Today we are exploring OhioRISE—a major new behavioral health program for children with mental, emotional, and substance abuse needs. Listen in to hear how it's impacting families. Our guests include Lisa Clark (Boundless state director of care coordination and management), Shannon Hunter (family engagement director at Aetna), Marisa Weisel (deputy director of strategic initiatives, Ohio Medicaid), and Shirley Grey-Nine (OhioRISE parent).
Today we are exploring OhioRISE—a major new behavioral health program for children with mental, emotional, and substance abuse needs. Listen in to hear how it's impacting families. Our guests include Lisa Clark (Boundless state director of care coordination and management), Shannon Hunter (family engagement director at Aetna), Marisa Weisel (deputy director of strategic initiatives, Ohio Medicaid), and Shirley Grey-Nine (OhioRISE parent).
Welcome to Well-Being a podcast brought to you by Boundless. Boundless is a nonprofit that provides residential support autism services, primary health care day programs, counseling and a whole lot more to children and adults. Our mission is to build a world that realizes the boundless potential of all people. And hey, if you like what you're hearing, give us a great review. Wherever you listen to our episodes. I'm your host, Scott Light. Folks, we've got big stuff. Today we are talking about a major behavioral health program for children with mental, emotional, and substance abuse needs called OhioRISE. So parents, teachers, coaches, and caregivers, if you and your kids are working with let's say Child Services, juvenile justice or substance use treatment programs, OhioRISE may be an option to help you navigate big systems and supports to help your child with us today. Lisa Clark, our state director of care coordination and management here at Boundless. Shannon Hunter family engagement director at Aetna, Shannon also represents families for OhioRISE. Marisa Weisel, Deputy Director of Strategic Initiatives is here from the state of Ohio Medicaid, and Shirley Grey-Nine whose son Curtis Curtis is 16. And he receives care here at Boundless and has a personal story to share already, from her experience with OhioRISE. Welcome, everyone. Hi, hi. Oh, surely I'd love to start with you tell our listeners more. First of all about Curtis, we want to know more about him and the care that he needs. And then if you would let me layer on top of that, give us kind of a before and after perspective before OhioRISE, and then what you've experienced from this program, since you've been part of it.
Shirley Grey-Nine:Yeah, as you said Curtis is 16 years old, he has had some challenges since he was about four years old. I knew at that point that something wasn't quite normal, if you will. So working with his preschool teacher, we were trying to get him tested. And they tested him for ADHD. And it was 12, before he was finally diagnosed with the autism diagnosis. So we were getting services through various entities. And it's been a lot of foot work for me to be able to, you know, get all of the people together what I call team Curtis, which is all of the folks that help us out, including the people in Ohio rise. And it's just a lot emotionally to handle and have to tell the story over and over of what was going on with Curtis. So with OhioRISE, it's been really helpful Tammika, who is the person that's been helping us she is the person who coordinates all of the people and tells that story so that I don't have to do it so many times, it's been super helpful for her to be able to gather everybody together and ensure that all of the services that Curtis needs are being met and as well as the family. So we stay in close contact with them, their communication is fantastic. And it's just been a blessing to be able to have them help us.
Scott Light:That is really good to hear, especially right out of the gate here. So let's break this down a couple of ways. First of all, the rise in OhioRISE is actually an acronym for resilience through integrated systems, and excellence. Okay, so to the rest of our guests here. I like to at least try to make it really conversational for our listeners. So let's say your neighbor, you and your neighbor are talking at the mailbox, and they're like, Okay, what is this OhioRISE? So Lisa, let me let me start with you here. How would you explain it to your neighbor, when they ask you what is this major, massive new program?
Lisa Clark:I think that the first thing I would say is, I know that can be really complicated and overwhelming, working with a child that has multi needs. And what OhioRISE does is provide what's called care coordination. And it's just that it helps to coordinate their care. So that instead of the parent having to figure out what services are best for their child, or where those services are also talking to all the service providers they already have, and then coordinating what needs to happen. We do that for them. There's a care coordinated care coordinator assigned to them. And the care coordinator will have regular meetings to discuss what's happening with the case. There, they're minimally weekly to monthly depending on the level of need, and where they are also 24 hours a day in case the crisis would occur. So that's pretty much what I would explain. I may add, that OhioRISE also will bring extra services that we haven't had in the state of Ohio, some in-home services, some mobile response services, and those things are going to be built and added as we go through building OhioRISE.
Scott Light:Shannon, in your most conversational way. What is OhioRISE?
Shannon Hunter:I would say that Ohio rise is a new health plan that is designed to provide children with behavioral challenges in their parents the services that will help them live healthier, and more productive lives. You see, before OhioRISE, many families across our state struggle to get their behavioral services that their children needed. And when services were available, many could not afford them. So that caused families to give up custody of their children to the state, just so that their children could get access to the services that they needed. And many at times, Families were torn apart by the placement of their children in faraway facilities. OhioRISE ensures that we improve on the behavioral health services that we have and build the services that we don't have across Ohio, so that our children and their families can receive the care that they need, right in their communities. As a mother, with children with behavioral health challenges, I can assure you that OhioRISE as a health plan like no other, that it will transform lives, and build communities, with collaboration from all of our entities.
Scott Light:We're going to talk about that collaboration in a little bit. Marissa, what is your elevator speech for OhioRISE.
Marisa Weisel:As others have said, OhioRISE is a specialized health program for kids who are experiencing some of the most challenging mental health needs and substance youth needs across the state. And these are challenges that have long existed in our state and have been exacerbated by the pandemic. It's our job at OhioRISE to step in and meet families where they are to help say, What have you been getting? And what's been working? What are your goals? And how can we help you then to collaborate the care as Lisa mentioned, and then to offer new suggestions for what else could help a child and family achieve the life that they want to leave. We hope to graduate kids from this program, we hope to help a kid in a family for a period of time and then to send them on their merry way to live their best life. If that's possible, and for others, we'll stick with them until we can connect them to longer term services into adulthood. We're really excited to be here.
Scott Light:Let's pick up on a word that well, all three of you have mentioned here just a second ago collaboration. I found it really interesting reading about Ohio rise and your you are all about knocking down walls, you know, and if there are turf battles out there, you know, getting rid of those and building up collaborative efforts. So Marissa, why don't you maybe start us off there in terms of how do you go about those collaborative efforts just structure wide in the program?
Marisa Weisel:the collaboration to create OhioRISE started from the very top of state government. When Governor DeWine took office, he charged all of the child serving state agencies, which is pretty nebulous for anyone who's not used to government. But you know, that's job and family services, its mental health, its developmental disabilities, Youth Service says so our juvenile justice, population, child protection, he charged us all to work together, and we all came up with Ohio rise together. It's a Medicaid program. But it was designed with us collaborative effort, knowing that we all serve the same kids and families and often kids and families are bounced between our systems, you're sent to the JFS office, then you're sent to the mental health board, then you're sent to the Developmental Disabilities place. So the idea is that from the top down, and hopefully as a model for others at the ground level, we bring everyone together around a table often in meetings or virtually in meetings. And we say, All right, everybody, tell us what's going on this month. Instead of having some a family go from each place to each place. This way, our experts get to talk to each other and share and build their knowledge. They get to share, you know, what could help this kid and a family they get to touch base regularly. And the the model that we've built here actually allows that to happen by one example is we allow all those people who are sitting at the table with that expertise who might have you know, maybe they're professionals. They couldn't get paid to do that work before. And OhioRISE provides a vehicle for them to be reimbursed for their time because their expertise is important to helping a child and a family succeed.
Scott Light:I wish our listeners could see our table here because Marissa you have a parent sitting right beside of you and Shirley who is nodding her head as you're explaining that collaboration so surely you're you're sensing this you're seeing this already. Yeah.
Shirley Grey-Nine:As I said earlier, our case manager a si has been able to connect everybody together. So I don't have to do all of that footwork it's been so so helpful to have everybody together on one call, you know, so I'm not having to do the footwork on to agency to agency and have to explain and the more people that you have, which I'm grateful for Team Curtis, but there's a lot of people involved there's a lot of moving parts so there's room for things to go wrong. So if we're all together at the same time, we're not playing telephone telling the story over and over and trying to relay information accurately if everybody's on that same call, then we're all getting the same information at the same time. And that's been really really helpful.
Scott Light:And Lisa, to you Boundless the way I understand it boundless serves as what's called a case management entity a CME in four counties, Delaware, Mauro, licking and Knox. So boundless will help families in those counties get the services they need, as it Shirleyt was describing is Boundless serving is kind of a hub for the delivery of the services.
Lisa Clark:Yes, we do actually have spent a lot of time as we were ramping up to start OhioRISE by going to each county, starting with their family, children, first councils, which brings together a lot of people having to do with serving similar children as OhioRISE does, and finding out what's available in the communities talking about how can we collaborate with you. And while at first there was a little bit of needing to explain exactly how we can collaborate and what we can do together. And now in just a relatively, you know, few months time, we have come together, and we've said, Hey, in this county, here's a resource you could use. Or I may say to them, I know you don't have this service in your county, but let me see what I can do to bring it to you. And so that's more at you know, at the macro level, at the micro level, we're already talking to different agencies and collaborating on specific youth, similar to what we're doing with Curtis. And it's helping bring everyone together. So we're happy to be a care management entity. And I can see already how this is going to be successful.
Scott Light:about this plan.
Shannon Hunter:The OhioRISE Health Plan is a broad array of services that is designed to support the needs of youth and behavioral health, substance use intellectual developmental challenges. And we provide an array of services. And I know that you were, you know, talking about the collaboration piece and the CME piece, OhioRISE has, you know, we have regional coordinators that help, you know, support those connections, to ensure that we put the puzzle out there and have the pieces together, ensuring that all of our catchment areas are able to provide services to our multi-system, youth and families and the communities that they live, we want to ensure that we are having that conversation and from a family engagement, you know, perspective, I want to ensure that we're listening, you know, to those families. And my, my role and the role of OhioRISE is to ensure that we're having that conversation with families, and that we're listening to families, and ensuring that their voice and their choice is in the forefront of our program. And I am boundless and the work they're doing with, you know, Curtis and his family. That's what we want to have in all 88 counties, we want to ensure that there's a seamless, you know, transfer of services. And if we can't get the services in the county that you're at, let's reach across and say, Hey, how are you doing this over here. And that's what OhioRISE is about ensuring that we are providing those services to all of our youth in Ohio, that is part of OhioRISE.
Scott Light:Marisa tell us why Medicaid is the overall agency here that is implementing this program.
Marisa Weisel:We are really lucky in the state of Ohio to have strong child serving agencies. And Medicaid is just one who helped develop OhioRISE. We had an opportunity, we were making some major reforms that Medicaid starting in 2019, that are just now coming to fruition with OhioRISE and some other things being implemented. And you know, when we looked at those reforms, we were able to go across the state, say where are the major challenges with what we're doing now? And how can we do better. And one area that many stakeholders in every county told us about was, you know, we needed to do better for kids who have mental health needs and substance use disorders. Where there were gaps in care, there was gaps. There are gaps in communication, this frequent challenge you've heard of a family's going from place to place to try to figure out what to do. That was something we heard resoundingly and we've heard for decades that this has been a problem. So Medicaid had an opportunity with our big reforms. We got our other child serving agencies together and said, All right, how can we all do better, and shoot for better outcomes for the kids we share?
Scott Light:Okay, let me ask a couple of questions about customization here to each patient And surely I'll come back to you. Let's do Talk about Curtis here. As he continues to grow and get older and mature, how will his healthcare needs evolve, and then in turn, how will you then go back to two providers like boundless and say, This is what we need. And then how will you get that care,
Shirley Grey-Nine:We will work with the OhioRISE program to get those resources that we need. Curtis's health care needs are pretty significant. He requires lots of professionals to help him he has multiple disabilities, mental health issues. So that makes it a challenge. And they are reaching out right now. And we're getting him the therapy that he needs. And they're coordinating all of that for us. I didn't say earlier, but Curtis is one of the children who had to be turned over to the state he was three years ago. So he's currently living in a group home in Dayton. And so me as a mother, it's really hard for me to be able to do all of that stuff, and work and take care of my family and my household. So by helping with that, it's making sure that Curtis is getting all of his needs met, and that there are no gaps. So they hold the group home accountable for Curtis's needs and make sure that they're being met, I see OhioRISE being able to help us as far as gathering all of those resources. As a parent, it's really hard to navigate the system. And that's the reason I'm here, if I can give hope to any parents, to any families to utilize the services that are being offered, it will make navigating this system so much easier.
Scott Light:Let me go back around the table to Lisa to Shannon and Marissa about that customization to other young people out there just like Curtis, but also different than Curtis that have different needs. How do you go about customizing a healthcare and a treatment plan for each individual? Lisa?
Lisa Clark:Well, it's very true that we can get, you know, a very different types of kiddos to our catchment area. And so one thing that we did was that when we hired care coordinators, and through that training process as well, we made sure that there was people who had experience from multi-systems because one care coordinator may know developmental disabilities really well, another may know substance abuse really well. And so we wanted to get a blend of care coordinators that could work with each other, to be able to serve families that have multiple and differing kinds of needs, so that we can make sure that the services that they are getting our customized to what they need.
Scott Light:Shannon, can you talk about that as well, that customization
Shannon Hunter:at OhioRISE, we believe in the wraparound services, ensuring that we wrap the services needed for our children, within, like I Am Boundless, they reach out to other entities, for instance, like Curtis who's in Dayton. So they coordinate those services. So ensuring that we're wrapping around those services and, and listening, as I always say to the families, and what they need for their children, because they're the expert. We're not, you know, we always have an ability to say, Okay, this is what you need. But to the family say this is what I think my child needs, and are we listening to them. So ensuring that we're, and we have a lot to do in Ohio. And I think that's what makes OhioRISE so extraordinary, because we're getting all those entities at the table to wrap those services around the children that we need.
Scott Light:Marisa, can you pick up on that that customization?
Marisa Weisel:Absolutely. You mentioned that the child and the family are really driving their own care. And I think that's unique to the wraparound model, where we have the parent as part of the team, we're not coordinating care for them, we're coordinating care with them. And for children who can participate and young adults who can participate. They're part of the team too. So when they set out their goals, it's the child's goal. It's the youth school, it's the family's goal for their child, and then all the creative people think, okay, how can we get there. And, you know, for some, it's not necessarily a healthcare service, right. So the over time, especially as the system builds at the local level, Lisa and her team are going to be really great at saying, Oh, he's really interested in basketball, let's hook him up with this one. Coach who runs a Youth League and you know, involving him in that sort of youth basketball league will give them a chance to be social, help him improve his self esteem. It's not about all about treatment. It's about thinking about how we fit treatment together with those other services and supports that are going to serve the child and their family long after they're in OhioRISE.
Scott Light:There may be some listeners listening in and maybe thinking this question. Okay, this sounds great. But my question is, what's covered under OhioRISE and what not.
Marisa Weisel:So, OhioRISE is a Medicaid program and to be in Ohio rise, you have to have Medicaid. And, you know, we have a couple of assessments that we can do for children who have the most extraordinary needs, some of those families might not be in Medicaid yet and we can look at assessing them for Medicaid eligibility to but the first thing to know is that you do have to be in Medicaid. When you're in OhioRISE Aetna, the Ohio rise plan covers all your behavioral health services. This might be, you know, counseling with a therapist, it might be going to outpatient treatment, even intensive outpatient treatment for substance use disorder, it might be going to the hospital and having an inpatient stay for a mental health need for someone who's been suicidal, or who's very, you know, aggressive toward others. But also, OhioRISE offers some new services beyond those that were covered by Medicaid before July 1. So everyone gets to keep everything they had before July 1. And now we've added on some new things. The first is this Intensive Care Coordination that's offered by our care management entities. This is a pretty intensive service. There are lots of meetings and pulling folks together to really figure out what to do to help a kid in a family. There's also a more advanced version of our in-home services. And this is really important because in Ohio, we have too many kids living in congregate settings, where we really want to help them be able to thrive and you know, do well in a family setting instead. But sometimes a family needs more support in the home to be able to do that. So this intensive in home service can help with that. We also have a new mobile crisis service. The mobile crisis service is all about behavioral health needs where a family might now call law enforcement or go to the ER, instead, they can call a number to know that someone can help and be at their house within 60 minutes to help with a mental health need. This isn't available across the state yet we're working on building up that capacity, it's available in about half the counties now. There's also a respite service. And again, we're sort of starting from scratch, we had none of this before. And so as we've gone through July and August, and now into September, we're building more and more of these providers. But sometimes one of the best things for a kid and a family is to just get a break from each other. Or for a parent to know that they could go to the grocery store on Saturday afternoons, every Saturday afternoon to be able to, you know, shop for their family and have a break from their child. Well, a caretaker is there with their child who is an expert and being able to work with a child who has behavioral health needs. And that could even be a neighbor. That's something new, so we're trying to expand the workforce too. We also have a new service that we're bringing up next year, that is a more intensive, longer term in-patient stay. It's called a psychiatric residential treatment facility service. And it's really for kids who have the most complex needs many of whom were sending out of state to get that care today.
Scott Light:It is an expensive program for sure. Lisa, I'd like to come to you with this, you and your teams, you're on the ground, so to speak, you're coordinating these services, you're talking to families talking to parents, like surely, in your mind, what needs and services are most acute right now, for young people all across our state.
Lisa Clark:I would say one of them. The most sought after need is the In-Home Services, families really want to be able to support their child in the home. And a lot of things that happen with behavioral health challenges don't happen in the office with the therapist, they happen in the home. And so with a team of professionals going into the home, integrating in with the family, providing some role modeling, and being right there when a concern occurs, and helping the family through that goes a long way in helping a family function better together and feel more confident about working with their child who has behavioral health needs. That's probably the number one service that that we've heard that parents are interested in with OhioRISE.
Shirley Grey-Nine:And as Marissa said, they're working with us, not for us. And I love that I feel like I still have the input of the things that I need to do. And eventually our goal with Curtis is to reunify him back into the home. That's ultimately our goal is to get him back home. So I think all of these services are going to be really helpful when he is at that point where he is ready to transition back to home. So I'm looking forward to using all of the services that we possibly can to make him be more successful and set our family up for success.
Scott Light:Shirley, let me follow up this way. I want to ask a question really around the table here about outcomes. When you're setting goals for Curtis? Where do you want him? Where do you want his progress? What should his progress look like in whether it's five months down the road or five years down the road?
Shirley Grey-Nine:Yeah, and the short term right now we're working with his behavioral blow ups to make sure that there's more time and that the blow ups are less intense. So they're working a lot with his frustration tolerance. And the counselor that he was working with previously, she was helping him with his Um, coping skills. So it's really important that he has those coping skills, the problem we've had with Curtis, as he knows the coping skills, he can rattle them all off to you. But at the moment, he forgot to use them. So we got to get him to a point where he is able to use those coping skills in the moment to help him deescalate when he's escalated. So yeah, I think that there's a lot of services out there that will hopefully be able to help him and somehow reach him, to get him to understand that he wants to be with our family, and we want him to be with our family, we want him to be home. But he has got to be safe. And so when he gets to the point where he is able to be safe, then we can have all of these services done back in our home.
Scott Light:whether it's big insurance companies, whether it's Medicaid, Medicare, the Affordable Care Act, there is a lot of talk right now in health care overall about improving outcomes. Shannon, what kind of outcomes should we look for from OhioRISE, whether it's five months or five years down the road?
Shannon Hunter:Wel with Aetna in OhioRISE, our goal is to form strong partnerships with our care management entities. With ODM who is the driving force behind Ohio rise from the governor's office, we want to ensure that we form those relationships with with our families and our youth. And, you know, they have charged myself and my counterpart, Nadia with our family engagement and youth engagement councils. And we want to ensure that the services are in Ohio, you know, we want the services to be in the neighborhood where the families are. So it's no strain on them. It's hard enough to have a child with behavioral health and multi-system issues. As a mom, I was a CME of one. I didn't have OhioRISE, I had to figure it out myself. And it wasn't the folks at the table for me. And so battling with the school system, and you know, with families, trying to understand you know, your child, that they're not bad or disruptive because they want to be it is a, it's a I don't like to say disability, I always try to stay ability within themselves to try to do better. And we want families not to suffer the way previous families did where they had to relinquish custody and send their child to another state, not knowing how are they being treated, we want to ensure that we rise above. And that's why OhioRISE here.
Scott Light:Marisa what makes OhioRISE unique from other states from other programs out there.
Marisa Weisel:OhioRISE is built on the evidence that's come from some other states where they've done some similar things. In New Jersey, they've been doing something similar for a couple of decades, Massachusetts, Indiana, Arizona, Tennessee, they all got little bits and pieces of what we put together for OhioRISE. And it was important to us to use evidence-based approaches that other states had already tested to know that what we were building could really succeed. I think what sets us apart in some respects is the speed with which we've started this getting all of the systems and folks around the table and all the buy in to say yes, we're going to jump we're going to do this, we're all going to invest in the same kids and families and try to streamline. One good example of this is, you know, over a short period of time, a number of you know governmental agencies decided we're all going to invest in a center of excellence. This is a specific place in the state that is now charged with training and developing expertise. And some of the services that folks have mentioned are really important to make the program successful. And in some other places that takes years to try to build up. But with you know, leadership and the right folks saying that they wanted this for our kids and families we've been able to stand this up really quickly and have the buy in to make it successful.
Scott Light:As we wrap up our conversation here for our listeners, where can they go for more information about OhioRISE?
Lisa Clark:They can first they can go to the OhioRISE website has a plethora of information there. They can also go to the I Am Boundless website and there's a direct link to OhioRISE services and the care management entity. And if your child if you're calling for your child is not part of our catchment area, we can link you to the correct catchment area. So really any of those sources and finally you can go directly to the Ohio Department of Medicaid. They too have information. Janet.
Shannon Hunter:let me take this opportunity to remind listeners that we have 18 organizations across the state of Ohio With OhioRISE care within the 20 catchment areas, so that means that there's a CME and everyone's community. The contact through our website is www Aetna better health.com/ohiorise, or if they'd like they can call Member Services at 1-833-711-0773.
Scott Light:Started with Shirley and talking about Curtis. And surely I'd like to come back to you to button it up this way, what has OhioRISE to you meant to Curtis meant to your family?
Shirley Grey-Nine:that's meant a lot to us. Because it's been really, really helpful with getting all of those things together. It's allowed us to focus more of our time on spending time together and having those conversations with Curtis. And they are looking at putting together a Youth Advisory Board. And Curtis may potentially be on that. And so Tammika our CME has talked to him about that. And he is just like, Mama, I'm going to be in a leader position. And it just makes him feel so good about himself. And then also, I may be part of the Parent Advisory Board, because I really believe and the services that are being provided for families and like I said, we've had to navigate we've been on this journey for years, and we've had to suffer through we've had the tears that Shannon was talking about, you know, I've been the mom who has been completely overwhelmed. And if I can help one family to be able to make their journey a little bit easier. I will be grateful to do that.
Scott Light:Well I know the hair on the back of my neck stood up when she talked about Curtis wanting to be on that advisory board that is just terrific. Thank you all for being here today and for doing this incredibly important work for young people all across our state to our listeners you can be part of episodes to come you can always email your questions or comments at podcast at I am boundless dot o RG and again don't forget to give us a review that is yet another way we want to hear from you. This is the Well-Being podcast brought to you by Boundless.