REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 9, 2026
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Professional Services Agreements for the Provision of Medical Services at Arrowhead Regional Medical Center
End
RECOMMENDATION(S)
Recommendation
1. Approve Professional Services Agreement, including non-standard terms, with California University of Science and Medicine to provide gastroenterology and hepatology services at Arrowhead Regional Medical Center, in the amount of $9,202,500, for the period of July 1, 2026 through June 30, 2029.
2. Approve Professional Services Agreement, including non-standard terms, with Mojave Radiation Oncology Medical Group, Inc. to provide radiation oncology services at Arrowhead Regional Medical Center, in the amount of $3,561,000, for the period of July 1, 2026 through June 30, 2029.
3. Approve Professional Services Agreement, including non-standard terms, with Arrowhead Pediatrics Medical Group, Inc., to provide neonatology medical services at Arrowhead Regional Medical Center, in the amount of $2,129,663, for the period of July 1, 2026 through June 30, 2029.
4. Approve Professional Services Agreement, including non-standard terms, with Valley Obstetrics and Gynecology Medical Group, Inc., to provide obstetrics, gynecology, maternal fetal medicine, and educational services at Arrowhead Regional Medical Center, in the amount of $15,758,664, plus variable costs, for the period of July 1, 2026 through June 30, 2029.
5. Direct the Clerk of the Board of Supervisors to maintain the confidentiality of the Professional Services Agreements in Recommendations Nos. 1 through 4 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). The total combined amount is $30,651,827, plus variable costs, is funded by State Medi-Cal, Federal Medicare, private insurance, 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 will be included in the Arrowhead Regional Medical Center (ARMC) 2026-27 and future recommended budgets.
BACKGROUND INFORMATION
Approval of this item will allow ARMC to continue providing specialty physician services through four Professional Services Agreements (Agreements) with California University of Science and Medicine, Mojave Radiation Oncology Medical Group, Inc., Arrowhead Pediatrics Medical Group, Inc., and Valley Obstetrics and Gynecology Medical Group, Inc. (Providers).
ARMC provides medical care and education programs through professional services agreements with specialized medical groups. These agreements support the delivery of essential specialty services in both inpatient and outpatient settings, including care for County residents, inmates, and juveniles.
The recommended Agreements provide continued access to gastroenterology and hepatology services, radiation oncology services, neonatology services, and comprehensive women’s health services, including obstetrics, gynecology, and maternal fetal medicine. These services include the diagnosis and treatment of complex medical conditions, support for the Neonatal Intensive Care Unit, and specialty physician coverage, consultations, and related clinical services.
The Agreements were negotiated by the parties and contain non-standard contract terms or omit
certain County standard contract terms as follows:
1. The County is required to defend and indemnify the Providers for medical malpractice and professional negligence.
• The County’s standard contract does not contractually require the County to indemnify its contractor under any circumstance.
• Potential Impact: By agreeing to indemnify the Providers, the County could be contractually waiving the protection of sovereign immunity. Claims that may otherwise be barred against the County, time limited, or expense limited could be brought against the Providers without such limitations and the County would be responsible to defend and reimburse the Providers for costs, expenses, and damages, which could exceed the total contract amount.
2. The Agreements do not require the Providers to meet all of the County insurance standards.
• The County’s standard contract requires contractors to carry appropriate insurance at limits and under conditions determined by County’s Risk Management Department.
• Potential Impact: The agreements do not include all of County standard insurance requirements. This means that the County has no assurance that Providers will be financially responsible for claims that may arise from the agreements, which could result in expenses to the County that exceed the total amount in the agreements.
3. The Agreements do not require Providers to indemnify or defend the County for claims that arise out of the acts or omissions of Providers, except for claims resulting from inaccurate and/or improper billing information furnished by Providers and relied upon by ARMC.
• The standard County contract requires contractors to indemnify, defend, and hold the County harmless from third party claims arising out of the acts, errors or omissions of any person.
• Potential Impact: Provider’s indemnity obligation is significantly more limited compared to the standard County general indemnity provision. In the event a claim arises that falls outside the scope of Provider’s limited indemnity obligation, the County could be financially responsible for the defense of the claim and any resulting judgment/settlement.
4. The termination without cause provision in the Agreements requires 120 days advanced
written notice.
• The County’s standard contract provides that either party may terminate the contract with 30 days’ written notice.
• Potential Impact: ARMC will need to be mindful of the additional notice period required to terminate the agreements.
5. Payment terms are 30 days.
• County standard payment terms are net 60 days.
• Potential Impact: County standard processing time is 60 days or more. Failing to pay within 30 days may result in a material breach of the agreements, which could allow Providers to terminate the agreements.
These Providers have a longstanding relationship with ARMC and have historically provided these services, supporting continuity of care and stability in clinical operations. Approval of the recommended Agreements will allow ARMC to maintain these services without interruption.
Pursuant to Health and Safety Code section 1457(c)(1), the records of a hospital or any other County medical facility 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 California Public Records Act for a period of three years following execution of a related agreement establishing rates of payment.
ARMC recommends approval of these Agreements to ensure continued access to essential specialty medical services.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Daniella Hernandez, Deputy County Counsel, 387-5455) on May 12, 2026; Risk Management (Arrissia Beaven, Staff Analyst II, 386-9030) on May 27, 2026; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on May 15, 2026; and County Finance and Administration (Jenny Yang, Administrative Analyst, 387-4884) on May 18, 2026.