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Home My WebLink About20143769.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 approval of the License is conditional upon execution of appropriate Mutual Aid Agreements. 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 8th day of December, A.D., 2014. BOARD OF COUNTY COMMISSIONERS ! / E ft LD COUNTY, COLORADO ATTEST: Y r��! . �� /0-12J-4-1 Fou 'T. Rademacher, hair 361 Weld County Clerk to the Boar.` s;; s 4 L tut. - {Jt1A- t/ • ara Kirkmeyer, ro-Tem / BY: :1.�.� D. • ,5y Clerk to the Board } - Sean P. nConway (^� APPROVED AS TO FORM: ' 0 r�,wL- Mike Fre an County Attorney ( // Wi iaM F. Garcia Date of signature: r 2/1,-) OC- � p� 2014-3769 ' �k'� � I J2� HL0047 1861 Memorandum TO: Douglas Rademacher, Chair U �l J \ Board of County Commissioners coUNTY1 FROM: Mark E. Wallace, MD, MPH, Director Department of Public Health & Environment DATE: December 4, 2014 SUBJECT: 2015 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 19, 2014. The Council recommended that each service provider 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 server 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 15th Street Windsor, Colorado Greeley, Colorado 2014-3769 SI i-1 E iR L�inir is lifi_� [ t(it gal l rill c� �� ji !] wow 57] Fri i Lu z ra Z = Lam ,a ` = alLl o ,� U Z �^ t1 Cr � z ICJ gg o o V N t�_° 0 FL rr Q �, vi U o 2 i's�'t. 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El Elni a LE911 i11gilntinli hall-giIIEfl1ElIIfralIIGllv�l 0 V`' 6 1 { DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 N. 17i"Avenue � t ' Greeley, CO 80631 a I ��fi Public Health Web:htip L/ ww.cu.weld_co.us/Dep<trtmcnts/HealthEnvironmenUindex.html r `1 ',�n,'f' Health Adminlatretion PubIlr.Ha all h S Clinical Environmental Health Communication, Emargoncy Preparetlnaas Vital Records Services Servkee Education d Planning 5 Raaponsa Laf 1 \ y, Y `-"" Tele:970.304 54i0 lele 970 304 0420 Tao:370 304 6415 7ele:970 304.647D TIE el,970.304 6424. • -- V _C Fsx• 97(3.4 0410 Far 970 306.617E Fax! 070 904 6.111 Fax:070.304.6452 Fear 970.304,6469 Ow valor r.gneber we'h t;Oorib,,ni,ea wu acne,w.ate,nyku.g to make Weki COu.ney the hoakh. Ipiaee to WC.ieore.,week 0c9/Roy. October 16.2014 Barry Schaefer Chair Weld County Emergency Medical/Trauma Service Council Via email: bs„hacl r"r 1 last,vrilleytire.org SUBJECT: 2015 Mountain View Fire Protection District EMS Application NO'T'ICE 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 beliall 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 Codc (enumerated below). The Department will forward your recommendation to the Commissioners. Below arc 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 (EMITS) 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. 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: Licensure authorizing for Primary Cam,as defined in Section 7-1-3U 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 7-1-3U of this Chapter. Tier Ill: 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-I 00.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 iil: FINDING #2: FINDING #3: FINDING #4: Recommended Level of Service: Kier 1 ; Tier 2 Tier 3 :T�Y: Recommended Service Area: Other EMTS Council recommendations or comments: Recommendation By: f. �!` . �� `' Date: /1`! DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT „rNGr,fr. 1�T�Cfj [itiij---��1 1555 North 17th Avenue ,r �; J r; jj1 Greeley, CO 80631 � Public Health GGJ~ T www.weldhealth.org Health Administration Public Health& Environmental Health Communication. Emergency Preparedness vital Records Clinical Services Services Education S.Planning d Response Tele:970-304-6410 le:c:970-304-6420 Tele:970-304-6415 Tele:970-304-6470 lele:970-304-6420 Fox: 970-304-6412 Fox: 970-304-6416 Fox: 970-304-6411 Fax: 970-304-6452 Fox: 970-304-6469 Our vision:Together with the communities we carve,we are working to make Weld Colony the healthiest place to live,learn,work,and play. AMBULANCE SERVICE LICENSE RENEWAL APPLICATION Date of application: ,497'8,/1 • Name of Ambulance Service: Plot-4 n17'r'171� x F_c.� i'�� ! R��P c 4 O 1.)—C>rS rR`T`G'T Owner: �j T Name: I4 Vtwt_hcria -f _AJ Address:_35'1,I 77A-_4 (4514 Z:23:1R p LO-2%.3LM4ni r CO S-**OS-e 41 Phone Number: 303 -- 7 7 2 - 07 1 0 Operations Manager: Name: !'A/AR lA. LA S£y , EccE_C F F Address: 3:x 1 5TA6ECDAc.4R.o'-p,- n16M9^li7 60 3as'04/ Phone Number: 363-7_7 7 a-` O 7/ �+ - Email: _ rr%LAIA,%- to ( 1 V FA- 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 EMTC: / / Approved Recommended(Y/N): Date Referred to B.O.C.C.: /_/_ Licensing Agent 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, -• - -S,LUs IA)E t. P _low many ambulances do you operate? 3.__iv T:r►+ 'Q E Location and description of the place(s)fi•am which this ambulance service will operate. If there are more than two locations,attach a separate sheet with the above information. Location#1: Street Nwtiber: SU. 'L5- T A'r'rp cj-i D City:_._ ________... -. State: _. _,.__.. _______ Phone: -• ._�._.__ Location#2: Street Number:_._,... ,_. __.-.._. _ __ — _. .._.._....__...__ City: _. State: _ ___ --- Phone:_. ____. ___. -- Medical Director: Name: ArrAt_Fi- /D __ ._. -••- —. Mailing Address: _ ...-----•-- ______.�_ —.. Phone Number: _ —As required in Section 7-3-30 of the Weld County Code Ordinance and Chapter 4 Section 6 of the CDPII.E Emergency Medical and Trauma Care System regulations,as of the dale of the application,are you in compliance with the minimum data collection and reporting of transportation and/or treatment of patients: Walk 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 of the date of the application,are you in compliance with the reporting requirements of the agency profile: ' Yes No Level of Service Requested(circle one or more): Tier I Tier 11 Tier III 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 be set by separate ordinance. The license shall issue only in the following tiers of service: Tier is Licensurc 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. Pier Ill: 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 Mountain View Fire Protection District Ambulance location and information Ambulance Number: 2224—Station 4 Name: Mountain View Fire Protection District )L)1; CI Address: 3561 N.Stagecoach Road, Longmont, CO 80504 Phone: 303-772-0710 Year Manufactured/in Service:2010 Mileage:90007 Make: Ford F-450 PUCO License: 319UGB VIN: 1FDUF4HT9BEA06970 Ambulance Number: 2226—Station 6 p oco Zg5k-1 Name: Mountain View Fire Protection District Address: 3561 N. Stagecoach Road, Longmont, CO 80504 Phone: 303-772-0710 Year Manufactured/in Service: 2014 Mileage: 139 Make: Ford PUCO License: VIN: 1FDXE4FS4EDB06897 Ambulance Number: 2227—Station 7 vrz• kcb l�yt' ,,-tU Name: Mountain View Fire Protection District . O tJ2 Address: 3561 N.Stagecoach Road, Longmont,CO 80504 ,-, Phone: 303-772-0710 Year Manufactured/in Service: 2011 Mileage:60973 Make: Ford F-450 PUCO License:415UHF VIN: 1FDUF4HT7BEB77779 Ambulance Number: Reserve—Station 10 Name: Mountain View Fire Protection District }`�• , ;� Address: 3561 N.Stagecoach Road, Longmont,CO 80504 Phone: 303-772-0710 Year Manufactured/in Service:2008 Mileage: 168110 Make: Dodge PUCO License: 315TFG VIN: 3D6WC66A38G148486 Ambulance Number: Reserve—Station 10 J,_10I '�i� Name: Mountain View Fire Protection District Address:3561 N.Stagecoach Road, Longmont,CO 80504 Phone: 303-772-0710 Year Manufactured/in Service: 2005 Mileage: 158664 Make: Ford F-450 PUCO License:627FTL VIN: 1FDXF47P25EB76481 Ambulance Number: Reserve- Maintenance {) 2 -1 OO 7.1 S Name: Mountain View Fire Protection District Address: 3561 N.Stagecoach Road, Longmont, CO 80504 Phone: 303-772-0710 Year Manufactured/in Service: 2003 Mileage: 167121 Make: Ford F-350 PUCO License: 609GPX VIN: 1FDWF36PX3EC29397 Ambulance Number: Reserve—Station 5 Name: Mountain View Fire Protection District , DJI 1- Q(L. Address: 3561 N.Stagecoach Road, Longmont, CO 80504 Phone: 303-772-0710 Year Manufactured/in Service:2001 Mileage: 168134 Make: Ford F-350 PUCO License: 395BHE VIN: 1FDWF36F61EA04348 All vehicles are registered with the State of Colorado as emergency vehicles. Reserve Ambulance move between locations, 3 in-service units assigned to station. MOUNTAIN VIEW FIRE PROTECTION DISTRICT Location/Description of Ambulance Location September 2014 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 X Z 10911 Dobbins Run Lafayette, CO 80026 Station 10 Battalion Chief Reserve Ambulance 9119 East County Line Road Longmont, CO 80501 Maintenance Dacono Reserve Ambulance 100 Forest Dacono, CO 80514 MOUNTAIN VIEW FIRE RESCUE 3561 N. Stagecoach Road • Longmont, CO 80504 MOUNTAIN ViEw (303)772-0710 • FAX (303) 651-7702 REScUE Medical Director. Adam Rush, MD Longmont United Hospital 1950 Mountain View Ave. Longmont, CO 80501 Phone: 303.651.5000 Cell: 720.684.6193 www.mvfpd.org 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 WRITTEN MUTUAL All) AGREEMENTS WITH ALL OTHER EMS PROVIDERS LOCATED WITHIN OR BORDERING ON'IHEIR AREAS OF RESPONSE. DETERMINATION THAT AN AMBULANCE SERVICES LICENSE HAS BEEN ISSUED BASED ON FALSE INFORMATION CONSTITUTES GROUNDS F LICENSE REVOCATION AND POSSIBLE CRIMINAL PROSECUTION. '' / Id-;iville4 7/, Signa u�re of pp ' ant T Title Date f SUBSCRIBE AND AFFIRMED BEFORE ME THIS Q DAY ,20 /! ,_,IN THE COUNTY OF 44.)yld ______,STATE OF COLORADO. 7 41 Sign re of Notary My Commission expires: _ !v / (o / /S Mat! __i_ i °3 ; I Innen 7 ;'- i {S /in I _ F ynY.a ;yid t. -11-111 MIL all 1 L1"i1iL ( n i t i4 t! p I C J Q-+.. ({ t 7.13 a C,m+JFil . Y �rrca. . 't y ie ral >}� aan w u. iti H i - .4,wIr ,. retie IA udir,.„,-Y1!�➢_ .fir 3*' ill i it" iivetruii ) ad iii A—Irtitt till... we iii 0. 't K iniir C Iii ? i f'a'it �_ l w^' i.-.),_ Ili Mil �Ili..assa ct.. /f 4.714111904t. . �T•M>`C d 4 11 a -. 9-4 1 rxwnc ao Rik ram.wsw. nv�a xea'7ty.w ill,' 1 '534m w At 1M 4Y �� V. .Ih a.4°I I 3 ig MAw.i, ss7� C �I S tfirl •• r,aal ,4 . .1 . w Y.. L pc t c /�S4 x _ G Hops[ as G�££ l _ ___ �11 I F e '5f{ _ ess 3 bT. :Y a,e 31:__. avaau % na wv_. G�ewxi..:m us 4 LV� j by Rs t Y a I !y `x ` _ ..Ow'� �*zmd.w 7 ass` S� .'t t{;rty 9. . ,... I a ti �. s i S�1 a.a..« ,ras :`l! c = Wes=°- ;y'"„"b', tl`'' • 4' ®f a. i ; ifi A.i L Ji;:_,, P4.1ig, ” - .: : . 4 _ 4. 3 a ate a+ a t �Itil NI /A 1 ': �{ i Pr y �+f , Mountain View Fire Protection District J non : ,��. �` , �. .. (Fire Response Zones) x il i till tens, :rte o r. 16 ` u.Msrtm nn - . / MOUNTAIN VIEW FIRE RESCUE 3561 N. Stagecoach Road, Unit 200 • Longmont, CO 80504 MOUNTAIN VIEW (303)772-0710 • FAX (303) 651-7702 RLSCUE 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/Ambulance(AMR) - 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. Roger Rademacher Assistant Chief Mountain View Fire Protection District. www.mvfpd.org Esther Gesick From: Kevin Antuna Sent: Wednesday, December 03, 2014 3:35 PM To: Herb Brady; Erik Morse; Ron Bateman; Mike Blackwill; Kate Jennings; Judi Bratten; scm@pvhs.org; Dave Bressler; Wagy, Mitch E; Joel D. Painter; Tom Beach; contact@stadiummedical.com; tdalton@mvfpd.org; ccraigle@pvmc.org; dprunk@fffd.us; jlum@stadiummedical.com; mdolgener@tvems.com; mlawley@mvfpd.org; rlesher@tvems.com; Christopher L. Mulberry Cc: bschaefer@plattevalleyfire.org; Rachel Scanlan; Deb Adamson; Mark Wallace; Melissa Taylor; bschaefer3761 @gmail.com; Trevor Jiricek; Esther Gesick; Skye Turchado; Tanya Geiser Subject: Ambulance BOCC Hearing Hi All, The Board of County Commissioners (BOCC) will review your Ambulance Service License applications on Monday December 8, 2014 at 9:00 am at 1150 O Street in Greeley (Weld County Administration Building).You may want to be present in case the Commissioners have questions. Thank you, Kevin Antuna Environmental Health Specialist Weld County Department of Public Health and Environment 1555 North 17th Avenue Greeley, CO 80631 Phone: 970.304.6415 x 2222 Fax: 970.304.6411 s ts.1867,. ✓ 1) t j r • __- �nt �uk, Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. 1 Hello