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Home My WebLink About20153889.tiff RESOLUTION 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 14th day of December, A.D., 2015. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, C LORADO ATTEST: diszofwv ll �� to•t,C arbara Kirkmey''`, Chair Weld Cou ty Clerk to the Boa EL EXCUSED Mike Freeman, Pro-Tem BY: Deputy CI: k to e " Se t APPROVED AS $ M:�� ( � • �; i Julie A. Cozad ount Attorney EXCUSED l �/�� Steve Moreno Date of signature: // 2015-3889 HL0047 1861 Memorandum TO: Barbara Kirkmeyer, Chair V 4� LwGO_u 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 SCjallEll-MIMI-BllnlLBMI-Enllgnlln-RV11-Mlnlnt B..g. w is li. ,_ -2 3. bmss^ OIme L.)() O-IS Z {�y W 3. 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L Z 3 Ww i E. * V 1 N NIN 3 - lig Mal HNItGTEMIlGMMellaIlE1lGiIRIBM0R1L EINIr, 1861 DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 N 17f'Avenue f j r , = i Greeley, CO 80631 Path i;tt:u,;vvw.co.weld.co.us/DevanmentsrHealthEnvironmenttindex.html Health Administration Public Health&Clinical Environmental Health Communication, Emergency Preparedness 4 J+ta;Records Services Services Education i Planning &Response COUNTY 304 Rct-:� Te'e 970 3041,420 1 ele y'0 704 5415 TeH 910 904 94700 Tele 970 304 6120 f a• ,v�;: un,�;� Fa, 970 304 6416 Fax 970 3C4 641 1 Pax 970 304 6452 Fax 970 3046469 !cgct•`.ei:Oh me commun:hes we serve we arc nork:^g to make We'o County the healthiest place to Ire,learn,wore end play November 4,2015 David Bressler Chair Weld County Emergency Medical/i rat!nin Service Council Via email: Dave.Bressler!u;bannerhealth.com SUBJECT: 2016 Windsor Severance 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 Windsor Severance Fire Protection District. Attached to this document arc the Ambulance Service I,icense 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,7-2-100.8.5 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. 11w fee for said license shall be set by separate ordinance. The license shall issue only in the following tiers of service: Tier I: l,iccnsure authorizing for Primary Care,as defined in Section 7-1-30 of this Chapter. Fier IL Licensure authorizing for transports of patient(s)to and from licensed medical facilities. This licensure does not provide for Primary Care, as defined in Section 7-1-30 of this Chaplet. Tier II l' I Jcensurc 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 11 ill 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, Kevin Antuna Environmental Health Specialist Environmental Health Services Recommendation of the Weld County Emergency Medical/Trauma Service Council for: Windsor Severance Fire Protection District As required in Section 7-2-100.8.5., 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 #l: This year Windsor Severance Fire Protection District has met the emergent ALS ambulance response time of<8:59 in urban areas 96% of the time, and <11:59 in suburban areas 91.4%of the time. FINDING #2: Windsor Severance Fire Protection District has mutual aid agreements for ambulance service with Lin\ersitc of Colorado l lealth. Thompson_Vallev Ambulance Service. and Front Range Fire Authority. Other mutual aid agreements include•_I__o eland Fire Rescue Authority. Poudre Fire Authority, Eaton Fire Protection District, Ault Fire Protection I hstrict. and Greeley Fire Department. FINDING #3: Service area includes one hundred square miles. ninety of which encompass a western portion of Weld • Counts'and the communities of Windsor and Severance. FINDING #4: There have been no issues reported to the EMTS Council concerning the service provided to the citizens and visitors to the Weld Count) Sers ice area. Recommended Level of Service: Tier I Tier 2 Tier 3 Recommended Service Area: As listed on the application. Other EMTS Council recommendations or comments: Recommend approval of a Tier 1 i icense as requested for the service area listed on application. Recommendation By: -+ �` "' �"-_ Date: 11-18-2015 DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT TA - r j 1555 North 17th Avenue t ` ? Greeley, CO 80631 Public Health 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 Tele:970-304-6420 Fox: 970-304-6412 Fox: 970.304-6416 Fax: 970-304-6411 Fox: 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. AMBULANCE SERVICE LICENSE APPLICATION Date of Application: 10/30/2015 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 Operations 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: Mike Apostle, M.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 stock of the company of having more than a 10%ownership interest(if applicable): 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 Page 3 How many ambulances do you operate? One 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 North 7th Street City: Windsor State: co Phone: 970-686-2626 Location#2: Street Number: N/A 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: ❑x Yes 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: ®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: ® Tier I ❑ Tier II ❑ Tier III Page 4 r ' • , ,o ) Windsor-Severance 1. „R. I CIO Fire Rescue 4 - N ' I I I .__.II _ - _ - l` .. S....FIRE PROTECTION DISTDIR i . -�-•. .—_.. ._._.(_�111~1, --=I i e _ .. 4 l I , —\` - . `\.f% 1/• t r-I I`-'• ' I1 ` rr .\ .rill, itli=• 1 zD �.-..--.I, I 1 ,% ,� 1--•I I ill I // I 4J 11111, ` i — 1 f:~. . •. - �_.. —tli i. lI I It I I , ��' ` i,� �� {i_ l t t i 4.,� _ ` '"- .j�....,, {1 1 1- / \ \//-�/1 � ,. 1.-� 1I ., 4-- 1 �� 11 t it -- i r `` .. ft -.� l s — I .' , . .11'. 1" 1,t t 1 �. — f �� t ��I 11111 # t..�,�,4! Tom, t �' 1 .. ,'t\7Jt ! t t T' ! 1 ₹ 1 'noi r• 1 I F Windsor Severance Fire Rescue 10 100 7t Street, Windsor, Colorado, 80550 • 970-686-2626 4'sri901' www.wsfr.us October 23, 2015 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 AID AGREEMENTS WITH ALL OTHER EMS PROVIDERS LOCATED WITHIN OR BORDERING ON THEIR AREAS OF RESPONSE. DETERMINATION THAT AN AMBULANCE SERVI IS LICENSE HAS BEEN ISSUED BASED ON FALSE INFORMATION CONSTITUTES OUNDS FOR CENSE REVOCATION AND POSSIBLE CRIMINAL PROSECUTION. (Zzez /0/274- Signature of Applicant Title Date SUBSCRIBE ND AFFIRMED BEFORE ME THIS .2 / DAY r ,20 I' ,IN THE COUNTY OF ,STATE OF COLORADO. Rg ANNo?Or ouzo 13 Signature of ary sioit ono �1,v�K s• y Commission expires:_.�[� / 14 00161% Page 7 Hello