REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
October 6, 2026
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Amendment to Product Supply Agreement and Riders with Linde Gas & Equipment, Inc. for Bulk Medical Gases, Medical Gas Cylinders, and Site Gas Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 1 to Agreement No. 24-643 with Linde Gas & Equipment, Inc., for the delivery of bulk medical gases, medical gas cylinders, and the provision of an onsite manager for site gas services, to remove the Nitric Oxide Rider and increase the amount by $1,099,499, from $2,400,000 to a total amount not-to-exceed $3,499,499, with no change to the term of July 9, 2024 through July 8, 2029.
(Presenter: Andrew Goldfrach, ARMC Chief Executive Officer, 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). The cost of $1,099,499 is funded by 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) 2026-27 budget and will be included in the future recommended budgets.
BACKGROUND INFORMATION
On July 9, 2024 (Item No. 7), as a result of a non-competitive procurement, the Board of Supervisors (Board) approved Agreement No. 24-643 (Agreement) with Linde Gas & Equipment Inc. (Linde), for the delivery of bulk medical gases, medical gas cylinders, and the provision of an onsite manager for site gas services, in an amount not-to-exceed $2,400,000, for the period of July 9, 2024 through July 8, 2029.
Under the Agreement, medical gas cylinders are delivered by Linde and distributed throughout ARMC and the affiliated Family Health Centers, and include oxygen tanks for patient transport and crash carts, compressed air utilized for oxygen at a patient’s bedside, and various specialty gases for anesthesia and procedural use. Bulk supply systems provide all of the compressed air and oxygen lines that enter ARMC facilities and are made available at the patient’s bedside for use as needed. The onsite manager is responsible for ensuring adequate supply of medical gases, delivering cylinders to all use points, retrieving all empty cylinders from ARMC and promptly returning to Linde, and serving as the single point of contact between ARMC and Linde.
The Agreement includes the following Riders: Product, Site Services and Nitric Oxide. ARMC was notified that Vero Biotech Inc. (Vero) acquired substantially all of the assets and contractual rights related to Linde’s inhaled nitric oxide business in the United States as of March 17, 2026. Approval of the recommendation will remove the Nitric Oxide Rider from the Agreement as Linde will no longer provide nitric oxide to ARMC. Nitric Oxide will be provided by Vero Biotech, Inc. to meet ARMC’s current needs.
ARMC has experienced an increase in oxygen and specialty gas usage as a result of an increase in surgeries and medical procedures. Based on the average annual cost of approximately $700,000, ARMC is requesting an increase of $1,099,499 to cover anticipated costs through the remainder of the Agreement term.
ARMC recommends approval of Amendment No. 1 to allow for the continued provision of the required and necessary bulk medical gases, medical gas cylinders and site gas services to provide for the health and safety of ARMC patients.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Daniella Hernandez, Deputy County Counsel, 387-5455) on August 21, 2026; Purchasing (Veronica Pedace, Buyer III, 387-2464) on August 27, 2026; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on September 11, 2026; and County Finance and Administration (Jenny Yang, Administrative Analyst, 387-4884) on September 14, 2026.