yamhillcco.org

Health-Related Social Needs (HRSN) Benefit

Health-Related Social Needs (HRSN) refer to barriers to health, like housing or access to food.

HRSN Services include:

Climate Services: Available Now

Climate Services: Available now! Receive help to get health-related air conditioners, heaters, air filters, portable power supplies, and mini fridges to store medication.

Housing Services: Available Now

Housing Services: Since November 1, 2024, Housing-Related support 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 include: 

  • 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.

Eligibility for HRSN Rent Assistance, Utilities Assistance, & Tenancy Services:

To qualify, a Member must meet all of the following criteria:

1. OHP Member and YCCO A or B Member who:

  • Is currently housed,
  • Needs support staying in home due to inability to pay rent, AND
  • Holds a lease or written agreement with their landlord

2. Is at risk of becoming homeless:   

  • Has an income that is 30% or less than the area median income in their area AND
  • Lacks sufficient resources or support network to prevent homelessness

3. Has at least one Housing Clinical Risk Factor

  • Complex behavioral health condition
  • Developmental disability
  • Complex physical health condition
  • Needs assistance with Activities of Daily Living/Instrumental Activities of Daily Living or is eligible for Long Term Services and Supports
  • Current or past interpersonal violence experience
  • Repeated emergency department use (2 or more visits in a 6-month period)
  • Repeated crisis encounters
  • Currently pregnant or 12 months postpartum and at risk of certain clinical factors
  • Less than six years of age and at risk of certain clinical factors
  • More than 65 years of age and at risk of certain clinical factors

Eligibility for HRSN Home Modification/Remediation’s:

1. Current OHP Member and YCCO A or B Member and has at least one Housing Clinical Factor

  • Complex behavioral health condition
  • Developmental disability
  • Complex physical health conditions
  • Assistance with Activities of Daily Living/Instrumental Activities of Daily Living or is eligible for Long Term Services and Supports
  • Current or past interpersonal violence experience
  • Repeated emergency department use (2+ visits within 6 months)
  • Repeated crisis encounters
  • Currently pregnant or 12 months postpartum and at risk of certain clinical factors
  • Less than six years of age and at risk of certain clinical factors
  • More than 65 years of age and at risk of certain clinical factors

2. Belongs to an HRSN covered Population

  • Adults and Youth Released from Incarceration
  • Individuals currently or previously involved in Oregon’s Child Welfare system
  • Individuals Transitioning to Dual Medicaid and Medicare Status
  • Individuals who meet the At-Risk of Homeless; or
  • Young Adults with Special HealthCare Needs ages 19 and 20(starting January 2025)
  • Adults and Youth Discharged from an HRSN Eligible Behavioral Health Facility:
    • Acute Care Psychiatric Hospitals
    • Institution for Mental Diseases
    • Integrated Psychiatric Residential Treatment Facilities and Residential Substance Use Disorders
    • Residential Treatment Facilities (RTF), Residential Treatment Homes (RTH), and Secure Residential Treatment Facilities (SRTF)
    • Psychiatric Residential Treatment Facilities (PRTF)
    • Residential Substance Use Disorders Treatment Programs

3. Additional Eligibility Requirements

  • Member must need the home modification or remediation to help prevent their health condition
  • Member must receive landlord approval for home modification or remediation

Nutrition Services: Available January 2025

Nutrition Services: Starting, January 1, 2025,  nutrition education, medically tailored meals, meals or pantry stocking, fruit and vegetable prescriptions will be available.

To be eligible for to receive HRSN services, you must be an OHP member with an eligible health condition and if you are or recently have experienced one of the following:

  • Adults and youth recently incarcerated in the past 12 months.
  • Adults and youth discharged from eligible behavioral health facility, residential mental health and substance use disorder facility, or inpatient psychiatric unit in the past 12 months.
  • Individuals who are currently involved in or have been previously involved in the Oregon child welfare system.
  • Individuals transitioning from Medicaid-only to dual eligibility (Medicaid and Medicare) status within the next three months or past nine months.
  • Individuals who are at risk of becoming unhoused.

Each benefit has different requirements such as income, age, your health, and housing situation.

Request Services

You are able to ask to be screened for eligibility or to deny screening for eligibility. If approved, you can choose to receive or not receive HRSN Services. If approved, HRSN Services are free to you and you can opt out at any time.

If you receive HRSN Services, your care coordination team will work with you to make sure your care plan includes the services you receive.  See the handbook for Care Coordination and care plans information.

Please note that to be screened for and receive HRSN Services, your personal data may be collected and used during referrals. You have the ability to limit the way in which your information is shared.

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 request HRSN Benefits.

There are rules you have to meet to qualify for HRSN,  details are included in the form.

The YCCO Information Sharing Authorization form must be sent in with your request.  Reach out to your Care Management Team for more info on HRSN at  833-257-2191.

Start today!

Prior Authorizations & Forms 

Questions? Contact our Customer Service at                  855-722-8205 (TTY 711)

Connect with a local agency to assist you in requesting HRSN Assistance

YCAP 

Agency Name: Yamhill Community Action Partnership 

Office Hours: Monday-Friday, 8 am to 5 pm 

HRSN Contact Name: Brittany Hanson 

HRSN Contact Phone: (503) 687-1494 

HRSN Contact Email: anydooryamhill@yamhillcap.org 

 

Creating Opportunities 

Agency Name: Creating Opportunities 

Office Hours: Office Hours Vary.  M-F 

HRSN Contact Name: Cheryl Cisneros 

HRSN Contact Phone: 503-559-0424 

HRSN Contact Email: support@creatingops.org 

 

Henderson House 

Agency Name: Henderson House 

Office Hours: 9am – 5pm, Monday – Friday 

HRSN Contact Name: Josie Bartlett 

HRSN Contact Phone: 503-472-0244 x 308 

HRSN Contact Email: Jbartlett@hendersonhouse.org 

 

Polk County 

Agency Name: Polk County Family & Community Outreach 

Office Hours: Monday-Friday 8am-12pm & 1pm-5pm 

HRSN Contact Name: Katrina Reimann 

HRSN Contact Phone: 503-751-1644 

HRSN Contact Email:  reimann.katrina@co.polk.or.us  

 

Just Compassion 

Agency Name: Just Compassion EWC 

Office Hours: 8:30am-5:00pm 

HRSN Contact Name: Matt Bunn 

HRSN Contact Phone: 848-333-7232 

HRSN Contact Email: matt@justcompassionewc.com 

 

Meals on Wheels People 

Agency Name: Meals on Wheels People 

Office Hours: M-Th. 8am-4pm 

HRSN Contact Name: Client Services Team 

HRSN Contact Phone: 503.953.8111 

HRSN Contact Email: intake@mowp.org 

 

Oregon Wellness Network 

Agency Name: Oregon Wellness Network 

Office Hours: M-F  8 – 5pm 

HRSN Contact Name:  Lavinia Goto 

HRSN Contact Phone:  503-304-3408 

HRSN Contact Email:  health.promotion@nwsds.org 

 

Helping Hands 

Agency Name: Helping Hands Reentry Outreach Centers 

Office Hours: M-F 9am-5pm 

HRSN Contact Name: Joshua Blomquist 

HRSN Contact Phone: n/a 

HRSN Contact Email: hrsnprogram@helpinghandsreentry.org 

 

Community Wellness Collective 

Agency Name: Community Wellness Collective (CWC) 

Office Hours: 9-5, Monday through Friday 

HRSN Contact Name: Elizabeth Martinez, Lead PSS/CMR 

HRSN Contact Phone: (503) 200-2923 

HRSN Contact Email: elizabeth@communitywellnesscollective.org  

Learn more about the HRSN Member Journey:

OHP Resources:

Health-Related Services Flex Funds

If you do not meet eligibility criteria for the HRSN benefit, you may qualify support through the health-related services flex funding program.
Call our Customer Service 855-722-8205 (TTY 711) to learn more.

 

HRSN Service Provider?

HRSN Service Provider Resource Page