GAO-06-807, Child Care and Early Childhood Education: More Information Sharing and Program Review by HHS Could Enhance Access for Families with Limited English Proficiency


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entitled 'Child Care and Early Childhood Education: More Information 
Sharing and Program Review by HHS Could Enhance Access for Families 
with Limited English Proficiency' which was released on September 18, 
2006. 

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Report to Congressional Requesters: 

United States Government Accountability Office: 

GAO: 

August 2006: 

Child Care And Early Childhood Education: 

More Information Sharing and Program Review by HHS Could Enhance Access 
for Families with Limited English Proficiency: 

Child Care and Early Childhood Education: 

GAO-06-807: 

GAO Highlights: 

Highlights of GAO-06-807, a report to congressional requesters 

Why GAO Did This Study: 

Questions have been raised about whether parents with limited English 
proficiency are having difficulty accessing child care and early 
education programs for their children. Research suggests that quality 
early care experiences can greatly improve the school readiness of 
young children. GAO was asked to provide information on (1) the 
participation of these children in programs funded through the Child 
Care and Development Fund (CCDF) and Head Start, (2) the challenges 
these families face in accessing programs, (3) assistance that selected 
state and local entities provide to them, and (4) actions taken by the 
Department of Health and Human Services (HHS) to ensure program access. 
To obtain this information, GAO analyzed program and national survey 
data, interviewed officials in 5 states and 11 counties, held 12 focus 
groups with mothers with limited English proficiency, and interviewed 
experts and HHS officials. 

What GAO Found: 

HHS’s Child Care Bureau (CCB) did not have information on the total 
enrollment in CCDF programs of children whose parents had limited 
English proficiency, but data collected by its Office of Head Start in 
2003 showed that about 13 percent of parents whose children were in 
Head Start reported having limited English proficiency. The most recent 
(1998) national survey data showed that children of parents with 
limited English proficiency were less likely than other children to 
receive financial assistance for child care from a social service or 
welfare agency or to be in Head Start, after controlling for selected 
characteristics. Eighty-eight percent of these children were Hispanic, 
and their results differed from Asian children. 

Table: Likelihood of Selected Outcomes for Children of Parents with 
Limited English Proficiency, after Controlling for Other Factors: 

Receipt of financial Assistance for child care; 
Compared to similar children of parents proficient in English: All 
children of parents with limited English proficiency: Less likely; 
Compared to similar children of parents proficient in English: Hispanic 
children of parents with limited English proficiency: Less likely; 
Compared to similar children of parents proficient in English: Asian 
children of parents with limited English proficiency: No significant 
difference. 

Head Start; 
Compared to similar children of parents proficient in English: All 
children of parents with limited English proficiency: Less likely; 
Compared to similar children of parents proficient in English: Hispanic 
children of parents with limited English proficiency: Less likely; 
Compared to similar children of parents proficient in English: Asian 
children of parents with limited English proficiency: More likely. 

Source: GAO analysis of Early Childhood Longitudinal Study, 
Kindergarten, Class of 1998-1999. 

[End of Table] 

Analysis of data from focus groups and site visit interviews held by 
GAO revealed that mothers with limited English proficiency faced 
multiple challenges, including lack of awareness of available 
assistance, language barriers during the application process, and 
difficulty communicating with English-speaking providers. Some of the 
challenges that low-income parents with limited English proficiency 
experienced, such as lack of transportation and shortage of subsidized 
child care slots, were common to other low-income families. The 
majority of state and local agencies that we visited offered some oral 
and written language assistance, such as bilingual staff or translated 
applications. Agencies in the majority of locations visited also made 
efforts to increase the supply of providers who could communicate with 
parents. Officials reported challenges in serving parents with limited 
English proficiency, such as difficulty hiring qualified bilingual 
staff. Some officials indicated that additional information on cost-
effective strategies to serve this population would facilitate their 
efforts. 

HHS issued guidance, translated materials, and provided technical 
assistance to grantees to help them serve children of parents with 
limited English proficiency. The Office of Head Start reviewed 
programs’ assessments of their communities’ needs and conducted formal 
monitoring reviews, but could not ensure that review teams consistently 
assessed grantees’ performance on the standards related to language 
access. CCB reviewed states’ plans on the use of CCDF funds generally 
and investigated specific complaints, but had no mechanism for 
reviewing how and whether states provide access to CCDF subsidies for 
eligible children of parents with limited English proficiency. 

What GAO Recommends: 

GAO recommends that HHS help states explore cost-effective ways of 
collecting data on the primary language of CCDF subsidy recipients and 
that HHS develop means of reviewing how states provide access to CCDF 
subsidies. In comments, HHS generally agreed with our recommendations 
and provided additional information on its actions and plans to 
implement them. 

[Hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-06-807]. 

To view the full product, click on the link above. Translated report 
summaries are available in selected languages at 
http://www.gao.gov/translations/childcare.html For more information, 
contact Cornelia Ashby at (202) 512-7215 or ashbyc@gao.gov. 

[End of Section] 

Contents: 

Letter: 

Results in Brief: 

Background: 

Children of Parents with Limited English Proficiency Were Less Likely 
than Other Children to Participate in Subsidized Programs: 

Parents with Limited English Proficiency Faced Multiple Challenges That 
May Have Limited Their Children's Participation in Federally Funded 
Child Care and Early Education Programs: 

Selected Agencies Took Some Steps to Assist Parents with Limited 
English Proficiency but Reported Challenges in Serving Them: 

HHS Provided Assistance to Grantees on Serving Children of Parents with 
Limited English Proficiency, but Gaps Remain in Its Program Review 
Efforts: 

Conclusions: 

Recommendations for Executive Action: 

Agency Comments and Our Evaluation: 

Appendix I: Scope and Methodology: 

Appendix II: Analyses of the Effects of Limited English Proficiency on 
Child Care and Early Education Patterns: 

Appendix III: Comments from the U.S. Department of Health and Human 
Services: 

Appendix IV: GAO Contact and Staff Acknowledgments: 

Tables: 

Table 1: Characteristics of Data Sources Examined: 

Table 2: Selected Characteristics of Site Visit Counties: 

Table 3: Composition of Focus Groups: 

Table 4: Differences in the Percentages and Odds of Receiving Any 
Nonparental Care, by Parents' English Proficiency Status, Race or 
Ethnicity, and Both, among Preschool-Aged Children: 

Table 5: Differences in the Percentages and Odds of Receiving Financial 
Assistance for Child Care, among Those in Any Prekindergarten Care, by 
Parents' English Proficiency Status, Race or Ethnicity, and Both: 

Table 6: Percentages of English Proficient Parents and Parents with 
Limited English Proficiency, by Race or Ethnicity: 

Table 7: Percentages of English Proficient Parents and Parents with 
Limited English Proficiency, by Family Income: 

Table 8: Percentages of English Proficient Parents and Parents with 
Limited English Proficiency, by Education: 

Table 9: Percentages of English Proficient Parents and Parents with 
Limited English Proficiency, by the Number of Persons over the Age of 
18 in the Household: 

Table 10: Percentages of English Proficient Parents and Parents with 
Limited English Proficiency, by Parents' Work Status: 

Table 11: Percentages of English Proficient Parents and Parents with 
Limited English Proficiency, by the Number of Different Types of Child 
Care Used, among Those Using Care: 

Table 12: Odds Ratios from Logistic Regression Models Used to Estimate 
the Effects of Different Factors on the Likelihood of Receiving Any 
Child Care, after Adjusting for Other Characteristics: 

Table 13: Odds Ratios from Logistic Regression Models Used to Estimate 
the Effects of Different Factors on the Likelihood of Receiving 
Financial Assistance for Child Care, among Those in Any Care, after 
Adjusting for Other Characteristics: 

Table 14: Odds Ratios from Logistic Regression Models Used to Estimate 
the Effects of Different Factors on the Likelihood of Receiving Center- 
Based Care, among Those in Any Care, after Adjusting for Other 
Characteristics: 

Table 15: Odds Ratios from Logistic Regression Models Used to Estimate 
the Effects of Different Factors on the Likelihood of Participating in 
Head Start, after Adjusting for Other Characteristics: 

Figures: 

Figure 1: Size and Growth of Population of Individuals with Limited 
English Proficiency, 1990-2000: 

Figure 2: Flow of Funds Under CCDF and Head Start: 

Figure 3: Relative Odds of Selected Outcomes for Children of Parents 
with Limited English Proficiency Compared to Children of Parents 
Proficient in English, for Hispanics and Asians, after Adjusting for 
Selected Family Characteristics: 

Figure 4: English and Chinese Versions of a Local Agency's Child Care 
Quality Brochure: 

Abbreviations: 

ACF: Administration for Children and Families: 
CBRS: Computer-Based Reporting System: 
CCB: Child Care Bureau: 
CCDF: Child Care and Development Fund: 
CRADLE: Culturally Responsive and Aware Dual Language Education: 
ECLS-K: Early Childhood Longitudinal Study, Kindergarten Class of 1998-
99: 
FACES: Family and Child Experiences Survey: 
HHS: Department of Health and Human Services: 
HSNRS: Head Start National Reporting System: 
LEP: limited English proficiency: 
NACCRRA: National Association of Child Care Resource and Referral 
Agencies: 
NCES: National Center for Education Statistics: 
OCR: Office for Civil Rights: 
PRISM: Program Review Instrument for Systems Monitoring: 
TANF: Temporary Assistance for Needy Families: 

United States Government Accountability Office: 
Washington, DC 20548: 

August 17, 2006: 

The Honorable Charles E. Grassley: 
Chairman: 
Committee on Finance: 
United States Senate: 

The Honorable Max Baucus: 
Ranking Minority Member: 
Committee on Finance: 
United States Senate: 

The Honorable Christopher J. Dodd: 
Ranking Minority Member: 
Subcommittee on Education and Early Childhood Development: 
Committee on Health, Education, Labor, and Pensions: 
United States Senate: 

Children whose parents have limited English proficiency are at greater 
risk of experiencing difficulties in school than children from English- 
speaking households. Research suggests that quality early care 
experiences can greatly improve the school readiness and future school 
success of young children, particularly children at greatest risk of 
failure. U.S. Census Bureau data from 2000 indicate that more than 1.6 
million children age 5 and younger lived in households where no one 
aged 14 or over reported English proficiency. Census data also show 
that these children were more likely than other children to be from low-
income families. There is interest in how this population is faring in 
accessing child care and early education programs that can ease 
children's transition to school. 

The U.S. Department of Health and Human Services (HHS) administers the 
two largest federally funded programs that support early childhood 
activities. HHS's Child Care Bureau (CCB) provides block grants to 
states through the Child Care and Development Block Grant, commonly 
referred to as the Child Care and Development Fund (CCDF), to subsidize 
child care for low-income children while their parents work or 
participate in education or training activities. HHS's Office of Head 
Start funds local grantees through its Head Start program, a 
comprehensive program designed to foster healthy child and family 
development and to help low-income children achieve school readiness. 
States receiving CCDF block grants and Head Start grantees have limited 
funds for these programs and employ priorities and waiting lists to 
ration services. In fiscal year 2006, CCDF provided approximately $4.9 
billion in federal funds to states and territories. In fiscal year 2004 
(the latest year for which service delivery data were available), 
states and territories received about $4.7 billion in federal funds and 
served approximately 1.74 million children in their CCDF programs. In 
fiscal year 2005, Head Start grantees received about $6.8 billion in 
federal funding and served approximately 900,000 children. The majority 
of individuals with limited English proficiency are immigrants-- 
individuals not born in the United States--although most children of 
immigrants were born in the United States. Children must be U.S. 
citizens or legal residents to receive CCDF subsidies, while a child's 
immigration status is not a factor in determining eligibility for Head 
Start. The parent's immigration status is not relevant for determining 
eligibility for either program. 

Organizations working on issues affecting children and parents with 
limited English proficiency have raised concerns that these families 
may have difficulties accessing federally funded child care and early 
education programs. In this context, you asked us to answer the 
following questions: (1) What is known about the participation of 
children whose parents have limited English proficiency in child care 
and early education programs funded through CCDF and Head Start? (2) 
What challenges do these families face in accessing these programs? (3) 
What assistance is provided by selected state and local entities to 
facilitate access for these families? (4) What actions has HHS taken to 
ensure that these families can access CCDF child care subsidies and 
Head Start? 

To address these issues, we used multiple data collection 
methodologies. To determine the participation in federally funded child 
care and early education programs by children of parents with limited 
English proficiency, we reviewed HHS data from a survey of Head Start 
participants and from a reporting system used by Head Start grantees. 
To assess the reliability of these data, we interviewed relevant HHS 
officials and contractors and reviewed documentation related to the 
procedures for collecting and analyzing these data. We found the Head 
Start survey data to be sufficiently reliable for the purposes of this 
report, and while we did not independently verify the data available 
through the reporting system, we found no evidence to suggest that they 
were unreliable. We also requested information from all 50 states and 
the District of Columbia on their collection of language data for CCDF 
subsidy recipients. To obtain information on the child care and early 
education patterns of these children that could not be obtained from 
HHS data, we analyzed national survey data collected in 1998 as part of 
the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 
(ECLS-K), from parents of kindergarten children about their children's 
experiences the year before. Specifically, we used a logistic 
regression model to estimate the effect of parents' English proficiency 
on children's child care and early education patterns, while 
controlling for selected individual and family characteristics such as 
race and parental education. ECLS-K, conducted by the National Center 
for Education Statistics (NCES), was the most recent national dataset 
that allowed us to examine child care and early education experiences 
of children while considering the English proficiency of their parents. 
We assessed the reliability of NCES data and found these data to be 
sufficiently reliable for the purposes of this report. To understand 
the challenges that parents with limited English proficiency face and 
what state and local entities are doing to assist them, we visited five 
states (Arkansas, California, Illinois, North Carolina, and Washington) 
and contacted 11 counties across these states. We interviewed state and 
local officials administering CCDF and Head Start as well as local 
child care and early education providers. We selected our site visit 
locations on the basis of the size and growth of their population with 
limited English proficiency, the presence of any initiatives focused on 
individuals with limited English proficiency, and their geographic 
location. We also conducted 12 focus groups in California, North 
Carolina, and Washington with mothers who spoke Spanish and Vietnamese, 
reported limited English proficiency, and had children aged 5 or 
younger enrolled in child care who likely qualified for CCDF subsidies 
based on their family's income and parental work and education 
activities. Six focus groups were conducted with mothers whose children 
received a government child care subsidy, and six focus groups were 
conducted with mothers whose children were eligible for but did not 
receive the subsidy. To determine what HHS is doing to ensure access to 
its programs, we interviewed HHS officials from the Office for Civil 
Rights (OCR), the Office of Head Start, and CCB, and reviewed relevant 
documents, legislation, guidance, and other federal resources related 
to language access. Appendix I contains more information about our 
scope and methodology. Appendix II contains information on the 
regression analysis of ECLS-K data that we conducted. We conducted our 
work between July 2005 and June 2006 in accordance with generally 
accepted government auditing standards. 

Results in Brief: 

The most recent national survey data showed that in 1998, children of 
kindergarten age whose parents had limited English proficiency were 
less likely than other children to have received financial assistance 
from a social service or welfare agency for child care or to 
participate in Head Start in the year before kindergarten, after 
controlling for selected individual and family characteristics such as 
race and parental education. Eighty-eight percent of these children 
were Hispanic, and the results differed between them and Asian 
children. However, these data could not be used to assess their 
likelihood of enrollment in CCDF programs because the survey questions 
did not ask for the specific agency providing financial assistance. 
Further, CCB did not have information on the total enrollment in CCDF 
programs of children of parents with limited English proficiency 
because it did not require states to collect and report any language 
data from parents of children receiving federal subsidies, such as 
their primary language or English proficiency. We found that 13 states 
collected some language data from parents whose children received CCDF 
subsidies, primarily to determine the need for interpreters or 
translated forms. However, these data had limitations that reduced 
their usefulness in assessing participation in CCDF programs by 
children of parents with limited English proficiency. For example, 5 
states made the collection of language data by caseworkers optional, 
and state officials told us they could not guarantee that the 
information was consistently collected. The Office of Head Start 
collected some language data on the language spoken by Head Start 
participants, which showed that about 13 percent of parents of the 
approximately 900,000 children enrolled in Head Start in 2003 reported 
speaking English "not well" or "not at all." 

Focus group participants, state and local child care officials, and 
advocates told us that parents with limited English proficiency faced 
multiple challenges in accessing federally funded child care and early 
education programs for their children. Analysis of data from focus 
groups with mothers whose children were eligible for federal child care 
subsidies revealed that some of them were not aware of the programs. 
Parents also faced challenges during the application process, according 
to focus group participants and state and local officials interviewed. 
For example, some of them faced obstacles due to a lack of bilingual 
staff or translated applications, especially for languages other than 
Spanish. Additionally, parents reported difficulties communicating with 
their children's English-speaking providers. Officials reported 
shortages of providers with the language ability to serve families with 
limited English proficiency. Parents' immigration status also presented 
indirect challenges to the participation of children in federally 
funded child care and early education programs. For example, local 
officials and community advocates told us that some parents with 
limited English proficiency may be reluctant to apply for fear of 
exposing undocumented immigrant members in the household. Finally, some 
parents with limited English proficiency experienced challenges that 
were common to low-income families generally. For example, difficulty 
finding care at nontraditional hours, lack of transportation, and the 
limited number of subsidized child care slots available affected the 
ability of these parents to access programs. 

The majority of state and local agencies and providers that we 
interviewed on our site visits took some steps to assist parents with 
limited English proficiency, but officials reported challenges in 
serving these parents. In all counties that we visited, agencies 
offered some form of oral language assistance, although the scope of 
this assistance varied and parents continued to experience challenges 
when accessing services. For example, agencies in 5 of the 11 counties 
visited had staff that could speak several languages; agencies in the 
remaining counties had Spanish-speaking staff, although in one case, 
the staff were not specifically assigned to work with program 
applicants and had other responsibilities. Most agencies also made 
available some written language assistance, such as translated 
applications, although the scope of the translations varied as well. 
For example, local agencies in one state used applications that the 
state had translated into eight languages, while agencies in 2 other 
states had state-translated applications only in Spanish. The majority 
of agencies and providers also disseminated information in other 
languages to raise awareness of their programs and services. Several 
state and local agency officials told us that they did not extensively 
disseminate information about their programs because their programs 
were already operating at full capacity or had substantial waiting 
lists. Agencies in the majority of locations that we visited had 
initiatives to increase the supply of providers able to communicate 
effectively with parents. For example, one local agency we visited, 
which provided child care information to parents and worked with child 
care providers in the community, offered training and other guidance to 
Somali-and Russian-speaking women interested in opening family child 
care homes. State and local officials cited several challenges in 
serving parents with limited English proficiency, including 
difficulties hiring qualified bilingual staff and the expense of 
translating materials into multiple languages. Some officials that we 
interviewed expressed the need for additional information on cost- 
effective strategies to serve parents with limited English proficiency, 
and several officials said it would be helpful to learn about provider 
training in use elsewhere. 

HHS provided a variety of assistance to grantees on serving children of 
parents with limited English proficiency, but gaps remained in its 
program review efforts. HHS's Office for Civil Rights conducted 
outreach to states to help them implement guidance on access to HHS 
programs by individuals with limited English proficiency and offered 
technical assistance in identifying appropriate language access 
strategies. The Office of Head Start provided assistance to increase 
awareness of the Head Start program and to help grantees better serve 
children of parents with limited English proficiency. The Office also 
reviewed grantees' assessments of child care and early education 
resources in their communities relative to the needs of their 
communities' Head Start-eligible children. In addition, the Office 
conducted formal monitoring reviews of grantees' compliance with Head 
Start performance standards, including standards specific to providing 
language access to children and parents with limited English 
proficiency. An Office of Head Start official, however, told us that 
the office could not ensure that its review teams consistently reviewed 
grantee compliance with these standards, and in our prior work we found 
that no mechanism existed to ensure consistency in the monitoring 
process. CCB provided a variety of assistance to help states and child 
care providers offer language access to individuals with limited 
English proficiency, such as translating brochures. CCB officials told 
us that because CCDF is a block grant, CCB's oversight of CCDF is 
limited to reviewing states' CCDF plans and investigating complaints. 
However, CCB does not require states to report in their CCDF plans how 
they will provide language access for individuals with limited English 
proficiency or have a mechanism for ensuring that eligible children of 
parents with limited English proficiency are not inadvertently excluded 
from receiving CCDF assistance because of their parents' citizenship or 
immigration status. 

To help agencies plan for and provide language assistance to parents 
with limited English proficiency who may want to access federally 
funded child care and early education programs for their children, we 
recommend that HHS work with states to help them explore cost-effective 
strategies for collecting data on CCDF subsidy recipients' language 
preference or English proficiency. Once these data are available, HHS 
may consider collecting information on existing cost-effective ways 
that agencies could use to provide language assistance and to recruit 
providers who speak other languages, as well as disseminating this 
information in the locations where the data show the greatest need. To 
provide opportunities for eligible children to receive federal child 
care subsidies regardless of their parents' English proficiency, we 
recommend that HHS develop and implement specific strategies to review 
whether and how states provide access to CCDF programs for these 
families. These strategies include the revision of the CCDF plan 
template to require states to report on how access will be provided and 
a systematic review of states' eligibility criteria to ensure that 
states comply with HHS policies related to participation of children 
whose parents have limited English proficiency. 

In its comments on a draft of this report, HHS's Administration for 
Children and Families (ACF) generally agreed with our recommendation to 
help states explore strategies for collecting data on CCDF subsidy 
recipients' language, and provided additional information on its plans 
and actions toward implementation of this recommendation. ACF also 
agreed to examine the feasibility of using the CCDF plan template to 
ask states to report on how they provide access to parents with limited 
English proficiency seeking CCDF subsidies for their children. However, 
ACF did not address our recommendation that it systematically review 
states' program eligibility criteria to ensure that states do not 
inadvertently exclude otherwise eligible children of parents with 
limited English proficiency from CCDF participation. In addition, ACF 
submitted detailed comments on certain aspects of this report, 
including comments related to our analysis of ECLS-K data. 

Background: 

Population Changes: 

The population of individuals with limited English proficiency in the 
United States has grown dramatically in recent years. The 2000 Census 
shows that the number of people reporting that they do not speak 
English well or very well grew by 65 percent, from 6.7 million in 1990 
to almost 11 million in 2000. The data also show that while growth in 
the population of individuals with limited English proficiency 
continues in states along the border, such as California and Texas, it 
is most rapid in other states. (See fig. 1.) 

Figure 1: Size and Growth of Population of Individuals with Limited 
English Proficiency, 1990-2000: 

[See PDF for image] 

Source: GAO analysis of U.S. Census data. Copyright Corel Corp. All 
rights reserved (mao). 

Note: In our analyses of Census data, we categorized the population of 
individuals reporting that they do not speak English well or very well 
as those with limited English proficiency. 

[End of figure] 

As figure 1 shows, for example, the number of individuals who did not 
speak English well or very well increased by more than 300 percent 
between 1990 and 2000 in North Carolina and Georgia, and by more than 
200 percent in states such as Nebraska, Arkansas, and South Carolina. 
In 2000, 14 percent of children age 5 and younger in households below 
the federal poverty level lived in linguistically isolated 
households.[Footnote 1] 

HHS Child Care and Early Education Programs: 

The two largest sources of federal support for child care and early 
education are CCDF and Head Start. CCB administers CCDF and the Office 
of Head Start[Footnote 2] administers Head Start. Both entities are 
housed within ACF. CCB provides block grants to states through CCDF to 
subsidize child care expenses of eligible families. In contrast, the 
Office of Head Start awards grants for the operation of Head Start 
programs directly to local public or private organizations, school 
systems, or Indian tribes. The flow of funds under CCDF and Head Start 
is shown in figure 2. 

Figure 2: Flow of Funds Under CCDF and Head Start: 

[See PDF for image] 

Source: GAO analysis and Art Explosion images. 

[A] These are examples of providers that parents may choose with CCDF 
vouchers. Parents may choose any other legally operating provider 
authorized by the state. 

[End of figure] 

CCDF is used to subsidize the child care expenses of low-income 
families with children under age 13 and to improve the overall quality 
and supply of child care. The goals of the program are to (1) allow 
each state maximum flexibility in developing child care programs and 
policies; (2) promote parental choice to empower working parents to 
make their own decisions on the child care that best suits their 
family's needs; (3) encourage states to provide consumer education 
information to help parents make informed choices about child care; (4) 
assist states to provide child care to parents trying to achieve 
independence from public assistance; and (5) assist states in 
implementing the health, safety, licensing, and registration standards 
established in state regulations. The parent whose child receives child 
care assistance may either enroll the child directly with a provider 
who has a grant or contract from the state for the provision of child 
care services or receive a certificate to enroll the child with a 
provider of the parent's choosing. Parents may choose from any child 
care legally offered in the state, which could include care provided in 
child care centers, family child care homes, or by relatives or 
nonrelatives in the child or provider's home. CCDF is a combination of 
discretionary and mandatory funds. In federal fiscal year 2006, CCDF 
provided about $4.9 billion in federal funds to states and territories. 
In fiscal year 2004 (the latest year for which data were available), 
the program served approximately 1.74 million children with federal 
funding of about $4.7 billion. In addition, federal CCDF funds are 
supplemented with state contributions, and HHS officials reported that 
total federal and state expenditures for CCDF amounted to almost $9.4 
billion in fiscal year 2004. 

Congress gave states considerable flexibility in administering and 
implementing their CCDF programs. States are required to submit 
biennial plans to CCB describing their CCDF activities. States 
determine income eligibility thresholds up to a federal maximum of 85 
percent of the state median income. In their CCDF plans for federal 
fiscal years 2004 and 2005, almost all states reported setting lower 
income eligibility limits, with only 5 states at the federal maximum of 
85 percent.[Footnote 3] 

Because CCDF is a nonentitlement program--one with limited funding and 
not necessarily intended to cover all eligible persons--states are not 
required to provide child care subsidies to all families whose incomes 
fall below the state-determined eligibility threshold, and states may 
establish priorities for serving eligible families, such as 
prioritizing families receiving Temporary Assistance for Needy Families 
(TANF), in order to support their work efforts. States can augment 
their CCDF funds with other funding sources, such as TANF, to increase 
funding available for subsidies. States spent $1.4 billion in federal 
TANF funds directly on child care in fiscal year 2004.[Footnote 4] 
States may also transfer up to 30 percent of their TANF block grants 
into their CCDF programs. In fiscal year 2004, the latest year for 
which data were available, $1.9 billion in TANF funds was transferred 
to CCDF. Funds transferred from TANF to CCDF must be spent in 
accordance with CCDF rules. This is significant partly because the 
effect of the child's or the parent's citizenship or immigration status 
on the child's eligibility differs depending on the program. For 
example, parents' immigration status may affect their eligibility for 
child care assistance under TANF,[Footnote 5] whereas only the 
immigration status of the child matters for determination of 
eligibility for subsidies from CCDF. Although legislation authorizing 
CCDF did not specify the effect of citizenship or immigration status on 
program eligibility, HHS's guidance to state agencies indicated that 
states should consider only the citizenship and immigration status of 
the child when determining the child's eligibility for federal child 
care assistance[Footnote 6]. Therefore, children who are citizens or 
legal residents are eligible for CCDF subsidies regardless of their 
parents' citizenship or immigration status. 

States are also required to dedicate at least 4 percent of their CCDF 
allotments to activities to provide comprehensive consumer education to 
parents and to improve the quality and availability of child 
care.[Footnote 7] States may use some of this quality set-aside to fund 
child care resource and referral services that are available in every 
state and most communities in the United States. These agencies provide 
information to parents on finding and paying for quality child care, 
offer training to child care providers, and frequently engage in 
efforts to analyze and report on child care supply and demand in their 
communities. Often, resource and referral agencies also manage the CCDF 
subsidy program or are part of local organizations that administer the 
subsidy in the community. 

Head Start offers child development programs to low-income children 
through age 5 and their families. The overall goal of Head Start is to 
promote the school readiness and healthy development of young children 
in low-income families. In addition to providing classroom programs for 
the children, Head Start grantees provide or arrange for a variety of 
services, including medical, dental, mental health, nutritional, and 
social services. Children in families with incomes below the federal 
poverty level ($20,000 for a family of four in 2006)[Footnote 8] are 
eligible for available Head Start programs regardless of their or their 
parents' immigration status. Head Start grantees must adhere to certain 
performance standards, including standards related to providing 
language access in Head Start programs. The Office of Head Start 
reviews the performance of Head Start grantees on these standards using 
a structured guide known as the Program Review Instrument for Systems 
Monitoring (PRISM). In fiscal year 2005, Head Start was funded at $6.8 
billion and served 906,993 children. 

Ensuring Meaningful Program Access for Persons with Limited English 
Proficiency: 

HHS has responsibility for monitoring grantees' compliance with program 
requirements. Through its Office for Civil Rights (OCR), HHS also 
oversees compliance with Title VI of the Civil Rights Act of 
1964,[Footnote 9] which states that no person shall "on the ground of 
race, color, or national origin, be excluded from participation in, be 
denied the benefits of, or be subjected to discrimination under any 
program or activity receiving federal financial assistance." HHS has 
issued regulations to recipients of HHS funds on implementing the 
provisions of Title VI, including requiring an assurance in every 
application for federal financial assistance that the program will be 
operated in compliance with all requirements imposed under HHS's Title 
VI regulations. 

Moreover, Executive Order 13166, issued in 2000, required federal 
agencies to prepare a plan and issue guidance to their funding 
recipients on providing meaningful access to individuals who, as a 
result of national origin, are limited in their English proficiency. In 
August 2003, HHS published revised guidance pursuant to Executive Order 
13166. The guidance states that Title VI and its implementing 
regulations require that grantees take reasonable steps to ensure 
meaningful access for individuals with limited English proficiency, and 
the guidance is intended to assist grantees in fulfilling their 
responsibilities to ensure meaningful access to HHS programs and 
activities by these individuals. Under the guidance, grant recipients 
are to determine the extent of their obligation to provide language 
assistance services by considering four factors: (1) the number or 
proportion of individuals with limited English proficiency eligible to 
be served or likely to be encountered by the program or grantee; (2) 
the frequency with which these individuals come in contact with the 
program; (3) the nature and importance of the program, activity, or 
service provided by the program to people's lives; and (4) the 
resources available to recipients of federal funds and costs of 
language assistance. The guidance states that grantees have two main 
ways to provide language assistance services: oral interpretation, 
either in person or via telephone, and written translation. Finally, 
the guidance lays out elements of an effective plan of language 
assistance for persons with limited English proficiency. 

Monitoring compliance with Title VI and providing technical assistance 
are functions of HHS's OCR. OCR enforces Title VI as it applies to 
agencies' responsibilities to ensure access for individuals with 
limited English proficiency. The mechanisms available to OCR for 
ensuring that agencies comply with their obligations to provide access 
include complaint investigations, compliance reviews, efforts to secure 
voluntary compliance, and technical assistance. 

Children of Parents with Limited English Proficiency Were Less Likely 
than Other Children to Participate in Subsidized Programs: 

The most recent national survey data showed that in 1998 children of 
parents with limited English proficiency, 88 percent of whom were 
Hispanic, were less likely than other children to receive financial 
assistance from a social service or welfare agency for child care or to 
participate in Head Start in the year before kindergarten, after 
controlling for selected individual and family characteristics. 
However, these data could not be used to assess their likelihood of 
enrollment in CCDF programs because the survey questions did not ask 
for the specific agency providing financial assistance. Further, CCB 
did not have information on the total enrollment in CCDF programs of 
children of parents with limited English proficiency because it did not 
require states to collect and report any language data from parents of 
children receiving federal subsidies, such as their primary language or 
English proficiency. The Office of Head Start collected some data on 
the language spoken by Head Start participants, which showed that about 
13 percent of parents of the approximately 900,000 children enrolled in 
Head Start in 2003 reported speaking English "not well" or "not at 
all." 

Children of Parents with Limited English Proficiency Were Less Likely 
to Receive Financial Assistance for Child Care or to Participate in 
Head Start: 

National survey data from ECLS-K showed that in 1998, kindergarten 
children of parents with limited English proficiency who were in 
nonparental child care in the previous year were less likely[Footnote 
10] than other children in child care to receive financial assistance 
from a social service or welfare agency for that care, after 
controlling for selected individual and family 
characteristics.[Footnote 11] However, parents' limited English 
proficiency had a different effect for Hispanics than for Asians in the 
dataset.[Footnote 12] Specifically, as shown in figure 3, Hispanic 
children of parents with limited English proficiency (who represented 
88 percent of all children in the dataset whose parents had limited 
English proficiency) were less likely than children of Hispanic parents 
proficient in English to receive financial assistance for their care. 
Among Asians, who constituted about 8 percent of all children of 
parents with limited English proficiency, we did not find a 
statistically significant difference in the receipt of financial 
assistance for child care between children of parents with limited 
English proficiency and other children. These results, however, cannot 
be used to draw conclusions about enrollment in CCDF programs by 
children of parents with limited English proficiency because the survey 
questions referred to assistance from a social service or welfare 
agency generally and did not ask specifically whether assistance came 
from CCDF.[Footnote 13] Also, while ECLS-K data are representative of 
the experiences of children in the year prior to entering kindergarten, 
they cannot be extrapolated to children of all ages. (See app. II for 
discussion of the methodology we used to analyze ECLS-K data and the 
results of our analyses.) 

Figure 3: Relative Odds of Selected Outcomes for Children of Parents 
with Limited English Proficiency Compared to Children of Parents 
Proficient in English, for Hispanics and Asians, after Adjusting for 
Selected Family Characteristics: 

[See PDF for image] 

Source: GAO analysis of ECLS-K data. 

Note: The numbers in this figure show how the odds of having a certain 
outcome compare among children whose parents have limited English 
proficiency and other children of the same race. For example, among 
Hispanics, children of parents with limited English proficiency were 
less than half as likely (0.44 times) to receive financial assistance 
for their care than other children. 

[A] Indicates that children of parents of that racial or ethnic group 
and with limited English proficiency had statistically significantly 
different odds (at the 95 percent level) of having that outcome 
compared to children of parents proficient in English of the same race. 

[End of figure] 

Our analysis of ECLS-K data also indicated that after controlling for 
selected individual and family characteristics,[Footnote 14] children 
of parents with limited English proficiency were less likely to 
participate in Head Start in the year before kindergarten. Again, this 
result did not hold consistently across racial and ethnic groups. 
Specifically, as shown in figure 3, children of Hispanic parents with 
limited English proficiency were less likely than children of Hispanic 
parents proficient in English to participate in Head Start in the year 
before kindergarten. In contrast, children of Asian parents with 
limited English proficiency were more likely than children of Asian 
parents proficient in English to participate in Head Start. 

While 1998 ECLS-K data showed that children of parents with limited 
English proficiency were less likely than other children to receive 
financial assistance for child care and to participate in Head Start in 
the year before kindergarten, it cannot be concluded from these data 
alone that the differences are due to language barriers in access to 
programs. Other factors, such as the availability of child care and 
early education programs in the areas in which members of different 
language groups reside or access to support networks that provide 
information about available programs may also explain this result. In 
addition, since the time of the survey, HHS has taken steps to increase 
the participation of minorities and children of parents of parents with 
limited English proficiency, such as translating CCDF program brochures 
and undertaking initiatives to raise awareness of the Head Start 
program in the Spanish-speaking community. Furthermore, HHS officials 
reported substantial increases in federal and state child care funding 
since ECLS-K data had been collected, suggesting that these increases 
may have increased program access for parents of children with limited 
English proficiency.[Footnote 15] However, neither CCB nor the Office 
of Head Start has more recent information on whether children whose 
parents had limited English proficiency are more likely to access 
financial assistance for child care and Head Start relative to children 
whose parents are proficient in English.[Footnote 16] ECLS-K was the 
most recent national dataset that allowed us to examine the receipt of 
financial assistance for child care and the participation in Head Start 
by children of parents with limited English proficiency in relation to 
the participation of similar children whose parents are proficient in 
English. 

CCB Does Not Collect Language Data on Children Receiving CCDF 
Subsidies, and the Data in the 13 States that Collect Them Have 
Limitations: 

While CCB requires that states submit a variety of demographic 
information in monthly or quarterly reports, such as information on the 
race and ethnicity of CCDF subsidy recipients, it collects no 
information on the language spoken by or the English proficiency of 
parents whose children receive CCDF subsidies. CCB officials told us 
that they had no plans to collect language data for those receiving 
CCDF subsidies because they generally collect only information 
specifically listed in the legislation authorizing CCDF. A CCB official 
with responsibility for the demographic data collected from states and 
officials from 1 state we visited told us that requiring states to 
provide language data would create difficulties for states, such as 
developing ways to identify individuals with limited English 
proficiency. Despite the potential difficulties, various state and 
local officials in states that do not collect this information, 
including the official who cited potential difficulties collecting the 
data, told us that having such data would help them evaluate program 
performance. 

While data on the receipt of CCDF subsidies were not available 
nationally, 13 states collected some language data from parents whose 
children receive CCDF subsidies.[Footnote 17] The specific type of data 
collected and the manner in which these data were collected varied 
among these 13 states, preventing comparisons among them on the extent 
to which state CCDF programs were serving children of parents with 
limited English proficiency. Officials in 10 of the 13 states that 
collected language data told us that their states used the data either 
to provide translated forms or interpreters to clients during the 
application process or for planning or program evaluation purposes, 
such as identifying areas with significant increases in the number of 
individuals with limited English proficiency and to determine the need 
for bilingual staff. State data, however, had limitations that 
decreased their usefulness in assessing participation in CCDF programs 
by children of parents with limited English proficiency. For example, 5 
states made the collection of language data by caseworkers optional, 
and officials in another 5 states told us that despite requiring 
caseworkers to collect the language data, compliance with the data 
requirements could not always be guaranteed. Officials in 8 of the 13 
states that collected language data told us that they could benefit 
from having more information on the collection or use of language data 
or from learning how other states collect or use them. 

Head Start Data Indicate That about One-Eighth of Participating 
Children Have Parents with Limited English Proficiency: 

The Office of Head Start collected some language data from the 
approximately 900,000 children enrolled in Head Start and their parents 
from two sources. First, the Office of Head Start interviewed parents 
through its Family and Child Experiences Survey (FACES), a series of 
longitudinal surveys of nationally representative samples of children 
in Head Start. Based on the 2003 parent interviews administered, FACES 
data showed that about 20 percent of parents of 3-and 4-year-old 
children in Head Start[Footnote 18] reported that a language other than 
English was most frequently spoken at home, and about 13 percent of 
parents reported that they spoke English "not well" or "not at 
all."[Footnote 19] Second, the Office of Head Start collected 
demographic information on all 4-and 5-year-old children in Head 
Start[Footnote 20] through its National Reporting System (HSNRS), 
including information on the child's primary language. These data 
showed that about one-quarter of children enrolled in Head Start in 
Spring 2005 had a primary language other than English.[Footnote 21] 

Parents with Limited English Proficiency Faced Multiple Challenges That 
May Have Limited Their Children's Participation in Federally Funded 
Child Care and Early Education Programs: 

Results from our focus groups, which were composed of mothers with 
limited English proficiency whose children were eligible for federal 
child care subsidies, revealed that some participants were unaware of 
the various federal child care and early education programs that may be 
available to them. Parents with limited English proficiency also faced 
challenges in the process of applying for programs and financial 
assistance, such as lack of interpreters and translated materials. They 
also encountered difficulties communicating with English-speaking child 
care providers. Some of the challenges to program access that these 
parents faced were the same challenges that many low-income families 
face, including difficulty finding care at nontraditional hours, lack 
of transportation, and the limited availability of subsidized child 
care slots. 

Lack of Program Awareness and Challenges during the Application Process 
May Have Limited Program Participation: 

Many parents with limited English proficiency were unaware of child 
care assistance available to them. All six of the focus groups with 
Spanish-speaking and Vietnamese-speaking mothers who were eligible but 
not receiving subsidies revealed that the majority were unaware of the 
assistance available. In addition, the mothers that we interviewed in 
Arkansas and focus group participants in North Carolina also told of 
misunderstandings and myths that some parents had regarding the 
consequences of participating in government-funded programs. For 
example, they had heard rumors that if they applied for child care 
assistance, their child might one day be drafted into the armed forces 
to repay the assistance they received. 

Shortages of bilingual staff also presented challenges to parents with 
limited English proficiency applying for subsidies for their children. 
State and local officials and providers that we interviewed identified 
the availability of bilingual staff as a factor that played a role in 
the ability of parents with limited English proficiency to apply for 
the subsidies. For example, subsidy administration officials in one 
rural county told us that they sometimes had to ask clients to come 
back because no staff were available to assist them in their language. 
In three of the four focus groups with Spanish-speaking mothers with 
subsidies, those who generally found the subsidy application process to 
be easy cited the availability of bilingual case workers as a factor in 
allowing them to apply for assistance successfully. 

In addition to shortages of bilingual staff, the lack of available 
translated materials also presented challenges to parents with limited 
English proficiency. Some programs did not have application forms 
translated into other languages, and local officials and parents 
expressed concerns about the quality of existing translated materials, 
saying that they were often translated by volunteers and that no 
quality checks were done. For example, one community group 
representative told us that volunteers had translated the Spanish forms 
that the local subsidy administration office used and that no quality 
controls had been applied, resulting in materials of such poor quality 
that she advised parents not to request the Spanish version of the 
application. 

These challenges may be more acute for individuals with limited English 
proficiency who speak languages other than Spanish. Local officials in 
three states reported that there were limited services available in 
languages other than Spanish. For example, local officials in 
Washington said that services to smaller, more diverse populations, 
such as African, Asian, and East Indian language speakers, were more 
limited. In North Carolina and California, local officials also 
reported that services for populations such as the Hmong were more 
limited than for English or Spanish speakers. 

Finally, although immigration status has no impact on Head Start 
eligibility and only the immigration status of the child is relevant to 
the determination of eligibility for CCDF subsidies, it nonetheless 
created indirect challenges for some children of parents with limited 
English proficiency. Local officials and community advocates told us 
that citizen children of parents with limited English proficiency might 
not participate in federal child care and early education programs 
because of fear within the family of exposing undocumented immigrant 
members in the household. Several officials told us that some of these 
families were reluctant to provide personal information and were 
inhibited from applying because of fear about how their personal 
information might be used. In one case, we discovered a state that 
improperly required a declaration of satisfactory immigration status 
for every member of the household in order to apply for federally 
funded child care subsidies, thereby potentially excluding some 
children who are U.S. citizens and otherwise eligible for subsidies. 
Officials in two states also told us that many parents with limited 
English proficiency were paid in cash, making it difficult to verify 
their income for eligibility purposes. 

Parents with Limited English Proficiency Had Difficulties Communicating 
with Providers: 

Parents reported difficulties communicating with their children's 
providers, and officials reported shortages of providers with the 
language ability to serve families with limited English proficiency. 
For example, officials at one local resource and referral agency that 
we visited in the county with the most Spanish speakers in the state 
told us that providers in the county did not have the capacity to meet 
the needs of families with limited English proficiency. Spanish- 
speaking mothers that we interviewed during a site visit to another 
state complained that some programs advertise themselves as bilingual 
when in reality they are not. Parents in focus groups also expressed 
concern about their ability to communicate with their child care 
providers. Local officials in one urban area that we visited said that 
among the primary challenges faced by families with limited English 
proficiency was the effect of the language barrier on the parents' 
ability to communicate with their child care providers. They stated 
this also made it difficult to ensure the same level of parent-provider 
interaction for families with limited English proficiency as for other 
families. For example, one provider with no bilingual staff said that 
she had a child with a disability in her center whose parents were 
limited in their English proficiency, making it difficult for staff to 
communicate with the parents about the child's needs. These 
communication difficulties had consequences in the classroom as well. 
For example, one Head Start provider reported instances of therapists 
and educators who were not trained to work with Hispanic families 
inaccurately assessing the needs of children with language or cultural 
differences. 

Low-Income Parents with Limited English Proficiency Faced Some of the 
Same Challenges to Program Access as Other Low-Income Families: 

Low-income parents with limited English proficiency faced some of the 
same challenges when attempting to access child care and early 
childhood education programs as other low-income families. Across all 
states visited, state and local officials as well as providers said 
that many low-income families, especially families with limited English 
proficiency, work nontraditional hours and have difficulty finding care 
that meets their needs. For example, a resource and referral agency 
official in one rural community said that the first shift at a local 
employer begins at 5:30 a.m., while most providers do not offer care 
before 6:00 a.m., and employees working second and third shifts face 
even more difficulty finding child care. Lack of transportation, 
especially in rural communities, also restricts the child care options 
available to low-income families. Officials said that it can be 
especially difficult for families with limited English proficiency to 
navigate public transportation or call transit agencies for assistance. 
In a previous report, we found that lack of English skills reduced 
individuals' ability to access public transportation systems.[Footnote 
22] 

Parents in some communities also faced shortages of child care and 
child care subsidies, especially for infants and toddlers. Officials 
with resource and referral agencies and local subsidy administration 
offices in 6 of the 11 counties that we contacted said that there were 
shortages of infant care in their communities. In addition, because 
funding for CCDF subsidies was limited, not all states provided 
subsidies to all families who applied and met eligibility criteria. Our 
prior work showed that 20 states did not serve all families who met 
state-determined eligibility criteria,[Footnote 23] and three of the 
five states that we visited (Arkansas, California, and North Carolina) 
had waiting lists for CCDF subsidies. In five of the eight focus groups 
with Spanish-speaking mothers (including both those receiving and not 
receiving subsidies), participants identified waiting lists as one of 
the difficulties they faced when seeking assistance for child care. In 
the two other states that we visited (Illinois and Washington), state 
officials said that although they did not maintain waiting lists, they 
spent all of the funds available to them for CCDF subsidies. To manage 
demand for the limited financial assistance available for child care, 
states took steps such as giving priority to certain groups. For 
example, in the three states we visited that maintained waiting lists, 
two (Arkansas and North Carolina) set priorities for eligible families, 
such as preferences for families on or coming off of TANF. In the 
third, California, families on or transitioning off of TANF were 
provided child care assistance through a guaranteed funding stream, 
while funding for other low-income families was capped. Officials in 
California told us that this system made it extremely difficult for low-
income families that were not in the TANF system to receive subsidized 
child care. While prioritization of TANF families would affect all low-
income families, it may have additional implications for some children 
of parents with limited English proficiency. Census 2000 data show that 
82 percent of individuals with limited English proficiency are foreign-
born, and since immigration status is a factor in TANF eligibility, 
children of immigrants who do not qualify for TANF would be less likely 
to receive CCDF subsidies in those states that give priority to TANF 
families. In 2005, we found that 17 of 20 states not covering all 
applicants who otherwise met the eligibility criteria gave TANF 
families priority for CCDF funds,[Footnote 24] consistent with CCDF's 
goal of providing child care to parents trying to become independent of 
public assistance. 

Selected Agencies Took Some Steps to Assist Parents with Limited 
English Proficiency but Reported Challenges in Serving Them: 

The majority of state and local agencies and providers that we visited 
took some steps to assist parents with limited English proficiency in 
accessing child care and early education programs for their children. 
Most agencies provided some oral and written language assistance, 
although the scope of the assistance varied. Most agencies also 
implemented initiatives to increase the supply of providers able to 
communicate effectively with parents. Officials told us that they faced 
several challenges in providing services to parents with limited 
English proficiency. Some state and local officials indicated that 
additional information on cost-effective strategies used by others to 
serve this population would facilitate their efforts to provide access. 

Selected State and Local Agencies Offered Language Assistance: 

The majority of the agencies that we visited had taken some steps to 
provide oral and written language assistance, such as interpreters and 
translated materials, to parents with limited English proficiency. In 
all 11 counties that we contacted, the local offices administering CCDF 
subsidies and providing resource and referral services offered some 
oral language assistance to clients with limited English proficiency 
although the scope of the assistance varied. In 5 of these counties, 
agencies had staff that could speak several languages, a fact that 
officials said reflected the community they served. In the other 6 
counties, agency staff had bilingual capacity for Spanish only, but 
officials said the vast majority of the individuals with limited 
English proficiency they served were Spanish-speaking. Although the 
subsidy administration office in one of these 6 counties had bilingual 
Spanish-speaking staff, these staff were not specifically assigned to 
work with individuals applying for CCDF subsidies but were clerical 
workers with other responsibilities. In most counties visited, child 
care and Head Start centers had bilingual staff to help parents with 
limited English proficiency enroll their children in the programs. For 
example, an official in one child care center that we visited where the 
majority of the families spoke Spanish said that all staff responsible 
for enrolling families in the program spoke Spanish. 

Several agencies that we visited also used telephone interpretation 
services to provide oral assistance to clients with limited English 
proficiency.[Footnote 25] For example, the subsidy administration 
offices that we visited in Washington primarily used a state-contracted 
telephone language line that connected agency staff with bilingual 
telephone operators who could offer interpreting assistance in a 
language spoken by the client. In an effort to help local agencies 
serve clients with limited English proficiency in a cost-effective 
manner, North Carolina was in the process of entering into a contract 
for a language line that would allow local social service agencies, 
including those administering CCDF subsidies, to provide oral language 
assistance to clients if bilingual staff were not available on-site. A 
state official told us that once the contract is awarded, the state 
will make the service available to all local social service agencies at 
a reduced cost. 

Several agencies also coordinated with one another to share resources 
for offering oral language assistance. For example, to help interpret 
for their Russian-speaking clients, a resource and referral agency in 
California with language capacity in Cantonese and Mandarin coordinated 
with staff at another nearby resource and referral agency that had 
language capacity in Russian. Subsidy administration officials in one 
rural county that we visited told us that the local hospital had a 
contract for the language line and they coordinated with the hospital 
to make use of that service. However, we did not find efforts to 
coordinate language assistance strategies among agencies in some 
locations visited, and agency officials in a few locations said that 
they could not always provide oral language assistance to clients with 
limited English proficiency on their own. 

The majority of agencies that we visited provided written language 
assistance, such as translated subsidy application forms. Seven of the 
11 subsidy administration offices contacted had subsidy applications 
translated into Spanish. Local agencies in Washington, California, and 
Illinois had applications that had been translated by the state. 
Washington required its application for the child care subsidy to be 
translated into eight languages,[Footnote 26] while California and 
Illinois made applications available in Spanish and gave local agencies 
the option of translating materials into other languages. Arkansas and 
North Carolina had no translated applications at the time of our 
visits, although officials in North Carolina said that the state was in 
the process of translating the subsidy application into 
Spanish.[Footnote 27] All of the resource and referral agencies that we 
visited translated materials into Spanish, such as brochures containing 
information on how to receive child care assistance and what to look 
for when choosing a provider. A few resource and referral agencies also 
made efforts to translate written information into other languages. For 
example, as shown in figure 4, one agency translated a brochure on 
child care quality into Chinese. However, some state and local 
officials told us that their offices lacked the resources to translate 
materials into other languages. 

Figure 4: English and Chinese Versions of a Local Agency's Child Care 
Quality Brochure: 

[See PDF for image] 

Source: Wu Yee Children's Services. 

[End of figure] 

The majority of local agency officials and providers that we 
interviewed told us that they relied on agency staff and volunteers to 
translate materials. For example, officials from a Head Start program 
told us that their staff had translated materials about the program 
into Spanish, Hmong, and Laotian. Officials at another Head Start 
program told us that they relied on bilingual staff, parents of 
children enrolled in the program, and Spanish-speaking volunteers from 
the community health clinic to translate the materials. Some agency 
officials told us that they also used outside contractors or other 
resources, such as commercially available translation software, to 
translate materials. Community group representatives expressed concerns 
about the quality of translations done by the local agencies, 
particularly in instances when volunteers or translation software had 
been used. 

Most local agencies and providers that we interviewed said that they 
disseminated translated information to raise awareness of their 
programs and services among parents with limited English proficiency. 
Agencies and providers employed various mechanisms to disseminate 
information, including using print and radio media and direct 
distribution of informational materials in the communities where many 
families with limited English proficiency reside. For example, some 
resource and referral agencies and providers said that they advertised 
their programs and services on Spanish-language television and radio 
stations, and a few agencies had placed advertisements in the Yellow 
Pages. Most of them also reported distributing information in various 
locations in the community, such as churches, neighborhood markets, and 
laundromats. 

Despite these agencies' various outreach efforts, mothers in focus 
groups, many of whom were unaware of the available assistance, said 
that there was a need for greater information dissemination in their 
communities. Spanish-and Vietnamese-speaking mothers in all 12 focus 
groups indicated that disseminating information in their language would 
help them learn about child care assistance and child care and early 
education programs for their children. At the same time, focus groups 
with Spanish-speaking mothers in California who were already receiving 
the subsidies revealed their ambivalence about increased advertising of 
certain child care programs because some of these programs already had 
waiting lists. Some state and local officials also acknowledged that 
they did little or no advertising because their programs were already 
operating at full capacity or had substantial waiting lists. 

Selected Agencies Took Steps to Increase the Supply of Providers Able 
to Communicate Effectively with Parents: 

Agencies in the majority of locations that we visited had initiatives 
to increase the supply of providers who spoke other languages or to 
offer training in other languages to existing providers. Some agencies 
had come up with initiatives that focused on helping individuals 
speaking other languages to enter the child care field. For example, 
one resource and referral agency that we visited offered the classes 
required for obtaining a child care license in Spanish, and another one 
offered them in Cantonese. A resource and referral agency that we 
visited in an urban county developed a program to help Somali-and 
Russian-speaking women in the community obtain the training necessary 
to become licensed family child care home providers. In four of the 
five states that we visited, officials told us that selected community 
colleges participated in efforts to increase provider capacity to serve 
children of parents with limited English proficiency. For example, a 
community college in Illinois offered early childhood education classes 
in Spanish, while a community college in California coordinated with a 
local resource and referral agency to offer these classes in Cantonese. 
However, some officials said that such efforts were insufficient, and 
in one state visited, an official from a university early childhood 
education program said that she was not aware of any efforts in the 
state to offer classes in other languages. 

Many agencies that we visited also provided training to existing child 
care providers who had limited English proficiency. For example, local 
referral agencies in Illinois included bilingual individuals in the 
technical assistance teams available to assist providers in improving 
the quality of care. 

Three of the five states that we visited used CCDF quality funds for 
various provider initiatives related to language, such as offering 
training to providers on working with families that had limited English 
proficiency or translating materials into other languages.[Footnote 28] 
For example, Arkansas used quality funds for training and technical 
assistance to help providers understand cultural issues that families 
with limited English proficiency face. California used these funds to 
offer training to providers throughout the state on working with 
children who speak other languages. Officials in North Carolina said 
that while they did not have any projects funded with CCDF quality 
funds that directly related to serving children of parents with limited 
English proficiency, they had used some of the funds to translate 
materials on child care health and safety practices into Spanish. Two 
of the states visited--Washington and Illinois--did not use CCDF funds 
directly on initiatives related to serving children of parents with 
limited English proficiency or providers working with them. However, 
both states used the funds to support other initiatives, such as the 
work of resource and referral agencies, which included outreach to 
parents with limited English proficiency in some of their efforts. 

State and local officials told us that despite efforts made, there was 
a shortage in some locations of training opportunities for providers 
who speak other languages. For example, officials across states and 
counties that we visited cited examples of child care providers with 
limited English proficiency who had attended training, such as training 
required for licensing, although they could not fully understand the 
course content because it was not available in their languages. An 
official we interviewed told us that this could affect the quality of 
child care they would offer to children because the training covered 
critical issues, such as health and safety procedures. 

Officials in Selected State and Local Agencies Reported Challenges in 
Providing Services to Parents with Limited English Proficiency: 

State and local agency officials, providers, and community college 
representatives reported several challenges associated with providing 
oral language assistance to parents with limited English proficiency 
applying for child care and early education programs for their 
children. Officials told us they faced challenges providing oral 
language assistance because of the difficulties that agencies had 
hiring qualified bilingual staff. Even when qualified bilingual 
individuals were found, officials said that these individuals were in 
very high demand and agencies could not always compete with other 
organizations interested in hiring them. For example, some child care 
and Head Start providers told us that they are losing qualified 
bilingual staff to school districts that offer higher salaries. Rural 
areas especially experienced difficulties hiring bilingual staff 
because their pool of qualified candidates was smaller than in the 
cities or virtually nonexistent. A few officials said that the lack of 
reliable transportation in rural areas makes it difficult to recruit 
staff from the cities. For example, a resource and referral agency 
official in one rural area that we visited told us that her office's 
bilingual staff had quit because they had difficulty getting to work. 
Officials also cited difficulties with finding professional 
interpreters and with the expense associated with hiring them when 
agencies lacked bilingual staff of their own to offer oral language 
assistance to clients. 

Agency officials also reported challenges providing written language 
assistance to parents with limited English proficiency. They said that 
translating materials into other languages was expensive, particularly 
for agencies that served clients from several different language groups 
and had to translate materials into multiple languages. Local agencies 
frequently relied on their own staff to translate the materials, but a 
few officials said that this posed a burden on staff with other full- 
time responsibilities. At the same time, state and local officials said 
that contracting out for translations was expensive. Although state 
officials acknowledged the expense associated with translating 
materials into other languages, some states left local agencies to 
shoulder the burden of translating documents on their own. For example, 
state officials in California told us that the expense prevented the 
state from translating applications into languages other than Spanish, 
but local agencies had absorbed the cost of translating applications 
themselves in order to meet the needs of program applicants who spoke 
other languages. 

In addition, officials said that providing language assistance or 
training in other languages was not always cost-effective because of 
the relatively small number of individuals that would benefit from such 
efforts. For example, one resource and referral agency official told us 
that the cost of ordering materials in Spanish was higher than the cost 
of ordering the same materials in English because the materials had to 
be purchased in smaller orders, thereby increasing their cost. Some 
officials said that while they were able to offer language assistance 
to larger language groups in the area, such as Spanish speakers, they 
chose not to expand their assistance to include other language groups 
because of the small number of individuals that would benefit from it. 

Despite challenges faced, agency officials that we interviewed 
expressed the need for effective and affordable ways to provide 
services to individuals with limited English proficiency. Officials in 
three states visited told us that they would benefit from having 
additional information on cost-effective strategies to serve parents 
with limited English proficiency. Several officials also told us that 
it would be helpful for them to learn more about the professional 
development opportunities for providers offered at other locations. For 
example, officials in Illinois said that the state's current capacity 
for provider training in Chinese was limited and that they would like 
to learn more about any curricula developed in other states with larger 
Asian populations. 

HHS Provided Assistance to Grantees on Serving Children of Parents with 
Limited English Proficiency, but Gaps Remain in Its Program Review 
Efforts: 

HHS issued general guidance, translated materials, and provided 
technical assistance to grantees on serving children of parents with 
limited English proficiency, but gaps remain in its program review 
efforts. The Office of Head Start has provided assistance to increase 
awareness of the Head Start program among families with limited English 
proficiency and has monitored local programs' efforts to provide access 
to these families by reviewing grantees' biennial assessments of need 
in the communities they serve and by conducting formal monitoring 
reviews of grantees. However, an Office of Head Start official told us 
that the office could not ensure that its review teams consistently 
reviewed grantee compliance with program standards related to language 
access, and in our prior work we found that no mechanism existed to 
ensure consistency in the monitoring process. CCB provided assistance 
to help programs serve children whose parents have limited English 
proficiency, as well as reviewed states' CCDF plans and investigated 
complaints. However, CCB had no mechanism for reviewing how access to 
CCDF subsidies was provided for children of parents with limited 
English proficiency or for ensuring that these children were not 
inadvertently excluded from the subsidies as a result of state 
eligibility criteria that were inconsistent with CCB's program 
eligibility guidance. 

HHS Issued General Guidance to Grantees on Providing Access to Federal 
Programs for Individuals with Limited English Proficiency: 

In 2003, consistent with Executive Order 13166, HHS issued guidance to 
federal financial assistance recipients regarding the Title VI 
prohibition against national origin discrimination as it affects 
individuals with limited English proficiency. The guidance was intended 
to help recipients of HHS funds, such as agencies administering CCDF 
subsidies and Head Start programs, provide meaningful access for 
individuals with limited English proficiency. The guidance, however, 
applied to all HHS programs and did not refer specifically to child 
care or early education. 

HHS' OCR provided outreach to potential beneficiaries of HHS programs 
and offered technical assistance to grantees to help them comply with 
the guidance. For example, OCR officials told us that they disseminated 
information about serving individuals with limited English proficiency 
at Hispanic health fairs, through recorded public service announcements 
and interviews on Spanish-language media, and by giving presentations 
before community service organizations. They also said that they 
provided grantees with technical assistance in identifying appropriate 
language access strategies. Regional OCR officials told us that their 
offices served as a resource for local social service agencies, 
directing them to less costly language access strategies, such as 
sharing interpreter services, and providing information on available 
resources and practices. 

OCR also participated in the Federal Interagency Working Group on 
Limited English Proficiency that developed, among other things, a Web 
site devoted to serving persons with limited English proficiency 
(www.lep.gov). The Web site serves as a clearinghouse, providing 
information, tools, and technical assistance regarding limited English 
proficiency and language services for federal agencies, recipients of 
federal funds, users of federally assisted programs, and other 
interested parties. It makes available a range of guidance and 
information on offering language assistance through mechanisms such as 
interpreter services and translated materials for clients with limited 
English proficiency in the areas of health care, the courts, and 
transportation. However, it does not include specific information on 
providing language assistance in child care and early education 
programs. In addition, CCB and Office of Head Start officials and 
officials from several HHS regional offices told us that they were 
unaware of the Web site. 

OCR is required to investigate all complaints of alleged 
discrimination, including lack of access to programs for individuals 
with limited English proficiency. OCR officials told us that Title VI 
violations in child care were rare. They said that when infractions do 
occur, they try to reach a voluntary compliance agreement with the 
state and conduct follow-up to ensure that the state takes corrective 
action to comply with the terms of the agreement. For example, North 
Carolina entered into a voluntary compliance agreement with OCR and 
implemented a corrective action plan for providing access for program 
applicants with limited English proficiency. A state official told us 
that the state was in the process of translating the subsidy 
application into Spanish as a result of this agreement. 

The Office of Head Start Provided Assistance to Increase Awareness of 
Head Start and to Improve Service Delivery and Conducted Limited 
Monitoring of Language Access in Head Start Programs: 

The Office of Head Start has provided a variety of assistance to 
increase awareness of the Head Start program among families with 
limited English proficiency. The office has twice hosted a National 
Head Start Hispanic Institute, the goals of which included improving 
outreach to Hispanic communities, developing methods to effectively 
serve Hispanic children and families, and helping ensure positive 
outcomes in language and literacy development for English-language 
learners. A Head Start official told us that the needs of other 
language groups needed to be addressed as well, and that the Office of 
Head Start was considering how to replicate the institute for groups 
that speak other languages. According to officials, the Office of Head 
Start has several other initiatives to reach parents with limited 
English proficiency, such as placing public service announcements on 
Spanish-language media and distributing a brochure in Spanish informing 
families potentially eligible for Head Start of the benefits of 
enrolling their children in Head Start. 

The Office of Head Start has also provided assistance to grantees to 
better serve children of parents with limited English proficiency. 
Recently, the office conducted a national language needs assessment of 
second language and dual language acquisition to identify culturally 
responsive, research-based strategies to improve outcomes for children 
and families. It also developed a Culturally Responsive and Aware Dual 
Language Education (CRADLE) training initiative that is designed to 
support grantees in their efforts to find best practices for language 
acquisition for the birth-to-3-year-old population. In addition, 
through its English Language Learners Focus Group, the Office of Head 
Start created materials for grantees working with second language 
learners, including Spanish speakers who constitute the majority of 
children in Head Start whose parents have limited English proficiency. 

The Office of Head Start monitors grantees' efforts to provide access 
for individuals with limited English proficiency by reviewing their 
biennial community assessments and conducting formal on-site monitoring 
reviews. Head Start programs are required to conduct a community 
assessment at least once every 3 years, and the Office of Head Start 
regional officials review these assessments for demographic disparities 
between program participants and the population of the community to be 
served. For example, programs with assessments showing large numbers or 
proportions of language groups in the community that are not reflected 
in the enrollees or the classroom teachers may be found out of 
compliance with meeting local needs. Head Start programs are also 
monitored by the Office of Head Start once every 3 years through the 
PRISM process. Head Start programs are required to adhere to program 
performance standards that define the services that programs are to 
provide to children and their families, and on-site PRISM review teams 
monitor Head Start grantees' adherence to the standards. Several of the 
standards directly address interactions with children and parents with 
limited English proficiency. For example, one performance standard 
requires communications with parents to be carried out in the parent's 
primary or preferred language or through an interpreter.[Footnote 29] 
Another performance standard directs programs in which the majority of 
children speak the same language to have at least one classroom staff 
member or home visitor who speaks that language.[Footnote 30] The 
contractor responsible for assigning bilingual reviewers to PRISM 
review teams told us that about 17 percent of reviewers were bilingual 
and that review teams requesting a Spanish-speaking bilingual 
individual had one assigned 70 percent of the time. 

A Head Start official with responsibility for the PRISM process told us 
that given the vast number of regulations, however, it was impossible 
to ensure that all of them were consistently reviewed in the course of 
a 1-week review. In our previous work, we reported that ACF had no 
process in place to ensure that its reviewers consistently followed the 
standards while conducting on-site PRISM reviews.[Footnote 31] We 
recommended that ACF develop an approach that can be applied uniformly 
across all of its regional offices to assess the results of the PRISM 
reviews and implement a quality assurance process to ensure that the 
framework for conducting on-site reviews was implemented as designed. 
HHS agreed with our recommendation, and Head Start officials indicated 
that the Office of Head Start was developing new PRISM protocols and 
training reviewers to add more uniformity to how grantees are assessed. 
In addition, the Office of Head Start recently announced plans to 
conduct follow-up reviews of grantees monitored through the PRISM 
system in an effort to ensure that PRISM review teams did not miss 
grantee deficiencies, such as in providing assistance to children and 
parents with limited English proficiency. 

CCB Provided Assistance to Help CCDF Programs Serve Children Whose 
Parents Have Limited English Proficiency but Had No Mechanism for 
Reviewing Agencies' Provision of Access: 

CCB provided assistance to raise program awareness among parents with 
limited English proficiency whose children may be eligible for CCDF 
subsidies. Officials told us that CCB had translated a number of its 
consumer education materials into Spanish, including the CCDF program 
brochure and public service announcements informing parents where and 
how to locate child care. In a targeted effort to reach Hispanic 
families and providers, CCB also translated into Spanish a brochure 
outlining what providers should know about child care assistance for 
families. CCB, through a cooperative agreement with the National 
Association of Child Care Resource and Referral Agencies (NACCRRA), 
provides educational information to parents through the Child Care 
Aware Web site (www.childcareaware.org). In addition, NACCRRA has 
translated consumer education publications into Spanish, including a 
publication on paying for child care, which it made available through 
its Web site to resource and referral agencies nationwide. CCB 
officials told us that they were also looking into translating these 
publications into Chinese. CCB also sponsors a National Child Care 
Information Center Web site (www.nccic.org), which offers information 
on a wide range of child care issues, including a number of documents 
that relate to serving children from families with limited English 
proficiency. 

CCB officials told us that they provided opportunities for agencies and 
providers to share information, including information on serving 
children of parents with limited English proficiency. For example, CCB 
convened meetings of state CCDF administrators that, while not focusing 
specifically on issues of limited English proficiency, covered topics 
such as meeting the needs of diverse groups of children and parents. In 
addition, CCB maintains an online forum for states to pose questions 
and share ideas, which has been used to discuss such issues as 
converting print materials into Spanish. CCB also offers child care 
providers online access to training modules, practical strategies for 
serving children and families, and interactive online chats in English 
and Spanish through the Center on Social and Emotional Foundations for 
Early Learning Web site (www.csefel.uiuc.edu). 

While it has made efforts to assist states with serving the needs of 
children whose parents have limited English proficiency, CCB has no 
mechanism for reviewing how agencies provide access to CCDF subsidies 
for eligible children of parents with limited English proficiency or 
ensuring that these children are not inadvertently excluded as a result 
of state CCDF eligibility criteria that are inconsistent with agency 
guidance. CCB officials told us that CCDF is a block grant and CCB 
receives no funding specifically for supporting monitoring activities. 
As a result, CCB's oversight of CCDF is limited to reviewing states' 
CCDF plans and investigating complaints. CCB, however, does not require 
states to include assurances in their CCDF plans that state agencies 
are providing access to CCDF subsidies for children of parents with 
limited English proficiency. Regional officials told us that they had 
complaint processes in place and would either review complaints or 
refer them to OCR, but said that they were unaware of any complaints 
regarding restricted access for individuals with limited English 
proficiency. Officials in one region told us that states appeared to 
understand the CCDF program eligibility criteria. Officials in another 
region told us that while they interacted with states through phone 
calls and occasional on-site visits, these contacts primarily focused 
on the provision of technical assistance. Thus, these interactions were 
not a systematic review of how states determine eligibility for federal 
child care assistance. 

On our site visit to Arkansas, we found that the state had eligibility 
requirements that appeared to violate CCB guidance. Specifically, 
although guidance to state agencies administering CCDF clarified that 
only the citizenship and immigration status of a child was relevant 
when determining the child's eligibility for federal child care 
assistance, applicants for child care assistance in Arkansas had to 
submit a declaration that the applicant (typically a parent applying to 
receive assistance for the child) and all the other members of the 
household were U.S. citizens, nationals, or legal residents. In 
addition, the state's policy manual for the administration of CCDF 
services indicated that the state would deny any applications for child 
care assistance that were submitted by parents or custodians who were 
neither citizens nor lawfully admitted residents. These requirements 
have the potential of precluding children who otherwise met the 
eligibility criteria from receiving federal financial assistance on the 
basis of their parents' citizenship or immigration status. CCB 
officials told us that they were unaware of the situation until we 
brought it to their attention and that they were in the process of 
discussing with state officials how to resolve it. They further noted 
that they would investigate formal complaints brought to their 
attention, which would include complaints about states requesting 
unnecessary information on their child care subsidy applications and 
adversely affecting individuals with limited English proficiency. 
However, officials indicated that they had received no such complaints 
from affected parties. 

Conclusions: 

Access to high-quality child care and early education programs helps 
promote healthy development of children and can provide an important 
support for parents as they pursue employment or education to secure 
the family's economic well-being and avoid public assistance. The 
resources available for nonentitlement child care and early education 
programs, such as CCDF subsidies and Head Start, are limited and not 
intended to cover everyone who meets eligibility criteria and is in 
need of assistance. Consequently, agencies have to make choices about 
who they will cover with the limited funds, employing strategies such 
as prioritization of certain groups of applicants or waiting lists. At 
the same time, federal, state, and local entities play important roles 
in ensuring that parents' language ability does not preclude children 
from being considered for coverage under these programs. 

These roles are becoming especially important as the demographics of 
many communities are changing rapidly and localities across the country 
are seeing increased numbers of individuals with limited English 
proficiency. While state and local agencies are making efforts to 
address the needs of this growing population, they experience 
difficulties offering language assistance to parents seeking to access 
programs for their children and recruiting new providers with the 
language ability to serve these families. However, without reliable 
data on who is enrolled in their programs, state and local officials 
may have difficulty determining the extent to which parents with 
limited English proficiency have access to these programs for their 
children and whether services need to be adjusted to accommodate 
changes in the population served. 

Although Congress provided states with flexibility in administering 
their CCDF program grants, HHS is responsible for ensuring that states 
adhere to the conditions of their grants and that they take reasonable 
steps to ensure access to individuals with limited English proficiency. 
Yet, HHS's existing methods for reviewing how CCDF funds are used by 
grantees do not systematically assess how access for parents with 
limited English proficiency is provided or identify state or local 
policies that may adversely affect these parents' ability to access 
programs for their children. HHS responds to complaints of any alleged 
discrimination or agency actions that adversely affect the ability of 
eligible children to access programs and services. However, HHS may 
lack the tools to ensure equal access for children whose parents have 
limited English proficiency if the parents do not bring complaints for 
reasons such as language difficulties, unfamiliarity with how the 
complaint process works, or fear about approaching government agencies. 
Without a mechanism to systematically review access to CCDF-funded 
programs for these families, HHS cannot provide all eligible children 
with the same opportunity to participate in programs that would benefit 
them and their families and possibly enhance their households' self- 
sufficiency. 

Recommendations for Executive Action: 

To help state and local agencies plan for language assistance and 
assess whether they provide meaningful access to eligible children, 
regardless of their parents' English ability, we recommend that CCB 
work with states to help them explore cost-effective strategies for 
collecting data on CCDF subsidy recipients' language preference or 
English proficiency and comparing these data with available information 
on community demographics. Once these data are available, HHS may 
consider collecting information on existing cost-effective ways for 
agencies to provide language assistance and to recruit providers who 
speak other languages, as well as disseminating this information in the 
locations where the data show the greatest need. 

To provide opportunities to parents with limited English proficiency to 
access federal child care subsidies for their children, we recommend 
that HHS develop and implement specific steps to review whether and how 
states provide access to CCDF programs for eligible children of parents 
with limited English proficiency, as well as provide information to 
help states evaluate their progress in this area. Specifically, HHS 
should: 

² revise the CCDF plan template to require states to report on how they 
will provide meaningful access to parents with limited English 
proficiency seeking CCDF subsidies for their children, and: 

² systematically review states' program eligibility criteria for CCDF 
subsidies to ensure that states comply with HHS policies related to 
participation by children of parents with limited English proficiency. 

Agency Comments and Our Evaluation: 

ACF provided written comments on a draft of this report, which are 
reproduced in appendix III. In its letter, ACF agreed with most aspects 
of our recommendations and provided information on its actions or plans 
that would support their implementation. In addition, ACF provided a 
number of technical comments that we incorporated as appropriate. 

In response to our recommendation that HHS work with states to help 
them explore cost-effective ways of collecting data on the primary 
language of CCDF subsidy recipients, ACF provided some additional 
information on actions it has taken to help states in this area. For 
example, it stated that in July 2006, CCB launched a technical 
assistance initiative that will, among other things, disseminate 
information to states on effective strategies to assist families with 
subsidy access, including families experiencing language barriers. 

Regarding our second recommendation, that HHS develop a mechanism to 
review how states provide access to CCDF subsidies for children of 
parents with limited English proficiency, ACF indicated that it will 
examine the feasibility of using the CCDF plan template to ask states 
to report on their efforts to promote access to these families. 
However, ACF did not address our recommendation that HHS systematically 
review states' eligibility criteria for CCDF subsidies to ensure that 
states comply with HHS policies related to participation by children 
whose parents have limited English proficiency. 

ACF also submitted detailed comments related to our analysis of 
national survey data collected in 1998 as part of ECLS-K. ACF noted 
that ECLS-K data only provide information on children in the year 
before kindergarten and that the analysis omits other variables that 
may explain our findings, such as preferences for certain types of care 
within ethnic communities and parents' immigration status. Our report 
discusses these data limitations, and as is the case with any 
statistical model, some of the factors with the potential to affect the 
outcomes we examined could not be included because the data measuring 
them were not collected. It is partly for that reason that we employed 
multiple methodologies in addressing our research objectives, including 
site visits and focus groups. 

ACF noted that the data represent child care and early education 
patterns for 1997 and that subsequent policy changes or increases in 
federal and state child care funding, may have narrowed the gap in 
program participation among different groups of children. However, we 
found that some of the policy changes ACF cited were not consistently 
implemented and ACF provided no more current data that would allow us 
to ascertain the effects of these changes. As such, ECLS-K remained the 
most recent national dataset that allowed us to compare children of 
parents with limited English proficiency and similar children whose 
parents are proficient in English with respect to their receipt of 
financial assistance for child care from a social service or welfare 
agency and their participation in Head Start. 

As arranged with your office, unless you publicly announce its contents 
earlier, we plan no further distribution of this report until 30 days 
after the date of this letter. At that time, we will send copies of 
this report to the Secretary of HHS, relevant congressional committees, 
and other interested parties. We will also make copies available to 
others upon request. In addition, the report will be made available at 
no charge on GAO's Web site at [Hyperlink, http://www.gao.gov]. 

If you or your staff have any questions about this report, please 
contact me at (202) 512-7215. Other contacts and major contributors are 
listed in appendix IV. 

Signed by: 

Marnie S. Shaul, Director: 
Education, Workforce, and Income Security Issues: 

[End of section] 

Appendix I: Scope and Methodology: 

In conducting our work, we employed multiple methodologies, including a 
review of available data on participation of children in child care and 
early education programs, state and county site visits, focus groups 
with mothers who have limited English proficiency, interviews with 
federal officials and national experts, and a review of available 
legislation, guidance, and other federal resources. We performed our 
work in accordance with generally accepted government auditing 
standards between July 2005 and June 2006. 

Analysis of National Program Participation Data and State Data 
Inquiries: 

To obtain information on the participation of children whose parents 
have limited English proficiency in child care and early education 
programs funded through the Child Care and Development Fund (CCDF) and 
Head Start, we obtained and reviewed the most recent program 
participation data from the U.S. Department of Health and Human 
Services (HHS), surveyed states about their data on CCDF subsidy 
recipients, and analyzed national survey data available through the 
Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 (ECLS-
K). The relevant characteristics of data sources we examined are shown 
in table 1. 

Table 1: Characteristics of Data Sources Examined: 

Source of data: CCB databases; 
Programs covered: CCDF; 
Scope of data collection: Enrollment or sample of program participants 
(depending on state); 
Availability of data on the language of program participants: None; 
Ability to use the data to estimate participation rates by children of 
parents with limited English proficiency: No; 
Reasons why data cannot be used to estimate participation rates by 
children of parents with limited English proficiency: CCB does not 
collect data related to language in its monthly or annual reports from 
states. 

Source of data: State databases; 
Programs covered: CCDF; 
Scope of data collection: Enrollment or sample of program participants 
(depending on state); 
Availability of data on the language of program participants: Varies by 
state; 
Ability to use the data to estimate participation rates by children of 
parents with limited English proficiency: No; 
Reasons why data cannot be used to estimate participation rates by 
children of parents with limited English proficiency: Approximately one-
quarter of states collect data; 
their data have many limitations, and states collect data differently. 

Source of data: NRS; 
Programs covered: Head Start; 
Scope of data collection: Enrollment, for all 4-and 5-year-old children 
in Head Start; 
Availability of data on the language of program participants: Child 
speaks language other than English at home, child's primary language, 
and child's English proficiency as determined by local staff; 
Ability to use the data to estimate participation rates by children of 
parents with limited English proficiency: No; 
Reasons why data cannot be used to estimate participation rates by 
children of parents with limited English proficiency: NRS data are 
collected only from children enrolled in Head Start, so the 
participation rate in the overall population is unknown; 
Data are not available on the parents' English proficiency. 

Source of data: FACES; 
Programs covered: Head Start; 
Scope of data collection: Sample of parents with 3 and 4-year-old 
children in Head Start; 
Availability of data on the language of program participants: Parent 
self-assessment of language ability and language spoken at home; 
Ability to use the data to estimate participation rates by children of 
parents with limited English proficiency: No; 
Reasons why data cannot be used to estimate participation rates by 
children of parents with limited English proficiency: FACES data are 
collected only on children enrolled in Head Start, so the overall 
participation rate is unknown. 

Source of data: ECLS-K; 
Programs covered: Child Care assistance and Head Start; 
Scope of data collection: Sample of children in kindergarten; 
Availability of data on the language of program participants: Parent 
self-assessment of language ability and language spoken at home; 
Ability to use the data to estimate participation rates by children of 
parents with limited English proficiency: No (for CCDF programs); 
Yes (for Head Start participation in the year before kindergarten); 
Reasons why data cannot be used to estimate participation rates by 
children of parents with limited English proficiency: The survey 
questions did not ask for the source of child care financial 
assistance. 

Source: GAO analysis of HHS program participation data, ECLS-K, and 
telephone interviews with state officials. 

[End of table] 

We reviewed CCDF program participation data collected by CCB in the 
reports that states are required to submit on CCDF subsidy recipients 
but found that these reports did not contain any data related to 
language from CCDF subsidy recipients or their families. CCB officials 
confirmed that they do not currently collect any language data, since 
such data collection was not listed in the CCDF authorizing 
legislation.[Footnote 32] 

We reviewed language data for Head Start participants available from 
the Office of Head Start through the Head Start National Reporting 
System (HSNRS) and the Head Start Family and Child Experiences Survey 
(FACES). HSNRS, implemented in August 2003, is the nationwide skills 
test of over 400,000 children aged 4 and 5 in Head Start, intended to 
provide information on how well Head Start grantees are helping 
children progress. The Computer-Based Reporting System (CBRS) was 
developed for HSNRS to allow local Head Start staff to enter 
descriptive information about their programs, including the demographic 
characteristics of children assessed by HSNRS. We requested and 
reviewed HSNRS demographic data from spring 2005 that provided 
information on the primary language of children in Head Start. FACES is 
a series of longitudinal surveys of nationally representative samples 
of children in Head Start. We requested and reviewed fall 2003 FACES 
data, which included about 2,400 parent interviews that provided 
information on the languages spoken at home by Head Start families, 
parents' self-reported English proficiency, and the availability of 
Head Start staff to communicate with children and parents in their 
preferred language. 

To assess the reliability of Head Start data, we interviewed relevant 
HHS officials and officials from Westat, a private research corporation 
administering and analyzing HSNRS and FACES under a contract with the 
Office of Head Start. In addition, we reviewed relevant documentation 
and examined the logs of the computer code used to generate the data 
provided to us. Because HSNRS data were collected only for 4-and 5- 
year-old children in Head Start, they cannot be used to generalize 
about all children in Head Start.[Footnote 33] The HSNRS data were 
entered into CBRS by the staff of local Head Start programs. While we 
did not independently verify these data, we did not find any evidence 
to suggest that they were unreliable. As part of FACES, interviews were 
held directly with parents of children in Head Start. While Spanish 
interviewers were available, parents with limited English skills who 
spoke other languages were required to provide their own interpreter. 
Parents unable to participate in an interview in English or Spanish or 
provide their own interpreters could not be included in the survey. 
According to a Westat official, however, only three interviews could 
not be conducted because of the lack of an interpreter. We determined 
that FACES data were sufficiently reliable for the purposes of this 
report. 

Because the available agency data did not allow us to determine the 
total participation of children of parents with limited English 
proficiency in federal child care and early education programs, we also 
analyzed survey data provided by NCES from ECLS-K, a national 
longitudinal study focusing on following children's early education and 
school experiences from kindergarten through 12th grade. We used data 
from the fall 1998 base year survey of approximately 18,000 parents 
with children in kindergarten. ECLS-K was the most recent national 
dataset that allowed us to compare child care, financial assistance for 
child care, and Head Start usage rates among children with parents who 
had limited English proficiency and children whose parents were 
proficient in English.[Footnote 34] Among other topics, ECLS-K asked 
parents about their English proficiency, the languages spoken at home, 
their child's use of child care in the year before kindergarten, any 
financial assistance from a social service or welfare agency, and the 
child's use of Head Start.[Footnote 35] The survey did not ask for the 
specific social service or welfare agency providing financial 
assistance for child care, so we were unable to make estimates about 
the use of CCDF subsidies from this dataset. NCES had bilingual 
interviewers available to conduct the survey in Spanish, Chinese, 
Hmong, and Lakota if the respondent was not able to speak English and 
no English-speaking member of the household was available. Slightly 
more than 7 percent of the interviewers were conducted in a language 
other than English. More information about our analysis of ECLS-K data 
can be found in appendix II. 

To assess the reliability of ECLS-K data, we reviewed relevant 
information about the survey, including the user manual, data 
dictionary, and steps taken to ensure the quality of these data, and 
performed electronic testing to detect obvious errors in completeness 
and reasonableness. We determined that the ECLS-K data were 
sufficiently reliable for the purposes of this report. 

We also contacted child care administrators in all 50 states and the 
District of Columbia to determine whether any states collected their 
own data on the language of CCDF subsidy recipients. We discussed data 
collection with officials in 5 states in the course of our site visits 
and contacted officials in the remaining 45 states and the District of 
Columbia by e-mail. Of those contacted by e-mail, 40 states and the 
District of Columbia responded. Overall, 12 states and the District of 
Columbia collected some language data from parents whose children 
received CCDF subsidies. We then followed up with officials in the 
District of Columbia and all 12 states that reported collecting the 
data on the language of CCDF subsidy recipients to ask questions about 
the type of data collected, the methods by which the data were 
collected, the challenges states faced in collecting the data, and the 
purposes for which the data were used. We did not ask states to submit 
their data to us because we determined that the differences in states' 
data collection approaches and the limitations of state data would 
preclude us from aggregating state data to produce national estimates 
of CCDF subsidy use among children of parents who speak other 
languages. 

Site Visits: 

To obtain information on the challenges that parents with limited 
English proficiency face in accessing CCDF subsidies and Head Start and 
the assistance provided to these families by state and local entities, 
we visited 5 states--Arkansas, California, Illinois, North Carolina, 
and Washington. We selected these states on the basis of the size and 
growth of their population of individuals with limited English 
proficiency as determined by our analysis of 1990 and 2000 data from 
the U.S. Census Bureau, the states' geographic location, and the 
presence of initiatives focused on individuals with limited English 
proficiency as determined by our review of CCDF plans that states are 
required to submit to CCB every 2 years. We visited 10 counties across 
these states, as well as contacted officials in 1 county by telephone. 
We selected counties with substantial numbers of individuals with 
limited English proficiency or that have experienced a significant 
growth in this population based on the analysis of 1990 and 2000 U.S. 
Census data. (See table 2.) In choosing counties, we also considered 
the proportion of residents living in urban and rural parts of the 
county to obtain information on the experiences of families in both 
urban and rural areas. 

Table 2: Selected Characteristics of Site Visit Counties: 

County: Washington County, Arkansas; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (1990): 483; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (1990): 0.5; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (2000): 4,925; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (2000): 3.4; 
Percentage change in number of individuals with LEP (1990- 2000): 
919.7; 
Percentage change in proportion of individuals with LEP as a percentage 
of population (1990-2000): 637.3. 

County: Fresno County, California; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (1990): 66,070; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (1990): 10.9; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (2000): 86,776; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (2000): 11.8; 
Percentage change in number of individuals with LEP (1990- 2000): 31.3; 
Percentage change in proportion of individuals with LEP as a percentage 
of population (1990-2000): 8.6. 

County: Los Angeles County, California; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (1990): 1,153,956; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (1990): 14.2; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (2000): 1,395,347; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (2000): 15.9; 
Percentage change in number of individuals with LEP (1990-2000): 20.9; 
Percentage change in proportion of individuals with LEP as a percentage 
of population (1990-2000): 11.9. 

County: San Francisco County, California; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (1990): 86,228; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (1990): 12.5; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (2000): 99,659; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (2000): 13.4; 
Percentage change in number of individuals with LEP (1990- 2000): 15.6; 
Percentage change in proportion of individuals with LEP as a percentage 
of population (1990-2000): 6.7. 

County: Cook County, Illinois; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (1990): 247,814; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (1990): 5.2; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (2000): 392,663; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (2000): 7.9; 
Percentage change in number of individuals with LEP (1990- 2000): 58.5; 
Percentage change in proportion of individuals with LEP as a percentage 
of population (1990-2000): 50.1. 

County: Winnebago County, Illinois; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (1990): 2,510; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (1990): 1.1; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (2000): 6,208; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (2000): 2.4; 
Percentage change in number of individuals with LEP (1990- 2000): 
147.3; 
Percentage change in proportion of individuals with LEP as a percentage 
of population (1990-2000): 123.3. 

County: Durham County, North Carolina; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (1990): 1,330; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (1990): 0.8; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (2000): 8,886; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (2000): 4.3; 
Percentage change in number of individuals with LEP (1990- 2000): 
568.1; 
Percentage change in proportion of individuals with LEP as a percentage 
of population (1990-2000): 442.6. 

County: Sampson County, North Carolina; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (1990): 377; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (1990): 0.9; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (2000): 2,618; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (2000): 4.7; 
Percentage change in number of individuals with LEP (1990- 2000): 
594.4; 
Percentage change in proportion of individuals with LEP as a percentage 
of population (1990-2000): 451.2. 

County: King County, Washington; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (1990): 27,329; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (1990): 1.9; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (2000): 63,004; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (2000): 3.9; 
Percentage change in number of individuals with LEP (1990- 2000): 
130.5; 
Percentage change in proportion of individuals with LEP as a percentage 
of population (1990-2000): 98.2. 

County: Yakima County, Washington; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (1990): 10,916; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (1990): 6.3; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (2000): 20,686; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (2000): 10.2; 
Percentage change in number of individuals with LEP (1990- 2000): 89.5; 
Percentage change in proportion of individuals with LEP as a percentage 
of population (1990-2000): 60.4. 

County: Chatham County, North Carolina[A]; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (1990): 297; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (1990): 0.8; 
Individuals with limited English proficiency (LEP): Number of 
individuals with LEP (2000): 2,243; 
Individuals with limited English proficiency (LEP): Individuals with 
LEP as a percentage of total population (2000): 4.8; 
Percentage change in number of individuals with LEP (1990- 2000): 
655.2; 
Percentage change in proportion of individuals with LEP as a percentage 
of population (1990-2000): 488.2. 

Source: GAO analysis of data from the U.S. Census. 

[A] We contacted officials in this county by telephone. 

[End of table] 

On each site visit, we interviewed various stakeholders in the child 
care and early education field at the state and local levels, including 
officials responsible for administering CCDF subsidies, representatives 
of child care resource and referral agencies, Head Start officials, and 
child care and early education providers, as well as officials from 
community organizations and advocacy groups working with individuals 
who have limited English proficiency. 

Focus Groups: 

To obtain information on the challenges that parents with limited 
English proficiency face when accessing child care subsidies for their 
children, we conducted 12 focus groups with mothers who had limited 
English proficiency in California, Washington, and North Carolina. We 
selected these locations in order to include both states with 
historically large populations of individuals with limited English 
proficiency (California and Washington) and a state experiencing a more 
recent growth in this population (North Carolina)--based on our 
analysis of data from the U.S. Census. GAO contracted with Aguirre 
International, a firm specializing in applied research with hard-to- 
reach populations, to recruit focus group participants through 
community-based organizations, arrange facilities for focus groups in 
locations familiar and accessible to the participants, provide 
transportation to and from child care during the focus groups, moderate 
the group discussions, and translate focus group transcripts. Focus 
groups were conducted from January 2006 to March 2006. 

Consistent with focus group data collection practices, our design 
involved multiple groups with certain homogeneous characteristics. All 
focus groups were conducted with mothers of children aged 5 or younger 
enrolled in child care. These mothers also had limited English 
proficiency as self-reported by potential participants during the focus 
group recruitment process and were eligible for CCDF subsidies as 
determined by family's income and parental work and education 
activities. The focus groups varied by primary language spoken and 
whether or not participants' children were receiving government child 
care subsidies.[Footnote 36] Eight of the 12 focus groups were 
conducted in Spanish and 4 in Vietnamese. We chose to conduct focus 
groups in Spanish and Vietnamese because these two languages were among 
the most prevalent languages, other than English, spoken in the states 
of interest. According to 2000 Census data, Spanish was the language 
most commonly spoken among these households in the states we visited. 
In Washington, Vietnamese was the most commonly spoken language after 
Spanish, and in California, Vietnamese was the second most commonly 
spoken language after Spanish. We did not conduct focus groups in 
Vietnamese in North Carolina because of the limited number of 
individuals who spoke languages other than English or Spanish in the 
state. Six of the focus groups consisted of mothers with young children 
(ages 0-5) who were enrolled in child care and received a government 
subsidy for that care; the other 6 groups consisted of mothers with 
young children (ages 0-5) who were enrolled in child care and did not 
receive a government subsidy for that care, but whose children likely 
qualified for subsidies based upon their family's income and employment 
or education activities. Table 3 describes the characteristics of the 
group at each location and lists locations and dates for each focus 
group conducted. The number of participants in each focus group ranged 
from 6 to 13. 

Table 3: Composition of Focus Groups: 

Subsidized; 
Language: Spanish; 
Location: Yakima, Wash; 
Date: January 31, 2006. 

Subsidized; 
Language: Spanish; 
Location: Siler City, N.C; 
Date: February 4, 2006. 

Subsidized; 
Language: Spanish; 
Location: Siler City, N.C; 
Date: March 2, 2006. 

Subsidized; 
Language: Spanish; 
Location: San Jose, Calif; 
Date: February 8, 2006. 

Subsidized; 
Language: Vietnamese; 
Location: San Jose, Calif; 
Date: February 11, 2006. 

Subsidized; 
Language: Vietnamese; 
Location: Seattle, Wash; 
Date: February 20, 2006. 

Unsubsidized; 
Language: Spanish; 
Location: Yakima, Wash; 
Date: February 20, 2006. 

Unsubsidized; 
Language: Spanish; 
Location: Pittsboro, N.C; 
Date: February 4, 2006. 

Unsubsidized; 
Language: Spanish; 
Location: Pittsboro, N.C; 
Date: February 18, 2006. 

Unsubsidized; 
Language: Spanish; 
Location: Oakland, Calif; 
Date: February 7, 2006. 

Unsubsidized; 
Language: Vietnamese; 
Location: San Jose, Calif; 
Date: February 9, 2006. 

Unsubsidized; 
Language: Vietnamese; 
Location: Seattle, Wash; 
Date: February 20, 2006. 

Source: GAO analysis of focus group transcripts. 

[End of table] 

To help the moderator lead the discussions, GAO developed a guide that 
included open-ended questions related to mothers' experiences finding 
appropriate child care and attempting to access financial assistance to 
help pay for the care. Discussions were held in a structured manner and 
followed the moderator guide. 

Focus groups involve structured small group discussions designed to 
gain in-depth information about specific issues that cannot easily be 
obtained from single or serial interviews. Methodologically, they are 
not designed to provide results generalizable to a larger population or 
provide statistically representative samples or reliable quantitative 
estimates. They represent the responses only of the mothers who 
participated in our 12 groups. The population of individuals with 
limited English proficiency in the United States consists of many 
cultural backgrounds and languages in addition to Spanish and 
Vietnamese, and those and other factors may influence the experience 
and attitudes of parents with limited English proficiency regarding 
child care. Therefore, the experiences of other mothers may be 
different from those of focus group participants. In addition, while 
the composition of the groups was designed to include different states, 
languages, and subsidy participation status, the groups were not random 
samples of mothers with limited English proficiency. 

Other Methodology: 

To assess HHS's efforts to ensure access to its programs for parents 
with limited English proficiency, we interviewed HHS officials, 
reviewed documents and guidance produced by HHS for state and local 
grantees, and analyzed relevant legislation. We interviewed officials 
from CCB, the Office of Head Start, HHS's Office for Civil Rights, and 
the five HHS regional offices that covered the states that we 
visited.[Footnote 37] We also reviewed informational materials produced 
by HHS to facilitate access to programs for individuals with limited 
English proficiency and online resources pertaining to language access 
that were available through HHS's and the Department of Justice's Web 
sites. Additionally, we analyzed relevant legislation, federal 
regulations, and reports from research organizations. 

Finally, to obtain information pertaining to our research objectives, 
we interviewed officials from various national organizations working on 
issues related to early child care and education, as well as 
organizations advocating on behalf of individuals with limited English 
proficiency. 

[End of section] 

Appendix II: Analyses of the Effects of Limited English Proficiency on 
Child Care and Early Education Patterns: 

We analyzed national survey data collected in 1998 as part of the Early 
Childhood Longitudinal Study, Kindergarten Class of 1998-99 (ECLS-K) 
from parents of kindergarten children about their children's 
experiences in the year before kindergarten. To conduct our analyses, 
we used logistic regression models to estimate the "net effects" of the 
parent's limited English proficiency on children's child care and early 
education patterns. We defined parents as having limited proficiency in 
English if the parent participating in the interview reported that a 
language other than English was spoken at home, and if the respondent 
him or herself reported speaking English either "not very well" or "not 
well at all." We made this decision because we surmised that speaking 
is one of the main channels through which information about child care 
is communicated. Additionally, we made the decision to focus on the 
English language ability of the parent participating in the interview 
on the assumption that the respondent participating in the survey about 
his or her child would have a primary role in child care decisions. 

We considered the effect of the parent's limited English proficiency on 
four outcomes. First, we looked at the effect it had on the likelihood 
of their child receiving any type of nonparental child care in the year 
before the child was in kindergarten, regardless of whether the care 
was provided in a child care center (including a prekindergarten 
program) or by relatives or nonrelatives in some other setting. Second, 
we looked at the effect that limited English proficiency had on the 
likelihood of receiving financial assistance from a social service or a 
welfare agency to help pay for child care among those who did receive 
child care. Third, we looked at the effect that limited English 
proficiency had on the likelihood that the child care provided was in a 
center-based facility (rather than care provided by relatives or 
nonrelatives) because it has been suggested that children whose parents 
have limited English proficiency may be less likely to receive center- 
based care than other children. Fourth, and finally, we considered 
whether limited English proficiency affected the likelihood of 
participating in Head Start. 

By "net effects," we mean the effects of limited English proficiency 
that operate after we control for other factors that affect these 
different outcomes and that are related to limited English proficiency. 
The most obvious among these other factors is race or ethnicity. That 
is, the probability of using any nonparental care, receiving financial 
assistance for child care, having center-based care rather than some 
other form of care, and participating in Head Start are different among 
racial and ethnic groups, and English proficiency is vastly different 
for some groups, particularly Hispanics and Asians, than for whites and 
other races. As such, after looking at the difference between children 
of parents with limited English proficiency and other children on these 
outcomes, we used multivariate logistic regression models to re- 
estimate this difference when controlling for the effect of 
characteristics such as the child's race or ethnicity. The other 
characteristics we controlled included household income (because of its 
effect on eligibility for some child care assistance programs and Head 
Start) and parental education(because previous studies have shown it to 
have an effect on participation in child care and early education 
programs). We also controlled for the number of persons over 18 in the 
household and whether the parent or parents in the house were employed 
because these can affect the availability of care givers in the home 
and determine the need for child care and child care assistance outside 
of the home. Another reason why we controlled for parental employment 
status is that it is one of the factors considered for CCDF 
eligibility. When we looked at the likelihood of receiving any care or 
receiving that care in a center-based facility, as well as at the 
likelihood of receiving financial assistance for care received, we 
controlled for whether the family participated in Head Start, since we 
surmised this may affect whether additional child care was needed. 
Additionally, because we thought that being in multiple types of child 
care may affect the likelihood of one of them being provided in a 
center-based facility or being subsidized by an outside source, we also 
controlled for whether the child received multiple types of child care 
when we looked at the likelihood of a child being in center-based care 
or receiving financial assistance for child care. Finally, when we 
looked at whether financial assistance was received for the care, we 
controlled for whether the care was provided in a center-based facility 
on the assumption that the cost of care may be higher when it is 
provided in a formal center-based setting. Additionally, other factors, 
such as family preferences for a certain type of care and parents' 
immigration status, as well as changes in the CCDF program and child 
care policies within a particular state of residence may affect child 
care and early education patterns of children. We partially mitigated 
the potential effect of preferences for certain types of care on the 
receipt of financial assistance for child care by controlling for 
whether or not the child was in center-based care. However, we could 
not include all factors that may have had an effect on the outcomes in 
the analysis because the ECLS-K did not collect the data to measure 
them. 

An understanding of how to interpret the results of these multivariate 
logistic regression models is facilitated by first considering tables 4 
and 5, which estimate the effects of limited English proficiency, and 
race or ethnicity, on the first two of these four outcomes. Tables 4 
and 5 estimate how English proficiency and race or ethnicity are 
related to receiving any nonparental child care and to receiving 
financial assistance for child care (among those who received any 
nonparental child care). It is important to note that these estimates 
are unadjusted for other characteristics that are related to these 
outcomes, such as education, income, and employment status. The top 
section of tables 4 and 5 shows the effect of parents' limited English 
proficiency on the two outcomes, the middle section shows the effect of 
the child's race or ethnicity, and the bottom section shows the joint 
effect of the two, or the effect of limited English proficiency within 
each racial or ethnic category. We show these effects in each section 
of the tables by first providing percentages of children of parents 
with limited English proficiency and other children having a certain 
outcome. We then calculate odds and odds ratios for the likelihood of 
children within each of the two groups having these outcomes. Odds and 
odds ratios are the measures used to describe effects that underlie the 
logistic regression models we later employ to estimate net effects of 
limited English proficiency while controlling for other factors. 

Consider table 4, which provides percentages, odds, and odds ratios 
related to the differences in receiving any type of child care across 
children that differ by their parents' English proficiency, their race 
or ethnicity, and both. We see in the top section that while 
approximately 75 percent of children whose parents are English 
proficient received some form of child care in the year preceding 
kindergarten, the same is true of only 46 percent of children whose 
parents have limited English proficiency. These percentages are derived 
from weighted data in our sample that take account of the fact that we 
are working with a sample that is not a simple random sample (where all 
individuals have an equal chance of being selected), but one in which 
children in some groups, namely Asians and Pacific Islanders, were 
oversampled. They are based, however, on the unweighted number of cases 
in our sample of 18,033 respondents (16,784 of them with parents 
proficient in English and 1,249 with parents with limited English 
proficiency), given in the third column of the table. The difference in 
these two percentages is sizable, and statistically significant, and 
would lead us to conclude that children of parents with limited English 
proficiency are less likely to receive nonparental care of any form. 

Table 4: Differences in the Percentages and Odds of Receiving Any 
Nonparental Care, by Parents' English Proficiency Status, Race or 
Ethnicity, and Both, among Preschool-Aged Children: 

Parents' English proficiency status: English proficient; 
No (%): 25.2; 
Yes (%): 74.8; 
N (unweighted): 16,784; 
Odds on yes: no: 2.97; 
Odds ratio: [Empty]. 

Parents' English proficiency status: Total: Limited English proficient; 
No (%): Total: 54.4; 
Yes (%): Total: 45.6; 
N (unweighted): Total: 1,249; 
Odds on yes: no: Total: 0.84; 
Odds ratio: Total: 0.28*. 

Total; 
Parents' English proficiency status: [Empty]; 
No (%): 27.3; 
Yes (%): 72.7; 
N (unweighted): 18,033; 
Odds on yes: no: [Empty]; 
Odds ratio: [Empty]. 

Parents' English proficiency status: Race or ethnicity; 
No (%): [Empty]; 
Yes (%): [Empty]; 
N (unweighted): [Empty]; 
Odds on yes: no: [Empty]; 
Odds ratio: [Empty]. 

Parents' English proficiency status: White; 
No (%): 21.8; 
Yes (%): 78.2; 
N (unweighted): 10,262; 
Odds on yes: no: 3.59; 
Odds ratio: [Empty]. 

Parents' English proficiency status: Black; 
No (%): 29.5; 
Yes (%): 70.5; 
N (unweighted): 2,638; 
Odds on yes: no: 2.39; 
Odds ratio: 0.67*. 

Parents' English proficiency status: Hispanic; 
No (%): 39.7; 
Yes (%): 60.3; 
N (unweighted): 3,205; 
Odds on yes: no: 1.52; 
Odds ratio: 0.42*. 

Parents' English proficiency status: Asian; 
No (%): 29.6; 
Yes (%): 70.4; 
N (unweighted): 979; 
Odds on yes: no: 2.38; 
Odds ratio: 0.66*. 

Parents' English proficiency status: Total: Other; 
No (%): Total: 33.9; 
Yes (%): Total: 66.1; 
N (unweighted): Total: 989; 
Odds on yes: no: Total: 1.95; 
Odds ratio: Total: 0.54*. 

Total; 
Parents' English proficiency status: [Empty]; 
No (%): 27.3; 
Yes (%): 72.7; 
N (unweighted): 18,073; 
Odds on yes: no: [Empty]; 
Odds ratio: [Empty]. 

Race or ethnicity; 
Parents' English proficiency status: Parents' English proficiency 
status; 
No (%): [Empty]; 
Yes (%): [Empty]; 
N (unweighted): [Empty]; 
Odds on yes: no: [Empty]; 
Odds ratio: [Empty]. 

White; 
Parents' English proficiency status: English proficient; 
No (%): 21.7; 
Yes (%): 78.3; 
N (unweighted): 10,204; 
Odds on yes: no: 3.62; 
Odds ratio: [Empty]. 

Parents' English proficiency status: Black: Limited English proficient; 
No (%): Black: 38.1; 
Yes (%): Black: 61.9; 
N (unweighted): Black: 34; 
Odds on yes: no: Black: 1.62; 
Odds ratio: Black: 0.45*. 

Black; 
Parents' English proficiency status: English proficient; 
No (%): 29.2; 
Yes (%): 70.8; 
N (unweighted): 2,611; 
Odds on yes: no: 2.43; 
Odds ratio: [Empty]. 

Parents' English proficiency status: Hispanic: Limited English 
proficient; 
No (%): Hispanic: 60.8; 
Yes (%): Hispanic: 39.2; 
N (unweighted): Hispanic: 10; 
Odds on yes: no: Hispanic: 0.65; 
Odds ratio: Hispanic: 0.27*. 

Hispanic; 
Parents' English proficiency status: English proficient; 
No (%): 32.4; 
Yes (%): 67.6; 
N (unweighted): 2,217; 
Odds on yes: no: 2.09; 
Odds ratio: [Empty]. 

Parents' English proficiency status: Asian: Limited English proficient; 
No (%): Asian: 55.6; 
Yes (%): Asian: 44.4; 
N (unweighted): Asian: 974; 
Odds on yes: no: Asian: 0.80; 
Odds ratio: Asian: 0.38*. 

Asian; 
Parents' English proficiency status: English proficient; 
No (%): 25.4; 
Yes (%): 74.6; 
N (unweighted): 753; 
Odds on yes: no: 2.94; 
Odds ratio: [Empty]. 

Parents' English proficiency status: Other: Limited English proficient; 
No (%): Other: 46.0; 
Yes (%): Other: 54.0; 
N (unweighted): Other: 222; 
Odds on yes: no: Other: 1.17; 
Odds ratio: Other: 0.40*. 

Other; 
Parents' English proficiency status: English proficient; 
No (%): 33.9; 
Yes (%): 66.1; 
N (unweighted): 976; 
Odds on yes: no: 1.95; 
Odds ratio: [Empty]. 

Parents' English proficiency status: Total: Limited English proficient; 
No (%): Total: 33.7; 
Yes (%): Total: 66.3; 
N (unweighted): Total: 8; 
Odds on yes: no: Total: 1.97; 
Odds ratio: Total: 1.01*. 

Total; 
Parents' English proficiency status: [Empty]; 
No (%): 27.2; 
Yes (%): 72.8; 
N (unweighted): 18,009; 
Odds on yes: no: [Empty]; 
Odds ratio: [Empty]. 
Source: GAO analysis of ECLS-K data. 

* Denotes significance at the 95 percent level. 

[End of table] 

An alternative way to look at this difference is by calculating the 
odds of receiving child care, which is the percentage of children who 
receive child care divided by the percentage of children who do not. In 
the case of children of parents that are English proficient, these odds 
are 74.8/25.2 = 2.97, which implies that in that group, approximately 3 
families use child care for every family that does not (or that 300 
families do for every 100 families that do not). In the case of 
children of parents that are not English proficient, these odds are 
45.6/54.4 = 0.84, which implies that for them, approximately 0.8 
families use child care for every family that does not (or that 80 
families do for every 100 that do not). The ratio of these two odds, or 
0.84/2.97 = 0.28, tells us that the odds on receiving any care are 
decidedly lower for children of parents with limited English 
proficiency than for children of parents that are English proficient, 
by a factor of 0.28. 

The middle section of table 4 shows the differences in the percentages 
and odds of children receiving child care across racial or ethnic 
categories. The percentages of children receiving child care in the 
year before kindergarten are lower for minority children than for 
whites, and these differences are reflected in the odds as well. Among 
white children, about 3.6 children received child care for every child 
that did not, while among blacks and Asians approximately 2.4 children 
received child care for every child that did not. Among Hispanics, 
approximately 1.5 children received child care for every child that did 
not. Where variables have more than two categories, such as different 
categories of race and ethnicity, we chose one category as the 
reference category and calculated odds ratios that reflect how 
different each of the other categories is relative to that one. In this 
case, whites were chosen as the reference category, and the odds ratios 
of 0.67, 0.42, 0.66 and 0.54 indicate how much lower the odds of 
receiving child care were for blacks, Hispanics, Asians, and other 
races, respectively, than for whites. 

The bottom section of table 4 shows the differences in the percentages 
of children receiving any child care across the joint (or combined) 
categories of parents' English proficiency and the child's race or 
ethnicity. Here we have calculated odds for each of the joint 
categories, and the odds ratios, which indicate how different the odds 
are across English proficiency categories, within each category of race 
or ethnicity. We can see that within most categories of race or 
ethnicity, children of parents with limited English proficiency have 
lower odds of receiving any child care than children of parents that 
are proficient in English, by factors such as 0.38 for Hispanics and 
0.40 for Asians. The odds ratios for whites, blacks, and others were 
based on very small numbers of children of parents with limited English 
proficiency. Of the 1,249 children of parents with limited English 
proficiency, only 34, 10, and 8 children are white, black, and other, 
respectively, and these numbers are too small for us to assess whether 
and how much they differ from children of parents that are proficient 
in English. 

In sum, table 4 indicates that children of parents with limited English 
proficiency were less likely to receive any child care than children of 
parents proficient in English. Some of this is due to the fact that 
children of parents with limited English proficiency tend to be 
Hispanic and Asian, groups that are less likely than whites to receive 
child care. However, not all of it is due to race or ethnicity 
differences, since among Hispanics and Asians the children of parents 
with limited English proficiency were less than half as likely as 
others within the same racial or ethnic group to receive any child 
care. 

Table 5 provides similar information with respect to the likelihood of 
receiving financial assistance for child care, among those children 
that received any care. Overall, children of parents with limited 
English proficiency were less likely than those with parents proficient 
in English to receive financial assistance (odds ratio = 0.60), though 
most racial or ethnic minorities, except for Asians, were more likely 
than whites to receive financial assistance when they received some 
type of care. That is, while Hispanic children were twice as likely as 
white children to receive financial assistance, and blacks and other 
races were approximately four times as likely, Asians' odds of 
receiving financial assistance were not statistically distinguishable 
from those of whites (odds ratio = 0.70). Further, in the two groups-- 
Hispanics and Asians--that had sizable numbers of children of parents 
with limited English proficiency, the effect of limited proficiency was 
different. Among Hispanics, the odds of receiving financial assistance 
were lower for children of parents with limited English proficiency 
than for children of parents that were proficient in English (odds 
ratio = 0.46), while among Asians the odds of receiving financial 
assistance were not statistically distinguishable between children of 
parents with limited English proficiency and children of parents that 
were proficient in English (odds ratio = 1.95). Among the other groups, 
the numbers of children of parents with limited English proficiency who 
received child care in the year prior to kindergarten were too small 
for us to be able to reliably detect any difference between them and 
others in the likelihood of receiving financial assistance. 

Table 5: Differences in the Percentages and Odds of Receiving Financial 
Assistance for Child Care, among Those in Any Prekindergarten Care, by 
Parents' English Proficiency Status, Race or Ethnicity, and Both: 

Parents' English proficiency status: English proficient; 
No (%): 93.2; 
Yes (%): 6.8; 
N (unweighted): 12,732; 
Odds on yes:no: 0.07; 
Odds ratio: : [Empty]. 

Parents' English proficiency status: Limited English proficient; 
No (%): 95.8; 
Yes (%): 4.2; 
N (unweighted): 584; 
Odds on yes:no: 0.04; 
Odds ratio: 0.60**. 

Total; 
Parents' English proficiency status: [Empty]; 
No (%): 93.4; 
Yes (%): 6.6; 
N (unweighted): 13,316; 
Odds on yes:no: [Empty]; 
Odds ratio: [Empty].  

Parents' English proficiency status: Race or ethnicity: White; 
No (%): 95.9; 
Yes (%): 4.1; 
N (unweighted): 8,173; 
Odds on yes:no: 0.04; 
Odds ratio: [Empty]. 

Parents' English proficiency status: Race or ethnicity: Black; 
No (%): 85.4; 
Yes (%): 14.6; 
N (unweighted): 1,874; 
Odds on yes:no: 0.17; 
Odds ratio: 4.02**. 

Parents' English proficiency status: Race or ethnicity: Hispanic; 
No (%): 92.5; 
Yes (%): 7.5; 
N (unweighted): 1,976; 
Odds on yes:no: 0.08; 
Odds ratio: 1.90**. 

Parents' English proficiency status: Race or ethnicity: Asian; 
No (%): 97.1; 
Yes (%): 2.9; 
N (unweighted): 676; 
Odds on yes:no: 0.03; 
Odds ratio: 0.70**. 

Parents' English proficiency status: Race or ethnicity: Other; 
No (%): 85.1; 
Yes (%): 14.9; 
N (unweighted): 637; 
Odds on yes:no: 0.17; 
Odds ratio: 4.11**. 

Total; 
Parents' English proficiency status: [Empty]; 
No (%): 93.4; 
Yes (%): 6.6; 
N (unweighted): 13,336; 
Odds on yes:no: [Empty]; 
Odds ratio: [Empty]. 

White; 
Parents' English proficiency status: English proficient; 
No (%): 95.9; 
Yes (%): 4.1; 
N (unweighted): 8,138; 
Odds on yes:no: 0.04; 
Odds ratio: [Empty]. 

White; 
Parents' English proficiency status: Limited English proficient; 
No (%): 100.0; 
Yes (%): 0.0; 
N (unweighted): 20; 
Odds on yes:no: 0.00; 
Odds ratio: 0.00**. 

Black; 
Parents' English proficiency status: English proficient; 
No (%): 85.4; 
Yes (%): 14.6; 
N (unweighted): 1,861; 
Odds on yes:no: 0.17; 
Odds ratio: [Empty]. 

Black; 
Parents' English proficiency status: Limited English proficient; 
No (%): 73.1; 
Yes (%): H26.9; 
N (unweighted): 4; 
Odds on yes:no: 0.37; 
Odds ratio: 2.15**. 

Hispanic; 
Parents' English proficiency status: English proficient; 
No (%): 91.5; 
Yes (%): 8.5; 
N (unweighted): 1,533; 
Odds on yes:no: 0.09; 
Odds ratio: [Empty]. 

Hispanic; 
Parents' English proficiency status: Limited English proficient; 
No (%): 95.9; 
Yes (%): 4.1; 
N (unweighted): 435; 
Odds on yes:no: 0.04; 
Odds ratio: 0.46**. 

Asian; 
Parents' English proficiency status: English proficient; 
No (%): 97.5; 
Yes (%): 2.5; 
N (unweighted): 554; 
Odds on yes:no: 0.03; 
Odds ratio: [Empty]. 

Asian; 
Parents' English proficiency status: Limited English proficient; 
No (%): 95.2; 
Yes (%): 4.8; 
N (unweighted): 120; 
Odds on yes:no: 0.05; 
Odds ratio: 1.95**. 

Other; 
Parents' English proficiency status: English proficient; 
No (%): 85.2; 
Yes (%): 14.8; 
N (unweighted): 629; 
Odds on yes:no: 0.17; 
Odds ratio: [Empty]. 

Other; 
Parents' English proficiency status: Limited English proficient; 
No (%): 100.0; 
Yes (%): 0.0; 
N (unweighted): 5; 
Odds on yes:no: 0.00; 
Odds ratio: 0.00**. 

Total; 
Parents' English proficiency status: [Empty]; 
No (%): 93.4; 
Yes (%): 6.6; 
N (unweighted): 13,299; 
Odds on yes:no: [Empty]; 
Odds ratio: [Empty]. 

Source: GAO analysis of ECLS-K data. 

* denotes significance at the 95 percent level. 

** denotes significance at the 90 percent level. 

[End of table] 

The tables above showed the gross or unadjusted differences in 
receiving child care and receiving financial assistance for child care 
between children of parents with limited English proficiency and 
children of parents proficient in English, and what those differences 
look like when we control for or take account of race or ethnicity, the 
factor with which parents' limited English proficiency is most closely 
associated. However, limited English proficiency is associated with a 
number of other factors that affect these two outcomes, as well as the 
other two outcomes that were of interest to us, which were the 
likelihood of receiving center-based care (as opposed to care from 
relatives or nonrelatives in some other setting) and the likelihood of 
participating in Head Start. Tables 6 through 9 show that the 
percentages of children that are Hispanic or Asian, from lower-income 
families, have less educated parents, and have three or more persons in 
the household over the age of 18 are higher among children of parents 
with limited English proficiency than among other children. Tables 10 
and 11 show that the percentage of children that have their parent (in 
single parent households) or both parents working and the percentage of 
children that receive multiple types of care are lower among children 
of parents with limited English proficiency than among other children. 

Table 6: Percentages of English Proficient Parents and Parents with 
Limited English Proficiency, by Race or Ethnicity: 

English proficient; 
Race or ethnicity: White (%): 61.5; 
Race or ethnicity: Black (%): 16.8; 
Race or ethnicity: Hispanic (%): 14.2; 
Race or ethnicity: Asian (%): 2.5; 
Race or ethnicity: Other (%): 5.0; 
Total (%): 100.0; 
N (unweighted): 16,784. 

Limited English proficient; 
Race or ethnicity: White (%): 2.6; 
Race or ethnicity: Black (%): 1.1; 
Race or ethnicity: Hispanic (%): 87.7; 
Race or ethnicity: Asian (%): 8.3; 
Race or ethnicity: Other (%): 0.4; 
Total (%): 100.0; 
N (unweighted): 1,249. 

Source: GAO analysis of ECLS-K data. 

[End of table] 

Table 7: Percentages of English Proficient Parents and Parents with 
Limited English Proficiency, by Family Income: 

English Proficient; 
Income (percentage of the poverty level): < 100 percent of poverty 
level (%): 20.9; 
Income (percentage of the poverty level): 100-200 percent of poverty 
level (%): 23.2; 
Income (percentage of the poverty level): >200 percent of poverty level 
(%): 55.9; 
Total (%): 100.0; 
N: (unweighted): 16,784. 

Limited English Proficient; 
Income (percentage of the poverty level): < 100 percent of poverty 
level (%): 55.4; 
Income (percentage of the poverty level): 100-200 percent of poverty 
level (%): 32.0; 
Income (percentage of the poverty level): >200 percent of poverty level 
(%): 12.6; 
Total (%): 100.0; 
N: (unweighted): 1,249. 

Source: GAO analysis of ECLS-K data. 

[End of table] 

Table 8: Percentages of English Proficient Parents and Parents with 
Limited English Proficiency, by Education: 

English proficient; 
Highest education level of parent(s) in the household: < High school 
graduate (%): 7.8; 
Highest education level of parent(s) in the household: High school 
graduate (%): 27.2; 
Highest education level of parent(s) in the household: > High school 
graduate (%): 65.0; 
Total (%): 100.0; 
N (unweighted): 16,784. 

Limited English proficient; 
Highest education level of parent(s) in the household: < High school 
graduate (%): 47.4; 
Highest education level of parent(s) in the household: High school 
graduate (%): 29.9; 
Highest education level of parent(s) in the household: > High school 
graduate (%): 22.7; 
Total (%): 100.0; 
N (unweighted): 1,249. 

Source: GAO analysis of ECLS-K data. 

[End of table] 

Table 9: Percentages of English Proficient Parents and Parents with 
Limited English Proficiency, by the Number of Persons over the Age of 
18 in the Household: 

English proficient; 
Number of persons over 18: 1 (%): 16.1; 
Number of persons over 18: 2 (%): 72.1; 
Number of persons over 18: 3+ (%): 11.8; 
Total (%): 100.0; 
N: (unweighted): 16,782. 

Limited English proficient; 
Number of persons over 18: 1 (%): 8.5; 
Number of persons over 18: 2 (%): 64.3; 
Number of persons over 18: 3+ (%): 27.2; 
Total (%): 100.0; 
N: (unweighted): 1,249. 

Source: GAO analysis of ECLS-K data. 

[End of table] 

Table 10: Percentages of English Proficient Parents and Parents with 
Limited English Proficiency, by Parents' Work Status: 

English Proficient; 
Parents working: Not all working (%): 33.4; 
Parents working: All working (%): 66.6; 
Total (%): 100.0; 
N (unweighted): 16,550. 

Limited English proficient; 
Parents working: Not all working (%): 63.7; 
Parents working: All working (%): 36.3; 
Total (%): 100.0; 
N (unweighted): 1,220. 

Source: GAO analysis of ECLS-K data. 

[End of Table] 

Table 11: Percentages of English Proficient Parents and Parents with 
Limited English Proficiency, by the Number of Different Types of Child 
Care Used, among Those Using Care: 

English proficient; 
Number of different types of child care used, among those using care: 
One (%): 72.3; 
Number of different types of child care used, among those using care: 
Two or more (%): 27.7; 
Total (%): 100.0; 
N (unweighted): 12,732. 

Limited English proficient; 
Number of different types of child care used, among those using care: 
One (%): 81.6; 
Number of different types of child care used, among those using care: 
Two or more (%): 18.4; 
Total (%): 100.0; 
N (unweighted): 584. 

Source: GAO analysis of ECLS-K data. 

Note: Each difference between families with limited English proficiency 
and other families in tables 6-11, except for the category of high 
school graduates, is significant at the 95 percent confidence level. 

[End of table] 

In tables 12 through 15 we show what the adjusted effect of parents' 
limited English proficiency is on the likelihood of their child (1) 
receiving any nonparental child care, (2) receiving financial 
assistance for child care, (3) receiving center-based care, and (4) 
participating in Head Start, when we estimate its effect using logistic 
regression models to control for the effects of the other factors. In 
the first two columns of each table, we show the unadjusted effect of 
parents' limited English proficiency on each outcome across all racial/ 
ethnic groups, and what the adjusted effect looks like when we control 
for race or ethnicity and other factors. In the third and fourth 
columns of each table, we show the unadjusted and adjusted effect of 
parents' limited English proficiency for Hispanics, and in the last two 
columns we show those same effects for Asians. Separate analyses were 
done only for Hispanics and Asians because, as table 6 shows, the 
percentage of children of other races whose parents have limited 
English proficiency was very small. For the adjusted models, we also 
show the effects of the other factors that we controlled for, such as 
income and education, on the four outcomes. In the case of variables 
that have multiple categories (such as race or ethnicity, income or 
poverty status, education, and number of persons in the household over 
18 years of age), the odds ratios indicate how much more or less likely 
the categories of families indicated are to have each outcome than the 
reference (or omitted) category. The reference category for race or 
ethnicity is white, the reference category for poverty status is less 
than 100 percent of the federal poverty level, the reference category 
for education is less than high school graduate, and the reference 
category for the number of persons in the household over 18 is one. 

Likelihood of receiving any nonparental care. Table 12 shows that 
before adjusting for other factors, the effect of parents' limited 
English proficiency on the likelihood of receiving any type of 
nonparental childcare was negative and significant for all groups 
considered together, and for Hispanics and Asians considered separately 
(odds ratios of 0.28, 0.38, and 0.40, respectively). After controlling 
for these other factors, the differences between children of parents 
with limited English proficiency and other parents in terms of their 
receipt of any type of child care were smaller for all groups 
considered together and for Hispanics (odds ratios of 0.77 and 0.75, 
respectively), but not statistically significant among Asians (odds 
ratio of 0.85). While almost all of the control variables attain 
statistical significance in the model that included all racial and 
ethnic groups, the statistical significance of individual control 
variables in the models including only Asian or Hispanic children 
varies. 

Table 12: Odds Ratios from Logistic Regression Models Used to Estimate 
the Effects of Different Factors on the Likelihood of Receiving Any 
Child Care, after Adjusting for Other Characteristics: 

Limited English proficient; 
All groups: Unadjusted: 0.28*; 
All groups: Adjusted: 0.77**; 
Hispanics: Unadjusted: 0.38*; 
Hispanics: Adjusted: 0.75*; 
Asians: Unadjusted: 0.40*; 
Asians: Adjusted: 0.85. 

White; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: Ref**; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: [Empty]; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: [Empty]. 

Black; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 1.19**; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: [Empty]; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: [Empty]. 

Hispanic; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.87**; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: [Empty]; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: [Empty]. 

Asian; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.81**; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: [Empty]; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: [Empty]. 

Other; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.86**; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: [Empty]; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: [Empty]. 

< 100 percent poverty; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: Ref**; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: Ref*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: Ref**. 

100-200 percent poverty; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 1.09**; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 1.15*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.66**. 

> 200 percent poverty; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 2.19**; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 1.96*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 1.88**. 

< High school graduate; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: Ref**; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: Ref*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: Ref**. 

High school graduate; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 1.44**; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 1.53*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 1.48**. 

> High school graduate; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 2.26**; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 2.16*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 1.79**. 

1 Person over 18; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: Ref**; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: Ref*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: Ref**. 

2 Persons over 18; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.65**; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 0.72*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.83**. 

More than 2 persons over 18; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.77**; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 0.89*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.81**. 

All parent(s) work; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 3.16**; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 3.17*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 3.24**. 

Head Start; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.38**; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 0.48*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.22**. 

Source: GAO analysis of ECLS-K data. 

* denotes significance at the 95 percent level. 

** denotes significance at the 90 percent level. 

Note: "Ref" refers to reference categories. 

[End of table] 

Likelihood of receiving financial assistance for child care. Table 13 
shows that before adjusting for other characteristics, the odds ratios 
estimating the effect of parents' limited English proficiency on the 
likelihood of receiving financial assistance for child care were 0.60, 
0.46, and 1.95 for all groups together, Hispanics, and Asians, although 
the result for Asians was not statistically significant. While other 
factors were significantly related to the likelihood of receiving 
financial assistance for child care, controlling for their effects did 
not markedly diminish the estimated difference between children of 
parents with limited English proficiency and other children overall, or 
for Hispanics or Asians. After other factors are taken into account, 
children of parents with limited English proficiency were about half as 
likely as others to receive financial assistance overall and among 
Hispanics (odds ratios of 0.41 and 0.44, respectively), but among 
Asians the difference was not statistically significant (odds ratio = 
1.85). 

Table 13: Odds Ratios from Logistic Regression Models Used to Estimate 
the Effects of Different Factors on the Likelihood of Receiving 
Financial Assistance for Child Care, among Those in Any Care, after 
Adjusting for Other Characteristics: 

Limited English proficient; 
All groups: Unadjusted: 0.60**; 
All groups: Adjusted: 0.41*; 
Hispanics: Unadjusted: 0.46*; 
Hispanics: Adjusted: 0.44*; 
Asians: Unadjusted: 1.95; 
Asians: Adjusted: 1.85**. 

White; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: Ref*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: [Empty]; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: [Empty]. 

Black; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 1.64*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: [Empty]; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: [Empty]. 

Hispanic; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 1.36*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: [Empty]; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: [Empty]. 

Asian; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.75; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: [Empty]; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: [Empty]. 

Other; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 2.73*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: [Empty]; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: [Empty]. 

<100 percent poverty; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: Ref*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: Ref*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: Ref**. 

100-200 percent poverty; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.68*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 0.64*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 8.40**. 

>200 percent poverty; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.18*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 0.25*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 2.83**. 

< High school graduate; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: Ref*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: Ref*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: Ref**. 

High school graduate; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 1.12*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 1.26*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.21**. 

> High school graduate; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.92*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 1.23*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.37**. 

1 person over 18; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: Ref*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: Ref; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: Ref**. 

2 persons over 18; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.42*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 0.27*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.09**. 

More than 2 persons over 18; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.51*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 0.21*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.09**. 

All parent(s) work; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 1.31*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 1.13*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 1.66**. 

Head Start; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 1.83*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 1.95*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 3.34**. 

Center-based care; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 2.16*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 1.63*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 1.64**. 

Multiple types of care; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 1.46*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 1.65*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 2.20**. 

Source: GAO analysis of ECLS-K data. 

* denotes significance at the 95 percent level. 

** denotes significance at the 90 percent level. 

Note: "Ref" refers to reference categories. 

[End of table] 

Likelihood of receiving center-based care. Table 14 shows that before 
adjusting for other factors, the effect of parents' limited English 
proficiency on the likelihood of receiving center-based child care 
among those who received any type of child care was significant when 
all racial/ethnic groups were considered together (odds ratio = 0.44), 
and significant for Hispanics (odds ratio = 0.73) but not for Asians 
(odds ratio = 0.92). None of the differences between children of 
parents with limited English proficiency and other children were 
statistically significant, however, after we controlled for other 
factors. 

Table 14: Odds Ratios from Logistic Regression Models Used to Estimate 
the Effects of Different Factors on the Likelihood of Receiving Center- 
Based Care, among Those in Any Care, after Adjusting for Other 
Characteristics: 

Limited English proficient; 
All groups: Unadjusted: 0.44*; 
All groups: Adjusted: 0.98*; 
Hispanics: Unadjusted: 0.73*; 
Hispanics: Adjusted: 0.83*; 
Asians: Unadjusted: 0.92; 
Asians: Adjusted: 1.10*. 

White; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: Ref*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: [Empty]; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: [Empty]. 

Black; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.98*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: [Empty]; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: [Empty]. 

Hispanic; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.61*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: [Empty]; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: [Empty]. 

Asian; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.77*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: [Empty]; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: [Empty]. 

Other; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.53*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: [Empty]; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: [Empty]. 

<100 percent poverty; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: Ref*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: Ref*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: Ref*. 

100-200 percent poverty; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.98*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 1.05*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.89*. 

>200 percent poverty; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 1.72*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 1.37*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 1.46*. 

< High school graduate; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: Ref*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: Ref*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: Ref*. 

High school graduate; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 1.36*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 1.17*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.59*. 

> High school graduate; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 2.45*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 1.94*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 1.15*. 

1 person over 18; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: Ref*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: Ref*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: Ref*. 

2 persons over 18; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 1.06*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 0.95*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.76*. 

More than 2 persons over 18; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.64*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 0.78*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.23*. 

All parent(s) work; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.39*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 0.33*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.51*. 

Head Start; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.18*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 0.26*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.17*. 

Multiple types of care; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 9.81*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 8.50*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 17.66*. 

Source: GAO analysis of ECLS-K data. 

* denotes significance at the 95 percent level. 

** denotes significance at the 90 percent level. 

Note: "Ref" refers to reference categories. 

[End of table] 

Likelihood of participating in Head Start. Table 15 shows that before 
adjusting for other factors, children of parents with limited English 
proficiency had higher odds of participating in Head Start when all 
ethnic/racial groups were considered together (odds ratio = 1.39). The 
same was true when Asians were considered separately (odds ratio = 
3.81), but no significant effect of parents' limited English 
proficiency was found for Hispanics (odds ratio = 0.98). After 
controlling for other characteristics, children of parents with limited 
English proficiency had significantly lower odds of participating in 
Head Start when all racial/ethnic groups were considered together (odds 
ratio = 0.67), and when Hispanics were considered separately (odds 
ratio = 0.69), but significantly higher odds among Asians (odds ratio = 
1.90). 

Table 15: Odds Ratios from Logistic Regression Models Used to Estimate 
the Effects of Different Factors on the Likelihood of Participating in 
Head Start, after Adjusting for Other Characteristics: 

Limited English proficient; 
All groups: Unadjusted: 1.39*; 
All groups: Adjusted: 0.67*; 
Hispanics: Unadjusted: 0.98; 
Hispanics: Adjusted: 0.69*; 
Asians: Unadjusted: 3.81*; 
Asians: Adjusted: 1.90**. 

White; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: Ref*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: [Empty]; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: [Empty]. 

Black; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 3.21*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: [Empty]; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: [Empty]. 

Hispanic; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 1.75*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: [Empty]; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: [Empty]. 

Asian; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 1.57*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: [Empty]; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: [Empty]. 

Other; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 2.69*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: [Empty]; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: [Empty]. 

<100 percent poverty; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: Ref*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: Ref*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: Ref**. 

100-200 percent poverty; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.66*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 0.72*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.69**. 

>200 percent poverty; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.18*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 0.22*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.18**. 

< High school graduate; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: Ref*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: Ref*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: Ref**. 

High school graduate; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 1.19*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 1.43*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.53**. 

> High school graduate; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.71*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 0.90*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.46**. 

1 person over 18; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: Ref*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: Ref*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: Ref**. 

2 persons over 18; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.82*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 0.87*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.94**. 

More than 2 persons over 18; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.74*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 0.91*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.60**. 

All parent(s) work; 
All groups: Unadjusted: [Empty]; 
All groups: Adjusted: 0.97*; 
Hispanics: Unadjusted: [Empty]; 
Hispanics: Adjusted: 1.09*; 
Asians: Unadjusted: [Empty]; 
Asians: Adjusted: 0.69**. 

Source: GAO analysis of ECLS-K data. 

* denotes significance at the 95 percent level. 

** denotes significance at the 90 percent level. 

Note: "Ref" refers to reference categories. 

[End of table] 

[End of section] 

Appendix III: Comments from the U.S. Department of Health and Human 
Services: 

Department Of Health & Human Services: 
Administration For Children And Families: 
Office of the Assistant Secretary, Suite 600: 
370 L'Enfant Promenade, S.W. 
Washington, D.C. 20447: 

Jul 2 8 2006: 

Ms. Mamie S. Shaul: 
Director, Education, Workforce, and Income Security Issues: 
Government Accountability Office: 
441 G Street, N.W. 
Washington, D.C. 20548: 

Dear Ms. Shaul: 

Attached are comments of the Administration for Children and Families 
on the Government Accountability Office Draft Report entitled, "Child 
Care and Early Childhood Education: More Information Sharing and 
Program Review by HHS Could Enhance Access for Families with Limited 
English Proficiency" (GAO-06-807). 

Should you have questions or need additional information, please 
contact Shannon Christian, Associate Director, Child Care Bureau, at 
202-260-2309 or Channell Wilkins, Director, Office of Head Start, at 
202-205-8573. 

Sincerely, 

Signed by: 

Wade F. Horn, Ph.D. 
Assistant Secretary for Children and Families: 

Enclosure: 

Comments Of The Administration For Children And Families On The 
Government Accountability Office Draft Report Entitled, "Child Care And 
Early Childhood Education: More Information Sharing And Program Review 
By HHS Could Enhance Access For Families With Limited English 
Proficiency" (GAO-06-807): 

The Administration for Children and Families (ACF) appreciates the 
opportunity to comment on the Government Accountability Office (GAO) 
draft report on this important topic. 

GAO Recommendations: 

To help State and local agencies plan for needed language assistance 
and assess whether they provide meaningful access to eligible children, 
regardless of their parents' English ability, we recommend that CCB 
work with states to help them explore cost-effective strategies for 
collecting data on CCDF subsidy recipients' language preference or 
English proficiency and comparing these data with available information 
on community demographics. Once these data are available, HHS may 
consider collecting information on existing cost-effective ways that 
agencies could use to provide language assistance and to recruit 
providers who speak other languages, as well as disseminating this 
information in the locations where the data show the greatest need. 

To provide opportunities to parents with limited English proficiency 
for accessing Federal child care subsidies for their children, we 
recommend that HHS develop and implement specific steps to review 
whether and how States provide access to CCDF programs for eligible 
children of parents with limited English proficiency, as well as 
provide information to help states evaluate their progress in this 
area. Specifically, HHS should: 

* revise the CCDF plan template to require states to report on how they 
will provide meaningful access to parents with limited English 
proficiency seeking CCDF subsidies for their children, and: 

* systematically review states' program eligibility criteria for CCDF 
subsidies to ensure that states comply with HHS policies related to 
participation by children of parents with limited English proficiency. 

ACF Comments: 

In prior years, the Child Care Bureau (CCB) has used the annual Child 
Care and Development Fund (CCDF) appropriation for child care research 
and evaluation to fund State Child Care Data and Research Capacity 
Projects in a number of States (Connecticut, Maine, Massachusetts, 
Oregon, Rhode Island, and Wisconsin). While these projects did not 
specifically focus on services to families with limited English 
proficiency, they assisted State CCDF Lead Agencies in developing 
greater capacity for policy-relevant research and analysis. Within each 
project, the primary goal was to create a Statewide research 
infrastructure to better understand child care needs, services, and 
outcomes for families in the context of social, economic, and cultural 
change. We will consider funding similar projects in the future, as 
well as other efforts to capture relevant information on the supply and 
demand of child care services. We are also planning to use other 
research projects, including our multi-State evaluation of child care 
subsidy strategies using experimental design, to address issues related 
to serving families with limited English proficiency. 

In July 2006, CCB launched a new technical assistance initiative 
focusing on CCDF administration. Through a partnership between the 
Urban Institute and CCB's National Child Care Information Center, the 
project will provide State CCDF Lead Agencies with technical assistance 
on strategies that promote child care subsidy access and retention. The 
project will disseminate information about effective strategies 
identified by the Urban Institute research in seven mid-western States, 
as well as supplemental information provided by other States. The 
strategies fall into eight key policy areas--one of which is assisting 
parents with language barriers. Strategies in this area include making 
documents available in other languages, using translators at local 
offices, and using computer programs to track the native language of 
clients. Other policy areas identified by the initial Urban Institute 
research have an impact on services to all families, including families 
with language barriers. These policy areas include linking subsidies to 
other social service programs; improving customer service practices; 
simplifying the application process; simplifying recertification 
requirements; simplifying reporting requirements; minimizing subsidy 
breaks; and assisting parents with fluctuating and non-traditional work 
schedules. The technical assistance provided under this project will 
focus on strategies that are practical and maintain program integrity. 

CCB appreciates this suggestion and will examine the feasibility of 
using the CCDF plan template for the next biennial cycle to require 
States to report on efforts to promote access to parents with limited 
English proficiency. 

ACF Overall Comment on the Report: 

We believe that the report could have benefited from additional 
contextual discussion about the complex array of factors that impact 
families' decisions related to child care. Factors such as family 
preferences, child care supply, and immigration status-rather than just 
the characteristics of the subsidy program itself may impact families' 
choices and participation in the subsidy system. 

The National Study of Child Care for Low-Income Families (conducted by 
Abt Associates for ACF) suggests that Hispanics often prefer a family, 
friend, or neighbor provider because of the congruence with language 
and cultural beliefs, and because they trust that the provider will 
care for their children as they personally would. In addition, low- 
income, minority populations tend to live in communities with a high 
concentration of people with similar backgrounds. Social supports, 
including child care by family, friends, and neighbors, are an 
important component of many such communities. 

Availability of formal care offered by providers that speak their 
language and share their cultural beliefs is often rare in these 
communities. Given that low-income, minority populations frequently 
work in the service and retail sectors, many communities lack formal 
providers who can provide care during the non-traditional and rotating 
hours that these jobs typically require. Furthermore, research suggests 
that recent immigrants are fearful of contacting social services 
agencies, even when they are aware of their eligibility for benefits. 
While the GAO report acknowledges immigration issues, the data from the 
Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 (ECLS-
K), do not allow GAO to control for "length of residence in the U.S." 
or "immigration status." 

In light of this complexity, we have serious questions about the 
report's analysis of ECLS-K data. The ECLS-K information is outdated 
(representing the situation in 1997) and limited to a narrow group of 
children (reflecting only the year before children enter kindergarten). 
Furthermore, the data do not allow GAO to control for a number of 
potentially key variables that impact the likelihood of child care 
subsidy receipt, including State of residence or geographic location, 
CCDF policies (such as family co-payment, reimbursement rate) that vary 
by State, the availability of State-funded pre-kindergarten programs, 
family preferences regarding non-parental care, length of residence in 
the U.S., and immigration status. We believe that the GAO report places 
too much emphasis on the findings of the ECLS-K analysis (for example, 
by devoting all of Appendix II to the analysis), without adequately 
acknowledging its limitations. 

Finally, it is unclear to us why the GAO report examines the impact of 
limited English proficiency on the likelihood that the child care 
provided was in a center-based facility versus a non-center-based 
facility (such as Table 13 on page 61). A rationale for this analysis 
and further explanation of the findings would have been useful. The 
CCDF program promotes parental choice, enabling families to choose any 
legally operating setting that best meets their needs. 

[End of section] 

Appendix IV: GAO Contact and Staff Acknowledgments: 

GAO Contacts: 

Marnie S. Shaul, (202) 512-7215, shaulm@gao.gov Cornelia M. Ashby, 
(202) 512-8403, ashbyc@gao.gov: 

Staff Acknowledgments: 

Betty Ward-Zukerman (Assistant Director) and Natalya Barden (Analyst- 
in-Charge) managed all aspects of the assignment. Laurie Latuda, Janet 
Mascia, Jonathan McMurray, and Ethan Wozniak made key contributions to 
multiple aspects of the assignment. Alison Martin, Grant Mallie, Amanda 
Miller, Anna Maria Ortiz, James Rebbe, and Douglas Sloane provided key 
technical assistance. 

FOOTNOTES 

[1] The U.S. Census defines a "linguistically isolated household" as 
one in which no person aged 14 or over reported either speaking only 
English at home or speaking English very well. 

[2] In June 2006, the Head Start Bureau was officially renamed the 
Office of Head Start. 

[3] National Child Care Information Center, "Trends in State 
Eligibility Policies: A CCDF Issue Brief," Vienna, Virginia, July 2004. 

[4] Partly as a condition of receiving federal funds, states also used 
their own funds for this purpose. According to HHS, this brought total 
federal and state child care expenditures under TANF to about $3.4 
billion in fiscal year 2004. 

[5] The Personal Responsibility and Work Opportunity Reconciliation 
Act, (PRWORA, Pub. L. No. 104-193) restricts access by some legal 
immigrants to certain programs and denies access by illegal immigrants 
to many government-funded programs. States can decide the eligibility 
for TANF of most of the qualified aliens who arrived in this country 
prior to August 22, 1996. Most of the qualified aliens who entered the 
United States on or after August 22, 1996 are barred from receiving 
TANF the first 5 years after their entry, although some states choose 
to provide their own state-funded public assistance to such immigrants. 

[6] The guidance states that "for implementing the verification 
requirements mandated by title IV of PRWORA, only the citizenship and 
immigration status of the child, who is the primary beneficiary of the 
child care benefit, is relevant for eligibility purposes." U.S. 
Department of Health and Human Services, Administration on Children, 
Youth, and Families. Log No. ACYF-PI-CC-98-08, November 25, 1998. 

[7] In addition to the minimum 4 percent quality set-aside, annual 
appropriations have provided funding for child care quality activities. 
HHS officials noted, for example, that the agency's 2006 fiscal year 
appropriation provided approximately $270 million for quality 
improvement activities, including nearly $100 million to improve the 
quality of infant and toddler care and approximately $10 million for 
child care research and evaluation initiatives. 

[8] Federal Register, Vol. 71, No. 15, January 24, 2006, pp. 3848-3849. 
Alaska and Hawaii have higher guidelines. 

[9] 42 U.S.C. § 2000d et. seq. 

[10] All differences reported were statistically significant at the 95 
percent confidence level unless otherwise noted. This means that if no 
difference actually existed in the population, we would only expect to 
find a difference as large as the one found in the ECLS-K sample less 
than 5 percent of the time. 

[11] The characteristics we controlled for in the analysis of the 
receipt of financial assistance for child care were race, household 
income and parental education, the number of individuals over 18 in the 
household, the presence of a parent who was not working, whether care 
was provided in a center-based facility, whether the child was in 
multiple types of care, and the child's participation in Head Start. In 
our analysis, we treated receipt of center-based care and Head Start 
participation as two distinct outcomes. 

[12] Our analysis was limited to Hispanics and Asians because the 
numbers of parents with limited English proficiency in other racial or 
ethnic categories in the survey were too small to allow the same 
analysis. 

[13] We also examined differences in the likelihood of being in any 
type of nonparental child care in general and in center-based care in 
particular in the year before kindergarten. We found that, among 
Hispanics, children of parents with limited English proficiency were 
less likely to have been in nonparental child care than other children. 
We did not find a significant difference in the use of nonparental 
child care among Asians, nor did we find a significant difference in 
the use of center-based care for either Hispanics or Asians. 

[14] The characteristics we controlled for in the analysis of the use 
of Head Start were race, household income and parental education, 
number of individuals over 18 in the household, and the presence of a 
parent who was not working. 

[15] As mentioned earlier, ECLS-K collected information on the receipt 
of financial assistance for child care generally (rather than the 
receipt of CCDF subsidies specifically). Therefore, while the ECLS-K 
data show that children of parents with limited English proficiency 
were less likely to receive financial assistance for child care, these 
data cannot be used to comment on the accessibility of a specific 
program such as CCDF. 

[16] According to an Office of Head Start official, there has been an 
increase in the number of linguistically and culturally diverse 
children and families served by Head Start in recent years. However, 
this increase could result from the increase of the population of such 
children and families in the United States generally. 

[17] Two of the 5 states that we visited reported collecting their own 
language data from clients. In addition, we surveyed the remaining 45 
states and the District of Columbia, and 11 of the 41 states responding 
to our e-mail requests for information reported collecting these data. 

[18] According to HHS, 3-and 4-year-olds constituted 87 percent of 
children enrolled in Head Start during the 2002-2003 program year. (See 
http://www.acf.hhs.gov/programs/hsb/research/2004.htm.) 

[19] While this number appears similar to the percentage of children 
aged 0 to 5 in low-income families that were in linguistically isolated 
households as reported in Census 2000 (14 percent), the two cannot be 
directly compared because they were collected in different years and 
because the definition of limited English proficiency we used in 
analyzing the information from FACES is different from the Census 
definition of a linguistically isolated household. 

[20] According to HHS, 4-and 5-year-olds constituted 58 percent of 
children enrolled in Head Start during the 2002-2003 program year. (See 
http://www.acf.hhs.gov/programs/hsb/research/2004.htm.) 

[21] The Office of Head Start also surveys grantees annually through 
its Program Information Report (PIR). The PIR asks grantees to report a 
variety of demographic information about children enrolled in their 
programs, including the primary language of the family at home, but not 
their need for language assistance. However, our prior work identified 
limitations of PIR data. See GAO, Head Start: Better Data and Processes 
Needed to Monitor Underenrollment, GAO-04-17 (Washington, D.C.: Dec. 4, 
2003), and GAO, Head Start: Comprehensive Approach to Identifying and 
Addressing Risks Could Help Prevent Grantee Financial Management 
Weaknesses, GAO-05-176 (Washington, D.C.: Feb. 28, 2005.) 

[22] See GAO, Transportation Services: Better Dissemination and 
Oversight of DOT's Guidance Could Lead to Improved Access for Limited 
English-Proficient Populations, GAO-06-52 (Washington, D.C.: Nov. 2, 
2005). 

[23] See GAO-05-667. 

[24] See GAO, Child Care: Additional Information Is Needed on Working 
Families Receiving Subsidies, GAO-05-667 (Washington, D.C.: June 29, 
2005). 

[25] Through a contract with organizations providing telephone 
interpretation services, agency staff typically can dial a telephone 
number provided by the organization and request to be connected to a 
professional interpreter speaking a particular language. The 
interpreter, proficient in both English and another language, listens 
to the conversation between the staff and the client with limited 
English proficiency, analyzes the meaning of the message, and conveys 
the meaning to each side. 

[26] Applications in Washington were available in Spanish, Chinese, 
Korean, Russian, Cambodian, Vietnamese, Somali, and Laotian. 

[27] In June 2006, a North Carolina official told us that the 
translation of the CCDF subsidy application into Spanish has been 
completed. Local agencies currently have access to the translated 
document, and the North Carolina Department of Health and Human 
Services is in the process of making both the English and the Spanish 
versions of the document available electronically for their use. 

[28] States are required to describe in their CCDF plans how CCDF 
quality funds will be used, but are not required to use them for 
initiatives focused on providers serving children of parents with 
limited English proficiency. 

[29] 45 CFR §1304.51(c)(2) 

[30] 45 CFR §1304.52(g)(2). In fiscal year 2004, the Office of Head 
Start found three programs in noncompliance with this performance 
standard. 

[31] GAO. Head Start: Comprehensive Approach to Identifying and 
Addressing Risks Could Help Prevent Grantee Financial Management 
Weaknesses, GAO-05-176 (Washington, D.C.: Feb. 28, 2005). 

[32] CCB collects data from states on the race and ethnicity of subsidy 
recipients, but these do not allow for identification of CCDF 
recipients speaking other languages. 

[33] The Head Start program also serves children who are 3 years old. 

[34] NCES started following a new cohort of children, starting at 
birth, in 2001. However, the data on their experiences in the year 
before kindergarten are not expected to be available until 2008. 

[35] NCES attempted to verify enrollment for children whose parents 
reported that they were in Head Start. While only about half of the 
enrollments could be confirmed, NCES concluded that "families with 
unconfirmed reports of Head Start participation by their children had 
demographic characteristics similar to those of families with confirmed 
participation in Head Start. This lends support to the notion that a 
substantial proportion of these children had indeed attended Head Start 
programs, even though their attendance could not be verified." (Source: 
"User's Manual for the ECLS-K Base Year Restricted-use Head Start Data 
Files and Electronic Codebook," NCES 2001-025.") 

[36] During the focus group recruitment process, mothers were asked a 
series of questions to ensure that it was likely that they were 
receiving CCDF subsidies or eligible for them (depending upon whether 
they were selected for the subsidized or unsubsidized groups), and to 
screen out participants in other similar local programs such as state 
preschool programs or local subsidy programs. However, states may use 
multiple sources to fund their child care assistance programs, and 
participants may not know whether the source of their assistance is 
federal or state funds. Therefore, it is possible that some of the 
government subsidies received by participants were not funded entirely 
or at all by CCDF even though the recipients met the criteria for 
eligibility. 

[37] The regional offices that we contacted were: Region IV (North 
Carolina); Region V (Illinois); Region VI (Arkansas); Region IX 
(California); and Region X (Washington). 

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