Title
Accept Maternal and Child Health Grant and Home Visiting Innovation Award (Districts: All)
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Overview
The County of San Diego (County) has long supported efforts to improve healthy births and reduce infant deaths. Title V funding from the California Department of Public Health helps the County provide services that support pregnant and parenting families. These services include improving access to prenatal and postpartum care, connecting families to medical providers, providing support for children with special health care needs, and supporting collaborative efforts to reduce preventable infant deaths.
The County also operates the California Home Visiting Program, which provides in-home support to families who may need extra help during pregnancy and early childhood. These services promote maternal health, child development, positive parenting, and school readiness. In 2025, the State offered additional funding to help local agencies test new approaches to home visiting. The County applied for this Innovation 3.0 award to better support families who face barriers accessing health care or staying engaged in home visiting services. In January 2026, the County received notice that it would receive this funding.
Today’s action requests the San Diego Board of Supervisors (Board) accept two funding awards to continue and expand essential services through Title V Maternal and Child Health grant funds of $320,491 for July 1, 2026-June 30, 2027, with the same amount expected each year through June 30, 2029. Also, to accept the Home Visiting Innovation funds for $600,000 for July 1, 2026-June 30, 2027, with the same amount expected each year through June 30, 2029.
This item supports the County vision of a just, sustainable, and resilient future for all, specifically those communities and populations in San Diego County that have been historically left behind, as well as our ongoing commitment to the regional Live Well San Diego vision of healthy, safe, and thriving communities. This will be accomplished by providing consistent and expanding support for families who need help to access health care.
Body
Recommendation by Chief Administrative Officer:
1) Waive Board Policy B-29, Fees, Grants, and Revenue Contracts-Department Responsibility for Cost Recovery, which requires prior approval of grant applications and full-cost recovery of grants.
2) Authorize the acceptance of Title V Maternal and Child Health Block Grant funding from the California Department of Public Health (CDPH), Maternal, Child, and Adolescent Health Division for $320,491 for July 1, 2026 through June 30, 2027, and subsequent annual allocations of $320,491 for the period of July 1, 2027, through June 30, 2029; and authorize the Chief Administrative Officer, or designee, to execute all required grant documents, including any annual extensions, amendments, and/or revisions thereto that do not materially impact or alter the services or funding level.
3) Authorize the acceptance of California Home Visiting Program State General Fund Innovation 3.0 funding from the California Department of Public Health, Maternal, Child, and Adolescent Health Division for a California Home Visiting Program Innovation grant for CDPH for $600,000 for the period of July 1, 2026, through June 30, 2027, and subsequent annual allocations of $600,000 for the period of July 1, 2027, through June 30, 2029, and authorize the Chief Administrative Officer, or designee, to execute all required grant documents, upon receipt, including any annual extensions, amendments, or revisions that do not materially impact or alter the services or funding level.
4) Authorize the Chief Administrative Officer, or designee, to apply for additional funding opportunities, if available, to improve health equity for San Diego County residents, with a focus on addressing the health of women of child-bearing age, pregnant and expecting parents, children, adolescents, and families in San Diego County.
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Equity Impact Statement
The County of San Diego (County) Maternal, Child, and Adolescent Health (MCAH) programs and the California Home Visiting Program (CHVP) help reduce health differences that affect families with the greatest needs. These programs support pregnant and parenting families by improving access to prenatal and postpartum care, connecting families to community resources, and providing in‑home support to promote healthy pregnancies, safe infant care, and healthy development.
The programs focus on communities that face the greatest barriers to care, including low‑income families, teen parents, and families with medical or other risk factors. Services are tailored to each family using best practices to ensure families receive care and support in ways that respect their backgrounds and needs.
MCAH and CHVP programs bring together community members, health providers, and other partners working with parents and infants to quarterly advisory board meetings. These meetings allow everyone to share the accomplishments and challenges that home visitors and families face to help ensure that services remain relevant, accessible, and responsive to community needs.
Sustainability Impact Statement
This item supports the County of San Diego (County) Sustainability Goal #1 to engage the community in meaningful ways; Sustainability Goal #2 to provide just and equitable access to County services; and Sustainability Goal #4 to protect the health and well-being of everyone in the region. Continued funding allows the County to maintain existing maternal and child health services and home visiting programs that families already depend on.
By keeping these programs in place and improving support for families, the County helps ensure pregnant and parenting families receive timely health care, child development screenings, and guidance that promotes healthy growth during early childhood. This contributes to long-term health, stronger family connections, and better outcomes for infants and young children.
The Maternal, Child, and Adolescent Health program and the California Home Visiting Program engage community partners through advisory boards and coordinated outreach efforts. These partnerships help connect families to resources, share information, and strengthen home visiting services across the region. Working together with community members and organizations supports resilient communities and reinforces the County’s ongoing commitment to healthy, safe, and thriving neighborhoods.
Fiscal Impact
Recommendation #2: Accept Title V Maternal and Child Health Services Block Grant Funding
Funding for this request is included in the Fiscal Year (FY) 2026-28 Operational Plan in the Health and Human Services Agency. If approved, today’s action will result in approximate annual costs of $1,964,540 and revenue of $773,220 in FY 2026-27 through FY 2028-29, for a total of approximately $2,319,660 in revenue. The funding sources are the Title V Maternal and Child Health Services Block Grant and Title XIX. A waiver of Board Policy B-29 is requested because the funding does not offset all costs. These unrecovered costs are estimated at $1,191,320 annually, which includes the matching requirement, the Title XIX component. The funding source for these costs will be existing Realignment. The public benefit for providing these services far outweighs the B-29 unrecoverable costs. There will be no change in net General Fund costs and no additional staff years.
Recommendation #3: Accept California Home Visiting Program Innovation 3.0 State General Funds Award
Funding for this request is included in the Fiscal Year (FY) 2026-28 Operational Plan in the Health and Human Services Agency. If approved, today’s action will result in approximate annual costs of $850,825 and revenue of $849,358 in FY 2026-27 through FY 2028-29, for a total of approximately $2,548,074 in revenue. The funding sources are the California Home Visiting Program State General Fund and Title XIX. A waiver of Board Policy B-29 is requested because the funding does not offset all costs. These unrecovered costs are estimated at $1,467 annually, as a result of the approved maximum allowed indirect rate percentage by CDPH. The funding source for these costs will be existing Realignment. The public benefit for providing these services far outweighs the B-29 unrecoverable costs. There will be no change in net General Fund costs and no additional staff years.
Business Impact Statement
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Advisory Board Statement
The Health Services Advisory Board voted to support the recommendations at its meeting on August 4, 2026.
Background
The County of San Diego (County) Health and Human Services Agency, Public Health Services (PHS), Maternal, Child, and Family Health Services (MCFHS) Branch is committed to improving the health of women of reproductive age, pregnant and expecting parents, infants, children (including Children, and Youth with Special Health Care Needs - CYSHCN), adolescents, and their families. This work is carried out through Maternal, Child, and Adolescent Health (MCAH) programs and initiatives that focus on key priorities, such as maternal morbidity and mortality, transition of care from pregnancy through the fourth trimester, infant mortality, prematurity, access to medical and dental care, mental health, and preconception and inter-conception health. The MCAH program services focus on five areas - Access to Quality Care and Services, Mental Health & Substance Use, Social Determinants & Family Supports, Physical Health & Prevention, Injury Prevention & Safe Environments. Beginning July 1, 2025, the California Department of Public Health (CDPH) MCAH Division expanded statewide priorities to amplify policy, systems, and environmental (PSE) strategies to reduce health inequities affecting the MCAH population. MCFHS has a long history of implementing MCAH core services and integrating PSE approaches into programs and collaborative initiatives, both internally and with community partners, to achieve sustainable improvements that meet the health needs of San Diego County communities.
To meet the MCAH requirements, the MCFHS team implements core services through a coordinated set of programs/initiatives and PSE-driven strategies. Among the programs offered are the Perinatal Care Network (PCN), which operates a MCAH toll-free line and coordinated referral system to connect pregnant individuals with Medi-Cal, prenatal care, and supportive resources. The Sudden Infant Death Syndrome (SIDS) program fulfills mandated services by providing safe-sleep education, grief and bereavement support, and prevention strategies. Additionally, the team advances PSE approaches by convening educational roundtables for health care professionals, the medical community, and community-based organizations. These activities strengthen support for CYSHCN, address adolescent health needs, and promote equitable, trauma-informed practices across service systems.
Highlights of MCFHS MCAH programs and initiatives outcomes from FY 2024-25 through FY 2025-26 include:
• PCN received 2,980 calls and helped pregnant individuals access Medi-Cal enrollment, prenatal care providers, and supportive services through the 24/7 toll-free phoneline, improving timely entry into prenatal care.
• SIDS program provided grief and bereavement support to 19 families and delivered safe-sleep education to 207 community partners, contributing to improved awareness of strategies that reduce the risk of SIDS and other infant deaths.
• CYSHCN Systems of Care initiative collaborated with 25 medical and service providers to assess local care coordination processes, resulting in the identification of the lack of operating room facilities for transitional age CYSHCN needing comprehensive dental treatment under anesthesia. This initiated 3 long-term coordination improvements including the promotion of hands-on experience for dental providers, engagement of Medi-Cal Managed Care Plans for collaborative solutions, and the development of resource guides and training for dental care providers and parents.
• Adolescent Health initiative collaborated with the Peer Education Project to deliver nutrition education directly to 270 students.
• Through oversight of the San Diego Childhood Obesity Initiative, MCAH supported the adoption, implementation, and assessment of Local School Wellness Policies in 9 districts.
To enhance and optimize efforts toward positive health outcomes for families, MCAH and the California Home Visiting Program (CHVP) goals are aligned. CHVP provides critical services to communities experiencing the greatest need for support, including low-income families, teen parents, and those with medical risk factors that might impede a healthy pregnancy. Families are referred to the CHVP by PCN, community-based organizations, birthing hospitals, and other agencies or providers who serve pregnant and postpartum women.
CHVP was created by the Patient Protection and Affordable Care Act of 2010. The Act requires participating counties to provide home visiting services that have shown evidence of effectively supporting families. Home visiting services are voluntary and offered to pregnant women or children from birth to age five. Services are designed to support families vulnerable to adverse childhood experiences such as child maltreatment, intimate partner violence, mental illness, and substance use. CHVP services focus on healthy moms, healthy babies, family needs, and building supportive communities.
Since 2012, the County has received non-competitive home visiting grant funding from CDPH to implement services to low-income, first-time mothers in the North Coastal and North Inland Regions of San Diego County. In subsequent years, CHVP funds have also been used to expand home visiting services to all regions and serve pregnant and parenting families until their child is 2 years old.
CHVP has two different grants that sustain home visiting services across the County. On January 24, 2023, the Board authorized acceptance of State funding to continue existing services. The total amount was $11,983,111 for five years, July 1, 2023, through June 30, 2028. The second grant is federal funding that goes to CDPH and then allocated to counties across California. This grant was most recently accepted on September 12, 2023. The Board accepted $4,746,340 for the funding period of July 1, 2023, through June 30, 2028.
CHVP outcomes from FY 24-25 through FY 25-26 include:
• Public Health Nurses (PHNs) provided 4,413 home visits to 416 families countywide, 81% of whom are enrolled in Medi-Cal.
• PHNs provided 943 referrals to connect families to medical services and 1877 referrals for non-medical services such as the Women, Infants, Children program, food banks, transportation, and housing assistance.
• 65% (270/416) of birthing parents received a mental health screening within one year of giving birth, exceeding the statewide Medi-Cal screening rate of 60%.
• 53% (189/359) of infants served received at least one developmental screening by age 1, nearly double the statewide Medi-Cal screening rate of 27%.
In 2025, the State offered additional funding to help local agencies test new approaches to home visiting. The County applied for the Innovation 3.0 award to better support families who face barriers accessing health care or staying engaged in home visiting services. In January 2026, the County received notice that it would receive this funding. CHVP will use this funding to develop and implement a program to reach vulnerable families who were referred to services but did not enroll in traditional home visiting services. This program will offer another choice of services to help ensure that families have access to essential health and social support, with a focus on:
• Connecting families to a medical and dental home,
• Utilizing preventive health care,
• Limiting gaps in health coverage, and
• Facilitating additional opportunities for families to receive ongoing support
and care coordination
The Title V MCH Block Grant and CHVP funding are the primary funding sources for the MCFHS Branch of PHS, MCAH programs, and are federally administered by the Health Resources and Services Administration. CDPH receives Title V MCH Block Grant and CHVP funding and distributes allocations to Local Health Jurisdictions, including the County. They determine how much each county receives based on their number of births, fetal and infant deaths, Medi-Cal factors, and risk factors for poor birth outcomes, such as low weight or preterm births. In San Diego County in 2023, Medi-Cal was the expected source of payment for 32% of approximately 36,000 births.
Today’s action requests the Board accept Title V Maternal Grant funding from the CDPH for $320,491 for July 1, 2026, through June 30, 2027, and a similar amount each year until June 30, 2027; and accept Innovation 3.0 funds of $600,000 annually from July 1, 2026, through June 30, 2029. MCH funds will support the health of women of child-bearing age, parents, infants, children, adolescents, and their families. Innovation 3.0 funding expands home visiting services by developing and implementing a program that establishes alternative support to families to improve their health outcomes.
Today’s action also requests to Waive Board Policy B-29, which typically requires full cost recovery for grants. These grants do not cover the entire program costs; however, the programs provide necessary public health benefits for families. Services ensure access to quality prenatal care and other resources. These services also support children with special health care needs and provide grief and bereavement services to families suffering sudden and unexpected infant loss.
Linkage To The County Of San Diego Strategic Plan
Today’s proposed actions support the Equity (Health) and Community (Quality of Life) initiatives in the County of San Diego 2026-2031 Strategic Plan as well as our commitment to the regional Live Well San Diego vision of healthy, safe, and thriving communities. This will be accomplished by ensuring that San Diego County has fully optimized its health service delivery system for women of childbearing age, infants, children, adolescents, and families.
Respectfully submitted,
Ebony N. Shelton
Chief Administrative Officer
Attachment(s)
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