REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 23, 2026
FROM
JANKI PATEL, Acting Director, Department of Public Health
SUBJECT
Title
Non-Financial Data Use and Disclosure Agreement with the California Department of Public Health, Office of Refugee Health for use of the Refugee Health Electronic Information Exchange System
End
RECOMMENDATION(S)
Recommendation
1. Approve non-financial Data Use and Disclosure Agreement with the California Department of Public Health, including non-standard terms, to access the Refugee Health Electronic Information Exchange System, effective for three years from execution by all parties.
2. Authorize the Director of the Department of Public Health to execute and submit subsequent non-substantive amendments to the non-financial Data Use and Disclosure Agreement, on behalf of the County, subject to review by County Counsel.
3. Direct the Director of the Department of Public Health to transmit all non-substantive amendments related to the non-financial Data Use and Disclosure Agreement to the Clerk of the Board of Supervisors within 30 days of execution.
(Presenter: Janki Patel, Acting Director, 387-9146)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Foster Sustainable Development Through Strategic Partnerships.
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
The item will not result in the use of Discretionary General Funding (Net County Costs) as the recommended Data Use and Disclosure Agreement with the California Department of Public Health (CDPH) is non-financial in nature.
BACKGROUND INFORMATION
The CDPH Office of Refugee Health provides federal funding to impacted local health jurisdictions to provide post-arrival health assessments to all new refugees coming to California. The Department of Public Health (DPH) has provided health assessments to newly arrived refugees in San Bernardino and Riverside Counties since 2014. DPH is required to enter health assessment results into the Refugee Health Electronic Information Exchange system (RHEIS).
RHEIS is a secure web-based application, established by the Office of Refugee Health for surveillance of communicable diseases, monitoring of chronic and mental health conditions, and to evaluate performance of contracted local health jurisdictions. RHEIS provides access to data reports, in real-time, as needed, for referring patients to primary health and mental health services providers and to evaluate overall program performance. CDPH requires a signed Data Use and Disclosure Agreement before granting DPH access to RHEIS.
On November 4, 2025 (Item No. 36), the Board of Supervisors (Board) approved Agreement No. 25-855 with CDPH for reimbursement of $153.93 per comprehensive health assessment and $29,165 in administrative costs for DPH to provide Refugee Health Assessment Program (RHAP) services for the period of October 1, 2025 through September 30, 2026.
The Data Use and Disclosure Agreement (Agreement) is a CDPH template that includes terms that differ from the standard County contract. Non-standard and missing terms include the following:
1. The Agreement requires the County to defend and indemnify CDPH for claims related to the use or disclosure of confidential information.
• The County standard contract does not include any defense or indemnification by the County of a contractor.
• Potential Impact: By agreeing to defend and indemnify CDPH, 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 CDPH without such limitations and the County could be responsible to defend and reimburse CDPH for costs, expenses, and damages.
2. The Agreement does not require CDPH to meet the County’s insurance standards as required pursuant to County Policies 11-05, 11-07 and 11-07SP.
• County policy requires contractors to carry appropriate insurance at limits and under conditions determined by the County’s Risk Management Department and as set forth in County policy and in the County standard contract.
• Potential Impact: The County does not have the assurance of specific insurance policies from CDPH that could cover any claims that may arise under the Agreement, which could result in expenses to the County that exceed the total Agreement amount.
DPH recommends approval of the non-financial Data Use and Disclosure Agreement, including non-standard terms, to ensure continued compliance with CDPH RHAP service requirements.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Adam Ebrigth, Deputy County Counsel, 387-5455) on June 3, 2026; Risk Management (Stephanie Pacheco, 386-9039) on June 5, 2026; and County Finance and Administration (Iliana Rodriguez, Administrative Analyst, 386-8392) on June 3, 2026.