AN ACT 1-1 relating to the creation and use of an emergency medical services 1-2 and trauma care system fund. 1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-4 SECTION 1. Subchapter E, Chapter 773, Health and Safety 1-5 Code, is amended by adding Sections 773.121 through 773.124 to read 1-6 as follows: 1-7 Sec. 773.121. FUND. (a) The emergency medical services and 1-8 trauma care system fund is created as a special account in the 1-9 state treasury. Money in the fund may be appropriated only to the 1-10 department for the purposes described by Section 773.122. 1-11 (b) The emergency medical services and trauma care system 1-12 fund is composed of money appropriated to the credit of the fund. 1-13 Sec. 773.122. PAYMENTS FROM THE FUND. (a) The 1-14 commissioner, with advice and counsel from the chairpersons of the 1-15 regional advisory councils, shall use money in the emergency 1-16 medical services and trauma care system fund established under 1-17 Section 773.121 to fund county and regional emergency medical 1-18 services and trauma care systems in accordance with this section. 1-19 (b) The commissioner shall maintain a reserve of $250,000 of 1-20 money appropriated from the emergency medical services and trauma 1-21 care system fund for extraordinary emergencies. 1-22 (c) In any fiscal year the commissioner shall use at least 1-23 70 percent of the appropriated money remaining in the emergency 2-1 medical services and trauma care system fund, after any amount 2-2 necessary to maintain the reserve established by Subsection (b) is 2-3 deducted, to fund, in connection with an effort to provide 2-4 coordination with the appropriate trauma support area, the cost of 2-5 supplies, operational expenses, education and training, equipment, 2-6 vehicles, and communications systems for local emergency medical 2-7 services. The money shall be distributed to counties on behalf of 2-8 eligible recipients. A county's share of the money shall be based 2-9 on the relative geographic size and population of the county and on 2-10 the relative number of emergency or trauma care runs performed by 2-11 eligible recipients in the county. Money that is not disbursed by 2-12 a county to eligible recipients for approved functions by the end 2-13 of the fiscal year in which the funds were disbursed to the county 2-14 shall be returned to the fund to be used in accordance with 2-15 Subsection (f). 2-16 (d) In any fiscal year, the commissioner may use not more 2-17 than 25 percent of the appropriated money remaining in the 2-18 emergency medical services and trauma care system fund, after any 2-19 amount necessary to maintain the reserve established by Subsection 2-20 (b) is deducted, for operation of the 22 trauma support areas and 2-21 for equipment, communications, and education and training for the 2-22 areas. Money distributed under this subsection shall be 2-23 distributed to the county in which the chairperson of an area's 2-24 regional advisory council sits on behalf of eligible recipients. A 2-25 regional advisory council's share of money distributed under this 3-1 section shall be based on the relative geographic size and 3-2 population of each trauma support area and the relative amount of 3-3 trauma care provided. Money that is not disbursed by a county to 3-4 eligible recipients for approved functions by the end of the fiscal 3-5 year in which the funds were disbursed to the county shall be 3-6 returned to the fund to be used in accordance with Subsection (f). 3-7 (e) In any fiscal year, the commissioner may use not more 3-8 than three percent of the appropriated money remaining in the 3-9 emergency medical services and trauma care system fund after any 3-10 amount necessary to maintain the reserve established by Subsection 3-11 (b) is deducted to fund the administrative costs of the bureau of 3-12 emergency management of the department associated with 3-13 administering the state emergency medical services program, the 3-14 trauma program, and the fund and to fund the costs of monitoring 3-15 and providing technical assistance for those programs and that 3-16 fund. 3-17 (f) In any fiscal year, the commissioner shall use at least 3-18 two percent of the appropriated money remaining in the emergency 3-19 medical services and trauma care system fund after any amount 3-20 necessary to maintain the reserve established by Subsection (b) is 3-21 deducted and the money in the fund not otherwise distributed under 3-22 this section to fund a portion of the uncompensated trauma care 3-23 provided at facilities designated as state trauma facilities by the 3-24 department. A regional advisory council chairperson may petition 3-25 the department for disbursement of funds to a trauma center in the 4-1 chairperson's trauma support area that has suffered deleterious 4-2 effects due to uncompensated trauma care. Funds may be disbursed 4-3 under this subsection based on a proportionate share of 4-4 uncompensated trauma care provided in the state and may be used to 4-5 fund innovative projects to enhance the delivery of patient care in 4-6 the overall emergency medical services and trauma care system. 4-7 (g) The department shall review the percentages for 4-8 disbursement of funds in the emergency medical services and trauma 4-9 care system fund on an annual basis and shall make recommendations 4-10 for proposed changes to ensure that appropriate and fair funding is 4-11 provided under this section. 4-12 Sec. 773.123. CONTROL OF EXPENDITURES FROM THE FUND. 4-13 (a) Except as provided by Subsection (b), money distributed from 4-14 the emergency medical services and trauma care system fund shall be 4-15 used in accordance with Section 773.122 on the authorization of the 4-16 chief executive of the county to which the money is disbursed on 4-17 vouchers issued by the county's treasurer. 4-18 (b) In a county with a population of 291,000 or more, money 4-19 distributed from the emergency medical services and trauma care 4-20 system fund shall be used in accordance with Section 773.122 on the 4-21 joint authorization of the chief executive of the county to which 4-22 the money is disbursed and the mayor of the principal municipality 4-23 in that county on vouchers issued by the county's treasurer. 4-24 (c) For the purposes of this section, "principal 4-25 municipality" means the municipality with the largest population in 5-1 a county to which this section applies. 5-2 Sec. 773.124. LOSS OF FUNDING ELIGIBILITY. For a period of 5-3 not less than one year or more than three years, as determined by 5-4 the department, the department may not disburse money under Section 5-5 773.122 to a county, municipality, or local recipient that the 5-6 department finds used money in violation of that section. 5-7 SECTION 2. Section 771.071, Health and Safety Code, is 5-8 amended by adding Subsection (g), to read as follows: 5-9 (g) Notwithstanding any other law, revenue derived from the 5-10 fees imposed under this section may be appropriated to the 5-11 emergency medical services and trauma care system fund established 5-12 by Section 773.121. The comptroller shall transfer funds 5-13 appropriated in accordance with this section to the emergency 5-14 medical services and trauma care system fund to be used only for 5-15 the purposes described by Section 773.121 through 773.124. 5-16 SECTION 3. Not later than December 1, 2000, the Texas 5-17 Department of Health shall submit to the lieutenant governor and 5-18 the speaker of the house of representatives a report concerning the 5-19 use of money under Section 773.122, Health and Safety Code, as 5-20 added by this Act, and any recommended changes to law to ensure 5-21 appropriate funding and coordination of services. 5-22 SECTION 4. This Act takes effect September 1, 1997. 5-23 SECTION 5. The importance of this legislation and the 5-24 crowded condition of the calendars in both houses create an 5-25 emergency and an imperative public necessity that the 6-1 constitutional rule requiring bills to be read on three several 6-2 days in each house be suspended, and this rule is hereby suspended. _______________________________ _______________________________ President of the Senate Speaker of the House I hereby certify that S.B. No. 102 passed the Senate on May 1, 1997, by a viva-voce vote; and that the Senate concurred in House amendments on May 28, 1997, by a viva-voce vote. _______________________________ Secretary of the Senate I hereby certify that S.B. No. 102 passed the House, with amendments, on May 25, 1997, by a non-record vote. _______________________________ Chief Clerk of the House Approved: _______________________________ Date _______________________________ Governor