WAIVER TIMELINE

May 1, 2012 – All regional health care partnerships should be formed.

May 17, 2012 – Public hearing in Austin on final regional geography and anchors.

May 23, 2012 – Webinar / conference call on the draft Program Funding and Mechanics Protocol, HHSC’s draft

DSRIP requirements.

June 7, 2012 – Public hearing on the Program Funding and Mechanics Protocol.

August 2012 – Regional health care partnership planning summit in Austin to provide technical

assistance on developing a regional plan. Due to limited space, online participation also will be available.

August -September 2012 - HHSC working with CMS to finalize PFM and RHP Planning Protocols. Regional planning at the RHP level taking place locally.

October 26, 2012 - Completed UC Tools must be received no later than 5 p.m. by HHSC.

October 31, 2012 – RHPs required to submit RHP Plan subset (Sections I-III of the Plan Template) to HHSC.

November 16, 2012 - Pass I DSRIP Sections, Workbooks and Checklist for ALL regions due to HHSC.

December 31, 2012 - Complete RHP Plans for ALL regions due to HHSC.

February 15, 2013 - ALL regions have received technical feedback from HHSC and have up to 30 days for revision of plans.

April 2013 - CMS formal feedback begins being returned to RHPs

October 1, 2013 - All DSRIP projects in the State must have final approval from CMS  

WAIVER RESOURCES

Overview of Texas Health Care Transformation Waiver (PDF)
Two-page highlight of the 1115 Medicaid Transformation Waiver including a brief background, goals, and
benefits to the State.

Draft RHP Governance Overview (PDF)
The proposed regional health care partnership governance structure submitted by HHSC; pending approval of the
Centers for Medicare and Medicaid Services (CMS).

RHP Principles (PDF)
A brief overview of the approach used to determine regional health care partnership boundaries, the role partnerships play in implementing the 1115 waiver, and coordination of each partnership by an anchor.

RHP Map (PDF)
Finalized map of the regional health care partnerships across the State (dated August 2012).

RHP Anchor List (PDF)
Final list of anchor entities for each regional health care partnership across the State (dated 05/30/12).

Final RHP Plan Template (PDF)
Approved HHSC template for use by regional health care partnerships in outlining the four-year program plan under which each RHP will operate (last updated 09/24/12).

Draft DSRIP Menu (XLS)
Proposed spreadsheet detailing delivery system reform categories, project areas, and potential milestones
associated with each.

DSRIP Funding and Reporting Flow (PDF)
Flowchart of the DSRIP document submission and reimbursement process.

Draft Uncompensated Care (UC) Protocol (RTF)
Draft version of the State's "working document" for UC requirements, subject to CMS approval (last updated 05/23/12).

** NEW ** Updated Program Funding and Mechanics Protocol (PDF)
Final (updated) version of the State's "working document" for the 1115 Waiver Program requirements (last updated 04/04/13).

Webinar: Program Funding and Mechanics Protocol Overview (PDF)
HHSC's webinar presentation (7/10/12) of the most recent version of their draft Program Funding and Mechanics Protocol submitted to CMS for comment/approval.

Webinar: DSRIP Planning Protocol (PDF)
HHSC's webinar presentation (7/11/12) of the most recent version of their draft RHP Planning Protocol (formerly referred to as the DSRIP menu) and DSRIP program requirements submitted to CMS for comment/approval.

UNCOMPENSATED CARE (UC) TOOL AND INFORMATION

The UC Tool has been posted by HHSC and can be found on the Rate Analysis webpage.

• UC Overview (PDF) -- a narrative explanation of the uncompensated care tool overview for both hospital UC (TXHUC) and physician UC (TXPUC) 
• UC Tool Information Sheet (DOCx)

• Access the DSH and Non-DSH Texas Hosptial UC Tool
• View the DSH and Non-DSH Texas Hospital UC Tool Instructions
• Access the Physician UC Tool
• View the Physician UC Tool Instructions

• Purchase of Services & UC Reporting Statutes and Regulations (PDF) 
• HHSC FY12 Waiver Cap Estimates (PDF)

Click the following links to visit HHSC's Rate Analysis Department website for:  Associated Waiver Payment Forms and the full UC Tool Page 

** NEW ** GUIDANCE RELATED TO COLLABORATION AMONG PERFORMING PROVIDERS (PDFs)

DSRIP projects proposed under Collaboration Option (01/18/13)

Implementation Guidance on Project Withdrawal and Conducting Pass 3B (01/25/13)

PLAN RESOURCES

Final RHP (DSRIP) Planning Protocol Documents (PDFs)
Final version of the State's working documents outlining the categories, project options, milestones and metrics recommended for each of the four delivery system reform categories approved by CMS (last updated 09/24/12).

FINAL RHP Planning Protocol - Approved 9/24/12 

Final RHP Plan Template (last updated 10/05/2012)

RHP Plan Template Companion Document (last updated 10/05/12)

Electronic Workbook Instructions (last updated 09/25/12) 

Community Data and Resources for RHP Assessment of Needs (PDF)
A table containing resources compiled by HHSC to assist in gathering community assessment needs data and health care infrastructure data for counties participating in DSRIP activities. HHSC has indicated the community assessment needs must drive the selection of DSRIP projects in a region, and the infrastructure data will be included in the RHP Plan.

RHP Planning Summit Presentations and Handouts (August 7-8, 2012 - Austin, Texas)  
PDF copies of the presentation slides and handouts provided by HHSC to summit attendees.

Summit Agenda

• RHP Plans, CMS Expectations, and Took Kit Primer (Speakers: Kirsch & Khalsa)
• Uncompensated Care (UC) Protocol and Requirements (Speakers: Davis, Miller & Seime)

• Texas Institute of Healthcare Quality & Efficiency Lunch Presentation (Speaker: Raimer)

• Program Funding and Mechanics Protocol (Speakers: Kirsch, FitzPatrick & Egan)

• RHP Planning Protocol (DSRIP Menu): Understanding Projects and Metrics (Speaker: Milligan; Panel: Culica, Hellerstedt, Spuria, Stoner & Woodard)

Day 2 Summit Presentations

• Intergovernmental Transfers and the Waiver (Speaker: Aragon)
• Behavioral Health Panel: Addressing the Needs of the Texas Population

• Outcomes-based Payment Systems Lunch Presentation (Speaker: Goldfield)

CATEGORY 4 GUIDANCE (PDF)

Category 4 Guidance (11/09/12) - Document provided by HHSC that outlines guidance for hospital performing providers who are required to participate in Category 4 reporting.

** NEW ** COMMON PROJECT PROBLEMS and IMMEDIATE GUIDANCE (PDF)

Immediate Guidance for Common Project Problems (12/03/12) - Document that outlines common problems HHSC has encountered in review of Pass 1 projects submitted by regions. HHSC recommends addressing these problems as final plans are put together for December 31 submission.  

** NEW ** GUIDANCE ON VALUATION (PDF)

Project Valuation Guidance (01/16/13) - Document provided by HHSC related to justification of project valuation and requirements for documenting quantifiable and direct patient impact as part of justifying valuation.

For additional information related to the 1115 Waiver, please visit the Texas Health and Human Services
Commission Medicaid Transformation Waiver website.