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Columbia Pacific CCO — Social Needs Request Form

Columbia Pacific CCO members can use this form to request climate, housing, or nutrition supports. Please note, we are currently experiencing a high volume of requests and calls that may delay initial response time. 

Please wait at least 28 days before you follow up or expect a call back about your request. 

If you are requesting housing support, please note that OHP housing benefits are not set up to address housing emergencies. These benefits are designed to support people before they have an eviction notice, and help them stabilize.

To be eligible to receive assistance, all of the following must be true: 

  • You must be a current Columbia Pacific CCO member
  • You must have a verified qualifying medical condition*
  • You are not able to get the item/service through any other benefit or means
  • The item or service must help with your medical condition 
  • You must provide all required documentation for the request

*Your health plan will need to verify your qualifying medical condition (for example, records of a hospital or doctor visit) before approving your request. Please review the Social Needs Assistance Guidelines for more information about qualifying medical conditions, life situations, benefit/program limitations and the commonly funded supports for each.

For members who meet all eligibility criteria and are approved, Columbia Pacific CCO and CareOregon also decide the amount(s) of funding provided as defined by OHA guidance. 

There are multiple steps involved in reviewing requests for the HRSN benefit:

  1. Initial screening (At least 28 days): After you submit a request, it will go through a first check. Please wait at least 28 days before you follow up or expect a call back.
  2. Checking if you qualify: The CareOregon team will look at your request to see if you qualify. They might call you for more information.
  3. Getting a decision letter (Up to 28 days): You will get a letter in the mail telling you if your request was approved or not. If it was approved, the letter will list what services or items you will get.
    Note: This letter does NOT mean you will start getting services. There are more steps before that happens.
  4. Making a care plan (Up to 2 weeks): If you receive an approval letter, CareOregon will call you to help make your Care Plan. This includes talking about your preferences for a provider and any additional needs you may have.
  5. Getting help:
    • Climate support (About 2 weeks): If your request for climate help, such as an air conditioner, is approved, CareOregon will order your device(s) to be delivered to you.
    • Nutrition support (About 3 weeks): If your request for nutrition support is approved, you’ll be sent to a nutrition service provider. They will contact you to coordinate your services.
      If your request for Medically Tailored Meals is approved, it can take up to 3 weeks to receive meals.
    • Housing support (Up to 4 weeks): If your request for housing support is approved, you will be sent to a housing service provider as soon as possible. This can take up to 2 weeks. Please continue to make your rent and utility payments as best you can.
      Once connected with your housing service provider, it will take another week or two weeks for rent or utilities payment(s) to be made.
      It can take up to 4 weeks total between receiving an approval letter to getting your rent paid.

If you are requesting:

  • Move-in fees or deposits (with or without utilities)
  • First month’s rent (with or without utilities)
  • Utilities only
  • Storage unit fees only

The following documentation must be provided in advance before the processing of your request, as relevant:  

  • Rental or lease agreement (must be signed)
  • Utility bill (such as electricity, natural gas, internet, water, sewer, garbage, cell phone, landline)
  • Shut-off notice for utilities
  • Storage unit bill
  • Budget worksheet

If you are requesting moving expenses or vehicle repairs, you must provide an invoice from the service provider that details the cost estimate. This must be sent in advance before the processing of your request.

Not all requested items or services are granted or funded. Columbia Pacific CCO and CareOregon evaluate each request on a case-by-case basis and makes the final decision, including the amount(s) of funding applied if members meet eligibility criteria. 

For more information, visit: 

https://colpachealth.org/members/more-services/social-needs-assistance

To download the Social Needs Assistance Guidelines, go to: 

https://www.colpachealth.org/docs/default-source/members/hrs/hrsn/social-needs-assistance-guidelines.pdf