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
Appropriation Adjustments to Contract with AtriCure, LLC for the Purchase of Specialized Disposal Arterial Fibrillation Products
End
RECOMMENDATION(S)
Recommendation
Approve an increase in funding allocation to Contract No. 24-918 with AtriCure, LLC, in the amount of $1,000,000, to purchase proprietary specialized disposable arterial fibrillation products used during open heart surgery, increasing the total contract amount from the not-to-exceed amount of $50,000 to the not-to-exceed amount of $1,050,000, with no change to the contract term of September 24, 2024 through September 23, 2026.
(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). The cost of $1,050,000 is funded by State Medi-Cal, Federal Medicare, private insurances, and other departmental revenue. Funding sources may change in the future pending any legislative activity related to the repeal and/or replacement of the Affordable Care Act. 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
The increase in funding allocation will allow ARMC to continue to purchase specialized disposable atrial fibrillation products from AtriCure, LLC (AtriCure) to meet the quantities that ARMC estimates it will need as a result of an increase in patient procedures. The specific products used in a single procedure will vary from one patient to another based the patients’ severity of diagnosis and comorbidities. Each potential product that may be used has its own pricing.
On September 24, 2024 (Item No. 14), as the result of a non-competitive procurement, the Board of Supervisors (Board) approved Contract No. 24-918 with AtriCure for the purchase of proprietary specialized disposal arterial fibrillation products used during open heart surgery, in the not-to-exceed amount of $50,000 for the period of September 24, 2024 through September 23, 2026. However, the terms of the contract did not include a dollar limit on the purchases; instead, the contract includes a price list only. The not-to-exceed amount of $50,000, was an internal County limit specified on the item and coversheet. As such, this item is now being presented to the Board to authorize an increase in the funding allocation to Contract No. 24-918 to enable ARMC to purchase the quantities needed to meet actual patient demands.
ARMC has a new cardiovascular surgical team, leading to a 400 percent increase of cardiovascular operations to meet the growing demand. The new surgical team is performing approximately five surgeries per week, up from approximately three surgeries per month. Ensuring critical cardiac patients receive comprehensive care within ARMC, attributes to meeting the Trauma I accreditation, as well as not delaying care with the need to transfer, or refer, patients to other facilities.
The specialized disposable atrial fibrillation products are the only approved disposable products that can be used with AtriCure’s equipment for the Open-Heart Surgery Program, which was launched in April 2022. A few examples of the proprietary disposable arterial fibrillation products are the Isolator Long Synergy Clamp, the AtriClip Flex Device, and the AtriClip PRO2 Device, which all aid in performing open heart surgery. At the initial launch, many of the products were purchased in bulk for cost savings. As the program enters its third year, ARMC has established minimum inventory thresholds.
ARMC recommends approval of the increases in funding allocation as it will enable the hospital to provide for the safety, health and social services needs of county residents.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Supervising Deputy County Counsel, 387-5455) on December 10, 2024; Purchasing (Veronica Pedace, Buyer III, 387-2464) on January 2, 2025; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on December 17, 2024; Finance (Jenny Yang, Administrative Analyst, 387-4884) on December 19, 2024; and County Finance and Administration (Valerie Clay, Deputy Executive Officer, 387-5423) on December 19, 2024.