HomeMy WebLinkAbout20194891.tiffRESOLUTION
RE: APPROVE APPLICATION FOR TIER I EMERGENCY MEDICAL SERVICES LICENSE
AND AUTHORIZE CHAIR TO SIGN - SOUTHEAST WELD 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 Southeast Weld Fire Protection District for
a Tier I Emergency Medical Services License and recommend approval, and
WHEREAS, after review, the Board deems it advisable to approve said Application for a
Tier I Emergency Medical Services 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 Southeast Weld Fire Protection District for a Tier I
Emergency Medical Services 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 27th day of November, A.D., 2019.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, CO ORADO
ATTEST: datifeivW jClto•er.
Weld County Clerk to the Board
Barbara Kirkmeyer, Chair
Mike Freeman, Pro-Tem
BY:
APP
Deputy Clerk to the Bo
ounty Attorney
Date of signature: /.11c(/) q
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2019-4891
HL0051
Memorandum
TO: Barbara Kirkmeyer, Chair
Board of County Commissioners
FROM: Mark E. Wallace, MD, MPH
Executive Director
Department of Public Health & Environment
DATE: November 21, 2019
SUBJECT: 2020 Applications for Ambulance Service
Licenses
Enclosed for the Board's review are thirteen 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 the application for each ambulance
service provider on November 20, 2019, and approved all thirteen applications.
Changes from last year include adding North Metro Fire Rescue District and Platteville-Gilcrest Fire Protection
District as new ambulance services.
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 found in
Chapter 7. As such, I am recommending the following ambulance service providers for licensure:
Tier I
Frederick & Firestone Fire
Protection District
8426 Kosmerl Place
Frederick, Colorado
Front Range Fire Rescue
101 South Irene Avenue
Milliken, Colorado
Mountain View Fire
Protection District
3561 Stagecoach Road, Unit 200
Longmont, Colorado
Banner Health/NCMC
Paramedic Service
1801- 16th Street
Greeley, Colorado
Poudre Valley EMS
3509 South Mason
Fort Collins, Colorado
IIf 7
Tier I Continued
4- Southeast Weld Fire
Protection District
65 East Gandy Avenue
Keenesburg, Colorado
Thompson Valley EMS
4480 Clydesdale Parkway
Loveland, Colorado
Windsor Severance Fire
Protection District
100 North 7th Street
Windsor, Colorado
Platte Valley Ambulance
Service EMS
1600 Prairie Center Parkway
Brighton, Colorado
Platteville-Gilcrest Fire
Protection District
303 Main Street
Platteville, Colorado
Tier I Continued
North Metro Fire
Rescue District
101 Spader Way
Broomfield, Colorado
Tier II
American Medical
Response of Colorado
3800 Pearl Street
Boulder, Colorado
Tier III
Stadium Medical
695 Canosa Court
Denver, Colorado
2019-4891
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WELD COUNTY DEPARTMENT OF
PUBLIC HEALTH & ENVIRONMENT
License to Operate Ambulance Service
TIER I
SOUTHEAST WELD FIRE PROTECTION
Name of Service
65 EAST GANDY AVENUE, KEENESBURG, COLORADO 80643
Address
SOUTHEAST WELD FIRE PROTECTION
Name of Owner
IS LICENSED UNTIL DECEMBER 31, 2020, TO OPERATE AN AMBULANCE SERVICE IN WELD COUNTY IN ACCORDANCE
WITH EXISTING WELD COUNTY RULES AND REGULATIONS.
I
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NOV Z fi 2019
BOARD OF WELD COUNTY COMMISSIONER 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.
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Recommendation of the Weld County Emergency Medical/Trauma Service Council
for: Southeast Weld Fire Protection 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 is the basis for the Council's
recommendation
The EMTS Council voting members have reviewed SEWFPD's application for Tier I Ambulance License The
Council unanimously agrees that SEWFPD is continually striving to contribute to an efficient, effective, and
coordinate response to those within their defined service area as well as assisting their neighbors as
needed.
SEWFPD has, established mutual aid agreements with PVAS, BFPD, SFPD, MCA, and a verbal agreement
with -Banner SEWFPD is willing to assist any agency that request assistance with EMS Transport
The Council has not been made aware of any complaints into the level of service that SEWFPD is providing
to the citizens and guest of their response and mutual aid areas The quality of service is meeting the
needs of their service area.
SEWFPD communicates effectively with their neighboring agencies when responding to calls that may be
on the borders of their district
SEWFPD has a representative at all EMTS Council meeting and is active participant in the Council
Recommended Level of Service. 1ieri
Tier 2 Tier 3
Recommended Service Area _ The service area indicated within SEWFPD Tier I application, indicates
SEWFPD will be providing service to their defined service area. The EMTS Council finds in favor of this
service area
Other EMTS Council recommendations or comments. The EMTS Council voting membership
unanimously voted to recommend SEWFPD for a Tier I Ambulance License
Recommendation By _Lance Homann Q 9---- Date• ti I a -Q / i 5
EMTS Council Chair
AMBULANCE SERVICE LICENSE APPLICATION
Date of Application // /O7 0/9
Name of Ambulance Set vice
Owner
Sec 4..L.,UUe// 1,73e /5
Name J cl Wdc, si /41e4//���
Address ) „-chid-y S�r2!av go 6 Y3
Phone Number 3U 3 - %302 - .`-07 03
Qpetat'ons Manager
Name.,
Add' ess
5 ?VI �ti S ar r>
Phone Number; SA.+, e
l :marl -11-X ems' a 'i 0 r �,
Medical Director atly
���%Name Cf`lC 4f `° rr 0 cLl-rte n .
Address %6 c'D /rc,, ,i'< Ceedr,- Pkiay ig,"Ft, :f, So '0/
Phone Number .30 3-- "9R- /6 a -
Name and addicss of each stockholder of psrtnet owning 10% 01 more of the outstanding stock
of the company of having mole than a 10% ownership intetest Of applicable)
J4
What area of Weld County will be served by this company'? Please attach a map indicating
the set vice area
510 h/e/c/
Page 2
1 -low many ambulances do you opciate9
3
Location and description of the place(s) from which this ambulance service will opetate If these
ate mote than two locations, attach a sepatatc sheet with the above information
Location #1 AA
StieetNumbei �lS (IL ,4/e
City yes .e c T State 61, Phone 30 3--75 - V) -c2
Location #2
Sttcet Numbei '9/a ,4&y' 7,
City State 14,0 Phone73.1 - Y23
As requited un Section 7-3-30 of the Weld County Code Oidmance and Chapter 4 Section 6 of
the CDPHE Emeigency Medical and Ti Emma Cale System iegulations, as of the date of the
application, ate you in compliance with the minimum data collection and wpm Wig of
hanspottatton and/oi tieatment of patients
Lames ❑No
As tequried in Section 7-3-40 of the Weld County Code and Chaptei 3 Section 3 of the CDPI-IE
Fmeigency Medical Seivices regulations, as of the date of the application, ate you in compliance
with the tepoiting requirements of the agency profile
.-Yes ❑No
Please read catefully
Sec. 7-2-10 License foi Ambulance Set vice. No peison shall piovide of operate an ambulance
seivice publicly of piivately in the County unless that peison holds a valid license to do so issued
by the Boatd of County Commissioners, except as piovided in Section 7-2-80 below, The fee foi
said license shall be set by sepatatc oidinance The license shall issue only in the following treys
of set vice
net I Licensute authorizing foi Ptirnaiy Cate, as defined in Section 7-1-30 of this Chapter
1lei II Licensuie authoti7rng foi tianspoits of patients that originate in Weld County from
licensed medical facilities This lieensute does not piovide foi piimaiy care, as defined in
Section 7-1-30 of this Chaptet
Tier nil Liecnsuie authorizing Col Standby Set vice, as defined in Section 7-1-30 of this Chapter
Level of Service Requested _Tier I El `fret II ❑ Tier III
Page 3
I HEREBY CERTIFY ['HAT I AM AUTHORI%FD TO SUBMI I PH FORGOING APPLICA I ION AND TILE
INCORMA I ION PROVIDED IN I HIS APPLICA PION IS I RUE PO TI IF BEST Of MY KNOWLEDGE AND
BEI IFi AND CONTAINS NO WILLFUL MISREPRESENTATION OR I AI,SIFICATION
IN ADDI I ION, l CERTIFY I HA I I HAVE READ AND UNDERS I AND THE PROVISIONS AND
RLQUIREMENTS OF WILD COUNT Y CODE CI IAPTER 7, INCLUDING, BU I NO I LIIv11 I ED 1O
SECTION 7-8-10, WHICH ENCOURAGES ALI LICENSED AGENCIES PROVIDING EMS RESPONSL IN
WELD COUN I Y1O MAKE A GOOD ['Al I H EPFORT 1O I Xt CIJ I E WRITTEN MUTUAL AID
AGREEMENTS WITH AI I OTI[ER CMS PROVIDERS I ()GATED WIT FEN OR BORDERING ON P11C[R
AREAS O1 RLSPONSL
DET ERMINAT ION THAT AN AMBULANCE SERVICES LICENSE HAS BEEN ISSUED BASED ON FALSE
INFORMA PION CONS III U PES GROUNDS FOR LICENSE REVOCA PION AND POSSIBLE CRIMINAL
PROSECU PION
,---re. a:4:74-
9X-7‘. O, ,
u� it ur of Applicant 7 Itle Date
SUBSCRIBED AND APE IRMLD BEFORL ME I HIS _/r/)th1
DAY -c-.ye/e er 20 / �% IN rim COUN I Y OC
40e. { I , S PA I C OF COLORADO
IRENE M BURKE-HYBERG
Notary Public — Slate of Colorado
Notary ID 20174003247
My Commission Expires Jan 20, 2021
Signatuie of Not ry
My Commission eapucs O/ / ao / ava/
*Please make additional copies as necessally.
SOUTHEAST WELD AMBULANCE
EMS DISPATCH ZONES
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9/18/2019
To Whom It May Concern
Southeast Weld Fire District has mutual aid agreements with Platte Valley Ambulance Service, Bennett
Fire District, Strasburg Fire District and Morgan County Ambulance. In addition, we have a mutual aid
agreement with all Weld County Fire Districts and "verbally" with Banner Paramedic Service and Weld
County Regional Communications Center
Sincerely,
om Q ach
Fire Chief
Southeast Weld Fire District
303-732-4203
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