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Home My WebLink About20194895.tiffRESOLUTION RE: APPROVE APPLICATION FOR TIER I EMERGENCY MEDICAL SERVICES LICENSE AND AUTHORIZE CHAIR TO SIGN - PLATTEVILLE-GILCREST 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 Platteville-Gilcrest 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 Platteville-Gilcrest 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 W. LD COUNTY, CO ORADO ATTEST: ditifo) jejw;ii Weld County Clerk to the Board BY: Deputy Clerk to the Boar APP ED ou Attorney Date of signature: Ja/1r/)°( Barbara Kirkmeyer Chair Mike Freeman, Pro-Tem EXCUSED Sean P. Conway Steve Moreno ccct HL(NNW/ Tv), 0Eto RR) /19/2O 2019-4895 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 2019-4895 (-1(.0051 O romarorstotorm orawarerotoromorarstowirorsta WELD COUNTY DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT License to Operate Ambulance Service TIER I PLATTEVILLE-GILCREST FIRE PROTECTION DISTRICT Name of Service 303 MAIN STREET, PLAT'TEVILLE, COLORADO 80651 Address PLATTEVILLE-GILCREST 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 ? 2019 HAIR, BOARD OF WELE COUNTY COMMISSIONE 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 roxox-owronor-owrotowroroxnirox-oxomroxorotomro 0 Recommendation of the Weld County Emergency Medical/Trauma Service Council for: Platteville Gilcrest 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 PGFPD's application for Tier I Ambulance License. The Council unanimously agrees that PGFPD is continually striving to contribute to an efficient, effective, and coordinate response to those within their defined Weld County service areas as well as assisting their neighbors. PGFPD has proven their service delivery over the past 8 months and is delivering excellent service to the citizens and guest of their district. PGFPD has established mutual aid agreements with MVFPD, FFFPD, FRFR, LSFPD, UCH -EMS, & Banner. The Council has not been made aware of any complaints into the level of service that PGFPD 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. PGFPD communicates effectively with their neighboring agencies when responding to calls that may be on the borders of their district. They are always willing to assist their neighbors with transport needs. PGFPD has a representative at all EMTS Council meetings. Recommended Level of Service: Recommended Service Area: _ Tier 2 Tier 3 Other EMTS Council recommendations or comments: The Council recommended for Recommendation By: __Lance Homann "1---- Date: 1 PI EMTS Council Chair WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 North 17th Avenue, Greeley, CO 80631 www.weldheaith.org AMBULANCE SERVICE LICENSE APPLICATION Date of Application: 'O1 Name of Ambulance Service: Owner: Name: PL - 1 vit4,,t . GI (-czcs i 1iz- 1 t1a I tc (lu-J vs j"12.rCr Address: Pt -AIM- , L 6 "1" Fat; Poo clo..i DiS;72re t` 1 , o +7"11 y('7 (3o3 �nA.v ST/ire- Phone Number: -I -] 6 5'j-7_ 5-P, 3 Operations Manager: Name: M Ali Ci,toa C. Address: ()terra' ct.ta 1 °-78c-Z2Z3 �. O. go),. i°7 P LA Viet ( r'CV6SI Phone Number: 9 )0 . 78c 22-3 L /9 ?c. 5-9-7-5n1 Email: M (OA/Ci.4(.6i CA 116 F- PO, 026 Medical Director: Name: k2is ii:u leNoi,.,L-c Address: -11.R /J. CLAt./ s'r,)trvL/t(Z,(o, 0211 Phone Number: 41 -20 -. 3 - D `19.5 - 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): What area of Weld County will be served by this company? Please attach a map indicating the service area. 1ob.r,rs OF PLi4r°u,u,E+ ArJii V'K.eC5% C eokit4 IN/ — ►LI4 sk Mr LL'.s Health Administration Vital Records Tele: 970-304-6410 Fax: 970-304-6412 Public Health 8 Clinical Services Tele:970-304-6420 Fax: 970-304-6416 Environmental Health Services Tele:970-304-6415 Fax: 970-304-6411 S 0‘51-11 Gt '-, 12rtL Communication, Education & Planning Tele: 970-304-6470 Fox: 970-304-6452 Emergency Preparedness 8 Response Tele: 970-304-6470 Fax: 970-304-6452 t -o PublicHealth CS1 Page 1 How many ambulances do you operate? I- o v 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: 3 a 3 AAA .N 5 -rat & r City: Pi, vi' -.-t State: C Phone: p 7U YS = 11-3 7 -- Location #2: Street Number: i `'I C --)q C Li City: G r c. C¢ ST- State: Phone: 7 0 - 7 7 -2 %C 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: 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 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 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. 6m,y /6 bo Jr� SignatuiofApplicant Title Date SUBSCRIBED AND AFFIRMED BE ORE ME THIS 10 DAYceit3y, , 20 L i , IN THE COUNTY OF VANESSA KOOPMANS WADER NOTARY FUSLIC STATE CV COLORADO NOTARY !0 ' '4012699 MY COMMISSION EXPIRES APRIL 7, 2024 , STATE OF COLORADO. Signature of Notary My Commission expires: ` I / / *Please make additional copies as necessary. Page 6 -1•, . • I Fi.tstonm 1 r f ride rick Evans A • i _......,.:•- PLATTEVILLE - GILCREST FIRE DISTRICT (RESPONSE AREAS) . :Al btu — lawy 4 -•n1 .A(Ft ,W •,:tag %.c..414 • M...,1 r.. r.u.ue, tiara • II (I • : /.-.••.y. IT. ..• • r. ..S OM. .L41l * awn ed►N Pt • nd..* Gtr.0 t M. A.. I.1 Pun f.*!Y, f .. M. I r, •.f hffA •Pr;d.... f• Nk,. r ..,11.y. tI141 A.•.Ad •.f*A fp•11.r04 Aare IN Ptt*L - n.,, x.q. l• :•10 Abu w It •taa.N awe AA flat .•.•6vf r..,... U Sal A.Is. w RYEA • E.W bap Y..nuc 'Ar.A. •IJ NYPI• hint115PoIr:J. a:+•.:. A..A.•a Ad nos•uy.. •A.• 0.1 I I F • Platteville-Gilcrest Fire Protection District P.O. Box 407 303 Main Street Platteville, CO 80651 970.785.2232 • FAX 970.785.0139 The Platteville-Gilcrest Fire Protection District is apart of the Weld County Mutual Aid Contract and currently has specific EMS Mutual -Aid and contract agreements with the following agencies: • Mountain View Fire Protection District • Frederick Firestone Fire Protection District • LaSalle Fire Protection District • Front Range Fire Rescue • UC Health • Banner Health Respectfully, Matt Concialdi EMS Division Chief Hello