Brazos Valley Regional Advisory Council
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Hospital Roles and Funding

Hospital Designations

Each type of prehospital care provider works in conjunction with local hospitals as specified by the provider’s medical director and the area RAC. Part of the coordination of care comes from a clear outline of a hospital’s capabilities. Currently, DSHS-licensed hospitals, state-owned hospitals and military facilities are eligible to become designated trauma facilities or designated stroke facilities, which helps direct specific medical or trauma emergency patients to the most appropriate care facility. Other hospital subspecialties such as burn centers may also impact where a patient may be treated.

Designated Trauma Facilities

DSHS can designate a health care facility as a trauma facility at four levels, based on specific criteria related to the available level of care. All designated trauma facilities must participate in a RAC and submit data to DSHS as requested.

Comprehensive (Level I) Trauma Facility

A regional resource trauma center that is a tertiary care facility central to the trauma care system. This facility must have the capability of providing leadership and total care for every aspect of injury, from prevention through rehabilitation. In addition to acute care responsibilities, Level I trauma centers have the major responsibility of providing leadership in education, research and system planning to all hospitals caring for injured patients in their regions. Physicians are available in-house 24 hours a day, seven days a week.

Major (Level II) Trauma Facility

A hospital that also is expected to provide initial definitive trauma care, regardless of the severity of injury. Depending on geographic location, patient volume, personnel, and resources, however, the Level II trauma center may not be able to provide the same comprehensive care as a Level I trauma center. Physicians are available in-house 24 hours a day, seven days a week.

Advanced (Level III) Trauma Facility

A hospital that provides resuscitation, stabilization and assessment of injury victims and either provides treatment or arranges for appropriate transfer to a higher level designated trauma facility; provides ongoing educational opportunities in trauma related topics for health care professionals and the public; and implements targeted injury prevention programs. The administrative commitment of a Level III trauma facility includes developing processes that define the trauma patient population evaluated by the facility and track patients throughout the course of their stay. Physicians are available on call 24 hours a day, seven days a week.

Basic (Level IV) Trauma Facility

A hospital that provides resuscitation, stabilization, and arranges for appropriate transfer of major and severe trauma patients to a higher level trauma facility when medically necessary; provides ongoing educational opportunities in trauma related topics for health care professionals and the public, and implements targeted injury prevention programs. The administrative commitment of a Level IV trauma facility includes developing processes that define the trauma patient population evaluated by the facility and track patients throughout the course of their stay. Physicians are not required to provide surgery call coverage.

Designated Stroke Facilities

DSHS can designate a health care facility as a stroke facility at three levels, based on specific criteria related to the available level of care. Facilities seeking Comprehensive, Primary or Support stroke facility designation are surveyed through The Joint Commission’s primary stroke center stroke certification program or another organization approved by the department to verify that the facility is meeting department-approved support stroke facility standards. All designated stroke facilities must participate in a RAC and submit data to DSHS as requested.

Comprehensive Stroke Facility Designation, Level I

The facility meets the current Brain Attack Coalition recommendations and will maintain neurosurgery capabilities, neurointerventional surgery capabilities, neurology capabilities, anesthesiology, emergency physicians, stroke medical director, stroke nurse coordinator/program manager and a stroke registry.

Primary Stroke Facility Designation, Level II

The facility meets the current Brain Attack Coalition recommendations and will maintain neurology capabilities, emergency physicians, stroke medical director, stroke nurse coordinator/program manager and a stroke registry.

Support Stroke Facility Designation, Level III

The facility meets the Support Stroke Facility Designation Criteria for an accredited support stroke facility and will maintain neurology capabilities, emergency physicians, stroke medical director, stroke nurse coordinator/program manager and a stroke registry.

Trauma systems Funding

The regional trauma systems and the designated trauma facilities within those systems receive funding from designated trauma funds that are distributed by the state. The resources for trauma systems come from the Tobacco Endowment (a portion of interest earned on the endowment is set aside as a permanent fund for EMS and Trauma care), the Driver Responsibility Program (Designated Trauma Facility and EMS Account), the 9-1-1 Equalization Surcharge Funds (EMS and Trauma Care System Account), Regional Trauma Account (Red Light Camera Funds) and the $100 DUI/DWI Conviction Surcharge Funds (Fund for EMS, Trauma Facilities, and Trauma Care Systems). The state then distributes funds to each of the 22 RACs through contract agreements for trauma system development and grants, to eligible EMS providers for equipment and non-disposable supplies through the local RAC, and to trauma facilities that have met designation criteria and have completed yearly applications requesting reimbursement for uncompensated trauma care.