REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
September 22, 2026
FROM
JANKI PATEL, Acting Director, Department of Public Health
SUBJECT
Title
Amendments to Contracts for Medical Care and Support Services Under Ending the HIV Epidemic: A Plan for America - Ryan White HIV/AIDS Program Parts A and B
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 4 to contracts with the following agencies, including a non-standard term, to continue providing medical care and support services under Ending the HIV Epidemic: A Plan for America - Ryan White HIV/AIDS Program Parts A and B, revising the payment terms and increasing the aggregate amount of the contracts by $687,782, from $8,327,786 to $9,015,568, with no change to the total contract period of March 1, 2023 through February 28, 2027:
1. AIDS Healthcare Foundation, Contract No. 23-64, increasing the contract amount by $17,079, from $1,059,895 to $1,076,974.
2. DAP Health, Contract No. 23-66, increasing the contract amount by $32,022, from $1,987,305 to $2,019,327.
3. Foothill AIDS Project, Contract No. 23-67, increasing the contract amount by $99,214, from $1,508,985 to $1,608,199.
4. Loma Linda University, Contract No. 23-68, increasing the contract amount by $539,467, from $3,771,601 to $4,311,068.
(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
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost). The amendments increase the aggregate contract amount by a total of $687,782, from $8,327,786 to $9,015,568. The $687,782 increase consists of $102,472 in additional funding from the final federal award for grant year 2026-27, and $585,310 in carryover funding from grant year 2025-26. The contract services are funded by the United States Department of Health and Human Services, Health Resources and Services Administration (HRSA). Adequate appropriation and revenue have been included in the Department of Public Health’s (DPH) 2026-27 budget.
BACKGROUND INFORMATION
The Ending the HIV Epidemic: A Plan for America - Ryan White HIV/AIDS Program Parts A and B (EHE) seeks to achieve the goal of reducing new human immunodeficiency virus (HIV) infections in the United States to less than 3,000 per year by 2030. The initiative promotes and implements four pillars to reduce HIV transmissions: Diagnose, Treat, Prevent, and Respond. HRSA launched EHE in 2019 to reduce HIV infections by scaling up key HIV prevention and treatment strategies. DPH acts as the lead agency for San Bernardino and Riverside counties and has been providing EHE services through contracted service providers since 2020. Approximately 1,983 unduplicated clients are served through EHE each year.
The activities of the EHE contractors include outreach to individuals who are infected with HIV, linking them to care and treatment, and re-engaging those who have stopped receiving care and or treatment. HIV treatment not only preserves the health of people with HIV but also reduces transmission.
On February 7, 2023 (Item No. 33), as a result of a formal procurement, the Board of Supervisors (Board) approved contracts with the agencies listed in the Recommendation to provide medical care and support services, in the aggregate amount of $2,552,000, for the period of March 1, 2023 through February 28, 2025.
On January 23, 2024 (Item No. 41), the Board approved Amendment No. 1 to the contracts with the agencies listed in the Recommendation to provide medical care and support services, increasing the aggregate amount of the contracts by $705,942, from $2,552,000 to $3,257,942, with no change to the period of March 1, 2023 through February 28, 2025.
On November 5, 2024 (Item No. 32), the Board approved Amendment No. 2 to the contracts with the agencies listed in the Recommendation to provide medical care and support services, increasing the aggregate amount of the contracts by $2,060,575, from $3,257,942 to $5,318,517, and extending the term for an additional year, for a total contract period of March 1, 2023 through February 28, 2026.
On December 16, 2025 (Item No. 79), the Board approved Amendment No. 3 to the contracts with the agencies listed in the Recommendation to provide medical care and support services, increasing the aggregate amount of the contracts by $3,009,269, from $5,318,517 to $8,327,786, and extending the contract period for one additional year, for a total period of March 1, 2023 through February 28, 2027.
Approval of Amendment No. 4 would increase the aggregate amount of the contracts by $687,782, from $8,327,786 to $9,015,568, with no change to the total contract period of March 1, 2023 through February 28, 2027.
The recommended amendment includes a non-standard term that differs from the standard County contract terms:
Payment terms are Net 30 days.
• County standard payment terms are Net 60 days.
• Potential Impact: County standard processing time is 60 days or more. Failing to pay timely may result in a material breach of the Agreement, which could allow the agency to terminate the Agreement and seek other legal remedies, which could include costs that exceed the Agreement amount.
Federal regulation 2 Code of Federal Regulations (CFR) section 200.305 requires pass-through entities to make reimbursement payments within 30 days of the payment request. Although the federal payment requirement applied previously, the Net 30 payment term was not incorporated into the contracts.
Amendment No. 4 adds the Net 30 payment term to align the contracts with federal requirements under 2 CFR section 200.305. DPH recommends approval of the amendments, including the non-standard term, to continue awarding under the Ending the HIV Epidemic: A Plan for America- Ryan White HIV/AIDS Program Parts A and B, while ensuring compliance with federal funding requirements.
Contractor performance is measured by review of monthly reporting and required data submission and an annual site visit by DPH staff to monitor compliance with the administrative, program, and fiscal terms and conditions of the contract.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Adam Ebright, Deputy County Counsel, 387-5455) on September 9, 2026; and County Finance and Administration (Guy Martinez, Principal Administrative Analyst, 386-5428) on September 10, 2026.