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Home My WebLink About20012762.tiff RESOLUTION RE: APPROVE COUNTY PLAN AND REPORT ON EMERGENCY MEDICAL SERVICES 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 County Plan and Report on Emergency Medical Services from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Ambulance Services Department, to the Department of Public Health and Environment, Health Promotion and Disease Prevention Division, with terms and conditions being as stated in said plan and report, and WHEREAS, after review, the Board deems it advisable to approve said plan and report, 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 County Plan and Report on Emergency Medical Services from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Ambulance Services Department, and the Department of Public Health and Environment, Health Promotion and Disease Prevention Division, be, and hereby is, approved. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 1st day of October, A.D., 2001. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: Mb/ Ek,� EXCUSED J. Geile, Chair Weld County Clerk to the :L�c' `N s I- ' CUSED DATE OF SIGNING (AYE) 1--21c2 i . rlenn Vaad, Pro-Tem BY: &c Z4-c, co ,: y l Deputy Clerk to the Boar ( lJ�,j`�s,--/- 111-1---.� --C-----7-->- Willia H. Jerke APPROVl D AS TO RM: H. iC �f / - vi E. Lo unty Attorn a ey / Robert D. Mas en Date of signature: /0 2001-2762 2001-2762 'C.-,77/7 , ,,7� AM0015 C Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Pre-Hospital Care Program HPDPD-PCP-A2 4300 Cherry Creek Drive South Denver, Colorado 80246-1530 303-692-2987 or 303-692-2980 Distributed July 20, 2001 Weld County Plan and Report On Emergency Medical Services 2001-2762 • Time Line For Submitting your County Report and Plan J October 1, 2001 Deadline -6 Copies of your report and plan must be US postmarked by this date and sent to the HPDP Division office at the address listed below. Reports and plans not US postmarked by this date will not be accepted and funding will not be provided. October-November Evaluation of your report and plan by the State Emergency Medical and Trauma Advisory Council. November You will be informed as to the acceptance of your report and plan, or requested to provide additional information and/or revisions. December 1 Revised copies of your report and plan must be mailed to the address below and US postmarked no later than December 1. December Evaluation of resubmitted plans January Payments will be made to Counties that have complied with the requirements of the law. Mail your plan to: The Department of Public Health & Environment Health Promotion and Disease Prevention Division Prehospital Care Program -Grants Manager 4300 Cherry Creek Drive South, HPDPD-PCP-A2 Denver, CO 80246-1530 Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distributtion Colorado Department of Public Health and Environment County Subsidy Program Application Please complete the tables below with the appropriate information - include the county person responsible for submitting the application followed by the county financial coordinator. Subsidy Plan Coordinator County: Federal Tax ID: Weld Contact Person: Title: Barbara Foster CME Program Director Mailing Address: City: Zip Code: PO Box 69 Greeley 80632 5401 West 20th Street Phone: FAX: E-mail: 970-330-8008 x 6449 970-339-6622 bfoster@aims.edu County Financial Coordinator County: Federal Tax ID: Weld 84-60000-813 Contact Person: Title: Don Warden Director/Finance/Adminn Mailing Address: City: Zip Code: 915 10th Street Greeley 80631 Phone: FAX: E-mail: 970-356-4000 County Commissioner County: Federal Tax ID: Weld 84-6000-813 Contact Person: Title: Rob Masden Commissioner Coordinator Mailing Address: City: Zip Code: 915 10th Street Greeley 80631 Phone: FAX: E-mail: 970-356-4000 Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution Section I Licensing and Inspection 1.1 County Resolution, Laws, or Ordinances Please answer the following questions regarding your current regulations governing ambulance services. County resolutions need to be reviewed on a regular basis. Please indicate the date of your last review: Review began in 2000, to be completed early 2002 due to regulation changes at state and local level. 1.2 Agency Responsible for Licensing, Inspecting and Regulating Ambulance Services Agency or Government Entity Weld County Health Department Contact Person Char Davis Title Environmental Health Specialist Address 1517 — 16th Street, Greeley, Colorado 80631 Phone 970-353-0635 Person performing physical inspection of ambulances Name Title Address Phone 1.3 Inspection and Licensing- Process Please place a check mark in the blank that most accurately applies to your county. 1. How often do you license ambulance services? Annually X Semi-Annually_ 2. How often do you physically inspect your ambulances? Annually X Semi-Annually_ 3. Are the policies and procedures for licensor of ambulances included in your county resolution? Yes X No 4. In your inspection of ambulances, do you verify that the vehicle equipment conforms to the minimum essential equipment list contained within the Colorado Board of Health Rules 6-CCR-1015-3? Yes X No If not please explain: Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution 5. Please attach Copies of the Form(s) you use to License and inspect your ambulances. 6. Do all of the licensed ambulance services based within your county comply with the statewide data collection program through the Colorado Emergency Medical Services and Prevention Division? Currently state data collection requires a completed agency profile be returned annually to the EMSP Division. Note: If they do not comply, your county will not be eligible for funding. Have you assured that all of these forms are attached and are complete and correct? Yes X No 1.4 Ambulance Agencies - licensed and inspected Please complete the following information for all transport agencies based in your county. Agency Weld County Ambulance Service Director Gary McCabe Agency Address (include zip code 1121 — M- Street Greeley, Colorado 80631 Phone 970-353-5700 Fax 970-304-06408 Director's E-mail omccabeAco.weld.co.us co.weld.co.us Agency Tri-Area Ambulance Service Director Tim Zimmerman Agency Address (include zip code) PO Box 708, Frederick, CO 80530 Phone 303-833-4824 Fax Director's E-mail AIR TRANSPORT Agency Air Life of Greeley Director Lvn Maier Agency Address (include zip code) 1801 - 16'h Street , Greeley, CO 80631 Phone 970-350-6258 Fax Director's E-mail If necessary, please insert another page to list any additional agencies. Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution EMERGENCY MEDICAL SERVICES SERVICE: AMBULANCE: DATE: TIME: AMBULANCE EQUIPMENT CHECKLIST (Basic Life Support) EMERGENCY SYSTEMS: (Cont.) Irrigation(sterile solution&50 ml syringe) Flashing red lights _I.V.solution,D-5 W,250 ml(4) * _Radio communications _I.V.solution,volume expander, 1,000 ml(4)* _Siren _I.V. administration sets 15 gtt(4)&60 gtt(4)* Oxygen and Suction _I.V.venipuncture sets* _Kit,sterile,obstetrical MEDICAL EQUIPMENT & SUPPLIES: -Litter,portable _Light,diagnostic _ Mask,surgical(2) Adjustable gurney (4 wheeled) — Airways,nasopharyngeal and oropharyngeal, —Newborn heat retention cap Adult to Infant _Oxygen,portable(2"E"tanks) Aluminum Foil,silver swaddler —Oxygen masks,canulas,nasal(4) —Oxygen masks,non-rebreather,four adult& or porta-warmer four child Bag Valve Mask, 1000 cc with _Poison treatment kit-30 ml Ipecac and activated masks&oxygen reservoir charcoal Bag Valve Mask,500 cc with _Pads,prep,alcohol&betadine masks and oxygen reservoir _Pads,sterile,eye Bandages,self-adhesive,roller _Shears,heavy duty _Bandages,triangular —Spine board,long,with straps adult&pediatric Bite Stick _Spine board,short,with straps or extrication Blankets(4) device Blood pressure manometer,large _Splints&arm boards(assorted) _Blood pressure manometer,med. _Splint,traction,lower extremity Blood pressure manometer,snit. _Stethoscope _Bulb suction _Stretcher,stair chair,with _Burn Sheets(2) wheels(optional) Cervical collars,rigid,adult _Stretcher,scoop to child&"no neck"sizes _Suction unit,portable with _Compartmentalized pneumatic rigid tips and soft catheters Trousers,three compartment* 5 Fr.through 14 Fr. Constricting band Tape,adhesive,2" (two rolls) Cutter,ring(optional) Dressings,sterile 4"x 4" Dressing s,sterile 10"x 36" ADDITIONAL EQUIPMENT & _Eye protection,crew _Gloves,sterile,2 pr. SUPPLIES Gloves,non sterile,one box Head immobilization devices, Advanced and Intermediate adult and pediatric life support *IF REQUIRED BY THE PHYSICIAN SEE SEPARATE LIST ADVISOR FOR THE SERVICE MEDICAL EQUIPMENT&SUPPLIES: AMBULANCE EQUIPMENT CHECKLIST (Cont.) SAFETY EQUIPMENT: "No Smoking"sign (patient compartment) Fire extinguishers(2.5 1b)(One accessible inside,one accessible from outside) _Safety belts-including squad bench "Sharps"collector _Flash light or lantern Spare tire and tools _Triangular warning reflectors _Radio equipment Vehicle condition(state motor vehicle regulations) Restraining devices for all items in patient compartment COMMENTS: SIGNATURE: SIGNATURE: (Ambulance Representative) Requirements for Advanced Life Support-Intermediate 1. All equipment listed under"Basic Life Support Ambulance " 2. Adult and pediatric endotracheal intubation equipment per physician protocol. Pediatric sizes for endotracheal tubes uncuffed range of 2.5-5.5 and cuffed range of 5.0-8.0: and laryngoscope blades straight and/or curved of 0-3. 3. Monitor/defibrillator with tape write out and adult EKG electrodes and paddles. For a manual model monitor/defibrillator you must have pediatric EKG electrodes and paddles or paddle adapters by July 1995 and the capability to dial down to appropriate watt/seconds for pediatrics by July 30, 2005. 4. Pharmacologic agents per physician advisor protocol. 5. Pediatric equipment and drug dosage tape or age/weight chart. Requirements for Advanced Life Support-Paramedic All equipment listed under"Basic Life Support Ambulance and other equipment and pharmacologic agents per physician advisor protocols. THIS IS A SAMPLE FORM AND SHOULD BE MODIFIED BY THE PHYSICIAN ADVISOR(S) IN THE COUNTY. DEPARTMENT OF HEALTH AND ENVIRONMENT EMERGENCY MEDICAL SERVICES SERVICE: AMBULANCE: DATE: TIME: AMBULANCE EQUIPMENT CHECKLIST (Advanced Life Support) EQUIPMENT: EQUIPMENT: (Cont.) Blood Pumps(6) _Microdrip administration set,60 gtt/ml, (6) _Chest decompression kit or angiocath, 10 gauge or _Monitor/Defibrillator(with adult and pediatric 12 gauge,with syringe paddles Cricothyrotomy tray or equipment _Nasogastric tube(sizes 16 or 18) Delee suction units(size 8)(2) _Nebulizer Disaster pack(triage tags) _Obstetric kit or equipment Endotracheal tubes,2 ea. (cuffed 2.5,3,4, 5,&5.5) Radio,portable,hand held(Medical UHF (cuffed 5,6,6'/n,7,7 l/z, 8,&9) frequencies) —Laryngoscope and blades(adult&pediatric curved Suction catheters,(5 fr. To 14 fr.) or straight) _Suction tips,rigid(6) _MAST suit _Pediatric Drug Dosage Tape or Age/Weight Chart _McGill forceps(adult&pediatric) MEDICAL EQUIPMENT & SUPPLIES INTRAVENOUS FLUIDS: MEDICATION: -D5W. 250 ML BAGS(6) _Dopamine,200 mg/5 ml(2) LR or NaCL, 1,000 ml bags(6) _Droperidol,2.5 mg/ml,2 ml amps(2) D5W or NaCL 50 ml bags(4) —Diphenhydramine, 50 mg/ml(2) Epinephrine, 1:1000, 1 mg/ml(2) MEDICATIONS: _Epinephrine, 1:10,000.01 mg/ml(4) _Furosemide,20 mg/ml(2) _Adenosine,6 mg.(4) —Glucagon, 1 mg(1) Albuterol Sulfate Sol.2 mg,3 ml unit Dose Vials(2) Ipecac,30 ml(2) _Atropine, 1 mg/5 ml(4) —Lidocaine,20%, 1 gm 5 ml(2) _Bretylium, 500 mg/10 ml(2) _Lidocaine,2%, 100 mg/5 ml(4) _Calcium chloride 10%, 1 gm/10 ml(2) _Magnesium sulfate,50%, 1 gm 2 ml(4) Charcoal,50 g,2 bottles Morphine sulfate, 10 mg/ml(2) ° _Naloxone,4 mg(4) —Dextrose,25%,250 mg/ml(1) Nitroglycerine,sublingual,tablet or spray,one of ea. _Dextrose,50%, 500 mg/ml(1) _Oxytocin 10 units/ml(2) —Diazepam, 10 mg/2 ml(2) _Racemic Epinephrine(1) Sodium Bicarbonate,4.2%, 5 meg/ 10 ml(4) _Sodium Bicarbonate,8.4%, 5 meg/5 ml Verapamil,5 mg/2 ml(2) MONITOR/DEFIBRILLATOR OPERATIONAL CHECK (OPTIONAL USE FORM) Model: Monitor Serial#: Defibrillator Serial#: PATIENT CABLES OUTPUT Lead 1 (white/black) _360 ws(338-382) Lead 2(white/red) 300 ws(282-318) _Lead 3 (black/red) 200 ws(188-212) 100 ws(94-106) _Paddles _50 ws(47-53) _Presentation _20 ws(18-22) Other Presentation Recorder COMMENTS: EMERGENCY MEDICAL SERVICES APPLICATION AMBULANCE SERVICE LICENSE Date of Application: Name of Ambulance Services: (owner or parent company) Doing Business As: Address: Name And Address Of Each Stockholder Or Partner owning 10% Or More Of The Outstanding Stock Of The Company Or Having More Than A 10% Ownership Interest(if applicable): Name,Address And Phone Number of Manager Or Individual Responsible for The Operation Of The Services: What Area Of Your County Will Be Served By This Company? Please Attach A Map Indicating The Service Area. List All Location (Central Station And Sub Stations) where ambulances are to be located. Attach Zoning Authorization If Appropriate. How Many Ambulances Do You Operate? If This Is An Initial Application(not a renewal application) Attach A SEPARATE Permit Request For Each Ambulance. Provide Name And Address Of Your Insurance Carrier: Name Of Agent: ATTACH A CERTIFICATE OF INSURANCE TO THIS APPLICATION. I HEREBY CERTIFY THAT THE INFORMATION PROVIDED IN THIS APPLICATION IS TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF AND CONTAINS NO WILLFUL MISREPRESENTATION OR FALSIFICATION. DETERMINATION THAT AN AMBULANCE SERVICES LICENSE HAS BEEN ISSUED BASED ON FALSE INFORMATION CONSTITUTES GROUNDS FOR LICENSE REVOCATION AND POSSIBLE CRIMINAL PROSECUTION. / / Signature of Applicant Date SUBSCRIBED AND AFFIRMED BEFORE ME THIS DAY , 19 ,IN THE COUNTY OF , STATE OF COLORADO. Signature of Notary My Commission expires: / / (For Office Use Only) Date Received: / / / Documents Checked: Fee Paid or Excused: Receipt#: Remarks: Approval Recommended(Y/N): Date Referred to B.O.C.C. / / / Licensing Agent COUNTY APPLICATION FOR AMBULANCE VEHICLE PERMIT DATE: / / NAME OF VEHICLE OWNER: NAME OF AMBULANCE SERVICE: ADDRESS: CITY: STATE: ZIP: TELEPHONE NUMBER: DESCRIPTION OF AMBULANCE: YEAR: MAKE: MODEL(type): 4 WHEEL DRIVE(Y/N): MANUFACTURERS IDENTIFICATION NUMBER(V.I.N.): COLORADO STATE LICENSE NUMBER(REGISTRATION NO.): REGISTERED WITH THE STATE OF COLORADO AS AN EMERGENCY VEHICLE?(y/n): DESCRIBE COLOR SCHEME,INSIGNIA,NAME,MONOGRAM AM)OTHER DISTINGUISHING CHARACTERISTIC: DATE AMBULANCE PLACED IN SERVICE: / / NORMAL LOCATION OF AMBULANCE: INSURANCE COVERAGE ON THIS VEHICLE: A. COMPANY: B.AGENT: C.BODILY INJURY:$ /$ D.PROPERTY DAMAGE:$ /$ I HEREBY CERTIFY THAT THE INFORMATION PROVIDED IN THIS APPLICATION IS TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF AND CONTAINS NO WILLFUL MISREPRESENTATIONS OR FALSIFICATION. SUBSEQUENT DETERMINATION THAT A PERMIT HAS BEEN ISSUED BASED ON FALSE INFORMATION CONSTITUTES GROUNDS FOR PERMIT REVOCATION. SIGNATURE OF APPLICANT DATE: / / / SUBSCRIBED AN AFFIRMED BEFORE ME THIS DAY OF 19_. IN THE COUNTY OF STATE OF COLORADO. SIGNATURE OF NOTARY: My Commission Expires: / (FOR OFFICE USE ONLY) Date Received: / / Documentation Verified: Inspection Satisfactory(y/n): Date: / / Hold For: Recommend Approval of Permit(y/n): Comments: SIGNATURE CERTIFICATE OF MOTOR VEHICLE CONDITION DATE: / / The undersigned, professing to be motor vehicle mechanic, has of this date, evaluated the mechanical condition o the identified ambulance and determined that this vehicle is in safe operating condition. Said evaluation does NOT warrantee future status of the ambulance due to conditions beyond my control. VEHICLE IDENTIFICATION NUMBER(V.I.N.): VEHICLE OWNER: EVALUATION CHECK LIST ITEMS ACCEPTABLE NOT COMMENTS ACCEPTABLE Wheels&Tires Steering Alignment Suspension Brakes Hand Brake Lights Electrical System Glass Exhaust System Fuel System Body& Sheet Metal MECHANIC: (SIGNATURE) AGENCY , ADDRESS 1.5 Please complete the following information for all agencies based in your county who provide non-transport Emergency Medical Services (i.e., search & rescue, fire, police, quick response teams, etc.). Agency Ault Pierce FPD Contact Darin Dalton Agency Address (include zip code) PO Box 1146, Ault, 80610 Phone 970-834-2848 Contact E-mail Agency Briggsdale FPD Contact Name Duane Halverson Agency Address (include zip code) PO Box 1, Eaton, 80615 Phone 970-656-3503 Contact E-mail Agency Eaton FPD Contact Name Pat Romansik Agency Address (include zip code) 224-1st Street, Eaton, CO 80615 Phone 970-454-2115 Contact E-mail Agency Evans FPD Contact Name Rob Standen Agency Address (include zip code) 1100 - 37th Street, Evan, 80620 Phone 970-339-5344 Contact E-mail Agency Frederick Fire Protection District Contact Name Dominic Chioda Agency Address (include zip code) PO Box 129, Frederick, 80530 Phone 303-833-2742 Contact E-mail Agency Fort Lupton FPD Contact Name Phil Tiffany Agency Address (include zip code) 1121 Denver Avenue, Fort Lupton 80621 Phone 303-857-4603 Contact E-mail Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution Agency Galeton FPD Contact Name Roger Hill Agency Address (include zip code) PO Box 697, Eaton, 80615 Phone 970- Contact E-mail Agency Hudson FPD Contact Name Bill Ramsel Agency Address (include zip code) PO Box 7, Hudson, 80642 Phone 303-536-4202 Contact E-mail Agency Johnstown FPD Contact Name Larry Ray Agency Address (include zip code) PO Box 979, Johnstown 80534 Phone 970-587-4477 Contact E-mail Agency Kodak Plant Protection Contact Name Win Homann Agency Address (include zip code) 9952 Eastman Pkwy, Windsor, 80551 Phone 970-686-4200 Contact E-mail Agency LaSalle FPD Contact Name Dave Eckhardt Agency Address (include zip code) PO Box 245, LaSalle, 80645 Phone 970-284-6336 Contact E-mail Agency Milliken FPD Contact Name Kelvin Knaub Agency Address (include zip code) 101 South Irene St, Milliken 80543 Phone 970-587-4464 Contact E-mail Agency Mountain View FPD Contact Name John Devlin Agency Address (include zip code) 9119 County Line Road, Longmont, 80501 Phone 303-772-0710 Contact E-mail Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution Agency Galeton FPD Contact Name Roger Hill Agency Address (include zip code) PO Box 697, Galeton 80622 Phone 970-454-0681 Contact E-mail Agency Hudson FPD Contact Name Bill Ramsel Agency Address (include zip code) PO Box 7, Hudson, 80642 Phone 303-536-4202 Contact E-mail Agency Johnstown FPD Contact Name Larry Ray Agency Address (include zip code) PO Box 979, Johnstown 80534 Phone 970-587-4477 Contact E-mail Agency Kodak Plant Protection Contact Name Win Homann Agency Address (include zip code) 9952 Eastman Pkwy, Windsor, 80551 Phone 970-686-4200 Contact E-mail Agency LaSalle FPD Contact Name Dave Eckhardt Agency Address (include zip code) PO Box 245, LaSalle, 80645 Phone 970-284-6336 Contact E-mail Agency Milliken FPD Contact Name Kelvin Knaub Agency Address (include zip code) 101 South Irene St, Milliken 80543 Phone 970-587-4464 Contact E-mail Agency Mountain View FPD Contact Name John Devlin Agency Address (include zip code) 9119 County Line Road, Longmont, 80501 Phone 303-772-0710 Contact E-mail Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution Agency New Raymer/ Stoneham FPD Contact Name Jim Mertens Agency Address (include zip code) PO Box 92, New Raymer, 80742 Phone 970- 437-5713 Contact E-mail Agency Nunn FPD Contact Name Alvan Shipps Agency Address (include zip code) PO Box 128, Nunn 80742 Phone Contact E-mail Agency Pawnee FPD Contact Name Dan Harms Agency Address (include zip code) PO Box 66, Grover, 80729 Phone 970-895-2461 Contact E-mail Agency Platte Valley FPD Contact Name Bill Izzi Agency Address (include zip code) PO Box 448, Kersey, 80644 Phone 970-353-3890 Contact E-mail Agency Platteville/Gilcrest FPD Contact Name Wes Scott Agency Address (include zip code) PO Box 407, Platteville, 80651 Phone 970-785-2232 Contact E-mail Agency Southeast Weld FPD (Roggen, Keenesburg, Prospect Valley) Contact Name Mark Gray Agency Address (include zip code) PO Box 1, Keenesburg, 80643 Phone 303-732-4424 Contact E-mail Agency Union Colony Fire Rescue Authority Contact Name Tom Bizzell Agency Address (include zip code) 919 7th Street, Greeley, 80631 Phone 970-350-9500 Contact E-mail Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution Agency Windsor/Severance FPD Contact Name Jerry Ward Agency Address (include zip code) 728 Main Street, Windsor, 80550 Phone 970-686-2626 Contact E-mail Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution Introduction County Plan Section of the Report The law enabling the County Subsidy Program requires that all plans submitted include a description of the existing system, deficiencies or improvements, and goals and objectives. You will see that the outline we are providing for submission of your plan emphasizes this. Do not reference page and paragraph numbers from a previous plan and complete all categories. This plan outline is available to download from the EMS website at: http://www.state.co.us/gov_dir/cdphe dir/em/emhom.html. If you have questions pertaining to the application please contact one of the following HPDPD Prehospital Care Program staff members: Laurie Borgers Grants Manager (303)692-2987 Laurie.Borgers@state.co.us Michael Armacost Program Director (303)692-2982 Michael.Armacost@state.co.us Martin Stolmack Technical Assistance (303)692-2988 Martin.Stolmack@state.co.us Kevin Meeks Communications (303)692-2986 Kevin.Meek@state.co.us Deb Polk Program Support (303)692-2583 Deb.Polk@state.co.us Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution Section II Subsidy Plan ACCOMPLISHMENTS In the table below please list any completed goals or accomplishments in the area of EMS in your county. Goal & Objective Type of Goal Description of Accomplishment(s) Number (Treatment, etc.) #4 Transportation Weld County Ambulance Service (WCAS) purchased 2 new vehicles, bringing fleet to 11 #4 Transportation Hudson FPD purchased new fire truck in September #4 Transportation Hudson FPD increased facilities at Lochbuie station #4 Transportation Platte Valley FPD added a new rescue #4 Transportation Galeton FPD added a new tanker #4 Treatment WCAS is conducting multi-lead (5) monitoring as a standard procedure for their patients #4 Transportation Ault Pierce FPD has added a new tanker and rescue to their fleet Ault Pierce has initiated a Paramedic 10 ambulance with employees of WCAS that respond with the fire department #4 Transportation MVFPD has added 2 rescues, 4 engines to their fleet and hired an additional 10 firefighters #4 Transportation Platteville/Gilcrest has added a new tanker and rescue vehicle #4 Treatment Platteville/Gilcrest have joined together for joint medical and fire training #5 Treatment WCAS has taught several PARTY programs for area high schools in conjunction with volunteer instructors from the county #4 Transportation Windsor FPD begins construction of their new station shortly Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution #5 Optional Windsor FPD has initiated their own QA/QI program in house #5 Optional Windsor FPD has hosted an EMT course and Firefighter I academy for their paid and volunteer staff #5 Optional Platte Valley FPD has hosted a First Responder course, an EMT course and Firefighter I academy #4 Treatment UCFRA has been instrumental in the development of a Hazmat plan for Weld County #3 Optional Platte Valley FPD has be working with TRIAD in Greeley to equip homes of elderly with smoke detectors #1 Treatment NCMC continues with plans for Emergency Department relocation #1 Treatment NCMC continues with plans for expanding their Burn unit #4 Transportation Eaton FPD is planning for a new station #1 Communication 800 megahertz - Phase I conversion is complete #1 Communication 800 megahertz - Monies have been allocated for Phase II and for reverse 911 #1 Communication Dispatch center is investigating a recording system to work in conjunction with the new 800 megahertz system #5 Optional NAPD driving course has been accepted as the standard for WCAS and UCFRA, and other volunteer agencies with 6 trained instructors #5 Optional County wide Protocols are being revised WCAS has donated surplus equipment to agencies in need #4 Transportation WCAS has increased staff by 17 EMTs #7 Optional UCFRA has hired an EMS Coordinator for their department #7 Optional WCAS has conducted conflict management courses taught by a UNC graduate intern #4 Transportation UCFRA will begin construction of Station 7 soon and will being hiring 6 firefighters shortly Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution #4 Transportation Windsor FPD has staffed a Fire Prevention Position and increased their paid staff to 5 County wide ID tags are almost completed WCAS has been granted a waiver for surgical cries #4 Treatment ConAgra has submitted an application for an AED program #5 Optional Aims CC has incorporated all new AHA guidelines in 8L5 and ALS programs #3 Treatment Conducted Recruitment and Retention seminar (State EMS) Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution COMMUNICATIONS 2.1.A EXISTING SYSTEM DESCRIPTION Please describe your current communications system and include the following: 1) Functional description of paging, dispatch, on scene and medical control, ambulance to ambulance, ambulance to hospital, alternate communications, communications to air transport and other agencies, etc. 2) System functional diagrams identify location of dispatch, base stations, control stations, repeaters, telephone lines, and include frequencies, etc. Include as much detail as possible. Weld County Regional Communications Center accepts and directs all calls for emergency services through an Enhanced 911 system, using Emergency Medical Dispatch (Medical Priority)procedures. Notification and information for emergency calls are then paged to the appropriate agency. If the agency has digital pagers, an alpha page is sent concurrently. The channels/frequencies are listed below. Weld County EMS VHF 155.400 (receive and transmit) Page and dispatch recorded line Fire A VHF 153.785 (receive and transmit) Fire B VHF 154.145 (receive and transmit) Fort Lupton Fire Prot. Dist VHF 154.235 (receive and transmit) Air Life of Greeley 155.400 (receive and transmit) North Colorado Medical Center 462.950 (receive and transmit) Union Colony Fire Rescue Authority UHF 451.150 (receive) 458.150 (transmit) Medical control is established and maintained either through the use of cellular phones of medical channels on the radios. Cellular phones are available now for fire departments and WCAS personnel Digital paging continues to increase as more agencies acquire pagers. A system diagram has been included for your review. Colorado Department of Public Health and Environment Health Promotion and Dices se Prevention Division Revised for 2001 distribution CITY/COUNTY EQUIPMENT ESTIMATE: REPEATE ' -25 CONTROL STATIONS -25 BASES -20 800 IdBZ DATA WELD COUNTY- REPEATERS - a EXISTING COMMUNICATIONS NETWORK • Lat. :40-42-42 n. :104-45-05 La.t. :40-32-36 Lat. :40-51-12 ,. AL0 :105_h1_52 Lon. :i04-03-30 1.ISIMEMOMUMME LAW4 North Weld Ambulance RIME ____9__ LAW1 (Independent Transmitter/ EMS M1113 LAWS Receiver) MED 1-10 (Back-Up Elect. enerator) FIRES UWY1 EMS FIREA -FIRES . E11ei Back—Up Elect./Battery) GREELEY FIRE (Back-Up Elect./Generator) • at. :40-25-22 • Lat. :4O-36-2S Lon. :104-41-35 jhon. :1O3-49-: Lat. : 40-23-07 rroma.cat Lon. :104-44-12 summon i MIEEENAL.U1E (Back-Up Elect./Generator GREELEY JUNCTION CI.EER PERM LAWS maim SECURITY (WCSO/Jail/s) 35th Ave (Back-Up Site) JAILMDT.s - (Back-Up Elect. OAEEI.EYPDIS PIMEA GREELEY FIRE Generator) DREELEYRRE FUZES FIRE A FIRE B w Independent Receive OREELEYOMO MIS _EMS _GREELEY. PD1f.2 ; Transmitter) - - -- ---GBEELEYERRRC1PAL 500DATA MED9 CLEER FERNi GREELEY. MUNICIPAL AlMED9 MED4 WCSO Jail/s • (Back-Up Elect./Generator) - North Colorado Medical Center ��yy t. :40-15-91 Base Station Radio 'fJ Lon. :104-42-21 Lat. '40-05-47 Med 1-10 (Scan Fire/Law) .O Lon. :104-54-04 MUM - LAW1 RREA EMS i • M*AMEEEEE WA - WCALO VE e tAW EMS EMDBat(Back-Up Elect. / Battery ) (Back-Up Elect. /Genarator) 2.1.8 IDENTIFY AREAS NEEDING IMPROVEMENT Identify the changes or improvements you plan to make within your current communications system. In a five-year plan, the entire Weld County Communication System, with the exception of the paging system, will be converted to an 800-megahertz system. The 800 MHz systems will replace all other frequencies being used. The plan calls for conversion to begin in the Greeley area in the first year, followed by sectors of the county for the remaining four years. The paging system will remain unchanged. The conversion began this year, and has had some issues arise which delayed the full conversion process. These issues are being resolved. The process continues.... Staffing seems to have become a significant issue in the past year. A larger than normal turnover has been seen at the Communications Center. 2.1.C GOALS AND OBJECTIVES In the space provided below please state your goals and objectives. COMMUNICATIONS GOAL #1 Work to recruit and retain dispatchers for the regional communication center. Objective A for Goal #1 Investigate the role that EMS Advisory Council may have to recommend changes or support the administration in the communications center when recruiting, hiring and training dispatchers. COMMUNICATIONS GOAL #2 Continue implementing digital pagers for countywide use. Objective A for Goal #2 Conduct needs assessment to determine the status of agencies in the county that are still in need of pagers. Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution Objective B for Goal #2 Use resources available through the Advisory Council to assist agencies that are not able to acquire pagers due to financial or other constraints. COMMUNICATIONS GOAL #3 Create and maintain open communication lines with care facilities to discuss common issues, transport procedures and concerns. Objective A for Goal #3 Contact facilities to assess needs that may exist, compile information and conduct training through the transport agencies. COMMUNICATIONS 6OAL #4 Continue with implementation of 800 megahertz system. Objective A for Goal #4 Continue with five year implementation plan, making adjustments where necessary. Objective B for Goal #4 Assure agencies are in the process of gathering information and resources to convert within timeline. Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution Transportation 2.2.A EXISTING SYSTEM DESCRIPTION Describe your current transportation system and include the following: 1) Number of ambulance agencies, quick response units, search and rescue, and fire agencies within your county 2) Number of licensed ambulances should be provided in Attachment A, Transport Agency Profile 3) Coverage 4) Mutual Aid Agreements in place 5) Coordination of resources At this time Weld County Ambulance Service and Tri-Area Ambulance Service are the only two agencies based in the county. There are several agencies that have entered into mutual aid agreements for transport if needed. Fire agencies are permitted to transport, under limited circumstance only. Limitations are addressed in the county resolution. Coverage for transport services includes the entire 4004 square miles of Weld County. Coordination of resources occurs at the time of an emergency through the dispatch center. Disaster drills, communication exercises, advisory committees and individual agencies all participate with regional and local planning in the event of an isolated emergency or multi-casualty incident. RETAC participation will continue to achieve a balance of resources in the northeastern part of the state. 2.2.B IDENTIFY AREAS NEEDING IMPROVEMENT Identify the changes or improvements you plan to make in your current EMS transportation system. Maintain current fleet status, and make adjustments as needed to accommodate the large growth in population that is predicted in the county over the next five years. Continue to assure proper response times with mutual aid agreements. Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution 2.2.C GOALS AND OBJECTIVES In the space provided below please state your goals and objectives. TRANSPORTATION GOAL #1 Develop procedure for addressing concerns transport agencies encounter when diverting from original hospital destination to alternative hospitals while en route. Objective A for Goal #1 Keep informed of the divert issues in the Denver Area and how that may effect local transport agencies. Objective B for Goal #2 Contact with the Divert committee at the SEMTAC level is required for complete and accurate information. Attending SEMTAC meetings is necessary with reports back to the EMS Advisory Council. TRANPORTATTON 6OAL #2 Research possibility for county preventative maintenance program for vehicles. Objective A for Goal #1 Assign contact person(s) to obtain information from agencies as to what needs, desires and requirements they would have for such a facility. Objective B for Goal #2 Summarize findings and present to Council for recommendations and suggestions. If feasible, construct timeline for project, including acquiring resources, facilities and staff. Reproduce this page if additional space is necessary. Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution Treatment 2.3.A EXISTING SYSTEM DESCRIPTION Describe your current system and include the following: 1) Treatment protocols 2) Destination policies 3) Medical control 4) Quality assurance 5) Manpower 6) Training 7) Mass casualty 8) Trauma specific policies, protocols and procedures Treatment protocols for the majority of the county are contained in one document for all levels of care in the county. These protocols are currently under revision. Medical control is established as described earlier in this document. Wont continues to be directed toward a countywide QA/QI system that will allow for accurate review and research. All fire agencies that submit reports are getting individual call review from staff at Aims Community College for use in CME training. Training for CME and initial courses is conducted through Aims Community College. Most agencies are getting CME from Aims except those covered by Dr. Mosey in the southern part of the county. Mass casualty drills occur on a regular basis across the county. Participation and notifications of the event can vary widely. The involvement with the RETAC has given us the opportunity to devote time to trauma specific topics. Destination policies, protocols and procedures are all in place. Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution 2.3.B IDENTIFY AREAS NEEDING IMPROVEMENT Identify the changes or improvements you plan to make within your current treatment system. Critical Care Transport issues must be addressed in this county, and correlate with the information that is currently being discussed at SEMTAC. New curricula is being accepted at the state level and must be integrated into the training programs at Aims Community College. Is tactical EMS worth pursuing in the region? What programs need to be available for the preparation of paramedic students? Training opportunities must be developed for the following: MCI Incidents HAZMAT Radiation Injuries and Hazards Terrorist activities The Quality Assurance committee needs to continue work to establish a county wide system that assures quality patient care. 2.3.C GOALS AND OBJECTIVES In the space provided below please state your goals and objectives. TREATMENT GOAL #1 Examine the potential for advanced care capabilities, including CCT and 12 lead monitoring, tactical EMS Objective A for goal #1 Conduct research and gather data from recognized sources to address concerns of ambulance personnel and acute care facilities. Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution Objective B for goal #1 Become an integral part of the conversations and discussions at the state level for these issues. (Go to the meetings.) TREATMENT 6OAL #2 Address and meet needs for training regarding paramedic preparation, current topics of concern as listed above, new EMT Intermediate and Paramedic curricula. Objective A for goal #2 Aims Community College is in the process of integrating and establishing new curriculum for the intermediates and paramedics, revising degree programs and establishing new certificate programs. These, in part are planned for implementation in early 2002. TREATMENT 6OAL #3 Establish countywide quality assurance program for the county fire and EMS agencies, consistent with the goals and objectives of the physician advisor. Objective A for goal #3 Work should continue for the established QA committee in the county and make recommendations to the Advisory Council. TREATMENT 6OAL #4 Coordinate disaster and MCI drills in the county. Objective A for Goal #4 Establish sub-committee of Advisory Council to address the need for combined training. Reproduce this page if additional space is necessary. Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution Documentation 2.4.A EXISTING SYSTEM DESCRIPTION Describe your existing system and include the following: 1) Describe any Prehospital Care reporting system that your county may have other than the statewide data collection system provided by the state. 2) Identify any medical quality control measures your county may have in place to evaluate and improve medical care. The current reporting system in the county has two formats. WCAS is currently working to incorporate computerized trip reporting using the MEDIC system. At this time, it is still paper based, using the same data fields. WCAS has an internal QA system that reviews all calls, some qualifying for follow up on a regular basis. Tri - Area and Frederick Fire Department operate with their physician advisor for their record-keeping. The remaining agencies use a common medical report form, or a variation of it to record all information from a medical call. Some agencies are purchasing computer report systems, which are currently being reviewed by the EMS Advisory Council and the physician advisor. Reports are sent to the appropriate EMS coordinator, to be reviewed. The physician advisor is involved in all calls that vary from protocol, are of specific interest, refusal for treatment and transport, or, calls that are identified for call review. The MEDIC system has encountered some technical difficulties. The eventual outcome of the system is not known at this time. There are software issues that need to be addressed at the county level. WCAS and NCMC are making progress with recording systems and radio/cell phone upgrades. Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution 2.4.6 IDENTIFY AREAS NEEDING IMPROVEMENT Identify the changes or improvements you plan to make within your current documentation system. MEDIC system issues must still be corrected, implemented for the county to move to a consistent reporting system. More information is needed to clarify questions and concerns with new medical record regulations. QA/QI issues that were addressed earlier certainly will impact this category. Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution 2.4.C GOALS AND OBJECTIVES In the space provided below please state your goals and objectives. Documentation Goal #1 Implementation of countywide reporting and data collection system. Objective A for Goal #1 Technical difficulties are being addressed as the system comes closer to implementation. Continue with the process to implement computerized trip reports. Objective B for Goal #1 As the system progresses, communicate with RETAC for input as to the common data points that are necessary to contribute information at the RETAC level Objective C for Goal #1 Coordinate efforts with county QA/Q2" committee to establish benchmarks in concert with the RETAC and also address those areas that may be unique to county or agency. Reproduce this page if additional space is necessary. Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution Optional Component(s) 2.5.A EXISTING SYSTEM DESCRIPTION State any component of your EMS system that has not already been identified and describe what systems are in place within your county at this time. Please see items that are listed below. 2.5.6 IDENTIFY AREAS NEEDING IMPROVEMENT Identify the changes or improvements you plan to make within your current system in the above stated area. Growth issues continue to raise new challenges for the EMS system. These include an increasing demand for facilities, and personnel. Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution 2.5.C GOALS AND OBJECTIVES Optional Goal #1 Examine demands on the current EMS system in the county and make recommendations to address those demands. Objective A for Goal #1 Conduct a needs assessment based on growth issues. Objective B for Goal #2 The advisory council must address funding issues for larger facilities to accommodate student populations in all emergency services. Reproduce this page if additional space is necessary. Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution Section III Planning and Coordination Please mark all the EMS representatives that were active in the development of this report and plan: County Health Department Others (describe): County Wide EMS Council X EMS Provider Agencies: Ambulance Agencies X Clinics or Hospitals X Dispatcher Communications X Fire Departments X Search & Rescue Providers X Training Center Representatives X Physician Advisors X RETAC Coordinator X RETAC Council 3.1.A Existing System Description Describe the way in which you coordinate emergency medical service efforts and do planning: This section must include but is not limited to the following: 1). A list of agencies that actively participate (do not list agencies that do not regularly attend meetings) in your current county EMS Council 2). Describe how you do needs assessment relative to planning for EMS within your county 3). Describe how you do needs assessment relative to requesting EMS grant funding within your county, i.e. some counties use a form to request information on agencies within the county who intend to submit grant applications to the EMS Grants program. 4). If you have a county EMS Council, how often do they meet and what is their relationship with the county commissioners. 5). If your county uses EMS subsidy funds to provide a County/Regional Coordinator for EMS, please explain what this coordinator does for EMS in the county,for instance, does the coordinator keep you informed of changes pertinent to federal, state, and local laws regarding EMS and EMS training; arrange and schedule training; write your county EMS plan; attend county EMS meetings; attend RETAC meeting; meet with your county commissioners and keep them informed on EMS issues?Provide your coordinators name, address, phone, and FAX number. Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution 6). Describe how and if the RETAC will provide for planning and coordination in future years. 1) List of agencies that are represented: a Sector Representative represents all agencies. Sector Representatives are selected by the agencies and recognized as their representative by the Board of County Commissioners. Our county is divided into four sectors, each sector with one representative. Any department can and do, send members to meetings at any time. Council votes however are restricted to the official membership. 2) Needs assessments were on the To Do list last year. It was not accomplished, so has been carried over to this year's projects. The EMS coordinator conducted one survey four years ago with poor response. 3) Funding requests are presented usually through the EMS Advisory Council The Council assists with the preparation of the grant applications, and does not screen requests in any way. 4) EMS Advisory Council meets once per month. County Commissioners have a standing invitation, and have been active in attending meetings and keeping informed. 5) County subsidy funds are used to support the county EMS coordinator's position. All state subsidy funds are allocated to that position and supplemented by WCAS and Aims Community College. The EMS Coordinator is based out of Aims Community College, as the training center for the county. Job responsibilities include regular reports to update the Council on current trends, new information and procedures for the EMS community. Other jobs include: organizing and teaching CME in the county, reviewing and revising protocols with the Physician Advisor, writing curriculum, assisting with grant applications, organizing skill and practical testing sessions, processing necessary paper work for state and local requirements, conducting assessments of training, personnel and protocol issues, evaluating CME faculty and staff, writing newsletters to inform EMS agencies of all changes and trends, acting as a liaison between the physician advisor and the 27 agencies he supervises, addressing QA issues, attending and participating at state meetings and instructor projects, and last but certainly not least compiling and writing the county EMS plan. EMS Coordinator: Barbara Foster Aims Community College/EMS Department PO Box 69 5401 West 20th Street Greeley, CO 80632-0069 PHONE 970-330-8008 ext. 6449 FAX 970-339-6622 Email bfoster@arins.edu Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution 6) RETAC planning and coordination has been addressed at several meetings, with committees suggested and plans forming at the local and RETAC level. At this time, while several things are being discussed, the author does not know of any definite plans. There was a needs assessment done last year for five of the nine counties in the RETAC. The assessment is to address the other counties this next year(?) and a final report is to be issued. 3.1.B Identify Any Areas Needing Improvement Identify the changes or improvements you plan to make within your current system in the above stated area. 3.1.C Goals and Objectives In the space provided below please state your goals and objectives. Planning and Coordination Goal#7 Continue EMS Coordinator position, despite lack of state subsidy funding. This position allows for continuity of training and coordination for all EMS training in the county. Objective A for Goal#1 Implement funding for the EMS Coordinator position, through fire agencies and Weld County Fire Chiefs Association. Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution Section IV Financial Reporting Current unspent balance (prior to and Including calendar year 2001 $ 0 (This figure should Include all subsidy funds carried over from previous years) County Subsidy for Calendar year 2002 $ 15,092.33 Additional County Subsidy funds for year 2002 $ (Carry this amount forward to the following page) Total Subsidy Funds Available $ 0 Expenditures In the table below please list all county subsidy expenses that were actually paid out of the county financial system between October 1, 2000 and September 30, 2001. Table One Date Vendor/Payee Amount Detailed Description: Purpose of the expenditure and Goal Reference Paid to Vendor type of purchase or expenditure Number (Found in Plan) Weld County $ 15,092.33 Forward to WCAS to subsidize funding for EMS Ambulance Service Coordinator TOTAL $ 15,092.33 Accounts Payable(Incurred expenses not yet paid for) In the table below please list all anticipated expenses as of September 30, 2001. These are expenses that are either encumbered or committed to by the county, but the county has not disbursed funds as of September 30, 2001. Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution Table Two Date Vendor/Payee Amount Detailed Description: Purpose of the expenditure, type of Goal Reference Anticipated purchase or expenditure and anticipated expense date Number (Found in Plan) $ $ Total $ Financial Summary Total Subsidy Funds Available (carry forward from previous page) $ 0 Total Expenditures from Table One: $ 15092.33 Total Accounts Payable Expenses from Table Two: $ 0 Total Amount Remaining as of September 30, 2001 $ 0 I attest to the fact that information contained in the financial section is accurate and that the county has documentation for all expenditures: Printed Nam 23o t' L ✓j N/� Signature: , m �� Title: !�l �'r r t /4-411//l/Date: 7/ e�U? Phone: 9--/ -3-5 6 ' %Gc * This form must be signed by the county official responsible for county financial transactions. If you have any questions on the financial forms you may call Laurie Borgers at (303)692-2987. Colorado Department of Public Health and Environment Health Promotion and Disennse Prevention Division Revised%r 2001 distribution Anticipated Expenditures For Calendar Year 2002 In the table below please list all anticipated county subsidy expenditures for calendar year 2002 as they correlate to the goal numbers in the narrative of the plan & description. Make sure you list anticipated expenditures for all unspent subsidy funds. Goal Number & Description Type of Expenditure Approx. Dollar Amount All goals and objectives are the priority of the Subsidize salary and expenses for EMS Coordinator for Weld County Weld County EMS Coordinator All Colorado Department of Public llealth and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution CHECK OFF LIST COUNTY SUBSIDY PLAN AND REPORT 6 COPIES OF YOUR COMPLETED PLAN ARE ENCLOSED ONE SET OF TRANSPORT AGENCY PROFILES IS INCLUDED WITH EACH PLAN COPY ONE SET OF NON-TRANSPORT AGENCY PROFILES IS INCLUDED WITH EACH PLAN COPY _ YOUR PLAN FINANCIAL INFORMATION IS SIGNED BY YOUR COUNTY FINANCE OFFICER ONE COPY OF YOUR COMMUNICATIONS FUNCTIONAL DIAGRAM IS INCLUDED WITH EACH PLAN COPY ONE COPY TO YOUR REGIONAL COORDINATOR WITH A COPY OF YOUR PLAN Colorado Department of Public Health and Environment Health Promotion and Disease Prevention Division Revised for 2001 distribution Hello