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Home My WebLink About20183844.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 Service 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 3rd day of December, A.D., 2018. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: Weld County Clerk to the Board ounty ttorney Date of signature: I (q 119 Moreno, Chair c_C:1-kLLMW I TCA Q MC & 113\1t9 2018-3844 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 2018-3844 Q/3 I-ILOOSO 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, 2019, TO OPERATE AN AMBULANCE SERVICE IN WELD COUNTY IN ACCORDANCE WITH EXISTING WELD COUNTY RULES AND REGULATIONS. DEC 0 3 2018 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: Windsor Severance FPD 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: Findings In review of WSFR application, we find it meets the requirements. They respond quickly and professional. Windsor Severance Fire provides EMS service to the response area in cooperation with UCH. This arrangement has been in place for several years and provides an efficient and effective EMS system to their area. Windsor Fire is available for mutual aid response. Windsor Severance FR has provided excellent service and mutual aid coverage when requested. No interaction with Winsor Severance, have no issues In review of WSFR 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. Windsor Severance Fire Rescue continues to provide timely response to their response area and works collaboratively to provide mutual aid resources when they are requested by neighboring districts. Meets the efficient, effective, and coordinated expectation Recommended Level of Service: Tier 1 Recommended Service Area: The EMTS Council recommends the service area as noted in Windsor Severance Fire Rescue's license application. Other EMTS Council recommendations or comments: The EMTS Council finds that Windsor Severance Fire Rescue's application meets all requirements and believe that their service deliver meets efficient, effective and coordinated service delivery. Recommendation By: _Lance Homann cam- (7 (IN----- Date: li- 1S - t% EMTS Council Chair AMBULANCE SERVICE LICENSE APPLICATION Date of Application: November 1, 2018 Name of Ambulance Service: Windsor Severance Fire Protection District Owner: Name: Windsor Severance Fire Protection District Address: 100 North Seventh Street, Windsor CO 80550 Phone Number: 970-686-2626 Operations Manager: Name: Michael Blackwill, Operations Chief Address: 100 North Seventh Street, Windsor CO 80550 Phone Number: 970-686-2626 Email: mblackwill@wsfr.us Medical Director: Name: Darren Tremblay, D.O. Address: 1024 South Lemay, 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. Page 2 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 Location #2: Street Number: 100 North Seventh Street State: CO Phone: 970-686-262 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: AUYes 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, arc you in compliance with the reporting requirements of the agency profile: ALl 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: ALJ Tier I ❑ Tier II ❑ Tier HI Page 3 I have verified the following information: SZ No employees of Colorado Ambulance Service have had any criminal complaint or convictions, including Class I and II traffic violations, within the previous twelve (12) months. Sec. 7-3-50 Criminal record of ambulance crew member. Unless waived by the Board of County Commissioners, no person shall be employed by an ambulance service as an ambulance crew member who has been convicted of any of the following offenses within the previous twelve (12) months from the date of application: felony, misdemeanor or Class I or Class II traffic offense. (Weld County Code Ordinance 2007-8) gl Colorado Ambulance Service has not had any judgments entered against us within the previous twelve (12) months, including findings of fact, conclusions of law and order by any court or other tribunal. Sec. 7-2-90 Application requirements. Copies of any judgments entered against the licensee or license applicant within the previous twelve (12) months, including findings of fact, conclusions of law and order by any court or other tribunal. Proof of a valid driver's license. Proof of insurance, as required in Section 7-3-60 of this Chapter. Colorado Ambulance Service maintains proof of valid driver's license for employees. The ambulance service has an ongoing medical continuous quality improvement program consistent with the requirements defined in the Colorado Board of Medical Examiners rules, 3 C.C.R. § 713-6, Rule 500, 3.2, b. The ambulance service meets the minimum insurance requirements. Sec. 7-3-60 Insurance. Each ambulance service shall maintain insurance coverage for each and every ambulance owned, operated or leased by the ambulance service, providing coverage for injury to or death of persons in accidents resulting from any cause for which the owner of said vehicle should be liable for any liability imposed on him or her by law, regardless of whether the ambulance was being operated by the owner, the owner's agent, lessee or any other person, and coverage as against damage to the property of another, including personal property, under like circumstances, in the following amounts: 1. Workers' compensation insurance: Each ambulance service shall maintain at least the statutorily required amount of workers' compensation insurance. 2. Public liability and property damage bodily injury: a. Each person, six hundred thousand dollars ($600,000.00); b. Each accident, six hundred thousand dollars ($600,000.00). 3. Property Damage: Each accident, six hundred thousand dollars ($600,000.00). 4. Professional Liability Coverage: a. Each person, six hundred thousand dollars ($600,000.00); b. Each accident, one million dollars ($1,000,000.00). 5. Ambulance vehicle coverage: The ambulance vehicle insurance shall be a complying policy for motor vehicles, as defined in Sections 10-4-609 and 42-7-103, C.R.S. Please be aware that the criminal background information and motor vehicle records information must be current at the time of submittal of the Ambulance Application. Page 5 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. Signature of Applicant -1F/TtJtia-- erne,. / a - 2 4 -/ 8 Title Date SUBSCRIBED AND AFFIRMED BEFORE ME THIS DAY e 9 , 20 14.75 , IN THE CO ITY OF 1"I�t , STATE OF COLORADO. ANN M SELLERS NOTARY PUBLIC STATE OF COLORADO Ml' C NOTARY ID # 20114067269 MISSION EX `. RES acTpgip is 2a1 s M 4,11 Signature of Notary u/ Commission expires: (/// /,‘" / ( 1 *Please make additional copies as necessary. Page 7 t Iresi S toe _. s' • M. . 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I1; .sews �. s • t..J/413::" 1 sees 1... HUH l 1 L r' •• 1 : i... . 1 .__ a � • h 1 I r M• .-•I i 111 1 • ..♦ `sae Sol" 1 1 1-4 •_ . F 1�1•` • i �,,, l° a en 111;11;(.. 1 1 / ay. . •raw It \11 sees ■ 1 •• •a.. •w• .�...' . 1 • Windsor Severance Fire Rescue 100 N. 7th Street • Windsor • Colorado • 80550 970-686-2626 October 31, 2018 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 • lnstagram • Facebook • Twitter • www.wsfr.us Hello