Uncompensated Trauma Care Application
Application period extended until May 15.
The Texas Department of State Health Services (DSHS), EMS/Trauma Systems (EMS/TS) application to apply for the 2024 Uncompensated Trauma Care (UCC) Funding begins February 1, 2024. Additionally, the application information will be emailed to the Trauma Coordinator/Trauma Program Manager for all designated and “in active pursuit” hospitals.
A completed application must be received by the department per the instructions provided below no later than midnight, May 15, 2024.
Designated Trauma Facilities and Emergency Medical Services Account (Fund 5111)
To be eligible for the hospital allocation from Fund 5111, a hospital must be either a designated trauma facility or meet the “in active pursuit of trauma designation” requirements by the application due date and maintain either status as directed by statute.
“In active pursuit” requirements:
- Submit a letter of intent to designate as a trauma facility
- Submit a “timely and sufficient” trauma designation application (with fee);
- Submit evidence of data submitted to the State EMS/Trauma Registry;
- Submit evidence of participation in the appropriate Regional Advisory Council; and
- Provide evidence that a hospital trauma performance improvement committee has been developed.
Background Info:
Texas Health and Safety Code §780.004 directs DSHS to use 94% of funds in the Designated Trauma Facility/Emergency Medical Services (DTF/EMS) Account (Fund 5111) to fund a portion of uncompensated trauma care provided at hospitals designated as state trauma facilities and facilities that are in active pursuit of trauma designation by the application due date.
Texas Health and Safety Code §773.122 directs DSHS to use 27% of funds in the Emergency Medical services, Trauma Facilities, and Trauma Care Systems Account (Fund 5108) and 27% of funds in the Emergency Medical Services and Trauma Care Systems Account (Fund 5007) to fund a portion of uncompensated trauma care provided at hospitals designated as state trauma facilities by the application due date.
Hospital Allotment Funds will be distributed in the following manner:
-
15% of the total amount of funds available for the Hospital Allocation will be divided equally among all eligible applicants.
- The remaining 85% of the UCC funds will be distributed to eligible hospitals based on the percentage of uncompensated trauma care a hospital provides in relation to the total uncompensated care provided by all the eligible hospitals that apply for the UCC Funding.
Uncompensated Trauma Care Application
The UCC application is a 3-part application process. All 3 parts of the application must be completed and submitted on or before the deadline to be considered for hospital allocation funding eligibility.
Application Information
Information regarding the Uncompensated Trauma Care (UCC) application.
Part A – Application
Complete all required portions of the application in order to submit the information directly to the department. It will not allow you to complete the form until all required fields have been addressed.
For this year’s funding patient data will be accepted for CY2022
This portion of the application is to be filled out online.
Application Part A - Helpful documents
Part B – Affidavits
This form must be completed and signed by all individuals listed to be eligible for funding. If the facility does not have a governing board, the Chief Executive Officer/Administrator must sign as the Board Chair.
Each of these signatures on the application must be signed and sworn to before a Texas Notary Public.
- Chief Executive Officer/Administrator
- Chairperson of the Board of Directors
- Chief Financial Officer
- Chief Nursing Officer
The Trauma Medical Director and Trauma Program Manager must sign the document.
Please send completed forms to: fundingapp@dshs.texas.gov.
This portion of the application can be downloaded.
Part C – Supporting Data Submission
Submit the excel spreadsheet with the detailed data for patient accounts and claims in Part A – Application, via email to fundingapp@dshs.texas.gov.
Note: The Facility Charges and Patient Records reported on Part A – Application, must match the information submitted in Part C – Supporting Data Submission.
This portion of the application can be downloaded.
Payment Information/Resources
Payments are issued after the calculations are completed for the Uncompensated Trauma Care (UCC) funding and Standard Dollar Amount (SDA) Trauma Add-On funding (reconciliation process).
If you would like to receive any issued payments for UCC for your facility as a direct deposit, complete the information below for initial set-up or to update any needed information for this process:
Formats available:
- DSHS Vendor Direct Deposit Form
- Texas Comptroller of Public Accounts (Online)
Setting Up, Changing, or Canceling Direct Deposit
To ensure that any issued payments for UCC for your facility are received promptly and at the correct location, complete the information below to either to create a new Texas Identification Number (TIN) or update information on a current TIN:
Formats available:
- DSHS Vendor Set-Up Form
- Texas Comptroller of Public Accounts (Online)
Application for a Texas Identification Number (TIN)