What are social needs?
Health-related social needs (HRSN) refer to social and economic needs that contribute to health and well-being. They include food security, transportation, interpersonal violence, education, income/employment, stable housing, social support, and utility assistance. When one or multiple of these needs are unmet, an individual can experience poor health outcomes.
What is the health-related social needs (HRSN) benefit?
As part of the state’s recent 1115 waiver, Oregon was approved to offer the new health-related social needs (HRSN) benefit. The health-related social needs (HRSN) benefit was developed to provide social support to OHP members who are experiencing certain life transitions, to improve their health during this specific time. Some examples of life transitions include:
- Involvement with the child welfare system
- Recently became eligible for both Medicaid and Medicare (within the past 9 months)
- Experiencing homelessness
- At risk for homelessness
- Released from jail, detention center, Oregon Youth Authority facility, prison, or the Oregon State Hospital within the past 12 months
The HRSN benefit will provide three types of support; housing, nutrition, and climate-related devices.
Who is eligible?
To be eligible members must meet all of the following 4 criteria:
1Is a current OHP member.
2Has a social health need.
- Food insecurity
- Housing instability or homelessness
- Climate-related needs
3Has experienced at least one of the following:
- Youth involved with the child welfare system, including youth leaving foster care
- People experiencing homelessness or are at risk of homelessness
- People released from custody or a residential behavioral health setting
- People transitioning from Medicaid-only to both Medicaid and Medicare coverage
- Youth ages 19-26 with special health care needs (starting 1/1/25)
4Has a clinical health need. some examples include:
- Complex physical health needs
- Complex behavioral health needs
- Pregnancy
- Age (under 6, over 65)
- Repeated use of crisis services, such as the Emergency Department
- Needs assistance with Activities of Daily Living (e.g., personal hygiene, eating, dressing)
- Has experienced interpersonal violence or domestic violence
- Developmental disability
HRSN benefit categories
Available starting on March 1, 2024. Items include:
- Air conditioners for individuals at health risk due to significant heat, including installation support as needed
- Air filtration devices for individuals at increased health risk due to compromised air quality
- Heaters for individuals at increased health risk due to significant cold
- Portable power supplies for powering medical devices
- Mini fridges for medications needing refrigeration
Additional eligibility criteria for climate benefit
- They have a health condition that makes extreme heat, cold temperature, poor air quality, or power outage particularly challenging or dangerous to you.
- They are in one of these transitional groups:
- Be in one of these transitional groups.
- Become eligible for Medicare in addition to OHP in the next 3 months.
- Enrolled in Medicare in addition to OHP for the first time no more than 9 months ago.
- May be homeless soon, spend at least 50% of income on rent, live in a recreational vehicle (RV, trailer).
- Currently experiencing homelessness, don’t have a regular place to sleep, or are staying at someone else’s home.
- Received care in the Oregon State Hospital or a large substance use disorder residential treatment or withdrawal management program in the past 12 months.
- Released from a jail, detention center, Oregon Youth Authority facility, prison in the last 12 months.
- Involved with child welfare services in Oregon at some point in their life. This includes foster or substitute care, received adoption or guardianship assistance or family preservation services, or has been in court regarding child welfare.
- Currently needs one of the above climate devices.
Tentatively available starting in November 2024
More details coming soon!
Tentatively available starting in January 2025
More details coming soon!
How do members request a Health-Related Social Needs (HRSN) Benefit?
A request form needs to be filled out and submitted to CareOregon by email or fax. Members have a couple of options:
- If the member would like help filling out the HRSN application form, they can contact Customer Service at customerservice@careoregon.org or 503-488-2822
- The member themselves, an organization or clinic supporting the member, a member’s parent, a caregiver, a guardian/support/trusted friend, or an HRSN Service Provider can fill this form out.
- The form can be returned to CareOregon by:
- Fax: 503-416-4726
- Email: Requests.social.determinants@careoregon.org
If a member does not meet eligibility criteria for the HRSN benefit, they may still use the same form to request climate support through the health-related services flex funding program.
