Maternal Levels of Care Designation

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In 2013, House Bill 15 was passed during the 83rd Legislature, Regular Session. The purpose of the bill was to develop initial rules for level of care designations for hospitals that provide maternal services. The hospital level of care designations for maternal care rules went into effect on March 1, 2018.

The Texas Department of State Health Services (DSHS) has the authority to designate facilities. The EMS/Trauma Systems Section of DSHS works with hospitals, Perinatal Care Regions (PCRs) and the Perinatal Advisory Council (PAC) to:

  • Improve maternal patient care and outcomes, 
  • Develop hospital requirements for facility designation, and
  • Establish regional coordination of maternal care.

*NEW* DSHS Designation Program: Facility Update Form

Use our online verification system to verify your current contact information (instructions).

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Maternal Levels of Care Development


Survey Organizations 

Advisory Council

  • Perinatal Advisory Council (PAC)
    Created by House Bill 15 of the 83rd Texas Legislature (Regular Session), the PAC examines utilization trends in neonatal and maternal care and recommends ways to improve neonatal and maternal outcomes.

Maternal Levels of Care Designation



The non-refundable maternal application fees for a three-year designation period are as follows:

  • Level I maternal facility application fees are as follows:
    • <=100 licensed beds fee is $250.00; or
  • Level II maternal facility application fee is $1,500.00.
  • Level III maternal facility application fee is $2,000.00.
  • Level IV maternal facility application fee is $2,500.00.



Resource Documents

The following tools may be used to evaluate your facility's compliance according to the Maternal Level of Care you are seeking.

Provider training webinars: Recordings of the training are listed below. Each link will take you to a page where you must enter your name and email address to access the video.  

Webinar recordings:

PowerPoint presentations from webinars:

Get In Touch

By Email

By Mail

Send mail correspondence to: 
Person's name  
Texas Department of State Health Services  
EMS/Trauma Systems 
Attn: Maternal Designation Program  
PO Box 149347 MC 1876 
Austin, Texas 78714-9347

Staff Contacts

For designation process or rule clarification, please contact: 
Perinatal Designation Coordinators
Debbie Lightfoot, R.N. - (512) 987-0565

Designation Program Manager
Elizabeth Stevenson, R.N. - (512) 284-1132

Last updated July 26, 2022