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Home My WebLink About20173980.tiffRESOLUTION RE: APPROVE APPLICATION FOR TIER III EMERGENCY MEDICAL SERVICES LICENSE AND AUTHORIZE CHAIR TO SIGN - STADIUM MEDICAL, INC. 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 Stadium Medical, Inc., 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 Stadium Medical, Inc., 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. ATTEST: ddtitusj JeC�� Weld County Clerk to the Board BY: C....„(2.(2o-e. Clerk to the Board APPROVED AS ounty A ttorney Date of signature: (Q1-1 / CT BOARD OF COUNTY COMMISSIONERS WELD COUNTY, CO ORADO I Julie A. Cozad, Chair EXCUSED Steve Moreno, Pro-Tem Sean P. Conway Freeman e c. H 6- C Tc) °I/tali Er 2017-3980 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 2017-3980 I-ILooy 9 tolamioinme sinmuligintutuntn MU La- 1 a M TE 7 "E 7 Name of Service 695 CANOSA COURT, DENVER, COLORADO 80204 Address STADIUM MEDICAL INC. 7 TE M 7 7 M 7 7 7 M "E 7 .g_ M 7 -7 mg_ 7 -E] 7 mi -7 7 7 E E_ 7 7, 7 M M -7 7 5 7 7 ni a 7 7 U_ al rg 3 7 7 7 "g_ "E 7 lanommunimummen-Le-mmumme- Recommendation of the Weld County Emergency Medical/Trauma Service Council for: Stadium Medical 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: Stadium Medical is a standby ambulance service running 14 ambulances. FINDING #2: Stadium Medical is in good standings with the Weld County Department of Public Health & Environment. FINDING #3: Communications with 911 providers in the service areas that standbys are done has improved, both prior to and during events. FINDING #4: Stadium Medical representative was in attendance for EMTS review and addressed questions from EMTS Council referenced in Finding #3. Recommended Level of Service: Tier 1 Tier 2 XX Tier 3 Recommended Service Area: As listed on their 2018 application. Other EMTS Council recommendations or comments: No other comments or questions. Recommendation B1L7* ' 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: 1 Oil of Name of Ambulance Service: Owner: Name: Address: 54-r.i lim Rodgc, Amts 6 15 CR.nus0. C4 . t,(P v (o _ 2 Phone Number: 3 a 3 54 9- 19111 Operations Manager: Name: Address: Ra �Gr An L5 C' 5 Cah osc. C+,-Derw2r, Co to2.04 Phone Number: 3a 3 - S `{ 9 - 7 q 14 Email: t4brtkC1 A05'-a,ii%dmMt,Ji c 1 . Conel Medical Director: Name: Pe+err Vey man Address: 12.454 BuLkhorrn be. Li;'1..+on, Co ?oiL7 Phone Number: 303 - 972- Iz53 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): What area of Weld County will be served by this company? Please attach a map indicating the service area. Bas c d- G rte. l v Health Administration Vital Records tele: 9?0-3@4-6410 l- ;a: 910-304-64 i 2 Public Health & Clinical Services Flo, 9'9 904 6420 -ax:9/0-304-6416 Environmental Health Services Tele 9.0-304-4415 Fix: 970-304 641 I Communication. Education & Planning tele 970-304-00470 Fax 970-304-0452 Emergency Preparedness & Response Tele:970-304-6470 ax: 970-+04-6452 Public Health Page 1 Iow many ambulances do you operate? 14 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: Q 4 Carlos., C4. City: t nVLi State: Phone: 710 - f; 30 — Zoo 0 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: FAIYes ❑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: es ENo 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 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. `Fier 111: Licensure authorizing for Standby Service, as defined in Section 7-1-30 of this Chapter. Level of Service Requested: ❑ Tier I ❑ Tier I1 2/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, [ 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. 1 C Signature of Applicant Title Jtl1a/17 Date SUBSCRIBED AND AFFIRMED BEFORE ME THIS I 0 4.4 DAY 0 c 4v tr , 20 i l , IN THE COUNTY OF Q 4>7 vL_f y, STATE OF COLORADO. MNtA M$$ANANTE . I11 SOW Woad. *Sem to 20144000113 My Comingon EIIp4NS Jan 2 201 1/14-,; ,.> D. 130-7., �s. Signature of Notary My Commission expires: 61 / O Z% I0 I g *Please make additional copies as necessary. Page 6 10/27/2016 Stadium Medical Inc- Google Maps IS I 1 rF Maps Stadium Medical Inc W 135, Ara rd-dt'An Lite- )(ye 1 •+T iv . 3 1§3► • r Vy a,'tS^ a..s Vd UV, A•e Xcs!tArow� Wilt Are VI an A ieA ui r A v Vca riifly • e ti !,•'• •1 3 9 Itr CI" • • 14,06.44,-4040914 VPIF r,1 W SibAry S1 i I _ t Go ogle *MEDICAL* Stadium Medical Inc 4 reviews Ambulance Service 695 Canosa Ct # Be Denver, CO 30204 stadiumr edicalecom (720) 630-2000 ri $moo. Crc,'1 Z. 7x it •�„•Yj �M teat clef: I, fa it : it: t .., '9.N%4 i • * ( •'s • i ;!a 4. 74 Laity? n Y I' F i • 5461 Cal Whit r 5 di S] 3 u W 2nd Mc Pt skA'it dtfC'2 • ax I w *Sint nlik9ar VT V* AS YHBch kit , 5 a INMN Map data ©2016 Google 500 ft L_,r...,... Ca al V. I I 5 a https://www.google.corn/maps/place&Stadiurn-FMedacal+Inc/@39,7284851,-105.021114,16z/d a=!4m5?3rn411s0x876c7fi4e23564b35:0xdb982b20a3e7bbblam213d.,. 1/2 10/27/2016 Denver - Google Maps Denver 1)x1:11111Cf !vast" Map data ®2016 Google 2 rnr https://www.goagle.com/maps/place/Denver,+ CO/@39,7426223,-105.0281798,11z/data=!4m5!3m4!1s0x876b80aa231f17cf:0xilf3ef4f8278a36d6!8m213d39.7392a.. 1/1 STADIUM *MEDICAL* Mutual Aid Agreements Date: 10/10/17 Stadium Medical currently has Mutual Aid Agreements with: Northglenn Ambulance Action Care Ambulance Denver Health Rodger Ames President, Stadium Medical Hello