Updated May 2023
1.1 A Regional Advisory Council (RAC) is a formal organization chartered by the Texas Department of Health, Bureau of Emergency Management, to develop and implement a regional emergency medical service/trauma system plan, and to facilitate trauma system networking. Locally, a Regional Advisory Council is an organization of citizens, representing health care entities, public service agencies and others, within a specified Trauma Service Area (TSA) boundary. These entities may include hospitals, Trauma Centers, Cardiac and Stroke Centers, First Responder groups, EMS provider organizations, health care educational institutions, public safety agencies, physicians, nurses, emergency management and other individuals or organizations interested in trauma and acute emergency care.
2.1 The organization developed to serve the area known as Trauma Service Area-H, as designated by the Texas Department of Health (TDH)—now known as the Texas Department of State Health Services (TDSHS), shall be known as the Deep East Texas Regional Advisory Council, Trauma Service Area H, hereinafter referred to as DETRAC. The DETRAC region includes the following counties:
Angelina Nacogdoches Polk Tyler
Sabine San Augustine San Jacinto
3.1 It is the philosophy of the Deep East Texas, Trauma Service Area H Regional Advisory Council (DETRAC) to provide a comprehensive continuum of quality healthcare for all victims of trauma and acute care emergencies within the Trauma Service Area H Regional Advisory Council response boundaries without regard to age, sex, ethnic origin, disability, religion, or ability to pay.
4.1 To serve our patients and communities by developing, implementing and sustaining a functional and fully integrated regional trauma, acute emergency care, and maternal-child care systems that, through adherence to the highest standards of care, significantly reduces mortality and morbidity in an efficient, cost effective manner.
5.1 The development of a trauma system plan, an acute emergency healthcare plan, and a maternal-child healthcare plan for the DETRAC is based on accepted industry guidelines for comprehensive system development. This plan is to be submitted to the Texas Department of State Health Services as required by the TAC § 157.124. The plan shall:
5.1.1 Perpetually encourage and assist member hospitals in attaining trauma facility designation at the level appropriate to the resources available within their immediate service area.
5.1.2 Perpetually encourage and assist member hospitals in attaining designation/accreditation in acute emergency care at the level appropriate to the resources available within their immediate service area.
5.1.3 Provide a forum to address issues among members regarding EMS, acute emergency care and obstetrical care for both adult and pediatric patient populations, and encourage activities designed to promote cooperation and collaboration between member organizations.
5.1.4 Promote increased funding for EMS, acute emergency care systems, and obstetrical care systems improvement within the counties served.
5.1.5 Increase public awareness and education of trauma and acute healthcare issues and prevention.
5.1.6 Enhance communication among system participants to facilitate patient access, care and transport to appropriate trauma, acute medical emergency, and obstetrical facilities.
5.1.7 Establish guidelines for expedient patient transport, bypass and transfer to appropriate trauma, acute medical emergency, and obstetrical facilities and/or rehabilitative services.
5.1.8 Coordinate emergency and disaster preparedness and response activities between area hospitals and other healthcare partners.
5.1.9 Provide aggregate capacities of hospitals and disaster response capabilities to DSHS Public Health and the DSHS Office of EMS/Trauma Systems.
5.1.10 Develop within the Trauma Service Area a comprehensive and standardized method of evaluating care through a quality management program that evaluates outcomes from a system perspective.
6.1 General Assembly Membership
6.1.1 The general membership of DETRAC is to be made up of individuals interested in First Response, EMS, trauma care, acute emergency care, maternal care, neonatal care and emergency management.
6.1.2 Membership requires that an individual reside within DETRAC boundaries; and/or be employed, volunteer or affiliated by an agency providing emergency medical, trauma, maternal, neonatal services within the TSA-H; or has a professional interest in emergency medical, trauma, maternal, neonatal services within the TSA-H.
6.1.3 The general assembly shall be made up of participant members present at general assembly meetings.
6.1.4 Voting members of the general assembly shall be those individuals designated by their respective entity to vote for, and on behalf of, the entity and other representatives of the entity.
184.108.40.206 An attendance sign-in sheet for all members attending a general assembly meeting will be completed stating the organization they represent.
220.127.116.11 Motions presented before the general assembly will be voted upon by those individuals referenced in Section 6.1.4.
18.104.22.168 Routinely, votes will be cast using a verbal ‘Yea’ or ‘Nay’ process.
22.214.171.124 Any general assembly voting member may request that any vote on a motion be performed using a written process.
126.96.36.199.1 When such a request is made, the attendance/sign-in sheet for that meeting will be used to identify entities represented at that meeting. These identified entity representatives will then provide a written vote, documented with the organization they are representing, to the Secretary for vote tallying/resulting. The written vote shall be cast as ‘For’ or ‘Against’ by the voting member.
6.1.5 A quorum for conducting the business of the general assembly shall consist of those voting members present.
6.1.6 A member of the general assembly may be solicited, as needed, to assist with the tallying of the votes.
6.2 Member Participation
6.2.1 Members shall attend and participate in DETRAC meetings and committees.
6.2.2 Members shall serve on standing committee(s) and/or participate in standing committee activities.
6.2.3 Member participation within the RAC shall be considered to be attendance to at least 50% of the general assembly meetings during the fiscal year.
188.8.131.52 Member participation shall include consistent and timely submission of DETRAC data requests for regional systems analysis.
184.108.40.206 Member participation shall include current compliance with all DETRAC dues requirements.
6.2.4 Participation shall be tracked through attendance rosters, which will be forwarded to the Texas Department of State Health Services upon request.
6.2.5 Non-participation will result in removal from the DETRAC participant member list.
6.3 Organization Participation
6.3.1 Organizations, which either provide First Response, EMS, trauma, acute emergency care, maternal care, neonatal care, emergency management; or are interested in the provision of First Response, EMS, trauma, acute emergency care, maternal care, neonatal care, or emergency management may be represented in the DETRAC.
6.3.2 Organizations may have an unlimited number of representatives participating in the DETRAC. Organization representatives may participate on standing committees.
6.3.3 Each entity represented shall designate one person and an alternate in the event the primary is unavailable to vote on behalf of the entity at the general assembly meetings. Entities shall submit in writing, no later than September 1 of each year, names of those individuals designated to vote for, and on behalf of, the entity. An individual may serve as primary voting representative for only one entity. An individual may serve as an alternate designee for only one entity. (i.e., an individual may be the primary voting designee for one entity and serve as an alternate designee for no more than one other entity).
6.3.4 Participation will be considered to be at least 50% attendance at the general assembly meetings by the individual (or alternate) designated as the representative(s) for the organization. Non-participation will result in removal from the participant list.
220.127.116.11 Organization participation shall include consistent and timely submission of DETRAC data requests for regional systems analysis.
18.104.22.168 Organization participation shall include current compliance with all DETRAC dues requirements.
6.3.5 Organizations, groups or entities may replace the named primary or alternate representative at any time by submitting a new voting representative form to the DETRAC office.
6.3.6 Representatives of the General Assembly may attend by proxy no greater than one time each fiscal year. A proxy must be communicated in writing to the DETRAC Chair prior to the General Assembly meeting being called to order. No standing proxy votes will be accepted.
6.3.7 Organization participation shall be tracked through attendance rosters that will be maintained at the DETRAC offices, with copies forwarded to the Texas Department of State Health Services upon request.
6.4 Executive Committee
6.4.1 An executive committee shall exist to conduct the business of the Trauma Service Area H Regional Advisory Council.
6.4.2 The executive committee shall consist of:
22.214.171.124 The DETRAC Board of Directors, and
126.96.36.199 DETRAC Standing Committee Chairs, and
188.8.131.52 One appointed member from each county not represented in Section 184.108.40.206 or 220.127.116.11 above.
6.4.3 Voting members of the executive committee shall be those individuals designated by their respective organization to vote for, and on behalf of, the organization and other representatives of the organization. This ruling stands in the event that two persons from an organization are serving on the executive committee.
18.104.22.168 An attendance/sign-in sheet for all members attending an executive committee meeting will be completed.
22.214.171.124.1 The attendance/sign-in sheet will include an area for the attending member to document the entity they are representing during that meeting.
126.96.36.199 Motions presented before the executive committee will be voted upon by those individuals referenced in section 6.4.3.
188.8.131.52 Routinely, votes will be cast using a verbal ‘Yea’ or ‘Nay’ process.
184.108.40.206 Any executive committee voting member may request that any vote on a motion be performed using a documented/written process.
220.127.116.11.1 When such a request is made, the attendance sheet for that meeting will be used to identify entities represented at that meeting. These identified entity representatives will then provide a written vote, documented with the entity they are representing, to the secretary for vote tallying/resulting. The written vote shall be cast as ‘for’ or ‘against’ by the voting member.
6.4.4 Participation will be considered to be at least 50% attendance at the Executive committee meetings by the individual designated as the representative(s) for the organization, group or entity.
6.4.5 Non-participation, as defined in §6.3.4 (at least 50% attendance at General Assembly meetings ) and §6.4.4 (at least 50% attendance at Executive committee meetings) of this document, by a DETRAC Executive Committee Member and/or a DETRAC Officer will result in removal of that individual from his position(s). Reappointment for a vacant Officer position will be performed at the next DETRAC Executive Committee meeting. Organizations will be requested to submit a replacement for a vacant Executive Committee member position as soon as possible.
6.5 Duties of the Executive Committee
6.5.1 Oversite of the business of the DETRAC.
6.5.2 Nominate and elect standing committee chairs from the members of DETRAC.
6.5.3 Assist with the composition of and activities of the standing and ad-hoc committees.
6.5.4 Make recommendation(s) on the agenda to the RAC Chair for the general assembly meetings.
6.5.5 Submit proposals from the subcommittees and ad-hoc committees for approval by the Board of Directors
6.5.6 Make recommendations to the Board of Directors.
6.5.7 Present proposals, plans and policies to the Board of Directors for approval.
6.5.8 Propose the RAC budget to the Board of Directors and administer the budget.
6.6 Board of Directors
6.6.1 Duties of the Board of Directors
18.104.22.168 Final approval of policies, procedures, budget, projects, contracts.
22.214.171.124 Accept and consider recommendations by the Executive Committee.
126.96.36.199 Manage and oversee human resources.
188.8.131.52 Select and appoint ad-hoc committee chairs.
184.108.40.206 Select and appoint county representatives to the Executive Committee.
6.6.2 A Board of Directors shall be maintained, consisting of a Chair, Vice-Chair, Secretary, and Treasurer. This Board of Directors shall be nominated from and elected by members of the executive committee and shall serve as Officers of the DETRAC.
6.6.3 Terms of office shall be for two years. The DETRAC year begins on September 01 and continues thru August 31 of the following year. Elections for DETRAC Board members should be staggered with only two board members being elected each year. The elections should be Chair and Secretary elected on even numbered years and Vice-Chair and Treasurer elected on odd numbered years. This will prevent the event of having an entirely new board elected at one time.
220.127.116.11 A quorum of the Executive Board consists of three.
6.6.4 Officer Duties
18.104.22.168 The Chair shall:
- Preside at the meetings of the general assembly, executive committee, and any special meetings.
- Serve as the Chair of the executive committee and general assembly.
- Call special meetings when necessary.
- The Chair shall not possess veto power.
- The Chair shall serve as ex-officio member of all committees.
22.214.171.124 The Vice-Chair shall:
- Attend the meetings of the general assembly, executive committee, and any special meetings.
- Perform such duties as assigned by the Chair.
- Perform the duties of the Chair at meetings in the absence of the Chair.
- In the event the Chair is unable to fulfill his/her term, the Vice-chair will assume the responsibilities of the Chair for the remainder of the term.
126.96.36.199 The Secretary shall:
- Attend the meetings of the general assembly, executive committee, and any special meetings.
- Serve as Secretary of the general assembly and executive committee.
- Maintain the roll at meetings of the general assembly and executive committee.
- Record the minutes of all proceedings of the general assembly and the executive committee.
- Distribute the minutes of meetings to members.
- Tally vote designation.
188.8.131.52 The Treasurer shall:
- Monitor the finances of the Deep East Texas (Trauma Service Area H) Regional Advisory Council.
- Provide oversight and hold accountability of the Deep East Texas (Trauma Service Area H) Regional Advisory Council checks and checkbook. The Treasurer should be immediately notified of any discrepancy(s) of the financial affairs of DETRAC, whether the discrepancy was intentional or non-intentional.
- Bears responsibility for the disbursement of DETRAC funds authorized by the general assembly and executive committee.
184.108.40.206.1 Signatory authority may be granted to a DETRAC Committee Chair with the approval of the DETRAC Executive Committee for funds directly related to that committee.
- Give a financial report at each general assembly and executive committee meeting.
- Present a written financial report at the annual general assembly meeting.
6.6.5 Removal of Officer
220.127.116.11 An officer who does not comply with assigned responsibilities or meet participation requirements in DETRAC activities may be relieved of office in the following manner:
18.104.22.168.1 The officer shall be notified in writing by the Board of Directors that his/her participation or compliance has been unsatisfactory. The board will recommend to the Executive Committee that he/she be removed from office.
22.214.171.124.2 The Executive committee shall vote on the recommendation of the Board of Directors.
126.96.36.199.3 In the event the Executive Committee votes to remove the officer, it shall appoint a replacement to serve out the Officer’s remaining term.
188.8.131.52.4 A report to all DETRAC members shall be made of the actions taken.
6.7 Standing Committees
6.7.1 The standing committees are pre-hospital, hospital acute care (trauma, stroke, cardiac, pediatrics, etc.), education/injury prevention, maternal-child/neonatal and quality improvement.
6.7.2 The DETRAC Board of Directors shall appoint Committee Chairs with the approval of the Executive Committee.
6.7.3 A quorum for conducting business of each standing committee shall consist of those members present.
6.7.4 A Secretary shall be nominated from and elected by the committee.
6.7.5 The Committee Chair shall report committee activity to the Executive Committee.
6.7.6 The Committee Secretary shall record committee activity and maintain a record of attendance.
6.8 Ad-Hoc Committees
6.8.1 Ad-hoc committees shall be developed by the Executive Committee as needed.
6.8.2 Ad-hoc committees shall serve as provided as guidance (refer to above section).
7.1 All meetings shall be conducted according to Robert’s Rules of Order.
7.2 Meetings of the General Assembly and Executive Committee should be held at least quarterly. Notice of meetings should be distributed at least 72 hours prior to the meeting.
7.3 The Board of Directors may convene upon the direction of the DETRAC Chair, or the request of at least two other Board of Director members.
7.4 A Special meeting of the Executive Committee may be called by any member of the Board of Directors. Notice of the special meeting shall be routinely given to members.
7.5 One general assembly meeting will be designated as the Annual General Assembly meeting in the month of July.
8.1 The DETRAC will establish an annual budget.
8.1.1 A draft annual budget will be created by the officers of the DETRAC and presented to the General Assembly membership at the July meeting.
8.1.2 The General Assembly membership will approve an annual budget for the DETRAC at the September meeting.
8.2 Expenditures made by the DETRAC will be made utilizing a written check or DETRAC credit card. Written checks require the signature of at least two officers and/or one officer and the DETRAC Trauma Service Area-H Manager.
8.2.1 A committee chair may be granted signatory authority by the DETRAC Executive Committee and replace the signature of one officer and/or the DETRAC Executive Director when expending funds directly related to activities of that committee.
8.3 At least annually, all provider grant requests received by the DETRAC will be reviewed by an ad-hoc committee following DETRAC Standard Operating Procedure 1 (Process for Determining Needs Assessment Funding). The recommendations of this committee will be forwarded to the Executive Committee for approval to make the disbursements.
8.3.1 Organizational representatives must physically attend a minimum of two General Assembly meetings prior to being eligible for DETRAC grant funding.
8.4 The Executive committee may authorize any Board member of the DETRAC to enter into a contract or execute and deliver any instrument in the name of and on behalf of the DETRAC. This authority may be limited to a specific contract or instrument, or it may extend to any number and types of possible contracts and instruments.
8.5 All funds of the DETRAC shall be deposited to the credit of the Deep East Texas Regional Advisory Council in banks, trust companies, or other depositories approved by the Executive Committee.
8.6 The Board of Directors may accept on behalf of the DETRAC any contribution, gift, bequest, or device for the purposes of the DETRAC. The Executive Committee may make gifts and give charitable contributions that are not prohibited by the Articles of Incorporation, the bylaws, State Law, or any requirements for maintaining the federal and state non-profit tax status of the DETRAC.
8.7 DETRAC shall not make any loan to any officer or participant member.
8.8 As long as the DETRAC is in existence, an officer or participant member shall not:
8.8.1 Act in violation of the Bylaws, Standing Operating Procedures or any other rules of the DETRAC’s operation.
8.8.2 Act with the intention of harming the DETRAC or any of its operations.
8.8.3 Act in any manner that would make it impossible or unnecessarily difficult to carry on the intended or ordinary business of the DETRAC.
8.8.4 Receive an improper personal benefit from the operation of the DETRAC.
8.8.5 Use the assets of the DETRAC, directly or indirectly, for any purpose other than carrying on the business of the DETRAC.
8.8.6 Wrongfully transfer or dispose of DETRAC property, including intangible property such as goodwill.
8.8.7 Use the name of the DETRAC (or any substantially similar name) or any trademark or trade name adopted by the DETRAC, except on the behalf of the DETRAC in the ordinary course of DETRAC business.
8.8.8 Disclose any of the DETRAC business practices, trade secrets, or any other information not generally known to the business community to any person not authorized to receive it.
8.8.9 Take any action inconsistent with the Articles of Incorporation.
8.9 Annual DETRAC membership dues will be:
8.9.1 $10.00 per licensed bed for hospitals
8.9.2 $250.00 for all ground EMS companies
8.9.3 $250.00 for all air medical EMS companies providing routine services in the DETRAC region.
8.9.4 $250.00 for First Responder Organizations and Fire Departments with >50% paid personnel.
8.9.5 $250.00 for Free Standing Emergency Centers
8.9.6 $250.00 for Limited Service Rural Hospitals
8.9.7 DETRAC ‘s fiscal year runs from September 1st to August 31st, dues will cover the same timeframe. An Invoice will be sent to administrators of all eligible organizations. Dues will be assessed per licensed bed count as of the first day of September each year.
8.9.8 The funds collected from dues will be considered unrestricted monies of DETRAC and may be used in an unrestricted methodology to pay for expenses not allowed by state or federal contracts.
8.9.9 A dues committee will be formed if/when needed. Any organization that seeks any type of reduction or exemption from the dues structure must submit a written request to the DETRAC Dues Committee.
184.108.40.206 First Responder Organizations and Fire Departments with <50% paid personnel will receive automatic dues exemption status.
8.9.10 Membership dues must be paid in full in order to receive financial awards such as Needs Assessment Grant Awards and EMS County Pass Through Funds.
9.1 The DETRAC shall keep correct and complete books and records of account.
9.2 Any officer, or participant member of the DETRAC, may inspect and receive copies of all books and records of the DETRAC. A participant member may inspect or receive said copies, if the member has a proper purpose related to the interests of the DETRAC, and if the member submits a request in writing. Such request to review, inspect or receive copies of the books and records of the DETRAC shall be made at a reasonable time during normal business hours. The Executive Committee may establish reasonable fees for copying the DETRAC books and/or records. The DETRAC shall provide copies of requested books no later than thirty (30) working days after the receipt of a proper request.
9.3 An audit shall be performed by an independent certified public accountant selected by the Board of Directors.
10.1 The Bylaws will be construed in accordance with the laws of the State of Texas. All references in the Bylaws to statutes, regulations or other sources of legal authority shall refer to the authorities cited or their successors, as they may be amended from time to time.
10.2 If any Bylaw is held to be invalid, illegal, or unenforceable in any respect, the invalidity, illegality or enforceability shall not affect any other provision, and the bylaws shall be construed as if the invalid or unenforceable provision had not been included in the Bylaws.
10.3 The headings and paragraph numbers used in the Bylaws are for convenience and shall not be considered in construing the terms of the Bylaws.
10.4 Whenever the context requires, all words in the Bylaws in the male gender shall be deemed to include the female or neuter gender. All singular words shall include the plural, and all plural words shall include the singular.
10.5 The Executive Committee may provide for a corporate seal.
10.6 The Bylaws shall be binding upon and inure to the benefit of the DETRAC officers and participant members.
11.0 Alternative Dispute Resolution
11.1 Any provider or individual representing a provider, service or hospital that has a dispute in connection with another provider, or the DETRAC itself (e.g., Bylaws, Trauma System Plan, guidelines or protocols, actions or in-actions, etc.) may formally voice its disapproval in writing. The written document must be addressed to the Chair of the DETRAC.
11.2 A formal protest must contain the following:
11.2.1 A specific statement of the situation that contains the description of each issue.
11.2.2 A proposed solution to resolve the matter(s).
11.3 A neutral or impartial group with no vested interest in the outcome of the dispute will be assembled to review the issue. This group may solicit written responses to the dispute from interested parties. If the dispute is not resolved by mutual agreement, the group will issue a written determination, within thirty (30) days of receipt of all pertinent data.
11.4 The written determination will be the opinion/recommendation of the DETRAC
11.5 Party or parties may appeal the determination by the group and request that the issue be presented to the General Membership of the DETRAC for a final determination. The party or parties have no later than thirty (30) working days after the determination to submit the written request for secondary review. This request must be submitted (mailed or hand delivered) to the following address:
Mailing address: Deep East Texas Regional Advisory Council
P.O. Box 190
Lufkin, TX 75902-0190
Physical address: 314 E. Lufkin Avenue
Lufkin, TX 75901
11.5.1 The secondary review will be limited to the original determination.
11.5.2 In the event the appeal for a secondary review is not delivered within the thirty (30) working days period, it will not be considered.
12.0 Bylaw Revisions
12.1 The Chair should appoint an ad-hoc committee to review the Bylaws annually.
12.2 Proposed amendments and revisions must be submitted to the Board of Directors for consideration at least six (6) months prior to the annual General Assembly meeting.
12.3 The Bylaws may be adopted, amended or revised by an affirmative vote of two-thirds of the General Assembly present at the annual General Assembly or a meeting designed for that purpose.
12.4 Copies of proposed amendments or revisions will be made available for review prior to the meeting.
Adopted: August 12, 1998
Revisions: February 2004 December 2004 October 2006
September 2007 February 2009
May 2012 November 2012 September 2014
September 2016 September 2020 November 2021