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HomeMy WebLinkAbout20130934RECORD OF PROCEEDINGS MINUTES BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO APRIL 15, 2013 The Board of County Commissioners of Weld County, Colorado, met in regular session in full conformity with the laws of the State of Colorado at the regular place of meeting in the Weld County Administration Building, Greeley, Colorado, April 15, 2013, at the hour of 9:00 a.m. ROLL CALL: The meeting was called to order by the Chair and on roll call the following members were present, constituting a quorum of the members thereof: Commissioner William F. Garcia, Chair Commissioner Douglas Rademacher, Pro-Tem Commissioner Sean P. Conway Commissioner Mike Freeman Commissioner Barbara Kirkmeyer Also present: County Attorney, Bruce T. Barker Acting Clerk to the Board, Susan Brown Director of Finance and Administration, Monica Mika • MINUTES: Commissioner Conway moved to approve the minutes of the Board of County Commissioners meeting of April 10, 2013, as printed. Commissioner Freeman seconded the motion, and it carried unanimously. a AMENDMENTS TO AGENDA: There were no amendments to the agenda. • PUBLIC INPUT: No public input was given. • CONSENT AGENDA: Commissioner Rademacher moved to approve the Consent Agenda as printed. Commissioner Conway seconded the motion, and it carried unanimously. NEW BUSINESS: • 1) CONSIDER COMMUNITY SERVICES BLOCK GRANT (CSBG) CONTRACT AMENDMENT FOR INITIAL ALLOCATION AND AUTHORIZE CHAIR TO SIGN: Judy Griego, Director of Department of Human Services, explained that due to the uncertainty of the federal budget, this grant is currently providing funding for a six-month period. Commissioner Rademacher moved to approve said contract amendment and authorize the Chair to sign. Seconded by Commissioner Conway, the motion carried unanimously. Ms. Griego and the Board planned a work session to discuss options as to services provided from these funds. (Clerk's note, items #2 and #3 were postponed at the Chair's discretion.) 6\q7 Minutes, April 15, 2013 Page 1 2013-0934 BC0016 4) CONSIDER TEMPORARY CLOSURE OF CR 41 BETWEEN CRS 74 AND 76, AND CRS 74 AND 72: Janet Carter, Department of Public Works, reviewed the temporary road closure for a gas line upgrade. Ms. Carter requested a grace period because the project is scheduled for April 16th thru May 1st, but may have a delayed start due to inclement weather. Commissioner Conway moved to amend the resolution to read "15 days after the start of construction," with a flexible start date. Seconded by Commissioner Rademacher, the motion carried unanimously. Commissioner Conway moved to approve said temporary closure as amended. Seconded by Commissioner Rademacher, the motion carried unanimously. 5) CONSIDER APPLICATION FOR TIER I EMERGENCY MEDICAL SERVICE LICENSE AND AUTHORIZE CHAIR TO SIGN - MILLIKEN FIRE PROTECTION DISTRICT: Dr. Mark Wallace, Director of Department of Public Health and Environment, favorably reviewed the application, and reported that the Emergency Medical Trauma Services (EMTS) Council also reviewed the application, and recommended granting a Tier I license. - Mike Blackwell, EMTS Council representative, said that the Council recommended this license on the basis of improved response times and having a dedicated ambulance for the region, and other factors they felt would improve emergency medical services in Milliken. In response to Commissioner Conway, Mr. Blackwell replied they are looking for an industry standard response time of less than nine (9) minutes (in urban areas) — 90 percent of the time. He explained that each district determines where the urban, suburban and rural areas are, and further explained the desired response times expected for each area. He said regular reports and meetings will be used to keep track of compliance with these expectations. Commissioner Kirkmeyer asked if the effect on county -wide service had been discussed and also asked about mutual -aid agreements (MAAs). Mr. Blackwell replied that MAAs with University of Colorado Health and Thompson Valley were in process, and Banner was approached, and confirmed that this information was used to determine the recommendation. aRichard Lyons, Lyons Gaddis Kahn and Hall, applicant's council, entered documents into the record, marked Exhibits A through D, which included a letter of support from the Mayor of Milliken, a letter from Dr. Wallace, a copy of the signed contract with Poudre Ambulance and the University of Colorado Health System establishing that the district will take title of the ambulance, and other back-up. a Ron Bateman, Milliken Fire Protection District Chief, thanked those in support of the application, and spoke to providing an efficient, effective, and coordinated response. He said response times will be cut nearly in half and may save lives and gave some specific examples. He added that call volumes increased 44% from 2010 to 2012. In response to Commissioner Kirkmeyer, Chief Bateman said they do not yet have MAAs in place, but they are in process and waiting for Tier I license approval. Some discussion ensued regarding MAAs and situations where these would be called into play. a Commissioner Kirkmeyer said the County has a contractual agreement with Banner to provide exclusive dispatch services and asked if the applicants had had discussions with Banner or Weld County regarding dispatch issues. Chief Bateman said they have intergovernmental agreements with both municipalities. There was further discussion regarding dispatch and legal issues regarding authority, especially in unincorporated Weld County, and the role of the Regional Communications Board. Chief Bateman referred to a meeting with the Weld County Fire Chiefs Executive Board and said he was awaiting feedback from them. There was additional discussion and Commissioner Kirkmeyer said that Weld County has a contract in place with Banner, and the County and Fire District need to resolve that matter before beginning operations on May 15, because at this point Banner is still doing ambulance service in all unincorporated Weld County, and only Banner can legally be dispatched in these areas. 12 Mr. Lyons said the mutual aid agreements are extremely close to being finalized. Most of them are standard, but there is some tweaking needed in regard to the urban and rural delineations. He said, with respect to the dispatch issue, it is the Districts' intention to use existing Minutes, April 15, 2013 Page 2 2013-0934 BC0016 numbers for dispatch, and it should not make a difference whether it is for a fire truck or an ambulance. He also referred to a seven page letter submitted to the County Attorney regarding the District's legal right to displace the County in their boundaries and referred to other examples in the County. Commissioner Kirkmeyer said the examples were prior to the contractual agreement with Banner. There was additional discussion about how to harmonize the two. In response to Commissioner Conway, Chief Bateman confirmed that it is their desire to have the MAAs in place prior to operation, Milliken will have a donated ambulance manned and located in Milliken and there will be a back-up reserve ambulance in Johnstown for the time being, in case of a break -down. In response to Commissioner Conway's concerns regarding the older ambulances, Chief Bateman said that if one breaks and is un-repairable, there is a replacement fund built into the intergovernmental agreement and the vehicles are designed to be rechassied; this would be in addition to using the reserve vehicle. aIn response to Chair Garcia, Chief Bateman spoke about subdivisions which will be covered by their district, and said the duty captain will be the person responsible to configure the ambulance locations. Chair Garcia opened the floor to Public Comment. Rebecca Clark, Johnstown resident, submitted her letter into the record, marked as Exhibit F and gave an example of driving her son to the hospital; she said she was in support of this application because she would no longer hesitate to call 911 because of a long wait. Janie McCullough, Treasurer, Milliken Fire Protection District Board of Directors, submitted a letter from his board into the record, marked as Exhibit E. El Blair Howe, Milliken Fire Protection District Board of Directors President, said in response to Commissioner Kirkmeyer, that he did not know why there was no meeting with the Board of Commissioners but they should have one. 3 Chief Bateman said that he was under the impression that the letter from council fulfilled that need. Kate Jennings, Johnstown resident and local firefighter, spoke about the long response times and said that her reluctant recommendation to her neighbors was to drive themselves if at all possible, and said she had shared her opinion with Chief Bateman. ! Kendra Currey, Windsor resident, said she has worked with Weld County paramedics and appreciates their service - she now works with Poudre Valley EMS, and as a first responder knows firsthand about long response times. aNathaniel Kronholm, Milliken resident and firefighter, spoke about the issue of citizens having to decide between driving themselves or calling an ambulance in an emergency and asked the Board to respect the decisions of the local fire districts. a' Commissioner Conway stated his support of the application based on testimony from Dr. Wallace and the EMTS Council's recommendations, adding that the MAAs are imperative, but he trusts that these will happen based on the testimony of Chief Bateman. Commissioner Kirkmeyer asked for an amendment for approval contingent upon the MAAs. Commissioner Rademacher made a motion to approve said license, with the condition that the MAAs be in place prior to operation. Commissioner Conway seconded the motion, and it carried unanimously. Mr. Lyons said the executed mutual aid agreements would be filed with the County Attorney as soon as possible and he supports the motion as presented. Dr. Wallace said actually his department would receive those and enter them as part of the record. Commissioner Kirkmeyer said she would like minutes from the EMTS Council to be entered into the record as well as minutes from the Minutes, April 15, 2013 2013-0934 Page 3 BC0016 Communications Board dealing with the dispatch issue, because all those things are a part of the Board's decision. Commissioner Conway concurred that the EMTS Council needs to provide additional information to help the Board make an informed ruling. 2) CONSIDER TEMPORARY ASSEMBLY PERMIT - FRANK'S RIDE FOR CHILDREN, C/O GREG RISEDORF: Bruce Barker, County Attorney, said that the numbers for attendance seemed to be taken from 2010, and so an up-to-date projected number of attendees was needed in addition to a clarification of security provisions. Lisa Carpenter, Sheriff's Deputy, stated they had no concerns with the volunteer security, and had had no past issues. Roy Rudisill, Office of Emergency Management, had two comments, first, that Mountain View Fire Protection said they were not informed of the planned event, and second, whether Longmont could provide ambulance service, but there is plenty of time to work out these issues. He said that the event has been going on for many years and is a great event. Greg Risedorf, Event Manager, said this is the 27th Annual Frank's Ride for Children and last year's event raised $30,000 dollars; as of 1995 a total of $495,000 has been raised and 104 wishes granted to terminally ill kids. He clarified that a Longmont Emergency Unit would be on -site as they have been in past years and several of the volunteer security guards have TIPS certification. The Board thanked Mr. Risedorf and all the volunteers for their good work. Commissioner Rademacher moved to approve said permit. The motion was seconded by Commissioner Kirkmeyer, and it carried unanimously. 3) CONSIDER SPECIAL EVENTS PERMIT AND AUTHORIZE CHAIR TO SIGN - MAKE -A - WISH FOUNDATION OF COLORADO, INC. /FRANK'S RIDE FOR CHILDREN, C/O GREG RISEDORF: Commissioner Kirkmeyer moved to approve said permit and authorize the Chair to sign. The motion was seconded by Commissioner Conway, and it carried unanimously. 6) CONSIDER APPLICATION FOR TIER I EMERGENCY MEDICAL SERVICE LICENSE AND AUTHORIZE CHAIR TO SIGN - JOHNSTOWN FIRE PROTECTION DISTRICT: Dr. Wallace commented that the Department of Public Health and Environment created the summary page and perhaps contributed to the brevity of the information provided, adding that the EMTS Council's minutes would be provided in the future. Commissioner Kirkmeyer noted that few of the Fire Chiefs even knew the Council existed and she was dismayed at the lack of findings on response time and impact to countywide service, and said the Board has tried to make clear what they need in a recommendation. Chair Garcia noted this is a new process. Mr. Lyons submitted exhibits for the record, marked Exhibits A through D, including letters from the Mayor of Johnstown and Dr. Wallace, the contract with University of Colorado Health, letter from Ronald Webber offering a historical perspective, and other documents. El Mr. Bateman referred to his previous statements and offered to answer any questions. He spoke about past and future response times in Johnstown and confirmed these will be reviewed monthly, and also at the EMTS Council, which meets every other month. In response to Commissioner Kirkmeyer, Chief Bateman said the benchmarks for the urban, suburban and rural area determinations are coming from national standards. After some discussion about the reserve ambulance, which will be located in Johnstown, it was clarified that the three Fire Districts will work together to re -configure where the ambulances are deployed as the need arises. Commissioner Kirkmeyer asked about the communication between the district and Weld County Regional Communication Center/dispatch so that they know where the ambulances are, Chief Bateman replied this has not yet been determined. A consensus was reached that there needs to be a meeting between the Board and the Districts to discuss the legal issues and obligations. There was further discussion regarding the definition of Division 5. In response to Commissioner Conway, Chief Bateman said that Milliken, Johnstown and Windsor -Severance are autonomous from the Poudre Valley license and said Minutes, April 15, 2013 Page 4 2013-0934 BC0016 the three operations chiefs are responsible for day-to-day situational awareness. a Mr. Lyons clarified that the Johnstown 2013 response times were entered into the record. i Chair Garcia opened the floor to public comment. El Larry Weber, Johnstown resident, volunteer and board member, gave some history about Johnstown emergency services and gave an example of his own heart -related call for service. He said an ambulance took 45 minutes to arrive while he was being cared for by fire fighters. Commissioner Conway spoke in support of the application, as long as the MAAs are in place. Commissioner Freeman concurred. Commissioner Kirkmeyer moved to approve said Tier I license upon execution of the MAAs and authorize the Chair to sign. Commissioner Conway seconded the motion, and it carried unanimously. Commissioner Kirkmeyer stated the EMTS Council minutes were needed, the dispatch and allocation of resources issues needed to be resolved, and also expressed her disappointment at the lack of any prior meetings with the Board. 7) CONSIDER APPLICATION FOR TIER I EMERGENCY MEDICAL SERVICE LICENSE AND AUTHORIZE CHAIR TO SIGN - WINDSOR SEVERANCE FIRE PROTECTION DISTRICT: Dr. Wallace introduced the application and reported the positive recommendation of himself and the EMTS Council. a Mr. Lyons, applicant's council, entered a packet into the record, marked exhibits A through G, which included a letters from the mayors of Windsor and Severance, and other pertinent documents. La Bill Grady, Severance Fire Protection District Chief, stated all the Chiefs felt a multi - jurisdictional approach would be most effective. Commissioner Conway noted that the letter from Mayor Vasquez does not seem to be a ringing endorsement. The Chief noted that the towns of Windsor and Severance made the first point of their comprehensive Flips a quality ambulance service (three ALS units and one reserve between the three districts). There was some discussion regarding MAAs and the services provided and ambulance units available, and Chief Brady said, in regard to dispatch, that the Captain will call in their ambulance deployment to the Weld County Regional Communication Center. Commissioner Kirkmeyer asked why the County was not invited to the meetings the fire districts had with the municipalities. She again cited the county's contractual obligation with Banner, and said she believed it was common knowledge. There was further discussion regarding response times, and Chief Brady explained that the fire district goes through a federal accreditation process, but the fire district determines what falls into which category, but has to be consistent within the district as to what that matrix is. Commissioner Conway clarified that the purpose for these changes is to improve the response times and the new arrangement will achieve that. In response to Commissioner Conway, Chief Brady clarified they are taking possession of two high - mileage ambulances; they have a contract for maintenance, a fund in place for replacement, and one in reserve, and if there was a second failure there would be a back-up provided out of Fort Collins for the term of the contract, and these provisions meet industry standards. aChair Garcia opened the floor to public comment. Tom Berkshire, Mayor of Severance, representing the Town Board, commended Chief Brady and others for their hard work putting this together and gave his support. He said that contractual agreements for unincorporated areas of their communities were entered by Weld County without consultation with the Fire Districts and that should be taken into consideration. Commissioner Kirkmeyer said that the County operated an ambulance service for 40 years and that all of the Fire Chiefs were notified and invited to a meeting, and that since last December the Board has been expressing an interest in, and a need for, discussion. Commissioner Kirkmeyer again expressed concerns about the level of service to unincorporated areas. aMayor Berkshire said cooperation should increase the level of service and a level of coordination still needs to happen in regard to logistics. Commissioner Conway stated that when the County transferred the ambulance services there were three public hearings with an opportunity to speak and ask questions. He added that the 911 Emergency Telephone Service Authority Board was also involved in that decision and there was also a meeting with the Fire Chiefs. Darren Jaques, Severance resident and Windsor -Severance Minutes, April 15, 2013 Page 5 2013-0934 BC0016 Fire Rescue, said that the only service issue he is concerned about are wait times. aDr. Stephanie Buchholze, President of the Windsor Fire Protection District Board of Directors, stated her Board received no notification of the ambulance service change and thanked the applicants for putting together a program to proved better service. In response to Commissioner Conway, she said that funds have been designated for replacement and repair of the ambulance, and University of Colorado Hospital will bring in another ambulance in case of a double failure. She said they have funds and are ready to buy a new chassis if required. In conclusion, she said that her Board is committed to communicating with the Board of Commissioners in future meetings. a Mr. Lyons clarified that the contingency of mutual aid is acceptable to the district. In response to Commissioner Conway, Mr. Brady explained Division 5, from a Windsor perspective, and said that allocation of resources is determined by the captain, as the captain is held accountable for response times. He stated the captain will also communicate with battalion chiefs on a daily basis, with regular monthly reviews, robust quarterly reviews and an annual report; the contractor has opportunity to make corrections monthly. aCommissioner Conway reiterated his previous support and comments and noted the Mayor's support. Commissioner Kirkmeyer stated her support is contingent upon MAAs being in effect prior to operation. She said the health, welfare and safety of Weld County citizens is paramount and the Board has a contractual agreement with Banner and there should be some sort of performance agreement in place. She also noted concerns about service to unincorporated areas of these fire districts and requested that the EMTS Council meeting minutes be entered into the record. Commissioner Conway moved to approve said license with an amendment that MAAs be in place prior to operation and authorize the Chair to sign. Commissioner Rademacher seconded the motion, and it carried unanimously. (Clerk's Note: Commissioner Conway made a motion to reconvene the last item of New Business at 1:00 p.m. Seconded by Commissioner Kirkmeyer, the motion carried unanimously. Commissioner Conway was excused.) HEALTH NEW BUSINESS: la 1) CONSIDER SUSPENSION OR REVOCATION OF COLORADO RETAIL FOOD ESTABLISHMENT LICENSE - EL PUEBLITO #1: Deb Adamson, Department of Public Health and Environment, introduced the issue and reported an extra interventional enforcement meeting was held in order to avoid a civil penalty and all the penalties were assessed for improper cold holding. Dan Joseph, Department of Public Health and Environment, presented a PowerPoint presentation outlining the nature and history of the violations, and the dangers of food borne illnesses. He also reviewed the applicable statutes and the history of the Health Department's interactions with El Pueblito #1; from June, 2012, until now they have been cited with 18 violations, 15 critical. Mr. Joseph said the restaurant was briefly closed and re -opened after a roach infestation, and also reported that the same cooler failed three (3) inspections in a row, and was later replaced; however cold holding issues continued. Mr. Joseph presented a Summary of an Enforcement Meeting, dated March 13, 2013, and recommended suspension or revocation of the license and assessment of the $1,000 civil penalty. " Ms. Adamson stated that they recommended the license be suspended long enough to get help from a professional consultant. Salvador Ortega and Rosalina Mireles introduced themselves. Ms. Mireles said this is a small family restaurant, three families depend on her restaurant for employment and they do not make a profit. She reported that she and her brother were in Mexico 3 times due to her father's death, and the employees were not running the restaurant responsibly, but she or her brother are usually there all the Minutes, April 15, 2013 Page 6 2013-0934 BC0016 time. The cooler was not working properly, and they were waiting for the new one. She stated that she cares about the people who come to her restaurant. The salsa Ph issue was discussed as well as the faulty calibration of a new thermometer. Mr. Ortega said they are hard workers and want to keep the business running. They reported that two employees will be taking the Weld STAR testing and a suspension would make it hard to keep the business afloat because of the effect on the restaurant's reputation. Ms. Adamson said a consultant could probably be available within a day. In response to Chair Garcia, Mr. Joseph reported that the second penalty was for eggs and other items being off temperature, not just for the salsa not being on ice. Commissioner Rademacher said in past cases the Board has allowed the $1,000 dollars penalty to go toward the cost of hiring a consultant, and Commissioner Kirkmeyer stated that typically a license is suspended until the consultant has done their work and another inspection has taken place. Chair Garcia said, in the interest of public health and safety, the owner needs to get someone in there immediately; a restaurant needs properly trained staff so the owner does not have to be there all the time. In response to Commissioner Kirkmeyer, Mr. Joseph said a consultant can usually be on -site within a day and an inspection occurs upon re -opening. Commissioner Rademacher suggested that conditions be added in regard to training, so that all four staff members have a certificate of safety training via Weld STAR or on-line. Mr. Joseph confirmed that there were no mechanical issues except that the thermometer was not working at the last inspection. Commissioner Kirkmeyer moved to suspend the license until such time as a consultant is on -site, requested that the health department assist with locating an available consultant, that the staff and owners participate in training, that there is a follow-up inspection, and that the $1,000 penalty be waived in lieu of contracting a consultant. Commissioner seconded the motion, and it carried unanimously. la 8) CONSIDER APPLICATION FOR TIER I EMERGENCY MEDICAL SERVICE LICENSE AND AUTHORIZE CHAIR TO SIGN - POUDRE VALLEY HOSPITAL: Dr. Wallace introduced the matter, and in response to Commissioner Conway, said the applicant would be operating out of a base on 10th Street in Greeley, but this is not their primary base of operations, which is in Fort Collins. Commissioner Conway questioned whether this application was separate from the prior Fire District's application, and Dr. Wallace replied that these four were presented together because they are integrated. Commissioner Conway stated that the fire chiefs had previously stated District 5 was separate. In response to Commissioner Conway, Dr. Wallace stated that granting a Tier II for this application would not be compatible with granting a Tier I license to the Fire Districts. Commissioner Kirkmeyer contended that Poudre Valley Hospital (PVH) could still provide mutual aid with a Tier II license. 12 Kevin Paul, Heizer Paul Grueskin, LLP, council for Poudre Valley Hospital, introduced Steve Main, Manager of Emergency Medical Services, and Division Chief Terry Kiel, and said the focus of our agreement is the three fire district agreements entered into with Johnstown, Milliken, and Windsor - Severance. PVH will operate those services; each of those contracts includes a conveyance of equipment to each district and staff to operate each service. El Mr. Main explained how their proposed system would work and said they have 40 years of experience, qualified staff and all the needed equipment and supplies, and will provide training. He also reviewed the MAAs in process, and other vehicles potentially available for use. Commissioner Kirkmeyer clarified that their service would honor a patient's request for a particular hospital and currently the are primarily dispatched out of Fort Collins, and Mr. Main addressed the average number of calls. La Mr. Main said that PVH is the operator and the fire districts are the providers; PVH provides man -power and know-how through an independent contract. Commissioner Conway explained his confusion as to the agreement and why a Minutes, April 15, 2013 Page 7 2013-0934 BC0016 Tier II license would not be adequate, and also questioned how PVH qualified for a Tier I license under the Weld County Code. After further discussion, Mr. Paul acknowledged that their primary base of operations is not in Weld County, but the basis of this application are the three contracts with the fire districts. Commissioner Kirkmeyer noted that the Weld County Ordinance makes a distinction between providing and operating and there was further discussion as to why a Tier II license would not be adequate to the situation under mutual -aid. • Amy Kolczak, University of Colorado Health Council, said the reason they are required to have a Tier I license by the Weld County Code is that Poudre Valley Health System, by law, is the operator of these ambulances and the Fire Districts are the providers. Commissioner Kirkmeyer contended that under the contract the Fire Districts are considered the operators. Ms. Kolczak cited that PVH donated the ambulances, but may have to sometimes call upon other ambulances, owned by PVH, which may be required to continue to provide emergency medical response. la Mr. Barker clarified the revised definitions of ambulance service under the code. Commissioner Conway expressed dismay that the afternoon testimony seemed so different from the morning testimony and that honoring these contracts seems contingent on PVH getting a Tier I license. He also said that either one or the other is the operator of the ambulance service, but not both. Chair Garcia noted that PVH does not seem to need a Tier I License for the districts to operate. • Mr. Paul said they want to ensure they are not operating outside of the scope of the ordinance, that they are fully authorized by Weld County, and that all of the resources that make this efficient and effective can be afforded to the fire districts. Commissioner Conway requested the Districts clarify the agreement as they understand it. Mr. Barker stated the ordinance does not prohibit PVH from operating ambulances on behalf of the districts and does not require them to have a separate license for that purpose. In response to Commissioner Freeman, there was discussion regarding the definitions of initial response and primary care and the effect on dispatching and mutual -aid. Mr. Main said that Poudre Valley's Fire District extends eight (8) miles into Weld County and they would like to formalize responding in that area, which would require a Tier I license. Commissioner Rademacher said there was a lot of discussion in the EMTS Meeting about mutual -aid agreements, and the consensus was that a Tier II License was only for non -emergency transport. • Chair Garcia opened the meeting up to public comment. • Herb Brady, Windsor Severance Fire Chief, and Mike Blackwell, Deputy Fire Chief, explained that Division 5 is a term that University of Colorado Health has chosen to use as their management of that area. He explained the Districts are not using that terminology, Division 5, and they are not trying to mislead, but they are fitting into their management structure. Chief Brady said they feel strongly that there should be no barriers to their ability to operate seamlessly with our districts, and added that citizens in Dos Rios and Arrowhead would benefit from their availability. He explained that the nearest ambulance would be called by the District Captain, including potential mutual -aid. In response to Commissioner Kirkmeyer, there was extensive discussion on whether or not a Tier I license for PVH is necessary. Further discussion took place on the topic of billing, which the Fire Districts have contracted to PVH, and whether or not having a Tier I license would cause billing difficulties. !I' Jim Young, Johnstown retired Firefighter and 15 year Johnstown Fire Protection District Board member, said the Board needs to consider the _ welfare of area residents and not be so concerned with the technicality of Tier I versus Tier II? Mr. Main said in a dynamic deployment plan the captain pre -positions resources, he does not wait until they are out of ambulances. In response to Chair Minutes, April 15, 2013 Page 8 2013-0934 BC0016 Garcia, Mr. Main said whether the section in discussion is dispatched through Larimer or Weld County depends on which cell tower gets hit with the call. He also stated Banner is unwilling to talk about mutual aid agreements. El Mr. Paul went back to the billing issues, stating the entire agreement hinges on how PVH is billing Medicare, and he explained this assertion further. There was further discussion regarding billing and federal regulations, and interpretation of the code language. aMs. Kolczak said they bill under a provider number, so anyone who operates in this County requires a Tier I license; if you are denied a license you are not the operator. Commissioner Kirkmeyer said PVH is currently providing response via mutual -aid in the County and they currently bill for that. Ms. Kolczak said under the former regulations there was not an issue, but the language of the new ordinance has created a problem in joint service. Commissioner Kirkmeyer noted that if they had a Tier II license under mutual -aid they would still be able to bill. Chief Brady said the goal is to call for service via mutual -aid before it is needed by pre -positioning, which requires a Tier I license; otherwise response times will be decreased. Commissioner Kirkmeyer said that if less service is provided that would be their responsibility, because there is a contract for these services in place throughout Weld County. There was extensive discussion regarding mutual -aid, the pre -positioning of ambulances and the wording of the Weld County Code. Chief Brady asked how their application was different from Platte Valley's, who were awarded a Tier I license in December. The Board explained that their existing license was renewed, they have an agreement with Brighton Fire, the new ordinance was not yet in effect, and Weld County does not dispatch Platte Valle : Mr. Paul said he disagreed with Commissioner Kirkmeyer's interpretation of the ordinance. Mr. Barker, in response to Commissioner Conway, said that Tier II does not provide for primary care and that, by statute, the Districts are the ones who provide the service. The question at issue is whether PVH doing it themselves or doing it on behalf of the Fire Districts, and as to billing, the question is on whose behalf are they billing? It comes down to who is the provider, and Mr. Barker said his interpretation is that they are on behalf of the Fire Districts. Commissioner Conway clarified that no one has been treated differently under the new system; that if the Board chooses to grant a Tier II license - that would not impact PVH's ability to service the Fire Districts who are granted licenses, and he reiterated it is incumbent that the MAAs are in place before May 15. Mr. Barker affirmed that the contracts can be upheld without a Tier I license. El Commissioner Rademacher said this was brought before the EMTS Council and the definition of primary care responder was well understood. He added that the whole County will benefit from granting this license, it should not be denied, and he believes Banner will just redeploy their ambulances elsewhere. Commissioner Kirkmeyer outlined in detail why she does not feel that PVH qualifies for this license under the code. She said again that the recommendation from the EMTS Council was entirely lacking in detail. In response to Commissioner Rademacher's question about being headquartered in Weld County, Commissioner Kirkmeyer stated that Banner is contracted with Northern Colorado Medical Center whose primary base of operations is in Weld County. Commissioner Freeman noted that they do have a contract in Weld County, and the recommendations from the EMTS Council and Dr. Wallace are in support. Commissioner Conway stated no evidence presented this afternoon counters evidence heard this morning; either you grant the three Fire District licenses in keeping with the spirit of the Code change, or grant a license to Poudre Valley Health; nothing prohibits Colorado University Hospital from engaging in what they are contracted for. The Fire Districts administer the contract and are the licensees. Commissioner Conway also noted that he does not believe Poudre Valley Health meets the definition of primary base of operations, therefore a Tier II license is appropriate, but not a Tier I, and, in regard to the EMTS Council meeting, there was a lot of discussion on how to get around the rules. He also noted that in the future the EMTS Council needs to Minutes, April 15, 2013 2013-0934 Page 9 BC0016 be present for a thorough vetting of the application. aChair Garcia said that he agreed with Mr. Barker that a Tier II license would be adequate, and as to the billing issue, he would defer to council. He said the application though, is for a Tier I, and noted that the vetting process would be better in the future. Chair Garcia also noted that the original Poudre Valley Application was denied under the old code because their place of business was of major concern. He then said he feels Poudre Valley now meets the minimum standards to be issued a Tier I license. Commissioner Rademacher moved to grant a Tier I license to Poudre Valley Hospital EMS. The motion was seconded by Commissioner Freeman. Upon a call for a roll -call vote, the motion passed 3- 2, with Commissioners Conway and Kirkmeyer opposed. RESOLUTIONS AND ORDINANCES: The resolutions were presented and signed as listed on the Consent Agenda. No Ordinances were approved. Let the minutes reflect that the above and foregoing actions were attested to and respectfully submitted by the Acting Clerk to the Board. There being no further business, this meeting was adjourned at 2:52 p.m. BOARD OF Cs NTY COMMISSIONERS WELD CO i�I1T SLORADO ATTEST: Welddnty Clerk to the Board BY: Deputy Cle o the Board illiam .- arci-, air ougl:s Rademacr, Pro-Tem an P. Conway Minutes, April 15, 2013 2013-0934 Page 10 BC0016 O O U CC ATTENDANCE M 0 N LL O Q C HEARINGS ARE AS FOLLOWS ON THIS PLEASE legibly write or print your name and complete address. 123 Nowhere Street, City, State, Zip s -7 c � �1 :le 5 u A j t, , t t 14 t . J,�;i Q _ O� s NAME John Doe t t c. --.N _O7a i it 5 J V Hello