OhioRISE (Resilience through Integrated Systems and Excellence) is a specialized Medicaid managed care program creating new access to in-home and community-based services for young people with severe behavioral health needs involved with multiple systems such as juvenile courts, child protection services, and developmental disabilities services.
Over time, it will mean that kids who deal with complex behavioral health issues do not have to travel across state lines or be in a secured facility. Instead, the goal is to bring their care closer to home in their familiar communities and surroundings. This approach builds upon Lighthouse’s approach. We want care to be more accessible and more manageable for children, youth, and their families.
As a care management entity (CME) for OhioRISE, Lighthouse Youth & Family Services supports OhioRISE members who live in western Hamilton County. CMEs are essential to the success of OhioRISE. They are responsible for coordinating care for a child: bringing together schools, behavioral health providers, juvenile services, hospitals, and other systems to provide what the child needs.
- Is centered on the needs of the child.
- Involves the youth and family in creating a comprehensive plan to reach their goals with coordinated care.
- Wraps all the programs that kids and families need around them.
Lighthouse is working with the following partner agencies:
- Best Point Education & Behavioral Health
- New Path Youth & Family Services
- Pressley Ridge
- Talbert House
Under OhioRISE, youth and families covered by Medicaid will be able to take advantage of intensive treatments and coordinated care paid for by Medicaid without the requirement that the state pays for everything.
Young people who may be eligible for OhioRISE include those who are:
- Ages 0-20
- Eligible for Ohio Medicaid, either managed care or fee-for-service, and
- In need of significant behavioral health services.
Aetna is the health insurance company overseeing the program.