Chapter Trans 309

Trans 309.02(16) (16) “Type III-AD ambulance” means an ambulance of 14,001 pound GVWR or more that is constructed on a cutaway van chassis with an integrated modular ambulance body.

Trans 309.02 History History: Cr. Register, October, 1986, No. 370, eff. 11-1-86; r. (2), (11), renum. (3), (5), (6), (9), (10), (12), (13) and (14) to be (2), (3), (5), (6), (9), (10), (11) and (12) and am. (5), (6) and (10), r. and recr. (4), Register, April, 1994, No. 460, eff. 5-1-94; correction in (5) made under s. 13.93 (2m) (b) 7., Stats., Register, August, 1996, No. 488; renum. (1) and (7) to (12) to be (1m), (8) to (10), (12) to (14) and am. (12) and (14), cr. (1), (7) and (11), Register, February, 1999, No. 518, eff. 4-1-99; corrections in (1), (2), (4), (5), (6), and (9) made under s. 13.92 (4) (b) 7., Stats., Register December 2010 No. 660; 2013 Wis. Act 363: r. (1) Register May 2014 No. 701, eff. 6-1-14; CR 19-074: cr. (1k), r. and recr. (4), (5), r. (6), cr. (6k), (6r), (9k), (9r), r. and recr. (12) to (14), cr. (15), (16) Register October 2020 No. 778, eff. 11-1-20; correction in (12), (15), (16) made under s. 35.17, Stats., Register October 2020 No. 778.

Trans 309.03 Trans 309.03 Inspections and enforcement.

Trans 309.03(1) (1) No person may use any motor vehicle for the purpose of providing ambulance services unless the vehicle has been inspected and approved by the department for use as an ambulance in this state. Except as otherwise provided, each ambulance shall be inspected at least biennially to the satisfaction of the inspector to ensure that the ambulance meets the minimum standards applicable to that vehicle under subchs. I, II and III. Whenever the ambulance service provider upgrades to a higher level of provider service, the service provider shall notify the inspector. When a reserve ambulance is put into in-service ambulance status, it shall meet all requirements of this chapter.

Trans 309.03(1g) (1g) Ambulance service providers based out of state but operating in Wisconsin shall have their home state’s most current inspection on file with the department and shall comply with all Wisconsin motor vehicle legal requirements including ch. Trans 305, ch. 347, Stats., and this chapter, except for inspection by the department under sub. (1).

Trans 309.03(1m) (1m) Sub. (1) does not prevent the inspector from doing spot inspections to check for compliance with this chapter.

Trans 309.03(1r) (1r) Whenever the department receives a complaint about a service provider alleging non-compliance with this chapter, the inspector shall investigate and, where appropriate, inspect the provider’s ambulances.

Trans 309.03(2) (2) The ambulance service provider shall present the vehicle for inspection when notified by the department and shall cooperate with the inspector. Whenever possible, the department shall perform the inspections at the ambulance service provider’s place of business or other site convenient to the ambulance service provider’s base of operation. The inspector shall conduct the inspection in a manner that will not interfere with the provision of ambulance service.

Trans 309.03(3) (3) 

Trans 309.03(3)(a) (a) Except as provided in sub. (4), if upon inspection a vehicle is found to be unsafe or improperly constructed or equipped for use as an ambulance, or if the ambulance service provider’s license has been revoked, the inspector shall attach an “OUT OF SERVICE” sticker to the glass in the rear door of the vehicle. A vehicle may not be put in service as an ambulance while the sticker is so displayed. Except as provided in par. (b), the “OUT OF SERVICE” sticker displayed shall be reinspected by and shall have the sticker removed after passing reinspection by an employee of the division of state patrol or authorized agent of the service provider at the direction of the division of state patrol employee prior to reuse as an ambulance. The “OUT OF SERVICE” sticker shall not be removed until the deficiencies noted on the inspection report have been corrected, or the ambulance provider’s license has been reinstated.

Trans 309.03(3)(b) (b)

Trans 309.03(3)(b)1. 1. If a vehicle that has been declared “out of service” and is no longer able to serve as an ambulance, the owner or lessee of the vehicle shall remove the “OUT OF SERVICE” sticker and all special ambulance markings and features from the vehicle, including all of the following:

Trans 309.03(3)(b)1.a. a. The warning, flood lights and siren unless the vehicle is being converted for use as another kind of authorized emergency vehicle. The current owner or lessee must physically remove all lighting equipment required by s. Trans 309.15 (2), the siren and public address equipment required by s. Trans 309.17 and all lettering and markings required by s. Trans 309.19. The current owner or lessee must also remove all equipment required in subch. III. Ambulance lighting shall be brought into compliance with vehicle general lighting requirements in ch. 347, Stats. and ch. Trans 305.

Trans 309.03(3)(b)1.b. b. Any lettering identifying the vehicle as an ambulance.

Trans 309.03(3)(b)1.c. c. All equipment required in subch. III.

Trans 309.03(3)(b)2. 2. The owner or lessee of the vehicle is not required to obtain approval from the department but shall notify the department when he or she proceeds under this paragraph.

Trans 309.03(4) (4) If upon inspection a vehicle is found defective or deficient but, in the judgment of the inspector, may nevertheless be operated as an ambulance without seriously affecting the safe transportation of individuals who are sick, injured, or disabled or the general public, the inspector shall note the deficiency on the ambulance inspection report and shall specify the time, not to exceed 30 days, in which the ambulance service provider is required to correct the defect or deficiency. The inspector may require proof of correction of the defect or deficiency in writing. If the defect or deficiency is not corrected within the time allowed, the vehicle may not be used as an ambulance.

Trans 309.03(5) (5) A vehicle being used as an ambulance shall immediately be rendered out of service and the service provider may be assessed a monetary penalty if, upon inspection, the ambulance is found to have any of the following, and sub. (4) does not apply:

Trans 309.03(5)(a) (a) A malfunctioning brake system.

Trans 309.03(5)(b) (b) A faulty exhaust system.

Trans 309.03(5)(c) (c) A faulty battery system.

Trans 309.03(5)(d) (d) A malfunctioning fuel system.

Trans 309.03(5)(e) (e) An inadequate on-board oxygen system.

Trans 309.03(5)(f) (f) An unsafe structure.

Trans 309.03(5)(g) (g) Unsafe tires.

Trans 309.03(5)(h) (h) Ten or more minor violations which, in the opinion of the inspector, shows a lack of effort on the part of the service provider to stay in compliance with this chapter.

Trans 309.03(5)(i) (i) Repeat violations from the previous inspection report with no maintenance history or documentation that the problem had been corrected.

Trans 309.03(5)(j) (j) A malfunctioning or inadequate environmental climatic control system.

Trans 309.03(5)(k) (k) A malfunctioning or inadequate cot or cot securement system.

Trans 309.03(5)(m) (m) Inoperative complete front, side or rear emergency lighting.

Trans 309.03(5)(n) (n) An inoperative siren.

Trans 309.03(5)(o) (o) Carbon monoxide concentrations within the vehicle greater than 10 ppm (parts per million) above the outside ambient carbon monoxide concentration.

Trans 309.03(5)(p) (p) A malfunctioning or inadequate steering system.

Trans 309.03(5)(q) (q) Belts that are damaged, contaminated by oil or improperly adjusted.

Trans 309.03(5)(r) (r) A defective or inadequate suspension system.

Trans 309.03(5)(s) (s) The ambulance exceeds the GVWR as set by the OEM.

Trans 309.03(5)(t) (t) The ambulance exceeds the GAWR as set by the OEM.

Trans 309.03(6) (6) The vehicle shall be rendered out of service and the provider may be assessed monetary penalties when the provider knowingly resists or obstructs the inspector while the inspector is doing any act in an official capacity and with lawful authority. For purposes of this subsection, “obstructs” includes, without limitation, knowingly giving or demonstrating false information to the inspector.

Trans 309.03(7) (7) The penalty for violating sub. (5) (a) to (h) or (j) to (t) is a forfeiture of up to $50.00 per violation. The penalty for violating sub. (5) (i) is a forfeiture of up to $100.00. The penalty for violating sub. (6) is a forfeiture of up to $200.00.

Trans 309.03(8) (8) 

Trans 309.03(8)(a) (a) The ambulance service provider shall notify the inspector as soon as possible if an ambulance is involved in a motor vehicle crash which involves serious injury or death.

Trans 309.03(8)(b) (b) If an ambulance is being placed back into service after being involved in a crash, the ambulance service shall notify the inspector and shall provide proof of the repairs in writing before being placed back into service.

Trans 309.03(9) (9) 

Trans 309.03(9)(a) (a) The department shall consider the age, condition, and equipment of ambulances before granting approval for their continued use. The department shall not permit the use of any ambulance for emergency medical purposes which is deemed to be unsafe or unfit for such service.

Trans 309.03(9)(b) (b) In construing and enforcing the provisions of this chapter, the act, omission or failure of any officer, agent, servant or other person acting for or employed by the registered owner or the lessee of the ambulance is deemed to be the act, omission or failure of such registered owner or lessee. This paragraph does not apply to violations of ch. 346, Stats.

Trans 309.03 History History: Cr. Register, October, 1986, No. 370, eff. 11-1-86; am. (1), (3) (a) and (b) 1. intro., r. (3) (b) 1. b., renum. (3) (b) 1.c. and d. to be (3) (b) 1. b. and c., Register, April, 1994, No. 460, eff. 5-1-94; am. (1), (3) (b) 1. (intro.), a., b., 2. and (4), cr. (1m), (1r) and (5) to (7), Register, February, 1999, No. 518, eff. 4-1-99; CR 19-074: am. (title), cr. (1g), am. (3) (a), (b) 1. (intro.), a., (4), cr. (5) (j) to (t), am. (7), cr. (8), (9) Register October 2020 No. 778, eff. 11-1-20; correction in (3) (b) 1. (intro.), a., (4), (8) (b), (9) (b) made under s. 35.17, Stats., Register October 2020 No. 778; CR 22-048: am. (4) Register July 2023 No. 811, eff. 8-1-23.

Trans 309.04 Trans 309.04 Specialized emergency medical care vehicles.

Trans 309.04(1) (1) In recognition of their highly specialized design, construction, equipment and function, mobile intensive care transport units, critical care transport units and intensive care vehicles designed and equipped for neonatology medical services, that are used only for transportation of patients between hospitals, are exempt from the vehicle equipment standards prescribed in ss. Trans 309.09 to 309.11, 309.14, 309.15 (3), 309.18 and 309.19 and subch. III.

Trans 309.04(2) (2) A vehicle subject to this section may not be used as a primary response vehicle, but may be used only for mobile intensive care or neonatology medical care purposes.

Trans 309.04(3) (3) A vehicle subject to this section may respond as an additional resource vehicle during times such as a disaster emergency when local resources, including mutual aid resources, are exceeded.

Trans 309.04 History History: Cr. Register, October, 1986, No. 370, eff. 11-1-86; am. (1), Register, April, 1994, No. 460, eff. 5-1-94; am. (2), cr. (3), Register, February, 1999, No. 518, eff. 4-1-99; CR 19-074: am. (1) Register October 2020 No. 778, eff. 11-1-20.

Trans 309.06 Trans 309.06 Sale or lease of new or used vehicles for use as ambulances.

Trans 309.06(1) (1) Any person selling or leasing any new or used vehicle that is intended to be used as an ambulance shall provide the purchaser or lessee with a written notice stating that the vehicle complies with the requirements of ss. Trans 309.09 to 309.16.

Trans 309.06(2) (2) An ambulance may be loaned or leased to an ambulance service provider by an ambulance manufacturer or dealer in order to avoid a hardship on that ambulance service provider and the emergency medical service needs of the community or communities it represents. The ambulance service must notify the inspector or department that they are obtaining the ambulance, the reason why, and the approximate duration as soon as possible. The loaned or leased ambulance must be temporarily replacing, for not more than 6 months, an ambulance inspected and approved by the department under this chapter. If the ambulance service needs the use of a loaned or leased ambulance for any period of time greater than 6 months, approval must be granted by the department’s inspector. The entity loaning or leasing the ambulance must ensure the ambulance complies with the requirements of ss. Trans 309.09 to 309.16. The ambulance service receiving the loaned or leased ambulance must comply with all the applicable requirements of this chapter, except for those requirements of this chapter that can be waived under the joint written agreement of the ambulance service provider receiving the loaned or leased ambulance and the department inspector.

Trans 309.06 History History: Cr. Register, October, 1986, No. 370, eff. 11-1-86; am., Register, April, 1994, No. 460, eff. 5-1-94; CR 19-074: renum. Trans 309.06 to (1), cr. (2) Register October 2020 No. 778, eff. 11-1-20; correction in (2) made under s. 35.17, Stats., Register October 2020 No. 778.

Trans 309.07 Trans 309.07 Variances.

Trans 309.07(1) (1) The department may grant a variance if it determines that the lack of such variance will create an undue hardship in meeting the emergency medical service needs of the community the applicant serves.

Trans 309.07(2) (2) In determining whether an undue hardship may be created if a variance is not granted, the department shall consider all of the following:

Trans 309.07(2)(a) (a) The kind and amount of emergency medical services available in the immediate area served by the applicant.

Trans 309.07(2)(b) (b) The presence of other ambulance service providers in surrounding communities that might be available to assist in emergencies through mutual aid agreements or other similar arrangements.

Trans 309.07(2)(c) (c) The number and type of emergency and nonemergency service calls made by the applicant within the 2-year period immediately preceding the date of application.

Trans 309.07(2)(d) (d) Any plans developed by the applicant to upgrade the existing vehicles to established specifications.

Trans 309.07(2)(e) (e) Any other information that may be relevant to the question of the need for a variance in the particular case.

Trans 309.07(3) (3) Each application for a variance shall be referred by the department to the department of health services for review and recommendation. The department shall give great weight to such recommendation when deciding whether a variance should be granted.

Trans 309.07(4) (4) The issuance of a variance to any person for any ambulance does not exempt that vehicle from the biennial inspection requirements imposed in this chapter.

Trans 309.07(5) (5) The right to continue operation of an ambulance for which a variance has been granted or recognized under this section is not transferable to any other person or vehicle and a copy of the variance must be carried in the ambulance at all times.

Trans 309.07 History History: Cr. Register, October, 1986, No. 370, eff. 11-1-86; am. (1) and (4), Register, April, 1994, No. 460, eff. 5-1-94; r. (1) and (4), renum. (2) (a), (b) (intro.), 1. to 5., (5) and (6) to be (1) and (2) (intro.), (a) to (e), (4) and (5) and am. (2) (intro.) to (d)., (4) and (5), Register, February, 1999, No. 518, eff. 4-1-99; correction in (3) made under s. 13.92 (4) (b) 6., Stats., Register December 2010 No. 660; CR 19-074: am. (5) Register October 2020 No. 778, eff. 11-1-20.

Trans 309.08 Trans 309.08 Documentation.

Trans 309.08(1) (1) Registration and insurance. At the time of inspection, the service provider shall open to inspection the proof of current registration and insurance on each ambulance to be inspected. The proof of registration and insurance or copies of each shall be carried in each ambulance and be available upon request of the inspector.

Trans 309.08(2) (2) Drug list. Upon inspection, the service provider shall provide a copy of the current list of approved drugs from the services medical director. The list shall state the minimum amount of each drug the provider will carry on each ambulance.

Trans 309.08(3) (3) Maintenance. An ambulance service provider shall maintain their ambulances as specified by the OEM. Vehicle service or maintenance records shall be maintained by the ambulance service provider for the life of the ambulance and shall be made available to the department upon inspection.

Trans 309.08(4) (4) Crash register. An ambulance service provider shall keep a written or electronic register of each crash their vehicles are involved in. The register shall include the crash number issued by the investigating agency, date, location, driver name, number of injuries, number of fatalities and vehicles towed.

Trans 309.08 History History: Cr. Register, February, 1999, No. 518, eff. 4-1-99; CR 19-074: am. (1), r. and recr. (2), cr. (3), (4) Register October 2020 No. 778, eff. 11-1-20; correction in (3), (4) made under s. 35.17, Stats., Register October 2020 No. 778.

subch. II of ch. Trans 309 Subchapter II—Vehicle Standards

Trans 309.09 Trans 309.09 Patient compartment interior dimensions.

Trans 309.09(1) (1) The patient compartment shall have not less than 300 cubic feet of space less 10% deviation for cabinets and shall meet the following specifications:

Trans 309.09(1)(a) (a) Length. Measured from the partition to the inside edge of the rear loading doors, the patient compartment shall be not less than 116 inches in length. There shall be not less than 25 inches and not more than 30 inches of unobstructed space at the head of the primary patient, measured from the face of the backrest of the EMT’s seat to the forward edge of the primary cot.

Trans 309.09(1)(b) (b) Width. The compartment shall provide a minimum of 12” of clear aisle walkway between the edge of the primary patient cot and base of the nearest vertical feature measured along the floor.

Trans 309.09(1)(c) (c) Height. The patient compartment shall be not less than 60 inches in height over the patient area measured from the floor to the ceiling, exclusive of cabinets or equipment and symmetrical corners and edges.

Trans 309.09(2) (2) The interior of the body shall be free of all unnecessary projections. It shall be maintained in a sanitary condition. All hangers or supports for equipment and devices shall be mounted as flush as possible with the surrounding surface when not in use. Padding shall be placed at all head area obstructions which may prove dangerous to persons moving about in the patient compartment. Other exposed edges shall be beveled with not less than a 1/8 inch radius or chamfer, and a 1/2 to 1 inch radius on exposed corners. The finish of the entire patient compartment including interiors of storage cabinets shall be impervious to soap and water, disinfectants and mildew and shall be fire resistant. Any floor to wall surface joints shall be sealed with an impervious seal.

Trans 309.09 History History: Cr. Register, October, 1986, No. 370, eff. 11-1-86; am. (1) (a) and (2), Register, April, 1994, No. 460, eff. 5-1-94; corrected to restore dropped copy, Register, April, 1997, No. 496; am. (1) (c), Register, February, 1999, No. 518, eff. 4-1-99; CR 19-074: am. (1) (b) Register October 2020 No. 778, eff. 11-1-20.

Trans 309.10 Trans 309.10 Doors. An ambulance shall have 2 unobstructed door openings in addition to the doors for the driver cab compartment. There shall be at least one door opening on the right forward side and a single door or double doors at the rear of the patient compartment. A forward hinged single door, double doors or a sliding type door shall have a minimum right side door opening of 30 inches in width, and 54 inches in height for Types I, I-AD, III and III-AD ambulances and 42 inches in height for Type II ambulances. The opening shall provide clearance to allow access and removal of a patient strapped to a long spine board. Single or double rear loading doors shall cover a clear opening of not less than 46 inches in height and 44 inches in width for Types I, I-AD, III and III-AD ambulances, and the manufacturer’s standard for Type II ambulances. The ambulance body doors shall be equipped with not less than 250 square inches of safety glass area per door. Doors shall be designed for easy release from both the interior and exterior of the ambulance, but an accidental opening shall be prevented by an interlocking system that functions even when doors are not completely closed. Each door shall have effective compression or overlapping seals to prevent the entry of dust, water and air. Doors may contain recessed compartments to the interior for storage of supplies and devices.

Trans 309.10 History History: Cr. Register, October, 1986, No. 370, eff. 11-1-86; CR 19-074: am. Register October 2020 No. 778, eff. 11-1-20.

Trans 309.11 Trans 309.11 Bumpers, steps and stepwells. Chassis manufacturer’s standard bumpers shall be furnished with the exception of the rear bumpers of Types I, I-AD, III and III-AD ambulances. Types I, I-AD, III and III-AD ambulances shall have a sturdy full width rear vehicular and body bumper with step, secured to the vehicle’s chassis-frame. The rear bumper and step shall be adequate to support the test weight of 500 pounds without flexing or buckling. If the patient compartment floor is more than 18 inches above the ground on a Type II ambulance, a step shall be installed within 2 inches of an equal distance between the ground and the patient compartment floor. All bumper steps shall be designed to prevent the accumulation of mud, ice or snow and shall be made of antiskid, open grating metal. Steps may be of a folding style but may not be located within or exposed to the interior of the ambulance when the doors are closed. All steps shall extend the full width of the door opening for which they are provided and shall be not less than 5 inches nor more than 10 inches in depth.

Trans 309.11 History History: Cr. Register, October, 1986, No. 370, eff. 11-1-86; CR 19-074: am. Register October 2020 No. 778, eff. 11-1-20.

Trans 309.12 Trans 309.12 Tires and wheels.

Trans 309.12(1) (1) Each tire shall have not less than 1/8 inch tread depth. The depth shall be measured at 2 points not less than 15 inches apart in any major tread groove at or near the center of the tire.

Trans 309.12(2) (2) Wheels, tires and brake drum assemblies shall be in balance.

Trans 309.12(3) (3) Snow tires with tungsten carbide studs, which shall not project more than one-eighth inch beyond the treads surface of the tire, may be installed on an ambulance from the 15th day of November each year through the 1st day of April of the following year.