HomeMy WebLinkAbout20232092.tiffCheryl Hoffman
From:
Sent:
To:
Cc:
Subject:
Gabri Vergara
Monday, July 10, 2023 3:46 PM
Cheryl Hoffman; Tanya Geiser; Jason Chessher; Bruce Barker; Karin McDougal
CTB
RE: Ord2023-11 - Chapter 7 Emergency Medical Services
The only comment I have is that the word "Reserve" in this section be lower case for, consistency.
Amend Sec. 7-4-20. Ambulance equipment.
Each ambulance. whether it be permitted as a Reserve, basic life support, or advanced
life support ambulance shall contain the following equipment which shall be maintained in good
working order:
All other requested changes were adequately captured.
Thank you,
Gabri Vergara, MPH
Consumer Protection Manager
Department of Public Health & Environment
1555 N. 17th Ave. I Greeley, CO 80631
970-400-2226 I gvergara@weldgov.com
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From: Cheryl Hoffman <choffman@weld.gov>
Sent: Monday, July 10, 2023 11:05 AM
To: Gabri Vergara <gvergara@weld.gov>; Tanya Geiser <tgeiser@weld.gov>; Jason Chessher <jchessher@weld.gov>;
Bruce Barker <bbarker@weld.gov>; Karin McDougal <kmcdougal@weld.gov>
Cc: CTB <CTB@co.weld.co.us>
Subject: Ord2023-11 - Chapter 7 Emergency Medical Services
Good morning,
Attached please find the draft of Ord2023-11 with a first reading scheduled for Monday, July 24, 2023. Could you please
review the attached and let me know if any corrections/changes need to be made?
1
2023-2092
Thanks!
Cheryl L. Hoffman
Deputy Clerk to the Board
1150 O Street/P.O. Box 758
Greeley, CO 80632
Tel: (970) 400.4227
choffrnan@weld.gov
2
BOARD OF COUNTY COMMISSIONERS
PASS -AROUND REVIEW
TITLE: Update to Weld County Code - Chapter 7- Emergency Medical Services (Ambulances)
DEPARTMENT: PUBLIC HEALTH & ENVIRONMENT DATE: June 23, 2023
PERSON REQUESTING: Jason Chessher, Executive Director
Brief description of the problem/issue:
For the Board's review and approval is a request from the Health Department to modify Weld County
Code, Chapter 7 — Emergency Medical Services.
The Weld County Emergency Medical/Trauma Service (EM/TS) council has been working with the Health
Department and is requesting language be added to Weld County Code, Chapter 7 - Emergency Medical
Services, to allow for the permitting of "reserve" ambulances. These reserve units are used infrequently
and are intended to come into use if one of the regular units is not in operation due to service issues or
accidents.
Adding this reserve unit option wouldn't change fees associated with the unit but would allow the unit to
have reduced requirements such as not storing medication or other items that may expire. Prior to
moving the unit into operation, it would need to meet the full requirements for either an ALS or BSI,
ambulance, depending on their current license type.
The primary changes are to section 7-1-30 Definitions and to section 7-4-20 Ambulance Equipment to
allow for reserve units. A strike -through version of Chapter 7 and its amended sections is attached to this
pass -around for the Board's review.
The county attorney's office has reviewed these proposed changes and have made their recommended
amendments.
What options exist for the Board? (include consequences, impacts, costs, etc. of options):
Approving this change will provide additional flexibility to ambulance services and should not impact
service operation.
Not approving this change will require services to carry additional equipment and supplies on units while
not in service which carries increase costs as medications expire and equipment goes unused
(defibrillator).
Recommendation: I recommend approval of this change to Weld County Code, Chapter 7.
Approve Schedule
Recommendation Work Session Other/Comments:
Perry L. Buck, Pro -Tern
Mike Freeman, Chair
Scott K. James
Kevin Ross
Lori Saine
Vi66911,
I
Karla Ford
From:
Sent:
To:
Subject:
Approve
Mike Freeman
Tuesday, June 27, 2023 9:52 AM
Karla Ford
Re: Please Reply - PASS -AROUND: County Code Proposed Change to Chapter 7 -
Emergency Medical Services
Sent from my iPhone
On Jun 27, 2023, at 4:48 PM, Karla Ford <kford@weld.gov>wrote:
Please advise if you approve recommendation. Thank you.
Karla Ford A
Office Manager Board of Weld County Commissioners
1150 O Street, P.O. Box 758, Greeley, Colorado 80632
:: 970.336-7204 :: kford@weldgov.com :: www.weldgov.com ::
**Please note my working hours are Monday -Thursday 7:00a.m.-5:00p.m.**
<imageUQl.jpg>
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this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying,
distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named
recipient is strictly prohibited.
From: Health Contracts <Health-Contracts@weld.gov>
Sent: Friday, June 23, 2023 9:15 AM
To: Karla Ford <kford@weld.gov>
Cc: Tanya Geiser <tgeiser@weld.gov>; Jason Chessher <jchessher@weld.gov>; Dan Joseph
<djoseph@weld.gov>; Health Contracts <Health-Contracts@weld.gov>
Subject: PASS -AROUND: County Code - Proposed Change to Chapter 7 - Emergency Medical Services
Hello, Karla,
For the Board's review and approval for placement on the agenda are a pass -around and proposed
update to county code regarding Chapter 7 — Emergency Medical Services (Ambulances).
If you have any questions, please let Tanya know.
Thank you!
HEALTH DEPARTMENT CONTRACTS TEAM
Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended
only for the person or entity to which it is addressed and may contain information that is privileged, confidential or
1
Karla Ford
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Subject:
Yes, thank you!
Lori Saine
Weld County Commissioner, District 3
1150 O Street
PO Box 758
Greeley CO 80632
Phone: 970-400-4205
Fax: 970-336-7233
Email: Isaine@weldgov.com
Website: www.co.weld.co.us
In God We Trust
Lori Saine
Monday, June 26, 2023 10:54 AM
Karla Ford
RE: PASS -AROUND: County Code - Proposed Change to Chapter 7 Emergency Medical
Services
Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for
the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise
protected from disclosure. If you have received this communication in error, please immediately notify sender by return
e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the
contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited.
From: Karla Ford <kford@weld.gov>
Sent: Monday, June 26, 2023 9:44 AM
To: Lori Saine <Isaine@weld.gov>
Subject: FW: PASS -AROUND: County Code - Proposed Change to Chapter 7 - Emergency Medical Services
Karla Ford
Office Manager, Board of Weld County Commissioners
1150 0 Street, P.O. Box 758, Greeley, Colorado 80632
:: 970.336-7204 :: kfordMweldgov. com :: www.weldgov.com
**Please note my working hours are Monday -Thursday 7:00a.m.-5:00p.m.**
1
Weld County, Colorado, Charter and County Code
CHAPTER 7 Emergency Medical Services
CHAPTER 7
Emergency Medical Services
ARTICLE I General Provisions
Sec. 7-1-10. Purpose.
The purpose of this Chapter is to set forth the requirements for high quality emergency medical services to
all citizens of the County It is the intent of the Board of County Commissioners that emergency medical service in
the County will consist of, at a minimum, timely response, 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
Sec. 7-1-20. Delegation.
A The Board of County Commissioners designates and delegates to the Director of the Weld County
Department of Public Health and Environment the authority to manage the Emergency Medical Services
Rules and Regulations as set out in this Chapter Under the direction of the Board, inspections, permitting of
individual ambulances, application processing and review, recommendations to the Board of County
Commissioners for licensure, and other administrative functions necessary to implement this Chapter shall
be the responsibility of the Director
B The Board of County Commissioners may promulgate and enforce such rules and regulations for the
operation and licensing of ambulance services in the County as recommended by the Director to provide for
quality emergency medical services and to ensure compliance with state law and any resolution adopted by
the Board
C The Board of County Commissioners shall review, and consider for approval, all applications for ambulance
service licenses, based upon the recommendation of the Director and the application materials submitted
(Weld County Codification Ordinance 2000-1, Weld County Code Ordinance 2007-8, Weld County Code Ordinance
2012-15)
Sec. 7-1-30. Definitions.
The following definitions shall apply in the interpretation and enforcement of this Chapter
Advanced life support personnel means a minimum of two (2) individuals, including at least one (1)
state -licensed Registered Nurse, or one (1) state -certified EMT -Paramedic or EMT Intermediate, and the
second individual must be, at a minimum, a current state -certified EMT -Basic One (1) of the two (2)
individuals may also serve as the emergency vehicle operator of the ambulance
Air ambulance means a fixed -wing or rotor -wing aircraft that is equipped to provide air transportation
and is specifically designed to accommodate the medical needs of individuals who are ill, injured or
otherwise mentally or physically incapacitated and who require in-flight medical supervision
Weld County, Colorado, Charter and County Code
(Supp No 77)
Created 2022-05-16 10 02 41 [EST]
Page 1 of 18
Ambulance means any privately or publicly owned land vehicle especially constructed or modified and
equipped, intended to be used and maintained or operated by an ambulance service for the transportation
in the County of individuals who are sick, injured or otherwise incapacitated or helpless. For the purposes of
this Chapter, ambulance shall not include air vehicles used in air medical transport because, by state law,
such air ambulances are licensed by the Colorado Department of Public Health and Environment.
a. Basic life support ambulance means an ambulance that meets the requirements for equipment as
established by the Board of County Commissioners and is staffed by at least one (1) Emergency
Medical Technician-Basic/EMT-B currently certified by the State, 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.
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.
c. Reserve ambulance meansi-s any ambulance that meets the minimal requirements for equipment
as outlined inp-e+ Weld County Code section 7-4-20. A reserve ambulance is considered non-
operational but can be transferredtransition to a Basic or Advanced life sSupport aAmbulance,
and become operational, at such time as deemed necessary by the licensed ambulance service.
The licensed ambulance service attests that, at the time a reserve ambulance is
transferreditioned to either a Basic or Advanced Ihife sSupport aAmbulance, it shall meet all the
requirements of Weld County Code
sections 7-1-20, 7-4-10, and 7-4-20 along with the requirements in the current EMS Laws
applicable to the type of ambulance either a Basic life support ambulance or Advanced life
support ambulance.
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.
Ambulance service license means a nonexclusive authorization issued by the Board of County
Commissioners to operate an ambulance service, publicly or privately within the County, as further defined
in Section 7-2-10 of this Chapter.
Ambulance vehicle permit means the authorization issued by the Department with respect to an
ambulance used, or to be used, to provide ambulance service in the County.
Applicant means that person or entity who is an initial applicant or an applicant for renewal for an
ambulance service license or ambulance vehicle permit.
Current E.M.S. laws means the Emergency Medical Services Act, Section 25-3.5-101 et seq., C.R.S., as
amended; the Colorado Department of Public Health and Environment Rules Pertaining to Emergency
Medical Services, 6 C.C.R. § 1015-3, as amended; and Colorado Board of Medical Examiners Rule 500, 3
C.C.R. § 713-6, as amended.
Department means the Weld County Department of Public Health and Environment.
Director means the Director of the Weld County Department of Public Health and Environment.
(Supp. No. 77)
Created: 2022-05-16 10:02:39 [EST]
Page 2 of 18
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
Emergency medical services means 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
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, Section 25-3 5-101 et seq , C R S
a Emergency Medical Technician -Basic (EMT -B) means an individual who has been duly certified by
the Emergency Medical Services Division of th'e 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
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
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
Emergency vehicle operator means any person authorized to drive an ambulance in the County as
provided in this Chapter
First Responder means 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 , CRS, and the
applicable regulations of the Colorado State Department of Public Safety
Medical Director means a physician who holds an active Colorado medical license, who establishes
protocols and standing orders for medical acts performed by First Responders, Registered Nurses or
Colorado -certified EMTs of a prehospital EMS service agency and who is specifically identified as being
responsible to assure the competency of the performance of those acts by such First Responders, Registered
Nurses or Colorado -certified EMTs
Mutual Aid Agreement means a written agreement between agencies, organizations, or jurisdictions to
lend assistance across jurisdictional boundaries It agrees to assist by furnishing personnel, equipment, and
expertise in a specified manner at requisite times
Patient means any individual who is sick, injured or otherwise incapacitated or helpless
Physician advisor means a medical director
Pnmary care means the initial response and care'for emergency medical services, by an ambulance
service whose primary base of operation is located in the County, or by an ambulance service that has a
contract or agreement with the County, a Weld County municipality or a fire, ambulance or hospital district
operating within the County, to provide emergency_ medical services
Quick response team means any organized group of individuals trained, at a minimum, as First
Responders, which provides initial care to a patient prior to the arrival of an ambulance
Created 2022-05-16 10 02 39 [EST]
(Supp No 77)
Page 3 of 18
Registered Nurse (R.N.) means a person duly licensed under the provisions of the Professional Nurse
Practice Act of the State of Colorado.
Rescue unit means any organized group chartered by the State as a corporation not for profit or
otherwise existing as a nonprofit 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 possess, civil defense units or other organizations
of governmental designation responsible for search and rescue.
Standby service means 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 requirements, including but not limited to insurance requirements for emergency medical
service providers set forth in this Chapter.
ARTICLE II Licenses and Permits
Sec. 7-2-10. License for ambulance service.
A. No person shall provide or operate an ambulance service publicly or privately in the County unless that
person holds a valid license to do so issued by the Board of County Commissioners, except as provided in
Section 7-2-80 of this Article. The fee for said license shall be set by separate ordinance. The license shall
issue only in the following tiers of service:
Tier I: Licensure authorizing for primary care, as defined in Section 7-1-30 of this Chapter.
Tier II: Licensure authorizing for transports of patients that originate in Weld County from licensed medical
facilities. This licensure does not provide for primary care, as defined in Section 7-1-30 of this Chapter.
Tier III: Licensure authorizing for standby service, as defined in Section 7-1-30 of this Chapter.
B. The Board of County Commissioners reserves the right to amend these rules and regulations and any other
individual conditions of licensing as applied to any particular license, as needed in keeping with its legislative
function and in order to implement the policy of the State that the regulation and control of ambulance
licenses is in the exclusive purview of the boards of county commissioners. Persons or firms seeking
application and approval of any ambulance license under this Chapter acknowledge that the County, a Weld
County municipality, or a district operating within the County may contract with specific ambulance service
providers which will serve their emergency ambulance needs.
(Weld County Codification Ordinance 2000-1; Weld County Code Ordinance 2012-15; Weld County Code Ordinance
2013-7)
Sec. 7-2-20. Vehicle permit for each ambulance.
In addition to the license required by Section 7-2-10 above, 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 this Chapter and the applicable requirements
set forth in the current EMS Laws. The permit issued for each vehicle will describe the maximum level of service
that can be provided by that vehicle (e.g., "ambulance reserve", "ambulance basic life support", or "ambulance
advanced life support"). The ambulance vehicle permit fee shall be set by separate ordinance.
Created: 2022-05-16 10:02:39 [EST]
(Supp. No. 77)
Page 4 of 18
Sec. 7-2-30. Expiration of licenses and permits.
All ambulance service licenses and ambulance vehicle permits issued by the County shall expire on December
31 of the year issued.
Sec. 7-2-40. Medical director required.
Each ambulance service licensed in the County shall have a medical director, who shall comply with all the
appropriate requirements of the current EMS Laws. The medical director shall be notified in writing by the
Department of any violation of this Chapter by any ambulance service or individual licensee for which the medical
director provides services and oversight.
Sec. 7-2-50. Advanced life support ambulance.
When an ambulance service operates or charges as a paramedic or advanced life support ambulance service,
the staffing and equipment must comply with the definition of advanced life support ambulance.
Sec. 7-2-60. 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 it is licensed as such.
Sec. 7-2-70. Reciprocal agreements with other jurisdictions.
The County may enter into reciprocal licensing and permitting agreements with other counties and
neighboring states.
A. The Department may accept vehicle inspections from other Colorado counties. Said inspections shall
have occurred within the most recent licensure period (not to exceed twelve [12] months) by the
inspecting county.
Sec. 7-2-80. Exclusions.
The provisions of this Chapter shall not apply to the following:
A. Vehicles used for the transportation of persons injured at a mine when the personnel used on the
vehicles are subject to the mandatory safety standards of the federal Mine Safety and Health
Administration, or its successor agency.
B. Vehicles used by other agencies, including quick response teams and rescue units that do not routinely
transport patients or vehicles used to transport patients for extrication from areas inaccessible to a
permitted ambulance. Vehicles used in this capacity may only transport patients to the closest practical
point for access to a permitted ambulance or hospital.
C Vehicles, including ambulances from another state, used during major catastrophe or mass casualty
incident, rendering services when permitted ambulances are insufficient.
D. An ambulance service that does not transport patients from points originating in the State, orState or
transporting a patient originating outside the borders of the State.
Created: 2022-05-16 10:02:39 [EST]
(Supp. No. 77)
Page 5 of 18
E Vehicles used or designed for the scheduled transportation of convalescent patients, individuals with
disabilities or persons who would not be expected to require skilled treatment or care while in the
vehicle
F Vehicles used solely for the transportation of intoxicated persons or persons incapacitated by alcohol,
as defined in Section 254-302, C R S , 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
G Ambulances operated by a department or an agency of the federal government, originating from a
federal reservation for the purpose of responding to or transporting patients under federal
responsibility
H An ambulance service, licensed by another Colorado county, that provides only intermittent transport
of patients from the County not exceeding one hundred (100) trips annually
Sec. 7-2-90. 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
A The name, address, and telephone number of the owner of the ambulance service
B The name, address and current telephone number of the person who will be in charge of the operation
of the ambulance service
C The description of the ambulance, including the make, model, year of manufacture, current Colorado
state license number, motor vehicle chassis number and length of time the vehicle has been in service
D The location and description of the place or places from which the ambulance service will operate
E The name, address, and telephone number of the required medical director to the ambulance service,
and an attestation by the medical director of willingness to provide medical oversight and a medical
continuous quality improvement program for the ambulance service
F The area to be served by the ambulance service
G 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
1 Complete name and date of birth
2 The highest level of certification, licensure or training attained
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
4 Proof of a valid driver's license
5 A current statement of criminal complaint or convictions, including Class I and II traffic violations
H Proof of insurance, as required in Section 7-3-60 of this Chapter
A current copy of EMT or Paramedic protocols adopted by the ambulance service in accordance with
standards approved by the ambulance service's medical director
Created 2022-05-16 10 02 40 [EST]
(Supp No 77)
Page 6of18
A current copy of the ambulance service's training standards in accordance with the requirements
approved by the ambulance service's medical director All training must be through a state -certified
emergency medical services training center
K Make available for review by the Department current records of compliance with the current EMS
Laws
Copies of any judgments entered against the licensee or license applicant within the previous twelve
(12) months, including findings of fact, conclusions of law and order by any court or other tribunal
M Such other information as the Department may require to make a fair determination
N A list of ambulance agencies, fire departments, special districts, and other EMS providers with which
the applicant has mutual aid agreements
Sec. 7-2-100. Approval of application.
A After receipt of an original application for an ambulance service license or 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 vehicles to determine compliance with this Chapter The Director shall make a
recommendation for licensure to the Board of County Commissioners, upon a finding that
1 The ambulance service staff, vehicles, records, insurance, protocols, equipment, and location comply
with the requirements of this Chapter
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
B The Director shall set a date for consideration of the application by the Board of County Commissioners, said
date being a regular Board of County Commissioners business meeting no less than ten (10) business days
after the Director has deemed the ambulance service to have met all licensure application requirements and
has received the recommendation of the Weld County Emergency Medical/Trauma Service (EM/TS) The
Board of County Commissioners must find that the issuance of the license will contribute to an efficient,
effective, and coordinated emergency medical response to residents of the County The Board shall consider
the following
1 The recommendation of the Director
2 The facts presented at the Board meeting
3 The information contained in the official record
4 Any agreement or contract to provide primary care in the County
5 The recommendation of the Weld County Emergency Medical/Trauma Service (EM/TS) Council as to
whether or not the issuance of the license will contribute to -an efficient, effective, and coordinated
emergency medical response to residents of the County The EM/TS Council shall also provide
a Recommended service area
b Recommended tier of license
6 The applicant has complied in all respects with the requirements of this Chapter
(Weld County Code Ordinance 2007-8, Weld County Code Ordinance 2012-15, Weld County Code Ordinance 2013-
7)
Created 2022-05-16 10 02 40 [EST]
(Supp No 77)
Page 7 of 18
Sec. 7-2-110. 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
Sec. 7-2-120. Additional or replacement vehicles.
If an ambulance is added to a service's fleet, an application for an ambulance vehicle permit shall be filed
with the Department prior to the new ambulance being placed in service, but in no event later than thirty (30) days
of receipt of the new ambulance The completed application shall include a description of the ambulance 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
Sec. 7-2-130. 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 performed The Department may modify this
regulation or adopt additional requirements with the consent of the Board of County Commissioners
Sec. 7-2-140. Appeal of application denial.
Any person or entity having been denied a license by the Director may appeal such denial to the Board of
County Commissioners 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 A hearing based upon the specific
grounds stated in the appeal shall be scheduled and conducted in accordance with Section 7-7-40 of this Chapter
The decision of the Board of County Commissioners shall be based solely on the grounds of the appeal set forth in
the applicant's request for hearing
Sec. 7-2-150. 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 Chapter Any
change of ownership or any change of stock ownership of ten percent (10%) or more shall be reported in writing to
the Director
Sec. 7-2-160. Licenses and permits not transferable.
No license or permit issued by the Director shall be sold, assigned, or otherwise transferred
Sec. 7-2-170. 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
Created 2022-05-16 10 02 40 [EST]
(Supp No 77)
Page 8 of 18
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
Sec. 7-2-180. Change of medical director.
An ambulance service must report any change of medical director, including name, address, and telephone
number, to the Director within fifteen (15) calendar days of such change
ARTICLE III Ambulance Operation
Sec. 7-3-10. Emergency vehicle operator.
For land vehicles, the ambulance driver shall meet the requirements of Section 25-3 5-202, C R S This
requirement may be waived in unusual emergency conditions when no driver meeting these requirements is
available
Sec. 7-3-20. Ambulance crew member training.
A 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
B 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
Sec. 7-3-30. Documentation.
Each ambulance service shall prepare, maintain, and submit upon request copies of uniform and
standardized records concerning the transportation and/or treatment of patients as required by the Director
and/or the Colorado Department of Public Health and Environment Such records shall include all information
determined to be essential by the Colorado Department of Public Health and Environment and set forth in the EMS
Laws for maintenance of adequate minimum records on the patient's medical condition and medical care provided
by the ambulance service All licensed ambulance services are required to utilize the statewide emergency medical
and trauma services uniform prehospital care reporting system operated by the Colorado Department of Public
Health and Environment
Sec. 7-3-40. Agency profile to be submitted to State.
Each licensed ambulance service shall complete and submit to the Colorado Department of Public Health and
Environment an agency profile as defined by the Colorado Emergency Medical and Trauma Services Advisory
Council and approved by the State to provide information on resources available for planning and coordination of
statewide emergency medical and trauma services on an annual basis
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Sec. 7-3-50 Criminal record of ambulance crew member.
Unless waived by the Board of County Commissioners, no person shall be employed by an ambulance service
as an ambulance crew member who has been convicted of any of the following offenses within the previous
twelve (12) months from the date of application felony, misdemeanor or Class I or Class II traffic offense
Sec. 7-3-60. insurance.
A Coverage No emergency medical service provider shall operate in the 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 said vehicle should be liable
for any liability imposed on him or her by law, regardless of whether the ambulance was being operated by
the owner, the owner's agent, 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
1 Workers' compensation insurance Each ambulance service shall maintain at least the statutorily
required amount of workers' compensation insurance
2 Public liability and property damage bodily injury
a Each person, six hundred thousand dollars ($600,000 00)
b Each accident, six hundred thousand dollars ($600,000 00)
3 Property Damage Each accident, six hundred thousand dollars ($600,000 00)
4 Professional Liability Coverage
a Each person, six hundred thousand dollars ($600,000 00)
b Each accident, one million dollars ($1,000,000 00)
5 Ambulance vehicle coverage The ambulance vehicle insurance shall be a complying policy for motor
vehicles, as defined in Sections 10-4-609 and 42-7-103, C R S
B Proof of insurance Proof of insurance shall be filed with the Department, along with the application for an
ambulance service license as required in this Chapter 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
C Certificate of insurance requirements A certificate of insurance, with the Board of County Commissioners
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, policy effective date, policy expiration date and
amount of coverage, and shall contain a provision that thirty (30) days' prior written notice of any
cancellation, termination, or revocation of said insurance policy shall be given to the Department
D 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
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E 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 the 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
(Weld County Codification Ordinance 2000-1, Weld County Code Ordinance 2007-8)
Sec. 7-3-70. 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, regardless of age or size Such devices shall be utilized when feasible
Sec. 7-3-80. Transport to medical facility.
All ambulances shall deliver patients to the most appropriate licensed medical facility, as determined by the
'physician advisor or his or her designee, dependent on the patient's medical needs When medically appropriate,
the patient's preference should be considered
Sec. 7-3-90. 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
Sec. 7-3-100. Compliance with all applicable laws and regulations.
Ambulance services operating in the County must comply with all applicable federal, state, and local laws
and regulations, including but not limited to EMS Laws, HIPPA laws and regulations and relevant County and
municipal zoning regulations
Sec. 7-3-110. Medical continuous quality improvement program required.
Each licensed ambulance service operating within the County must have an ongoing medical continuous
quality improvement program consistent with the requirements defined in the Colorado Board of Medical
Examiners rules, 3 C C R § 713-6, Rule 500, 3 2, b
ARTICLE IV Ambulance Vehicle Requirements
Sec. 7-4-10 Specifications.
Land vehicles obtained, licensed, and placed in use as ambulances shall, at the minimum, meet the
guidelines as established by the provisions in the EMS Laws applicable to ambulances Variances of the above -
mentioned specifications may be granted at the discretion of the Director All ambulances shall have the name and
level of service of the ambulance service clearly visible on said vehicles
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Sec. 7-4-20. Ambulance equipment.
Each ambulance, whether it be permitted as a Reserve, basic Ibife sSupport, or advanced Rife sSupport
ambulance , at a minim -um, shall contain the following equipment which shall be maintained in good working
order:
A. Emergency lighting and audible warning equipment which complies with state law for emergency
vehicles.
B. Safe tires and, in addition, adequate snow tires or chains when weather conditions demand.
C. Patient assessment equipment, including blood pressure cuffs (large adult, regular adult, child, and
infant sizes); stethoscope; illumination device capable of testing for pupillary reaction; and pulse
oximeter with adult and pediatric sensors:.
In the case of ambulances providing primary care in the County, or otherwise qualified pursuant to
Section 7-2-90 of this Chapter, capability of two-way radio communication with the following: the
ambulance dispatcher, the Weld County Regional Communication Center, and on-line medical control.
E Body substance isolation equipment, including non -sterile disposable latex -free gloves; protective eye
wear; non -sterile surgical masks; NIOSH approved N95 or superior particulate filtering respirator
(universal size); and sharps container.
F. Basic Safety equipment,
including appropriate protective restraints for patients, crew, accompanying family members, and
other vehicle occupants; a properly secured patient transport system; child protective restraint system
that accommodates a weight range of 5 to 99 pounds; one ten -pound 'or two five- pound) ABC fire
extinguisher; warning reflectors (set of three:; and triage tags.
E. The minimal required equipment s-hal4 be that set forth as required, either fFor either basic Ibife sSupport
or Advanced advanced Itife sSupport ambulances, th-e-additional equipment required shall be set forth, or Basic
Life Support, as applicable, in the current EMS Laws. The Director may add to this list at his or her discretion as
other needs or new methodology becomes known.
ARTICLE V Qualifications of Emergency Medical Technicians
Sec. 7-5-10. Valid EMT certificate required.
No person shall practice as an Emergency Medical Technician for any ambulance service subject to the
licensing requirements of this Chapter unless that person holds a current, valid Emergency Medical Technician
certificate from the State.
Sec. 7-5-20. List of EMS providers required.
Each ambulance service subject to the licensing requirements of this Chapter shall provide the Department
with a list of its Emergency Medical Service providers as stated in Subsection 7-2-90.G of this Chapter and shall
notify the Department of any changes in that list within thirty (30) days of the change in the list.
Sec. 7-5-30. Current EMT certificate required.
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
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the certificate number of the new state certificate Failure to comply with this Section disqualifies an EMT from
practice in any County ambulance service
ARTICLE VI EMS Providers Not Employed or Utilized by a County -Licensed
Ambulance Service
Sec. 7-6-10. Compliance by contract with ambulance services.
Emergency Medical Services contracting with, or employed by, groups and organizations for public events
and not employed or utilized by a licensed ambulance service licensed by the County shall, upon request, be able
to demonstrate compliance with rules and regulations as promulgated by the County, and through the EMS Laws
Sec. 7-6-20. Standby services.
A 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 7-3-60 of this Chapter
B The following is the minimum equipment required for standby services
1 Direct communication access to 911 for requesting advance life support care
2 Oropharyngeal airways in adult, child, and infant sizes
3 Assorted dressings (sterile - large and small)
4 Soft roller bandages
5 Tape
6 Blanket
7 Triangular bandages
8 Shears capable of cutting clothing or bandages, including heavy leather or canvas
9 Flashlight
10 Oral suction device
11 Portable oxygen and pocket mask and administration equipment
(Weld County Code Ordinance 2001-3, Weld County Code Ordinance 2020-04)
ARTICLE VII Suspension or Revocation of License or Permit
Sec. 7-7-10. Unlawful practices.
The following practices shall be unlawful and shall be grounds for a suspension or revocation of a license
A Willful and deliberate failure to respond to any emergency call
J B Willful and deliberate failure to transport a patient when required in the event of an emergency
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C Administering unnecessary treatment or supplies to a patient for the purpose of increasing the
patient's bill
D Administration of any substance unless under the protocol and/or order of the physician advisor or
medical control
E Charging for treatment or supplies not actually provided to a patient
F Requiring and/or allowing any employee of an ambulance service or fire department licensed to
provide ambulance service to be on continuous duty not in excess of internal agency fatigue policy,
except in cases of extreme emergency or disaster
G Except as otherwise provided in this Chapter, failure to deliver a patient to the most appropriate
licensed medical facility as determined by the physician advisor, dependent upon the patient's medical
needs
H Conduct which constitutes a significant threat to the health or safety of the individuals receiving
emergency care from a licensed ambulance service or a fire department licensed to provide ambulance
service
Noncompliance with any rule or regulation set forth in the EMS Laws concerning the duties and
responsibilities of emergency medical technicians or medical directors
Call lumping, which is defined as a response to a call for ambulance service by one (1) ambulance
service company or a fire department licensed to provide ambulance service with the knowledge that
another ambulance service company or a fire department licensed to provide ambulance service has
either been notified to respond to the call or is actually responding to the call, unless the call is of a life -
critical nature and the closest ambulance has responded
Sec. 7-7-20. Complaints concerning ambulance services.
Complaints against an ambulance service in the County, whether or not such ambulance service currently
holds a license pursuant to this Chapter, must be filed in writing with the Director The written complaint must
contain the name, address, and telephone number where the complaining party may be reached, and as detailed
information as possible concerning the complaint The Director will investigate such incidents Upon completion of
the investigation, the Director shall report the resolution of the investigation to the complaining party and any
other entity as appropriate or required pursuant to the provisions of 6 C C R 1015-3, § 12 4 2 A report of all
complaints and the resolutions of such complaints shall be provided to the medical director who oversees the
relevant ambulance service
Sec. 7-7-30. Temporary suspension.
Upon a determination by the Director that any person has violated or failed to comply with any provisions of
this Chapter, the Director may temporarily suspend, for a period not to exceed thirty (30) days, any license or
permit issued pursuant to this Chapter 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 of County Commissioners 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 Chapter
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Sec. 7-7-40. Hearings to be public.
All hearings before the Board of County Commissioners shall be public and every vote and official act of the
Board 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
Sec. 7-7-50. Hearing in two phases.
A The hearing before the Board of County Commissioners shall be conducted in two (2) phases
B 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 (1) or more of the following has
occurred
1 Violation of any provision of this Chapter
2 Violation of any state law or any ordinance or regulation of a municipality in the County Evidence of
any violation may be considered, regardless of any conviction thereof
3 Commission of any practices set forth in Section 7-7-10 above
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 (1) or more of the above
acts has occurred, the public hearing shall progress to Phase II
C During Phase II of the public hearing, the Board of County Commissioners shall consider whether to suspend
or revoke permanently the license or permit The Board may suspend any license or permit issued pursuant
to this Chapter 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 (2) violations or on two (2) separate occasions has failed to comply with any
provision of this Chapter, 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
1 The seriousness of the violation
2 Corrective actions taken by the license holder
3 Prior violations and offenses and the effectiveness of prior corrective action
4 Prior violations and offenses by the licensee or permit holder
5 The violation, offense, or occurrence as a repeated course of conductor as a single event
6 The likelihood of recurrence
7 All circumstances surrounding the violation, offense, or occurrence
8 Willfulness of the violation, offense, or occurrence
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9 The length of time the license or permit has been held by the licensee or permit holder being
disciplined
10 Previous sanctions imposed against the licensee or permit holder
11 Other factors making the situation unique to the licensee or permit holder subject to discipline
(Weld County Codification Ordinance 2000-1, Weld County Code Ordinance 2007-8)
Sec. 7-7-60. Notification 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 of revocation or suspension of any ambulance service license or vehicle permit
ARTICLE VIII Countywide Emergency Service
Sec. 7-8-10. Mutual aid agreements.
The County encourages a cooperative systems approach towards improved patient care All licensed
agencies providing EMS responses in the 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
Sec. 7-8-20. Repealed.
(Weld County Code Ordinance 2012-15)
Sec. 7-8-30. Repealed.
(Weld County Code Ordinance 2012-15)
Sec. 7-8-40 Nonliability
Nothing in this Chapter shall be construed to create a cause of action and/or civil liability remedy in any
person This Chapter 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 of County Commissioners that any third -party receiving services or
benefits under this Chapter shall be deemed an incidental beneficiary only
ARTICLE IX Enforcement
Sec. 7-9-10. Violations and penalties.
The County, through the Director of the Weld County Department of Public Health and Environment, may
enforce this Chapter through methods included in this Chapter, or through other methods adopted by the Board of
County Commissioners
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Sec. 7-9-20. Criminal penalties.
A Any person, firm, corporation, or ambulance service violating any provision of this Chapter is guilty of a
misdemeanor and, upon conviction thereof, shall be punished by a fine of not more than one hundred
dollars ($100 00) or by imprisonment in the County Jail for not more than ten (10) days, or by such fine and
imprisonment for each offense or violation Each day during which such violation continues shall be deemed
a separate offense
B Whenever the Department of Public Health and Environment, through one (1) of its employees, has personal
knowledge of any violation of this Chapter, it shall give written notice to the violator to correct such violation
within fifteen (15) days after the date of the notice Should the violator fail to correct the violation within
such fifteen -day -period, the Director may request that the Sheriff's Office issue a summons and complaint to
the violator, stating the nature of the violation with sufficient particularity to give notice of said charge to the
violator The summons and complaint shall require that the violator appear in court at a definite time and
place stated therein to answer and defend the charge One (1) copy of the summons and complaint shall be
served upon the violator by the Sheriff's Office in the manner provided by law for the service of a criminal
summons One (1) copy each shall be retained by the Sheriff's Office and the Director, and one (1) copy shall
be transmitted to the Clerk of the Court
C It is the responsibility of the County Attorney to enforce the provisions of this Section In the event the Board
of County Commissioners deems it appropriate, the Board of County Commissioners may appoint the District
Attorney to perform such enforcement duties in lieu of the County Attorney
(Weld County Code Ordinance 2007-8)
Sec. 7-9-30. Equitable relief in civil action.
In the event that any ambulance service is being operated within the County in violation of any provision of
this Chapter, the County Attorney, or where the Board of County Commissioners deems a appropriate, the District
Attorney, in addition to the other remedies provided by law, ordinance or resolution, may institute an injunction,
mandamus or other appropriate action or proceeding to prevent or enjoin such violation
Sec. 7-9-40. Civil penalties.
A In addition to any penalties imposed pursuant to Section 7-9-20 above, any person, firm, corporation, or
ambulance service violating any regulation or provision contained in this Chapter may be subject to the
imposition, by order of the County Court, of a civil penalty in an amount of not less than two hundred fifty
dollars ($250 00), nor more than five hundred dollars ($500 00) It is within the discretion of the County
Attorney to determine whether to pursue the civil penalties set forth in this Article Each day after the
issuance of the order of the County Court during which such violation continues shall be deemed a separate
violation and shall, in accordance with the subsequent provisions of this Section, be the subject of a
continuing penalty in an amount not to exceed fifty dollars ($50 00) for each such day
B The Department of Public Health and Environment, through one (1) of its employees, shall, upon personal
information and belief that a violation of any regulation or provision of this Chapter has occurred, give
written notice to the violator to correct such violation within fifteen (15) days after the date of such notice If
the violator fails to correct the violation within such fifteen -day period or within any extension period
granted by the Director, the Director may request that the County Sheriff or the County Attorney issue a
summons and complaint to the violator, stating the nature of the violation with sufficient particularity to give
notice of such charge to the violator
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C One (1) copy of the summons and complaint issued pursuant to Subsection B above shall be served upon the
violator in the manner provided by law for the service of a County Court civil summons and complaint in
accordance with the Colorado Rules of County Court Civil Procedure The summons and complaint shall also
be filed with the Clerk of the County Court, and thereafter the action shall proceed in accordance with the
Colorado Rules of County Court Civil Procedure
D If the County Court finds, by a preponderance of the evidence, that a violation of any provision of this
Chapter, as enacted and adopted by the Board of County Commissioners, has occurred, the Court shall order
the violator to pay a civil penalty in an amount allowed pursuant to Subsection A above Such penalty shall
be payable immediately by the violator to the County Treasurer In the event that the alleged violation has
been cured or otherwise removed at least five (5) days prior to the appearance date in the summons, then
the County Attorney shall so inform the Court and request that the action be dismissed without fine or
appearance of the defendant
E Upon the filing with the Court of a receipt issued by the County Treasurer showing payment in full of a civil
penalty assessed pursuant to this Section and upon the filing of an affidavit of the Department of Public
Health and Environment that the violation has been cured, removed, or corrected, the Court shall dismiss the
action and issue a satisfaction in full of the judgment
F If a receipt showing full payment of the civil penalty or the affidavit required by Subsection E above is not
filed, the action shall continue, and the Court shall retain jurisdiction to impose an additional penalty against
the violator in the amount specified in Subsection A of this Section Such additional penalty shall be imposed
by the Court upon motion filed by the County and proof that the violation has not been corrected
Thereafter, the action shall continue until the penalty and any additional penalties are assessed, and the
filing of an affidavit of the Department of Public Health and Environment verifies that the violation has been
corrected
(Weld County Code Ordinance 2007-8)
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