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.
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.
How do we provide social needs assistance?
There are two ways members may be eligible to receive the social needs supports described above: Health Related Social Needs (HRSN) or Health Related Service Fund (HRSF).
When a request is submitted, CareOregon will review it to determine whether the request meets eligibility criteria for one of these two sources, based upon the information provided.
Requesting different types of social needs supports
What kind of climate devices are available?
- Air conditioners
- Air filtration units and/or filters
- Mini-refrigerators
- Heaters
- Portable power supplies
Members may be eligible for one of each device every three (3) years. They are allowed one replacement device in that time frame if their item stops working.
Eligibility
To be eligible for a climate device, all of the following must be true for a patient:
- They must be a current member
- They are not able to get the item/service through any other benefit or means
- The item or service must help with their medical need or life situation, and
- They provide all required documentation for the request
Not all requested items or services are granted/funded. Our team evaluates each request on a case-by-case basis and makes the final funding determination, including the amount(s) of funding rewarded if members meet eligibility criteria. Please review the following Social Needs Assistance Guidelines for more information about qualifying medical conditions and life situations and the commonly funded supports for each.
Social Needs Assistance Guidelines (PDF)Requesting a climate device
If the member meets the eligibility standards listed above and want to request a climate device, simply click the button below to fill out the digital Climate Device Request Form.
Digital Climate Device request formYou can also download and fill out the Climate Device request form (PDF) and submit it to 211 by email or fax.
- Fax number: 503-214-8909
- Email: hrsn@211info.org
If you have questions or would like help filling out the request form with a member, call 211's direct line at 503-468-5375.
Housing support options and limits
| Support | Limitations |
| Rent support | Three to six months (depending on eligibility), available once every three years, including back rent |
| Utilities | No more than six (6) months, including any arrears, available once every three years |
| Home modifications | Available as needed to help medical conditions such as ramps, grip bars, cabinet handles |
| Home remediations | Available once. For methods or actions taken to address and fix issues or problems in a home. |
| Hotel stays |
|
| Storage fees | Up to six (6) months every three years |
| Housing deposits | Available once |
| Moving fees | Available once |
Exclusions include mortgage payments and payments related to the construction of new physical structures.
Eligibility
To be eligible for a climate device, all of the following must be true for a patient:
- They must be a current member;
- They are not able to get the item/service through any other benefit or means,
- The item or service must help with their medical need or life situation, and;
- They provide all required documentation for the request.
Not all requested items or services are granted/funded. Our team evaluates each request on a case-by-case basis and makes the final funding determination. Please review the following Social Needs Assistance Guidelines for more information about qualifying medical conditions and life situations and the commonly funded supports for each.
Social Needs Assistance Guidelines (PDF)Requesting a housing support
If a member meets the eligibility standards listed above and want to request a housing support, simply click the button below to fill out the secure digital Housing Request Form.
Digital Housing Request FormYou can also download and fill out the Housing request form (PDF) and submit it to 211 by email or fax.
- Fax number: 503-214-8909
- Email: hrsn@211info.org
If you have questions or would like help filling out the request form with a member, call 211's direct line at 503-468-5375.
Examples of other supports covered
Here are some examples of common support for social needs. This list isn't comprehensive. If a member needs something for their health that isn't listed, just submit a form and we'll consider the request.
- Food assistance (grocery store gift cards, nutrition education, etc)
- Sensory support items/tools (Weighted blankets, sleep aids, vouchers for yoga classes, etc.)
- Exercise equipment and gym memberships
- Electronic devices such as laptops and communication devices
- Baby equipment
- Specific educational materials and/or classes
- Camp enrollment
Eligibility
To be eligible for a housing support, all of the following must be true for a patient:
- They must be a current member;
- They are not able to get the item/service through any other benefit or means,
- The item or service must help with their medical need or life situation, and;
- They provide all required documentation for the request.
Not all requested items or services are granted/funded. Our team evaluates each request on a case-by-case basis and makes the final funding determination. Please review the following Social Needs Assistance Guidelines for more information about qualifying medical conditions and life situations and the commonly funded supports for each.
Social Needs Assistance Guidelines (PDF)Requesting a social needs support
If a member meets the eligibility standards listed above and wants to request a housing support, simply click the button below to fill out the secure digital social needs request form.
Digital social needs request formYou can also download and fill out the Health-related services Flex Form (PDF) and submit it to 211 by email or fax.
- Fax number: 503-214-8909
- Email: hrsn@211info.org
If you have questions or would like help filling out the request form with a member, call 211's direct line at 503-468-5375.
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.
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
Requesting bulk purchases
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.
- Required member level reporting on bulk purchases can be provided by using the Bulk request tracker below.
- It is a requirement that reporting be current before new items may be requested.
Helpful resources
Health Related Social Needs (HRSN)
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. The HRSN benefit will provide three types of support; housing, nutrition, and climate-related devices. 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
Health Related Service Fund (HRSF), or “Flex”
Health-related services (HRS) are non-covered services under Oregon’s Medicaid plan that are not administrative requirements and are intended to improve care delivery and overall member and community health and well-being. One of the purposes of HRS is to allow coordinated care organizations (CCOs) an opportunity to address the social determinants of health and equity (SDOH-E), including the health-related social needs, of their members. For CCOs to use Oregon’s Medicaid funds to pay for HRS, they must comply with state and federal criteria.
The HRS section on the Oregon Health Authority (OHA) website has the most up-to-date information, including more information on using HRS to address SDOH-E.
Questions? Email us at social.determinants@careoregon.org.
Providing additional documentation for HRSF requests
Budget worksheet
Often evaluating requests involves asking for more information about the member, which may include the member's budget information. If more details about the budget are indicated, this form can be used to provide that information.
K Plan Letter requests
K Plan is a Medicaid funding source through the Department of Human Services that may be available for members with intellectual or developmental disabilities. The K Plan request is a request for a denial letter issued by CareOregon stating the requested item or service is not covered by the member’s Medicaid plan. This is a required part of the Oregon Developmental Disabilities Services (ODDS) funding process.
Flex FAQ
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.
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.
CareOregon evaluates all completed request forms based on:
- The member’s eligibility
- How the request matches their treatment plan
- Which other community resources or safety net funds (besides HRS) were pursued before the request was made
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).
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. Members can also now submit requests themselves on our member-facing Social Needs Assistance page.
If you
are a CBO and need help connecting a member to a provider, please complete the Care Coordination referral form.
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 a request, please ensure the following items are met and included in the request submission:
- 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.
- 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.
Submitting requests with incomplete forms or missing required documentation will significantly delay the processing of requests.
In addition to CareOregon’s Health Related Services, there are other local resources that offer social needs assistance in our community. If a member finds that they do not qualify for our program, they may be able to access what they need from one of the links below.
- Medical transportation: Non-emergency Medical Transportation (NEMT)
- Discounted car repairs: Oregon's Car Care Program or Self-Sufficiency Grants
- Car Assistance: How to Get a Donated Car From Goodwill or Salvation Army
- Pet assistance: Multnomah County Animal Services
- Discounted phone or internet: Oregon Lifeline program
- Utility assistance: Oregon Energy Assistance Program or call 211
- Furniture: Community Warehouse
- Home repairs: Home Repair and Home Ownership Retention Services
- Bikes: Bike Farm or Bikes for Humanity PDX
