[Federal Register Volume 61, Number 215 (Tuesday, November 5, 1996)]
[Rules and Regulations]
[Pages 57186-57227]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-28134]
[[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
Federal Register / Vol. 61, No. 215 / Tuesday, November 5, 1996 /
Rules and Regulations
[[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:
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.
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.
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).
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:
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.
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.
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:
Striving for excellence in staffing, management,
oversight, facilities, and research;
Expanding to better meet the needs of children and
families; and
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:
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.
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:
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
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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.
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.
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:
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.
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.
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
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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, most commonly known as 70.2. In the proposed Appendix A, we
omitted the columns for the Executive Director and the Early Head Start
or Head Start Director to emphasize and depict the roles and
responsibilities within the governance structure. However, in response
to the overwhelming recommendations from commenters, we have
reconfigured Appendix A to include columns for key management staff
responsibilities in order to emphasize the linkages and partnerships
between the policy groups and the management staff of Early Head Start
and Head Start programs. In order to build strong partnerships when
there is a shared decision-making structure, it is essential that the
roles and responsibilities of each entity be clearly understood.
However, we want to emphasize that it is the responsibility of each
agency's governing body to establish the role of the agency director
and to participate with the Policy Council or the Policy Committee in
setting the direction for the Early Head Start or Head Start director's
role in managing the day-to-day operations of the program.
To underscore and support linkages and partnerships among the
governance functions and the management staff functions, we have made
several changes in Appendix A. First, we retitled the chart
``Governance and Management Responsibilities.'' Secondly, we cross-
referenced applicable standards to the functions listed in Appendix A.
Third, we added cross-references to appropriate standards in 45 CFR
Part 1304.51, Management Systems and Procedures, and in 45 CFR part
1301, both in the standards and in Appendix A. Fourth, as stated above,
two columns have been added to the chart regarding the roles and
responsibilities of key management staff and how they relate to the
governing bodies and policy groups of Early Head Start and Head Start
programs. In some cases, we consolidated similar functions to improve
clarity and avoid repetition. Fifth, we added a new standard, 45 CFR
1304.50(g)(2), to the body of the regulation. Previously, this
requirement was presented only in Appendix A. This new standard clearly
outlines the responsibility of grantee and delegate agencies to ensure
that there are appropriate internal controls established and
implemented to safeguard Federal funds, in accordance with 45 CFR
1301.13. In addition, to further
[[Page 57202]]
underscore the importance of the oversight functions of the grantee or
delegate agency governing bodies, 45 CFR 1304.50(d)(1)(ix) was added.
It cross-references 45 CFR 1301.12, which requires each Early Head
Start and Head Start program have an annual independent audit.
In order to underscore linkages and partnerships between governance
structures and management staff, we removed the word ``help'' from 45
CFR 1304.50(d)(1) and added the language ``* * * work in partnership
with key management staff and the governing body to develop, review,
and approve the following policies and procedures * * *'' A number of
commenters recommended changing the word ``agency'' to ``program'' in
45 CFR 1304.50(d)(1)(iv), and we have done so in order to more closely
match the corresponding standard in Management Systems and Procedures,
45 CFR 1304.51(a)(1)(ii). The standard now reads, ``The program's
philosophy and long- and short-range program goals and objectives.''
In many instances, commenters requested more specific language in
the standards. For example, in response to the comments received, we
added more stringent language in 45 CFR 1304.50(b)(6) which excludes
staff of grantee and delegate agencies and members of their immediate
families from participating on policy groups. We also added language to
limit exclusions of Tribal staff.
Commenters also recommended several changes or additions in wording
to increase clarity. For example, commenters found the requirement that
community representatives ``* * * provide resources and services to
low-income children and families'' in 45 CFR 1304.50(b)(4) in the NPRM
to be unduly restrictive of community membership, and stated that it
posed a potential conflict of interest for community members. We agree,
and have changed the language in 45 CFR 1304.50(b)(3) in the final rule
to individuals who are ``* * * familiar with resources and services for
low-income children and families'' in order to broaden the pool of
potential community representatives. Several commenters suggested that
a definition be provided for ``parents of currently enrolled children''
and, in response, we have cross-referenced the definition of ``Head
Start parent'' in 45 CFR 1306.3(h) in 45 CFR 1304.50(b)(2) in the final
rule. A few commenters called our attention to the incorrect inclusion
of the term ``indirect cost rates'' in 45 CFR 1304.50(d)(1)(i). We have
replaced this term with ``administrative services,'' which more
accurately reflects the intent in this standard.
Finally, commenters suggested adding language to 45 CFR
1304.50(d)(1)(x) to clarify which staff hirings or terminations the
Policy Council or Policy Committee can review and approve or
disapprove. We have created two standards to increase clarity. The
first standard, 45 CFR 1304.50(d)(1)(xi), addresses decisions related
to the hiring or termination of the Early Head Start or Head Start
director. The second standard, 45 CFR 1304.50(d)(1)(xii), relates to
the hiring or termination decisions regarding other Early Head Start or
Head Start staff. A few commenters also questioned the legality of
Policy Councils and Policy Committees being involved in hirings or
terminations because it might violate employees' rights to privacy. We
believe that the procedures, when properly implemented, will ensure
that staff rights are protected.
Section 1304.51 Management Systems and Procedures
In general, there was strong support for the addition of a new
section on management systems and procedures, since it added standards
in areas that are critical to program quality but which are not
addressed explicitly in current Head Start regulations. Commenters
suggested that having all of the standards on management systems and
procedures in one place would facilitate program implementation. Many
commenters stressed that strong systems are essential to maintaining
quality in Early Head Start and Head Start programs. They particularly
liked the standards on planning and communication, stating that they
were well written and clear. Where commenters suggested changes, they
generally requested wording changes to help clarify a standard, rather
than significant changes.
Overall, there was strong support for addressing planning in the
standards and for the clarity of the language and intent of 45 CFR
1304.51(a) on program planning. There were, however, a few requests to
change or clarify wording, including a recommendation by several
commenters to change the term ``Community Needs Assessment'' to
``Community Assessment.'' They felt the latter term is more inclusive,
taking into account community strengths and assets as well as needs. We
agree with this recommendation, and have changed the term to
``Community Assessment'' in this section. Conforming changes also were
made in 45 CFR 1305.3.
We invited comments in the NPRM on whether the standards in 45 CFR
1304.51(g) should require that record-keeping systems be supported by
appropriate computer technology, and whether such a requirement would
pose an unreasonable burden for agencies. Most commenters, while
supporting the use of computer technology as a cost-efficient means of
enhancing the accuracy and timeliness of record-keeping functions,
thought that computerized record-keeping should not be required. Most
said that such a requirement would place an undue financial burden on
local programs, unless they received additional funding for computers,
computer software, additional training for staff, additional support
staff to enter data, and technical support. Such support would be
needed, as many agencies, particularly small and rural ones, lack the
infrastructure and funding to support computer technology. In response,
we have not added language that would require record-keeping systems to
utilize computer technology. In the Guidance, however, we intend to
encourage grantee and delegate agencies to use technology to more
efficiently manage records and other program information.
Some commenters noted that we did not address the confidentiality
of records in 45 CFR 1304.51(g). We agree that this concern should be
addressed, and have added language in the final rule stating that
grantee and delegate agencies must ensure the ``* * * appropriate
confidentiality of * * * information'' contained in the records.
We received many supportive comments on 45 CFR 1304.51(i), program
self-assessment and monitoring. Commenters expressed support both for
the description of self-assessment as a process for program
improvement, rather than as one to address compliance issues only, and
for the addition of language in the standard related to effectiveness
and progress in meeting grantee-specific program goals and objectives.
There were some requests for clarifications of the wording used.
Commenters thought, for example, that the language in 45 CFR
1304.51(i)(1) requiring that self-assessments be conducted ``in
consultation with other community agencies'' was confusing,
particularly since the standard also states that the self-assessment
must be conducted ``with the consultation and participation of policy
groups.'' In response, we have slightly reworded the standard, while
retaining the intent of involving community agencies in the self-
assessment process.
Commenters noted that 45 CFR 1304.51(i)(2) called for monitoring
the
[[Page 57203]]
program operations of delegate agencies, but not those of grantees. In
response, we have clarified that grantees must monitor their own Early
Head Start or Head Start program operations as well as, in the case of
Head Start, those of each of their delegate agencies, since it is the
intent of this standard that Early Head Start and Head Start grantees
ensure that high quality services are being delivered in their own
programs as well as by Head Start delegate agencies.
Several commenters took issue with the fact that, in 45 CFR
1304.51(i)(3), we state that the grantee must inform the delegate
agency governing body of any deficiencies that are identified in the
review of delegate agency performance. They thought it inappropriate to
inform the governing body before staff have an opportunity to correct a
problem. We did not change this standard, since the governing body of a
grantee or delegate agency is ultimately responsible and accountable
for ensuring that all Head Start regulations are met.
Section 1304.52 Human Resources Management
Overall, there was considerable support for the proposed Human
Resources Management standards, particularly in the areas of
qualifications for the Early Head Start or Head Start director and a
number of other staff positions, training and development, staff
performance appraisals, and standards of conduct. Commenters agreed
that the increased emphasis on these areas would directly promote
improved program quality. Criticism focused on: Organizational
structure and management roles; staff qualifications and availability
for some staff positions; staff and volunteer health; staffing
patterns; and staff training and development. Each of these issue areas
is discussed in turn below.
Some commenters felt that the proposed standard at 45 CFR
1304.52(a)(1) on organizational structure did not give sufficient
flexibility to programs in designing their own organization and in
developing staff positions. However, after reviewing the standard in
light of these comments, we have concluded that it does not need to be
changed, because the original standard is written to provide the
flexibility the commenters desired. This standard requires that
agencies adopt an organizational structure that will suit their own
individual needs while addressing the management functions contained in
the standards, but it does not, and is not intended to, require any
specific organizational structure. We agree fully with commenters that
individual programs are organized very differently to meet the
particular needs of the children and families they serve.
Commenters also found the proposed standards on program management
roles at 45 CFR 1304.52(a)(1), 45 CFR 1304.52(a)(2), and 45 CFR
1304.52(b)(2) confusing, and we have tried to address these concerns.
One area of confusion related to whether the management roles specified
in 45 CFR 1304.52(a)(2) were different from the positions identified in
45 CFR 1304.52(c) (2)-(5) (45 CFR 1304.52(d) in the final rule)
regarding management staff qualifications. We have made several changes
to reduce this confusion. First, we have substituted the term
``functions'' for ``roles'' in 45 CFR 1304.52(a)(2) to clarify that we
are only requiring that the expertise to perform these management
functions exist somewhere within each agency. How and to what extent an
agency provides for this expertise in its organizational structure is
dependent upon its needs. In many cases, agencies will choose to divide
each of the responsibilities, or functions, listed among more than one
program manager. Second, we deleted the list of positions at 45 CFR
1304.52(b)(2) in the NPRM since it was confusing, and was intended only
to reference other positions that might be regulated in this Part or in
45 CFR Part 1306.
With regard to 45 CFR 1304.52(b)(3) concerning the employment of
current and former Head Start parents, the NPRM stated that parents ``*
* * must receive preference for employment vacancies if they are well
qualified.'' Most commenters suggested that the word ``well'' be
eliminated, since it is a subjective term that is difficult to define
and might discourage agencies from considering parents for many
positions. We agree with this concern, and have made this change. We
have also added Early Head Start parents to this standard.
Finally, 45 CFR 1304.52(c), which addresses management staff
qualifications, now only includes qualifications for the Early Head
Start or Head Start director. A number of commenters noted that
limiting the director's training and experience to the areas of early
childhood or human services program management is too restrictive, and
that management skills and abilities are critical qualifications for
this position. Therefore, we have changed the language in the standard
to state that the director must have ``* * * demonstrated skills and
abilities in a management capacity relevant to human services program
management.''
The remainder of 45 CFR 1304.52(c) in the NPRM has been reorganized
as 45 CFR 1304.52(d) in the final rule and retitled ``Qualifications of
Content Area Experts,'' since it refers to staff or consultant
positions related to individual program content areas. We have also
substituted the term ``supported by'' for ``managed by'' to highlight
that staff or consultants who provide the necessary content area
expertise to an agency do not necessarily have to be designated as
managers. We do, however, expect these individuals to provide expertise
and oversight in activities such as planning, service delivery and
staff training and development.
A major concern raised related to the specific kinds of staff
qualifications that are proposed for certain managerial positions, such
as health, nutrition, and mental health. Many commenters were concerned
that, particularly in rural areas, staff who meet the proposed
qualifications for these positions may not be available. A secondary
concern was the impact that the proposed qualifications might have on
current staff, who do not possess the proposed qualifications for the
roles they are currently performing.
In addressing these concerns, we tried to balance our commitment to
program quality, as suggested by the Advisory Committee on Head Start
Quality and Expansion, with our commitment to providing maximum
flexibility to grantee and delegate agencies. On the one hand, we want
to ensure that staff are well qualified to perform their work with
children and families, since the quality of staff has a direct bearing
on the quality of an Early Head Start or Head Start program and the
services it provides. On the other hand, we tried to ensure that the
new standards are sufficiently flexible to allow agencies both to look
outside their programs for needed expertise and to provide current
employees time to obtain the additional training that they will need.
For example, in the new standard at 45 CFR 1304.52(d), we added
language that allows for the use of consultants on a regularly
scheduled or ongoing basis in agencies where staff do not possess the
expertise to provide the content expertise or oversight roles in
education and early childhood development, health, nutrition, mental
health, family and community partnerships, parent involvement,
disabilities services, and fiscal services.
In addition, in response to the comments received, we have provided
greater flexibility with regard to two of the specific oversight roles
listed in the new 45 CFR 1304.52(d). In the area of
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nutrition, we have deleted the reference to full-time personnel, since
commenters pointed out that it is inconsistent with other standards in
this section. In response to the comments, and in consultation with our
colleagues in other agencies, we believe that nutrition services must
be supported on at least a regularly scheduled consultant basis by
registered dietitians or nutritionists. However, the Guidance will
clarify how other professionals, such as Certified Dietary Managers,
may be used to help support nutrition services as well. In the new 45
CFR 1304.52(d)(8), we dropped the requirement that the fiscal officer
possess ``Certified Public Accountant or other appropriate
credentials,'' since many commenters raised the issue of cost regarding
this requirement. However, even though it might entail additional costs
to agencies, we still require that fiscal officers be ``qualified'' to
perform their responsibilities, since this is a critical area in
ensuring program quality. In some cases, agencies may decide that a CPA
provides the most appropriate qualifications for their particular
program.
We believe that the persons providing expertise and content
oversight in the program areas listed in 45 CFR 1304.52(d)(1)-(8) must
have the broad kinds of training, experience, and license or
certification specified, since their jobs require them to provide
direction to and input into program planning and service delivery, as
well as training and other developmental activities to staff in program
content areas who are working directly with children and families.
Therefore, we have left the kinds of training and experience listed
largely unchanged for each of the oversight roles. However, we decided
not to define what ``training and experience'' means in regulation, in
the interest of allowing maximum flexibility for grantee and delegate
agencies. We will provide examples of best practice with regard to
training and experience in the program Guidance.
Finally, many commenters asked if there would be opportunities for
current staff who do not meet the qualifications required in this Part
to remain in their positions through provision of a ``grandfather
clause.'' Although we have not chosen to provide such language in the
final rule, we note that the effective date at 45 CFR 1304.2 by which
agencies must implement the new rule has been extended to January 1,
1998. This will provide each agency with the opportunity to review the
qualifications of its current staff and to assist staff in obtaining
the necessary additional training, where appropriate. In addition, as
previously mentioned, the needed expertise can also be obtained through
regularly scheduled program consultants.
The Preamble to the NPRM stated that Sec. 1304.52(f) cross-
referenced the requirements in section 648A of the Head Start Act. Our
intent was to require the Child Development Associate (CDA) or
equivalent credential for Early Head Start teachers and other staff
working as teachers of infants and toddlers as well as for regular Head
Start teachers. Some commenters indicated that our language did not
clearly convey this intent. We therefore have revised this standard to
make clear that the staff working as teachers of infants and toddlers
are required to obtain the Child Development Associate or equivalent
credential.
Most of the commenters agreed that it was important to have
qualifications for infant and toddler staff to ensure program quality,
and many specifically supported the proposed requirement in 45 CFR
1304.52(f) that staff working as teachers have the CDA or an equivalent
credential. However, there were some concerns. First, commenters found
the use of the term ``caregiver'' ambiguous, confusing and, for some,
``unprofessional.'' Second, a number of commenters expressed confusion
as to which classroom staff would be required to obtain CDAs or
equivalent credentials, with some commenters suggesting that we set a
minimum standard for all classroom staff. Third, concern was expressed
that we needed to provide a reasonable period of time for staff to earn
their CDA or equivalent credential. Finally, some commenters felt that
insufficient detail was provided regarding the training and experience
necessary for infant and toddler staff.
In response to these comments, we have changed, as discussed in the
section in this Preamble related to 45 CFR 1304.3, the term infant and
toddler ``caregiver'' to ``teacher.'' In response to the second issue
described above, we have modified Sec. 1304.52(f) to indicate that all
staff working as classroom teachers, including those working as
teachers of infants and toddlers, are required to obtain CDAs or
equivalent credentials. We did not, however, prescribe a minimum
standard for all classroom staff, because we believed that it would
impede the ability of some programs to hire staff from the communities
they serve and to provide career development opportunities for parents
and former parents of program children. With regard to the third issue,
we have revised the standard to indicate that current teachers of
infants and toddlers must obtain a CDA credential or its equivalent
within one year of the January 1, 1998, effective date of the final
rule. We believe that this will provide sufficient time for infant and
toddler teachers to obtain the necessary credentials. Finally, we have
amended Sec. 1304.52(f) to require that Early Head Start staff or other
staff working as teachers of infants and toddlers must obtain a
specific CDA credential for infant and toddler caregivers or an
equivalent credential that addresses comparable competencies. In our
Guidance to the field, we will provide examples of appropriate training
and experience for staff working with infants and toddlers.
In response to commenters' requests, we have added a new standard
at 45 CFR 1304.52(e) regarding home visitor qualifications. This
standard does not require specific academic training, certification or
licensure, because of the many different kinds of backgrounds that
could be appropriate. Instead, it requires that home visitors have
knowledge and experience in key areas related to child and family
growth and development.
Many commenters supported the standard at 45 CFR 1304.52(i)(1) (45
CFR 1304.52(j)(1) in the final rule) requiring initial health
examinations and periodic re-examinations for staff, since they believe
that this standard will safeguard the health and wellness of Early Head
Start and Head Start children and families as well as staff. However,
there were some concerns about requiring health examinations for all
staff, rather than just for those with direct contact with children. We
have decided that it is important to retain the requirement that all
Early Head Start and Head Start staff receive health examinations, as
each staff member is a model for enrolled families.
Many comments addressed the standard at 45 CFR 1304.52(i)(2) in the
NPRM (45 CFR 1304.52(j)(2)) in the final rule) regarding the screening
of volunteers for tuberculosis. First, some commenters felt that we
were being inconsistent in requiring tuberculosis screening for
volunteers in 45 CFR 1304.52(i)(2) of the NPRM, but not requiring such
screening for staff in 45 CFR 1304.52(i)(1). We agree with this
concern, and have added a requirement for the tuberculosis screening of
staff to this standard (45 CFR 1304.52(j)(1) in the final rule) to
clarify our previous intent that this screening be included in health
examinations for all staff.
Second, many commenters felt that whether volunteers were screened
for tuberculosis should depend on State and local health department
regulations;
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others felt that this would be an appropriate issue to take before
their Health Services Advisory Committee. Because the prevalence of
tuberculosis varies considerably among communities, we agree that State
and local health requirements should be followed, and that input should
be sought from the Health Services Advisory Committee. Therefore, the
standard, as revised (45 CFR 1304.52(j)(2) in the final rule), now
states that ``volunteers must be screened for tuberculosis in
accordance with State, Tribal, and or local laws.'' In the absence of
any such laws, we have required that the Health Services Advisory
Committee make recommendations about tuberculosis screening for
volunteers.
Other commenters wanted a clearer definition of a volunteer, and
questioned whether the term included parents. If volunteers were to
include parents, many respondents felt that this standard would have a
negative impact on parent involvement. Others felt that the screening
requirement should only apply to ``regular'' volunteers, and not to
``one-time'' or ``occasional'' volunteers. Many felt that, if the
screening were required of all volunteers, it would reduce their
numbers and, ultimately, impact on the agencies' non-Federal share. We
agree that tuberculosis screening should apply only to regular
volunteers, and not to parents who might drop in to a center to visit
or to the fire chief who comes in to discuss fire prevention week. As a
result, we have added the word ``regular'' before the term
``volunteer'' in the standard, and have cross-referenced the term
``volunteer'' to the definition in 45 CFR 1304.3(a)(20) in the final
rule.
Many commenters commended the Head Start Bureau for addressing the
mental health and wellness concerns of staff at 45 CFR 1304.52(i)(3)
(45 CFR 1304.52(j)(3) in the final rule), but felt that this standard
could be very costly to implement. Further, they asked for
clarification on how agencies could ``assist staff'' in addressing
their mental health and wellness concerns. As a result of these
comments, we have substituted the phrase ``* * * make mental health and
wellness information available to staff'' for the words ``assist
staff'' to reduce cost and to provide greater clarity. The Guidance
will provide further details about the kinds of information that
agencies could provide to their staff.
Commenters supported the inclusion of the section on staffing
patterns (45 CFR 1304.52(j) in the NPRM and 45 CFR 1304.52(g) in the
final rule), but raised several concerns, particularly regarding the
terminology used. To address these concerns, we have made several
changes. First, for the sake of clarity, we changed the title of this
section to ``Classroom staffing and home visitors.'' Second, we
substituted the term ``group'' for ``room'' in 45 CFR 1304.52(g)(4) in
order to be consistent with 45 CFR 1306.20. We have not changed 45 CFR
1304.52(j)(2) (45 CFR 1304.52(g)(2) in the final rule) regarding multi-
lingual staff or 45 CFR 1304.52(j)(3) (45 CFR 1304.52(g)(3) in the
final rule) regarding the use of substitutes, despite requests for
changes from some commenters. With reference to the first standard, we
feel that it would be too costly to require agencies to ensure that
teachers or paid aides speak the languages of every child in the
classroom. In addition, 45 CFR 1304.52(b)(4) safeguards the goal of
best practice by requiring that staff and program consultants be able
to communicate, to the extent feasible, with children and families with
no or limited English proficiency. With reference to 45 CFR
1304.52(g)(3), while we recognize the cost burden that the use of
substitutes may pose for agencies, we believe that substitutes have
always been encouraged in practice and are critical to maintaining high
standards of program quality.
Most commenters were strongly supportive of the new section on
staff training and development at 45 CFR 1304.52(k). Although few
specific changes to the language of this section were suggested, some
commenters questioned why only two training topics were specifically
mandated in 45 CFR 1304.52(k)(3). In response, we did not wish to limit
agency flexibility by mandating a specific list of training topics, and
the two areas listed are specifically required by the 1994 Amendments
to the Head Start Act. With regard to 45 CFR 1304.52(k)(4), some
commenters stated that it would be unrealistic to provide training to
some governing bodies, particularly when they are school boards or
university boards of regents. In response to these concerns, we
clarified the language to require the provision of ``* * * training or
orientation to Early Head Start and Head Start governing body members.
Agencies must also provide orientation and ongoing training to Early
Head Start or Head Start Policy Council and Policy Committee members *
* *.'' This change recognizes that, although training for governing
bodies does not present a problem for most agencies, they may choose to
provide a brief orientation as a substitute for training when more
comprehensive training is not feasible. On the other hand, we have made
it clear that training for policy groups must occur on an ongoing basis
in order to ensure that these groups are prepared to meet complex
responsibilities as those responsibilities arise.
Section 1304.53 Facilities, Materials, and Equipment
Most of the comments on the Facilities, Materials and Equipment
section expressed support for the proposed standards, as they promote
excellence in facilities, materials, and equipment. The majority of
suggested changes called for additional safety requirements to
safeguard the health and well-being of children.
A number of commenters were concerned that the annual safety
inspection of a facility's space, light, ventilation, heat, and other
physical arrangements required in 45 CFR 1304.53(a)(10) was
insufficient to ensure that facilities meet the health, safety, and
developmental needs of children. In response, we have clarified that a
safety inspection must be conducted ``at least annually.'' We did not
establish a more specific timetable for safety inspections, leaving it
to the discretion of grantee and delegate agencies to determine the
appropriate annual, monthly, weekly or daily inspection schedule for
each of the 17 requisite safety checks of local facilities.
As a further response to comments requesting additional emphasis on
safety issues, we amended 45 CFR 1304.53(a)(7) to require that
``grantee and delegate agencies must provide for the maintenance,
repair, safety, and security of all Early Head Start and Head Start
facilities, materials, and equipment.'' We have also amended 45 CFR
1304.53(b)(1)(iii) 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, with adaptations, if
necessary, for children with disabilities.'' Further, we have
reinstated, as 45 CFR 1304.53(b)(1)(vi), the existing standard that
requires that equipment, toys, materials and furniture must be ``Safe,
durable and kept in good condition.''
A few commenters requested standards on safe surfaces beneath play
equipment, an issue that was not addressed either in the current
standards for preschoolers or in the NPRM. In response, we have added a
new 45 CFR 1304.53(a)(10)(x) requiring grantee and delegate agencies to
ensure
[[Page 57206]]
that ``the selection, layout, and maintenance of playground equipment
and surfaces minimize the possibility of injury to children.''
Commenters also requested the strengthening of 45 CFR
1304.53(a)(8), which requires grantee and delegate agencies to ``* * *
provide a center-based environment free of toxins, such as cigarette
smoke, pesticides, herbicides, and other air pollutants as well as soil
and water contaminants.'' In response to these comments, we have
amended the standard to include ``lead'' in the list of examples of
toxins from which the center-based environment must be free; and have
also specified that agencies must ensure that ``* * * no child is
present during the spraying of pesticides or herbicides. Children must
not return to the affected area until it is safe to do so.'' In
addition, we intend to clarify in the Guidance that the spraying of
herbicides and pesticides outside and inside centers poses risks to
children and staff and should be minimized to the greatest extent
possible.
Another set of comments sought clarification of the proposed
standards addressing new safety issues related to services for infants
and toddlers. In some cases, we have made minor changes to the language
in the standards; in others, we intend to provide further clarification
through Guidance. For example, we intend to provide best practice in
the Guidance on the new 45 CFR 1304.53(a)(10)(xiv) regarding the
precautions that grantees should take to avoid exposing infants and
toddlers to E coli bacteria if they locate diapering areas within
classrooms. The Guidance will also address requests for additional
information on Sudden Infant Death Syndrome (SIDS) and on more general
issues related to safe sleeping arrangements for infants and toddlers
(45 CFR 1304.53(b)(3)).
A few commenters suggested that the standards include the
requirement that all Early Head Start and Head Start facilities,
materials and equipment must be accessible to children with
disabilities, in accordance with the Americans with Disabilities Act
and Section 504 of the Rehabilitation Act of 1973. This important
requirement is found at 45 CFR 1304.53(a)(2), which refers grantee and
delegate agencies to 45 CFR 1308.4 for specific access requirements for
children with disabilities. Federal requirements for making services
accessible in conformance with the Americans with Disabilities Act and
45 CFR Part 84, Nondiscrimination on the Basis of Handicap in Programs
and Activities Receiving or Benefiting from Federal Financial
Assistance, are described in 45 CFR 1308.4(o)(4) as well as in the
Guidance materials accompanying 45 CFR 1308.4(f)(3). Further
information on appropriate furniture, equipment, and materials for
children with disabilities is provided in 45 CFR 1308.4(f)(4) and
1308.4(o)(6).
Finally, a few commenters noted that additional funding would be
needed to bring local facilities into compliance with the standards.
However, no individual standard in 45 CFR 1304.53 was singled out as
raising significant cost concerns.
Subpart E--Implementation and Enforcement
Section 1304.60 Deficiencies and Quality Improvement Plans
Many commenters were supportive of the section on compliance in the
Program Performance Standards, stating that it will ensure that
children and families receive quality services and that poorly
performing grantee and delegate agencies will not be tolerated as Early
Head Start or Head Start providers.
The NPRM described two different negative findings which could
result from a review of a Head Start grantee: A determination that the
grantee is out-of-compliance with one or more standards or other
requirements; or, because of the scope and magnitude of the problem,
that the grantee has one or more deficiencies. It also provided two
different timeframes in which corrections were to be made, with
grantees having up to 90 days to remedy areas of non-compliance and up
to one year to correct deficiencies. Many commenters found these
distinctions confusing and requested clarification of the terms ``out-
of-compliance'' and ``deficiency,'' stating that, as used in the NPRM,
these terms are vague and overly broad. Others stated that the
differences between the types of determinations that would result in a
grantee being found to be out-of-compliance or to be deficient needed
to be more clearly delineated.
We have made major changes in this Subpart of the final rule, both
to address the concerns raised by commenters and to focus this section
more directly on the new provisions at section 641A(d) of the Head
Start Act, as amended, regarding the actions to be taken when a grantee
is found to have one or more deficiencies.
Additionally, in response to questions raised regarding the wording
of 45 CFR 1304.60(a) in the NPRM, we have also clarified that the
requirements at 45 CFR 1304.60(a), as well as those at 45 CFR
1304.60(b)-(f) and 45 CFR 1304.61 as revised in the final rule, apply
both to Early Head Start and to Head Start grantee agencies. The NPRM,
at 45 CFR 1304.60(a) stated that ``Head Start grantee and delegate
agencies funded for indefinite periods must comply with the
requirements of this part in accordance with the effective dates set
forth in 45 CFR 1304.2.'' Commenters questioned whether this wording
meant that Early Head Start grantees, which are funded for specific
project periods, did not have to comply with the requirements of the
Program Performance Standards. This was not our intent. Therefore, we
deleted the reference to agencies funded for indefinite project periods
in 45 CFR 1304.60(a) and also added the term ``Early Head Start'' at
the beginning of the sentence (``Early Head Start and Head Start
grantee and delegate agencies must * * *''). We have further added the
requirement that Early Head Start grantees will be given the same
opportunity as Head Start grantees to remedy identified program
deficiencies through, where appropriate, the use of a Quality
Improvement Plan.
We have rearranged and revised the paragraphs in 45 CFR 1304.60 and
45 CFR 1304.61 in the NPRM in order to more clearly differentiate
between a deficiency and an area of noncompliance as well as the
actions that must be taken when a deficiency or an area of
noncompliance is identified. As revised, 45 CFR 1304.60 in the final
rule relates only to deficiencies, while 45 CFR 1304.61 focuses on
areas of noncompliance. The wording of the standards in 45 CFR 1304.60
in the final rule closely parallels the language of the Head Start Act,
and relates to the determination and official notification by a
responsible HHS official regarding one or more deficiencies and the
timeframe in which it is to be corrected (45 CFR 1304.60(b); the
submission of a Quality Improvement Plan by the grantee specifying the
actions to be taken to remedy each deficiency and the timeframe in
which it will do so (45 CFR 1304.60(c); and the approval or disapproval
by the responsible HHS official of the grantee's Quality Improvement
Plan and the resubmission of the Plan, as required (45 CFR 1304.60(d)
and (e)). The paragraph at 45 CFR 1304.60(f) provides that Early Head
Start or Head Start grantees which fail to correct a deficiency, either
immediately, if required, or within the timeframe specified in the
approved Quality Improvement Plan, will be issued a letter of
termination or denial
[[Page 57207]]
of refunding by the responsible HHS official.
The standard at 45 CFR 1304.60(f) also has been expanded to state
that a ``deficiency that is not timely corrected shall be a material
failure of a grantee to comply with the terms and conditions of an
award * * *.'' This provision is part of the implementation of the
requirement at Section 641A(d)(1)(C) of the Head Start Act, as amended,
that the Secretary must initiate proceedings to terminate the
designation of an agency as a Head Start grantee unless the grantee
corrects the deficiency; it also is consistent with past agency
interpretation that the failure to comply with any of the Program
Performance Standards and other requirements constitutes a material
breach of the terms of the grant. The language also further establishes
that, since a deficiency, by its nature, materially impairs the
accomplishment of program goals, the failure to correct a deficiency in
a timely manner will constitute grounds for termination. Additionally,
45 CFR 1304.60(f) clarifies that Head Start grantees may appeal
terminations and denials of refunding under 45 CFR part 1303, while
Early Head Start grantees may not appeal under 45 CFR part 1303, but
must appeal terminations and denials of refunding under 45 CFR part 74
and 45 CFR part 92.
We also have revised substantially the definition of ``deficiency''
at 45 CFR 1304.3(a)(5) in order to clarify the types of determinations
which could result in a grantee being found deficient and which,
therefore, would have to be addressed either immediately or under a
Quality Improvement Plan. Our goal in revising this definition, and
particularly in referring to a ``failure to perform substantially'' in
45 CFR 1304.3(a)(6)(i)(C), was to make it clear that a determination
that a grantee is out-of-compliance with one or more requirements will
not, in and of itself, constitute a deficiency. Rather, these areas of
non-compliance must be of a level of significance that results in the
failure of the grantee to substantially provide required services or to
substantially implement required procedures. As used in the revised
definition, the term ``substantially'' does not necessarily mean that a
majority of the requirements are not being met but, rather, that a
knowledgeable person reviewing the findings would determine that the
grantee agency is not operating a quality program.
Additionally, the revised definition at 45 CFR 1304.3(a)(6)(iii)
states that ``Any other violation of Federal or State requirements,
including, but not limited to, the Head Start Act or one or more of the
regulations under Parts 1301, 1304, 1305, 1306, or 1308 of this Title,
and which the grantee has shown an unwillingness or inability to
correct within the period specified by the responsible HHS official, of
which the responsible HHS official has given the grantee written notice
of pursuant to 45 CFR 1304.61'' also constitutes a deficiency. The
intent here is to underscore that grantees are also expected to correct
all areas of noncompliance which have been identified, including those
which do not need to be addressed under a Quality Improvement Plan;
and, that, if the responsible HHS official determines that the grantee
is unable or unwilling to do so within the specified timeframes, the
area or areas in which the violations exist become deficiencies, which
must then be corrected either immediately or under a Quality
Improvement Plan.
We believe that the processes encompassed by 45 CFR 1304.60, as
revised in the final rule, will be fully supportive of efforts to
improve the quality of Early Head Start and Head Start programs. The
requirement that grantees develop Quality Improvement Plans specifying
the actions they will take to correct identified deficiencies and the
timeframes within which they will do so will enable both agency and
Federal staff to focus in a more comprehensive and holistic manner on
the improvements that are needed and how they should be addressed.
Commenters also raised other questions related to 45 CFR 1304.60
and 45 CFR 1304.61 in the NPRM. A number of commenters questioned the
requirement in 45 CFR 1304.61(d) that deficiencies must be corrected
within a period not to exceed 12 months. Some felt that one year was
too long, particularly if the deficiency reduced the quality of
services being provided or affected the health and safety of children
and staff. Others felt that the timeframes should be established on a
case-by-case basis or that time periods longer than one year should be
allowed, because many problems cannot be resolved within 12 months. A
number of commenters also suggested that the timeframe within which a
grantee agency must correct a deficiency should start on the date that
the Quality Improvement Plan is approved by the responsible HHS
official, rather than on the date of official notification of the
deficiency. We did not make any changes with respect to the one-year
timeframe within which a deficiency must be corrected or the date on
which the one-year period begins, as both requirements are established
by Section 641A(d)(2)(A)(ii) of the Head Start Act, as amended. In the
final rule, these timeframe requirements appear in 45 CFR 1304.60(c).
It should be noted, however, that a grantee can be required to correct
a deficiency immediately or within less than a 12-month period.
Deficiencies which endanger the health and safety of Early Head Start
or Head Start children, families and staff, among others, would fall
into this category.
Other commenters focused on the monitoring process, requesting that
the On-Site Program Review Instrument (OSPRI) be revised to conform
with the new Program Performance Standards and released simultaneously
with them, or questioning why monitoring was not addressed in this
section and who (Federal or peer reviewers) would be involved in the
on-site reviews. We are currently conducting an intensive review of the
monitoring process, and intend to ensure that it is fully consistent
with the revised Program Performance Standards by the time that the
standards become effective on January 1, 1998. We also intend to
provide extensive training to Federal and peer reviewers on the revised
standards. We will continue to conduct a full review of each grantee at
least once every three years, with follow-up reviews being conducted as
needed.
Finally, a number of commenters stated that additional resources,
in the form of training and technical assistance as well as additional
funding, would be required to remedy deficiencies to be addressed under
Quality Improvement Plans. We did not change the language of this
Subpart. As required by section 641A(d)(3) of the Head Start Act, as
amended, training and technical assistance will be available in the
development and implementation of Quality Improvement Plans. However,
the primary financial resources which agencies must draw upon to
correct deficiencies are the resources provided through their Early
Head Start or Head Start grants.
Section 1304.61 Noncompliance
As revised in the final rule, 45 CFR 1304.61 relates to an area or
areas, identified during a review of an Early Head Start or Head Start
grantee, in which the grantee is found to be out-of-compliance with
Federal or State requirements, including the Head Start Act and
regulations, and which, while not of the scope or magnitude to
constitute a deficiency, still require correction.
The standard in the final rule is designed to allow for greater
flexibility and to reduce paperwork in dealing with areas of
noncompliance than did
[[Page 57208]]
the processes described in 45 CFR 1304.60 (c) and (d) in the NPRM.
Unlike the NPRM, which specified that all areas of noncompliance were
to be corrected within a period not to exceed 90 days, the final rule
does not establish a specific timeframe in which the corrections are to
be made. Rather, the timeframe will be established by the responsible
HHS official, based on the type of noncompliance and on his or her
knowledge of the circumstances of a particular grantee. The definition
of the term ``noncompliance'' (45 CFR 1304.3(a)(15) in the NPRM) has
been deleted in the final rule because the definition is incorporated
into the revised standard at 45 CFR 1304.61(a).
The standard at 45 CFR 1304.61(b) reiterates that the inability or
unwillingness of a grantee to correct an area or areas of non-
compliance within the timeframe specified by the responsible HHS
official will result in the area or areas of non-compliance becoming a
deficiency, to be corrected under the procedures established in 45 CFR
1304.60.
PART 1301--HEAD START GRANTS ADMINISTRATION
Many commenters applauded the addition of the section on personnel
policies in 45 CFR 1301.31 to the Program Performance Standards,
stating that it was greatly needed and well written. However, a number
of other commenters raised concerns about changes from the current
requirements that were proposed in the NPRM.
First, many commenters questioned the application of the personnel
policies in 45 CFR 1301.31 to volunteers and consultants, since they
are not considered employees of the agency. Some stated that
consultants often have specific agreements with an agency that may or
may not incorporate relevant sections from the agency's personnel
policies. Many more commenters were concerned about having personnel
policies apply to volunteers. Doing so could mean that volunteers would
need a job description, a selection process, and a performance
appraisal that would make the process of obtaining volunteers so
complicated that people would be discouraged from volunteering. By far
the greatest number of critical comments related to the need for
criminal record checks for volunteers (45 CFR 1301.31(b)(1)(iii)).
While concerns were raised related to conducting such checks for all
volunteers, there were special concerns regarding conducting checks for
parent volunteers. Commenters were concerned about the impact that this
requirement would have on their relationship with parents, and were
also concerned that parents would be discouraged from volunteering.
Another concern was the cost associated with obtaining criminal record
checks for all volunteers. To respond to these concerns, we have
eliminated volunteers and consultants from the requirements in 45 CFR
1301.31. These personnel policies will only apply to staff.
The second concern raised by several commenters related to the
inclusion of job descriptions in personnel policies (45 CFR
1301.31(a)). Commenters stressed that, while job descriptions should be
governed by personnel policies, they should be separate. One reason
given by several commenters was that, given the growing number of staff
positions in Head Start, it would be cumbersome to submit minor
revisions in job descriptions to the Policy Council for its approval
each time revisions were made. While we considered these comments, we
retained the original language, since we believe that it is appropriate
to link position descriptions to personnel policies. However, unless
there are significant changes made or new positions added, we do not
believe that it is necessary for Policy Councils or Policy Committees
to approve minor changes to position descriptions.
Third, commenters suggested that, instead of conducting a criminal
record check before an employee is hired, we permit programs to hire
staff for a probationary period while the check is being conducted
since, in many States, the criminal record check can take several
months to complete. We understand that the timing of securing criminal
record checks is sometimes beyond the control of an Early Head Start or
Head Start agency. To address this concern we added a sentence to 45
CFR 1301.31(b)(1)(iii) that reads, ``If it is not feasible to obtain a
criminal record check prior to hiring, an employee must not be
considered permanent until such a check has been completed.''
Other commenters suggested wording that would help clarify the
intent of this section. For example, one commenter suggested that, in
order to make this section consistent with Appendix A of 45 CFR
1304.50, we should specifically state that Policy Committees or Policy
Councils must approve the personnel policies of delegate agencies in 45
CFR 1301.31(a). Others suggested that we use the term ``salary range''
within job descriptions in 45 CFR 1301.31(a)(1) instead of ``salary.''
We agree with these comments, and have made these changes.
PART 1303--APPEAL PROCEDURES FOR HEAD START GRANTEES AND CURRENT OR
PROSPECTIVE DELEGATE AGENCIES
Several comments were received on part 1303 which expressed concern
about the requirement that financial assistance be terminated or
refunding be denied due to one or more deficiences. The termination of
financial assistance or the denial of refunding due to one or more
deficiencies is required by section 641 of the Head Start Act, as
amended.
For clarification purposes, we made a technical change to the NPRM
text for Sec. 1303.14(b)(4) to provide that one of the reasons for
termination of financial assistance to a grantee is the failure to
timely correct one or more deficiencies as defined in 45 CFR part 1304.
We deleted the proposed revision to Sec. 1303.15(c) because the
clarification to Sec. 1303.14(b)(4) negates the need to revise the
current Sec. 1303.15(c).
PART 1305--ELIGIBILITY, RECRUITMENT, SELECTION, ENROLLMENT, AND
ATTENDANCE IN HEAD START
Commenters pointed out that the term ``Community Needs Assessment''
focuses too heavily on the deficits in a community, rather than on its
strengths. We agree, and have changed the title of this process to
``Community Assessment'' wherever the term ``Community Need
Assessment'' appears in part 1305. No other changes were made to the
NPRM language for part 1305.
PART 1306--HEAD START STAFFING REQUIREMENTS AND PROGRAM OPTIONS
The comments received on the sections in this part as set forth in
the NPRM raised concerns that have been addressed earlier in this
Preamble such as the requirement for CDA training, the need to
integrate 45 CFR parts 1305, 1306, and 1308 into 45 CFR Part 1304, and
the need for guidance on class size and home visitor caseloads.
Subsequently, no changes were needed to this part.
PART 1308--HEAD START PROGRAM PERFORMANCE STANDARDS ON SERVICES FOR
CHILDREN WITH DISABILITIES
The comments received on part 1308 basically requested the
integration of part 1308 into the Program Performance Standards. The
reasons for not integating part 1308 have been discussed earlier in
this Preamble.
We have reworded the amendment to 45 CFR 1308.6(b)(1) to reflect
the wording in 45 CFR 1304.20.
[[Page 57209]]
VII. Impact Analysis
Executive Order 12866
Executive Order 12866 requires that regulations be drafted to
ensure that there is consistency with the priorities and principles set
forth in this Executive Order. The Department has determined that this
significant rule, which was reviewed by OMB, is consistent with these
priorities and principles. This final rule implements the statutory
authority to promulgate regulations for Head Start Program Performance
Standards. The Head Start Act, as amended, requires the addition of new
performance standards in the following areas: administrative and
financial management, transition activities, family literacy, a family
needs assessment and consultation process, and standards for programs
serving low-income pregnant women and families with infants and
toddlers. Many of the new standards in this final rule are directly
related to these specific legislative mandates. Congress made no
additional appropriation to fund these new requirements, however, and
so any funds spent toward the improvement of services, facilities,
infrastructures, or other purposes related to this regulation are funds
that would have been otherwise spent by the program or other programs
from the same appropriation amount. In addition, new standards have
been added in the areas of child health and developmental services,
education and early childhood development in home-based settings,
health emergency and safety procedures, and family and community
partnerships which are responsive to the legislative mandate and to
Advisory Committee recommendations to improve the quality of the Head
Start program and to establish the Early Head Start program. We believe
that this final rule is focused in ways that encourage maximum cost-
effectiveness in agency spending decisions.
Regulatory Flexibility Act
The Regulatory Flexibility Act (Pub. L. 96-354) requires the
Federal government to anticipate and reduce the impact of rules and
paperwork requirements on small businesses.
For each rule with a ``significant economic impact on a substantial
number of small entities,'' an analysis must be prepared describing the
rule's impact on small entities. Small entities are defined by the Act
to include small businesses, small non-profit organizations and small
governmental entities. While these regulations would affect small
entities, the Secretary certifies that this rule will not have a
significant impact on substantial numbers of small entities for the
reasons noted below.
All grantee and delegate agencies are currently required to meet a
large group of Head Start Program Performance Standards. In keeping
with the Head Start Act, as amended, the new standards have been
developed in consultation with individuals who have experience
operating Head Start programs. Further, the requirements that are more
stringent with regard to paperwork burden than the current requirements
are based on the new legislative mandates contained in the 1994 Head
Start reauthorization, such as the requirement for new infant and
toddler standards, the need to respond to changes over time in the
kinds of services that the Head Start population requires, the need to
reflect best practices in the field of early childhood development, and
the need to promote Head Start program quality and to facilitate Head
Start expansion. Finally, we believe that meeting these requirements
will not be burdensome to grantee and delegate agencies because we are
not requiring compliance until January 1, 1998. We also believe that,
as grantee and delegate agencies implement these requirements, there
will be no ongoing burden.
Paperwork Reduction Act
Under the Paperwork Reduction Act of 1995, no persons are required
to respond to a collection of information unless it displays a valid
OMB control number. No OMB control numbers have yet been assigned to
the information collection requirements in this final rule. We have
submitted the information collection package to OMB for review. When
OMB approves the information collection package, we will publish the
OMB control numbers in the Federal Register.
The sections that contain information collection are: Child health
and developmental services (45 CFR 1304.20(a)(1), (c)(5), and (d));
child health and safety (45 CFR 1304.22(c); child nutrition (45 CFR
1304.23(a)(1)); family partnerships (45 CFR 1304.40(a)(2)); community
partnerships (45 CFR 1304.41(a)(1)); program governance (45 CFR
1304.50(f), (g) and (h)); management systems and procedures (45 CFR
1304.51(a)(1) (i)-(iii), (2), and (i)(1)); human resources management
(45 CFR 1304.52(j)(2)); deficiencies and quality improvement plans (45
CFR 1304.60 (b) and (c)); criminal record checks and declarations (45
CFR 1301.31(b)(1)(iii) and (b)(2)); and community assessment (45 CFR
1305.3 (b) and (d)).
Relatively few of the nearly 15,000 comments received on the NPRM
addressed the collection of information requirements proposed in the
NPRM. However, some comments were received concerning information
collection requirements contained in specific sections of the NPRM.
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 assessments information for each
child. Changes have been made in the standards to emphasize that Early
Head Start and Head Start grantee and delegate agencies should assist
parents in connecting to a ``medical home'' (45 CFR 1304.20(a)(1)(i))
and that they should obtain information as to whether a child is up-to-
date on a schedule of age-appropriate preventive and primary health
care from a health care professional rather than gathering the
information themselves (45 CFR 1304.20(a)(1)(ii)).
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 agencies to provide ``written
documentation of their efforts to access other available sources of
funding'' (45 CFR 1304.20(c)(5)).
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 the
conduct of 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
[[Page 57210]]
than conducting special nutritional assessments.
Some commenters stated that developing the Family Partnership
Agreements required in 45 CFR 1304.40(a)(2) might increase the amount
of time necessary for working with families. This agreement process is
expected to result in better outcomes than the process required in the
current standards. Therefore, we have retained the standard.
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 agencies should document
``the level of effort undertaken to establish community partnerships.''
This requirement addresses concerns raised by commenters about
situations where community planning efforts are not supported by other
community groups, and is designed to give agencies a chance to document
their ongoing efforts, which may not always be successful.
We received only one comment on the information collection
requirements in Program Governance (45 CFR 1304.50). This comment
expressed concern about the paperwork associated with reimbursing
parents serving on policy making bodies (45 CFR 1304.50(f)). No change
was made in the standard, since records are required to support such
reimbursements.
We received only a few comments on the information collection
requirements placed on grantee and delegate agencies regarding
Management Systems and Procedures. These commenters stated that the
documentation related to program planning might be burdensome (45 CFR
1304.51(a)(2)). Although we recognize that there may be some burden
involved, we made no changes to the standard because we feel that the
documentation required is important to program quality.
We received several comments on the information collection
requirements in 45 CFR 1304.52, Human Resources Management. Commenters
stated that we significantly increased the number of individuals who
would need a tuberculosis screening, and that it is often difficult to
obtain the screening or to document that it is unnecessary (45 CFR
1304.52(j)(2)). In response, we have clarified that only regular
volunteers must be screened in accordance with State, Tribal or local
laws or when recommended by the local Health Services Advisory
Committee.
We received a few comments about the information collection
requirements related to deficiencies and quality improvement plans (45
CFR 1304.60 and 45 CFR 1304.61 in the NPRM). A few commenters stated
that specifics should be provided regarding the documentation that can
be requested by officials of the U.S. Department of Health and Human
Services (45 CFR 1304.60(b)). This level of specificity cannot be
included in the standard, because the documentation that will be
required will relate to the specific deficiency that is identified.
We received no information collection comments on several sections:
45 CFR 1304.21, Education and Early Childhood Development; 45 CFR
1304.22, Child Health Safety; 45 CFR 1304.24, Child Mental Health; 45
CFR 1304.53, Facilities, Materials, and Equipment; and 45 CFR 1301.31,
Personnel Policies.
In this final rule, we are including the OMB approval number for 45
CFR 1305.3(b) and (d) on community assessments at the end of the
section which has an expiration date of September 30, 1998.
We are soliciting comments on 45 CFR 1301.31 (b)(1)(iii) and (b)(2)
on criminal record checks and declarations, for a 60 day period. We
inadvertently did not solicit comment on this section in the NPRM.
However, this requirement is not new as it is now in current Head Start
regulations. Written comments to OMB on this section should be sent to
the following: Office of Management and Budget, Paperwork Reduction
Project, 725 17th Street NW., Washington, DC 20503, Attn: Ms Wendy
Taylor.
List of Subjects
45 CFR Part 1301
Administrative practice and procedure, Education of the
disadvantaged, Grant programs/social programs, Selection of grantees.
45 CFR Part 1303
Administrative practice and procedure, Education of the
disadvantaged, Grant programs/social programs, Reporting and
recordkeeping requirements.
45 CFR Part 1304
Dental health, Education of the disadvantaged, Grant programs/
social programs, Health care, Mental health programs, Nutrition,
Reporting and recordkeeping requirements.
45 CFR Part 1305
Education of the disadvantaged, Grant programs/social programs,
Individuals with disabilities.
45 CFR Part 1306
Education of the disadvantaged, Grant programs/social programs.
45 CFR Part 1308
Education of the disadvantaged, Grant programs/social programs,
Health care, Individuals with disabilities, Nutrition, Reporting and
recordkeeping.
(Catalog of Federal Domestic Assistance Program Number 93.600,
Project Head Start)
Dated: September 17, 1996.
Mary Jo Bane,
Assistant Secretary for Children and Families.
Approved: September 19, 1996.
Donna E. Shalala,
Secretary.
For the reasons set forth in the preamble, 45 CFR chapter XIII,
subchapter B is amended to read as follows:
1. Part 1304--is revised to read as follows:
PART 1304--PROGRAM PERFORMANCE STANDARDS FOR THE OPERATION OF HEAD
START PROGRAMS BY GRANTEE AND DELEGATE AGENCIES
Subpart A-General
Sec.
1304.1 Purpose and scope.
1304.2 Effective date.
1304.3 Definitions.
Subpart B-Early Childhood Development and Health Services
1304.20 Child health and developmental services.
1304.21 Education and early childhood development.
1304.22 Child health and safety.
1304.23 Child nutrition.
1304.24 Child mental health.
Subpart C-Family and Community Partnerships
1304.40 Family partnerships.
1304.41 Community partnerships.
Subpart D--Program Design and Management
1304.50 Program governance.
1304.51 Management systems and procedures.
1304.52 Human resources management.
1304.53 Facilities, materials, and equipment.
[[Page 57211]]
Subpart E--Implementation and Enforcement
1304.60 Deficiencies and quality improvement plans.
1304.61 Noncompliance.
Authority: 42 U.S.C. 9801 et seq.
Subpart A--General
Sec. 1304.1 Purpose and scope.
This part describes regulations implementing sections 641A, 644(a)
and (c), and 645A(h) of the Head Start Act, as amended (42 U.S.C. 9801
et seq.). Section 641A, paragraph (a)(3)(C) directs the Secretary of
Health and Human Services to review and revise, as necessary, the Head
Start Program Performance Standards in effect under prior law. This
paragraph further provides that any revisions should not result in an
elimination or reduction of requirements regarding the scope or types
of Head Start services to a level below that of the requirements in
effect on November 2, 1978. Section 641A(a) directs the Secretary to
issue regulations establishing performance standards and minimum
requirements with respect to health, education, parent involvement,
nutrition, social, transition, and other Head Start services as well as
administrative and financial management, facilities, and other
appropriate program areas. Sections 644(a) and (c) require the issuance
of regulations setting standards for the organization, management, and
administration of Head Start programs. Section 645A(h) requires that
the Secretary develop and publish performance standards for the newly
authorized program for low-income pregnant women and families with
infants and toddlers, entitled ``Early Head Start.'' The following
regulations respond to these provisions in the Head Start Act, as
amended, for new or revised Head Start Program Performance Standards.
These new regulations define standards and minimum requirements for the
entire range of Early Head Start and Head Start services, including
those specified in the authorizing legislation. They are applicable to
both Head Start and Early Head Start programs, with the exceptions
noted, and are to be used in conjunction with the regulations at 45 CFR
parts 1301, 1302, 1303, 1305, 1306, and 1308.
Sec. 1304.2 Effective date.
Early Head Start and Head Start grantee and delegate agencies must
comply with these requirements on January 1, 1998. Nothing in this part
prohibits grantee or delegate agencies from voluntarily complying with
these regulations prior to the effective date.
Sec. 1304.3 Definitions.
(a) As used in this part:
(1) Assessment means the ongoing procedures used by appropriate
qualified personnel throughout the period of a child's eligibility to
identify:
(i) The child's unique strengths and needs and the services
appropriate to meet those needs; and
(ii) The resources, priorities, and concerns of the family and the
supports and services necessary to enhance the family's capacity to
meet the developmental needs of their child.
(2) Children with disabilities means, for children ages 3 to 5,
those with mental retardation, hearing impairments including deafness,
speech or language impairments, visual impairments including blindness,
serious emotional disturbance, orthopedic impairments, autism,
traumatic brain injury, other health impairments, specific learning
disabilities, deaf-blindness, or multiple disabilities, and who, by
reason thereof, need special education and related services. The term
``children with disabilities'' for children aged 3 to 5, inclusive,
may, at a State's discretion, include children experiencing
developmental delays, as defined by the State and as measured by
appropriate diagnostic instruments and procedures, in one or more of
the following areas: Physical development, cognitive development,
communication development, social or emotional development, or adaptive
development; and who, by reason thereof, need special education and
related services. Infants and toddlers with disabilities are those from
birth to three years, as identified under the Part H Program
(Individuals with Disabilities Education Act) in their State.
(3) Collaboration and collaborative relationships:
(i) With other agencies, means planning and working with them in
order to improve, share and augment services, staff, information and
funds; and
(ii) With parents, means working in partnership with them.
(4) Contagious means capable of being transmitted from one person
to another.
(5) Curriculum means a written plan that includes:
(i) The goals for children's development and learning;
(ii) The experiences through which they will achieve these goals;
(iii) What staff and parents do to help children achieve these
goals; and
(iv) The materials needed to support the implementation of the
curriculum. The curriculum is consistent with the Head Start Program
Performance Standards and is based on sound child development
principles about how children grow and learn.
(6) Deficiency means:
(i) An area or areas of performance in which an Early Head Start or
Head Start grantee agency is not in compliance with State or Federal
requirements, including but not limited to, the Head Start Act or one
or more of the regulations under parts 1301, 1304, 1305, 1306 or 1308
of this title and which involves:
(A) A threat to the health, safety, or civil rights of children or
staff;
(B) A denial to parents of the exercise of their full roles and
responsibilities related to program governance;
(C) A failure to perform substantially the requirements related to
Early Childhood Development and Health Services, Family and Community
Partnerships, or Program Design and Management; or
(D) The misuse of Head Start grant funds.
(ii) The loss of legal status or financial viability, as defined in
part 1302 of this title, loss of permits, debarment from receiving
Federal grants or contracts or the improper use of Federal funds; or
(iii) Any other violation of Federal or State requirements
including, but not limited to, the Head Start Act or one or more of the
regulations under parts 1301, 1304, 1305, 1306 or 1308 of this title,
and which the grantee has shown an unwillingness or inability to
correct within the period specified by the responsible HHS official, of
which the responsible HHS official has given the grantee written notice
of pursuant to section 1304.61.
(7) Developmentally appropriate means any behavior or experience
that is appropriate for the age span of the children and is implemented
with attention to the different needs, interests, and developmental
levels and cultural backgrounds of individual children.
(8) Early Head Start program means a program that provides low-
income pregnant women and families with children from birth to age 3
with family-centered services that facilitate child development,
support parental roles, and promote self-sufficiency.
(9) Family means for the purposes of the regulations in this part
all persons:
(i) Living in the same household who are:
(A) Supported by the income of the parent(s) or guardian(s) of the
child enrolling or participating in the program; or
[[Page 57212]]
(B) Related to the child by blood, marriage, or adoption; or
(ii) Related to the child enrolling or participating in the program
as parents or siblings, by blood, marriage, or adoption.
(10) Guardian means a person legally responsible for a child.
(11) Health means medical, dental, and mental well-being.
(12) Home visitor means the staff member in the home-based program
option assigned to work with parents to provide comprehensive services
to children and their families through home visits and group
socialization activities.
(13) Individualized Family Service Plan (IFSP) means a written plan
for providing early intervention services to a child eligible under
Part H of the Individuals with Disabilities Education Act (IDEA). (See
34 CFR 303.340-303.346 for regulations concerning IFSPs.)
(14) Minimum requirements means that each Early Head Start and Head
Start grantee must demonstrate a level of compliance with Federal and
State requirements such that no deficiency, as defined in this part,
exists in its program.
(15) Policy group means the formal group of parents and community
representatives required to be established by the agency to assist in
decisions about the planning and operation of the program.
(16) Program attendance means the actual presence and participation
in the program of a child enrolled in an Early Head Start or Head Start
program.
(17) Referral means directing an Early Head Start or Head Start
child or family member(s) to an appropriate source or resource for
help, treatment or information.
(18) Staff means paid adults who have responsibilities related to
children and their families who are enrolled in Early Head Start or
Head Start programs.
(19) Teacher means an adult who has direct responsibility for the
care and development of children from birth to 5 years of age in a
center-based setting.
(20) Volunteer means an unpaid person who is trained to assist in
implementing ongoing program activities on a regular basis under the
supervision of a staff person in areas such as health, education,
transportation, nutrition, and management.
(b) In addition to the definitions in this section, the definitions
as set forth in 45 CFR 1301.2, 1302.2, 1303.2, 1305.2, 1306.3, and
1308.3 also apply, as used in this part.
Subpart B--Early Childhood Development and Health Services
Sec. 1304.20 Child health and developmental services.
(a) Determining child health status. (1) In collaboration with the
parents and as quickly as possible, but no later than 90 calendar days
(with the exception noted in paragraph (a)(2) of this section) from the
child's entry into the program (for the purposes of 45 CFR
1304.20(a)(1), 45 CFR 1304.20(a)(2), and 45 CFR 1304.20(b)(1),
``entry'' means the first day that Early Head Start or Head Start
services are provided to the child), grantee and delegate agencies
must:
(i) Make a determination as to whether or not each child has an
ongoing source of continuous, accessible health care. If a child does
not have a source of ongoing health care, grantee and delegate agencies
must assist the parents in accessing a source of care;
(ii) Obtain from a health care professional a determination as to
whether the child is up-to-date on a schedule of age appropriate
preventive and primary health care which includes medical, dental and
mental health. Such a schedule must incorporate the requirements for a
schedule of well child care utilized by the Early and Periodic
Screening, Diagnosis, and Treatment (EPSDT) program of the Medicaid
agency of the State in which they operate, and the latest immunization
recommendations issued by the Centers for Disease Control and
Prevention, as well as any additional recommendations from the local
Health Services Advisory Committee that are based on prevalent
community health problems:
(A) For children who are not up-to-date on an age-appropriate
schedule of well child care, grantee and delegate agencies must assist
parents in making the necessary arrangements to bring the child up-to-
date;
(B) For children who are up-to-date on an age-appropriate schedule
of well child care, grantee and delegate agencies must ensure that they
continue to follow the recommended schedule of well child care; and
(C) Grantee and delegate agencies must establish procedures to
track the provision of health care services.
(iii) Obtain or arrange further diagnostic testing, examination,
and treatment by an appropriate licensed or certified professional for
each child with an observable, known or suspected health or
developmental problem; and
(iv) Develop and implement a follow-up plan for any condition
identified in 45 CFR 1304.20(a)(1)(ii) and (iii) so that any needed
treatment has begun.
(2) Grantee and delegate agencies operating programs of shorter
durations (90 days or less) must complete the above processes and those
in 45 CFR 1304.20(b)(1) within 30 calendar days from the child's entry
into the program.
(b) Developmental, sensory, and behavioral screening. (1) In
collaboration with each child's parent, and within 45 calendar days of
the child's entry into the program, grantee and delegate agencies must
perform or obtain linguistically and age appropriate developmental,
sensory and behavioral screenings of motor, language, social,
cognitive, perceptual, and emotional skills (see 45 CFR 1308.6(b)(3)
for additional information). To the greatest extent possible, these
screenings must be sensitive to the child's cultural background.
(2) 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.
(3) Grantee and delegate agencies must utilize multiple sources of
information on all aspects of each child's development and behavior,
including input from family members, teachers, and other relevant staff
who are familiar with the child's typical behavior.
(c) Extended follow-up and treatment. (1) Grantee and delegate
agencies must establish a system of ongoing communication with the
parents of children with identified health needs to facilitate the
implementation of the follow-up plan.
(2) Grantee and delegate agencies must provide assistance to the
parents, as needed, to enable them to learn how to obtain any
prescribed medications, aids or equipment for medical and dental
conditions.
(3) Dental follow-up and treatment must include:
(i) Fluoride supplements and topical fluoride treatments as
recommended by dental professionals in communities where a lack of
adequate fluoride levels has been determined or for every child with
moderate to severe tooth decay; and
(ii) Other necessary preventive measures and further dental
treatment as recommended by the dental professional.
(4) Grantee and delegate agencies must assist with the provision of
related services addressing health concerns in accordance with the
Individualized Education Program and the Individualized Family Service
Plan (IFSP).
[[Page 57213]]
(5) Early Head Start and Head Start funds may be used for
professional medical and dental services when no other source of
funding is available. When Early Head Start or Head Start funds are
used for such services, grantee and delegate agencies must have written
documentation of their efforts to access other available sources of
funding.
(d) Ongoing care. In addition to assuring children's participation
in a schedule of well child care, as described in Sec. 1304.20(a) of
this part, grantee and delegate agencies must implement ongoing
procedures by which Early Head Start and Head Start staff can identify
any new or recurring medical, dental, or developmental concerns so that
they may quickly make appropriate referrals. These procedures must
include: periodic observations and recordings, as appropriate, of
individual children's developmental progress, changes in physical
appearance (e.g., signs of injury or illness) and emotional and
behavioral patterns. In addition, these procedures must include
observations from parents and staff.
(e) Involving parents. In conducting the process, as described in
Secs. 1304.20 (a), (b), and (c), and in making all possible efforts to
ensure that each child is enrolled in and receiving appropriate health
care services, grantee and delegate agencies must:
(1) Consult with parents immediately when child health or
developmental problems are suspected or identified;
(2) Familiarize parents with the use of and rationale for all
health and developmental procedures administered through the program or
by contract or agreement, and obtain advance parent or guardian
authorization for such procedures. Grantee and delegate agencies also
must ensure that the results of diagnostic and treatment procedures and
ongoing care are shared with and understood by the parents;
(3) Talk with parents about how to familiarize their children in a
developmentally appropriate way and in advance about all of the
procedures they will receive while enrolled in the program;
(4) Assist parents in accordance with 45 CFR 1304.40(f)(2) (i) and
(ii) to enroll and participate in a system of ongoing family health
care and encourage parents to be active partners in their children's
health care process; and
(5) If a parent or other legally responsible adult refuses to give
authorization for health services, grantee and delegate agencies must
maintain written documentation of the refusal.
(f) Individualization of the program. (1) Grantee and delegate
agencies must use the information from the developmental, sensory, and
behavioral screenings, the ongoing observations, medical and dental
evaluations and treatments, and insights from the child's parents to
help staff and parents determine how the program can best respond to
each child's individual characteristics, strengths and needs.
(2) To support individualization for children with disabilities in
their programs, grantee and delegate agencies must assure that:
(i) Services for infants and toddlers with disabilities and their
families support the attainment of the expected outcomes contained in
the Individualized Family Service Plan (IFSP) for children identified
under the infants and toddlers with disabilities program (Part H) of
the Individuals with Disabilities Education Act, as implemented by
their State or Tribal government;
(ii) Enrolled families with infants and toddlers suspected of
having a disability are promptly referred to the local early
intervention agency designated by the State Part H plan to coordinate
any needed evaluations, determine eligibility for Part H services, and
coordinate the development of an IFSP for children determined to be
eligible under the guidelines of that State's program. Grantee and
delegate agencies must support parent participation in the evaluation
and IFSP development process for infants and toddlers enrolled in their
program;
(iii) They participate in and support efforts for a smooth and
effective transition for children who, at age three, will need to be
considered for services for preschool age children with disabilities;
and
(iv) They participate in the development and implementation of the
Individualized Education Program (IEP) for preschool age children with
disabilities, consistent with the requirements of 45 CFR 1308.19.
Sec. 1304.21 Education and early childhood development.
(a) Child development and education approach for all children. (1)
In order to help children gain the skills and confidence necessary to
be prepared to succeed in their present environment and with later
responsibilities in school and life, grantee and delegate agencies'
approach to child development and education must:
(i) Be developmentally and linguistically appropriate, recognizing
that children have individual rates of development as well as
individual interests, temperaments, languages, cultural backgrounds,
and learning styles;
(ii) Be inclusive of children with disabilities, consistent with
their Individualized Family Service Plan (IFSP) or Individualized
Education Program (IEP) (see 45 CFR 1308.19);
(iii) Provide an environment of acceptance that supports and
respects gender, culture, language, ethnicity and family composition;
(iv) Provide a balanced daily program of child-initiated and adult-
directed activities, including individual and small group activities;
and
(v) Allow and enable children to independently use toilet
facilities when it is developmentally appropriate and when efforts to
encourage toilet training are supported by the parents.
(2) Parents must be:
(i) Invited to become integrally involved in the development of the
program's curriculum and approach to child development and education;
(ii) Provided opportunities to increase their child observation
skills and to share assessments with staff that will help plan the
learning experiences; and
(iii) Encouraged to participate in staff-parent conferences and
home visits to discuss their child's development and education (see 45
CFR 1304.40(e)(4) and 45 CFR 1304.40(i)(2)).
(3) Grantee and delegate agencies must support social and emotional
development by:
(i) Encouraging development which enhances each child's strengths
by:
(A) Building trust;
(B) Fostering independence;
(C) Encouraging self-control by setting clear, consistent limits,
and having realistic expectations;
(D) Encouraging respect for the feelings and rights of others; and
(E) Supporting and respecting the home language, culture, and
family composition of each child in ways that support the child's
health and well-being; and
(ii) Planning for routines and transitions so that they occur in a
timely, predictable and unrushed manner according to each child's
needs.
(4) Grantee and delegate agencies must provide for the development
of each child's cognitive and language skills by:
(i) Supporting each child's learning, using various strategies
including experimentation, inquiry, observation, play and exploration;
(ii) Ensuring opportunities for creative self-expression through
activities such as art, music, movement, and dialogue;
(iii) Promoting interaction and language use among children and
between children and adults; and
[[Page 57214]]
(iv) Supporting emerging literacy and numeracy development through
materials and activities according to the developmental level of each
child.
(5) In center-based settings, grantee and delegate agencies must
promote each child's physical development by:
(i) Providing sufficient time, indoor and outdoor space, equipment,
materials and adult guidance for active play and movement that support
the development of gross motor skills;
(ii) Providing appropriate time, space, equipment, materials and
adult guidance for the development of fine motor skills according to
each child's developmental level; and
(iii) Providing an appropriate environment and adult guidance for
the participation of children with special needs.
(6) In home-based settings, 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.
(b) Child development and education approach for infants and
toddlers. (1) Grantee and delegate agencies' program of services for
infants and toddlers must encourage (see 45 CFR 1304.3(a)(5)):
(i) The development of secure relationships in out-of-home care
settings for infants and toddlers by having a limited number of
consistent teachers over an extended period of time. Teachers must
demonstrate an understanding of the child's family culture and,
whenever possible, speak the child's language (see 45 CFR
1304.52(g)(4));
(ii) Trust and emotional security so that each child can explore
the environment according to his or her developmental level; and
(iii) Opportunities for each child to explore a variety of sensory
and motor experiences with support and stimulation from teachers and
family members.
(2) Grantee and delegate agencies must support the social and
emotional development of infants and toddlers by promoting an
environment that:
(i) Encourages the development of self-awareness, autonomy, and
self-expression; and
(ii) Supports the emerging communication skills of infants and
toddlers by providing daily opportunities for each child to interact
with others and to express himself or herself freely.
(3) Grantee and delegate agencies must promote the physical
development of infants and toddlers by:
(i) Supporting the development of the physical skills of infants
and toddlers including gross motor skills, such as grasping, pulling,
pushing, crawling, walking, and climbing; and
(ii) Creating opportunities for fine motor development that
encourage the control and coordination of small, specialized motions,
using the eyes, mouth, hands, and feet.
(c) Child development and education approach for preschoolers. (1)
Grantee and delegate agencies, in collaboration with the parents, must
implement a curriculum (see 45 CFR 1304.3(a)(5)) that:
(i) Supports each child's individual pattern of development and
learning;
(ii) Provides for the development of cognitive skills by
encouraging each child to organize his or her experiences, to
understand concepts, and to develop age appropriate literacy, numeracy,
reasoning, problem solving and decision-making skills which form a
foundation for school readiness and later school success;
(iii) Integrates all educational aspects of the health, nutrition,
and mental health services into program activities;
(iv) Ensures that the program environment helps children develop
emotional security and facility in social relationships;
(v) Enhances each child's understanding of self as an individual
and as a member of a group;
(vi) Provides each child with opportunities for success to help
develop feelings of competence, self-esteem, and positive attitudes
toward learning; and
(vii) Provides individual and small group experiences both indoors
and outdoors.
(2) Staff must use a variety of strategies to promote and support
children's learning and developmental progress based on the
observations and ongoing assessment of each child (see 45 CFR
1304.20(b), 1304.20(d), and 1304.20(e)).
Sec. 1304.22 Child health and safety.
(a) Health emergency procedures. Grantee and delegate agencies
operating center-based programs must establish and implement policies
and procedures to respond to medical and dental health emergencies with
which all staff are familiar and trained. At a minimum, these policies
and procedures must include:
(1) Posted policies and plans of action for emergencies that
require rapid response on the part of staff (e.g., a child choking) or
immediate medical or dental attention;
(2) Posted locations and telephone numbers of emergency response
systems. Up-to-date family contact information and authorization for
emergency care for each child must be readily available;
(3) Posted emergency evacuation routes and other safety procedures
for emergencies (e.g., fire or weather-related) which are practiced
regularly (see 45 CFR 1304.53 for additional information);
(4) Methods of notifying parents in the event of an emergency
involving their child; and
(5) Established methods for handling cases of suspected or known
child abuse and neglect that are in compliance with applicable Federal,
State, or Tribal laws.
(b) Conditions of short-term exclusion and admittance. (1) Grantee
and delegate agencies must temporarily exclude a child with a short-
term injury or an acute or short-term contagious illness, that cannot
be readily accommodated, from program participation in center-based
activities or group experiences, but only for that generally short-term
period when keeping the child in care poses a significant risk to the
health or safety of the child or anyone in contact with the child.
(2) Grantee and delegate agencies must not deny program admission
to any child, nor exclude any enrolled child from program participation
for a long-term period, solely on the basis of his or her health care
needs or medication requirements unless keeping the child in care poses
a significant risk to the health or safety of the child or anyone in
contact with the child and the risk cannot be eliminated or reduced to
an acceptable level through reasonable modifications in the grantee or
delegate agency's policies, practices or procedures or by providing
appropriate auxiliary aids which would enable the child to participate
without fundamentally altering the nature of the program.
(3) Grantee and delegate agencies must 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.
(c) Medication administration. Grantee and delegate agencies must
establish and maintain written procedures regarding the administration,
handling, and storage of medication for every child. Grantee and
delegate agencies may modify these procedures as necessary to satisfy
State or Tribal laws, but only where such
[[Page 57215]]
laws are consistent with Federal laws. The procedures must include:
(1) Labeling and storing, under lock and key, and refrigerating, if
necessary, all medications, including those required for staff and
volunteers;
(2) Designating a trained staff member(s) or school nurse to
administer, handle and store child medications;
(3) Obtaining physicians' instructions and written parent or
guardian authorizations for all medications administered by staff;
(4) Maintaining an individual record of all medications dispensed,
and reviewing the record regularly with the child's parents;
(5) Recording changes in a child's behavior that have implications
for drug dosage or type, and assisting parents in communicating with
their physician regarding the effect of the medication on the child;
and
(6) Ensuring that appropriate staff members can demonstrate proper
techniques for administering, handling, and storing medication,
including the use of any necessary equipment to administer medication.
(d) Injury prevention. Grantee and delegate agencies must:
(1) Ensure that staff and volunteers can demonstrate safety
practices; and
(2) Foster safety awareness among children and parents by
incorporating it into child and parent activities.
(e) Hygiene. (1) Staff, volunteers, and children must wash their
hands with soap and running water at least at the following times:
(i) After diapering or toilet use;
(ii) Before food preparation, handling, consumption, or any other
food-related activity (e.g., setting the table);
(iii) Whenever hands are contaminated with blood or other bodily
fluids; and
(iv) After handling pets or other animals.
(2) Staff and volunteers must also wash their hands with soap and
running water:
(i) Before and after giving medications;
(ii) Before and after treating or bandaging a wound (nonporous
gloves should be worn if there is contact with blood or blood-
containing body fluids); and
(iii) After assisting a child with toilet use.
(3) Nonporous (e.g., latex) gloves must be worn by staff when they
are in contact with spills of blood or other visibly bloody bodily
fluids.
(4) Spills of bodily fluids (e.g., urine, feces, blood, saliva,
nasal discharge, eye discharge or any fluid discharge) must be cleaned
and disinfected immediately in keeping with professionally established
guidelines (e.g., standards of the Occupational Safety Health
Administration, U.S. Department of Labor). Any tools and equipment used
to clean spills of bodily fluids must be cleaned and disinfected
immediately. Other blood-contaminated materials must be disposed of in
a plastic bag with a secure tie.
(5) Grantee and delegate agencies must adopt sanitation and hygiene
procedures for diapering that adequately protect the health and safety
of children served by the program and staff. Grantee and delegate
agencies must ensure that staff properly conduct these procedures.
(6) Potties that are utilized in a center-based program must be
emptied into the toilet and cleaned and disinfected after each use in a
utility sink used for this purpose.
(7) Grantee and delegate agencies operating programs for infants
and toddlers must space cribs and cots at least three feet apart to
avoid spreading contagious illness and to allow for easy access to each
child.
(f) First aid kits. (1) Readily available, well-supplied first aid
kits appropriate for the ages served and the program size must be
maintained at each facility and available on outings away from the
site. Each kit must be accessible to staff members at all times, but
must be kept out of the reach of children.
(2) First aid kits must be restocked after use, and an inventory
must be conducted at regular intervals.
Sec. 1304.23 Child nutrition.
(a) Identification of nutritional needs. Staff and families must
work together to identify each child's nutritional needs, taking into
account staff and family discussions concerning:
(1) Any relevant nutrition-related assessment data (height, weight,
hemoglobin/hematocrit) obtained under 45 CFR 1304.20(a);
(2) Information about family eating patterns, including cultural
preferences, special dietary requirements for each child with
nutrition-related health problems, and the feeding requirements of
infants and toddlers and each child with disabilities (see 45 CFR
1308.20);
(3) For infants and toddlers, current feeding schedules and amounts
and types of food provided, including whether breast milk or formula
and baby food is used; meal patterns; new foods introduced; food
intolerances and preferences; voiding patterns; and observations
related to developmental changes in feeding and nutrition. This
information must be shared with parents and updated regularly; and
(4) Information about major community nutritional issues, as
identified through the Community Assessment or by the Health Services
Advisory Committee or the local health department.
(b) Nutritional services. (1) Grantee and delegate agencies must
design and implement a nutrition program that meets the nutritional
needs and feeding requirements of each child, including those with
special dietary needs and children with disabilities. Also, the
nutrition program must serve a variety of foods which consider cultural
and ethnic preferences and which broaden the child's food experience.
(i) 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.
(ii) Each child in a part-day center-based setting must receive
meals and snacks that provide at least \1/3\ of the child's daily
nutritional needs. Each child in a center-based full-day program must
receive meals and snacks that provide \1/2\ to \2/3\ of the child's
daily nutritional needs, depending upon the length of the program day.
(iii) All children in morning center-based settings who have not
received breakfast at the time they arrive at the Early Head Start or
Head Start program must be served a nourishing breakfast.
(iv) Each infant and toddler in center-based settings must receive
food appropriate to his or her nutritional needs, developmental
readiness, and feeding skills, as recommended in the USDA meal pattern
or nutrient standard menu planning requirements outlined in 7 CFR parts
210, 220, and 226.
(v) For 3- to 5-year-olds in center-based settings, the quantities
and kinds of food served must conform to recommended serving sizes and
minimum standards for meal patterns recommended in the USDA meal
pattern or nutrient standard menu planning requirements outlined in 7
CFR parts 210, 220, and 226.
(vi) For 3- to 5-year-olds in center-based settings or other Head
Start group experiences, foods served must be high in nutrients and low
in fat, sugar, and salt.
(vii) Meal and snack periods in center-based settings must be
appropriately scheduled and adjusted, where necessary, to ensure that
individual needs are met. Infants and young toddlers who need it must
be fed
[[Page 57216]]
``on demand'' to the extent possible or at appropriate intervals.
(2) Grantee and delegate agencies operating home-based program
options must provide appropriate snacks and meals to each child during
group socialization activities (see 45 CFR 1306.33 for information
regarding home-based group socialization).
(3) Staff must promote effective dental hygiene among children in
conjunction with meals.
(4) Parents and appropriate community agencies must be involved in
planning, implementing, and evaluating the agencies' nutritional
services.
(c) Meal service. Grantee and delegate agencies must ensure that
nutritional services in center-based settings contribute to the
development and socialization of enrolled children by providing that:
(1) A variety of food is served which broadens each child's food
experiences;
(2) Food is not used as punishment or reward, and that each child
is encouraged, but not forced, to eat or taste his or her food;
(3) Sufficient time is allowed for each child to eat;
(4) All toddlers and preschool children and assigned classroom
staff, including volunteers, eat together family style and share the
same menu to the extent possible;
(5) Infants are held while being fed and are not laid down to sleep
with a bottle;
(6) Medically-based diets or other dietary requirements are
accommodated; and
(7) As developmentally appropriate, opportunity is provided for the
involvement of children in food-related activities.
(d) Family assistance with nutrition. Parent education activities
must include opportunities to assist individual families with food
preparation and nutritional skills.
(e) Food safety and sanitation. (1) Grantee and delegate agencies
must post evidence of compliance with all applicable Federal, State,
Tribal, and local food safety and sanitation laws, including those
related to the storage, preparation and service of food and the health
of food handlers. In addition, agencies must contract only with food
service vendors that are licensed in accordance with State, Tribal or
local laws.
(2) For programs serving infants and toddlers, facilities must be
available for the proper storage and handling of breast milk and
formula.
Sec. 1304.24 Child mental health.
(a) Mental health services. (1) Grantee and delegate agencies must
work collaboratively with parents (see 45 CFR 1304.40(f) for issues
related to parent education) by:
(i) Soliciting parental information, observations, and concerns
about their child's mental health;
(ii) Sharing staff observations of their child and discussing and
anticipating with parents their child's behavior and development,
including separation and attachment issues;
(iii) Discussing and identifying with parents appropriate responses
to their child's behaviors;
(iv) Discussing how to strengthen nurturing, supportive
environments and relationships in the home and at the program;
(v) Helping parents to better understand mental health issues; and
(vi) Supporting parents' participation in any needed mental health
interventions.
(2) Grantee and delegate agencies must secure the services of
mental health professionals on a schedule of sufficient frequency to
enable the timely and effective identification of and intervention in
family and staff concerns about a child's mental health; and
(3) Mental health program services must include a regular schedule
of on-site mental health consultation involving the mental health
professional, program staff, and parents on how to:
(i) Design and implement program practices responsive to the
identified behavioral and mental health concerns of an individual child
or group of children;
(ii) Promote children's mental wellness by providing group and
individual staff and parent education on mental health issues;
(iii) Assist in providing special help for children with atypical
behavior or development; and
(iv) Utilize other community mental health resources, as needed.
Subpart C--Family and Community Partnerships
Sec. 1304.40 Family partnerships.
(a) Family goal setting. (1) Grantee and delegate agencies must
engage in a process of collaborative partnership-building with parents
to establish mutual trust and to identify family goals, strengths, and
necessary services and other supports. This process must be initiated
as early after enrollment as possible and it must take into
consideration each family's readiness and willingness to participate in
the process.
(2) As part of this ongoing partnership, grantee and delegate
agencies must offer parents opportunities to develop and implement
individualized Family Partnership Agreements that describe family
goals, responsibilities, timetables and strategies for achieving these
goals as well as progress in achieving them. In home-based program
options, this Agreement must include the above information as well as
the specific roles of parents in home visits and group socialization
activities (see 45 CFR 1306.33(b)).
(3) To avoid duplication of effort, or conflict with, any
preexisting family plans developed between other programs and the Early
Head Start or Head Start family, the Family Partnership Agreement must
take into account, and build upon as appropriate, information obtained
from the family and other community agencies concerning preexisting
family plans. Grantee and delegate agencies must coordinate, to the
extent possible, with families and other agencies to support the
accomplishment of goals in the preexisting plans.
(4) A variety of opportunities must be created by grantee and
delegate agencies for interaction with parents throughout the year.
(5) Meetings and interactions with families must be respectful of
each family's diversity and cultural and ethnic background.
(b) Accessing community services and resources. (1) Grantee and
delegate agencies must work collaboratively with all participating
parents to identify and continually access, either directly or through
referrals, services and resources that are responsive to each family's
interests and goals, including:
(i) Emergency or crisis assistance in areas such as food, housing,
clothing, and transportation;
(ii) Education and other appropriate interventions, including
opportunities for parents to participate in counseling programs or to
receive information on mental health issues that place families at
risk, such as substance abuse, child abuse and neglect, and domestic
violence; and
(iii) Opportunities for continuing education and employment
training and other employment services through formal and informal
networks in the community.
(2) Grantee and delegate agencies must follow-up with each family
to determine whether the kind, quality, and timeliness of the services
received
[[Page 57217]]
through referrals met the families' expectations and circumstances.
(c) Services to pregnant women who are enrolled in programs serving
pregnant women, infants, and toddlers. (1) Early Head Start grantee and
delegate agencies must assist pregnant women to access comprehensive
prenatal and postpartum care, through referrals, immediately after
enrollment in the program. This care must include:
(i) Early and continuing risk assessments, which include an
assessment of nutritional status as well as nutrition counseling and
food assistance, if necessary;
(ii) Health promotion and treatment, including medical and dental
examinations on a schedule deemed appropriate by the attending health
care providers as early in the pregnancy as possible; and
(iii) Mental health interventions and follow-up, including
substance abuse prevention and treatment services, as needed.
(2) Grantee and delegate agencies must provide pregnant women and
other family members, as appropriate, with prenatal education on fetal
development (including risks from smoking and alcohol), labor and
delivery, and postpartum recovery (including maternal depression).
(3) Grantee and delegate agencies must provide information on the
benefits of breast feeding to all pregnant and nursing mothers. For
those who choose to breast feed in center-based programs, arrangements
must be provided as necessary.
(d) Parent involvement--general. (1) In addition to involving
parents in program policy-making and operations (see 45 CFR 1304.50),
grantee and delegate agencies 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.
Other community agencies should be encouraged to assist in the planning
and implementation of such programs.
(2) Early Head Start and Head Start settings must be open to
parents during all program hours. Parents must be welcomed as visitors
and encouraged to observe children as often as possible and to
participate with children in group activities. The participation of
parents in any program activity must be voluntary, and must not be
required as a condition of the child's enrollment.
(3) Grantee and delegate agencies must provide parents with
opportunities to participate in the program as employees or volunteers
(see 45 CFR 1304.52(b)(3) for additional requirements about hiring
parents).
(e) Parent involvement in child development and education. (1)
Grantee and delegate agencies must provide opportunities to include
parents in the development of the program's curriculum and approach to
child development and education (see 45 CFR 1304.3(a)(5) for a
definition of curriculum).
(2) Grantees and delegate agencies operating home-based program
options must build upon the principles of adult learning to assist,
encourage, and support parents as they foster the growth and
development of their children.
(3) Grantee and delegate agencies must provide opportunities for
parents to enhance their parenting skills, knowledge, and understanding
of the educational and developmental needs and activities of their
children and to share concerns about their children with program staff
(see 45 CFR 1304.21 for additional requirements related to parent
involvement).
(4) Grantee and delegate agencies must provide, either directly or
through referrals to other local agencies, opportunities for children
and families to participate in family literacy services by:
(i) Increasing family access to materials, services, and activities
essential to family literacy development; and
(ii) Assisting parents as adult learners to recognize and address
their own literacy goals.
(5) In addition to the two home visits, teachers in center-based
programs must conduct staff-parent conferences, as needed, but no less
than two per program year, to enhance the knowledge and understanding
of both staff and parents of the educational and developmental progress
and activities of children in the program (see 45 CFR
1304.21(a)(2)(iii) and 45 CFR 1304.40(i) for additional requirements
about staff-parent conferences and home visits).
(f) Parent involvement in health, nutrition, and mental health
education. (1) Grantee and delegate agencies must provide medical,
dental, nutrition, and mental health education programs for program
staff, parents, and families.
(2) Grantee and delegate agencies must ensure that, at a minimum,
the medical and dental health education program:
(i) Assists parents in understanding how to enroll and participate
in a system of ongoing family health care.
(ii) Encourages parents to become active partners in their
children's medical and dental health care process and to accompany
their child to medical and dental examinations and appointments; and
(iii) Provides parents with the opportunity to learn the principles
of preventive medical and dental health, emergency first-aid,
occupational and environmental hazards, and safety practices for use in
the classroom and in the home. In addition to information on general
topics (e.g., maternal and child health and the prevention of Sudden
Infant Death Syndrome), information specific to the health needs of
individual children must also be made available to the extent possible.
(3) Grantee and delegate agencies must ensure that the nutrition
education program includes, at a minimum:
(i) Nutrition education in the selection and preparation of foods
to meet family needs and in the management of food budgets; and
(ii) Parent discussions with program staff about the nutritional
status of their child.
(4) Grantee and delegate agencies must ensure that the mental
health education program provides, at a minimum (see 45 CFR 1304.24 for
issues related to mental health education):
(i) A variety of group opportunities for parents and program staff
to identify and discuss issues related to child mental health;
(ii) Individual opportunities for parents to discuss mental health
issues related to their child and family with program staff; and
(iii) The active involvement of parents in planning and
implementing any mental health interventions for their children.
(g) Parent involvement in community advocacy. (1) Grantee and
delegate agencies must:
(i) Support and encourage parents to influence the character and
goals of community services in order to make them more responsive to
their interests and needs; and
(ii) Establish procedures to provide families with comprehensive
information about community resources (see 45 CFR 1304.41(a)(2) for
additional requirements).
(2) Parents must be provided regular opportunities to work
together, and with other community members, on activities that they
have helped develop and in which they have expressed an interest.
(h) Parent involvement in transition activities. (1) Grantee and
delegate agencies must assist parents in becoming their children's
advocate as they transition both into Early Head Start or Head Start
from the home or other child care setting, and from Head Start to
elementary school, a Title I of
[[Page 57218]]
the Elementary and Secondary Education Act preschool program, or a
child care setting.
(2) Staff must work to prepare parents to become their children's
advocate through transition periods by providing that, at a minimum, a
staff-parent meeting is held toward the end of the child's
participation in the program to enable parents to understand the
child's progress while enrolled in Early Head Start or Head Start.
(3) To promote the continued involvement of Head Start parents in
the education and development of their children upon transition to
school, grantee and delegate agencies must:
(i) Provide education and training to parents to prepare them to
exercise their rights and responsibilities concerning the education of
their children in the school setting; and
(ii) Assist parents to communicate with teachers and other school
personnel so that parents can participate in decisions related to their
children's education.
(4) See 45 CFR 1304.41(c) for additional standards related to
children's transition to and from Early Head Start or Head Start.
(i) Parent involvement in home visits. (1) Grantee and delegate
agencies must not require that parents permit home visits as a
condition of the child's participation in Early Head Start or Head
Start center-based program options. Every effort must be made to
explain the advantages of home visits to the parents.
(2) The child's teacher in center-based programs must make no less
than two home visits per program year to the home of each enrolled
child, unless the parents expressly forbid such visits, in accordance
with the requirements of 45 CFR 1306.32(b)(8). Other staff working with
the family must make or join home visits, as appropriate.
(3) Grantee and delegate agencies must schedule home visits at
times that are mutually convenient for the parents or primary
caregivers and staff.
(4) In cases where parents whose children are enrolled in the
center-based program option ask that the home visits be conducted
outside the home, or in cases where a visit to the home presents
significant safety hazards for staff, the home visit may take place at
an Early Head Start or Head Start site or at another safe location that
affords privacy. Home visits in home-based program options must be
conducted in the family's home.
(5) In addition, grantee and delegate agencies operating home-based
program options must meet the requirements of 45 CFR 1306.33(a)(1)
regarding home visits.
(6) Grantee and delegate agencies serving infants and toddlers must
arrange for health staff to visit each newborn within two weeks after
the infant's birth to ensure the well-being of both the mother and the
child.
Sec. 1304.41 Community partnerships.
(a) Partnerships. (1) Grantee and delegate agencies must take an
active role in community planning to encourage strong communication,
cooperation, and the sharing of information among agencies and their
community partners and to improve the delivery of community services to
children and families in accordance with the agency's confidentiality
policies. Documentation must be maintained to reflect the level of
effort undertaken to establish community partnerships (see 45 CFR
1304.51 for additional planning requirements).
(2) Grantee and delegate agencies must take affirmative steps to
establish ongoing collaborative relationships with community
organizations to promote the access of children and families to
community services that are responsive to their needs, and to ensure
that Early Head Start and Head Start programs respond to community
needs, including:
(i) Health care providers, such as clinics, physicians, dentists,
and other health professionals;
(ii) Mental health providers;
(iii) Nutritional service providers;
(iv) Individuals and agencies that provide services to children
with disabilities and their families (see 45 CFR 1308.4 for specific
service requirements);
(v) Family preservation and support services;
(vi) Child protective services and any other agency to which child
abuse must be reported under State or Tribal law;
(vii) Local elementary schools and other educational and cultural
institutions, such as libraries and museums, for both children and
families;
(viii) Providers of child care services; and
(ix) Any other organizations or businesses that may provide support
and resources to families.
(3) Grantee and delegate agencies must perform outreach to
encourage volunteers from the community to participate in Early Head
Start and Head Start programs.
(4) To enable the effective participation of children with
disabilities and their families, grantee and delegate agencies must
make specific efforts to develop interagency agreements with local
education agencies (LEAs) and other agencies within the grantee and
delegate agency's service area (see 45 CFR 1308.4(h) for specific
requirements concerning interagency agreements).
(b) Advisory committees. Each grantee directly operating an Early
Head Start or Head Start program, and each delegate agency, must
establish and maintain a Health Services Advisory Committee which
includes professionals and volunteers from the community. Grantee and
delegate agencies also must establish and maintain such other service
advisory committees as they deem appropriate to address program service
issues such as community partnerships and to help agencies respond to
community needs.
(c) Transition services. (1) Grantee and delegate agencies must
establish and maintain procedures to support successful transitions for
enrolled children and families from previous child care programs into
Early Head Start or Head Start and from Head Start into elementary
school, a Title I of the Elementary and Secondary Education Act
preschool program, or other child care settings. These procedures must
include:
(i) Coordinating with the schools or other agencies to ensure that
individual Early Head Start or Head Start children's relevant records
are transferred to the school or next placement in which a child will
enroll or from earlier placements to Early Head Start or Head Start;
(ii) Outreach to encourage communication between Early Head Start
or Head Start staff and their counterparts in the schools and other
child care settings including principals, teachers, social workers and
health staff to facilitate continuity of programming;
(iii) Initiating meetings involving Head Start teachers and parents
and kindergarten or elementary school teachers to discuss the
developmental progress and abilities of individual children; and
(iv) Initiating joint transition-related training for Early Head
Start or Head Start staff and school or other child development staff.
(2) To ensure the most appropriate placement and services following
participation in Early Head Start, transition planning must be
undertaken for each child and family at least six months prior to the
child's third birthday. The process must take into account: The child's
health status and developmental level, progress made by the child and
family while in Early Head Start, current and changing family
circumstances, and the availability of
[[Page 57219]]
Head Start and other child development or child care services in the
community. As appropriate, a child may remain in Early Head Start,
following his or her third birthday, for additional months until he or
she can transition into Head Start or another program.
(3) See 45 CFR 1304.40(h) for additional requirements related to
parental participation in their child's transition to and from Early
Head Start or Head Start.
Subpart D--Program Design and Management
Sec. 1304.50 Program governance.
(a) Policy Council, Policy Committee, and Parent Committee
structure. (1) Grantee and delegate agencies must establish and
maintain a formal structure of shared governance through which parents
can participate in policy making or in other decisions about the
program. This structure must consist of the following groups, as
required:
(i) Policy Council. This Council must be established at the grantee
level.
(ii) Policy Committee. This Committee must be established at the
delegate agency level when the program is administered in whole or in
part by such agencies (see 45 CFR 1301.2 for a definition of a delegate
agency).
(iii) Parent Committee. For center-based programs, this Committee
must be established at the center level. For other program options, an
equivalent Committee must be established at the local program level.
When programs operate more than one option from the same site, the
Parent Committee membership is combined unless parents choose to have a
separate Committee for each option.
(2) Parent Committees must be comprised exclusively of the parents
of children currently enrolled at the center level for center-based
programs or at the equivalent level for other program options (see 45
CFR 1306.3(h) for a definition of a Head Start parent).
(3) All Policy Councils, Policy Committees, and Parent Committees
must be established as early in the program year as possible. Grantee
Policy Councils and delegate Policy Committees may not be dissolved
until successor Councils or Committees are elected and seated.
(4) When a grantee has delegated the entire Head Start program to
one delegate agency, it is not necessary to have a Policy Committee in
addition to a grantee agency Policy Council.
(5) The governing body (the group with legal and fiscal
responsibility for administering the Early Head Start or Head Start
program) and the Policy Council or Policy Committee must not have
identical memberships and functions.
(b) Policy group composition and formation. (1) Each grantee and
delegate agency governing body operating an Early Head Start or Head
Start program must (except where such authority is ceded to the Policy
Council or Policy Committee) propose, within the framework of these
regulations, the total size of their respective policy groups (based on
the number of centers, classrooms or other program option units, and
the number of children served by their Early Head Start or Head Start
program), the procedures for the election of parent members, and the
procedure for the selection of community representatives. These
proposals must be approved by the Policy Council or Policy Committee.
(2) Policy Councils and Policy Committees must be comprised of two
types of representatives: parents of currently enrolled children and
community representatives. At least 51 percent of the members of these
policy groups must be the parents of currently enrolled children (see
45 CFR 1306.3(h) for a definition of a Head Start parent).
(3) Community representatives must be drawn from the local
community: businesses; public or private community, civic, and
professional organizations; and others who are familiar with resources
and services for low-income children and families. Community
representatives may include the parents of formerly enrolled children.
(4) All parent members of Policy Councils or Policy Committees must
stand for election or re-election annually. All community
representatives also must be selected annually.
(5) Policy Councils and Policy Committees must limit the number of
one-year terms any individual may serve on either body to a combined
total of three terms.
(6) No grantee or delegate agency staff (or members of their
immediate families) may serve on Policy Councils or Policy Committees
except parents who occasionally substitute for regular Early Head Start
or Head Start staff. In the case of Tribal grantees, this exclusion
applies only to Tribal staff who work in areas directly related to or
which directly impact upon any Early Head Start or Head Start
administrative, fiscal or programmatic issues.
(7) Parents of children currently enrolled in all program options
must be proportionately represented on established policy groups.
(c) Policy group responsibilities--general. At a minimum policy
groups must be charged with the responsibilities described in
paragraphs (d), (f), (g), and (h) of this section and repeated in
appendix A of this section.
(d) The Policy Council or Policy Committee. (1) Policy Councils and
Policy Committees must work in partnership with key management staff
and the governing body to develop, review, and approve or disapprove
the following policies and procedures:
(i) All funding applications and amendments to funding applications
for Early Head Start and Head Start, including administrative services,
prior to the submission of such applications to the grantee (in the
case of Policy Committees) or to HHS (in the case of Policy Councils);
(ii) Procedures describing how the governing body and the
appropriate policy group will implement shared decision-making;
(iii) Procedures for program planning in accordance with this part
and the requirements of 45 CFR 1305.3 (this regulation is binding on
Policy Councils exclusively);
(iv) The program's philosophy and long- and short-range program
goals and objectives (see 45 CFR 1304.51(a) and 45 CFR 1305.3 for
additional requirements regarding program planning);
(v) The selection of delegate agencies and their service areas
(this regulation is binding on Policy Councils exclusively) (see 45 CFR
1301.33 and 45 CFR 1305.3(a) for additional requirements about delegate
agency and service area selection, respectively);
(vi) The composition of the Policy Council or the Policy Committee
and the procedures by which policy group members are chosen;
(vii) Criteria for defining recruitment, selection, and enrollment
priorities, in accordance with the requirements of 45 CFR part 1305;
(viii) The annual self-assessment of the grantee or delegate
agency's progress in carrying out the programmatic and fiscal intent of
its grant application, including planning or other actions that may
result from the review of the annual audit and findings from the
Federal monitoring review (see 45 CFR 1304.51(i)(1) for additional
requirements about the annual self-assessment);
(ix) The annual independent audit that must be conducted in
accordance with 45 CFR 1301.12;
(x) Program personnel policies and subsequent changes to those
policies, in accordance with 45 CFR 1301.31, including standards of
conduct for
[[Page 57220]]
program staff, consultants, and volunteers;
(xi) Decisions to hire or terminate the Early Head Start or Head
Start director of the grantee or delegate agency; and
(xii) Decisions to hire or terminate any person who works primarily
for the Early Head Start or Head Start program of the grantee or
delegate agency.
(2) In addition, Policy Councils and Policy Committees must perform
the following functions directly:
(i) Serve as a link to the Parent Committees, grantee and delegate
agency governing bodies, public and private organizations, and the
communities they serve;
(ii) Assist Parent Committees in communicating with parents
enrolled in all program options to ensure that they understand their
rights, responsibilities, and opportunities in Early Head Start and
Head Start and to encourage their participation in the program;
(iii) Assist Parent Committees in planning, coordinating, and
organizing program activities for parents with the assistance of staff,
and ensuring that funds set aside from program budgets are used to
support parent activities;
(iv) Assist in recruiting volunteer services from parents,
community residents, and community organizations, and assist in the
mobilization of community resources to meet identified needs; and
(v) Establish and maintain procedures for working with the grantee
or delegate agency to resolve community complaints about the program.
(e) Parent Committee. The Parent Committee must carry out at least
the following minimum responsibilities:
(1) Advise staff in developing and implementing local program
policies, activities, and services;
(2) Plan, conduct, and participate in informal as well as formal
programs and activities for parents and staff; and
(3) Within the guidelines established by the Governing Board,
Policy Council, or Policy Committee, participate in the recruitment and
screening of Early Head Start and Head Start employees.
(f) Policy Council, Policy Committee, and Parent Committee
reimbursement. Grantee and delegate agencies must enable low-income
members to participate fully in their group responsibilities by
providing, if necessary, reimbursements for reasonable expenses
incurred by the members.
(g) Governing body responsibilities. (1) Grantee and delegate
agencies must have written policies that define the roles and
responsibilities of the governing body members and that inform them of
the management procedures and functions necessary to implement a high
quality program.
(2) Grantee and delegate agencies must ensure that appropriate
internal controls are established and implemented to safeguard Federal
funds in accordance with 45 CFR 1301.13.
(h) Internal dispute resolution. Each grantee and delegate agency
and Policy Council or Policy Committee jointly must establish written
procedures for resolving internal disputes, including impasse
procedures, between the governing body and policy group.
Appendix A--Governance and Management Responsibilities
[A=General responsibility; B=Operating responsibility; C=Must approve or disapprove; D=Determined locally]
--------------------------------------------------------------------------------------------------------------------------------------------------------
Grantee agency Delegate agency Grantee or delegate management staff
-----------------------------------------------------------------------------------------------------------------------
Function HS* program
Governing body Policy council Governing body Policy cmte. director Agency director
--------------------------------------------------------------------------------------------------------------------------------------------------------
I. Planning
--------------------------------------------------------------------------------------------------------------------------------------------------------
(a) 1304.50(d)(1)(iii) A & C C C C B D
Procedures for program planning
in accordance with this Part
and the requirements of 45 CFR
1305.3 (this regulation is
binding on Policy Councils
exclusively).
(b) 1304.50(d)(1)(iv) The A & C C C C B D
program's philosophy and long-
and short-range program goals
and objectives (see 45 CFR
1304.51(a) and 45 CFR 1305.3
for additional requirements
regarding program planning).
(c) 1304.50(d)(1)(v) The A & C C -- -- B D
selection of delegate agencies (Grantee only) (Grantee only)
and their service areas (this
regulation is binding on Policy
Councils exclusively) (see 45
CFR 1301.33 and 45 CFR
1305.3(a) for additional
requirements about delegate
agency and service area
selection, respectively).
(d) 1304.50(d)(1)(vii) Criteria A C A C B D
for defining recruitment,
selection, and enrollment
priorities, in accordance with
the requirements of 45 CFR Part
1305.
(e) 1304.50(d)(1)(i) All funding A & C C A & C C B D
applications and amendments to
funding applications for Early
Head Start and Head Start,
including administrative
services, prior to the
submission of such applications
to the grantee (in the case of
Policy Committees) or to HHS
(in the case of Policy
Councils).
(f) 1304.50(f) Policy Council, A C A C B D
Policy Committee, and Parent
Committee reimbursement.
Grantee and delegate agencies
must enable low-income members
to participate fully in their
group responsibilities by
providing, if necessary,
reimbursements for reasonable
expenses incurred by the
members.
[[Page 57221]]
(g) 1304.50(d)(1)(viii) The A C A C B D
annual self-assessment of the
grantee or delegate agency's
progress in carrying out the
programmatic and fiscal intent
of its grant application,
including planning or other
actions that may result from
the review of the annual audit
and findings from the Federal
monitoring review (see 45 CFR
1304.51(i)(1) for additional
requirements about the annual
self-assessment).
--------------------------------------------------------------------------------------------------------------------------------------------------------
II. General Procedures
--------------------------------------------------------------------------------------------------------------------------------------------------------
(a) 1304.50(d)(1)(vi) The A & C C A & C C B D
composition of the Policy
Council or the Policy Committee
and the procedures by which
policy group members are chosen.
(b) 1304.50(g)(1) Grantee and A & C C A & C C -- D
delegate agencies must have
written policies that define
the roles and responsibilities
of the governing body members
and that inform them of the
management procedures and
functions necessary to
implement a high quality
program.
(c) 1304.50(d)(1)(ii) Procedures A & C C A & C C D D
describing how the governing
body and the appropriate policy
group will implement shared
decision-making.
(d) 1304.50(h) Internal dispute A & C C A & C C D D
resolution. Each grantee and
delegate agency and Policy
Council or Policy Committee
jointly must establish written
procedures for resolving
internal disputes, including
impasse procedures, between the
governing body and policy group.
(e) 1304.50(d)(2)(v) Establish B B B B D D
and maintain procedures for
hearing and working with the
grantee or delegate agency to
resolve community complaints
about the program.
(f) 1304.50(g)(2) Grantee and A -- A -- D D
delegate agencies must ensure
that appropriate internal
controls are established and
implemented to safeguard
Federal funds in accordance
with 45 CFR 1301.13.
(g) 1304.50(d)(1)(ix) The annual A -- A -- D D
independent audit that must be
conducted in accordance with 45
CFR 1301.12.
--------------------------------------------------------------------------------------------------------------------------------------------------------
III. Human Resources Management
--------------------------------------------------------------------------------------------------------------------------------------------------------
(a) 1304.50(d)(1)(x) Program A & C C A & C C D D
personnel policies and
subsequent changes to those
policies, in accordance with 45
CFR 1301.31, including
standards of conduct for
program staff, consultants, and
volunteers.
(b) 1304.50(d)(1)(xi) Decisions A & C C -- -- -- D
to hire or terminate the Early
Head Start or Head Start
director of the grantee agency.
(c) 1304.50(d)(1)(xii) Decisions C C -- -- B D
to hire or terminate any person (Grantee only)
who works primarily for the
Early Head Start or Head Start
program of the grantee agency.
(d) 1304.50(d)(1)(xi) Decisions -- -- A & C C -- D
to hire or terminate the Early
Head Start or Head Start
director of the delegate agency.
(e) 1304.50(d)(1)(xii) Decisions -- -- C C B D
to hire or terminate any person (Delegate only)
who works primarily for the
Early Head Start or Head Start
program of the delegate agency.
--------------------------------------------------------------------------------------------------------------------------------------------------------
KEY AND DEFINITIONS AS USED IN CHART
* When a grantee or delegate agency operates an Early Head Start program only and not an Early Head Start and a Head Start program, these
responsibilities apply to the Early Head Start Director.
A. General Responsibility. The group with legal and fiscal responsibility that guides and oversees the carrying out of the functions described through
the individual or group given operating responsibility.
B. Operating Responsibility. The individual or group that is directly responsible for carrying out or performing the functions consistent with the
general guidance and oversight from the group holding general responsibility.
C. Must Approve or Disapprove. The group that must be involved in the decision-making process prior to the point of seeking approval. If it does not
approve, a proposal cannot be adopted, or the proposed action taken, until agreement is reached between the disagreeing groups.
D. Determined locally. Management staff functions as determined by the local governing body and in accordance with all Head Start regulations.
[[Page 57222]]
Sec. 1304.51 Management systems and procedures.
(a) Program planning. (1) Grantee and delegate agencies must
develop and implement a systematic, ongoing process of program planning
that includes consultation with the program's governing body, policy
groups, and program staff, and with other community organizations that
serve Early Head Start and Head Start or other low-income families with
young children. Program planning must include:
(i) An assessment of community strengths, needs and resources
through completion of the Community Assessment, in accordance with the
requirements of 45 CFR 1305.3;
(ii) The formulation of both multi-year (long-range) program goals
and short-term program and financial objectives that address the
findings of the Community Assessment, are consistent with the
philosophy of Early Head Start and Head Start, and reflect the findings
of the program's annual self- assessment; and
(iii) The development of written plan(s) for implementing services
in each of the program areas covered by this part (e.g., Early
Childhood Development and Health Services, Family and Community
Partnerships, and Program Design and Management).
(2) All written plans for implementing services, and the progress
in meeting them, must be reviewed by the grantee or delegate agency
staff and reviewed and approved by the Policy Council or Policy
Committee at least annually, and must be revised and updated as needed.
(b) Communications--general. Grantee and delegate agencies must
establish and implement systems to ensure that timely and accurate
information is provided to parents, policy groups, staff, and the
general community.
(c) Communication with families. (1) Grantee and delegate agencies
must ensure that effective two-way comprehensive communications between
staff and parents are carried out on a regular basis throughout the
program year.
(2) Communication with parents must be carried out in the parents'
primary or preferred language or through an interpreter, to the extent
feasible.
(d) Communication with governing bodies and policy groups. Grantee
and delegate agencies must ensure that the following information is
provided regularly to their grantee and delegate governing bodies and
to members of their policy groups:
(1) Procedures and timetables for program planning;
(2) Policies, guidelines, and other communications from HHS;
(3) Program and financial reports; and
(4) Program plans, policies, procedures, and Early Head Start and
Head Start grant applications.
(e) Communication among staff. Grantee and delegate agencies must
have mechanisms for regular communication among all program staff to
facilitate quality outcomes for children and families.
(f) Communication with delegate agencies. Grantees must have a
procedure for ensuring that delegate agency governing bodies, Policy
Committees, and all staff receive all regulations, policies, and other
pertinent communications in a timely manner.
(g) Record-keeping systems. Grantee and delegate agencies must
establish and maintain efficient and effective record-keeping systems
to provide accurate and timely information regarding children,
families, and staff and must ensure appropriate confidentiality of this
information.
(h) Reporting systems. Grantee and delegate agencies must establish
and maintain efficient and effective reporting systems that:
(1) Generate periodic reports of financial status and program
operations in order to control program quality, maintain program
accountability, and advise governing bodies, policy groups, and staff
of program progress; and
(2) Generate official reports for Federal, State, and local
authorities, as required by applicable law.
(i) Program self-assessment and monitoring. (1) At least once each
program year, with the consultation and participation of the policy
groups and, as appropriate, other community members, grantee and
delegate agencies must conduct a self-assessment of their effectiveness
and progress in meeting program goals and objectives and in
implementing Federal regulations.
(2) Grantees must establish and implement procedures for the
ongoing monitoring of their own Early Head Start and Head Start
operations, as well as those of each of their delegate agencies, to
ensure that these operations effectively implement Federal regulations.
(3) Grantees must inform delegate agency governing bodies of any
deficiencies in delegate agency operations identified in the monitoring
review and must help them develop plans, including timetables, for
addressing identified problems.
Sec. 1304.52 Human resources management.
(a) Organizational structure. (1) Grantee and delegate agencies
must establish and maintain an organizational structure that supports
the accomplishment of program objectives. This structure must address
the major functions and responsibilities assigned to each staff
position and must provide evidence of adequate mechanisms for staff
supervision and support.
(2) At a minimum, grantee and delegate agencies must ensure that
the following program management functions are formally assigned to and
adopted by staff within the program:
(i) Program management (the Early Head Start or Head Start
director);
(ii) Management of early childhood development and health services,
including child development and education; child medical, dental, and
mental health; child nutrition; and, services for children with
disabilities; and
(iii) Management of family and community partnerships, including
parent activities.
(b) Staff qualifications--general. (1) Grantee and delegate
agencies must ensure that staff and consultants have the knowledge,
skills, and experience they need to perform their assigned functions
responsibly.
(2) In addition, grantee and delegate agencies must ensure that
only candidates with the qualifications specified in this part and in
45 CFR 1306.21 are hired.
(3) Current and former Early Head Start and Head Start parents must
receive preference for employment vacancies for which they are
qualified.
(4) Staff and program consultants must be familiar with the ethnic
background and heritage of families in the program and must be able to
serve and effectively communicate, to the extent feasible, with
children and families with no or limited English proficiency.
(c) Early Head Start or Head Start director qualifications. The
Early Head Start or Head Start director must have demonstrated skills
and abilities in a management capacity relevant to human services
program management.
(d) Qualifications of content area experts. Grantee and delegate
agencies must hire staff or consultants who meet the qualifications
listed below to provide content area expertise and oversight on an
ongoing or regularly scheduled basis. Agencies must determine the
appropriate staffing pattern necessary to provide these functions.
(1) Education and child development services must be supported by
staff or
[[Page 57223]]
consultants with training and experience in areas that include: The
theories and principles of child growth and development, early
childhood education, and family support. In addition, staff or
consultants must meet the qualifications for classroom teachers, as
specified in section 648A of the Head Start Act and any subsequent
amendments regarding the qualifications of teachers.
(2) Health services must be supported by staff or consultants with
training and experience in public health, nursing, health education,
maternal and child health, or health administration. In addition, when
a health procedure must be performed only by a licensed/certified
health professional, the agency must assure that the requirement is
followed.
(3) Nutrition services must be supported by staff or consultants
who are registered dietitians or nutritionists.
(4) Mental health services must be supported by staff or
consultants who are licensed or certified mental health professionals
with experience and expertise in serving young children and their
families.
(5) Family and community partnership services must be supported by
staff or consultants with training and experience in field(s) related
to social, human, or family services.
(6) Parent involvement services must be supported by staff or
consultants with training, experience, and skills in assisting the
parents of young children in advocating and decision-making for their
families.
(7) Disabilities services must be supported by staff or consultants
with training and experience in securing and individualizing needed
services for children with disabilities.
(8) Grantee and delegate agencies must secure the regularly
scheduled or ongoing services of a qualified fiscal officer.
(e) Home visitor qualifications. Home visitors must have knowledge
and experience in child development and early childhood education; the
principles of child health, safety, and nutrition; adult learning
principles; and family dynamics. They must be skilled in communicating
with and motivating people. In addition, they must have knowledge of
community resources and the skills to link families with appropriate
agencies and services.
(f) Infant and toddler staff qualifications. Early Head Start and
Head Start staff working as teachers with infants and toddlers must
obtain a Child Development Associate (CDA) credential for Infant and
Toddler Caregivers or an equivalent credential that addresses
comparable competencies within one year of the effective date of the
final rule or, thereafter, within one year of hire as a teacher of
infants and toddlers. In addition, infants and toddler teachers must
have the training and experience necessary to develop consistent,
stable, and supportive relationships with very young children. The
training must develop knowledge of infant and toddler development,
safety issues in infant and toddler care (e.g., reducing the risk of
Sudden Infant Death Syndrome), and methods for communicating
effectively with infants and toddlers, their parents, and other staff
members.
(g) Classroom staffing and home visitors. (1) Grantee and delegate
agencies must meet the requirements of 45 CFR 1306.20 regarding
classroom staffing.
(2) When a majority of children speak the same language, at least
one classroom staff member or home visitor interacting regularly with
the children must speak their language.
(3) For center-based programs, the class size requirements
specified in 45 CFR 1306.32 must be maintained through the provision of
substitutes when regular classroom staff are absent.
(4) Grantee and delegate agencies must ensure that each teacher
working exclusively with infants and toddlers has responsibility for no
more than four infants and toddlers and that no more than eight infants
and toddlers are placed in any one group. However, if State, Tribal or
local regulations specify staff:child ratios and group sizes more
stringent than this requirement, the State, Tribal or local regulations
must apply.
(5) Staff must supervise the outdoor and indoor play areas in such
a way that children's safety can be easily monitored and ensured.
(h) Standards of conduct. (1) Grantee and delegate agencies must
ensure that all staff, consultants, and volunteers abide by the
program's standards of conduct. These standards must specify that:
(i) They will respect and promote the unique identity of each child
and family and refrain from stereotyping on the basis of gender, race,
ethnicity, culture, religion, or disability;
(ii) They will follow program confidentiality policies concerning
information about children, families, and other staff members;
(iii) No child will be left alone or unsupervised while under their
care; and
(iv) They will use positive methods of child guidance and will not
engage in corporal punishment, emotional or physical abuse, or
humiliation. In addition, they will not employ methods of discipline
that involve isolation, the use of food as punishment or reward, or the
denial of basic needs.
(2) Grantee and delegate agencies must ensure that all employees
engaged in the award and administration of contracts or other financial
awards sign statements that they will not solicit or accept personal
gratuities, favors, or anything of significant monetary value from
contractors or potential contractors.
(3) Personnel policies and procedures must include provision for
appropriate penalties for violating the standards of conduct.
(i) Staff performance appraisals. Grantee and delegate agencies
must, at a minimum, perform annual performance reviews of each Early
Head Start and Head Start staff member and use the results of these
reviews to identify staff training and professional development needs,
modify staff performance agreements, as necessary, and assist each
staff member in improving his or her skills and professional
competencies.
(j) Staff and volunteer health. (1) Grantee and delegate agencies
must assure that each staff member has an initial health examination
that includes screening for tuberculosis and a periodic re-examination
(as recommended by their health care provider or as mandated by State,
Tribal, or local laws) so as to assure that they do not, because of
communicable diseases, pose a significant risk to the health or safety
of others in the Early Head Start or Head Start program that cannot be
eliminated or reduced by reasonable accommodation. This requirement
must be implemented consistent with the requirements of the Americans
with Disabilities Act and section 504 of the Rehabilitation Act.
(2) Regular volunteers must be screened for tuberculosis in
accordance with State, Tribal or local laws. In the absence of State,
Tribal or local law, the Health Services Advisory Committee must be
consulted regarding the need for such screenings (see 45 CFR 1304.3(20)
for a definition of volunteer).
(3) Grantee and delegate agencies must make mental health and
wellness information available to staff with concerns that may affect
their job performance.
(k) Training and development. (1) Grantee and delegate agencies
must provide an orientation to all new staff, consultants, and
volunteers that includes, at a minimum, the goals and underlying
philosophy of Early Head Start and/or Head Start and the ways in
[[Page 57224]]
which they are implemented by the program.
(2) Grantee and delegate agencies must establish and implement a
structured approach to staff training and development, attaching
academic credit whenever possible. This system should be designed to
help build relationships among staff and to assist staff in acquiring
or increasing the knowledge and skills needed to fulfill their job
responsibilities, in accordance with the requirements of 45 CFR
1306.23.
(3) At a minimum, this system must include ongoing opportunities
for staff to acquire the knowledge and skills necessary to implement
the content of the Head Start Program Performance Standards. This
program must also include:
(i) Methods for identifying and reporting child abuse and neglect
that comply with applicable State and local laws using, so far as
possible, a helpful rather than a punitive attitude toward abusing or
neglecting parents and other caretakers; and
(ii) Methods for planning for successful child and family
transitions to and from the Early Head Start or Head Start program.
(4) Grantee and delegate agencies must provide training or
orientation to Early Head Start and Head Start governing body members.
Agencies must also provide orientation and ongoing training to Early
Head Start and Head Start Policy Council and Policy Committee members
to enable them to carry out their program governance responsibilities
effectively.
Sec. 1304.53 Facilities, materials, and equipment.
(a) Head Start physical environment and facilities. (1) Grantee and
delegate agencies must provide a physical environment and facilities
conducive to learning and reflective of the different stages of
development of each child.
(2) Grantee and delegate agencies must provide appropriate space
for the conduct of all program activities (see 45 CFR 1308.4 for
specific access requirements for children with disabilities).
(3) The center space provided by grantee and delegate agencies must
be organized into functional areas that can be recognized by the
children and that allow for individual activities and social
interactions.
(4) The indoor and outdoor space in Early Head Start or Head Start
centers in use by mobile infants and toddlers must be separated from
general walkways and from areas in use by preschoolers.
(5) Centers must have at least 35 square feet of usable indoor
space per child available for the care and use of children (i.e.,
exclusive of bathrooms, halls, kitchen, staff rooms, and storage
places) and at least 75 square feet of usable outdoor play space per
child.
(6) Facilities owned or operated by Early Head Start and Head Start
grantee or delegate agencies must meet the licensing requirements of 45
CFR 1306.30.
(7) Grantee and delegate agencies must provide for the maintenance,
repair, safety, and security of all Early Head Start and Head Start
facilities, materials and equipment.
(8) Grantee and delegate agencies must provide a center-based
environment free of toxins, such as cigarette smoke, lead, pesticides,
herbicides, and other air pollutants as well as soil and water
contaminants. Agencies must ensure that no child is present during the
spraying of pesticides or herbicides. Children must not return to the
affected area until it is safe to do so.
(9) Outdoor play areas at center-based programs must be arranged so
as to prevent any child from leaving the premises and getting into
unsafe and unsupervised areas. Enroute to play areas, children must not
be exposed to vehicular traffic without supervision.
(10) Grantee and delegate agencies must conduct a safety
inspection, at least annually, to ensure that each facility's space,
light, ventilation, heat, and other physical arrangements are
consistent with the health, safety and developmental needs of children.
At a minimum, agencies must ensure that:
(i) In climates where such systems are necessary, there is a safe
and effective heating and cooling system that is insulated to protect
children and staff from potential burns;
(ii) No highly flammable furnishings, decorations, or materials
that emit highly toxic fumes when burned are used;
(iii) Flammable and other dangerous materials and potential poisons
are stored in locked cabinets or storage facilities separate from
stored medications and food and are accessible only to authorized
persons. All medications, including those required for staff and
volunteers, are labeled, stored under lock and key, refrigerated if
necessary, and kept out of the reach of children;
(iv) Rooms are well lit and provide emergency lighting in the case
of power failure;
(v) Approved, working fire extinguishers are readily available;
(vi) An appropriate number of smoke detectors are installed and
tested regularly;
(vii) Exits are clearly visible and evacuation routes are clearly
marked and posted so that the path to safety outside is unmistakable
(see 45 CFR 1304.22 for additional emergency procedures);
(viii) Indoor and outdoor premises are cleaned daily and kept free
of undesirable and hazardous materials and conditions;
(ix) Paint coatings on both interior and exterior premises used for
the care of children do not contain hazardous quantities of lead;
(x) The selection, layout, and maintenance of playground equipment
and surfaces minimize the possibility of injury to children;
(xi) Electrical outlets accessible to children prevent shock
through the use of child-resistant covers, the installation of child-
protection outlets, or the use of safety plugs;
(xii) Windows and glass doors are constructed, adapted, or adjusted
to prevent injury to children;
(xiii) Only sources of water approved by the local or State health
authority are used;
(xiv) Toilets and handwashing facilities are adequate, clean, in
good repair, and easily reached by children. Toileting and diapering
areas must be separated from areas used for cooking, eating, or
children's activities;
(xv) Toilet training equipment is provided for children being
toilet trained;
(xvi) All sewage and liquid waste is disposed of through a locally
approved sewer system, and garbage and trash are stored in a safe and
sanitary manner; and
(xvii) Adequate provisions are made for children with disabilities
to ensure their safety, comfort, and participation.
(b) Head Start equipment, toys, materials, and furniture.
(1) Grantee and delegate agencies must provide and arrange
sufficient equipment, toys, materials, and furniture to meet the needs
and facilitate the participation of children and adults. Equipment,
toys, materials, and furniture owned or operated by the grantee or
delegate agency must be:
(i) Supportive of the specific educational objectives of the local
program;
(ii) Supportive of the cultural and ethnic backgrounds of the
children;
(iii) Age-appropriate, safe, and supportive of the abilities and
developmental level of each child served, with adaptations, if
necessary, for children with disabilities;
[[Page 57225]]
(iv) Accessible, attractive, and inviting to children;
(v) Designed to provide a variety of learning experiences and to
encourage each child to experiment and explore;
(vi) Safe, durable, and kept in good condition; and
(vii) Stored in a safe and orderly fashion when not in use.
(2) Infant and toddler toys must be made of non-toxic materials and
must be sanitized regularly.
(3) To reduce the risk of Sudden Infant Death Syndrome (SIDS), all
sleeping arrangements for infants must use firm mattresses and avoid
soft bedding materials such as comforters, pillows, fluffy blankets or
stuffed toys.
Subpart E--Implementation and Enforcement
Sec. 1304.60 Deficiencies and quality improvement plans.
(a) Early Head Start and Head Start grantee and delegate agencies
must comply with the requirements of this part in accordance with the
effective date set forth in 45 CFR 1304.2.
(b) If the responsible HHS official, as a result of information
obtained from a review of an Early Head Start or a Head Start grantee,
determines that the grantee has one or more deficiencies, as defined in
Sec. 1304.3(a)(6) of this part, and therefore also is in violation of
the minimum requirements as defined in Sec. 1304.3(a)(14) of this part,
he or she will notify the grantee promptly, in writing, of the finding,
identifying the deficiencies to be corrected and, with respect to each
identified deficiency, will inform the grantee that it must correct the
deficiency either immediately or pursuant to a Quality Improvement
Plan.
(c) An Early Head Start or Head Start grantee with one or more
deficiencies to be corrected under a Quality Improvement Plan must
submit to the responsible HHS official a Quality Improvement Plan
specifying, for each identified deficiency, the actions that the
grantee will take to correct the deficiency and the timeframe within
which it will be corrected. In no case can the timeframes proposed in
the Quality Improvement Plan exceed one year from the date that the
grantee received official notification of the deficiencies to be
corrected.
(d) Within 30 days of the receipt of the Quality Improvement Plan,
the responsible HHS official will notify the Early Head Start or Head
Start grantee, in writing, of the Plan's approval or specify the
reasons why the Plan is disapproved.
(e) If the Quality Improvement Plan is disapproved, the Early Head
Start or Head Start grantee must submit a revised Quality Improvement
Plan, making the changes necessary to address the reasons that the
initial Plan was disapproved.
(f) If an Early Head Start or Head Start grantee fails to correct a
deficiency, either immediately, or within the timeframe specified in
the approved Quality Improvement Plan, the responsible HHS official
will issue a letter of termination or denial of refunding. Head Start
grantees may appeal terminations and denials of refunding under 45 CFR
part 1303, while Early Head Start grantees may appeal terminations and
denials of refunding only under 45 CFR part 74 or part 92. A deficiency
that is not timely corrected shall be a material failure of a grantee
to comply with the terms and conditions of an award within the meaning
of 45 CFR 74.61(a)(1), 45 CFR 74.62 and 45 CFR 92.43(a).
Sec. 1304.61 Noncompliance.
(a) If the responsible HHS official, as a result of information
obtained from a review of an Early Head Start or Head Start grantee,
determines that the grantee is not in compliance with Federal or State
requirements (including, but not limited to, the Head Start Act or one
or more of the regulations under parts 1301, 1304, 1305, 1306 or 1308
of this title) in ways that do not constitute a deficiency, he or she
will notify the grantee promptly, in writing, of the finding,
identifying the area or areas of noncompliance to be corrected and
specifying the period in which they must corrected.
(b) Early Head Start or Head Start grantees which have received
written notification of an area of noncompliance to be corrected must
correct the area of noncompliance within the time period specified by
the responsible HHS official. A grantee which is unable or unwilling to
correct the specified areas of noncompliance within the prescribed time
period will be judged to have a deficiency which must be corrected,
either immediately or pursuant to a Quality Improvement Plan (see 45
CFR 1304.3(a)(6)(iii) and 45 CFR 1304.60).
PART 1301--HEAD START GRANTS ADMINISTRATION
2. The authority citation for part 1301 is revised to read as
follows:
Authority: 42 U.S.C. 9801 et. seq.
3. Section 1301.31 is revised to read as follows:
Sec. 1301.31 Personnel policies.
(a) Written policies. Grantee and delegate agencies must establish
and implement written personnel policies for staff, that are approved
by the Policy Council or Policy Committee and that are made available
to all grantee and delegate agency staff. At a minimum, such policies
must include:
(1) Descriptions of each staff position, addressing, as
appropriate, roles and responsibilities, relevant qualifications,
salary range, and employee benefits (see 45 CFR 1304.52(c) and (d));
(2) A description of the procedures for recruitment, selection and
termination (see paragraph (b) of this Section, Staff recruitment and
selection procedures);
(3) Standards of conduct (see 45 CFR 1304.52(h));
(4) Descriptions of methods for providing staff and volunteers with
opportunities for training, development, and advancement (see 45 CFR
1304.52(k), Training and development);
(5) A description of the procedures for conducting staff
performance appraisals (see 45 CFR 1304.52(i), Staff performance
appraisals);
(6) Assurances that the program is an equal opportunity employer
and does not discriminate on the basis of gender, race, ethnicity,
religion or disability; and
(7) A description of employee-management relation procedures,
including those for managing employee grievances and adverse actions.
(b) Staff recruitment and selection procedures. (1) Before an
employee is hired, grantee or delegate agencies must conduct:
(i) An interview with the applicant;
(ii) A verification of personal and employment references; and
(iii) A State or national criminal record check, as required by
State law or administrative requirement. If it is not feasible to
obtain a criminal record check prior to hiring, an employee must not be
considered permanent until such a check has been completed.
(2) Grantee and delegate agencies must require that all current and
prospective employees sign a declaration prior to employment that
lists:
(i) All pending and prior criminal arrests and charges related to
child sexual abuse and their disposition;
(ii) Convictions related to other forms of child abuse and neglect;
and
(iii) All convictions of violent felonies.
(3) Grantee and delegate agencies must review each application for
employment individually in order to assess the relevancy of an arrest,
a pending criminal charge, or a conviction.
(c) Declaration exclusions. The declaration required by paragraph
(b)(2) of this section may exclude:
[[Page 57226]]
(1) Traffic fines of $200.00 or less;
(2) Any offense, other than any offense related to child abuse and/
or child sexual abuse or violent felonies, committed before the
prospective employee's 18th birthday which was finally adjudicated in a
juvenile court or under a youth offender law;
(3) Any conviction the record of which has been expunged under
Federal or State law; and
(4) Any conviction set aside under the Federal Youth Corrections
Act or similar State authority.
(d) Probationary period. The policies governing the recruitment and
selection of staff must provide for a probationary period for all new
employees that allows time to monitor employee performance and to
examine and act on the results of the criminal record checks discussed
in paragraph (b) (1) of this Section.
(e) Reporting child abuse or sexual abuse. Grantee and delegate
agencies must develop a plan for responding to suspected or known child
abuse or sexual abuse as defined in 45 CFR 1340.2(d) whether it occurs
inside or outside of the program.
(Approved by the Office of Management and Budget under control
number 0980-0173.)
PART 1303--APPEAL PROCEDURES FOR HEAD START GRANTEES AND CURRENT OR
PROSPECTIVE DELEGATE AGENCIES
3. The authority citation for part 1303 continues to read as
follows:
Authority: 42 U.S.C. 9801 et seq.
4. Section 1303.14 is amended by revising paragraph (b)(4) and
republishing the introductory text to paragraph (b) to read as follows:
Sec. 1303.14 Appeal by a grantee from a termination of financial
assistance.
* * * * *
(b) Financial assistance may be terminated for any or all of the
following reasons:
* * * * *
(4) The grantee has failed to timely correct one or more
deficiencies as defined in 45 CFR Part 1304;
* * * * *
PART 1305--ELIGIBILITY, RECRUITMENT, SELECTION, ENROLLMENT AND
ATTENDANCE IN HEAD START
5. The authority citation for part 1305 continues to read as
follows:
Authority: 42 U.S.C. 9801 et seq.
6. Section 1305.1 is amended by adding a sentence at the end to
read as follows:
Sec. 1305.1 Purpose and scope.
* * * These requirements are to be used in conjunction with the
Head Start Program Performance Standards at 45 CFR part 1304, as
applicable.
7. Section 1305.3 is amended by revising the heading and revising
paragraphs (b), introductory text, (c), introductory text, (d), and
(f)(1) to read as follows:
Sec. 1305.3 Determining community strengths and needs.
* * * * *
(b) Each Early Head Start and Head Start grantee and delegate
agency must conduct a Community Assessment within its service area once
every three years. The Community Assessment must include the collection
and analysis of the following information about the grantee's or
delegate's Early Head Start or Head Start area:
* * * * *
(c) The Early Head Start and Head Start grantee and delegate agency
must use information from the Community Assessment to:
* * * * *
(d) In each of the two years following completion of the Community
Assessment the grantee or delegate agency must conduct a review to
determine whether there have been significant changes in the
information described in paragraph (b) of this section. If so, the
Community Assessment must be updated and the decisions described in
paragraph (c) of this section must be reconsidered.
* * * * *
(f) * * *
(1) Select an area or areas that are among those having the
greatest need for Early Head Start or Head Start services as determined
by the Community Assessment; and
* * * * *
(The information collection requirements contained in this section
are approved by the Office of Management and Budget (OMB) under OMB
Control number 0970-0124)
PART 1306--HEAD START STAFFING REQUIREMENTS AND PROGRAM OPTIONS
8. The authority citation for part 1306 is revised to read as
follows:
Authority: 42 U.S.C. 9801 et seq.
9. Section 1306.1 is revised to read as follows:
Sec. 1306.1 Purpose and scope.
This Part sets forth requirements for Early Head Start and Head
Start program staffing and program options that all Early Head Start
and Head Start grantee and delegate agencies, with the exception of
Parent Child Center programs, must meet. The exception for Parent Child
Centers is for fiscal years 1995, 1996, and 1997 as consistent with
section 645A(e)(2) of the Head Start Act, as amended. These
requirements, including those pertaining to staffing patterns, the
choice of the program options to be implemented and the acceptable
ranges in the implementation of those options, have been developed to
help maintain and improve the quality of Early Head Start and Head
Start and to help promote lasting benefits to the children and families
being served. These requirements are to be used in conjunction with the
Head Start Program Performance Standards at 45 CFR Part 1304, as
applicable.
10. Section 1306.20 is amended by redesignating paragraphs (a)
through (e) as (b) through (f) and adding a new paragraph (a) to read
as follows:
Sec. 1306.20 Program staffing patterns.
(a) Grantees must meet the requirements of 45 CFR 1304.52(g),
Classroom staffing and home visitors, in addition to the requirements
of this Section.
* * * * *
11. Section 1306.21 is revised to read as follows:
Sec. 1306.21 Staff qualification requirements.
Head Start programs must comply with section 648A of the Head Start
Act and any subsequent amendments regarding the qualifications of
classroom teachers.
12. Section 1306.30 is amended by revising paragraph (c) to read as
follows:
Sec. 1306.30 Provisions of comprehensive child development services.
* * * * *
(c) The facilities used by Early Head Start and Head Start grantee
and delegate agencies for regularly scheduled center-based and
combination program option classroom activities or home-based group
socialization activities must comply with State and local requirements
concerning licensing. In cases where these licensing standards are less
comprehensive or less stringent than the Head Start regulations, or
where no State or local licensing standards are applicable, grantee and
delegate agencies are, at a minimum, required to assure that their
facilities are in compliance with the Head Start Program Performance
Standards related to the safety of facilities found in 45 CFR
1304.53(a), Physical environment and facilities.
* * * * *
[[Page 57227]]
13. Section 1306.33 is amended by revising paragraph (c)(3) to read
as follows:
Sec. 1306.33 Home-based program option.
* * * * *
(c) * * *
(3) Grantees must follow the nutrition requirements specified in 45
CFR 1304.23(b)(2) and provide appropriate snacks and meals to the
children during group socialization activities.
PART 1308--HEAD START PROGRAM PERFORMANCE STANDARDS ON SERVICES FOR
CHILDREN WITH DISABILITIES
14. The authority citation for Part 1308 continues to read as
follows:
Authority: 42 U.S.C. 9801 et seq.
15. Section 1308.6 is amended by revising paragraph (b)(1) to read
as follows:
Sec. 1308.6 Assessment of children.
* * * * *
(b) * * *
(1) Grantees must provide for developmental, hearing and vision
screenings of all Early Head Start and Head Start children within 45
days of the child's entry into the program. This does not preclude
starting screening in the spring, before program services begin in the
fall.
* * * * *
[FR Doc. 96-28134 Filed 11-4-96; 8:45 am]
BILLING CODE 4184-01-P