The URL can be used to link to this page

Browse Search

Home My WebLink About20213316.tiffRESOLUTION RE: APPROVE APPLICATION FOR TIER II AMBULANCE SERVICE LICENSE AND AUTHORIZE CHAIR TO SIGN - AMBULNZ CO, LLC 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 Ambulnz CO, LLC, for a Tier II Ambulance Service License and recommend approval, and WHEREAS, after review, the Board deems it advisable to approve said Application for a Tier II 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 Ambulnz CO, LLC, for a Tier II 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 6th day of December, A.D., 2021. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: G. XL 72 - Steve M ' reno. hair Weld County Clerk to the Board County rney Date of signature: cc: HL(Tm/'v),OEKCRR' o./p.O /2 2021-3316 HL0053 Memorandum TO: Steve Moreno, Chair Board of County Commissioners FROM: Mark A. Lawley, Executive Director Department of Public Health & Environment DATE: November 29, 2021 SUBJECT: 2022 Applications for Ambulance Service Licenses Enclosed for the Board's review are sixteen applications for ambulance service licenses, pursuant to the 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 17, 2021, and approved all sixteen applications. 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 Tier II Banner Health/NCMC Paramedic Service 1801 16th St. Greeley, CO Platte Valley Ambulance Service 1750 E. Egbert St. Brighton, CO Ambulnz CO, LLC 7100 E. Belleview Ave., Ste. 112 , Greenwood Village, CO Frederick Firestone Fire Protection District 8426 Kosmerl Pl. Frederick, CO Platteville Gilcrest Fire Protection District 202 Main St. Platteville, CO American Medical Response of Colorado 3800 Pearl St. Boulder, CO Front Range Fire Rescue 101 S. Irene Ave. Milliken, CO Southeast Weld Fire Protection District 95 W. Broadway Ave. Keenesburg, CO Tier III Greeley Fire Department 1155 10th Ave. Greeley, CO Thompson Valley EMS 4480 Clydesdale Pkwy. Loveland, CO Stadium Medical, Inc. 695 Canosa Ct. Denver, CO North Metro Fire Rescue District 101 Spader Way Broomfield, CO UCHealth EMS 1024 S. Lemay Ave. Fort Collins, CO Mile High Ambulance Service 3251 N. Stagecoach Rd. Englewood, CO Mountain View Fire Protection District 3561 Stagecoach Rd., Unit 200 Longmont, CO Windsor Severance Fire Protection District 100 N. 7th St. Windsor, CO 12/DU �1L Ws3 0 0 rorstonotworemrourffromparomtem ol at oi 121 ol �J WELD COUNTY DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT License to Operate Ambulance Service TIER II AMBULNZ CO, LLC Name of Service 7100 E. BELLEVIEW AVENUE, STE 112, GREENWOOD VILLAGE, COLORADO 80111 Address AMBULNZ HOLDINGS, LLC f UCHEALTH Name of Owner IS LICENSED UNTIL DECEMBER 31, 2022, TO OPERATE AN AMBULANCE SERVICE IN WELD COUNTY IN ACCORDANCE WITH EXISTING WELD COUNTY RULES AND REGULATIONS. CHAIR, BOARD OF WELD COUNTY COMMISSIONERS DEC o s 2021 NOT TRANSFERRABLE / POST IN A CONSPICUOUS PLACE DATE Tier II: Licensure authorizing for transports of patient(s) to and from licensed medical facilities. This licensure does not provide for Primary Care, as defined in Section 7-1-30 of the Weld County Code. rosterastop 0 ter tes Le" JG J� ter te" JG Lea E". raPPPiarsaimaraPPPPiarard • 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: Ambulnz Colorado As required in Section 7-2-100.6.5., 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 are the basis for the Council's recommendation: FINDING #1: Ambulanz Colorado provides interfacility transportation of patients from facilities within Weld County to facilities in the metro area of Denver. The service allows for Weld units to remain available within the county for a 911 response. FINDING #2: Ambulanz contributes to an efficient, effective, and coordinated service for the citizens and guests of Weld County. FINDING #3: Ambulanz has all necessary State of Colorado Mutual Aid Channels to communicate with agencies in the event of a significant event in Weld County. FINDING #4: The Weld County EMTS Council has not been made aware of any negative or problems with service delivery to the citizens and guests of Weld County. Recommended Level of Service: InTier 1 Filler 2 nTier 3 Recommended Service Area: Ambulanz has provided a service area map within the license application. Upon review, there are no concerns with the service area. Other EMTS Council recommendations or comments: The EMTS Council voting members recommend the Weld County Department of Health and Environment and the Board of County Commissioner to approve Ambulanz for a Tier II license. Recommendation By: Jeff Stiafiahan EMTS Council Chair Date: 11/17/2021 WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 North 17th Avenue, Greeley, CO 80631 www.weldhealth.org AMBULANCE SERVICE LICENSE APPLICATION Date of Application: October 27, 2021 Name of Ambulance Service: Ambulnz Co LLC Owner: Name: Please see attached documentation. Address: Phone Number: Operations Manager: Name: Candice Moncayo Address: 7100 E. Belleview St. Suite 112 Greenwood Village 80111 Phone Number: 720-354-6833 Email: cmoncayo@ambulnz.com Medical Director: Name: Dr. Angela Wright and Dr. Eric Wu Address: Please see attached documentation. Phone Number: 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): Please see attached documentation. What area of Weld County will be served by this company? Please attach a map indicating the service area. Please see attached documentation. Health Administration Vital Records Tele: 970-304-6410 Fax: 970-304-6412 Public Health & Clinical Services Tele: 970-304-6420 Fax: 970-304-6416 Environmental Health Services Tele: 970-304-6415 Fax: 970-304-6411 Communication, Education & Planning Tele: 970-304-6470 Fax: 970-304-6452 Emergency Preparedness & Response Tele: 970-304-6470 Fax: 970-304-6452 PublicHealth Page 1 Medical Director Medical Director: Dr. Eric Wu, MD eric.wu.md@gmail.com Qualifications: Please see attached CV. Company Name: Ambulnz CO, LLC 2420 E. Pikes Peak Avenue, Suite 1001 Colorado Springs, CO 80909 866-255-7671 Ownership 50% Ambulnz Holdings, LLC 50% University of Colorado Health Owner Information: Ambulnz Holdings, LLC 35 West 35th Street, 5th Floor New York, NY 10001 212-273-9774 Owner Information: University of Colorado Health 12401 E. 17th Avenue Mail Stop F415, Aurora, CO 80045 720-848-0000 Manager or Responsible Individual: Candice Moncayo 7100 E. Belleview Ave Suite 112 Greenwood Village, CO 80111 720-354-6833 Authorized Contact Personnel: Candice Moncayo 7100 E. Belleview Ave Suite 112 Greenwood Village, CO 80111 720-354-6833 Management: Ambulnz Holdings, LLC How many ambulances do you operate? 19 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: 7100 E. Belleview St. Suite 112 City: Greenwood Village State: CO Phone: 720-354-6833 Location #2: Street Number: 2420 E. Pikes Peak Ave Suite 1001 City: Colorado Springs State: CO Phone: 720-354-6833 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: 2rYes ❑No As required in Suction 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: Yes 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 O Tier II ❑ Tier III Page 2 Business Office / Main Location: 2420 East Pikes Peak Ave. Suite 1001 Colorado Spring, CO 80909 Business Office/ Secondary Location: 7100 E. Belleview Ave. Greenwood Village, CO 80111 Main Dispatch Center: UCHealth Administration Building 2450 S. Peoria St. Aurora, CO 80014 866-255-7671/720-553-0511 Backup Dispatch Centers: 2627 10th Ave. Tuscaloosa, AL 35401 35 West 35th St. 5th Floor New York, NY 10001 Vehicle Locations: 2420 East Pikes Peak Ave. Suite 1001 Colorado Spring, CO 80909 16990 Village Center Dr. East, Parker, CO 80134 9475 S. University Blvd. Highlands Ranch, CO 80126 7100 E. Belleview Ave. Suite 112, Greenwood Village, CO 80111 11820 Destination Dr. Broomfield, CO 80021 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. £Cr1Crt& Signature afipplicant 7i11e SUBSCRIBED AND AFFIRMED BEFORE ME THIS 28*` DAY OF Ocrb66e , 20 ZI , IN THE COUNTY OF i4LA'McY , STATE OF COLORADO. r -�r ignature of Notary STEVEN ZAUGG NOTARY PUBLIC STATE OF COLORADO NOTARY ID 20034009024 PAY COMMISSION EXPIRES 03114/2023 My Commission expires: O3 / 14 / Zo23 Page 7 Operations, Locations, Service area, Personnel & Ambulances Service Area: Moffat Routt Rio Blanco Garfield arimer Jackson Grand Eagle Mesa Delta Montrose O San Miguel Dolores Pitkin Lake Gunnison Boulder Cle Cr Par co San Juan Montezuma La ' Plata S or CD c 0 Weld e Logan organ Adams Arapahoe Elbert glas Fremont Saguache 5 cD Custer Rio Grande Archuleta Conejos El Pas Pueblo Huerfa-io Costilla ashington incoln Crowley Sedgwi ck Phillips Yuma Kit Carson Cheyenne Kiowa Otero Bent Las Animas Prowers Baca Ambulnz l nz currently operates in the following counties: • Adams • Arapahoe • Boulder • Broomfield • Denver • Douglas • Elbert • El Paso • Jefferson • Larimer • Weld Hello