TITLE 7 HEALTH
CHAPTER 27 EMERGENCY
MEDICAL SERVICES
PART 9 TRAUMA
SYSTEM FUND
7.27.9.1 ISSUING
AGENCY: New Mexico Department of Health.
[7.27.9.1 NMAC - N,
02/29/2008]
7.27.9.2 SCOPE: The
Trauma System Fund Authority shall apply to requests made for funds available
pursuant to the Trauma System Fund Authority Act, Sections 24-10E-1, et seq,
NMSA 1978.
[7.27.9.2 NMAC - N,
02/29/2008]
7.27.9.3 STATUTORY
AUTHORITY: This rule is promulgated pursuant to the
following statutory authorities 1) the Department of Health Act, Section
9-7-6E., NMSA 1978, which authorizes the secretary of the department of health
to “make and adopt such reasonable and procedural rules and regulations as may
be necessary to carry out the duties of the department and its divisions”, and
2) the Trauma System Fund Authority Act, Section 24-10E-7., NMSA 1978, which
authorizes the department of health to adopt rules to carry out the provisions
of the act.
[7.27.9.3 NMAC - N,
02/29/2008]
7.27.9.4 DURATION:
Permanent.
[7.27.9.4 NMAC - N,
02/29/2008]
7.27.9.5 EFFECTIVE
DATE: 02/29/2008, unless a later date is cited at
the end of a section.
[7.27.9.5 NMAC - N,
02/29/2008]
7.27.9.6 OBJECTIVE: The
objective of Part 9, Chapter 27 is to establish standards and procedures for
funding programs under the Trauma System Fund Authority Act. These standards and procedures are designed
for the purpose of making funds available to sustain existing trauma centers,
support the development of new trauma centers, and develop a statewide trauma
system. This rule will inform New Mexico
hospitals and other trauma system stakeholders of the procedures to access
funds. The department of health through
the emergency medical systems bureau, will administer the fund pursuant to the
Trauma System Fund Authority Act and this rule.
[7.27.9.6 NMAC - N,
02/29/2008]
7.27.9.7 DEFINITIONS:
A. “Accumulation” defined as the prior approved expenditure or
disposition in the current fiscal year of funds distributed in the fiscal year.
B. “Act” defined as the Trauma System Fund Authority
Act, Section 24-10E-1, et seq, NMSA 1978.
C. “Authority” defined as those individuals, representing specific
agencies, organizations and individuals appointed by the governor to serve on
the Trauma System Fund Authority pursuant to Section 24-10E-4, B., NMSA 1978.
D. “Bureau” defined as the emergency medical systems
bureau of the epidemiology and response division, New Mexico department of
health.
E. “Chief” defined as the chief of the emergency
medical systems bureau.
F. “Department” defined as the New Mexico department of
health.
G. “Designated trauma centers” defined as those hospitals or other healthcare
facilities designated by the department as having met the requirements of the
rule 7.27.7 NMAC, “Trauma Care System” as a level I, II, III, or IV trauma
center.
H. “Director” defined as the director of the epidemiology
and response division.
I. “Division” defined as the epidemiology and response
division.
J. “Emergency medical services (EMS)” defined as the services rendered by
emergency medical technicians, licensed emergency medical services first
responders or emergency medical dispatchers in response to an individual’s need
for immediate medical care to prevent loss of life or aggravation of physical
or psychological illness or injury.
K. “Fiscal year” defined as the state fiscal year that runs
from July 1 through June 30 each year.
L. “Fund” defined as the trauma system authority fund.
M. “Injury prevention program” defined as a planned activity with a defined
purpose, stated objectives, implementation schedule and an evaluation component
that seeks to prevent or reduce illness or injury. Examples include but not limited to bicycle
helmet promotion, seat belt awareness campaign, child care seat distribution
program, driving while intoxicated (DWI) prevention and first aid training.
N. “Secretary” defined as the secretary of the New Mexico
department of health.
O. “Trauma registry” defined as a database that documents and
integrates medical and system information related to the provision of trauma
care by hospitals or healthcare facilities.
P. “Trauma advisory system stakeholders
committee (TAC)” defined as
the statewide committee on trauma comprised of pre-hospital, hospital,
rehabilitation, injury prevention and system support staff involved in trauma
care established pursuant to the EMS Act.
Q. “Uncompensated trauma care” defined as the difference between the costs
incurred by a hospital in providing the service and the amount that the
hospital has been paid for providing the service.
[7.27.9.7 NMAC - N,
02/29/2008]
7.27.9.8 DUTIES
OF THE BUREAU: On behalf of the department, the bureau shall
provide administrative and staff support to the authority, including the
administration and distribution of the fund, pursuant to oversight by the
authority in conformance with the act and this rule.
[7.27.9.8 NMAC - N,
02/29/2008]
7.27.9.9 DUTIES
OF THE AUTHORITY: The authority shall:
A. develop
criteria by which distribution of funds to existing trauma centers and
potential new centers will occur;
B. receive
applications and determine and monitor the actual distribution of money from
the fund that will support the development of a statewide system of trauma
care;
C. oversee
the department’s administration of the fund and development of a trauma system;
D. report
annually to the interim legislative health and human services committee and the
legislative finance committee.
[7.27.9.9 NMAC - N,
02/29/2008]
7.27.9.10 ANNUAL
REPORT: The authority shall prepare an annual written
report that includes a summary of the current fiscal year distribution from the
fund, including the number of approved applications and amount awarded to
sustain existing trauma centers, support the development of new trauma centers,
and develop a statewide trauma system.
In addition, the report will include an assessment of progress and
remaining challenges to achieve the purposes of the act. The report shall be made to the interim
legislative committees and made available to public entities and the public on
request.
[7.27.9.10 NMAC - N,
02/29/2008]
7.27.9.11 EXISTING
TRAUMA CENTER FUNDING PROGRAM: The purpose of this program is to sustain
existing New Mexico trauma centers to ensure optimal care for those who suffer
traumatic injuries.
A. Eligibility:
subject to the availability of the funds in the trauma system fund,
facilities that are currently designated by the department as trauma centers
may apply for financial support under this rule.
B. Application process:
annually, prior to the start of each state fiscal year, eligible trauma
centers may apply to participate in the existing trauma center funding program
by submitting the application forms in a timely manner, as prescribed by the
authority and distributed by the bureau.
Such application forms will include, but not be limited to:
(1) identifying
information;
(2) assurances from the
trauma center’s governing authority;
(3) de-identified data
regarding trauma patients served during a specified previous time period
according to the case-inclusion criteria of the trauma registry;
(4) financial data
associated with those trauma patients including charges, collections, and
uncompensated trauma care;
(5) a plan of expenditure
for the amount requested from the fund.
C. Funding amounts: Based
upon the allocation decision by the authority in 7.27.9.12 NMAC, the following
formula will be applied to determine the annual funding for each existing
trauma center with an approved application:
(1) an allocation will be
made to each trauma center based on their level of designation subject to the
availability of funds;
(2) additionally, level
I, II, and III trauma centers will receive their share of the remaining dollars
in the existing trauma center funding program, based upon their relative share
of uncompensated trauma care for these centers as determined by the authority.
D. Award of funds: The
authority shall approve the applications and the funding amounts for each
existing trauma center no later than July 31st.
The department shall prepare a written agreement with each existing
trauma center awarded funding under this rule that reflects the term and amount
of the award, and the expectations and conditions for receiving the award,
including fiscal accountability and reporting requirements.
E. Use of funds: Funds
awarded under the existing trauma center funding program must be used to
support, sustain, or enhance the trauma program including support for
trauma-related clinical and administrative personnel on-call costs for trauma
program as determined by the authority.
F. Accumulation: It is
anticipated that the entire amount of the annual award to each existing trauma
center will be spent during the fiscal year in which it is awarded. In the event that the entire amount cannot or
will not be expended, the trauma center must return the unexpended balance to
the department, unless it submits an accumulation and expenditure plan that is
approved by the authority prior to the close of the fiscal year in which it was
awarded. The authority may approve up to
one additional fiscal year to expend the balance.
G. Change in trauma center designation
status: If an existing trauma center fails to
maintain its level of trauma center designation following an award under this
rule, the authority shall review all the pertinent information and determine
what amount, if any, the department shall recover from the trauma center.
[7.27.9.11 NMAC - N,
02/29/2008]
7.27.9.12 DEVELOPING
TRAUMA CENTER FUNDING PROGRAM: The purpose of this program is to support the
development of new trauma centers to enhance the overall statewide trauma
system.
A. Eligibility: Any
facility that has submitted a letter of intent to the bureau to become a
designated trauma center under 7.27.9 NMAC prior to the issuance of the
application for this developing trauma center funding program shall be deemed
eligible to apply.
B. Application process:
Annually prior to the start of each state fiscal year, hospitals or
healthcare facilities that have submitted a timely letter of intent to become a
designated trauma center and desired level of designation, may apply to
participate in the developing trauma center funding program. Such
hospitals/healthcare facilities shall submit the application forms in a timely
manner, as prescribed by the authority and distributed by the bureau. Such application forms will include, but not
be limited to:
(1) identifying
information;
(2) assurances from the
trauma center’s governing authority;
(3) a detailed plan to
become a designated trauma center with time frames. milestones, and an
associated budget which specifically indicates how funding under the program
will be utilized in the coming fiscal year.
C. Funding amounts: Based
upon the allocation decision by the authority in 7.27.9.2 NMAC, the authority
will annually establish an award for each developing trauma center. The authority will consider the merits of
each application under the developing trauma center funding program and will
determine the actual award for each applicant.
D. Award of funds: The
authority shall approve the applications and the funding amounts for each
developing trauma center no later than July 31st. The department shall prepare a written
agreement with each developing trauma center awarded funding under this rule
that reflects the term and amount of the award, and the expectations and
conditions for receiving the award, including fiscal accountability and
reporting requirements.
E. Use of funds: Funds
awarded under the developing trauma center funding program must be used to
support the developing trauma program as determined by the authority.
F. Accumulation: It is
anticipated that the entire amount of the annual award to each developing
trauma center will be spent during the fiscal year in which it is awarded. In the event that the entire amount cannot or
will not be expended, the developing trauma center must return the unexpended
balance to the department, unless it submits an accumulation and expenditure
plan that is approved by the authority, prior to the end of the fiscal year in
which it is awarded. The authority may
approve up to one additional fiscal year to expend the balance.
G. Eligibility limit: Under
the developing trauma center program there is a limit of two fiscal years
during which designation as a trauma center must be achieved by a developing
trauma center. If designation is not achieved during this time period, the
authority shall review the circumstances and all pertinent information
determining what amount if any, the department shall recover, from developing
trauma center.
[7.27.9.12 NMAC - N,
02/29/2008]
7.27.9.13 TRAUMA
SYSTEM DEVELOPMENT PROGRAM: The purpose of this program is to provide
financial support to various statewide system development activities,
initiatives, agencies, or programs, as prioritized annually by the
authority. The amount of funds available
in a given fiscal year will be based upon the allocation decision by the
authority in 7.27.9.11 NMAC.
A. System development priorities: Prior
to each fiscal year, the authority shall establish priorities for statewide
system development activities and initiatives.
These priorities shall be communicated to the (TAC) and to the bureau.
B. Proposals solicited and reviewed: Early
each fiscal year, the bureau, with guidance from the TAC, will widely
distribute a request for applications to meet the system development priorities
as specified by the authority. All
applications received in a timely manner on the forms specified by the bureau
will be reviewed and considered by the TAC.
C. Recommendations to the authority: Based
upon their review, the TAC will make written recommendations to the authority
for which system development applications warrant funding and at what levels.
D. Funding decisions: The
authority will review the system development applications and the recommendations
from the TAC, in making their funding decisions under the trauma system
development program.
E. Award of funds: The
authority shall approve the trauma system development applications and the
funding amounts no later than July 31st.
[7.27.9.13 NMAC - N,
02/29/2008]
7.27.9.14 GENERAL
PROVISIONS:
A. Spending flexibility: If in
any fiscal year, the authority decides not to spend the entire amount allocated
under any of the three trauma system funding programs as initially decided in
7.27.9.12 NMAC, the authority, at their discretion, may re-allocate that amount
to either or both of the remaining funding programs for expenditure in that
fiscal year.
B. Procedures for reconsideration:
Applications applying for and funding under this rule may request a
reconsideration of their funding amount by notifying the bureau in writing
within ten (10) working days after notification to the applicant of the
authority’s funding determination. The
authority must review the reconsideration request within thirty (30) working
days and issue a final written determination within ten (10) working days of
their review.
C. Oversight, inspection, and audit: The
authority, working with and through the department, is responsible for the
oversight of expenditures from the fund and the development of the statewide
trauma system. All recipients of trauma
funds under the act shall be subject to reasonable oversight and as needed,
visitation by authorized representatives of the bureau or the authority. Records of purchases, training programs, or
personnel expenditures accomplished with awards from the fund shall be open for
inspection. This oversight may include
an objective audit if deemed necessary.
Findings from all oversight activities will be shared with the fund
recipient and as appropriate a written deficiency correction report may be
requested.
D. Monitoring and accountability: The
bureau will be responsible for monitoring the trauma system development program
and for periodically, but no less than annually, reporting the progress or
results to both the TAC, and the authority.
[7.27.9.14 NMAC - N,
02/29/2008]
HISTORY OF 7.27.9 NMAC: [RESERVED]