a. Authorize the Interim Chief Executive Officer for Natividad Medical Center (NMC) or a designee to execute a nonstandard retroactive agreement with R1 RCM Holdco, Inc for billing and appeal process services at NMC for a maximum County obligation of $200,000 for the term of May 15, 2026 through May 14, 2028; and b. Authorize the Interim Chief Executive Officer for Natividad Medical Center or a designee to execute up to three (3) future amendments that do not in total exceed 10% ($20,000) of the original agreement, do not significantly change the scope of services, and do not increase the total not to exceed amount over $220,000; and c. Approve the NMC’s Interim Chief Executive Officer’s recommendation to accept non-standard indemnification, insurance, limitations on liability, and limitations on damages provisions within the agreement; and d. Approve the NMC’s Interim Chief Executive Officer’s recommendation to accept non-standard indemnification, insurance, limitations on liability, and limitations on damages provisions within the Business Associates Agreement, in substantially the same form as that which has been presented to the Board without significant change to its content, and subject to further review by and approval of County Counsel.

BoS Agreement Passed Introduced June 25, 2026

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