The
Texas Department of State Health Services (DSHS) Office of EMS & Trauma
Systems Coordination is pleased to announce that the final disbursement for the
FY 2015 Uncompensated Trauma Care Fund distributions occurred the week of
August 22, 2016.
The
disbursement will serve two purposes: 1) Ensure that any hospital that received
the Medicaid SDA “trauma add on” did not receive less than the amount
calculated for the DSHS FY 2015 uncompensated trauma care disbursement; and 2)
Distribute any unexpended funds in the accounts (Comptroller’s 5111) to all
hospitals that were eligible for the FY 2015 Uncompensated trauma care
disbursement.
As
reminder and for reference, see New Process for Hospitals receiving SDA “trauma
add on” below for more information.
Background
Info on the Accounts:
Texas
Health and Safety Code Chapter §780.004 directs DSHS to use 96% of funds in the
DTF/EMS Account (3588 monies - 5111) to fund a portion of uncompensated
trauma care provided at hospitals designated as state trauma facilities or a
hospital meeting “in active pursuit” requirements.
Uncompensated Trauma Care Disbursement Methodology:
Calculations
are made in the following manner:
- Calendar Year (CY)
2013 uncompensated trauma care charges reported by eligible hospitals on the
Fiscal Year (FY) 2015 Uncompensated Trauma Care Fund Application (Hospital
Allocation) were used in the funding formula.
- Fifteen percent (15%)
of the total amount of funds available was divided equally amongst all eligible
applicants.
- The remaining
eighty-five percent (85%) was distributed to eligible applicants based on the
percentage of uncompensated trauma care a hospital provided in relation to the
total uncompensated trauma care provided by all the eligible hospitals that
applied.
Process for Hospitals receiving SDA “trauma add on”
Effective Fiscal Year 2012
Senate Bill 7 from
the 82nd Texas Special Legislative Session S(1) amended Chapter §780.004
of the Health and Safety Code, to authorize the Texas Department of State
Health Services (DSHS) to transfer ~$26,000,000 from the Designated Trauma
Facility and Emergency Medical Services Account (Comptroller’s Account 5111) to
Health and Human Services Commission (HHSC) to maximize the receipt of federal
funds that HHSC receives under the medical assistance program (MAP),
established under Chapter 32 of the Human Resources Code. To facilitate
the effort to maximize receipt of MAP federal funds, HHSC amended its Medicaid
hospital reimbursement rule in 1 Texas Administrative Code 355 to create a
“trauma add on” for designated trauma facilities that qualify for Standard
Dollar Amount (SDA) payments from HHSC. The statute requires hospitals to
be held harmless and in a given fiscal year to receive at a minimum the amount
disbursed using the DSHS funding methodology outlined in Chapter §780.004.
The
uncompensated trauma care disbursement process changed for hospitals receiving
the SDA “trauma add on” effective FY2012. DSHS is required to follow the
same methodology as in years past to calculate the amount of the uncompensated
trauma care disbursement for each eligible hospital, including the SDA
hospitals receiving the “trauma add on.” DSHS has entered the data
provided in the FY 2015 Uncompensated Trauma Care Applications to calculate the
formula to determine the disbursement amounts for the DSHS FY 2015
uncompensated trauma care disbursement. HHSC provided DSHS with the
amounts hospitals received from the SDA “trauma add on.” The statute requires
that DSHS compare the total amount each SDA hospital received in the HHSC
“trauma add on” payments to the amount calculated for the DSHS FY 2015
uncompensated trauma care funding disbursement. If a hospital receives less in
the FY2015 “trauma add on” payments than in the amount calculated for the DSHS
FY 2015 uncompensated trauma care disbursement, then DSHS will make a
disbursement to the hospital to cover the difference. If a hospital receives
more from the HHSC “trauma add on” payments than the DSHS uncompensated trauma
care disbursement, then the hospital will not receive a payment from DSHS in FY
2015.
The
calculation spreadsheet indicating disbursement amounts for each hospital (SDA
and non-SDA hospitals):
FY15 Final 3588 Disbursement Summary August 2016
Questions:
If
you have questions about the SDA “trauma add on,” please contact Kevin
Niemeyer, HHSC Hospital Rate Analysis at (512) 730-7445 or kevin.niemeyer@hhsc.state.tx.us
Please contact Indra Hernandez (indra.hernandez@dshs.texas.gov;
512-834-6669) if you
have any questions about the uncompensated trauma care funding