REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
January 13, 2026
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Revisions to San Bernardino County Health Center Governing Board Bylaws and Resolution
End
RECOMMENDATION(S)
Recommendation
1. Adopt Resolution to rescind and replace Resolution No. 2025-73, to require ratification of new members by the San Bernardino County Health Center Governing Board, following appointment by the San Bernardino County Board of Supervisors.
2. Approve revised San Bernardino County Health Center Governing Board Bylaws for the Department of Public Health Federally Qualified Health Centers, to require ratification of new members, following appointment by the San Bernardino County Board of Supervisors, to the San Bernardino County Health Center Governing Board.
3. Approve non-financial Co-Applicant Agreement, effective January 13, 2026, between the San Bernardino County Board of Supervisors and the San Bernardino County Health Center Governing Board, delineating the roles and responsibilities for the administration and operation of the Department of Public Health Federally Qualified Health Centers.
(Presenter: Joshua Dugas, Director, 387-9146)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Improve County Government Operations.
Provide for the Safety, Health and Social Service Needs of County Residents.
Pursue County Goals and Objectives by Working with Other Agencies and Stakeholders.
FINANCIAL IMPACT
This item will not result in the use of Discretionary General Funding (Net County Cost). The San Bernardino County Health Center Governing Board (CHCGB) Bylaws and Resolution are requirements of the Public Health Services Act and the United States Department of Health and Human Services, Health Resources and Services Administration’s (HRSA) grant funding for Federally Qualified Health Centers (FQHCs).
BACKGROUND INFORMATION
The San Bernardino County Department of Public Health (DPH) receives annual Health Center Program funding from HRSA for operational support of its four DPH clinics, designated as FQHCs by HRSA, located in Adelanto, Hesperia, Ontario, and San Bernardino. FQHCs provide primary care, pediatric, obstetric, and reproductive health services in underserved and rural communities. For FQHCs operated by public agencies, HRSA requires a community-based governing board that includes representatives of both patients who receive services and members of the broader community. Community representation may include other County departments, healthcare and behavioral health professionals, community-based organizations, and other community-focused leaders.
On August 13, 2025, HRSA issued a finding to DPH during the 2025 audit, requiring an update to the CHCGB Bylaws and Co-Applicant Agreement to ensure the CHCGB has final authority to appoint new members. In order to comply with current County processes following County Policy 02-09, DPH is recommending changes to the Bylaws and Co-Applicant Agreement to require the CHCGB to ratify new members, following appointment by the Board of Supervisors (Board). Approval of Recommendation Nos. 1 and 2 will satisfy this requirement and reconcile the 2025 audit finding. Failure to make this correction may jeopardize DPH’s FQHC designation which will significantly impact Medi-Cal reimbursement rates and other funding.
On November 15, 2011 (Item No. 40), the Board of Supervisors (Board) adopted Resolution No. 2011-220 formally establishing the CHCGB and specifying its purpose and objectives, membership, meetings, limitations of authority, duties, officers, committees, and adoption and amendments.
On April 23, 2013 (Item No. 36), the Board adopted Resolution No. 2013-59 rescinding and replacing Resolution No. 2011-220 modifying the voting members of the CHCGB from nine to at least nine, but no more than 13.
On August 23, 2013 (Item No. 37), the Board approved the CHCGB Bylaws, which were incorporated in and consistent with Resolution No. 2013-59.
On October 8, 2013 (Item No. 32), the Board approved a Co-Applicant Agreement between the CHCGB and the Board delineating the roles and responsibilities of DPH’s FQHCs. The non-financial Co-Application Agreement allows DPH to continue its eligibility to apply for and receive Health Center Program funding to operate the FQHCs from HRSA.
On September 12, 2017 (Item No. 38), the Board adopted Resolution No. 2017-182 rescinding and replacing Resolution No. 2013-59 and revised the Bylaws modifying the upper limit of the number of voting members to no more than 17 and non-consumer member requirements defining them as persons who have expertise in the medical and/or mental health fields or other community members such as those belonging to a Community Based Organization, Faith Based organization, etc. In addition, this action amended the Co-Applicant Agreement.
On April 30, 2019 (Item No. 48), the Board adopted Resolution No. 2019-58 rescinding and replacing Resolution No. 2017-182 and revised the Bylaws updating meeting requirements to ensure a quorum in order to efficiently conduct CHCGB business. In addition, this item approved an updated Co-Applicant Agreement, County Contract No. 19-276, effective April 30, 2019.
On March 29, 2022 (Item No. 42), the Board adopted Resolution No. 2022-53 rescinding and replacing Resolution No. 2019-58 and revised the Bylaws adding language pertaining to member absences, temporary voting privileges, meetings following Robert’s Rules of Order, elections affected by a catastrophic event, and formation of the Credentialing and Privileging Committee.
On April 8, 2025 (Item No. 41), the Board adopted Resolution No. 2025-73 rescinding and replacing Resolution No. 2022-53 and revised the Bylaws pertaining to membership responsibilities for meeting attendance and absences, the availability of meeting agendas and supporting materials before meetings, reporting to the Board annually, modification to the committee composition language to remove temporary voting privileges, and the availability of mentorships.
Upon Board approval, revisions to the Bylaws will be updated requiring ratification of members by the CHCGB following appointment by the Board. The updated Bylaws were recommended for approval by the CHCGB on December 9, 2025.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Adam Ebright, Deputy County Counsel, 387-5455) on November 4, 2025; and Finance (Iliana Rodriguez, Administrative Analyst, 387-4205) on November 26, 2025.