If you are a member looking for information on how to make a flex request or find other health related services, please visit our Social Needs Assistance page.
Attention: HRSF request Turn-Around-Times
Due to the high volume of HRSF request we are receiving at this time, processing Turn-Around-Times (TATs) for HRSF requests are temporarily extended. To better support members, we want to make sure we are setting realistic expectations for HRSF Turn-Around-Times when working with members.
Effective immediately Turn-Around-Times on HRSF requests are as follows:
- HRSF Standard requests now have a minimum TAT of 4+ weeks
- HRSF Urgent requests now have a minimum TAT of 2+ weeks
Please note this does include fulfillment time for approved requests.
To ensure timely review of your request, please ensure the following items are met and included in your request submission:
- A completed Health-Related Services Flexible Services Funding Request Form
- Please ensure the form is completed in its entirety and efforts to access other sources of funding and support are adequately described in detail
- Climate devices should be submitted on this form: OHP HRSN Eligibility Form
- Medical documentation, this could include a care plan, treatment plan or chart notes that address the specific diagnosis listed on the request form
- We may also need other types of documentation such as lease agreements, a budget/ledger or copies of utility bills in order to process requests
For Hotel Requests:
- A completed Health-Related Services Flexible Services Funding Request Form
- Please ensure the form is completed in its entirety and efforts to access other sources of funding and support are adequately described in detail
- Medical documentation, this could include a care plan, treatment plan or chart notes that address the specific diagnosis listed on the request form
- Completed Hotel Request Checklist
- Completed CareOregon member code of conduct including signature and date
Submitting requests with incomplete forms or missing required documentation will significantly delay the processing of requests.
Detailed information on how to submit an HRS-flexible services request are available in the Health-Related (Flex) Services instructions
On this page find:
Flexible services (flex requests)
What are flexible services?
Flexible services are cost-effective items and/or services delivered to an individual OHP member to supplement covered benefits and improve their health and well-being. Flexible services are intended to meet immediate social needs, stabilize crisis situations and support a sustainable plan for ongoing needs. These are commonly referred to as flex requests.
Limitations of flexible services:
The Oregon Administrative Rules restrict health-related services to items not paid for with grant money, funding separate from CCO contract revenue, normal clinical service billing, and is the payor of last resort. In other words, health-related services may be used only if other funding is not available.
How members access flexible services:
Any primary care or behavioral health provider or care team, care coordination staff member working directly with members, or other subcontractors of CareOregon’s network, may make a flex request for a member. CareOregon encourages
our community-based organization (CBO) partners to help our shared members access flexible services. CBOs can work with members and their treatment providers to identify the need, and the provider can submit a request.
If you
are a CBO and need help connecting a member to a provider, please complete the Care Coordination referral form.
Evaluating requests
CareOregon evaluates all completed request forms based on:
- The member’s eligibility
- How the request matches their treatment plan.
- Because CCOs are not able to support long term needs, a sustainability plan describing how the member’s needs will be met long-term must be outlined.
- Which other community resources or safety net funds (besides HRS) were pursued before the request was made.
- Often evaluating requests involves asking for more information about the member, which may include the member's budget information. Requests cannot be fulfilled until all information is received.
- Depending on the nature of the request, if more details about the budget are indicated, this form can be used to provide that information.
We will provide members with a written outcome (mailed to the address on file with the CCO) and copy the requesting provider (and the member’s representatives, if applicable).
Requesting flexible services funds
Standard individual flex request
For non-hotel requests, for individual members:
- Please include:
- Standard health-related flexible services request
- Medical documentation (care plan, progress notes, chart notes, etc.) and information about the member’s diagnosis.
- Items that are needed on a repeating basis — like gym memberships, phone minutes, etc. — require the submission of a new Standard health-related services funding request form each month.
Hotel flex requests
For stays in hotels for individual members:
- The maximum number of days we will consider funding in a single request is 30, but be aware that many hotels do have shorter limits of time a member can stay without checking out and checking back in. Please have a conversation with the member and potentially the hotel to make sure the requested hotel is a good fit. Some reasons it may not be a good fit:
- No rooms are available that meet accessibility requirements
- No smoking rooms are available or there is no easy access to an outside smoking area
- No pets are allowed
- The member does not have ID and the hotel requires it
- There will be transportation challenges (if the only challenge is getting to the hotel, you can also request help with transportation in the request)
To submit a request for a hotel:
There are two different options for submitting hotel requests. Please note, both options do still require medical documentation (care plan, progress notes, chart notes, etc)
- Submit multiple documents:
- Standard health-related flexible services request
- Hotel request checklist
- CareOregon member code of conduct
- Medical documentation (care plan, progress notes, chart notes, etc.) and information about the member’s diagnosis.
- Submit a Hotel Flex Request (which combines all of the forms listed above into one document)
If a member needs an extension, please note:
- Extensions of hotel stays require a new submission of a Funding Request form but do not require a new code of conduct or checklist.
- To avoid disruption of services, please submit extension requests at least three to five business days prior to checkout.
If a member lives in an area being impacted by a current state of emergency and needs a hotel, you can submit the request without clinical documentation.
Bulk Purchasing Program
We recognize that providers frequently feel there is a small window of opportunity to provide some services for members, so we’ve made some of these items that are commonly needed and have a clear benefit available via our bulk purchasing programs. This allows providers to have them on hand and give them to members as needed.
If your clinic or organization is interested in using the Bulk Purchasing Program, please reach out to socialhealth@careoregon.org to get information about signing up. Here are some highlights of the program:
- Items should only be requested that are anticipated to be distributed over a one-month period.
- Once CareOregon receives your request, it will be reviewed and verified for accuracy before order fulfillment. Requests must be submitted using the link below with the PIN Code assigned to your clinic.
- It is a requirement that reporting be current before new items may be requested.
Below are some examples of items available via bulk reimbursement.
- Cell phones with 1-year data plans
- Transit passes
- Sleeping bags
- Shelter materials (tents and tarps)
- City Team shelter vouchers
- Personal hygiene products
Helpful Resources:
