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Home My WebLink About20194893.tiffRESOLUTION RE: APPROVE APPLICATION FOR TIER I EMERGENCY MEDICAL SERVICES LICENSE AND AUTHORIZE CHAIR TO SIGN - WINDSOR SEVERANCE 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 Windsor Severance 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 Windsor Severance 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: d„,,A,A, �' JC, ;ok, Weld County Clerk to the Board BY: Deputy Clerk to the Board APP' •' ED ou ty ttorney Date of signature: P-/1871©( arbara Kirkmeyer, i hair Mike Freeman, Pro -Tern EXCUSED Sean P. Conway Steve Moreno GG' HLCC 1-r(,), O8-m(RR) I/14 /2o 2019-4893 H L0051 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 4- 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 2019-4893 (110-1 f (LOOS 0 rotemprototoronairomatoronotorommundramia WELD COUNTY DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT License to Operate Ambulance Service TIER I WINDSOR SEVERANCE FIRE PROTECTION DISTRICT Name of Service 100 NORTH 7TH STREET, WINDSOR, COLORADO 80550 Address WINDSOR SEVERANCE 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 AIR, BOARD OF WELD CO TY COMMISSIONE'_ 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. NIMINIMMEIWWW1O1O1ffla MEINIFORMONINIP 0 Recommendation of the Weld County Emergency Medical/Trauma Service Council for: Windsor Severance 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 WSFR's application for Tier I Ambulance License. The Council unanimously agrees that WSFR 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. WSFR and FRFR work closely to ensure all needs are being met by both districts. PVH EMS has contracted with three additional districts in Weld County. The level of service has not been impacted. SWFR has established mutual aid agreements with all Weld County agencies, PVH EMS, TVEMS, and Banner. The Council has not been made aware of any complaints into the level of service that WSFR 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. WSFR communicates effectively with their neighboring agencies when responding to calls that may be on the borders of their district. WSFR 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 WSFR Tier I application, indicates WSFR 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 WSFR for a Tier I Ambulance License Recommendation By: _Lance Homann P `— Date: It I a;, f l°I EMTS Council Chair AMBULANCE SERVICE LICENSE APPLICATION Date of Application: November 1, 2019 Name of Ambulance Service: Windsor Severance Fire Protection District Owner: Name: Windsor Severance Fire Protection District Address: 100 North 7th Street, Windsor, CO 80550 Phone Number: 970-686-2626 Operations Manager: Name: Michael Blackwill, Operations Chief Address: 100 North 7th Street, Windsor, CO 80550 Phone Number: 970-686-2626 Email: emorse@wsfr.us Medical Director: Name: Darren Tremblay, D,O, Address: 1024 South Lemay Avenue, Fort Collins, CO 80524 Phone Number: 970-495-8006 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): Not applicable What area of Weld County will be served by this company? Please attach a map indicating the service area. Windsor, Severance and western Weld County How many ambulances do you operate? Two, one primary and one reserve 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: City: Windsor 100 North 7th Street State: CO Phone: 80550 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: KJ 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: OLJ 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: IZ Tier I ❑ Tier II ❑ Tier III 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-S-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. SUBSCRIBED AND AFFIRMED BEFORE ME THIS of Applicant Title DAY :r` , 20 / c3 , IN THE COUNTY OF STATE OF COLORADO. TRICIA z GER NOTARY PUBLIC STATE OF COLOR NOTARY ID 201 © ON EXPIRES MAY Signature' of Notary My Commission expires: pelayLL6,1,Ae2 *Please make additional copies as necessary. Page 6 Windsor -Severance Fire Rescue Windsor Severance Fire Rescue 100 N. 7th Street • Windsor • Colorado • 80550 970-686-2626 October 26, 2019 Mutual Aid Agencies that Windsor Severance Fire Rescue operates with: Fire Departments: • Loveland Fire Rescue • Poudre Fire Authority • Ault -Pierce Fire Protection District • Eaton Fire Protection District • Greeley Fire Department • Front Range Fire Rescue EMS Transport Agencies: • Poudre Valley Hospital EMS (UC Health) • Thompson Valley EMS • Banner Ambulance Follow us on • Instagram • Facebook • Twitter • www.wsfr.us Hello