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Jackson Care Connect — Social Needs Request Form

We are currently experiencing a high volume of requests & calls that may delay initial response time. 

Please allow 15-20 business days for an initial call back or before following up on your request. 

If you are requesting housing support, please note that OHP housing benefit benefits are not set up to address housing emergencies. Housing benefit applications may take up to two weeks to be reviewed. 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 of the following must be true: 

  • You must be a current 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/or life situation, 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.

If you are requesting housing support, the following documentation must be provided in advance before the processing of your request, as relevant:  

  • Rental/lease agreement

  • Court-ordered eviction notice

  • Utility bill (such as electricity, natural gas, internet, water, sewer, garbage, cell phone, landline)

  • Shut-off notice for utilities

  • Storage unit bill

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 from 211info, 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