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Model Profiles

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2023 Yearbook

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’ target population includes the following:

  • Families with low incomes, unstable housing, or who are unemployed
  • Unmarried mothers or single parents
  • Parents/caregivers with limited education
  • Families with a history of substance or tobacco use
  • Families facing challenges such as marital problems or inadequate social networks
  • Mothers with late or no prenatal care or history of abortion
  • Families with mental health issues

Who is implementing the model?

Home Visitors

HANDS was implemented by 280.5 full-time equivalent (FTE) home visitors in 2019. 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.


HANDS was implemented by 55.6 FTE supervisors in 2019. 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 61 local agencies in 1 state in 2019.

Families Served Through Evidence-Based Home Visiting in 2019

home visits provided
families served
children served

Caregiver age

27% ≤ 21 years

48% 22-29 years

24% 30-44 years

1% ≥ 45 years

Caregiver education

25% No HS diploma

39% HS diploma or GED

30% Some college or training

5% Bachelor's degree or higher


7% Hispanic or Latino

93% Not Hispanic or Latino

Household income

36% ≤ $10,000

58% $10,001-50,000

5% $50,001-100,000

1% ≥ $100,001

Child age

44% < 1 year

53% 1-2 years

3% 3-5 years

Child insurance status

80% Public

7% Private

13% None

Note • Percentages may not add to 100 due to rounding. • To protect confidentiality, race and ethnicity categories with 10 or fewer caregivers were replaced with *.