ARC 9076C - Iowa Administrative Rules

Adopted and Filed

Trauma triage and transfer protocols, ch 135

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ARC 9076C

PUBLIC HEALTH DEPARTMENT[641]

Adopted and Filed

Rulemaking related to trauma triage and transfer protocols

The Department of Health and Human Services hereby rescinds Chapter 135, “Trauma Triage and Transfer Protocols,” Iowa Administrative Code, and adopts a new chapter with the same title.

Legal Authority for Rulemaking

This rulemaking is adopted under the authority provided in Iowa Code section 147A.27.

State or Federal Law Implemented

This rulemaking implements, in whole or in part, Iowa Code section 147A.23.

Purpose and Summary

This chapter was reviewed and is being rescinded and adopted anew as part of the Red Tape Review process laid out by Executive Order 10. The purpose of the chapter is to provide written directives that support decision making by emergency medical services (EMS) clinicians in transport destination determinations for injured patients, which will improve survival after injury. The chapter will help ensure that seriously injured patients are transported to the most clinically appropriate higher-level trauma centers, and patients with minor to moderate injuries can be cared for in lower-level trauma centers.

Public Comment and Changes to Rulemaking

Notice of Intended Action for this rulemaking was published in the Iowa Administrative Bulletin on December 11, 2024, as ARC 8526C. A public hearing was held on the following date(s):

●January 15, 2025

●January 21, 2025

No one attended the public hearings. No public comments were received.

One change from the Notice has been made in that appeals language has been standardized to reflect current practice.

Adoption of Rulemaking

This rulemaking was adopted by the Department on March 14, 2025.

Fiscal Impact

This rulemaking has no fiscal impact to the State of Iowa.

Jobs Impact

After analysis and review of this rulemaking, no impact on jobs has been found.

Waivers

Any person who believes that the application of the discretionary provisions of this rulemaking would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to 441—Chapter 6.

Review by Administrative Rules Review Committee

The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rulemaking by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rulemaking at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).

Effective Date

This rulemaking will become effective on June 1, 2025.

The following rulemaking action is adopted:

ITEM 1.Rescind 641—Chapter 135 and adopt the following new chapter in lieu thereof:

CHAPTER 135

TRAUMA TRIAGE AND TRANSFER PROTOCOLS

641—135.1(147A) Definitions. For the purposes of these rules, the following definitions apply:

“Out-of-Hospital Trauma Triage Destination Decision Protocols” means written directives to assist in trauma and triage decision-making, established and approved by the department, to be followed by the service program.

“Service program” or “service” means the same as defined in Iowa Code section 147A.1.

“Transfer” means the process of a patient being transferred from the scene of an injury to a trauma care facility or from one trauma care facility to another.

“Trauma care facility” means the same as defined in Iowa Code section 147A.21.

“Trauma triage and transfer” means to determine the trauma care facility destination.

641—135.2(147A) Trauma triage and transfer protocols. Trauma triage and transfer protocols approved by the department assist personnel from each service program and trauma care facility. These protocols do not preclude service programs or trauma care facilities from making emergency revisions of the approved triage and transfer protocols when an incident overburdens medical care resources, causing an unnecessary delay in patient care.

135.2(1) Adoption by reference. The 2021 National Guideline for the Field Triage of Injured Patients, as amended to August 1, 2024, is incorporated by reference and adopted as the Out-of-Hospital Trauma Triage Destination Decision Protocol for the state of Iowa.

135.2(2) Revisions and modifications to the protocols adopted by reference in subrule 135.2(1) may be made upon recommendation to and approval of the department.

641—135.3(147A) Offenses and penalties. The department may deny verification as a trauma care facility or deny authorization as a service program or may give a citation and warning, place on probation, suspend, or revoke existing trauma care facility verification or service program authorization if the department finds reason to believe that the facility or service program has not been or will not be operated in compliance with Iowa Code section 147A.27 and these administrative rules. The denial, citation and warning, period of probation, suspension, or revocation shall be effected in accordance with 441—Chapter 16 and may be appealed in accordance with the requirements of 441—Chapter 7.

These rules are intended to implement Iowa Code section 147A.23.

[Filed 3/14/25, effective 6/1/25]

[Published 4/2/25]

EDITOR’S NOTE: For replacement pages for IAC, see IAC Supplement 4/2/25.