(a) Trauma service areas (TSAs) are established for effective coordination, oversight, system development and enhancements, and delivery of trauma, stroke, perinatal, acute care, disaster response, and emergency medical services (EMS) in geographical regions consistent with national standards.
(b) Texas is geographically divided into defined TSAs. Each TSA shall:
  (1) contain no fewer than three Texas counties;
  (2) use county borders to geographically define the TSA boundaries; and
  (3) have at least one designated trauma facility within its boundaries that has or exceeds the advanced Level III trauma facility designation requirements as defined in §157.125 of this title (relating to Requirements for Trauma Facility Designation).
(c) The Department of State Health Services (department) shall maintain the current list of counties included in each TSA and make the list available on the department's website: dshs.texas.gov.
(d) The realignment of a county to a different TSA may be initiated by the department or at the request of the Regional Advisory Council (RAC), provided the transferring county is contiguous to the county in the receiving TSA.
  (1) The requesting RAC shall submit a request to the Director of EMS/Trauma Systems Section specifying:
    (A) reasons for realignment request such as a decrease in EMS transport time, access to higher levels of care, or access to additional resources;
    (B) existing patient routing patterns used by both EMS providers and health care facilities, including distances and transport times involved in this patient routing;
    (C) a list of all health care facilities and all first responder organizations, EMS providers, and county governments affected by the requested realignment; and
    (D) documentation that the RAC of the receiving TSA agrees with the proposed re-alignment.
  (2) The requesting RAC shall forward copies of the request to all impacted health care facilities' chief executive officer, first responder organizations, EMS provider medical directors, and county governments.
  (3) The department evaluates the re-alignment request based on the impact to patient care, including transport times, access to higher levels of care facilities, or resources.

Source Note: The provisions of this §157.122 adopted to be effective February 17, 2022, 47 TexReg 650