REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
September 23, 2025
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Non-Financial Memorandum of Understanding with Local Hospitals for Continuity of Care of Federally Qualified Health Center Patients
End
RECOMMENDATION(S)
Recommendation
1. Approve non-financial Memoranda of Understanding, for the continuity of care of Federally Qualified Health Center patients, for the period of November 1, 2025 through October 31, 2030 with the following hospitals:
a. Desert Valley Hospital, LLC
b. Pomona Valley Hospital Medical Center
c. San Antonio Regional Hospital
d. St. Mary Medical Center
2. Approve Amendment No. 1 to non-financial Memorandum of Understanding No. 25-92 with Montclair Hospital Medical Center for the continuity of care of Federally Qualified Health Center patients, removing the billing arrangements provision, with no change to the term of February 15, 2025 through February 14, 2030.
(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.
Pursue County Goals and Objectives by Working with Other Agencies and Stakeholders.
FINANCIAL IMPACT
The Memoranda of Understanding (MOUs) are non-financial in nature and will not result in the use of Discretionary General Funding (Net County Cost).
BACKGROUND INFORMATION
The Department of Public Health (DPH) currently operates four Federally Qualified Health Centers (FQHCs) located in the cities of Adelanto, Hesperia, Ontario, and San Bernardino. The FQHCs are required to follow the United States Department of Health and Human Services, Health Resources and Services Administration (HRSA) regulations. These regulations require agreements with local hospitals to establish procedures for referrals, hospitalization, and emergency department visits, including medical emergencies, discharge planning, and patient tracking for FQHC patients receiving treatment at such hospitals.
Recommendation No. 1 will create MOUs with the listed four local hospitals to establish procedures and information exchange required by HRSA for the department’s FQHC patients receiving direct care or being admitted to their hospital. DPH has collaborated with these local hospitals to serve FQHC clients for the past eight years.
On February 11, 2025 (Item No. 32), the Board of Supervisors approved non-financial MOU No. 25-92 with Montclair Hospital Medical Center for the continuity of care of FQHC patients, for a five-year period, effective February 15, 2025 through February 14, 2030.
Recommendation No. 2 will approve Amendment No. 1 to MOU No. 25-92, which removes the billing arrangements provision, ensuring the MOU aligns with current operations and complies with federal requirements related to patient billing and Federal Poverty Guidelines.
Approval of the MOUs in Recommendation No. 1, and Amendment No. 1 to MOU No. 25-92 in Recommendation No. 2, will allow the department to meet federal requirements and enable DPH to continue this partnership for the next five years until 2030. Each of the MOUs contain a provision that either party may terminate with or without cause by providing 30 days’ written notice.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Daniel Pasek, Deputy County Counsel, 387-5455) on August 25, 2025; Risk Management (Stephanie Pacheco, Staff Analyst, 386-9039) on August 27, 2025; and County Finance and Administration (Iliana Rodriguez, Administrative Analyst, 387-4205) on September 3, 2025.