Please find links below to 1115 Waiver reporting templates and instructions.
Demonstration Year (DY) 6
DY6 Sustainability Planning Milestone Draft Questions
Below are the draft questions that will be included on the DY6 Sustainability Planning milestone template.
The final template will be an Excel file with drop-down menus for discrete responses and open text fields for narrative responses. Providers do not need to send answers to these questions now. Sustainability templates will need to be completed to be eligible for payment of the DY6 Sustainability Planning Milestone in October 2017.
DY6 DSRIP Participation Template (Summer 2016 Form)
The links below are to the DY6 Delivery System Reform Incentive Payment (DSRIP) Participation Template and instructions.
- DY6 DSRIP Participation Template Companion Document (PDF) (6/27/16)
- DY6 DSRIP Participation Template (XLSM) (updated 7/7/16 to address an issue with calculating Intergovernmental Transfer (IGT) for Category 3 outcomes on the DY6 IGT Information tab. If you already have completed the previous template, the updated template does not need to be used because the change does not impact provider entries.)
- DY6 DSRIP Participation Template Webinar Presentation (PDF) (6/29/16)
Demonstration Year 5 Reporting
October DY5 Reporting
- Estimated Intergovernmental Transfer (IGT) for DY5 Round 2 (XLSX) (11/21/16): This file contains DY5 Round 2 estimated DSRIP program payments and remaining DY5 Monitoring IGT due. The estimated payments are based on the assumption that all milestones/metrics reported as achieved in DY5 Round 2 will be approved by HHSC. Do not use these estimates to submit IGT.
- October DY5 Reporting Companion Document (PDF) (9/30/16)
- Updated User Guide for the DSRIP Online Reporting System (PDF) (9/30/16)
- DY3-DY5 Reporting Coversheet (PDF) (9/30/2016)
- Learning Collaborative Participation Template (PDF) (9/30/2016)
Quantifiable Patient Impact (QPI)
- October DY5 Category 4 Template (XLSM) (10/4/16)
DSRIP - Anchor and Provider Resources
DSRIP Project Payment Summaries
The links below are to the project payment summaries. Note that these are the official payment files and may not match the amounts included in the DSRIP Online Reporting System.
- DY2 - April DY3 Project Payment Summary (XLSM) (5/15/15)
- October DY3 Project Payment Summary (XLSM) (5/15/15)
- April DY4 Project Payment Summary (XLSM) (7/31/15)
- October DY4 Project Payment Summary (XLSM) (1/13/16)
- April DY5 Project Payment Summary (XLSM) (7/13/16)
- October DY5 Project Payment Summary (XLSM) (1/17/17)
DSRIP Provider and Project Reporting Summaries
Please find links below to the provider and project reporting summaries. The Provider Summaries provide a high-level narrative overview of the status of all of a provider's DSRIP projects. The Project Summaries provide project-level status information related to a specific project's accomplishments, challenges, lessons learned, etc. Both summary files contain information from the October DY2 through October DY4 reporting periods.
- DSRIP Provider Reporting Summary Oct DY2 - October DY5 (XLSX) (posted 1/17/17)
- DSRIP Project Reporting Summary Oct DY2 - October DY5 (XLSX) (posted 1/17/17)
Updated DSRIP Protocols
The document below contains the following updated items approved by CMS: 1115 Waiver Standard Terms & Conditions (STC), Program Funding and Mechanics Protocol (PFM), Regional Healthcare Partnership (RHP) Planning Protocol, and Anchor Administrative Claiming Protocol.
- 1115 Waiver STCs, PFM, RHP Planning Protocol, Anchor Admin Claiming (PDF)
- Introduction to 3-Year RHP Planning Protocol (PDF)(posted 1/9/14)
- Category 1 Menu for 3-Year Projects (PDF) (posted 1/9/14)
- Category 2 Menu for 3-Year Projects (PDF) (posted 1/9/14)
- Core Components List (XLS) (updated 11/8/13)
- Cat 1 & 2 Project Milestones and Metrics spreadsheet (XLS) (posted 11/8/13)
Anchor Administrative Cost Claiming
The documents below will assist in claiming Anchor administrative costs.
- Attachment A: Cost Principles for Expenses (PDF) (10/10/14)
- Percent of Effort Spreadsheet (XLSX) (updated 4/24/15)
- Anchor Administrative Cost Claiming Overview Presentation (PDF) (10/10/14)
- Anchor Administrative Cost Template (XLSX) (updated 4/25/15)
The documents below relate to Category 3 outcome measures. Category 3 outcome specific information can be found in the Compendium of Category 3 Measures.
- Myers & Stauffer LC- Summary of Findings for Category 3 (PDF) (10/11/16)
- Category 3 Reporting Summary and Goal Calculator (XLSM) (updated 1/20/17)
- Category 3 Interim Corrections Template DY6 R1 (XLSM) (updated 1/20/17)
- Stretch Activity 3 Program Evaluation Guidance (PDF) (11/24/15)
- Category 3 Companion Document (PDF)(2/27/14)
- Key Points about Category 3 Framework (PDF) (2/25/14)
- Category 3 Measures List (XLS) (updated 10/2/14)
- Compendium of Category 3 Measures (PDF) (updated 10/2/14)
- Draft TX Improvement Target Methodology (PDF) (1/8/14)
- Proposed Stretch Activities (PDF) (2/14/14)
- Population-Focused Priority Measures (XLSX) (9/4/14)
- Risk Adjustment Overview for PPE Cat 3 Measures (PDF)
- Description of Risk Adjustment for Category 3 (PDF) (9/25/14)
- Normative Data for Risk Adjustment Rates (XLSX) (9/25/14)
- Contact Information Change Form (PDF) (updated 2/11/15 )
- IGT Entity Change Form (XLSX) (updated 12/16/16)
Regional Healthcare Partnership (RHP) Planning - Historical Information
The Centers for Medicare & Medicaid Services (CMS) has granted final approval (PDF) of this Regional Healthcare Partnership (RHP) Planning Protocol document (PDF). This document was updated Oct. 1, 2012, to include minor technical corrections (PDF). The protocol provides the menu of project options approved by HHSC and the CMS that contribute to delivery transformation and quality improvement. The only projects eligible for payments from the DSRIP pool are those contained in this menu that are implemented as outlined in an RHP Plan approved by HHSC and CMS, with corresponding measures, milestones and performance improvement targets. The links below open individual sections of the approved protocol and include the Oct. 1, 2012, technical corrections.
- Introduction – RHP Planning Protocol (PDF) (10/01/2012)
- Category 1 – RHP Planning Protocol (PDF) (10/01/2012)
- Category 2 – RHP Planning Protocol (PDF) (10/01/2012)
- Category 3 – RHP Planning Protocol (PDF) (10/01/2012)
- Category 4 – RHP Planning Protocol (PDF) (10/01/2012)
- Appendix – RHP Planning Protocol (PDF) (10/01/2012)
RHP Plan Template
- List of RHP Websites (PDF) (updated 9/10/15)
- Regional Healthcare Partnership Governance Overview (PDF)
- Regional Healthcare Partnership Principles (PDF) (posted 4/2/2012)
- Anchor List (PDF) (updated 1/11/17)
- Regional Healthcare Partnership Map (PDF) - (updated 8/7/2012)
Other Planning Tools
Each regional healthcare partnership must submit a plan to HHSC. The following documents are intended to help with the planning process.
- Community Data and Resources for Assessment of Needs (DOC) (3/2012)
- HITECH Funding Available to Hospitals (DOC) (4/2012)
- Emergency and Outpatient Utilization Data for Texas Acute Care Hospitals by County, 2010 (PDF) (1/2012)
- Exempt Small and Rural Hospitals (PDF)
- Major Safety Net Hospitals by Regional Healthcare Partnership (PDF) (updated 10/12/2012)
- Links to public and private affiliation forms (10/23/2012):
Other HHSC Guidelines
- Guidelines for Intergovernmental Transfers (PDF)
- DSRIP Funding and Reporting Flow (PDF) (4/2/2012)
- TEXNET Instructions (DOC)