REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 25, 2024
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Grant Agreements with California Department of Health Care Access and Information to Support the Internal Medicine and Family Medicine Residency Programs
End
RECOMMENDATION(S)
Recommendation
1. Approve Grant Agreement, including non-standard terms, with the California Department of Health Care Access and Information, for the Song-Brown Primary Care Residencies Grant to support the training of internal medicine resident physicians, in the amount of $500,000, for the period of June 30, 2024 through August 31, 2027.
2. Approve Grant Agreement, including non-standard terms, with the California Department of Health Care Access and Information, for the Song-Brown Primary Care Residencies Grant to support the training of family medicine resident physicians, in the amount of $500,000, for the period of June 30, 2024 through August 31, 2027.
3. Authorize the ARMC Chief Executive Officer to electronically execute and submit the Song-Brown Primary Care Residencies Grant Agreements and all required supporting materials, as well as any non-substantive amendments necessary, on behalf of the County, subject to review by County Counsel.
4. Direct the ARMC Chief Executive Officer to transmit the executed Song-Brown Primary Care Residencies Grant Agreements, including non-substantive amendments, to the Clerk of the Board of Supervisors within 30 days of execution.
(Presenter: Andrew Goldfrach, ARMC Chief Executive Officer, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
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). The Grant Agreements through the Song-Brown Primary Care Residencies Grant Agreements will result in up to $1,000,000 in revenue to Arrowhead Regional Medical Center (ARMC). The grant awards do not require matching funds and were not included in the ARMC 2024-25 budget. Budget adjustments are not requested at this time, but will be included in a future countywide budget report presented to the Board of Supervisors (Board) for approval, if necessary.
BACKGROUND INFORMATION
On August 22, 2023 (Item No. 12) the Board approved and authorized the submission of a grant application to the Department of Health Care Access and Information (Department), for the Song-Brown Primary Care Residencies Grant Program (Program), in the amount of $1,250,000 to fund residency positions in family medicine and internal medicine at ARMC.
In April 2024, ARMC was notified by the Department that it was being awarded grant funds from the Program in the amount of $1,000,000 to support four internal medicine residents and five family practice residents. The awarded funding will help provide offsets to resident salaries, faculty development, resident conference travel, and other direct educational costs for operating the training program. The training program allows resident physicians to provide primary care services in medically under-served communities in the county.
In order for the County to accept the grant funds through the Program, the Department requires the parties to enter into two separate Grant Agreements, which are not negotiable by the County, and contain the following non-standard provisions:
1. The County must indemnify, defend, and hold harmless the State, its officers, agents, and employees from any claims arising out of the County’s performance under the agreements and for any third-party claims for injuries caused by the County.
• The standard County contracts for the provision of goods and services do not impose a contractual indemnification obligation on the County.
• Potential Impact: The County will be required, at the County’s cost, to defend and indemnify the State for claims caused by the County’s performance under the agreements and for any third-party claims for injuries caused by the County.
2. The State has the ability to audit the County’s records for a period of up to three years after the termination/expiration of the agreements to ensure that the grant funds are spent in accordance with the terms of the grant program and agreements.
• The standard County contracts for the provision of goods and services do not include the ability of a contractor to audit the County’s records.
• Potential Impact: In the event that any State audit determines that the County utilized grants funds for a prohibited purpose, the County will be considered in breach of the agreements, and may be required to return any funds spent by the County back to the State.
Notwithstanding the non-standard provisions, ARMC recommends that the Board approve the Grant Agreements for awarded funding to support residency programs and provide quality primary care services to County residents.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Supervising Deputy County Counsel, 387-5455) on April 30, 2024; Risk Management (Loretta Acuña, Staff Analyst II, 386-9039) on June 11, 2024; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on May 31, 2024; Finance (Jenny Yang, Administrative Analyst, 387-4884) on June 4, 2024; and County Finance and Administration (Valerie Clay, Deputy Executive Officer, 387-5423) on June 5 2024.