REPORT/RECOMMENDATION TO THE BOARD OF DIRECTORS
OF SAN BERNARDINO COUNTY FIRE PROTECTION DISTRICT
AND RECORD OF ACTION
October 20, 2026
FROM
DAN MUNSEY, Fire Chief/Fire Warden, San Bernardino County Fire Protection District
SUBJECT
Title
Amendments to Memorandum of Understanding with Molina Healthcare of California Related to Emergency Medical Ground Transport Services
End
RECOMMENDATION(S)
Recommendation
Acting as the governing body of the San Bernardino County Fire Protection District:
1. Approve Amendment No. 8 to Memorandum of Understanding No. 15-705, including non-standard terms, with Molina Healthcare of California, for the Intergovernmental Transfer Program with the California Department of Health Care Services, in which Molina Healthcare of California shall pay San Bernardino County Fire Protection District funds received from the California Department of Health Care Services, for the cost of emergency medical ground transport provided to Medi-Cal recipients enrolled with Molina Healthcare of California, during the state-established claim period of January 1, 2024, through December 31, 2024, with an agreement term effective January 1, 2024, through December 31, 2027, for a total term of October 1, 2013, through December 31, 2027.
2. Approve Amendment No. 9 to Memorandum of Understanding No. 15-705, including non-standard terms, with Molina Healthcare of California, for the Intergovernmental Transfer Program with the California Department of Health Care Services, in which Molina Healthcare of California shall pay San Bernardino County Fire Protection District funds received from the California Department of Health Care Services, for the cost of emergency medical ground transport provided to Medi-Cal recipients enrolled with Molina Healthcare of California, during the state-established claim period of January 1, 2025, through December 31, 2025, with an agreement term effective January 1, 2025, through December 31, 2028, for a total term of October 1, 2013 through December 31, 2028.
3. Direct the Secretary of the Board of Directors to maintain confidentiality of the amendments identified in Recommendation Nos. 1 and 2 pursuant to Health and Safety Code section 1457(c)(1).
(Presenter: Dan Munsey, Fire Chief/Fire Warden, 387-5779)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
Foster Sustainable Development Through Strategic Partnerships.
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of the recommended actions will not result in the use of Discretionary General Funding (Net County Cost). The amendments to the Memorandum of Understanding (MOU) with Molina Healthcare of California (Molina) pertain to the Intergovernmental Transfer (IGT) Program with the California Department of Health Care Services (DHCS), which will allow San Bernardino County Fire Protection District (SBCFPD) to continue to receive federal matching funds under the IGT Program. Sufficient appropriation and revenue for the MOU are included in SBCFPD’s 2026-27 budget and will be included in future year budgets.
BACKGROUND INFORMATION
Molina is a Medi-Cal Managed Care Plan Provider (MMCPP) offering services to residents eligible for Medi-Cal benefits. Molina contracts with SBCFPD for emergency medical ground transport services provided to residents of SBCFPD. Molina is also an MMCPP under the IGT Program with the DHCS, which authorizes SBCFPD to receive federal matching funds to support the costs of providing emergency medical ground transport services for Medi-Cal managed care beneficiaries.
SBCFPD has been participating in the IGT Program since 2013. The original MOU with Molina was approved by SBCFPD’s Fire Chief on July 14, 2015. Since then, the SBCFPD Board of Directors (Board) has approved the following amendments to extend the term of the agreement and update the State-established period:
|
Amendment No. |
Approval Date |
Item No. |
|
1 |
September 15, 2015 |
78 |
|
2 |
June 14, 2016 |
138 |
|
3 |
May 23, 2017 |
145 |
|
4 |
July 10, 2018 |
41 |
|
5 |
June 9, 2020 |
59 |
|
6 |
March 24, 2026 |
58 |
|
7 |
March 24, 2026 |
58 |
Amendment No. 8 applies to the State-established claim period of January 1, 2024, through December 31, 2024, and has a term of January 1, 2024, through December 31, 2027. Amendment No. 9 applies to the State-established claim period of January 1, 2025, through December 31, 2025, and has a term of January 1, 2025, through December 31, 2028. DHCS updates capitation rates annually and retroactively based on, but not limited to, changes to baseline costs, member eligibility, and policy mandates.
The recommended Amendments include updated capitation rates and are retroactive due to the annual revision of capitation rates under the IGT Program. SBCFPD received the new amendments from Molina on September 24, 2026. The amendment terms extend beyond and overlap the applicable State-established claim periods to allow sufficient time after each claim period for the receipt, payment, and reconciliation of IGT funds. Amendment No. 8 therefore addresses the 2024 IGT claim period, while Amendment No. 9 separately addresses the 2025 IGT claim period.
This item is being presented at this time, as this is the first available date following the required operational, fiscal, and legal reviews.
Except for the applicable IGT year, State-established claim period, and corresponding amendment term, the substantive provisions of Amendments Nos. 8 and 9 (together, “Amendments”) remain the same. Approval of the Amendments will allow SBCFPD to receive applicable IGT matching funds for emergency medical ground transport services provided to Medi-Cal beneficiaries enrolled with Molina during the State-established claim periods of January 1, 2024, through December 31, 2024, and January 1, 2025, through December 31, 2025, respectively.
Amendments Nos. 8 and 9 also contain the following non-standard contract terms that differ from the County's standard contract terms:
1. The Amendments provide that Molina and SBCFPD will mutually indemnify and hold harmless the other party for losses or delays in capitation payments resulting from the IGT.
• County Standard: The standard County contract requires contracting parties to indemnify the County/SBCFPD.
• Potential Impact: The Amendments create an affirmative indemnification obligation for SBCFPD in favor of Molina, a private entity, that is not expressly limited to SBCFPD's comparative fault. As a result, SBCFPD could be responsible for certain losses or delays in IGT capitation payments under circumstances broader than the County's standard indemnification provisions.
2. The Amendments require the parties to attempt to resolve disputes by mutual agreement or mediation and, if unsuccessful, require final and binding arbitration before a single arbitrator, which must take place in San Diego, CA.
• County Standard: The parties use their best efforts to resolve disputes through good-faith negotiations. The County standard contract does not require arbitration.
• Potential Impact: Unresolved disputes would be decided through binding arbitration rather than ordinary court litigation, and SBCFPD would be foregoing its right to a jury trial pursuant to the rules of civil procedure and proceedings in the state superior court, and have limited ability to obtain judicial review of the arbitrator's final decision.
3. The Amendments provide that the prevailing party in arbitration is entitled to reimbursement of its attorneys' fees, costs, arbitration fees, and expenses.
• County Standard: Each party is responsible for its own attorneys' fees and costs, except for fees and costs arising from indemnification obligations.
• Potential Impact: If SBCFPD does not prevail in an arbitration, SBCFPD could be required to pay Molina's attorneys' fees, costs, and arbitration expenses in addition to any other amounts awarded by the arbitrator.
4. The Amendments do not require Molina to carry insurance meeting the County’s standards under County Policy 11-07.
• The County Policy requires contracting parties to carry appropriate insurance at limits and under conditions determined by the County’s Risk Management Department and set forth in the County standard contract.
• Potential Impact: SBCFPD has no assurance that Molina will be financially responsible for claims that may arise from the Agreement.
SBCFPD recommends acceptance of these non-standard terms because continued participation under the MOU allows SBCFPD to participate in the IGT Program and receive federal matching funds supporting the costs of providing emergency medical ground transport services to Medi-Cal managed care beneficiaries. SBCFPD has determined that the benefits of continued participation in the IGT Program outweigh the potential risks associated with these non-standard provisions.
Approval of Amendments Nos. 8 and 9 will allow SBCFPD to receive applicable IGT matching funds for services provided during the State-established claim periods of January 1, 2024, through December 31, 2024, and January 1, 2025, through December 31, 2025, respectively.
Pursuant to Health and Safety Code section 1457(c)(1), specific terms related to the rates of payment for health care services are not immediately subject to laws related to public records. Therefore, the Secretary of the Board is directed to maintain confidentiality of this agreement and amendment with DHCS.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Aaron Gest, Deputy County Counsel, 387-5455) on October 6, 2026; Risk Management (Rebecca Suarez, Director, 386-8723) on September 25, 2026; and County Finance and Administration (Matthew Dalton, Administrative Analyst, 387-5005) on October 1, 2026.