RAC Operation Guidelines

Regional Advisory Councils are the backbone of the Texas EMS and trauma system. This overview of their history, purpose and structure is adapted from the Texas RAC operations manual (rev. 06/2008) and explains how CVRAC and the other 21 councils came to be and what they are expected to do.

I. Purpose

The purpose of a Regional Advisory Council (RAC) is to develop, implement and monitor a regional emergency medical services (EMS) trauma system plan to facilitate trauma system networking within its TSA or group of TSAs. A RAC is an organized group of healthcare entities and other concerned citizens who have an interest in improving and organizing trauma care within a specified Trauma Service Area (TSA). RAC membership may include hospitals, physicians, nurses, EMS providers, rehabilitation facilities, dispatchers, as well as other community groups.

II. Omnibus Rural Health Care Rescue Act

The Texas legislature wanted trauma care resources to be available to every Texan. The Omnibus Rural Health Care Rescue Act, passed in 1989, directed the Bureau of Emergency Management of the Texas Department of Health to develop and implement a statewide emergency medical services (EMS) and trauma care system, designate trauma facilities, and develop a trauma registry to monitor the system and provide statewide cost and epidemiological statistics.

III. Implementation of the trauma system

The trauma system was initially adopted by the Texas Board of Health in accordance with Senate Bill 530, Health & Safety Code, Chapter 773 (Emergency Medical Services), whereby the state was divided into twenty-two regions called Trauma Service Areas (Texas Administrative Code § Rule 157.122), and provided for the formation of a Regional Advisory Council (Texas Administrative Code § Rule 157.123). In each area, a regional trauma system plan was developed and implemented, delineating the trauma facility designation process, and provided for the development of a state trauma registry.

A Regional Advisory Council, an organization of healthcare entities and individuals such as hospitals, physicians, nurses, EMS providers and other individuals interested in trauma care and injury prevention, thus provides a vital link in implementing the regional trauma system plan.

IV. Functions

The functions of Regional Advisory Councils (RACs) were to:

1. Develop and implement a regional EMS/trauma system plan
2. Provide public information and education about prevention of trauma and a trauma system
3. Provide a forum for EMS providers and hospitals to address trauma service area issues
4. Network with other regional advisory councils
5. Document and report trauma system data that meets trauma service criteria

V. The 22 Regional Advisory Councils of Texas

The geographic demographics of the twenty-two regional advisory councils:

• AAmarilloPanhandle RAC TSA-A
• BLubbockTSA-B RAC BRAC
• CWichita FallsNTRAC TSA-C Inc.
• DAbileneBig Country RAC Inc
• EDallas/Ft WorthNorth Central Texas Trauma RAC
• FTexarkanaNortheast Texas RAC
• GTylerPiney Woods RAC
• HLufkin/NacogdochesTSA-H RAC
• IEl PasoFar West Texas & Southern New Mexico Trauma RAC
• JMidland/OdessaTexas J RAC
• KSan AngeloConcho Valley RAC TSA-K
• LBeltonCentral Texas Regional Trauma RAC
• MWacoHeart of Texas RAC
• NBryan/College StationBrazos Valley RAC
• OAustinCapital Area Trauma RAC
• PSan AntonioSouthwest Texas RAC
• QHoustonSoutheast Texas Trauma RAC
• RGalveston/BeaumontEast Texas Gulf Coast Regional Trauma RAC
• SVictoriaGolden Crescent RAC TSA-S
• TLaredoSeven Flags RAC on Trauma TSA-T
• UCorpus ChristiCoastal Bend RAC on Trauma TSA-U Inc
• VHarlingenLower Rio Grande Valley RAC on TSA-V Inc

VI. Trauma facilities

Trauma facilities are an integral component of a well-developed trauma system. An essential part of the trauma care plan is the designation of definitive care facilities.

VII. Trauma funding

During the 75th Legislative Session, Senate Bill 102 (SB-120) was enacted, creating the Emergency Medical Services (EMS) and Trauma Care System Fund. During the 76th Legislative Session, the EMS and Trauma Care System Fund was changed with the enactment of HB-2085. During the 1999 Legislative Session, the Department of Health was empowered to distribute funding directly to a regional advisory council if the council was an IRS 501(c)(3) organization. Additional funding sources, such as the extraordinary emergency allotment (EEF), the uncompensated care allotment and the tobacco endowment, have significantly enabled regional advisory councils and providers to impact trauma care.

VIII. RAC structure

As approval for RAC development occurred, among the essential events was the selection of leadership. The following components were, and remain, essential in selecting RAC leadership:

1. Composition of the officers (mix of geographic areas or professions)
2. Title and number of officers (chairman, president, etc.)
3. Method of selection (by appointment or by vote)
4. Length of term for each officeholder (number of years)
5. Responsibilities of each officeholder (duties and functions)

Group support and agreement among the members is enhanced if the “key” people are representative of the membership across a broad spectrum. Limiting the number of leadership positions held by people in the same profession, or who live in the same county, was and is critical. It was and is suggested that at least one position be from the prehospital discipline.

The history and development of Regional Advisory Councils has moved rapidly over the course of several years. They have not been static since their inception, nor should they be. No one RAC is the same; each has components that are unique.

IX. What is a RAC?

Regional Advisory Councils are responsible for developing, implementing and monitoring a regional emergency medical service trauma system plan. They are an organized group of healthcare entities and other concerned citizens who have an interest in improving and organizing trauma care within a specific TSA.

Not every Regional Advisory Council will be structured the same, but each must have the same objectives: to reduce the incidence of trauma through education, data collection and analysis, and performance improvement. This is accomplished by providing educational initiatives, looping data back into those initiatives, and conducting performance improvement that gives every provider guidance and motive to reduce the incidence of trauma and improve the outcome of trauma patients.

Source: Texas Regional Advisory Council operations manual, rev. 06/2008.