HomeMy WebLinkAbout20223256.tiffRESOLUTION
RE: APPROVE APPLICATION FOR TIER III AMBULANCE SERVICE LICENSE AND
AUTHORIZE CHAIR TO SIGN - STADIUM MEDICAL, INC.
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, pursuant to Section 7-2-100 of the Weld County Code, the Weld County
Department of Public Health and Environment and the Weld County Emergency Medical/Trauma
Services Council have reviewed the application of Stadium Medical, Inc., for a Tier III Ambulance
Service License and recommend approval, and
WHEREAS, after review, the Board deems it advisable to approve said Application for a
Tier III Ambulance Service License, a copy of which is attached hereto and incorporated herein
by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the application of Stadium Medical, Inc., for a Tier III Ambulance Service
License, be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said license.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 21st day of November, A.D., 2022.
BOARD OF COUNTY COMMISSIONERS
WELDnCOUNTY, COLORADO
ATTEST: d);
Weld County Clerk to the Board
BY:
eputy Clerk to the Boar
Scott K. James, Chair
APP VEDATiR��I ��•. �1 _ - /rLo't-�
teve Moreno
ounty Attorney
Date of signature: 11/3/2
Lori Saine
CC :HL(TG/&,/), OEf-t (aR)
l2/.2 /:22
2022-3256
HL0054
Memorandum
TO:
FROM:
Scott James, Chair
Board of County Commissioners
Gene O'Hara, Interim Director
Department of Public Health & Environment
DATE: November 17, 2022
SUBJECT: 2023 Applications for Ambulance Service Licenses
Enclosed for the Board's review are 15 applications for ambulance service licensing, pursuant to Weld County
Code, Chapter 7, Emergency Medical Services, from the ambulance service providers listed below. The Weld
County Emergency Medical Trauma Service (EMTS) Council reviewed each application on November 16, 2022
and approved all 15 applications.
Changes from 2022 include the removal of Windsor -Severance Fire Protection District and Front Range Fire Rescue.
The areas previously covered by these two ambulance services will now be covered by UCHealth EMS. Additions
include PVHC dba UCHealth Lifeline, which will provide only critical care response, and Brighton Fire Rescue
District, whose application was previously submitted and approved in August 2022 for licensure through 2023.
Based on the delegated responsibility of the Department, we have reviewed the applications and have
deemed all ambulance services listed below to have met all applicable licensure application requirements as
per Chapter 7. As such, I am recommending the following ambulance service providers for licensure:
Tier I
Tier I (cont.)
Tier II
Banner Health
Paramedic Service / AMR
1801 16th St.
Greeley, CO
Platteville Gilcrest Fire
Protection District
202 Main St.
Platteville, CO
Ambulnz CO, LLC
2140 S. Holly St.
Denver, CO
Frederick Firestone Are
Protection District
8426 Kosmerl PI.
Frederick, CO
PVHC dba UCHealth Lifeline
2450 S. Peoria St., 3`d Floor
Aurora, CO 80014
American Medical Response
of Colorado
3800 Pearl St.
Boulder, CO
Greeley Fire Department
1155 10th Ave.
Greeley, CO
Southeast Weld Fire
Protection District
95 W. Broadway Ave.
Keenesburg, CO
Tier III
Mountain View Fire
Protection District
Stagecoach Rd.
Longmont, CO
Thompson Valley EMS
4480 Clydesdale Pkwy.
Loveland, CO
Stadium Medical, Inc.
695 Canosa Ct. If --3561
Denver, CO
North Metro Fire
Rescue District
101 Spader Way
Broomfield, CO
UCHealth EMS
3509 S. Mason St.
Fort Collins, CO
Mile High Ambulance Service
3251 S. Zuni St.
Englewood, CO
Platte Valley Ambulance Service
1750 E. Egbert St.
Brighton, CO
2022-3256
i-}Luusy
A A A A A A A A A A A A_A A A A AA A A A AA AVATATAWYNNAWAVATATAWAWYAWAWN
WELD COUNTY DEPARTMENT OF
PUBLIC HEALTH & ENVIRONMENT
License to Operate Ambulance Service
TIER III
STADIUM MEDICAL, INC.
Name of Service
695 CANOSA COURT, DENVER, COLORADO 80204
Address
STADIUM MEDICAL INC.
Name of Owner
IS LICENSED UNTIL DECEMBER 31, 2023, TO OPERATE AN AMBULANCE SERVICE IN WELD COUNTY IN ACCORDANCE
WITH EXISTING WELD COUNTY RULES AND REGULATIONS.
NOV 2 1 1022
CHAIR. BARD OF WELD COUNTY COMMISSIONERS
NOT TRANSFERRABLE / POS
IN A CONSPICUOUS PLACE
Tier III: Licensure authorizing for Standby Service, as defined in Section 7-1-30 of the Weld County Code.
DATE
I
LtssAvArKzerKKKKKKKAvsKKKKATKKATKKATKKKArgavranvAnwnwat
WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
1555 North 17th Avenue, Greeley, CO 80631 www.weldhealth.org
Recommendation of the Weld County Emergency Medical/Trauma Service Council
for: Stadium Medical
As required in Section 7-2-100.B.S., the EMTS Council should review the application to assess as to whether
the ambulance service will contribute to an efficient, effective, and coordinated emergency medical response
to residents of the County? Please include any findings related to response time, coordination with other
ambulance services, location, service area, etc. that is the basis for the Council's recommendation:
FINDING #1:
Stadium Medical provides EMS Standby service for various events throughout the County. The EMTS Council
Voting members have reviewed the above -noted agency and find that they contribute to an efficient, effective,
and coordinated emergency response as a Tier 111 service. Tier III service providers allow 911 response
agencies to remain available for calls for service within their jurisdiction.
FINDING #2:
The members of Stadium Medical are dedicated to delivering excellent and timely service. The EMTS Council
Voting members did not identify any negative findings relating to the service performed by the applicant.
FINDING #3:
In the overall review, the EMTS Council membership does not find any matter that would prohibit a
recommendation to the Weld County Board of County Commissioner.
Recommended Level of Service: Tier III
Recommended Service Area:
The service area indicated within the applicant's application packet is acceptable to the Council.
Other EMTS Council recommendations or comments:
The EMTS Council membership unanimously votes to recommend Stadium Medical for a Tier III Weld County
Ambulance License.
Recommendation By:
Matt Concialdi, EMTS Council Chair
Page 1 of 1
Date: /(//(/Z Z
Weld County
Department of Public Health and Environment
AMBULANCE SERVICE LICENSE APPLICATION
Date of Application: CD (11-•
Name of Ambulance Service: Sfii-PIs&A M� E0�CFt1 t tf.Jc
Owner:
Name: I%61t5D- AO/WS
Address: loci CSVANSF � "r PE1i` i2-1 w '$ 02-4 1
Phone Number: (502)) 541 —11 l 4 —
Operations Manager:
Name: n/tEGt A-0- S
Address: (a 5- (Adt c* c -D42 --lam" D Jam' 1 c0 Lib
Phone Number: el Si,) 31i�
Email: MAPA'S ciiikok I\MVOLcA4_ • 4OIv\
Medical Director:
Name: C.L•ARJc— SAM Oa— Stvkt' H —
Address: '&4-- 41V0 fned-D0rJ L Ie I4 DOD, C 0 $02-2'2,
Phone Number(Sol) 7i 39 —
Name and address of each stockholder of partner owning 10% or more of the outstanding stock
of the company of having more than a 10% ownership interest (if applicable):
€.76e Acremia, .
What area of Weld County will be served by this company? Please attach a map indicating
the service area.
JEiit` $A-S1aD — v4VLD c -Wan- ?
Page 1
1555 N. 17th Avenue
Greeley, CO 80631
Phone: (970) 304-6410
weldhealth.org
,/
P3
Public Health„vna
OWNER & MANAGER INFORMATION You must list all officers, directors, general partners, managing members, stockholders, partners, and members. If a holding company has
an ownership interest in the licensed business, list that company and its ownership percentage as well. Please attach additional pages if necessary.
+'
.,
NAME,
i3`d
- EIRST AND'LAST , _
HMISADORESS ,i
''' p1 ' p`f +, i !
STREET'ADDRESS1 T .< . err STATE ZIP CODE±
; �p�ATIEiocsttTH
fi 4 '''-'1' '7 ''^
imml aCl
Rodger Ames
5363 Parfet St. Arvada, CO 80002
08/21/1959
. ENWLASORESs,
PNph�ti
RQSITI05
%OWNERSHIP' `
contact@stadiummedical.com
303-549-7914 j
CEO
70%
?ND.
CONTACT:
Any..
FIRST AND LAST
HOmE' JIDDRE3S " , :,-
a
ZIP CODE
DA"fE OF BIR'rli
STREET ADDRESS CITtf' . STATE
(mrnfdd(yy) '
Meghan Adas
3262 Elm St. Denver, CO 80207
04/28/2090
EMAIL ADDRESS
PHONES
PosrrneN
%OWNERSHIP
madas@stadiummedical.com
(720) 384-3189 l
COO
4.72%
3
co30/2056..4,
, . Z.,
NAnAE
FIRST AND LAST
HOME ADDRESS ,, .:. . ::.,
.
A P CODE
"";DAT rOESIRTH`,'`,
STREETSODRE59_ rn
uyy)
Wiliam Veltman
12654 Buckhorn DriveLittleto 80127
01oenld
EMAIL ADDRESS
• P.NOAE
,POSITION
'%'OVYMERSHIP
303-809-5347
Partner
8%
--
aril
'-~coivrACT -'
.:. .: .-NAME
FIRST AND LAST:.,
.- .•.-- • , .,, _.,. ,- )IOME'ADDRESS
- - • `," ,
. ZIP CODE
--iDATE`OFBIRT1+, T.
STREET ADDRESS CITY ' STATE
(mmfddlyyr)
Andrew W. Parker
5000 E. Oxford AvenueCher Village, CO 80113
w Hills Villa g
EMAIL ADDRESS
PHONE 0
• > • POSITION
% OWNERSHIP
Partner
4.72%
_ -. '.'
.;. 5114
CONTACT
..... .. ... ... NAME
FIRST AND LAST
HOME'ADDRESS : -=•
ZIP CODE
-DATE`OF
STREET ADDRESSCITY STATE
(mmlddfyy)
Miriam McCarty
419 Majestic View rlveBou er, COC 80 0
EMAIL
P,HDNE POSrrION
RSHIP .
q6 Prig ,:.
Partner
4.72%
^moo
,..... N•AME
FIRST AND LAST
HOME ADDRESS F(,,•DATE
- P CODE
of BIRTH
$TREETAbDRESS;,'. C "' STATE
,'' dd j
Charles Rupert
6888 Otis CourtArvada, CO 80003
12/6/60
EMSIL:AD RESS i
- -
• £I 'C!P E
-. ..
z. P0,.? pN ' e
.. e h: .ig
: d �'X+'OW ERSHIP`
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Partner
8.9%
How many ambulances do you operate? '2-1
Location and description of the place(s) from which this ambulance service will operate. If there
are more than two locations, attach a separate sheet with the above information.
Location #1:
Street Number: ioCt$' 0111,49:4- 40Utlur"'
City: 1)i'JVE1'L— State: em, Phone: $Z'72,4
Location #2:
Street Number: L-L5r Crr-- 5s6r,1'$11ar3S A-nPChf v
City: State: Phone:
As required in Section 7-3-30 of the Weld County Code Ordinance and Chapter 4 Section 6 of
the CDPHE Emergency Medical and Trauma Care System regulations, as of the date of the
application, are you in compliance with the minimum data collection and reporting of
transportation and/or treatment of patients:
'Yes ❑No
As required in Section 7-3-40 of the Weld County Code and Chapter 3 Section 3 of the CDPHE
Emergency Medical Services regulations, as of the date of the application, are you in compliance
with the reporting requirements of the agency profile:
gYes ❑ No
Please read carefully:
Sec. 7-2-10 License for Ambulance Service. 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 below. 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.
Level of Service Requested: ❑ Tier I ❑ Tier II LJ Tier III
Page 2
STADIUM
*MEDICAL*
Locations of Operations
Main Headquarters: 695 Canosa Ct. Denver, CO
80204
Substations:
Fairmount Fire Station: 12901 W 43rd Dr,
Golden, CO 80403
Pleasant View Fire Station: 955 Moss St,
Golden, CO 80401
Golden Fire Station #1: 911 10th St, Golden, CO
8O401
I HEREBY CERTIFY THAT I AM AUTHORIZED TO SUBMIT THE FORGOING
APPLICATION AND THE INFORMATION PROVIDED IN THIS APPLICATION IS TRUE
TO THE BEST OF MY KNOWLEDGE AND BELIEF AND CONTAINS NO WILLFUL
MISREPRESENTATION OR FALSIFICATION.
IN ADDITION, I CERTIFY THAT I HAVE READ AND UNDERSTAND THE PROVISIONS
AND REQUIREMENTS OF WELD COUNTY CODE CHAPTER 7, INCLUDING, BUT NOT
LIMITED TO, SECTION 7-8-10, WHICH ENCOURAGES ALL LICENSED AGENCIES
PROVIDING EMS RESPONSE IN WELD COUNTY TO MAKE A GOOD FAITH EFFORT TO
EXECUTE WRITTEN MUTUAL AID AGREEMENTS WITH ALL OTHER EMS PROVIDERS
LOCATED WITHIN OR BORDERING ON THEIR AREAS OF RESPONSE.
DETERMINATION THAT AN AMBULANCE SERVICES LICENSE HAS BEEN ISSUED
BASED ON FALSE INFORMATION CONSTITUTES GROUNDS FOR LICENSE
REVOCATION AND POSSIBLE CRIMINAL PROSECUTION.
cg -t oPaainf44 DfF'I cI2- tO/I4_.I21
Signatw•e off icant
My Commission expires:
Page 7
Title Date
SUBSCRIBED AND AFFIRMED BEFORE ME THIS I'i
DAY OF61;e� , 20 ZZ , IN THE COUNTY OF
NI , STATE OF COLORADO.
Signature of Notary
7
7,e,
SCOTT A. PHILLIPS
NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 20094016691
MY COMMISSION EXPIRES JULY 14.2025
map f Servke Are
S uroundhi ; Crunfles
ewer Metri -1r a and
STADIUM
*MEDICAL*
Mutual Aid Agreements
Stadium Medical currently has Mutual Aid Agreements
with:
Northglenn Ambulance
Action Care Ambulance
Denver Health
Summit County
Rodger Ames
President, Stadium Medical
Hello