Trauma Service Area E (TSA-E) encompasses 19 counties: Cooke, Collin, Dallas, Denton, Ellis, Erath, Fannin, Grayson, Hood, Hunt, Johnson, Kaufman, Navarro, Palo Pinto, Parker, Rockwall, Somervell, Tarrant, and Wise. Covering approximately 16,476 square miles – more land area than nine U.S. states – TSA-E represents one of the largest and most populous regions in Texas. With a 2017 projected population of 7,755,244, TSA-E accounts for roughly 27% of Texas’ total population and nearly 2.5% of the U.S. population. The Dallas-Fort Worth (DFW) Metroplex, located within TSA-E, is the fourth-largest metropolitan statistical area in the nation and has experienced rapid growth, adding nearly half a million residents in just five years.

HCC-E supports preparedness and response coordination across more than 180 hospitals and over 250 EMS agencies throughout the region. More than 120 hospitals actively participate in the HPP, including all 37 designated trauma centers and 42 stroke centers. The coalition also includes five full-service county health departments, the Department of State Health Services regional offices, and partners within the Public Health Emergency Preparedness and Cities Readiness Initiative programs. HCC-E maintains strong integration with emergency management officials from all 19 counties, major municipalities, and the Texas Department of Public Safety regional offices, ensuring a coordinated, multi-disciplinary approach to health and medical response.

Note: A TSA defines the geographical boundaries of a region, while a HCC refers to the partners and organizations that operate within those defined boundaries.

Texas Department of State Health Services (DSHS) Hospital Preparedness Program