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Home My WebLink About20183837.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 Service 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 3rd day of December, A.D., 2018. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: dottAvo jeito%eik Weld County Clerk to the Board BY: Deputy Cle ounty Attorney Date of signature: I /61119 Steve Moreno, Chair rbara Kirkmeyer, FJro-Tem-4-4/1" CC: t-tt-CMwITC,), Ol;MCRR) 11311A 2018-3837 HL0050 Memorandum TO: Steve Moreno, Chair Board of County Commissioners FROM: Mark E. Wallace, MD, MPH Executive Director Department of Public Health & Environment DATE: November 27, 2018 SUBJECT: 2019 Applications for Ambulance Service Licenses Enclosed for the Board's review are eleven 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 15, 2018, and approved all 11 applications. Changes from last year include adding American Medical Response of Colorado as a new ambulance service and removing Colorado Motocross Medics because they have stopped operating in Weld County. 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/Northern Colorado Medical Center Paramedic Service 1801 - 16th Street Greeley, Colorado TIER I — Cont'd Poudre Valley EMS 3509 South Mason Fort Collins, Colorado 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 TIER I — Cont'd Platte Valley Ambulance Service EMS 1600 Prairie Center Parkway Brighton, Colorado TIER II American Medical Response of Colorado 3800 Pearl Street Boulder, Colorado TIER III Stadium Medical 695 Canosa Court Denver, Colorado 2018-3837 i' f3 I -I LOOSO 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, 2019, TO OPERATE AN AMBULANCE SERVICE IN WELD COUNTY IN ACCORDANCE WITH EXISTING WELD COUNTY RULES AND REGULATIONS. CHAIR, BOARD OF WELD COUNTY COMMISSIONERS 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. Recommendation of the Weld County Emergency Medical/Trauma Service Council for: Frederick Firestone Fire Protection District efficient, Recommendation 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: Findings In review of FFFPD application, we find no reason to have issue. They are well staffed, well trained and professionals. I have heard no complaints from anyone living in the Frederick Firestone service area. Frederick Firestone Fire provides EMS transport services. License request should be approved. Frederick provides excellent service and back up when needed in Weld County. Meet the efficient, effective and coordinated expectation. In review of FFFPD application we find that their service meets the necessary requirements. They have a service that provides an efficient, and effective, and coordinate response to the resident of their response area. Additionally, they are willing to assist neighboring agencies when requested. Frederick Firestone Fire continues to provide timely response to their response area and works collaboratively to provide mutual aid resources when they are requested by neighboring districts. Recommended Level of Service: CD Recommended Service Area: The EMTS Council recommends the service area as noted in Frederick Firestone Fire Protection Districts license application. Other EMTS Council recommendations or comments: The EMTS Council finds that Frederick Firestones Fire Protection Districts application meets all requirements and believe that their service deliver meets effective and coordinated service delivery. By: _Lance Homann r 0,.-- Date: 1 i - IC - ill 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: 0 -O,6 - Z9, Z.aY Name of Ambulance Service: Pderi G k T, -✓65 Owner: Name: FPS Address: gYZ 6 XO5/ Pke. , Phone Number: 305-753- Z -71-/Z Operations Manager: Name: Vpt'ccqq 8.0-1lr�� Address: �it➢�7P Phone Number: 60-nre Email: dprtink r 11e4 #1, 0s Medical Director: Name: a V ?l C%eeK SC_L. 6OOC/ 61 a- 7071 4d/Celt t eACO3 Phone Number: Address: 303- i/Z5-- Zz2317 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): .4/ ce— What area of Weld County will be served by this company? Please attach a map indicating the service area. /;lap it- i aci4ed Health Administration Vital Records Tele: 970-304-6410 Fax: 970-304-6412 Public Health 8 Clinical Services lele: 970 304-6420 Fax: 970-304-6416 Environmental Health Services Tele.:970-304-641.5 Fax: 970-304 641 I Communication, Education & Planning Tele: 770-304-6470 Fax: 970-304-6452 Emergency Preparedness & Response Tele:970-304-6470 Fax: 970-304-6452 Public Health Page I 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: City: L Location #2: Street Number: State: Phone: 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: NIYes ❑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: pirYes ❑ 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 SERVICE LICENSE HAS BEEN ISSUED BASED ON FALSE INFORMATION CONSTITUTES GROUNDS FOR LICENSE REVOCATION AND POSSIBLE CRIMINAL PROSECUTION. gtlature of Applicant Title Ito/PA Ito/PA SUBSCRIBED AND AFFIRMED BEFORE ME THIS 0 DAY _Val et- , 20 t�+ , IN THE COUNTY OF Wzld STATE OF COLORADO. DALE ROBIN INGRAHAM NOTARY PUBLIC STATE OF COLORADO NOTARY ID 20044034067 My Commission Expires Sept. 23, 2020 ature of Notary My Commission expires: 09 / a3 / 10.20 *Please make additional copies as necessary. Page 6 I 'Frederick Firestone Fire Response Zones r t. l t . - Cr 12 �- n- -•- -0- •-_ •-• • IlPO11►IlS �... Ilia ass WY - •..ta.fb-•. _.... --r • sf I-1 • V troikas . 'Sloe "el 0• 4. r • I I I I I 1 I 1 I 1 1 • wl u1 M '1 I • • 1 •3)---a a� . I I I t • - S a r M 1 I 1 I 1 1 I I 1 1 C. 6 Is a Op • 3 FREDERICK -FIRESTONE FIRE PROTECTION DISTRICT Operations Section Office: (303) 833-2742 Fax: (303) 833-3736 E -Mail: dprunk@fffd.us October 23, 2018 The Frederick -Firestone Fire Protection District currently has EMS Mutual -Aid agreements with the following agencies: • Mountain View Fire Protection District Respectfully, Doug Prunk Assistant Chief Physical: 8426 Kosmerl Place, Frederick, CO 80504, Mailing: P. O. Box 129, Frederick, CO 80530; www.fffd.us FREDERICK -FIRESTONE FIRE PROTECTION DISTRICT Operations Section Office: (303) 833-2742 Fax: (303) 833-3736 E -Mail: dprunk@fffd.us October 23, 2018 The Frederick -Firestone Fire Protection District currently has three fire stations. Each fire station houses one of the District's Ambulances. These ambulances are located at: Station #1 - Ambulance 3421 31 Walnut Drive Frederick, CO 80530 303-833-3727 Station #3 - Ambulance 3423 6800 Tilbury Avenue Firestone, CO 80504 303-833-4458 Station #4 - Ambulance 3424 3525 Hwy 119 Firestone, CO 80504 303-710-1720 Respectfully, uglas J. Prunk Assistant Chief Physical: 8426 Kosmerl Place, Frederick, CO 80504, Mailing: P. O. Box 129, Frederick, CO 80530; www.fffd.us Hello