| (ii) School districts. (iii) Emergency service districts (ESDs). (iv) Hospital districts. (v) Utility districts. (vi) Prison districts. (3) RAC Allocation. To be eligible for funding from the TSA allocation, 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 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; or (iii) lists of issues being reviewed in the system performance improvement meetings. (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 and TSA allocations, 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) Hospital Allocation. To be eligible for funding from the hospital allocation, a hospital must be a department designated trauma facility or in active pursuit of a department designation as a trauma facility or a Department of Defense hospital that is a department designated trauma facility or in active pursuit of a department designation as a trauma facility. (A) To receive funding from the hospital allocation, 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; (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) Additional information may be requested at the department's discretion. (E) A department-designated trauma facility in receipt of funding from the hospital allocation that fails to maintain its designation, must return an amount as follows to the account: (i) 1 to 60 days expired/suspended designation during any given state biennium: 0% of the facility's hospital allocation for the state biennium when the expiration/suspension occurred; (ii) 61 to 180 days expired/suspended designation during any given state biennium: 25% of the facility's hospital allocation for the state biennium when the expiration/suspension occurred plus a penalty of 10%; (iii) greater than 181 days expired/suspended designation during any given state biennium: 100% of the facility's hospital allocation for the biennium when the expiration/suspension occurred plus a penalty of 10%; and (iv) the department may grant an exception to subparagraph (E) of this subsection if it finds that compliance with this section would not be in the best interests of the persons served in the affected local system. (F) A facility in active pursuit of designation before September 1, 2005, that has not achieved department-trauma designation by December 31, 2005, must return to the account by no later than January 31, 2006, all funds received from the hospital allocation in FY04 and FY05 plus a penalty of 10%. (G) A undesignated facility in active pursuit of designation requirements in subsection (a)(10) of this section after September 1, 2005, that has not achieved department-trauma designation on or before the second anniversary of the date the facility notified the department of the facility's compliance with subsection (a)(10) of this section, must return to the account any funds received from the account, plus a penalty of 10%. (H) A facility must comply with subparagraphs (E) - (G) of this paragraph and have no outstanding balance owed to the department prior to receiving any future disbursements from the designated trauma facility and emergency medical services account. (e) Calculation Methods. Calculation of county shares of the EMS allocation, the RAC shares of the TSA allocation, and the hospital allocation. (1) EMS allocation. (A) Counties will be classified as urban or rural based on the latest official federal census population figures. (B) The EMS allocation 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 allocation 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. (D) The formula shall be: ((the county's population multiplied by an adjustment factor) plus (the county's geographic size multiplied by an adjustment factor) plus (the county's total emergency health care runs multiplied by an adjustment factor) divided by 3) multiplied by the total EMS allocation). The adjustment factors will be manipulated so that the distribution approximates the required percentages to urban and rural counties. Total emergency health care runs shall be the number of emergency runs electronically transmitted to the department in a given calendar year by EMS providers. (2) TSA allocation. (A) A RAC's share of the TSA allocation shall be based on its relative geographic size, population, and trauma care provided as compared to all other TSAs. (B) The formula shall be: ((the TSA's percentage of the state's total population) plus (the TSA's percentage of the state's total geographic size) plus (the TSA's percentage of the state's total trauma care) divided by 3) multiplied by the total TSA allocation). Total trauma care shall be the number of trauma patient records electronically transmitted to the department in a given calendar year by EMS providers and hospitals. (3) Hospital allocation. (A) There will be one annual application process from which all distributions from the hospital allocation, plus any unexpended portion of the EMS and TSA allocations, in a given fiscal year will be made. The department will notify all eligible designated trauma facilities and those hospitals in active pursuit of designation at least 90 days prior to the due date of the annual application. Based on the information provided in the application, each facility shall receive: (i) an equal amount, with an upper limit of $50,000, from up to 15 percent of the hospital allocation; and (ii) an amount for uncompensated trauma care as determined in subparagraphs (B) - (C) of this paragraph, less the amount received in clause (i) of this subparagraph. (B) Any funds not allocated in subparagraph (A)(i) of this paragraph shall be included in the distribution formula in subparagraph (D) of this paragraph. (C) If the total cost of uncompensated trauma care exceeds the amount appropriated from the account, minus the amount referred to in subparagraph (A)(i) of this paragraph, the department shall allocate funds based on a facility's percentage of uncompensated trauma care costs in relation to the total uncompensated trauma care cost reported by qualified hospitals that year. (D) The hospital allocation formula for Level I, II, III and IV trauma facilities and those facilities in active pursuit of designation shall be: ((the facility's reported costs of uncompensated trauma care) minus (any collections received by the hospitals for any portion of their uncompensated care previously reported for the purposes of this section) divided by (the total reported cost of uncompensated trauma care by qualified hospitals that year)) multiplied by (total money available for facilities minus the amount distributed in subparagraph (A)(i) of this paragraph). (E) For purposes of subparagraph D of this paragraph, the reporting period of a facility's uncompensated trauma care shall apply to costs incurred during the preceding calendar year. (F) Hospitals should have a physician incentive plan that supports the facility's participation in the trauma system. (f) Loss of funding eligibility. If the department finds that an EMS provider, RAC, or hospital has violated the Health and Safety Code, §780.004, or fails to comply with this section, the department may withhold account monies for a period of one to three years depending upon the seriousness of the infraction. |
