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Home My WebLink About20173974.tiffRESOLUTION RE: APPROVE APPLICATION FOR TIER I EMERGENCY MEDICAL SERVICES LICENSE AND AUTHORIZE CHAIR TO SIGN - 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 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 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 27th day of November, A.D., 2017. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: datAvv ;gi Weld County Clerk to the Board BY:(pj.•R puty Clerk to the Board APPROVE AS TO ou y : ��. ney Date of signature: k a I 1 < t? C. RLCT6.) Ol/''a(18' EXCUSED . Cozad, Chair Steve Moreno, Pro-Tem Sean P. Conway ike Freeman 2017-3974 HL0049 Memorandum TO: Julie A. Cozad, Chair Board of County Commissioners FROM: Mark E. Wallace, MD, MPH Executive Director Department of Public Health & Environment DATE: November 20, 2017 SUBJECT: 2018 Applications for Ambulance Service License 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 16, 2016, and approved all 11 applications. Please note: Front Range Fire Rescue is asking the BOCC for a waiver per county code for an employee convicted of a Class I driving offense. Front Range Fire Rescue has included a letter with further detail in their application. Weld County Code, Section 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; Weld County Code Ordinance 2013-7)." 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 continued Tier I continued 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 Platte Valley Ambulance Service EMS 1600 Prairie Center Parkway Brighton, Colorado Tier HI Colorado Motocross Medics 729 Remington Street Fort Collins, Colorado Stadium Medical 695 Canosa Court Denver, Colorado 2017-3974 (i, L OO ti ci LL I r a "7 jummuntutemantunnmennunanc 7 TE 7 E. E Name of Service 2315 EAST HARMONY ROAD, SUITE 200, FORT COLLINS, COLORADO 80524 Address POUDRE VALLEY HEALTHCARE, INC. 7 7 7 3_ M M "E 7 la la 3_ 7 7 rai ca a "R -E. 7 N_ rg -7 "E -7 7 2 7 5 -7 7 M ral "E. rai -3 -3 la 7 -7 U._ 7 ra I r7� 7 IuILommamInnIannwanIuman-mar, Recommendation of the Weld County Emergency Medical/Trauma Service Council for: Poudre Valley Health EMS 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: FINDING #1: Poudre Valley Health EMS (PVH EMS) services approximately 100 square miles of Weld County, running 700 calls for service. FINDING #2: PVH EMS is in good standings with the Weld County Department of Public Health & Environment. FINDING #3: Per neighboring agencies, PVH EMS provides mutual and auto aid in an efficient, effective and coordinated manner. FINDING #4: Recommended Level of Service: XX Tier 1 Tier 2 Tier 3 Recommended Service Area: As listed in the PVH EMS 2018 application. Other EMTS Council recommendations or comments: Recommendation By: Date: 11/20/2017 AMBULANCE SERVICE LICENSE APPLICATION Date of Application: 10/25/17 Name of Ambulance Service: University of Colorado Health Emergency Medical Services (UCHealth EMS) Owner: Name: Poudre Valley Health Care Inc. Address: 2315 E. Harmony Rd. Suite 200, Fort Collins, CO. 80528 Phone Number: 970-237-7900 Operations Manager: Name: Bryon A. Kerbs Address: 3509 S. Mason St #1, Fort Collins, CO. 80525 Phone Number: 970-213-8969 Email: bryon.kerbs@uchealth.org Medical Director: Name: Darren Tremblay, DO. Address: 1024 S. Lemay Ave., 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): N/A What area of Weld County will be served by this company? Please attach a map indicating the service area. Response areas of Windsor Severance Fire Rescue, Front Range Fire Rescue, and Poudre Fire Authority. How many ambulances do you operate? 27 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: See Attached City: State: Phone: 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: X 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: X 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: X Tier I Tier II Tier III Page 3 UCHealth October 12, 2017 Weld County Department of Public Health and Environment 1555 North 17th Avenue Greeley, CO 80631 To Whom It May Concern: University of Colorado Health Emergency Medical Services The location and description of places from which Poudre Valley Hospital Emergency Medical Services will operate include the following fixed locations: Windsor Fire Department Station 100 N. 7th St. Windsor, CO 80550 970-686-9623 Severance Fire Station 9 Timber Ridge Parkway Severance, CO 80546 970-686-1280 Milliken Fire Station 101 Irene St. Fort Collins, CO 80543 970-587-4464 Sincerely, Brye ft-lfer bsN 11P Manager, Emergency Medical Services Deputy Chief UCHealth EMS University of Colorado Health Brvon.kerbsPuchealth.org 970-213-8969 Johnstown Fire Deptment Station 100 Telep Avenue Fort Collins, CO 80534 970-587-4477 Fort Collins South Ambulance Station 3509 S. Mason St #1 Fort Collins, CO 80525 970-223-8020 Fort Collins East Ambulance Station 913 E Myrtle Fort Collins, CO 80524 970-224-2067 3509 S. Mason St. Suite #1 • Fort Collins, CO 80525 ■ Phone: 970-237-7000 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 Gam. DS FOR LICENSE REVOCATION AND POSSIBLE CRIMINAL PROSECUTION. SUBSCRIBE FFIRMED BEFORE ME THIS / DAY t� , 20 f_ iii}, THE COUNTY OF STAT • OF CO • RADO. 1 ANN M SELLERS NOTARY PUBLIC STATE OF COLORADO NOTARY ID N ?0114057759 MY GQMOId410N txriolteucLellajja ignature of Notary � l My Commission expires: ///) �, t *Please make additional copies as necessary. Page 7 e •4 Y• as I a a d �.a Windsor-Stvera nce Fire Rescue pY",',I.c-yea:.ti.�.uw.^�.+.--•�L.asv�.-+�ld'^pMM^i-u^:.�L"r.'4ir.=wr; 4' 4.•-• C. W. VALLEY FIRE' PROTECi7ON B3 ' la7 • WSFA Staten © Scnoor M;reposi Road Ceolefine a+-_ . a fist 4 A•: T9;t w' Stabcn Bour.dary -- : caz VVSFR Boundary Wa^!' ••••••••••••••444.4404. Vwrvr�•.. 1 i4 $-.* of 3.r0- 9 . 4144. 44. rf•c • . 4- inteliirI� _,.<.„ - . •• M N. w Iw4�• . i f....•w. . ...3*. 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Mason St. Suite #1 • Fort Collins, CO 80525 • Phone: 970-237-7000 Hello