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. See these CCO SDOH spending overviews for more details for each CCO.

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

2018 legislative requirement: House Bill 4018, Section 3, 1(b)(C)
2019 legislation that modified minimum financial standards for CCOs, over which a portion must be dedicated to the SHARE Initiative: Senate Bill 1041, Section 57, 1(b)
SHARE Initiative definitions and requirements: Oregon Administrative Rule 141-414-3735

Office hours

June 14, 10:05–10:30 a.m.

Join meeting

ID: 251 326 440 832
Passcode: Fqjhvm

Or call in (audio only): +1 971-277-2343,,241120301#

Phone ID: 241 120 301#

2023 CCO convening

September 13, 2023
See the event page

Addressing housing through HRS, SHARE, ILOS

See CCO event materials

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 and summaries

CCO spending plans and reports are posted on the SHARE Initiatve reports page.
For a summary of CCO spending plans, see the 2022 SHARE Spending Plan Report.

Spending plan report summary webinar: Slides / Recording

Guidance and reporting templates

Guidance

Change log of guidance updates (updated 1/4/23)
2023 SHARE Initiative Guidance for CCOs
2023 SHARE Initiative FAQ
CCO memo: Changing SHARE designations (9/9/22)

Reporting templates

2022 SHARE Initiative Designation Report in Exhibit L (Report L6.7 and L6.71): Due June 30
2023 SHARE Initiative Detailed Spending Report Template: Due June 30
2023 SHARE Initiative Spending Plan Template: Due December 31 by participating CCOs

2023 SHARE Initiative Spending Plan Evaluation Tool

Supplemental resources

SHARE, HRS and ILOS comparison document
Oregon's SUD 1115 demonstration waiver (see Attachment F: Community Integration Services and Eligibility)

Community integration services fact sheet for OHP members

Oregon's 1115 Medicaid waiver, 2022-2027 (see Section 9: Health-related Social Needs)
Health and Housing: Introduction to Cross-Sector Collaboration (National Academy for State Health Policy, 2021)
Health System Investments in Housing: A Development Guide (Corporation for Supportive Housing, 2020)

Webinars

Collaboration and sustainability through SHARE: Impactful CCO processes and investments: Slides / Recording (6/7/23)
Nuts and bolts of grantmaking: Slides / Recording (2/15/23)
2023 SHARE guidance updates: Slides / Recording (1/30/23)
SMARTIE goals: Slides / Recording / Handout (12/2/22)
Partnering to provide supportive housing services: an introduction for CCOs: Slides / Recording (6/2/22)

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)
Two CCO approaches to SHARE in the first year
- Slides: Columbia Pacific CCO / PacificSource Central Oregon
- Recording (11/29/21)
CAC role in reviewing CCO SHARE spending: Recording (6/10/21)
SHARE Initiative overview: Slides / 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 houselessness)
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)

Contact

If you have questions about the SHARE Initiative, please contact Transformation.Center@odhsoha.oregon.gov.