OhioRISE

Ohio Resilience Through Integrated Systems And Excellence (OhioRISE)

 

The OhioRISE (Resilience through Integrated Systems and Excellence) program is a managed care program for children and youth with complex behavioral health and multisystem needs. OhioRISE aims to expand access to in-home and community-based services to ensure members and families have the tools they need to work with community systems such as education, developmental disabilities, child protection, juvenile justice, mental health and addiction, and others. An individual who is enrolled in the OhioRISE program will keep their managed care enrollment for the physical health benefit.

 

Children and youth who may be eligible for OhioRISE:

 

 Are enrolled in Ohio Medicaid

 

 Are under the age of 21

 

 Are not enrolled in a MyCare Ohio plan.

 

 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 child or youth is in a hospital for behavioral health reasons or is admitted into a Psychiatric Residential Treatment Facility (PRTF).

OhioRISE Services

 

In addition to the behavioral health services already available through Medicaid, OhioRISE offers the following services:

 

 Care Coordination determined by the CANS assessment

 

 Intensive Home-Based Treatment (IHBT)

 

 Mobile Response and Stabilization Service (MRSS)

 

 Behavioral Health Respite

 

 Primary Flex Funds

 

 Psychiatric Residential Treatment Facility (PRTF) — Available January 2023

 

Children and Youth enrolled in OhioRISE will have access to the array of behavioral health services through the OhioRISE plan and will continue to remain enrolled with Anthem for their physical health benefits. The OhioRISE plan is responsible for covering all medically necessary behavioral health services.

Please contact OhioRISE Member Services at 833-711-0773 (TTY:711) for questions about whether a behavioral health service is covered.

Through Anthem, OhioRISE members will maintain access to all medically necessary physical health benefits such as primary care visits, vaccinations, dental, and vision care.

 

View your member handbook [PDF] or contact Anthem Member Services for questions on your physical health coverage.

Child And Adolescent Needs And Strengths (CANS) Assessment

 

To request a CANS assessment, contact Anthem Member Services.  A member of our Care Coordination team will initiate the CANS referral within 1 business day and ensure a CANS assessment is scheduled within 3 business days, keeping you informed every step of the way from referral to OhioRISE eligibility determination. Once a CANS assessment is completed and the child/youth is deemed eligible for OhioRISE, enrollment begins the date their CANS assessment is submitted.

 

Find a CANS provider using our Find Care tool 

 

For more information on OhioRISE services, contact Aetna Better Health of Ohio Member Services at 833-711-0773 (TTY: 711).