HomeMy WebLinkAboutR15-072 completeCommissioner l yf0 moved adoption of the following resolution7BOARDOFCOUNTYCOMMISSIONERSCOUNTYOFEAGLESTATEOFCOLORADORESOLUTIONNO200705ARESOLUTIONCONCERNINGAMBULANCELICENSINGSTANDARDSANDAPPOINTMENTOFREGIONALEMERGENCYTRAUMAADVISORYCOUNSEL WHEREAS the General Assembly of Colorado enacted the Colorado Emergency Medical and Trauma Services Act c RS 25 3 5 101 et seq and WHEREAS the Act requires the Board of County Commissioners of each County to adopt by resolution rules and regulations governing the licensure of ambulance services and emergency services personnel and WHEREAS the Board desires to appoint members to the Regional Emergency Trauma Services Advisory Counsel RET AC WHEREAS the terms and conditions of this Resolution are intended to reaffirm Eagle County s commitment to and implementation of the General Assembly s declaration that it is in the public interest to provide available coordinated quality sufficient and reliable emergency medical services to the state s residents NOW THEREFORE BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF THE COUNTY OF EAGLE STATE OF COLORADO THAT the Board hereby appoints the following members to the RET AC with future vacancies additions and deletions to be approved in accordance with the bylaws Anne Wardrop John Woodland M D W Andrew Lawrence Christopher Montera Christopher Dick Fred Morrison Peter Brandes Michael Trujillo Steve Zuckerman Vail Valley Medical Center Vail Valley Medical Center Vail Valley Medical Center Western Eagle County Ambulance District Western Eagle County Ambulance District Eagle County Ambulance District Eagle County Ambulance District Colorado Mountain College Vail Mountain Rescue Group THAT the Board hereby adopts Rules Pertaining to Emergency Medical Services in the form as set forth in Exhibit A attached hereto and made a part hereof by this reference I THAT the Board finds determines and declares that this Resolution is necessaryforthepublichealthsafetyandwelfareofthecitizensoftheCountyofEagleStateofColoradoMOVEDREADANDADOPTEDbytheBoardofCountyCommissionersoftheCountyofEagleStateofColoradoatitsregularmeetingheldthedayofMay2007COUNTYOFEAGLESTATEOFCOLORADOBYANDTGHITSBOARDOFCOUNTYCOMMISON BY LCommissioner t f seconded adoption of the foregoing resolution The roll having been called the vote was as follows Commissioner Arn M Menconi Commissioner Sara J Fisher Commissioner Peter F Runyon GC t JjO O y 1 This Resolution passed by J vote of the Board of County Commissioners of the County of Eagle State of Colorado EXHIBIT AEMERGENCYMEDICAL SERVICESAMBULANCELICENSINGSTANDARDSARTICLEIAUTHORITYPURPOSEANDINTENTATheseRegulationsareadoptedpursuanttotheauthoritygranted the Board of CountyCommissionersundertheColoradoEmergencyMedicalServicesActSection2535101etseqcRSBThepurposeoftheseRegulationsistosetforththerequirementsfortheinspection licensure and operation of ambulance services ambulance personnel and ambulance vehicles operating in the County pursuant to the Colorado Emergency Medical Services Act establish the structure and authority for regulatory oversight and provide for the development and implementation of high quality ambulance services for the County C The Board reserves the right to amend these 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 The Board may grant a variance from the terms of these Regulations if the Board finds such action is necessary to protect the public health safety or welfare D Nothing in these Regulations shall be construed to create a cause of action or civil liability remedy in any person These Regulations shall not be construed to create a duty to any third party where no such duty otherwise existed It is the express intention of the Board that any third party receiving services or benefits under these Regulations shall be deemed to be an incidental beneficiary only E If any of the provisions of these Regulations are determined to be invalid such determination shall not affect the remaining provisions of these Regulations ARTICLE II DEFINITIONS 1 Ambulance Any public or privately owned land vehicle especially constructed or modified and equipped intended to be used and maintained or operated by ambulance services for the transportation upon the roads streets and highways of this state of individuals who are sick injured or otherwise incapacitated or helpless 2 Ambulance Service The furnishing operating conducting maintaining advertising or otherwise engaging in or professing to be engaged in the transportation of patients byambulanceTakenincontextthepersonsoengagedorprofessingtobesoengagedandthe vehicles used for the emergency transportation of persons injured at a mine are excluded from this definition when the personnel utilized in the operation of said vehicles are 1 subject to the mandatory safety standard of the Federal Mine Safety and HealthAdministrationoritssuccessoragency3AmbulanceTransportAgencyAnypublicagencyvolunteerorganizationorcommercialenterpriselicensedasanambulanceservicebytheBoardofCountyCommissionersofanyColoradocountysometimesreferredtohereinasalicensedambulanceservice4AmbulanceadvancedlifesupportAvehicleequippedinaccordancewithSection1293oftherulespertainingtoEmergencyMedicalServices6CCR10153andoperatedbyanambulanceserviceauthorizingthevehicletobeusedtoprovideambulanceservicelimitedtothescopeofpracticeoftheEmergencyMedicalTechnicianIntermediateor Emergency Medical Technician Paramedic as defined in the Colorado Board of Medical Examiners rules 3 CCR 713 6 Rule 500 Sections 5 and 6 5 Ambulance basic life support A vehicle equipped in accordance with Section 12 92 of the rules pertaining to Emergency Medical Services 6CCR1015 3 and operated by an ambulance service authorizing the vehicle to be used to provide ambulance service limited to the scope of practice of the Emergency Medical Technician Basic as defined in the Colorado Board of Medical Examiners rules 3 CCR 713 6 Rule 500 Section 4 6 Authorized Representative The Public Health Manager as designated by the Director of the Eagle County Department of Health and Human Services This individual is responsible for coordinating the licensure of ambulances and the administration of these regulations 7 Based An ambulance service headquartered having a substation office ambulance post or other permanent location in a county 8 Board Means the Board of County Commissioners for Eagle County 9 Board of Medical Examiners Rules Rules adopted by the Board of Medical Examiners which establish responsibilities of Medical Directors and all authorized acts of Emergency Medical Technicians 10 Council State Emergency Medical and Trauma Services Advisory Council SEMT AC 11 County Eagle County 12 Department Colorado Department of Public Health Environment CDPHE 13 Director The Director of the Eagle County Department of Health 14 Disaster Aid In the event of an all hazards event including but not limited to air transport crash terrorist attack natural disaster earthquake ambulances may be called upon by another jurisdiction or county in which they are not licensed to serve to provide 2 emergency support No formal contracts or mutual aid agreements for assistance oradditionallicensesareneededforthistypeofdisasterresponseduringacatastrophicevent15EmergencyActualorselfperceivedeventwhichthreatenslifelimborwellbeingofanindividualinsuchamannerthatimmediatemedicalcareisneeded16EmergencyCallArealorselfperceivedeventwheretheEMSsystemisaccessedbythe911emergencyaccessnumberoritslocalequivalentoraninterfacilitytransferwherethepatientshealthorwellbeingcouldbecompromisedifthepatientisheldattheoriginatingfacilityindefinitely17EmergencyFacilityAgeneralhospitaltraumacenterorfreestandingemergency facility with an emergency department staffed twenty four 24 hours a day seven 7 days per week with a licensed physician or an emergency medical outpatient facility staffed twenty four 24 hours a day seven 7 days per week with a licensed physician or registered nurse with direct medical supervision by a licensed physician or an emergency facility with a licensed physician who responds on an on call basis 18 Emergency Medical Technician An individual who holds a valid Emergency Medical Technician s certificate issued by the Colorado Department of Public Health and Environment The three classes of emergency medical technicians as follows a Emergency Medical Technician Basic EMT B An individual who holds a current and valid Emergency Medical Technician Basic certificate issued by the Department b Emergency Medical Technician Intermediate EMT I An individual who holds a current and valid Emergency Medical Technician Intermediate certificate issued by the Department c Emergency Medical Technician Paramedic EMT P An individual who holds a current and valid Emergency Medical Technician Paramedic certificate issued by the Department 19 Graduate EMT Intermediate An individual who has successfully completed a Department recognized Emergency Medical Technician Intermediate training course but has not yet successfully completed the certification requirements set forth in these rules 20 Graduate EMT Paramedic An individual who has successfully completed a Department recognized Emergency Medical Technician Paramedic training course but has not yet successfully completed the certification requirements set forth in these rules 21 License The authorization issued by the appropriate authority to operate an ambulance service in the County The license may not be assigned sold or otherwise transferred 22 Licensee The legal entity that has been issued a license by the appropriate authority to provide ambulance service in the County 23 Medical Director A physician who holds an active Colorado Medical License who establishes protocols and standing orders for medical acts performed by Department 3 certified EMTs of a prehospital EMS service agency who is specifically identified as beingresponsibletoassurethecompetencyoftheperformanceofthoseactsbysuchdepartmentcertifiedEMTsasdescribedinthephysiciansmedicalcontinuousqualityimprovementprogramAnyreferencetoaphysicianadvisorinthestateEMSrulesorintheBoardofMedicalExaminerspreviouslyadoptedrulesshallapplytoaMedicalDirectorasdefinedintheserules24MedicalqualityimprovementprogramAprocessconsistentwiththeColoradoBoardofMedicalExaminersrules3CCR7136Rule500Section32busedtoobjectivelysystemicallyandcontinuouslymonitorassessandimprovethequalityandappropriatenessofcareprovidedbythemedicalcareprovidersoperatingonanambulanceservice 25 Mutual Aid A written contractual agreement between two licensees to supplement services in each other s response districts A mutual aid agreement does not exempt an Ambulance from the licensing requirements of the local government within which mutual aid is provided 26 Patient Means any individual who is sick injured has experienced a traumatic injury or is in need of immediate professional medical attention and who has been treated 27 Patient Care Report A medical record of an encounter between any patient and a provider of medical care 28 Permit The authorization issued by the governing body of a local government with respect to an ambulance used or to be used to provide ambulance service in this state The permit may not be assigned sold or otherwise transferred 29 Quick Response Teams Provides initial care to a patient prior to the arrival of an ambulance 30 Rescue Unit Any organized group chartered by this state as a corporation not for profit or otherwise existing as a nonprofit organization whose purpose is the search for and the rescue of lost or injured persons and includes but is not limited to such groups as search and rescue mountain rescue ski patrols either volunteer or professional law enforcement posses civil defense units or other organizations of governmental designation responsible for search and rescue 31 Service Area means the geographic area of the County where an ambulance service provides services Boundaries for service areas may be defined by customary practice or legally established by a Special District or other political subdivision 32 To Operate in Eagle County The providing of Ambulance service or transport of patients within the boundaries of Eagle County ARTICLE III REGULATIONS 4 A Ambulance Service License Required No person or agency public or private shall transportapatientfromanypointwithintheCountyinanambulancetoanypointwithinoroutsidetheCountyunlessthatpersonoragencyholdsavalidlicenseandpermitsissuedbytheCountyexceptasprovidedinsubsectionIIICoftheseRegulationsBAmbulancePermitNoambulanceshallbeoperatedwithintheCountyunlessapermithasbeenissuedashereinafterprovidedCExceptionstoLicensingandPermitsRequiredTheprovisionsofthelicensingandpermitparagraphsAandBaboveshallnotapplytothefollowing1Vehiclesusedbyotheragenciesincludingquickresponseteamsandrescueunitsthat do not routinely transport patients and are only used to transport patients for extrication from areas inaccessible to a permitted ambulance Vehicles used in this capacity may only transport patients to the closest practical point for access to a permitted ambulance or hospital 2 Vehicles including ambulances from another jurisdiction used during a major catastrophe or mass casualty incident when permitted ambulances are insufficient 3 An ambulance service that does not transport patients from points originating in Eagle County or transporting a patient originating outside the borders of Eagle County 4 Vehicles used or designated for the scheduled transportation of convalescent patients individuals with disabilities or persons who would not be expected to require skilled treatment or care while in the vehicle 5 Vehicles used solely for the transportation of intoxicated persons or persons incapacitated by alcohol as defined in Section 25 1 302 c RS 2006 but who are not otherwise disabled or seriously injured and who would not be expected to require skilled treatment or care while in the vehicle 6 Vehicles used for the transportation of persons injured at a mine when the personnel used on the vehicles are subject to the mandatory safety standards of the Federal Mine Safety and Health Administration or its successor agency 7 Ambulances operated by a department or an agency of the federal government originating from a federal reservation for the purpose of responding to or transporting patients under federal responsibility 8 Ambulances duly licensed by another jurisdiction providing services in Eagle County pursuant to a mutual aid or automatic aid agreement with an ambulance service licensed in Eagle County or otherwise summoned to assist by an ambulance service licensed in Eagle County 5 D Ambulance Crew Members Required No patient shall be transported in an ambulance whichisoperatingintheCountyunlesstheambulanceisstaffedbyacrewconsistingofatleastoneemergencyvehicleoperatorandoneEmergencyMedicalTechnicianexceptunderextraordinarycircumstancespursuanttoCRS2535202EMedicalDirectorRequiredAllambulanceservicesshallhaveasinglemedicaldirectormeetingtherequirementsestablishedbytheColoradoBoardofMedicalExaminerstosupervisethemedicalactsofallpersonnelontheambulanceservicepursuantto3CCR7136Rule500oritssuccessorThemedicaldirectorshallbenotifiedinwritingbytheBoardortheirauthorizedrepresentativeofanyviolationsoftheseRegulationsbytheambulanceserviceorallegedcomplaintsorviolationsbyindividualmedicalprovidersoperatingonanambulanceserviceTheBoardshallbeinformedwithinfive5businessdaysinwritingofanychangesin medical director during the term of the ambulance service license The Medical Director shall attest to his or her willingness to provide medical oversight and a medical continuous quality improvement for the ambulance service in writing F Insurance 1 No ambulance service shall operate in the County unless it is covered by workers compensation insurance commercial or comprehensive general liability insurance complying motor vehicle liability insurance medical malpractice or professional liability insurance and other insurance policies as may be required by law in amounts that meet or exceed limits specified in the Workers Compensation Act the Governmental Immunity Act the Motor Vehicle Financial Responsibility Act or other applicable statutes furnished by an insurance carrier appropriately licensed to write such policies in Colorado Every insurance policy required shall provide for continuing liability thereunder to the full amount not withstanding any recovery thereon that the liability of the insured shall not be affected by the insolvency or bankruptcy of the insured and that the insurance company will not be relieved from liability on account of nonpayment of premiums failure to renew the ambulance service license or any act or omission of the insured unless the policy is canceled terminated or revoked with appropriate written notification as required in these Regulations 2 In addition to the coverage described above each ambulance service shall maintain insurance coverage for each and every ambulance owned operated or leased by the ambulance service providing coverage for injury or death of persons in accidents resulting from any cause for which the owner of the ambulance should be liable on account of any liability imposed on him by law regardless of whether the ambulance was being operated by the owner his agent or lessee or any other person and coverage as against damage to the property of another including personal property under like circumstances in the following minimum amounts Public Liability and Bodily Injury Each Person 1 000 000 Each Accident 2 000 000 Property Damage 6 Each Accident 1 000 000ProfessionalLiabilityEachPerson1000000EachAccident20000003TheCountyshallbenotifiedinwriting thirty 30 days prior to any cancellationterminationrevocationorothermaterialchangeincoverage4ProofofinsuranceshallbefiledwiththeCountywiththeapplicationforanambulanceservicelicenseasrequiredintheseRegulations5AcertificateofinsurancewiththeCountynamedascertificateholdershall indicate the vehicles covered by the policy type of insurance policy number s policy effective date and expiration date and amount of coverage Notification of any changes in insurance including vehicles covered under the policy shall be made to the County in writing and a new certificate of insurance forwarded to the Board within thirty 30 days of the changes 6 Each ambulance service shall provide written notice to all personnel regarding the amount of professional liability insurance the ambulance service carries Ambulance service must attest to and provide if requested documentation regarding the process used to inform ambulance staff of the amount of professional liability insurance carried by the servIce 7 The Board may require reasonable additional coverage and proof of insurance at any time it deems necessary to promote the public health safety and welfare G Standards 1 Ambulance Specifications a Ambulances permitted by the County prior to the effective date of these Regulations may continue to be used as ambulances provided that they continue to meet minimum standards for suitability construction and general condition as determined by the Board b Each ambulance shall clearly display permanent markings on both sides showing the name of the ambulance service under which they are licensed c Each ambulance shall be maintained at all times in a safe operating condition and in compliance with Colorado motor vehicle statutes rules or regulations At the time of application for permit the ambulance service shall submit to the County a certificate prepared by a qualified mechanic certifying the ambulance is in a safe operating condition 2 Ambulance Equipment Each ambulance shall contain minimal required equipment listed in the Department s rules pertaining to Emergency Medical Services 6 7 CCR 1015 3 Section 12 9 Minimum Equipment Requirements Further each ambulanceshallbeoutfittedwiththefollowingequipmentaAudibleandvisualwarningdevicesandanyspecialmarkingstodesignateitasanambulanceasrequiredbystatuteforauthorizedemergencyvehiclesbSafetiresandinadditionapprovedsnowtiresorchainswhenweatherconditionsdemandcAppropriateprotectiveoccupantrestraintsforthevehicleoperatorandanyotherambulancepersonnel d Appropriate protective occupant restraints for patients accompanymg family members or other persons being transported e The minimum required equipment for a Basic Life Support ambulance shall be as listed in the current edition of the State Board of Health Rules Pertaining to Emergency Medical Services 6 CCR 1015 3 or its successor f The minimum required equipment for an Advanced Life Support ambulance shall be as listed in the current edition of the State Board of Health Rules Pertaining to Emergency Medical Services 6 CCR 1015 3 or its successor 3 Inspections a The designee of Eagle County Department of Health and Human Services shall inspect any and all ambulances owned leased or operated by a licensed ambulance service annually or more often if required by the Board to assure compliance with applicable rules and regulations Inspections may be performed at any time Any inspection shall be for the purpose of determining that each vehicle is being properly maintained and contains the equipment specified in these Regulations Maintenance records shall be made immediately available upon the County inspector s request Such inspections shall be in addition to other safety or motor vehicle inspections required under Colorado law b Any inspection necessary for application or renewal must be completed prior to the acceptance of the application or renewal application c New vehicles shall be inspected prior to the vehicle being operated and used in the course of providing emergency medical services c It is the responsibility of the ambulance service operator to have each vehicle inspected prior to licensing An appointment must be made in advance to the performance of an inspection 4 General Regulations 8 a All ambulance services shall have an ongoing medical continuous qualityimprovementprogramconsistentwiththerequirementsestablishedbytheColoradoBoardofMedicalExaminerspursuantto3CCR7136Rule50032boritssuccessorbEachambulanceservicelicensedintheCountyshallcompleteapatientcarereportandtransmitsaidrecordstoCDPHEintheprescribedmethodbyJuly1sl2007includingtheminimumprehospitalcaredatasetdescribedin6CCR10153Section11oritssuccessorforeachpatientassessedandeachcallreceived c Each ambulance service licensed in the County shall complete and submit an agency profile to the Colorado Department of Public Health and Environment pursuant to 6 CCR 1015 3 Section 12 on an annual basis d All personnel shall be readily identifiable as to their ambulance service and level of training at the scene of a call and while treating a patient e The medical director for each ambulance service shall establish destination guidelines that conform to state and regional requirements generally accepted standards of medical care for patients transported by ambulance or as otherwise mandated by rule regulation or statute f Any ambulance service using the radio frequencies licensed to or operated by the Eagle County Communications Center for agree to abide by Federal Communications Commission regulations and operating procedures or other usage requirements established by the Eagle County Communications Center g The Board shall be authorized to promulgate and enforce such additional rules and regulations as it deems necessary to provide for quality emergency medical services and insure compliance with Colorado law and any resolution adopted by the Board which regulate the operation and licensing of ambulance services in the County h All ambulance services licensed by the County are required to agree to and comply with all provisions of these Regulations or any amendments thereto any other conditions pertinent to the license reasonably imposed by the Board all rules regulations and plans developed by the Central Mountains RET AC and adopted by the County and all applicable provisions of Federal State and local laws rules and regulations in order to maintain licensure The Board may also consider medical practices that deviate significantly from accepted standards of care and business practices that pose a risk to the public health safety and welfare as a violation of these Regulations ARTICLE IV LICENSES AND PERMITS 9 A Application for Ambulance Service License An application for an ambulance servicelicenseshallbesubmittedtotheCountyandshallcontainthefollowinginformationsupportingdocumentsandapplicationfees1TypeoflicenseBLSambulanceserviceorALSambulanceserviceThetypeoflicensewilldescribethemaximumlevelofservicethatcouldbeprovidedatanytimebytheambulanceservice2Thenameaddressandtelephonenumbersoftheownerofeachambulance3Thenameaddressandtelephonenumbersofthepersonapplyingforthelicensehereinafterreferredtoastheapplicant 4 The name address and telephone number s of the person who will be in charge of the operation of the ambulance service 5 If the owner of an ambulance or the applicant is a partnership the name and address of each partner If the owner of an ambulance or the applicant is a corporation the name and address of each stockholder owning ten percent 10 or more of the outstanding stock of each such corporation and the name and address of each director of the corporation If the owner of an ambulance or the applicant is a government the name and address of each member of the governing board 6 The trade or other name if any under which the applicant does business or proposes to do business 7 A completed ambulance vehicle permit application for every ambulance to be used by the applicant in providing service in the County 8 The location and description of the place or places from which it is intended to operate the ambulance service 9 For a new application certificates of inspection or other documentation that the physical inspection of the ambulances equipment and location of the applicant has been completed and the ambulance s equipment and location s were found to be in compliance with the provisions of these Regulations 10 The area to be served by the ambulance service 11 The name address and telephone number s of the ambulance service medical director 12 Attestation by the medical director of willingness to provide medical oversight and a medical continuous quality improvement program for the ambulance service 13 For a new license application a service plan demonstrating the need for services to be provided pro forma income statements balance sheets bank records or other financial information as may be reasonably requested by the Board sufficient to demonstrate the ambulance service s ability to operate and respond within the area to be served 10 14 For a renewal license application an income statement balance sheet and other financialinformationforthelastfiscalyearsufficienttodemonstratetheambulanceservicesabilitytocontinueoperationsandrespondwithintheareatobeserved15CertificatesofinsuranceasrequiredbytheseRegulations17ThefollowingshallbeavailableforinspectionaThelistofallemergencypersonnelwhomaybecalledupontorespondtoanemergencywiththeambulanceserviceThislistshallincludethefollowinginformationicompletenameaddressanddateofbirth ii the current training level b The ambulance service shall maintain documentation for all emergency personnel who may be called upon to respond to an emergency with the ambulance service demonstrating their qualifications The documentation shall include the following information i a copy of a current Colorado Emergency Medical Technician certificate or a First Responder course completion certificate Cardiopulmonary Resuscitation card issued a nationally recognized training program and an Advanced Cardiac Life Support card issued by a nationally recognized training program if applicable ii copy of a valid Colorado driver s license c A complete copy of the ambulance service s medical treatment protocols A copy shall be provided to the Board upon request B Issuance of a New Ambulance Service License Upon receipt of a complete application for a license to provide ambulance services the Board shall review the application the applicant s record and hold a public hearing to allow input from interested parties No license shall be granted unless the application demonstrates complete compliance with this resolution and applicable laws Each license shall be granted by resolution of the Board and shall be valid for a period of twelve 12 months following the date of issue providing that the ambulance service personnel vehicle s equipment and location comply with the requirements of these Regulations C Renewal of Ambulance Service License Unless revoked by the Board any license issued by the County may be renewed by submitting to the County Department of Health and Human Services a completed application for renewal containing the required information necessary supporting documents and application fees Application for renewal shall be filed annually but not less than thirty 30 days before the date the license expires If re application is not received at least thirty 30 days prior to license expiration County shall issue a temporary suspension notice and the applicant shall cease operation until license is reissued If re application is received license will not be suspended pending administration and completion of the renewal process 11 D Issuance of a Renewal Ambulance Service License License renewals shall be issuedadministrativelyunlesstheCountyDepartmentofHealthandHumanServicesortheapplicantrequestsafullhearingThentheprocessshallbeasfollowsTheBoardshallreviewtheapplicationtheapplicantsrecordandholdapublichearingtoallowinputfrominterestedpartiesAlicenserenewalshallbegrantedbyresolutionoftheBoardandshallbevalidforaperiodoftwelve12monthsfollowingthedateofissueprovidingthattheambulanceservicepersonnelvehiclesequipmentandlocationcomplywiththerequirementsoftheseRegulationsEAmbulanceVehiclePermitsPermitsshallbeissuedadministrativelyAnapplicationforanambulancepermitshallbesubmittedtotheEagleCountyDepartmentofHealthandHuman Services and shall contain the following information supporting documents and application fees if any 1 Type of permit BLS ambulance or ALS ambulance The type of permit will describe the maximum level of service that could be provided at any time by that vehicle and appropriate staff 2 The name address and telephone number s of the owner of the ambulance 3 The name address and telephone number s of the person applying for the license hereinafter referred to as the applicant 4 The trade or other name if any under which the applicant does business or proposes to do business 5 A description of the ambulance including make model year of manufacture vehicle identification number Colorado license plate number for the current year the length of time the vehicle has been in use and the color scheme insignia name monogram and other distinguishing characteristics used to designate the vehicle 6 Certificate of inspection or other documentation that the physical inspection of the ambulance equipment has been completed and the ambulance and equipment were found to be in compliance with the provisions of these Regulations 7 Certificate of inspection by a qualified mechanic F Issuance of Ambulance Vehicle Permits The County Department of Health and Human Services shall review the application An ambulance vehicle permit shall be valid for a period of twelve 12 months following the date of issue or the remaining term of the applicant s ambulance service license providing that the vehicle and equipment comply with the requirements of these Regulations G Transfer of License or Permits No license or permit issued by the County shall be sold assigned or otherwise transferred 12 H Change of Ownership Change of ownership shall require a new application license andpaymentoflicensefeesAnysaleorexchangeofstockinexcessoftwentyfivepercent25ofthetotaloutstandingstockofacorporationtoanyoneotherthananexistingstockholderatthetimeoftheoriginalissuanceoflicenseshallbedeemedachangeofownershipforthepurposeoftheseRegulationsAnychangeofownershipofanytransferofstockownershipoftenpercent10ormoreshallbereportedinwritingtotheCountyDepartmentofHealthandHumanServiceswithinthirty30daysofsuchchangeortransferIReciprocity1TheEagleCountyDepartmentofHealthandHumanServicesmayissueanambulanceservicelicenseandambulancepermitstoanambulanceservicelicensedby another Colorado county upon a finding that the requirements in the county are substantially equivalent and the ambulance service agrees to comply in full with these Regulations An ambulance service license and ambulance permit s may be issued by completing the application requirements and payment of the appropriate fee if any as specified in these Regulations 2 Based on the finding that the requirements of Pitkin County are substantially equivalent to the requirements of Eagle County Ambulance service providers not licensed by Eagle County but who are licensed by and in good standing with Pitkin County may operate within those portions of the Basalt and Rural Fire Protection District that are within the jurisdiction of Eagle County J Service Area No ambulance service may operate within the County for the express purpose of providing only inter facility transports without written consent from the Ambulance District they serve and must agree to take an equivalent proportion of Emergency Calls generating from the 9 1 1 center in the area served This does not apply to provisions as set forth in Article III C of this resolution ARTICLE V COMPLAINTS A Origination of Complaints Alleged violation of these Regulations by a licensed ambulance service individual medical providers on a licensed ambulance service or of an ambulance service operating in the County without a license may be made in writing by any party and addressed to the Board or by the Board on its own initiative Any individual bringing a matter of medical competency to the Board shall waive the right of patient confidentiality as a condition of complaint submission and subsequent investigation If any legal action is filed against a licensed ambulance service in a court of the United States the State of Colorado or any of its political subdivisions the licensee shall notify the Board within ten 10 business days A violation of these Regulations shall not be presumed based on the allegation In the event that a judgment is entered against the licensee the licensee shall file a copy of the findings of fact conclusions of law and order of the court with the Board within ten 10 business days If an action against an ambulance service license is undertaken by another jurisdiction the licensee shall notify the Board within ten 10 business days A violation of these Regulations shall not be presumed based on the action If the action results in a suspension or revocation of the 13 ambulance service license by another jurisdiction the licensee shall file a copy of the record oftheadverseactionwiththeBoardwithinten10businessdaysBValidationofComplaintsTheBoardoritsdesigneeshallcompleteaninitialreviewofthecomplaintjudgmentoradverseactionwithinfive5businessdaystodetermineifitconstitutesaviolationoftheseRegulationsandhassufficientfoundationtowarrantacompleteinvestigationAnyapparentviolationoftheseRegulationshavingsufficientfactualbasisshallbefullyinvestigatedbytheBoardAllegationsofviolationsoutsidethepurviewoftheBoardshallbereturnedtothecomplainantforreferraltotheappropriateauthorityorjurisdictionTheBoardshallnotifythecomplainantinwritingiftheallegationlackssufficientbasistowarrantinvestigationTheBoardshallnotifythelicenseeinwritingifajudgmentoradverseactionfiledwiththeBoarddoesnotconstituteaviolationoftheseRegulations C Investigation of Complaints The Board shall notify the complainant in writing that the allegation is sufficient to warrant a full investigation Upon initiation of a full investigation the Board shall notify the ambulance service and the medical director for the ambulance service of the alleged violation in writing The Board shall commence action against the ambulance service or unlicensed ambulance service if the allegation is determined to be a violation of these Regulations or at its discretion may provide a reasonable period of time for the licensee to cure any violation or to implement corrective measures to bring the licensee s business activities into conformance with these Regulations before commencing action to suspend or revoke a license or permit The Board may forego further hearing or action against the license or permit upon confirmation that the licensee has cured the violation and satisfied any conditions reasonably imposed by the Board The Board shall notify the complainant in writing if an investigation determines that the allegation fails to constitute a violation of these Regulations or that the licensee has cured the violation ARTICLE VI PROCEDURES FOR REVOCATION OR SUSPENSION A The Board may on its own initiative or upon written complaint made by any party temporarily suspend suspend for a definite period or revoke any license or permit issued pursuant to these Regulations upon a determination that a violation of these Regulations by a licensed ambulance service or by individual medical providers on a licensed ambulance service has occurred B Temporary Suspension Without prior notice to the licensee and upon determination that a violation that poses immediate threat to the public health safety and welfare has occurred the Board may temporarily suspend any license or permit Such temporary suspension shall be effective upon delivery of written notice to the licensed ambulance service by the Board No temporary suspension shall be valid for more than thirty 30 days or until a final decision by the Board concerning suspension or revocation whichever period is longer Any written notice of temporary suspension shall also provide notice of the time date and place of a hearing before the Board to consider the suspension or revocation of the license Except upon written consent of the licensee the hearing shall be held not more than ten 10 business days following the effective date of the temporary suspension The Board shall secure an equal level of service to the area that was covered by the suspension and fund the provision of EMS to maintain adequate coverage based on the traditional service provided during the suspension 14 C Suspension for Definite Period or Revocation of License Following notice to the licenseeandapublichearingatwhichthelicenseeshallbeaffordedanopportunitytobeheardtheBoardmaysuspendorrevokeanylicenseorpermitAnysuspensionorrevocationshallrequireafindingbytheBoardofaviolationoftheseRegulationsbasedupontheevidencepresentedatthehearingSuspensionshallbeforaspecificanddefiniteperiodoftimenottoexceedanyremainingcurrentlicenseperiodTheCountyshallbeartheburdenofproofofaviolationjustifyinganysuspensionorrevocationofalicenseorpermitIssuanceofatemporarysuspensionshallnotbeaprerequisitetotheconductofahearingtoconsiderthesuspensionorrevocationofalicenseorpermitTheBoardshallsecureanequallevelofservicetotheareathatwascoveredbythesuspensionandfundtheprovisionofEMStomaintainadequatecoveragebasedonthetraditionalserviceprovidedduringthesuspension D Hearings All suspension or revocation hearings shall be open to the public and shall be conducted in accordance with the Colorado Open Meetings Act The Board shall be authorized to administer oaths and issue subpoenas to require the attendance of witnesses and the production of papers books and records necessary to the determination of any issue at any hearing E Surrender of License or Permit Following receipt of a written notice of suspension or revocation the licensee shall surrender and deliver its license and all ambulance permits to the Board within forty eight 48 hours F Notices Any notice issued pursuant to these Regulations shall be made in writing and provided to the licensee and the medical director at the address listed in the application for license The Board shall use its best efforts to immediately notify in writing any communications center and notify within three 3 business days any first response agencies mutual aid agencies local law enforcement agencies hospitals and medical directors of any suspension or revocation The Board may send notice to the County Emergency Medical Services Council Regional Emergency Medical and Trauma Services Advisory Council Coordinator Colorado Board of Medical Examiners Colorado Department of Public Health and Environment or other interested parties provided however that such notice shall not entitle these parties to a right to participate in any hearing concerning suspension or revocation of a license ARTICLE VII MISCELLANEOUS PROVISIONS A Use of sirens and Emergency Equipment All emergency equipment and warning devises shall be used in accordance with all Colorado traffic statutes local ordinances and rules and regulations B Severability If any of the provisions of these regulations are determined to be invalid such determination shall not affect the remaining provisions of these regulations C Remedies These regulations create no third party beneficiaries and no private remedies for the breach of any provision of these regulations The penalties set forth herein are the sole and exclusive penalties and remedies for the breach of any provisions of these regulations 15 Dated S s Ol EAGLE CO NTY STATE OF COLORADOBYANDHOUGHITSBOARDOFCOUNCMISSIONERSBy 16