OhioRISE

Holistic managed care for children and youth in Ohio with complex behavioral health needs.

OhioRISE (Resilience through Integrated Systems and Excellence) is a specialized Medicaid managed care program designed for Ohio children and youth (up to age 20) with complex behavioral health and multi-system needs. This program is available across Ohio, including Cuyahoga County, Franklin County, Summit County, and beyond.

Unlike regular Ohio Medicaid coverage, OhioRISE brings together multiple providers and organizations to create a comprehensive, individualized care plan. This approach ensures that the voices of children and their families are valued throughout the process.

Why OhioRISE is Different: Children and youth with complex needs are often involved in multiple, disconnected community systems. OhioRISE acts as a bridge, connecting these systems to provide unified, wraparound care. Key systems involved often include:

• Juvenile justice

• Child protection services

• Developmental disabilities support

• Education

• Addiction and mental health services

As an official Care Management Entity, Coleman Health Services partners with OhioRISE to help connect kids and families in our service areas with the tailored care coordination they need at every step of their behavioral health journey.

Children and youth may be eligible for OhioRISE if they are eligible for Ohio Medicaid, are 20 years old or younger, and require significant behavioral health treatment.

Children and youth who may benefit from OhioRISE:

• Have multiple needs that result from behavioral health challenges
• Have multi-system 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.

A Child and Adolescent Needs and Strengths (CANS) assessment is used to determine eligibility for OhioRISE. It gathers the young person and family’s story, strengths and needs, to determine the best ways to provide help. An individual’s assessment is updated regularly to aid with ongoing care planning.

CANS assessments are available from:

• Child or youth’s managed care organization
• Aetna Better Health of Ohio
• Coleman Health Services
• Medicaid Consumer Hotline
• Behavioral health providers
• Family and Children first councils

A Child and Adolescent Needs and Strengths (CANS) assessment is the starting point that is used to determine eligibility for OhioRISE. It gathers the young person and family's story, strengths and needs, to determine the best ways to provide help. An individual's assessment is updated regularly to aid with ongoing care planning.

As an OhioRISE Care Management Entity, Coleman Health Services can complete your child's CANS assessment and walk with your family through every step that follows.

How It Works

1. Reach out to Coleman. Fill out the referral form on this page, or find and call a Coleman location near you. Our team will answer your questions and help you get started.
2. Confirm the basics. We'll review a few eligibility details with you — your child is 20 or younger, is enrolled in or eligible for Ohio Medicaid, and has significant behavioral health needs — then schedule your assessment at a time that works for your family.
3. Complete the assessment. A certified assessor meets with your child and family for a relaxed, conversation-based assessment, in person or virtually, to talk through your child's strengths, needs, and story.
4. Review the results. Once the assessment is submitted, we'll go over what it found. Eligible children and youth are enrolled in OhioRISE effective the date the assessment is submitted.
5. Begin care coordination. If your child qualifies, Coleman connects your family with the wraparound services and care coordination OhioRISE provides.

Ready to begin? Start your child's OhioRISE referral below and our team will guide you through the CANS assessment.

Following a CANS assessment, eligible children and youth are enrolled in OhioRISE effective the date their assessment is submitted.

In urgent cases, enrollment into OhioRISE will be:
The date of admission for an inpatient hospital stay for a mental illness or substance use disorder.

Enrollment for OhioRISE is mandatory for children and youth who are eligible. Parents or guardians will receive a notice of denial if their child or youth is not eligible. If a parent or guardian does not want their eligible child or youth enrolled in the program, they can submit a disenrollment request to the Ohio Department of Medicaid.

Intensive and Moderate Care Coordination
This service offers tailored wraparound support through two treatment tiers: Intensive Care Coordination for youth with high, multi-system needs, and Moderate Care Coordination for those requiring mid-level support. Dedicated care coordinators partner with the family to build and manage a unified plan of care.

Improved Intensive Home-Based Treatment (IHBT)
IHBT is a comprehensive, time-limited mental health service delivered directly in a youth's home, school, or community to stabilize severe behavioral health challenges. This high-intensity tier of intervention is designed for youth at risk of out-of-home placement to preserve the family unit.

In-State Psychiatric Residential Treatment Facilities (PRTFs)
PRTFs provide inpatient-level, trauma-informed care in a non-acute residential environment for youth with complex behavioral needs. This intensive residential tier aims to stabilize behaviors while helping families build the skills needed to manage their child at home safely.

Behavioral Health Respite
This service provides short-term, temporary relief for primary caregivers to support and preserve the caregiving relationship. Options range from brief daytime care to overnight stays, offering youth a safe, structured environment while caregivers recharge.

Primary Flex Funds
Primary flex funds offer financial assistance for specific services, equipment, or items that directly address a youth's behavioral needs when standard Medicaid doesn't cover them. This customizable funding tier helps fulfill goals in the care plan, such as tutoring or specialized sensory items.

Mobile Response and Stabilization Services (MRSS)
MRSS delivers immediate, on-site intervention for youth (age 20 and under) experiencing an urgent behavioral health crisis, aiming for arrival within 60 minutes. Following the initial crisis response tier, MRSS includes an extended stabilization tier of up to 42 days to help connect the family with long-term community support.

OhioRISE enrollees will also be offered new and improved behavioral health services. They will receive their behavioral health benefits through Aetna (the OhioRISE plan) and their physical health services through a separate managed care organization or fee-for-service Medicaid.

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.

Learn more about Care Coordination.

Ohio Medicaid and OhioRISE follow state and federal civil rights laws that protect against discrimination or unfair treatment. To help you understand this page, language assistance, interpretation services, auxiliary aids and services are available upon request at no cost to you, connect with the Coleman Health Services team. More information is also available at the OhioRISE website.

Coleman is ready to answer your questions about OhioRISE – get connected with our team today.

Ashland, Holmes, Portage, Richland, Summit, Wayne

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Someone from Coleman will respond to your request within one business day.

If you are in a mental health crisis, please call 988.

If you are experiencing a medical emergency, please call 911.