REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
April 8, 2025
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Non-Financial Agreement with Loma Linda University for the Student Internship Program
End
RECOMMENDATION(S)
Recommendation
Approve the non-financial Student Internship Program Agreement with Loma Linda University, including non-standard terms, for the provision of Nurse Practitioner Student and Nursing Student Internship training and field experience, for the period of April 8, 2025, through June 30, 2029.
(Presenter: Georgina Yoshioka, Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Promote the Countywide Vision.
Create, Maintain and Grow Jobs and Economic Value in the County.
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost) as the Student Internship Program Agreement (Agreement) is non-financial in nature.
BACKGROUND INFORMATION
The Department of Behavioral Health (DBH) employs qualified professionals in multiple disciplines including medicine, nursing, psychology, marriage and family therapy, and social work. As a result, DBH can provide necessary tutelage and guidance to student interns participating in a variety of behavioral health-related educational programs. Reciprocally, the use of interns to assist the County’s workforce is a valuable means of maximizing available public resources. Through student internship programs, DBH provides learning experiences that will help students develop the skills they need to prosper in their chosen profession, which aligns with the Countywide Vision2Succeed initiative.
Since 2008, DBH has operated an internship program through agreements with schools and other institutions, which establish the terms and conditions under which DBH will accept student interns. These agreements enable students to earn required internship hours while working under the supervision of qualified DBH staff.
This internship program will allow Nurse Practitioner Student and Nursing Student Intern placement in DBH clinics and/or programs through the internship program. Interns will perform specialty Nurse Practitioner duties involving examination, evaluation, diagnosis, and treatment of behavioral health patients. Interns will also advise and counsel patients or legal guardians, perform related duties as required on assigned patients under DBH standardized procedures and protocols, and report to a designated supervising Nurse Practitioner, in the outpatient clinics, to develop the experience required to perform at fully qualified working level.
On February 27, 2024 (Item No. 21), the Board of Supervisors approved a standard agreement template (Template) for private schools and other institutions. The recommended Agreement with Loma Linda University (LLU) contains modifications from the Template; however, it remains in conformance with County Policy 11-05. The modifications are as follows: additional language was developed for conformance with DBH’s Sound and Photographic Recordings Policy (COM0922) and requires students to sign the DBH Oath of Confidentiality and Code of Conduct prior to initial contact with DBH clients.
The indemnification and insurance provisions have also been modified from the Template and differ from the standard County contract language. The non-standard terms include the following:
1. Per the Agreement, each party is required to defend, indemnify or hold the other party harmless to the extent arising out of the respective party’s breach of the Agreement and negligent or wrongful acts or omissions in connection with its performance under the Agreement.
• County Policy 11-07 requires the contractor to indemnify the County against all claims arising out of the contract from any cause whatsoever.
• Potential Impact: By agreeing to indemnify LLU, the County could be contractually waiving the protection of sovereign immunity. If the County is sued for any claim resulting from its own breach of the Agreement and negligent or wrongful acts or omissions in connection with its performance under the Agreement, the County may be solely liable for the costs of defense and damages.
2. The Agreement does not require LLU to meet the County’s insurance standards as required pursuant to County Policy 11-07.
• The County Policy requires contractors to carry appropriate insurance at limits and under conditions determined by the Risk Management Department and set forth in the County standard contract.
• Potential Impact: The contract does not include all of the County standard insurance requirements. This means that the County has no assurance that LLU will be financially responsible for the claims that may arise under the contract.
DBH recommends approval of this Agreement, including the non-standard terms, as it will allow students from LLU to participate in a valuable learning opportunity and provide DBH with additional staffing resources for service of delivery.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Michael Shin, Contracts Manager, 388-0899) on January 28, 2025; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on March 7, 2025; Risk Management (Gregory Ustaszewski, Staff Analyst II, 386-8631) on February 28, 2025; Finance (Paul Garcia, Administrative Analyst, 386-8392) on March 24, 2025; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0332) on March 24, 2025.