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RULE §157.130Emergency Medical Services and Trauma Care System Account and Emergency Medical Services, Trauma Facilities, and Trauma Care System Fund

    (C) Eligible designated hospitals may opt to pool funds or contribute funds for a specified RAC purpose for novel or innovative projects.

(d) Eligibility requirements. To be eligible for funding from the accounts, all potential recipients (EMS Providers, RACs, Registered First Responder Organizations and hospitals) must maintain active involvement in regional system development. Potential recipients must also meet requirements for reports of expenditures from the previous year and planning for use of the funding in the upcoming year.

  (1) Extraordinary Emergency Funding. To be eligible to receive extraordinary emergency funding, an entity must:

    (A) be a licensed EMS provider, a licensed general hospital, or a registered first responder organization;

    (B) submit to the department a signed written request, containing the entity name, contact information, amount of funding requested, and a description of the extraordinary emergency; and

    (C) timely submit a signed and fully completed extraordinary emergency information checklist (on the department's form) to the department.

  (2) EMS Allotment. To be eligible for funding from the EMS allotment, an EMS provider must meet the following requirements:

    (A) maintain provider licensure as described in §157.11 of this title (relating to Requirements for An EMS Provider License) and provide emergency medical services and/or emergency transfers;

    (B) demonstrate utilization of the RAC regional protocols regarding patient destination and transport in all TSAs in which they operate (verified by each RAC);

    (C) demonstrate active participation in the regional system performance improvement (PI) program in all TSAs in which they operate (verified by each RAC);

    (D) if an EMS provider is licensed in a county or contracted to provide emergency medical services in a county that is contiguous with a neighboring TSA, it must participate on at least one RAC of the TSAs:

      (i) participation on both RACs is encouraged;

      (ii) RAC participation shall follow actual patient referral patterns;

      (iii) an EMS provider, contracted to provide emergency medical services within a county of any one TSA and whose county of licensure is another county not in or contiguous with that TSA, must be an active member of the RAC for the TSA of their contracted service area and meet that RAC's definition of participation and requirements listed in subparagraph (E)(i)-(vi) of this paragraph; and

      (iv) it is the responsibility of an EMS provider to contact each RAC in which it operates to ensure knowledge of the provider's presence and potential eligibility for funding from the EMS allotment related to that RAC's TSA;

    (E) if an EMS provider is serving any county beyond its county of licensure it must provide to the department evidence of a contract or letter of agreement with each additional county government or taxing authority in which service is provided:

      (i) inter-facility transfer letters of agreement and/or contracts, as well as mutual aid letters of agreement and/or contracts, do not meet this requirement;

      (ii) contracts or letters of agreement must be dated and submitted to the department on or before August 31 of the respective year, and be effective more than six months of the upcoming fiscal year;

      (iii) effective dates of the contracts or letters of agreement should be provided;

      (iv) EMS providers with contracts or letters of agreement on file with the department which include contract service dates that meet the required time period need not resubmit.

      (v) EMS providers are responsible for assuring that all necessary portions of their contracts and letters of agreement have been received by the department; and

      (vi) air ambulance providers must meet the same requirements as ground transport EMS providers to be eligible to receive funds from a specific county other than the county of licensure; and

    (F) if an EMS provider is licensed in a particular county and has a contract (with a county government or taxing authority) for a service area which is a geopolitical subdivision (examples listed below) whose boundary lines cross multiple county lines, it will be considered eligible for the 911 EMS Allotment for all counties overlapped by that geopolitical subdivision's boundary lines. A contract with every county that composes the geopolitical subdivision is not necessary. And, the eligibility of EMS providers, whose county of licensure is in a geopolitical subdivision other than those listed in clauses (i)-(vi) of this subparagraph, will be evaluated on a case-by-case basis.

      (i) Municipalities.

      (ii) School districts.

      (iii) Emergency service districts (ESDs).

      (iv) Hospital districts.

      (v) Utility districts.

      (vi) Prison districts.

  (3) RAC Allotment. To be eligible for funding from the RAC allotment, a RAC must:

    (A) be officially recognized by the department as described in §157.123 of this title (relating to Regional Emergency Medical Services/Trauma Systems);

    (B) be incorporated as an entity that is exempt from federal income tax under §501(a) of the United States Internal Revenue Code of 1986, and its subsequent amendments, by being listed as an exempt organization under §501(c)(3) of the code;

    (C) submit documentation of ongoing system development activity and future planning;

    (D) have demonstrated that a regional system performance improvement (PI) process is ongoing by submitting to the department the following:

      (i) lists of committee meeting dates and attendance rosters for the RAC'S most recent fiscal year;

      (ii) committee membership rosters which included each member's organization or constituency; and

      (iii) lists of issues being reviewed in the system performance improvement meetings; and

    (E) submit all required EMS allocation eligibility items addressed in paragraph (2)(B)-(C) of this subsection.

  (4) To be eligible to distribute the EMS, Uncompensated Care and TSA allotments, a RAC must be incorporated as an entity that is exempt from federal income tax under §501(a) of the Internal Revenue Code of 1986, and its subsequent amendments, by being listed as an exempt organization under §501(c)(3) of the code.

  (5) Uncompensated Care Allotment. To be eligible for funding from the Uncompensated Care allotment, a hospital must be a department designated trauma facility or a Department of Defense hospital that is a department designated trauma facility.

    (A) To receive funding from the Uncompensated Care allotment, an application must be submitted within the time frame specified by the department and include the following:

      (i) name of facility;

      (ii) location of facility including mailing address, city and county; and

      (iii) Texas Provider Identifier (TPI number) or accepted federal identification number.

    (B) The application must be signed and sworn to before a Texas Notary Public by the chief financial officer, chief executive officer and the chairman of the facility's board of directors.

    (C) A copy of the application shall be distributed by Level I, II, or III facilities to the trauma medical director and Level IV facilities to the physician director.

    (D) The department may opt to use data from applications submitted by qualified hospitals in accordance with §157.131(d)(5) of this title (relating to Designated Trauma Facility and Emergency Medical Services Account) for the distribution of funds outlined in subsection (e)(3) of this section.

    (E) Additional information may be requested at the department's discretion.

(e) Calculation Methods. Calculation of county shares of the EMS allotment, the RAC shares of the TSA allotment, and the TSA's share of the uncompensated care allotment.

  (1) EMS allotment.

    (A) Counties will be classified as urban or rural based on the latest official federal census population figures.

    (B) The EMS allotment will be derived by adjusting the weight of the statutory criteria in such a fashion that, in so far as possible, 40% of the funds are allocated to urban counties and 60% are allocated to rural counties.

    (C) An individual county's share of the EMS allotment shall be based on its geographic size, population, and number of emergency health care runs multiplied by adjustment factors, determined by the department, so the distribution approximates the required percentages to urban and rural counties.


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