Below is the HillCo client report from the September 23 Neonate Designation Stakeholder's Meeting.

Please see attached for the Neonate Designation Draft Rules.

  • HB 15 passed in the 83rd Legislative session created the Perinatal Advisory Committee (PAC) and instructed to the Committee to develop designations for facilities that provide neonatal and maternal care
  • The draft rule is in a very early phase
  • There are 254 hospitals in Texas with OB services that need to be designated
    • Must get designation for Medicaid reimbursement
    • DSHS has no authority to collect a designation fee at this point, so they do not know what it will be
  • American Council of Pediatrics is interested in partnering with DSHS to do on-site surveys of the facilities with the highest designations
    • Designations 1-4, with 4 being able to provide the highest level of care
    • Opposite of trauma care designations
    • The surveys will be based on solely on Texas standards
  • Each location in a health system is considered separately, despite one multi-location license
  • The draft rule uses Texas Public Health Regions for perinatal regions
    • Lengthy discussion of if the 22 trauma regions would be better fit for this population
      • Concerned with possible disruption of referral patterns
      • DSHS assured stakeholders that the state is not trying to change referral patterns
      • Stakeholders are concerned with the regional designations – they believe that the regions will going to be used to measure outcomes
  • The Regional Advisory Councils will want to be very much involved
    • Program specialist, and supports – designation coordinator nurse positions will be added over the next 2 fiscal years
  • Some facilities have had problems with Managed Medicaid and transfers – they do not let patients go where they want to go
  • Would like to roll the current Level 3a standards down to Level 2 to maintain current level of care at facilities, especially rural facilities to ensure there is no disruption of care or displacement of families
  • Dr. Toy – Perinatal guidelines changed as of 2012 – There was a lot of input into the draft from rural hospitals and the PAC continues to want to have that input
    • Requests for stakeholders to look though the perinatal standards on the HHSC website
    • Stressed that this is the first draft of this rule and they are still working through it
    • Translation is very difficult
  • Stakeholders discussed that HB 15 isn’t doing anything to reduce costs and improve outcomes like it was intended
  • Eric Epply – South Texas RAC
    • Has headed up the RAC for 15 years
    • Appointed positions from major health care systems in San Antonio,  elected positions from smaller facilities
    • Advisory function of 60 different committees
    • They bring people to the table to get them to work together to get a consensus and move forward
    • Multi RAC regions for different needs