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Home My WebLink About20153891.tiff RESOLUTION RE: APPROVE APPLICATION FOR TIER III EMERGENCY MEDICAL SERVICES LICENSE AND AUTHORIZE CHAIR TO SIGN -COLORADO MOTOCROSS MEDICS, LLC 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 Colorado Motocross Medics, LLC, for a Tier III Emergency Medical Services License and recommend approval, and WHEREAS, after review on December 14, 2015, which was continued to December 16, 2015„ the Board deems it advisable to approve said Application for a Tier III 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 Colorado Motocross Medics, LLC, for a Tier III 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 16th day of December, A.D., 2015. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, CO ORADO ATTEST: dez-Amov CZ e, .:n 44, .[. _ �,•= ♦ arbara Kirkmey6, Chair Weld County Clerk to the B �- ' ��IT XCUSED / T/Or(lqi.izileoi_daN � ike Freeman, Pro-Tern BY: ii ' , MEW ,f is-:',�0-1 .11il -i.? Deputy C‘ rk to he BrPlIes 4 �� `' I/ Sean P. C way APP A M: ``""`� Z/L1/ Julie A. ozad ountyAttorney / o'1-0---yY Steve Moreno Date of signature: /// 1//(O cam: /IL 11.9-0114 2015-3891 HL0047 X861 Memorandum II Tr TO: Barbara Kirkmeyer, Chair 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 ,O �emon umu mum anni J a writ; la .7"/Aft la Lu '' Il&'F" "g_ U._ (..) z ', rz � 0 � � El O El U U I 3. 3 V z _ E. ; E, z o E. 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Ar �► 1861 DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 N 17'h Avenue t Greeiey, CO 80631 Public Health Web blip/1v/vv.,:co.weid.co usIDepartmentsiHealthEnvironmentnndex h?m1 Health Administration Public Health i Clinical Environmental Health Communication, Emergency Preparedness - - - A _ Vital Records Services Services Education&Planning II Response N O T T .. ,:33.,4:;464 IC T etc 970 304 6420 Tee 970 304 6415 Tele:970 304 6070 Tale 970 300.6070 1 v 9'.0 3:4 6412 Fax 970 304 64th Fax 9i D 304 6411 Fax 970 304 6052 Fax 970 304 6469 Gr,s o•t Tuyeiner wen Me communities we serve.the are working to make Weld County the healthiest place to rrve teem work end play November 16.201 5 David Bressler Chair Weld County Emergency Medical/I rauma Service Council Via email Da\e.ltressler�i hmutcrherth{i.c:+n. SUBJECT: 2016 Colorado Motocross Medics, 1,LC 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 Colorado Motocross Medics, LLC. 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-I00.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,7-2-100.13.5 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: 1:icensurc authorizing for Standby Service, as defined in Section 7-1-30 of this Chapter. I A. The Board of Count) 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 providers) 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, tAgA. 111)P Melissa Taylor Environmental Health Specialist Environmental Health Services Recommendation of the Weld County Emergency Medical/Trauma Service Council for: Colorado Motocross Medics, LLC As required in Section 7-2-1(10.8.5., 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 #1: No findings were presented or received at the time of the review. There was no one in attendance at the meeting. Only discussion was a question defining the service area for Colorado Motocross Medic, LLC. The service area was presented from the application received by the Weld County Health Department. FINDING#2: 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: FINDING #4: 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 3 License as requested for the service area listed on application. Recommendation B �`'" "� Date: 11-18-2015 NOV-13-2015 79:35 FROM:THE JACOB CENTER 9784828713 TO:3046411 P.2/5 a:o.birk , 44 -- : DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT A 1555 North 17th Avenue p Greeley, CO 80631 © © Pgbl�c>�Jtl P>•.•-nr Am itt Pmmaq.vnuo! www.weldhealth.org Health Administration Public Hearth& Environmental Health Communication, Cnwrgwiwy Preparednam Vital Records Clinical Services Services Education rR Planning t Responso Tele:970-304-6410 Tale'970.304.6420 Tale:970.304.6415 Tele:970304.6470 Tete:970-304-6420 Far 970-304-6412 Fax: 970 304-6416 Fox; 970-304-641 I Fox: 970-304-6452 Fax; 970304-6469 Our vision:Togeihor with the ceouriunitiot we serve,we Otte working In snake Weld County the hcelthiesi plane to live,learn,work,and ploy AMBULANCE SERVICE LICENSE RENEWAL APPLICATION Date of application: 10(30/15 Name of Ambulance Service; Colorado Motocross Medics, ',IX Own Name: Joel II Painter Address' 729 Remlnkfon Street Port Collins,Cotora1410 80524 Phone Number: 970-4484.8427 Operions Manager: Name: Jodi?,Painter Address:^ 729 ReminEton Street FortSollins,Colorado 80524 Phone Number:,.970-4R4.$427 Email; jociAlacopcenter.org Pursuant to Section 7.2-150 of Weld County Code Ordinance,any change of ownership requires a new application for ambulance service license. (For Office Use Only) Date Received: / / Documents Checked: Remarks: Date Referred to EM'1'C: / / Approvod Recommended(Y/N): Date Referred to B.0,C,C.: / / Licensing Agent NOV-13-2015 09:35 FROM:THE JACOB CENTER 9704828713 TO:3046411 P.3/5 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): Joel D. Painter, 729 Remington Street, FoQllins, Colorado 80524 100% What area of Weld County will be served by this company? Please attach a map indicating the service area. t_,.Valley Dirt.Ritiers Track 20125, 1-25 Frontage Road.Berthoud,Colorado Z. Island Grave Regional Park North l4`"Ave Greeley Celorn4q 80431 How many ambulances do you operate? i Location and description of the place(s) from which this ambulance service will operate. If there are more than two locutions,attach a separate sheet with the above information. Location#1; Street Number:20125 Frontage Road City: Berthoud State: Colorado Phone: 217-74134 Location/#2: Street Number: l4`''North Ave. City: Cjgeley State: Colorado Phone: 217-7484 Medical Director: Name: Dr. Kelby Bcthards.MP Address: 729 Remington Street. Fort rnllins.x 910 rado 8024 - Phone Number 1.970-484.8427 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, arc you '' compliance with the minimum data collection and reporting of transportation and/or treatment of patients: Y se No As required in Section 7-3-40 of the Weld County Code and Chapter 3 Section 3 of the CDPHE Emergency Medical Services regulation as of the date of the application,are you in compliance with the reporting requirements of the agency profile: es No Level of Service Requested(circle one or more): Tier 1 Tier iT ier li Please read carefully: 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 he 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. 'Pier II: Licensure authorizing for transports of patients that originate in Weld County from licensed medical facilities. This licensure does not provide for primary cart, as defined in Section 7-1-30 ot'this Chapter. Tier II]; Licensure authorizing for Standby Service,as defined in Section 7-1-30 of this Chapter. 7-2-170 Annual Renewal All licenses and permits shall be renewed annually,shall expire on December 31 of the year issued,and shall not be renewed until the application has been approved by the Department. All applications for renewal of licenses and permits shall be made not later than sixty(60)days prior to the date of expiration. The Department shall notify,by certified mail, return receipt requested,each licensee of the renewal requirements of this section within ninety(90)days prior to the date of expiration(Weld County Code Ordinance 2007-8 mom. Map of 20125 W Frontage Rd#I-25 Berthoud, CO by MapQuest Page 2 of 2 MAPO EST 250 01 t goo m 1 1200 ft 1561 X44 '44' V 1 `J m pT 3 1,, 7 $ .. !42, .42, I I 'n of ,pi 9. i i i tT 2009 MapOuest Inc I Map Data 2009 N/VTEO or TeleAtta.5 All rights reserved.Use subject to License/Copyright Map Legend Directions and maps are informational only.We make no warranties on the accuracy of their content,road conditions or route usability or expeditiousness.You assume all risk of use.MapQuest and its suppliers shall not be liable to you for any loss or delay resulting from your use of MapQuest.Your use of MapQuest means you agree to our Terms of Use http://www.mapquest.com/maps?city=Berthoud&state—Co&address-20125+I-25+Fronta... 10/29/2009 Map of Island Grove Park,N 14th Ave Greeley, CO by MapQuest Page 2 of 2 MAPQYEST. 0l 1200 m 1 600 ft Q L z cJ NI f,,_, 4 a 91 d 1- , l, 2 a w c G c, P Q Si Z m D { S \ T HR z BSt 4. it X85 n A s Z t N m J 7 O 1 s.St v f z N i rl L D D ,p K t7 C 2?nd St 4 4 3rd St s z _.i T.' A 3. :Y N Q C] ; ,p di 3.". G g c S 'L 6 1` — P a `a 4th St - 3 T ; N F Q 1 n i Sth St " ,r > r 0th St 5 L O 2009 Mapauest Inc Map Data 02009i4AVTEQ or TeleAttas All rights reserved Use subject to License/Copyright Map Legend Directions and maps are informational only.We make no warranties on the accuracy of their content,road conditions or route usability or expeditiousness.You assume all risk of use.MapQuest and its suppliers shall not be liable to you for any loss or delay resulting from your use of MapQuest.Your use of MapQuest means you agree to our Terms of Use 1 h ttp://www.mapquest.com/maps?name=Island+Grove+Park&city—Greeley&state=CO&a... 10/29/2009 lb 4 Colorado Motocross Medics 729 Remington Street,Fort Collins,Colorado 80524 1-303-907-9694 comxmedics@msn.com Mutual Aid Agreements Colorado Motocross Medics, LLC does not have any Mutual Aid Agreements. 11/16/15. Joel D. Painter Colorado Motocross Medics. LLC NOU-13-2015 09:36 FROM:THE JACOB CENTER 9704828713 TO:3046411 P.5/5 Page 4 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 W KII I'EN MUTUAL AID AGREEMENTS WITH ALL OTHER EMS PROVIDERS LOCATED WITHIN OK BORDERING ON THEIR AREAS OF RESPONSE. DETERMINATION THAT AN AMBULANC ' ' VICES LICENSE HAS BEEN ISSUED BASED ON FALSE INFORMATION CONSTITUTES GKO S R 'ENSE REVOCATION AND POSSIBLE CRIMINAL PROSECUTION. S' ature of Applicant Title Date SUBSCRIBED AND AFFIRMED BEFORE ME THIS xfJ ,20 15 , l.N TIRE COUNTY OF . STATE OF COLORADO. NOTARI) ture of ary ►•''-, 'O My Commission expires: to / 2 4 / p p18 - I Hello