REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 13, 2023
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Amendment to Contract with Faculty Physicians and Surgeons of LLUSM dba Loma Linda University Faculty Medical Group for Pediatric Physician Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 1 to Contract No. 20-173 with Faculty Physicians and Surgeons of LLUSM dba Loma Linda University Faculty Medical Group to continue providing pediatric physician services, increasing the contract by a not to exceed amount of $918,000, from $2,698,920 to $3,616,920, and exercising the first option to extend for one additional year, for the total contract period of July 1, 2020 through June 30, 2024.
(Presenter: Joshua Dugas, Director, 387-9146)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Ensure Development of a Well-Planned, Balanced, and Sustainable County.
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of this item will not impact Discretionary General Funding (Net County Cost). The cost will not exceed $918,000 for the continuation of services for the contract period of July 1, 2023 through June 30, 2024, and is funded by fee-for-services Medi-Cal, Managed Care Medi-Cal, private insurance, 1991 Realignment funds, and sliding fee-scale clients. Payment will be on a fee-for-service basis. Adequate appropriation and revenue will be included in the Department of Public Health’s (DPH) 2023-24 recommended budget.
BACKGROUND INFORMATION
Section 330 of the Public Health Services Act requires that Federally Qualified Health Centers (FQHCs) serve an underserved area or population, offer a sliding fee scale, and provide comprehensive health services including pediatric services. Currently, DPH operates four FQHCs in Adelanto, Hesperia, Ontario, and San Bernardino. Comprehensive pediatric services were integrated into the FQHCs in 2014 and 2015. In 2022, DPH collaborated with Preschool Services Department (PSD) and added two school-based service sites (SBSS) in the cities of Ontario and Apple Valley. This supports local partnerships between schools and health centers to improve access to comprehensive primary care services to children and adolescents in the community. It is DPHs goal to expand the collaboration with PSD and finding locations that are mutually beneficial to provide pediatric physician services.
Under the terms of the recommended amendment to the contract with Faculty Physicians and Surgeons of LLUSM dba Loma Linda University Faculty Medical Group (LLUFMG), board certified pediatric physicians will continue to provide comprehensive pediatric services at each FQHC, along with the two SBSS, based on patient need and volume. The schedule will be coordinated with the DPH Clinic Operations section. For calendar year 2022, pediatric services were provided to approximately 2,200 unique patients (this is not inclusive of any return or follow-up visits). Cost for services varied based on the type of visit, test administered, and/or procedure/treatment given based on the patient’s need. In addition, LLUFMG will participate in administrative duties by assisting DPH in developing and implementing policies and procedures, long-range strategic plans, chart activities to meet performance measures, and participate in continuous quality improvement/quality assurance.
LLUFMG’s performance is monitored by review of monthly reports to ensure compliance with the administrative, program, and fiscal terms and conditions of the contract. LLUFMG will cooperate with the County in the implementation, monitoring, and evaluation of this contract and will comply with all reporting requirements established by the contract. Charges must be for services provided to eligible beneficiaries under applicable Federal, State, and locally funded programs. DPH Budget and Administrative Services will review invoices and attachments remitted by LLUFMG prior to payment. The County reserves the right to request additional program and/or fiscal reports to facilitate this monthly review.
PROCUREMENT
On April 7, 2020 (Item No. 34), as a result of a formal procurement, the Board of Supervisors approved Contract No. 20-173 with LLUFMG to provide pediatric physician services, in the amount of $2,698,920, for the period of July 1, 2020 through June 30, 2023, with the option to extend the Contract for two additional one-year periods.
REVIEW BY OTHERS
This item has been reviewed by Human Services Contracts (Patty Steven, Contracts Manager, 388-0241) on May 23, 2023; County Counsel (Adam Ebright, Deputy County Counsel, 387-5455) on May 4, 2023; Finance (Paul Garcia, Administrative Analyst, 386-8392) on May 23, 2023; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on May 23, 2023.