146.50(1)(d)
(d) "Basic life support" means emergency medical care that is rendered to a sick, disabled or injured individual, based on signs, symptoms or complaints, prior to the individual's hospitalization or while transporting the individual between health care facilities and that is limited to use of the knowledge, skills and techniques received from training required for licensure as an emergency medical technician - basic, or for certification as a first responder.
146.50(1)(dm)
(dm) "Defibrillation" means administering an electrical impulse to an individual's heart in order to stop ventricular fibrillation or rapid ventricular tachycardia.
146.50(1)(e)
(e) "Emergency medical technician" means an emergency medical technician – basic, an emergency medical technician – intermediate or an emergency medical technician – paramedic.
146.50(1)(f)
(f) "Emergency medical technician – basic" means an individual who is licensed by the department to administer basic life support and to properly handle and transport sick, disabled or injured individuals.
146.50(1)(g)
(g) "Emergency medical technician – intermediate" means an individual who is licensed by the department as an emergency medical technician - intermediate under
sub. (5).
146.50(1)(h)
(h) "Emergency medical technician – paramedic" means an individual who is specially trained in emergency cardiac, trauma and other lifesaving or emergency procedures in a training program or course of instruction prescribed by the department and who is examined and licensed as an emergency medical technician – paramedic under
sub. (5).
146.50(1)(hm)
(hm) "First responder" means an individual who is certified by the department as a first responder under
sub. (8).
146.50(1)(hr)
(hr) "Governmental unit" means the United States; the state; any county, city, village, or town; or any political subdivision, department, division, board, or agency of the United States, the state, or any county, city, village, or town.
146.50(1)(i)
(i) "Indian tribe" means a federally recognized American Indian tribe or band in this state.
146.50(1)(ig)
(ig) "Intent to terrorize" means intent to influence the policy of a governmental unit by intimidation or coercion, to punish a governmental unit for a prior policy decision, to affect the conduct of a governmental unit by homicide or kidnapping, or to intimidate or coerce a civilian population.
146.50(1)(im)
(im) "Manual defibrillator" means a heart monitor and defibrillator that:
146.50(1)(im)1.
1. Is operated only after an operator has first analyzed and recognized an individual's cardiac rhythm;
146.50(1)(im)2.
2. Charges and delivers, only at the command of the operator, an electrical impulse to an individual's heart; and
146.50(1)(im)3.
3. In the case of a defibrillator that may be operated in either an automatic or a manual mode, is set to operate in the manual mode.
146.50(1)(j)
(j) "Medical director" means a physician who trains, medically coordinates, directs, supervises, establishes standard operating procedures for, and designates physicians for direction and supervision of, emergency medical technicians and who reviews the performance of emergency medical technicians and ambulance service providers.
146.50(1)(k)
(k) "Nonprofit corporation" means a nonstock corporation organized under
ch. 181 that is a nonprofit corporation, as defined in
s. 181.0103 (17).
146.50(1)(L)
(L) "Person" includes an individual, firm, partnership, association, corporation, trust, foundation, company, public agency or a group of individuals, however named, concerned with the operation of an ambulance.
146.50(1)(n)
(n) "Public agency" means this state, a county, city, village or town; an agency of this state or of a county, city, village or town; or an Indian tribe.
146.50(1)(o)
(o) "Semiautomatic defibrillator" means a heart monitor and defibrillator that:
146.50(1)(o)1.
1. Is capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia and determining, without intervention by an operator, whether defibrillation should be performed; and
146.50(1)(o)2.
2. Charges and, at the command of the operator, delivers an electrical impulse to an individual's heart.
146.50(1)(p)
(p) "Ventricular fibrillation" means a disturbance in the normal rhythm of the heart that is characterized by rapid, irregular and ineffective twitching of the ventricles of the heart.
146.50(2)
(2) License or certificate required. No person may act as or advertise for the provision of services as an ambulance service provider unless the person holds an ambulance service provider license issued under this section. No individual may act as or advertise for the provision of services as an emergency medical technician unless he or she holds an emergency medical technician license or training permit issued under
sub. (5). No individual may act as or advertise for the provision of services as a first responder unless he or she holds a first responder certificate issued under
sub. (8).
146.50(3)
(3) Exception to treatment. This section and the rules promulgated under this section may not be construed to authorize the provision of services or treatment to any individual who objects for reasons of religion to the treatment or services, but may be construed to authorize the transportation of such an individual to a facility of the individual's choice within the jurisdiction of the emergency medical service.
146.50(4)
(4) Ambulance staffing; limitations; rules. 146.50(4)(a)(a) If a sick, disabled or injured individual is transported by ambulance, the following other individuals shall be present in the ambulance:
146.50(4)(a)1.
1. Any 2 emergency medical technicians, licensed registered nurses, licensed physician assistants or physicians, or any combination thereof; or
146.50(4)(a)2.
2. One emergency medical technician plus one individual with a training permit issued under
sub. (5) (b).
146.50(4)(b)
(b) An ambulance driver who is not an emergency medical technician may assist with the handling and movement of a sick, injured or disabled individual if an emergency medical technician, registered nurse, physician assistant or physician directly supervises the driver. No ambulance driver may administer care procedures that an emergency medical technician is authorized to administer unless he or she is an emergency medical technician.
146.50(4)(c)
(c) Notwithstanding
par. (a), the department may promulgate rules that establish standards for 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.
146.50(5)
(5) Licensing of ambulance service providers and emergency medical technicians; training permits. 146.50(5)(a)(a) Except as provided in
ss. 146.51 and
146.52, the department shall license qualified applicants as ambulance service providers or emergency medical technicians. The department shall, from the information on the certification form specified under
sub. (6) (c) 2., establish in each ambulance service provider's biennial license the primary service or contract area of the ambulance service provider.
146.50(5)(b)
(b) The department shall promulgate rules establishing a system and qualifications for issuance of training permits, except as provided in
ss. 146.51 and
146.52, and specifying the period for which an individual may hold a training permit.
146.50(5)(c)
(c) A training permit application shall be signed by an ambulance service provider.
146.50(5)(d)
(d) An individual who holds a training permit issued under
par. (b) may do the following:
146.50(5)(d)1.
1. If issued an emergency medical technician – basic training permit, he or she may perform the actions authorized under rules promulgated by the department for an emergency medical technician - basic, but only if an emergency medical technician directly supervises him or her.
146.50(5)(d)2.
2. If issued an emergency medical technician – intermediate training permit, he or she may perform the actions authorized under rules promulgated by the department for an emergency medical technician - intermediate, but only if a medical director or training instructor is present and giving direction.
146.50(5)(d)3.
3. If issued an emergency medical technician - paramedic training permit, he or she may perform the actions authorized under rules promulgated by the department for an emergency medical technician - paramedic, but only if a medical director or training instructor is present and giving direction.
146.50(5)(e)
(e) A license or training permit issued under this subsection is nontransferable and is valid for the balance of the license or training permit period or until surrendered for cancellation or suspended or revoked for violation of this section or of any other statutes or rules relating to ambulance service providers or emergency medical technicians.
146.50(5)(f)
(f) The department may charge a reasonable fee for a license or training permit issued under this subsection, except that no fee may be charged to an individual who is an employee of a public agency and who works for volunteer or paid-on-call ambulance service providers and who is an applicant for a license as an emergency medical technician - basic or for a training permit.
146.50(5)(g)
(g) Except as provided in
ss. 146.51 and
146.52, an emergency medical technician license shall be issued to the individual licensed, and the department may not impose a requirement that an individual be affiliated with an ambulance service provider in order to receive an emergency medical technician license or to have an emergency medical technician license renewed.
146.50(6)(a)(a) Except as provided in
ss. 146.51 and
146.52, to be eligible for an initial license as an emergency medical technician, an individual shall:
146.50(6)(a)1.
1. Be 18 years of age or older; be capable of performing the actions authorized in rules promulgated under
sub. (13) (c) for an emergency medical technician – basic, an emergency medical technician - intermediate or an emergency medical technician – paramedic, for which licensure is sought; and, subject to
ss. 111.321,
111.322 and
111.335, not have an arrest or conviction record.
146.50(6)(a)2.
2. Have satisfactorily completed a course of instruction and training, including training for response to acts of terrorism, prescribed by the department or have presented evidence satisfactory to the department of sufficient education and training in the field of emergency care.
146.50(6)(a)3.
3. Have passed an examination approved by the department.
146.50(6)(a)4.
4. Have such additional qualifications as may be required by the department.
146.50(6)(b)1.1. Except as provided in
ss. 146.51 and
146.52, to be eligible for a renewal of a license as an emergency medical technician, the licensee shall, in addition to meeting the requirements of
par. (a) 1., complete the training, education or examination requirements specified in rules promulgated under
subd. 2.
146.50(6)(b)2.
2. The department, in conjunction with the technical college system board, shall promulgate rules specifying training, education, or examination requirements, including requirements for training for response to acts of terrorism, for license renewals for emergency medical technicians.
146.50(6)(c)
(c) Except as provided in
ss. 146.51 and
146.52, to be eligible for a license as an ambulance service provider, an individual shall be 18 years of age or older and have such additional qualifications as may be established in rules promulgated by the department, except that no ambulance service provider may be required to take training or an examination or receive education to qualify for licensure or for renewal of licensure. An ambulance service provider shall, as a condition of licensure, provide medical malpractice insurance sufficient to protect all emergency medical technicians who perform for compensation as employees of the ambulance service provider. For renewal of a biennial license as an ambulance service provider, an applicant shall also provide all of the following:
146.50(6)(c)1.
1. A financial report, on a form developed and provided by the department, of all expenditures made in the 2 previous fiscal years from all funds provided to the ambulance service provider under
s. 146.55 (4).
146.50(6)(c)2.
2. Certification, on a form developed and provided by the department, signed by a representative of the ambulance service provider and the clerk of each county, city, town or village served by the ambulance service provider, of the population and boundaries of the ambulance service provider's primary service or contract area in that county, city, town or village.
146.50(6g)
(6g) Certification for performance of defibrillation. 146.50(6g)(a)(a) Except as provided in
ss. 146.51 and
146.52, the department shall certify qualified applicants for the performance of defibrillation, under certification standards that the department shall promulgate as rules.
146.50(6g)(b)
(b) A certificate issued under this subsection shall specify whether the holder of the certificate is authorized to perform defibrillation by use of any of the following:
146.50(6n)
(6n) Authorized actions of emergency medical technicians. An emergency medical technician may undertake only those actions that are authorized in rules promulgated under
sub. (13) (c).
146.50(7)
(7) Licensing in other jurisdictions. Except as provided in
ss. 146.51 and
146.52, the department may issue a license as an emergency medical technician, without examination, to any individual who holds a current license or certificate as an emergency medical technician from another jurisdiction if the department finds that the standards for licensing or issuing certificates in the other jurisdiction are at least substantially equivalent to those in this state, and that the applicant is otherwise qualified.
146.50(8)
(8) Certification of first responders. 146.50(8)(a)(a) Except as provided in
ss. 146.51 and
146.52, the department shall certify qualified applicants as first responders.
146.50(8)(b)
(b) To be eligible for initial certification as a first responder, except as provided in
ss. 146.51 and
146.52, an individual shall meet all of the following requirements:
146.50(8)(b)1.
1. The individual is 18 years of age or older and capable of performing the actions authorized under
par. (e), or in rules promulgated under
par. (e), for a first responder.
146.50(8)(b)3.
3. The individual satisfactorily completes a first responder course that meets or exceeds the guidelines issued by the National Highway Traffic Safety Administration under
23 CFR 1205.3 (a) (5), that includes training for response to acts of terrorism, and that is approved by the department.
146.50(8)(c)
(c) To be eligible for a renewal of a certificate as a first responder, except as provided in
ss. 146.51 and
146.52, the holder of the certificate shall satisfactorily complete a first responder refresher course that meets or exceeds the guidelines issued by the National Highway Traffic Safety Administration under
23 CFR 1205.3 (a) (5), that includes training for response to acts of terrorism, and that is approved by the department.
146.50(8)(d)
(d) The department may not charge a fee for a certificate initially issued or renewed under this subsection.
146.50(8)(e)
(e) A certified first responder is authorized to use an automatic or semiautomatic defibrillator, as prescribed for first responders in rules promulgated by the department. The rules shall set forth authorization for the use of an automatic defibrillator, a semiautomatic defibrillator or, for a defibrillator that may be operated in more than one mode, use in the automatic or semiautomatic mode only. A certified first responder is also authorized to employ other techniques, including the administration of nonvisualized advanced airways, and the administration of medications that are specified by the department by rule. In promulgating the rules under this paragraph, the department shall consult with the state medical director for emergency medical services and the emergency medical services board. The rule shall include those techniques that are specified in the most current guidelines issued by the National Highway Traffic Safety Administration under
23 CFR 1205.3 (a) (5).
146.50(8)(f)
(f) Except as provided in
ss. 146.51 and
146.52, the department may issue a certificate as a first responder, without requiring satisfactory completion of any instruction or training that may be required under
par. (b), to any individual who holds a current license or certificate as a first responder from another jurisdiction if the department finds that the standards for licensing or issuing certificates in the other jurisdiction are at least substantially equivalent to the standards for issuance of certificates for first responders in this state, and that the applicant is otherwise qualified.
146.50(8)(g)
(g) The department may not impose a requirement that an individual be affiliated with an ambulance service provider in order to receive a first responder certificate.
146.50(8g)
(8g) Special use of semiautomatic defibrillators. 146.50(8g)(a)1.
1. "Cardiac arrest" means the sudden cessation of cardiac function and the disappearance of arterial blood pressure that connote ventricular fibrillation or pulseless ventricular tachycardia.
146.50(8g)(a)2.
2. "Pulseless ventricular tachycardia" means a disturbance in the normal rhythm of the heart that is characterized by rapid electrical activity of the heart with no cardiac output.
146.50(8g)(b)
(b) Notwithstanding
subs. (6g) (b) and
(8) (e), a person other than an emergency medical technician or a first responder - defibrillation may use a semiautomatic defibrillator in rendering emergency care or treatment to an individual who appears to be in cardiac arrest if the person has received training in a course that is approved by the department under
par. (d).
146.50(8g)(c)
(c) A person who provides a semiautomatic defibrillator for use under
par. (b) shall do all of the following:
146.50(8g)(c)1.
1. Provide written notification to the nearest emergency medical services program under
s. 146.55 (2). The notification shall include information as to the type of the semiautomatic defibrillator, the location of the defibrillator on the premises of the person, the intended usage area for the defibrillator and the owner of the defibrillator.
146.50(8g)(c)2.
2. Ensure that the semiautomatic defibrillator is maintained and tested in accordance with any operational guidelines of the manufacturer.
146.50(8g)(d)
(d) The department shall review training courses for the use of a semiautomatic defibrillator under this subsection and may approve those training courses that satisfy standards for approval that are specified by the department.
146.50(8m)
(8m) Qualifications for medical directors. The department shall promulgate rules that set forth qualifications for medical directors. Beginning on July 1, 1995, no ambulance service provider that offers services beyond basic life support services may employ, contract with or use the services of a physician to act as a medical director unless the physician is qualified under this subsection.
146.50(9)
(9) Training. The department may arrange for or approve courses of or instructional programs in or outside this state to meet the education and training requirements of this section, including training required for license or certificate renewal. Courses required for a license or renewal of a license as an emergency medical technician - basic shall be free of charge to an individual who is employed by or affiliated with a public agency, volunteer fire company or nonprofit corporation and is the holder of a license or training permit as an emergency medical technician - basic or eligible to hold such a license or training permit. If the department determines that an area or community need exists, the courses shall be offered at technical colleges in the area or community. Initial priority shall be given to the training of emergency medical technicians – basic serving the rural areas of the state. If an emergency medical technician - basic completes a course approved by the department on treatment of anaphylactic shock, the emergency medical technician – basic acts within the scope of the license if he or she performs injections or other treatment for anaphylactic shock under the direction of a physician.
146.50(10)
(10) License renewal. Every holder of a license issued under
sub. (5) or
(7) shall renew the license on July 1 of each even-numbered year by applying to the department on forms provided by the department. Upon receipt of an application for renewal containing documentation acceptable to the department that the requirements of
sub. (6) have been met, the department shall renew the license unless the department finds that the applicant has acted in a manner or under circumstances constituting grounds for suspension or revocation of the license.
146.50(11)
(11) Unlicensed or uncertified operation. Notwithstanding the existence or pursuit of any other remedy, the department may, in the manner provided by law, upon the advice of the attorney general, who shall represent the department in all proceedings, institute an action in the name of the state against any person for any of the following:
146.50(11)(a)
(a) To restrain or prevent action as an ambulance service provider by a person in violation of
sub. (2).
146.50(11)(b)
(b) To restrain or prevent action by an ambulance service provider in violation of this section or a rule promulgated under this section.
146.50(11)(c)
(c) To restrain or prevent action as an emergency medical technician by an individual in violation of
sub. (2).
