Head Start, the centerpiece of federal early childhood programs, was created in 1965 as part of President Johnson’s War on Poverty. 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. Social competence involves the interrelatedness of cognitive and intellectual development, physical and mental health, nutritional needs, and other factors. To support the social competence goal, Head Start programs deliver a broad range of services to children. These services include educational, medical, nutritional, mental health, dental, and social services. Another essential part of every program is parental involvement in parent education, program planning, and operating activities. Head Start programs are governed by performance standards, which set forth the expectations and minimum requirements that all Head Start programs are expected to meet. Program officials expect these standards, however, to be largely self-enforcing, with the exception that Head Start’s 12 regional offices conduct on-site monitoring of Head Start programs every 3 years. The program also has a separate set of performance standards for services for children with disabilities. Both sets of performance standards, which have governed the program since 1975, were revised in the 1990s. Head Start issued performance standards for children with disabilities in 1993. The performance standards for the rest of the programs became effective in January 1998 and attempt to reflect the changing Head Start population, the evolution of best practices, and program experience with the earlier standards. Head Start targets children from poor families, and regulations require that at least 90 percent of the children enrolled in each program be low income. By law, certain amounts are set aside for special populations of children, including those with disabilities and Native American and migrant children. The program is authorized to serve children at any age before the age of compulsory school attendance; however, most children enter the program at age 4. Head Start programs may be delivered in any of three Head Start-approved program options. One option involves the enrolled child receiving the bulk of Head Start services at a center; however, some home visits are required. Centers operate varying numbers of hours per day for either 4 or 5 days per week. Providing services at children’s homes is a second option. The children receive the bulk of services at home, with some opportunities for them to interact in a group setting. The combination option—the third— entails both center attendance and home visits. In addition, programs may implement a locally designed option, which, as the name implies, is developed at the local program level. Locally designed options may take many forms, such as family day care homes. How are services delivered in a center setting, the most common option? The center may be housed in a church basement, at a parent’s work site, in a public school building, at a college or university, or some other location. A Head Start teacher as well as a second adult instruct the children using a curriculum relevant to and reflective of the needs of the population served. Head Start regulations emphasize that large and small group activities take place throughout the day. Children should be encouraged to solve problems, initiate activities, explore, experiment, question, and gain mastery through learning by doing. In addition to educational services, children receive other services. Meals and snacks are provided as appropriate. Within a certain number of days of entering the program, children receive a thorough health screening and medical and dental examination. This screening may take place on or off site. Program staff ensure that treatment and follow-up services are arranged for all health problems detected. In addition, Head Start staff are expected to visit the children’s homes to assess their and their families’ need for services. For example, these visits may identify the families’ need for services such as emergency assistance or crisis intervention. Staff may also provide families with information about community services and how to use them. During these visits, staff are expected to develop activities for family members to use at home that will reinforce and support the child’s total Head Start experience. Head Start is administered by HHS’ Administration for Children and Families (ACF), which includes the Head Start Bureau—one of several under ACF. Grantees, which deliver Head Start services at the local level, numbered about 1,440 in fiscal year 1996. Grantees 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. Unlike some other federal social service programs funded through the states, HHS awards Head Start grants directly to local grantees. HHS distributes Head Start funds using a complex formula, based upon, among other things, previous allotments and the number of children, aged 5 and under, below the poverty line in each state compared with the number in other states. Head Start, a federal matching grant program, requires grantees to typically obtain 20 percent of program costs from nonfederal funds. These funds can be in the form of cash, such as state, county, and private money, or in-kind contributions such as building space and equipment. Head Start regulations require that programs identify, secure, and use community resources in providing services to Head Start children and their families before using Head Start funds for these services. As a result, Head Start programs have established many agreements for services. Head Start has served over 16 million children since its inception. The passage of the 1990 Head Start Expansion and Quality Improvement Act resulted in increased funding for Head Start to allow more children the opportunity to participate in Head Start as well as improve the quality of Head Start services. In fiscal year 1996, Head Start received $3.6 billion in funding and served about 752,000 children. This figure reflects children served through all of Head Start’s programs. The regular Head Start program serves children and families residing in the 50 states and the District of Columbia. About 85 percent of Head Start children are served through the regular Head Start program. Head Start also operates programs for migrant and Native American populations. Recognizing that the years from conception to age 3 are critical to human development, the Congress established Early Head Start in 1994. This program targets children under age 3 from low-income families as well as expectant mothers. Since 1967, however, Head Start has served children and families now targeted by the Early Head Start program through Parent Child Centers. In the past 3 years, we have issued several reports on the Head Start program. One report discussed local perspectives on barriers to providing Head Start services. That report, among other things, concluded that Head Start lacked enough qualified staff to meet the complex needs of children and families. Other barriers included a limited availability of health professionals in the community willing to help Head Start staff in providing services and programs having difficulties getting suitable facilities at reasonable costs. In our most recent report, we concluded that the body of research conducted on the Head Start program does not provide information on whether today’s Head Start is making a positive difference in participants’ lives. Specifically, we found that the body of research conducted on the program was inadequate for use in drawing conclusions about the impact of the national program in any area in which Head Start provides services such as school readiness or health-related services. We also stated that no single study of the program used a nationally representative sample so that findings could be generalized to the national program. We recommended that the Secretary of HHS include in HHS’ research plan an assessment of the impact of regular Head Start programs. In commenting on this report, HHS mentioned, among other things, that estimating program impact at the national level is not appropriate because of the extreme variability of local programs. That is, local Head Start sites have great flexibility, and, even though all programs share common goals, they may operate very differently. Thus, HHS considers a single, large-scale, national study of impact to be methodologically inappropriate. Head Start programs were funded to serve about 701,000 children at any one time in program year 1996-97; however, the number of different children enrolled in the program throughout the 1996-97 program year was about 782,000, which averaged about 454 children per program, ranging from a low of 17 to a high of 6,045. The number of different children enrolled in the program includes children who are funded with all sources of funds, such as those received from state agencies, and who have been enrolled in Head Start for any length of time, even if they dropped out or enrolled late, provided they have attended at least one class or, in home-based programs, received at least one home visit. Head Start estimates capacity or the number of children that can be served at any one time in two ways. Total funded enrollment (701,000) is the number of children that can be served at any one time with Head Start grant funds, as well as funds from other sources, such as state agencies. This estimate includes children, regardless of funding source, who are an integral part of the Head Start program and who receive the full array of Head Start services. Head Start-funded enrollment (667,000) is an estimate of the number of children that can be served at any one time with Head Start grant funds only (see table II.1 in app. II for enrollments by state). Although programs are authorized and expected to serve a certain number of children, according to Head Start Bureau officials, local programs may negotiate with their regional offices to adjust their enrollment. Thus, programs may choose to fill fewer slots or establish more slots. To illustrate, a program authorized to serve 50 children may choose to actually serve only 40 children or to serve 60. By serving fewer children, the program can support other enhancements, such as providing employees with full benefits. Head Start Bureau officials also stated that some states have regulations and laws that also affect the number of slots that can be filled. A state that requires training and licensing of its early childhood staff, for example, might be limited in the number of children it could serve if licensed staff cost more. Differences in the cost of living can also affect the number of slots that can be filled. In addition, Head Start programs served about 711,000 families of Head Start children, which Head Start regulations define as all people living in the same household who are supported by the income of the parent or guardian and related by blood, marriage, or adoption. Head Start does not require that programs count the number of individual family members served, however, so the number of services provided them is unknown. The children and families Head Start served had some similar demographic characteristics (see fig. 1). Most were either 3 (31 percent) or 4 (63 percent) years old. 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. Most Head Start families have more than one child; most have two or three children (see fig. 2). In addition, most (61 percent) have only one parent or are headed by other relatives, or they are foster families or have other living arrangements. Head Start families are generally very poor as indicated by several measures (see fig. 3). More than one-half are either unemployed or work part time or seasonally, and about 60 percent have family incomes under $9,000 per year. Furthermore, only 5 percent have incomes that exceed official poverty guidelines, and 46 percent receive TANF benefits. Through Head Start, children received access to a large array of services. Children received medical and dental services, immunizations, mental health services, social services, child care, and meals. According to Head Start’s annual survey, nearly all children enrolled in Head Start received medical screening/physical exams, dental exams, and immunizations in the 1996-97 program year. Most children received medical screening, including all appropriate tests and physical examinations as well as dental examinations by a dentist. Most had also received all immunizations required by the Head Start immunization schedule for the child’s age. Children also received education services in various settings. In addition, Head Start programs provided children’s families access to services (see table II.2 in app. II). Of the services we asked about, parent literacy, social services, job training, and mental health were the most frequently provided (see table II.4 in app. II). Programs were least likely to provide dental and medical services to siblings and other family members, with 64 percent reporting they never provided dental services and 56 percent reporting they never provided medical services. Most children attended centers that operated part day and part year. About 90 percent of the children received services through center programs. Fifty-one percent of children attending centers went to centers that operated 3 to 4 hours per day (see fig. 4). Another 42 percent went to centers that operated between 5 and 7 hours per day. Only 7 percent of the children went to centers that operated 8 or more hours per day. In addition, 63 percent of the children attended centers that operated 9 months of the year. However, only 27 percent of the children attended centers that operated 10 to 11 months, and even less—7 percent— attended centers that operated year round. According to Head Start’s survey, about 38 percent of the families needed full-day, full-year child care services. However, this proportion may increase dramatically as welfare reform is implemented. About 44 percent of the families needing 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, according to Head Start’s survey. In 1997, the Congress appropriated additional funds to, among other things, increase local Head Start enrollment by about 50,000 children. Recognizing that an increasing proportion of Head Start families work and many who may receive public assistance are participating in welfare reform initiatives in response to TANF, the Head Start Bureau announced that programs that provide more full-day, full-year Head Start services will receive special priority for funding. Head Start urged programs to consider combining 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. This focus on providing full-day, full-year services departs from previous expansion priorities, which emphasized part-day, part-year, or home-based services. For our review we talked with Head Start program officials who had applied for expansion funds to meet the needs of working parents. Officials operating a program in Florida, for example, stated that they plan to expand the number of days and hours the program currently operates: hours of operation will be expanded from 7:30 a.m. to 4:00 p.m. to 6:30 a.m. to 7:00 p.m. In addition, officials operating a program in Vermont stated that it plans to provide full-day, full-year services as well. Their strategy involves collaborating with an existing private center that will offer children extended-day services. Head Start provides services in a number of ways. In some instances, Head Start programs both delivered and paid for services. In most cases, however, Head Start arranged for or referred participants to services, and some other agency delivered and paid for the services. In these cases, Head Start provided information to help participants get services from some other source. For example, when asked the main methods the programs 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, primarily paid for the service (see fig. 5 and table II.3 in app. II). Because most Head Start children are eligible for Medicaid’s Early and Periodic Screening, Diagnosis, and Treatment Program, Head Start programs may refer children to Medicaid providers; thus, Head Start provides access to these services with little or no impact on the Head Start programs’ budgets. The same was true of dental services and immunizations. About 40 percent of the programs reported Head Start funds, however, as the primary source for meals and food, even though Head Start expects programs to seek reimbursement for these expenses from the U.S. Department of Agriculture’s (USDA) Adult and Child Care Food Program. Education was the service most directly provided by Head Start for enrolled children. Nearly 90 percent of programs reported that they both delivered and funded education services for enrolled children. Some Head Start program officials we interviewed, however, told us that they contracted with a private preschool or child care centers to provide education services. These cases are rare, however; only 3 percent of respondents to our survey reported that Head Start funded, but someone else delivered, education services. These programs purchased “slots” in centers operated by other organizations for about 2,000 children. In addition, Head Start typically provides services for children’s siblings and other family members indirectly (see table II.4 in app. II). Of those respondents to our survey who indicated that they provided services to siblings and other family members, at least half reported that Head Start programs neither delivered nor paid for the services. As shown in figure 6, programs were more likely to report full Head Start involvement (that is, the program paid for and delivered the service) in the areas of education; social services; child care; and meals, food, and nutrition. For our review, we asked several Head Start directors about some of the services they provided directly to family members. Program officials stated that they typically provided services to the siblings, while providing services to the enrolled child. For example, education services provided to enrolled children in a home-based program may be provided to siblings as well, benefiting all enrolled children and their siblings. The director of a program in Montana, for example, stated that staff bring along snacks for the siblings during home visits. The director of a program in Ohio stated that if the enrolled child, as well as the child’s siblings, needs a physical exam, they will ensure that the siblings are also referred for physical exams. When asked to report the funds received from all sources to operate their Head Start programs, survey respondents reported that different funding sources supported Head Start programs (see fig. 7). Most programs— about 90 percent—had multiple sources. The number of different funding sources that respondents reported varied (see fig. 8). The largest portion of programs, 40 percent, reported one other non-Head Start funding source followed by 27 percent of the respondents who reported two other non-Head Start funding sources. At the other extreme, however, the number of programs reporting six to seven funding sources was small— about 1 percent. The multiple funding sources included other federal programs, such as the Child Care and Development Block Grant Program and the Social Services Block Grant Program, both of which provide funding for child care. USDA was also a source of federal funding for programs, which, among other things, supplemented Head Start program food and nutrition resources by reimbursing food costs for eligible children. States, charitable organizations, and businesses also provided program funds. Some of this non-Head Start funding may have been part of the 20 percent of nonfederal matching funds that programs typically have to provide. In addition, programs received in-kind support for their operations such as building space, transportation, training, supplies and materials, and health services. In fact, many Head Start agencies also operated other programs from which Head Start participants sometimes received services but whose budgets were separate from Head Start. For example, we spoke to one Head Start director whose program was operated by a public school. According to this official, the school district bears a number of the Head Start program expenses. For example, the school district bears a portion of the cost of facilities, Head Start children receive their meals in the cafeteria using school staff, and some staff funded with title I and special education money provide services for Head Start children. As shown in table 1, respondents reported receiving a total of $3.1 billion to operate their Head Start programs in their most recently completed budget year, of which $2.7 billion, or 85 percent, was income from the Head Start grant. Head Start grant funds were the largest single source of funding for most programs. For example, for about 77 percent of the respondents, Head Start funding represented between 80 and 100 percent of the programs’ total funds. Other non-Head Start funding totaled about $456 million and represented about 15 percent of the total funds received. The states provided the largest source of other funding, which totaled about $169 million and represented about 5 percent of the total funds in programs’ last budget year. The next largest source of funds came from a federal source—USDA. USDA funding of $168 million also represented about 5 percent of the total program funds. The non-Head Start funding increased the amount of funds available per child. Average Head Start grant funds per child were $4,637 for the responding programs. The total amount of funds per child, including Head Start grant funds, was $5,186 per child, a difference of about $549 or 12 percent Head Start-wide. Across most states and territories, the non-Head Start funding increased the amount available per child (see table II.5 in app. II). As shown in figure 9, for the majority of states, the additional funds increased the amount available per child by over 10 percent; in four states and the District of Columbia, additional funds increased the amount available per child by at least 21 percent. Head Start and total funding per child varied considerably (see table II.6 in app. II). Across all programs, the median amount of Head Start grant funds per child was $4,450 for the responding programs but ranged from a low of $792 to a high of $16,206. Median total funds per child of $4,932 across all programs ranged from $1,081 to $17,029 per child. Several reasons may explain the funding variation by state and program such as the hours and days of program operation and the characteristics of the children served. We spoke with a Head Start director in the District of Columbia, whose program had high per child Head Start and total funding. The director told us that the program provided service for children in centers that operated year round and for 10 hours or more per day. We also spoke with a director of a program in New York City that had high funding per child. That program provided part-day center services. The children it served, however, had multiple disabilities or special needs. We also spoke with directors whose funding per child was low. One director stated that because the Head Start program is operated by the public school, the school bears a number of the expenses—such as facilities and food cost as well as some staff costs—of the Head Start program. Head Start programs spent 68 percent of their overall funds on personnel. Personnel included teachers, teacher aides, home visitors, social service workers, and administrators. Personnel costs for educational services were the single largest personnel expense (53 percent). According to Head Start’s annual survey, Head Start programs employed many staff. About 129,000 staff worked either full or part time in regular Head Start programs nationwide (see fig. 10). These staff, in addition to providing direct services, such as education, facilitated children’s and families’ access to services. One way Head Start tries to encourage parental involvement is by providing parents preference for employment in Head Start programs as nonprofessionals. Thus, about one-third of the staff were parents of current and former Head Start children. The remaining funds—32 percent—were spent on nonpersonnel-related expenses. Interestingly, direct payment for medical services accounted for only 3 percent of nonpersonnel-related expenses. In this area, programs are encouraged to seek non-Head Start sources of funds, and many programs link families and children to the Medicaid Early and Periodic Screening, Diagnosis, and Treatment Program. In addition, programs spent their funds on a range of services. As shown in figure 11, education services were the largest expense (39 percent). The smallest expenses were for health (4 percent), disabilities services (3 percent), and parent involvement services (3 percent). Many Head Start programs reported that state-funded preschools (70 percent), other preschools, child development and child care centers (90 percent), and family day care homes (71 percent) operated in their communities serving Head Start-eligible children. The extent to which these programs resemble Head Start is not known. However, programs that serve disadvantaged children may—like Head Start—help children and families obtain additional services such as medical and social services. To test this assumption, we gathered information on Head Start agencies that also operated other early childhood programs. About 11 percent of the Head Start respondents (in 39 states) reported that they operated other early childhood programs and that these programs served Head Start-eligible children. These children received some or most—but not all—of the services typically provided by Head Start programs. Respondents reported serving about 14,000 Head Start-eligible children through these other programs. California served the greatest number of such children (3,216) followed by Kentucky (2,652) (see table II.7 in app. II). These programs provided many of the same services as Head Start programs, but not all services were provided to all children. Education services, meals, social services, and immunizations were the most often provided; dental, medical, and other nutrition services were the least often provided. Thirty percent of the programs responded that they provided no services to families. Families or siblings were more likely to receive social services and parent literacy training through Head Start and less likely to receive medical services, such as dental, mental health, and immunizations. In many respects, the Head Start program is at a crossroads because the context in which it operates today differs greatly from that of 30 years ago when the program was established. The services available to poor children have changed and communities have enhanced resources for serving poor children and their families. Consequently, Head Start facilitates or brokers many services provided by others, referring and linking families to these services, rather than providing them directly. The one service that almost all Head Start programs provide directly is education, although the number of early childhood education programs other than Head Start has grown in the past 30 years. Furthermore, changes in welfare policy have important implications for Head Start. Most Head Start programs operate for only part of the day and part of the year. As changes in welfare policy require increasing numbers of poor people—including Head Start parents—to seek and maintain employment, however, the need for full-day, full-year services will intensify. The administration’s proposals to help working parents secure affordable, quality child care include substantially increasing Head Start enrollment. Head Start’s predominantly part-day, part-year programs present obstacles for meeting the needs of working families. Head Start will need to balance the administration’s wish to serve more eligible children, which has typically been done by creating more part-day, part-year slots, with the need for more full-day, full-year services more compatible with working families’ needs. Finally, information about Head Start’s effectiveness and the efficiency of various Head Start models is lacking. As we reported earlier, although Head Start research has been conducted, it does not provide information on whether today’s Head Start is positively affecting the lives of today’s participants whose world differs vastly from that of the 1960s and early 1970s. In addition, funding for Head Start programs varies widely. We do not know to what extent, however, this variation may be attributable to efficiencies in providing services or to other factors such as programs’ ability to leverage other community resources, characteristics of the population served, or program structure. ACF provided general comments about the Head Start program and specific technical comments, which we incorporated in the report as appropriate. Four of ACF’s comments that were not incorporated in the report addressed services provided to children’s siblings, data on hours and months of attendance, use of funds for food costs, and hiring of parents. ACF commented that our discussion of services provided to enrolled children’s siblings is misleading because it implies that Head Start programs are actively providing services to such children. ACF contends that Head Start programs do not use grant funds to provide services to siblings and that such services are provided only to the extent that they are part of the enrolled child’s services. Nevertheless, a small percentage of Head Start survey respondents reported that they did use Head Start funds to deliver services to families and siblings. Our report emphasizes, however, that when provided, many of these services are neither paid for nor delivered by Head Start. Head Start facilitates siblings’ and families’ access to services in much the same way as it does to enrolled children. We also report that our interviews with Head Start officials showed that siblings sometimes receive services as part of the program’s services to the enrolled child. For example, Head Start staff may bring along snacks for siblings during home visits and provide education services for the siblings during such visits. It is likely that in such a situation, the Head Start program would consider this to be providing services directly because Head Start funds might have been used to pay the staff’s salary and the cost of siblings’ snacks. In addition, ACF commented that Head Start does collect data on the number of hours per day or months per year that enrolled children attend center programs and that such information is available through its Head Start Cost data system. During this study, we reviewed the Head Start Cost data system and found—and Head Start officials had previously confirmed—that reporting of Head Start Cost data is optional and not all programs provide such data. Furthermore, the data collected by the system on the number of hours per day or months per year that children attend center programs really reflect programs’ projected center operating schedules, not their actual schedules. ACF also stated that our discussion of USDA reimbursement is somewhat inaccurate and that USDA covers the vast majority of all food costs incurred by Head Start programs, with Head Start grant funds paying only a small portion of these costs. AFC stated that it is not conceivable that 40 percent of Head Start programs are using Head Start funds as their primary source of meals and food because programs are required to seek such reimbursement from USDA. We did not change our figures in the report, however, because they directly reflect the reports of our survey respondents. In addition, ACF stated that the discussion of hiring parents should clarify that Head Start hires parents only for jobs for which they are qualified and that many parents have advanced through the Head Start ranks and now hold professional-level positions in the program. We assessed, however, neither the qualifications of the parents Head Start employs nor the number who hold professional-level positions in the programs and therefore the report does not address these issues. We are sending copies of this report to the Secretary of Health and Human Services, the Head Start Bureau, appropriate congressional committees, and other interested parties. Please call me at (202) 512-7014 if you or your staff have any questions about this report. Major contributors to this report are listed in appendix V. In preparation for Head Start’s reauthorization, the Chairman and Ranking Minority Member, House Committee on Education and the Workforce; the Chairman and Ranking Minority Member, Subcommittee on Early Childhood, Youth and Families, House Committee on Education and the Workforce; Chairman and Ranking Minority Member, Subcommittee on Children and Families, Senate Committee on Labor and Human Resources; and Representatives Cunningham and Kildee asked us to describe the (1) number and characteristics of Head Start participants, (2) services provided and the way they are provided, (3) federal and nonfederal program dollars received and spent by programs delivering Head Start services, and (4) other programs providing similar—in part or in whole—early childhood services. As agreed with the requesters’ offices, however, we did not comprehensively review other early childhood programs. We focused on collecting information on Head Start’s regular program; thus, programs serving special populations, such as migrant and Native American and pregnant women and infants, were excluded. About 85 percent of Head Start children are served through regular Head Start programs. Programs for special populations represent only a small portion of Head Start children served and each program is unique. We administered our survey about the same time Head Start conducted its annual survey (May 1997), which we also analyzed. Both surveys collected information on the 1996-97 program year, which spanned September 1996 to May 1997. Head Start refers to its annual survey as the Program Information Report (PIR). Our survey was mailed to 1,783 regular Head Start programs; of these, 1,722 were determined to be active Head Start programs that served children. The PIR was a second source of information on programs. (Both instruments are described in more detail in the following section.) Because the mailing list HHS provided us was the same one used for the PIR, all regular Head Start programs should have received both our survey and the PIR. To obtain a broader understanding of Head Start, our questionnaire mostly avoided questions appearing on the PIR. For example, we asked respondents to report the number of months and hours of the day children attended centers, the number of classes operated on weekends, and whether Head Start programs paid for children to attend centers operated by someone else. We also asked them the number of months they provided services in their home-based programs. In addition, we asked how services are provided to enrolled children and their family members and the extent to which family members are served. We also asked them about the funds they received to operate their Head Start programs as well as their Head Start program expenditures. We asked Head Start programs if they served Head Start-eligible children through other early childhood programs they operated and about the services provided them and their families. Our complete survey appears in appendix III. HHS requires that all grantees and delegate agencies complete annual PIRs. Although the questions asked in the report change somewhat from year to year, in general, the report asks about program management issues. Among other things, the 1996-97 report asked about the numbers of children served by the Head Start program in that program year, the number receiving particular kinds of services, and details about the Head Start staff, for example, the number of staff in various kinds of positions, their educational level, and so forth. All Head Start programs are required to complete a PIR; however, not all had done so at the time of our analyses. Because we collected data from two major sources, response rates are shown in table I.1 in several ways. The overall response rate (98 percent) is based on the number of eligible respondents divided by the number from which information was obtained from at least one source. Our survey response rate is based on the number of eligible respondents divided by the number completing and returning our survey (86 percent). Finally, the PIR response rate (94 percent) is based on the number of eligible respondents for whom HHS provided us with completed 1996-97 PIR information. Response rate (percent) All surveys are vulnerable to some nonsampling errors, including errors due to imperfect population lists, measurement errors due to ambiguous questions or inaccurate responding, or errors due to lack of response. These errors may affect both our survey and the PIR to some unknown degree. We took several steps to minimize the impact of these errors. First, we examined responses for extreme values. In many cases, we reviewed questionnaires for explanations of questionable responses. When we could not resolve questions, we called survey respondents for clarification. In a few cases, respondents had reported numbers incorrectly; and, in these cases, we corrected the data, or, if correction was not possible, we rejected the erroneous data. Second, we looked for a systematic pattern in the distribution of nonrespondents. Because we thought that program size (defined by total funded enrollment) might be related to response patterns, we examined whether programs of various sizes were more or less likely to respond. Although smaller programs tended to be somewhat less likely to respond, the difference in the response rate, coupled with the small number of the nonrespondents, yielded an inconsequential overall impact. In most cases we based our analyses simply on the answers of survey respondents. No weighting for nonresponse was done because our response rate was so high that adjustments for nonresponse would have hardly affected our findings. In reporting total enrollment information, however, we adjusted the data so that more complete total enrollment could be reported. For those programs lacking enrollment data, we imputed enrollment from the 1996-97 PIR (or in cases where the 1996-97 PIR was not available, we used the 1995-96 PIR). To gather illustrative information, we conducted telephone interviews of nine Head Start programs in Florida, Iowa, Montana, New York, Ohio, Pennsylvania, Vermont, Arkansas, and Oregon, which were judgmentally selected. We selected large and small programs in different parts of the country and programs representing a mixture of the types of program options Head Start offers such as centers and homes. We selected programs operated by different types of agencies—including community action agencies, universities, and nonprofit organizations. In addition, we selected grantees that operated the program directly as well as those that did not and programs that received funds from various sources to operate their program as well as those operating with only Head Start grant funds. Finally, we selected programs in which a portion of the total enrollment was funded with non-Head Start income. We asked Head Start program officials a number of questions, including whom they served, their funding sources, availability of other early childhood programs in their communities, and general questions about program operations. We also asked programs about further program expansion. Finally, we validated selected responses to our survey by visiting several Head Start programs, which we also wanted to observe. We visited programs in Philadelphia, Pennsylvania; Boston, Massachusetts; Kansas City, Missouri; Chicago, Illinois; Atlanta, Georgia; and Seattle, Washington. We conducted our work between March 1997 and November 1997 in accordance with generally accepted government auditing standards. The tables in this appendix provide selected information on Head Start programs. Table II.1 presents data on Head Start enrollments by state. Tables II.2 provides data on the extent to which families received services, and tables II.3 and II.4 present information on how services are provided to enrolled children and their families. Table II.5 presents by state information on the average Head Start grant funding per child and the average funding per child from all sources, including Head Start grants. Table II.6 presents data on the variation in funds per child by and within state. Table II.7 presents information on the number of Head Start-eligible children receiving services through other early childhood programs that Head Start agencies operate. Head Start grant funds per child (in dollars) Total funds per child (in dollars) (continued) Head Start grant funds per child (in dollars) Total funds per child (in dollars) (continued) Head Start grant funds per child (in dollars) Total funds per child (in dollars) Head Start funds per child Average (median) Average (median) (continued) Head Start funds per child Average (median) Average (median) 5,522 Receive some or most services (continued) Receive some or most services Respondents in these states and territories did not report serving children who received some or most Head Start-like services. In addition to those named above, the following individuals made important contributions to this report: Deborah Edwards developed the survey, performed the statistical analyses, and co-wrote the report; Donnesha Correll co-wrote the report and managed survey operations; Wayne Dow performed the statistical analyses; Liz Williams edited the report; and Ann McDermott created the report graphics. The first copy of each GAO report and testimony is free. Additional copies are $2 each. Orders should be sent to the following address, accompanied by a check or money order made out to the Superintendent of Documents, when necessary. VISA and MasterCard credit cards are accepted, also. Orders for 100 or more copies to be mailed to a single address are discounted 25 percent. U.S. General Accounting Office P.O. Box 37050 Washington, DC 20013 Room 1100 700 4th St. NW (corner of 4th and G Sts. NW) U.S. General Accounting Office Washington, DC Orders may also be placed by calling (202) 512-6000 or by using fax number (202) 512-6061, or TDD (202) 512-2537. Each day, GAO issues a list of newly available reports and testimony. To receive facsimile copies of the daily list or any list from the past 30 days, please call (202) 512-6000 using a touchtone phone. A recorded menu will provide information on how to obtain these lists.

Summary: Pursuant to a congressional request, GAO provided information on the Head Start Program in preparation for its reauthorization, focusing on: (1) the number and characteristics of those served; (2) the services provided and the way they are provided; (3) federal and nonfederal program dollars received and spent by programs delivering Head Start services; and (4) other programs providing similar early childhood services. GAO noted that: (1) Head Start served about 782,000 disadvantaged children and 711,000 families in program year 1996-97, according to GAO's review; (2) the demographics of these children and families were similar in many respects; (3) most children were 4 years old and spoke English as their main language; (4) families typically had more than one child and were very poor; (5) through Head Start, children received access to a large array of services, as did their families in some cases; (6) most child and family services, however, were neither paid for nor provided directly by Head Start programs; (7) instead, Head Start programs often functioned as a coordinator or facilitator, referring and linking children and families to needed services; (8) although many families required full-day, full-year child care, Head Start services were typically provided in centers that operated part day on schedules that paralleled the school year; (9) only a small percentage of children attended programs in centers that operated year round; (10) virtually no programs operated on weekends, and only a few operated before 7 a.m. or after 5 p.m.; (11) almost half of the families identified as needing full-day services left their children at a relative's or unrelated adult's home when the children were not in Head Start; (12) most programs responding to GAO's survey secured funding for their operations from multiple sources; (13) among all programs in the states and territories, the average amount of Head Start grant funds per child was $4,637, ranging from a low of $792 to high of $16,206; (14) the additional income programs received from other sources increased the amount of funds available per child to an average of $5,186, 12 percent more income per child; (15) total funds per child varied widely by program, ranging from $1,081 to $17,029 per child; (16) programs spent their income on a variety of services and activities; however, the largest promotion of programs' overall income was spent on education services; (17) most Head Start programs reported that state-funded preschools, other preschools, child development centers and child care centers, and family day care homes operated in the same communities as Head Start programs; and (18) although GAO's review did not determine the extent to which these programs resemble Head Start, some that serve disadvantaged children sometimes help children and families obtain additional services, such as medical services, as Head Start does.