Office of Transformation & Innovation (OTI)

OTI was established in November 2017 to serve as a centralized process improvement consultancy for HHS. OTI's overarching goal is to identify and implement actionable, tangible improvements in the daily operations of HHS staff, which in turn improves service delivery outcomes and enhances the health and safety of Texans.

OTI’s divisions work in close collaboration with all areas of HHSC and DSHS to identify, develop and implement improvement initiatives across the HHS system. Working with HHS divisions, departments and programs, including administrative support services, OTI provides expertise in the following areas:

  • Identifying, implementing and supporting process and system improvements.
  • Facilitating coordination across HHS agencies and divisions.
  • Promoting a culture of continuous improvement through training, consultative services and technical support to build process improvement expertise throughout the HHS system.
  • Applying a structured approach to change management to promote participation and buy-in.
  • Planning and facilitating ongoing transformation activities within the HHS System.
  • Developing and managing the HHS System and HHSC strategic planning process.

Ongoing Initiatives

At any given time, OTI has many projects affecting groups throughout the HHS System. Below you will find a sampling of ongoing initiatives. If you want to know more about a particular initiative, please email the OTI team at

The Continuous Improvement Ideas Portal

This portal offers an opportunity for employees to suggest ideas for cost savings and business improvements throughout HHS.  Each quarter, the public may vote on their favorite idea using an online form on the Process Improvement page.

OTI Training

Through training, consultative services, and technical support, OTI is developing HHS team members' capacity to conduct process improve­ments and address the people side of change for best success. The Continuous Improvement Academy training covers the foundational elements of Lean, Six Sigma, and other continuous improvement methodologies while also teaching sound change management, with a dedicated focus on emotional intelligence. OTI offers two change management workshops under the banner Take the Surprise Out of Change: one for leaders in HHS, and one for HHS team members involved in improving processes, programs, and policies.

Support Services Agreements

These agreements bring more transparency to the various services each HHSC administrative support area provides and clarity to the business relationship support areas have with their HHSC and DSHS customers. The Support Service Agreements (SSA) ensure that there are clear expectations between HHSC administrative support areas and their customers, and that everyone understands the responsibilities each party brings to the business relationship. OTI manages the agreements and information for contacts, conducts surveys and prepares an executive report to provide continuous improvement to the SSAs process.

Cross-Division Coordination Group

The Cross-Division Coordination Group (CDCG) consists of staff with both strong connections to upper-level leaders, as well as with frontline staff from across the HHS System. Members of this group work collaboratively to enhance coordination among the various programs and services within the HHS System. OTI manages and support the ongoing efforts of the CDCG, serves as facilitator and provides administrative support to this critical group.

HHS Strategic Planning

Strategic planning is more than just a statutory requirement - it helps agencies establish a vision and direction for long-term success. The process aligns everyone's efforts and is linked to operational planning for best results. OTI manages the strategic planning process for the HHS System and helps executive, division and program leaders develop goals, objectives, strategies that align with the system’s vision.


Since its inception, OTI has partnered with the Department of State Health Services (DSHS) and most divisions of the Health and Human Services Commission (HHSC) to complete more than 70 process improvement projects. Learn more in the OTI Year In Review.


In response to recommendations provided by the Sunset Advisory Commission and legislation enacted by the 84th Texas Legislature (2015), the Health and Human Services System has undergone a reorganization to produce a more efficient, effective and responsive system. These extensive changes are commonly referred to as "Transformation." The Office of Transformation and Innovation helped plan that process.

Although the organizational changes required by statute are largely complete, OTI works to promote and enable an efficient, accountable and data-driven organization as envisioned by the Legislature.

​OTI works collaboratively with programs and administrative support service departments to fulfill the mission of creating a culture of continuous improvement. The office includes five departments: Innovation, Strategic Operations, Process Improvement, Strategic Engagement and Transformation.

Health and Human Services Transition Legislative Oversight Committee

The Health and Human Services Transition Legislative Oversight Committee helps direct the HHS transformation. The committee is made up of 11 voting members – 4 each from the Texas Senate and the Texas House and 3 public members appointed by the Governor. The Texas Health and Human Services Executive Commissioner serves as an ex officio, nonvoting member.

OTI Reports

HHS Strategic Plans

​​Legislative Reports