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OhioRISE Together | Issue 03 | November 7, 2023
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I am a proud mom of four beautiful children, two of whom are enrolled in OhioRISE. On most days, each is a source of joy and laughter. Yet, raising children with significant emotional needs places all sorts of demands on parents and caregivers that can impact the entire family, put a strain on friendships, and negatively affect careers, health, or family stability. Worse yet, the stress carried by parents and caregivers can trigger bouts of depression and anxiety, creating further isolation from needed supports.
Fortunately, Ohio’s policy makers recognize the need for caregiver relief and have developed policies and funding to deliver much needed relief, or respite, to overwhelmed OhioRISE families. In fact, when a child is enrolled in OhioRISE, the family or caregivers automatically qualify for 50 days of respite services per year. And if the situation calls for more, additional respite support can be authorized.
Unfortunately, despite the policies and funding available to support caregiver relief, the reality of respite care in any community relies on the availability of people to step in and temporarily “parent” the child. As a resident in Southeast Ohio, finding and securing respite care has been daunting. That’s why I want to share some tactics we’ve explored to find relief, as well as suggestions for future efforts to bolster the respite caregiver population.
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It starts with my child’s care coordinator. Every OhioRISE enrollee has care coordinators who champion the needs of the youth and their families/caregivers. These individuals play a vital role in scouting out local, community-based individuals and agencies who are committed to serving kids. Take advantage of their role and work with them closely – they’ll see options you don’t.
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It takes creativity. OhioRISE respite services can be provided by those who serve as natural support, including relatives, friends, teachers, coaches, or anyone who is known and trusted to provide quality oversight. These individuals need to register as a Medicaid provider with the state and complete required training. Our OhioRISE care coordinators can assist individuals in clearing the logistical hurdles to becoming a respite provider by waling them through the process or connecting them to others who can.
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Consider the “village” supporting the child. Natural supports aren’t always an option, so look at the broader community and programs you might tap. Court Appointed Special Advocates (CASA) or guardian ad litem volunteers who are appointed by judges to advocate for children’s best interests may also be willing and available to step in when a break is needed. Your child’s special needs teachers and teachers aid are other options to consider.
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Tap local colleges and technical education centers. Many educational institutions encourage students to get real-life work experience in their fields of study. Reach out to the education, child development, social work, or psychology departments of local schools to seek potential candidates.
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Advertise your search. Social media platforms like Facebook allow users to promote employment opportunities and recruit potential candidates for free. Most areas have local parent groups that offer support and recommended resources. Care.com is another option for searching for people who have experience working with children.
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Contact your local mental health board, legislative officials, and other community leaders. Ultimately, our region, and likely others, is suffering from a dearth of respite providers; broad community and political support will be needed to build up this necessary resource. Local boards, legislators, and philanthropists might be able to better advertise for respite providers (think, the statewide marketing efforts in place to recruit foster parents) and legislators and others could advocate for funding to seed a respite program within a local service agency, which is lacking in our region of the state.
As a primary caregiver to children and young people enrolled in OhioRISE, it’s crucial to recognize your needs in addition to your loved ones. Caregiver burnout is real and overlooking its impact can compromise your ability to perform your duties to the fullest. There are different paths to find a respite provider, and not all of these paths may ultimately lead to success. But by being creative, working together, and advocating for needed community resources, perhaps we, as parents and caregivers, can support one another in ensuring widespread access to this essential service.
To learn more about OhioRISE behavioral health services, visit the Aetna OhioRISE Behavioral Health Services webpage.
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Do you have a story to share about how OhioRISE is making a difference?
Please share a couple of paragraphs explaining how OhioRISE has made an impact. Do not include personal identifiable information.
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If you know a youth, youth’s family, or youth’s caregiver who is interested in sharing their own story, please e-mail
OhioRISE@medicaid.ohio.gov to coordinate an interview.
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Positive Education Program’s (PEP) approach to care coordination is rooted in emphasizing family voice and choice and the value in relationships and community supports. PEP’s growing OhioRISE team of more than 60 professionals embraces these principles to support young people as they thrive.
“As we carry out our work at PEP, we do so with a focus on our north star, that all young people thrive in their school, home, and community environments,” said PEP CEO Habeebah R. Grimes. “As we continue our work as an OhioRISE CME, we are committed to developing the partnerships and resources that will move us closer to that north star.”
Care coordination is also about making sure that people feel seen, heard, and understood. They are techniques PEP care coordinator Michael Sankey demonstrates daily to open doors to unique supports that help youth overcome challenges and thrive. Michael is currently working with a young man who struggles in many areas of his life, including the juvenile legal system. Together they helped the young man tap community activities that taught ways to direct his emotions and manage his behaviors in ways that bring him joy. Now he regularly attends school, reaches out to the adults in his life when he feels upset and sees his mom gaining confidence in supporting her son’s individual needs.
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When OhioRISE launched in 2022, Magistrate Lenski of the Montgomery County Juvenile Court reached out to partner with Choices to begin OhioRISE outreach efforts. Through this partnership, Choices Coordinated Care Solutions found an advocate for not only youth and families, but for care coordination. Choices met with Montgomery County Child Protection Services to start the conversation on how care coordination could help families and keep youth with behavioral needs in their homes and communities. Through that early partnership, Choices connected with Juvenile Probation, Juvenile Court, and the Department of Job and Family Services (JFS) to strengthen the system of care and care coordination process.
Montgomery County Prosecutor’s Office - Child Protection Unit contacts Choices anytime a care coordinator is involved in an active case so that the care coordinator may be present for hearings. Choices care coordinators work with families and JFS to prevent placement outside of the home by providing more support for the family. Through this early partnership, Choice’s information is sent to case managers through an internal JFS process which automatically triggers the OhioRISE referral process. Choices also developed a system with Nicolas Residential Treatment Center to serve their members in-person while at the facility in preparation for the step-down transition. This would not be possible without the collaboration with the Montgomery County Juvenile Court. Choices appreciates that the Montgomery County Court and Magistrate Lenski recognize OhioRISE as an asset.
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Ohio’s child-serving agencies have worked closely with the OhioRISE plan, Aetna Better Health of Ohio, Inc. (Aetna), to establish a new PRTF (Psychiatric Residential Treatment Facility) service and select providers to extend Ohio’s continuum of care for youth with the most intensive behavioral health needs. Beginning in November 2023, PRTF services will gradually become available as the selected providers are able to obtain necessary licensing and contracting to plan for implementation and begin accepting OhioRISE members. Based on the facilities that were selected by Aetna, over the course of the next three years we anticipate:
- Eleven facilities strategically placed throughout Ohio.
- Assuming all eleven PRTF providers are successful in licensing and contracting activities, the expected capacity is to serve about 100 children over the next 2-3 years.
- In addition to the regulatory activities, providers will be working with Aetna, ODM, OhioMHAS and clinicians to refine the needed clinical and program capacities and may have major or minor capital revisions for their facilities.
- Aetna and ODM will continue to assess overall capacity needs, with a priority on the expansion of intensive community services, such as Intensive Home-Based Treatment (IHBT) and Mobile Response Stabilization Services (MRSS).
Aetna and ODM will introduce each PRTF as the provider completes licensing, certification, contracting, enrollment, and readiness activities by each PRTF.
For a youth to be considered for these services, the family or caregiver should contact their OhioRISE care coordinator. Upon request of the youth’s child and family team, the OhioRISE care coordinator submits the request to Aetna who evaluates the youth for medical necessity using Ohio’s PRTF clinical criteria. When medically necessary PRTF services are needed, Aetna refers youth to clinically appropriate PRTFs. To learn how to enroll in OhioRISE read How to enroll in OhioRISE within in this newsletter to enroll and learn more about the PRTF benefit.
Learn more about PRTF by visiting the Aetna OhioRISE PRTF Resources webpage.
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✔ Medicaid Eligibility and Enrollment
To enroll in OhioRISE, a child or youth must be determined eligible for and enrolled in Medicaid. This document explains how a Medicaid application should be submitted to determine Medicaid eligibility.
✔ OhioRISE Eligibility: Child and Adolescent Needs and Strengths (CANS) Assessment
Children and youth who may be eligible for OhioRISE must meet each of the following criteria:
- Are eligible for Ohio Medicaid (either managed care or fee-for-service).
- Are age 0-20.
- Require significant behavioral health treatment needs, measured using the CANS assessment.
Children and youth may also be eligible for OhioRISE due to certain urgent conditions. For example, if a child or youth is in a hospital for behavioral health reasons.
Unless urgently enrolling because of a hospitalization, OhioRISE eligibility is assessed using the CANS. A CANS assessment is a tool that gathers the young person and family’s story to understand their needs and strengths, and to help determine the best ways to provide help.
To ask for a CANS assessment, you can contact any of the following:
- A local care management entity.
- A child or youth’s managed care organization.
- Aetna Better Health of Ohio.
- Medicaid Consumer Hotline.
- Behavioral health providers or Family and Children First Councils, which may have a CANS assessor onsite or be able to link to one.
To find contact information for an OhioRISE care management entity in your community and schedule a CANS assessment, click here.
Click here for more information about how to schedule a CANS assessment from your managed care organization, Ohio Medicaid, or Aetna, the OhioRISE plan.
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Are you interested in taking a community or provider training? Click here to register for the OhioRISE Community and Provider Training or to learn more about OhioRISE trainings.
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If you or your family member is experiencing a mental health, behavioral health, or addiction crisis, know that the following resources are available to help.
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If you or someone close to you is experiencing a mental health or behavioral health crisis, call 1-888-418-MRSS (6777).
Families with youth and young adults up to age 21 who are experiencing difficulties or distress can receive assistance within 60 minutes after contacting MRSS. You may also receive up to 42 days of intensive, in-home services and linkage to on-going supports.
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If you are experiencing a crisis, text “4hope” to 741741 from anywhere in Ohio, anytime.
Crisis Text Line is here for any crisis. A live, trained crisis counselor receives the text and responds, all from a secure online platform. The volunteer crisis counselor will help you move from a hot moment to a cool moment.
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If you or someone close to you is experiencing a mental health or addiction crisis, call, text, or chat 988.
By contacting the Suicide & Crisis Lifeline, you will reach a trained call specialist who can offer help and support in your time of need.
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