St. Vincent Mercy Medical Center will collaborate with Lucas County Children's Services, Lucas County Family Council, Children's Trust Fund, Northwest Ohio Family and Child Abuse Prevention Center and other Federal, State and local programs to develop a comprehensive child maltreatment prevention strategy. This collaborative group will leverage multiple funding streams to provide home visiting services. The planned project, Healthy Connections Home Visitation Project, will implement an enhanced Healthy Families America model. Planned enhancements will address existing concerns that partner violence, parent substance use, and depression are not adequately addressed if paraprofessional home visitors are not comfortable addressing these issues by: (1) using bachelor and master-prepared home visitors with expertise in substance use, maternal depression, and/or partner violence and (2) assigning home visitors to families based on their primary area of risk. St. Vincent will evaluate their project through a randomized control evaluation that compares the enhanced HFA model to usual care.