Jane Guerrero, Director Office of EMS/Trauma Systems Coordination Texas Department of State Health Services

1. Jane Guerrero, DirectorOffice of EMS/Trauma Systems CoordinationTexas Department of State Health Services RACS GETAC DSHS

2. Objectives • provide an overview of relationships between GETAC council, GETAC committees, and state agencies. • define the roles & responsibilities of committee members • promote understanding of the state processes

3. Organizational Chart-HHSC

4. Organizational Chart - DSHS

5. Organizational Chart-Division

6. DSHS Organizational Chart Commissioner of Health: David Lakey, MD Assistant Commissioner: Kathy Perkins, RN (Regulatory) Health Care Quality Section: Renee Clack, LNFA Office of EMS/Trauma Systems Coordination: Director: Jane G. Guerrero, RN State EMS Director: Mr.Maxie Bishop Manager, EMS/Trauma Systems Group: Emily Parsons Manager, Stakeholders Information Group: Kelly Harrell

7. Office of EMS/Trauma System Programs • Governors EMS & Trauma Advisory Council • Regional Trauma Systems Development • Regional Trauma Systems Designation Program • Trauma Facility Designation Program • Funding: EMS, Trauma Facilities, and RACs • Out of Hospital/Do-Not-Resuscitate • Texas EMS Conference (annual event) • Texas EMS Magazine

8. State Trauma System Trauma Service Areas (TSA): geography Regional Advisory Councils (RAC): people Terms are used interchangeably: RACs = TSAs (sometimes)

9. State Trauma Systems 1 State Trauma System • 22 trauma service areas (TSAs) • 22 regional advisory councils (RACs) • DSHS • Regulatory authority for RACs • Funding

10. Trauma Service Areas & RACs

11. Members of the Governors EMS & Trauma Advisory Council 15 seats appointed by the governor • Emergency physician • EMS medical director • Fire chief: municipal • EMS private provider • EMS volunteer • EMS educator • EMS air medical • Fire department that provides EMS • Urban trauma center • Rural trauma center • County EMS • Pediatrician • Trauma Surgeon OR Registered Nurse • 2 general public

12. Governors EMS & Trauma Advisory Council • Established in Statute • Health & Safety Code, Chapter 773-Emergency Medical Services • Texas Administrative Code (TAC), Chapter 157

13. Vision A unified, comprehensive, and effective EMS/trauma systems for a healthy, safe Texas

14. Mission To promote, develop, and maintain a comprehensive EMS/trauma system that will meet the needs of all patients and that will raise the standards for community health care by implementing innovative techniques and systems for the delivery of emergency care for the entire population

15. Governors EMS & Trauma Advisory Council Vance L. Riley, LP, Chair Victoria Fire Department P.O. Box 1758 Victoria, Texas 77902 Work: 361/485-3450 Fax: 361/485-3459 Email: vriley@victoriatx.org TERM EXPIRES: 01/01/2016

16. Governors EMS & Trauma Advisory Council • Approximately ½ of the members must be residents of rural areas • Meetings conducted in accordance with “Open Meetings” law • Meets at least quarterly • May appoint committees necessary to perform its duties • Review comments on • EMS/trauma system rules • Strategic plan for developing • EMS and trauma care systems

17. GETAC Committees • GETAC Committee members: • Apply at designated time • Applications reviewed and voted on by chair • Committees consist of 11 members (unless exceptions are requested by chair to council) • Currently 10 Committees • Air Medical • Cardiac Care • Disaster/Emergency Preparedness

18. GETAC Committees (cont.) • Education • EMS • Injury Prevention • Medical Directors • Pediatrics • Stroke (mandated by statute) • Trauma Systems

19. GETAC meetings (historical) • Scheduled quarterly meetings • February • May • August • November meetings held in conjunction with Texas EMS Conference • Committee chair can request for additional meetings when needed.

20. ACEP – American College of Emergency Physicians (www.acep.org) AHA – American Heart Association (www.americanheart.org) CCMP – Comprehensive Clinical Management Program DADS – Department of Aging and Disability Services (www.dads.state.tx.us) DARS – Department of Assistive and Rehabilitative Services (www.dars.state.tx.us) DIRT – Data, Informatics and Research Task Force (GETAC) DTF – Designated Trauma Facility alphabet soup of acronyms

21. Committee Meeting Process • Submit agenda items to committee chair • Draft agenda • from committee chair • 30-45 days before scheduled meeting • No additions to agenda once submitted • DSHS-Legal Dept for review • need to comply with Open Meetings Act • Submit supporting documents (if applicable)

22. Committee Member Responsibilities • attend at least 50% of meetings • download meeting documents before scheduled meeting(s) • maintain contact information updated • Complete the Open Meetings/Public Information Act video training • within 90 days of their appointments • Submit copies to DSHS (OEMS/TS)

23. Rules – Rules - Rules • Where do they come from? • Best Practice • Minimum Standards

24. Overview • All rules to be reviewed – every 4 years • At least 1 change to every rule • Timeline – 30 rules • Department rulemaking process • Batches • Concept / Draft / Proposal at each meeting • Writing sessions between meetings • Published template on web • Buffer periods • Rules coordinator

25. 4-yr. review • Government Code 2001.039 • Dept. policy

26. Constant motion • 30 rules • 4 GETAC meetings / year • Legal: There’s always some necessary change

27. Timeline • Constant forward motion • Legislative mandated changes • Set calendar

28. Dept. Process • The Good, Bad & Ugly • Good: Plenty of input • Bad: Long & deliberate • Ugly: See flow chart

30. Batches • Compile according to content & effective dates

31. Concept / Draft / Proposal • 1st Reading – concept • 2nd Reading – draft • 3rd Reading – proposal

32. Writing Sessions • Stakeholder appointed by GETAC chair • Between GETAC meetings

33. Published Template • Specific rules scheduled • Concept / Draft / Proposal versions • Stakeholders can anticipate & plan discussion

35. Buffer Periods • Plan B, when disasters, etc. happen

36. Coordinator • Phil Lockwood, Stakeholder Information Group • Not content expert • Process expert (eventually) • Traffic cop

37. Summary • Every meeting: 3 batches (concept, draft, proposal) • 4 proposal batches per year (appx. 8 rules)

38. Needs • Don’t kill the messenger • Process input • Batching advice • Work session appointee • Understanding the deliberate agency rule process • Do homework – anticipate • Be patient

39. Governors EMS & Trauma Advisory Council Next GETAC Meetings: May 19-21, 2010 Omni Austin Hotel at SouthparkAustin, Texas

40. QUESTIONS? Governor’s EMS and Trauma Advisory Council (GETAC) Contact: Jane Guerrero, Director Office of EMS/Trauma Systems Coordination Phone: (512) 834-6700 Email: jane.guerrero@dshs.state.tx.us