REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
November 17, 2026
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Non-Financial Participating Site Agreement Template for the Integrated Community Health Mobile Clinic Program
End
RECOMMENDATION(S)
Recommendation
1. Approve a revised non-financial Participating Site Agreement Template for the Integrated Community Health Mobile Clinic Program, for the delivery of on-site respiratory and medical services to the community, for a term not to exceed five years from the date of execution.
2. Authorize the ARMC Chief Executive Officer to execute individual Participating Site Agreements with participating sites for variable agreement periods as negotiated between the parties, which will not exceed a five-year period, subject to review by County Counsel.
(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 recommended agreement template is non-financial, and the costs for the provision of medical care services provided by the Arrowhead Regional Medical Center (ARMC) Mobile Medical Clinic Program are 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 have been included in ARMC’s 2026-27 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
Approval of the Participating Site Agreement Template for the Integrated Community Health Mobile Clinic Program will replace the prior approved Mobile Medical Clinic Site Agreement template and non-financial Breathmobile Program School Site Agreement template. The existing contracts will naturally expire at the end of their terms. Participants wishing to continue service will need a new executed agreement under the Integrated Community Health Mobile Clinic Program using the recommended template.
The Integrated Community Health Mobile Clinic Program brings mobile medical clinics and mobile respiratory care programs to County residents. The revised template will allow ARMC to operate in a broader range of community locations beyond schools, improving flexibility and access to care for County residents. The revisions also update the program designation to “Integrated Community Health Mobile Clinic Program” to reflect a more inclusive respiratory and medical care model. The changes will improve continuity of care, expand service availability for children and young adults, and better align the program with ARMC’s current service delivery model.
On August 25, 2020 (Item No. 11), the Board of Supervisors (Board) accepted a grant award from First 5 in the amount of $1,086,537, and approved funding Agreement No. 20-679 with First 5 for the Breathmobile, for the period of August 25, 2020, through June 30, 2023. ARMC’s Breathmobile has received grant funding support from Children and Families Commission’s First 5 Program since August of 2010. ARMC’s use of other funds, such as Medi-Cal, Medicare, private pay, co-payments, or private insurance, covers the cost of service provided to any child that does not qualify for First 5 funding. Through the establishment of school site agreements, ARMC’s Breathmobile will continue to provide services to children of all ages, with or without funding from First 5.
On September 14, 2021 (Item No. 10), the Board approved revised non-financial Master Mobile Medical Clinic Site Agreement between ARMC and various facilities to use their site for the purpose of providing mobile medical care services to County residents with a term beginning on the date of execution through September 13, 2026, with one two-year option to extend each individual agreement.
On June 28, 2022 (Item No. 18), the Board approved the non-financial Breathmobile Program School Site Agreement template for the provision of the ARMC Breathmobile at school and/or district sites, for a term of five years from the date of execution. The item also authorized the ARMC Chief Executive Officer to execute the template with schools and/or school districts, for the period July 1, 2022, through June 30, 2027, on behalf of the County, with non-substantive changes, subject to review by County Counsel.
On January 14, 2025 (Item No.16), the Board approved the revised School Site Agreement template for the Breathmobile Program to remove language that indicates the services are at no cost to the student. Additionally, the Board authorized the ARMC Chief Executive Officer to execute agreements with participating schools and school districts through June 30, 2027.
On June 18, 2025 (Item No.12), the Board approved non-financial Mobile Medical Clinic Site Agreement template between ARMC and various facilities to use their site for the purpose of providing mobile medical care services to County residents with a term beginning on the date of execution through September 12, 2030.
Approval of the Integrated Community Health Mobile Clinic Program Template will enable a broader term “Participating Site” to include locations beyond schools and current designated sites. The program combines both medical and respiratory into one mobile service.
Approval of Recommendation No. 2 will authorize the ARMC Chief Executive Officer to execute individual agreements with participating sites using the approved revised template, allowing ARMC to timely establish services at participating sites. The agreement will be effective for terms not to exceed five years from the date of execution, unless earlier terminated by the parties.
ARMC recommends approval of the revised Participating Site Agreement template to expand access to mobile medical and respiratory care services at community locations and support the continued provision of primary healthcare services to County residents.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Kaleigh Ragon, Deputy County Counsel, 387-5455) on October 1, 2026; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on October 21, 2026; and County Finance and Administration (Jenny Yang, Administrative Analyst, 387-4884) on October 26, 2026.