Health Access Nurturing Development Services
Health Access Nurturing Development Services (HANDS) is a statewide home visiting program in Kentucky that provides assistance to overburdened parents during the prenatal period until their child is 3 years old. The model’s main goals are to promote healthy pregnancies and births, optimal child growth and development, safe homes, and family self-sufficiency.
What is the model’s approach to providing home visiting services?
Home visits take place weekly, beginning prenatally, until the child is 6 months old. After the child is 6 months old, visit frequency is determined by the family’s level of need. Services are offered until the child is 3 years old. HANDS requires families to initiate services prenatally or before the child is 3 months old.
HANDS’ service population includes the following:
- Families experiencing low incomes, unstable housing, or unemployment
- Caregivers who are unmarried or single
- Caregivers with limited access to education
- Families with a history of substance or tobacco use
- Families facing challenges such as marital concerns or inadequate social networks
- Caregivers with delayed or no prenatal care or history of abortion
- Families experiencing mental health concerns
Who is implementing the model?
Home Visitors
HANDS was implemented by 347 home visitors in 2025. Paraprofessional home visitors must have a high school diploma. Professional home visitors must have a bachelor’s or associate’s degree in a related field or be a registered nurse or social worker. Home visitor caseloads are weighted based on families’ needs; home visitors are expected to maintain an average weighted caseload of 38 to 40 families.
Supervisors
HANDS was implemented by 95 supervisors in 2025. The model requires supervisors to be an advanced registered nurse practitioner, registered nurse, or licensed social worker.
Where is the model implemented?
HANDS operated in 59 local agencies in 1 state in 2025.
Families Served Through Evidence-Based Home Visiting in 2025
Race
<1% American Indian Alaska Native
1% Asian
10% Black
<1% Native Hawaiian Pacific Islander
87% White
1% Multiple
0% Another race
Ethnicity
13% Hispanic or Latino
87% Not Hispanic or Latino
Caregiver age
33% ≤21 years
33% 22-29 years
34% 30-44 years
1% ≥45 years
Caregiver education
19% No HS diploma
43% HS diploma or GED
30% Some college or training
9% Bachelor's degree or higher
Household income
62% Low-income status
38% Not low-income status
Child age
48% <1 year
50% 1-2 years
2% 3-5 years
Child insurance status
87% Public
9% Private
4% None
Primary language
85% English
12% Spanish
3% Another language