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Home My WebLink About20213305.tiff RESOLUTION RE: APPROVE APPLICATION FOR TIER I AMBULANCE SERVICE LICENSE AND AUTHORIZE CHAIR TO SIGN — FREDERICK-FIRESTONE 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 Frederick-Firestone 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 Frederick-Firestone 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: • .�IC.�GIO;K Steve oreno, Chair Weld County Clerk to the Board • Sco s, Pro-Tem �I V BY: Deputy Clerk to the Boardlit,,,..,„„w " P ry L. Bu A / ED F*R 2 0 � EXCUSED V t RIM� ike Freeman County Attorney '��; ~l / �`to �� Lori Sain Date of signature: I ,..,� EC:HLCTG/64,0EROM 2021-3305 ( HL0053 1861 Memorandum ,-,----, __ ,,---,------;c- --; C ----'• ��_/ \,' TO: Steve Moreno,Chair 7] 1 N T Y =� Board of County Commissioners G O u__�—T I 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 Platte Valley Ambulance Service Ambulnz CO, LLC Paramedic Service 180116th St. 1750 E. Egbert St. 7100 E. Belleview Ave.,Ste. 112 Greeley, CO Brighton,CO Greenwood Village,CO Frederick Firestone Fire Platteville Gilcrest Fire American Medical Response Protection District Protection District of Colorado 8426 Kosmerl Pl. 202 Main St. 3800 Pearl St. Frederick, CO Platteville,CO Boulder, CO Front Range Fire Rescue Southeast Weld Fire 101 S. Irene Ave. Protection District Tier III Milliken, CO 95 W. Broadway Ave. Keenesburg, CO Greeley Fire Department Thompson Valley EMS Stadium Medical, Inc. 1155 10th Ave. 4480 Clydesdale Pkwy. 695 Canosa Ct. Greeley, CO Loveland, CO Denver,CO North Metro Fire Rescue District UCHealth EMS Mile High Ambulance Service Res Spader Way 1024 S. Lemay Ave. 3251 N.Stagecoach Rd. 101Broomfield, CO Fort Collins,CO Englewood, CO Mountain View Fire Windsor Severance Fire Protection District Protection District 3561 Stagecoach Rd., Unit 200 100 N. 7th St. Longmont,CO Windsor, CO 0 FaraPPPPPRIDPIDP [0 . FaraialaniaraPiarararaPPP 0 5 WELD COUNTY DEPARTMENT OF E G PUBLIC HEALTH & ENVIRONMENT GLicense to Operate Ambulance Service E. G TIER I E G E GFREDERICK• FIRESTONE FIRE PROTECTION DISTRICT IName of Service 8426 KOSMERL PLACE , FREDERICK , COLORADO 80516 E IAddress IFREDERICK FIRESTONE FIRE PROTECTION DISTRICT 5 IName of Owner GIS LICENSED UNTIL DECEMBER 31 , 2022 , TO OPERATE AN AMBULANCE SERVICE IN WELD COUNTY IN ACCORDANCE E � ' WITH EXISTING WELD COUNTY RULES AND REGULATIONS . Esu1 ”E" , , ni :‘ ‘ \ i . „ 71 E El A • 7) 2C---L-C )^stX CEC 0 6 2021 s I ' E CHAIR . BOARD OF WFI fl C : ( � I INTY CnMMISSIONERS DATE � V y ,I" . , all ` / NOT TRANSFERRABLE / POST IN A CONSPICUOUS PLACE E. G E SI Tier I : Licensure authorizing for Primary Care , as defined in Section 7 - 1 - 39 of the Weld County Code . Ems a"D° E ad aioialraMp _ o pp p rap _ ralp pogtoloolasio 11 0 • r 4 Irgi !I WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1/1 1555 North 17th Avenue, Greeley, CO 80631 www.weldhealth.org Recommendation of the Weld County Emergency Medical/Trauma Service Council for: Frederick Firestone FPD 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: Frederick Firestone Fire Protection District(FFFPD)provides Advanced Life Support treatment and transport service to citizens and guests of Weld County. They have a strong working relationship with neighboring agencies and will provide service to them when necessary. FINDING#2: FFFPD service contributes to an efficient,effective, and coordinated emergency medical response to their Fire District. FFFPD supports the neighboring agencies when called upon to do so FINDING#3: FFFPD has an excellent working relationship with the surrounding agencies. FFFPD has formal agreements with Platteville Gilcrest and Mountain View Fire Protection districts and Weld County Fire Agenices Mutual Aid agreement.They will informally help out any agency that requests their assistance. 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 nTier 3 Recommended Service Area: In reviewing the service area map submitted by FFFPD,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 Frederick Firestone Fire Protection District for a Tier I license. Recommendation By: 'Date: 11/17/2021 Jeff ra an EMTS Council Chair i cA 'It',) WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1, ` , 1555 North 17th Avenue, Greeley, CO 80631 www.weldhealth,org AMBULANCE SERVICE LICENSE APPLICATION Date of Application: I DI III 2o1--\ Name of Ambulance Service: i'Ced,Aryl{— rt tt{SIVet t_ FPO Owner: Name: Frehr,a— r‘fedichie PAD Address: $424 ko5r,142.4..1 pt. fee.66,rr' ic_,14 5 05-0c) Phone Number: 3363— $33-a7y2 Operations Manager:/ 11 nr Prt4— Name: T, efA J NI$Address: '12(0 k o ,i i er r ?L, Phone Number:'—aQ--(04 l•-ALI Email: 4ru41k Q C12( t' , kt5 Medical Director: Name: pf• Dev. el\2et< Address: SAC. [ yea 4.44,1014,fI 4-ftvx MAGI tddX C.ti 1k) Phone Number: WO—f'73.-5 d(e y Name and address of each stockholder of partner owning 10%or more of the outstanding stock of the conx711of 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. � ,, -n M.f. 1tti t Health Administration Public Health& Environmental Health Communication. Emergency Preparedness Vital Records Clinical Services Services Education&Planning &Response Tele:970-304-6410 lele:970-304-6420 Tele:970-304-641.5 fele:970-304-6470 Tele:970-304-6470 7- Fax: 970-304-6412 Fax: 970-304-6416 Fox: 970-304-6411 Fax; 970-304-6452 Fax: 970-304-6452 PublicHealth Page 1 How many ambulances do you operate? L I 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: Set � Street Number: 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: gees ❑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: XYes ❑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: Iicensure 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 ❑ Tier III Page 2 FREDERICK FIRESTONE f t ;1 ,0.•1„},,it"\!: Operations Section FIRE PROTECTION DISTRICT •/ Office: (303) 833-2742 Fax: (303) 833-3736 40 ; E-Mail: dprunk@fffd.us IIrI October 12,2021 The Frederick-Firestone Fire Protection District currently has three fire stations. Each fire station houses one or two of the District's Ambulances. These ambulances are located at: Station#1 - Ambulance 3421 31 Walnut Drive Frederick, CO 80530 303-833-3727 Station#3 - Ambulance 3423 6800 Tilbury Avenue Firestone, CO 80504 303-833-4458 Station#4 - Ambulance 3424, Reserve Ambulance 3428 10706 WCR 7 Frederick, CO 80504 303-710-1720 Respectfully, Douglas J.Prunk Assistant Chief Physical:8426 Kosmerl Place,Frederick,CO 80504,Mailing:P.O.Box 129,Frederick,CO 80530;www.fffd.us I HEREBY CERTIFY THAT I AM AUTHORIZED TO SUBMIT THE FORGOING APPLICATION AND TI IE 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 TIIE 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 REV TION AND POSSIBLE CRIMINAL PROSECUTION. ASS"- D gnature of Applicant Title Da e 111-4122e."1 SUBSCRIBED AND AFFIRMED BEFORE ME THIS 15 DAY OF OC*DB , 20 'Z. I , IN THE COUNTY OF Wet-6 , STATE OF COLORADO. ERIKA L.VASQUEZ __,� , Q NOTARY PUBLIC l�tc /L. STATE OF C 174031 O NOTARY ID 2017�931773 Signature of Nota —MIV COMMISSION EXPIRES 07125J1125 My Commission expires: 01./ 2.8/2025 Page 7 FREDERICK FIRESTONE ►^t !�:;,,1��'► Operations Section FIRE PROTECTION DISTRICT * Office: (303) 833-2742 si , Fax: (303)833-3736 '0a t E-Mail: dprunk@fffd.us Hui October 12,2021 The Frederick-Firestone Fire Protection District currently has EMS Mutual-Aid agreements with the following agencies: • Mountain View Fire Protection District • Platteville-Gilcrest Fire Protection District Respectfully, Doug Prunk Assistant Chief Physical:8426 Kosmerl Place,Frederick,CO 80504,Mailing:P.O.Box 129,Frederick,CO 80530;www.fffd.us I - 1 Frederick Firestone Fir Response Zones . • • i 4/ 14111.. ........,7 • 1 t SI :81Z.411 s ' . . l NW N .•02 1 14•••••••••4<i 42 1 11 . • • � • '� Te411•C• :Di I .4 • I e i t 1 r/(, ,��II " • . • •• f-- i - • I 1 1 1 • •• • f • • • • • 1 1 • • A • • • I 1 • • 1 • • • • • • • • • / • • • • 1• • • • • • 1 • • • % . • • . . • . • = • • • ' tit + • • • • f • • • . •• •e •. . • . . . 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