REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
August 20, 2019
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
CalMedForce Program Grant Awards and Agreements
End
RECOMMENDATION(S)
Recommendation
1. Accept grant award and approve CalMedForce Awardee Grant Agreement with Physicians For A Healthy California in the amount of $225,000 annually for a four year grant program in the total amount of $900,000 for the period of July 1, 2019 through September 30, 2023, for the support of the training of primary and emergency physicians in California and for support funding for graduate medical education at Arrowhead Regional Medical Center’s Obstetrics and Gynecology Residency Program.
2. Accept grant award and approve CalMedForce Awardee Grant Agreement with Physicians For A Healthy California in the amount of $225,000 annually for a three year grant program in the total amount of $675,000 for the period of July 1, 2019 through September 30, 2022, for the support of the training of primary and emergency physicians in California and for support funding for graduate medical education at Arrowhead Regional Medical Center’s Internal Medicine Residency Program.
3. Accept grant award and approve CalMedForce Awardee Grant Agreement with Physicians For A Healthy California in the amount of $75,000 annually for a three year grant program in the total amount of $225,000 for the period of July 1, 2019 through September 30, 2022, for the support of the training of primary and emergency physicians in California and for support funding for graduate medical education at Arrowhead Regional Medical Center’s Family Medicine Residency Program.
4. Accept grant award and approve CalMedForce Awardee Grant Agreement with Physicians For A Healthy California in the amount of $375,000 annually for a four year grant program in the total amount of $1,500,000 for the period of July 1, 2019 through September 30, 2023, for the support of the training of primary and emergency physicians in California and for graduate medical education at Arrowhead Regional Medical Center’s Emergency Medicine Residency Program.
(Presenter: William L. Gilbert, Director, 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 the Recommendations does not impact Discretionary General Funding (Net County Cost) as the $3,300,000 awarded grant funds detailed below do not require matching funds. The grant funding will be used to support direct costs including resident and faculty salaries, simulation training, ultrasound equipment and training, faculty development, and resident and faculty travel expenses for presenting at local, regional, and national conferences as part of the program’s scholarly activity requirements. Approval of the necessary budget adjustment’s to the Arrowhead Regional Medical Center (ARMC) is not requested at this time, but will be included on a future quarterly countywide budget report presented to the Board of Supervisors and will be included future recommended budgets.
|
Year |
Obstetrics and Gynecology |
Internal Medicine |
Family Medicine |
Emergency Medicine |
Annual Grant Total |
|
1 |
$225,000 |
$225,000 |
$75,000 |
$375,000 |
$900,000 |
|
2 |
$225,000 |
$225,000 |
$75,000 |
$375,000 |
$900,000 |
|
3 |
$225,000 |
$225,000 |
$75,000 |
$375,000 |
$900,000 |
|
4 |
$225,000 |
|
|
$375,000 |
$600,000 |
|
Total |
$900,000 |
$675,000 |
$225,000 |
$1,500,000 |
$3,300,000 |
BACKGROUND INFORMATION
Approval of Recommendations will accept four CalMedForce grants awarded by Physicians For A Healthy California (PHC), as specified in the grant applications, to support the specific Residency programs funded by the grants. More specifically, approval of the grant award agreements will allow ARMC to use the funding from the grants to support the educational training of the Obstetrics and Gynecology, Emergency Medicine, Internal Medicine, and Family Medicine Residency Programs.
The California Healthcare, Research and Prevention Tobacco Tax Act of 2016 (Proposition 56) was approved by voters and allocates $40 million of funding towards Graduate Medical Education (GME) to sustain, retain, and expand California residency positions in primary care and emergency medicine. All accredited residency programs in the state meeting the guidelines set forth in Proposition 56 are eligible to apply for funding. The University of California is the designated recipient of the funding and has contracted with PHC to administer the annual $40 million in grants allocated from Proposition 56.
On January 14, 2019, ARMC submitted four CalMedForce grant applications for its Obstetrics and Gynecology, Emergency Medicine, Internal Medicine, and Family Medicine Residency Programs. ARMC inadvertently did not request and receive approval from the Chief Executive Officer (CEO) prior to submitting the grant applications. Pursuant to County Policy Nos. 05-13 and 05-13SP1, on August 6, 2019, the CEO ratified ARMC’s submittal of the grant applications. ARMC has since implemented additional processes to ensure future compliance with grant application procedures identified in County Policy Nos. 05-13 and 05-13SP1. The purpose and scope of work for the grants are to support the training of primary care residents at ARMC over the next three and four years depending on the length of the program. The applications were developed in coordination with program leadership following the guidelines established by PHC.
On January 30, 2019, ARMC received notice of award for all four grants. However, ARMC did not receive the grant award contracts from PHC until June 18, 2019. PHC is unable to change the start date as it has to coincide with the academic year, which starts July 1. PHC has approved ARMC to submit the signed agreements after Board of Supervisors’ (Board) approval is obtained without any affect to the award amounts. This item is being presented at this time as this is the first date available after the required administrative, operational, and legal reviews.
PHC is authorized by Proposition 56 and the University of California to issue grants for the purpose of increasing the number of primary care and emergency physicians trained in California (“Purpose”). Use of the grant funding will support and provide for the safety, health and social services needs of County residents, as the goal of the grant funding is to sustain, retain, and expand graduate medical education programs to achieve the Purpose, based on demonstrated workforce needs and priorities.
The grant agreements incorporate by reference the State’s travel restriction in AB 1887, as follows:
California law AB 1887 also imposes restrictions on the use of state funds to travel to states that authorize discrimination or repeal existing laws prohibiting discrimination based on sexual orientation, gender identity and gender expression. An up- to-date list of all of banned travel states can be found at <https://oag.ca.gov/ab1887>. Grantees must comply with this rule for any/all grant-related travel using state funds.
The grant award agreements also include the following indemnification provision:
Each party shall indemnify, defend and hold harmless the other party, its officers, employees, and agents from any and against any and all liability, losses, or expenses (including reasonable attorney’s fees), or claims for injury or damages arising out of the performance of this Agreement, but only in proportion to and to the extent such liability, loss, expense, attorney’s fees, or claims for injury or damages are caused by or result from the negligent or intentional acts or omissions of the indemnifying party, its officers, agents or employees.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Scott Runyan, Deputy County Counsel, 387-5455) on July 25, 2019; Finance (Amanda Trussell, Principal Administrative Analyst, 387-4773) on August 7, 2019; and County Finance and Administration (Katrina Turturro, Deputy Executive Officer, 387-5423) on August 7, 2019.