REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 25, 2024
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Purchase of Three Mobile Health Clinics from M3 Group Inc., dba Mission Mobile Medical Group
End
RECOMMENDATION(S)
Recommendation
1. Approve Agreement with M3 Group Inc., dba Mission Mobile Medical Group, including non-standard terms, for the one-time purchase of three mobile health clinics, in the amount of $1,299,000, to provide healthcare services to San Bernardino County residents, as well as support to the community.
2. Approve a fixed asset substitution to amend the Department of Public Health’s 2023-24 fixed asset budget to accommodate the purchase of three mobile health clinics, requiring payment of approximately $433,000 each, plus $151,000 for state taxes and registration, in lieu of the previously budgeted two mobile health clinics at a cost of approximately $475,000 each.
3. Authorize the Auditor-Controller/Treasurer/Tax Collector to post the necessary budget adjustment of $500,000 to the Department of Public Health’s 2023-24 budget, as detailed in the Financial Impact section (Four votes required).
(Presenter: Joshua Dugas, Director, 387-9146)
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). The Department of Public Health (DPH) included $950,000 in the 2023-24 budget to fund the purchase of two mobile health clinics. As DPH has received a State funding allocation, a total of three mobile health clinics will be purchased to provide health and dental services. A budget adjustment is requested to add funds for the purchase of the third mobile health clinic to the 2023-24 DPH budget, as detailed below.
|
Fund Center |
Commitment Item/ GL Account |
Description |
Action |
Amount |
|
9300001000 |
54504050 |
Vehicles |
Increase |
$500,000 |
|
9300001000 |
40408840 |
State Other |
Increase |
$500,000 |
In addition to the cost to build the mobile health clinics, DPH will incur operational costs including computer hardware and software, medical equipment, medications, and consumables (i.e., gloves, gowns, sutures, syringes, etc.). Budget adjustments for operational costs are not requested at this time but may be included in the 2024-25 mid-year budget report presented to the Board of Supervisors (Board) for approval, if necessary.
BACKGROUND INFORMATION
The implementation of mobile health clinics will allow DPH to expand the provision of onsite medical and dental services to San Bernardino County (County) residents, as well as provide services such as medical and dental screenings within the community. The mobile health clinics can be deployed in multiple locations throughout the county to offer healthcare services and expand DPH’s community outreach efforts. It is envisioned that the mobile health clinics will be deployed to assist in areas lacking medical and dental facilities. The mobile health clinics will be equipped with, but not limited to, exam rooms, dental operatories, medical and non-medical lighting, electricity, and plumbing. Recruitment for state licensed physicians and dentists to provide mobile health clinic services is currently being conducted by DPH in collaboration with the County Human Resources Department.
Through negotiation between M3 Group Inc., dba Mission Mobile Medical Group (Mission) the parties agreed to certain standard contract terms. However, Mission would not agree to all County standard terms. The non-standard and missing terms include the following:
1. The Agreement is silent on governing law.
• The County standard contract requires California governing law.
• Potential Impact: Having no specified governing law in the Agreement results in uncertainty over which state’s laws will govern the interpretation of the Agreement, and leads to ambiguity in interpretation of the Agreement terms. Any questions, issues or claims arising under this Agreement could require the County to hire outside counsel competent to advise on the applicable state law, which may result in fees that exceed the total Agreement amount.
2. The County is required to indemnify.
• The County standard contract does not include any indemnification or defense by the County of a contractor.
• Potential Impact: By agreeing to indemnify Mission, the County could be contractually waiving the protection of sovereign immunity. Claims that may otherwise be barred against the County, time limited, or expense limited could be brought against Misson without such limitations and the County could be responsible to defend and reimburse Mission for costs, expenses, and damages, which could exceed the total Agreement amount.
DPH recommends approval of the Agreement with Mission, including the non-standard terms. The purchase of the mobile health clinics will provide for the overall health of County residents by being able to be deployed in multiple locations throughout the County to assist in areas lacking medical and dental clinics.
Approval of the agreement with M3 Group Inc., dba Mission Mobile Medical Group (Mission), including non-standard terms, will allow for the purchase of these mobile health clinics and will provide for the overall health of communities by offering additional health services s throughout the county. The requested adjustment to the DPH 2023-24 budget will allow for payment of three mobile health clinics, rather than two, as initially budgeted, supporting an increased level of health services.
DPH had initially included the cost of two mobile health clinics in the 2023-24 budget. However, additional funding was provided by a State allocation allowing DPH to purchase three mobile health clinics, with one unit dedicated to the provision of services within the communities of Havasu Landing and Needles. The other two mobile health clinics will provide services throughout the county, including additional support for the Havasu Landing and Needles area on a rotational basis.
PROCUREMENT
On May 1, 2024, DPH released Invitation to Bid (ITB) No. DPHE24-CO-5354 via the County’s electronic procurement system (ePro) to solicit vendors to build three mobile health clinics. The ITB process resulted in receipt of bids from Mission, Tesco Specialty Vehicles LLC, and Truck Builders LLC - DBA Chef Units, by the established deadline. Upon initial review, the three bids met the minimum requirements and continued through the evaluation process.
The evaluation committee, comprised of three representatives from DPH, reviewed and evaluated bids based on pricing schedule, certification, vehicle specifications, and organizational experience. Based on the evaluation criteria, the committee determined the bid provided by Mission best met the predetermined specifications listed in the ITB and needs of DPH. DPH recommends award of an agreement with Mission for the purchase of three mobile health clinics, which are expected to be completed and delivered within one year. Following notification to vendors regarding intent to award, no protests were received.
County Policy 11-04 requires Board approval for fixed asset substitutions with a $10,000 unit value or more.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Adam Ebright, Deputy County Counsel, 387- 5455) on May 31, 2024; Purchasing (Ariel Gill, Supervising Buyer, 387-2065) on June 3, 2024; Finance (Carl Lofton, Administrative Analyst, 387-5404) on June 6, 2024; and County Finance and Administration (Robert Saldana, Deputy Executive Officer, 387-5423) on June 6, 2024.