| (a) The department recognizes a Regional Advisory Council
(RAC) as the coordinating entity for the development and advancement
of the regional trauma and emergency health care system within the
defined trauma service area (TSA) as described in §157.122 of
this subchapter (relating to Trauma Service Areas).
(1) The department recognizes only one RAC for each
TSA.
(2) Trauma, prehospital, perinatal, stroke, cardiac,
disaster response, and emergency health care stakeholders in the TSA
must be eligible for participation or membership in the RAC.
(b) A RAC must meet the following requirements to be
recognized as a RAC:
(1) maintain incorporation as an entity 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, and to
be eligible to receive, distribute, and utilize the emergency medical
services (EMS), uncompensated care, and TSA allotments;
(2) submit required documentation to the department
that includes, at a minimum, the following:
(A) a summary of regional trauma, prehospital, pediatric,
geriatric, perinatal, stroke, cardiac, and emergency health care system
activities;
(B) evidence of an annual summary of the EMS, trauma,
and emergency health care system performance improvement plan; and
(C) a completed regional self-assessment by the end
of each odd state fiscal year, and a current trauma and emergency
health care system plan by the end of each even state fiscal year,
with documented evidence the performance criteria are met;
(3) maintain external financial audits and financial
statements as defined by the department; and
(4) maintain a current website to communicate with
regional stakeholders.
(c) Each RAC must develop and maintain a regionally
specific comprehensive trauma and emergency health care system plan.
The plan must include all counties within the TSA and must be based
on current industry standards and guidelines.
(1) The trauma and emergency health care system plan
must address the following elements:
(A) epidemiology data resources available;
(B) integration of regional stakeholders, identified
coalitions, and community partners pertinent to the priorities and
needs identified through the regional self-assessment;
(C) regional guidelines for prehospital field triage
and destination, treatment, transport, and transfer of patients with
time-sensitive health care injuries or illnesses;
(D) prevention and outreach activities guided by data
available;
(E) system coordination and patient flow;
(F) meaningful participation in regional disaster preparedness,
planning, response, recovery, after-action review, data tracking needs,
and support of the hospital preparedness stakeholders, including the
identified health care coalition and the department;
(G) identification of system-wide health care education
sponsored or coordinated through the RAC;
(H) execution of a systems performance improvement
plan that aligns with the state system performance improvement plan,
and includes regional outcome data;
(I) current pediatric readiness capabilities that identifies
opportunities to improve pediatric readiness within the region;
(J) integration of public health and business community
stakeholders; and
(K) guidelines to support regional research projects.
(2) All health care entities and identified coalition
partners should participate in the regional planning process.
(d) A RAC must maintain the ability to collect and
report data from each hospital within the TSA to facilitate emergency
preparedness and response planning for a public health disaster, public
health emergency, or outbreak of communicable disease, in a manner
directed by the department and consistent with Texas Health and Safety
Code §§81.027, 81.0443, 81.0444, and 81.0445.
(1) Unless otherwise directed by the department, at
least once each calendar quarter, a RAC must collect and report to
the department the following data from each hospital in their TSA:
(A) general beds available and occupied;
(B) intensive care unit (ICU) beds available and occupied;
(C) emergency department visits;
(D) hospital admissions;
(E) ventilators available and in use; and
(F) hospital deaths.
(2) The department may request more or less frequent
collection or reporting or may request different information from
individual RACs to adequately prepare for and respond to any public
health disaster, public health emergency, outbreak of communicable
disease, or federal reporting requirement relating to emergency preparedness
and response.
(3) RACs must make the collected data publicly available
by posting the data on the RAC's internet website.
(e) A RAC with at least one county within the region
located on the international border of Texas and at least one county
within the region adjacent to the Gulf of Mexico must provide guidelines
and protocols related to trauma patient transfer and related services
meeting the following requirements.
(1) The RAC must develop an advisory committee composed
of equal representation from designated trauma facilities within the
RAC.
(2) The advisory committee must develop regional protocols
for managing the dispatch, triage, transport, and transfer of patients.
(A) The advisory committee must periodically review
patient transfers ensuring the applicable protocols are met.
(B) Each hospital and EMS provider operating within
this TSA must collect and report to the RAC data on patients transferred
outside of the TSA following the developed and approved regional protocols.
(C) The advisory committee and activities must be integrated
into the regional trauma and emergency health care system plan.
(f) A RAC must meet the defined performance criteria
to ensure the mission of the regional system is maintained. A RAC
must:
(1) notify the department and RAC membership within
five days of the loss of capabilities to maintain the infrastructure
to oversee and maintain the regional systems as required by the provisions
within subsections (a) and (b) of this section or the department contract;
(2) provide the department with a plan of correction
(POC) no more than 90 days from the onset of the deficiency for the
RAC; and
(3) comply with the provisions of subsections (a) and
(b) of this section, all current state and system standards as described
in this chapter, and all guidelines and procedures as set forth in
the regional trauma and emergency health care system plan.
(g) If a RAC chooses to relinquish services, it must
provide at least a 30-day written advance notice to the department,
all RAC membership, RAC coalition partners, and county judges within
the impacted TSA.
(1) The RAC must submit a written plan to the department
for approval before the 30-day notice to relinquish services.
(2) The RAC funding and assets must be dissolved in
accordance with state and federal requirements.
(3) The department must consider options of realigning
the TSA with another RAC to continue services.
(h) The department has the authority to schedule conferences,
in-person or virtual, with 10-calendar days advanced notice, to review,
inspect, evaluate, and audit all RAC documents to validate the department
RAC performance criteria are met.
(i) RACs must maintain virtual options for stakeholder
participation in committees or other activities.
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