1304.40

 

 

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1304.40

Family Partnerships

(a) Family Goal Setting

(b) Accessing Community Services and Resources

(c) Services to Pregnant Women who are Enrolled in Programs Serving Pregnant Women, Infants, and Toddlers

(d) Parent Involvement - General

(e) Parent Involvement in Child Development and Education

(f) Parent Involvement in Health, Nutrition, and Mental Health Education

(g) Parent Involvement in Community Advocacy

(h) Parent Involvement in Transition Activities

(i) Parent Involvement in Home Visits

Introduction to 1304.40

Head Start offers parents opportunities and support for growth, so that they can identify their own strengths, needs and interests, and find their own solutions. The objective of 45 CFR 1304.40 is to support parents as they identify and meet their own goals, nurture the development of their children in the context of their family and culture, and advocate for communities that are supportive of children and families of all cultures. The building of trusting, collaborative relationships between parents and staff allows them to share with and to learn from one another.

This section discusses family goal setting through the family partnership agreement process, access to community services and resources, services to pregnant women, and parent involvement across all areas of Head Start — including child development and education, health, nutrition, mental health education, community advocacy, transition practices, and home visits.
   

 
Performance Standard

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.

  

Rationale: By working in a partnership that is driven by parents’ identification of their family’s strengths and needs, parents and staff determine how the program can support families in pursuing their goals. This rationale serves 45 CFR 1304.40(a)(1)-(5).

Guidance: Early establishment of a partnership process between parents and staff provides for the exchange of valuable information about the child and her or his family. Sensitivity to family privacy is important, however, as parents have the right to choose how much personal information to share, as well as if and how this information is recorded. The desire of agencies to collect information "up front," therefore, must be balanced against the necessity of allowing time for staff and families to develop meaningful one-on-one relationships. Early and frequent interaction and follow-up help build trusting relationships. Once such relationships are established, parents will be more likely to openly discuss issues that interest or concern them.
Performance Standard

1304.40(a)(2)

(2) As part of this ongoing partnership, grantee and delegate agencies must offer parents opportunities to develop and implement individualized family partnership agreements that describe family goals, responsibilities, timetables and strategies for achieving these goals as well as progress in achieving them. In home-based program options, this agreement must include the above information as well as the specific roles of parents in home visits and group socialization activities (see 45 CFR 1306.33(b)).

 Related Information: See 45 CFR 1304.51(g) concerning record-keeping systems.

Guidance: The family partnership agreement process provides opportunities for families to set goals and to design an individualized approach for achieving those goals. Staff assist families, when they are ready, in identifying and defining goals in measurable terms, discussing what needs to be done to achieve these goals, and how the accomplishment of each goal will be determined.

The emphasis here is on the process of relationship building, and not on the agency’s system of keeping family records. Because the family partnership agreement process is family driven, plans will vary across families, and, in some cases, may not be written documents. In order to help families document the agreement process and progress toward achievement of their goals, methods such as written plans, case notes, tape recordings or other means are used. In the case of families returning or moving from an earlier Head Start experience, the partnership process builds upon any existing agreement.
Performance Standard

1304.40(a)(3)

(3) To avoid duplication of effort, or conflict with, any preexisting family plans developed between other programs and the Early Head Start or Head Start family, the family partnership agreement must take into account, and build upon as appropriate, information obtained from the family and other community agencies concerning preexisting family plans. Grantee and delegate agencies must coordinate, to the extent possible, with families and other agencies to support the accomplishment of goals in the preexisting plans.

 Guidance: To facilitate efficient access to appropriate information, grantee and delegate agencies:
Discuss with families other community agencies that are assisting them currently or have assisted them previously;
Develop an approach to confidential information sharing that is sensitive to family privacy and endorsed by all human service agencies in the community; and
Develop strategies with other community agencies to ensure that responsibility for delivering services to the family is shared properly.

When working with other community agencies or organizations that may appropriately have the lead in case management, the grantee or delegate agency does not require parents and staff to duplicate needlessly the process of developing family plans. Instead, it is more useful to support families in achieving the goals set in preexisting family plans. In such instances, the grantee or delegate agency documents its efforts to participate in the process of supporting the accomplishment of goals.

Performance Standard

1304.40(a)(4) & (5)

(4) A variety of opportunities must be created by grantee and delegate agencies for interaction with parents throughout the year.

(5) Meetings and interactions with families must be respectful of each family’s diversity and cultural and ethnic background.

  

Guidance: In collaboration with parents, staff develop a variety of group and individual opportunities to interact with parents on a regular basis. Interactions with families recognize the customs and beliefs of children and families. To develop meaningful relationships with families, agencies:

Work with Parent Committees to plan and publicize an array of individual options and group activities;
Include culturally relevant activities that interest both men and women;
Plan activities at varying times of the day and week — such as at breakfast, at the end of the day, or on weekends — in order to encourage the participation of as many parents as possible;
Develop alternative work schedules to allow staff to interact with working families during weekend events, such as picnics, religious and Tribal ceremonies, or other cultural events;
Respect the uniqueness of each family, and train staff and volunteers to recognize that families differ across many dimensions, including language, family structure, religion, and educational and socioeconomic background;
Maintain an annual calendar of culturally relevant dates, taking care not to acknowledge one group while possibly slighting another;
Consider the needs of family members with disabilities when planning meetings and activities; and
Honor the primary language of the family by enlisting the aid of bilingual and biculturally trained individuals who have experience with the cultures and languages of families.
Performance Standard

1304.40(b)(1)

(b) Accessing community services and resources.

(1) Grantee and delegate agencies must work collaboratively with all participating parents to identify and continually access, either directly or through referrals, services and resources that are responsive to each family's interests and goals, including:

  

Rationale: All families can benefit from access to community services and resources. This rationale serves 45 CFR 1304.40(b)(1)-(2).

Related Information: See 45 CFR 1304.40(b)(2) regarding follow-ups to service referrals, 45 CFR 1304.40(g)(1)(ii) on providing comprehensive information about community resources, and 45 CFR 1304.41(a)(2) on establishing collaborative relationships with community organizations.

Guidance: Because of the diversity of interests and needs of families, staff are familiar with the array of available services (and of the quality of such services). Agencies assist parents in learning how to identify and access community services in the following ways:

Make appropriate references in the family partnership agreement process to community resources that are critical for accomplishing goals;
Provide up-to-date resource directories, invite representatives from various community agencies to speak with individual families and at committee meetings, and maintain displays that include brochures and information sheets concerning community services;
Assist in locating services, translators, and translations in the families’ preferred languages; and
Form partnerships with other community agencies to assist families to gain access to services and resources.
Performance Standard

1304.40(b)(1)(i)

(i) Emergency or crisis assistance in areas such as food, housing, clothing, and transportation;

  

Guidance: Families may require immediate assistance; and, agencies have clear policies and guidelines related to crisis intervention in order to address these needs. It is important to train staff in culturally sensitive, realistic crisis intervention techniques and procedures for referring families to appropriate resources in the community. Home visitors and other staff who provide services directly to families are able to identify signs of crisis, to make referrals that link families to appropriate services, and to support families during crisis periods, without building dependence.

Performance Standard

1304.40(b)(1)(ii)

(ii) Education and other appropriate interventions, including opportunities for parents to participate in counseling programs or to receive information on mental health issues that place families at risk, such as substance abuse, child abuse and neglect, and domestic violence; and

  

Related Information: See 45 CFR 1304.24(a)(3)(iv) concerning community mental health resources, 45 CFR 1304.40(f) regarding mental health education programs, and 45 CFR 1304.41(a)(2)(ii) concerning community partnerships with mental health providers. Also, see 45 CFR 1301.31(e), Appendix A to 45 CFR 1301.31, and 45 CFR 1304.22(a)(5) concerning requirements for reporting child abuse and neglect, and 45 CFR 1304.52(k)(3) for related training.

Guidance: Agencies assist parents to form linkages with counseling programs that target specific mental health issues. Educational materials and opportunities to learn about mental health can be provided through brochures, bulletin boards, community resource and referral information, support groups, and by ensuring that well-informed staff are available to informally and confidentially discuss issues with children and families and to make appropriate referrals.

Mental health information to parents includes, but should not be limited to:

prevention programs for at-risk families,
help for other family members through such groups as Al-Anon and other support organizations,
identification of resources relating to domestic violence, and
information about local substance abuse treatment programs.
Performance Standard

1304.40(b)(1)(iii)

(iii) Opportunities for continuing education and employment training and other employment services through formal and informal networks in the community.

  

Guidance: Staff assist parents in identifying and securing access to continuing education, training, and employment opportunities by:

Encouraging and assisting parents to participate in and keep a record of volunteer work and training activities, both inside and outside the Head Start community, particularly in areas that may lead to paying jobs;
Providing information and referrals to education and training programs;
Establishing a formal career path within the Head Start program;
Forming partnerships with family literacy and adult education programs, training programs, and employment service programs; and
Becoming a formal training or work site for welfare-to-work programs.
Performance Standard

1304.40(b)(2)

(2) Grantee and delegate agencies must follow-up with each family to determine whether the kind, quality, and timeliness of the services received through referrals met the families' expectations and circumstances.

  

Guidance: While Head Start staff and families are assessing the accomplishment of goals identified through the family partnership agreement process, they also discuss the level of family satisfaction with the services they receive. To determine such satisfaction (or lack of satisfaction), staff may ask parents to discuss questions such as:

Did the services match your family’s individual needs and expectations?
Did the service agency treat you with understanding and respect?
What problems, if any, did you encounter at the agency?
Do you have suggestions for what Head Start staff could do to improve the process of referring families to services?

By accompanying parents to community agencies on a periodic basis, staff can see for themselves whether or not families are receiving the requested services, and whether the referral process needs to be improved.
Performance Standard

1304.40(c)(1)(i), (ii) & (iii)

(c) Services to pregnant women who are enrolled in programs serving pregnant women, infants, and toddlers.

(1) Early Head Start grantee and delegate agencies must assist pregnant women to access comprehensive prenatal and postpartum care, through referrals, immediately after enrollment in the program. This care must include:

(i) Early and continuing risk assessments, which include an assessment of nutritional status as well as nutrition counseling and food assistance, if necessary;

(ii) Health promotion and treatment, including medical and dental examinations on a schedule deemed appropriate by the attending health care providers as early in the pregnancy as possible; and

(iii) Mental health interventions and follow-up, including substance abuse prevention and treatment services, as needed.

 Related Information: See 45 CFR 1304.40(f) concerning health, nutrition, and mental health education; and see 45 CFR 1304.24(a)(1)(vi) for additional guidance on supporting parents’ participation in any mental health interventions.

Guidance: As staff serve as advocates and liaisons between pregnant women and service providers, their role includes:

Educating pregnant and breast feeding women through brochures, bulletin boards, discussions, and other means about proper health and nutrition and about the effects of substance abuse on fetal development;
Explaining how inadequate nutrition leads to the delivery of low birthweight babies, and assisting families to access and to enroll in assistance agencies, such as the Supplemental Nutrition Program for Women, Infants, and Children (WIC);
Encouraging expectant parents to keep all prenatal appointments and to attend all childbirth classes. Staff encourage the participation of fathers, while remaining sensitive to the cultural backgrounds of families;
Working with the Health Services Advisory Committee to develop linkages in the community that assist pregnant women;
Discussing with parents the need to be prepared to provide information to health care providers about genetic, environmental and other health risks;
Helping expectant parents to identify family and cultural support networks that may provide support and assistance;
Establishing a support group for new and expectant parents;
Developing and making available a list of substance abuse treatment programs, including those that work with pregnant women; and
Identifying resources to meet day-to-day needs, such as baby clothing and diapers.
Performance Standard

1304.40(c)(2)

(2) Grantee and delegate agencies must provide pregnant women and other family members, as appropriate, with prenatal education on fetal development (including risks from smoking and alcohol), labor and delivery, and post-partum recovery (including maternal depression).

  

Guidance: Both mothers and fathers, as well as any other family members responsible for infant care, are encouraged to learn about fetal development and proper postpartum care. Such education and information includes:

basic knowledge about fetal development,
risks to the fetus that may occur during pregnancy, such as effects from alcohol, smoking, and other toxic substances,
what to expect during labor and delivery, and encouragement for families to attend childbirth classes. Agencies may make arrangements for staff or volunteers interested in training as labor support persons to be with parents during labor and delivery,
what to expect during postpartum recovery, including the possibility of maternal depression, and
a schedule of community-based parenting classes and support groups, or parenting classes at the program.

All Head Start agencies are expected to include maternal and child health topics in the health education programs required by 45 CFR 1304.40(f), and are expected to encourage pregnant women to secure access to comprehensive prenatal and postpartum care.
Performance Standard

1304.40(c)(3)

(3) Grantee and delegate agencies must provide information on the benefits of breast feeding to all pregnant and nursing mothers. For those who choose to breast feed in center-based programs, arrangements must be provided as necessary.

  

Related Information: See 45 CFR 1304.23(b)(1)(iv) on nutrition needs of infants and toddlers, and 45 CFR 1304.23(e)(2) on facilities for the storage of breast milk.

Guidance: It is important to respect each mother’s decision concerning whether or not to breast feed, and to be sensitive to cultural differences that may affect that decision. Agencies serving pregnant women, infants, and toddlers support those mothers who choose to breast feed by:

Conveying a positive attitude toward breast feeding in orientation and educational programs, and in culturally appropriate materials for mothers;
Designating a quiet, comfortable, and private place where mothers may nurse their infants;
Providing mothers with necessary fluids and nutritious snacks; and
Training staff to serve as lactation (breast feeding) consultants.
Performance Standard

1304.40(d)(1)

(d) Parent involvement — general.

(1) In addition to involving parents in program policy-making and operations (see 45 CFR 1304.50), grantee and delegate agencies must provide parent involvement and education activities that are responsive to the ongoing and expressed needs of the parents, both as individuals and as members of a group. Other community agencies should be encouraged to assist in the planning and implementation of such programs.

 Rationale: Parent participation in the design of activities and experiences that will assist in expanding parental strengths and interests is essential. By welcoming parents during all program hours, agencies demonstrate respect for them as the primary educators of their children. Observation of children and participation in group activities also provide parents with opportunities to learn how programs operate and to see how their child is learning and growing. This rationale serves 45 CFR 1304.40(d)(1)-(3).

Guidance: Establishing a process through which parents and staff jointly determine the activities to be developed leads to more meaningful parent involvement. Together, parents and staff decide what roles parents and other community agencies play in assisting staff to plan and implement activities consistent with parents’ needs and interests, and with the cultural and linguistic diversity of the families (see 45 CFR 1304.40(a)(5)).
Performance Standard

1304.40(d)(2)

(2) Early Head Start and Head Start settings must be open to parents during all program hours. Parents must be welcomed as visitors and encouraged to observe children as often as possible and to participate with children in group activities. The participation of parents in any program activity must be voluntary, and must not be required as a condition of the child's enrollment.

  

Related Information: See 45 CFR 1306.33(b) for parental participation requirements in home-based programs.

Guidance: The program staff welcome parents and communicate the importance of parental participation to the success of the Head Start experience by:

Maintaining an environment in which all family members are welcome at all times — men as well as women, and members of extended and non-traditional families. Visual cues, such as pictures and posters, indicate to fathers and extended family members that they are welcome;
Informing parents of the different volunteer roles and parental involvement opportunities that are available. Parents participate in classrooms, on field trips, in community events, in supporting program operations, and by preparing materials at home; and
Arranging opportunities for parent participation that take into account parental work, education, or training schedules, as well as family obligations.
Performance Standard

1304.40(d)(3)

(3) Grantee and delegate agencies must provide parents with opportunities to participate in the program as employees or volunteers (see 45 CFR 1304.52(b)(3) for additional requirements about hiring parents).

  

Related Information: See 45 CFR 1304.52(b)(3) regarding the requirement that parents be given priority for employment in positions for which they are qualified.

Guidance: Through the development of an ongoing volunteer program, agencies place parents in positions that match their interests, abilities, and time availability, and that provide opportunities to add to their job skills and experience. Agencies assign a person the duties of coordinating and supporting volunteers. It is important to develop a diverse array of volunteer opportunities that span many areas of the program.

To recruit parents as employees, agencies post program job vacancies in newsletters and on bulletin boards in locations such as churches, schools, clinics, laundromats, libraries, and stores.

Ways to assist parents to qualify for employment in Head Start include:

Selecting parents as substitute classroom aides;
Establishing on-site training classes offered by local institutions; and
Providing evening and weekend sessions on developing job-readiness and job skills.
Performance Standard

1304.40(e)(1)

(e) Parent involvement in child development and education.

(1) Grantee and delegate agencies must provide opportunities to include parents in the development of the program's curriculum and approach to child development and education (see 45 CFR 1304.3(a)(5) for a definition of curriculum).

  

Rationale: Parental involvement in the program’s approach to child development and education enhances the ability of parents and staff to work together to support each child’s growth and learning in the home and program environments. Parents who understand how children grow and develop usually are more responsive to their children’s needs, and are better able to support child development. Parental involvement also provides parents with opportunities to share knowledge about their children so that staff can individualize the program to support each child’s individual pattern of development and learning. This rationale serves 45 CFR 1304.40(e)(1)-(5).

Related Information: See 45 CFR 1304.21(a)(2) on involving parents in planning activities for the child development and education program, and 45 CFR 1304.21(c)(1) on implementing a curriculum.

Guidance: Some suggestions for involving parents in the ongoing process of individualizing and developing the program’s approach to child development and learning follow:

Develop a process for parents to make suggestions, individually or in groups, on such topics as goals and activities for children, what staff and parents can do to help children achieve developmental and educational goals, and the relevance of the curriculum to the culture and language of enrolled families;
Provide parents and staff with information and training on developmentally appropriate practices;
Provide opportunities for parents, community members, and early childhood professionals to serve on education committees and subcommittees; and
Involve parents in planning classroom and home activities in areas such as art and music experiences, field trips, storytelling, and preparation of foods particular to their various cultures.
Performance Standard

1304.40(e)(2)

(2) Grantee and delegate agencies operating home-based program options must build upon the principles of adult learning to assist, encourage, and support parents as they foster the growth and development of their children.

  

Guidance: When home visitors and other staff work with parents, parents are active partners in the learning process. In accordance with the principles of adult learning, staff:

Encourage active participation, independent learning, and problem-solving;
Identify, acknowledge, and build upon past experiences, and use current experiences as learning opportunities; and
Use the home as the setting for adult learning, to enhance the parents’ role as the primary educators of their children.
Performance Standard

1304.40(e)(3)

(3) Grantee and delegate agencies must provide opportunities for parents to enhance their parenting skills, knowledge, and understanding of the educational and developmental needs and activities of their children and to share concerns about their children with program staff (see 45 CFR 1304.21 for additional requirements related to parent involvement).

  

Related Information: See 45 CFR 1304.51(c) on staff-family communications; and see the Head Start Home Visitor Handbook.

Guidance: Ways to support family members in their parenting roles include:

Encouraging parents to use home materials and family routines and conversations to help children learn concepts, develop language and other skills, and explore feelings;
Assisting parents to foster the knowledge, self-confidence, self-esteem, and sense of independence they need to strengthen their role as the primary influence in their child’s life;
Supporting parents in their efforts to find opportunities to spend quality time with their children during meal time, bath times, bed times, travel, and on weekends;
During home visits, reviewing the activities and experiences of the parent and child since the last visit. This provides opportunities for discussing child development principles, appropriate activities, behavior management strategies, and family concerns about children;
Establishing a buddy system to ensure that frequent one-on-one contacts between staff and parents occur in the program setting;
Maintaining a daily log or notebook through which parents and staff can share observations and comments;
Taking the communication requirements of parents into account when developing methods of communicating with them. For example, if parents have difficulty with written communication, agencies make extra efforts to share information, observations, concerns, and comments through phone contacts or through face-to-face meetings; and
Providing parents with information about programs and services available to children with disabilities, and in particular, the right of all children to a free and appropriate education under the Individuals with Disabilities Education Act (IDEA).
Performance Standard

1304.40(e)(4)(i) & (ii)

(4) Grantee and delegate agencies must provide, either directly or through referrals to other local agencies, opportunities for children and families to participate in family literacy services by:

(i) Increasing family access to materials, services, and activities essential to family literacy development; and

(ii) Assisting parents as adult learners to recognize and address their own literacy goals.

  

Related Information: See 45 CFR 1304.21(a)(4)(iii) and (iv) on promoting language use of children and supporting children’s emerging literacy and numeracy development; and see CFR 1304.41(a)(2)(vii) on forming partnerships with institutions such as libraries and museums.

Guidance: To increase family participation in literacy-related services, staff:

Plan literacy activities that involve both parent and child, provide information on how to incorporate literacy activities into everyday family routines, and take time to demonstrate and reinforce parent practices that promote literacy in both English and the home languages if they differ;
Encourage families to check books out of the public library or to acquire books that may be available free or at low cost through local programs promoting literacy;
Recruit qualified volunteers to serve as tutors, coaches, and mentors, and to collect and distribute reading materials;
Establish a Head Start book-lending collection;
Refer parents to adult literacy programs in the community, matching families with programs sensitive to issues of language and culture; and
Promote partnerships with local libraries, museums and family literacy programs, and invite representatives from local literacy programs to meet with Head Start families and staff to plan collaborations.
Performance Standard

1304.40(e)(5)

(5) In addition to the two home visits, teachers in center-based programs must conduct staff-parent conferences, as needed, but no less than two per program year, to enhance the knowledge and understanding of both staff and parents of the educational and developmental progress and activities of children in the program (see 45 CFR 1304.21(a)(2)(iii) and 45 CFR 1304.40(i) for additional requirements about staff-parent conferences and home visits).

 Guidance: Staff-parent conferences do not take the place of the home visits required under 45 CFR 1304.40(i), or of daily communication with parents. Conferences provide teachers and parents with the opportunity for an in-depth discussion of each child’s development and adjustment to the program. Conferences, which occur at the Head Start facility, in the home, or at any other appropriate location, provide a time for parents to share their observations of their children, ask questions, discuss their expectations, or express concerns. Conferences also offer opportunities to identify ways to improve the child’s learning in the home and program environments.
Performance Standard

1304.40(f)(1)

(f) Parent involvement in health, nutrition, and mental health education.

(1) Grantee and delegate agencies must provide medical, dental, nutrition, and mental health education programs for program staff, parents, and families.

  

Rationale: As the primary caregivers, parents play the lead role in maintaining the health and nutrition of their children. Learning more about health, nutrition, and mental health assists parents in establishing healthy habits in the home and in securing access to needed services in the community. This rationale serves 45 CFR 1304.40(f)(1)-(4).

Related Information: See 45 CFR 1304.21(c)(1)(iii) on integrating educational aspects of health, nutrition, and mental health services into program activities.

Guidance: When planning medical, dental, nutrition, and mental health education programs, each interaction with families provides an opportunity to convey health education. Staff:

Use a variety of methods for conveying information, for example, guest speakers, hands-on experiences, or newsletters;
Consider parent attitudes, cultures, languages, beliefs, fears, and educational levels. To the extent possible, education for parents should be designed around each family’s individual characteristics;
Make use of content experts in the areas of health, nutrition, and mental health for assistance in designing appropriate programs;
Refer to the Community Assessment, and consider using community resources when developing education programs for parents; and
Consult with the Health Services Advisory Committee.
Performance Standard

1304.40(f)(2)(i), (ii) & (iii)

(2) Grantee and delegate agencies must ensure that, at a minimum, the medical and dental health education program:

(i) Assists parents in understanding how to enroll and participate in a system of ongoing family health care;

(ii) Encourages parents to become active partners in their children's medical and dental health care process and to accompany their child to medical and dental examinations and appointments; and

(iii) Provides parents with the opportunity to learn the principles of preventive medical and dental health, emergency first-aid, occupational and environmental hazards, and safety practices for use in the classroom and in the home. In addition to information on general topics (e.g., maternal and child health and the prevention of Sudden Infant Death Syndrome), information specific to health needs of individual children must also be made available to the extent possible.

  

Related Information: See 45 CFR 1304.20(a)(1) on assisting parents in accessing a source of care, 45 CFR 1304.20(e) on involving parents in child health and developmental services, 45 CFR 1304.22 for further information on child health and safety, and 45 CFR 1304.40(c) for suggestions of health education topics for pregnant women.

Guidance: By working with parents, both individually and in groups, agencies assist families to become more aware of basic aspects of health care systems, and the services that are available to them. Staff and parent discussions about health care emphasize the importance of parents understanding all medical and dental procedures affecting their child, particularly as treatment relates to the family’s knowledge about child health and development. Staff encourage parents to:

Accompany their child to appointments, provide emotional support, if the child is apprehensive, and ask providers to explain medical conditions and procedures in understandable terms;
Enroll in a system of ongoing family health care, rather than relying upon emergency rooms. Agencies provide the names and addresses of medical practices, clinics, or health maintenance organizations, including a list of providers who accept Medicaid, as well as information about after-hours care and how to obtain medical advice by telephone;
Apply for Medicaid. Options for obtaining health insurance or low-cost medical care are discussed, if the family is not eligible for Medicaid;
Recognize the importance of preventive care and of detecting signs of health problems;
Model healthy behaviors by having the child observe parents going to the doctor and dentist; and
Keep their child connected with a "medical home," after the child leaves Head Start.

In some cases, staff will need to work with parents and providers to facilitate more active parent involvement. For example, the schedule of working parents may make them unable to accompany their children to examinations. Night clinics or services at non-traditional times will make services more accessible. Services are not delayed or denied because of parents’ working hours. If parents are unable to accompany their children to appointments, they are provided information about treatment and follow-up.

Home visitors and other staff encourage and assist parents to integrate health education into daily routines in the home. For example, staff assist parents in assembling a first aid kit, including information on emergency first aid, and in "child-proofing" the home.
Performance Standard

1304.40(f)(3)(i) & (ii)

(3) Grantee and delegate agencies must ensure that the nutrition education program includes, at a minimum:

(i) Nutrition education in the selection and preparation of foods to meet family needs and in the management of food budgets; and

(ii) Parent discussions with program staff about the nutritional status of their child.

  

 

Related Information: See 45 CFR 1304.23(a) on discussions between staff and parents of each child’s nutritional needs, and 45 CFR 1304.23(d) on parent education activities related to nutrition.

Guidance: An effective nutrition education program conveys the message that what the child eats has long-term effects on health and development. Nutrition education provided by program staff is a supplement to, and not a replacement for, nutritional advice from health care professionals.

Parents and staff share information about the child’s eating habits and nutritional needs on an ongoing basis. In addition to the topics required by 45 CFR 1304.23(a), discussions between staff and parents can focus on such issues as economical food buying and individual family challenges, such as distance from supermarkets or inadequate refrigeration or cooking facilities.
Performance Standard

1304.40(f)(4)(i), (ii) & (iii)

(4) Grantee and delegate agencies must ensure that the mental health education program provides, at a minimum (see 45 CFR 1304.24 for issues related to mental health education):

(i) A variety of group opportunities for parents and program staff to identify and discuss issues related to child mental health;

(ii) Individual opportunities for parents to discuss mental health issues related to their child and family with program staff; and

(iii) The active involvement of parents in planning and implementing any mental health interventions for their children.

  

Related Information: See 45 CFR 1304.24(a)(1)(vi) on supporting parents’ participation in any needed mental health interventions.

Guidance: Regular meetings and training sessions with parents and staff, as well as one-on-one interactions, are used to identify and to discuss a variety of topics related to child mental health. Mental health professionals assist parents in promoting a positive mental health environment at home, in recognizing stress factors and other risk factors, and in knowing when and how to ask for appropriate help from other parents, extended family members, members of the local or Tribal community, and professional resources.

Group opportunities allow parents to share experiences and to develop their own solutions to problems they encounter with their children. It may be beneficial to establish family support groups that meet on a regular basis or to refer families to existing support groups in the community. In addition, families may wish to privately discuss mental health issues related to their child and family.

Discussions about mental health issues are facilitated by such actions as:

Building trusting and respectful relationships between staff and parents, so that parents will be comfortable in sharing information on sensitive issues and confident that their privacy will be respected;
Staff modeling healthy habits and programs providing positive working conditions and staff training;
Including parents in meetings that discuss issues related to individual children, and respecting and supporting the right of parents to make informed decisions to meet the interests of their child;
Ensuring that staff are aware of their limitations in dealing with serious mental health issues; and
Encouraging parents to talk confidentially with a trusted staff member who can refer them to professionals or other staff, when appropriate. Agencies may choose to designate specific staff members for parents to contact with mental health issues.

When there are misperceptions about mental health professionals, staff, community elders, or other respected individuals known to the family may be called upon to bridge the gap between parents and mental health professionals. Parents, mental health professionals, and staff need to work together to build a realistic mental health plan that best serves the needs of individual children and families.

By listening to parents and staff, the mental health professional gains a better understanding of family concerns and cultural issues, thus helping him or her to facilitate appropriate interventions. In addition, the mental health professional can help to explain the concept of "mental health" to parents and staff, as well as identify and develop their skills, and offer suggestions for more effective parent-child and teacher-child interactions.
Performance Standard

1304.40(g)(1) & (2)

(g) Parent involvement in community advocacy.

(1) Grantee and delegate agencies must:

(i) Support and encourage parents to influence the character and goals of community services in order to make them more responsive to their interests and needs; and

(ii) Establish procedures to provide families with comprehensive information about community resources (see 45 CFR 1304.41(a)(2) for additional requirements).

(2) Parents must be provided regular opportunities to work together, and with other community members, on activities that they have helped develop and in which they have expressed an interest.

  

Rationale: The active involvement of parents in advocacy and activities with other community members develops self-esteem and builds skills, while helping to organize and enhance community services and resources that best respond to parents’ needs and interests.

Related Information: See 45 CFR 1304.41(a)(2) for suggestions on how to form linkages with community service agencies.

Guidance: Staff and parents are encouraged to work together in a creative manner to identify ways that parents can play a role in supporting the improvement of community services. By using a broad definition of parental involvement, it is possible to overcome challenges such as parental work and training schedules, difficulties securing child care and transportation, language barriers, and the length of the family’s stay in the local area.

Ways for parents to influence community services include, but are not limited to:

Receiving information about the roles and functions of Head Start policy groups early in the program year, and during recruitment and enrollment;
Participating actively in Parent Committees and policy groups, which provide opportunities for developing confidence and skills for further community advocacy, and encouraging community members to attend policy group meetings;
Serving on the Health Services Advisory Committee and other advisory committees;
Becoming involved in groups and organizations that support the culture of the family or community;
Participating in parent-teacher organizations and local school boards and communicating with school organizations about ways that parents can assist in decision-making in schools;
Joining or starting various community committees that have well-defined goals, such as improving neighborhood safety;
Obtaining information on organizing techniques and, as appropriate, using Head Start facilities and equipment for meetings;
Taking individual actions to improve the community; and
Helping other parents and community members to understand the impact they have on the character of community services and the impact that such services have on the lives of Head Start families.

The active involvement of parents and staff in an ongoing process of identifying and evaluating resources and services is needed to maintain comprehensive and up-to-date information about community resources. One way to let families know about available services and resources is by providing appropriate lists of community resources published by other public or private community agencies. If there is no comprehensive list of community resources, or if the existing lists are not sufficiently comprehensive or up-to-date, the agency itself could develop a directory. It is helpful to provide information about the experiences of Head Start families with the services, based upon agency follow-ups to referrals conducted under 45 CFR 1304.40(b)(2), as well as basic information about hours, location, telephone number, and so forth.

Parent participation in developing and updating information about community resources improves the usefulness of the information. Parents, for example, could visit and conduct on-site interviews at community agencies in order to gather information that is specifically related to Head Start families. Staff are encouraged to train parents on how to use the information provided about community resources to access services that meet the goals identified in the family partnership agreement process.

Performance Standard

1304.40(h)(1) - (4)

(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 elementary school, a Title I of the Elementary and Secondary Education Act preschool program, or a child care setting.

(2) Staff must work to prepare parents to become their children's advocate through transition periods by providing that, at a minimum, a staff-parent meeting is held toward the end of the child's participation in the program to enable parents to understand the child's progress while enrolled in Early Head Start or Head Start.

(3) To promote the continued involvement of Head Start parents in the education and development of their children upon transition to school, grantee and delegate agencies must:

(i) Provide education and training to parents to prepare them to exercise their rights and responsibilities concerning the education of their children in the school setting; and

(ii) Assist parents to communicate with teachers and other school personnel so that parents can participate in decisions related to their children's education.

(4) See 45 CFR 1304.41(c) for additional standards related to children's transition to and from Early Head Start or Head Start.

 Rationale: Home visits are valuable in building respectful relationships with parents and in developing a broad understanding of every child in the program. This rationale serves 45 CFR 1304.40(i)(1)-(6).

Related Information: See 45 CFR 1304.21(a)(2)(iii) on encouraging parent participation in staff-parent conferences and home visits.

Guidance: Teachers and other staff have many opportunities to discuss with parents the advantages that home visits provide for both parents and children. Home visits are opportunities for:

Making connections between the home and program settings;
Learning more about parent-child interactions;
Developing positive relationships, which allow parents and staff to get to know one another;
Identifying learning opportunities in home environments;
Identifying techniques that can be generalized to other children in the family; and
Focusing individualized attention on family strengths, interests and goals.

Teachers are required to make two visits to the home of each child, in addition to the two staff-parent conferences required under CFR 1304.40(e)(5). Any additional home visits are coordinated to support the partnership between family and program staff.

If two home visits are not possible in a program of less than 90 days in duration, the agency still arranges two additional meetings with the parents, in addition to the two staff-parent conferences.

More frequent interactions provide opportunities to exchange important information about the child. In particular, agencies serving infants and toddlers schedule frequent home visits, because infants and toddlers develop so rapidly.

Agencies document instances when parents expressly forbid home visits. In such cases, staff continue to work on building a trusting relationship, which, over time, may provide opportunities for meeting with families in their homes. Sensitivity to parents’ cultural preferences is an important consideration. Flexibility in the scheduling of home visits may be needed for working parents and others with time constraints. Agreeing to meet at an alternative location may be a solution for some families, under the circumstances discussed below in 45 CFR 1304.40(i)(4).
Performance Standard

1304.40(i)(4) & (5)

(4) In cases where parents whose children are enrolled in the center-based program option ask that the home visits be conducted outside the home, or in cases where a visit to the home presents significant safety hazards for staff, the home visit may take place at an Early Head Start or Head Start site or at another safe location that affords privacy. Home visits in home-based program options must be conducted in the family’s home. (See 45 CFR 1306.33 regarding the home-based program option.)

(5) In addition, grantee and delegate agencies operating home-based program options must meet the requirements of 45 CFR 1306.33(a)(1) regarding home visits.

 Related Information: See 45 CFR 1306.33(a)(1) and 45 CFR 1306.34 regarding home visits in home-based and combination-option programs.

 

Guidance: Agencies operating center-based programs have some flexibility in allowing visits to be conducted outside the home, but it is critical that staff understand that visits outside the home are appropriate only under exceptional circumstances. Every effort is made to conduct the visit in the home. Services in the home-based option must be provided in the family’s home, because the home setting is integral to the success of this option.

Agencies ensure that teachers, home visitors, and other staff are provided with appropriate training, supervision, and support for safely conducting home visits. Support may include a monitoring system or the assignment of two individuals to make certain home visits. Because staff may find themselves in threatening situations, they are cautious during home visits, and follow basic safety guidelines and precautions. Staff are encouraged to look to the family, its strengths and its ways of coping with potentially hazardous situations.
Performance Standard

1304.40(i)(6)

(6) Grantee and delegate agencies serving infants and toddlers must arrange for health staff to visit each newborn within two weeks after the infant's birth to ensure the well-being of both the mother and the child.

  

Guidance: A visit to the family of each newborn child provides an opportunity to identify and to discuss needs and interests related to the child’s optimal development, including the importance of connecting with a "medical home." It also underscores the program’s emphasis on early intervention and on supporting parents as they adjust to the demands of life with a newborn child. Suggested ways for arranging visits by health staff include employing staff with the necessary training and experience, contracting for services, and collaborating with a public health or other community agency.

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