REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 28, 2022
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Non-Financial Medical Residency/Fellowship Training Agreement with the United States Air Force and a Non-Financial Resident Employment Agreement for the Provision of Clinical Training at Arrowhead Regional Medical Center
End
RECOMMENDATION(S)
Recommendation
1. Approve a Non-Financial Medical Residency/Fellowship Training Agreement with the United States Air Force for a general surgery physician resident, Dr. Kevin Perez, to obtain clinical training at Arrowhead Regional Medical Center, effective upon execution and continuing until terminated by either party.
2. Approve a Non-Financial Resident Employment Agreement with Dr. Kevin Perez for participation in the general surgery residency program at Arrowhead Reginal Medical Center, effective upon execution until June 30, 2023.
3. Authorize the Director of Arrowhead Regional Medical Center to execute amendments to extend the term of the Non-Financial Resident Employment Agreement for a maximum of four successive one-year periods on behalf of the County, subject to County Counsel review.
4. Direct the Director of Arrowhead Regional Medical Center to transmit all documents related to the Non-Financial Resident Employment Agreement amendments to the Clerk of the Board of Supervisors within 30 days of execution.
(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 training agreement with the United States Air Force (Air Force) is non-financial in nature. Approval of the Resident Employment Agreement with Dr. Perez will also not result in the use of Discretionary General Funding (Net County Cost) as Dr. Perez’s salary and benefits during his participation in the residency program at Arrowhead Regional Medical Center (ARMC) will be paid directly to him by the Air Force.
BACKGROUND INFORMATION
Approval of the Training Agreement and the Resident Employment Agreement will provide for the safety, health, and social services needs of County residents by allowing ARMC to provide clinical training to one Air Force general surgery resident physician, which as a result, will assist in the delivery of specialized medical care to ARMC patients.
ARMC operates eight medical residency programs accredited by the Accreditation Council for Graduate Medical Education for the training of physicians in various specialties, including emergency medicine, general surgery, family medicine, internal medicine, neurology, obstetrics/gynecology, and psychiatry. Medical school graduates are required to complete a residency in a specialty to obtain their license to practice medicine.
Generally, the County pays resident physicians a salary and benefits (including professional liability insurance) as employees of the County while they undergo their residency training at ARMC. However, in this case, as reflected in the Training Agreement, because the resident physician is an employee of the Air Force, the Air Force has agreed to pay Dr. Kevin Perez his salary and benefits, with the exception of professional liability insurance, while Dr. Perez undergoes ARMC’s general surgery residency program. Under the Training Agreement, the County is obligated to provide professional liability coverage and defend Dr. Perez in the event of a medical malpractice claim. This is consistent with the benefits the County provides to other resident physicians at ARMC. Under the Training Agreement, the County also agrees to not seek indemnification from the Air Force for any claims arising out of the resident’s professional duties while at ARMC to the extent the injury was caused by conduct undertaken at the direction of ARMC or its employees.
The Resident Employment Agreement with Dr. Perez is substantively similar to the 2022-23 Physician Residency Program Master Resident Employment Agreement approved by the Board of Supervisors on May 24, 2022 (Item No. 21), with the exception that the agreement includes language that Dr. Perez will be paid by the Air Force.
ARMC recommends approval of the Training Agreement and Resident Employment Agreement so that Dr. Perez can receive general surgery training while also assisting in the delivery of specialized medical care to County residents at ARMC.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Cynthia O’Neill, Principal Assistant County Counsel, and Charles Phan, Deputy County Counsel, 387-5455) on June 14, 2022; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on June 10, 2022; Finance (Jenny Yang, Administrative Analyst, 387-4884) on June 10, 2022; and County Finance and Administration (Diana Atkeson, Deputy Executive Officer, 387-5423) on June 10, 2022.