REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 23, 2026
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Amendment to Agreement with Howmedica Osteonics Corp. for Orthopedic Implants for Surgical Patients
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 4 to Agreement No. 25-148 with Howmedica Osteonics Corp., for the provision of orthopedic implants for surgical patients, increasing the contract amount by $2,000,000, from $1,450,000 to a total not-to-exceed amount of $3,450,000, with no change to the contract term of January 5, 2024 through January 4, 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 $2,000,000 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) 2025-26 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
Amendment No. 4 to Agreement No. 25-148 (Agreement) will allow ARMC to continue purchasing orthopedic products, including upper extremity, trauma, foot, ankle, and biologic implants for surgical patients. Since achieving Level I Trauma Center designation in mid-2024, ARMC has experienced a significant increase in the complexity and resource intensity of its orthopedic case mix. Higher-acuity, multi-system trauma injuries and more complex surgical procedures have increased implant utilization per case and require broader implant inventories to support intraoperative flexibility and patient care needs. Additionally, longer procedures require contingency implant availability to ensure intraoperative clinical adaptability and patient safety.
The requested increase is based on actual expenditures incurred during the first 20 months of use of the Agreement from August 2024 through March 2026, and projected implant utilization through the remainder of the contract term. The additional funding will allow ARMC to maintain access to necessary orthopedic implant inventory and support continued orthopedic and trauma surgical services.
On January 5, 2024, as the result of a non-competitive procurement, the Purchasing Department (Purchasing) approved Agreement No. 25-148 with Howmedica Osteonics Corp. (Howmedica) for the provision of orthopedic implants in the amount not to exceed $250,000 for the period of January 5, 2024 through January 4, 2029.
Many of the specialty products were previously purchased through a separate vendor, which was acquired by Howmedica. As a result, on June 20, 2024, Purchasing approved Amendment No. 1 to Agreement No. 25-148 to include the additional orthopedic products and increase the not-to-exceed contract amount by $400,000, from $250,000 to an amount not-to-exceed $650,000, with no change to the contract term of January 5, 2024 through January 4, 2029.
On March 11, 2025 (Item No. 10), the Board of Supervisors (Board) approved Amendment No. 2 to Agreement No. 25-148 to increase the contract amount by $600,000, from a not-to-exceed amount of $650,000 to a total not-to-exceed amount of $1,250,000, with no change to the contract term of January 5, 2024 through January 4, 2029.
On January 13, 2026 (Item No. 13), the Board approved Amendment No. 3 to Agreement No. 25-148 with Howmedica for the provision of orthopedic implants for surgical patients, updating the list of products available for purchase and increasing the contract amount by $200,000 from a not-to-exceed amount of $1,250,000 to a total not-to-exceed amount of $1,450,000, with no change to the contract term of January 5, 2024 through January 4, 2029. The increase approved at that time was based on the estimated cost of those additional products only.
ARMC recommends approval of the Amendment with Howmedica to provide for the safety, health and social service needs of County residents by ensuring continued access to specialty orthopedic implants necessary to support orthopedic and trauma surgical services and promote timely, safe, and effective patient care.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Daniella Hernandez, Deputy County Counsel, 387-5455) on May 21, 2026; Purchasing (Veronica Pedace, Buyer III, 387-2464) on May 21, 2026; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on May 29, 2026; and County Finance and Administration (Jenny Yang, Administrative Analyst, 387-4884) on June 5, 2026.