Below is the HillCo client report from the June 11 Perinatal Advisory Council meeting.
The Perinatal Advisory Council held a regular meeting to discuss the status of the neonatal standards being developed and to receive an update on the drafting of the rules for neonatal levels of care.
Chair Dr. Eugene Toy provided an update to the council
- Neonatal regions are likely to be modeled after the state’s health service regions; this will make it easy for everyone who is already familiar with that format
- An analysis was done by HHSC to determine how far the neonatal standards are from the hospital licensing regulations; most of the requirements in the standards were already in the regulations
- Standards are almost complete and rule drafting has begun, the next step is to begin working on maternity standards
- The definitions subcommittee has drafted definitions which should be completed soon; only a few revisions are left to be made
- The next meeting will be July 22
Discussion of neonatal standards (the latest draft standards are attached)
- The standards are about 95% complete and should be ready for adoption by the next meeting
- Some of the standards were removed from the draft which are better suited for the maternity standards
- At the suggestion of HHSC, much of the “should” language was either changed to “must” or deleted; when developing rules you cannot have suggestions, only requirements
- A council member suggested that requirements for readily available pediatric surgical specialists be pared down for rural hospitals; there are only about 108 in the United States and they aren’t easy to come by; some hospitals use adult surgeons to perform simple operations on infants because they don’t have access to pediatric specialists; if requirements are left in many level III units will have to change their designation
- The numerical requirements for staffing ratios in level I and II have been removed
- Texas Hospital Association and Texas Nurses Association expressed concern that mandatory staffing ratios are still included in other parts of the standards
- A council member noted that without requirements, some hospitals will staff an inadequate number of nurses for financial reasons
- Another council member suggested that reducing the ratios is also a bad idea because hospitals will use the requirements instead of the ideal ratio which may be higher
Discussion of rules for neonatal levels of care (the rules presented to the council are attached)
- The rules are being written as a subsection of Ch. 133; some pieces may end up being added elsewhere
- The structure of the rules is based on trauma center rules
- A council member noted the rules as they are currently written seem to create quite a bit of administrative burden; more so than the standards suggest
- Toy replied that the rules developed so far are very rough; HHSC is expecting the council to work with them very closely to fine tune them; the rules will be perfected the same way as the standards and everyone will have input
- A council member asked about including some kind of waiver language for rural hospitals who cannot find the personnel they need to meet level III requirements
- HHSC staff replied that the rules should not be written with the intention of providing waivers; they should be changed so that waivers aren’t necessary, or rural hospitals will just have to deal with not meeting the requirements