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Health Share of Oregon — Social Needs Request Form

Health Share of Oregon- Health-Related Social Needs (HRSN) Request Form

All Health Share of Oregon members can use this form to request HRSN housing or nutrition supports. 

  • Health Share -CareOregon members can also use this form to request HRSN climate supports (also known as Home Changes for Health). 
  • Health Share members assigned to other plans (Kaiser Permanente, OHSU Health, or Providence Health Assurance) should request HRSN climate supports directly through their assigned plan. See here for more information.

Please don’t use this form to request Flexible Services. For Flexible Services, please see request process on this page

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

  • You must be a current Health Share of Oregon member (this includes members of all Health Share plans: CareOregon, Kaiser Permanente, OHSU Health, and Providence Health Assurance)
  • You must have a verified qualifying medical condition*
  • You cannot 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. 

For members who meet all eligibility criteria and are approved,  CareOregon will 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: After you submit a request, it will be reviewed by CareOregon and you will be contacted if more information is needed. Please wait at least 28 days before you follow up or expect a call back.
  2. Getting a decision letter : 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.
  3. Making a care plan  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.
  4. Getting help:
    • Climate support for CareOregon members (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 (Up to 4 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.
    • Housing support (Up to 4 weeks): If your request for housing support is approved, you will be sent to a housing service provider. Please continue to make your rent and utility payments as best you can.

      It can take up to 4 weeks total between receiving an approval letter to getting your rent paid.

For HRSN Housing supports:  If you are requesting housing support, please note that OHP housing benefits are not for housing emergencies. These benefits are designed to support people before they have an eviction notice and help them stabilize.

The following documentation must be provided before processing  your housing request:

  • 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 (if you have one)
  • Storage unit bill (if you have one)
  • Income Verification/Budget worksheet
  • Proof of income (most recent two months pay stubs, unemployment letter, Social Security Statement, etc.)

Documents related to your housing request should be uploaded in advance. Documentation can be emailed to hrsncx@careoregon.org or uploaded to your member portal. If you already have an account go here to login or you can find registration information here to set up an account. Once logged in, upload your documents by doing the following:

  1. Go to the message center and click “new message”
  2. Click “add recipients” and select “Health Related Services Requests”
  3. Add HRSN in the subject line and attach the file(s) to the message using the attach file feature
  4. Add any other context and click “send”

For more information, visit: 

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

To download the Social Needs Assistance Guidelines, go to: 

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