HomeMy WebLinkAbout20203773.tiffRESOLUTION
RE: APPROVE APPLICATION FOR TIER III AMBULANCE SERVICE LICENSE AND
AUTHORIZE CHAIR TO SIGN - STADIUM MEDICAL, INC.
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 Stadium Medical, Inc., for a Tier III Ambulance
Service License and recommend approval, and
WHEREAS, after review, the Board deems it advisable to approve said Application for a
Tier III 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 Stadium Medical, Inc., for a Tier III 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: ditif,„
Weld County Clerk to the Board
BY:
Deputy Clerk to the Board
APPED AS
ounty A ttorney
Date of signature: 1223/
Mike Freeman, Chair
Steve/Moreno, Pro -Tern
CC: HL( -6/6v), OEM (RR)
of/o8/21
2020-3773
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
3 Stadium Medical, Inc.
695 Canosa Court
Denver, CO
2020-3773
cal cal al al - mormarammtoronemwrom � I
WELD COUNTY DEPARTMENT OF
PUBLIC HEALTH & ENVIRONMENT
License to Operate Ambulance Service
TIE - III
STADIUM MEDIC A': L INC.
Name of Service
695 CANOSA COURT, DENVER, COLORADO 80204
Address
STADIUM MEDICAL INC.
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.
L
EEC 1 6 2J
CHAIR, BOARD OF WELD COUNTY COMMISSIONERS
NOT TRANSFERRABLE / POST IN A CONSPICUOUS PLACE
Tier III: Licensure authorizing for Standby Service, as defined in Section 7-1-30 of the Weld County Code.
DATE
oi cal ol ol cal a 1 B El.Uilal
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: Stadium Medical
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 is the basis for the Council's recommendation:
FINDING #1: Stadium Medical provides standby service for events throughout Weld County. They are
partnering with local jurisdictions when staffing an event.
FINDING #2: Stadium strives to communicate with AHJ while working an event in the authority's response
area. Communications have significantly improved from 2018. It would be great to allow Stadium to have
the ability to communicate via radio with WCRCC as well as the AHJ.
FINDING #3: Stadium contributes to an efficient, effective, and coordinated EMS response by allowing the
AHJ to remain available to serve its citizens and guest.
Recommended Level of Service:
Tier 1 Tier 2
Recommended Service Area:
The EMTS Council has reviewed the service area for Stadium Medical 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 III
Ambulance License to Stadium Medical.
9,'
Recommendation By: Date: _11/18/2020_
Jeff Stranahan EMTS Council Chair
Page 1 of 1
AMBULANCE SERVICE LICENSE APPLICATION
Date of Application: /11 /10 10
Name of Ambulance Service: Mi.; Lim c
Owner:
Name: Roc4ct2r I Vn_S
C95 C&vio fa C -I-, j)tr v ,
Address:
(0 S 20 /
Phone Number: 3t) - S`l Q - l
Operations Manager:
Name: ryA 2. q 41 a.v\ A a 0. S
Address: G 6 C cu -10 5 a C+ • J C n 2_0 L(
Phone Number: 72 0 " 3 g — 3 1 $ I
Email: tY1n‘.()LS 03 c a.1 . co wl
Medical Director:
Name:
PtlCv Ve_11n' vi
Address:
1 c 5 13,4L.k O ✓✓1 D L1 I{ 1d- ,, C 0 ka
Phone Number: S b } - 7 Z - 3
I27
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):
hrvw S
What area of Weld County will be served by this company? Please attach a map indicating
the service area.
Evert be‘. c Wei
1
How many ambulances do you operate? I 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:
Street Number: 4 S C64,0 Sc. C F,
City: 1a eAh V. cr
Location #2:
Street Number:
State: C O Phone: -12,0 — 6 3 0- 20,9 v
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:
El es ❑ 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 EVTier III
2
I have verified the following information:
LV No employees of Colorado 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)
E 'Colorado 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.
L'1 Colorado Ambulance Service maintains proof of valid driver's license for employees.
R the 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.
it he 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:
1. Workers' compensation insurance: Each ambulance service shall maintain at least the statutorily
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 ($600,000.00).
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 complying policy for
motor vehicles, as defined in Sections 10-4-609 and 42-7-103, C.R.S.
gnature of Applicant
Preside d /CEO q/lq /10
Title Date
Please be aware that the criminal background information and motor vehicle records information must be
current at the time of submittal of the Ambulance Application.
4
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.
CEO
Signature of Applicant Title
SUBSCRIBED AND AFFIRMED BEFORE ME THIS PI '
Date
DAY ce.tr4-e4v b z , 20 22 , IN THE COUNTY OF
0 en Ye " , STATE OF COLORADO.
MIKAYLA 0 PASSANANTE
Notary Pudic — State of Colorado
Notary ID 20144000113
My Commission Wass Jan 2. 2022
Signature of Notary
My Commission expires: I / 2 J 2 02 2
*Please make additional copies as necessary.
STADIUM
*MEDICAL*
Mutual Aid Agreements
Date: 9/14/20
Stadium Medical currently has Mutual Aid Agreements
with:
Northglenn Ambulance
Action Care Ambulance
Denver Health
Summit County
Rodger Ames
President, Stadium Medical
Map of Service Area: Denver Metro Area and
Surrounding Counties
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