Health-related social needs support


What are health-related 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 benefit?

As part of the state’s recent 1115 waiver, Oregon was approved to offer the new HRSN benefit. The HRSN benefit was developed to provide social support to Oregon Health Plan (OHP) members who are experiencing certain life transitions, to improve their health during this specific time. Some examples of qualifying life transitions may 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:


1. Is a current OHP member.


2. Has a social health need:


  • Food insecurity
  • Housing instability or homelessness
  • Climate-related needs


3. Has 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)


4. Has 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

Home Changes for Health During Extreme Weather

Home changes for health are a health-related social needs (HRSN) benefit. They are devices to help keep members who qualify healthy in their homes during extreme weather. These include:

  • Air conditioners, heaters, and air filters to provide clean air and healthy temperatures
  • Mini fridges to keep medication cold during a power outage
  • Portable power supplies to operate medical devices like ventilators during a power outage


Additional eligibility criteria for climate benefit


1. They have a health condition that makes extreme heat, cold temperature, poor air quality, or power outage particularly challenging or dangerous to you.



2. They are 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.

3. Currently needs one of the above climate devices.



Requesting a climate device

If a member has Providence Health Assurance:




Housing supports

Housing isn't just about having a roof over your head. It affects your health in many ways, like how you feel physically, mentally, and socially. Having a safe and steady place to live is really important for people and communities to be healthy and do well. CareOregon helps our members who qualify find a stable home.


Housing support options and limits

Requests will be reviewed for appropriateness and some requests may not be funded. Exclusions include mortgage payments and payments related to the construction of new physical structures.



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  Availability varies. For methods or actions taken to address and fix issues or problems in a home. 
Hotel stays Up to three (3) months for members requiring home modification or home remediation who are unable to stay in their home while the service is being provided  Available for up to six (6) months for duration of waiver
Storage fees Up to six (6) months every three years 

Am I eligible for housing support?

To be eligible for a housing support:

  • You must be a current member.
  • You are not able to get the item/service through any other benefit or means.
  • The item or service must help with a qualifying medical need or life situation.
  • You provide all required documentation for your 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 our Social Needs Assistance Guidelines for more information about qualifying medical conditions and life situations and the commonly funded supports for each.


How do I request housing support?


You can fill out and submit the form yourself, or with the help of a parent, a caregiver, or a guardian/support/trusted friend, or a staff member from an organization or clinic.

Nutrition Supports

HRSN nutrition benefits are for OHP members with certain life situations and health conditions. For members who qualify, services may include medically tailored meals and nutrition education.


Am I eligible for nutritional support?

To qualify, Health Share/Providence members must be in at least one of these life transitions. Additional criteria also applies for each type of HRSN service.

  • Release from incarceration in the past 12 months
  • Discharge from an Institution for Mental Disease (IMD) in the past 12 months
  • Current or past involvement in the Oregon child welfare system
  • Transitioning from Medicaid-only to dual eligibility (Medicaid and Medicare) status within the next three months or has transitioned in the past nine months
  • Being homeless or at risk of becoming homeless.


Members must also have qualifying social needs and health conditions to be eligible for nutritional support. This may include, but is not limited to:


  • Food insecurity
  • Complex physical health condition
  • Complex behavioral health condition
  • Difficulty with self-care and daily activities
  • Experience of abuse or neglect
  • Under age 6 or 65 and older
  • Pregnancy or gave birth in the last 12 months
  • Repeated trips to the emergency room or crisis services


How do I request nutrition support?


You can fill out and submit the form yourself, or with the help of a parent, a caregiver, or a guardian/support/trusted friend, or a staff member from an organization or clinic.