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The American health care industry wastes $1T by some estimates, and possibly as much as 30% of health care spending by others. US health care expenditures are twice the OECD average – for instance, we spend twice what the UK does on health care (as a percentage of GDP) – and American health care costs are growing at 5% a year.Healthcare presents one of the greatest policy challenges for our country because profit incentives and care for the patient are often misaligned. It’s clear that the government is going to play some role in making sure the least well-off Americans have access to medicine, but we need healthcare policies that incentivize providers and payors to educate patients to make informed, data-driven choices. Only intelligent consumer choice will stimulate functioning, competitive markets in insurance, patient care, the pharmaceutical industry, and elsewhere. Today, pharmaceutical companies, health providers, electronic health record (EHR) systems, and other actors often have misaligned incentives and fail to enable more efficient solutions that do more for the patient per dollar - indeed, often the winners in these areas are those that unnecessarily charge more. Aligning incentives will spur top technology startups to develop innovative healthcare solutions, bring down costs, and deliver superior outcomes to American patients. Here are a few necessary reforms:Medical SchoolsExperts project a total physician shortfall of between 42,600 and 121,300 by 2030.* We need more medical schools fast, but the Liaison Committee on Medical Education accreditation process takes 8 years on average and most states require new medical schools to obtain a “certificate of need” before beginning construction. In addition, medical schools are required to sustain the high overhead of medical research rather than focusing exclusively on training doctors, and inflexible requirements prevent medical schools from experimenting with new curricula. Organic chemistry and other undergraduate prerequisites are completely irrelevant to becoming a good practicing doctor, and should be optional.High medical school costs force students to become high-earning specialists, e.g. plastic and orthopedic surgeons, when our country really needs more primary care physicians (PCPs). Primary care physicians, nurse practitioners, and physician’s assistants are far cheaper than specialists, but limited medical school and residency supply as well as occupational licensing concerns keep them out of the market. In addition, foreign doctors are almost always required to complete a full residency before being allowed to practice in the United States. Given a current skills gap of 30,000 doctors, adding 30,000 new PCPs, nurse practitioners, or physicians assistants could save $2.3B, $5.1B, or $6B in salary costs alone relative to the current mix of specialists and primary care doctors.In addition, primary care doctors achieve better health outcomes for patients than specialists by engaging in long-term counselling, tracking, and preventive care. Scholars estimate that replacing specialists with primary care physicians at a density of 1 per 10,000 population could save $931 per beneficiary a year. Adding a supply of 30,000 primary care physicians would save our country about $150-200B a year.*If implemented correctly, data-driven telemedicine can ameliorate demand for physicians somewhat. Doctors should be able to digitally prescribe most drugs, and data from increasingly sophisticated wearables will enable physicians to swiftly and efficiently diagnose patients.Reform PBMsIn 2017 the Centers for Medicare and Medicaid Services (CMS) spent $175B on prescription drugs alone, and there are currently shortages of vital drugs across the country. An oligopoly of Pharmacy Benefit Managers (PBMs) generates $200B a year in revenue by forcing drug manufacturers to pay rebates and other kickbacks in order for the PBM to place their drug on the “formulary”, or list of insurable drugs. Securing a place on the formulary is a matter of life and death for manufacturers, and by one estimate the current value of rebates and other price concessions from manufacturers to PBMs increased from $59B in 2012 to $127B in 2016.After speaking extensively with politicians on both sides, we were thrilled to see the Senate recently outlaw PBM “gag-orders” on pharmacies by a 98-2 vote. We are encouraged to see that Alex Azar’s Department of Health and Human Services (HHS) is planning to subject PBM rebates to anti-kickback law, but we would go further and require full price transparency on PBM contracts in the style of Colorado HB 1260. Although some rebate money flows to insurers, we estimate that reforming the space could save America on the order of $50B.End of Life Palliative CareAlthough discredited by hyperbolic language about “death panels”, counselling patients at end-of-life is both cost-effective and humane. 30% of Medicare expenditures are attributable to 5% of beneficiaries who die each year, and acute care in the final 30 days of life accounts for 78% of the costs incurred in the final year of life. While acute-care for the dying should obviously be available to those who want it, our country must shift to a model of counselling and palliative care at the end of life.Just having an end of life discussion with the cancer patient reduces medical costs by 35.7% on average, and given that there are roughly 600,000 cancer deaths in the United States a year, would have saved $687M a year for cancer patients in the last week of life alone! In addition accountable care organizations (ACOs) have saved $12,000 per patient during the final three months of life by implementing home-based palliative care. If extended to all cancer, end stage renal disease, and congestive heart failure patients this program could save the country $11.7B a year.We all agree that we must treat families of the dying with delicacy and compassion. But introducing a program by which families will share in Medicare/Medicaid savings from palliative care would help families and patients factor the overall social cost of end-of-life care into their decision calculus. We estimate that extending proven programs and testing different incentives structures could save our country $30-50B a year.FDA ReformClinical trials are an arduous multi-year process and have become drastically more costly in the last 30 years. Phase II and III efficacy trials cost roughly $400M per new drug, which severely limits the number of drugs that make it to the final stage of Food and Drug Administration (FDA) approval. A “progressive approval” approach would allow drugs to be repurposed for other uses and possibly sold after passing Phase I safety trials, which establish that a drug has a favorable risk balance and qualifies as value-based care. Drug companies could gradually establish efficacy by logging the effects the drug has on each person who opts to use it over the next several years.The extreme costs of clinical trials and FDA approval not only stymie drug development and the application of treatments to new indications, they effectively privilege Big Pharma over other innovators, inhibiting innovation and medical progress. A data-driven approach in which doctors and hospitals verify drug efficacy over time would allow the FDA to concentrate its resources on ensuring safety, particularly as the market for new drugs becomes sophisticated at assimilating information from the progressive approval process. While ramping up the number of drugs approved may not save our healthcare system money on net, a framework which encourages innovation will positively impact millions of lives by improving quality of care.Give Medicare Negotiating PowerTo pass the Affordable Care Act (ACA), the Obama Administration made a critical concession: Medicare would not be able to negotiate the price of drugs by controlling which drugs make it onto Medicare’s formulary. As a consequence, our federal government is a “price taker” that must blindly accept whatever prices drug companies demand, and the American government winds up subsidizing drug development costs for the rest of the world. Drug prices at home are extremely high, representing 10% of total healthcare expenditures, and about $144B of federal healthcare spending.In many other developed countries, governments use their monopsony or near-monopsony buying power to force pharmaceutical companies to sell drugs at much cheaper rates. For instance, Canada spends 70% of what the US spends on brand name drugs, the UK 40% of what we spend, and Denmark only 35%. If the US federal government used its considerably larger “countervailing power” to negotiate reduced drug prices – whether on a case by case basis or by pegging the value of a Quality Adjusted Life Year at a generous but fixed rate - savings could be in the range of $30-40B, possibly even as high as $90B a year.Pharmaceutical industry lobbyists (PhRMA) argue that high drug prices are necessary to stimulate R&D which generates many new life saving drugs every year. But in fact, median R&D spending on new cancer drugs – the most difficult to develop – is only around 40% of total revenue. In addition, most R&D is funded by American universities, and manufacturers of silver-bullet specialty drugs could continue to charge high prices to a federal payor. Giving government negotiating power isn’t a novel solution, but it’s one of the correct solutions to driving down drug costs for Americans.Tort LawThe threat of malpractice lawsuits forces doctors to engage in costly defensive medicine. Although the current administration has made some progress on tort reform (making arbitration legal for federal contractors and nursing homes), Congress must insist on Texas-style reforms including capped punitive and noneconomic damages from healthcare providers, eliminating contingency fees for speculative tort lawyers, reinforced federal preemption doctrine for food and drug products, and more. Unfortunately the trial lawyers lobby – one of the biggest political donors in the country – will fight reform at every step of the way.Some studies estimate that reducing physician malpractice fears to “somewhat concerned” about malpractice would decrease costs by 14%, saving the country $100B a year. Others argue that medical liability reform could save our country up to $210B a year. Congress must protect our doctors from being attacked by unscrupulous prosecutors in order to reduce the cost of healthcare for American citizens. We all agree that we must insist on protecting patients, but unchecked tort lawsuits just punish American patients and taxpayers with an unaffordable system.Data InteroperabilityThe ACA’s “meaningful use” requirements did little to make healthcare data accessible. As of 2015, only 6% of health care providers could share patient data with other clinicians who use an EHR system different from their own. Although 21st Century Cures Act made “information blocking” illegal, big EHR vendors routinely prevent their competitors from importing patient data by disclosing health records in garbled, incoherent formats. As a result, physicians are unable to make fully informed decisions about their patients.Judy Faulkner, CEO of EPIC, famously condescended then Vice-President Biden, “Why do you want your medical records? They’re a thousand pages of which you understand 10.” The answer is that only real, semantic interoperability which makes health data available to third parties via and open application programming interface (API) will allow an innovation ecosystem of apps, medical devices, and novel insurance plans to flourish. Granular, transparent healthcare data will allow entrepreneurs – whether college students or IBM executives – to invent new solutions from the bottom up and swiftly incorporate best practices into their businesses. In addition, direct service-to-service comparisons will allow consumers to make informed decisions about how to stay healthy, stimulating market competition for their dollars.We have been excited to see CMS’s Blue Button 2.0 API program formalize the Fast Healthcare Interoperability Resources (FHIR) standard for health records, which includes programmer resources, a complete API, and gives beneficiaries full control over their data – but EHR providers are refusing to use it. While any EHR system should ensure compliance with the Health Insurance Portability and Accountability Act (HIPAA) by storing protected health information on secure servers, we need to make interoperability truly mandatory.If patients could easily share their medical records with new providers and selectively reveal their data to health apps, fitness devices, diagnostic companies, insurers, and academic researchers, our entire healthcare industry would become hugely more affordable and effective. Reliable, real-time information about which treatments work, which failed, and what they cost will enable hospitals to identify and minimize cost centers as they strive to produce care more cheaply than federal benchmarks and share in the savings.Financing ReformOvertreatment and poor physician incentives may be the main driver of health care costs. Most hospital networks are local monopolies with limited incentives to innovate or save money. Replacing this broken system with value-based care models will immediately save over $100B in total, and should grow steadily over time to $200-300B as doctors harness digital technology interventions and other new techniques to make care cheaper and more effective. We break down a few potential sources of savings below:Bundled PaymentsThe Bundled Payment Care Initiative (“BPCI”) introduced in 2013 shows serious promise in making acute care clinical workflows more efficient, particularly in orthopedic care and oncology. Results continue to improve as providers adapt to the program.After adopting a bundled payment model, the NYU Medical center reduced costs to Medicare by 10% and reduced patient stays by 25% for total hip arthroplasty procedures, and a private practice joint arthroplasty generated 20% savings for CMS per episode while decreasing readmissions. The Congressional Budget Office estimates that a voluntary bundled payments system could save Medicare $6.6B a year. If CMS makes bundled payments mandatory for both Medicare and Medicaid, achieves health record interoperability, and allows the ecosystem to iterate on data-driven incentives, we expect savings to surpass $100B.Accountable Care OrganizationsACOs are widely seen as the Affordable Care Act’s main instrument to rein in health care spending, and ultimately we expect that bundled payments will be folded into a broader ACO model. To date ACOs have generated modest savings on average, but some, such as the Memorial-Hermann ACO, have generated 11% savings for Medicare. ACO contracts are more efficient if they involve two-sided risk (rewards for savings, penalties for overages), but studies have shown that even early versions of upside-risk only ACOs are associated with a 3% reduction in Medicare reimbursement. In addition, Medicare ACOs have improved quality measures across the board, despite their old, sickly populations.Provider networks are still adjusting to the ACO model, and returns will increase in the future. Projecting savings at 5-10% and assume that all Medicare beneficiaries are enrolled in ACO providers, ACOs would save Medicare $30-60B a year. If extended to Medicare and Medicaid, full ACO enrollment could generate between $56-112B a year.Preventive MedicineThe ACA now mandates coverage for all evidence-based prevention in non-grandfathered plans, so preventative screening and vaccinations have increased since the advent of Obamacare. However we need to drastically increase the scope of preventive medicine under the aegis of value-based care. Preventable chronic diseases are 7 of 10 top causes of death in the country, and account for 75% of health care costs. Half of American adults have chronic disease, and surprisingly, chronic illness among those younger than 65 years accounts for 67% of total medical spending. 70% of American adults are overweight, and 1 in 3 American kids and teens is overweight or obese. Prevalence of obesity has tripled since 1971.Some of the most cost-effective, successful preventive health interventions include childhood immunization, youth and adult tobacco counselling, alcoholism interventions, aspirin use for people with heart disease, and screenings for common cancers, STDs, and chronic conditions like hypertension. Evidence suggests that many other preventive health interventions are cost-neutral or increase long-term medical costs (because they extend lifespans). However critics often miss the fact that preventive health measures will extend the working careers of Americans, and pay for themselves in the long-run.In kidney care, for example, the federal government subsidizes extremely costly dialysis treatments for end stage renal disease patients but has not crafted incentives to perform preventative treatments before a patient advances to this critical, debilitating condition. Rather than fill the coffers of the corrupt duopoly that runs the dialysis industry, we should give providers incentives to halt the progression of kidney disease in its tracks. As a country we spend $42B on hemodialysis. Just getting prevention right here could save our system north of $10B a year.ConclusionFixing our sprawling, tangled healthcare system is one of our nation’s greatest policy challenges. In the coming years, America should move swiftly to embrace value-based care models which align market incentives to produce a wealth of patient data and an ecosystem of new information technologies geared at preventive treatment. At the same time, we must address specific areas where poor incentives have throttled the production and delivery of medical services. Replacing bureaucratic mandates with proven Western values of entrepreneurial innovation and educated individual decision-making will yield better patient experiences and results for Americans from every walk of life while saving our country $600-$900B annually – a transformative amount of money for the well-being of our nation.

We were never supposed to look like this.Until 1965, immigration to the United States was determined by a blatantly discriminatory national quota system. The brainchild of Congressman Albert Johnson, this system used the findings of a 1907 Congressional Report, the "Dictionary of Races or Peoples", to determine what ethnicities to prioritize for entry into the United States.People coming from Northern and Western European countries were heavily favored over those from countries like those Trump now derides. More than 50,000 immigrant visas were reserved for Germany each year. The United Kingdom had the next biggest share, with about 34,000.Ireland, with 28,000 slots, and Norway, with 6,400, had the highest quotas as a share of their population. Each country in Asia, meanwhile, had a quota of just 100, while Africans wishing to move to America had to compete for one of just 1,200 visas set aside for the entire continent.Despite fierce opposition from President Truman in 1952, this system continued mostly unchanged until 1965, when, in the wake of the Civil Rights movement, advocates sought to bring immigration policy in line with other anti-discriminatory measures.Congress found itself in a pickle. There was sizable pressure to undo the codification of discrimination in immigration law, yet few wanted to change the ethnic makeup of the country.“The people of Ethiopia have the same right to come to the United States under this bill as the people from England, the people of France, the people of Germany, [and] the people of Holland,” complained Senator Sam Ervin, a Democrat from North Carolina. “With all due respect to Ethiopia,” Ervin said, “I don’t know of any contributions that Ethiopia has made to the making of America.”Representative Micheal Feighan, a Democrat from Ohio, came up with a compromise. Instead of using national quotas, America would prioritize the family of United States citizens. It was simple, the vast majority of Americans were white, and prioritizing their relatives meant that the vast majority of future migrants would be white. This would prevent an officially discriminatory policy, while retaining the then current ethnic makeup of the United States. As described in an issue of The American Legion Magazine:It preserved the bulk of the national-origins base of immigration to the United States, but keyed it to a system of preferences rather than quotas.But Feighan had made a huge miscalculation.In the following decades, immigration from Europe would fall flat, while immigration from Asia and Latin America would rise drastically. The phenomenon that followed, in which these immigrants would migrate to the United States and go on to sponsor other members of their family, would result in the exact diversification that many supporters of this bill sought to prevent.This law is still the basis for our immigration system today, and while refugees and employment-based migrants do represent sizable portions of our legal non-citizen population, the majority still come via family-based migration.Of the more than 1 million new green-card holders in 2016, 48 percent were immediate relatives of U.S. citizens, 20 percent entered through a family-based preference, and 12 percent via an employment-based preference. Another 13 percent adjusted from refugee or asylee status, and 4 percent were diversity lottery winners.It is this prioritization scheme that President Trump, with his proposed expansion of the public charge rule, hopes to undercut. This executive order would give the Trump Administration great leeway in determining the makeup of immigrants to the United States, without legislation from Congress.The impact of this change would go far beyond incoming migrants, with potentially severe ramifications for public health, intergenerational mobility, and the American Economy. This would be the most significant change in federal immigration policy in decades and among the most consequential decisions of Trump’s presidency.What is a Public Charge?The best description would be an immigrant deemed an excessive cost to the United States government. Under the current federal policy, if an immigrant is deemed excessively dependent upon government benefits, they can be considered a “public charge” and thereby made inadmissible to the United States.For purposes of determining inadmissibility, “public charge” means an individual who is likely to become primarily dependent on the government for subsistence, as demonstrated by either the receipt of public cash assistance for income maintenance or institutionalization for long-term care at government expense.The current policy was set following the 1996 Personal Responsibility and Work Opportunity Act, under which the public benefits available to recent immigrants were drastically reduced. Right now, only cash benefits (TANF) and government-funded institutional care are considered, with only 3% of current immigrants using benefits that could be used in a public charge determination. The Trump Administration intends to modify this rule, with the proposed revision including cash, healthcare, food, and tax benefits.Below is an overview of the proposed changes.In light of these changes, there would be a new determination scheme with the following negative and positive factors.NegativeAuthorization to work without employment prospectsCurrent use or receipt of one of these benefits/tax credits.Use or receipt of public assistance within the last 36 monthsPresence of a medical condition and presumed necessity of government means in paying or treatmentA previous public charge determinationOther factors as warranted, according to DHS discretionPositiveFinancial assets. resources, and support of at least 250 percent of the federal poverty levelWork authorization and current employment with an annual income of at least 250% of federal poverty guidelines.Other factors as warranted, according to DHS discretionBenefit use by individuals and their dependents would be considered.This would drastically increase the number of immigrants that could be deemed a public charge, going from 3 to 47% of the non-citizen population. States with larger immigrant communities and more immigrant-friendly welfare systems, like California and New York, would be especially affected.The latest draft indicated that the Administration has not decided if a public charge determination should be grounds for deportation. If this were to occur, the number of unauthorized immigrants within the United States could drastically increase, and many previously legally present immigrants could face deportation for their or their families use of public benefits.Children's HealthThe ramifications of this rule change go far beyond these migrants. Millions of them have citizen children, a significant portion of whom have Medicaid/CHIP coverage.Most of these parents work, yet 67% have incomes below 250% the FPL encouraged by these new guidelines. This could make permanent entry into the United States very difficult for these parents, and risks destabilizing the lives of their American children.This policy could drastically reduce use rates of benefit programs among immigrants, even among those who couldn’t be deemed a public charge. After the 1996 bill several non-determinable immigrants and their relatives (refugees, beneficiary children) stopped using welfare benefits, a decline not accounted for by increased naturalization or rising income.The fear of losing future citizenship, coupled with the possible threat of deportation, and the hostility surrounding immigration today, could result in a massive exodus of children from public benefit programs. The Kaiser Family Foundation estimates that around 75% of disenrollees would become uninsured. If the dis-enrollment rate is high enough, millions of American children could lose access to health services.The positive effect of healthcare on children’s health is well documented, and such a mass exodus could spark a miniature public health crisis. Current immigration rhetoric and fear towards this proposal has already sparked a downturn in benefit applications in Central Texas.Under the proposed change, if family members receive government services — even if those family members are citizens — it would ding the applicants' chances of approval for permanent residency. “We are seeing families having to make this impossible choice,” says Maria Hernandez, the founder of Vela, a non-profit in Austin that helps parents who have children with disabilities.Moreover, widespread withdrawal's from SNAP could result in these children losing an essential means of combating food insecurity. As noted by the Children's Health Watch:These data suggest that young children from families that have been cut off from SNAP or had their SNAP benefits reduced when their income exceeds eligibility limits are significantly more likely to be in poor health, be at risk for developmental delays and experience child food insecurity than those whose families currently receive benefits.These changes could harm the prospects of some of our greatest economic contributors, second-generation immigrants.Generational View of ImmigrantsWhile immigrants may, on average, earn less than American citizens, it’s important to consider their fiscal impact from a generational perspective.The tax contributions of first generation immigrants are significantly lower than the native born. However, their descendants’ tax contributions are noticeably higher than their own, and are even greater than third-plus generation immigrants.Wages across immigrant generations reflect this trend, with second-generation immigrants again outperforming their predecessors and successors.We see the same in education, though our incoming immigrant population is more educated than it was in the past, resulting in less of an educational disparity than previous generations.However, first-generation immigrants compare remarkably well when considering federal benefit use per capita, with these immigrants likely to use less federal benefits over the course of their lives. This is particularly noticeable among the elderly, with elderly immigrants averaging thousands less per year in received benefits than succeeding generations. While the first generation is more costly to the government due to smaller tax contributions, their lower benefit usage does not support the notion of excessive dependency.Moreover, low TANF usage rates and high employment rates in immigrant families suggests that immigrants are likely to use welfare policies as work supports, with non-citizens and naturalized citizens in benefits receiving families being employed at higher rates than U.S born citizens.Altogether, we see clear evidence here of upward progression across generations. Many immigrants come here poor, yet they work at higher rates when receiving benefits, average less benefit use per capita when factoring in age, and their children tend to earn more and make higher tax contributions than other natives.Role in the American EconomyHowever, it would be a mistake to delineate the contributions of first-generation immigrants to some tax dollar to benefit use ratio. Immigrants, poor and wealthy, make up sizable portions of many American industries. They work in numerous sectors that are unpopular to American citizens, and increasing specialization has seen their representation in several fields go up over time.Over time, low-skilled immigrants have become more specialized in particular lines of work. The share employed in immigrant-intensive sectors in 2015 reaches 14.8 percent in construction (from 7.8 percent in 1990), 11.3 percent in eating and drinking establishments (from 8.7 percent in 1990), 7.2% in personal services (from 6.9% in 1990), and 6.9 percent in agriculture (from 5.7% in 1990).That isn’t to say all aspects of immigration are positive. Immigrants may slightly decrease the wages of similarly skilled natives, and costs associated with immigration are disproportionately assigned to state governments. Yet the benefits provided by these immigrants are manifold. They are responsible for the continued growth of our labor force, increase aggregate demand, increase productivity, are critical to the “care economy”, and their communities often serve as fertile grounds for new businesses.These communities are especially important. They provide a social and economic bedrock for these immigrants and serve as incubators for many hopeful entrepreneurs among them. Immigrants account for 90% of self-employment growth since 2000, with growth among “low skilled” immigrants being especially high. Altogether immigrants are on average far more entrepreneurial than American citizens, and as noted by Representative Zoe Lofgren,I often say I am glad that Google is in Mountain View rather than Moscow. Like eBay, Intel and Yahoo!, Google was founded by an immigrant. But it’s worth noting that none of the founders of these companies came to the U.S. because of their skills.There’s also evidence to suggest that low-income migrants exude an upward pressure on natives in an increasingly automatized economy, causing them to pursue higher wage productive occupations and protecting them from many of automation’s pitfalls.The increasing number of low-wage positions, such as manual-intensive personal services, was mostly filled by immigrants, thus moderating the resulting upward wage pressure. This contributed to push natives to upgrade their skills and join better paying production occupations, even as employment of computer capital continued to rise. This reduced the ‘de-routinisation’ of native employment and boosted natives’ routine and analytical wages through an increase in aggregate demand.The benefits provided by low income immigrants might not be obvious when only considering taxes. But they are an important cog in the American machine, and their loss would be felt.Looking AheadIn threatening the legal status of these immigrants, we risk increased unemployment, an increased unauthorized population, a labor shortage in several key American industries, a loss of entrepreneurship, a spike in the uninsured population, increased hunger, increased child poverty, and endangering some of our most productive future taxpayers.These immigrants are not on the periphery waiting to enter, they are contributing inhabitants of our country. They work in our fields and hospitals, our homes and restaurants, our roads and our factories. Their children attend our schools and share our playgrounds.The Trump administration has often questioned the place of immigrants in the United States, and in light of this proposal, Americans have an important choice to make.These immigrants have worked to become ours.Will we allow them to?Glossary and Miscellaneous InformationNon-Citizen: Any person in the United States, legally or illegally, who is not a citizen.Non-Determinable Immigrant: immigrants who cannot be determined a public chargeBeneficiary children: benefit receiving children with non-citizen parentsCare Economy: “Part of human activity, both material and social, that is concerned with the process of caring for the present and future labour force, and the human population as a whole, including the domestic provisioning of food, clothing and shelter. “Graphs showing wages, tax contributions, education and benefit usage display averages per age.SourcesEverything you need to know about family-based migrationHow the Immigration Act of 1965 Inadvertently Changed Americahttps://fas.org/sgp/crs/homesec/R43145.pdfFrequently Requested Statistics on Immigrants and Immigration in the United StatesPublic ChargeChilling Effects: The Expected Public Charge Rule and Its Impact on Legal Immigrant Families’ Public Benefits UsePotential Effects of Public Charge Changes on Health Coverage for Citizen ChildrenMPI: Public Charge EstimatesFearing Deportation, Some Immigrants Opt Out Of Health Benefits For Their KidsMPI: WebinarPresident Trump's Idea Of Good And Bad Immigrant Countries Has A Historical PrecedentWhy Are Immigrants More Entrepreneurial?THE EFFECT OF CHILD HEALTH INSURANCE ACCESS ON SCHOOLING: EVIDENCE FROM PUBLIC INSURANCE EXPANSIONSFifty Years On, the 1965 Immigration and Nationality Act Continues to Reshape the United StatesAmerican Legion ExcerptThe Economic and Fiscal Consequences of ImmigrationRecent US Trends (2017 APPAM Fall Research Conference)https://www.washingtonpost.com/news/wonk/wp/2014/06/05/how-medicaid-lowers-high-school-dropout-rates-and-leads-to-more-college-grads/?utm_term=.c6cdd9a2f9a3http://www.nber.org/papers/w20178.pdfhttp://budgetmodel.wharton.upenn.edu/issues/2016/1/27/the-effects-of-immigration-on-the-united-states-economyImmigration in the era of automationPunishing Hard Work: The Unintended Consequences of Cutting SNAP Benefits - Children's HealthWatchhttps://www.brookings.edu/wp-content/uploads/2017/03/2_hansonetal.pdfJennifer Hu's answer to How do immigrants who come to the U.S. with nothing start a business?Care economyThe Advantages of Family-Based ImmigrationThe Economics of Immigration: A Story of Substitutes and Complements10 demographic trends that are shaping the U.S. and the worldSpecial thanks to Mac Tan for the help, Habib for his graphs, and Jennifer Hu for her excellent answer.

Teens browse this list for services in your area. Don’t run away, call for help.NEW YORK AMERICAN CIVIL LIBERTIES UNION (ACLU) : YRights As a Pregnant Or Parenting Teen (2007)]Pregnant or Parenting? Title IX Protects You From Discrimination At SchoolGuttmacher Data: Minors’ Rights as ParentsIf you are facing abuse or threats because of your pregnancy here is a crisis line. http://www.thursdayschild.org/html/about.htm 800-USA-KIDSRESOURCES STATE BY STATE:ALABAMA: Babies First: United Methodist Children's HomeFor teen mothers in foster care.If you are a pregnant teen in Alabama in foster care, ask your case manager, counselor or CASA worker if this program could be right for you.ALASKA Passage House: Passage House907-272-1255 (Call to get help now.)Ages 17–21ARIZONA: Girls Ranch Scottsdale: Girls Ranch - Florence Crittenton.Ask a school counselor, case manager, or CASA Advocate about Girls Ranch Scottsdale.An adult needs to help arrange admission if this program is right for you.Most but not all pregnant teens at Girls Ranch Scottsdale are in Arizona state custody.ARIZONA:The House of El-Elyon:HousingParenting ClassesAges 12–18ARIZONA: Starting Out Right: Starting Out Right | Free Pregnancy Test | Arizona Youth PartnershipCall 520–719–2014 or email [email protected] suppliesARIZONA: Tempe. TeenAge Pregnancy Program (TAPP) / APPP👩‍🎓Educational support.Case management.Counseling.Parenting preparation.ARKANSAS: Compassion House: Get Help - Compassion House479-419-9100 (Call for help.)HousingChristian orientation.Ages: 19 and underARKANSAS: Hanna House: Hannah House of Fort Smith Arkansas479–782–5683 phone or email: [email protected] 13–29CALIFORNIA: (Alameda County) Bay Area Youth Center: Real AlternativesEmail: [email protected] SkillsAges 16–25CALIFORNIA: El Nido Programs - El Nido Family Centers: Teen Family ServicesHome Visits help teens connect to healthcare, education, counseling, financial help employment and childcare.Several locations in Los Angles areaAntelope Valley: Pacoima office at: 818.896.7776CALIFORNIA:Maternity Shelter Program - Home [email protected] Diego AreaAges 18–24CALIFORNIA : (Lake County) Lake Family Resource Center. Teen Parenting/Adolescent Family Life ProgramServices for Pregnant and Parenting teensMust enroll before 19th birthdaCalifornia: Welcome to Mary's Pregnant Teen Shelter .Housing.CALIFORNIA: (Sacramento) Waking the VillageHome Infograph — Waking the VillageContact us about our housing programs: 916-601-2979HousingEducational SupportIntensive MentoringCase ManagementArt, Friendship, Community, CreativityChild Development CenterTravel, Recreation, CampingAges 18–24CALIFORNIA (HOUSING) (North Hollywood.) Youth Volunteers of America Los Angeles. (VOALA) Women’s Care Cottage. Women’s Care Cottage is an Independent/Transitional living program assisting homeless young women coming out of emergency shelters, foster care and probation. Admits women with one infant up to the age of 1 year. Provides up to 18 months – 3 years of housing, case management, counseling, social and cultural activities. Ages 18–21.COLORADO: options for Pregnant or Parenting Teens. Jefferson County Adolescent Pregnancy and Parenting Program (JCAPPP) Jeffco Public Schools. Non-residential. Specialized curricula, job-training, social support. Onsite childcare for teen parents.COLORADO: ttp://ttps://obgyn.coloradowomenshealth.com/health-info/teens/teen-pregnancy-programs Non-residential. University of Colorado/Colorado Adolescent Maternity Program. (CAMP) Specialized obstetrical care for teens. Emotional and social support.COLORADO: (HOUSING) Hope House of Colorado Quote from the website: “Hope House is metro-Denver's only resource providing free self-sufficiency programs to parenting teen moms, including Residential, GED, and College & Career Support programs. Additional supportive services include parenting and life skills classes, healthy relationship classes, and certified counseling, all designed to prepare them for long-term independence.” (ages 16 to 24)COLORADO: Yampah Mountain High School Non-residential, public School-based support for pregnant and parenting teens. High quality Infant and toddler childcare onsite.CONNECTICUT: Noank Community Support Services Clift House. Shelter care for ages infant to 18, either gender. Pregnant and Parenting teens.CONNECTICUT: Young Parents Program Public school-based services for pregnant and parenting teens. High School completion support and ONSITE childcare at High Schools for teen parents. Districts offering the Young Parents Program: Bridgeport, Griswold, New Britain, Torrington, Waterbury, Windham. Contact: Shelby Pons, MSW, [email protected] (860) 807-2126DISTRICT OF COLUMBIA: (Non-Residential) Teen Alliance for Prepared Parenting Specialized Pre-natal care. Education support. Counseling. Teen fathers also served. Ages Served: Adolescents who are pregnant and aged 21 or younger are eligible to enroll at any time during their pregnancy. Young fathers may enroll if they are expecting a child, or if they have a child under the age of five years. Once enrolled, youth may continue to participate in the program until 23 years of age.DISTRICT OF COLUMBIA: http://tps://dcps.dc.gov/page/expectant-and-parenting-students (Non-residential). Expectant and Parenting Students. New Heights. “Supportive case management and assistance with securing services, such as a childcare voucher, WIC, housing, TANF, employment, job training opportunities, college/university admissions and more.” Public High School Programs: The following schools have the New Heights program in their buildings, and can be reached at the following phone numbers:Anacostia, (202) 645-4040Ballou, (202) 645-3400Ballou STAY, (202) 727-5344Cardozo, (202) 671-1995CHEC, (202) 939-7700 ext. 5063Coolidge, (202) 282-0081Dunbar, (202) 698-3762Luke C. Moore, (202) 678-7890Roosevelt, (202) 576-8899Roosevelt STAY, (202) 576-8399Washington MET, (202)727-4985Wilson, (202) 282-0120Woodson, (202) 939-20324. DISTRICT OF COLUMBIA (HOUSING) Perennial Transitional House for Teen Parent23.DISTRICT OF COLuMBIA: HBP Teens Non-residential. Support services and structured classes for pregnant and parenting teens. Case Management and Home Visiting. Centered particularly on the needs of young African-American parents. Multi-phase program. Ages Served:12–2124.DISTRICT OF COLUMBIA: DC Social Innovation Project Non-residential. Teens to Doulas: This innovative program trains teens who are already parenting to serve as doulas for women in the community. The goal is for successful teen mothers to share their skills to reduce the risk factors in the community for other mothers.25. DISTRICT OF COLUMBIA: Teen Parent Assessment Program (TPAP)(Non-residential) Financial Issues: This is an assessment program that evaluates teens for independent living in the D.C. area. Usually, teens can apply for TANF (Temporary Assistance for Needy Families) in D.C. , but must be living with their parents to receive this aid. The Teen Assessment program determines on a case by case if the pregnant/parenting teen in an independent or other living situation qualifies for the aid. Service Contact: Teen Parent Assessment Program Contact Phone: (202) 698-6671Contact TTY: 711. If you are unable to get an appointment for the Teen Parent Assessment Program, you may need to get a referral from your school guidance counselor or other social services.26.DELAWARE: Diocese of Wilmington Bayard House27.FLORIDA: (HOUSING) Group Home, Bellview FL, Hands of Mercy Everywhere Hands of Mercy Everywhere. Christian-oriented residence that also offers diverse practical, educational, and therapeutic services to teen mothers. Ages served not specified28.FLORIDA: Hannah's Transitional Living || ANCHORAGE CHILDREN'S HOME || (850) 763-7102 Transitional living apartments for pregnant and parenting young women. Ages 16–2229.FLORIDA: Home Our Mother’s Home. Keeps teen mothers who are in foster care with their children.30.FLORIDA: (Pinellas County) Transitional Living Programs - Family Resources SafePlace2BTOO-Young Moms. (Scroll down the page for maternity services. The first program listed on the page has the same name but is for LGBT youth.) Housing and support. 18 month program. Ages 16–21.31.FLORIDA: Woman to Woman - Children & Family Services Gulf CoasJewish Children & Family Services. Non-residential mentoring and goal-setting for pregnant and parenting teens. No age range specified.GEORGIA: House of Dawn: Changing Lives, Changing Generations770–477–2385Housing👩‍🎓Educational SupportCareer and Life skillsCounselingAges 13–23GEORGIA: Home | The Living Vine Christian Maternity Home.HousingProgram emphasizes strict Christian environment, so possibly suitable only for committed Christians.Hawaii: Hale Kipa: Independent Living Program808.754.9844Emergency ShelterAges 12–17HAWAII: Neighborhood Helping Pregnant and Parenting Teens Neighborhood Place of Puna. Non-residential. Practical, material and emotional support.37.HAWAII: (HOUSING) Mary Jane Home | Catholic Charities Hawaii The Mary Jane Home. Ages Served: 18 and over.38. IDAHO: (and Eastern Washington) Alexandria's House | Volunteers of America Ages Served: 16–20.39.IDAHO: (Burley) Cassia High School Alternative Public High School. Serves teens who would benefit from an alternative school, including pregnant and parenting teens. Childcare for teen parents provided.40.IDAHO: Marian Pritchett School Marian Pritchett School. (Serving pregnant teens since 1964) Public High School for pregnant and parenting teens. Includes Giraffe Laugh Childcare for students attending Marian Pritchett School. Marian Pritchett - Giraffe Laugh.41.ILLINOS: (HOUSING) (Chicago) response-Ability Pregnant and Parenting Program (RAPPP) The Night Ministry operates 120-day housing programs for youth and for pregnant and parenting young mothers and their children. Call toll-free 877-286-2523. Ages 14–19.42.ILLINOIS: http://theharbour.org/successful-teenseffective-parents.html The Harbour. STEPS Program. Individual subsidized apartments for teens and their children. Parenting classes, counseling and case management. Age range served: not specified.43.INDIANA: Maternity Home With A Heart Hannah’s House. (HOUSING.) Faith-based/Christian. Parenting classes, counseling, referrals to community resources, emotional support. Serves ages 13 up. (Website states youngest resident they have served was 13 and the oldest was 43.)44. Indiana: Project Home IndyResidency for Teenage Mothers (Link leads to application page)HousingMedical CareEducational SupportParenting ClassesLife Skills ClassesAges 15 -19 at admission.45.INDIANA: Young Families of Indiana Network Future Promises. Non-residential school-based support for pregnant and parenting teens.46.INDIANA: (South Bend) Youth Service Bureau of St. Joseph County Young Mom’s Self-Sufficiency Program. (YMSSP) Non-residential support services.47. IOWA: Ruth Harbor - Pregnant? Christian orientation. Counseling, midwife care, doula services, recreation, outings. Ages ?-24. Does not specify minimum age.48.IOWA: Transitional Living for Teen Parents United Action for Youth. (UAC) Housing and other supports. Ages 17–21.49. IOWA: Transitional Living Services - Youth & Shelter Services, Inc. - Iowa50..KANSAS: About Us | Wichita Children's Home 1. Bridges. Housing for pregnant and parenting teen mothers 2. Moving on to Motherhood (MOM-Non-residential case management and support.)52. KENTUCKY: (HOUSING)Mother & Baby Home All God’s Children Mother & Baby Home. Faith-based. Nationally Accredited Childcare program onsite provides care for resident’s babies so they can attend school. Support, therapy, classes. Ages 13–21.53.KENTUCKY: (Louisville) Teenage Parent Program Georgia Chaffee Teenage Parent Program (TAPP). Non-residential. Provides support and services to help pregnant and parenting teens complete their high school educations.54. KENTUCKY: 👩‍⚕️ Young Parents Program (YPP.) Non-residential. Specialized obstetrical care, support and counseling. Ages served: Under age 18.55. LOUISIANA: I'm Pregnant. Now What?Phone : (318) 925-4663Crisis Line : (318) 277-9506Email : [email protected] Sanctuary for Women. Faith-based/Christian. Counseling, goal-setting, career planning, parenting classes, life skills and recreation. Participation in religious activities may be required. Onsite accredited education/certified teacher for High School completion or GED. Ages served: 13–23.56. LOUISIANA: Parenting Jus4me. Non-residential. Support and parenting classes for pregnant and parenting teens. No age range specified.57. LOUISIANA: http://ttp://www.lighthouseministriesinc.org/ The Lighthouse Child Residential Center. Faith-based. Cares for pregnant and parenting teens and their children. Licensed to care for children from birth through age 18.MAINE: FINANCIAL HELP: TANF and Teen Parents58. MAINE: rgh Rumford Group Homes Teens are housed in several different apartments supervised by the program and are provided with various services. Ages 16–21.59. MAINE: Crisis Center | Bangor, ME Shepherd’s Godparent Home. Ages served: teens to thirties.60. MARYLAND: Programp=s for Pregnant Teens and Teen Mothers | Hearts & Homes for Youth Damamli. This program is for pregnant and parenting teens in the foster care or juvenile justice system. The program starts the teen in a specialized foster home and later she lives independently with her child, with support from the program in her own apartment. Age range: 16–20.61. MARYLAND: Housing & Support Saint Ann’s: Grace House, Hope House and Faith House. Residence with onsite High School. Ages 13–21.62. MASSACHUSETTS: Programs Bridge Over Troubled Waters. Single Parent Housing. Transitional Housing for teen parents. Does not specify age range served.63. MASSACHUSETTS: (Boston) St. Mary’s Home Faith-based history but apparently no religious requirements or programming for participants. Housing. Case management, onsite high school completion, parenting classes, therapy. Ages 13–21.64. MICHIGAN: Shelter - Alternatives For Girls Provides emergency shelter for homeless teens and their children. Transitional housing program also available. Website did not mention specific maternity care programs offered. Ages 15—MICHIGAN: Eastpointe. Gianna House now open, but the website isn’t up currently. RESIDENTIAL. Ages 13–17. Contact information will be posted here ASAP>65. MICHIGAN: MI Health Family - MOASH Websites provide information on help for pregnant and parenting teens in Michigan. Michigan Organization on Adolescent Sexual Health. (MOASH) PREGNANT & PARENTING TEENS Ages served not specified.66. MICHIGAN: Michigan Adolescent Pregnancy and Parenting Program (MI-APPP) Case Management for pregnant and parenting teens. No are range specified.MINNESOTA: LEGAL RIGHTS OF TEENS: The Rights of Teen ParentsMINNESOTA: A School for Pregnant and Parenting Teens Longfellow High School. Non-residential public high school.MINNESOTA: The Nest: A Maternity Home The Nest. Focuses on ages 18–25 but may accept minors placed by parents. More information soon.MISSISSIPPI: http://mchms.org/pdfs/MCH_Two_of_Us_Brochure_032314_RGB.pdf Two of Us Therapeutic Maternity Home. Full-time licensed nursing staff. Highly specialized intensive care and education for mothers and infants. Ages 10–18.MISSOURI: 👩‍⚕️ https://www.barnesjewish.org/Medical-Services/Obstetrics-Gynecology/Women-Infants/Childbirth-at-Barnes-Jewish/Teen- Pregnancy-Center Barnes Jewish Hospital. Non-residential services, including specialized obstetrical care, classes and support. Ages 17 and under.MISSOURI: Mother's Refuge - Supporting Young Mother (HOUSING). Ages 12-21. Does not appear to focus on excessive religious pressureMISSOURI: Nativity House KC Faith-based. Roman Catholic.MISSOURI: Youth Services - reStart reStart Youth Services. Four transitional housing units for pregnant and parenting teens. Ages 16–21.MISSOURI: Home The Sparrow's Nest. (HOUSING) Ages 19 and under.MONTANA: Blackfeet Teen Pregnancy/Parenting Coalition Teen Pregnancy Parenting Coalition. Non-residential. GED tutoring. Case Management. Peer support. Nutritional Counseling. Childcare. Ages Served not specified.MONTANA: Mountain Home Montana Non-religious, comprehensive program. Housing. Bonnie Hamilton Home. (Group living) Mountain Home Apartments. (Individuals living with child.) Licensed Therapy. 24–7 mental health crisis line. Other resources. Ages 16–29.MONTANA: Nurtured baby, Healthy adult, Strong community Florence Crittenton . (Needs updating)NEBRASKA: CARES. ( info needs updating-program may be closed.)NEBRASKA: Center for Healthy Families Nebraska Mental Health/Project Harmony. Non-residential. Support services for pregnant and parenting teens. No age range specified. (Omaha residents only).NEBRASKA:Teen & Young Parent Program - Nebraska Early Childhood CollaborativeNNEVADA: “Living Grace” website is not available as of 8/15/2019. Will update as I get more information.NEVADA: Pregnant and Parenting Teen Saint Jude’s Ranch. Most residents are youth placed here by state social service and juvenile justice agencies.NEVADA: Contact Casa De Vida. (HOUSING) —More information available soon.NEW HAMPSHIRE: (Littleton)TRANSITIONAL LIVING PROGRAM (HOUSING). Case management, GED/Highschool completion, parenting classes and other services for pregnant and parenting teens and young adults. Ages served 18–21.NEW HAMPSHIRE: Our Place | Catholic Charities New Hampshire Our Place. Non-residential Faith-based. (Roman Catholic) Prenatal, breastfeeding, parenting and other classes and resources for parents of all ages.NEW JERSEY: http://ttps://www.cge-nj.org/program-offerings/adolescent-program/ The Center for Great Expectations (Adolescent Program) (HOUSING) AOther programs for women also available. Licensed Clinical Staff. Ages served: 13–18,NEW JERSEY: Capable Adolescent Mothers Crossroads Programs. (HOUSING) Intensive Long-term program. For General Program Information regarding Crossroads’ programs and services, please contact Michelle Wright at 609 880 0210, ext 109. Ages: 16–21.NEW JERSEY:services and Programs that help young homeless mothers and pregnant women Raphael’s Life House, Inc. Housing, licensed counseling, parenting classes, GED completion and career development. Ages served: Not specified.NEW MEXICO: Catholic Charities of Gallup NM (HOUSING)Casa San Jose. Residential care for pregnant and parenting teens. Ages Served: Not specified.NEW MEXICO: 14 to 17 Information Page Information from Pegasus Legal Services for Children about legal rights of minors in New Mexico, including teen pregnancy and parenting.NEW YORK: Residential Services Catholic Charities Community Maternity Services. Multiple programs: Heery Center-Ages 12–21, focuses on pregnant and parenting girls placed by juvenile and state agencies. Joyce Center is the transitional living maternity home.NEW YORK: Pregnant/Parenting Teens Children’s Village-Inwood House. Age range served not specified.NEW YORK: (Rochester) http://ttp://centerforyouth.net/index.php?cID=89 The Center For Youth. Chrysalis Program. 18 month program. Residential setting for pregnant or parenting young women. Ages 16–21.NEW YORK: Supportive Housing (Brooklyn) Diaspora Community Services/ “Mother’s Gaining Hope”. Federally funded “Maternity Group Home”. (MGH) I have not further details on ages served or its programs at this writing.NEW YORK: SERVICES SUSPENDED DUE TO BUDGET. (Concerned readers please consider donating. )(Niagara region) https://hannahhouse.ca/ Ages: through age 24. No lower age limit stated.NEW YORK: Regina Maternity Services Catholic Charities of Rockville Centre. Housing For pregnant teens and their children. Regina Residence is a structured program with case management. Mary Residence is supported independent living for graduates of Regina Residence. Ages 11–24.NORTH CAROLINA: http://www.angelhousematernityhome.org/admission_information0.aspx Angel House Maternity Home. Minimum Age: 17NORTH CAROLINA: Services for single, pregnant, & non-pregnant teens, women and their families | Florence Crittenton Services | Charlotte, NC Multiple residential programs. Ages 10 and up.NORTH DAKOTA: St. Gianna Maternity Home (HOUSING) Residents required to participate in prayers and attend Mass. Ages Served: Serves minors but does not specify age range.NORTH DAKOTA: Home | The Perry Center Serves minors placed by parents, but does not give age-range. Christian oriented services, apparently placing emphasis on evangelism but also offering life-skills and other practical services.OHIO: (Franklin County) The Center for Healthy Families The Center for Healthy Families. Non-residential. School and Community based services for pregnant and parenting teens offered at four high schools. Services for teen fathers also included. Ages: 13–19.OHIO: (Mentor, Ohio) Pregnancy - Hannah’s Home. Minimum age 18. More information available soon.OHIO: The Highlands - Shelter Care (HOUSING) Residential care for pregnant and parenting teens and their children. Ages 14–20.OHIO: (Columbus) 👩‍⚕️Teen and Pregnant Program Nationwide Children’s (Hospital). TaP. Non-residential. Comprehensive medical care, classes, counseling, referrals for pregnant girls and women ages 21.5 and under.OHIO: WIC (Supplemental food for Women, Infant Children) WIC - American Pregnancy Association\http://file:///C:/Users/17074/AppData/Local/Pa/TempState/Downloads/158843%20(1).pdfOKLAHOMA: Broken Arrow Public Schools Mentoring Healthy Parents (Formerly Margaret Hudson Program). Non-residential. Support for pregnant and parenting teens. Age range not specified.OKLAHOMA: J.A.M.E.S., INC. WEBSITE CURRENTLY DOWN> CHECK BACK SOON> Educational support and college scholarships for pregnant and parenting teens. High School seniors and college students.OKLAHOMA: http://s://www.choctawnation.com/tribal-services/member-services/choctaw-support-expectant-and-parenting-teens-sept Choctaw Support for Expectant and Parenting Teens. (SEPT) Services for teens pregnant with or parenting a Native American child under the age of one year. Must live within the 10.5 county service area of Choctaw Nation. Ages 13–21.OKLAHOMA: (Owassa) Oklahoma Baptist Homes for Children . (HOUSING) (Owassa) Maternity Cottage and transitional living apartments for Mother and Child Program. Participants must attend Southern Baptist church while in residence. Age range served not specified.OKLAHOMA: Transitional Living Program (HOUSING) Housing offered to youth, including pregnant and parenting teens and their children. Ages 16–21.OREGON: Safe Haven Maternity Home Safe Haven Maternity Home.OREGON: Dedicated to helping young mothers Saint Child. Housing for pregnant girls and women and their infants. May stay for up to a year after birth of baby. Faith-based (Christian). Counseling, education, job training, life skills and other supports. Participants are offered bible study and other Christian activities but are apparently not coerced. Ages 14–24.Pennsylvania: (Lansdale) (HOUSING) Home Morning Star Maternity Home. Ages 13–25.Pennsylvania: Maternity & Pregnancy Services - Catholic Charities of Harrisburg PAPENNSYLVANIA: http://ttps://www.valleyyouthhouse.org/programs/transitional-housing/maternity-group-home-mgh/RHODE ISLAND: (HOUSING) (may be for 18 and above only) Little Flower Home - Serving RI & Southern MA - Housing for 'Pregnant Homeless' WomenRHODE ISLAND: About Nowell Leadership Academy (Public Charter High School) For Pregnant and Parenting teens.SOUTH CAROLINA: Help for pregnant and parenting young women in South CarolinTENNESSEE: Comprehensive Resource Center The Hagar Center. Non-residential. Classes, support and material assistance.102. TENNESSEE: http://ttps://mercymultiplied.com/about-us/ Mercy Multiplied. Faith-based/Non-denominational Christian. Residential programs are located in four states for girls including a facility in Nashville, Tennessee. The programs are designed to work with on many issues, including pregnancy. The website states that the program does not demand that the pregnant mother relinquish her child to adoption, however, neither is there any indication of housing or services offered for the mother/child family. Adoption services prominently noted on website. Counseling is strongly centered on Christian teachings, although Mercy Multiplied states that its counselors are Master’s Level or graduate student interns. Counseling process includes/demands “commitment to Christ”. This program might be appropriate for young women who of their own free will wish to pursue Christianity. Ages Served: Unknown at this writing.107. TEXAS: Annunciation House: Apply for Services108. TEXAS: Apply | LifeHouse Houston. Housing and other support. Strong focus on Christian evangelizing. Ages 12 and up. (Other services for non-residential clients also available.)109. TEXAS: Teen Parenting Help - Jane's Due Process Information and support for pregnant teenagers concerning Texas legal rights.110.TEXAS: Viola's House111. UTAH: 👩‍🎓Horizonte Instruction and Training Center. Young Parent Program. Programs Non-residential. High School completion and vocational education with onsite childcare provided by Head Start. Parenting and other skills. Flexible scheduling. Contact Person: Kathy Williams (801) 578-8574 ext. 233.112. UTAH: Teen Mother & Child Program Non-residential. University of Utah/Teen Mother and Child Program. Obstetrical care/Nurse-Midwives. Social and psychological support and referrals for other needed services. Ages served: 19 and younger.113. UTAH: YWCA Of Salt Lake City. Referrals to Transitional Housing. No other details as of this writing.114. VERMONT: Family Literacy Center (Non-residential) Educational center for pregnant and parenting teens and young adults. Infants may attend classes with parents until they are four months old and after that Onsite Nationally Accredited childcare is available full-time. Onsite licensed therapy, parenting and nutrition classes and other social supports. Ages served: High school freshmen age through age 25.115. VIRGINIA: Grace Home Ministries. (HOUSING) Program is long-term and residents encouraged to stay for as long as two years with their babies. Faith based/Christian. Program includes participation in Christian experiences. However, Grace Home states: “We believe religion is a matter of personal conviction; therefore, we don’t put any pressure on program participants in matters of personal faith or beliefs. Mentoring, childcare classes, case management. Ages 1–20.116. VIRGINIA: (Lynchburg) ADOPTION-ORIENTED! Liberty Godparent Maternity Home. Services | Liberty Godparent Home If you have decided for adoption AND you are a Baptist or of a similar faith, you might consider this facility, as its emphasis is on adoption. The program does offer “Mommy and Me” support if you decide on raising your baby yourself, however, the emphasis is clearly adoption. Faith-based. (Baptist) Residents attend Thomas Road Baptist church. Other services from their website: All residents are required to attend school, pursue a GED, or participate in vocational training. Classes are offered off site at Liberty Christian Academy through Liberty University Online Academy (grades 6-12). Tutoring services for GED and SAT exams are available as needed. To help each young lady build a positive future, the LGH staff is committed to educating the residents on Life Skills and other topics such as Decision-Making, Parenting, Adoption, and Nutrition. About Us Overview | Liberty Godparent Home Ages Served: Not specified.VIRGINIA: (Fairfax County) Second Story for Young Mothers - assistance for mothersSecond Story for Young Mothers. (HOUSING) Residential services offered through independent living in townhouses for young mothers between the ages of 18–21. Pregnant and parenting teens between the ages of 16 and 18 receive non-residential community based support, education and services. Follow-up support and case management also offered. 24/7 Crisis Hotline - Call 1-800-SAY-TEEN or text “TEENHELP” to 855-11 TTY 711VIRGINIA: (Alexandria) Keep it 360 | The Alexandria Campaign on Adolescent Pregnancy (ACAP) T.C. Futures. (Non-residential.) From website: The T.C. Futures Group provides parenting meetings and developmental playgroups specifically for Alexandria’s teenage parents and their children. Parents learn about positive parenting skills, child development, and local resources. The group meets every other week after school at T.C. Williams High School. Participation is not limited to T.C. Williams students; all teenage parents in Alexandria are invited to attend. Participation is free, and Spanish translation is available. For more information, contact David Wynne, TC Williams Social Worker, at 703.824.6800.VIRGINIA (Fredricksburg) Mary's Shelter Mary’s Shelter. (HOUSING) Faith-based. Provides residential care for up to three years. Minimum Age: 18.VIRGINIA: Mommy and Me Program. ( A program component of “Youth For Tomorrow”.). (RESIDENTIAL/HOUSING) Faith based/Christian. Intensive program for pregnant teens and their infants. Education for teens at accredited school on campus, health care, parenting classes, in-house therapy and nursing staff. ) Admissions are either by court placement or social service agency referral. Teens may stay until their child is four-years-old. Ages: 12–18.VIRGINIA: (Winchester.) About | New Eve Maternity Home New Eve Maternity Home. (HOUSING). Faith-based/Roman Catholic. Help with education, employment, life skills. Ages served: 18 and above. (?)VIRGINIA: (Norfolk) THIS LISTING NOT ACTIVE CURRENTLY. WILL UPDATE ASAP. Eastern Virginia Medical School. Non-residential. Specialized obstetrical care. Classes, parenting skills, emotional support, transportation to prenatal appointments.WASHINGTON: (Seattle area.) Housing Cocoon House. (HOUSING) Housing for pregnant and parenting teens and their children. (Short -term and long-term.) Support for education, life skills and employment. Ages 12–17.WASHINGTON: (Spokane) Alexandria's House | Volunteers of America (HOUSING). “Spacious historic home”. Mentoring, support, doulas, other services. Ages: 16–20.WASHINGTON: (Spokane)http://ttp://gracesonhousingfoundation.org/ Hope and Housing for Teen Moms and their Children Graceson Housing Foundation. (Housing.) Faith-based/Christian but spiritual activities are left up to choice. This program is strong on community and nurturing. Classes, life skills, and employments skills also offered. Ages 13-18.WASHINGTON (Seattle) 👩‍⚕️ "Family Medicine Residency Teen Pregnancy and Parenting Clinic. (A program of Kaiser Permanente but you DO NOT have to be a Kaiser Permanente member to receive services.) Non-residential. Accepts Medicaid and other insurance. Prenatal care with delivery at Swedish First Hill Hospital. Offers help getting medical care coverage, nutritious food, childbirth classes, parenting classes and well-child care for the baby until two years of age. (Well-child care is only for the babies whose mothers used the Teen Pregnancy and Parenting Clinic for their prenatal care and delivery.) Open Tuesdays and Thursdays. Drop by or call: Kaiser Permanente Capitol Hill Campus, West Building 206-326-2656. On the bus line. Ages served: Not specified.WEST VIRGINIA: Crittenton Services, Inc. A Florence Crittenton program. (More information to follow)WISCONSIN: (Milwaukee) Pregnant and Parenting Youth Program (PPYP). Non-residential public school-based support.WISCONSIN: (Sheboygan) 👩‍🎓 Sheboygan Area School District Non-residential. TAPP/Parenting Lab. School-based support for pregnant and parenting teens. Guidance counselor assists pregnant students with educational plan/ONSITE childcare/parenting lab for teen parents. Classes designed/flexible to accommodate pregnancy related issues. Pregnant or parenting students in Sheboygan contact your school guidance counselor to access these services.