REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
December 16, 2025
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Amendment to Contract with Faculty Physicians and Surgeons of LLUSM dba Loma Linda University Faculty Medical Group for Pediatric Physician Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 4 to Contract No. 20-173 with Faculty Physicians and Surgeons of LLUSM dba Loma Linda University Faculty Medical Group for pediatric physician services, increasing the contract amount by $588,640, from $5,382,840 to $5,971,480, and extending the term by six months, for a total contract period of July 1, 2020 through June 30, 2026.
2. 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).
(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 this contract, not-to-exceed $5,971,480, is funded by Medi-Cal reimbursement, private insurance, existing ongoing 1991 Realignment funds, and fee revenue. Payment is made on a fee-for-service basis. Adequate appropriation and revenue have been included in the Department of Public Health’s (DPH) 2025-26 budget.
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. 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. Faculty Physicians and Surgeons of LLUSM dba Loma Linda University Faculty Medical Group (LLUFMG) currently provides pediatric services for the FQHCs in Ontario and San Bernardino, as well as the SBSS in Ontario.
On April 7, 2020 (Item No. 34), as a result of Request for Proposals (RFP) No. DPHE20-CO-3445, the Board of Supervisors (Board) approved Contract No. 20-173 (Contract) with LLUFMG to provide pediatric physician services, in the amount of $2,698,920, for the period of July 1, 2020 through June 30, 2023.
On June 13, 2023 (Item No. 59), the Board approved Amendment No. 1 to the Contract, to continue providing pediatric physician services, increasing the contract by a not-to-exceed amount of $918,000, from $2,698,920 to $3,616,920, and extending the term by one year, for a total contract period of July 1, 2020 through June 30, 2024.
On May 21, 2024 (Item No. 66), the Board approved Amendment No. 2 to the Contract, to continue providing pediatric physician services, increasing the contract by a not-to-exceed amount of $1,177,280, from $3,616,920 to $4,794,200, and extending the term by one year, for a total contract period of July 1, 2020 through June 30, 2025.
On May 21, 2024 (Item No. 66), the Board approved Amendment No. 3 to the Contract, to continue providing pediatric physician services, increasing the contract by $588,640, from $4,794,200 to $5,382,840, and extending the term by six months, for a total contract period of July 1, 2020 through December 31, 2025. The amendment prevented a disruption in services while the department reviewed proposals and began negotiations for a new contract.
On February 21, 2025, DPH released RFP No. DPHE25-CO-5726 to solicit pediatric providers for a new service contract. DPH and the contractor have been negotiating the payment system in order to mitigate the requested rate increases for providers. Contract negotiations are expected to be completed within the next six months. As DPH continues to negotiate a new contract for pediatric services, the recommended Amendment No. 4 to the Contract will ensure continuity of services, as required by Section 330 of the Public Health Services Act, for the Ontario and San Bernardino FQHCs and the Ontario SBSS. The Contract will terminate and be superseded upon execution of a new contract.
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 is directed to maintain confidentiality of the Contract.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Adam Ebright, Deputy County Counsel, 387-5455) on November 25, 2025; and County Finance and Administration (Iliana Rodriguez, Administrative Analyst, 387-4205) on November 24, 2025.