REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
October 7, 2025
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Non-Financial Injectable Syphilis Treatment Delivery Agreement Template
End
RECOMMENDATION(S)
Recommendation
1. Approve non-financial Injectable Syphilis Treatment Delivery Agreement Template for the Department of Public Health to provide delivery of the injectable syphilis treatment to requesting medical providers, effective upon execution by both parties to remain in effect for one year from the signature date.
2. Authorize the Director of the Department of Public Health to execute individual non-financial Injectable Syphilis Treatment Delivery Agreement Templates with requesting medical providers on behalf of the County, subject to review by County Counsel.
(Presenter: Joshua Dugas, 387-9146)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
Pursue County Goals and Objectives by Working with Other Agencies and Stakeholders.
FINANCIAL IMPACT
This item will not result in the use of Discretionary General Funding (Net County Cost) as this Injectable Syphilis Treatment Delivery Agreement template (Template Agreement) is non-financial in nature. The Department of Public Health (DPH) will purchase the injectables requested by medical providers via executed individual Agreements through the federal Health Resources and Services Administration’s 340B Drug Pricing Program funded with the California Department of Public Health’s Syphilis and Congenital Syphilis Outreach Strategy grant.
BACKGROUND INFORMATION
DPH plays a vital role in identifying and investigating cases of syphilis and congenital syphilis infections, while providing support to patients throughout the treatment process, to ensure access to timely and effective care and treatment.
DPH aims to decrease the number of rising syphilis cases by partnering with medical providers across San Bernardino County (County) to supply Bicillin-LA, an injectable syphilis treatment at no cost to providers or patients.
The recommended Template Agreement is a requirement of the California Department of Public Health (CDPH) under the County’s participation in the 340B drug pricing program. DPH is eligible to purchase low and no cost medications to treat an array of sexually transmitted diseases. Additionally, DPH distributes these treatments to local providers, requiring them to adhere to the requirements of the 340B program, necessitating the execution of the Template Agreement. Under this agreement, DPH agrees to supply the necessary medications at no cost to providers, conduct disease investigations to potentially identify and treat others who may have been exposed and coordinate the care of patients through follow-up of their treatment plan. Providers are required to notify DPH of patients testing positive for syphilis, administer the medication at no charge to the patient, and provide medical records to DPH to assist with the ongoing patient support.
Delegated authority by the Board of Supervisors (Board) is requested to allow the Director of the DPH to execute individual Template Agreements with local providers, to expedite the distribution of critical medications and allow for widespread access to treatment across the region.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Kristina Robb, Deputy County Counsel, 387-5455) on September 19, 2025; and County Finance and Administration (Iliana Rodriguez, Administrative Analyst, 387-4205) on September 22, 2025.