Health System: Family Health Services (6240P)

Program Outcome Statement

Improve the health of children, families, and communities.

Program Services

  • Home Visting Services for Infants, Children, and Adults
  • Nutritional Support and Education
  • Care Coordination and Medical Support for Low-Income and Disabled Children
  • Immunizations for Children and Adults
  • Training and Technical Assistance for Pedriatric and Obstetric Medical Providers
  • Physical and Occupational Therapy for Disabled Children


Family Health Services (FHS) provides services to more than 30,000 low-income clients annually. FHS home visiting conducts approximately 15,000 home visits per year using evidence-based models to teach parenting and nutrition skills, provide education to  parents and caregivers regarding infant attachment and bonding, and link families to medical and other services as necessary. FHS nutrition programs serve more than 15,000 participants annually, providing nutrition education to mothers and children through school ages. FHS provides physical and occupational therapy to over 500 children per year with severe disabilities. FHS collaborates with community organizations, leads group efforts to improve community health, and staffs immunization clinics. Programs include California Children’s Services, Child Health & Disability Prevention Program, Oral Health Program, Home Visiting (Black Infant Health, Dad’s Program, Field-Nursing, Nurse-Family Partnership, Lead Program, and Prenatal-to-Three), Women, Infants and Children (WIC), and the Nutritional Education and Obesity Prevention Program (NEOP).

Percent of Mothers and Expectant Mothers Served by Home Visiting who are Screened for Depression Meeting Target

Percent of Infants Served by WIC who are Breastfed Exceeding Target

Percent of Live Births to SMC Residents that Were Low Birth Weight is Above Target

FY 2017-18 Mid-Year Story Behind Performance

Percent of mothers and expectant mothers served by Home Visiting who are screened for depression

We plan to update all staff on our progress with this performance measure to encourage staff to continue screening for depression.  We will review our current records to better understand why we might be missing assessments.  Some reasons for missed assessments include - client unavailable, client refused, client already served by Behavioral Health and Recovery Services (BHRS) and regularly screened by BHRS.  In the last fiscal year we also found that approximately 33 percent of clients referred to us do not engage, or only receive one home visit.  Clients may refuse ongoing services or may move out of county which is another reason for a missed opportunity to screen for depression. We plan to schedule joint meetings between FHS Home Visiting staff and BHRS Pre-To-Three and Partners Program staff to increase collaboration and encourage connection to BHRS services.  

Percent of infants served by WIC who are breastfed

In order to improve our breastfeeding rates, the following action items will be conducted: continued Breastfeeding Learning Days and procedures around standard education, an improvement event held in collaboration with Home Visiting during which International Board Certified Lactation Consultant nurses will assist at WIC sites to improve breastfeeding education, increased work within Black Infant Health (BIH) and WIC to train BIH nurses and community workers in standardized education.

Percent of live births to San Mateo County residents that were low birth weight

Low birth weight (LBW), defined as birth weight of less than 2,500 grams, is an important health outcome associated with significant long-term medical and developmental issues for the child, stress for families, and costs to the healthcare system. The Healthy People 2020 goal is to reduce LBW from 8.2 percent of live births in 2007 to 7.8 percent in 2020. FHS home visiting and nutrition services can be expected to have an impact on LBW among clients served in these programs. Over the next several years, our goal is to link birth certificate outcome data with client service data in FHS to determine the impact of our services on LBW.

Countywide, the overall percent of LBW live births decreased from 7.2 percent in 2010 to 6.5 percent in 2013, but by 2015 had risen back up to 7.5 percent. Among singleton births, the percent of LBW live births increased from 4.8 percent in 2013 to 5.4 percent in 2015. Multi-variable analysis of singleton births shows that race was the primary risk factor for LBW. There were no independent associations for other risk factors (age, region, late/no prenatal care, medical insurance and smoking during pregnancy). In 2015, Asian and Latina mothers had the highest increase in number of LBW births (26 and 33 additional LBW births); however, Latinas had 106 fewer births and Asian women had 179 additional births compared to 2013. Among multiple gestational births (i.e twins), LBW increased from 51 percent in 2013 to 58 percent in 2015. Multiple births comprise only four percent of all births in SMC.

In fiscal year 2016-17, 7.5 percent of infants were delivered at low birth weight, exceeding the Healthy People 2020 goal of 7.8 percent.  Fiscal year 2017-18 results will be provided as soon as data is available from the State.

Future Priorities

  • Deepen performance improvement and problem solving skills using LEAP tools and data in a meaningful way to achieve ongoing improvement in our programmatic and operational results;
  • Increase employee engagement at the leadership level to sustain and improve engagement across the division; and,
  • Implement a client satisfaction tool across all programs.
Author: Gina Wilson, Chief Financial Officer    Contact Email:     Last Updated: 01-29-2018