This week, Prevent Blindness urged the U.S. Department of Health and Human Services (HHS) to withdraw and revise its proposed rule, “Reducing Federal Burden for Head Start Programs,” citing serious concerns about the impact on children’s vision screenings, eye care referrals, and school readiness. In our response to the proposed rule, Prevent Blindness outlined a set of recommendations for HHS to retain the existing federal standards for vision screening and support for families to get their child needed healthcare while providing targeted flexibilities that reflect specific local needs and capacity.
Comments are due to HHS on October 6, 2026, with a final rule reflecting public input expected over the coming months.
Read the Letter
Background
HHS is seeking to repeal the Head Start Performance Standards, which require evidence-based vision screenings to be conducted within 45 days from a child’s first enrolled day, referrals for children who need follow-up vision care, and supportive services to help families connect their child to needed care. Early detection establishes a pathway to treatment and contributes to school readiness, overall health, academic success, and future productivity that can follow a child into their adult earning years. A referral to care following a vision screening connects children who need further evaluation from an eye care provider in a timely way, and family engagement and support for follow-up eye examinations is an essential component of Head Start programs. If HHS’s proposal to repeal the Head Start Performance Standards goes forward, Head Start programs would still be required to provide vision screenings but would have significantly more variations around the timeline and processes for ensuring vision screenings and critical follow-up to eye care.
Prevent Blindness warned HHS that opting for a flexible state-driven approach to vision screenings in Head Start would create significant variability in how and when children are screened, referred, and treated and ultimately undermine the program’s goals of addressing school readiness and healthy development in young children. Approximately one in five Head Start preschoolers (21.4%) have a vision disorder, making vision-related health issues among the most common conditions identified in the program. Delays in early detection of potential vision problems during the preschool years can result in developmental delays, poorer educational outcomes, and, in some cases, permanent vision loss if not caught and treated as early as possible.
Prevent Blindness also opposed the proposed reduction in allowable administrative expenditures from 15% to 5%, warning that the change could reduce local programs’ ability to coordinate referrals, track treatment completion, and ensure children receive necessary follow-up care.
