Health Related Social Needs (HRSN) Benefits
What are Health Related Social Needs Benefits?
Starting in 2024, certain OHP members may be eligible for extra non-medical services and supports. These services help address barriers to health that may affect well-being, including:
- Climate-related supports (available March 2024)
- Includes air conditioners, heaters, air-filtration devices, mini-refrigerators, and portable power supply units.
- Housing supports (available November 2024)
- Includes help with the cost of rent, utilities, and other bills, help finding a place to live, and help with changes to make peoples’ homes safer and more accessible.
- Nutrition supports (available in 2025)
- Includes nutrition counseling, prescriptions for fruits and vegetables, and covering the cost of meals.
How Do I Know if I’m Eligible?
To qualify for HRSN benefits, you must be a current Oregon Health Plan (OHP) member, and be in one or more of the following groups:
- I am an adult or youth discharged within the past year from mental health or substance use disorder Institution of Mental Disease.
- I am an adult or youth released within the past year from incarceration.
- I have been involved in the child welfare system at some point in my life.
- Within the next three (3) months or past nine (9) months, I am transitioning from Medicaid-only to dual coverage (receiving both Medicaid and Medicare).
- I am houseless or at risk of becoming houseless.
- I am a young adult, aged 19-26, with Special Healthcare Needs (eligible starting in 2025).
There are additional eligibility requirements for specific HRSN benefits, including climate, housing, and food supports.
For climate benefits, you must be experiencing at least one (1) of the required benefit specific risk factors. This means at least one (1) of the following applies to you:
- I am younger than 6 years old.
- I am 65 years old or older.
- I am currently pregnant.
- I have a sensory, physical, intellectual, or developmental disability.
- I need assistance with activities of daily living (ADLs), instrumental activities of daily living (iADLs), or am eligible for long-term services and supports (LTSS).
- I receive in-home hospice care.
- I have complex physical health needs, like a chronic heart or lung condition, kidney disease, diabetes, or a condition that makes me at risk for blood clots or a stroke.
- I have multiple sclerosis.
- I have Parkinson’s.
- I have had a spinal cord injury.
- I have schizophrenia.
- I have bipolar disorder.
- I have an alcohol or substance use disorder.
- I have major depressive disorder and have needed crisis services, hospitalization, or residential treatment in the past 12 months.
How do I start the process and get HRSN services?
Eligibility Screening
If you are an Umpqua Health Alliance (UHA) member, we can help you complete the eligibility screening process. The first step is to complete the HRSN Assistance Request Form. You can complete this form yourself, or you can work with your primary care provider, a community organization, or someone you trust to complete the form.
You can download a copy of this form, fill it out, and then return it to UHA via one of the following:
- Email: HRSN@umpquahealth.com
- Fax: 541-677-5881
- Mail or in-person: 3031 NE Stephens Street, Roseburg, OR 97470
Sharing Additional Information
As part of the screening process, you may need to provide more documents or information to help us decide if you qualify.
Receiving Services
Once your HRSN Assistance Request Form is received by UHA, you will receive a decision from us within 14 days.
- If you qualify, we will refer you to the appropriate HRSN service provider to help you get what you need. It may take up to 30 days to receive services or equipment. You’ll receive these services at no cost, and you can opt out of receiving these services at any time.
- If you don’t qualify, we will send you a letter by mail. If you think we’ve made a mistake, you can ask for an appeal. You also may be eligible for these services through another program.
Device Delivery
If your HRSN services involve delivery of a device to your home (for example, an air conditioner, power supply unit, etc.):
- You will receive a call before the delivery to let you know when the equipment will be available.
- You will need to verify your address to receive the equipment.
- You can ask for help installing your device(s).
- You will receive a call to make sure you received your services or equipment, and that everything works properly.
- If you’re eligible for a climate device, use this document to show your landlord that you have legal rights to install portable cooling devices.
Get Help When Needed
- You can contact your UHA Care Coordinator to fix or replace your equipment, or to request more benefits.
- Your Care Coordinator will also check in with you every six (6) months to understand if your services are meeting your needs, or if you need other services.
Questions?
If you have questions about the HRSN Benefit program that aren’t answered above, please contact us at hrsn@umpquahealth.com.
Become an HRSN Service Provider
Umpqua Health Alliance (UHA) is looking to contract with Community Benefit Organizations (CBOs) and providers to become HRSN Service Providers for climate, housing, and nutrition benefits. UHA uses a closed-loop referral system to request HRSN services on behalf of a member or receive referrals to provide HRSN services to a member as requested through a Community Information Exchange (CIE). A closed-loop referral is the process of exchanging information between and among UHA, Oregon Health Authority (OHA) (which may include its Fee For Service (FFS) Program), a member, HRSN Service Providers, and other similar organizations, to make referrals and communicate the status of referrals for a member. For more information about this process, visit step 2 of the HRSN Provider Guide using the Learn More button below.
Invoicing and Fee Schedules
You will submit an invoice to UHA within 120 calendar days of delivering services or equipment. You will receive payment within 30 days of submitting the invoice. If the invoice is returned, you can correct and resubmit within UHA’s required timeframe. You can call UHA with any questions or concerns. You can access the HRSN fee schedule here.
HRSN Services Webpage
Learn more about how Oregon is expanding Medicaid to cover more people and benefits.
Ways to Update Your Contact Information
Learn how you can update your contact information so we can reach you with updates on your benefits.
Tenants Have the Right to Install Portable Cooling Devices
Eligible for a climate device? Use this document to show your landlord that you have legal rights to install portable cooling devices.
Umpqua Health Alliance (UHA) Appeals and Hearings
Learn more about the steps you need to take to request a hearing if you disagree with a decision about your benefits.
Umpqua Health Alliance (UHA) Appeals and Hearings
Learn more about the steps you need to take to request a hearing if you disagree with a decision about your benefits.
All members have a right to know about Umpqua Health Alliance’s programs and services.
Members or potential members who do not speak English as their primary language and who have a limited ability to read, speak, write, or understand English are called Limited English Proficient or LEP. Anyone who is LEP may be entitled to language assistance for healthcare services/encounters or benefits.
We provide the following at no cost to you:
- Sign language interpreters
- Spoken language interpreters for other languages
- Written materials in other languages
- Braille
- Large print
- Audio
- Auxiliary Aids and other formats
If you need help or have questions, please call Customer Care at 541-229-4842, Toll-Free 866-672-1551, or TTY 711.
Todos los miembros tienen derecho a conocer los programas y servicios de Umpqua Health Alliance.
Los miembros o miembros potenciales que no hablan inglés como idioma principal y que tienen una capacidad limitada para leer, hablar, escribir o entender inglés se denominan dominio limitado del inglés o LEP. Cualquier persona que sea LEP puede tener derecho a asistencia lingüística para servicios de salud, encuentros o beneficios.
Proporcionamos lo siguiente sin costo alguno para usted:
- Intérpretes de lenguaje de signos
- Intérpretes de idiomas hablados para otros idiomas
- Materiales escritos en otros idiomas
- Braille
- Impresión grande
- Audio
- Ayudas auxiliares y otros formatos
Si necesita ayuda o tiene preguntas, llame al servicio de atención al cliente al 541-229-4842, al número gratuito 866-672-1551 o al TTY 711.