Read more: Members may have trouble getting meds at some pharmacies.

Select language

Provider document update: Non-contracted Behavioral Health Fee Schedule effective June 1, 2025.

Social needs assistance

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.

How do we provide social needs assistance?

There are two ways members may be eligible to receive the social needs supports: 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 form

You can also download and fill out the Climate Device request form (PDF) and submit it to 211 by email or fax.

If you have questions or would like help filling out the request form with a member, call 211's direct line at 866-698-6155.

Housing support options and limits

SupportLimitations
Rent supportThree to six months (depending on eligibility), available once every three years, including back rent
UtilitiesNo more than six months, including any arrears, available once every three years
Home modificationsAvailable as needed to help medical conditions such as ramps, grip bars, cabinet handles
Home remediationsAvailable once. For methods or actions taken to address and fix issues or problems in a home.
Hotel stays
  • Up to three months for members requiring additional assistance, post hospitalization
  • Up to seven days for unhoused members with a medical condition impacted by severe heat or cold
  • Potentially up to three months for members waitlisted for longer term housing
  • Includes members who are unable to remain in their home during approved home remediations/modifications
Storage feesUp to six months every three years
Housing depositsAvailable once
Moving feesAvailable once

Exclusions include mortgage payments and payments related to the construction of new physical structures. 

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 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 Form

You 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 866-698-6155.

What kind of nutrition supports are available?

  • Assessment for medically tailored meals
  • Medically tailored meals
  • Nutrition education

Eligibility

To be eligible for a nutrition 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 must be experiencing significant food insecurity.

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 nutrition support

If a member meets the eligibility standards listed above and want to request a nutrition support, simply click the button below to fill out the secure digital social needs request form.

Digital Nutrition Request Form

You can also download and fill out the Nutrition request form 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 866-698-6155.

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
  • Specific educational materials and/or classes
  • Camp enrollment

Eligibility

To be eligible for this 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 form

You 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 866-698-6155.

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:

  • 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.
Digital bulk request form Bulk request tracker

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 nine 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

What is an HRSN Service Provider?

As an integral part of the community, HRSN Service Providers help connect members with the HRSN benefit. These can be public or private social service organizations or clinics who work with Columbia Pacific CCO to identify eligible members, help them complete requests for support and directly provide HRSN services for the member.

  • Be accessible to OHP members in your region.
  • Demonstrate the ability and/or experience of effectively serving at least 1 of OHA’s Priority Populations.
  • Demonstrate qualified services and administrative staff.
  • Provide culturally and linguistically appropriate, responsive and trauma-informed services.
  • Demonstrate a history of responsible financial administration.

  • Meet readiness standards defined above.
  • Demonstrate readiness to send and receive closed loop referrals.
  • Comply with reporting and oversight requirements and applicable laws relating to privacy and security.

CPCCO will utilize OHA’s HRSN fee schedule to reimburse HRSN Service Providers. During the contracting process, we will work together to establish reporting and invoicing processes, which may look different depending on the type of services or financial needs of the HRSN Service Provider. Those who want to participate as HRSN Service Providers will get proper training on reporting and invoicing prior to any deadlines.

Listed below are the types of information that HRSN Service Providers may be required to submit. This list is subject to change:

  • Member identifying information (name, date of birth, Medicaid ID)
  • Date(s) of service
  • Location where services were provided (e.g., home, in office, in the community)
  • A description of HRSN Services
HRSN Devices Fee Schedule:
Climate-Related Supports
Climate Devices Fee Schedule (Version 7, January 17, 2024)

Procedure Code

Modifiers

Service Description

Unit

OHA Expected Unit Costs

Rate1,2

Procedure Code

Modifiers

Service Description

Unit

OHA Expected Unit Costs

Rate1,2

S5165 – Home modifications; per service

U1 – HRSN Waiver Program
V1 – Air conditioner

Medically necessary – Air conditioner, including delivery

Per Item

660

Actual cost, subject to maximum allowable

Procedure Code

Modifiers

Service Description

Unit

OHA Expected Unit Costs

Rate1,2

T2029 – Specialized medical equipment, NOS, waiver

U1 – HRSN Waiver Program

Medically necessary – Air filtration device, including delivery

Per Item

500

Actual cost, subject to maximum allowable

Procedure Code

Modifiers

Service Description

Unit

OHA Expected Unit Costs

Rate1,2

S5165 – Home modifications; per service

U1 – HRSN Waiver Program
TS – Follow up service

Medically necessary – Air filter replacement, including delivery

Per Item

70

Actual cost, subject to maximum allowable

Procedure Code

Modifiers

Service Description

Unit

OHA Expected Unit Costs

Rate1,2

S5165 – Home modifications; per service

U1 – HRSN Waiver Program
V3 - Generator

Medically necessary – Portable power supply, including delivery

Per Item

1590

Actual cost, subject to maximum allowable

Procedure Code

Modifiers

Service Description

Unit

OHA Expected Unit Costs

Rate1,2

S5165 – Home modifications; per service

U1 – HRSN Waiver Program
V4 – Heater

Medically necessary – Heater, including delivery

Per Item

290

Actual cost, subject to maximum allowable

Procedure Code

Modifiers

Service Description

Unit

OHA Expected Unit Costs

Rate1,2

S5165 – Home modifications; per service

U1 – HRSN Waiver Program
V2 – Refrigeration

Medically necessary – Mini refrigerator, including delivery

Per Item

170

Actual cost, subject to maximum allowable

Procedure Code

Modifiers

Service Description

Unit

OHA Expected Unit Costs

Rate1,2

S5165 – Home modifications; per service

U1 – HRSN Waiver Program
NU – New Equipment

Medically necessary climate device installation

Per Service

28

Actual cost, subject to maximum allowable

Procedure Code

Modifiers

Service Description

Unit

OHA Expected Unit Costs

Rate1,2

T1017 – Targeted case management, each 15 minutes

U1 – HRSN Waiver Program
UD – Outreach and engagement

Outreach and Engagement by CBO or HRSN provider3

Per 15 minutes

20

20

Procedure Code

Modifiers

Service Description

Unit

OHA Expected Unit Costs

Rate1,2

N/A

N/A

CCO variable administrative load4

Per Device

NA

78

Footer:
  1. Rates listed as “Actual cost, subject to maximum allowable” will have an upper payment limit of 150% of the OHA Expected Unit Costs. The 150% factor is to allow for variation in device and shipping costs over time and across geographies.
  2. A 2% MCO tax load will be added to all payments included in the fee schedule.
  3. Outreach and Engagement applies to activities performed by CBOs and HRSN providers. This activity is only billable for HRSN-eligible members.
  4. Must be billed in conjunction with a climate device.

Download the HRSN Devices Fee Schedule

Closed loop referrals refer to the process of exchanging information between and among the CCO and HRSN Service Providers to make referrals and communicate about the status of referrals for a member. This can occur through multiple different avenues including email, community information exchange (CIE), direct mail, and/or phone calls. This process with our network and in the community is still under development. More concrete workflows and procedures will be available later this year.

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.

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.

Website feedback

close icon

Help us improve our website

Having trouble finding what you’re looking for? Want to tell us about your website experience? Take our feedback survey and let us know!