DHS 110.34(12) (12) Maintain a communication system that allows communication between medical control and EMS professionals and complies with the Wisconsin Emergency Medical Services Plan.

DHS 110.34(13) (13) Designate and maintain affiliation with a training center to provide required training.

DHS 110.34(14) (14) Maintain a quality assurance program that provides continuing education and assures continuing competency of EMS professionals.

DHS 110.34(15) (15) If the emergency medical services provider is an ambulance service provider, maintain at least one ambulance vehicle in good operating condition as required under ch. Trans 309.

DHS 110.34(16) (16) Refuse to respond to an interfacility transport request by a hospital for an emergency transfer that is dispatched through a 9-1-1 center, if not licensed to provide interfacility transports.

DHS 110.34 Note Note: Data system guidelines can be found on the department’s website at www.dhs.wisconsin.gov/ems.

DHS 110.34 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11; CR 20-028: am. (intro.), (2), (3), (5), (7) to (9), cr. (9m), am. (12), (14) Register September 2021 No. 789, eff. 10-1-21.

DHS 110.35 DHS 110.35 License and application requirements. To apply for a license as an ambulance service provider, a non-transporting emergency medical service provider, or an emergency medical responder service provider, a person shall do all of the following:

DHS 110.35(1) (1) Feasibility study. Complete a feasibility study and submit it to the department for approval. First responder service providers are not required to do a feasibility study.

DHS 110.35(2) (2) Application and operational plan. Upon the department’s approval of the feasibility study required under sub. (1), complete and submit an application and an operational plan to the department in the manner specified by the department. The operational plan and its addendums shall include all of the following:

DHS 110.35(2)(a) (a) Signed patient care protocols approved by the service medical director.

DHS 110.35(2)(b) (b) A formulary list of medications the emergency medical service provider will use.

DHS 110.35(2)(c) (c) A list of the advanced skills and procedures the applicant intends to use to provide services within the Wisconsin scope of practice of the level of care for which licensure is sought.

DHS 110.35(2)(d) (d) Proof of professional liability or medical malpractice insurance, and, if the emergency medical service provider is an ambulance service provider, proof of vehicle insurance.

DHS 110.35(2)(e) (e) Operational policies for all of the following:

DHS 110.35(2)(e)1. 1. Response cancellation, describing how the emergency medical service provider will handle a cancellation of a response while en route to the scene.

DHS 110.35(2)(e)2. 2. Use of lights and sirens in responding to a call.

DHS 110.35(2)(e)3. 3. Dispatch and response, describing how EMS professionals are dispatched and how the emergency medical service provider acknowledges to the dispatcher that it is responding.

DHS 110.35(2)(e)4. 4. Refusal of care, describing the procedure for accepting a refusal of care from a patient.

DHS 110.35(2)(e)5. 5. Destination determination, describing how the transport destination of the patient is determined if the provider is an ambulance service provider.

DHS 110.35(2)(e)6. 6. Emergency vehicle operation and driver safety training.

DHS 110.35(2)(e)7. 7. Controlled substances and how the service provider will obtain, store, secure, exchange, and account for any and all controlled substances used to provide patient care.

DHS 110.35(2)(e)8. 8. Continuous quality assurance and improvement program describing the components of the program, including how patient care and documentation will be reviewed, by whom, and how the results will be shared with practitioners and incorporated into continuing education.

DHS 110.35(2)(e)9. 9. Multiple patient incidents describing how the service will handle the response to the incident including triage, care, transportation and patient tracking.

DHS 110.35(2)(f) (f) Written letters or other documentation of endorsement from the local hospital and government within the proposed primary service area, if the application is for licensure as a 9-1-1 ambulance service provider or non-transporting emergency medical service provider, whether the application is for initial licensure or a service level upgrade.

DHS 110.35(2)(g) (g) When a service provider is required to submit an update to its operational plan, the update to the operational plan must be submitted on the form or in the manner approved by the department indicating:

DHS 110.35(2)(g)1. 1. The section of the operational plan being updated or revised.

DHS 110.35(2)(g)2. 2. Description detailing the change and intended impact on the service.

DHS 110.35(2)(g)3. 3. Approval of the update or revision by the service director and when involving patient care or patient care equipment, the service medical director.