Hidden behind serene trees on a busy street in Angleton, Texas, lies a safe house for the mentally ill in crisis. The Gulf Coast Center’s Bayou House Crisis Respite Care Center reopened in August 2013, thanks to the Section 1115 Medicaid Waiver. The Gulf Coast Center provides services for individuals with intellectual and developmental disabilities, mental illness or substance abuse in Brazoria and Galveston Counties. 
The Bayou House’s goal is to stabilize individuals suffering from a mental health crisis through a short-term stay in its facility where clients receive guidance counseling and psychological and social rehabilitative services. 
“One of our most memorable cases came from a Galveston resident who called our mental health crisis hotline,” said David Hernandez, crisis respite liaison for the Bayou House. A 62-year old male, whom we will call Jim, called the hotline, crying hysterically and showing signs of severe depression. “When he first came to us he wasn’t able to speak without crying,” said Hernandez. “Through the assessment, I discovered he was homeless, had gone through a divorce and was severely depressed.”
Hernandez quickly realized that Jim wasn’t aware he was eligible to receive social security retirement. He took him to the social security office and got his social security retirement payments started. He connected Jim with a psychiatrist who started him on anti-depressant medications. 
“After a week or so he was doing great,” said Hernandez. Jim stopped crying, could express himself and figure out what he wanted to do with his life. The Bayou House Crisis Respite Care Center was able to help Jim turn his life around. He received his first social security check the next month and was discharged to friends in Galveston with a new outlook on life.
This is just one of many success stories due to the Texas Healthcare Transformation and Improvement Program, referred to as the 1115 Medicaid Waiver, which was granted to Texas in 2011. The waiver encourages health care providers to collaborate on innovative solutions to improve patient care for all Texas residents, with a special emphasis on Medicaid and uninsured patients. Providers submit their proposed projects to Texas Health and Human Services and the Center for Medicare and Medicaid Services for approval before implementation and earn incentives for successful outcomes.  
The state is divided into 20 regions, with UTMB serving as the anchor for Region 2. Part of UTMB’s role as the anchor institution is to serve as the liaison between regional providers and Texas Health and Human Services.
“UTMB has held our hands and walked us through the process,” said Patricia Wareing, chief operations officer of the Gulf Coast Center. 
“This is an opportunity to work together as providers — sharing ideas and developing innovative solutions to improve lives through health care,” said Craig Kovacevich, associate vice president of Waiver Operations and Community Health Plans for UTMB. 
Gulf Coast’s waiver-funded Crisis Respite and Stabilization Service for Individuals with Intellectual and Developmental Disabilities, works to prevent persons with IDD from being hospitalized, incarcerated or removed from their home because they are a danger to themselves or others. The program started in October of 2013.
Single parent Cynthia Spiller contacted the service in January for help with her 17-year-old son Brandon, who was exhibiting behavioral problems at home and had been jailed for an incident at school. The Crisis Respite and Stabilization team helped get Brandon placed back in his home, implemented a behavior plan and is providing weekly follow-up sessions based on the principles of applied behavior analysis. 
“Before this program existed, individuals in circumstances like Brandon, who can be a contributing member of society, would simply be incarcerated, institutionalized or placed in a mental hospital,” said program director Pamela Washington.
Since the team intervened, Brandon’s behavior has turned around and given the family the support they had been seeking for three years.
“[This program] has given me hope, where there was hopelessness,” said an emotional Spiller.