REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
June 9, 2020
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Resident Affiliation Agreement with Loma Linda University Health
End
RECOMMENDATION(S)
Recommendation
Approve reciprocal Resident Affiliation Agreement with Loma Linda University Health, for resident physicians to obtain clinical experience at the respective facilities of Arrowhead Regional Medical Center and Loma Linda University Health, for the period of July 1, 2020, through June 30, 2025, at an estimated net cost of $4,978,390.
(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 reciprocal Resident Affiliation Agreement will not result in the use of Discretionary General Funding (Net County Cost). The estimated net costs of $4,978,390 are funded by State Medi-Cal, Federal Medicare, private insurances, and other departmental revenue. The total cost of this agreement is dependent upon the number of resident physicians assigned to each facility. Arrowhead Regional Medical Center (ARMC) will reimburse Loma Linda University Health (LLUH) for services provided by LLUH resident physicians at ARMC, and vice versa. It is estimated for the five-year period, ARMC will reimburse LLUH approximately $5,268,700 and ARMC will receive $290,310 from LLUH, respectively. Sufficient appropriation and revenue will be included in the ARMC 2020-21 recommended budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
This reciprocal resident affiliation agreement will allow ARMC and LLUH resident physicians to obtain clinical experience at the respective facilities in order to meet requirements for graduation and specialty board eligibility. ARMC and LLUH will reimburse one another for services provided by resident physicians at each of the facilities. The reimbursement amount varies dependent upon the number and level of resident physicians assigned to each of the facilities from the other. The resident affiliation agreement with LLUH will provide for the health and social services needs of County residents by ensuring that ARMC residents receive specialty clinical training and experience, resulting in the delivery of specialized medical care to ARMC patients.
Clinical experience is a requirement of residents enrolled in the ARMC Resident Programs. This resident affiliation agreement allows ARMC to provide a well-rounded educational program for its resident physicians and allows ARMC to work in a collaborative manner with LLUH. The volume and patient mix at LLUH will provide an appropriate educational opportunity to the ARMC resident physicians.
The residency programs at ARMC are accredited by the Accreditation Council of Graduate Medical Education (ACGME). These residency programs have specific requirements as to the numbers and types of patients to whom a resident physician must provide care. In order to meet these requirements, with respect to volume and types of patients, it is necessary to provide educational opportunities at other facilities to supplement those available at ARMC. These medical facilities offer the opportunity for resident physicians to gain experience caring for patients and performing procedures in specialties that ARMC may not offer, or have too few patients to provide sufficient experience. The volume and patient mix at LLUH will provide a suitable education opportunity to the ARMC resident physicians.
On May 9, 2015 (Item No. 9), the Board of Supervisors approved the reciprocal resident affiliation Agreement No. 15-219 with LLUH for resident physicians to obtain clinical experience at the respective facilities of ARMC and LLUH for the period of July 1, 2015, through June 30, 2020. ARMC has had active resident affiliation agreements in place with LLUH since 1979.
This resident affiliation agreement may be terminated by either party, for any reason, upon 90 days prior written notice to the other party. However, this agreement shall be immediately terminated by either party if the residency program at the other facility is unacceptable or found not to meet ACGME standards, or if the other party fails to maintain appropriate necessary licenses.
PROCUREMENT
Not Applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Michael Markel, Principal Assistant County Counsel, 387-5455) on May 12, 2020; ARMC Finance (Chen Wu, Budget and Finance Officer, 909-580-3165) on May15, 2020; Finance (Yael Verduzco, Administrative Analyst, 387-5285) on May 20, 2020; and County Finance (Matthew Erickson, Co. Chief Finance Officer, 387-5423) on May 25, 2020