MARCH 12, 2024 –

Audio recording here

Amanda McCarthy - Advanced Health - Health Related Social Needs - Director of Social Determinants of Health

  • What’s covered:

    • Climate

      • Who is Eligible

        • Transition population

          • Homeless or at risk of homelessness

          • Dischargeed from adult BH residential

          • Child-welfaire involved

          • Trasitioning to dual status

          • Released from Incarceration

          • Youth with Special Health Care Needs (YSHCN)

          • Clinical or social risk factors

    • Housing

    • Cover temporary rental assistance for up to 6 months

      • Utility assisatance for up to 6 months

      • Pre-tenancy and tenancy support services

      • Housing -focused navigation and /or case management

    • Food

      • Who is Eligible

        • Members with an identified food insecurity need

        • Members with clinical risk factors where medically

  • Who is Eligible

  • Transition population

    • Homeless or at risk of homelessness

    • Dischargeed from adult BH residential

    • Child-welfaire involved

    • Trasitioning to dual status

    • Released from Incarceration

    • Youth with Special Health Care Needs (YSHCN)

    • Clinical or social risk factors

  • Implementation timeline:

    • Climate Benefits - March 1, 2024 Population - Transitions

      Housing - November 2024 Population - At risk for homelessness as defined by HUD

    • Food - Januray 2025 Population: Members experiencing food insecurity & Members with a clinical need

  • Refferals

    • Referral from CBO, ICC, healthcare providers and clinic care management teams

    • Member direct outreach by CCO

    • Existing Flex Fund or HRS requests (built in process to determine the best source of funding for the request)

    • UnitieUS Community Information Exchange

      • Primary referral pathway to the CCO for HRSN benfits

      • Screening and referral form in Unite Us will offer supporting details to determine HRSN eligibilty

      • Meets the closed loop referral requirement of the the benefit

  • Care Management Requirements

    • Contract language: Person-Centered Service Plan (PCSP)

      • In writing and developed with an agreed upon by the member

      • At least one meeting required

      • 6 month check in after services rendered

      • PCSP must include:

        • The recommendded HRSN services

        • Service duration

        • Service provider

        • Goals of the HRSN service

        • The follow-up and transition plan

      • Care Plans may be required for all members receiving HRSN benefits

      • Care management can be done by the CCO,CBO or Primary care clinic

  • Introductions of new members:

    • William Wagner LPC Roseburg VA work with suicide prevention

      • Saturday event

      • Advocate for the support systems supporting veterans

Community partner updateFlyers:

South Coast Together Brag Sheet

Friends of Bandon Parks Tri Fold

Devereux Center Needs

Devereux Center Brochure

Coos Hispanic Allies Agile Funds Flyer

Next month meeting - February 13, 2024 - Jamar Ruff - SCEC

March meeting - March 12, 2024 - Pamela Huntley - Systems of Care

Send suggestions for future topics to Jen Shafer director@unitedwayswo.org