REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
February 10, 2026
FROM
MOE YOUSIF, Interim Director, Project and Facilities Management Department
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Budget Adjustment for Arrowhead Regional Medical Center’s Planning and Design Project
End
RECOMMENDATION
Recommendation
1. Approve a budget increase, in the amount of $1,500,000, to the Arrowhead Regional Medical Center Planning and Design Project, Capital Improvement Program Project No. 19-126, increasing the total project budget from $2,150,000 to $3,650,000, for the development of Arrowhead Regional Medical Center’s funding ready packages, continuation of program management services, and pre-design services for various projects.
2. Authorize the Auditor-Controller/Treasurer/Tax Collector to post the necessary budget adjustments as detailed in the Financial Impact section (Four votes required).
(Presenter: Moe Yousif, Interim Director, 387-5000)
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 require the use of Discretionary General Funding (Net County Cost). The proposed budget increase of $1,500,000 for Arrowhead Regional Medical Center (ARMC) Planning and Design Project, Capital Improvement Program (CIP) Project No. 19-126, (Project) (WBSE 10.10.0777) will be fully funded through Medi Cal, Federal Medicare, private insurance reimbursements, and other departmental revenues. Funding sources may change in the future depending on any legislative activity related to the repeal or replacement of the Affordable Care Act.
Approval of this recommendation will allow the Auditor-Controller/Treasurer/Tax Collector to post the following adjustments to the CIP 2025-26 budget:
|
Fund Center |
Commitment Item |
Description |
Action |
Amount |
WBSE |
|
7700004204 |
54304030 |
Structures & Improvements to Structures |
Increase |
$1,500,000 |
10.10.0777 |
|
7700004204 |
40909995 |
Residual Equity Transfers In |
Increase |
$1,500,000 |
10.10.0777 |
|
7701004204 |
40909999 |
Residual Equity Transfers Out |
Decrease |
$1,500,000 |
- |
|
7701004204 |
54304030 |
Structures & Improvements to Structures |
Decrease |
$1,500,000 |
- |
BACKGROUND INFORMATION
ARMC and Project and Facilities Management Department (PFMD) continues to advance multiple capital initiatives necessary to maintain regulatory compliance, support evolving clinical services, and address aging infrastructure across the hospital campus. These efforts require sustained program management, early project planning, and the development of funding-ready project packages to ensure timely execution and alignment with County capital planning and financing strategies.
The Project was previously approved by the Board of Supervisors (Board) on September 25, 2018 (Item No. 41), as part of ARMC’s capital planning efforts to support ongoing program management, early project development, and pre-design services for multiple hospital initiatives.
The Project was established to fund centralized program management, pre-design services, and early project development activities for a portfolio of ARMC capital projects. These services include project prioritization, stakeholder coordination, operational programming, regulatory strategy development, preliminary scope definition, schedule development, and preparation of cost estimates sufficient to support funding requests and Board consideration.
The requested budget increase of $1,500,000 will allow ARMC and PFMD to continue these critical activities, including the preparation of funding-ready packages for near-term and future capital projects, continuation of program management services, and initiation of pre-design efforts where required. This work is essential to maintain project momentum, reduce downstream risks, and ensure that proposed projects are appropriately scoped, sequenced, and aligned with operational needs, regulatory requirements, and fiscal constraints.
Funding for this Project is replenished periodically as services are utilized and capital planning demands increase, ensuring flexibility to respond to regulatory requirements, operational needs, and future Board funding actions. As the volume and complexity of planning and pre-design efforts expanded beyond the original assumptions, the additional $1.5 million is now required to continue these essential services and maintain momentum across ARMC’s capital program.
ARMC recommends the approval of this budget adjustment because it will support proactive planning and disciplined capital execution, allowing ARMC to manage its capital program in a fiscally responsible and business-like manner while continuing to provide critical services that protect the health and safety of county residents.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Daniel Pasek, Deputy County Counsel, 387-5455) on December 23, 2025; Auditor-Controller/Treasurer/Tax Collector (Charlene Huang, Auditor-Controller Manager, 382-7022) on December 31, 2025; Arrowhead Regional Medical Center Finance (Chen Wu, Finance Budget Officer, 580-3165) on January 5, 2026; Project and Facilities Management (Rob Gilliam, Chief of Project Management, 387-5115) on January 5, 2026; and County Finance and Administration (Yael Verduzco, Principal Administrative Analyst, 387-5285) on January 21, 2026.