AB524: Bill Text

LRB-3716/2

DAK:cjs:jf

2001 - 2002 LEGISLATURE

2001 Assembly BILL 524

October 2, 2001 - Introduced by Administrative Rules. Referred to Committee on Public Health.

AB524,1,5 An Act to renumber and amend 146.50 (4) (c); to amend 146.50 (4) (title) and 146.50 (13) (a); and to create 146.50 (4) (c) 1., 146.50 (4) (c) 2. and 146.50 (4) (c) 3. of the statutes; relating to: limiting the approval of operational plans for staffing of ambulances for services authorized to be provided by emergency medical 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 Section 1. 146.50 (4) (title) of the statutes is amended to read:

AB524,2,3 146.50 (4) (title) Ambulance staffing and operational plans; limitations; rules.

AB524, s. 2 Section 2. 146.50 (4) (c) of the statutes is renumbered 146.50 (4) (c) (intro.) and amended to read:

AB524,3,13 146.50 (4) (c) (intro.) Notwithstanding par. (a), the department may promulgate rules that establish standards for approval by the department of operational plans for the staffing of ambulances in which the primary services provided are those which an emergency medical technician - intermediate is authorized to provide or those which an emergency medical technician - paramedic is authorized to provide. Rules promulgated by the department under this paragraph may permit the department to approve an operational plan for services that an emergency medical technician-paramedic is authorized to provide that is submitted by an ambulance service provider that provided these services before January 1, 2000, only if the operational plan specifies all of the following for the transport of a patient in a prehospital setting:

AB524, s. 3 Section 3. 146.50 (4) (c) 1. of the statutes is created to read:

AB524,3,20 146.50 (4) (c) 1. That the ambulance service provider ensures, in writing, that the ambulance is staffed with at least two emergency medical technicians-paramedic, licensed registered nurses, licensed physician assistants, or physicians or a combination of any two of these, who are trained in the use of all skills authorized by rule for an emergency medical technician-paramedic and are designated by the medical director of the ambulance service.

AB524, s. 4 Section 4. 146.50 (4) (c) 2. of the statutes is created to read:

AB524,3,24 146.50 (4) (c) 2. That the ambulance staff, as specified in subd. 1., is dispatched from the same site, together, to the scene of an emergency and returns, together, to the dispatching site.

AB524, s. 5 Section 5. 146.50 (4) (c) 3. of the statutes is created to read:

AB524,4,4 146.50 (4) (c) 3. That if an emergency medical technician-paramedic arrives at the scene of an emergency prior to the arrival of the ambulance staff, as specified in subd. 1., the emergency medical technician-paramedic may provide services using all skills authorized by rule for an emergency medical technician-paramedic.

AB524, s. 6 Section 6. 146.50 (13) (a) of the statutes is amended to read:

AB524,4,7 146.50 (13) (a) The department may promulgate rules necessary for administration of this section, as limited under sub. (4) (c).

AB524,4,8 (End)