Part 1. DEPARTMENT OF STATE HEALTH SERVICES
Chapter 157. EMERGENCY MEDICAL CARE
Subchapter G. EMERGENCY MEDICAL SERVICES TRAUMA SYSTEMS
The Executive Commissioner of the Health and Human Services Commission (commission), on behalf of the Department of State Health Services (department), adopts an amendment to §157.131, concerning the designation of Trauma Facilities and the Emergency Medical Services (EMS) Account without changes to the proposed text as published in the December 8, 2006, issue of the Texas Register (31 TexReg 9800) and, therefore, the section will not be republished.
BACKGROUND AND PURPOSE
The amendment to this section is necessary to provide clarification and narrow the definition of trauma care to meet the original intent outlined in Health and Safety Code, §780.004. The new language more clearly defines the types of trauma patients to be reported by hospitals in the uncompensated trauma care funding application. The existing rule language currently allows a hospital to include patient charges that meet the existing definition of trauma care but do not meet the intent of the statute in its uncompensated trauma care application. The intent of the statute is to help reimburse a portion of the uncompensated trauma care for emergent trauma patients provided by trauma centers. The existing language allows for non-emergent and non-trauma related charges to be included. Additionally, the amendment was endorsed by the Governor's EMS and Trauma Advisory Council at its May 2006 meeting. The amendment clarifies the definition of trauma care and ensures that appropriate trauma patient charges are reported in a hospital's uncompensated trauma care application.
SECTION-BY-SECTION SUMMARY
The amendment to §157.131 provides clarification to the definition of trauma care. The amendment concerns the types of patients that can be reported in a hospital's uncompensated trauma care funding application. The amendment to the definition of trauma care requires a patient to meet a hospital's trauma team activation criteria and\or be entered into the hospital's trauma registry in addition to the existing criteria outlined in the rule language.
COMMENTS
The department, on behalf of the commission, has reviewed and prepared responses to the comments received regarding the proposed amendment during the comment period, which the commission has reviewed and accepts. Comments were received from two individuals and were not against the amendment, as discussed in the following summary of comments.
Comment: Concerning §157.131, one individual provided a comment asking clarification if the proposed rule language would impact Level IV trauma facilities because the individual perceived that Level IV facilities could not apply for uncompensated trauma care funding.
Response: The commission would like to clarify that Level IV trauma facilities can apply for uncompensated trauma care funding and the language in the proposed rule does apply. No change was made as a result of the comment.
Comment: Concerning §157.131, one individual provided a comment with concerns that the definition as stated in the proposed rule would not reimburse hospitals for patients that were transferred out of their facility because it specifically requires that they undergo "an operative intervention as defined in §157.131(a)(9) or were admitted as an inpatient for greater than 23-hours".
Response: The commission disagrees with the comment. A patient who is transferred from a facility could meet the definition of trauma care and included in the uncompensated trauma care application without having undergone an operative intervention or without being admitted for greater than 23-hours. No change was made as a result of the comment.
LEGAL CERTIFICATION
The Department of State Health Services, General Counsel, Cathy Campbell, certifies that the amendment, as adopted, has been reviewed by legal counsel and found to be a valid exercise of the agencies' legal authority.
STATUTORY AUTHORITY
The amendment is authorized by the Health and Safety Code, Chapter 773, Emergency Medical Services, which provides the department with the authority to adopt rules to implement the Emergency Medical Services Act; and Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation, provision, and administration of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 19, 2007.
TRD-200701473
Cathy Campbell
General Counsel
Department of State Health Services
Effective date: May 9, 2007
Proposal publication date: December 8, 2006
For further information, please call: (512) 458-7111 x6972