Health-related social needs (HRSN)

Health-related social needs (HRSN) are benefits meant to assist EOCCO members in navigating challenging weather conditions, major life transitions that may impact their ability to secure a safe place to live, and the affordability of quality food. Some EOCCO members may be able to get the following services:

• Climate supports (starting March 1, 2024): Devices to keep members healthy during extreme weather. These include:
  • Air conditioners for heat risks
  • Air filtration devices to protect against wildfire smoke
  • Portable heaters
  • Mini-refrigeration units for medications
  • Portable power supplies to keep medical devices running during power outages
    
    
• Housing supports (starting Nov. 1, 2024): More information coming.
• Nutrition supports (starting in 2025): More information coming.
• Outreach and engagement supports: Materials and services to help people find necessary resources, including HRSN services and other medical and nonmedical benefits.

How to become an HRSN provider

EOCCO is actively developing a network of HRSN providers. These organizations will offer HRSN services in a culturally and linguistically appropriate, responsive and trauma-informed manner. All contracted HRSN providers must meet specific provider qualifications.

1. Become a Medicaid HRSN provider by visiting our Become a provider page. Even if you are already registered, re-enroll as an HRSN provider type:
   a. HRSN Provider Type 68.  
   b. Specialty code 680 climate
   c. Specialty code 681 outreach/engagement
   d. Taxonomy 171WH0202X
   
   
2. Email EOCCO to request an HRSN provider contract at HRSNQuestions@eocco.com.
   
   
3. Serve as an HRSN provider for EOCCO.
   
   
4. Get a referral and provide HRSN services. (See the Outreach and engagement services and Climate services sections below to learn more.)
   
   
5. Send EOCCO a bill or invoice for payment.
   a. You must send a bill to EOCCO within 120 calendar days of delivering services or equipment.
   b. You’ll receive payment within 30 days of sending your bill.
   c. If your bill is returned to you, correct and resend it within EOCCO’s required timeframe. You can call EOCCO with any questions or concerns.
   d. EOCCO will provide more information on submitting bills and invoices for payment throughout the contracting process.
   
   
6. Stay enrolled or disenroll.
   a. Stay enrolled with Oregon Medicaid.
   b. Disenroll if you no longer want to provide HRSN services. Please contact EOCCO if you no longer want to serve as a contracted provider.

Read the HRSN Provider Journey to learn more about the process and qualifications to becoming an HRSN provider.

Outreach and engagement services

You can encourage people to start the process by:

• Working with CCOs to conduct outreach to potential eligible members. Members may also reach out to you directly to learn more.
• Helping members find their CCO if they’re not a part of EOCCO. If they are Open Card members, you can refer them to OHP Open Card.
• Filling out and sending HRSN request forms to CCOs. Find EOCCO’s HRSN request form on our member-facing Health-Related Social Needs page.
• Alternatively, using your own form. It must include the eligible person’s name, contact information and the HRSN services they need. People can self-attest to the questions on the form. EOCCO highly recommends using our online climate device request form to request climate devices or HRSN services.
• Helping people fill out the information sharing authorization form that gives EOCCO permission to share member information with HRSN providers to deliver services.
• Documenting these activities and your time spent on them in order to send  for payment later.
• Getting notification that services are approved or denied. EOCCO members will hear from EOCCO if they are approved for HRSN services within 14 days of completing the HRSN screening.
  • If approved, EOCCO will contact the person and refer them to providers for services.
  • If denied, EOCCO will contact the person by mail. You can help people request an appeal or hearing or refer them to an OHP ombudsperson. You can also help them check if they can receive the same or similar services through EOCCO’s HRS/Flex program.

HRSN service providers assisting members in requesting HRSN services will also receive notifications regarding the approval or denial status of their requests. Additionally, they will be notified upon the administration of the service or device. This process is referred to as a "closed-loop referral."

Climate services

Climate services fall into two categories:

Getting referral services from the CCO

EOCCO will contact you to provide HRSN services to people. You will let EOCCO know if you can or cannot immediately fulfill these requests.

Delivering services and notifying EOCCO

• Contacting people to deliver or coordinate delivery of services or equipment within 30 days of getting a referral, and notifying the CCO by phone, email or fax within 14 days of delivery.
• Helping with repairs and replacements of climate devices.
• Helping people get their devices repaired or replaced through the manufacturer and/or their care coordination team if you ordered the device for the member.
• If applicable, answering basic questions and helping people with proper care and use of their climate devices. You should do this before getting replacements, to reduce waste. If you ordered the device, you can review details related to device restrictions, failures, warranties and the replacement process.

Invoicing and fee schedules

You can view the HRSN devices fee schedule for climate-related supports. 

Eligibility criteria: clinical and social risk factors

To qualify, EOCCO members must be in at least one of the following populations. They must also meet criteria for each type of HRSN service:

• Released from incarceration within the past 12 months.
• Discharged from an institution for mental disease (IMD) within the past 12 months.
• Current or past involvement in the Oregon child welfare system.
• Transitioning from Medicaid-only to dual eligibility (Medicaid and Medicare) status within the next three months or past nine months.
• Being homeless or at risk of becoming homeless.

Examples of conditions that qualify for HRSN climate supports:

• Air conditioners: a health condition that gets worse during hot weather.
• Heaters: a health condition that gets worse when a member gets very cold.
• Air filtration devices: a health condition that gets worse when air quality is poor.
• Mini-fridges: a health condition that requires temperature-controlled medication.
• Portable power supply: a health condition that requires a powered medical device.

Additional resources

If you want to know more about health-related social needs, you can check these websites:

• OHA: 2022-2027 Medicaid 115 Demonstration Waiver
• OHA: Report Changes to the Oregon Health Plan
• OHA: Outreach and Engagement Fact Sheet
• OHA: Climate Resources Fact Sheet
• EOCCO 2024 Provider Manual
• EOCCO 2024 Member Handbook
• EOCCO Member HRSN Webpage
• Community Capacity Building Funding Grants

Questions?

We’re here to help. Give Customer Service a call at 888-788-9821 (TTY users: 711), Monday through Friday, 7:30 a.m. to 5:30 p.m. PST.