Wisconsin Legislature: DHS 110.395(1)(g)

(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.

History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.

DHS 110.37 Service level downgrades.

(1) An ambulance service provider or non-transporting emergency medical service provider may downgrade the level of its service only after department approval. The ambulance service provider or non-transporting emergency medical 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.

(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.

History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11; CR 20-028: am. (1) Register September 2021 No. 789, eff. 10-1-21.

DHS 110.38 Interfacility 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:

(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.

(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.

(3) The ambulance service provider shall not use mutual aid agreements to cover its primary service area while providing interfacility transports.

(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.

History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.

DHS 110.39 Critical 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:

(1) The ambulance service provider shall be licensed at the EMT-paramedic level.

(2) The ambulance service provider shall designate the specialty services it offers.

(3) The ambulance service provider shall identify a schedule for the availability of specialty care services, if it does not provide 24 hour-a-day, 7 day-a-week coverage.

(4) The ambulance service provider shall implement and maintain patient care protocols to be used by critical care paramedics, which follow the Wisconsin scope of practice for the critical care paramedic.

(5) The ambulance service provider shall staff an ambulance appropriately for the acuity of the patient as designated by the sending physician and in conformity to the staffing requirements in s. DHS 110.50.

(6) The ambulance service provider shall specifically identify the EMS professionals that are credentialed or part of the interfacility transport program.

(7) The ambulance service provider shall meet other requirements the department specifies.

History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11; CR 20-028: am. (6) Register September 2021 No. 789, eff. 10-1-21.

DHS 110.395 Community EMS.

(1) In addition to the responsibilities under s. DHS 110.34, an emergency medical services provider or other organization licensed to provide CEMS shall obtain department approval before using licensed EMS practitioners to provide CEMS. To obtain department approval, the EMS provider or other organization shall submit all of the following to the department:

(a) Name of the EMS provider or other organization requesting approval.

(b) Contact information for the service director of the CEMS program, including how to contact the EMS provider or other organization.

(c) Name, address, phone number and e-mail address for the each medical director or member of the medical advisory committee who will oversee the CEMS program.

(d) The type of CEMS service that will be provided and at what licensure level.

(e) The staffing configurations for providing CEMS service.

(f) An explanation of how medical direction or consultation will be contacted at the patient location, if indicated.

(g) Patient care protocols and guidelines for providing CEMS services.

(h) An explanation of how the CEMS provider will be notified and requested for CEMS services.

(i) An explanation of how the CEMS provider will notify and integrate with the 9-1-1 system, should the patient require an ambulance.

(j) Identification of the ambulance service provider(s) that will respond to a 9-1-1 call initiated by the CEMS provider.

(k) Copies of each agreement or contract for providing community emergency medical services.

Note: When submitting copies of agreements or contracts, the submitter may redact any compensation information.

(L) Written acknowledgement that community emergency medical services will not interfere with the emergency medical services provider’s responsibility to provide 9-1-1 emergency response within its primary service area, if the ambulance service provider or non-transporting emergency medical practitioner service provider is also licensed as a 9-1-1 provider.

(m) Other information as determined by the department.

(2) An emergency medical services provider or other organization licensed to provide community emergency medical service shall adhere to all applicable sections of this chapter as determined by the department.

(3) The community emergency medical services program shall submit patient care report data electronically to the department through the WARDS using a department approved direct web-based system within seven days of patient contact.

History: CR 20-028: cr. Register September 2021 No. 789, eff. 10-1-21.

DHS 110.40 Intercept service. In addition to the responsibilities under s. DHS 110.34, and ambulance service provider or non-transporting emergency medical service that provides intercept services is subject to all of the following requirements:

(1) The emergency medical service provider shall be licensed as a 9-1-1 emergency medical service provider.

(2) The emergency medical service provider intercept services shall not interfere with its responsibility to provide 9-1-1 emergency response within its primary service area.

(4) The intercept service shall identify a schedule for availability of intercept services, if the service does not provide 24 hour-a-day, 7 day-a-week coverage.

History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11; CR 20-028: am. (intro), r. (3) Register September 2021 No. 789, eff. 10-1-21.

DHS 110.41 Air medical services.

(1) In order to provide air medical service in Wisconsin, an ambulance service provider, including an ambulance service provider licensed in another state that makes more than 10 patient transports a year that originate and terminate in Wisconsin, shall be licensed under s. DHS 110.35, to provide air medical services and shall be nationally accredited for air medical transports by an entity approved by the department as follows:

(a) An ambulance service provider that was licensed by the department as an air medical service provider before July 1, 2010 shall obtain national accreditation for air medical transports by an entity approved by the department no later than July 1, 2015.

(b) Effective July 1, 2010, only ambulance service providers licensed at the paramedic level may be licensed as air medical services providers.

(2) An ambulance service provider licensed at the paramedic level and endorsed to provide air medical services that responds to 9-1-1 emergency response calls in its primary service area, shall provide 24-hour-a-day, 7days-a-week air medical service, except when limited in particular circumstances by safety or mechanical considerations.

(3) When an ambulance service provider receives a request for air medical services transport, the ambulance service provider shall notify the requesting agency of the estimated time of arrival at the scene of a medical emergency or the medical facility for an interfacility transport, and it shall immediately communicate any changes in estimated time of arrival to the requesting agency.

History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11; CR 20-028: am. (1) (intro.) Register September 2021 No. 789, eff. 10-1-21.

DHS 110.42 Tactical emergency medical services. An ambulance service provider or other agency shall obtain departmental approval before using licensed EMS professionals to provide tactical emergency medical services as follows:

(1) Ambulance services providers. To obtain department approval to provide tactical emergency medical services, an ambulance service provider shall submit an application and operational plan as provided under s. DHS 110.35 (2).

(2) Tactical teams. To obtain department approval, an agency shall do all of the following:

(a) Apply on a form obtained from the department.

(b) Submit patient care protocols for the emergency medical care the agency intends to provide.

(c) Submit an explanation of how the agency will interact with an ambulance service provider and maintain the initial level of patient care.

(d) Submit proof of medical liability insurance.

(e) Submit a written quality assurance and training plan for the EMS professionals that operate on the team.

Note: An application form may be obtained through the department’s website 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.

History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11; CR 20-028: am. (intro.), (2) (e) Register September 2021 No. 789, eff. 10-1-21.

DHS 110.43 Special units. If a licensed ambulance service owns, operates, and maintains special transport vehicles including, but not limited to, boats, ATV’s, or snowmobiles, the licensed ambulance service shall identify them in its application and operational plan as required under s. DHS 110.35 (2).

History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.

DHS 110.44 Special events. A licensed ambulance service provider or non-transporting emergency medical service provider shall obtain department approval before providing emergency medical services for special events outside its primary service area or that will require the provider to exceed its normal staffing and equipment levels within its primary service area. Events that occur on a regular basis may be included in the service operational plan and an update submitted in lieu of a complete plan. To obtain department approval, the ambulance service provider or emergency medical service provider shall submit all of the following to the department not less than 10 business days before the event:

(1) Name of the ambulance service provider or non-transporting emergency medical service provider requesting approval.

(2) Contact information for the event manager, including how to contact the ambulance service provider during the event.

(3) Locations, dates, and times of the event.

(4) Name, address, phone numbers, and e-mail addresses for each service medical director who will oversee the medical services at the event.

(5) Name and contact information for the medical control facility.

(6) The types of EMS services that will be provided.

(7) The level of EMS service that will be provided.

(8) The number of ambulances dedicated to the event including ambulance staffing configurations and types.

(9) Whether the service will be “dedicated services” or “as available” based on resources.

(9m) Whether the special event coverage is for participants, spectators, or both.

(10) Description of on-site communications between the event manager, event staff, dispatch, and 9-1-1 dispatch.

(11) Explanation of how medical consultation will be contacted or if on-site medical consultation will be used.

(12) Any special patient care protocols for use at the event.

(13) Explanation of how EMS professionals will be notified and requested during the event.

(14) Explanation of how the ambulance service provider will integrate with the 9-1-1 system.

(15) Explanation of how a 9-1-1 request that is generated within the event by a participant or spectator will be handled.

(16) Identification of the service provider that will respond to a 9-1-1 call initiated from within the event.

(17) If the event occurs outside the primary service area of the ambulance service provider or non-transporting emergency medical service, documentation that the ambulance service provider for the primary service area in which the event is located has been notified at least 10 business days prior to the event or documentation that the ambulance service provider for the primary service area in which the event is located has approved the ambulance service provider or non-transporting emergency medical service requesting special event approval to provide event coverage within its primary service area.

(18) Written assurance that adequate resources will be available.

(19) Written acknowledgement that the ambulance service provider requesting special event approval assumes all liability for ambulance coverage and response during the event.

(20) Copies of any agreement or contract for providing emergency medical services for the event.

Note: When submitting copies of the contracts or agreements the service may redact any compensation information.

(20g) Written acknowledgement that the special event coverage will not interfere with its responsibility to provide 9-1-1 emergency response within its primary service area, if the ambulance service provider or non-transporting emergency medical service provider is also licensed as a 9-1-1 provider.

(20r) If the special event coverage is for spectators and participants or both and more than 5000 people total are anticipated to be in attendance, a mass casualty plan including all of the following: