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A testing site affiliated with Community Wellness America briefly operated in Santa Cruz earlier this year.

This free coronavirus testing site operated by Emerald Premier was doing business at Plaza Bonita Mall in National City (San Diego County). Petition circulators, who typically make a living gathering signatures to qualify political measures for the ballot, found a new, highly profitable cottage industry during the pandemic: operating pop-up COVID testing sites.

This free COVID testing site operated by a company called Emerald Premier was doing business at Chula Vista Mall in Chula Vista (San Diego County). Petition circulators, who typically make a living gathering signatures to qualify political measures for the ballot, found a new, highly profitable cottage industry during the pandemic: operating pop-up COVID testing sites.

Petition circulators who typically make a living gathering signatures to qualify political measures for the ballot found a new, highly profitable cottage industry during the pandemic: operating pop-up coronavirus testing sites.

The sites, often tents on sidewalks with banners that advertised “Free COVID testing,” started appearing across California and the nation last spring, as a surge in cases strained access to tests.

At first, the pop-ups — which offered self-administered nasal swab tests — confounded health officials. They often weren’t run by medical workers and had no connection to public testing efforts.

The confusion prompted a flurry of complaints, followed by investigations in San Francisco, Marin and Santa Cruz counties, among other places, as well as by the California Department of Public Health.

In San Francisco, City Attorney David Chiu opened a probe into a company that his office said ran two “dubious” and “rogue” sites near Golden Gate Park and Dolores Park. Chiu’s office said Community Wellness America of Encinitas (San Diego County) could not produce required laboratory licenses, while some patients complained they had not received results.

“San Francisco is increasingly concerned with unlawful, fly-by-night facilities claiming to offer COVID-19 tests to the public,” Chiu wrote in a letter to the company.

City employees were first alerted to a woman offering tests at the site near Golden Gate Park. When asked for her credentials, the woman presented a license for a small Irvine-based lab, according to court filings. The federal government has paid the lab more than $100 million for COVID testing.

The license was expired, the city’s filings allege, and similar concerns about another testing site in the Mission soon drew scrutiny. Testing sites are required to show a valid Clinical Laboratory Improvement Amendments license, which indicates they are partnered with a lab using FDA-approved tests.

But as scrutiny of the sites intensified, the tents disappeared just as they had come — practically overnight and with little explanation of who was behind them.

The Chronicle, however, found that a handful of political operatives, led by a San Diego-based petition firm, organized an army of signature gatherers who worked on behalf of Community Wellness America to operate dozens of testing sites across the country.

The picture that emerges in legal filings, social media posts and online videos is one of an opportunistic business venture that united a highly portable group of workers with a desperate societal need for swift COVID test results.

How exactly the venture worked — whether all tests were properly handled and lab-tested, for example, how medical information was safeguarded and how workers were paid — remains mysterious. More than three months after the testing sites disappeared, Chiu’s office said it is still trying to force Community Wellness America to comply with a January subpoena for records related to its operations.

Steve Sterling, a San Diego-based acupuncturist, is listed as the firm’s president and sole officer in business filings with the state of Nevada, where he incorporated the company as a nonprofit in February 2021.

“Everything that we’ve been doing is legal and legitimate,” Sterling told The Chronicle in a brief phone interview. “The (city attorney has) political agendas to try and further their career and make us look like we’re some criminal element when we’re not.”

This week, Sterling said in a text, “Your story is a great Big nothing burger! Covid Test Collection in San Francisco ceased over a year ago the subcontractors said they were not welcome. There is no story here, you’re obviously on a fact finding mission for the SF city attorney’s office.”

Organizers of the pop-up testing effort discussed their work in numerous social media posts. Robert Bush, a petition gatherer who owns the firm Emerald Premier and partnered with Community Wellness America, appears to have been at the center of coordinating field operations.

In a series of Facebook posts reviewed by The Chronicle, Bush recruited petition gatherers to operate COVID testing sites, writing that they could earn $12 per test and set their own hours. In one post, Bush shared a photo of a sidewalk test tent under the heading, “Current direct marketing opportunities.”

“At Emerald Premier we have just surpassed 1,000,000 patient tests given nationwide this year,” Bush, who also uses the name Rob Diamante online, wrote in a Dec. 10 post. “Thank you to all the hard working testers out there serving our community in 33 states.”

In YouTube and Facebook videos, he touted lavish bonuses, displaying giant $7,500 and $5,000 checks that he presented to top-performing collectors. One video showed him giving a man he identified as his father a Jaguar convertible, which Bush said was for his help on COVID testing and petition work. Another video showed Bush presenting Darrius Gibson, a Florida-based petition gatherer, with a $5,000 check after his team supposedly conducted the most COVID tests in the country — about 6,800 in a week.

“He might be the Michael Jordan of COVID testing,” Bush said in the video, pointing out that Gibson was wearing a Jordan T-shirt.

Gibson boasted of his profits on his Facebook page. He wrote that he had recruited workers to open testing sites in Los Angeles, Las Vegas, North Carolina and Texas.

“A few months ago I started putting COVID 19 tents up all over Floirda [sic] ... free COVID testing site … I was able to generate half a million in profits and such a short time frame,” Gibson wrote. “This is one way I can help all my Freind [sic] to become rich fast I mean real fast... Who want to be a millionaire?”

Bush, in a brief phone interview, downplayed his connection to Community Wellness America and his role coordinating test sites. He said he worked for the company as a contractor and is no longer doing so.

“That has nothing to do with me,” Bush said of San Francisco’s investigation into the firm. “I am not associated with them.”

Bush declined to answer further questions. But in numerous Facebook posts and online videos, he cited his partnership with the company and displayed the company’s banner. A business tax account previously on file with the city of San Diego listed both Bush and Sterling as the owners of Community Wellness America. Bush said his name was listed on the account without his permission.

Sterling previously told the Seattle Times that Community Wellness America partnered with a petition firm to staff testing sites in numerous states.

“Since the election is over, these people have been out of work,” Sterling said told the newspaper. “It seemed like a no-brainer to see how we could repurpose people.”

It’s unclear how exactly the signature-gatherers-turned-COVID-testers got paid for their work. Sterling has previously said that Community Wellness America provided free testing through the HRSA/Medicare program, which allows medical providers to bill the federal government for tests.

The government directly reimburses labs for COVID testing, so it’s difficult to know how much Community Wellness America has been paid for its sample collection efforts. The company appears to have worked with multiple labs.

One of the these labs was Crestview Clinical Laboratory of Irvine (Orange County), according to court filings and the company’s social media posts. The lab has received more than $100 million in payments for COVID testing claims it submitted to the federal government, data shows.

According to court filings, San Francisco became aware of Crestview because it was listed on an expired clinical lab license offered up by workers at a Community Wellness America pop-up site.

Chiu’s office scrutinized Crestview’s connection to the sites, but his office said the lab had complied with a subpoena. Justin Nguyen, a representative for Crestview, wrote in an email that the lab’s “only relationship with (Community Wellness America) is to test their samples and provide test results to their patients.”

Sterling said in court filings in April that Crestview was one of the labs his company used at that time to perform PCR tests. He said his company wasn’t responsible for the expired lab license that San Francisco investigators allege was shown to them, and said test collection sites were operated by an unnamed third-party vendor.

Community Wellness America also faces scrutiny over a doctor listed as its medical director on test requisition forms filled out by patients and workers at the pop-up sites.

Dr. Phillip Milgram, an addiction medicine specialist in Carlsbad (San Diego County), was sued in 2020 by a patient of his former gynecology practice who alleged that he used his own sperm to artificially inseminate her without her consent decades earlier — which she said she discovered after her son took a DNA test. The woman’s attorney said the case is scheduled to go to trial in August.

Milgram declined to comment about the patient’s lawsuit or his work with Community Wellness America.

The subpoena Chiu’s office sent to Community Wellness America and Crestview demands that they hand over “all documents concerning Phillip Milgram, MD’s involvement.” In a court filing, San Francisco highlighted the accusations against Milgram.

Chiu’s office has described two primary concerns central to its investigation: Did the company properly handle test samples, including giving patients their results? Did the company properly handle sensitive patient information like Social Security numbers?

The ordeal has prompted San Francisco to enact new regulations for COVID test specimen collection sites. While laboratories are tightly regulated by the state, standalone specimen collection sites are not.

In late January, the city’s health officer issued new regulations requiring all collection sites to adhere to basic safety standards, provide anyone who asks with an up-to-date lab license and maintain written policies outlining their training practices and how they will notify patients of results, among other measures.

California lawmakers have not adopted any similar rules to close the oversight loophole for specimen collection sites on a statewide level.

It’s unclear exactly how many workers who staffed Community Wellness America’s testing sites in San Francisco were previously employed as signature gatherers, though the City Attorney’s Office highlighted the connection in a recent court filing.

Charlie Chavez, a Denver-based petition collector, said a contractor for Community Wellness America hired him to work as a courier, transporting test kits from field collection sites to the airport so they could be transported to a lab. He said most people involved knew one another from working on ballot measures.

“That’s where most of these people came out of, was people that was in the petition business,” Chavez said.

He said he eventually quit because the organizers working with him were not paying field workers in full. He said he became suspicious of the operation, including Bush, when nobody would share a subcontractor agreement showing the flow of funds.

“You never really could figure out who was working for who,” Chavez said, adding that the business model involved “layers and layers of independent contractors.”

Another independent contractor, who said Bush hired them to manage field testing sites, said they were put to work after a single phone call with him and after watching a short training video. The contractor, who spoke on the condition of anonymity because they feared speaking out would harm their business, said they knew Bush through signature-gathering work.

The contractor said they also quit because Bush had not paid field workers in full.

It’s unknown exactly how many testing sites were operated by contractors working for Community Wellness America and Emerald Premier. What is clear, though, is that complaints followed their work in multiple cities.

In Washington state, public health officials in Seattle and Kings County issued a warning in April 2021 about “unusual COVID testing operations ... that the public should avoid.”

Health officials said they became suspicious of the pop-up testing sites operated by Community Wellness America after it operated in the Seattle area for several weeks and the lab the company used sent no positive results to the public health department, raising concerns that they “may not be properly processing test specimens.”

The warning also alleged that testing staffers had not properly worn protective equipment, had stored patient information insecurely and had falsely claimed they were “with public health.”

Sterling told the Seattle Times, “All the people I’ve been in contact with said we’ve been in good compliance and haven’t had any problems.”

In Marin County, health officials shut down what they called an unauthorized testing site operated by Community Wellness America last August. A county official said the company did not have a business license and had elicited concerns due to a lack of professionalism among the workers and because there was no clear indication of the company the site represented.

In Santa Cruz, Mayor Sonja Brunner raised questions about the company after she visited one of its testing sites and, she said, did not receive results until eight days later, despite being told to expect the information in two to three days.

County health officials said some residents never received their results. By the time they went to investigate, the pop-up had disappeared, reported KSBW, a local TV station.

Chiu, the San Francisco city attorney, continues to investigate Community Wellness America’s test sites. His office wrote in a recent court filing that the company cannot insulate itself from investigation by rushing to open testing sites and then absconding “as soon as it draws unwanted attention.”

An attorney for Community Wellness America argued in a court filing that the subpoena was a “pretextual stalking horse” to pursue a criminal investigation against the company when it was no longer operating in San Francisco.

By February, Bush, the petition firm owner, appeared to have soured on the prospect of sidewalk COVID testing. In a Facebook post, he told his network of signature gatherers that it was time to focus again on the petition business.

Bush recruited signature gatherers for a host of petition campaigns this year, including a ballot measure to require funding for pandemic prevention and another to regulate kidney-dialysis clinics.

“After 13 months of straight COVID testing we are backing away from field test collection and encouraging everyone to come to California for the 2022 petition season until the end of April,” Bush wrote on Feb. 3. “This is also extremely lucrative for those participating as many people make over $500 a day during the petition season.”

Dustin Gardiner (he/him) is a San Francisco Chronicle staff writer. Email: dustin.gardiner@sfchronicle.com Twitter: @dustingardiner

Dustin Gardiner is a state Capitol reporter for The San Francisco Chronicle. He joined The Chronicle in 2019, after nearly a decade with The Arizona Republic, where he covered state and city politics. Dustin won several awards for his reporting in Arizona, including the 2019 John Kolbe Politics Reporting award, and the 2017 Story of the Year award from the Arizona Newspapers Association. Outside of work, he enjoys hiking, camping, reading fiction and playing Settlers of Catan. He's a member of NLGJA, the association of LGBTQ journalists.