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Question. We have several concerns relating to the implementation of the 1990 reauthorization of Head Start. In creating the quality set-aside, the reauthorization bill was careful to protect the program's ability to maintain current service levels. Section 105 of PL 101-501 specifically states that before the Secretary can use funding increases to expand the number of children served by the program, he must ensure that allocations to existing programs are sufficient to maintain the previous years service level, accounting for inflation. Please explain why the Administration's FY 1992 budget proposal outlines its intention to use increases to serve additional children and not to provide an inflation adjustment so that existing programs can meet rising costs such as rent, heat and supplies?


Answer. Funds from the FY 1992 requested budget increase will be available for grantees to maintain the current levels of service in their programs. Section 105 of PL 101-501 does not mandate a standard cost-of-living increase for all Head Start programs. Instead, it requires that the Secretary shall not increase enrollment in FY 1992 without first assuring that grantees have sufficient funds to maintain FY 1991 service levels. This will be accomplished by allowing grantees to use funds from their FY 1992 increase to maintain services, before they add new children to their programs. Such decisions will be made on a case-by-case basis, since the amount of funds that will be needed to maintain service levels will vary depending on each program's particular circumstances.



Question. Under the new Head Start reauthorization, 25% of the monies above the cost-of-living increase are to be available for a "Quality Reserve." Inasmuch as the budget request is just short of (about $11.2 million) the cost-of-living, did you make a conscious decision to ignore the Quality Reserve Provisions in the new


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Answer. No, there was no intention to avoid the Quality Reserve Provisions. The FY 1992 request of $100 million represents as large an increase as can be justified given the current funding constraints and the necessity to comply with the terms of last year's budget accord agreed to by the President and the Congress.

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Question. According to your statement, the FY 1992 budget request will allow Head Start to serve 59 percent of disadvantaged children in the year before they enter school. Congress does not accept that Head Start is a program designed for a single age group, as evidenced by the passage of the reauthorization of the Head Start program last year. What is the percentage of all eligible children being served?

Answer. In past years, we often expressed the number of children served by Head Start was often expressed as the percentage of the income eligible three to five year-old children who were enrolled in Head Start in a given year. If this approach were used in FY 1992, it would appear that Head Start is only serving 22 percent of the eligible population.

However, we believe this gives an inaccurately low picture of the number of children Head Start actually reaches. For example, almost all of the five year-olds can never be served by Head Start because they are in kindergarten. We believe it is more useful and realistic to state, as we did in the budget statement, that 59 percent of children will be served by Head Start, for one or more years, before they enter school.

While the budget statement assumes that most Head Start children will be served for one year, as has always been the case, it does not assume all Head Start children will be served for only one year. It should be noted that serving all the income eligible three and four year-olds does not increase the number of eligible children who would be served by Head Start but, rather, increases the time for which these children would be served, i.e. two years.

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Question. Substantial increases have been made over the last two years in the Head Start program. Are there sufficient numbers of qualified personnel on which grantees can draw to staff new and expanded Head Start programs?

Answer. Yes. The requirement in the new Head Start legislation that every Head Start teacher have a Child Development Associate (CDA) credential does not take effect until September 30, 1994. Thus, programs are still able to recruit staff from many sources, including local community residents, and train those which are not fully qualified. It does not appear that Head Start programs have had problems finding sufficient staff to implement the FY 1990 expansion nor do we anticipate problems finding staff to assure full implementation of the FY 1991 expansion. We cannot predict, at this point, the impact that the 1994 credential requirement will have on the ability of Head Start programs to hire staff.

Question. What steps have been taken to meet new statutory requirements related to improving the quality of Head Start programs, including the requirement that all Head Start classrooms have a teacher with a Child Development Associate credential by the end of FY 1994?

Answer. In FY 1991, $195,180,000 in increased funding to help maintain or improve the quality of Head Start services is being provided to Head Start grantees. As required by statute, most of these funds are being allotted to grantees in proportion to the number of children they serve. Fifteen million dollars will be awarded competitively for special quality improvement projects to help grantees address the needs of families with special problems, such as substance abuse.

We are continuing our efforts to increase the number of teachers with Child Development Associate (CDA), or equivalent,

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All Head Start grantees have been made aware of the new statutory requirement and are expected to be in full compliance by that time. We will continue to support the CDA credentialing effort, under a cooperative agreement with the Council for Early Childhood Professional Development. We have recently revised the credentialing process to allow candidates more flexibility in preparing for the CDA credential. We will also continue to make an estimated $8 million a year available to grantees to pay the costs of CDA training. It is our judgement that grantees, in recent years, have made commendable progress in improving the qualifications of classroom staff. In 1990 approximately 82 percent of all Head start teachers had a CDA or other qualifying credential.

Other statutory requirements related to program quality are being implemented. The announcement requesting applications for Head Start Transition grants and expansion of Parent Child Center projects will be published in the Federal Register in the coming months. Training and technical assistance funds have been increased to the full amount required by statute.


Question. How effective is the Child Development Associate Scholarship Program in providing training and recruiting individuals into the Head Start program?

Answer: Beginning in FY 1991, the CDA Scholarship Assistance Program authorizes States to use up to 35 percent of their annual CDA allocation to provide scholarship assistance to economically eligible individuals to cover the cost of CDA training necessary for CDA credentialing. It is expected that the availability of these training funds will have a positive impact in recruiting individuals into the field of early childhood education, including Head Start.

Question. Do you plan to use any of the training monies available under Head Start to provide scholarships to train new Head Start teachers?

Answer. As in the past, local Head Start agencies will use their training and technical assistance funds to provide training for Head Start staff, including new teachers.


Question. Beginning in FY 1982, the Social Services Block Grant was formed by replacing Grants to States for Social Services, Child Care, and State and local training and retraining. The argument used at the time of the consolidation was that this would give States more flexibility. What we did give the States was fewer dollars. After ten years, funding for programs that make up the Social Services Block Grant is still $100 million below what it was in FY 1981.

Now, here we are again. The FY 1992 budget identifies $21 billion in grants from five major policy areas for possible turnover to State and local governments as part of a single block grant. The Social Services Block Grant is one of the programs identified for consolidation. What would be the impact on social service programs were the Social Services Block Grant to be folded

into a new block grant along with several housing, community development, environmental, and education programs?

Answer. The Social Services Block Grant is included on the list of several programs which the Administration proposes to consolidate into a single, larger, multipurpose program of grants to States. The Administration's stated approach for design of the new block grant is to enter into a dialogue with the States and the Congress on what programs would be included. The rationale driving this proposal is to allow for a reduction of Federal administrative overhead, to increase State flexibility, and to place power and decisionmaking closer to the people being served by these programs.

We can not with any specificity predict the impact on social services programs if the Social Services Block Grant program were folded into a new "super" block grant. The specific impact of a consolidated block grant on social service programs in the States would depend upon decisions made at the State level. Currently under the Social Services Block Grant program, the States have wide flexibility to select which services are most needed in their particular circumstances. The new block grant would only increase their ability to tailor programs to best meet the needs of their citizens. As evidence of this, the National Governor's Association has endorsed the proposal in concept and praises the Administration's flexibility and general attitude of partnership in formulating the design of the new block grant proposal.

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Question. Each day, about 6,000 people turn 65 years of age. By the year 2000 just nine short years away 13% of the population will be 65 or over. Iowa's 65 and over population is already at 15.1 percent, and we have one of the largest 85 years of age and over populations in the country. In spite of the fact that the "AGING OF AMERICA" is very real, no increases not even cost of living increases have been requested that will put programs into place to deal with this population growth. What steps is the Administration taking to put into place long-term strategies and programs to deal with this population growth?



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Answer: The Department of Health and Human Services is keenly aware that the growth of the aging population poses major challenges to policy makers and program administrators at all levels. We are aware, as is the Congress, that the population aged 65 and older increased from approximately 25,700,000 in 1980 to 31,000,000 in 1989, an increase of some 21%. We are equally aware that these increases will continue in the next decade and into the next century.

In view of these developments, the Department has assigned a high priority to assuring that adequate resources are available to support the program efforts required to address the pressing needs of the Nation's older citizens. We note that Administration on Aging programs have received on-going budgetary increases during the past decade. During that period we have also encouraged programs to solicit increased contributions from older recipients able to pay and have emphasized efforts to improve the management of service efforts. We believe that the results have been very positive.

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For example, over the seven year period 1982-1989, meals provided under the Title III-C program have increased by more than one third, from 190,000,00 to 250,000,000. Voluntary contributions have more than doubled from $69,000,000 in 1982 to $150,000,000 in 1989. Where opportunities present themselves, the aging services network will make additional efforts to expand services through increasing voluntary contributions and further improving service program administration.

In addition, the Administration on Aging has recently launched its national Eldercare Campaign designed to mobilize additional resources from both the public and private sectors on behalf of older persons at risk of losing their independence. The Campaign is nation-wide in scope and will assist the aging services network to draw upon significant resources which have not been available in the past.


Question: Ms. Gall, as you know, I have introduced the Older Americans Health Promotion and Disease Prevention Act. This bill expands Part F of the Older Americans Act to establish a state grants program that would provide disease prevention and health promotion services and information at senior centers, congregate meals sites, home-delivered meals programs or at other sites. Prevention and health promotion is important at any age however, to the elderly, disease prevention and health promotion could well mean the difference between independence or nursing home care. just think that prevention makes good sense and will save money in the out years.


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With this as background, it is of concern to me that Administration has never requested funding for Part F of the Older Americans Act Health Prevention for Older Americans. Is it felt that these services are unimportant for older Americans, and if you feel that these services are important, why have you not requested funding for Part F?

Answer: The Department of Health and Human Services assigns tremendous importance to health promotion and disease prevention activities. We share your conviction that such activities not only enhance the quality of life for persons of all ages and that they also contribute significantly to helping individuals maintain their independence. This latter consideration is, as you suggest, especially important for older persons.

Because of the great significance which the Department attaches to health promotion programs, we continue to make major investments in this area. The Administration on Aging has directed Title IV funds in substantial amounts to a variety of health promotion activities in recent years, including support for projects in Health Promotion/Health Education, Mental Health Promotion, and Dental Health Promotion. In addition, Title IV funds have also been used to establish the Health Promotion and Wellness National Resource Center, which is operated by the American Association of Retired Persons.

Concerning Title III, Part F, of the Older Americans Act, the Department believes that Title III contains ample authority for any

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