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.


Regulatory Services

When it was created through consolidation in 2017, HHSC's Regulatory Services division inherited disparate enforcement policies and procedures carried over by legacy DADS Regulatory, DFPS Child Care Licensing and Provider Investigations, and DSHS programs involved in regulation of hospitals. 

As part of the ongoing transformation of HHS, OTI's Innovation team led a 10-month comprehensive review and evaluation of Regulatory Services' enforcement processes, and related statutes and policies, with an eye toward identifying opportunities for consolidation, streamlining and expansion of best practices.

The result was a portfolio of 35 deliverables, anchored by detailed process maps of enforcement for all areas including child care operations, nursing facilities, home health agencies, healthcare quality and provider investigations. Deliverables included both statutory and management recommendations targeting further efficiencies.

CAPPS Financials 2.0 

OTI’s Strategic Engagement team worked with HHSC’s Information Technology (IT) and Procurement and Contracting Services (PCS) divisions to prepare staff for further expansion of CAPPS, system for financial transactions and bookkeeping.

The services provided by Strategic Engagement include collaboration with PCS and IT to provide thoughtful, proactive, and planned communication and outreach about the "why" behind the new business processes, updates on progress and training opportunities that will help improve buy-in for the changes.

Fully informed and trained staff will be able to: more efficiently utilize the system upon rollout; know how to preemptively adapt their business processes to accommodate system changes; and reduce unnecessary errors and corrective work that result from insufficient planning.

Engaging and informing stakeholders on a regular basis will enhance PCS efforts to get end-users up to speed quickly to meet agency deadlines and create the foundation for a smooth, timely implementation of further expansion of the CAPPS system.

Procurement and Contracting Improvement Plan (PCIP) 

HHSC contracted with Ernst & Young, LLP (EY) to perform a comprehensive assessment and root cause analysis of weaknesses within the HHS procurement and contracting system. EY developed a proposed improvement plan, and based on their recommendations, OTI’s Transformation team led a system-wide effort to develop the PCIP for HHSC and DFPS.

As the plan is implemented, the Transformation team manages the portfolio of improvement projects proposed by EY, as well as other projects deemed critical to the restructuring of the procurement and contracting process. During the course of this project, Transformation:

  • Manages the consultant contract and provides project management services in accordance with the contract.
  • Solicits input from all areas of the HHS System throughout all phases of the project.
  • In collaboration with the Procurement and Contracting Services division, plans, facilitates and manages the implementation of system and process improvements to address identified weaknesses.

Key Projects

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

HHSC and DSHS Coordination Committee

This project developed a cross-agency oversight committee comprised of executive staff from both HHSC and DSHS. The committee’s charge is to analyze, identify and address opportunities for improvement of policies and procedures related to operational and administrative support services. This project also encourages increased communication and collaboration between the two agencies.

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, serve as facilitators and provide 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.

Revised Support Services Agreements

As part of the restructuring of the HHS System, support services agreements (SSAs) ensure that HHSC and DSHS programs receive the administrative services and support they need. OTI is leading the effort to revise SSAs to enhance accountability in the performance and delivery of administrative services.

HHSC Employment Engagement Improvement Initiative

Responses from the 2018 Survey of Employee Engagement and focus groups of HHSC employees from around the state reflect generally low morale and a high level of employee disengagement. The EEII is a portfolio of 14 projects​ designed to improve employee engagement throughout HHSC and through that effort, improve the workplace culture and boost morale.

History and Transition Plan


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 three departments: Innovation, Strategic Engagement and Transformation.

Transition Plan

The Health and Human Services System Transition Plan provides an overview of the structural changes.

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.


Progress Report on Transformation of Health and Human Services System, July 2018 (PDF)


OTI Reports

HHS Strategic Plans

​​Legislative Reports