REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 10, 2025
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Grant Agreements with California Department of Health Care Access and Information to Support Arrowhead Regional Medical Center’s Family Medicine and Internal Medicine Residency Programs
End
RECOMMENDATION(S)
Recommendation
1. Approve Grant Agreement, including non-standard terms, with the California Department of Health Care Access and Information for the Song-Brown Primary Care Residencies Grant to support the training of internal medicine residents, in the amount of $625,000, for the period of July 1, 2025 through August 31, 2028.
2. Approve Grant Agreement, including non-standard terms, with the California Department of Health Care Access and Information for the Song-Brown Primary Care Residencies Grant to support the training of family medicine residents, in the amount of $625,000, for the period of July 1, 2025 through August 31, 2028.
3. Authorize the ARMC Chief Executive Officer to electronically execute and submit the Grant Agreements referenced in Recommendation Nos. 1 and 2, including all required supporting materials, as well as non-substantive amendments necessary, on behalf of the County, subject to review by County Counsel.
4. Direct the ARMC Chief Executive Officer to transmit the executed Song-Brown Primary Care Residencies Grant Agreements referenced in Recommendation Nos. 1 and 2, and any subsequent non-substantive amendments, to the Clerk of the Board of Supervisors within 30 days of execution by all parties.
(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). The Grant Agreements through the Song-Brown Primary Care Residency grant program will result in up to $1,250,000 in revenue to Arrowhead Regional Medical Center (ARMC). The grant award does not require matching funds. Budget adjustments are not requested at this time but will be included in a future countywide budget report presented to the Board of Supervisors (Board) for approval, if necessary.
BACKGROUND INFORMATION
On September 10, 2024 (Item No. 13) the Board approved and authorized the submission of a grant application to the Department of Health Care Access and Information (Department) for the Song-Brown Primary Care Residencies Grant Program (Program) in the amount of $1,250,000 to fund residency positions in family medicine and internal medicine at ARMC.
In April 2025, ARMC was notified by the Department that it was being awarded grant funds from the Program in the amount of $1,250,000. The proposed funding will help provide offsets to resident salaries, faculty development, resident conference travel, and other direct educational costs for operating the residency training programs. The training programs enable resident physicians to provide primary care services in medically under-served communities in the county.
In order for the County to accept the grant funds through the Program, the Department requires the parties to enter into two separate Grant Agreements, which are non-negotiable, and include the following non-standard contract provisions:
1. The County must indemnify, defend and hold harmless the State, its officers, agents, and employees from any claims arising out of the County’s performance under the agreements for any third-party claims for injuries caused by the County.
• The standard County contracts for the provision of goods and services do not impose a contractual indemnification obligation on the County.
• Potential Impact: The County will be required, at the County’s cost, to defend and indemnify the State for claims caused by the County’s performance under the agreements and for any third-party claims for injuries caused by the County.
2. The State has the ability to audit the County’s records for a period of up to three years after the termination/expiration of the agreements to ensure that the grant funds are spent in accordance with the terms of the grant program and agreements.
• The standard County contracts for the provision of goods and services do not include the ability of a contractor to audit the County’s records.
• Potential impact: In the event that any State audit determines that the County utilized grants funds for a prohibited purpose, the County will be considered in breach of the agreements and may be required to return any funds spent by the County back to the State.
ARMC recommends approval of the Grant Agreements, including the non-standard provisions, to support the family medicine and internal medicine residency programs and provide quality primary care services to 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 May 2, 2025; Risk Management (Stephanie Mead, Staff Analyst II, 386-9044) on May 13, 2025; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on May 16, 2025; Finance (Jenny Yang, Administrative Analyst, 387-4884) on May 20, 2025; and County Finance and Administration (Valerie Clay, Deputy Executive Officer, 387-5423) on May 20, 2025.