REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
July 28, 2020
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title v
Grant Application to the California Office of Statewide Health Planning and Development for Psychiatry Education Capacity Expansion Grant Program
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RECOMMENDATION(S)
Recommendation
1. Approve and authorize the submission of the grant application, including the Letter of Sustainability, to the Office of Statewide Health Planning and Development for the Workforce Education and Training Psychiatry Education Capacity Expansion Grant Program in the amount of $1,905,712.
2. Designate the Chair of the Board of Supervisors or Chief Executive Officer or Arrowhead Regional Medical Center Hospital Director to execute and electronically transmit the grant application, including the Letter of Sustainability and any subsequent non-substantive grant application amendments and documents necessary on behalf of the county, subject to review by County Counsel.
3. Direct the Arrowhead Regional Medical Center Hospital Director to transmit the grant application, and all documents and amendments in relation to this application, to the Clerk of the Board of Supervisors within 30 days.
(Presenter: William L. Gilbert, Director, 580-6150)
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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 the recommendations will not result in the use of Discretionary General Funding (Net County Cost). The Office of Statewide Health Planning and Development (OSHPD) does not require a match from the County to receive an award under the Psychiatry Education Capacity Expansion (PECE) Grant Program. However, the PECE Grant Program requires the County to commit to sustaining the two residency positions that are expanded with the grant funds beyond the expiration of the grant, as the positions will be permanent. Arrowhead Regional Medical Center (ARMC) plans to continue to fund these positions after the expiration of the grant through State Medi-Cal, Federal Medicare, private insurances, and other departmental revenue. Sufficient appropriation and revenue will be included in future recommended budgets.
BACKGROUND INFORMATION
In November 2004, California voters approved Proposition 63, the Mental Health Services Act (MHSA). Sections 2 and 3 of the MHSA provide increased funding, personnel, and other resources to support public mental health programs and monitor progress toward statewide goals for children, transition age youth, adults, older adults, and families.
The OSHPD administers the Workforce Education and Training (WET) Program, a component of the MHSA. State budget appropriations fund the WET program, which promotes the expansion of postsecondary education and training to meet mental health occupational shortage needs.
This grant opportunity will result in grant agreement with educational and/or medical institutions to develop and expand psychiatry residency programs that train and prepare residents to work in the Public Mental Health System (PMHS), which includes:
1. Working on multi-disciplinary teams
2. Working with populations identified by the local PMHS
3. Acquiring MHSA values and principles
4. Promoting wellness, recovery, and resilience
The proposed funding will help offset the cost of adding two new residency positions to ARMC’s Psychiatry Residence Program. Grant funding will provide support for a period up to four academic years.
The grant application requires Board approval under County Policy No. 05-13 as the application is binding on the County and by applying, the County agrees to certain grant terms as part of the application and any subsequent award. Those terms include non-standard County contract terms, including the following:
Insurance
Minimum insurance coverage type and limits are not specified.
• The County’s standard contract has an extensive list of insurance requirements relating to various insurance coverage and limits, and requires contractors to add the County as an additional insured and waive subrogation rights.
• Potential Impact: The terms and conditions of any award issued do not include any insurance requirements. This means the County has no assurance that the State will have the financial support of an insurance company for any claims that may arise under any subsequent award Agreement, which could result in the County bearing financial responsibility if the State does not, or is unable to, fulfill its obligations. Additionally, to the extent the State has the proper insurance coverage, the policy will not provide direct coverage to the County as a named insured.
Indemnification
The County is required to indemnify, defend, and save harmless the State, its officers, agents, and employees from any claims arising out of the County’s performance under any award Agreement. There is no reciprocal indemnification requirement on the OSHPD or the State of California.
• The County’s standard contract does not include any indemnification or defense by the County.
• Potential Impact: The County would be responsible to defend and reimburse the State for the County’s acts or omissions under certain circumstances for costs, expenses, and damages, which could exceed the total amount the State awards the County under this grant program.
Moreover, acceptance of the award requires the County to sustain the expanded positions beyond the expiration of the grant.
Approval of Recommendation No. 2 would authorize the Chair of the Board of Supervisors, Chief Executive Officer, or ARMC Hospital Director to electronically sign and transmit to OSHPD, on behalf of the County, the grant application, Letter of Sustainability, as well as any non-substantive amendments necessary in relation to this grant application, subject to County Counsel review. The Letter of Sustainability, which is required by OSHPD, reflects the number of residents to be added to ARMC’s Psychiatry Residency Program as a result of the grant, and the County’s commitment to sustain the new positions after the grant expires.
ARMC will seek the approval of a Board Resolution at a later date to accept an award under this program in accordance with County Policy 05-13 and as required by the OSHPD.
PROCUREMENT
Not Applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Deputy County Counsel, 387-5455) on July 13, 2020; ARMC Finance (Chen Wu, Budget and Finance Officer, 580-3165) on July 13, 2020; Finance (Yael Verduzco, Administrative Analyst, 387-5285) on July 13, 2020; and County Finance and Administration (Matthew Erickson, County Chief Financial Officer, 387-5423) on July 13, 2020