REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
May 23, 2023
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Grant Agreements with the California Department of Health Care Access and Information for the Song-Brown Primary Care Residency Program Grant
End
RECOMMENDATION(S)
Recommendation
1. Approve Grant Agreement with the California Department of Health Care Access and Information, including non-standard terms, for the Song-Brown Primary Care Residency Program Grant to support Arrowhead Regional Medical Center’s existing Family Medicine Residency Program in the amount of $625,000, for the period of June 30, 2023 through August 31, 2026.
2. Approve Grant Agreement with the California Department of Health Care Access and Information, including non-standard terms, for the Song-Brown Primary Care Residency Program Grant to support Arrowhead Regional Medical Center’s existing Internal Medicine Residency Program in the amount of $250,000, for the period of June 30, 2023 through August 31, 2026.
3. Approve Grant Agreement with the California Department of Health Care Access and Information, including non-standard terms, for the Song-Brown Primary Care Residency Program Grant to support the expansion of Arrowhead Regional Medical Center’s Internal Medicine Residency Program in the amount of $900,000, for the period of June 30, 2023 through August 31, 2026.
4. Authorize the Director of Arrowhead Regional Medical Center to electronically execute the Grant Agreements identified in Recommendation Nos. 1 through 3, all required supporting materials, as well as any non-substantive amendments necessary, on behalf of the County, subject to review by County Counsel.
5. Direct the Director of Arrowhead Regional Medical Center to transmit the executed Grant Agreements and any amendments to the Clerk of the Board of Supervisors within 30 days of execution by all parties.
(Presenter: William L. Gilbert, Director, 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). The grant agreements will result in up to $1,775,000 of additional revenue to Arrowhead Regional Medical Center (ARMC). A match is not required from the County to receive the grant awards under the Song-Brown Primary Care Residency Program Grant (Song-Brown Program). Adequate appropriation and revenue will be included in the ARMC 2023-24 recommended budget and future recommended budgets.
BACKGROUND INFORMATION
The California Department of Health Care Access and Information (HCAI) works to increase and diversify California’s healthcare workforce through the Healthcare Workforce Development Division (HWDD) using funding initiatives such as the Song-Brown Program. The Song-Brown Program funds institutions that train primary care physicians to provide health care in California’s medically underserved areas. Competitive proposals for this grant funding were required to demonstrate a commitment to Song-Brown Program goals and success in meeting the following three statutory priorities:
• Attracting and admitting underrepresented minorities and those from underserved communities
• Training Physician Residents in underserved areas
• Placing graduates in underserved areas
On August 9, 2022 (Item No. 10), the Board of Supervisors (Board) approved grant applications to be submitted to HCAI on behalf of ARMC to support its residency programs in family medicine and internal medicine. On April 18, 2023, ARMC was informed by HCAI that its grant applications were approved and that ARMC would be awarded a total amount not-to-exceed $1,775,000 in funding. The family medicine residency grant will assist in funding five existing family medicine resident physician positions, while the internal medicine residency grant will assist with funding two existing resident physician positions and two additional positions. The Song-Brown Program grant funds will support the hospital’s effort to increase physicians in the underserved regions of the county.
In order for the County to accept the grant funds through the Song-Brown Program, HCAI requires the parties to enter into three separate grant agreements, which are non-negotiable. Although County Policy No. 11-05 does not apply to grant agreements, it should be noted that the grant agreements with HCAI contain the following significant terms that differ from the County standard contract terms:
1. The County must indemnify, defend, and hold harmless the State, its officers, agents, and employees from any claims arising out of the County’s performance under the agreements and for any third-party claims for injuries caused by the County.
• The standard County contract does not require the County to indemnify the vendor for any reason.
• Potential Impact: The County will be required, at the County’s cost, to defend and pay for any settlements or judgments arising out of any claims that are brought by a third-party against the State for damages or injuries caused by the County’s performance under the agreements.
2. The State has the ability to audit the County’s records for a period of up to three years after the termination/expiration of the agreements to ensure that the grant funds are spent in accordance with the terms of the grant program and agreements.
• The standard County contract does not include the ability for a vendor to audit the County’s records.
• Potential Impact: In the event that any State audit determines that the County utilized grants funds for a prohibited purpose, the County will be considered in breach of the agreements, and may be required to return any funds spent by the County back to the State.
ARMC recommends approval of the grant agreements with HCAI, including non-standard terms, for the Song-Brown Program as the funding will provide for the safety, health and social services needs of County residents by providing funding to support the education and training of primary care physicians serving in medically underserved communities.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Deputy County Counsel, 387-5455) on April 26, 2023; Risk Management (Victor Tordesillas, Director, 386-8623) on May 2, 2023; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on May 1, 2023; Finance (Jenny Yang, Administrative Analyst, 387-4884) on May 4, 2023; and County Finance and Administration (Valerie Clay, Deputy Executive Officer, 387-5423) on May 4, 2023.