REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
August 18, 2026
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Amendment to Revenue Agreement with California Physician’s Service, Inc., dba Blue Shield of California
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 1 to Revenue Agreement No. 25-754 with California Physician’s Service, Inc., dba Blue Shield of California, including a non-standard term, for Arrowhead Regional Medical Center to provide healthcare services to eligible military beneficiaries, adding participation in the TRICARE program, with no change to the contract period of September 23, 2025 through September 22, 2027.
2. Direct the Clerk of the Board of Supervisors to maintain the confidentiality of Amendment No. 1 to Revenue Agreement No. 25-754, pursuant to Health and Safety Code section 1457(c)(1).
(Presenter: Andrew Goldfrach, ARMC Chief Executive Officer, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
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). Healthcare services provided to TRICARE beneficiaries by Arrowhead Regional Medical Center (ARMC) under the Revenue Agreement will be reimbursed in accordance with the federally established reimbursement methodologies set forth in the TriWest TRICARE Terms and Conditions. Adequate appropriation and revenue have been included in the ARMC 2026-27 budget and will be included in 2027-28 recommended budget.
BACKGROUND INFORMATION
On September 23, 2025 (Item No. 18), the Board of Supervisors approved the Agreement No. 25-754 (Agreement) with California Physician’s Service, Inc., dba Blue Shield of California (Blue Shield) to allow ARMC to provide healthcare services to eligible veterans through the Department of Veterans Affairs Community Care Network, which is administered by TriWest Healthcare Alliance (TriWest). Blue Shield works with TriWest to build provider networks and administer claims for certain federal healthcare programs.
Approval of Amendment No. 1 (Amendment) to the Agreement with Blue Shield will allow ARMC to participate in the TRICARE program (TRICARE) through the existing Agreement. TRICARE is a federally funded healthcare program that provides coverage for active-duty military personnel, retirees, and their eligible family members. Through participation in the TRICARE network, ARMC may provide covered inpatient, outpatient, emergency, behavioral health, and other healthcare services to eligible beneficiaries in accordance with program requirements.
This Amendment incorporates the TRICARE Terms and Conditions and expands ARMC’s participation under the existing Agreement to include TRICARE beneficiaries.
The TRICARE Terms and Conditions contain a non-standard County indemnity contract term, as follows:
The County is required to indemnify TriWest and the federal government from any and all claims arising from any acts or omissions in the provision of medical care provided under the Agreement to TRICARE beneficiaries.
• County standard contract terms do not impose any indemnification obligation on the County.
• Potential Impact: In the event that TriWest or the federal government (collectively, Indemnitees) is sued as a result of any act or omission of the County, including ARMC’s physicians, in the provision of medical services to TRICARE beneficiaries, the County is financially responsible for defending and indemnifying the indemnitees.
Pursuant to Health & Safety Code section 1457(c)(1), the records of a county hospital which reveal the rates of payment for health care services rendered by or purchased by the hospital are not considered public records subject to disclosure under the California Public Records Act or any other law requiring the disclosure of records for a period of three years following execution of a related contract establishing rates of payment.
ARMC recommends approval of this Amendment, including the non-standard term, to support continued access to healthcare services for military members, veterans, and their families within the community.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Daniella Hernandez, Deputy County Counsel, 387-5455) on June 4, 2026; Risk Management (Stephanie Pacheco, Staff Analyst II, 386-9039) on June 4, 2026; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on July 10, 2026; and County Finance and Administration (Jenny Yang, Administrative Analyst, 387-4884) on July 13, 2026.