REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
December 16, 2025
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Amendment to Professional Service Agreement with Arrowhead Neurosurgical Medical Group, Inc. to Expand Neurointensivist Coverage
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 1 to Agreement No. 23-1321 with Arrowhead Neurosurgical Medical Group, Inc., to expand Neurointensivist coverage, increasing the contract amount by $228,396, from $14,212,128 plus variable costs to $14,440,524 plus variable costs, with no change to the contract term of January 1, 2024 through December 31, 2026.
2. Direct the Clerk of the Board of Supervisors to maintain the confidentiality of Amendment No. 1 to Agreement No. 23-1321, 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 will not result in the use of Discretionary General Funding (Net County Cost). The cost of $228,396 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) 2025-26 budget and will be included in the 2026-27 recommended budget.
BACKGROUND INFORMATION
Amendment No. 1 (Amendment) to Agreement No. 23-1321 (Agreement) allows ARMC to enhance patient access to specialized neurocritical care by expanding provider coverage for Neurointensivist services to meet increasing patient demand. This expansion is necessary due to a sustained increase in the volume and acuity of patients requiring advanced neurological intervention, including stroke, traumatic brain injury, and complex post-operative neurosurgical care. Additional Neurointensivist coverage will support timely evaluations, continuous bedside management, and improved patient outcomes while ensuring ARMC meets current standards of neurocritical care.
On December 19, 2023 (Item No. 21) the Board of Supervisors approved the Agreement with Arrowhead Neurosurgical Medical Group, Inc. (ANMG) to provide neurosurgical and neurocritical care services in the amount of $14,212,128 plus variables, for the contract period of January 1, 2024 through December 31, 2026.
ARMC recommends approval of this Amendment to support timely neurological assessments, interventions, and continuity of care for patients requiring complex neurosurgical and neurocritical management, thereby improving patient outcomes and care efficiency.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Supervising Deputy County Counsel, 387-5455) on November 5, 2025; ARMC Finance (Chen Wu, Finance Budget Officer, 580-3165) on November 20, 2025; and County Finance and Administration (Jenny Yang, Administrative Analyst, 387-4884) on November 24, 2025.