REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
August 20, 2024
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Amendment to Funding Agreement with Children and Families Commission for San Bernardino County for the Breathmobile Program
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 2, retroactively effective as of July 1, 2024, to Funding Agreement No. 20-679 with the Children and Families Commission for San Bernardino County, for the Breathmobile Program services, increasing the revenue amount by $603,217, from $1,635,886 to $2,239,103, and extending the term by one year, for a total contract term of August 25, 2020 through June 30, 2025.
(Presenter: Andrew Goldfrach, ARMC Chief Executive Officer, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
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) as Amendment No. 2 (Amendment) to Funding Agreement No. 20-679 (Agreement) will increase funding to Arrowhead Regional Medical Center (ARMC) in the amount of $603,217, for a total funding amount not to exceed $2,239,103, for certain Breathmobile Program services provided to children ages five and under. Expenses, such as salaries, vehicle maintenance, clinic supplies, and education material, for services provided to children over five years of age are funded by State Medi-Cal, Federal Medicare, private insurance, 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 ARMC 2024-25 budget.
BACKGROUND INFORMATION
ARMC operates a Breathmobile Program, which is a mobile asthma clinic that provides coordinated case identification, structured mobile office visits, diagnostic testing, physical exam, pharmacological therapy, and patient/family education in asthma management. It travels to approximately 40 different school sites throughout the county, and during school hours, the Breathmobile staff sees patients that attend the school site as well as any child referred from the surrounding areas. A complete evaluation, examination, care plan, and extensive patient family education are completed at the time of the visit.
The Breathmobile healthcare model has proven to be very successful in overcoming the complex social and economic barriers that can prevent successful chronic disease management
in children in lower socio-economic areas. To date, the ARMC Breathmobile Program has improved asthma management and provided education to over 10,600 children in the County.
This Amendment with Children and Families Commission for San Bernardino County (CFC) will increase the amount of funding for ARMC’s Breathmobile Program by $603,217 and extend the term of the Agreement by an additional year. The Amendment is being presented to the Board of Supervisors (Board) for approval at the earliest available meeting after receiving approval by the CFC on June 5, 2024, and the necessary fiscal and legal reviews. The Amendment is required in order for ARMC to invoice for services provided through the Breathmobile Program. Approval of this retroactive item will allow ARMC to continue to provide asthma care management and healthcare education for children through the utilization of the Breathmobile Program in conjunction with CFC.
On August 25, 2020 (Item No. 11), the Board accepted a grant award and approved the Agreement with CFC to support ARMC’s Breathmobile Program, in the amount of $1,086,537, for the period of August 25, 2020 through June 30, 2023.
On August 22, 2023 (Item No. 11), the Board approved Amendment No. 1 to the Agreement with the CFC for Breathmobile Program services, increasing the revenue amount by $549,349, from $1,086,537 to $1,635,886, and extending the term for one year, for a total term of August 25, 2020 through June 30, 2024, retroactively effective as of July 1, 2023.
ARMC recommends approval of the Amendment to ensure the continued management of asthma care and education for these children and families, which will provide for the safety, health and social service needs of county residents, while furthering the goals and objectives of the County by collaborating with other governmental agencies. The Amendment also allows ARMC to operate in a fiscally-responsible and business-like manner by providing funding specific to the operations of the ARMC Breathmobile Program.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Supervising Deputy County Counsel, 387-5455) on July 10, 2024; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on July 29, 2024; Finance (Jenny Yang, Administrative Analyst, 387-4884) on July 30, 2024; and County Finance and Administration (Valerie Clay, Deputy Executive Officer, 387-5423) on August 5, 2024.