Qualify For HRSN?
Your CCO, & strict confusing rules, ultimately decides. If you feel you meet the qualifications for the HRSN benefit, use the links attached to your CCO/OHP insurer at the bottom of this page to submit your application.
Potential Benefits:
Housing: Rent / Hotel / Utilities
Nutrition: Food
Climate: Air-Con / Heater / Fridge / Filter
Quick Guide on Primary Qualifications
(Select links below for full criterion of qualification)
1) Must be an OHP Member
&
2) Must have at least one of these:
~ Easy 2nd layer qualifiers ~
• Experience of abuse or neglect
• 65 or older
• Under age 6
• Difficulty with self-care and daily activities
~ Medium 2nd layer Qualifiers ~
• Complex physical health condition
• Complex behavioral health condition
• Developmental or intellectual disability
~ Rare Events 2nd layer Qualifiers ~
• Pregnant or gave birth in the past 12 months
• Repeated use of emergency room or crisis services
3) 3rd layer qualifiers are complex and not uniform. Some have no 3rd layer qualifiers. Let the CCO sort it out with an HRSN application below this section.
If you hope to discern absolute qualification (That is the CCO’s Job by the way) here you go:
Housing qualification document: Qualifications
Nutrition qualification document: Qualifications
Climate qualification document: Qualifications
In an effort to assist Oregonians who have OHP and may be applicable for HRSN, we have listed & linked the applications for HRSN below.
Click the blue hyper-linked text to be taken to the appropriate application portal for the CCO (your OHP health insurer).
By Insurance (Alphabetical)
Advanced Health CCO
AllCare CCO
Cascade Health Alliance CCO
Columbia Pacific CCO
Eastern Oregon CCO
Health Share of Oregon
InterCommunity Health Network CCO
Jackson Care Connect
PacificSource Community Solutions
Trillium Community Health Plan
Umpqua Health Alliance CCO
Forewarning, they use multiple PDFs, per request, and emailing/mailing it in.
Douglas County
Email: HRSN@umpquahealth.com
Fax: 541-677-5881
Mail or in-person: 3031 NE Stephens Street, Roseburg, OR 97470
Yamhill Community Care
Forewarning: they use multiple PDFs, each request, an authorization as well as faxing it in.
Yamhill County
Washington County
Polk County
Authorization Form (Needed with all requests)
Only way to submit is by FAX 503.850.9398 Questions call 855.722.8205
By County (Alphabetical)
Baker County
Benton County
InterCommunity Health Network CCO
Clackamas County
Trillium Community Health Plan
Clatsop County
Columbia County
Coos County
Crook County
PacificSource Community Solutions
Curry County
Deschutes County
PacificSource Community Solutions
Douglas County
Forewarning: They use multiple PDFs, per request, and emailing/mailing it in.
Email: HRSN@umpquahealth.com
Fax: 541-677-5881
Mail or in-person: 3031 NE Stephens Street, Roseburg, OR 97470
Trillium Community Health Plan
Gilliam County
Grant County
Harney County
Hood River County
PacificSource Community Solutions
Jackson County
Jefferson County
PacificSource Community Solutions
Josephine County
Klamath County
PacificSource Community Solutions
Lake County
Lane County
Trillium Community Health Plan
PacificSource Community Solutions (until 2026)
Lincoln County
InterCommunity Health Network CCO
Linn County
InterCommunity Health Network CCO
Malheur County
Marion County
PacificSource Community Solutions
Morrow County
Multnomah County
Trillium Community Health Plan
Polk County
PacificSource Community Solutions
Forewarning, they use multiple PDFs for each request, an authorization as well as faxing it in.
Authorization Form (Needed with all requests)
Only way to submit is by FAX 503.850.9398 Questions call 855.722.8205
Sherman County
Tillamook County
Umatilla County
Union County
Wallowa County
Wasco County
PacificSource Community Solutions
Washington County
Trillium Community Health Plan
Forewarning, they use multiple PDFs for each request, an authorization as well as faxing it in.
Authorization Form (Needed with all requests)
Only way to submit is by FAX 503.850.9398 Questions call 855.722.8205
Wheeler County
Yamhill County
Forewarning, they use multiple PDFs for each request, an authorization as well as faxing it in.
Authorization Form (Needed with all requests)
Only way to submit is by FAX 503.850.9398 Questions call 855.722.8205