HANDs is a voluntary home visiting program designed to assist overburdened first-time parents at critical development points. Beginning in the prenatal clinic or hospital, parents are encouraged to obtain appropriate care. Pre- and post-natally, a trained para-professional or professional visits the home frequently to provide information, problem solve, facilitate parenting skill development, and assist in meeting basic needs such as housing, food, health care, and other required services. HANDS has been designed to replicate and expand on elements that have been shown through research to correlate with positive child and family outcomes. All of Kentucky’s 120 counties now offer the HANDS program, and it has become one of the largest early childhood home visitation program in the nation.