MATERNAL AND CHILD HEALTH BRANCH

Today, the Your ʻOhana Network serves families across Hawaiʻi through community-based programs that promote health, safety, and early learning. The program tracks progress using federal Demonstration of Improvement (DOI) measures, which show positive results statewide. Families participating in home visiting report greater use of health care and developmental services, fewer reports of child maltreatment, and stronger parent-child relationships.

Home visitors continue to play a vital role by building trusting, respectful partnerships with parents and caregivers. Together, they help ensure that Hawaiʻi’s youngest children grow up healthy, safe, and ready to learn.

In 2024, Governor Josh Green declared Hawaiʻi a trauma-informed state, committing all departments, including those focused on health, education, and early childhood, to serve families with care, empathy, and healing. Your ʻOhana Network providers have strengthened their trauma-informed practices, giving family support professionals the tools and encouragement they need to help families recover, grow, and thrive.

Looking ahead, in 2026, the program will launch Infant and Early Childhood Mental Health Consultation (IECMHC) to further support home visitors and promote children’s emotional and relational well-being. This new effort will deepen the network’s focus on nurturing relationships, the heart of every healthy start.

Between 2018 and 2021, Hawaiʻi was one of a small number of states selected through a competitive federal process to receive a Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Innovation Award from the Health Resources and Services Administration (HRSA). The award supported the continued development of the Hawaiʻi Home Visiting Network (HHVN) as a coordinated statewide system connecting evidence-based home visiting models.

Funding from the Innovation Award strengthened the DOH role in providing training, technical assistance, and data monitoring. It also enhanced coordination among home visiting programs serving families in communities including ʻEwa/Waiʻanae, Hilo/Puna, Maui, Kalihi, and Kona.

Through this initiative, DOH and its partners expanded access for families with the greatest needs, modernized the Early Identification (EID) and referral systems, and built lasting capacity for consistent, high-quality service delivery. The Innovation Award period laid the groundwork for a unified statewide home visiting network and reinforced Hawaiʻi’s reputation as a national leader in building coordinated, evidence-based systems of family support.

With support from the federal MIECHV program and matching state funds, Hawaiʻi launched the Hawaiʻi Home Visiting Network (HHVN), also known as the Your ʻOhana Network. The new system brought together community organizations delivering evidence-based models such as Healthy Families America (HFA), Parents as Teachers (PAT), and Home Instruction for Parents of Preschool Youngsters (HIPPY).

Services returned to hospitals and neighborhoods, reconnecting families with home visiting and Early Identification (EID) supports. HHVN focused on ensuring quality and consistency across programs through shared training, data systems, and continuous quality improvement. These efforts rebuilt a coordinated statewide network grounded in research, collaboration, and respect for families.

In 2013, Hawaiʻi passed Act 91, establishing the Hawaiʻi Home Visiting Program in state law. The Act positioned Hawaiʻi to receive new federal funding through the Affordable Care Act and required the use of evidence-based home visiting models to support families with young children who were at risk for stress or other challenges.

Act 91 gave the Department of Health (DOH) formal authority to develop, coordinate, and expand home visiting services statewide. It also created a system for referrals from hospitals and community providers to evidence-based programs, ensuring that families could receive consistent, high-quality support wherever they lived.

The 2009 economic downturn deeply affected Hawaiʻi’s home visiting system. Severe budget cuts led to the closure of most Healthy Start sites across the state, and the Early Identification (EID) screening program in hospitals was suspended. Many long-time home visitors and community partners were forced to end services they had provided for decades.

To continue supporting families facing the greatest challenges, the Department of Human Services (DHS) maintained a smaller Enhanced Healthy Start program focused on families involved with Child Welfare Services.

At the same time, the State began preparing for a new chapter of home visiting through the federal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) initiative, which would soon help rebuild and strengthen services statewide.

During this period, Healthy Start continued to evolve as Hawaiʻi’s statewide home visiting and family support system. Independent studies by Johns Hopkins University, in partnership with the Department of Health (DOH), confirmed that the program helped reduce parental stress, strengthen parenting confidence, and connect families with needed health and social services.

Hawaiʻi invested in expanding training, supervision, and quality improvement for home visitors to ensure consistent, high-quality support for families. By the early 2000s, Healthy Start operated 17 sites statewide, reaching thousands of families each year through local partners.

In 2003, the Hawaiʻi State Legislature passed House Concurrent Resolution 9, establishing the Healthy Start Interagency Task Force to improve coordination among state agencies, service providers, and community organizations. This collaboration strengthened the foundation for a more integrated early childhood and family support system across Hawaiʻi.

In 1985, with strong support from the Hawaiʻi State Legislature, the Healthy Start Demonstration Project began in the ʻEwa District of Oʻahu. The project built on earlier work by the HFSC, offering a voluntary home visiting program for families with newborns who were experiencing high levels of stress or other challenges.

Every family that gave birth in the ʻEwa community was offered a brief screening soon after delivery. Families who wanted additional support were paired with a home visitor who provided parenting guidance, emotional encouragement, and help connecting to community resources.

An early evaluation found no confirmed cases of child abuse among the 241 families who participated in the pilot, and only a few reports of medical neglect. Families described feeling less stressed and more confident in caring for their children. The success of the ʻEwa pilot inspired the Legislature to expand Healthy Start to additional communities, setting the stage for a statewide program of family-centered support and home visiting.

In 1975, Hawaiʻi pediatrician Dr. Calvin Sia founded the Hawaiʻi Family Stress Center (HFSC) with support from the National Center on Child Abuse and Neglect. HFSC began as one of the first community programs in Hawaiʻi dedicated to helping parents build safe, nurturing homes for their children. The program introduced home visiting as a way to strengthen families through caring relationships and practical support rather than judgment or punishment.

At Kapiʻolani Maternity Hospital, now known as Kapiʻolani Medical Center for Women & Children, new mothers were offered a simple conversation about stress and family support soon after birth. When families wanted more help, trained home visitors came to their homes to listen, share parenting skills, and connect them with medical and social services. This caring, strengths-based approach became the foundation for home visiting in Hawaiʻi.

That same year, HFSC launched the Hana Like Home Visitor Program, a federally funded prevention project whose name means “to work together” in ʻŌlelo Hawaiʻi. The name reflected the program’s belief that families and helpers should stand side by side. Hana Like paired new and expectant parents with trusted community home visitors who offered encouragement, practical guidance, and access to resources. The program was implemented in partnership with community organizations such as Parents And Children Together (PACT), which helped bring services directly into neighborhoods through staff who understood the families they served.

Building on Hana Like’s success, the State Council on Child Abuse and Neglect, with guidance from HFSC, supported the creation of new family support programs on the neighbor islands beginning in 1976. These included Maui Family Support Services and Family Support Services of West Hawaiʻi, which adapted the home visiting approach for their local communities. Child & Family Service also became an early partner in expanding family-centered prevention services across the islands. Together, these early efforts created a network of community-based programs that shared a commitment to prevention, partnership, and early support, principles that later shaped Hawaiʻi’s statewide Healthy Start Program.