EMS chief, paramedic retire after audit reveals critical billing issues
One of the outgoing employees mentioned the audit that revealed revenue losses of at least $200,000 in his resignation letter
BARABOO, Wis. — The day after an unflattering audit of the Baraboo District Ambulance Service’s finances was presented to city council and ambulance commission members, two administrative employees have announced their retirement.
EMS Chief Dana Sechler and Logistics Coordinator Amos Vande Hei, who also serves the department as a paramedic, submitted letters of resignation to Ambulance Commission President David Dahlke late Wednesday.
Baraboo Common Council President Joel Petty, who serves as a member of the Ambulance Commission that represents the eight municipalities in the district, said Thursday that the commission unanimously accepted their resignations. Vande Hei’s last day was Friday and Sechler will depart Jan. 17, Petty said.
Petty also noted that given the results of the audit presented by Baker Tilly Virchow Krause, reorganization may likely be considered within the service. Vande Hei made a similar point in his resignation letter.
“I know that there are big decisions ahead for the BDEMS billing department and hope it will help BDEMS management to be able to plan for the years ahead, with the knowledge of my retirement being factored into that planning,” Vande Hei wrote, noting that his reason for retirement from the department is due to a desire to spend more time with his family.
The audit pointed to financial problems, in particular a communication and training disconnect between administrative officials in charge of billing. The audit was compiled, in part, with interviews of several key employees. One was Jess Seefeld, who according to the audit, may have been the only employee who knew how to perform certain functions within billing software, which resulted in revenue delays and increased write-offs — loss of revenue.
The department struggled financially when Seefeld was absent from the service between May 2018 and July 2019 because she was deployed overseas in the military. During that period, Seefeld told auditors and Ambulance Commission members that claims submitted to insurance companies, Medicare and Medicaid went unattended if they were returned for a paperwork error. Seefeld said the issue can simply require a correctly checked box and a resubmission, but returned claims went unattended until she returned.
Auditors found that the service suffers from a lack of cross-training, good communication and lapses in their billing system which allow for bills to be misplaced or calls to never be recorded accurately. In July, Ambulance Commission members were told there were financial concerns. The BDAS was operating with its reserve funding and its accounts receivable balance, meaning the amount still needed to receive to pay its expenses, was $1.2 million, Sechler said at the time. He asserted Wednesday the service has corrected its operation, no longer using reserve funding and has not accessed the credit line approved by commission members in July.
Sechler disputed some of the findings of the audit and said he was confused as to how there was misinformation included within it. Findings that Vande Hei didn’t attend to bills for months at a time in Seefeld’s absence are untrue because the service would have had to compile its financial statements for approval each month by the commission, Sechler said. The audit also found that there were several instances in which numbers were not verified independently between Financial Coordinator Troy Snow and Sechler.
Petty said he felt the $25,000 investment by the city in the audit was beneficial and expressed confidence that the findings were correct.
“There were obviously some concerns in regards to whether or not the financials were accurate,” Petty said. “It’s not like general audits. They’re a specialized group of individuals. I’m very confident in their credentials, in their experience.”
Sechler wrote in his retirement notice that he has been “considering a number of options in my personal and professional life,” adding that he has decided to pursue his work as a partner in Strategic Management & Consulting, a firm that specializes in advising statewide emergency medical services and fire departments. He noted in his letter that since he began in January 2010, “the Service has grown by leaps and bounds to become a full-time career Critical Care Paramedic level service.”
“We’re a highly professional paramedic team that has many facets to provide 911 service,” Sechler said Friday. “I think I am leaving the ambulance service in a very positive place.”
The city had previously allocated funding at $30 per capita for the ambulance service in its 2020 budget, but withheld a portion until the results of the audit were presented. No action was taken on whether it will contribute funds. Another closed session to “deliberate the City’s investment of public funds in and contractual arrangement with the Baraboo District Ambulance Service” is scheduled for Tuesday.
Though Petty said there are no definitive steps forward being considered by the city, echoing fellow council and commission member Heather Kierzek’s recent comments after a three-hour closed meeting Tuesday, he also noted that members of the district always have an option to leave if they feel their money is not being well spent. It’s complicated given all of the people involved, he added, with the city as the biggest contributor.
“The question really is, is the ambulance service worth it for the rate,” Petty said. “I can’t speak for other municipalities, but they may think, just like people do when they go shopping, if you’re not getting the best for your dollar value, you’re going to try to get a better deal.”