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Healthy Families America allows for a great deal of flexibility at the program level. Thus there is much variability among programs and from state to state regarding program costs, budgets and funding sources. The cost of living varies from state to state; geographical difference can impact service delivery; and staffing models vary from program to program as they reflect the needs of the families being served by the program.

Following are some guidelines around these issues. This information comes from two main sources – an annual profile of program sites and a state systems survey. It is important to note that the figures represent averages, so each site or state may be somewhat different.


Q: What is the average cost per family per year?
The average cost is $3,348.1 The range is from $1,950 to $5,768. Programs differed in the methods used to determine costs per family. Most programs determined this figure by dividing their total budget by the number of families enrolled, served or unduplicated.


Q: How much is being spent in states on Healthy Families America?
State allocations for HFA range from $350,000 to over $40 million. Clearly expenditures within states are linked with the number and size of programs. The greater the number of programs in a state and/or the higher the number of families served in each program will impact how much money is allocated to Healthy Families America in a given state.


Q: What percentage of a state level budget goes directly to sites? To support state level activities?
According to survey results, approximately 95% of a state’s budget goes to sites. Respondents indicated that on average, 8% of the budget supports state systems activities such as evaluation, training, the provision of technical assistance, advocacy, etc. The percentage of support for state systems ranges from 2% to 20%.


Q: What are some of the critical start-up costs for a site?
There are many factors that a program should consider before beginning to serve families. These include at the very minimum paying salaries and benefits for staff providing assessment and home visiting services as well as a program manager/supervisor to provide oversight to the program. One of the tenets of Healthy Families America is a small caseload so determining staff size will hinge on the number of families being served.

Healthy Families America places a high priority on training, thus budgets should include adequate funding to ensure staff receive ongoing training. Staff also require travel reimbursements to provide services to families in the field. In addition, programs must account for overhead expenses such as rent, office and telecommunications supplies and expenses, computer hardware and software, any tools and/or trainings that might be required for evaluation purposes, and fees associated with affiliation and credentialing should be considered.

For more information on starting up an HFA program, get in touch with your Primary State Contact. Also available on the website is the Healthy Families America Site Development Guide, a comprehensive overview of the necessary steps to establish a program.


Q: Where can I get more information about Healthy Families America?
If you have additional questions about the program, please visit the website at www.healthyfamiliesamerica.org or call the national office at 312.663.3520.

Additional Funding Resources
For more information on the diversity of funding sources used to sustain HFA program throughout the country, download "How are Healthy Families America Programs Funded" and Healthy Families America: State of State Systems.

For more information on accessing funding sources to build and sustain your HFA program, please also access our Peer Mentoring Network Funding Section with access to those in the field with particular expertise in securing federal and state funding.

For more information on strategies for long-term funding, please see the National Association of Counties’ Proactive Funding Strategies for Home Visitation .


  1. Average derived from the 15 states who answered this question on the 2004 State Systems Survey


Copyright 2003-2008 PCA America. All rights reserved.

Healthy Families America is generously supported by the Freddie Mac Foundation, Doris Duke Charitable Foundation, and Ronald McDonald House Charities.

Healthy Families America is a trademark of PCA America.