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Home My WebLink About20173979.tiffRESOLUTION RE: APPROVE APPLICATION FOR TIER III EMERGENCY MEDICAL SERVICES LICENSE AND AUTHORIZE CHAIR TO SIGN - COLORADO MOTOCROSS MEDICS, LLC 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 Colorado Motocross Medics, LLC, for a Tier III Emergency Medical Services License and recommend approval, and WHEREAS, after review, the Board deems it advisable to approve said Application for a Tier III 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 Colorado Motocross Medics, LLC, for a Tier III 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, COLQRADO ATTEST: dartAvo;g1 Weld County Clerk to the Board BY: APP � 43 , (_ / uty Clerk to the Boar r J�1tte A. Cozad, Chair ounty Attorney XCUSED HLC-f•C. ) Barbara Kirkmeyer l' _1/4/ Date of signature: L'd ! 1 ( ( 1 2017-3979 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 2017-3979 t t I ea -7 H L O O t -I wommitemeinnwanummtamminimnr7 5 7 7 M 7 Name of Service 729 REMINGTON, FORT COLLINS, COLORADO 80524 Address JOEL D. PAINTER E 7 M 7 7 7 E M M E M E M M M 7 M 7 7 7 E 7 7 7 4 m 7 7 7 7 7 7 7 7 7 7 7 o M 7 E 7 7 7 7 7 M E 5 M 7Ammmumminmnmnnmammnamor Recommendation of the Weld County Emergency Medical/Trauma Service Council for: Colorado Motorcross 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: Colorado Motorcross EMS functions as a standby medical service with one ambulance in service. FINDING #2: Colorado Motorcross EMS is in good standings with the Weld County Department of Public Health & Environment. FINDING #3: Per Weld County agencies that have worked directly with Colorado Motorcross EMS, they provide medical services in an efficient, effective and coordinated manner. Communications with local 911 providers has been consistent without and reported issues. FINDING #4: A Colorado Motorcross EMS representative was in attendance for EMTS review. Recommended Level of Service: Tier 1 Tier 2 XX Tier 3 Recommended Service Area: Standby events as listed in their application. Other EMTS Council recommendations or comments: No other comments. Recommendation By�� — -- — Date: 11-20-2017 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/Z (v ((7 Name of Ambulance Service: Owner: C -o lerzh aelf /I-r,s Name: 7dC Address: 71-9 •of'd Ai 17/9. ‘1,es f Phone Number: 170 • take- aYC Operations Manager: Name: ,'r ors e - Address: Phone Number: fit 7 Email: Medical Director: Name: Address: Phone Number: jd e /C° Jc-t oACet4 4-007 4 rdr tM 0 ?7c9 cr9' S`lz) 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): a; evs-er (mp _ rt'© ' What area of Weld County will be served by this company? Please -attach a map indicating the service area. (. zo ,r ^ tc ocewt 4,..e 4e. 4,, 4.4.. .1 6, Health Administration Vital Records 1@.Ic,-Y/ 3x04-6410 Pac Yi_1304-4=112 Public Health & Clinical Services Q-0 304 5420 'es! /0-304-6416 Environmental health Services Tele' 970-304-6415 Fox: 9 '0 304 641! Communication, Education & Planning Tele: 9/ 304-5470 Fu:: 5'0-3046752 Emergency Preparedness & Response Tele_ 970-304-64.70 Far: 910-304-6452 Public Health Page l 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: 70 f Z r ,� -�f" F��9�✓_0# etc./ - City: 4./44 ad6( State: Phone: 77o • ?i7 ,>fefy Location #2: Street Number: j C/ ./v. /Q City: ON( State: 6.2 Phone: P >'0 - 2/ > 71/1 5/ 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: ErYes ENo 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: L'JYes ❑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 he 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 X 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 SERVICES LICENSE HAS BEEN ISSUED BASED ON FALSE INFORMATION CONSTITUTES GROUNDS I* -R LICENSE REVOCATION AND POSSIBLE CRIMINAL PROSECUTION. nature of Applicant ec G Title Ire -'(I/7 Date SUBSCRIBED AND AFFIRMED BEFORE ME THIS 4-7. DAjG+�+� , 20 11-- , IN THE COUNTY OF , STATE OF COLORADO. of otary y Commission expires: L / 04 / ,201e *Please make additional copies as necessary. Page 6 Map of 20 4 25 W Fronde Rd # 1-25 Berthoud, CO by MapQuest Page 2 of 2 r MAP M [56i;44; 7 42 0 2009 MapQuest Inc JG 44 c40D m I 120C ft 4.} It Map Data 2009 NAVTEC, or TeleAUas All rights reserved. Use subject to License/Copyright Map Legend Directions and maps are informational only. We make no warranties on the accuracy of their content, road conditions or route usability or expeditiousness_ You assume all risk of use_ MapQuest and its suppliers shall not be liable to you for any loss or delay resulting from your use of MapQuest. Your use of MapQuest means you agree to our Terms of http:// wwo apquest.con /maps?cit =Bertoud k styte=Co&address=20125±1.25+Fronta... 10/29/2009 Map of Island Grove Park, N 14th Ave Greeley, COby MapQuest Page 2 of 2 Ma l E P z IV —A en rti at c • •3 ID P9AV WOE bdh St 2009 MapQuest !Re. C I c1 et' '0 1OI3 V IVgI. eAV I-119 I. N 5th St e t ' 4. ,.n.4 fl r;. 2nd St 3rd St 4th St 2' 71-4 CJ C �f r z C Q 7 sex erns omy zr YJ F2011m 1600 ft r: "at Q≥' ..r • z 244 m 0) BR 85 W Map Data -O 200 l�Rv1 ,VTEQ or TeleAtias All rights reserved. Use subject to License/Copyright Map Legend Directions and maps are informational only. We make no warranties on the accuracy of their content, road conditions or route usability or expeditiousness. You assume all risk o€ use. Mapcuest and its suppliers shall not be liable to you for any loss or delay resulting from your use of MapQtuest. Your use of M apQuest means you agree to our Terms of Use Imp://w r. apquest.corn./maps?narne=Island+Grove+Park&citrGreeley&state= CO&a... 10/29/2009 Hello