SDOH Screening Tool Request Review Form

This questionnaire is for measurement year (MY) 2025 Social Determinants of Health (SDOH) screening tool exemption and/or statewide approval. Your CCO may submit tools for exemption on behalf of your CCO and organizations in your network who will be conducting screenings for the SDOH Social Needs Screening and Referral Metric. When an exemption is granted, the tool can be used to fulfill the requirements of the Component 2 Hybrid Sample. Component 2 starting in MY2025.

OHA strongly encourages CCOs and organizations that are conducting SDOH screenings to use tools from the OHA approved SDOH screening tools list. Having a common screening tool across the CCO population can streamline the process administratively and lead to better coordination of care. The approved SDOH screening tool list contains tools that have housing, food, and/or transportation questions that automatically qualify as acceptable for use for the identified SDOH metric domains. These tools do not need to be submitted to OHA for exemption to be used for the metric. In addition, tools that have already been exempted do not need to be resubmitted unless changes have been made since OHA granted the exemption.

For more information on requirements for exemption and statewide approval, please see Appendix 2: Social Needs Screening Tools Process of the MY 2025 technical specifications. The questionnaire must be submitted by June 30, 2024 to be considered. Please email Metrics.Questions@odhsoha.oregon.gov with any questions.