LRB-3716/2
DAK:cjs:jf
2001 - 2002 LEGISLATURE
October 2, 2001 - Introduced by Administrative Rules. Referred to Committee on
Public Health.
AB524,1,5 1An Act to renumber and amend 146.50 (4) (c); to amend 146.50 (4) (title) and
2146.50 (13) (a); and to create 146.50 (4) (c) 1., 146.50 (4) (c) 2. and 146.50 (4)
3(c) 3. of the statutes; relating to: limiting the approval of operational plans for
4staffing of ambulances for services authorized to be provided by emergency
5medical technicians-paramedic.
Analysis by the Legislative Reference Bureau
Under current law, emergency medical technicians are licensed in three
categories with differing sets of skills: emergency medical technician-basic,
emergency medical technician-intermediate, and emergency medical
technician-paramedic. Persons required to be present in an ambulance, in addition
to a sick, disabled, or injured individual, are any two licensed emergency medical
technicians, registered nurses, physician assistants, or physicians or a combination
of any two of these; or one licensed emergency medical technician and one emergency
medical technician who has a training permit. However, notwithstanding this
requirement, the department of health and family services (DHFS) is authorized to
promulgate rules that establish standards for the staffing of ambulances in which
the primary services provided are those authorized to be provided by an emergency
medical technician-intermediate or by an emergency medical
technician-paramedic.
This bill authorizes DHFS to promulgate rules for approval of emergency
medical technician-paramedic operational plans submitted by ambulance service

providers that provided the emergency medical technician-paramedic level of
service before January 1, 2000, only if the rules require that the plan specifies, for
the transport of patients in prehospital settings, all of the following:
1. That the ambulance service provider ensures, in writing, that the ambulance
is staffed with at least two emergency medical technicians-paramedic or licensed
registered nurses, physician assistants, or physicians or a combination of any two of
these, who are trained in the use of skills authorized for an emergency medical
technician-paramedic and are designated by the medical director.
2. That this ambulance staff is dispatched from the same site, together, and
returns, together, to the dispatching site.
3. That if an emergency medical technician-paramedic arrives at the scene of
an emergency before this ambulance staff arrives, the emergency medical
technician-paramedic may provide services using the skills authorized for an
emergency medical technician-paramedic.
This bill is introduced as required by s. 227.19 (5) (e), stats., in support of the
objection of the senate committee on health, utilities, veterans, and military affairs
on June 21, 2001, and the joint committee for review of administrative rules on
August 30, 2001, to the issuance of a portion of clearinghouse rule 00-091 by DHFS.
The portion of the rule to which objection was made authorized approval by DHFS
of an operational service plan of an ambulance service provider using emergency
medical technicians-paramedic under a service in operation before January 1, 2000,
that, for patients transported in a prehospital setting, required the ambulance
service provider's written commitment to ensure ambulance staffing with at least
two licensed emergency medical technicians-paramedic, registered nurses,
physician assistants, or physicians or any combination of two of these. Of these
persons, a single emergency medical technician-paramedic, registered nurse,
physician assistant, or physician would be authorized to perform all of the skills
authorized by rule for an emergency medical technician-paramedic before the
arrival of a second emergency medical technician-paramedic, registered nurse,
physician assistant, or physician, as long as both persons had been immediately
dispatched. After the patient had been assessed and stabilized, one of the required
staffing persons would be authorized to be released by protocol or under a verbal
order from a physician.
For further information see the state and local fiscal estimate, which will be
printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB524, s. 1 1Section 1. 146.50 (4) (title) of the statutes is amended to read:
AB524,2,32 146.50 (4) (title) Ambulance staffing and operational plans; limitations;
3rules.
AB524, s. 2
1Section 2. 146.50 (4) (c) of the statutes is renumbered 146.50 (4) (c) (intro.) and
2amended to read:
AB524,3,133 146.50 (4) (c) (intro.) Notwithstanding par. (a), the department may
4promulgate rules that establish standards for approval by the department of
5operational plans for the
staffing of ambulances in which the primary services
6provided are those which an emergency medical technician - intermediate is
7authorized to provide or those which an emergency medical technician - paramedic
8is authorized to provide. Rules promulgated by the department under this
9paragraph may permit the department to approve an operational plan for services
10that an emergency medical technician-paramedic is authorized to provide that is
11submitted by an ambulance service provider that provided these services before
12January 1, 2000, only if the operational plan specifies all of the following for the
13transport of a patient in a prehospital setting:
AB524, s. 3 14Section 3. 146.50 (4) (c) 1. of the statutes is created to read:
AB524,3,2015 146.50 (4) (c) 1. That the ambulance service provider ensures, in writing, that
16the ambulance is staffed with at least two emergency medical
17technicians-paramedic, licensed registered nurses, licensed physician assistants, or
18physicians or a combination of any two of these, who are trained in the use of all skills
19authorized by rule for an emergency medical technician-paramedic and are
20designated by the medical director of the ambulance service.
AB524, s. 4 21Section 4. 146.50 (4) (c) 2. of the statutes is created to read:
AB524,3,2422 146.50 (4) (c) 2. That the ambulance staff, as specified in subd. 1., is dispatched
23from the same site, together, to the scene of an emergency and returns, together, to
24the dispatching site.
AB524, s. 5 25Section 5. 146.50 (4) (c) 3. of the statutes is created to read:
AB524,4,4
1146.50 (4) (c) 3. That if an emergency medical technician-paramedic arrives
2at the scene of an emergency prior to the arrival of the ambulance staff, as specified
3in subd. 1., the emergency medical technician-paramedic may provide services using
4all skills authorized by rule for an emergency medical technician-paramedic.
AB524, s. 6 5Section 6. 146.50 (13) (a) of the statutes is amended to read:
AB524,4,76 146.50 (13) (a) The department may promulgate rules necessary for
7administration of this section, as limited under sub. (4) (c).
AB524,4,88 (End)
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