The HFA model is scalable to meet local needs. We have HFA sites serving rural areas with one or two Family Support Specialists and large urban sites with more than 100 Family Support Specialists — and everything in between!
Family Support Specialists usually serve up to 20 families at a time (typically fewer in their first few years)
The largest cost of implementing any home visiting program, including HFA, is in personnel expenses (home visiting staff, supervisor and manager wages and benefits). The total cost includes personnel, non-personnel, accreditation and training fees, and data collection. Less than 5% of a site’s annual budget goes to HFA national for training and accreditation fees. See our budgeting calculator to determine your specific cost.
Sites must be able to offer services for a minimum of three years to families, which means their funding must be structured to cover that full period.
A local site is oftentimes working with multiple funding streams, doing the work of braiding it together to fully cover the workforce, including staff turnover.
State general revenue, other state or local revenue funds (such as tobacco taxes or opioid settlement funds, local tax levies, etc.), and required federal match funds (such as matching funds for MIECHV and Family First) are important sources of funding for home visiting. Oftentimes local sites have a combination of state funding as well as federal funding which states are responsible for administering.
These funding streams are all approved at a federal level, but largely controlled and administered at a state and local level.
The single largest source of federal funding dedicated to home visiting is the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV). The MIECHV program is a federal-state partnership that provides evidence-based home visiting services in all 50 states, the District of Columbia, and five US Territories. MIECHV is the cornerstone of evidence-based public policy and has widespread bipartisan support.
The Family First Prevention Service Act (Family First) of 2018 includes reforms to help keep children safe with their families and avoid entry into foster care. This is a historic law that, for the first time, provides flexibility for child welfare programming by allowing states, territories, and tribes the option of using federal Title IV-E funds within the Social Security Act before children enter the foster care system by utilizing important services such as mental health, substance use, counseling, and other in-home parent skill-based programs.
Temporary Assistance for Needy Families (TANF) is a federally-funded program that provides grant funds to states, tribes, and territories for a wide range of services that address economic disadvantage and child poverty. At the federal level, TANF is administered by the Department of Health and Human Services (HHS). However, benefits and services are provided by states, territories, and tribes, which have broad flexibility in how to administer and design their programs.
Medicaid is a joint federal-state program that provides health coverage to groups of low-income adults, children, people who are pregnant, and certain individuals with disabilities. As the primary health care program for low-income pregnant people and children, states seek Medicaid funding for their home visiting programs because these programs successfully promote positive health and well-being outcomes among these populations.
