REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
November 18, 2025
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Contract with California University of Science and Medicine for Primary Care, Pediatric, Psychiatric, and Refugee Health Assessment Program Services
End
RECOMMENDATION(S)
Recommendation
1. Approve contract with California University of Science and Medicine to provide primary care, pediatric, psychiatric, and Refugee Health Assessment Program services in the Department of Public Health’s Federally Qualified Health Centers and School-based Service Sites, in an amount not-to-exceed $16,258,096, for the contract period of January 1, 2026 through December 31, 2028.
2. Authorize the Chair of the Board of Supervisors, Chief Executive Officer, or the Director of the Department of Public Health to execute non-substantive amendments to the contract with California University of Science and Medicine, subject to review by County Counsel.
3. Direct the Clerk of the Board of Supervisors to maintain the confidentiality of the contract, pursuant to Health and Safety Code Section 1457(c)(1).
4. Direct the Director of the Department of Public Health to transmit any amendments to the contract with California University of Science and Medicine to the Clerk of the Board of Supervisors within 30 days of execution.
(Presenter: Joshua Dugas, Director, 387-9146)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
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 total cost of these services, not-to-exceed $16,258,096, is funded by Medi-Cal reimbursement, private insurance, existing ongoing1991 Realignment funds, and fee revenue. Payment will be on a fee-for-service basis. Adequate appropriation and revenue have been included in the Department of Public Health’s (DPH) 2025-26 budget and will be included in future recommended budgets.
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 to patients, provide comprehensive health services, and have an ongoing quality assurance program. FQHCs qualify for enhanced reimbursement from Medicare and Medicaid, as well as other benefits. DPH operates four FQHCs in San Bernardino, Ontario, Hesperia, and Adelanto. The services provided include primary care, maternal health, HIV care and treatment, reproductive health, dental and nutrition care, and diagnostic radiology. In 2014, DPH added comprehensive pediatric services through its FQHCs. In 2023, DPH expanded pediatric services to two School-based Service Sites (SBSSs) in Apple Valley and Ontario.
Under the terms of the recommended contract with California University of Science and Medicine (CUSM), licensed physicians, mid-level practitioners, and psychiatrists will provide primary care, psychiatric, and Refugee Health Assessment Program services at all four of DPH’s FQHCs, and pediatric services in the High Desert region (at the FQHCs located in Hesperia and Adelanto and the SBSS in Apple Valley). CUSM plans to sub-contract a portion of the services through an agreement with CEP-America AUC, dba Vituity, Inc. Qualified and licensed staff will provide a broad spectrum of basic medical services to patients referred by DPH. Physician support services include supervision and clinical oversight of mid-level practitioners, assistance in the development of policies and procedures, participation in quality improvement/quality assurance activities, and ensuring compliance with productivity standards and long-term strategic plans.
Approval of the recommended contract will allow for the continued provision of comprehensive health services through the County’s FQHCs and Apple Valley SBSS. CUSM’s performance will be monitored by review of monthly reports to ensure compliance with the administrative, program, and fiscal terms and conditions of the contract. Recommendation No. 2 authorizes the Director of DPH to approve non-substantive amendments to the contract such as changes to the scope of work and work locations, subject to review by County Counsel.
Pursuant to Health and Safety Code section 1457(c)(1), specific terms related to the rates of payment for health care services are not immediately subject to laws related to public records. Therefore, the Clerk of the Board of Supervisors (Board) is directed to maintain confidentiality of the contracts.
DPH recommends approval of the contract with CUSM to obtain licensed physicians to provide primary care and pediatric services at the County’s FQHCs and Apple Valley SBSS, as required by Section 330 of the Public Health Services Act.
PROCUREMENT
On February 21, 2025, the Chief Executive Officer approved the release of Requests for Proposals (RFP) Nos. DPHE25-CO-5725 and DPHE25-CO-5726; one to solicit for doctors or physician groups to provide primary care and another for pediatric services, through qualified, board certified physicians and mid-level practitioners, at the FQHCs and SBSSs.
The RFPs were posted on San Bernardino County’s Electronic Procurement Network (ePro). Two proposals were received by the established deadline in response to each of the RFPs as follows:
|
Proposer/Agency |
DPH Site(s)/Region |
Service Category |
|
CUSM |
High Desert Region • Adelanto FQHC • Hesperia FQHC |
Primary Care |
|
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|
Valley Region • Ontario FQHC • San Bernardino FQHC |
Primary Care |
|
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|
High Desert Region • Hesperia FQHC |
Psychiatric |
|
|
Valley Region • Ontario FQHC • San Bernardino FQHC |
Psychiatric |
|
|
Valley Region • Ontario FQHC • San Bernardino FQHC |
Refugee Health Assessment |
|
Michael F. Esber DPM P.C. |
High Desert Region • Adelanto FQHC • Hesperia FQHC |
Primary Care |
|
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Valley Region • Ontario FQHC • San Bernardino FQHC |
Primary Care |
|
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|
High Desert Region • Hesperia FQHC |
Psychiatric |
|
|
Valley Region • Ontario FQHC • San Bernardino FQHC |
Psychiatric |
|
|
Valley Region • Ontario FQHC • San Bernardino FQHC |
Refugee Health Assessment |
|
CUSM |
High Desert Region • Adelanto FQHC • Hesperia FQHC • Apple Valley Head Start SBSS |
Pediatric |
|
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Valley Region • Ontario FQHC • Ontario Head Start SBSS • San Bernardino FQHC |
Pediatric |
|
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Loma Linda University School of Medicine (LLUSM) |
Valley Region • Ontario FQHC • Ontario Head Start SBSS • San Bernardino FQHC |
Pediatric |
|
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|
|
A team comprised of DPH staff conducted a best-value evaluation of the proposals based on qualifications and experience, scope of work for service delivery, capacity, cost, references, and presentations. Through this competitive process, CUSM ranked higher and was determined to best meet the County’s need for pediatric services in the High Desert Region and for all other service categories in both regions. LLUSM is receiving an award for pediatric services in the Valley Region. That contract is still being negotiated and will be presented at a future Board meeting. Michael F. Esber DPM P.C. was notified by letter of its option to submit a formal protest letter. No protest letter was received by the deadline.
As a result of contract negotiations, modified hourly rates along with an incentivized payment structure, were agreed upon.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Adam Ebright, Deputy County Counsel, 387-5455) on October 29, 2025; Purchasing (Ariel Gill, Supervising Buyer, 387-2070) on October 23, 2025; and County Finance and Administration (Iliana Rodriguez, Administrative Analyst, 387-4205) on October 27, 2025.