Chapter 256

256.15(6n) (6n) Authorized actions of emergency medical services practitioners. An emergency medical services practitioner may undertake only those actions that are authorized in rules promulgated under sub. (13) (c).

256.15(6p) (6p) Delegation from a health care provider. An emergency medical services practitioner who is acting upon a delegation by a health care provider does not violate the actions authorized for emergency services under sub. (6n) for actions taken in accordance with that delegation if all of the following criteria are satisfied:

256.15(6p)(a) (a) The health care provider delegates to the emergency medical services practitioner only actions that are within the scope of the health care provider’s credential and competency.

256.15(6p)(b) (b) The health care provider ensures that the action is delegated to an emergency medical services practitioner who is adequately knowledgeable and trained to perform the delegated action.

256.15(7) (7) Licensing in other jurisdictions. Except as provided in ss. 256.17 and 256.18, the department may issue a license as an emergency medical services practitioner, without examination, to any individual who holds a current license or certificate as an emergency medical services practitioner 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.

256.15(8) (8) Certification of emergency medical responders.

256.15(8)(a) (a) Except as provided in ss. 256.17 and 256.18, the department shall certify qualified applicants as emergency medical responders.

256.15(8)(b) (b) To be eligible for initial certification as an emergency medical responder, except as provided in ss. 256.17 and 256.18, an individual shall meet all of the following requirements:

256.15(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 an emergency medical responder.

256.15(8)(b)2. 2. Subject to ss. 111.321, 111.322 and 111.335, the individual does not have an arrest or conviction record.

256.15(8)(b)3. 3. The individual satisfactorily completes an emergency medical 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. Any relevant education, training, instruction, or other experience that an applicant for initial certification as an emergency medical responder who is not affiliated with an ambulance service provider or emergency medical services program obtained in connection with any military service, as defined in s. 111.32 (12g), satisfies the completion of an emergency medical responder course, 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 emergency medical responder course.

256.15(8)(bm) (bm) The department may not require an applicant for certification as an emergency medical responder to register with or take the examination of the national registry of emergency medical technicians. An ambulance service provider or another emergency medical services program may require an emergency medical responder to register with or take the examination of the national registry of emergency medical technicians as a condition of being employed by or volunteering with the provider or program.

256.15(8)(c) (c) To be eligible for a renewal of a certificate as an emergency medical responder, except as provided in ss. 256.17 and 256.18, the holder of the certificate shall satisfactorily complete an emergency medical 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.

256.15(8)(cm) (cm) Every holder of a certificate issued under this subsection shall renew the certificate every 3 years 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 for certification have been met, the department shall renew the certificate unless the department finds that the applicant has acted in a manner or under circumstances constituting grounds for suspension or revocation of the certificate.

256.15(8)(d) (d) The department may not charge a fee for a certificate initially issued or renewed under this subsection.

256.15(8)(e) (e) A certified emergency medical responder is authorized to use an automated external defibrillator, as prescribed for emergency medical responders in rules promulgated by the department. The rules shall set forth authorization for the use of an automated external defibrillator or, for a defibrillator that may be operated in more than one mode, use as an automated external defibrillator only. A certified emergency medical responder is authorized to administer naloxone or another opioid antagonist if the emergency medical responder has received training necessary to safely administer naloxone or the other opioid antagonist, as determined by the department. A certified emergency medical 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).

256.15(8)(f) (f) Except as provided in ss. 256.17 and 256.18, the department may issue a certificate as an emergency medical 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 an emergency medical 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 emergency medical responders in this state, and that the applicant is otherwise qualified.

256.15(8)(fm) (fm) Except as provided in ss. 256.17 and 256.18, the department shall issue a certificate as an emergency medical responder, without requiring satisfactory completion of any instruction or training that may be required under par. (b), to any individual who meets the criteria under par. (b) 1. and 2. and has obtained relevant education, training, and experience in connection with military service, as defined in s. 111.32 (12g). The determination of whether an individual has obtained relevant education, training, and experience is solely within the discretion of the ambulance service provider or emergency medical services program with which the individual intends to be employed or to volunteer.

256.15(8)(g) (g) The department may not impose a requirement that an individual be affiliated with an ambulance service provider in order to receive an emergency medical responder certificate.

256.15(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.

256.15(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. 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 serving the rural areas of the state. If an emergency medical technician completes a course approved by the department on treatment of anaphylactic shock, the emergency medical technician 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.

256.15(9m) (9m) Defibrillation training. The department shall promulgate rules requiring emergency medical services practitioners, emergency medical responders, and individuals who provide instruction to emergency medical services practitioners or emergency medical responders to successfully complete training on the use of an automated external defibrillator. The rules shall specify the content of the training, qualifications for providers of the training, and the frequency with which emergency medical services practitioners, emergency medical responders, and individuals who provide instruction to emergency medical services practitioners or emergency medical responders must complete the training.

256.15(10) (10) License renewal. Every holder of a license issued under sub. (5) or (7) shall renew the license every 3 years 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.

256.15(10m) (10m) Exclusive arrangements prohibited. An ambulance service provider or emergency medical services program may not prohibit an emergency medical responder or emergency medical services practitioner who is employed by or volunteering with the ambulance service provider or emergency medical services program from being employed by or volunteering with another ambulance service provider or emergency medical services program.

256.15(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:

256.15(11)(a) (a) To restrain or prevent action as an ambulance service provider by a person in violation of sub. (2) (a).

256.15(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.

256.15(11)(c) (c) To restrain or prevent action as an emergency medical services practitioner by an individual in violation of sub. (2) (a).

256.15(11)(d) (d) To restrain or prevent action by an emergency medical services practitioner in violation of this section or a rule promulgated under this section.

256.15(11)(e) (e) To restrain or prevent the establishment, management or operation of an ambulance service in violation of sub. (4).

256.15(11)(f) (f) To restrain or prevent action by an emergency medical responder in violation of this section or a rule promulgated under this section.

256.15(12) (12) Confidentiality of records.

256.15(12)(a) (a) All records made by an ambulance service provider, an emergency medical services practitioner, or an emergency medical responder in administering emergency care procedures to and handling and transporting sick, disabled, or injured individuals shall be maintained as confidential patient health care records subject to s. 252.15 (3m), (6), (8) and (9), if applicable. Nothing in this paragraph or ss. 146.81 to 146.84 permits disclosure to an ambulance service provider, an emergency medical services practitioner, or an emergency medical responder under s. 252.15 (3m), except under s. 252.15 (3m) (e).

256.15(12)(b) (b) Notwithstanding s. 146.82, an ambulance service provider, who is an authority, as defined in s. 19.32 (1), may make available, to any requester, information contained on a record of an ambulance run which identifies the ambulance service provider and emergency medical services practitioners involved; date of the call; dispatch and response times of the ambulance; reason for the dispatch; location to which the ambulance was dispatched; destination, if any, to which the patient was transported by ambulance; and name, age and gender of the patient. No information disclosed under this paragraph may contain details of the medical history, condition, or emergency treatment of any patient.

256.15(13) (13) Rules.

256.15(13)(a) (a) The department may promulgate rules necessary for administration of this section.

256.15(13)(b) (b) The department shall promulgate rules under subs. (8) (b), (c) and (e) and (8m).

256.15(13)(c) (c) The department shall promulgate rules that specify actions that emergency medical services practitioners may undertake after December 31, 1995, including rules that specify the required involvement of physicians in actions undertaken by emergency medical services practitioners.

256.15 History History: 1973 c. 321; 1975 c. 39 ss. 645 to 647d, 732 (2); 1975 c. 224; 1977 c. 29, 167; 1979 c. 321; 1981 c. 73, 380; 1981 c. 391 s. 211; 1983 a. 189; 1985 a. 120, 135; 1987 a. 70, 399; 1989 a. 31; 1989 a. 102 ss. 20, 21, 36 to 59; 1991 a. 39, 238; 1993 a. 27, 29, 105, 183, 251, 399; 1997 a. 79, 191, 237; 1999 a. 7, 56; 2001 a. 109; 2005 a. 25, 486; 2007 a. 104; 2007 a. 130 ss. 50 to 52, 55 to 57, 63 to 66, 69, 71 to 104; Stats. 2007 s. 256.15; 2009 a. 28, 42; 2009 a. 180 s. 123; 2009 a. 209; 2011 a. 120, 209; 2013 a. 200; 2015 a. 26, 55, 83, 113; 2017 a. 12, 66, 97, 350; 2019 a. 25; 2021 a. 238 s. 45; 2023 a. 12, 176.

256.15 Cross-reference Cross-reference: See also chs. DHS 110, Wis. adm. code.

256.15 Annotation Malpractice liability of state officers and employees is discussed. 67 Atty. Gen. 145.

256.15 Annotation Under present law, ambulance records relating to medical history, condition, or treatment are confidential while other ambulance call records are subject to disclosure under the public records law. 78 Atty. Gen. 71.

256.155 256.155 First aid to domestic animals.

256.155(1) (1) Definition. In this section, “domestic animal” has the meaning given in s. 895.484 (1) (a).

256.155(2) (2) Rendering first aid allowed. An emergency medical services practitioner or emergency medical responder who, in the course of responding to a call for service, encounters a domestic animal that is sick or injured may render any first aid service to the domestic animal before the domestic animal is transferred to a veterinarian for further treatment if the service is in the scope of practice of the license or certification of that emergency medical services practitioner or emergency medical responder when applied to human beings.

256.155(3) (3) Immunity from liability.

256.155(3)(a) (a) An ambulance service provider, emergency medical services practitioner, or emergency medical responder is immune from civil or criminal liability for any outcomes resulting from an emergency medical services practitioner or an emergency medical responder rendering first aid to a domestic animal in accordance with sub. (2).

256.155(3)(b) (b) An ambulance service provider, emergency medical services practitioner, or emergency medical responder is immune from civil or criminal liability from declining to render first aid to a domestic animal.

256.155 History History: 2017 a. 166.

256.17 256.17 Denial, nonrenewal and suspension of license, training permit or certification based on certain delinquency in payment.

256.17(1) (1) Except as provided in sub. (1m), the department shall require each applicant to provide the department with the applicant’s social security number, if the applicant is an individual, as a condition of issuing or renewing any of the following:

256.17(1)(a) (a) A license under s. 256.15 (5) (a).

256.17(1)(b) (b) A training permit under s. 256.15 (5) (b).

256.17(1)(c) (c) A certification under s. 256.15 (6g) (a) or (8) (a).

256.17(1m) (1m) If an individual who applies for or to renew a license, training permit or certification under sub. (1) does not have a social security number, the individual, as a condition of obtaining the license, training permit or certification, shall submit a statement made or subscribed under oath or affirmation to the department that the applicant does not have a social security number. The form of the statement shall be prescribed by the department of children and families. A license, training permit or certification issued or renewed in reliance upon a false statement submitted under this subsection is invalid.

256.17(2) (2) The department of health services may not disclose any information received under sub. (1) to any person except to the department of children and families for the purpose of making certifications required under s. 49.857.

256.17(3) (3) The department of health services shall deny an application for the issuance or renewal of a license, training permit or certification specified in sub. (1), shall suspend a license, training permit or certification specified in sub. (1) or may, under a memorandum of understanding under s. 49.857 (2), restrict a license, training permit or certification specified in sub. (1) if the department of children and families certifies under s. 49.857 that the applicant for or holder of the license, training permit or certification is delinquent in the payment of court-ordered payments of child or family support, maintenance, birth expenses, medical expenses or other expenses related to the support of a child or former spouse or fails to comply, after appropriate notice, with a subpoena or warrant issued by the department of children and families or a county child support agency under s. 59.53 (5) and related to paternity or child support proceedings.

256.17 History History: 1997 a. 191; 1999 a. 9; 2007 a. 20 ss. 2863 to 2865, 9121 (6) (a); 2007 a. 130 ss. 105 to 110; Stats. 2007 s. 256.17.

256.17 Cross-reference Cross-reference: See also chs. DHS 110, Wis. adm. code.

256.18 256.18 Denial, nonrenewal, and revocation of license, certification, or permit based on delinquent taxes or unemployment insurance contributions.

256.18(1) (1) Except as provided in sub. (1m), the department shall require each applicant to provide the department with his or her social security number, if the applicant is an individual, or the applicant’s federal employer identification number, if the applicant is not an individual, as a condition of issuing or renewing any of the following:

256.18(1)(a) (a) A license under s. 256.15 (5) (a) or (7).

256.18(1)(b) (b) A training permit under s. 256.15 (5) (b).

256.18(1)(c) (c) A certificate under s. 256.15 (6g) (a) or (8) (a) or (f).

256.18(1m) (1m) If an individual who applies for or to renew a license, training permit or certificate under sub. (1) does not have a social security number, the individual, as a condition of obtaining the license, training permit or certificate, shall submit a statement made or subscribed under oath or affirmation to the department that the applicant does not have a social security number. The form of the statement shall be prescribed by the department of children and families. A license, training permit or certificate issued or renewed in reliance upon a false statement submitted under this subsection is invalid.

256.18(2) (2) The department may not disclose any information received under sub. (1) to any person except to the department of revenue for the sole purpose of requesting certifications under s. 73.0301 and to the department of workforce development for the sole purpose of requesting certifications under s. 108.227.

256.18(3) (3) Except as provided in sub. (1m), the department shall deny an application for the issuance or renewal of a license, certificate or permit specified in sub. (1) if the applicant does not provide the information specified in sub. (1).

256.18(4) (4) The department shall deny an application for the issuance or renewal of a license, certificate or permit specified in sub. (1) or shall revoke a license, certificate or permit specified in sub. (1), if the department of revenue certifies under s. 73.0301 that the applicant for or holder of the license, certificate or permit is liable for delinquent taxes.

256.18(4m) (4m) The department shall deny an application for the issuance or renewal of a license, certificate, or permit specified in sub. (1) or shall revoke a license, certificate, or permit specified in sub. (1), if the department of workforce development certifies under s. 108.227 that the applicant for or holder of the license, certificate, or permit is liable for delinquent unemployment insurance contributions.

256.18(5) (5) An action taken under sub. (3), (4), or (4m) is subject to review only as provided under s. 73.0301 (2) (b) and (5) or 108.227 (5) and (6), whichever is applicable.

256.18 History History: 1997 a. 237; 1999 a. 9; 2007 a. 20; 2007 a. 130 ss. 111 to 116; Stats. 2007 s. 256.18; 2013 a. 36.

256.18 Cross-reference Cross-reference: See also chs. DHS 110, Wis. adm. code.

256.205 256.205 Community paramedics.

256.205(1) (1) Definition. In this section, “community paramedic” means an individual who has obtained an approval issued under sub. (2).

256.205(2) (2) Departmental approval. No person may use the title “community paramedic” unless he or she obtains an approval from the department issued under this section to provide services as a community paramedic. To be eligible for an approval by the department as a community paramedic, an individual shall meet all of the following criteria:

256.205(2)(a) (a) The individual is licensed as a paramedic, that license is not suspended or revoked, and the individual is not the subject of an action under s. 256.15 (11).

256.205(2)(b) (b) The individual has the equivalent of 2 years of service as a paramedic.

256.205(2)(c) (c) The individual successfully completes a training program that has been approved by the department under sub. (3).

256.205(2)(d) (d) The individual submits an application for the approval on a form specified by the department.

256.205(2)(e) (e) The individual satisfies any other requirements established by the department.

256.205(3) (3) Training program. The department shall, after consulting the board, approve training programs for community paramedics that include clinical experience, that provide flexibility in addressing local service needs, and that meet any other criteria established by the department.

256.205(4) (4) Affiliation. A community paramedic may provide services under sub. (6) only if he or she is a volunteer for or an employee of a community emergency medical services provider, as defined in s. 256.215 (1) (a), or if he or she is an employee of or under contract with a hospital, clinic, or physician.

256.205(5) (5) Requirements.

256.205(5)(a) (a) A community paramedic shall follow any protocols and supervisory standards established by the department or by a medical director.

256.205(5)(b) (b) A community paramedic is subject to certification, disciplinary, complaint, and other regulatory requirements that apply to emergency medical services practitioners under s. 256.15.

256.205(6) (6) Services provided. Notwithstanding the actions authorized for emergency services under s. 256.15 (6n), a community paramedic may provide services for which he or she is trained under a training program approved by the department under sub. (3), that are not duplicative of services already being provided to a patient, and that are approved by the hospital, clinic, or physician for which the community paramedic is an employee or contractor or are incorporated in the patient care protocols under s. 256.215 (2) (b).

256.205 History History: 2017 a. 66.

256.21 256.21 Community emergency medical services practitioners.

256.21(1) (1) Definition. In this section, “community emergency medical services practitioner” means an individual who has obtained an approval issued under sub. (2).