DHS 110.44(20r)(h) (h) Written acknowledgement that the ambulance service has identified potential staging areas and landing zones near the event.
DHS 110.44(20r)(i) (i) Written acknowledgement that the ambulance service provider or non-transporting emergency medical service provider has notified area hospitals of the date of the event.
DHS 110.44(21) (21)Other information as determined by the department.
DHS 110.44 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11; CR 20-028: am. (intro.), (1), (8), cr. (9m), am. (11), (13), r. and recr. (17), cr. (20g), (20r) Register September 2021 No. 789, eff. 10-1-21.
DHS 110.45 DHS 110.45Department decisions on applications.
DHS 110.45(1)(1)Except as provided in sub. (2), the department shall review and make a determination on an application that has been completed in accordance with all of the department's instructions for completion within 60 business days of receiving the application. If the department approves the application, the department will notify the applicant and issue a license. If the department denies the application, the department will notify the applicant of the reason for the denial and any appeal rights.
DHS 110.45(2) (2)The department shall either approve the application and issue a license or deny the application within 90 business days after receiving a complete application for an emergency medical service provider license that requires department review of algorithm protocols, including an application for a change or update of any algorithm protocol. If the application for a license or algorithm protocol approval is denied, the department shall give the applicant reasons, in writing, for the denial and shall inform the applicant of the right to appeal that decision.
DHS 110.45(3) (3)The department's failure to deny an application within the time period established under sub. (1) or (2) does not constitute department approval of the license application. An applicant may not provide emergency medical services until the department has issued the applicant a license.
DHS 110.45 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11.
DHS 110.46 DHS 110.46License duration and application for renewal license.
DHS 110.46(1)(1)A license issued by the department to an emergency medical service provider is valid for the duration of the triennium as long as the provider remains in continuous compliance with EMS-related federal and state statutes, this chapter, and the operational plan approved by the department, or until the provider notifies the department in writing that it intends to cease providing emergency medical services or the department suspends or revokes the license.
DHS 110.46(2) (2)Notwithstanding sub. (1), an emergency medical service provider shall renew its license by June 30 of the third year of the triennium by submitting to the department an updated application that includes documentation acceptable to the department showing proof of eligibility. The application and documentation shall be submitted to the department in the manner or method specified by the department.
DHS 110.46 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11; CR 20-028: am. (title), renum. DHS 110.46 to (1) and am., cr. (2) Register September 2021 No. 789, eff. 10-1-21.
DHS 110.47 DHS 110.47Required personnel and responsibilities. An emergency medical service provider shall have all of the following personnel:
DHS 110.47(1) (1)A service director qualified under s. DHS 110.49.
DHS 110.47(2) (2)A service medical director qualified under s. DHS 110.50.
DHS 110.47(3) (3)An infection control designee who is responsible for maintaining the infection control program and meeting Occupational Safety and Health Administration standards for blood borne pathogens and safety.
DHS 110.47(4) (4)A quality assurance designee who is responsible for managing patient-based quality improvement processes in collaboration with the service medical director.
DHS 110.47(5) (5)A training designee who is responsible for assisting the service medical director in assuring continued competency and facilitating the continuing education of the provider's EMS professionals.
DHS 110.47(6) (6)A data contact designee who is responsible for assuring that patient care report data is submitted to the department as required in this chapter.
DHS 110.47(7) (7)EMS professionals sufficient to meet the staffing requirements under s. DHS 110.51.
DHS 110.47 Note Note: These personnel do not have to be separate people. One person may hold several of these positions.
DHS 110.47 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11; CR 20-028: am. (1), (2), (5), (7) Register September 2021 No. 789, eff. 10-1-21.
DHS 110.48 DHS 110.48Service director. An emergency medical service provider shall have a service director who shall:
DHS 110.48(1) (1)Serve as the primary contact between the emergency medical service provider and the department.
DHS 110.48(2) (2)Assure that all elements of the operational plan are kept current.
DHS 110.48(3) (3)Assure that EMS professionals are properly licensed and credentialed.
DHS 110.48(4) (4)Provide day-to-day supervision of the ambulance service provider's operations.
DHS 110.48 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11; CR 20-028: am. (3) Register September 2021 No. 789, eff. 10-1-21.
DHS 110.49 DHS 110.49Service medical director. An emergency medical service provider shall have a service medical director who meets all of the qualifications under sub. (1) and has all the responsibilities under sub. (2):
DHS 110.49(1) (1)Qualifications. The service medical director shall meet all the following within 180 days from the date of his or her appointment:
DHS 110.49(1)(a) (a) Licensure as a physician.
DHS 110.49(1)(b) (b) Current certification in CPR for health care professionals and, if the medical director provides medical direction for an EMT-intermediate, Advanced Emergency Medical Technician or paramedic emergency medical services provider, current certification in ACLS and PALS unless the physician is certified by the American Board of Emergency Medicine or the American Osteopathic Board of Emergency Medicine.
DHS 110.49(1)(c) (c) Education, training and experience in emergency medicine.
DHS 110.49(1)(d) (d) Familiarity with the design and operation of pre-hospital EMS systems.
DHS 110.49(1)(e) (e) Experience or training in the EMS quality improvement process.
DHS 110.49(1)(f) (f) Successful completion of the department's service medical director course or equivalent as determined by the department for any service medical director who is not board certified as specified in par. (b).
DHS 110.49(1)(g) (g) Any additional requirements prescribed by the department.
DHS 110.49(2) (2)Responsibilities. The service medical director shall do all of the following:
DHS 110.49(2)(a) (a) Prescribe patient care protocols under which the provider's professionals treat.
DHS 110.49(2)(b) (b) Develop, review and approve in writing all patient care protocols that will be used by EMS professionals delivering patient care under the operational plan.
DHS 110.49(2)(c) (c) Ensure that physicians providing on-line medical control do so in a manner consistent with the department approved patient care protocols.
DHS 110.49(2)(d) (d) Ensure that all aspects of the emergency medical services are under medical supervision and direction at all times.
DHS 110.49(2)(e) (e) Establish, participate in, and ensure the continuing implementation of a quality assurance program as part of a patient care improvement process.
DHS 110.49(2)(f) (f) Approve, limit, suspend, or revoke credentials as provided under s. DHS 110.53.
DHS 110.49(2)(g) (g) Maintain liaison with the medical community, including hospitals, emergency departments, urgent care clinics, physicians, nurses, and other healthcare providers.
DHS 110.49(2)(h) (h) Work with regional, state and local EMS authorities to ensure that standards, needs and requirements are met and resource utilization is optimized.
DHS 110.49(2)(i) (i) Maintain, through continuing education, current knowledge and skills appropriate for a service medical director.
DHS 110.49(2)(j) (j) Approve, direct, and assist in providing training activities that assure EMS professionals are competent to provide safe and efficient patient care, based on the department approved patient care protocols.
DHS 110.49 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11; CR 20-028: am. (1) (b), (f), (2) (a), (b), (f), (j) Register September 2021 No. 789, eff. 10-1-21.
DHS 110.495 DHS 110.495Community emergency medical services medical director. A CEMS provider shall have a minimum of one medical director who meets all of the qualifications under sub. (1) and has all the responsibilities under sub. (2).
DHS 110.495(1) (1)Qualifications. Except as provided by sub. (3), a community emergency medical services medical director shall have all of the following:
DHS 110.495(1)(a) (a) Current licensure as a physician.
DHS 110.495(1)(b) (b) Familiarity or experience with emergency medical services and practitioners.
DHS 110.495(1)(c) (c) Any additional requirements as prescribed by the department.
DHS 110.495(2) (2)Responsibilities. The CEMS medical director or medical direction team shall:
DHS 110.495(2)(a) (a) Develop, review and approve in writing all patient care protocols that will be used by community emergency medical services practitioners delivering patient care under the operational plan.
DHS 110.495(2)(b) (b) Ensure that physicians providing online medical consultation do so in a manner consistent with department-approved patient care protocols and guidelines.
DHS 110.495(2)(c) (c) Establish, participate in, and ensure a continual quality improvement program as part of a patient care improvement process specific to the community emergency medical services.
DHS 110.495(2)(d) (d) Approve, limit, suspend or revoke credentials as provided under s. DHS 110.53.
DHS 110.495(2)(e) (e) Maintain liaison with the medical community, including hospitals, emergency departments, urgent care clinics, physicians, nurses, and other healthcare providers.
DHS 110.495(2)(f) (f) Work with regional, state and local authorities to ensure that standards, needs and requirements are met.
DHS 110.495(2)(g) (g) Maintain current knowledge and skills appropriate for a community emergency medical services medical director/team through continuing education.
DHS 110.495(2)(h) (h) Approve, direct, and assist in providing training activities that assure community emergency medical services practitioners are competent to provide safe and efficient patient care, based on the department approved patient care protocols/guidelines.
DHS 110.495(3) (3)Medical direction teams. A medical direction team may be used in lieu of a medical director so long as one member of the team meets the qualifications and responsibilities described under sub. (1) and (2). If the CEMS provider using a medical direction team is also licensed to provide other EMS education or patient services, a CEMS medical direction team shall include the EMS service medical director.
DHS 110.495 History History: CR 20-028: cr. Register September 2021 No. 789, eff. 10-1-21.
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. All individuals constituting the minimum staffing shall be credentialed with the emergency medical service provider under s. DHS 110.53. 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 ambulance. An EMT ambulance shall be staffed with at least two individuals, credentialed with that emergency medical service provider under s. DHS 110.53, who are licensed at the EMT level or one licensed EMT and one with an EMT training permit. When staffed with a person that holds an EMT training permit the licensed EMT must be in the patient compartment during transport.
DHS 110.50(1)(b) (b) AEMT ambulance. An AEMT ambulance shall be staffed with at least two individuals credentialed with that emergency medical service provider under s. DHS 110.53. One individual shall be licensed at the AEMT level and one individual licensed at or above the EMT level. If a patient requires AEMT skills, medications or equipment, the AEMT 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 credentialed with that emergency medical service provider under s. DHS 110.53. One individual shall be licensed at the EMT-intermediate level and one individual licensed at or above the EMT 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 paramedics credentialed with that emergency medical service provider under s. DHS 110.53 except if any of the following apply:
DHS 110.50(1)(d)1.a. a. The ambulance is responding in a municipality with a population of less than 10,000.
DHS 110.50(1)(d)1.b. b. The ambulance is performing an interfacility transport.
DHS 110.50(1)(d)1.c. c. All regularly staffed two-paramedic ambulances are committed to emergency events. In that case, additional ambulances may be staffed with one paramedic and individual licensed at or above the EMT level.
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 two individuals credentialed with that emergency medical service provider under s. DHS 110.53. One individual shall be licensed at the paramedic level and one individual licensed at or above the EMT 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 paramedics, the ambulance shall be staffed with two paramedics except if any of the following apply:
DHS 110.50(1)(d)3.a. a. The ambulance is responding in a municipality with a population of less than 10,000.
DHS 110.50(1)(d)3.b. b. The ambulance is performing an interfacility transport.
DHS 110.50(1)(d)3.c. c. All regularly staffed two-paramedic ambulances are committed to emergency events. In that case, additional ambulances may be staffed with one paramedic and individual licensed at or above the EMT level.
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 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 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 2 paramedics respond, after the patient has been assessed and stabilized, one paramedic may be released by patient care protocol or verbal order from a medical control physician. An ambulance service provider that responds with paramedics from two different locations, or that releases one 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 two individuals credentialed with that emergency medical service provider under s. DHS 110.53. One individual shall be licensed and credentialed at the critical care paramedic level and one individual shall be licensed and credentialed as an emergency medical services practitioner at any 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 emergency medical service provider. A non-transporting emergency medical service provider shall respond to a request for service with at least one licensed emergency medical services practitioner at the level for which the service provider is licensed.
DHS 110.50(1)(g) (g) Emergency medical responder service provider. When an emergency medical responder service provider responds to a request for service at least one certified emergency medical 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 emergency medical responder or emergency medical services practitioner at any service level provided he or she is trained and competent in all skills, medications and equipment used by that level of emergency medical responder or emergency medical services practitioner 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 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(2m) (2m)Subject to the population requirements identified in s. 256.15 (4) (e) and (f), an ambulance service provider licensed at the EMT, AEMT, or EMT-intermediate level may staff an ambulance with one emergency medical service practitioner licensed at the level of the ambulance service provider and one certified emergency medical responder. The licensed emergency medical services practitioner shall remain with the patient at all times during care and transport of the patient.
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Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date the chapter was last published.