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 Professional Services Agreement with California University of Science and Medicine for Cardiology Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 1 to Agreement No. 24-764 with California University of Science and Medicine, for cardiology services at Arrowhead Regional Medical Center, to increase cardiology coverage, and increase the total agreement amount by $4,065,594, from $17,881,000 plus variable costs to $21,946,594 plus variable costs, with no change to the agreement term of September 10, 2024 through December 31, 2027.
2. Direct the Clerk of the Board of Supervisors to maintain the confidentiality of Amendment No. 1 to Agreement No. 24-764, 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
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 $4,065,594, plus variable costs, 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 2027-28 recommended budget.
BACKGROUND INFORMATION
Approval of Amendment No. 1 will increase cardiology coverage at ARMC provided by California University of Science and Medicine (CUSM). Amendment No. 1 provides for the potential addition of an interventional cardiologist and cardiac electrophysiologist. An interventional cardiologist will only be added when certain performance metrics are met, and both the additional interventional cardiologist and the cardiac electrophysiologist may only be added after receiving written approval from the ARMC Chief Executive Officer. This will only occur when the number of cardiac cases exceeds the existing thresholds. The additional positions will allow ARMC to accommodate anticipated increases in demand for cardiology services. The increase of $4,065,594 represents the maximum amount payable under Amendment No. 1 if all additional positions are added during the remaining term. Funds for the additional positions will be spent only if and when the positions are added. Because cardiac case volumes are difficult to predict, approval of the maximum funding amount at this time will allow ARMC to quickly add the necessary positions and expand cardiology coverage when case volumes increase.
On August 20, 2024 (Item No. 9), the Board of Supervisors approved Agreement No. 24-764 (Agreement) with CUSM to provide inpatient and outpatient cardiology services at ARMC, in the amount of $17,881,000 plus variable costs, for the period of September 10, 2024 through December 31, 2027. The Agreement provides cardiology services for ARMC patients, including patients receiving care through the Level-1 Trauma Center, outpatient clinics, diagnostic services, cardiac catheterization lab, and Emergency Department.
ARMC recommends approval of Amendment No. 1 to support continued cardiology services at ARMC.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Supervising Deputy County Counsel, 387-5455) on September 11, 2026; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on September 14, 2026; and County Finance and Administration (Jenny Yang, Administrative Analyst, 387-4884) on September 16, 2026.