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ORDINANCE NO. 77-D
•
IN THE MATTER OF THE REPEAL AND RE-ENACTMENT WITH AMENDMENTS OF
ORDINANCE NO. 77-C, EMERGENCY MEDICAL SERVICES RULES AND REGULATIONS
BE IT ORDAINED BY THE BOARD OF COUNTY COMMISSIONERS OF THE COUNTY OF
WELD, STATE OF COLORADO:
WHEREAS, the Board of County Commissioners of the County of Weld, State of 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, pursuant to the recently modified Colorado Emergency Medical Services Act
Rules and pursuant to the recommendation of the Department of Health, and the Weld County
Emergency Medical Services Council, the Board of County Commissioners of Weld County,
Colorado, deems it advisable to amend the Emergency Medical Services Rules and Regulations
Ordinance, and to otherwise update the general wording to coincide with that of the current
Emergency Medical Services Acts, C.R.S., 25-3.5-101, et seq., as amended, and
WHEREAS, said Act requires that the Board of County Commissioners of each county
adopt certain standards, requirements and procedures for providing emergency medical services
within each county, and
WHEREAS, said Act authorizes the Board of County Commissioners of each county to
license and regulate ambulances, and ambulance services, and
WHEREAS,the Board of County Commissioners of the County of Weld deems it in the best
interest of the citizens of said County to adopt the following Ordinance.
NOW, THEREFORE, BE IT ORDAINED, by the Board of County Commissioners of the
County of Weld, State of Colorado, that Ordinance No. 77-C previously enacted be, and hereby
is, repealed an re-enacted with amendments as follows:
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Section 1 - Purpose
1.1 The purpose of these Rules and Regulations is to set forth the requirements for high quality
emergency medical services to all citizens of Weld County. It is the intent of the Board of
County Commissioners that the emergency medical service in Weld County will consist of
at least transportation, treatment, communication and documentation subsystems designed
to prevent premature mortality and to reduce the morbidity that arises from critical injuries,
exposure to poisonous substances, and illnesses.
1.2 Delegation
The Board of Weld County Commissioners designates and delegates to the Director and
the Director's designees the authority to manage the Emergency Medical Services Rules
and Regulations. Under the direction of the Board, inspections, licenses, permits,
applications, and other functions necessary to implement these Rules and Regulations shall
be the responsibility of the Director and the Director's designees.
The Director shall be authorized to promulgate and enforce such rules and regulations for
the operation and licensing of ambulance services in Weld County as the Director deems
necessary to provide for quality emergency medical services and to ensure compliance with
Colorado law and any resolution adopted by the Board.
Section 2 - Definitions
2.1 The following definitions shall apply in the interpretation and enforcement of these Rules
and Regulations.
2.1.1 "Ambulance" means any privately or publicly owned land or air vehicle especially
constructed or modified and equipped, intended to be used and maintained or
operated by an ambulance service for the transportation in this County, of
individuals who are sick, injured, or otherwise incapacitated or helpless. For the
purposes of this Ordinance, "Ambulance" shall include air vehicles used in air
medical transport.
2.1.1.a "Basic Life Support Ambulance" means a land ambulance that
meets the requirements for equipment as established by the Board
and is staffed by at least one Emergency Medical Technician-
Basic/EMT-B currently certified by the State of Colorado, and a
driver that as a minimum has a current American Red Cross
Advanced First Aid Card, an American Heart Association Health
Care Provider Cardiopulmonary Resuscitation Card, or its
equivalent, or the equivalent of both as established by the State
Advisory Council on Emergency Medical Services, and a valid
Colorado Driver's License.
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2.1.1.b "Advanced Life Support Ambulance" means an ambulance
which, in addition to meeting the basic requirements for equipment,
has on board the equipment and medications required by the
Physician Advisor's protocol, and which operates with advanced life
support personnel. An ALS Transport shall include the scope of
practice of a State certified EMT-Paramedic, or EMT-Intermediate.
2.1.2 "Advanced Life Support Personnel" means a minimum of one state certified
Emergency Medical Technician-Paramedic or Emergency Medical Technician-
Intermediate and a current Colorado state certified Emergency Medical Technician-
Basic. One of the above named personnel may also serve as the emergency
vehicle operator of a land ambulance.
2.1.3 "Emergency Vehicle Operator" means any person authorized to either drive a
land ambulance, or pilot an air ambulance, in this County as provided in these Rules
and Regulations.
2.1.4 "Ambulance Service" means the furnishing, operating, conducting, maintaining,
advertising, or otherwise engaging in or professing to be engaged in the
transportation of patients by ambulance. Taken in context, it also means the person
so engaged or professing to be engaged. The person so engaged and the vehicles
used for the emergency transportation of persons injured at a mine are excluded
from this definition when the personnel utilized in the operation of said vehicles are
subject to the mandatory safety standards of the Federal Mine Safety and Health
Administration, or its successor agency.
2.1.5 "Ambulance Service License" shall mean a nonexclusive authorization issued by
the Board of County Commissioners to operate an ambulance service, publicly or
privately within Weld County; the license shall issue only to ambulance services
whose primary base of operation is located in Weld County, or whose operation
includes providing primary care in Weld County.
2.1.6 "Ambulance Vehicle Permit" shall mean the authorization issued by the
Department with respect to an ambulance used or to be used to provide ambulance
service in Weld County.
2.1.7 "Applicant" shall mean that person who is an initial applicant or an applicant for
renewal for an ambulance service license, or ambulance vehicle permit.
21.8 "Board" shall mean the Board of County Commissioners of Weld County.
2.1.9 "County" shall mean Weld County, Colorado.
2.1.10 "Current E.M.S. Act" shall mean the Emergency Medical Services Act, C.R.S.,
25-3.5-101 et seq., as amended.
2.1.11 "Department" shall mean the Weld County Health Department.
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2.1.12 "Director" shall mean the Director of the Weld County Health Department.
2.1.13 "Emergency" means any actual or self-perceived event which threatens life, limb,
or well-being of an individual in such a manner that a need for immediate medical
care is created.
2.1.14 "Emergency Medical Services" shall mean the services, or the training therein,
utilized in a pre-hospital environment in response to the perceived individual needs
for prevention of: loss of life, further aggravation to physiological and/or
psychological injury, and/or inherent harm to an individual or group of individuals.
2.1.15 "Emergency Medical Technician (EMT)" means an individual who holds a valid
Emergency Medical Technician certificate issued by the Colorado Department of
Public Health and Environment, as provided in the Emergency Medical Services
Act, C.R.S. 25-3.5-101, et. seq., as amended.
2.1.15.a "Emergency Medical Technician-Basic (EMT-B)" means an
individual who has been duly certified by the Emergency Medical
Services Division of the Colorado Department of Public Health and
Environment, and who is authorized to provide basic emergency
medical care in accordance with the acts allowed by the Colorado
State Board of Medical Examiners and the rules of the Colorado
Board of Health.
2.1.15.b "Emergency Medical Technician-Intermediate(EMT-I)"means an
individual who has been duly certified by the Emergency Medical
Services Division of the Colorado Department of Public Health and
Environment, and who is authorized to provide emergency medical
care in accordance with the acts allowed by the Colorado State
Board of Medical Examiners and the Colorado Board of Health.
2.1.15.c "Emergency Medical Technician-Paramedic" means an individual
who has been duly certified by the Emergency Medical Services
Division of the Colorado Department of Public Health and
Environment and who is authorized to provide advanced emergency
medical care in accordance with the acts allowed by the Colorado
State Board of Medical Examiners and the rules of the Colorado
Board of Health.
2.1.16 " Standby Service" is a service provided by contract or on a voluntary basis to
provide emergency medical services at special events including athletic and
competitive events which may pose a potential hazard for injury or death and
require immediate emergency medical care. Standby Service providers must
comply with all insurance requirements for emergency medical service providers set
forth in this ordinance.
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2.1.17 "First Responder" shall mean an individual who has successfully completed the
First Responder Certification Program administered by the Division of Fire Safety
pursuant to Section 24-33.5-1201, et seq., C.R.S., and the applicable regulations
of the Colorado State Department of Public Safety.
2.1.18 "Medical Director" shall mean a Physician Advisor.
2.1.19 "Patient" means any individual who is sick, injured, or otherwise incapacitated or
helpless.
2.1.20 "Physician Advisor" means a physician who establishes protocols and standing
orders for medical acts performed by EMT-Basics, EMT-Intermediates, EMT-
Paramedics, First Responders, or Registered Nurses, of a pre-hospital emergency
medical care service agency and who is specifically identified as being responsible
to assure the competency of the performance of those acts by such EMT-Basics,
EMT-Intermediates, EMT-Paramedics, First Responders, or Registered Nurses.
"Physician Advisor" shall also mean a Colorado licensed physician who is
specifically designated and has accepted responsibility for directing the conduct of
pre-hospital training courses conducted by a Division-recognized training center or
training group, and for evaluating the performance of students in such training
courses.
2.1.21 "Primary Care" shall mean the initial response and care for Emergency Medical
Services either by contract or agreement.
2.1.22 "Rescue Unit" means any organized group chartered by this State as a corporation
not for profit or otherwise existing as a non-profit organization whose purpose is the
search for and the rescue of lost or injured persons and includes, but is not limited
to, such groups as search and rescue, mountain rescue, ski patrols (either volunteer
or professional), law enforcement posses, civil defense units, or other organizations
of governmental designation responsible for search and rescue.
2.1.23 "Registered Nurse," abbreviated R.N., shall mean a person duly licensed under
the provisions of the Professional Nurse Practice Act of the State of Colorado.
Section 3 - Requirements for Licensure of Ambulance Services and Ambulance Vehicle
Permits
3.1 License for Ambulance Service Required. No person, partnership or corporation, shall
provide or operate an ambulance service publicly or privately in Weld County unless that
person holds a valid license to do so issued by the Department, except as provided in
subsection 3.7 of this section. The fee for said license shall be set by separate Ordinance.
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3.2 Vehicle Permit Required for each Ambulance. In addition to the license required by
Section 3.1 for an ambulance service, the Department shall issue a permit for each
ambulance used. Said Ambulance Vehicle Permit shall be issued upon a finding that the
applicant's vehicle and equipment comply with the requirements of these Rules and
Regulations and the current E.M.S. Act. The Ambulance Vehicle Permit fee shall be set
by separate Ordinance.
3.3 Expiration of Licenses and Permits. The Ambulance Service License and Ambulance
Vehicle Permit shall expire on December 31 of the year issued.
3.4 Physician Advisor Required. Each ambulance service licensed in Weld County shall
have a physician advisor. The physician advisor shall be notified in writing by the
Department of any violation of this Ordinance by any ambulance service or individual
licensee.
3.5 Advanced Life Support Ambulances. When an ambulance service operates, or charges,
as a paramedic or advanced life support ambulance service, the staffing must comply with
the definition of Advanced Life Support Ambulance.
3.6 Basic Life Support Ambulance. Any ambulance staffed and operating as a Basic Life
Support Ambulance Service, shall in no way advertise, display or claim to be an Advanced
Life Support Ambulance Service unless they are licensed as such.
3.7 Exclusions. The provisions of this Section 3 shall not apply to the following:
3.7.1 The exceptional emergency use of a privately or publicly owned vehicle, including
search and rescue unit vehicles, or aircraft not ordinarily used in the formal act of
transporting patients.
3.7.2 A vehicle rendering services as an ambulance in case of a major catastrophe or
emergency when ambulances with permits based in the localities of the catastrophe
or emergency are insufficient to render the services required.
3.7.3 Ambulances based outside the State of Colorado or Weld County which are not
providing primary care, but are solely transporting a patient in Weld County and
which are licensed by another state or by another Colorado county.
3.7.4 Vehicles used or designated for the scheduled transportation of convalescent
patients, handicapped individuals, or persons who would not be expected to require
skilled treatment or care while in the vehicle.
3.7.5 Vehicles used solely for the transportation of intoxicated persons or persons
incapacitated by alcohol as defined in current C.R.S., 25-1-302 as amended, but
who are not otherwise disabled or seriously injured and who would not be expected
to require skilled treatment or care while in the vehicle.
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3.8 Application - Requirements. Every applicant for an Ambulance Service License or an
Ambulance Vehicle Permit shall complete and submit to the Department an application and
supporting documents for approval. Said application for approval shall contain but not be
limited to the following information:
3.8.1 The name, address and telephone number of the owner of the ambulance service.
3.8.2 The name and address and current telephone number of the person who will be in
charge of the operation of the ambulance service.
3.8.3 Land Vehicles: The description of the ambulance(s), including the make, model,
year of manufacture, current Colorado state license number, motor vehicle chassis
number, length of time the vehicle has been in service.
Air Vehicles: The description of the ambulance(s), including the make, model, tail
number, and identifying colors, as well as a current part 135 certificate.
3.8.4 The location and description of the place or places from which the ambulance
service will operate.
3.8.5 The name, address and telephone number of the required physician advisor to the
ambulance service.
3.8.6 The area to be served by the ambulance service.
3.8.7 A list of all emergency medical service providers who may be called upon to
respond to an emergency with the ambulance service. This list shall include the
following information on each person:
3.8.7.1 complete name, address, and date of birth.
3.8.7.2 the highest level of certification, licensure or training attained.
3.8.7.3 a copy of a current EMT-B, EMT-I or EMT-P certificate issued by
the Colorado Department of Public Health and Environment; nurse
licensure, or an Advanced First Aid card from the American Red
Cross; or a First Responder Course completion certificate issued by
a Division-recognized training center or training group.
3.8.7.4 proof of a valid Colorado Driver's License.
3.8.7.5 a statement of criminal complaint or convictions including Class I
and II traffic violations within the previous twelve (12) months.
3.8.8 Proof of insurance, as required, below, in Section 4.5 of this Ordinance 77-D.
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3.8.9 A current copy of EMT or Paramedic Protocols adopted by the ambulance service
in accordance with standards approved by the ambulance service's physician
advisor.
3.8.10 A current copy of the ambulance service's training standards in accordance with the
requirements approved by the ambulance service's Physician Advisor. All training
must be through a state certified emergency medical services training center.
3.8.11 Such other information as the Department may require to make a fair determination.
3.9 Application -Approval. After receipt of an original application for an Ambulance Service
License or an Ambulance Vehicle Permit, or a renewal thereof, the Department shall review
the application and the applicant's record and provide for an inspection of equipment and
vehicle(s)to determine compliance with this Ordinance. The Director shall issue a license
to the applicant to provide ambulance service and a permit for each ambulance used upon
a finding that:
3.9.1 The ambulance service staff, vehicles, equipment, and location comply with the
requirements of this Ordinance, and
3.9.2 The ambulance service's emergency medical technicians are certified in accordance
with the rules pertaining to emergency medical services of the Colorado Department
of Public Health and Environment, and
3.9.3 The applicant has complied in all respects with the requirements of this Ordinance.
3.10 Fraud or Misrepresentation. Obtaining or attempting to obtain any license or permit
hereunder by fraudulent means or misrepresentation shall be grounds for denial,
suspension, or revocation of such license or permit.
3.11 Additional or Replacement Vehicles. If an ambulance is replaced or an additional
ambulance or ambulances are added to a service's fleet, an application for an ambulance
vehicle permit shall be filed with the Department within 30 days of receipt of the new
ambulance(s). The completed application shall include a description of the ambulance(s)
replaced. Upon receipt of a new ambulance vehicle permit application the Department shall
inspect the new ambulance and issue the new ambulance vehicle permit, if appropriate.
3.12 Additional Inspections. In addition to the inspection required at the time of application,
the Department may also visit or contact all ambulance services at any other time during
the year at which time an inspection may or may not be performed. The inspections of the
ambulances and related equipment shall cover but not be limited to the following items:
condition of the ambulance, safety and warning systems, and minimum equipment for the
relevant ambulance. Each service shall provide evidence of an adequate ongoing vehicle
safety and maintenance program. This shall be a log which shows the dates of the service
and list of service(s) performed. The Department may modify this regulation or adopt
additional requirements with the consent of the Board.
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3.13 Application - Denial Appeal. Any person or entity having been denied a license by the
Director may appeal such denial to the Board. The request for a hearing on such denial
must be in writing and shall be filed with the Clerk to the Board no later than thirty (30) days
after the date of notification by the Director to the applicant of such denial. The request for
a hearing shall specify the grounds of the appeal.
3.14 Change of Ownership. Any change of ownership shall require a new application and
license, with payment of the same license fee as is required for an original application. Any
sale or exchange of stock of fifty percent (50%) or more of the total outstanding stock of a
corporation shall be deemed a change of ownership for purposes of this Ordinance. Any
change of ownership or any change of stock ownership of ten percent (10%) or more shall
be reported in writing to the Director.
3.15 Licenses and Permits Non-Transferable. No license or permit issued by the Director
shall be sold, assigned, or otherwise transferred.
3.16 Annual Renewal. All licenses and permits shall be renewed annually, shall expire on
December 31 of the year issued, and shall not be renewed until the application has been
approved by the Department. All applications for renewal of licenses and permits shall be
made not later than sixty (60) days prior to the date of expiration. The Department shall
notify, by certified mail, return receipt requested, each licensee of the renewal requirements
of this section, within ninety (90) days prior to the date of expiration.
Section 4 - Requirements for the Operation of Ambulances
4.1 Emergency Vehicle Operator. For land vehicles, the ambulance driver shall meet the
requirements of 25-3.5-202, C.R.S., as amended. This requirement may be waived in
unusual emergency conditions when no driver meeting these requirements is available. For
air vehicles, the pilot of the aircraft must have a current pilot's license issued by the FAA,
which permits the pilot to operate the relevant aircraft.
4.2 Ambulance Crew Members -Training. No patient shall be transported in an ambulance
within the county unless there is available in the patient compartment, a Colorado State-
certified EMT-Basic or higher level trained person.
Ambulances responding to a call without a State-Certified EMT-Basic or higher level trained
person on board the ambulance shall immediately, upon acknowledgment of the call, notify
Weld County Regional Communications Center that the ambulance is responding without
such person on board. Upon notification, Weld County Regional Communications Center
shall immediately contact and dispatch back-up ambulance service coverage.
4.3 Documentation. Each ambulance service shall prepare, maintain, and submit upon
request, copies of uniform and standardized records concerning the transportation and
treatment of patients as required by the Director. Such records shall include all information
determined to be essential by the Colorado Department of Public Health and Environment
for maintenance of adequate minimum records on the patient's medical condition and
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medical care provided by the ambulance service. All records shall be preserved by the
ambulance service for a period of at least three (3) years.
4.4 Ambulance Crew Members - Criminal Record. Unless waived by the Board, no person
shall be employed by an ambulance service as an ambulance crew member who has been
convicted of a felony, misdemeanor, Class I, or Class II traffic offense within the previous
twelve (12) months from the date of application.
4.5 Insurance. No emergency medical service provider shall operate in Weld County unless
it is covered by insurance as set forth in this paragraph. Each ambulance service shall
maintain insurance coverage for each and every ambulance owned, operated or leased by
the ambulance service, providing coverage for injury to or death of persons in accidents
resulting from any cause for which the owner of the said vehicle should be liable for any
liability imposed on him by law, regardless of whether the ambulance was being operated
by the owner, his agent or lessee, or any other person, and coverage as against damage
to the property of another, including personal property, under like circumstances, in the
following amounts:
4.5.1 Worker's Compensation Insurance: Each ambulance service shall maintain at
least the statutorily required amount of worker's compensation insurance.
4.5.2 Public Liability and Property Damage Bodily Injury:
Each person $ 500,000
Each accident $ 500,000
Property Damage:
Each accident $ 500,000
Professional Liability Coverage:
Each person $ 500,000
Each accident $1,000,000
4.5.3 Proof of Insurance. Proof of insurance shall be filed with the Department, along
with the application for an ambulance service license as required in these
regulations. Every insurance policy required shall contain a provision for continuing
liability thereunder to the full amount thereof, notwithstanding any recovery thereon,
that the liability of the insured shall not be affected by the insolvency or bankruptcy
of the insured, and that until a policy is revoked, the insurance company will not be
relieved from liability on account of nonpayment of premiums, failure to renew
license at the end of the year, or any act or omission of the named insured. Al any
time said insurance is required to be renewed proof of renewal shall be provided to
the Department. The land vehicle insurance shall be a complying policy for motor
vehicles as defined in Section 10-4-703, C.R.S., as amended.
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4.5.4 A certificate of insurance, with the Board named on the certificate holder's copy,
shall indicate the vehicles covered by the policy, type of insurance, (vehicle and
professional liability, etc.), policy number(s), policy effective date, policy expiration
date, amount of coverage, and contain a provision that thirty (30) days prior written
notice of any cancellation or termination or revocation of said insurance policy shall
be given to the Department.
4.5.5 Any changes in the status of vehicles listed on the certificate of insurance during the
licensing cycle, shall be noted on a new certificate of insurance and forwarded to
the Department within thirty (30) days of the changes.
4.5.6 Notification of any changes in insurance shall be made in writing within thirty (30)
days of such changes to the Department by the licensee, to be followed with a
certificate of insurance as outlined in previous paragraphs. The Director may
require additional proof of insurance at any time needed in order to promote health,
safety, and welfare of residents of the County.
4.6 Safety Belts. Safety belts shall be utilized by all persons in the forward compartment.
Attending personnel shall utilize seat belts when feasible. Safety belts or other safety
restraining devices shall be available for patients being transported. Such devices shall be
utilized when feasible.
4.7 Transport-Medical Facility. All ambulances shall deliver patients to the most appropriate
licensed medical facility, as determined by the physician advisor or his designee, dependent
on the patient's medical needs. When medically appropriate, the patient's preference
should be considered.
4.8 Approved Locations -Abandonment. No licensed ambulance service shall operate from
locations other than those approved by the Director nor shall such licensed ambulance
service abandon approved locations without prior notification of the Director.
4.9 An ambulance service operating in the County must comply with all relevant County and
municipal zoning and other regulations.
Section 5 -Ambulance vehicle requirements
5.1 Specification. Land vehicles obtained, licensed and placed in use as ambulances, shall
at the minimum, meet the guidelines as established by the State EMS Advisor. Variances
of the above-mentioned specifications may be granted at the discretion of the Director. Air
vehicles obtained, licensed and placed in use as ambulances shall, at the minimum, be in
compliance with all state and federal regulations including Federal Aviation Regulations
(FARs) specific to the operations of the air medical service. All ambulances shall have the
name of the ambulance service clearly visible on said vehicles.
5.2 Ambulance Equipment. Each ambulance shall contain the following equipment which
shall be maintained in good working order:
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5.2.1 Land Vehicles.
5.2.1.1 Emergency lighting and audible warning equipment which complies
with Colorado State law for emergency vehicles.
5.2.1.2 Safe tires and in addition, adequate snow tires or chains when
weather conditions demand.
5.2.1.3 In the case of ambulances providing primary care in the County, or
otherwise qualified pursuant to Section 2.1.7, a capability of two-
way radio communication with the following: their dispatcher, the
Weld County Regional Communication Center, and on-line medical
control.
5.2.1.4 Safety belts for both the ambulance driver and other attending
personnel.
5.2.1.5 The minimal required equipment shall be that listed in the list
established by the Colorado Department of Public Health and
Environment Emergency Medical Services Division. The Director
may add to this list at his direction as other needs or new
methodology becomes known.
5.2.2 Air Vehicles.
5.2.2.1 All air ambulances must comply with the requirements set forth in
Section 2.0, Aircraft Equipment and Configuration, of the Colorado
Air Medical Service Guidelines, April, 1995, or its successor.
5.2.2.2 All air ambulance services must comply with the relevant safety
standards for rotor wing or fixed wing aircraft, or both, as set forth in
Sections 17.0, 18.0, and 19.0 of the Colorado Air Medical Service
Guidelines, April, 1995, or its successor.
Section 6 -Qualifications of Emergency Medical Technicians
6.1 No person shall practice as an Emergency Medical Technician for any Ambulance Service
subject to the licensing requirements of this Ordinance unless that person holds a valid
Emergency Medical Technician certificate from the State of Colorado.
6.2 Each Emergency Medical Service shall provide the Department with a list of its Emergency
Medical Service Providers, as per section 3.8-7.
6.3 Before the State certification of an EMT expires, the ambulance service shall provide the
department with a written statement showing the name of the EMT, the date the certificate
was issued, the date of expiration, and the certificate number of the new State certificate.
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Failure to comply with this Section disqualifies an EMT from practice in any Weld County
ambulance service.
Section 7 - Requirements for Emergency Medical Service Providers not licensed by Weld
County
7.1 Emergency Medical Services contracting with, or employed by, groups and organizations
for public events and not affiliated with a licensed ambulance service licensed by the
County shall, upon request, be able to demonstrate compliance with rules and regulations
as promulgated by Weld County, State of Colorado, and State Board of Medical Examiners.
7.2 Standby Services. Emergency Medical Services contracting with, or employed by, groups
or organizations for public events to provide emergency medical care in the County must
have sufficient personnel, supplies and equipment to effect care on the First Responder or
higher level basis, and provide proof of compliance with the insurance requirements set
forth in Section 4.5 of this Ordinance. Assemblages of 5,000 or more persons shall require
the standby services of at least one Advanced Life Support Ambulance staffed with at least
one EMT-P and one EMT-B. Each additional 5,000 persons shall meet the same
requirements.
7.2.1 The following is the minimum equipment required for standby services:
7.2.1.1 Direct communication access to 911 for requesting advance life
support care.
7.2.1.2 Oropharyngeal Airways in adult, child, and infant sizes.
7.2.1.3 Assorted dressings (Sterile - large and small).
7.2.1.4 Soft roller bandages.
7.2.1.5 Tape.
7.2.1.6 Blanket.
7.2.1.7 Triangular bandages.
7.2.1.8 Shears capable of cutting clothing or bandages including heavy
leather or canvas.
7.2.1.9 Flashlight.
7.2.1.10 Oral suction device.
7.2.1.11 Portable oxygen and pocket mask and administration equipment.
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Section 8 - Unlawful Practices
8.1 The following practices shall be unlawful and shall be grounds for a suspension or
revocation of a license:
8.1.1 Willful and deliberate failure to respond to any call.
8.1.2 Willful and deliberate failure to transport a patient when required.
8.1.3 Administering unnecessary treatment or supplies to a patient for the purpose of
increasing the patient's bill.
8.1.4 Administration of any substance unless under the protocol and/or order of the
Physician Advisor, or medical control or designee.
8.1.5 Charging for treatment or supplies not actually provided to a patient.
8.1.6 Requiring and/or allowing any employee of an ambulance service to be on
continuous duty for any one period in excess of forty-eight (48) hours, except in
cases of extreme emergency.
8.1.7 Except as otherwise provided in this Ordinance, failure to deliver a patient to the
most appropriate licensed medical facility as determined by the physician advisor
or his designee, dependent upon the patient's medical needs.
8.1.8 Conduct which constitutes a significant threat to the health or safety of the
individuals receiving emergency care from a licensed ambulance service or
services.
8.1.9 Noncompliance with any rule or regulation promulgated by the Colorado State
Board of Medical Examiners for the duties and responsibilities of Emergency
Medical Technicians or Physician Advisors.
Section 9 -- Suspension or Revocation of License or Permit; Conditional Permits
9.1 Temporary Suspension. Upon a determination by the Director that any person has
violated or failed to comply with any provisions of this Ordinance, the Director may
temporarily suspend, for a period not to exceed thirty (30) days, any license or permit
issued pursuant to this Ordinance. The licensee or permit holder shall receive written
notice of such temporary suspension. The temporary suspension shall be effective upon
the date of mailing the written notice by certified mail, return receipt requested, to the
licensee or permit holder, or on the date of service of the notice upon the licensee or permit
holder pursuant to the Colorado Rules of Civil Procedure. A hearing on the temporary
suspension shall be held before the Board not later than ten (10) days after the effective
date of the temporary suspension. The written notice of temporary suspension shall include
960515
ORD77-D
RE: ORDINANCE NO. 77-D
PAGE 15
notice of the time and place of such hearing. Prior to such hearing, the Director may
reinstate the license or permit upon a finding that the licensee has come into compliance
with the provisions of this ordinance.
9.2 All hearings before the Board of County Commissioners shall be public and every vote and
official act of the Board of County Commissioners shall be public. The Board of County
Commissioners may require an ambulance service company which is the subject of a
hearing, to make available such books and records as are desired and requested by the
Board of County Commissioners. All testimony at the hearings shall be under oath and
shall be electronically recorded. If a stenographic shorthand reporter is desired by any
party, such reporter shall be permitted at the requesting party's expense. The Board of
County Commissioners shall make other rules and regulations for the conduct of the
hearing as are deemed necessary in its discretion.
9.3 The hearing before the Board of County Commissioners shall be conducted in two (2)
phases.
9.3.1 During Phase I of the hearing, the Board of County Commissioners shall determine
whether, by a preponderance of the evidence presented in the public hearing, any
one or more of the following has occurred:
9.3.1.1 Violation(s) of any provision of this Ordinance.
9.3.1.2 Violation(s) of any law of the State of Colorado, or Ordinance or
regulation of any municipality in the County. Evidence of any
violation may be considered, regardless of any conviction thereof.
9.3.1.3 Commission of any practices set forth in Section 8.
9.3.1.4 If the Board does not find that any of the above acts has occurred,
the Board shall conclude the hearing and shall reinstate the license
or permit for the remainder of its term. If the Board finds that one or
more of the above acts has occurred, the public hearing shall
progress to Phase II.
9.3.2 During Phase II of the public hearing, the Board shall consider whether to suspend
or revoke permanently the license or permit. The Board may suspend any license
or permit issued pursuant to this Ordinance for any portion of or for the remainder
of its life. At the end of such period, the person whose license or permit was
suspended, may apply for a new license or permit as in the case of an original
application. Upon a finding by the Board that the licensee or permit holder has
committed, within two (2) consecutive calendar years, two violations or on two
separate occasions has failed to comply with any provision of this Ordinance, the
Board may permanently revoke such license or permit. The Board's decision to
suspend or to revoke permanently the license or permit shall be based upon
whether evidence of the following factors mitigates or aggravates the effects of the
acts found by the Board during Phase I of the public hearing:
960515
ORD77-D
RE: ORDINANCE NO. 77-D
PAGE 16
9.3.2.1 The seriousness of the violation.
9.3.2.2 Corrective actions taken by the license holder.
9.3.2.3 Prior violations and offenses and the effectiveness of prior corrective
action.
9.3.2.4 Prior violations and offenses by the licensee or permit holder.
9.3.2.5 The violation, offense, or occurrence as a repeated course of
conduct or as a single event.
9.3.2.6 The likelihood of recurrence.
9.3.2.7 All circumstances surrounding the violation, offense, or occurrence.
9.3.2.8 Willfulness of violation(s), offense(s), of occurrence(s).
9.3.2.9 The length of time the license or permit has been held by the
licensee or permit holder being disciplined.
9.3.2.10 Previous sanctions imposed against the licensee.
9.3.2.11 Other factors making the situation unique to the license or permit
holder subject to discipline.
9.4 It shall be the duty of the Director to notify local law enforcement authorities, fire
departments, hospitals and the physician advisor(s) of revocation or suspension of any
ambulance service license or vehicle permit.
Section 10 - Countywide Emergency Service
10.1 Mutual Aid Agreements. Weld County encourages a cooperative systems approach
towards improved patient care. All licensed agencies providing EMS responses in Weld
County shall make a good faith effort to execute written mutual aid agreements with all
other EMS providers located within or bordering on their area of response. Copies of these
agreements shall be kept on file for review.
10.2 County Ambulance Service. The Weld County Ambulance Service is the ambulance
service organized and furnished by Weld County, pursuant to the provisions of Colorado
statute. So long as the Weld County Ambulance Service is in existence and is duly
licensed pursuant to this Ordinance, the Weld County Ambulance Service may provide
emergency service to all areas of Weld County and to those other areas specifically set
forth in the Weld County Ambulance Service application and license. Weld County
Regional Communications Center may dispatch Weld County Ambulance Service to
respond to a call within another ambulance service's service area under the terms and
conditions set forth in Section 4.2.
960515
ORD77-D
• RE: ORDINANCE NO. 77-D
PAGE 17
10.3 Triage Authority. Incident Command shall appoint triage authority at an active incident.
Weld County Ambulance Service shall be appointed medical triage authority in Weld County
when Weld County Ambulance Service and any other ambulance service have responded
to calls for emergency assistance where medical triage authority has not yet been
established, and/or a dispute concerning medical triage exists.
Section 11 - No Third Party Beneficiary Enforcement
Nothing in this Ordinance shall be construed to create a cause of action and/or civil liability remedy
in any person. This Ordinance shall not be construed to create a duty to any third party where no
such duty otherwise existed. It is the express intention of the Board that any third party receiving
services or benefits under this Ordinance shall be deemed an incidental beneficiary only.
Section 12 -Savings Clause
12.1 The repeal of Ordinance 77-C and its reenactment as Ordinance 77-D shall not have the
effect to release, extinguish, alter, modify, or change in whole or in part any penalty,
forfeiture, or liability, either civil or criminal,which shall have been incurred under Ordinance
77-C. Ordinance 77-C shall be treated and held as remaining in force for the purpose of
sustaining any and all proper actions, suits, proceedings and prosecutions, criminal as well
as civil, for the enforcement of such penalty, forfeiture, or liability, as well as for the purpose
of sustaining any judgment, decree or order which can or may be rendered, entered or
made in such actions, suits, proceedings, or prosecutions, imposing, inflicting or declaring
such penalty, forfeiture or liability.
12.2 All licenses in existence under Ordinance 77-C, at the time that said Ordinance was
repealed and reenacted as this Ordinance 77-D, shall continue in validity for their term as
provided under Ordinance 77-C. Such existing licenses shall be subject, however, to the
terms and requirements of this Ordinance 77-D without the need for a new application or
inspection pursuant to this Ordinance 77-D.
BE IT FURTHER ORDAINED that the Board of County Commissioners of Weld County
hereby finds, determines, and declares that this Ordinance is necessary for the health, safety, and
welfare of the citizens of Weld County, Colorado.
BE IT FURTHER ORDAINED by the Board if any section, subsection, paragraph, sentence,
clause, or phrase of this Ordinance is for any reason held or decided to be unconstitutional, such
decision shall not affect the validity of the remaining portions hereof. The Board of County
Commissioners hereby declares that it would have enacted this Ordinance in each and every
section, subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that
any one or more sections, subsections, paragraphs, sentences, clauses, or phrases might be
declared to be unconstitutional or invalid.
960515
ORD77-D
RE: ORDINANCE NO. 77-D
• PAGE 18
BE IT FURTHER ORDAINED by the Board of County Commissioners of Weld County,
Colorado, that this Ordinance No. 77-D shall become effective five days after its final public notice,
in accordance with Section 3-14(2) of the Weld County Home Rule Charter.
The above and foregoing Ordinance Number 77-D was, on motion duly made and
seconded, adopted by the following vote on the 29th day of April, A. D., 1996.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST:
Barbara J. Kirkmeyer, Chair
Weld County Clerk to the Board
George E. Baxter, Pro-Tem
BY:
Deputy Clerk to the Board Dale K. Hall
APPROVED AS TO FORM: Constance L. Harbert
County Attorney
W. H. Webster
First Reading: April 1, 1996
Publication: April 4, 1996, in the North Weld Herald
Second Reading: April 15, 1996
Publication: April 18, 1996, in the North Weld Herald
Final Reading: April 29, 1996
Publication: May 2, 1996, in the North Weld Herald
Effective: May 7, 1996
960515
ORD77-D
AFFIDAVIT OF PUBLICATION
STATE OF COLORADO
ss.
COUNTY OF WELD
I, Bruce J. Bormann, of said County of Weld, being duly
sworn, say that I am Publisher of
THE NORTH WELD HERALD
a weekly newspaper having a general circulation in said
County and State, published in the Town of Eaton, in said
County and State; and that the notice, of which the annexed is
a true copy, has been published in said weekly newspaper for
CrIA-e .- successive week(s), that the notice was published
in the regular and entire issue of every number of the paper
during the period and time of publication, and in the
newspaper proper and not in a supplement, and that the
publication of said notice:
{rd t n CLC.Q_ * 1
was in said newspaper bearing the date(s) of:
Thursday,the ry day of 491. / , 1996
Thursday,the day of , 1996
Thursday,the day of , 1996
Thursday,the day of , 1996
and that the said THE NORTH WELD HERALD has been
published continuously and uninterruptedly for the period of 52
consecutive weeks, in said County and State, prior to the date
of first publication of said notice, and the same is a newspaper
within the meaning of an Act to regulate printing of legal
notices and adve ' ements, approved y 18, 1931, and all
prior acts so far s force.
BR C J. BORMANN, PUBLISHER
Publication Cost: $
Y..Poe
�
Subscribed and sworn to before me - •'•
p r�.f ' •.•�
this Bf4 day of April, 1996 Irte ERIKA C.
bleb' . (�. ` ala r BAGLEY I
ERIKA C. BAGLEY,NOTARY TUB 9/ .........OF My commission expires October 21, 1999 _ y
g ORDINANCE NO.77-D
IN THE MATTER OF THE REPEAL AND RE-ENACTMENT WITH AMENDMENTS OF ORDINANCE NO.77-C, EMERGENCY MEDICAL
SERVICES RULES AND REGULATIONS
BE IT ORDAINED BY THE BOARD OF COUNTY COMMISSIONERS OF THE COUNTY OF WELD,STATE OF COLORADO:
WHEREAS,the Board of County Commissioners of the County of Weld,State of 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, pursuant to the recently modified Colorado Emergency Medical Services Act Rules and pursuant to the l
recommendation of the Department of Health, end the Weld County Emergency Medical Services Council, the Board of County
Commissioners of Weld County, Colorado,deems it advisable to amend the Emergency Medical Services Rules and Regulations Ordinance,
and to otherwise update the general wording to coincide with that of the current Emergency Medical Services Acts,C.R.S.,25-3.5-101,et seq.,
as amended,and
WHEREAS,said Act requires that the Board of County Commissioners of each county adopt certain standards, requirements and
procedures for providing emergency medical services within each county,and
WHEREAS, said Act authorizes the Board of County Commissioners of each county to license and regulate ambulances. and
ambulance services, and
WHEREAS the Board of County Commissioners of the County of Weld deems it in the best interest of the citizens of said County
to adopt the followingOrdinance.
NOW, THEREFORE, BE IT ORDAINED, by the Board of County Commissioners of the County of Weld, State of Colorado, that
Ordinance No.77-C previously enacted be,and hereby is,repealed and re-enacted with amendments as follows:
Section 1-Purpose
1.1 The purpose of these Rules and Regulations is to set forth Ute requirements for high quality emergency medical services to all
citizens of Weld County. it is the intent of the Board of Cbunty Commissioners that the emergency medical service in Weld
County will consist of at least transportation, treatment, communication and documentation subsystems designed to prevent
premature mortality and to reduce the morbidity that arises from critical injuries,exposure to poisonous substances,and Illnesses.
1.2 Delegation
The Board of Weld County Commissioners designates and delegates to the Director and the Director's designees the authority to
manage the Emergency Medical Services Rules and Regulations. Under the direction of the Board, inspections, licenses,
permits, applications, and other functions necessary to implement these Rules and Regulations shall be the responsibility of the
Director and the Director's designees.
The Director shall be authorized to promulgate and enforce such rules and regulations for the operation and licensing of ambulance
services in Weld County as the Director deems necessary to provide for quality emergency medical services and to ensure
compliance with Colorado law and any resolution adopted by the Board.
Section 2-Definitions
2.1 The following definitions shall apply in the interpretation end enforcement of these Rules and Regulations.
2.1.1 "Ambulance" means any privately or publicly owned land or air vehicle especially constructed or modified and
equipped. intended to be used and maintained or operated by an ambulance service for the transportation in this
County, of individuals who are sick, injured, or otherwise Incapacitated or helpless. For the purposes of this
Ordinance,"Ambulance"shall include air vehicles used in air medical transport.
2.1.1.a "Basic Life Support Ambulance" means a land ambulance that meets the requirements for equipment as
established by the Board and is staffed by at least one Emergency Medical Technician-Basic/EMT-B
currently certified by the State of Colorado, and a driver that as a minimum has a current American Red
Cross Advanced First Aid Card, an.American Heart Association Health Care Provider Cardiopulmonary
Resuscitation Card,or its equivalent,or the equivalent of both as established by the State Advisory Council
on Emergency Medical Services,and a valid Colorado Driver's License.
21.1A c
requirementsLforr equipment,has lonoboard the equ' means an pent ambulance mepdpicatio jn nsdition to regrsonnel. Auired by the the
Adincluderthe scopeelof practic and e of a h operates
tate certified EMT-Paramedic,life support
orr EMT-Intermediate.n ALS Transport shall
2.1.2 "Advanced Life Support Personnel' means a minimum of one state certified Emergency Medical Technician-
Paramedic or Emergency Medical Technician-Intermediate and a current Colorado state certified Emergency Medical
Technician-Basic. One of the above named personnel may also serve as the emergency vehicle operator of a land
ambulance.
2.1.3 "Emergency Vehicle Operator' means any parse^ authorized to either drive a land ambulance, or pilot an air
ambulance, in this County as provided in these Rules and Regulations.
2.1.4 'Ambulance Service' means the furnishing,operating,conducting,maintaining,advertising, or otherwise engaging in
or professing to be engaged in the transportation of patients by ambulance. Taken in context,it also means the person
so engaged or professing to be engaged. The person
so a ngagedon and
dethe vehicles
iiclesnul utilized the
hehe operationen
transportation of persons Injured at a mine are excluded personnel .
of said vehicles are subject to the mandatory safety standards of the Federal Mine Safety and Health Administration,or
its successor agency.
2.1.5 "Ambulance Service License' shall mean a nonexclusive authorization issued by the Board of County Commissioners
to operate an ambulance service, publicly or privately within Weld County;the license shall issue only to ambulance
services whose primary base of operation is located in Weld County, or whose operation includes providing primary
can in Weld County.
2.1.6 "Ambulance Vehicle Permit'shall mean the authorization issued by the Department with respect to an ambulance
used or to be used to provide ambulance service in Weld County.
2.1.7 "Applicant" shall mean that person who is an initial applicant or an applicant for renewal for an ambulance service
license,or ambulance vehicle permit.
21.8 "Board"shall mean the Board of County Commissioners of Weld County.
2.1.9 "County"shall mean Weld County,Colorado.
2.1.10 'Current E.M.S.Act'shall mean the Emergency Medical Services Act,C.R.S.,25.3.5-101 et seq.,as amended.
2.1.11 "Department'shall mean the Weld County Health Department.
2.1.12 "Director"shall mean the Director of the Weld County Health Department.
2.1.13 "Emergency" means any actual or self-perceived event which threatens life,ilmb,or well-being of an individual in such
a manner that a need for immediate medical care Is created.
he services,or the 2.1.14 to Emergncy n response to the 1perceived individual needs cal Services"shall mean f for prevention of: loss training therein, utilized
of life,further0 v agatio^ ph pre-hospital
is
Iologicd and/or
psychological injury,and/or inherent harm to an individual or group of individuals.
2.1.15 "Emergency Medical Technician (EMT)" means an individual who holds a valid Emergency Medical Tychnician
certificate issued by the Colorado GDepartment of Public Health and Environment, as provided in the Emergency
Medical Services Act.C.R.S.25.3.5-101,et.seq.,as amended. -
2.1.15.a 'Emergency Medical Technician-MSc(EMT-B)" means en individual who has been duly certfied by the
Emergency Medical Services Division of the Colorado Department of Public Health and Environment, and
who is authorized to provide basic emergency medical care in accordance with the acts alloyed by the
Colorado State Board of Medical Examiners and the rules of the Colorado Board of Health.
2.1.15.b "Emergency Medical Technician-Intermediate(EMT-1)"means an individual who has been dulycertifled by
the Emergency Medical Services Division of the Colorado Department of Public Health and ErvIronment,
and who is Colorado State Boarded to of Meddicalde emergency medical care Examiners and the Colorado In
with the acts allowed Ly the
Board of Health.
2.1.15.c "Emergency Medical Technician-Paramedic' means an individual who has been duly certified by the
nt lth d nd
Emergency Medical Services Division of the Colorado medical can e^accordance fPublic
l salt the acts allowedt and
who Is authorized provide f ca Enced and nay
Colorado State Board of Medical Examiners a the rules of the Colorado Board of Heetth.
medicel services at
by contract or on a voluntary basis to provide emergency, or c and
2.1.16 "Staspecial
events including c u g atrvce providedtitive events which ma pose a potential hazarrd for injury r death nd
require m athletic and medical ca es
require immediate emergency care. Standby Service providers must comply
for emergency medical service providers set forth in this ordinance.
administered by the Division of Fire Safety pursuant to Section 24-33.5-1201, et seq., C.R.S., and the applicable
2.1.17 "First Responder" shall mean an individual who has successfully completed the First Responder Certification Program
regulations of the Colorado State Department of Public Safety.
21 18 "Medical Director'shall mean a Physician Advisor.or otherwise incapacitated or helpless.
2.1.19 "Patient" means any individual who is sick,injured,
by
EMT-Intermedlates, EMT-Paramedics, First Responders, or egistered Nurses, of a pre-hospital
2.1.20 Physician Advisor" means a physician who establishes protocols and standing orders for medical acts performed First •
emerge ys, and who is specifically identified a binresponsible
onsibl EMT-Paramedics,as cure the
emergency medical care service agencysuch
comResponder of r the Registered
Nur of those-Physician
by EMT-Basics,
specifically
designated
Nurses. responsibility Advisor il mean a Colorado licene-hos dit aining wuo is
conducted by a Divisio^•recognized training center or training group,and for evaluating the performance of students in
speeificalhy deal sated and has accepted responsl611ity for directing the conduct of pre-hospital training courses
such training courses. I
2.1.21 "Primary Cars" shall mean the initial response and care for Emergency Medical Services either by contract or
agreement. by
purpose is the search for and the rescue of lost or injured persons and Includes,but is
21 2p 'Rescue Unit"means any organized group chartered this State as a corporation not for profit or otherwise existing as a not limited
organizationsugroups whose search )
or other organizations of governmental designation responsible for search and
Nmited to,such as and rescue, mountain rescue,ski patrols (either volunteer or professional), law
entorcament posses,civil defense units,
rescue.
21 23 "Registered Nurse," abbreviated R.N., shall mean a person duly licensed under the provisions of the Professional
Nurse Practice Act of the State of Colorado.
Section 3-Requirements for Licensure of Ambulance Services and Ambulance Vehicle Permits
3.1unless that person holds a valid license to do so issued by the Department, except as
License for Ambulance Service Required. No person,partnership or corporation,shall provide or operate an ambulance service
provide or privately Weld County
provided in subsection 3.7 of this section. The fee for said license shall be set by separateOrdinance.
3.1 ter an the
3.2 Permit Required eafor each abu di n the u required by
fi gwith the requirements of these Rules and Regulations and the current E.M.S.Act. The
Department shall qu a permit r for each ambulance e. Inused.ddit Said Ambulance license
Vehicle Se shall be issued ranambulance bu a e service,e that the
bu vehicle and equipment e comply
Ambulance Vehicle Permit fee shall be set by separate Ordinance.
3.3 Expiration of Licenses and Permits. The Ambulance Service License and Ambulance Vehicle Permit shall expire on December
31 of the year issued. h sician advisor. The physician
3.4 Physician Advisor Required. Each ambulance service licensed in Weld County shall have a p Y
advisor shall be notified in writing by the Department of any violation of this Ordinance by any ambulance service or individual
licensee.
3.5 Advancedoe service,eSupport staffing must Ambulances. When
with ce ambulance definition service
oi a open to Lior Support as Ambulance.rmedic or advanced life support
Ad c3.6 Basic Life Support Ambulance."Any ambulance staffed and operating as a Basic Life Support Ambulance Service, shall in no
way advertise. display or claim to be an Advanced Life Support bulance Service unless they are licensed as such.
B7 Exclusions- The provisions of this use of a privately or publicly owned vehicle,Section 3 shall not apply the following:
including search and rescue unit vehicles,or
aircraft not ordinarily used,`n the formal act of transporting patients.3.7.1 The exceptional emergency
3.7.2 perrmits vehicle rendering
in theservices
localities as an ambulance of the catastrophe in
emergency a of a rerinsufficientnto or emergency
the sera cesnrequiredsaes with
transporting a patient in Weld County and which are licensed by another state pr by another Colorado county.
3.7.3 Ambulances based outside the State of Colorado or Weld County which are not providing primary care, but are solely
33.4 Vehicles used or designated for the scheduled transportation of convalescent patients, handicapped individuals, or
persons who would not be expected to require skilled treatment or care while in the vehcle.
3.7.5amended, but who are not otherwise disabled or seriously injured and who would not be
Vehicles used solely for the transportation of intoxicated persons or persons incapacitated by alcohol as defined in
current p C.R.S., 02 as a b
expected to require skilled treatment or care while in the vehicle.3.8 Application-Requ
irements. Every applicant for an Ambulance Service License or an Ambulance
application for approval shall contain
Vehicle Permit shall complete
and submit to the Department an application and supposing documents for approval. S
but not be limited to the in following oration:
3.8.1 The name,address and telephone number of the owner of the ambulance service.
3.8.2 The name and address and current telephone number of the person who will be in charge of the operation of the
ambulance service.
3.8.3 Land Vehicles: The description of the ambulance(s),including the make,mode of manufacture,current Colorado
l,year
state license number, motor vehicle chassis number,length of time the vehicle model,has/beenl een In number, andcolors, as
Air Vehicles:The description of the ambulance(s), including the make,
well as a current part 135 certificate.
3.8.4 The location and description of the place or places from which the ambulance service will operate.
3.8.5 The name,address and telephone number of the required physician advisor to the ambulance service.
3.8.6 The area to be served by the ambulance service.
3.8.7 A list of all emergency medical service providers who may be called upon to respond to an emergency with the
ambulance service. This list shall include the following Information on each person:
3.8.7.1 complete name,address,and date of birth.
3.8.7.2 -the highest level of certification, licensure or training attained.
3.8.7.3 a copy of a current EMT-B,EMT-I or EMT-P certificate issued by the Colorado-Department of Public Health
and Environment; nurse licensure, or an Advanced First Aid card from the American Red Cross; or a First
Responder Course completion certificate issued by a Division-recognized training center or training group.
3/.7.4 proof of a valid Colorado Driver's License.
3.8.7.5 a statement of criminal complaint or convictions including Class I and II traffic violations within the previous
twelve(12)months.
3.8.8 ' Proof of insurance,as required,below,in Section 4.5 of this Ordinance 77-D.
3.8.9 A Current copy of EMT or Paramedic Protocols adopted by the ambulance service in accordance with standards
approved by the ambulance service's physician advisor.
uirements roved the
3.8.10 aA current mbulance servof ce?sePhysicilance service's an Advisor. All training standards
in thro through state with
certifedsemergency mescal services
training center.
3.8.11 Such other information as-the Department may pp require to make a fair determination.
e License or n nce 3.9 or all renewal herreof,tthe Departmept of an nt shall reviiesl wtheication applcationr n and the applicaulance nt's record andaprovide)For an Vehicle Permit,
of
equipment and vehicle(s) to determine compliance with this Ordinance. The Director shall issue a license to the applicant to
provide ambulance service and a permit for each ambulance used upon a finding that:
3.9.1 The ambulance service staff,vehicles,equipment, and location comply with the requirements of this Ordinance,and
3.9.2 The ambulance service's emergency medical technicians are certified in accordance with the rules pertaining to
emergency medical services of the Colorado Department of Public Health and Environment, and
3.9.3 The applicant has complied in all respects with the requirements of this Ordinance.
3.10 - Fraud or Misrepresentation. Obtaining or attempting to obtain any license or permit hereunder by fraudulent means or
misrepresentation shall be grounds for denial,suspension,or revocation of such license or permit.
3.11 services fleet, an Replacement
c Vehicles.
ambulance vehiclece is permitshall be filed withlaced or an the(Department within 30 days of are
receipt of t the
new ambulance vehicle The permit applcationpthestion Departmll ent shale) nspecttlption of the newthe ambulancen and issue the nelaced. won a(nbul ncet fvehicle
permit,if appropriate.
3.12 allAdditional ambulance services-atnanyaddition
other time the inspection
yeared atat the whchtitime ane of pinispection the
may or may s not bealso
performed. The contact
inspections of the ambulances and related edquipment shall cover but not be limited to the following items: condition of the
evidence of an ade and quate ongongs systems,
safety and mainnimum tenance ce programment for . relevant
shall beulance.a log which shows thech service sdates of the
service and list of service(s) performed. The Department may modify this regulation or adopt additional requirements with the
consent of the Board.
3.13 Application - Denial Appeal. Any person or entity having been denied a license by the Director may appeal such denial to the
Board. The request for a hearing on such denial must be in writing and shall be filed with the Clerk to the Board no later than thirty
(30) days after the date of notification by the Director to the applicant of such denial. The request for a hearing shall specify the
grounds of the appeal. th 3.14 fee as s of required ortte originachange of l application.n Any sale olr exchangeire a new of stock of fifty perication andcent(50%)nor payment
oft of thethe same license
total outstanding
stock of a corporation shall be deemed a change of ownership for purposes of this Ordinance. Any change of ownership or any
change of stock ownership of ten percent(10%)or more shall be reported in writing to the Director.
3.15 LIeensee and Permits Non-Transferable. No license or permit issued by the Director shall be sold, assigned, or otherwise
transferred.
3.16 Annual Renewal. All licenses and permits shall be renewed annually,shall expire on December 31 of the year issued, and shall
not be renewed until the application has been approved by the Department. All applications for renewal of
yf licenses and p return
ermits
rshall be made eceipt requested,not
license than e oof(the ren0) ews al requirementsrior to the s of of this expiration.
withinDninety(90)days partment shall or notify, the date18d of expiration.
Section 4-Requirements for the Operation of Ambulances
4.1 Emergency Vehicle Operator. For land vehicles, the ambulance driver shall meet the requirements of 25-3.5-202, C.R.S., as
amended. This requirement may be waived in unusual emergency conditions when no driver meeting these requirements is
available For air vehicles,the pilot of the aircraft must have a current pilot's license issued by the FAA,which permits the pilot to
operate the relevant aircraft.
4.2 Ambulance Crew Members-Training. No patient shall be transported in an ambulance within the county unless there is available
in the patient compartment,a Colorado State-certified EMT-Basic or higher level trained person.
Ambulances responding to a call without a State-Certified EMT-Basic or higher level trained person on board the ambulance shall
immediately, upon acknowledgment of the call, notify Weld County Regional Communications Center that the ambulance is
responding without such person on board. Upon notification, Weld County Regional Communications Center shall immediately
contact and dispatch back-up ambulance service coverage. request,
es of orm and 4.3 records concerning the transportation and service shall treatment tof patients asd submit required upon the Director.piSu h ecords shall standardized
ezallll
Information determined to be essential by the Colorado.Department of Public Health and Environment for maintenance of adequate
minimum
in mum rbeycorr eseon tenppetie is a medical condition
otl of t and
leas medicale( c)are provided by the ambulance service.
y All records shall be
pe by an lance
4 4 service as an ambulla e„crrew memb Criminal
er whoa has been convicted offaa felony,mis the deme no anor,Class shall
I bor C Cl
ass II traffic offense uwith within
the previous twelve(12)months from the date of application.
4.5 - Insurance. No emergency medical service provider shall operate in Weld County unless it is covered by insurance as set forth in
this paragraph.the Each ambulance grovidinrvice ghall lgein for insurance too death of persons e for each inaccidents resulting from ance owned,
se for
h by the owner-of
he service, providing coverage injury
s the peraathe saide n is e liable for r ybith imposed on him by law, regardless t of eherto the property e
of
was being operated by the owner,his agent or lessee,or any other person,and coverage as against damage to the property of
another,including personal property,under like circumstances, in the following amounts:
4.5.1 - Worker's Compensation Insurance: Each ambulance service shall maintain at least the statutorily required amount of
Continue to next page
PUBLICI
Ordinance NO. 77-D Continued from prevloys page
worker's compensation insurance.
4.5.2 Public Liability and Property Damage Bodily Injury:
Each person $ 500,000
Each accident $ 500,000
Property Damage:
Each accident $ 500,000
Professional Liability Coverage:
Each person $ 500,000
Each accident $1,000,000
4.5.3 . Proof of insurance. Proof of insurance shall be filed with the Department,along with the application for an ambulance
• service license as required in these regulations. Every insurance policy required shall contain a provision for
continuing liability thereunder to the full amount thereof, notwithstanding any recovery thereon, that the liability of the
insured shall not be affected by the insolvency or bankruptcy of the Insured, and that until a policy Is revoked, the
insurance company wdl not be relieved from liability on account of nonpaayment of premiums,failure.to renew license at
the
of renewal sshallrbe providd to act or itheen ofDepartment named Insured.
lanaddvehic a in time
surancesaid
sInsurance
hall be a complyiired ng policy for motor
vehicles as defined in Section 10-4-703,C.R S.,as amended.
4.5.4 A certificate of insurance,with the Board named on the certificate holder's copy,shall indicate the vehicles covered by
the policy, type of insurance, (vehicle and professional liability, etc.), policy number(s), policy effective date, policy
expiration date,amount of coverage,and containa provision that thirty(30)days prior written notice of any cancellation
or termination or revocation of said insurance policy shall be given to the Department.during
4.5.5 Any changes in the status of vehicles listed on the certificate of insurance a new certificate of insurance and forwarded to the Department within thirty(30)daysof the changesthe licensing a,shall be noted on
4:5.6 Notification of any changes in insurance shall be made in writing within thirty (30) days of such changes to the
Department by the licensee, to be followed with a certificate of insurance as outlined in previous paragraphs. The
Director may require additional proof of insurance at any time needed in order to promote health,safety,and welfare of
residents of the County.
4.6 Safety Belts.Safety belts shall be utilized by all persons in the forward compartment. Attending personnel shall utilize seat belts
when feasible. Safety belts or other safety restraining devices shall be available for patients being transported. Such devices
shall be utilized when feasible.
4.7 Transport - Medical Facility. All ambulances shall deliver patients to the most appropriate licensed medical facility, as
determined by the physician advisor or his designee,dependent on the patient's medical needs. When medically appropriate,the
patients preference should be considered.
4.8 Approved Legations-Abandonment. No licensed ambulance service shall operate from locations other than those approved by
the Director nor shall such licensed ambulance service abandon approved locations without prior notification of the Director.
4.9 An ambulance service operating in the County must comply with all relevant County and municipal zoning and other regulations.
Section 5-Ambulance vehicle requirements
5.1 Specification. Land vehicles obtained,licensed and placed in use as ambulances, shall at the minimum, meet the guidelines as
established by the State EMS Advisor. Variances of the above-mentioned specifications may be granted at the discretion of the
Director. Air vehicles obtained,licensed and placed in use as ambulances shall,at the minimum, be in compliance with all state
and ambulances regulations
the nameof the ambulanceAviation
Rservicelcleas ry visible onfic to the said vehiclesretions of the air medical.service. All
5.2 Ambulance Equipment. Each ambulance shall contain the following equipment which shall be maintained In good working order:
5.2.1 Land Vehicles. •
5.2.1.1 Emergency lighting and audible warning equipment which complies with Colorado State law for emergency
vehicles.
5.2.1.2 Safe tires and in addition,adequate snow tires or chains when weather conditions demand.
5.2.1.3 In the case of ambulances providing primary care in the County,or otherwise'qualified pursuant to Section
2.1.7, a capability of two-way radio communication with the following: their dispatcher, the Weld County
Regional Communication Center,and on-line medical control.
5.2.1.4 Safety belts for both the ambulance driver and other attending personnel.
5.2.1.5 The minimal required equipment shall be that listed in the list established by the Colorado Department of
Public Health and Environment Emergency Medical Services Division. The Director may add to this list at
his direction as other needs or new methodology becomes known.
5.2.2 Air Vehicles. comply
5.2.2.1 Configuration,on,of t
he Colorado Air Medical Service Guidelines,with the requirements set oApril, 1995,or its successor.
rth in Section 2.0, t Equipment and
or fixed 5.2.2.2 All air aircraft,ambulance
both,as set forth in Sectionrvices must s 1y with 17 O, 18 0e and 19.0 of tht e Colorado Air for
Medical Service Guidelines,wing
April, 1995,or its successor.
Section 6-Qualifications of Emergency Medical Technicians
6.1 No person shall practice as an Emergency Medical Technician for any Ambulance Service subject to-the licensing requirements
of this Ordinance unless that person holds a valid Emergency Medical Technician certificate from the State of Colorado.
6.2 •Each Emergency Medical Service shall provide the Department with a list of its Emergency Medical Service Providers, as per
section 3.8-7.
6.3 Before the State certification of an EMT expires, the ambulance service shall provide the department with a written statement
showing the name of the EMT, the date the certificate was Issued,the date of expiration, and the certificate number of the new
State certificate. Failure to comply with this Section disqualifies an EMT from practice in any Weld County ambulance service.
Section?-Requirements for Emergency Medical Service Providers not licensed by Weld County
7.1 Emergency Medical Services contracting with, or employed by,groups and organizations for public events and not affiliated with a
licensed ambulance service licensed by the County shall, upon request, be able to demonstrate compliance with rules and
regulations as promulgated py Weld County,State of Colorado,and State Board of Medical Examiners. _ _ _
7.2 Standby Services. Emergency Medical Services contracting with, or employed by, groups or organizations for public events to
provide emergency medical care in the County must have sufficient personnel,supplies arid equipment to
f in 4.5t care on the
of this
Responder or higher level basis, and provide proof of compliance with the insurance requirements set forth
Ordinance. Assemblages of 5,000 or more persons shall require the standby services
shall l me
et the same re one Advanced
d Life Susupd
Ambulance staffed with at least one EMT-P and one EMT-B. Each additional 5,000 persons 7.2.1 The following is the minimum equipment required for standby services:
7.2.1.1 Direct communication access to 911 for requesting advance life support care.
7.2.1.2 Oropharyngeal Airways in adult,child,and infant sizes.
7.2.1.3 Assorted dressings(Sterile-large and small).
7.2.1.4 Soft roller bandages.
7.2.1.5 Tape.
7.2.1.6 Blanket. '
7.2.1.7 Triangular bandages.
7.2.1.8 Shears capable of cutting clothing or bandages including heavy leather or canvas.
7.2.1.9 Flashlight.
7.2.1.10 Oral suction device.
7.2.1.11 Portable oxygen and pocket mask and administration equipment.
Section 8-Unlawful Practices
8.1 The following practices shall be unlawful and shall be grounds for a suspension or revocation of a license:
8.1.1 Willful and deliberate failure to respond to any call.
8.1.2 Willful and deliberate failure to transport a patient when required.
8.1.3 Administering unnecessary treatment or suppHee to a patient for the purpose of increasing the patient's bHl.
8.1.4 Administration of any substance unless under the protocol and/or order of the Physician Advisor,or medical control or .
designee.
8.1.5 Charging for treatment or supplies not actually provided to a patient.
8.1.6 Requiring and/or allowing any employee of an ambulance service to be on continuous duty for any one period in
excess of forty-eight(48)hours,except in cases of extreme emergency.
8.1.7 acilityy as determined by the physician advisorfailure
is/deesignee,I depenr a dentnt to uponthe most the patient'sappropriate
cal licensed needs. medical
8.1.8 Conduct which constitutes a significant threat to the health or safety of the individuals receiving emergency care from a
licensed ambulance service or services. promulgated
8.1.9 duties and responsibilities of Emergelation ncy MdicaTechnicianshe or Physician Advis State ors.
of Medical Examiners for the
Section 9—Suspension or Revocation of License or Permit;Conditional Permit
9.1 Temporary Suspension. Upon a determination by the Director that any person has violated or failed to comply with any provisions
of this Ordinance,the Director may temporarily suspend,for a period not to exceed thirty(30)days,any license or permit issued
pursuant to this Ordinance. The licensee or permit holder shall receive written notice of such temporary suspension. The
temporary suspension shell be effective upon the date of mailing the written notice by certified mail,return receipt requested,to the
licensee or permit holder,or on the date of service of the notice upon the licensee or permit holder pursuant to the Colorado Rules
of Civil Procedure. A hearing on the temporary suspension shall be held before the Board not later than ten (10) days after the
effective date of the temporary suspension. The written notice of temporary suspension shall include notice of the time and place
of such hearing. Prior to such hearing,the Director may reinstate the license or permit upon a finding that the licensee has come
into compliance with the provisions of this ordinance.
9.2 All hearings before the Board of County Commissioners shell be public end every vote and official act of the Board of County
Commissioners shall be public. The Board of County Commissioners may require an ambulance service company which is the
subject of a hearing, to make available such books and records as are desired and requested by the Board of County
Commissioners. All testimony at the hearings shall sohri be under oath and shall be electronically recorded.res ecorded. If a stenographic
unty
Commissioners shall desired
othhe any party,
regulations foer r the conll be duct of thet the hearinguas tare deemed necessary ense. in ie�discard ret of n.
9.3 The hearing before the Board of County
yyCommissioners shall be conducted in two(2)phases.
9.3.1 eviden Phase I of the ce presented in the public hearing,any rd of County
or moCoorelssioners shall of the following has ine occurred:
by a preponderance of the
9.3.1.1 Vlolation(s)of any provision of this Ordinance.
9.3.1.2 Evidences o of f any violation the
may State
he onsidered,oregardless Ordinance
of any conviction lation of thereof.municipality in the County.
9.3.1.3 Commission of any practices set forth In Section 8.
9.3.1.4 If the Board does not find that any of the above acts has occurred,the Board shall conclude the hearing and
shall reinstate above acts the license or
occurred,thepermit for the public hearingrshallnder of Its term.progress to Phaslf e II.
Board finds that one or more of the
r o e 9.3.2 During
Phase
the
public
bend an the
or shall
issued pursuantt touthis Ordinance for permanently
yaport o oaf license for the
remainder of its life. At the end of such period,the parson whose license or permit was suspended,may apply for a
new license or permit as In the case of an original application. Upon a finding by the Board that the licensee or permit
holder has committed, within two (2) consecutive calendar years, two violations or on two separate occasions has
failed to comply with any provision of this Ordinance,the Bard may permanently revoke such license or permit. The
Board's decision to suspend or to revoke permanently the license or permit shall be based upon whether evidence of
the following factors mitigates or aggravates the effects of the acts found by the Board during Phase I of the public
hearing:
9.3.2.1 The seriousness of the violation.
9.3.2.2 Corrective actions taken by the license holder.
9.3.2.3 Prior violations and offenses and the effectiveness of prior corrective action.
THE NORTH WELD HERALD 15
THURSDAY,APRIL 4, 1996
9.3.2.4 Prior violationeand offenses by the licensee or permit holder.
9.3.2.5 The violation,offense,or occurrence as a repeated course of conduct or as a single event.
9.3.2.6 The likelihood of recurrence.
9.3.2.7 All circumstances surrounding the violation,offense,or occurrence. ,
9.3.2.8 Willfulness of violation(s),offense(s),of occurrence(s).
9.3.2.9 The length of time the license or permit has been held by the licensee or permit holder being disciplined.
9.3.2.10 Previous sanctions.Imposed against the licensee.
9.3.2.11 Other factors making the situation unique to the license or permit holder subject to discipline.
9.4 It shall be the duty of the Director to notify local law enforcement authorities, fire departments;hospitals and the physician
advisor(s)of revocation or suspension of any ambulance service license or vehicle permit.
Section 10-Countywide Emergency Service
10.1 Mutual Ald Agreements, Weld County encourages a cooperative systems approach towards improved patient care. All licensed
agencies providing EMS responses in Weld County shall make a good faith effort to execute written mutual aid agreements with
all other EMS providers located within or bordering on their area of response. Copies of these agreements shall be kept on file for
review.
10.2 County Ambulance Service. The Weld County Ambulance Service is the ambulance service organized and furnished by Weld
County, pursuant to the provisions of Colorado statute. -So long as the Weld County Ambulance Service is in existence and is
duly licensed pursuant to this Ordinance, the Weld County Ambulance Service may provide emergency service to all areas of
Weld County and to those other areas specifically set forth in the Weld County Ambulance Service application and license. Weld
County Regional Communications Center may dispatch Weld County Ambulance Service to respond to a call within another
ambulance service's service area under the terms and conditions get forth in Section 4.2.
10.3 Triage Authority. Incident Command shall appoint triage authority at an active incident. Weld County Ambulance Service shall
be appointed medical triage.authority In Weld County when Weld County Ambulance Service and any other ambulance service
have responded to calls for emergency assistance where medical triage authority has not yet been established, and/or a dispute
concerning medical triage exists.
Section 11-No Third Party Beneficiary Enforcement
Nothing in this Ordinance shall be construed to create a cause of action and/or civil liability remedy in any person. This Ordinance shall not
be construed to create a duty to any third arty where no such duty otherwise existed. It is the express intention a the Board that any third
party receiving services or benefits under this Ordinance shall be deemed an incidental beneficiary only.
Section 12-Savings Clause
12.1 The repeal of Ordinance 77-C and its reenactment as Ordinance 77-D shall not have the effect to release extinguish,alter,modify,
or change in whole or in part any penalty, forfeiture, or liability, either civil or criminal, which shall lave been incurred under
Ordinance 77-C. Ordinance 77-C shall be treated and held as remaining in force for the purpose of sustaining any and all proper
actions, suits, proceedings and prosecutions,criminal as well as civil, for the enforcement of such penalty,forfeiture, or liability,
actions,suits,the proceeedings,or prosecutions,anyimpossng, int,nflicting or declar nrw such h pen nalty,forfee tureeordli�ility. or made in such
12.2 All licenses in existence under Ordinance 77-C,at the time that said Ordinance was repealed and reenacted as this Ordinance 77-
D, shall continue in validity for their term as provided under Ordinance 77-C. Such existing licenses shall be subject, however,to
the terms and requirements of this Ordinance 77-D without the need for a new application or inspection pursuant to this Ordinance
77-D.BE f County hereby finds,determines,and declares that
this Ordinance is necessary for u the health,lt that
safety,and w County
of the Commissioners of Weld
citizens of Weld County,Colorado.
BE IT FURTHER ORDAINED by the Board if any section,subsection,paragraph,sentence,clause,or phrase of this Ordinance is
for any reason held or decided to be unconstitutional,such decision shall not affect the validity of the remaining portions hereof. The Board of
County Commissioners hereby declares that it would have enacted this Ordinance in each and everyseco4 subsection, paragraph,
sentence,clause, and phrase thereof Irrespective of the fact that any one or more sections,subsections, paragraph,
phrases might be declared to be unconstitutional or invalid. that this Ordinance become effeBE IT ctive five days after its fiER nal public notice,In accordED by the Board of ance with Commissioners
3-14(2)County,
°the Weld County Home Rule Charter. 77-D shall
The above and foregoing Ordinance Number 77-D.was,on motion duly made and seconded, adopted by the following vote on the
29th day of.April,A.D.,1996.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY,COLORADO
ATTEST: •
Barbara J.Kirkmeyer,Chair
Weld County Clerk to the Board
George E.Baxter,Pro-Tem
BY:
Deputy Clerk to the Board Dale K.Hall
APPROVED AS TO FORM: Constance L.Harbert -
County Attorney W.H.Webster
First Reading: April 1,1996
Publication: April 4, 1998,in the North Weld Herald
Second Reading: APpril 18.199l 15, 6
Publication: ,in the North Weld Herald
Final Reading: April 29,1996 bin the North Weld Herald
Publication: Y
Effective: May 7,1996
Hello