HomeMy WebLinkAbout20194886.tiffRESOLUTION
RE: APPROVE APPLICATION FOR TIER I EMERGENCY MEDICAL SERVICES 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 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 Frederick -Firestone 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, COLORADO
ATTEST: ditilyo G XL;ok,
Weld County Clerk to the Board
BY:
Deputy Clerk to the Board
APP :•v DAS
Date of signature: Ia. A E(/1 q
rbara Kirkmeyer, 4/air
Mike Freeman, Pro-Tem
EXCUSED
Sean P, Conway
James
ounty t• rney�i ,,�i'
Steve Moreno
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1 /10/20
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2019-4886
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
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
2019-4886
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WELD COUNTY DEPARTMENT OF
PUBLIC HEALTH & ENVIRONMENT
License to Operate Ambulance Service
TIER I
FREDERICK -FIRESTONE FIRE PROTECTION DISTRICT
Name of Service
8426 KOSMERL PLACE, FREDERICK, COLORADO 80516
Address
FREDERICK FIRESTONE FIRE PROTECTION DISTRICT
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.
J
NOV 2 7 2D19
Q
AIR, BOARD OF WELD CONTY COMMISSIO RS 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: Frederick Firestone 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 FFFPD's application for Tier I Ambulance License. The
Council unanimously agrees that FFFPD 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
necessary.
FFFPD has established mutual aid agreements with MVFPD and PGFPD.
The Council has not been made aware of any complaints into the level of service that FFFPD 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.
FFFPDs communicates effectively with their neighboring agencies when responding to calls that may be on
the borders of their district.
FFFPD has a representative at all EMTS Council meeting and is active within the Council.
Recommended Level of Service:
Tier 2 Tier 3
Recommended Service Area: _The service area indicated within FFFPD Tier I application, indicates FFFPD
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 FFFPD for a Tier I Ambulance License.
Recommendation By: Lance Homann t' Date: h e)
EMTS Council Chair
WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
1555 North 17th Avenue, Greeley, CO 80631 www.weldhealth.org
AMB
Date of Application:
CE SERVICE LICENSE APPLICATION
/i 20/7
Name of Ambulance Service:.
Owner:
Name: _
Address:
Phone Number:
Operations Manager:
Name:
Address: ,,,c4, -0,0 -or
r
- -z12
Phone Number:
Email:
Medical Director:
Name:
Address:
Phone Number:
te
vyriY.'br f/ 6,74; Za
sg°O3—G/ZS-2 -
Name and address of each stockholder of partner owning 10% or more of the outstanding stock
of the company of ing 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 ea.
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
Page 1
Emergency Preparedness
& Response
Tele: 970-304-6470
Fax: 970-304-6452
PublicHealth
How many ambulances do you operate?
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: //S 44,41
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:
aYes ONO
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:
E5 -Yes El 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 ❑ Tier II ❑ Tier III
Page 2
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MIMS
I HEREBY CERTIFY THAT I AM A UTI rO RI ZED TO SUBMIT THE FORGOING r� �
INFORMATION PROVIDED IN THIS APPLICATION I I� I�"OR�C�CI��.r APPLICATION AND THE
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 UNDERS
REQUIREMENTS OF WELD COUNTY CODE TAND THE PROVISIONS AND
CHAPTER 7, INCLUDING, BUT NOT LIMITED TO,
SECTION 7-8-10, WHICH ENCOURAGES ALL LICENSED AGENC
WEL,I) COUNTYTO MACE A GOOD FAITH NC:'IES PROVIDING EMS RESPONSE ,.IN
EFFORT TO �,�ECLJTF, WRITTEN MUTUAL AID
AGREEMENTS WITH ALL OTHER EMS PROVIDERS LOCATED
AREAS OF RESPONSE. WITHIN OR BORDERING ON THEIR
DETERMINATION THAT AN AMBULANCE SERVICES LICENSE
INFORMATION CONSTITUTES GROUNDS FOR HAS BEEN ISSUED BASED ON
LICENSE REVOCATION AND FALSE
PROSECUTION, POSSIBLE CRIMINAL
N ti
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t gnature of Applicant
SUBSCRIBED AND AFFIRMED BEFORE ME THISVith
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DAY )-,-- 2039 , IN THE COUNTY OF
ea____ ._ STATE OF COLORADO.
DALE ROBIN INCIRAHAM
NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 20044034067
Mkt Commission Expires Sept. 23, 2020
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*Please make additional copies as necessary.
Page 6
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FREDERICK -FIRESTONE
FIRE PROTECTION
DISTRICT
October 7th, 2019
Operations Division
Office: (303) 833-2742
Fax: (303) 833-3736
Email: dprunk@fffd.us
The Frederick -Firestone Fire Protection District currently has four fire stations. Three of the four
fire stations each house one of the District's Ambulances. These ambulances are located at:
Station #1 - Ambulance 3421
31 Walnut Drive
Frederick, C 80530
303-833-3727
Station #3 - Ambulance 3423
6800 Tilbury Avenue
Firestone, CO 80504
303-833-4458
Station #4 - Ambulance 3 424
10706 Co Rd 7
Firestone, CO 80504
303-710-1720
Respectfully,
:d.
/2„,"
cuas J. I''
Assistant Chief
8426 Koszmerl Place, Frederick, Colorado, 80504-5444, www.fird.us
Frederick Firestone Fi
Response Zones
FREDERICK -FIRESTONE
FIRE PROTECTION
DISTRICT
October 7th, 2019
Operations Division
Office: (303) 833-2742
Fax: (303) 833-3736
Email: dpr nk a@ffcfd.us
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,
pc.,1/4
Doug Prunk
Assistant Chief
8426 Kosmerl Place, Frederick, Colorado, 80504-5444, www.itfd.us
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