REPORT/RECOMMENDATION TO THE BOARD OF DIRECTORS
OF INLAND COUNTIES EMERGENCY MEDICAL AGENCY
AND RECORD OF ACTION
REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 10, 2025
FROM
DANIEL MUÑOZ, Interim EMS Administrator, Inland Counties Emergency Medical Agency ANDREW GOLDFRACH, Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Contract Amendments with Local Hospitals for Stroke Receiving Center Designation
End
RECOMMENDATION(S)
Recommendation
1. Acting as the governing body of the Inland Counties Emergency Medical Agency, approve revenue contract amendments with each of the hospitals listed below, extending the term an additional four years, from July 1, 2025, through June 30, 2029, in which Inland Counties Emergency Medical Agency shall continue to receive an annual fee, currently $19,045, from each contract to offset the costs associated with designating these hospitals as Stroke Receiving Centers:
a. Desert Regional Medical Center, Amendment No. 1 to Contract No. 20-533.
b. Kaiser Foundation Hospitals - Fontana, Amendment No. 1 to Contract No. 20-534.
c. Kaiser Foundation Hospitals - Ontario, Amendment No. 1 to Contract No. 20-535.
d. Loma Linda University Medical Center, Amendment No. 1 to Contract No. 20-536.
e. Pomona Valley Hospital Medical Center, Amendment No. 1 to Contract No. 20-537.
f. Redlands Community Hospital, Amendment No. 1 to Contract No. 20-538.
g. San Antonio Regional Hospital, Amendment No. 1 to Contract No. 20-539 .
h. St. Bernardine Medical Center, Amendment No. 1 to Contract No. 20-540 .
i. St. Mary Medical Center LLC., Amendment No. 2 to Contract No. 20-541.
j. Arrowhead Regional Medical Center, Amendment No. 2 to Contract No. 20-547.
k. Hi-Desert Medical Center, Amendment No. 1 to Contract No. 20-1208.
2. Acting as the governing body of San Bernardino County, approve Amendment No 2 to Memorandum of Understanding No 20-547 with the Inland Counties Emergency Medical Agency for Stroke Receiving Center Designation of Arrowhead Regional Medical Center, extending the term an additional four years, from July 1, 2025, through June 30, 2029, in the current annual amount of $19,045.
(Presenter: Daniel Muñoz, Interim EMS Administrator, 388-5807)
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). Arrowhead Regional Medical Center (ARMC) expenditures in the amount of $19,045 are funded by reimbursements from Medi-Cal, Medicare, private insurances, and other departmental revenue.
The current annual fee of $19,045 paid by each hospital will cover the costs incurred by Inland Counties Emergency Medical Agency (ICEMA) related to the evaluation and oversight of the Stroke program. Revenue and appropriation from these contracts will be included in ICEMA’s 2025-26 recommended budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
ICEMA, as the local Emergency Medical Services (EMS) agency, is responsible for ensuring effective EMS for the Counties of San Bernardino, Inyo, and Mono. ICEMA administers State and local codes and regulations governing the provision of emergency medical care to the sick and injured at the scene of an emergency and during transport to an acute care hospital. ICEMA ensures an effective system of quality patient care and coordinated emergency medical response by planning, implementing and evaluating an effective emergency medical services system including pre-hospital providers, specialty care hospitals and hospitals.
Approval of these amendments will allow the hospitals listed above to receive and provide care for stroke patients, as well as allow ICEMA to administer, monitor, evaluate, and provide continuous quality improvements to the implemented Stroke Care System.
On July 1, 2019, the State of California’s Stroke Critical Care System Regulations became effective. To align current Stroke Receiving Center Designation standards with State regulations, ICEMA updated its stroke designation policy to reflect language from the California Code of Regulations, Title 22, Division 9, Chapter 7.2, Stroke Critical Care System. ICEMA has since recognized Stroke Receiving Centers as Acute Ready (ARSC), Primary (PSC), Thrombectomy-Capable (TCSC), and Comprehensive (CSC) Stroke Centers.
Currently, ICEMA designates the following hospitals as Stroke Receiving Centers; Arrowhead Regional Medical Center (ARMC), Hi-Desert Medical Center (HDMC), Desert Regional Medical Center (DRMC), Loma Linda University Medical Center (LLUMC), Pomona Valley Hospital Medical Center (PVHMC), Kaiser Foundation Hospitals - Fontana (KFHF), Kaiser Foundation Hospitals - Ontario (KFHO), San Antonio Regional Hospital (SARH), St. Bernardine Medical Center (SBMC), St. Mary Medical Center LLC (SMMC), Redlands Community Hospital (RCH), and Bear Valley Community Healthcare District (BVCHC). The designations are summarized below:
|
Hospital |
Board Date |
Item No. |
Designation |
Term |
|
DRMC |
June 23, 2020 |
104 |
CSC |
July 1, 2020 - June 30, 2025 |
|
LLUMC |
June 23, 2020 |
104 |
CSC |
July 1, 2020 - June 30, 2025 |
|
PVHMC |
June 23, 2020 |
104 |
CSC |
July 1, 2020 - June 30, 2025 |
|
ARMC |
June 23, 2020 |
118 |
PSC |
July 1, 2020 - June 30, 2025 |
|
KFHF |
June 23, 2020 |
104 |
PSC |
July 1, 2020 - June 30, 2025 |
|
KFHO |
June 23, 2020 |
104 |
PSC |
July 1, 2020 - June 30, 2025 |
|
SARH |
June 23, 2020 |
104 |
PSC |
July 1, 2020 - June 30, 2025 |
|
SBMC |
June 23, 2020 |
104 |
PSC |
July 1, 2020 - June 30, 2025 |
|
SMMC |
June 23, 2020 |
104 |
PSC |
July 1, 2020 - June 30, 2025 |
|
RCH |
June 23, 2020 |
104 |
TCSC |
July 1, 2020 - June 30, 2025 |
|
ARMC * |
November 17, 2020 |
95 |
CSC |
July 1, 2020 - June 30, 2025 |
|
HDMC |
December 8, 2020 |
47 |
ARSC |
December 1, 2021 - June 30, 2025 |
|
SMMC ** |
December 14, 2021 |
65 |
PSC |
July 1, 2020 - June 30, 2025 |
|
BVCHC |
December 3, 2024 |
53 |
ARSC |
December 3, 2024 - June 30, 2029 |
* Amendment to increase designation level.
** Amendment to update the official name of the hospital.
The goal of designating Stroke Receiving Centers is to identify medical facilities that have an organized approach to treatment of stroke patients with qualified staff and appropriate capabilities. EMS field personnel, who are specially trained to identify stroke victims in the pre-hospital setting, can rapidly transport stroke patients directly to designated centers for timely treatment. Data demonstrates that the survival from a stroke is largely dependent upon prompt recognition and transport to facilities demonstrating the ability and commitment to provide rapid care with the proper resources. Current treatment guidelines from the American Stroke Association recommend rapid identification of stroke patients and transport to specialized medical facilities that have an organized approach to the management of stroke patients.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (John Tubbs II, Deputy County Counsel, 387-3203) on April 16, 2025; County Counsel (Charles Phan, Supervising Deputy County Counsel, 387-5455) on April 22, 2025; Risk Management (Gregory Ustaszewski, Staff Analyst II, 386-9008) on April 22, 2025; Finance (Carl Lofton, Administrative Analyst, 387-5404 May 22, 2025; and County Finance and Administration (Robert Saldana, Deputy Executive Officer, 387-5423) on May 23, 2025.