Health-Related Social Needs (HRSN) Benefits
Health-Related Social Needs (HRSN) Benefits support the social and economic needs that impact an individual’s ability to maintain their health and well-being.
Jump to a section on this page:
- Home Changes for Health Support (Formerly Climate Devices)
- Housing Benefits
- Outreach & Engagement
- Nutrition Benefits
- HRSN Service Provider Qualifications
- HRSN Invoicing and Fee Schedule
- Closed-Loop Referrals
- How Members Request HRSN Benefits
- Health-Related Services Flex Funds
Oregon’s HRSN Services Benefits Include:
Please review eligibility requirements for each benefit service.
HRSN Home Changes for Health Support
The HRSN Home Changes for Health Supports (formerly Climate) benefits launched to include air conditioners for heat risks, air filters to protect against wildfire smoke, and home modifications to protect people from extreme weather.
Clinically Appropriate climate-related devices for Members residing in their home or non-institutional primary residence include:
- Air conditioners for individuals at health risk due to significant heat,
- Heaters for individuals at increased health risk due to significant cold,
- Air filtration devices and, as needed, replacement air filters for individuals at health risk due to compromised air quality,
- Mini refrigeration units as needed for individuals for medication storage, and
- Portable power supplies (PPSs) for individuals who need access to electricity-dependent equipment (e.g., ventilators, dialysis machines, intravenous equipment, chair lifts, mobility devices, communication devices, etc.) or are at risk of public safety power shutoffs (PSPS) that may compromise their ability to use medically necessary devices.
Prior Authorizations & Forms
Housing Benefits
The Housing-Related Benefits supports will be available to eligible individuals who are at-risk of losing their current housing. The aim of these services is to support well-being by preventing homelessness, sustaining current housing and supporting tenancy case management services during times of housing insecurity.
HRSN Covered Benefits
- Rent Assistance for up to 6 months including past due months.
- Utilities set up and costs up to 6 months including past due amounts (must be receiving rental assistance to receive utility assistance).
- Tenancy Services (housing case management) for up to 18 months are crucial to support individuals maintain their housing and are offered to members who qualify for any of the other HRSN housing services. Tenancy Services can also be authorized as a stand-alone service.
- Medically-necessary home accessibility modifications and remediations, such as ramp and grab bar installation, pest control, heavy duty cleaning, and hotel costs for members who need temporarily move so that work can be completed in home.
- Storage Fees for members who need to relocate while home modification or remediation is completed.
- Additional benefits may be added in the future.
Prior Authorizations & Forms
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Spanish
Outreach & Engagement
YCCO incorporates HRSN O&E services into their Care Coordination processes by developing a Person Centered Service Plan (PCSP) for each member who qualifies for HRSN Services.
HRSN Outreach & Engagement Services include:
- Engaging member who may be eligible for HRSN Services
- Identifying and verifying the member’s CCO enrollment or, as applicable, enrollment in OHP’s FFS program
- Verifying the member is presumed HRSN eligible
- Submitting HRSN request to YCCO or OHA
- Working with members to obtain the information necessary to determine HRSN service need
- Helping members maintain enrollment in OHP
- Helping members with obtaining and maintaining other entitlements and benefits: TANF, WIC, SNAP, etc.
- Assisting member with obtaining identification and other required documentation needed to receive benefits and other supports
- Connecting members to settings where basic needs can be met
- Providing members, who may need a medical, peer, social, educational, legal, and other related services, with information and support necessary to connect to resources.
HRSN Outreach & Engagement Services are intended to:
- Identify members who may be eligible for HRSN Services and help them access needed HRSN Services
- Connect members to additional healthcare and non-healthcare services to address overall health and well-being needs
- Be readily accessible, culturally specific and responsive
To be eligible for HRSN Outreach & Engagement Services, a member must be enrolled in OHP and presumed eligible for HRSN.
Nutrition Benefits
The below Nutrition Services will be available to eligible members:
- Medically Tailored Meals (MTM) Assessment — an initial assessment and a reassessment, with a licensed dietician (preferred), or, if not available, a primary care provider, to develop a medically appropriate nutrition care plan specific to HRSN MTM service. This service does not require prior authorization.
- Medically Tailored Meals — provide meals to Members with health-related condition(s) for which nutrition supports would improve health outcomes. The service includes: preparation and provision of the prescribed meals consistent with the nutrition care plan and delivery of meal. To receive meals, Members must first be assessed by RDN or PCP to develop a medically appropriate nutrition care plan. Eligibility criteria for MTM Meals follows the same criteria as MTM Assessment. Meals will delivered to the Member’s home or private residence, which may include shelters that do not provide residents with meals.
- Nutrition Education — any combination of educational strategies designed to motivate and facilitate voluntary adoption of food choices and other food and nutrition-related behaviors conducive to health and well-being. The service can consist of nutrition education or information to an individual or group that offers evidence-based or evidence-informed strategies, and/or meal preparation education. This service can be provided one-time or on a recurring weekly or monthly basis. Eligibility criteria for Nutrition Education follows the same criteria as MTM Assessment. Members eligible for the same service through non-HRSN Medicaid or Medicare/Medicaid are not eligible for the HRSN Service. Members receiving Medical Nutrition Therapy (MNT) through their Medicare benefit are not eligible for this service.
- More information coming soon on Pantry Stocking and Fruit and Vegetable Benefits!
Prior Authorizations & Forms
HRSN Service Provider Qualifications
HRSN Service Providers can be a public or private social service organization or clinic, community organization, or other similar individual or entity that provides HRSN services and helps to connect members with the HRSN benefit.
The service provider must:
- Be accessible to HRSN participants in your region, which may include having operating hours and staff necessary to meet member need
- Demonstrate the ability and/or experience to effectively serve at least one of OHA’s Priority Populations
- Demonstrate qualified service delivery and administrative staff
- Provide culturally and linguistically appropriate, responsive and trauma-informed services
- Demonstrate a history of responsible financial administration
Specific Qualifications for HRSN Providers:
HRSN Invoicing and Fee Schedule
YCCO will follow OHA’s HRSN fee schedule to reimburse and/or directly pay through an automated payment system. OHA has determined that MMIS will be ready to accept CCO Encounter Data for HRSN Services beginning August 1, 2024.
- To receive payment, YCCO will collect the following information from HRSN Service Providers:
- Member identifying information (name, date of birth, Medicaid ID)
- Rendering provider organization
- Qualifying member information
- Date(s) of service
- Location of service
- Description of service provided
- Applicable service code
Closed-Loop Referrals
Closed-Loop referrals refers to the process of exchanging information between and among YCCO, OHA, a member, and/or HRSN Service Provider, Primary Care Provider, and referent to communicate about the status of referrals for a member. The structures currently in place at YCCO for Closed-Loop Referrals include secure email, Community Information Exchange (CIE), direct mail, and/or phone.
Members can opt out of their data being shared through CIE. If a member opts out of their data being shared through technology, it will be documented in YCCO’s Member Service Documentation System and YCCO will notify the HRSN Service Provider.
The Closed-Loop Referral Process will continued to be developed and expanded according to HRSN processes and requirements, which will continue to be created in the next two years.
How Members Request HRSN Benefits
A request form needs to be filled out and submitted to YCCO by email or fax. Members have a couple of options:
If the member would like help filling out the HRSN application form, they can contact Customer Service at 855-722-8205 (TTY 711).
- The member themselves, an organization or clinic supporting the member, a member’s parent, a caregiver, a guardian/support/trusted friend, case manager or an HRSN Service Provider can fill the forms out.
- The form can be returned to YCCO by:
Fax: 503.850.9398
Email: utilizationmanagement@yamhillcco.org
- The form can be returned to YCCO by:
Additional Forms & Documents:
If you are not a YCCO HRSN Provider or Contracted Provider, please complete the YCCO Information Sharing Authorization Form (ISAF) with the member before submitting the request.
Flexible Services Request Funds
If a member does not meet eligibility criteria for the HRSN benefit, they may qualify for support through the flexible services funding program, formerly know as Health Relates Services. Flexible service may be approved if criteria are met.