1115 Waiver DSRIP Projects, including MHMRA and CADH



The Delivery System Reform Incentive Payment (DSRIP) pool, one component of the 1115 Waiver initiative, has become an essential part of Texas’ healthcare safety net. The DSRIP pool is a mechanism to fund innovative health care projects that improve the care, quality and access for low income and uninsured Texans. There are 1,458 DSRIP projects organized geographically in 20 regions throughout Texas.

Read the personal outcomes of this collaboration below.

Region 3 is the Southeast Texas Regional Healthcare Partnership that includes Harris, Chambers, Ft. Bend, Austin, Wharton, Waller, Colorado, Matagorda and Calhoun Counties. There are approximately 180 projects that focus on behavioral healthcare, access to primary care, chronic care management, and navigation of the healthcare system.

A key component of DSRIP funding is the evaluation of the projects. The documentation of reductions in hospital admissions and percent decrease in the use of illicit substances, for example, are defining and important indicators. However, the personal side of the outcomes, the individual experiences and stories that offer depth to the data show project value and impact from another perspective.

An example of this 1115 Waiver project is the collaboration between the Mental Health Mental Retardation Authority (MHMRA) of Harris County and the Council on Alcohol and Drugs Houston (CADH). MHMRA contracts with CADH to provide counseling services from Licensed Chemical Dependency Counselors (LCDC) to persons with dual diagnoses (mental illness and substance abuse). Prior to the Waiver, funding streams to serve persons facing mental health and substance abuse challenges were separate, making it difficult to adequately and effectively serve this population. As part of this project, individuals with these multiple diagnoses are receiving services from LCDCs, getting help and making positive changes that wouldn’t have been possible without the innovative and synergistic Waiver collaboration.

Following are two stories that are the result of an 1115 collaborative project between Mental Health Mental Retardation Authority (MHMRA) and Council on Alcohol and Drugs Houston (CADH):

After finding his two young nephew’s dead bodies Ed experienced an episode of schizophrenia when he was around 18. The boys’ murderers were unknown and the stress from the traumatic experience triggered schizophrenia for the young man. Ed used drugs to forget the horrors; he became homeless, and was incarcerated many times. His last incarceration was 15 years. During this time, Ed knew this was not the life he wanted to live, but he did not know how to find help or change the direction of his life.

Through the LCDC Waiver collaboration between MHMRA and CADH, Ed was able to get critical services. Now, he is living in his own apartment and has been drug free since his last incarceration. Also, through medication management and treatment, his symptoms of schizophrenia have decreased.

Various programs, including the MHMRA CADH collaboration, have been essential in Ed’s stability in recovery. Today, he is enrolled in college, volunteering at a retirement home and chairing 12-step meetings. Ed believes his faith in God was essential to his recovery, and that the help he has received from the different programs is proof of his value as a person.

Hidden to Transparency

James, (not his real name), 50-year old man, had spent his life drinking and using drugs. Although he was in counseling, James’ substance abuse continued, and his psychiatrist at MHMRA was concerned about his health.

Through the MHMRA CADH Waiver collaborative, James’ psychiatrist referred him to a counselor for his substance abuse. James was assessed and it was determined that he needed inpatient care. James was placed in a residential treatment center, successfully completed the program, and has remained sober and drug-free for the past 10 months.

He is grateful that he got help, and says that he is in a better place now that drugs and alcohol are no longer a part of his life. Read more about this 1115 Waiver project between MHMRA and CADH

Other quotes from LCDC Waiver program participants include:

“Treatment has helped me express my feelings and communicate better with my husband and has helped me learn skills to help me stop drinking.”

Treatment has helped me to survive, stop using and I am preparing to go back to school for my GED. I feel that it’s helping me.”

“Treatment has helped me gain insight on what I need to do, how to stay focused and has shown me the consequences of using.”


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