REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
January 14, 2025
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Agreement with CEP America-California dba Vituity for the Provision of Substance Abuse Services
End
RECOMMENDATION(S)
Recommendation
Approve Agreement, including non-standard terms, with CEP America-California dba Vituity, for the provision of a principal investigator, co-investigator, and an emergency department-based substance abuse navigator for work on the National Institute of Health-funded study titled, “Reducing Overdose and Suicide Risk in Individuals with Opioid Use Disorder and Co-occurring Disorders,” in an amount not to exceed $100,968, with a performance period of January 14, 2025 through March 31, 2028.
(Presenter: Andrew Goldfrach, ARMC Chief Executive Officer, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
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). Arrowhead Regional Medical Center (ARMC) is anticipated to receive up to $111,065 from the National Institutes of Health (NIH) through the RAND Corporation (RAND) for ARMC’s work on the study titled, “Reducing Overdose and Suicide Risk in Individuals with Opioid Use Disorder and Co-occurring Disorders” (Study). Partial funds, up to the amount of $100,968, will be used to support the Agreement with CEP America-California dba Vituity (CEP). The remaining balance of the funds will be used for administrative costs. Adequate appropriation and revenue have been included in the Arrowhead Regional Medical Center (ARMC) 2024-25 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
On February 27, 2024 (Item No. 19), the Board of Supervisors (Board) approved Revenue Subaward Agreement No. 24-158 with RAND that enables ARMC to receive up to $111,065 for participating in the Study from February 27, 2024 through March 31, 2028. The Study seeks to develop best practices for substance abuse services to opioid use disorder patients to improve effectiveness of treatment services and reduce overdose and suicide ideation among patients.
Participation in the Study requires ARMC to have a principal investigator, co-investigator, and an emergency department-based substance abuse navigators to provide services to patients with substance abuse. This Agreement with CEP will allow ARMC to comply with the requirements of the Study by obtaining staffing.
ARMC has had a very successful Substance Use Navigator program in place through the emergency department for the past five years. ARMC has received State of California funding in prior years to help facilitate this program, and the success rate is one of the highest in the State. In March of 2021, RAND approached ARMC to discuss the possibility of having ARMC be a participating Study site in a grant application that RAND was applying for with the NIH to study the integration of mental health counseling with substance use navigator programs. In 2023, RAND was awarded the grant by the NIH.
The Agreement with CEP was negotiated by the parties with the following terms that differ from the standard County contract:
1. CEP limits its indemnity obligations to claims that arise due to the negligent, reckless or willful acts, errors, or omissions of CEP or any person engaged by CEP to perform the services.
• The County standard contract general indemnity provision requires the contractor to indemnify, defend, and hold County harmless from third party claims arising out of the acts, errors or omissions of any person.
• Potential Impact: CEP's indemnity obligation is more limited compared to the standard County general indemnity obligation. In the event a claim arises that falls outside the scope of the CEP's limited indemnity obligation, the County could be financially responsible for the defense of the claim and any resulting judgment/settlement.
2. The Agreement does not require CEP to maintain abuse and molestation insurance.
• County policy requires contractors to carry appropriate insurance at limits and under conditions determined by the County's Risk Management Department and as set forth in County policy and in the County standard contract.
• Potential Impact: The County has no assurance that in the event of a claim based on abuse or molestation, CEP will be financially responsible for such claims, which could result in expenses to the County.
ARMC recommends approval of the Agreement, including the non-standard terms, with CEP to provide for the safety, health and social service needs of county residents by implementing expanded substance abuse services to opioid use disorder patients and improving treatment for patients with suicide ideation.
PROCUREMENT
Government Code Section 31000 provides the Board with the authority to contract with and employ persons for the furnishing of special service, which include professional medical services.
The Purchasing Department recognizes the specialized credentials of CEP to provide Substance Abuse services and supports the non-competitive procurement of these services.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Supervising Deputy County Counsel, 387-5455) on January 3, 2024; Purchasing (Veronica Pedace, Buyer III, 387-2464) on December 16, 2024; Risk Management (Gregory Ustaszewski, 386-9008) on December 16, 2024; ARMC Finance (Chen Wu, Budget and Finance Officer, 580-3165) on December 17, 2024; Finance (Jenny Yang, Administrative Analyst, 387-4884) on December 18, 2024; and County Finance and Administration (Valerie Clay, Deputy Executive Officer, 387-5423) on December 18, 2024.