HomeMy WebLinkAbout20080598.tiff RESOLUTION
RE: APPROVE COLORADO EMS PROVIDER GRANT APPLICATION AND AUTHORIZE
CHAIR TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS,the Board has been presented with a Colorado EMS Provider Grant Application
from the County of Weld, State of Colorado, by and through the Board of County Commissioners
of Weld County, on behalf of the Weld County Paramedic Service, to the Colorado Department of
Public Health and Environment, with terms and conditions being as stated in said application, and
WHEREAS, after review, the Board deems it advisable to approve said application, a copy
of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Colorado EMS Provider Grant Application from the County of Weld,
State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf
of the Weld County Paramedic Service, to the Colorado Department of Public Health and
Environment be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said application.
The above and foregoing Resolution was,on motion duly made and seconded, adopted by
the following vote on the 13th day of February, A.D., 2008.
BOARD OF COUNTY COMMISSIONERS
// WELD COUNTY, COLORADO
ATTEST: f � ,n/ ' "\-s1,11:,, it\ I C J
r1F#Irait H. Jerke, Chair
Weld County Clerk to the Board ;1861M:-
w,R9bO p den, Pro-Tem
Deputy erk to the Board 1 •
`
liam Garr
(7
AP ED AS TO
David E. Long ririb/A orneyi , (�cam (o cAl
Douglas/tademache '
4O72' O8
Date of signature:
2008-0598
AM0019
��[�':/7->&,J t? - DE7-CAE"
WELD COUNTY PARAMEDIC SERVICES
1121 M STREET
GREELEY, COLORADO 80631
PHONE (970) 353-5700 EXTENSION 3211
E-MAIL: dbresslergeo.weld.co.us
FAX: (970) 304-6408
February 13, 2008
Weld County
Board of County Commissioners
Agenda Item February 13, 2008
State EMS Provider Grant
Attached is the 2009 State EMS Provider Grant with all necessary documentation for the
application to by the Northern Colorado Regional Emergency Trauma/ Medical Advisory
Council, (NCRETAC) and State Emergency Medical and Trauma Advisory Council,
(SEMTAC).
Weld County Paramedic Services is applying to the State of Colorado Department of Health
EMS Division for a fifty(50) percent matching grant for the re-chassis of on Ford E-450 Super
Duty Ambulance.
Thank you,
Dave Bressler,
Director
EMS Provider Grant Application Page 1 ot- it)
ATTACHMENT A
Colorado EMS Provider Grant
Application
Colorado I.)epartnrent of Public Health and Eoviromnent
HFEMSD-A2
-8110 Cherry Creek Drive South
Denver,er.CO i4 24i,-15341
I. Legal Name: Weld County Goverment 2. Federal Tax II)Number
Doing Business As: Weld Count}'Paramedic Services 846000813
Grant Contact Person: Director Dave Bressler 4 Phone Numbers
Day: 970-353-5700 Nubile:
E-mail: dbressieraco.weld.co.us
Fax: 970-304-6408
5. Agency Mailing Address:
1121 M Street,Greeks',CO 80631
nLegal Status of Agency Cite/County Government,Cite/Counts Government
7. Is this a RETAC or statewide grant?False
Note:(;rants for RETAC or statewide projects will he reviewed by the SEMTAC only.
® Do you have any current grant requests to other agencies for the current budget year? False
®IMulti-Agency Application?False Lead Agency?False
Request Categories
Agency Match:50%
PROJECT.aRE.a St.UMM.>,R). .aoencv�Shire State Share CI)NHE List Out'
No More than 2 categories allowed per application Total Category(o 1 • �(ioo aQoa Amount Funded SEMT_aC
Eval=
El I Ambulance.Other Vehicle I. $76.WN►.1 N 1 $38.40 two► $;5.4t 111.1 N1
Ir
(Grant Request Totals: �I $76,800.001I $38,400.0011 S38,400.000����I
Grant Application Nistor i For Agency
Grant Fiscal
Year Category Status
2tN) Data Funded: l$41.7(N1.uu
Spent:
'ill)R Veh Funded: $;5.-t2_u.(Nt
Spent:
2tlt>7 IEMSEquipj Denied: Eval I Cat
'01)7Vela Funded: $365r3 H I
Spent: $36.8t 13.1N.)
N)
Funded: 42.575.E N l
'006 EMSEquip Spent: $2.198.67
20O6 Veh Funded: $76_814.uu
,Spent: $74.829.85
2(105 Defib DDenied: Eval
2()0� Veh Funded: $7; N
()1"1•1 N 1
Spent: $73.51NLtill
MATRIX Data Submission Requirement
https://www.hfemsd2.dphe.state.co.us/CEMSISWeb_Grants/frm_5102_PrintApp.aspx 2008-0598
EMS Provider Grant Appl i cati on Page 2 of 10
�Is this agency currently participating in the statewide data collection system"Yes
Balance Sheet for Entire Agency
Enter the date of your most current financials far your
entire agency: For 12 months ending:
Note: Use this same accounting period throughout the 12/31/2007
financial infommtion Category
nAccounting Method: Accrual
sho fur
Ili'eiux..icci�' iut;iiiZu .d ivi vepr2ia.hiuit and :iyiial il.xialiaiteilic l
�. List New Capital Item,Purchased: Exhaust System-54.iNNt Remounts of ambulance-
127 i)41 Cardiac monitor-23.1x)2
Assets
nUnreserved Cash Accounts �'_7tNT.tNI
F-7 Reserved Cash Accounts $(t(N I
n�i.im-eser ed Investments
n'Reser�ed Investments
HHeld in trust for Pension Benefits
®!Real Estate and Buildings $(!.tN►
F,quipntent------- --------
11. Market Value: No $17_,916.t)u
Depreciated Value: Yes
nkccounts Receivable $3.t)7`).4?6.(u0
® Prepaid Expenses V1.OO
t
n�Iuveutor,
n C)ther Assets $I74A44.IitI
Total Assets j$4,303,991.00
Liabilities
Acconts Payable $76-_'tlL).tHI
H Short Tenu Notes and Loans l$-l5.?(9).f.m
tit. Long Term Notes and Loans
!Taxes Pay able J$t u,t N.►
" IPayable Payroll Expenses 1,044.025.m
nPrepaid and Deferred Rey enue $t►(x t
Total Liabilities S1,011,214.410
INetW ourtb (`.'13,292,780.00
Profit and Loss
l Enter the date of your most current financials for your For 12 months ending:
(agency I 12/31/2007
Income/Revenues
.) For this agency: The EMS Portion of our budget is
different from the Entire Agency(budget) N"
Entire Agency EMS Portion
?. (iouernnient $t7-(N 1 VIA N I
https://www.hfemsd2.dphe.state.co.us/CEMSISWeb_Grants/frm_5102_PrintApp.aspx 2/10/200$
EMS Provider Grant Application Page 3 of to LI Mil Levy=O% $rl.(H) $0.ox}
enter dollar revenues-->
5. Donations_Contributions.Bequests $0.4 N) Vito')
® EMS Fee for Service $5.;14.47:.(x11 $ortir
7.1 Fund Raising $O.OO $0.tx)
8. Interest and Dividends I !WAR.' $0.ox)
9.1 Grants-List Sources: AFG and State provider $1'O,7'8.OO $0.0()
l+).1 Subscription Program $O.O O1 $(1.(x)
1 I L.11Other Income.I)etine: Salle assets/mist fees $17.354.0(1 $0.(x)
Total Income $8,652,955.00 $0.00
Expenses
12.IIOperational Expense 1 $1.417.6&44.00► $8 4.4'4)
Personnel CostS
1'' Salaries. benefits.etc. $;_S69.6O9,1N) $41.(NI
14.1 Depreciation Expense I V09_580.01:1 $11,1141
I 15.QQDebt Service _j $41.1 N Ill_ Surd
II
1 16.11Capital Expenditures i $108.)19.14 . $0.001
If Mier F\.nense s Defun .id ��t lI $',.93 .977'(14111 $1)0411
(Total Expenditures $8,51-1,284.00 I $0.00
Profit(or Loss) I $108,671.00 $0.00
Rates and Collection
i1.1 This agency charges for EMS services Yes
Agency: Yes
2. Who processes this agency's pilling and accounting'' Contract Service: No
tt No Billing/Accounting: No
I _ `—_iService 1 Base Rate Medicare Allowable
3.iIBL S(Basic Life Support►non-emergent I $I.342.tx) $2181.35
4. 'BLS—Emergent $1.;42.4x)i $322.16
ALSI (Advanced Life Support-I.cyel It $1.342.(.N} $241 62
Non-emergent
I 6. ALSI —Emergent II $1.342.(KII $;52.57
1 7. (ALS2-non-emergent II $4),4 x Il $O.OO
S. ALS2 -emergent 1 $1.•42.t0I $553.72
SCT(S?ecialty Care Transport)
�� non-emergent I $1 L 1 N I $5 1.110
1-1471 SCT(Specialty Care Transport I $0.880 $i1.0()
I Oemergent II II J
It. PI(Paramedic AL S Intercept) $)1.(M I $6.0o
non-emergent
12.4 FW(fixed Wing)—non-emergent I $8).rx l ;().(x I
1 3.1IFW(fixed Wing)—emergent Il $t).t d $O.OO
® RVv' (Rotary Wing'—non-emergent - Pt'ti t $81.)x)
® RW(Rotary Wing—emergent $r ton(N) Viol'
II II II
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EMS Provider Grant Application Page 4 of 10
I WI'Treat and Release ll tl.t 'II
® Mileage Rate—1 ilban $I8.►HJ
r 17. Mileage Rate-Rural 1 h' 17 ntik, $I K.ou
I I�I��NA;1C'�r. R•:f�-Riur'.1 I Scto ill ui tN, II ,&I t N
1_JI ..{. J1 .. .
2(1. Overall collection rate(Percentage t: 27
Financial Narrative (REQUIRED)
1. Please explain below
- Any information about your agency financials that will help evaluators understand your financial situation,such as
reserves or balances. If your board requires a specific balance or reserve for example,use this space to explain that.
Explanations of unreserved cash accounts and investments,as well as reserved cash accounts or investments.
Your cash match source.
If applicable,the issues which have dictated your choice for filing a financial waiver. Your comments should
- include explanations of extenuating circumstances that have rendered financial hardship or other reasons for
requesting a financial waiver
(The numbers provided throughout section I are based on the fiscal year 2006. These facts have been
audited and are accurate. The 2007 financial records have been completed but have not been audited.)
Weld County Paramedic Services(WCPS)is owned and operated by the Board of County
Commissioners of Weld County. The agency being an enterprise fund is solely responsible for its
budget and financial well being within the county. The agency serves over 4,000 square mile of
North /Northeastern Colorado. Operating as and enterprise of Weld County Government since 1989,
WCPS is required to bill and collect all of their operational costs of providing advanced life support
treatment and transportation. The service area and customer base include a population that is over
50%Medicare, Medicaid and medically indigent. With the required changes placed on ambulance
services in the Medicare/Medicaid fee schedules and forced acceptance of assignment, coupled with
eh changes in the Colorado No Fault automobile insurance on collections rates, WCPS has
experienced an average collection rate of 27% over the last year. This year has been a transition year
for WCPS; the service has had to fill 4 FTE's due to increasing call volume and the need for better
system coverage. WCPS has continued to strictly monitor the budget along with decreasing certain
items, and continuing to electronically bill patients to address the revenue shortfall created by these
changes. The result being a negative impact on our scheduled replacement of ambulances, along with
the inability to purchase needed data collection laptops. WCPS has had to lengthen the service life of
our ambulances and continue to employ a re-chassis program for maximum cost savings and timely
replacement of vehicles. Uncollected debt still continues to be a burden on WCPS; it is recorded as
bad debt and reflects negatively on our budget numbers. The fact is that this portion of uncollected
money affects the operation and administrative functions of WCPS When providing services to the
citizens and visitors of Weld County, WCPS maintains 100% compliance. Bad debt reflects that
portion of services that will never pay for themselves. Collection rates of 27%explain that with 100%
services provided we are losing 73% of our budget to bad debt or write offs. This trend has continued
be consistent over the last few years and will continue to be in our future. This uncollected debt
obviously affects our ability to maintain equipment, purchase new equipment, and provide data
collections to the state as requested. WCPS has maintained a solid budget but with increasing bad
dept and mandatory write-offs they will continue to the strain the budgets for replacement of vehicles
and the purchase of new equipment.
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EMS Provider Grant Application Page 5 of 10
Narrative Describing Your Agency's Structure and Service Area
Please use this area to describe your agency to someone from outside your area. Include a description of your district
I. proper,response area and the number of residents. Assume that the reader does not know the structure and staffing of
your agency,the terrain and roads of your area,and any special circumstances your agency contends with.
Weld County Paramedic Services (WCPS)provides advanced life support response, evaluation,
treatment and transport to the 300,000 citizens and numerous visitors throughout the 4,000 square
miles of Weld County Colorado. This service is provided in cooperation with surrounding ALS
providers via mutual aid agreements along with the tiered response of first responders from the fire
departments operating throughout Weld County. Of the near 13,500 calls for service, over 60%of the
calls for service fall into the rural /frontier areas, county roads and highways of Weld County. The
other 40%of calls occur within the city of Greeley. Advanced Life Support coverage is provided
through the fluid deployment of six ambulances during the day, five ambulances during 2000 to 0200
and four ambulances from 0200 to 0600, via fixed stations and system status placement of resources
throughout Weld County. Operating with 38 full time field staff and an office and administrative staff
of 8 Weld County operates as and enterprise of Weld County Government, billing and collecting all
costs of operation.
Grant Request Categories
Category I - Ambulance, Other Vehicle
'Category I-Ambulance,Other Vehicle_(Request Details)
IQt Description Price Each !Agency Share State Share Amount Funded
III :2 wd
I re-chassis of eNsistin€unit (Braun) V76.7.(_H►.on 1;38.400.(}0.(H I $384(10.00
Replacement
t [Totals —_ __ ___.. $38,400.00 $38,400.00
Category I-Ambulance,Other Vehicle(Equipment Request Details)
Qty Description Price Each Agency Share j State Share 1 Amount Funded
_ _ 11
lo Vehicle Equipment Requests
[Category I-Ambulance, Other Vehicle(Additional Questions)
IIf the requested vehicle(s)is(are)replacement(s): F
What was the number of calls your agency was
1 unable to respond to due to mechanical
unavailablility of the emergency vehicle to be -
replaced
2 What will be done with the unit that is replaced? The unit will be re-chassis and box
used on the new chassis.
What is the average length of service, in miles and or years,
3 HHof vehicles operated by your agency? 4 Years
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EMS Provider Grant Application rage b or to
Category I-Ambulance,Other Vehicle(Narratives)
Weld County Paramedic Services(WCPS) has initiated a re-chassis
program in which chassis would be replaced and patient modules would be
remounted. The first re-chassis occurred in 2004 and was a great success at
an average savings of over $68,000 over the purchase of a new ambulance.
This project will continue until each of the 9 type III ambulances have been
remounted 3 times each. The vehicles with one remount are as follows in
Please describe your 2004 vehicles 16 and 18 were remounted and in 2005 vehicles 17, 19, 20
agency's vehicle were remounted. At the present time we had two vehicles being remounted
replacement program. for 2006 and it was vehicles 21 and 22. In 2007 we had to purchase a new
ambulance to add to the fleet with increasing call volume and with the
addition of 12 hour ambulance. Vehicle 23 was sent in for re-chassis in
2007 but we have yet to receive the vehicle back. We will need to remount
vehicle 24 to complete the first cycle of the three remounts. We will need to
complete the last vehicle in 2008 due to mileage and increased cost of
operation due maintenance issues.
Weld County Paramedic Services(WCPS) is an agency of Weld County
Government that operates as an enterprise fund. Funding is provided solely
through fees for service. The economy, federal fee schedules, along with the
changing of auto insurance in recent years combine with the constant
increasing costs that have negatively affected WCPS. Strict budgetary
oversight has been critical to meet the needs of a rapidly growing county
and the calls for service. The management of WCPS continues to search for
methods to operate more efficiently and effectively. In 1998 a decision was
made to establish a program that would S'u`re and estimated w'_).c nilli.�li
over the following 12 years. A re-chassis program was undertaken in which
Vehicle request
ambulances chassis would be replaced and patient modules would be
narrative -Please
explain if this vehicle remounted. The first re-chassis occurred in 2004 at a savings of
will be re lacing an approximately $68,000 over the purchase of a new ambulance. This project
y owned y will continue until each of the 9 type III ambulances have been remounted 3
previousl
vehicles and how the times. This project will require the remounting of 1 unit this fiscal year.
With considerations for inflation and variations in the requirements of each
cost was determined, as
specific unit it is estimated that the cost of remounting 1 chassis this year
well as any other will be $76,800.00. WCPS respectfully requests matching funds from the
information that would state for our re-chassis project. This program of remounting ambulances is a
help an outside person responsible and effective utilization of funds that are increasingly difficult
understand the needs of too obtain. It is but one of many methods by which WCPS strive to
your vehicle request. maintain the highest quality emergency service with less financial
resources. WCPS wants to acknowledge the support received from the State
of Colorado, SEMTAC and RETAC through the funds released to EMS
agencies through its State EMS Provider Grant Program. WCPS was the
recipient of a grant award last year to support the integration of our field
data collection system with our accounts receivable system This allowed us
to establish a strong foundation for our quality assurance and improvement
programs via improved efficiencies and the monitoring of goals for future
improvement. WCPS will deploy this new data collection program in early
2008 at the service. The two EMS agencies that we currently provide billing
services for will enjoy the benefits of the system as well. In the interim
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EMS Provider Grant Application Nage'/of 10
WCPS prides itself in our commitment to the submission of quarterly data
to the State EMS Data Collection Program. As many of you know,
ambulances are vital in the realm of EMS and with the constant increasing
cost of fuel, preventative and scheduled maintenance, the ambulance re-
chassis program continues to be the most cost effective method of obtaining
a new ambulance. This is the single request by WCPS this year and we
would like to thank everyone for their time and daunting task of
maintaining an excellent grant program.
Attestation
I. Legal Name of Agency: ...;;:., {,;,:. �,:;:;•;.,
DBA (Doing Business As- If s ..
Applicable: E
3. Federal Tax ID Number: M
4. Grant Contact Person:
4a. Title: E
4b. First Name: F }., .
4c. Last Name
Authorized Agent
The individual whose name and signature appear below, has been designated by the
agency/organization listed above as the Authorized Agent to complete and submit this grant
application on its behalf The agency/organization agrees to comply with the rules and regulations
governing the State of Colorado EMS Grants Program concerning grant requests.
Financial information
The Authorized Agent attests to the agency or organization's ability to provide the matching funds
5. (50%,40%, 30%, 20%or 10%)to complete the purchase of the grant award, should the agency be
awarded state funds.
The Authorized Agent is aware that EMS vehicles and equipment purchased must be without any
6. financial liens and without the item being used as collateral to secure a loan of any kind.
The Authorized Agent attests that, to the best of his/her knowledge, the information contained
7. herein, with regard to the Agency's financial condition, is true, accurate and correctly reflects the
financial condition of the agency/organization.
Notification of Affected Entities
By signing below, the Authorized Agent also attests to the fact that:
The agency(ies)/organization(s)affected by the possible outcome of this grant request, including
8. but not limited to agencies/organizations listed in this application if it is a multi-agency application,
has(have)been notified and has(have) agreed to its submission.
Applicant Duties and Obligations Should Funding be Awarded
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EMS Provider Grant Application rage a or Iu
Should the agency/organization listed in this application receive funding under this grant application,
the agency/organization(hereinafter referred to as'grantee')shall, and affirmatively promises to,
comply with all of the provisions set forth below.
9 The grantee shall use grant funds received under this grant to complete all aspects of its grant
application, and shall not use such funds for purposes other than this.
0 The grantee shall submit quarterly progress reports to the Colorado Department of Public Health
and Environment, EMS Category (hereinafter referred to as'the State')
11. Requirements for Training and Education Grants
For any training or education requests funded from this application the grantee shall comply with the
following terms and conditions:
Reimbursement for all travel expenses associated with the training or education program shall
A. be made in accordance with the then current state of Colorado reimbursement rates for travel
as specified in the Fiscal Rules of the state of Colorado.
Written proof of the successful completion of any training or educational program shall be
B. submitted at the same time as the invoice requesting reimbursement for that training or
educational program.
C. Prompt billing at the end of each quarter or semester is expected.
If the grantee provides a training or educational program, then the grantee shall acknowledge
D the use of emergency medical and trauma services account grant funds in all public service
announcements, program announcements, or any other printed material used for the purpose of
promoting or advertising the training or educational program.
If the grantee provides a training or educational program, then the grantee shall develop and
E utilize a course evaluation tool to measure the effectiveness of that training or educational
program. The grantee shall submit a copy of all evaluation reports to the State upon
completion of the training or educational program.
12. Requirements for Equipment Grants
For any equipment purchases funded from this application, the grantee shall comply with the
following requirements.
A The grantee shall provide the state with written documentation of the purchase of the specified
equipment.
All communications equipment shall be purchased from the State award for communications
equipment, or from another vendor for a comparable price and quality. If the grantee desires to
purchase communications equipment which is not listed on the State award then the grantee
B. must complete, with the State's assistance if needed, an informal competitive solicitation
process before purchasing that equipment. If a competitive solicitation process is used, then
the grantee shall purchase the communications equipment from the lowest bidder whose bid
meets the bid specifications.
If the grantee desires to purchase emergency vehicles other than ambulances, then the grantee
must complete, with the State's assistance if needed, an informal competitive solicitation
process before purchasing that equipment. The proposed specifications for these emergency
C. vehicles must be approved by the State prior to the initiation of the informal competitive
solicitation process. If a competitive solicitation process is used, then the grantee shall
purchase the emergency vehicles from the lowest bidder whose bid meets the bid
specifications.
If the grantee desires to purchase medical equipment, then the grantee must complete, with the
D. State's assistance if needed, an informal competitive solicitation process before purchasing
that equipment. If a competitive solicitation process is used, then the grantee shall purchase
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EMS Provider Grant Application Page 9 of 10
the medical equipment from the lowest bidder whose bid meets the bid specifications.
During the initial term and any renewal or extension term of the contract or purchase order
issued to convey funding to the grantee, and after the cancellation, termination, or expiration
F. date of caid contract or pi rrhace order the grantee chall acquire and maintain personal
property casualty insurance for the replacement value of all equipment it purchases under this
grant for the useful life of that purchased equipment.
The grantee shall keep inventory control records for all equipment it purchases. The grantee
F. shall obtain the prior, express, written consent of the State before relocating or reallocating
any equipment it purchases.
The grantee shall provide the State with a picture of each piece of equipment it purchases. The
G. grantee may submit a picture of a piece of purchased equipment at any time, but in no event
no later than the date the grantee's final progress report is due to the State.
The grantee shall maintain all equipment it purchases in good working order, normal wear and
tear excepted. The grantee shall perform all necessary maintenance services for all equipment
H. it purchases in a timely manner and in accordance with all manufacturer's specifications and
all manufacturer's warranty requirements. The grantee shall keep detailed and accurate records
of all maintenance services it performs on all equipment it purchases.
The grantee shall repair or replace all purchased equipment which is damaged, destroyed, lost,
stolen, or involved in any other form of casualty.
If the grantee ceases to provide emergency medical and trauma services in the state of
Colorado, then all equipment purchased under this grant shall either be placed with another
operating emergency medical services provider in the state of Colorado, or be sold at public
J. auction for its then fair market value. That portion of the sale proceeds which equals the
State's initial financial contribution towards the purchase of that equipment shall be refunded
to the State by the grantee. The grantee shall obtain the prior, express written consent of the
State prior to any relocation or sale of any purchased equipment.
Authorized Agent
13.11First Name i William H.
14. Last Name Jerke
15. Title Commissioner Chairperson
16. Daytime Phone Number 1970 356-4000 1
17. Daytime Phone Number Extension X 4200
18. Date 02/13/2008
19. Signature of Authorized Agent ✓� F
Required Attachments
Mail One hard copy of you application with original signatures and any attachments to:
EMS Provider Grants Program
Health Facilities and Emergency Medical Services Division
4300 Cherry Creek Drive South
Denver, CO 80246
# Description
.2?co'/-6S4YP
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EMS Provider Grant Application gage iu of iu
I1 'Hard copy of the agency profile. No signature required.
Hard copy of the financial waiver. Signature required. (The financial waiver is only a part of
2. your application if your cash match is less than 50°-0 )
Only if agency cash match percent is less than 50%
Hard copy of the grant application.
3. Signature of the authorized agent required. Signature of the medical director is required only if
jyou are requesting the defibrillation/cardiac monitor category.
4. W-9. Signature required.
Any other attachments you wish to include. These should be documents useful to the reviewers,
5. and can include letters of support, maps of your service area, maintenance records, quotes or
pictures of equipment you wish to replace.
Go Back
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Colorado EMS Agency Profile Page 1 ot-5
For Agency ID 322 - Weld County Paramedic
Services
Submission Year: 2008
Date Submitted to State: 2/6/2008
Is this agency a licensed ground I
Yes
ambulance service?
Is this agency a licensed air ambulance No
service?
Service Types: Ground Transport
Service Levels: 'ALS
Agency Information
1 Agency Weld County Paramedic Services
Name:
Agency
2. DBA Weld County Paramedic Services
Name:
3a. Agency 1121 M St
Mailing Greeley, CO 80631
Address:
3b. Physical 1121 M St
Address: Greeley, CO 80631
Main4. Phone 970-353-5700 ext. 3211
Number:
Contact
5. David W Bressler
Person:
Fax
6. 970-304-6408
Number:
7. Web Site: www.co.weld.co.us/departments/paramedic_services/ambulance.h
8. E-Mail: dbressler@co.weld.co.us
Emergency
9 24 Hour 970-302-2833
Phone
Number:
Emergency
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Colorado EMS Agency Profile _Page 2 of 5
10. 24 Hour Field Supervisor
Contact:
'Radio
Channel or
11. DTR Talk
Group:
RETAC
12. Affiliated Northeast Colorado
With:
Agency Director
1. Agency Director's Name: David W Bressler
1121 M St
2. Mailing Address:
Greeley, CO 80631
3. Work Phone Number: 970-353-5700 ext. 3211
4. E-Mail: Idbressler@co.weld.co.us
Deputy Director
1. Deputy Director's Name:
2. E-Mail:
Medical Director
1. Medical Director's Name: 'Tyler James
2. Mailing Address: 1121 M St
WMailingCity), CO 80631
3. Office Phone Number: 970-353-5700 ext. 3211
4. E-Mail: tjames@co.weld.co.us
5. Colorado License Number: 37443
Person Filling Out this Form
1. Name: Robert T Osborne
2. Work Phone: 970-353-5700 ext. 3216
�l 3 ljE Mail: Qrosborne@ca.weiw.cc.us
Demographics of Service Area
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Colorado EMS Agency Profile Page 3 of 5
1. Square Miles: 4,040
2. Population: 235,000
3. Average BLS Call Time: 25 Minutes
4. Average ALS Call Time: 27 minutes
5. Number of years that this agency has 34 years
provided EMS services:
6. What area does this agency serve: County
7. Number of stations for this agency: 4
8. Average mileage to nearest hospital: 5 miles
9. Average round trip mileage per call: 10 miles
10. Primary mode of patient transport: Ambulance
Personnel
For each level of responding personnel, Employed Employed Volunteer
please indicate how many are Full Time Part Time
employed
1. EMT-Basic: 10 20
2. EMT-Intermediate: 2
3. EMT-Paramedic: 32 22 j
4. First Responder:
5. Nurse:
6. Other:
Requests for Service for Calendar Year 2007
Response Type Total Number of Number of Calls
Calls Reported in Matrix
1. Emergency with Transport: 8,594 6,323
2. Emergency without Transport: 4,389 530
3. Non-Emergency: 8,304 11
4. Standbys: 71 59
5. Canceld Calls: 912 1,305
6. Total Requests for Service: 13,350 8,228
Data Collection / System Participation
https://www.hfemsd2.dphe.state.co.us/CEMSISWeb AgencyProfiles/page1000AgencyPro... 2/10/2008
l,olora io LMJ Agency riot!le rage•+ ui
1. What Data Collection System are Healthware Solutions - EMS Solution
you using at your Agency Now: Suite
2. Ross Agency ID: 322
3. Is your agency National Incident Yes
Management System (NIMS)
compliant?
Counties Served
Counties Served: Weld
Organizational / Financial Structure
Organizational Type: County government
Legal Status: City / county government
Funding Type: Patient fees
Billing Method: Agency
Vehicle Inventory
Vehicle Make / Chassis / Mileage Equipped 4WD Type Bought Date
Unit Model Box Year For KKK.1822 with Replacing
Number EMS this
Funds Vehicle
35 Ford / 2007 / 15 193 ALS No III No 1/1/2000
E-450 2002 '
33 Ford / 2007 / 32,382 ALS No III No 8/1/2012
E-450 2003 '
24 Ford / 2003 / 132,510 ALS No III No 6/1/2008
E-450 2003 `
25 Ford / 2003 / 146,110 ALS No III Yes 8/1/2008
E-450 1999
26 Ford / 2005 / 112,738 ALS No III Yes 6/1/2010
E-450 1999
27 Ford / 2006 / 93,424 ALS No III Yes 6/1/2011
E-450 1999
28 Ford / 2006 / 83,666 ALS No III Yes 6/1/2011
E-450 1999 '
29 Ford / 2006 / 84,940 ALS No III No 6/1/2011
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Colorado EMS Agency Profile Page 5 of 5
1 - E-450 20O0 r
30 Ford / 2006 / 68 215 ALS No III No 8/1/2006
E-450 2002 '
31 Ford / 2006 / 56,795 ALS No III No 6/1/2011
E-350 2006
34 Ford / 2007 / 25,963 ALS No III No 1/1/2000
F450 2007
32 Ford / 2007 / 42 733 BLS No Rescue No 1/1/2000
E-350 2007 '
Ambulance Operation Safety
1. ITotal number of requests for service: 13,350
2. !Total estimated vehicle miles: 386,262
otal number of reportable crashes in
3' 2007: 5
4. [Total number of persons injured: 1
Number of persons admitted to the
5' hospital:
Number of injured persons treated and
6. released from the emergency 1
department:
Number of injured persons treated and
7' released on scene: 1
8. Total number of persons killed:
Total estimated dollar value of property
9' damage: $6,133
Please be advised that the information you are providing is a matter of public record.
Failure to provide complete and accurate information may adversely impact your opportunity to obtain funding under the EMS Provider Grants
Program.
Colorado Department of Public Health and Environment
https://www.hfemsd2.dphe.state.co.us/CEMSI SW eb_AgencyProfi les/page 1000AgencyPro... 2/10/2008
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