While parents are primarily responsible for the education and care of children who are younger than school age, a variety of factors have led to an increased demand for early learning and child care programs. For example, workforce participation among mothers with children age 5 and under has generally increased since the 1970s. In addition, initiatives to expand access to preschool have developed at the local, state, and federal level. Federal support for early learning and child care has developed gradually in response to emerging needs. Historically, early learning and child care programs existed separately with separate goals: early learning programs focused on preparing young children for school, while child care programs subsidized the cost of child care for low-income parents who worked or engaged in work-related activities. Over time, the distinction between these two types of programs has blurred somewhat as policymakers seek to make educationally enriching care available to more young children. In addition to costs paid by parents, multiple levels of government contribute funding to support early learning and child care through a loosely connected system of private and public programs. Public financing for early learning and child care in the United States involves multiple funding streams and programs at the federal, state, and local level. A portion of federal support for child care is provided through funding to states, which in turn provide subsidies to low-income families. Within the parameters of federal law, regulations, and guidance, states generally determine their own specific policies concerning the administration of these funds, including who is eligible to receive subsidies, the amount of the subsidies, and the standards that programs must meet. We previously reported that different agencies administer the array of federal early learning and child care programs. This report, like our prior work, uses standard definitions to describe fragmentation, overlap, and duplication among government programs: Fragmentation refers to those circumstances in which more than one federal agency (or more than one organization within an agency) is involved in the same broad area of national need and opportunities exist to improve service delivery. Overlap occurs when multiple agencies or programs have similar goals, engage in similar activities or strategies to achieve their goals, or target similar beneficiaries. Duplication occurs when two or more agencies or programs are engaged in the same activities or provide the same services to the same beneficiaries. As we have previously reported, fragmentation, overlap, and duplication exist across many areas of government activity. In some cases it may be appropriate or beneficial for multiple agencies or entities to be involved in the same programmatic or policy area, due to the complex nature or the magnitude of the federal effort. For policy makers considering investments in early learning or child care programs, understanding more about the quality of the program or the results of early learning interventions can be instructive. Evaluative information can help demonstrate whether and why a program is working well or not. We have previously reported that performance assessment is an important way to obtain such information. Performance assessment is also critical to effective program management. Agencies may use different methods to assess the performance of programs. Performance measurement focuses on whether a program has achieved its objectives, expressed as measureable standards, while program evaluations typically examine a broader range of information on program performance and its context. Both forms of assessment aim to support resource allocation and other management decisions. Agencies may measure different types of performance information, including the type or level of program activities (process), the direct products and services delivered by a program (output), or the results of those products and services (outcomes). Multiple federal programs may provide or support early learning or child care for children age 5 and under. The federal investment in early learning and child care includes three broad categories of programs: 1. Programs with an explicit early learning or child care purpose: For these programs, early learning or child care is specifically described as a program purpose, according to our analysis of the CFDA and agency documents. This may include some programs that also serve children older than 5 or provide some services outside a formal early learning or child care setting. The Child Care and Development Fund (CCDF), which provides subsidies to low-income working families, is an example of a program in this category. 2. Programs without an explicit early learning or child care purpose: These programs may provide or support early learning or child care; however, early learning or child care is not specifically described as a program purpose in the CFDA or agency documents. According to agency officials, these programs permit, but do not require, using funds for these services. Programs in this category include multipurpose block grants; programs that permit funds to be used for early learning or child care as an ancillary service; and programs that support early learning or child care through food, materials, or other services. Examples of programs without an explicit early learning or child care purpose include Temporary Assistance for Needy Families (TANF), the Workforce Innovation and Opportunity Act Adult program, and the Child and Adult Care Food Program. 3. Tax expenditures that subsidize child care through the tax code: These include tax credits and exclusions that subsidize the private purchase of child care. Tax credits allow eligible individuals or employers to reduce their tax liability dollar for dollar. The credits included in this review are nonrefundable and do not offer benefits to individuals or businesses with no tax liability. Exclusions allow individuals to exclude certain compensation from their taxable income and generally provide larger tax savings to those taxed at higher rates. The revenue that the government forgoes through tax expenditures can be viewed as spending channeled through the tax system, which contributes to the overall federal investment. The credit for child and dependent care expenses is an example of such a tax expenditure. Within this framework, we identified 9 programs that have an explicit early learning or child care purpose and another 35 programs that do not have an explicit early learning or child care purpose. In addition to these federally funded programs, we identified three federal tax expenditures that forgo tax revenue to subsidize the private purchase of child care and adult dependent care services. (For a complete list of programs and tax expenditures we identified, see fig. 5 through fig. 14 in appendix II.) Agencies obligated approximately $15 billion in fiscal year 2015, the most recent obligations data available at the time we conducted our review, across the nine programs with an explicit early learning or child care purpose. The vast majority of this funding is concentrated in two programs administered by HHS: Head Start and CCDF. Together, these two programs comprised over 90 percent of total obligations for programs with an explicit early learning or child care purpose in fiscal year 2015. All other programs with an explicit early learning or child care purpose each obligated less than $500 million in fiscal year 2015 (see table 1). All of the programs with an explicit early learning or child care purpose require at least some funds to be used on early learning or child care services, according to agency officials. However, not all funds for these programs are targeted toward children from birth through age 5 in an early learning or child care setting, and agencies noted that they are generally not required to track funds used specifically for these purposes. One exception is the Striving Readers Comprehensive Literacy Program: Education officials collect data on the amount of funds used for pre- literacy activities because grantees must ensure that local providers use 15 percent of funds to serve children from birth through age 5. In fiscal year 2015, all four programs that exclusively target children age 5 or under—Early Intervention Program for Infants and Toddlers with Disabilities, Preschool Development Grants, Preschool Grants for Children with Disabilities, and Head Start—used 100 percent of their funds for early learning or child care services for this population, according to agency officials. In contrast, CCDF, Family and Child Education (FACE), Promise Neighborhoods, and Child Care Access Means Parents in School (CCAMPIS) programs provide services to school-age children in addition to children age 5 and under. Officials told us they were unable to identify the amount of funds used specifically for children age 5 and under for these programs. For example, CCDF serves eligible children under age 13, and while states report the percentage of children served by age, officials told us states are not required to report the amount of CCDF funds spent by age. Not all CCDF funds are used for child care subsidies. In addition to directly subsidizing access to child care services for eligible low-income children, CCDF invests in improving the quality of child care available to families. We recently reported that the majority of children who received CCDF subsidies were under age 5. Among programs without an explicit early learning or child care purpose, none require spending on early learning or child care, according to agency officials. Further, agency officials told us that they do not track the amount of funds used for early learning or child care for most of these programs and are not required to do so. Officials from 3 of these 35 programs could identify the amount of funds obligated for early learning and child care purposes. Funding for early learning or child care for these three programs ranged from $2 million to $14 million in fiscal year 2015. Additionally, HHS officials told us that although they do not track program obligations specifically for early learning or child care purposes for the Social Services Block Grant (SSBG) and TANF, they do track state spending on child care. However, HHS does not track spending specifically for services provided to children age 5 and under, according to agency officials. (See table 6 in appendix III for details.) Moreover, although they do not track this information, officials from some programs without an explicit early learning or child care purpose said it is likely that little funding, if any, actually went toward these purposes. For example, officials from the U.S. Department of Agriculture (USDA) told us that the National School Lunch Program and School Breakfast Program are targeted to school-age children, and they did not think very many children under age 5 receive meals from the program. Additionally, Department of Labor officials told us that the Native American Employment and Training Program permits funds to be used for child care services, among other supportive services, to enable parent participation in the program. However, due to the limited grant size, officials said it is likely that most participants only receive referrals to child care providers. Much like the agencies with programs that do not have an explicit early learning or child care purpose, Treasury does not estimate the amount of forgone revenue resulting specifically from tax credits or exclusions that support the care of children age 5 and under, according to agency officials. All of the tax expenditures we identified are available for the care of dependent children. The credit for child and dependent care expenses also subsidizes dependent care of individuals who are physically or mentally incapable of self-care, including adults with disabilities or who are elderly. Combined, these tax expenditures accounted for approximately $5.4 billion of forgone federal income tax revenue in fiscal year 2015 (see table 2). This amount, however, includes forgone revenue for care of children older than age 5 and dependent adults, since the available data do not distinguish children and other dependents by age. As we found in 2012, some fragmentation, overlap, and potential duplication exist among early learning and child care programs. The federal investment in early learning and child care is fragmented in that it is administered through multiple agencies. HHS, Education, and Interior administer programs with an explicit early learning or child care purpose. Five additional agencies and one regional commission administer programs without an explicit early learning or child care purpose, and the Internal Revenue Service at Treasury is responsible for administering federal tax expenditures (see table 3). We found some overlap between early learning and child care programs, as some programs target similar beneficiaries (see fig. 1). For example, five of the nine programs with an explicit early learning or child care purpose primarily target children age 5 and under, and four programs target low-income children. Despite these general similarities, however, some of these programs target very specific populations that in some cases have limited overlap or no overlap. For example, Preschool Development Grants specifically target 4-year-olds, the Early Intervention Program for Infants and Toddlers with Disabilities targets children with disabilities from birth through age 2, and Preschool Grants for Children with Disabilities targets children with disabilities ages 3 through 5. Other programs target more specific populations, such as children whose low- income parents are pursuing postsecondary education, or children living in certain distressed geographic areas. Additionally, some programs engage in similar activities, according to our analysis of agency-provided information. For example, grantees of Head Start, Preschool Development Grants, and FACE use funds for enrollment slots (spots for individual children to participate in programs on an ongoing basis), health care, and social services or transportation, according to agency officials. However, other programs with an explicit early learning or child care purpose do not fund enrollment. Instead, some programs fund additional services to aid early learning, such as special education services or evaluations (see fig. 2). Despite some similarities in target populations and activities, programs with an explicit early learning or child care purpose often have different goals and administrative structures. For example, while the CCAMPIS program and CCDF both fund child care, they have different goals. The goal of CCAMPIS is to support the participation of low-income parents in postsecondary education. In contrast, CCDF has dual goals of providing child care as a work support to parents and providing children with quality child care to prepare them for success in school, according to HHS. Additionally, the two largest programs—Head Start and CCDF—differ significantly from each other both in their goals and in how they are administered. Head Start was created, in part, to support children’s early development by offering comprehensive, community-based services to meet children’s multiple needs and, as such, provides federal grants directly to community-based public and private service providers. In contrast, CCDF was created to help states reduce dependence on public assistance. It provides grants to states to subsidize child care to support parents’ involvement in the workforce. States, in turn, generally provide subgrants to counties or other local entities for distribution to parents. Though some overlap exists among programs with an explicit early learning or child care purpose, the majority of the programs we identified– 35 of 44–do not have such a purpose. Overlap is limited among these 35 programs and those 9 programs with an explicit early learning or child care purpose for a number of reasons. For example: Multipurpose block grants can be combined and jointly administered: In their comments regarding our 2012 report, HHS officials noted that many states choose to integrate CCDF, TANF, and SSBG funding streams to provide services. They noted that states jointly administer these funding streams under one set of rules, often in coordination with other state and local funding. Programs that provide child care as an ancillary purpose are not targeted toward children: Overlap between programs that permit funds to be used for child care as an ancillary service and those with an explicit child care purpose is limited given that such programs are not targeted to children and that child care is not among the programs’ objectives. For example, six worker training programs authorized by the Workforce Innovation and Opportunity Act allow for grant dollars to pay for child care and other supportive services that are necessary to enable an individual to participate in training and other authorized activities. These programs are not targeted to children age 5 or under—their objectives are to provide individuals with job search assistance and training. Some programs support but do not provide early learning or child care for young children: Other programs we identified support early learning or child care by providing food, materials, or other services. These programs have limited overlap with programs with an explicit early learning or child care purpose because they support such programs rather than provide early learning or care for children age 5 and under. For example, the Child and Adult Care Food Program, which is administered by USDA, reimburses child care centers for the cost of meals and snacks, among other things. Additionally, the General Services Administration donates unused federal property to certain state and local agencies through the Donation of Federal Surplus Personal Property program. Officials from the General Services Administration told us that agencies that receive the donations pass them along to eligible organizations, which may include preschools. They also told us that they do not track the ultimate destination of the donated property. HHS and Education have acknowledged some overlap among early learning and child care programs. In a November 2016 joint report to Congress, HHS and Education identified eight federal programs with a primary purpose of providing early learning for young children. In this report, HHS and Education stated that overlap among early learning and child care programs is purposeful and necessary to meet the needs of children and parents. For example, some programs fund enrollment slots and others fund additional services to aid early learning, such as special education services, according to HHS and Education officials. They also noted that families may have multiple needs that require more than one type of service. For instance, families can combine Head Start and CCDF, which allows families to meet children’s learning needs and parents’ child care needs, according to HHS officials. Despite this overlap, there may be service gaps because these programs are not entitlements, and therefore do not serve all eligible children. For example, we recently reported that an estimated 1.5 million children received CCDF subsidies, out of an estimated 8.6 million children who were eligible in their state in an average month in 2011 and 2012. Additionally, Education officials told us that many states have narrowed their eligibility criteria for the Early Intervention Program for Infants and Toddlers with Disabilities because of funding constraints. According to these officials, states are focusing these services on children with the most severe disabilities. There may be potential for duplication among early learning and child care programs insofar as some programs may fund similar types of services for similar populations. However, as we noted in our 2012 review, the extent to which actual duplication exists is difficult to assess at the federal level due to differing program eligibility requirements and data limitations. For example: Program eligibility requirements: Eligibility requirements differ among programs, even for similar subgroups of children, such as those from low-income families. For example, Head Start serves primarily low-income children under age 5 whose families have incomes at or below the official federal poverty guidelines, while CCDF serves children under age 13 whose parents are working or in school and who earn up to 85 percent of state median income. Moreover, states have the flexibility to establish specific eligibility policies for CCDF within broad federal eligibility requirements. Given this flexibility, it may be possible for families with similar circumstances to be eligible to receive CCDF subsidies in some states but not others. Additionally, although the CCAMPIS program also provides funding for child care, families must be eligible for Pell Grants, which are need-based federal grants to low-income undergraduate students, in order to receive services. Data limitations: For some programs, relevant programmatic information is sometimes not readily available. For example, as we previously reported, HHS does not collect data on all families who receive child care funded by TANF. This is because some families that do not receive cash assistance receive child care funded through TANF. States are not required to report on families who receive only TANF-funded child care without also receiving cash assistance. This leaves an incomplete picture of the number of children receiving federally funded child care subsidies. We previously suggested requiring additional data collection on families receiving TANF-funded child care, but this information is currently not collected. Additionally, inadequate or missing data, as well as difficulties quantifying the outcomes of some tax expenditures, can make it difficult to study the beneficiaries of these expenditures. While the extent of potential duplication may be difficult to fully assess, some early learning and child care programs include some safeguards against duplication. For example, some programs can use funds to expand access to other programs, thus limiting the likelihood that the same beneficiaries receive the same services from more than one program. Promise Neighborhood grantees can use funds to expand access to Head Start or to establish new child care or preschool options. Similarly, Preschool Development Grants can be used to expand the capacity of Head Start to serve more eligible children. Specifically, Preschool Development Grant funds must be used to supplement, not supplant, any federal, state, or local funds, including Head Start and CCDF, among others. In addition, the tax code has limits on combining the credit for child and dependent care and the employer-provided child care exclusion. Taxpayers can claim the credit for child and dependent care if they pay someone to care for a dependent under age 13 or for a spouse or other dependents who are not able to care for themselves. The credit can be up to 35 percent of dependent care expenses with a limit of $3,000 per qualifying person and $6,000 for two or more qualifying persons. The employer-provided child care exclusion, a kind of flexible spending account for dependent care expenses, generally provides participants an opportunity to exclude an amount not to exceed $5,000 for dependent care each year from their gross income. Families using the employer- provided child care exclusion must subtract the amount of those benefits from the maximum they are eligible to receive for the credit for child and dependent care, thereby preventing duplication of benefits. We found that since our 2012 review of early learning and child care programs, HHS and Education have improved coordination among the agencies that administer these programs, which has helped to address potential risks regarding fragmentation, overlap, and potential duplication. As we previously reported, effective coordination can help mitigate the effects of program fragmentation and overlap and potentially help bridge service gaps. Based upon our analysis, the Early Learning Interagency Policy Board— HHS and Education’s inter-departmental workgroup that focuses on children from birth through age 8—has followed leading practices for interagency collaboration that we have identified, such as defining outcomes, tracking progress toward goals, and including relevant participants across agencies, among others (see table 4). For example, in response to needed actions we identified in 2012, HHS and Education expanded membership of this group to include other agencies with early learning and child care programs. In addition to efforts related to the Interagency Policy Board, HHS and Education have improved coordination in other ways since our 2012 review of early learning and child care programs. For example, they have: Jointly administered the Preschool Development Grants: HHS and Education coordinate to co-administer the Preschool Development Grants program, which began in 2014. Issued joint policy statements: HHS and Education have also issued joint policy statements on a range of early learning and child care issues. Examples include statements on limiting preschool suspensions and expulsions, and strategies to increase the inclusion of young children with disabilities in high-quality early learning programs. Joint policy statements create consistent guidance for local programs, according to HHS and Education officials. Coordinated training and technical assistance: In 2015, HHS redesigned its training and technical assistance system across Head Start and CCDF. Previously, Head Start and CCDF had separate training and technical assistance centers that were operated independently of one another. The new training and technical assistance centers provide services to both Head Start and CCDF. Additionally, HHS and Education coordinated technical assistance by issuing a literature review about strategies to help children maintain the benefits of preschool attendance. They also held joint webinars on the use of assistive technology to support young children with disabilities and strategies to limit preschool suspensions and expulsions. Agencies assess performance for all nine programs with an explicit early learning or child care purpose, and they do so using different methods. The agencies use various combinations of three approaches: performance monitoring, conducting program evaluations or studies, and reviewing other performance information (see fig. 3). Specifically: Performance monitoring: For all nine programs, agencies reported they monitor performance annually either through performance measures or other annual reviews. Interior monitors performance for the FACE program through an annual review. This review includes implementation data and program outcomes, such as children’s proficiency in math and literacy, parenting practices, and integration of native language and culture into FACE program instruction, which officials can use to assess program progress from year to year. For the other eight programs, HHS and Education report results on measureable performance standards in agency congressional budget justifications or other publicly available sources. Program evaluations or studies: For six of the nine programs, agency officials also periodically conduct internal or contracted program evaluations or studies. Most of the programs that have conducted program evaluations have done so to fulfill a program requirement. For example, the 2004 reauthorization of the Individuals with Disabilities Education Act (IDEA) called for a national assessment to measure the implementation progress and relative effectiveness of the law. Similarly, in response to a congressional mandate in the 1998 reauthorization of Head Start, HHS conducted a national impact evaluation of Head Start and an evaluation of the Early Head Start program. Additionally, since fiscal year 2000, Congress has appropriated funds through CCDF specifically for research and evaluation, according to agency officials. Other performance information: Officials from six of the nine programs told us they collect other performance information through grantee-submitted performance reports or other methods. For example, the CCAMPIS program, which funds child care for student parents enrolled in postsecondary institutions, uses grantee-submitted annual reports to collect detailed information about individual student enrollment that provides context for understanding performance measures. Additionally, some programs track information about the cost of certain outcomes. Agency officials told us they use results from performance monitoring, evaluations, and other performance information to assist in grantee monitoring, determine continued funding to grantees, and develop technical assistance, among other things. While agencies use different methods to assess programs, all agencies that administer programs with an explicit early learning or child care purpose collect performance information that aligns with program objectives to determine progress toward those objectives. For example, the Striving Readers Comprehensive Literacy program aims to advance literacy skills—including pre-literacy skills, reading, and writing—for students from birth through grade 12. The program has four performance measures that assess student’s literacy proficiency at age 4, grade 5, grade 8, and again at high school. (See appendix IV for more details on recent program performance for each of the nine explicit-purpose early learning or child care programs.) Additionally, agency officials examine common aspects of performance for many programs with an explicit early learning or child care purpose. Specifically, we found that many programs had assessments relating to 1) results for children age 5 and under, 2) program quality or teacher qualifications, and 3) academic improvement or kindergarten readiness (see fig. 4). For example: Children age 5 and under: Eight of the nine programs assess results regarding this age group. For example, for the Early Intervention Program for Infants and Toddlers with Disabilities, Education officials assessed the percentage of children who entered the program with below age social-emotional skills and who then substantially increased their rate of growth by the time they exited the program. Program quality or teacher qualifications: Six of the nine programs assess program quality or teacher qualifications. For example, CCDF measures the number of states that implement a systemic approach to assessing, improving, and communicating a child care or education program’s level of quality, including meeting certain benchmarks. Similarly, Preschool Grants for Children with Disabilities measures the number of states with at least 90 percent of special education teachers certified in the areas in which they are teaching. Academic improvement or kindergarten readiness: Eight of the nine programs, including all seven of the programs with an explicit early learning purpose, assess academic improvement or kindergarten readiness. For example, for the Striving Readers Comprehensive Literacy program, Education measures the percentage of participating 4-year-old children who achieve significant gains in oral language skills. For Preschool Development Grants, Education measures the number and percentage of children served by the grant who are ready for kindergarten. Although many of the programs with an explicit early learning or child care purpose assess common aspects of performance, the specific results agencies examine differ for a number of reasons. One reason is that agencies use different tools to assess performance. For example, although all seven early learning programs assess some aspect of academic improvement or kindergarten readiness, programs vary in how they perform these assessments. The Striving Readers Comprehensive Literacy program provides grants to states and requires them to use approved state accountability assessments to determine most program performance measures. In contrast, the FACE program provides grants to Bureau of Indian Education-funded schools that implement in-home and center-based services, and uses a single student assessment tool to measure performance across participants. Another reason assessments differ is that some programs examine students’ progress while they participate in the program, whereas others assess proficiency at a particular point in time. For instance, both of the special education programs administered by Education that we reviewed collect entry and exit data on children with disabilities who receive program services. Officials use these assessments to show children’s developmental progress while in the program across a number of early childhood outcomes, including early language and literacy knowledge skills, including early language and literacy knowledge skills. In contrast, other programs assess children only once, during the academic year. For example, the Preschool Development Grants program assesses children once at kindergarten entry. Programs also differ in the time frame over which officials assess performance. For example, HHS has assessed the long-term impact of Head Start and Early Head Start by evaluating the same cohort of children as they progress through later grades, even after the children stopped receiving program services. Other programs gauge children’s performance annually while grantees receive funding, but do not evaluate them after they stop receiving grant-funded services. (See appendix IV for additional performance details and a complete list of program performance measures for all nine programs with an explicit early learning or child care purpose.) In addition to assessing performance by program, HHS and Education each have an agency-wide priority goal that incorporates early learning or child care program performance measures, and both agencies assess performance on meeting these goals. The GPRA Modernization Act of 2010 (GPRAMA) requires that every 2 years, certain agencies identify their highest priority performance goals, which GPRAMA refers to as agency priority goals. Agencies are expected to identify performance measures to track progress on achieving these goals, or identify alternative ways of measuring progress, such as milestones for completing major deliverables. Education incorporated performance measures for the Preschool Development Grants program into its priority goal, and HHS incorporated performance measures from Head Start and CCDF (see table 5). Education and HHS have incorporated these goals into their strategic plans and have published updates on progress toward meeting their priority goals at performance.gov. Guidance from the Office of Management and Budget states that agencies are to identify tax expenditures, as appropriate, among the various federal programs and activities that contribute to their strategic objectives and agency priority goals. HHS officials told us that they decided the three child care-related tax expenditures we identified are not potential contributors to their agency priority goal to improve the quality of early childhood programs for low-income children. According to HHS officials, they concluded that low-income families who qualify for HHS’s key programs, such as CCDF, are not likely to benefit from these tax expenditures due to their lack of tax liabilities. Moreover, agency officials told us the child care-related tax expenditures we identified are available to help pay for dependent care and do not directly align with HHS’s priority goal focused on program quality. According to Education officials, Education also does not incorporate these tax expenditures in its agency priority goal because families who benefit from publicly provided early learning services would not incur tuition costs, and therefore would not benefit from these expenditures. We provided a draft of this report for review and comment to the Departments of Education (Education), Health and Human Services (HHS), and the Interior (Interior). We also sent selected excerpts of the report to the Appalachian Regional Commission, and to the Departments of Agriculture, Housing and Urban Development, Justice, Labor, the Treasury, and the General Services Administration. We received formal written comments from HHS, which are reproduced in appendix V. In addition, Education and HHS provided technical comments, which we incorporated as appropriate. Interior did not have comments on our report. In its written comments, HHS agreed with our findings and noted that children and families benefit most from investments in federal early learning and child care programs when they are coordinated with similar programs and activities. The agency also noted that it will continue to work with the Department of Education and other agencies to streamline resources for early learning and child care programs, to the extent permitted by law. We are sending copies of this report to the appropriate congressional committees, the Secretaries of Education, Health and Human Services, and the Interior, and other interested parties. In addition, the report will be available at no charge on the GAO website at http://www.gao.gov. If you or your staff have any questions concerning this report, please contact me at (202) 512-7215 or brownbarnesc@gao.gov. Contact points for our Offices of Congressional Relations and Public Affairs may be found on the last page of this report. GAO staff who made key contributions to this report are listed in appendix VI. The objectives of this review were to examine: (1) what is known about the federal investment in early learning and child care programs; (2) the extent to which early learning and child care programs are fragmented, overlap, or are duplicative, and the efforts agencies have made to manage these conditions; and (3) the extent to which agencies assess performance for programs with an explicit early learning or child care purpose. To count the number of federal early learning and child care programs, we examined the key benefits and services they provide. We used the following three criteria to identify relevant programs. The programs (1) funded or supported early learning or child care services, (2) were provided to children age 5 and under, and (3) delivered services in an educational or child care setting. We excluded kindergarten programs from our scope because early learning applies to children who are preschool age (age 5 and under), while children who are in kindergarten are grouped as part of the standard K-12 education demographic. We also excluded any programs that were not listed in the Catalog of Federal Domestic Assistance (CFDA), a government-wide compendium of federal programs, projects, services, and activities that provide assistance or benefits to the American public. Additionally, we limited our review to programs for which federal funds were obligated in fiscal year 2015, the most recent available obligations data at the time we conducted our work. As we did in 2012 and prior work, we excluded programs operated by the U.S. Department of Defense because these programs are available only to members of the military and their families. Furthermore, these programs are not listed in the CFDA. Tax expenditures included in this review include those that (1) fund or support early learning or child care services, (2) are obtained on behalf of children under age 5, and (3) forgo taxes so those funds can be used to purchase child care services occurring in an educational or child care setting. In identifying programs and tax expenditures for this work, we relied on the results of our 2012 report, agency responses to our questionnaires, and other supplemental information provided by agencies. We did not conduct an independent legal analysis to verify the accuracy of the information provided to us by agencies. To identify federal programs and tax expenditures, we started with the list of 45 programs and 5 tax expenditures in our 2012 review. For each program, we sent questionnaires to and received responses from nine agencies and one regional commission and conducted follow-up interviews to confirm that these programs and tax expenditures continued to meet all three of our criteria, which are described more fully below, in fiscal year 2015. We asked agency officials to identify additional programs meeting these criteria that were not included in our 2012 review. We reviewed descriptions in the Congressional Research Service’s 2014 Tax Compendium to identify any new tax expenditures that can be used for early learning or child care. We used the questionnaires we sent to the Department of the Treasury (Treasury) to confirm that the tax expenditures we identified in 2012 remained in effect in fiscal year 2015. In addition to agency responses to our questionnaires, we obtained supplementary information from the Departments of Education (Education), Health and Human Services (HHS), the Interior (Interior), and other agencies. Using a similar definition as in our prior review, we considered a program to have an explicit early learning or child care purpose if, according to our analysis, early learning or child care is specifically described as a program purpose in the CFDA or other agency information. After we identified programs and tax expenditures that met our criteria, we obtained information about fiscal year 2015 program obligations, the most recent year for which these data were available, from the President’s budget for fiscal year 2017. We obtained information on estimated losses in revenue from fiscal year 2015 tax expenditures from Treasury’s Tax Expenditure Estimates for fiscal year 2017. To analyze potential fragmentation, overlap, and duplication across programs, we assessed the programs’ activities and target populations using questionnaire responses from the nine agencies and one commission, as well as from supporting documentation. We also interviewed Education and HHS officials regarding their efforts to coordinate with other agencies that administer early learning and child care programs, and examined documents about these efforts. We compared these efforts against leading practices for agency collaboration. In addition, we obtained information about program performance for programs with an explicit early learning or child care purpose by reviewing agency performance reports, congressional budget justifications, and program studies, and by interviewing agency officials. For programs with performance measures, we reported the results for the last 3 years of available data found in agency congressional budget justifications, or other publically available sources. We also reviewed program studies that were cited in congressional budget justifications or other published performance documents, and obtained additional program studies that Education, HHS, and Interior conducted or used independent contractors to conduct. Through these steps, we identified 30 studies published between 2002 and 2016. We then reviewed a subset of 27 studies that we determined to have assessed results aligned with the programs’ objectives. We reviewed the methodological and analytical approaches of each of these studies to ensure that they were appropriate to measure program performance. The Department of Education (Education) has two performance measures for Child Care Access Means Parents in School program (CCAMPIS), but has not set program-wide targets (see table 7). Education reports performance on these measures separately for four- year and two-year institutions of higher education in its annual congressional budget justification. The fiscal year 2017 budget justification contained performance information for fiscal years 2012 and 2013. Education officials told us reporting requirements for the program changed recently, from 18- and 36-month performance reporting to annual performance reporting. At that time, officials revised the data collection instrument and program performance measures to reflect the annual data collection. As of 2016, officials said they have two years of baseline data and are considering setting performance targets for future years. Education has not conducted an evaluation of the CCAMPIS program. However, officials told us they use data from other Education-conducted evaluations of post-secondary students to gather contextual information about conditions associated with low-income student parents. Education has six performance measures for the Early Intervention Program for Infants and Toddlers with Disabilities and set program-wide targets for each of these (see table 8). In its congressional budget justification, Education reports its progress toward achieving these targets annually. Results have remained relatively stable among the six measures over the 3 years of data we reviewed (2012-2014). However, in 2014, the most recent year of available data, Education reported meeting two performance targets: the number of states that serve at least 1 percent of infants in the general population under age 1 through this program, and the percentage of children receiving age-appropriate early intervention services in the home or in programs designed for typically developing peers. Other measures were relatively close to meeting targets. Education acknowledges that some data quality issues exist, particularly with regard to missing data. In various reauthorizations, the Individuals with Disabilities Education Act (IDEA) has included provisions for collecting information on the implementation and impact of the law. For example, in response to a requirement in the 1997 reauthorization, Education conducted four longitudinal child-based studies on specific age groups, including the National Early Intervention Longitudinal Study (NEILS). NEILS was a descriptive study of young children and families served through this program, the services they received, the cost of those services, and the outcomes that children and their families experienced. According to the authors of the final NEILS report, outcomes for families and children from birth through age 3 were generally positive. For example, nearly one third of children who received early interventions were not receiving special education services at kindergarten, nor did they have any disability. However, a large percentage of children who received early intervention services had communication problems, such as speech or communication delay, or the inability to make needs known, and for many children, these problems continued through kindergarten. The 2004 reauthorization of IDEA also called for a national assessment to measure the implementation progress and the relative effectiveness of the law. Among other reports published as part of the IDEA national assessment, Education published an analysis of the patterns in identification of and outcomes for children with disabilities as well as a report on IDEA implementation. Among other key findings, Education found that 32 states have early learning guidelines for infants and toddlers. Few states, however, provide a mandated or suggested written plan documenting the early intervention services a child should receive and how these services are to be administered for infants and toddlers and their families. Education also uses the Early Childhood Longitudinal Study, Birth Cohort, a nationally representative sample of children studied from birth through their entry into kindergarten, to obtain important demographic information on infants and toddlers with disabilities. The Preschool Development Grants program has three performance measures for its fiscal year 2014 cohort of grantees (see table 9). Education has not set program-wide performance targets, but requires individual grantees to set targets. Education published a progress update on grantee performance for the 2015-2016 school year, which was the program’s first year of implementation. In this update, Education reported that the state grantees met nearly 90 percent of their targets for the number of children served in high-quality preschool programs. Education has not yet published results for all three of its performance measures. Education officials told us that Education and HHS have not conducted an evaluation of this program, in part because the program is new and in the process of implementation. Education has five performance measures for Preschool Grants for Children with Disabilities and sets program-wide targets for each of these (see table 10). In its congressional budget justification, Education reports its progress toward achieving these targets annually. Results have remained relatively stable among the five measures over the 3 years of data we reviewed (2012-2014). However, in 2014, the most recent year of available data, Education reported meeting only one performance target—the percentage of children with disabilities (ages 3 through 5) attending a regular early childhood program and receiving the majority of hours of special education and related services in the regular early childhood program. Other measures were relatively close to meeting targets. Education acknowledges that some data quality issues exist, particularly with regard to missing data. In various reauthorizations, IDEA has included provisions for collecting information on the implementation and impact of the law. For example, in response to a requirement in the 1997 reauthorization, Education conducted four longitudinal child-based studies on specific age groups, including the Pre-Elementary Education Longitudinal Study (PEELS). PEELS was designed to describe young children with disabilities, their experiences, the services they receive, as well as their performance over time in preschool, kindergarten, and elementary school. Education has conducted several reports based on these longitudinal data. In the most recent report we reviewed, Education found, among other things, that children who received preschool special education services showed growth each year in vocabulary and mathematics; however, growth slowed in both subject areas as children got older. Children’s performance varied across assessments and across subgroups defined by disability. At age 10, the gap between these subgroups persisted, and there were no differences in growth rates between subgroups. The 2004 reauthorization of IDEA also called for a national assessment to measure the implementation progress and the relative effectiveness of the law. Among other reports published as part of the IDEA national assessment, Education published an analysis of the patterns in identification of and outcomes for children with disabilities as well as a report on IDEA implementation. Education found that the percentage of children identified for services increased every year from 1997 to 2006 for all preschool-age children, among other findings. Furthermore, children in each of the disability categories differed significantly from the general population in academic skills as well as social development. Among other key findings, this study found that 27 states either mandate or suggest a standards-based individualized education program for preschool age children. Such a program is designed to enable a child to make progress in the general education curriculum through the inclusion of state academic standards, among other things. Additionally, through two complementary cohort studies of children’s early school experiences, Education is currently investigating outcomes experienced by children with and without disabilities in preschool programs, through its National Center for Education Statistics. Education has 15 performance measures for the Promise Neighborhoods program (see tables 11 and 12). Education requires that individual grantees set their own performance targets. Education publicly reports available data for its two grant cohorts online. Due to data reliability concerns, Education officials have not reported results for some of the performance measures. Education officials stated that some of these data are under development because they have not been able to collect them consistently from their grantees. They noted that they have made efforts to address these concerns by investing in technical assistance to grantees. Education has not conducted an evaluation of the Promise Neighborhoods program. A key purpose of the Promise Neighborhoods Grant program is to learn how particular strategies affect student outcomes through a rigorous evaluation of the program. In 2014, we recommended that the Secretary of Education develop a plan to use the data collected from grantees to conduct a national evaluation of the program. As of May 2017, this recommendation remained unimplemented. Education has four performance measures for the Striving Readers Comprehensive Literacy program and sets program-wide targets for each of these (see table 13). In its congressional budget justification, Education reports its progress toward achieving these targets annually. One of the four performance measures is specific to the early learning population: the percentage of participating 4-year-old children who achieved significant gains in oral language skills. Results on this measure have declined over the 2 years of data we reviewed (2013-2015). Education reported meeting none of the four performance targets in 2015, the most recent year of available data. Education has not conducted an evaluation of the current Striving Readers Comprehensive Literacy program, but officials told us they are considering conducting one in the future. However, Education has synthesized evaluations of adolescent reading interventions implemented by the related 2006 and 2009 Striving Readers grant cohorts. The original Striving Readers program funded only the 2006 and 2009 grant cohorts and aimed to build a scientific research base for identifying and replicating strategies to improve adolescent literacy skills. For those cohorts, Education found that four of the 10 interventions had at least one study showing a positive effect on reading achievement. The remaining six interventions had no discernible effects. The findings from the studies funded by Striving Readers expanded the evidence base on effective reading interventions for adolescents by adding information on interventions not previously reviewed by Education’s Institute of Education Sciences. HHS has six performance measures for CCDF and sets targets for the four that it considers outcome measures (see table 14), and reports results annually. HHS reported in its congressional budget justification that CCDF met two of its six performance targets in 2014, the last year of available data. Some of CCDF measures are reviewed biannually. HHS is in the process of updating these measures due to recent statutory and legislative changes to the Child Care and Development Block Grant program. In addition, one of CCDF’s measures is under development, and HHS is still building capacity to collect this information from all states. Officials plan to obtain this information from states and territories in 2017. HHS has conducted evaluations of CCDF to learn about different approaches to improving quality and helping parents retain employment. For example, one evaluation examined three types of programs that promote language development. This evaluation found that two of these programs improved teacher interactions with children and increased pre- literacy skills of children. Another evaluation found that expanding income eligibility and extending the time before families have to reapply for child care subsidies temporarily increased the use and stability of subsidy receipt. HHS has 11 performance measures for Head Start. In fiscal year 2015, the last year of available data, HHS reported progress toward achieving targets for the five measures that it considers related to outcomes or efficiency (see table 15). HHS reported meeting two of these five performance targets in fiscal year 2015. For example, HHS reported that Head Start met its target for reducing the proportion of grantees receiving a score in the low range on a classroom assessment tool. Officials told us that improving the quality of teacher-child interactions, staff training and competency, and classroom environments have been primary goals of the program in recent years. HHS added a fifth outcome measure, to increase the percentage of Head Start and Early Head Start teachers that have a Bachelor’s degree or higher. In its fiscal year 2017 performance report, HHS collected baseline data on this measure, and used this information to set targets for the future. In response to a mandate in the 1998 reauthorization of Head Start, HHS conducted a national level, random-assignment impact evaluation of the Head Start program (Head Start Impact Study). HHS published this impact study, which followed children through first grade, in 2010, and in a subsequent report, researchers followed the same cohorts of children as they transitioned to third grade. These impact studies assessed the advantages that 4-year-old children gained during 1 year of participation in Head Start and 3-year-old children gained during 2 years of participation in Head Start among cognitive, social-emotional, health, and parenting outcomes. The Head Start Impact Study showed that having access to Head Start improves children’s preschool experiences and school readiness in certain areas, though few of those advantages persist through third grade. However, some subgroups of children in this study experienced sustained benefits into third grade. In more recent work, HHS examined the extent to which classroom quality affected outcomes observed in the impact study. Although some subgroups experienced sustained positive effects, the evaluation found little evidence to support that Head Start leads to program impacts lasting into third grade for participants overall, regardless of the program’s quality level. However, the study’s ability to detect effects of Head Start participation may have been limited by difficulty maintaining the random assignment of children to Head Start and to comparison groups, an important component of such impact studies. The 1994 reauthorization of Head Start that established the Early Head Start program called for an evaluation to focus on services delivered to families with infants and toddlers and the impacts of these services on children and families. In response, in 2002 HHS published a separate rigorous, random-assignment evaluation of the Early Head Start program. This evaluation investigated program impacts on children and families through their time in the program. Subsequent reports followed children and families as they transitioned from preschool and again in the 5th grade. HHS found, among other things, a consistent pattern of modest, favorable impacts across a range of outcomes when participating children were 2 and 3 years old, with larger impacts in some subgroups. However, some impacts on the full sample of children and families did not persist when assessed at grade 5, though some subgroup impacts remained. In more recent work, the Centers for Disease Control and Prevention linked data from this project with child welfare records to and found that the program may be effective in reducing some kinds of child maltreatment outcomes among Early Head Start children when compared to children in a control group. Additionally, HHS collects information on the characteristics, experiences, and outcomes of children participating in Head Start through the Head Start Family and Child Experiences Survey (FACES). This survey provides data from five successive, nationally representative samples of Head Start participants. HHS also maintains a similar survey specific to the Early Head Start population called Baby FACES. The Department of the Interior (Interior) does not have specific performance measures for the Family and Child Education (FACE) program. Instead, Interior uses an independent contractor to conduct annual reviews of the FACE program to obtain performance information. These reviews identify program outcomes and provide implementation data, which are summarized for the program overall and disaggregated for individual program sites. Interior reports a number of outcomes in these reviews, including children’s proficiency in math and literacy, parenting practices, and integration of native language and culture into FACE program instruction. In response to a 2004 Office of Management and Budget mandate, Interior contracted an external impact evaluation of the FACE program. In 2008, Interior funded a second FACE impact study. Interior subsequently published a report that integrated findings from both impact studies. Selected findings from this report indicate that a greater number of the FACE parents included in this study were more likely to participate in literacy activities with their children and to be involved in their children’s school than parents of non-FACE participants. However, both groups of children appeared equally kindergarten-ready, on several measures. Because FACE serves children with greater needs, the study concludes the program puts those children, as well as those with special needs, on an equal playing field with their peers. However, the study did not account for some child and program factors that may have affected participants’ outcomes. In addition to the contact named above, Rebecca Woiwode (Assistant Director), Hedieh Fusfield (Analyst-in-Charge), Colin Ashwood, and Karissa Robie made key contributions to this report. Additional assistance was provided by Kay Brown, Carol Henn, Brian James, Melissa Jaynes, John Lack, Kirsten Lauber, Benjamin T. Licht, Elizabeth Mixon, Janet Mascia, Drew Nelson, Mimi Nguyen, Dae Park, Jessica Orr, James Rebbe, Marylynn Sergent, Stephanie Shipman, Deborah A. Signer, Almeta Spencer, Rachel Stoiko, Rebecca Kuhlmann Taylor, Sarah Veale, Betty Ward-Zuckerman, Greg Whitney, and Craig Winslow.

Summary: Millions of children age 5 and under participate each year in federally funded preschool and other early learning programs, or receive federally supported child care. Federal support for early learning and child care has evolved over time to meet emerging needs. In 2012, GAO reported that multiple federal agencies administer numerous early learning and child care programs. GAO was asked to re-examine federal programs that provide or support early learning and child care. This report examines 1) the federal investment in early learning and child care programs; 2) fragmentation, overlap, and duplication among early learning and child care programs and agencies' efforts to address these conditions; and 3) the extent to which agencies assess performance for programs with an explicit early learning or child care purpose. GAO analyzed responses to questionnaires from nine agencies and one regional commission; reviewed budget and tax expenditure documentation, evaluations, annual program performance results, and other agency documentation; and interviewed officials from HHS, Education, and Interior. Multiple federal programs may provide or support early learning or child care for children age 5 and under. Of these programs, nine describe early learning or child care as an explicit purpose and are administered by the Departments of Health and Human Services (HHS), Education (Education), and the Interior (Interior). Fiscal year 2015 obligations for these nine programs totaled approximately $15 billion, with the vast majority of these funds concentrated in Head Start and the Child Care and Development Fund. An additional 35 programs did not have an explicit early learning or child care purpose, but permitted funds to be used for these services. Additionally, three tax expenditures subsidized individuals' private purchase of child or dependent care. As GAO found in 2012, some early learning and child care programs are fragmented, overlap, or have potential for duplication. Specifically: Fragmentation. The federal investment in early learning and child care is fragmented in that it is administered through multiple agencies. Overlap. Some programs with an explicit early learning or child care purpose overlap, given that they target similar beneficiaries, such as low-income children, or engage in similar activities. However, these programs often have different goals and administrative structures. Duplication. Some programs are potentially duplicative because they may fund similar types of services for similar populations. However, the extent to which actual duplication exists is difficult to assess due to differing program eligibility requirements and data limitations. HHS and Education have helped address these conditions through improved agency coordination, particularly by following leading practices for interagency collaboration. For example, in response to needed actions GAO identified in 2012, HHS and Education expanded membership of their inter-departmental workgroup on young children to include other agencies with early learning and child care programs. The agencies have also documented their agreements, dedicated staff time to promote the goals and activities of this inter-departmental workgroup, and issued joint policy statements. The resulting improvement in coordination has helped mitigate the effects of fragmentation and overlap. HHS, Education, and Interior use different methods to assess performance for the nine programs with an explicit early learning or child care purpose. These agencies collect performance information through various combinations of performance monitoring, program evaluations or studies, and other information, such as grantee-submitted reports. In addition, they collect performance information that aligns with program objectives, and many programs examine common aspects of performance. However, the specific results agencies assess differ for a number of reasons. For example, some programs assess children only while they receive services, while others assess later impacts on children. GAO makes no recommendations in this report. In its comments, HHS agreed with GAO's findings and noted that children benefit most from investments in federal early learning and child care programs when they are coordinated with similar programs. Education and HHS also provided technical comments, which GAO incorporated as appropriate.