Every year millions of children under the age of 5 participate in federal and state early care and education programs. For fiscal years 2010 to 2015, Congress appropriated almost $48 billion to Head Start and over $31 billion to the Child Care and Development Fund (CCDF), the two largest sources of federal funding for early care and education. To better leverage funds, expand services, and make quality improvements, many providers delivering these early care and education services are forming partnerships with other providers or combining funds from federal and other sources. The United States Government Accountability Office (GAO) was asked to examine how state and local grantees are managing multiple funding sources and partnering with other providers to provide quality early care. This report describes what selected state officials and local child care providers identified as: (1) the benefits to integrating funding from federal Head Start, CCDF, and state Pre-K programs and partnering with other providers; (2) factors that adversely affect integration and partnering; and (3) ways these adverse impacts were mitigated. To gather information about the factors that affected integrating funds and partnering, GAO conducted 24 interviews with state officials and local providers in four states (Colorado, Maryland, Washington, and West Virginia). They initially identified states using recommendations from HHS, state officials, and child care stakeholder groups. The final list of states selected was based on the following criteria: (1) participation in the Department of Health and Human Services (HHS's) Early Head Start-Child Care Partnerships (EHS-CCP) grant program; (2) experiences with partnering among early care and education programs; (3) variation in licensing standards; and (4) differences in state income eligibility levels for CCDF. 5 In each state, GAO selected 2 to 5 providers for interviews, also based on recommendations of state officials or providers that were integrating funds or partnering as part of their provision of early care and education services. They also conducted interviews with HHS, Education, and representatives of child care stakeholder groups. GAO also reviewed relevant federal laws and regulations, agency documentation, and literature. Enclosure I provides briefing slides. Enclosure II provides comments from the Department of Health and Human Services.