122 
‘‘(1) ensure an equitable national geographic 
distribution of the grants; and 
‘‘(2) award grants to applicants proposing to 
serve communities in rural areas and to applicants 
proposing to serve communities in urban areas. 
‘‘(g) MONITORING, TRAINING, TECHNICAL ASSIST-
ANCE, AND EVALUATION.— 
‘‘(1) REQUIREMENT.—To ensure the successful 
operation of programs assisted under this section, 
the Secretary shall use funds from the portion speci-
fied in section 640(a)(6) to monitor the operation of 
such programs, evaluate their effectiveness, and pro-
vide training and technical assistance tailored to the 
particular needs of such programs. 
‘‘(2) TRAINING
AND
TECHNICAL
ASSISTANCE 
ACCOUNT.— 
‘‘(A) IN GENERAL.—Of the amount made 
available to carry out this section for any fiscal 
year, not less than 5 percent and not more than 
10 percent shall be reserved to fund a training 
and technical assistance account. 
‘‘(B) ACTIVITIES.—Funds in the account 
may be used by the Secretary for purposes in-
cluding— 
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‘‘(i) making grants to, and entering 
into contracts with, organizations with spe-
cialized expertise relating to infants, tod-
dlers, and families and the capacity needed 
to provide direction and support to a na-
tional training and technical assistance 
system, in order to provide such direction 
and support; 
‘‘(ii) providing ongoing training and 
technical assistance for regional and pro-
gram staff charged with monitoring and 
overseeing the administration of the pro-
gram carried out under this section; 
‘‘(iii) providing ongoing training and 
technical assistance for existing recipients 
(as of the date of such training or assist-
ance) of grants under subsection (a) and 
support and program planning and imple-
mentation assistance for new recipients of 
such grants; 
‘‘(iv) providing professional develop-
ment and personnel enhancement activi-
ties, including the provision of funds to re-
cipients of grants under subsection (a) for 
the recruitment and retention of qualified 
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staff with an appropriate level of education 
and experience; and 
‘‘(v) providing professional develop-
ment designed to increase program partici-
pation for underserved populations of eligi-
ble children. 
‘‘(h) CENTER-BASED STAFF.—The Secretary shall 
ensure that, not later than September 30, 2009, all teach-
ers providing direct services to children and families par-
ticipating in early Head Start programs located in early 
Head Start centers have a minimum of a child develop-
ment associate credential, and have been trained (or have 
equivalent course work) in early childhood development’’. 
SEC. 14. PARENTAL CONSENT REQUIREMENT FOR HEALTH 
CARE SERVICES. 
The Head Start Act (42 U.S.C. 9831) is amended 
by inserting after section 645A the following: 
‘‘SEC. 645B. PARENTAL CONSENT REQUIREMENT FOR 
HEALTH CARE SERVICES. 
‘‘(a) DEFINITIONS.—For purposes of this section: 
‘‘(1) The term ‘health care service’ includes— 
‘‘(A) any nonemergency intrusive physical 
examination; and 
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‘‘(B) any screening, including but not lim-
ited to, a medical, dental, developmental, men-
tal health, social, or behavioral screening. 
‘‘(2) The term ‘nonemergency intrusive physical 
examination’ means, with respect to a child, a phys-
ical examination that— 
‘‘(A) is not immediately necessary to pro-
tect the health or safety of such child, or the 
health or safety of another individual; and 
‘‘(B) includes incision or is otherwise 
invasive, or includes exposure of private body 
parts. 
‘‘(b) REQUIREMENT.—Before administering any 
health care service to a child (or referring a child to obtain 
such service) in connection with participation in a program 
under this subchapter, a Head Start agency and an entity 
that receives assistance under section 645A shall obtain 
the written consent of a parent of such child indicating 
consent for each specific health care service to be per-
formed. 
‘‘(c) RULE OF CONSTRUCTION.— 
‘‘(1) Nothing in this section shall be construed 
to prohibit a Head Start agency or an entity that re-
ceives assistance under section 645A from using es-
tablished methods for handling cases of suspected or 
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known child abuse and neglect, that are in compli-
ance with applicable Federal, State, or tribal law. 
‘‘(2) Nothing in this subchapter shall be con-
strued to permit a Head Start agency, an entity that 
receives assistance under section 645A, or the per-
sonnel of such agency or entity to administer any 
health care service to a child (or to refer a child to 
obtain such service) without the informed written 
consent of a parent of such child indicating consent 
for each specific health care service to be performed. 
‘‘(3) Nothing in this section shall be construed 
to require a Head Start agency or an entity that re-
ceives assistance under section 645A to provide sep-
arate consent forms for each specific health care 
service.’’. 
SEC. 15. APPEALS, NOTICE, AND HEARING. 
Section 646(a)(3) of the of the Head Start Act (42 
U.S.C. 9841(a)(3)) is amended to read as follows: 
‘‘(3) if financial assistance under this sub-
chapter is terminated or reduced, an application for 
a noncompeting continuation award is denied based 
on a previous failure to comply with terms applicable 
to financial assistance previously provided under this 
subchapter, or suspension of financial assistance is 
continued for more than 30 days, the recipient with 
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respect to whom such action is taken shall have the 
opportunity to appeal such action in accordance with 
such procedures, except that no funds made avail-
able under this subchapter may be used to reimburse 
any such recipient for legal fees and other costs in-
curred in pursuing such an appeal.’’. 
SEC. 16. RECORDS AND AUDITS. 
Section 647 of the Head Start Act (42 U.S.C. 9842) 
by adding at the end the following: 
‘‘(d) Each recipient of financial assistance under this 
subchapter shall— 
‘‘(1) maintain, and annually submit to the Sec-
retary, a complete accounting of its administrative 
expenses (including a detailed statement identifying 
the amount of financial assistance provided under 
this subchapter used to pay expenses for salaries 
and compensation and the amount (if any) of other 
funds used to pay such expenses); 
‘‘(2) within 30 days after the completion of an 
audit conducted in the manner and to the extent 
provided in chapter 75 of title 31, United States 
Code (commonly known as the ‘Single Audit Act 
Amendments of 1996’), submit to the Secretary a 
copy of the audit management letter and of any 
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audit findings as it relates to the Head Start pro-
gram; and 
‘‘(3) provide such additional documentation as 
the Secretary may require.’’. 
SEC. 17. TECHNICAL ASSISTANCE AND TRAINING. 
Section 648 of the of the Head Start Act (42 U.S.C. 
9843) is amended to read as follows: 
‘‘SEC. 648. TECHNICAL ASSISTANCE AND TRAINING. 
‘‘(a) The Secretary shall provide, directly or through 
grants or other arrangements— 
‘‘(1) technical assistance to communities in de-
veloping, conducting, and administering programs 
under this subchapter; and 
‘‘(2) training for specialized or other personnel 
needed in connection with Head Start programs, in 
accordance with the process, and the provisions for 
allocating resources, set forth in subsections (b) and 
(c). 
‘‘(b) The process for determining the technical assist-
ance and training activities to be carried out under this 
section shall— 
‘‘(1) ensure that the needs of local Head Start 
agencies and programs relating to improving pro-
gram quality and to program expansion are ad-
dressed to the maximum extent feasible; 
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