A decision on the Westside Community Healthcare District’s (WSCHD) future will have to wait after the district’s board voted to look into beginning an appeal process to secure reimbursement payments with its billing company.

The district will look to have its staff members or a legal counsel coordinate with its billing company, Quick-Med Claims (QMC), to ensure accurate billing while also focusing on receiving Public Provider Ground Emergency Medical Transport Intergovernmental Transfer (PP-GEMT-IGT) payments.

David Varnell, the board president, told the Westside Connect that a decision has not been made on which pathway to move forward with.

“I believe the district can still be prosperous … and I think we can go in the right direction and keep this ambulance running,” Varnell said.

Prior to Tuesday’s meeting, a special meeting was held on March 17, which focused on the Ad Hoc Committee’s findings within the district. Some of those findings include that $337,000 were under-billed and under-paid from January 2023 to today due to lack of transparency with QMC about changes to state laws and public agencies group, not enough full-time staffing through the district’s ambulance operations and tax expenses not being reported accurately in the fiscal year they were paid in.

Additionally, the subcommittee proposed two pathways for WSCHD to consider.

The first pathway brought up was the district continuing its ambulance operations. For the district to continue with this option, it was recommended to address its issues with staffing, QMC and ongoing operations.

The subcommittee recommended WSCHD retain skilled professionals within the field to handle demands and come to a collective bargaining agreement with its union for staffing.

Regarding its billing situation, it was recommended to switch from QMC to a new billing company to work with. This would require the district to have $1.4 million to cover six months of expenses during its change to another billing company. When considering the previously mentioned recommendations as well as purchasing and replacing medical equipment, it could cost the district $2 million to maintain its ambulance operations.

The second pathway proposed that the district move on from Emergency Medical Services (EMS) and toward offering broader healthcare initiatives. The move would require WSCHD to give its Local Emergency Service Agency (LEMSA) contract to Stanislaus County. Afterwards, a provider, who meets the same standards as WSCHD, will be contacted to provide services for the district within Stanislaus and Merced Counties.

Karin Freese, the CEO of Del Puerto Health Care District and a subcommittee member, said at the special meeting that emergency services will still be available within the district’s boundaries of operations if it transitions away from EMS. This was in response to concerns she’s heard from board and community members.

With its focus shifted away from EMS, the transition could help the district. With a property tax revenue of $335,000, it was proposed that the district could use the revenue towards paying off its debt of more than $1 million.

Additionally, it was also proposed that WSCHD could use its direct assessment annual revenue of $360,000 towards a grant-making process that would support EMS services within its boundaries. With an agreement with an LEMSA contractor, grants could be used towards providing coverage for local events, covering operating losses and helping with vehicle replacements and equipment.

Lastly, WSCHD could help provide district residents with scholarships and education opportunities, preventative screenings, patient care and community services. 

With the first pathway recommending that the district address its three issues to continue its ambulance operations, each issue was presented with options to consider as well as pros and cons in a printed PowerPoint presentation document provided at the meeting.

Some additional paths mentioned in the document were bankruptcy, financial assistance from the counties and dissolving or consolidating the district through the Local Agency Formation Commission.   

Aside from mentioning that WSCHD needs to coordinate with QMC about billing and proper payments, the billing section in the document for the first path also mentioned the subcommittee’s recommendation of the district terminating its contract with QMC.

Some of the benefits of the options in the first phase include being more cost-effective, optimizing PP-GEMT billing to potentially receive supplemental payments and using any monies recovered towards sustainable practices that the subcommittee recommended.

The challenges that come with this phase are an uncertain timeline for the appeal process, such as payment delays and requiring $1.4 million to switch billing companies.

Throughout Tuesday’s meeting, attendees voiced their concerns about the situation. Delya Stoltz, a paramedic for Westside Community Ambulance and Oak Valley Hospital District, expressed to the board why they should consider maintaining their ambulance operations, mentioning the fondness that she and her colleagues have for the areas that the district operates in, such as Newman and Gustine.

“The current crew you have is invested, we’re motivated and we’re already a really lean, mean machine,” Stoltz said. “Please, as you consider path one, that you have a group of people that you cannot replace.”  

The district will discuss further details about the situation in a special meeting in April.  

Navtej Hundal is a freelance journalist in Stanislaus County.