OhioRISE Transition Grants Announced


Included below is recent communication from the Ohio Department of Medicaid regarding grants to expedite readiness and support the transition to OhioRISE.


An overview of this announcement is also included here.


The Ohio Department of Medicaid (ODM) will offer $25 million in grants to expedite readiness and support the transition to OhioRISE. ODM’s grants are being made to catalyze our collective work to serve the urgent needs of children who will be eligible for OhioRISE next year. Two new types of Medicaid providers, Care Management Entities (CMEs) and Mobile Response and Stabilization Services (MRSS) providers, will be offered grant opportunities to support workforce and organizational development so they can serve future OhioRISE enrollees. These Transition Grants will ensure a strong start for OhioRISE, which is a key component of Governor DeWine’s efforts to better serve the needs of multi-system youth and is vitally important to the overall success of implementing Ohio Medicaid’s Next Generation of Managed Care. The OhioRISE managed care plan, Aetna Better Health of Ohio (Aetna), will administer the OhioRISE Transition Grants in support of the following:


1. Launching CMEs and Initiating Care Coordination Services for Priority Populations

OhioRISE is creating a network of Care Management Entities (CMEs) to serve as the locally based “locus of accountability” within 20 catchment areas spanning the state. CMEs will be responsible for delivering care coordination services and engaging in community resource development for children who have complex behavioral health needs within their catchment area. Aetna is soliciting applications to become a CME, and CMEs selected by Aetna will have an opportunity to receive OhioRISE Transition Grants based on their level of need to meet immediate organizational growth goals in early 2022. For example, CMEs may need grants to quickly establish infrastructure, hire and train staff, develop IT systems, conduct community outreach and engagement activities, and work to understand community resources. CMEs receiving Transition Grants will be expected to begin providing high-fidelity wraparound-based care coordination services to key groups of children before they are able to bill Medicaid for the new OhioRISE care coordination services. Early CME care coordination will target priority populations (e.g. children in custody receiving residential treatment and children living in out-of-state residential treatment facilities) that will greatly benefit from increased coordination of care prior to the OhioRISE go-live date.


As a reminder to providers, Aetna released its CME Request for Applications (RFA) on October 18; the RFA is available on Aetna’s website and applications are due by December 8, 2021. CMEs will be selected in January 2022 and will need to establish their contracts with Aetna to access Transition Grant funding. Questions about the CME application process can be directed to CMEapplication@AETNA.com.


2. Maintaining and Expanding Access to MRSS ODM will begin covering a new MRSS billable service in July 2022. In recent years, grants from the Ohio Department of Mental Health and Addiction Services (OhioMHAS) helped establish two cohorts of MRSS providers in 31 Ohio counties. OhioRISE Transition Program grant funds will create a bridge and continue state support for these MRSS providers until OhioRISE goes live, as well as provide funding opportunities to stand up a third cohort of MRSS providers in additional counties across the state.


What’s Next?

ODM and Aetna will communicate about the grant processes and timelines in the coming months. Following grantmaking activities, Aetna will actively support the grantees in their start-up work. While building relationships with CME and MRSS providers, Aetna will assist with building the System of Care across the state. ODM and Aetna are deeply committed to providing resources to develop the workforce and infrastructure that is needed to successfully launch the OhioRISE program.

For your reference, additional background information about the OhioRISE program can be found on the OhioRISE page of the Ohio Medicaid Managed Care Procurement website. If you have any questions, please reach out to OhioRISE@medicaid.gov.


Thank You!

As the OhioRISE Transition Program moves forward with the support of grant-funding, I want to thank you for the valuable input and feedback you continue to contribute to the development of OhioRISE. Your partnership not only helps us ensure a strong and successful startup of OhioRISE, which is vital to the families and children who will be served by the program, but also contributes to the overall success of implementing our Next Generation of Managed Care. We value our partnership with each of you and look forward to our collective work ahead to better serve Ohio’s children and youth and their families.


Maureen M. Corcoran, Director