Wisconsin Legislature: DHS 110.44(20r)

(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:

(a) Name and contact information of the ambulance service provider or public safety agency that shall be the lead agency in the event of a mass casualty incident.

(b) A copy of the triage protocol to be used in the mass casualty incident.

(d) A list of destination hospitals including contact information.

(e) Copies of any mutual aid agreements specific to the event.

(f) A list of any specialty resources prepositioned for the event.

(g) Patient tracking method to be used.

(h) Written acknowledgement that the ambulance service has identified potential staging areas and landing zones near the event.

(i) Written acknowledgement that the ambulance service provider or non-transporting emergency medical service provider has notified area hospitals of the date of the event.

(21) Other information as determined by the department.

History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11; CR 20-028: am. (intro.), (1), (8), cr. (9m), am. (11), (13), r. and recr. (17), cr. (20g), (20r) Register September 2021 No. 789, eff. 10-1-21.

DHS 110.45 Department decisions on applications.

(1) Except as provided in sub. (2), 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.

(2) The department shall either approve the application and issue a license or deny the application within 90 business days after receiving a complete application for an emergency medical service provider license that requires department review of algorithm protocols, including an application for a change or update of any algorithm protocol. If the application for a license or algorithm protocol approval is denied, the department shall give the applicant reasons, in writing, for the denial and shall inform the applicant of the right to appeal that decision.

(3) The department’s failure to deny an application within the time period established under sub. (1) or (2) does not constitute department approval of the license application. An applicant may not provide emergency medical services until the department has issued the applicant a license.

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

DHS 110.46 License duration and application for renewal license.

(1) A license issued by the department to an emergency medical service provider is valid for the duration of the triennium as long as the provider remains in continuous compliance with EMS-related federal and state statutes, this chapter, and the operational plan approved by the department, or until the provider notifies the department in writing that it intends to cease providing emergency medical services or the department suspends or revokes the license.

(2) Notwithstanding sub. (1), an emergency medical service provider shall renew its license by June 30 of the third year of the triennium by submitting to the department an updated application that includes documentation acceptable to the department showing proof of eligibility. The application and documentation shall be submitted to the department in the manner or method specified by the department.

History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11; CR 20-028: am. (title), renum. DHS 110.46 to (1) and am., cr. (2) Register September 2021 No. 789, eff. 10-1-21.

DHS 110.47 Required personnel and responsibilities. An emergency medical service provider shall have all of the following personnel:

(1) A service director qualified under s. DHS 110.49.

(2) A service medical director qualified under s. DHS 110.50.

(3) An infection control designee who is responsible for maintaining the infection control program and meeting Occupational Safety and Health Administration standards for blood borne pathogens and safety.

(4) A quality assurance designee who is responsible for managing patient-based quality improvement processes in collaboration with the service medical director.

(5) A training designee who is responsible for assisting the service medical director in assuring continued competency and facilitating the continuing education of the provider’s EMS professionals.

(6) A data contact designee who is responsible for assuring that patient care report data is submitted to the department as required in this chapter.

(7) EMS professionals sufficient to meet the staffing requirements under s. DHS 110.51.

Note: These personnel do not have to be separate people. One person may hold several of these positions.

History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11; CR 20-028: am. (1), (2), (5), (7) Register September 2021 No. 789, eff. 10-1-21.

DHS 110.48 Service director. An emergency medical service provider shall have a service director who shall:

(1) Serve as the primary contact between the emergency medical service provider and the department.

(2) Assure that all elements of the operational plan are kept current.

(3) Assure that EMS professionals are properly licensed and credentialed.

(4) Provide day-to-day supervision of the ambulance service provider’s operations.

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

DHS 110.49 Service medical director. An emergency medical service provider shall have a service medical director who meets all of the qualifications under sub. (1) and has all the responsibilities under sub. (2):

(1) Qualifications. The service medical director shall meet all the following within 180 days from the date of his or her appointment:

(a) Licensure as a physician.

(b) Current certification in CPR for health care professionals and, if the medical director provides medical direction for an EMT-intermediate, Advanced Emergency Medical Technician or paramedic emergency medical services provider, current certification in ACLS and PALS unless the physician is certified by the American Board of Emergency Medicine or the American Osteopathic Board of Emergency Medicine.

(d) Familiarity with the design and operation of pre-hospital EMS systems.

(e) Experience or training in the EMS quality improvement process.

(f) Successful completion of the department’s service medical director course or equivalent as determined by the department for any service medical director who is not board certified as specified in par. (b).

(g) Any additional requirements prescribed by the department.

(2) Responsibilities. The service medical director shall do all of the following:

(a) Prescribe patient care protocols under which the provider’s professionals treat.

(b) Develop, review and approve in writing all patient care protocols that will be used by EMS professionals delivering patient care under the operational plan.

(c) Ensure that physicians providing on-line medical control do so in a manner consistent with the department approved patient care protocols.

(d) Ensure that all aspects of the emergency medical services are under medical supervision and direction at all times.

(e) Establish, participate in, and ensure the continuing implementation of a quality assurance program as part of a patient care improvement process.

(f) Approve, limit, suspend, or revoke credentials as provided under s. DHS 110.53.

(g) Maintain liaison with the medical community, including hospitals, emergency departments, urgent care clinics, physicians, nurses, and other healthcare providers.

(h) Work with regional, state and local EMS authorities to ensure that standards, needs and requirements are met and resource utilization is optimized.

(i) Maintain, through continuing education, current knowledge and skills appropriate for a service medical director.

(j) Approve, direct, and assist in providing training activities that assure EMS professionals are competent to provide safe and efficient patient care, based on the department approved patient care protocols.

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

DHS 110.495 Community emergency medical services medical director. A CEMS provider shall have a minimum of one medical director who meets all of the qualifications under sub. (1) and has all the responsibilities under sub. (2).

(1) Qualifications. Except as provided by sub. (3), a community emergency medical services medical director shall have all of the following: