Ohio Medicaid Creates Specialized Managed Care Program for Children, Requests Bids

The Ohio Department of Medicaid is officially inviting bidders to submit proposals for its specialized, child-focused managed care plan OhioRISE (Ohio Resilience through Integrated Systems and Excellence), which serves Ohio youth with complex behavioral health and multisystem needs.

In a press release, the state agency explained that the model will consist of a network of behavior health providers and care management entities that work together to deliver intensive, coordinated services, and reach more children and families statewide.

According to statistics, More than 40% of children over age 15 years in the child welfare system live in congregate care settings; and youth
out-of-state placements have grown 200% since 2016, with 140 Ohio kids living in out-of-state mental health treatment facilities on any given day.

“Too many times parents wrestle with a heart-wrenching choice: relinquishing custody of their child in exchange for access to life-saving services or face insurmountable health care bills and financial insolvency by seeking care on their own,” said Maureen Corcoran, director of Ohio Medicaid in a press release. “The current approach is not good for the child or their family and costs the state and county more money for custody or court involvement. We can do better for the children we serve.”

OhioRISE will focus on improving care coordination for the more than 60,000 potentially eligible children aged up to 21 years in the state through the expansion of in-home and community-based services and reducing out of home care. In addition, goals of the program include expanding earlier intervention to reduce hospitalization and emergency department use, improving school attendance rates, reducing recidivism rates in the juvenile justice system, and providing families with training and support to stabilize their home environment.

“For too many Ohio families, especially families with children in crisis, navigating services and supports across Ohio’s state agencies can be a challenge,” said LeeAnne Cornyn, director of Governor DeWine’s Children’s Initiative. “OhioRISE will help to eliminate the barriers that families face, replacing them with a highly engaged, integrated support structure that begins and ends with the child’s needs.”

The program will be managed and governed in a joint effort from Ohio Medicaid and Governor DeWine’s Family and Children First Cabinet Council, though Ohio Department of Medicaid will hold the program contract, noted the press release.

Ohio Medicaid’s request for applications will be posted until December 16 and bidders can learn more about the OhioRISE procurement process and goals at https://medicaid.ohio.gov/RESOURCES/Legal-and-Contracts/RFPs. —Edan Stanley