REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 27, 2023
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Non-Financial Affiliation Agreement with Loma Linda University School of Nursing, School of Allied Health Professions, and School of Public Health for Clinical Training
End
RECOMMENDATION(S)
Recommendation
Approve non-financial Affiliation Agreement, including non-standard terms, with Loma Linda University, School of Nursing, School of Allied Health Professions, and School of Public Health for their students to obtain clinical training at Arrowhead Regional Medical Center, for the five-year period of July 10, 2023, through July 9, 2028.
(Presenter: William L. Gilbert, Director, 580-6150)
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) as this Affiliation Agreement with Loma Linda University School of Nursing, School of Allied Health Professions and School of Public Health (Loma Linda) is non-financial in nature.
BACKGROUND INFORMATION
This Affiliation Agreement will provide clinical training at Arrowhead Regional Medical Center (ARMC) to students from Loma Linda’s nursing school, public health school, and school of allied health professions. As a teaching hospital, ARMC has a number of agreements with educational institutions to provide onsite training for students. The clinical training is necessary for students to obtain their degrees, licenses, and/or certifications and will provide for the safety, health, and social service needs of County residents through the provision of services rendered by these students.
The volume and diversity of ARMC patients provides a comprehensive educational opportunity to Loma Linda’s students. The schools and ARMC will mutually determine the number of students that will receive training. The Affiliation Agreement ensures the students receive specialty onsite training and experience from ARMC and gain vital skills needed in developing a competent workforce. The Affiliation Agreement will also enable the County to attract students to the region, thereby increasing the potential pool of future healthcare providers.
On July 10, 2018 (Item No. 7), the Board of Supervisors (Board) approved non-financial Affiliation Agreement No. 18-427 with Loma Linda for their students to obtain training for the period of July 10, 2018, to July 9, 2023.
The Affiliation Agreement has been negotiated by the parties with the following non-standard contract terms or is missing the following standard County contract terms:
1. Loma Linda limits its indemnification obligation to claims for injury or damages that arise out of the performance of the Affiliation Agreement, but only in proportion to and to the extent such claims are caused by or result from the negligent or intentional acts of Loma Linda, its officers, students, employees, and agents.
• The County standard general indemnify provision requires the vendor to indemnify, defend, and hold County harmless from third party claims arising out of the acts, errors or omissions of any person.
• Potential Impact: Loma Linda’s indemnify obligation is more limited than the standard County general indemnity provision. In the event a claim arises that falls outside the scope of Loma Linda’s limited indemnity obligation, the County may be solely liable for the costs of defense and damages.
2. The County must indemnify Loma Linda, its officers, employees, and agents from claims for injury or damages arising out of the performance of the Affiliation Agreement, but only in proportion to and to the extent such claims are caused by or result from the negligent acts or omissions of County, its officers, employees, and agents.
• The County standard contract does not contractually require the County to indemnify the vendor.
• Potential Impact: By agreeing to indemnify Loma Linda, the County could be contractually waiving the protection of sovereign immunity. Claims that may otherwise be barred against the County, time limited, or expense limited could be brought against Loma Linda without such limitations and the County would be responsible to defend and reimburse Loma Linda for costs, expenses, and damages, which could exceed the total Affiliation Agreement amount.
ARMC recommends approval of the Affiliation Agreement, including the non-standard terms, to provide clinical training and experience to Loma Linda students, which will result in the students gaining vital skills needed to develop a competent workforce.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Deputy County Counsel, 387- 5455) on June 2, 2023; Risk Management (Victor Tordesillas, Director, 386-8623) on June 8 2023, ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on June 8, 2023; Finance (Jenny Yang, Administrative Analyst, 387-4884) on June 8, 2023; and County Finance and Administration (Valerie Clay, Deputy Executive Officer, 387- 5423) on June 8, 2023.