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Home My WebLink About20183841.tiffRESOLUTION RE: APPROVE APPLICATION FOR TIER I EMERGENCY MEDICAL SERVICES LICENSE AND AUTHORIZE CHAIR TO SIGN - UC HEALTH EMERGENCY MEDICAL SERVICE, DBA POUDRE VALLEY HOSPITAL EMERGENCY MEDICAL SERVICE 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 UC Health Emergency Medical Service, dba Poudre Valley Hospital Emergency Medical Service 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 Service 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 UC Health Emergency Medical Service, dba Poudre Valley Hospital Emergency Medical Service for a Tier I Emergency Medical Service 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: datitoti je to%vi. Weld County Clerk to the Board BY: AP Deputy Cle to(the Bbar County torney Date of signature: l/q ci StevMoreno, Chair • arbara Kirkmeyer, ro-Tem can P. Conway id -e; efraad L. HLCMW I TGA,L MLRIl 11311iq 2018-3841 HL0050 Memorandum TO: Steve Moreno, Chair .1 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 2018-3841 1 -IL 0050 WELD COUNTY DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT License to Operate Ambulance Service TIER I POUDRE VALLEY HOSPITAL EMERGENCY MEDICAL SERVICE Name of Service 2315 EAST HARMONY ROAD, SUITE 200, FORT COLLINS, COLORADO 80524 Address POUDRE VALLEY HEALTHCARE, INC. 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: UC Health EMS dba Poudre Valley Hospital EMS 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: Comments Poudre Valley continues to provide timely response to their response area, and quality care. Poudre Valley has been serving the western part of Weld County for several years. I have heard no complaints. FRFR and Windsor Severance have no issues with the service being provided. The cooperative arrangement provides for an effective and efficient EMS service delivery model for their response areas. Poudre Valley / UCH continues to provided excellent service both 911 and routine transfer work in Weld County. No interaction with Poudre Valley EMS, have no issues PVH EMS has been responsive for request for mutual aid and is supportive of adding FRFR and WSFR on providing excellent service to the guest and citizens of our respective response areas. The meet if not exceed our ability to provide a coordinated, effective and efficient response. Poudre Valley Hospital EMS continues to provide timely response to their response area and works collaboratively to provide mutual aid resources when they are requested by neighboring districts. Contributes to the efficient, effective, and coordinated emergency response to the residents of Weld County. Has mutual aid agreements with other Ambulance Service providers to assist other agencies when possible. Meets all contractual response/service requirements. Communicates effectively with the other ambulance providers when they are responding to or transporting from, as well as standing by at events in Weld County. No MAA with other Ambulance services? EMS's and agreements. Recommendation Recommended Level of Service: 0 Recommended Service Area: The EMTS Council recommends the service area as noted in Poudre Valley Hospital EMS license application. Other EMTS Council recommendations or comments: The EMTS Council finds that Poudre Valley Hospital application meets all requirements and believe that their service deliver meets efficient, effective coordinated service delivery. UCH/PVH EMS will send the WCDPHE an updated list of all mutual aid They presented the list at the meeting. By: Lance Homann ? 'A- Date: 11 - li -1 y 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 Dale o. 1'ApplicaIion: /0/45--/g Name of Ambulance Service: (�('l�ifi�� c1;is -( , Pocidtr,__._lltlr/r rr�ll/i_;!9, i.. Owner: Name: /Lie Ueclky Aiidkur/-- _Z1r Adriress. 31 �- l c xncvy_ c/.. SL6dt--- ,O ) 6)//i,.,-i �v Phone Number: _ %5: _ _ . Operations Manager: Name: c(S-40, t✓ Address: C7)47 5, /YIr/,‘.nn a/ /-Lt /Orf Phone Number: 7, - ,r - 2cll,0 Elrod l : it /i,,r- Sepik/47. hrcr// 4 etc Medical Director: Name: __batrrll ', b/cry 1_60 Address: //))4' .5. .4i?a.iy err' l!U/,r[s{ e,s-?` Phone Number. _9?e, - 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 applicahte): .x,1:1 What area of Weld County will be served by this company? Please attach a map indicating the service area. H?uilh 0 J rlrr sir atlon Jitcl Rcr crU. Emrno-m�,ntnl r�,ealir -crrmoni:choir irnerg <:ncy GrennriiJ ,,c:s a Snrvicec .Her.:5�,n': P-unni',g 2 Rn;pon sc • Public Health • IIow many ambulances do you operate? 21 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: Location #2: Street Number: City .. State: Phone: State: Phone: As required in Section 7-3-30 of the Weld County Code Ordinance and Chapter 4 Section 6 of the CDPIIE 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: iZt 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 pro tided in Se'aion 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: 'l'ier I: Licensure authorizing for Primary Care, as defined in Section 7-1-30 of this Chapter. 'Her I1: 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 111 I HEREBY C'ERT'IFY TI IAT I AM AUTHORIZED TO SUBMIT THE FORGOING APPLICATION AND THE INFORMATION PROVIDED IN THIS APPLICATION IS TRUE TO THE BEST OF MY KNOWLEDGE AND BEI,IEF AND CONTAINS NO WILLFUL, MISREPRESENTATION OR FALSIFICATION. IN ADDITION, I CERTIFY THAT I HAVE READ AND UNDERSTAND TIIE PROVISIONS AND REQUIREMENTS OF WELD COUNTY CODE CHAPTER 7, INCLUDING, I3UT NOT LIMITED TO, SECTION 7-S-10, WIIICII ENCOURAGES ALL LICENSED AGENCIES PROVIDING EMS RESPONSE IN WELD COUNTY TO MAKE A GOOD FAITH EFFORT TO EXECUTE WRITTEN MUTUAL AID AGREEMENTS WITH AEI. 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. r f ( Signature of Aplicant Title' SUBSCRIBED AND AFFIRMED BEFORE ME TIIIS DAY Cal -O,,( , 201 , IN THE COUNTY OF A'Lt fit L'R- , STATE OF COLORADO. LINDA J. RIGGS STATE CY OLOR PUBLIC MY COMMISSION ID SAN EMBER 17, 2019 Date 4, Sign, ui'e of Not •y 0 My Commission expires: _ ( / _ 17 / ){-l)I 7 • "Please make additional copies as necessary. Windsor -Severance Fire Rescue mMACHFlamm !ar cremes.. Ity • 4 a I -err ••••f1 •••t I barPage • I • I sin k. -diet C3*SA ease Vin • ••1T •• i ,, - - _ 'Pt. 1111 • - •- 11 11 _ : I • •pm... 1 I p. i OS. ,..11,..1•0. •••••••••• • sr so o• •sallo-C11 I I •M — 1 • • • pi 0 } 0: PJ6JAP D 7 Lr:3 NAP P'06 PAP PAE POBNAP • ces 1-44 14- HI RATj' r.AITV t<f' Ar RI' P06KTP :N=L1 COUNTY RO.AC ?1 $ \ N P .AE UCHealth UCHealth Emergency Medical Services October 15, 2018 To Whom It May Concern: UCHealth Emergency Medical Services (UCHealth EMS) has mutual aid agreements in place with the following agencies: Fort Collins Police Services Larimer County Sheriff's Office .Larimer County Dive Team Larimer County Search and Rescue Jackson County Emergency Medical Services Livermore Fire Protection District Red Feather Lakes Fire Protection District Wellington Fire Protection District Glacierview Fire Protection District Estes.Park Emergency Medical Services Thompson Valley Emergency Medical Services Poudre Canyon Fire Protection District Rist Canyon Volunteer Fire Department Crystal Lakes Fire Department Laramie County, Wyoming Sincerely, Nicholas Nolen Quality Manager / Division Chief UCHealth EMS 605-390-3718 3509 5. Mason St. Suite 41 • Fort Collins, CO 80525 • Phone; 970-237-7000 Hello