Central Texas Medical Center and Hays County partnered on the Live Oak Community Clinic's operations on Jan. 1, 2013, and since then the San Marcos clinic has increased its hours of operation, added staff and made certain medical procedures more accessible, Physician Practice Administrator Lenore DePagter said. "It's interesting because what we've found is word of mouth is very powerful in our community," DePagter said. "We haven't put out ads in the paper. We don't even have the right sign on the door yet. But people have been coming." Since CTMC took over the clinic's operations, 8,800 patients have been seen at the clinic. Last year 815 students received free immunizations before the 2013–14 school year began. Community Clinic Director Regina Henderson said on certain days the line of parents waiting to get their children immunizations stretches past the door. The clinic provides services on a sliding scale for uninsured and underinsured patients and also accepts Medicare, Blue Cross Blue Shield Medicaid and Blue Cross Blue Shield CHIP Perinate. The clinic is currently staffed with a physician assistant and family nurse practitioner, and in August it will add a doctor to its ranks. Dr. Stephen Richardson is expected to start at the clinic Aug. 1. "Not only is he going to see acute care, he's going to see women's health and OB/GYN," Henderson said. "It's going to open us up to more patients." Since CTMC took over the clinic, more and more patients are finding it and using it as a resource for their health care needs, Henderson said. She estimated the clinic sees about 22 patients per day, and that number has been increasing. Using the Section 1115 Medicaid Waiver, Hays County makes quarterly contributions to the state, and the state matches each local dollar with $1.40 of federal money, which is then given to CTMC and used to treat the county's uninsured residents. The county has transferred $1,852,715 to be matched with federal money in fiscal year 2014. Combined with the federal money from the waiver program, CTMC stands to receive more than $4.4 million to treat the county's uninsured and underinsured population. Debbie Gonzales-Ingalsbe, Hays County Precinct 1 commissioner, said handing control of the clinic to CTMC has allowed the clinic to provide better service to more people in a more cost-effective manner. "We felt [the 1115 waiver program] was a good way for us to partner with CTMC and expand and improve the health care delivery system in Hays County for everyone, including the uninsured and the underinsured," Gonzales-Ingalsbe said. To make room for the new patients the community clinic staff are expecting, the clinic recently began renovations, which will expand the number of exam rooms from seven to 10 and will give the facility what Henderson called "more of a medical clinic" setting. Instead of each area of specialty being separated, the clinic will have a more open feel, she said. In April, Hays County approved up to $110,000 to fund the renovations. "There's got to be a place where the low-income residents of Hays County can go, so I'm glad they can come here and get the quality health care services they need," Henderson said.