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File #: 12086   
Type: Consent Status: Passed
File created: 4/29/2025 Department: Arrowhead Regional Medical Center
On agenda: 5/6/2025 Final action: 5/6/2025
Subject: 2024-25 Budget Adjustments for Increased Hospital Expenses
Attachments: 1. Item #11 Executed BAI

 REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS

OF SAN BERNARDINO COUNTY

AND RECORD OF ACTION

 

                                          May 6, 2025

 

FROM

ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center 

SHANNON D. DICUS, Sheriff/Coroner/Public Administrator

MATTHEW ERICKSON, County Chief Financial Officer

        

SUBJECT                      

Title                     

2024-25 Budget Adjustments for Increased Hospital Expenses

End

 

 

RECOMMENDATION(S)

Recommendation

1.                     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 2024-25 budget to fund increased costs in staffing, pharmaceuticals, physician costs, and medical supplies (Four votes required).

2.                     Approve Medication-Assisted Treatment Services Initiative related to the Opioid Settlement Expenditure Plan.

3.                     Approve the addition of the Medication-Assisted Treatment Services Initiative to the County Opioid Settlement Funding Expenditure Plan, increasing the amount by $1,000,000 from $22,249,532 to a total amount of $23,249,532, to address the opioid epidemic within the County.

(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 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 2024-25 to fund increased costs for staffing, computer software, pharmaceuticals, and other medical supplies. These costs will be funded by fixed asset savings from unpurchased fixed asset in the budget, additional supplemental revenue from Quality Improvement Program (QIP), Assembly Bill 85 (AB85) Rate Range, Interest Revenue and Reimbursement from the Sheriff/Coroner/Public Administrator’s Department (Sheriff), which includes $1,000,000 from the Opioid Settlement Funding. 

 

SAP Fund Center

Commitment Item/GL

Description

Action

Amount

9110004200

51001010

Regular Salary

Increase

$16,350,000

9184804200

52002115

Computer Software Expense

Increase

$6,000,000

9177104200

52003800

Pharmaceuticals

Increase

 $5,000,000

9174214200

52004100

Other Medical Supplies

Increase

 $5,400,000

9186104200

54404040

Equipment

Decrease

$6,000,000

9177104200

55415013

Services And Supplies Transfers In

Increase

$1,400,000

9110004200

40308500

Interest

Increase

$12,000,000

9110004200

40449625

ARMC - Managed Care LGT

Increase

$10,000,000

9110004200

40449685

ARMC - AB85 Rate Range Revenue

Increase

$3,350,000

4420001000

55405012

Services And Supplies Transfers Out

Increase

$1,000,000

4420001000

55415013

Services And Supplies Transfers In

Increase

$1,000,000

 

BACKGROUND INFORMATION

Approval of the recommendation will allow ARMC to fund increased costs in staffing, computer software, pharmaceuticals, and other medical supplies. Staffing costs increased primarily due to Memorandum of Understanding (MOU) increases and State Bill 525 (SB525) Healthcare minimum wage increases. Pharmaceutical costs increased due to an unexpected increase in census and medical supply costs increases, primarily due to inflation. The increase in pharmaceutical costs will be partially offset by the Sheriff. 

 

The Sheriff operates a Detention and Corrections Bureau with more than 58,000 annual bookings and an average daily population of 4,912 inmates housed.  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.  The requested $1,000,000 increase, reimbursed by the Opioid Settlement Fund, will allow the Sheriff to fund the cost for opioid medication for incarcerated individuals. 

 

The increased costs will be funded by additional supplemental revenue from the Quality Improvement Program (QIP), AB85 Rate Range and Interest Revenue. In addition, the adjustments include an increase in computer software with an offsetting decrease in equipment to correct the budgetary category.

 

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 3, 2025; Sheriff/Coroner/Public Administrator (Carolina Mendoza, Chief Deputy Director, 387-0640) on April 21, 2025; Auditor-Controller/Treasurer/Tax Collector (Mima Ugbo, Deputy Chief Controller, 382-3035) on April 11, 2025; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on April 9, 2025; Finance (Erika Rodarte, Administrative Analyst, 387-4919 and Jenny Yang, Administrative Analyst, 387-4884) on April 22, 2025; and County Finance and Administration (Valerie Clay, Deputy Executive Officer 387-5423) on April 22, 2025.