GETAC and TETAF Summary
November 2014
Disaster
 Texas Disaster Medical System (TDMS) Update - (Dr. Emily Kidd) – continue to work on the
overview document which is expected to be complete at first of the year; mass fatality
management training; resource typing is still working on typing all Texas teams; working on crisis
standards for care; TMORT being housed at a State University but is undetermined at this time;
Medical Countermeasures survey will be coming out; setting 2015 priorities with the GETAC
Disaster Committee.
 Emergency Medical Task Force (EMTF) Update – (Victor Wells) – have established 3 deployable
Type 1 Pharmacy Caches located in EMTF 8, 7, & 2; will be including AMBUS Medical Directors
with EMTF Medical Directors because they are not the same physicians; EMTF display at the EMS
Conference Exhibit Hall; tasking EMTF Coordinators and Ops to discuss partnerships with
hospitals, etc. to help rotate stock before expiration; AMBUS notification directly from CADs when
deployed – still needs some work; tasked STANDARDIZATION in 2015; increase physician
participation.
 Medical Incident Support Team (M-IST) and Ambulance Strike Team Leader (ASTL) Courses –
(Victor Wells) - training dates will be made available soon; April 28-29, 2015 for M-IST with
location to be determined.
 Power Grid/EMP/Loss of Infrastructure Presentation – (Dan Woodfin, ERCOT) – Texas is separate
from the rest of the State; ERCOT handles 90% of the electric need in Texas; shed plan is setup at
the local level, ERCOT only assist with the load amount not how it is done, they determine which
lines are actually crisis load – hospitals, military bases, etc. (established definition); Geomagnetic
Disturbance (GMD) is naturally occurring (solar) and Electromagnetic Disturbance (EMD) is
manmade; #1 ensure that critical locations are noted locally; #2 planning with electric provides.
 2015 Goals – STANDARDIZATION; crisis standards of care during electric emergency; increase
physician participation in EMTF; tracking EMS routinely; infectious disease response.
Pediatric
 Committee Liaison Reports.
 Update of Child Fatality Review Team (CFRT) – (Amy Bailey, State CFRT Coordinator) – Forming a
drowning prevention workgroup December 2nd, comprehensive drowning data set, evidence –
based drowning prevention education; will work with DSHS to join together the trauma and
submersion registries
 CT Radiation position paper – postponed to February.
 Pediatric Facility Recognition Program – (Sally Snow) – takes many years to establish; workgroup
partnership with EMS-C; supports a voluntary program.
 EMS-C Update – (Sam Vance) – EMS Recognition program, possibility of the RACs doing the
surveys; it is voluntary.
o Special Needs Assistance Program (SNAP) Presentation – (Injury Prevention at Cook’s) –
very similar to STEAR and four other similar databases.
 Pediatric Transport Guidelines Document – (Sally Snow) – APPROVED as presented.
 EMS Clinical Guidelines Project – (Sam Vance) – have been completed, are available for use, and
may be found on the NAEMSO website.
 Quality Performance Metrics for Pediatrics – DI’s CV5 that does not have a State connection but is
working on it; many of the pediatric facilities are moving to CV5.
 Trauma Registry Report – expect the release of upload update within the next two weeks; moving
forward the Registry will email all with upcoming changes and when they will be available; will be
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working with the CFRT Drowning Workgroup; once the new release comes out and everyone is
getting data into the State registry, they will be able to provide statewide reports on a regular
basis, a pediatric report available for review on the DSHS website.
Strategic Plan Update – this will be discussed at a December 15th meeting.
PUBLIC COMMENTS: Sam Vance recommends inclusion of pediatrics in disaster preparedness in
the strategic plan and how military bases are caring for children to include military EMS and
military hospitals; Christine Reeves commented on steering towards a single pediatric registry for
special needs as well as keeping the Perinatal/Maternal designation process.
Injury Prevention – attended another meeting during this time.
 Welcomed new members to the Committee (Shelli Stephens-Stidham)
 Trauma Registry Update
 GETAC Strategic Planning
 injuryfreetexas.org
 PUBLIC COMMENTS: add resources for military returning with PTSD
Stroke – came in late due to another meeting.
 Recommendation from Brain Attack Coalition (BAC) for stroke ready hospitals as a basis for
acceptable certification of Level III stroke support facilities (Dr. Alberts) – APPROVED and moving
forward to GETAC.
 4 hours of Stroke Education for EMS to Recertify (HT Fillingim) – will continue to work on this issue
with not only the EMS Education but EMS and EMS Medical Directors as well; Jodie Harbet spoke
to some of the issues; supports standardized stroke education but not necessarily the number of
hours; objectives are more important.
 Transport Bypass Workgroup Update (Dr. Craven) – reviewed half of the RAC plans; looking to
adding severity adjusted triage criteria for hospital bypass by EMS; interested in people that wish
to help.
 Hospital Database Surveillance Subcommittee (Deb Motz) – 10 stroke data elements: mode of
arrival, diagnosis, tPA 3-4 ½ hours, door to needle time, complication rate & definition, mortality
rate, discharge disposition, tPA rate, number of IV tPA out of hospital (drip & ship), number of
intravascular cases, # of ischemic strokes, and initial NIH scale; Dr. Bill Moore asked about
tracking when tPA was given in a perceived contra-indicator; El Paso suggested tracking strokes
called from the field (over and under activation).
 PUBLIC COMMENTS – Dr. Rutledge asked: Is EMS required to take patients to freestanding EDs?
No. Are there “up time” requirements for designated centers? No, but will ask how long the
“down time” will be must be reported to the RAC and DSHS. SETRAC announced their Stroke
Conference April 30-May 1 in Houston – Emergency Medical Life Support (EMLS) will be available,
partner with American Heart Association and host the Stroke Coordinator training.
Air Medical
 Moment of Silence and Prayers for AEL – Wichita Falls recent helicopter crash.
 Reviewed accomplishments of Air Medical Committee (Alicia McDonald)
 Ebola Discussion Opportunity – nothing brought up exception to look at infection control practices.
 EMS-C Pediatric EMS Recognition Program Presentation – (Sam Vance) – generally explained the
program’s Bronze (affidavit process), Silver (survey process), and Gold (survey process) levels;
equipment list is only for ground units and wants input from air providers for an air medical
providers; Amarillo RAC will be piloting this program.
 EMTF and Air Medical – (Eric Epley) – almost all providers have signed on; fixed wing is working
on the reimburse rates for the State MOA; once the MOA is done then would like to have a group
begin to meet/conference call; need to Type airports.
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EMS interstate compact agreement for training/clinical rotations - no update from DSHS at this
time.
Trauma Registry Update (Traci Fox) – meeting is tomorrow; holding webinars and calls.
**EMS Run Sheet and Facility Loop Closure – DSHS looking for barriers to leaving a brief report
and/or a full report; a complete run report must be provided to a facility within 24 hours.
Strategic Plan Recommendations (Alicia McDonald) – move to emergency healthcare; better
inclusion of EMS and air medical; revisit emergency medical dispatch; will hold a separate meeting
to discuss and provide finals recommendations to GETAC Council on January 7 in Austin at a
location to be determined.
Air Medical Committee Accomplishments (Alicia McDonald) – pulled minutes from 2003 to present
to develop a list of accomplishments.
Cardiac
 Most of the discussion was about the Texas Heart Attack Coalition and what this committee could
do to be supportive moving forward.
 Data was provided to the committee on the cardiac and stroke data that was collected by the RACs.
 Very lengthy discussion on data and how to collect it; what to do with it
TETAF
 Very low attendance of Board members, RACs, and RAC membership.
 Scott Christopher chaired the meeting.
 Acute Care (Brenda Putz) – CVD Partnership, Lisa Hutchinson was elected Chair of the partnership.
 EMS (Ricky Reeves) – no update.
 Education (Courtney Edwards) – moving forward with data management course in February.
 Injury Prevention (Robin Garza) – postponed TIPS from February to August 2015; Just Drive
Campaign is under way and TTCF has purchased give-a-ways; TETAF partnering with DSHS for
grant funding for the data management course.
 Pediatrics (Lori Vinson) – e codes for child abuse project were delayed due to issues with the State
Registry that should be ready by the next meeting; December 15th meeting in Dallas to discuss
working with EMS-C.
 RAC (Shae Watson & Eric Epley) – Media Training in Austin; sum total of RACs can be split into 3
areas: scope/work, enabling language, and funding; RAC have not been good at the enabling
language portion; lengthy discussion on RAC funding and needs; approves money for another RAC
leadership summit within the next 6 months.
 Trauma (Lisa Price) – burn group still working on clinical guidelines; busy doing surveys;
surveyor process is currently open for nurses and physicians.
 Perinatal Council Update (Brenda Putz) – NICU designation proposal being prepared by TETAF,
looking for someone with NICU experience to help with the proposal; December 2nd is the next
meeting date at the ITT Building on Hwy 290 in Austin; NICU designation by 9/1/17 and
Maternal/Child designation by 9/1/19.
 Legislative Update (Dinah Welsh) – 21 of 22 RACs responded to the TETAF survey; documents
being prepared for the legislative session; 9 new members in the Senate; Senate Finance Chair is
expected to be Senator Jane Nelson; Senator Charles Schwertner is expected to be the Health and
Human Services Chair (one of our Senators); Trauma Day at the Capital on February 17th; updated
the Drivers Responsibility Program (DRP) meeting this week with the Urban County Judges,
currently supporting leaving the DRP.
 TETAF Update (Dinah Welsh) – announced that Ann Ward will be retiring the end of this year;
interviewing for the legislative position and expand it to a Legislative Communications
Coordinator and plan to offer this week; Milkshake Media (Live Strong yellow arm bands) is being
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interviewed as a marketing firm for TETAF; will be getting the Structure Workgroup back together
but the staff has been working up.
University of Houston Study of the Texas Trauma System – report expected the first week of
December to TETAF and still expected to have out to us by the end of the year.
Treasurer’s Report (Dinah Welsh) – +$101,759.17 for the year ending August 30, 2014; mainly due
to contingency surveys that were no budgeted; +$52,067.60 in September; -$10,705.89 in October.
Secretary’s Report (Scott Christopher) – August face-to-face meeting minutes provided; October
conference call minutes will be transcribed from the recording and presented at the next
conference call meeting.
Open Discussion – none.
Education
 Committee discussed its accomplishments since its beginning.
 Ebola- retraining donning and doffing on PPE and the advanced skills that it takes to complete this
task especially if you are not used to taking care of infectious patients. How many education
programs actually do an N-95 fit testing for their students? Discussion of differences between
entry into a scene, patient contact and exposure.
 RAC EMS Educational Opportunities in the Panhandle- a request for a list of needs specific to the
area to TSA A, so that the committee can collect those resources . One issue was age demographics
of paramedics especially in rural areas TSA A stated that there are only about 325 new certifying
paramedics / year for the whole state and that they are predominately in the urban areas. Also a
request for a report on how many paramedics /year do not renew their license.
 Development of Community Health Paramedic Curriculum- rural area development of educational
opportunities is in progress. How can we continue to employee and develop paramedics in urban
and frontier areas? There should be a basic core of requirements for the paramedic’s education
that is state wide developed. The paramedic in rural and frontier settings may need additional
education d/t more primary care necessities. In addition, medical record education should also be
developed into these curriculums. We as educators should look at the future and realize that a
good solid foundation is what we need to consider when developing the curriculum. We also need
to consider the funding stream required to provide this. Minnesota has a state model / legislature
that supports this. A need for a change in rules to where a patient can be transported and some
system changes needs to be develop as well. Book “Mobile Integrated Healthcare: Approach to
Implementation “ by Matt Zavadsky is a recommended read.
EMS
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Reviewed accomplishments of EMS Committee.
Ebola preparedness discussion. Using this event, to remind EMS about infectious disease
preparedness across the board not just focus on Ebola.
Rule Revision 157 Update – no update at this time; having a meeting December 11th at the Pickles
Center in Austin from 10am-4pm to re-review the recommendations for Rule 157.11 initially and
moving through; expecting to take the committee on a road show for input.
**EMS Run Report Discussion
All other items tabled due to time.
EMS Medical Directors – (Unable to attend due to another meeting.)
 **EMS Run Report discussion
RAC Chairs
 Funding and staffing reports were provided by DSHS.
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Long discussion on the “RAC Champion for the State Registry” and training that is being made
available. This topic was clarified in Trauma Systems.
Some discussion on the development of RAC Executive Director mentoring program. RAC ED
Summit is scheduled for December 18-19 in San Antonio.
Discussion on Ebola surveys from RACs (Ray Apodaca).
Trauma
 Jorie Klein reviewed the history and accomplishments of the Trauma System in Texas. Each RAC
was given a chance to highlight where they are now versus where they were in 1993.
 Jorie reviewed general 2013 trauma stats for the State.
 Ebola Discussion (Jorie Klein) – asked for lessons learned PowerPoint to be sent to DSHS to be
posted on the website; shared Parkland’s preparedness activities.
 Rule Revision Update (Jane Guerrero) – DSHS is almost ready to review the draft rules with
Committee Chairs and have ready for February GETAC.
 GETAC Strategic Planning (Jane Guerrero) – No update available from DSHS.
 Trauma Registry & Registrars Workgroup Update (Jorie Klein) – Thanked Chris Drucker for his
work. She reported that the data was not complete. Adopted NTDB 91 data elements but DSHS
uses 9 data elements. Recommending all 91 elements as required starting January 1, 2015. 22
hospital champions and 22 EMS champions for the data management course (February 26-27,
2015 – 100 total spaces available); 49 Level IIIs and 22 hospital reps for AAAM AIS course.
 Pediatric Trauma Coding (Lori Vinson) – will need to report out in February due to data registry
issues.
 Alcohol-related Injuries – will need to report out in February due to data registry issues.
 **EMS Run Report Requirement (Jorie Klein) – Chapter 157.11 (m) (9) – must leave an abbreviated
report at the time of the patient “drop-off” and a full report within one business day; it is
important for the hospitals to provide loop closure back to the EMS Providers (this is not a HIPPA
violation).
GETAC
 Chair Report (Dr. Bobby Greenberg) – Covering for Chief Vance due to a family emergency.
 Assistant Commissioner of EMS/Trauma Systems Report (Kathy Perkins) – Continued Ebola
planning across the State; reviewed the surveys that DSHS have collected through the RACs;
preparation for the legislative session; no major issues in the Department’s LAR, figured in a 10%
cut; Sunset report – no major impacts to EMS/Trauma in the report, one bill for DSHS clean up,
one bill for DSHS sunset recommendations, Health & Human Services Commission (HHSC) sunset
(HB2292) from 12 to 5 and new one is 5 to 1 (just HHSC) with only one administrative section,
only one hearing so far, December 10th second hearing and will vote on recommendation; new bill
filing: 570 filed already: HB142 – red light funding repeal; SB93 repeals DRP; HB237 (Springer)
state agency may not require a industrial ERT be certified (under government code) or require a
volunteer firefighter to be certified; SB66 epi auto-injectors in all schools and advisory committee
for implementation; recognized Fernando for 30 years of services.
 State EMS/Trauma System Report (Jane Guerrero) – 2015 meeting dates have been set in Austin at
the Crowne Plaza for February 18-20, May 13-15, August 19-21, and November 21-23 in Dallas;
reviewed total number of Trauma and/or Stroke Designated Center; funding report provided; LPG
awards should be posted sometime the first week of December; discussed the trauma registrars
training coming up.
 Assistant Commissioner of Epidemiology & Disease Registries Report (John Villanacci) – Announced
the promotion of Chris Drucker to Registry Manager; reviewed the trauma registry training;
holding webinars and looking for suggestions on additional needs;
 Assistant Commissioner of Regional & Local Health Services – no update provided.
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Preparedness Coordinating Council (Eric Epley) – No meeting due to Ebola.
Committee Reports
Update from Joe Schmider on the Administrator of Record (AOR) course; the first went well at
EMS Conference; 206 AORs have passed the course; no other courses at this time; waiting for the
evaluations from this course; possibly online in the future.
TETAF Update (Dinah Welsh) – focus on funding at the legislature; DRP on the block again for
possible repeal and expect additional bills with different wording; February 17th – Day at the
Capital, bringing in trauma survivors, hosting a Survivors Reception with Legislators
EMS-C Update (Sam Vance) – nothing to add to Pediatric Report; will be presenting the EMS-C
EMS agency survey data; Dr. Macias is the chair of the emergency medicine for ACEP; Sam sitting
on several national leadership roles
ACTION ITEMS
o Endorsement of the Injury Prevention’s document entitled “Hospital-based Injury
Prevention Components” – APPROVED
o Endorsement of the Injury Prevention’s position paper on Workforce Development
(supports Safe States) – APPROVED
**Rule 157.11 (m)
(9) assuring that patient care reports are provided to emergency facilities receiving the patients:
(A) the report shall be accurate, complete and clearly written or computer generated;
(B) the report shall document, at a minimum, the patient's name, condition upon arrival at the scene; the
prehospital care provided; the patient's status during transport, including signs, symptoms, and responses
during the transport; the call initiation time; dispatch time; scene arrival time; scene departure time; hospital
arrival time; and, the identification of the EMS staff;
(C) whenever operationally feasible, the report shall be provided to the receiving facility at the time the
patient is delivered; and/or
(D) if in a response-pending status, an abbreviated written report shall be provided at the time the patient is
delivered and a full written or computer generated report shall be delivered to the facility within one business
day of the delivery of the patient.