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Home My WebLink About20163606.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 28th day of November, A.D., 2016. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: datiad „do•Ok. Weld County Clerk to the Board n ► eputy Clerk to the Board Filue.ne."'4% D AS �gCUSED �., rbara Kirkmeyer Mike Freeman, Chair ce C Sean P. Conway, Pro-Te County Attorney Steve Moreno Date of signature: lcJIG'&/((o ulie A. Cozad � CC! HLCemrrG/rnLof Ka) °"03/1-1 2016-3606 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 2016-3606 0 0 .-.�l�llull�lL�JU 11 ea w U iI` Z0 •Net whit Iv. 3 L 11 DATE CUOUS PLACE Weld County Code. E. ORADO 8O 10 TI a 1I .0 -1-0 W w 0� O a...0�' Q cu _c Z ,l -- A z z 4--.Q F. Z o 0 b., U IR Q Is! O m j F--- U i IQ O U Q 0 z `4 f� cc ° J -, w Q W '-'-' o ' O'Q ) c IW N 0 c/ l (4) W O L7 Z W H Z o -a VU , 7 J J S N O R H CO C I� rii 54.7 �1 W 03 O N X W 0 et U LU '10 W M IJ. 1 0 Y f N OA T ^^ 11 Z W em Z ~ l Z ro IR .co Z U I ccM o O w o L Q M O C� ro ~ *r L ll.. ' U O Z a. oIR LU s ° a CI 0OD 1 O I Z U 0 'cu IR S w i, QI tt, Z U C) WV) I*1 - ill H ii 0 Ulu u(ululUlulululululul ululult�l 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 h as 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 2017 WSFPD application Other EMTS Council recommendations or comments: Recommendation By: /— Date: / / —1k Date of Application: 10/25/2016 Name of Ambulance Service: Windsor Severance Fire Protection District Owner: Name: Windsor Severance Fire Protection District Address: 100 North 7th Street, Windsor, CO 80550 Phone Number: 970-686-2626 Qperations Manager: Name: Michael Blackwill - Operations Chief Address: 100 North 7th Street; Windsor CO 80550 Phone Number: 970-686-2626 Email: mblackwill©wsfr us Medical Director: Name: Michael Apostle, N1.D Address: 1024 South Lemay Avenue, Fort Collins, CO 80524 Phone Number: 970-495-8006 Name and address of each stockholder of partner owning 10% or more of the outstanding stuck of the company of having more than a 10% ownership interest (if appl icahle): Not applicable What area of Weld County will be served by this company? Please attach a map indicating the service area. Windsor, Severance & western Weld County How many ambulances do you operate? _ e Tidy I've 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 N 7th Street City: Windsor Location 42: Street Number: _ City: - State: Colorado 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: El 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 ❑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 sery ice: Tier I: I,icensure authorizing for Primary Care, as defined in Section 7-1-30 of this Chapter. Tier Il: 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 Ill: Licensure authorizing for Standby Service, as defined in Section 7-1-30 of this Chapter. Level of Service Requested: "Tier [ ❑ Tier It I Her III I have attached the following documents to this application: Page 3 VI -•• I.. 111th, ( Windsor -Severance Fire Rescue • • h.sae* M I I`•A • w e.••••••• I I 'Well IFS 1 L•.••• It 4 •1 station 3 • • • I .. • • V. i•• 1.0. 1 • II • I Sta on 2 • i • • i! 1 Statto ) 1 V. . 1 r _ •r.— — ..c•. . _•• • ..i • •. • . .. ••. .4.....- ...., • • I • i•• • .•11.. • • •1"•. till . I• •I. Well I'll I{4•11• I • • N .. - Windsor Severance Fire Rescue 100 7th Street, Windsor, Colorado, 80550 970-686-2626 www.wsfr.us October 23, 2016 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 • Johnstown Fire Protection District (Front Range Fire Rescue) EMS Transport Agencies: • Poudre Valley Hospital EMS • Thompson Valley EMS 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 All) AGREEMENTS WITH ALL OTHER EMS PROVIDERS LOCATED WITHIN OR BORDERING ON THEIR AREAS OF RESPONSE. DETERMINATION TI EAT AN AMBULANCE JERVICES LICENSE HAS BEEN ISSUED BASED ON FALSE INFORMATION CONSTITUTES GROUND: PROSECUTION. Signature of Applicant )R LICENSE REVOCATION AND POSSIBLE CRIMINAL Title ,a3e7±.:2 44 SUBSCRIBED AND AFFIRMED B : FORE ME THIS .2 �- DAY L 1�Y- , 20 )�,D , IN THE COUNTY OF U1 G , STATE OF COLORADO. D.n$NM SFS .,`(ski PUIILit: +jTkie Of t.t.)L.csItAil!' N;i(R!?Y If; 1 Ali Hda'l'1''' 1 t,li L :,h p.1ls:l.l itr UAi`IIZF 5 r l; i,,rJE t.: 20 i J );/( r r Signature of Notary My r onunission expires: /ThJ9 *Please make additional copies as necessary. Page 7 Hello