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
Intergovernmental Transfer Agreement with the California Department of Health Care Services for the Medi-Cal Voluntary Rate Range Program
End
RECOMMENDATION(S)
Recommendation
1. Approve the Intergovernmental Transfer Agreement with the California Department of Health Care Services, to receive supplemental payments for Medi-Cal managed care capitation rate increases, and for the provision of an intergovernmental transfer assessment fee for administration of the intergovernmental transfer program during the State-established claim period of January 1, 2025 through December 31, 2025, for the agreement term of January 1, 2025 through June 30, 2028.
2. Direct the Clerk of the Board of Supervisors to maintain confidentiality of the Agreement 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). Under the terms of the agreement, Arrowhead Regional Medical Center (ARMC) will be eligible to receive supplemental payments resulting from Medi-Cal managed care capitation rate increases paid to Medi-Cal managed care plans for the service period of January 1, 2025 through December 31, 2025.
The County will first send funds to California Department of Health (DHCS) to cover the County’s share of the Medi-Cal Voluntary Rate Range Program (VRRP). DHCS will add federal matching funds and use the combined amount to increase payments to participating Medi-Cal managed care plans. The health plans will then make supplemental payments to ARMC. After ARMC receives those payments, ARMC will repay the County for the amount the County initially provided. Adequate appropriation and revenue have been included in the ARMC and Health Administration 2026-27 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
DHCS administers the VRRP, which allows eligible public entities, including the County, to provide the non-federal share of funding needed to increase certain Medi-Cal managed care capitation payments. Under this process, the County transfers public funds to DHCS through an IGT. DHCS combines the County funds with federal matching funds and directs the resulting funding to the participating Medi-Cal managed care plans. The plans then make supplemental payments to ARMC based on eligible services and member enrollment during the applicable service period.
Approval of this agreement authorizes ARMC’s participation in the DHCS VRRP for the January 1, 2025 through December 31, 2025 service period. DHCS’s administrative process includes reviewing claims and enrollment activity from the preceding calendar year. As a result, this recommended Agreement applies retroactively to the January 1, 2025 through December 31, 2025 service period. It will remain in effective through June 30, 2028 to allow sufficient time for reconciliation and final settlement.
The agreement with DHCS allows ARMC to receive supplemental payments resulting from Medi-Cal managed care capitation rate increases for enrolled patients. The agreement sets forth the conditions for the transfer and receipt of funds through the DHCS IGT program.
Pursuant to Health and Safety Code section 1457(c)(1) specific terms related to the rates of payment for health care services are not immediately subject to laws related to public records; therefore, the Clerk of the Board of Supervisors is directed to maintain confidentiality of this agreement.
ARMC recommends approval of the agreement as it will allow ARMC to operate in a fiscally responsible and business-like manner by working with the State to obtain reimbursements for the healthcare services it renders to certain County residents who are members of Medi-Cal managed care plans.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Supervising Deputy County Counsel, 387-5455) on July 28, 2026; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on July 28, 2026; and County Finance and Administration (Jenny Yang, Administrative Analyst, 387-4884) on July 29, 2026.