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Home My WebLink About20153885.tiff Nimmommum RESOLUTION RE: APPROVE APPLICATION FOR TIER I EMERGENCY MEDICAL SERVICES LICENSE AND AUTHORIZE CHAIR TO SIGN - BANNER HEALTH/NORTH COLORADO MEDICAL CENTER PARAMEDIC 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 Banner Health/NCMC Paramedic 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 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 Banner Health/NCMC Paramedic Service 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 0 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 4COUNTY, OLORADO ATTEST: dadivti CV r�_; a/ 1t, ,IAje_Auy, L.- arbara`"�"� Kirkme er, Chair Weld County Clerk to the Bo. E L /�, EXCUSED `�` Mike Freeman, Pro-Tem BY: t�. �..�� ►i. �..��' �- Deputy Cl-) to t e ' ``s — �t � — 7 r i Sean P. Conway r : ' . . ;.,� `, j, �__..... a 6/7,' APP D AS Ruta `► ,r.I Julie A. ozad u County Attorney EXCUSED Steve Moreno Date of signature: 0106, e,e_ 4//1/ 2015-3885 �� HL0047 �861 Memorandum r • TO: Barbara Kirkmeyer, Chair 1/3 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 . • 'cjeguninamemonimmen-rmininnnamma O El FIVI -6 3 . i 7-•,,,,,, bi 3. w i Z ■ _ E. taw o 3., E. 0 1LJMtM W W N o o 3 3. 0 Z 0 z �, a ao d z - g... — Z1 `�lg._ Z W o 6a 15 N 3... w w 0 3... lue I. _ mini ti ° N m Z Z E. 3. a.3_ LIJ w E 6 . 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W r -2 m Z Z E I I W UR..] • as4 AV ${l a,r DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 N. 17th Avenue ► r r ) Greeley, CO 80631 �1 Public Health Web httu l'1vww co weld co us/Oe ppriments/1lealthEnvironment/index html i _� ' Health Adminlatration Public Health i Clinical Environmental Health Communication, Emergency Preparedness Vital Records Services Serdcee Education&Planning I Response ''ff 'ft,* 9 r!334 C,', Tele 970 3016470 Tate 970 904 5415 Tale 970 3046170 Tate 970 309 612') C a V . -•- f a. 9%0 309 84t Fax 970 304 6416 Fax 671'304 6411 Fax 570 304 6452 Fax 970 304 6469 O.,,v P•cn Together kWh the oommun6ex we serve we are working to make Weld County the hea7.,+esl place to km team,work and play October 23,2015 David Bressler Chair Weld County Emergency Medical/-rraunia Service Council Via email: Dave,Bressler@bannerhealth.com SUBJECT:2016 Banner Health/NCMC Paramedics 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 r Emergency Medical Service License Application from Banner Health/NCMC Paramedics. 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 7-2-100.8.5. 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. h. 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: Licensurc authorizing for Primary Care,as defined in Section 7-1-30 of this Chapter. Tier II: Liccnsurc authorizing for transports of patients)to and from licensed medical facilities. This licensure does not provide for Primary Care,as defined in Section 7-1-30 of this Chapter. Tier Ill: Li,enmurc authorizing for Standby Service,as defined in Section 7-1-30 of this Chapter. I , I 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 nun icipalities 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 I � 1 ! Recommendation of the Weld County Emergency Medical/Trauma Service Council for: Banner Health/NCMC Paramedics • 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 services,location, service area,etc. that is the basis for the Council's recommendation: FINDING#1: Banner NCMC Paramedic Services is in compliance with their contracts in Weld County for emergency and routine response. 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#2: Banner NCMC Paramedic Seri ices has provided assistance to all agencies that have requested assistance throughout the 2015. There have been no issues reported to the EMTS Council concerning mutual aid requests. FINDING #3: FINDING #4: Recommended Level of Service: Tier 1 Tier 2_ Tier 3 Recommended Service Area: ;1s 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: 11-18-201 5 Banner Health/NCMC Paramedics Ambulance Service License Application Date of Application: 10/21/2015 Name of the Ambulance Service: Banner Health/North Colorado Medical Center Paramedic Services Owner: Name Banner Health/North Colorado Medical Center Address: 1801 16th Street. Greeley,CO. 80631 Phone Number: (970)810-2435 Assistant Chief: Name Mitch Wagy Address: 1121 M Street. Greeley,CO. 80631 Phone Number: (970)810-2435 Medical Director: Name Dr.Rob Lowe Address: 1121 M Street. Greeley,CO. 80631 Phone Number: (720)317-9964 For Office Use Only: Name and address of each stockholder or partner owning 10%or more of the outstanding stock of the company or having more than a 10%ownership interest if applicable: Not Applicable. What area of your County will be served by this company? Please attach a map indicating the service area. • Map#1. I • Map 1f2. All of the Weld County Service area with the exception of the following cities or towns: • Dacono. • Firestone. • Frederick. • Johnstown. • Lochbuie. • Milliken. • Severance. • Windsor. • Southeast Weld. / vnid ' _ ,_ c tv ,/--- — _ _-- :.,.V_ - — . • •- — ® WELD COUNTY 11.40010.1 . to. . '"'.R" Y �"* uu. :i/1 le K *4 �___ .V... ...84 R �,f 4YNh L 'Jo PCMY.-, How many ambulances do you operate? 14 Stations: How many stations do you have? 5 Indicate the location and description of the stations from which these ambulances will operate. If there are more than two locations,attach a separate sheet with the above information: Location#1 Address: 1121 M Street. Greeley,CO. 80631 Phone Number: (970)810-2438 Location#2 Address: 3401 S. 11th Avenue. Evans,CO. 80620 Phone Number: (970)810-2452 Location#3 Address: 2000 70th Avenue Phone Number: (970)395-2690 Location#4 Address: Glicrest Fire Department: 14679 WCR 42. Glicrest,CO. 80651 Phone Number: (970)737-2966 Location#5 Address: Fort Lupton Fire Department: 2999 9th Street. Fort Lupton,CO. 80621 Phone Number: (970)392-2446 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: littps://www.colorado.gov/cdphe/regulations %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: OYes 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: I,icensure 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 I have attached the following documents to this application: A list of all emergency medical service providers who may be called upon to respond to an emergency with the ambulance service. This list shall include the following information on each person: 1. Complete name and date of birth 2. The highest level of certification, licensure or training attained. 3. A copy of current EMT-B, EMT-I or EMT-P certificate issued by the Colorado Department of Public Health and Environment;nurse licensure or an Advanced First Aid card from the American Red Cross; or a First Responder course completion certificate issued by a Division-recognized training center or training group. A current copy of EMT or Paramedic protocols adopted by the ambulance service in accordance with standards approved by the ambulance service's medical director. http://www.hannerhealth.com/Locations/Colorado/Northi Colorado f Medical+Center/Pro grams+and+Services/Paramedics/Medical+Professionals/Medical+Protocols.htm Ni A current copy of the ambulance service's training standards in accordance with the requirements approved by the ambulance service's medical director that includes proof of a medical continuous quality improvement program.All training must be through a state- certified emergency medical services training center. ❑ A list of ambulance agencies,fire departments,special districts and other EMS providers with which the applicant has mutual aid agreements,or: 'A' At this time our agency does not have mutual aid agreements with other ambulance agencies, fire departments, special districts or EMS providers. A current copy of the ambulance service's pharmacological agents and delivery devices per medical director protocol. I HEREBY CER'I IFY 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 1 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 WITIIIN OR BORDERING ON THEIR AREAS OF RESPONSE. DETERMINATION THAT AN AMBULANCE SERVICES LICENSE HAS BEEN ISSUED BASED ON FALSE INFORMATION CON mums GROUNDS FOR LICENSE REVOCATION AND POSSIBLE CRIMINAL PROSECUTION. 7 _ C_ j' nMUrcof %t Title Date SUBSCRIBED AND AFFIRMED BEFORE ME THIS 1 1% 54 DAY Oc -obi!' ,20 15 ,IN THE COUNTY OF LA...)-a-lc4 STATE OF COLORADO. TARENA RAE EMOEI 4:;tkia-t A. e. — � weOf Of Signature of Nota Notary ID 201010190!21 My Commission T 2017 My Commission expires:_ og / - / go kl Page 6 Hello