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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’ 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 209.1 full-time equivalent (FTE) home visitors in 2021. 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 50.4 FTE supervisors in 2021. 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 2021.


Families Served Through Evidence-Based Home Visiting in 2021

home visits provided
including 131,959 virtual visits
families served
children served


3% Hispanic or Latino

97% Not Hispanic or Latino

Primary language

95% English

5% Another language

Caregiver age

22% ≤21 years

50% 22-29 years

27% 30-44 years

1% ≥45 years

Child age

36% <1 year

57% 1-2 years

7% 3-5 years

Caregiver education

24% No HS diploma

41% HS diploma or GED

29% Some college or training

7% Bachelor's degree or higher

Household income

66% Low-income status

34% Not low-income status

Child insurance status

91% Public

4% Private

4% None

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