JEFFERSON COUNTY EDUCATIONAL SERVICE CENTER

2023 Sunset Blvd., Steubenville, Ohio 43952  Phone: 740-283-3347  Fax: 740-283-2709 www.jcesc.k12.oh.us

PROGRAM OVERVIEW

As a part Ohio Medicaid’s effort to launch the next generation of Medicaid, Ohio Department of Medicaid (ODM) will implement OhioRISE (Resilience through Integrated Systems and Excellence), a specialized managed care program for youth with complex behavioral health and multi-system needs in July of 2022. The program will add more intensive in-home and community-based services and supports. Additionally, family and youth will be at the center with voice and choice being prioritized.

Care Management Entities (CMEs) will serve as a ‘locus of accountability’ for children & youth with complex behavioral health challenges and their families by offering two tiers of care coordination: intensive care coordination and moderate care coordination. They will grow the system of care in their catchment areas and create a platform for robust community resource development.

By developing a network, it will allow CMEs to concentrate their efforts to ensure they can develop a strong network that can meet the needs of the children and caregivers being served. There will be a focused effort to help improve experience and processes when interacting with other system partners.

OhioRISE Outcomes:
		
Improved family success and satisfaction measures
	Improved HEDIS measures
	
Improved OhioRISE quality measures
	Improved system collaboration
	
Reduced unnecessary hospitalizations
	Decreased juvenile justice/corrections involvement
	
Reduce out-of-home and out of-state placements
	Increase school attendance and performance
	
Reduce custody relinquishment
		
OhioRISE Eligibility:
		
Medicaid Eligible: Fee for service or managed care
	Age 0-20 at time of enrollment
		
Has existing 1915(c) waiver for intellectual/developmental disability, Ohio Home Care, etc.
	Meet functional needs criteria as assessed by the Child and Adolescent Needs and Strengths assessment (CANS)
	
Requires significant and intensive behavioral health treatment
	An inpatient in a psychiatric residential treatment facility (PRTF)
	
An inpatient in a hospital for mental illness or substance use disorder (SUD)
		
Referrals can be made by:
		
•	Parent/Caregiver •	Psychiatrist
•	FCFC Service Coordinator •	Counselor
•	Case Manager
•	Children Services Worker
		•	Probation Officer
	
	•	Private or local School District Staff •	Pediatrician
•     Primary Care Physician •     Emergency Room Staff
•     Behavioral Health Staff after admission to a psychiatric hospital or residential facility
	
To start the referral process:
	
Contact the child’s Managed Care Organization (MCO) through Ohio Medicaid for assistance. The number will be found on the back of the child’s medical card or:
If the child lives in Belmont, Carroll, Columbiana, Harrison, Jefferson, Monroe, Stark or Tuscarawas counties they can call 740.792.4011 (main line) or the 24-hour hotline # - 740.792.4012 (crisis line)
	
For more information about the program: https://managedcare.medicaid.ohio.gov/managed-care/ohiorise