When parents are under significant stress, children, as well as society, too often pay a terrible price. Among the consequences for children are poor nutrition, low immunization rates, lack of school readiness and increasing rates of child abuse and neglect. As a society, we pay when we face a future in which poorly nurtured children become unproductive adults. 

Indeed, parenting is too often a responsibility that cannot be performed alone. It is imperative for communities to support overburdened families with resources so that parents can provide their children with a safe and supportive environment.  When these obstacles are removed and parents are supported in caring for their newborns, they are better equipped to nurture and enjoy their children’s growth and development.  

Helping new parents meet the challenges that surround the birth of their child is the focus of our Healthy Families America (HFA) initiative. Launched in 1992, in partnership with Ronald McDonald House Charities and the Freddie Mac Corporation, the HFA initiative is based on over two decades of research and the experiences of numerous communities nationwide. HFA’s growth over the years has exceeded all expectations. Today, there are over 300 programs in 40 states and the District of Columbia. 

HFA assists parents by assessing the needs of families prenatally or immediately after the birth of a baby and offering, on a voluntary basis, the services of a home visitor.  Home visitors are selected for their ability to develop trusting, nonjudgmental and supportive relationships with parents.  They work with families to identify strengths and specific needs, link them to health and social services, and provide family support and parenting education.  

In addition to working with families in the home, home visitors empower parents to access the resources they need to better care for themselves and their children. Home visiting is most effective when it is integrated into other community services. Whenever possible, HFA collaborates with existing local programs to provide more complete and comprehensive support for overburdened families. 

Formal partnerships have been established with over twenty organizations including the American Academy of Pediatrics; the National Association of Children’s Hospitals and Related Institutions (NACHRI); First Steps; the National Indian Child Welfare Association; the National Head Start Association; the National Black Child Development Institute; and the U.S. Department of Agriculture, Cooperative States Research Education and Extension Service. Through the support of these national partnerships, HFA’s goal is to provide universal home visitation for all new parents and intensive services for families most in need. Prevent Child Abuse America chapters and HFA programs also work directly with statewide affiliates of national partners to offer specialized services to their local communities. 
  
Last year we sponsored two major conferences. Our third annual HFA Conference was held in Chicago, with almost 800 professionals attending. In a new initiative, we explored the role of HFA in a managed care environment.  As a result, Prevent Child Abuse America in partnership with NACHRI, and with funding from the Baxter Allegiance Foundation, sponsored a Training Institute in Chicago. More than 125 representatives from Prevent Child Abuse America and the HFA network participated in the training along with representatives from 41 hospitals. The goal is to increase the number of children’s hospitals that promote and support HFA by serving as lead agencies or on task forces to develop HFA sites, house HFA sites, and provide training, technical assistance, and evaluation to HFA sites. 

In order to make an impact on child maltreatment rates, effective services must reach significant numbers of families.  With that purpose in mind, HFA is initiating and expanding program services across the country. HFA programs are being integrated into local communities and partnerships with existing service delivery systems are being created.  And in collaboration with Prevent Child Abuse America state chapters, HFA helps maintain and improve the quality of services families receive, while expanding the reach of its programs. 

To ensure the integrity of these community-driven efforts and expand the HFA initiative, Prevent Child Abuse America offers training and technical assistance to communities and state planning teams as they work to develop HFA programs.  Through various media, including conferences, seminars, telephone consultations, teleseminars, and publications, we continually support HFA efforts. We also provide updates to our HFA network partners, sites, and state leaders through regular mailings. These mailings announce the latest research findings, upcoming conferences and events, and provide up-to-date information on HFA activities.  

Prevent Child Abuse America continues to conduct the “Train the Trainer Institutes” to develop a pool of certified state and national HFA Trainers. Our emphasis has been on developing in-state training teams to help states become self-sufficient.  Today, several states have the ability to train and support local HFA sites.  For example, last year three state training teams provided a total of 25 trainings in their own states. 

In addition, Prevent Child Abuse America continues to provide HFA primary training in a comprehensive program, which includes pre- and post-training technical assistance to new HFA sites.  In 1997, Prevent Child Abuse America arranged a total of 56 primary trainings nationwide that were provided by HFA certified trainers. 

As the number of programs grows, it becomes necessary to ensure that each program is following best practice standards to provide quality service over time.  Prevent Child Abuse America, with the Council on Accreditation of Services for Families and Children, identified critical elements necessary to the long-term success of the HFA initiative.  Prevent Child Abuse America also developed an assessment tool for use in monitoring and credentialing HFA sites. Only programs that have successfully completed the credentialing process will be entitled to continue using the trademarked HFA name.  In 1997, twenty-four programs were approved for a four-year credential as part of a pilot testing of the credentialing system.  Currently, Prevent Child Abuse America is in the process of a full scale roll-out of the credentialing system for individual HFA sites and entering the pilot phase for multi-site or state systems. 

Following the goals of our long-range plan, we have started to develop state and regional systems to sustain HFA in the future. This includes building and supporting state and regional teams to become more self-sufficient. Thus, information and technical assistance that were previously provided by the national office can be provided locally.  These efforts will result in quality, statewide and state funded HFA programs that meet the specific needs of each community.