REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
March 24, 2026
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Amendment to Professional Service Agreement with CEP America - California Emergency Medicine Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 3 to Agreement No. 23-1325 with CEP America - California, for emergency medicine services at Arrowhead Regional Medical Center, to revise the payment schedule to reflect Sheriff/Coroner/Public Administrator’s Department reimbursement for inmate emergency medical services, with no change to the total contract amount of $70,850,549 plus variable amounts, and no changes to the contract term of January 1, 2024 through December 31, 2026.
2. Direct the Clerk of the Board of Supervisors to maintain the confidentiality of Amendment No. 3 to Agreement No. 23-1325, pursuant to Health and Safety Code Section 1457(c)(1).
(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 cost of $70,850,549, plus variable amounts, is funded by the State Medi-Cal, Federal Medicare, private insurances, and other departmental revenue. Funding sources may change in the future pending any legislative activity related to the repeal and/or replacement of the Affordable Care Act. Adequate appropriation and revenue have been included in the Arrowhead Regional Medical Center (ARMC) and the Sheriff/Coroner/Public Administrator’s (Sheriff) Department 2025-26 budgets and will be included in the respective 2026-27 recommended budgets.
BACKGROUND INFORMATION
Approval of Amendment No. 3 will revise the Agreement’s payment schedule to clarify the Sheriff’s Department responsibility for reimbursing CEP America - California (CEP) for costs associated with the provisions of emergency medical services to non-covered inmates housed within its detention facilities. This Amendment does not modify the scope of services, the term, or increase the total contract amount. Rather, it updates the payment structure to align with the County department responsible for inmate healthcare expenditures.
On December 19, 2023 (Item No. 21), the Board of Supervisors (Board) approved Agreement No. 23-1325 (Agreement) with CEP to provide emergency, family medicine, and street medicine services at ARMC and within County-operated detention facilities for the period of January 1, 2024 through December 31, 2026, for a total amount of $66,543,912, plus variable amounts, for the period of January 1, 2024 through December 31, 2026.
On April 9, 2024 (Item No. 13), the Board approved Amendment No. 1 to the Agreement, removing all family medicine and street medicine services and increasing the number of psychiatrists and primary care physicians for Department of Behavioral Health, increasing the total contract by $4,306,637 from $66,543,912 plus variable amounts to $70,850,549 plus variable amounts, with no change to the contract term of January 1, 2024 through December 31, 2026.
On September 24, 2024 (Item No. 15), the Board approved Amendment No. 2 to the Agreement, which authorized CEP to provide emergency medical treatment to uninsured inmates housed in Sheriff detention facilities and to be reimbursed for those services under the Agreement with no change to the total contract amount of $70,850,549 plus variable amounts and no change to the contract term of January 1, 2024 through December 31, 2026.
ARMC recommends approval of this Amendment to support continued coordination of emergency medical services for individuals in County custody while ensuring that inmate healthcare costs are assigned to the appropriate County department.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Supervising Deputy County Counsel, 387-5455) on February 24, 2026; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on March 2, 2026; and County Finance and Administration (Jenny Yang, Administrative Analyst, 387-4884) on March 5, 2026.