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Implementing Healthy Families America (HFA)®

Meets DHHS criteria for an evidenced based model

Prerequisites for Implementation

Last Updated

May 2015


Type of Implementing Agency

There are no national requirements for agency type; HFA sites are implemented by many different types of public and private agencies, including public health, mental health, education, child welfare agencies, Federally Qualified Health Centers, community-based nonprofit health and human service agencies, and as stand-alone entities.


Staffing Requirements

HFA has four primary staff positions: (1) family support staff who conduct home visits with families; (2) parent survey staff who conduct family and child assessments and sometimes screen families for enrollment in the program; (3) supervisors who provide administrative, clinical, and reflective supervision to family support and parent survey staff; and (4) program managers who oversee program operations, funding, quality assurance, and evaluation.


Staff Education and Experience

The HFA National Office requires that direct service staff (family support and parent survey staff) have a minimum of a high school diploma. It also requires that staff are selected based on their personal characteristics, including their experience working with or providing services to children and families; an ability to establish trusting relationships; acceptance of individual differences; their experience working with culturally diverse communities (that are present among the site’s target population); their knowledge of infant and child development; their ability to maintain boundaries between personal and professional life; and their reflective capacity. The HFA National Office requires all staff to complete mandatory HFA training.

The HFA National Office requires that supervisors have a minimum of a baccalaureate degree with three years of supervisory experience; or a master’s degree with clinical and reflective background, and Infant Mental Health Endorsement preferred.


Supervision Requirements

The HFA National Office requires one full-time supervisor for every six full-time direct service staff, although a ratio of 1 to 5 is preferred.

The HFA National Office requires each direct service staff member receive a minimum of 1.5 to 2.0 hours of individualized supervision per week to provide them with skill development and professional support and hold them accountable for the quality of their work. Supervisory sessions include administrative, clinical, and reflective supervisory practices. Additionally, supervisors shadow direct service staff at least once per year to monitor and assess their performance and provide constructive feedback and development.


Staff Ratio Requirements

The HFA National Office requires that one home visitor serve no more than 15 families when all are receiving weekly visits or 25 families when receiving less frequent visits. In many instances, the caseload may need to be reduced to accommodate families with multiple needs or to accommodate communities in which there are long distances between home visits.


Data Systems/Technology Requirements

The HFA National Office recommends that affiliated sites use an appropriately designed data system to manage and report the participant services they provide; site, community, and staff characteristics; funding sources; agency collaborations; and preliminary outcomes information. The HFA National Office requires sites to report aggregate information on family characteristics, services, and outcomes in the web-based HFA site tracker system, which is free to affiliated sites.



The information contained on this page was last updated in May 2015. HFA/8/7#devreferences"> Recommended Further Reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by the HFA National Office in April 2015. HomVEE reserves the right to edit the profile for clarity and consistency.