Ch. DHS 110 Note
Note: Chapter H 20 was repealed and recreated as HSS 110.01 to 110.09 by emergency rule effective July 1, 1990. Chapter H 20 as it existed on January 31, 1991 was repealed and HSS 110.01 to 110.09 was created effective February 1, 1991. Chapter HSS 110 was renumbered chapter HFS 110 under s. 13.93 (2m) (b) 1., Stats., and corrections made under s. 13.93 (2m) (b) 6. and 7., Stats.,
Register, November, 1998, No. 515. Chapter HFS 110 was repealed and recreated,
Register, February, 2001, No. 542, eff. 3-1-01. Chapter HFS 110 was renumbered to ch. DHS 110 under s. 13.92 (4) (b) 1., Stats., and corrections made under s. 13.92 (4) (b) 7., Stats.,
Register January 2009 No. 637. Chapter DHS 110 as it existed on December 31, 2010, was repealed and a new chapter DHS 110 was created effective January 1, 2011.
DHS 110.01
DHS 110.01 Authority and purpose. This chapter is promulgated under the authority of ss.
256.08 (4) and
256.15 (13), Stats., to establish standards for all of the following:
DHS 110.01(1)
(1) Certifying, training, and credentialing emergency medical responders.
DHS 110.01(2)
(2) Licensing, training, and credentialing emergency medical services practitioners.
DHS 110.01(3)
(3) Licensing emergency medical services providers.
DHS 110.01(4)
(4) Certifying emergency medical services training centers.
DHS 110.01 History
History: CR 10-085: cr.
Register December 2010 No. 660, eff. 1-1-11;
CR 20-028: am. (1), (2)
Register September 2021 No. 789, eff. 10-1-21.
DHS 110.02
DHS 110.02 Applicability. This chapter applies to all of the following:
DHS 110.02 History
History: CR 10-085: cr.
Register December 2010 No. 660, eff. 1-1-11;
CR 20-028: am. (1) to (3), (5)
Register September 2021, No. 789, eff. 10-1-21.
DHS 110.03
DHS 110.03 Waivers. The department may waive any non-statutory requirement under this chapter, upon written request, if the department finds that strict enforcement of the requirement will create an unreasonable hardship for the emergency medical services provider or the public in meeting the emergency medical service needs of the provider's primary service area and that waiver of the requirement will not adversely affect the health, safety or welfare of patients or the general public. The department's denial of a request for a waiver shall constitute the final decision of the department and is not subject to a hearing under s.
DHS 110.59.
DHS 110.03 History
History: CR 10-085: cr.
Register December 2010 No. 660, eff. 1-1-11.
DHS 110.04
DHS 110.04 Definitions. In this chapter:
DHS 110.04(1r)
(1r) “Advanced life support" means prehospital and interfacility emergency medical care consisting of basic life support procedures and invasive lifesaving procedures including the placement of advance airway adjuncts, intravenous infusions, manual defibrillation, electrocardiogram interpretation, administration of approved drugs and other advanced skills identified in the Wisconsin scopes of practice.
DHS 110.04(2)
(2) “Air medical service" means a licensed ambulance service provider that specializes in transport by helicopter or airplane.
DHS 110.04(3)
(3) “Algorithm protocol" means a graphical representation or flow chart of a written patient care protocol.
DHS 110.04(4)
(4) “Ambulance" means an emergency vehicle, including any motor vehicle, boat or aircraft, whether privately or publicly owned, which is designed, constructed or equipped to transport sick, disabled or injured individuals.
DHS 110.04(5)
(5) “Ambulance service provider" means a person engaged in the business of transporting sick, disabled or injured individuals by ambulance to or from facilities or institutions providing health services.
DHS 110.04(6)
(6) “Ambulance staffing configuration" means the different ways that an ambulance can be staffed based on level of services as described in s.
DHS 110.50.
DHS 110.04(7)
(7) “As needed services" means that with respect to special events the EMS service provider will provide emergency medical services as its resources are available and will not commit resources exclusively for the event.
DHS 110.04(9)
(9) “Backup agreement" means a written agreement between nearby licensed ambulance service providers to provide response when the primary service provider is unable to do so.
DHS 110.04(12)
(12) “CPR organization" means an entity whose program is authorized to provide CPR certification or training based on national standards and is approved by the department to fulfill the CPR requirement for certified emergency medical responders and licensed emergency medical services practitioners.
DHS 110.04(13)
(13) “Cardiopulmonary resuscitation" or “CPR" means a combination of rescue breathing and chest compressions delivered to victims believed to be in cardiac arrest.
DHS 110.04(14)
(14) “Clinical training" means training received in a hospital or other health care facility.
DHS 110.04(14m)
(14m) “Community emergency medical services practitioner” or “CEMS practitioner” has the meaning given under s.
256.21 (1), Stats.
DHS 110.04(14r)
(14r) “Community emergency medical services provider” or “CEMS provider” has the meaning given under s.
256.215(1)(a), Stats.
DHS 110.04(15)
(15) “Coverage agreement" means a written agreement between two neighboring ambulance service providers that each will cover the other's 9-1-1 area when the other knows in advance that it will be unable to do so.
DHS 110.04(16)
(16) “Credential" means written authorization by the service director and medical director of a licensed emergency medical services provider permitting a certified emergency medical responder or licensed emergency medical services practitioners to perform specified emergency medical care while in the service of the provider. To be “credentialed" means to hold a credential issued by a licensed emergency medical services provider.
DHS 110.04(17)
(17) “Critical care paramedic" means a paramedic who is licensed and endorsed by the department to provide an advanced level of paramedic care based on completion of an advanced level of paramedic training.
DHS 110.04(18)
(18) “Dedicated services" means that with respect to special events the emergency medical services provider will have resources dedicated and immediately available on the grounds of the event that will not be subject to responses other than requests from the event.
DHS 110.04(20)
(20) “Department" means the Wisconsin department of health services.
DHS 110.04(21)
(21) “Emergency medical care" means medical care to sick, disabled, or injured individuals at the scene of an emergency, during transport to a hospital, while in the hospital emergency department until responsibility for care is assumed by the regular hospital staff, and during transfer of a patient between health care facilities, which is based on department approved patient care protocols.
DHS 110.04(21e)
(21e) “Emergency medical dispatch” means a process used by a public safety answering point or dispatch center to determine whether to dispatch an advanced life support or basic life support ambulance based on information obtained from a 9-1-1 caller.
DHS 110.04(21s)
(21s) “Emergency medical responder service provider" means an emergency medical service provider that provides emergency medical care with staff certified as emergency medical responders to sick, disabled or injured individuals before hospitalization and the arrival of an ambulance, but that does not provide transportation for patients.
DHS 110.04(22)
(22) “Emergency medical services" or “EMS" means an arrangement of personnel, communications, equipment, and supplies for the delivery of emergency medical care.
DHS 110.04(23)
(23) “EMS instructor" means a person approved by the department or, if employed by the Wisconsin technical college system board, jointly approved by the department and the Wisconsin technical college system board, at a specified level or levels, to train individuals in the provision of emergency medical services.
DHS 110.04(24)
(24) “EMS professional" means a certified emergency medical responder, licensed emergency medical services practitioner, registered nurse, physician assistant or physician, who is authorized to provide emergency medical care.
DHS 110.04(25)
(25) “Emergency medical service provider" or “EMS provider" means an emergency medical services program under s.
256.12, Stats., that provides emergency medical services as an emergency medical responder service provider, non-transporting EMS provider, or ambulance service provider.
DHS 110.04(26)
(26) “Emergency medical services practitioner” or “EMS practitioner” has the meaning given in s.
256.01 (5), Stats.
DHS 110.04(28)
(28) “Emergency medical technician — intermediate" or “EMT-Intermediate" has the meaning given in s.
256.01 (7), Stats.
DHS 110.04(31)
(31) “Endorsement" means validation by the department that a licensed EMS practitioner has received the training and education required to be a specialist within a license level.
DHS 110.04(32)
(32) “Field training" means a training experience where a student is placed with an ambulance service provider and, under direct supervision of an approved preceptor, cares for patients to gain proficiency in the skills, medications, and treatments taught in the training program in which the student is enrolled.
DHS 110.04(36)
(36) “Individual" means a natural person, and does not include a firm, corporation, association, partnership, institution, public agency, joint stock association or any other group of individuals.
DHS 110.04(37)
(37) “Interfacility transport" means any transfer of a patient between health care facilities or any non-emergent transfer of a patient.
DHS 110.04(38)
(38) “Intercept service" means a specialized EMS service provider that sends higher trained EMS professionals to assist a lower level EMS service provider in caring for a patient who requires a higher level of emergency medical care than the lower level EMS service provider is able to administer.
DHS 110.04(40)
(40) “Medical consultation" means all of the following:
DHS 110.04(40)(b)
(b) Supervision and quality control of patient care by the service medical director or by a physician designated by the service medical director.
DHS 110.04(40)(c)
(c) Coordination of all medical-related activities of EMS professionals in a pre-hospital setting or interfacility transport of a patient.
DHS 110.04(42)
(42) “Medical director" means a physician who trains, medically coordinates, directs, supervises, establishes standard operating procedures for, designates physicians for direction and supervision of, and reviews the performance of the service's emergency medical responders or emergency medical services practitioners and ambulance service providers, as required under s.
256.15 (8m), Stats.
DHS 110.04(43)
(43) “Mutual aid agreement" means a written agreement between licensed ambulance service providers whereby each provides emergency medical care in the other's primary service area when the primary ambulance service provider requires additional resources because it has already committed all its resources to other 9-1-1 emergency responses.
DHS 110.04(43m)
(43m) “National emergency medical service information system” or “NEMSIS” means the national database system used to aggregate, store, and share emergency medical service data from multiple states and federal territories administered through the National Highway Traffic Safety Administration of the U.S. Department of Transportation.
DHS 110.04(43r)
(43r) “National EMS Education Standards” or “national education standards” means the most recent edition of the emergency medical responder or emergency medical services practitioner curriculum published by the national highway traffic safety administration of the U.S. department of transportation.
DHS 110.04(44)
(44) “National registry of emergency medical technicians" or “NREMT" means the non-profit, independent, non-governmental agency that certifies the proficiency of EMS professionals through provision of a standardized examination for individuals who have completed state-approved EMS training.
DHS 110.04(46)
(46) “9-1-1 emergency response" means the dispatch and movement of an ambulance in response to a request for emergency medical services, which was initiated by a 9-1-1 phone call and dispatched through a 9-1-1 dispatch center.
DHS 110.04(47)
(47) “Non-transporting EMS provider" means an emergency medical service provider that provides emergency medical care with staff licensed as EMS practitioners to sick, disabled or injured individuals, but that does not transport patients.
DHS 110.04(49)
(49) “On-line medical consultation" means direct contact between a medical consultation physician or physician assistant or advanced practice nurse practitioner and EMS professionals for the purpose of medical direction. Physician assistants or advanced practice nurse practitioners shall only act within their credentialed or licensed scope of practice for the facility in which they are employed in providing on-line medical consultation.
DHS 110.04(50)
(50) “On-site medical consultation" means that a service medical director or designee is located at a special event and directs EMS professionals in the treatment of patients.
DHS 110.04(51)
(51) “Operational plan" means a written plan of operations prepared by or for an emergency medical service provider that describes the provider's methods and procedures for providing emergency medical services in the provider's primary service area and other areas served through mutual aid or contract.
DHS 110.04(52)
(52) “Patient" means individual of any age who may require assessment, treatment or transport.
DHS 110.04(53)
(53) “Patient care report" means the written documentation that is the official medical record that documents events and the assessment and care of a patient treated by EMS professionals.
DHS 110.04(54)
(54) “Patient care protocol" means a written statement signed and dated by the service medical director and approved by the department that lists and describes the steps within the applicable scope of practice that EMS professionals are required to follow when assessing and treating a patient.
