Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 110 - Emergency Medical Services Licensing, Certification, And Training Requirements › Subchapter IV - Emergency Medical Service Provider Licensing and Operation › Section DHS 110.35 - License and application requirements

Current through June 24, 2024
To apply for a license as an ambulance service provider, a
					 non-transporting emergency medical service provider, or an emergency medical
					 responder service provider, a person shall do all of the following:
(1) FEASIBILITY STUDY. Complete a feasibility
				  study and submit it to the department for approval. First responder service
				  providers are not required to do a feasibility study.
(2) APPLICATION AND OPERATIONAL PLAN. Upon
				  the department's approval of the feasibility study required under sub. (1),
				  complete and submit an application and an operational plan to the department in
				  the manner specified by the department. The operational plan and its addendums
				  shall include all of the following:
(a) Signed
				  patient care protocols approved by the service medical director.
(b) A formulary list of medications the
				  emergency medical service provider will use.
(c) A list of the advanced skills and
				  procedures the applicant intends to use to provide services within the
				  Wisconsin scope of practice of the level of care for which licensure is
				  sought.
(d) Proof of professional
				  liability or medical malpractice insurance, and, if the emergency medical
				  service provider is an ambulance service provider, proof of vehicle
				  insurance.
(e) Operational policies
				  for all of the following:
1. Response
				  cancellation, describing how the emergency medical service provider will handle
				  a cancellation of a response while en route to the scene.
2. Use of lights and sirens in responding to
				  a call.
3. Dispatch and response,
				  describing how EMS professionals are dispatched and how the emergency medical
				  service provider acknowledges to the dispatcher that it is
				  responding.
4. Refusal of care,
				  describing the procedure for accepting a refusal of care from a
				  patient.
5. Destination
				  determination, describing how the transport destination of the patient is
				  determined if the provider is an ambulance service provider.
6. Emergency vehicle operation and driver
				  safety training.
7. Controlled
				  substances and how the service provider will obtain, store, secure, exchange,
				  and account for any and all controlled substances used to provide patient
				  care.
8. Continuous quality
				  assurance and improvement program describing the components of the program,
				  including how patient care and documentation will be reviewed, by whom, and how
				  the results will be shared with practitioners and incorporated into continuing
				  education.
9. Multiple patient
				  incidents describing how the service will handle the response to the incident
				  including triage, care, transportation and patient tracking.
(f) Written letters or other
				  documentation of endorsement from the local hospital and government within the
				  proposed primary service area, if the application is for licensure as a 9-1-1
				  ambulance service provider or non-transporting emergency medical service
				  provider, whether the application is for initial licensure or a service level
				  upgrade.
(g) When a service provider
				  is required to submit an update to its operational plan, the update to the
				  operational plan must be submitted on the form or in the manner approved by the
				  department indicating:
1. The section of the
				  operational plan being updated or revised.
2. Description detailing the change and
				  intended impact on the service.
3.
				  Approval of the update or revision by the service director and when involving
				  patient care or patient care equipment, the service medical director.
4. Other information as determined by the
				  department.