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Supporting Health for All through REinvestment: the SHARE Initiative

SHARE Initiative

The SHARE Initiative comes from a legislative requirement for coordinated care organizations (CCOs) to invest some of their profits back into their communities. After meeting minimum financial standards, CCOs must spend a portion of their net income or reserves on services to address health inequities and the social determinants of health and equity (SDOH-E). 

The SHARE Initiative is just one way that CCOs respond to SDOH-E, health inequities and the social needs of their members. CCOs may also use their global budgets to address members’ social needs and community SDOH-E through health-related services (HRS). See this SHARE, HRS and ILOS comparison for an overview of CCO spending programs to meet member and community needs.

The SHARE Initiative is defined by the following state law and Oregon Administrative Rule:

Webinar: 2023 SHARE guidance updates

  • January 30, 11 a.m.-Noon
  • Register here
  • A brief overview of the SHARE Initiative intent and requirements, summary of 2023 guidance updates, and time to answer questions.

Addressing housing through HRS, SHARE, ILOS

SHARE Initiative requirements

According to requirements in OAR 410-141-3735, a CCO’s SHARE Initiative dollars must:
  • Align with community priorities in the CCO's current community health improvement plan;
  • Include any statewide priorities for SHARE spending that are identified in the contract between CCOs and OHA (currently housing-related services and supports);
  • Include a role for the CCO’s community advisory council;
  • Involve community partnerships, with a portion of dollars going to SDOH-E partners (see definitions below); and
  • Fit into one of four SHARE Initiative domains related to the social determinants of health and equity (SDOH-E): economic stability, neighborhood and built environment, education, and social and community health.

CCO reports

CCO spending plans and reports are posted on the SHARE Initiatve reports page.

Guidance and reporting templates

Guidance Reporting templates Supplemental resources

Technical assistance

  • Webinar: 2023 SHARE guidance updates
    • January 30, 11 a.m.-Noon
    • Register here
    • In this session we will provide a brief overview of the SHARE Initiative intent and requirements, walk through 2023 guidance updates, and answer questions about the SHARE Initiative.
  • Webinar: Nuts and bolts of grantmaking
    • February 15, 11 a.m.–Noon
    • Please join us as we share lessons learned about the nuts and bolts of community grantmaking. Presenter Rebeckah Berry will offer examples of working with community organizations, considerations for designing applications, opportunities to involve community advisory councils, setting up projects for success, and the importance of building relationships with grantees. We will also discuss how CCOs can work with foundations and other funders to move community projects forward.
  • Webinar: SMARTIE goals: Slides / Recording / Handout (12/2/22)
  • Webinar: Partnering to provide supportive housing services: an introduction for CCOs: Slides / Recording (6/2/22)
  • Webinar: Collaborating within your region to address housing and homelessness: an overview for CCOs from one Oregon region’s experience: Slides / Recording (4/13/22)
  • Learning collaborative session: Identifying ROI for investments that address SDOH-E: Slides (3/28/22)
  • Webinar: Two CCO approaches to SHARE in the first year
  • Webinar: CAC role in reviewing CCO SHARE spending: Recording (6/10/21)
  • Webinar: SHARE Initiative overviewSlides / Recording (1/26/21)

SHARE Initiative spending areas: examples

  • Income/poverty
  • Employment
  • Food security/insecurity 
  • Diaper security/insecurity
  • Access to quality childcare
  • Housing stability/instability (including house​lessness)
  • Access to banking/credit
  • Early childhood education and development
  • Language and literacy
  • High school graduation
  • Enrollment in higher education​​
  • Access to healthy foods
  • Access to transportation (non-medical)
  • Quality, availability and affordability of housing
  • Crime and violence (including intimate partner violence)
  • Environmental conditions, such as clean air and water
  • Access to outdoors, parks
  • Social integration
  • Civic participation/community engagement
  • Meaningful social role
  • Citizenship/immigration status
  • Corrections
  • Discrimination (for example, race, ethnicity, culture, gender, sexual orientation, disability)
  • Trauma (for example, adverse childhood experiences)


If you have questions about the SHARE Initiative, please contact