The Pregnancy Assistance Fund

The Pregnancy Assistance Fund

Updated October 6, 2021
The Pregnancy Assistance Fund
The Pregnancy Assistance Fund (PAF) grant program was
 to provide, in partnership with states’ attorneys general
established by the Patient Protection and Affordable Care
offices, certain legal and supportive services for women
Act (ACA; P.L. 111-148, as amended), which provided $25
who experience domestic violence, sexual violence,
million in annual mandatory funding for each of FY2010
sexual assault, or stalking while they are pregnant or
through FY2019. (No new grants were issued after FY2019,
parenting an infant; and
effectively terminating the program; the ACA provisions
 to support, either directly or through a subgrantee,
that apply to the program have not been repealed.) The PAF
public awareness about PAF services for the expectant
focused on meeting the educational, social service, and
and parenting population that is eligible for the program.
health needs of vulnerable expectant and parenting
individuals and their families during pregnancy and the
The PAF authorizing law required each subgrantee to
postnatal period. The ACA identified eligible populations
provide an annual report to the state grantee that itemized
as expectant and parenting teens, college students, and
program expenditures; reviewed and evaluated its
women of any age who experience domestic violence,
performance; and described its achievements in meeting the
sexual violence, sexual assault, or stalking.
needs of participants, including the frequency with which
they used services. It also required that grantees prepare an
Section 25003 of H.R. 5376, as reported by the House
annual report to HHS on this subgrantee information, the
Budget Committee on September 27, 2021, would amend
number of subgrantees that were awarded funds, and the
the ACA to reauthorize the PAF program by providing $25
number of individuals who were served with funds.
million in mandatory funding for each of FY2022 through
FY2024. (No changes would be made to the program
IHEs, High Schools, and Community Service
itself.) For a discussion of issues associated with
Providers
reauthorization that Congress might consider, see CRS
PAF grantees could provide subgrants to high schools
Report R45426, The Pregnancy Assistance Fund: An
(schools that serve grades 7-12), community service
Overview.
organizations (organizations that provide social services
directly or by government contract), and IHEs (vocational
Background
schools, community colleges, universities, etc.). IHEs were
The research literature indicates that pregnancy has high
required to provide a 25% match of their awards with funds
costs for the individuals eligible for the PAF program.
or non-monetary support such as services and facilities .
Teenage mothers and fathers tend to have less education
and are more likely to live in poverty than their peers who
The law specified that subgrantees could carry out selected
are not parenting. Nearly one-third of adolescent females
activities on campuses and in communities, such as
who have dropped out of high school and college cite
conducting needs assessments to examine pregnancy and
pregnancy or parenthood as a reason. One analysis found
parenting resources on campuses and within communities,
that single young women who had children after enrolling
as well as setting goals for improving such resources and
in community college were 65% more likely to drop out
access to them. Other activities could include annually
than their same-age peers who did not have children after
assessing the performance of subgrantees in meeting the
enrolling. Studies further indicate that approximately 3% to
needs of participants with regard to child care, flexible or
9% of women experience domestic violence during
alternative academic scheduling, parenting education, basic
pregnancy.
provisions, and including maternity coverage and
availability of riders for additional family members in
Grant Categories and Requirements
student health coverage.
The U.S. Department of Health and Human Services (HHS)
administered the PAF program, and funding was awarded
Offices of State Attorneys General
competitively to the 50 states, District of Columbia (DC),
State grantees were required to partner with their state’s
U.S. territories, and tribal entities (hereinafter, state
office of the attorney general to provide specified
grantees) that applied successfully. The grantees were to
activities—intervention services, accompaniment services,
use the funds as follows:
and supportive social services—targeted to individuals of

any age who were pregnant or had been pregnant in the past
to provide subgrants to institutions of higher education
year and were victims of domestic violence, sexual
(IHEs), high schools, or community service providers to
violence, sexual assault, or stalking. “Intervention services”
enable these subgrantees to establish, operate, or
meant 24-hour telephone hotline services for police
maintain pregnancy or parenting services for the
protection and referral to shelters. “Accompaniment
expectant and parenting population;
services” meant assisting, representing, and accompanying
a woman in seeking judicial relief for restraining orders and
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The Pregnancy Assistance Fund
help with filing criminal charges, among other activities.
parenting individuals, 38% were dependent children, and
“Supportive social services” meant transitional and
11% were extended family members .
permanent housing, vocational counseling, and individual
and group counseling aimed at preventing domestic
HHS provided participant age and race data for expectant
violence, sexual violence, sexual assault, or stalking.
and parenting individuals, but not their children. Of the
7,564 expectant or parenting participants, more than half
These partnership grants also focused on providing training
(54%) were ages 16 to 19, and approximately 6% were age
and technical assistance (related to domestic violence,
15 or younger. Data on race were available for about 60%
sexual violence, sexual assault, or stalking against pregnant
of participants, of whom 44% were African American or
women or women pregnant within the past year) to
Black, 38% were White, and the rest were another race or
specified entities, such as government agencies,
multiracial. Ethnicity was reported for 80% of participants;
professionals working in social service settings, and
of those, 42% identified as Hispanic/Latino.
nonprofit organizations.
Services Provided to Participants
Public Awareness Activities
Grantees provided two categories of core services to meet
State grantees and/or their subgrantees could fund public
the needs of participants within each of the program’s
awareness activities for individuals who were eligible for
purpose areas: services for expectant or parenting
the PAF program. Such activities could include print
individuals, and services for dependent children. In
materials, in-person events, social media campaigns, public
FY2018, the most common categories of services provided
services announcements, and websites. State grantees were
were parenting supports and concrete supports, and health
responsible for setting guidelines or limits on how much
care services. The types of parenting supports PAF
funding was to be used for public awareness activities. HHS
expectant and parenting individuals most frequently
specified in guidance that grantees could not use PAF
received were parenting education and resources (28% of
funding exclusively for public awareness activities.
participants receiving parenting supports); healthy
relationship education, skill building, and resources (24%);
Grantees
and stress management support (22%). Of the concrete
From FY2010-FY2019, HHS provided funding to grantees
supports, expectant and parenting individuals most
in 31 states, DC, and seven tribal entities (see Figure 1). In
frequently received food (16% of those who received
general, these grantees provided PAF subgrants to high
concrete supports), transportation (14%), child needs
schools, community service organizations, and IHEs.
(13%), and means-tested benefits eligibility screening or
application assistance (13%). Of the health care services,
Figure 1. Jurisdictions with PAF Grants
individuals most frequently received health insurance
Grantees in each of the below states received funds in at least
supports (17% of those who received health care services
one year over the period from FY2010 through FY2019.
supports), reproductive health care (16%), and primary
health care (14%). The services most frequently received by
dependent children were nutritional counseling and services
(23% of those who received dependent services); health
insurance supports (22%); child care resources, referrals,
and placement (18%); and well-child/primary care visits
(18%). Some services were more likely to be provided
directly by grantees or subgrantees (e.g., case management
and home visiting services), while other services were more
likely to be referred to external organizations (e.g., health
care, child care, and food and clothing).
Evaluation
An HHS study by Mathematica Policy Research, a social
policy research organization, evaluated the effectiveness of
the program in shaping youth outcomes. The evaluation

measured selected outcomes of PAF participants in three
Source: Prepared by CRS, based on https://opa.hhs.gov/grant-
jurisdictions: Washington, DC, California, and Houston,
programs/pregnancy-assistance-fund-paf/paf-funded-grantees-fy-2010-
TX. Findings are available for the program in one of the
2019.
jurisdictions (DC), where PAF-funded services were

provided in nine high schools through a voluntary program
Participants
known as New Heights. Researchers found that teen
HHS collected and reported data on expectant and parenting
mothers improved in school engagement and credits earned
individuals and their children who received PAF services.
per year compared to teen mothers who attended the high
Overall, the PAF program has served approximately
schools immediately before the program was introduced.
110,000 expectant and parenting teens, adults, and their
Case coordinators from the program were embedded at the
families. During the 2017-2018 reporting period, 19
schools to provide case management, weekly educational
grantees (18 state grantees and 1 tribal entity) served 14,800
workshops, and in-kind incentives.
individuals. Of these participants, 51% were expectant or
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The Pregnancy Assistance Fund

Jessica Tollestrup, Specialist in Social Policy
IF11040
Taylor R. Wyatt, Analyst in Public Health Emergency
Management

Disclaimer
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