Disaster Response & Recovery

The State Medical Operation Center (SMOC) serves as the ESF-8 (Public Health & Medical) lead to support the Texas State Operations Center (SOC). The SMOC provides operations support and coordination of state-level ESF-8 response activities during disasters. 

The SMOC provides four basic functions in emergency response when state and federal resources are needed within our 17 Core Functional Areas:

• Coordination and control
• Communications
• Resource allocation (personnel, supplies, equipment)
• Recovery

Types of Disaster/Emergency Incidents:

• Hurricanes
• Tornados
• Wildfires
• Other Severe Weather (e.g., Winter Storm)
• Mass Casualty Events
• Public Health Emergencies (e.g., COVID, Zika, Ebola)

DSHS Major Activities:

• Evacuation Support for Persons with Medical Needs (hospital, nursing home, home health care)
• Patient Care
• Support for Medical Shelters
• Re-population of Persons with Medical Needs
• Immunizations Support
• Medical Supplies Support
• Mass Fatality Support
• Health Surveillance

For additional information, questions, and comments please email: dshsoperations@dshs.texas.gov

The Texas Department of State Health Services administers and maintains the Emergency Medical Task Force (EMTF). The EMTF program is made up of multiple emergency medical response resources that are designed to deploy quickly to a disaster or emergency.

For more information on the EMTF program, you may visit the EMTF website.

EMTF Resource Requirements, Reimbursement, and Allowable Costs Requirements for Resources

1. The Resource and its assets must meet the following criteria: 
   1. Have at least twelve (12) months of experience providing local and/or long-distance emergency medical services to live human beings in the State of Texas. 
   2. Adhere and abide by all federal, state, and local laws and must adhere and abide by the Texas Health & Safety Code, Chapter 773, Emergency Medical Services and the Texas Administrative Code, Title 25: Health Services, Chapter 157: Emergency Medical Care during the time of its deployment to provide mutual aid in a pending or actual disaster and must adhere and abide by all laws and rules at all times. 
   3. Will only respond when activated by the contractor as described in Section II of this agreement. 
   4. Keep detailed records (utilizing the DSHS packet of documents/forms) of the services requested and fulfilled, and provide those records as requested to include, but not limited to: 
      • Patient Care Records; 
      • Patient demographics, including patient(s) insurance information; 
      • A Time Log Record form of activities. 
   5. Keep all receipts of its expenditures during deployment.    
   6. Be required to be self-sufficient for an undetermined amount of time and should be aware that its staff could be living in austere field conditions. The following personnel items are suggested, but not limited to: 
      • Cell phone and charger; 
      • Cash and credit cards to purchase fuel and food; 
      • Extra uniforms; 
      • Extra expendable medical supplies; 
      • Food and water; and 
      • Sleeping bags. 
   7. Ensure that all personnel responding have proof of their appropriate licenses and a form of picture identification with them at all times.    
   8. Bill primary sources of reimbursement, such as Medicaid, Medicare, private insurance, or third-party providers before sending an invoice to DSHS. The DSHS Licensed rotor-wing air ambulance provider must submit proof of denial and proof of payment for each patient that is transported. 

EMTF Reimbursements and Allowable Costs 

Below are the DSHS reimbursement rates effective during activation for the various ground assets described.  Any asset not described or any deviation from these amounts should be specifically included in the Activation Order at the time of the deployment. 

Allowable costs for EMS Assets: 

DSHS will reimburse a base rate for Basic Life Support (BLS), Advanced Life Support (ALS), and Mobile Intensive Care Unit (MICU) ambulances as outlined below. 

Provider with Volunteer Personnel: 

• DSHS will reimburse a labor rate of $20.00 for paramedics, $17.50 for EMT I, and $13.50 for EMT B for each hour the staff are deployed, plus overtime at time and a half the established rate for any hours worked over 8 (eight) within each twenty-four (24) hour period; and 
• DSHS will reimburse a maximum of $50.00 per crew member per deployment (Total of $100.00 per two-member crew) for items needed for the crew to be self-sufficient during the deployment.  These items will include food, water, and personal care items.  The DSHS EMS licensed provider must keep receipts for these items and must submit them to DSHS when the DSHS EMS licensed provider submits an invoice to DSHS. 
• Providers with Paid Personnel: 
• DSHS will reimburse actual labor costs plus fringe benefits for two (2) crew members per ground ambulance
• DSHS will reimburse a maximum of $50.00 per crew member per deployment (Total of $100.00 per two-member crew) for items needed for the crew to be self-sufficient during the deployment.  These items will include food, water, and personal care items.  The DSHS EMS licensed provider must keep receipts for these items and must submit them to DSHS when the DSHS EMS licensed provider submits an invoice to DSHS; and 
• DSHS will reimburse each agency sending ambulance personnel the overtime portion of all back-fill costs associated with the deployment if it is supported with adequate documentation. 

Allowable costs for Professional Staff Assets: 

a. Unpaid Staff: 

• Labor rate of $20.00 for paramedic, $17.00 for EMT I, and $13.50 for EMT B for each hour the staff are deployed plus overtime at 1 ½ times the established rate for any hours worked over 8 (eight) within every 24 hours
• No fringe benefit cost will be reimbursed; and 
• Personal mileage from home to the deployment site and return at a rate per mile as published by the State Comptroller for the time period specified or other specific travel costs (airline travel, rental vehicle, parking, etc.). 

b. Paid staff: 

• Actual hourly labor cost of deployed staff plus fringe benefits
• Personal mileage from home to the deployment site and return at a rate per mile as published by the State Comptroller for the time period specified or other specific travel costs (airline travel, rental vehicle, parking, etc.); and 
• Overtime cost of staff required to fill the regularly scheduled shift of staff deployed. 
• Vehicles 
• Provider-owned vehicles that will be used during deployment for field supervision or team leaders will be reimbursed at a daily Federal Emergency Management Agency (FEMA) established rate per hour for vehicle type
• Use of personal vehicles will only be reimbursed for mileage using the mileage rates currently in effect at the time of deployment as published by the State Comptroller.  No other expenses related to the use of personal vehicles will be reimbursed; and 
• Support trailers or provider-owned vehicles that are not supervisor vehicles may be used by deployed personnel if approved on the Mobilization Order by DSHS.  Reimbursement for these assets shall be reimbursed at the current FEMA-published rate. 

Allowable costs for MMU Assets: 

• Uncompensated salary costs of staff to “make ready” the assets for deployment.  Documentation must be submitted for proof of payment
• Uncompensated salary costs of staff deployed with assets for set up and management.  Documentation must be submitted for proof of payment
• Actual hourly labor costs of deployed staff plus fringe benefits
• Fuel 
• Shipping/transportation fees 
• Daily usage fee 
• Actual cost for food and lodging will be reimbursed at the rates established by the State Comptroller  
• Personal mileage from home to the deployment site and return at a rate per mile as published by the State Comptroller for the time period specified or other specific travel costs 
• Use of rented vehicles will only be reimbursed at the rental rate as established by the State Comptroller 
• Use of personal vehicles will only be reimbursed for mileage using the mileage rates currently in effect at the time of deployment as published by the State Comptroller.  No other expenses related to the use of personal vehicles will be reimbursed 
• Supplies used; and 
• Repair of damaged equipment; if applicable. 

Allowable costs for Ambus Assets: 

• Uncompensated salary costs of staff to “make ready” the assets for deployment.  Documentation must be submitted for proof of payment
• Uncompensated salary costs of staff deployed with assets for set up and management.  Documentation must be submitted for proof of payment
• Actual hourly labor costs of deployed staff plus fringe benefits 
• Fuel
• Shipping/transportation fees 
• Daily usage fee 
• Actual cost for food and lodging will be reimbursed at the rates established by the State Comptroller
• Personal mileage from home to the deployment site and return at a rate per mile as published by the State Comptroller for the time period specified or other specific travel costs
• Use of rented vehicles will only be reimbursed at the rental rate as established by the State Comptroller 
• Use of personal vehicles will only be reimbursed for mileage using the mileage rates currently in effect at the time of deployment as published by the State Comptroller’s office.  No other expenses related to the use of personal vehicles will be reimbursed
• Supplies used; and repair of damaged equipment; if applicable.