OhioRISE Care Program Provides Support for Children and Youth
OhioRISE Care Program Provides Support for Children and Youth
The Ohio Department of Medicaid offers OhioRISE, which stands for Resilience through Integrated Systems and Excellence. This Medicaid-managed care program provides specialized behavioral health support for children and youth who need a higher level of care.
The goal of OhioRISE is to help more children stay with their families and receive care in their homes and communities whenever possible. The program supports young people with complex behavioral health needs by connecting them to coordinated services, treatment options, and additional community-based support.
Who Is Eligible for OhioRISE?
Children and youth may qualify for OhioRISE if they:
- Are eligible for Ohio Medicaid, either through managed care or fee-for-service.
- Are between the ages of 0 and 20.
Have significant behavioral health treatment needs, which are identified through the Ohio Child and Adolescent Needs and Strengths assessment, also known as the CANS assessment.
Some children and youth may also qualify because of urgent behavioral health needs. For example, a child who meets the age and Medicaid coverage requirements and is hospitalized for behavioral health reasons may be eligible for the program.
Services Covered Under OhioRISE
Along with the mental health and substance use disorder services already covered by Ohio Medicaid, OhioRISE offers additional behavioral health services, including:
- Care coordination
- Enhanced Intensive Home-Based Treatment
- Psychiatric Residential Treatment Facility services
- Behavioral health respite support
- Primary flex funds
- Mobile Response and Stabilization Services
How Providers Can Help
- If you think your patient may benefit from the program, check the OhioRISE page on the Ohio Medicaid Managed Care website for eligibility and other details.
- Get certified through ODM in the Child and Adolescent Needs and Strengths (CANS) assessment so you can complete it for your patient.
- If you are not CANS-certified, refer your patient to a CANS-certified assessor.
How to Receive Reimbursement for CANS Assessments
To get reimbursed for a CANS assessment, providers must be enrolled with Medicaid and add the CANS assessor specialty to their registration. More details are available on the CANS Resources page.
For help, providers can also use the 24/7 chat in the UnitedHealthcare Provider Portal.
