Subject of Possible Rule Making: WAC 246-976-580 and 246-976-700, trauma designation process and trauma service standards—Criteria for minimum and maximum distribution of trauma services. The department of health (department) is considering amending the rules to establish clear requirements and criteria for assessing needs for trauma centers and determining minimum and maximum hospital and health care facilities in the state.

Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: RCW 70.168.060(4) tasked the department with establishing the minimum and maximum number (min/max) of hospitals and health care facilities that may provide designated trauma care services across the state of Washington and within each emergency medical services and trauma care planning and service region. These designations are based upon approved regional emergency medical services and trauma care plans. RCW 70.168.100 then tasked each trauma care region to establish the number and level of facilities to be designated which are consistent with state standards and based upon availability of resources and the distribution of trauma within the region.

Since the trauma system's inception, there has not been a review of the process or criteria by which the trauma care regions and department make min/max decisions. The first established criteria have not been formalized in rule and have been used in varying degrees by trauma care regions. As the trauma system matures, trauma centers have expressed interest in applying for level I trauma designation and there is currently no process or criteria in place to objectively evaluate the need and impact of additional trauma centers.

Developing a criteria to determine the need for new trauma centers will help ensure that Washingtonians have optimal access to trauma care services while helping to maintain a healthy system that balances access with other important considerations, such as maintenance of subspecialty volume and patient outcomes.

Chapter 70.168 RCW tasks the department with establishing the number of trauma centers, as operationalized in the trauma care regional planning, which is reviewed and approved by the emergency medical systems and trauma care steering committee as part of the state planning process. Including the intent of this statute in rule would create a formalized, enforceable process across Washington state, and convening a group of subject matter experts to inform on the criteria will best serve our unique state system needs.

Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: No other federal or state agencies regulate this subject.

Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Anthony W. Bledsoe, P.O. Box 47853, Olympia, WA 98504-7853, phone 360-236-2871, fax 360-236-2830, TTY 711, email anthony.bledsoe@doh.wa.gov, website www.doh.wa.gov.

Additional comments: Interested parties may participate in the development of draft rules prior to a formal proposal by joining the interested parties list (GovDelivery) by contacting Tony Bledsoe, trauma designation program administrator, at Anthony.Bledsoe@doh.wa.gov.