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Home My WebLink About20173972.tiffRESOLUTION RE: APPROVE APPLICATION FOR TIER I EMERGENCY MEDICAL SERVICES LICENSE AND AUTHORIZE CHAIR TO SIGN - MOUNTAIN VIEW 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 Mountain View 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 Mountain View 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 27th day of November, A.D., 2017. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLOF DO ATTEST: d,..1,,tittA) A4;11 Weld County Clerk to the Board BY` 2QO ' Deputy Clerk to the Board County Attorney Date of signature: ta 11 ( l7 CG : (-I LC M6) Ol/la/ I� Julie A. Cozad, Chair EXCUSED Steve Moreno, Pro -Tern Sean P. Conway ike Freeman 2017-3972 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 III Colorado Motocross Medics 729 Remington Street Fort Collins, Colorado Stadium Medical 695 Canosa Court Denver, Colorado 2017-3972 II/a7 H l_O OM 9 Name of Owner :D UNTIL DECEMBER 31, 2018, TO OPERATE AN AMBULANCE SERVICE IN WELD COUNTY IN ACCORDANCE 7 L Recommendation of the Weld County Emergency Medical/Trauma Service Council for: Mountain View Fire and Rescue 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: Mountain View Fire Protection District (MVFPD) services areas of Boulder and Weld County. In Weld County they cover the Town of Mead, City of Dacono, Town of Erie and unincorporated area of Del Camino. Of the three ambulances in service, two are located in Weld County. FINDING #2: MVFPD meets the Standard of Cover Response times adopted by the Board of Directors. FINDING #3: MVFPD is in good standings with the Weld County Department of Public Health & Environment. FINDING #4: Per neighboring agencies, MVFPD provides mutual and auto aid in an efficient, effective and coordinated manner. Recommended Level of Service: XX Tier 1 Tier 2 Tier 3 Recommended Service Area: As listed in the MVFPD 2018 application. Other EMTS Council recommendations or comments: Recommendation B Date: 11/20/2017 Date of Application: AMBULANCE SERVICE LICENSE APPLICATION 1p/L3 /,}- Name of Ambulance Service: 17*rft/ V,. f f rte— f0 i t 7s,./ 0rf P+ -r cr. Owner: Name: Ale ,.w 7797 .✓ V�✓ /114-e- P'U' ree.7, 1 O15 .. --f Address: 3aj/ N 5-r :! -,4 # fD ,(o..h rts+..i C'o p'cs c- Phone Number: . 7 71. - '7 Operations Manager: Name: KGr.'7•- Go -r4 E.+1 f C/6 Ef Address: ?SG / (ThtG E coA cry 40 1o,✓5af--T <c re, y Phone Number: Jo 3- 7 7 2- 0 >) o Email: JL 1 e m✓ f(d. e J Medical Director: Name: (,?e, /4-o, 4 A4'# Address: 5Q, n/. f,7rGErc r e4, /1,r7 c,. �,Hs, :, �. f vrz y Phone Number: 3v7 - 771- - C71 o 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): Ai/4 What area of Weld County will be served by this company? Please attach a map indicating the service area. Scr �y e -t ft" WE c J Page 2 How many ambulances do you operate? S A,ri a✓e 4,..t -c f Az, Fri -1 5 ilzCe s 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: Ste /t,iAef,0 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 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: ®Yes 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: ® 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 O Tier III Page 3 MOUNTAIN VIEW FIRE PROTECTION DISTRICT Location/Description of Ambulance Location October 2017 Station 1- Hwy 119 Engine 2201 10939 WCR 5 Longmont, CO 80504 303-772-0710 Station 3 — Mead Paramedic Engine 2203 441 Third Street Mead, CO 80542 970-535-4330 Station 4 — Niwot Ambulance 2224 Engine 2204 8500 Niwot Road Niwot, CO 80544 303-652-2984 Station 6 — Erie Ambulance 2226 Engine 2206 50 Bonanza Drive Erie, CO 80516 303-828-3152 Station 7 — Dacono Ambulance 2227 Engine 2207 161 Perry Lane Dacono, CO 80514 303-833-3896 Station 5 Brownsville Reserve Ambulance 10911 Dobbins Run Lafayette, CO 80026 Station 10 Battalion Chief Reserve Ambulance 9119 East County Line Road Longmont, CO 80501 Maintenance Dacono Reserve Ambulance 100 Forest Dacono, CO 80514 Dispatch Centers Boulder County and Weld County 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 IIAS BEEN ISSUED BASED ON FALSE INFORMATION CONSTITUTES GROUNDS FOR LICENSE REVOCATION AND POSSIBLE CRIMINAL PROSECUTION. /44k)/ flu 7>2 Signature of pplicant Title Date SUBSCRIBED AND AFFIRMED BEFORE ME THIS 4� DAY DCi-C, )-(2.r , 20 1 , IN THE COUNTY OF V\J c\ CHERYL S LARSON NOTARY PUBLIC STATE OF COLORADO NOTARY ID # 19914017547 MY COMMISSION EXPIRES 01-14-2020 i , STATE OF COLORADO. —OA- &1446L-' Signature of Notary My Commission expires: ` / )4, *Please make additional copies as necessary. Page 7 C per • w a. ....r. L' t -4- 1 } Mountain View Fire Protection District (Fire Response Zones) Vint{.... Z.•t GP.a• lest••).Y .... NW a �.fndrtd Svetl MtFen B !fi/� 1-1(4^44•41 Ytt-is L 1Wn" vs. 4 - wt. ...... c •4 '74 •{ L. 0 •s - vearreva 4.• LI MOUNTAIN VIEW FIRE RESCUE 3561 N. Stagecoach Road, Unit 200 • Longmont, CO 80504 (303) 772-0710 • FAX (303) 651-7702 To Whom It May Concern: Below is a listing of the mutual aid agreements Mountain View Fire Protection District has with surrounding agencies. Mutual Aid Agencies Frederick/Firestone Fire — Fire/Ambulance Longmont Fire- Fire Berthoud Fire - Fire Johnstown Fire - Fire Platteville Fire - Fire Fort Lupton Fire - Fire North Metro Fire — Fire/Ambulance Lafayette Fire — Fire/Ambulance - Boulder Rural Fire - Fire Louisville Fire — Fire/Ambulance Mountain View Fire Protection District has mutual aid with all fire agencies in both Weld and Boulder County. We are in the process of getting a mutual aid agreement AMR Ambulance. Keith Long Assistant Chief Mountain View Fire Protection District. www.mvfpd.org Hello