REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
June 2, 2020
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Agreement with Desert Regional Medical Center for Clinical Rotations in Neurosurgery
End
RECOMMENDATION(S)
Recommendation
Approve Agreement with Desert Regional Hospital, Inc. dba Desert Regional Medical Center, for clinical rotations of resident physicians in neurosurgery in the amount of $622,800, for the period of July 1, 2020, through June 30, 2025.
(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 this item will not result in the use of Discretionary General Funding (Net County Cost). The cost of $622,800 is funded by State Medi-Cal, Federal Medicare, private insurances, 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 the Arrowhead Regional Medical Center (ARMC) 2019-20 budget and will be included in future recommended budgets.
It is estimated that resident physicians will be paid approximately $124,560 annually for a five- year period when Desert Regional Medical Center (DRMC) conducts clinical rotations at ARMC.
|
Year |
Cost |
|
Year 1 |
$124,560 |
|
Year 2 |
$124,560 |
|
Year 3 |
$124,560 |
|
Year 4 |
$124,560 |
|
Year 5 |
$124,560 |
|
Total |
$622,800 |
BACKGROUND INFORMATION
Approval of this recommendation will provide for the health and safety of San Bernardino County residents by allowing DRMC resident physicians to obtain clinical experience, specifically in Neurosurgery, at ARMC to enhance training and improve patient care. It is customary for resident physicians to acquire specialty clinical knowledge at medical facilities other than their primary training facility. The other medical facilities offer the opportunity for resident physicians to gain experience caring for patients and performing procedures in specialties that their primary facility, in this case DRMC, may not offer or may offer at a lesser volume.
DRMC operates several accredited residency programs, and each program has specific requirements related to the number and types of patients for whom a resident must provide care. To meet the volume requirements, it is necessary to partner with other facilities, such as ARMC, to provide educational opportunities.
Under the clinical rotation agreement, DRMC remains the primary provider training site for the resident physicians. At ARMC, the resident physicians will receive specialty training in neurosurgery with an emphasis on complex spine, open vascular, neuro-endovascular and skullbase neurosurgery. Both ARMC and DRMC, have specifically stated their educational goals and objectives for the training program in Exhibit C of the agreement.
This Clinical Rotation Agreement is DRMC’s standard rotation agreement, as negotiated by the County, with the following non-standard contract terms:
Termination
• The County standard termination provision permits the County to terminate the Agreement for convenience with 30 days written notice without any limitations. This Agreement allows the County to terminate for any reason with 30 days notice, but in such event, any resident physician that is rotating at ARMC during the termination, must be given the opportunity to complete his/her rotation at ARMC, if able to do so within 90 days of the termination.
• Potential Impact: ARMC would continue to host and provide training to resident physicians, and reimburse DRMC for resident physician salaries and benefits, for up to 90 days beyond termination of the agreement.
Additionally, the agreement does not contain all of the standard insurance terms, but pursuant to County Policy No. 11-05, the Department of Risk Management can and has approved the non-standard insurance contract terms in this Agreement.
ARMC recommends approval of this clinical rotation agreement in neurosurgery to provide training for resident physicians to gain experience and provide patient care for the residents of San Bernardino County.
PROCUREMENT
This is a non-competitive affiliation agreement approved by Purchasing based on the specialized credentials of DRMC and the specialized training that ARMC can offer to their resident physicians in neurosurgery. The cost associated with the affiliation covers resident salaries and benefits when DRMC resident physicians are doing their clinical rotations at ARMC. Specifically, while DRMC will remain as the employer of the resident physicians during their time at ARMC, ARMC will reimburse DRMC for the resident physicians’ salaries and benefits. However, ARMC will be able to bill, through the supervising attending physician at ARMC, for the services rendered by the resident physicians.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Deputy County Counsel, 387-5455) on April 30, 2020; Purchasing Department (Jacqueline Ambrose, Lead Buyer, 777-0722) on May 8, 2020; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on May 6, 2020; Finance (Yael VerduzcoYael Verduzco, Administrative Analyst, 387-5285) on May 11, 2020; and County Finance and Administration (Matthew Erickson, County Chief Financial Officer, 387-5423) on May 17, 2020.