EMERGENCY
PREPAREDNESS
AND
HEALTHCARE
PLAN
Introduction
NAME
The organization will be known as Northeast Texas Regional Advisory Council. (NETRAC).
NETRAC represents Trauma Service Area F (TSA-F), as designated by the Texas Department of
Health (TDH). TSA-F includes the following counties:
Bowie County, Texas
Cass County, Texas
Delta County, Texas
Hopkins County, Texas
Lamar County, Texas
Miller County, Arkansas
Morris County, Texas
Titus County, Texas
Red River County, Texas
MISSION STATEMENT
Provide a comprehensive continuum of quality health care for all victims of disasters, trauma,
and acute care in TSA-F without regard to age, race, sex, color, national, origin, disability,
religion, or ability to pay. Provide disaster preparedness, trauma, and acute care prevention
activities and education to professionals and the public within TSA-F.
PRINCIPAL OFFICE
The principal office of the Corporation in the State of Texas shall be located at 4090 Summerhill
Square - Texarkana, Texas. The Corporation may have such other offices, either in Texas or
elsewhere, as the General Assembly may determine. The General Assembly may change the
location of any office of the Corporation.
REGISTERED OFFICE AND REGISTERED AGENT
The Corporation shall comply with the requirements of the Act and maintain an office and
registered agent in Texas. The principal office of the Corporation may, but need not be, in the
State of Texas. The General Assembly may change the main office or principal place of business
and the registered agent as provided in the Act.
Texas Trauma Service Area F consists of 9 counties. Although there are eight (8) hospitals
serving these 9 counties, only five (5) have bed capacity exceeding 100.
As of July 1, 2012 , the following TSA-F hospital
Level 1: None
Level 2: None
Lead Level 3:
Titus Regional Medical Center – Mt Pleasant, Texas (Titus County)
Level 3:
Wadley Regional Medical Center – Texarkana, Texas (Bowie County)
Level 4:
East Texas Medical Center – Clarksville, Texas (Red River County)
Good Shepherd Medical Center – Linden, Texas (Cass County)
Hopkins County Memorial Hospital – Sulphur Springs, Texas (Hopkins County)
Non-designated
CHRISTUS – St. Michaels – Texarkana, Texas (Bowie County)
Paris Regional Medical Center – Paris, Texas (Lamar County)
The original trauma plan for TSA-F was distributed July 13, 1999 to the Regional Advisory
Committee members in preliminary form. The plan and suggested modifications were voted
upon. The plan in final form was signed by the Chairperson of NETRAC and forwarded to the
Texas Department of Health for approval. The Trauma Plan for Trauma Service F will be
reviewed annually by the Board of Directors and changes will be presented to the membership at
the next scheduled meeting.
This Trauma Plan incorporates major trauma triage criteria to identify those persons to be
transported to a trauma center. The Plan also establishes a formal evaluation mechanism to
determine whether trauma patients receive appropriate care. These mechanisms encompass data
recording and collection, evaluation and analysis of data, and incorporation of needed changes as
recommended by various quality assurance and improvement monitors. The collection,
evaluation and improvement actions will be a cooperative process among physicians, prehospital, and hospital personnel.
RAC Executive Officers and Board Members
NETRAC OFFICERS
2012 - 2013
Chair:
Chair Elect:
Chair Past/Vice:
Executive Director:
Treasurer:
Assistant Treasurer:
Secretary:
Russell VanBibber Elected 10/09
Robin Gage
Mark Mallory
Shae Watson
Norman Prewitt
Meagan Beauchamp
Vornetta Compton
NETRAC OFFICERS AND BOARD MEMBERS
2012-2013
Chair:
Chair Elect:
Chair Past/Vice:
Executive Director:
Treasurer:
Assistant Treasurer:
Secretary:
Russell VanBibber Elected 10/09
Robin Gage
Mark Mallory
Shae Watson
Norman Prewitt
Meagan Beauchamp
Vornetta Compton
Education:
EMS/Aeromedical:
Hospital:
Nurse:
At-Large:
Rehab:
Physician:
Response Partner:
Blaine Jones
Brent Smith
Mark Mallory
Bertha Evans
Connie Stauter
Scott Reid
Elected 10/11
Elected 10/11
Elected 10/11
Elected 10/10
Elected 10/11
Elected 10/10
Mary Beth Rudel
Elected 10/10
System Plan Participation
It is crucial that each involved entity be accountable for participation within the Regional
Advisory Council for TSA-F to remain in compliance with standards set forth by the Texas
Department of Health. Only with collective participation, can an effective and efficient trauma
system plan function on a region-wide basis.
Regional Advisory Council meeting notices are published on the NETRAC Website and are
emailed to the following, but not limited to:
Health Care Facilities, i.e., Hospitals
Emergency Medical Services (EMS)
Physicians from various specialties
Emergency Response Parnters
County and/or City Clinics
NETRAC Executive Board Members
NETRAC Committee Chairs and Committee Members
Non-profit community health and safety agencies
At each RAC meeting, a general roster is placed for each attendee to sign-in by name and
representing facility. These rosters serve as the identifiable means of tracking what
facilities/agencies have been represented and are considered to be participating in the RAC.
General sign-in rosters are also kept by individual committee chairs and serve as further tracking
information of what facilities are represented and participating in various committee-planning
stages.
Participation is defined as individuals or entity representation actively pursing interest and
involvement in the priorities and goals set forth by the Regional Advisory Council for TSA-F as
defined by each committee RAC approved mission statement and plans.
To confirm the above, individuals or entity representatives must be accounted for by attending
three or more RAC meetings per year, AND, individuals or entity representatives must attend
two or more committee meetings of their choice, AND, entities must be in compliance of the
Regional Advisory Council Emergency Preparedness and HealthCare plan for TSA-F within the
guidelines set forth by the Texas Department of State Health Services.
Persons involved in system planning are as follows but not limited to...
Health Care Facilities, i.e.,
Hospitals Emergency Nurses Association and members
Physicians from various specialties
EMS Agencies
County and/or City Clinics
NETRAC Executive Board Members
NETRAC Disaster Preparedness Committee Chairs and Committee Members
Mobile Medical Unit:
Communications:
Northeast Texas Regional Medical
Operations Center (NETMOC):
Symposium Committee:
Mobile Medical Unit Committee Members:
Shae Watson
Robin Gage
Karen Stephens
Bertha Evans
Russell VanBibber
Mark Mallory
Meagan Beauchamp
Russell Thrasher
Brent Smith
Wade Cannon
Sarah Campbell
Frank Williams
Vornetta Compton
Norman Prewitt
Kent Klinkerman
Greg Friesen
Jeff Nichols
Dave Dutton
Beckie Lewis
JJ Vaughan
Scott Reid
Keith Kelley
Sandra Jeffrey
Danny Wilburn
Mike Western
Bruce Bushee
Gloria Cooper
Alasha Williams
LeighAnnScates
Dr. Michael Williams
Robin Gage, Chair
Karen Stephens, Chair
Mark Mallory, Chair
Shae Watson, Chair
Shae Watson, Chair
Communications Members:
Shae Watson
Mark Mallory
Russell VanBibber
Russell Thrasher
Kent Klinkerman
Brent Smith
Scott Conway
Scott Reid
NETMOC Committee Members:
Shae Watson
Mark Mallory
Norman Prewitt
Meagan Beauchamp
Russell Thrasher
Bertha Evans
Karen Stephens
Vornetta Compton
Drills/Exercise Committee Members:
Shae Watson
Norman Prewitt
Bertha Evans
Blaine Jones
Keith Kelley
Mary Beth Rudel
Vornetta Compton
Symposium Committee Members:
Shae Watson
Robin Gage
Vornetta Compton
Bertha Evans
Meagan Beauchamp
Liberty Bailey
Russell VanBibber
Russell Thrasher
Blaine Jones
Dave Dutton
Carol Slider
NETRAC Trauma/Acute Care Committee Chairs and Committee Members
Acute Care:
EMS/Aeromedical:
Hospital/Registry/Quality Improvement:
Injury Prevention/Pediatrics/Education:
Acute Care Committee Members:
Kathy Griffis
Dr. Khalid Malik
Dr. Nancy Griffin
Denise Dowell
SherFomby
Cyndi Chamblee
EMS/Aeromedical Committee:
Brent Smith
Danny Wilburn
Mark Mallory
Russell Thrasher
Brent Smith
Kent Klinkerman
Ricky Draper
Dave Dutton
Jim Spier
Scott Miller
Denis Roach
Patrick Barkley
Stephanie Jackson
Hospital/Registry/QI Committee:
Keith Kelley
Vornetta Compton
Bertha Evans
Dr. Morney Sorenson
Leigh Ann Scates
Meagan Beauchamp
BeckieCressionnie
Louise Thornell
Liberty Bailey
Jeff Nichols
Kathy Griffis, Chair
Brent Smith, Chair
Keith Kelley, Chair
Blaine Jones, Chair
Injury Prevention/Pedi/Education Committee:
Blaine Jones
Robin Gage
Russell VanBibber
Melissa Granberry
Shannon Cox
EMERGENCY
PREPAREDNESS
Northeast Texas Preparedness Coalition(NETPC)
The Northeast Texas Regional Advisory Council(NETRAC) Board of Directors(Board) and Ark-Tex Council of
Governments (ATCOG) recognizes the Northeast Texas Preparedness Coalition (NETPC) as the Preparedness
Coalition for the geographic area encompassing Trauma Service Area F (TSA-F) and ATCOG and as a Standing
Committee of the NETRAC Board, with the authority, responsibilities and specific duties as described in this
Charter.
Definition:
For the purposes of this instrument, Charter shall be defined as: “A written instrument given as evidence of
agreement.”
Composition of the NETPC Governance Board:
The NETPC Governance Board shall consist of the following:
Voting Members:
 3 - Hospital Representatives (1 Lead Level III Facility; 1 – Level III Facility; 1 – Level IV Facility)
 3 - EMS Representatives(1 Large EMS Agency; 1 – Medium EMS Agency; 1 – Small EMS Agency)
 1 - City Emergency Management Representative;
 1 - County Emergency Management Representative;
 1 - Public Health Representative;
 1 - Response Partner Representative;
 1 - At Large Position chosen by NETRAC Board Chair;
Non-Voting Members:

NETRAC Executive Director

NETRAC Chair

Hospital Planning Group Chair

NETRAC Treasurer

ATCOG Homeland Security Manager
NETPC Governance Board Membership Votes:
Voting:
All members of the NETPC Governance Board shall have voting rights with the exception of the
NETRAC Executive Director and the ATCOG Homeland Security Manager. No employee of these two
organizations shall have voting rights in the NETPC.
Non-Voting: Invited guests and any employee(s) of the two organizations, including, but not limited to, the
organization’s Executive Director.
NETPC Coalition Membership:
The NETPC Coalition should be made up of the following members:
Primary Members:
Participating NETRAC Hospitals and Healthcare organizations
Participating NETRAC EMS Agencies
Participating NETRAC Colleges/Universities
Participating ATCOG Public Safety Agencies
Elected Officials
Essential Partners Members:













Emergency Management/Public Safety
Department of State Health Services (DSHS)
Emergency Medical Task Force (EMTF)
Long-term care providers
Mental/Behavior health providers
Private entities associated with healthcare (e.g., Hospital Associations)
Specialty service providers (e.g., dialysis, pediatrics, woman’s health, stand-alone surgery, urgent care)
Support service providers (e.g., laboratories, pharmacies, blood banks, poison control)
Primary care providers
Community health centers
Local/Public health
Tribal healthcare
Federal entities (e.g., National Disaster Medical System (NDMS), Veteran’s Affairs (VA) hospitals, Indian
Health Services (IHS) facilities, Department of Defense facilities)
Additional Healthcare Coalition partnerships/memberships:










Local and state law enforcement and fire services
Public Works
Private organizations
Non-governmental organizations
Non-profit organizations
Volunteer Organizations Active in Disaster (VOAD)
Faith-based Organizations (FBOs)
Community-based Organizations (CBOs)
Volunteer medical organizations (e.g., American Red Cross, Medical Reserve Corp, CanHelp 211)
Others partnerships as relevant
Mission and Scope:
The mission and scope of the NTCP Coalition is to encourage collaborative healthcare community planning and
emergency preparedness planning to natural and man-made disasters affecting the NETRAC and ATCOG region by
providing an aligned forum for persons, businesses, healthcare entities, and public safety agencies within or
surrounding the geographic boundaries of NETRAC and ATCOG.
Responsibilities, include, but are not limited to, the following:
1.
2.
3.
4.
5.
6.
7.
8.
Coordinate with local, regional and state officials/jurisdictions in planning efforts for the healthcare
community and emergency preparedness community.
Identify and determine gaps in planning, resources, education, or training and develop action plans to
support educational and process refinement.
Facilitate integration with local, regional and state response partners.
Assist in development and execution of exercises and drills based on identified needs/issues, formulate
corrective action plans, and perform follow-up measures to ensure best practices have been instituted.
Ensure sustainment of medical coordination through support of the Northeast Texas Medical Operations
Center.
Coordinate planning with response partners for unique needs of special medical populations/at-risk
individuals.
Disseminate planning and response initiatives.
Provide and receive guidance and recommendations to/from the NETRAC Board, ATCOG and other
committees, including ad hoc committees, on planning initiatives, program development and grant
expenditures.
The NETPC Coalition may establish subcommittees as part of the committee structure designated to accomplish
these responsibilities.
REPORTING STRUCTURE:
The NETPC Governance Board reports each meeting to the NETRAC Executive Board and ATCOG.
CHAIR:
The Chair of the NETPC Governance Board will be appointed by the NETRAC Chair and will serve a two year
term.
TERM:
NETPC Governance Board Members will be appointed for a term of two years unless representation is positiondesignated by the NETRAC Executive Board.
ROLE OF NETPC CHAIR:
The Chair of the NETPC is responsible for the following:
 Working with the NETRAC Executive Director and ATCOG Homeland Security Manager on setting the
agenda and ensuring that agenda items are addressed.
 Facilitating achievement of committee priorities.
 Communicating the activities of the NETPC to the NETRAC and ATCOG Board of Directors and
following up on issues identified.
 Identifying planning gaps within the purview of the NETPC and addressing those issues in an appropriate
manner.
 Referring planning gaps or concerns outside the purview of the NETPC to the appropriate
committees/departments
ATTENDANCE:
Members of the NETPC Coalition are expected to attend (75%) of all meetings annually and actively participate in
all meetings. If an NETPC member is unable to attend, this should be communicated in advance to the NETPC
Chair, NETRAC Executive Director, or the ATCOG Homeland Security Manager.
Annually, the Northeast Texas Regional Advisory Council (NETRAC) – Hospital Preparedness
Group reviews the regional Hazardous Assessment. This assessment aids in annual planning for
our region.
Figure 1: NORTHEAST TEXAS HAZARD MATRIX
HAZARD TYPE:
FREQUENCY
WARNING TIME
SEVERITY
RISK
PRIORITY
Unlikely
Minimal
Catastrophic
Low
Highly Likely
6-12 hours
Limited
High
Likely
24+ hours
Limited
Medium
Unlikely
24+ hours
Negligible
Low
TORNADO
Highly Likely
Minimal
Catastrophic
High
WILDFIRE
Likely
Minimal
Critical
Low
WINTER STORM
Likely
24+ hours
Catastrophic
Medium
Possible
24 + hours
Critical
High
Possible
Minimal
Critical
Medium
NATURAL
EARTHQUAKE
FLASH FLOODING
FLOODING (RIVER OR
TIDAL)
HURRICANE
ENDEMIC/PANDEMIC
MAN-MADE
CHEMICAL/HAZARDOUS
MATERIALS
DAM FAILURE
Unlikely
Minimal
Critical
Low
Likely
Minimal
Limited
Medium
Unlikely
Minimal
Catastrophic
Low
FREQUENCY
WARNING TIME
SEVERITY
RISK
PRIORITY
Highly Likely
Minimal
Critical
Medium
Possible
6-12 Hours
Critical
Low
Highly Likely
Minimal
Limited
High
CIVIL DISORDER
Unlikely
6-12 Hours
Negligible
Possible
EXPLOSION
Possible
Minimal
Limited
Low
WEAPONS ASSAULT
Possible
Minimal
Limited
Low
TERRORISM - CHEMICAL
Possible
Minimal
Catastrophic
Low
TERRORISM - BIOLOGICAL
Possible
Minimal
Catastrophic
Low
TERRORISM - RADIOLOGICAL
Possible
Minimal
Catastrophic
Low
TERRORISM - NUCLEAR
Unlikely
Minimal
Catastrophic
Low
TERRORISM - EXPLOSIVES
Possible
Minimal
Catastrophic
Low
FIRE
NUCLEAR FACILITY
INCIDENT
HAZARD TYPE:
POWER OUTAGE
WATER SYSTEM FAILURE
ACCIDENTS
(TRANSPORTATION)
TERRORISM –
COMMUNICATIONS FAILURE
Possible
Minimal
Critical
Medium
MOBILE MEDICAL UNIT (MMU):
In 2006, NETRAC purchased a 28-bed field deployable tentage system. NETRAC also
purchased supplies and equipment to care for patients within our region. The MMU use the ICS
Structure for operations.
Northeast Texas Regional Medical Operations Center (NETMOC):
During the event of a disaster or hazardous event within our region, the NETMOC will act as the
Health and Medical Component for regional Emergency Operations Centers, and the District
Disaster Centers.
“Mission Statement”
“To aid and provide assistance by coordinating regional assets and resources during
the time of disasters.”
NETMOC
POLICY AND PROCEDURE: LOCATION OF ACTIVATION
Location of Activation:
 Set-up at and with the MACC at the ATCOG – 4808 Elizabeth Street - Texarkana,
TX 75501
 NETMOC can also become a Mobile MOC to be deployed within the region
NETMOC
POLICY AND PROCEDURE: ACTIVATION CRITERIA
Activation Criteria:
 Any local disaster that exceeds the resources of the local Emergency Operations Center
 Upon request of the State SOC and State DDC
 Upon request of the Mobile Medical Asset needs
NETMOC
POLICY AND PROCEDURE: ACTIVATION AUTHORITY
Activation Authority – the following have activation authority
 MACC
 RAC Chair
 Executive Director
 Executive Board Members
NETMOC
POLICY AND PROCEDURE: STAFFING
Address Staffing:
 Shifts will be 12 hours
 Minimum of 1 person per entity per 12 hour shift
Must have ICS 100, 200, 700, and 800
NETMOC PROCESS FLOW AT THE MACC
(NETMOC duties: Assign patients
To hospitals in/out of RAC; EMS
Deployment; Resources Deployment)
NETMOC
EOC
Medical Incident Commander needs to be the
1st Responder on the scene
(Identifies patients as:
Red, Yellow, Green, or Black)
MEDICAL
INCIDENT
COMMANDER
COMMANDER
MOBILE MEDICAL UNIT (MMU) COMMITTEE:
The NETRAC MMU Committee provides oversight for all the NETRAC MMU operations, to
include planning, staffing, transportation efforts for deployment.
NORTHEAST TEXAS REGIONAL MEDICAL OPERATIONS CENTER (NETMOC)
COMMITTEE:
The NETRAC NETMOC Committee provides health and medical directions for regional
response partners, Disaster District Chairs, and State Medical Operations Center during the effort
or a disaster.
COMMUNICATIONS COMMITTEE:
The NETRAC Communications Committee provides oversight for all the NETRAC
Communications Systems. The committees focus is to ensure our region has interoperable
communications and can demonstrate vertical and horizontal communications with all RAC
agencies and Regional Response Partners. NETRAC Communications Systems consist of the
following:
WebEOC: WebEOC is the original web-enabled crisis information management system and
provides secure real-time information sharing to help managers make sound decisions quickly.
Originally developed for public safety and emergency management officials, WebEOC is now
also used also for routine operations in private corporations, public utilities, domestic and
international airlines, healthcare associations, and universities, as well as by government at every
level---city, county and state agencies nationwide and NASA, EPA, and other federal agencies
within the Departments of Defense, Energy, Agriculture, and Health & Human Services.
EMSystems: Internet based system that captures Hospital Bed availability and EMS
availability.
Immediate Response Information System (IRIS): Regional communications call down
system for Mass Notification. IRIS, the Immediate Response Information System, is a system for
broadcasting alerts to multiple communication devices simultaneously via a secure web-based
administrator interface, designed and developed by TechRadium, Inc. Alerts are delivered
according to organization and/or individual user preferences including multilingual translations.
IRIS has multiple options for message creation including text-to-speech, a method for recording
voice and saved alerts. Two other key components of the system are the user data management
module and the system reporting module.
Texas Disaster Volunteer Registry (TDVR): – statewide system using for credentialing
licensed personnel, i.e. Physicians, Nurses, Paramedics, EMT’s, Physicians Assistants, Nurse
Practioners, and Lay-persons.
DRILLS/EXERCISE TEAM/COMMITTEE:
The NETRAC Drills and Exercise Committee is responsible for aiding the Executive Director
with planning and scheduling or regional disaster preparedness courses/education, regional drills
and exercises.
SYMPOSIUM COMMITTEE:
The NETRAC Symposium Committee is responsible for aiding the Executive Director in
planning efforts for our Annual Disaster Preparedness and Healthcare Symposium.
EMERGENCY MANAGEMENT TASK FORCE (EMTF):
The Emergency Management Task Force is a state project with a team goalto work together to
provide a well coordinated response in offering rapid professional medical assistance to support
emergency medical operation systems during disaster events or incidences. The EMTF Team is
made up of four components: RN Nurse Strike Teams, Mobile Medical Unit Teams, Ambulance
Strike Teams, and Ambus.
NORTHEAST TEXAS PREPAREDNESS COALITION:
The Northeast Texas Preparedness Coalition is collaboration and co-chaired by the NETRAC
and Ark-Tex Council of Governments. The committee is made up of regional response partners
and works to collaborate all disaster preparedness efforts and planning.
TRAUMA
AND
ACUTE CARE
HEALTHCARE
SYSTEMS
The NETRAC General Assembly is made up of four committees: Hospital/Registry/Quality
Improvement; Education/Injury Prevention/Pediatric; Acute Care; EMS/Aeromedical
HOSPITAL/REGISTRY/QUALITY IMPROVEMENT COMMITTEE:
The NETRAC Hospital/Registry/Quality Improvement is responsible for aiding in the
implementation of regional hospitals policies and procedures as it relates to Trauma/Acute Care
and Disaster Preparedness. The committee helps in the development of the Regional Trauma
Registry Programs, development of Registry Reports, and Performance Improvement. This
committee also assist the Education Committee by supplying registry information to help
develop Regional Injury Prevention Programs.
EDUCATION/INJURY PREVENTION/PEDIATRIC COMMITTEE:
The NETRAC Education/Injury Prevention/Pediatric Committee is responsible for developing
and scheduling Trauma, Acute Care, and Disaster Preparedness educational courses and
trainings. The committee works with community partners to promote Injury Prevention
activities and pediatric educational activities.
ACUTE CARE COMMITTEE:
The Acute Care committee is responsible for the development of regional plans, policies and
procedures, protocols as it relates to acute care. The committee has developed the NETRAC
regional Stroke Plan (adopted by all NETRAC Hospitals). This committee has also been tasked
with working on Cardiac/Stemi and Burns. The Acute Care committee works closely with the
EMS/Aeromedical Committee to ensure that the pre-hospital information is incorporated into all
acute care plans.
EMS/AEROMEDICAL COMMITTEE:
The EMS/Aeromedical Committee is responsible for ensuring all NETRAC EMS providers are
properly training, and are meeting Performance Improvement Indicators developed by the RAC.
System Access
Basic 9-1-1 is a regional system providing dedicated trunk lines which allow direct routing of
emergency calls. Routing is based on the telephone exchange area, not municipal boundaries.
Automatic Number Identification (ANI)is not provided with Basic 9-1-1. There are no basic 9-11 systems within the NETRAC 9-1-1 Emergency Communication System Plan. All systems are
enhanced 9-1-1 with different levels of service.
Enhanced 9-1-1
Enhanced 9-1-1 is a system which automatically routes emergency calls to a pre-selected
answering point based upon geographical location from which the call originated.
A 9-1-1 system operates by a caller dialing the digits 9-1-1, then the call is routed to the local
telephone company central office or CO; at the CO, the telephone number or ANI is attached to
the voice and sent to the Public Safety Answering Point PSAP). With Automatic Location
Identification and Selective Routing, the call is sent to the CO and the Computer (9-1 -1
Database) assigns an address to the phone number and routes the call to the designated PSAP.
In TSA-F, the primary emergency communication systems for public access is Enhanced 9-1-1.
The emergency communication systems were implemented providing citizen’s access to
emergency communications to municipalities and counties (incorporated and unincorporated
areas) in the TSA-F.
ANI is a system capability that enables an automatic display of the seven-digit number of the
telephone used to place a 9-1-1 call. This system enables the automatic display of the calling
party’s name, address and other information.
Alternate Routing (AR) is a selective routing feature which allows 9-1-1 calls to be routed to a
designated alternative location if all incoming 9-1-1 lines are busy or the central system (PSAP)
closes down for a period of time.
Selective Routing (SR) is a telephone system that enables 9-1-1 calls from a defined
geographical area to be answered at a pre-designated PSAP.
Communications Network
The Ark-Tex Council of Governments administers the 9-1-1 Emergency Communications
Systems. The communications system includes the following counties:
Bowie
Cass
Morris
Titus
Red River
Franin
Lamar
Delta
Hopkins
Miller
The contingency plan for the 9-1-1 system includes redundancy of all communications links,
with alternate routing capabilities for either system overflow, or evacuation of any of the
communications centers. Each center is equipped with an emergency backup power source, and
ring down circuits connecting each 9-1-1 answering point. Connectivity is available through the
cellular network, as well as radio communications.
Strengths
Strengths of the current 9-1-1 system include~
Fully enhanced 9-1-1 system which provides ANI information and the appropriate police, fire
and EMS agencies that respond to that location.
PCs that were provided to the answering point to assist in locating the caller in and AINI level of
service areas.
All answering points are equipped with voice recording equipment, instant playback capabilities
of previous telephone and/or radio conversations. Answering points have access to language line
interpretation services, the communication devices for deaf (TDD/TTY), as well as conference
call capability.
Immediate activation of 9-1-1 with phone calls and break disconnection, even though database
information is not current.
Weakness
Weakness of the current 9-1-1 system includes:
1. Potential average delay for database updates from time of telephone connection (72 hour
average).
2. General public awareness and use of the 9-1-1 system.
System Access
All coin operated telephones in the NETRAC region are programmed to offer free access to 9-11 without depositing coins into coin operated telephones.
Communications
In TSA-F, LifeNet EMS, Titus Regional Medical Center EMS, and HopkinsCounty Memorial
EMS maintain individual emergency medical dispatch systems location in each EMS
administrative offices and dispatch for their respective agencies. The City of Paris dispatches
EMS calls in LamarCounty. Champion EMS dispatches EMS calls in MorrisCounty and parts of
CassCounty. LifeNet EMS dispatches EMS call in Bowie, Red River, and parts of Cass
counties. All dispatch personnel in LifeNet, Titus County and Hopkins County are verified by
Texas Department of Health as Paramedics and/or Emergency Medical Technicians (EMT) and
currently trained in Medical Priority Dispatch for pre-arrival instructions.
The EMS dispatch Centers are currently using Dr. Jeff Clawson’s Medical Priority Dispatch PreArrival Instructions.
There are high frequency and ultra high frequency radio capabilities throughout TSA-F region.
Within the UHF radio band, ten paired sets of frequencies which are reserved for EMS
communication have been assigned. Aeromedical communication capabilities are also available.
All landing zone communications and assigned to the teams Texas Fire 3 interoperable
frequency.
Full regional telemetry capability is not available to all EMS agencies. Mobile units can
communicate with hospital control console for EMS communications. Outlying areas have
access to dispatch operation center through repeater towers.
Law Enforcement and fire department frequencies are programmed in all mobile radios.
Provisions made for communications with those agencies are for contacting law enforcement and
fire agencies in each city or county for coordination during EMS responses.
Short Term Goals
1. Develop and implement a standard radio frequency to be used during Disasters and
mutual aid assistance within NETRAC.
2. Update Regional Disaster Plan.
Long Term Goals
1. Develop and implement a standardized dispatching format to be utilized throughout
NETRAC.
2. Insure the delivery of radio communications throughout NETRAC. (No dead spots for
communications).
Medical Oversight, Medical Direction & Quality Management
An essential component of system networking is the presence of strong medical direction (offline/indirect/prospective/retrospective) and available medical control (on-line/direct/immediate)
for Pre-hospital EMS service throughout an entire regional trauma system.
Texas Trauma Service Area F is both rural and urban. Currently each EMS system and each
Hospital have their own Medical Directors which are experienced in emergency medical systems
and trauma care, both pre-hospital and hospital.
The Physician Advisory and Quality Improvement Committee should be involved in all the
critical areas of the Regional Trauma System particularly field triage, pre-hospital and hospital
care. The resources of the Physician Advisory and Quality Improvement Committee will also be
utilized for trauma prevention, disaster medical care, education and research.
Triage, patient delivery decisions, treatment and transfer protocols should be integrated within
the system. Field triage is according to the AmericanCollege of Surgeons’ system. Pre-hospital
protocols for all levels of EMS personnel are presently in place and revised yearly (refer to
Protocol Manual).
Any materials introduced in the revisions are taught to the appropriate EMS personnel at
multiple sessions, and the material presented should be evaluated by written tests.
The Physician Advisory and Quality Improvement Committee should be involved in continuing
education and outreach programs. The Committee should also participate in protocol, bypass and
diversion decisions and emergency disaster preparedness.
On line medical control for EMS personnel utilizes ambulance based radios, regional repeaters
and hospital based communications in order to utilize the appropriate resources available for the
injured patient.
Scene times are evaluated and collected with each run report filed within the respective service.
These will be readily available from each entity registry.
A standardized data set should be used throughout the region to collect data in Trauma Service
Area-F area. These standardized data sets were approved by the Texas Department of Health
Services and adopted for usage by all EMS agencies in Trauma Service Area-F counties.
TEXEMS Data Points are collected and transmitted to the Texas Department of Health Services.
Pre-hospital Triage Criteria
Major trauma patients are either categorized as “Critical” or “Urgent” on the Triage Decision
Scheme.
Refer to attached Triage Decision Scheme; the chart at the bottom of the page identifies the
appropriate destination for a patient. It includes recommendations for transfer based on the type
of facility which provides initial care.
Trauma centers are identified by the type of resources provided by the institution. Triage and
transport protocols are based on the resources these hospitals provide.
Pediatric patients and patients with burn injuries are addressed specifically in the scheme.
Patients with spinal cord injury are identified for appropriate treatment and transfer during the
initial assessment. (Vital Signs, determination of the Glasgow Coma Scale and the Revised
Trauma Score.)
Patients who sustain major injuries may require care at a Level I or Level II trauma center. They
may be able to receive initial stabilization at a Level III or Level IV trauma center if the injury
occurs in a rural area of the service area. Their clinical needs may include access to rapid
transport to a Level I or Level II facility.
Demography of the population in the trauma service area is summarized in Appendix C.
The trauma service area has six ground EMS services and three air medical services providing
emergency care and transport to trauma centers. Appendix D shows the staffing and service level
of each of these agencies.
Texas Department of Health Services, Bureau of Emergency Services is the regulatory agency
for the emergency vehicles, equipment and personnel.
The trauma service area utilizes Enhanced 9-1-1 capabilities for accessing the EMS system.
Emergency vehicles are dispatched based on the proximity to the injured patient(s). Air medical
transport via helicopter or fixed wing is available throughout the region.
Ground ambulances follow treatment and transportation guidelines found in the RAC protocol
manual. Air Medical Transport treatment and transportation protocols are available through the
respective services. All protocols are based on nationally recognized standards. These standards
may include Pre-hospital Trauma Life Support (PHTLS), Pediatric Advanced Life Support
(PALS), Advanced Cardiac Life Support (ACLS), TNCC and ATLS.
Current licensed acute care facilities in the service area are listed in Appendix D. Pre-hospital
protocols are reviewed on an annual basis for revisions and refinement. Protocol update classes
provide pre-hospital care personnel with information about changes in patient care
recommendations. Case reviews should be conducted monthly to analyze and evaluate specific
patient care situations and to provide recommendations.
Trauma facilities are notified using the field triage decision scheme of incoming patients via
radio, cell phone, or telephone from ambulances and aeromedical transportation. The nationally
designated radio frequencies are utilized for the transmission of patient information to the
hospital (including expected time of arrival at the Emergency Department).
Time and distance are extremely important variables to consider when triaging injured patients to
local hospitals or trauma centers. Patients who meet the following guidelines and are within
twenty (20) minutes transport time to a trauma center should be strongly considered for transport
directly to that center. In the rural environment, an injured patient may be at a substantial
distance from a trauma center and as such injured patients should ideally be treated initially at
the nearest available hospital facility. Patients with major severe injuries should then be
secondarily triaged to more distant trauma centers should local resources prove inadequate for
continued care.
The below criteria are suggestive operating guidelines. The time frame set is a collective
guideline set by TSA-F members. Agencies should go by their established protocols set by their
medical director.
Referral To Trauma Center
Initial Procedures
Upon encountering any injured patient, pre-hospital personnel must make a rapid assessment of
the patient pausing as necessary to treat life threatening situations.
This assessment includes:
1. Vital signs and breath sounds
2. Glascow Coma Scale Score / Revised Trauma Score.
3. As thorough a secondary survey as the situation permits
Trauma Center Referral
Any patient presenting with one or more of the following physiological signs or anatomical
injuries in a traumatic setting are considered trauma center candidates:
1. Systolic blood pressure less than 90 with clinical evidence of impending shock
2. Respiratory rate less than 10 or greater than 29, with evidence of trauma
3. Total Glascow Score of 12 or less
4. Penetrating injury to chest, abdomen, head, neck or groin
5. Flail Chest
NOTE: Patients in cardiac arrest secondary to hypovolemia due to blunt trauma are NOT trauma
center candidates due to uniformly poor outcome regardless of treatment.
All patients meeting the above criteria are to be directly triaged from the scene to the nearest
tertiary care center or regional resource trauma center (if transport time is less than 20 minutes).
This assessment/referral is to be made by the EMT/Paramedic (if transport exceeds 20 minutes,
call the closest hospital for consultation and advice).
The EMT/Paramedic should employ the treatment regiment as outlined in the Pre-hospital
trauma protocol while enroute to the trauma center. To expedite field time, medical control does
not need to be established until the unit is enroute to the trauma center.
Potential Trauma Center Referral
Traumatically injured patients not evidencing absolute criteria for trauma center referral may still
be candidates if; on the basis of anatomical sites and/or mechanism of injury, the potential exists
for the patient to have sustained critical injuries. These considerations include:
1.
2.
3.
Two or more proximal large bone fractures.
Combination with burns greater than fifteen percent, face or airway
Evidence of high impact
a.
Falls greater than 12 feet or for pediatric patients falls that are two time the
patients height.
b.
Passenger compartment intrusion 18 inches on patient side of car
c.
Ejection of patient
d.
Rollover
e.
Death of same car occupant
f.
Pedestrian struck at 20 mile per hour or more
When presented with trauma patients not meeting triage criteria, but meeting potential triage
criteria, the EMT/Paramedic is to contact their medical control, advise the physician (nearest
hospital) of a potential trauma center candidate and relay pertinent information and assessment
findings. Realizing that patient conditions may alter the order of a typical report, it is necessary
to rapidly and briefly, convey essential information. This includes:
1. Brief description of scenario (auto accident, gunshot, etc.)
2. Patient age, sex, class
3. Vital signs, GCS and assessment findings
4. Other information, including estimated times for transit and/or extrication
NOTE: If pre-hospital personnel are unable to directly relay the patient assessment to the
physician, they may relay the assessment via other on-scene personnel/dispatcher.
If trauma center referral is directed by the physician, transport to the nearest designated trauma
center should proceed. Radio contact with the trauma center should be established if possible and
maintained throughout the transport. If radio contact with trauma center is not possible, the local
command hospital should maintain communication and this hospital should call the trauma
center via telephone to relay patient information. Transportation should be expeditious and
uninterrupted.
For patients not meeting trauma center referral criteria or for patients directed by medical control
physician to be transported to the local hospital, the EMT and EMT Paramedic will proceed with
BLS and/or ALS treatment as appropriate and transport to the nearest hospital.
It must be remembered that transportation of trauma patients is a high priority. On the scene
treatment should be limited only to those techniques to stabilize life threatening injuries. Once
enroute, further splinting, bandaging, and IV therapy should be initiated and/or continued.
Trauma Helicopter Service
Multiple factors are involved in determining the most expedient method of transportation to the
trauma center. In some cases, the most expedient means may be via a helicopter service. The
following are guidelines to be utilized in determining ground vs air transportation.
Utilize land transport to nearest regional or regional resource trauma center when:
1.
2.
Patient is non-entrapped, or extricated and time from scene to trauma center (by land) is
20 minutes or less.
Helicopter is not available to fly
Consider air transport to nearest regional or regional resource trauma center when:
1.
2.
Patient is entrapped, helicopter can arrive at scene prior to extrication, and scene-totrauma center time can be considerably shortened by utilizing helicopter.
Patient is non-entrapped or extricated and land transport time to the nearest trauma center
is greater than 20 minutes. In this case, transport to a rendezvous landing zone should be
employed.
Radio/Communication Failure
When communications cannot be established, or once established are interrupted, the decision to
triage potential trauma center candidates to a trauma center must be made by the
EMIT/Paramedic. The decision of the EMT or paramedic to “by-pass” a local hospital for a
trauma center is expected to be made with the patients best interest in mind and in accordance
with the trauma referral criteria.
Section VI of this policy is to be applied only in bonafide situation of communication failure
where multiple attempts to reach medical command have been unsuccessful.
Description Of Triage Decision Scheme
The Trauma Triage Scheme was a collaboration of the American College of Surgeons and
American College of Emergency Physicians guidelines.
The Triage Decision Scheme was a collaborative effort of the Bypass/Diversion Committee. This
scheme was to serve as a model for TSA-F to incorporate hospitals from Levels I to IV. The
Triage Decision Scheme is an algorhythm approach to differentiating patient categories as well
as a mechanism for activation of Trauma Team Alerts in Facilities.
Patient Categories--The Triage Decision Scheme defines patient categories as critical and urgent.
Critical patients meet criteria for instability of hemodynamic and neurologic functions, as well as
specific anatomical injuries patterns that place them at a high suspicion for significant risk.
Urgent categorized patients are those that are evaluated for evidence of mechanism of injury,
high-energy impact and age or disease specific history.
Facility Triage Action Plan
The facility triage action plan is included within the Triage Decision Scheme to assist facilities in
determining where a trauma patient should be transferred. It includes the service that should
admit the patients, the Level to be transferred to and stabilization and transport. Guidelines for
aeromedical transport are included within this to assist facilities in assuring “the right patient, to
the right facility, in the right amount of time.”
When in Doubt, Patient should be taken to a Trauma Center Consider Air Transport for all
Critical and Urgent Patients
Inter-Hospital Transfers
All interhospital transfers must comply with current Federal and State regulations, with
appropriate transfer memoranda and patient data accompanying the patient.
Inpatient to inpatient transfers are accomplished directly from transferring attending to receiving
attending physician, and from transferring hospital administration to receiving hospital
administration.
Trauma patients requiring specialized treatment or specialized care are identified via the Triage
Decision Scheme and transfer to an appropriate facility is based on this criteria.
Written transfer agreements are available to the major tertiary care facilities within the region.
These agreements may be broad in nature or specific, i.e., burn or pediatric.
PLAN FOR DESIGNATION OF TRAUMA FACILITIES
The purpose of designation is to allow healthcare facilities to determine the level of trauma care
they wish to provide. Designation affords healthcare providers a means of recognizing the
various levels of service capabilities, within their own institutions and other facilities, thus
allowing them to make informed decisions as to the care and treatment of their injured patients.
In urban areas, designation may assist with determining patient destination. Designation is not
intended to provide a means of determining hospital capabilities by the lay public.
Level I
The Level I facility is 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 the Trauma Service Area F, currently we do not have any facilities seeking designation as a
Level I trauma facility.
Level II
The Level II trauma center is a hospital that is also 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. Therefore, patients with more complex
injuries may have to be transferred to a Level I center. If a Level I center does not exist the Level
II center should take on the responsibility for education and system leadership.
In the Trauma Service Area F, currently we do not have any facilities seeking designation as a
Level II trauma facility.
Level III
The Level III trauma center serves communities that do not have immediate access to a Level I
or II institution. Level III trauma centers can provide prompt assessment, resuscitation,
emergency operations, and stabilization and arrange for possible transfer to a facility that can
provide definitive trauma care.
Currently Titus Regional Medical Center is the only designated Lead Level III trauma center in
the Trauma Service Area F (NETRAC) region. Wadley Regional Medical Center – Texarkana,
Texas is designated as a Level III Facility in Trauma Service Area F (NETRAC) region
Level IV
Level IV trauma facilities provide advanced trauma life support prior to patient transfer in
remote areas where no higher level of care is not available. Such a facility may or may not have a
physician available. Because of geographic isolation, however, the Level IV trauma facility is the
de facto primary care provider. If willing to make the commitment to provide optimal care, given
its resources, the Level IV trauma facility should be an integral part of the inclusive trauma care
system.
In Trauma Service Area F (NETRAC), currently we have (four) Level IV trauma centers. Atlanta
Memorial Hospital – Atlanta, TX; East Texas Medical Center – Clarksville, TX; Good Shepherd
Medical Center – Linden, and Hopkins County Memorial Hospital – Sulphur Springs, TX
NETRAC actively encourages and works to facilitate trauma center designation in the region.
Facility RAC participation and trauma center designation are encouraged through individual
contacts and through prevention programs as well as physician contacts.
System Quality Management Program
Mission Statement
To get the “right patient” to the “right place” in the “right time”.
Trauma Service Area F is dedicated to the provision of quality healthcare for the community and
the surrounding region. It provides accessible, comprehensive, compassionate, high quality
healthcare to all disaster, trauma, and acute patients regardless of age, race, religion, sex,
nationality, ability to pay, diagnosis or prognosis, to assure that all patients receive the optimal
level of care.
The purpose of continuous quality management is to provide ongoing quality assessment and
improvement activities designed to objectively and systematically monitor and evaluate the
quality of patient care through system analysis, to identify and pursue opportunities to improve
patient care, and sustain improvement over time and ultimately to improve survival and reduce
morbidity from injury.
By participating in the TSA-F RAC, all member organizations embrace the guiding principles for
Trauma System QI outlined by the Texas Department of Health.
Goals/Objectives
The Trauma Service Area F quality management plan is designed to achieve the following goals:
1. To facilitate continuous quality improvement in patient care and services provided, by
establishing mechanisms to identify opportunities to improve. This can be achieved by
evaluation of clinical processes which may affect patient outcomes and clinical aspects of
care or services which are key function activities.
2. To provide a framework for a planned, systematic, ongoing approach for the objective
monitoring and evaluation of the quality, appropriateness and effectiveness of trauma
patient services provided within the region.
3. To pursue opportunities for improving patient care by evaluating systems and addressing
educational issues. Actions will be taken to rectify identified issues.
4. To centralize the flow of information through the organized committee structure, to
prevent duplication of effort and to facilitate early awareness of opportunities for
improvement.
5. To create an organizational structure which will provide for the coordination, integration
and accountability of quality management activities commensurate with established
standards.
6. Mandatory participation in the QI process by all member organizations, both hospitals
(designated and non-designated facilities) and EMS Systems.
7. To achieve a 5% decrease in trauma morbidity/mortality within TSA-F over the next five
years.
8. To identify and recommend corrective action for components of the trauma system which
will significantly decrease delays in meeting our mission of getting patients to tertiary
care within the “golden hour” for optimum outcomes.
9. Develop a data base through continuous quality improvement activities that will allow
identification of trends and/or significant events.
10. Develop and utilize tools for continuous quality improvement review throughout the
region, which will serve to identify areas for improvement within the trauma care
delivery system.
11. To assist in developing guidelines and standards of care in TSA-F through identification
of educational needs via system continuous quality improvement activities.
Functional Authority: The final authority and ultimate responsibility for a flexible,
comprehensive and integrated quality management plan shall rest with the Northeast Texas
Regional Advisory Council.
Program Evaluation
The effectiveness of the Quality Management Plan will be evaluated on an annual basis and
revised as deemed appropriate.
Confidentiality
All documents generated concerning quality management activities within the region shall be
confidential and used only in the exercise of designated functions of the Quality Management
Plan.
Conflict of Interest
No practitioner or other individual involved in quality management activities shall be required to
review any case in which they are professionally involved but shall be given the opportunity to
participate in the review.
Membership
Membership of the Quality Improvement Committee is recommended as follows but not limited
to:
One Representative (Trauma Coordinator, QI representative, or ED Medical Director)
from each hospital;
EMS Medical Director or EMS Director from each EMS agency;
Committee Chair - Quality Improvement
The Quality Improvement Committee is involved in all critical areas of the regional trauma
system, including field triage, pre-hospital care and hospital care. The resources of the committee
will also be used in trauma prevention activities, disaster medical care, and education.
Recommendations are made from the Quality Improvement Committee to the Executive Board.
System Management Indicators
System management indicators should include financial indicators, injury prevention indicators,
and outcome indicators. It is essential that the overall financial impact of the trauma care system
be analyzed, including the cost of the system and its impact on direct and indirect costs of
decreased morbidity and mortality. While specific financial indicators for NETRAC system
performance have not been precisely defined at the present time, research into these areas is
ongoing.
Similarly, injury prevention and control is a critical area where NETRAC can have a major
impact on lessening the injury and morbidity in our region. As this area becomes better defined,
more specific injury control indicators will be developed.
The majority of the system management indicators focus on outcome evaluation. At an absolute
minimum, all patients who expire must be identified.
Pre-hospital Indicators
Pre-hospital care and treatment of trauma patients continually undergoes significant scrutiny.
NETRAC will monitor areas such as access to the system, response time, and efficacy of field
therapy, triage, transport decisions, scene time, and transport time.
EMS Audit Filters
1. Ambulance scene time> 20 minutes (system filter)
2. Trauma patient (GCS  8) leaving the ED or arriving at the ED without a definitive airway
(endotracheal tube or surgical airway).
Hospital Audit Filters
1. Time of arrival to ED until admission, death, or transfer to another facility.
2. Patient transferred from a higher Level designation to a lower Level designation.
System Audit Filters
NETRAC serves in an advisory capacity only, with authority to make recommendations and
develop standard of care guidelines for TSA-F.
Authority for peer review activities rests with the Quality Improvement Committee, and shall be
for educational purposes. This authority may be delegated in individual situations to the
Executive Board or other standing committee(s) as appropriate. Pre-hospital quality
improvement activities are delegated to the EMS Medical Advisory Committee, with mutual
reporting and recommendations as appropriate.
All peer review activities conducted under the auspices of the NETRAC shall be kept strictly
confidential under Texas legal requirements for peer review activities.
Authority and responsibility for any disciplinary action rests exclusively with the individual
member entities in regard to their employees/medical staff
Any liability arising from decisions by individual member entities not to abide by the standard of
care developed for TSA-F and approved by the Texas Department of Health shall rest entirely
with those member entities.
Confidentiality Agreement
The purpose of the Northeast Texas Advisory Council Quality Improvement Committee is:
1. To conduct case review and peer review of trauma cases;
2. To make recommendations for improvement in trauma system processes and/or education of
trauma providers in the TSA-F region;
3. Through the above processes to establish a standard of trauma care within the region.
In order to assure a review that fully addresses all relevant data, including historical information
and opportunities for trauma system improvement, full disclosure by all involved parties is
required. This information is protected from disclosure by law, especially medical information
and potential medical/legal liability issues. Therefore, team reviews are closed to the public and
cannot be lawfully discussed unless the public is excluded. In NO CASE should any team
member or designee disclose any information regarding team discussion/decisions outside the
team, other than pursuant to team confidentiality guidelines?
Failure to observe this procedure may violate various confidentiality statutes that contain
penalty.
Team Operating Procedures Regarding Confidentiality
1. Records acquired by the team to conduct a review are exempt from disclosure under the
Open Records Law, Chapter 552 of the Government Code.
2. Data collected and information regarding a review team meeting is confidential.
3. A report or statistical compilation of a review team is a public record subject to the Open
Records Law, Chapter 522 of the Government Code IF it does not permit the
identification of an individual or HIPAA relevant policies
4. A team member may not disclose any information that is confidential.
5. Information, documents and records of the team are confidential and are not subject to
subpoena or discovery and may not be introduced into evidence in any civil or criminal
proceedings.
6. Information that would otherwise be available from other sources is immune because
they were included in a review team meeting.
Confidentiality Agreement
The confidentiality agreement pertains to all members and guests of the NETRAC Quality
Improvement Committee meeting.
It is not considered a breach of confidentiality when:
1.A team member invites a guest, who has information on a case to be reviewed, to a
meeting.
2.Information is shared by a team member or guest with the agency that members
represents, provided no identifying information is given, in order to change policy, or to
carry out prevention issues identified by the team.
3. A team member or guest shares information which that member brought to the meeting,
and no mention is made that the case was reviewed at the NETRAC Quality Improvement
Committee meeting.
It is considered a breach of confidentiality information when:
1. A team member or guest shares identifying information for any reason outside the
NETRAC Quality Improvement Committee meeting.
2. Information is shared with any media without the expressed direction of the NETRAC
Quality Improvement Committee or the presiding officer. This does not apply to
information of which the member had knowledge before the meeting occurred.
3. A team member or guest shares an opinion of anyone present or any facility represented
at the NETRAC Quality Improvement Committee meeting outside of such a meeting.
4. A team member or guest expresses an opinion (outside of meeting) which was formed at
or derived from a meeting of the NETRAC Quality Improvement Committee regarding a
case that was reviewed.
Rehabilitation
Rehabilitation resource information is included in the hospital needs assessment survey a found
in the appendix.
Currently HealthSouth Rehabilitation Hospital.
Education/Prevention Plan
The trauma education/prevention committee has identified three major areas of focus:
1. Education of Pre-hospital personnel.
2. Education of hospital-based personnel.
3. Education of the public, particularly in the area of injury prevention.
Pre-hospital Personnel Education
Goals
All emergency medical services personnel involved in Pre-hospital care of injured patients in
Trauma Service Area F will have access to initial and continuing education necessary to
developing and maintaining proficiency in trauma care.
Immediate Objectives for new Pre-Hospital Agencies
1. Within 90 days, an information packet explaining the purpose of the Regional Advisory
Council and the Regional Trauma Care System will be distributed to new Regional EMS
providers and personnel. In cooperation with other RAC Committees, an attempt will be
made to identify questions which are likely to arise and provide answers to these
questions.
2. Within 180 days, a workshop will be conducted to educate new Regional EMS personnel
on the scope and function of the Regional Trauma Care System.
Intermediate Objectives
1. Initial Education - All basic, intermediate, and advanced EMS students will adhere to the
requirements set forth by the Department of Transportation’s National Standard
Curriculum, which will include the following:
a. Pediatric Trauma
b. Adult Trauma
c. HazMat Recognition & Identification
d. Burn Management
e. Aeromedical landing zone safety procedures
f. Incident command
g. Regional Trauma Care System
h. EMS Dispatch Systems
i. Regional Communication Systems
j. Survival Training
k. Street Safety
2. Continuing Education:
a.
b.
All basic, intermediate, and advanced EMS personnel will participate in
continuing education which may include PEP, PALS, PHTLS, BTLS, ACLS,
and review the Department of Transportation’s National Standard’s
Curriculum.
A NETRAC Training calendar will be published on an as needed basis. The
calendar will be expanded to incorporate information about hospital based
training/education, training/education available through all schools and
departments at local community colleges, and relevant training/education
available through other Regional organizations.
Long Range Objectives
1. On an on-going basis, data from the Trauma Registry and the Regional quality
improvement process will be used to target specific areas of the initial and continuing
education programs for revision and improvement.
2. Intermediate-range objectives for Pre-hospital personnel training will be reviewed and
revised on an annual basis.
Hospital Personnel Education
Goal
All hospital personnel involved in care of injured patients in Trauma Service Area F will have
access to education necessary to developing and maintaining proficiency in trauma care.
Intermediate Objectives
1. Advanced Cardiac Life Support Courses will continue to be offered by the American
Heart Association approved ACLS training centers. Every effort will be made to provide
courses for personnel from Regional hospitals who must obtain ACLS provider
recognition to enable their facility to apply for trauma center designation.
2. Trauma Nurse Core Curriculum will be offered at least twice annually. The Pediatric
Emergency Nurse Pediatric Course will be offered at least twice.
3. The ATLS courses will be available for audit by nurses and paramedics.
4. A NETRAC Training calendar will be published on the NETRAC Website. The calendar
will be expanded to incorporate information about relevant hospital-based
training/education and training/education.
5. To the greatest extent possible, every hospital in the Region will open its staff
development activities to personnel from every other hospital and to Pre-hospital
personnel.
6. To provide familiarization with Pre-hospital procedures and to promote integration of
Pre-hospital and hospital disaster response procedures, representatives of Regional
hospitals will be invited and encouraged to participate in the Regional Major EMS
Incident Plan review and update sessions.
7. As the Mutual Aid and Disaster Planning Committee and the Education Committee
conduct table-top exercises throughout the Region, representatives of local health care
facilities will be invited and encouraged to participate to promote integration of Prehospital and hospital disaster response procedures.
Long Range Objectives
1. Hospital personnel need education on the roles and capabilities of EMS personnel. To the
greatest extent possible, all training/education activities will move toward being:
interdisciplinary to encourage personnel to interact, to be aware one another’s
capabilities, and to learn to work together more effectively.
2. On an on-going basis, data from the Trauma Registry and the Regional quality
improvement process will be made available to hospital staff development coordinators
to target specific areas of the initial and continuing education programs for revision and
improvement.
3. As the Mutual Aid and Disaster Planning Committee and the Education Committee begin
to conduct small and large full-scale exercises of the Regional Major EMS Incident Plan,
Regional health care facilities will be invited and encouraged to participate by conducting
simultaneous exercises of their in-house disaster plans.
4. Intermediate-range Objectives for hospital personnel training will be reviewed and
revised on an annual basis Although the initial focus of trauma system education for
hospital personnel will be on individuals who provide care immediately following arrival
of the patient in the emergency department, as the system develops, educational efforts
will necessarily have to expand to include personnel providing care to trauma patients in
the operating room, the intensive care areas, and the rehabilitation units.
Physician Education
Goal
All physicians involved in care of injured patients in TSA-F will have access to education
necessary to developing and maintaining proficiency in trauma care.
Trauma Prevention & Education
Goal
Activities which increase public understanding of the trauma care system and which encourage
the prevention and reduction of injuries through education of the public and through legislation
will be identified and supported, both in Trauma Service Area F and in cooperation with other
Trauma Service Areas and the Texas Department of Health, on a statewide basis.
Immediate Objectives
1. An expanded Trauma Prevention network of county based coalitions will be established.
This network will coordinate safety/injury prevention efforts to avoid duplication of
efforts and to target groups with special needs.
2. Involve school systems in the bicycle helmet program through working with PTAs and
school administrators to provide bicycle safety education and fit helmets at our costs (or
through grants) to students.
Intermediate Objectives
1. Trauma prevention programs already being conducted by area organizations will
continue. These programs include:
a. DWI Awareness. Conducted by NETRAC E.N.C.A.R.E. instructors, this is a
grassroots alcohol-awareness slide program developed by emergency nurses in
1982, and presented by professional emergency personnel on a volunteer basis to
middle schools, high schools, colleges, parents, and concerned civic groups. The
program graphically depicts the dangers associated with drinking and driving, as
well as safety-belt noncompliance.
b. Think Child Safety programs already being conducted throughout TSA-F region.
c. Facilitate increased use of seat belts and child safety seats throughout ~NETRAC
region through surveys, public education, car safety checks, and provisions of
loaner car seats.
2. The Regional Advisory Council will sponsor a general education program.
3. Bookmarks and book covers with trauma prevention information and referrals to
organizations which address specific areas of prevention will be distributed. The
possibility of doing media PSA’s should also be evaluated. The objective will be to after
the public perception that accidents are chance events that ‘just happen.”
4. A master index of trauma prevention education programs in the Trauma Care System
area will be developed. Needs of regional communities for trauma prevention programs
will be evaluated as will resources available to meet these needs.
5. Local EMS organizations and hospitals will be provided with resources to promote the
incorporation of prevention education materials into the public school curricula in their
communities. Local EMS organizations and hospitals will be encouraged and supported
in efforts to become American Heart Association CPR Training Centers. The possibility
of local EMS organizations and hospitals providing first aid training to the community
will also be explored. When a community is served by both an EMS organization and a
hospital, cooperative efforts in providing CPR and first aid training to the community will
be encouraged.
Long-Range Objectives
1. A program will be developed to assist local EMS organizations in conducting
home/business safety inspections in their communities. The rationale for this program is
similar to the rationale for fire departments preventing fires rather than extinguishing
them. This program will have the added benefit of enhancing the public image and
visibility of EMS in the Regional communities.
2. In cooperation with the Mutual Aid and Disaster Planning Committee, a program will be
developed to involve Regional EMS, fire~-department, and hospital personnel in training
Citizen Disaster Response Teams. Based on a concept originally developed by the Los
Angeles City Fire Department, Citizen Disaster Response Teams consist of private
citizens who have received training in first aid, basic triage, basic fire suppression, light
structural rescue, and personal disaster preparedness. During a disaster, when the
resources of the local emergency services organizations are stretched to their limits, these
citizen responders are able to help their neighbors until professionals arrive. They are also
able to act in support of public safety professionals, expanding the community’s
resources rapidly.
3. Initial and continuing trauma education programs for Pre-hospital and hospital-based
health care personnel will include information on the role of substance abuse as a
contributing factor in many types of trauma. The impact of early intervention and
counseling with patients in mitigating the consequences of these behaviors will be
stressed.
4. Initial and continuing trauma education programs for Pre-hospital and hospital-based
health care personnel will stress the importance of active participation in injury
prevention programs through:
a. role modeling safe practices and health behaviors in the home and work settings.
b. counseling activities with patients in the Pre-hospital, hospital, and other healthcare settings.
c. participation in political activities to support prevention legislation.
d. collaborative participation with other disciplines in injury prevention activities.
e. participation in school and community education programs.
5. On an on-going basis, information from the Trauma Registry will be used to evaluate
effectiveness of prevention programs, to target areas that need specific programs, and to
support legislative efforts.
6. Based on data from the Trauma Registry, the Regional Advisory Council will identify
areas of specific concern in which new legislation or revision of existing legislation could
reduce or prevent traumatic injuries. Either independently, or in cooperation with the
Texas Department of Health and other Regional Advisory Councils, appropriate
legislative initiatives will be pursued or supported.
Trauma Policy For Inter-Hospital Patient Transfer
Goal
The following list is to be utilized as guideline for the transfer of trauma patients between a local
hospital and a tertiary care center. The list identifies patients at a particular high risk of dying
from multiple and severe injuries. Ideally, such patients should be treated at a trauma center
where continuing exposure to such problems by team systems may afford a patient an optimum
outcome. Such patients should be considered for transfer to a Level I or a Level II whenever
possible.
1. Central nervous system
a. Central nervous system, head injury:
b. Penetrating injury
c. Depressed skull fracture
d. Open injury
e. CSF leak
f. Severe coma (GCS less than 10)
g. Deterioration in GCS of two points or more
h. Lateralizing signs.
i. Central nervous system, spinal cord injury
Chest
a. Wide superior mediastinum
b. Major chest wall injury
c. Cardiac injury
d. Patients who may require protracted ventilation
Pelvis
a. Pelvic ring disruption with shock
b. Pelvic injury with more than five units transfusion
c. Evidence of continued pelvic hemorrhage
d. Compound (open) pelvic injury
e. Pelvic visceral injury
Multiple system injury
a. Severe injury to two or more body regions
Secondary Deterioration (Late sequelae)
a. Patient requiring mechanical ventilation
b. Sepsis
c. Single or, multiple organ system failure (deterioration in CNS, cardiac,
pulmonary,
hepatic, renal or coagulation systems)
d. Osteomyelitis
Responsibility for Transfer
1. Shared by referring and receiving physicians. (Referring physician should establish direct
communication with the receiving physician. This should not be delegated to hospital
clinical or administrative staff).
2. Referring facility responsible for requesting appropriately trained and equipped air or
ground
transportation resources.
3. Receiving physician should be consulted regarding arrangements and details of the
transfer, including transportation.
4. Referring physician is responsible for briefing the transferring EMS crew (Advanced Life
Support, hospital staff and/or helicopter crew) on the patient’s condition/vital signs and
special care/equipment needed during the transfer.
5. To be done prior to transfer:
a. Resuscitate patient and attempt to stabilize patient condition using the following
as guidelines:
i. Respiratory management
1. Insert an airway or endotracheal tube (if needed)
2. Determine rate and method of oxygen administration
3. Provide suction (if needed)
4. Provide mechanical ventilation (if needed)
5. Insert chest tube (if needed)
6. Insert a nasogastric tube to prevent aspiration
ii. Shock Management
1. Control external bleeding
2. Establish patient IV lines using large bore catheters
3. Replace blood volume - or begin such replacement and continue
replacement during transfer (consider MAST)
iii. Insert Foley catheter and connect to closed system
iv. Central nervous system
1. Proper hyperventilation in head injury
2. Mannitol load (if needed)
3. Immobilize all head injuries for possible spinal injuries
v. Diagnostic studies
1. Referring and receiving physicians should consult about the
appropriate lab studies and x-ray prior to transfer
vi. Wound care
1. Clean and dress wounds (Do Not Delay Transport)
2. Tetanus toxoid (when indicated)
3. Antibiotics (when indicated)
vii. Fracture management
1. Utilize appropriate splinting and traction
2. Utilize long backboard (when indicated)
6. Management during transport
a. Advanced Life Support Level of care necessary
b. Continued support of cardio-pulmonary system
c. Continued blood volume replacement
d. Frequent monitoring of vital signs
e. Use of appropriate medications as ordered by physician or as provided by written
medical protocol
f. Maintain communication with the receiving physician(s) during transfer
g. Update and maintain accurate records during the transfer
Patient Records and Reports
The referring hospital is responsible for sending a complete copy of the patient record or chart
from the Emergency Department with appropriate transfer format and copies of the Basic and/or
Advance Life Support pre-hospital report form(s) with the patient.
Transfer agreements have been in established and in place within TSA-F. Criteria for transfers
are utilized and appropriate communication between entities is expected.
Facility Diversion Policy
Goal
To establish a recommended NETRAC wide policy for facility diversion. Aside from the RAC
approved diversion policy each hospital is responsible to develop a diversion policy/procedure.
Policy
Diversion of ambulance traffic will occur only by prearrangement. Facilities may request
diversion for 2, 4, or 12 hour periods of time. In order to implement the diversion period, as well
as to extend the period, the facility must have a person in authority (house supervisor,
administrative representative, or emergency physician) contact the appropriate communications
communication systems (9-1-1 communications center, lead facility, etc.) identify him/herself,
and request this stand-down status.
The lead Trauma facility should not be on diversion unless under severe crisis such as those
specified below. All such diversions by these facilities or any facility are subject to review by
the Texas Department of Health.
The categories of diversions are:
Neurosurgical Diversion: All potential neurosurgical patients would be diverted, except
prearranged, direct hospital admissions. The neurosurgeon will be notified of such in advance.
Critical Care Diversion: If no critical beds are available, all emergency traffic would be
diverted to other facilities until beds are available.
Full Diversion: All ambulance traffic except direct admissions would be diverted due to
emergency and/or operative facilities being overwhelmed with patients.
In the event that multiple facilities request simultaneous diversion status, then ambulances would
rotate delivery of patients among the city’s facilities until a facility is off diversion status. EMS
personnel will be notified of facility status via the communications centers. Diversion status
automatically expires at the end of the allotted time period (see above). However, a facility can
request to be taken off diversion status in the same manner as the request is made to be placed on
diversion.
Recommended Guidelines For Diversion Protocol
Under the present system each facility will designate a person (ED Physician, Administrative
representative, etc.) to be responsible for decisions regarding diversion.
1. Each facility will develop a procedure for their facility to be put on diversion status. These
procedures shall be put in writing and presented to the RAC Hospital Care and
Management Committee.
2. Reasons for facilities to be put on diversion status:
a. Trauma Surgeon is not available *Internal disaster
b. Specialty Surgeon (Neuro, Ortho) is not available
c. Or Specialty equipment (CT scanner, MIRI is not available)
3. Each facility must have records showing why they were put on diversion.
4. Each facility must have policies and procedures for plans to open up critical-care beds.
5. Each facility must have a Mass Casualty protocol and know how to access other resources
within TSA-F region.
7. Level II, III, and IV facilities must notify all EMS communication centers within their
service area whenever a facility goes on or off diversion.
Facility Bypass Policy
Goal
Trauma patients who are medically unstable, unconscious, or at high risk of multiple and/or
severe injuries will be quickly identified and transported to the appropriate trauma system
hospital.
Guidelines for facility bypass protocols
When developing bypass protocols, each individual entity should consider the capabilities of
Pre-hospital firms and facility emergency resources within Trauma Service Area-F.
Transport protocols must ensure that patients who meet triage criteria for activation of the
regional EMS/trauma system plan will be transported directly to an appropriate trauma facility
rather than to the nearest hospital except under the following circumstances:
1. If unable to establish and/or maintain an adequate airway, or in the case of traumatic
cardiac arrest, the patient should be taken to the nearest acute care facility for
stabilization.
2. A General facility may be appropriate if the expected transport time to the lead trauma
facility is excessive. *
3. A Basic facility may be appropriate for immediate evaluation and stabilization if the
expected transport time to the lead facility is excessive. *
4. Medical Control may wish to order bypass in any of the above situations as appropriate,
such as when a facility is unable to meet hospital resource criteria or when there are
patients in need of specialty care.
5. If expected transport time is excessive * or if a lengthy extrication time* is expected,
medical control may consider activating air transportation resources if they are available
within TSA-F.
6. NOTE: If there should be any question regarding whether or not to bypass a facility, online medical control should be consulted for the final decision.
* Exact time should be specified, and will be determined by geography, mode of transportation,
patient condition, and other issues as deemed necessary by NETRAC.
Air Ambulance Usage Policy
Goal
To establish the guideline for access to and dispatch of helicopter emergency care services to
achieve, effective, efficient and coordinated responses to emergencies involving major trauma
victims.
Helicopter Capabilities
Must be equipped to meet all the standards of an Advanced Life Support Unit (without using
ground unit’s equipment). It is recommended that the pilot have experience in EMS flying. Flight
crew must have at least two allied medical personnel capable of providing Advance Life Support
in Texas (not including ground personnel).
Policy
Helicopter services may be utilized for the care and transport of major trauma victims according
to the Texas Trauma Service-F Guidelines, under the following circumstances.
1. Scenes involving major trauma victims where treatment or transport will be delayed and
this delay may impact patient outcome.
2. When helicopter services can respond and deliver the major trauma victims to a trauma
center more rapidly than land transportation, i.e., ground transportation time is greater
than 25 minutes. In prolonged extrication, call medical control as per trauma protocol.
3. Scenes inaccessible by ground routes.
Dispatch
All dispatch and coordination of helicopter services shall be accomplished through the
responding helicopter communication system.
Communication
All helicopter communication will be conducted on frequency 155.340, unless otherwise advised
by the responding helicopter or the landing zone coordinator.
Helicopter Stand-By
Helicopter services may be placed on the stand-by mode by police, fire, and EMS personnel. The
stand-by mechanism is a means of alerting the helicopter personnel of a possible call and assist
in shortening the response time by allowing the pilot to locate the accident and coordinates from
appropriate maps.
Stand-By Procedure
The agency requesting helicopter stand-by should acquire the following information regarding
the incident, and contact the local EMS dispatch center (if applicable) or the helicopter service
for the request.
1. City
2. Accident location
3. Nearest landing site
4. Requesting units name and unit number
5. Nature of the incident
6. Frequency to communicate
7. Unit name and number that is setting up landing site.
Dispatch Procedure
EMS personnel on scene may request helicopter services for dispatch.
1. Contact responding unit dispatch center and request a helicopter dispatch.
2. Advise the dispatch of the following information:
a. City (if not already given)
b. Accident location (if not already given)
c. Nearest landing site (if not already given)
d. Requesting units name and unit number (if not already given)
e. Nature of the incident (if not already given)
f. Frequency to communicate (if not already given)
g. Unit name and number that will set up landing site (if not already given)
h. Number of patients (if not already given)
3.
4.
5.
6.
Vital signs (only if available)
Level of consciousness (only if available)
Specific injuries (only if available)
If patients are trapped
NOTE: If unable to give vital signs and/or specific injuries, then give a brief explanation why
helicopter service is requested (i.e., care overturned, accident with entrapment).
An Fire Departments should be dispatched to the designated landing site to prepare landing zone
and communicate with the helicopter during landing and takeoff.
Safety Rules
All personnel working with or around helicopter service will adhere to the following safety rules:
1. Never approach the helicopter until signaled to do so by the flight crew.
2. Always approach the helicopter from the front.
3. NO ONE is permitted near the tail rotor of the helicopter at any time.
4. No smoking or running and avoid placing loose objects around the helicopter.
5. Do not assist the flight crew in opening or closing the helicopter doors.
6. The flight crew will assist, direct the loading and unloading of patients and equipment.
7. Crowds MUST be kept back 150 feet from the helicopter at all times.
Charting
In the event that helicopter services are used a patient care report will be completed by the
helicopter crew and a copy left at the receiving medical facility.
Landing Zone
A minimum area of 100 X 100 feet, a red light or marker at each corner, clear of wires, trees,
brush, bush, large rocks, emergency vehicles, signs and loose objects is required.
The pilot will, at all times, be the final authority on determining the appropriateness of the
landing site and all matters concerning the aircraft and safety of the aircraft.
Criteria For the Consideration Of Air Medical Transport Of Trauma Patients
1. Lengthy extrication of the patient at the scene and the severity of the patient’s injury
requires delivery of a critical care team to the scene.
2. Criteria for consideration of Air Medical transport is as allows but not limited to the
following:
a. the patient was ejected from the vehicle;
b. another person in the same vehicle died;
c. the patient was a pedestrian struck by a vehicle traveling more than 20 mph;
d. the patient was not wearing a safety belt in a car which was overturned;
e. the patient was thrown from a motorcycle traveling more than 20 mph;
f. the front bumper of the vehicle was displaced to the rear by more than 30 inches,
or the front axle was displaced to the rear.
3. The patient fell from a height of greater than 20 feet.
4. The patient experienced a penetrating injury between the mid-thigh and the head.
5. The patient experienced an amputation or near amputation and required timely evaluation
for possible reimplantation.
6. The patient experienced a scalping or degloving injury.
7. The patient experienced a severe hemorrhage. Included are those patients with a systolic
blood pressure of less than 90 mmHg after initial volume resuscitation and those
requiring ongoing blood transfusions to maintain a stable blood pressure.
8. The patient experienced 2nd-3rd degree burns of the skin greater than 15 percent of the
body surface, or major burns of the face, hands, feet, perineum, or associated with an
airway or inhalation injury.
9. The patient experienced, or had great potential to experience, injury to the spinal cord,
spinal column, or neurologic deficit.
10. The patient suffered injuries to the face or neck which might result in an unstable or
potentially unstable airway and might require invasive procedures (such as endotracheal
or nasotracheal intubation, tracheotomy, cricothyroidotomy) to stabilize the airway.
11. The patient had a score from an objective ranking system for trauma (such as the Trauma
Score, Revised Trauma Score, Glasgow Coma Scale, etc.) at the scene or at the referring
hospital’s emergency department which indicated a severe injury.
12. The patient is a child less than five years of age with multiple traumatic injuries.
13. The patient is greater than 55 years of age and has multiple traumatic injuries, whether
with or without preexisting illness, such as diabetes mellitus, coronary artery disease,
chronic obstructive lung disease or chronic renal failure.
14. The patient is an adult with respiratory rate of less than 10 or greater than 30 breaths per
minute, or a heart rate of less than 60 or greater than 120 beats per minute End of Day 1
Regional Facility Triage Criteria Policy
Goal
Purpose
The purposes of the Regional Facility Triage Criteria scheme are:
a. To categorize patients for determination for facility transport and/or transfer
b. To specify facility action plans for transfer of patients
c. To include pediatric and burn criteria for patient transport and/or transfer
Policy
Trauma patients should be placed into one of the following categories by the attending physician
based upon the severity of their injuries. Interhospital transfer should then be initiated as
appropriate according to the Regional Trauma System’s Facility Triage Decision Scheme.
Category I Patients
Central Nervous System:
 Neurological injuries producing prolonged loss of consciousness, posturing, paralysis, or
lateralizing sign
 Spinal injuries with or without neurological deficit
 Deterioration of the neurological status as indicated by Glascow Coma Scale of <10.
 Open, penetrating, or depressed skull fracture
 CSF leak
 Deterioration of GCS of 2 or more
Chest





Major chest wall injury
Suspected great vessel or cardiac injuries
Patients who may require protracted mechanical ventilation
Respiratory distress with a rate> 35 or < 10
Penetrating thoracic wound
Pelvis
 Pelvic ring disruption with shock requiring more than five units transfusion ‘-Evidence of
continued hemorrhage
 Compound/open pelvic injury or pelvic visceral injury
 Blunt abdominal trauma with hypotension or penetrating abdominal wound
Multiple System Injury
 Severe injury to two or more body regions
Specialized Problems
 Second or third degree burns greater than 10% of body surface area or involving airway
 Baratrauma
 Uncontrolled hemorrhage




Severe maxillofacial or neck injuries
Revised Trauma Score of 11 or less
Open fractures
Second/third trimester of pregnancy
Secondary Deterioration
 Patients requiring mechanical ventilation Sepsis
 Organ system(s) failure (deterioration in CNS, cardiac, pulmonary, hepatic, renal, or
coagulation)
 Osteomyelitis
Category II Patients
Patients who are hemodynamically and physiologically stable whose injuries may include:
Central Nervous System
 Transient loss of consciousness
Chest
 Injuries not producing respiratory distress
 Rib fractures without flail segments
Abdomen
 Blunt trauma not producing hypotension (should also be managed by trauma service)
Specialized Problems
 Closed fractures
 Soft tissue injuries with controlled hemorrhage
 Second/third trimester of pregnancy
Category III Patients
Patients who are continually stable but whose injuries may include:
 Closed fracture without neurological deficit
 Normotensive and/or hemodynamically stable
 Soft tissue injuries of moderate degree
EMS Disaster Response Policy
Goal
To establish a plan for RAC EMS response in case of MCI or disaster
Policy
Activation Protocol
TDH-Tyler will act as central notification site. Once an agency has determined that local
resources have been exhausted they should contact the RAC. The requesting agency should in
their initial request, at a minimum, describe the task to be performed, number of units needed,
supplies needed, how quickly the units will be needed and for how long.
TDH-Tyler will then determine the NETRAC EMS agencies to be alerted and request support.
Responder will advise the requesting party of an approximate ETA of the unit(s) that may be
responding
Upon request by TDH-Tyler, each agency will commit one ambulance and crew to respond to
the effected area for a minimum of 24 hours.
Standard Operating Procedures
Unless advised otherwise the following operating procedures will be followed:
1. All units will report to requesting agency’s main base of operation.
2. On arrival the agency’s crew will combine their staff with the requesting
agency’s staff with the paramedic staying with his vehicle and practicing
under his own set of medical protocols.
3. Each responding agency’s paramedic will provide patient care as set forth
by their agency’s medical protocols.
4. All dispatch and radio communications will utilize 155.340.
5. The agency requesting aid will act as the EMS commander and the
responding agency crews will report to him/her.
6. The requesting agency will be responsible for providing food, housing,
and any additional supplies to responding agency units.
Affidavit Acknowledging Participation in RAC NETRAC EMS
Response Plan
Provider:
License #:
County of Licensure:
Counties of Operations:
Level of Service:
The RAC NETRAC EMS are collectively referred to as the “Agencies.” The Agencies are
desirous of entering into this RAC NETRAC EMS Response Plan whereby the Agencies agree to
provide back-up ambulance service to one another under the conditions and pursuant to the terms
specified in this Plan.
 We as the Administrator and Medical Director for
agree:
To provide ambulance service within requesting agency’s service area when requested to do so
by TDH except when agency’s units are unavailable.
This RAC NETRAC EMS Response Plan includes, but is not limited to, responding to each
agency’s service area when requested to respond to manmade or natural disaster, periods of
unusual call volume, sudden unit or equipment mechanical failure, or other extraordinary
situations, unless the agency is unable to do so because its personnel and ambulances are
providing services elsewhere.
To participate in mutual disaster preparedness drills and training sessions, given reasonable
notice and availability of personnel, equipment and units.
To operate an ambulance that is specifically designed, constructed and equipped to be used for
and maintained or operated for the transportation of Patients (such vehicles hereinafter
sometimes referred to as an “ambulance”).
That agency is in good standing with the State of Texas and has the necessary authority to
perform its requirements under these guidelines and to perform the services described herein.
To assume all responsibility and liability for medical direction to its own medical service
personnel. Each agency assumes no responsibility or liability for payment to each other for
services rendered under the terms of this guideline, and the agencies agree to hold each other
harmless for payment for any and all services provided to individuals or organizations under the
terms of this guideline.
That agency participating in the RAC NETRAC EMS Response Plan are independent contractors
and not agents, servants, employees, partners or joint ventures of or with each other.
That agency shall be responsible for any claims, demands, losses, costs, damages, suits,
judgments, penalties, expenses and liabilities of any kind or nature arising directly or indirectly
out of or in connection with agency’s activities wherein the agency is negligent.
Administrator (Printed Name)
Administrator (Signature)
Medical Director (Printed Name)
Medical Director (Signature)
Appendix
Appendix A: Map of Texas Trauma Service Areas
Appendix B: Northeast Texas Regional Advisory Council “F” - Map
Appendix C: List of TSA-F Hospitals
HOSPITAL INFORMATION
Name:
Christus St. Michael Health System
Address:
2600 St. Michael Drive
Texarkana, TX 75503
Telephone:
903-614-1000
Please list the names of facilities /entities Administrators:
CEO: Chris Karam
CFO: Thomas Harvey
CNO: Nancy Keenan
Other Administrator: COO Jason Rounds (Effective 11/7/11)
Designation Level:
Number of Licensed Beds: Acute Care 312
HGP Representative:
Contact Number:
Norman Prewitt
903 614-2760
HGP Representative –
Alternate:
Contact Number:
Ray Hervey
903 614-2799
Voting Member:
Contact Number:
Liberty Bailey
903 614-5558
Alternate Voting Member: Louise Thornell
Contact Number:
903 614-2027
Trauma Registrar:
Contact Number:
Liberty Bailey
903 614-5558
Name:
East Texas Medical Center - Clarksville
Address:
3000 West Main
PO Box 1270
Clarksville, TX 75426
Telephone:
903-427-6400
Please list the names of facilities /entities Administrators:
CEO: John Hart
CFO: Jim Hines
CNO: Rhonda Strate
Other Administrator:
Designation Level:
IV
Number of Licensed Beds: 49
HGP Representative:
Contact Number:
Jeff Nichols
903-427-6487
HGP Representative –
Alternate:
Contact Number:
Rhonda Strate
903-427-6588
Voting Member:
Contact Number:
Jeff Nichols
903-427-6487
Alternate Voting Member: Rhonda Strate
Contact Number:
903-427-6588
Trauma Registrar:
Contact Number:
Jeff Nichols
903-427-6487
Name:
Good Shepherd Medical Center - Linden
Address:
404 North Kaufman
Linden, TX 75563
Telephone:
903-756-5561
Please list the names of facilities /entities Administrators:
CEO: Carla Roadcap
CFO:
CNO:
Other Administrator:
Designation Level:
IV
Number of Licensed Beds: 25
HGP Representative:
Contact Number:
Bertha Evans
903-756-9859
HGP Representative –
Alternate:
Contact Number:
Karen Stephens
903-756-5561
Voting Member:
Contact Number:
Bertha Evans
903-756-9859
Alternate Voting Member: Karen Stephens
Contact Number:
903-756-5561
Trauma Registrar:
Contact Number:
Bertha Evans
903-756-9859
Name:
HealthSouth Rehab Hospital
Address:
515 W 12th
Texarkana, TX 75501
Telephone:
903-735-5000
Please list the names of facilities /entities Administrators:
CEO: Jerry Jasper
CFO:Phylis Buck
CNO: Carla Hogde
Other Administrator:
Designation Level: N/A
Number of Licensed Beds: 50
HGP Representative:
Contact Number:
Scott Reid
903-735-5028
HGP Representative –
Alternate:
Contact Number:
Vornetta Compton
903-735-5057
Voting Member:
Contact Number:
Scott Reid
903-735-5028
Alternate Voting
Member:
Contact Number:
Vornetta Compton
903-735-5028
Trauma Registrar:
Contact Number:
Vornetta Compton
903-735-5028
Name:
Hopkins County Memorial Hospital
Address:
115 Airport Drive
Sulphur Springs, TX 75482
Telephone:
903-885-7671
Please list the names of facilities /entities Administrators:
CEO: Michael McAndrew
CFO: Donna Wallace
CNO: Terri Bunch
Other Administrator:
Designation Level:
IV
Number of Licensed Beds: 96
HGP Representative:
Contact Number:
Stuart Cody, RN
903-439-4089
HGP Representative –
Alternate:
Contact Number:
Cheryl Pierce
903-439-2847
Voting Member:
Contact Number:
Stuart Cody, RN
903-439-4089
Alternate Voting Member: Cheryl Pierce
Contact Number:
903-439-2847
Trauma Registrar:
Contact Number:
Stuart Cody, RN
903-439-4089
Name:
Paris Regional Medical Center
Address:
820 Clarksville Street
Paris, TX 75421
Telephone:
903-737-4521
Please list the names of facilities /entities Administrators:
CEO: Bill Porter
CFO: Ken Miller
CNO: Connie Murchinson
Other Administrator: Rita Conder, ACNO
Carole Grant, Risk Manager
Designation Level:
None
Number of Licensed Beds: 364
HGP Representative:
Contact Number:
Scott Conway
903-737-3100
HGP Representative –
Alternate:
Contact Number:
Don Garrison
903-249-6551
Voting Member:
Contact Number:
Carolyn Kain
903-737-3100
Alternate Voting Member: Byron Prince
Contact Number:
903-249-6551
Trauma Registrar:
Contact Number:
Carolyn Kain
903-737-3100
Name:
Titus Regional Medical Center
Address:
2001 North Jefferson Ave
Mt. Pleasant, TX 75455
Telephone:
903-577-6000
Please list the names of facilities /entities Administrators:
CEO: Ron Davis
CFO: Duane Shafer
CNO: Carol Slider
Other Administrator:
Designation Level:
Lead Level III
Number of Licensed Beds: 164
HGP Representative:
Contact Number:
Mark Mallory
903-577-6362
HGP Representative –
Alternate:
Contact Number:
Robin Gage
903-577-6276
Voting Member:
Contact Number:
Robin Gage
903-577-6276
Alternate Voting Member:
Contact Number:
Trauma Registrar:
Contact Number:
Robin Gage
903-577-6276
Name:
Wadley Regional Medical Center
Address:
1000 Pine Street
Texarkana, TX 75501
Telephone:
903-798-8000
Please list the names of facilities /entities Administrators:
CEO: Thomas Gilbert
CFO: Steve Winegart
CNO: Jeanette Akin
Other Administrator:
Designation Level:
None
Number of Licensed Beds: 370
HGP Representative:
Contact Number:
David Ryther
903-798-8761
HGP Representative –
Alternate:
Contact Number:
LeighAnnScates
903-798-8860
Voting Member:
Contact Number:
David Ryther
903-798-8761
Alternate Voting Member: LeighAnnScates
Contact Number:
903-798-8860
Trauma Registrar:
Contact Number:
LeighAnnScates
903-798-8860
Appendix D: List of TSA-F EMS Agencies
Champion EMS
do Arnie Spier
Longview, TX
903-291-2504
Emergency Number: E91 1
Number of Vehicles - 4
Type of Service - Hospital - Non Profit
Level of Service - MICU
County Served – Morris & Cass
Square Miles Covered - 1219
Medical Director - Dr. Chris Dunnahoo
City of Atlanta Fire Dept. EMS
do Robin Betts
P.O. Box 669
Atlanta, TX 75551
903-799-4062
Emergency Number ~ E9 11
Number of Vehicles -2/0 backup
Type of Service - Public - FD
Level of Service - BLS w/ MICU Capability
County Served - Cass
Square Miles Covered - 1000
Medical Director - Tim O’Kelly, MD
City of Paris - EMS
do Kent Klinkerman, EMT-P
P.O. Box 9037
Paris, TX 75460
903-785-7511
Emergency Number E91 1
Number of Vehicles - 7
Type of Service - Public
Level of Service - MICU
County Served - Lamar
Square Miles Covered - 930
Medical Director – Sharon Malone, MI)
Hopkins County EMS
do Brent Smith
115 Airport Drive
Sulphur Springs, TX 75482
903-885-7671
Emergency Number - E91 1
Number of Vehicles - 7
Type of Service - Public - Hospital District
Level of Service - MICU
County Served – Hopkins/Delta
Square Miles Covered - 1046
Medical Director – Sandra Deniz, M.D.
LifeNet
do Darren Higgs
6225 St. Michael Drive
Texarkana, TX 75503
903-832-8531
Emergency Number E911
Number of Vehicles - 24
Type of Service - Private - Non Profit
Level of Service - MICU
County Served - Red River, Bowie, Cass, Little River, and Miller Co., ARK.
Square Miles Covered - 3232
Medical Director – Matthew Young, MD, FACEP
LifeNet EMS Air
do Darren Higgs
6225 St. Michael Drive
Texarkana, TX 75503
903-832-8531
Emergency Number - 1-800-582-5433
Number of Vehicles - 1
Type of Vehicles - Bell 407 Helicopter
Type of Service - Private Non Profit
Level of Service - MICU
Titus Regional Medical Center EMS
do Mark Mallory, RN, LP, MS
2001 N. Jefferson
Mt. Pleasant, TX 75455
903-577-6362
Emergency Number E911
Number of Vehicles - 6
Type of Service - Public - Hospital District
Level of Service - MICU
County Served - Titus
Square Miles Covered - 500
Medical Director – Harris Hollingsworth, M.D.
Appendix E: List of TSA -F First Responder Organizations
Sugarhill VFD
do Chief Jerry Clark
60 County Road 3925
Mt. Pleasant, TX 78455
903-563-3100
Emergency Number - E91 1
Number of Vehicles -1 Rescue
Level of Service - BLS
County Served - Titus
Square Miles Covered Authorizing EMS Agency – Titus Regional Medical Center EMS
Mount Pleasant Fire Department
do Chief Larry McRae
728 E. Ferguson Road
Mt. Pleasant, TX 78455
903-575-4144
Emergency Number - E91 1
Number of Vehicles -1 Rescue Truck, Several Additional Trucks
Level of Service - BLS
County Served - Titus
Square Miles Covered Authorizing EMS Agency – Titus Regional Medical Center EMS
Talco VFD
do Randy Carroll
400 West Broad
Talco, TX 78487
903-379-3731
Emergency Number – E911
Number of Vehicles – 1 Rescue
Level of Service – BLS
County Served - Titus
Square Miles Covered –
Authorizing EMS Agency – Titus Regional Medical Center - EMS
Avery VFD
do Chief Gary Tucek
P.O. Box 7
Avery,TX 75554
903-684-3361
Emergency Number - E91 1
Number of Vehicles -3 Fire Trucks
Level of Service - BLS
County Served - Bowie
Square Miles Covered - 100
Authorizing EMS Agency - LifeNet EMS
Bogata Fire and Rescue
do Chief Jerry Hutson
P.O. Box 488
Bogata, TX 75417
903-632-5234
Emergency Number - E91 1
Number of Vehicles -4 Fire Trucks, 1 Tanker, Rescue w rescue tools and AED
Level of Service - BLS w/AED
County Served - Red River
Square Miles Covered - 150
Authorizing EMS Agency - LifeNet EMS
Boxelder VED
do Chief Glen Floyd
P.O. Box 109
Annona,TX 75550
903-697-3524
Emergency Number - E91 I
Number of Vehicles - 2 Fire Trucks
Level of Service - BLS
County Served - Red River
Square Miles Covered - 100
Authorizing EMS Agency - LifeNet EMS
C-S - Redlick/Leary VFD
do Chief Greg Liles
P.O. Box 1132
Nash, TX 75569
903-831-7900
Emergency Number - E911
Number of Vehicles- I Rescue
Level of Service - BLS
County Served - Bowie
Square Miles Covered - 50
Authorizing EMS Agency - LifeNet EMS
Cass County EDS #2
do Chief Chuck Weerts
P.O. Box 157
Queen City, TX 75572
903-796-9101
Emergency Number - E911
Number of Vehicles Level of Service - BLS
County Served - Cass
Square Miles Covered Authorizing EMS Agency - LifeNet EMS
Clarksville VFD
do FRO Coordinator – Wesley Patrick
300 N. Pecan
Clarksville, TX 75426
903-427-3836
Emergency Number - E911
Number of Vehicles Level of Service - BLS
County Served –Red River
Square Miles Covered Authorizing EMS Agency - LifeNet EMS
Cuthand VFD
do Chief Phillip Andrews
3705 FM 1487
Bogota, TX 75417
903-249-5668
Emergency Number - E911
Number of Vehicles Level of Service - BLS
County Served –Red River
Square Miles Covered Authorizing EMS Agency - LifeNet EMS
DeKalb VFD
do Chief Robby Barrett
110 E. Grizzly St.
DeKalb, TX 75559
903-667-3846
Emergency Number - E911
Number of Vehicles Level of Service - BLS
County Served - Bowie
Square Miles Covered Authorizing EMS Agency - LifeNet EMS
Hooks First Responders
do Michael Western
P.O. Box 37
Hooks, TX 75561
903-547-2250
Emergency Number - E911
Number of Vehicles: 2 – Fire Trucks, 1 Rescue
Level of Service - BLS
County Served - Bowie
Square Miles Covered - 60
Authorizing EMS Agency - LifeNet EMS
Liberty-Eylau
doChief David Wesselholf
7675 Eylau Loop Rd.
Texarkana, TX 75501
903-832-1874
Emergency Number - E91 1
Number of Vehicles - 5 Fire Trucks
Level of Service - BLS
County Served - Bowie
Square Miles Covered - 60
Authorizing EMS Agency - LifeNet
Nash VFD
doChief Steve Rogers
P.O. Box 520
Nash, TX 75569
903-832-7071
Emergency Number - E9 11
Number of Vehicles - 3 Fire Trucks
Level of Service - BLS
County Served - Bowie
Square Miles Covered -30
Authorizing EMS Agency - LifeNet EMS
Maud VFD
do Roy Beckett
P.O. Box 123
Maud, TX 75576
903-585-5813
Emergency Number - E9 11
Number of Vehicles - 1 Rescue
Level of Service - BLS
County Served – Bowie 4
Square Miles Covered -30
Authorizing EMS Agency - LifeNet EMS
Pleasant Grove VFD
do Chief Josh Kurtz
P.O. Box 4968
Texarkana, TX 75501
903-831-7123
Emergency Number - E911
Number of Vehicles - 2
Level of Service - BLS
County Served - Bowie
Square Miles Covered - 70
Authorizing EMS Agency - LifeNet EMS
Simms VFD
doChief Chris Taillon
P.O. Box 87
Simms, TX 75574
903-543-2032
Emergency Number - E9 11
Number of Vehicles – 2 Rescue Truck
Level of Service - BLS
County Served – Bowie 4
Square Miles Covered -80
Authorizing EMS Agency - LifeNet EMS
Redwater VFD
doChief Merle Luster
P.O. Box 316
Redwater, TX 75573
903-671-2688
Emergency Number - E91 I
Number of Vehicles -2 Rescue
Level of Service - BLS
County Served – Bowie 4
Square Miles Covered - 80
Authorizing EMS Agency - LifeNet EMS
Wake Village VFD
doChief James Guyton
551 Redwater Rd.
WakeVillage,TX 75501
903-838-0515
Emergency Number - E91 1
Number of Vehicles - I Rescue, 2 Pumpers
Level of Service - BLS
County Served - Bowie
Square Miles Covered - 40
Authorizing EMS Agency - LifeNet EMS
Texarkana Texas Fire Department
do Chief Kenneth Copeland
3124 Texas Blvd
Texarkana, TX 75501
903-798-3994
Emergency Number E91 I
Number of Vehicles Level of Service - BLS
County Served - Bowie
Square Miles Covered Authorizing EMS Agency - LifeNet EMS
Brinker Fire Dept.
do Andy Endsley
1415 FM 69 South
Sulphur Springs, TX 75482
903-348-8337
Emergency Number - E91 1
Number of Vehicles - 1
Level of Service - BLS
County Served - Hopkins
Square Miles Covered - 100
Authorizing EMS Agency - Hopkins County EMS
Dike VFD
do A.G. Sandifeer
1057 CR 3525
Dike, TX 75437
903-945-2061
Emergency Number - E91 1
Number of Vehicles - 1
Level of Service - BLS
County Served - Hopkins
Square Miles Covered - 100
Authorizing EMS Agency - Hopkins County EMS
Hopkins County Fire/Rescue
do Carl Nix
P.O. Box 288
Sulphur Springs, TX 75482
903-438-4024
Emergency Number - E91 1
Number of Vehicles - 1
Level of Service - BLS
County Served - Hopkins
Square Miles Covered - 100
Authorizing EMS Agency - Hopkins County EMS
Klondike VFD
do Janet Currin
P.O. Box 489
Klondike, TX 75448
903-517-4057
Emergency Number - E91 1
Number of Vehicles - 1
Level of Service - BLS
County Served - Delta
Square Miles Covered - 100
Authorizing EMS Agency - Hopkins County EMS
North Hopkins VFD
do Craig Morgan
111 County RD 4796
Sulphur Springs, TX 75482
Emergency Number - E91 1
Number of Vehicles - 1
Level of Service - BLS
County Served - Hopkins
Square Miles Covered - 100
Authorizing EMS Agency - Hopkins County EMS
Peerless VFD
do Jim Rich
Box 239 CR 4754
Sulphur Springs, TX 75482
903-945-2267
Emergency Number - E91 1
Number of Vehicles - 1
Level of Service - BLS
County Served - Hopkins
Square Miles Covered - 100
Authorizing EMS Agency - Hopkins County EMS
Pickton-Pine Forest VFD
do Mark Sustaire
5308 FM 269
Pickton, TX 75471
903-866-3101
Emergency Number - E91 1
Number of Vehicles - 1
Level of Service - BLS
County Served - Hopkins
Square Miles Covered - 100
Authorizing EMS Agency - Hopkins County EMS
Saltillo FD
do Dutch Vallaster
412 CR 3350
Saltillo, TX 75478
903-537-2617
Emergency Number - E91 1
Number of Vehicles - 1
Level of Service - BLS
County Served - Hopkins
Square Miles Covered - 100
Authorizing EMS Agency - Hopkins County EMS
Sulphur Springs FD
do Asst. Chief Tim Vaughn
627 Church Street
Sulphur Springs, TX 75482
903-885-7548
Emergency Number - E91 1
Number of Vehicles Level of Service - BLS
County Served - Hopkins
Square Miles Covered - 100
Authorizing EMS Agency - Hopkins County EMS
Biardstown VFD
do Spencer Eppler
164 CR 13685
Paris, TX 75462
903-783-0404
Emergency Number Number of Vehicles – 1 Medical Vehicle
Level of Service - BLS
County Served - Lamar
Square Miles Covered Authorizing EMS Agency – City of Paris - EMS
Blossom VFD
do Sam Cullum
P.O. Box 201
Blossom, TX 75416
903-982-5400
Emergency Number Number of Vehicles – 1 Medical Vehicle
Level of Service - BLS
County Served - Lamar
Square Miles Covered Authorizing EMS Agency – City of Paris - EMS
Brookston VFD
do Bruce Ary
P.O. Box 246
Brookston, TX 75421
903-785-2221
Emergency Number Number of Vehicles – 1 Medical Vehicle
Level of Service - BLS
County Served - Lamar
Square Miles Covered Authorizing EMS Agency – City of Paris - EMS
Campbell Soup E.R.T.
do Nancy Whitten
500 N.W. Loop 286
Paris, TX 75460
903-737-2285
Emergency Number Number of Vehicles – 0
Level of Service - BLS
County Served - Lamar
Square Miles Covered Authorizing EMS Agency – City of Paris - EMS
Chicota VFD
do Debbie Lambert
P.O. Box 63
Chicota, TX 75425
903-732-3359
Emergency Number Number of Vehicles – 1 Medical Vehicle
Level of Service - BLS
County Served - Lamar
Square Miles Covered Authorizing EMS Agency – City of Paris - EMS
Cunningham VFD
do Pat Norwood
P.O. Box 36
Cunningham, TX 75434
903-652-2672
Emergency Number Number of Vehicles – 1 Medical Vehicle
Level of Service - BLS
County Served - Lamar
Square Miles Covered Authorizing EMS Agency – City of Paris - EMS
Deport VFD
doNanalee Nichols
P.O. Box 498
Deport, TX 75435
903-652-5823
Emergency Number Number of Vehicles – 1 Medical Vehicle
Level of Service - BLS
County Served - Lamar
Square Miles Covered Authorizing EMS Agency – City of Paris - EMS
East Post Oak VFD
doVerlon Vaught
1011 CR 44750
Blossom TX 75416
903-982-6463
Emergency Number Number of Vehicles – 1 Medical Vehicle
Level of Service - BLS
County Served - Lamar
Square Miles Covered Authorizing EMS Agency – City of Paris - EMS
Faught VFD
do Rick Browning
197 CR 43420
Paris, TX 75462
903-785-9490
Emergency Number Number of Vehicles – 1 Medical Vehicle
Level of Service - BLS
County Served - Lamar
Square Miles Covered Authorizing EMS Agency – City of Paris - EMS
Kimberly-Clark First Responders
do Sherry Williams
2466 FM 137
Paris, TX 75460
903-737-5667
Emergency Number Number of Vehicles – 1 Medical Vehicle
Level of Service - BLS
County Served - Lamar
Square Miles Covered Authorizing EMS Agency – City of Paris - EMS
Northwest First Responders
do David Edelhauser
Rt 1 box 271B
Paris, TX 75460
903-785-3003
Emergency Number Number of Vehicles – 1 Medical Vehicle
Level of Service - BLS
County Served - Lamar
Square Miles Covered Authorizing EMS Agency – City of Paris - EMS
NOVICE VFD
do Chris Shoemate
13834 FM 195
Paris, TX 75462
903-784-1148
Emergency Number Number of Vehicles – 1 Medical Vehicle
Level of Service - BLS
County Served - Lamar
Square Miles Covered Authorizing EMS Agency – City of Paris - EMS
Pairs Fire Department
do Ronnie Grooms
P.O. Box 9037
Paris, TX 75461
903-784-9208
Emergency Number Number of Vehicles – 1 Medical Vehicle
Level of Service - BLS
County Served - Lamar
Square Miles Covered Authorizing EMS Agency – City of Paris - EMS
PattonvilleVFD
do Chet Downs
212 FM 196
Pattonville, TX 75435
903-652-3668
Emergency Number Number of Vehicles – 1 Medical Vehicle
Level of Service - BLS
County Served - Lamar
Square Miles Covered Authorizing EMS Agency – City of Paris - EMS
Powderly VFD
do Jack Steed
P.O. Box 188
Powderly TX 75473
903-732-4488
Emergency Number Number of Vehicles – 1 Medical Vehicle
Level of Service - BLS
County Served - Lamar
Square Miles Covered Authorizing EMS Agency – City of Paris - EMS
Reno VFD
do Leslie Watkins
185 Bybee Street
Paris, TX 75462
903-785-4502
Emergency Number Number of Vehicles – 1 Medical Vehicle
Level of Service - BLS
County Served - Lamar
Square Miles Covered Authorizing EMS Agency – City of Paris - EMS
RoxtonVFD
do Paul Helms
Box 156
Roxton, TX 75477
903-346-3292
Emergency Number Number of Vehicles – 1 Medical Vehicle
Level of Service - BLS
County Served - Lamar
Square Miles Covered Authorizing EMS Agency – City of Paris - EMS
Siligan First RespondersVFD
do George Rhodes
500 N.W. Loop 286
Paris, TX 75460
903-739-9104
Emergency Number Number of Vehicles – 0
Level of Service - BLS
County Served - Lamar
Square Miles Covered Authorizing EMS Agency – City of Paris - EMS
REGIONAL PLANS
REGIONAL MASS
FATALITY PLAN
FOR
TRAUMA SERVICE AREA-F
(SERVING BOWIE, CASS, DELTA, HOPKINS,
LAMAR, MORRIS, REDRIVER, TITUS, AND
MILLER, AR COUNTIES)
Northeast Texas Regional Mass Fatality Plan
Table of Contents
I.
Purpose………………………………………………………………………………………….……..4
II.
Explanation of Terms……………………………………………………………………….………...4
III.
Situations and Assumptions……………………………………………………….……………...….4-5
IV.
Mass Fatality Response Plan………………………………………………….………...……………5
V.
Evaluation & Assessment……………………………………………………….…….………..…….5-6
VI.
Concept of Operations……………………………………………………………....….….…………6
VII.
Incident Management Structure…………………………………………….….………………..….7
VIII.
Organization and Assignment of Responsibilities…………………………………………...…..…8-10
IX.
Resource Management……………………………………………………………..……..………….10
X.
Resource Management Flow Chart ..………………………………………….………………….…11
XI.
Plan Review………………………………………………………………………….……...………...11
XII.
Reference…………………………………………………………………………………….……….12
Regional Mass Fatality Plan
I.
PURPOSE
The purpose of this plan is to identify actions to be taken during the regional response of
a mass fatality event. This plan defines a concept of operations for the fulfillment of
NIMS compliant organizational roles and responsibilities for a coordinated regional
response effort. Primary objectives in mass fatality management include handling human
remains in a dignified, respectful, timely, methodical, and safe manner; accomplishing
the identification of victims and the certification of cause and manner of death; and
advancing to the final disposition of remains according to the wishes of the next of kin,
whenever possible.
Management of the overall disaster is accomplished using the Incident Command System
as codified by the NIMS. The primary functions of command, operations, planning,
logistics, and administration/finance are the foundation of a scalable platform that can
expand or contract as the scope of the disaster dictates. The Justice of Peace role in an
incident is to function in concert with the overall Incident Commander.
II.
EXPLANATION OF TERMS
A. ACRONYMS

EOC: Emergency Operations Center

FAC: Family Assistance Centers

JIC: Joint Information Center

JIS: Joint Information System

MACC: Multi-Agency Coordination Center

MOU: Memorandum of Understanding

NIMS: National Incident Management System

PPE: Personal Protective Equipment

RLO: Regional Liaison Officer

NETMOC: Northeast Texas Medical Operations Center

TDEM: Texas Division of Emergency Management

TER: Texas Electronic Registry
B. DEFINITION
A mass fatality incident is a term used to describe an incident with multiple deaths that
exceeds the routine capability of the Coroner/Medical Examiners and Justices of the
Peace.
III.
SITUATIONS AND ASSUMPTIONS
A. Situation
The region is vulnerable to natural disasters, hazardous materials incidents, transportation
accidents, and acts of terrorism. An occurrence could result in multiple deaths that would
require a response that could overwhelm local capabilities. Support from neighboring
jurisdictions, counties, state agencies, and federal agencies may be required.
B. Assumption
IV.
Mass fatality disasters have the potential to quickly overwhelm a single jurisdiction’s
resources depending on the capacity of the facility and the number of fatalities. Offices
that are overwhelmed may seek assistance at region, state and federal levels.
Jurisdictions within the Northeast Texas Region (Bowie, Cass, Delta, Hopkins, Lamar,
Morris, Red River, Titus, and Miller, AR counties) will provide assistance in the
necessary acts of recovery, evacuation, sanitation, temporary storage of remains,
notification of next of kin, counseling, and release of remains.
MASS FATALITY RESPONSE
A. Purpose
The purpose of the Mass Fatality Response Plan is to define roles and procedures in
preparedness, response, and recovery from mass fatality incidents. The plan will provide
proper coordination of incident response activities and establishes methods for sensitive
and respectful care in handling human remains. The goal of these guidelines is to
enhance the ability of the Northeast Texas Region and its healthcare partners to respond
V.
to and manage a surge in the number of decedents as a result of any disaster, including an
influenza pandemic.
While the importance of religious and cultural considerations is recognized, it is not
addressed here. These guidelines focus on decedent processing for medical and legal
reasons.
EVALUATION & ASSESSMENT
An initial site visit will be conducted by Emergency Responders/Healthcare facilities to
establish a legal; pronouncement of death to determine the following:
 Number of fatalities involved.
VI.

Condition of the bodies, i.e. burned, dismembered, etc.

Difficulties anticipated in the recovery of the bodies and the types of personnel
and equipment needed, i.e. search & rescue, heavy equipment, dog teams, etc.

Location of the incident as far as the accessibility and difficulties that may be
encountered in transporting bodies from the scene.

Formulation of a plan for documentation, body recovery, and transportation.

Ascertain the types and numbers of personnel needed to staff the recovery site and
morgue operations.

Try to anticipate what type of facility would be the most useful for the families of
the victims as a Family Support Center.

Determine the extent of possible chemical, biological, radiological, or other
hazards associated with recovery operations.

Determine the need for activation of state and/or federal resources. The request
will be initiated by the Incident Commander in coordination with the County
EOC/NETMOC.
CONCEPT OF OPERATIONS
A. General
The City/County is responsible for developing and maintaining emergency mass fatality
plans within the legal authority delegated to the City/County through the State of Texas.
Local and regional resources should be used before requesting additional resources
through the State of Texas.
The City/County prepares and coordinates procedures, personnel, equipment, supplies,
and facilities necessary to conduct activities associated with the mass fatality incident,
including:
a. Provide and test communications equipment.
b. Maintain permanent and temporary morgue capability for bodies (Develop MOU
with agencies for refrigerated truck availability; pre-identify temporary
internment locations, etc).
c. Provide identification and appropriate level PPE for all Health/Medical response
personnel.
d. Maintain current call lists for supplemental resources of equipment, personnel, or
other resources.
e. Coordinate with the NETMOC as needed.
B. Direction and Control
a. All mass fatality management decisions regarding response are made at the local
jurisdiction level.
b. In accordance with a mission assignment and mutual aid agreements resource
support organizations assisting will retain administrative control over their
resources and personnel but will be under the operational control of the requesting
jurisdictions Incident Commander.
c. Management of fatality related operations under the direction of the Justice of
Peace is coordinated with the Incident Commander.
d. Volunteer groups and individuals may also offer services to assist the Incident
Commander or Justice of Peace. Traditionally, this includes forensic pathologists
from other regions and members of various funeral associations and dental
societies. Funeral service personnel can be a valuable asset to provide, at a
minimum, additional staff to serve as “trackers” to monitor custody and
processing steps for each set of remains through the morgue process. Likewise,
dental personnel, even if they possess no forensic experience, can assist forensic
odontologists in a number of areas.
For such volunteers who are not already pre-registered, the Incident Commander
should ensure that each volunteer acknowledges a liability waiver for workrelated injury and registers in for each period of service.
e. Regardless of the source of personnel (local, regional, state, federal, or volunteer)
detailed time records must be maintained to document the nature and periods of
duty for each and every person assisting during the operation.
VII.
INCIDENT MANAGEMENT STRUCTURE
A. Example: Organization Chart for Decedent Operations in a Mass Fatality
VIII.
ORGANIZATION AND ASSIGNMENT OF RESPONSIBILITIES
A. General
The County Judge/City Mayor has the overall authority in the event of a Mass Fatality
incident. The County Judge/City Mayor will set the incident objectives, manage the
incident operations, oversee the application of resources, and has responsibility over all
personnel involved in the response.
B. Role of the Justice of the Peace
The Justice of the Peace assumes custody of the deceased in order to determine identity,
document findings, inventory belongings, tracking the deceased, initiate the death
investigation, make notification to family and authorities, determine cause and manner of
death, issue death certificates, and coordinate disposition of the remains.
Resources normally available to the Justice of the Peace may be outweighed by the
volume of deceased remains. The Justice of the Peace may request and obtain additional
resources by identifying equipment and personnel assets needed to manage the deceased
and channeling those requests through the IC or local Emergency Operations Center. This
may include specialized assets to assist with decontamination of deceased who were
exposed to chemical, radiological, or biological agents.
If the Justice of the Peace requests the assistance of the Medical Examiner’s Office that
they routinely use for their non-mass disaster autopsy needs, the Medical Examiner’s
Office will assist the Justice of the Peace under his/her authority.
C. Task Assignments
1. County/City/Emergency Management:
 Endorse and support a Mass Fatality Response Plan consistent with the
City/County Emergency Operations Plan.
 Cooperate and coordinate with local, MACC, NETMOC, state, and
federal mass fatality resources through all phases of the emergency.
 Identify sites for temporary internment and develop MOUs.
 Issue a Disaster Declaration.
2. Justice of the Peace:
 Establish manner and cause of death.
 The Justice of the Peace may request assistance from the TER for
death certificate processing, as needed.
3. Law Enforcement:
 Provide security and investigation of the scene, and/or security of
transportation as needed.
 Establish security for short-term morgue operations, and other mass
fatality operations.
4. Funeral Home/Mortuary Services:
 Provide morgue capacity, including equipment, supplies, personnel,
and PPE.
 Maintain a sufficient supply of body bags.
 Facilitate transportation of bodies.
 Provide family with funeral services
5. Public Information Officer
 Prepare statements to the media in coordination with the JIC, utilizing
the JIS.
6. Public Health Region 4/5N:
 Assist the jurisdictional medico-legal authority and law enforcement
agencies in the tracking and documenting of human remains and
associated personal effects.
 Reduce the hazard presented by chemically, biologically, or
radiologically contaminated human remains (when indicted and
possible).
 Assist in the establishment of temporary morgue facilities.
 Assist in disaster related mortality surveillance.
 Assist in the collection of antemortem data in a compassionate and
culturally competent fashion from authorized individuals.
 Assist in assessing the threat of vector-borne diseases.
 Ensure provision of psychosocial support to the families of the
deceased
7. Mental Health
 Provide immediate crisis intervention.
 Assess the scope of disaster and provide support for first responders
and their families.
 Provide short and long term support for emotional needs.
 Ensure provision of psychosocial support to the families of the
deceased, in conjunction with public health.
8. Hospital:
 Assist in providing morgue storage space.
 Assist in providing medical staff for first aid/medication at the mass
fatality operations site.
9. EMS:
 Assist in recovery and transport to care for injured victims.
10. Fire:
 Assist with evaluation of the incident site/scene safety.
 Provide life saving operations.
 Protect property from fire and hazards.
 Assist with decontamination of remains.
 Provide guidance regarding hazards at the incident scene and
consultation on decontamination.
11. NETMOC:
 Assist with coordinating the regional health and medical response
activities.
 Locate additional regional health and medical resources (if needed).
 Assist with requesting additional health and medical resources from
the State (in coordination with the County)
IX.
RESOURCE MANAGEMENT
A. Resource Management is the responsibility of the City/County EOC. The
NETMOC is available to assist with health and medical resources (including
fatality management) if needed; once the County resources have been depleted.
X.
RESOURCE MANAGEMENT FLOW CHART
Loca
Local resources
Once local
Once City
Once County
should be used first
resources are
resources are
resources are
i.e. hospital
depleted; then
depleted; contact
depleted; contact
NETMOC or
resources.
contact the City.
the County.
Once County resources are depleted; then the NETMOC/MACC and the County will coordinate to
request
MACC.
additional resources from the State.
XI.
PLAN REVIEW
A. The Regional Mass Fatality Workgroup is responsible for maintaining and updating this plan on
an annual basis.
Reference
A. The following should be addressed by the local jurisdiction:

Process for notifying the County Judge.

The activation of the Regional Mass Fatality Response Plan in coordination with
Incident Command.

The process for carrying out field operations according to Texas statutes.

Procedures for examinations, identification, and notification of next of kin.

The use of Funeral Homes for mortuary services.

Coordination of a Family Support Center.

The use of the NIMS structure for all emergency operations.

Completion of an After-Action Report; as well as critique.

Coordination of response and recovery teams.

Identify temporary internment locations.
Regional Trauma Registry Plan
Goal
To develop and maintain a trauma reporting and analysis system which will meet requirements
of the Texas Department of Health for Trauma Registry, including:
 Identification of major or severe trauma patients within each health care entity in the
region.
 Identification of the amount of uncompensated trauma care expenditures for each fiscal
year by health care entity within the region.
 Collecting trauma patient data within each health care entity and regional emergency
medical service within the region.
 To improve trauma patient care in the region through analysis of data gathered by the
Regional Trauma Registry.
Strategies For Accomplishing The Goals:
Adopt the American College of Surgeons guidelines for identification of trauma patients.
Use the Standard Data Set developed by the Texas Department of Health as a basis for collection
of—Pre-hospital and hospital patient data.
Coordinate and assist the various health care entities with the region to facilitate data collection
and reporting.
Survey each health care entity within the region to determine (a) present data collection methods
and software programs in use (b) availability and location of computers as possible data entry
sites.
Simplify the process of data submission while maintaining accuracy and sufficient detail to
enable analysis, evaluation, and improvement of trauma care.
Maintain confidentiality of all records while assisting other RAC committees in evaluation and
modification of patient care procedures for an overall improved patient outcome.
NETRAC Stroke Transport Plan
This Plan has been developed in accordance with generally accepted Stroke guidelines and procedures for
implementation of a comprehensive Emergency Medical Services (EMS) and Stroke System plan. This
plan does not establish a legal standard of care, but rather is intended as an aid to decision-making in
general patient care scenarios. It is not intended to supersede the physician’s prerogative to order
treatment.
Goal
Recognition of a facility’s capability to treat stroke patients within Trauma Service Area F in the state of
Texas
.
Objectives
1. To develop a system by which facilities within Area F may seek RAC recognition of stroke capabilities.
Discussion
A facility interested in seeking RAC-Recognition as a Stroke Capable Facility must contact the RAC offices
and obtain a letter of participation to include in application for designation. To successfully obtain this RAC
recognition, the entity must present page two of this plan along with the application. These documents will
be reviewed by the acute care committee for possible recommendations.
Facilities must meet all essential criterions as described on the NETRAC Recognized Stroke Capable
Facility Essential Criteria Summary Sheet. (See form following this section.)
A survey of the document will be completed by the RAC Executive Director and Acute Care Committee.
Only after review by the NETRAC Acute Care Committee, will any hospital recognition be given. If said
hospital meets requirements, the NETRAC Recognized Stroke Capable Facility Essential Criteria Summary
Sheet will be signed.
A RAC Recognized Stroke Capable Facility should then apply for certification/designation through Joint
Commission or DSHS within a reasonable length of time. Stroke designation expires within two years and
the facility must reapply using the process described for re-designation/certification. After meeting Stroke
Capable Facility Criteria, the hospital has a six month window in which to obtain designation by either Joint
Commission or DSHS. If the hospital fails to obtain this designation the RAC Stroke Capable Facility
Designation will expire.
RAC Recognized Stroke Capable Facilities will cease to exist when the facility successfully passes a formal
designation/certification process from either the Joint Commission or DSHS.
CRITERIA DEFINED
A. PERSONNEL
1. 24/7 PHYSICIANS
2. STROKE COORDINATOR
3. STROKE MEDICAL DIRECTOR
B. PROTOCOLS
1. NIH STROKE SCALE
PROTOCOL
2. DYSPHAGIA SCREENING TOOL
3. ED ORDER SET
4. TPA CHECKLIST
5.THROMBOLYTIC THERAPY
ADMINISTRATION PROTOCOL
6.CHOLESTEROL SCREENING
7. DVT PROPHYLAXIS
8. REHAB EVALUATION
C. EQUIPMENT/LAB
1. 24/7 STAT CT
3. 24/7 LABORATORY
D. TRANSFER AGREEMENTS
1. TRANSFER AGREEMENT
WITH CERTIFIED/DESIGNATED
PRIMARYSTROKECENTER(S)
2. EMS TRANSPORT
AGREEMENT(S)
E. EDUCATION
1. NIH STROKE SCALE
2. CORE STROKE TEAM
3. PHYSICIANS
4. NURSING PERSONNEL
5. OTHER PERSONNEL
6.CINNCINATI STROKE SCALE
7. PATIENT/FAMILY EDUCATION
F. STROKE SYSTEM PI
G. PUBLIC AWARENESS
ESSENTIAL
OR
DESIRED
E
E
E
E
D
E
E
E
E
E
E
E
E
E
E
E
E
E
E
E
E
E
E
E
MEETS
DOES
NOT
MEET
COMMENTS
Northeast Texas Regional Advisory Council
RECOGNIZED STROKE CAPABLE FACILITY ESSENTIAL CRITERIA
SUMMARY SHEET
FACILITY: _______________________________
STROKE COORDINATOR/CHAMPION:
ESSENTIAL CRITERIA MET
ESSENTIAL CRITERIA NOT MET
_________________________has met / not met the essential criteria requirements as defined by The Northeast
Texas Regional Advisory Council to be recognized as a NETRAC Stroke Capable Facility and to seek further
leveled stroke designation.
RAC Chair _______________________________ Date
Stroke Committee Chair____________________ Date
Executive Director ______________________
Date____________________
CRITERIA CLARIFICATION
PERSONNEL
24/7 Physician – The facility must have a physician in the ED available 24/7.
Stroke Coordinator – The facility must have a designated Stroke Coordinator. The Stroke
Coordinator must attend NETRAC Stroke Committee meetings.
Stroke Medical Director – The facility must have a designated Medical Director for stroke
protocols. It is preferred (but not required) that this physician attend NETRAC Stroke
Committee Meetings.
PROTOCOLS
NIH Stroke Scale Protocol – The facility must have a written protocol utilizing the NIH
Stroke Scale.
Dysphasia Screening Tool – It is desired that the facility must utilize an accepted Dysphasia
screening tool as well as a protocol outlining how patients will be screened for Dysphasia.
ED Stroke Order Set- It is essential that the facility have in place an ED Stroke order set to
expedite quality care of the patient.
tPA Checklist – The facility must have a protocol/ policy and checklist in place for the
administration of tPA in their facility.
Thrombolytic Therapy Administration Protocol – This criterion refers to a facility having a
written protocol for administering thrombolytics if the facility will be administering
thrombolytics.
Cholesterol Screening – It is essential that the institution should include cholesterol
screening in an order set to assure that the patient is accurately assessed.
DVT Prophylaxis – It is essential that all patients will be assessed and potentially treated for
DVT Prophylaxis either in the Emergency Department or upon admission to the hospital.
Rehabilitation Evaluation – It is essential that stroke patients be evaluated for potential
Rehab placement in a timely manner.
EQUIPMENT/LAB
24/7 STAT CT – This criterion is essential. This criterion refers to the ability to have a CT
completed and read within 45 minutes of arrival to ED.
24/7 Laboratory – The facility must have laboratory available 24/7 on-site. These labs
include but are not limited to PT, PTT, INR, CBC, and CMP. The turn around time for these
tests should be < 45 minutes.
TRANSFER AGREEMENTS
Agreements with Certified Primary Stroke Centers - The facility should have verbal and/or
written transfer agreements with Certified or DesignatedPrimaryStrokeCenters.
Agreements with EMS Providers – The facility should have at least one verbal and/or written
agreement with an EMS Provider allowing stroke patients to be treated as priority
one/emergent.
EDUCATION
NIH Stroke Scale Education - The facility must mandate that their Emergency Room and ICU
nurses along with any Specialty Stroke Unit nurses caring for stroke patients be trained in
the NIH Stroke Scale. This training should be completed on an annual basis.
Core Stroke Team Education - The facility must have a written protocol outlining core stroke
team education. A minimum of 8 hours of CE must be completed annually by all personnel
on core stroke team. The core stroke team must be a minimum of the Stroke Medical
Director and Stroke Coordinator. Additional members are recommended.
Physician Education - The facility must have a written protocol outlining physician education.
Other Personnel Stroke Education - It is essential that the entity educate other personnel
within the facility regarding the signs and symptoms of stroke.
Cincinnati Stroke Scale - It is essential that all EMS providers practicing within NETRAC be
trained and their competency documented.
Patient/Family Education – The program must address the education needs of the
participant, including lifestyle changes that support self management regimens. The
program involves participants in making decisions about managing their disease or
condition.
STROKE SYSTEM PI
The facility must have a system to PI stroke cases. Additionally, the facility must participate
in NETRAC Stroke Committee.
PUBLIC AWARENESS/EDUCATION
The facility must participate in regional stroke awareness campaigns and other public
education activities regarding stroke as required for designation. NETRAC and the Certified
or DesignatedPrimaryStrokeCenters within the area will be assisting Support Stroke Centers
in meeting this criterion.
Goal
Patients will be identified, rapidly and accurately assessed, and based on identification of their actual or
suspected onset of symptoms, will be transported to the nearest appropriate NETRAC stroke facility.
Purpose
In order to ensure the prompt availability of medical resources needed for optimal patient care, each patient
will be assessed for the presence of abnormal vital signs, Cincinnati Stroke Scale, and concurrent
disease/predisposing factors.
System Triage

Patients with an onset of stroke symptoms < 4.5 hours should always be taken to the closest
PrimaryStrokeCenter within the region. The expection to that is when the ground to ED door time
is greater than 30 minutes, making a SupportStrokeCenter the first choice. All unstable patients
should be taken to the nearest Emergency Department for stabilization and transfer to an
appropriate StrokeCenter. If the stabilization process exceeds the 4.5 hour window for IV tPa, a
ComprehensiveStrokeCenter should then be considered. If ground transport time to the nearest
StrokeCenter is greater than 30 minutes, consider calling for the helicopter transport to meet you at
the closest agreed upon landing zone.

Unless immediate stabilization (ABC’s, cardiac arrest, etc.) is required, patients in NETRAC with an
onset of stroke symptoms > 4.5 hours and < 8 hours shall be taken to the nearest Stroke Facility.
At that time the patient will be assessed by the Stroke physician for possible transfer to a center
functioning under guidelines set forth for Comprehensive Stroke Care.
Certified/Designated Primary Stroke Center bypass may only occur for the following reasons:
1) Patient preference
2) Physician Preference
3) StrokeCenter is on diversion status on EMSystems.
4) Patients with an onset of stroke symptoms > 8 hours should be taken to the closest acute care
facility for treatment.
Helicopter Activation
Goal
NETRAC air transport resources will be appropriately utilized in order to reduce delays in providing optimal
stroke care.
Decision Criteria
1. Helicopter activation/scene response should be considered when it can reduce transportation time for
patients with onset of symptoms <4.5 hours. Should there be any question whether or not to activate air
transport resources, on-line medical control should be consulted for the final decision.
2. Patients transported via helicopter should be taken to the nearest CertifiedPrimaryStrokeCenter.
Facility Diversion
Goal
NETRAC stroke facilities will communicate “facility diversion” status promptly and clearly to regional EMS
and other facilities through EM Systems in order to ensure that stroke patients are transported to the
nearest appropriate stroke facility.
System Objectives
1. To ensure that stroke patients will be transported to the nearest appropriate NETRAC stroke
facility.
2. To develop system protocols for regional facility and stroke diversion status
3. Regional stroke care problems associated with facility diversion will be assessed through
the NETRAC Q A Committee.
4. All facilities and pre-hospital providers will use EM Systems to notify and track resource alert
Status.
Facility Bypass
Goal
Suspected stroke patients will be safely and rapidly transported to the nearest appropriate stroke facility
within Area F.
Decision Criteria
Regional transport protocols ensure that patients who meet the triage criteria for activation of the NETRAC
Regional Stroke Plan will be transported directly to the nearest appropriate stroke facility rather than to the
nearest hospital except under the following circumstances:
1. If unable to establish and/or maintain an adequate airway, the patient should be taken to the
nearest acute care facility for stabilization.
2. Medical Control may wish to order bypass in any of the above situations as appropriate, such as
when a facility is unable to meet hospital resource criteria or when there are patients in need of
specialty care.
3. If expected transport time to the nearest appropriate Stroke Facility is excessive, > 30 minutes,
medical control or the EMS crew on scene should consider activating air transportation resources.
Facility Triage Criteria
Goal
The goal of establishing and implementing facility triage criteria in Area F is to ensure that all regional
hospitals use standard definitions to classify stroke patients in order to ensure uniform patient reporting and
facilitate inter-hospital transfer decisions.
Objectives
1. To ensure that each stroke patient is identified, rapidly and accurately assessed, and based on
identification and classification of their actual or suspected onset of symptoms, transferred to the
nearest appropriate NETRAC stroke facility.
2. To ensure the prompt availability of medical resources needed for optimal patient care at the
receiving stroke facility.
3. To develop and implement a system of standardized stroke patient classification definitions.
Discussion

Patients with an onset of stroke symptoms < 4.5 hours will be taken to the closest Recognized
Stroke Facility for treatment and evaluation for interventional care.

Patients with an onset of stroke symptoms >4.5 hours and < 8 hours should be taken to the
nearest Stroke Facility for evaluation. At that time the patient will be assessed by the Stroke
physician for possible transfer to a center functioning under guidelines set forth for Comprehensive
Stroke Centers
Field and Inter-hospital Transport Plan
Identification of Stroke Patients & Stroke Transfers - Stroke patients and their treatment requirements for
optimal care are identified in the facility triage criteria and pre-hospital triage criteria. Written transfer
agreements are available between all hospital facilities,and hospital facilities in adjacent regions. Stroke
patients with special needs may be initially transferred to a Certified/Designated Primary Stroke Center for
assessment and treatment. When resources beyond its capability are needed, transfer to another stroke
designated facility outside Area F should be expedited, (Comprehensive Center). The Area F initialreceiving hospitals may also choose to transfer patients with special needs or patient preference directly to
these facilities, bypassing the Designated Primary Stroke Centers when appropriate.
Stroke Patient Transport - Stroke patients in NETRAC are transported according to patient need,
availability of air transport resources, and environmental conditions. Ground transport via BLS, ALS, or
MICU ground ambulance is available throughout the Region. Air Medical transport is also available in this
Region.
Stroke Patient Rehabilitation – Rehabilitation and continued care of the stroke patient will be a coordinated
effort involving but not limited to the stroke patient, the patient’s family, physicians, stroke facility and
referring facility. The goal of this region is to provide the best possible care for a stroke survivor.
DISASTER
PREPAREDNESS
APPENDIX
Regional Alternate Care Sites:
ALTERNATE CARE SITES - LOCATIONS
(per Hospital)
ATLANTAMEMORIALHOSPITAL:
Name of Facility:
Address:
Contact Person:
and Number:
Horne Enterprises, Inc.
101 East Pinecrest Drive
Atlanta, TX 75551
Jim Horne, M-F 8a-5p, 903-796-4107
Guard at Ft. Horne: Line 1: 903-796-5206
Radio call sign unit 65 AFD & APD
Number of Beds: Estimate of 20, facility has an open floor plan;
Level of care to be provided or types of patients that can be taken care of : Non-emergent acute care patients
Summary of plans for staffing, supply and re-supply of sites: Institute Chain of Command, we will access PRN
Roster and Volunteers for staffing facilities, supplies will be taken from hospital to site and requested on WebEOC
for supply and re-supply.
Name of Facility:
Address:
The Mattie Lanier Richey Center
#1 Sportplex Drive
Atlanta, TX 75551
Contact Person
and Number:
Chamber of Commerce: 903-796-3296
Bobby Embry: 903-796-8572
903-824-8572 (cell)
Judy Nuckels: 903-796-2192
Jennifer Hodges: 903-796-7836
903-824-2279 (cell)
Number of Beds: Estimate of 20, facility has an open floor plan;
Level of care to be provided or types of patients that can be taken care of : Non-emergent acute care patients
Summary of plans for staffing, supply and re-supply of sites: Institute Chain of Command, we will access PRN
Roster and Volunteers for staffing facilities, supplies will be taken from hospital to site and requested on WebEOC
for supply and re-supply.
CHRISTUS ST. MICHAEL HEALTH SYSTEM:
Name of Facility:
On Campus Buildings (Fitness Center, Outpatient Rehab,
ImagingCenter, RehabilitationHospital)
Address:
2600 St. Michael Drive
Texarkana, TX 75503
Contact Person
and Number:
Jesse Buchanan – 903-614-2391
Number of Beds: 100
Level of care to be provided or types of patients that can be taken care of : Non-critical; Critical patients would
shelter in the facility until transport and transfer to a comparable facility
Summary of plans for staffing, supply and re-supply of sites: Staff will move with patients. Supplies that can be
salvaged from hospital will be moved to ALC, Re-supply will deliver to supply staging area located at ALC.
EASTTEXASMEDICALCENTER – CLARKSVILLE:
Name of Facility:
Address:
Clarksville Nursing Center
300 E. Baker
Clarksville, TX 75460
Name of Facility:
Address:
Regency at Red River Rehab and Healthcare
2800 W. Main
Clarksville, TX 75460
Contact Person
and Number:
Ruth Brown
Number of Beds:
Level of care to be provided or types of patients that can be taken care of :
Summary of plans for staffing, supply and re-supply of sites:
GOOD SHEPHERD MEDICAL CENTER – LINDEN:
Name of Facility:
Address:
Longview Regional Medical Center
Longview, TX
Contact Person
and Number:
Jerri Pendarvis
903-315-2000
Number of Beds:
10-25 or what’s available
Level of care to be provided or types of patients that can be taken care of : Acute Care
Summary of plans for staffing, supply and re-supply of sites: The Linden facility will provide staff and supplies
Name of Facility:
Address:
Jerry Neel - GSMC-Marshall Center
Marshall, TX
Contact Person
and Number:
903-927-6000
Name of Facility:
Address:
Atlanta Memorial Hospital
1007 S. William
Atlanta, TX 75551
Contact Person
and Number:
Meagan Beauchamp
903-799-3000
Number of Beds:
10
Level of care to be provided or types of patients that can be taken care of : Acute Care
Summary of plans for staffing, supply and re-supply of sites: Linden will bring their own staff and supplies
HEALTHSOUTH REHABILITATION HOSPITAL:
Name of Facility:
Address:
WRMC
1000 Pine Street
Texarkana, TX 75501
Contact Person
and Number:
Norman Pruitt – 903-798-8047 or Jeanette Akin @ 903-798-8086
Number of Beds:
unknown, estimate 10 to 20
Level of care to be provided or types of patients that can be taken care of : Full nursing care, Healthsouth will send
nursing with patients.
Summary of plans for staffing, supply and re-supply of sites: Call back list for staffing, standing supply for 96 hr
sustainability, resupply using MOU’s with vendors for food, medical supplies, water, fuel and laundry
Name of Facility:
Address:
Contact Person
and Number:
4-States Fair Ground
3700 E. 50th Street
Texarkana, AR 71854
870-773-2941
Number of Beds: unknown, open cot layout
Level of care to be provided or types of patients that can be taken care of : minor wounds, bed and meals (basic
sheltering)
HOPKINS COUNTY MEMORIAL HOSPITAL:
Name of Facility:
Address:
Wesley United Methodist Church
Sulphur Springs, TX 75482
Contact Person
And Number:
Jay Sanders
Number of Beds:
200
Level of care to be provided or types of patients that can be taken care of : Minor Care, mostly sheltering
Summary of plans for staffing, supply and re-supply of sites: Will utilize our emergency call back list
PARIS REGIONAL MEDICAL CENTER:
Name of Facility:
Address:
Love Civic Center
2025 S. Collegiate Dr.
Paris, TX75460
Contact Person
and Number:
903-739-9912
Number of Beds:
Estimate of 150, facility has an open floor plan;
Level of care to be provided or types of patients that can be taken care of :Non-emergent acute care patients
Summary of plans for staffing, supply and re-supply of sites: Chain of Command, as instituted in our emergency
Plan and Volunteers for staffing facilities, supplies will be taken from hospital to site and requested on WebEOC for
supply and re-supply.
Name of Facility:
Address:
Paris Junior College Gymnasium
2400 Clarksville St.
Paris, TX75460
Contact Person
and Number:
903-782-0218
Number of Beds:
Estimate of 50, facility has an open floor plan;
Level of care to be provided or types of patients that can be taken care of :
Non-emergent acute care patients
Summary of plans for staffing, supply and re-supply of sites:Chain of Command, as instituted in our emergency Plan
and Volunteers for staffing facilities, supplies will be taken from hospital to site and requested on WebEOC for
supply and re-supply.
Name of Facility:
Address:
Paris High School Gymnasium
2400 Jefferson Rd.
Paris, TX75460
Contact Person
and Number:
Number of Beds:
903-737-7473
Estimate of 30, facility has an open floor plan;
Level of care to be provided or types of patients that can be taken care of :
Non-emergent acute care patients
Summary of plans for staffing, supply and re-supply of sites:
Chain of Command, as instituted in our emergency Plan and Volunteers for staffing facilities, supplies will be taken
from hospital to site and requested on WebEOC for supply and re-supply.
Name of Facility:
Address:
North Lamar High School Gymnasium
3201 Lewis Ln.
Paris, TX75460
Contact Person
and Number:
903-737-2000
Number of Beds:
Estimate of 50, facility has an open floor plan
Level of care to be provided or types of patients that can be taken care of :Non-emergent acute care patients
Summary of plans for staffing, supply and re-supply of sites:Chain of Command, as instituted in our emergency Plan
and Volunteers for staffing facilities, supplies will be taken from hospital to site and requested on WebEOC for
supply and re-supply.
TITUSREGIONALMEDICALCENTER:
Name of Facility:
Address:
Mount Pleasant Convention Center
1800 N. Jefferson
Mt. Pleasant, TX 75455
Contact Person
and Number:
Bill Luck - 903-575-4190
Number of Beds:
120
Level of care to be provided or types of patients that can be taken care of : Non-acute patients. Limited bathrooms
and no on site shower facilities.
Summary of plans for staffing, supply and re-supply of sites: Hospital to supply if needed for hospital patients.
Local emergency management has cots and blankets.
WADLEY REGIONAL MEDICAL CENTER:
Name of Facility:
Address:
Southwest Center
3222 W. 7th Street
Texarkana, TX75501
Contact Person:
and Number:
Robert McDonald – 903-223-3298
Number of Beds:
Level of care to be provided or types of patients that can be taken care of :
Summary of plans for staffing, supply and re-supply of sites:
*****See Attachment
Regional Utilities:
FY 2012 - 2013
NETRAC REGIONAL UTILITIES
AtlantaMemorialHospital Utilities
Atlanta Fire/EMS Utilities
CASSCOUNTY
Water Utilities:
Name:
Address:
Phone Number:
Atlanta Utilities
P.O. Box 669, 315 N Buckner, Atlanta, Texas75551
903-796-7153, after hours 903-796-7973
Electric/Power Utilities:
Name:
Address:
Phone Number:
American Electric Power
P.O. Box 24422, Canton, OH44701
1-800-216-3523
Gas Utilities:
Name:
Address:
Phone Number:
Center Point
P.O. Box 2628, Houston, Tx77252
1-800-752-8036
Phone Utilities:
********NEW CHANGE FROM PREVIOUS REPORT********
Name:
Airespring, Total Telecom Solutions of Louisiana
Address:
P.O. Box 53342, Shreveport, LA71135
Phone:
1-888-389-2899
Food Services:
Name:
Address:
Phone Number:
Fax:
Contact:
Ben. E. Keith Foods
10610 Metric Drive, Suite 191, Dallas, Tx75243
214-388-5411 or 1-800-588-5411
903-223-7955
Brian Strand, cell 903-278-2337
Medical Supplies
Name:
Address:
Phone:
Contact:
Cardinal
3080 W Interstate 29, Dallas, Tx75052
1-800-964-5227
Linda Ingram, 1-800-724-1111 option 3
Christus St. Michael Health Care System - Hospital Utilities
BOWIECOUNTY
WATER UTILITIES:
Name:
Texarkana Water Utilities
Address:
801 Wood Street
Texarkana, TX75501
Phone Number:
903 798-3800
Contact Person:
Patrick Reed
ELECTRIC/POWER UTILITIES:
Name:
AEP
Address:
3708 West 7th
Texarkana, TX75503
Phone Number:
903 748-2110
Contact Person:
John Jones
GAS UTILITIES:
Name:
Centerpoint Energy
Address:
PO Box 520
Texarkana, TX75504
Phone Number:
870 779-6338
Contact Person:
Diane Englekiss
TELEPHONE UTILITIES:
Name:
Windstream
Address:
507 Olive St.
Texarkana, AR71854
Phone Number:
903 748-5588
Contact Person:
Greg Einsberg
FOOD SERVICES:
Name:
Aramark
Address:
2600 St. Michael Drive
Texarkana, TX75503
Phone Number:
903 614-2093
Contact Person:
Malcolm McInnis
MEDICAL SUPPLIES:
Name:
CHRISTUS St. Michael, Material Management
Address:
2600 St. Michael Drive
Texarkana, TX75503
Phone Number:
903 614-2830
Contact Person:
John Morkavich, Director of Material Management
East Texas Medical Center - Clarksville - Hospital Utilities
REDRIVERCOUNTY
WATER UTILITIES:
Name:
City of Clarksville
Address:
800 West Main Street
Clarksville, TX75426
Phone Number:
903-427-3834
Contact Person:
Penny Hobbs
ELECTRIC/POWER UTILITIES:
Name:
Direct Energy
Address:
1001 Liberty
Pittsburg, PA15222
Phone Number:
1-888-925-9115
Contact Person:
GAS UTILITIES:
Name:
None
Address:
Phone Number:
Contact Person:
TELEPHONE UTILITIES:
Name:
Address:
Windstream
Phone Number:
1-800-792-6206
Contact Person:
FOOD SERVICES:
Name:
US Foodservice
Address:
950 South Shiloh Rd
Garland, TX 75042
Phone Number:
1-800-527-1691
Contact Person:
Pete Beswick
MEDICAL SUPPLIES:
Name:
Owens & Minor
Address:
1434 Patton Place
Carrollton, TX75007
Phone Number:
1-800-726-5599
Contact Person:
Bruce Whitley
GoodShepherdMedicalCenter - Linden- Hospital Utilities
CASSCOUNTY
WATER UTILITIES:
Name:
City of Linden
Address:
104 South Main Street
Linden, TX 75563
Phone Number:
903-756-7502
Contact Person:
Gary Wells (903) 235-2109
ELECTRIC/POWER UTILITIES:
Name:
AEP Swepco
Address:
PO Box 24404
Canton, OH 44701-4401
Phone Number:
1-888-216-3523
Contact Person:
Gary Wells (903) 235-2109
GAS UTILITIES:
Name:
Centerpoint Energy
Address:
PO Box 4981
Houston, TX 77210-4981
Phone Number:
1-800-259-5544
Contact Person:
Gary Wells (903) 235-2109
TELEPHONE UTILITIES:
Name:
Windstream
Address:
507 Olive Street
Texarkana, TX75501
Phone Number:
1-866-225-8356
Contact Person:
Gary Wells (903) 235-2109
FOOD SERVICES:
Name:
US Food
Address:
Dallas, TX
Phone Number:
Doug – 903-244-5215
Contact Person:
Jessica Moore - 940-597-7604 (cell); 903-756-5561
MEDICAL SUPPLIES:
Name:
GoodShepherdMedicalCenter - Longview
Address:
700 East Marshall Ave.
Longview, TX75601
Phone Number:
903-315-2000
Contact Person:
Melanie Nipper
HealthSouthRehabHospital- Hospital Utilities
BOWIECOUNTY
WATER UTILITIES:
Name:
TEXARKANA WATER UTILITIES
Address:
801 WOOD ST.
TEXARKANA, TX 75501
Phone Number:
903-798-3800, ENG. – 903-798-3829
Contact Person:
ELECTRIC/POWER UTILITIES:
Name:
SWEPCO
__________
Address:
Phone Number:
Contact Person:
1-888-216-3523, 877-237-2886______
GAS UTILITIES:
Name:
CENTERPOINT ENERGY
Address:
Phone Number:
1-800-259-7552, 1-800-259-5544
Contact Person:
TELEPHONE UTILITIES:
Name:
WINDSTREAM
Address:
2315 RICHMOND RD STE 101
TEXARKANA, TX. 75501
Phone Number:
1-800-843-9214
Contact Person:
FOOD SERVICES:
Name:
SYSCO FOOD SERVICES (EAST TEXAS, LLC)
Address:
4577 ESTES PARKWAY
LONGVIEW, TEXAS., 75603
Phone Number:
Contact Person:
903-252-6100
MEDICAL SUPPLIES:
Name:
CARDINAL
HEALTH
Address:
7000 CADINAL PLACE
DUBLIN, OH 43017
Phone Number:
1-800-567-5831
Contact Person:
HopkinsCountyMemorialHospital- Hospital Utilities
HopkinsCountyEMS Utilities
DELTA-HOPKINSCOUNTY
WATER UTILITIES:
Name:
City of Sulphur Springs
Address:
Sulphur Springs, TX
Phone Number:
903-885-7541
Contact Person:
ELECTRIC/POWER UTILITIES:
Name:
OnCore; Texas Power Consult
Address:
Phone Number:
903-439-4233; 1-888-313-6862; 1-800-223-2133
Contact Person:
Victor Davis - 903-533-9953
GAS UTILITIES:
Name:
Atmos Energy
Address:
Phone Number:
1-800-817-8090
Contact Person:
TELEPHONE UTILITIES:
Name:
Address:
Phone Number:
Contact Person:
FOOD SERVICES:
Name:
Address:
Phone Number:
Contact Person:
MEDICAL SUPPLIES:
Name:
Beacon Medical
Address:
Phone Number:
Contact Person :
1-817-366-1134
Paris Regional Medical Center - Hospital Utilities
LAMARCOUNTY
WATER UTILITIES:
Name:
City of Paris
Address:
50 West Hickory St.
Paris, TX75460
Phone Number:
903-784-9277 or 903-249-5160
Contact Person:
Doug Harris
ELECTRIC/POWER UTILITIES:
Name:
Oncor
Address:
Phone Number:
1-888-313-3747
Contact Person :
GAS UTILITIES:
Name:
Atmos
Address:
Phone Number :
Contact Person:
1-866-322-8667
TELEPHONE UTILITIES:
Name:
AT&T
Address:
Phone Number:
1-800-442-9950 (Repairs); 1-800-286-8313 (Circuits)
Contact Person:
FOOD SERVICES:
Name:
SYSCO FOOD SERVICES (EAST TEXAS, LLC)
Address:
4577 ESTES PARKWAY
LONGVIEW, TEXAS., 75603
Phone Number:
903-252-6100
Contact Person:
Michael Dewitt
MEDICAL SUPPLIES:
Name:
Owens & Minor
Address:
1434 Patton Place
Carrollton, TX75007
Phone Number:
972-242-5599
Contact Person:
Craig Dabbs
TitusRegionalMedicalCenter- Hospital Utilities
TitusRegionalMedicalCenter- EMS Utilities
TITUSCOUNTY
WATER UTILITIES:
Name:
City of Mt. Pleasant
Address:
501 North Madison Ave
Mt. Pleasant, TX 75455-3650
Phone Number:
903-575-4000 after hours – 903-575-4132
Contact Person:
ELECTRIC/POWER UTILITIES:
Name:
Swepco
Address:
PO Box 24422
Canton, OH 44701-4422
Phone Number:
903-748-2110
Contact Person:
John James
GAS UTILITIES:
Name:
Centerpoint Energy
Address:
PO Box 3391
Lawton, OK73502
Phone Number:
580-591-3356
Contact Person:
Sam Helton
TELEPHONE UTILITIES:
Name:
AT&T
Address:
Phone Number:
888-944-0447
Contact Person:
FOOD SERVICES:
Name:
Sysco East Texas
Address:
4577 Estes Pkwy
Longivew, TX 75603
Phone Number:
903-285-7842; 1-866-959-5184
Contact Person:
Mike Pewitt
MEDICAL SUPPLIES:
Name:
Cardinal Health
Address:
601 Windsor Pl
Tyler, TX 75701
Phone Number:
903-303-8417 (cell); 1-800-964-5227
Contact Person:
Kevin Thomas
WadleyRegionalMedicalCenter- Hospital Utilities
BOWIECOUNTY
WATER UTILITIES:
Name:
TEXARKANA WATER UTILITIES
Address:
801 WOOD ST.
TEXARKANA, TX 75501
Phone Number:
903-798-3800, ENG. – 903-798-3829
Contact Person :
Bill Darby (903) 278-0562
ELECTRIC/POWER UTILITIES:
Name:
AEP SWEPCO
__________
Address:
West 7th Street
Phone Number:
1-888-216-3523, 877-237-2886______
Contact Person:
J R Jones@aep.com (903)748-2110
GAS UTILITIES:
Name:
CENTERPOINT ENERGY
Address:
Phone Number:
1-800-259-7552, 1-800-259-5544
Contact Person:
Jonathan Dothage (314) 991-7381
TELEPHONE UTILITIES:
Name:
WINDSTREAM
Address:
2315 RICHMOND RD STE 101
TEXARKANA, TX. 75501
Phone Number:
1-800-843-9214; 903-223-4688
Contact Person:
FOOD SERVICES:
Name:
SYSCO FOOD SERVICES
Address:
4577 ESTES PARKWAY
LONGVIEW, TEXAS., 75603
Phone Number:
903-252-6100
Contact Person:
MEDICAL SUPPLIES:
Name:
Owens and Minor
Address:
550 Lakeside ParkwayBldg 200
Flower Mound, TX 75028
Phone Number:
1-800-726-5599
Contact Person:
Betty – 972-538-6507
Champion EMS- Utilities
MORRISCOUNTY
WATER UTILITIES:
Name:
City of Daingerfield
Address:
108 Coffey
Daingerfield, TX 75638
Phone Number:
903-645-5511
Contact Person:
Name:
City of Lone Star
Address:
PO Box 0218
Lone Star, TX 75668
Phone Number:
903-656-2311
Contact Person:
ELECTRIC/POWER UTILITIES:
Name:
Swepco
Address:
PO Box 24401
Canton, OH44701-4401
Phone Number:
1-888-216-3523
Contact Person:
Name:
Bowie Cass Electric
Address:
PO Box 47
Douglassville, TX75560
Phone Number:
Contact Person:
1-800-794-2919
GAS UTILITIES:
Name:
CenterPoint Energy
Address:
PO Box 2628
Houston, TX77252-2628
Phone Number:
1-800-259-5544
Contact Person:
TELEPHONE UTILITIES:
Name:
Windstream
Address:
1720 Galleria Blvd.
Charlotte, NC 28270
Phone Number:
903-645-5978
Contact Person :
FOOD SERVICES:
Name:
Address:
Phone Number:
Contact Person :
MEDICAL SUPPLIES:
Name:
Boundtree Medical
Address:
23537 Network Place
Chicago, IL60673
Phone Number:
1-800-533-0523
Contact Person:
Elizabeth Woodyard
Champion EMS- Utilities
CASSCOUNTY
WATER UTILITIES:
Name:
City of Linden
Address:
PO Box 419
Linden, TX75563
Phone Number:
903-756-7502
Contact Person:
ELECTRIC/POWER UTILITIES:
Name:
Swepco
Address:
PO Box 24401
Canton, OH44701-4401
Phone Number:
Contact Person:
1-888-216-3523
GAS UTILITIES:
Name:
CenterPoint Energy
Address:
PO Box 2628
Houston, TX77252-2628
Phone Number:
1-800-259-5544
Contact Person:
TELEPHONE UTILITIES:
Name:
Windstream
Address:
1720 Galleria Blvd.
Charlotte, NC 28270
Phone Number:
903-645-5978
Contact Person:
FOOD SERVICES:
Name:
Address:
Phone Number:
Contact Person:
MEDICAL SUPPLIES:
Name:
Boundtree Medical
Address:
23537 Network Place
Chicago, IL60673
Phone Number:
1-800-533-0523
Contact Person:
Elizabeth Woodyard
`
City of Paris - EMS- Utilities
LAMARCOUNTY
WATER UTILITIES:
Name:
Address:
Phone Number:
Contact Person:
ELECTRIC/POWER UTILITIES:
Name:
Address:
Phone Number:
Contact Person:
GAS UTILITIES:
Name:
Address:
Phone Number:
Contact Person:
TELEPHONE UTILITIES:
Name:
Address:
Phone Number:
Contact Person:
FOOD SERVICES:
Name:
Address:
Phone Number:
Contact Person:
MEDICAL SUPPLIES:
Name:
Address:
Phone Number:
Contact Person:
LifeNetEMS – Utilities
BOWIECOUNTY
WATER UTILITIES:
Name:
TEXARKANA WATER UTILITIES
Address:
801 WOOD ST.
TEXARKANA, TX 75501
Phone Number:
903-798-3800, ENG. – 903-798-3829
Contact Person:
Bill Darby (903) 278-0562
ELECTRIC/POWER UTILITIES:
Name:
Bowie Cass Electric Co.
Address:
HWY 8 N – PO Box 47
__________
Douglasville, TX75560
Phone Number:
903-846-2311
______
Contact Person :
GAS UTILITIES:
Name:
CENTERPOINT ENERGY
Address:
PO Box 2628
Houston, TX77252
Phone Number:
Contact Person:
1-888-876-5786
TELEPHONE UTILITIES:
Name:
WINDSTREAM
Address:
507 Olive Street
TEXARKANA, TX. 75501
Phone Number:
903-792-6226; 1-877-520-5210
Contact Person:
Tim Day – 903-791-3765
FOOD SERVICES:
Name:
Address:
Phone Number:
Contact Person:
MEDICAL SUPPLIES:
Name:
Boundtree Medical
Address:
23537 Network Place
Chicago, IL 60673
Phone Number:
1-817-658-4168; 1-800-533-0523 x 5141
Contact Person:
Gerald Ramirez
Regional Shelters:
NETRAC REGIONAL SHELTERS
AND
ALTERNATE CARE SITES - LOCATIONS
(per Hospital)
ATLANTAMEMORIALHOSPITAL:
Name of Facility:
Address:
Horne Enterprises, Inc.
101 East Pinecrest Drive
Atlanta, TX75551
Contact Person:
Jim Horne, M-F 8a-5p, 903-796-4107
and Number:
Guard at Ft.Horne: Line 1: 903-796-5206
Radio call sign unit 65 AFD & APD
Number of Beds:
Estimate of 20, facility has an open floor plan;
Level of care to be provided or types of patients that can be taken care of : Non-emergent acute care patients
Summary of plans for staffing, supply and re-supply of sites: Institute Chain of Command, we will access PRN
Roster and Volunteers for staffing facilities, supplies will be taken from hospital to site and requested on WebEOC
for supply and re-supply.
Name of Facility:
Address:
The Mattie Lanier Richey Center
#1 Sportplex Drive
Atlanta, TX75551
Contact Person
and Number:
Chamber of Commerce: 903-796-3296
Bobby Embry: 903-796-8572
903-824-8572 (cell)
Judy Nuckels: 903-796-2192
Jennifer Hodges: 903-796-7836
903-824-2279 (cell)
Number of Beds:
Estimate of 20, facility has an open floor plan;
Level of care to be provided or types of patients that can be taken care of : Non-emergent acute care patients
Summary of plans for staffing, supply and re-supply of sites: Institute Chain of Command, we will access PRN
Roster and Volunteers for staffing facilities, supplies will be taken from hospital to site and requested on WebEOC
for supply and re-supply.
CHRISTUS ST. MICHAEL HEALTH SYSTEM:
Name of Facility:
On Campus Buildings (Fitness Center, Outpatient Rehab,
ImagingCenter, RehabilitationHospital)
Address:
2600 St. Michael Drive
Texarkana, TX75503
Contact Person
and Number:
Jesse Buchanan – 903-614-2391
Number of Beds:
100
Level of care to be provided or types of patients that can be taken care of : Non-critical; Critical patients would
shelter in the facility until transport and transfer to a comparable facility
Summary of plans for staffing, supply and re-supply of sites: Staff will move with patients. Supplies that can be
salvaged from hospital will be moved to ALC, Re-supply will deliver to supply staging area located at ALC.
EASTTEXASMEDICALCENTER – CLARKSVILLE:
Name of Facility:
Address:
Clarksville Nursing Center
300 E. Baker
Clarksville, TX75460
Name of Facility:
Address:
Regency at Red River Rehab and Healthcare
2800 W. Main
Clarksville, TX75460
Contact Person
and Number:
Ruth Brown
Number of Beds:
Level of care to be provided or types of patients that can be taken care of :
Summary of plans for staffing, supply and re-supply of sites:
GOODSHEPHERDMEDICALCENTER – LINDEN:
Name of Facility:
Address:
Longview Regional Medical Center
Longview, TX
Contact Person
and Number:
Jerri Pendarvis
903-315-2000
Number of Beds:
10-25 or what’s available
Level of care to be provided or types of patients that can be taken care of : Acute Care
Summary of plans for staffing, supply and re-supply of sites: The Linden facility will provide staff and supplies
Name of Facility:
Address:
Jerry Neel - GSMC-Marshall Center
Marshall, TX
Contact Person
and Number:
903-927-6000
Name of Facility:
Address:
Atlanta Memorial Hospital
1007 S. William
Atlanta, TX75551
Contact Person
and Number:
Meagan Beauchamp
903-799-3000
Number of Beds:
10
Level of care to be provided or types of patients that can be taken care of : Acute Care
Summary of plans for staffing, supply and re-supply of sites: Linden will bring their own staff and supplies
HEALTHSOUTH REHABILITATION HOSPITAL:
Name of Facility:
Address:
WRMC
1000 Pine Street
Texarkana, TX75501
Contact Person
and Number:
Norman Pruitt – 903-798-8047 or Jeanette Akin @ 903-798-8086
Number of Beds:
unknown, estimate 10 to 20
Level of care to be provided or types of patients that can be taken care of : Full nursing care, Healthsouth will send
nursing with patients.
Summary of plans for staffing, supply and re-supply of sites: Call back list for staffing, standing supply for 96 hr
sustainability, resupply using MOU’s with vendors for food, medical supplies, water, fuel and laundry
Name of Facility:
Address:
Contact Person
and Number:
Number of Beds:
4-States Fair Ground
3700 E. 50th Street
Texarkana, AR71854
870-773-2941
unknown, open cot layout
Level of care to be provided or types of patients that can be taken care of : minor wounds, bed and meals (basic
sheltering)
HOPKINS COUNTY MEMORIAL HOSPITAL:
Name of Facility:
Address:
Wesley United Methodist Church
Sulphur Springs, TX 75482
Contact Person
And Number:
Jay Sanders
Number of Beds:
200
Level of care to be provided or types of patients that can be taken care of : Minor Care, mostly sheltering
Summary of plans for staffing, supply and re-supply of sites: Will utilize our emergency call back list
PARIS REGIONAL MEDICAL CENTER:
Name of Facility:
Address:
Love Civic Center
2025 S. Collegiate Dr.
Paris, TX75460
Contact Person
and Number:
903-739-9912
Number of Beds:
Estimate of 150, facility has an open floor plan;
Level of care to be provided or types of patients that can be taken care of :Non-emergent acute care patients
Summary of plans for staffing, supply and re-supply of sites: Chain of Command, as instituted in our emergency
Plan and Volunteers for staffing facilities, supplies will be taken from hospital to site and requested on WebEOC for
supply and re-supply.
Name of Facility:
Address:
Paris Junior College Gymnasium
2400 Clarksville St.
Paris, TX 75460
Contact Person
and Number:
903-782-0218
Number of Beds:
Estimate of 50, facility has an open floor plan;
Level of care to be provided or types of patients that can be taken care of :
Non-emergent acute care patients
Summary of plans for staffing, supply and re-supply of sites:Chain of Command, as instituted in our emergency Plan
and Volunteers for staffing facilities, supplies will be taken from hospital to site and requested on WebEOC for
supply and re-supply.
Name of Facility:
Address:
Paris High School Gymnasium
2400 Jefferson Rd.
Paris, TX75460
Contact Person
and Number:
Number of Beds:
903-737-7473
Estimate of 30, facility has an open floor plan;
Level of care to be provided or types of patients that can be taken care of :
Non-emergent acute care patients
Summary of plans for staffing, supply and re-supply of sites:
Chain of Command, as instituted in our emergency Plan and Volunteers for staffing facilities, supplies will be taken
from hospital to site and requested on WebEOC for supply and re-supply.
Name of Facility:
Address:
North Lamar High School Gymnasium
3201 Lewis Ln.
Paris, TX75460
Contact Person
and Number:
903-737-2000
Number of Beds:
Estimate of 50, facility has an open floor plan
Level of care to be provided or types of patients that can be taken care of :Non-emergent acute care patients
Summary of plans for staffing, supply and re-supply of sites:Chain of Command, as instituted in our emergency Plan
and Volunteers for staffing facilities, supplies will be taken from hospital to site and requested on WebEOC for
supply and re-supply.
TITUSREGIONALMEDICALCENTER:
Name of Facility:
Address:
Mount Pleasant Convention Center
1800 N. Jefferson
Mt. Pleasant, TX 75455
Contact Person
and Number:
Bill Luck - 903-575-4190
Number of Beds:
120
Level of care to be provided or types of patients that can be taken care of : Non-acute patients. Limited bathrooms
and no on site shower facilities.
Summary of plans for staffing, supply and re-supply of sites: Hospital to supply if needed for hospital patients.
Local emergency management has cots and blankets.
WADLEY REGIONAL MEDICAL CENTER:
Name of Facility:
Address:
Southwest Center
3222 W. 7th Street
Texarkana, TX75501
Contact Person:
and Number:
Robert McDonald – 903-223-3298
Number of Beds:
Level of care to be provided or types of patients that can be taken care of :
Summary of plans for staffing, supply and re-supply of sites:
*****See Attachment
OTHER REGIONAL SHELTERS
Bowie:
Contact Name:
Agency:
Address:
Phone:
Email:
Cass:
Contact Name:
Agency:
Address:
Phone:
Email:
Delta:
Contact Name:
Agency:
Address:
Phone:
Email:
Hopkins:
Contact Name:
Jim Whiteside
American Red Cross
903-793-5602
jwhiteside@cableone.net
Agency:
Address:
Phone:
Email:
Morris:
Contact Name:
Agency:
Address:
Phone:
Email:
Lamar:
Contact Name:
Agency:
Address:
Phone:
Email:
Red River:
Contact Name:
Agency:
Address:
Phone:
Email:
Titus:
Contact Name:
Agency:
Address:
Phone:
Email:
Brad Scott
American Red Cross – Lamar Chapter
903-737-4390
Judge Harville
County Judge
903-427-2680
Bill Luck
903-575-4190
Regional Nursing Homes:
BOWIECOUNTYNURSING HOMES
ICF/MR Facilities
Evergreen Northwood Community Home
113 Northwood
Nash 75569
(903) 831- 4239
New Horizons Elizabeth
4820 Elizabeth St
Texarkana75503
(903) 794- 0509
New Horizons Magnolia
4125 Magnolia St
Texarkana75503
(903) 794- 0509
New Horizons West 27th St
404 W 27th St
Texarkana75503
(903) 794- 0509
Evergreen Cooper Lane Community Home
3312 Cooper Ln
Texarkana75503
(903) 831- 4632
Evergreen Fortune Community Home
3002 Fortune Ave
Texarkana75503
(903) 838- 5625
Evergreen Maryland Community Home
106 Maryland
Texarkana 75501
(903) 831- 4967
Evergreen Meadow Lane Community Home
#20 Meadow Ln
Texarkana75503
(903) 792- 2529
Evergreen Moores Lane Community Home
3611 Moores Ln
Texarkana75503
(903) 832- 2682
Evergreen Pine Knoll Community Home
3603 Pine Knoll
Texarkana 75503
(903) 793- 0193
New Horizons Stillwell
2611 Stillwell Dr
Texarkana75503
(903) 794- 0509
Nursing facilities that accept Medicaid and/or Medicare
Heritage Plaza Nursing Center
600 W 52nd St
Texarkana75501
(903) 792- 6700
Christian Care Center
1008 Citizens Trail
Texarkana 75501
(903) 838- 9526
Edgewood Manor
4925 Elizabeth St
Texarkana75503
(903) 793- 4645
Mshc The Waterton At Cowhorn Creek LLC
5524 Cowhorn Creek
Texarkana 75503
(903) 223- 1188
Reunion Plaza Senior Care And Rehabilitation Center
1401 Hampton Rd
Texarkana 75503
(903) 792- 7994
New Boston Healthcare Center
210 Rice St
New Boston 75570
(903) 628- 5551
Texarkana Nursing And Healthcare Center LLC
4920 Elizabeth St
Texarkana75503
(903) 792- 3812
Sunny Acres Of Dekalb
12520 Fm 1840
Dekalb 75559
(903) 667- 2572
Nursing facilities that do not accept Medicaid or Medicare
Cornerstone Retirement Community
4100 Moores Ln
Texarkana75503
(903) 832- 5515
CASS COUNTY NURSING HOMES
ICF/MR Facilities
Evergreen Choctaw Community Home
1313 Choctaw
Atlanta 75551
(903) 796- 9619
Evergreen Clearview Community Home
101 Clearview
Atlanta 75551
(903) 796- 5552
Nursing facilities that accept Medicaid and/or Medicare
Golden Villa
1104 S William St
Atlanta75551
(903) 796- 0290
Linden Healthcare Center
1201 W Houston St
Linden75563
(903) 756- 5537
Rose Haven Retreat
200 Live Oak St
Atlanta75551
(903) 796- 4127
Hughes Springs Ltc Partners Inc
215 Highway 161 South
Hughes Springs75656
(903) 639- 2561
The Springs
704 N Taylor Rd
Hughes Springs 75656
(903) 639- 2531
DELTA COUNTYNURSING HOMES
Nursing facilities that accept Medicaid and/or Medicare
Birchwood Nursing And Rehabilitation LP
110 W HWY 64
Cooper 75432
(903) 395- 2125
HOPKINSCOUNTYNURSING HOMES
Nursing facilities that accept Medicaid and/or Medicare
Sulphur Springs Health And Rehabilitation
411 Airport Rd
Sulphur Springs75482
(903) 885- 7668
Carriage House Manor
210 Pipeline Rd
Sulphur Springs75482
(903) 885- 3589
Rock Creek Health And Rehabilitation LLC
1414 College Street
Sulphur Springs75483
(903) 439- 0107
Sunny Springs Nursing & Rehab
1200 N Jackson St
Sulphur Springs 75482
(903) 885- 6571
LAMAR COUNTYNURSING HOMES
Nursing facilities that accept Medicaid and/or Medicare
Brentwood Terrace Healthcare And Rehabilitation Center
2885 Stillhouse Road
Paris75460
(903) 784- 4111
Heritage House Of Paris Health & Rehabilitation Center
150 S.E. 47th Street
Paris75462
(903) 784- 3100
Legend Healthcare And Rehabilitation - Paris
520 SE 8th St
Paris75460
(903) 737- 9820
Paris Nursing & Rehabilitation Center
2900 Stillhouse Road
Paris75462
(903) 785- 1601
Paris Healthcare Center
610 DeshongDr
Paris75460
(903) 784- 6638
Paris Skilled Nursing Facility Inc
820 Clarksville Street 7th FlSouth
Paris75460
(903) 737- 3747
MORRIS COUNTYNURSING HOMES
Nursing facilities that accept Medicaid and/or Medicare
Omaha Healthcare Center
205 N Giles St
Omaha75571
(903) 884- 2358
Windsor Place
507 E Watson Blvd
Daingerfield75638
(903) 645- 3915
RED RIVER COUNTY NURSING HOMES
Nursing facilities that accept Medicaid and/or Medicare
Clarksville Nursing Center
300 E Baker St
Clarksville75426
(903) 427- 2236
Regency Healthcare And Rehabilitation Center At Red River
2407 West Main Street
Clarksville75426
(903) 427- 3821
TITUS COUNTYNURSING HOMES
ICF/MR Facilities
Pleasant Living Inc
2003 Happy St
Mount Pleasant 75455
(903) 577- 8055
Nursing facilities that accept Medicaid and/or Medicare
Mount Pleasant Healthcare Center
1606 Memorial Ave
Mount Pleasant75455
(903) 572- 3618
Pleasant Springs Healthcare Center
2003 N Edwards St
Mount Pleasant 75455
(903) 572- 5511
Greenhill Villas
2530 Greenhill Rd
Mount Pleasant75455
(903) 572- 0974
Hospital-based Nursing Facilities
Titus Regional Medical Center
2001 N Jefferson
Mount Pleasant 75455
(903) 577- 6000
Regional Home Health Agencies:
DELTA COUNTY HOME HEALTH AGENCIES
Home Health Agencies that accept Medicare
Cooper Home Health Inc
51 North Side Square
Cooper 75432
(903) 395- 2811
HOPKINS COUNTY HOME HEALTH AGENCIES
Home Health Agencies that accept Medicare
1st Choice Home Health
1091 Church Street
Sulphur Springs75482
(903) 439- 4757
At Home Healthcare
858 Gilmer
Sulphur Springs75482
(903) 885- 5606
Cypress Home Care
1304 Church St
Sulphur Springs75482
(903) 438- 8400
Heritage Home Health
301 Gilmer Street Suite A
Sulphur Springs 75482
(903) 561- 7250
Hospice At Memorial
1228 Church St
Sulphur Springs75482
(903) 438- 4448
Legacy Hospice
301 Gilmer StSte A
Sulphur Springs75482
(903) 569- 5167
Vibrant Home Health Care Inc
1707 S Broadway Suite #4
Sulphur Springs75482
(903) 454- 2273
Home Health Agencies that do not accept Medicare
Hearts Choice Health Care Inc
1335 Shannon Road East
Sulphur Springs75482
(903) 439- 6030
LAMAR COUNTY HOME HEALTH AGENCIES
Home Health Agencies that accept Medicare
At Home Healthcare
2775 NE Loop 286
Paris 75460
(903) 785- 5467
Country Style Health Care Of Texas
1603 Lamar Avenue
Paris75460
(903) 567- 7770
Critical Provisions Inc
1705 E Houston Street
Paris75460
(903) 739- 9090
Cypress Home Care
5020 SE Loop 286
Paris 75460
(903) 784- 8088
Hometown Home Health Services
2815 Fm 79
Paris 75460
(903) 737- 0116
Jordan Health Services
3745 Lamar
Paris 75460
(903) 785- 4326
Legacy Hospice
2675 NE Loop 286
Paris 75460
(903) 784- 1147
Mays Home Care
385 Stone Avenue
Paris75460
(903) 785- 6297
Mays Hospice Tx LLC
3310 B Lamar Ave
Paris75460
(903) 785- 4357
Millennium Home Care Of NE Texas
3160 Clarksville Street
Paris75460
(903) 737- 9865
On Call Home Health And Rehab Services
147 North Collegiate Drive
Paris 75460
(903) 784- 6300
Paris Signature Home Health Inc
420 N Collegiate
Paris 75460
(903) 785- 4900
Platinum Home Health Inc
140 S Collegiate Dr
Paris 75460
(903) 739- 8070
Premier Home Care And Rehab / Premier Hospice
750 Clarksville St
Paris75460
(903) 737- 9010
Red River Homecare LLC
6345 Lamar Road
Reno75462
(903) 739- 9483
Home Health Agencies that do not accept Medicare
Delta Home Health Care Of Greenville Inc
1705 E Houston Street
Paris75460
(903) 739- 9600
Delta Home Health Care Of Paris Inc
1705 E Houston Street
Paris75460
(903) 784- 1486
Genesis Pediatric Home Health
35 12th SE
Paris75460
(855) 436- 7334
Home Helpers Homecare Inc
2845 Loop 286 NE
Paris75460
(903) 784- 5500
Mays Plus Inc
3310 A Lamar Avenue
Paris75460
(903) 783- 0525
Nurses Unlimited Inc
2625 N E Loop 286
Paris 75460
(903) 783- 0489
On Call Elder Care
147 North Collegiate Drive
Paris 75460
(903) 905- 4975
Paris Pediatric Home Health Care Inc
3605 NE Loop 286 Suite 200
Paris 75460
(903) 737- 4337
Platinum Palliative & Hospice Care Inc
140 South Collegiate Drive Suite 10
Paris 75460
(903) 783- 1818
Red River Health Care Systems Inc
2152 Clarksville Street
Paris75460
(903) 785- 4070
Visiting Angels Of Paris
1849 Lamar Ste 200
Paris 75460
(903) 784- 3902
Waterford Hospice LLC
420 N Collegiate Drive
Paris 75460
(903) 785- 1800
MORRIS COUNTY HOME HEALTH AGENCIES
Home Health Agencies that accept Medicare
Cypress Home Care
200 Scurry St
Daingerfield75638
(903) 645- 7854
RED RIVER COUNTY HOME HEALTH AGENCIES
Home Health Agencies that accept Medicare
Country Home Care
1505 W Main St
Clarksville75426
(903) 427- 8366
Cypress Home Care
389 US HWY 82 West
Clarksville75426
(903) 427- 4598
Hometown Home Health Services
597 US Highway 271 South
Bogata 75417
(903) 632- 4790
Lewis Home Health Care Inc
157 North Main Street
Bogata75417
(903) 632- 2173
TITUS COUNTY HOME HEALTH AGENCIES
Home Health Agencies that accept Medicare
Best Star Home Health Inc
2001 W Ferguson Road Suite 1010
Mount Pleasant75455
(903) 577- 9119
Chambers Home Health Agency Of Northeast Texas Company
801 North Madison
Mount Pleasant 75455
(903) 572- 9700
Champion Home Health Services
1002 N Jefferson Avenue
Mount Pleasant75455
(903) 577- 0355
Cypress Basin Hospice Inc
207 Morgan Street
Mount Pleasant75455
(903) 577- 1510
Cypress Home Care
1318 S Jefferson
Mount Pleasant 75455
(903) 577- 0577
Hnb Home Health Agency
406 2nd St
Mount Pleasant75455
(903) 577- 5666
Hometown Home Health Services
1007 North Jefferson
Mount Pleasant 75455
(903) 577- 9412
Integracare Of North East Texas
106 Morgan
Mount Pleasant 75455
(800) 572- 8751
Jordan Health Services - Pediatrics
203 W 20th Street Suite A
Mount Pleasant 75455
(903) 577- 8822
Mays Home Care
804 West 16th Suite 1
Mount Pleasant 75455
(903) 577- 0748
Premier Home Care Inc
2605 West Ferguson Rd
Mt Pleasant 75455
(903) 667- 2000
Texas Helping Hands Inc
116 East 3rd Street
Mount Pleasant75455
(903) 572- 4280
Home Health Agencies that do not accept Medicare
At Home Healthcare
806 N Jefferson Avenue
Mount Pleasant75455
(903) 577- 9877
Outreach Health Services
618 South Jefferson Ave
Mt Pleasant 75455
(903) 575- 9251
Regional Health Departments:
Regional Mental Health Agencies:
Regional Assisted Living Facilities:
BOWIE COUNTY ASSISTED LIVING FACILITIES
Assisted Living - Type A Facilities
Independent Living Of Texarkana LLC
3120 Smith St
Texarkana75501
(903) 831- 3911
Mshc Colonial Lodge Of Texarkana LLC
5001 N Elizabeth
Texarkana 75503
(903) 792- 0838
Mshc The Oaks Assisted Living LLC
4317 Mcknight Rd
Texarkana75503
(903) 838- 5001
Mshc Whispering Pines Of Texarkana, LLC
5002 N Elizabeth
Texarkana 75503
(903) 792- 8014
Assisted Living - Type B Facilities
Cornerstone Retirement Community Personal Care Unit
4100 Moores Ln
Texarkana75503
(903) 832- 5515
Sterling House Of Texarkana
4204 Moores Ln
Texarkana75503
(903) 838- 3562
The Magnolia Alzheimer's Assisted Living
4205 Richmond Meadows
Texarkana 75503
(903) 838- 7319
CASSCOUNTY ASSISTED LIVING FACILITIES
Assisted Living - Type B Facilities
Wesley House
1102 S Williams
Atlanta 75551
(903) 796- 6300
HOPKINSCOUNTY ASSISTED LIVING FACILITIES
Assisted Living - Type A Facilities
Wesley House
1044 Church St
Sulphur Springs75482
(903) 439- 0529
Assisted Living - Type B Facilities
Hopkins House
890 Camp St
Sulphur Springs75482
(903) 439- 1202
LAMARCOUNTY ASSISTED LIVING FACILITIES
Assisted Living - Type A Facilities
Paris Oaks
2905 N Main St
Paris75460
(903) 784- 3243
Assisted Living - Type B Facilities
Paris Oaks
2905 N Main St
Paris75460
(903) 784- 3243
Pine Tree Ranch
2990 Pine Mill Rd
Paris75460
(903) 783- 0652
Spring Lake Assisted Living And Memory Care Community
750 N Collegiate Drive
Paris 75460
(903) 785- 1110
Sterling House Of Paris
2410 Stillhouse Rd
Paris75462
(903) 784- 8800
The Home Place
115 NE 27th St
Paris75460
(903) 739- 9450
MORRISCOUNTY ASSISTED LIVING FACILITIES
Assisted Living - Type A Facilities
Bluebonnet Elite Assisted Living
102 Floyd St
Naples75568
(903) 897- 9600
TITUSCOUNTY ASSISTED LIVING FACILITIES
Assisted Living - Type A Facilities
Mount Pleasant Assisted Living
2009 N Edwards
Mount Pleasant 75455
(903) 572- 8123
Assisted Living - Type B Facilities
Mount Pleasant Hospitality House
804 West 16th St
Mount Pleasant75455
(903) 572- 9893
Mt Pleasant Assisted Living
2013 N Edwards
Mount Pleasant 75455
(903) 572- 8123
Mt Pleasant Assisted Living
2011 N Edwards
Mount Pleasant 75455
(903) 572- 8123
Villa Of Mount Pleasant
1714 N Edwards St
Mount Pleasant 75455
(903) 577- 0759
Villa Residential Care Of Mount Pleasant
1712 North Edwards St
Mount Pleasant 75455
(903) 577- 0759
Vintage Lace Inc
409 W 1st
Mount Pleasant 75455
(903) 577- 0158
Regional School Districts:
REGIONAL SCHOOL DISTRICTS INFORMATION
Region 8 ISDs
Click on name to view website (where available). All area codes are 903.
District
Superintendent
Phone #
Atlanta ISD
Mr. Sidney Harrist, Interim
796-4194
Avery ISD
Mr. Barry Bassett
684-3460
Avinger ISD
Mr. Kenny Abernathy
562-1271
Bloomburg ISD
Mr. Mike White
728-5216
Chapel Hill ISD
Mr. Marc Levesque
572-8096
Chisum ISD
Ms. Diane Stegall
737-2830
Clarksville ISD
Ms. Pam Bryant
427-3891
Como-Pickton CISD
Ms. Sandra Billodeau
488-3671
Cooper ISD
Mr. Jason Marshall
395-2112
Cumby ISD
Mr. Lance Campbell
994-2261
Daingerfield-Lone Star ISD
Mr. Pat Adams
645-2239
DeKalb ISD
Mr. David Manley
667-2566
Detroit ISD
Mr. Steve Drummond
674-2208
Fannindel ISD
Mr. Harvey Lynn Milton
367-7251
Harts Bluff ISD
Mr. Eddie Johnson
572-5427
Hooks ISD
Ms. Kathy Allen
547-6077
Hubbard ISD
Ms. Traci Drake
667-2645
Hughes Springs ISD
Mr. Rick Ogden
639-3800
Jefferson ISD
Dr. Sharon D. Ross
665-2461
Leary ISD
Mr. Jim Tankersley
838-8960
Liberty-Eylau ISD
Mr. Nick Blain, Interim
832-1535
Linden-Kildare CISD
Mr. Clint Coyne
756-5027
Malta ISD
Ms. Linda Estill
667-2950
Maud ISD
Mr. Robert Stinnett
585-2219
McLeod ISD
Mrs. Cathy May
796-7181
Miller Grove ISD
Mr. Steve Johnson
459-3288
Mount Pleasant ISD
Mr. Terry Myers
575-2000
Mount Vernon ISD
Mr. Rick Flanagan
537-2546
New Boston ISD
Dr. Gary VanDeaver
628-2521
North Hopkins ISD
Ms. Donna George
945-2192
North Lamar ISD
Mr. James Dawson
737-2000
Paris ISD
Mr. Paul Trull
737-7473
Pewitt ISD
Dr. David Fitts
884-2804
Pittsburg ISD
Ms. Judy Pollan
856-3628
Pleasant Grove ISD
Ms. Margaret Davis
831-4086
Prairiland ISD
Mr. James Morton
652-6476
Queen City ISD
Mr. Rob Barnwell
796-8256
Red Lick ISD
Ms. Rose Mary Neshyba
838-8230
Redwater ISD
Ms. Anne Farris
671-3481
Rivercrest ISD
Mr. Rickey Logan
632-5205
Roxton ISD
Mr. Dan Pickering, Interim
346-3213
Saltillo ISD
Mr. Paul Jones
537-2386
Simms ISD
Mr. Rex Burks
543-2219
Sulphur Bluff ISD
Mr. Robert (Robin) Ross
945-2460
Sulphur Springs ISD
Mrs. Patsy Bolton
885-2153
Texarkana ISD
Mr. James Henry Russell
794-3651
Winfield ISD
Mr. Danny Denton
524-2221
College/University
President
Phone #
Texas A. & M. - Commerce
Dr. Keith D. McFarland
886-5011
Texas A. & M. - Texarkana
Dr. Stephen Hensley
223-3002
Texarkana College
Mr. Frank Coleman
838-4541
Northeast Texas Community College
Dr. Bradley Johnson
572-1911
Paris Junior College
Dr. Pamela Anglin
785-7661
AreaColleges and Universities
Regional Churches: