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Home My WebLink About20213315.tiffRESOLUTION RE: APPROVE APPLICATION FOR TIER I AMBULANCE SERVICE LICENSE AND AUTHORIZE CHAIR TO SIGN - WINDSOR -SEVERANCE FIRE PROTECTION 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 Windsor -Severance Fire Protection 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 Windsor -Severance Fire Protection 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: /,,dttaot) 4.feliD•&k, Weld County Clerk to the Board County A`orney Date of signature: reno, C air Steve S mes, Pro-Te Cc: HLCTG/60, OE-tCRRr! 1?/ao/2 2021-3315 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 12/0(0 f L -OD 0 rotostrowarompourommoromm al pi el 21910101 oil [21 oi WELD COUNTY DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT License to Operate Ambulance Service TIER I WINDSOR -SEVERANCE FIRE PROTECTION DISTRICT Name of Service 100 NORTH 7TH STREET, WINDSOR, COLORADO 80550 Address WINDSOR SEVERANCE FIRE PROTECTION 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 1 CHAIR, BOARD OF WELD COUNTY COMMISSIONERS DATE NOT TRANSFERRABLE / PO5 IN A CONSPICUOUS PLACE Tier I: Licensure authorizing for Primary Care, as defined in Section 7-1-39 of the Weld County Code. O proirataromorstonourommoreta al al al al 91 al al al al 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: Windsor Severance FPD As required in Section 7-2-100.8.5., 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: Windsor Severance Fire Rescue (WSFR) provides Advanced Life Support treatment and transport ambulances through a contractual agreement with UCHealth EMS to provide service to the citizens and guests of Weld County. They have an excellent working relationship with neighboring agencies and will provide service to them when requested. FINDING #2: WSFR ensures that the service contributes to an efficient, effective, and coordinated emergency medical response to the citizens and guests of the response areas. WSFR will provide support to the neighboring agencies when called upon to do so. FINDING #3: WSFR does formally have mutual aid agreements with FRFR, LFRA, GFD, PFA, APFPD, EFPD, UCHealth EMS, TVEMS, Banner Health Paramedic Sevice, and Weld County Fire Agencies MA. Whenever called upon, WSFR will assist any requesting agencies. 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: [Tier 1 [Tier 2 [Tier 3 Recommended Service Area: In reviewing the service area map submitted by WSFR, 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 Windsor Severance Fire Rescue for a Tier I license Recommendation By: Je'ff Stfarnahan EMTS Council Chair Date: 11/18/2021 WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 North 17th Avenue, Greeley, CO 80631 www.weidhealth.org AMBULANCE SERVICE LICENSE APPLICATION Date of Application: October 10, 2020 Name of Ambulance Service: Windsor Severance Fire Protection District Owner: Name: Windsor Severance Fire Protection District Address: 100 North 7th Street, Windsor, CO 80550 Phone Number: 970-686-2626 Operations Manager: Name: Erik Morse Address: 100 North 7th Street, Windsor, CO 80550 Phone Number: 970-686-2626 Email: emorse@wsfr.us Medical Director: Name: Darren Tremblay, D.O. Address: 1024 South Lemay Avenue, Fort Collins, CO 80524 Phone Number: 970-495-8006 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): Not applicable What area of Weld County will be served by this company? Please attach a map indicating the service area. Windsor, Severance and western Weld County 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 PablicHealth Page 1 How many ambulances do you operate? Two, one primary and one reserve 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: City: Windsor Location #2: Street Number: 100 North 7th Street State: CO Phone: 970-686-2626 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 CI 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: f Tier I ❑ Tier II ❑ Tier III Page 2 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 REVOCATIQN AND POSSIBLE CRIMINAL PROSECUTION. Signatte of Applicant N N 1 (4t 0 j?f Title Date SUBSCRIBED AND AFFIRMED BEFORE ME THIS /' DAY OF 0 Gfc' t-4 r , 20 2- / , IN THE COUNTY OF , STATE OF COLORADO. Signature of Notary My Commission expires: i95 / 2 -7 / Z 6i 4 y Page 7 t S In n n. ••.•.I, 4InVHrtt•r rltlmmntmmflnnmtnM nl'Hamm}ntlntn rtmntt-•••t,••••1„nr/11nMTlf.., • ynNDSo4 Alt "9. 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S, !A..Lt. dt,a,41luue.�1, car r, a••.•aMaMiMYAYM11MeA11Wt ao \t•\ )OHNSTOWN FIR OROTECTION DISTRICT IPI WINDSOR SEVERANCE FIRE RESCUE 100 N. 7th Street • Windsor • Colorado • 80550 970-686-2626 October 10, 2021 Mutual Aid departments that Windsor Severance Fire Rescue operates with: Fire Departments: • Loveland Fire Rescue • Greeley Fire Rescue • Poudre Fire Authority • Ault -Pierce Fire Protection District • Eaton Fire Protection District • Front Range Fire Rescue EMS Transport Agencies: • UCHealth EMS • Thompson Valley Ambulance Service • Banner Ambulance Follow us on • Instagram • Facebook • Twitter • www.wsfr.us Hello