With uncertainty around its future, the Westside Community Healthcare District (WSCHD) Board held a special meeting on Monday to discuss findings and possible pathways for the district to take into consideration.
The meeting consisted of a presentation presented by Karin Freese, the CEO of Del Puerto Health Care District. Freese alongside members of an Ad Hoc Committee have met within the past couple of months to discuss their findings and develop a sustainable business plan.
Multiple topics were mentioned including the district’s revenue, expenses, payroll and staffing, financial health and equipment. Additionally, there were two proposed paths that the district could take: continue operations for Westside Ambulance or exit from Emergency Medical Services (EMS) and shift the district’s focus towards broader healthcare initiatives.
Each topic brought up the core problem with a possible solution or plan to deal with the issue.
Westside Ambulance currently has nine part-time Emergency Medical Technicians (EMTs), eight part-time paramedics, three full-time EMTs and paramedics. Based on dispatch data the committee found from the past two calendar years, the district only had two Advance Life Support (ALS) Ambulance staff units for 89% of the time in 2023. Last year saw a decrease as the district had two full ALS staff units for 65% of the time. Additionally, the number of transports dropped from 1677 transports in 2023 to 1282 last year.
The proposed idea to help negate this issue is to have a minimum of ALS Ambulances while hiring nine full-time paramedics, four full-time EMTs and additional part-time paramedics and EMTs could help with possible shortages within the units.
“If you have three paramedics scheduled and a paramedic gets sick, you can still replace them with an EMT and still have two ALS Ambulances,” Freese said. “If your EMT is the one that calls out, you can replace them with an EMT or paramedic and still have two ALS ambulances.”
Another staffing proposal was to have a full-time District Administrator and Ambulance Operations Manager.
The District Administrator will be the board’s clerk and handle a multitude of responsibilities including representing the district with various agencies, handling staff development, working on an annual strategic plan, dealing with labor-management contracts and managing board orientation and training.
The Ambulance Operations Manager will focus on handling internal responsibilities within the ambulance units, management of supplies, equipment maintenance, maintaining quality improvements and filling in needed staffing.
Freese said that these positions will help alleviate the responsibilities of the current Chief Administrative Officer and Administrative Service Manager, adding that they were given an “impossible job.”
As the presentation shifted toward the expenses, an unaudited profit & loss chart from the district’s Fiscal Year 2024 was shown. The district’s adjusted ambulance operations had an income of around $1.85 million. However, the adjusted ambulance operations and administration expenses were around a combined $2.3 million. Freese told the Westside Connect that this report did not include any unreported expenses.
The committee also found out that WSCHD didn’t report various expenses and tax revenue. Between January 2024 and June 2024, there were unreported legal expenses and $6,937 spent on vehicle maintenance based on receipts found but only $1,553 was reported in FY24.
The taxes were reported incorrectly as it was not reported in the fiscal year they were paid in. There were also untimely audits that occurred 16 months following a fiscal year. During the COVID-19 pandemic, the district received $135,000 in pandemic funding but was not eligible for the funding and had to repay the amount. This was reported as a tax expense.
For this issue, it was recommended to hire a full-time Finance Manager who can track expenses, ensure accurate and timely audits, get revenue from multiple public agencies and the transport billing accurate. Additionally, it was also recommended for the district to hire a part-time Human Resources Generalist.
The district has four ambulances that are at least six years old and with 29k miles left. Freese said the Local Emergency Medical Service Agency (LEMSA) standard for the lifespan of EMS vehicles is up to 250,000 miles. The asset replacement fund will be used to schedule replacement ambulances.
It was recommended that the district have four ALS Ambulances with two being primaries that are operating 24/7, one backup in case of mechanical failures in the primary vehicles and one used for scheduled events such as high school sporting events.
For equipment, it was recommended to do regular maintenance and repairs for reliability such as spending $5,000 per year for ambulance maintenance and $1,000 annually per device repairs and maintenance.
The final recommendation for the district is to switch from its current billing company, Quick Med Claims (QMC). Due to a lack of transparency to QMC about changes to California law and public agencies group, the district had $337,000 under-billed and underpaid from January 2023 to today. However, changing billing companies will require $1.4 million to cover expenses as there will be no cash flow when making the transition.
If the district continues operating its ambulance services, some of the recommendations for that path were to focus on recruiting and hiring individuals in the profession with the right expertise, settling on a collective bargaining agreement with the union, switching to a new billing provider and purchasing required medical equipment for the ambulances. It could cost $2 million to address these issues.
One of the individuals who attended Monday’s meeting was Gustine City Council member Mark Melville. Melville suggested the idea of going with the first path because he was concerned about whether or not the ambulance service within Gustine and Newman would be available if the district went with another pathway, adding that he does not want EMS services to be abandoned.
“We want that as much as possible in our communities. I know Newman wants it [and] we (Gustine) want it.” Melville said.
If WSCHD decides to move toward broader healthcare initiatives, the district will have to return its LEMSA contract to Stanislaus County. The county will then contract with a contractor who meets or exceeds the expectations set by WSCHD in Stanislaus and Merced Counties.
Additionally, the district can use its annual Direct Assessment Revenue of $360,000 towards supporting timely and quality EMS service with an agreement with a LEMSA contractor to help provide event coverage and cover any operating losses, equipment and vehicle replacements.
The district’s property tax revenue of $335,000 can be used toward paying off WSCHD’s more than $1 million debt. This direction can also help WSCHD provide multiple initiatives including education and scholarship opportunities, direct patient care within the district’s boundaries, preventative screenings and community services.
Freese, who heard concerns from board and community members about the district’s ambulance service, ensured that there would be still EMSs available within the district boundaries as Stanislaus and Merced Counties’ are responsible for keeping the same standards that WSCHD follow even if the district decides to transition away from EMS.
Board President David Varnell said it’s important to ensure residents that the same services will be still available regardless of what the district decides.
A meeting will be held on Tuesday to decide whether the district will pursue either one of the two options or not.
Navtej Hundal is a freelance journalist in Stanislaus County.
