HB 15, of the 83rd Texas legislative session, created a Perinatal Advisory Council charged with
developing and recommending criteria for designating levels of neonatal and maternal care. The
primary purpose being to improve neonatal and maternal outcomes in the state of Texas. The process
includes making recommendations for specifying the minimum requirements needed to qualify for
each level of care, designating neonatal and maternal care regions and a process for determining levels of care.
These requirements are based on the national standards noted in the Guidelines for Perinatal Care,
Seventh Edition published jointly by the American Academy of Pediatrics and the American College of
Obstetricians and Gynecologists. The Perinatal Advisory Council is currently working on the maternal
recommendations. They have completed their recommendations for the proposed Neontal Designation
Rule and the rule has been published for public comment (Texas Register Vol 40, No 47, Section
133.183-133.190). It is expected to be finalized in March 2016.The neonatal levels of care will range from:
The neonatal levels of care will range from:
- Level 1 – Well Nursery
- Level 2 – Special Care Nursery
- Level 3 – Neonatal Intensive Care Unit
- Level 4 – Advanced Neonatal Intensive Care Unit
A designation process will determine the level of care for all neonatal facilities in Texas. In addition, the
neonatal and maternal care regions will align with the existing Trauma Service Area Regional Advisory
Councils (RACs). Each RAC should have a neonatal committee or subcommittee to assist with the
Once the final rule is published, TETAF will begin to formally develop the survey process. Additional
information will be available in the next couple months to assist facilities in applying for their survey, as
well as education on how to meet the new guidelines.
TETAF looks forward to working with stakeholders to improve outcomes for mothers and babies
throughout the state.