DHS 110.28(4)(b) (b) To renew EMS instructor II certification, the individual shall submit in the manner specified by the department the application and documentation required under sub. (2) and documentation of continued affiliation with the training center on or before June 30 of the even numbered year of the biennial licensing period.
DHS 110.28 Note Note: Instructor application is submitted by the applicant to the department electronically through the department's E-Licensing system available at www.dhs.wisconsin.gov/ems. Completed applications are processed electronically through this system. For further information contact the Emergency Medical Services Section, 1 W. Wilson St., P.O. Box 2659, Madison, WI 53701-2659.
DHS 110.28 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.
DHS 110.29 DHS 110.29Training center oversight.
DHS 110.29(1)(1)Quality assurance.
DHS 110.29(1)(a)(a) The department is responsible for quality assurance of training centers and instructors. If a training center or instructor is part of the WTCS, quality assurance is a joint responsibility of the department and the WTCS.
DHS 110.29(1)(b) (b) The department may review the performance of training centers and instructors and conduct quality assurance assessments and audits to assure quality education and compliance with educational standards and curriculum. Failure to meet educational, professional, or ethical standards may result in department action under subch. V against a training center or instructor.
DHS 110.29(2) (2)Wisconsin Technical College System. The WTCS office and the department will work to assure that the training centers and instructors under their authority are jointly regulated. The responsibilities of the department and the WTCS will be outlined in a memorandum of understanding, which will be reviewed at least once every 5 years and updated as appropriate.
DHS 110.29 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.
DHS 110.30 DHS 110.30Department decision on applications.
DHS 110.30(1)(1)Complete application. The department shall review and make a determination on an application that has been completed in accordance with all of the department's instructions for completion within 60 business days of receiving the application. If the department approves the application, the department will notify the applicant and issue a certificate of approval. If the department denies the application, the department will notify the applicant of the reason for the denial and any appeal rights.
DHS 110.30(2) (2)Incomplete application. When an incomplete application is received, the department will notify the applicant of any deficiencies within 60 business days. If the applicant fails to respond to the notice and fails to complete the application within 6 months from the date of initial submission to the department, the application is void. The department will not take any further action on the incomplete application. To be considered further by the department, the applicant shall meet the eligibility requirements and submit a new application as required under this subchapter.
DHS 110.30 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.
DHS 110.31 DHS 110.31Expiration dates; approvals and certifications.
DHS 110.31(1)(1)Medical director and program director approval. Department approval of the training center medical director and the training center program director shall remain in effect as long as all requirements continue to be met or until the approval is revoked, suspended, or voluntarily surrendered.
DHS 110.31(2) (2)EMS instructor II certification. Certification for EMS instructor II shall expire on June 30 of the even numbered year of the biennial period unless renewed. If an individual does not timely renew his or her EMS instructor II certification, under s. DHS 110.28 (2), the certification expires and the individual may not act as an EMS instructor II until the certification is renewed.
DHS 110.31 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.
subch. IV of ch. DHS 110 Subchapter IV — Emergency Medical Service Provider Licensing and Operation
DHS 110.32 DHS 110.32Emergency medical service provider license required; license levels.
DHS 110.32(1)(1)No person may act as or advertise for the provision of services as a first responder service, a non-transporting EMT service provider, or an ambulance service provider unless the person is licensed by the department to do so.
DHS 110.32(2) (2)A person licensed as a first responder service provider may provide emergency medical services at the first responder level of care before hospitalization and the arrival of an ambulance but may not transport patients.
DHS 110.32(3) (3)A person licensed as a non-transporting EMT service provider may provide emergency medical services before hospitalization and the arrival of an ambulance at the EMT-basic, EMT-intermediate technician, EMT-intermediate, or EMT-paramedic level of care, but may not transport patients.
DHS 110.32(4) (4)A person may be licensed as an ambulance service provider to provide 9-1-1 emergency response, interfacility transport or both, and at one of the following levels of care: EMT basic, EMT-intermediate technician, EMT-intermediate, or EMT-paramedic. An ambulance service provider licensed to provide both a 9-1-1 emergency response and interfacility transports shall be licensed at the same level of care for both services.
DHS 110.32 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.
DHS 110.33 DHS 110.33Authorized services.
DHS 110.33(1)(1)An emergency medical services provider may advertise and provide only those services for which it has been licensed by the department.
DHS 110.33(2) (2)An emergency medical services provider may advertise and provide only those services that are within the Wisconsin scope of practice for the level at which the provider is licensed.
DHS 110.33(3) (3)An emergency medical services provider may advertise and provide only those services that are described in its department-approved operational plan. The provider shall keep the operational plan and any addendums current. Any changes to the operational plan, including addendums, shall be submitted to the department for approval not less than 60 days before the intended implementation date and may not be implemented until the service receives department approval.
DHS 110.33 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.
DHS 110.34 DHS 110.34Responsibilities. An emergency medical service provider shall do all of the following:
DHS 110.34(1) (1)Comply with the requirements of this chapter and ch. 256, Stats.
DHS 110.34(2) (2)Advertise and provide only those services it is authorized to provide under this subchapter.
DHS 110.34(3) (3)Designate a hospital that will provide day-to-day medical control.
DHS 110.34(4) (4)Designate the primary service area in which it will operate.
DHS 110.34(5) (5)Assure response to 9-1-1 emergency response requests 24 hours-a-day, 7 days-a-week, unless it is not licensed to do so. First responder services are exempt from this requirement but should assure every effort is made to respond to 9-1-1 requests.
DHS 110.34(6) (6)Meet the staffing requirements identified in s. 256.15 (4), Stats., and s. DHS 110.50.
DHS 110.34(7) (7)If the emergency medical services provider is an ambulance service provider, submit a written report to the receiving hospital upon delivering a patient and a complete patient care report within 24 hours of patient delivery. A written report may be a complete patient care report or other documentation approved by the department and accepted by the receiving hospital. A non-transporting EMT service provider or first responder service provider shall hand a written report to the ambulance service provider at the time of the patient care transfer.
DHS 110.34(8) (8)If the emergency medical service provider is an ambulance service provider or non-transporting EMT service provider, submit patient care report data electronically to the department through WARDS using direct web-based input to WARDS or uploading patient care report data to WARDS within 7 days of the patient transport. If the emergency medical service provider is a first responder service provider, submit a patient care report to WARDS only if advanced skills are used in caring for the patient.
DHS 110.34 Note Note: An abbreviated first responder report is available in WARDS to eliminate duplicate entry and facilitate quick entry of this information. The WARDS system can be accessed via the internet at www.emswards.org.
DHS 110.34(9) (9)Comply with the data system guidelines published by the department.
DHS 110.34(10) (10)Maintain written mutual aid and coverage agreements with ambulance service providers operating within or adjacent to its primary service area.
DHS 110.34(11) (11)Designate and maintain affiliation with a regional trauma advisory council.
DHS 110.34(12) (12)Maintain a communication system that allows communication between medical control and EMS personnel and complies with the Wisconsin Emergency Medical Services Communications Plan.
DHS 110.34(13) (13)Designate and maintain affiliation with a training center to provide required training.
DHS 110.34(14) (14)Maintain a quality assurance program that provides continuing education and assures continuing competency of EMS personnel.
DHS 110.34(15) (15)If the emergency medical services provider is an ambulance service provider, maintain at least one ambulance vehicle in good operating condition as required under ch. Trans 309.
DHS 110.34(16) (16)Refuse to respond to an interfacility transport request by a hospital for an emergency transfer that is dispatched through a 9-1-1 center, if not licensed to provide interfacility transports.
DHS 110.34 Note Note: Data system guidelines can be found on the department's website at www.dhs.wisconsin.gov/ems.
DHS 110.34 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.
DHS 110.35 DHS 110.35License and application requirements. To apply for a license as an ambulance service provider, a non-transporting EMT service provider, or a first responder service provider, a person shall do all of the following:
DHS 110.35(1) (1)Feasibility study. Complete a feasibility study and submit it to the department for approval. First responder service providers are not required to do a feasibility study.
DHS 110.35(2) (2)Application and operational plan. Upon the department's approval of the feasibility study required under sub. (1), complete and submit an application and an operational plan to the department in the manner specified by the department. The operational plan and its addendums shall include all of the following:
DHS 110.35(2)(a) (a) Signed patient care protocols approved by the service medical director.
DHS 110.35(2)(b) (b) A formulary list of medications the emergency medical service provider will use.
DHS 110.35(2)(c) (c) A list of the advanced skills and procedures the applicant intends to use to provide services within the Wisconsin scope of practice of the level of care for which licensure is sought.
DHS 110.35(2)(d) (d) Proof of professional liability or medical malpractice insurance, and, if the emergency medical service provider is an ambulance service provider, proof of vehicle insurance.
DHS 110.35(2)(e) (e) Operational policies for all of the following:
DHS 110.35(2)(e)1. 1. Response cancellation, describing how the emergency medical service provider will handle a cancellation of a response while en route to the scene.
DHS 110.35(2)(e)2. 2. Use of lights and sirens in responding to a call.
DHS 110.35(2)(e)3. 3. Dispatch and response, describing how EMS personnel are dispatched and how the emergency medical service provider acknowledges to the dispatcher that it is responding.
DHS 110.35(2)(e)4. 4. Refusal of care, describing the procedure for accepting a refusal of care from a patient.
DHS 110.35(2)(e)5. 5. Destination determination, describing how the transport destination of the patient is determined if the provider is an ambulance service provider.
DHS 110.35(2)(e)6. 6. Emergency vehicle operation and driver safety training.
DHS 110.35(2)(f) (f) Written letters or other documentation of endorsement from the local hospital and government within the proposed primary service area, if the application is for licensure as a 9-1-1 ambulance service provider or non-transporting EMT service provider, whether the application is for initial licensure or a service level upgrade.
DHS 110.35(3) (3)Department decisions on application.
DHS 110.35(3)(a)(a) Complete application. The department shall review and make a determination on an application that has been completed in accordance with all of the department's instructions for completion within 60 business days of receiving the application. If the department approves the application, the department will notify the applicant and issue a license. If the department denies the application, the department will notify the applicant of the reason for the denial and any appeal rights.
DHS 110.35(3)(b) (b) Incomplete application. When an incomplete application is received, the department will notify the applicant of any deficiencies within 60 business days. If the applicant fails to respond to the notice and fails to complete the application within 6 months from the date of initial submission to the department, the application is void. The department will not take any further action on the incomplete application. To be considered further by the department, the applicant shall meet the eligibility requirements and submit a new application as required under this subchapter.
DHS 110.35 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.
DHS 110.36 DHS 110.36Phase-in period; service level upgrades and downgrades.
DHS 110.36(1)(1)A licensed ambulance service provider applying for licensure at a higher service level that can demonstrate hardship in attaining the higher level may request department approval of a phase-in period not to exceed 12 months. During a phase-in period, an ambulance service provider that is upgrading to a higher service level may provide emergency medical care at both the higher service level and its current service level without assuring a consistent level of care at the higher level 24 hours a day.
DHS 110.36(2) (2)An applicant for department approval of a phase-in period to upgrade its service level shall submit a license application, operational plan and addendums for the higher service level as specified under s. DHS 110.35 and all of the following:
DHS 110.36(2)(a) (a) A detailed explanation of why the phase-in period is necessary, how the phase-in will be accomplished and the specific date, not to exceed 12 months from department approval, that full-time 24 hours-per day, 7 days-per-week service at the higher service level will be achieved.
DHS 110.36(2)(b) (b) An explanation of how quality assurance will be maintained and skill proficiency will be evaluated.
DHS 110.36(3) (3)If the department approves a request to provide emergency medical care at a higher service level during a phase-in period, the department shall issue a provisional license for the duration of the phase-in period.
DHS 110.36(4) (4)During the phase-in period, the applicant shall meet all of the requirements under s. 256.15, Stats., this chapter, and the approved operational plan, except the requirement to provide 24-hour-per-day, 7-day-per-week staffing coverage at the higher service level.
DHS 110.36(5) (5)An emergency medical service provider that does not achieve full-time 24 hours-per-day, 7 days-per-week service within the approved 12 month phase-in period shall notify the department, cease providing service at the upgraded level, and revert back to its previous service level, unless the department approves an extension under sub. (6).
DHS 110.36(6) (6)An emergency medical service provider that does not achieve full-time 24 hours per day, 7 days-per-week service within the 12 month phase-in may request one extension for an additional 12 months if the request is made in writing to the department no less than 60 business days before the expiration of the phase-in period. A phase-in period shall not exceed a total of 24 months.
DHS 110.36 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.
DHS 110.37 DHS 110.37Service level downgrades.
DHS 110.37(1)(1)An ambulance service provider or non-transporting EMT service provider may downgrade the level of its service only after department approval. The ambulance service provider or non-transporting EMT service provider shall submit a complete operational plan under s. DHS 110.35 (2), provide documentation from each community it serves that a public meeting was held at which the downgrade was an agenda item, and submit to the department a letter of support or understanding from each community it serves.
DHS 110.37(2) (2)An ambulance service provider may reduce the number of available ambulances for 9-1-1 emergency responses from the number identified in its operational plan if the ambulance service provider documents a hardship other than financial in an operational plan amendment and receives department approval.
DHS 110.37 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.
DHS 110.38 DHS 110.38Interfacility transports. In addition to the responsibilities under s. DHS 110.34, an ambulance service provider licensed to provide interfacility transports shall satisfy all of the following requirements:
DHS 110.38(1) (1)The ambulance service provider shall ensure that interfacility transports do not interfere with its responsibility to provide 9-1-1 emergency response in its primary service area, if it is also licensed as a 9-1-1 provider.
DHS 110.38(2) (2)The ambulance service provider shall assure proper staffing for interfacility transports based on the acuity of the patient, the orders of the sending physician and the staffing requirements in s. DHS 110.50.
DHS 110.38(3) (3)The ambulance service provider shall not use mutual aid agreements to cover its primary service area while providing interfacility transports.
DHS 110.38(4) (4)If the ambulance service provider is licensed as both a 9-1-1 provider and interfacility provider, the provider shall have a minimum of one ambulance for 9-1-1 emergency response and one ambulance for interfacility transports, unless the ambulance service provider has a coverage agreement with a neighboring ambulance service provider that will be able to provide one 9-1-1 ambulance for each primary service area.
DHS 110.38 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.
DHS 110.39 DHS 110.39Critical care and specialty care transports. In addition to the responsibilities under s. DHS 110.34, an ambulance service provider that provides critical care and specialty care transport services shall satisfy all of the following requirements:
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Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date the chapter was last published.