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‘‘(f) FACILITIES.— 
‘‘(1) The Secretary shall establish uniform pro-
cedures for Head Start agencies to request approval 
to purchase facilities, or to request approval of the 
purchase (after December 31, 1986) of facilities, to 
be used to carry out Head Start programs. The Sec-
retary shall suspend any proceedings pending 
against any Head Start agency to claim costs in-
curred in purchasing such facilities until the agency 
has been afforded an opportunity to apply for ap-
proval of the purchase and the Secretary has deter-
mined whether the purchase will be approved. The 
Secretary shall not be required to repay claims pre-
viously satisfied by Head Start agencies for costs in-
curred in the purchase of such facilities. 
‘‘(2) Financial assistance provided under this 
subchapter may not be used by a Head Start agency 
to purchase a facility (including paying the cost of 
amortizing the principal and paying interest on 
loans) to be used to carry out a Head Start program 
unless the Secretary approves a request that is sub-
mitted by such agency and contains— 
‘‘(A) a description of the consultation con-
ducted by the Head Start agency with the pro-
viders in the community demonstrating capacity 
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HR 1429 PCS
and capability to provide services under this 
subchapter, and of the potential for collabora-
tion with such providers and the cost effective-
ness of such collaboration as opposed to the 
cost effectiveness of the purchase of a facility; 
‘‘(B) a description of the site of the facility 
proposed to be purchased or that was previously 
purchased; 
‘‘(C) the plans and specifications of such 
facility; 
‘‘(D) information demonstrating that— 
‘‘(i) the proposed purchase will result, 
or the previous purchase has resulted, in 
savings when compared to the costs that 
would be incurred to acquire the use of an 
alternative facility to carry out such pro-
gram; or 
‘‘(ii) the lack of alternative facilities 
will prevent, or would have prevented, the 
operation of such program; 
‘‘(E) in the case of a request regarding a 
previously purchased facility, information dem-
onstrating that the facility will be used prin-
cipally as a Head Start center, or a direct sup-
port facility for a Head Start program; and 
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HR 1429 PCS
‘‘(F) such other information and assur-
ances as the Secretary may require. 
‘‘(3) Upon a determination by the Secretary 
that suitable facilities are not otherwise available to 
Indian tribes to carry out Head Start programs, and 
that the lack of suitable facilities will inhibit the op-
eration of such programs, the Secretary may author-
ize the use of financial assistance, from the amount 
reserved under section 640(a)(2)(A), to make pay-
ments for the purchase of facilities owned by such 
tribes. The amount of such a payment for such a fa-
cility shall not exceed the fair market value of the 
facility.’’. 
SEC. 12. PARTICIPATION IN HEAD START PROGRAMS. 
Section 645 of the Head Start Act (42 U.S.C. 9840) 
is amended— 
(1) in subsection (a)— 
(A) by amending paragraph (1)(B)(i) to 
read as follows: 
‘‘(i) programs assisted under this sub-
chapter may include, to a reasonable ex-
tent, participation of children in the area 
served who would benefit from such pro-
grams, including children referred by child 
welfare services, but whose families do not 
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HR 1429 PCS
meet the low-income criteria prescribed 
pursuant to subparagraph (A) (A homeless 
child shall be deemed to meet the low-in-
come criteria.); and’’, and 
(B) by adding at the end the following: 
‘‘(3) The amount of a basic allowance provided under 
section 403 of title 37, United States Code, on behalf of 
an individual who is a member of the uniformed services 
for housing that is acquired or constructed under the au-
thority of subchapter IV of chapter 169 of title 10, United 
States Code, or any other related provision of law, shall 
not be considered to be income for purposes of deter-
mining the eligibility of a child of the individual for pro-
grams assisted under this subchapter. 
‘‘(4)(A) Upon written request and pursuant to the 
requirements of this paragraph, a Head Start agency may 
use funds under section 640(a) to serve infants and tod-
dlers if the agency submits an application to the Secretary 
containing the following information, as specified in rules 
issued by the Secretary— 
‘‘(i) the amount of funds under section 640(a) 
that are proposed to be used in accordance with sec-
tion 645A(b); 
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HR 1429 PCS
‘‘(ii) a community-wide needs assessment dem-
onstrating how the use of such funds would best 
meet the needs of the community; 
‘‘(iii) a description of how the needs of preg-
nant women, and of infants and toddlers, will be ad-
dressed in accordance with section 645A(b), and 
with regulations prescribed by the Secretary pursu-
ant to section 641A in areas including the agency’s 
approach to child development and provision of 
health services, approach to family and community 
partnerships, and approach to program design and 
management; 
‘‘(iv) a description of how the needs of eligible 
Head Start children will be met in the community; 
‘‘(v) assurances that the agency will participate 
in technical assistance activities (including a plan-
ning period, start-up site visits, and national train-
ing activities) in the same manner as recipients of 
grants under section 645A; and 
‘‘(vi) evidence that the agency meets the same 
eligibility criteria as recipients of grants under sec-
tion 645A. 
‘‘(B) An application that satisfies the requirements 
specified in subparagraph (A) shall be approved by the 
Secretary unless the Secretary finds that— 
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HR 1429 PCS
‘‘(i) the agency lacks adequate capacity and ca-
pability to carry out an effective Early Head Start 
program; or 
‘‘(ii) the information provided under subpara-
graph (A) is inadequate. 
‘‘(C) Any Head Start agency approved under sub-
paragraph (B) shall be considered to be an entity that re-
ceives assistance under section 645A, and such funds 
under (i) shall be subject to the same rules, regulations, 
and conditions as apply to recipients of grants under sec-
tion 645A. 
‘‘(5)(A) Upon written request and pursuant to the 
requirements of this paragraph, a Head Start agency may 
consider children from low-income families to be eligible 
for participation in programs assisted under this sub-
chapter if their family income is at or above the poverty 
line but below 130 percent of the poverty line, if the agen-
cy submits an application to the Secretary containing the 
following information, as specified in rules issued by the 
Secretary— 
‘‘(i) a description of how the needs of eligible 
Head Start children, as described in paragraph 
(1)(A) are being adequately met in the agency’s 
service area; 
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HR 1429 PCS
‘‘(ii) a description of outreach efforts to the 
community to reach full enrollment under the eligi-
bility guidelines under paragraph (1), including 
using outreach efforts that are linguistically and cul-
turally appropriate; 
‘‘(iii) assurance that the agency will prioritize 
serving children currently eligible under the guide-
lines under paragraph (1); and 
‘‘(iv) a description of why increasing the num-
ber of infants and toddlers being served, as de-
scribed in paragraph (4), is not appropriate based 
upon the communitywide needs assessment or the 
agency’s capability. 
‘‘(B) In approving such applications, the Secretary 
shall take into account the— 
‘‘(i) cost of living for families living in the area 
served by the Head Start agency; 
‘‘(ii) the efforts the Head Start agency has un-
dertaken to be fully enrolled under the eligibility cri-
teria in paragraph (1); and 
‘‘(iii) the policies and procedures the Head 
Start agency will implement to ensure that children 
currently eligible under the criteria described under 
paragraph (1) will be prioritized. 
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HR 1429 PCS
‘‘(C) No more than 20 percent of children served by 
such Head Start agency may be from families above the 
poverty line.’’, 
(2) in subsection (c) by striking ‘‘(age 3 to 
compulsory school attendance)’’, and 
(3) in subsection (d) by adding at the end the 
following: 
‘‘(4) Notwithstanding any other provision of this Act, 
an Indian tribe that operates both a Head Start program 
and an Early Head Start program under section 645A 
may, at its discretion, at any time during the grant period 
involved, reallocate funds between the Head Start pro-
gram and the Early Head Start program in order to ad-
dress fluctuations in client population, including pregnant 
women and children birth to compulsory school age. The 
reallocation of such funds between programs by an Indian 
tribe shall not serve as the basis for the Secretary to re-
duce a base grant (as defined in section 641A(g)(1)) for 
either program in succeeding years.’’. 
SEC. 13. EARLY HEAD START PROGRAMS. 
Section 645A of the Head Start Act (42 U.S.C. 
9840a) is amended to read as follows: 
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HR 1429 PCS
‘‘SEC. 645A. EARLY HEAD START PROGRAMS FOR FAMILIES 
WITH CHILDREN UNDER 3 YEARS OF AGE. 
‘‘(a) IN
GENERAL.—The Secretary shall make 
grants, in accordance with this section for programs (to 
be known as ‘Early Head Start programs’) that provide 
family-centered services for low-income families with very 
young children designed to promote the development of the 
children, and to enable their parents to fulfill their roles 
as parents and to move toward self-sufficiency. Faith- 
based and community-based organizations continue to be 
eligible, on the same basis as other organizations, to par-
ticipate in any program under this section for which they 
are otherwise eligible. 
‘‘(b) SCOPE AND DESIGN OF PROGRAMS.—In car-
rying out a program described in subsection (a), an entity 
receiving assistance under this section shall— 
‘‘(1) provide, either directly or through referral, 
early, continuous, intensive, and comprehensive child 
development and family support services that will 
enhance the physical, social, emotional, and intellec-
tual development of participating children; 
‘‘(2) ensure that the level of services provided 
to families responds to their needs and cir-
cumstances; 
‘‘(3) promote positive parent-child interactions; 
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HR 1429 PCS
‘‘(4) provide services to parents to support their 
role as parents (including parenting skills training 
and training in basic child development) and to help 
the families move toward self-sufficiency (including 
educational and employment services as appro-
priate); 
‘‘(5) coordinate services with services provided 
by programs in the State (including home-based 
services) and programs in the community (including 
programs for infants and toddlers with disabilities 
and programs for homeless infants and toddlers) to 
ensure a comprehensive array of services (such as 
health and mental health services and family support 
services); 
‘‘(6) ensure formal linkages with local Head 
Start programs in order to provide for continuity of 
services for children and families; 
‘‘(7) in the case of a Head Start agency that 
operates a program and that also provides Head 
Start services through the age of mandatory school 
attendance, ensure that children and families partici-
pating in the program receive such services through 
such age; 
‘‘(8) ensure formal linkages with the agencies 
and entities described in section 644(b) of the Indi-
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HR 1429 PCS
viduals with Disabilities Education Act (20 U.S.C. 
1444(b)) and providers of early intervention services 
for infants and toddlers with disabilities under the 
Individuals with Disabilities Education Act (20 
U.S.C. 1400 et seq.) and the agency responsible for 
administering section 106 of the Child Abuse Pre-
vention and Treatment Act (42 U.S.C. 5106a); 
‘‘(9) develop and implement a systematic proce-
dure for transitioning children and parents from an 
Early Head Start program under this section into a 
Head Start program or other local early childhood 
education program; 
‘‘(10) establish channels of communication be-
tween staff of Early Head Start programs under 
this section and staff of Head Start programs or 
other local early childhood education programs, to 
facilitate the coordination of programs; and 
‘‘(11) meet such other requirements concerning 
design and operation of the program described in 
subsection (a) as the Secretary may establish. 
‘‘(c) PERSONS ELIGIBLE TO PARTICIPATE.—Persons 
who may participate in programs described in subsection 
(a) include— 
‘‘(1) pregnant women; and 
‘‘(2) families with children under age 3; 
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HR 1429 PCS
who meet the income criteria specified for families in sec-
tion 645(a)(1). 
‘‘(d) ELIGIBLE SERVICE PROVIDERS.—To be eligible 
to receive assistance under this section, an entity shall 
submit an application to the Secretary at such time, in 
such manner, and containing such information as the Sec-
retary may require. Entities that may apply to carry out 
activities under this section include— 
‘‘(1) entities operating Head Start programs 
under this subpart; 
‘‘(2) Indian Head Start programs; and 
‘‘(3) other public entities, and nonprofit or for- 
profit private entities, including community-based 
and faith-based organizations, capable of providing 
child and family services that meet the standards for 
participation in programs under this subchapter and 
meet such other appropriate requirements relating to 
the activities under this section as the Secretary may 
establish. 
‘‘(e) SELECTION OF GRANT RECIPIENTS.—From the 
portion specified in section 640(a)(6), the Secretary shall 
award grants under this subsection on a competitive basis 
to applicants meeting the criteria specified in subsection 
(d) (giving priority to entities with a record of providing 
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HR 1429 PCS
early, continuous, and comprehensive childhood develop-
ment and family services). 
‘‘(f) DISTRIBUTION.—In awarding grants to eligible 
applicants under this section, the Secretary shall— 
‘‘(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. In 
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HR 1429 PCS
determining the amount so reserved, the Sec-
retary shall consider the number of new pro-
grams serving pregnant women, infants, tod-
dlers, and their families, recognizing their need 
for more intensive training and technical assist-
ance services during program expansion. 
‘‘(B) ACTIVITIES.—Of the funds in the ac-
count described in subparagraph (A)— 
‘‘(i) not less than 50 percent shall be 
available to local entities that carry out 
Early Head Start programs for training 
and technical assistance activities in order 
to make program improvements identified 
by such entities; 
‘‘(ii) not less than 30 percent shall be 
available to the Secretary to support a 
State-based system of early childhood edu-
cation training and technical assistance to 
local entities that carry out Early Head 
Start programs that shall meet the re-
quirements of subparagraph (C), including 
the creation, management, and support of 
a national network of the State-based in-
fant-toddler specialists specified in such 
subparagraph; and 
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HR 1429 PCS
‘‘(iii) the remainder of such amount 
shall be available to the Secretary to assist 
local entities that carry out Early Head 
Start programs in meeting and exceeding 
the 
standards 
described 
in 
section 
641A(a)(1), including— 
‘‘(I) making grants to, and enter-
ing into contracts with, organizations 
with specialized expertise relating to 
infants, toddlers, and families and the 
capacity needed to provide direction 
and support to a national training 
and technical assistance system, in 
order to provide such direction and 
support; 
‘‘(II) providing ongoing training 
and technical assistance on Early 
Head Start program development and 
improvement 
for 
regional 
staff 
charged with monitoring and over-
seeing the administration of the pro-
gram carried out under this section; 
‘‘(III) developing training and 
technical assistance materials and re-
sources to support program develop-
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HR 1429 PCS
ment and improvement and best prac-
tices in providing services to children 
and families served by Early Head 
Start programs; 
‘‘(IV) creating special training 
and technical assistance initiatives 
targeted to serving high risk popu-
lations, such as children in the child 
welfare system and homeless children; 
‘‘(V) providing ongoing training 
and technical assistance to Early 
Head Start grantees, and support and 
program planning and implementation 
assistance for new recipients of such 
grants, including the conversion of 
Head Start grants to Early Head 
Start grants; and 
‘‘(VI) providing professional de-
velopment designed to increase pro-
gram participation for underserved 
populations of eligible children. 
‘‘(C) CONTRACTS.—For the purposes of 
delivering a State-based training and technical 
assistance system, as described in subparagraph 
(B)(ii), that will meet the needs of local grant-
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HR 1429 PCS
ees and provide high quality, sustained, and in-
tensive training and technical assistance on pro-
gramming for infants and toddlers to Early 
Head Start programs and in order to help such 
programs meet or exceed the program perform-
ance standards described in section 641A(a)(1), 
the Secretary shall— 
‘‘(i) enter into contracts in each State 
with 1 or more entities that have a dem-
onstrated expertise in supporting the deliv-
ery of high quality programs for pregnant 
women and children less that 3 years of 
age, except that bi-State or multi-State 
contracts may be entered into if the demo-
graphics of proximal States make such a 
system more appropriate; 
‘‘(ii) ensure that contracts awarded 
under clause (I) are in an amount suffi-
cient to provide for each state a minimum 
of one full-time specialist with expertise in 
the development of children under age 
three and programming for pregnant 
women and such children; 
‘‘(iii) to the maximum extent prac-
ticable, ensure that the contracts awarded 
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HR 1429 PCS
Under clause (I) and the services provided 
therein are integrated with and augment 
the contract or contracts awarded and 
services provided under section 648 (n); 
and 
‘‘(iv) ensure that the entities de-
scribed in clause (I) determine the types of 
services to be provided through consulta-
tion with— 
‘‘(I) local entities that carry out 
Early Head Start programs; 
‘‘(II) the State Head Start col-
laboration office; and 
‘‘(III) the State Head Start As-
sociation. 
‘‘(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. 
‘‘(i) STAFF QUALIFICATIONS AND DEVELOPMENT.— 
‘‘(1) HOME
VISITOR
STAFF
STANDARDS.—In 
order to further enhance the quality of home visiting 
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HR 1429 PCS
services provided to families of children participating 
in home-based, center-based, or combination pro-
gram options under this subchapter, the Secretary 
shall establish standards for training, qualifications, 
and the conduct of home visits for home visitor staff 
in Early Head Start programs. 
‘‘(2) CONTENTS OF STANDARDS.—The stand-
ards for training, qualifications, and the conduct of 
home visits shall include content related to— 
‘‘(A) structured child-focused home visiting 
that promotes parents’ ability to support the 
child’s cognitive, social, emotional, and physical 
development; 
‘‘(B) effective strengths-based parent edu-
cation, including methods to encourage parents 
as their child’s first teachers; 
‘‘(C) early childhood development with re-
spect to children from birth through age 3; 
‘‘(D) methods to help parents promote 
emergent literacy in their children from birth 
through age 3; 
‘‘(E) ascertaining what health and develop-
mental services the family receives and working 
with these providers to eliminate gaps in service 
by offering annual health, vision, hearing, and 
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HR 1429 PCS
developmental screening for children from birth 
to entry into kindergarten, when needed; 
‘‘(F) strategies for helping families coping 
with crisis; and 
‘‘(G) the relationship of health and well- 
being of pregnant women to prenatal and early 
child 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 
‘‘(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— 
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HR 1429 PCS
‘‘(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 
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 
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