Ravenwood Health CME
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. Ravenwood Health 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.
Who may benefit from OhioRISE?
OhioRISE serves young people who are dealing with behavioral health challenges. These children/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/or family relationships.
- Problems at school.
Who qualifies for OhioRISE?
- Age 0 to 20
- Eligible for Medicaid
- Require significant behavioral health treatment needs, measured using the Ohio Child and Adolescent Needs and Strengths (CANS) Assessment
- Children and youth may be eligible for OhioRISE due to certain urgent conditions. For example, a child who has been hospitalized or admitted to a residential treatment facility for behavioral health.
- Or the youth is involved with two or more systems such as behavioral health, child protection, developmental disabilities, juvenile justice, and special education.
What is care coordination? How does OhioRISE help youth with behavioral health needs?
- Development of an individualized care plan that builds on the family’s strengths, needs, culture, and vision.
- Builds a care team that prioritizes youth and family voice and choice.
- A partner to join you in advocating for your child in meetings such as those at school, juvenile court, mental health providers etc.
- Families can expect scheduled weekly or bi-weekly communication with their care coordinator.
- Care coordination is not treatment, you will not have to replace your current providers. Instead, it involves mobilizing local resources and facilitating the delivery of needed services.
- Care coordinators plan regularly scheduled family-team meetings to get all involved parties in one space to work together on goals for the child.
- Youth and families will have access to care coordination resources that include but are not limited to online/mobile app platforms with tools to help emotional health, nutritional counseling, online job and life skills training, and financial assistance for members to obtain their GED.
- Youth and families will have access to primary flex funds to provide funding for recovery-oriented activities and supports.
About Ravenwood CME
Care coordination is assigned by county and housed at the following behavioral health agencies:
- Community Counseling Centers
- Crossroads Health
- New Directions
- Ravenwood Health
Each with a unique understanding of services available in the local community. Ravenwood CME has the ability to pull resources from each agency to secure the best services for our CME members and their families.
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/youth’s caregiver(s).
- Primary flex funds, which is funding for services or items to help address a need in a young person’s care plan.
What is a CANS assessment?
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 young person and their caregiver/family’s story.
- Helps understand the young person and their caregiver/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/youth’s needs are being met.
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 denial notice with hearing rights.
Where can a child or youth get a CANS assessment?
Ravenwood Health completes CANS assessments. To request a CANS assessment, call our local hotline to learn more. 833-382-1576
What is a CME?
A CME is an organization that is contracted by the OhioRISE plan (Aetna). In addition to completing CANS assessments, CMEs:
- Provide care coordination for many of the young people enrolled in OhioRISE.
- Have regular communication with OhioRISE enrollees and their caregivers/families.
- Work with community organizations to see what other services and supports are available for the enrollee and their family/caregiver.
- Offer 24/7 crisis support to OhioRISE enrollees and their caregivers/families so they are never alone.
- Advocate for enrollees and their caregivers/families with schools, juvenile courts, behavioral health providers, and others, to ensure their voices are heard and their needs are being met.
What is the OhioRISE Waiver?
As part of the OhioRISE program, the OhioRISE 1915(c) waiver was created.
The OhioRISE Waiver helps young people who are at risk of custody relinquishment or placement in a facility.
This waiver has specific eligibility criteria and includes additional services. To learn more about the OhioRISE Waiver, click here.