EMS Provider Operational Plan

An operational plan is a requirement under Wis. Admin. Code ch. DHS 110 to operate an EMS Service in the State of Wisconsin. Initial plans and amendments to current plans can be submitted to the appropriate EMS regional coordinator (regional map) for review and approval.

The following forms and components are required:

Each Service is required to submit and maintain the EMS Application and Operational Plan Form and Components

Additionally, the following components are required by service license level:

Advanced Skill Addendums by license level:

For questions on assistance on how to complete an operational plan, please contact your EMS Regional Coordinator

Wisconsin Admin. Code ch. DHS 110 Relating to EMS Service Requirements

DHS 110.32 Emergency Medical Service Provider License Required; License Levels.

(1) No person may act as or advertise for the provision of services as a first responder service, a non-transporting EMT service provider, or an ambulance service provider unless the person is licensed by the department to do so.

(2) A person licensed as a first responder service provider may provide emergency medical services at the first responder level of care before hospitalization and the arrival of an ambulance but may not transport patients.

(3) A person licensed as a non-transporting EMT service provider may provide emergency medical services before hospitalization and the arrival of an ambulance at the EMT-basic, EMT-intermediate technician, EMT-intermediate, or EMT-paramedic level of care, but may not transport patients.

(4) A person may be licensed as an ambulance service provider to provide 9-1-1 emergency response, interfacility transport or both, and at one of the following levels of care: EMT basic, EMT-intermediate technician, EMT-intermediate, or EMT-paramedic. An ambulance service provider licensed to provide both a 9-1-1 emergency response and interfacility transports shall be licensed at the same level of care for both services.

DHS 110.33 Authorized Services.

(1) An emergency medical services provider may advertise and provide only those services for which it has been licensed by the department.

(2) An emergency medical services provider may advertise and provide only those services that are within the Wisconsin scope of practice for the level at which the provider is licensed.

(3) An emergency medical services provider may advertise and provide only those services that are described in its department-approved operational plan. The provider shall keep the operational plan and any addendums current. Any changes to the operational plan, including addendums, shall be submitted to the department for approval not less than 60 days before the intended implementation date and may not be implemented until the service receives department approval.

DHS 110.34 Responsibilities

An emergency medical service provider shall do all of the following:

(1) Comply with the requirements of this chapter and 256, Stats.

(2) Advertise and provide only those services it is authorized to provide under this subchapter.

(3) Designate a hospital that will provide day-to-day medical control.

(4) Designate the primary service area in which it will operate.

(5) Assure response to 9-1-1 emergency response requests 24 hours-a-day, 7 days-a-week, unless it is not licensed to do so. First responder services are exempt from this requirement but should assure every effort is made to respond to 9-1-1 requests.

(6) Meet the staffing requirements identified in s. 256.15 (4), Stats., and s. DHS 110.50.

(7) If the emergency medical services provider is an ambulance service provider, submit a written report to the receiving hospital upon delivering a patient and a complete patient care report within 24 hours of patient delivery. A written report may be a complete patient care report or other documentation approved by the department and accepted by the receiving hospital. A non-transporting EMT service provider or first responder service provider shall hand a written report to the ambulance service provider at the time of the patient care transfer.

(8) If the emergency medical service provider is an ambulance service provider or non-transporting EMT service provider, submit patient care report data electronically to the department through WARDS using direct web-based input to WARDS or uploading patient care report data to WARDS within 7 days of the patient transport. If the emergency medical service provider is a first responder service provider, submit a patient care report to WARDS only if advanced skills are used in caring for the patient.

Note: An abbreviated first responder report is available in WARDS to eliminate duplicate entry and facilitate quick entry of this information. The WARDS system can be accessed via the internet at www.emswards.org.

(9) Comply with the data system guidelines published by the department.

(10) Maintain written mutual aid and coverage agreements with ambulance service providers operating within or adjacent to its primary service area.

(11) Designate and maintain affiliation with a regional trauma advisory council.

(12) Maintain a communication system that allows communication between medical control and EMS personnel and complies with the Wisconsin Emergency Medical Services Communications Plan.

(13) Designate and maintain affiliation with a training center to provide required training.

(14) Maintain a quality assurance program that provides continuing education and assures continuing competency of EMS personnel.

(15) If the emergency medical services provider is an ambulance service provider, maintain at least one ambulance vehicle in good operating condition as required under ch. Trans 309.

(16) Refuse to respond to an interfacility transport request by a hospital for an emergency transfer that is dispatched through a 9-1-1 center, if not licensed to provide interfacility transports.

DHS 110.35 License and Application Requirements

To apply for a license as an ambulance service provider, a non-transporting EMT service provider, or a first 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 personnel 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.

(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 911 ambulance service provider or non-transporting EMT service provider, whether the application is for initial licensure or a service level upgrade.

(3) Department decisions on application.

(a) Complete application. 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.

(b) Incomplete application. When an incomplete application is received, the department will notify the applicant of any deficiencies within 60 business days. If the applicant fails to respond to the notice and fails to complete the application within six months from the date of initial submission to the department, the application is void. The department will not take any further action on the incomplete application. To be considered further by the department, the applicant shall meet the eligibility requirements and submit a new application as required under this subchapter.

DHS 110.36 Phase-in Period; Service Level Upgrades and Downgrades

(1) A licensed ambulance service provider applying for licensure at a higher service level that can demonstrate hardship in attaining the higher level may request department approval of a phase-in period not to exceed 12 months. During a phase-in period, an ambulance service provider that is upgrading to a higher service level may provide emergency medical care at both the higher service level and its current service level without assuring a consistent level of care at the higher level 24 hours a day.

(2) An applicant for department approval of a phase-in period to upgrade its service level shall submit a license application, operational plan and addendums for the higher service level as specified under s. DHS 110.35 and all of the following:

(a) A detailed explanation of why the phase-in period is necessary, how the phase-in will be accomplished and the specific date, not to exceed 12 months from department approval, that full-time 24 hours-per day, 7 days-per-week service at the higher service level will be achieved.

(b) An explanation of how quality assurance will be maintained and skill proficiency will be evaluated.

(3) If the department approves a request to provide emergency medical care at a higher service level during a phase-in period, the department shall issue a provisional license for the duration of the phase-in period.

(4) During the phase-in period, the applicant shall meet all of the requirements under s. 256.15, Stats., this chapter, and the approved operational plan, except the requirement to provide 24-hour-per-day, 7-day-per-week staffing coverage at the higher service level.

(5) An emergency medical service provider that does not achieve full-time 24 hours-per-day, 7 days-per-week service within the approved 12 month phase-in period shall notify the department, cease providing service at the upgraded level, and revert back to its previous service level, unless the department approves an extension under sub. (6).

(6) An emergency medical service provider that does not achieve full-time 24 hours per day, 7 days-per-week service within the 12 month phase-in may request one extension for an additional 12 months if the request is made in writing to the department no less than 60 business days before the expiration of the phase-in period. A phase-in period shall not exceed a total of 24 months.

DHS 110.37 Service Level Downgrades

(1) An ambulance service provider or non-transporting EMT service provider may downgrade the level of its service only after department approval. The ambulance service provider or non-transporting EMT service provider shall submit a complete operational plan under s. DHS 110.35 (2), provide documentation from each community it serves that a public meeting was held at which the downgrade was an agenda item, and submit to the department a letter of support or understanding from each community it serves.

(2) An ambulance service provider may reduce the number of available ambulances for 9-1-1 emergency responses from the number identified in its operational plan if the ambulance service provider documents a hardship other than financial in an operational plan amendment and receives department approval.

DHS 110.38 Interfacility Transports

In addition to the responsibilities under s. DHS 110.34, an ambulance service provider licensed to provide interfacility transports shall satisfy all of the following requirements:

(1) The ambulance service provider shall ensure that interfacility transports do not interfere with its responsibility to provide 9-1-1 emergency response in its primary service area, if it is also licensed as a 9-1-1 provider.

(2) The ambulance service provider shall assure proper staffing for interfacility transports based on the acuity of the patient, the orders of the sending physician and the staffing requirements in s. DHS 110.50.

(3) The ambulance service provider shall not use mutual aid agreements to cover its primary service area while providing interfacility transports.

(4) If the ambulance service provider is licensed as both a 9-1-1 provider and interfacility provider, the provider shall have a minimum of one ambulance for 9-1-1 emergency response and one ambulance for interfacility transports, unless the ambulance service provider has a coverage agreement with a neighboring ambulance service provider that will be able to provide one 9-1-1 ambulance for each primary service area.

DHS 110.39 Critical Care And Specialty Care Transports

In addition to the responsibilities under s. DHS 110.34, an ambulance service provider that provides critical care and specialty care transport services shall satisfy all of the following requirements:

(1) The ambulance service provider shall be licensed at the EMT-paramedic level.

(2) The ambulance service provider shall designate the specialty services it offers.

(3) The ambulance service provider shall identify a schedule for the availability of specialty care services, if it does not provide 24 hour-a-day, 7 day-a-week coverage.

(4) The ambulance service provider shall implement and maintain patient care protocols to be used by critical care paramedics, which follow the Wisconsin scope of practice for the critical care paramedic.

(5) The ambulance service provider shall staff an ambulance appropriately for the acuity of the patient as designated by the sending physician and in conformity to the staffing requirements in s. DHS 110.50.

(6) The ambulance service provider shall specifically identify the EMS personnel that are credentialed or part of the interfacility transport program.

(7) The ambulance service provider shall meet other requirements the department specifies.

DHS 110.40 Intercept Service

In addition to the responsibilities under s. DHS 110.34, an ambulance service provider or non-transporting EMT service that provides intercept services is subject to all of the following requirements:

(1) The emergency medical service provider shall be licensed as a 9-1-1 emergency medical service provider.

(2) The emergency medical service provider intercept services shall not interfere with its responsibility to provide 9-1-1 emergency response within its primary service area.

(3) If providing intercept services in a 2 paramedic system, the ambulance service provider shall use 2 paramedics during transports, and, if 2 paramedics are not available, it shall operate at the next lower level of service.

(4) The intercept service shall identify a schedule for availability of intercept services, if the service does not provide 24 hour-a-day, 7 day-a-week coverage.

DHS 110.41 Air Medical Services

(1) In order to provide air medical service in Wisconsin, an ambulance service provider, including an ambulance service provider licensed in another state that makes more than 4 patient transports a year that originate and terminate in Wisconsin, shall be licensed under s. DHS 110.35, to provide air medical services and shall be nationally accredited for air medical transports by an entity approved by the department as follows:

(a) An ambulance service provider that was licensed by the department as an air medical service provider before July 1, 2010, shall obtain national accreditation for air medical transports by an entity approved by the department no later than July 1, 2015.

(b) Effective July 1, 2010, only ambulance service providers licensed at the paramedic level may be licensed as air medical services providers.

(2) An ambulance service provider licensed at the paramedic level and endorsed to provide air medical services that responds to 9-1-1 emergency response calls in its primary service area, shall provide 24-hour-a-day, 7 days-a-week air medical service, except when limited in particular circumstances by safety or mechanical considerations.

(3) When an ambulance service provider receives a request for air medical services transport, the ambulance service provider shall notify the requesting agency of the estimated time of arrival at the scene of a medical emergency or the medical facility for an interfacility transport, and it shall immediately communicate any changes in estimated time of arrival to the requesting agency.

DHS 110.42 Tactical Emergency Medical Services

An ambulance service provider or other agency shall obtain departmental approval before using licensed EMS personnel to provide tactical emergency medical services as follows:

(1) Ambulance services providers. To obtain department approval to provide tactical emergency medical services, an ambulance service provider shall submit an application and operational plan as provided under s. DHS 110.35 (2).

(2) Tactical teams. To obtain department approval, an agency shall do all of the following:

(a) Apply on a form obtained from the department.

(b) Submit patient care protocols for the emergency medical care the agency intends to provide.

(c) Submit an explanation of how the agency will interact with an ambulance service provider and maintain the initial level of patient care.

(d) Submit proof of medical liability insurance.

(e) Submit a written quality assurance and training plan for the EMS personnel that operate on the team.

DHS 110.43 Special Units

If a licensed ambulance service owns, operates, and maintains special transport vehicles including, but not limited to, boats, ATV's, or snowmobiles, the licensed ambulance service shall identify them in its application and operational plan as required under s. DHS 110.35 (2).

DHS 110.44 Special Events

A licensed ambulance service provider or non-transporting EMT service shall obtain department approval before providing emergency medical services for special events outside its primary service area or that will require the provider to exceed its normal staffing and equipment levels within its primary service area. Events that occur on a regular basis may be included in the service operational plan and an update submitted in lieu of a complete plan. To obtain department approval, the ambulance service provider shall submit all of the following to the department not less than 14 business days before the event:

(1) Name of the ambulance service provider or non-transporting EMT service requesting approval.

(2) Contact information for the event manager, including how to contact the ambulance service provider during the event.

(3) Locations, dates, and times of the event.

(4) Name, address, phone numbers, and e-mail addresses for each service medical director who will oversee the medical services at the event.

(5) Name and contact information for the medical control facility.

(6) The types of EMS services that will be provided.

(7) The level of EMS service that will be provided.

(8) The ambulance staffing configurations and types.

(9) Whether the service will be “dedicated services" or “as available" based on resources.

(10) Description of on-site communications between the event manager, event staff, dispatch, and 9-1-1 dispatch.

(11) Explanation of how medical control will be contacted for on-site medical direction at the patient location.

(12) Any special patient care protocols for use at the event.

(13) Explanation of how EMS personnel will be notified and requested during the event.

(14) Explanation of how the ambulance service provider will integrate with the 9-1-1 system.

(15) Explanation of how a 9-1-1 request that is generated within the event by a participant or spectator will be handled.

(16) Identification of the service provider that will respond to a 9-1-1 call initiated from within the event.

(17) Documentation that the ambulance service provider for the primary service area in which the event is located has approved the ambulance service provider who is outside its service area to provide event coverage within its primary service area.

(18) Written assurance that adequate resources will be available.

(19) Written acknowledgement that the ambulance service provider requesting special event approval assumes all liability for ambulance coverage and response during the event.

(20) Copies of any agreement or contract for providing emergency medical services for the event.

Note: When submitting copies of the contracts or agreements the service may redact any compensation information.

(21) Other information as determined by the department

DHS 110.45 Department Decisions on Applications

(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.

(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.

(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 110.46 License Duration

A license issued by the department to an emergency medical service provider is valid 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 110.47 Required Personnel and Responsibilities

An emergency medical service provider shall have all of the following personnel:

(1) A service director qualified under s. DHS 110.48.

(2) A service medical director qualified under s. DHS 110.49.

(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.

(4) A quality assurance designee who is responsible for managing patient-based quality improvement processes in collaboration with the service medical director.

(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 personnel.

(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.

(7) EMS professionals sufficient to meet the staffing requirements under s. DHS 110.50.

DHS 110.48 Service Director

An emergency medical service provider shall have a service director who shall:

(1) Serve as the primary contact between the emergency medical service provider and the department.

(2) Assure that all elements of the operational plan are kept current.

(3) Assure that EMS personnel are properly licensed and credentialed.

(4) Provide day-to-day supervision of the ambulance service provider's operations.

DHS 110.49 Service 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):

(1) Qualifications. The service medical director shall meet all the following within 180 days from the date of his or her appointment:

(a) Licensure as a physician.

(b) Current certification in CPR for health care professionals and, if the medical director provides medical direction for an EMT-intermediate or EMT-paramedic emergency medical services provider, current certification in ACLS, unless the physician is certified by the American Board of Emergency Medicine or the American Osteopathic Board of Emergency Medicine.

(c) Education, training and experience in emergency medicine.

(d) Familiarity with the design and operation of pre-hospital EMS systems.

(e) Experience or training in the EMS quality improvement process.

(f) Successful completion of the department's service medical director course.

(g) Any additional requirements prescribed by the department.

(2) Responsibilities. The service medical director shall do all of the following:

(a) Prescribe patient care protocols under which the provider's EMS personnel treat.

(b) Develop, review and approve in writing all patient care protocols that will be used by EMS personnel delivering patient care under the operational plan.

(c) Ensure that physicians providing on-line medical control do so in a manner consistent with the department approved patient care protocols.

(d) Ensure that all aspects of the emergency medical services are under medical supervision and direction at all times.

(e) Establish, participate in, and ensure the continuing implementation of a quality assurance program as part of a patient care improvement process.

(f) Approve, limit or withdraw credentials as provided under s. DHS 110.52.

(g) Maintain liaison with the medical community, including hospitals, emergency departments, urgent care clinics, physicians, nurses, and other healthcare providers.

(h) Work with regional, state and local EMS authorities to ensure that standards, needs and requirements are met and resource utilization is optimized.

(i) Maintain, through continuing education, current knowledge and skills appropriate for a service medical director.

(j) Approve, direct, and assist in providing training activities that assure EMS personnel are competent to provide safe and efficient patient care, based on the department approved patient care protocols.

DHS 110.50 EMS Provider Staffing Requirements

(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:

(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.

(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.

(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.

(d)Paramedic ambulance.

  1. For an ambulance service provider licensed before January 1, 2000, the ambulance shall be staffed with two EMT-paramedics.
  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.
  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.
  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.

(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.

(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.

(g) First responder. When a first responder service provider responds to a request for service at least one certified first responder shall respond.

(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.

(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.

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.

(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:

(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.

(b) In a two paramedic system, if only one paramedic is available, the ambulance shall operate at the next lower EMT level.

DHS 110.51 Preceptors

(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.

(2) In order to serve as a preceptor for field training, an individual shall have all of the following qualifications:

(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.

(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.

(c) A preceptor shall oversee and mentor students during supervised field training and shall complete the records required to document the field training.

(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 110.52 EMS Personnel Credentialing

(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.

(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.

(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.

(4) A certified first responder or licensed EMT may be credentialed by more than one emergency medical service provider.

(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.

(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.

(7) An emergency medical service provider shall notify the department promptly if its service medical director withdraws an individual's credential.

(8) The termination or withdrawal of an individual's credential does not by itself affect the individual's certificate or license.

DHS 110.525 Field Training Requirements

(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).

(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.

Last Revised: May 27, 2020