On October 28, 2020, ODM released a request for applications (RFA) to solicit responses from managed care organizations (MCOs) interested in serving as their OhioRISE (Resilience through Integrated Systems and Excellence), specialized managed care organization for eligible Medicaid youth with complex behavioral health and multi-system needs. ODM seeks to contract for comprehensive and highly coordinated behavioral health services provided by a specialized MCO experienced in and dedicated to serving the unique needs of this population.
Organizations have until December 16, 2020 to place their bids and after extensive review and scoring, awards are estimated to be made on February 19, 2021.
OhioRISE aims to shift the system of care and keep more kids and families together by creating new access to in-home and community-based services for children with the most complex behavioral health challenges. The OhioRISE program’s child and family-centric delivery system recognizes the need to specialize services and support for this unique group of children and families. Once selected, the OhioRISE plan will partner with ODM, sister state agencies, providers, families, and other stakeholders to develop and implement new and enhanced services, including those listed below. OhioRISE will also feature a new 1915(c) Medicaid waiver that will drive toward improving cross-system outcomes for its enrollees. OhioRISE will feature intensive care coordination and both new and enhanced behavioral health services targeted toward this population and will offer a new Medicaid waiver program that will help families prevent custody relinquishment.
OhioRISE Eligibility
Enrolled in Ohio Medicaid – either managed care or fee for service
Under the age of 21
Meet a functional needs threshold for behavioral health care, as identified by the Child and Adolescent Needs and Strengths (CANS) tool