Implementing Healthy Families America (HFA)® Meets HHS Criteria

Implementation last updated: 2020

The information in this profile reflects feedback, if provided, from this model’s developer as of the above date. The description of the implementation of the model(s) here may differ from how the model(s) was implemented in the research reviewed to determine this model’s evidence of effectiveness. Inclusion in the implementation report does not mean the practices described meet the HHS criteria for evidence of effectiveness. Similarly, models described here may not all have impact studies, and those with impact studies may vary in their effectiveness. Please see the Effectiveness button on the left for more information about research on the effectiveness of the models discussed here.

Prerequisites for implementation

Type of implementing program

There are no requirements for agency type; many different types of public and private agencies are implementing the HFA model, including public health, mental health, education, child welfare agencies, federally qualified health centers, community-based nonprofit health and human service agencies, and stand-alone entities.

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Staffing requirements

HFA has four primary staff positions: (1) family support staff who conduct home visits with families; (2) family resource 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 family resource staff; and (4) program managers who oversee program operations, funding, quality assurance, and evaluation.

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Staff education and experience

The HFA National Office requires that direct service staff (family support and family resource staff) have a minimum of a high school diploma. It also requires that sites select staff 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 bachelor’s degree and either three years of supervisory experience or a master’s degree with a clinical and reflective background. The HFA National Office requires that program managers have a bachelor’s degree and either (1) three years of related experience or (2) a master’s degree. In addition, Infant Mental Health Endorsement is preferred, but not required, for all supervisors and program managers.

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Supervision requirements

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

The HFA National Office requires each direct service staff member to 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. Supervision sessions include administrative, clinical, and reflective supervision practices. In addition, supervisors shadow direct service staff at least twice per year to monitor and assess their performance and provide constructive feedback and professional development.

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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 might have to be reduced to accommodate families with multiple needs or to accommodate communities in which there are long distances between home visits.

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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.

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Implementation notes

The information contained on this page was last updated in April 2020. Recommended further reading lists the sources for this information. In addition, the HFA National Office reviewed the information contained in this profile for accuracy on February 13, 2020. HomVEE reserves the right to edit the profile for clarity and consistency.

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