Welcome to OhioRISE

Starting on July 1, eligible Ohio Medicaid members can receive expanded support for children with complex behavioral health needs through the OhioRISE (Resilience through Integrated Systems and Excellence) program. The Ohio Department of Medicaid created this specialized managed care program to make new services available to families and children, and help them navigate through multiple agencies such as juvenile justice, child protection, developmental disabilities, mental health and addiction services and others.

OhioRISE will be managed by Aetna Better Health of Ohio.  Buckeye Health Plan will continue to provide physical healthcare services for our members who are enrolled in OhioRISE.

Here are some of the services that OhioRISE offers to better support qualifying children and their families:

• Care Coordination - Team-based service planning and evidence-based care for a unified approach to support
• Intensive Home-Based Treatment (IHBT) - Professional care in a familiar setting, like home or school
• Psychiatric Residential Treatment Facilities (PRTF) - Inpatient care at a facility close to home
• Mobile Response and Stabilization Services (MRSS) - Provides immediate care and intervention to youth in crisis from professionals that come directly to your location
• Behavioral Health Respite - Provides short-term childcare support for primary caregivers of children enrolled in OhioRISE
• Primary Flex Fund- Provides funding for services, equipment, or supplies not otherwise provided through the Medicaid state plan that addresses an identified need in the service plan.

Who is eligible for OhioRISE?

Your child qualifies for OhioRISE if they are:

• Enrolled in Ohio Medicaid – either managed care or fee for service
• Age 0-20 at the time of enrollment
• In need of significant behavioral health services
• Identified by the Child and Adolescent Needs and Strengths (CANS) tool

Is enrollment in OhioRISE mandatory?

Yes. If a child or youth is eligible for OhioRISE, enrollment into OhioRISE is mandatory.

When does coverage start?

Following a CANS assessment, children and youth found to be eligible are enrolled into OhioRISE. The coverage effective date is the date the CANS assessment is submitted.  In urgent cases, enrollment into OhioRISE will be effective the date of an inpatient psychiatric/ substance use disorder admission or admission into a psychiatric residential treatment facility.

For more information, contact:

Buckeye Member Services: 866-296-8731