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Implementing Health Access Nurturing Development Services (HANDS) Program

Meets DHHS criteria for an evidenced based model

Prerequisites for Implementation

Last Updated

June 2015


Type of Implementing Agency

HANDS is implemented by Kentucky’s local public health agencies or a local health or human service agency that serves as a subcontractor to local public health agencies.


Staffing Requirements

Local implementing agencies employ a program coordinator, supervisor, parent visitor, a registered nurse or social worker visitor, a family support worker (professional or paraprofessional), and data entry personnel. In smaller sites these roles may be combined.


Staff Education and Experience

Kentucky regulations state that both professionals and paraprofessionals may serve as home visitors.

Paraprofessional home visitors must (1) be at least 18 years old; (2) complete training in family needs and strengths assessment, service plan development, home visiting, coordination of services, and evaluation; (3) have a high school diploma or equivalent; and (4) be supervised by a licensed public health nurse or social worker.

Professional home visitors and program coordinators may be (1) licensed public health nurses or registered nurses, (2) licensed social workers, (3) individuals with a bachelor’s or master’s degree in social work from an accredited program, (4) individuals with a bachelor’s degree in the social or behavioral sciences with at least one year of case management experience, or (5) individuals with an associate’s degree in early childhood education with training in home visitation.

The supervisor must be a licensed professional such as a nurse or social worker.


Supervision Requirements

Supervision is required weekly for all employees for a minimum of one hour for full-time employees and half an hour for part-time employees. The expectations of supervision are:

  • Skill development through home visit observation
  • Skill development through parent survey observation
  • Systematic chart review
  • Review and sign off on forms by licensed personnel
  • Evaluation of family needs by licensed personnel
  • Staff support to prevent turnover
  • Discussion of: caseload, engagement strategies, family strengths/concerns, family goal, follow-up plans, use of curriculum, parent-child interaction, and staff development
  • Tracking of completed/declined services and active/exits


Staff Ratio Requirements

Each home visitor is expected to complete three home visits per day. On average each home visitor works with 20 to 30 families.


Data Systems/Technology Requirements

Staff enter HANDS participant information such as demographics, birth information, health and social outcomes, and exit status into the HANDS 2.0 web-based data system.

HANDS sites and quality assurance staff also enter surveys and site review summaries, which provide real-time data to assist in monitoring program fidelity and annual reporting.

Billing and payment reports have been added to assist sites with monitoring monthly activity from each payment source.



The information contained on this page was last updated in June 2015. Recommended Further Reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by the HANDS program office on April 24, 2015. HomVEE reserves the right to edit the profile for clarity and consistency.