HomeMy WebLinkAbout20194898.tiffRESOLUTION
RE: APPROVE APPLICATION FOR TIER III EMERGENCY MEDICAL SERVICES LICENSE
AND AUTHORIZE CHAIR TO SIGN - STADIUM MEDICAL, INC.
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 Stadium Medical, Inc., for a Tier III
Emergency Medical Services License and recommend approval, and
WHEREAS, after review, the Board deems it advisable to approve said Application for a
Tier III 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 Stadium Medical, Inc., for a Tier III 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
WEk�D COUNTY, COLRADO
ATTEST: dia./Let) G •�C/to��
Weld County Clerk to the Board
BY:
Deputy Clerk to the Boar
APP D AS
Cou y A`'orney
Date of signature: I D. /1 T/1 q
ara Kirkmeyer, hair
Mike Freeman, Pro-Tem
Steve Moreno
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2019-4898
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
2019-4898
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WELD COUNTY DEPARTMENT OF
PUBLIC HEALTH & ENVIRONMENT
License to Operate Ambulance Service
TIER III
STADIUM MEDICAL INC.
Name of Service
695 CANOSA COURT, DENVER, COLORADO 80204
Andress
STADIUM MEDICAL INC.
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.
fitn NOV 272019
R. BOARD OF WELD COUNT' COMMISSIONERS / DATE
NOT TRANSFERRABLE / POST IN A CONSPICUOUS PLACE
Tier III: Licensure authorizing for Standby Service, as defined in Section 7-1-30 of the Weld County Code.
10101010101MlioniornislifflP
0
Recommendation of the Weld County Emergency Medical/Trauma Service Council
for: Stadium Medical
As required in Section 7-2-100.6.5., 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 Stadium's application for a Tier Ill License. The Council
unanimously agrees that Stadium is striving to contribute to an effective, efficient, and coordinate
response as a standby agency. Their communications have improved greatly over the past and has been a
pleasure to work with.
Stadium has established mutual aid agreements with agencies outside of Weld County. As a Tier Ill
License the Council does not believe it is necessary for Stadium to have MA agreements as the AHJ will fall
primary in any additional responses if necessary.
The Council has not been made aware of any complaints into the level of service that Stadium is providing
at the venues they perform standby services.
Stadium provides standby services under contractual agreements with various venues throughout Weld
County.
Recommended Level of Service:
Tier 1 Tier 2
Recommended Service Area: _ Stadium Medical provides standby service throughout Weld County. The
Council recommends that Stadium Medical service areas is the defined boundaries of Weld County.
Other EMTS Council recommendations or comments: The EMTS Council voting members
unanimously voted to recommend Stadium Medical for a Tier Ill License.
Recommendation By: _Lance Homann PDate: 1.1/ I 1'1
EMTS Council Chair
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: 1 0/) y l I
Name of Ambulance Service: S. -FA, , v„ryt ivi e - J; i c l
Owner:
Name: Q a d y e Amt. S
Address: 6 5 S C o-rl o s& G} ,Dot ve-r- C°
Phone Number: ?O 3- 5 i q- 7 q( 'f
Operations Manager:
Name:
R6djcr AvYttc
Address: 6 g S f a, rp f . DG rivt r, L v 20 Y
Phone Number: 3 0 3_ s Li 4_ "q ► y
Email: CQr,.h.cq7s--z iv,.,nto ci;c w 1 - Carr,
Medical Director:
Name: Pt Ls- VC l ItCUVt
Address: 1 2 C 5''( B vc kinur,n Or. LA I db h
Phone Number: 30 Z, K "7 2 Z C
t
Co So I Z7
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):
K Byte S
What area of Weld County will be served by this company? Please attach a map indicating
the service area. j
Evt h- ct t d w c, I
Co, + y
Health Administration
Vital Records
Tele: 970-304-6410
Fax: 970-304-64'2
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
Fox: 970-304-6452
Emergency Preparedness
& Response
Tele: 970-304-6470
Fax: 970-304-6452
PublicHealth
Page 1
How many ambulances do you operate? I
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:
b95 (Pnasa Cf
City: D l~ h%/ _ c State: L 0 Phone: - 2 0 - C 30 - 2 o o b
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:
EK.es El 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:
L 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 L1' Tier III
Page 2
I HEREBY CERTIFY THAT I AM AUTHORIZED TO SUBMIT THE FORGOING APPLICATION AND THE
INFORMATION PROVIDED IN THIS APPLICATION [S 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.
Art si J zA-4- /C Co I°/i Li 41
Signature of Applicant Title Date
SUBSCRIBED AND AFFIRMED BEFORE ME THIS 1 4
DAY d c+0 , 20_19_, IN THE COUNTY OF
D eArpre .c , STATE OF COLORADO.
1
Signature of Notary
My Commission expires: I / / 1Z
*Please make additional copies as necessary.
Page 6
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STADIUM
*MEDICAL*
Mutual Aid Agreements
Date: 10/14/19
Stadium Medical currently has Mutual Aid Agreements
with:
Northglenn Ambulance
Action Care Ambulance
Denver Health
Rodger Ames
President, Stadium Medical
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