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[Federal Register: November 5, 1996 (Volume 61, Number 215)]
[Rules and Regulations]
[Page 57185-57227]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr05no96-13]

[[Page 57185]]

_______________________________________________________________________

Part III
Department of Health and Human Services

_______________________________________________________________________
Administration for Children and Families

_______________________________________________________________________
45 CFR Part 1301 et al.
Head Start Program; Final Rule
[[Page 57186]]
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
45 CFR Parts 1301, 1303, 1304, 1305, 1306, and 1308

RIN 0970-AB55
Head Start Program
AGENCY: Administration on Children, Youth and Families (ACYF),
Administration for Children and Families (ACF), HHS.
ACTION: Final rule.

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SUMMARY: The Administration for Children and Families is issuing this
final rule to implement the statutory provisions for establishing
Program Performance Standards for Early Head Start grantees and Head
Start grantee and delegate agencies providing services to eligible
children from birth to five years and their families as well as
pregnant women, and for taking corrective actions when Early Head Start
or Head Start agencies fail to meet such standards.
 
EFFECTIVE DATES: The effective date of these requirements is January 1,
1998. Nothing in this Part prohibits grantee or delegate agencies from
voluntarily complying with these regulations prior to the effective
date. The information requirements in Secs. 1304.20, 22, 23, 40, 50,
51, 55 and 60 in the rule shall go into effect on the latter of the
date on which they are approved by the Office of Management and Budget
or January 1, 1998. A document will be published in the Federal
Register announcing the approval date of the information requirements.
 
FOR FURTHER INFORMATION CONTACT: E. Dollie Wolverton, Head Start
Bureau, 202/205-8418.
 
SUPPLEMENTARY INFORMATION:
 
I. Summary
 
The Head Start program is authorized under the Head Start Act (the
Act), as amended (42 U.S.C. 9801 et seq.). Founded in 1965, the program
currently offers comprehensive services, including high quality early
childhood education, nutrition, health, and social services, along with
a strong parent involvement focus, to low-income children nationwide.
The overall goal of the program is to bring about a greater degree of
social competence in preschool children from low-income families.
Social competence refers to the child's everyday effectiveness in
dealing with both his or her present environment and later
responsibilities in school and life. It takes into account the
interrelatedness of cognitive, intellectual, and social development;
physical and mental health; and nutritional needs.
The Program Performance Standards have played a central role in the
Head Start program since the 1970s. They provide a standard definition
of quality services for the 2,112 community-based organizations
nationwide that administer Head Start as grantee or delegate agencies;
serve as a training guide for staff and parents on the key elements of
quality; articulate a vision of service delivery to young children and
families that has served as a catalyst for program development and
professional education and training in the preschool field; and provide
the regulatory structure for the monitoring and enforcement of quality
services in Head Start. Thus, their importance to the Head Start
program and to preschool education generally goes far beyond the
typical role of Federal regulations.
The authority for this final rule is sections 641A(a) and (d),
644(a) and (c), and 645A(h)(2) of the Head Start Act, as amended (42
U.S.C. 9801 et seq.). More specifically, the purpose of this final
rule, the first wide-ranging revision of the Program Performance
Standards in over 20 years, is to carry out the language in the 1994
amendments to the Head Start Act providing for an update of the Head
Start Program Performance Standards.
Key provisions in the 1994 amendments require a review of the
performance standards in order to bring them up to date, cover new
topics, and include services to low-income pregnant women and families
with infants and toddlers. In particular:
<bullet> The new section 641A provides that the Secretary must
establish, by regulation, performance standards covering: (1) A range
of services for children and families including health, education,
parental involvement, nutritional, and social services as well as
transition activities; (2) financial management and administration; and
(3) facilities. Subparagraph (a)(3)(C) of the new section provides that
the Secretary must review and revise, as necessary, the performance
standards in effect under prior law.
<bullet> The amendments further provide that any revisions should
not result in an elimination or reduction of requirements regarding the
scope or types of health, education, parental involvement, nutritional,
social, or other services to a level below that of the requirements in
effect on November 2, 1978.
<bullet> Section 641A(d) prescribes procedures for corrective
actions or termination to be taken with agencies which fail to meet the
standards described in subsection (a).
<bullet> Section 645A(h)(2) requires that the Secretary develop
program guidelines for Early Head Start, the newly authorized program
for low-income pregnant women and families with infants and toddlers,
and to publish performance standards for such programs.
 
II. The Head Start Program
 
The Head Start program served approximately 751,000 low-income
children and families in fiscal year 1995 through a network of 2,112
grantee and delegate agencies. (Delegate agencies have approved written
agreements with grantees to operate the program.) Grantee agencies are
funded through a direct Federal-to-local relationship, and include a
wide range of local agencies: Community Action Agencies, nonprofit
agencies, local governments, Tribal governments, and school districts,
among others. About 95 percent of the children in Head Start programs
are from low-income families (below the Federal poverty line); about 13
percent of the children have disabilities; and about 90 percent of the
children served are 3 or 4 years old. As described below, the 1994 Head
Start amendments created a new initiative within Head Start to expand
and focus on services to low-income pregnant women and families with
infants and toddlers.
Key principles of Head Start since its inception in 1965, and
reaffirmed most recently through a thorough review by the bipartisan
Advisory Committee on Head Start Quality and Expansion, include the
following:
<bullet> Comprehensive Services. To develop fully and to achieve
social competence, children and their families need a comprehensive,
inter-disciplinary approach to services including education, health,
nutrition, social services, and parent involvement. The range of
services available must also be responsive and appropriate to each
child and family's unique developmental, ethnic, cultural, and
linguistic experience and heritage.
<bullet> Parent Involvement and Family Focus. The Head Start
program is family centered and is designed to foster the parent's role
as the principal influence on the child's development and as the
child's primary educator, nurturer, and advocate. Local Head Start
programs work in close partnerships with parents to develop and utilize
parents' individual strengths in order to successfully meet personal
and family
 
[[Page 57187]]
 
objectives. In addition, parents are encouraged to become involved in
all aspects of Head Start, including direct involvement in policy and
program decisions that respond to their interests and needs.
<bullet> Community Partnerships and Community-Based Services. Head
Start programs are intended to be community-based, with different
specific models of service provision flowing out of the differing needs
of differing communities. In addition, the most effective Head Start
programs have always been, in the words of the Advisory Committee on
Head Start Quality and Expansion, ``central community institutions''
for low-income families, building linkages and partnerships with other
service providers and leaders in the community.
 
III. Legislative and Programmatic History
 
In May 1994, the President signed into law the Head Start
Reauthorization Act of 1994. This legislation, enacted with bipartisan
sponsorship and support, amended the Head Start Act to extend the
program authorization period through fiscal year 1998.
It also made a number of changes to ensure that all children and
families enrolled in Head Start are offered high quality services that
are responsive to their needs. The legislation built on the vision and
recommendations contained in Creating A 21st Century Head Start, the
report of the Advisory Committee on Head Start Quality and Expansion,
which was issued in December 1993.
The Secretary formed the Advisory Committee in June 1993 to look at
Head Start quality and program expansion issues. The Committee worked
for six months before issuing its report. The report included numerous
recommendations centered around:
<bullet> Striving for excellence in staffing, management,
oversight, facilities, and research;
<bullet> Expanding to better meet the needs of children and
families; and
<bullet> Forging new partnerships with communities, schools, the
private sector and other national initiatives.
In its report, the Advisory Committee reaffirmed the role and value
of the existing Head Start Program Performance Standards. However, it
also recommended that the standards be reviewed and revised to reflect
the changing nature of the Head Start population, the evolution of best
practices, program experience with the existing standards, and the
pending program expansion. Reviews in several specific areas were
recommended, including: Business practices and financial management;
staff levels and qualifications; developmentally appropriate curricula
and emergent literacy; transition services; mental health; nutritional
requirements; family services; parental roles; services for the
``birth-to-three'' population; transportation; and program
coordination. It also recommended the consideration of: (1) Standards
and systems in effect in other early childhood programs; (2) work in
other fields to establish outcome-based accountability systems; and (3)
the guiding principles of the Administration's National Performance
Review (i.e., increased responsiveness to clients and the minimization
of regulations and paperwork). As principles for the review effort, it
called for the promotion of quality, responsiveness to community needs,
and the strengthening and streamlining of the standards. Finally, it
advised consideration of the special needs and circumstances of
programs serving American Indians and migrant and seasonal farm
workers.
In making its general recommendations, the Advisory Committee noted
the dramatic changes that had occurred in the world of Head Start
families since 1965:
<bullet> The needs of poor children and families are more
complicated and urgent. Violence, substance abuse, homelessness, lack
of education, and unemployment are helping to make them so. At the same
time, more of the Head Start service population is coming from single-
parent families, increasing numbers of parents are working, and family
literacy is increasingly being recognized as an important service need.
<bullet> Over the past three decades, the landscape of community
services has changed dramatically. There are new roles and enhanced
capacities for serving young children and their families. Today, we
also have new knowledge about the attributes of services and supports
that are effective in changing long-term outcomes for young children,
new knowledge about the importance of the first three years of life,
and new knowledge and appreciation for the continuum of developmental
and comprehensive services that are often needed before school and into
the early years to help children succeed in school.
While the Advisory Committee found that Head Start has succeeded in
improving the lives of young children and their families, it cited some
areas wherein further improvements were possible. These include: (1)
Consistency in the quality of programs; (2) responsiveness to the
diverse needs of Head Start families; (3) addressing the large unmet
need for Head Start services; and (4) coordination of Head Start with
other early childhood programs and elementary schools.
The 1994 Head Start Amendments reflect similar concerns on the part
of the Congress. They include a number of provisions designed to
improve program quality, including new requirements with respect to
quality standards and program monitoring, technical assistance and
training, staff qualifications and development, and an allocation for
quality improvement activities. They also include a number of
provisions to expand the nature and scope of services and to make
programs more responsive to the needs of their service populations. For
example, they add new requirements with respect to family literacy
services and parental involvement, provide for an initiative for low-
income pregnant women and families with infants and toddlers (Early
Head Start), add requirements to facilitate the successful transition
of Head Start children to elementary school, and mandate a study of the
adequacy of full-day/full-year programs.
The amendments further provide that, in revising the current
Program Performance Standards and in developing new ones, the Secretary
must consult with experts in the fields of child development, early
childhood education, family services (including ``linguistically and
culturally appropriate services'' to children and families for whom
English is not the primary language), and administration and financial
management. They also require consultation with individuals with
experience operating Head Start programs.
Additionally, the amendments require that the Secretary take
several factors into consideration in developing the Program
Performance Standards. These include: Past experience with the existing
standards; changes over time in the Head Start service population;
developments in best practices with respect to child development,
children with disabilities, family services, program administration,
and financial management; projected needs related to Head Start
expansions; existing and potential standards and guidelines related to
the promotion of child health; changes in the population of eligible
children (including changes in family structures and languages spoken
in the home); and local policies and activities designed to ensure the
successful transition of Head Start children to elementary school.
 
[[Page 57188]]
 
The Advisory Committee on Services for Families with Infants and
Toddlers was formed by the Secretary of Health and Human Services in
July 1994 to advise and inform the Department on the development of
program approaches for the new Head Start initiative serving low-income
pregnant women and families with infants and toddlers (later named
``Early Head Start''). The Advisory Committee drew upon the experiences
of a number of different programs (such as the Comprehensive Child
Development Program, Parent and Child Centers, and Head Start Migrant
Programs), the insights provided by participants in over 30 focus
groups, three decades of research on child and family development, and
extensive consultations with experts and practitioners in the field.
In September 1994, the Advisory Committee on Services for Families
with Infants and Toddlers issued a formal statement setting forth both
its vision and goals and its recommendations for program principles and
cornerstones. It called for the development of a range of service
strategies that would support the growth of the young child within the
family and the growth of the family within the community. Thus, it
envisioned program approaches that were family-centered and community-
based. Its program principles included: (1) A commitment to excellence
in the quality of the services provided as well as in program
management; (2) the prevention and early detection of and early
intervention with problems; (3) the early, proactive, and ongoing
promotion of a child's healthy development; (4) the promotion of
positive, continuous relationships that nurture the child, parents,
family, and caregiving staff; (5) the promotion of parent involvement;
(6) the inclusion of children with disabilities and respect for
individual children and adults; (7) respect for home languages and
cultures; (8) responsiveness to the unique strengths and abilities of
the children, families, and communities served; (9) ensuring smooth
transitions; and (10) collaboration and the active pursuit of
partnerships with kindred programs.
On April 22, 1996, the Department of Education published a notice
of interpretation in the Federal Register in which the Assistant
Secretary for Elementary and Secondary Education interpreted section
1112(c)(1)(H) of Title I of the Elementary and Secondary Education Act
of 1965 to require, beginning in fiscal year 1997, that local
educational agencies choosing to use Title I, Part A funds to provide
early childhood development services to low-income preschool children
comply with the Head Start performance standards in 45 CFR 1304.21,
Education and Early Childhood Development. (Title I preschool programs
using the Even Start model or Even Start programs which are expanded
through the use of Title I funds are exempt from this requirement.)
Elsewhere in this issue of the Federal Register, the Assistant
Secretary has published a notice of interpretation regarding compliance
with this provision for the school year 1997-1998. For further
information on the applicability of the Head Start Program Performance
Standards to Title I programs, please contact the Director of
Compensatory Education Programs at the Office of Elementary and
Secondary Education, U.S. Department of Education, 600 Independence
Avenue SW., Portals Building, Room 4400, Washington, DC 20202-6132.
Telephone (202) 260-0826. Individuals who use a telecommunications
device for the deaf (TDD) may call the Federal Information Relay
Services (FIRS) at 1-800-877-8339 between 8 a.m. and 8 p.m. Eastern
time, Monday through Friday.
 
IV. Approach
 
A fundamental challenge that we addressed in developing this
regulation was to find the right balance between three important goals:
(1) Addressing the critically important new areas for regulation
identified in the statute; (2) maintaining quality and avoiding any
reduction in the level of services prescribed in the standards, as
mandated by statute; and (3) attempting to streamline the standards,
avoid regulatory burden, and encourage flexibility and innovation.
Our approach to identifying the right balance included wide-ranging
consultation with many different individuals and groups, consistent
with the statutory requirements at section 641(A)(a)(3) regarding the
consultations the Secretary had to undertake and the factors which the
Secretary must consider in developing the revised Program Performance
Standards. Following both the statute and the Administration's
regulatory revision principles, we offered extensive opportunities for
a wide range of interested parties to review and discuss the current
Program Performance Standards.
Over 70 focus groups were convened in 1994-1995 involving
approximately 2,000 individuals including subject experts, parents,
educators, technical assistance providers, local sponsors of Head Start
programs, Federal staff and persons with extensive program monitoring
experience. In addition, representatives from a wide array of national
organizations and agencies with particular interest in child and family
issues were consulted, as were staff in other Federal agencies
responsible for administering related programs and serving similar
populations.
Based on this broad consultation, as well as on the work of the
national Advisory Committees on Head Start Quality and Expansion and on
Services for Families with Infants and Toddlers, we developed the
following key elements of our approach to this regulation: (1) The
current Program Performance Standards should be reorganized to reduce
fragmentation and duplication, encourage holistic approaches, and
emphasize partnerships with families and communities; (2) a single set
of integrated standards for services from birth to age five should be
developed; (3) the regulation should focus on requirements that are key
to maintaining quality services and meeting new and emerging needs; and
(4) the least burdensome approach to maintaining quality and meeting
emerging challenges should be sought.
The Notice of Proposed Rulemaking (NPRM) was published in the
Federal Register on April 22, 1996 (61 FR 17754-17792) with a 60-day
public comment period. Over 1,100 comment letters were received,
containing nearly 15,000 comments. We believe that the large number of
comments received reflects the extensive consultation process which was
used in developing the NPRM. Many of the comments were from current
Head Start grantee and delegate agencies. Other commenters included:
National, Regional and State Head Start associations; State agencies;
and representatives of major professional associations and
organizations concerned with infants, toddlers and preschoolers. In
analyzing the comments received and in developing the final rule, the
comments were grouped according to the specific standard being
addressed, the broad issue areas raised, the major cross-cutting themes
presented, and the type of comment.
We drew upon a number of principles in order to balance the many
different views expressed in the comments and to help clarify and guide
our decision-making for the final rule. Key among these were:
<bullet> The purposes of the Program Performance Standards as
established by the 1994 reauthorization of the Head Start Act and
emphasized by the Advisory Committees on Head Start
 
[[Page 57189]]
 
Quality and Expansion and on Services for Families with Infants and
Toddlers. These purposes include updating the standards to respond to
the emerging needs and circumstances of families and communities as
well as to new research knowledge; ensuring program quality (and, as
required by statute, ensuring that the level and quality of services do
not fall below the current standards); and providing an entirely new
set of standards to govern programs serving low-income pregnant women
and families with infants and toddlers.
<bullet> The appropriate role of Federal regulations as opposed to
guidance on best practices or technical assistance and training. Many
commenters requested additional detail, specificity and
prescriptiveness in the standards. While we balanced each request for
more detail on an individual basis, in general we chose not to make the
standards themselves more specific in the belief that overly
prescriptive Federal regulations should be avoided in order to provide
flexibility to grantee and delegate agencies to enable them to make
programmatic decisions based on the needs of the children and families
they serve and of the communities in which they are located. For
example, many commenters questioned the deletion of the requirement in
the current standards related to the use of child-sized utensils; and
others sought more specificity about the curriculum that is required
and how it should be implemented. With respect to the first example,
while we would expect programs to use age-appropriate utensils, we did
not include the requirement in the final rule because we felt that it
would be overly prescriptive. Relative to the second example, we added
a definition of ``curriculum'' in the final rule, but did not include
more specifics in the standards themselves. Following the publication
of the final rule, we do, however, plan to follow up with training and
technical assistance as well as Guidance in order to share best
practices and to give agencies the tools they need to make effective
decisions at the local level.
<bullet> The need to be sensitive and responsive to the major views
expressed, while giving all perspectives full consideration, even when
these perspectives were sharply different or even contradictory. In a
number of cases, we were able to identify new and better policy options
as a result of contradictory comments provided on the NPRM. For
example, as a result of the comments on both sides of the issue of a
90- versus a 45-day period for the conduct of health and developmental
assessments, we developed an option that combines the benefits of both
approaches.
In general, the comments we received confirmed the broad principles
and structure of the NPRM, and were supportive of both the proposed
standards and the consultation process we employed in their
development. Commenters generally found the standards to be ``user-
friendly,'' comprehensive and well-integrated, and expressed support
for their tone and approach. They praised the standards' clarity,
flexibility, cultural sensitivity, and responsiveness to the many
issues expressed in the public consultation process. In addition to the
integration of standards serving children from birth to age 5,
particular aspects of the standards which the comments supported
included the reorganization of the standards into three major new areas
(Early Childhood Development and Health Services, Family and Community
Partnerships, and Program Design and Management) to make them simpler
and less fragmented than the existing standards; the increased emphasis
on quality services and best practices; the strengthened emphasis on
family and community partnerships; and the new sections on program
design and management.
In addition to providing support for the proposed rule, other major
categories of comments included the following:
<bullet> A number of commenters identified proposed standards that
they believed imposed costs or other burdens or that were too rigid to
meet local circumstances. Except in a very few cases, where we believed
that the proposed standard was critical to ensuring quality, health or
safety or meeting a statutory mandate, we sought to respond to these
concerns by making the standards more flexible; by clarifying the
intent more clearly through wording changes; or by proposing guidance
or technical assistance to reduce the potential burden on grantees. For
example, many commenters were concerned that the proposed standard
requiring that volunteers be screened for tuberculosis before coming
into contact with children would be costly, create a barrier to parent
volunteers, and make no sense in communities with low incidences of
tuberculosis. We have modified the standard to require screening only
for regular volunteers and only when required by State, Tribal or local
law. In the absence of such laws, Centers also may screen based on the
recommendations of the Health Services Advisory Committee.
<bullet> Many commenters requested clarification of terms used in
the standards which they found confusing. We have taken many of these
comments into account and, in several cases, the requests for
clarification were extremely helpful in identifying policy improvements
that could be made. For example, many commenters pointed out that the
proposed standards on compliance were confusing because they mixed two
terms (non-compliance and deficiencies) and two different timeframes.
In response, we revised these standards to focus solely on
deficiencies. We believe that this change will enhance the ability of
grantee and Federal staff to focus more analytically and systemically
on areas affecting quality and results for children and families.
<bullet> Finally, many commenters provided suggestions regarding
the implementation of the standards, including examples from their own
practice. While most of these comments are not reflected in the
language of the final rule, they were extremely helpful and will be
used in guiding the major training, technical assistance and guidance
efforts that we plan to undertake in the future.
 
V. Cross-Cutting Themes
 
The sections of the NPRM which received the most comments were
Human Resources Management (45 CFR 1304.52), Program Governance (45 CFR
1304.50), Family Partnerships (45 CFR 1304.40), and Child Health and
Developmental Assessment (45 CFR 1304.20). In addition, commenters
raised important issues that cut across sections of the NPRM, such as
the new structure of the Program Performance Standards; the provision
of high quality services to infants and toddlers, including the need to
ensure a sufficient emphasis on their needs in an integrated
regulation; linkages between the proposed rule and the Head Start
Program Performance Standards on Services to Children with Disabilities
(45 CFR part 1308); and the need to place greater emphasis on the
provision of services within the home-based program option.
 
Structure of the Standards
 
As noted above, a large number of commenters supported the
reorganization of the standards into three major new areas: Early
Childhood Development and Health Services, Family and Community
Partnerships, and Program Design and Management. Commenters stated that
the new approach is supportive of quality and integrated services and
is more ``user-
 
[[Page 57190]]
 
friendly.'' We concur with these comments, and have retained the
proposed structure.
Several commenters, however, raised concerns about how the new
approach would be implemented, as the organizational structures and
staffing patterns of many local programs are based on the program
component structure of the current Program Performance Standards. There
was also concern that the integration of program components proposed
under the new structure would cause confusion for staff. We intend to
respond to these comments by providing training, technical assistance
and guidance following the publication of the final rule. We appreciate
the suggestions made by some commenters regarding particular approaches
and best practices that might be implemented to promote collaboration,
and intend to draw on these suggestions in preparing the Guidance and
the technical assistance materials.
 
Services for Infants and Toddlers
 
Overall, strong support emerged for the integration of standards
for services to children from birth to age 5. The commenters generally
felt that one set of standards for infants, toddlers and preschoolers
would improve the quality and the continuity of services to children
and families. We agree with these comments, and have retained the
integrated structure of the standards.
At the same time, a number of concerns and questions were raised.
Some commenters were unsure which standards apply to infants and
toddlers and which apply to preschoolers and, in a few instances,
requested that separate standards be established for each age group. In
response, we reviewed each standard and have changed the wording, where
appropriate, to reflect the standard's applicability to services for
infants and toddlers, for preschoolers or for both groups.
Other commenters expressed the concern that, by integrating the
standards for infants and toddlers with those for preschoolers,
critical and distinct issues related to infant and toddler care would
be lost, resulting in a dilution in the quality of services provided to
those children. While we continue to believe, along with the majority
of the commenters, that the integrated approach will support quality
services for children from birth to age 5 and will also be easier for
grantee and delegate agencies to use, we have responded to this concern
in a number of ways. First, we reviewed individual standards to ensure
that they reflect the particular needs of infants and toddlers.
Standards which pertain specifically to the care of infants and
toddlers and which are designed to ensure that their particular and
special needs are addressed can now be found throughout the final rule
in the areas of education, health and safety, nutrition, staff
qualifications, child:staff ratios and group sizes, and facilities,
materials, and equipment. Second, we intend to develop and issue
Guidance materials and to provide extensive training and technical
assistance specific to infants and toddlers following the publication
of the final rule.
Several commenters requested further information and guidance on
how to implement the new standards related to Early Head Start,
particularly those pertaining to infants. We intend to provide such
supportive technical information in the Guidance pertaining to the
standards and in supplemental descriptive materials about Early Head
Start. Commenters also questioned why the nine principles identified by
the Advisory Committee on Services for Families with Infants and
Toddlers as being characteristic of successful programs for families
with very young children as well as the four cornerstones of such
programs were not included in the NPRM. Although not explicitly
referenced, these principles and cornerstones are reflected both in the
organizational structure of the revised standards and in specific
standards themselves. These principles and cornerstones, however, will
be more specifically addressed in the Guidance and related materials to
be developed in the future.
Many commenters proposed that the title ``Head Start'' be used to
describe services to all children from birth to age 5, and that the
title ``Early Head Start'' be deleted. There are, however, reasons for
retaining the separate program designations. The two programs are
described in separate sections of the Head Start Act, and there also
are operational distinctions. For one, Early Head Start is a
demonstration program, with specific project periods, whereas funding
for Head Start is generally continued from year to year provided that
grantees implement their programs in conformance with the Program
Performance Standards and with other requirements. A recommendation
also was made that Early Head Start be renamed ``Head Start for Infants
and Toddlers''; we believe, however, that the title ``Early Head
Start'' more accurately reflects the program's emphasis, since it
serves low-income pregnant women as well as infants and toddlers.
 
Services for Children With Disabilities
 
Many of the comments about the NPRM raised issues related to the
Head Start Program Performance Standards on Services to Children With
Disabilities (45 CFR part 1308). The recommendations included: (1)
Providing additional cross-references to 45 CFR part 1308; (2)
developing specific standards on services to infants and toddlers with
disabilities; (3) including a statement in 45 CFR part 1304 about the
need to serve children with disabilities; and (4) integrating the
standards in 45 CFR part 1308 into the final rule.
We share the concerns of these commenters that the provision of
quality services to children with disabilities is a critical part of
Early Head Start and Head Start programs, and that linking the two sets
of standards as clearly as possible would not only contribute to
quality services, but also would be easier for grantees to use.
However, we chose not to integrate 45 CFR part 1304 and 45 CFR part
1308 at this time for several reasons. First, the disability standards
at 45 CFR part 1308 were published in 1993, and our experience with
them is still relatively new. Secondly, we wanted to ensure that
sufficient attention would be focused on the new standards for infants,
toddlers and pregnant women as well as on the revised standards for
preschool children, which have not been revised since the 1970s. Should
the need to integrate the two sets of standards become apparent in the
future, we would consider amendments to the rules to do so.
We have responded to the concerns raised in several ways which we
believe will make the linkages between the two sets of standards
clearer and will further elevate attention to disabilities issues in
the final rule. First, we have made additional cross-references to the
disabilities standards in the final rule in order to improve
cohesiveness between the two regulations. We also have incorporated a
number of specific changes in the final rule designed to improve
services for children with disabilities, drawing upon suggestions
provided by commenters. For example, we have restored the 45-day
timeframe for the conduct of developmental, behavioral and sensory
screenings of children (which had been increased to 90 days in the
NPRM) to ensure that children who require further evaluation or
treatment and services are identified in time to be linked into the
appropriate service systems.
Additionally, we intend to issue both 45 CFR part 1304 and 45 CFR
part 1308
 
[[Page 57191]]
 
in the same document along with other applicable Head Start
regulations. We believe that having the regulations located together,
along with cross-referencing, will assist readers in better
comprehending the full body of standards. We also will provide Guidance
and fund training and technical assistance efforts to support our
commitment to effectively serving children with disabilities from birth
to age 5.
 
Home-Based Services
 
A number of commenters expressed the concern that the proposed
standards, as written, focus primarily on center-based programs and do
not adequately address other program options, particularly the home-
based program option. To address these concerns, we reviewed each
standard and changed the wording, where appropriate, to clarify the
standard's applicability to center-based, home-based, or other program
options. We also have added standards that apply specifically to the
home-based option in the areas of education and early childhood
development, family partnerships, and human resources management.
In addition to the changes in the NPRM based upon comments
received, as discussed below, we also have made a number of technical
edits to the NPRM in this final rule which did not alter policy and,
therefore, they are not discussed.
 
VI. Section-by-Section Discussion of the Final Rule
 
SUBPART A--General
 
Section 1304.2 Effective Date
The majority of commenters found the proposed timeframes in which
Early Head Start and Head Start grantee and delegate agencies must come
into compliance with these standards confusing. Others said the
deadlines were too short, arguing that they were inconsistent with the
quality improvements being required; would not allow for the
implementation of new requirements in a meaningful way; and would
preclude the meaningful inclusion of parents, staff and community
members in the decision-making processes. Commenters proposed several
approaches and timeframes up to 24 months for planning and
implementation. Other commenters, while supportive of the timeframes
proposed, suggested that waivers be available to grantees which are
unable to meet all of the requirements within these time periods.
We have changed the effective date in the final rule to January 1,
1998. We established one specific date in order to eliminate the
confusion that was generated by the timeframes proposed in the NPRM. In
addition, we extended the effective date in recognition of the time
that will be needed by grantee and delegate agencies to comply with the
new requirements established in the final rule, and by the Federal
government to provide the Guidance materials and training and technical
assistance necessary to assist agencies in these efforts.
Section 1304.3 Definitions
A number of commenters were supportive of the set of definitions
provided, describing them as being specific, helpful and clear. Others
requested that additional definitions be included in the final rule. In
some cases, we decided that the concerns raised about definitions could
best be addressed through clarifications provided in other sections of
the Preamble or in the standards themselves, rather than in this
section or through additional definitions. Requests for further
clarification of the terms ``out-of-compliance'' and ``deficiency,''
for example, are discussed in the section of the Preamble relating to
45 CFR 1304.60; and requests for a definition of ``screening'' are
addressed through the standards in 45 CFR 1304.20. Other additions, as
well as deletions, to the definitions provided in 45 CFR 1304.3 of the
NPRM based upon the comments received are discussed below.
Several commenters stated that, since the term ``center'' is used
so often in the standards, a definition should be provided for clarity.
However, since ``center-based program option'' is defined in 45 CFR
1306.3(a), we have not added this definition.
The definition of ``collaboration and collaborative relationships''
with other agencies (45 CFR 1304.3(a)(3)) remains the same as that
provided in the NPRM. Grantee and delegate agencies are cautioned,
however, that such collaborative relationships must be undertaken in a
manner which is consistent with the cost principles established in OMB
Circulars A-122 (``Cost Principles for Nonprofit Organizations'') and
A-87 (``Cost Principles for State and Local Governments'').
Numerous commenters suggested that a definition of ``curriculum''
was needed in order to clarify the requirement in 45 CFR 1304.21(c)(1)
that grantee and delegate agencies implement a curriculum. Others were
concerned that the absence of a definition would result in too much
room for misunderstanding and too much flexibility in curriculum
development and selection. Other commenters raised more specific
questions, such as: does the term refer to an individual or to a group
curriculum? In response to such concerns, a definition of
``curriculum'' has been added in the final rule. The Guidance
materials, to be developed at a later date, will discuss the
implementation of a curriculum in both center-based and home-based
settings.
Several commenters found the definition of ``home visitor'' in the
NPRM confusing because it mixed center- and home-based program options
and also applied the term to the infant and toddler caregiver in Early
Head Start and to the classroom teacher in Head Start. We have revised
the definition in the final rule so that it refers only to ``the staff
member in the home-based option * * * '' and have made other clarifying
edits.
The definitions of ``infant,'' ``toddler'' and ``preschooler''
proposed in the NPRM raised a number of concerns, particularly related
to the issue of continuity of care. One commenter, for example,
questioned whether the definition of ``toddler'' would mean that Early
Head Start services must end the day that a child reaches his or her
third birthday, resulting in the child being abruptly terminated during
the program year. We concur with the concern that defining children by
specific age groupings could restrict the ability of programs to make
sound decisions about appropriate placements for children, particularly
in Early Head Start. Therefore, we have deleted these definitions in
the final rule. Additionally, the definition of Early Head Start has
been clarified to emphasize that the program serves low-income pregnant
women and families with children from birth to age three.
A few commenters questioned the use of ``staff caregiver'' for
those staff having direct responsibility for the care and development
of infants and toddlers and ``teacher'' for those staff having direct
responsibility for the care and development of preschool children in
center-based settings. In response to these comments, we have deleted
the term ``staff caregiver'' in the final rule and have revised the
definition of ``teacher'' to ``an adult who has direct responsibility
for the care and development of children from birth to five years of
age * * *.'' While we recognize that there is no consensus in the field
on this issue, we believe that it is important to use one, consistent
 
[[Page 57192]]
 
term in order to create an integrated set of standards for services to
children from birth to age five. By using common terminology, we are
conveying the importance of continuity of care for children as well as
helping to build professionalism in the field of infant and toddler
care.
The term ``volunteer'' generated many comments, particularly in
relation to the requirement in 45 CFR 1304.52(i)(2) in the NPRM that
volunteers must be screened for tuberculosis. Many commenters stated
that this requirement should apply only to volunteers who participate
on an ongoing basis. We revised the definition in 45 CFR 1304.3(a)(20)
in the final rule to clarify that a volunteer ``* * * assists in
implementing ongoing program activities on a regular basis * * *''
Other commenters questioned why volunteers had to be 16 years of age or
older, citing the fact that many students assist with Head Start
program activities. We deleted the age reference in the definition of
``volunteer'' in response to these comments.
 
Subpart B--Early Childhood Development and Health Services
 
Section 1304.20 Child Health and Developmental Services
We received hundreds of comments related to child health and
developmental assessment (45 CFR 1304.20), demonstrating the importance
of this area to the Head Start community. While many of the comments
were supportive of the requirements in the NPRM, it was clear from the
numerous questions and requests for further clarification that the
intent of these standards was not understood by many readers. In
response, we have taken another look at the framework and structure for
providing health services to children and families, beginning with
changing the word ``assessment'' in the title of this section to
``services.''
Our primary goal in establishing standards for health services is
to link children and families to a system of health care and to ensure
that families have an ongoing source of continuous, accessible medical
care. A new standard has been added at 45 CFR 1304.20(a)(1)(i) which
formally expresses this goal.
To support this goal, major changes were made to the other
standards in this section. These include: (1) Defining the roles of
Early Head Start and Head Start staff and other health professionals;
(2) clarifying the set of required clinical, laboratory, developmental,
behavioral and sensory screenings and tests; (3) establishing
timeframes for the completion of the screenings and tests; and (4)
strengthening the requirements for services to children with
disabilities. The specific changes related to each of these four areas
are described below.
In specifying the roles and responsibilities of staff and other
health professionals in the provision of health services, we refer
again to the primary goal of establishing a long-term medical home for
children and families. As revised, 45 CFR 1304.20(a)(1)(ii) indicates
clearly that local health care professionals have primary
responsibility for making decisions about the child's health status and
the need for further services. This provides an opportunity for a
relationship to develop between provider and patient that, hopefully,
will continue after the family has left Early Head Start or Head Start.
Early Head Start and Head Start staff will continue to have an
important role in determining the health status of children by working
with parents to ensure that health care professionals conduct an
initial determination of the status of the child's health and provide
any further diagnostic testing, examinations and treatment as needed.
In order to assure that staff have the information needed to ensure
that proper and timely health services are being provided, we have
added another standard at 45 CFR 1304.20(a)(1)(ii)(C), which requires
grantee and delegate agencies to establish procedures to track the
provision of health care services.
During the process of describing the roles and responsibilities for
the provision of health services, we looked at both the short-term and
long-term needs of children and families. Currently, Early Head Start
and Head Start staff have a pivotal role in providing and organizing
health care services. We acknowledge that Early Head Start and Head
Start staff, especially those in communities with limited health care
resources, assume the role of the provider or organizer of health care
services to meet the immediate health care needs of children. However,
staff must keep in mind the long-term goal of ensuring that each child
and family has a ``medical home'' with which they can remain involved
when the child is no longer enrolled in Early Head Start or Head Start.
In 45 CFR 1304.20(b), (45 CFR 1304.20(d) in the NPRM), the division
of responsibilities with regard to the conduct of developmental,
behavioral, and sensory screenings of the child's motor, language,
social, cognitive, perceptual, and emotional skills is further
delineated. (The standard at 45 CFR 1308.6(b)(3) contains additional
information on identifying children with disabilities.) Recognizing
that it is the staff and parents who have the opportunity to observe
children on an ongoing basis and in a variety of settings, Early Head
Start and Head Start staff, in collaboration with the parents, are
responsible for performing or obtaining the majority of these
screenings. Staff must, however, work with mental health, child
development, or other health professionals in the administration of
these tests as needed, in the interpretation of the results, and in
obtaining assistance in planning further screening and treatment.
In keeping with our new framework of establishing an ongoing system
of health care for children and families, we also moved 45 CFR
1304.22(a) (as printed in the NPRM), which requires the provision of
extended health follow-up and treatment, to 45 CFR 1304.20(c).
The second major change to this section was the deletion of the
standard listing the specific medical and developmental tests that must
be completed (45 CFR 1304.20(c)(1) in the NPRM). Instead, 45 CFR
1304.20(a)(1)(ii) in the final rule states that the requirements for
well child care must incorporate the latest immunization
recommendations of the Centers for Disease Control and Prevention and
the requirements for a schedule of well child care employed by the
Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program for
the State in which the grantee operates, as well as any additional
recommendations from the local Health Services Advisory Committee based
on prevalent community health problems.
This change satisfies several concerns. First, some commenters
raised the concern that the schedule from the Centers for Disease
Control and Prevention evolves over time and that the EPSDT program
varies from State to State. Because, under the EPSDT, each State can
determine for itself the list of appropriate tests, immunizations, and
schedules of well child care, commenters stated that they had
experienced problems in the past in getting local providers to complete
Head Start's list of screenings, assessments, immunizations, and other
well child procedures when State requirements did not include one or
more of these procedures and Medicaid would not pay for the service.
This change provides local health professionals with the ability to
respond to the needs of their communities.
Other commenters pointed out that, by following State requirements,
grantee and delegate agencies across the country
 
[[Page 57193]]
 
would be using somewhat different criteria for the provision of health
services, and they questioned how on-site program reviewers would
respond to this situation. It is our intent that the reviewers will be
provided with the information needed to monitor each grantee and
delegate agency according to its State's standards.
A second concern addressed by eliminating the specific list of
screenings and tests relates to the fact that medical standards change
over time. By linking health care services to the Centers for Disease
Control and Prevention and EPSDT schedules, the services received by
children will generally not become outdated, as both of these schedules
are updated regularly to reflect current knowledge and best practice.
Third, reliance on the Centers for Disease Control and Prevention and
EPSDT schedules will eliminate duplication of effort between Early Head
Start and Head Start staff and other health professionals and, finally,
this change supports our goal of limiting the prescriptiveness of
Federal regulations.
The third major change in this section relates to the proposed
requirement that the health care screenings and tests be completed
within 90 calendar days from the child's enrollment in Early Head Start
or Head Start. This standard (45 CFR 1304.20(a)(1) in the NPRM)
received more comments than any other in this section. Commenters
either supported the new timeframe, wanted it returned to 45 days as
required by 45 CFR part 1308, or proposed a compromise of 60 days. Of
the commenters in support of the 90-day requirement, many were from
rural areas of the country and pointed out that the resources
(particularly dental services) do not exist to serve all children
within the 45-day limit. On the other hand, critics of the 90-day
requirement were concerned about the importance of identifying health
conditions as early as possible for infants and toddlers and for
children with (or suspected of having) disabilities. Those in favor of
retaining the 45-day limit in Part 1308, felt that, while challenging,
it was reasonable, and that many grantee and delegate agencies already
had systems in place to meet that requirement.
Due to the wide variation in the availability of health care from
community to community, and because our general approach to rule-making
highlights flexibility for local programs, we have retained the 90-day
requirement for the determination of the child's health status and
needs in the final rule. In response to the comments received, and in
recognition of the difficulties in delivering health care services to
low-income families, we have clarified the tasks that must be completed
within the 90 calendar day timeframe. In retaining this longer
timeframe, we do not wish to suggest that grantee and delegate agencies
should take the full 90 days to determine each child's status. Rather,
we encourage all agencies to complete the process described in 45 CFR
1304.20(a) as early as possible after a child's entry into the program.
We recognize the critical nature of time in determining the health
status of infants, and we particularly recommend an early start and
completion of the process for this age group.
While the initial determination of children's health status, which
depends in part on available resources in the community, may take up to
90 days, the process of developmental, sensory, and behavioral
screenings must take place within 45 calendar days (as discussed in the
final rule in 45 CFR 1304.20(b)). As indicated above, these screenings
will be performed, in large part, by Early Head Start and Head Start
staff in collaboration with each child's parents. As the conduct of
these screenings do not depend as much on the availability of local
health care resources, we believe that the 45-day timeframe is
appropriate. Further, the 45-day limit supports the early
identification and provision of services for children with disabilities
as described in 45 CFR part 1308, and supports coordination with other
Federal programs serving children with disabilities (i.e., the Child
Count submitted to the U.S. Department of Education by each State
Education Agency).
A related standard, 45 CFR 1304.20(a)(2) in the final rule,
requires that grantee and delegate agencies operating programs for 90
days or less must complete health determinations and follow-up plans no
later than 30 calendar days after the child's entry into the program.
We received both criticism and support for this requirement. The
supporters pointed out that this standard would ensure that children
receive needed health services, while the critics stated that the 30-
day limit would be difficult to meet. We have not changed the timeframe
in this standard because we believe that it is critically important
that children enrolled in programs of shorter duration, who are less
likely to have a stable ``medical home'' due to the transient nature of
their parents' employment, have their health needs identified as soon
as possible.
We received a few comments on the information collection
requirements concerning child health and developmental assessments
which are required in 45 CFR 1304.20(a). These comments concerned the
gathering of health and developmental assessment information for each
child. Changes have been made to the standards to emphasize that Early
Head Start and Head Start programs should assist parents in connecting
to a ``medical home'' (45 CFR 1304.20(a)(1)(i) and that they should
obtain information from a health care professional rather than
gathering it themselves.
The last major change to this section relates to the requirements
for health care services for children with disabilities. In response to
the comments received throughout this section regarding the inter-
relation of this section with the requirements of 45 CFR Part 1308, we
modified 45 CFR 1304.20(f)(2) and have added four new standards at 45
CFR 1304.20(f)(2) (i)-(iv) in order to more clearly specify the
requirements for programs serving infants and toddlers suspected of
having or having diagnosed disabilities. These standards clearly state
the requirement that Early Head Start staff coordinate with and
actively support the efforts of Part H of the Individuals with
Disabilities Education Act providers to attain expected outcomes in
each child's Individualized Family Service Plan, including the support
of transition activities. As such, they are consistent with and
supportive of 45 CFR part 1308, which articulates the requirements for
serving children with disabilities. The standards also emphasize our
commitment to collaborate with other agencies serving Head Start
families.
In addition to the major revisions to this section, a number of
modifications were made to the wording in several of the standards in
response to the comments received. For example, we substituted
``consult with parents'' for ``inform parents'' about suspected
problems in 45 CFR 1304.20(b)(1) (45 CFR 1304.20(e)(1) in the final
rule) because commenters wanted to acknowledge and support the two-way
nature of the process. We have also specified that a child's ``entry''
into the program for the purposes of 45 CFR 1304.20(a)(1) and 45 CFR
1304.20(a)(2) means the first day that Early Head Start or Head Start
services are provided to the child. Additionally, in response to
technical comments received, we made two changes which do not result in
any reduction of services: We dropped the reference to ``dental bone''
(45 CFR 1304.22(a)(3)(i) in the NPRM) which is not technically
accurate, and we also deleted ``dental sealants'' (45 CFR
 
[[Page 57194]]
 
1304.22(a)(3)(ii) in the NPRM) as they are not customarily used for
preschool children. In 45 CFR 1304.22(a)(2) (45 CFR 1304.22(b)(2) in
the NPRM) the reference to ``staff member'' was removed because this
section of the regulation addresses child health and safety issues. We
will provide information on procedures for dealing with staff
emergencies in the Guidance. We also reworded, and added new standards
to, 45 CFR 1304.20(f)(2) regarding the roles of Early Head Start and
Head Start and Part H staff in order to emphasize partnerships between
grantee and delegate agencies and other agencies serving Early Head
Start and Head Start children and families and to enhance collaboration
with the Part H agency in supporting family involvement and child
participation.
An issue raised by some commenters related to the appropriate role
of parents in obtaining assessment, screening, and follow-up services
for their children. Some commenters stated that the role of parents in
45 CFR 1304.20(e) (45 CFR 1304.20(b) in the NPRM) should be
strengthened. They argued that parents should be required to accompany
their child to all assessment, screening and follow-up services, both
to be part of the decision making team and to learn about effective
ways to advocate for their children's health care in the future. Others
opposed requiring parents to be present during the health screening
process, arguing that welfare reform requirements for parents to work
or be enrolled in a training program greatly limit the ability of
parents to accompany their children to these appointments. Although we
clearly prefer that parents accompany their children to these
appointments, we have not changed the standard, choosing instead to
provide grantee and delegate agencies with the flexibility needed to
respond to the circumstances facing individual parents in their
communities.
Comments also were received on the information collection
requirement that grantee and delegate agencies have ``written
documentation of their efforts to access other available funds for
medical and dental services.'' (45 CFR 1304.22(a)(5) in the NPRM; 45
CFR 1304.20(c)(5) in the final rule). Commenters stated that it is
sometimes difficult to obtain written documentation on why agencies
refuse to pay for or will not provide services. It was not the intent
of the standard to have other agencies provide this information, but,
rather, to have Early Head Start and Head Start agencies create a
record of their efforts to access other sources of funding. Thus, we
have reworded the standard to require programs to provide ``written
documentation of their efforts to access other available sources of
funding'' (45 CFR 1304.20(c)(5)).
The last group of comments on this section were requests for
additional guidance on the following issues: how to share information
with parents regarding staff concerns about their children; how to work
with parents so that they effectively introduce upcoming health
procedures to their children; how to obtain input from multiple sources
concerning the child's behavior; and who might be used to conduct the
different assessments. Each of these issues will be addressed in the
Guidance to be developed at a later date.
Section 1304.21 Education and Early Childhood Development
Commenters generally supported the new standards regarding child
development and education, and they applauded the standards' clarity,
specificity, and developmental appropriateness. Many approved the fact
that the standards cover the age range from birth to age 5 and address
the common needs of young children across this age span. In addition,
commenters supported the flexibility to design and implement programs
to meet the needs of the whole child. Many positive comments also
focused on the expanded discussion of the involvement of parents in the
organization and delivery of education and early childhood development
services.
Commenters expressed three overarching concerns regarding the
education and early childhood development standards as they appeared in
the NPRM: (1) They are not integrated with the disability regulations
(45 CFR Part 1308), (2) they over-emphasize the center-based program
option, and (3) they are unclear concerning curriculum development.
First, a number of commenters questioned why the disability regulations
were not integrated within this set of regulations. They felt that a
fully integrated set of standards would be more powerful in
communicating the message that services for children with disabilities
is an integral part of Early Head Start and Head Start. They also
suggested that it would be more practical for staff and parents to look
at only one document to find a complete set of standards for the
education of all children. We have chosen not to more fully integrate
the disability standards into this set of standards at this time for
the reasons discussed earlier in Part V of the Preamble. However, we
have increased the cross-references to 45 CFR part 1308 in this
section.
Second, many commenters felt that the standards were too oriented
toward the center-based program option and did not fully discuss the
delivery of services through other program options. In order to address
these concerns, and to underscore the viability of the home-based
program option, we have made several types of changes in the standards.
In response, we have added two standards to this section of the
final rule to further support program implementation of the home-based
program option. In 45 CFR 1304.21(a)(1)(iii) of the NPRM, the standard
required a balanced daily program of staff-directed and child-initiated
activities in center-based settings (45 CFR 1304.21(a)(1)(iv) in the
final rule). A new standard, 45 CFR 1304.40(e)(2), reinforces that the
home visitor must ``* * * build upon the principles of adult learning
to assist, encourage and support parents as they foster the growth and
development of their children.'' This standard makes clear the role of
the parent in fostering child development.
The second standard is concerned with the physical development of
children in home-based program options. In the NPRM, 45 CFR
1304.21(a)(5) discussed program requirements related to the physical
development of children in center-based settings only. In the final
rule, we have added 45 CFR 1304.21(a)(6) to support the physical
development of children in home-based settings, stating that ``grantee
and delegate agencies must encourage parents to * * * appreciate the
importance of physical development, provide opportunities for
children's outdoor and indoor active play, and guide children in the
safe use of equipment and materials.''
We also changed the wording in other standards in this section to
clarify their relevance to the home-based option. In general, these
changes have consisted of changing a verb, such as ``provide.'' In the
NPRM, the standards frequently required the grantee to ``provide'' a
service. In order to reflect more accurately that grantee and delegate
agency staff do not directly provide all of the opportunities and
services in the home-based option, but rather work with parents to
ensure that the breadth of services is provided, we have changed the
language used. For example, in 45 CFR 1304.21(a)(4)(ii) of the NPRM,
grantee and delegate agencies were required to support the development
of cognitive and language skills by ``providing opportunities for
creative self-expression through activities such as art, music,
movement,
 
[[Page 57195]]
 
and dialogue.'' We changed ``providing opportunities * * *'' to
``ensuring opportunities * * *'' in the final rule to make clear that
the standard applies to home-based as well as center-based options.
The NPRM encouraged comments on the standards related to the
development of the curriculum (45 CFR 1304.21(a)(2)(i) and 45 CFR
1304.21(c)(1)). Commenters supported the requirements regarding the
developmental and educational needs of young children, and stated that
the requirements for the curriculum were strong and age-appropriate.
However, many commenters requested clarification of the terms used in
this section. The questions asked included: Must a new curriculum be
selected each year, since the group of parents will change each year?
What exactly is the role of the parents in the development, selection
or adaptation of the curriculum? Do the standards require that each
agency purchase a pre-packaged curriculum? Must each agency adopt a
program-wide curriculum that will be uniformly implemented with each
child? The intent of these standards was to ensure that parents, and
potentially other persons, such as early childhood education
professionals and Tribal elders, are integrally involved in the process
of building a curriculum for their children, but the specific tasks in
which the parents might be involved were not listed because they are
the decision of each grantee or delegate agency.
The intent of the standard was not that agencies must select a new
curriculum each year but, rather, that staff and parents work together
to modify and individualize the curriculum. These decisions are the
local agency's prerogative and these standards, therefore, reflect the
flexibility we believe that local agencies should have. In the final
rule, we have made clarifying changes in order to eliminate the
confusion generated by some of the standards as proposed in the NPRM.
We are now requiring in 45 CFR 1304.21(c)(1) that agencies
``implement'' a curriculum in collaboration with the parents rather
than develop or select a curriculum that is adapted for each group and
applied cocsistently in the program as proposed in the NPRM. A number
of commenters also requested a definition of curriculum, and a
definition applicable to both center-based and home-based options has
been added in 45 CFR 1304.3(a)(5) of the final rule.
Based upon the recommendations of several commenters, we amended
the standards at 45 CFR 1304.21(a)(1)(ii) (45 CFR 1304.21(a)(1)(iii) in
the final rule) and 45 CFR 1304.21(a)(3)(i)(E) to require that grantee
and delegate agencies support and respect gender, culture, language,
ethnicity, and ``family composition.'' We also have added a new
standard at 45 CFR 1304.21(a)(2)(iii) which more clearly links the
staff-parent conferences in 45 CFR 1304.40(e)(4) and the home visits in
45 CFR 1304.40(i)(2) with opportunities for parents to discuss their
child's development, progress and education.
Several commenters were concerned about the use and possible misuse
of some new phrases. First, the heading of 45 CFR 1304.21, ``Education
and early childhood development,'' was criticized as inventing a new
discipline. We believe that this title appropriately reflects the
substance of the section. It is not intended to, nor should it be read
to, invent a new discipline.
Second, the requirement of helping children gain the skills and
confidence needed to succeed in their present environment as well as
later in life, including school, was used in 45 CFR 1304.21(a)(1).
Further, the development of cognitive skills to form a foundation for
school readiness and later school success was presented in 45 CFR
1304.21(c)(1)(ii). Several commenters felt that these references to the
child's upcoming experiences in elementary school suggested that school
performance is now the overall goal for Head Start's child development
and education program, which is clearly not the case. In introducing
this language, we did not intend to restrict or diminish Head Start's
overall goal of increasing the social competence of young children.
Rather, the intent was to recognize that the benefits of Head Start's
attention to social-emotional, physical and cognitive development will
be valuable in all settings, including schools. Primary schools require
children to demonstrate skills in all of these areas: Not only must
they respond to cognitive challenges, but they also are asked to
interact with other adults and children, show responsibility and self-
help skills, and demonstrate physical competence. Therefore, the
language has been retained in the final rule.
Most of the other comments on the individual standards within the
Education and Early Childhood Development section dealt with requests
for the clarification of terms. In some instances, the commenters
requested a change in the language used. For example, several found the
phrases ``individual preferences'' and ``individual patterns of
development'' and ``different ability styles'' in 45 CFR
1304.21(a)(1)(i) confusing, and suggested changing them to ``individual
rates of development'' and ``individual interests, temperaments,
languages, cultural backgrounds, and learning styles.'' A number of
commenters did not support the use of the terms ``large muscle'' and
``small motor'' skills in 45 CFR 1304.21(a)(5)(i) and 45 CFR
1304.21(a)(5)(ii), preferring ``gross motor'' and ``fine motor.''
Because the suggested language is clearer and more consistent with the
field of child development, these changes have been made. A few
commenters struggled with the use of the term ``self-knowledge'' in 45
CFR 1304.21(b)(2)(i) in the context of infants and toddlers, noting
that infants and toddlers are not at the point of reflecting on their
own state of being. Therefore, the term ``self-awareness'' has been
substituted for ``self-knowledge.''
A few commenters recommended that a balanced daily program (45 CFR
1304.21(a)(1)(iv)) should include activities which are ``child-
initiated and adult-directed,'' rather than ``staff-directed and child-
initiated.'' The final rule includes this recommended language.
Finally, a few commenters recommended that the proposed standard at 45
CFR 1304.21(b)(3)(iii), requiring that infants and toddlers be
supported in their toilet training and in their use of toilet
facilities, be applied to preschoolers as well. These commenters stated
that this issue is important to the development of all young children,
regardless of age. We agree with this recommendation, and have
organized the section so that this standard now appears in the section
that applies to all children at 45 CFR 1304.21(a)(1)(vi).
Section 1304.22 Child Health and Safety
In general, commenters supported the increased emphasis on health
and safety in 45 CFR 1304.22. In particular, they praised the addition
of standards in the areas of hygiene (45 CFR 1304.22 (f)), short-term
exclusion (45 CFR 1304.22(c)), and first aid (45 CFR 1304.22(g) in the
NPRM and (45 CFR 1304.22(e), (b) and (f), respectively, in the final
rule). Other commenters indicated that some of the standards in this
section would impose additional costs on grantee and delegate agencies
or needed to be further clarified.
While some comments indicated support for the section on the
conditions of short-term exclusion and admittance (45 CFR 1304.22(c) in
the NPRM), the majority found the wording to be confusing and
contradictory. Some
 
[[Page 57196]]
 
commenters stated that this section may conflict with the Americans
with Disabilities Act (ADA), in particular expressing concern that the
proposed wording might result in the exclusion of children with
conditions such as Human Immunodeficiency Virus (HIV) infection or
severe behavioral problems. Our intent is not to permanently exclude
children with chronic or communicable diseases. Rather, it is to ensure
the health and safety of all children by requiring that grantee and
delegate agencies exclude children who have short-term acute conditions
that are contagious and pose an immediate risk to others in Early Head
Start and Head Start settings. Infection with HIV is definitely not a
condition of short-term exclusion; when proper precautions are used,
children with HIV infections do not pose risks to others. We have
streamlined, reworded, and reorganized this section (45 CFR 1304.22(b)
in the final rule) in order to clarify our intent. As revised, the
first paragraph (45 CFR 1304.22(b)(1) relates to enrolled children with
short-term injuries or illnesses (such as chicken pox or strep throat).
The second paragraph (45 CFR 1304.22(b)(2)) stresses that grantee and
delegate agencies must not deny children admission to, or participation
in the program for a long-term period, solely on the basis of their
health care needs or medication requirements (such as HIV or asthma),
consistent with the requirements of the Americans with Disabilities Act
and section 504 of the Rehabilitation Act. Further clarification of
issues, such as examples of acute conditions which pose a significant
risk to health or safety, will be provided in the Guidance.
Some commenters raised concerns about potential confidentiality
issues. For example, a number of comments were received on the proposed
standard at 45 CFR 1304.22(c)(5) in the NPRM (45 CFR 1304.22(b)(3) in
the final rule), which requires staff to ask parents about any health
risks that their child may pose. Using HIV as an example, the majority
of commenters focused on legal issues and the potential conflict
between the standard, ADA, and other laws. The purpose of this standard
is two-fold. First, it ensures that staff are informed about conditions
that they may need to address during program hours, both to prevent
contagion and to protect the affected children whose conditions may
place them at risk of harm from contact with others. Second, it ensures
proper observation and supervision for children who require close
monitoring because of potential side effects from the medications they
are receiving. We have modified the wording of the standard for
clarity. The standard at 45 CFR 1304.22(b)(3) now requires that grantee
and delegate agencies ``* * * request that parents inform them of any
health or safety needs of the child that the program may be required to
address. Programs must share information, as necessary, with
appropriate staff, regarding accommodations needed in accordance with
the program's confidentiality policy.''
Confidentiality concerns also were raised about the standard
mandating the sharing of information with staff, parents, and
physicians regarding a child's reaction to medication (45 CFR
1304.22(d)(5) of the NPRM). Many commenters were concerned that
information would be shared with others without expressed parental
authorization. We agree with these concerns, and have changed the
wording in the final rule (45 CFR 1304.22(c)(5)) to clarify that the
intent of this standard is to ensure the health and safety of a child
who is taking medication and to assist parents ``* * * in communicating
with their physician regarding the effect of the medication on the
child.''
Concerns raised about potential costs to grantees focused on two
standards. First, while several commenters supported the standard
mandating the use of a utility sink for cleaning potties (45 CFR
1304.22(f)(6) in the NPRM), a larger number raised concerns about the
present lack of utility sinks in some centers and the costs of plumbing
modifications. Nonetheless, due to the risk of contamination, and in
the interest of the health and safety of all children and adults at
Early Head Start programs, we believe that utility sinks must be used
when cleaning potties. Furthermore, this requirement is consistent with
licensing requirements or regulations in over one-third of the States.
Therefore, we have made no changes to this standard, which can be found
at 45 CFR 1304.22(e)(6) in the final rule.
Standard 45 CFR 1304.22(f)(7) on the spacing of cribs and cots also
produced many comments. A number of commenters supported this standard,
but the majority raised concerns about the cost of spacing cribs and
cots three feet apart and the impact that this would have on programs'
ability to serve children: either more space would be required or the
number of children served would decrease. After careful consideration,
we have decided to keep the required space between cribs and cots at
three feet (45 CFR 1304.22(e)(7) in the final rule). Although we
recognize the possible cost impact, we want to emphasize the importance
of avoiding the spread of contagious illness and the need to allow for
easy access to each child in case of an emergency.
A number of commenters indicated the need for clarification and
additional information on several health and safety standards. For
example, the majority of comments received on the proposed standard at
45 CFR 1304.22(f)(3) in the NPRM (45 CFR 1304.22(e)(3) in the final
rule) mandating the use of gloves criticized the lack of clarity and
the potential for a very rigid interpretation. This standard does not
require staff to wear gloves during routine diapering or when wiping
noses. Following guidelines established by the Occupational Safety and
Health Administration, gloves are to be worn when staff come into
contact with spills of blood or other visibly bloody bodily fluids. We
believe that the proposed standard is sound, and will provide
additional information on when gloves should be used in the Guidance
and in training materials. Other health and safety standards that
require further clarification will also be addressed in the Guidance.
Commenters also noted areas throughout this section in which staff
would need training. In order to maintain consistency throughout the
standards, staff development and training are addressed in 45 CFR
1304.52(k)(3), which requires that training be provided on the content
of the Program Performance Standards. We will address specific training
issues in the Guidance and through training and technical assistance
efforts. For example, staff training on emergency procedures, such as
CPR, first aid, and medication administration, will be addressed in the
Guidance. We also recognize that the intent of certain health and
safety standards is to ensure that staff demonstrate and implement
health and safety practices and procedures. Accordingly, we have
revised the language in 45 CFR 1304.22(c)(6) and 1304.22(d)(1) to
clarify that intent.
In other cases, we have made changes in the standards themselves
based upon the suggestions provided by commenters. For example, a few
commenters proposed that emergency procedures be practiced monthly or
on a specified time schedule. We agree that these procedures need to be
practiced regularly, and have changed standard 45 CFR 1304.22(b)(3) of
the NPRM (45 CFR 1304.22(a)(3) in the final rule) to reflect this
important issue. We have not, however, specified a particular time
 
[[Page 57197]]
 
period in the standard, as some commenters suggested. We believe that
grantee and delegate agencies need to exercise sound judgement in this
area, and that establishing a schedule goes beyond the scope of Federal
regulation. We intend to provide additional information on best
practices in these areas in the Guidance. We also have deleted the
reference to ``staff member'' in 45 CFR 1304.22(a)(2) (45 CFR
1304.22(b)(2) in the NPRM) because this section of the regulation
addresses child health and safety issues. We will provide information
on procedures for dealing with staff emergencies in the Guidance.
Finally, due to the changes made to 45 CFR 1304.20 on child health
and developmental services, sections of the NPRM on medical and dental
follow-up and treatment (45 CFR 1304.22(a) (1)-(5)) have been moved to
45 CFR 1304.20 in the final rule, since they are a key part of the
processes described in that section.
Section 1304.23 Child Nutrition
Commenters were generally supportive of the nutrition standards,
citing, in particular, the flexibility they give grantees in the
implementation of the nutrition program. Criticisms centered around
four issues. First, many commenters noticed the absence of a standard
requiring that Early Head Start and Head Start grantee and delegate
agencies participate in one of the child nutrition programs offered by
the U.S. Department of Agriculture. They pointed out that such a
requirement had been issued previously (see ACYF Transmittal Notice
80.2, dated April 17, 1980, and ACYF-IM-HS-95-29) and, in the interest
of completeness, should be repeated here. We agree, and in order to
consolidate the existing requirements have added a new standard, 45 CFR
1304.23(b)(1)(i) in the final rule, which states that ``All Early Head
Start and Head Start grantee and delegate agencies must use funds from
USDA Food and Consumer Services Child Nutrition Programs as the primary
source of payment for meal services. Early Head Start and Head Start
funds may be used to cover those allowable costs not covered by the
USDA.''
Second, numerous commenters criticized the omission of the standard
requiring the use of child-sized utensils and furniture. They strongly
supported the use of such furniture and equipment, and stated that a
standard was needed to facilitate such use. Although we also strongly
support the use of age appropriate equipment and materials, such as
child-sized utensils and furniture, we have not added such a standard
to this section, as we do not believe that Federal regulations should
prescribe practice at this level of detail. A related standard, 45 CFR
1304.53(b)(1)(iii), continues to require that equipment, toys,
materials, and furniture owned or operated by the grantee or delegate
agency must be ``age appropriate, safe and supportive of the abilities
and developmental level of each child served * * *,'' while leaving
grantee and delegate agencies with the flexibility of determining how
to implement this requirement in accordance with sound early childhood
practice.
Third, many commenters criticized the inclusion of the words
``family style'' in the description of meal service in center-based
settings (see 45 CFR 1304.23(c)(4)), arguing that: (1) The phrase could
be interpreted in many ways, depending on family and cultural
traditions; (2) some local and State laws prohibit ``family meal
service'' for sanitation reasons; (3) in some instances teachers' job
descriptions may be inconsistent with this requirement; and (4) it
would be difficult to comply with this standard if the grantee or
delegate agency is part of a local school system or purchases food
service from an outside vendor because food may come to children in
prepackaged portions. Many commenters recommended returning to language
similar to that in the current standard. Although many of these
concerns are valid, we have retained ``family style'' in the final
rule, defining it simply as adults and children eating together,
sharing the same menu, and talking together in an informal way. To
address the stated concerns, the Guidance will discuss a variety of
ways in which agencies might implement this standard. For example, it
will suggest that, if teachers are required to have time off between
morning and afternoon sessions, aides, volunteers, and other adult
staff may eat with the children. In addition, if children's meals are
already packaged in individual servings, staff and children may still
enjoy eating together and talking.
Finally, several commenters were concerned about the proposed
qualifications for nutrition staff, and stated that they had
difficulties finding appropriately qualified staff in their
communities. Because the qualifications of staff are discussed in a
different section of the standards (45 CFR 1304.52(d)), we have
consolidated the comments on nutrition staff qualifications in that
location of the Preamble.
In addition to the four issues cited above, many commenters
requested clarification of the language used in the proposed standards.
For example, several commenters cited difficulties in interpreting the
term ``nutritional assessment'' in 45 CFR 1304.23(a) in the NPRM,
indicating that this term, as used in medical communities, would
require the services of a licensed assessor, increasing costs
considerably. Since we did not intend that this evaluation of children
be as extensive as a formal medical assessment, we have changed the
title of 45 CFR 1304.23(a) from ``Nutritional assessment'' to
``Identification of nutritional needs.'' In addition, we have clarified
45 CFR 1304.23(a)(1) by changing the phrase ``The nutrition-related
assessment data'' to ``Any relevant nutrition-related assessment data''
to suggest that the data that are collected as a part of the medical
and dental evaluations of children should be examined from the point of
view of child nutrition and used to support and direct the nutrition
program.
We received several comments on the information collection
requirements to complete nutritional assessments and to record
information on family eating patterns and community nutritional issues
which are required in 45 CFR 1304.23(a). Some concern was expressed
about the level of paperwork that would be required to document
nutritional assessments with families. In response, we have clarified
45 CFR 1304.23(a)(1) so that, in identifying a child's nutritional
needs, staff must take into account ``any relevant nutrition related
assessment'' data. This will increase the flexibility in using pre-
existing records rather than conducting special nutritional
assessments.
Several commenters discussed the fact that their Health Services
Advisory Committee was instrumental in identifying major community
nutritional issues, and recommended that this group be identified by
name in 45 CFR 1304.23(a)(4). We have adopted this suggestion, and have
added the Health Services Advisory Committee to the list of sources to
be used. A few commenters suggested changes in the phrasing of 45 CFR
1304.23(b), Nutritional services, and its subparts. Some stated that 45
CFR 1304.23(b)(1) was too prescriptive, as it implied that an agency
must devise a special feeding schedule for each child. This was not the
intent. In order to clarify the meaning of this standard, we have
omitted the term ``feeding schedules'' and have changed the language to
``* * *a nutrition program that meets the nutritional needs and feeding
requirements of each child, including those with special dietary needs
and
 
[[Page 57198]]
 
children with disabilities.'' We also have modified the language in 45
CFR 1304.23(b)(1)(ii) (45 CFR 1304.23(b)(1)(i) in the NPRM) by changing
the list of required types of meals that must be served from ``snack(s), lunch, and other meals, as appropriate'' to simply ``meals
and snacks.'' In response to comments requesting clarification of the
term ``sparingly'' as used in 45 CFR 1304.23(b)(1)(v) in the NPRM (45
CFR 1304.23(b)(vi) in the final rule), we have rewritten the language
to require that agencies serve foods ``high in nutrients and low in
fat, sugar, and salt.''
Several commenters requested the addition of more definitive food
group references to 45 CFR 1304.23(c)(1). We have not changed the
standard because we do not believe that Federal regulations should
prescribe practice at this level of detail. However, the Guidance will
discuss ways in which a variety of foods from all food groups can be
served to children.
Finally, many commenters suggested new language for 45 CFR
1304.23(e), Food safety and sanitation. In 45 CFR 1304.23(e)(1), a few
commenters requested clarification of the term ``properly licensed'' in
reference to food service agencies. We have omitted the word
``properly'' in the final standard, using instead the phrase ``licensed
in accordance with State, Tribal or local laws.'' Several commenters
suggested that we add ``formula'' to the requirement for the proper
storage and handling of breast milk in 45 CFR 1304.23(e)(2), as both of
these substances may be brought from home to the center and need to be
stored and handled appropriately. Although we believe that formula is
covered under 45 CFR 1304.23(e)(1), which requires the safe and
sanitary storage and preparation of food, we also have included it in
45 CFR 1304.23(e)(2) in order to re-emphasize the critical nature of
food storage and handling for infants.
In addition to the issues raised with regard to nutrition and the
requests for clarification of the language used in the standards,
commenters also described the need for guidance in the implementation
of several of the standards. Specifically, they requested more
information on activities to promote effective dental hygiene (45 CFR
1304.23(b)(3)); a listing of the appropriate community agencies to
involve in implementing nutritional services (45 CFR 1304.23(b)(4));
guidelines regarding the amount of time children should be given to eat
meals and snacks (45 CFR 1304.23(c)(3)); a list of ``other'' dietary
requirements that children might have (45 CFR 1304.23(c)(6));
suggestions for how families can be assisted with food preparation and
nutrition skills (45 CFR 1304.23(d)); and a detailed description of the
optimal procedure for storing and handling breast milk (45 CFR
1304.23(e)(2)). These topics will be addressed in the Guidance
materials to be published at a later date.
Section 1304.24 Child Mental Health
Commenters generally supported the increased emphasis on mental
health services for children in the proposed standards, which they
found to be consistent with the needs identified by grantees and with
the recommendations of the Advisory Committee on Head Start Quality and
Expansion. In particular, several commenters commended the increased
emphasis on parent involvement in mental health. Commenters also
supported the proposed standards' listing of the mental health services
to be provided. On the other hand, commenters expressed significant
concern that the level of effort expected from the mental health
professional in carrying out these services would be difficult to
obtain because of the limited availability of such professionals,
particularly in rural areas, and because of the costs of obtaining such
services from these professionals.
Our intent in this section is to ensure that parents and staff
understand the contribution that mental health services can make to the
well-being of each child as well as the role that various individuals,
including parents, staff, and mental health professionals, play in this
effort. Therefore, we believe that it is important for mental health
professionals to be included in program services. We do not mean,
however, that mental health professionals must be hired as staff or be
physically present on a daily basis. Rather, they must be available to
provide services for which State licensing and certification are
required, and to advise and make recommendations to grantee and
delegate agencies as necessary. We have modified several standards to
provide clarification in this area (see the previous discussion in this
Preamble on 45 CFR 1304.20(b)(2) and 45 CFR 1304.20(d)).
Cost concerns were raised by commenters relative to the requirement
in 45 CFR 1304.20(e) of the NPRM that ongoing assessments be conducted,
which they interpreted to mean that the mental health professional must
individually observe each child in Early Head Start or Head Start. This
was not the intent. We have revised the standard in the final rule (45
CFR 1304.20(d)) to emphasize the need for grantee and delegate agencies
to implement procedures to identify new or recurring developmental
concerns so that they can quickly make appropriate referrals. However,
we leave agencies with the discretion to determine the level of
involvement of mental health professionals. We do require, however, in
45 CFR 1304.20(b)(2) of the final rule on developmental, sensory, and
behavioral screenings, that ``Grantee and delegate agencies must obtain
direct guidance from a mental health or child development professional
on how to use the findings to address identified needs.''
Several commenters sought clarification on the level of effort and
the costs implied by other requirements in the child mental health
section. For example, some asked for a definition of ``a schedule of
sufficient frequency'' in 45 CFR 1304.24(a)(2). We will provide
information in the Guidance on determining a schedule of frequency most
appropriate for meeting local needs. Likewise, some commenters asked if
persons other than a licensed or certified mental health professional
could perform some of the functions described in order to avoid costs
to the agency and to ensure that an individual is available to perform
the required services. Since we consider it critical that a licensed or
certified individual be available to each program, we continue to
require the services of mental health professionals. We encourage
agencies to augment the services of mental health professionals with
non-certified and non-licensed individuals as long as the functions
these individuals serve are consistent with State licensing and
certification requirements. In the Guidance, we will describe
arrangements that demonstrate ways to make use of non-certified and
non-licensed individuals in order to augment the services of mental
health professionals. For example, some parent education and teacher
consultation may be performed by non-certified or non-licensed
individuals.
In response to the standard requiring agencies to utilize community
mental health resources, 45 CFR 1304.24(a)(3)(iv), many commenters
indicated that such services either do not exist in their communities
or do not address Early Head Start and Head Start's needs. Commenters
strongly recommended that Early Head Start and Head Start agencies work
with other community agencies serving children and families (e.g.,
child care or early childhood special education agencies) to develop
and sustain family-centered services in their community. Although we
agree with these comments, we have
 
[[Page 57199]]
 
not changed this requirement. Information on partnerships with mental
health and other family support agencies in order to address mental
health service needs will be provided in the Guidance.
 
Subpart C--Family and Community Partnerships
 
Section 1304.40 Family Partnerships
Overall, the comments regarding the new Family Partnerships section
expressed strong approval for the philosophy of supporting families to
foster their child's development and assisting families to attain their
personal goals. The comments made clear that the development of family
partnerships is not a new activity for many Head Start grantee and
delegate agencies, and that there are a variety of models and
experiences which can be drawn upon in formulating successful
partnerships. We have made every effort to allow for local program
flexibility in the implementation of these standards.
Many of the commenters identified areas requiring clarification or
further guidance on exactly ``how to'' implement particular standards.
The need for enhanced training and resources was echoed throughout the
comments. In response, minor revisions were made to several of the
standards to improve their clarity. For most of the standards, however,
additional information will be provided in the Guidance.
Several commenters expressed concern about the term ``assessment''
in the title of 45 CFR 1304.40(a) in the NPRM. As indicated by their
comments, the term has many connotations and was understood by some to
identify a particular process for determining family strengths and
needs. This was not the intent. Rather, the new standard was designed
to give grantee and delegate agencies the flexibility needed to develop
their own strategies for working with a diverse group of families.
However, in response to these concerns, the language in 45 CFR
1304.40(a) has been changed from ``Assessment and goal setting'' to
``Family goal setting.'' To further strengthen the concept that grantee
and delegate agencies must develop strategies that suit the interests,
needs, and circumstances of the families that they serve, the language
in 45 CFR 1304.40(a)(1) has been expanded to state that the process
``must take into consideration each family's readiness and willingness
to participate in the process.'' The new term to describe the document
jointly created through this process is the Family Partnership
Agreement, which replaces the current standard related to conducting a
family needs assessment.
Other commenters suggested that the language in several of the
standards in 45 CFR 1304.40(a) conveys the sense that Early Head Start
or Head Start staff are setting goals ``for'' families rather than
``with'' families. In order to strengthen the notion of partnerships,
the language in several standards has been slightly modified. In 45 CFR
1304.40(a)(2), for example, the language has been changed from ``assist
parents'' to ``offer parents opportunities.'' Other similar changes
were made throughout this section. We have also added language in 45
CFR 1304.40(a)(2) that further clarifies the role of parents and staff
in home-based programs in the development of Family Partnership
Agreements.
Commenters supported the increased coordination with families and
other community agencies to avoid duplication between the Family
Partnership Agreement and other preexisting family plans as required in
45 CFR 1304.40(a)(3). However, many raised issues related to
confidentiality, timeliness, and the willingness of community agencies
to share such information. Although we recognize that these constraints
may exist and that partnerships cannot be mandated, we do expect
agencies to find ways to develop partnerships, even with less willing
partners, and to establish alliances that will provide the desired
results over a period of time.
Commenters questioned the new requirement in 45 CFR
1304.40(b)(1)(i) that agencies directly provide emergency or crisis
assistance to families as well as the possible costs and liabilities
associated with the provision of such assistance. For purposes of
clarity, we deleted the words ``including such direct interventions as
the provision of,'' and added ``in areas such as.'' We emphasize that
this standard, as revised, reflects our long-standing view that grantee
and delegate agencies should continue to develop partnerships and to
link families to existing community resources in order to address
emergency or crisis assistance needs. We believe that this intent is
further clarified if the standard is read in conjunction with the
preceding language of 45 CFR 1304.40(b)(1).
Several commenters questioned which pregnant women are covered
under 45 CFR 1304.40(c). These standards are limited to pregnant women
enrolled in Early Head Start programs. However, we expect that all
pregnant women, those in Early Head Start as well as those in Head
Start, will be provided with opportunities to learn about the
principles of health and wellness as articulated in 45 CFR
1304.40(f)(2)(iii).
Many commenters responded favorably to the expanded integration of
parent involvement throughout the standards and especially to its
emphasis within the section on Family Partnerships. Other comments
regarding parent involvement raised several concerns. One concern
focused on the issue surrounding parent involvement activities for
parents who are working or who are in training and are not able to
spend time in their child's classroom. Many grantee and delegate
agencies have faced this situation for some time, and have developed an
array of methods to involve parents in less traditional ways. Given the
shift towards increased workforce participation for the parents of
young children, agencies are expected to offer parent participation
opportunities to all interested family members, both men and women, in
a sufficiently varied manner that enables them to participate. We
recognize the added challenges of encouraging parents to participate.
However, we believe that 45 CFR 1304.40 (d)-(f) encourage grantee and
delegate agencies to broaden their vision about how to develop and
implement meaningful parent involvement opportunities. Additional
discussion will be included in the Guidance.
In response to several comments that encouraged us to support a
wide range of parent involvement opportunities, we have changed the
language in 45 CFR 1304.40(d)(1) from ``must provide parent involvement
and education activities that are responsive to the ongoing and
expressed needs of the parents themselves'' to ``must provide parent
involvement and education activities that are responsive to the ongoing
and expressed needs of the parents, both as individuals and as members
of a group.''
The parent involvement standards include the requirement in 45 CFR
1304.40(e)(3) that grantee and delegate agencies provide, either
directly or through referrals, opportunities for children and families
to participate in family literacy services in accordance with Section
641(4)(c)(i) of the Head Start Act, as amended. Although a few
commenters indicated that providing such services would result in a
financial burden, the majority made no mention of additional costs or
concerns surrounding this requirement. We interpreted this to mean that
the funding received by grantee and delegate agencies for family
literacy,
 
[[Page 57200]]
 
which is now part of their basic grants, covers costs related to this
service; and that resources for family literacy activities are
available in most communities, and that grantee and delegate agencies
expect to be able to work with community providers to support family
literacy efforts.
Commenters raised questions about the requirements of 45 CFR
1304.40(e)(4) and 45 CFR 1304.40(i)(2) regarding the relationship
between staff-parent conferences and teacher home visits. These
standards require a minimum of four parent contacts (two home visits
and two staff-parent conferences) throughout the program year. To
clarify this intent, and to emphasize the importance of contacts
between education staff and parents, a new standard was added in 45 CFR
1304.21(a)(2)(iii) which encourages parents to participate in staff-
parent conferences and home visits to discuss their child's development
and education. In addition, language was added to 45 CFR 1304.40(i)(2)
to emphasize the importance of other staff making or joining home
visits, as appropriate. Other clarifying information on this topic will
be provided in the Guidance.
Numerous commenters on 45 CFR 1304.40(g)(1)(ii) proposed that the
provision of a comprehensive community resource list to parents be
mandatory, rather than being provided ``when available.'' We have
revised the standard to require that agencies ``establish procedures to
provide families with comprehensive information about community
resources'' in order to better reflect the intent that providing
families with such information is a cornerstone of parent involvement
activities.
The requirement at 45 CFR 1304.40(h)(2) to conduct staff-parent
meetings to support transition services in accordance with section
642(d)(4) of the Head Start Act, as amended, raised concerns among some
commenters, particularly related to the timing of these meetings at the
end of children's participation in the program. We expect that,
throughout the program year, parents will be provided with
opportunities to expand their knowledge about community services and
resources and to develop networks and relationships with families,
service providers, community agencies, and school systems. Therefore,
the standard has been retained as proposed.
Commenters expressed their support for the acknowledgment that home
visits may present safety hazards for staff in 45 CFR 1304.40(i)(4).
However, we want to emphasize the importance of home visits occurring
in the home setting to the extent possible in order to maximize the
personal interaction of the parent, child, and program staff, and we
will further address the topic of home visits in the Guidance.
Section 1304.41 Community Partnerships
Many of the comments on the new Community Partnerships section
strongly endorsed the focus on community planning, cooperation, and
information sharing in order to improve the delivery of community-based
services to children and families. The standards on parent involvement
in transition services in 45 CFR 1304.41(c) also generated favorable
comments. While a number of commenters stated that cultivating
alliances with other community agencies and service providers takes
time and persistence on the part of Early Head and Head Start grantee
and delegate agencies, a significant number indicated that they have
already embraced this process, and that the families they serve are
reaping the benefits of these partnerships. Many of the comments
included practical information on successful efforts to build such
partnerships. This information will be integrated into the program
Guidance.
While the comments were generally positive, two important concerns
with respect to the development of community partnerships emerged.
First, one group of commenters expressed concern about the likelihood
of success in developing community partners, as required in 45 CFR
1304.41(a), citing the competition for scarce resources and local
obstacles, both of which have prevented cooperation in the past. As the
development of community partnerships is now a requirement, concerns
around monitoring issues were also expressed. Specifically, many
commenters stated that grantee and delegate agencies, by themselves,
cannot make parents and communities receptive to partnerships.
We recognize that fostering and building partnerships is an
activity that occurs over time and will require differing levels of
effort for Early Head Start and Head Start grantee and delegate
agencies. However, we firmly believe that these agencies have both the
responsibility and the capacity to provide leadership in their
communities to promote access to services that will enhance the well-
being of families and children. While the standards do set high
expectations for agencies, they also provide the flexibility needed to
respond to a wide variety of circumstances. We are confident that each
agency can demonstrate progress in this area, recognizing that, for
some, partnerships will develop more slowly than for others. Therefore,
the intent of 45 CFR 1304.41(a) remains unchanged. We will support
agencies in these efforts by providing program Guidance and training
for staff in the area of developing partnerships.
The second overarching theme that was raised is the need for
additional resources, both staff time and training, to support the
development of community partnerships. The commenters stressed that
cultivating relationships with a variety of agencies and organizations
requires time to make telephone calls, to attend meetings, and to share
ideas. While this move toward a greater emphasis on community
partnerships may require an initial shifting of responsibilities and
scheduling for staff in some agencies, we expect that, over time, this
effort will become an integral and routine part of agency operations.
The standards provide agencies with a great deal of flexibility in
deciding how to undertake this effort. We are also providing additional
funds for transition coordination. With these additional resources and
targeted training, we expect that every agency will be able to meet
these standards.
The remaining comments about the Community Partnerships section
addressed specific standards. For example, 45 CFR 1304.41(a)(2)
contains a list of community agencies and service providers with which
Early Head Start and Head Start agencies must take steps to establish
ongoing relationships. The commenters, while supportive of the proposed
list, provided many potential additions. We believe that the list of
potential partners provided in the NPRM represents a core set of
resources that will be found in most communities. In developing this
list, we attempted to create a balance between articulating a range of
entities representing a possible complement of community partnerships
and not causing a burden on agencies located in areas that lack
supports. Agencies are encouraged to expand upon this list. We have
made one addition to the standard, namely ``businesses,'' in order to
include another important community partner (45 CFR 1304.41(a)(2)(ix)).
Commenters questioned the rationale for mandating a Health Services
Advisory Committee in 45 CFR 1304.41(b), while making other Service
Area Committees voluntary. We structured the standard in this manner to
minimize regulatory burden and to ensure flexibility for local grantee
and delegate agencies. A Health Services
 
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Advisory Committee is required in the current regulation. We have
maintained this requirement because our experience indicates that the
Committee plays an important role in helping grantee and delegate
agencies access needed health services for Head Start children and
families as well as in ensuring that agency health and safety practices
are consistent with the most current information available from the
health fields. We support the importance of grantee and delegate
agencies structuring and operating additional Advisory Committees
should they feel the need to do so.
Commenters also requested clarification about the transitioning of
Early Head Start children and how to plan for the next level of
service. Therefore, to provide the greatest degree of flexibility
possible for the program and the family, and to allow for adequate
advance time for consideration of potential alternate placements, a new
standard, 45 CFR 1304.41(c)(2), has been added which describes the
transition planning process. We received a few comments about the
information collection requirements regarding the building of
partnerships in the community in 45 CFR 1304.41. Commenters supported
the partnership building process, but were unsure about how to document
it. In response, language was added to 45 CFR 1304.41(a)(1) to state
that programs should document ``the level of effort undertaken to
establish community partnerships.'' This language also responds to the
concerns expressed by some commenters about situations where community
planning efforts are not supported by other community groups. This
requirement gives agencies a chance to document their ongoing efforts,
which may not always be successful.
 
Subpart D--Program Design, Design and Management
 
Section 1304.50 Program Governance Standards
Commenters stated that the proposed standards in the Program
Governance section more clearly outline the structure,
responsibilities, and roles of the governance structure within Early
Head Start and Head Start than do the existing standards. In addition,
they supported the greater focus in these standards on parent decision-
making responsibilities which broaden and increase the linkages between
the governance structures. Commenters also approved the renaming of
``Center Committee'' to ``Parent Committee'' in 45 CFR
1304.50(a)(1)(iii), viewing this change as reflecting consistency among
all of the program options, since a ``Parent Committee'' must exist
regardless of the program option. Many positive comments focused on the
increase to 51 percent representation of parents of currently enrolled
children on the Policy Councils and Policy Committees (45 CFR
1304.50(b)(2). Many said that this requirement maintained the intent
and philosophy of Head Start.
Commenters also expressed a number of concerns about the governance
section as a whole. First, a general sense of confusion existed about
the role of the Parent Committee as a policy-making body because the
proposed standards erroneously implied that Parent Committees have
formal policy-making authority. Parent Committees are part of the
shared decision-making governance structure and perform a number of
functions, including planning with staff and providing input regarding
program decisions. They also provide leadership in electing Policy
Council representatives to perform policy-setting tasks. To address the
concerns, we changed 45 CFR 1304.50(a) from ``Policy group structure''
to ``Policy Council, Policy Committee, and Parent Committee
structure.''
Second, nearly all of the commenters were critical of giving Early
Head Start and Head Start programs the latitude to determine term
limits for Policy Council and Policy Committee members (45 CFR
1304.50(b)(5)). The intent was to provide greater flexibility to local
agencies than exists in the current standards. However, many commenters
felt that term limits were necessary because of the benefit they
provide to the parents and the program. In response to the overwhelming
comments that membership on the Policy Council or Policy Committee
should be limited to a combined total of three one-year terms, we have
restored this requirement.
In Sec. 1304.50(b)(7) the word ``adequately'' was changed to
``proportionally'' for clarification purposes. Grantee and delegate
agencies operating programs with more than one program option are
expected to ensure that there is sufficient representation from each
option on the policy groups and for establishing a ratio of
representation on the Policy Council or Policy Committee that is
proportionate to the relative size of each of the program options.
A final area of concern raised by many commenters related to
``Appendix A: Policy Group Responsibilities.'' Appendix A, as proposed
in the NPRM, attempted to resolve some long-standing misunderstandings
about the chart in Appendix B to the current Program Performance
Standards,