Prepared by C. Reeves
TETAF
 No updates from most of TETAF Committees due to scheduling conflicts.
 Education (Courtney Edwards) – EMS Data Management Course was held on May 7 th ; TETAF Injury
Prevention Symposium will be the Monday of GETAC. Medical Directors Course in Dallas later this year
 Pediatric (Lisa Vinson) – monitoring E-codes but still missing pediatric facilities; will provide listing of e-codes that are more appropriate e-codes for child abuse and post on the TETAF website;
 RAC (Shae Watson)– reporting assisting with legislative session
 Trauma (Lisa Price)– burn still in process; productivity report development and plan to do some time studies at facilities; review and revision of the trauma survey process; rule changes will also have some survey changes included
 TETAF Update (Dinah Welsh) – doodle poll on meeting dates for Board meetings – 1 st and 2 nd
Wednesday as potential dates for future meetings; strategic planning and looking for dates in June;
 Legislative Update (Dinah Welsh) – ends June 1 st ; 5111 $160-200 million not appropriate – Rep
Turner wants all funding appropriated as the law states, these funds are expected to go to hospitals;
Rep Schwertner very important and sits on the Budget and Conference Committees; dispro hospitals have become “safety net hospitals”; looking for funds to go to hospitals and it may not all go to trauma hospitals; focus is on trauma not necessarily about EMS and RACs; huge divide on tax cuts, more cuts equal less appropriated funds; working to get RAC funding into Article 2; DRP will mostly likely survive; Action Alert for the ‘don’t text’ bill; EMS personnel compact is moving along out of the House
– HB2498; Air Medical HB3077 came out of the House; merging red light camera funding to 5111
HB1437 amended to HB 7 and then to HB?; if not a second reading in House by May 14 th then a bill is dead; meeting with Appropriation Staff went okay but not great, good questions;
 TTCF – honored Kathy Perkins with a life time achievement award; Ms. Janice Markwardt as the
Trauma Champion
 TQIP (Jorie Klein) – Dr. Matt Davis will be the surgeon in charge and TETAF will provide administration; 17 Level I & II are participating; looking for Level III to pilot use of the TQIP – 15 so far but want 20-25
PEDIATRIC
 Committee Updates
 State CFRT – Dr. Macias reported that Ohio established a model to decrease child abuse; Texas
Children’s’ Hospital Association sent two persons to review this process; will report out in the future
 Pediatric Readiness Survey – ENA would develop state champion teams to work with hospitals on this issue, 4-5 pilot states
 EMS-C Facility Recognition Program developed by HRSA; by 2017 a recognition program must be established in each state; 14 states have this process in place – not Texas; a toolkit is being developed; presented to the Perinatal Advisory Council and plans to work with TETAF; looking at
TETAF to provide the recognition surveys; will be checking to see if any rule making language will be needed for state recognition although it is voluntary
 EMS-C EMS Reassessment (Sam Vance) – nationwide 81% participation; in Texas did a sample of
459 responded 326 EMS and FROs which is 71% response rate;
 online medical direction BLS 88.9% ALS 86.1% up from 2011 survey – Nation 90.1% and
89.5 % respectively

 offline medical direction protocols – BLS 95.1% ALS 96.5% also up from 2011 – Nation
93% and 98.7% respectively; however less than BLS 73% ad ALS 96.5% say the protocols are available in their trucks – Nation 72% and 93.5% respectively
 pedi equipment – BLS 90.1% ALS 96.2%; least available equipment is neonatal BVM, suctions, nasal airways, pulse ox with pedi probe – Nation 91.8% and 95.5% respectively
Evidence based pediatric guidelines are available on the EMS-C and NASMSA website; not carrying recommended equipment if not required, EMS-C recommends changes to rule 157.11 to include such requirements
 Special Population – STEAR seems to be the only one; mostly transport needs; only 10-15% of the enrollees are pediatrics
 Update on Pediatric Facility Transfer Guidelines (Sally Snow) – final on GETAC website; still needs to be vetted by the other GETAC Committees
 Trauma Registry Update (Dr. Chris Drucker) – pedi is 0-17 years old; presented 2013 Pediatric
Summary Report and report by Pediatric Facilities and Non-Pediatric Facilities Treatment; available on GETAC website; crash report data is now connected to the Trauma Registry;
 EMTF presentation on pediatric capabilities (Joe Palfini)
INJURY PREVENTION
 EMS-C Update (Sam Vance) – see Pediatric Committee notes
 Legislative Update (Chair) – see TETAF plus a Narcan - SB1462 has passed to the Senate and has been read once in the House
 Hospital-based Injury Prevention Components – document on the GETAC website; doing a survey in August of several RAC Regions (Austin, San Antonio, Houston, DFW, and Temple)
 Data to determine/prioritize activities
 Working with partners
 Appropriate injury prevention for Injury Prevention and/or Trauma Coordinator as well as
CE
 Implementing evidence-based strategies
 Use the outcomes to move forward
 Inaugural American Trauma Society Injury Prevention Coordinator Course (Mary Ann Contreras) -
$495, JPS sent people and said it was great; will be held annually; looking at a certification for these persons
 Injury Prevention Summit the half day prior the Las Vegas Conference in September – adult falls, alcohol, distracted driving abstracts open
 SafeKids National Conference July 27 – August 2 in Washington D.C.
 Work day meeting on July 21 st in Austin.
 Dr. Chris Drucker (DSHS) updated about the crash data connection to the Trauma Registry. 2013 records link and hospitalizations back to 2010.
STROKE – no quorum present
 TETAF Legislative Report (Dinah Welsh) - $4.5 million for LoneStar Stroke and $1.5 million for data collection – from Senate
 DSHS CVD Rider 97 Report (Karla Granando) – AHA part has 55 hospitals for heart attack and 47 hospitals for stroke data – presentation given, Heart Attack & Stroke Summit on July 24 in Austin;
RAC Stroke Survey all 22 RACs responded; data on the CVD Council website; regular reports provided monthly
 Update on EMS/Trauma System (Dr. Chris Drucker) – last year of legacy standard, expect NEMSIS
V3 standard in the coming weeks, collect all EMS calls not just trauma, information from 2010today, 2010-2013 closed years

 Transport Plan Workgroup Report (Dr. Neal Rutledge) – report provided and recommendations, publish it on the website; recommend highest level of care and time limits for bypass;
 Stroke Education CE (HT Fillingham) – will be discussing with EMS Education at tomorrow’s meeting
AIR MEDICAL
 Rule Revision Update (Joe Schmider) – first draft revision is available; will schedule a special meeting for the air medical portion prior to August GETAC
 State Compact Update (Joe Schmider) – moving along in legislature but no decision yet
 Pediatric Inter-facility Transfers Guidelines document (Sally Snow) – looking for support from the committee; will take action at the next meeting;
 EMS-C Pediatric EMS Recognition Program (Sam Vance/Traci Fox) – follow up for air medical; reminder – voluntary; developing an air medical equipment list since one does not currently exist
 Update on NCTTRAC data sharing (Jennifer Gardner) – provide update on status; almost met their
30% goal
 This group and Disaster are doing disaster typing of airports so they will join together; Steve with
Air Life with get with Eric Epley to check status.
 EMTF Air MOA – reported to have moved forward but not all air providers agreed; committee will follow up with Eric Epley on the true status.
 Activation of Air Medical by non-EMS and non-hospital entities (Eddie Martin) – public requesting air directly outside of 9-1-1 system
EDUCATION
 Advanced Practice Paramedic/Community Health Paramedic (Jodie Harbert) – provided update from the summit held in DFW area last month; it was clear that lots of areas are moving forward with this project; a workgroup is being started and chaired by NCTTRAC
 Stroke EMS CEs (HT Fillingham) – lots of public comment on this recommendation; varying sides; discussion on increasing basic stroke training; push for this should be by National Registry.
 Panhandle Region issues with decrease in EMS personnel (Jodie Harbert/Justin Boyd) – has not had time to collect all of the input on this document focused on
 2015 Texas EMS Educators Summit (Jodie Harbet) – 80 attended and went well; will continue to hold annually
 Joe Schmider talked about an educational program in North Texas; suggested June 26th in
Amarillo
EMS
 CCMP (Allen Johnson) – leave on agenda, short summary provided again
 Rule 157 Revision Update (Chief Cunningham) - Met March 5 th and April 1 st ; revisions should be ready middle of June which will be the first draft and hold stakeholder meetings; Dudley Wait would like to start this committee’s “road trips” in mid-September; will set dates at the August
GETAC meetings
 EMS-C Update (Sam Vance) – see Pediatric Committee notes; EMS Week May 18-23, EMS-C Day is
May 20 th , present awards on May 22 nd at Lone Start Campus in Cypress
 Pediatric Inter-Facility Transfer Guidelines (Sally Snow) – change from guideline to considerations; will not go to GETAC this session; Christine Reeves offered to bring up at RAC
Chairs
 EMS Data Reporting Rules (Dr. Chris Drucker) - Recommendations will be sent to Dudley Wait in order for Dr. Drucker to have before August GETAC. Joe Schmider reminded them that if EMS
Providers don’t enter into the State Registry could effect license and possibly LPG applications

 National Rural EMS Conference (Justin Boyd/Eddie Martin) – reported on this inaugural conference; hoped Texas would host one in the near future
 EMS Regulatory Site Surveys (Joe Schmider) – noted that site surveys have been going on for years; additionally, a FAQ can be found in the current online EMS magazine; DSHS has developed a survey tool that they want committee input on before making it public
 Update on NCTTRAC data sharing (Jennifer Gardner) – see notes above
EMS MEDICAL DIRECTORS
 EMS-C EMS Recognition Program (Sam Vance) - Passed 5 to 4 to support; however, provided some suggestions for review and inclusion.
 EMS-C National EMS Reassessment (Sam Vance) – See Pediatric Committee Notes.
 Trauma Registry Update – NEMSIS V3 within the next week; EMS Data Management Course went well; must be submitting to the registry electronically by 1/1/15 – no affidavits; NEMSIS may extend their deadline for state submission at V3.3.4
 Position Paper on the Transport and Care of Patients with Behavioral Disorders (Dr. Bill Moore) – basically do not want to transport these voluntary patients in an ambulance but with police like noted in law; could medical clearance be done in the field by a paramedic;
 Pediatric Transfer and Transport Guideline (Dr. Katherine Remick/Sally Snow) – want to push to
August for action.
 Community Paramedic/Mobile Integrated Healthcare/Advanced Practice Paramedic (Dr. Sharon
Malone) – a minimum set of core components across the nation – cardiology, pulmonology, nephrology, endocrinology, and neuropsychiatric and behavioral health; establish a task force including EMS Medical Directors, EMS Education, and EMS Committees: ACTION approved to move forward to GETAC; NAEMSO has “special credentialing”;
 Narcan Administration by Persons Not Licensed by DSHS (Dr. Sharon Malone) – Joe Schmider updated that HB225 – Good Samaritan Bill – passed today that will allow for non-clinical persons to give meds for drug overdoses
 Gap Between TMB and DSHS Rules – tabled to August; develop an agreement between EMS and
EMS Medical Directors: ACTION approved to move forward to GETAC
 Gap Between EMS Medical Director and EMS Clinicals (Dr. Jeff Beeson) – DSHS requires that persons coming into Texas to complete clinicals does require approval by their home EMS Medical
Directors; position paper that DSHS will swiftly address these gaps; Joe Schmider suggested addressing during the rule making process
 Joe Schmider updated over 200 physicians have taken the online EMS Medical Directors course; job description of the EMS Medical Advisor is under consideration at DSHS at this time; provided them with the EMS Compliance Survey Process
TRAUMA SYSTEMS
 Rule Revision Update – Nothing provided.
 Legislative/Sunset Update – Nothing provided.
 Trauma System Strategic Plan Revisions (Dr. Brian Eastridge) – Will be discussed in depth at
GETAC; draft available on website but does not encompass all of the suggested changes
 Trauma Registry Workgroup Update (Dr. Chris Drucker) – user guide (185 pages) on the DSHS website
 Trauma Medical Directors WG (Dr. Brian Eastridge) – worked on strategic plan; general practice guidelines like TQIP has begun with; substance for the August meeting
 RAC Updates (A-H) – A, B, E, F, G, H
 Trauma Registrar Workgroup (Irene Lopez) – met with DSHS about TQIP
 Trauma EMR Workgroup (Jorie) – EMR Guide available on the DSHS website

 Regional PI (Christi Reeves) - TSA E set up like our RBH/CFRT; TSA P is same but not all cases only system issues; TSA I; TSA M; Dr. Gandhi wants double transfers to be audited across the State
 Trauma Center Activation Process – tabled to August
 Stand-Alone EDs Workgroup – has not met; tabled to August
 Texas EMS/Registry Report (Jorie Klein) – Presentation is available if someone wishes to review;
Dr. Drucker updated about the linkage of crash data and trauma records, mandatory vs. required
(not) - DSHS standard matches NTDB/NEMSIS; Legacy data will close 12/31/15
 Liaison Reports
 Sally Snow updated about the Pediatric Transfer Guidelines. Will be on the August agenda.
 TQIP Update and Level III Initiatives
 PUBLIC COMMENT – to get registry numbers for free standing EDs; email Kelly Stowell if interested in participating in the Mid-Level Workgroup; Rule 103 (trauma registry) will be under revision
CARDIAC
 AHA ACTION Registry Report (Dr. Richard Smalling) – 1 st quarter 2014, 137 hospitals participating in ACTION in Texas out of a total STEMI receiving of about 150; median length of stay is 3 days for STEMI and NSTEMI; 6.4% in-hospital mortality rate for STEMI and 3.4% for
NSTEMI; PCI door-to-balloon 96% STEMI; will send out the NSTEMI guideline updates
 RAC Stroke/STEMI Data – Rider 97 (Karla Granado) – AHA part has 55 hospitals for heart attack and 47 hospitals for stroke data, Heart Attack & Stroke Summit on July 24 in Austin; presentation data on the CVD Council website; Dr. Chris Drucker noted that he can provide EMS data – 116
NEMSIS STEMI data points, will send what it collected
 Trauma Strategic Plan Update – postponed discussions
 Texas Heart Attack Collaborative Progress - THAC (Dr. Tim Mixon) – explained the process and how/why it got started; pre-hospital is an important target and goal
 STEMI Texas in Dallas on October 29-30, 2015
 SETRAC part of the Accelerator II Project and will update as the project unfolds.
RAC Chairs
 Funding/Contract Update (Indra Hernandez) – the RAC/EMS and EMS/County contracts will be issued through the e-grants system (CMPS); each RAC has a minimum of the ED and Chair listed in the system; any issues should be directed to Indra.
 Staff Update (Jane Guerrero)
 Rule Revision Update (Jane Guererro) – 13 chapters are being revised; stakeholder meetings will begin soon; RAC and Trauma Rule will have a meeting in Austin at the Pickles Center in June to review the rule; a copy of the draft rule should be available in 30 days
 Neonatal Status Update (Jane Guerrero) – Rule goes before DSHS HHSC Council on June 17 th ;
Perinatal Regions will be laid on the TSA boundaries; updated possible legislative changes but none had passed at this time;
 AAAM AIS Course (Colin Croker) – all spaces were filled for the June 11-12 courses
 Sunset/legislative Update (Jane Guererro) – provided status, nothing different than otherwise documented in this report
 Appointment of RAC Rep to Trauma Registry Workgroup (Colin Croker) – the group chose Terry
Valentino (TSA L) and Lori Boyett (TSA M)
 Texas EMS/Trauma Registry (Dr. Chris Drucker) – see rest of this report; RACs statewide will review double transfers, a report will be compiled by Registry staff
 Future meetings (Colin Croker) – May and November will remain a requirement for RAC Chairs; due to the lack of agenda items, DSHS proposed that February and August meetings would be RAC-

lead with a DSHS agenda item; after some discussion, it was decided to try to continue as has been done and see if more items come forward for the agenda
DISASTER (Mark Montgomery) – met in San Antonio with TDEM Conference (CR did not attend)
 Who will be trained for Ebola response?
 Reviewing the EMTF MOA for possible revision
 Joe Palfini working on funding for the EMTF program.
 EMTF was deployed to Van, TX response.
 AMBUS crew chief training needs.
 Governor’s Display scheduled for May 30 th in Austin.
GETAC
 Assistant Commission Report, Regulatory Services (Kathy Perkins) – budget is still not passed; sunset have passed, HB2510 crashed a couple of weeks ago, SB202 is no longer a sunset bill and passed yesterday, deregulation of 8 programs, 10-12 to Texas Department of License and
Regulation, 4 programs moved to Texas Medical Board; HHSC sunset bill (Christmas Tree bill) is moving slowly, DSHS will not be sunsetted, consolidation is weak, DSHS will maintain public health mission, final will be done with a committee but has not passed; HB1437 – red light camera on State calendar on page 17, weak; Fetal Care will add a subcommittee and rural reps to the
Perinatal Advisory Council, not passed but only two facilities in State may comply; HB3077 – air medical changed to air, EMS, and trauma still needs to pass Senate; HB3433 – additional time for neonatal and maternal designation, Senate hearing next week; SB424 – needs to pass House;
Sunset lost EMS provisions but moved to SB1899 adds paramedic to work in hospital as a paramedic, waiting on House; SB1753 – ID badges in hospitals on Governor’s desk; contracting was moved to HHSC (explained LPG contract issue)
 State EMS/Trauma Report (Jane Guerrero) – Reported funding; tentative GETAC dates for 2016 -
February 10-12, May 11-13, August 24-26 in Austin at Windam Garden Hotel; 285 trauma designated facilities, 134 stroke designated facilities; LPG issue caused use of EEF funds $304,000 remaining in that account; Uncomp will still use trauma add-on, next year may change, still in discussion with Medicaid; staffing update; ACS statement on designation of trauma centers to be based on need, DSHS can NOT deny any facility designation if meets criterion; update on AAAM
AIS state-sponsored course on June 11-12
 Assistant Commissioner Report, Epidemiology (John Villanacci) – staffing update; submitted
TxDOT grant and will find out in July if awarded, includes training and improvement of registry; contracted with TETAF on training; staff available to visit RACs to discuss registry and data; crash data connected to Trauma Registry; attempting to connect discharge data as well; NEMSIS 3.3.4 is still pending; ISS calculation is coming soon; user guide completed and available on the DSHS website
 Assistant Commissioner Report, Division of Regional & Local Health Services (Dave Gruber) – updated on response to Van, TX; focused on the sunset but very minimal impact to this division; staffing update; exceptional items is expected to be $13 million which will go to LRN labs, epi support across the state, and communication (new software solution); Ebola funding update;
Texas Infectious Disease Network established to connect everyone
 Committee Summary Reports – beginning in August reports will complete a form to show on the
PowerPoint screen; this change will allow for more in depth discussion on important information
 Liaison Summary Reports o Texas CVD – updated with Stroke Committee Report; Kudos to TETAF o TETAF – see notes from meeting above o EMS-C Update & Report – see Pediatric Committee notes
 ACTION ITEMS

1.
Stroke CE – tabled to August
2.
Position Statement on the Overuse or inappropriately mandated for inter-facility –
3.
Interstate EMS CompAct – in process, questions should be directed to Joe Schmider
4.
Support Infectious Disease Response Units as a part of EMTF – postponed to August
5.
Information Sharing for High-consequence Infectious Disease – postponed to August
6.
EMS Medical Director Notice/Inclusion on Clinical activities/contracts – no action needed because already done in 2013
7.
Freestanding EDs inclusion in 9-1-1 System – on hold until next meeting due to legislative session
8.
STEMI as a Reportable Disease – tabled to speak with Dr. Smalling
9.
Direct Calls to Air Medical Providers for Service
10.
How to Improve the Sharing of Outcomes with EMS – more work to be done on this issue; lots of public comment on this issue
11.
Pediatric Transfer Guidelines – tabled to August
12.
Pediatric Recognition Program
13.
National EMS Assessment
14.
Gaps between TMB and DSHS – tabled to August
15.
Review and Update of the Strategic Plan for the Texas EMS/Trauma Systems
16.
Renaming the Texas Trauma and EMS System Strategic Plan Report