Chapter 256

256.23 256.23 Ambulance service provider fee.

256.23(1) (1) In this section:

256.23(1)(a) (a) “Eligible ambulance service provider” means any privately owned ambulance service provider. “Eligible ambulance service provider” does not include any ambulance service provider that is owned by any municipality or group of municipalities regardless of whether or not the ambulance service provider is organized as a nonprofit corporation.

256.23(1)(b) (b) “Emergency ambulance transport” means all of the following:

256.23(1)(b)1. 1. Each ground emergency ambulance transport that requires the delivery of life support services, including basic life support or advanced life support, by an emergency medical responder or emergency medical services practitioner at any practice level.

256.23(1)(b)2. 2. Any other ambulance transport that is designated by the department to be subject to the fee under sub. (2).

256.23(2) (2) For the privilege of doing business in this state, there is imposed on each eligible ambulance service provider a fee that is equal to a uniform percentage, as determined under sub. (3), of the eligible ambulance service provider’s net patient revenues from emergency ambulance transports. Except as provided in sub. (4), each eligible ambulance service provider shall pay the fee under this subsection in a manner determined by the department acting in collaboration with the Professional Ambulance Association of Wisconsin, or its successor organization, no more frequently than quarterly. An eligible ambulance service provider cannot increase rates it charges for its services because of the imposition of the fee under this subsection.

256.23(3) (3) The department shall establish the uniform percentage of the eligible ambulance service provider’s net patient revenues so that the total amount of fees collected from an eligible ambulance service provider under sub. (2) in a state fiscal year is an amount not less than one quarter of 1 percent lower than the maximum limit for a provider fee under 42 CFR 433.68 (f) but does not exceed the maximum limit.

256.23(4) (4) The department may allow an eligible ambulance service provider that is unable to make a payment of the fee by the date specified under sub. (2) to make a delayed payment.

256.23(5) (5) In accordance with s. 20.940, the department shall submit to the federal department of health and human services a request for any state plan amendment, waiver or other approval that is required to implement this section and s. 49.45 (3) (em). If federal approval is required, the department may not implement the collection of the fee under sub. (2) until it receives approval from the federal government to obtain federal matching funds.

256.23(6) (6) In each fiscal year, the secretary of administration shall transfer from the ambulance service provider trust fund under s. 25.776 to the appropriation under s. 20.435 (4) (jw) an amount equal to the annual costs of administering the ambulance assessment as specified under this section and making supplemental reimbursements to ambulance service providers under s. 49.45 (3) (em).

256.23 History History: 2021 a. 228; 2023 a. 30.

256.25 256.25 Statewide trauma care system.

256.25(1g) (1g) In this section, “performance improvement” means a method of evaluating and improving processes of trauma patient care that emphasizes a multidisciplinary approach to problem solving.

256.25(1r) (1r) The department shall develop and implement a statewide trauma care system. The department shall seek the advice of the statewide trauma advisory council under s. 15.197 (25) in developing and implementing the system, and, as part of the system, shall develop regional trauma advisory councils.

256.25(2) (2) The department shall promulgate rules to develop and implement the system. The rules shall include a method by which to classify all hospitals as to their respective emergency care capabilities. The classification rule shall be based on standards developed by the American College of Surgeons. Within 180 days after promulgation of the classification rule, and every 3 years thereafter, each hospital shall certify to the department the classification level of trauma care services that is provided by the hospital, based on the rule. The department may require a hospital to document the basis for its certification. The department may not direct a hospital to establish a certain level of certification. Confidential injury data that is collected under this subsection shall be used for confidential review relating to performance improvements in the trauma care system, and may be used for no other purpose.

256.25(3) (3) Except as provided in sub. (4), all information and documents provided by a hospital under sub. (2) and all information and documents procured by or furnished to the department, the statewide trauma advisory council, or regional trauma advisory councils with respect to performance improvement activities, certifications by hospitals under sub. (2), and documentation of the bases for hospitals’ certifications under sub. (2) are immune from discovery under ch. 804, confidential, and privileged and may not be used or admitted into evidence in a civil action. With respect to a communication made by a staff member of the department or by an individual serving on the statewide trauma advisory council or a regional trauma advisory council, and to a finding or recommendation made under this section by the department, the statewide trauma advisory council, or a regional trauma advisory council, all of the following apply:

256.25(3)(a) (a) The staff member or individual may not be examined in an action for civil damages with respect to the communication, finding, or recommendation.

256.25(3)(b) (b) The staff member or individual has immunity from civil liability, with respect to the communication, finding, or recommendation, for any of the following:

256.25(3)(b)1. 1. An action taken or omitted by the staff member or individual in an official capacity.

256.25(3)(b)2. 2. A statement made in good faith by the staff member or individual in an official capacity.

256.25(4) (4) Subsection (3) does not apply to the release of information and documents specified in sub. (3) created apart from a performance improvement activity or apart from a certification by a hospital under sub. (2) that are maintained by or for a hospital, the department, the statewide trauma advisory council, or a regional trauma advisory council for the particular purpose of diagnosing, treating, or documenting care provided to a particular patient or for another purpose, upon a showing by clear and convincing evidence that the information or documents are otherwise unavailable.

256.25(5) (5) This section does not apply to s. 146.38.

256.25 History History: 1997 a. 154; 1999 a. 9; 2001 a. 16, 109; 2005 a. 315; 2007 a. 130 s. 150; Stats. 2007 s. 256.25.

256.25 Cross-reference Cross-reference: See also ch. DHS 118, Wis. adm. code.

256.30 256.30 Refusal or delay of emergency service.

256.30(1) (1) In this section “hospital providing emergency services” means a hospital which the department has identified as providing some category of emergency service.

256.30(2) (2) No hospital providing emergency services may refuse emergency treatment to any sick or injured person.

256.30(3) (3) No hospital providing emergency services may delay emergency treatment to a sick or injured person until credit checks, financial information forms or promissory notes have been initiated, completed or signed if, in the opinion of one of the following, who is an employee, agent or staff member of the hospital, the delay is likely to cause increased medical complications, permanent disability or death:

256.30(3)(a) (a) A physician, registered nurse, or paramedic.

256.30(3)(b) (b) A licensed practical nurse under the specific direction of a physician or registered nurse.

256.30(3)(c) (c) A physician assistant or any other person under the specific direction of a physician.

256.30(3m) (3m) Hospitals shall establish written procedures to be followed by emergency services personnel in carrying out sub. (3).

256.30(4) (4) No hospital may be expected to provide emergency services beyond its capabilities as identified by the department.

256.30(5) (5) Each hospital providing emergency services shall create a plan for referrals of emergency patients when the hospital cannot provide treatment for such patients.

256.30(6) (6) The department shall identify the emergency services capabilities of all hospitals in this state and shall prepare a list of such services. The list shall be updated annually.

256.30(7) (7) A hospital which violates this section may be fined not more than $1,000 for each offense.

256.30 History History: 1977 c. 361; 1983 a. 273 s. 8; 1989 a. 102; 1993 a. 105; 2007 a. 130 s. 43; Stats. 2007 s. 256.30; 2017 a. 12.

256.35 256.35 Statewide emergency services number.

256.35(1) (1) Definitions. In this section:

256.35(1)(a) (a) “Automatic location identification” means a system which has the ability to automatically identify the address of the telephone being used by the caller and to provide a display at the central location of a sophisticated system.

256.35(1)(b) (b) “Automatic number identification” means a system which has the ability to automatically identify the caller’s telephone number and to provide a display at the central location of a sophisticated system.

256.35(1)(c) (c) “Basic system” means a telecommunications system which automatically connects a person dialing the digits “911” to a public safety answering point.

256.35(1)(cm) (cm) “Commercial mobile radio service provider” has the meaning given in s. 196.01 (2g).

256.35(1)(d) (d) “Department” means the department of military affairs.

256.35(1)(e) (e) “Direct dispatch method” means a telecommunications system providing for the dispatch of an appropriate emergency service vehicle upon receipt of a telephone request for such service.

256.35(1)(em) (em) “Emergency number system” means any basic system, sophisticated system, or Next Generation 911, as defined in sub. (3s) (a) 3., regardless of technology platform.

256.35(1)(es) (es) “Originating service provider” means an entity that provides a service that may be used to generate a request for emergency assistance and that may connect to an emergency number system.

256.35(1)(f) (f) “Public agency” means any municipality as defined in s. 345.05 (1) (c) or any state agency which provides or is authorized by statute to provide fire fighting, law enforcement, ambulance, medical or other emergency services.

256.35(1)(g) (g) “Public safety agency” means a functional division of a public agency which provides fire fighting, law enforcement, medical or other emergency services.

256.35(1)(gm) (gm) “Public safety answering point” means a facility to which a call on an emergency number system is initially routed for response, and on which a public agency directly dispatches the appropriate emergency service provider, relays a message to the appropriate emergency service provider or transfers the call to the appropriate emergency services provider.

256.35(1)(h) (h) “Relay method” means a telecommunications system whereby a request for emergency services is received and relayed to a provider of emergency services by telephone.

256.35(1)(i) (i) “Sophisticated system” means a basic system with automatic location identification and automatic number identification.

256.35(1)(k) (k) “Transfer method” means a telecommunications system which receives telephone requests for emergency services and transfers such requests directly to an appropriate public safety agency or other provider of emergency services.

256.35(2) (2) Emergency phone system.

256.35(2)(a) (a) Every public agency may establish and maintain within its respective jurisdiction a basic or sophisticated system under this section. Such a system shall be in a central location.

256.35(2)(b) (b) Every basic or sophisticated system established under this section shall be capable of transmitting requests for law enforcement, fire fighting and emergency medical and ambulance services to the public safety agencies providing such services. Such system may provide for transmittal of requests for poison control to the appropriate regional poison control center under s. 255.35, suicide prevention and civil defense services and may be capable of transmitting requests to ambulance services provided by private corporations. If any agency of the state which provides law enforcement, fire fighting, emergency medical or ambulance services is located within the boundaries of a basic or sophisticated system established under this section, such system shall be capable of transmitting requests for the services of such agency to the agency.

256.35(2)(c) (c) The digits “911” shall be the primary emergency telephone number within every basic or sophisticated system established under this section. A public agency or public safety agency located within the boundaries of a basic or sophisticated system established under this section shall maintain a separate 7-digit phone number for nonemergency telephone calls. Every such agency may maintain separate secondary 7-digit back-up numbers.

256.35(2)(d) (d) Public agencies, including agencies with different territorial boundaries, may combine to establish a basic or sophisticated system established under this section.

256.35(2)(e) (e) If a public agency or group of public agencies combined to establish an emergency phone system under par. (d) has a population of 250,000 or more, such agency or group of agencies shall establish a sophisticated system.

256.35(2)(f) (f) Every basic or sophisticated system established under this section shall utilize the direct dispatch method, the relay method or the transfer method.

256.35(2)(g) (g) Every telecommunications utility providing coin-operated telephones for public use within the boundaries of a basic or sophisticated system established under this section shall convert, by December 31, 1987, all such telephones to telephones which enable a user to reach “911” without inserting a coin. Any coin-operated telephone installed by a telecommunications utility after December 31, 1987, in an agency which has established an emergency phone system under this section shall enable a user to reach “911” without inserting a coin.

256.35(2)(h) (h) A commercial mobile radio service provider shall permit a user of the provider to access a basic or sophisticated system if the provider operates within the boundaries of a system.

256.35(2)(i) (i) If a user reaches a basic or sophisticated system through a commercial mobile radio service provider and the service requested is to be provided outside of the jurisdiction served by the system, the public agency operating the system shall transfer the request for services to the appropriate jurisdiction.

256.35(2m) (2m) Dispatcher assisted bystander cardiopulmonary resuscitation.

256.35(2m)(a) (a) In this subsection, “department” means the department of health services.

256.35(2m)(b) (b) Beginning on May 1, 2021, every public safety answering point shall, in appropriate circumstances, provide telephonic assistance on administering cardiopulmonary resuscitation by doing any of the following:

256.35(2m)(b)1. 1. Providing each dispatcher with training in cardiopulmonary resuscitation that includes all of the following:

256.35(2m)(b)1.a. a. Certification in cardiopulmonary resuscitation.

256.35(2m)(b)1.b. b. Use of an evidence-based protocol or script for providing cardiopulmonary resuscitation instruction recommended by an academic institution or a nationally recognized organization specializing in medical dispatch.

256.35(2m)(b)1.c. c. Appropriate continuing education, as determined by the department.

256.35(2m)(b)2. 2. Transferring callers to a dedicated telephone line, a telephone center, or another public safety answering point to provide the caller with assistance on administering cardiopulmonary resuscitation. If a public safety answering point transfers callers under this subdivision, the transferring public service answering point shall do all of the following:

256.35(2m)(b)2.a. a. Use an evidence-based protocol for the identification of a person in need of cardiopulmonary resuscitation.

256.35(2m)(b)2.b. b. Provide appropriate training and continuing education, as determined by the department, on the protocol for identification of a person in need of cardiopulmonary resuscitation.

256.35(2m)(b)2.c. c. Ensure that any dedicated telephone line, a telephone center, or public safety answering point to which calls are transferred under this subdivision uses dispatchers that meet the training requirements under subd. 1. to provide assistance on administering cardiopulmonary resuscitation.

256.35(2m)(c) (c) Beginning on May 1, 2021, every public safety answering point shall conduct ongoing quality assurance of its dispatcher assisted bystander cardiopulmonary resuscitation program.

256.35(2m)(d) (d)

256.35(2m)(d)1. 1. From the appropriation under s. 20.435 (1) (cj), the department shall distribute moneys for dispatcher training on telephonic assistance on administering cardiopulmonary resuscitation, as required under par. (b).

256.35(2m)(d)1m. 1m. The department may distribute moneys under this subsection through grants, by establishing an application process for persons to submit proposals and establishing a contract with the department to provide training as described under par. (b), or through a combination of these methods.

256.35(2m)(d)2. 2. A public safety answering point is eligible to receive a grant under this paragraph if it employs one or more dispatchers that have not completed training as described under par. (b).

256.35(2m)(d)2m. 2m. A recipient of moneys received under this paragraph shall use the moneys to provide dispatchers with training in accordance with the standards under par. (b).

256.35(2m)(d)3. 3. Subject to subd. 2., the department shall establish criteria for approving and distributing moneys under subd. 1.

256.35(3) (3) Funding for countywide systems.

256.35(3)(a) (a) Definitions. In this subsection:

256.35(3)(a)1. 1. “Commission” means the public service commission.

256.35(3)(a)2. 2. “Costs” means the costs incurred by a service supplier after August 1, 1987, in installing and maintaining the trunking and central office equipment used only to operate a basic or sophisticated system and the database used only to operate a sophisticated system.

256.35(3)(a)3. 3. “Service supplier” means a telecommunications utility which provides exchange telephone service within a county.

256.35(3)(a)4. 4. “Service user” means any person who is provided telephone service by a service supplier which includes access to a basic or sophisticated system.

256.35(3)(b) (b) Charge authorized. A county by ordinance may levy a charge on all service users in the county to finance the costs related to the establishment of a basic or sophisticated system in that county under sub. (2) if: