Strong project-management skills, including the ability to manage multiple deadlines, budgets, and deliverables.
  • Familiarity with the North Carolina General Assembly, state agencies, and state policymaking processes.
  • Demonstrated ability to facilitate diverse groups, navigate differing perspectives, and build consensus.
  • Commitment to racial, geographic, disability, and economic equity.
  • Ability to work independently and adapt to rapidly changing policy conditions.
  • Willingness to travel within North Carolina and occasionally work outside regular business hours.

 

How to Apply: To apply, send your resume and cover letter to admin@ncallianceforhealth.org by September 4, 2026.

September 27, 2023

Katie Herndon Dawkins, North Carolina Alliance For Health Communications Manager

On Tuesday, the USDA pushed out a press release titled, “USDA Expands Access to School Breakfast and Lunch for More Students.” The title is confusing and, frankly, misleading. What the USDA did was lower the Identified Student Percentage or ISP for schools to be able to participate in the Community Eligibility Program (CEP) from 40% to 25%. It did not increase reimbursements for school meals or provide any additional funding to allow more schools to participate in CEP.

Here’s what you need to know:

  • Identified Student Percentage (ISP) is the percentage of students living in households participating in certain income-based federal assistance programs like WIC, SNAP, TANF, and Medicaid. 
  • The Community Eligibility Program (CEP) is a simplified meal service option that allows qualifying schools to provide meals at no cost to all students without requiring families to apply for free and reduced-price meals. Instead, school districts receive federal funding based on a formula using existing data from SNAP, WIC, TANF, Medicaid, and other programs (the ISP). 
  • The CEP formula is complicated. The higher the ISP, the higher the level of federal reimbursement the school receives. The ISP is multiplied by 1.6 to determine the percentage of meals that will be reimbursed at the free rate, the highest rate of reimbursement. So, a school with an ISP of 25% would be reimbursed at the free rate for 40% of meals served since 25 x 1.6 = 40. The remaining 60% of meals served would be reimbursed at the paid rate. The current free reimbursement rate for breakfast is $2.28 and lunch is $4.25. The paid reimbursement rate is only $0.38 for breakfast and $0.40 for lunch. 
  • When schools participate in the CEP program, no students pay for meals. This means that having less than half of the meals reimbursed at the free rate is problematic because it does not provide schools with enough funds to cover the cost of producing the meal. 
  • Local or state funds must fill any gaps between program costs and federal support. 
  • The new rule allowing for more schools to participate in the CEP program does NOT provide any extra federal funding and does NOT increase the multiplier. 
  • Schools that are now eligible to participate in CEP based on the new USDA rule would have to make up the difference between how much it costs to provide meals at no cost to families and the federal reimbursement rate they would receive.
  • Many schools and districts are not able to participate in CEP because the school nutrition programs are not able to fill the gap between program costs and federal reimbursements for meals.
  • Without additional federal funding and increasing the multiplier, this new rule effectively changes nothing for the students and families in North Carolina who could benefit from no-cost school meals. 
  • While the press release states that the “USDA offers extensive financial support for schools,” the reality is that with the cost of food and supply chain issues, the federal reimbursements aren’t keeping up with the cost of meals served. 

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