1115 Waiver

In December 2011, the Centers for Medicare and Medicaid Services (CMS) approved the Texas Health and Human Services (HHSC) Healthcare Transformation and Quality Improvement Program 1115 demonstration waiver.

Through 20 Regional Healthcare Partnerships (RHPs), this CMS waiver seeks to transform local health care delivery systems for low income Texans by improving access to services and reducing reliance on higher cost care.

Like public hospitals and other governmental entities, Community Centers can leverage state and local funds to draw down federal dollars for Delivery System Reform Incentive Payment (DSRIP) projects via an Intergovernmental Transfer (IGT).

DSRIP is a pay-for-performance program: providers receive payments for achieving performance metrics and outcomes. These payments are used to incentivize providers to transform service delivery practices to improve quality, health status, patient experience, care coordination, and overall cost-effectiveness.

All 39 Community Centers actively collaborate with local stakeholders in RHPs, conducting 340 projects across Texas, providing nearly 73 percent of all behavioral health projects within the 1115 Waiver.

Projects include expanding access to integrated physical, mental health and substance use disorder services, peer specialists, and telemedicine; implementing outpatient substance use treatment and counseling for Veterans, children and people with intellectual disabilities in underserved areas; crisis stabilization services and mobile units to address identified gaps in community; and interventions tailored for target populations (e.g., high utilizers of emergency rooms, hospitals and jails).