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Model Profiles

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2023 Yearbook

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 functioning 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. All families are offered weekly home visits at the start of services. Family 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, if possible, but allows for families to enroll after the child is born. Programs are required 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 was implemented by 3,839 full-time equivalent (FTE) home visitors in 2021. 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 15–20 families.


HFA was implemented by 919.4 FTE supervisors in 2021. 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 582 local agencies across 38 states and the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands in 2021. HFA also operated outside the United States and its territories in Israel in 2021.


Families Served Through Evidence-Based Home Visiting in 2021

home visits provided
including 645,444 virtual visits
families served
children served

Child age

37% <1 year

41% 1-2 years

21% 3-6 years

Child insurance status

91% Public

7% Private

2% None

Primary language

76% English

19% Spanish

5% Another language

Caregiver age

24% ≤21 years

43% 22-29 years

32% 30-44 years

<1% ≥45 years

Caregiver education

29% No HS diploma

42% HS diploma or GED

22% Some college or training

6% Bachelor's degree or higher

Percentages may not add to 100 due to rounding.