Office of Transformation and Innovation (OTI)

In response to recommendations from the Sunset Advisory Commission and legislation enacted by the 84th Texas Legislature (2015), the Health and Human Services (HHS) System has been reorganized to produce a more efficient, effective, and responsive system. These extensive changes are commonly referred to as "Transformation." Although the organizational changes required by statute are largely complete, the Office of Transformation and Innovation (OTI) works to promote and enable an efficient, accountable, and data-driven organization as envisioned by the Legislature.

OTI includes five teams: Transformation, Strategic Engagement, Innovation, Strategic Operations, and Process Improvement. OTI's overarching goal is to identify and implement actionable, tangible improvements in the daily operations of HHS employees, improving service delivery outcomes, and enhancing Texans' health and safety.

OTI’s divisions collaborate with all areas of the Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS) to identify, develop and implement improvement initiatives across HHS. 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 HHSC and the HHS coordinated strategic planning process.

Since its inception, OTI completed more than 300 process improvement projects. Learn more in the OTI Year in Review.

Ongoing Initiatives

Below are several ongoing initiatives OTI is responsible for that affect how HHS does business. For more information about a particular initiative, please email OTI at

The Continuous Improvement Ideas Portal

This portal allows 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 the best success. The Continuous Improvement Academy training covers the foundational elements of Lean, Six Sigma, and other continuous improvement methodologies while teaching sound change management with a dedicated focus on emotional intelligence. OTI offers change management workshops under the banner Take the Surprise Out of Change where HHS employees can learn about the concepts, principles and practices of change management, and how to apply those to process improvement projects.

Support Services Agreements

These agreements bring 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 partners. The Support Service Agreements (SSA) ensure that there are clear expectations between HHSC administrative support areas and their customers and that everyone understands each party's responsibilities in the business relationship. OTI manages the agreements and information for contacts, conducts surveys, and prepares an executive report to improve the SSAs process continuously.

Cross-Division Coordination Group

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

Legislative Coordination

Health and Human Services Transition Legislative Oversight Committee (TLOC)

TLOC helps direct HHS transformation efforts. The committee comprises 11 voting members – four from the Texas Senate and the Texas House and three public members appointed by the Governor. The HHS executive commissioner serves as an ex officio, non-voting member.

When OTI receives requests for substantial organizational changes to the HHS system, OTI works with executive leadership to submit reports detailing proposed changes to the HHS TLOC.

HHS Strategic Plans

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 the best results. OTI manages the strategic planning process for the HHS System and helps executive, division, and program leaders develop goals, objectives, and strategies that align with the system’s vision.