HomeMy WebLinkAbout20163600.tiffRESOLUTION
RE: APPROVE APPLICATION FOR TIER I EMERGENCY MEDICAL SERVICES LICENSE
AND AUTHORIZE CHAIR TO SIGN - FRONT RANGE FIRE RESCUE
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 Front Range Fire Rescue 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 Front Range Fire Rescue 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 28th day of November, A.D., 2016.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: �� W, ..aClato•ja
Weld County Clerk to the Board
eputy Clerk to the Board
Mike Freeman, Chair
Sean P. Conway, Pro -Tern
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APP' :'; D AS S ' • RM: r /� �•._ . �i USED
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Date of signature: I alas'/ Icy
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2016-3600
HL0048
Memorandum
TO: Mike Freeman, Chair
Board of County Commissioners
FROM: Mark E. Wallace, MD, MPH
Executive Director
Department of Public Health & Environment
DATE: 11/28/16
SUBJECT: 2017 Applications for Ambulance Service
License
Enclosed for the Board's review are eleven applications for ambulance service licenses pursuant to Chapter 7 of
the Weld County Code (WCC) from the ambulance service providers listed below. Chapter 7 pertains to
Emergency Medical Services.
The Weld County Emergency Medical Trauma Service (EMTS) Council reviewed the application for each
ambulance service on November 16, 2016. The Council approved 10 of the 11 applications. *Colorado Motocross
is contingent on their attendance at BOCC hearing (11/28/16). *Stadium Medical was the only application not
approved by EMTS council.
Based on the scope 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,
am recommending the following ambulance service providers listed 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
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
Tier I continued
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
2016-3600
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Recommendation of the Weld County Emergency Medical/Trauma Service Council
for: Front Range Fire 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: Front Range Fire Rescue (FRFR) services approximately 75 square miles of Weld County,
including the Towns of Johnston and Milliken running 1,500 calls for service. FRFR runs 2 ambulances.
FINDING #2: FRFR meets the Standard of Cover Response times adopted by the Board of Directors.
FINDING #3: FRFR is in good standing with the Weld County Department of Public Health & Environment.
FINDING #4: Per neighboring agencies, FRFR 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 FRFR 2017 application.
Other EMTS Council recommendations or comments:
Recommendation By:
(-- 1S
-� Date: / Mc
Date of Application: 10/22/2016
Name of Ambulance Service: Front Range Fire Rescue Authority
Owner:
Name: Operations Chief Bernie Covillo
Address: 101 S. Irene Avenue Milliken, CO 80543
Phone Number: 970-587-4464
Operations Manager:
Name: Bernie Covillo
Address: 101 S. Irene Avenue Milliken, CO 80534
Phone Number: 970-587-4464
Email:
bcovillo@frfr.co
Medical Director:
Name: Doctor Michael Apostile
Address: 1024 South 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.
How many ambulances do you operate? 3
Page 2
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:
t
Street Number:
1_00 Telep Ave
City: Johnstown State: CO Phone: 970-587.4464
Location #2:
Street Number: 101 South Irene Ave
City: Milliken State: Co Phone: 970-587-4464
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:
kl 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:
® Yes CI 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 ❑ Tier III
I have attached the following documents to this application:
Page 3
C
I HEREBY CERTIFY
INFORMATION
BELIEF AND CONTAINS
IN ADDITION, I
THAT I
PROVIDED
NO
CERTIFY THAT
AM
IN
WILLFUL
AUTHORIZED TO SUBMIT THE
THIS APPLICATION IS TRUE TO THE
MISREPRESENTATION OR
I HAVE READ AND UNDERSTAND
FORGOING APPLICATION
BEST OF
FALSIFICATION.
THE PROVISIONS
AND THE
MY KNOWLEDGE AND
AND
REQUIREMENTS OF WELD COUNTY CODE CHAPTER 7, INCLUDING, BUT NOT LIMITED
SECTION 7-8-10, WHICH ENCOURAGES ALL LICENSED AGENCIES PROVIDING EMS RESPONSE
TO,
IN
WELD COUNTY TO MAKE A GOOD
FAITH EFFORT
TO EXECUTE WRITTEN MUTUAL AID
AGREEMENTS WITH
AREAS OF RESPONSE.
DETERMINATION THAT
INFORMATION CONSTITUTES
PROSECUTIO
ALL OTHER EMS PROVIDERS LOCATED WITHIN OR BORDERING ON THEIR
AN AMBULANCE SERVICES LICENSE HAS BEEN ISSUED BASED ON FALSE
GROUNDS FOR LICENSE REVOCATION AND POSSIBLE CRIMINAL
t
Signature of Appli
an
Title Date
SUBSCRIBED AND AFFIRMED BEFORE ME THIS PC--
OF
DAY r
�� , 20 1
k, IN THE COUNTY
, STATE OF COLORADO.
LANE WATT
ariZ'
—
,A-Q,ri,c---
NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 20164008982
MY COMMON ECPRE8 MARCH 3, 2020
My Commission
Signature of Notary
expires: D3 / D
3 / ?rv.e)
*Please make additional copies as necessary.
Page 7
EMS MUTUAL AID AGREEMENT
This agreement, made and entered into this le day of April 2013, by and between
Thompson Valley EMS and Windsor -Severance Fire Protection District,
Johnstown Fire Protection District & the Milliken Fire Protection District
WITNESS THAT:
WHEREAS, the agencies hereto maintain paid and/or volunteer emergency medical
services, together with personnel and equipment therefore; and
WHEREAS, it is, and will continue to be, to the mutual benefit of each of the agencies to
assist the other when necessary in providing additional emergency medical equipment and
personnel for the purpose of delivering pre -hospital patient care within the boundaries of the other
agency, and in turn to receive such assistance and
NOW, THEREFORE, in consideration of the premises and the mutual covenants,
performances and agreements hereinafter set forth, it is mutually understood and agreed between
agencies as follows:
1 DEFINITIONS:
1.1 The agency responding to a request within the boundaries of the other agency is
designated as the "answering agency".
1.2 The agency requesting aid under this agreement is designated as the "requesting
agency".
1.3 "Director" or "Chief' means the person responsible for the respective ambulance
service/company or his/her designated and authorized representative.
2 MUTUAL AID ASSISTANCE:
2.1 Each of the agencies agree to respond to the requests for assistance within the
boundaries of the other agency upon request of the requesting director at any and all
times, provided that it shall be entirely within the discretion of the director of the
answering agency as to what personnel and equipment shall answer such call and
whether or not, in any event, such call may be answered consistently with the safety
and protection of the citizens and property of said answering agency.
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