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Home My WebLink About20153886.tiff RESOLUTION RE: APPROVE APPLICATION FOR TIER I EMERGENCY MEDICAL SERVICES LICENSE AND AUTHORIZE CHAIR TO SIGN - POUDRE VALLEY HOSPITAL EMERGENCY MEDICAL 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 Poudre Valley Hospital Emergency Medical 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 Service 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 Poudre Valley Hospital Emergency Medical Service for a Tier I Emergency Medical Service 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 WE D COUNTY, CO ORADO ATTEST: dide/t) x4,4 arbara Kirkmeye , Chair Weld County Clerk to the B.- 1E LA EXCUSED Mike Freeman, Pro-Tern BY: Deputy CIS rk to the o� � •.,�,► Sean P. Conway C 9 APPR D RM: ''� ,, .I' C� &1 (/(0z,0( Julie A. Cozad Attorney EXCUSED Steve Moreno Date of signature: ///2/1/6' /-0.21-16' 2015-3886 HL0047 Memorandum ..._': . TO: Barbara Kirkmeyer, Chair N T Y 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 ja-an-nma-mn-n-n-oa-mun-n-ona-on-ommmlrj El RI "2 U § E. g r -:,' "E 3._ "FE "I O $.-§. Z mild W 00 [�' V l p z o m . ing (U Wd Ou ,- e mg Iii 1.- u) '0 9 La 1.' r3 O Z < O � Z ca a (U ., w U V z0 IL�J .0 Z If zzg -2 W W 3 ? 5 W O L 2 � g la I .2�, � a) O a (11! � a; rxa, V U UZU g 1' d U Q m d Z = ~ W o mg- 1' 611 Z J o uIM aw a mv 'Q d oc z 33- co WA 0 � W C �, Wa Q � �, .0_, x i N I . e z z off. w (U W � W � z a n \11.1 1 I me Zj CSL i" J I- U mg_ n 1" 2 g a ix 0 ci '' x 0 3 Lij(A W O5 LL u I 3. o .9 o = o 0 oZ z J , N N .g- 3 O J W E— lij SI .1 >- M. o x o Z N W UIR i'' Z -:,,,,a)2 "g- 1 >w< m I- ,-i' 1 "Ig,. 3_ 13 Li 1- w o am "E -6 8 d W U w m J :Ice 'N .0... 7... .5O mg C4 0 3 le In 3_, N Z §_ ig_ U J E. t: E. N a: 5 ~ ," LG1iBIRO iniG1lowiLGlLG tugg1LG1LG1LGltG1LG1luguigr) DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 N 17r"Avenue• Greeley. CO 80631 PublcHealth Web: tst.f;i/wvwv.co weld.co.us/Departmeats/fieafthEnwionment/index.hlr t - I . Health Administration Public Health i Clinical Environmental Health Communication, Emergency Preparedness Vital Records Services Services Education i Planning Si Response COUNTY 1 3^,iy Ga t Tele 970 304 6420 Title 970 304 6415 Tele 970 304 0470 Tele 970 304 0470 i as 9;,,,30 1,4 t 2 Fax 910 304 6416 Far. 970 304 6411 Fax 970 304 6452 Fax 970 304 6459 O� e•:on Tpget"e,win the commun,ties we serve,we are working tti maxe Weld County the healthiest piece to hve,team,we,*and play October 30.2015 David Bresslci Chair Weld County Emergency Medical/llaunia Service Council Via email: 1)atic_13reslerri•hamiei•l,cahtll.coni SUBJECT: 2016 Poudre Valley Hospital 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 Poudre Valley Hospital EMS. 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 MedicaUTrauma 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 EMITS 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. 1 he fee for said license shall be set by separate ordinance. The license shall issue only in the following tiers of service: Tier 1: I.,icensurc authorizing for Primary Care,as defined in Section 7-1-30 of this Chapter. Tier II: LR:CnsUrc authorizing for transports of patient(s)to and from licensed medical facilities. This Iicerisure does not provide for Primary Care, as defined in Section 7-1-30 of this Chapter. Fier Ill: l.icensutc 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 emergent 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, r ) Lif Rachel Scanlan Environmental Health Specialist Environmental Health Services Recommendation of the Weld County Emergency Medical/Trauma Service Council for: Poudre Valley Hospital EMS As required in Section 7-2-100.11.5., 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 sen ices, location, service area,etc. that is the basis for the Council's recommendation: FINDING #1: University of Colorado Health (UCH) via Poudre Valley Hospital Emergency Medical Services (PVH EMS) is committed to providing the resources necessary to maintain an effective level of EMS coverage in the Weld County fire districts we contract with. There have been no issues reported to the EMI'S Council concerning the service provided the citizens and visitors to the Weld County Service area. FINDING #2: Joint protocols.joint training and after_action reviews of high acuity calls and large incidents ensures coordination of efforts on scenes and a_seamless transition of patient care between the fire district responders and PVII EMS personnel. FINDING #3: Mutual aid agreements between Windsor Severance Fire Rescue (WSFR). Front Range Fire Rescue(FRFR) and PVII EMS ensures efficient cm-crate when resources need to be transferred between fire districts to handle major incidents or period., of unusually high call volume. In addition we have a mutual aid agreement with Thompson Valleti Emergency Medical Services (TVEMS). FINDING #4: PVH EMS has resources located on the borders of WSFR and FRFR districts that allow us to quickly respond to mutual aid requests as well as providing ambulances for `vehicle down' periods when fire district ambulances are being serviced or repaired. Recommended Level of Service: Tier 1 Tier 2 Tier 3 Recommended Service Area: The WSFR district excluding those areas in TVEMS district, the FRI-7R district excluding those areas in TVEMS District, Greeley Emergency and Surgical Center 6906 10Th St., Greeley 80634. that part of Poudre Fire Authority (PFA) district in Weld. 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. % ,. - Recommendation By: Date: 11-18-2015 DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT IP ; 1 . 1! 1� Ir I k'i .\.',:o0(..,,.,,r) 1, , 1555 North 17th Avenue ,..q Greeley, CO 80631 it Public Health www,weldhealth,org Health Administration Public Health& Environmental CommvnlcaHon, Emergency Preparedness VHal Record: Clinical Services Health Services Education&Planning &Response Tale:970.304-6410 Tele:970-304-6420 rele:970.304-6415 Tele:970-304-6470 Tele:970-304.6420 Fax: 970-304-6412 Fox: 970-304-6416 Fax: 970-304-6411 Fax: 970-304-6452 Fox: 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: /0/:.).-0 / 5 Name of Ambulance Service: R:'i-)c-it t V n //8r /-f 0,5,1-tQ / Pn S 0111-14 uyJ Owner: Name: Pcu &- Uc;Qe A e,1+L e0/ 3 ,,I e-- • Address: '3/5' '._ _llaitoridNy Al. „S Phone Number: (9ia) % 7 - 7 O 0 Operations Manager: Name: ju4i--1a , BR,4* Teni q Address: 3 c o I S' r Au s d Al • t / go5a S .. t O /Z Email; L_ R. .>< eA! __.m,. �' � Medical Director: _ Name: Yl lCk L_ kei2 P.t.iYI.0. Address: l_.Q s `L.__ .C. ttz, —fig_if ___.._ Phone Number: (9ô) '9g 30 0 5 - 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): - .- - What area of Weld County will be served by this company? Please attach a map indicating the service area, , Q _ut,r.;.Alrju4Lt 4JA. . S'eOLA_NC �'_.._ __ .eit /` C _(d L— _ [ /._lL _ �.I.ZL',*y hifi coOWty-_.-_G� _ How many ambulances do you operate? ( _ __ ____- P age 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: 0''� Street Number: _3,5-Q s. frtasa/vS . City: f.Co//1-A LS State: CO 8o 55 Phone: q70).2 3 7 79 CO Location #2: pie 4.5-r See SA.41" 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: 11:2‹: El 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: 'es ❑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-I-30 of this Chapter. Level of Service Requested:.Er Tier I E Tier II T1 Tier III I'age 2 Poudre Valley Hospital UNIVERSITY OF COLORADO HEALTH 10/15/15 I Locations of PVH EMS stations and places from which PVH EMS operates are listed below. Our vehicles are not assigned to a particular station and we operate via a dynamic deployment model. 1. Main station is at 3509 S. Mason St. Units 1-4 80525 2. 913 E. Myrtle St. FC, CO 80524 3. 415 S. Bryon St. FC, CO 80521 4. 2127 E. Harmony Rd. FC, CO 80528 5. Poudre Valley Hospital 1024 S. Lemay Ave NC,CO 80524 6. Wellington Fire Station 1: 8130 3rd St. Wellington,CO 80549 7. Greeley Emergency& Surgical Center, 6906 10th St. Greeley 80634 8. Windsor/Severance Fire 110 N. 7'h St Windsor, CO 80550 9. Milliken FRFR 101 S. Irene Ave. Milliken, CO 80543 10. Johnstown FRFR 100 Telep Ave. Johnstown, CO 80534 11. Sometime in early 2016 from Timnath, CO. a location yet to be determined Judi Bratten PVH EMS Manager/Admin Chief University Colorado Health 3509 S.Mason St#1 Fort Collins, CO 80525 iudi.bratten@uchealth.org (970)237-7903 office (970)391-9826 cell 1024 S Lemay Ave • Foil Col firs.CO 90574 • Phone:970 495.7000 • pvhs erg 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 I'ROSECUTION. • 'h"' Signature of Applicant Title Date SUBSCRIBED AND AFFIRMED BEFORE ME THIS J chi DAY ®oo-i-- ,20 /S ,IN THE COUNTY OF cIega s,,-y,. ,STATE OF COLORADO. MICHELE SHAFER NOTARY PUBLIC STATE OF OF COLORADO Signature of Notary NOTARY ID 19984028092 COMMISSION EXPIRES OCT 8.2018 My Commission expires: i d / 'Y / a-" !d' Page 6 Poudre Valley Hospital UNIVERSITY OF COLORADO HEALTH 10/15/2015 Weld County Department of Public Health and Environment 1555 North 17th Avenue Greeley, Colorado 80631 To Whom It May Concern: PVH EMS currently has mutual aid agreements with the following agencies: Fort Collins Police Services 4 Larimer County Sheriff's Office Larimer County Dive Team Larimer County Search and Rescue Jackson County EMS Livermore FD Red Feather Lakes FD Wellington FD Glacier View FD Estes Park EMS Thompson Valley EMS Upper Poudre Canyon FD Lower Poudre Canyon FD Sincerely, udi Bratten PVH EMS Manager/Admin Chief University Colorado Health 3509 S.Mason St#1 Fort Collins, CO 80525 judi.bratten(itIuchealth.org (970)237-7903 office (970)391-9826 cell 1 1024 S.Lemay Ave. • Fort Collins,CO 80624 - Phone:970.496 7000 • pvhs erg [...: ( 1 Windsor-Severance0 „ . _ _ Fire Rescue " sir^ r .x..,Lm .. .b- •e.{Y i\ .. .. -.. —. _.._ ..m. -•4..�. _ _ , .•, — »HrYI4t• — _ I:.. ! 1 t' Ii __. . ... •,... •.-- y I t.. . s. ,1 I 1iatp. 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