OhioRISE: Resilience through Integrated Systems and Excellence
OhioRISE is a Medicaid program in Ohio designed to help young people with significant behavioral health issues succeed in their schools, homes, and communities.
“RISE” stands for “Resilience through Integrated Systems and Excellence,” highlighting the program’s mission to provide comprehensive care that meets the needs of each unique individual. NYAP is proud to partner with OhioRISE as one of 18 care management entities (CME). We help connect OhioRISE members in our service areas with the care they need. We serve Allen, Auglaize, Champaign, Clark, Darke, Hardin, Greene, Logan, Madison, Miami, and Shelby counties.
Who may benefit from OhioRISE?
OhioRISE serves young people who are dealing with behavioral health challenges. These children and youth may need extra support and could be at risk for out-of-home placement or deeper system involvement due to:
Mental health needs.
Substance use challenges.
Autism or other developmental disabilities.
Juvenile court involvement.
Situations that lead to child protective services involvement.
Difficulty with peer and family relationships.
Problems at school.
What does OhioRISE cover?
The program provides new and improved behavioral health services including:
Intensive in-home and crisis services.
Outpatient services, such as individual and group counseling.
Inpatient mental health and substance use care at hospitals.
Behavioral health respite, which is temporary relief for a child or youth’s caregiver.
Primary flex funds, which is funding for services or items to help address a need in a youth’s care plan.
What is a CANS assessment? And where can I get one?
The Ohio Child and Adolescent Needs and Strengths (CANS) assessment is a tool used to determine eligibility for OhioRISE. The CANS assessment also:
Gathers the youth and their caregiver or family’s story.
Helps understand the youth and their caregiver or family’s needs and strengths.
Guides the best ways to provide support.
Assists with ongoing care planning.
The CANS assessment is updated regularly to make sure the child or youth’s needs are being met.
To request a CANS assessment, you can complete an online referral form.
How does OhioRISE help youth with behavioral health needs?
OhioRISE provides support for behavioral health concerns through “care coordination.” An OhioRISE enrollee and their caregiver or family are paired with a care coordinator who assists them by:
Designing a care plan that builds on the youth and caregiver or family’s strengths, needs, culture, and vision.
Building a care team that collaborates to prioritize child or youth and family voice and choice.
Connecting a child or youth to treatment services and resources.
Ensuring all needed services are received and barriers to care are removed.
Who qualifies for OhioRISE?
Children and youth can be eligible for OhioRISE if they are:
Between the ages of 0-20.
Eligible for Medicaid.
Need significant behavioral health treatment, as measured by the Child and Adolescent Needs and Strengths Assessment (CANS).
Children and youth may also be eligible because of certain urgent conditions. For example, if a child or youth is in a hospital for behavioral health reasons.
What happens after the CANS assessment?
Following a CANS assessment, eligible children and youth are enrolled in OhioRISE effective the date their assessment is submitted.
If a child or youth is determined to not be eligible, they will be sent a notice with hearing rights.