REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
September 24, 2024
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Amendments to the Professional Service Agreements with CEP America - California for Emergency and Family Medicine Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 1 to Professional Services Agreement No. 24-305, with CEP America - California for family medicine services at Arrowhead Regional Medical Center and affiliated Family Health Centers, to add administrative support staff and an additional Advanced Practice Provider, increasing the total contract amount by $1,319,556 from $50,974,700 plus variable amounts to $52,294,256 plus variable amounts, with no change to the contract term of May 1, 2024 through June 30, 2027.
2. Approve Amendment No. 2 to Professional Services Agreement No. 23-1325 with CEP America - California for emergency services, adding service to non-covered inmates for emergency medical treatment and one position for physician and leadership support at the Department of Behavioral Health, with no change to the total contract amount of $70,850,549 plus variable amounts and no change to the contract term of January 1, 2024, through December 31, 2026.
3. Direct the Clerk of the Board of Supervisors to maintain the confidentiality of the Amendments in Recommendation Nos. 1 and 2, pursuant to Health and Safety Code Section 1457(c)(1).
(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 may result in the future use of Discretionary General Funding (Net County Cost). The costs associated with Recommendation Nos. 1 and 2 will be 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 Arrowhead Regional Medical Center (ARMC), Sheriff/Coroner/Public Administrator (Sheriff), and Department of Behavioral Health (DBH) 2024-25 budgets and will be included in future recommended budgets. Currently, ARMC funds the physician cost of emergency medical treatment for non-covered inmates; however, should this responsibility transfer to the Sheriff, additional funding will be required.
BACKGROUND INFORMATION
Approval of Amendment No. 1 to Agreement No. 24-305 (Amendment No. 1) will enable CEP America - California (CEP) to provide up to two administrative support staff to assist with daily operational and administrative tasks. These staff members will increase the efficiency of CEP, ensuring the best quality of care to patients. The duties of the administrative support staff include, but are not limited to, scheduling appointments, billing, compiling and recording medical charts, producing reports, etc. The administrative support staff will perform their duties at ARMC, Sheriff, and DBH, as needed. Amendment No. 1 will also enable CEP to provide one additional Advanced Practice Provider - a nurse practitioner or a physician assistant - to aid in direct patient care, which can also include mobile medicine and home health services.
Approval of Amendment No. 2 to Agreement No. 23-1325 (Amendment No. 2) will enable CEP to treat and be reimbursed for treating uninsured inmates in the Sheriff’s detention facilities who require emergency medical services. Amendment No. 2 will also enable CEP to provide one position in physician and leadership support for DBH for the continued improvement, delivery, and management of healthcare services.
On December 19, 2023 (Item No. 21), as the result of a non-competitive procurement, the Board approved Agreement No. 23-1325 with CEP for emergency medical services and limited family medicine and street medicine services at ARMC and its Family Health Centers, Sheriff’s Detention Facilities, Probation Department, DBH, and San Bernardino County Fire Protection District, in the annual amount of $22,181,304, for a total amount of $66,543,912, plus variable amounts, for the period of January 1, 2024 through December 31, 2026.
On April 9, 2024 (Item No. 13), the Board approved Amendment No. 1 to Professional Services Agreement No. 23-1325 with CEP, removing all family medicine and street medicine services, increasing the number of psychiatrists and primary care physicians for DBH, and increasing the total contract by $4,306,637 from $66,543,912 plus variable amounts to $70,850,549 plus variable amounts, with no change to the contract term of January 1, 2024 through December 31, 2026.
On April 9, 2024 (Item No. 13), as the result of a non-competitive procurement, the Board approved Professional Services Agreement No. 24-305, with CEP for family medicine services at ARMC and its Family Health Centers, in the amount of $50,974,700 plus variable amounts, for the period of May 1, 2024, through June 30, 2027
The Agreements with CEP have fixed and variable costs. The variable costs are dependent on patient and student training volumes.
Pursuant to Health & Safety Code section 1457(c)(1), the records of a hospital or other county medical facility which reveal the rates of payment for health care services are not considered public records subject to disclosure under the California Public Records Act or any other law requiring the disclosure of records for a period of three years following execution of a related contract establishing rates of payment.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Supervising Deputy County Counsel, 387-5455) on September 6, 2024; Behavioral Health (Georgina Yoshioka, Director, 252-5142) on September 6, 2024; Sheriff/Coroner/Public Administrator (Kelly Welty, Chief Deputy Director, 387-3760) on September 8, 2024; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on August 29, 2024; Finance (Administrative Analysts Jenny Yang, 387-4884; Erika Rodarte, 387-4919; and Paul Garcia, 386-8392) on September 9, 2024; and County Finance and Administration (Valerie Clay, Deputy Executive Officer, 387-5423) on September 9, 2024.