East Texas Gulf Coast Regional Trauma Advisory Council
CPS/Hospital Preparedness Grant
Letter of Agreement
Hospital / Healthcare Facility: _____________________________________________________
Street:_____________________ City & Zip:
______________ Phone:_________________
Representative: ___________________________ Alternate Contact: _____________________
Our facility/agency agrees to comply with the TSA-R CPS/Hospital Preparedness Program (HPP) Office of the
Assistant Secretary for Preparedness and Response (OASPR) YR 10 Expenditure and work Plan as follows:
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Utilize Communications tools to communicate with Regional Health Care and Governmental Partners in both
planning and disaster response. Includes EMSystem & WebEOC.
Agree to comply with NIMS compliance initiative as outlined in guidance document.
Agrees to maintain an inventory system for equipment or supplies purchased with OASPR funds.
Abide by the East Texas Gulf Coast Regional Trauma Advisory Council, HPP Grant Guidance & DSHS HPP
contract policies established, including procurement policies. Our facility/agency agrees to request
reimbursement using the East Texas Gulf Coast Regional Trauma Advisory Council reimbursement check
request form, policies and procedures.
Agrees to scheduled on-site quality assurance reviews by the East Texas Gulf Coast Regional Trauma
Advisory Council and or DSHS representatives.
Agrees to attend and participate in assigned committee meetings in addition to East Texas Gulf Coast
Regional Trauma Advisory Council General Assembly meetings.
Agrees to complete and submit requested preparedness status reports to the East Texas Gulf Coast Regional
Trauma Advisory Council representative within announced deadlines.
Participate in all actual emergency response activities in the region, which includes receiving patients that are
approved for our classification and capabilities from the scene of a major incident within our region. Notify the
East Texas Gulf Coast Regional Trauma Advisory Council of major occurrences that impact daily operations
of business and could potentially impact regional partners.
I understand that our facility/agency may be subject to Federal A-133 audits and other performance measures
related specifically to expenditures of the HPP funds.
The East Texas Gulf Coast Regional Trauma Advisory Council agrees to the following:
 The Finance Committee will develop, monitor and modify the HPP spending priorities and budget, planning
efforts, and preparedness efforts in accordance with Hospital Preparedness Program guidelines and allocate
regional funds based on Regional Hazardous Vulnerability Assessment.
 Will coordinate response activities with jurisdictional partners, Multi Agency Coordination Center, and DSHS.
Includes: Situational awareness, evacuation, repatriation activities and training.
Contract period for the OASPR YR 10 (FY12) funds will be the same as the Department of State Health Services
(DSHS) contract period between East Texas Gulf Coast Regional Trauma Advisory Council and DSHS. Contract
period: July 1, 2011 to June 30 2012.
Administrator/Designee: ________________________________ Date:_______________________
RAC-R Chairman:
__________________________________
Date:_______________________
PO Box 2878 Angleton, Tx 77516-2878
201 E. Mulberry Angleton, TX 77515
Phone: 979-888-8005
Fax: 979-888-8006
www.rac-r.com
East Texas Gulf Coast Regional Trauma Advisory Council
PO Box 2878 Angleton, Tx 77516-2878
201 E. Mulberry Angleton, TX 77515
Phone: 979-888-8005
Fax: 979-888-8006
www.rac-r.com