The Southwest Texas Regional Advisory Council (STRAC) is designated by the Texas Department of State Health Services (DSHS) to develop, implement and maintain the regional trauma and emergency healthcare system for the 22 counties in Trauma Service Area - P (TSA-P). TSA-P has a mixture of urban, suburban, rural and frontier areas, from the 7th largest city in the US to the Mexican border, encompassing over 26,000 square miles in southwest Texas. STRAC is one of twenty-two regional advisory councils in Texas that comprise the Texas Trauma / Emergency Healthcare system.STRAC has 53 hospitals and 70 EMS services, including 4 air-medical programs that comprise its membership. STRAC has several important initiatives to the membership and other entities, including a mature electronic medical records system for EMS agencies with over 2 million records to date, a regional trauma registry with well over 100,000 records, and other clinical informatics efforts. As the designated coordination point for disaster management and preparedness for the hospitals and EMS, STRAC was selected to manage the CDC/ASPR Hospital Preparedness Program (HPP) for the last 10 years. STRAC is also the State Coordination Office (SCO) for the Texas Emergency Medical Task Force (EMTF) program, which has 8 regional teams across Texas. Each region has a Mobile Medical Unit (MMU), 5 Ambulance Strike Teams and 2 Ambuses, and 5 RN Strike Teams. This effort allows rapid, tailored response to both large scale emergencies like hurricanes and no-notice incidents like the recent feritlizer explosion in the town of West, TX. STRAC's executive board is comprised of senior leaders from all major healthcare systems in San Antonio, major EMS entities and representatives from the other rural facilities to allow collaborative solutions to challenges. STRAC also manages the Regional Cardiac and Stroke Systems, and has implemented LifeNet 12-lead EKG transmission system throughout the region.