HomeMy WebLinkAbout20173977.tiffRESOLUTION
RE: APPROVE APPLICATION FOR TIER I EMERGENCY MEDICAL SERVICES LICENSE
AND AUTHORIZE CHAIR TO SIGN - WINDSOR SEVERANCE 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 Windsor Severance 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 Windsor Severance 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.
ATTEST: datitilo
Weld County Clerk to the Board
Date of signature: Va (1 I 1 ?
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BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ie A. Cozad, Chair
EXCUSED
Steve Moreno, Pro -Tern
can P. Conway
2017-3977
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
2017-3977
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Name of Service
100 NORTH 7TH STREET, WINDSOR, COLORADO 80550
Address
WINDSOR SEVERANCE FIRE PROTECTION DISTRICT
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Recommendation of the Weld County Emergency Medical/Trauma Service Council
for: Windsor Severance Fire Protection District
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: Windsor Severance Fire Protection District (WSFPD) services approximately 90 square miles
of Weld County, including the Towns of Windsor and Severance running 1,900 calls for service. WSFPD
runs 2 ambulances.
FINDING #2: This year Windsor Severance Fire Protection District has met the emergent ALS ambulance
response time of <8:59 in urban areas over 90% of the time, and <11:59 in suburban areas over 90% of the
time.
FINDING #3: WSFPD is in good standings with the Weld County Department of Public Health &
Environment.
FINDING #4: Per neighboring agencies, WSFPD 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 2018 WSFPD application
Other EMTS Council recommendations or comments:
r
Recommendation By: mo o. �--�� Date: 11/20/2017
AMBULANCE SERVICE LICENSE APPLICATION
Date of Application: October 27, 2017
Name of Ambulance Service: Windsor Severance Fire Protection District
Owner:
Name: Windsor Severance Fire Protection District
Address: 100 North Seventh Street, Windsor, CO 80550
Phone Number: 970-686-2626
Operations Manager:
Name: Michael Blackwill, Operations Chief
Address: 100 North Seventh Street, Windsor, CO 80550
Phone Number: 970-686-2626
Email: mblackwill@wsfr.us
Medical Director:
Name: Darren Tremblay, Q.O.
Address:
Phone Number:
1024 South Lemay, Fort Collins, CO 805254
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):
Not applicable
What area of Weld County will be served by this company? Please attach a map indicating
the service area.
Windsor, Severance, and western Weld County
Page 2
How many ambulances do you operate? 0¢if? Two
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: 100 North Seventh Street
City; Windsor
Location #2:
Street Number:
City:
State: CO Phone: 970-686-2626
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:
D 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:
D 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 1: 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 11I: Licensure authorizing for Standby Service, as defined in Section 7-1-30 of this Chapter.
Level of Service Requested: 0 Tier I ❑ Tier II ❑ Tier III
Page 1
Windsor -Severance
Fire Rescue
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Windsor Severance Fire Rescue
100 7th Street, Windsor, Colorado, 80550
970-686-2626
www.wsfr.us
October 24, 2017
Mutual Aid Agencies that Windsor Severance Fire Rescue operates with:
Fire Departments:
• Loveland Fire Rescue
• Poudre Fire Authority
• Ault -Pierce Fire Protection District
• Eaton Fire Protection District
• Greeley Fire Department
• Front Range Fire Rescue)
EMS Transport Agencies:
• Poudre Valley Hospital EMS (UC Health)
• Thompson Valley EMS
I HEREBY CERTIFY THAT I AM AUTHORIZED TO SUBMIT THE FORGOING APPLICATION AND THE
INFORMATION PROVIDED IN TIiIS 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 SERVI ' 'S LICENSE HAS BEEN ISSUED BASED ON FALSE
INFORMATION CONSTITUTES GROUNDS FO C"ENSE REVOCATION AND POSSIBLE CRIMINAL
PROSECI_ITION.
Signature of ApE
n
Title
SUBSCRIBED AND AFFIRMED BEFORE ME THI '
DAY 20j IN THE COUNTY OF
aSTATE OF COLORADO.
ANN M SELLERS
NOTARY PUBLIC
STATE OF CUE r)PAUO
NQT4ftY IC d 201140(5?189
JESSE NEXPIRf9O;TOlfj;Ft I;?_fQli
Signature of Notary
My Commission expires:
*Please make additional copies as necessary.
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