EHS Tip Sheet No. 23: Program Options

As Early Head Start Programs Design and Adapt Their Program Models Based on the Needs of the Families They Serve, How Do They Determine Which Program Option(s) to Offer, and the Flexibility Within Those Program Options? Note: This resource is under review.

Early Head Start Tip Sheet No. 23

According to the Head Start Performance Standards, Head Start Programs must conduct a community assessment every three years to determine the needs of the families they serve. Program directors and staff use this assessment to determine if a center-based option, a home-based option, or a combination of the two is best for the families in their community. The benefits and challenges of a mixed-model approach are discussed.

Response:

Choosing a program option
Before a program can begin to plan for services, they must understand the strengths and needs of the families in the community. One of the most important features of the Head Start program is ensuring that programs are designed to meet the needs of families in local communities. Head Start and Early Head Start programs do this by completing a community assessment once every three years as required by the Head Start Program Performance Standards (45 CFR 1305.3). Based on what they learn from the community assessment, programs design their services to best meet the need of the families in that community. Programs can choose to serve families using one or more of the following program options: center-based, home-based, and a combination of center-based and home-based. Some of the services may be delivered by local community agencies through community partnership agreements.

As defined in the regulations for Head Start Staffing Requirements and Program Options (45 CFR 1306.3(a)(c)(j)), a center-based program option means services provided to children primarily in classroom settings. A home-based program option means services provided to children primarily in the child's home. In a combination option, services are provided to children in both a center setting and through intensive work done with the child's family in the home. In order to meet the changing needs of families, Early Head Start (EHS) programs are encouraged to be flexible in the options they offer in two ways:

1) By allowing families to move between home-based and center-based care as their needs change. It can be a challenge for programs to balance the changing needs of the child and family with the funding and staffing complexities of the program. It is therefore important to incorporate careful transition planning when considering a change in program options. The flexibility of moving from one option to another better enables EHS programs to serve pregnancy to age three, since parental and child needs fluctuate over time.

2) By supporting families in center-based care with additional home visiting services as determined by family need and program design. The latter is sometimes called enhanced home visiting or a mixed-model approach.

Historical perspective
When Early Head Start began in 1996, most of the programs started out with home based program options. However, the impact of welfare reform led to an increase in the need for center-based child care for some families, and affected other families' availability for home visiting (Administration for Children and Families, Pathways to quality and full implementation of Early Head Start 2003). In the face of new welfare to work policies and programs, the needs of families changed. Family members who had been appropriately serviced through home-based services were now entering the work force or job training, and requiring out of home care for their children. Over time, as the employment status of parents changed, some families needed to reenter home-based services. EHS programs quickly learned that they needed to accommodate changing family needs by offering multiple program options.

Families needing additional support
EHS programs have found that some families enrolled in center-based care need more support than the program option allows. As staff members focus on the parent-child relationship, they find they need additional time with the parent and child in order to facilitate strengthening this relationship. These programs enhance their services with additional home visits for some families, mainly focusing on parenting and attachment issues. Other EHS programs working with families with multiple challenges, such as teen parents or very high risk families, see a need to provide additional support through regularly scheduled home visits in addition to center based care. And some programs consider it best practice to provide regular home visits for all center-based families, and incorporate that into their program model. The Head Start Program Performance Standards must be met no matter which program option the child is enrolled in. If the family is receiving "enhanced" home visits in addition to being in the center based option, however, there is no requirement for the frequency and length of those visits. The EHS program determines what the additional home visiting services will be.

Benefits according to the research
The EHS National Research Evaluation has demonstrated that programs offering a mixed-approach option had the broadest range of impacts of all options. The outcomes for families were greatest when programs combined early and full implementation of the Head Start Program Performance Standards with a mixed-model approach.

Mixed-approach programs that were early implementers demonstrated a consistently strong pattern of impacts in every area, including child, parenting and family self-sufficiency outcomes. (Administration for Children and Families, Making a difference in the lives of infants and toddlers and their families: The impacts of Early Head Start, 2002)

Challenges with enhanced home visits and a mixed-model approach
Changing approaches or offering a mixed-model approach can create challenges for programs. The complexity of multiple options can be difficult to administer as children and families move between options. Programs need to be thoughtful about issues such as staffing patterns, caseloads, coordination of services, transition planning, and training for staff. Enhanced services, such as including regular home visits for center-based families, adds additional costs to the program and increases the complexity of staff roles and responsibilities.

EHS programs have had to be creative in their approach to providing services for families whose needs change frequently. The Early Head Start National Evaluation has shown that those programs that have been able to thoughtfully and deliberately adjust to family needs, while maintaining the integrity of their services and adherence to the Head Start Program Performance Standards, have the best outcomes for children and families in EHS.

Considerations:

The following are questions or issues to consider when looking at program options:

Does the program engage in ongoing community assessments?

  • What did the last community assessment indicate about the value of the services currently offered? Is the program offering home based services when the need in the community is for more center based care? What else is needed by families in the community?
  • Does the program have opportunities for staff training in areas of home visiting and center- based services?
  • Are families fully engaged in the options currently offered? If not, is the program asking the question, "why not?"
  • Are there other community services offering home visits and/or center-based care? Are there gaps? Is there a potential for partnerships?
  • How does the program build relationships with families characterized by mutual trust and ongoing communication?
  • How does the program work with families and children as they transition between options?
  • Is the program accessing other funding streams that help support mixed model services?
  • A number of EHS programs are serving homeless families, so this may be a population to consider in terms of additional and enhanced support.
  • How does the program plan and coordinate the availability of slots and staff with the changing needs of the families, such as when services to a pregnant family change to require services for the born child, or when a family needs to transition from home based to center based services?
  • How does the program address continuity of care issues when a family moves from one program option to another?

Performance Standards, Title 45, Code of Federal Regulations:

1304.51(a)(1)(i)
(a) Program Planning.
(1) Grantee and delegate agencies must develop and implement a systematic, ongoing process of program planning that includes consultation with the program's governing body, policy groups, and program staff, and with other community organizations that serve Early Head Start and Head Start or other low-income families with young children. Program planning must include:
i. An assessment of community strengths, needs and resources through completion of the Community Assessment, in accordance with the requirements of 45 CFR 1305.3.

1305.3(b)&(c)(2)
(b) Each Early Head Start and Head Start grantee agency must conduct a Community Assessment within its service area once every three years…
(c) The Early Head Start and Head Start grantee and delegate agency must use information from the Community Assessment to:
(2) Determine the type of component services that are most needed and the program option or options that will be implemented

1304.40(a)(1)
(a) Family goal setting.
(1) Grantee and delegate agencies must engage in a process of collaborative partnership-building with parents to establish mutual trust and to identify family goals, strengths, and necessary services and other supports. This process must be initiated as early after enrollment as possible and it must take into consideration each family's readiness and willingness to participate in the process.

1304.40(h)(1)
(h) Parent involvement in transition activities
(1) Grantee and delegate agencies must assist parents in becoming their children's advocate as they transition both into Early Head Start or Head Start from the home or other child care setting, and from Head Start to the elementary school, a Title 1 of the Elementary and Secondary Education Act preschool program, or a child care setting.

Resources

Administration for Children and Families (2002). Making a difference in the lives of infants and toddlers and their families: The impacts of Early Head Start. Washington, DC: U.S. Department of Health and Human Services.
http://www.acf.hhs.gov/programs/opre/

Administration for Children and Families (2003). Pathways to quality and full implementation of Early Head Start. Washington, DC: U.S. Department of Health and Human Services.
http://www.acf.hhs.gov/programs/opre/

Early Head Start National Resource Center. (2004). Transition Strategies: Continuity and change in the lives of infants and toddlers. Washington, DC: U.S. Department of Health and Human Services.
http://eclkc.ohs.acf.hhs.gov/hslc/ecdh/Disabilities/Transition/...

U.S. Department of Health and Human Services. (1999). Training guides for the Head Start learning community: Infant and toddler transitions. Washington, DC: Head Start Bureau.

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The Tip Sheet is not a regulatory document. Its intent is to provide a basis for dialogue, clarification, and problem solving among the Head Start Bureau, Regional Offices, T & TA consultants, and grantees.

See also:
     Early Head Start (EHS) Tip Sheets

As Early Head Start Programs Design and Adapt Their Program Models Based on the Needs of the Families They Serve, How Do They Determine Which Program Option(s) to Offer, and the Flexibility Within Those Program Options? Early Head Start Tip Sheet 23. HHS/ACF/ACYF/HSB. 2004. English.

Last Reviewed: March 2010

Last Updated: November 4, 2016