Head Start Health Services Competencies: A Tool to Support Health Managers and Staff

The Head Start program has always had a commitment to health and wellness. Health promotion and prevention activities are at the center of the program’s requirement to offer comprehensive services to support children’s healthy growth and development. Healthy growth and development are critical for school readiness.

What are competencies?

Competencies are the ability to do something successfully or efficiently. Competencies are a way to assess what a person values or does not value; knows or does not know; and can or cannot do.

The Head Start Health Services Competencies are a set of 68 competencies. Each describes an attitude, knowledge, or skill important for effective health services. The competencies include attitudes because it is important for health services staff to consider different perspectives, use self-reflection, and be open to learning new knowledge and skills.

The competencies are organized into four categories. The first category, Overarching (O), is a set of competencies that apply to all health services. The other three categories, Child and Family Health (CFH), Engaging Families (EF), and Leadership (L), address specific types of Head Start health services.

These competencies are not a complete list of everything one person may need to know or be able to do. Individual competencies may not apply to every job description. In some programs, more than one person may be responsible for meeting the health requirements. Health services staff may have other responsibilities that are not in this list. In some programs, the health manager may have less skill in some areas but will need to know how to manage people who have these skills. Each program will decide its own approach, job descriptions, and written services plan. The competencies also list federal, state, local, and Tribal regulations. Programs should follow regulations that have authority over a program or its families.

How to Use the Competencies

Staff can use the competencies to learn more about the attitudes, knowledge, and skills needed to deliver high-quality health and safety practices. There will be some competencies where one excels, and others where one may benefit from continued learning. Developing staff’s skills in many categories will help programs manage Head Start health services.

Many organizations and government agencies use competencies to hire, develop, and keep qualified staff.

Health services managers and staff, supervisors, and program directors can use the competencies to learn about the most important ways to keep children, families, and staff healthy and safe. Health leaders and staff can also use the competencies to identify their areas of strength and areas for improvement. This may improve the ability of the staff and the program to offer high-quality early childhood health services and help children and families achieve positive health outcomes.

Programs can also use the competencies to:

• Explore values and ideas about health care practices
• Examine how to talk to families about health topics
• Hire and supervise health services staff
• Create individualized professional development plans for health staff

Overarching Competencies

These competencies show the most important attitudes (A), knowledge (K), and skills (S). They are the foundation for health services in Head Start programs.

• O-1 A Value the connection between health and learning.
• O-2 A Acknowledge how one’s own values, beliefs, attitudes, and preferences affect interactions with children, families, and staff.
• O-3 K Have a working knowledge of the Head Start Program Performance Standards and other federal, Tribal, state, and local requirements regarding health and safety in early care and education.
• O-4 K Understand the general principles of health and wellness, including promotion, prevention, early identification, and intervention.
• O-5 K Understand the social determinants of health (SDOH) that may create risk and protective factors that make some people healthy and other people unhealthy.
• O-6 S Assist staff and families to understand children’s healthy growth and development.
• O-7 S Model and reinforce healthy and safe behaviors.
• O-8 S Assist children and families to address challenges that affect their well-being, promote resilience, and strengthen protective factors.
• O-9 S Be able to find and use appropriate sources of evidence-based or science-informed health and safety information.
• O-10 S Share culturally, linguistically, and developmentally appropriate science-informed health education materials with children, families, and staff.
• O-11 S Apply the principles of health literacy when communicating with staff and families.

Child And Family Health Competencies

These competencies address the healthy growth and development of young children from birth to age 5, family well-being, and Head Start requirements for the health and safety of children, families, and staff.

• CFH-1 A Believe that children and families have the right to be healthy and safe.
• CFH-2 A Acknowledge the importance of safe, responsive, and nurturing relationships for healthy social and emotional development.
• CFH-3 K Be familiar with early childhood developmental milestones including cognitive, motor, language, and social and emotional.
• CFH-4 K Be aware that maternal and family health and wellness begin with preconception.
• CFH-5 K Know current pediatric periodicity schedules (EPSDT), dental periodicity schedules, and immunization recommendations and requirements, and understand screening, assessment, and examination results.
• CFH-6 K Be aware of changes in health care delivery systems (e.g., eligibility, provider participation, covered services).
• CFH-7 K Understand how toxic stress and adverse childhood experiences influence health and development.
• CFH-8 K Know the importance of healthy oral development, risks, and protective factors.
• CFH-9 K Know about food safety and sanitation practices (e.g., food preparation, cross-contamination, temperatures, and storage and handling of food,  breast milk, and infant formula).
• CFH-10 K Be familiar with individual child and adult nutritional needs, preferences, and special dietary requirements including feeding recommendations for infants (e.g., breastfeeding, introduction of solids) and young children (e.g., food allergy/ intolerance, portion size, BMI).
• CFH-11 K Know about physical activity and screen-time recommendations for infants, toddlers, and preschool children, and physical activity recommendations for adults.
• CFH-12 S Assist eligible families to access health insurance for themselves and their children.
• CFH-13 S Assist families to access medical and dental homes.
• CFH-14 S Identify whether children are up to date on their EPSDT and immunization requirements.
• CFH-15 S Help families identify and overcome barriers to completing further diagnostic testing, follow-up, and treatment.
• CFH-16 S Develop and implement Individual Healthcare Plans (IHP) for children with special health care needs, in collaboration with families, the medical home, and other related service providers.
• CFH-17 S In collaboration with the program’s mental health consultant and families, assess risk and make appropriate referrals for children with mental health concerns.
• CFH-19 S Demonstrate infection control procedures: basic assessment, initial management, and prevention of communicable diseases.
• CFH-20 S Identify indoor and outdoor hazards related to common child and adult injuries, and apply age and developmentally appropriate injury prevention strategies.
• CFH-21 S Demonstrate safe methods that meet state and Tribal requirements of administering medications, including consent, handling, labeling, storing, disposing, and recognizing possible side effects.
• CFH-22 S Support family-style meals for children and staff as appropriate.
• CFH-23 S Support positive oral health practices during program hours.
• CFH-24 S Ensure that program staff can provide first aid and CPR and always have access to well-maintained first aid supplies in order to respond to medical and dental emergencies.
• CFH-25 S Plan and oversee ongoing training to meet programmatic health and safety requirements.
• CFH-26 S Ensure staff implement health and safety practices, including daily health checks.
• CFH-27 S Establish and maintain confidentiality policies and procedures.
• CFH-28 S Maintain effective recordkeeping systems, and accurately track individual child and family health information.
• CFH-29 S Collect and use child and family health history, including current health needs, to help children and families achieve optimal wellness.
• CFH-30 S Facilitate comprehensive services, including appropriate education, information, support, and referrals for prenatal and postpartum women, fathers, and significant family members.

Engaging Families Competencies

These competencies reflect the relationship-based approach in the Head Start Parent, Family, and Community Engagement Framework and recognize that families are the most important decision makers about their children’s health.

• EF-1 A Believe that families are experts about, and the primary decision makers for, their children’s health.
• EF-2 K Understand how the attitudes, beliefs, and traditions of individuals from different backgrounds affect health practices.
• EF-3 K Be familiar with strength-based communication strategies such as reflective listening and motivational interviewing.
• EF-4 S Develop and sustain trusting relationships with families.
• EF-5 S Identify and use family strengths when addressing health concerns.
• EF-6 S Partner with families to promote safe, healthy, and nurturing home environments.
• EF-7 S Educate families about how all aspects of health affect children’s learning and school readiness.
• EF-8 S Engage families in the review and development of program policies and activities related to all areas of health (e.g., health education curriculum, menu planning).

Leadership Competencies

These competencies address how to effectively manage and lead Head Start health services and work together with families, staff, individual providers, health organizations, and other partners.

• L-1 A Be open to multiple perspectives, new information, and novel approaches to working with children, families, and staff.
• L-2 A Be willing to take advantage of professional development and support activities (e.g., training, higher education, and professional networking).
• L-3 K Know how to access and use external health resources, including technical assistance providers, health consultants, and State, Tribal, and community agencies.
• L-4 K Understand adult learning principles.
• L-5 S Gather and use community health data, make use of available resources, and develop strategies to address service delivery gaps and barriers to care.
• L-6 S Use data to plan, implement, and evaluate health services.
• L-7 S Report program-level health information to meet program, federal, Tribal, and state requirements and requests, including the Head Start Program Information Report (PIR).
• L-8 S Use technology to improve efficiency and strengthen the quality of health services.
• L-9 S Demonstrate responsive program management practices (e.g., collaboration, communication, meeting facilitation).
• L-10 S Develop, disseminate, review, and update program health and safety policies and procedures.
• L-11 S Conduct ongoing monitoring activities to ensure healthy and safe program practices and implement improvements as needed.
• L-12 S Maintain a state of readiness to address the needs of children, families, and staff that cover the three phases of an emergency: preparedness, response, and recovery.
• L-13 S Be able to successfully use USDA Food and Consumer Services Child Nutrition Programs.
• L-14 S Assist families and staff to increase their health literacy.
• L-15 S Promote staff wellness, including stress management, injury and illness prevention (e.g., staff immunizations), and healthy active living.
• L-16 S Establish partnerships with local health care providers to support the health needs of children and families and promote healthy communities.
• L-17 S Maintain a Health and Mental Health Services Advisory Committee (HMHSAC) that includes engaged Head Start families, health and mental health professionals, program staff, and other community volunteers.

How were the competencies developed?

The competencies are consistent with science-informed practices for early childhood health staff. A variety of resources informed the development of these competencies, including the Head Start Program Performance Standards; Caring for Our Children National Health and Safety Performance Standards; and published research on the early childhood health services workforce, including Transforming the Workforce for Children Birth Through Age 8, a report on the importance of a competency-based approach.

Last Updated: May 23, 2025