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Health-Related Social Needs

More Support for Oregon Health Plan (OHP) Members Facing Life Challenges or Transitions

OHP members facing life certain life challenges will have services available to them. These services are to help members stay healthy during times of greater need.

These interventions have been found to improve health outcomes and health inequities and decrease health care costs. 

What Are Health-Related Social Needs?

Health-related social needs (HRSNs) are social and economic needs that affect your ability to maintain health and well-being.


​Supports may include:

  • Payment for devices that maintain healthy temperatures and clean air, including air conditioners, heaters and air filters
  • Mini refrigerators to keep medications cold during a power outage
  • Portable power supplies to keep medical devices running during a power outage ​

​Housing supports may include:

  • Rental assistance or temporary housing (e.g., rental payments, deposits, utility assistance) for up to 6 months
  • Home modifications (e.g., ramps, handrails, environmental remediation)
  • Pre-tenancy and tenancy support services (e.g., housing application, moving support, eviction prevention)
  • Housing-focused navigation and/or case manager

​Nutrition supports may include:

  • Links to community-based food resources (e.g., application support for Supplemental Nutrition Assistance Program (SNAP)/Special Supplemental Nutrition Program for Women, Infants and Children (WIC)
  • Nutrition and cooking education
  • Fruit and vegetable prescriptions (for up to 6 months, also known as VeggieRX) and healthy food boxes/meals
  • Medically tailored meal delivery

​These services connect members to HRSN screening and other resources. Services must include these activities:

  • Engaging OHP members who may be eligible for HRSN climate-related services
  • Verifying the member's coordinated care organization (CCO) or open card enrollment
  • For CCO members, verifying the member's CCO

Services may also include these activities:

  • Sending the HRSN request to the member's CCO or to Oregon Health Authority (OHA) for open card members. 
  • Providing members with information and support to connect with other services they need. Other services include medical, peer, social, educational or legal services.

Who Will Qualify for These Services?

To qualify, OHP members must be in at least one of these life transitions. Additional criteria also applies for each type of HRSN service.

  • Release from incarceration in the past 12 months
  • Discharge from an Institution for Mental Disease (IMD) in 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. 

Who Will Deliver These Services?

Community-based organizations (CBOs) and partners will be integral to this work. They may be able to receive funding to help with these efforts. 

​HRSN providers are organizations that will provide HRSN services in a way that is culturally and linguistically appropriate, responsive and trauma-informed. All contracted HRSN providers must meet certain provider qualifications.

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

​Oregon has been approved to spend up to $119 million in community capacity building funds (CCBF), specifically to support investments to enable partners to provide HRSN services.

Learn more about who can apply for CCBF and how funds may be used.