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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.
DHS 110.50(3) (3)Except as provided under subs. (2) and (2m), 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 the following condition applies:
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(4) (4)An ambulance service provider may supplement its 9-1-1 response resources with ambulances staffed at a lower service level in addition to the ambulances staffed at its normal level of licensure under all of the following conditions:
DHS 110.50(4)(a) (a) The ambulance service provider does not reduce the number of ambulances staffed at the level of its licensure available for 9-1-1 responses, except as permitted under s. DHS 110.37 (2).
DHS 110.50(4)(b) (b) The ambulance service provider maintains a minimum of one 9-1-1 response ambulance staffed at the level of its licensure 24 hours-a-day, 7 days-a-week.
DHS 110.50(4)(c) (c) The ambulance service provider provides documentation to the department that the ambulance service provider is dispatched by a public safety answering point or dispatch center using an emergency medical dispatch system. Ambulances staffed at a lower level of service shall only be dispatched if one of the following applies:
DHS 110.50(4)(c)1. 1. The emergency response meets the standards identified within the public safety answering point's or dispatch center's emergency medical dispatch system for the lower service level.
DHS 110.50(4)(c)2. 2. All 9-1-1 ambulances staffed at the highest level of licensure are already committed to other 9-1-1 responses.
DHS 110.50(4)(d) (d) The ambulance service provider has protocols approved by the service medical director and the department for when a patient's condition requires a response must be upgraded to a higher level of care.
DHS 110.50(4)(e) (e) If an ambulance service provider is licensed as both a 9-1-1 provider and an inter-facility provider, the provider shall maintain a minimum of one ambulance available at the level of its licensure in its primary service area for 9-1-1 response while providing interfacility transports.
DHS 110.50(4)(f) (f) The ambulance service provider obtains approval from the department. The ambulance service provider shall request approval through submission of an operational plan.
DHS 110.50 History History: CR 10-085: cr. Register December 2010 No. 660, eff. 1-1-11; CR 20-028: am. (1) (intro.), (a) to (c), renum. (1) (d) 1. to (1) (d) 1. (intro.) and am., cr. (1) (d) 1. a. to c., am. (1) (d) 2., renum. (1) (d) 3. to (1) (d) 3. (intro.) and am., cr. (1) (d) 3. a. to c., am. (1) (d) 4., (e) to (g), (2), cr. (2m), am. (3) (intro.), r. (3) (b), cr. (4) Register September 2021 No. 789, eff. 10-1-21; correction in (3) (intro.) made under s. 35.17, Stats., Register September 2021 No. 789.
DHS 110.51 DHS 110.51Preceptors.
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 emergency medical services practitioner 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 emergency medical services practitioner 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; CR 20-028: am. (2) (a), (b) Register September 2021 No. 789, eff. 10-1-21.
DHS 110.52 DHS 110.52EMS professional credentialing.
DHS 110.52(1)(1)In order to provide emergency medical care, an emergency medical responder or emergency medical services practitioner must first be credentialed with an emergency medical service provider with which the emergency medical responder or emergency medical services practitioner 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. The service medical director may only authorize EMS professionals 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 emergency medical responder or licensed emergency medical services practitioner 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 limits, suspends, or revokes the credential, or the department suspends or revokes the individual's license.
DHS 110.52(6) (6)The service medical director may limit or suspend 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 limited or suspended 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)The service medical director may revoke 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. Prior to the revocation, the service medical director shall consult with the department's emergency medical services staff and the state emergency medical services medical director.
DHS 110.52(8) (8)The limitation, suspension, or revocation 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; CR 20-028: am. (title), (1), (3) to (6), r. and recr. (7), am. (8) Register September 2021 No. 789, eff. 10-1-21.
DHS 110.525 DHS 110.525Field training requirements.
DHS 110.525(1)(1)An ambulance service provider may provide supervised field training of EMS professionals 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 professionals shall have a written agreement with a certified training center that describes who the field training is provided and the responsibilities of the provider and the training center with respect to the field training. This 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; CR 20-028: am. Register September 2021 No. 789, eff. 10-1-21.
DHS 110.526 DHS 110.526Opioids training.
DHS 110.526(1)(1)An EMS practitioner shall undergo training regarding the safe and proper administration of naloxone or another opioid antagonist to individuals who are undergoing or suspected of undergoing an opioid-related drug overdose consisting of instruction in recognizing opioid-related drug overdose patients, medication preparation and administration, and any other information requested by the department.
DHS 110.526(2) (2)An EMS practitioner may fulfill the training requirement under sub. (1) through any of the following:
DHS 110.526(2)(a) (a) Initial training in the applicable Wisconsin curriculum that includes administration of naloxone or another opioid antagonist.
DHS 110.526(2)(b) (b) Continuing education through a training center that includes administration of naloxone or another opioid antagonist.
DHS 110.526(2)(c) (c) Training provided by an emergency medical service provider with which the individual is credentialed that is approved by the service medical director and the department.
DHS 110.526(2)(d) (d) Any other training as approved by the department.
DHS 110.526 History History: CR 20-028: cr. Register September 2021 No. 789, eff. 10-1-21.
subch. V of ch. DHS 110 Subchapter V — Enforcement
DHS 110.53 DHS 110.53Authority 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 110.54Reasons 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 an emergency medical responder, emergency medical services practitioner 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 an emergency medical responder or emergency medical services practitioner.
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 an emergency medical responder or emergency medical services practitioner.
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.
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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.