Trauma Designation
In 1989, House Bill 18 was passed during the 71st Legislature. The purpose of the bill was to develop an emergency medical services (EMS) and trauma care system. This allowed for the creation of trauma service areas (TSAs), formed regional advisory councils (RACs), and outlined the trauma facility designation process. The trauma designation rules went into effect on December 26, 2006.
The Texas Department of State Health Services (DSHS) has the authority to designate facilities. The Office of EMS/Trauma Systems Section of DSHS works with hospitals and Regional Advisory Councils (RACs) to:
- Develop facility designation protocols,
- Develop policies, and
- Designate facilities in the state.
Adopted Trauma Rule Comparison Documents
- Chapter 157 Adopted Level III Rule Language Comparison Document
- Chapter 157 Adopted Level IV Rule Language Comparison Document
Register Now
Statewide Trauma Designation Meetings
Texas trauma designation program staff are invited to attend our monthly meeting in collaboration with the department and peers throughout the state. Share ideas and best practices to improve patient outcomes for Texans.
Join us by requesting registration below:
- Monthly, recurring - Trauma Level I & II
- Monthly, recurring - Trauma Level III & Non-Rural Level IV
- Monthly, recurring - Trauma Rural Level IV
- May 19, 2025 2-4 PM – Trauma Level III Gap Analysis Review Meeting
- May 21, 2025 3-5 PM - Level IV Gap Analysis for Level IV Trauma Facilities with 101+ Trauma Patients
- July 8, 2025, 3-4 PM – Trauma PI: Ask the Experts (all levels)
- August 5, 2025, 3-4 PM – Trauma PI: Ask the Experts (all levels)
- September 9, 2025 – Trauma PI: Ask the Experts (rural level IV)
- October 7, 2025 – Trauma PI: Ask the Experts (all levels)
- November 4, 2025 – Trauma PI: Ask the Experts (all levels)
- December 9, 2025 – Trauma PI: Ask the Experts (rural level IV)
Trauma System Development
Overview
Related Programs
Councils
Trauma Facility Designation
Documents
- Applications and Forms
- DSHS Designation Program: Facility Program Contact Update Form
Use our online verification system to verify your current contact information (instructions). - Designation Site Survey Guidelines
- Texas DSHS Designation Survey Organization Application
Fees
The non-refundable trauma application fees for a three-year designation period are as follows:
- Level I trauma facility application fee will be no more than $10 per licensed bed, with an upper limit of $5,000.00 and a lower limit of $4,000.00.
- Level II trauma facility application fee will be no more than $10 per licensed bed, with an upper limit of $5,000.00 and a lower limit of $4,000.00.
- Level III trauma facility application fee will be no more than $10 per licensed bed, with an upper limit of $2,500.00 and a lower limit of $1,500.00.
- Level IV trauma facility application fee will be no more than $10 per licensed bed, with an upper limit of $1,000.00 and a lower limit of $500.00.
Facilities
Map
Best Practice Guidelines
- ACS TQIP Best Practice Guidelines
- GETAC Trauma Systems Committee - Recommended Best Practice Guidelines
Resources
- Level IV Trauma Center TOPIC Workshop Documents
- ISS Scoring/TQIP Assistance Workgroup Resource Documents
For the purposes of Trauma Facility designation, DSHS will accept certifications or survey results from these recognized organizations:
- American College of Surgeons (ACS): Comprehensive, Major, and Advanced
- Texas EMS Trauma & Acute Care Foundation (TETAF): Advanced and Basic
Get In touch
Fax
512-834-6611
Mailing Address
Texas Department of State Health Services EMS/Trauma Systems
Attn: Trauma Designation Program
PO Box 149347 MC 1876
Austin, TX 78714-9347
United States
Phone
512-605-9108
Phone
737-354-1849
Phone
512-834-6794
For technical difficulties, information, or process or rule clarification:
Phone
737-267-4467
For Trauma Uncompensated Care Funding questions