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Home My WebLink About20194889.tiffRESOLUTION RE: APPROVE APPLICATION FOR TIER I EMERGENCY MEDICAL SERVICES LICENSE AND AUTHORIZE CHAIR TO SIGN - BANNER HEALTH / NORTH COLORADO MEDICAL CENTER PARAMEDICS 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 the Banner Health / North Colorado Medical Center Paramedics Service 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 Banner Health / North Colorado Medical Center Paramedics Service 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, COLD ADO ATTEST: ditAido G: jdo;&k. Weld County Clerk to the Board BY: APP Cou y orney Date of signature: )2 1( �VI' rbara Kirkmeyer, .4,_1.A.i./Azi.i; Chair Mike Freeman, Pro -Tern EXCUSED Sean P. Conway . James Steve Moreno Cc--s•{--1u( -T'C,tMW), c..AvIc RR) 1/Ioao 2019-4889 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 I %/87 Tier I Continued 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 2019-4889 (—ILOOS ( O 1O11O11O11O1O11O11-01O1 DJarouromprommonoraronorp WELD COUNTY DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT License to Operate Ambulance Service TIER I BANNER HEALTH / NORTH COLORADO MEDICAL CENTER PARAMEDICS SERVICE Name of Service 1801 16TH STREET GREELEY, COLORADO, 80631 Address BANNER HEALTH f NORTH COLORADO MEDICAL CENTER 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. AIR. BOARD OF WEL C UNTY COMMISSIO RS • Nov 272019 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 roronororoaroxoxfflr-oxotaromrardrpuroxomrot-omraiotoaa O O Recommendation of the Weld County Emergency Medical/Trauma Service Council for: Banner NCMC Ambulance 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 otherambulance services, location, service area, etc that is the basis for the Council's recommendation The EMTS Council voting members have reviewed Banner's application for Tier I Ambulance License. The Council unanimously agrees that Banner is continually striving to contribute to an efficient, effective, and coordinate response to those within their defined service area as well as assisting as necessary to their neighbors Banner has supported EMS response into the City of Greeley, FLFPD, and the northern county Fire Agencies effectively over the past 12 months. Having AMR as a support to take care of interfacility transfers has keep Banner units available for 911 calls for service Banner has established mutual aid agreements with FRFR and Cheyenne/Laramie County Emergency Services However, Banner is always willing to assist any agency if they are able to do so. The Council has not been made aware of any complaints into the level of service that Banner 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 Banner communicates effectively with their neighboring agencies when responding to calls that may be on the borders of their district Banner has a representative at all EMTS Council meeting and is active within the Council. Recommended Level of Service. Crier 1) Tier 2 Tier 3 Recommended Service Area _The service area indicated within Banner's Tier I application, indicates Banner 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 Banner NCMC Ambulance for a Tier I Ambulance License. Recommendation By _Lance Homann C Date 11/.2_0 I I`1 EMTS Council Chair Banner Health / NCMC Paramedics Ambulance Service License Application Date of Application: 10/21/2019 N ame of the Ambulance Service: Banner Health / North Colorado Medical Center Paramedic Services Owner: N ame Address: Phone Number: Banner Health / North Colorado Medical Center 1801 16th Street. Greeley, CO. 80631 (970) 810 - 2435 Chief: N ame Address: Phone Number: Mitch Wagy 1801 16th Street Greeley, CO 80631 (970) 810 - 2435 Medical Director: N ame Address: Phone Number: Dr. Joshua Poles 1121 M Street. Greeley, CO. 80631 720-422-9877 For Office Use Only: N ame and address of each stockholder or partner owning 10% or more of the outstanding stock of the company or having more than a 10% ownership interest if applicable: N ot Applicable. How many ambulances do you operate? 16 Stations: How many stations do you have? 10 Indicate the location and description of the stations from which these ambulances will operate. If there are more than two locations, attach a separate sheet with the above information: Location #1 Address: Phone Number: GFD Station 1— 1155 10th St. Greeley CO 80631 970-350-9500 Location #2 Address: Phone Number: GFD Station 2 — 2301 Reservoir Road. Greeley CO 80631 970-330-1771 Location #3 Address: Phone Number: GFD Station 3- 150 35th Ave Greeley CO 80631 970-336-4240 Location #4 Address: Phone Number: GFD Station 4- 2191 1St Ave Greeley CO 80631 970-353-3741 Location #5 Address: Phone Number: GFD Station 7- 6623 W 10th St. Greeley CO 80634 970-336-1402 Location #6 Address: Phone Number: 2000 70th Avenue Banner West ED (970) 395 - 2690 Location # 7 Address: Phone Number: 3401 S. 11th Avenue. Evans, CO. 80620 (970) 810-2452 Location # 8 Address: Phone Number: Fort Lupton Fire Department: 1121 Denver Ave. Fort Lupton, CO. 80621 303-857-4603 Location # 9 Address: Phone Number: Fort Lupton Fire Department 2999 9th Street Fort Lupton, CO 80621 970-810-2448 Location # 10 Address: Phone Number: Ault -Pierce Fire Department 16680 Hwy 14 Ault CO 80610 970-834-2838 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 g 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 m 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 m 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 0 Tier II 0 Tier III I have attached the following documents to this application A list of all emergency medical service providers who may be called upon to respond to an emergency with the ambulance service This list shall include the following information on each person. 1 Complete name and date of birth 2 The highest level of certification, hcensure or training attained 3 A copy of current EMT -B, EMT -I or EMT -P certificate issued by the Colorado Department of Public Health and Environment, nurse hcensure 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. A current copy of EMT or Paramedic protocols adopted by the ambulance service m accordance with standards approved by the ambulance service's medical director A current copy of the ambulance service's training standards in accordance with the requirements approved by the ambulance service's medical director that includes proof of a medical continuous quality improvement program All training must be through a state - certified emergency medical services training center 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 CO ISTITUTES GROUNDS FOR LICENSE REVOCATION AND POSSIBLE CRIMINAL PROSECUTION. (,,,- c...4.4:1, _,_,0 ""°7""2.,,14 Signature o A.. l►cant Title Date SUBSCRIBED AND AFFIRMED BEFOREME THIS 0 b — DAY I (7 , 20 11 , IN THE COUNTY OF C",1 Ci „STATE OF COLORADO TERI SAILOR NOTARY PUBLIC - STATE OF COLORADO D NOTARY ID 20154036774 1 MY COMMISSION EXPIRES SEP 17, 2023 ! -44 My Commission expires 9 / I 'a---, a'3 1 F7.1 i Tfl .- �1 f � 1 y{ 1 , I 1 i 1 1 E Ore. a. L i . I I L. e _ • • Si _ ru1..g.ar. e.w•....... �s....a....ea.,............w...r................w....................... ...........y ......«. ........e...al�wa.r...... As... .....«..«....«.. .........*.. .r......,..............,.,+...r�.w•...rEw..rr.s.w ...... .'. - ...... �...�....« ..,.. Z ',. , I L il • I; i _ r I I 1 IUt CII I 6 I I 1 1 1 1 ' 1 „I .1 I; 1 at i` r _ 1 _ I 1 I' I 1: 1 i Ir... I I I I CR .I ! r—_1rr_—•__1__• ..M. Mk - •••• I. 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LEVI. .x911. swwl.n. -- • ,:c.arE .S Iq.tictric ►a•u. .alrrt0'etaar eat Sources Wow totally G15 ESW Pnriing Gals NovImb., 7011 WWI Cotay GIS What area of your County will be served by this company? Please attach a map indicating the service area Map 1 Banner Health Paramedic Services Weld County Service area following Fire D►str,cts ® Nunn Fire Protection District e Pawnee Fire Protection District ® Briggsdale Fire Protection District e Galton Fire Protection District e Eaton Fire Protection District e Stoneham / New Raymer Fire Protection District e Greeley Fire Department ® Fort Lupton Are Protection District ® Ault -Pierce Fire Protection District I Banner Health' October 1, 2019 Kevin Antuna Environmental Specialist Weld County Health Department Kevin Antuna NCMC Paramedic Services 1801 16th STREET Greeley, Colorado 80631 Phone (970) 810-2435 Email mitch wagy@bannerhealth.com Banner Health NCMC Paramedic Service currently has mutual aid agreements with the following entities and agencies ® Front Range Fire Rescue Authority © Cheyenne / Laramie County Emergency Medical Service Joint Powers Board Please contact me with any questions Sin ely, itch Wagy Cluef Banner Health Paramedic Services 1801 16"' Street Greeley CO 80631 Hello