Head Start Program

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

[[Page 57189]]

Quality and Expansion and on Services for Families with Infants and

Toddlers. These purposes include updating the standards to respond to

the emerging needs and circumstances of families and communities as

well as to new research knowledge; ensuring program quality (and, as

required by statute, ensuring that the level and quality of services do

not fall below the current standards); and providing an entirely new

set of standards to govern programs serving low-income pregnant women

and families with infants and toddlers.

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

[[Page 57197]]

period in the standard, as some commenters suggested. We believe that

grantee and delegate agencies need to exercise sound judgement in this

area, and that establishing a schedule goes beyond the scope of Federal

regulation. We intend to provide additional information on best

practices in these areas in the Guidance. We also have deleted the

reference to ``staff member'' in 45 CFR 1304.22(a)(2) (45 CFR

1304.22(b)(2) in the NPRM) because this section of the regulation

addresses child health and safety issues. We will provide information

on procedures for dealing with staff emergencies in the Guidance.

Finally, due to the changes made to 45 CFR 1304.20 on child health

and developmental services, sections of the NPRM on medical and dental

follow-up and treatment (45 CFR 1304.22(a) (1)-(5)) have been moved to

45 CFR 1304.20 in the final rule, since they are a key part of the

processes described in that section.

Section 1304.23 Child Nutrition

Commenters were generally supportive of the nutrition standards,

citing, in particular, the flexibility they give grantees in the

implementation of the nutrition program. Criticisms centered around

four issues. First, many commenters noticed the absence of a standard

requiring that Early Head Start and Head Start grantee and delegate

agencies participate in one of the child nutrition programs offered by

the U.S. Department of Agriculture. They pointed out that such a

requirement had been issued previously (see ACYF Transmittal Notice

80.2, dated April 17, 1980, and ACYF-IM-HS-95-29) and, in the interest

of completeness, should be repeated here. We agree, and in order to

consolidate the existing requirements have added a new standard, 45 CFR

1304.23(b)(1)(i) in the final rule, which states that ``All Early Head

Start and Head Start grantee and delegate agencies must use funds from

USDA Food and Consumer Services Child Nutrition Programs as the primary

source of payment for meal services. Early Head Start and Head Start

funds may be used to cover those allowable costs not covered by the

USDA.''

Second, numerous commenters criticized the omission of the standard

requiring the use of child-sized utensils and furniture. They strongly

supported the use of such furniture and equipment, and stated that a

standard was needed to facilitate such use. Although we also strongly

support the use of age appropriate equipment and materials, such as

child-sized utensils and furniture, we have not added such a standard

to this section, as we do not believe that Federal regulations should

prescribe practice at this level of detail. A related standard, 45 CFR

1304.53(b)(1)(iii), continues to require that equipment, toys,

materials, and furniture owned or operated by the grantee or delegate

agency must be ``age appropriate, safe and supportive of the abilities

and developmental level of each child served * * *,'' while leaving

grantee and delegate agencies with the flexibility of determining how

to implement this requirement in accordance with sound early childhood

practice.

Third, many commenters criticized the inclusion of the words

``family style'' in the description of meal service in center-based

settings (see 45 CFR 1304.23(c)(4)), arguing that: (1) The phrase could

be interpreted in many ways, depending on family and cultural

traditions; (2) some local and State laws prohibit ``family meal

service'' for sanitation reasons; (3) in some instances teachers' job

descriptions may be inconsistent with this requirement; and (4) it

would be difficult to comply with this standard if the grantee or

delegate agency is part of a local school system or purchases food

service from an outside vendor because food may come to children in

prepackaged portions. Many commenters recommended returning to language

similar to that in the current standard. Although many of these

concerns are valid, we have retained ``family style'' in the final

rule, defining it simply as adults and children eating together,

sharing the same menu, and talking together in an informal way. To

address the stated concerns, the Guidance will discuss a variety of

ways in which agencies might implement this standard. For example, it

will suggest that, if teachers are required to have time off between

morning and afternoon sessions, aides, volunteers, and other adult

staff may eat with the children. In addition, if children's meals are

already packaged in individual servings, staff and children may still

enjoy eating together and talking.

Finally, several commenters were concerned about the proposed

qualifications for nutrition staff, and stated that they had

difficulties finding appropriately qualified staff in their

communities. Because the qualifications of staff are discussed in a

different section of the standards (45 CFR 1304.52(d)), we have

consolidated the comments on nutrition staff qualifications in that

location of the Preamble.

In addition to the four issues cited above, many commenters

requested clarification of the language used in the proposed standards.

For example, several commenters cited difficulties in interpreting the

term ``nutritional assessment'' in 45 CFR 1304.23(a) in the NPRM,

indicating that this term, as used in medical communities, would

require the services of a licensed assessor, increasing costs

considerably. Since we did not intend that this evaluation of children

be as extensive as a formal medical assessment, we have changed the

title of 45 CFR 1304.23(a) from ``Nutritional assessment'' to

``Identification of nutritional needs.'' In addition, we have clarified

45 CFR 1304.23(a)(1) by changing the phrase ``The nutrition-related

assessment data'' to ``Any relevant nutrition-related assessment data''

to suggest that the data that are collected as a part of the medical

and dental evaluations of children should be examined from the point of

view of child nutrition and used to support and direct the nutrition

program.

We received several comments on the information collection

requirements to complete nutritional assessments and to record

information on family eating patterns and community nutritional issues

which are required in 45 CFR 1304.23(a). Some concern was expressed

about the level of paperwork that would be required to document

nutritional assessments with families. In response, we have clarified

45 CFR 1304.23(a)(1) so that, in identifying a child's nutritional

needs, staff must take into account ``any relevant nutrition related

assessment'' data. This will increase the flexibility in using pre-

existing records rather than conducting special nutritional

assessments.

Several commenters discussed the fact that their Health Services

Advisory Committee was instrumental in identifying major community

nutritional issues, and recommended that this group be identified by

name in 45 CFR 1304.23(a)(4). We have adopted this suggestion, and have

added the Health Services Advisory Committee to the list of sources to

be used. A few commenters suggested changes in the phrasing of 45 CFR

1304.23(b), Nutritional services, and its subparts. Some stated that 45

CFR 1304.23(b)(1) was too prescriptive, as it implied that an agency

must devise a special feeding schedule for each child. This was not the

intent. In order to clarify the meaning of this standard, we have

omitted the term ``feeding schedules'' and have changed the language to

``* * *a nutrition program that meets the nutritional needs and feeding

requirements of each child, including those with special dietary needs

and

[[Page 57198]]

children with disabilities.'' We also have modified the language in 45

CFR 1304.23(b)(1)(ii) (45 CFR 1304.23(b)(1)(i) in the NPRM) by changing

the list of required types of meals that must be served from

``snack(s), lunch, and other meals, as appropriate'' to simply ``meals

and snacks.'' In response to comments requesting clarification of the

term ``sparingly'' as used in 45 CFR 1304.23(b)(1)(v) in the NPRM (45

CFR 1304.23(b)(vi) in the final rule), we have rewritten the language

to require that agencies serve foods ``high in nutrients and low in

fat, sugar, and salt.''

Several commenters requested the addition of more definitive food

group references to 45 CFR 1304.23(c)(1). We have not changed the

standard because we do not believe that Federal regulations should

prescribe practice at this level of detail. However, the Guidance will

discuss ways in which a variety of foods from all food groups can be

served to children.

Finally, many commenters suggested new language for 45 CFR

1304.23(e), Food safety and sanitation. In 45 CFR 1304.23(e)(1), a few

commenters requested clarification of the term ``properly licensed'' in

reference to food service agencies. We have omitted the word

``properly'' in the final standard, using instead the phrase ``licensed

in accordance with State, Tribal or local laws.'' Several commenters

suggested that we add ``formula'' to the requirement for the proper

storage and handling of breast milk in 45 CFR 1304.23(e)(2), as both of

these substances may be brought from home to the center and need to be

stored and handled appropriately. Although we believe that formula is

covered under 45 CFR 1304.23(e)(1), which requires the safe and

sanitary storage and preparation of food, we also have included it in

45 CFR 1304.23(e)(2) in order to re-emphasize the critical nature of

food storage and handling for infants.

In addition to the issues raised with regard to nutrition and the

requests for clarification of the language used in the standards,

commenters also described the need for guidance in the implementation

of several of the standards. Specifically, they requested more

information on activities to promote effective dental hygiene (45 CFR

1304.23(b)(3)); a listing of the appropriate community agencies to

involve in implementing nutritional services (45 CFR 1304.23(b)(4));

guidelines regarding the amount of time children should be given to eat

meals and snacks (45 CFR 1304.23(c)(3)); a list of ``other'' dietary

requirements that children might have (45 CFR 1304.23(c)(6));

suggestions for how families can be assisted with food preparation and

nutrition skills (45 CFR 1304.23(d)); and a detailed description of the

optimal procedure for storing and handling breast milk (45 CFR

1304.23(e)(2)). These topics will be addressed in the Guidance

materials to be published at a later date.

Section 1304.24 Child Mental Health

Commenters generally supported the increased emphasis on mental

health services for children in the proposed standards, which they

found to be consistent with the needs identified by grantees and with

the recommendations of the Advisory Committee on Head Start Quality and

Expansion. In particular, several commenters commended the increased

emphasis on parent involvement in mental health. Commenters also

supported the proposed standards' listing of the mental health services

to be provided. On the other hand, commenters expressed significant

concern that the level of effort expected from the mental health

professional in carrying out these services would be difficult to

obtain because of the limited availability of such professionals,

particularly in rural areas, and because of the costs of obtaining such

services from these professionals.

Our intent in this section is to ensure that parents and staff

understand the contribution that mental health services can make to the

well-being of each child as well as the role that various individuals,

including parents, staff, and mental health professionals, play in this

effort. Therefore, we believe that it is important for mental health

professionals to be included in program services. We do not mean,

however, that mental health professionals must be hired as staff or be

physically present on a daily basis. Rather, they must be available to

provide services for which State licensing and certification are

required, and to advise and make recommendations to grantee and

delegate agencies as necessary. We have modified several standards to

provide clarification in this area (see the previous discussion in this

Preamble on 45 CFR 1304.20(b)(2) and 45 CFR 1304.20(d)).

Cost concerns were raised by commenters relative to the requirement

in 45 CFR 1304.20(e) of the NPRM that ongoing assessments be conducted,

which they interpreted to mean that the mental health professional must

individually observe each child in Early Head Start or Head Start. This

was not the intent. We have revised the standard in the final rule (45

CFR 1304.20(d)) to emphasize the need for grantee and delegate agencies

to implement procedures to identify new or recurring developmental

concerns so that they can quickly make appropriate referrals. However,

we leave agencies with the discretion to determine the level of

involvement of mental health professionals. We do require, however, in

45 CFR 1304.20(b)(2) of the final rule on developmental, sensory, and

behavioral screenings, that ``Grantee and delegate agencies must obtain

direct guidance from a mental health or child development professional

on how to use the findings to address identified needs.''

Several commenters sought clarification on the level of effort and

the costs implied by other requirements in the child mental health

section. For example, some asked for a definition of ``a schedule of

sufficient frequency'' in 45 CFR 1304.24(a)(2). We will provide

information in the Guidance on determining a schedule of frequency most

appropriate for meeting local needs. Likewise, some commenters asked if

persons other than a licensed or certified mental health professional

could perform some of the functions described in order to avoid costs

to the agency and to ensure that an individual is available to perform

the required services. Since we consider it critical that a licensed or

certified individual be available to each program, we continue to

require the services of mental health professionals. We encourage

agencies to augment the services of mental health professionals with

non-certified and non-licensed individuals as long as the functions

these individuals serve are consistent with State licensing and

certification requirements. In the Guidance, we will describe

arrangements that demonstrate ways to make use of non-certified and

non-licensed individuals in order to augment the services of mental

health professionals. For example, some parent education and teacher

consultation may be performed by non-certified or non-licensed

individuals.

In response to the standard requiring agencies to utilize community

mental health resources, 45 CFR 1304.24(a)(3)(iv), many commenters

indicated that such services either do not exist in their communities

or do not address Early Head Start and Head Start's needs. Commenters

strongly recommended that Early Head Start and Head Start agencies work

with other community agencies serving children and families (e.g.,

child care or early childhood special education agencies) to develop

and sustain family-centered services in their community. Although we

agree with these comments, we have

[[Page 57199]]

not changed this requirement. Information on partnerships with mental

health and other family support agencies in order to address mental

health service needs will be provided in the Guidance.

Subpart C--Family and Community Partnerships

Section 1304.40 Family Partnerships

Overall, the comments regarding the new Family Partnerships section

expressed strong approval for the philosophy of supporting families to

foster their child's development and assisting families to attain their

personal goals. The comments made clear that the development of family

partnerships is not a new activity for many Head Start grantee and

delegate agencies, and that there are a variety of models and

experiences which can be drawn upon in formulating successful

partnerships. We have made every effort to allow for local program

flexibility in the implementation of these standards.

Many of the commenters identified areas requiring clarification or

further guidance on exactly ``how to'' implement particular standards.

The need for enhanced training and resources was echoed throughout the

comments. In response, minor revisions were made to several of the

standards to improve their clarity. For most of the standards, however,

additional information will be provided in the Guidance.

Several commenters expressed concern about the term ``assessment''

in the title of 45 CFR 1304.40(a) in the NPRM. As indicated by their

comments, the term has many connotations and was understood by some to

identify a particular process for determining family strengths and

needs. This was not the intent. Rather, the new standard was designed

to give grantee and delegate agencies the flexibility needed to develop

their own strategies for working with a diverse group of families.

However, in response to these concerns, the language in 45 CFR

1304.40(a) has been changed from ``Assessment and goal setting'' to

``Family goal setting.'' To further strengthen the concept that grantee

and delegate agencies must develop strategies that suit the interests,

needs, and circumstances of the families that they serve, the language

in 45 CFR 1304.40(a)(1) has been expanded to state that the process

``must take into consideration each family's readiness and willingness

to participate in the process.'' The new term to describe the document

jointly created through this process is the Family Partnership

Agreement, which replaces the current standard related to conducting a

family needs assessment.

Other commenters suggested that the language in several of the

standards in 45 CFR 1304.40(a) conveys the sense that Early Head Start

or Head Start staff are setting goals ``for'' families rather than

``with'' families. In order to strengthen the notion of partnerships,

the language in several standards has been slightly modified. In 45 CFR

1304.40(a)(2), for example, the language has been changed from ``assist

parents'' to ``offer parents opportunities.'' Other similar changes

were made throughout this section. We have also added language in 45

CFR 1304.40(a)(2) that further clarifies the role of parents and staff

in home-based programs in the development of Family Partnership

Agreements.

Commenters supported the increased coordination with families and

other community agencies to avoid duplication between the Family

Partnership Agreement and other preexisting family plans as required in

45 CFR 1304.40(a)(3). However, many raised issues related to

confidentiality, timeliness, and the willingness of community agencies

to share such information. Although we recognize that these constraints

may exist and that partnerships cannot be mandated, we do expect

agencies to find ways to develop partnerships, even with less willing

partners, and to establish alliances that will provide the desired

results over a period of time.

Commenters questioned the new requirement in 45 CFR

1304.40(b)(1)(i) that agencies directly provide emergency or crisis

assistance to families as well as the possible costs and liabilities

associated with the provision of such assistance. For purposes of

clarity, we deleted the words ``including such direct interventions as

the provision of,'' and added ``in areas such as.'' We emphasize that

this standard, as revised, reflects our long-standing view that grantee

and delegate agencies should continue to develop partnerships and to

link families to existing community resources in order to address

emergency or crisis assistance needs. We believe that this intent is

further clarified if the standard is read in conjunction with the

preceding language of 45 CFR 1304.40(b)(1).

Several commenters questioned which pregnant women are covered

under 45 CFR 1304.40(c). These standards are limited to pregnant women

enrolled in Early Head Start programs. However, we expect that all

pregnant women, those in Early Head Start as well as those in Head

Start, will be provided with opportunities to learn about the

principles of health and wellness as articulated in 45 CFR

1304.40(f)(2)(iii).

Many commenters responded favorably to the expanded integration of

parent involvement throughout the standards and especially to its

emphasis within the section on Family Partnerships. Other comments

regarding parent involvement raised several concerns. One concern

focused on the issue surrounding parent involvement activities for

parents who are working or who are in training and are not able to

spend time in their child's classroom. Many grantee and delegate

agencies have faced this situation for some time, and have developed an

array of methods to involve parents in less traditional ways. Given the

shift towards increased workforce participation for the parents of

young children, agencies are expected to offer parent participation

opportunities to all interested family members, both men and women, in

a sufficiently varied manner that enables them to participate. We

recognize the added challenges of encouraging parents to participate.

However, we believe that 45 CFR 1304.40 (d)-(f) encourage grantee and

delegate agencies to broaden their vision about how to develop and

implement meaningful parent involvement opportunities. Additional

discussion will be included in the Guidance.

In response to several comments that encouraged us to support a

wide range of parent involvement opportunities, we have changed the

language in 45 CFR 1304.40(d)(1) from ``must provide parent involvement

and education activities that are responsive to the ongoing and

expressed needs of the parents themselves'' to ``must provide parent

involvement and education activities that are responsive to the ongoing

and expressed needs of the parents, both as individuals and as members

of a group.''

The parent involvement standards include the requirement in 45 CFR

1304.40(e)(3) that grantee and delegate agencies provide, either

directly or through referrals, opportunities for children and families

to participate in family literacy services in accordance with Section

641(4)(c)(i) of the Head Start Act, as amended. Although a few

commenters indicated that providing such services would result in a

financial burden, the majority made no mention of additional costs or

concerns surrounding this requirement. We interpreted this to mean that

the funding received by grantee and delegate agencies for family

literacy,

[[Page 57200]]

which is now part of their basic grants, covers costs related to this

service; and that resources for family literacy activities are

available in most communities, and that grantee and delegate agencies

expect to be able to work with community providers to support family

literacy efforts.

Commenters raised questions about the requirements of 45 CFR

1304.40(e)(4) and 45 CFR 1304.40(i)(2) regarding the relationship

between staff-parent conferences and teacher home visits. These

standards require a minimum of four parent contacts (two home visits

and two staff-parent conferences) throughout the program year. To

clarify this intent, and to emphasize the importance of contacts

between education staff and parents, a new standard was added in 45 CFR

1304.21(a)(2)(iii) which encourages parents to participate in staff-

parent conferences and home visits to discuss their child's development

and education. In addition, language was added to 45 CFR 1304.40(i)(2)

to emphasize the importance of other staff making or joining home

visits, as appropriate. Other clarifying information on this topic will

be provided in the Guidance.

Numerous commenters on 45 CFR 1304.40(g)(1)(ii) proposed that the

provision of a comprehensive community resource list to parents be

mandatory, rather than being provided ``when available.'' We have

revised the standard to require that agencies ``establish procedures to

provide families with comprehensive information about community

resources'' in order to better reflect the intent that providing

families with such information is a cornerstone of parent involvement

activities.

The requirement at 45 CFR 1304.40(h)(2) to conduct staff-parent

meetings to support transition services in accordance with section

642(d)(4) of the Head Start Act, as amended, raised concerns among some

commenters, particularly related to the timing of these meetings at the

end of children's participation in the program. We expect that,

throughout the program year, parents will be provided with

opportunities to expand their knowledge about community services and

resources and to develop networks and relationships with families,

service providers, community agencies, and school systems. Therefore,

the standard has been retained as proposed.

Commenters expressed their support for the acknowledgment that home

visits may present safety hazards for staff in 45 CFR 1304.40(i)(4).

However, we want to emphasize the importance of home visits occurring

in the home setting to the extent possible in order to maximize the

personal interaction of the parent, child, and program staff, and we

will further address the topic of home visits in the Guidance.

Section 1304.41 Community Partnerships

Many of the comments on the new Community Partnerships section

strongly endorsed the focus on community planning, cooperation, and

information sharing in order to improve the delivery of community-based

services to children and families. The standards on parent involvement

in transition services in 45 CFR 1304.41(c) also generated favorable

comments. While a number of commenters stated that cultivating

alliances with other community agencies and service providers takes

time and persistence on the part of Early Head and Head Start grantee

and delegate agencies, a significant number indicated that they have

already embraced this process, and that the families they serve are

reaping the benefits of these partnerships. Many of the comments

included practical information on successful efforts to build such

partnerships. This information will be integrated into the program

Guidance.

While the comments were generally positive, two important concerns

with respect to the development of community partnerships emerged.

First, one group of commenters expressed concern about the likelihood

of success in developing community partners, as required in 45 CFR

1304.41(a), citing the competition for scarce resources and local

obstacles, both of which have prevented cooperation in the past. As the

development of community partnerships is now a requirement, concerns

around monitoring issues were also expressed. Specifically, many

commenters stated that grantee and delegate agencies, by themselves,

cannot make parents and communities receptive to partnerships.

We recognize that fostering and building partnerships is an

activity that occurs over time and will require differing levels of

effort for Early Head Start and Head Start grantee and delegate

agencies. However, we firmly believe that these agencies have both the

responsibility and the capacity to provide leadership in their

communities to promote access to services that will enhance the well-

being of families and children. While the standards do set high

expectations for agencies, they also provide the flexibility needed to

respond to a wide variety of circumstances. We are confident that each

agency can demonstrate progress in this area, recognizing that, for

some, partnerships will develop more slowly than for others. Therefore,

the intent of 45 CFR 1304.41(a) remains unchanged. We will support

agencies in these efforts by providing program Guidance and training

for staff in the area of developing partnerships.

The second overarching theme that was raised is the need for

additional resources, both staff time and training, to support the

development of community partnerships. The commenters stressed that

cultivating relationships with a variety of agencies and organizations

requires time to make telephone calls, to attend meetings, and to share

ideas. While this move toward a greater emphasis on community

partnerships may require an initial shifting of responsibilities and

scheduling for staff in some agencies, we expect that, over time, this

effort will become an integral and routine part of agency operations.

The standards provide agencies with a great deal of flexibility in

deciding how to undertake this effort. We are also providing additional

funds for transition coordination. With these additional resources and

targeted training, we expect that every agency will be able to meet

these standards.

The remaining comments about the Community Partnerships section

addressed specific standards. For example, 45 CFR 1304.41(a)(2)

contains a list of community agencies and service providers with which

Early Head Start and Head Start agencies must take steps to establish

ongoing relationships. The commenters, while supportive of the proposed

list, provided many potential additions. We believe that the list of

potential partners provided in the NPRM represents a core set of

resources that will be found in most communities. In developing this

list, we attempted to create a balance between articulating a range of

entities representing a possible complement of community partnerships

and not causing a burden on agencies located in areas that lack

supports. Agencies are encouraged to expand upon this list. We have

made one addition to the standard, namely ``businesses,'' in order to

include another important community partner (45 CFR 1304.41(a)(2)(ix)).

Commenters questioned the rationale for mandating a Health Services

Advisory Committee in 45 CFR 1304.41(b), while making other Service

Area Committees voluntary. We structured the standard in this manner to

minimize regulatory burden and to ensure flexibility for local grantee

and delegate agencies. A Health Services

[[Page 57201]]

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

[[Page 57204]]

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;

[[Page 57205]]

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 130

This text is long and has been trimmed here. Open the source document for the complete record.