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Home My WebLink About20213309.tiffRESOLUTION. RE: APPROVE APPLICATION FOR TIER I AMBULANCE SERVICE LICENSE AND AUTHORIZE CHAIR TO SIGN - NORTH METRO FIRE RESCUE DISTRICT 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 the North Metro Fire Rescue District for a Tier I Ambulance Service License and recommend approval, and WHEREAS, after review, the Board deems it advisable to approve said Application for a Tier I 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 the North Metro Fire Rescue District for a Tier I 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: daicsA) ..e. Weld County Clerk to the Board BY: Steve ;•reno, Chair Perry L. Bu AP=XCUSED County '''"orney Lori Sai Date of signature: cc..1-it.(1-6/6v),00-kakit) (2/20% 2021-3309 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 180116th 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 0 0 PPRPP[Pf[aPP1DrarnrararJrDPPrnraPraP WELD COUNTY DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT License to Operate Ambulance Service TIER I NORTH METRO FIRE RESCUE DISTRICT Name of Service 101 SPADER WAY, BROOMFIELD, COLORADO 80020 Address NORTH METRO FIRE RESCUE DISTRICT 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. p J CI IAIR, BOARD OF WELD COUNTY COMMISSIONERS DATE NOT TRANSFERRABLE / POST IN A CONSPICUOUS PLACE Tier I: Licensure authorizing for Primary Care, as defined in Section 7-1-39 of the Weld County Code. EiDJL2Jr1N�h?JE!TEffiuIEJE 0 0 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: North Metro Fire Rescue District As required in Section 7-2-100.B.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: North Metro Fire Rescue (NMFR) provides Advanced Life Support treatment and transport ambulances to the citizens and guests of Weld, Broomfield, and Adams County. They have a strong working relationship with neighboring agencies and will provide service to them when requested. FINDING #2: NMFR ensures that the service contributes to an efficient, effective, and coordinated emergency medical response to the citizens and guests of the response area. NMFR will provide support to the neighboring agencies when called upon to do so. FINDING #3: NMFR has a strong working relationship with the surrounding agencies and has formal agreements with Adam County Fire PD, Brighton FPD, Federal Heights Fire Department, Lafayette FD, Louisville FPD, Mountain View FPD, South Adams County FPD, Thornton FD, and Westminster FD. NMFR will respond when requested to assist agencies outside of their district. FINDING #4: The Weld County EMTS Council has not been made aware of any negative or problematic concerns with service delivery to the citizens and guests of Weld County. Recommended Level of Service: nTier 1 [Tier 2 [Tier 3 Recommended Service Area: In reviewing the service area map submitted by NMFR, the EMTS Council has no concerns and supports the service area indicated. Other EMTS Council recommendations or comments: The EMTS Council voting members recommend that the Weld County Department of Health and Environment and the Board of County Commissioner approve North Metro Fire Rescue for a Tier I license. Recommendation By: nahan 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: A 2,O 1 24,21 Name of Ambulance Service: k‘o(2,11.1 T% tAGre.O Fdis- QF$.L "c>siv1C V Owner: Name: 5 fE aix 1of r c-tt tE,c Address: 10 eoPAx(L OW TA-00mAE —li O' gpO2z Phone Number: 361- NSA - °M ID Operations Manager: Name: age i3t(i3fC - OPfgArta cAktLF Address: \OO SQA 6JAY PlezuviFt—'D CO Z0(32D Phone Number: c3 -%)5 -'ia 10 Email: '3 t=F 121H2;a: e.....Jpavvit:Twt1F t R, -' Medical Director: Name: AL c' 112_ /ELLM AN 1 MciP Address: Phone Number: 34 VfriA1 402.3.3.1 KELJao7 co ISO -3t\ -`-«61 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): What area of Weld County will be served by this company? Please attach a map indicating the service area. Health Administration Vital Records Tele: 970-304-6410 Fax: 970-304-6412 Public Health & Clinical Services fele: 970-304-6420 Fax: 970.304.6416 Environmental Health Communication. Services Education & Planning Tele:970-304.6415 Tele: 970-304-6470 Fox: 970-304-6411 Fax: 970-304-6452 Emergency Preparedness & Response Tele: 970-304-6470 Fox: 970-304-6452 PublicHealth Page t How many ambulances do you operate? CJ 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: AcTT`AC.�1C� City: State: Phone: Location #2: Street Number: 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: 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: IX Tier I ❑ Tier II ❑ Tier III Page 2 North Metro Fire Rescue District Ambulances Station 61 Medic 61 M12 - 2015 Ford Plate # OJY-233 1FDXE4FS8FDA24978 Reserve Ambulance M7 - 2011 Ford Plate # ORU-064 1FDXE4FS1BDA61266 1275 W Midway Blvd Broomfield CO 8002O Station 82 10550 Huron St Northglenn CO 80234 Station 63 10941 Irma Dr Northglenn CO 80233 Station 64 13515 Lowell Blvd Broomfield CO '80020 Station 65 9900 W 120 Ave Broomfield CO 80020 Station 66 1750 W 160th Ave I Broomfield CO 80020 Station 67 13875 S 96th Street Broomfield CO 80020 Station 68 1006 WCR 11 Erie CO 80602 Medic 62 M8 - 2011 Ford Plate # ORU-065 1FDXE4FS68BDB09054 Medic 63 M13 - 2015 Ford Plate # QJY-234 1FDXE4FSXFDA24979 Medic 64 M10 - 2012 Ford Plate # ORU-067 1FDXE4FS5DDA19430 Baraitric Ambulance M3 - 2000 Ford Plate ft ORU-063 1FDXE45F5YHB85479 Medic 66 M14 - 2019 Ford AEV Plate # BHJL90 1FDXE4FS8KDC36113 Reserve Ambulance M11 - 2015 Ford Plate # 099-VQE 1FDXE4FS8FDA00051 1 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 REVOCATIIIN : i POSSIBLE CRIMINAL PROSECUTION. E NS LA.\ Title Date Date SUBSCRIBED AND AFFIRMED BEFORE ME THIS DAY OF - 444 20 v , IN THE COUNTY OF fit` , STATE OF COLORADO. My Commission expires: 1-' (S LZA0 HEATHER W. BROWN NOTARY PUBLIC STATE OF COLORADO NOTARY ID 19974012875 MY COMMISSION EXPIRES 07t1Sl2O2S Page 7 North Metro Fire Rescue District — Mutual Aid Agencies 2021 - Adams County Fire Protection District - Brighton Fire Protection District - Federal Heights Fire Department - Lafayette Fire Department - Louisville Fire Protection District - Mountain View Fire Rescue Protection District - South Adams County Fire Department - Thornton Fire Department - Westminster Fire Department Denver Metro Area Departments 10/23/19, 11:16 AM 1 $ I I I LI 5 0 .,. O'S '" 1 m i w 136th Ave 4.110 i I I I W 144th A v • . 36 Hf-(A3mi#eiCi County Rood 8 I I 1 a a.. .a... s, w.. sir .,.ru. 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