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Withdrawal of 1115 Waiver Extension Threatens Mental Health Services

WACO, TX – Imagine going backward over three million steps regarding local mental health care. Those imaginary steps equate to real-world dollars that will be lost by the Heart of Texas Region MHMR Center on September 01, 2021, if the Centers for Medicare and Medicaid Services (CMS) does not reinstate the recently withdrawn Texas 1115 Waiver extension in terms of local mental health care. 

In April 2021, CMS informed the State of Texas that they were withdrawing consideration of the Texas expansion due to a technicality and with no regard for those affected.  For the Heart of Texas Region MHMR Center, the loss going forward in year one could be up to $3.6 million in local funding for services.  In Fiscal Year 2020, the Center used nearly $3.9 million in federal waiver funds to provide enhanced or expanded services for nearly 3,000 clients. These services included integrated physical and behavioral health care, substance use addiction services, expanded services into Bosque, Falls, Freestone, Hill, and Limestone Counties.  Additionally, it included underserved areas, evidence-based interventions for people with serious mental illness, and specialized programs for individuals with challenging behavioral issues.

The loss of these funds will create a devastating impact on the much-needed expansion of mental and behavioral health services in our six-county region. It would threaten the loss of services for nearly 5,000 consumers and potentially 150 Center staff through no choice of their own. The loss of these services most likely leads to a domino effect of a further strain and underfunded mental and developmental health system.  HOTRMHMR is often the failsafe for the most fragile, who will likely fall to the health and medical system and local law enforcement and courts without expanded services. With a reduction of Center services and staff, which flies in the opposite direction of further implementing the CCHBC model. In short, this is a monstrous move backward at a time when The Center is dedicated and committed to moving forward to meeting the mental and behavioral health of the people of our region.

We can move forward if we do it together. The state Health and Human Services Commission (HHSC) plans to re-submit the 10-year 1115 Waiver extension request and will take public comment on the application at upcoming hearings. We urge you to make your voice heard—to speak on behalf of the Center about the value the 1115 waiver extension funds bring to our region's mental and behavioral health care. Your voices are vital to prevent the loss of life-saving services to thousands of people with serious mental illness and other co-occurring conditions. The stakes for your community, our community, could not be higher.

The HHSC has announced a virtual public hearing on the 1115 Waiver Extension request.  Anyone wishing to take part may do so through the attached link.


Wednesday, July 14, 2021 at 9:30 a.m. CT.
Register to attend here.