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C4/6410
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is, repealed and re-enacted with amendments as follows:
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.
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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.
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.
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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.
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.
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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.
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.
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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.
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.
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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.
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.
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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 No. 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.
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.
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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.
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
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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
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.
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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. At 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.
4.5.4 Certificate of Insurance Requirements. 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.
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4.5.5 Changes in the Status of Vehicles. 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 Changes in Insurance. 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 Compliance with Zoning and Other Regulations. 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:
5.2.1 Land Vehicles.
5.2.1.1 Emergency lighting and audible warning equipment which complies
with Colorado State law for emergency vehicles.
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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 Valid EMT Certificate Required. 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 List of EMS Providers Required. 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 EMT Certificate Number Must be Kept Current with State. 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.
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Section 7 - Requirements for Emergency Medical Service Providers Not Licensed by Weld
County
7.1 Contract Ambulance Services Must Comply with Rules and Regulations. 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
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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 Hearings to be Public. 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 Hearing in Two Phases. 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 Director to Notify of Revocation or Suspension. 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 Ordinance No. 77-C Continues in Effect Concerning Prior Actions. The repeal of
Ordinance No. 77-C and its reenactment as Ordinance No. 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 No. 77-C.
Ordinance No. 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 Existing License Valid for Their Term. All licenses in existence under Ordinance
No. 77-C, at the time that said Ordinance was repealed and reenacted as this Ordinance
No. 77-D, shall continue in validity for their term as provided under Ordinance No. 77-C.
Such existing licenses shall be subject, however, to the terms and requirements of this
Ordinance No. 77-D without the need for a new application or inspection pursuant to this
Ordinance No. 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
OY1L 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:
a ..r-4— ji 77- ..) a
was in said newspaper bearing the date(s) of:
Thursday,the day of / / , 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 advertisements, approv ay 18, 1931, and all
prior acts so far 'n force.
B E J. BORMANN, PUBLISHER
Publication Cost: $ J ' °ls
Subscribed and sworn to before me ,NR.........14
this /674/4 day of April, 1996 �Y
ERIKA G. 11
E ez, C' cA 1 BAGLEY icz
ERIKA C. BAGLEY, O RY PUBLIC QpO
e (1F G0t
My commission expires October 21, 1999
12 THURSDAYHAPRI D18ERAALGD •
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 Canmissioners of Weld County,
Colorado theme 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,Need,as amended,and
WHEREAS,said Act requires that the Board of Counry.Commisssioner;of each county adopt certain standards,requirements and
procedures for providing emergency medial 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 and re-enacted with amendments as follows:
Section 1-Purpose
1.1 The p rpoes 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 Me Board of County Commissioners that the emergency medical service in Weld County will consist
of at least bransportation,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 dire:bon 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 retolutln adopted by the Board.
Section 2-DMnitions
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 publiclyt weed land or air vehicle especially constructed or modified and equipped,
.untended to be used and maintained or operated by an ambulance service for the transportation in this County, of
individuals who are rick;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 Bard and Is staffed by at least one Emergency Medical Technician-BaslcEMT-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 Drivers License.
2.1.1.b "Advanced Life Support Ambulance".means an ambulance which, in addition to meeting the basic
requirements for equpment,has on board the equipment and medications required by the Physician Advisors
of r to practice and
of a Seteat operates with
EMT-Paramedic.advanced a life
support
ortpunl�onnel. An
ALS Transport shall include the scope
2.1.2 "Advanced Lie Support Personnel"means a minimum of one state certified Emergency Medical Technician-Paramedic or rado state ergency Medical O of the above na nmed n-intemediate and a current personne may also serve as theloemergency vehicle operator of a land Emergency scal ambulance.Technician-
Basic.
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 end Regulations.
2.1.4 "Ambulance Service"means the fumishing,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 percepts aired at a mine n excsrded from this definition when the personnel utilized In the operation of said vehicles
are subject 13 the mandatory safety standards of the Federal Mine Safety and Health Administration,or its successor
2.1.5 "Ambiance Service License"shall mean a nonexclusive authorization issued by the Board of County Commissioners
to operate an anibuMge servia publicly or pnvably within Wald County;the license shall Issue only to ambulance
services whose primry base dioperation is Rated 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 "Cement E.M.B.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,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 Medal 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 Medal 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 Technican-Paramedic"means an Individual who has been duly certified by the
•Emergency Medical Services Division of the Colorado Depntrrent 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 Medal Examiners and the rules of the Colorado Board of Health.
2.1.18 "Standby Service"is a service provided by contract or on a voluntary basis to provide emergency medical services at
'specal 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.
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-Baum,EMT-Inter ediaes.EMT-Paramedla.First Responders,or Registered Nurses,of a pre-hospital emergency
• medical are service agency and who Is specifically identified as being responsible to assure the competency of the
performance of those acts by such EMT-Base,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-hosplal training courses conducted by a DMson-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 Medal 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 orgenistonsof governmental designattion responsible for search and
reawt
2.1:23 "Registered Nurse,"abbreviated R.N.,shall moan a person duly licensed under the provisions of the Professional Nurse
Practice Act of the State of Colorado.
•
Section 3-Requirements for Lkensure of Ambulance Services and Ambulance Vehicle Permits
3.1 • License or Ambulance Service Required. No person,pamership 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.
3.2 Vehicle Permit Required for each Ambu . In addition to the license required by Section 3.1 for an ambulance service,the
Department shall issue a permit for each a lance used. Said Ambulance Vehicle Permit shall be issued upon a finding that the
applicants vehicle and equipment comply the requirements of these Rules and Regulations and the current E.M.S.Act. The
Ambulance Vehicle Permit fee shall be set separate Ordinance.
3.3 Expiration W Licenses and Penults. The lance Service Danes and Ambulance Vehicle Permit shall expire on December 31
of the yea!issued.
•
3.4 Physician Advisor Required. Each ambulance tens licensed in Weld County shall have a physician advisor. The physician
101.71c
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-Wren 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.
•
3.8" Bask Life Support Ambulance. My 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 patents.handicapper,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.,254-302 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.
i 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.
Alr 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.
3.8.8 The area to be served by the ambulance service
3.8.7 A list of all emergency medical service providers who maybe ailed 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 No.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.
3.8.10 A current copy of the ambulance service's training standards in accordance with the requirements approved by the
ambulance services 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 applicants rimed 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:
I r
Nina are
Heal
3.9.1 The ambulance service staff vehicles,equipmen' and location comply with the requirements of this Ordinance,and
3.9.2 The ambulance"service's emergen/medical technician,ar-osraMA M accasdarma with Its nee pertaining to emergency
medical services of the Colorado Department of Public Health and Environment,end
3.9.3 The applicant has complied in all respects with the requiremeAla 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 fpr an ambulance vehicle permit shall be filed with the Department within 90 days of receipt of the new
ambulance(s). The completed application shall include a descnption of the ambulance(s)replaced. Upon receipt of a new ambulance
vehicle permit application the DeparbneM shat inspect the new ambulance and issue the new ambulance vehicle permit,If appropriate.
3.ti 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: Co dltion of the ambulance,safety and
warning systems,and minimum equipment for the relevant ambulance. Each service shall provide evidence of en 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.
3.13 Application-Denial Appeal. My 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 shalt 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. My 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 shell notify,by certified mail,retum receipt
requested,each licensee of the renewal requirements of this section,wedn 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 FM.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-Cemfed 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 end standardized
records concerning the transportation and treatment of patients as required by the Director. Such records shall Indus all information
determined to be essential by the Colorado Department of Public Health and Environment for maintenance of adequate minimum
records on the patents medical condition and medical care provided by the ambulance service. All records shall as 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 in ambulance service
as an ambulance crew member who has been convicted of a felony,misdemeanor,Class I,or Class II traffic oferse 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 inanance 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;regardess of whet erpa ambulance was being
operated by the owner,his agent or lessee,or any other person,and coverage as against damage to the prlperty 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 stsaaoriy required amount of
workers 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 61,000,000
•
4.5.3 Proof of Insurance. Proof of insurance shall be filed with the Department,along with the implication for an ambulance
service license as required in these regulations. Every Insurance policy required shall contail a provision for continuing
liability thereunder to the full amount thereof:notwithstanding any recovery thereon,that the lability 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 oflhe year,
Continue to next pago
�C r
•
all
or any act or omission of the named insured. At any time said insurance is required to bearer Pr motor prrohof as vial defined be provided to the Department The land vehicle insurance shall be a complying policy
Section 10-4-703,C.R.S..as amended.
4.5.4 Certificate of insurance Requirements. A certificate of insurance,with the Board named on thecertificate ly,holder's
p�'
shall indicate the vehicles covered by the policy,type of insurance, (vehicle and professional
number(s),policy effective date,policy expiration date,amount of coverage,
said nd iccontaince provision
oro�slate thirtygiven(30)odaysys
prior writtennotice of any cancellation or termination or revocation
Department.
4.5.5 Changes in the Status at Vehicles. My changes In the status of vehicles lie ed on to the the certifiate of
within spiry ce during
the licensing cycle.shell be noted one new certificate d insurance and forwarded
of the changes. of
4.5.6 Changes in Insurance. Notification of any changes in Insurance shall be Made in wrsgrenceng in thirty
outlined(i 0)d a ssuch
changes to the Department by the licensee,to be followed with a certificate health,previous evNy,
paragraphs. The Director nm.reqolre additional prod of insurance at any time needed in order to promote
and welfare of residents of the County
belts shag be Wised by all persons o the(award compariment ent. Attending personnel shall utilize seat belts when
4.6 feasible.Safety Belts.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. Al 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 Compliance with Zoning and Other Regulations. 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,meat the guidelines as
established by the State EMS Advisor. Variances of the above-mentioned specifications may be granted at the discretion of the
FAR5)specific to the operatons of the air medical service. All ambulances
Director. Air vehicles obtained,licensed and placed in use as ambulances shall.at the minimum,be in compliance with all state and
shfederalall
rve the includingofthe bulal Aviationry Redeaeonvisible on said vehicles.
have the name of the ambulance service cleats
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/, 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. of
5.2.1.5 The minimal requited equipment shall be that listed in thhee llist established
aDD rector Colorado
ay Department
l at Public
ic
Health and Environment Emergency Medical��s known.
direction as other needs or new methodology
5.2.2 Air Vehicles.
5.2.2.1 All
ambulances must comply with the Configuration,of the Colorado Air Medical Service mGeuiidel nts set
s, April,1995.5 Section
its Aircraft
iguccessorE9uipmenl and
5.2.2.2 At air ambulance services must comply with the relevant safety standards for rotor wing or fixed wing aircraft.
or both,as sat forth in Sections 17.0.18.0,and 19.0 of the Colorado Air Medical Service Guidelines,April,
1995.o is successor.
Section e-Qualifications
of Emergency Medical Technicians
6.1 Valid EMT Certificate Requ
ired. No person shall practice as an Emergency Medical Technicianfor 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 List of EMS Providers Required. Each Emergency Medical Service shall provide the Department with a list of its Emergency Medical
Service Providers,as per section 3.8-7.
8.3 EMT Cogitate Number Must be Kept Current with State. Before the
e name State
New EMT, the date tion fan
EMT
certificate the ambulance
service
of
shall provide the dsprMooto nu a r of the
statement wStetFailure to comply with this Section disqualifies an EMT from practice
ergtraton,ale its osrlMeMe number dtie new Stete_daeAcNe.
In any Weld County sinholehpe service. __
section 7-Requirements for Emergency Medical Service Providers Not Licensed by Weld County
7.1 Contract Ambulances Servhees Must Comply with Rules and Regulations. 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
agency 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.
Assegai:egos of 5,000 or more persons shall require the with at least one EMT-P and one EhlT-B. Each standby
additional 000 persons shall meet the same requirements Ambulance staffed
7.2.1 The following Is the minimum equipment required for standby services:
7.2.1.1 Dart communication access to 911 for requesting advance life support care.
•
7.2.1.2 Oropharyrgeal 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 Wilful 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 patients 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.
8.1.8 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 eases of extreme emergency.
•
8.1.7 Except a ream otherwise provided n iii or or is,s d wire�dde�aden patient the most
medical needssed.. medical facility
as 8.1-.9 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 7 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 mall,return receipt requested,to the licensee or
permit holder,or on the date of service of the notice upon the licensee pr permit holder pursuant to the Colorado Rules of Civil
• Procedure. A hearing on the temporary suspension shat be held before the Board not later than ten(10)days rafter the effective date
of Be 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 perm upon a finding that the licensee has come into compliance with
the provisions of this ordinance.
9.2 W ri gsto be Public.Ali hearings before the Board of County Commissioners shall be public and every vote and official act of the
Board of County Commissioners shell be pudic..The Board of County Commissioners may require an ambulance service company
which is the subject of a hearing,to make meltable such books and records as are desired and requested by the Board of County
Commissioners. All testimony at the tsarinas shat 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 Baird of County
Commissioners shall make other rules and regulations for the conduct of the hearing as are deemed necessary in its discretion.
9.3 Hearing in Two Phases. The hearing before the Board of Courtly Commissioners shall be conducted in two(2)phases.
9.3.1 wring 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°cour ltd:
9.3.1.1 Violation(s)of any provision of this Ordinance.
9.3.1.2 ° of any
viola the State of tion mmey be considered,regaarrdinance or rdless of anyconlation conv conviction thereof.
eunicipalty in the County.
• Evidence 9.3.1.3 Commission of any practices set forth in Section 8. Continue to next column
THERTH WELD HERALD
THURSDAY,APRIL 18, 1996
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. N 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~Mt.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 theme 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 Ms failed to comply
with any provision of this Ordinance,the Board may permanently revoke such license or pemdt. 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.
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 Director to Notify of Revocation or Suspension. 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 perm*.
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 speciticaly 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. •
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 nci 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 Ordinance No.TI-C Continues hi Effect Concerning Prier Actions. The repeal of Ordinance No.77-C and its reenactment as
Ordinance No.77-D ehalyd hove the effect to release,extinguish,alter,molly,or change In wide or in pert any penalty,fodekure,
or liability,either civil or criminal,which shall have been incurred under Ordinance No.77-C. Ordinance No.77-C shall be treated and
held as remaining in force for the purpose of sustaining any and all proper actions,suts,proceedings and pros Lions,criminal as
well as dvil,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 prosecut ions.imposing,inflicting or
declaring such penalty,forfeiture or liability.
12.2 Existing License Valid for Their Term. All licenses in existence under Ordinance No.77-C,-at the time that said Ordinance was
repeated and reenacted as this Ordinance No.77-O.shall continue in validity for their term as provided under Ordinance No.77-C.
Such existing licenses shall be subject however,olhe terms and requirements of this Ordinance No.77-D without the need for a new
application or inspection pursuant to this Ordinance No.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 wildly 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,
dause,and phrase thereof irrespective of the fact that any one of more sections:subsections,paragraphs,sentences,clauses,or phrases might
be declared to be unconstitutional or invalid.
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
FLY-
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
Published April 18,1996,in The North Weld Herald
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