1. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services June 25 2014 Jennifer Ullsvik - Section Chief Emergency Health Care and Preparedness Ray Lemke - EMS Coordinator Wisconsin EMS Update

2. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services Mission The mission of the Wisconsin Emergency Medical Services Unit is to ensure that the highest quality and standards of pre-hospital emergency medical care is available to all citizens of and visitors to Wisconsin. 2

3. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services Vision Through leadership, support, and regulation, the EMS Unit ensures the development and maintenance of a high quality Emergency Medical Services delivery system for the State of Wisconsin. Its primary focus is to reduce both human suffering and economic loss from premature death and disability resulting from sudden illness or injury. 3

4. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services Number of WI Services Licensed and/or certified EMS services (809 total statewide [11 out of state])  First Responder Groups (343 certified groups)  EMT- Basic (137 licensed services)  EMT - Intermediate Technician (148 licensed services)  Intermediate (13 licensed services)  Paramedic (147 licensed services)  Critical Care Paramedic Endorsed (49 services)  Air Medical Services (9 licensed services)  Tactical EMS Teams (21 recognized teams) 4

5. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services EMS Personnel Licensed and/or certified EMS personnel (19,953 total statewide)  First Responders (3,640 certified personnel)  EMT-Basics (9,001 licensed personnel)  Intermediate Technicians (2,781 licensed personnel)  Intermediates (217 licensed personnel)  Paramedics (4,285 licensed personnel) 2011 Statewide call volume = 631,230 2012 Statewide call volume = 654,528 2013 Statewide call volume = 645,182 5

6. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services EMS Presentations Working Together Conference University of Wisconsin Trauma Symposium Governor's Traffic Safety Conference Wisconsin State Fire Chiefs Association Paramedic Seminars of Wisconsin Paramedic Systems of Wisconsin Wisconsin State Firefighter’s Association 6

7. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services Year in Review As of June 25, 2014 - Renewed 15,796 providers for the 2014-2016 licensing period As of June 25, 2014 – Renewed 697 Services Licensing renewal webinars Implemented the “training center training permit” extension process Revised and approved first responder curricula 7

8. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services Year in review ( cont.) Assisted local services Continued partnering with Wisconsin Hospital Preparedness program to support the Tactical EMS program Continued to streamline and update licensing process EMS Lean Project 8

9. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services Year in review ( cont.) Worked with paramedic training centers to achieve program accreditation Updated the State EMS Plan for 2014-2016 Worked on plan for National EMS Information System dataset upgrade to version 3.0 New patch vendor Trauma tourniquet project

10. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services Year in review ( cont.) Updated scopes of practice o EMR Albuterol – Aspirin o EMR Hemostatic agents o Paramedic chest tube monitoring o Changed D50 to dextrose Updated course on weapons of mass destruction

11. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services Looking Forward 2014-2016 renewal process Focus group meetings for renewal process Continuing to work on the NHTSA recommendations Strategic plan development with EMS Board utilizing NHTSA recommendations RN equivalency application in E-Licensing Review of driver safety policies 11

12. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services Looking Forward (cont.) Review of revised renewal process Regionalization discussion Service director courses o February 19 – WI Rapids o March 13 – Rice Lake o April 9 – Rhinelander o May 15 - Fennimore Narcan pilot study 12

13. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services EMS Program Location Department of Health Services - Division of Public Health Room 1150 13

14. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services EMS Program Website www.dhs.wisconsin.gov/EMS Considered our “24/7 employee” Updated frequently Licensing page 14

15. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services National Highway Transportation Safety Administration (NHTSA) NHTSA reviewed Wisconsin EMS in June 2012 Public comment requested on recommendations in December 2012 Department worked with partners to identify 13 of the 59 priorities as needing immediate attention These priorities were included in the 2014- 2016 State EMS Plan 15

16. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services Curricula Competency Based o First Responder (49 hours – not including CPR or advanced skills) o EMT - Basic (150-180 hours) o Intermediate -Tech (140-150 hours) o Intermediate (496 hours) o Paramedic (1200 hours) 16

17. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services National Scope Transitions Transition to the new levels and scopes of practice Information will be posted on our website Investigating best method to facilitate name changes for EMS levels – in progress 17

18. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services WARDS – Wisconsin Ambulance Run Data System Required to submit patient care reports Standard reporting Service director can manage personnel Ability to keep individual and service demographic information up to date Hospitals should have access for reports 18

19. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services WARDS – Wisconsin Ambulance Run Data System (cont.) National EMS Information System compliant submission of data Upgrade to Version 3 data set coming by the end of 2014 Streamlining report process with dynamic run report 19

20. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services WISCOM 20 Statewide communications system for all public safety users 95% mobile coverage statewide - many areas for portables Local, regional, state mutual aid talk groups Dedicated talk groups for hospitals, EMS Already over 10,000 users Hospital radio installations

21. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services Director Courses Service director course o Six courses completed since 2011 o Four completed so far in 2014 February 19 – WI Rapids March 13 – Rice Lake April 9 – Rhinelander May 15 - Fennimore o Discussing development of a “new” versus “experienced” director course Medical director course to WI-TRAIN 21

22. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services Funding Assistance Program Application will be sent via e-mail New electronic application located in E- Licensing Change to application to elevate return of education money All expenses will be reviewed 22

23. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services First Responder Grants Department of Transportation $150,000 Potential funding Change in recipient match from 25% to 75% Survey regarding viability of grant Training, equipment, supplies and marketing o Last year 42 of 341 services applied 23

24. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services Critical Care Paramedic (CCP) Compliance date was 1/1/13 Scope implemented Required plan update o Medication list o Self-designated medications o Just-in-time training 24

25. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services DHS 110.35 – Service Policies (2) (e) Policy requirements o Response cancellation o Lights and siren use o Dispatch and response o Refusal of care o Destination determination o Emergency vehicle operation and driver safety 25

26. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services DHS 110.42 - TEMS Training not specified in rule Affiliation with recognized team DHS 110.42(2) Tactical EMS team recognition requirements o Protocols o Interaction with local EMS o Liability insurance o Quality Assurance and Training plan 26

27. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services Enforcement 110.54: Reasons why enforcement may take place 110.55: Warning letter 110.56: Reprimand 110.57: Summary suspension 110.58: Multiple actions – Revocation 110.59: Appeals 27

28. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services Renewals 2014-2016 Opened in November 2013 Training focus is on transition to the new national EMS scope of practice levels Renewal information was widely distributed in January/February 2014 Will be sent via e-mail and U.S. Postal Service Check our website for updated information (www.dhs.wisconsin.gov/ems/License_certification/index.htm) 28

29. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services E-Licensing New interface! Please use recovery options on log-in screen if you lose your username or password EMS website link updated PLEASE keep contact information current This is the primary database for correspondence 29

30. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services DHS 110.09 - Renewals Late renewal – less than 6 months o Complete refresher activities o Pay $50 fee Reinstatement – 6 months – 24 months o Complete refresher activities o Complete National Registry of EMT’s assessment written and practical exams o Pay $75 reinstatement fee Lapsed – over 24 months o Complete original training for specified level 30

31. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services DHS 110.16 - Fees Late renewal fee - $50 Reinstatement fee - $75 Returned renewal fee - $30 Verification fee - $25 Reciprocity fee - $50 Manual application fee - $35 31

32. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services Training Permits Two separate processes o Training Center Training Permit (all levels)  For patient contacts and clinicals  Places responsibility on student  Provides better screening of applicants with issues that may prevent them from being licensed  Extension of permits o EMT-Basic Training Permit  To be used as part of an EMT-Basic licensed crew – EMT-Basic level ONLY 32

33. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services Complaints and Waivers New form for complaints o Public o EMS services o EMS personnel New form for waiver requests o Medical o Military o Other ? 33

34. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services Vehicle Standards National standards changing o National Fire Protection Agency (NFPA) Standard 1917 o Government Service Administration (GSA) KKK-A-1822F Standard o American Society for Testing and Materials (ASTM) Administrative rule TRANS 309 open for revision 34

35. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services EMS Board Working board meetings o February and August Regular board meetings o April, June, October, and December Now available via webcast o Static link for meetings o Information on our website http://www.dhs.wisconsin.gov/ems/EMSU nit/Board/Meetings.htm 35

36. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services EMS Board Committees Data Management and System Quality EMS Systems Management Education and Training Service Development http://www.dhs.wisconsin.gov/ems/EMSU nit/EMSBoards.htm 36

37. WI EMS Update 2014 DPH/EMS Program Wisconsin Department of Health Services Questions? E-Mail: dhsemssmail@dhs.wisconsin.gov Website: http://dhs.wisconsin.gov/EMS Main phone: (608) 266-1568 37