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Information for HRSN service providers

Here’s what providers should know if they want to provide health-related social needs (HRSN) services.

Qualifications and process for becoming an HRSN service provider

To become an HRSN service provider, you must:

  • Be accessible to HRSN participants
  • Demonstrate your ability and/or experience with effectively serving at least one Oregon Health Authority (OHA) priority population (see “Clinical and social risk factor criteria,” below)
  • Provide culturally and linguistically appropriate, responsive, and trauma-informed service delivery
  • Demonstrate a history of responsible financial administration via recent annual financial reports, an externally conducted audit, and/or other similar documentation
  • Have the ability to directly meet member needs for the activities listed in the benefit service descriptions, or have the ability to connect members to the appropriate service provider or vendor

For more detailed information on HRSN service provider requirements, see the OHA’s HRSN Guidance Document (PDF).

If you would like to become a PacificSource HRSN provider, please contact our team at HRSNServiceProviderRequests@PacificSource.com.
 

Invoicing and fee schedules for HRSN services

PacificSource will reimburse HRSN service providers for services rendered, outreach, and engagement at the rates established by the OHA. The OHA-approved fee schedule for HRSN climate supports (PDF) is currently available; fee schedules will eventually be available for the housing and nutrition supports as well.

Invoices and supporting documentation for HRSN services rendered must be submitted within 120 calendar days. PacificSource will reimburse providers within 30 days of the invoice date.

Invoices may be submitted:

Conducting closed loop referrals

Members can request and receive HRSN benefits in a variety of ways.

PacificSource is working with Connect Oregon–Unite Us to implement a simple closed loop referral process for HRSN benefits through our HRSN service providers. Connect Oregon will provide trainings and support for using their platform.

Providers who do not use the Unite Us platform may submit closed-loop referrals via the following options:

Clinical and social risk factor criteria

To qualify for HRSN services, individuals must meet the following criteria.

They must:

  • Be a current Oregon Health Plan member
  • Be a member of a covered population
    - Involved in child welfare, including youth leaving foster care
    - Homeless or at risk for homelessness
    - Released from custody or residential behavioral healthcare settings
    - Transitioning from Medicaid-only to having both Medicaid and Medicare coverage
    - Youth with special healthcare needs (starting January 1, 2025)
  • Have a clinical health need such as a chronic health condition
  • Have a social health need related to climate, housing, or food

For more information on HRSN benefit eligibility, see the OHA’s HRSN Services Protocol (PDF).
 

Medicaid/OHP Providers