80818 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

45 CFR Parts 1301, 1302, 1303, 1304, 

and 1305 

RIN 0970–AD01 

Supporting the Head Start Workforce 

and Consistent Quality Programming 

AGENCY: Office of Head Start (OHS), 

Administration for Children and 

Families (ACF), Department of Health 

and Human Services (HHS). 

ACTION: Notice of proposed rulemaking. 

SUMMARY: We propose to add new 

requirements to the Head Start Program 

Performance Standards (HSPPS) to 

support and stabilize the Head Start 

workforce, including requirements for 

wages and benefits, breaks for staff, and 

enhanced supports for staff health and 

wellness. We also propose to enhance 

several existing requirements and add 

new requirements to promote consistent 

quality of services across Head Start 

programs. This includes proposed 

enhancements to requirements for 

mental health services to better integrate 

these services into every aspect of 

programs as well as elevate the role of 

mental health consultation to support 

the well-being of children, families, and 

staff. Enhancements are also proposed 

in the areas of family service, worker 

family assignments, identifying and 

meeting community needs, ensuring 

child safety, services for pregnant 

women and people, and alignment with 

State early childhood systems. Finally, 

we propose minor clarifications to 

existing standards to promote better 

transparency and clarity of 

understanding for grant recipients. 

DATES: Consideration will be given to 

comments received on or before January 

19, 2024. 

ADDRESSES: You may submit comments, 

identified by [docket number and/or 

RIN number] by any of the following 

methods: 

• Federal eRulemaking Portal: http:// 

www.regulations.gov. Follow the 

instructions for submitting comments. 

• Mail: Office of Head Start, 

Attention: Director of Policy and 

Planning, 330 C Street SW, 4th Floor, 

Washington, DC 20201. 

Instructions: All submissions received 

must include the agency name and 

docket number or Regulatory 

Information Number (RIN) for this 

rulemaking. All comments received will 

be posted without change to http://

www.regulations.gov, including any 

personal information provided. 

FOR FURTHER INFORMATION CONTACT: 

Lindsey Hutchison, Office of Head Start, 

Division of Planning, Oversight, and 

Policy, 202–205–8539, OHS_NPRM@

acf.hhs.gov. Telecommunications Relay 

users may dial 711 first. 

SUPPLEMENTARY INFORMATION: 

Table of Contents 

I. Background 

II. Statutory Authority To Issue NPRM 

III. Section-by-Section Discussion of 

Proposed Changes 

Definition of Head Start and Related Terms 

(§ 1305.2) 

Workforce Supports: Staff Wages 

(§ 1302.90) 

The Need for Wage Requirements 

Progress to Pay Parity for Head Start 

Education Staff With Elementary School 

Education Staff 

Pay Scale for All Staff 

Minimum Pay Requirement 

Wage Comparability Across Head Start 

Preschool and Early Head Start 

Staff for Whom Wage Standards Apply 

Workforce Supports: Staff Benefits 

(§ 1302.90) 

Workforce Supports: Staff Wellness 

(§ 1302.93) 

Workforce Supports: Employee 

Engagement (§§ 1302.92, 1302.101) 

Mental Health Services (Subpart D; 

Subpart H; Subpart I) 

1302 Subpart A—Eligibility, Recruitment, 

Selection, Enrollment, and Attendance 

1302 Subpart D—Health Program Services 

§ 1302.40 Purpose 

§ 1302.41 Collaboration and 

Communication With Parents 

§ 1302.42 Child Health Status and Care 

§ 1302.45 Child Mental Health and Social 

and Emotional Well-Being 

§ 1302.46 Family Support Services for 

Health, Nutrition, and Mental Health 

1302 Subpart H—Services to Enrolled 

Pregnant Women and People 

1302 Subpart I—Human Resources 

Management 

§ 1302.91 Staff Qualification and 

Competency Requirements 

§ 1302.93 Staff Health and Wellness 

Modernizing Head Start’s Engagement 

With Families (§§ 1302.11; 1302.13; 

1302.15; 1302.34; 1302.50) 

Community Assessment (§ 1302.11) 

Adjustment for Excessive Housing Costs 

for Eligibility Determination (§ 1302.12) 

Migrant and Seasonal Head Start Eligibility 

(§ 1302.12) 

Transportation & Other Barriers to 

Enrollment and Attendance (§§ 1302.14; 

1302.16) 

Serving Children With Disabilities 

(§ 1302.14) 

Ratios in Center-Based Early Head Start 

Programs (§ 1302.21) 

Center-Based Service Duration for Early 

Head Start (§ 1302.21) 

Center-Based Service Duration for Head 

Start Preschool (§§ 1302.21; 1302.24) 

Ratios in Family Child Care Settings 

(§ 1302.23) 

Safety Practices (§ 1302.47) 

Preventing and Addressing Lead Exposure 

(§ 1302.48) 

Lead in Water 

Lead in Paint 

Notification 

Conflicting Requirements 

Family Service Worker Family 

Assignments (§ 1302.52) 

Participation in Quality Rating and 

Improvement Systems (§ 1302.53) 

Services to Enrolled Pregnant Women and 

People (§ 1302.80; § 1302.82) 

Standards of Conduct (§ 1302.90) 

Staff Training To Support Child Safety 

(§§ 1302.92; 1302.101) 

Incident Reporting (§ 1302.102) 

Facilities Valuation (§ 1303.44) 

Definition of Income (§ 1305.2) 

Definition of Federal Interest and Major 

Renovations (§ 1305.2) 

Definition of the Poverty Line (§ 1305.2) 

Effective Dates 

Removal of Outdated Sections 

Compliance With Sec. 641A(a)(2) of the 

Act 

Severability 

IV. Regulatory Process Matters 

Regulatory Flexibility Act 

Unfunded Mandates Reform Act of 1995 

Federalism Assessment Executive Order 

13132 

Treasury and General Government 

Appropriations Act of 1999 

Paperwork Reduction Act of 1995 

V. Regulatory Impact Analysis 

Introduction and Summary 

A. Introduction 

B. Summary of Benefits, Costs, and 

Transfers 

Preliminary Economic Analysis of Impacts 

A. Analytic Approach 

B. Baseline: Budget, Staffing, and Slots 

Baseline Budget Scenario 

Baseline Scenario for Staffing, Wages, and 

Enrollment 

Connecting Baseline Uncertainty With 

Differing Estimates of Regulatory Effects 

C. Workforce Supports: Staff Wages and 

Staff Benefits 

Wage-Parity Targets 

Disaggregation of Wage-Parity Policy 

Implementation Costs 

Impact of the Minimum Pay Requirement 

Impact on Expenditures Through Wage 

Compression 

Overall Impacts of Wage Parity on 

Expenditures, Holding Benefits Constant 

Expenditures Associated With Fringe 

Benefits 

Disaggregation of Fringe Benefit Estimates 

Discussion of Uncertainty 

D. Workforce Supports: Staff Wellness— 

Staff Breaks 

E. Family Service Worker Family 

Assignments 

F. Mental Health Services 

G. Preventing and Addressing Lead 

Exposure 

Lead in Water 

Lead-Based Paint 

H. Administrative Costs 

I. Timing of Impacts 

J. Sensitivity Analysis—Potential 

Enrollment Reductions 

K. Alternative Policy Scenario: Required 

Retirement 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80819 

1 Deming, D. (2009). Early Childhood Intervention 

and Life-Cycle Skill Development: Evidence from 

Head Start. American Economic Journal: Applied 

Economics, 1:3, 111–134.; Lipscomb, S.T., Pratt, 

M.E., Schmitt, S.A., Pears, K.C., and Kim, H.K. 

(2013). School readiness is children living in nonparental care: Impacts of Head Start. Journal of 

Applied Developmental Psychology, 31 (1), 28–37. 

2Source: Head Start 2022 Program Information 

Report (PIR). 

3Burchinal, M., Zaslow, M., & Tarullo, L. (eds.) 

(2016). Quality thresholds, features, and dosage in 

early care and education: Secondary data analyses 

of child outcomes. Monographs of the Society for 

Research in Child Development. 81(2). 

4Choi, Y., Horm, D., Jeon, S. & Ryu, D. (2019). 

Do Stability of Care and Teacher-Child Interaction 

Quality Predict Child Outcomes in Early Head 

Start?, Early Education and Development, 30:3, 

337–356. 

5Hamre, B., Hatfield, B., Pianta, R., Jamil, F. 

(2013). Evidence for General and Domain-Specific 

Elements of Teacher-Child Interactions: 

Associations with Preschool Children’s 

Development. Child Development, 85:3; Grunewald, 

R., Nunn, R., Palmer, V. (2022). Examining teacher 

turnover in early care and education. Federal 

Reserve Bank of Minneapolis. 

6Source: Head Start 2022 PIR. 

7 Ibid. 

8Source: Head Start 2010–2022 PIR. 

9Bassok, D., Doromal, J., Michie, M., & Wong, V. 

(2021). The Effects of Financial Incentives on 

Teacher Turnover in Early Childhood Settings: 

Experimental Evidence from Virginia. 

EdPolicyWorks at the University of Virginia.; 

Whitebook, M., Howes, C., & Phillips, D. (2014). 

Worthy Work, STILL Unlivable Wages: The Early 

Childhood Workforce 25 Years after the National 

Child Care Staffing Study. Center for the Study of 

Child Care Employment. https://cscce.berkeley.edu/ 

publications/report/worthy-work-still-unlivablewages/.; Whitebook, M., Sakai, L., Gerber, E., & 

Howes, C. (2001). Then & Now: Changes in Child 

Care Staffing, 1994–2000. Washington, DC: Center 

for the Child Care Workforce and Institute of 

Industrial Relations, University of California, 

Berkeley. https://cscce.berkeley.edu/publications/ 

report/then-and-now-changes-in-child-care-saffing1994-2000/. 

L. Non-Quantified Impacts of Certain 

Elements of the Proposed Rule 

Estimated Impact of Relevant Provisions on 

Slot Loss 

Expected Impact of Preventing and 

Addressing Lead Exposure (§ 1302.48) 

Additional Impact of Workforce Supports: 

Staff Wages and Benefits (§ 1302.90) 

Estimated Impact of Mental Health 

Services (§ 1302 Subpart D; Subpart H; 

Subpart I) 

Estimated Impact of Modernizing 

Engagement With Families (§ 1302.11; 

§ 1302.13; § 1302.15; § 1302.34; 

§ 1302.50) 

Estimated Impact of Community 

Assessments (§ 1302.11) 

Estimated Impact of Adjustment for 

Excessive Shelter Costs for Eligibility 

Determination (§ 1302.12) 

Estimated Impact of Migrant and Seasonal 

Head Start Eligibility (§ 1302.12) 

Estimated Impact of Serving Children With 

Disabilities (§ 1302.14) 

Expected Benefits of Ratios in CenterBased Early Head Start Programs 

(§ 1302.21) 

Expected Benefits of Center-Based Service 

Duration for Early Head Start (§ 1302.21) 

Expected Benefits of Family Service 

Worker Family Assignments (§ 1302.52) 

Expected Benefits of Participation in 

Quality Rating and Improvement 

Systems (§ 1302.53) 

Expected Benefits of Services to Enrolled 

Pregnant People (§ 1302.80; § 1302.82) 

Expected Benefits of Standards of Conduct 

(§ 1302.90) 

Expected Benefits of Staff Training To 

Support Child Safety (§ 1302.92; 

§ 1302.101) 

Expected Benefits of Definition of Income 

(§ 1305.2) 

Initial Small Entity Analysis 

A. Description and Number of Affected 

Small Entities 

B. Description of the Potential Impacts of 

the Rule on Small Entities 

C. Alternatives To Minimize the Burden on 

Small Entities 

I. Background 

The Federal Head Start program 

provides early education and other 

comprehensive services to children 

birth to age 5 and during pregnancy in 

center- and home-based settings across 

the country. Since its inception in 1965, 

Head Start has been a leader in 

providing high-quality services that 

support the development of children 

from low-income families, helping them 

enter kindergarten more prepared to 

succeed in school and in life. Evidence 

continues to support the positive 

outcomes for children and families who 

participate in and graduate from Head 

Start programs.1 The most essential 

component to accomplishing Head 

Start’s mission of providing high-quality 

early childhood education and 

comprehensive services is the workforce 

of approximately 260,000 staff 2 that 

provide the services to children and 

families each day. 

However, due to a severe nationwide 

staffing shortage, Head Start grant 

recipients across the country are 

struggling to retain and hire qualified 

staff to fully enroll classrooms. Early 

educators provide a critical foundation 

for children to learn and develop 3 and 

positively impact children’s outcomes.4

Strong, stable relationships between 

young children and educators are the 

key to promoting early development. If 

programs cannot retain high-quality 

staff, these relationships are disrupted 

and outcomes for children and families 

are negatively impacted.5 Currently, 

Head Start programs across the nation 

are experiencing a severe staff shortage 

with turnover at its highest point in two 

decades.6 For Head Start classroom 

teachers, the rate of turnover has more 

than doubled over the past decade.7

Low wages and poor benefits—despite 

increased expectations and 

requirements for staff—are a key driver 

of rapidly increasing staff turnover 

among Head Start teachers and staff. 

Since 2010, the share of Head Start 

Preschool teachers with a bachelor’s 

degree increased substantially, but 

inflation-adjusted salaries for these 

teachers decreased by 2 percent.8

Research indicates that well 

compensated early childhood teachers 

and staff have lower turnover rates and 

provide higher quality services.9 For 

decades, the Head Start program has 

been subsidized by low paid workers 

committed to the mission; and the 

absence of clear Federal requirements 

for staff compensation has allowed this 

practice to continue. Urgent regulatory 

action is needed to stabilize the 

workforce and ensure the Head Start 

program can continue to fulfill its 

mission to promote strong outcomes for 

children and families. The background 

context and need for this regulatory 

action is expanded on further in the 

following paragraphs. 

Through the Improving Head Start for 

School Readiness Act of 2007 (the 2007 

Reauthorization), which amended the 

Head Start Act (the Act), Congress 

required the Department of Health and 

Human Services (HHS) to ensure 

children and families receive the 

highest quality Head Start services 

possible. In line with this, Congress 

mandated HHS to revise the Head Start 

Program Performance Standards 

(HSPPS). Through the 2007 

Reauthorization, Congress also made a 

number of changes to increase 

qualifications and other requirements 

for staff, particularly education staff. 

This proposed rule responds to the 

mandate to revise and improve the 

HSPPS in the Act and makes additional 

revisions to the HSPPS that were 

finalized in 2016. 

The HSPPS, first published in the 

1970s, are the foundation on which 

programs design and deliver highquality, comprehensive services to 

children and their families. The HSPPS 

set forth the requirements local grant 

recipients must meet to support the 

cognitive, social, emotional, and healthy 

development of children enrolled in the 

program. They include requirements to 

provide education, health, mental 

health, nutrition, and family and 

community engagement services, as 

well as requirements for local program 

governance and Federal administration 

of the program. In response to 

requirements in the 2007 

Reauthorization, HHS conducted a 

major revision of the performance 

standards, through a final rule 

published in 2016. In line with statutory 

requirements, the 2016 overhaul of the 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80820 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

10Source: Head Start 2022 PIR. 

11Source: Head Start 2010–2022 PIR. 

12Whitebook, M., Philipps, D., & Howes, C. 

(2014). Worthy work, still unlivable wages: The 

early childhood workforce 25 years after the 

national child care staffing study. Center for the 

Study of Child Care Employment. 

13Lippard, C.L., La Paro, K.M., Rouse, H.L., 

Crosby, D.A. (2018). A closer look at teacher-child 

relationships and classroom emotional context in 

preschool. Child Youth Care Forum, 47, 1–21.; 

Sabol, T.J. & Pianta, R.C. (2012). Recent Trends in 

Research on Teacher-Child Relationships. 

Attachment and Human Development, 14(3), 213– 

231. 

14Pianta, R. & Stuhlman, M.W. (2019). Teacherchild relationships and children’s success in the 

first years of school. School Psychology Review, 

33(3), 444–458; Ros Pilarz, A. & Hill, H.D. (2014). 

Unstable and multiple child care arrangements and 

young children’s behavior. Early Childhood 

Research Quarterly, 29(4), 471–483; Tran, H. & 

Winsler, A.W. (2011). Teacher and center stability 

and school readiness among low-income, ethnically 

diverse children in subsidized, center-based child 

care. Children and Youth Services Review, 33(11), 

2241–2252. 

15Hale-Jinks, C., Knopf, H., & Kemple, K. (2006). 

Tackling teacher turnover in childcare: 

Understanding causes and consequences, 

identifying solutions. Childhood Education, 82, 

219–226. 

16Hale-Jinks, Knopf, & Kemple (2006). Tackling 

teacher turnover in childcare: Understanding causes 

and consequences, identifying solutions. Childhood 

Education, 82, 219–226. 17Source: Head Start 2022 PIR. 

performance standards updated and 

enhanced program requirements to 

reflect the latest science on child 

development, while also streamlining 

requirements where possible, to 

promote stronger transparency and 

support programs to deliver more 

efficient and effective services. 

While the 2016 revision to the HSPPS 

gave careful attention to the type and 

quality of early education and 

comprehensive services to be provided 

to children and their families, as well as 

requirements for training, professional 

development, and qualifications for 

staff, other supports for the Head Start 

workforce were not included. Indeed, 

the 2007 Reauthorization and the 2016 

revision to the HSPPS resulted in 

enhanced requirements and 

responsibilities for program staff, but 

lacked specific requirements for staff 

pay, benefits, and other supports for 

staff wellness necessary to sustain a 

workforce that could implement those 

quality provisions. For instance, while 

qualifications for Head Start preschool 

teachers have increased dramatically 

over the past decade (52 percent 

nationwide had a bachelor’s degree in 

2010 compared to 71 percent in 2022), 

inflation-adjusted salary for these 

teachers decreased by 2 percent during 

this timeframe, from $39,912 in 2010 to 

$39,096 in 2022.10 Given the increased 

expectations and requirements for these 

staff positions without corresponding 

increases in wages, it is unsurprising 

that turnover among classroom teachers 

as well as other staff positions has 

increased markedly over the past 

decade.11

For decades, Head Start staff— 

particularly frontline staff whose daily 

job responsibilities include working 

directly with children and families— 

have received low, stagnant wages, poor 

benefits, and inadequate supports for 

health and wellness. Research 

demonstrates that low wages in the 

early care and education (ECE) sector 

are a critical driver of staff turnover.12

Frontline Head Start staff do important 

and difficult jobs to promote the 

development of children participating 

in Head Start and provide 

individualized supports to families. A 

strong relationship between a child and 

their early educator provides the 

foundation for all learning and 

development in ECE settings.13 Stability 

and continuity in these relationships are 

important for high-quality care and for 

supporting positive developmental 

outcomes for children.14 Conversely, a 

higher rate of turnover among ECE staff 

is associated with lower quality services 

and care, as well as poorer 

developmental outcomes for children.15

For instance, research has demonstrated 

that turnover among early childhood 

educators is linked to worse cognitive 

and social developmental outcomes in 

children birth to age 5.16 Given this, the 

unprecedented rate of turnover and staff 

vacancies programs are currently 

experiencing is concerning and 

threatens the stability of the national 

Head Start program and the quality of 

services it provides, which are a critical 

resource for hundreds of thousands of 

families annually. 

Head Start and ECE programs 

nationwide have faced increasing rates 

of staff turnover, a situation that has 

been exacerbated drastically by the 

COVID–19 pandemic. While high staff 

turnover rates are an issue for the entire 

ECE sector in the United States, HHS 

has the authority and opportunity to 

address the systemic problems driving 

high turnover in Head Start, and this 

NPRM proposes policies to address 

these issues. In 2022, turnover across all 

staff positions was 19 percent, marking 

the highest rate of turnover in Head 

Start in over two decades, and a drastic 

jump from 13.5 percent in 2019 (prior 

to the COVID–19 pandemic). While 

turnover rates were exacerbated by the 

labor market conditions during the 

pandemic, the workforce challenges in 

Head Start remain intractable even after 

some other industries have regained 

pre-pandemic employment levels. 

Because Head Start serves the children 

and families most in need, it is critical 

the workforce is well-positioned to be 

stable as communities recover from the 

pandemic and during and after future 

emergencies. Thus, the changes in this 

proposed regulation are necessary in 

both the long and short terms. The 

staffing crisis faced by programs across 

the nation is an untenable situation for 

the future of Head Start. This proposed 

regulation is urgently needed to 

establish clearer requirements for 

programs to support and stabilize their 

workforce, while also serving those 

children and families most in need of 

Head Start services. The challenges 

faced by the workforce—and the need 

for Federal guardrails in the form of 

additional regulations—are described in 

additional detail in the subsequent 

section, Workforce Supports: Staff 

Wages. 

This NPRM will also propose new or 

enhanced standards to promote more 

consistent implementation of quality 

services in other programmatic areas. 

Enhancements and clarifications to 

existing standards are proposed in the 

following areas: family service worker 

caseloads; procedures for identifying 

and meeting community needs, 

including consideration of 

transportation as a possible barrier to 

children’s attendance; ensuring child 

safety; services for pregnant women and 

people; and better aligning with State 

early childhood systems. We also 

propose enhancements to requirements 

for mental health services to integrate 

mental health more fully into every 

aspect of program services, as well as 

elevate the role of mental health 

consultation to support the well-being 

of children, families, and staff. Existing 

requirements in the performance 

standards in these areas are broad and 

flexible and have contributed to wide 

variation in the quality of the 

implementation of those standards. For 

instance, some programs have many 

families (e.g., more than 100 17) assigned 

to one family service worker, which 

reduces the quality of services provided 

to each family. Many programs have 

also made decisions to cut 

transportation services as a primarily 

budgetary decision, resulting in families 

in need of services no longer being able 

to attend the program. Within 

constrained budgets, programs must 

make difficult choices about where to 

invest funds as they strive to provide 

high-quality Head Start services to as 

many eligible children as possible. 

Programs often make decisions aimed at 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80821 

18Barr, A., & Gibbs, C.R. (2002). Breaking the 

Cycle? Intergenerational Effects of an Antipoverty 

Program in Early Childhood. Journal of Political 

Economy, 130.; Bauer, L., & Schanzenbach, D. 

(2016). The Long-Term Impact of the Head Start 

Program. The Hamilton Project, The Brookings 

Institution.; Deming, D. (2009). Early Childhood 

Intervention and Life-Cycle Skill Development: 

Evidence from Head Start. American Economic 

Journal: Applied Economics, 111–134. Montialoux, 

C. (2016). Revisiting the impact of Head Start. IRLE: 

Institute for Research on Labor and Employment. 

University of California: Berkeley; Phillips, D., 

Gormley, W., & Anderson, S. (2016). The Effects of 

Tulsa’s CAP Head Start Program on Middle-School 

Academic Outcomes and Progress. Developmental 

Psychology 52(8), 1247–61. 19See section 641A(a)(1) and (2) of the Act. 

enrolling as many children and families 

as possible and sometimes accomplish 

this by cutting back on critical areas of 

services. The enhancements proposed in 

this NPRM will promote more 

consistent implementation of program 

services across a variety of areas, 

ultimately improving outcomes for 

enrolled children and their families. 

Additionally, since the inception of 

the 2016 revision to the performance 

standards, the Administration for 

Children and Families (ACF) received 

feedback about areas where standards 

have not been implemented as intended 

in the field, or areas where standards are 

not clear. Therefore, this proposed 

regulation will also enhance and clarify 

standards across a variety of areas, 

codify certain essential best practices, 

and/or streamline processes for 

programs implementing the standards, 

with the goal of further improving the 

quality of services. 

Finally, the changes proposed to the 

HSPPS are necessary to maintain the 

quality of the Head Start program and 

respond to the current early childhood 

landscape which has changed 

dramatically since the HSPPS were first 

published in the 1970s and even since 

the 2016 overhaul of the HSPPS. As 

discussed elsewhere, Head Start 

workforce compensation has not kept 

pace with inflation or with rising wages 

in other industries. Further, postpandemic workforce recovery has been 

slow and mental and behavioral health 

issues have risen among children and 

adults. Head Start programs must adapt 

and evolve to continue leading the 

sector in quality programing for 

children and families. These factors 

together suggest that regulatory action is 

warranted and necessary. As explained 

in detail in this section and throughout 

the NPRM, stronger workforce supports 

are necessary to meet the purpose of the 

Act of promoting school readiness for 

low-income children. See 42 U.S.C. 

9831. The Act authorizes the Secretary 

to modify the program performance 

standards as necessary, and while the 

proposals here retain flexibility and 

discretion that Head Start programs are 

accustomed to, it is evident by the 

lagging compensation and other 

workforce supports that additional 

guardrails are necessary to maintain 

quality. Head Start’s standards have 

historically provided a benchmark for 

high-quality early childhood programs. 

This NPRM affirms that higher wages 

and benefits are a key driver of quality 

in early childhood. 

Establishing the new or enhanced 

standards described below—particularly 

for the workforce—will promote higherquality services for children in Head 

Start programs across the country and 

are necessary to ensure there is a stable 

workforce to maintain consistent 

operations. There will be a substantial 

cost associated with enacting the 

proposed standards at current Head 

Start funded enrollment levels. 

However, ACF asserts that the policy 

proposals in this NPRM are necessary 

for the Head Start program to continue 

to operate effectively and meet its 

mission. ACF understands that as a 

result of these necessary reforms, one 

potential impact could be a reduction in 

Head Start slots in some programs in 

order to ensure the quality of services 

delivered. The NPRM proposals contain 

some ability to mitigate the magnitude 

of slot loss by providing a longer 

implementation timeline for the 

proposed wage requirements (see a 

further discussion on this in the section 

on Workforce Supports: Wage 

Requirements). While slot loss is a 

difficult trade-off, a number of programs 

are already reducing slots because they 

are forced to close classrooms due to a 

severe shortage of qualified staff. The 

current staffing shortage needs to be 

addressed quickly, as it is imperative 

that programs be able to retain qualified 

staff in order to provide high-quality 

services to children and prepare them 

for success in elementary school and 

beyond.18 Failure to act would threaten 

the ability for Head Start to continue to 

recruit and retain effective staff and 

thereby deliver high-quality services. 

This action carefully balances the ability 

of programs to maintain staffing with 

the goal to serve as many children as 

possible, while helping stabilize the 

Head Start program long-term. Further, 

the establishment of new or enhanced 

expectations in program quality through 

the proposed standards described in this 

NPRM will provide a better foundation 

for more consistent implementation of 

high-quality services and provide an 

opportunity for future Congressional 

investments in quality improvement. 

II. Statutory Authority To Issue NPRM 

We publish this NPRM under the 

authority granted to the Secretary of 

Health and Human Services by sections 

640(a)(5)(A)(i) and (B)(viii), 641A, 645, 

645A, 648A, and 653 of the Act (42 

U.S.C. 9835, 9836a, 9840, 9840a, 9843a, 

and 9848), as amended by the 

Improving Head Start for School 

Readiness Act of 2007 (Pub. L. 110– 

134). Under these sections, the Secretary 

is required to establish performance 

standards and other regulations for 

Head Start and Early Head Start 

programs. Specifically, the Act requires 

the Secretary to ‘‘. . . modify, as 

necessary, program performance 

standards by regulation applicable to 

Head Start agencies and programs 

. . .’’ 19 and explicitly directs the 

Secretary to prescribe eligibility 

standards, establish staff qualification 

goals, and assure the comparability of 

wages. This rule meets the statutory 

requirements Congress put forth in its 

2007 bipartisan reauthorization of the 

Head Start and addresses Congress’s 

mandate that called for the Secretary to 

review and revise the performance 

standards. As discussed throughout the 

preamble, the performance standards in 

this proposed rule build upon field 

knowledge and experience to codify 

best practices and ensure Head Start 

programs deliver high-quality education 

and comprehensive services to the 

children and families they serve. The 

Secretary has determined that the 

modifications to performance standards 

contained in this regulation are 

appropriate and needed to effectuate the 

goals of the performance standards and 

the purposes of the Act. 

III. Section-by-Section Discussion of 

Proposed Changes 

Definition of Head Start and Related 

Terms (§ 1305.2) 

Section 1305.2 establishes definitions 

for key terms used throughout the 

HSPPS. These include terms to define 

programs that operate Head Start 

services, including Early Head Start 

Agency, Head Start Agency, and 

Program. We begin by explaining 

proposed changes to clarify these terms 

and definitions used to describe Head 

Start and Early Head Start programs. 

Our proposed changes will also promote 

more consistent use of these terms 

throughout the HSPPS and in subregulatory policy guidance and training 

and technical assistance (TTA) materials 

developed by ACF. The proposed 

revised terms and definitions described 

in this section are also used throughout 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80822 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

the rest of the preamble to describe 

other proposed changes, where 

applicable. 

First, the term Head Start, which is 

not currently defined in § 1305.2, is 

used inconsistently throughout the 

current HSPPS, sometimes in reference 

to a program that serves children ages 

three to compulsory school age and 

other times in reference to any type of 

program authorized under the Act. 

Consequently, this inconsistency is also 

present throughout sub-regulatory 

policy and TTA documents published 

by ACF. In some cases, a footnote is 

used to denote that the term Head Start 

refers to programs including Head Start, 

Early Head Start, and Migrant or 

Seasonal Head Start (MSHS). In other 

cases, the phrase ‘‘Head Start and Early 

Head Start’’ is used to represent all 

types of programs. This inconsistency 

may be challenging for those who are 

new to Head Start and troublesome for 

the field in the general. ACF recognizes 

the need for consistent and clear 

terminology in this area. 

Therefore, we propose to use the term 

Head Start as an umbrella term that 

represents all program types authorized 

under the Act. We propose to add to 

§ 1305.2 a definition for Head Start that 

states that Head Start refers to any 

program authorized under the Head 

Start Act. Furthermore, we propose to 

add to § 1305.2 a definition for Head 

Start Preschool so that programs that 

provide services to children from age 

three to compulsory school age will be 

referred to as Head Start Preschool 

(HSP). In order to maintain consistency 

across definitions of program types, we 

also propose adding a definition of Early 

Head Start that refers to a program that 

serves pregnant women and children 

from birth to age three. 

We propose two other definitional 

changes to align with the revised terms 

above. First, we propose to revise the 

current definition of Program by striking 

‘‘a Head Start’’ and adding ‘‘any funded 

Head Start Preschool;’’ striking 

‘‘migrant, seasonal, or’’ and replacing 

with ‘‘Migrant or Seasonal Head Start;’’ 

and striking the word ‘‘program’’ and 

adding ‘‘or other program authorized’’ 

after the comma. 

Furthermore, we propose to revise the 

definition of Head Start Agency to add 

the word ‘‘Preschool’’ after ‘‘Head Start’’ 

and replace the words after ‘‘program’’ 

with ‘‘, an Early Head Start program, or 

Migrant or Seasonal Head Start program 

pursuant to the Head Start Act.’’ We 

further propose to update the usage of 

these terms as they are used throughout 

the HSPPS. 

We propose to remove the term Early 

Head Start Agency. We further propose 

a nomenclature change of ‘‘grantee’’ to 

‘‘grant recipient’’. We do not propose 

any changes to other relevant terms 

including Agency, Delegate Agency, 

Indian Head Start Agency, and Migrant 

or Seasonal Head Start Program. 

We believe that these revised 

definitions will provide more clear and 

consistent terminology when referring 

to the various program types authorized 

by the Act and to the entirety of Head 

Start. Distinguishing Head Start 

Preschool from Head Start is intended to 

improve comprehension for both 

experienced and novice readers of the 

HSPPS and will codify the colloquial 

use of the term Head Start. 

Note that ACF will not consider 

comments regarding changes to the 

HSPPS that purely reflect the updated 

usage of these terms, such as those 

throughout Part 1304 Subpart B— 

Designation Renewal. 

Workforce Supports: Staff Wages 

(§ 1302.90) 

Section 1302.90 outlines requirements 

for personnel policies, including the 

establishment of personnel policies and 

procedures, background check 

procedures, standards of conduct, and 

communication with dual language 

learners. In this section, we propose the 

addition of a new paragraph (e) that 

outlines four areas of proposed 

requirements for wages for Head Start 

staff. First, we describe requirements for 

programs to make progress to pay parity 

with kindergarten to third grade 

teachers, for Head Start education staff 

who work directly with children as part 

of their daily job responsibilities. Head 

Start programs will demonstrate 

progress to parity by ensuring that Head 

Start educators are paid at a rate that is 

at least comparable to preschool 

teachers in public school settings. 

Second, we describe requirements to 

establish or enhance a salary scale, wage 

ladder, or other pay structure that 

applies to all staff in the program and 

incorporates the requirements for pay 

for education staff. Third, we describe 

requirements that all staff must receive 

a salary that is sufficient to cover basic 

costs of living in their geographic area, 

including those at the lowest end of the 

pay structure. Lastly, we describe 

requirements to affirm and emphasize 

that the requirements for progress to pay 

parity should also promote 

comparability of wages across Head 

Start Preschool and Early Head Start 

staff positions. Taken together, 

implementing this set of standards will 

stabilize and strengthen Head Start 

programs across the country by ensuring 

competitive wages that will promote 

recruitment and retention of qualified 

staff and support delivery of highquality education and comprehensive 

services for children and families. These 

proposed standards will also support 

more equitable, fair wages for a 

workforce that is largely comprised of 

women and people of color. 

In addition to the authority to modify 

all program performance standards, the 

Head Start Act mandates that programs 

provide compensation that is adequate 

to attract and retain qualified staff to 

enhance program quality. See 42 U.S.C. 

9836A(a) and 42 U.S.C. 9835(a)(5)(i). 

Section 653 of the Head Start Act, 42 

U.S.C. 9848 directs the Secretary to 

encourage Head Start agencies to 

provide compensation according to 

salary scales that are based on training 

and experience. This section also directs 

the Secretary to take such actions as are 

necessary to assure that compensation is 

not in excess of the average rate of 

compensation paid in the area where 

the program is carried out to a 

substantial number of persons providing 

substantially comparable services as 

well as See 42 U.S.C. 9848. Historically, 

the Office of Head Start has seen very 

few instances of excessive 

compensation for staff, especially for 

education staff, as evidenced in data 

from the Program Information Report 

(PIR). Nothing in these proposed 

regulations is expected to result in the 

excess compensation described by 

Congress in this section. In rare cases, 

there may be some risk that positions of 

leadership are paid salaries in excess of 

compensation paid to similar positions. 

This risk should be addressed with a 

program’s wage scale. However, this 

limit is not intended to suppress wages, 

because, as discussed herein, underpaid 

staff is a pervasive issue. This section 

makes it clear that staff salaries should 

be comparable to compensation in other 

comparable services, including 

consideration of salaries paid to 

elementary school staff. The proposed 

requirements will help programs design 

their staff compensation packages and 

salary scales while still allowing 

programs some flexibility to determine 

what works best for their program. 

The Need for Wage Requirements 

The main goals of Head Start 

programs are to support the 

development of children from lowincome families and to promote 

economic self-sufficiency for families 

through the delivery of high-quality 

comprehensive services. Head Start’s 

critical mission is carried out every day 

by the staff working with children and 

families. Strong, stable relationships 

between children and their early 

educators provide the foundation for 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80823 

20Lippard, C.L., La Paro, K.M., Rouse, H.L., 

Crosby, D.A. (2018). A closer look at teacher-child 

relationships and classroom emotional context in 

preschool. Child Youth Care Forum, 47, 1–21; 

Sabol, T.J. & Pianta, R.C. (2012). Recent Trends in 

Research on Teacher-Child Relationships. 

Attachment and Human Development, 14(3), 213– 

231. 

21Nguyen, T., Ansari, A., Pianta, R., Whittaker, 

J.V., Vitiello, V.E., & Ruzek, E. (2020). The 

classroom relational environment and children’s 

early development in preschool. Social 

Development, 00, 1–21; Pearlman, M., Falenchuk, 

O., Fletcher, B., McMullen, E., Beyene, J., & Shah, 

P. (2016). A Systematic Review and Meta-Analysis 

of a Measure of Staff/Child Interaction Quality (the 

Classroom Assessment Scoring System) in Early 

Childhood Education and Care Settings and Child 

Outcomes, PLOS ONE 11 (12). 

22Bassok, D., Markowitz, A.J., Bellows, L., 

Sadowski, K. (2021). New Evidence on Teacher 

Turnover in Early Childhood. Educational 

Evaluation and Policy Analysis, 43(1), 172–180; 

Phillips, D., Austin, L.J.E., & Whitebook, M. (2016). 

The Early Care and Education Workforce. The 

Future of Children, 26(2), 139–158. 

23 Institute of Medicine and National Research 

Council. (2015). Transforming the Workforce for 

Children Birth Through Age 8: A Unifying 

Foundation. Washington, DC: The National 

Academies Press.; National Research Council and 

Institute of Medicine. (2000). From Neurons to 

Neighborhoods: The Science of Early Childhood 

Development. Committee on Integrating the Science 

of Early Childhood Development. Jack P. Shonkoff 

and Deborah A. Phillips, eds. Board on Children, 

Youth, and Families, Commission on Behavioral 

and Social Sciences and Education. Washington, 

DC: National Academies Press. 

24 Institute of Medicine and National Research 

Council. (2015). Transforming the Workforce for 

Children Birth Through Age 8: A Unifying 

Foundation. Washington, DC: The National 

Academies Press. 

25National Academies of Sciences, Engineering, 

and Medicine. (2018). Transforming the Financing 

of Early Care and Education. Washington, DC: The 

National Academies Press. 

26Source: Head Start 2010–2022 PIR. 

27U.S. Bureau of Labor Statistics. Occupational 

Employment and Wages. May 2022. 25–2012 

Kindergarten Teachers, Except Special Education. 

https://www.bls.gov/oes/current/oes252012.htm; 

U.S. Bureau of Labor Statistics. Occupational 

Employment and Wages. May 2022. 25–2011 

Preschool Teachers, Except Special Education. 

https://www.bls.gov/oes/current/oes252011.htm. 

28Whitebook, M., Philipps, D., & Howes, C. 

(2014). Worthy work, still unlivable wages: The 

early childhood workforce 25 years after the 

national child care staffing study. Center for the 

Study of Child Care Employment; U.S. Department 

of Labor (2022). Bearing the cost: How 

overrepresentation in undervalued jobs 

disadvantaged women during the pandemic. 

https://www.dol.gov/sites/dolgov/files/WB/media/ 

BearingTheCostReport.pdf. 

29Source: Head Start 2021 PIR. 

30 Downer, J.T., Goble, P., Myers, S.S., & Pianta, 

R.C. (2016). Teacher-child racial/ethnic match 

within pre-kindergarten classrooms and children’s 

early school adjustment. Early Childhood Research 

Quarterly, 37, 26–38.; Markowitz, A., Bassok, D., & 

Grissom, J.A. (2020). Teacher-child racial/ethnic 

match and parental engagement with Head Start. 

American Educational Research Journal, 57(5), 

2132–2174. 

31National Head Start Association (NHSA). 

(2023). An Update on Head Start’s Ongoing 

Workforce Crisis. Washington, DC: NHSA. 

32Source: Head Start 2022 PIR. 

children to learn and develop.20 Indeed, 

research indicates that high-quality 

interactions between staff and children 

in ECE settings relate to stronger 

developmental outcomes for children.21

Conversely, high turnover among ECE 

staff is related to lower quality 

education and care and poorer outcomes 

for enrolled children.22 But, as 

described previously, Head Start 

programs nationwide are experiencing a 

severe shortage of staff across a variety 

of positions, particularly for those that 

provide direct services to children and 

families. The staffing crisis is a result of 

a confluence of factors, including 

persistently low, stagnant wages, 

particularly for frontline staff; a lack of 

comprehensive benefits; and 

insufficient supports for staff health and 

wellness, despite increased need for 

staff to be more qualified, more 

competent, and bear more complex job 

responsibilities. Urgent action and 

change are needed to stabilize the Head 

Start workforce to ensure the future 

viability of Head Start programs 

nationwide. 

The qualifications, expectations, and 

responsibilities of Head Start staff have 

significantly increased over the past 

decade, first with the reauthorization of 

the Head Start Act in 2007 and then 

with the revisions to the HSPPS 

finalized in 2016. This increase in 

expectations and responsibilities is 

largely a reflection of advancing science 

in child development, particularly 

research on birth to 5 as an important 

period for brain development and as a 

critical foundation on which all later 

development builds.23 Relatedly, our 

understanding of what an early educator 

needs to know and do in order to 

effectively promote child development 

during this period has also advanced. A 

notable report from the National 

Academies for Science, Engineering, 

and Medicine provided a framework for 

knowledge and competencies that early 

educators need, grounded in the latest 

science on child development.24 A 

subsequent report from the National 

Academies highlighted the importance 

of a highly qualified ECE workforce that 

is well compensated with appropriate 

professional development supports and 

career opportunities, in order to provide 

high quality services to children and 

families.25

However, these increased 

expectations, qualifications, and 

requirements have not been followed by 

increases in compensation. As a result, 

average wages have remained low and 

stagnant for years, particularly for staff 

who work directly with children and 

families as their primary job 

responsibility. From 2010 to 2022, the 

share of Head Start Preschool teachers 

with a bachelor’s degree increased from 

52 percent to 71 percent, but inflationadjusted salaries for these teachers 

decreased by 2 percent during this 

timeframe, with an average teacher 

salary of just $39,096 in 2022 compared 

to $39,912 in 2010.26 By comparison, in 

2022, the average salaries for a 

preschool teacher in a school-based 

setting and a kindergarten teacher were 

$53,200 and $65,120, respectively.27

This is a persistent issue not just for 

Head Start, but also for the broader early 

childhood field. ECE as a field is 

comprised primarily of women— 

including a large share of women of 

color—doing work that has been 

historically uncompensated and led to 

today’s workforce being undervalued 

and underpaid.28 Additionally, ACF 

administrative data indicates that just 

over 60 percent of Head Start education 

staff (i.e., teachers, assistant teachers, 

home visitors, and family child care 

providers) are people of color.29 It is 

critical to maintain and strengthen the 

incredible diversity of our workforce 

while we seek to fix the historic 

problem of a reliance on staff committed 

to the mission of early care and 

education that has led to an underpaid 

workforce today. This is especially 

important since Head Start programs 

serve a large share of children of color 

and there are benefits when program 

staff reflect the communities they 

serve.30

In addition to low compensation, 

Head Start staff often report insufficient 

supports for their health and wellness. 

Even prior to the pandemic, many Head 

Start programs reported challenges with 

increasing rates of staff stress and 

burnout, which is a common experience 

throughout ECE programs. See the 

section in this NPRM on Workforce 

Supports: Staff Wellness for a fuller 

discussion on the poor physical and 

mental health experienced by Head 

Start and other ECE staff, as well as 

proposed new standards for supports to 

address these issues. 

Taken together, low wages and 

benefits for demanding work, and high 

rates of stress and burnout, are causing 

qualified staff to leave for higher paid 

positions with better benefits in public 

schools or to leave the early childhood 

field entirely (e.g., retail, service, food 

industries).31 The turnover rate for Head 

Start classroom teachers doubled over 

the past decade, from 11 percent in 2010 

to an alarming 22 percent in 2022.32 As 

a point of comparison, in 2019, turnover 

for preschool teachers in school-based 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80824 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

33 Grunewald, R., Nunn, R., Palmer, V. (2022). 

Examining teacher turnover in early care and 

education. Federal Reserve Bank of Minneapolis. 

34 Ibid. 

35Source: Head Start program monthly 

enrollment data reported internally to OHS. Note 

that the percent of programs experiencing staffing 

challenges is likely higher since it was not 

explicitly requested that programs report this 

information. 

36National Head Start Association (NHSA). 

(2022). Confronting Head Start’s Workforce Crisis. 

Washington, DC: NHSA. 

37Source: OHS administered survey on 

background checks and the workforce. Percentages 

exclude positions reported as not applicable. 

38 In the survey, recipients were instructed that 

‘‘high’’ or very severe indicates the staffing shortage 

is a severe problem for that position. For example, 

there are several staff vacancies and/or relatively 

high turnover, impacting enrollment to a great 

extent; there are concerns that these issues cannot 

be resolved within the next few months. 

39Child Care Services Association, 2020. 

childcareservices.org/wp-content/uploads/2020/02/ 

CCSA_2020_TchrTurnover_Brief_Final_InteractiveFINAL.pdf. 

40Caven, M., Khanani, N., Zhang, X., & Parker, C. 

E. (2021). Center-and program-level factors 

associated with turnover in the early childhood 

education workforce (REL 2021–069). U.S. 

Department of Education, Institute of Education 

Sciences, National Center for Education Evaluation 

and Regional Assistance, Regional Educational 

Laboratory Northeast & Islands.; Whitebook, M., 

Howes, C., & Phillips, D. (2014). Worthy Work, 

STILL Unlivable Wages: The Early Childhood 

Workforce 25 Years after the National Child Care 

Staffing Study. Center for the Study of Child Care 

Employment. https://cscce.berkeley.edu/wpcontent/uploads/publications/ReportFINAL.pdf. 

41Burchinal, M., Zaslow, M., & Tarullo, L. (eds.) 

(2016). Quality thresholds, features, and dosage in 

early care and education: Secondary data analyses 

of child outcomes. Monographs of the Society for 

Research in Child Development. 81(2). 

42Hamre, B., Hatfield, B., Pianta, R., Jamil, F. 

(2013). Evidence for General and Domain-Specific 

Elements of Teacher-Child Interactions: 

Associations with Preschool Children’s 

Development. Child Development, 85:3; Grunewald, 

R., Nunn, R., Palmer, V. (2022). Examining teacher 

turnover in early care and education. Federal 

Reserve Bank of Minneapolis. 

43Choi, Y., Horm, D., Jeon, S. & Ryu, D. (2019). 

Do Stability of Care and Teacher-Child Interaction 

Quality Predict Child Outcomes in Early Head 

Start?, Early Education and Development, 30:3, 

337–356. 

44 Institute of Medicine (IOM) and National 

Research Council (NRC). 2015. Transforming the 

workforce for children birth through age 8: A 

unifying foundation. Washington, DC: The National 

Academies Press.; Rhodes, H., & Huston, A. (2012). 

Building the Workforce Our Youngest Children 

Deserve. Social Policy Report. Volume 26, Number 

1. Society for Research in Child Development. 

settings was about 7.7 percent.33 This 

situation has also been exacerbated by 

the COVID–19 pandemic, during which 

staff continued to do their utmost to 

support children and families despite 

high uncertainty and widespread 

closure of many aspects of the economy 

across the country. Across all Head Start 

staff positions, between 2019 and 2022 

turnover jumped by an unprecedented 

41 percent, from 13.5 percent to 19 

percent.34

Overall, these turnover rates are 

sobering and have grim implications for 

the viability of Head Start if they are not 

addressed. Given these rates of turnover, 

it is unsurprising that many programs 

are unable to reach full enrollment and/ 

or are impeded from providing highquality services to enrolled children and 

families. Inadequate and unstable 

staffing prevents programs from opening 

all classrooms, conducting home visits, 

providing family services, or providing 

transportation services. In April 2022, 

about two-thirds of Head Start programs 

reported experiencing significant 

enrollment challenges and half of those 

programs reported that staffing 

shortages contributed to those 

challenges, which resulted in many 

classroom closures.35 Furthermore, in a 

2022 survey of 900 Head Start programs 

staff conducted by the National Head 

Start Association, 85 percent of 

respondents indicated staff turnover 

was higher than in a typical program 

year. Almost all respondents (90 

percent) said staff shortages forced their 

programs to close classrooms either 

permanently or temporarily. Over half 

(57 percent) of respondents said 

compensation is the number one reason 

staff are leaving Head Start programs.36

In a November 2022 survey conducted 

by ACF on a random sample of Head 

Start grant recipients, the majority 

reported experiencing shortages with 

teaching positions (85 percent), assistant 

teaching positions (86 percent), bus 

drivers (70 percent), and home visitor 

positions (60 percent).37 At least half of 

those recipients described the staff 

shortage as very severe for teachers (59 

percent), bus drivers (53 percent), and 

assistant teachers (50 percent).38 These 

shortages were forcing the closure of a 

large portion of classrooms for the 

majority of respondents, with nearly 

half reporting difficulty keeping up to a 

quarter of their classrooms open and 

another 16 percent reporting difficult 

keeping up to half of their classrooms 

open. 

This problem is not unique to Head 

Start, as a recent study in North 

Carolina found that the most common 

reason staff leave the early childhood 

workforce in the State is to make more 

money.39 Indeed, a large body of 

research indicates that low wages in the 

field of ECE are a strong driver of 

turnover among staff. And some 

research indicates that low wages are in 

fact the strongest determinant of staff 

turnover, with the lowest paid early 

educators being twice as likely to leave 

their jobs compared to the highest paid 

early educators.40

Each staff position in a program is 

critical to the mission and vision of 

Head Start, and to the delivery of highquality services. As summarized 

previously, strong, stable relationships 

between young children and their 

teachers and caregivers provide a 

critical foundation for children to learn 

and develop.41 If programs cannot retain 

high-quality education staff, these 

relationships are disrupted and 

outcomes for children and families are 

negatively impacted.42 Research 

indicates that stable early care and 

education and strong teacher-child 

relationships positively influence 

children’s outcomes.43 In addition, 

family services staff in Head Start 

programs play a critical role of engaging 

and supporting economic stability of 

families (see the section on Family 

Service Worker Family Assignments for 

a further discussion on the critical role 

of these staff). Further, capable, 

consistent leadership and management 

staff are necessary to support a high 

functioning work environment that is 

positive and welcoming for both direct 

service staff and children and families. 

Bus drivers, janitors, and cooks are 

needed to ensure other important 

aspects of Head Start services are 

provided in a high-quality manner, 

including safe transportation, clean 

environments, and nutritious meals for 

children. Without a workforce at all 

levels that is stable, well-compensated, 

and supported, Head Start is not able to 

fully meet its mission of closing the 

achievement gap and preparing young 

children from low-income families for 

entry into kindergarten. Head Start staff 

work with children that need a range of 

developmental supports to ensure their 

success and preparedness for school. In 

order to break the cycle of poverty for 

children in Head Start, it is critical that 

the key change agents in this process 

(the staff) are compensated 

appropriately and supported in 

achieving their mission. 

To promote the retention of talented 

staff at all levels of the program, fill 

vacancies in a sustainable manner, keep 

classrooms open, provide the highest 

quality services, and ultimately promote 

strong outcomes for enrolled children 

and their families, staff must receive 

compensation (wages and benefits) that 

better reflects their experience and 

qualification and the value and 

importance of their critical work, as 

well as necessary staff wellness 

supports.44 Compensation must be 

competitive with other local employers 

that draw qualified staff away from 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80825 

45Source: Head Start program monthly 

enrollment data reported internally to OHS. Note 

that the percent of programs experiencing staffing 

challenges is likely higher since it was not 

explicitly requested that programs report this 

information. 

46Bassok, D., Doromal, J., Michie, M., & Wong, V. 

(2021). The Effects of Financial Incentives on 

Teacher Turnover in Early Childhood Settings: 

Experimental Evidence from Virginia. 

EdPolicyWorks at the University of Virginia.; 

Caven, M., Khanani, N., Zhang, X., & Parker, C.E. 

(2021). Center-and program-level factors associated 

with turnover in the early childhood education 

workforce (REL 2021–069). U.S. Department of 

Education, Institute of Education Sciences, National 

Center for Education Evaluation and Regional 

Continued 

Head Start, including local school 

districts. 

There is a clear need for better 

guardrails in the form of strong Federal 

requirements in this area. While ACF 

strongly values local flexibility and has 

historically allowed for substantial local 

flexibility in many areas of service 

delivery, in other areas, the HSPPS are 

quite prescriptive about what all 

programs must do. One area in which 

flexibility is most prominent is in what 

ACF currently requires for the 

workforce, including wages, benefits, 

and other supports for health and 

wellness. For instance, currently, the 

HSPPS do not require wage targets or 

include other compensation 

requirements for Head Start programs, 

and national program data show that 

Head Start grant recipients have 

historically prioritized serving more 

children over increasing wages for 

qualified education staff to be 

comparable to similar industries that 

compete for these staff, particularly 

elementary schools. This is not because 

programs do not value their staff or 

want to compensate them fairly. 

Without additional appropriations, 

programs would have to serve fewer 

children to achieve the necessary cost 

savings to fund increases in staff 

compensation. Faced with this difficult 

decision to either increase staff 

compensation or serve the same number 

or more children, Head Start grant 

recipients have, in general, chosen to 

serve the same or more children and 

have chosen to rely on a missioncommitted workforce—largely women 

of color—to bear the cost of this 

decision. In the fall of 2022, ACF 

published an information memorandum 

(IM) encouraging programs to consider 

restructuring their programs, including 

reducing the number of children served 

if needed, in order to permanently 

increase staff compensation. Since the 

release of this IM, many programs have 

responded to this guidance and taken 

initial steps to improve wages; however, 

despite this, compensation for Head 

Start staff still falls far below that in the 

public education sector. It is clear that 

regulatory action is needed in order to 

provide Head Start staff with 

appropriate compensation and stabilize 

the program long-term. 

The proposed changes to workforce 

supports will provide clarity to Head 

Start grant recipients that, in the 

absence of additional appropriations, 

slot loss is an acceptable tradeoff in 

order to improve staff compensation and 

other supports. Without required 

compensation targets at the Federal 

level, severe inequities in the pay of 

these workers will likely persist. This 

fact jeopardizes the ability of Head Start 

programs to provide high-quality 

services and promote strong outcomes 

for children and results in classrooms 

being closed due to staffing shortages.45

In other words, failure to address the 

current severe inequities in pay would 

likely also have a negative impact on the 

number of children served due to 

ongoing and worsening staffing 

shortages. The proposed regulations in 

this area will promote consistent 

expectations in staff pay and once 

implemented, will substantially 

increase the ability of programs to 

recruit and retain qualified staff. 

Even at the expense of serving more 

children in the absence of additional 

appropriations, these changes are 

necessary for Head Start programs to 

enable the children that are served to 

reach their full potential and attain 

school readiness. A stable, wellqualified workforce is fundamental to 

providing high-quality Head Start 

services to children and families. 

We recognize there will be costs 

associated with enacting the proposed 

standards at current Head Start funded 

enrollment levels, however, we note 

that the number of children currently 

served in Head Start is well below the 

funded enrollment level, primarily due 

to closed classrooms because programs 

cannot find qualified staff. While 

programs may need to reduce their 

funded slots to better reflect their 

enrollment levels, we expect that many 

programs will be able to redirect 

portions of their budget to wage 

increases and other requirements. As 

described in this section, we propose a 

7-year ramp-up for the full 

implementation of the new wage 

requirements. This will allow ample 

time for programs to prepare for 

implementation. Due to the long 

implementation timeline, reductions in 

the number of children served would 

not be realized immediately or soon 

after the effective date of a final rule and 

would only occur in future years in the 

absence of additional funding. We 

understand funded slot loss is a difficult 

trade-off to consider, but a number of 

programs are already requesting and 

enacting slot reductions due to closed 

classrooms that are a result of staffing 

challenges, and programs are often 

proposing to reinvest these cost savings 

into better wage and other supports for 

staff. The current staffing challenges and 

inequities that Head Start is facing make 

it imperative to act now to establish 

these requirements that are critical to set 

the Head Start program on the pathway 

to stabilizing their workforce that can 

allow for continued high quality 

operations of this program. 

The following four sections go into 

more detail on the proposed standards 

to establish this pathway which include 

requirements for: (1) progress to pay 

parity for Head Start education staff 

with elementary school education staff 

(§ 1302.90(e)(2); (2) pay scale for all staff 

(§ 1302.90(e)(1)); (3) minimum pay 

standard § 1302.90(e)(3); and (4) wage 

comparability across Head Start 

Preschool and Early Head Start 

§ 1302.90(e)(4). 

Progress To Pay Parity for Head Start 

Education Staff With Elementary School 

Education Staff 

We intentionally begin with a 

discussion of the proposed standards in 

new paragraph § 1302.90(e)(2), Progress 

to pay parity for education staff with 

elementary school staff, as the rationale 

for these standards sets the foundation 

for the rest of the proposed wage 

standards. This set of proposed 

standards requires programs to make 

progress towards achieving pay parity 

for Head Start education staff with 

kindergarten through third grade 

teachers by providing these staff with 

wages that are at least comparable to 

those paid to public school preschool 

teachers. These proposed standards 

require programs to take into account 

staff responsibilities, qualifications, and 

experience when determining these 

wages. In the context of these standards, 

Head Start education staff refers to those 

staff who work directly with children as 

part of their daily job responsibilities, 

including lead teachers, assistant 

teachers, home visitors and family child 

care providers. There is a body of 

research evidence to indicate that 

increasing compensation can help with 

retention of ECE teachers. Studies of the 

broader ECE field indicate strategies to 

improve compensation for ECE 

professionals can improve employment 

stability for teachers and reduce 

turnover (and vice versa, with lower 

wages linked to higher turnover).46 For 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80826 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

Assistance, Regional Educational Laboratory 

Northeast & Islands. 

47Bassok et al. (2021). 

48Whitebook, M., Howes, C., & Phillips, D. 

(2014). Worthy Work, STILL Unlivable Wages: The 

Early Childhood Workforce 25 Years after the 

National Child Care Staffing Study. Center for the 

Study of Child Care Employment. https://

cscce.berkeley.edu/wp-content/uploads/ 

publications/ReportFINAL.pdf.; Whitebook, M., 

Sakai, L., Gerber, E., & Howes, C. (2001). Then & 

Now: Changes in Child Care Staffing, 1994–2000. 

Washington, DC: Center for the Child Care 

Workforce and Institute of Industrial Relations, 

University of California, Berkeley. https://

cscce.berkeley.edu/wp-content/uploads/ 

publications/Then-and-Now.pdf. 

49Retrieved from: https://sfdec.org/mayor-breedannounces-landmark-pay-raise-initiative-for-earlyeducators-in-city-funded-programs/. 

50Early Educator Equitable Compensation Task 

Force. (March 2022). Final Report of the Early 

Educator Equitable Compensation Task Force. 

Washington, DC. Retrieved from: https://

lims.dccouncil.gov/downloads/LIMS/49122/ 

Introduction/RC24-0154-Introduction.pdf. 

51New Mexico Early Childhood Education and 

Care Department. (2021). Child Care Workers in 

New Mexico Eligible for $1,500 Incentive Payments. 

https://www.nmececd.org/2021/11/01/child-careworkers-in-new-mexico-eligible-for-1500-incentivepayments/. 

52New Mexico Early Childhood Education and 

Care Department. (2022) Gov. Lujan Grisham 

announces historic pay increase for early childhood 

workforce. https://www.nmececd.org/2022/10/11/ 

gov-lujan-grisham-announces-historic-pay-increasefor-early-childhood-workforce/. 

53American Academy of Pediatrics. (2023). Early 

childhood. https://www.aap.org/en/patient-care/ 

early-childhood/; Hyson, M., & Tomlinson, H.B. 

(2014). The early years matter: Education, care, and 

the well-being of children, birth to 8. Washington, 

DC: National Association for the Education of 

Young Children and Teachers College Press. 

54 Institute of Medicine (IOM) and National 

Research Council (NRC). 2015. Transforming the 

workforce for children birth through age 8: A 

unifying foundation. Washington, DC: The National 

Academies Press. 

55Source: Head Start 2022 PIR. 

56U.S. Bureau of Labor Statistics. Occupational 

Employment and Wages. May 2022. 25–2012 

Kindergarten Teachers, Except Special Education. 

https://www.bls.gov/oes/current/oes252012.htm; 

U.S. Bureau of Labor Statistics. Occupational 

Employment and Wages. May 2022. 25–2011 

Preschool Teachers, Except Special Education. 

https://www.bls.gov/oes/current/oes252011.htm. 

57Source: Head Start 2022 PIR. 

instance, a recent randomized 

controlled trial study in Virginia found 

that financial incentives (i.e., bonuses) 

for early educators of up to $1,500 

reduced teacher turnover by 11 

percentage points, with even stronger 

impacts for educators with the lowest 

levels of compensation.47 Other 

research demonstrates that programs 

that have better compensated staff also 

have lower turnover and provide higher 

quality services to children.48

Several states, cities, and localities are 

implementing targeted efforts to 

strengthen wages for early educators. 

For instance, San Francisco is newly 

investing up to $60 million annually to 

significantly raise wages for educators 

in eligible ECE programs in the city. The 

investment will raise annual salaries by 

anywhere from $8,000 to $30,000 and 

by 2025, the city aims to ensure all early 

educators in eligible programs are 

earning at least $28 per hour.49 Further, 

through the formation of the Early 

Childhood Educator Equitable 

Compensation Task Force, the District 

of Columbia recently developed a pay 

scale for all early educators in DC that 

will promote pay parity for early 

educators with elementary teachers, 

with gradations within the pay scaled 

based on job role, credentials, and 

experience.50 Additionally, New Mexico 

created two programs to support the 

early childhood workforce. In 2021, 

New Mexico created a $1,500 incentive 

payment plan in recognition of 

pandemic recovery efforts.51 Later, in 

2022, New Mexico began a new 

initiative where child care providers are 

able to apply for funding to increase 

their staff wages $3 per hour for all staff, 

and raise the wage floor to $15 per hour 

for new teachers and $20 per hour for 

lead teachers.52

There are four provisions to the 

proposed § 1302.90(e)(2). We begin with 

a proposed standard, § 1302.90(e)(2)(i) 

that requires programs to make progress 

towards pay parity for Head Start and 

Early Head Start teachers with 

kindergarten through 3rd grade teachers 

by providing wages that are at least 

comparable with preschool teachers in 

the local public schools. The proposed 

standard requires a program to make 

measurable progress towards pay parity 

for Head Start teachers with 

kindergarten through third grade 

teachers. To demonstrate progress to 

pay parity, by August 1, 2031, a program 

must ensure each Head Start teacher 

receives an annual salary that is at least 

comparable to the annual salary paid to 

preschool teachers in public school 

settings in the program’s local or 

neighboring school district, adjusted for 

responsibilities, qualifications, and 

experience. A program may provide 

annual salaries comparable to a 

neighboring school district if the 

salaries are higher than a program’s 

local school district. We recognize there 

are many nuances to this proposed 

standard, and we further explain our 

intent in the following paragraphs. 

First, the standard states that a 

program must make measurable 

progress towards pay parity for Head 

Start teachers with kindergarten through 

3rd grade teachers. Teachers in these 

elementary grades perform similar 

duties and have similar responsibilities 

in supporting young children’s learning 

and development—in other words, they 

provide similar services—as teachers in 

Head Start programs. It is widely 

understood in the fields of child 

development and education that the 

‘early childhood’ developmental stage 

encompasses birth through age 8.53

Indeed, a recent well-regarded report 

from the Institute of Medicine and 

National Research Council provides a 

framework and foundation for 

supporting the workforce that educates 

and works with children from birth 

through age 8.54 The report emphasizes 

that this developmental time period 

should be supported holistically by 

supporting the diverse workforce that 

works with this age group across 

sectors. Typically, children are 8 years 

old when they enter 3rd grade, which 

aligns with our reference point in the 

proposed standard for programs to make 

progress towards pay parity for Head 

Start teachers with public school 

teachers through 3rd grade. 

Despite the similar roles and 

responsibilities of Head Start teachers 

and elementary teachers both working 

with children in early childhood, these 

educators have stark differences in 

average pay. For instance, in 2022 

average pay was approximately: $39,096 

for Head Start Preschool teachers and 

$32,373 for Early Head Start teachers,55

as compared to $53,200 for preschool 

teachers in school-based settings and 

$65,120 for public school kindergarten 

teachers.56

This represents alarming pay gaps for 

Head Start Preschool teachers and Early 

Head Start teachers compared to both 

kindergarten teachers and school-based 

preschool teachers. Furthermore, as 

discussed previously, many Head Start 

teachers are highly skilled and 

credentialed; 71 percent of Head Start 

Preschool teachers and 23 percent of 

Early Head Start teachers have at least 

a bachelor’s degree. Further, 94 percent 

of Head Start Preschool teachers and 45 

percent of Early Head Start teachers 

have at least an associate degree.57 Head 

Start programs often report that they 

compete with public schools to retain 

teachers, particularly those with 

bachelor’s degrees, as they are well 

qualified to work in elementary school 

settings. In fact, Head Start programs in 

multiple school districts across the 

country have anecdotally reported to 

ACF that public schools are 

intentionally recruiting their most 

qualified Head Start teachers. Therefore, 

the first part of this standard sets the 

goal of making progress toward pay 

parity for Head Start educators with 

elementary school educators by 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80827 

58U.S. Bureau of Labor Statistics. Occupational 

Employment and Wages. May 2022. 25–2011 

Preschool Teachers, Except Special Education. 

https://www.bls.gov/oes/current/oes252011.htm. 

59Source: Head Start 2022 PIR. 

60This analysis uses BLS average annual salaries 

as wage targets. However, since the BLS national 

average for kindergarten teacher salaries ($65,120) 

includes all kindergarten teachers, of which 

approximately half have a master’s degree or higher, 

adjust this annual salary to reflect the target salary 

for a teacher with a bachelor’s degree ($58,608) 

guided by salary differences observed in National 

Center for Education Statistics data (https://

nces.ed.gov/surveys/ntps/). The BLS reported 

annual salary for preschool teacher in school 

settings ($53,200) is therefore approximately 90% of 

the annual salary for kindergarten teachers with a 

bachelor’s degree ($58,608). 

61 Garcia, E., & Weiss, E. (2019). Low relative pay 

and high incidence of moonlighting play a role in 

the teacher shortage, particularly in high-poverty 

schools. The third report in ‘The Perfect Storm in 

the Teacher Labor Market’ series. Washington, DC: 

Economic Policy Institute. 

62https://cscce.berkeley.edu/workforce-index2020/state-policies-to-improve-early-childhoodeducator-jobs/early-childhood-educator-workforcepolicies/compensation-financial-relief/. 

63 Kini, T. & Podolsky, A. (2016). Does Teaching 

Experience Increase Teacher Effectiveness? A 

Review of the Research. Palo Alto: Learning Policy 

Institute. Retrieved from: https://learningpolicy

institute.org/product/does-teaching-experienceincrease-teacher-effectiveness-review-research. 

narrowing the pay gap between these 

groups. The proposed standard also 

requires ‘‘measurable progress’’ towards 

pay parity, which is discussed further 

below in the context of proposed 

§ 1302.90(e)(2)(iv). Finally, this 

language also aligns with section 653(a) 

of the Act, which requires that program 

staff are not paid in excess of the 

average rate of compensation in the area 

where the program is carried out to a 

substantial number of persons providing 

comparable services. 

Next, assuming publication of a final 

rule in 2024, this standard provides 

approximately a 7-year implementation 

window for programs to meet this 

requirement by August 2031, aligning 

with the approximate start of a new 

program year. We believe this 7-year 

window is necessary to allow programs 

sufficient time to thoughtfully plan and 

prepare for implementation of this 

standard, without impacting currently 

enrolled students. We recognize it will 

require significant effort on the part of 

programs to establish and revise their 

pay structures to align with these 

proposed requirements (and a 

requirement to establish or update an 

overall pay structure is discussed 

further in the next section). The 7-year 

implementation timeline also creates an 

opportunity for future potential 

Congressional investment in Head Start. 

However, we recognize that there are 

a range of possible options regarding the 

effective dates for the proposed 

standards to improve staff wages. We 

request public comment on our 

proposed effective date for this standard 

for progress to pay parity for Head Start 

teachers. 

Next, the proposed standard 

(§ 1302.90(e)(2)(i)) clarifies that 

programs must demonstrate they are 

making progress to pay parity by 

ensuring that the salary paid to Head 

Start Preschool and Early Head Start 

teachers is at least comparable to the 

salary paid to preschool teachers in 

public school settings. The goal of this 

phrasing is to clarify that, in order to 

demonstrate sufficient progress on pay 

parity for Head Start teachers with 

kindergarten through third grade 

teachers, programs must ensure Head 

Start teachers receive wages that are, on 

average, comparable with those paid to 

preschool teachers in elementary and 

secondary schools, who are educating 

young children. This standard serves as 

a progress marker towards ultimately 

achieving full pay parity for Head Start 

teachers with kindergarten through 

third grade teachers. As noted 

previously, preschool teachers in 

school-based settings earn an average 

annual salary of $53,200,58 which is 

$14,000 more than the average salary of 

$39,096 for Head Start Preschool 

teachers and nearly $21,000 more than 

the average salary of $32,373 for Early 

Head Start teachers.59

The target comparison of preschool 

teachers in public school settings is 

intended to represent substantial 

progress towards parity with K-third 

grade public school elementary 

teachers. Specifically, we intend the 

benchmark of preschool teacher annual 

salaries in public school settings to 

represent about 90% of the amount of 

kindergarten teacher annual salaries, for 

those with comparable qualifications.60

Achieving wages for Head start teachers 

that are at least comparable to salaries 

for preschool teachers in school-based 

settings will provide a significant boost 

in wages for this well-qualified but 

underpaid workforce. 

Next, the proposed standard, 

§ 1302.90(e)(2)(i), states that wages for 

Head Start teachers should be 

comparable to preschool teachers in 

school-based settings in the program’s 

local school district. However, research 

indicates that teachers in public schools 

that serve a high proportion of children 

living in poverty are paid significantly 

lower on average compared to teachers 

in low-poverty schools.61 To avoid 

unintentionally suppressing wage 

growth of Head Start teachers by 

requiring a comparison to public school 

teachers in only one school district, who 

may be underpaid, we include an 

additional sentence in § 1302.90(e)(2)(i) 

that allows a program to provide annual 

salaries comparable to a neighboring 

school district if the salaries are higher 

than a program’s local school district. 

This sentence intentionally allows a 

Head Start program the flexibility to 

consider salaries of preschool teachers 

in public schools across multiple school 

districts in their geographic area when 

determining what benchmark to use for 

teacher salaries, if those school districts 

offer higher salaries. We recognize some 

programs may be located in geographic 

areas where there is not a sufficient 

number of preschool teachers in public 

schools in their local or neighboring 

school district to benchmark to, in terms 

of comparable wages. Below, we discuss 

proposed § 1302.90(e)(2)(iii) that 

describes what programs should do in 

these instances, to develop an 

appropriate wage comparison. We 

request comment on any barriers that 

Head Start programs may face in 

identifying a comparable population of 

school-based preschool teachers for the 

purposes of benchmarking wages and 

whether the options described below for 

an alternative method to benchmark to 

preschool wages are sufficient to 

overcome any potential challenges. We 

also request comment on whether the 

benchmark of annual salaries paid to 

public school preschool teachers is an 

accurate reflection of approximately 

90% of annual salaries paid to 

kindergarten teachers with comparable 

qualifications. 

Finally, the proposed standard, 

§ 1302.90(e)(2)(i), requires a program to 

consider responsibilities, qualifications, 

and experience of the teachers when 

determining salaries. This aligns with 

recommendations from ECE research 

experts, which suggest that wages for 

the ECE workforce should be reflective 

of job role, experience, and education.62

This portion of the proposed standard 

acknowledges that responsibilities and 

expectations of a job position should be 

a key factor in determining wages. In 

general, an individual in a given 

position with a more advanced degree 

or credential should be compensated 

more than an individual in the same 

position with a lower degree or 

credential, all other factors being equal. 

However, degrees or credentials are not 

the only important factor to consider 

when determining salaries. Experience 

is also key, particularly in the field of 

ECE where many teachers have years of 

experience, but may have never attained 

a bachelor’s degree, for instance.63

Further, research indicates that degrees 

are not the only thing that matters for 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80828 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

64 Kini, T. & Podolsky, A. (2016). Does Teaching 

Experience Increase Teacher Effectiveness? A 

Review of the Research. Palo Alto: Learning Policy 

Institute. Retrieved from: https://learningpolicy

institute.org/product/does-teaching-experienceincrease-teacher-effectiveness-review-research; 

Yoshikawa, H., Weiland, C., Brooks-Gunn, J., 

Burchinal, M., Espinosa, L., Gormley, W.T., 

Ludwig, J., Magnuson, K., Phillips, D., & Zaslow, M. 

(October, 2013). Investing in our future: The 

evidence base on preschool. Society for Research in 

Child Development. 

65Source: Head Start 2022 PIR. 

66Source: Head Start 2019 PIR; this was the last 

year of PIR that collected data on the number of 

home visitors with a bachelor’s degree. 

67Source: Head Start 2022 PIR. 

determining teaching quality in ECE; 

experience and other supports such as 

professional development, coaching, 

and training, are also critically 

important for high quality teaching.64

Therefore, the proposed standard 

elevates the importance of considering 

an individual’s experience when 

establishing wages, in addition to 

qualifications. 

We recognize that qualifications and 

experience intersect in complex ways 

when determining wages. For instance, 

we would expect that a teacher with a 

bachelors who is new to the ECE field 

would likely earn a higher wage than a 

teacher with an associate degree who is 

also new to the field. However, we 

would expect that a teacher with an 

associate degree and many years of 

experience in ECE may likely earn a 

higher wage than a teacher with a 

bachelor’s degree who is brand new to 

the field. This is consistent with section 

653 of the Act which encourages 

programs to consider experience when 

determining salaries. The phrasing of 

the proposed requirement provides 

flexibility to programs to determine how 

they consider responsibilities, 

qualifications and experience when 

determining salaries. Our goal here is to 

provide programs with flexibility to 

determine wages that make the most 

sense for their program structure, while 

also balancing experience and 

qualifications. 

Next, we turn to the second provision 

of § 1302.90(e)(2). Here we propose a 

new standard in § 1302.90(e)(2)(ii) that 

provides a deadline of August 1, 2031, 

for programs to make measurable 

progress towards pay parity for all other 

education staff who work directly with 

children as part of their daily job 

responsibilities. To demonstrate this, a 

program must provide these staff an 

annual salary that is at least comparable 

to salaries for Head Start teachers as 

described above, but adjusted for role, 

responsibilities, qualifications, and 

experience. This proposed standard is 

intended to apply to education staff 

other than lead teachers whose primary 

job is to work in classrooms or homes 

with children, including assistant 

teachers, home visitors, and family 

child care providers. Once 

implemented, this standard would 

significantly raise wages for these 

positions. We request public comment 

on whether there are other education 

staff positions besides these who work 

regularly with children to whom this 

standard should apply. 

To align with the prior standard on 

progress to pay parity that applies to 

Head Start teachers, this standard will 

also go into effect in August of 2031, 

approximately 7 years after publication 

of the final rule. We request public 

comment on our proposed effective date 

for this standard for progressing towards 

pay parity for Head Start education staff. 

The average salaries for these 

education staff are far below what they 

could earn with other employers and do 

not reflect the qualifications they hold 

or the important work they do. In 2022, 

average salaries for these education staff 

were as follows: $25,570 for assistant 

teachers; $38,510 for home visitors; and 

$40,902 for family child care 

providers.65 Meanwhile, 52 percent of 

home visitors have a bachelor’s 

degree,66 and 88 percent of assistant 

teachers have at least a Child 

Development Associate (CDA) or 

comparable credential.67 These 

education staff provide critical services 

in classroom- and home-based settings 

in Head Start programs. 

Similar to lead teachers, without 

qualified staff in these positions, the 

quality and availability of classroomand home-based services are impacted, 

which in turn negatively impacts 

outcomes for children. Home-based 

services in particular—through home 

visiting or family child care—are 

provided to a large share of infants and 

toddlers in Early Head Start. In 

addition, assistant teachers play critical 

roles in Head Start Preschool classrooms 

to support children’s learning and 

development alongside lead teachers. 

As previously noted, all classroom staff, 

regardless of position, build strong 

relationships with children that are 

crucial to healthy child development 

and can be damaging when disrupted. 

Retaining assistant teachers is as 

beneficial to the program—and to the 

children enrolled—as retaining lead 

teachers. Further, promoting stronger 

wages for assistant teachers can help 

support career pathways so that they 

eventually may become lead teachers or 

take on other positions in programs. 

Therefore, in the context of these 

proposed standards, we expect that 

education staff with less experience or 

qualifications will still receive 

significant compensation increases, and 

that these increases will be reflective of 

the important jobs they perform. 

The phrasing of proposed standard 

§ 1302.90(e)(2)(ii) requires that a 

program provide an annual salary to 

these other education staff positions that 

is comparable to salaries described in 

the prior provision in proposed 

paragraph (e)(2)(i), but is adjusted for 

role, responsibilities, qualifications, and 

experience. As summarized previously, 

the intention of this phrasing is to 

acknowledge that education staff in 

different positions, with different 

qualifications, and/or with different 

experience may receive different levels 

of compensation, relative to lead 

teachers. However, it is our intention 

that salaries for these other education 

positions with varying qualifications 

and experience are not simply 

compared to and set at the same level 

as salaries for other potentially lower 

paid staff in school-based settings, such 

as teacher aides or paraprofessionals. 

Rather, salaries for Head Start teachers 

established under proposed 

§ 1302.90(e)(2)(i) should serve as an 

anchor for salaries for other education 

staff captured by the standard proposed 

in (e)(2)(ii). This is best described with 

a few concrete examples. 

For instance, a home visitor and a 

lead teacher could reasonably be 

considered to hold similar important 

responsibilities within the context of the 

Head Start program; both play a primary 

role in supporting the development of 

enrolled children. Therefore, if a home 

visitor holds a bachelor’s degree and 

similar experience as a lead teacher 

with a bachelor’s degree, the program 

should consider compensating this 

home visitor at a similar level as a lead 

teacher. However, if a home visitor 

holds an associate degree and a few 

years of experience, the program could 

reasonably compensate the home visitor 

at an amount below an experienced 

teacher with a bachelor’s degree, with 

an expectation of salary growth as the 

home visitor gains experience. As 

another example, an assistant teacher 

and a lead teacher could be reasonably 

considered to hold different levels of 

responsibilities within the Head Start 

classroom. Therefore, a program could 

reasonably choose to compensate an 

assistant teacher with an associate 

degree below that for a lead teacher with 

an associate degree. 

Taken together, we do expect that 

wages will vary for education staff 

across the complex intersections of role, 

responsibilities, qualifications, and 

experience. However, it is also our 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80829 

68Early Educator Equitable Compensation Task 

Force. (March 2022). Final Report of the Early 

Educator Equitable Compensation Task Force. 

Washington, DC. Retrieved from: https://

lims.dccouncil.gov/downloads/LIMS/49122/ 

Introduction/RC24-0154-Introduction.pdf. 

69https://cscce.berkeley.edu/workforce-index2020/state-policies-to-improve-early-childhoodeducator-jobs/early-childhood-educator-workforcepolicies/compensation-financial-relief/. 

70CityHealth & NIEER (n.d.); McLean, C., Dichter, 

H., & Whitebook, M. (2017). Strategies in Pursuit of 

Pre-K Teacher Compensation Parity: Lessons From 

Seven States and Cities. Berkeley, CA: Center for 

the Study of Child Care Employment, University of 

California, Berkeley and New Brunswick, NJ: the 

National Institute for Early Education Research. 

Retrieved from https://cscce.berkeley.edu/wpcontent/uploads/publications/Strategies-in-Pursuitof-Pre-K.pdf. 

intention that programs ensure wage 

scales are not drastically different 

between education staff positions based 

solely on degrees or credentials held, 

particularly for positions that have the 

same or similar responsibilities in the 

program. Programs must also consider 

experience when determining pay for 

education staff. 

Next, we propose a new standard 

§ 1302.90(e)(2)(iii) that provides an 

allowance for programs to use an 

alternative method for determining the 

comparable preschool salaries in 

specific circumstances. More 

specifically, if there is not a sufficient 

number of comparable public school 

preschool teachers in the program’s 

local or neighboring school district, this 

proposed standard allows a program to 

use an alternative method to implement 

the requirements in clause (i) and (ii) of 

§ 1302.90(e)(2) to determine appropriate 

comparison salaries. The alternative 

method must be approved by ACF. This 

standard acknowledges that some 

programs are located in areas which do 

not have, or have a small number of, 

preschool teachers in school-based 

settings in local or neighboring school 

districts. In these cases, we recognize 

that it may not be possible to obtain a 

reliable estimate of comparison salaries. 

Programs are still required to make 

measurable progress toward pay parity 

in such circumstances, but this standard 

allows for an alternative approach to 

anchor comparison salaries. The 

proposed standard would require 

programs to use an alternative method 

for determining comparison salaries, 

and this method must be approved by 

ACF. For instance, this could include 

using salaries from preschool teachers 

in school-based settings in a 

geographically and/or 

socioeconomically similar area. Or 

programs may consider increasing 

salaries to a specified percentage of 

kindergarten to third grade teacher 

salaries in the local school district. ACF 

may provide guidance on pre-approved 

alternative methods to facilitate 

implementation of this standard where 

applicable. We request comment on 

what type of guidance or technical 

assistance Head Start programs need to 

develop an alternative method in areas 

without school-based preschool teachers 

in local school districts. 

Finally, as referenced previously, ACF 

expects that programs will make 

measurable progress towards pay parity 

for Head Start education staff with 

kindergarten to third grade teachers. 

The fourth and final provision of 

§ 1302.90(e)(2) proposes a new standard 

that requires programs to examine their 

progress to pay parity by regularly 

tracking data on how wages paid to their 

education staff compare to wages paid 

to preschool through third grade 

teachers in their local or neighboring 

school district. The intention of this 

standard is for programs to regularly 

track and examine pay gaps between 

Head Start education staff and teachers 

in comparable settings. The comparison 

to preschool teachers serves as a way to 

track in alignment with the proposed 

standards on progress to pay parity as 

described above. Programs should 

capitalize on existing data sources to 

implement this requirement to track 

wage data. Many, if not all, programs 

have internal data which they can 

leverage to track wages paid to their 

education staff. Additionally, to track 

wages for preschool through third grade 

teachers in the local or neighboring 

school district, programs can leverage 

publicly available information from 

these settings. Programs may already 

have methods for obtaining this 

information as part of their wage 

comparability surveys, or through 

existing partnerships with local 

education agencies and local schoolbased preschool programs. Regular 

tracking would ideally occur on an 

annual basis at minimum so that 

programs are aware of their progress, or 

lack thereof, in closing pay gaps and can 

make necessary adjustments. 

Pay Scale for All Staff 

Here we discuss the proposed changes 

to the new § 1302.90(e)(1), Pay scale. 

There has been growing interest in the 

field to implement wage ladders or pay 

scales that promote more competitive 

wages for the ECE workforce. As 

summarized previously, the District of 

Columbia (DC) recently developed a pay 

scale for all early educators in DC that 

will promote pay parity for early 

educators with elementary teachers, 

with gradations within the pay scaled 

based on job role, credentials, and 

experience.68 Alabama and a handful of 

other states have pushed forward to 

require pay parity for staff across all 

preschool programs in the State with K– 

3 elementary staff, including the same 

starting salary and salary schedule.69 A 

few cities, such as New York City and 

San Antonio, have also pushed forward 

with policies for pay parity for 

preschool staff with elementary staff.70

We propose three provisions to 

§ 1302.90(e)(1) to describe requirements 

for pay scales in Head Start programs. 

In the first provision, 

§ 1302.90(e)(1)(i), we propose a new 

requirement that, by August 1, 2031, 

programs must implement a pay scale, 

salary scale, wage ladder, or other pay 

structure that applies to all staff in the 

program. This pay structure must 

incorporate the requirements in 

paragraphs (2), (3), and (4) of 

§ 1302.90(e) and promote salaries that 

are comparable to similar services in 

relevant industries in their geographic 

area. The pay structure must consider, 

at a minimum, responsibilities, 

qualifications, and experience relevant 

to the position, and schedule or hours 

worked. The intention of this standard 

is to ensure a program’s pay structure 

promotes competitive wages for all staff 

in the program, in addition to education 

staff. The proposed § 1302.90(e)(1)(i) 

contains many components; we explain 

each here in further detail. 

First, we intentionally structured this 

standard with the same implementation 

timeline—August 1, 2031—as the 

proposed standards for progress to pay 

parity for education staff, 

§ 1302.90(e)(2), that were described 

previously. We recognize it is critical for 

program planning and implementation 

purposes for these standards to go into 

effect within the same timeframe. We 

request public comment on our 

proposed effective date for this 

standard. 

Next, we specify that a program must 

develop or update a pay structure for 

program staff salaries. Since ACF 

believes the majority of programs 

already have a pay structure of some 

kind in place for employees, such as a 

pay scale, salary schedule, or wage 

ladder. In cases where a program does 

not have a pay structure in place, a 

program must establish one under this 

proposed requirement. 

For the majority of programs that 

already have an established pay 

structure, they must update it to reflect 

the requirements of the proposed 

§ 1302.90(e)(1)(i). Next, we specify that 

the program’s pay structure must 

incorporate the requirements in newly 

proposed § 1302.90(e)(2), (e)(3), and 

(e)(4), as well as wages for all other staff 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80830 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

71See for instance this resource on salary/wage 

scales for the ECE workforce: https://www.teachec

nationalcenter.org/wp-content/uploads/2021/11/ 

CCSA_2021_Salary-Scale-White-Paper-FINAL.pdf. 

in the program. As summarized 

previously, proposed § 1302.90(e)(2) 

outlines wage requirements for Head 

Start teachers and other education staff. 

Newly proposed paragraphs (e)(3) and 

(e)(4) are discussed in further detail in 

subsequent sections and encompass 

requirements for a pay floor and for 

wage comparability across Head Start 

Preschool and Early Head Start staff 

positions. 

The proposed § 1302.90(e)(1)(i) 

specifies that the program’s pay 

structure must promote salaries that are 

comparable to similar services in 

relevant industries. This phrasing is the 

main thrust of this proposed 

requirement. Overall, we intend for this 

standard to improve wages for a variety 

of staff positions in the program, in 

addition to improved wages for 

education staff specified in 

§ 1302.90(e)(2). As discussed 

previously, education staff are not the 

only positions for which programs are 

struggling to recruit and retain staff. 

Programs report difficulty filling other 

positions including family services staff, 

bus drivers, janitors, cooks, mid-level 

managers, and center directors. While 

not all these staff necessarily leave Head 

Start due to low wages, many do. It is 

critical to retain high-quality staff across 

these positions in order to maintain a 

high functioning program. 

Therefore, ACF expects programs will 

thoroughly consider wages of 

comparable industries to assess whether 

and how wages for various positions in 

their program should be improved. For 

instance, a family services staff member 

who holds a bachelor’s degree in social 

work or another related field could be 

considered to provide comparable 

services to a family outreach or 

engagement specialist in a public school 

setting. If a health services staff member 

holds a nursing degree, this staff 

member could be comparable to a nurse 

with a similar degree providing similar 

services in other healthcare settings. In 

addition, as programs consider how to 

restructure their pay scales to provide 

significantly higher raises for education 

staff as described in § 1302.90(e)(2), we 

expect that wages for most other staff 

positions will need to be lifted as well, 

to avoid the unintended consequence of 

wage compression. 

Finally, in establishing or updating 

their pay scale, proposed 

§ 1302.90(e)(1)(i) requires that a program 

consider responsibilities, qualifications, 

and experience relevant to the position, 

as well as schedule or hours worked. 

We believe these factors are important 

to consider when establishing or 

updating a pay scale, for the same 

reasons as described previously for 

proposed § 1302.90(e)(2). Here we 

specify that the responsibilities, 

qualifications, and experience 

considered when establishing wages 

should be relevant to the position. This 

specification is meant to clarify that a 

program does not necessarily have to 

consider qualifications that are 

irrelevant to a given position, when 

determining wages. For instance, if a 

janitor holds a master’s degree and the 

program determines this position does 

not require a degree, the program does 

not have to compensate that individual 

at a similar rate as other staff members 

in the program who hold master’s 

degrees that are relevant to their job role 

and responsibilities. 

Next, we turn to the second provision 

of § 1302.90(e)(1). Here we propose a 

new paragraph § 1302.90(e)(1)(ii) that 

requires, after August 1, 2031, programs 

to review their pay structure at least 

once every 5 years to ensure it continues 

to provide competitive wages for staff 

reflective of the requirements described 

previously, without causing undue 

burden by requiring it more frequently. 

By requiring this at least once every 5 

years, it is our intention that grant 

recipients can align this review of their 

pay structure with other planning and 

strategic activities as part of their 5-year 

grant cycle, if desired. We request 

public comment on our proposed 

effective date for this standard. 

In the third and final provision of 

§ 1302.90(e)(1), we propose a new 

paragraph that requires programs to 

ensure that staff salaries do not exceed 

the rate payable for level II of the 

Executive Schedule, which aligns with 

42 U.S.C. 9848(b)(1). This provision 

reminds programs of the limitations on 

excessive compensation for the highest 

paid positions and ensures that salaries 

at the highest end of the pay scale are 

compliant with the limits described in 

the Act. 

Finally, we recognize programs may 

need training and technical assistance 

(TTA) support to revise their salary 

scale or pay structure. Materials are 

available that describe key components 

and considerations of a salary scale for 

ECE staff.71 Upon publication of a final 

rule, ACF will also be prepared to offer 

TTA supports to grant recipients. We 

invite public comment on what types of 

TTA supports programs will need to 

successfully implement the standards 

described here. 

Minimum Pay Requirement 

Here we discuss the proposed changes 

to the new § 1302.90(e)(3), Salary floor. 

We propose a new standard in 

§ 1302.90(e)(3) that requires programs to 

establish a salary floor or minimum pay 

that is sufficient to cover basic costs of 

living in the geographic area. This 

standard is intended to ensure that all 

staff in the program earn a wage 

sufficient to cover their basic living 

needs. More specifically, the proposed 

standard requires that, by August 1, 

2031, a program must ensure the pay 

scale established or updated under 

§ 1302.90(e)(1)(i) provides all staff with 

a wage or salary that is generally 

sufficient to cover basic needs such as 

food, housing, utilities, medical costs, 

transportation, and taxes, or would be 

sufficient if the worker’s hourly rate 

were paid according to a full-time, fullyear schedule. It is our intention that 

this standard targets those staff who 

currently receive the lowest wages in 

the program; this requirement will raise 

the pay for these staff. This could 

include aides, floaters, office staff, 

janitors, cooks, bus monitors, or other 

positions. This proposed standard 

contains multiple components each 

explained here in further detail. 

First, the proposed § 1302.90(e)(3) 

specifies the same implementation 

timeline of August 1, 2031, as the other 

proposed wage requirements described 

in this section. We believe this will 

make it easier for programs to consider 

changes in wages holistically across 

these new requirements and provides 

programs ample time to plan for 

implementation. We request public 

comment on our proposed effective date 

for this standard. 

Next, the proposed standard specifies 

that the wage or salary structure 

established or updated under 

§ 1302.90(e)(1)(i) must provide all staff 

with a wage or salary that is generally 

sufficient to cover basic needs. With this 

language, we intend for programs to 

carefully consider costs of living in their 

local geographic area to cover basic 

needs, and what an individual should 

truly be earning to cover all of those 

costs. The language of the proposed 

standard further provides examples of 

basic needs which a full-time staff 

member’s hourly wages or annual salary 

should be able to cover, no matter the 

job they work for the program, including 

food, housing, utilities, medical costs, 

transportation, and taxes. In most 

geographic areas of the country, ACF 

expects that, at a minimum, a sufficient 

wage under this provision would be 

equivalent to $15 per hour. We 

recognize that in some communities or 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80831 

72 Glasmeier, A.K. Living Wage Calculator. 2020. 

Massachusetts Institute of Technology. 

livingwage.mit.edu. 

73The Center for Women’s Welfare. The SelfSufficiency Standard. University of Washington. 

https://selfsufficiencystandard.org/. 

74https://www.huduser.gov/portal/datasets/ 

fmr.html#2023. 

75https://www.fns.usda.gov/cnpp/usda-foodplans-cost-food-reports-monthly-reports. 

76https://www.bls.gov/cex/. 

77https://www.bls.gov/cex/. 

78Source: Head Start 2021 PIR. 

79 Ibid. 

geographic areas, this floor may not be 

sufficient and may need to be adjusted 

to reflect higher costs of living. Further, 

programs would still be required to pay 

higher salaries when required by other 

sections of this NPRM. 

Finally, the proposed § 1302.90(e)(3) 

specifies that the minimum pay or pay 

floor would be sufficient if the workers’ 

hourly rate were paid according to a 

full-time, full-year schedule (or over 

2,080 hours per year). This phrasing of 

the proposed requirement is to 

recognize that not all staff are full-time 

employees of the program, and it allows 

the implementation of this standard for 

staff employed part time. The proposed 

standard is intended to convey that 

programs are not expected to pay wages 

to a part-time employee that, in total, 

would cover all costs of living. Rather, 

this phrasing conveys that the wage 

paid to a part-time employee would be 

sufficient to cover the costs of living if 

that employee worked full time for the 

program. To illustrate, consider an 

example of a program that has 

determined $35,000 per year is the 

appropriate salary floor for their area. It 

is not the expectation that all employees 

of that program earn at least $35,000 per 

year, regardless of how many hours they 

work. Instead, the program should 

calculate the hourly rate associated with 

their salary floor, $35,000 in this 

example, according to a full-time, full 

year schedule. A standard full-time 

employee works 2,080 hours per year 

(i.e., 40 hours per week for 52 weeks per 

year), which in this example 

corresponds to a minimum hourly rate 

of $16.83. As such, in our example, all 

employees of the program must earn at 

least $16.83 per hour. 

We recognize that programs may need 

support or guidance to determine what 

wages are necessary, at the minimum, to 

cover basic costs of living for staff. Upon 

publication of a final rule, ACF will 

provide grant recipients with TTA 

supports in this area. We also 

acknowledge that there are several 

possible ways and existing resources 

available to calculate and determine 

what wage is required to cover basic 

costs of living. We offer a few examples 

here. It is of note that these are 

examples only and should not be 

considered an endorsement by ACF of 

these specific calculators or tools. First, 

there are multiple nationally recognized 

tools or calculators to assist employers 

in making this kind of determination. 

One such tool is the Living Wage 

Calculator developed by experts at the 

Massachusetts Institute of Technology 

(MIT).72 Another is the Self-Sufficiency 

Standard developed by experts at the 

Center for Women’s Welfare of the 

University of Washington.73 These types 

of publicly available calculators take 

into account a variety of costs for basic 

needs and how these costs vary by 

geographic area, to help determine an 

appropriate hourly wage sufficient to 

cover these costs. Some calculators 

provide estimates for different family 

sizes and structures, but it is not the 

intent of the proposed standard to 

require programs to pay a wage 

sufficient to cover basic needs for staff 

that is adjusted by family size or family 

structure. 

Alternatively, programs who wish to 

calculate their own minimum pay 

estimates could consider looking to 

other reliable data sources to determine 

expected costs for different types of 

expenditures for their geographic area, 

such as the following publicly available 

alternatives. Examples of publicly 

available data include, but are not 

limited to: Housing costs could be 

approximated using Fair Market Rent 

estimates published annually by the 

U.S. Department for Housing and Urban 

Development (HUD); 74 Food costs can 

be estimated using the USDA’s food 

plan national average for adult food 

consumption; 75 Health care costs can be 

estimated using estimates from the 

Bureau of Labor Statistics’ (BLS) 

Consumer Expenditures Survey for 

average consumer costs for health 

insurance, medical services, drugs, and 

medical supplies; 76 Transportation 

expenses can also be estimated using 

estimates from BLS Consumer 

Expenditures Survey for average 

consumer costs for cars and trucks, gas 

and oil, other vehicle expenses, and 

public transportation; 77 Expenses for 

taxes can be estimated by calculating 

percentages based on required Federal 

and State taxes. Finally, a program 

could consider if they want to 

incorporate estimates for other 

important costs such as personal care 

products, apparel, basic supplies, 

broadband, and telephone services. 

Wage Comparability Across Head Start 

Preschool and Early Head Start 

Finally, now we turn to the last of the 

proposed changes on wages, new 

paragraph § 1302.90(e)(4), Wage 

comparability for all ages served. Here, 

we propose a new standard that 

promotes wage comparability across 

Head Start Preschool and Early Head 

Start staff positions by requiring that the 

pay structure established or updated 

under § 1302.90(e)(1)(i) does not differ 

by age of children served for similar 

program staff positions with similar 

qualifications and experience. Head 

Start Preschool and Early Head Start 

staff perform similar important roles 

and responsibilities to support the 

development of enrolled infants, 

toddlers, and preschoolers. In classroom 

settings, Early Head Start teachers must 

have at least a CDA credential or 

equivalent credential, with training or 

coursework in infant and toddler 

development (§ 1302.91(e)(1)). Head 

Start Preschool teachers must have at 

least an associate or bachelor’s degree in 

child development or early childhood 

education or otherwise meet the 

requirements of section 648(a)(3)(B) of 

the Act (§ 1302.91(e)(2)(ii)). The Act also 

requires that at least 50 percent of Head 

Start Preschool teachers nationwide 

have a bachelor’s degree. We would 

expect that these differences in 

qualifications would result in different 

salaries or wages. However, a good share 

of Early Head Start teachers also hold a 

bachelors or higher degree (23 percent 

in 2022). Nonetheless, our 

administrative data from Head Start 

programs indicates a stark difference in 

average salaries between Head Start 

Preschool and Early Head Start teachers, 

even among those teachers with similar 

qualifications. 

In 2022, the average Early Head Start 

teacher with a bachelor’s degree earned 

an annual salary of $37,805, compared 

to $40,041 for the average Head Start 

Preschool teacher with a bachelor’s 

degree, a salary gap of just over $2,000 

per year.78 For teachers with advanced 

degrees, the disparity is even greater; in 

2022, these Head Start Preschool 

teachers earned on average 20 percent 

more in annual salary ($51,162) 

compared to Early Head Start teachers 

($42,761), a salary gap of over $8,000.79

This is a substantial gap in average 

salary between professionals holding 

the same qualifications and performing 

similar roles in supporting the learning 

and development of Head Start 

children. These disparities are common 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80832 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

80 Ibid. 

in the field and lead to increased 

turnover.80 Anecdotally, ACF has 

received reports that programs find it 

more difficult to hire Early Head Start 

teachers than Head Start Preschool 

teachers. The proposed § 1302.90(e)(4) 

will help close the wage gap between 

Early Head Start and Head Start 

Preschool teachers with similar degrees 

and promote stronger retention of Early 

Head Start teachers, thereby improving 

quality of services for enrolled infants 

and toddlers. 

Staff for Whom Wage Standards Apply 

Taken together, the new standards for 

wage requirements proposed in this 

NPRM include requirements for (1) 

progress to pay parity for Head Start 

education staff with kindergarten 

through third grade elementary teachers 

by providing wages comparable to 

preschool teachers in school-based 

settings, adjusted for responsibilities, 

qualifications, and experience ; (2) a pay 

scale that applies to all staff and 

promotes competitive wages across 

positions; (3) a minimum pay floor 

sufficient to cover basic costs of living; 

and (4) wage comparability across Head 

Start and Early Head Start positions for 

staff with similar qualifications and 

experience. We recognize that it must be 

clear for programs to which staff these 

newly proposed standards apply. It is 

our intention that these newly proposed 

standards improve wages for staff in the 

program who are either employees or 

contractors and who provide regular 

services for children and families in the 

program that are integral to program 

quality or functioning. 

First, we propose that these standards 

apply to staff who are employees of the 

Head Start program, whose salary is 

paid at least in part with Head Start 

funds, and whose regular job 

responsibilities include activities or 

services to support enrolled children 

and families. We invite public comment 

on this clarification of which staff the 

wages standards apply to, including any 

potential unintended consequences. 

Next, we summarize our expectations 

for how the proposed wage standards 

should apply to contracted staff. 

Contracted staff typically includes 

individuals who are not Head Start 

employees, with whom the program has 

contracted to provide an ongoing service 

(e.g., disabilities specialists and mental 

health professionals, bus drivers, etc.). 

We recognize that many individuals 

who provide critical services for Head 

Start programs do so through contracted 

services. We also recognize that for 

Early Head Start—Child Care 

Partnership grant recipients, many child 

care partners are funded through 

contracts or other mechanisms with the 

grant recipients. In the context of the 

new wage standards, we propose that, 

for contracted staff, language in the 

contract must provide for wages 

comparable to what the recipient 

organization would provide if they were 

the employer. Further, we propose to 

require that programs strongly 

encourage contractors to use the funding 

to increase salaries for their staff. 

We invite public comment on this 

expectation for how the wage standards 

apply to contractors or other partnership 

agreements, including any potential 

unintended consequences. 

Finally, we recognize that these 

proposed standards will have different 

ramifications for implementation within 

certain organizational structures or for 

certain types of agencies. For example, 

grant recipients with employee 

bargaining agreements and those in 

organizations with existing formal 

salary structures that extend beyond just 

Head Start staff, such as in community 

action agencies, may need to engage 

representatives of workers if they need 

to negotiate new collective bargaining 

agreements that increase wages for Head 

Start staff (or for specific groups of Head 

Start staff, such as teachers). We also 

recognize that many Tribal grant 

recipients may have pay structures 

already in place for Tribal employees 

that include staff beyond Head Start. We 

encourage all programs, not solely those 

with collective bargaining agreements, 

to engage Head Start staff as they work 

to meet these new proposed standards, 

both for wages and other proposed 

changes. ACF intends to provide TTA 

supports to understand options and 

strategies for implementing wage 

increases within the context of varied 

organizational structures and agency 

types. 

ACF recognizes that the proposed 

wage requirements are complex, and as 

discussed previously, may be 

experienced differently by different 

communities. We seek public comment 

on how any of the proposed wage 

requirements in this section may impact 

various communities. We specifically 

request public comment from the 

special populations served by Head 

Start, including American Indian and 

Alaska Native (AIAN) and MSHS 

programs and communities. We also 

specifically request comment from Head 

Start staff and their representatives, and 

other early childhood program 

providers. 

Workforce Supports: Staff Benefits 

(§ 1302.90) 

Section 1302.90 outlines requirements 

for personnel policies, including the 

establishment of personnel policies and 

procedures, background check 

procedures, standards of conduct, and 

communication with dual language 

learners. In alignment with the newly 

proposed requirements in § 1302.90(e) 

to improve wages for staff, we also 

propose a new paragraph (f) in this 

section that outlines requirements for 

grant recipients to provide benefits to 

staff. The proposed new standards 

require grant recipients to provide or 

facilitate access to health insurance for 

all staff; paid sick leave, and paid family 

leave for full-time staff; provide shortterm behavioral health services for fulltime staff for free or at minimal cost to 

them; and facilitate access to Public 

Service Loan Forgiveness (PSLF) and 

child care subsidies for eligible staff. We 

are also considering a requirement for 

recipients to provide retirement benefits 

to all full-time staff and we specifically 

request public comment on whether to 

add such a requirement in a final rule. 

This request for comment on a possible 

requirement for retirement benefits is 

discussed in further detail below. In the 

context of these proposed requirements, 

we propose to define ‘‘full-time staff’’ as 

those working 30 hours per week or 

more while the program is in session. 

For programs operating longer than a 

typical school year (e.g., year-round 

programs), we propose a requirement 

that such programs develop a policy for 

vacation or personal leave. Grant 

recipients are encouraged to consider 

and offer other benefits that may 

support staff recruitment and retention. 

First, we propose to add 

§ 1302.90(f)(1) as a lead in statement to 

define full-time staff as it applies to 

several proposed benefit requirements. 

Proposed (f)(1) defines full-time staff as 

those working 30 or more hours per 

week during the program year. Next, we 

propose to add (f)(1)(i) which requires a 

program to provide or facilitate access to 

high-quality, affordable health 

insurance. This proposed standard 

would require grant recipients to either: 

(1) provide and contribute to employersponsored health insurance coverage, or 

(2) educate, connect, and facilitate the 

enrollment of employees in health 

insurance options in the Healthcare.gov 

Marketplace (Marketplace), the 

appropriate State-specific health 

insurance marketplace, or Medicaid, for 

full-time staff. Employees are not 

obligated to accept employer-provided 

or employer-facilitated health 

insurance, such as those receiving 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80833 

81See the healthcare.gov website for a description 

of Marketplace plans and actuarial value: https://

www.healthcare.gov/choose-a-plan/planscategories/. 

82See the Internal Revenue Service (IRS) website 

for more information on minimum value and 

affordability: https://www.irs.gov/affordable-careact/employers/minimum-value-and-affordability. 

83See healthcare.gov for a list of essential health 

benefits: https://www.healthcare.gov/glossary/ 

essential-health-benefits/. 

84See the IRS website for more information on 

the employer shared responsibility provisions: 

https://www.irs.gov/affordable-care-act/employers/ 

employer-shared-responsibility-provisions. 

85See the healthcare.gov website for a description 

of premium tax credits and eligibility: https://

www.healthcare.gov/lower-costs/save-on-monthlypremiums/. 

86Bureau of Labor Statistics (BLS). (2022). 

Employee Benefits in the United States, March 

2022. https://www.bls.gov/news.release/pdf/ 

ebs2.pdf. 

87Rudich, J., Sugar, S., Chien, N., Peters, C., & 

Sommers, B. (2021, November). Assessing 

uninsured rates in early care and education 

workers. Office of the Assistant Secretary for 

Planning and Evaluation, U.S. Department of Health 

and Human Services. https://www.aspe.hhs.gov/ 

sites/default/files/documents/ 

557aff156a2eac8dd50b489172c7eac6/earlyeducators-uninsured-data-point.pdf?_

ga=2.163634812.2117647616.1661871770- 

774747381.1611252684. 

88Rudich et al. (2021). 

89See https://www.federalregister.gov/ 

documents/2014/02/12/2014-03082/sharedresponsibility-for-employers-regarding-healthcoverage. 

90See https://www.cms.gov/blog/inflationreduction-act-tax-credits-improve-coverageaffordability-middle-income-americans#_ftnref6/. 

insurance coverage through a spouse or 

another manner. Through input from 

OHS regional office staff and members 

of the Head Start community, we are 

aware that, while many Head Start staff 

are already offered employer-sponsored 

health coverage, this coverage may still 

entail considerable out-of-pocket costs 

for staff. Thus, if grant recipients choose 

to offer employer-sponsored coverage, 

we encourage employers to provide an 

insurance plan that offers coverage 

similar to that offered by silver, gold, or 

platinum plans in the Marketplace.81

Definitions of affordable coverage, 

minimum value,82 and minimum 

essential health benefits 83 are 

determined by the Affordable Care Act 

(ACA), and large Head Start grant 

recipients are already subject to the 

employer shared responsibility 

provisions in the ACA.84 Premium tax 

credits 85 subsidize the cost of health 

insurance coverage in the Marketplace 

and are available to individuals in 

households with incomes up to 400 

percent of the Federal Poverty 

Guidelines. We anticipate most Head 

Start staff are currently eligible for these 

tax credits, and some may be eligible for 

Medicaid depending on their family 

size, household income, and the State in 

which they live. Because premium tax 

credit amounts vary with household 

income and household compositional 

changes, we also anticipate that as the 

wage requirements proposed in new 

paragraph (e) of this section are 

implemented, this would affect 

premium tax credit amounts or 

eligibility, as well as Medicaid 

eligibility, for some staff. 

For part-time staff who work fewer 

than the 30 hour per week as defined 

above, we propose to require programs 

to facilitate the enrollment of these staff 

in health insurance options in the 

Marketplace or through Medicaid for 

which they may be eligible. Specifically, 

we propose to add new paragraph (f)(2) 

which requires a program to facilitate 

access to high-quality, affordable health 

insurance for each part-time staff 

member. That is, grant recipients would 

not be required to offer nor precluded 

from offering employer-sponsored 

health insurance to part-time staff, but 

the proposed standard would require, at 

a minimum, that the grant recipient 

make part-time staff aware of potential 

benefits through premium tax credits for 

which they may be eligible and facilitate 

their connection to the Marketplace or 

Medicaid. 

Increasing Head Start staff access to 

and the quality of health insurance 

benefits is key to attracting and 

retaining skilled staff and to being 

competitive with other jobs. In March 

2022, 73 percent of the civilian 

workforce had access to employersponsored healthcare benefits (88 

percent of full-time workers and 23 

percent of part-time workers), with 

employers paying on average 80 percent 

of premiums for employee coverage and 

67 percent for family coverage.86 By 

comparison, in 2019, only 27 percent of 

ECE workers in center-based settings 

had private health insurance through 

their own employer, while nearly all K– 

12 educators had employer-sponsored 

coverage.87 Nearly 16 percent of the ECE 

workforce lacked health insurance.88 As 

previously described, we are also aware 

that, while many Head Start staff may be 

offered employer-sponsored health 

coverage, it may not cover many health 

expenses, may not cover family 

members and/or may entail 

considerable out of pocket costs for 

staff. In order for Head Start programs 

to compete with other sectors that could 

potentially employ staff qualified for 

Head Start—including public schools— 

it is critical that Head Start programs 

offer or connect staff to quality, 

affordable health insurance. 

Based on our analysis of OHS 

administrative data from grant 

recipients, we have determined that 

most recipients employ more than 50 

workers and are therefore subject to the 

ACA’s shared responsibility for 

employers regarding health coverage, 

and many offer some level of health 

insurance or other employee benefits.89

We anticipate some implementation 

issues for small grant recipients with 

fewer than 50 employees who do not 

currently offer or administer employersponsored benefits like health 

insurance. However, the proposed 

requirements as written allow recipients 

to facilitate full-time staff members’ 

enrollment in health insurance options 

in the Marketplace, which helps the 

logistical difficulties of negotiating 

employee benefits plans with insurers, 

though we acknowledge that recipients 

may require technical assistance to 

connect with Navigators or other 

resources. The American Rescue Plan 

Act of 2021 and the Inflation Reduction 

Act of 2022 90 increased the subsidies 

for purchasing private health insurance 

in the Marketplace available to those 

meeting income and other requirements, 

and grant recipients may choose to 

administer or contribute to employees’ 

flexible spending accounts (FSAs) to 

defray out-of-pocket health care costs. 

When employees are covered by a 

health savings account (HSA)-eligible 

high-deductible health plan, grant 

recipients may choose to administer or 

contribute to employees’ HSAs to defray 

out-of-pocket health care costs. 

Next, we propose a new paragraph 

(f)(1)(ii) which requires that programs 

offer paid sick leave to full-time staff, 

based on an accrual system based on 

hours worked or by offering a number 

of days updated annually. At a 

minimum, the accrual must meet the 

standards set by State or local laws, if 

applicable. Paid leave due to illness or 

other reasons is a typical employersponsored benefit in the U.S. workforce. 

We do not propose a specific required 

number of days per year but seek 

comments on whether the standard 

should specify a minimum number of 

leave days or accrual rate. 

Paid sick leave for workers allows for 

recovery from personal illness or the 

time to care for ill family members, but 

employer-provided paid sick leave is 

not universal and varies with worker 

wages. In March 2022, 79 percent of 

civilian workers had access to paid sick 

leave, 79 percent had paid holidays, and 

77 percent had paid vacation leave, but 

just 40 percent of the lowest 10 percent 

of earners had access to paid sick leave 

compared to nearly all (96 percent) of 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80834 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

91BLS. (2022). Table 6. Selected paid leave 

benefits: Access, March 2022. 

92BLS. (2022). Table 6. Selected paid leave 

benefits: Access, March 2022. https://www.bls.gov/ 

news.release/pdf/ebs2.pdf. 

93Schneider D. Paid sick leave in Washington 

State: Evidence on employee outcomes, 2016–2018. 

Am J Public Health. 2020;110(4):499–504. 

doi:10.2105/AJPH.2019.305481; DeRigne LA, 

Stoddard-Dare P, Quinn L. Workers without paid 

sick leave less likely to take time off for illness or 

injury compared to those with paid sick leave. 

Health Aff. 2016;35(3):520–527. doi:10.1377/ 

hlthaff.2015.0965. Schenider, D., Harknett, K., & 

Vivas-Portillo, E. Olive Garden’s expasion of paid 

sick leave during COVID–19 reduced the share of 

employees workign while sick. Health Aff. 

2021;40(8):1328–1336. https://www.health

affairs.org/doi/10.1377/hlthaff.2020.02320. 

94Bradley, R. H. (2003). Child care and common 

communicable illnesses in children aged 37 to 54 

months. Archives of Pediatric and Adolescent 

Medicine, 157(2), 196–200. https://

pubmed.ncbi.nlm.nih.gov/12580692/. 

95Rossin-Slater, M., & Uniat, L. (2019). Paid 

family leave policies and Population Health. Health 

Affairs Brief. https://www.healthaffairs.org/do/ 

10.1377/hpb20190301.484936/ Waldfogel, J., Doran, 

E., & Pac, J. (2019). Paid family and medical leave 

improves the well-being of children and families. 

SRCD Child Evidence Brief. https://www.srcd.org/ 

research/paid-family-and-medical-leave-improveswell-being-children-and-families. 

96See: https://www.nationalpartnership.org/ourwork/resources/economic-justice/paid-leave/statepaid-family-leave-laws.pdf. 

97BLS. (2022). National Compensation Survey: 

Employee Benefits in the United States, March 

2022. Table 7: Leave benefits by occupational 

category, Civilian workers, March 2022. https://

www.bls.gov/ebs/publications/september-2022- 

landing-page-employee-benefits-in-the-unitedstates-march-2022.htm. 

98As of October 2022, paid family leave laws 

were in place in 11 states and the District of 

Columbia. See: https://www.national

partnership.org/our-work/resources/economicjustice/paid-leave/state-paid-family-leave-laws.pdf. 

99BLS. (2022). National Compensation Survey: 

Employee Benefits in the United States, March 

2022. Table 7: Leave benefits by occupational 

category, Civilian workers, March 2022. https://

www.bls.gov/ebs/publications/september-2022- 

landing-page-employee-benefits-in-the-unitedstates-march-2022.htm. 

100https://www.dol.gov/agencies/whd/fmla. 

101U.S. Department of Labor. FMLA Frequently 

Asked Questions. https://www.dol.gov/agencies/ 

whd/fmla/faq#3. 

102BLS. (2022). National Compensation Survey: 

Employee Benefits in the United States, March 

2022. Table 7: Leave benefits by occupational 

category, Civilian workers, March 2022. https://

www.bls.gov/ebs/publications/september-2022- 

landing-page-employee-benefits-in-the-unitedstates-march-2022.htm. 

103BLS. (2022). Employee Benefits in the United 

States, March 2022. https://www.bls.gov/ 

news.release/pdf/ebs2.pdf. 

the top 10 percent of earners.91 Eightyeight percent of full-time civilian 

workers had access to paid sick leave 

compared to just about half (51 percent) 

of part-time workers.92 Workers who 

lack paid sick leave are more likely to 

go to work while ill and to forgo 

medical care for themselves and their 

families,93 problems exacerbated by the 

pandemic. Having access to sick leave is 

particularly important for a workforce 

that directly cares for, teaches, and 

interacts with young children in group 

settings in which the spread of 

communicable illness is common.94

Next, we propose a new paragraph 

(f)(1)(iii) which requires that programs 

offer job-protected periods of paid 

family leave to employees consistent 

with eligibility for and protections in 

the Family and Medical Leave Act 

(FMLA) of 1993 regardless of employer 

size. Or, if applicable, the proposed 

standard clarifies that programs should 

comply with requirements set by State 

or local laws for paid family leave. 

Periods of leave that are longer than the 

few days per year typically offered by 

paid sick leave may be needed during 

certain life events, including a serious 

illness for a staff member or their family 

members, or the birth of a child. A 

growing body of research shows that 

access to paid family leave improves 

maternal and child health and family 

economic well-being and increases 

father engagement and preventive care 

receipt.95 We intend for this 

requirement to apply to all programs, 

even those who are not covered by 

FMLA due to employer size (e.g., fewer 

than 50 employees). As such, we expect 

that the proposed paid family leave 

policy would apply for full-time 

employees in all Head Start programs, 

regardless of the number of employees 

in the program, who have had at least 

12 months of tenure with their 

employer. The reason for the leave must 

be a qualifying reason under FMLA, 

regardless of whether the employer is 

covered by FMLA. 

An estimated 29 percent of Head Start 

staff work in one of the 11 states and the 

District of Columbia that have enacted 

paid family leave laws as of October 

2022, though the requirements in these 

laws vary.96 In March 2022, more than 

one-quarter (29%) of primary and 

secondary, and special education 

teachers had access to paid family leave 

benefits through their employers,97 with 

others having access to State-sponsored 

public paid family leave programs.98

Employer-provided paid family leave 

benefits are inequitably distributed in 

the workforce, with 34 percent of 

civilian workers in management, 

professional and related occupations 

having access, compared to 15 percent 

of those in service occupations.99

FMLA entitles eligible workers to 

periods of unpaid, job-protected leave 

for up to 12 weeks per 12-month period 

for the birth, adoption, or foster care 

placement of a new child within one 

year of birth, adoption, or placement; to 

care for a spouse, child, or parent with 

a serious health condition; a serious 

health condition that makes the 

employee unable to perform the 

essential functions of his or her job; or 

a qualifying exigency arising out of the 

fact that the employee’s spouse, son, 

daughter, or parent is a covered military 

member on covered active duty. Up to 

26 weeks of leave is available for an 

employee to care for a covered 

servicemember with a serious injury or 

illness if the eligible employee is the 

servicemember’s spouse, son, daughter, 

parent, or next of kin.100 To be eligible 

for FMLA, workers must work for a 

covered employer at a location with 50 

or more employees within 75 miles; 

have worked 1,250 hours or more 

during the 12 months prior to the start 

of leave; and have worked for the 

employer for 12 months or more before 

the start of leave.101 However, under 

this proposed new requirement, all 

Head Start programs, regardless of 

employer size, would be required to 

provide full-time staff that meet the 

employee eligibility requirements (i.e., 

have worked 1,250 hours or more 

during the 12 months prior to the start 

of leave; and have worked for the 

employer for 12 months or more before 

the start of leave) with partial or full 

wage replacement during qualifying 

periods of leave. We request comments 

on whether the reasons for leave or 

eligibility requirements, such as how 

long a staff member has been with an 

employer or employer size, should be 

modified for this proposed standard, or 

if aligning with FMLA is the best 

approach. 

Next, for programs whose program 

year lasts longer than a typical school 

year, we propose in new paragraph 

(f)(1)(iv) to require such programs offer 

full-time staff the accrual of paid 

vacation or personal leave 

commensurate with experience or time 

working at the program. In 2022, 77 

percent of civilian workers had paid 

vacation leave and 48 percent had paid 

leave designated as personal leave. That 

year, only 21 percent of primary and 

secondary teachers had paid vacation 

leave.102 But as noted by BLS,103 the 

majority of K–12 school districts 

function on a school year schedule (37– 

38 weeks per year) with regular breaks, 

as do many Head Start Preschool 

programs. However, most Early Head 

Start programs and some Head Start 

Preschool programs operate throughout 

the summer months as well, and these 

‘‘year-round’’ program staff are not 

benefitting from a summer break. We 

believe these staff working on more of 

a year-round schedule should have the 

opportunity to accrue paid vacation 

leave, but we do not propose a specific 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80835 

104When offering access to the behavioral health 

services that would be required under these 

proposed rules, an employer should be aware that 

other provisions of law may apply to that 

arrangement. In general, the provision of medical 

care, including the provision of behavioral health 

services, could result in the arrangement being 

considered a group health plan subject to the 

relevant provisions of the Employee Retirement 

Income Security Act (ERISA) that applies to group 

health plans, unless the arrangement qualifies as an 

excepted benefit. For an Employee Assistance 

Program (EAP) to qualify as an excepted benefit, the 

EAP must meet the requirements of 26 CFR 

54.9831–1(c)(3)(vi); 29 CFR 2590.732(c)(3)(vi) and 

45 CFR 146.145(b)(3)(vi), including that the 

program may not provide significant benefits in the 

nature of medical care and that no employee 

premiums or contributions or cost-sharing can be 

required as a condition of participation in the EAP. 

To the extent the arrangement that provides the 

behavioral health visits required under these 

proposed rules does not meet the requirements to 

qualify as an excepted benefit, the arrangement may 

be considered a group health plan subject to the 

requirements of Part 7 of the Employee Retirement 

Income Security Act (ERISA). 

105Section 1251 of the Affordable Care Act 

provides that grandfathered health plans are not 

subject to certain provisions of the Code, ERISA, 

and the PHS Act, as added by the Affordable Care 

Act, for as long as they maintain their status as 

grandfathered health plans. See 26 CFR 54.9815– 

1251; 29 CFR 2590.715–1251 and 45 CFR 147.140. 

For a list of the market reform provisions applicable 

to grandfathered health plans under title XXVII of 

the PHS Act that the Affordable Care Act added or 

amended and that were incorporated into the Code 

and ERISA, visit https://www.dol.gov/sites/default/ 

files/ebsa/laws-and-regulations/laws/affordablecare-act/for-employers-andadvisers/grandfatheredhealth-plans-provisions-summary-chart.pdf. 

106BLS. (2023). High deductible health plans and 

health savings accounts. https://www.bls.gov/ebs/ 

factsheets/high-deductible-health-plans-and-healthsavings-accounts.htm. 

107Council of Economic Advisors. (2022, May). 

Reducing the economic burden of unmet mental 

health needs. The White House. https://

www.whitehouse.gov/cea/written-materials/2022/ 

05/31/reducing-the-economic-burden-of-unmetmental-health-needs/. 

108 Ibid. 

109Whitaker, R., Becker, B., Herman, A., & Gooze, 

R. (2013). The physical and mental health of Head 

Start staff: The Pennsylvania Head Start staff 

wellness survey, 2012. Preventing chronic disease, 

10(1), 1–9. 

110 Kwon, K.-Ah., Ford, T.G., Tsotsoros, J., 

Randall, K., Malek-Lasater, A., & Kim, S.G. (2021). 

Challenges in working conditions and well-being of 

early childhood teachers by teaching modality 

during the COVID–19 pandemic. International 

Journal of Environmental Research and Public 

Health, 19, 4919. 

111Elharake, J.A., Shafiq, M., Cobanoglu, A., 

Malik, A.A., Klotz, M., Humphries, J.E., . . . & 

Gilliam, W.S. (2022). Prevalence of Chronic 

Diseases, Depression, and Stress among US Child 

Care Professionals during the COVID–19 Pandemic. 

medRxiv, 2022–03. 

112Li-Grining, C.L., Raver, C.C., Champion, K., 

Sardin, L., Metzger, M., & Jones, S.M. (2010). 

Understanding and improving classroom emotional 

climate and behavior management in the ‘‘real 

world’’: The role of Head Start teachers’ 

psychosocial stressors. Early Education and 

Development, 21(1), 65–94.; Roberts, A., LoCasaleCrouch, J., Hamre, B., & DeCoster, J. (2016). 

Exploring Teachers’ Depressive Symptoms, 

Interaction Quality, and Children’s SocialEmotional Development in Head Start. Early 

Education and Development, 27(5), 642–654.; 

Whitaker, R.C., Dearth-Wesley, T., & Gooze, R.A. 

(2015). Workplace stress and the quality of teacherchildren relationships in Head Start. Early 

Childhood Research Quarterly, 30, 57–69. 

113 Jeon, S., Jeon, L., Lang, S. & Newell, K. (2021). 

Teacher depressive symptoms and child math 

achievement in Head Start: The roles of familyteacher relationships and approaches to learning. 

Child Development, 92(6), 2478–2495. 

required number of days per year or 

accrual rate. We request comment on 

whether these requirements regarding 

paid vacation or personal leave are 

important for attracting and retaining 

qualified staff. We seek comments on 

whether the implementation of these 

requirements would lead to unintended 

consequences or unpredictable 

expenses, particularly in the case of 

paying out upon an employee leaving a 

program. 

Next, we propose to add new 

paragraph (f)(1)(v) which requires that 

employers offer access to short-term 

behavioral health services for full-time 

staff that entails minimal or no out-ofpocket costs for staff. We propose that 

these services include access to 

approximately three to five outpatient 

visits per year.104 The Paul Wellstone 

and Pete Domenici Mental Health Parity 

and Addiction Equity Act of 2008 

requires that group health plans and 

health insurance coverage ensure that 

financial requirements and treatment 

limitations on mental health and 

substance-use disorder services are no 

more restrictive than the predominant 

financial requirements and treatment 

limitations applicable to medical and 

surgical health services, and that there 

are no financial requirements and 

treatment limitations applicable only 

with respect to mental health and 

substance use disorder services. Mental 

health and substance-use disorder 

services, including treatment such as 

counseling and psychotherapy, are also 

one category of the essential health 

benefits that health insurance issuers 

offering non-grandfathered 105 group or 

individual health insurance coverage 

(including health insurance coverage 

offered in the Marketplace) must cover 

without annual dollar caps. 

Even with health insurance, out-ofpocket expenses like high deductibles or 

copays may serve as barriers for 

individuals facing mental illness or 

symptoms for receiving care. In 2010, 

only 15 percent of private industry 

workers had a high deductible plan, 

compared to 45 percent in 2018.106 In a 

2020 nationally representative survey, 

among those reporting perceived unmet 

mental health care needs in the prior 

year, 46 percent reported that they 

could not afford the cost of treatment, 

19 percent reported that their health 

insurance did not pay enough for 

mental health services, and 29 percent 

reported they did not know where to go 

for services.107

Research suggests that Head Start staff 

face a constellation of stressors, 

including financial stress and 

challenging behaviors in the classroom, 

which are in turn associated with poorer 

staff physical and psychological wellbeing, and may benefit from increased 

access to mental health care services. 

Head Start teachers experience high 

rates of health problems and depressive 

symptoms, with some studies finding 

that nearly one-third have depressive 

symptoms.108 A 2013 study in 

Pennsylvania found that Head Start 

teachers showed higher rates of poor or 

fair health, depressive symptoms, 

unhealthy days, and having three or 

more health conditions compared to 

women with similar backgrounds.109

The challenges surrounding the COVID– 

19 pandemic exacerbated stress and 

health problems among early childhood 

teachers. A study of ECE professionals 

conducted in summer 2020 in New York 

City found that 31 percent reported 

doctor-diagnosed anxiety and 23 

percent reported doctor-diagnosed 

depressive symptoms.110 Another study 

of over 80,000 ECE professionals found 

that 47.5 percent screened positive for 

depression and 66.5 percent reported 

moderate to high stress levels, which 

was a higher prevalence of both 

depression and stress than among US 

adults overall in 2020.111 Further, 

research on Head Start programs has 

linked staff job stressors and poor 

mental health to lower-quality teacherchild interactions and teachers’ 

behavioral management skills.112 In a 

sample of Head Start programs, 

teachers’ depressive symptoms were 

associated with fewer gains in 

children’s math skills across the year.113

Access to free or low-cost short term 

mental health services is key to 

promoting staff well-being and 

children’s development. Programs may 

use a variety of strategies to ensure staff 

facing mental health conditions or 

symptoms have access to short-term, 

affordable mental health treatment. 

Employers may do so through an 

employer-sponsored group health plan 

that provides short-term, outpatient 

behavioral health care at low out-ofpocket costs, or through an Employee 

Assistance Program (EAP) that qualifies 

as an excepted benefit and can refer and 

connect employees to mental health 

resources and providers. While we 

propose to require programs to cover 

approximately three to five outpatient 

visits, nothing in these rules prohibit a 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80836 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

114Coffey, M. (2022). Still underpaid and 

unequal: Early childhood educators face low pay 

and a worsening wage gap. Center for American 

Progress. https://www.americanprogress.org/article/ 

still-underpaid-and-unequal/; Mayfield, W., & Cho, 

I. (2022). The National Workforce Registry Alliance 

2021 Workforce Dataset: Early Childhood and 

School-age Workforce Trends, with a Focus on 

Racial/Ethnic Equity. National Workforce Registry 

Alliance. https://www.registryalliance.org/wpcontent/uploads/2022/05/NWRA-2022-ECEworkforce-data-report-final.pdf ; Smith, L., 

McHenry, K., Morris, & Chong, H. (2021). 

Characteristics of the child care workforce. 

Bipartisan Policy Center. https://bipartisan

policy.org/blog/characteristics-of-the-child-careworkforce/. 

115Child Care Aware. (2022). 2021 Child Care 

Affordability. https://www.childcareaware.org/ 

catalyzing-growth-using-data-to-change-child-care/ 

#ChildCareAffordability. 

116Chaudry, A., Morrissey, T.W., Weiland, C., & 

Yoshikawa, Y. (2021). Cradle to Kindergarten: A 

New plan to combat inequality, 2nd Edition. New 

York: Russell Sage Foundation. 

117https://www.childcareaware.org/about/childcare-resource-referral/. 

118RAPID Survey, Student Debt in the Early 

Childhood Workforce, May 2022. Retrieved from: 

https://rapidsurveyproject.com/our-research/ 

student-debt-in-the-early-childhood-workforce. 

119BLS. (2022). Employee benefits in the United 

States. Table 1. Retirement benefits: Access, 

participation, and take-up rates. 

120Sakai, L. (2014). ‘‘Economic Insecurity and 

Early Childhood Teaching.’’ In Worthy Work, Still 

Unlivable Wages: The Early Childhood Workforce 

25 Years after the National Child Care Staffing 

Study, edited by Marcy Whitebook, Deborah 

Phillips, and Carollee Howes, 41–54. Berkeley, CA: 

Center for the Study of Child Care Employment. 

program from providing additional 

visits. 

Next, we propose to add new 

paragraph (f)(3) which requires 

programs to connect staff members who 

are parents with affordable child care 

resources and information—including 

connections to child care resource and 

referral agencies if applicable—and to 

facilitate the enrollment of staff 

members who may be eligible in the 

child care subsidy program. The early 

childhood workforce, including Head 

Start staff, are disproportionately 

women of color,114 many of whom rely 

on child care for their own children. 

High-quality child care is expensive and 

difficult to find,115 particularly for 

infants and toddlers, but key to both 

promoting labor force participation and 

children’s development.116 Child Care 

Resource and Referral (CCR&R) 

organizations and other child care 

consumer education organizations serve 

as resource hubs to connect families to 

high-quality, affordable child care 

through referrals and information on 

licensing, subsidies, and how to access 

services for children with disabilities.117

Head Start programs can ensure that 

staff members are aware of and 

connected to local CCR&Rs or other 

consumer education organizations in 

their communities. For each staff 

member who may be eligible for public 

child care assistance, a program should 

educate and facilitate application to and 

enrollment in the child care subsidy 

program. 

Further, we recognize that many Head 

Start staff members’ own children may 

be eligible for Head Start services. Being 

able to enroll one’s own child in an ECE 

program where that individual is also 

employed could be an important benefit 

to support recruitment and retention of 

staff. Therefore, we also propose to add 

a new paragraph (5) to § 1302.14(a) 

Selection criteria that clarifies programs 

can choose to prioritize the enrollment 

of staff members’ children through 

selection criteria. Section 1302.14(a) 

includes requirements for establishing 

selection criteria to weigh the 

prioritization of selection of participants 

for the program. The proposed standard 

in new paragraph (5) clarifies that 

programs can choose, as part of this 

process, to prioritize staff members’ 

children. Programs are reminded that in 

order to be enrolled in a Head Start 

funded slot, such children would still 

need to be age eligible and meet an 

eligibility category described in 

§ 1302.12(c) or (d). We also note that as 

the wage requirements proposed in this 

NPRM are implemented, this would 

likely affect eligibility for some staff. 

Next, we propose a new paragraph (4) 

in § 1302.90(f) that requires programs to 

facilitate access to Public Service Loan 

Forgiveness (PSLF), or other applicable 

student loan debt relief programs, for 

any Head Start staff who may have 

student loan debt. This includes timely 

certification of employment for the staff 

member. Evidence suggests that student 

loan debt is higher among the ECE 

workforce than the overall population. 

When combined with relatively low 

wages, this compounds economic 

hardship. According to a March 2022 

survey of approximately 2,500 ECE 

providers, 19 percent reported they had 

student debt, compared to 17 percent of 

the U.S. adult population overall, and 

17 percent reported they carried debt for 

others.118

The PSLF Program, administered by 

the U.S. Department of Education, is 

intended to encourage individuals to 

enter and continue in full-time public 

service employment by forgiving the 

remaining balance of their Direct loans 

after they satisfy public service and loan 

payment requirements. Many Head Start 

programs share information with staff 

about the PSLF program as well as other 

State or local student debt relief 

opportunities they may be eligible for as 

a staff recruitment and retention strategy 

that can reduce financial stress among 

staff. Individual borrowers who are 

eligible for PSLF must submit with their 

PSLF application a certification of 

qualifying employment which requires a 

signature from the employer. It is 

important that Head Start programs offer 

timely certification of employment to 

facilitate debt relief for Head Start staff. 

This proposed standard would require 

programs to facilitate access to PSLF 

and other available student debt relief 

by providing information about debt 

relief opportunities and offering timely 

certification of employment. 

Next, recognizing that there are other 

benefits that may enhance programs’ 

ability to compete for skilled staff, we 

propose to require programs, at least 

once every 5 years, to assess and 

determine if their benefits package is 

adequate for recruiting and retaining 

full-time staff and competitive with 

benefits offered by local or neighboring 

school districts. The proposed standard 

specifies that programs may offer 

additional benefits to staff, including 

more enhanced health benefits, 

retirement savings plans, flexible 

savings accounts, or life, disability, and 

long-term care insurance. We propose to 

encourage programs to offer additional 

benefits to all staff based on the needs 

of their workforce. Additional benefits 

may include but are not limited to 

retirement, dental or vision benefits; 

subsidized health insurance for staff 

members’ dependents; tax-exempt 

health, dependent care, or flexible 

spending accounts; or other benefits to 

staff such as life, long-term care, and 

disability insurance. 

Finally, ACF is considering adding 

retirement savings plans to the list of 

required benefits to be provided to fulltime Head Start staff and specifically 

seeks public comment on whether to 

add an additional requirement for 

recipients to provide retirement savings 

benefits to full-time staff. Research 

indicates that the majority of public 

school teachers are offered some type of 

retirement or pension plan.119 And a 

study of ECE professionals in one State 

found that 80 percent were worried 

about their retirement savings.120

Providing retirement benefits may 

provide another mechanism for Head 

Start programs to recruit and retain staff. 

However, we also recognize that such a 

requirement could lead to additional 

slot loss in Head Start absent additional 

appropriations. We seek public 

comment on whether retirement savings 

benefits, ranging from employer 

assistance in establishing retirement 

accounts to more comprehensive 

benefits with employer matching 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80837 

121The Happy Teacher Project. (2020). 

Strengthening Health, Wellness, and Psychosocial 

Environments in Head Start: Technical Report 

2020. Johns Hopkins University and Oklahoma 

State University 

122 Kwon, K., Ford, T., Randall, K., Castle, S. 

(2021). Head Start Teacher Paradox: Working 

conditions, well-being, and classroom quality. The 

Happy Teacher Project: Johns Hopkins University 

and Oklahoma State University. 

123 Ibid. 

contributions, consistent with what 

public schools offer, should be required 

as an effective mechanism for staff 

recruitment and retention, especially 

when weighed against potential slot 

loss. Overall, we believe this set of 

employer-provided benefits is necessary 

to attract and retain a skilled, qualified 

workforce in Head Start programs. In 

general, as Head Start programs phase in 

wage increases and benefits, they 

should hold harmless existing benefits 

such that employees receive benefits 

that are at least as generous as their 

current benefits. ACF requests comment 

about the degree to which grant 

recipients are currently offering a set of 

high-quality benefits and the 

administrative difficulty or expense 

creating these benefits would entail. We 

also seek public comment on how any 

of the proposed benefit requirements in 

this section may impact various 

communities. We specifically request 

public comment from the special 

populations served by Head Start, 

including AIAN and MSHS programs 

and communities. 

Workforce Supports: Staff Wellness 

(§ 1302.93) 

Section 1302.93 outlines program 

requirements for promoting staff health 

and wellness, including that staff: have 

regular health examinations; do not 

pose a risk of exposing others in the 

program to communicable diseases; are 

provided access to mental health and 

wellness information, including 

opportunities to learn about these 

topics. However, these current 

standards lack critical requirements to 

promote staff physical and mental 

wellness on the job, including regular 

breaks during the workday and access to 

appropriate adult-size furniture in 

classrooms. We believe the proposed 

requirements described in this section, 

together with the proposed 

requirements described in the Subpart 

I—Human Resources Management 

subsection of the Mental Health Services 

section of this preamble, will provide 

much needed supports to reduce staff 

stress and burnout; improve the quality 

of interactions between teachers and 

children; and improve staff recruitment 

and retention. Importantly, improving 

staff retention will also contribute to a 

more positive, improved working 

environment for all staff. 

In this section we describe newly 

proposed requirements for grant 

recipients to provide a minimal level of 

regular breaks for staff as well as brief 

unscheduled ‘wellness breaks’ for staff 

who work directly in classrooms with 

children to support stress management, 

improve well-being, reduce turnover, 

and improve staff retention and the 

quality of services. We also propose a 

requirement for classroom staff to have 

access to appropriate adult-sized 

furniture in classrooms to support 

ergonomic health. These newly 

proposed provisions are consistent with 

the proposed requirements in new 

paragraphs (e) and (f) of § 1302.90 that 

support improved staff wages and 

benefits. 

First, we propose to add a new 

paragraph (c) to § 1302.93 which 

outlines requirements for break times 

during work shifts. In new paragraph 

(c)(1)(i) we specify that a program must 

provide, for each staff member working 

a shift lasting between four and six 

hours, a minimum of one 15-minute 

break per shift. In new paragraph 

(c)(1)(ii), we specify that a program must 

provide, for each staff member working 

a shift lasting six hours or more, a 

minimum of one 30-minute break per 

shift. Newly proposed paragraph (c)(2) 

requires programs to comply with State 

laws or regulations that are more 

stringent for staff breaks, if applicable. 

The required breaks outlined in new 

paragraph (c)(1) are minimums, and 

programs may choose to provide staff 

with longer or more frequent breaks 

depending on the needs of staff, 

children, and their programs. 

For staff members who regularly work 

in classrooms with children, the breaks 

for staff described in (c)(1) will be 

subject to required staff-child ratios. 

However, in newly proposed paragraph 

(c)(3), we specify that during break 

times for classroom staff, one teaching 

staff member may be replaced by one 

staff member who does not meet the 

teaching qualifications required for the 

age, as long as this staff member has the 

necessary training and experience to 

ensure safety of children and minimal 

disruption to the quality of services. 

ACF expects that, for classroom staff, 

these regular breaks will be scheduled 

for periods that are least disruptive for 

classroom instruction or routines, such 

as during nap times, meals, or outside 

play periods and will be covered by staff 

who have completed the appropriate 

background checks. 

In addition, we propose to add new 

paragraph (c)(4), which requires a 

program to design and implement a 

systematic approach to ensure each staff 

member that works directly with 

children as part of their regular job 

responsibilities can have access to brief 

unscheduled wellness breaks of about 5 

minutes as needed while ensuring child 

safety. ACF expects these unscheduled 

breaks to be brief, of approximately 5 

minutes in length. The safety of 

children is of the utmost importance to 

ACF, and we recognize this is a key 

priority for programs as well. By 

designing an intentional, systematic 

approach for brief ‘wellness’ breaks, we 

think programs will be able to better 

support staff members who feel 

temporarily overwhelmed or stressed by 

the challenges of the position in the 

classroom or otherwise need a very brief 

break (e.g., to use the restroom or take 

an emergency phone call). It will allow 

staff the opportunity to briefly step 

away from an overwhelming situation, 

calm down as needed, and think 

through an appropriate approach to 

handling the given situation. We believe 

this can help prevent or reduce child 

incidents in classrooms. At the same 

time, careful attention should be given 

at the program level to allow for these 

brief wellness breaks while also 

promoting the safety of children. It is 

expected that the number of 

unscheduled breaks could vary daily, 

and it may be the case that on any given 

day individuals may not need 

unscheduled breaks whereas on other 

days they could need more. We request 

public comment on the length or ideal 

frequency of these brief wellness breaks. 

We also propose to add a new 

paragraph (d) to § 1302.93 which 

requires programs to ensure staff have 

access to adult size furniture in 

classrooms. This could include, for 

instance, adult sized chairs or desks 

depending on what the classroom layout 

allows. This change was motivated by 

the data indicating that staff in Head 

Start programs experience work-related 

ergonomic pain. For example, a survey 

of Head Start teachers in Baltimore 

found that 80 percent reported 

musculoskeletal pain as a result of their 

work.121 In an Oklahoma sample of 

Head Start teachers, more than seven in 

ten (73 percent) Head Start staff 

reported work-related ergonomic pain, 

including in routine activities like 

diapering or stooping to pick up 

children.122 Additionally, nearly onethird reported neck pain (31 percent), 

one in four reported shoulder pain (26 

percent), and over half reported back 

pain (56 percent).123 The proposed 

requirement for adult size furniture will 

support the physical health of teachers 

and aligns with ACF’s goal of improving 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80838 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

124 Kwon, K., Ford, T., Randall, K., Castle, S. 

(2021). Head Start Teacher Paradox: Working 

conditions, well-being, and classroom quality. The 

Happy Teacher Project: Johns Hopkins University 

and Oklahoma State University. 

125The Happy Teacher Project. (2020). 

Strengthening Health, Wellness, and Psychosocial 

Environments in Head Start: Technical Report 

2020. Johns Hopkins University and Oklahoma 

State University. 

126 Kwon, K., et al., (2022). Neglected elements of 

a high-quality early childhood workforce: Whole 

teacher well-being and working conditions. Early 

Childhood Education Journal, 50, 157–168. 

127 Jeon, L., & Ardeleau, K. (2020). Work climate 

in early care and education and teachers’ stress: 

Indirect associations through emotion regulation. 

Early Education & Development, 31(7), 1031–1051; 

Jeon, L., Buettner, C., & Grant, A. (2018). Early 

childhood teachers’ psychological well-being: 

Exploring potential predictors of depression, stress, 

and emotional exhaustion. Early Education & 

Development, 29(1), 53–69. 

128 Grant, A., Jeon, L. & Buettner, C. (2019). 

Relating early childhood teachers’ working 

conditions and wellbeing in their turnover 

intentions. Educational Psychology, 39(3), 294–312. 

129The Happy Teacher Project. (2020). 

Strengthening Health, Wellness, and Psychosocial 

Environments in Head Start: Technical Report 

2020. Johns Hopkins University and Oklahoma 

State University. 

130Markowitz, A., & Bassok, D. (2018). Teacher 

turnover and child development in Head Start. 

Paper presented at the Association for Public Policy 

Analysis and Management Conference. U.S. 

Department of Health and Human Services & U.S. 

Department of Education. (2016). 

131Cassidy, D.J., Lower, J.K., Kintner-Duffy, V.L., 

Hegde, A.V., & Shim, J. (2011). The day-to-day 

reality of teacher turnover in preschool classrooms: 

An analysis of classroom context and teacher, 

director, and parent perspectives. Journal of 

Research in Childhood Education, 25(1), 1–23. 

132 Jeon, L., Buettner, C., Grant, A., & Lang, S. 

(2019). Early childhood teachers’ stress and 

children’s social, emotional, and behavioral 

functioning. Journal of Applied Developmental 

Psychology, 61, 21–32.; Jeon, S., Jeon, L., Lang, S. 

& Newell, K. (2021). Teacher depressive symptoms 

and child math achievement in Head Start: The 

roles of family-teacher relationships and 

approaches to learning. Child Development, 92(6), 

2478–2495.; The Happy Teacher Project (2020).; 

Smith, S., & Lawrence, S. (2019). Early Care and 

Education Teacher Well-Being: Associations with 

Children’s Experience, Outcomes, and Workplace 

Conditions (Issue March). http://www.nccp.org/ 

publications/pdf/text_1224.pdf. 

133 Jeon, L., Buettner, C., Grant, A., & Lang, S. 

(2019). Early childhood teachers’ stress and 

children’s social, emotional, and behavioral 

functioning. Journal of Applied Developmental 

Psychology, 61, 21–32. 

134Hanno, E., Gardner, M., Jones, S., & Lesaux, N. 

(2022). An ecological perspective on early educator 

well-being at the start of the COVID–19 pandemic. 

Early Childhood Research Quarterly. https://

doi.org/10.1016/j.ecresq.2022.02.002; Kwon, K., 

Ford, T., Tsotsoros, J., Randall, K., Malek-Lasater, 

A., & Kim, S. (2022). Challenges in working 

conditions and well-being of early childhood 

teachers by teaching modality during the COVID– 

19 pandemic. International Journal of 

Environmental Research and Public Health, 19, 

4919.; Markowitz, A., & Bassok, D. (2022). 

Understanding the well-being of early educators in 

the wake of the coronavirus pandemic: Lessons 

from Louisiana. Early Childhood Research 

Quarterly. https://doi.org/10.1016/ 

j.ecresq.2022.05.001; Souto-Manning, M., & Melvin, 

S. (2022). Early childhood teachers of color in New 

York City: Heightened stress, lower quality of life, 

declining health, and compromised sleep amidst 

COVID–19. Early Childhood Research Quarterly, 60, 

34–48. 

135 Kwon, K., Ford, T., Tsotsoros, J., Randall, K., 

Malek-Lasater, A., & Kim, S. (2022). Challenges in 

working conditions and well-being of early 

childhood teachers by teaching modality during the 

COVID–19 pandemic. International Journal of 

Environmental Research and Public Health, 19, 

4919.; Souto-Manning, M., & Melvin, S. (2022). 

Early childhood teachers of color in New York City: 

Heightened stress, lower quality of life, declining 

health, and compromised sleep amidst COVID–19. 

Early Childhood Research Quarterly, 60, 34–48. 

136 Kwon, K., Ford, T., Tsotsoros, J., Randall, K., 

Malek-Lasater, A., & Kim, S. (2022). Challenges in 

working conditions and well-being of early 

childhood teachers by teaching modality during the 

COVID–19 pandemic. International Journal of 

Environmental Research and Public Health, 19, 

4919. 

and investing in staff health and 

wellness. 

Together, regularly scheduled breaks, 

brief unscheduled wellness breaks, and 

access to adult size furniture in 

classrooms will provide staff with more 

of the support they need to provide 

high-quality education and care to 

enrolled children. There are no Federal 

and few State or local laws regarding 

employers’ offering of staff breaks. The 

work of ECE staff, including Head Start 

teachers, involves actively educating, 

caring for, and supervising young 

children, jobs that require the full 

attention of staff members and can be 

physically, mentally, and emotionally 

demanding, particularly if done for long 

shift periods. Prior research suggests 

that Head Start teachers have low or 

inconsistent access to regular or 

unscheduled breaks at work. For 

instance, in 2021, the Happy Teacher 

Project found that 62 percent of Head 

Start teachers have no designated 

breaks, compared to 44 percent of the 

general ECE workforce.124 In another 

survey of Head Start teachers in 

Maryland, 85 percent reported there was 

no designated break time for staff (other 

than children’s nap time) and 69 

percent reported there were no 

consistent bathroom breaks for staff; 55 

percent indicated that more daily breaks 

would improve overall well-being.125 In 

samples of ECE teachers, up to one-third 

have reported diseases such as urinary 

tract infections and high blood pressure 

at higher rates than in populations of 

similar sociodemographic 

composition.126 This research suggests 

some Head Start staff may work full-day 

shifts without adequate breaks to eat 

their own meals, attend to minor 

personal tasks, or take care of their own 

mental and physical well-being. 

The lack of access to breaks at work 

may be part of a constellation of 

workplace stressors faced by Head Start 

staff, which as described previously, 

includes financial stress and the 

significant responsibility entrusted to 

Head Start staff who are charged with 

supporting the most vulnerable children 

and families who face a myriad of 

challenges. Work climate and stressors 

are associated with teacher 

psychological well-being,127 and in 

turn, contribute to staff turnover.128 In 

the Baltimore survey, 43 percent of 

Head Start teachers surveyed reported 

an intention to leave the job.129

Additionally, as stated earlier, Head 

Start staff turnover in 2022 was the 

highest it has been in two decades. Staff 

turnover interrupts adult-child 

relationships and is associated with 

poorer child outcomes 130 and increases 

the workloads and schedule changes for 

the teachers who remain.131 Among staff 

who remain in their jobs, work 

environments and physical and 

psychological well-being are associated 

with teachers’ relationships with 

children and children’s outcomes.132 In 

a study of ECE centers that included 

Head Start programs, lead and assistant 

teachers’ work stress was associated 

with children’s social and emotional 

outcomes, including anxiety-withdrawal 

and social competence.133

Research suggests that early 

childhood teacher well-being was low 

prior to the COVID–19 pandemic, and 

that the pandemic exacerbated the 

workplace, financial, and other stressors 

among the ECE workforce, contributing 

to reductions in emotional well-being, 

physical health, and job commitment in 

the workforce.134 Further, research finds 

evidence of racial differences, such as 

higher rates of stress for Black teachers 

and higher rates of ergonomic pain for 

Latinx teachers for those teaching inperson when compared to their White 

counterparts, with implications for 

equity among a workforce that is 

disproportionately women of color.135

The pandemic also exacerbated the 

challenges in recruiting and retaining 

ECE staff. 

Each standard that ACF proposes in 

this section is responsive to research, 

survey data, and Head Start 

administrative and internal data which 

collectively demonstrate that more 

attention must be paid to educator 

wellness and well-being. Evidence from 

the field shows that early childhood 

educators’ mental and physical health 

and well-being are often neglected or 

overlooked. One survey administered 

during the COVID–19 pandemic found 

that teachers ranked ‘‘more daily breaks 

and paid leave’’ in the top five items 

needed to support their well-being.136

Other research prior to the pandemic in 

a national sample and one in Oklahoma 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80839 

137 Kwon, K., Ford, T., Randall, K., Castle, S. 

(2021). Head Start Teacher Paradox: Working 

conditions, well-being, and classroom quality. The 

Happy Teacher Project: Johns Hopkins University 

and Oklahoma State University. 

138 Gallup, I. State of the global workplace report. 

Gallup.com. https://www.gallup.com/workplace/ 

349484/state-of-the-global-workplace-2022- 

report.aspx. 

139 Jennings, P.A., & Greenberg, M.T. (2009). The 

Prosocial Classroom: Teacher Social and Emotional 

Competence in Relation to Student and Classroom 

Outcomes. Review of Educational Research, 79(1), 

491–525. https://doi.org/10.3102/003465

4308325693. 

140Salamon, J., Blume D., Orosz G., Nagy T. 

(2021). The interplay between the level of voluntary 

participation and supervisor support on trainee 

motivation and transfer. Human Resource 

Development Quarterly Volume 32, Issue 4, pages 

459–481. https://doi.org/10.1002/hrdq.21428. 

found that teachers rated breaks as fifth 

and second, respectively, as needs for 

their workplaces.137 ACF’s proposed 

requirements in this section are 

intended to be responsive to these 

research findings and support Head 

Start staff well-being by ensuring they 

have access to regular, scheduled 

breaks, and to brief unscheduled breaks, 

which may be useful stress management 

strategies in infrequent circumstances 

when a teacher is feeling overwhelmed. 

Additionally, these proposed standards 

will strengthen supports for Head Start 

early educators during the on-going 

post-pandemic and long-term recovery 

of the workforce. 

We seek public comment on how any 

of the proposed staff wellness 

requirements in this section may impact 

various communities. We specifically 

request public comment from the 

special populations served by Head 

Start, including AIAN and MSHS 

programs and communities. 

Workforce Supports: Employee 

Engagement (§ 1302.92, § 1302.101) 

Section 1302.101(a)(2) requires 

programs to implement a management 

system that provides regular and 

ongoing staff supervision to support 

individual professional development 

and continuous program quality 

improvement. Disengaged staff are not 

as emotionally committed to or proud of 

their work or organization, are less 

motivated, and are more eager to 

leave.138 Disengagement negatively 

affects the well-being of staff, the quality 

of their work, and the attitudes held 

toward children.139 Meaningful and 

effective employee engagement 

practices that promote clear roles and 

responsibilities are needed to improve 

the well-being of the workforce by 

helping identify and address job-related 

stress, burnout, and workload issues. 

These practices also empower the 

workforce, build respect in the 

workplace, and improve staff retention 

and overall job satisfaction. As such, we 

propose to revise this requirement to 

discourage staff supervision approaches 

that are primarily top-down by requiring 

programs to promote clear and 

reasonable roles and responsibilities for 

all staff with meaningful and effective 

employee engagement practices as part 

of their systematic approach to staff 

supervision. The changes proposed in 

this section are intended to be scaled to 

the size of the Head Start organization 

and are not anticipated to incur a large 

cost. 

Specifically, in § 1302.101(a)(2) we 

propose to strike ‘‘Provides regular and 

ongoing supervision to support 

individual staff professional 

development and continuous program 

improvement’’ and replace it with 

‘‘Promotes clear and reasonable roles 

and responsibilities for all staff and 

provides regular and ongoing staff 

supervision with meaningful and 

effective employee engagement 

practices.’’ 

Meaningful and effective employee 

engagement practices will vary among 

programs, but examples include 

discussions of explicit and implicit 

expectations, recognition for highquality work, open communication 

between management and staff, 

conducting and responding to 

workplace climate surveys, responding 

to feedback, working in partnership 

with staff to identify and ameliorate any 

barriers to high-quality job performance 

that may exist including workload 

issues, formal and informal 

opportunities for discussions related to 

job satisfaction and performance, and 

having employee engagement inform 

professional development opportunities 

for staff. In general, these practices 

should aim to understand the 

expectations imposed on staff, identify 

and address barriers staff are 

experiencing in being able to fulfill their 

roles and responsibilities (e.g., filling 

multiple roles, job-related stressors 

impacting job performance, unclear 

roles and responsibilities), and 

recognize high-quality work. 

We also propose two revisions to 

§ 1302.92(b), which requires programs 

to implement a systematic approach to 

staff training and professional 

development, in order to integrate 

meaningful and effective employee 

engagement practices and professional 

development. First, in § 1302.92(b) we 

propose to add the phrase ‘‘and 

integrated with employee engagement 

practices in accordance with 

§ 1302.101(a)(2).’’ This revision builds 

on the proposed revision to 

§ 1302.101(a)(2) and is intended to 

ensure programs implement an 

approach to staff training and 

professional development that is 

designed to be informed by input from 

staff, identified barriers to job 

performance, and other employee 

engagement practices. Training and 

professional development opportunities 

are more effective in transferring to 

practice when staff are opting into the 

training and receive support from their 

supervisor in the process.140

Second, we propose a change to 

§ 1302.92(b)(1). Currently, 

§ 1302.92(b)(1) requires that staff receive 

a minimum of 15 clock hours of 

professional development per year. For 

teaching staff, this professional 

development must meet the 

requirements described in section 

648A(a)(5) of the Act, which specifies 

that the professional development must 

be high-quality, sustained, intensive, 

and classroom-focused in order to have 

a lasting positive impact on classroom 

instruction and teacher performance. 

The program must also regularly 

evaluate the professional development 

for effectiveness. Section 648A(f) of the 

Act requires programs to create, in 

consultation with an employee, a 

professional development plan for all 

full-time Head Start employees who 

provide direct services to children and 

requires that such plans are regularly 

evaluated for their impact on teacher 

and staff effectiveness. The agency and 

staff shall implement the plan to the 

extent feasible and practicable. Section 

648A(f) of the Act has been 

implemented in practice through 

technical assistance and monitoring, but 

it has not been explicitly codified in the 

HSPPS. We propose to add new 

language to § 1302.92(b)(1) that codifies 

the requirement in section 648A(f) of 

the Act for the creation of individual 

professional development plans. This 

proposed change is anticipated to be 

cost neutral and is not a policy change 

or a new or modified requirement, since 

programs have always been held to this 

statutory requirement in practice. 

Further, programs are currently able to 

use their professional development and 

training and technical assistance funds 

to help staff earn their credentials and 

degrees. 

We believe this proposed change is an 

important clarification as data from 

OHS monitoring findings show that 

programs are being cited for lacking 

professional development plans for their 

education staff. Indeed, analysis of 

internal data from fiscal year 2020–2022 

reveals a top cited monitoring finding in 

OHS oversight reviews of programs was 

related to lack of appropriate 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80840 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

141 Data from narrative responses from monitoring 

reviews from fiscal years 2020–2022. 

142https://www.acf.hhs.gov/ecd/policy-guidance/ 

dear-colleague-social-emotional-development-andmental-health. 

143National Research Council and Institute of 

Medicine Committee. Preventing mental, emotional, 

and behavioral disorders among young people: 

progress and possibilities. Washington, DC: 

National Academies Press; 2009. 

Brauner, C.B., & Stephens, C.B. (2006). Estimating 

the prevalence of early childhood serious 

emotional/behavioral disorders: Challenges and 

recommendations. Public health reports, 121(3), 

303–310. 

144Leventhal, T., & Brooks-Gunn, J. (2003). 

Moving to Opportunity: an Experimental Study of 

Neighborhood Effects on Mental Health. American 

Journal of Public Health 93(9). 1576–1582. doi: 

10.2105/ajph.93.9.1576. 

145https://www.nami.org/Blogs/NAMI-Blog/ 

August-2020/Ways-We-Can-Address-the-SocialDeterminants-of-Mental-Health. 

146Otten, J.J., Bradford, V.A., Stover, B., Hill, 

H.D., Osborne, C., Getts, K., & Seixas, N. (2019). The 

culture of health in early care and education: 

workers’ wages, health, and job characteristics. 

Health affairs, 38(5), 709–720. 

147Substance Abuse and Mental Health Services 

Administration. (2022). Key substance use and 

mental health indicators in the United States: 

Results from the 2021 National Survey on Drug Use 

and Health (HHS Publication No. PEP22–07–01– 

005, NSDUH Series H–57). Center for Behavioral 

Health Statistics and Quality, Substance Abuse and 

Mental Health Services Administration. https://

www.samhsa.gov/data/report/2021-nsduh-annualnational-report. 

148Working to ensure that all young children and 

their caregivers have access to high-quality 

resources that equitably support social-emotional 

development and mental health. U.S. Department of 

Health and Human Services, Administration for 

Children and Families, Early Childhood 

Development, 2022. 

149https://aspe.hhs.gov/sites/default/files/ 

documents/4e2fff45d3f5706d35326b320ed842b3/ 

roadmap-behavioral-health-integration.pdf. 

150Mental health consultation is a preventionbased approach that teams a mental health 

professional with early care and education staff and 

families. This team works on ways to help promote 

the social and emotional development of the young 

children in their care. 

professional development plans for 

staff.141 Additionally, as described 

previously, since the onset of the 2020 

COVID–19 pandemic, many Head Start 

programs have had turnover in 

leadership and have suffered from ongoing staffing shortages and vacancies in 

staff positions. The proposed addition to 

§ 1302.92(b)(1) will remind new 

program leaders of this important 

requirement for their program staff to 

support the professional development of 

their workforce. It can also help 

improve staff retention by leveraging an 

existing requirement intended to 

support staff growth and professional 

development. 

Mental Health Services (Subpart D; 

Subpart H; Subpart I) 

Currently, programmatic requirements 

related to mental health appear in 

several areas of the standards, including 

§ 1302 Subpart A, Subpart D, Subpart H, 

and Subpart I. In this NPRM, we 

propose several changes to these 

sections of the HSPPS to enhance and 

clarify the importance of mental health 

services for Head Start children, 

families, and staff. Mental health and 

social-emotional well-being during early 

childhood are foundational for family 

well-being and children’s healthy 

development and early learning and are 

associated with positive long-term 

outcomes.142

We know that social-emotional 

difficulties impact up to 20 percent of 

children under the age of 5, and that 

over half of mental health disorders 

begin before age 14.143 We also know 

that children and families experiencing 

poverty are more likely to encounter 

stressors linked to mental health 

challenges as well as experience barriers 

to accessing mental health services. 

Research findings specifically indicate 

that children and families living in 

high-poverty neighborhoods exhibit 

worse mental health outcomes 

compared to individuals living in lowpoverty neighborhoods.144 Therefore, a 

focus on social determinants of health, 

or the conditions in which individuals 

live, work and play, can lead to better 

mental health outcomes and prevent 

future mental illness.145 Head Start 

programs are well positioned to support 

children and families experiencing 

poverty by strengthening the focus on 

mental health in the settings where 

children spend most of their day and 

where families are provided the services 

that they need to help their children 

succeed in school and in life. 

In addition to children, the impact of 

poor adult mental health has also 

garnered national attention, including 

the importance of addressing mental 

health for the ECE workforce.146 In 

2021, 57.8 million adults (22.8 percent) 

were affected by mental illness and 46.3 

million (16.5 percent) of people aged 12 

and older had a substance use 

disorder.147 We know that mental health 

of young children is intertwined with 

the mental health of the adults that care 

for them. We also know that early 

childhood experiences, like trusting 

relationships with caregivers in a stable, 

nurturing environment, aid in the 

development of skills that build 

resilience. Head Start is in a unique 

position to provide these experiences 

and extend them to the home 

environment. Fostering a child’s 

relationship with adults in their life and 

providing them with the best 

environment to grow requires an 

intentional focus on both child and 

adult well-being. Head Start strives to 

do both. 

Changes to the HSPPS related to 

mental health are needed to leverage 

and build on Head Start’s capacity to 

promote wellness and prevent future 

mental health challenges for Head Start 

children, families, and staff. The 

approach taken in this NPRM aligns 

with efforts across HHS 148 to (1) 

increase mental health integration, 

coordination, and consultation in a 

range of settings outside traditional 

mental health service spaces; (2) create 

healthy environments that focus on 

promotion and prevention efforts across 

the lifespan; and (3) connect people to 

the care they need via an approach that 

engages high-risk populations in 

integrated mental health care through 

targeted outreach tailored to their 

needs.149

The proposed changes described here 

cut across multiple areas of the 

standards and serve to strengthen, 

clarify, and enhance existing Head Start 

requirements to highlight a 

comprehensive and integrated approach 

to elevate mental health across the 

entire Head Start program. Head Start 

programs are a conduit to mental health 

services for those most in need and are 

settings in which children spend a 

significant amount of time. With an 

emphasis on a holistic approach to 

healthy development, it stands to reason 

that the HSPPS should reflect the 

importance of this service in an 

integrated fashion. The proposed 

changes clarify what is meant by 

wellness promotion, affirm that mental 

health is included in health services 

provided in Head Start, strengthen 

language to integrate coordinating 

support for child and adult mental 

health, incorporate strengths-based 

language by reducing the focus on 

concerns or challenging behaviors 

related to mental health and adding a 

focus on supports and development of 

children, strengthen requirements to 

prevent and work towards eliminating 

all suspension and expulsions in Head 

Start programs, clarify expectations and 

responsibilities of the mental health 

consultant by aligning the definition of 

infant and early childhood mental 

health consultation with the Substance 

Abuse and Mental Health Services 

Administration (SAMHSA) and research 

in the field, and reduce barriers to 

obtaining mental health consultation 

services by clarifying staff qualifications 

and removing language that consent is 

needed by a parent as mental health 

consultants do not provide treatment.150

Implementation of these changes will 

involve both updates to existing practice 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80841 

151 Gilliam, W.S. (2005). Prekindergarteners left 

behind: Expulsion rates in state prekindergarten 

systems. New York, NY: Foundation for Child 

Development. 

152Horowitz, M. (2015). Early Childhood 

Suspension and Expulsion. Center on Enhancing 

Early Learning Outcomes (CEELO). Retrieved from: 

http://ceelo.org/wp-content/uploads/2015/08/ 

ceelo_annotated_bib_expulsion_2015_08_final_

web.pdf. 

153U.S Department of Education Office for Civil 

Rights (2021). An overview of exclusionary 

discipline practices in public schools for the 2017– 

18 school year. See https://ocrdata.ed.gov/assets/ 

downloads/crdc-exclusionary-school-discipline.pdf. 

154Perry, D.F., Holland, C., Darling-Kuria, N., & 

Nadiv, S. (2011). Challenging behavior from child 

care: The role of mental health consultation (32, pp. 

4–11). Zero to Three. 155https://eclkc.ohs.acf.hhs.gov/childrendisabilities/article/head-start-center-inclusion. 

156McCabe, L.A & Frede, E.C. (2007). Challenging 

behaviors and the role of preschool education. New 

Brunswick, NJ: National Institute for Early 

Education Research. Available: nieer.org/wpcontent/uploads/2016/08/16.pdf. 

as well as new internal processes for 

programs. OHS will support programs 

as they implement these enhanced 

requirements through the robust Head 

Start training and technical assistance 

system. 

1302 Subpart A—Eligibility, 

Recruitment, Selection, Enrollment, and 

Attendance 

Section 1302.17 describes Head 

Start’s policies that severely limit 

suspension and prohibit expulsion due 

to a child’s behavior. Data with 

nationally representative samples of 

State-funded prekindergarten programs, 

including Head Start programs, have 

found that over 10 percent of preschool 

teachers expelled at least one 

preschooler in the previous year, which 

was three times the rate for K–12 

students.151 Suspension and expulsion 

practices have long-lasting negative 

impacts for young children and their 

families, including on children’s later 

school attendance, academics, and 

family stress. Additionally, research has 

well documented that 

disproportionalities exist in suspending 

or expelling students who are young 

boys of color, children with disabilities, 

and children who are dual language 

learners.152 For example, in the 2017– 

2018 school year there were about 2800 

preschool suspensions, and African 

American boys received 43 percent of 

suspensions despite making up 18 

percent of preschool enrollment.153

ACF has a focus on preventing use of 

suspension and expulsion in programs, 

and ensuring that any use of these 

disciplinary practices does not 

perpetuate disproportionalities across 

different groups of children, and many 

of the proposed changes to regulations 

codify this further. This NPRM retains 

the prohibition on expulsions and 

severe limitations on use of suspension, 

clarifying that suspension is a measure 

of last resort to allow the program time 

to put needed supports and 

accommodations in place. Additionally, 

several of the mental health related 

approaches proposed in this NPRM are 

targeted at building adult capacity to 

understand and respond to challenging 

behaviors associated with suspension/ 

expulsion early and effectively, such as 

requiring staff to be trained to 

understand behavior and implement 

positive disciplinary strategies as well 

as effective implementation of mental 

health consultation.154 The proposed 

changes to the suspension and 

expulsion section of the standards are 

intended to further our efforts to reduce 

the use of suspension and expulsion 

and clarify terminology and 

expectations related to suspension and 

expulsion practices. 

First, we propose to add broad 

definitions of suspension and expulsion 

to § 1305.2 to provide clarity on which 

disciplinary practices are captured 

under these respective categories. The 

broader definitions proposed here align 

with Caring for our Children standards, 

which are developed in collaboration 

with experts and widely used in ECE 

settings, and the Head Start Center for 

Inclusion.155 We propose to define 

expulsion as the permanent removal of 

a child from the learning setting or a 

requirement that a child unenroll in a 

program. We propose to define 

suspension as the temporary removal of 

a child from the learning setting 

including all reductions in the amount 

of time a child may be in attendance of 

the regular group setting, either by 

requiring the child to cease attendance 

for a particular period of time or 

reducing the number of days or amount 

of time that a child may attend. 

Requiring a child to attend the program 

away from the other children in the 

regular group setting is included in this 

definition. Requiring the parent or the 

parent’s designee to pick up a child for 

reasons other than illness or injury is 

also included in this definition. 

The goal of suspension should always 

be for the child to return to the least 

restrictive and most integrated 

educational environment safely and 

expediently. We do not provide 

guidelines for the specific length of time 

for suspensions because the appropriate 

time depends on many factors, such as 

the immediacy and severity of the safety 

concern and the complexity and 

availability of supports needed to 

facilitate the child’s return to full 

participation. Suspensions should not 

be used indefinitely or repeatedly, and 

longer periods of suspension take away 

opportunities for children to develop 

the social and emotional skills that 

improve challenging behaviors in the 

long-term.156 Programs should use the 

temporary suspension period to actively 

collaborate with families, mental health 

professionals, the multidisciplinary 

team responsible for mental health and 

others to develop a coordinated plan 

and timeline for supporting the 

identified child and their family to 

return to full participation. Programs 

should also engage with the child and 

family, mental health professionals, 

multidisciplinary team responsible for 

mental health, and other relevant staff, 

regularly during the temporary 

suspension period to ensure that the 

child continues to be supported during 

this time, such as through home 

visitation or community services, and to 

provide regular check-ins on the 

program’s progress in implementing the 

collaborative plan. 

The existing suspension standards in 

§ 1302.17(a) already include many of the 

components of the approach described 

above. However, we propose to add 

language to clarify the expectations of 

the steps that should be taken before a 

suspension can be determined to be 

necessary, and that a program needs to 

thoroughly document plans related to 

suspension similar to how they 

document plans related to transferring a 

child to a setting that can better meet 

their needs. By documenting suspension 

practices, we intend to be better 

positioned to assess how and when 

disproportionalities in the use of 

suspensions may be occurring across 

different groups of children. 

Specifically, we propose to modify 

§ 1302.17(a)(2) to say that a suspension 

must be used only as a resort where 

there is a serious safety threat that ‘‘has 

not been’’ reduced instead of ‘‘cannot 

be’’ reduced or eliminated to emphasize 

that the program should take active 

steps to attempt to reduce or eliminate 

the concern and demonstrate that these 

have not worked. Additionally, the 

current standard notes the provision of 

‘‘reasonable modifications’’ which we 

propose to change to ‘‘interventions and 

supports recommended by the mental 

health consultant’’ to again emphasize 

that prior to a suspension being 

considered, it is expected that the 

program engages with the mental health 

consultant to apply and assess whether 

supports and interventions, such as use 

of visual aids or preferred seating, can 

have an impact. Finally, we add an 

additional phrase that reflects the 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80842 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

157https://www.zerotothree.org/preventingexpulsion-from-preschool-and-child-care/. 

158https://www.gao.gov/assets/gao-23- 

105250.pdf. 

intended purpose of a temporary 

suspension, ‘‘and the program needs 

time to put additional appropriate 

services in place.’’ 

In addition to the mental health 

consultant, we have added in 

§ 1302.17(a)(3) that ‘‘the 

multidisciplinary team responsible for 

mental health’’ must also be part of the 

discussion before a program determines 

whether a temporary suspension is 

necessary. This new addition of a 

multidisciplinary team is discussed 

further in proposed changes to § 1302.45 

below. 

If a temporary suspension is deemed 

necessary by the program, we have 

added proposed language to 

1302.17(a)(4) to clarify and strengthen 

existing standards regarding what a 

program must do to bring the child back 

to the program as expediently as 

possible. Specifically, we propose to 

add a statement to of § 1302.17(a)(4) that 

states a program must explore all 

possible steps and document all steps 

taken to address the behavior(s) and 

supports needed to facilitate the child’s 

safe reentry and continued participation 

in the program. In outlining these steps, 

we propose to strengthen existing 

language in § 1302.17(a)(4)(i) to (iii) to 

further clarify and enhance the actions 

a program must take to reengage the 

child in program services. First, we 

propose to revise § 1302.17(a)(4)(i) by 

adding ‘‘the multidisciplinary team 

responsible for mental health, and other 

appropriate staff’’ to clarify that these 

are additional groups the program must 

continue to engage to support the child. 

Next, we propose to remove current 

§ 1302.17(a)(4)(ii), which requires a 

written plan to document action and 

supports, as this is now incorporated 

into new language proposed for 

§ 1302.17(a)(4), described previously. 

Next, we propose to redesignate 

§ 1302.17(a)(4)(iii) as § 1302.17(a)(4)(ii) 

and further enhance this requirement by 

adding language that clarifies that home 

visits could be one of multiple 

additional services for the child. The 

revised § 1302.17(a)(4)(ii) reads 

‘‘Providing additional program supports 

and services, including home visits.’’ 

Finally, we propose to redesignate 

§ 1302.17(a)(4)(iv) as § 1302.17(a)(4)(iii) 

and enhance this standard with 

additional language that requires 

coordination with a child’s individual 

family service plan (IFSP) or individual 

education plan (IEP), if appropriate. In 

the rare instance the program is unable 

to meet the needs of a child while they 

are in the learning setting, our intent is 

that these changes will provide 

sufficient clarity on how to return a 

child quickly to program services with 

the correct supports in place. 

Furthermore, while Head Start 

prohibits expulsion, as stated in 

§ 1302.17(b), we do know there are 

instances where there is a more 

appropriate placement for a child. In 

those instances, it is imperative that the 

child is not unenrolled from the Head 

Start program without having a more 

appropriate placement to attend that is 

prepared to provide services 

immediately. Therefore, we propose to 

add additional language to the end of 

§ 1302.17(b)(3) to clarify that a program 

must work to directly facilitate the 

transition of the child to a more 

appropriate placement ‘‘that can 

immediately enroll and provide services 

to the child.’’ We also propose to add 

language to § 1302.17(b)(2) and (b)(3) to 

require that the multidisciplinary team 

responsible for mental health join in 

discussions of how to prevent an 

expulsion from occurring, as well as 

new language to require engagement of 

parents in § 1302.17(b)(2). Taken 

together, we believe these changes will 

ensure that the child is surrounded by 

the appropriate care team that can make 

decisions in the best interest of the 

child. It is particularly important that 

we incorporate parents early on as we 

know that high expulsion rates are an 

indicator that we are not helping 

parents and caregivers to support the 

positive social and emotional 

development that is foundational for 

positive future outcomes.157

ACF seeks public comment on 

whether the proposed definitions for 

suspension and expulsion are 

appropriate, as well as on the process 

proposed in order to support programs 

in determining whether a temporary 

suspension is warranted. 

1302 Subpart D—Health Program 

Services 

There are many barriers to mental 

health care, including stigmatization of 

mental health and concerns about 

availability of the behavioral health 

workforce.158 By strengthening 

promotion and prevention efforts 

throughout the standards, we are 

seeking to provide a strong socialemotional foundation for children by 

being more intentional about the 

integration of mental health supports 

across all aspects of the Head Start 

program. We intend to reinforce that 

mental health is integral to many other 

aspects of the Head Start system and 

propose regulatory changes that utilize 

preventive approaches to mental health 

in other comprehensive service areas, 

such as health and family engagement. 

If programs have conversations about 

mental health early and often, they can 

also identify children, families, and staff 

with specific needs and intervene before 

more time and resource intensive care 

becomes necessary. 

Subpart D outlines the program 

requirements to support the provision of 

high-quality health, oral health, mental 

health, and nutrition services. We 

propose to change the name of this 

section from ‘‘Health Program Services’’ 

to ‘‘Health and Mental Health Program 

Services’’ to include mental health more 

explicitly in the standards, affirm that 

mental health is a critical component of 

health, and to facilitate ease of access to 

standards that closely relate to mental 

health topics. 

§ 1302.40 Purpose 

This section describes the overarching 

purpose of health and mental health 

program services in Head Start. In 

paragraph (b) we propose to replace 

‘‘Health Services Advisory Committee’’ 

with ‘‘Health and Mental Health 

Services Advisory Committee’’ to 

include mental health more explicitly in 

this requirement. The proposed change 

will clarify that mental health should be 

represented in conversations about 

health needs and services, including in 

the advisory committee. The proposed 

change would carry throughout the 

proposed standards for consistency, 

including in § 1302.42(b)(1)(i), 

§ 1302.43(b)(4), and § 1302.94(a). 

§ 1302.41 Collaboration and 

Communication With Parents 

Section 1302.41 requires Head Start 

programs to collaborate with parents as 

partners in the health and well-being of 

their children and communicate timely 

with parents about their children’s 

health needs and development 

concerns. 

Throughout § 1302.41, we propose to 

add ‘‘mental health’’ wherever health is 

mentioned to clarify that mental health 

is an integral part of health. 

Incorporating mental health into 

conversations about a child’s 

development and health normalizes and 

destigmatizes talking about mental 

health. These proposed regulatory 

changes are intended to increase 

conversations about mental health 

strengths and areas of concern early on 

with parents so that everyone has the 

information and tools to support the 

child’s mental health across different 

settings, contributing to reducing 

barriers to accessing care and increasing 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80843 

159 Glascoe, F.P. (2005). Screening for 

developmental and behavioral problems. Mental 

retardation and developmental disabilities research 

reviews, 11(3), 173–179. 

160https://www.medicaid.gov/medicaid/benefits/ 

early-and-periodic-screening-diagnostic-andtreatment/index.html. 

161Zero to Three (2016). DC: 0–5: Diagnostic 

Classification of mental health and developmental 

disorders of infancy and early childhood. 

Washington, DC; American Psychiatric Association. 

Diagnostic and statistical manual of mental 

disorders (DSM–5) American Psychiatric Pub; 2013. 

162Wolicki SB, Bitsko RH, Cree RA, et al. 

Associations of mental health among parents and 

other primary caregivers with child health 

indicators: Analysis of caregivers, by sex—National 

Survey of Children’s Health, 2016–2018, Adversity 

and Resilience Science: Journal of Research and 

Practice. Published online April 19, 2021. Lowry C, 

Stegeman I, Rauch F, Jani A. Modifying the school 

determinants of children’s health. J R Soc Med. 

2022;115(1):16–21. doi:10.1177/ 

01410768211051718. Jeon L, Buettner CK, Grant 

AA, Lang SN. Early childhood teachers’ stress and 

children’s social, emotional, and behavioral 

functioning. Journal of Applied Developmental 

Psychology. 2019;61:21–32. doi: 10.1016/ 

j.appdev.2018.02.002. 

163SAMHSA (2016). Creating a Healthier Life: A 

Step-by-Step Guide to Wellness. Publication ID: 

SMA16–4958. Available online at https://

store.samhsa.gov/product/Creating-a-HealthierLife/SMA16-4958. 

164 Green, B. & Allen, M.D. (2012). Developing 

and Implementing a Program wide Vision for 

Effective Mental Health Consultation. Center for 

Early Childhood Mental Health Consultation. 

https://www.iecmhc.org/documents/CECMHC_

AdministratorsToolkit.pdf. 

165For a federally accepted definition of 

‘multidisciplinary,’ see: https://sites.ed.gov/idea/ 

regs/c/a/303.24. 

the chance that future mental illness 

will be prevented. 

§ 1302.42 Child Health Status and Care 

Section 1302.42 describes the 

requirements of programs with respect 

to a child’s health status and care, 

including the timelines by which 

programs must ensure a child has an 

ongoing source of continuous, 

accessible health care; determine if a 

child is up to date on a schedule of ageappropriate care; and obtain or perform 

evidence-based vision and hearing 

screenings. We propose two changes to 

this section. 

First, we know that many young 

children with mental health issues do 

not have them identified by the time 

they enter elementary school,159 and are 

therefore losing a critical opportunity to 

receive early interventions and 

supports. The current regulations only 

specify that programs should ensure 

that children are up to date with 

medical, developmental, and oral health 

care schedules. Regular screening for 

mental health concerns is also necessary 

to ensure children and families with 

needs are identified early so that they 

can access appropriate interventions. 

Therefore, in § 1302.42 (b)(1)(i), we 

propose to add ‘‘mental health’’ to align 

with the purpose and intent of the Early 

and Periodic Screening, Diagnostic and 

Treatment (EPSDT) benefit that provides 

comprehensive and preventive health 

care services, including mental health, 

for children who are enrolled in 

Medicaid.160

Second, in § 1302.42 (b)(4), we 

propose to add ‘‘relevant developmental 

or mental health concerns’’ to clarify 

that when a program is identifying a 

child’s nutritional health needs, that 

developmental and mental health 

concerns should also be considered. 

This proposed addition is intended to 

capture best practices in the field, 

which acknowledge that developmental 

and mental health factors such as 

sensory aversions and feeding disorders 

play a role in nutritional health.161

§ 1302.45 Child Mental Health and 

Social and Emotional Well-Being 

This section outlines what programs 

must do to support a culture that 

promotes children’s mental health and 

outlines the scope of responsibilities of 

mental health consultants. For reasons 

stated at the outset of this section, Head 

Start has the capacity to reach people 

who are at higher risk for experiencing 

stressors and barriers to care and 

provide integrated preventive mental 

health supports into comprehensive 

services provided for the child and 

family. We propose numerous changes 

to § 1302.45 to strengthen, clarify and 

enhance existing Head Start mental 

health requirements, including 

intentionally integrating more staff 

attuned to the mental health needs of 

children and families by requiring a 

multidisciplinary team responsible for 

mental health within the program. This 

multidisciplinary team is intended to 

both destigmatize mental health and 

increase the capacity and reach of the 

mental health consultant. Other 

proposed changes range from important 

revisions to language to proposed 

changes to the approach to service 

delivery. We describe each of these 

changes in turn. 

First, we propose to change the title 

of this section from ‘‘Child mental 

health and social and emotional wellbeing’’ to ‘‘Supports for mental health 

and well-being.’’ Research demonstrates 

that child well-being is inextricably 

linked to adult well-being and in order 

to address child mental health, we need 

to address the mental health of 

caregivers as well, including both staff 

and parents.162

Next, we propose four changes in 

§ 1302.45(a). First, in the overarching 

requirement, we propose to change 

‘‘Wellness promotion’’ to ‘‘Programwide wellness supports’’ to align with 

the new title of this section and to 

clarify that programs should provide 

wellness supports across the program. 

Second, we propose to remove 

‘‘children’s’’ in this section to clarify 

that program-wide wellness supports 

are intended to promote the wellness of 

both children and adults. Third, we also 

propose to add ‘‘safety’’ in the 

description of a program-wide culture 

because wellness is dependent on 

meeting basic needs, including safety, 

and because it aligns with language in 

other standards which refer to 

children’s health and safety.163

Fourth, to clarify what programs must 

do to support a program-wide culture 

that promotes mental health, social and 

emotional well-being, and overall health 

and safety, we add new guidance to 

§ 1302.45(a) that a program must ‘‘have 

a multidisciplinary team responsible for 

mental health.’’ In addition to 

integrating more people into the 

conversation to address mental health, 

the multidisciplinary team responsible 

for mental health is also intended to 

develop and implement mental health 

efforts and supports that are not related 

to consultation, and to facilitate 

communication across service areas and 

systems in Head Start. The formation of 

such a team also aligns with 

recommendations by infant and early 

childhood consultation experts to have 

a group that can provide strategic 

planning, guidance and coordination 

related to mental health.164 By requiring 

a multidisciplinary team focused on 

mental health, we also aim for mental 

health supports and interventions, 

which have the potential to be more 

sustainable in programs. Currently, if 

the program relies on a consultant to 

provide all mental health related 

services, issues such as the availability 

of the mental health workforce and 

turnover may have a larger impact on 

the continuation of quality services. 

Multidisciplinary means the 

involvement of two or more separate 

disciplines or professions that actively 

work in tandem with parents to provide 

supports for children and families.165

For example, a mental health team may 

be comprised of a family service worker, 

teacher, mental health manager, 

disability service coordinator, and 

health specialist. This list is not 

intended to be exhaustive, and the 

intent is for programs to have flexibility 

in determining the appropriate 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80844 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

166U.S. Department of Health and Human 

Services, Administration for Children and Families, 

Office of Head Start, National Center on Parent, 

Family, and Community Engagement. (2019). Infant 

and Early Childhood Mental Health Consultation: 

Engaging with Families. 

167https://www.gao.gov/assets/gao-23- 

105250.pdf. 

composition of the multidisciplinary 

team. The rationale for this change is 

that providing program-wide wellness 

supports cannot rely on one individual 

such as a mental health consultant, and 

that many individuals working in Head 

Start already have expertise that can 

benefit program-wide wellness support 

efforts. Based on our experience 

overseeing the implementation of the 

Head Start program across the country, 

recipients that are most effective at 

supporting mental health create a team 

comprised of multiple individuals that 

may work with children, families, or 

staff in different capacities. We also 

want to acknowledge that many Head 

Start programs already have this 

practice in place in the form of case 

conferencing, which will facilitate the 

implementation of this practice as 

described in the proposed regulation. 

Furthermore, the establishment of a 

formal multidisciplinary team focused 

on mental health will support programs 

in the implementation of the other 

enhancements to mental health services 

described in this proposal. 

In addition to the changes to the 

overarching requirement in paragraph 

(a), we also propose changes and 

additions to the provisions for what 

activities are expected from the 

program-wide wellness supports, for a 

total of six provisions. The first 

provision, new § 1302.45(a)(1), 

describes that the multidisciplinary 

team responsible for mental health 

‘‘coordinates supports for adult mental 

health and well-being including 

engaging in nurturing and responsive 

relationships with families, engaging 

families in home visiting services, and 

promoting staff health and wellness, as 

described in § 1302.93.’’ We believe this 

language clarifies how a program most 

effectively addresses adult mental 

health. 

For the second provision, we propose 

to redesignate current § 1302.45(a)(1) to 

become § 1302.45(a)(2) with the revised 

language describing that the 

multidisciplinary team’s role is to 

‘‘coordinate’’ as opposed to ‘‘provide 

supports.’’ We then propose language 

changes to describe what supports the 

team is responsible for coordinating, 

including supports for positive learning 

environments, supportive teacher 

practices and strategies to support 

children’s mental health concerns. 

Specifically, we propose to remove 

‘‘effective classroom management’’ since 

this specific term is less aligned with a 

strengths-based approach and can 

contribute to stigma related to a child’s 

behavior. Instead, we keep the broader 

strengths-based term of positive learning 

environments, as classroom 

management is one part of creating a 

positive learning environment, and the 

need to monitor and effectively respond 

to child behavior applies across program 

options. We also make clear that these 

positive learning environments are for 

‘‘all children’’. Finally, we propose to 

replace ‘‘challenging behaviors’’ with 

‘‘behavioral or mental health concerns’’ 

to align with mental health language in 

other sectors that are less stigmatizing 

and more reflective of the concern 

programs are addressing within infant 

and early childhood mental health. 

We propose to remove the current 

§ 1302.45(a)(3), which states that ‘‘a 

program must obtain parental consent 

for mental health consultation services 

at enrollment’’ as this phrasing implies 

that mental health consultants provide 

treatment when, in fact, they provide 

consultation services, which do not 

require parental consent because the 

child is not directly receiving the 

service. Further, consistent with how 

programs communicate with parents 

about health and developmental 

services, we propose to include mental 

health services (which can include 

consultation services) in § 1302.41(b)(1). 

For the third provision, in new 

paragraph § 1302.45(a)(3), we propose to 

redesignate language from the current 

(a)(2) and further revise the language by 

replacing ‘‘schedule of sufficient and 

consistent frequency’’ with ‘‘no less 

than once a month’’ to specify, at a 

minimum, how often mental health 

consultation services should be 

provided in the program in order for 

partnerships with staff and families to 

be timely and effective. Experts from 

SAMHSA’s Center of Excellence in 

Infant and Early Childhood Mental 

Health Consultation recommend that 

mental health consultation services 

should be provided at least every other 

week, though considerations such as the 

size of the program and availability of 

services in the community can also 

impact the suggested frequency of 

consultation.166 We recognize that a 

biweekly frequency may not be feasible 

for all programs at this time, particularly 

in the context of larger concerns about 

recruiting and retaining an adequate 

mental health workforce.167 Therefore, 

we propose a minimum monthly 

frequency for these services, which we 

believe provides a regular enough 

schedule of services to allow for 

opportunities to embed the consultant 

into the program and therefore provide 

more effective services. ACF specifically 

requests comment on this section 

regarding whether ‘‘no less than once a 

month’’ as a minimum frequency is 

appropriate to meet the mental health 

consultation needs of programs. We also 

add to new (a)(3) that the 

multidisciplinary team responsible for 

mental health ‘‘examines the approach 

to mental health consultation on an 

annual basis to determine if it meets the 

needs of the program’’ in order to 

provide continuous quality 

improvement to ensure that the systems 

set up in the program are meeting the 

mental health needs of adults and 

children in the program. Examples of 

ways programs may want to examine 

their approach could include 

determining whether the program size 

and needs are being met by the 

frequency of consultation services or 

whether the program needs to change 

who is targeted to receive consultation 

services. 

For the fourth provision, we propose 

an entirely new § 1302.45(a)(4) that 

requires that the multidisciplinary team 

responsible for mental health ‘‘ensures 

that all children receive adequate 

screening and appropriate follow up 

and the parent receives referrals about 

how to access services for potential 

social, emotional, behavioral, or other 

mental health concerns, as described in 

§ 1302.33.’’ This language clarifies the 

responsibility of the program to ensure 

screenings related to social and 

emotional milestones that impact 

mental health are completed or obtained 

from an appropriate provider. 

Additionally, the responsibility of the 

program is to ensure appropriate follow 

up and referral for necessary supports or 

services takes place, as warranted, 

which may be done in coordination 

with health and other early childhood 

systems. 

For the fifth provision, we propose an 

entirely new § 1302.45(a)(5) where we 

propose to add that the 

multidisciplinary team responsible for 

mental health must facilitate 

coordination and collaboration between 

mental health and other relevant 

program services, including education, 

disability, family engagement, and 

health services. We believe this 

language clarifies and emphasizes that 

mental health should be considered 

holistically along with physical health 

and requires a program-wide approach 

that includes coordinating across 

program services. 

Finally, the sixth provision in 

§ 1302.45(a) is a redesignation of an 

existing provision. We propose that the 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80845 

168 Duran, F. et al. (2009). What Works?: A Study 

of Effective Early Childhood Mental Health 

Consultation Programs. Washington, DC: 

Georgetown University Center for Child and Human 

Development.; Kaufmann, R. et al. (2012). Creating 

Practice-Based Principles for Effective Early 

Childhood Mental Health Consultation Services. 

Washington, DC: Georgetown University Center for 

Child and Human Development. 

169 Kaufmann, R., Perry, D., Irvine, M., Duran, F., 

Hepburn, K., & Bruno, A. (2012. Creating PracticeBased Principles for Effective Early Childhood 

Mental Health Consultation Services. Center for 

Child and Human Development, Georgetown 

University. 

current § 1302.45(a)(4) be redesignated 

to new § 1302.45(a)(6) to accommodate 

the changes described in the previous 

paragraphs. 

Next, we propose numerous changes 

to paragraph (b) of § 1302.45 and its 

provisions. We recognize there is an 

ongoing need to strengthen and build a 

more diverse behavioral health 

workforce. We also recognize that 

mental health consultants with specific 

early childhood expertise are 

particularly challenging for programs to 

identify and secure. To address this 

barrier and facilitate the implementation 

of the proposed enhancements to other 

mental health policies, the proposed 

regulation changes in § 1302.91(e)(8)(ii), 

discussed later in this section, 

specifically allow programs to secure 

mental health consultation from 

professionals who are in the process of 

obtaining licensure and are under the 

supervision of a licensed mental health 

professional. We also include proposed 

language that reflects the existing 

literature on effective practices in infant 

and early childhood consultation. 

Together, the proposed changes in 

§ 1302.45(b) are intended to align the 

standards with best practices in infant 

and early childhood mental health 

consultation.168 Most notably, the 

changes are intended to require that 

programs focus consultation services on 

promotion and prevention efforts by 

broadening and building programmatic 

and adult capacity to support the mental 

health of the children for whom they 

care. We also add language in this 

section that clarifies expectations and 

responsibilities of the mental health 

consultant by aligning with the 

definition of the consultation model that 

appears in research as well as in other 

Federal entities such as the Substance 

Abuse and Mental Health Services 

Administration. We include general 

types of consultation services that can 

be leveraged within programs in the six 

provisions that follow. However, 

effective consultation occurs when there 

is ongoing collaboration between 

consultant and consultee and 

consideration of individualized 

strengths and needs.169

In the first provision, § 1302.45(b)(1), 

we add to the existing language to 

clarify a central type of mental health 

consultation with the program is 

focused on promotion and prevention of 

mental health concerns, in addition to 

identifying and supporting existing 

mental health concerns. 

For the second provision, 

§ 1302.45(b)(2), we propose several 

changes that clarify that mental health 

consultants can consult with any staff 

who work with children and families, 

which may include teachers, family 

child care providers, or home visitors, 

and describe the general goals of this 

type of consultation. This change aligns 

with our approach of ensuring that 

every adult who works with children 

can benefit from understanding and 

receiving supports related to mental 

health. First, we propose to replace 

‘‘teachers, including family child care 

providers’’ with ‘‘child and family 

services staff’’ to clarify that mental 

health consultation can occur with any 

staff member who works with children 

and families. For example, some 

programs may determine with their 

consultant that they would like to 

increase consultation targeted at 

engaging home visitors, given that 

program’s specific needs. We also 

propose to remove the phrase ‘‘improve 

classroom management and supportive 

teacher practices’’ to align with the 

clarification that mental health 

consultation is not solely focused on 

specific classroom or teaching practices. 

Next, we propose to replace ‘‘through 

strategies that include using classroom 

observations and consultations to 

address teacher and individual child 

needs and creating physical and cultural 

environments’’ with ‘‘implement 

strategies that build nurturing and 

responsive relationships and create 

positive learning environments.’’ We 

believe this language more clearly aligns 

with the intended role of a mental 

health consultant to help child and 

family staff implement strategies that 

will build strong relationships and 

positive learning environments, which 

should not be limited only to 

conducting observations. We also note 

that building positive learning 

environments may still include 

activities such as classroom 

management, supportive teacher 

practices, and creating positive physical 

and cultural environments. Our 

intention is to encourage flexibility and 

to acknowledge that there are many 

ways to build relationships and learning 

environments. Finally, we also propose 

to replace the phrase ‘‘functioning’’ with 

‘‘development of all children’’ to specify 

that when working with infants and 

toddlers as well as preschoolers, the 

focus is on social and emotional 

development and creating environments 

and relationships that have the capacity 

to help young children grow in these 

foundational skills. 

In the third provision, § 1302.45(b)(3), 

we propose to replace ‘‘other staff, 

including home visitors’’ with ‘‘staff 

who have contact with children’’ to 

clarify that the mental health 

consultants can provide consultation to 

any staff that have contact with children 

as needed, including, for example, 

transportation staff or food services 

staff. Our rationale for this change is to 

elevate that any staff who have contact 

with children play an important role in 

promoting young children’s mental 

health and wellness. We also propose to 

remove ‘‘to meet children’s mental 

health and social and emotional needs 

through strategies that include 

observation and consultation’’ as mental 

health consultation is not a strategy of 

consultation. Instead, we propose to add 

the elements outlined in the current 

§ 1302.45(b)(4) to § 1302.45(b)(3), 

including the existing phrase ‘‘prevalent 

child mental health concerns; 

internalizing problems such as 

appearing withdrawn and externalizing 

problems such as challenging 

behaviors’’, which we propose to further 

revise. We propose to clarify what is 

meant by ‘‘addressing’’ prevalent child 

mental health concerns in the current 

§ 1302.45(b)(4) by adding to 

§ 1302.45(b)(3) ‘‘to understand and 

appropriately respond to.’’ Finally, we 

propose to revise and expand what is 

meant by prevalent child mental health 

concerns by revising that phrase to 

‘‘prevalent child mental health 

concerns, including internalizing 

problems such as appearing withdrawn, 

externalizing problems such as 

behavioral concerns; and how exposure 

to trauma and substance use can 

influence risk’’. 

In a new fourth provision, 

§ 1302.45(b)(4), we use language from 

the current § 1302.45(b)(5) and propose 

to replace ‘‘parents’’ with ‘‘families’’ to 

expand with whom the consultant can 

provide consultation within a child’s 

family unit. We also propose to add the 

phrase ‘‘or supports’’ to clarify that 

mental health consultation is not 

limited to accessing interventions. 

Furthermore, we propose to add 

‘‘including in the event of a natural 

disaster or crisis’’ to clarify that mental 

health consultants are vital in 

emergency, preparedness, response and 

recovery. 

Finally, the last provisions of 

1302.45(b) are intended to highlight two 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80846 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

170Howard, L.M., & Khalifeh, H. (2020). Perinatal 

mental health: a review of progress and challenges. 

World Psychiatry, 19(3), 313–327. 171Rao, W.W., Zhu, X.M., Zong, Q.Q., Zhang, Q., 

Hall, B.J., Ungvari, G.S., & Xiang, Y.T. (2020). 

Prevalence of prenatal and postpartum depression 

in fathers: A comprehensive meta-analysis of 

observational surveys. Journal of affective disorders, 

263, 491–499. https://doi.org/10.1016/ 

j.jad.2019.10.030. 

172Maternal Mental Health Leadership Alliance. 

(July 2020). Maternal Mental Health Overview. Fact 

Sheet available on online at: www.mmhla.org/factsheets Maternal Mental Health Leadership Alliance. 

situations in which involving a mental 

health consultant is crucial. Expulsion 

and suspension, as reviewed previously, 

can have long-lasting impacts on stress 

and mental health of children and 

families and therefore Head Start has 

prohibited or severely limited these 

disciplinary practices. The proposed 

changes require the program to engage 

the mental health consultant so that 

supports and accommodations are in 

place to ensure children’s safe and full 

participation in the program. 

Specifically, in the fifth provision, 

§ 1302.45(b)(5), we propose to use 

language from the current 

§ 1302.45(b)(6) and add ‘‘the program’’ 

to clarify that implementation of 

policies to limit suspension and 

prohibit expulsion would occur in 

consultation with the program. 

Similarly, we recognize that child 

safety incidents can negatively impact 

the mental health of children and their 

families, as well as their relationships 

with the program. Therefore, we 

propose to add a sixth provision, 

§ 1302.45(b)(6), which requires a 

program to support the well-being of 

children and families involved in any 

significant child health, mental health, 

or safety incident described in 

§ 1302.102(d)(1)(ii). As health and safety 

are a part of well-being, it falls within 

the role of a mental health consultant to 

ensure that the program, affected staff, 

child, and/or family members are 

connected to appropriate supports if an 

incident impacting a child’s health and 

safety occurs. 

§ 1302.46 Family Support Services for 

Health, Nutrition, and Mental Health 

Section 1302.46 requires programs to 

collaborate with families to promote 

children’s health and well-being and 

describes what that collaboration must 

include. We propose several changes to 

this section. These proposed changes 

are intended to integrate the preventive 

approach to mental health into family 

support services by using more 

strengths-based language, providing 

opportunities to engage families in 

discussions about mental health even 

when there is not an identified problem, 

and ensuring the mental health of 

parents is also a function of family 

support services. First, in paragraph 

§ 1302.46(b)(1)(iii), we propose to 

replace ‘‘substance abuse problems’’ 

with ‘‘substance use concerns’’ to use 

language that is person-centered and 

destigmatizing. We also propose to 

remove ‘‘perinatal’’ before ‘‘depression’’ 

and add ‘‘anxiety’’ to provide a more 

comprehensive description of what is 

meant by common parent mental health 

concerns. 

Second, in § 1302.46(b)(1)(iv), we 

propose to remove ‘‘identify issues 

related to child mental health and social 

and emotional well-being, including 

observations and any concerns about 

their child’s mental health’’ and replace 

it with ‘‘information related to their 

child’s mental health with staff, 

including.’’ We believe that this 

language clarifies a strengths-based 

approach to mental health where 

parents are not expected to identify 

issues with child mental health and that 

the focus of collaboration with parents 

is to help them respond appropriately to 

their individual child. 

Third, in § 1302.46(b)(2), we propose 

to add ‘‘and mental health systems’’ to 

clarify that a program must support 

parents’ navigation of mental health 

systems in addition to the health 

system. The purpose of this change is to 

acknowledge that navigation of health 

and mental health systems may be 

complex for families served by Head 

Start. The intent is to clarify our 

expectation that Head Start programs 

assist families in navigating these 

systems, which will ultimately benefit 

the family beyond their time in Head 

Start. Finally, we also propose a new 

§ 1302.46(b)(2)(iv) that reads ‘‘in 

providing information about how to 

access evidence-based mental health 

services for young children and their 

families, including referrals if 

appropriate’’ to clarify what is meant by 

helping parents navigate the mental 

health system. 

1302 Subpart H—Services to Enrolled 

Pregnant Women and People 

Section 1302.81 describes the prenatal 

and postpartum information, education, 

and services programs must provide 

enrolled pregnant women and people, 

fathers, and partners or other relevant 

family members. Perinatal mental health 

conditions are experienced in up to 20 

percent of pregnancies and can have 

significant impacts on children and 

families.170 There is increasing 

recognition that depression is not the 

only mental health condition that can be 

exacerbated by or emerge during the 

perinatal period, and that mental health 

concerns can impact family members 

who are not pregnant.171 Therefore, we 

propose changes in § 1302.81 that are 

intended to broaden the scope of 

awareness of the mental health 

information and education that may be 

helpful to provide to expectant families. 

Additionally, our proposed changes 

more explicitly recognize ties between 

social support and mental health and 

call for programs to ensure that social 

support is part of prenatal and postnatal services for enrolled families. 

More specifically, we propose four 

changes to § 1302.81(a) to highlight 

potential services related to mental 

health and to promote language that is 

more inclusive of family members and 

social supports. First, we propose to 

remove the word ‘‘relevant’’ that 

currently precedes ‘‘family members.’’ 

This change is intended to be inclusive 

of different family compositions, clarify 

that any family member identified by 

the enrolled pregnant woman or person 

may be eligible to receive such 

information, and make clear that a 

program does not have to determine 

whether a family member is relevant. 

Second, we propose to revise the phrase 

‘‘benefits of breastfeeding’’ to 

‘‘including breastfeeding’’ and relocate 

it to earlier in the standard to clarify 

that this is a component of ‘‘the 

importance of nutrition.’’ The purpose 

of this change is to clarify that 

breastfeeding, in addition to other forms 

of healthy infant feeding, is one aspect 

of nutrition when programs are 

providing prenatal and postpartum 

information. We also propose in 

§ 1302.81(a) to move ‘‘parental 

depression’’ from the list of information, 

education, and services to a newly 

created paragraph § 1302.81(b) focused 

on mental health, which is discussed in 

the following paragraph. We also 

propose to add ‘‘and the benefits of 

substance use treatment’’ to the list of 

topics. Finally, we propose to add 

‘‘mothers’’ to the list of family members 

a program must provide information to, 

to be inclusive of women who have 

already given birth. 

We further propose to redesignate the 

current § 1302.81(b) to § 1302.81(c) and 

insert a new § 1302.81(b). The proposed 

new § 1302.81(b) requires programs to 

support pregnant women, mothers, 

fathers, partners, or other family 

members to access mental health 

services, including referrals, as 

appropriate, to address concerns 

including perinatal depression, anxiety, 

grief or loss, birth trauma, and substance 

use. This language captures common 

mental health concerns that can arise 

during the perinatal period.172


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80847 

(June 2021). Dads and Depression. Fact Sheet 

available on online at: www.mmhla.org/fact-sheets. 

173Chu, R.C., Peters, C., De Lew, N., and 

Sommers, B.D. State Medicaid Telehealth Policies 

Before and During the COVID–19 Public Health 

Emergency (Issue Brief No. HP–2021–17). Office of 

the Assistant Secretary for Planning and Evaluation, 

U.S. Department of Health and Human Services, 

July 2021. https://aspe.hhs.gov/reports/statemedicaid-telehealth-policies. Karimi, M., Lee, E.C., 

Couture, S.J., Gonzales, A.B., Grigorescu, V., Smith, 

S.R., De Lew, N., and Sommers, B.D. National 

Trends in Telehealth Use in 2021: Disparities in 

Utilization and Audio vs. Video Services. (Research 

Report No. HP–2022–04). Office of the Assistant 

Secretary for Planning and Evaluation, U.S. 

Department of Health and Human Services. 

February 2022. 

174https://www.cdc.gov/workplacehealth

promotion/planning/leadership.html; https://

aspe.hhs.gov/sites/default/files/private/pdf/76661/ 

rpt_wellness.pdf. 

175U.S. Surgeon General. (2022). The U.S. 

Surgeon General’s Framework for Workplace 

Mental Health & Well-Being. U.S. Department of 

Health and Human Services. 

Finally, in redesignated § 1302.81(c), 

we propose to add ‘‘pregnant women’s’’ 

after ‘‘A program must also address’’ to 

clarify whose needs are being 

addressed. We also propose to add 

‘‘social’’ before emotional well-being to 

provide consistency with other language 

throughout the HSPPS. Finally, we 

propose to add ‘‘partner, or other family 

member’’ to clarify that programs must 

address the potential benefits of 

building supports and engagement with 

other family members in addition to 

fathers. 

1302 Subpart I—Human Resources 

Management 

§ 1302.91 Staff Qualification and 

Competency Requirements 

Section 1302.91 establishes the staff 

qualifications and competencies for all 

staff, consultants, and contractors 

engaged in the delivery of program 

services. We propose two changes in 

§ 1302.91(e)(8)(ii) that pertain to mental 

health consultants and align with our 

goals of reducing barriers to securing 

consultants while maintaining effective 

consultation services. First, we propose 

to remove ‘‘certified’’ and replace it 

with ‘‘under the supervision of a 

licensed’’ to align with qualifications of 

mental health consultation in the field. 

Second, we propose to remove ‘‘if 

available in the community.’’ We 

believe that clarifying that mental health 

consultants can include individuals 

who are working under the supervision 

of another licensed individual will open 

avenues to a larger pool of mental health 

consultants to choose from and provide 

opportunities to build the mental health 

workforce in the ECE field. We also 

know that in recent years, access to 

telehealth services has expanded and 

overall use of telehealth modality for 

services has become more prevalent.173

Even if a consultant cannot be on site, 

teleconsultation services can be utilized 

to work with adults in the program. 

Finally, striking the ‘‘if available’’ 

language is intended to emphasize that 

mental health consultation is vital to 

providing high quality comprehensive 

services in Head Start programs. 

§ 1302.93 Staff Health and Wellness 

As described in the earlier section, 

Workforce Supports: Staff Wellness, 

§ 1302.93 outlines requirements of 

programs in the area of staff health and 

wellness with § 1302.93(b) speaking 

specifically to mental health and 

wellness information for staff. We 

propose to expand on these 

requirements to align with the goals 

described in the earlier sections 

Workforce Supports: Staff Wellness and 

Workforce Supports: Employee 

Engagement. These changes are 

intended to further amplify the 

importance of an intentional focus on 

staff wellness to improve staff wellbeing, reduce burnout, and improve 

retention, as well as to promote highquality services for children and 

families. 

Specifically, we propose to add a new 

§ 1302.93(e) that states that a program 

should cultivate a program-wide culture 

of wellness that empowers staff as 

professionals and supports staff to 

effectively accomplish their job 

responsibilities in a high-quality 

manner, in line with the requirement at 

§ 1302.101(a)(2). We believe this 

language clarifies that program-wide 

wellness supports extend to staff and 

that these supports include addressing 

program management such as 

implementing positive employee 

engagement practices, opportunities for 

training and professional development 

and ongoing supervisory support.174

Indeed, a recent report from the U.S. 

Surgeon General highlights the 

importance of employers focusing 

intentionally on the mental health and 

well-being of their employees. The 

report establishes a framework for 

workers’ mental health with a focus on 

five essential areas including, creating 

connection and community in the 

workplace; protecting workers from 

physical and mental harm; providing 

intentional supports for work-life 

balance including paid leave; providing 

opportunities for growth and career 

advancement; and making employees 

feel valued in their roles in the 

workplace.175

Taken together, ACF believes the 

proposed changes discussed in the 

Mental Health Services section will 

greatly improve services for children, 

families, and staff. We seek public 

comment on how any of the proposed 

mental health requirements in this 

section may impact various 

communities. We specifically request 

public comment from the special 

populations served by Head Start, 

including AIAN and MSHS programs 

and communities. 

Modernizing Head Start’s Engagement 

With Families (§ 1302.11; § 1302.13; 

§ 1302.15; § 1302.34; § 1302.50) 

In Head Start’s nearly 60-year history, 

programs have cultivated trust with the 

public. However, ACF acknowledges 

there are areas that could benefit from 

time-saving improvements and muchneeded efficiencies. Below, we outline 

several areas in the HSPPS where we 

would like to draw specific attention to 

and elevate the need for programs to 

dedicate time, attention, and resources 

to making improvements in the 

efficiency of delivering services. 

Section 1302.11 describes the 

requirements programs must follow 

when completing their community 

needs assessment. ACF believes this is 

an area where we should require 

programs to identify the best and most 

efficient ways of communicating with 

families who are both currently enrolled 

and prospective families who might be 

eligible. Specifically, we propose a new 

(v) under § 1302.11(b)(1) that requires 

programs to identify communication 

methods and modalities that best engage 

with prospective and enrolled families 

of all abilities. This ensures that 

programs will use the community needs 

assessment as a method to determine 

the optimal communication modalities 

(be it digital through text messaging 

software, improved websites, automated 

phone calls or phone lines that provide 

program updates, etc.) that families 

prefer. 

Second, § 1302.13 outlines the 

requirements for recruiting children to a 

Head Start program. We propose to 

include specific language regarding the 

usage of modern technologies in the 

program’s recruitment strategies, and we 

propose to include a specific phrase on 

reducing family burden during the 

enrollment process. We envision 

programs utilizing information they 

gather from current families to learn 

about ways they can reduce unnecessary 

paperwork during the enrollment 

process. We propose to require that 

Head Start programs examine their 

current enrollment processes and 

determine ways to streamline and 

improve their strategies. Specifically, 

we propose to edit § 1302.13 to clarify 

that programs must use modern 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80848 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

technologies to encourage and assist 

families in applying for admission to the 

program, and to streamline the 

application and enrollment process, 

while ensuring families without access 

to technology have equitable access to 

the program. 

Section 1302.15 contains 

requirements related to enrolling new 

families into the Head Start program. 

We propose the addition of a new 

paragraph (g) that requires a userfriendly enrollment process. Programs 

must regularly examine their enrollment 

processes and implement any identified 

improvements to streamline the 

enrollment experience for families. This 

new provision would require programs 

to establish new procedures, or update 

current procedures, that are streamlined 

and efficient and keep the end-user in 

mind. This provision would also require 

programs to regularly update these 

procedures to keep up with latest 

innovative practices. 

Section 1302.34 describes parent and 

family engagement in education 

services. We propose to add a new 

subparagraph (9) to § 1302.34(b) that 

clarifies that communication methods 

and modalities used by the program 

should be the best available for engaging 

families of all abilities, including 

currently enrolled families as well as 

prospective families. These changes 

would ensure that programs are 

consulting and engaging with current 

parents and families to be involved in 

the methods the program uses to 

communicate with both prospective 

families and enrolled families of all 

abilities. Parents and families may have 

suggestions for how to improve 

communication channels, methods or 

modalities, or for potential innovations. 

Head Start’s customers are the children 

and families it serves. Including their 

voices in the creation of processes and 

communication streams is imperative to 

making improvements to efficiencies. 

The final section that we propose 

updates to is § 1302.50, Family 

engagement. We propose to modify the 

purpose statement in § 1302.50(a) by 

adding a sentence at the end that states, 

‘‘This includes communicating with 

families in a format that is most 

accessible.’’ This section of the HSPPS 

requires programs to serve both the 

child and their family in innovative 

two-generation approaches. Our 

proposed addition would require 

programs to also address 

communication methods and determine 

the most efficient and accessible format 

that families prefer and that may be 

necessary to address the needs of family 

members who have limited English 

proficiency or who are individuals with 

disabilities. 

We expect that many Head Start 

programs are already engaging in several 

of these strategies to improve their 

communication methods and reach 

families using the modalities and 

methods that are easiest for them, 

though some programs may need to 

make bigger changes to meet this 

proposed standard. However, overall, 

we anticipate minimal costs associated 

with this new requirement. Importantly, 

ACF would like to ensure that all 

programs are implementing these 

strategies equitably and universally. 

ACF recognizes that what works for one 

community may not work for another, 

so programs are tasked with the 

challenge of meeting the unique needs 

of the communities they serve. ACF 

seeks public comment on how the 

proposed requirements in this section 

may differentially impact different 

communities. We specifically request 

public comment from the special 

populations served by Head Start, 

including AIAN and MSHS programs 

and communities. Additionally, ACF 

requests comments on what new and 

innovative approaches or methodologies 

programs might use to fulfill this 

requirement, as well as potential costs 

associated with new approaches. 

Community Assessment (§ 1302.11) 

Section 1302.11(b) requires Head Start 

programs to conduct a community 

assessment to design a program that 

meets community needs and builds on 

strengths and resources. The current 

requirement describes a broad and 

comprehensive assessment of 

community needs, strengths, and 

resources and specifies the minimum 

data Head Start programs must use in 

this process. The community 

assessment must be done at least once 

during a 5-year grant period with an 

annual update of significant changes. 

We recognize that many Head Start 

programs utilize the community 

assessment to inform the design of the 

program to a great extent. However, 

Head Start programs and others from the 

field have raised concerns with the 

requirements as currently written. First, 

the standards do not clearly articulate 

the purpose of the community 

assessment or the purpose and scope of 

the annual update. The requirement 

lists the data a program must collect and 

analyze without identifying the 

overarching goals of the endeavor. 

Second, there is concern that in some 

cases, programs approach the 

community assessment as an 

unnecessarily detailed community 

assessment with overly complex 

analytical methodologies. Third, some 

community members express concern 

about the cost of the requirement. These 

concerns are related; the cost can be 

particularly great, for example, if a 

program deploys time-consuming 

surveys using complex analytical 

techniques. Additionally, some 

programs use program funds to hire 

demographers and analysts to conduct 

community assessments, which is not a 

concern in itself. However, the costs of 

this work could balloon if the scope of 

project is too exhaustive and complex 

and does not efficiently leverage 

existing available data. These concerns 

combined can cause costly barriers to 

some programs being able to use their 

community assessment data effectively 

to guide programmatic decisions as 

intended. Changes are proposed to this 

section to promote clarity on the intent 

of the community assessment, align 

with best practices, incorporate 

feedback from programs, and increase 

the effectiveness in how the community 

assessment is used to inform key aspects 

of program design and approach. 

In this section, we propose new 

language to be specific on the intended 

outcomes of the community assessment 

and requiring programs to be strategic in 

what data is collected and how it will 

be used to achieve those intended 

outcomes. This better reflects best 

practices to collect meaningful data and 

use it with purpose. We also propose 

new language to ensure programs assess 

readily available data on their 

community that provides usable 

information on the community for the 

grant recipient to design a program that 

meets the needs in the community. 

Altogether, these revisions direct 

programs to more effectively focus 

resources allocated to their community 

assessment on areas that matter most for 

program design, enrolling and serving 

the most in need in the community, 

what services are provided, and how or 

by whom families are served including 

which community strengths and 

resources are leveraged in service 

delivery. 

Specifically, we propose to split 

current § 1302.11(b)(1) into two 

paragraphs in order to expand on the 

purpose of the community assessment 

before detailing the data that programs 

are required to collect and utilize. 

Section 1302.11(b)(1) has been revised 

to articulate the goals of the community 

assessment and is designed to clarify the 

purpose and intended outcomes of the 

community assessment. We propose to 

add a new (i) to (iv) which describe in 

more detail the objectives of community 

assessment which include: identifying 

who programs will serve and their 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80849 

176https://www.ncbi.nlm.nih.gov/books/ 

NBK218229/#:∼:text=Counting%20the%

20homeless%20population%20is,

of%20homelessness%20for%20many%20

individuals. 

177https://www.naccho.org/programs/publichealth-infrastructure/performance-improvement/ 

community-health-assessment; https://

phaboard.org/accreditation-recognition/ 

reaccreditation/. 

178https://www.irs.gov/charities-non-profits/ 

community-health-needs-assessment-for-charitablehospital-organizations-section-501r3. 

associated risk factors; how they will 

serve them in a manner that reflects 

their needs and diversity, while 

promoting equity, inclusion, and 

accessibility in service delivery; 

informing eligibility, recruitment, 

selection, enrollment and attendance 

(ERSEA) processes to prioritize the 

enrollment of those most in need of 

services; and identify strengths and 

resources in the community a program 

can leverage in service delivery. 

We propose to revise paragraph (b)(2) 

so that it contains mostly existing 

standards redesignated from current 

paragraph (b)(1) and continues to focus 

on what data a program is required to 

collect, but with a few revisions. We 

propose to revise (b)(2)(i) to be the stem 

of the requirement to collect relevant 

data on eligible children and expectant 

mothers. Additionally, we revise this 

clause to no longer specifically require 

counts of eligible children and 

expectant mothers including counts by 

their geographic location, race, 

ethnicity, and languages spoken for 

enumerated items that follow. This has 

been moved to a new item as described 

in the following paragraph. Upon 

moving it, it has been broadened in the 

stem to ‘‘relevant demographic and 

other data about’’ eligible children and 

expectant mothers. This change allows 

programs to make strategic decisions on 

what relevant demographic and other 

data to collect on eligible populations to 

meet the intended outcomes of their 

community assessment. Also, it 

challenges programs to consider what 

demographic and relevant data to 

collect beyond counts of eligible 

populations by geographic location, 

race, ethnicity, and languages spoken. 

We propose to add ‘‘Children living in 

poverty’’ as the first enumerated item to 

follow the revised clause in paragraph 

(b)(2) to promote clarity. Programs were 

already required to include data on 

children living in poverty in their 

community assessments since these 

children are considered ‘‘eligible 

infants, toddlers, and preschool age 

children,’’ but adding it to the list makes 

this more explicit. We propose to 

redesignate A, B and C from previous 

paragraph (b)(1) to follow the newly 

added item (A) in paragraph (b)(2). A 

new (E) is added to revised paragraph 

(b)(2) which includes the language from 

the current introductory clause in 

(b)(1)(i) which reads ‘‘Geographic 

location, race, ethnicity and languages 

they speak.’’ This specific language is 

pulled out to become (b)(2)(i)(E) to 

continue to highlight the importance of 

understanding these elements related to 

the diversity of populations most in 

need of services, which in turn can help 

promote equity, inclusion, and 

accessibility in service delivery as noted 

in the proposed new (b)(1)(ii). 

We do not propose any changes to the 

rest of the required list of factors 

programs must consider in redesignated 

§ 1302.11(b)(2)(ii)–(vi). The only 

revisions to the list are the addition of 

the phrases ‘‘such as transportation 

needs’’ in § 1302.11(b)(ii) as an 

economic factor impacting well-being 

and ‘‘especially transportation 

resources’’ in § 1302.11(b)(2)(v) to 

require programs to consider what 

resources are available in the 

community to address the needs of 

eligible children and families. The 

rationale for proposing to include 

transportation explicitly in the 

requirements for relevant data in the 

community assessment is because 

transportation remains a significant 

barrier for many of the hardest to serve 

families and impedes Head Start’s 

mission. Access or lack of access to 

transportation plays a role in 

determining which families enroll in 

and attend Head Start programs. ACF 

wants to ensure transportation needs 

and resources are part of the data that 

informs a program’s design and service 

delivery. A more extensive discussion of 

transportation is included in the 

Transportation and Other Barriers to 

Enrollment and Attendance section of 

this preamble. 

We propose to add a new paragraph 

(b)(3), which requires programs to have 

a strategic approach to determine what 

data to collect prior to conducting the 

community assessment and how to use 

the data acquired after conducting the 

community assessment in order to 

achieve the intended outcomes outlined 

in the newly proposed (b)(1). This 

proposed requirement helps address the 

concern that some programs use overly 

exhaustive approaches or using 

unnecessarily complex analytical 

techniques to assess their communities. 

This requirement intends to align with 

best practices and promote overall 

effectiveness of the community 

assessment to drive programmatic 

decision making. 

We also propose adding a new 

paragraph (b)(4) to require programs to 

identify certain data that would be 

unreasonably burdensome and costly to 

collect and consider using publicly or 

locally available data as a proxy instead. 

This proposed requirement addresses 

the cost and complexity some programs 

report in accessing certain data. For 

example, a program may determine it is 

unreasonable to collect data on the exact 

counts of children under the age of 6 

experiencing homelessness due to the 

general difficulties and costliness in 

collecting accurate counts of 

populations experiencing 

homelessness.176 Although these counts 

may be helpful, the proposed 

requirement encourages this program to 

consider other available data that can be 

used as a proxy to meet the intended 

outcomes of the community assessment 

including how to prioritize the 

enrollment of populations experiencing 

homelessness in their community, in 

what areas of their community are they 

located, and what community strengths 

and resources can be leveraged to 

promote the delivery of program 

services to these populations. It is 

feasible to meet these intended 

outcomes without exact counts of 

children under the age of 6 experiencing 

homelessness using other available data 

such as location of homeless shelters, 

enrollment rates of children 

experiencing homelessness in schools, 

and through discussions with local 

community-based organizations that 

provide services to populations 

experiencing homelessness. 

Furthermore, programs may be able to 

leverage existing data collected in 

community health assessments 

conducted by local health 

departments 177 and non-profit 

hospitals 178 to support their own 

community assessments. 

We propose to redesignate paragraph 

(b)(2) to become (b)(5) and revise it to 

describe the purpose and goals of the 

annual review and update of the 

community assessment. There is a 

concern that the current annual update 

standard effectively requires a 

comprehensive update each year of the 

community assessment. The proposed 

requirement in redesignated and revised 

(b)(5) allows the program to determine 

where updates are needed based on 

areas where significant shifts in their 

community may have occurred that may 

impact their program design and service 

delivery, while also establishing that the 

annual update must consider how it can 

inform and support other relevant 

management and program improvement 

efforts as required in § 1302 Subpart J. 

These revisions to the annual update are 

intended to ensure programs are 

strategic in their approach to the annual 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80850 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

179See the Head Start Act: https://

eclkc.ohs.acf.hhs.gov/sites/default/files/pdf/HS_

Act_2007.pdf. 

180Congressional Budget Office. (2015, 

September). Federal Housing Assistance for Lowincome Households. https://www.cbo.gov/sites/ 

default/files/114th-congress-2015-2016/reports/ 

50782-lowincomehousing-onecolumn.pdf. 

181https://www.huduser.gov/portal/pdredge/pdredge-featd-article-081417.html. 182Measuring Housing Affordability: Assessing 

the 30 Percent of Income Standard. https://

www.jchs.harvard.edu/sites/default/files/Harvard_

JCHS_Herbert_Hermann_McCue_measuring_

housing_affordability.pdf. 

183Center on Budget and Policy Priorities. (2023, 

January). A Quick Guide to SNAP Eligibility and 

Benefits. https://www.cbpp.org/sites/default/files/ 

11-18-08fa.pdf. 

184Utility Allowances. U.S. Department of 

Housing and Urban Development. https://

www.hud.gov/program_offices/public_indian_

housing/programs/ph/phecc/allowances#:∼:text=

The%20utilities%20for%20which%20allowances,

as%20well%20as%20garbage%20collection. 

update, which in turn can promote the 

effectiveness and usefulness of the 

update. Finally, we propose to 

redesignate paragraph (b)(3) to become 

(b)(6) without revisions to the regulatory 

text. 

Conducting the community 

assessment is a complex process and we 

want to understand whether these 

proposed revisions to § 1302.11(b) will 

help address underlying challenges with 

the community assessment and whether 

they may cause any unintended 

consequences. Therefore, we are seeking 

public comment on the current 

development, utilization, and 

challenges of the community assessment 

as well as perceived impact of the 

changes proposed in this NPRM. ACF 

also seeks public comment on how the 

proposed requirements in this section 

may differentially impact different 

communities. We specifically request 

public comment from the special 

populations served by Head Start, 

including AIAN and MSHS programs 

and communities. We appreciate input 

that is specific and actionable. We also 

request public comment on whether any 

of the proposed revisions to the 

community assessment described in this 

NPRM will reduce program operational 

costs related to the community 

assessment. 

Adjustment for Excessive Housing Costs 

for Eligibility Determination (§ 1302.12) 

Head Start is intended to promote the 

school readiness of children living in 

low-income households.179 However, 

many programs have expressed concern 

that Head Start eligibility criteria does 

not account for high cost of living in 

some areas across the country. Many 

families earn just above poverty wages, 

but more than 30 percent of their 

income goes to housing costs. In 2015, 

the Congressional Budget Office 

estimated that about 14 million 

households are eligible for housing 

assistance since they paid more than 30 

percent of their income on housing, 

with some households paying more than 

50 percent of their income on rent.180

Children whose families earn nearpoverty level wages and who live in 

areas with a high-cost of living have 

fewer family resources remaining after 

paying for shelter costs, compared to 

families in lower-cost of living areas. 

High housing cost burdens have 

increased for low- and moderate-income 

renting households since the 1960s.181

Affordable housing costs have long been 

defined as costs that total 30 percent or 

less of a family’s total gross income. The 

30 percent threshold is an income 

standard that has been incorporated into 

laws for Federal housing assistance 

programs since the early 1980s. It has 

been a norm for defining housing 

affordability and is used by the U.S. 

Department of Housing and Urban 

Development (HUD) as a rent limit in 

the HOME Investment Partnerships 

Program for low-income rental units.182

Other means-tested programs that aim 

to serve those experiencing poverty, like 

SNAP, use an income adjustment to 

account for excessive housing costs.183

Adjusting income for housing expenses 

is an effective way to provide additional 

flexibility for families who are making 

above or near poverty wages, but face 

high housing costs, and would be 

eligible for Head Start if those 

disproportionally high housing costs 

were taken into account when 

determining eligibility. 

Therefore, we propose to revise 

§ 1302.12(i)(1) by adding a new (i) and 

(ii) to allow a program to adjust a 

family’s income to account for excessive 

housing costs, when determining 

eligibility. We propose to redesignate 

current § 1302.12(i)(1)(i) as clause (iii) 

and subsequent clauses are renumbered 

accordingly. Additionally, we propose 

to add a definition of ‘‘housing 

expenses’’ to § 1305.2. 

Specifically, § 1302.12(i)(1)(i) is a new 

stem to introduce the calculation of 

income and it states, ‘‘The program 

must calculate total gross income using 

applicable sources of income.’’ In a 

subsequent section of this NPRM, we 

described proposed clarifications to the 

definition of ‘‘income’’ in § 1305.2. 

Proposed new clause, § 1302.12(i)(1)(ii) 

introduces the adjustment for housing 

expenses and states that a program may 

make an adjustment to a family’s gross 

income calculation for the purposes of 

determining eligibility in order to 

account for excessive housing expenses. 

A program must use available bills, 

bank statements, and other relevant 

documentation provided by the family 

to calculate total annual housing 

expenses with appropriate multipliers. 

There are two additional subclauses (A) 

and (B) that describe how programs 

should adjust income to account for 

housing expenses. Specifically, (A) 

states that programs should determine if 

a family spends more than 30 percent of 

their total gross income on housing 

expenses, and (B) states that, if 

applicable, programs may reduce the 

total gross income by the amount spent 

in housing expenses above the 30 

percent threshold to calculate the 

adjusted gross income for determining 

income eligibility. 

In addition, a new term for housing 

expenses in § 1305.2 is proposed which 

means the total annual applicable 

expenses spent by the family on rent or 

mortgage payments, homeowner’s or 

renter’s insurance, utilities, interest, and 

taxes on the home. Utilities includes 

electricity, gas, water, sewer, and trash. 

To illustrate how income deductions 

would be calculated under these new 

proposed regulations, we describe the 

following example. If a family’s annual 

gross income is $10,000 and they spend 

$5,000 on housing, their housing cost is 

50 percent of their total gross income. 

Therefore, the percent of the family’s 

income spent on housing is 20 percent 

higher than the 30 percent threshold, 

and the family’s total gross income can 

be adjusted down by an amount equal 

to 20 percent of annual gross income. 

This results in a $2,000 reduction. 

Therefore, instead of a total gross 

income of $10,000 that the program 

must consider for eligibility purposes, 

this family’s total gross income would 

be $8,000 after application of proposed 

§ 1302.12(i)(1)(ii). ACF recognizes that 

programs do not need to calculate 

housing expenses for all families since 

many will still qualify for Head Start 

services based on income alone, or due 

to some other qualifying factor, 

including participation in SNAP or 

TANF. Therefore, the proposed 

regulatory language in (i)(1)(ii) indicates 

that a program ‘‘may’’ use available 

documents to calculate housing 

expenses. 

We propose to add the definition of 

‘‘housing expenses’’ to provide clarity 

about what can be considered in the 

calculation of total housing costs 

including what utility costs can be taken 

into account. In considering what 

utilities to include in the definition, 

ACF used HUD regulatory guidance for 

utility allowances as a resource.184 The 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80851 

HUD definition of utility allowances 

includes electricity, natural gas, 

propane, fuel oil, wood or coal, and 

water and sewage service, as well as 

garbage collection. Programs can use 

bills and expenses from one month to 

calculate the average expenses that a 

family has throughout the year. Further, 

programs should only be using bills for 

which families have paid for out of 

pocket. For example, housing vouchers, 

rental assistance, support from the Low 

Income Energy Assistance Program 

(LIHEAP), or other types of financial 

assistance should not be included in 

calculations of housing expenses. 

Programs should continue using their 

current methods of verifying eligibility 

based on tax forms, pay stubs, or other 

proof of income. These proposed 

regulatory changes would allow 

programs to also use bills, lease 

agreements, mortgage statements, and 

other documentation that shows 

housing and utility expenses. 

By including this income deduction 

calculation in eligibility determination 

for Head Start, ACF expects many 

programs to utilize this deduction 

calculation for families seeking 

eligibility. However, programs must 

adhere to their recruitment and 

selection criteria to ensure they 

prioritize enrollment for those who may 

benefit most from Head Start services. 

Specifically, all Head Start programs 

must continue to use their selection 

criteria to prioritize the enrollment of 

the families most in need of services as 

required in 45 CFR 1302.13. The sole 

purpose of this proposed rule is to allow 

programs to consider income 

deductions for the purposes of 

determining Head Start eligibility. 

ACF would like to invite comment on 

including a limit to the total amount in 

housing costs that can be deducted from 

a family’s income. ACF is not concerned 

with high income families being 

enrolled in Head Start since families 

still must be income-eligible after 

accounting for high housing costs, and 

programs should continue prioritizing 

highest need families based on their 

selection criteria. However, we invite 

comments on whether there should be 

a dollar limit or percentage limit to how 

much is allowed to be deducted from 

income to account for housing costs. 

ACF seeks public comment on how the 

proposed requirements in this section 

may differentially impact different 

communities. We specifically request 

public comment from the special 

populations served by Head Start, 

including AIAN and MSHS programs 

and communities. 

Migrant and Seasonal Head Start 

Eligibility (§ 1302.12) 

Section 1302.12(f) describes the 

eligibility requirements for enrollment 

in MSHS programs. Currently, to be 

eligible for MSHS, a family must 

demonstrate that their income comes 

primarily from agricultural labor which 

has been interpreted and implemented 

to mean a family’s income must be more 

than 50 percent from agricultural work. 

This presents an additional challenge to 

MSHS programs in finding eligible 

families. It has become increasingly less 

common for agricultural work to be the 

primary source of an entire family’s 

income as agricultural work has become 

less available or stable due to 

unpredicted weather events and due to 

higher pay in other industries. These 

changes impacting the agriculture 

industry have resulted in barriers to 

enrolling farmworker families in need of 

program services. 

To address this barrier, we propose to 

add language to § 1302.12(f) to add the 

policy that ‘‘one family member is 

primarily engaged in agricultural 

employment’’ rather than ‘‘family’s 

income comes primarily from 

agricultural work.’’ A family must still 

meet an eligibility criterion for Head 

Start services under 45 CFR 1302.12(c) 

(i.e., living at or below the 100 percent 

poverty guideline, experiencing 

homelessness, receiving public 

assistance, or in foster care). However, 

due to challenges migrant families face 

in relocating often to seek agricultural 

work, MSHS programs must prioritize 

migrant families for selection as 

required in § 1302.14(a)(2). 

Additionally, § 1302.12(j) outlines the 

requirements related to the period of 

time a child remains eligible for Head 

Start and when program staff must 

verify the family’s eligibility again 

before continuing services. In paragraph 

(2), specifically, the HSPPS notes that 

children who are enrolled in a program 

receiving funds under the authority of 

section 645A of the Act, which refers to 

the Early Head Start program, remain 

eligible while they participate in the 

program. 

The current standards do not specify 

eligibility duration related to the unique 

programs operated by MSHS. Current 

practice is that MSHS programs verify 

eligibility every two years. However, 

MSHS programs serve children from 

birth to school age and nearly half of 

MSHS enrollment consists of children 

under the age of three. Furthermore, 

many MSHS programs also receive Early 

Head Start funding. 

The existing requirement creates an 

inequity because infants and toddlers 

served in Early Head Start programs can 

receive services for the duration of the 

program, meaning until they turn three 

and age out of the program, whereas the 

MSHS family is no longer considered 

eligible for the program after two years. 

Therefore, the young children of 

agricultural workers are not provided 

the same potential duration of services 

as infants and toddlers served by Early 

Head Start. 

To address this inequity and extend 

the same opportunity to MSHS infants 

and toddlers that is available to infants 

and toddlers served through an Early 

Head Start grant, we propose to add a 

paragraph to address eligibility duration 

for infants and toddlers participating in 

MSHS programs. Specifically, we 

propose to add a new paragraph (5) to 

existing § 1302.12(j). The new language 

clarifies that MSHS programs can serve 

infants and toddlers for 3 years, 

consistent with the requirement in 

§ 1302.12(j)(2) that children 

participating in Early Head Start are 

eligible for the duration of the program. 

We believe this new language will 

correct this inequity and promote 

continuity for families served by MSHS 

and reduce paperwork for families and 

programs. 

Transportation & Other Barriers to 

Enrollment and Attendance (§ 1302.14; 

§ 1302.16) 

Sections 1302.14 and 1302.16 address 

the requirements for the selection 

process and attendance, two key 

components of ERSEA. Section 1302.14 

outlines the current requirements for 

programs’ selection of eligible children. 

It currently specifies that programs must 

annually develop selection criteria, 

based on community needs identified in 

the community needs assessment, for 

how they will prioritize the selection of 

eligible children. It also requires that a 

program ensure at least 10 percent of its 

total funded enrollment is filled by 

children eligible for services under 

IDEA unless a wavier is granted 

throughout the program year once the 

assessments are completed. Finally, it 

requires that programs maintain a 

waitlist. Section 1302.16 outlines the 

requirements of programs in the area of 

attendance. It articulates what programs 

must do to support regular attendance, 

to manage systematic program 

attendance issues, and to support 

attendance for children who are 

homeless. 

Through the course of implementing 

these provisions and discussions with 

constituents, ACF believes strongly that 

these requirements do not adequately 

reflect the importance of acknowledging 

barriers to enrollment and attendance, 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80852 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

185Source: Head Start 2010–2020 PIR. 

186 Ibid. Note: Uniform data on the population of 

children under five taking a bus or other ECE 

transportation services is not collected by the 

Bureau of Transportation Statistics. 

187U.S. Department of Transportation, Bureau of 

Transportation Statistics, Transportation Economic 

Trends, available at www.bts.gov/product/ 

transportation-economic-trends. 

188Chetty, R., Hendren, N., Kline, P., & Saez, E. 

(2014). Where is the land of opportunity? The 

geography of intergenerational mobility in the 

United States. The Quarterly Journal of Economics, 

129(4), 1553–1623.; Kaufman, S., Moss, M.L., 

Tyndall, J., & Hernandez, J. (2014). Mobility, 

economic opportunity and New York City 

neighborhoods. NYU Wagner Research Paper, 

(2598566). 

189Stern, A., Stacy, C., Blagg, K., Su, Y., Noble, 

E., Rainer, M., & Ezike, R. (2020). Access to 

Opportunity through Equitable Transportation. 

Available at: https://www.urban.org/research/ 

publication/access-opportunity-through-equitabletransportation. 

which is a critical part of selecting 

children for participation and ensuring 

they can attend regularly. There are 

many barriers that may impede 

enrollment or attendance in Head Start 

programs even after a child is selected. 

These barriers include, but are not 

limited to, transportation access, 

affordability and reliability challenges, 

particularly for individuals with 

disabilities; demands of family life (e.g., 

balancing work and school schedules, 

housing instability, caring for sick or 

disabled relatives); or hours and 

schedules that are not flexible enough to 

meet a family’s needs (e.g., additional 

child care needed to enable attendance 

at programs that do not operate for a full 

work day). 

We expand here on the example of 

transportation because of concerns that 

transportation to local programs remains 

a significant barrier for many of the 

hardest to serve families and impedes 

Head Start’s mission. The decision to 

cut or reduce transportation services is 

often part of a difficult budget decisionmaking process to free up funds for 

other rising program costs. For instance, 

in an analysis of Head Start Preschool 

and Early Head Start grants across the 

county, the average cost of a bus is 

about $90,000, or roughly $2,500 per 

seat. This cost excludes the cost of bus 

drivers and ongoing bus maintenance. 

As a result, Head Start programs 

nationally provide transportation to 

only 20 percent of enrolled children, 

more than 100,000 fewer children as 

compared to a decade ago.185

According to the Bureau of 

Transportation Statistics, about 70 

percent of low-income families with 

children ages 5 to 14 take a school bus 

to school.186 The Consumer Expenditure 

Survey (CE), administered by the 

Bureau of Labor Statistics (BLS), found 

that households spent an average of 

$9,826 on transportation in 2020—the 

second largest household expenditure 

category after housing. And low-income 

households spend a much higher 

proportion of their income on 

transportation expenses than non-lowincome households. In 2021, the average 

household with an income equal to or 

below $24,127 spent nearly a third of 

their income, 26.9 percent, on 

transportation. To compare, households 

with an income equal to or above 

$129,534 spent an average of 10.4 

percent on transportation.187 Having 

better clarity on this particular barrier 

and providing more targeted 

transportation assistance, if possible, 

allows these households to use their 

limited funds for other essential 

expenses. 

Research has shown that 

transportation is linked to economic 

mobility and documented links between 

poor public transit access and higher 

rates of unemployment.188 Additionally, 

accessing public transportation can be 

challenging and less reliable for lowincome communities, the same 

communities in which many eligible 

families are located and are most in 

need of reliable public transportation.189

We propose new language in § 1302.14 

and § 1302.16 to require programs to 

consider barriers to enrollment and 

attendance. In § 1302.14 Selection, we 

propose to add a new paragraph (d) to 

require programs to use data from the 

selection process to understand why 

children selected for the program do not 

enroll or attend. We specifically name 

transportation in the proposed language 

as one such barrier. We propose to 

amend paragraph § 1302.16 Attendance 

by adding § 1302.16(a)(2)(v) to require 

programs to examine barriers to regular 

attendance. Given the centrality of 

transportation as a barrier to reaching 

children and families, we again name 

access to transportation in the proposed 

language, and require programs to, if 

possible, provide or facilitate 

transportation if needed. Note that we 

also explicitly include transportation in 

§ 1302.11 on the community assessment 

to ensure that transportation needs and 

resources are part of the community 

wide strategic planning and needs 

assessment. 

The objective of the proposed changes 

to these requirements is to ensure 

programs are using their data to 

understand the factors that impede 

Head Start enrollment and participation 

in their service area, and ultimately, 

equip programs with more data to 

inform continuous improvement of 

service delivery as described in 

§ 1302.102(c). We propose to 

specifically require programs to 

consider transportation as a barrier to 

enrollment and attendance because of 

its significance in determining which 

children can enroll and participate in 

Head Start. In tandem with proposed 

revisions in § 1302.11(b) and 

§ 1302.16(a)(2), strengthening our 

HSPPS to increase transportation 

services to more children will help to 

provide more educational opportunity 

while also addressing these inequities. 

We believe these proposed changes will 

promote the thoughtful use of the 

community assessment, selection 

process, and attendance process to 

inform responsive program design, and 

ultimately, ensure children who would 

benefit most from Head Start services 

are identified, enrolled, and supported 

in attendance. With the additional data 

required in these sections, Head Start 

programs can better meet their current 

families’ needs and help to make 

services more accessible to future 

families. ACF seeks public comment on 

how the proposed requirements in this 

section may differentially impact 

different communities. We specifically 

request public comment from the 

special populations served by Head 

Start, including AIAN and MSHS 

programs and communities. 

Serving Children With Disabilities 

(§ 1302.14) 

Section 1302.14 outlines the 

requirements for selecting eligible 

children for participation in the Head 

Start program. Paragraph (b) of this 

section requires a program to ensure at 

least 10 percent of its total funded 

enrollment is filled by children eligible 

for services under the Individuals with 

Disabilities Education Act (IDEA) unless 

the responsible HHS official grants a 

waiver. 

Though § 1302.14(b) reads ‘‘funded 

enrollment,’’ section 640(d)(1) in the 

Act states the percentage of children 

with disabilities (eligible under IDEA) is 

based on ‘‘the number of children 

actually enrolled,’’ rather than the 

funded enrollment. ACF has received 

feedback from various interested groups 

that this error has caused confusion 

among programs because the Act and 

the HSPPS state different requirements. 

To address this inconsistency, we 

propose to change ‘‘funded’’ to ‘‘actual’’ 

in 1304(b)(1) so the HSPPS are 

consistent with the Act. This change 

will clarify the requirement and address 

the confusion caused by the 

discrepancy. 

We encourage all Head Start programs 

to recruit and enroll as many children 

who are eligible for IDEA services as 

possible. The 10 percent requirement is 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80853 

190Letter can be found at this link: https://

eclkc.ohs.acf.hhs.gov/local-early-childhoodpartnerships/press-release/encouraging-ideacollaboration-between-state-agencies-localagencies-head-start-programs. 

191American Academy of Pediatrics, American 

Public Health Association, & National Resource 

Center for Health and Safety in Child Care and 

Early Education. (2020). Caring for Our Children 

(CFOC) online standards database. National 

Resource Center for Health and Safety in Child Care 

and Early Education. https://nrckids.org/CFOC. 

192Bowne, J.B., Magnuson, K.A., Schindler, H.S., 

Duncan, G.J., & Yoshikawa, H. (2017). A MetaAnalysis of Class Sizes and Ratios in Early 

Childhood Education Programs: Are Thresholds of 

Quality Associated With Greater Impacts on 

Cognitive, Achievement, and Socioemotional 

Outcomes? Educational Evaluation and Policy 

Analysis, 39(3), 407–428. https://doi.org/10.3102/ 

0162373716689489; Xue, Y., Atkins-Burnett, S., 

Vogel, C., and Cannon, J. (2022). Teacher–Child 

Relationship Quality and Beyond: Unpacking 

Quality in Early Head Start Classrooms in 2018. 

OPRE Report 2022–122. Washington, DC: Office of 

Planning, Research, and Evaluation, Administration 

for Children and Families, U.S. Department of 

Health and Human Services. 

meant to be a floor rather than a ceiling 

for serving children who would benefit 

from the program. ACF strongly 

encourages Head Start programs to 

maximize services to children with 

disabilities who will benefit from the 

program’s strong focus on inclusive 

early childhood settings. Early 

intervention and access to available 

services through Head Start provides 

children with disabilities with supports 

that can positively impact their 

education and well-being over the long 

term. Through partnerships with State 

and local education agencies, Head Start 

plays an important role in identifying 

children with disabilities or 

developmental delays and referring 

families to services and follow-up care. 

Head Start programs are required to 

design and implement a coordinated 

approach that ensures the full and 

effective participation of all children 

with disabilities and their families (45 

CFR 1302.101(b)(3)). The long-standing 

collaboration between ACF and the U.S. 

Department of Education Office of 

Special Education Programs (OSEP) 

seeks to ensure young children with 

disabilities are served in high-quality 

early childhood programs, including 

Head Start programs. This requires 

ongoing partnerships between the 

Individuals with Disabilities Education 

Act (IDEA) Part C early intervention and 

Part B, section 619 preschool special 

education programs and Head Start 

programs. 

During the return to in-person 

services in 2022, OHS and OSEP issued 

a joint letter 190 to reiterate important 

policies and practices related to 

providing services to young children 

with disabilities. The joint letter (1) 

reminds programs of requirements 

under Part B of the IDEA to provide 

special education and related services to 

eligible preschool-aged children with 

disabilities, (2) promotes collaboration 

at the State and local program level to 

meet requirements, and (3) provides 

resources to assist Head Start and other 

providers in creating effective 

memoranda of understanding for 

coordinating the implementation of 

high-quality programs for all children. 

Ratios in Center-Based Early Head Start 

Programs (§ 1302.21) 

This section establishes requirements 

for staff-child ratios and group sizes for 

center-based Head Start Preschool, Early 

Head Start, and Migrant or Seasonal 

Head Start classes. The current 

standards at § 1302.21(b)(1) require 

staff-child ratios and group size 

maximums to be determined by the age 

of the majority of children in a class. 

The age of majority of the children is 

generally determined at the start of the 

year but may be adjusted during the 

program year if needed. Where State or 

local licensing requirements are more 

stringent, then staff-child ratios and 

group size specifications must meet the 

stricter requirements. 

Further, § 1302.21(b)(2) requires that 

classrooms that serve children under 36 

months old must have two teachers with 

no more than eight children, or three 

teachers with no more than nine 

children. The current standards in 

paragraph (b)(2) also emphasize that 

each teacher serving children under 36 

months must be assigned consistent, 

primary responsibility for no more than 

four children to promote continuity of 

care for individual children. A program 

must also minimize teacher changes 

throughout a child’s enrollment and 

consider mixed age group classes to 

support continuity of care. 

However, we propose to add a new 

standard that encourages programs to 

use a lower teacher-child ratio of no 

more than three children to every 

teacher for classrooms where the 

majority of children are infants under 12 

months. Specifically, we propose to add 

the following new sentence after the 

second sentence in § 1302.21(b)(2), that 

states that programs are encouraged to 

establish a lower teacher to child ratio 

for the youngest children they serve, 

provided that it does not jeopardize 

continuity of care for children. As the 

premier ECE provider in the United 

States, Head Start sets an example for 

early childhood programs nationwide. 

Head Start programs are known for 

providing high-quality early childhood 

services. Furthermore, a warm, 

responsive relationship between an 

infant and caregiver is a crucial 

foundation for infants to learn and 

develop. A lower teacher-child ratio can 

support the establishment of this strong, 

secure relationship and allow for more 

individualized attention between the 

infant and teacher. A lower ratio of one 

teacher to three infants also aligns with 

the National Resource Center for Health 

and Safety in Child Care and Early 

Education recommendations for centerbased programs with classrooms where 

the majority of children are under 12 

months old.191 Further, research 

indicates that, generally, lower teacherchild ratios in ECE classrooms relate to 

higher classroom quality and stronger 

child outcomes.192 This proposed 

revision takes into consideration 

research findings and recommendations 

and encourages programs to consider 

reducing teacher-child ratios for their 

youngest classrooms, to provide the 

highest quality care and learning 

opportunities for infants enrolled in 

Head Start. 

We further clarify that this proposed 

change is an encouragement for 

programs and should not be interpreted 

as a new ratio requirement for 

classrooms very young children. We 

recognize that a lower teacher-child 

ratio will likely be challenging for some 

programs to implement during the 

current staffing shortage. We further 

emphasize that the requirements in 

§ 1302.21(b)(2) on promoting continuity 

of care by minimizing teacher changes 

throughout a child’s enrollment in Head 

Start, and doing so through mixed age 

classrooms, is still of top priority. ACF 

understands that implementing different 

ratio requirements for different age 

groups in Early Head Start can be 

challenging and antithetical to 

continuity of care (e.g., if children need 

to switch classrooms after their first 

birthday). This can be challenging when 

programs are also trying to ensure that 

teacher-child relationships are stable 

across a child’s early years in a program. 

ACF intentionally prioritizes continuity 

of care especially for younger children 

and programs should continue to create 

policies that support strong teacherchild relationships. ACF invites public 

comment on possible costs associated 

with lowering ratios for the youngest 

children served, for programs that may 

choose to do so. 

We would also like to understand the 

potential implications of lowering ratio 

requirements for the youngest 

classrooms, particularly for children 12 

months old or younger. According to 

2020 State licensing standards, there are 

three states that have a ratio of one 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80854 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

193https://childcareta.acf.hhs.gov/sites/default/ 

files/public/center_licensing_trends_brief_2020_

final.pdf. 194 Yoshikawa, H., Weiland, C., Brooks-Gunn, J., 

Burchinal, M.R., Espinosa, L.M., Gormley, W.T., 

Ludwig, J., Magnuson, K.A., Phillips, D., & Zaslow, 

M.J. (2013). Investing in Our Future: The Evidence 

Base on Preschool Education. Policy Brief. 

Foundation for Child Development.; Wasik, B.A., & 

Snell, E.K. (2019). Synthesis of preschool dosage: 

How quantity, quality, and content impact child 

outcomes. In A.J. Reynolds & J.A. Temple (Eds.), 

Sustaining early childhood learning gains: Program, 

school, and family influences (pp. 31–51). 

Cambridge University Press. 

195This requirement would have required all 

Head Start programs to provide at least 1,020 

annual hours of service for all (100 percent) of their 

center-based preschool slots. 

196https://www.federalregister.gov/documents/ 

2020/01/30/2020-00635/secretarial-determinationto-lower-head-start-center-based-service-durationrequirements; https://www.federalregister.gov/ 

teacher to three children for infants 12 

months old or younger.193 ACF is 

interested in applying this reduced 

teacher-child ratio requirement for 

classrooms where the majority of 

children are 12 months old or younger. 

We invite public comment on such a 

possible change, as well as possible 

costs associated with such a change. 

Center-Based Service Duration for Early 

Head Start (§ 1302.21) 

Section 1302.21(c)(1)(i) requires Early 

Head Start center-based programs to 

provide 1,380 annual hours of planned 

class operations for all enrolled 

children. It has been a long-standing 

expectation of ACF that EHS programs 

provide continuous services, which we 

have interpreted as full-day, full-year 

services. Therefore, while not explicitly 

stated, the intent of the Early Head Start 

1,380 hours requirement for centerbased service duration is for programs to 

provide full-day, full-year services. 

Research on full-day and full-year 

programs suggests children in poverty 

benefit from longer exposure to highquality early learning programs than 

what is provided by part-day and/or 

part-year programs.194

However, the standard does not 

explicitly require a minimum number of 

weeks per year over which the 1,380 

hours should be provided. Therefore, 

we propose to add a phrase to 

§ 1302.21(c)(1)(i) to clarify that the 1,380

hours of planned class operations for

children in EHS should occur across a

minimum of 46 weeks per year. Based

on our experiences implementing the

current requirement, we believe most

programs are already operating yearround; however, a small number of

programs may be operating less than a

full year and we would like to promote

full-year services for infants and

toddlers in EHS. However, we are also

aware that specifying the requirement as

at least 46 weeks per year may have

unintended consequences, such as

programs moving to part-day services or

reducing their weeks per year to 46 to

align with a new requirement.

Therefore, we request comment on these

possible unintended consequences as

well as on other ways we can ensure 

EHS services are full-day and full-year 

as intended, while still providing 

flexibility to programs in developing 

their program schedules. ACF also seeks 

public comment on how the proposed 

requirements in this section may 

differentially impact different 

communities. We specifically request 

public comment from the special 

populations served by Head Start, 

including AIAN and MSHS programs 

and communities. Finally, we also 

invite comment on how such a change 

would impact service delivery and any 

challenges that may be associated with 

meeting a revised standard, including 

the implementation timeframe. 

Center-Based Service Duration for Head 

Start Preschool (§ 1302.21; § 1302.24) 

Section 1302.21 establishes the 

program structure standards that are 

required to operate Head Start 

Preschool, Early Head Start, American 

Indian and Alaska Native, and Migrant 

or Seasonal Head Start center-based 

program options. This includes 

standards for ratios and group size, 

service duration, and licensing and 

square footage. In this section, we 

propose seven technical corrections to 

existing provisions in § 1302.21(c)(1) 

through (6) to remove outdated text and 

improve readability of these standards. 

We do not propose any change in policy 

to these existing standards. 

First, in § 1302.21, we propose to 

revise paragraph (c)(1)(i) by removing 

the phrase ‘‘By August 1, 2018.’’ That 

date has already passed and does not 

add any substance to that paragraph. 

Second, we propose to revise 

paragraph (c)(2)(i) by adding the phrase 

‘‘Service Duration for at Least 45 

Percent’’ as a subheading. We remove 

the phrase ‘‘Until a program is operating 

all of its Head Start center-based funded 

enrollment at the standard described in 

paragraph (c)(2)(iv) or (c)(2)(v)’’ and 

replace it with ‘‘A program must 

provide 1,020 annual hours of planned 

class operation over the course of at 

least eight months per year for at least 

45 percent of its Head Start Preschool 

center-based funded enrollment,’’ which 

reflects the current requirement. We 

also propose to amend paragraph 

(c)(2)(i) by removing the language that 

details the minimum number of hours 

per day and days per year a program 

must operate for any child (‘‘a program 

must provide, at a minimum, at least 

160 days per year of planned class 

operations if it operates for five days per 

week, or at least 128 days per year if it 

operates four days per week. Classes 

must operate for a minimum of 3.5 

hours per day’’) and moving that 

language into a new paragraph (ii). We 

also propose to add the phrase ‘‘Service 

Duration for Remaining Slots’’ as a 

subheading to the new paragraph (ii). 

Third, we propose to redesignate 

existing paragraph (c)(2)(ii) as paragraph 

(c)(2)(iii) and revise the redesignated 

paragraph (c)(2)(iii) by adding the 

phrase ‘‘Double session’’ as a 

subheading. In redesignated paragraph 

(c)(2)(iii) we also propose to remove the 

language ‘‘Until a program is operating 

all of its Head Start center-based funded 

enrollment at the standard described in 

paragraph (c)(2)(iv) or (c)(2)(v) of this 

section, if a program operates’’ and 

instead begin that paragraph with 

‘‘Double session variation must,’’ to 

improve readability. In addition, we 

propose to remove the term ‘‘aides’’ 

from the third sentence of redesignated 

paragraph (c)(2)(iii) and replace that 

term with ‘‘assistants.’’ We propose the 

term ‘‘assistant’’ as this term more 

accurately reflects this staff role in Head 

Start Preschool classrooms and aligns 

with other requirements for preschool 

classrooms to have at least a teacher and 

teacher assistant in each classroom. 

Fourth, we propose to remove existing 

paragraphs (c)(2)(iii) and (iv), which 

describe the two-part phase in for the 

outdated 100-percent service duration 

requirement. The 100-percent service 

duration requirement 195 was effectively 

eliminated when the Secretary lowered 

the Head Start center-based service 

duration requirement from 100 percent 

to 45 percent in a Federal Register 

notice, 85 FR 5332. 

Fifth, we propose to redesignate 

existing paragraph (c)(2)(v) as new 

paragraph (iv). We propose to revise the 

redesignated paragraph (iv) by adding 

‘‘Special Provision for Alignment with 

Local Education Agency’’ as a 

subheading to make this section easier 

for the public to read. We also propose 

to update cross-references to existing 

paragraphs by replacing the phrase 

‘‘paragraphs (c)(2)(iii) and (iv)’’ with 

‘‘paragraph (c)(2)(i)’’ to align with the 

proposed revisions described 

previously. 

Sixth, we propose to eliminate 

paragraph (c)(3) since the provisions in 

this paragraph are outdated; the 

Secretary already exercised authority to 

lower the Head Start center-based 

service duration requirements and the 

dates have passed.196


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80855 

documents/2018/01/19/2018-00897/secretarialdetermination-to-lower-head-start-center-basedservice-duration-requirement. 

Lastly, we propose to remove 

paragraph (c)(4) because the November 

7, 2016, date mentioned in that standard 

has passed and the standard is no longer 

applicable. We propose to redesignate 

existing paragraph (c)(5) ‘‘Exemption for 

Migrant or Seasonal Head Start 

programs’’ as the new paragraph (3) and 

redesignate existing paragraph (6) 

‘‘Calendar planning’’ as the new 

paragraph (4). 

Section 1302.24 describes locally 

designed program option variations, 

including waiver requirements. We 

propose to make updates in this section 

to align with the proposed updates for 

center-based service duration in 

§ 1302.21. Specifically, in paragraph

(c)(1) we propose to remove the

reference to ‘‘(c)(2)(iii) and (iv)’’ and

replace it with ‘‘(c)(2)(i).’’ In paragraph

(c)(3) we propose to remove the

reference to ‘‘(c)(2)(iii) or (iv)’’ and

update it with ‘‘(c)(2)(i).’’ In paragraph

(c)(3) we also propose to remove the

reference to ‘‘(c)(2)(i)’’ and update it

with ‘‘(c)(2)(ii).’’ Finally, at the end of

the sentence in paragraph (c)(3), we

propose to remove the reference to

‘‘(c)(2)(ii)’’ and update it with

‘‘(c)(2)(iii).’’ In paragraph (c)(5) we

propose to remove the reference to

‘‘(c)(2)(iii) and (iv)’’ and replace it with

‘‘(c)(2)(i).’’ Finally, we propose to

remove paragraph (d) ‘‘Transition from

previously approved program options’’

because the November 7, 2016, date

mentioned in that standard has passed

and the standard is no longer

applicable.

Ratios in Family Child Care Settings 

(§ 1302.23)

Family child care is an important

component of a robust state mixed 

delivery early care and education 

system that supports flexibility and 

choice for parents. Families may prefer 

a home-based option for various 

reasons, including meeting their 

cultural or scheduling needs, offering a 

smaller family like setting, or enabling 

younger and older siblings to be served 

in the same location. For families who 

opt for a home-based program for their 

children, Head Start services provided 

within a family child care option can 

help to ensure services are high-quality 

and include supports such as 

professional development and technical 

assistance to home-based providers. 

Section 1302.23(b) lays out the provider 

to child ratio and group size 

requirements for programs that operate 

a family child care option with enrolled 

Head Start children. Paragraph (b) 

requires a grant recipient that operates 

this option to maintain a group size of 

no more than six children in mixed age 

groupings with no more than two of 

those children under age 24 months 

with one family child care provider. 

And a provider may have no more than 

four children in a grouping of children 

under age 36 months with no more than 

two of those children under age 18 

months. 

We believe that these standards for 

the family child care option 

demonstrate a commitment to quality; 

however, we recognize that the wording 

of the existing standards has led to 

confusion among grant recipients, 

particularly in understanding the 

difference between the standards for 

groupings that include older children 

and those that serve only infants and 

toddlers. It was our intent during the 

initial drafting of the standards that an 

acceptable grouping of infants and 

toddlers should be smaller than a mixed 

age grouping of children that includes 

preschool or older children. However, 

we received feedback from the field that 

the current standards are unclear. 

Based on this input, we propose to 

make clarifying revisions to the current 

standard. Specifically, § 1302.23(b)(2) as 

written establishes the maximum group 

size of six children with no more than 

two children under the age of 24 months 

of age with one provider but does not 

reference the age makeup allowances for 

the rest of the group. The language at 

§ 1302.23(b)(3) references an acceptable

ratio and group size of one provider

with up to four children younger than

age 36 months with no more than two

of the four children under 18 months of

age. Taken together the two standards

§ 1302.23(b)(2) and (3) are not

sufficiently distinct. Therefore, we

propose to amend § 1302.23(b)(2) to

clarify that the maximum group size

with one provider and six children,

with no more than two under 24 months

of age, refers to a mixed age grouping

that includes preschool children (e.g.,

children over the age of 36 months).

Specifically, we propose to add the

header ‘‘Mixed Age with Preschoolers’’

to paragraph § 1302.23(b)(2) and add the

following language to the first sentence

after the phrase ‘‘family child care

provider’’: ‘‘with a mixed-age group of

children that includes children over 36

months of age.’’ Similarly, we propose

to clarify § 1302.23(b)(3) by adding the

header ‘‘Infants and Toddlers Only’’,

and deleting ‘‘One family child care

provider may care for up to four

children younger than 36 months of age

with a maximum group size of four

children’’ and replacing it with ‘‘When

there is one family child care provider 

with a group of children that are all 

under 36 months of age, the maximum 

group size is four children.’’ 

ACF believes these fixes will not alter 

the substance of the regulation but will 

provide much needed clarity to Head 

Start programs with a family child care 

option while acknowledging the 

importance of maintaining ratios and 

group sizes that facilitate high-quality 

interactions and support children’s 

safety and development. 

In making these clarifying revisions, 

we noted that the standards in 

§ 1302.23(b)(2) allow for an increased

group size when both a family child

care provider and an assistant provider

are present. However, the role of

‘‘family child care assistant provider’’ is

not defined and is not addressed in the

staff qualifications and competency

requirements outlined in § 1302.91(e)(5)

for child and family services staff.

We believe that all adults who 

provide direct services to children 

regardless of setting should have 

appropriate, training, knowledge, and 

experience that will enable them to 

support children’s development through 

effective teaching practices and 

nurturing adult-child interactions. As a 

model for high quality early childhood 

supports and services, Head Start 

programs must ensure that providers 

have the necessary skills to ensure 

quality programming that will lead to 

positive outcomes for children and 

families. Therefore, we propose to 

amend the second sentence of 

§ 1302.23(b)(2) by removing the phrase

‘‘When there is a provider and an

assistant provider’’ and replacing it with

the phrase ‘‘When there are two

providers.’’ We believe this change will

help ensure that large mixed-age groups

(of up to twelve children) in family

child care settings are supported by

qualified family child care providers. In

addition, for consistency and clarity, we

propose to strike the phrase ‘‘and

assistant providers’’ from the final

sentence of § 1302.23(b)(4) to emphasize

that programs must ensure any staff who

may have primary responsibility for

children have the necessary training and

experience to ensure quality services are

not interrupted.

We invite comment on the potential 

impact of removing these two references 

to ‘‘assistant provider’’ in the family 

child care option and the requirement 

that all family child care providers meet 

the qualification requirements. We seek 

comment specifically from family child 

care programs that currently employ 

assistant providers. ACF also seeks 

public comment from the special 

populations served by Head Start, 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80856 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

197Caring for our Children. (2022). Chapter 2.2 

Supervision and Discipline. National Resource 

Center for Health and Safety in Child Care and 

Early Education, Department of Health and Human 

Services. Available online at https://nrckids.org/ 

cfoc/database/2.2.0.1. 

198See https://www.cdc.gov/nceh/lead/ 

prevention/health-effects.htm

#:∼:text=Lead%20exposure%

20occurs%20when%20a,Slowed%20

growth%20and%20development. 

199 Dear Colleague Letter on Funding to Test for 

and Address Lead in Water in Early Care and 

Education Settings. (2023). https://

www.acf.hhs.gov/ecd/policy-guidance/dearcolleague-letter-funding-test-and-address-leadwater-early-care-and. 

including AIAN and MSHS programs 

and communities. 

Safety Practices (§ 1302.47) 

Section 1302.47 establishes 

expectations for Head Start programs to 

ensure basic health and safety measures 

are taken for the protection of all 

children. Here, we propose changes to 

§ 1302.47(b), which requires programs 

to implement a system of management, 

training, and oversight to ensure safe 

practices in a list of areas in order to 

ensure child safety. In the years of 

implementing these requirements since 

the 2016 revision of the HSPPS, grant 

recipients and other interested parties 

have raised questions about these 

requirements and to whom they apply. 

Given how critical child safety is in 

Head Start programs, it is imperative 

that we are as clear as possible and that 

our requirements reflect current best 

practices and terminology. In this 

section, we propose to clarify expected 

safety practices related to child health, 

mental health, and safety incidents. 

More specifically, the proposed 

requirements specify that any adult 

working in Head Start is responsible for 

safety practices and more precisely 

define safety practices by including the 

existing minimum Federal standard for 

abuse and neglect, clarifying that 

children should be supervised at all 

times, and drawing attention to the 

relevant paragraphs of the Standards of 

Conduct. 

We propose to remove from 

§ 1302.47(b)(5) the phrase ‘‘staff and 

consultants’’ and replace it with ‘‘staff, 

consultants, contractors, and 

volunteers.’’ This revision is intended to 

clarify that Head Start contractors and 

volunteers, in addition to staff and 

consultants, should be aware of and are 

expected to follow safety practices. The 

proposed change will clarify that all 

individuals working in Head Start must 

be aware of and responsible for child 

safety practices. 

Section 1302.47(b)(5)(i) describes the 

safety practice of reporting suspected or 

known child abuse and neglect. We 

propose to add the phrase ‘‘as defined 

by the Federal Child Abuse Prevention 

and Treatment Act (CAPTA) (42 U.S.C. 

5101 note).’’ The proposed change will 

clarify the definition of child abuse and 

neglect that is aligned with existing 

Federal statute, CAPTA, which states 

that ‘‘the term ‘child abuse and neglect’ 

means, at a minimum, any recent act or 

failure to act on the part of a parent or 

caretaker, which results in death, 

serious physical or emotional harm, 

sexual abuse or exploitation (including 

sexual abuse as determined under 

section 111), or an act or failure to act 

which presents an imminent risk of 

serious harm.’’ The Federal definition is 

a minimum standard and programs 

must also comply with State, local, and 

Tribal laws, which may have additional 

stipulations related to defining child 

abuse and neglect and other 

requirements for mandated reporting. If 

there are discrepancies between Federal 

and State, local, and Tribal laws, 

programs should comply with the more 

stringent regulation. 

In § 1302.47(b)(5)(iii), appropriate 

supervision of children is described as 

a safety practice. We propose to remove 

the phrase ‘‘indoor and outdoor.’’ This 

proposed change clarifies that 

appropriate supervision of children is 

expected at all times and aligns with 

Caring for Our Children guidelines.197

Next, in § 1302.47(b)(5)(v), the 

standards of conduct in § 1302.90(c) are 

referenced as a safety practice. We 

propose to add the designation ‘‘(ii)’’ to 

the citation to clarify that 

§ 1302.47(b)(5)(v) references the specific 

standards of conduct that are related to 

staff behavior that could be reasonably 

suspected to negatively impact children, 

which are described in § 1302.90(c)(ii). 

This addition would also reduce 

redundancies since supervision and 

reporting of suspected or known child 

abuse and neglect are listed as standalone safety practices as well as 

embedded in subparagraphs of the 

broader standards of conduct. Further 

discussion of child safety, which is of 

the utmost importance to Head Start 

programs, can be found in the sections 

of this preamble titled Standards of 

Conduct and Staff Training to Support 

Child Safety. 

Lastly, we propose to add a clause to 

the end of § 1302.47(b)(1)(ii), ‘‘including 

lead consistent with § 1302.48’’, to align 

with the changes discussed in the 

following section of this preamble. 

ACF seeks public comment on how 

the proposed requirements in this 

section may differentially impact 

different communities. We specifically 

request public comment from the 

special populations served by Head 

Start, including AIAN and MSHS 

programs and communities. 

Preventing and Addressing Lead 

Exposure (§ 1302.48) 

In this section, we propose new 

requirements on preventing and 

addressing lead exposure through water 

and lead-based paint in Head Start 

facilities. Protecting children from 

exposure to lead is important to 

promote lifelong good health, as there is 

no safe level of lead, especially for the 

ages of children Head Start serves. Even 

low levels of lead in blood have been 

shown to affect learning, ability to pay 

attention, and academic achievement.198

These requirements together will help 

prevent and address lead exposure for 

children in settings used to provide 

Head Start program services by ensuring 

programs test for and remediate lead 

hazards on a regular basis. Specifically, 

we propose to add a new section 

§ 1302.48 to Subpart D Health and 

Mental Health Program Services that 

includes four paragraphs: paragraph (a) 

contains proposed requirements to 

prevent and address lead exposure 

through water, paragraph (b) contains 

proposed requirements to prevent and 

address lead exposure through paint, 

paragraph (c) contains proposed 

requirements to ensure public 

notification of test results and 

remediation actions as an outcome of 

paragraphs (a) and (b), and paragraph 

(d) contains a requirement that, should 

applicable State or local laws or 

regulations have more stringent 

requirements for lead testing or 

remediation, programs should comply 

with the more stringent requirements. 

Lead in Water 

Paragraph (a) of § 1302.48 introduces 

new proposed requirements to address 

lead in water from water fixtures used 

for human consumption (see proposed 

definition for water fixtures used for 

human consumption in § 1305.2). These 

include requirements on sampling and 

testing for lead in water from such 

fixtures, the frequency of testing, 

detectable lead level that requires 

remediation action, and requirements 

on point-of-use (POU) devices for 

reducing lead levels. This regulation is 

supportive of ongoing efforts across the 

Federal Government that is addressing 

lead in water in early care and 

education settings.199

As specified in paragraph (a), these 

requirements only apply to Head Start 

facilities constructed before 2014 and 

where lead service lines, plumbing, or 

fixtures may still exist. The year 2014 is 

selected as it aligns with the effective 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80857 

200See https://www.epa.gov/sdwa/use-lead-freepipes-fittings-fixtures-solder-and-flux-drinkingwater. 201Triantafyllidou S, Burkhardt J, Tully J, et al. 

Variability and sampling of lead (Pb) in drinking 

water: Assessing potential human exposure 

depends on the sampling protocol. Environ Int. 

2021;146:106259. https://doi.org/10.1016/ 

j.envint.2020.106259. 202See https://www.cdc.gov/nceh/lead/ 

prevention/sources/water.htm. 

203U.S. EPA 3Ts Program—Lead Sample 

Collection field Guide for Schools and Child Care 

Facilities; EPA 816–F–22–009, July 2022 at https:// 

www.epa.gov/system/files/documents/2022-07/

US%20EPA%203Ts%20Lead%20Sample%20

Collection%20Field%20Guide%20

For%20Schools%20and%20Child%20

Care%20Facilities_508.pdf. 

204See https://www.fda.gov/consumers/ 

consumer-updates/bottled-water-everywherekeeping-it-safe. 

205See https://www.nsf.org/news/drinking-watertreatment-units-stricter-requirements-leadreduction-cert. 

date of the Reduction of Lead in 

Drinking Water Act which established 

that any pipe, pipe fitting, plumbing 

fitting, and fixture installed, 

manufactured, or imported for new 

construction is lead-free at a weighted 

lead content average of less than or 

equal to 0.25 percent 200 We also 

recognize some older facilities have all 

lead service lines, plumbing, and 

fixtures removed and replaced, and we 

do not intend to impose unnecessary 

burden on testing for lead in water for 

programs operating in such facilities. If 

a program operates in a facility 

constructed prior to 2014 and can 

demonstrate that all of these lead-based 

facility features no longer exist, then 

requirements in paragraph (a) do not 

apply. 

We propose in paragraph (a)(1) that 

programs sample and test water for lead 

from such fixtures on an annual basis. 

This requirement is to ensure programs 

test for lead in water to catch and 

address lead contamination on a regular 

schedule. A sample test is a snapshot of 

the lead level taken at the time it was 

collected. Lead levels at a fixture or 

within a building have been shown to 

vary over time. Factors that contribute 

to this variability include water 

chemistry, hydraulics, lead plumbing 

sources, and water consumption 

patterns.201 Regularly scheduled testing 

and routine maintenance are essential to 

reducing lead in drinking water. 

Annual monitoring of lead levels in 

water can provide information to the 

program on potential changes in the 

lead levels, the ongoing effectiveness of 

remediation or treatment efforts, and 

detection of lead levels that need to be 

addressed. We recognize that how 

frequently programs should test is 

dependent on a variety of factors 

including the age of the facility and 

plumbing, characteristics of plumbing 

infrastructure, water quality, prior lead 

testing and results, and remediation 

efforts implemented.202 To provide 

flexibility to test less frequently when 

reasonable, we propose that a program 

may choose to only test water from a 

proportion of fixtures each year with 

governing body approval. If a program 

decides to use this flexibility, they must 

still ensure that all water fixtures used 

for human consumption are tested at 

least once every 5 years. For example, 

a program will meet this requirement if 

they decide to test one-fifth and a 

different set of their water fixtures each 

year since this would result in all water 

fixtures being tested within a 5-year 

timeframe. This flexibility is proposed 

to allow programs to weigh the variety 

of factors discussed earlier when 

determining the frequency of testing, 

while still ensuring all water fixtures are 

tested within at least a 5-year window. 

We propose in paragraph (a)(2) that 

programs sample and test water fixtures 

used for human consumption following 

remediation actions to address 

detectable lead or following a change to 

the water profile (see proposed 

definition for change in water profile in 

§ 1305.2). This proposed requirement 

adds an additional layer of protection to 

the requirements in the prior clause on 

frequency of testing to ensure testing 

occurs on water fixtures following an 

event that has a high likelihood of 

impacting the lead level in water used 

for human consumption. Additionally, 

testing following remediation actions to 

address detectable lead supports 

programs in meeting the other proposed 

requirements in paragraphs (a)(5) 

through (7). 

We propose in paragraph (a)(3) that 

all samples must be collected by an 

individual who is adequately trained to 

collect samples for lead testing. We 

recognize that most programs will need 

to train an individual to collect samples. 

Programs should leverage available 

trainings and technical assistance, 

including resources developed by the 

EPA 3Ts for Reducing Lead in Drinking 

Water in Schools and Child Care 

Facilities—A Training, Testing and 

Taking Action Approach (3Ts) program, 

to ensure the individual is adequately 

trained to collect samples. A trained 

individual should understand how to 

conduct a 2-step sampling procedure 

(i.e., a first draw sample and flush 

sample), ensure water remained 

stationary in the plumbing system of the 

facility for at least 8 but no more than 

18 hours 203 prior to collecting the 

sample when appropriate, ensure 

samples are collected at correct 

volumes, and how to have the sample 

delivered to a laboratory. 

We propose in paragraph (a)(4) that 

all samples are analyzed for lead by a 

laboratory that is certified by EPA or the 

State, territory, or Tribe for testing lead 

in drinking water. The resource, 

‘‘Contact Information for Certification 

Programs and Certified Laboratories for 

Drinking Water’’ is readily available for 

programs to find EPA certified 

laboratories by State: https://

www.epa.gov/dwlabcert/contactinformation-certification-programs-andcertified-laboratories-drinking-water. 

This requirement ensures the entity 

conducting the lead level test is 

following EPA Federal standards on 

testing to promote consistent and highquality results. 

We propose in clause paragraphs 

(a)(5) and (6) that, together, programs 

are required to restrict access to water 

fixtures used for human consumption 

within 24 hours of determining the 

water has a lead sample result at or 

above 5 parts per billion, provide notice 

in a timely manner to parents of 

children who may have consumed the 

water, and access to these water fixtures 

is not allowed for human consumption 

until lead sample results indicate the 

water fixture is below 5 parts per billion 

following remediation actions. Ways to 

restrict access can include closing the 

water supply valve to the fixture or 

placing a sign that the water cannot be 

consumed. The 24-hour timeframe for 

restricting access was selected to 

provide a reasonable timeframe for the 

program to take action to restrict access 

and prevent any exposure to the 

identified source of lead. The 5 parts per 

billion level requiring remediation 

action was selected for several reasons, 

including that it aligns with the Food 

and Drug Administration (FDA) lead 

level limit 204 in bottled water and the 

NSF/ANSI 53 certification for POU 

devices.205 While not explicitly stated 

in the regulatory text, OHS encourages 

programs to notify parents of children 

who may have consumed water within 

24 hours if feasible, and not later than 

10 business days. 

We understand that there is no safe 

lead level for children and therefore we 

propose in paragraph (a)(7) a 

requirement that programs still consider 

taking remediation actions to address 

water fixtures used for human 

consumption with detectable lead below 

5 parts per billion with the goal to lower 

the lead level as low as practicable. This 

proposed requirement promotes a 

shared health goal of no detectable lead 

in water, while recognizing that there 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80858 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

206U.S. EPA Consumer Tool for Identifying POU 

Drinking Water Filters Certified to Reduce Lead at 

https://www.epa.gov/water-research/consumer-toolidentifying-pou-drinking-water-filters-certifiedreduce-lead. 

207For details specific to remediation, go to EPA 

3Ts guidance at https://www.epa.gov/ground-waterand-drinking-water/3ts-reducing-lead-drinkingwater#mod6. 

208See https://www.nsf.org/consumer-resources/ 

articles/standards-water-treatment-systems. 

209Use of Lead Free Pipes, Fittings, Fixtures, 

Solder, and Flux for Drinking Water—Final ‘‘Lead 

Free’’ Rule at https://www.epa.gov/sdwa/use-leadfree-pipes-fittings-fixtures-solder-and-flux-drinkingwater. 

210See https://www.epa.gov/dwreginfo/ 

information-about-public-water-systems. 

211See https://www.cdc.gov/nceh/lead/ 

prevention/sources/paint.htm. 

212https://www.hud.gov/sites/dfiles/HH/ 

documents/AHHS_II_Lead_Findings_Report_Final_

29oct21.pdf. 

213See https://www.epa.gov/sites/default/files/ 

2020-10/documents/lead-in-soil-aug2020.pdf. 

214Urban-Soil Pedogenesis Drives Contrasting 

Legacies of Lead from Paint and Gasoline in City 

Soil,’’ Anna M. Wade, Daniel D. Richter, 

Christopher B. Craft, Nancy Y. Bao, Paul R. Heine, 

Mary C. Osteen and Kevin G. Tan; May 21, 2021, 

Environmental Science & Technology. DOI: https:// 

doi.org/10.1021/acs.est.1c00546. 

may be challenges achieving such a 

goal. 

As part of these proposed 

requirements, programs have the 

flexibility in determining which 

remediation steps to take when 

addressing elevated lead levels in water, 

including the use of POU 206 devices on 

water fixtures, replacement of plumbing 

materials including pipes and fixtures, 

or a combination of these and other 

approaches. Programs can determine 

which remediation actions 207 to take 

based on various factors including the 

options and resources available to them. 

We propose in paragraph (a)(8) that 

when programs decide to use POU 

devices to address lead in water, that 

programs must appropriately use and 

maintain POU devices that reduce lead 

levels as tested and certified by a third 

party according to NSF/ANSI Standards 

for lead reduction. Programs should 

follow manufacturer instructions to 

appropriately maintain POU devices, 

which would include replacing filters in 

a timely manner and ensuring 

replacement filters also comply with 

NSF/ANSI standards. Currently, NSF/ 

ANSI Standard 53 for Drinking Water 

Treatment Units is the nationally 

recognized standard for evaluating and 

certifying POU devices for the reduction 

of lead in drinking water.208

EPA implements safe drinking water 

in partnership with states, Tribes, and 

water system operators. EPA regulates 

public water systems (PWSs) in 

accordance with the Safe Drinking 

Water Act. EPA’s Lead and Copper Rule 

establishes requirements for PWSs to 

address lead in drinking water. Most 

Head Start facilities are served by PWSs. 

Even when water entering a facility 

meets all Federal and State public 

health standards for lead, internal 

building plumbing and fixtures may 

contribute to sources of lead in drinking 

water, particularly those installed prior 

to the EPA 1986 Lead Ban.209 Another 

significant source of lead localized to 

the Head Start building can occur 

through the main service line if it is a 

lead service line. This is why it is 

important that programs test for and 

remediate detectable lead in water 

within Head Start facilities. We 

recognize that a few programs may be 

using privately owned water systems. If 

this privately owned water system has 

at least 15 service connections or serves 

at least 25 people per day for 60 days 

of the year, it is considered a public 

water system and would be regulated by 

EPA.210 If the facility does not meet this 

definition, then the system is not 

regulated by EPA. The owners of these 

systems are responsible for the safety of 

their water, and it is important Head 

Start programs in these rare 

circumstances take steps to understand 

the overall quality of their water and to 

also remediate exceedances of the 5 

parts per billion lead level. 

In implementing these requirements, 

ACF encourages programs to refer to the 

EPA voluntary program: 3Ts available at 

https://www.epa.gov/ground-water-anddrinking-water/3ts-reducing-leaddrinking-water. The purpose of this 

program is to assist states, schools, and 

child care facilities with implementing 

their own testing and remediation 

programs, developing a plan, 

conducting outreach, and taking action 

to address elevated levels of lead. 

Further, programs may be able to utilize 

funding available from the Bipartisan 

Infrastructure Act to cover some of the 

costs associated with lead testing and 

remediation. 

Lead in Paint 

Paragraph (b) introduces new 

requirements on preventing and 

addressing lead exposure in paint, with 

its associated exposures from lead in 

dust and lead in soil, in facilities 

constructed before 1978 and in facilities 

where lead-based paint may exist, 

including appropriate abatement 

actions, and the frequency of reassessing lead-based paint hazards 

following abatement. 

We propose to limit requirements 

associated with paragraph (b) to 

programs operating in facilities 

constructed prior to 1978 and where 

lead-based paint may still exist. The 

year 1978 is when the Federal 

Government banned the consumer use 

of lead-based paint, and this 

requirement targets the risk associated 

with facilities constructed prior to this 

date.211 However, we recognize that 

there are facilities constructed prior to 

1978 where lead paint has been 

completely removed (e.g., through major 

renovation or studs-out remodel), or that 

were constructed without lead paint. If 

a program operates in a facility 

constructed prior to 1978 and is able to 

demonstrate that lead-based paint no 

longer exists, then requirements in 

paragraph (b) do not apply. We propose 

in paragraph (b)(1) that programs work 

with a risk assessor who is certified by 

either the EPA or by a State, territory, 

or Tribe with an EPA-authorized leadbased paint certification program to 

inspect for lead-based paint and assess 

for lead-based paint hazards. Of rooms 

in Head Start facilities undergoing an 

evaluation, we assume approximately 

43.8% would be identified as 

potentially having a lead-based paint 

hazard requiring abatement.212 We 

understand this value may be an 

overestimate since it is based on a study 

covering pre-1978 child care centers, 

and we request public comment on 

whether there is a better assumption 

that can be applied regarding the 

percent of rooms in Head Start facilities 

that may require abatement. 

We propose in paragraphs (b)(2) and 

(3) that programs immediately restrict 

access to identified lead hazards until 

abatement actions are completed by a 

lead abatement contractor certified by 

the EPA or State, territory, or Tribal 

agency (see proposed definition for 

abatement in section 1305.2). These 

provisions aim to minimize risk of lead 

exposure for children, while 

maintaining flexibility for programs to 

determine appropriate lead abatement 

strategies that best meet local program 

needs and available resources, in 

consultation with certified lead 

abatement experts and contractors. 

Lead is naturally present in soil, but 

we recognize that deposits from leaded 

gasoline, exterior lead-based paint, and 

industrial sources may contribute to 

concerning levels of lead in the soil 

surrounding a program, especially in 

urban areas with historic use of leaded 

paint or leaded gasoline, and in rural 

areas where there was heavy pesticide 

use for agriculture.213 Lead does not 

biodegrade over time and remains in 

soil for a long time.214 Although there 

are no proposed requirements to 

explicitly address lead in soil, the 

requirements in this paragraph may 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80859 

215US EPA 3Ts communication templates can be 

found at https://www.epa.gov/ground-water-anddrinking-water/3ts-reducing-lead-drinkingwater#mod1. 

result in hazardous levels of lead in soil 

to be identified and addressed through 

inspections of lead-paint hazards and 

associated abatement efforts. 

Additionally, we encourage programs to 

consider the risk of lead in their soil, 

and take any steps needed to ensure any 

bare soil where children play is nontoxic. 

We propose in paragraph (b)(4) that 

following the conclusion of any 

abatement actions, those facilities that 

have lead-based paint or lead-based 

paint hazards as determined by the 

initial inspection and risk assessment, 

would have a certified risk assessor 

reassess for lead-based paint hazards at 

least once every 2 years unless two 

reassessments conducted two years 

apart identify no lead-based paint 

hazards, indicating the quality of the 

ongoing lead-based paint maintenance 

of the facility. Two years is selected as 

it aligns with the Lead Safe Housing 

Rule recommendation for reevaluation 

of HUD-assisted properties (24 CFR 

35.1355(b)(4)). Further, allowing a 

program to no longer reassess every 2 

years when two reassessments 

conducted 2 years apart identify no 

lead-based paint hazards is intended to 

remove unnecessary burden of 

reassessments when the risk of leadbased paint hazards to re-emerge is low. 

However, programs are encouraged to 

visually monitor for potential 

deterioration of lead abatement 

measures on an ongoing basis, including 

looking for any peeling or chipping 

paint. We request comment on whether 

we should require regular visual 

inspections. 

We request comment on whether the 

dust-lead hazards should be specified or 

referenced to EPA established clearance 

levels and whether the reassessment 

process proposed following abatements 

of lead-based paint hazards should be 

modified such that a reassessment is 

required if the EPA promulgates more 

stringent abatement requirements that 

take effect following the two 

reassessments envisioned by this 

proposal’s regulatory text. 

Notification 

In paragraph (c), we propose 

requirements that programs provide 

notification of lead testing results and 

remediation actions to parents, 

caregivers, and staff to promote 

transparency and raise awareness. 

Additionally, notification of results and 

actions to parents, caregivers, and 

program staff can help build community 

trust and engagement and demonstrate a 

commitment to children’s health and 

safety. While the proposed provision 

does not provide a specific timeframe 

for notification, EPA’s 3T’s program 

encourages beginning 

communication 215 before testing begins 

and ongoing throughout the testing 

process. We encourage programs to 

consider leveraging existing methods of 

communication already established 

throughout the program year. For 

example, if there is suspicion that a 

child may have been exposed to lead, 

programs should encourage parents to 

talk to their child’s healthcare provider 

about completing the appropriate blood 

lead tests. We also encourage programs 

to consider a notification schedule and 

approach that is appropriate for their 

community. Notifications must be 

translated and interpreted for families 

with limited English proficiency, in 

alignment with § 1302.90(d)(1) and 

consistent with Title VI of the Civil 

Rights Act of 1964. Programs also must 

provide effective communication to 

individuals with disabilities about lead 

testing results and remediation actions, 

consistent with the Rehabilitation Act of 

1973. 

Conflicting Requirements 

As with many areas of the HSPPS, 

there may be situations in which the 

HSPPS differ somewhat from State or 

local laws or regulations. In those cases, 

it is standard practice that programs 

adhere to the more stringent 

requirement. In paragraph (d) we 

propose a requirement that specifically 

states that programs should comply 

with the more stringent requirement, 

should State or local laws or regulations 

differ from the requirements described 

in paragraphs (a) through (c). We note 

that we interpret this standard to apply 

to each specific aspect of these 

requirements. For example, if a State 

requires licensed programs to have a 

more stringent action level when lead is 

identified in water but a less stringent 

standard for testing frequency, a 

program should use the more stringent 

action level required by the State and 

the more stringent testing frequency 

required by the proposed standard in 

HSPPS. 

We welcome all public comments on 

the proposed requirements to prevent 

and address lead exposure through 

water and paint (including associated 

dust and soil exposures). We are 

specifically interested in public 

comment on the issues programs have 

experienced with previously addressing 

harmful lead exposure in water or paint, 

whether the proposed flexibilities are 

helpful or if additional flexibility is 

needed, and the action level requiring 

remediation for lead in water, as well as 

any areas that are particularly unclear. 

We did not propose any requirements 

to specifically target lead in soil, since 

we believe this will be captured through 

proposed requirements on lead-paint 

inspections and through programs 

determining when it is necessary to test 

lead in their soil (e.g., programs testing 

bare soil accessible for children to play 

in since they are in an urban area near 

older buildings that currently or 

previously contained lead paint). We 

were concerned that lead in soil testing 

and remediation requirements would 

cause too much undue burden and by 

not including them, we aim to ensure 

programs have flexibility in their 

approaches to determining and 

addressing lead in soil hazards. 

Finally, ACF seeks public comment 

on how the proposed requirements in 

this section may differentially impact 

different communities. We specifically 

request public comment from the 

special populations served by Head 

Start, including AIAN and MSHS 

programs and communities. 

Family Service Worker Family 

Assignments (§ 1302.52) 

Since its inception in 1965, Head 

Start has been a leader in anti-poverty, 

two generation early childhood 

programming focused on school 

readiness, family well-being, and family 

and community engagement. Section 

1302.52 outlines the requirements for 

family partnership services, the 

foundational and central process by 

which staff engage with each family of 

enrolled children. This section 

describes the required components of 

the family partnership process: the 

intake and family assessment 

procedures to identify family strengths 

and needs related to family engagement 

outcomes; what must occur as part of 

individualizing family partnership 

services; and the need to consider 

existing plans and community resources 

to support families in order to ensure 

that families can take full advantage of 

services for which they are eligible and 

promote coordination across service 

providers. This section also describes 

what is needed to individualize family 

partnership services and how staff must 

collaborate with families to identify 

needs, interests, and individualized 

family goals. Head Start staff who 

partner with families play a critical role 

in helping families achieve their goals 

and aspirations for themselves and for 

their children. 

Family well-being is one of the 

greatest predictors of school 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80860 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

216Chazan-Cohen, R., Raikes, H., Brooks-Gunn, J., 

Ayoub, C., Pan, B.A., Kisker, E.E., . . . Fuligni, A.S. 

(2009). Low-income children’s school readiness: 

Parent contributions over the first five years. Early 

Education & Development, 20(6), 958–977. Duncan 

G.J. & Magnuson, K.A., (2005). Can family 

socioeconomic resources account for racial and 

ethnic test score gaps? The Future of Children, 

15(1). Retrieved from http://www.jstor.org/stable/ 

1602661 Fantuzzo, J., Leboeuf, W., Brumley, B., & 

Perlman, S. (2013). A population-based inquiry of 

homeless episode characteristics and early 

educational well-being. Children and Youth 

Services Review, 35(6), 966–972. Mistry, R.S., 

Benner, A.D., Biesanz, J.C., Clark, S.L., & Howes, C. 

(2010). Family and social risk, and parental 

investments during the early childhood years as 

predictors of low-income children’s school 

readiness outcomes. Early Childhood Research 

Quarterly, 25(4), 432–449. Ryu, J.H., & Bartfeld, J.S. 

(2012). Household food insecurity during childhood 

and subsequent health status: The Early Childhood 

Longitudinal Study—Kindergarten Cohort. 

American Journal of Public Health, 102(11), e50– 

e55. 

217Brooks-Gunn, J., Duncan, G.J., & Maritato, N. 

(1999). Poor families, poor outcomes: The wellbeing of children and youth. In G.J. Duncan & J. 

BrooksGunn (Eds.), Consequences of growing up 

poor (pp. 1–17). New York: Russell Sage 

Foundation; Vernon-Feagans, L., & Cox, M. (2012). 

I. Poverty, rurality, parenting, and risk: An 

introduction. Monographs of the Society for 

Research in Child Development, 78(5), 1–23. 

218Alitz, P., Geary, S., Birriel, P., Sayi, T., 

Ramakrishnan, R., Balogun, O., . . . Marshall, J. 

(2018). Work-Related Stressors Among Maternal, 

Infant, and Early Childhood Home Visiting 

(MIECHV) Home Visitors: A Qualitative Study. 

Maternal and Child Health Journal, 22, 62–69. 

219Boston Children’s Hospital. (2012). Family 

connections. U.S. Department of Health and Human 

Services, Administration for Children and Families, 

Office of Head Start. Retrieved from https://

eclkc.ohs.acf.hhs.gov/sites/default/files/pdf/ 

introduction-to-family-connections.pdf; Child 

Welfare Information Gateway. (2016, July). Caseload 

and workload management. Retrieved from https:// 

www.childwelfare.gov/pubPDFs/case_work_

management.pdf; Howes, C., Phillips, D.A., & 

Whitebook, M. (1992). Thresholds of Quality: 

Implications for the Social Development of 

Children in Center-Based Child Care. Child 

Development, 63(2), 449–460.; Social Work Policy 

Institute. (2010, January). High caseloads: How do 

they impact delivery of health and human services? 

Retrieved from http://www.socialworkpolicy.org/ 

wp-content/uploads/2010/02/r2p-cw-caseloadswpi-1-10.pdf. 

220Administration for Children and Families, 

U.S. Department of Health and Human Services. 

(2022). Survey of Head Start Grantees on Training 

and Technical Assistance. [Unpublished data 

analyses]. 

readiness.216 Many families of all 

backgrounds in the U.S. face various 

challenges, such as unemployment, 

poverty, high housing costs, food 

insecurity, community violence, limited 

education, and poor health. Each of 

these alone can cause family stress and 

negatively impact family well-being. 

When combined, these negative effects 

on family well-being and child 

outcomes can be even greater.217 The 

Head Start workforce that supports 

families provides many of the 

comprehensive services that reflect 

Head Start’s focus not only on the 

health and development of young 

children, but the well-being and 

leadership of their families. 

When Head Start staff that provide 

family services have high family 

assignments, which are sometimes 

referred to as caseloads, they may feel 

overwhelmed and experience burnout, 

which in turn negatively impacts the 

quality of family services. Data from 

Head Start’s technical assistance 

trainings shows that high family 

assignments and being asked to take on 

additional responsibilities beyond the 

job description are often accompanied 

by expressions of job frustration and 

dissatisfaction among staff who work 

directly with families. Further, OHS 

regional offices have reported that when 

cost savings are needed, programs will 

first look to personnel budgets by 

decreasing family service positions. 

This can lead to larger family 

assignments for remaining staff and less 

stability in staffing for family support 

services in Head Start, which may 

decrease the quality of services. Many 

family services staff with higher family 

assignments share with OHS that they 

have too many family assignments to 

meaningfully and consistently address 

supports for family wellbeing, 

parenting, and family engagement 

around children’s early learning and 

education. Though there is not much 

literature on the family engagement 

specialist caseload experience, research 

on home visiting demonstrates that 

stressors in caseload management relate 

to diminished engagement with 

participants that could negatively 

impact the participant experience.218

Research from related fields shows 

that high family assignments 

compromise workers’ ability to provide 

effective services to families. High 

family assignments also exacerbate 

already high levels of staff burnout and 

turnover.219 Further, program leaders 

describe family assignments as a major 

challenge. In a 2019 National TTA study 

of Head Start programs, Family and 

Community Services Managers, who 

oversee family services staff, cited their 

top two program challenges as (1) 

workload/family assignments being too 

large for staff and (2) families faced so 

many challenges that staff were not able 

to support families as well as they 

would like.220

ACF has sought various ways to 

support the family services workforce. 

For example, ACF established the 

National Center on Parent, Family and 

Community Engagement (NC PFCE) in 

2010. The NC PFCE developed researchbased resources, including a set of 

family services competencies which 

articulate best practices in family 

assignment limits. NC PFCE also 

conducted hundreds of trainings to 

assist Head Start programs with 

implementing these best practices. 

Additionally, to improve workloads for 

staff working directly with families, in 

the 2016 revisions to the HSPPS, ACF 

added § 1302.52(c)(4) ‘‘Assign staff and 

resources based on the urgency and 

intensity of identified family needs and 

goals.’’ Despite these efforts, we have 

seen little change to family assignment 

ratios across time, as evidenced by our 

own Head Start Program Information 

Report (PIR) data. 

According to the PIR for program year 

2021, 50 percent of programs had one 

staff partnering with 40 or more 

families. Of those programs, 21 percent 

had family assignments of one staff to 

40–50 families; 16 percent had family 

assignments of one staff to 50–60 

families; seven percent had family 

assignments of one staff to 60–75 

families; and six percent of programs 

had family assignments of one staff to 

75–200+ families. Based on these data, 

there is a wide range of family 

assignments across our programs, 

therefore we feel it is necessary to 

establish a standardized family 

assignment requirement. 

Section 648A(c)(2) of the Act provides 

ACF with the authority to review and if 

necessary, revise, requirements related 

to family assignments, as suggested by 

best practice, to improve the quality and 

effectiveness of staff providing services 

to families. We believe the research in 

this field coupled with our own PIR 

data and feedback we received from 

programs indicates a strong need for 

clearer standards for management of 

family assignments. We propose an 

additional provision in § 1302.52 

Family Partnership Services, (d) 

Approaches to Family Services. 

We propose to add this section to 

address the long-standing problem of 

overly high family assignments for 

many family services staff. We 

recommend this change to promote 

consistent, reasonable family 

assignments for staff who work directly 

with families in the family partnership 

process. We believe this change will 

improve the quality of support that 

family support services provide and 

improve their own well-being as well. 

For these reasons, we propose to 

insert a new section (d) Approaches to 

family services to 1302.52 Family 

Partnerships. In (d)(1), we propose 

minor edits for alignment with the new 

section and to emphasize the familycentered nature of the process by 

including language that specifies both 

family interests and family needs. Next, 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80861 

221Bipartisan Policy Center. (2018). Creating an 

integrated efficient early care and education system 

to support children and families: A state-by-state 

analysis. https://bipartisanpolicy.org/report/eceadministration-state-by-state/; Warner-Richter M. 

(2016, February 9). Promoting quality improvement 

in early care and education. Child Trends. https:// 

www.childtrends.org/promoting-qualityimprovement-in-early-care-and-education; Tout, K., 

Friese, S., Starr, R. & Hirilall, A. (2018). 

Understanding and Measuring Program Engagement 

in Quality Rating and Improvement Systems. OPRE 

Research Brief #2018–84. Washington, DC: Office of 

Planning, Research and Evaluation, Administration 

for Children and Families, U.S. Department of 

Health and Human Services. 

222Build Initiative & Child Trends. (2021). A 

Catalog and Comparison of Quality Improvement 

Systems [Data System]. Retrieved from https://

qualitycompendium.org/ on September 29, 2022. 

223 Ibid. 

we propose a new (d)(2) that requires 

programs to ensure the planned number 

of families assigned to work with 

individual family services staff is no 

greater than 40, unless a program can 

demonstrate higher family assignments 

provide high quality family and 

community engagement services and 

maintain reasonable staff workload as 

described in (d)(3). 

There are no research-based 

assignment ratios to adopt from other 

fields that are aligned enough in job 

description with this unique early 

childhood workforce. Therefore, we 

propose a maximum of 40 families per 

family services staff member, 

considering the large variation in 

families’ interests, needs, goals and the 

variation of families’ engagement with 

their programs. 

We include an implementation date of 

two years from an estimated date of a 

final rule because we recognize the 

degree of change required by programs 

will vary depending on programs’ 

current family assignment systems and 

procedures. This proposal could mean 

substantial change for some programs 

and little to no change for others. In fact, 

2021 PIR data reveals that 

approximately 50 percent of programs 

have staff family assignments that are 40 

families or less. It should be noted that 

the proposed maximum is intended for 

programs with higher than 40 

assignments per staff to lower their 

family assignment ratios. The proposed 

maximum is not meant to bring 

programs with lower assignment 

numbers up to 40. Programs who have 

already established best practices at 

lower staff: family ratios are encouraged 

to continue these responsive family 

services. 

In addition to the proposed family 

assignment maximum, we propose to 

include language in a new (d)(3) to 

allow for program designs that best meet 

the needs of the program and 

community, based on community and 

family assessment data. We include this 

language recognizing that programs may 

need the flexibility to design family and 

community engagement services in 

ways that are preventative and 

responsive to emerging family and 

community needs. 

Finally, we also propose a 

requirement for effective and 

meaningful employee engagement 

practices that include opportunities for 

staff to discuss and address workloadrelated issues. We propose this language 

to promote such practices to address the 

negative impact of family services 

workload factors, such as the stress of 

unofficial job duties and lack of clear 

job expectations can have on staff 

wellness, job satisfaction, and providing 

high-quality services. 

ACF seeks input from the public on 

the benefits and challenges of 

implementing a family assignment cap 

of 40 families per family service worker, 

using a phased in approach over a 

period of 3 years from the publication 

date of a final rule. To better understand 

programs’ specific experiences, ACF is 

also seeking programs’ feedback on the 

benefits and challenges of implementing 

family assignments between 30 and 40 

per individual staff and the same for 

implementing family assignments 

between 40 and 50 per individual staff. 

Finally, ACF also seeks public comment 

on how the proposed requirements in 

this section may differentially impact 

different communities. We specifically 

request public comment from the 

special populations served by Head 

Start, including AIAN and MSHS 

programs and communities. 

Participation in Quality Rating and 

Improvement Systems (§ 1302.53) 

Section 1302.53 establishes the 

requirements for Head Start programs to 

participate in State quality rating and 

improvement systems (QRIS). With the 

exception of American Indian and 

Alaska Native programs, each Head 

Start program must currently participate 

in its State QRIS if three conditions are 

met—its State or local QRIS accepts 

Head Start monitoring data to document 

quality indicators included in the 

State’s tiered system; participation 

would not impact a program’s ability to 

comply with the HSPPS; and the 

program has not provided ACF with a 

compelling reason not to comply with 

this requirement. 

A QRIS is a systemic approach to 

assess, improve, and communicate the 

level of quality in early and school-age 

care and education programs within a 

State or locality. These accountability 

systems unify standards, evaluate and 

report quality to the public, and provide 

supports and incentives for 

improvement.221 These systems award 

quality ratings to programs that meet a 

set of criteria as defined by the QRIS. 

Criteria Head Start programs must meet 

to enter the QRIS and maintain 

participation vary greatly by State. 

QRIS can be an important mechanism 

for coordinating and aligning various 

programs into a broader statewide 

system of early care and education. 

Participation by Head Start and other 

programs into a QRIS can provide 

continuity, alignment of standards and 

a common means by which families can 

understand and make decisions among 

which program options are best for their 

family. As states continue to move in 

the direction of more streamlined, 

coordinated early care and education 

systems that are easier for families to 

navigate, Head Start participation in 

QRIS can serve to ensure that Head Start 

programs are part of these statewide 

coordination efforts and that eligible 

families consider Head Start alongside 

other options in the QRIS. 

Currently, 41 states have statewide 

QRIS (Florida has three local QRIS). Of 

these 41 states with statewide QRIS, 27 

states require at least some types of 

programs (generally licensed programs 

and programs receiving child care 

subsidy funds) to participate in the 

system. In 15 States, Head Start 

programs are required by the State to 

participate in the QRIS, either as a 

function of licensing or receiving 

subsidy funds, or through reciprocity 

agreements or alternate pathways that 

bring Head Start programs into the 

system automatically.222 Fourteen states 

have fully voluntary systems in which 

programs are not required to participate 

regardless of licensure status or receipt 

of child care subsidies. 

State QRIS are structured very 

differently across states, and 

participation may be required for all 

types or some types of programs or may 

be voluntary for all programs. In states 

with voluntary QRIS, participation rates 

average 40 percent for licensed centerbased programs. While at least some 

Head Start programs participate in QRIS 

even within voluntary systems, states 

may require a broad range of 

documentation for entry into the QRIS, 

as well as additional assessments, 

monitoring visits, or reviews. These 

requirements, along with periodic 

revisions to aspects of a State’s QRIS 223

may impact a Head Start program’s 

ability to participate in the system. 

We recognize the importance of 

quality improvements and encourage 

Head Start programs to continue their 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80862 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

224Firoz, T., McCaw-Binns, A., Filippi, V., Magee, 

L.A., Costa, M.L., Cecatti, J.G., Barreix, M., Adanu, 

R., Chou, D., & Say, L. (2018), A framework for 

healthcare interventions to address maternal 

morbidity. Int J Gynecol Obstet, 141: 61–68. https:// 

doi.org/10.1002/ijgo.12469. 

225Trost SL, Beauregard J, Njie F, et al. 

Pregnancy-Related Deaths: Data from Maternal 

Mortality Review Committees in 36 US States, 

2017–2019. Atlanta, GA: Centers for Disease Control 

and Prevention, US Department of Health and 

Human Services; 2022.; Petersen EE, Davis NL, 

Goodman D, et al. Vital Signs: Pregnancy-Related 

Deaths, United States, 2011–2015, and Strategies for 

Prevention, 13 States, 2013–2017. MMWR Morb 

Mortal Wkly Rep 2019;68:423–429. DOI: http://

dx.doi.org/10.15585/mmwr.mm6818e1. 

participation in these important quality 

improvement efforts. Many Head Start 

grant recipients receive funds from 

Head Start as well as other early 

childhood funding streams. 

Participating in QRIS and other State 

and local quality initiatives can help 

drive quality across a program. At the 

same time, ACF wants to ensure that 

QRIS requirements are not duplicative 

of Head Start requirements, thus 

requiring a program to undergo the same 

process multiple times. Nor does ACF 

want Head Start programs to draw 

resources away from other early 

childhood programs that do not have 

access to resources provided through 

ACF and are in greater need of support 

from State and local resources that 

support quality. Based on findings from 

an analysis of current State QRIS 

systems and their evolutions, and input 

from ACF regional staff and Head Start 

Collaboration Offices who support 

coordination among Head Start 

programs and State systems, we propose 

to revise the language at § 1302.53(b)(2) 

to clarify that Head Start programs 

should participate in QRIS to the extent 

practicable if the State system has 

strategies in place to support their 

participation. These proposed changes 

recognize that QRIS systems differ 

significantly across states and continue 

to evolve rapidly. Substantive changes 

to QRIS may require additional burden 

on programs in the form of revised 

processes and potentially additional or 

different documentation, as well as 

possible duplication of monitoring and 

assessment processes. These proposed 

changes are intended to allow Head 

Start programs to focus their resources 

on activities that are most likely to 

support quality services for children 

and families. For programs in states 

where the QRIS does not have strategies 

in place to support Head Start 

participation, does not accept existing 

documentation for participation, or that 

would in any way impact a program’s 

ability to comply with the HSPPS, staff 

effort and program resources may be 

better directed at other activities. 

However, ACF notes that Head Start 

programs currently participating in their 

State QRIS are encouraged to continue 

to do so. 

We propose further to eliminate the 

three conditions for participation in the 

State QRIS as written in the current 

standards at § 1302.53(b)(2)(i)–(iii), as 

we believe these conditions 

unnecessarily require the Head Start 

grant recipient to document individual 

circumstances that support or impede 

participation in the system. By 

eliminating these specific conditions 

and substituting language that 

emphasizes the State strategies for Head 

Start participation in general, we believe 

Head Start grant recipients, along with 

Head Start Collaboration Offices and 

OHS regional staff, can collectively 

encourage the evolution of State systems 

like QRIS to better receive Head Start 

programs. 

In paragraph (b)(2), we propose to 

replace ‘‘must’’ with ‘‘should’’ in the 

overarching requirement. We propose to 

add ‘‘to the extent practicable, if a State 

or local QRIS has a strategy to support 

Head Start participation without 

requiring programs to duplicate existing 

documentation from Office of Head 

Start oversight.’’ We believe this change 

will clarify for programs that there is an 

expectation from ACF that they 

participate in the QRIS if the system has 

a strategy that will support Head Start 

participation. Strategies may include 

reciprocal agreements or alternate 

pathways, as well as mandatory 

requirements for Head Start programs to 

participate. Some Head Start programs 

may be required to participate if they 

receive other funds or are licensed as a 

child care program. The change further 

emphasizes that ACF does not expect 

programs to duplicate documentation 

efforts that are required for Head Start 

oversight purposes in order to 

participate in the QRIS. We also propose 

to delete paragraphs (b)(2)(i) through 

(iii) in this section in their entirety 

which delineate the current conditions 

for QRIS participation. 

The current standards include the 

State’s acceptance of Head Start 

monitoring data, which continues to be 

a barrier to participation in some states. 

We believe that eliminating these 

criteria will lessen the documentation 

required on individual circumstances 

for participating or not participating in 

a QRIS, but rather would help programs 

examine their State’s QRIS as a State 

system and better understand Head 

Start’s overall role in that broader 

system. ACF still strongly supports the 

central requirement that programs 

should participate in a QRIS to the 

extent practicable as this standard 

provides programs with an important 

lever for participating in a State’s highquality mixed delivery ECE system and 

in accessing State quality improvement 

efforts where participation pathways 

and strategies exist. Participation in the 

QRIS also serves as an important 

mechanism in some states to assist 

families in recognizing quality program 

options that can include Head Start 

programs. Head Start programs must 

maintain a high level of quality, and it 

is important that parents understand the 

services offered in Head Start. 

Services to Enrolled Pregnant Women 

and People (§ 1302.80; § 1302.82) 

Section 1302.80 describes the services 

programs must provide to enrolled 

pregnant women and people. It requires 

programs to: assess whether enrolled 

pregnant women and people have 

access to an ongoing source of health 

care and health insurance, and if not, to 

facilitate their access to such care and 

insurance; facilitate access to 

comprehensive services; and schedule a 

visit with each newborn and their 

mother or birthing parent within two 

weeks after the newborn’s birth, to 

identify family needs and offer support 

(referred to as the ‘‘newborn visit’’). 

Women and people receiving Head 

Start services face social determinants of 

health that may impact their prenatal 

and postpartum outcomes. Early 

postpartum intervention is key to 

preventing and addressing maternal 

health-related challenges.224 Postpartum 

support and intervention can identify 

and address issues such as postpartum 

depression, intimate partner violence, 

and physical health issues that occur 

during pregnancy. The period after 

childbirth is critical to assess the child 

care, health, and mental health needs of 

mothers and families. In fact, over half 

of maternal deaths occur between 1 

week and 1 year after birth, most of 

which are preventable.225 Early Head 

Start programs are critical in addressing 

the maternal mortality crisis and other 

maternal-health related challenges as 

they are positioned to provide 

postpartum support by ensuring the 

required newborn visit provides 

intentional opportunities for 

collaboration, intervention, and support. 

Paragraph (d) in this section focuses 

on the required newborn visit. We 

propose to revise paragraph (d) by 

adding a new sentence to the end of the 

paragraph that requires the newborn 

visit to include a discussion of 

postpartum mental and physical health, 

infant health, and support for basic 

needs. We believe this language will 

clarify for programs what areas—at a 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80863 

226See ACF–IM–HS–22–02, Documenting 

Services to Enrolled Pregnant Women, https://

eclkc.ohs.acf.hhs.gov/policy/im/acf-im-hs-22-02. 

227Source: Head Start 2022 PIR. 

228Novoa, C. (2020). Ensuring Healthy Births 

Through Prenatal Support Innovations From Three 

Models. https://www.americanprogress.org/article/ 

ensuring-healthy-births-prenatal-support/. 

229Bornstein, E., Eliner, Y., Chervenak, F. A., & 

Gru ̈nebaum, A. (2020). Racial Disparity in 

Pregnancy Risks and Complications in the US: 

Temporal Changes during 2007–2018. Journal of 

clinical medicine, 9(5), 1414. 

230Office of Minority Health & Health Equity 

(OMHHE). April 2022. https://www.cdc.gov/ 

healthequity/features/maternal-mortality/ 

index.html. 

231Hoyert DL. Maternal mortality rates in the 

United States, 2021. NCHS Health E-Stats. 2023. 

DOI: https://dx.doi.org/10.15620/cdc:1246. 

232U.S. Department of Health and Human 

Services, Centers of Disease Control and Prevention, 

National Center for Chronic Disease Prevention and 

Health Promotion, Division of Reproductive Health. 

Pregnancy Mortality Surveillance System: Trends in 

pregnancy-related mortality ratio by race/ethnicity: 

2017–2019. https://www.cdc.gov/reproductive

health/maternal-mortality/pregnancy-mortalitysurveillance-system.htm. 

233 Ibid. 

234Ely DM, Driscoll AK. Infant mortality in the 

United States, 2019: Data from the period linked 

birth/infant death file. National Vital Statistics 

Reports; vol 70 no 14. Hyattsville, MD: National 

Center for Health Statistics. 2021. DOI: https://

dx.doi.org/10.15620/cdc:111053. 

235Maternal morbidity describes any short- or 

long-term health problems that result from being 

pregnant and giving birth. National Institute of 

Child Health and Human Development. (June 2021). 

https://www.nichd.nih.gov/health/topics/maternalmorbidity-mortality. 

minimum—should be included as part 

of the newborn visit. This requirement 

is intended to reflect the minimum 

requirements for the newborn visit. 

Programs may choose to include other 

areas of assessment or support based on 

the needs of both parent and newborn. 

The proposed requirement is intended 

to clarify requirements and provide 

consistency in topics covered during the 

newborn visit. 

Section 645A(a) of the Act authorizes 

funding for Early Head Start programs to 

provide services that encompass the full 

range of the family’s needs, from 

pregnancy through a child’s third 

birthday, to promote the child’s 

development and move the parents 

toward self-sufficiency. Early Head Start 

programs are not required to enroll 

expectant families, but many choose to 

do so. If an Early Head Start program 

chooses to enroll pregnant women and 

people, they must identify the total 

number of pregnant women and people 

they anticipate serving each program 

year in the grant application, provide 

high-quality prenatal and postnatal 

education, and help them access 

comprehensive prenatal services. 

However, currently, Early Head Start 

programs are not explicitly required in 

regulation to track and record 

interactions with pregnant women and 

people. Moreover, programs are not 

currently required to detail and record 

the services they provide enrolled 

pregnant women and people as well as 

the services received from community 

partners or providers. Although 

programs are not required to do so, 

generally, programs do track and record 

this information. However, there is 

significant variation in format and level 

of detail across programs, which often 

makes it difficult to verify actual 

enrollment numbers and challenging for 

OHS to understand the services 

provided to pregnant women and 

people. 

Early Head Start programs with 

identified slots to serve pregnant 

women and people are responsible for 

creating a system of care that supports 

the well-being of mothers, parents, and 

newborns. This includes tracking and 

documenting services a pregnant 

woman or person receives, including 

those received via referrals to 

community partners, to the extent 

practical, in order to identify how to 

best be responsive to the needs of the 

enrolled pregnant woman and people. 

Information captured about individual 

services provided to pregnant women 

and people is essential because it can be 

used to validate the use of Federal funds 

to serve pregnant women and people 

and to inform ongoing conversations 

program staff have with a pregnant 

woman or person about their needs 

before and after the baby is born.226

As such, we also propose to amend 

§ 1302.80 by adding a new paragraph 

(e). The goal of new paragraph (e) is to 

enhance program accountability by 

requiring programs to track and record 

information on service delivery for 

enrolled pregnant women and people. 

We believe this proposed standard will 

enhance program accountability by 

requiring programs to verify the number 

of pregnant women and people they 

serve along with details on the services 

received. 

Head Start PIR data from FY 2022 227

reveals that most pregnant parents that 

enroll in Early Head Start services do so 

during their second and third trimesters. 

Early prenatal care is key for optimal 

outcomes for pregnant women and 

newborns.228 We believe all Head Start 

programs are in unique positions to 

support pregnant women and people, 

including staff working in programs, by 

identifying, understanding, and 

addressing barriers to healthy 

pregnancies. This begins by 

understanding the impact systemic 

racism has on the maternal health 

outcomes of women of color,229— 

particularly African American or Black 

and AIAN women—as many women of 

color and their children are served in 

Head Start programs. 

According to the Office of Minority 

Health and Health Equity, pregnancyrelated death impacts Black women at 

higher rates than White women.230 Data 

from 2021 shows that the maternal 

mortality rate for non-Hispanic Black 

women was over twice the rate for nonHispanic White women.231 There are 

also disparities in maternal mortality for 

Native Hawaiian or Other Pacific 

Islander (NHOPI) and AIAN 

populations.232 Inadequate access to 

quality health care, systemic racism, 

and disparities in social determinants of 

health may contribute to disparities in 

healthy pregnancy and birth outcomes 

for many pregnant women and people 

from racial and ethnic minority 

groups.233

Newborn babies are also impacted by 

systemic racism. Infant mortality data 

show that African American or Black, 

NHOPI, and AIAN babies are dying at 

higher rates in the U.S. than other racial 

or ethnic groups.234 Head Start 

programs are positioned to address 

racial gaps in maternal mortality, 

morbidity, and infant deaths by 

customizing services for the pregnant 

women and people they serve based on 

the needs of their community. 

To help programs better understand 

and address barriers a pregnant woman 

or person may have to a healthy 

pregnancy and childbirth, we further 

propose to amend § 1302.80 by adding 

a new paragraph (f). The new paragraph 

requires programs to identify and 

reduce barriers to healthy pregnancy 

outcomes for enrolled pregnant women 

and people based on the information 

and data collected on this population. 

The goal is also to help reduce racial 

inequities in maternal and infant 

morbidity 235 and mortality. This 

proposed paragraph states, ‘‘The 

program must provide services that help 

reduce barriers to healthy maternal and 

birthing outcomes for each family, 

including services that address 

disparities across racial and ethnic 

groups, and use data on enrolled 

pregnant women to inform program 

services.’’ We believe this new 

paragraph will ensure programs 

customize prenatal and postnatal 

services to help improve outcomes and 

contribute to the reduction of racial 

inequities in maternal and infant 

morbidity and mortality. Programs 

should use data and information 

collected from referrals and general case 

management to inform and 

individualize services. Documentation 

of services should include a summary of 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80864 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

236Britta C. Mullany, S Becker, MJ Hindin, The 

impact of including husbands in antenatal health 

education services on maternal health practices in 

urban Nepal: results from a randomized controlled 

trial, Health Education Research, 22(2), April 2007, 

Pages 166–176. 

237 ‘‘Mandated’’ reporter or reporting refers to 

statutory requirements related to mandatory 

reporting of suspected instances of child abuse and 

neglect by individuals as applicable under State law 

and in accordance with the Federal Child Abuse 

Prevention and Treatment Act (CAPTA), 42 U.S.C. 

5106a(b)(2)(B)(i). 

238Child Welfare Information Gateway. (2019). 

Mandatory reporters of child abuse and neglect. 

Washington, D.C.: U.S. Department of Health and 

Human Services, Children’s Bureau. 

239Leeb R.T., Paulozzi L., Melanson C., Simon T., 

Arias I. (2008). Child Maltreatment Surveillance: 

Uniform Definitions for Public Health and 

Recommended Data Elements, Version 1.0. Atlanta 

(GA): Centers for Disease Control and Prevention, 

National Center for Injury Prevention and Control. 

interactions with the pregnant woman 

or person through case notes, strengths 

and needs assessment, referrals and the 

results of the referrals to community 

partners, and information from the 

family partnership agreement and any 

relevant community partnership 

agreements. The program should 

examine this information and data for 

any barriers that prevent pregnant 

women and people from having healthy 

pregnancies and birth outcomes. Plans 

may include approaches developed with 

the Health Services Advisory Committee 

and community partners to help address 

or reduce identified barriers. 

Next, we discuss proposed revisions 

to § 1302.82. In general, this section 

highlights that, as with all other 

families, enrolled pregnant women and 

people should receive the family 

partnership services described in 

§ 1302.52 Family partnership services. 

However, § 1302.82 clarifies that these 

services should be explicitly directed 

toward their prenatal and postpartum 

care needs. This section also describes 

requirements to support the enrollment 

of the newborn into a program as 

appropriate. 

Programs are not currently required to 

use a curriculum in the provision of 

services to pregnant women and people, 

nor are there any requirements for the 

type of curriculum if one is used. 

However, if a curriculum is used, it 

should be responsive to the needs of the 

population served. As such, programs 

opting to use a maternal health 

curriculum should consider the needs of 

the pregnant women and people in their 

program. If used, the curriculum should 

provide information that increases the 

knowledge of pregnant women or 

people and their support system. Those 

who attend maternal health courses 

with their partners are more likely to 

attend postpartum visits and had higher 

positive maternal health behaviors.236 It 

is imperative that any selected 

curriculum be responsive to the cultures 

and context of the communities served. 

Therefore, we propose to revise 

paragraph (a) in § 1302.82 by adding 

language to clarify that if a program 

chooses to use a curriculum with 

pregnant women and people, they 

should select a curriculum that focuses 

on maternal and child health. We 

believe this will improve maternal and 

child outcomes by helping to reduce 

prematurity and low birth weight, as 

well as support increased initiation and 

continuation of breastfeeding and other 

healthy infant feeding. 

ACF seeks public comment on how 

the proposed requirements in this 

section may differentially impact 

different communities. We specifically 

request public comment from the 

special populations served by Head 

Start, including AIAN and MSHS 

programs and communities. 

Standards of Conduct (§ 1302.90) 

Section 1302.90(c) establishes the 

standards of conduct for all staff, 

consultants, contractors, and volunteers, 

which are part of a program’s personnel 

policies. Given how critical child safety 

is in Head Start programs, we propose 

revisions to these requirements to 

ensure we are as clear as possible and 

that our requirements reflect current 

best practices and more precise 

terminology. 

The proposed revisions to this section 

would align definitions related to child 

maltreatment with other Federal 

resources. We propose this alignment to 

facilitate understanding of staff 

responsibilities related to child health, 

mental health, and safety incidents. 

Additionally, the proposed revisions 

would underscore typical 

responsibilities of mandated 

reporters 237 of child abuse and neglect, 

which applies to all Head Start staff. 

These responsibilities include reporting 

when an individual ‘‘suspects or has 

reason to believe that a child has been 

abused or neglected,’’ or when a 

reporter has knowledge of or observes 

‘‘conditions that would reasonably 

result in harm to the child.’’ 238 The 

proposed changes further clarify that 

reports must include suspected or 

known incidents perpetrated by Head 

Start staff before they have been 

verified. 

First, we propose to redefine and 

reorganize provisions related to the 

prohibition of child maltreatment or 

endangerment in § 1302.90(c)(1)(ii). 

First, in § 1302.90(c)(1)(ii) we propose to 

remove the phrase ‘‘do not maltreat or 

endanger the health or safety of 

children, including at a minimum, that 

staff must not’’ and replace it with ‘‘do 

not engage in behaviors that would be 

reasonably suspected to negatively 

impact the health, mental health, or 

safety of children, including at a 

minimum.’’ We believe the proposed 

revisions set a higher yet reasonable 

standard for staff conduct to include 

prohibition of behaviors that have the 

potential to negatively impact children. 

We believe removing the word 

‘‘maltreat’’ from this paragraph and 

instead providing clearer definitions 

and examples of maltreatment in the 

subsection that follows will provide 

greater clarification about expectations. 

The inclusion of children’s mental 

health as a potential area of impact is 

proposed to underscore that a behavior 

does not have to cause physical harm to 

a child to be of notable concern for a 

child’s well-being. This understanding 

is consistent with research and guidance 

in the field of child maltreatment.239

More specifically, under 

§ 1302.90(c)(1)(ii), we propose to 

remove paragraphs (A) through (I) in 

their entirety and to replace these with 

paragraphs (A) through (D), each of 

which specifies a category of potential 

child abuse or neglect including a 

definition and specific examples. First 

in new paragraph (A) we define corporal 

punishment or physically abusive 

behavior as the intentional use of 

physical force that results in, or has the 

potential to result in, physical injury. 

Examples in the definition include, but 

are not limited to, hitting, kicking, 

shaking, biting, forcibly moving, 

restraining, force feeding, or dragging a 

child. Next in new paragraph (B) we 

define sexually abusive behavior as any 

completed or attempted sexual act, 

sexual contact, or exploitation. 

Examples in the definition include, but 

are not limited to, behaviors such as 

inappropriate touching, inappropriate 

filming, or exposing a child to other 

sexual activities. Next in new paragraph 

(C) we define emotionally harmful or 

abusive behavior as behaviors that harm 

a child’s self-worth or emotional wellbeing or behaviors that are insensitive to 

the child’s developmental needs. 

Examples in the definition include, but 

are not limited to, using isolation as 

discipline, exposing a child to public or 

private humiliation, or name calling, 

shaming, intimidating, or threatening a 

child. Finally, in new paragraph (D) we 

define neglectful behavior as the failure 

to meet a child’s basic physical and 

emotional needs including access to 

food, education, medical care, 

appropriate supervision by an adequate 

caregiver, and safe physical and 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80865 

240Leeb RT, Paulozzi L, Melanson C, Simon T, 

Arias I. Child Maltreatment Surveillance: Uniform 

Definitions for Public Health and Recommended 

Data Elements, Version 1.0. Atlanta (GA): Centers 

for Disease Control and Prevention, National Center 

for Injury Prevention and Control; 2008. 

241Fortson B, Klevens J, Merrick M, Gilbert L, 

Alexander S. (2016). Preventing Child Abuse and 

Neglect: A Technical Package for Policy, Norm, and 

Programmatic Activities. Atlanta, GA: National 

Center for Injury Prevention and Control, Centers 

for Disease Control and Prevention. Available 

online at https://www.cdc.gov/violenceprevention/ 

childabuseandneglect/fastfact.html. 

242 42 U.S.C. 5106g. Available online at https://

www.govinfo.gov/content/pkg/USCODE-2017- 

title42/html/USCODE-2017-title42-chap67.htm. 

243Elharake JA, Shafiq M, Cobanoglu A, Malik 

AA, Klotz M, Humphries JE, et al. Prevalence of 

Chronic Diseases, Depression, and Stress Among 

US Childcare Professionals During the COVID–19 

Pandemic. Prev Chronic Dis 2022;19:220132. DOI: 

http://dx.doi.org/10.5888/pcd19.220132. NAEYC, 

‘‘NAEYC Pandemic Surveys,’’ February 2022. 

https://www.naeyc.org/pandemic-surveys. 

244Fortson, B.L., Klevens, J., Merrick, M.T., 

Gilbert, L.K., & Alexander, S.P. (2016). Preventing 

child abuse and neglect: A technical package for 

policy, norm, and programmatic activities. Atlanta, 

GA: National Center for Injury Prevention and 

Control, Centers for Disease Control and Prevention. 

Daly & Dowd (1992), Characteristics of effective, 

harm free environments for children in out of home 

care, Child Welfare, 71(6):487–96. 

245 Koralek, D. (1992). Caregivers of young 

children: Preventing and responding to child 

maltreatment. U.S. National Center on Child Abuse 

and Neglect, Department of Health and Human 

Services. Available online at https://www.ojp.gov/ 

pdffiles1/Digitization/142411NCJRS.pdf. 

emotional environments. Examples in 

the definition include, but are not 

limited to, withholding food as 

punishment or refusing to change soiled 

diapers as punishment. These proposed 

categories, definitions, and examples of 

potential child maltreatment are 

adapted from the CDC resources, Child 

Maltreatment Surveillance: Uniform 

Definitions for Public Health and 

Recommended Data Elements 240 and an 

online Fast Facts review of child abuse 

and neglect prevention.241 The CDC 

resources were established through 

extensive consultation with experts to 

recommend consistent terminology 

related to potential child maltreatment. 

By providing definitions, we intend to 

clarify that adults in Head Start 

programs may not engage in any 

behavior that may have potential to 

negatively impact children. The 

examples are intended to provide more 

concrete information for clarification 

but are not an exhaustive list. The 

proposed paragraphs (A) through (D) 

retain some examples from the current 

standards that have been of particular 

concern to early child care settings 

according to internal data. Namely, we 

retained behaviors related to corporal 

punishment, public or private 

humiliation, and feeding and toileting 

practices as punishment in the 

examples. Forcibly moving and 

restraining are included as examples 

because they are also harmful to 

children’s well-being. 

Furthermore, under § 1302.90(c)(1), 

we propose to add a new paragraph 

(c)(1)(iii) that clarifies the requirement 

to ensure staff, consultants, contractors, 

and volunteers report reasonably 

suspected or known incidents of child 

abuse and neglect, as defined by the 

Federal Child Abuse Prevention and 

Treatment Act (CAPTA) (42 U.S.C. 5101 

note) 242 and in compliance with 

Federal, State, local, and Tribal laws. 

We believe that including this provision 

in the standards of conduct will bring 

attention to existing requirements that 

all staff are mandated reporters of 

suspected incidents of child abuse and 

neglect, even in the absence of 

definitive proof and even in instances in 

which the reporting staff member did 

not directly engage in or witness the 

alleged behavior. The Federal definition 

in CAPTA provides a minimum 

standard that ‘‘the term ‘child abuse and 

neglect’ means, at a minimum, any 

recent act or failure to act on the part 

of a parent or caretaker, which results in 

death, serious physical or emotional 

harm, sexual abuse or exploitation 

(including sexual abuse as determined 

under section 111), or an act or failure 

to act which presents an imminent risk 

of serious harm.’’ Programs must also 

comply with State, local, and Tribal 

laws, which may have additional 

stipulations related to defining child 

abuse and neglect and other 

requirements for mandated reporting. If 

there are differences between Federal 

and State, local, and Tribal laws, 

programs should comply with the more 

stringent regulation. As a result of this 

proposed new paragraph (iii), we 

propose to redesignate in § 1302.90(c)(1) 

current paragraphs in (iii), (iv), and (v) 

as paragraphs (iv), (v), and (vi), 

respectively. 

In redesignated § 1302.90(c)(1)(iv), 

formerly § 1302.90(c)(1)(iii), we propose 

to remove the phrase ‘‘child and family’’ 

and replace it with ‘‘each individual.’’ 

This proposed change to ensure staff are 

included is aligned with efforts to 

promote well-being and safety across 

Head Start and increase the supportive 

and responsive relationships among 

staff. 

Finally, the requirement in Standards 

of Conduct for staff at redesignated 

paragraph § 1302.90(c)(1)(vi), formerly 

§ 1302.90(c)(1)(v), underscores that 

children cannot be left alone or 

unsupervised by staff, consultants, 

contractors, or volunteers under their 

care. However, as it is currently written, 

the language can be erroneously 

interpreted to mean that a child may be 

left solely under the supervision of 

volunteers. ACF has been clear that this 

is not allowed, and § 1302.94(b) states 

that ‘‘a program must ensure children 

are never left alone with volunteers.’’ 

For this reason, we propose to update 

the provision at § 1302.90(c)(1)(vi). 

Specifically, we propose to remove 

the phrase ‘‘by staff, consultants, 

contractors, or volunteers while under 

their care’’ in paragraph (v). The stem of 

§ 1302.90 (c)(1) reads ‘‘a program must 

ensure all staff, consultants, contractors, 

and volunteers abide by the program’s 

standards of conduct that:’’ and 

effectively captures the applicable 

subjects of the requirement without 

allowing for alternative inaccurate 

interpretations of the requirement. This 

update to the language is not a policy 

change but rather clarifies the longstanding requirement to prevent any 

misinterpretation and to bring it into 

full alignment with requirement 

§ 1302.94(b). 

ACF seeks public comment on how 

the proposed requirements in this 

section may differentially impact 

different communities. We specifically 

request public comment from the 

special populations served by Head 

Start, including AIAN and MSHS 

programs and communities. 

Staff Training To Support Child Safety 

(§ 1302.92; § 1302.101) 

As described in the earlier section on 

Workforce Supports: Employee 

Engagement, § 1302.92 establishes 

requirements for staff training and 

professional development. Specifically, 

§ 1302.92(b) requires programs to 

establish and implement systematic 

approaches to training and professional 

development in key areas. We know 

Head Start programs are experiencing a 

workforce shortage and the continued 

effects of the pandemic, both of which 

place significant stress on staff.243 We 

also know that higher caregiver stress 

and lower quality caregiver-child 

relationships can be risk factors for 

child abuse and neglect, and that 

prevention of child abuse and neglect 

often relies on strategies to reduce 

caregiver stress, increase caregiver 

supports, and foster higher quality 

caregiver-child relationships.244

Ongoing training to build and apply 

staff knowledge of child development 

and positive guidance or other 

developmentally appropriate behavior 

strategies are critical components of 

reducing caregiver stress and associated 

risks in ECE settings.245 Given the 

potential harm that any single incident 

may pose to children, families, and staff, 

we believe that providing ample 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80866 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

246U.S. Department of Health & Human Services, 

Administration for Children and Families, 

Administration on Children, Youth and Families, 

Children’s Bureau. (2022). Child Maltreatment 

2020. Available from https://www.acf.hhs.gov/cb/ 

data-research/child-maltreatment. 

247Lee, J. & Weigensberg, E. (2022). ‘‘How Do 

Laws and Policies for Reporting Child Abuse and 

Neglect Vary Across States?’’ OPRE Report #2022– 

165. Washington, D.C.: Office of Planning, 

Research, and Evaluation, Administration for 

Children and Families, U.S. Department of Health 

and Human Services. 

248National Center for Community-Based Child 

Abuse Prevention (CBCAP). 

249OIG Final Report: ACF Should Improve 

Oversight of Head Start To Better Protect Children’s 

Safety, OEI–BL–19–00560. 

opportunities to learn and practice 

safety skills is essential to preventing 

incidents. This emphasis is of utmost 

importance to the Head Start population 

since younger children are more likely 

to be victims of child abuse and 

neglect.246 In this section, we propose 

revisions and an addition to emphasize 

training and professional development 

related to child safety. 

In § 1302.92(b)(2), we propose to add 

a requirement that mandated reporter 

training is conducted on an annual 

basis. We believe that more frequent 

training will support staff in recognizing 

potential child abuse and neglect and 

understanding their legal responsibility 

as a mandated reporter. Many states do 

not require mandated reporter 

trainings 247 but all Head Start staff are 

mandated reporters regardless of 

whether they work directly with 

children and, as previously noted, 

young children are a particularly 

vulnerable population. We believe this 

proposed policy change will create more 

equitable opportunities for staff to 

understand and discuss their ethical 

and legal responsibilities. The greater 

frequency of training would also allow 

programs to offer staff advanced training 

opportunities on areas of local 

importance or greater complexity, such 

as culturally responsive practices in 

reporting, issues related to 

disproportionate reporting, and 

information about at-risk populations, 

as well as emphasize the importance of 

child safety in Head Start. We also add 

language to clarify expectations with 

more precise language in this section. 

Currently, training and professional 

development related to using positive 

strategies to support children is only 

required for education staff, per 

§ 1302.92(b)(5). Yet, all staff are required 

to use positive strategies to support 

children according to existing standards 

of conduct, per § 1302.90(c)(1)(i), and 

ongoing training and professional 

development is an effective strategy for 

preventing child maltreatment.248 As 

such, under this section, we propose to 

add a new paragraph as § 1302.92(b)(3) 

which will require annual training on 

positive strategies to understand and 

support children’s social and emotional 

development, including the 

implementation of tools for preventing 

and managing challenging behavior. We 

also believe enhancing use of positive 

strategies among all staff will have the 

added benefit of increasing 

opportunities for peer support as 

appropriate. We are prescribing general 

areas of focus but allowing for programs 

to select approaches so that programs 

may fulfill this requirement in ways that 

are responsive to their community 

needs and cultural practices. As a result 

of this proposed addition, we further 

propose to redesignate current 

paragraphs (3), (4), and (5) of 

§ 1302.92(b) to (4), (5), and (6), 

respectively. 

We also propose a revision to 

§ 1302.101 which establishes 

management responsibilities governed 

by a system that enables the delivery of 

the high-quality services. ACF is aware 

that there has been inconsistent 

implementation of required reporting 

procedures.249 In order to promote 

consistent implementation of paragraph 

(a)(5), we propose to add a new clause 

to § 1302.101(a)(5) to require a system 

that ensures that all staff are trained to 

implement reporting procedures in 

§ 1302.102 (d)(1)(ii). By requiring that 

programs provide training on reporting 

procedures, we anticipate that staff will 

have greater familiarity with and 

understanding of institutional reporting 

procedures. Additionally, with an 

implementation system in place, ACF 

may more easily provide guidance on 

what steps should be taken to ensure 

that staff report incidents appropriately. 

Incident Reporting (§ 1302.102) 

Section 1302.102 outlines the 

requirements that programs establish 

program goals and a process for 

monitoring program performance, 

including how programs use data and 

report out to the governing body and 

policy council. Paragraph (d) of 

§ 1302.102 establishes required reports 

that programs must submit for 

monitoring and oversight purposes, and 

§ 1302.102(d)(1)(ii) specifically 

addresses required incident reports. 

In the years of implementing these 

provisions since the 2016 revision of the 

HSPPS, it is evident that child incidents 

are not always reported to the OHS 

Regional Office or are not reported in a 

timely manner. The importance of 

reporting child incidents to OHS cannot 

be overstated. We propose several 

changes to § 1302.102(d)(1)(ii) to make 

clear and strengthen the reporting 

requirements associated with child 

health and safety incidents. 

Section 1302.102(d)(1)(ii) introduces 

general requirements related to when 

and to whom incident reports should be 

submitted and specifies types of 

situations that require incident reports. 

We make two changes to 

§ 1302.102(d)(1)(ii). First, we propose to 

remove the phrase ‘‘as soon as 

practicable’’ and replace it with ‘‘no 

later than 3 business days following the 

incident’’ to clarify the timeline by 

which programs are expected to make 

reports. The timeline of three business 

days more closely aligns our 

institutional reporting practices with 

child welfare reporting practices, which 

often require reports to be filed within 

48 hours of learning of a suspected 

incident. Shortening the timeline will 

allow for earlier processing and 

monitoring of reports, and for more 

expedient access to technical assistance 

or other supports for programs when 

needed. 

Our second proposed change is to add 

two new paragraphs to 

§ 1302.102(d)(1)(ii) to clarify reportable 

incidents. First, the new 

§ 1302.102(d)(1)(ii)(A) describes one 

type of reportable incident as any 

significant incident that affects the 

health, mental health, or safety of a 

child that occurs in a setting where 

Head Start services are provided and 

that involve either a Head Start adult or 

Head Start child, as further defined 

below. This change clarifies that mental 

health incidents are included in 

significant incidents and that only those 

incidents that occur in settings where 

Head Start services are provided, such 

as a Head Start program, playground, or 

transportation utilized by a Head Start 

program, are reportable to OHS. This 

definition is intentionally broad and 

intended to capture any setting for 

which Head Start funding is used. The 

following two new sub-paragraphs 

clarify who must be involved in the 

incident in order for it to be reportable 

to OHS. Reportable incidents include 

those that involve either (I) a staff 

member, contractor, volunteer, or other 

adult that participates in either a Head 

Start program or a classroom at least 

partially funded by Head Start, 

regardless of whether the child receives 

Head Start services; or (II) a child that 

receives services fully or partially 

funded by Head Start or a child that 

participates in a classroom at least 

partially funded by Head Start. 

The proposed change is intended to 

expand incidents that are reportable to 

Head Start to include more individuals 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80867 

250Caring for our Children. (2022). Chapter 9.2: 

Policies. National Resource Center for Health and 

Safety in Child Care and Early Education, 

Department of Health and Human Services. 

Available online at https://nrckids.org/CFOC/ 

Database/9.2.4.8. 

than the current standard. However, 

incidents that do not meet both of these 

conditions: (1) a child incident that 

occurs in a setting where Head Start 

services are provided and (2) that 

involves a person described by either 

§ 1302.102(d)(1)(ii)(A)(I) or 

§ 1302.102(d)(1)(ii)(A)(II), would be 

beyond the scope of what is reportable 

to OHS. We note that these incidents 

may still be reportable to other agencies, 

such as child care licensing agencies. 

We retain the language in the current 

standard describing another type of 

reportable incident in the new 

§ 1302.102(d)(1)(ii)(B), which pertains to 

circumstances affecting the financial 

viability of the program; breaches of 

personally identifiable information, or 

program involvement in legal 

proceedings; or any matter for which 

notification or a report to State, Tribal, 

or local authorities is required by 

applicable law. 

Additional proposed language also 

requires programs to report other health, 

mental health, or safety incidents of 

concern to Head Start that are not 

explicitly named in the sections that 

follow. The following subsections of 

redesignated § 1302.102(d)(1)(iii) 

describe minimum expectations for 

situations that require an incident report 

to be submitted. We propose several 

changes to further clarify and strengthen 

incident reporting requirements. We 

note that some of the changes describe 

situations that are currently expected to 

require incident reports. However, our 

goal in including them explicitly in the 

list of minimally reportable incidents is 

to make this expectation clear and 

facilitate navigation and understanding 

of the OHS reporting requirements. 

First, we propose to add ‘‘mandated’’ 

to § 1302.102(d)(1)(iii)(A) to provide 

clarification that any incidents 

involving mandated reporter 

responsibilities should be reported to 

Head Start as well as the appropriate 

State, local, or Tribal authority, 

independent of the status of 

investigation or outcome of such 

reports. 

Second, in § 1302.102(d)(1)(iii)(B) we 

propose to remove ‘‘for any reason’’ and 

replace it with ‘‘except for 

circumstances such as natural disasters 

that interfere with program operations.’’ 

This revision is intended to account for 

circumstances where it may be unsafe or 

unreasonable to expect a program to 

report center closings within the 

proposed revised timeline in 

§ 1302.102(d)(1)(ii) especially if 

communication channels are not 

operable. 

Next, we propose to add three new 

paragraphs (E), (F), and (G) to 

§ 1302.102(d)(1)(iii) to better describe 

the types of incidents that should be 

reported to OHS. First, we propose a 

requirement that programs report any 

suspected or known violations of 

Standards of Conduct under 

§ 1302.90(c)(ii). The standards of 

conduct, described in the earlier 

section, Standards of Conduct, outline 

behaviors that staff must not engage in 

that would be reasonably suspected to 

negatively impact the health, mental 

health, and safety of children. 

Therefore, the addition of 

§ 1302.102(d)(1)(iii)(E) is intended to 

clarify that programs must submit 

incident reports for any violations of 

Head Start standards of conduct in 

§ 1302.90(c)(ii), even if those violations 

do not require a mandated report under 

State, Tribal, or local law. 

The second addition to incidents that 

should be reported to OHS is significant 

health or safety incidents related to 

suspected or known lack of supervision 

or lack of preventative maintenance in 

§ 1302.102(d)(1)(iii)(F). This addition is 

intended to clarify that programs must 

submit reports for significant incidents 

that may be associated with reasonably 

suspected or known lack of appropriate 

supervision or failure to carry out 

reasonably expected maintenance, such 

as maintenance of playground 

equipment. We acknowledge that some 

incidents involving injuries to children 

may be unintentional and unavoidable. 

Therefore, we wish to provide clarity 

about which health and safety incidents 

should be reported to OHS. We consider 

significant incidents in these cases to be 

those that result in serious injury or 

harm to a child, specifically incidents 

that require hospitalization or 

emergency room care, such as a broken 

bone; severe sprain; chipped or cracked 

teeth; head trauma; deep cuts; 

contusions or lacerations; or animal 

bites. In addition, we would like to 

clarify that lack of supervision while in 

the care of program staff includes 

leaving a child unsupervised anywhere 

on the grounds of a Head Start facility, 

such as in a classroom, bathroom, or on 

a playground, as well as outside the 

facility, such as in a parking lot, on a 

nearby street, on a bus, or during 

another program-approved 

transportation or excursion. Including 

these types of incidents in what is 

reportable to Head Start allows us to 

expedite access to technical assistance 

or other supports, as needed, to address 

systemic issues that impact children’s 

health and safety. 

The third addition of 

§ 1302.102(d)(1)(iii)(G) describes any 

unauthorized release of a child as a 

reportable incident and is intended to 

ensure that programs submit reports for 

incidents involving the unauthorized 

release of children. Unauthorized 

release occurs when a child is released 

from a Head Start facility, bus, or other 

approved program transportation to a 

person without the permission or 

authorization of a parent or legal 

guardian and whose identity had not 

been verified by photo identification. 

This addition codifies expectations 

outlined in ACF–IM–HS–22–07 and 

aligns with Caring for Our Children 

standards.250

Finally, we propose to revise the title 

for § 1302.102 ‘‘Achieving Program 

Goals’’ to read ‘‘Program Goals, 

Continuous Improvement, and 

Reporting,’’ to clarify the contents of 

this section and further improve ease of 

navigation. 

ACF seeks public comment on how 

the proposed requirements in this 

section may differentially impact 

different communities. We specifically 

request public comment from the 

special populations served by Head 

Start, including AIAN and MSHS 

programs and communities. 

Facilities Valuation (§ 1303.44) 

Section 1303.44(a)(7) establishes that 

if a grant recipient is preliminarily 

eligible under § 1303.42 to apply for 

funds to purchase, construct, or 

renovate a facility, the recipient must 

submit to the responsible HHS official, 

among other requirements, an estimate 

by a licensed independent certified 

appraiser of the facility’s fair market 

value. 

Fair market value can take many 

forms; this depends on the purpose or 

intended use of the valuation. 

Appraisers generally rely on three 

methods of establishing real estate 

value, which complies with the Uniform 

Standards of Professional Appraisal 

Practice (USPAP) and local guidelines: 

sales approach, cost approach, and 

income approach. Sales approach 

compares the sales price of comparable 

facilities, and it accounts for the price 

at sale of the facility. Cost approach 

evaluates the cost to reproduce or 

replace an equivalent facility, and it 

accounts for the acquisition cost of the 

land, construction expense, and 

depreciation of the property. Income 

approach estimates the value based on 

income potential of an equivalent 

facility. 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80868 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

251National Equity Analysis. (2020). 

Neighborhood poverty: All neighborhoods should 

be communities of opportunity. Retrieved from: 

https://nationalequityatlas.org/indicators/ 

Neighborhood_poverty. 

252Phillips, D. A. & Cabrera, N. J. (eds.) (1996). 

Beyond the Blueprint: Direction for Research on 

Head Start’s Families. Washington, DC: National 

Academies Press. 253See: https://www.irs.gov/taxtopics/tc407. 

Applications under this section 

include applications for constructions, 

purchase, and significant renovation to 

facilities. Based on a review of 

applications to purchase, construct, or 

renovate facilities, the cost approach to 

valuation is most relevant. 

The sales approach can be 

problematic since many facility projects 

show large discrepancies in sales 

valuation and total project cost, 

particularly as real property sales prices 

depend heavily on the locality of the 

property. Sales valuation does not 

account for the large cost needed to 

ready the property for its intended use. 

Sales approach can be relevant for 

certain proposed facility projects, but 

when relevant, it is already covered by 

other required activities under § 1303. 

Specifically, recipients are required to 

compare the cost associated with the 

proposed action to other available 

alternatives in the service area, pursuant 

to § 1303.45. Requirements under 

§ 1303.45 discover the actual purchase 

cost of comparable alternate facilities in 

the service area and therefore the sales 

approach valuation remains less 

relevant to require in paragraph (7) of 

§ 1303.44(a). 

Head Start facilities are woven into 

the fabric of communities they serve as 

highly valued, safe spaces for children 

and families. This is especially 

important as Head Start programs are 

often located in low-income 

communities and geographic areas with 

a high concentration of poverty. 

Programs are often also located in 

communities with more people of color 

as people of color are more likely than 

their white counterparts to live in lowincome neighborhoods. For instance, in 

2020, about 14 percent of people of 

color lived in high-poverty 

neighborhoods, compared to about 4 

percent of White people.251 Head Start 

programs are known to invigorate their 

communities including the 

development of strong partnerships 

with many local community-based 

organizations.252 As such, it is essential 

that Head Start programs receive 

accurate valuation of facility project 

costs to ensure responsible acquisition 

of facilities continues in communities in 

need. 

For these reasons, we propose to 

eliminate from § 1303.44(a)(7) the term 

‘‘fair market’’ and replace it with the 

term ‘‘cost’’ because the cost valuation 

is most relevant in determining fair cost 

of a facility acquisition action under this 

section. This will assist the awarding 

agency in making determinations on 

proposed project costs and fair market 

costs. 

We welcome any additional public 

comments on the 45 CFR 1303 process 

and associated requirements. We 

specifically request public comment 

from the special populations served by 

Head Start, including AIAN and MSHS 

programs and communities. 

Definition of Income (§ 1305.2) 

The current HSPPS definition lists 

several types of income sources that 

could be included in the calculation of 

gross income and references additional 

sources that can be found in a lengthy 

document from the Census Bureau. The 

current definition has caused confusion 

regarding what should be included in 

income calculations. We propose to 

revise the definition of income to make 

it up to date, clear, and less burdensome 

to implement. The proposed language 

provides a clear and finite list of what 

is considered income. It also provides 

clarification on what is not considered 

income as it relates to military income 

and refundable tax credits and public 

assistance. These changes are to ensure 

programs can more easily identify an 

applicants’ income. This will also 

promote consistent interpretation on 

what to include in calculating income 

across programs. 

Specifically, we proposed to strike the 

current definition: ‘‘Income means gross 

cash income and includes earned 

income, military income (including pay 

and allowances, except those described 

in section 645(a)(3)(B) of the Act), 

veteran’s benefits, Social Security 

benefits, unemployment compensation, 

and public assistance benefits. 

Additional examples of gross cash 

income are listed in the definition of 

‘‘income,’’ which appears in U.S. 

Bureau of the Census, Current 

Population Reports, Series P–60–185 

(available at https://www2.census.gov/ 

prod2/popscan/p60-185.pdf). 

We propose to replace the definition 

and define income as gross income that 

only includes wages, business income, 

veteran’s benefits, Social Security 

benefits, unemployment compensation, 

alimony, pension or annuity payments, 

gifts that exceed the threshold for 

taxable income, and military income 

(excluding special pay for a member 

subject to hostile fire or imminent 

danger under 37 U.S.C. 310 or any basic 

allowance for housing under 37 U.S.C. 

403 including housing acquired under 

the alternative authority under 10 U.S.C. 

169 or any related provision of law). 

The revised definition is clear that gross 

income only includes sources of income 

provided in the definition; it does not 

include refundable tax credits nor any 

forms of public assistance. 

As mentioned previously, the current 

HSPPS definition includes a link to a 

250+ page Census Bureau document 

from 1992. We believe the definition 

and reference to the document are 

outdated and complicated for programs 

to utilize. We propose to remove the 

current reference to this dated Census 

report and replace the definition with a 

finite number of income sources and 

remove the reference to the Census 

Bureau report. The proposed revision 

includes many sources of income from 

the definition in the Census Bureau 

document currently cited. 

The proposed language removes the 

term ‘‘cash’’ from ‘‘gross cash income’’ 

in recognition that most income is not 

provided in the form of cash. The word 

‘‘only’’ is proposed before ‘‘includes’’ to 

clearly define a finite list of sources 

considered income for Head Start 

purposes. Further the proposal replaces 

the term ‘‘earned income’’ with more 

specific terms ‘‘wages,’’ and ‘‘business 

income.’’ Business income includes 

income obtained from rental properties, 

as defined by the Internal Revenue 

Service.253 We also do not propose to 

include ‘‘dividends’’ or ‘‘capital gains’’ 

to avoid unnecessary burden in 

requesting this information from 

families since we believe it unlikely 

Head Start applicants would have such 

sources of income that would make 

them ineligible for Head Start, and these 

terms may be difficult to understand 

and cause confusion to families during 

the eligibility determination process. 

We remove ‘‘public assistance’’ from 

the definition because if a family is 

receiving SNAP, TANF, or SSI, then 

they are already eligible for Head Start. 

Removing this source of income reduces 

the administrative burden of calculating 

income from such sources. The current 

referenced Census Bureau document 

includes ‘‘regular contributions from 

others not living in the household,’’ 

which we do not include in the 

proposal. We interpret this to mean 

money received periodically to assist 

the family in meeting basic needs. We 

do not believe one-time or periodic gifts 

should be counted as income for Head 

Start eligibility purposes, especially 

since it may not be relied upon as a 

regular source of income. We have 

determined that these payments should 

be considered gifts and therefore not 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80869 

taxable until they reach the IRS 

threshold for gifts which is $17,000 for 

2023 and updated on an annual basis. 

Therefore, we propose to include ‘‘gifts 

that exceed the threshold for taxable 

income’’ as a source of income. 

To facilitate the implementation of 

the exclusions from military pay 

specified by the Head Start Act, we 

detail the exclusions from military pay 

as designated in the statute rather than 

referencing it. We propose this to allow 

programs and families to determine 

what counts as income through the 

definition in the regulations. 

We clarify that gross income only 

includes sources of income provided in 

the definition, and does not include 

refundable tax credits nor any forms of 

public assistance, to be explicit that this 

is a finite list of sources of income and 

call out two common other sources of 

income that might be inadvertently 

considered to be added. Although the 

finite list does not include refundable 

tax credits, we are concerned that 

programs may include it as part of the 

‘‘wages’’ category. We believe this 

makes it clear that the tax credits 

commonly received by Head Start 

applicants such as the Earned Income 

Tax Credit and the Child Tax Credit are 

not included as part of calculated 

income. Furthermore, the finite list of 

sources of income intentionally 

precludes any other emergency or 

temporary forms of income or assistance 

from being included in calculations of 

income for eligibility purposes, such as 

the enhanced unemployment insurance 

that was available during the COVID–19 

pandemic. 

All the revisions proposed together 

simplify the definition of income and 

clarify how it will be implemented 

consistently across programs when 

determining income eligibility for Head 

Start. We seek public comment on this 

definition so that we ensure this is the 

most accurate and streamlined 

definition. We also specifically request 

public comment from the special 

populations served by Head Start, 

including AIAN and MSHS programs 

and communities. 

Definition of Federal Interest and Major 

Renovations (§ 1305.2) 

ACF has received questions that 

suggest our definitions of Major 

Renovation and Federal Interest are too 

imprecise and consequently lead to 

Head Start grant recipients 

misinterpreting and inconsistently 

applying the definitions when filing an 

official Notice of Federal Interest 

(NOFI). In this section, we propose 

technical fixes and additional clarifying 

language to address common questions. 

The proposed changes do not 

substantively change the meaning of the 

definitions, but rather clarify issues that 

have arisen since the implementation of 

the 2016 revisions to the HSPPS. ACF 

believes these minor revisions 

encourage recipients to maintain safe 

and updated facilities. 

First, we propose changes to the 

definition of Major Renovation. We 

propose to address a typo in the 

definition—the term, ‘‘collection 

renovation’’—and in amending this 

minor error, we offer some additional 

text to improve understanding. 

Furthermore, we add additional text to 

clarify that separate renovation 

activities only equate to a major 

renovation if (1) they have a cost equal 

to or exceeding $250,000, (2) the 

renovation activities are intended to 

occur concurrently or consecutively, or 

altogether address a specific part or 

feature of a facility, and (3) per 

§ 1303.44, certification from a licensed, 

independent architect or engineer 

indicates that the repair(s) adds 

significant value to the real property to 

be repaired or extends its useful life. If 

these three conditions are met, the 

group of renovations should be 

understood as a Major Renovation. 

We understand that grant recipients 

have been misinterpreting the definition 

of Major Renovation to include multiple 

renovation activities on the same facility 

that have a cost equal to or exceeding 

$250,000. To help clarify, ACF is 

providing the following common 

examples: 

• A recipient completes a minor 

renovation to install a new roof at 

$150,000. The next year, the recipient 

replaced all the windows at a cost of 

$50,000. The year after that, the 

recipient re-surfaced the parking lot for 

$75,000. While this was always the case, 

under this clarified definition, it is 

clearer that the unrelated renovation 

project activities in this example do not 

equate to a Major Renovation. 

• A recipient replaces the roof of one 

of their facilities for $200,000. Two 

years later, the recipient replaces the 

same facility’s HVAC units for 

additional $200,000. These renovation 

activities are not considered a collective 

group of facility renovation activities 

because the project activities are not 

intended to occur concurrently or 

consecutively, or altogether address a 

specific part or feature of a facility, and 

thus, they are not considered a Major 

Renovation. 

• In 1 year, a recipient repairs the 

roofs of two different centers totaling 

$300,000, each for $150,000. Since these 

are separate centers, they are not related 

to the same facility and therefore, the 

collective renovation activities are not 

considered a Major Renovation. 

• A recipient replaces part of their 

roof at one of their facilities for 

$200,000. Two years later, the recipient 

replaces another part of the same roof 

for $200,000. In this instance, whether 

the roof repairs are considered a Major 

Renovation depends. While these 

collective renovation activities address a 

specific part or feature of a facility, and 

are greater than the $250,000 threshold, 

the expenditure may not add significant 

value to the real property. In advance of 

commencing the proposed roof repairs, 

the recipient must submit a certification 

from a licensed, independent architect 

or engineer indicating whether the 

expenditure identified as repairs adds 

significant value to the real property to 

be repaired or extends its useful life. If 

the required certification is not 

provided, the activity will be classified 

as a Major Renovation and compliance 

with part 1303, subpart E of the HSPPS 

is required. 

• In 1 year, a recipient repairs the 

roof, replaces the HVAC system, 

repaints walls, and renovates a 

bathroom, totaling $350,000. These 

collective renovation activities are 

greater than the $250,000 threshold and 

are occurring concurrently or 

consecutively to address a specific part 

or feature of a facility, so they are likely 

related. However, the expenditure may 

or may not add significant value to the 

real property so whether the repairs are 

considered a Major Renovation 

depends. In advance of commencing the 

renovations, the recipient must submit a 

certification from a licensed, 

independent architect or engineer 

indicating whether the expenditure 

adds significant value to the real 

property to be repaired or extends its 

useful life. If the required certification is 

not provided, the activity will be 

classified as a Major Renovation and 

compliance with part 1303, subpart E is 

required. 

We propose technical fixes to the 

definition of Federal Interest to address 

confusion with respect to the type of 

facility activities that result in Federal 

interest and what satisfies the nonFederal matching requirement. 

Specifically, the proposed additional 

language, in tandem with the proposed 

definition for Major Renovation, 

clarifies the distinction between repairs 

and minor renovations versus purchase, 

construction and major renovations 

under § 1303, the latter of which do 

result in a Federal interest. This 

proposed definition also clarifies that 

the non-Federal match, which is 

separate from the base grant non-Federal 

match, is only intended to include the 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80870 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

non-Federal match associated with the 

facility activity funded under subpart E. 

In sum, these changes are not 

substantive changes to the definition 

itself but rather provide clarification on 

how Federal interest works. 

Together, these proposed specified 

conditions to the definition of Major 

Renovation, and clarification proposed 

to the definition of Federal Interest, 

ultimately seek to ensure recipients 

understand when a group of renovations 

would require filing of a NOFI. 

Definition of the Poverty Line (§ 1305.2) 

In this section, we propose to add to 

§ 1305.2 a definition for the term 

Poverty line that is currently used in 

§ 1302.12 paragraph (c) and (d) on 

income eligibility to clarify and codify 

existing practice. This is only intended 

to codify the working definition for 

poverty line, including the existing 

practice that the HHS poverty 

guidelines set for the contiguous-statesand-DC also apply to Puerto Rico and 

U.S. Territories. The HHS poverty 

guidelines are used to determine income 

eligibility in Head Start and align with 

requirements in the Head Start Act set 

by Congress. The requirements in the 

Head Start Act are set by statute and 

cannot be changed through regulation. 

Therefore, we cannot consider public 

comments regarding changes to the 

poverty line. 

Effective Dates 

The current Head Start Program 

Performance Standards remain in effect 

until this NPRM becomes final. We 

propose for all changes in this NPRM to 

become effective 60 days after it is 

published as a final rule in the Federal 

Register, unless otherwise noted in this 

section. For section 1302.48(a), (b), and 

(c), while the effective date is upon 

publication of final rule, programs will 

not be monitored on the new regulatory 

requirements until 1 year after 

publication of the final rule to give 

programs additional time to adjust to 

the new regulatory requirements. 

Programs may require more time to 

implement several proposed sections in 

this NPRM. Therefore, we propose a 1- 

year delay in implementation deadline 

for the proposed revisions to the 

following sections: § 1302.11(b); 

1302.14(d); 1302.16(a)(2)(v); the changes 

made to remove ‘‘assistant provider’’ in 

1302.23(b); 1302.45(a); 1302.82(a); and 

1302.93(d). 

The following sections also have 

longer implementation timelines, 

outlined below: 

• § 1302.52(d)(2): 3 years after 

publication of final rule; 

• § 1302.80(e) Enrolled pregnant 

women: 120 days after publication of 

final rule; 

• § 1302.80(f) Enrolled pregnant 

women: 180 days after publication of 

final rule; 

• § 1302.90(e)(1), (e)(2)(i) and (ii), 

(e)(3) and (e)(4): Staff wages: Effective 

August 1, 2031; 

• § 1302.90(f) Staff benefits: 2 years 

after publication of final rule; 

• § 1302.93(c) Staff Health and 

Wellness: 3 years after publication of 

final rule. 

We request public comment on all of 

these proposed effective dates, 

including whether this is sufficient time 

for programs to implement the proposed 

changes and any possible unintended 

consequences. 

Removal of Outdated Sections 

The current HSPPS contain regulatory 

language associated with the last 

overhaul of the standards, published 

through a final rule in 2016. We propose 

to remove two sections of the standards 

that refer to the implementation 

timeline of those changes, which has 

since passed and therefore these 

sections are no longer relevant. The first 

section to be removed is § 1302.103 

Implementation of program 

performance standards. The second is 

the term Transition Period, which is 

defined under § 1305.2. These changes 

do not represent substantive policy 

changes. 

Compliance With Sec. 641A(a)(2) of the 

Act 

We sought extensive input to develop 

this NPRM. We collaborated and 

consulted with many policy and 

programmatic expert staff in OHS, 

ACF’s Office of Child Care, and ACF’s 

Office of Early Childhood Development. 

Several staff, particularly in OHS, are 

former Head Start program directors, 

family service workers, teachers, home 

visitors, etc. and have extensive on the 

ground knowledge of Head Start 

program operations. We also consulted 

extensively with OHS regional staff who 

directly oversee and support Head Start 

grants and program operations as their 

primary job responsibility. We held 

multiple listening and input sessions 

with these regional office staff to 

identify the most challenging aspects of 

Head Start policy and programmatic 

requirements for grant recipients. We 

also sought their feedback on proposed 

policies we were considering for the 

NPRM. We intentionally consulted with 

OHS staff that oversee Migrant and 

Seasonal Head Start and Tribal Head 

Start programs, to learn about specific 

challenges and considerations for these 

programs. Similarly, we met with 

members of the OHS Diversity, Equity, 

Inclusion, and Accessibility 

Commission to discuss possible equity 

implications of the proposed changes. 

We consulted with experts in early 

childhood development including staff 

in ACF’s Office of Planning, Research 

and Evaluation. These staff hold 

research expertise in a wide range of 

early childhood issues relevant to Head 

Start. Additionally, we reviewed many 

research reports on a variety of topics, 

including NAS reports on the 

workforce. Taken together, our 

consultation with all of these groups 

and sources allowed provided us with 

relevant data points and advice on how 

to promote quality across all Head Start 

settings. 

Furthermore, over the past several 

years since the last revision of the 

HSPPS (finalized in 2016), OHS has 

held many webinars for grant recipients 

on a variety of policy and programmatic 

topics, including the workforce, 

eligibility, mental health, child health 

and safety, and more. OHS has also 

given multiple presentations on key 

policy and program issues at Head Start 

relevant conferences, including those 

organized by the National Head Start 

Association. During these webinars and 

conference presentations, grant 

recipient participants often ask 

questions and provide input regarding 

challenges with implementing various 

aspects of program requirements, 

including for different types of child 

and family populations and in different 

types of geographic settings. This allows 

OHS the opportunity to gain critical onthe-ground understanding of areas 

where the standards are confusing and 

could be made clearer, particularly 

since the 2016 revisions. We also 

regularly hear from Tribal leaders at 

OHS’s annual Tribal consultations. In 

addition, in consultation with our OHS 

training and technical assistance 

experts, we considered the types of 

technical assistance requested by and 

provided to Head Start agencies and 

programs. We also reviewed findings 

from monitoring reports to glean more 

insights into where grant recipients 

struggle the most with implementing 

requirements. We also recently fielded a 

survey of grant recipients (November 

2022) which provided real time 

information on workforce challenges 

programs are experiencing. Lastly, ACF 

asserts that the revisions to the HSPPS 

proposed in this NPRM will not result 

in the elimination of or any reduction in 

quality, scope, or types of health, 

educational, parental involvement, 

nutritional, social, or other services 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80871 

required to be provided under the 

standards that were in effect when the 

Head Start Act was last reauthorized in 

2007. 

Severability 

To the extent that any portion of the 

requirements arising from the rule once 

it becomes final is declared invalid by 

a court, HHS intends for all other parts 

of the final rule that are capable of 

operating in the absence of the specific 

portion that has been invalidated to 

remain in effect. 

IV. Regulatory Process Matters 

We have examined the impacts of the 

proposed rule under Executive Order 

12866, Executive Order 13563, 

Executive Order 13132, the Regulatory 

Flexibility Act (5 U.S.C. 601–612), and 

the Unfunded Mandates Reform Act of 

1995 (Pub. L. 104–4). Executive Orders 

12866 and 13563 direct us to assess all 

benefits, costs, and transfers of available 

regulatory alternatives and, when 

regulation is necessary, to select 

regulatory approaches that maximize 

net benefits (including potential 

economic, environmental, public health 

and safety, and other advantages; 

distributive impacts; and equity). 

Section 3(f) of Executive Order 12866, 

as amended by Executive Order 14094, 

defines a ‘‘significant regulatory action’’ 

as an action that is likely to result in a 

rule: (1) Having an annual effect on the 

economy of $200 million or more, or 

adversely affecting in a material way the 

economy, a sector of the economy, 

productivity, competition, jobs, the 

environment, public health or safety, or 

State, local, territorial, or Tribal 

governments or communities; (2) 

creating a serious inconsistency or 

otherwise interfering with an action 

taken or planned by another agency; (3) 

materially altering the budgetary 

impacts of entitlement grants, user fees, 

or loan programs or the rights and 

obligations of recipients thereof; or (4) 

raising legal or policy issues for which 

centralized review would meaningfully 

further the President’s priorities or the 

principles set forth in Executive Order 

12866, as specifically authorized in a 

timely manner by the Administrator of 

OIRA in each case. This proposed rule 

is a significant rule and the Regulatory 

Impact Analysis for this proposed rule 

identifies economic impacts that exceed 

the threshold for significance under 

Section 3(f)(1) of Executive Order 

12866. 

Regulatory Flexibility Act 

The Regulatory Flexibility Act (5 

U.S.C. 601–612) requires us to analyze 

regulatory options that would minimize 

any significant impact of a rule on small 

entities. Because the proposed rule, if 

finalized, would result in increased 

expenditures by Head Start programs 

that exceed HHS’s default threshold, we 

have initially determined that the 

proposed rule will have a significant 

economic impact on a substantial 

number of small entities. 

Unfunded Mandates Reform Act of 1995 

The Unfunded Mandates Reform Act 

of 1995 (Pub. L. 104–4, section 202(a)) 

requires us to prepare a written 

statement, which includes estimates of 

anticipated impacts, before proposing 

‘‘any rule that includes any Federal 

mandate that may result in the 

expenditure by State, local, and Tribal 

governments, in the aggregate, or by the 

private sector, of $100,000,000 or more 

(adjusted annually for inflation) in any 

one year.’’ The current threshold after 

adjustment for inflation is $177 million, 

using the most current (2022) Implicit 

Price Deflator for the Gross Domestic 

Product. This proposed rule would 

likely result in expenditures that meet 

or exceed this amount. 

Federalism Assessment Executive Order 

13132 

Executive Order 13132 requires 

Federal agencies to consult with State 

and local government officials if they 

develop regulatory policies with 

federalism implications. Federalism is 

rooted in the belief that issues that are 

not national in scope or significance are 

most appropriately addressed by the 

level of government close to the people. 

This proposed rule will not have 

substantial direct impact on the States, 

on the relationship between the Federal 

Government and the States, or on the 

distribution of power and 

responsibilities among the various 

levels of government. Therefore, in 

accordance with section 6 of Executive 

Order 13132, it is determined that this 

action does not have sufficient 

federalism implications to warrant the 

preparation of a federalism summary 

impact statement. 

Treasury and General Government 

Appropriations Act of 1999 

Section 654 of the Treasury and 

General Government Appropriations 

Act of 1999 requires Federal agencies to 

determine whether a policy or 

regulation may negatively affect family 

well-being. If the agency determines a 

policy or regulation negatively affects 

family well-being, then the agency must 

prepare an impact assessment 

addressing seven criteria specified in 

the law. ACF believes it is not necessary 

to prepare a family policymaking 

assessment, see Public Law 105–277, 

because the action it takes in this 

proposed rule will not have any impact 

on the autonomy or integrity of the 

family as an institution. 

Paperwork Reduction Act of 1995 

The Paperwork Reduction Act (PRA) 

of 1995, 44 U.S.C. 3501 et seq., 

minimizes government-imposed burden 

on the public. In keeping with the 

notion that government information is a 

valuable asset, it also is intended to 

improve the practical utility, quality, 

and clarity of information collected, 

maintained, and disclosed. 

The PRA requires that agencies obtain 

OMB approval, which includes issuing 

an OMB number and expiration date, 

before requesting most types of 

information from the public. 

Regulations at 5 CFR part 1320 

implemented the provisions of the PRA 

and § 1320.3 of this part defines a 

‘‘collection of information,’’ 

‘‘information,’’ and ‘‘burden.’’ PRA 

defines ‘‘information’’ as any statement 

or estimate of fact or opinion, regardless 

of form or format, whether numerical, 

graphic, or narrative form, and whether 

oral or maintained on paper, electronic, 

or other media (5 CFR 1320.3(h)). This 

includes requests for information to be 

sent to the government, such as forms, 

written reports and surveys, 

recordkeeping requirements, and thirdparty or public disclosures (5 CFR 

1320.3(c)). ‘‘Burden’’ means the total 

time, effort, or financial resources 

expended by persons to collect, 

maintain, or disclose information. 

This NPRM establishes new 

recordkeeping requirements under the 

PRA. Under this NPRM, Head Start 

grant recipients will be required to keep 

and maintain records related to salary 

wage scales and staff benefits, 

improvements to community 

assessment, documentation related to 

lead exposure, among several other 

requirements. In addition, changes to 

policies proposed in the NPRM may 

result in changes to existing information 

collections approved under the PRA, 

including the information collection for 

the existing program performance 

standards, the Program Information 

Report (PIR), applicable collections in 

the Head Start Enterprise Systems 

(HSES), and other information 

collections. ACF invites public 

comments concerning changes to 

existing or new information collections 

that may be necessary as a result of this 

NPRM, including on practical utility 

and burden. 

The HSPPS are covered already by an 

existing OMB control number 0970– 

0148. This OMB control number already 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80872 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

254 If future Head Start appropriations designated 

for expansion grow at similar rates —for reasons 

that are independent of this proposal—then 

estimates reflecting growth at or below the rate of 

inflation (such as what appears in this regulatory 

impact analysis) would have a tendency toward 

understating effects. 

covers burden associated with updating 

personnel policies and documenting 

eligibility. The below table outlines the 

burden of complying with the proposed 

standards in this NPRM. These 

estimated burden hours represent the 

additional burden to be added to this 

existing information collection. We 

estimate the burden at the appropriate 

level depending on the given 

information collection, specified in the 

table below (program, family, or 

enrollee level). In 2022, there were 

3,000 Head Start programs across the 

country. 

V. Regulatory Impact Analysis 

Introduction and Summary 

A. Introduction 

We have examined the impacts of the 

proposed rule under Executive Order 

12866, Executive Order 13563, 

Executive Order 14094, the Regulatory 

Flexibility Act (5 U.S.C. 601–612), and 

the Unfunded Mandates Reform Act of 

1995 (Pub. L. 104–4). Executive Orders 

12866 and 13563 direct us to assess all 

benefits, costs, and transfers of available 

regulatory alternatives and, when 

regulation is necessary, to select 

regulatory approaches that maximize 

net benefits (including potential 

economic, environmental, public health 

and safety, and other advantages; 

distributive impacts; and equity). This 

analysis identifies economic impacts 

that exceed the threshold for 

significance under Section 3(f)(1) of 

Executive Order 12866, as amended by 

Executive Order 14094. 

The Regulatory Flexibility Act 

requires us to analyze regulatory options 

that would minimize any significant 

impact of a rule on small entities. 

Because the proposed rule, if finalized, 

would result in increased expenditures 

by Head Start programs that exceed 

HHS’s default threshold, we have 

initially determined that the proposed 

rule will have a significant economic 

impact on a substantial number of small 

entities. 

No unfunded mandates would be 

imposed by this proposed rule. The 

Unfunded Mandates Reform Act of 1995 

(section 202(a)) requires us to prepare a 

written statement, which includes 

estimates of anticipated impacts, before 

proposing ‘‘any rule that includes any 

Federal mandate that may result in the 

expenditure by State, local, and Tribal 

governments, in the aggregate, or by the 

private sector, of $100,000,000 or more 

(adjusted annually for inflation) in any 

one year.’’ The current threshold after 

adjustment for inflation is $177 million, 

using the most current (2022) Implicit 

Price Deflator for the Gross Domestic 

Product. This proposed rule would not 

likely result in unfunded expenditures 

that meet or exceed this amount. 

B. Summary of Benefits, Costs, and 

Transfers 

The most likely impacts of the 

proposed provisions depend, in large 

part, on funds available to Head Start 

programs; for example, the proposals to 

increase remuneration per teacher 

would have bigger aggregate effects to 

the extent that Head Start entities 

employ more teachers. Historically, 

Congress has funded Head Start at levels 

that exceed inflation. During the tenyear period between 2010 and 2020, 

Head Start appropriations grew by 25 

percent, after accounting for 

inflation.254 Some of the past increase in 

appropriations was in response to new 

initiatives in Head Start, such as the 

creation of Early Head Start-Child Care 

Partnerships and other quality 

initiatives. It is possible that this trend 

continues and Head Start appropriations 

will increase in response to the quality 

improvements under the proposed rule. 

In such a case, the regulation’s effects 


ddrumheller on DSK120RN23PROD with PROPOSALS2EP20NO23.000</GPH>

Information Collection Number of Average Annual 

respondents burden burden 

hours per hours 

response 

Updating written personnel policies and 3,000 1 3,000 

procedures to reflect staff wage scales and 

benefits and approach to staff breaks (program 

level) 

Documenting eligibility with application of 340,000 .167 56,780 

revised income definition (family level) 

Reporting child incidents within 3 business days 131 .083 11 

( enrollee level) 

Maintenance of lead testing results and 3,000 1 3,000 

notification to families of such results (program 

level) 

Documenting services to enrolled pregnant 13,000 .5 6,500 

women ( enrollee level) 

Tracking wages for Head Start staff and staff in 3,000 5 15,000 

local school districts 

TOTAL BURDEN HOURS 84,291 
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80873 

254 If future Head Start appropriations designated 

for expansion grow at similar rates —for reasons 

that are independent of this proposal—then 

estimates reflecting growth at or below the rate of 

inflation (such as what appears in this regulatory 

impact analysis) would have a tendency toward 

understating effects. 

255Some of the expenditures would, from a 

society-wide perspective, be categorized as costs 

and others would be transfers to Head Start entities 

and participants. 

257Even if this were the case, OHS asserts that 

this is unlikely to meaningfully impact the quality 

of services provided to children, as the necessary 

components of high-quality services are required 

under the Head Start Program Performance 

Standards, and could not be dropped from program 

offerings. 

258The additional benefits expenditures 

associated with increased wages under the wage 

policy at the baseline fringe rate of 24% are 

included in the estimated benefits expenditures. 

manifest themselves as expenditures by 

taxpayers.255 By contrast, if a 

comparison of the hypothetical futures 

with and without the rule is not 

characterized by a difference in Head 

Start appropriations or by such a 

difference that is not prompted by this 

proposal, then rule-induced spending 

would instead be shifted within Head 

Start. 

One form that such shifting could take 

relates to enrollment, so it is important 

to distinguish between the various 

benchmarks for enrollment that were 

used for this analysis. Head Start 

programs receive funding for a specific 

number of slots (funded enrollment). 

Historically there has been little 

difference between funded enrollment 

and actual enrollment,256 which 

represents the number of children who 

are actually enrolled in the Head Start 

programs. However, in recent years, 

Head Start programs have experienced 

significant and persistent underenrollment where the number of 

children actually served is far less than 

the number of funded slots, due in large 

part to widespread staffing shortages. As 

Head Start programs work to improve 

their actual enrollment levels, many are 

also requesting reductions in their 

funded enrollment. Head Start programs 

are trying to right-size their funded 

enrollment to match their community 

needs, staffing realities, and fiscal 

constraints. It is difficult, if not 

impossible, to predict the net impacts of 

these ongoing efforts in years to come. 

As such, assessing whether the rule’s 

effects would manifest themselves as 

enrollment reductions is especially 

challenging. In theory Head Start 

programs could attempt to stretch their 

existing budgets to provide the same 

number of funded enrollment slots 

while also complying with the new 

requirements by choosing to not spend 

funding on optional activities. However, 

OHS believes that programs have long 

stretched their funding as far as is 

possible and are unlikely to have many 

optional activities available to drop.257

Moreover, the difference between 

funded and actual enrollment also 

generates uncertainty regarding the 

magnitude of regulatory effects; for 

example, if Head Start entities use 

excess funding for teacher bonuses, the 

estimates, below, of rule-induced effects 

on teacher remuneration would have 

some tendency toward overstatement 

(even as the form of the remuneration is 

changing from bonuses to salaries, 

fringe benefits or changes in working 

conditions). 

OHS has taken the approach of 

estimating all effects based on the 

projected FY2023 funded enrollment of 

755,074, which is the highest 

enrollment level, funded or actual, 

possible absent additional 

appropriations specifically designated 

for expansion. 

Using the current funded enrollment 

as a starting point, this analysis shows 

that the costs associated with the 

NPRM, when fully phased in after 7 

years as currently proposed, can be 

mostly paid for by reducing enrollment 

levels to the FY2023 actual enrollment, 

leading to a funded enrollment level 

decline from 755,074 to 644,374. 

As compared to the current 

enrollment level of about 650,000, this 

represents about a 1 percent reduction 

from the current number of children 

served. In other words, implementation 

of these proposed regulatory changes 

would be a de minimis impact on actual 

enrollment. With additional 

appropriations—in excess of cost of 

living adjustments to keep pace with 

inflation—Head Start could avoid 

reducing funded enrollment below 

current actual enrollment. This analysis 

includes estimates of the necessary 

appropriations needed under the 

proposed policy to serve 650,000 

children, which reflects the estimated 

FY2023 actual enrollment. Sometimes 

the narrative description of this (same) 

analysis will be framed as estimating the 

increases in expenditures that would 

enable full implementation of this 

proposed rule without reducing funded 

enrollment below projected FY2023 

funded enrollment levels. 

The largest elements of the proposed 

rule relate to staff wages and benefits for 

the Head Start workforce. To fully 

implement the staff wage provisions, 

including the wage-parity targets, 

minimum pay requirement, and impacts 

associated with wage compression, 

expenditures on wages 258 would need 

to increase by about $1.0 billion 

(reported in nominal dollars) in 2030 

and then maintained annually through a 

cost-of-living adjustment. In that same 

year, the expenditures on staff benefits, 

which include the policy to increase 

fringe benefits, would require about an 

additional $932 million, with further 

increases in line with wage growth. 

Also, in 2030, we identify the annual 

expenditures to fully implement the 

following provisions: staff breaks about 

$118 million; family service worker 

family assignments, $210 million; and 

mental health supports, $152 million. 

We also quantify expenditures 

associated with preventing and 

addressing lead exposure and 

expenditures associated with program 

administration. 

In total, we estimate that full 

implementation would require an 

increase in expenditures of about $2.4 

billion in 2030 assuming no reductions 

in the current funded enrollment level 

of 755,074, with further increases that 

are consistent with impacts tied to wage 

growth. Over a 10-year time horizon, 

which covers for the timeline that the 

proposed policies would take effect, we 

estimate annualized expenditures of 

$1.6 billion under a 3% discount rate or 

$1.5 billion under a 7% discount rate. 

In addition to calculating the 

expenditures necessary to fully 

implement the proposed rule, this 

analysis also considers a scenario of no 

additional funding above baseline 

funding levels (i.e., funding increasing 

over time, to account for inflation but 

not in response to this regulatory 

proposal). Under this scenario, we 

estimate that Head Start programs 

would need to reduce the total number 

of funded slots available by about 15% 

compared to projected FY2023 funded 

enrollment, or 1% from estimated 

FY2023 actual enrollment in 2030, to 

fully implement the proposed rule. 

Table 1 reports the summary of 

expenditures of the proposed rule, 

reported in constant 2023 dollars and 

nominal dollars. 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80874 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

259Office of Management and Budget. ‘‘Analytical 

Perspectives, Budget of the U.S. Government, Fiscal 

Year 2024.’’ Table 2–1 Economic Assumptions. 

https://www.whitehouse.gov/wp-content/uploads/ 

2023/03/spec_fy2024.pdf. 

260H.R. 2617—Consolidated Appropriations Act, 

2023. https://www.acf.hhs.gov/sites/default/files/ 

documents/olab/fy-2024-congressionaljustification.pdf. 

261Budget data submitted to the Office of Head 

Start for FY2022, which is the most recent data 

available at the time this analysis was prepared, 

showed that about 74% of operations awards were 

allocated to personnel costs. In this analysis, we 

assume a majority share of the savings from the 

projected reduction in funded enrollment from 

FY2022 to FY2023 will go towards personnel costs, 

and will therefore increase the overall share of 

operations awards allocated to personnel costs to 

about 75%. 

We request comment on our estimates 

of benefits, costs, and transfers of this 

proposed rule. OHS specifically 

requests comment on how spending 

patterns when under enrolled may be 

different if funded enrollment were 

reduced and the possible impact on 

programs if spending were redirected 

towards the policies in this proposed 

rule. 

Preliminary Economic Analysis of 

Impacts 

A. Analytic Approach 

In conducting this analysis, we began 

by identifying the most consequential 

impacts that would likely occur under 

the proposed rule, if finalized. We 

identify expenditures associated with 

increases in staff wages and staff 

benefits for the Head Start workforce as 

the largest potential impact and devote 

significant attention to those effects. We 

also identify and monetize expenditures 

associated with staff breaks, 

expenditures associated with hiring 

additional family service workers, 

expenditures associated with the 

increased workload required to provide 

mental health supports, expenditures 

associated with preventing and 

addressing lead exposure, and 

expenditures associated with 

administrative implementation costs. 

We qualitatively discuss other impacts 

of the proposed rule. 

For the purposes of this analysis, we 

assume that the proposed rule, if it is 

finalized, will be published and begin to 

take effect before the 2024–2025 

program year. To simplify the narrative, 

we describe effects occurring in that 

program year as occurring in ‘2024.’ We 

adopt a time horizon of analysis of ten 

years, covering the period 2024 through 

2033. 

This analysis adopts a baseline 

forecast that assumes Federal 

appropriations grow at a constant rate of 

inflation in fiscal years 2026 through 

2033, with slower growth during fiscal 

years 2024 and 2025. 

All analyses provided here were 

completed using national level 

estimations. In our main analysis, we 

estimate the increases in Federal 

appropriations needed to fulfill the 

goals of the proposed rule while also 

maintaining the size of the Head Start 

workforce consistent with the projected 

FY2023 funded enrollment level of 

755,074 slots. We also present a 

sensitivity analysis that explores how 

the rule’s effects would manifest 

themselves if there are no increases in 

Federal appropriations above baseline 

(or such increases occur but not in 

response to this regulatory proposal 

and/or the increased appropriations 

could not be used to support the 

policies in the proposed rule). For this 

scenario, we report the likely reductions 

in funded enrollment, and associated 

reductions in the size of the Head Start 

workforce, under the proposed rule. We 

also report the likely reductions in 

funded enrollment compared to the 

estimated FY2023 actual enrollment 

under the proposed rule. 

In general, we have rounded total cost 

estimates but have not rounded 

itemized cost estimates for transparency 

and reproducibility of the estimation 

process. These unrounded itemized cost 

estimates should not be interpreted as 

representing a particular degree of 

precision. 

B. Baseline: Budget, Staffing, and Slots 

Baseline Budget Scenario 

We measure the impacts of the rule 

against a common budget baseline 

forecast that assumes Federal 

appropriations grow at a constant rate of 

inflation in fiscal years 2026 through 

2033, with slower growth during fiscal 

years 2024 and 2025. We adopt 2.3% for 

the rate of inflation for each year in the 

time horizon, matching an economic 

assumption in the President’s Budget for 

Fiscal Year 2024.259 Across all years, we 

assume that the cost-of-living 

adjustment (COLA) for Head Start staffthe portion of Head Start that goes 

towards operations awards, will match 

the 2.3% rate of inflation. 

In FY2023, Head Start appropriations 

totaled $11,996,820,000.260 About 97% 

of these appropriations, $11.6 billion, 

will go towards operations awards; and 

from these operations awards, about 

75% 261 will go towards personnel costs, 

or about $8.7 billion. Compared to 

FY2023, we assume that FY2024 


ddrumheller on DSK120RN23PROD with PROPOSALS2EP20NO23.001</GPH>

Table 1. Summary of Expenditures of the Proposed Rule, Millions of Dollars 

Units 

Category Primary Low High 

Estimate Estimate Estimate Year Discount Period 

Dollars Rate Covered 

Federal Sl,314 

2024-

2023 7% 

Annualized 2033 

Expenditures Monetized 2024-

(Sm/year) Sl,385 2023 3% 

2033 

Federal Sl,521 Nominal 

2024-

7% 

Annualized 2033 

Expenditures Monetized 2024-

(Sm/year) Sl,611 Nominal 3% 

2033 
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80875 

262For completeness, we also note that Head Start 

funding increases at greater than the rate of 

inflation (for reasons independent of this regulation 

being proposed) would lead to effects being 

underestimated in this analysis, if that funding is 

designated for expansion. For exploration not of 

overall magnitude of effects but instead related to 

the form they take, please see the sensitivity 

analysis below. 

263https://eclkc.ohs.acf.hhs.gov/data-ongoingmonitoring/article/program-information-report-pir. 

appropriations will increase to account 

for inflation for operations awards, but 

will not increase for other spending 

categories. Compared to FY2024, we 

assume that FY2025 appropriations will 

again increase to account for inflation 

for operations awards, with a 1% 

increase for other spending categories. 

Thus, we anticipate that total 

appropriations will increase by 2.22% 

in FY2024, 2.26% in FY2025, and 2.3% 

in all future years. Table B1 reports the 

appropriations and funding breakdowns 

in nominal dollars over the time horizon 

of our analysis. 

Baseline Scenario for Staffing, Wages, 

and Enrollment 

This analysis adopts one scenario 

covering projections of staffing, wages, 

and enrollment at Head Start programs. 

This baseline scenario assumes long-run 

staffing, wages, and enrollment that are 

consistent with those projected for FY 

2023, based on patterns observed in 

FY2022. 

This analysis assumes that all 

programs are fully enrolled, and that 

actual enrollment is consistent with 

funded enrollment. Therefore, the 

analysis does not distinguish between 

funded slots that are actually filled with 

enrolled families and funded slots that 

are vacant. These assumptions 

introduce uncertainty into the analysis, 

creating some tendency toward 

overestimation of effects (a tendency 

that would partially be mitigated by a 

number of decisions, for example if 

Head Start entities use excess funds, in 

the baseline, for teacher bonuses).262

We again note that this estimation 

does not account for the underenrollment that Head Start programs are 

currently facing. In 2023, Head Start 

programs are projected to be funded to 

serve 755,074 children; however, OHS 

estimates only about 650,000 children 

and families are actually being served. 

Many Head Start programs are 

requesting reductions to their funded 

enrollment, even while they continue to 

work to improve their enrollment. As 

this situation is unprecedented, it is 

nearly impossible to predict both 

funded and actual enrollment levels in 

future years. 

As such, OHS first estimates costs by 

using the FY2023 funded enrollment of 

755,074 which represents the funding 

needed to implement the proposed rule 

and maintain current funded 

enrollment, or the maximum 

appropriations needed to fully 

implement the proposed rule. Using the 

cost per slot determined by this 

estimate, we also describe the necessary 

appropriations needed to maintain 

funded slots to serve 650,000 children, 

which reflects the FY2023 actual 

enrollment. Relatedly, we also provide 

estimates of the reduction in the total 

number of funded slots in a scenario 

where no additional funding is provided 

(or funding increases occur but not in 

response to this proposal), compared to 

both projected FY2023 funded 

enrollment and to estimated FY2023 

actual enrollment. 

Our baseline scenario is informed by 

staffing levels, credentials, wage rates, 

and enrollment figures from Program 

Information Report (PIR) data covering 

2022,263 with a few adjustments. The 

PIR contains program-level counts of 

teachers, assistant teachers, home 

visitors, and family child care providers, 

each disaggregated by type of credential. 

For teachers and assistant teachers, we 

observe the following credential 

categories: advanced degree, 

baccalaureate degree (BA), associate 

degree (AA), Child Development 

Associate (CDA) credential, and no 

credential. For home visitors and family 

child care providers, we observe 

whether staff holds a credential, but not 

the type of credential. We make the 

following adjustments to the raw 2022 

PIR data: 

(1) We adjust the counts of each rolecredential combination to account for a 

small share of staff without any 

credential information, which is less 

than 0.3% of total staff. For simplicity, 

we assume that the credentials of staff 

without this information are distributed 

in proportion with the observed 

credentials of other staff in the same 

role. 

(2) We augment the 2022 PIR data 

with 2019 PIR data, which contained 

information on the specific credential 


ddrumheller on DSK120RN23PROD with PROPOSALS2EP20NO23.002</GPH>

Table Bl. Baseline Head Start Bud~et Scenario. Nominal Dollars (in thousands) 

Total Operations Operations 

Operations Awards: Awards: Other Other Head 

Year Total Fundin2 Awards Personnel Costs Costs Start Costs 

2022 $11,036,820 $10,647,160 $7,878,898 $2,768,262 $389,660 

2023 $11,996,820 $1 L599,855 $8,699,892 $2,899,964 $396,965 

2024 $12,263,617 $11,866,652 $8,899,989 $2,966,663 $396,965 

2025 $12,540,519 $12,139,585 $9,104,689 $3,034,896 $400,934 

2026 $12,828,951 $12,418,796 $9,314,097 $3,104,699 $410,156 

2027 $13,124,017 $12,704,428 $9,528,321 $3,176,107 $419,589 

2028 $13,425,870 $12,996,630 $9,747,472 $3,249,157 $429,240 

2029 $13,734,665 $13,295,552 $9,971,664 $3,323,888 $439,112 

2030 $14,050,562 $13,601,350 $10,201,012 $3,400,337 $449,212 

2031 $14,373,725 $13,914,181 $10,435,636 $3,478,545 $459,544 

2032 $14,704,320 $14,234,207 $10,675,655 $3,558,552 $470,113 

2033 $15,042,520 $14,561,594 $10,921,195 $3,640,398 $480,926 
80876 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

264https://eclkc.ohs.acf.hhs.gov/policy/im/acfim-hs-22-09. 

type for home visitors and family child 

care providers. We assume that, 

conditional on reporting any credential 

in 2022, the credentials of staff with 

each credential type are distributed in 

proportion with observed credentials of 

other credentialed staff in the same role 

in 2019. 

With these adjustments, we report 

36,517 Head Start teachers, 32,286 Early 

Head Start teachers, 38,316 Head Start 

assistant teachers, 6,676 home visitors, 

and 2,046 family child care providers. 

Table B2 reports these counts by 

credential type. 

In 2022, Head Start programs were 

funded to serve 833,075 slots and 

reported 115,841 education staff. At the 

time this analysis was prepared, ACF 

did not have comparable information 

from the PIR for 2023, which is ongoing; 

however, we anticipate significant 

changes to staffing levels, wage rates, 

and slots compared to those observed in 

2022 for reasons described above. We 

anticipate enrollment reductions, 

including through requests from 

programs proposing to reduce their 

funded enrollment to maintain quality 

of program services.264 We currently 

project 755,074 funded slots, or a 9% 

reduction in funded enrollment in 2023 

compared to 2022, and adopt a 

corresponding reduction in education 

staff by the same percentage. Compared 

to a scenario of no reduction in slots or 

education staff, we anticipate that this 

will lead to increases in total 

compensation for education staff. Again, 

this does not reflect the difference 

between funded enrollment and actual 

enrollment of families in the program. 

OHS anticipates that funded enrollment 

will continue to decline; however, for 

the reasons described above, we model 

projections based on funded enrollment 

in 2023 at 755,074 for the purposes of 

this analysis. 


ddrumheller on DSK120RN23PROD with PROPOSALS2EP20NO23.003</GPH> EP20NO23.004</GPH>

Table B2. Head Start Staff Counts by Role and Credential, 2022 

Family Child 

De2ree HS Teacher EHS Teacher Asst. Teacher Home Visitor Care Provider 

Advanced 4,528 754 371 429 38 

BA 21,080 6,405 3,712 2,964 217 

AA 8,774 7,271 8,178 1,444 241 

CDA 1,181 12,791 15,416 1,128 1,238 

No Credential 954 5,065 10,639 711 312 

Total 36,517 32,286 38,316 6,676 2,046 

Table B3. 2023 Enrollment Scenarios 

Year 2022 2023 

Scenario NIA Baseline 

Operations Award Amounts $10,647,159,826 $11,599,855,394 

Personnel Costs, Share 74% 75% 

Personnel Staff Costs, $ $7,878,898,271 $8,699,891,546 

Other Costs, Share 26% 25% 

Other Costs $2,768,261 555 $2,899,963,849 

Education Staff 115,841 104,995 

Education Staff Costs $4,994,940,873 $5,515,421,367 

Wage Compensation $3,796,155,063 $4,191,720,239 

Non-Wage Compensation $1,198,785,809 $1,323,701,128 

Cost per Education Staff $43,119 $52,530 

Total Slots 833,075 755,074 

Cost per Slot $12,781 $15,363 
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80877 

265This analysis uses BLS average annual salaries 

as wage targets. However, since the BLS national 

average for kindergarten teacher salaries ($65,120) 

includes all kindergarten teachers, of which 

approximately half have a master’s degree or higher, 

adjust this annual salary to reflect the target salary 

for a teacher with a bachelor’s degree ($58,608) 

guided by salary differences observed in National 

Center for Education Statistics data (https://

nces.ed.gov/surveys/ntps/). The BLS reported 

annual salary for preschool teacher in school 

settings ($53,200) is therefore approximately 90% of 

the annual salary for kindergarten teachers with a 

bachelor’s degree ($58,608). 

266U.S. Bureau of Labor Statistics. Occupational 

Employment and Wages. May 2022. 25–2011 

Preschool Teachers, Except Special Education. 

https://www.bls.gov/oes/current/oes252011.htm. 

267Multiplied by a ratio of May 2023 (304.127) to 

May 2022 (292.296) CPI. U.S. Bureau of Labor 

Statistics. CPI for all Urban Consumers (CPI–U), Not 

Seasonally Adjusted, https://data.bls.gov/ 

timeseries/CUUR0000SA0. Accessed June 19, 2023. 

Connecting Baseline Uncertainty With 

Differing Estimates of Regulatory Effects 

Head Start programs must be in a 

position to serve their full funded 

enrollment at all times, regardless of 

their actual enrollment levels. When 

programs are under-enrolled, they must 

continue their operations in a way that 

is sufficient to serve their funded 

enrollment. As Head Start funds are 

allocated to a variety of fixed cost 

categories (like facilities, personnel, 

supplies, and transportation), only some 

of these costs are saved when a funded 

slot is empty. If a slot is empty, a 

program must still pay for a facility with 

classrooms, along with utilities and 

maintenance. Programs must also 

attempt to hire (or, spend the associated 

funds recruiting) staff, and have 

transportation that can accommodate 

the slot. Where there is a difference 

between actual and funded enrollment, 

the majority of the difference in 

allocated funding is used in this 

manner, thus doing little to improve the 

Head Start experience for remaining 

students. 

Therefore, to the extent that underenrolled Head Start programs will, over 

the analytic time horizon of this 

regulatory impact assessment, be 

approved to reduce their funded 

enrollment without those slots being 

shifted to other Head Start entities, the 

estimates that use actual enrollment as 

a key input or comparison—for 

example, the rightmost columns of 

Tables J1 and K5—are informative and 

meaningful. By contrast, if reductions of 

funded enrollment at entities that are 

under-enrolled in the baseline were 

accompanied (also in the baseline) by 

shifting of those slots to other Head 

Start entities, the estimates that use 

funded enrollment as a key comparison 

are more informative. Similarly, if 

under-enrollment were to ease in the 

future (perhaps to due further 

stabilization in the labor market as the 

biggest disruptions of the COVID–19 

pandemic recede into the past), the 

latter set of estimates should receive the 

analytic focus. 

C. Workforce Supports: Staff Wages and 

Staff Benefits 

The proposed rule outlines four areas 

of proposed requirements for wages for 

Head Start staff: (1) that education staff 

working directly with children as part of 

their daily job responsibilities must 

receive a salary comparable to preschool 

teachers in public school settings in the 

program’s local school district, adjusted 

for qualifications, experience, and job 

responsibilities; (2) to establish or 

enhance a salary scale, wage ladder, or 

other pay structure that applies to all 

staff in the program and takes into 

account job responsibilities, hours 

worked, and qualifications and 

experience relevant to the position; (3) 

that all staff must receive a salary that 

is sufficient to cover basic costs of living 

in their geographic area, including those 

at the lowest end of the pay structure; 

and (4) to affirm and emphasize that the 

requirements for pay parity should also 

promote comparability of wages across 

Head Start Preschool and Early Head 

Start staff positions. 

The proposed rule also outlines 

requirements for grant recipients to 

provide benefits to staff, discussing 

health insurance, paid sick leave, paid 

vacation or personal leave, paid family 

leave, access to short-term free or lowcost mental health services, and other 

considerations. We also describe an 

alternative policy scenario in which 

retirement benefits are also included in 

the proposed benefit requirements, see 

Section K below. 

In this section, we describe baseline 

wages for Head Start education staff and 

their corresponding wage-parity targets. 

We also describe baseline staff benefits 

and the enhanced-benefit policy. 

Wage-Parity Targets 

The proposed rule would result in 

Head Start staff receiving an annual 

salary commensurate with preschool 

teachers in local public school settings, 

adjusted for qualifications, experience, 

and job responsibilities. The target 

comparison of preschool teachers in 

public school settings is intended to 

represent substantial progress towards 

parity with public school elementary 

teachers. Specifically, we intend the 

benchmark of preschool teacher annual 

salaries in public school settings to 

represent about 90% of kindergarten 

teacher annual salaries, for those with 

comparable qualifications.265 While 

wage rates would be determined locally, 

we present estimates of the likely 

impact measured at the national level. 

For the purposes of this analysis, we 

adopt an estimate of the target salary in 

2022 of $53,200, which corresponds to 

the mean annual wage for preschool 

teachers in elementary and school-based 

settings as reported by the Bureau of 

Labor Statistics for occupation code 25– 

2011, Preschool Teachers, Except 

Special Education for 2022.266 This 

estimate is intended to be consistent 

with the requirement that annual 

salaries be ‘‘comparable to preschool 

teachers in public school settings.’’ We 

assume that a typical Preschool teacher 

works 1,680 hours per year, so this 

annual salary corresponded to a $31.67 

hourly wage in 2022, or a $32.95 hourly 

wage in 2023 under an assumption that 

Preschool teacher salaries will grow 

approximately in relation to inflation.267

We adopt this estimate as the hourly 

wage target for teachers, home visitors, 

and family child care providers with a 

BA, which serves as the base wage rate 

for other credentials. For staff in these 

roles with an advanced degree (i.e., 

master’s degree or higher), we adopt an 

hourly wage target 10% above the base 

wage rate; for AA degrees, 20% below 

the base wage rate; for CDA, 30% below 

the base wage rate; and for no 

credential, 40% below the base wage 

rate. For assistant teachers, who often 

have fewer responsibilities than lead 

teachers, we adopt hourly wage targets 

that are about 17% less than other roles. 

For example, the wage rate target for 

assistant teachers with a BA is $27.35 

per hour. Table C1 reports the hourly 

wage targets for each staff role by 

credential under the proposed rule and 

the baseline scenario. 

We note that the assumption that a 

typical Preschool teacher works 1,680 

hours per year differs with the source of 

the annual wage data comparison. U.S. 

Bureau of Labor Statistics (BLS) 

assumes a ‘‘year-round, full-time hours 

figure of 2,080 hours’’ which is 

consistent with a 40-hour work week for 

all 52 weeks of the year. The proposed 

policy requires comparable annual 

salaries, however hourly estimates are 

provided and used here for the purposes 

of calculating the estimated impacts of 

the proposed policies. We have 

therefore chosen to calculate the hourly 

target wage using 1,680 hours, which is 

our estimate of the number of paid 

hours worked by preschool education 

staff. We request comment on the best 

approach to handle the discrepancy in 

assumptions about the number of hours 

worked. In particular, we request 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80878 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

comment on the best estimate for the 

annual hours worked by Head Start 

education staff, as well as by preschool 

teachers in public school settings. We 

further request comment on the degree 

to which paid hours worked aligns with 

actual hours worked, as education staff 

in both Head Start and preschools in 

public school settings may perform 

additional work tasks outside official 

work hours. 

To estimate the likely impact of the 

wage-parity policy on expenditures, we 

calculate the expenditures under the 

baseline scenario, then calculate the 

expenditures needed to fund the wage 

increases. Table C2 reports these 

impacts under the baseline scenario. 

Note that these are reported in constant 

2023 dollars. 

Disaggregation of Wage-Parity Policy 

Implementation Costs 

While estimates in this analysis are 

performed at the national level, the cost 

of implementing the wage policies will 

likely not be borne equally by each 

program. Programmatic data suggests 

Head Start programs vary in their 

current compensation practices and 

therefore will likely have varying costs 

associated with implementing the wage 

parity policy. Head Start data shows 

that wages and enrollment are not 

distributed evenly across various 

program types. Furthermore, some 

programs across the country are 

experiencing a workforce shortage and 

are in varying stages of implementing 

changes to address issues related to lack 

of qualified and available staff to fill 

classrooms and associated underenrollment. 

Data from 2019 PIR shows that 

programs located in school systems pay 

classroom teachers at the highest rate, 

on average. Grant recipients in school 

districts also have more programs that 

are fully enrolled compared to other 

agencies. Meanwhile, grant recipients 

that are Community Action Agencies 

are, on average, the lowest paying 

agency type and pay more than $10,000 

less annually to classroom teachers, on 

average, compared to school systems. 

Finally, ACF published sub-regulatory 

guidance to encourage Head Start 

programs to increase staff and teacher 

wages. Some Head Start programs have 

responded to this guidance by 

requesting to reduce their funded 

enrollment in order to increase staff 

wages, but those programs are in 

varying stages of implementing these 

changes. 

Given this information, we expect that 

the cost of implementing these proposed 

policies will vary depending on a 

variety of factors, such as agency type. 

For instance, programs in school 

systems that already compensate at a 

higher level, will likely incur lower 

costs when implementing the wage 

policies in this proposal compared to 

programs in Community Action 

Agencies that, on average, tend to 

provide lower compensation. The costs 

of implementing these proposed 

policies will likely further vary based on 

the local wage targets used for each 

program, the distribution of 

qualifications for existing staff, and the 

degree to which each program has 

already made efforts to improve 

compensation. 


ddrumheller on DSK120RN23PROD with PROPOSALS2EP20NO23.005</GPH> EP20NO23.006</GPH>

Table Cl. Hourly Wage Targets by Credential Under Wage-Parity Targets (Constant 2023 

dollars) 

Family Child 

De~ree HS Teacher EHS Teacher Asst. Teacher Home Visitor Care Provider 

Advanced $36.24 $36.24 $30.08 $36.24 $36.24 

BA $32.95 $32.95 $27.35 $32.95 $32.95 

AA $26.36 $26.36 $21.88 $26.36 $26.36 

CDA $23.06 $23.06 $19.14 $23.06 $23.06 

No Credential $19.77 $19.77 $16.41 $19.77 $19.77 

Weighted Average $31.11 $25.56 $19.87 $28.66 $24.24 

Table C2. Expenditure on Wages to Fund Wage Parity, Constant 2023 Dollars 

Family 

HS EHS Asst. Home Child Care 

Teacher Teacher Teacher Visitor Provider 

Baseline Wage ($) $28.35 $19.02 $18.53 $22.56 $23.96 

Hours Per Staff 1,680 2,080 1,680 2,080 2,080 

Staff Count 33,098 29,263 34,728 6,051 1,854 

Baseline Expenditure ($M) $1,576 $1,158 $1,081 $284 $92 

Parity Wage Target $31.11 $25.56 $19.87 $28.66 $24.24 

Parity Expenditure $1,730 $1,556 $1,159 $361 $94 

Expenditure Increase $153 $398 $78 $77 $1 
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80879 

268 In the absence of data from Head Start 

programs that reports the wages paid to the lowest 

paid staff, this estimate assumes that all of the 

35,000 staff earned minimum wage in their State in 

2022, which is consistent with an average hourly 

wage of $10.68. The estimate of average minimum 

wage was calculated using the minimum wage for 

each State (https://www.dol.gov/agencies/whd/mwconsolidated) and the number of Head Start staff in 

each State according to administrative data from the 

Office of Head Start in 2022. For those staff where 

minimum wage data were not available due to lack 

of data for the U.S. Territory or data entry error, the 

Federal minimum wage of $7.25 was used. In the 

baseline analysis, we assume that all staff receive 

a pay increase, to $13.00 per hour, due to the 

projected reductions in funded enrollment from 

FY2022 to FY2023, and the associated reduction in 

staff and increased share of personnel funds. These 

staff would therefore need an additional $2.00 per 

hour to meet the $15 per hour minimum pay policy 

goal. 

269The additional annual expenditures on fringe 

associated with the wage policies (i.e., the fringe 

associated with the increased wages in the wage 

policies at the baseline fringe rate of 24%), are 

included in the estimates reported in Table C6 in 

the benefits section. 

The national estimates provided in 

this analysis cannot necessarily be 

applied at the individual program level. 

For instance, the hourly wage targets 

described in the previous section (Table 

C2) represent national averages and 

targets for individual programs will vary 

based on salaries for preschool teachers 

in their community. Program-level wage 

targets will vary based on factors such 

as local compensation rates and cost of 

living. Depending on the existing 

compensation structure in each 

program, some programs will have to 

increase their hourly wages 

substantially, and others may only need 

to make small increases. Program-level 

costs for implementing this policy are 

expected to be impacted by a variety of 

factors such as local pay compensation 

rates, education/credential levels of 

program staff, and the degree to which 

programs have already attempted to 

increase wages. 

HHS acknowledges that a limitation 

of using national level estimates is that 

these program-level nuances are not 

specifically illustrated in the analysis. 

However, using national averages to 

estimate costs at the national level 

accounts, in some ways but not others, 

for program-level variation. 

Impact of the Minimum Pay 

Requirement 

The proposed rule would require that 

all staff receive, at minimum, a salary 

that is sufficient to cover basic costs of 

living in their geographic area, 

including those at the lowest end of the 

pay structure. We anticipate that Head 

Start programs in low-income areas 

would spend additional resources to 

fulfill the basic cost-of-living 

requirement. We assume that the 

incremental impact of this provision is 

approximately $116 million per year, 

which accounts for $88 million through 

hourly wage increases, and $28 million 

in corresponding increases in non-wage 

benefits. This estimate is consistent 

with about 15% of all Head Start staff, 

about 35,000 staff members in the 

baseline, each working an average of 30 

hours per week for 42 weeks, receiving 

an additional $2.00 268 per hour in 

wages to meet the goal of establishing a 

minimum hourly wage of $15.00, or a 

total average increase in hourly 

compensation of $2.63. 

Impact on Expenditures Through Wage 

Compression 

In addition to the direct impacts on 

teachers, assistant teachers, home 

visitors, and family child care providers, 

we anticipate that the proposed rule 

would result in increased compensation 

for family service workers as well as 

other non-education staff positions to 

address wage compression and wage 

equity issues that would arise. For 

example, proposed wage increases to 

lead teachers may far exceed what a 

similarly credentialed family service 

worker makes in a program and those 

programs would need to plan for 

compensation increases for such staff to 

avoid a significant wage gap between 

those positions. As another example, 

with rising wages for education staff, 

other staff in supervisory or midmanagement roles would likely receive 

wage increases as well (e.g., coaches, 

education managers, etc.). To account 

for this impact, we assume that the total 

impacts on expenditures associated 

with wages would be 10% higher than 

the sum of the impacts associated with 

wage targets and the minimum pay 

requirement. We seek comment on 

whether 10% is an appropriate 

adjustment to estimate expenses that 

programs will incur to avoid wage 

compression. 

Overall Impacts of Wage Parity on 

Expenditures, Holding Benefits 

Constant 

Next, we report the total 

expenditures, including the impacts of 

the wage targets, minimum pay 

requirement, and impacts associated 

with wage compression. Table C3 

reports the net impacts on expenditures, 

holding benefits constant. The ‘‘wage 

targets’’ row is equal to the totals of the 

‘‘expenditure increase’’ rows contained 

in Tables C1 and C2. When pay parity 

is fully implemented, the wages policies 

would result in about $875 million in 

additional annual expenditures on 

wages.269 Note that these estimates are 

reported in constant 2023 dollars. 

The estimates in Table C3 reflect the 

expenditures needed to fully implement 

pay parity, which would occur in 2030 

under the NPRM, if finalized. Table C4 

reports the expenditures by year under 

the implementation schedule, reported 

in constant 2023 dollars and also 

nominal dollars. 


ddrumheller on DSK120RN23PROD with PROPOSALS2EP20NO23.007</GPH>

Table C3. Total Expenditures on Wages to Fund Wage Policies (Millions of Constant 2023 

Dollars) 

Scenario Baseline 

Wage Targets $707 

Minimum Pay $88 

Subtotal $795 

Wage Compression $80 

Total $875 
80880 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

270Under the Required Retirement Scenario and 

absent all other provisions in the NPRM, adopting 

the benefits policy at baseline wages would increase 

fringe benefits in constant 2023 dollars from $2.1 

billion to about $3.2 billion, and total compensation 

from about $8.7 billion to $9.8 billion, for an 

increase of about $1.1 billion. 

Expenditures Associated With Fringe 

Benefits 

As discussed above, based on an 

analysis of current Head Start programs, 

about 24% of total personnel costs go 

towards fringe benefits, rather than 

wage compensation. Table B1 reports 

personnel costs of about $8.7 billion in 

2023. Of this figure, 76% goes to wage 

compensation, or about $6.6 billion, and 

24% goes to fringe benefits, or about 

$2.1 billion. We assume that this ratio 

will remain constant over time, absent 

the staff benefits provisions of the 

proposed rule. 

The proposed rule outlines 

requirements for grant recipients to 

provide benefits to staff, discussing 

health insurance, paid sick leave, 

vacation or personal leave, paid family 

leave, short term mental health services, 

and other considerations. In our 

alternative policy scenario, discussed 

further in Section K, grant recipients 

would also be required to provide 

retirement benefits to staff. For the 

purposes of this analysis, we assume 

that these enhancements would increase 

the share of total personnel costs that go 

towards fringe benefits from 24% to 

27.8%, or to 32.5% in the alternative 

policy scenario, holding wages 

compensation constant. Absent all other 

provisions in the NPRM, adopting the 

benefits policy at baseline wages would 

increase fringe benefits in constant 2023 

dollars from $2.1 billion to about $2.5 

billion, and total compensation from 

about $8.7 billion to $9.2 billion, for an 

increase of about $458 million.270 In 

nominal dollars, these impacts would 

increase with the Head Start COLA, or 

2.3% per year. 

Table C5 reports the impacts of the 

benefit policy over time, accounting for 

the yearly impact of the wage policies 

reported in Table C4, reported in 

constant and nominal dollars. These 

tables report the changes to benefits, 

some of which are driven by wage 

increases of the wage policies. 


ddrumheller on DSK120RN23PROD with PROPOSALS2EP20NO23.008</GPH> EP20NO23.009</GPH>

Table C4. Total Additional Expenditures on Wages by Year to Fund Wage Policies, 

Millions of Dollars 

Year Policy Phase-In Constant 2023 Dollars Nominal Dollars 

2023 0% $0 $0 

2024 5% $44 $45 

2025 10% $87 $92 

2026 25% $219 $234 

2027 40% $350 $383 

2028 60% $525 $588 

2029 80% $700 $802 

2030 100% $875 $1,026 

2031 100% $875 $1,049 

2032 100% $875 $1,073 

2033 100% $875 $1,098 

Table C5. Total Additional Expenditures by Year on Benefits, Millions of Dollars 

Year Policy Phase-In Constant 2023 Dollars Nominal Dollars 

2023 24.0% $0 $0 

2024 24.0% $14 $14 

2025 24.0% $28 $29 

2026 27.8% $542 $580 

2027 27.8% $593 $649 

2028 27.8% $660 $739 

2029 27.8% $727 $834 

2030 27.8% $795 $932 

2031 27.8% $795 $953 

2032 27.8% $795 $975 

2033 27.8% $795 $998 
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80881 

271This occupational group was chosen because 

the total fringe rate aligns with internal estimates 

of the total fringe rate that would be associated with 

the proposed benefit policies. The occupational 

group includes postsecondary teachers; primary, 

secondary, and special education teachers; and 

other teachers and instructors. 

272https://www.bls.gov/news.release/archives/ 

ecec_03172023.pdf. 

273Estimates based on average fringe for each 

category of benefits calculated from a sample of 

Head Start program budgets. 

Disaggregation of Fringe Benefit 

Estimates 

To estimate the cost associated with 

each category of benefits in the 

proposed rule, we refer to the 

distribution of benefits provided to 

teachers,271 who have an overall fringe 

rate of 32.5% according to data on 

employer costs for employee 

compensation released by BLS in 

December 2022.272 There are more 

categories of benefits provided to 

teachers described by the BLS than will 

be required under the proposed rule, 

specifically retirement benefits are 

provided to teachers in the BLS data. In 

order to estimate the expenditures on 

the major benefits categories that will be 

required under the proposed rule, we 

first estimate the cost of Head Start 

teachers receiving the same fringe rate 

and major benefits categories (32.5%: 

health insurance, retirement, and paid 

leave). We then calculate the associated 

reduction in fringe associated with 

removing the retirement benefit in order 

to estimate the cost of the benefits 

policy under the proposed rule. 

We tentatively apply the same 

distribution of fringe associated with 

each fringe category to the estimated 

expenditure on benefits for Head Start 

using the same overall fringe rate of 

32.5%, which represents an increase of 

8.5% from the current fringe rate. We 

then calculate the increased expenditure 

needed for each of the major benefits 

categories: health insurance, retirement, 

and paid leave, compared to existing 

expenditures in each category for Head 

Start programs.273 This approach 

estimates that of the total projected cost 

associated with increasing the fringe 

rate from 24.0% to 32.5%, 16.6% will 

be accounted for by increased spending 

on health insurance. Increased spending 

on retirement will account for 54.7% of 

the total projected cost, and increased 

spending on paid leave will account for 

28.7% of the total projected cost. Thus, 

of the total increase of 8.5% in fringe, 

we anticipate about 1.4% of this 

increase will go towards health 

insurance, 4.7% of this increase will go 

towards retirement benefits, and 2.4% 

will go towards paid leave. 

As retirement benefits are only 

proposed to be required under the 

alternative policy scenario, we reduce 

the estimated increase on fringe by the 

increase associated with retirement 

benefits, 4.7%, for a target fringe rate of 

27.8% under the benefits policy in the 

proposed rule. Under the proposed rule, 

increased spending on health insurance 

will account for 37% of the total cost of 

the benefits policy, and increased 

spending on paid leave will account for 

the remaining 63% of the total cost of 

the benefits policy. 

Table C6 reports an expenditure 

breakdown for each major category of 

benefits that would be impacted by the 

proposed rule. 

We identify several significant caveats 

to this analysis. First, because many 

existing Head Start grant recipients 

provide health insurance, the growth in 

costs for expanded health insurance 

may be smaller than projected. We do 

expect that there will be improvements 

in the quality of health plans and what 

employees are covered, and increases in 

the provision of life and disability 

insurance, which may increase overall 

insurance costs for some grant 

recipients, but it is likely not to increase 

linearly with wage increases. Further, 

some grant recipients may choose to 

encourage staff to enroll in plans 

available in the Marketplace because the 

quality and expenses of health 

insurance in the Marketplace may be 

better than what they can obtain as an 

employer, and therefore the proportion 

of fringe spent on insurance for those 

grant recipients would decrease. 

Second, legally required fringe 

components such as Social Security 

taxes and retirement and savings fringe 

are not necessarily comparable between 

the reference group of teachers included 

in the BLS data and Head Start staff. 

Many elementary teachers are State 


ddrumheller on DSK120RN23PROD with PROPOSALS2EP20NO23.010</GPH>

Table C6. Additional Expenditure Breakdown by Benefit Policy, Millions of Nominal Dollars 

Benefits Benefits Policy: Fringe 

Total Benefits Benefits Policy: Paid Health Associated with 

Year Expenditures 1, 2 Policy Total Leave Insurance Wa~e Policy3 

2024 $14 $0 $0 $0 $14 

2025 $29 $0 $0 $0 $29 

2026 $580 $506 $319 $187 $74 

2027 $649 $528 $333 $195 $121 

2028 $739 $554 $349 $205 $186 

2029 $834 $580 $366 $215 $253 

2030 $932 $608 $383 $225 $324 

2031 $953 $622 $392 $230 $331 

2032 $975 $636 $401 $235 $339 

2033 $998 $651 $410 $241 $347 1 Only benefits expenditures associated with baseline staff are shown here. Benefits expenditures associated with hiring additional staff under other 

policies in the proposed rule (e.g., additional Family Service Workers hired under the Family Service Worker Family Assignments policy) are 

included in the estimates for each specific policy. 2 These estimates are calculated using the wages estimated under the proposed wage policy. 3 This cost represents the additional benefits expenditures associated with increased wages under the wage oolicv at the baseline fringe rate of 24%. 
80882 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

274 13% * 15 + 87% * 30 = 28.05. 

275 2,805 * 180 = 5,049. 

276 5,049 * 104,995/60 = 8,835,310. 

277Under the Required Retirement Scenario, the 

Breaks policy would cost $64 million in Constant 

2023 dollars. 

employees and not all State employees 

are covered by Social Security because 

they are covered by State pension plans; 

as a result, legally required fringe may 

be lower and retirement fringe higher 

for teachers relative to a comparable 

benefits package for Head Start staff. 

Discussion of Uncertainty 

We have attempted to provide our 

best estimates of the potential effects of 

the staff wages and staff benefit 

provisions. We acknowledge several 

significant and unresolved sources of 

uncertainty. First, we note that these 

estimates use a single baseline, which is 

a limitation of this analysis. We have 

provided estimates using a single 

baseline that assumes a stable funded 

enrollment level consistent with 

projected FY2023 funded enrollment of 

755,074. If funded enrollment were to 

increase, which would require 

Congressional investment designated for 

expansion (and such increase occurs for 

reasons separate from this regulatory 

proposal), the impacts of this proposed 

rule would be underestimated. If funded 

enrollment were to decrease, 

particularly if it were to decrease below 

the level of our current actual 

enrollment of 650,000, then the impacts 

of this proposed rule would be 

overestimated. Furthermore, if other 

baseline assumptions were to vary, such 

as the child-to-staff ratio or the share of 

appropriations allocated to personnel 

costs, that would also impact the 

estimated effects. However, absent 

guiding data for the timing and 

magnitude of these possible variations, 

OHS presents estimates using the single, 

data-informed baseline. 

Second, we followed a partial 

equilibrium modeling approach, 

focusing the primary scope of our 

analysis on the impacts to Head Start. 

General equilibrium modeling could 

potentially explore the impacts of the 

proposed rule on wages beyond Head 

Start staff. These effects could be 

informative for the estimates on 

expenditures, since wage increases 

experienced by Head Start staff could 

result in wage increases to other 

occupations that draw from a similar 

supply of workers, such as Kindergarten 

teachers. It is possible to anticipate a 

gradual feedback effect between Head 

Start staff and occupations that provide 

reference wages under the wage-parity 

policy. If this is the case, this would 

tend to indicate that our expenditure 

estimates are underestimated. 

Third, the analysis assumes that 

average compensation for Head Start 

staff (in the baseline scenario) and 

preschool teachers in public school 

settings (in the baseline scenario and 

under the NPRM) increases with 

inflation, or equivalently, that their 

average compensation remains constant 

in real terms, over the time horizon of 

this analysis. If compensation for 

preschool teachers in public school 

settings grows more slowly over time 

than compensation for Head Start staff, 

this would tend to indicate that our 

expenditure estimates are 

overestimated. Alternatively, if 

compensation for preschool teachers in 

public school settings grows faster than 

compensation for Head Start staff, this 

would tend to indicate that our 

expenditure estimates are 

underestimated. 

In regard to the inherent uncertainty 

over the availability of funding to fully 

implement this proposed rule, if 

finalized, Section J presents a sensitivity 

analysis on that significant source of 

uncertainty. 

D. Workforce Supports: Staff Wellness— 

Staff Breaks 

The proposed rule outlines 

requirements for programs to provide 

break times during work shifts. 

Specifically, for each staff member 

working a shift lasting between four and 

six hours, programs would be required 

to provide a minimum of one 15-minute 

break per shift; and for each staff 

member working a shift lasting six 

hours or more, programs would be 

required to provide a minimum of one 

30-minute break per shift. 

The scope of this element of the 

proposed rule covers approximately 

104,995 education staff, the estimate of 

education staff that is proportionally 

decreased to reflect the reduced 

enrollment in 2023 compared to 2022. 

We assume that 13% of education staff 

typically work shifts lasting between 

four and six hours, and that 87% of 

education staff typically work shifts 

lasting 6 hours or more. Thus, across all 

staff, the proposed rule would require 

an average break time of about 28 

minutes per shift.274 We assume 180 

average shifts per year for each 

education staff, for a total of 5,049 

minutes of break time per year per 

staff.275 For 104,995 total education 

staff, the proposed rule would require a 

minimum of about 8.8 million hours of 

break time per year.276 We do not have 

detailed information from Head Start 

programs on their current policies for 

staff breaks. For the purposes of this 

analysis, we adopt the following 

assumptions: 

(1) Under the baseline scenario of no 

regulatory action, 20% of Head Start 

programs offer break time for education 

staff. 

(2) Under the proposed rule, 50% of 

Head Start programs would shift the 

workloads of existing Head Start staff to 

provide coverage during the additional 

breaks. 

(3) Under the proposed rule, Head 

Start programs who do not already 

provide breaks and cannot shift 

workloads of existing staff would 

provide coverage during the additional 

breaks by hiring ‘floaters.’ 

(4) On average, Head Start programs 

would pay the ‘floaters’ hourly wages in 

line with assistant teachers with no 

credential. 

In line with assumptions 1 and 2, we 

adjust the 8.8 million hours estimate 

downwards by 70% and estimate that 

the proposed rule would result in about 

2.7 million hours of additional breaks 

for educational staff. Using the wage 

target for assistant teachers of $16.41 per 

hour under the wage-parity target, this 

policy would result in additional 

expenditures of about $57 million per 

year, or $60 million when also 

accounting for the benefits policy.277

This policy would take effect in 2027, 

and the total expenditures would 

increase in line with the wages under 

the wage-parity policy. Table D1 reports 

the expenditures needed to fund this 

policy, in constant and nominal dollars. 

Table D2 reports the additional value-oftime costs by year for those programs 

who provide breaks by shifting existing 

workloads, in constant and nominal 

dollars. Both Table D1 and Table D2 

reflect the policy cost using the benefits 

fringe rate in the proposed benefits 

policy. 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80883 

278For the purposes of this estimation we assume 

that all of the programs that exceed the threshold 

have an average caseload of 60. 

279Under the Required Retirement Scenario total 

compensation for each additional family service 

worker would be $59,259 in constant 2023 dollars. 

E. Family Service Worker Family 

Assignments 

The proposed rule would ensure the 

planned number of families assigned to 

work with individual family services 

staff is no greater than 40, unless a 

program can demonstrate higher family 

assignments provide high quality family 

and community engagement services 

and maintain reasonable staff workload. 

2019 PIR data reveals that 

approximately 50 percent of programs 

have staff family assignments that are 40 

families or less. Across all programs 

with ratios of families per family 

services staff that exceed 40, we 

estimate that Head Start programs 

would need to hire an additional 3,231 

family service workers to meet this 

requirement at the funded enrollment 

level projected for FY2023, compared to 

the baseline scenario. This estimate 

includes an assumption that 10% of 

programs will exceed a caseload of 

40,278 as is allowable under the 

proposed policy. 

We adopt an estimate of $40,000 in 

wage compensation per year per family 

service worker, which results in a 

$52,631 total compensation in the 

baseline scenario or $55,401 total 

compensation under the benefit 

policy.279 For 3,231 workers, this would 

result in additional expenditures across 

Head Start programs of $179,002,770. 

This policy would begin to take effect in 

2027. Table E1 reports the expenditures 

needed to fund this policy, in constant 

and nominal dollars. 


ddrumheller on DSK120RN23PROD with PROPOSALS2EP20NO23.011</GPH> EP20NO23.012</GPH>

Table Dl. Expenditures by Year to Fund Staff Breaks Policy, Millions of Dollars 

Year Constant 2023 Dollars Nominal Dollars 

2023 $0 $0 

2024 $0 $0 

2025 $0 $0 

2026 $0 $0 

2027 $60 $66 

2028 $60 $67 

2029 $60 $69 

2030 $60 $71 

2031 $60 $72 

2032 $60 $74 

2033 $60 $76 

Table D2. Additional Value-of-Time Costs by Year for Staff Breaks Policy, Millions of 

Dollars 

Year Constant 2023 Dollars Nominal Dollars 

2023 $0 $0 

2024 $0 $0 

2025 $0 $0 

2026 $0 $0 

2027 $100 $110 

2028 $100 $112 

2029 $100 $115 

2030 $100 $118 

2031 $100 $120 

2032 $100 $123 

2033 $100 $126 
80884 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

280Under the Required Retirement Scenario, the 

fringe associated with each additional FTE is 

estimated to be $28,889 for a total compensation of 

$88,889. The total policy cost for the mental health 

policy under the Robust Benefit Scenario is $139 

million. 

F. Mental Health Services 

The proposed rule would enhance 

requirements for mental health supports 

to integrate mental health more fully 

into every aspect of program services as 

well as elevate the role of mental health 

consultation to support the wellbeing of 

children, families, and staff. We 

anticipate that this element of the 

proposed rule would result in 

additional work for a variety of program 

staff, which we estimate will add up to 

together to be roughly equivalent to one 

full-time employee (FTE) per Head Start 

agency. We estimate 1,564 agencies 

needing the additional FTE to comply 

with the proposed policy. 

We adopt an estimate of $60,000 in 

wage compensation per year per FTE 

which represents an average of the 

various salaries of the staff members 

who we assume will complete the 

additional work. In addition to wage 

compensation, we assume that fringe 

benefits will be associated with the 

additional FTE, or about $18,947 under 

the baseline assumptions for benefits, or 

$23,102 under the benefit policy. In 

total, under the proposed rule, we 

estimate that each additional FTE would 

require $78,947 in total compensation in 

years prior to the effective date of the 

benefits policy, and $83,102 in total 

compensation in all future years. For 

1,564 FTEs, this would result in 

additional expenditures across Head 

Start programs of $129,972,299.280 We 

assume that these impacts would begin 

immediately. Table F1 reports the 

expenditures needed to fund this policy, 

in constant and nominal dollars. 


ddrumheller on DSK120RN23PROD with PROPOSALS2EP20NO23.013</GPH> EP20NO23.014</GPH>

Table El. Expenditures by Year to Fund Family Service Worker Policy, Millions of Dollars 

Year Constant 2023 Dollars Nominal Dollars 

2023 $0 $0 

2024 $0 $0 

2025 $0 $0 

2026 $0 $0 

2027 $179 $196 

2028 $179 $201 

2029 $179 $205 

2030 $179 $210 

2031 $179 $215 

2032 $179 $220 

2033 $179 $225 

Table Fl. Expenditures by Year to Fund Mental Health Services Policy, Millions of Dollars 

Year Constant 2023 Dollars Nominal Dollars 

2023 $0 $0 

2024 $123 $126 

2025 $123 $129 

2026 $130 $139 

2027 $130 $142 

2028 $130 $146 

2029 $130 $149 

2030 $130 $152 

2031 $130 $156 

2032 $130 $159 

2033 $130 $163 
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80885 

281https://www.hud.gov/sites/dfiles/HH/ 

documents/AHHS_II_Lead_Findings_Report_Final_

29oct21.pdf. 

282We note that the First National Environmental 

Health Survey of Child Care Centers published by 

HUD in 2003, found that child care centers were 

significantly less likely to have lead-based hazards 

than residences. As such, cost of the proposed rule 

may be overestimated. 

G. Preventing and Addressing Lead 

Exposure 

The proposed rule includes new 

requirements on preventing and 

addressing lead exposure through water 

and lead-based paint in Head Start 

facilities. This analysis presents 

estimates of the costs associated with 

testing and remediating water fixtures, 

and costs associated with evaluating 

and reducing the hazards from lead 

paint in classrooms and common areas 

at Head Start facilities. 

Lead in Water 

To assess the likely magnitude of the 

costs associated with the lead in water 

requirement, we first adopt estimates of 

19,400 service locations, with an 

average of 7.5 water fixtures per service 

location, for 145,500 total fixtures. We 

assume that half of these fixtures would 

be tested annually, and half of these 

fixtures would be tested once every 5 

years. Thus, in a given year, about 60% 

of the total fixtures, or 87,300 fixtures, 

would be tested per year. We adopt an 

estimate of $100 per fixture tested, for 

an annual cost associated with testing of 

$8,730,000. In addition to these testing 

costs, we assume that 25% of fixtures, 

or 35,375 fixtures, will require ongoing 

remediation using point-of-use devices. 

We identify filter replacements as 

largest cost associated with remediation, 

and adopt an estimate of $30 per filter, 

with filters replaced quarterly, or a cost 

per fixture of $120 per year. Across 

35,375 fixtures requiring ongoing 

remediation, we calculate an annual 

cost of $4,365,000 for remediation. In 

total, we estimate $13,095,000 per year 

in annual costs associated with testing 

and remediating water fixtures. Some of 

this cost can be covered by Federal 

funding under the Bipartisan 

Infrastructure Law (as enacted by the 

Infrastructure Investment and Jobs Act); 

many states are already using this 

funding. 

Lead-Based Paint 

To assess the likely magnitude of the 

costs associated with the lead-based 

paint requirement, we first adopt 

estimates of 25,409 total rooms across 

Head Start facilities, consisting of 

19,500 classrooms and 5,909 common 

areas. We assume that about 46% Head 

Start facilities were constructed prior to 

1978 and would require a lead-hazard 

evaluation under the proposed rule. 

Thus, about 11,688 rooms would require 

evaluation. We adopt an estimate of 

$700 per room for the evaluations, 

which would consist of a lead-based 

paint inspection and risk assessment. 

Across all rooms requiring evaluation, 

we estimate an initial total cost 

associated with evaluations of about 

$8.2 million. 

Of rooms undergoing an evaluation, 

we assume that 43.8% of rooms would 

be identified as potentially having a 

lead-based paint hazard requiring 

abatement.281 282 Thus, after the first 

round of assessments covering 11,688 

rooms, we estimate that 5,125 rooms 

would require abatement. We assume 

that half of the rooms requiring 

abatement would require interior paint 

repair, with a per-room cost of $710; 

that half of the rooms would require 

friction/impact work, with a per-room 

cost of $280; and assume that that all 

rooms undergoing abatement would 

incur costs associated with unit cleanup 

of $430 per room and costs associated 

with clearance of $170 per room. In 

total, we estimate an average cost of 

abatement of $1,095 per room. Across 

all 5,125 rooms requiring abatement 

following the first round of assessments, 

this would be about $5.6 million. 

The proposed rule outlines a process 

for subsequent assessments for rooms 

requiring abatement. These 

reassessments occur at least once every 

2 years unless two reassessments 

conducted two years apart identify no 

lead-based paint hazards. To model 

assessments in future years, we assume 

that 21.9% of all rooms that are 

reassessed will require abatement, 

which is half the rate of abatement 

compared to initial assessments. Thus, 

for the 5,125 rooms that required 

abatement, we estimate that 1,124 

would require additional abatement. 

The other 4,001 rooms would still 

require a second reassessment. Table G1 

reports the number of assessments and 

abatements by year, the costs of those 

assessments and abatements, and the 

yearly costs of the lead-based paint 

policy. 

BILLING CODE 4184–40–P 


ddrumheller on DSK120RN23PROD with PROPOSALS2EP20NO23.015</GPH>

Table G 1. Cost of Lead-Based Paint Policv 

Cost of 

Final Cost of Cost of Lead-Based 

Year Reassessments Assessments Abatements Evaluations Abatements Paint Policy 

2024 0 11,688 5,125 $8,181,727 $5,611,883 $13,793,611 

2025 0 0 0 $0 $0 $0 

2026 5,125 0 1,124 $3,587,505 $1,230,343 $4,817,848 

2027 0 0 0 $0 $0 $0 

2028 1,124 4,001 1,124 $3,587,505 $1,230,343 $4,817,848 

2029 0 0 0 $0 $0 $0 

2030 1,124 877 439 $1,400,605 $480,341 $1,880,946 

2031 0 0 0 $0 $0 $0 

2032 439 877 289 $921,152 $315,911 $1,237,063 

2033 0 0 0 $0 $0 $0 
80886 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

283 $36,000 = 600 hours * $60/hour. 

284 $108,000,000 = $36,000/program * 3,000 

programs. Head Start funding is only used for a 

portion of the salaries of these management 

positions. 

Table G2 reports the yearly costs 

associated with the lead in water policy, 

the lead-based paint policy, and the 

total cost associated with the two lead 

policies in constant and nominal 

dollars. 

BILLING CODE 4184–40–C 

H. Administrative Costs 

Several of the provisions of the NPRM 

would likely entail additional 

administrative costs beyond those that 

we have otherwise quantified in this 

analysis. For example, we anticipate 

that programs would expend resources 

to develop program-specific policies 

while preparing to implement the 

workforce wage and benefits provisions. 

To account for these impacts, we adopt 

an assumption that each Head Start 

program would spend a total of 600 

hours per program, spread across 

directors, education managers, disability 

managers, health managers, and other 

management staff to develop programspecific policies. To value the time 

spent on these activities, we adopt a 

fully loaded hourly wage of $60 per 

hour, reflecting a mix of wages across 

several roles. We assume that this 

impact would primarily occur in the 

first year of the time horizon of our 

analysis, before most of the impacts 

associated with wage and benefits 

policies take effect, and thus we do not 

adjust these upwards to account for 

other provisions of the proposed rule. 

For each program, we value this impact 

at $36,000.283 Across 3,000 programs, 

we estimate the total impact as $108 

million, all occurring in 2024.284 We 

request comment on whether 600 hours 

is a reasonable assumption for each 

program to review, understand, and 

plan for implementation for these 

proposed changes to the standards. 

I. Timing of Impacts 

The proposed rule includes an 

implementation timeline for several of 

the provisions, described above. Table 

I1 summarizes the impacts on 

expenditures assuming a funded 

enrollment level consistent with the 

projected FY2023 funded enrollment, 

consistent with this implementation 

timeline, reporting yearly estimates, and 

present value and annualized values 

corresponding to 3% and 7% discount 

rates, with all monetary estimates 

reported in millions of constant 2023 

dollars. Table I2 reports the same 

impacts except in nominal dollars. 

BILLING CODE 4184–40–P 


ddrumheller on DSK120RN23PROD with PROPOSALS2EP20NO23.016</GPH>

Table G2. Total Cost of Lead Policies 1 in Millions) 

Cost of Lead Cost of Leadin Water Based Paint Total Cost, Total Cost, 

Year Policy Policy Constant$ Nominal$ 

2024 $13.1 $13.8 $26.9 $27.5 

2025 $13.1 $0.0 $13.1 $13.7 

2026 $13.1 $4.8 $17.9 $19.2 

2027 $13.1 $0.0 $13.1 $14.3 

2028 $13.1 $4.8 $17.9 $20.1 

2029 $13.1 $0.0 $13.1 $15.0 

2030 $13.1 $1.9 $15.0 $17.6 

2031 $13.1 $0.0 $13.1 $15.7 

2032 $13.1 $1.2 $14.3 $17.6 

2033 $13.1 $0.0 $13.1 $16.4 
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80887 

285For this analysis, we assume that staffing 

reductions occur at the same rate as slot reductions. 

286We note that reductions in funded enrollment 

in response to the proposed rule will require some 

shifting of transfer of funds from existing 

expenditures, such as those to support funded slots 

that are currently empty or spending to recruit and 

train staff in a high turnover environment. Please 

see our request for comment on this point in 

Section B and the discussion under the heading 

‘‘Connecting Baseline Uncertainty with Differing 

Estimates of Regulatory Effects.’’ 

BILLING CODE 4184–40–C 

All estimates reported above are 

impacts compared to our baseline 

budget scenario described reported in 

Table B1. Further, we calculate the cost 

per child, in 2030, when the rule is fully 

implemented, using 2023 funded 

enrollment levels to be $21,797 

(nominal dollars). As discussed 

previously, we recognize that projected 

FY2023 funded enrollment greatly 

exceeds estimated FY2023 actual 

enrollment. If programs were to fully 

implement the proposed policies and 

maintain funded enrollment at least 

consistent with FY2023 actual 

enrollment (i.e., 650,000), they would 

not need additional appropriations 

beyond the baseline budget scenario 

until 2030, when they would need an 

additional $118 million. In 2031, 

programs would again need an 

additional $118 million, $122 million in 

2032, and additional $124 million in 

2033 above the baseline budget scenario 

funding levels to fully implement the 

proposed policies and maintain a 

funded enrollment level consistent with 

estimated FY2023 actual enrollment. 

J. Sensitivity Analysis—Potential 

Enrollment Reductions 

In the previous analysis, we framed 

results as the Federal appropriations 

increase needed to fully fund these 

requirements and maintain current 

funded enrollment of 755,074. 

However, in the interest of 

transparency, we perform a sensitivity 

analysis to evaluate the impacts of the 

proposed rule under a scenario of no 

additional funding above the baseline 

budget scenario in Table B1 (or 

increased appropriations that cannot be 

used to support this regulatory proposal 

and/or are not increased in response to 

it). Under this scenario, Head Start 

programs would likely comply with the 

proposed rule by reducing the size of 

their funded enrollment, which would 

also result in a reduced workforce at 

Head Start programs. 

To calculate the number of slots at 

Head Start programs under this last 

scenario, we multiply the total number 

of slots under the full-funding scenario 

by the share of funding available 

compared to full funding. For example, 

we estimate that $15.2 billion would be 

necessary to fully implement the 

proposed rule in 2033 and maintain 

funded enrollment consistent with the 

estimated FY2023 actual enrollment of 

650,000. Under our baseline budget 

scenario, $15.0 billion would be 

available, which is about 99% of the 

funding needed. Thus, we estimate 

644,374 slots would be available, which 

is 99% of enrollment at the estimated 

FY2023 actual enrollment level, or a % 

change in slots of ¥1%. 

Table J1 reports the change in total 

slots 285 over time that would be 

necessary to implement the proposed 

rule compared to both projected FY2023 

funded enrollment and estimated 

FY2023 actual enrollment, absent an 

increase in Federal appropriations. We 

estimate that programs can approach 

full implementation of the policies in 

the proposed rule without additional 

appropriations by aligning their funded 

enrollment levels with their actual 

enrollment. Only a small reduction in 

slots from estimated FY2023 actual 

enrollment, 1%, would be needed to 

reach full implementation of the 

policies in the proposed rule. 

Specifically, programs would need to 

reduce funded enrollment from the 

projected FY2023 funded enrollment of 

755,074 by 15%, to a funded enrollment 

of 644,605 in 2030, which reflects a 1% 

reduction from estimated FY2023 actual 

enrollment of 650,000.286 All monetary 

estimates are reported in nominal 

dollars. 


ddrumheller on DSK120RN23PROD with PROPOSALS2EP20NO23.017</GPH>

Table 11. Expenditures of the Proposed Rule, Baseline Scenario (Millions of Constant 2023 

Dollars) 

Family Service Mental 

Year Wa2e Benefit Breaks Workers Health Lead Other 

2024 $44 $14 $0 $0 $123 $27 $108 

2025 $87 $28 $0 $0 $123 $13 $0 

2026 $219 $542 $0 $0 $130 $18 $0 

2027 $350 $593 $60 $179 $130 $13 $0 

2028 $525 $660 $60 $179 $130 $18 $0 

2029 $700 $727 $60 $179 $130 $13 $0 

2030 $875 $795 $60 $179 $130 $15 $0 

2031 $875 $795 $60 $179 $130 $13 $0 

2032 $875 $795 $60 $179 $130 $14 $0 

2033 $875 $795 $60 $179 $130 $13 $0 

PV,3% $4,398 $4,714 $343 $1,021 $1,096 $136 $105 

PV,7% $3,377 $3,680 $265 $787 $901 $114 $101 

Annualized, 3% $516 $553 $40 $120 $129 $16 $12 

Annualized, 7% $481 $524 $38 $112 $128 $16 $14 

Total 

$316 

$252 

$909 

$1,325 

$1,572 

$1,809 

$2,054 

$2,052 

$2,053 

$2,052 

$11,813 

$9,226 

$1,385 

$1,314 
80888 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

K. Alternative Policy Scenario: Required 

Retirement 

The proposed rule outlines 

requirements for grant recipients to 

provide benefits to staff, discussing 

health insurance, paid leave, access to 

short-term free or low-cost mental 

health services, and other 

considerations. The proposed rule 

requests comment on whether grant 

recipients should also be required to 

provide retirement savings plans as part 

of their benefits. 

In this section, we describe the 

alternative policy scenario, the Required 

Retirement Scenario, in which the 

proposed benefits policy includes a 

requirement that grant recipients also 

provide retirement benefits to staff. We 

analyze this scenario to identify the 

most consequential impacts that would 

likely occur under the Required 

Retirement Scenario, should it be 

included in a finalized rule. 

We base this analysis on the same 

methodology described in Section C: 

Disaggregation of Fringe Benefit 

Estimates. Based on the data on 

employer costs for employee 

compensation released by the U.S. 

Bureau of Labor Statistics in December 

2022, teachers have an overall fringe 

rate of 32.5%, which is inclusive of 

health insurance, paid leave, retirement, 

and other benefits. As such, we assume 

an overall fringe rate of 32.5% under the 

Required Retirement Scenario, which is 

inclusive of fringe associated with all 

three major benefits policies included in 

the policy: health insurance, paid leave, 

and retirement. The disaggregation of 

these costs is described in Section C: 

Disaggregation of Fringe Benefit 

Estimates. 

Table K1 reports the impacts of the 

robust benefit policy over time, 

accounting for the yearly impact of the 

wage policies reported in Table C5, 

reported in constant and nominal 

dollars. These tables report the changes 

to benefits, some of which are driven by 

wage increases of the wage policies. 

Table K2 reports a breakdown of 

increased expenditure for each major 

category of benefits that would be 

impacted by the proposed rule under 

the Required Retirement Scenario. 

BILLING CODE 4184–40–P 


ddrumheller on DSK120RN23PROD with PROPOSALS2EP20NO23.019</GPH> EP20NO23.020</GPH>

Table Jl. Slot Loss under Baseline Head Start Budget Scenario (Millions of Nominal 

Dollars) 

Funding under Slots Funded by % Change in Slots % Decline in Slots 

Baseline Budget Baseline Budget from 2023 Funded from 2023 Actual 

Year Scenario under Proposed Rule Enrollment Enrollment* 

2024 $12,264 735,687 -3% -- 2025 $12,541 739,542 -2% -- 2026 $12,829 701,854 -7% -- 2027 $13,124 679,906 -10% -- 2028 $13,426 667,511 -12% -- 2029 $13,735 656,017 -13% -- 2030 $14,051 644,605 -15% -1% 

2031 $14,374 644,692 -15% -1% 

2032 $14,704 644,635 -15% -1% 

2033 $15 043 644,692 -15% -1% 

* We note that reductions in funded enrollment in response to the proposed rule will require some degree of shifting of funds from existing 

expenditures, such as those to support funded slots that are currently empty or spending to recruit and train staff in a high turnover environment. 

Please see our request for comment on this point in Section Band the discussion under the heading "Connecting Baseline Uncertainty with 

Differing Estimates of Regulatory Effects." 

Table Kl. Total Additional Expenditures on Benefits by Year, Millions of Constant 

and Nominal Dollars 

Year Policy Phase-In Constant 2023 Dollars Nominal Dollars 

2023 24.0% $0 $0 

2024 24.0% $14 $14 

2025 24.0% $28 $29 

2026 32.5% $1,201 $1,286 

2027 32.5% $1,264 $1,384 

2028 32.5% $1,348 $1,511 

2029 32.5% $1,432 $1,642 

2030 32.5% $1,517 $1,778 

2031 32.5% $1,517 $1,819 

2032 32.5% $1,517 $1,861 

2033 32.5% $1,517 $1,904 
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80889 

The inclusion of retirement benefits 

under the Required Retirement Scenario 

impacts the cost estimates for other 

policies that required increased 

expenditures on compensation, such as 

the family service worker and mental 

health policies. Table K3 summarizes 

the impacts on expenditures for the 

Required Retirement Scenario, 

consistent with the implementation 

timelines described in the proposed 

rule, reporting yearly estimates and 

present value and annualized values 

corresponding to 3% and 7% discount 

rates, all with monetary estimates 

reported in millions of constant 2023 

dollars. Table K4 reports the same 

impacts for the Required Retirement 

Scenario in nominal dollars. 


ddrumheller on DSK120RN23PROD with PROPOSALS2EP20NO23.021</GPH>

Table K2. Additional Expenditure Breakdown by Benefit Policy, Millions of Nominal 

Dollars 

Benefits Benefits Fringe 

Benefits Policy: Policy: Benefits Associated 

Total Benefits Policy Paid Health Policy: with Wage 

Year Expenditures 1,2 Total Leave Insurance Retirement Policy3 

2024 $14 $0 $0 $0 $0 $14 

2025 $29 $0 $0 $0 $0 $29 

2026 $1,286 $1,212 $348 $201 $663 $74 

2027 $1,384 $1,263 $363 $210 $692 $121 

2028 $1,511 $1,325 $380 $220 $725 $186 

2029 $1,642 $1,389 $399 $231 $760 $253 

2030 $1,778 $1,455 $417 $241 $796 $324 

2031 $1,819 $1,488 $427 $247 $815 $331 

2032 $1,861 $1,522 $437 $253 $833 $339 

2033 $1,904 $1,557 $447 $258 $853 $347 

Note that the estimates for paid leave and health insurance shown here differ slightly from those in Table C7 due to the influence of rounding 

during the estimation process. 1 Only benefits expenditures associated with baseline staff are shown here. Benefits expenditures associated with hiring additional staff under 

other policies in the proposed rule (e.g., additional Family Service Workers hired under the Family Service Worker Family Assignments 

policy) are included in the estimates for each specific policy. 2 These estimates are calculated using the wages estimated under the proposed wage policy. 

3 This cost represents the additional benefits expenditures associated with increased wages under the wage policy at the baseline fringe rate of 

24%. 
80890 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

BILLING CODE 4184–40–C 

All estimates reported above are 

impacts compared to our baseline 

budget scenario reported in Table B1. 

Further, we calculate the cost per child, 

in 2030, when the rule is fully 

implemented, using 2023 funded 

enrollment levels to be $22,958 

(nominal dollars). As discussed 

previously we recognize that projected 

FY2023 funded enrollment greatly 

exceeds estimated FY2023 actual 

enrollment. If programs were to fully 

implement the proposed policies and 

maintain funded enrollment at least 

consistent with FY2023 actual 

enrollment (i.e., 650,000), they would 

not need additional appropriations 

beyond the baseline budget scenario 

until 2027, when they would need an 

additional $80 million. In future years 

(all in nominal dollars), programs would 

need $336 million in 2028, $595 million 

in 2029, $872 million in 2030, $890 

million in 2031, $912 million in 2032, 


ddrumheller on DSK120RN23PROD with PROPOSALS2EP20NO23.022</GPH> EP20NO23.023</GPH>

Table K3. Expenditures of the Proposed Rule, Required Retirement Scenario (Millions of 

Constant 2023 Dollars) 

Family Service Mental 

Year Wa~e Benefit Breaks Workers Health Lead Other 

2024 $44 $14 $0 $0 $123 $27 $108 

2025 $87 $28 $0 $0 $123 $13 $0 

2026 $219 $1,201 $0 $0 $139 $18 $0 

2027 $350 $1,264 $64 $191 $139 $13 $0 

2028 $525 $1,348 $64 $191 $139 $18 $0 

2029 $700 $1,432 $64 $191 $139 $13 $0 

2030 $875 $1,517 $64 $191 $139 $15 $0 

2031 $875 $1,517 $64 $191 $139 $13 $0 

2032 $875 $1,517 $64 $191 $139 $14 $0 

2033 $875 $1,517 $64 $191 $139 $13 $0 

PV,3% $4,398 $9,346 $367 $1,092 $1,156 $136 $105 

PV,7% $3,377 $7,321 $283 $842 $948 $114 $101 

Annualized, 3% $516 $1,096 $43 $128 $136 $16 $12 

Annualized, 7% $481 $1 042 $40 $120 $135 $16 $14 

Table K4. Expenditures of the Proposed Rule, Required Retirement Scenario (Millions of 

Nominal Dollars) 

Family Service Mental 

Year Wa~e Benefit Breaks Workers Health Lead Other 

2024 $45 $14 $0 $0 $126 $28 $110 

2025 $92 $29 $0 $0 $129 $14 $0 

2026 $234 $1,286 $0 $0 $149 $19 $0 

2027 $383 $1,384 $71 $210 $152 $14 $0 

2028 $588 $1,511 $72 $215 $156 $20 $0 

2029 $802 $1,642 $74 $219 $159 $15 $0 

2030 $1,026 $1,778 $76 $225 $163 $18 $0 

2031 $1,049 $1,819 $77 $230 $167 $16 $0 

2032 $1,073 $1,861 $79 $235 $171 $18 $0 

2033 $1,098 $1,904 $81 $240 $175 $16 $0 

PV,3% $5,165 $10,851 $430 $1,278 $1,309 $152 $107 

PV,7% $3,950 $8 462 $331 $983 $1 066 $127 $103 

Annualized, 3% $606 $1,272 $50 $150 $153 $18 $13 

Annualized, 7% $562 $1,205 $47 $140 $152 $18 $15 

Total 

$316 

$252 

$1,576 

$2,022 

$2,286 

$2,540 

$2,801 

$2,799 

$2,801 

$2,799 

$16,599 

$12,987 

$1,946 

$1,849 

Total 

$323 

$263 

$1,688 

$2,214 

$2,561 

$2,912 

$3,285 

$3,358 

$3,437 

$3,514 

$19,292 

$15,021 

$2,262 

$2,139 
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80891 

287Finkelstein, Y., Markowitz, M. E., & Rosen, J. 

F. (1998). Low-level lead-induced neurotoxicity in 

children: an update on central nervous system 

effects. Brain research reviews, 27, 168–176. 

and $932 million in 2033 above the 

baseline budget funding scenario to 

implement the proposed policies and 

maintain a funded enrollment level 

consistent with estimated FY2023 actual 

enrollment. 

We also replicate the sensitivity 

analysis described in Section J. In this 

analysis, we assume an alternative 

funding scenario in which no additional 

funding above the baseline budget 

scenario in Table B1 is available to 

enact the proposed rule under the 

Required Retirement Scenario (or 

increases in appropriations over time 

that cannot be used to support the 

proposed rule, if finalized, and/or are 

not increased in response to it). In this 

scenario, Head Start programs would 

likely comply with the proposed rule by 

reducing the size of their funded 

enrollment, which would also result in 

a reduced workforce at Head Start 

programs. We apply the same 

methodology used in Section J to this 

analysis. Table K5 reports the change in 

total slots that would be necessary to 

implement the proposed rule under the 

Required Retirement Scenario, absent a 

responsive increase in Federal 

appropriations. 

L. Non-Quantified Impacts of Certain 

Elements of the Proposed Rule 

In addition to the effects that are 

quantified elsewhere in this analysis, 

we have identified a select number of 

provisions that would have impacts that 

are not quantified or monetized. 

Estimated Impact of Relevant Provisions 

on Slot Loss 

Sections C through G of this RIA 

monetize the provisions of this 

proposed rule that we anticipate would 

have the largest potential impact. Some 

of the provisions described in this 

section may also result in costs that 

have not been monetized. As quantified 

above, one potential impact of enacting 

the proposed standards at current 

funding levels is a reduction in Head 

Start slots in some programs. A 

reduction in Head Start slots would 

reduce access to high-quality early 

childhood education for some children 

ages birth to 5 from low-income 

families. However, this impact is 

difficult to qualify because a substantial 

number of current Head Start slots 

remain unfilled currently, due to 

staffing shortage and other constraining 

factors. A loss of funded slots that are 

unfilled would not impact children who 

are currently enrolled. 

The children who would be impacted 

by this loss of access would not receive 

high-quality services from Head Start 

and would not experience the positive 

outcomes for children and families who 

participate in the Head Start program. 

Some children who lose access to Head 

Start may receive early childhood 

education through State or local 

preschool programs, which are offered 

in many areas of the country. Another 

potential impact is that some children 

who would otherwise have been served 

by Head Start may receive early care 

and education in programs or settings 

that lack the quality to adequately 

support their learning and development, 

though we note that, as described in the 

NPRM preamble, absent the quality 

improvements under the proposed rule, 

Head Start quality is likely to deteriorate 

over time. Loss of access to Head Start 

may also reduce opportunity for parents 

and caregivers to participate in the 

workforce. 

Expected Impact of Preventing and 

Addressing Lead Exposure (§ 1302.48) 

This NPRM has new requirements for 

programs to test the lead levels in their 

facilities and if applicable, remediate 

exposure risks. Below we summarize 

findings from a few select research 

studies. Decades of research have shown 

that high lead levels are harmful for 

children’s development.287 Research 

also shows, however, that lead 

remediation has long-term benefits to 

children’s health and economic benefits 

to society as they mature into 

adolescence and beyond. For instance, a 


ddrumheller on DSK120RN23PROD with PROPOSALS2EP20NO23.024</GPH>

Table KS. Slot Loss under Baseline Head Start Budget and Required Retirement 

Scenarios (Millions of Nominal Dollars) 

Slots Funded by 

Baseline Budget % Change in % Difference in 

Funding under under Required Slots from 2023 Slots from 2023 

Baseline Budget Retirement Funded Actual 

Year Scenario Scenario Enrollment Enrollment* 

2024 $12,264 735,687 -3% 13% 

2025 $12,541 739,542 -2% 14% 

2026 $12,829 667,288 -12% 3% 

2027 $13,124 646,063 -14% -1% 

2028 $13,426 634,110 -16% -2% 

2029 $13,735 623,005 -17% -4% 

2030 $14,051 612,004 -19% -6% 

2031 $14,374 612,082 -19% -6% 

2032 $14,704 612,031 -19% -6% 

2033 $15,043 612,082 -19% -6% . . .. * We note that reductions m funded enrollment m response to the proposed rule will reqwre some degree of shifting of funds from existing 

expenditures, such as those to support funded slots that are currently empty or spending to recruit and train staff in a high turnover environment. 

Please see our request for comment on this point in Section Band the discussion under the heading "Connecting Baseline Uncertainty with 

Differing Estimates of Regulatory Effects." 
80892 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

288 Grosse, S. D., Matte, T. D., Schwartz, J., & 

Jackson, R. J. (2002). Economic gains resulting from 

the reduction in children’s exposure to lead in the 

United States. Environmental health perspectives, 

110(6), 563–569. https://doi.org/10.1289/ 

ehp.02110563. 289Levin, R., & Schwartz, J. (2023). A better 

cost:benefit analysis yields better and fairer results: 

EPA’s lead and copper rule revision. Environmental 

Research, 229, 115738. https://doi.org/10.1016/ 

j.envres.2023.115738. 

290 Gould, E. (2009). Childhood Lead Poisoning: 

Conservative Estimates of the Social and Economic 

Benefits of Lead Hazard Control. Environmental 

Health Perspectives, 117(7). https://doi.org/ 

10.1289/ehp.0800408. 

291Caven, M., Khanani, N., Zhang, X., & Parker, 

C.E. (2021). Center-and program-level factors 

associated with turnover in the early childhood 

education workforce (REL 2021–069). U.S. 

Department of Education, Institute of Education 

Sciences, National Center for Education Evaluation 

and Regional Assistance, Regional Educational 

Laboratory Northeast & Islands.; Whitebook, M., 

Howes, C., & Phillips, D. (2014). Worthy Work, 

STILL Unlivable Wages: The Early Childhood 

Workforce 25 Years after the National Child Care 

Staffing Study. Center for the Study of Child Care 

Employment. https://cscce.berkeley.edu/wpcontent/uploads/publications/ReportFINAL.pdf. 

292 Isaccs, J., Adelstein, S., Kuehn, D. (2018). 

Early Childhood Educator Compensation in the 

Washington Region. Urban Institute. https://

www.urban.org/sites/default/files/publication/ 

97676/early_childhood_educator_compensation_

final_2.pdf. 

2002 CDC study found that reduced lead 

exposure in the United States since 

1976 has resulted in a $110 billion to 

$319 billion economic benefit due to 

higher IQs and worker productivity.288

Research has also found that the lead 

and copper rule investment from the 

EPA has led to an estimated benefit ratio 

of 35:1 meaning that that for every $1 

invested, the economic return would be 

about $35.289 Furthermore, a research 

study that conducted a cost-benefit 

analysis on every dollar invested in lead 

paint control has been estimated to be 

a $17 to $221 return.290 This research 

suggests there may be a societal benefit 

that lead remediation regulations can 

make. While we cannot estimate the 

quantitative cost savings that this 

provision will have, we note that testing 

on its own does not make anyone 

healthier; the cause-and-effect chain 

between testing and health outcomes 

includes activities that have costs. We 

welcome public comment on these costs 

and on this analysis more generally, 

including interpretation of and 

extrapolation from the studies 

referenced above. 

Additional Impact of Workforce 

Supports: Staff Wages and Benefits 

(§ 1302.90) 

In addition to the effects (costs) 

quantified in this RIA, these provisions 

may also result in potential cost savings 

to governments at various jurisdictional 

levels (which are mostly transfers, when 

categorized from a society-wide 

perspective) due to benefit reductions 

for ECE workers. Specifically, an 

increase in wages and benefits for ECE 

workers may result in a reduction in the 

number of households receiving a range 

of safety net benefits, including 

LIHEAP, housing assistance, Medicaid/ 

CHIP, SNAP, SSI, TANF, and WIC. 

Additionally, increases in staff wages 

will likely have an outsized impact on 

improving educational quality of Head 

Start programming. When teachers are 

fairly compensated their stress likely 

decreases, and dedication and 

commitment to their work likely 

improves. This will improve the quality 

of services delivered in programs. While 

descriptive and non-causal, research 

illustrates that low wages are a primary 

driver of high turnover in early 

childhood educator positions.291

Research has also demonstrated that 

improved wages are correlated with 

higher quality programs.292 These 

research findings are not causal, and, to 

the best of our knowledge, no costbenefit analysis has been conducted 

related to the impact of increased wages 

in the early childhood sector. Therefore, 

our conclusions here are tentative. 

By improving wages, teachers may 

choose to stay in the profession longer 

and may spend more time building the 

skills necessary to support high-quality 

early childhood programming and highquality teacher-child interactions. 

Furthermore, improvements in staff 

retention overall due to improved wages 

and benefits likely promotes more stable 

staffing across the program and provides 

continuity of services for enrolled 

children and may also reduce stress and 

workload for other staff in the program 

due to fewer staff vacancies. 

It is also likely that there will be 

potential cost savings from the effects of 

this proposed rule mitigating the high 

expenses associated with high turnover. 

When Head Start programs experience 

staffing shortages, they will often ask 

existing staff to work additional hours to 

compensate for the lack of adequate 

coverage. In some cases, substitute or 

temporary staff will be hired and 

sometimes this comes at an increased 

cost. Presumably, after the 

implementation of this proposed policy, 

these excess costs (experienced as 

remunerations increases for the 

aggregate collection of Head Start 

teachers) will be reduced because the 

workforce will be more stable and 

programs will experience improved 

retention. 

Estimated Impact of Mental Health 

Services (§ 1302 Subpart D; Subpart H; 

Subpart I) 

In addition to the effects (costs) 

quantified in Section E of this RIA, there 

are numerous additional benefits to 

enhancing provisions related to mental 

health supports. Advancing science in 

child development demonstrates that 

birth to age five is an important period 

for brain development and is a critical 

foundation on which all later 

development builds. Mental health and 

social-emotional well-being during this 

period are foundational for family wellbeing, children’s healthy development, 

and early learning and are associated 

with positive long-term outcomes. Early 

childhood experiences, like trusting 

relationships with caregivers in a stable, 

nurturing environment, aid in the 

development of skills that build 

resilience. The enhancements to the 

requirements for mental health supports 

would promote higher-quality services 

for children in Head Start programs 

across the country and would support 

child, family, and staff well-being. 

Specifically, enhancements to § 1302 

Subpart D enhances health program 

services to explicitly include mental 

health. These regulatory changes also 

reflect a preventative approach to 

mental health across comprehensive 

service areas, such as health and family 

engagement. The addition of mental 

health screening would support 

programs in having conversations about 

mental health early and often. Screening 

would facilitate the identification of 

children, families, and staff with 

specific needs and allow for 

intervention before more time and 

resource intensive care becomes 

necessary. Mental health screening may 

result in nominal costs to programs that 

elect to purchase specific screening 

tools. § 1302.45(a) also adds a 

requirement that a program have a 

multidisciplinary team responsible for 

mental health. We believe this team 

would be comprised of existing staff 

positions so would have an associated 

opportunity cost not reflected in 

budgets. 

Estimated Impact of Modernizing 

Engagement With Families (§ 1302.11; 

§ 1302.13; § 1302.15; § 1302.34; 

§ 1302.50) 

These provisions enhance existing 

requirements that programs must follow 

when completing their community 

needs assessments. Programs would be 

required to identify communication 

methods to best engage with prospective 

and enrolled families, and to use 

modern technologies to streamline 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80893 

information gathering and improve 

communications. There is significant 

benefit to families in giving them a 

voice in the way that programs choose 

to communicate. Using communication 

modalities and methods that are easiest 

to families would enhance engagement 

with Head Start and increase program 

accessibility. Programs would also be 

required to implement improvements to 

streamline the enrollment experience 

for families. There may be nominal costs 

for programs to make these 

determinations and implement new 

technologies. Streamlining the 

enrollment experience for families 

would create more user-friendly and 

efficient processes, reduce burden and 

build trust with families, and support 

Head Start in more equitably and 

effectively delivering services. 

Estimated Impact of Community 

Assessments (§ 1302.11) 

The changes to these provisions 

address concerns that Head Start 

programs and others in the field have 

raised about the burdens of the 

community needs assessment. These 

provisions would promote clarity on the 

intent of the community assessment, 

align with best practices, and increase 

the effectiveness in how the community 

assessment is used to inform key aspects 

of program design and approach. 

Requiring a strategic approach to 

determine what data to collect prior to 

conducting the community needs 

assessment and how to use the needs 

assessment to achieve intended 

outcomes would promote overall 

effectiveness of the community 

assessment to drive programmatic 

decision making. They may also 

facilitate reductions in cost of timeconsuming or complex assessment and 

analytical techniques and reduce 

barriers to programs being able to use 

their community assessment data to 

effectively guide programmatic 

decisions. Programs would also be 

allowed to use publicly or local 

available data as a proxy, which would 

reduce duplication of efforts and further 

lessen burden, and may facilitate 

coordination with other community 

programs. 

Other new requirements related to the 

collection of specific elements in the 

community needs assessment, such as 

geographic location, race, ethnicity, and 

languages, would facilitate Head Start’s 

ability to understand the diversity of 

populations most in need of services, 

which in turn would help promote 

equity, inclusion, and accessibility in 

service delivery. Factors related to 

transportation needs and resources in 

communities reflects that transportation 

remains a significant barrier for many of 

the hardest to serve families and 

impedes Head Start’s mission. Ensuring 

transportation needs and resources are 

part of the data that informs a program’s 

design and service delivery would 

enable Head Start to more effectively 

meet the needs of families and improve 

access to Head Start services. 

Estimated Impact of Adjustment for 

Excessive Shelter Costs for Eligibility 

Determination (§ 1302.12) 

This provision would allow a program 

to adjust a family’s income to account 

for excessive shelter costs. This 

provision reflects a transfer of benefits 

from one potentially eligible family to 

another, however consistent with 

Section 1302.14 and 1302.13 in the 

HSPPS which is unchanged in this 

current proposal, programs will 

continue to establish selection criteria 

that prioritizes selection of participants 

based on need. There may be nominal 

implementation costs as Head Start 

programs implement these new income 

calculations. Children whose families 

have few resources because they earn 

near-poverty level wages and live in 

areas with a high-cost of living would 

newly be eligible for Head Start. This 

would enable Head Start to continue to 

prioritize the enrollment of families 

most in need of services. This provision 

also increases alignment with other 

means-tested Federal programs (e.g., 

SNAP, see relevant section in Preamble 

for details) that use an income 

adjustment to account for excessive 

shelter costs. 

Estimated Impact of Migrant and 

Seasonal Head Start Eligibility 

(§ 1302.12) 

The modifications to eligibility 

requirements in this provision would 

benefit MSHS programs and families by 

reducing barriers to enrolling 

farmworker families in need of program 

services. The provisions related to 

eligibility duration would address an 

existing inequity between infants and 

toddlers served in Early Head Start 

programs and those served in MSHS 

programs. The existing requirement 

creates an inequity because infants and 

toddlers served in Early Head Start 

programs can receive services for the 

duration of the program, meaning until 

they turn three and age out of the 

program, whereas the MSHS family is 

no longer considered eligible for the 

program after two years. Therefore, the 

young children of agricultural workers 

are not provided the same potential 

duration of services as infants and 

toddlers served by Early Head Start. 

This change would also promote 

continuity for families served by MSHS 

and reduce paperwork for families and 

programs. 

Estimated Impact of Serving Children 

With Disabilities (§ 1302.14) 

These provisions clarify language to 

address an inconsistency between the 

HSPPS and the Act. This provision 

reflects a transfer of benefits from one 

potentially eligible family to another. A 

non-quantifiable benefit of this 

provision would be addressing 

confusion caused by the discrepancy. 

Further clarification that the 

requirement to fill ten percent of slots 

with children with disabilities under 

IDEA is a floor and not a ceiling would 

support Head Start in maximizing 

services to children with disabilities 

who would benefit from the program’s 

strong focus on inclusive early 

childhood settings. 

Expected Benefits of Ratios in CenterBased Early Head Start Programs 

(§ 1302.21) 

This provision encourages programs 

to consider reducing teacher-child ratios 

for their youngest classrooms, to 

provide the highest quality care and 

learning opportunities for infants 

enrolled in Head Start. This provision 

has numerous non-quantifiable benefits 

for children and families served by 

Head Start. A warm, responsive 

relationship between an infant and 

caregiver is a crucial foundation for 

infants to learn and develop. A lower 

teacher-child ratio would support the 

establishment of this strong, secure 

relationship and allow for more 

individualized attention between the 

infant and teacher. A lower ratio of one 

teacher to three infants also aligns with 

the National Resource Center for Health 

and Safety in Child Care and Early 

Education recommendations for centerbased programs with classrooms where 

the majority of children are under 12 

months old. Further, research indicates 

that, generally, lower teacher-child 

ratios in ECE classrooms relate to higher 

classroom quality and stronger child 

outcomes. As the premier ECE provider 

in the United States, Head Start sets an 

example for early childhood programs 

nationwide, and this provision would 

further support high-quality early 

childhood services across the country. 

Expected Benefits of Center-Based 

Service Duration for Early Head Start 

(§ 1302.21) 

This provision clarifies that the 1,380 

hours of planned class operations for 

children in EHS should occur across a 

minimum of 46 weeks per year. We 

believe most programs are already 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80894 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

293U.S. Small Business Administration (2023). 

‘‘Table of Size Standards.’’ March 17, 2023 https:// 

www.sba.gov/document/support--table-sizestandards. 

operating year-round; however, a small 

number of programs may be operating 

less than a full year and we would like 

to promote full-year services for infants 

and toddlers in EHS. These programs 

may incur costs associated with 

transitioning to full-year services. 

However, there are substantial nonquantifiable benefits to young children’s 

development. Research on full-day and 

full-year programs suggests children in 

poverty benefit from longer exposure to 

high-quality early learning programs 

than what is provided by part-day and/ 

or part-year programs. 

Expected Benefits of Family Service 

Worker Family Assignments (§ 1302.52) 

This provision seeks to ensure that an 

individual family services staff is 

assigned to work with no greater than 40 

families. Based on internal data, 42 

percent of programs have caseloads that 

exceed 40 families. We estimate that a 

total of 3,231 new family services staff 

would need to be hired to meet this new 

requirement at a total cost of 

$170,052,632. There are numerous nonquantifiable benefits to lower family 

services staff caseloads. This provision 

would address staff well-being, reduce 

burnout, and lower expressions of job 

frustration and dissatisfaction. For staff 

well-being, large caseloads are 

associated with staff burnout and 

turnover, feeling overwhelmed, and 

expression of job frustration and 

dissatisfaction. This provision would 

improve the quality of family services 

and improve staff well-being and 

reflects best practice in the field. 

Expected Benefits of Participation in 

Quality Rating and Improvement 

Systems (§ 1302.53) 

This provision encourages Head Start 

programs to participate in State QRIS to 

the extent practicable if the State system 

has strategies in place to support their 

participation. We assume that programs 

newly participating in QRIS would 

incur additional costs and burden from 

substantive changes in the form of 

revised processes and potentially 

additional or different documentation, 

as well as possible duplication of 

monitoring and assessment processes. 

Non-quantifiable benefits of 

participation in QRIS include continued 

quality improvement efforts, providing a 

common metric through which families 

can understand and make decisions 

about program options, and aligning 

standards across a statewide early care 

and education system. 

Expected Benefits of Services to 

Enrolled Pregnant People (§ 1302.80; 

§ 1302.82) 

This provision enhances services to 

enrolled pregnant people by requiring 

the newborn visit to include a 

discussion of maternal mental and 

physical health, infant health, and 

support for basic needs; and requiring 

programs to track and record 

information on service delivery for 

enrolled pregnant women. We assume 

programs may incur nominal costs 

associated with enhancements to 

record-keeping. Non-quantifiable 

benefits of these provisions would be 

assessing the child care, health, and 

mental health needs of mothers in the 

critical period after child birth, which 

would enable Head Start to provide 

support to mothers and identify 

opportunities for collaboration and 

intervention. Improved tracking and 

recording of services to enrolled 

pregnant women would also support 

OHS in understanding the services 

provided and identifying how to best be 

responsive to the needs of enrolled 

pregnant people. These records would 

also be used to validate the use of 

Federal funds to serve pregnant people 

and to inform ongoing conversations 

program staff have with the pregnant 

people about her needs before and after 

the baby is born. 

Expected Benefits of Standards of 

Conduct (§ 1302.90) 

These provisions revise current 

requirements to ensure we are as clear 

as possible and that our requirements 

reflect current best practices and more 

precise terminology around standards of 

conduct. These changes would result in 

aligned definitions with other Federal 

resources and clarifications to existing 

requirements. Non-quantifiable benefits 

of these enhancements include critical 

supports to child safety by supporting 

staff in recognizing potential child 

abuse and neglect and understanding 

their legal responsibility as a mandated 

reporter, which would improve child 

safety and program response to 

violations of standards of conduct. 

Expected Benefits of Staff Training to 

Support Child Safety (§ 1302.92; 

§ 1302.101) 

These provisions enhance 

requirements and frequency of staff 

training and professional development. 

We assume there would be nominal 

costs associated with more frequent 

training. Non-quantifiable benefits of an 

increased frequency of training would 

be to allow programs to offer staff 

advanced training opportunities on 

areas of local importance or greater 

complexity, such as culturally 

responsive practices in reporting, issues 

related to disproportionate reporting, 

and information about at-risk 

populations, as well as emphasize the 

importance of child safety in Head Start. 

This proposed policy change would also 

create more equitable opportunities for 

staff to understand and discuss their 

ethical and legal responsibilities. 

Annual training on positive strategies to 

understand and support children’s 

social and emotional development 

would also enhance the use of positive 

strategies and have the added benefit of 

increasing opportunities for peer 

support as appropriate. 

Expected Benefits of Definition of 

Income (§ 1305.2) 

This provision would revise the 

definition of income by providing a 

clear and finite list of what is 

considered income and what is not 

considered income. Non-quantifiable 

benefits of this provision include 

making the policy less burdensome and 

complicated for programs to implement, 

ensuring programs can more easily 

identify an applicants’ income, and 

promote consistent interpretation on 

what to include in calculating income 

across programs. 

Initial Small Entity Analysis 

The Regulatory Flexibility Act 

requires Agencies to analyze regulatory 

options that would minimize any 

significant impact of a rule on small 

entities. This analysis, as well as other 

sections in this document and the 

Preamble of the proposed rule, serves as 

the Initial Regulatory Flexibility 

Analysis, as required under the 

Regulatory Flexibility Act. 

A. Description and Number of Affected 

Small Entities 

The SBA maintains a Table of Small 

Business Size Standards Matched to 

North American Industry Classification 

System Codes (NAICS).293 We replicate 

the SBA’s description of this table: 

This table lists small business size 

standards matched to industries 

described in the North American 

Industry Classification System (NAICS), 

as modified by the Office of 

Management and Budget, effective 

January 1, 2022. 

The size standards are for the most 

part expressed in either millions of 

dollars (those preceded by ‘‘$’’) or 

number of employees (those without the 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80895 

‘‘$’’). A size standard is the largest that 

a concern can be and still qualify as a 

small business for Federal Government 

programs. For the most part, size 

standards are the average annual 

receipts or the average employment of a 

firm. How to calculate average annual 

receipts and average employment of a 

firm can be found in 13 CFR 121.104 

and 13 CFR 121.106, respectively. 

This proposed rule will impact small 

entities in NAICS category 624410, 

Child Care Services, which has a size 

standard of $9.5 million dollars. We 

assume that most Head Start programs, 

if not all, are below this threshold and 

are considered small entities. 

B. Description of the Potential Impacts 

of the Rule on Small Entities 

In the main analysis, we estimate that 

about $2.576 billion in additional 

funding would be necessary to fully 

implement the proposed rule in 2033, 

which is about a 17% increase above 

baseline funding levels. Most of the 

funding needed is proportional to the 

size of the Head Start program or 

agency, so we do not separately assess 

the potential impacts of the rule on 

small entities of different sizes. The 

Department considers a rule to have a 

significant impact on a substantial 

number of small entities if it has at least 

a 3% impact on revenue on at least 5% 

of small entities. Since the proposed 

rule would likely result in increased 

expenditures of about 17%, we find that 

the proposed rule would likely have a 

significant impact on a substantial 

number of small entities. 

C. Alternatives To Minimize the Burden 

on Small Entities 

ACF considered many policy 

alternatives to the proposed rule, some 

of which are quantified in this analysis. 

Tables I1 through I4 summarize the 

impacts on expenditures under the 

wage-parity policy, reporting yearly 

estimates, and present value and 

annualized values corresponding to 3% 

and 7% discount rates. This table 

presents separate analyses of the 

following policies: staff wages, staff 

benefits, staff breaks, family service 

worker family assignments, mental 

health supports, and preventing and 

addressing lead exposure. This 

document also considers the impacts of 

expenditures associated with the 

minimum pay requirement, and 

itemized impacts of the lead in water 

and lead-based paint policies. These 

tables and additional analyses in the 

narrative of this document enabled ACF 

to appropriately consider a range of 

feasible policy alternatives. This 

analysis also considers excluding the 

following elements of the proposed rule: 

provisions related to benefits, 

provisions related to staff breaks, 

provisions related to family service 

workers, provisions related to mental 

health support, and provisions related 

to lead hazards. 

List of Subjects 

45 CFR Part 1301 

Early education, Grant programs, 

Head Start, Program governance, Social 

programs 

45 CFR Part 1302 

Compensation, Early education, Grant 

programs, Head Start, Mental health, 

Quality improvement, Social programs, 

Workforce. 

45 CFR Part 1303 

Early education, Financial 

management, Grant programs, Head 

Start, Social programs. 

45 CFR Part 1304 

Accountability, Early education, 

Grant programs, Head Start, Monitoring, 

Social programs. 

45 CFR Part 1305 

Definitions, Early education, Grant 

programs, Head Start, Social programs. 

Dated: November 8, 2023. 

Xavier Becerra, 

Secretary, Department of Health and Human 

Services. 

For reasons stated in the preamble, we 

propose to amend 45 CFR parts 1301, 

1302, 1303, 1304, and 1305 as follows. 

PART 1301—PROGRAM 

GOVERNANCE 

■ 1. The authority citation for part 1301 

continues to read as follows: 

Authority: 42 U.S.C. 9801 et seq. 

■ 2. Revise § 1301.1 to read as follows: 

§ 1301.1 Purpose 

An agency, as defined in part 1305 of 

this chapter, must establish and 

maintain a formal structure for program 

governance that includes a governing 

body, a policy council at the agency 

level and policy committee at the 

delegate level, and a parent committee. 

Governing bodies have a legal and fiscal 

responsibility to administer and oversee 

the agency’s Head Start programs. 

Policy councils are responsible for the 

direction of the agency’s Head Start 

programs. 

■ 3. Amend § 1301.3 by revising 

paragraph (a) and removing the word 

‘‘grantee’’ and adding in its place the 

words ‘‘grant recipient’’ in paragraph 

(b)(2). 

The revision reads as follows: 

§ 1301.3 Policy council and policy 

committee. 

(a) Establishing policy councils and 

policy committees. Each agency must 

establish and maintain a policy council 

responsible for the direction of the Head 

Start program at the agency level, and a 

policy committee at the delegate level. 

If an agency delegates operational 

responsibility for the entire Head Start 

program to one delegate agency, the 

policy council and policy committee 

may be the same body. 

* * * * * 

■ 4. Amend § 1301.4 by revising 

paragraph (b)(3) to read as follows: 

§ 1301.4 Parent committees. 

* * * * * 

(b) * * * 

(3) Within the guidelines established 

by the governing body, policy council or 

policy committee, participate in the 

recruitment and screening of Head Start 

employees. 

PART 1302—PROGRAM OPERATIONS 

■ 5. The authority for part 1302 

continues to read as follows: 

Authority: 42 U.S.C. 9801 et seq. 

■ 6. Revise § 1302.1 to read as follows: 

§ 1302.1 Overview 

This part implements these statutory 

requirements in sections 641A, 645, 

645A, and 648A of the Act by describing 

all of the program performance 

standards that are required to operate 

Head Start Preschool, Early Head Start, 

American Indian and Alaska Native and 

Migrant or Seasonal Head Start 

programs. The part covers the full range 

of operations from enrolling eligible 

children and providing program 

services to those children and their 

families, to managing programs to 

ensure staff are qualified and supported 

to effectively provide services. This part 

also focuses on using data through 

ongoing program improvement to 

ensure high-quality service. As required 

in the Act, these provisions do not 

narrow the scope or quality of services 

covered in previous regulations. Instead, 

these regulations raise the quality 

standard to reflect science and best 

practices, and streamline and simplify 

requirements so programs can better 

understand what is required for quality 

services. 

Subpart A—Eligibility, Recruitment, 

Selection, Enrollment, and Attendance 

§ 1302.10 [Amended] 

■ 7. Amend § 1302.10 in the first 

sentence by removing the word 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80896 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

‘‘grantee’’ and adding in its place the 

words ‘‘grant recipient’’. 

■ 8. Amend § 1302.11 by revising 

paragraph (b) to read as follows: 

§ 1302.11 Determining community 

strengths, needs, and resources. 

* * * * * 

(b) Community wide strategic 

planning and needs assessment 

(community assessment). (1) A program 

must conduct a community assessment 

at least once over the five-year grant 

period to: 

(i) Identify populations most in need 

of services including relevant family or 

child risk factors; 

(ii) Inform the program’s design and 

service delivery to reflect needs and 

diversity of the community, and to 

promote equity, inclusion, and 

accessibility; 

(iii) Inform the enrollment, 

recruitment, and selection process to 

prioritize the enrollment of those 

populations with relevant risk factors 

identified under paragraph (b)(1)(i) of 

this section; 

(iv) Identify strengths and resources 

in the community that can be leveraged 

for service delivery, coordination, and 

partnership efforts including in the 

delivery of education, health, nutrition, 

and referrals to social services to eligible 

children and families; 

(v) Identify the communication 

methods and modalities available to the 

program that best engage with 

prospective and enrolled families of all 

abilities. 

(2) In conducting the community 

assessment, a program must collect and 

utilize data that describes community 

strengths, needs, and resources and 

include, at a minimum: 

(i) Relevant demographic and other 

data about eligible children and 

expectant mothers, including: 

(A) Children living in poverty; 

(B) Children experiencing 

homelessness in collaboration with, to 

the extent possible, McKinney-Vento 

Local Education Agency Liaisons (42 

U.S.C. 11432 (6)(A)); 

(C) Children in foster care; 

(D) Children with disabilities, 

including types of disabilities and 

relevant services and resources 

provided to these children by 

community agencies; and 

(E) Geographic location, race, 

ethnicity, and languages they speak. 

(ii) The education, health, nutrition 

and social service needs of eligible 

children and their families, including 

prevalent social or economic factors, 

such as transportation needs, that 

impact their well-being; 

(iii) Typical work, school, and 

training schedules of parents with 

eligible children; 

(iv) Other child development, child 

care centers, and family child care 

programs that serve eligible children, 

including home visiting, publicly 

funded State and local preschools, and 

the approximate number of eligible 

children served; 

(v) Resources that are available in the 

community to address the needs of 

eligible children and their families, 

especially transportation resources; and, 

(vi) Strengths of the community. 

(3) Programs should have a strategic 

approach: 

(i) To determine what data to acquire 

to reach goals in paragraph (b)(1) of this 

section prior to conducting the 

community assessment and 

(ii) For how to use the data acquired 

to reach goals in paragraph (b)(1) of this 

section after conducting the community 

assessment 

(4) When determining what data to 

acquire under paragraph (b)(2) of this 

section, if the burden or cost to acquire 

certain data is unreasonable, programs 

should identify other publicly or locally 

available data that could be used as a 

proxy. 

(5) A program must annually review 

and, where needed as determined by the 

program, update the community 

assessment to identify any significant 

shifts in community demographics, 

needs, and resources that may impact 

program design and service delivery. 

Programs must consider how the annual 

update can inform and support 

management approaches for continuous 

quality improvement, program goals, 

ongoing oversight, and results from their 

self-assessment as required in subpart J 

of this part (§§ 1302.101 through 

1302.103). 

(6) A program must consider whether 

the characteristics of the community 

allow it to include children from diverse 

economic backgrounds that would be 

supported by other funding sources, 

including private pay, in addition to the 

program’s eligible funded enrollment. A 

program must not enroll children from 

diverse economic backgrounds if it 

would result in a program serving less 

than its eligible funded enrollment. 

■ 9. Amend § 1302.12 by revising 

paragraphs (b)(1), (b)(2) introductory 

text, (b)(2)(i), (e)(1)(ii), (e)(4), (f), (i)(1), 

and (j)(3) and (4), adding paragraph 

(j)(5), and revising paragraph (l) to read 

as follows: 

§ 1302.12 Determining, verifying, and 

documenting eligibility. 

* * * * * 

(b) * * * 

(1) For Early Head Start, except when 

the child is transitioning to Head Start 

Preschool, a child must be an infant or 

a toddler younger than three years old. 

(2) For Head Start Preschool, a child 

must: 

(i) Be at least three years old or, turn 

three years old by the date used to 

determine eligibility for public school in 

the community in which the Head Start 

Preschool program is located; and, 

* * * * * 

(e) * * * 

(1) * * * 

(ii) The Tribe has resources within its 

grant, without using additional funds 

from HHS intended to expand Head 

Start services, to enroll pregnant women 

or children whose family incomes 

exceed low-income guidelines or who 

are not otherwise eligible; and, 

* * * * * 

(4) An Indian Tribe or Tribes that 

operates both an Early Head Start 

program and a Head Start Preschool 

program may, at its discretion, at any 

time during the grant period involved, 

reallocate funds between the Early Head 

Start program and the Head Start 

Preschool program in order to address 

fluctuations in client populations, 

including pregnant women and children 

from birth to compulsory school age. 

The reallocation of such funds between 

programs by an Indian Tribe or Tribes 

during a year may not serve as a basis 

for any reduction of the base grant for 

either program in succeeding years. 

(f) Migrant or Seasonal eligibility 

requirements. A child is eligible for 

Migrant or Seasonal Head Start, if the 

family meets an eligibility criterion in 

paragraphs (c) and (d) of this section; 

and one family member is primarily 

engaged in agricultural employment. 

* * * * * 

(i) * * * 

(1) To verify eligibility based on 

income, program staff must use tax 

forms, pay stubs, or other proof of 

income to determine the family income 

for the relevant time period. 

(i) The program must calculate total 

gross income using applicable sources 

of income. 

(ii) A program may make an 

adjustment to a family’s gross income 

calculation for the purposes of 

determining eligibility in order to 

account for excessive housing expenses. 

A program must use available bills, 

bank statements, and other relevant 

documentation provided by the family 

to calculate total annual housing 

expenses with appropriate multipliers 

to: 

(A) Determine if a family spends more 

than 30 percent of their total gross 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80897 

income on housing expenses, as defined 

in part 1305 of this subchapter, and 

(B) If applicable, reduce the total gross 

income by the amount spent in housing 

expenses above the 30 percent threshold 

to calculate the adjusted gross income 

for determining income eligibility. 

(iii) If the family cannot provide tax 

forms, pay stubs, or other proof of 

income for the relevant time period, 

program staff may accept written 

statements from employers, including 

individuals who are self-employed, for 

the relevant time period and use 

information provided to calculate total 

annual income with appropriate 

multipliers. 

(iv) If the family reports no income for 

the relevant time period, a program may 

accept the family’s signed declaration to 

that effect, if program staff describes 

efforts made to verify the family’s 

income, and explains how the family’s 

total income was calculated or seeks 

information from third parties about the 

family’s eligibility if the family gives 

written consent. If a family gives 

consent to contact third parties, program 

staff must adhere to program safety and 

privacy policies and procedures and 

ensure the eligibility determination 

record adheres to paragraph (k)(2) of 

this section. 

(v) If the family can demonstrate a 

significant change in income for the 

relevant time period, program staff may 

consider current income circumstances. 

* * * * * 

(j) * * * 

(3) If a child moves from an Early 

Head Start program to a Head Start 

Preschool program, program staff must 

verify the family’s eligibility again. 

(4) If a program operates both an Early 

Head Start and a Head Start Preschool 

program, and the parents wish to enroll 

their child who has been enrolled in the 

program’s Early Head Start, the program 

must ensure, whenever possible, the 

child receives Head Start Preschool 

services until enrolled in school, 

provided the child is eligible. 

(5) If a program operates a Migrant 

and Seasonal Head Start program, 

children younger than age three 

participating in the program remain 

eligible until they turn three years old 

consistent with paragraph (j)(2) of this 

section. 

* * * * * 

(l) Program policies and procedures 

on violating eligibility determination 

regulations. A program must establish 

written policies and procedures that 

describe all actions taken against staff 

who intentionally violate Federal and 

program eligibility determination 

regulations and who enroll pregnant 

women and children that are not 

eligible to receive Head Start services. 

* * * * * 

■ 10. Revise § 1302.13 to read as 

follows: 

§ 1302.13 Recruitment of children. 

In order to reach those most in need 

of services, a program must develop and 

implement a recruitment process 

designed to actively inform all families 

with eligible children within the 

recruitment area of the availability of 

program services. A program must use 

modern technologies to encourage and 

assist families in applying for admission 

to the program, and to reduce the 

family’s administrative and paperwork 

burden in the application and 

enrollment process. A program must 

include specific efforts to actively locate 

and recruit children with disabilities 

and other vulnerable children, 

including homeless children and 

children in foster care. 

■ 11. Amend § 1302.14 by revising 

paragraph (a)(3), adding paragraph 

(a)(5), revising paragraph (b)(1), and 

adding paragraph (d) to read as follows: 

§ 1302.14 Selection process. 

(a) * * * 

(3) If a program operates in a service 

area where Head Start Preschool eligible 

children can enroll in high-quality 

publicly funded pre-kindergarten for a 

full school day, the program must 

prioritize younger children as part of the 

selection criteria in paragraph (a)(1) of 

this section. If this priority would 

disrupt partnerships with local 

education agencies, then it is not 

required. An American Indian and 

Alaska Native or Migrant or Seasonal 

Head Start program must consider 

whether such prioritization is 

appropriate in their community. 

* * * * * 

(5) A program may consider the 

enrollment of children of staff members 

as part of the selection criteria in 

paragraph (a)(1) of this section. 

(b) * * * 

(1) A program must ensure at least 10 

percent of its total actual enrollment is 

filled by children eligible for services 

under IDEA, unless the responsible HHS 

official grants a waiver. 

* * * * * 

(d) Understanding barriers to 

enrollment. A program is required to use 

data from the selection process to 

understand why children selected for 

the program do not enroll or attend, 

such as a lack of transportation being a 

barrier to enrolling once they are 

selected. A program must use this data 

to inform ongoing program 

improvement efforts as described in 

§ 1302.102(c) to promote enrolling the 

children most in need of program 

services. 

■ 12. Amend § 1302.15 by revising 

paragraph (b)(2) and adding paragraph 

(g) to read as follows: 

§ 1302.15 Enrollment. 

* * * * * 

(b) * * * 

(2) Under exceptional circumstances, 

a program may maintain a child’s 

enrollment in Head Start Preschool for 

a third year, provided that family 

income is verified again. A program may 

maintain a child’s enrollment in Early 

Head Start as described in 

§ 1302.12(j)(2). 

* * * * * 

(g) User-friendly enrollment process. 

A program must regularly examine their 

enrollment processes and implement 

any identified improvements to 

streamline the enrollment experience 

for families. 

■ 13. Amend § 1302.16 by adding 

paragraph (a)(2)(v) to read as follows: 

§ 1302.16 Attendance. 

(a) * * * 

(2) * * * 

(v) Examine barriers to regular 

attendance, such as access to safe and 

reliable transportation, and where 

possible, provide or facilitate 

transportation for the child if needed; 

* * * * * 

■ 14. Amend § 1302.17 by revising 

paragraphs (a)(2) through (4), (b)(2) 

introductory text, and (b)(3) to read as 

follows: 

§ 1302.17 Suspension and expulsion. 

(a) * * * 

(2) A temporary suspension must be 

used only as a last resort in 

extraordinary circumstances where 

there is a serious safety threat that has 

not been reduced or eliminated by the 

provision of interventions and supports 

recommended by the mental health 

consultant and the program needs time 

to put additional appropriate services in 

place. 

(3) Before a program determines 

whether a temporary suspension is 

necessary, a program must engage with 

a mental health consultant, the 

multidisciplinary team responsible for 

mental health, collaborate with the 

parents, and utilize appropriate 

community resources—such as behavior 

coaches, psychologists, other 

appropriate specialists, or other 

resources—as needed, to determine no 

other reasonable option is appropriate. 

(4) If a temporary suspension is 

deemed necessary, a program must help 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80898 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

the child return to full participation in 

all program activities as quickly as 

possible while ensuring child safety. A 

program must explore all possible steps 

and document all steps taken to address 

the behavior(s) and supports needed to 

facilitate the child’s safe reentry and 

continued participation in the program. 

Such steps must include, at a minimum: 

(i) Continuing to engage with the 

parents, mental health consultant, the 

multidisciplinary team responsible for 

mental health, and other appropriate 

staff, and continuing to utilize 

appropriate community resources; 

(ii) Providing additional program 

supports and services, including home 

visits; and, 

(iii) Determining whether a referral to 

a local agency responsible for 

implementing IDEA is appropriate, or if 

the child has an individualized family 

service plan (IFSP) or individualized 

education program (IEP), consulting 

with the responsible agency to ensure 

the child receives the needed support 

services. 

(b) * * * 

(2) When a child exhibits persistent 

and serious challenging behaviors, a 

program must explore all possible steps 

and document all steps taken to address 

such problems, and facilitate the child’s 

safe participation in the program. Such 

steps must include, at a minimum, 

engaging the parents, mental health 

consultant, and the multidisciplinary 

team responsible for mental health; 

considering the appropriateness of 

providing appropriate services and 

supports under section 504 of the 

Rehabilitation Act of 1973 to ensure that 

the child who satisfies the definition of 

disability in 29 U.S.C. 705(9)(b) of the 

Rehabilitation Act is not excluded from 

the program on the basis of disability, 

and consulting with the parents and the 

child’s teacher, and: 

* * * * * 

(3) If, after a program has explored all 

possible steps and documented all steps 

taken as described in paragraph (b)(2) of 

this section, a program, in consultation 

with the parents, the child’s teacher, the 

agency responsible for implementing 

IDEA (if applicable), the mental health 

consultant, and the multidisciplinary 

team responsible for mental health 

determines that the child’s continued 

enrollment presents a continued serious 

safety threat to the child or other 

enrolled children and determines the 

program is not the most appropriate 

placement for the child, the program 

must work with such entities to directly 

facilitate the transition of the child to a 

more appropriate placement that can 

immediately enroll and provide services 

to the child. 

Subpart B—Program Structure 

■ 15. Amend § 1302.20 by: 

■ a. Revising paragraphs (a)(1) and (2) 

and (c)(1) and (2); 

■ b. Removing the word ‘‘grantees’’ and 

adding in its place words ‘‘grant 

recipients’’ in paragraph (c)(3) 

introductory text; 

■ c. Revising paragraphs (c)(3)(i) and 

(iii); 

■ d. Removing the word ‘‘grantees’’ and 

adding in its place words ‘‘grant 

recipients’’ in paragraph (c)(3)(vi); and 

■ e. Revising paragraphs (c)(4) and (d). 

The revisions read as follows: 

§ 1302.20 Determining program structure. 

(a) * * * 

(1) A program must choose to operate 

one or more of the following program 

options: center-based, home-based, 

family child care, or an approved locally 

designed variation as described in 

§ 1302.24. The program option(s) chosen 

must meet the needs of children and 

families based on the community 

assessment described in § 1302.11(b). A 

Head Start Preschool program may not 

provide only the option described in 

§ 1302.22(a) and (c)(2). 

(2) To choose a program option and 

develop a program calendar, a program 

must consider in conjunction with the 

annual review of the community 

assessment described in § 1302.11(b)(2), 

whether it would better meet child and 

family needs through conversion of 

existing slots to full school day or full 

working day slots, extending the 

program year, conversion of existing 

Head Start Preschool slots to Early Head 

Start slots as described in paragraph (c) 

of this section, and ways to promote 

continuity of care and services. A 

program must work to identify alternate 

sources to support full working day 

services. If no additional funding is 

available, program resources may be 

used. 

* * * * * 

(c) * * * 

(1) Consistent with section 

645(a)(5)15 of the Head Start Act, grant 

recipients may request to convert Head 

Start Preschool slots to Early Head Start 

slots through the refunding application 

process or as a separate grant 

amendment. 

(2) Any grant recipient proposing a 

conversion of Head Start Preschool 

services to Early Head Start services 

must obtain policy council and 

governing body approval and submit the 

request to their regional office. 

(3) * * * 

(i) A grant application budget and a 

budget narrative that clearly identifies 

the funding amount for the Head Start 

Preschool and Early Head Start 

programs before and after the proposed 

conversion; 

* * * * * 

(iii) A revised program schedule that 

describes the program option(s) and the 

number of funded enrollment slots for 

Head Start Preschool and Early Head 

Start programs before and after the 

proposed conversion; 

* * * * * 

(4) Consistent with section 

645(d)(3)16 of the Act, any American 

Indian and Alaska Native grant recipient 

that operates both an Early Head Start 

program and a Head Start Preschool 

program may reallocate funds between 

the programs at its discretion and at any 

time during the grant period involved, 

in order to address fluctuations in client 

populations. An American Indian and 

Alaska Native program that exercises 

this discretion must notify the regional 

office. 

(d) Source of funding. A program may 

consider hours of service that meet the 

Head Start Program Performance 

Standards, regardless of the source of 

funding, as hours of planned class 

operations for the purposes of meeting 

the Head Start Preschool and Early Head 

Start service duration requirements in 

this subpart. 

■ 16. Amend § 1302.21 by revising 

paragraphs (b)(2), (c)(1)(i), (c)(2) and (3), 

and (c)(4) introductory text to read as 

follows: 

§ 1302.21 Center-based option. 

* * * * * 

(b) * * * 

(2) A class that serves children under 

36 months old must have two teachers 

with no more than eight children, or 

three teachers with no more than nine 

children. Each teacher must be assigned 

consistent, primary responsibility for no 

more than four children to promote 

continuity of care for individual 

children. A program is encouraged to 

establish a lower teacher to child ratio 

for the youngest children they serve, 

provided that it does not jeopardize 

continuity of care for children. A 

program must minimize teacher changes 

throughout a child’s enrollment, 

whenever possible, and consider mixed 

age group classes to support continuity 

of care. 

* * * * * 

(c) * * * 

(1) * * * 

(i) A program must provide 1,380 

annual hours of planned class 

operations over the course of at least 

forty-six weeks per year for all enrolled 

children. 

* * * * * 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80899 

(2) Head Start Preschool—(i) Service 

duration for at least 45 percent. A 

program must provide 1,020 annual 

hours of planned class operation over 

the course of at least eight months per 

year for at least 45 percent of its Head 

Start Preschool center-based funded 

enrollment. 

(ii) Service duration for remaining 

slots. A program must provide, at a 

minimum, at least 160 days per year of 

planned class operations if it operates 

for five days per week, or at least 128 

days per year if it operates four days per 

week. Classes must operate for a 

minimum of 3.5 hours per day. 

(iii) Double session. Double session 

variation must provide classes for four 

days per week for a minimum of 128 

days per year and 3.5 hours per day. 

Each double session class staff member 

must be provided adequate break time 

during the course of the day. In 

addition, teachers, assistants, and 

volunteers must have appropriate time 

to prepare for each session together, to 

set up the classroom environment, and 

to give individual attention to children 

entering and leaving the center. 

(iv) Special provision for alignment 

with local education agency. A Head 

Start Preschool program providing fewer 

than 1,020 annual hours of planned 

class operations or fewer than eight 

months of service is considered to meet 

the requirements described in paragraph 

(c)(2)(i) of this section if its program 

schedule aligns with the annual hours 

required by its local education agency 

for grade one and such alignment is 

necessary to support partnerships for 

service delivery. 

(3) Exemption for Migrant or Seasonal 

Head Start programs. A Migrant or 

Seasonal program is not subject to the 

requirements described in paragraph 

(c)(1) or (2) of this section, but must 

make every effort to provide as many 

days and hours of service as possible to 

each child and family. 

(4) Calendar planning. A program 

must: 

* * * * * 

■ 17. Amend § 1302.22 by revising 

paragraphs (a) and (c)(2) introductory 

text to read as follows: 

§ 1302.22 Home-based option. 

(a) Setting. The home-based option 

delivers the full range of services, 

consistent with § 1302.20(b), through 

visits with the child’s parents, primarily 

in the child’s home and through group 

socialization opportunities in a Head 

Start classroom, community facility, 

home, or on field trips. For Early Head 

Start programs, the home-based option 

may be used to deliver services to some 

or all of a program’s enrolled children. 

For Head Start Preschool programs, the 

home-based option may only be used to 

deliver services to a portion of a 

program’s enrolled children. 

* * * * * 

(c) * * * 

(2) Head Start Preschool. A Head Start 

Preschool home-based program must: 

* * * * * 

■ 18. Amend § 1302.23 by revising 

paragraphs (b)(2) through (4) to read as 

follows: 

§ 1302.23 Family child care option. 

* * * * * 

(b) * * * 

(2) Mixed age with preschoolers. 

When there is one family child care 

provider, with a mixed-age group of 

children that includes children over 36 

months of age, the maximum group size 

is six children and no more than two of 

the six may be under 24 months of age. 

When there are two providers, the 

maximum group size is twelve children 

with no more than four of the twelve 

children under 24 months of age. 

(3) Infants and toddlers only. When 

there is one family child care provider 

with a group of children that are all 

under 36 months of age, the maximum 

group size is four children, and no more 

than two of the four children may be 

under 18 months of age. 

(4) Maintaining ratios. A program 

must maintain appropriate ratios during 

all hours of program operation. A 

program must ensure providers have 

systems to ensure the safety of any child 

not within view for any period. A 

program must make substitute staff 

available with the necessary training 

and experience to ensure quality 

services to children are not interrupted. 

* * * * * 

■ 19. Amend § 1302.24 by revising 

paragraphs (c)(1), (3), and (5) and 

removing paragraph (d). 

The revisions read as follows: 

§ 1302.24 Locally-designed program 

option variations. 

* * * * * 

(c) * * * 

(1) The responsible HHS official may 

waive one or more of the requirements 

contained in §§ 1302.21(b), (c)(1)(i), and 

(c)(2)(i); 1302.22(a) through (c); and 

1302.23(b) and (c), but may not waive 

ratios or group size for children under 

24 months. Center-based locally 

designed options must meet the 

minimums described in section 

640(k)(1) of the Act for center-based 

programs. 

* * * * * 

(3) If the responsible HHS official 

approves a waiver to allow a program to 

operate below the minimums described 

in § 1302.21(c)(2)(i), a program must 

meet the requirements described in 

§ 1302.21(c)(2)(ii), or in the case of a 

double session variation, a program 

must meet the requirements described 

in § 1302.21(c)(2)(iii). 

* * * * * 

(5) In order to receive a waiver of 

service duration, a program must meet 

the requirement in paragraph (c)(4) of 

this section, provide supporting 

evidence that it better meets the needs 

of parents than the applicable service 

duration minimums described in 

§ 1302.21(c)(1) and (c)(2)(i), 

§ 1302.22(c), or § 1302.23(c), and assess 

the effectiveness of the variation in 

supporting appropriate development 

and progress in children’s early learning 

outcomes. 

■ 20. Amend § 1302.34 by adding 

paragraph (b)(9) to read as follows: 

§ 1302.34 Parent and family engagement in 

education and child development services. 

* * * * * 

(b) * * * 

(9) The communication methods and 

modalities utilized by the program are 

the best available to engage with 

prospective and enrolled families of all 

abilities. 

Subpart D—Health and Mental Health 

Program Services 

■ 21. Revise the heading for subpart D 

to read as set forth above. 

■ 22. Amend § 1302.40 by revising 

paragraph (b) to read as follows: 

§ 1302.40 Purpose. 

* * * * * 

(b) A program must establish and 

maintain a Health and Mental Health 

Services Advisory Committee that 

includes Head Start parents, 

professionals, and other volunteers from 

the community. 

■ 23. Revise § 1302.41 to read as 

follows: 

§ 1302.41 Collaboration and 

communication with parents. 

(a) For all activities described in this 

part, programs must collaborate with 

parents as partners in the health, mental 

health, and well-being of their children 

in a linguistically and culturally 

appropriate manner and communicate 

with parents about their child’s health 

and mental health needs and 

development concerns in a timely and 

effective manner. 

(b) At a minimum, a program must: 

(1) Obtain advance authorization from 

the parent or other person with legal 

authority for all health, mental health, 

and developmental procedures 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80900 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

administered through the program or by 

contract or agreement, and, maintain 

written documentation if they refuse to 

give authorization for health and mental 

health services; and, 

(2) Share with parents the policies for 

health or mental health emergencies 

that require rapid response on the part 

of staff or immediate medical attention. 

■ 24. Amend § 1302.42 by: 

■ a. Revising paragraph (b)(1)(i) and 

(b)(4); and 

■ b. Removing the word ‘‘grantee’’ and 

adding in its place the words ‘‘grant 

recipient’’ in paragraph (e)(2). 

The revisions read as follows: 

§ 1302.42 Child health status and care. 

* * * * * 

(b) * * * 

(1) * * * 

(i) Obtain determinations from health 

care and oral health care professionals 

as to whether or not the child is up-todate on a schedule of age appropriate 

preventive and primary medical, mental 

health, and oral health care, based on: 

the well-child visits and dental 

periodicity schedules as prescribed by 

the Early and Periodic Screening, 

Diagnosis, and Treatment (EPSDT) 

program of the Medicaid agency of the 

State in which they operate, 

immunization recommendations issued 

by the Centers for Disease Control and 

Prevention, and any additional 

recommendations from the local Health 

and Mental Health Services Advisory 

Committee that are based on prevalent 

community health problems; 

* * * * * 

(4) A program must identify each 

child’s nutritional health needs, taking 

into account available health 

information, including the child’s 

health records, relevant developmental 

or mental health concerns, and family 

and staff concerns, including special 

dietary requirements, food allergies, and 

community nutrition issues as 

identified through the community 

assessment or by the Health and Mental 

Health Services Advisory Committee. 

* * * * * 

■ 25. Amend § 1302.44 by revising 

paragraph (b) to read as follows: 

§ 1302.44 Child nutrition. 

* * * * * 

(b) Payment sources. A program must 

use funds from USDA Food, Nutrition, 

and Consumer Services child nutrition 

programs as the primary source of 

payment for meal services. Head Start 

funds may be used to cover those 

allowable costs not covered by the 

USDA. 

■ 26. Revise § 1302.45 to read as 

follows: 

§ 1302.45 Supports for mental health and 

well-being. 

(a) Program-wide wellness supports. 

To support a program-wide culture that 

promotes mental health, social and 

emotional well-being, and overall health 

and safety, a program must have a 

multidisciplinary team responsible for 

mental health that: 

(1) Coordinates supports for adult 

mental health and well-being including 

engaging in nurturing and responsive 

relationships with families, engaging 

families in home visiting services, and 

promoting staff health and wellness, as 

described in § 1302.93; 

(2) Coordinates supports for positive 

learning environments for all children; 

supportive teacher practices; and 

strategies for supporting children with 

social, emotional, behavioral or mental 

health concerns; 

(3) Secures mental health consultation 

services no less than once a month to 

ensure a mental health consultant is 

available to partner with staff and 

families in a timely and effective 

manner and examines the approach to 

mental health consultation on an annual 

basis to determine if it meets the needs 

of the program; 

(4) Ensures that all children receive 

adequate screening and appropriate 

follow up and the parent receives 

referrals about how to access services 

for potential social, emotional, 

behavioral, or other mental health 

concerns, as described in § 1302.33; 

(5) Facilitates coordination and 

collaboration between mental health 

and other relevant program services, 

including education, disability, family 

engagement, and health services; and 

(6) Builds community partnerships to 

facilitate access to additional mental 

health resources and services, as 

needed. 

(b) Mental health consultants. A 

program must ensure that mental health 

consultants provide consultation 

services that build the capacity of adults 

in an infant or young child’s life to 

strengthen and support the mental 

health and social and emotional 

development of children, including 

consultation with: 

(1) The program to implement 

strategies that promote a program-wide 

culture of mental health, prevent mental 

health challenges from developing, and 

identify and support children with 

mental health and social and emotional 

concerns; 

(2) Child and family services staff to 

implement strategies that build 

nurturing and responsive relationships 

and create positive learning 

environments that promote the mental 

health and social and emotional 

development of all children; 

(3) Staff who have contact with 

children to understand and 

appropriately respond to prevalent child 

mental health concerns, including 

internalizing problems such as 

appearing withdrawn; externalizing 

problems such as behavioral concerns; 

and how exposure to trauma and 

substance use can influence risk; 

(4) Families and staff to understand 

mental health and access mental health 

interventions or supports, if needed, 

including in the event of a natural 

disaster or crisis; 

(5) The program to implement 

policies to limit suspension and 

prohibit expulsion as described in 

§ 1302.17; and 

(6) The program to support the wellbeing of children and families involved 

in any significant child health, mental 

health, or safety incident described in 

§ 1302.102(d)(1)(ii). 

■ 27. Amend § 1302.46 by revising 

paragraphs (b)(1)(iii) and (iv), (b)(2) 

introductory text, and (b)(2)(ii) and (iii), 

and adding paragraph (b)(2)(iv) to read 

as follows: 

§ 1302.46 Family support services for 

health, nutrition, and mental health. 

* * * * * 

(b) * * * 

(1) * * * 

(iii) Learn about healthy pregnancy 

and postpartum care, as appropriate, 

including breastfeeding support and 

treatment options for parental mental 

health, including depression, anxiety, 

and substance use concerns; 

(iv) Discuss information related to 

their child’s mental health with staff, 

including typical and atypical behavior 

and development, and how to 

appropriately respond to their child and 

promote their child’s social and 

emotional development; and, 

* * * * * 

(2) A program must provide ongoing 

support to assist parents’ navigation 

through health and mental health 

systems to meet the general health and 

specifically identified needs of their 

children and must assist parents: 

* * * * * 

(ii) In understanding the results of 

diagnostic and treatment procedures as 

well as plans for ongoing care; 

(iii) In familiarizing their children 

with services they will receive while 

enrolled in the program and to enroll 

and participate in a system of ongoing 

family health care; and 

(iv) In providing information about 

how to access evidence-based mental 

health services for young children and 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80901 

their families, including referrals if 

appropriate. 

■ 28. Amend § 1302.47 by revising 

paragraphs (b)(1)(iii), (b)(5) introductory 

text, and (b)(5)(i), (iii), and (v) to read as 

follows: 

§ 1302.47 Safety practices. 

* * * * * 

(b) * * * 

(1) * * * 

(iii) Free from pollutants, hazards and 

toxins that are accessible to children 

and could endanger children’s safety 

including lead consistent with 

§ 1302.48; 

* * * * * 

(5) Safety practices. All staff, 

consultants, contractors, and volunteers 

follow appropriate practices to keep 

children safe during all activities, 

including, at a minimum: 

(i) Reporting of suspected or known 

child abuse and neglect, as defined by 

the Federal Child Abuse Prevention and 

Treatment Act (CAPTA) (42 U.S.C. 5101 

note), including that staff comply with 

applicable Federal, State, local, and 

Tribal laws; 

* * * * * 

(iii) Appropriate supervision of 

children at all times; 

* * * * * 

(v) All standards of conduct described 

in § 1302.90(c)(ii); and, 

* * * * * 

■ 29. Add § 1302.48 to subpart D to read 

as follows: 

§ 1302.48 Preventing and Addressing Lead 

Exposure. 

(a) Preventing and addressing lead 

exposure through water. A program 

must address lead in water from water 

fixtures used for human consumption in 

Head Start facilities constructed before 

2014 and where lead service lines, 

plumbing, or fixtures may still exist, 

including, at a minimum: 

(1) Sample and test water in such 

fixtures for lead on an annual basis, or, 

if approved by the governing body, a 

proportion of water in such fixtures 

each year to ensure they are tested at 

least once every five years; 

(2) Sample and test water in such 

fixtures following remediation actions 

to address detectable lead or following 

a change to the water profile; 

(3) All samples must be collected by 

an individual adequately trained to 

collect samples for lead testing; 

(4) All samples must be analyzed by 

a laboratory that is certified by 

Environmental Protection Agency (EPA) 

or the State, territory, or Tribe for testing 

lead in drinking water; 

(5) Restrict access to such fixtures 

within 24 hours of determining the 

water has a lead sample result at or 

above 5 parts per billion and provide 

notice in a timely manner to parents of 

children who may have consumed the 

water; 

(6) Take remediation actions and 

restrict access until follow-up lead 

sample results indicate the water lead 

level is below 5 parts per billion; 

(7) For lead sample results with 

detectable lead below 5 parts per 

billion, consider taking remediation 

actions to lower the lead level as low as 

practicable; and 

(8) If point-of-use devices are used to 

address lead in water, appropriately use 

and maintain point-of-use devices that 

reduce lead levels as tested and certified 

by a third party according to National 

Sanitation Foundation/American 

National Standards Institute (NSF/ 

ANSI) Standards for lead reduction. 

(b) Preventing and addressing lead 

exposure through paint. A program 

must address lead-based paint hazards 

in paint, dust, and soil in Head Start 

facilities constructed before 1978 and 

where lead-based paint may still exist, 

including, at a minimum: 

(1) Inspect for lead-based paint and 

assess for lead-based paint hazards (that, 

in the case of dust-lead hazards, are at 

or above the clearance levels) by a lead 

risk assessor certified by the EPA or an 

EPA-authorized State, territory, or Tribe; 

(2) Immediately restrict access to any 

identified lead-based paint hazards 

(that, in the case of dust-lead hazards, 

are at or above the clearance levels) 

until abatement is completed; 

(3) Abate any identified lead-based 

paint hazards (that, in the case of dustlead hazards, are at or above the 

clearance levels) by a lead abatement 

contractor certified by the EPA or EPAauthorized State, territory, or Tribe; and 

(4) Following conclusion of 

abatement, reassess for lead-based paint 

hazards by a certified risk assessor at 

least once every 2 years unless two 

reassessments conducted 2 years apart 

identify no lead-based paint hazards 

(that, in the case of dust-lead hazards, 

are at or above the clearance levels) in 

areas accessible to children. 

(c) Notification of lead testing and 

remediation. A program must provide 

notification of results of any lead testing 

and any planned or completed 

remediation actions to parents and staff. 

(d) Conflicting requirements. If 

applicable State or local laws or 

regulations have more stringent 

requirements for lead testing or 

remediation, a program should comply 

with the more stringent requirements. 

Subpart E—Family and Community 

Engagement Program Services 

■ 30. Amend § 1302.50 by revising 

paragraph (a) to read as follows: 

§ 1302.50 Family engagement. 

(a) Purpose. A program must integrate 

parent and family engagement strategies 

into all systems and program services to 

support family well-being and promote 

children’s learning and development. 

Programs are encouraged to develop 

innovative two-generation approaches 

that address prevalent needs of families 

across their program that may leverage 

community partnerships or other 

funding sources. This includes 

communicating with families in a 

format that is most accessible. 

* * * * * 

■ 31. Amend § 1302.52 by revising 

paragraphs (c)(2) and (3) and (d) and 

adding paragraph (e) to read as follows: 

§ 1302.52 Family partnership services. 

* * * * * 

(c) * * * 

(2) Help families achieve identified 

individualized family engagement 

outcomes; and 

(3) Establish and implement a family 

partnership agreement process that is 

jointly developed and shared with 

parents in which staff and families to 

review individual progress, revise goals, 

evaluate and track whether identified 

needs and goals are met, and adjust 

strategies on an ongoing basis, as 

necessary. 

(d) Approaches to family services. A 

program must: 

(1) Ensure the family services 

assignment process takes into account 

the varied interests, urgency, and 

intensity of identified family needs and 

goals. 

(2) Ensure the planned number of 

families assigned to work with 

individual family services staff is no 

greater than 40, unless a program can 

demonstrate higher family assignments 

provide high quality family and 

community engagement services and 

maintain reasonable staff workload as 

described in paragraph (d)(3) of this 

section. 

(3) Ensure meaningful employee 

engagement practices address family 

services workload experiences, in 

accordance with § 1302.101(a)(2). 

(e) Existing plans and community 

resources. In implementing this section, 

a program must take into consideration 

any existing plans for the family made 

with other community agencies and 

availability of other community 

resources to address family needs, 

strengths, and goals, in order to avoid 

duplication of effort. 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80902 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

■ 32. Amend § 1302.53 by revising 

paragraphs (b)(1) and (2) to read as 

follows: 

§ 1302.53 Community partnerships and 

coordination with other early childhood and 

education programs. 

* * * * * 

(b) * * * 

(1) Memorandum of understanding. 

To support coordination between Head 

Start Preschool and publicly funded 

preschool programs, a program must 

enter into a memorandum of 

understanding with the appropriate 

local entity responsible for managing 

publicly funded preschool programs in 

the service area of the program, as 

described in section 642(e)(5)22 of the 

Act. 

(2) Quality Rating and Improvement 

Systems. A program, with the exception 

of American Indian and Alaska Native 

programs, should participate in its State 

or local Quality Rating and 

Improvement System (QRIS), to the 

extent practicable, if a State or local 

QRIS has a strategy to support Head 

Start participation without requiring 

programs to duplicate existing 

documentation from Office of Head 

Start oversight. 

* * * * * 

Subpart F—Additional Services for 

Children With Disabilities 

■ 33. Amend § 1302.61 by revising 

paragraphs (c)(1)(v) and (c)(2)(ii) to read 

as follows: 

§ 1302.61 Additional services for children. 

* * * * * 

(c) * * * 

(1) * * * 

(v) Services are provided in a child’s 

regular Head Start classroom or family 

child care home to the greatest extent 

possible. 

(2) * * * 

(ii) For children with an IEP who are 

transitioning out of Head Start 

Preschool to kindergarten, collaborate 

with the parents, and the local agency 

responsible for implementing IDEA, to 

ensure steps are undertaken in a timely 

and appropriate manner to support the 

child and family as they transition to a 

new setting. 

Subpart G—Transition Services 

■ 34. Amend § 1302.70 by revising 

paragraphs (b)(1) and (2) and (d) to read 

as follows: 

§ 1302.70 Transitions from Early Head 

Start. 

* * * * * 

(b) * * * 

(1) Takes into account the child’s 

developmental level and health and 

disability status, progress made by the 

child and family while in Early Head 

Start, current and changing family 

circumstances and, the availability of 

Head Start Preschool, other public prekindergarten, and other early education 

and child development services in the 

community that will meet the needs of 

the child and family; and 

(2) Transitions the child into Head 

Start Preschool or another program as 

soon as possible after the child’s third 

birthday but permits the child to remain 

in Early Head Start for a limited number 

of additional months following the 

child’s third birthday if necessary for an 

appropriate transition. 

* * * * * 

(d) Early Head Start and Head Start 

Preschool collaboration. Early Head 

Start and Head Start Preschool programs 

must work together to maximize 

enrollment transitions from Early Head 

Start to Head Start Preschool, consistent 

with the eligibility provisions in subpart 

A of this part, and promote successful 

transitions through collaboration and 

communication. 

* * * * * 

■ 35. Amend § 1302.71 by revising the 

section heading to read as follows: 

§ 1302.71 Transitions from Head Start 

Preschool to kindergarten. 

* * * * * 

■ 36. Amend § 1302.72 by revising 

paragraphs (a) and (c) to read as follows: 

§ 1302.72 Transitions between programs. 

(a) For families and children who 

move out of the community in which 

they are currently served, including 

homeless families and foster children, a 

program must undertake efforts to 

support effective transitions to other 

Head Start programs. If Head Start is not 

available, the program should assist the 

family to identify another early 

childhood program that meets their 

needs. 

* * * * * 

(c) A migrant or seasonal Head Start 

program must undertake efforts to 

support effective transitions to other 

migrant or seasonal Head Start or, if 

appropriate, Early Head Start or Head 

Start Preschool programs for families 

and children moving out of the 

community in which they are currently 

served. 

Subpart H—Services to Enrolled 

Pregnant Women 

■ 37. Amend § 1302.80 by revising 

paragraph (d) and adding paragraphs (e) 

and (f) to read as follows: 

§ 1302.80 Enrolled pregnant women. 

* * * * * 

(d) A program must provide a 

newborn visit with each mother and 

baby to offer support and identify family 

needs. A program must schedule the 

newborn visit within two weeks after 

the infant’s birth. At a minimum, the 

visit must include a discussion of the 

following: maternal mental and physical 

health, infant health, and support for 

basic needs. 

(e) A program must track and record 

services an enrolled pregnant woman 

receives both from the program and 

through referrals, to help identify 

specific prenatal care services and 

resources the enrolled pregnant woman 

needs to support a healthy pregnancy. 

(f) The program must provide services 

that help reduce barriers to healthy 

maternal and birthing outcomes for each 

family, including services that address 

disparities across racial and ethnic 

groups, and use data on enrolled 

pregnant women to inform program 

services. 

■ 38. Revise § 1302.81 to read as 

follows: 

§ 1302.81 Prenatal and postpartum 

information, education, and services. 

(a) A program must provide enrolled 

pregnant women, mothers, fathers, and 

partners or other family members the 

prenatal and postpartum information, 

education and services that address, as 

appropriate, fetal development, the 

importance of nutrition including 

breastfeeding, the risks of alcohol, 

drugs, and smoking and the benefits of 

substance use treatment, labor and 

delivery, postpartum recovery, and 

infant care and safe sleep practices. 

(b) A program must support pregnant 

women, mothers, fathers, partners, or 

other family members to access mental 

health services, including referrals, as 

appropriate, to address concerns 

including perinatal depression, anxiety, 

grief or loss, birth trauma, and substance 

use. 

(c) A program must also address 

pregnant women’s needs for appropriate 

supports for social and emotional wellbeing, nurturing and responsive 

caregiving, and father, partner, or other 

family member engagement during 

pregnancy and early childhood. 

■ 39. Amend § 1302.82 by revising 

paragraph (a) to read as follows: 

§ 1302.82 Family partnership services for 

enrolled pregnant women. 

(a) A program must engage enrolled 

pregnant women and other relevant 

family members, such as fathers, in the 

family partnership services as described 

in § 1302.52 and include a specific focus 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80903 

on factors that influence prenatal and 

postpartum maternal and infant health. 

If a program uses a curriculum in the 

provision of services to pregnant 

women, this should be a maternal 

health curriculum, to support prenatal 

and postpartum education needs. 

* * * * * 

Subpart I—Human Resources 

Management 

■ 40. Amend § 1302.90 by revising 

paragraphs (c)(1)(ii) through (iv) and 

adding paragraphs (c)(1)(vi), (e), and (f) 

to read as follows: 

§ 1302.90 Personnel Policies. 

* * * * * 

(c) * * * 

(1) * * * 

(ii) Ensure staff, consultants, 

contractors, and volunteers do not 

engage in behaviors that would be 

reasonably suspected to negatively 

impact the health, mental health, or 

safety of children, including at a 

minimum: 

(A) Corporal punishment or 

physically abusive behavior, defined as 

intentional use of physical force that 

results in, or has the potential to result 

in, physical injury. Examples include, 

but are not limited to, hitting, kicking, 

shaking, biting, forcibly moving, 

restraining, force feeding, or dragging. 

(B) Sexually abusive behavior, 

defined as any completed or attempted 

sexual act, sexual contact, or 

exploitation. Examples include, but are 

not limited to, behaviors such as 

inappropriate touching, inappropriate 

filming, or exposing a child to other 

sexual activities. 

(C) Emotionally harmful or abusive 

behavior, defined as behaviors that 

harm a child’s self worth or emotional 

well-being or behaviors that are 

insensitive to a child’s developmental 

needs. Examples include, but are not 

limited to, using isolation as discipline, 

using or exposing a child to public or 

private humiliation, or name calling, 

shaming, intimidating, or threatening a 

child. 

(D) Neglectful behavior, defined as the 

failure to meet a child’s basic physical 

and emotional needs including access to 

food, education, medical care, 

appropriate supervision by an adequate 

caregiver, and safe physical and 

emotional environments. Examples 

include, but are not limited to, 

withholding food as punishment or 

refusing to change soiled diapers as 

punishment. 

(iii) Ensure staff, consultants, 

contractors, and volunteers report 

reasonably suspected or known 

incidents of child abuse and neglect, as 

defined by the Federal Child Abuse 

Prevention and Treatment Act (CAPTA) 

(42 U.S.C. 5101 note) and in compliance 

with Federal, State, local, and Tribal 

laws. 

(iv) Ensure staff, consultants, 

contractors, and volunteers respect and 

promote the unique identity of each 

individual and do not stereotype on any 

basis, including gender, race, ethnicity, 

culture, religion, disability, sexual 

orientation, or family composition; 

* * * * * 

(vi) Ensure no child is left alone or 

unsupervised. 

* * * * * 

(e) Wages—(1) Pay scale. (i) By 

August 1, 2031, a program must 

implement a salary scale, salary 

schedule, wage ladder, or other similar 

pay structure for program staff salaries 

that incorporates the requirements in 

paragraphs (e)(2), (3), and (4) of this 

section, reflects salaries or wages for all 

other staff in the program, promotes 

salaries that are comparable to similar 

services in relevant industries in their 

geographic area, and considers, at a 

minimum, responsibilities, 

qualifications, and experience relevant 

to the position, and schedule or hours 

worked. 

(ii) After August 1, 2031, a program 

must review its pay structure at least 

once every 5 years to assess whether it 

continues to meet the expectations 

described in paragraph (e)(1)(i) of this 

section. 

(iii) A program must ensure that staff 

salaries are not in excess of level II of 

the Executive Schedule, as required in 

42 U.S.C. 9848(b)(1). 

(2) Progress to pay parity for 

education staff with elementary school 

staff. (i) A program must make 

measurable progress towards pay parity 

for Head Start teachers with 

kindergarten through third grade 

teachers. By August 1, 2031, a program 

must demonstrate it has made progress 

to parity by ensuring that each Head 

Start teacher receives an annual salary 

that is at least comparable to the annual 

salary paid to preschool teachers in 

public school settings in the program’s 

local school district, adjusted for 

responsibilities, qualifications, and 

experience. A program may provide 

annual salaries comparable to a 

neighboring school district if the 

salaries are higher than a program’s 

local school district. 

(ii) A program must make measurable 

progress towards pay parity for all other 

Head Start education staff who work 

directly with children as part of their 

daily job responsibilities. By August 1, 

2031, a program must demonstrate it has 

made progress to parity by ensuring that 

each staff member described in this 

provision receives an annual salary that 

is at least comparable to the salaries 

described in paragraph (e)(2)(i) of this 

section, adjusted for role, 

responsibilities, qualifications, and 

experience. 

(iii) If there is not a sufficient number 

of comparable preschool teachers in 

school-based settings in the program’s 

local or neighboring school district, a 

program may use an alternative method 

to implement the requirements in 

paragraphs (e)(2)(i) and (ii) of this 

section to determine appropriate 

comparison salaries. The alternative 

method must be approved by ACF. 

(iv) To demonstrate measurable 

progress towards pay parity as described 

in paragraph (e)(2)(i) of this section, a 

program must regularly track data on 

how wages paid to their education staff 

compare to wages paid to preschool 

through third grade teachers in their 

local or neighboring school district. 

(3) Salary floor. By August 1, 2031, a 

program must ensure, at a minimum, 

the wage or salary structure established 

or updated under paragraph (e)(1)(i) of 

this section provides all staff with a 

wage or salary that is generally 

sufficient to cover basic needs such as 

food, housing, utilities, medical costs, 

transportation, and taxes, or would be 

sufficient if the worker’s hourly rate 

were paid according to a full-time, fullyear schedule (or over 2,080 hours per 

year). 

(4) Wage comparability for all ages 

served. A program must ensure the wage 

or salary structure established or 

updated under paragraph (e)(1)(i) of this 

section does not differ by age of 

children served for similar program staff 

positions with similar qualifications and 

experience. 

(f) Staff benefits. (1) For each full-time 

staff member, defined as those working 

30 or more hours per week during the 

program year, a program must: 

(i) Provide or facilitate access to highquality affordable health insurance; 

(ii) Offer the accrual of paid sick leave 

based on hours worked or days of sick 

leave updated annually and the accrual 

at a minimum must meet the standards 

set by State or local laws, if applicable; 

(iii) Offer job-protected periods of 

paid family leave consistent with 

eligibility for and protections in the 

Family and Medical Leave Act (FMLA) 

or, if applicable, the standards set by 

State or local laws; 

(iv) Offer the accrual of paid vacation 

or personal time commensurate with 

experience or tenure, if the program 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80904 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

operates longer than a typical school 

year; and 

(v) Offer access to short-term, free or 

minimal cost behavioral health services 

of approximately three to five outpatient 

visits per year; 

(2) For each part-time staff member, a 

program must facilitate access to highquality, affordable health insurance. 

(3) For each staff member, a program 

must facilitate access to affordable child 

care, including connections to child 

care resource and referral agencies or 

other childcare consumer education 

organizations and, for staff who meet 

eligibility guidelines, facilitate 

enrollment in the child care subsidy 

program. 

(4) For each staff member, a program 

must facilitate access to the Public 

Service Loan Forgiveness (PSLF) 

program, or other applicable student 

loan debt relief programs, including 

timely certification of employment. 

(5) At least once every 5 years, a 

program must assess and determine if 

their benefits package for full-time staff 

is at least comparable to those provided 

to elementary school staff in the 

program’s local or neighboring school 

district. Programs may offer additional 

benefits to staff, including more 

enhanced health benefits, retirement 

savings plans, flexible savings accounts, 

or life, disability, and long-term care 

insurance. 

■ 41. Amend § 1302.91 by revising 

paragraphs (b), (e)(2) and (3), and 

(e)(8)(ii) to read as follows: 

§ 1302.91 Staff qualification and 

competency requirements 

* * * * * 

(b) Head Start director. A program 

must ensure a Head Start director hired 

after November 7, 2016, has, at a 

minimum, a baccalaureate degree and 

experience in supervision of staff, fiscal 

management, and administration. 

* * * * * 

(e) * * * 

(2) Head Start Preschool center-based 

teacher qualification requirements. (i) 

The Secretary must ensure no less than 

fifty percent of all Head Start Preschool 

teachers, nation-wide, have a 

baccalaureate degree in child 

development, early childhood 

education, or equivalent coursework. 

(ii) As prescribed in section 

648A(a)(3)(B) 27 of the Act, a program 

must ensure all center-based teachers 

have at least an associate’s or bachelor’s 

degree in child development or early 

childhood education, equivalent 

coursework, or otherwise meet the 

requirements of section 648A(a)(3)(B) of 

the Act. 

(3) Head Start Preschool assistant 

teacher qualification requirements. As 

prescribed in section 648A(a)(2)(B)(ii) of 

the Act, a program must ensure Head 

Start Preschool assistant teachers, at a 

minimum, have a CDA credential or a 

State-awarded certificate that meets or 

exceeds the requirements for a CDA 

credential, are enrolled in a program 

that will lead to an associate or 

baccalaureate degree or, are enrolled in 

a CDA credential program to be 

completed within two years of the time 

of hire. 

* * * * * 

(8) * * * 

(ii) A program must ensure all mental 

health consultants are licensed or under 

the supervision of a licensed mental 

health professional. A program must use 

mental health consultants with 

knowledge of and experience in serving 

young children and their families. 

* * * * * 

■ 42. Amend § 1302.92 by revising 

paragraph (b) to read as follows: 

§ 1302.92 Training and professional 

development. 

* * * * * 

(b) A program must establish and 

implement a systematic approach to 

staff training and professional 

development designed to assist staff in 

acquiring or increasing the knowledge 

and skills needed to provide highquality, comprehensive services within 

the scope of their job responsibilities, 

and attached to academic credit as 

appropriate, and integrated with 

employee engagement practices in 

accordance with § 1302.101(a)(2). At a 

minimum, the system must include: 

(1) Staff completing a minimum of 15 

clock hours of professional development 

per year. For teaching staff, such 

professional development must meet the 

requirements described in section 

648A(a)(5) of the Act, and includes 

creating individual professional 

development plans as described in 

section 648A(f) of the Act. 

(2) Annual training on mandatory 

reporting of suspected or known child 

abuse and neglect, that complies with 

applicable Federal, State, local, and 

Tribal laws; 

(3) Annual training on positive 

strategies to understand and support 

children’s social and emotional 

development, including the 

implementation of tools for preventing 

and managing challenging behavior; 

(4) Training for child and family 

services staff on best practices for 

implementing family engagement 

strategies in a systemic way, as 

described throughout this part; 

(5) Training for child and family 

services staff, including staff that work 

on family services, health, and 

disabilities, that builds their knowledge, 

experience, and competencies to 

improve child and family outcomes; 

and, 

(6) Research-based approaches to 

professional development for education 

staff, that are focused on effective 

curricula implementation, knowledge of 

the content in Head Start Early Learning 

Outcomes Framework: Ages Birth to 

Five, partnering with families, 

supporting children with disabilities 

and their families, providing effective 

and nurturing adult-child interactions, 

supporting dual language learners as 

appropriate, addressing challenging 

behaviors, preparing children and 

families for transitions (as described in 

subpart G of this part), and use of data 

to individualize learning experiences to 

improve outcomes for all children. 

* * * * * 

■ 43. Amend § 1302.93 by adding 

paragraphs (c) through (e) to read as 

follows: 

§ 1302.93 Staff Health and Wellness. 

* * * * * 

(c)(1) A program must provide: 

(i) For each staff member working a 

shift lasting between four and six hours, 

a minimum of one 15-minute break per 

shift; and 

(ii) For each staff member working a 

shift lasting six hours or more, a 

minimum of one 30-minute break per 

shift. 

(2) If applicable State laws or 

regulations have more stringent 

requirements for breaks, a program 

should comply with the more stringent 

requirements. 

(3) During break times for classroom 

staff described in paragraph (c)(1) of this 

section, one teaching staff member may 

be replaced by one staff member who 

does not meet the teaching 

qualifications required for the age, 

provided that this staff member has the 

necessary training and experience to 

ensure safety of children and minimal 

disruption to the quality of services. 

(4) A program must design and 

implement a systematic approach to 

ensure each staff member that works 

directly with children as part of their 

regular job responsibilities can have 

access to brief unscheduled wellness 

breaks of about 5 minutes as needed 

while ensuring child safety. 

(d) A program must ensure staff have 

access to adult size furniture in 

classrooms. 

(e) A program should cultivate a 

program-wide culture of wellness that 

empowers staff as professionals and 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80905 

supports staff to effectively accomplish 

their job responsibilities in a highquality manner, in line with the 

requirement at § 1302.101(a)(2). 

■ 44. Amend § 1302.94 by revising 

paragraph (a) to read as follows: 

§ 1302.94 Volunteers. 

(a) A program must ensure volunteers 

have been screened for appropriate 

communicable diseases in accordance 

with State, Tribal or local laws. In the 

absence of State, Tribal, or local law, the 

Health and Mental Health Services 

Advisory Committee must be consulted 

regarding the need for such screenings. 

* * * * * 

Subpart J—Program Management and 

Quality Improvement 

■ 45. Amend § 1302.101 by revising 

paragraph (a)(2) and adding paragraph 

(a)(5) to read as follows: 

§ 1302.101 Management System. 

(a) * * * 

(2) Promotes clear and reasonable 

roles and responsibilities for all staff 

and provides regular and ongoing staff 

supervision with meaningful and 

effective employee engagement 

practices. 

* * * * * 

(5) Ensures that all staff are trained to 

implement reporting procedures in 

§ 1302.102(d)(1)(ii). 

* * * * * 

■ 46. Amend § 1302.102 by revising the 

section heading and paragraph (d)(1)(ii) 

and adding paragraph (d)(1)(iii) to read 

as follows: 

§ 1302.102 Program Goals, Continuous 

Improvement, and Reporting. 

* * * * * 

(d) * * * 

(1) * * * 

(ii) Reports, as appropriate, to the 

responsible HHS official immediately or 

no later than 3 business days following 

the incident, related to: 

(A) Any significant incident that 

affects the health, mental health, or 

safety of a child that occurs in a setting 

where Head Start services are provided 

and that involves: 

(1) A staff member, contractor, 

volunteer, or other adult that 

participates in either a Head Start 

program or a classroom at least partially 

funded by Head Start, regardless of 

whether the child receives Head Start 

services; or 

(2) A child that receives services fully 

or partially funded by Head Start or a 

child that participates in a classroom at 

least partially funded by Head Start; or 

(B) Circumstances affecting the 

financial viability of the program; 

breaches of personally identifiable 

information, or program involvement in 

legal proceedings; any matter for which 

notification or a report to State, Tribal, 

or local authorities is required by 

applicable law. 

(iii) Reportable incidents under 

paragraph (d)(1)(ii) of this section 

include at a minimum: 

(A) Any mandated reports regarding 

agency staff or volunteer compliance 

with Federal, State, Tribal, or local laws 

addressing child abuse and neglect or 

laws governing sex offenders; 

(B) Incidents that require classrooms 

or centers to be closed, except for 

circumstances such as natural disasters 

that interfere with program operations; 

(C) Legal proceedings by any party 

that are directly related to program 

operations; and, 

(D) All conditions required to be 

reported under § 1304.12 of this chapter, 

including disqualification from the 

Child and Adult Care Food Program 

(CACFP) and license revocation. 

(E) Any suspected or known 

violations of Standards of Conduct 

under § 1302.90(c)(1)(ii); 

(F) Significant health or safety 

incidents related to suspected or known 

lack of supervision or lack of 

preventative maintenance; and, 

(G) Any unauthorized release of a 

child. 

* * * * * 

§ 1302.103 [Removed] 

■ 47. Remove § 1302.103. 

PART 1303—FINANCIAL AND 

ADMINISTRATIVE REQUIREMENTS 

■ 48. The authority for part 1303 

continues to read as follows: 

Authority: 42 U.S.C. 9801 et seq. 

Subpart D—Delegation of Program 

Operations 

■ 49. Revise § 1303.30 to read as 

follows: 

§ 1303.30 Grant recipient responsibility 

and accountability. 

A grant recipient is accountable for 

the services its delegate agencies 

provide. The grant recipient supports, 

oversees and ensures delegate agencies 

provide high-quality services to 

children and families and meet all 

applicable Head Start requirements. The 

grant recipient can only terminate a 

delegate agency if the grant recipient 

shows cause why termination is 

necessary and provides a process for 

delegate agencies to appeal termination 

decisions. The grant recipient retains 

legal responsibility and authority and 

bears financial accountability for the 

program when services are provided by 

delegate agencies. 

Subpart E—Facilities 

■ 50. Amend § 1303.44 by revising 

paragraph (a)(7) to read as follows: 

§ 1303.44 Applications to purchase, 

construct, and renovate facilities. 

(a) * * * 

(7) An estimate by a licensed 

independent certified appraiser of the 

facility’s cost value after proposed 

purchase and associated repairs and 

renovations, construction, or major 

renovation is completed is required for 

all facilities activities except for major 

renovations to leased property; 

* * * * * 

■ 51. Amend § 1303.48 by revising the 

section heading to read as follows: 

§ 1303 Grant recipient limitations on 

Federal interest. 

* * * * * 

Subpart F—Transportation 

■ 52. Amend § 1303.70 by revising 

paragraph (c)(1) introductory text to 

read as follows: 

§ 1303.70 Purpose. 

* * * * * 

(c) * * * 

(1) A program that provides 

transportation services must comply 

with all provisions in this subpart. A 

Head Start Preschool program may 

request to waive a specific requirement 

in this part, in writing, to the 

responsible HHS official, as part of an 

agency’s annual application for 

financial assistance or amendment and 

must submit any required 

documentation the responsible HHS 

official deems necessary to support the 

waiver. The responsible HHS official is 

not authorized to waive any 

requirements with regard to children 

enrolled in an Early Head Start program. 

A program may request a waiver when: 

* * * * * 

■ 53. Amend § 1303.75 by revising 

paragraph (a) to read as follows: 

§ 1303.75 Children with disabilities. 

(a) A program must ensure there are 

school buses or allowable alternate 

vehicles adapted or designed for 

transportation of children with 

disabilities available as necessary to 

transport such children enrolled in the 

program. This requirement does not 

apply to the transportation of children 

receiving home-based services unless 

school buses or allowable alternate 

vehicles are used to transport the other 

children served under the home-based 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80906 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

option by the grant recipient. Whenever 

possible, children with disabilities must 

be transported in the same vehicles used 

to transport other children enrolled in 

the Head Start program. 

* * * * * 

PART 1303—[AMENDED] 

■ 54. Further amend part 1303 by: 

■ a. Removing the word ‘‘grantee’’ and 

adding the words ‘‘grant recipient’’ in 

its place wherever it appears; 

■ b. Removing the word ‘‘grantees’’ and 

adding the words ‘‘grant recipients’’ in 

its place wherever it appears; and 

■ c. Removing the word ‘‘grantee’s’’ and 

adding the words ‘‘grant recipient’s’’ in 

its place wherever it appears. 

PART 1304—FEDERAL 

ADMINISTRATIVE PROCEDURES 

■ 55. The authority for part 1304 

continues to read as follows: 

Authority: 42 U.S.C. 9801 et seq. 

Subpart A—Monitoring, Suspension, 

Termination, Denial of Refunding, 

Reduction in Funding, and Their 

Appeals 

§ 1304.5 [Amended] 

■ 56. Amend § 1304.5 by removing the 

word ‘‘Grantee’s’’ and adding in its 

place the words ‘‘Grant recipient’s’’ in 

the paragraph (c) heading and removing 

the word ‘‘grantees’’ and adding in its 

place the words ‘‘grant recipients’’ 

paragraph (c)(1) and the paragraph (e) 

heading. 

§ 1304.6 [Amended] 

■ 57. Amend § 1304.6 by removing the 

word ‘‘grantees’’ and adding in its place 

the words ‘‘grant recipients’’ in the 

paragraph (c) heading. 

Subpart B—Designation Renewal 

■ 58. Revise § 1304.10 to read as 

follows: 

§ 1304.10 Purpose and scope. 

The purpose of this subpart is to set 

forth policies and procedures for the 

designation renewal of Head Start 

programs. It is intended that these 

programs be administered effectively 

and responsibly; that applicants to 

administer programs receive fair and 

equitable consideration; and that the 

legal rights of current Head Start grant 

recipients be fully protected. The 

Designation Renewal System is 

established in this part to determine 

whether Head Start agencies deliver 

high-quality services to meet the 

educational, health, nutritional, and 

social needs of the children and families 

they serve; meet the program and 

financial requirements and standards 

described in section 641A(a)(1) of the 

Head Start Act; and qualify to be 

designated for funding for five years 

without competing for such funding as 

required under section 641(c) or 

645A(b)(12) and (d) of the Head Start 

Act. A competition to select a new Head 

Start agency to replace a Head Start 

agency that has been terminated 

voluntarily or involuntarily is not part 

of the Designation Renewal System 

established in this part, and is subject 

instead to the requirements of § 1304.20. 

■ 59. Amend § 1304.11 by revising the 

introductory text and paragraphs (d) and 

(e) to read as follows: 

§ 1304.11 Basis for determining whether a 

Head Start agency will be subject to an 

open competition. 

A Head Start agency will be required 

to compete for its next five years of 

funding whenever the responsible HHS 

official determines that one or more of 

the following seven conditions existed 

during the relevant time period under 

§ 1304.15: 

* * * * * 

(d) An agency has had a revocation of 

its license to operate a Head Start center 

or program by a State or local licensing 

agency during the relevant time period 

under § 1304.15, and the revocation has 

not been overturned or withdrawn 

before a competition for funding for the 

next five-year period is announced. A 

pending challenge to the license 

revocation or restoration of the license 

after correction of the violation will not 

affect application of this requirement 

after the competition for funding for the 

next five-year period has been 

announced. 

(e) An agency has been suspended 

from the Head Start program by ACF 

during the relevant time period covered 

by the responsible HHS official’s review 

under § 1304.15 and the suspension has 

not been overturned or withdrawn. If 

the agency did not have an opportunity 

to show cause as to why the suspension 

should not have been imposed or why 

the suspension should have been lifted 

if it had already been imposed under 

this part, the agency will not be required 

to compete based on this condition. If 

an agency has received an opportunity 

to show cause and the suspension 

remains in place, the condition will be 

implemented. 

* * * * * 

■ 60. Amend § 1304.12 by revising the 

section heading to read as follows: 

§ 1304.12 Grant recipient reporting 

requirements concerning certain 

conditions. 

* * * * * 

■ 61. Revise § 1304.13 to read as 

follows: 

§ 1304.13 Requirements to be considered 

for designation for a five-year period when 

the existing grant recipient in a community 

is not determined to be delivering a highquality and comprehensive Head Start 

program and is not automatically renewed. 

In order to compete for the 

opportunity to be awarded a five-year 

grant, an agency must submit an 

application to the responsible HHS 

official that demonstrates that it is the 

most qualified entity to deliver a highquality and comprehensive Head Start 

program. The application must address 

the criteria for selection listed at section 

641(d)(2)58 of the Act for Head Start. 

Any agency that has had its Head Start 

grant terminated for cause in the 

preceding five years is excluded from 

competing in such competition for the 

next five years. A Head Start agency that 

has had a denial of refunding, as 

defined in 45 CFR part 1305, in the 

preceding five years is also excluded 

from competing. 

■ 62. Amend § 1304.14 by revising 

paragraphs (a) introductory text, (a)(2) 

and (3), (b), and (c) to read as follows: 

§ 1304.14 Tribal government consultation 

under the Designation Renewal System for 

when an Indian Head Start grant is being 

considered for competition. 

(a) In the case of an Indian Head Start 

agency determined not to be delivering 

a high-quality and comprehensive Head 

Start program, the responsible HHS 

official will engage in government-togovernment consultation with the 

appropriate Tribal government or 

governments for the purpose of 

establishing a plan to improve the 

quality of the Head Start program 

operated by the Indian Head Start 

agency. 

* * * * * 

(2) Not more than six months after the 

implementation of that plan, the 

responsible HHS official will reevaluate 

the performance of the Indian Head 

Start agency. 

(3) If the Indian Head Start agency is 

still not delivering a high-quality and 

comprehensive Head Start program, the 

responsible HHS official will conduct 

an open competition to select a grant 

recipient to provide services for the 

community currently being served by 

the Indian Head Start agency. 

(b) A non-Indian Head Start agency 

will not be eligible to receive a grant to 

carry out an Indian Head Start program, 

unless there is no Indian Head Start 

agency available for designation to carry 

out an Indian Head Start program. 

(c) A non-Indian Head Start agency 

may receive a grant to carry out an 


ddrumheller on DSK120RN23PROD with PROPOSALS2
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 80907 

Indian Head Start program only until 

such time as an Indian Head Start 

agency in such community becomes 

available and is designated pursuant to 

this part. 

■ 63. Amend § 1304.15 by revising 

paragraphs (a), (b), (c) introductory text, 

and (c)(1) to read as follows: 

§ 1304.15 Designation request, review and 

notification process. 

(a) A grant recipient must apply to be 

considered for Designation Renewal. A 

Head Start agency wishing to be 

considered to have its designation as a 

Head Start agency renewed for another 

five-year period without competition 

must request that status from ACF at 

least 12 months before the end of their 

five-year grant period or by such time as 

required by the Secretary. 

(b) ACF will review the relevant data 

to determine if one or more of the 

conditions under § 1304.11 were met by 

the Head Start agency during the current 

project period. 

(c) ACF will give notice to grant 

recipients on Designation Renewal 

System status, except as provided in 

§ 1304.14, at least 12 months before the 

expiration date of a Head Start agency’s 

current grant, stating: 

(1) The Head Start agency will be 

required to compete for funding for an 

additional five-year period because ACF 

finds that one or more conditions under 

§ 1304.11 were met by the agency’s 

program during the relevant time period 

described in paragraph (b) of this 

section, identifying the conditions ACF 

found, and summarizing the basis for 

the finding; or 

* * * * * 

Subpart C—Selection of Grant 

Recipients through Competition 

■ 64. Revise the heading for subpart C 

to read as set forth above. 

■ 65. Amend § 1304.20 by revising 

paragraph (a) to read as follows: 

§ 1304.20 Selection among applicants. 

(a) In selecting an agency to be 

designated to provide Head Start 

Preschool, Early Head Start, Migrant or 

Seasonal Head Start or Tribal Head Start 

Preschool or Early Head Start services, 

the responsible HHS official will 

consider the applicable criteria at 

section 641(d) of the Head Start Act and 

any other criteria outlined in the 

funding opportunity announcement. 

* * * * * 

Subpart D—Replacement of American 

Indian and Alaska Native Grant 

Recipients 

■ 66. Revise the heading for subpart D 

to read as set forth above. 

PART 1304—[AMENDED] 

■ 67. Further amend part 1304 by: 

■ a. Removing the word ‘‘grantee’’ and 

adding the words ‘‘grant recipient’’ in 

its place wherever it appears; and 

■ b. Removing the word ‘‘grantees’’ and 

adding the words ‘‘grant recipients’’ in 

its place wherever it appears; and 

PART 1305—DEFINITIONS 

■ 68. The authority for part 1305 

continues to read as follows: 

Authority: 42 U.S.C. 9801 et seq. 

■ 69. Amend § 1305.2 by: 

■ a. Adding in alphabetical order 

definitions for ‘‘Abatement’’ and 

‘‘Change to the water profile’’; 

■ b. Revising the definition of 

‘‘Continuity of care’’; 

■ c. Removing the word ‘‘grantee’’ and 

adding in its place the words ‘‘grant 

recipient’’ in the definition of ‘‘Denial of 

Refunding’’; 

■ d. Adding in alphabetical order a 

definition for ‘‘Early Head Start’’; 

■ e. Removing the definition of ‘‘Early 

Head Start agency’’; 

■ f. Adding in alphabetical order a 

definition for ‘‘Expulsion’’; 

■ g. Revising the definitions of ‘‘Federal 

interest’’, ‘‘Fixed route’’, and ‘‘Fullworking-day’’; 

■ h. Removing the word ‘‘grantee’’ and 

adding in its place the words ‘‘grant 

recipient’’ in the definition of ‘‘Funded 

enrollment’’; 

■ i. Removing the definition of 

‘‘Grantee’’; 

■ j. Adding in alphabetical order 

definitions for ‘‘Grant recipient’’ and 

‘‘Head Start’’; 

■ k. Revising the definition of ‘‘Head 

Start agency’’; 

■ l. Adding in alphabetical order 

definitions for ‘‘Head Start Preschool’’ 

and ‘‘Housing expenses’’; 

■ m. Revising the definitions of 

‘‘Income’’, 

■ n. Removing the word ‘‘grantee’’ and 

adding in its place the words ‘‘grant 

recipient’’ in the definition of ‘‘Legal 

status’’; 

■ o. Revising the definitions of ‘‘Major 

renovation’’ and ‘‘Migrant family’’; 

■ p. Removing the word ‘‘grantee’’ and 

adding in its place the words ‘‘grant 

recipient’’ in the definition of ‘‘Modular 

unit’’; 

■ q. Revising the definition of 

‘‘Participant’’; 

■ r. Adding in alphabetical order a 

definition for ‘‘Poverty line’’; 

■ s. Revising the definitions of 

‘‘Program’’ and ‘‘Purchase’’; 

■ t. Removing the word ‘‘grantee’’ and 

adding in its place the words ‘‘grant 

recipient’’ in the definition of ‘‘Service 

area’’; 

■ u. Adding in alphabetical order a 

definition for ‘‘Suspension’’; 

■ v. Removing the word ‘‘grantee’s’’ and 

adding in its place the words ‘‘grant 

recipient’s’’ in the introductory text and 

paragraph (1) of the definition of 

‘‘Termination of a grant or delegate 

agency agreement’’ and removing the 

word ‘‘grantee’’ and adding in its place 

the words ‘‘grant recipient’’ in 

introductory text of the definition of 

‘‘Termination of a great or delegate 

agency agreement’’; 

■ w. Removing the definition of 

‘‘Transition period’’; 

■ x. Revising the definition of 

‘‘Transportation services’’; and 

■ y. Adding in alphabetical order a 

definition for ‘‘Water fixtures used for 

human consumption’’. 

The additions and revisions read as 

follows: 

§ 1305.2 Terms. 

Abatement means actions designed to 

eliminate lead-based paint or lead-based 

paint hazards. Abatement can include 

the: 

(1) Removal of lead-based paint and 

dust-lead hazards, the enclosure or 

encapsulation of lead-based paint, the 

replacement of components or fixtures 

painted with lead-based paint, and the 

removal or permanent covering of soillead hazards; and 

(2) Preparation, cleanup, disposal, 

and post-abatement testing to determine 

the effectiveness of such measures. 

* * * * * 

Change to the water profile means 

change in source of water, water 

plumbing, or water fixture. 

* * * * * 

Continuity of care means Head Start 

services provided to children in a 

manner that promotes primary 

caregiving and minimizes the number of 

transitions in teachers and teacher 

assistants that children experience over 

the course of the day, week, program 

year, and to the extent possible, during 

the course of their participation from 

birth to age three in Early Head Start 

and in Head Start Preschool. 

* * * * * 

Early Head Start means a program 

that serves pregnant women and 

children from birth to age three, 

pursuant to section 645A(e) of the Head 

Start Act. This includes Tribal and 

migrant or seasonal programs. 


ddrumheller on DSK120RN23PROD with PROPOSALS2
80908 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Proposed Rules 

Expulsion is the permanent removal 

of a child from the learning setting or a 

requirement that a child unenroll in a 

program. 

* * * * * 

Federal interest is a property right 

which secures the right of the Federal 

awarding agency to recover the current 

fair market value of its percentage of 

participation in the cost of the facility 

subject to part 1303, subpart E of this 

chapter funding in the event the facility 

is no longer used for Head Start 

purposes by the grant recipient or upon 

the disposition of the property. When a 

grant recipient uses Head Start funds to 

purchase, construct or make major 

renovations to a facility, or make 

mortgage payments, it creates a Federal 

interest. The Federal interest includes 

any portion of the cost of purchase, 

construction, or major renovation 

contributed by or for the entity, or a 

related donor organization, to satisfy a 

matching requirement. 

* * * * * 

Fixed route means the established 

routes to be traveled on a regular basis 

by vehicles that transport children to 

and from Head Start program activities, 

and which include specifically 

designated stops where children board 

or exit the vehicle. 

* * * * * 

Full-working-day means not less than 

10 hours of Head Start services per day. 

* * * * * 

Grant recipient means the local public 

or private non-profit agency or for-profit 

agency which has been designated as a 

Head Start agency under 42 U.S.C. 9836 

and which has been granted financial 

assistance by the responsible HHS 

official to operate a Head Start program. 

Head Start means any program 

authorized under the Head Start Act. 

Head Start agency means a local 

public or private non-profit or for-profit 

entity designated by ACF to operate a 

Head Start Preschool program, an Early 

Head Start program, or Migrant or 

Seasonal Head Start program pursuant 

to the Head Start Act. 

* * * * * 

Head Start Preschool means a 

program that serves children aged three 

to compulsory school age, pursuant to 

section 641(b) and (d) of the Head Start 

Act. This includes Tribal and migrant or 

seasonal programs. 

* * * * * 

Housing expenses means the total 

annual expenses spent by the family on 

rent or mortgage payments, 

homeowner’s or renter’s insurance, 

utilities, interest, and taxes on the 

home. Utilities include electricity, gas, 

water, sewer, and trash. 

Income means gross income and only 

includes wages, business income, 

veteran’s benefits, Social Security 

benefits, unemployment compensation, 

alimony, pension or annuity payments, 

gifts that exceed the threshold for 

taxable income, and military income 

(excluding special pay for a member 

subject to hostile fire or imminent 

danger under 37 U.S.C. 310 or any basic 

allowance for housing under 37 U.S.C. 

403 including housing acquired under 

the alternative authority under 10 U.S.C. 

169 or any related provision of law). 

Gross income only includes sources of 

income provided in this definition; it 

does not include refundable tax credits 

nor any forms of public assistance. 

* * * * * 

Major renovation means any 

individual or collective group of 

renovation activities related to the same 

facility that has a cost equal to or 

exceeding $250,000 in Head Start funds. 

Renovation activities that are intended 

to occur concurrently or consecutively, 

or altogether address a specific part or 

feature of a facility, are considered a 

collective group of renovation activities. 

Unless included in a purchase 

application, minor renovations and 

repairs are excluded from major 

renovations. 

Migrant family means, for purposes of 

Head Start eligibility, a family with 

children under the age of compulsory 

school attendance who changed their 

residence by moving from one 

geographic location to another, either 

intrastate or interstate, within the 

preceding two years for the purpose of 

engaging in agricultural work. 

* * * * * 

Participant means a pregnant woman 

or child who is enrolled in and receives 

services from a Head Start Preschool, an 

Early Head Start, a Migrant or Seasonal 

Head Start, or an American Indian and 

Alaska Native Head Start program. 

* * * * * 

Poverty line is set by the poverty 

guidelines updated periodically in the 

Federal Register by the U.S. Department 

of Health and Human Services under 

the authority of 42 U.S.C. 9902(2). 

Poverty guidelines for the contiguousstates-and-DC apply to Puerto Rico and 

U.S. Territories. 

Program means any funded Head 

Start Preschool, Early Head Start, 

Migrant or Seasonal Head Start, Tribal, 

or other program authorized under the 

Act and carried out by an agency, or 

delegate agency, to provide ongoing 

comprehensive child development 

services. 

* * * * * 

Purchase means to buy an existing 

facility, including outright purchase, 

down payment or through payments 

made in satisfaction of a mortgage or 

other loan agreement, whether 

principal, interest or an allocated 

portion principal and/or interest. The 

use of grant funds to make a payment 

under a finance lease agreement, as 

defined in the cost principles, is a 

purchase subject to these provisions. 

Purchase also refers to an approved use 

of Head Start funds to continue paying 

the cost of purchasing facilities or 

refinance an existing loan or mortgage 

beginning in 1987. 

* * * * * 

Suspension is the temporary removal 

of a child from the learning setting 

including all reductions in the amount 

of time a child may be in attendance of 

the regular group setting, either by 

requiring the child to cease attendance 

for a particular period of time or 

reducing the number of days or amount 

of time that a child may attend. 

Requiring a child to attend the program 

away from the other children in the 

regular group setting is included in this 

definition. Requiring the parent or the 

parent’s designee to pick up a child for 

reasons other than illness or injury is 

also included in this definition. 

* * * * * 

Transportation services means the 

planned transporting of children to and 

from sites where an agency provides 

services funded under the Head Start 

Act. Transportation services can involve 

the pick-up and discharge of children at 

regularly scheduled times and prearranged sites, including trips between 

children’s homes and program settings. 

The term includes services provided 

directly by the Head Start grant 

recipient or delegate agency and 

services which such agencies arrange to 

be provided by another organization or 

an individual. Incidental trips, such as 

transporting a sick child home before 

the end of the day, or such as might be 

required to transport small groups of 

children to and from necessary services, 

are not included under the term. 

* * * * * 

Water fixtures used for human 

consumption means fixtures used for 

drinking, cooking, hand washing, teeth 

brushing, food preparation, 

dishwashing, and maintaining oral 

hygiene. 

[FR Doc. 2023–25038 Filed 11–15–23; 4:15 pm] 

BILLING CODE 4184–40–P 


ddrumheller on DSK120RN23PROD with PROPOSALS2