256.12(2)(b)5.
5. Assist hospitals in planning for appropriate and efficient handling of the critically ill and injured.
256.12(2m)
(2m) State medical director for emergency medical services program. 256.12(2m)(a)(a) The department shall contract with a physician to direct the state emergency medical services program. The department may expend from the funding under the federal preventive health services project grant program under
42 USC 2476 under the appropriation account under
s. 20.435 (1) (mc), $25,000 in each fiscal year for this purpose.
256.12(2m)(b)
(b) The physician under
par. (a) shall be called the state medical director for the emergency medical services program, shall have at least 3 years of experience in the conduct and delivery of prehospital emergency medical services as a physician practicing emergency or prehospital medicine in a hospital or agency and shall have actively participated in and had major responsibility for the development, management, execution and coordination of programs, policies and procedures in the delivery of emergency medical services.
256.12(4)
(4) Support and improvement of ambulance services. 256.12(4)(a)(a) From the appropriation account under
s. 20.435 (1) (ch), the department shall annually distribute funds for ambulance service vehicles or vehicle equipment, emergency medical services supplies or equipment or emergency medical training for personnel to an ambulance service provider that is a public agency, a volunteer fire department or a nonprofit corporation, under a funding formula consisting of an identical base amount for each ambulance service provider plus a supplemental amount based on the population of the ambulance service provider's primary service or contract area, as established under
s. 256.15 (5).
256.12(4)(b)
(b) If a public agency has contracted for ambulance service with an ambulance service provider that operates for profit, the department shall distribute funds under
par. (a) to the public agency.
256.12(4)(c)
(c) Funds distributed under
par. (a) or
(b) shall supplement existing, budgeted moneys of or provided to an ambulance service provider and may not be used to replace, decrease or release for alternative purposes the existing, budgeted moneys of or provided to the ambulance service provider. In order to ensure compliance with this paragraph, the department shall require, as a condition of relicensure, a financial report of expenditures under this subsection from an ambulance service provider and may require a financial report of expenditures under this subsection from an owner or operator of an ambulance service or a public agency, volunteer fire department or a nonprofit corporation with which an ambulance service provider has contracted to provide ambulance services.
256.12(5)
(5) Emergency medical technician training and examination aid. 256.12(5)(a)(a) From the appropriation account under
s. 20.435 (1) (ch), the department shall annually distribute funds to ambulance service providers that are public agencies, volunteer fire departments, or nonprofit corporations to purchase the training required for licensure and renewal of licensure as an emergency medical technician — basic under
s. 256.15 (6), and to pay for administration of the examination required for licensure or renewal of licensure as an emergency medical technician — basic under
s. 256.15 (6) (a) 3. and
(b) 1.
256.12(5)(b)
(b) The department shall require as a condition of relicensure that an ambulance service provider submit to the department a financial report on the expenditure of funds received under
par. (a).
256.12(6)(b)
(b) 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 to restrain or prevent the establishment, management or operation of any emergency medical services program that is not approved under
sub. (2) (a) or that is in violation of this section or a rule promulgated under this section.
256.12(7)
(7) Insurance. A physician who participates in an emergency medical services program under this section or as required under
s. 256.15 shall purchase health care liability insurance in compliance with
subch. III of ch. 655, except for those acts or omissions of a physician who, as a medical director, reviews the performance of emergency medical technicians or ambulance service providers, as specified under
s. 146.37 (1g).
256.12(8)
(8) 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.
256.12 History
History: 1989 a. 102 ss.
15 to
17,
23,
25,
26,
60;
1991 a. 39,
269;
1993 a. 16,
251,
399,
491;
1997 a. 27,
79;
2001 a. 16,
109;
2005 a. 25;
2007 a. 130 ss.
130,
131,
137 to
149; Stats. 2007 s. 256.12;
2009 a. 28.
256.13
256.13
Cardiocerebral resuscitation. Any person who offers certification in cardiopulmonary resuscitation shall provide the written information on cardiocerebral resuscitation that is prepared by the emergency medical services board under
s. 256.04 (9) to each individual to whom the person provides instruction in cardiopulmonary resuscitation.
256.13 History
History: 2007 a. 104;
2009 a. 180 s.
124; Stats. 2009 s. 256.13.
256.15
256.15
Emergency medical services personnel; licensure; certification; training. 256.15(1)(ag)
(ag) “Act of terrorism" means a felony under
ch. 939 to
951 that is committed with intent to terrorize and is committed under any of the following circumstances:
256.15(1)(ag)1.
1. The person committing the felony causes bodily harm, great bodily harm, or death to another.
256.15(1)(ag)2.
2. The person committing the felony causes damage to the property of another and the total property damaged is reduced in value by $25,000 or more. For purposes of this subdivision, property is reduced in value by the amount that it would cost either to repair or replace it, whichever is less.
256.15(1)(ag)3.
3. The person committing the felony uses force or violence or the threat of force or violence.
256.15(1)(cr)
(cr) “Automated external defibrillator" means a defibrillator device to which all of the following apply:
256.15(1)(cr)1.
1. It is approved for commercial distribution by the federal food and drug administration.
256.15(1)(cr)2.
2. It is capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia and of determining without intervention by the user of the device whether defibrillation should be performed.
256.15(1)(cr)3.
3. After having determined that defibrillation should be performed, it is capable, either at the command of an operator or without intervention by an operator, of delivering an electrical shock to an individual.
256.15(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.
256.15(1)(dm)
(dm) “Defibrillation" means administering an electrical impulse to an individual's heart in order to stop ventricular fibrillation or rapid ventricular tachycardia.
256.15(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.
256.15(1)(i)
(i) “Indian tribe" means a federally recognized American Indian tribe or band in this state.
256.15(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.
256.15(1)(im)
(im) “Manual defibrillator" means a heart monitor and defibrillator that:
256.15(1)(im)1.
1. Is operated only after an operator has first analyzed and recognized an individual's cardiac rhythm;
256.15(1)(im)2.
2. Charges and delivers, only at the command of the operator, an electrical impulse to an individual's heart; and
256.15(1)(im)3.
3. In the case of a defibrillator that may be operated as a manual defibrillator or as an automated external defibrillator, is set to operate as a manual defibrillator.
256.15(1)(iw)
(iw) “Mutual aid" means emergency medical care provided in another service area when the primary ambulance service provider in that area requires additional resources because it has already committed all its resources to other emergency responses.
256.15(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.
256.15(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.
256.15(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.
256.15(2)
(2) License or certificate required; exceptions. 256.15(2)(a)(a) Except when acting under
s. 257.03 and except as provided in
pars. (b) and
(c), 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. Except when acting under
s. 257.03 and except as provided in
pars. (b) and
(c), 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). Except when acting under
s. 257.03 and except as provided in
pars. (b) and
(c), 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).
256.15(2)(b)
(b) An ambulance service provider licensed in another state that makes 10 or fewer patient transports per year that originate and terminate within this state is not required to hold an ambulance service provider license under this section. An emergency medical technician licensed in or holding a training permit in another state who is involved in 10 or fewer patient transports per year that originate and terminate within this state is not required to hold an emergency medical technician license or training permit under this section. A first responder certified in another state who provides emergency medical care to 10 or fewer patients per year within this state is not required to hold a first responder certificate under this section.
256.15(2)(c)
(c) Notwithstanding
par. (a), a person may act as an ambulance service provider, emergency medical technician, or first responder without a license, training permit, or certificate described under
par. (a) if all of the following apply:
256.15(2)(c)1.
1. The person holds a valid license, training permit, certificate, or other credential allowing the person to act as an ambulance service provider, emergency medical technician, or first responder in another state.
256.15(2)(c)2.
2. The person is acting in response to a request for mutual aid and responding from the state in which that person holds a license, training permit, certificate, or other credential allowing the person to act as an ambulance service provider, emergency medical technician, or first responder.
256.15(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.
256.15(4)
(4) Ambulance staffing; limitations; rules. 256.15(4)(a)(a) If a sick, disabled or injured individual is transported by ambulance, any of the following combinations of other individuals shall be present in the ambulance:
256.15(4)(a)1.
1. Any 2 emergency medical technicians, licensed registered nurses, licensed physician assistants or physicians, or any combination thereof.
256.15(4)(a)2.
2. One emergency medical technician plus one individual with a training permit issued under
sub. (5) (b) or plus one first responder, subject to
par. (e).
256.15(4)(a)3.
3. If the ambulance is a fixed-wing airplane and the sick, disabled, or injured individual is a pediatric patient who is being transferred from one hospital to another hospital, one individual specified in
subd. 1. plus one respiratory care practitioner certified under
subch. II of ch. 448.
256.15(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.
256.15(4)(c)
(c) Notwithstanding
par. (a) 1. and
2. and subject to
pars. (d) and
(e), 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.
256.15(4)(d)
(d) If an ambulance service provider that was initially licensed at the paramedic level in 1993 and is located in a municipality in Dodge and Jefferson counties has dispatched an ambulance containing 2 emergency medical technicians — paramedics, the department shall allow that ambulance service provider to staff an ambulance at the paramedic level for a subsequent call with one emergency medical technician — paramedic and one emergency medical technician of any level while the first ambulance containing 2 emergency medical technicians — paramedics is occupied providing service.
256.15(4)(e)1.1. The department shall allow an ambulance service provider providing services at the emergency medical technician — basic level to staff an ambulance with at least one emergency medical technician — basic and one individual who is an emergency medical technician — basic, an individual with an emergency medical technician — basic training permit, or a first responder. An ambulance service provider providing services at the emergency medical technician — basic level shall require an emergency medical technician — basic to be in the patient compartment of the ambulance during transport.
256.15(4)(e)2.
2. The department shall allow an ambulance service provider providing services at the emergency medical technician — intermediate or emergency medical technician — intermediate technician level to staff an ambulance with one emergency medical technician at the level of the ambulance service and one individual who holds a credential at the first responder level or higher. An ambulance service provider providing services at the emergency medical technician — intermediate or emergency medical technician — intermediate technician level shall require the individual who holds the same level credential as the ambulance service to remain with the patient at all times during care and transport of the patient, if the patient requires that level of care.
256.15(4)(e)3.
3. This paragraph applies to ambulance service providers for which the population of the largest single municipality, as defined in
s. 5.02 (11), in the ambulance service provider's service area is less than 10,000 and to ambulance service providers with a staffing waiver under
par. (f). This paragraph does not apply to ambulance service providers for which the population of the largest single municipality, as defined in
s. 5.02 (11), in the ambulance service provider's service area is more than 20,000.
256.15(4)(f)1.1. An ambulance service provider for which the population of the largest single municipality, as defined in
s. 5.02 (11), in the ambulance service provider's service area is 10,000 or more but not more than 20,000 may apply to the department for a waiver of any existing staffing plan in order to staff an ambulance with the personnel described in
par. (e).
256.15(4)(f)2.
2. The department may approve a waiver under
subd. 1. for an ambulance service provider that demonstrates all of the following:
256.15(4)(f)2.a.
a. The ambulance service provider has undertaken efforts to recruit and train emergency medical technicians capable of being licensed under this section.
256.15(4)(f)2.b.
b. Despite efforts under
subd. 2. a., licensed emergency medical technicians are not available in sufficient numbers for staffing for the ambulance services provider.
256.15(4)(f)2.c.
c. Without a waiver under
subd. 1., the municipality that the ambulance service provider serves is unable to meet staffing requirements for ambulances that require 2 emergency medical technicians on every service call.
256.15(4)(f)3.
3. The department shall provide a written staffing waiver to any ambulance service provider it approves under
subd. 2.
256.15(4)(f)4.
4. A waiver under
subd. 1. is valid for 48 months after the date of issuance, and an ambulance service provider may apply to renew the waiver.
256.15(4)(f)5.
5. An ambulance service provider with a waiver under
subd. 1. shall attempt to staff an ambulance with 2 licensed emergency medical technicians whenever possible.
256.15(5)
(5) Licensing of ambulance service providers and emergency medical technicians; training permits. 256.15(5)(a)(a) Except as provided in
ss. 256.17 and
256.18, 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.
256.15(5)(b)
(b) The department shall promulgate rules establishing a system and qualifications for issuance of training permits, except as provided in
ss. 256.17 and
256.18, and specifying the period for which an individual may hold a training permit. The department shall consider any relevant education, training, instruction, or other experience that an applicant for a training permit has obtained in connection with any military service, as defined in
s. 111.32 (12g) to count toward satisfying the education or training qualifications for issuance of training permits, if the applicant demonstrates to the satisfaction of the department that the education, training, instruction, or other experience obtained by the applicant is substantially equivalent to the education or training qualifications required for the training permit.
256.15(5)(c)
(c) A training permit application shall be signed by an ambulance service provider.
256.15(5)(d)
(d) An individual who holds a training permit issued under
par. (b) may do the following:
256.15(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.
256.15(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.
256.15(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.
256.15(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.
256.15(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, and no fee may be charged to an individual who is eligible for the veterans fee waiver program under
s. 45.44.
256.15(5)(g)
(g) Except as provided in
ss. 256.17 and
256.18, 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.
256.15(6)(a)(a) Except as provided in
ss. 256.17 and
256.18, to be eligible for an initial license as an emergency medical technician, an individual shall:
256.15(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.
256.15(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. The department shall consider as satisfactory evidence of education and training in the field of emergency care any relevant education, training, instruction, or other experience that an applicant for an initial license obtained in connection with any military service, as defined in
s. 111.32 (12g), if the applicant demonstrates to the satisfaction of the department that the education, training, instruction, or other experience obtained by the applicant is substantially equivalent to the course of instruction and training required under this subdivision.
256.15(6)(a)3.
3. Have passed an examination approved by the department.
256.15(6)(a)4.
4. Have such additional qualifications as may be required by the department.
256.15(6)(b)1.1. Except as provided in
ss. 256.17 and
256.18, 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.
