The North Carolina Department of Health and Human Services launched its COVID-19 Support Services Program in August 2020 to address multiple pandemic-related social needs in counties with COVID-19 hot spots in four target regions of the state. Lessons from the COVID-19 Support Services Program can inform other states’ and payers’ efforts to address social needs, as well as North Carolina’s soon-to-launch $650 million Healthy Opportunities Pilots, which will pay for and provide social services through Medicaid managed care programs. To study the COVID-19 Support Services Program, we interviewed its administrators and frontline providers across the program’s service regions and partnered with one of the program’s largest grantee organizations to analyze survey data.