Healthy Families America
Healthy Families America (HFA) works with pregnant and parenting families of children prenatally up to age 5. The model is grounded in an infant mental health framework and aims to cultivate and strengthen nurturing parent-child relationships, promote healthy childhood growth and development, and enhance family well-being by reducing risk and building protective factors.
What is the model’s approach to providing home visiting services?
All families receive an initial assessment of risks, resilience, and opportunities for growth, which is used to tailor services to meet their specific needs. Families are offered weekly home visits at the start of services and progress criteria are then used to determine a family’s readiness to move to less frequent visits—from weekly to every other week, then monthly, and finally, quarterly.
Services are offered for a minimum of 3 years and up to 5 years. HFA recommends that services start prenatally or shortly after the child is born. Programs are expected to enroll at least 80 percent of families by the time the child is 3 months old. One exception is families referred from child welfare, whose children can be up to 24 months old at intake. Local programs have the flexibility to define their service populations based on community needs data.
Who is implementing the model?
Home Visitors
HFA’s local workforce included 4,099 home visitors in 2025. The model requires a
minimum of a high school diploma or equivalent for home visitors. The average caseload size for a full-time home visitor is 15 to 20 families.
Supervisors
HFA’s local workforce included 1,147 supervisors in 2025. HFA requires a master’s
degree, bachelor’s degree plus 3 years of experience, or less than a bachelor’s degree
with commensurate HFA experience for supervisors.
Where is the model implemented?
HFA operated in 595 local agencies across 37 states and the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands in 2025.
Families Served Through Evidence-Based Home Visiting in 2025
Race and ethnicity
1% American Indian Alaska Native
2% Asian
22% Black
32% Hispanic or Latino
<1% Middle Eastern North African
<1% Native Hawaiian Pacific Islander
34% White
4% Multiple
3% Another race
Child age
41% <1 year
44% 1-2 years
16% 3-5 years
Child insurance status
89% Public
8% Private
3% None
Primary language
67% English
26% Spanish
7% Another language
Caregiver age
19% ≤21 years
41% 22-29 years
40% 30-44 years
<1% ≥45 years
Caregiver education
26% No HS diploma
43% HS diploma or GED
23% Some college or training
8% Bachelor's degree or higher