REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
April 21, 2026
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical
Center
SHANNON D. DICUS, Sheriff/Coroner/Public Administrator
SUBJECT
Title
2025-26 Budget Adjustments for Increased Pharmaceutical Expenses
End
RECOMMENDATION(S)
Recommendation
Authorize the Auditor-Controller/Treasurer/Tax Collector to post the necessary budget adjustments, as detailed in the Financial Impact section, to the Sheriff/Coroner/Public Administrator and Arrowhead Regional Medical Center's 2025-26 budget to fund increased costs in pharmaceuticals (Four votes required).
(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 result in the use of additional Discretionary General Funding (Net County Cost). The recommended budget adjustments, as reflected in the table below, are needed to provide Arrowhead Regional Medical Center (ARMC) with sufficient appropriation authority in 2025-26 to fund increased costs for pharmaceuticals. These costs will be funded by reimbursement from the Sheriff/Coroner/Public Administrator’s Department (Sheriff), which includes $500,000 from the Opioid Settlement Funding, $400,000 one-time in Net County Cost, and $200,000 funded by the Sheriff’s 2025-26 existing budget allocation.
|
SAP Fund Center |
Commitment Item/GL |
Description |
Action |
Amount* |
|
9177104200 |
52003800 |
Pharmaceuticals |
Increase |
$1,100,000 |
|
9110004200 |
55415013 |
Services And Supplies Transfers In |
Increase |
$1,100,000 |
|
4420001000 |
55405012 |
Services And Supplies Transfers Out |
Increase |
$400,000 |
|
1280001000 |
56006000 |
APPR Contingencies (For Budget) |
Decrease |
$400,000 |
*Requested budget adjustment amount of $500,000 has been incorporated into the 2025-26 Opioid Settlement Funding Expenditure Plan revision, in a related item.
BACKGROUND INFORMATION
California Code of Regulations, title 15, section 1200 et seq. identifies the responsibilities of the Sheriff to provide medical and mental health care services for correctional patients. The Medication Assisted Treatment (MAT) program, overseen by the Sheriff, is critical for compliance with legal mandates, improving health and outcomes, and enhancing public safety by reducing recidivism related to opioid use disorder.
Approval of the recommendation will allow ARMC to fund increased costs in pharmaceuticals of $1.1 million primarily associated with the Sheriff’s Medication Assisted Treatment (MAT) program and increased patient census. These costs are partially offset by funding from the Sheriff/Coroner/Public Administrator’s Department, including $500,000 from Opioid Settlement Funding and $200,000 from the Sheriff’s existing budget. The Sheriff does not have sufficient appropriation to fully cover the total pharmaceutical cost increase, due to lack of funding, resulting in a remaining $400,000 funding gap. This gap is funded by one-time Discretionary General Funding (Net County Cost) to ensure continuity of critical medical services and compliance with mandated care requirements.
Approval of this item will allow ARMC and the Sheriff to make the necessary appropriation adjustments to operate in a fiscally responsible and business-like manner and continue to provide for the health and safety of county residents, as it will help continue critical services.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Supervising Deputy County Counsel, 387-5455) on April 1, 2026; Sheriff/Coroner/Public Administrator (Carolina Mendoza, Chief Deputy Director, 387-0640) on April 2, 2026; Auditor-Controller/Treasurer/Tax Collector (Charlene Huang, General Accounting Manager, 382-7022) on April 2, 2026; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on March 17, 2026; and County Finance and Administration (Erika Rodarte, Administrative Analyst, 387-4919 and Jenny Yang, Administrative Analyst, 387-4884) on April 6, 2026.