Feed for /code/admin_code/dhs/110/110 PDF
DHS 110.49 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.
DHS 110.50 DHS 110.50EMS provider staffing requirements.
DHS 110.50(1)(1) An emergency medical service provider shall satisfy the staffing requirements appropriate to the level of service for which it is licensed. Except as provided in sub. (2) or (3), an emergency medical service provider shall comply with the following requirements that are applicable to the provider's level of service:
DHS 110.50(1)(a) (a) EMT-basic ambulance. An EMT-basic ambulance shall be staffed with at least two individuals who are licensed at the EMT-basic level or one licensed EMT-basic and one with an EMT-basic training permit. When staffed with a person that holds an EMT-basic training permit the licensed EMT-basic must be in the patient compartment during transport.
DHS 110.50(1)(b) (b) EMT-intermediate technician ambulance. An EMT- intermediate technician ambulance shall be staffed with at least two individuals. One individual shall be licensed at the EMT-intermediate technician level and one individual licensed at or above the EMT-basic level. If a patient requires EMT-intermediate technicians skills, medications or equipment, the EMT-intermediate technicians shall remain with the patient at all times during care and transport of the patient.
DHS 110.50(1)(c) (c) EMT-intermediate ambulance. An EMT- intermediate ambulance shall be staffed with at least two individuals. One individual shall be licensed at the EMT-intermediate level and one individual licensed at or above the EMT-basic level. If a patient requires EMT-intermediate skills, medications or equipment, the EMT-intermediate shall remain with the patient at all times during care and transport of the patient.
DHS 110.50(1)(d) (d) Paramedic ambulance.
DHS 110.50(1)(d)1.1. For an ambulance service provider licensed before January 1, 2000, the ambulance shall be staffed with two EMT-paramedics.
DHS 110.50(1)(d)2. 2. Except as provided in subd. 3., for an ambulance service provider licensed after January 1, 2000, the ambulance shall be staffed with at least one EMT-paramedic and one EMT at any level. If a patient requires patient care at the paramedic level, the paramedic shall remain with the patient at all times during care and transport of the patient.
DHS 110.50(1)(d)3. 3. For an ambulance service provider licensed at the paramedic level in the same primary service area in which paramedic service was or is provided by two EMT-paramedics, the ambulance shall be staffed with two EMT-paramedics.
DHS 110.50(1)(d)4. 4. A provider that uses a two paramedic system, in which paramedics respond separately from different locations, shall dispatch both EMT-paramedics immediately and simultaneously for all emergency response requests. A single paramedic performing in this staffing configuration may perform all the skills allowed in the scope of practice of the EMT-paramedic prior to the arrival of a second paramedic, as long as the arrival of the second paramedic is expected within a reasonable and prudent time based on the patient's condition. If only one EMT-paramedic responds, care shall be provided within the next lower level scope of practice, and transport of the patient requires one EMT-paramedic and one additional EMT at any level. If 2 EMT-paramedics respond, after the patient has been assessed and stabilized, one EMT-paramedic may be released by patient care protocol or verbal order from a medical control physician. An ambulance service provider that responds with EMT-paramedics from two different locations, or that releases one EMT paramedic after assessment, shall identify in its operational plan what time frame is considered to be a timely response based on its resources and primary service area logistics.
DHS 110.50(1)(e) (e) Critical care ambulance. A critical care level interfacility transport shall be staffed with at least one individual licensed and credentialed at the critical care paramedic level and one individual licensed and credentialed at any EMT level. If a patient requires critical care paramedic skills or medications, the critical care paramedic shall remain with the patient at all times during care and transport of the patient.
DHS 110.50(1)(f) (f) Non-transporting EMT. A non-transporting EMT service provider shall staff the same as an ambulance service provider with the exception of the requirements relating to transporting of the patient.
DHS 110.50(1)(g) (g) First responder. When a first responder service provider responds to a request for service at least one certified first responder shall respond.
DHS 110.50(1)(h) (h) Interfacility transfers. Staffing for interfacility transfers shall be based on the needs of the patient as identified by the sending physician. A service may staff to any of the configurations in this subsection but may not exceed the level at which the service is licensed.
DHS 110.50(2) (2) A physician, physician assistant or a registered nurse may take the place of any EMT at any service level provided he or she is trained and competent in all skills, medications and equipment used by that level of EMT in the pre-hospital setting and provided he or she is approved by the service medical director. A physician assistant or registered nurse may not practice at a higher level of care than the level at which the service is licensed.
DHS 110.50 Note Note: To assist the service medical director in assuring competency, there are registered nurse to EMT-basic and registered nurse to paramedic transition courses available through the certified training centers. A physician, physician assistant, or registered who is not licensed as an EMS professional is operating under his or her physician, nurse or physician assistant license. Any conduct subject to enforcement action under subch. V while operating as an EMS professional will be reported to the appropriate governing board and may affect the individual's physician, nurse or physician assistant license.
DHS 110.50(3) (3) An ambulance service provider may only deviate from the ambulance staffing requirements under sub. (1) if all 9-1-1 response ambulances are busy and the service has an approved reserve ambulance vehicle and one of the following conditions apply:
DHS 110.50(3)(a) (a) An ambulance service provider may staff and operate reserve ambulances at a lower service level appropriate to the licensure level of the available staff if it obtains approval from the department. The reserve or back-up ambulance shall be stocked and equipped appropriately for the level of service provided. The ambulance service provider shall request approval through submission of an operational plan amendment.
DHS 110.50(3)(b) (b) In a two paramedic system, if only one paramedic is available, the ambulance shall operate at the next lower EMT level.
DHS 110.50 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.
DHS 110.51 DHS 110.51 Preceptors.
DHS 110.51(1)(1) The service medical director shall designate those individuals who may serve as preceptors based on the director's determination that the individuals are qualified to act as preceptors for supervised field training. Only individuals who are designated by the service medical director may serve as preceptors for supervised field training. The service medical director shall withdraw an individual's designation if the director determines that the individual is no longer qualified or at the request of the department, the training center, or the individual.
DHS 110.51(2) (2) In order to serve as a preceptor for field training, an individual shall have all of the following qualifications:
DHS 110.51(2)(a) (a) The individual shall be licensed as an EMT at or above the skill level of the training provided and shall have the knowledge and experience in using the skills, equipment and medications that are required by the scope of practice for the certification or licensure for which training is provided. A physician, registered nurse or physician assistant with training and experience in the pre-hospital emergency care of patients is deemed trained to the paramedic level.
DHS 110.51(2)(b) (b) A preceptor shall have a minimum of two years pre-hospital patient care experience as a licensed, practicing EMT at or above the level of the training provided, or as a physician, registered nurse or physician assistant.
DHS 110.51(2)(c) (c) A preceptor shall oversee and mentor students during supervised field training and shall complete the records required to document the field training.
DHS 110.51(2)(d) (d) The ambulance service provider shall keep résumés and other documentation of the qualifications of those individuals designated as preceptors on file and shall make this documentation immediately available for review by the certified training center or the department.
DHS 110.51 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.
DHS 110.52 DHS 110.52 EMS personnel credentialing.
DHS 110.52(1) (1) In order to provide emergency medical care above the first aid scope of practice level, a first responder or EMT must first be credentialed with an emergency medical service provider with which the first responder or EMT will provide emergency medical care.
DHS 110.52(2) (2) An individual is credentialed when the medical director of an emergency medical services provider authorizes the individual to perform specified emergency medical care while in the service of the provider. Authorization is made through a local credentialing agreement form which is submitted by the individual in the manner specified by the department.
DHS 110.52(3) (3) The service medical director shall authorize any skills, equipment, or medications that the individual may use in the service of the provider, other than those that are within the first aid scope of practice. The service medical director may only authorize EMS personnel to perform skills, use equipment and administer medications that are within the scope of practice of the individual's certificate or license and within the scope of practice of the emergency medical service provider's license.
DHS 110.52(4) (4) A certified first responder or licensed EMT may be credentialed by more than one emergency medical service provider.
DHS 110.52(5) (5) An individual's credential remains in effect until the individual's service with the emergency medical services provider ceases, the service medical director withdraws the credential, or the department suspends or revokes the individual's license.
DHS 110.52(6) (6) The service medical director may withdraw an individual's credential if the individual has engaged in conduct that is dangerous or is detrimental to the health or safety of a patient or members of the general public, while acting under the authority of his or her certificate or license, or if the service medical director determines that individual needs remedial training to properly treat patients. If an individual's credential is withdrawn for remedial training, the service medical director and service director shall develop a course of remedial training for the individual with a timeline for completion and return to full service.
DHS 110.52(7) (7) An emergency medical service provider shall notify the department promptly if its service medical director withdraws an individual's credential.
DHS 110.52(8) (8) The termination or withdrawal of an individual's credential does not by itself affect the individual's certificate or license.
DHS 110.52 Note Note: Local credentialing agreement forms may be obtained electronically through the department's E-Licensing system available at www.dhs.wisconsin.gov/ems. For further information or to request an assessment exam contact the Emergency Medical Services Section, 1 W. Wilson St., P.O. Box 2659, Madison, WI 53701-2659.
DHS 110.52 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.
DHS 110.525 DHS 110.525 Field training requirements.
DHS 110.525(1) (1) An ambulance service provider may provide supervised field training of EMS personnel through its licensed staff who have been designated as preceptors by the provider's service medical director under s. DHS 110.51 (1).
DHS 110.525(2) (2) An ambulance service provider that provides supervised field training of EMS personnel shall have a written agreement with a certified training center that describes how the field training is provided and the responsibilities of the provider and the training center with respect to the field training. The agreement shall be signed by the training center's program director and the ambulance service provider's service director after consultation with both the training center medical director and the service medical director.
DHS 110.525 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.
subch. V of ch. DHS 110 Subchapter V — Enforcement
DHS 110.53 DHS 110.53 Authority to investigate.
DHS 110.53(1) (1) The department may conduct an investigation to determine whether there has been a violation of this chapter or ch. 256, Stats.
DHS 110.53(2) (2) An authorized employee or agent of the department, upon presentation of identification, shall be permitted to do all of the following:
DHS 110.53(2)(a) (a) Enter the offices of an emergency medical service provider or training center during business hours without advance notice or at any other reasonable prearranged time.
DHS 110.53(2)(b) (b) Inspect equipment and vehicles.
DHS 110.53(2)(c) (c) Inspect and reproduce records pertinent to the requirements of this chapter and ch. 256, Stats., including but not limited to administrative records, personnel records, ambulance run records, training records and vehicle records, whether the records are maintained in written, electronic or other form.
DHS 110.53(2)(d) (d) Interview persons.
DHS 110.53(2)(e) (e) Conduct other activities to determine whether a violation has occurred.
DHS 110.53(3) (3) Persons subject to this chapter shall cooperate with department employees or agents during an investigation. No person may do any of the following:
DHS 110.53(3)(a) (a) Refuse entry or access to an authorized employee or agent of the department to act under this section.
DHS 110.53(3)(b) (b) Refuse to provide original records to, or refuse to copy or permit the copying of records for an authorized employee or agent of the department.
DHS 110.53(3)(c) (c) Obstruct, hamper, or otherwise interfere with the actions of a department employee or agent under this subchapter.
DHS 110.53 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.
DHS 110.54 DHS 110.54 Reasons for enforcement actions. The department may take any enforcement action under ss. DHS 110.55 to 110.58, which it determines is appropriate against a person subject to the requirements of this chapter and ss. 256.12 to 256.18, Stats., for any of the following reasons:
DHS 110.54(1) (1) The person is not eligible for a certificate, permit or license under this chapter or ss. 256.15 to 256.17, Stats.
DHS 110.54(2) (2) The person made a false statement on an application for, or otherwise obtained a permit, certificate or license through fraud or error.
DHS 110.54(3) (3) The licensing examination for the person was completed through error or fraud.
DHS 110.54(4) (4) The person violated any provision of ch. 256, Stats., or this chapter.
DHS 110.54(5) (5) The person violated an order of the department.
DHS 110.54(6) (6) The person violated a court order pertaining to emergency medical services.
DHS 110.54(7) (7) The person was disciplined as a first responder, EMT or other healthcare provider in Wisconsin or another state.
DHS 110.54(8) (8) The person's license or certification was revoked within the past two years.
DHS 110.54(9) (9) The person has an arrest or conviction history substantially related to the performance of duties as an EMS professional, as determined by the department.
DHS 110.54(10) (10) The person committed or permitted, aided or abetted the commission of an unlawful act that substantially relates to performance of EMS duties, as determined by the department.
DHS 110.54(11) (11) The person failed to report to the department or to the emergency medical service provider director or medical director a violation of the rules of this chapter by a licensee, certificate holder or permit holder.
DHS 110.54 Note Note: This provision does not require an emergency medical service provider to report treatment information in violation of the protection of the confidentiality of health care records under s. 146.82, Stats., or the privilege for confidential communication under s. 905.04, Stats.
DHS 110.54(12) (12) The person failed to cooperate with the department in an investigation or made a false statement during an investigation.
DHS 110.54(13) (13) The person failed to maintain certification in CPR for health care professionals by completing a course approved by the department and has performed as a first responder or EMT.
DHS 110.54(14) (14) The person practiced beyond the scope of practice for his or her license or certificate.
DHS 110.54(15) (15) The person practiced or attempted to practice when unable to do so with reasonable skill and safety.
DHS 110.54(16) (16) The person practiced or attempted to practice while impaired by alcohol or other drugs.
DHS 110.54(17) (17) The person engaged in conduct that was dangerous or detrimental to the health or safety of a patient or to members of the general public while performing as a first responder or EMT.
DHS 110.54(18) (18) The person administered, supplied, obtained or possessed any drug other than in the course of legitimate EMS practice or as otherwise permitted by law.
DHS 110.54(19) (19) The individual engaged in inappropriate sexual contact, exposure, gratification, or other sexual behavior with or in the presence of a patient.
DHS 110.54(20) (20) The person abused a patient by any act of nonconsensual force, violence, harassment, deprivation, nonconsensual sexual contact or neglect.
DHS 110.54(21) (21) The person obtained or attempted to obtain anything of value from a patient for the benefit of self or a person other than the patient unless authorized by law.
DHS 110.54(22) (22) The person falsified or inappropriately altered patient care reports.
DHS 110.54(23) (23) The person revealed to another person not engaged in the care of the patient information about a patient's medical condition when release of the information was not authorized by the patient, authorized by law, or requested by the department in the investigation of complaints.
DHS 110.54(24) (24) The person failed or refused to provide emergency medical care to a patient because of the patient's race, color, sex, age, beliefs, national origin, handicap, medical condition, or sexual orientation.
DHS 110.54(25) (25) The person abandoned a patient.
DHS 110.54(26) (26) A person certified as a training center or EMS instructor failed to adhere to the requirements under ss. DHS 110.18 to 110.24.
DHS 110.54(27) (27) A person licensed as an emergency medical services provider failed to provide or maintain, when required, insurance coverage sufficient to protect EMS personnel in the performance of their duties for the provider.
DHS 110.54(28) (28) A person licensed as an emergency medical services provider violated any provision of its approved operational plan or took actions not authorized by the plan.
DHS 110.54 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11; correction in (intro.) made under s. 13.92 (4) (b) 7., Stats., Register December 2010 No. 660.
Loading...
Loading...
The Wisconsin Administrative Code on this web site is updated on the 1st day of each month, current as of that date. See also Are the Codes on this Website Official?