Oregon has received a waiver from the federal government to pilot Medicaid benefits that can address health related social needs (HRSN). HRSN’s, such as housing, shape people’s lives from birth onward, and they wield far-reaching influence over health outcomes, surpassing the significance of clinical care. Through its waiver, Oregon not only is working to innovate ways to better address health issues, but also to ensure that folks whose lives are in transition are eligible for more comprehensive care.
Those on Oregon’s Medicaid program (OHP) may be eligible for the added benefits if they are:
- Released from incarceration in the past 12 months
- Discharged from an institution for mental disease in the past 12 months
- Currently or previously involved in the Oregon child welfare system
- Transitioning from Medicaid-only to dual eligibility (Medicaid and Medicare) status within the next three months or has transitioned in the past nine months
- Homeless or at risk of becoming homeless.
Individuals also need to be experiencing a health issue that the benefit will address. Some benefits have additional requirements, e.g., rent assistance is only available to those with a signed lease.
Local Coordinated Care Organizations (CCOs) (networks of providers serving OHP members) are standing up the new benefit locally by contracting with social service providers. UCAN has entered into contracts with both AllCare in Josephine County and Umpqua Health in Douglas County to receive certain referrals for the new benefit. UCAN has also entered into an agreement with the Oregon Health Authority to serve local residents who are not members of their local CCO.
Individuals must first apply to their CCO or the Oregon Health Authority, as appropriate, and have them authorize the service. Once approved, we receive the referral (we are not authorized to approve applications). We have just started receiving our first HRSN referrals (from Umpqua Health). These initial referrals are for home modification and home remediation services. We are currently able to offer installation of ramps, grab bars, pull-down drawers, window blinds, as well as home cleaning and pest control.
In the near future, we will begin helping local residents complete HRSN applications. We also expect to receive referrals for other services, such as rent and utility assistance and tenancy support. Jordan Jungwirth, UCAN’s Chief Operating Officer applauds the State for moving forward with the expanded Medicaid benefit, sharing that “these benefits are a welcome addition to services we already offer to thousands of local residents.”
