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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’ 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 239.8 full-time equivalent (FTE) home visitors in 2020. 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 48.6 FTE supervisors in 2020. 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 60 local agencies in 1 state in 2020.

US map with Health Access Nurturing Development Services service area highlighted


Families Served Through Evidence-Based Home Visiting in 2020

home visits provided
including 120,551 virtual visits
families served
children served

Child insurance status

88% Public

8% Private

4% None

Caregiver education

24% No HS diploma

40% HS diploma or GED

30% Some college or training

6% Bachelor's degree or higher

Child age

38% <1 year

58% 1-2 years

4% 3-5 years


3% Hispanic or Latino

Primary language

96% English

0% Spanish

4% Another language

Household income

68% Low-income status

32% Not low-income status

Caregiver age

24% ≤21 years

49% 22-29 years

26% 30-44 years

1% ≥45 years

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