Public Health Provider – Charity Care Program


The Texas Health and Human Services Commission (HHSC) is working to develop the Public Health Provider – Charity Care Program (PHP-CCP) that is designed to allow qualified providers to receive reimbursement for the cost of delivering healthcare services, including behavioral health services, immunizations, and other preventative services, when those costs are not reimbursed by another source. The program is authorized under the 1115 waiver. Year 1 of the program will consist of uncompensated care and Medicaid shortfall. In year 2, the program will transfer to charity care only. 

In accordance with the Special Terms and Conditions of the 1115 waiver, to participate in the program, providers must be funded by a unit of government able to certify public expenditures. Publicly-owned and operated providers eligible to participate include:

• Established under the Texas Health and Safety Code Chapters 533 and 534 and are primarily providing behavioral health services:

  • Community Mental Health Clinics (CMHCs)
  • Community Centers
  • Local Behavioral Health Authorities (LBHAs)
  • Local Mental Health Authorities (LMHAs)

• Local Health Departments (LHDs) and Public Health Districts (PHDs) established under the Texas Health and Safety Code Chapter 121

Beginning October 1, 2021, the PHP-CCP will be operational and allow certain providers to receive a supplemental payment for certain medical services. Payments from the pool are to defray the cost of uncompensated costs of providing medical services to Medicaid eligible or uninsured individuals. Total funding will not exceed 500 million (total computable) in each of the first two years of the program. In future years, this pool is subject to resizing based on actual charity care costs incurred by eligible providers.


The initial interest form is currently open to providers and can be found here. The form must be submitted by 5:00 PM on July 30, 2021. Note that this is not a requirement to be enrolled in PHP-CCP but will assist HHSC in developing an initial provider list.

To participate in the program, an eligible provider must attend annual training prior to the program period start date (October 1, 2021) and complete a cost report application within 45 days of the program period end date (September 30, 2022). Each PHP-CCP program period is equal to a Federal Fiscal Year (FFY) beginning October 1 and ending September 30 of the following year.

The initial cost report training will be available in August 2021. The training will be mandatory to qualify for participation in the program, no exception will be made or makeup training provided. For questions regarding the content of the training, please email to with “PHP-CCP Initial Cost Report Training” in the subject line. Training dates and registration links can be found below:

Please find a copy of the training slides here. Please find a FAQ that we’ve put together from questions that were received during the trainings here.


HHSC has adopted new §355.8215, concerning the PHP-CCP, which is published in the Texas Administrative Code here. HHSC has adopted this new rule under the 1115 waiver to reimburse certain costs for qualifying providers associated with providing care, including behavioral health, immunizations, chronic disease prevention, and other preventative services for the uninsured.

HHSC has adopted new §355.8217, concerning the PHP-CCP payments being available for eligible providers to help defray the uncompensated costs of charity care beginning October 1, 2022, which is published in the Texas Administrative Code here.