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Home My WebLink About20194888.tiffRESOLUTION RE: APPROVE APPLICATION FOR TIER I EMERGENCY MEDICAL SERVICES LICENSE AND AUTHORIZE CHAIR TO SIGN - MOUNTAIN VIEW 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 Mountain View 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 Mountain View 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: ddehA) V•‘,k Weld County Clerk to the Board BY: Deputy Clerk to the Board APP: • v D AS County Attorney Date of signature: Ia/tfK/ldj l Barbara Kirkmeyer,'Chair, „,,_ _ - Mike Freeman, Pro -Tern EXCUSED Sean P. Conway James Steve Moreno cc- : HI- (Mw(TG), pE.111(RR) 1 /to /aO 2019-4888 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 11197 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 2019-4888 HI -0051 O O O 1 INFEIMININIE1SMIIrEJ WELD COUNTY DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT License to Operate Ambulance Service TIER I MOUNTAIN VIEW FIRE PROTECTION DISTRICT Name of Service 3561 NORTH STAGECOACH ROAD, LONGMONT, COLORADO 80504 Address MOUNTAIN VIEW 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. NOV 2 7 209 A A BOA RD BOARD OF WELD COUNrfY COMMISSION 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 ronotonotormaromponototomorownliolioW O 0 Recommendation of the Weld County Emergency Medical/Trauma Service Council for: Mountain View 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 MVFPD's application for Tier I Ambulance License The Council unanimously agrees that MVFPD 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 MVFPD has established mutual aid agreements with PGFPD, FRFR, FFFPD, Longmont FD, NMFR, Lafayette FD, Boulder Rual, & Louisville FPD The Council has not been made aware of any complaints into the level of service that MVFPD 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. MVFPD communicates effectively with their neighboring agencies when responding to calls that may be on the borders of their district MVFPD 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 MVFPD Tier I application, indicates MVFPD 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 MVFPD for a Tier I Ambulance License Recommendation By Lance Homann C� --- Date It L i i - EMTS Council Chair • i' 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: /0/A9 /9 Name of Ambulance Service: iniVr-ni-/Pi Vti •J /m� Ae/Z5 ot42 O Six � ,� Owner: Name: Address: Phone Number: Operations Manager: Name: Address: 04-vt 46± e 6e s ice C /T. e c 35-6/ 41. S. -fl ee (o47 of ,12..D tor -)6 •t1 o , Co le X2)1 Phone Number: 3€; 7- 7» - o 7 1 o Email: D46666A & 4rd‘,610 . ort G Medical Director: Name: DA gas,/ Address: fs-e / 4/. sr-no-no/9(d 44 z or./ 6Atv,v, , Co fl'ny' Phone Number: 703 - 7 72 e O 7/ Name and address of each stockholder of partner owning 10% a or more of the outstanding stock of the company of having more than a 10% ownership interest (if applicable): r✓%A What area of Weld County will be served by this company? Please attach ' the service area. a map indicating see •�•� 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: 970-304-641 1 Communication, Education & Planning Tele: 970-304-6470 Fax: 970-304-6452 Page 1 Emergency Preparedness & Response Tele: 970-304-6470 Fax: 970-304-6452 Public Health 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: Set 4 Thit Cr'ft 0 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: 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: Rces 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 I HEREBY CERTIFY THAT I AM AUTHORIZED TO SUBMIT THE FORGOING INFORMATION PROVIDED IN THIS APPLICATION IS APPLICATION AND THE S TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF AND CONTAINS NO WILLFUL MISREPRESENTATION OR FA LSIFICATION. IN ADDITION, I CERTIFY THAT I HAVE READ AND UNDERSTAND REQUIREMENTS OF WELD COUNTY CODE CHAPTER PROVISIONS AND FIAPTER 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 AREAS OF RESPONSE. OR BORDERING ON THEIR DETERMINATION THAT AN AMBULANCE SERVICES LICENSE HAS BEEN ISSUED BASED ON FALSE INFORMATION CONSTITUTES GROUNDS FOR LICENSE REVOCATION AND POSSIBLE CRIMINAL Signature of Applicant ai/d /7,4 dji /P/ediy Title Date SUBSCRIBED AND AFFIRMED BEFORE ME THIS u( S 14% DAY OCA-otr , 20 NI , M THE COUNTY OF \N 21--p , STATE OF COLORADO. * CHERYL S LARSON NOTARY PUBLIC STATE OF COLORADO NOTARY ID # 19914017547 MY COMMISSION EXPIRES 01-14.2020 Signature of Notary tuLtm My Commission expires: r / 14 / aoao • *please make additional copies as necessar y. Page 6 Mountain View Fire Protection District Location/Description of Ambulance Location October 2019 Station 1 — Hwy 119 Engine 2201, Ambulance 2221 10939 WCR 5 Longmont, CO 80504 303-772-0710 Station 3 — Mead Paramedic Engine 2203 441 Third Street Mead, CO 80542 970-535-4330 Station 4 — Niwot Engine 2204, Ambulance 2224 8500 Niwot Road Niwot, CO 80544 303-828-3152 Station 6 — Erie Engine 2206, Ambulance 2226 50 Bonanza Drive Erie, CO 80516 303-828-3152 Station 7 — Dacono Paramedic Engine 2207 161 Perry Lane Dacono, CO 80514 303-833-3896 Station 5 — Brownsville Reserve Ambulance 10911 Dobbins Drive Lafayette, CO 80026 Station 10 — Longmont Reserve Ambulance 9119 East County Line Road Longmont, CO 80501 Maintenance — Dacono 100 Forest Dacono, CO 80514 MOUNTAIN VIEW FIRE RESCUE 3561 N. Stagecoach Road • Longmont, CO 80504 (303) 772-0710 • FAX (303) 651-7702 www.mvfpd.org October 29, 2019 To Whom It May Concern: Below is a listing of the mutual aid agreements Mountain View Fire Protection District has with surrounding agencies. Mutual Aid Agencies • Frederick/Firestone Fire — Fire/Ambulance • Longmont Fire — Fire/Ambulance (AMR) • Berthoud Fire — Fire • Front Range Fire — Fire • Platteville Fire — Fire • Fort Lupton Fire - Fire • North Metro — Fire/Ambulance • Lafayette Fire — Fire/Ambulance • Boulder Rural Fire — Fire • Louisville Fire — Fire/Ambulance Mountain View Fire Protection District has mutual aid will all fire agencies in both Weld and Boulder County. Keith Long Assistant Chief Station #1 10939 CR 5 Longmont, CO 80504 Station #3 441 3rd Ave. Mead, CO 80542 Station #4 8500 Niwot Road Niwot, CO 80544 Station #5 10911 Dobbins Run Lafayette, CO 80026 Station #6 50 Bonanza Dr Erie, CO 80516 Station #7 161 Perry Lane Dacono, CO 80514 Station #8 400 Bonanza Dr Erie, CO 80516 Station #10 9119E County Line Rd. Longmont, CO 80501 Hello