Early Head Start (EHS) is a federally funded program serving pregnant women and infants, toddlers, and their caregivers in families with low incomes.1 EHS promotes healthy social, emotional, cognitive, and physical development in young children, assists parents in developing positive parenting skills and moving toward self-sufficiency goals, and brings together community partners and resources to provide families with comprehensive services and support.2

Early Head Start Is Delivered in Various Formats to Promote Child and Family Wellbeing

Early Head Start can be home-based, center-based, focused on family child care, or an alternative locally-designed approach. Each format approaches the goal of child wellbeing and healthy development differently. By providing comprehensive services to the family, including mental and physical health services to children and a variety of supports to parents, EHS aims to bolster the child’s social support through family members.3

Home-Based Early Head Start Supports Parents, Promoting Child Development Indirectly

Early Head Start provided in the home aims to improve child development indirectly through providing services and supports to parents. By improving parents’ knowledge of child development, warm and responsive caregiving skills, social support, and coping and problem-solving skills, as well as connecting families to community and health resources during the prenatal and early childhood period, home-based EHS can promote positive short-term child wellbeing outcomes4 and long-term developmental trajectories in children5 and buffer the long-term negative effects of childhood stress and adversity.6

Center-Based Early Head Start Impacts Children Directly Through High-Quality Classroom Environments and Teacher-Child Interactions

Early Head Start early care and education (ECE) environments have the potential to impact children by providing high-quality classroom environments that can lead to improved child outcomes (e.g., school readiness).7 Early Head Start ECE environments include direct support to children through their classroom context (e.g., evidence-based curricula, physical environment) and indirect supports through quality teacher-child interactions (fostered by small group sizes, low child-to-adult ratios, and high teacher qualifications).8,9,10

Search the Prenatal-to-3 Policy Clearinghouse for an ongoing inventory of rigorous evidence reviews, including more information on Early Head Start.


Early Head Start improves numerous aspects of children’s relationships with the adults in their lives, leaving children better off due to more nurturing and responsive relationships with parents and teachers in safe settings. Early Head Start also improves parent health and emotional wellbeing, promotes access to good-quality child care, and improves indicators of healthy child development (e.g., reducing behavior problems, improving language and vocabulary skills).

More Research Is Needed to Determine the Potential for Early Head Start to Reduce Disparities

Although no strong causal evidence evaluates the effectiveness of EHS at reducing disparities in outcomes between groups by race and ethnicity, research demonstrates that Black families benefit the most from EHS, in absolute terms, relative to their nonparticipant counterparts, particularly in terms of the impact of EHS on child-parent relationships and optimal child health and development.11

For more information on what we know and what we still need to learn about Early Head Start, see the evidence review on Early Head Start.


In contrast to the evidence for the five state-level policies that are included in this Roadmap, the current evidence base does not identify a specific policy lever that states should adopt and fully implement to effectively provide Early Head Start to all of the children who are eligible. In the absence of an evidence-based state policy lever to ensure eligible children have access to EHS, we present several choices that states can make to more effectively implement EHS. Additionally, we leverage available data to assess state variation across a range of factors to identify the leaders in implementing Early Head Start at the state level, and to demonstrate what progress states are making relative to one another.

State Leaders in Early Head Start:

  • Serve a high share of their state’s eligible infants and toddlers relative to others;
  • Have a state-specific program that has a similar structure and performance standards as Early Head Start; and
  • Provide state financial support for Early Head Start or provide a state match as an Early Head Start–Child Care Partnership (EHS-CCP) grantee.

Policy and Administrative Choices States Make Affect the Implementation of Early Head Start

States vary considerably in the percentage of children under age 3 who are served by Early Head Start, whether they offer their own state-specific program, and the funding streams states access to support EHS programs within their state.

Across all states, the estimated percentage of income-eligible children with access to EHS ranges from 3.8% to 31.0%. Although access is typically driven by local grantees within a state, by providing supplemental funding to EHS, states can improve the share of eligible children with access to EHS. The seven state leaders support EHS by contributing state-level funding or adopting and funding a state-based program with a structure and quality standards similar to EHS, in addition to having some of the highest percentages of income-eligible infants and toddlers with access to EHS.

Although some other states also have relatively high percentages of eligible children with access to EHS, these states tend to be states with smaller populations and did not provide additional funding at the state level for EHS, and to our knowledge, have not developed their own programs that are similar to EHS.

States Can Use a Variety of Funding Sources to Support State Early Head Start Programs

States can financially support EHS by supplementing federal funding directly with state dollars, by acting as an Early Head Start–Child Care Partnership grantee and contributing a state match to participate in this program, and/or by creating and funding a state-specific program with a similar structure and quality standards as EHS.

As of July 2021, 13 states supplement federal Early Head Start funding at the state-level, six states are an Early Head Start–Child Care Partnership grantee, and four states have a known state-specific program with similar structures and quality standards as EHS.

Additionally, states may choose to leverage other federal funding sources to support the expansion of EHS slots within their states (e.g., through the use of Child Care Development Fund, Temporary Assistance to Needy Families, or Preschool Development Grant Birth through Five funds).


Over the last year, several states took legislative or administrative action to enhance access to their EHS services. Maine, Oregon, and Washington all further invested in expanding access to Early Head Start programs. In Maine, state legislators passed a bill to expand access to a variety of early childhood services, including EHS programs. The legislation directs federal funding to broaden access and launch pilot initiatives. Similarly, Oregon made strides in the past year to expand access to its Pre-Kindergarten Prenatal to Five program, which has a similar program structure and standards as EHS. Between 2019 and 2020, the state increased the number of EHS slots from 64 to 1,127. Legislators in Washington state also made progress towards increasing EHS access this year, with the passage of the comprehensive Fair Start Act, which, among many other initiatives, will expand access to Early ECEAP, the state’s extension of their comprehensive preschool program for children from birth to age 3, with a similar structure and standards to EHS.

Other states have longer running initiatives and continued to support EHS programs in their state this year. For example, state-specific programs in Nebraska and Illinois are well established and continue to be supported. Additionally, the District of Columbia has used EHS-CCP funding braided with city funds for several years to support EHS-CCP grants and the EHS-CCP model in 18 family child care homes. Alaska also invests at the state level in EHS, contributing $6.8 million annually through the general revenue fund to support Early Head Start and Head Start programming.


Relatively Few Income-Eligible Children Are Served by Early Head Start in Most States

States vary in the share of income-eligible children with access to EHS programs within that state, ranging from 3.8% in Tennessee to 31.0% in the District of Columbia, the highest in the nation. In three states, approximately 25% or more of their income-eligible children have access to EHS (Alaska, the District of Columbia, and Vermont), but 30 states provide access to fewer than 10% of income-eligible children. In five states (Indiana, Nevada, South Carolina, Tennessee, and Texas), approximately 5% or fewer of children who are eligible for the effective program have access to it.

By providing supplemental funding to EHS, states can improve the share of eligible children with access to EHS, however, this metric is typically driven by local grantees within a state, with the exception of the District of Columbia.

A Minority of States Supplement Federal Funding with State Funding to Implement Early Head Start Programs

Only 13 states invest state funds in Early Head Start. These states facilitated the additional infusion of EHS funding through state statute—as is the case in Connecticut—and through line-item or department-specific budget allocations. In some states, funding is allocated to both Early Head Start and Head Start programs in a single statute or budgetary line item, which makes delineating the exact impact on EHS programs challenging.

Whereas some states dedicate funds to serve a larger number of eligible children, other states set aside funds to increase pay for Early Head Start staff, to extend the hours that Early Head Start is available throughout the day, to improve program quality, or to aid local programs so they can meet the non-federal share-matching requirement of 20%.

6 States Leverage Federal Funding by Partnering with Child Care Providers

States can also leverage federal funding by acting as Early Head Start–Child Care Partnership grantees (EHS–CCP) and contributing a state match to participate in the program. The EHS-CCP program brings together EHS programs and child care providers participating in the Child Care and Development Fund (child care subsidy program) by layering program funding. Participating child care providers must meet the Head Start Program Performance Standards, which should ensure high-quality care and education and access to comprehensive services for participating children.12

Only six states are EHS–CCP grantees and these states vary in their use of funds, including to increase per child payments to child care partners, run regional hub models to provide services and supports to child care partners, and improve the quality of care children receive.

4 States Have State-Specific Programs Similar to EHS

State support of EHS also includes creating, funding, and implementing a state-specific program with a similar structure and quality standards as EHS. Currently, we are aware of four states that have state-specific programs, including Illinois (Illinois Prevention Initiative), Nebraska (Sixpence Early Learning Fund), Oregon (Oregon Pre-K), and Washington (Early ECEAP). These state-specific programs are typically designed with similar eligibility criteria, quality performance standards, and program structures as EHS.

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