REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
August 19, 2025
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Grant Application to the California Department of Health Care Access and Information for the Song-Brown Primary Care Residency Program Grant
End
RECOMMENDATION(S)
Recommendation
1. Approve and authorize the submission of the following grant applications to the California Department of Health Care Access and Information, for the Song-Brown Primary Care Residency Training Program each in the amount of $625,000, for the combined total amount up to $1,875,000, for the grant performance period of June 30, 2026 through August 31, 2029:
a. Family Medicine
b. Internal Medicine
c. Obstetrics and Gynecology
2. Authorize the ARMC Chief Executive Officer to execute and electronically transmit the grant applications referenced in Recommendation No. 1, including any subsequent non-substantive amendments, subject to review by County Counsel.
3. Direct the ARMC Chief Executive Officer to transmit the grant applications referenced in Recommendation No. 1, and any subsequent non-substantive amendments, to the Clerk of the Board of Supervisors within 30 days of the transmission or execution of the documents.
(Presenter: Andrew Goldfrach, ARMC Chief Executive Officer, 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 California Department of Health Care Access and Information (HCAI) does not require matching funds from the County to receive an award under the Song-Brown Primary Care Residency Grant Program (Song-Brown Program). If the funds are awarded by HCAI, Arrowhead Regional Medical Center (ARMC) will return to the Board of Supervisors (Board) for award acceptance and any necessary budget adjustments.
BACKGROUND INFORMATION
In accordance with the Song-Brown Health Care Workforce Training Act (Song-Brown Act), Health & Safety Code Sections 128200, et. seq., the California Healthcare Workforce Policy Commission (Commission) will consider applications to support the training of primary care physicians. After review of the applications, the Commission makes recommendations for grant awards to the Director of HCAI. HCAI works to increase and diversify California’s healthcare workforce through the Healthcare Workforce Development Division using funding initiatives such as the Song-Brown Program.
The Song-Brown Program funds institutions that train primary care physicians to provide health care in California’s medically underserved areas. HCAI gives priority to competitive proposals from programs that demonstrate success in the following areas:
• Graduating individuals who practice in medically underserved areas
• Enrolling members of underrepresented groups in medicine to the program
• Locating the program’s main training site in a medically underserved area
• Operating a main training site at which the majority of the patients are Medi-Cal recipients
ARMC has applied for and received Song-Brown Program funding since 2020. The proposed funding in the current item will help provide offsets to resident salaries, faculty development, resident conference travel, and other direct educational costs for operating the resident physician training program. ARMC is asking the Board to approve the submission of grant applications for its Family Medicine, Obstetrics and Gynecology, and Internal Medicine Residency Training Programs to HCAI.
The grant applications require Board approval under County Policy No. 05-13 as the applications are 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 the following:
1. HCAI has the right to audit the County’s expenditure of the grant funds to ensure compliance with the grant program requirements.
• The County standard contract does not permit a contractor to audit the County’s compliance.
• Potential Impact: HCAI has the right to review and copy the County’s records relating to the County’s use of the grant funds, and to the extent HCAI determines that the County failed to perform under the terms of the award agreement, HCAI may recover any and all amounts provided under the grant.
2. The County is required to indemnify, defend, and hold 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 HCAI 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.
Approval of Recommendation No. 2 would authorize the ARMC Chief Executive Officer to electronically sign and submit the Song-Brown Program grant applications, on behalf of the County, to HCAI, as well as any non-substantive amendments necessary, subject to County Counsel review. ARMC will seek Board’s approval in the event the County is awarded grant funds in accordance with County Policy 05-13 and as required by the HCAI.
ARMC recommends approval of the Grant Applications to provide for the safety, health and social services needs of County residents by providing funding to support the education and training of primary care physicians in medically underserved communities.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Supervising Deputy County Counsel, 387-5455) on August 7, 2025; Risk Management (Stephanie Pacheco, Staff Analyst II, 386-9044) on August 8, 2025; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on August 11, 2025; County Finance and Administration (Jenny Yang, Administrative Analyst, 387-4884) on August 11, 2025.