REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
September 26, 2023
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
DON DAY, Director, Project and Facilities Management Department
SUBJECT
Title
Appropriation and Revenue Adjustments to Fund Various Hospital Capital Improvement Program Projects
End
RECOMMENDATION(S)
Recommendation
1. Authorize the reallocation of funds from the Residual Equity Account, in the amount of $21,581,048, to the following:
a. Capital Improvement Program Project No. 17-283 (WBSE 10.10.0266) for the Arrowhead Regional Medical Center Air Conditioning in Sterile Processing Project, in the amount of $2,526,819.
b. Capital Improvement Program Project No. 18-061 (WBSE 10.10.0453) for the Computed Tomography Scanner Project, in the amount of $1,376,425.
c. Capital Improvement Program Project No. 18-066 (WBSE 10.10.0458) for the Arrowhead Regional Medical Center Air Transfer Switch Replacement Project, in the amount of $465,462.
d. Capital Improvement Program Project No. 19-068 (WBSE 10.10.0720) for the Arrowhead Regional Medical Center Variable Frequency Device Replacement Project, in the amount of $300,000.
e. Capital Improvement Program Project No. 20-011 (WBSE 10.10.0847) for the Replacement Deaerator No. 1 Project, in the amount of $600,000.
f. Capital Improvement Program Project No. 21-054 (WBSE 10.10.1061) for the Arrowhead Regional Medical Center Interior Plumb Infrastructure Plan Project, in the amount of $1,010,002.
g. Capital Improvement Program Project No. 22-020 (WBSE 10.10.1207) for the Arrowhead Regional Medical Center Behavioral Health Adolescent Unit Project, in the amount of $14,000,000.
h. Capital Improvement Program Project No. 17-104 (WBSE 10.10.0239) for the Emergency Department Staff Bathroom Remodel Project, in the amount of $500,000.
i. Capital Improvement Program Project No. 18-067 (WBSE 10.10.0459) for the Boiler Motors Uninterrupted Power Source Project, in the amount of $2,340.
j. Capital Improvement Program Project No. 17-112 (WBSE 10.10.0246) for the Magnetic Resonance Imaging Replacement Project, in the amount of $800,000.
2. Authorize the Auditor-Controller/Treasurer/Tax Collector to post the necessary budget adjustments to the Arrowhead Regional Medical Center Capital Improvement Program 2023-24 budget to reallocate funds to several existing projects, as detailed in the Financial Impact section (Four votes required).
(Presenter: William L. Gilbert, Director, 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 recommended budget reallocation, as detailed below, are necessary to provide Arrowhead Regional Medical Center (ARMC) Capital Improvement Program budget with sufficient appropriation authority in 2023-24 for various costs associated with existing Capital Improvement Program (CIP) projects. The budget adjustments include reallocating funds that were previously provided by the County Jail Ward Reserve that is being repurposed for other ARMC projects. Any potential additional costs will be funded by State Medi-Cal, Federal Medicare, private insurances, and other department revenue. Funding sources may change in the future pending any legislative activity related to the repeal and/or replacement of the Affordable Care Act.
|
Funds Center |
Commitment Item |
Description |
Action |
Amount |
WBSE |
|
7700004204 |
40909995 |
Residual Equity Transfers In |
Increase |
$2,526,819 |
10.10.0266 |
|
7700004204 |
40909995 |
Residual Equity Transfers In |
Increase |
$1,376,425 |
10.10.0453 |
|
7700004204 |
40909995 |
Residual Equity Transfers In |
Increase |
$465,462 |
10.10.0458 |
|
7700004204 |
40909995 |
Residual Equity Transfers In |
Increase |
$300,000 |
10.10.0720 |
|
7700004204 |
40909995 |
Residual Equity Transfers In |
Increase |
$600,000 |
10.10.0847 |
|
7700004204 |
40909995 |
Residual Equity Transfers In |
Increase |
$1,010,002 |
10.10.1061 |
|
7700004204 |
40909995 |
Residual Equity Transfers In |
Increase |
$14,000,000 |
10.10.1207 |
|
7700004204 |
40909995 |
Residual Equity Transfers In |
Increase |
$500,000 |
10.10.0239 |
|
7700004204 |
40909995 |
Residual Equity Transfers In |
Increase |
$2,340 |
10.10.0459 |
|
7700004204 |
40909995 |
Residual Equity Transfers In |
Increase |
$800,000 |
10.10.0246 |
|
7700004204 |
54304030 |
Structures and Improvements to Structures |
Increase |
$2,526,819 |
10.10.0266 |
|
7700004204 |
54304030 |
Structures and Improvements to Structures |
Increase |
$1,376,425 |
10.10.0453 |
|
7700004204 |
54304030 |
Structures and Improvements to Structures |
Increase |
$465,462 |
10.10.0458 |
|
7700004204 |
54304030 |
Structures and Improvements to Structures |
Increase |
$300,000 |
10.10.0720 |
|
7700004204 |
54304030 |
Structures and Improvements to Structures |
Increase |
$600,000 |
10.10.0847 |
|
7700004204 |
54304030 |
Structures and Improvements to Structures |
Increase |
$1,010,002 |
10.10.1061 |
|
7700004204 |
54304030 |
Structures and Improvements to Structures |
Increase |
$14,000,000 |
10.10.1207 |
|
7700004204 |
54304030 |
Structures and Improvements to Structures |
Increase |
$500,000 |
10.10.0239 |
|
7700004204 |
54304030 |
Structures and Improvements to Structures |
Increase |
$2,340 |
10.10.0459 |
|
7700004204 |
54304030 |
Structures and Improvements to Structures |
Increase |
$800,000 |
10.10.0246 |
|
7701004204 |
40909999 |
Residual Equity Transfers Out |
Increase |
$21,581,048 |
Not Relevant - Funded Program |
|
7701004204 |
54304030 |
Structures and Improvements to Structures |
Decrease |
$21,581,048 |
Not Relevant - Funded Program |
BACKGROUND INFORMATION
The requested budget adjustment will allow ARMC to reallocate funding from the Residual Equity Account for the capital improvement projects (CIP) listed in the Recommendation No. 1 that have been prioritized as critical to the continued operations of the hospital.
CIP Project No. No. 17-283 is ARMC’s Air Conditioning in Sterile Processing Project to replace the air conditioning equipment in the hospital’s Sterile Processing Department.
The following CIP projects are to replace equipment that is at the end of life and no longer supported: CIP Project No. 18-061 for the Computed Tomography Scanner Project; CIP Project No. 18-066 for the ARMC Air Transfer Switch Replacement Project, CIP Project No. 19-068 for the ARMC Center Variable Frequency Device Replacement Project, CIP Project No. 20-011 for the Replacement Deaerator No. 1 Project, and CIP Project No. 18-067 for the Boiler Motors Uninterrupted Power Source Project.
CIP Project No. 21-054 is for ARMC’s Interior Plumb Infrastructure Plan Project to replace interior plumbing at the hospital to address ongoing leaks and water waste.
CIP Project No. 22-020 is for ARMC’s Behavioral Health Adolescent Unit Project to add a behavioral health unit specifically for adolescents.
CIP Project No. 17-104 is for the Emergency Department Staff Bathroom Remodel Project for safety, functionality, and usability of hospital bathrooms in the Emergency Department.
ARMC is a 456-bed university-affiliated teaching hospital licensed by the California Department of Public Health, operated by San Bernardino County, and governed by the Board of Supervisors. ARMC delivers a large spectrum of essential services including emergency medicine, family medicine, internal medicine, neurology, obstetrics and gynecology, psychiatry, and ophthalmology. ARMC is composed of the main hospital, a behavioral health center, five primary care centers, and 40 subspecialty clinics.
ARMC recommends approval of this appropriation and reallocation adjustments because it will allow ARMC to operate in a fiscally-responsible and business-like manner and continue to provide for the health and safety of county residents as it will help ARMC to continue critical services.
Approval of the recommendations will allow ARMC to reallocate funds related to existing CIP projects as listed in the Financial Impact section.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Deputy County Counsel, 387-5455) on September 13, 2023; Auditor-Controller/Treasurer/Tax Collector (Charlene Huang, General Accounting Manager, 382-7022) on September 13, 2023; Project and Facilities Management Department (Robert Gilliam, Chief of Project Management, 387-5000) on September 14, 2023; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on September 13, 2023; Finance (Jenny Yang, Administrative Analyst, 387-4884, and Yael Verduzco, Principal Administrative Analyst, 387-5285) on September 11, 2023; and County Finance and Administration (Valerie Clay, Deputy Executive Officer 387-5423) on September 13, 2023.