REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
October 20, 2026
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Workforce Staffing Support for Arrowhead Regional Medical Center to Ensure Continued Hospital Operations
End
RECOMMENDATION(S)
Recommendation
1. Authorize the ARMC Chief Executive Officer to execute agreements with workforce staffing agencies, including new agreements and/or amendments, including agreements with non-standard terms, in an amount not to exceed the aggregate total of $20,000,000, to support hospital operations during temporary absences due to strikes or other concerted work activity that result in workforce shortages, as required to meet patient needs, effective upon receipt of notice of a strike or other concerted work activity through November 17, 2026, subject to County Counsel review.
2. Direct the ARMC Chief Executive Officer to submit any agreement or amendment executed pursuant to Recommendation No. 1 to the Board of Supervisors for ratification at the next available Board of Supervisors meeting.
(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 not to exceed aggregate total cost of $20,000,000 for multiple workforce staffing contracts is funded by State Medi-Cal, Federal Medicare, private insurances, and other departmental revenue. Approval of the necessary budget adjustment is not requested at this time, but will be included on a future quarterly countywide budget report presented to the Board of Supervisors (Board) for approval, if needed.
BACKGROUND INFORMATION
Recommendation No. 1 gives the Arrowhead Regional Medical Center (ARMC) Chief Executive Officer (CEO) the ability to provide necessary personnel to replace and/or augment critical hospital staffing who do not report to work due to an employee strike or other concerted work activity.
Labor strikes and other concerted work activities may result in a significant number of employees being unavailable to work, which can substantially impact ARMC’s ability to maintain necessary staffing levels and continue hospital operations. As a Level I Trauma Center and acute care hospital providing critical and specialized services, ARMC must maintain sufficient qualified personnel to ensure continuity of patient care, legal compliance, and protect patient health and safety. Agreements with workforce staffing agencies provide ARMC with access to qualified temporary personnel when needed to maintain essential hospital services, appropriate staffing levels, and continued access to patient care during labor-related staffing disruptions.
ARMC received notice of planned labor activity on October 16, 2026, that may result in workforce shortages. This limited notice may not provide sufficient time to obtain Board approval of staffing agreements before replacement or supplemental personnel are needed. The authorization will allow ARMC to respond promptly to staffing needs, maintain continuity of hospital operations and legal compliance, and ensure that patient care and access to critical hospital services are not disrupted.
ARMC recommends that the ARMC CEO be authorized to execute the necessary staffing services agreements, if needed, which may contain non-standard County terms or may omit certain standard County contractual provisions, and that the ARMC CEO also be allowed to execute amendments upon consultation with County Counsel, as needed, so the County is able to meet patient needs and ensure patients have timely access to specialized hospital services. Pursuant to Recommendation No. 2, the ARMC CEO will submit any agreement or amendment executed pursuant to Recommendation No. 1 to the Board for ratification at the next available meeting.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Scott Runyan, Principal Assistant County Counsel, and Charles Phan, Supervising Deputy County Counsel, 387-5455) on October 19, 2026; Human Resources (Leonardo Gonzalez, Director, 387-5570) on October 19, 2026; and County Finance and Administration (Jenny Yang, Administrative Analyst, 387-4884) on October 19, 2026.