HOME    SEARCH    ABOUT US    CONTACT US    HELP   
           
Montana Administrative Register Notice 37-687 No. 16   08/21/2014    
Prev Next

 

BEFORE THE DEPARTMENT OF PUBLIC

HEALTH AND HUMAN SERVICES OF THE

STATE OF MONTANA

 

In the matter of the amendment of ARM 37.104.3001, 37.104.3012, 37.104.3013, 37.104.3021, and 37.104.3022 pertaining to updating the state trauma plan to reflect current dates, terminology, and medical practice

)

)

)

)

)

)

NOTICE OF PUBLIC HEARING ON PROPOSED AMENDMENT

 

 

TO: All Concerned Persons

 

            1. On September 15, 2014, at 11:00 a.m., the Department of Public Health and Human Services will hold a public hearing in the auditorium of the Department of Public Health and Human Services Building, 111 North Sanders, Helena, Montana, to consider the proposed amendment of the above-stated rules.

 

2. The Department of Public Health and Human Services will make reasonable accommodations for persons with disabilities who wish to participate in this rulemaking process or need an alternative accessible format of this notice. If you require an accommodation, contact Department of Public Health and Human Services no later than 5:00 p.m. on September 8, 2014, to advise us of the nature of the accommodation that you need. Please contact Kenneth Mordan, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; telephone (406) 444-4094; fax (406) 444-9744; or e-mail dphhslegal@mt.gov.

 

3. The rules as proposed to be amended provide as follows, new matter underlined, deleted matter interlined:

 

            37.104.3001 DEFINITIONS In addition to the definitions in 50-6-401, MCA, the following definitions apply to this subchapter: 

            (1) (11) "Appendix I of the State Trauma Plan" means the appendix of the 2006-2010 Montana Trauma System Plan that "Montana Trauma Facility Designation Criteria (2014)" means the document that contains the requirements for a facility to meet in order to be designated as a particular type of trauma care facility. The department adopts and incorporates by reference Appendix I of the department's 2006-2010 Montana Trauma Facility Designation Criteria (2014) located within the Montana Trauma System Plan, which sets forth the facility requirements for designation of trauma facilities. A copy of Appendix I of the 2006-2010 Montana State Trauma Plan the Montana Trauma Facility Designation Criteria (2014) may be obtained from the Department of Public Health and Human Services, Public Health and Safety Division, Emergency Medical Services and Trauma Systems Section, 1400 Broadway, P.O. Box 202951, Helena, MT 59620-2951 or at this web site: http://www.dphhs.mt.gov/ems/trauma/designation/designation.shtml.

            (2) remains the same but is renumbered (1).

            (3) (2)  "Application" means the submission of written information by a health care facility, on forms required by the department, requesting designation as a specific level of trauma facility and providing information regarding its compliance with the criteria in Appendix I the Montana Trauma Facility Designation Criteria of the State Trauma Plan concerning the resources a facility must have to qualify as that level of trauma facility.

            (4) (3)  "Area trauma hospital" means a health care facility that is designated by the department as having met the essential standards for area trauma hospitals as specified in Appendix I the Montana Trauma Facility Designation Criteria of the State Trauma Plan.

            (5) (4)  "Community trauma facility" means a health care facility that is designated by the department as having met the standards for a community trauma facility as described in Appendix I the Montana Trauma Facility Designation Criteria of the State Trauma Plan.

            (6) remains the same but is renumbered (5).

            (7) (6)  "Designated facility" refers to a health care facility that has been determined by the department to satisfy the requirements of one of the four categories of trauma facilities as described in Appendix I the Montana Trauma Facility Designation Criteria of the State Trauma Plan.

            (8) (7)  "Designation" means a formal determination by the department that a health care facility has met the requirements for a level of trauma facility as described in Appendix I the Montana Trauma Facility Designation Criteria of the State Trauma Plan.

            (9) and (10) remain the same but are renumbered (8) and (9).

            (11) (10)  "Focused review" means a method established by the department to assess a health care facility's compliance with a corrective action plan to meet the resource criteria in Appendix I the Montana Trauma Facility Designation Criteria of the State Trauma Plan.

            (12) through (17) remain the same.

            (18) "Regional trauma center" means a health care facility that is designated by the department as having met the criteria for a regional trauma center as described in Appendix I the Montana Trauma Facility Designation Criteria of the State Trauma Plan.

            (19) through (23) remain the same.

            (24) "Trauma receiving facility" means a health care facility that is designated by the department as having met the criteria for a trauma receiving facility as described in Appendix I the Montana Trauma Facility Designation Criteria of the State Trauma Plan.

 

AUTH: 50-6-402, MCA

IMP:    50-6-401, 50-6-402, MCA

 

            37.104.3012 LEVELS OF TRAUMA FACILITIES (1) remains the same.

            (2) Requirements for each level are contained in Appendix I the Montana Trauma Facility Designation Criteria of the State Trauma Plan.

 

AUTH: 50-6-402, MCA

IMP:     50-6-402, MCA

 

            37.104.3013 TRAUMA FACILITY REQUIREMENTS (1) A designated trauma facility must:

            (a) and (b) remain the same.

            (c) continue to provide the resources required for its designated level of trauma facility, as described in Appendix I the Montana Trauma Facility Designation Criteria of the State Trauma Plan.

            (2) If the designated facility is unable to provide the care required by (1), it must:

            (a) observe the trauma diversion plan required by Appendix I the Montana Trauma Facility Designation Criteria of the State Trauma Plan for its facility; and

            (b) through (4) remain the same.

 

AUTH: 50-6-402, MCA

IMP:     50-6-402, 50-6-410, MCA

 

            37.104.3021 DESIGNATION PROCEDURES FOR FACILITIES NOT VERIFIED BY AMERICAN COLLEGE OF SURGEONS (1) A Montana health care facility that is not currently verified by the American College of Surgeons as meeting the American College of Surgeons' criteria to qualify for verification as a trauma facility and that wishes a designation or renewal of designation as a Montana trauma facility shall must submit to the department an application for trauma facility designation, supplied by the department.

            (2) The application must:

            (a) remains the same.

            (b) provide information about the facility's compliance with the trauma facility resource criteria in Appendix I the Montana Trauma Facility Designation Criteria of the State Trauma Plan that are required for that level of trauma facility.

            (3) The department shall will review the application for completeness and shall within 30 days, after receiving the application, notify the health care facility that:

            (a) and (b) remain the same.

            (4) When the application is complete, the department shall will:

            (a) and (b) remain the same.

            (5) The health care facility shall must:

            (a) and (b) remain the same.

            (6) The site review team shall will:

            (a) review the commitment and capabilities of the applicant health care facility to meet the resource criteria described in Appendix I the Montana Trauma Facility Designation Criteria of the State Trauma Plan for the level of designation sought, based upon consideration of all pertinent information, including but not limited to:

            (i) through (c) remain the same.

            (7) The department shall will review the report of the site review team and forward a copy to the designation subcommittee.

            (8) The designation subcommittee shall will review the report of a site review team at the next quarterly State Trauma Care Committee meeting and make a recommendation to the department regarding the trauma designation of the applicant facility.

            (9) The department shall must:

            (a) and (b) remain the same.

            (10) The department shall will take one of the following actions:

            (a) designate the applicant as qualifying for the trauma facility level requested, providing there is compliance with the trauma facility resource criteria in Appendix I the Montana Trauma Facility Designation Criteria of the State Trauma Plan;

            (b) through (d) remain the same.

 

AUTH: 50-6-402, MCA

IMP:     50-6-402, 50-6-410, MCA

 

            37.104.3022 DESIGNATION PROCEDURES FOR FACILITIES VERIFIED AS A TRAUMA FACILITY BY AMERICAN COLLEGE OF SURGEONS (1) A health care facility with a current certificate of verification from the American College of Surgeons as a trauma facility qualifies as one of the following types of Montana trauma facility as set out in (2), providing it submits an application, department staff attend the on-site review conducted by the American College of Surgeons, and the facility demonstrates compliance with any requirements described in Appendix I the Montana Trauma Facility Designation Criteria of the State Trauma Plan that may exceed the American College of Surgeons' standards in the college's document entitled "Resources for Optimal Care of the Injured Patient: 1999 2014.". A copy of this document may be obtained as set forth in (8).

            (2) remains the same.

            (3) A Montana health care facility that is seeking verification or reverification by the American College of Surgeons as a trauma center and wishes to be designated as a Montana trauma facility must submit to the department:

            (a) remains the same.

            (b) any additional information required by the department to verify compliance with any requirements described in Appendix I the Montana Trauma Facility Designation Criteria of the State Trauma Plan that exceed the American College of Surgeons' standards;

            (c) and (d) remain the same.

            (4) The department shall will review the application for completeness and shall within 30 days after receiving the application:

            (a) and (b) remain the same.

            (5) When the application and the site review are complete, and the American College of Surgeons' letter is received that indicates whether the facility is successfully verified as a trauma facility, the department shall will provide a copy of the application and the letter to the designation subcommittee at the next quarterly State Trauma Care Committee meeting.

            (6) The designation subcommittee shall will review the application and American College of Surgeons' letter at the next quarterly State Trauma Care Committee meeting and make a recommendation to the department regarding the trauma designation of the applicant facility.

            (7) Within 30 days after receiving a recommendation from the designation subcommittee, the department shall will take one of the following actions:

            (a) through (d) remain the same.

            (8) The department adopts and incorporates by reference "Resources for Optimal Care of the Injured Patient: 1999 2014,", published by the American College of Surgeons. The document contains the trauma facility criteria used by the American College of Surgeons in its process for verification of trauma facilities. A copy may be obtained from the Department of Public Health and Human Services, Public Health and Safety Division, Emergency Medical Services and Trauma Systems Section, 1400 Broadway, P.O. Box 202951, Helena, MT 59620-2951.

 

AUTH: 50-6-402, MCA

IMP:     50-6-402, 50-6-410, MCA

 

            4. STATEMENT OF REASONABLE NECESSITY

 

The Department of Public Health and Human Services (the department) is proposing amendments to ARM 37.104.3001, 37.104.3012, 37.104.3013, 37.104.3021, and 37.104.3022. These proposed amendments are needed to bring the rules up to date with current medical standards of care and practice guidelines. Medical standards of care and practice guidelines have changed since 2006 when these rules were adopted.  The requirements that must be met in order to be designated as a particular type of trauma care facility need to be updated to reflect today's practice standards and remain applicable and usable to customers across the state.

 

The American College of Surgeons has recently released a new version of their criteria "Resources for Optimal Care of the Injured Patient 2014."  Currently, the rules refer to "Resources for Optimal Care of the Injured Patient 1999" and need to be updated to reflect the most recent version.

 

The department is proposing changes throughout the rule by removing the term "shall" and replacing it with either "must" or "will" in order to update the rule language to current department standards.

 

These proposed amendments will be effective on January 1, 2015. The department is allowing time for the programs to review and implement the changes to these rules.

 

ARM 37.104.3001

 

The department is proposing to change the reference to "Appendix I" to the new title "Montana Trauma Facility Designation Criteria" and update the date of incorporation by reference to 2014.

 

ARM 37.104.3012, 37.104.3013, 37.104.3021, and 37.104.3022

 

The department is proposing to change all references to "Appendix I" to the title "Montana Trauma Facility Designation Criteria." The name of "Appendix I" needs to be altered to refer to the actual name of the document for ease and clarity.

 

ARM 37.104.3022

 

The department is proposing to amend the date of the American College of Surgeons' standards document from 1999 to the most current document dated 2014. This is necessary to ensure the department is using the most current standards.

 

Fiscal Impact

 

Montana Trauma Facility Designation Criteria closely follow American College of Surgeon standards.  There are four levels of designation and the individual standards are defined as either an essential "E" or desirable "D" criterion.  Any fiscal impact would be to the designating facilities in the realm of workforce requirements or equipment needs in order to meet standards for designation.  This could potentially affect up to 63 hospitals that are currently designated or seeking designation.

 

            5. The department intends to adopt these proposed amendments effective January 1, 2015.

 

            6. Concerned persons may submit their data, views, or arguments either orally or in writing at the hearing. Written data, views, or arguments may also be submitted to: Kenneth Mordan, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; fax (406) 444-9744; or e-mail dphhslegal@mt.gov, and must be received no later than 5:00 p.m., September 18, 2014.

 

7. The Office of Legal Affairs, Department of Public Health and Human Services, has been designated to preside over and conduct this hearing.

 

8. The department maintains a list of interested persons who wish to receive notices of rulemaking actions proposed by this agency.  Persons who wish to have their name added to the list shall make a written request that includes the name, e-mail, and mailing address of the person to receive notices and specifies for which program the person wishes to receive notices. Notices will be sent by e-mail unless a mailing preference is noted in the request. Such written request may be mailed or delivered to the contact person in 6 above or may be made by completing a request form at any rules hearing held by the department.

 

9. An electronic copy of this proposal notice is available through the Secretary of State's web site at http://sos.mt.gov/ARM/Register.  The Secretary of State strives to make the electronic copy of the notice conform to the official version of the notice, as printed in the Montana Administrative Register, but advises all concerned persons that in the event of a discrepancy between the official printed text of the notice and the electronic version of the notice, only the official printed text will be considered.  In addition, although the Secretary of State works to keep its web site accessible at all times, concerned persons should be aware that the web site may be unavailable during some periods, due to system maintenance or technical problems.

 

10. The bill sponsor contact requirements of 2-4-302, MCA, do not apply.

 

11. With regard to the requirements of 2-4-111, MCA, the department has determined that the amendment of the above-referenced rules will not significantly and directly impact small businesses.

 

 

/s/ Shannon L. McDonald                          /s/ Richard H. Opper                                   

Shannon L. McDonald                               Richard H. Opper, Director

Rule Reviewer                                          Public Health and Human Services

           

Certified to the Secretary of State August 11, 2014.

 

 

Home  |   Search  |   About Us  |   Contact Us  |   Help  |   Disclaimer  |   Privacy & Security