Texas Register, Volume 29, Number 5, Pages 727-1096, January 30, 2004 Page: 795
727-1096 p. ; 28 cm.View a full description of this periodical.
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(i) all counties within the TSA have been included
unless a specific county, or portion thereof, has been aligned within an
adjacent system;
(ii) all health care entities and interested specialty
centers have been given an opportunity to participate in the planning
process; and
(iii) the following components have been addressed:
(I) injury prevention;
(II) access to the system;
(III) communications;
(IV) medical oversight;
(V) pre-hospital triage criteria;
(VI) diversion policies;
(VII) bypass protocols;
(VIII) regional medical control;
(IX) regional trauma treatment guidelines;
(-a-) Guidelines consistent with current
Advanced Trauma Life Support (ATLS), Advanced Pediatric Life
Support (APLS), Basic Trauma Life Support (BTLS), Pre-Hospital
Trauma Life Support (PHTLS), Trauma Nurse Core Course (TNCC),
Emergency Nurse Pediatric Course (ENPC), Pediatric Advanced Life
Support (PALS) and Pediatric Education For Pre-Hospital Providers
(PEPP) standards shall be developed, implemented, and evaluated.
(-b-) Individual agencies and medical direc-
tors may, and are encouraged, to exceed the minimum standards.
(-c-) Major/severe trauma patients will be
cared for by health professionals with documented education and skill
in the assessment and care of injuries throughout their pre-hospital
and hospital course.
(-d-) Major/severe trauma patients will have
their medical care, as documented by pre-hospital run forms and hos-
pital charts, reviewed by the individual entity's medical director for
appropriateness and quality of care.
(-e-) Major/severe trauma patients will have
deviations from standard of care addressed through a documented
trauma performance improvement process.
(X) facility triage criteria;
(XI) inter-hospital transfers;
(XII) planning for the designation of trauma fa-
cilities, including the identification of the lead facility(ies); and
(XIII) regional guidelines for disaster prepared-
ness; and
(XIV) a performance improvement program that
evaluates processes and outcomes from a system perspective.
(C) Bureau approval of the completed plan may qualify
health care entities participating in the system to receive state funding
for trauma care if funding is available.
(3) The third phase begins with approval of a complete plan
by the bureau and ends with the regional EMS/trauma system being
recognized by the bureau.
(A) Upon approval, a RAC implements the plan to in-clude:
nents;come data; and
(ii) on-going review of resource, process, and out-
(iii) if necessary, revision and re-approval of the planor plan components by the bureau.
(B) Following implementation of the plan, the bureau
shall recommend to the commissioner of health (commissioner) the
designation of a regional EMS/trauma system if the applicant RAC
meets or exceeds the current Texas EMS/trauma systems essential cri-
teria; actively participates at the bureau's quarterly RAC Chairs meet-
ings; and submits data as requested.
(C) The designation process shall consist of three
phases:
(i) The first phase is the application phase which be-
gins with completing and submitting to the bureau a complete applica-
tion and non-refundable fee for designation as a regional EMS/trauma
system and ends when the bureau approves a site survey (survey);
(ii) The second phase is the review phase which be-
gins with the survey and ends with a bureau recommendation to the
commissioner to designate a regional EMS/trauma system; and
(iii) The third phase is the final phase which begins
with the commissioner reviewing the recommendations and ends with
his/her final decision. This phase also includes an appeal procedure for
the denial of a designation application in accordance with the Admin-
istrative Procedure Act, Government Code, Chapter 2001.
(D) The bureau's analysis of submitted application
materials, which may result in recommendations for corrective action
when deficiencies are noted, shall include a review of:
(i) evidence of participation at the bureau's quarterly
RAC Chairs meetings;
(ii) the completeness and appropriateness of the ap-
plication materials submitted, including the non-refundable application
fee.
(iii) the non-refundable application fee shall be
based on the trauma service area's geographic size, population and
trauma death rate.
(iv) a RAC's non-refundable application fee shall be
no more than $10,000 and not less than $2500.
(E) When the application phase results in a bureau ap-
proval for survey, the bureau shall notify the regional EMS/trauma sys-
tem' s RAC that will then contract for the survey by a team of approved
non-Texas Department of Health (department) surveyors.
(i) The bureau, at its discretion, may appoint an ob-
server to accompany the survey team. In this event, the cost for the
observer(s) shall be borne by the bureau. A RAC shall have the right
to refuse to allow non-department observers to participate in a survey.
(ii) The survey shall be completed within one year
of the date of the approval of the application.
(iii) At any time, a RAC may file a complaint with
the bureau regarding the conduct of a surveyor. The bureau will inves-
tigate and notify the RAC of the outcome.
(F) The survey team composition shall consist of at
minimum a physician; an EMS provider representative; a trauma
nurse from a designated trauma facility; all of which shall have
demonstrated knowledge and experience with system development.
A fourth surveyor with experience in system management may be
requested by the RAC or the bureau.PROPOSED RULES January 30, 2004 29 TexReg 795
(i) education of all entities about the plan compo-
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Texas. Secretary of State. Texas Register, Volume 29, Number 5, Pages 727-1096, January 30, 2004, periodical, January 30, 2004; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth101101/m1/67/: accessed April 25, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.