Texas Health Care Transformation and Quality Improvement Program – 1115 Waiver Background: 2011 Texas Legislature directed TX Health and Human Services Commission to expand managed care, achieve savings, and improve quality 1115 Waiver provides flexibility for Texas to expand managed care statewide while preserving Upper Payment Limit funding to hospitals.
1115 Waiver Goals• Expand risk-based managed care statewide• Support development and maintenance of a coordinated care delivery system• Improve outcomes while containing cost• Improve and prepare the health care infrastructure increasing access to services• Transition to quality based payment systems• Provide a mechanism for improved coordination in the current indigent care system in advance of health care reform
1115 Waiver• Texas was granted authority from the Federal Government to create a waiver pool, with funds being distributed through two sub-pools, both of which are part of a Regional Healthcare Partnership. 1. Uncompensated Care - Hospitals 2. Delivery System Reform Incentive Payment (DSRIP
1115 WaiverRegional Health Partnership (RHP) – San Angelo’s RHP consists of 17 counties: Coke, Coleman, Concho, Crockett, Irion, Kimble, Mason, McCulloch, Menard, Pecos, Reagan, Runnels, Schleicher, Sterling, Sutton, Terrell, Tom Green.Projects Shall Meet One of the Following Initiatives: 1. Infrastructure Development 2. Program Innovation and Redesign 3. Population-focused improvement 4. Clinical Improvement in care
Proposed Project• Re-establish a Sexually Transmitted Disease Clinic within San Angelo’s Health Department.• Requested 1115 Waiver Funds: $960,000 (4 year span) Must be used to establish or enhance programs, and cannot be used for maintaining a program.• Required City Match: $400,000 (4 year span) Will utilize Health Department’s $100,000 of yearly budgeted General Fund dollars. This would require Council to continue funding of the Department at this level for at least the next 4 years. No financial commitment of the City is required beyond the 4 years proposed.
Health Department STD Clinic Project• Rationale behind choosing project: • In 2011, according to DSHS Midland sub-office, Tom Green County had 3856 confirmed positive STD cases; therefore with the elimination of the City’s STD Clinic, hundreds of citizens were left with less options for testing and treatment.• Project Description Goals: • Re-establish an STD Clinic for Testing, Treating and preventing the spread of STD’s (Chlamydia, Gonorrhea and Syphilis) • Decrease number of ER visits (keep costs down), and • Establish the STD Clinic in a Central Location (close to Shannon ER and the Multi-Modal Transportation Center) • Project period ends FY2016.