Flex requests

On this page find:

• Standard individual flex request
• Hotel flex request
• Bulk request

Flexible services (flex requests)

What are flexible services? 

Flexible services are cost-effective items and/or services delivered to an individual OHP member to supplement covered benefits and improve their health and well-being. Flexible services are intended to meet immediate social needs, stabilize crisis situations and support a sustainable plan for ongoing needs. These are commonly referred to as flex requests. 

Limitations of flexible services:

The Oregon Administrative Rules restrict health-related services to items not paid for with grant money, funding separate from CCO contract revenue, normal clinical service billing, and is the payor of last resort. In other words, health-related services may be used only if other funding is not available. 

How members access flexible services: 

Any primary care or behavioral health provider or care team, care coordination staff member working directly with members, or other subcontractors of Columbia Pacific’s network, may make a flex request for a member. Columbia Pacific encourages our community-based organization (CBO) partners to help our shared members access flexible services. CBOs can work with members and their treatment providers to identify the need, and the provider can submit a request.  

If you are a CBO and need help connecting a member to a provider, please complete the Care Coordination referral form.  

Evaluating requests 

Columbia Pacific evaluates all completed request forms based on: 

• The member’s eligibility  
• How the request matches their treatment plan. 
• Because CCOs are not able to support long term needs, a sustainability plan describing how the member’s needs will be met long-term must be outlined. 
• Which other community resources or safety net funds (besides HRS) were pursued before the request was made.
• Often evaluating requests involves asking for more information about the member, which may include the member's budget information. Requests cannot be fulfilled until all information is received.
• Depending on the nature of the request, if more details about the budget are indicated, this form can be used to provide that information.

We will provide members with a written outcome (mailed to the address on file with the CCO) and copy the requesting provider (and the member’s representatives, if applicable).  

Requesting flexible services funds 

Standard individual flex request

For non-hotel requests, for individual members:

• Please include:
• Standard health-related flexible services request
• Medical documentation (care plan, progress notes, chart notes, etc.) and information about the member’s diagnosis.
• Items that are needed on a repeating basis — like gym memberships, phone minutes, etc. — require the submission of a new Standard health-related services funding request form each month.

Hotel flex requests

For stays in hotels for individual members:

• The maximum number of days we will consider funding in a single request is 30, but be aware that many hotels do have shorter limits of time a member can stay without checking out and checking back in. Please have a conversation with the member and potentially the hotel to make sure the requested hotel is a good fit. Some reasons it may not be a good fit: 
• No rooms are available that meet accessibility requirements 
• No smoking rooms are available or there is no easy access to an outside smoking area 
• No pets are allowed 
• The member does not have ID and the hotel requires it 
• There will be transportation challenges (if the only challenge is getting to the hotel, you can also request help with transportation in the request) 

To submit a request for a hotel:

There are two different options for submitting hotel requests. Please note, both options do still require medical documentation (care plan, progress notes, chart notes, etc) 

• Submit multiple documents:
  • Standard health-related flexible services request
  • Hotel request checklist
  • CPCCO Member Code of Conduct 
  • Medical documentation (care plan, progress notes, chart notes, etc.) and information about the member’s diagnosis.
• Submit a Hotel Flex Request (which combines all of the forms listed above into one document)

If a member needs an extension, please note:

• Extensions of hotel stays require a new submission of a Funding Request form but do not require a new code of conduct or checklist.
• To avoid disruption of services, please submit extension requests at least three to five business days prior to checkout.

If a member lives in an area being impacted by a current state of emergency and needs a hotel, you can submit the request without clinical documentation.

Bulk reimbursement

We recognize that providers frequently feel there is a small window of opportunity to provide some services for members, so we’ve made some of these items that are commonly needed and have a clear benefit available via our bulk reimbursement process. This allows providers to have them on hand and give them to members as needed. 

If your clinic or organization is interested in using the Bulk Purchasing Program, please reach out to socialhealth@careoregon.org to get information about signing up. Here are some highlights of the program: 

• Items should only be requested that are anticipated to be distributed over a one-month period. 
• Once CareOregon receives your request, it will be reviewed and verified for accuracy before order fulfillment. Requests must be submitted using the link below with the PIN Code assigned to your clinic. 
• It is a requirement that reporting be current before new items may be requested. 
  

Below are some examples of items available via bulk reimbursement. 

• Cell phones with 1-year data plans 
• Transit passes 
• Sleeping bags 
• Shelter materials (tents and tarps) 
• City Team shelter vouchers 
• Personal hygiene products 
  

Helpful Resources: 

• Bulk flex request form
• Bulk request tracker
• Bulk Purchasing Program overview
• Bulk Purchasing Program phone details
• Visit our NEMT provider for transportation requests