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Columbia Pacific CCO — Social Needs Request Form

You should use this form to request climate, housing, or nutrition supports. Please note, we are currently experiencing a high volume of requests & calls that may delay initial response time. 

Please allow 15-20 business days before following up on your request. 

If you are requesting housing support, please note that OHP housing benefits are not set up to address housing emergencies. If approved, additional time may be needed to provide the housing support.  Rather, these benefits are designed to support people before they have an eviction notice—and help them stabilize.

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

  • You must be a current Health Share CareOregon, Jackson Care Connect CCO, or 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 and
  • You must provide all required documentation for the request
  • Your health plan will need to verify your qualifying medical condition (for example hospital or doctor visit or records) before approving your request. Please review the following 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, CareOregon also decides 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 with 211 (phone call to you to verify information and collect documentation if needed)

  1. Please allow at least 20 business days before following up on your request.
  1. Eligibility is checked by the CareOregon team (you will receive a decision letter in the mail letting you know if your request was approved or not approved)
  1. Care plan is developed with the CareOregon team (phone call to you)
  1. If it is a housing or nutrition request, you will be connected with a provider (outreach by that provider to you) within 6-8 weeks. If it is a climate request, you will be sent the item(s) directly.
  1. For housing requests, it will take another 1-2 weeks for payment to be fulfilled once connected to an HRSN service provider.

If you are requesting:

  • move in fees/deposits with or without utilities
  • first months’ 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/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
  • Vehicle repairs

the following documentation must be provided in advance before the processing of your request:

  • Invoice from the service provider that details the cost estimate

Not all requested items or services are granted/funded. CareOregon 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. While we attempt to process standard requests within 14 days of receipt, some requests may take 28 days or more to complete.

Social Needs Assistance Guidelines site: https://www.careoregon.org/docs/default-source/members/hrs/hrsn/social-needs-assistance-guidelines.pdf?sfvrsn=e512d64b_1