Disclaimer: These meeting minutes will not be official until approved at the 08/20/2010 Governor s EMS and Trauma Advisory Council (GETAC) Meeting

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Disclaimer: These meeting minutes will not be official until approved at the 08/20/2010 Governor s EMS and Trauma Advisory Council (GETAC) Meeting MEETING MINUTES Governor s EMS and Trauma Advisory Council (GETAC) Friday, May 21, 2010, 9:05 a.m. 10:10 a.m. Council Members: Attendance Name Position X Vance Riley, LP Fire Chief, Chair X Mike Click, RN Rural Trauma Facility X Linda W. Dickerson Public Member Luis G. Fernandez, MD Trauma Surgeon or Nurse X Jodie Harbert III, LP EMS Educator X James Randall Loflin, MD Emergency Physician X Ryan Matthews, LP Private EMS Provider X Donald G. Phillips, DO EMS Medical Director X Shirley Scholz, RN EMS Air Medical Service John D. Smith, Lieutenant Fire Department Joan Shook, MD Pediatrician X Ronald M. Stewart, MD Urban Trauma Facility X Marti VanRavenswaay County EMS Provider X Pete Wolf, EMT-P EMS Volunteer Department of State Health Services Staff: Attendance Name Position X Kathryn C. Perkins, RN Assistant Commissioner for the Division of Regulatory Services X Jane G. Guerrero, RN Director of the Office of EMS and Trauma Systems Coordination X Adolfo Valadez, MD, MPH Assistant Commissioner of Prevention and Preparedness X Maxie Bishop, LP, RN State EMS Director Item 1: Governor s EMS and Trauma Advisory Council (GETAC) The meeting commenced at 9:05 a.m. on Friday, May 21, 2010, at the Omni Southpark in Austin, Texas. A quorum was present.

Item 2: Approval of minutes A motion was made by Pete Wolf and seconded by Ronald Stewart, MD, to approve the meeting minutes from February 26, 2010. All council members were in favor; the motion passed. Item 3: Chair Report Chair Vance Riley asked everyone to observe a moment of silence for TDEM Chief Jack Colley, who passed away in early May. Chief Riley reminded the council of the need to update the current strategic plan and would like to tentatively schedule a retreat in June 2011. The proposed date to present the revised plan to the stakeholders would be January 2012. Chief Riley also requested that the GETAC committee chairs present all committee motions in writing to the council chair to ensure accuracy. Riley also requested that in August, each committee present a history of how the committee was created and its current accomplishments. Item 4: Regulatory Division Report Kathryn C. Perkins, Assistant Commissioner for the Division of Regulatory Services, says DSHS-Regulatory Services is monitoring the oil spill in the Gulf of Mexico. DSHS is evaluating the impact of health care reform and providing information to state leadership, especially as it relates to two programs that have helped the Texas/EMS trauma system develop: the Medicaid disproportionate share program (as insurance rates go up, dispro may be decreased) and the uncompensated trauma care funds. DSHS is preparing documentation for the agency s sunset review in the 2013 legislative session. Sunset is a process during which the agency s policies and programs are thoroughly reviewed by the Sunset Commission that makes

recommendations to the Texas legislature about continuation of the agency. All state agencies were asked to provide options to produce a 5 percent reduction in budget, and DSHS completed its proposal and submitted it to HHSC. Regulatory Services proposal included $10 million from the uncompensated trauma fund. State leadership cut that to $5 million. DSHS does not yet know exactly when the cut will take effect, i.e. half this year, half next year; or the full amount next year. The department expects that agencies will be directed to make additional cuts, but it does not know yet how much the cuts will be. Reductions in Regulatory Services are difficult because most programs generate revenue above the cost of operating the program. Ms. Perkins thanked everyone for their participation in the ACS trauma survey. The survey team told her they were impressed with the state and the people who participated in the survey. Item 5: State EMS/Trauma System Report Jane Guerrero, Director of the Office of EMS and Trauma Systems Coordination, thanked everyone for their participation in and cooperation with the ACS trauma survey. Current hospital designation: 254 are designated as trauma facilities, with 18 in activepursuit; and 54 are designated as primary stroke centers. Currently, only one designation coordinator position is filled for more than 300 facilities; the Division recently received approval to hire the two vacant coordinator positions. Additionally, TETAF was recently approved as the survey organization for Level III stroke support. DSHS did audits on 69 of the submitted uncompensated trauma care funding applications. Sixty of the facility responses have been approved, six are pending approval, and three responses are still pending from the facilities.

On other funding issues: the Local Project Grants (LPG) funding RFP opened April 23rd and closed May 13th. The announcement for these grant awards will be made in August. Four requests for Extraordinary Emergency Funds (EFF) were submitted (remaining balance of $900,000); and DSHS has funded nine Emergency Care Attendant (ECA) courses this fiscal year (remaining balance of $15,000). Item 6: State EMS/Trauma Registry Report/Preparedness Adolfo Valadez, MD, MPH, Assistant Commissioner of Prevention and Preparedness, reported they are evaluating the impact of budget cuts on their programs, but the EMS/trauma registry is not being cut and will continue to be a high priority. Dr. Valadez gave a report on registry projects and thanked the trauma registry solutions workgroup, including DSHS staff and the following hospital stakeholders: Mary Frost from Houston; Sandra Garcia from Dallas; Nita Gallegos from McAllen; Debra Hutton from San Antonio; Tammy Morgan from Dallas; Jan Price from Waco; Rohit Shenoi from Houston; and Louise Thornell from Texarkana. From the EMS side, he recognized Robert Folden from Commerce; Ryan Matthews from Wichita Falls; Paul Nelson from Houston; Andrew Petty from Tyler; and Marti VanRavenswaay from Fort Worth. The department posted the request for offers (RFO) for a vendor to replace the current system and a vendor selection committee has been formed and is developing specific evaluation criteria from the RFO. DSHS hopes that by September 1st, there will be a contract with a vendor in place for replacing the Trauma Registry. The department does have funding from TxDOT as well as internal funding to in place to support this project. Dr. Valadez expressed that he would like to continue discussions like these with GETAC and stakeholders to develop ways to bring the his division and EMS/trauma system stakeholder organizations closer together, particularly concerning the EMS/Trauma Registry. Dr. Valadez discussed TDEM s hurricane conference and preparations for the hurricane season. FEMA suggested DSHS review the current plan for evacuation of medical

special needs patients. DSHS is exploring the concept but changes are not being made during this year s hurricane season. DSHS supports the concept of medical strike teams. Item 7: Standing Committee/Task Force Reports Air Medical Committee Chair Shirley Scholz, RN, said the committee finished reviewing the draft of the air medical provider rule suggestions and the next step will be to work them into rules 157.12 and 157.13. The committee is planning to have suggestions ready for the council to review by August. Cardiac Care Committee no report Disaster/Emergency Preparedness Committee no report Education Committee no report EMS Committee no report Injury Prevention Committee no report Medical Directors Committee no report Pediatric Committee no report Stroke Committee no report Trauma Systems Committee Chair Ronald Stewart, MD, reported that the Trauma Registry Quality Improvement Workgroup met April 28th and came up with a draft that is ready for review. This draft will be provided to DSHS for uploading onto its DSHS website.

The committee will monitor freestanding emergency medical care facilities through the RACs to determine if they are being incorporated appropriately in the regional trauma systems. Dr. Stewart reiterated that two of the Trauma Systems Committee priorities are preserving the uncompensated trauma care monies and rebuilding the Trauma Registry. Jim Parisi provided an update from the University of Texas Medical Branch (UTMB) impact workgroup. The committee also discussed the trauma systems rule review timeline and will have proposals after the ACS trauma survey report is available. The committee is looking at geriatric/special needs from the trauma systems point of view and will partner with the Injury Prevention Committee to come up with recommendations. Item 8: GETAC Liaison Summaries DSHS Preparedness Coordination Council No report Traumatic Brain Injury Advisory Council No report DSHS Hospital Licensing Rules Review Workgroup No report Texas EMS, Trauma, and Acute Care Foundation (TETAF) Diana Welsh, CEO of TETAF, reported that the leadership summit was held on May 7th and covered strategies for preserving the Texas Driver Responsibility program (DRP) and uncompensated trauma care funding. This leadership summit developed two main priorities: the need to develop a communications strategy to preserve and increase the amount of

uncompensated trauma care funding and the need for a workgroup to look at the policy issues surrounding the DRP to see if improvements can be made that are acceptable to all stakeholders. TETAF is monitoring the current state budget deficit and testified at a hearing in April about the DRP. The hearing focused on how this program has been implemented and possible revisions. TETAF wants to make sure people understand that money allocated to trauma from this program is important and demonstrate its needs in the trauma community. TETAF has been asked to testify in a Homeland Security hearing that will be held in Amarillo in June on disaster response and coordination with trauma facilities. That same committee will be having another hearing in August that will focus more on the DRP and they are interested in TETAF s testimony. TETAF was recently named by DSHS as the organization to support the stroke certification process. TETAF will begin training for credentialing stroke surveyors in the fall and possibly start surveying facilities late this year or early next year. TETAF is trying to put together a strategic planning meeting and would like a focus for the strategic plan by the time GETAC meets in August. Item 9: Discussion and possible actions on General Counsel clarifying letter: The Council reviewed the item and no action was needed. Item 10: Public comment on committee, task force and liaison summaries and proposals No public comment was made. Item 11: Action items No action items were presented. Item 12: General public comment

No general public comment was made. Item 13: Review and list of agenda items for next meeting Meeting dates in 2010: August 18-20, 2010, in Austin; and November 20-22, in conjunction with Texas EMS Conference in Austin. Chief Riley also requested that the August agenda include each committee presenting a history of how the committee was created, its charge, and current accomplishments. Item 14: Adjournment The meeting was adjourned at 10:10 a.m.