Healthy Families America (HFA)^®

Healthy Families America’s (HFA) goals include reducing child maltreatment, improving parent-child interactions and children’s social-emotional well-being, and promoting children’s school readiness. Local HFA sites select the target population they plan to serve and offer hour-long home visits at least weekly until children are 6 months old, with the possibility of less frequent visits thereafter. Visits begin prenatally or within the first three months after a child’s birth and continue until children are between 3 and 5 years old. In addition, many HFA sites offer parent support groups and father involvement programs. Sites also can develop activities to meet the needs of their specific communities and target populations.

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Healthy Families America (HFA) is theoretically rooted in the belief that early, nurturing relationships are the foundation for life-long, healthy development. Building upon attachment and bio-ecological systems theories and the tenets of trauma-informed care, interactions between direct service providers and families are relationship-based, designed to promote positive parent–child relationships and healthy attachment, strengths-based, family-centered, culturally sensitive, and reflective.

HFA includes (1) screenings and assessments to determine families at risk for child maltreatment or other adverse childhood experiences; (2) home visiting services; and (3) routine screening and assessment of parent–child interactions, child development, and maternal depression. In addition, many HFA sites offer services such as parent support groups and father involvement programs. HFA encourages local sites to implement additional services such as these that further address the specific needs of their communities and target populations.

The HFA National Office does not require sites to use a specific curriculum; however, it does require that sites use an evidence-informed curriculum with (1) participant and family materials and (2) a facilitator’s manual with specific guidelines for delivering the curriculum and a focus on anticipatory guidance. The curriculum should address the HFA goals related to cultivating, strengthening, and nurturing parent–child relationships; promoting healthy childhood growth and development; and enhancing family functioning by reducing risk and building protective factors.

HFA seeks to engage parents facing challenges such as single parenthood; low income; childhood history of abuse and other adverse child experiences; and current or previous issues related to substance abuse, mental health issues, and/or domestic violence.

Individual HFA sites select the specific characteristics of the target population they plan to serve (such as first-time parents, parents on Medicaid, or parents within a specific geographic region); however, the HFA National Office requires that all families complete the parent survey (formerly the Kempe Family Stress Checklist), a comprehensive psychosocial assessment used to determine the presence of various factors associated with increased risk for child maltreatment or other adverse childhood experiences.

The HFA National Office requires that sites enroll families before the child’s birth or within three months of the child’s birth. After families are enrolled, HFA sites offer them services until the child’s third birthday, and preferably until the child’s fifth birthday.

Healthy Families America (HFA) is theoretically rooted in the belief that early, nurturing relationships are the foundation for life-long, healthy development. Building upon attachment and bio-ecological systems theories and the tenets of trauma-informed care, interactions between direct service providers and families are relationship-based, designed to promote positive parent–child relationships and healthy attachment, strengths-based, family-centered, culturally sensitive, and reflective.

HFA is the signature program of Prevent Child Abuse America (PCA America). The HFA National Office, located in Chicago, Illinois, provides support, technical assistance, training, affiliation, state or multisite system development, and accreditation services to HFA sites.

Several states and metropolitan areas have affiliated as an HFA state or multisite system. These systems have a central administration or other entity providing an infrastructure of support for HFA sites in a state or geographical region. The designated central administrative entity provides HFA training for staff at all sites, facilitates implementing the model, assists established sites in preparing for HFA accreditation, increases public awareness and advocacy, identifies potential funding streams, and evaluates services and outcomes. The HFA National Office provides support to each state or multisite system through guidance on best standards for the central administrative entity.

HFA seeks to engage parents facing challenges such as single parenthood; low income; childhood history of abuse and other adverse child experiences; and current or previous issues related to substance abuse, mental health issues, and/or domestic violence.

Individual HFA sites select the specific characteristics of the target population they plan to serve (such as first-time parents, parents on Medicaid, or parents within a specific geographic region); however, the HFA National Office requires that all families complete the parent survey (formerly the Kempe Family Stress Checklist), a comprehensive psychosocial assessment used to determine the presence of various factors associated with increased risk for child maltreatment or other adverse childhood experiences.

The HFA National Office requires that sites enroll families before the child’s birth or within three months of the child’s birth. After families are enrolled, HFA sites offer them services until the child’s third birthday, and preferably until the child’s fifth birthday.

HFA aims to (1) reduce child maltreatment, (2) improve parent–child interactions and children’s social-emotional well-being, (3) increase school readiness, (4) promote children’s physical health and development, (5) promote positive parenting, (6) promote family self-sufficiency, (7) increase access to primary care medical services and community services, and (8) decrease children’s injuries and emergency department use.

HFA includes (1) screenings and assessments to determine families at risk for child maltreatment or other adverse childhood experiences; (2) home visiting services; and (3) routine screening and assessment of parent–child interactions, child development, and maternal depression. In addition, many HFA sites offer services such as parent support groups and father involvement programs. HFA encourages local sites to implement additional services such as these that further address the specific needs of their communities and target populations.

The HFA National Office does not require sites to use a specific curriculum; however, it does require that sites use an evidence-informed curriculum with (1) participant and family materials and (2) a facilitator’s manual with specific guidelines for delivering the curriculum and a focus on anticipatory guidance. The curriculum should address the HFA goals related to cultivating, strengthening, and nurturing parent–child relationships; promoting healthy childhood growth and development; and enhancing family functioning by reducing risk and building protective factors.

HFA sites offer at least one home visit per week for the first six months after the child’s birth. After the first six months, visits might be less frequent. Visit frequency depends on families’ needs and progress over time. Typically, home visits last one hour.

HFA sites begin to provide services prenatally or at birth and continue through the first three to five years of the child’s life. Each local site determines—usually based on available funding—whether to extend services beyond three years.

HFA sites may implement enhancements to the model, as long as those enhancements do not compromise the site’s fidelity to the model as established in the HFA Best Practice Standards (rev. 2018). For example, some sites have included clinical staff to address substance abuse and depression. Any adaptations or proposed changes that compromise the site’s fidelity to the HFA model require a formal adaptation request, and any approval of such are the sole discretion of the HFA National Office and PCA America.

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.

All HFA sites must adhere to 12 critical elements that serve as the framework for developing and implementing the model. The 12 critical elements are put into operation as best practice standards with specific criteria for rating site compliance. Please contact the model developer for additional information about the critical elements.

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.

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 intended 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 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. In addition, Infant Mental Health Endorsement is preferred, but not required, for all supervisors.

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.

Before providing services, the HFA National Office requires affiliated sites to provide orientation training to supervisors, program managers, and direct service staff. The training includes information about the challenges faced by the community’s families, the local resources available to support those families, and staff safety and confidentiality. HFA core training is a mandatory four-day seminar delivered by nationally certified HFA trainers. The trainers provide separate trainings for family support staff (home visitors) and family resource staff. Supervisors and program managers attend each training and an additional day focused on administrative, clinical, and reflective supervision.

The HFA National Office requires staff to participate in ongoing professional development. Within 12 months of hire, supervisors, program managers, and direct service staff must complete wrap-around training on multiple topics. The HFA National Office offers affiliated sites more than 38 hours of distance learning modules and/or recorded webinars that meet all the mandatory training requirements within 3, 6, and 12 months of hire. Supervisors, program managers, and direct service staff must participate in annual ongoing training after the first year of employment based on staff need.

Healthy Families America National Office
Prevent Child Abuse America
228 S. Wabash, 10th Floor
Chicago, IL 60604

Phone:
 (312) 663-3520
Fax:
 (312) 939-8962
Email:
 hfamail@preventchildabuse.org
Website:
 http://www.healthyfamiliesamerica.org