Five years after bringing in an outside firm to manage operations, the board which oversees West Side Community Ambulance has decided to return to an in-house management structure.

Board members voted 3-0 during a special meeting Friday evening to proceed with hiring its own operations manager and setting up the network of support services required to take the reins of the taxpayer-supported ambulance which serves Newman, Gustine and the surrounding areas.

“I think it is the right thing for our communities,” said Dennis Brazil, president of the ambulance board. “I think we have lost a lot of local control by not having (an in-house operations manager). We are always at the mercy of whoever is operating us, and our hands are tied in terms of operations. I think this will make us a stronger organization.”

West Side had turned to an outside firm in 2014 when the organization was in turmoil, but its experiences with two management companies were not without their own challenges.

The first, Sierra Medical Services Alliance, advised West Side a year into a five-year contract that it would need to restructure its agreement at a significantly higher cost in order to continue providing services.

West Side eventually turned to American Medical Response (AMR) to provide management services - but early on in that agreement AMR notified West Side that it had determined the contractual arrangement to be unsustainable. At the time, AMR proposed to essentially absorb the West Side operation as an alternative to simply exiting the management contract.

Finances alone made the AMR proposal untenable, Brazil said Friday.

He said AMR wanted annual fees of nearly $2.8 million to incorporate West Side - and that did not include expenses such as legal representation, billing and accounting which would push the total cost past $3 million a year.

“Our estimated budget is about $2.1 million,” Brazil pointed out. “It is not hard to figure out that the $2.8 million plus the extended services would not be something the district could afford.”

The message from AMR was also that the proposal was not subject to negotiation, Brazil added.

AMR has continued to provide management services on a temporary basis, Brazil noted, and the two agencies are working together on a transition plan.

He said that West Side hopes to complete that transition by Sept. 1 - a process that includes hiring a local chief of ambulance operations.

In anticipation of Friday’s decision, the board did advertise the position and received 25 applicants, Brazil said.

“It was a good response. I would assume that there would be some locals (in the applicant pool) as well as people from outside the area,” said Brazil, adding that board members have not yet seen the applications.

Brazil acknowledged that the full financial outlook for the self-operating model has not yet been compiled. But, he said, what the West Side Community Healthcare District will pay its own operations manager is comparable to that being paid by AMR for the service.

The district’s accountant “is very confident that we are going to stay within the estimated budget,” Brazil said. “There is a little cushion that he has built in, so if something were to swing a little higher we will still be okay.”

The three-member board of Brazil, David Varnell and Charles Tanner was in agreement on the decision to return to in-house management.

“I have always been for switching back over,” Varnell stated. “I would like to see us do it.”

“I’m all for it,” Tanner added.

The ambulance service operated successfully for years with an in-house management structure, Brazil pointed out.

“We have made huge steps in the last seven or eight months to make West Side stable,” Brazil remarked. “I think that, given this point and time, it is absolutely the right move to get back on our own.”