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Home My WebLink About20163602.tiffRESOLUTION RE: APPROVE APPLICATION FOR TIER I EMERGENCY MEDICAL SERVICES LICENSE AND AUTHORIZE CHAIR TO SIGN - PLATTE VALLEY AMBULANCE SERVICE 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 Platte Valley Ambulance Service 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 Platte Valley Ambulance Service 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: Wait/Li jel0;oki Weld County Clerk to the Board BY: f Mike Freeman, Chair • eauty Clerk to the Sean P. Co way, Pro-Tem } eputy Clerk to the Boar•'~`. Julie A. Cozad AP' ' S ASXCUSED arbara Kirkmeyer o'u n y ttorney Steve Moreno Date of signature: la `aia/ Ifo cc � H ST/ TGtier) cc/ Kai) 01 /03/ 2016-3602 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 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 2016-3602 0 PimpILMUMMMINMNMMLUMMUMMLUMMM ro. mg_ "E "g. "E N ACCORDANCE a N CO N I- c� z D U 0 W Vi z it k— .i CC w N w CC ai (r)w p w 0 QU U U ZQ J Z 4-0 Q LUli ( O ca u D 0 -g Q cu Q D o 0 w O U m D Q U z A o L-1CC 0J �— o vo � C) 0 L9 W \ C H Z o . w 0 J - E- uui c O X o "0 N w U v r. = z (n a: m H o U ao w O L li w o Z U ° o Lu o mF 3. N _ L H = o3 Z U 3 5D co _ O t O 4 CU v) c w t —JE. 7 L IN, 1E. Jo annetanamonnwalanntaninmer - ance Service License to Operate Ambu 6 w 0 W w 0 U < C o m w o Is U) 0 w W U z U Z 0 d 5 1 U 0 o 2 v v v W 3 2 46 cav 'Q w w Z W M J W I-, a ,Q o w W W m 5 0 W 1 a I. 0 W 0 h w a O NOT TRANSFERRABLE / POST IN A CONSPICUOUS PLACE ma Recommendation of the Weld County Emergency Medical/Trauma Service Council for: Platte Valley Ambulance Service As required in Section 7-2-100.6.5., 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: Platte Valley Ambulance services approximately 25 square miles of Weld County, including the Town of Lochbuie and Wattenburg running 800 calls for service. Platte Valley runs 3 ambulances. FINDING #2: Platte Valley Ambulance is in good standings with the Weld County Department of Public Health & Environment. FINDING #3: Per neighboring agencies, Platte Valley Ambulance provides mutual and auto aid in an efficient, effective and coordinated manner. FINDING #4: Recommended Level of Service: XX Tier 1 Tier 2 Tier 3 Recommended Service Area: As listed in the Platte Valley Ambulance 2017 application. Other EMTS Council recommendations or comments: Recommendation B / r / 2 4O Date: _ l Health AdmU9sralion VRar Records Teie: Y/0-3046410 Fax: 970-304-6412 DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 North 17th Avenue Greeley, CO 8O631 www.weldhealth.org Public Hearth & Clinical Services fele; 970-304-6420 Fox 970-304-6.4I6 lID Environmental Health services Isle: 970-344-6415 Fax: 970304-64i I Corm urtitc atom. Education& naming fele: 973-304-6470 Fax: 970-304-6452 Public Health Emergency Pv.pas.dn.ss & Response Tele: 970-304-6420 Fax: 970-304-6469 Ott vision- Together with the communities we serve, we are working to make weld County the healthiest place to live. learn, work, and play. AMBULANCE SERVICE LICENSE APPLICATION Date of Application: Monday, October 24, 2016 Name of Ambulance Service: Platte Valley Ambulance Service Owner: Name: Platte Valley Medical Center Address: 1600 Prairie Center Parkway, Brighton, Phone Number: (3 03 ) 498-1600 CO 80601 Operations Manager: Name: Carl A. Craigle, Jr. NR -Paramedic (Chief Paramedic) Address; 1750 E. Egbert Street, Brighton, CO 80601 Phone Number: (720) 685-8439 Email: earl.craiglejr@sclhs.net Medical Director: Name: Candace Harrod, MD Address: Z600 Prairie Center Parkway, Brighton, CO 80601 Phone Number: (303 ) 498-1600 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): Platte Valley Ambulance Service is a department of Platte Valley Medical .Center_,__communi r v- clwned., non-profit hospital __As._such_tte_ have no 1S oc)cdt cholders Attached i_c a current list of theboard of directors What area o e County will be served by indicating this company'ease attach a map the service area. Towns of Lochbuie and Wattenburg. We also provide mutual -aid coverage for the communities of Ft. Lupton, Keensburg, Prospect valley and Roggen. Occasionally asked to provide coverage for the town of Platteville. How many ambulances do you operate? Six, three of which are normally on duty and three in reserve. 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 # I: Street Number: 17 5 0 E. Egbert Street City: Brighton State: CO Phone: (303) 981-8740 Location #2: Street Number: PVAS station #2, on Platte valley Medical Center Campus City: Brighton State: CO Phone: (303 ) 498-1820 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 die date of the application, are you in compliance with the minimum data collection and reporting of transportation and/or treatment of patients: mYes 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: EYes ❑N() 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 sery ice: Tier 1: Licensure authorizing for Primary Carc, 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 1 ❑ Tier II ❑ Tier III Page 3 IL ih IF d v ai co v c m 7.O y G Q m J+ V CD :a co a) J E tiPs L ITI3 it: II a M N C O rr t mL cO m a) 0 LI .0 Q 0) Cu y ci) c 0 0 0 0. z u) s2 a) cg to E >1 cc C >, = O O Iii v z 31-6 Q. 13 co W N C . O > S C •� O D mU rot}}1°) a)7 L LU a w- -o Co CL E 7-62 o U C C 0) 0 ca I— N - 0) C .C a • ` a) CD C L 0 a• a 03 0 E1- . cri 0 o Mr C C O • .. .E N 73 V i 0 0 Z Mutual Aid Platte Valley Ambulance Service is the designated 911 ALS transport provider for the Greater Brighton Fire Protection District. Under the terms of our agreement, we service the terms of the Fire District's mutual agreements. In addition to those, we also maintain mutual aid agreements of our own with Northglenn Ambulance Service and Weld County Paramedics (now Banner Health). I III'ItEBY CERTIFY THAT I AM AUTHORIZED TO SUBM:T TILE 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. TN 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 ALI, OTHER EMS PROVIDERS LOCATED WITHIN OR BORDERING ON THEER 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' 1 FPmasfr`YptG i>3gJ2>11� ign ' - Hle Srg�talur� ul Alipl -ant Title t41I SUBSCRIBEDA'dp&gtMED I EVOKE ME IT US -11- DAY CC�-�r tI , 20 U% , IN *HIE COUNTY OF A- j , STATE OF COLORADO. NICKIE MAILLET NOTARY PUBLIC STATE OF COLORADO NOTARY ID 20074020287 MY COMMISSION EXPIRES MAY 23, 2019 Signature. of Notary My Commission expires: 0 Sl 2 3 L269 Page 7 Hello