Head Start was created in 1965 as part of President Johnson's War on Poverty. It was built on the premise that effective intervention in the lives of children can be best accomplished through family and community involvement. Fundamental to this notion was that communities should be given considerable latitude to develop their own Head Start programs. Head Start's primary goal is to improve the social competence of children in low-income families. Social competence is the child's everyday effectiveness in dealing with both the present environment and later responsibilities in school and life. Because social competence involves the interrelatedness of cognitive and intellectual developmental, physical and mental health, nutritional needs, and other factors, Head Start programs provide a broad range of services. Another essential part of every program is parental involvement in parent education, program planning, and operating activities. Head Start is administered by HHS' Administration for Children and Families (ACF), which includes the Head Start Bureau--one of several under ACF. Agencies that deliver Head Start services at the local level may be either grantees or delegate agencies. Unlike some other federal social service programs that are funded through the states, HHS awards Head Start grants directly to local grantees. Grantees numbered about 1,460 in fiscal year 1997. They may contract with organizations--called delegate agencies--in the community to run all or part of their local Head Start programs. Grantees and delegate agencies include public and private school systems, community action agencies and other private nonprofit organizations, local government agencies (primarily cities and counties), and Indian tribes. and grantees typically must contribute 20 percent of program costs from nonfederal funds. These funds can be cash, such as state, county, and private money, or in-kind contributions such as building space and equipment. The average amount of funds available per child in Head Start programs in the 1996-97 program year was $5,186; an average of $4,637 of this amount came from Head Start grant funds. Total funds per child varied widely by program, however, ranging from $1,081 to $17,029 per child. Before using Head Start funds for services, local agencies are required by Head Start regulations to identify, secure, and use community resources to provide services to children and their families. Consequently, Head Start programs have established many agreements for services. Head Start targets children from poor families, and regulations require that at least 90 percent of the children enrolled in each local agency program be low income. As shown in figure 1, Head Start families are poor as indicated by several measures. During the 1996-97 program year, more than one-half of the heads of Head Start households were either unemployed or worked part time or seasonally, and about 60 percent had family incomes under $9,000 per year. Furthermore, only 5 percent had incomes that exceeded official poverty guidelines, and 46 percent received Temporary Assistance for Needy Families (TANF) benefits. similar demographic characteristics. Most of the children--79 percent-- spoke English as their main language. Spanish-speaking children constituted the next largest language group--18 percent. About 38 percent of the children were black, 33 percent were white, and 25 percent were Hispanic. About 13 percent of Head Start children had some sort of disability. The Congress has recently acted to strengthen Head Start's emphasis on achieving program purposes by, for example, requiring the program to develop performance measures. In reauthorizing the Head Start Act in 1994, the Congress required HHS to develop specific performance measures for Head Start so that program outcomes could be determined. This requirement is consistent with the Results Act, which seeks to shift the focus of federal management away from inputs and processes and toward outcomes. Under the Results Act, agencies are required to develop goals and performance measures that will be assessed annually to show progress toward reaching the goals. Agencies are also expected to conduct specific evaluation studies as needed to obtain additional information about what federal programs are achieving. In response to this emphasis on performance assessment, Head Start has developed a framework that links program activities of local Head Start grantees to the program's overall strategic mission and goal. This framework emphasizes the importance not only of complying with statutes and regulations, but also of achieving demonstrable outcomes. Head Start has developed five measurable, performance-based objectives. Two of these focus on outcomes: (1) enhancing children's growth and development and (2) strengthening families as the primary nurturers of their children. The other three focus on program activities that the agency believes are critical to achieving the two outcome objectives: (1) providing children with educational, health, and nutritional services; (2) linking children and families to needed community services; and (3) ensuring well-managed programs that involve parents in decision-making. has established one or more performance indicators by which to track the percentage of change. Because data on many of these indicators were not previously available, HHS has designed initiatives to collect the data. Head Start intends to assess progress toward these goals mainly through the Family and Child Experiences Survey (FACES). This survey will collect data from families with children enrolled in a random sample of Head Start centers (3,200 families were selected when the survey began in fall 1997), assessing them on a wide range of characteristics at the beginning of program participation, at the end of each year they participate, and at the end of kindergarten. Thus, Head Start will know, for example, if participants' physical health and emergent literacy and math and language skills have improved. The FACES survey, however, will collect information only at the national level. At the local level, HHS does not require individual Head Start agencies to demonstrate that they have achieved program outcomes. They are only held accountable for achieving the objectives linked specifically to activities, such as providing a developmentally appropriate educational environment. HHS officials told us, however, that they intend in the future to require local agencies to assess what outcomes they have achieved, as some agencies already do. HHS has no specific plan or timetable yet for when this transition will take place. In addition, these HHS initiatives will not address the need for information on Head Start's impact, limiting its ability to assess how well the program is achieving its purpose. That is, the initiatives will not explain what caused any improved outcomes--whether the same outcomes would have occurred if children and families were in other kinds of early childhood programs or none at all. Although we acknowledge the difficulty of conducting impact studies of programs such as Head Start, we believe that research could be done that would assure the Congress and HHS that the current $4 billion federal investment in Head Start is achieving its purpose. program impact will be unclear. The most reliable way to determine program impact is to compare a group of Head Start participants with an equivalent group of nonparticipants. Comparable groups of participants are important to determining impact because they prevent mistakenly attributing outcomes to program effects when these outcomes are really caused by other factors. For instance, a recent evaluation of the Comprehensive Child Development Program, a demonstration project involving comprehensive early childhood services like those of Head Start, found positive changes in the families participating. Because the study could compare participants with a comparable group not in the program, however, researchers discovered that families that had not participated also had similar positive changes. They concluded, therefore, that the positive changes could not be attributed to the program. Because of the importance of being able to attribute outcomes to Head Start rather than to other experiences children and their families might have had, we recommended in our 1997 report that HHS include in its research plan an assessment of the impact of regular Head Start programs. Head Start operates in a social environment that differs greatly from that of 30 years ago when the program was established: more parents are working full time, either by choice or necessity, and many more social service programs exist to address the needs of disadvantaged children and their families. These circumstances raise policy questions relevant to any consideration of the Head Start program's future. financial penalties. The required participation rate rises to 50 percent in fiscal year 2002. Head Start's own data show that about 38 percent of Head Start families needed full-day, full-year child care services in 1997. About 44 percent of the families that needed full-day, full-year child care services left their children at a relative's or unrelated adult's home when the children were not in Head Start. Because Head Start is predominantly a part-day, part-year program, the full-day needs of families conflict with the way program services have traditionally been delivered. In program year 1996-97, most Head Start children (90 percent) attended programs at group centers, rather than in home settings; about half of them (51 percent) attended centers that operated 3 to 4 hours per day. Only 7 percent of the children attended centers that operated 8 or more hours a day (see fig. 3). Almost two-thirds of the children attended centers that operated 9 months of the year; only one-fourth (27 percent) of the children attended centers that operated 10 to 11 months. And even fewer--7 percent--attended centers that operated year round. hours of care for their children. The director stated that the need for part-day services is "evaporating." Other aspects of the program may also conflict with the priorities of working parents. For example, Head Start's emphasis on strong parental involvement, its requirement that staff visit children's homes, and its home-based service delivery option may be more difficult to implement given the schedules of working parents. Head Start program officials told us that welfare reform was already seriously affecting their programs' makeup. For example, a Head Start director in Montana reported that the program eliminated some of the home-based slots so that more children could attend centers. According to a Head Start director in Pennsylvania, the changed environment presents considerable obstacles to the home-based program. This program will try to accommodate families' schedules and perhaps conduct home visits in the evening, but the director acknowledged that sometime in the future home visits may no longer be feasible. In 1997, the Congress appropriated additional funds to, among other things, increase local Head Start enrollment by about 50,000 children. The Head Start Bureau's priorities for allocating these funds differed from those of the past. In the past, priorities for allocating funds to expand Head Start emphasized part-day, part-year, or home-based services. In recognition of the increasing proportion of Head Start families needing full-day programs for their children, however, the Head Start Bureau announced that programs providing more full-day, full-year Head Start services will receive special priority for the new funds. Head Start has urged local agencies to consider combining these new Head Start expansion funds with other child care and early childhood funding sources and to deliver services through partnerships, such as community-based child care centers. According to HHS officials, this shift in emphasis was responsible for the fact that more than 30,000 of the 36,000 new enrollment opportunities for 3- to 5-year-olds will be for full-day, full-year Head Start. often facilitates its participants' access to services, such as immunizations, rather than provide them directly. For example, when we asked Head Start programs the main methods used to provide medical services for enrolled children, 73 percent of survey respondents said that they referred participants to services, and some other entity or program, such as Medicaid's Early and Periodic Screening, Diagnosis, and Treatment Program, primarily paid for the services. Dental services were also mainly provided by entities other than Head Start programs. Although the number of other programs that provide educational services has also grown in the past 30 years, education is the one service that local Head Start agencies typically provide by delivering it directly rather than facilitating access to it from another source. Some Head Start program officials who contracted with private preschools or child care centers to provide education services described the arrangement as offering benefits to both Head Start and the other program. For example, the arrangement eliminated the need to find a facility for the Head Start program as well as to provide the facility startup costs. The private center benefited from the arrangement as well because the Head Start funds allowed the center to do some repair work and purchase computers and playground equipment. We do not know the numbers of community programs that may provide education services, their capacity, or the overall quality of these programs. Head Start programs reported, however, that an array of early childhood programs operate in their communities and serve Head Start-eligible children. For example, 70 percent of Head Start program respondents reported to us that their area had state-funded preschools; 90 percent had other preschools and child development and child care centers in their area; and 71 percent reported that family day care homes served Head Start-eligible children in their area. Just as Head Start is not the only community program providing specific services to disadvantaged children and their families, it is also not the only program that uses a community's network of services to facilitate access to a comprehensive set of services. In a 1995 report (which used 1990 data from a nationally representative sample of early childhood centers), we concluded that most disadvantaged children did not receive a full range of services from early childhood centers in part because of the limited number that could be served and limited subsidies and in part because of such centers' limited missions. More recent evidence, however, suggests growth in the availability of such services for children. HHS has no information about the number of community programs providing comprehensive services, nor did we obtain this information in our recent study; we plan to explore this further in another study. about 11 percent of the local Head Start agencies served some children who were eligible for Head Start through other early childhood programs. (Respondents reported serving about 14,000 such children in program year 1996-97.) These children received some or most--but not all--of the services typically provided to children in Head Start programs. These programs were more likely to provide education services, meals, social services, and immunizations; dental and medical services were least often provided. In addition, some states offer preschool programs that emulate Head Start's comprehensive model. In fact, some states provide services that are seemingly identical to those provided through Head Start. For example, in 1993, Georgia initiated its first statewide prekindergarten program. The program coordinates services for families, and children receive basic health and dental screenings and meals. In addition, Ohio has a state-funded Head Start initiative that coordinates closely with the federal Head Start program. The state-funded initiative offers children services that are identical to Head Start's. In addition, Ohio has a state- funded preschool program for disadvantaged children that operates according to Head Start performance standards. While recognizing that these social changes may significantly affect Head Start now and in the future, the Congress and Head Start lack information needed to decide what specific actions to take in response to them. Information is lacking about families' needs for services, how well Head Start's current structure can respond to those needs, and the array of options available to disadvantaged children and their families. For example, although we expect the need for full-day services to grow, we do not know the extent to which families will choose Head Start--a predominantly part-day educational program--over full-day programs that offer child care, even if the Head Start program has an arrangement with another provider for child care for the rest of the day. Moreover, evidence suggests that more states, for example, are investing in child care and prekindergarten initiatives. The number of such initiatives is not known, however, nor do we have information on their quality. In addition, only limited anecdotal information exists about Head Start agencies' initiatives for responding to these trends and the success of those initiatives. Additional information on family service needs and the options available to them would be valuable to Head Start and the Congress in ensuring that the significant investment of federal dollars is used to the greatest advantage to improve the social competence of children in low-income families. Mr. Chairman, this concludes my statement. I would be happy to answer any questions you or members of the Subcommittee may have. The first copy of each GAO report and testimony is free. Additional copies are $2 each. 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Summary:
Pursuant to a congressional request, GAO discussed its work on the Head Start program, focusing on: (1) how well the Department of Health and Human Services (HHS) ensures that the Head Start program is achieving its purpose; and (2) how well Head Start is structured to meet the needs of program participants in today's social context, which differs significantly from that of 30 years ago. GAO noted that: (1) Head Start has, through the years, provided a comprehensive array of services and, as envisioned by the Government Performance and Results Act, has in recent years substantially strengthened its emphasis on determining the results of those services; (2) its processes still provide too little information, however, about how well the program is achieving its intended purposes; (3) HHS has developed a performance assessment framework that effectively links program activities with the program's overall strategic mission and goal; (4) this framework also includes measurable objectives for how the program will be implemented and what outcomes will be achieved; (5) HHS has new initiatives that will, in the next few years, provide information not previously available on outcomes such as gains made by children and their families while in the program; (6) currently, however, these initiatives are limited to assessing outcomes at the national level, not at the local agency level; (7) in addition, GAO is not convinced that these initiatives will provide definite information on impact, that is, whether children and their families would have achieved these gains without participating in Head Start; (8) although obtaining this kind of impact information would be difficult, the significance of Head Start and the sizeable investment in it warrant conducting studies that will provide answers to questions about whether the program is making a difference; (9) in addition to questions about the program's impact, questions exist about whether Head Start is structured to meet the needs of today's participants who live in a society much changed since the mid-1960s when the program was created; (10) families' needs have changed as more parents are working full time either by choice or necessity; (11) in addition, children and their families can now receive services similar to Head Start's from a growing number of other programs; (12) these social trends raise questions about how well Head Start is structured to meet participants' needs and, if changes are needed, what those changes should be; and (13) a lack of information about the array of community programs available and about actions local Head Start agencies have already taken hinders decisionmakers' ability to respond to these trends.