Inter-Departmental Correspondence

Health System



December 30, 2009


January 26, 2010







Honorable Board of Supervisors



Jean S. Fraser, Chief, Health System


Mary J. Hansell, Director, Family Health Services



Position Changes in the Women, Infants and Children Program




Adopt an Amendment to the Salary Ordinance to add and delete positions in the Family Health Services Division; and



Approve an Appropriation Transfer Request recognizing unanticipated revenue in the amount of $158,396 and increasing appropriations in the Women, Infants and Children Program for FY 2009-10.



The Women, Infants and Children (WIC) Supplemental Nutrition Program is USDA-funded through the California Department of Public Health (CDPH) and provides food vouchers, nutrition education, breastfeeding support and health referrals to low income pregnant women, mothers and their children up to the age of 5 years. Over the past two years, program participation has increased more than 15% as a result of the economic downturn. San Mateo County provides WIC benefits through the Family Health Services Division to approximately 14,800 participants per month.


The WIC Program Breastfeeding Peer Counselor Project provides support to new mothers encouraging breastfeeding as the healthy choice to prevent chronic disease and childhood obesity. Counselors work with all participant populations and specifically with populations identified as having lower rates of breastfeeding.



Beginning October 1, 2009, USDA and CDPH are providing San Mateo County with increased funding with a request to increase our caseload. To maximize the funding, it has been necessary to assess the skill mix of WIC staff. The Breastfeeding Peer Counselor Project funds have increased in line with other WIC funding. USDA has identified breastfeeding support as one of the priorities for increased funding to local WIC programs.


The salary ordinance changes herein represent the:

    The deletion of one position, and

    The addition of five positions.


Below is a summary of the requested salary ordinance changes to implement the personnel recommendations at Family Health Services:



Delete: 1.0 FTE Dietitian (S024)


Add: 0.50 FTE Community Worker II (G113) and 1.0 FTE Medical Office Assistant II (E417)


In order to adequately meet the State’s request to increase caseload and minimize the increase in the number of WIC positions, WIC staffing skill mix has been assessed, resulting in a need to increase front-line staffing to meet increased demand for services. High risk clients will continue to be served by the existing team of dietitians, maintaining a high level of quality services. This change represents a minimal increase in staffing costs which is covered by the increased revenue, and therefore no change in Net County Cost.



Add: Three 0.5 FTE Community Worker I – Unclassified (B183)


USDA is providing special funding to expand the current Breastfeeding Peer Counselor project within WIC. The funding is targeted at increasing the number of peer counselors to assist WIC mothers in successfully breastfeeding. The three additional counselors will increase the number of clients reached to continue to increase breastfeeding rates in the targeted communities. The cost of the additional three positions is covered completely by the increased revenue and there is no change in Net County Cost.


This Salary Ordinance Amendment has been reviewed and approved by County Counsel.


This Amendment contributes to the Shared Vision 2025 outcome of a Healthy Community by ensuring that the WIC program has staff with the skills to develop strategies that will promote healthy behaviors. It is anticipated that the percent of children who are breastfed will increase from 80% to 82%.


Performance Measure:


FY 2008-09


FY 2009-10


Percent of children served who are breastfed





WIC Program revenues have increased $374,029 annually for a new total of $2,984,797. The position changes are fully funded by the increased revenue, resulting in no change to Net County Cost. The Appropriation Transfer Request (ATR) accepts the portion of the unanticipated revenue that will be received in FY 2009-10 and appropriates $48,396 for the salary and benefits costs associated with the new positions and $110,000 for program improvement efforts to help support caseload increases such as education, training and marketing efforts and WIC office remodels. The remainder of the revenue increase will be appropriated in the Family Health Services FY 2010-11 Recommended Budget.