HomeMy WebLinkAbout20153884.tiff RESOLUTION
RE: APPROVE APPLICATION FOR TIER I EMERGENCY MEDICAL SERVICES LICENSE
AND AUTHORIZE CHAIR TO SIGN-MOUNTAIN VIEW 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 Mountain View 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 Mountain View 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 14th day of December, A.D., 2015.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: did&
C jC,G o;ti
arbara Kirkmeyer, Chair
Weld County Clerk to the B-r*-
sLa`� EXCUSED
Mike Freeman, Pro-Tern
BY:
Deputy CI:e to the 'oa' %:►�' �� c
Sean P. Conway C
APP' Ali • , r.�p MN G � ( ,�
diA041,
Julie A. Cozad
ounty Attorney EXCUSED
Steve Moreno
Date of signature: ///1/-M,
-M,
2015-3884
����/ HL0047
1861 Memorandum
c
TO: Barbara Kirkmeyer, Chair
O U N T Board of County Commissioners
FROM: Mark E. Wallace, MD, MPH,
Executive Director
Department of Public Health & Environment
DATE: November 23, 2015
SUBJECT: 2016 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 (EM/TS) Council reviewed the application
for each ambulance service on November 18, 2015. The Council recommended that each service
receive a license based on their tier level.
The Department has reviewed the applications and has deemed all ambulance services listed
below to have met all applicable licensure application requirements found in Chapter 7. As such,
I am recommending licensure for the following ambulance service providers.
Tier I Tier I continued Tier I continued
Frederick— Firestone Fire Poudre Valley EMS Platte Valley Ambulance
Protection District 3509 South Mason Service EMS
8426 Kosmerl Place Fort Collins, Colorado 1600 Prairie Center Parkway
Frederick, Colorado Brighton, Colorado
Front Range Fire Rescue Southeast Weld Fire
101 South Irene Avenue Protection District
Milliken, Colorado 65 East Gandy Avenue
Keenesburg, Colorado Tier III
Mountain View Fire Thompson Valley EMS Colorado Motocross Medics
Protection District 4480 Clydesdale Parkway 729 Remington Street
3561 Stagecoach Road, Unit 200 Loveland, Colorado Fort Collins, Colorado
Longmont, Colorado
Banner Health/Northern Windsor Severance Fire Stadium Medical
Colorado Medical Center Protection District 695 Canosa Court
Paramedic Service 100 North 7th Street Denver, Colorado
1801 16th Street Windsor, Colorado
Greeley, Colorado
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All- allall all- lG1t-MIN-MtNEVIN1NIELB A
1861 DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
� _�_ -� 1555 N. 17th Avenue
• ' Greeley, CO 80631
r I . PublicH4 lth
=-='— Web: httD://www.co.weld.co.us/Departments/HealthEnvironmentrndex.html
,J''/� J'II, ' I Health Administration Public Health&Clinical Environmental Health Communication, Emergency Preparedness
-- Vital Records Services Services Education&Planning &Response
COUNT Y Tele:970 304 6410 Tele:970 304 6420 Tele:970.304 6415 Tele:970 304.6470 Tele:970 304 6420
Fax. 970 304.6412 Fax: 970.304 6416 Fax: 970 3046411 Fax: 970 304 6452 Fax: 970 304 6469
Our vision:Together with the communities we serve,we are working to make Weld County the healthiest place to live,learn,work and play.
October 30,2015
David Bressler
Chair
Weld County Emergency Medical/Trauma Service Council
Via email: Dave.Bressler@bannerhealth.com
SUBJECT: 2016 Mountain View Fire Protection District EMS Application
NOTICE OF EMERGENCY MEDICAL SERVICES LICENSE APPLICATION TO THE
WELD COUNTY EMERGENCY MEDICAL/TRAUMA SERVICE COUNCIL
The Weld County Department of Public Health and Environment has received and is in process of reviewing an
Emergency Medical Service License Application from Mountain View Fire Protection District. Attached to this
document are the Ambulance Service License Application,and Maps of its proposed Service Area.
On behalf of the Board of County Commissioners, the Department is requesting the Emergency Medical/Trauma Service
Council review the attached documents in accordance with Section 7-2-100.B.5. of the Weld County Code (enumerated
below). The Department will forward your recommendation to the Commissioners.
Below are the most applicable portions of the code:
Weld County Code,7-2-100.B.5
The recommendation of the Weld County Emergency Medical/Trauma Service (EM/TS) Council as to
whether or not the issuance of the license will contribute to an efficient, effective, and coordinated
emergency medical response to residents of the County. The EM/TS Council shall also provide:
a. Recommended Service Area.
b. Recommended Tier of License.
Weld County Code,7-2-10.
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.
A. The Board of County Commissioners reserves the right to amend these rules and regulations and any
other individual conditions of licensing as applied to any particular license, as needed in keeping with
its legislative function and in order to implement the policy of the State of Colorado that the
regulation and control of ambulance licenses is in the exclusive purview of the boards of county
commissioners. Persons or firms seeking application and approval of any ambulance license under
this Chapter acknowledge that Weld County may contract with specific ambulance service
provider(s) which will serve the emergency ambulance need of Weld County and participating
municipalities.
Please forward the Councils recommendation to the Department including minutes of the EMS Council meeting
pertaining to this application. Please do not hesitate to call me should you have any questions.
Sincerely,
Rachel Scanlan
Environmental Health Specialist
Environmental Health Services
Recommendation of the Weld County Emergency Medical/Trauma Service
Council for: Mountain View 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:
No findings were presented or received at the time of the review. Mountain View Fire Protection District
has a Standard of Cover that states our needed response times on all 911 incidents including
EMS/Ambulance. Mountain View Fire meets those times as stated in their SOC.
FINDING #2:
Mountain View Fire has a large response area in two counties making Ambulance coverage a challenge but
Mountain View Fire has a system in place to cover the area following stated response criteria. There have
been no issues reported to the EMTS Council concerning the service provided to the citizens and visitors to
the Weld County Service area.
FINDING #3:
Mountain View Fire has mutual aid agreements with a number of Ambulance providers to maintain our
response criteria but also assist other agencies as needed.
• FINDING #4:
Mountain View Fire Protection District has basically remained the same. The location of the Ambulances
are determined by call volume and response time, which may dictate a change in location within the district
Recommended Level of Service: Tier 1 Tier 2 Tier 3
Recommended Service Area:
As listed on the application.
Other EMTS Council recommendations or comments:
Recommend approval of a Tier 1 License as requested for the service area listed on application.
I
C�c
Recommendation By: - """`��" Date: 11-18-2015
DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
4 t r )
- ,r t;. 1555 North 17th Avenue
Greeley, CO 80631 _ Public,Heatth
•
www.weldhealth.org
Health Administration Public Health& Environmental Communication, Emergency Preparedness
Vital Records Clinical Services Health Services Education&Planning &Response
Tele:970-304-6410 Tele:970-304-6420 Tele:970-304-6415 Tele:970-304-6470 Tefe:970-304-6420
Fax.: 970-394-6412 Fox: 970-304-6416 Fax: 970-304-6411 Fox: 970-3046452 Fax: 970-304-6469
Our 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: /o/z4/iS'
Name of Ambulance Service: 41ovvrn-t ) 1//E.) 14 it 4'f 1a'✓ as"'le r
Owner:
Name: /1ov,r ,✓ YE,.1 Fri Apt—ve7c,.✓ Dr si' zic:
Address: 35-6/ Al, 377,64 cs4�/ /1D IbN.*►o. C6 ,Pc-,rte-/
Phone Number: 3o 3-772 - 7/D
Operations Manager:
Name: M".,-a( 4. Lr-wt.,/ - AXE. fifr6#
Address: 3S,/ Al. S,--acE ce*us/ 4O .L.a✓G,ie '1 <e ere,j-c'�
Phone Number: 3n3- 77Z-''7'&
Email: vN /ow It y F nr✓ �,o� c -y
Medical Director:
Name: DA, A 2✓s r/
Address: 35-6 / N S;- ee(r,v-ci/ +i') Lo..GwrN.4-, Co 8e:suy
Phone Number: 3e 3 - 772 -0 7 rD
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):
Af4
What area of Weld County will be served by this company? Please attach a map indicating
the service area.
3 v - 4/CL0
How many ambulances do you operate? 3 ' •rri 3 /1ti S,._,1 s
Page 1
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: .ce r c is r ,41Pfe/16')
City: State: Phone:
Location#2:
Street Number:
City: 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:
Yes DNo
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 ONo
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: J1 Tier I O Tier II O Tier III
Page 2
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 G OUNDS FOR CENSE REVOCATION AND POSSIBLE CRIMINAL
PROSECUTION.
Signal r of A (cant it Date
SUBSCRIBE A AFFIRMED BEFORE ME THIS
DAY ,20 /S ,IN THE COUNTY OF
,STATE OF COLORADO.
CHERYL S. CARSON
L.s
NOTARY PUBLIC Signature of Notary
STATE OF COLORADO
NOTARY ID# 19914017547 MY COMMISSION EXPIRES JANUARY 14,2020 My Commission expires: / /
/ / Ufb
Page 6
MOUNTAIN VIEW FIRE PROTECTION DISTRICT
Location/Description of Ambulance Location October 2015
Station 1- Hwy 119
Engine 2201
10939 WCR 5
Longmont, CO 80504
303-772-0710
Station 3 — Mead
Paramedic Engine 2203
441 Third Street
Mead, CO 80542
970-535-4330
Station 4— Niwot
Ambulance 2224
Engine 2204
8500 Niwot Road
Niwot, CO 80544
303-652-2984
Station 6 — Erie
Ambulance 2226
Engine 2206
50 Bonanza Drive
Erie, CO 80516
303-828-3152
Station 7 — Dacono
Ambulance 2227
Engine 2207
161 Perry Lane
Dacono, CO 80514
303-833-3896
Station 5 Brownsville
Reserve Ambulance
10911 Dobbins Run
Lafayette, CO 80026
Station 10
Battalion Chief
Reserve Ambulance )< z
9119 East County Line Road
Longmont, CO 80501
Maintenance Dacono
Reserve Ambulance
100 Forest
Dacono, CO 80514
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4'"� MOUNTAIN VIEW FIRE RESCUE
3561 N. Stagecoach Road, Unit 200 - Longmont, CO 80504
/MOUNTAIN VIEW (303) 772-0710 FAX (303) 651-7702
RESCUE
To Whom It May Concern:
Below is a listing of the mutual aid agreements Mountain View Fire Protection District has with
surrounding agencies.
Mutual Aid Agencies
- Frederick/Firestone Fire—Fire/Ambulance
- Longmont Fire- Fire
- Berthoud Fire - Fire
- Johnstown Fire - Fire
- Platteville Fire- Fire
- Fort Lupton Fire - Fire
- North Metro Fire—Fire/Ambulance
- Lafayette Fire—Fire/Ambulance
- Boulder Rural Fire- Fire
- Louisville Fire—Fire/Ambulance
Mountain View Fire Protection District has mutual aid with all fire agencies in both Weld and Boulder
County. We are in the process of getting a mutual aid agreement AMR Ambulance.
Keith Long
Assistant Chief
Mountain View Fire Protection District.
www.mvfpd.org
Hello