REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
February 11, 2025
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Amendment to Contract with California University of Science and Medicine for Pediatric Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 4 to Contract No. 19-398 with the California University of Science and Medicine for primary care services, psychiatry services, and the Refugee Health Assessment Program, adding pediatric services at the Apple Valley and Ontario Maple Head Start school-based service sites, and updating contract language, with no change to the contract amount of $19,473,711, or the contract period of July 1, 2019 through June 30, 2025.
(Presenter: Joshua Dugas, Director, 387-9146)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
This item will not result in the use of Discretionary General Funding (Net County Cost). The cost of $19,473,711 for the continuation of primary care and psychiatry services at the Department of Public Health’s (DPH) Federally Qualified Health Centers (FQHCs) is funded by Medi-Cal, private insurance, self-pay, and 1991 Realignment funds. Services provided under the Refugee Health Assessment Program (RHAP) include health assessments and referrals for identified health conditions and are reimbursed by the State. There are no additional costs for the California University of Science and Medicine (CUSM) to provide pediatric services at the two school-based sites because a portion of the existing patient contact hours at FQHCs will be redirected to provide pediatric services at the two school-based service sites. Adequate appropriation and revenue will be included in the DPH 2025-26 Recommended Budget.
BACKGROUND INFORMATION
DPH currently operates four FQHCs in the cities of Adelanto, Hesperia, Ontario, and San Bernardino. Section 330 of the Public Health Services Act requires that FQHCs serve an underserved area or population. Services provided at the FQHCs include primary care, maternal health, pediatric care, HIV care and treatment, reproductive health services, dental and nutrition services, and diagnostic radiology.
DPH contracts with CUSM for comprehensive primary care, RHAP, and psychiatry services through licensed physicians and mid-level practitioner support at the FQHCs. CUSM acts as the lead agency and subcontracts services through an agreement with CEP-America AUC, dba Vituity, Inc. (Vituity). Vituity provides licensed physicians and mid-level practitioners for the delivery of the contracted services.
CUSM’s performance is monitored by review of monthly reports to ensure compliance with the administrative, program, and fiscal terms and conditions of the contract.
On June 11, 2019 (Item No. 42), as a result of Request for Proposals (RFP) No. DPHE19-CO-3153, the Board of Supervisors (Board) approved Contract No. 19-398 (Contract) with CUSM to provide primary care services, in the amount of $7,667,464, for the period of July 1, 2019, through June 30, 2022, with the option to extend the Contract two additional one-year periods.
On June 14, 2022 (Item No. 55), the Board approved Amendment No. 1 to the Contract to continue to provide primary care services, expand services to include RHAP and psychiatric services, exercise the first option to extend for one year, and increase the contract amount by $3,368,343, from $7,667,464 to $11,035,807, for the total contract period of July 1, 2019, through June 30, 2023.
On May 23, 2023 (Item No. 61), the Board approved Amendment No. 2 to the Contract to continue to provide primary care services, psychiatry services and RHAP services, update contract language, exercise the second option to extend for one additional year, and increase the contract amount by $3,630,080, from $11,035,807 to $14,665,887, for the total contract period of July 1, 2019, through June 30, 2024.
On June 11, 2024 (Item No. 64), the Board approved Amendment No. 3 to increase the Contract amount by $4,807,824, from $14,665,887 to $19,473,711 and extend the term by an additional year, for a total contract period of July 1, 2019 through June 30, 2025, to allow DPH to conduct a new procurement for a service provider.
The recommended Amendment No. 4 to the Contract adds the Apple Valley and Ontario Maple Head Start school-based sites as locations for CUSM to provide pediatric care, which furthers the County’s goal of providing for the safety, health and social service needs of county residents. Amendment No. 4 to the Contract avoids a gap in service at the Apple Valley and Ontario Maple Head Start school-based sites due to a termination of service notice, effective December 8, 2024, received from the previous service provider. DPH staff have been providing services in the interim to ensure no disruption in care. However, to ensure continuity of services beyond the current contract term with CUSM, DPH has released RFP No. DPHE25-CO-5726 to secure future services.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Adam Ebright, Deputy County Counsel, 387-5455) on January 17, 2025; Finance (Iliana Rodriguez, Administrative Analyst, 387-4205) on January 22, 2025; and County Finance and Administration (Robert Saldana, Deputy Executive Officer, 387-5423) on January 27, 2025.