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Home My WebLink About20203769.tiffRESOLUTION RE: APPROVE APPLICATION FOR TIER I AMBULANCE SERVICE LICENSE AND AUTHORIZE CHAIR TO SIGN - THOMPSON VALLEY EMERGENCY MEDICAL SERVICE 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 Thompson Valley Emergency Medical Service 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 Thompson Valley Emergency Medical Service 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 16th day of December, A.D., 2020. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: dcetirjA)�' j,dea•‘,e Weld County Clerk to the Board BY: Deputy Clerk to the Board APP' e vD AS y torney Date of signature: a/L3/?0�'` Mike Freeman, Chair StevMoreno, Pro -Tern ott K. James Kevin D. Ross cc: I- L(TG//v), OE'M(RR) otiose/al 2020-3769 HL0052 Memorandum TO: Mike Freeman, Chair Board of County Commissioners FROM: Mark A. Lawley, Executive Director Department of Public Health & Environment DATE: December 11, 2020 SUBJECT: 2021 Applications for Ambulance Service Licenses Enclosed for the Board's review are fifteen 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 18, 2020, and approved all fifteen applications. Changes from 2020 include the addition of Ambulnz CO, LLC as a new Tier II ambulance service. Mile High Ambulance Service was previously approved in September 2020 for licensure through 2021. 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 Banner Health/NCMC Paramedic Service 1801 16th Street Greeley, CO Frederick Firestone Fire Protection District 8426 Kosmerl Place Frederick, CO Front Range Fire Rescue 101 South Irene Avenue Milliken, CO Greeley Fire Department 1155 10th Avenue Greeley, CO Mountain View Fire Protection District 3561 Stagecoach Road, Unit 200 Longmont, CO Tier I (continued) North Metro Fire Rescue District 101 Spader Way Broomfield, CO Platte Valley Ambulance Service 1750 East Egbert Street Brighton, CO Platteville Gilcrest Fire Protection District 202 Main Street Platteville, CO Poudre Valley Hospital EMS 3509 South Mason Fort Collins, CO Southeast Weld Fire Protection District 65 East Gandy Avenue Keenesburg, CO Tier I (continued) * Thompson Valley EMS 4480 Clydesdale Parkway Loveland, CO Windsor Severance Fire Protection District 100 North 7th Street Windsor, CO Tier II Ambulnz CO, LLC 7100 East Belleview Ave., Ste. 112 Greenwood Village, CO American Medical Response of Colorado 3800 Pearl Street Boulder, CO Tier III Stadium Medical, Inc. 695 Canosa Court Denver, CO 2020-3769 N LOOS' CJJtica.I ci DIELIDSIEJEiDi ci ci..ci ci ci ci c ci ci ci cl cJ WELD COUNTY DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT License to Operate Ambulance Service TIER I THOMPSON VALLEY EMERGENCY MEDICAL SERVICE Name of Service 4480 CLYDESDALE PARKWAY, LOVELAND, COLORADO 80537 THOMPSON Address LLEY HE ,,,•, LTI"I SERVICES S DISTRICT Name of Owner IS LICENSED UNTIL DECEMBER 31, 2021, TO OPERATE AN AMBULANCE SERVICE IN WELD COUNTY IN ACCORDANCE WITH EXISTING WELD COUNTY RULES AND REGULATIONS. DEC 1 6 2020 CHAIR, BOARD OF WELD COUNTY COMMISSIONERS 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. DATE �.� seas • 1961 G.0 N 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: Thompson Valley EMS 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 is the basis for the Council's recommendation: FINDING #1: Thompson Valley EMS provides EMS Transport services with the Berthoud Fire Protection District, which resides within Weld County. The majority of TVEMS response areas are in Larimer County, and they provide mutual aid to agencies within Weld County. FINDING #2: The EMTS Council is not aware of any deficiencies in the area of service level or response time. All comments have been favorable. FINDING #3: The EMTS Council believes that TVEMS contributes to an efficient, effective, and coordinated EMS service to the citizens and guests of Weld County. TVEMS is will to assist neighboring agencies whenever requested. FINDING #4: 2020 has brought significant challenges to the EMTS Council. TVEMS is an active participant in the EMTS Council and attends meetings as well as participates in the R&I discussions. Recommended Level of Service: Tier 2 Tier 3 Recommended Service Area: The EMTS Council has reviewed the service area for Thompson Valley EMS and foresees no concerns. Other EMTS Council recommendations or comments: The EMTS Council recommends that the Weld County Board of County Commissioner grant a Tier I Ambulance License to Thompson Valley EMS. 9r''' Recommendation By: Date: _11/18/2020_ Jeff Stranahan EMTS Council Chair Page 1 of 1 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: 1011a I a o o Name of Ambulance Service:T\AO cc\ v i \LLE`1 Owner: Address: t-4 `2:C) C_L•i (R LE Phone Number:et -(v la 3 44, 0 OS Operations Manager: Name: 1)\cJ 13 Address: -O T.) S AL >~ �I�W i l -0V 0= LA1Jc� C.0%053` Phone Number: 1 6-3 -4L70 as Email: ()..LESk-k @TV Ecr' . C�(� Medical Director: Name: PR. MC--�� A Z J O b\ 1v E 11"AS Name:` N;OMV C.1�l v Amt-��J �-1 E 1-1�-t E-1 ¶DERV ICES "1-‘s 1 pz 1 LOVEt..ArJD C •O SOS Address: (o 65 goaae) Phone Number:,�0 -S % a - 3 a ` D; 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): IV A 7-1T LE. 3a. N -A i GL..'rlA What area of Weld County will be served by this company? Please attach a map indicating the service area. W E S -c tZ-1J W tc.Lo C O U i\y'u, W t'r-1 { Iry -T -1-1E_ Cr 1b c,, (Lft 3H l_ pU1\Y-6Q, koc..< 0c TV Nso' CAz-r be C J01-4 5_—rt �ti ice- IS`t1Zlc 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 PablicRealth Page 1 How many ambulances do you operate? Ia - C (n \ 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: of') 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: .glYes ❑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: Tier I O Tier II ❑ Tier III Page 2 I have attached the following documents to this application: A list of ambulance agencies, fire departments, special districts, and other EMS providers with which the applicant has mutual aid agreements, or: ® Currently, our agency does not have mutual aid agreements with other ambulance agencies, fire departments, special districts or EMS providers. A map of the service area. If ambulance service/ambulances have been licensed/inspected by another County in Colorado within the most recent licensure period, attach current license and vehicle permits or other proof of recent vehicle inspection (not to exceed twelve months) for each vehicle operating in Weld County. A current copy of the ambulance service's pharmacological agents and delivery devices per medical director protocol. This only needs to be provided if your ambulances are to be inspected by the Weld County Department of Public Health and Environment. If your ambulances have been inspected by an outside party, within the most recent licensure period, you do not need to include in your application. Page 3 I have verified (no attachments required) the following information: This ambulance service maintains a list of all emergency medical service providers who may be called upon to respond to an emergency, including: 1. Complete name and date of birth. 2. The highest level of certification, licensure, or training attained by each. 3. Current EMT -B, EMT -I or EMT -P certificate issued by the Colorado Department of Public Health and Environment; nurse licensure or an Advanced First Aid card from the American Red Cross; or a First Responder course completion certificate issued by a Division -recognized training center or training group. Csd EMT or paramedic protocols adopted by this ambulance service are in accordance with standards approved by the ambulance service's medical director. This ambulance service's training standards are in accordance with the requirements approved by the ambulance service's medical director, and all trainings are provided by a state -certified emergency medical services training center. No employees of this ambulance service have had any criminal complaint or convictions, including Class I and II traffic violations, within the previous twelve (12) months. Sec. 7-3-50 Criminal record of ambulance crew member. Unless waived by the Board of County Commissioners, no person shall be employed by an ambulance service as an ambulance crew member who has been convicted of any of the following offenses within the previous twelve (12) months from the date of application: felony, misdemeanor or Class I or Class II traffic offense. (Weld County Code Ordinance 2007-8) This ambulance service has not had any judgments entered against us within the previous twelve (12) months, including findings of fact, conclusions of law and order by any court or other tribunal. Sec. 7-2-90 Application requirements. Copies of any judgments entered against the licensee or license applicant within the previous twelve (12) months, including findings of fact, conclusions of law and order by any court or other tribunal. Proof of a valid driver's license. Proof of insurance, as required in Section 7- 3-60 of this Chapter. This ambulance service maintains proof of valid driver's license for each employee. This ambulance service has an ongoing medical continuous quality improvement program consistent with the requirements defined in the Colorado Board of Medical Examiners rules, 3 C.C.R. § 713-6, Rule 500, 3.2, b. This ambulance service meets the minimum insurance requirements. Sec. 7-3-60 Insurance. Each ambulance service shall maintain insurance coverage for each and every ambulance owned, operated or leased by the ambulance service, providing coverage for injury to or death of persons in accidents resulting from any cause for which the owner of said vehicle should be liable for any liability imposed on him or her by law, regardless of whether the ambulance was being operated by the owner, the owner's agent, lessee or any other person, and coverage as against damage to the property of another, including personal property, under like circumstances, in the following amounts: Page 4 1. Workers' compensation insurance: Each ambulance service shall maintain required amount of workers' compensation insurance. 2. Public liability and property damage bodily injury: a. Each person, six hundred thousand dollars ($600,000.00); b. Each accident, six hundred thousand dollars ($600,000.00). 3. Property Damage: Each accident, six hundred thousand dollars ($600,000. 4. Professional Liability Coverage: a. Each person, six hundred thousand dollars ($600,000.00); b. Each accident, one million dollars ($1,000,000.00). 5. Ambulance vehicle coverage: The ambulance vehicle insurance shall be a vehicles, as defined in Sections 10-4-609 and 42-7-103, C.R.S. Signature ofAppliQdnt Title at least the statutorily 00). complying policy for motor lo lakb Date Please be aware that the criminal background and motor vehicle records information must be current at the time of submittal of the ambulance application. Copies of anv of the above do not need to be provided with the application, but must be made available upon request. at any timme. Page 5 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 REV AND PO BBL / RIMINAL PROSECUTION. Signalure of Applic l o c a l ao ao Date SUBSCRIBED AND AFFIRMED BEFORE ME THIS f a-TH DAY OF Obi b , 20 9 O , IN THE COUNTY OF \ '. , STATE OF COLORADO. Signature of Not'a My ('nmmigsion expires: 0 i MARVI CELESTE D0LGENER Notary Public Stets of Colorado Notary ID 419914010442 My Commission Expires 07-31-2023 Page 7 Hello