OhioRISE

OhioRISE (Resilience Through Integrated Systems and Excellence) is a Medicaid managed care program for children and youth with complex behavioral health and multisystem needs. Children and youth with multisystem needs are often involved in multiple community systems such as juvenile justice, child protection, developmental disabilities, education, mental health and addiction to others. OhioRISE aims to support these children and youth succeed in their schools, homes, and communities. This support is provided through care coordination and specialized services that are provided in-home or in the young person’s community.

Children and youth who benefit from OhioRISE:

  • Have multiple needs that result from behavioral health challenges 
  • Have multisystem needs or are at risk for deeper system involvement 
  • Are at risk of out-of-home placement or are returning to their families from out-of-home placement

An individual who is enrolled in the OhioRISE program has their physical health services covered by managed care organizations (MCO) or fee-for-service (FFS) Medicaid.

OhioRISE eligibility

A child and youth may be eligible for OhioRISE if they:

  • Are eligible for Ohio Medicaid,
  • Are under the age of 21, and
  • Need significant behavioral health treatment, as identified by the Ohio Child and Adolescent Needs and Strengths (CANS) assessment, or 
  • Are in a hospital for mental health or substance use needs.

OhioRISE services:

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

  • Care coordination — assistance with planning support and care for a child or youth’s behavioral needs. Their care coordinator through their managed care organization (MCO) can also be part of this process. 
  • Intensive home-based treatment (IHBT) — intensive, short-term services within a child’s or youth’s home to help stabilize and improve their behavioral health. 
  • Behavioral Health Respite — short-term relief to the primary caregivers of a child or youth who is in a home- or community-based environment.
  • Primary Flex Funds — $1,500 in a 365-day period to purchase certain resources that address a specific need for a child or youth.
  • Psychiatric Residential Treatment Facility (PRTF) — facilities, other than hospitals, that provide intensive psychiatric residential treatment services to individuals age 20 or younger.
  • Mobile Response and Stabilization Services (MRSS) — immediate behavioral health services for children/youth in crisis. MRSS helps to ensure children and youth receive urgent, necessary care in their homes and communities. This service is also provided through Medicaid managed care organizations (MCOs) and fee-for-service (FFS) Medicaid.

CANS Assessments

To have a child or youth assessed for OhioRISE, contact AmeriHealth Caritas Ohio Member Services at 1-833-764-7700 (TTY 1-833-889-6446), 24 hours a day, seven days a week. We will help find a CANS assessor in the child’s or youth’s community to have the CANS assessment completed.

OhioRISE contact information 

For more information on OhioRISE, contact AmeriHealth Caritas Ohio Member Services at 1-833-764-7700 (TTY 1-833-889-6446), 24 hours a day, seven days a week, or Aetna OhioRISE Member Services at 1-833-711-0773 (TTY 711).

Mental health and addiction crisis

A mental health or addiction crisis is not a life-threatening situation. In a crisis, a person may be thinking about hurting themselves or someone else or may be extremely emotionally upset or distressed — call 988. If you or someone you know is experiencing a mental health or addiction emergency or life-threatening situation, call 911.

Examples of a mental health and addiction crisis:

  • Talking about suicide or planning to harm oneself
  • Talking about harm to self or others
  • Self-injury that doesn’t need immediate medical attention
  • Overuse of alcohol or other drugs
  • Extreme depression, anxiety, or other mental illness symptoms

If someone is having a mental health and/or addiction crisis, call 988.

Is it a mental health and addiction emergency or crisis? Read Mental Health and Addiction Emergency or Crisis? to learn the difference and know when to call 911 or 988.

Mobile Response and Stabilization Services (MRSS) provide immediate behavioral health services, at home or another safe location, for young people under 21 experiencing significant behavioral or emotional distress. Call the MRSS hotline at 1-888-418-MRSS (6777).

Members