HomeMy WebLinkAbout20163598.tiffRESOLUTION
RE: APPROVE APPLICATION FOR TIER I EMERGENCY MEDICAL SERVICES LICENSE
AND AUTHORIZE CHAIR TO SIGN - BANNER HEALTH/NORTH COLORADO
MEDICAL CENTER PARAMEDIC 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 Banner Health/NCMC Paramedic 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 Banner Health/NCMC Paramedic 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: WitifidA) eskito;oka
Weld County Clerk to the Board
BYGZ, •
eputy Clerk to the Board
APP
y Attorney
Date of signature: 1ra I aS-tI Co
Mike Freeman, Chair
Sean P. Conway, Pro-Te
e A. ozad
CUSED
rbara Kirkmeyer
rizo
Steve Moreno
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2016-3598
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, I
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
2016-3598
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Recommendation of the Weld County Emergency Medical/Trauma Service Council
for: Banner Health NCMC Paramedic Services
As required in Section T2 -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: Banner Health NCMC Paramedic Services provided ALS emergent and routine response to
approximately 4000 square miles of Weld County. Responding to approximately 24,000 calls for service,
with a 24 / 7 365 coverage of a minimum of nine (9) ambulances. These ambulances are located at the
station and posting locations listed in the applications throughout Weld County.
FINDING #2: Banner Health NCMC Paramedic Services is in good standings with the Weld County
Department of Public Health & Environment. Banner Health NCMC Paramedic Services meets or exceeds
all contractual requirements with their partners in Weld, Greeley and Evans Colorado.
FINDING #3: Per neighboring agencies, Banner Health NCMC Paramedic Services 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 Banner Paramedics 2017 application
Other EMTS Council recommendations or comments:
-- Date: LL'` !g— 1,17
Recommendation By:
Banner Health / NCMC Paramedics
Ambulance Service License Application
Date of Application: 10/21/2016
Name of the Ambulance Service: Banner Health / North Colorado Medical Center Paramedic Services
Owner:
Name
Address:
Phone Number:
Assistant Chief:
Name
Address:
Phone Number:
Medical Director:
Name
Address:
Phone Number:
For Office Use Only:
Banner Health / North Colorado Medical Center
1801 16th Street. Greeley, CO. 80631
(970) 810 - 2435
Mitch Wagy _
1121 M Street. Greeley, CO. 80631
(970) 810 - 2435
Dr. Rob Lowe
1121 M Street. Greeley, CO. 80631
(720) 317-9964
Name and address of each stockholder or partner owning 10% or more of the outstanding stock of the company
or having more than a 10% ownership interest If applicable:
Not Applicable.
What area of your County will be served by this company?
Please attach a map indicating the service area.
• Map #1.
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:
®Yes ON
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:
NI 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 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: Cgi, Tier I O Tier I1 O Tier Ill
I have attached the following documents to this application:
® A list of all emergency medical service providers who may be called upon to respond to
an emergency with the ambulance service. This list shall include the following
information on each person:
1. Complete name and date of birth
2. The highest level of certification, licensurc or training attained.
3. A copy of current EMT -B, EMT -1 or EMT -P certificate issued by the Colorado
Department of Public Ilealth and Environment; nurse licensure or an Advanced
First Aid card from the American Red Cross; or a First Responder course
completion certificate issued by a Division -recognized training center or training
group.
x
A current copy of EMT or Paramedic protocols adopted by the ambulance service in
accordance with standards approved by the ambulance service's medical director.
Stations:
How many stations do you have? 5
Indicate the location and description of the stations from which these ambulances will operate.
If there are more than two locations, attach a separate sheet with the above information:
Location #1
Address:
Phone Number:
1121 M Street. Greeley, CO. 80631
(970) 810 - 2438
Location #2
Address:
Phone Number:
3401 S. 11th Avenue. Evans, CO. 80620
(970) 810-2452
Location #3
Address:
Phone Number:
2000 70th Avenue
(970) 395 - 2690
Location #4
Address:
Phone Number:
Gilcrest Fire Department: 14679 WCR 42. Gilcrest, CO. 80651
(970) 737 - 2966
Location #5
Address:
Phone Number:
Fort Lupton Fire Department: 2999 9th Street. Fort Lupton, CO. 80621
(970) 392 - 2446
• Map #2.
All of the Weld County Service area with the exception of the following cities or towns:
• Dacono,
• Firestone.
• Frederick.
• Johnstown,
• Lochbule.
• Milliken.
• Severance,
• Windsor,
• Southeast Weld.
County _-
11.A.14
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How many ambulances do you operate? 14
C WELD COUNTY
• V
Cg A current copy of the ambulance service's training standards in accordance with the
requirements approved by the ambulance service's medical director that includes proof of
a medical continuous quality improvement program. All training must be through a state -
certified emergency medical services training center.
O A list of ambulance agencies, fire departments, special districts and other EMS providers
with which the applicant has mutual aid agreements, or:
X At this time our agency does not have mutual aid agreements with other
ambulance agencies, fire departments, special districts or EMS providers.
® A current copy of the ambulance service's pharmacological agents and delivery devices
per medical director protocol.
Banner Health / North Colorado Medical Center
Paramedic Services
1121 M Street
Greeley, CO. 80631
ti
Manner l lunith
North Colorado
Medical Center
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 FOR LICENSE REVOCATION AND POSSIBLE CRIMINAL
PROSECUTION.
v2
lgnature of App
/DI ZS" /16
T , Date
►6s� rc,.
SUBSCRIBED AND AFFIRMED BEFORE ME THIS o5
DAY gt: , 20 1(p IN TIM COUNTY OF
tL , STATE OF COLORADO.
Il TARENA RAE ENGEL I
4 Notary Public I
State of Colorado
+
Notary ID 20134012423
My Commission Expires Feb 27, 2017
Signature of Noty
My Commission expires: 9' / 2-7 / 17
Please make additional copies as necessary.
Banner Health / NCMC Paramedics: County Licensing Application (764 ta2016)- LO I i) C_J
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