Explore the benefits of the OhioRISE care program for children and youth

The Ohio Department of Medicaid (ODM) offers the OhioRISE (Resilience through Integrated Systems and Excellence) care program. 

This Medicaid-managed care program¹ offers specialized behavioral health care for children and youth. It aims to keep more kids and families together by creating access to in-home and community-based services for young people who have complex behavioral health needs.

Eligibility

To be eligible for OhioRISE, children and youth must:

• Be eligible for Ohio Medicaid (either managed care or fee-for-service)
• Be age 0–20
• Require significant behavioral health treatment needs, measured using the Ohio Child and Adolescent Needs and Strengths (CANS) assessment

Children and youth may also be eligible for OhioRISE due to certain urgent conditions. For example, if a patient meets the age and coverage requirements and is in a hospital for behavioral health reasons.

OhioRISE services

In addition to the mental health and substance use disorder services currently covered by Ohio Medicaid, OhioRISE also provides these behavioral health services:

• Care coordination
• Improved Intensive Home-Based Treatment (IHBT)
• Psychiatric Residential Treatment Facilities (PRTF)
• Behavioral health respite support
• Primary flex funds
• Mobile Response and Stabilization Services (MRSS)

How you can help

1. If you think your patient may benefit from the program, please see information about eligibility and other topics on the OhioRISEopen_in_new page of the Ohio Medicaid Managed Care site
2. Become certified in the Child and Adolescent Needs and Strengths (CANS) assessment through the ODM to perform it with your patient
3. Refer your patient to a CANS-certified assessoropen_in_new if you aren’t one

How to receive reimbursement

To receive reimbursement for performing a CANS assessment, you must be registered with Medicaid and update your registration to include the CANS assessor specialty. For more information, visit the CANS Resourcesopen_in_new page.

¹Eligible children and youth receive their behavioral health benefits through Aetna Better Health of Ohio, the OhioRISE plan

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