GiveBetter x New York City

The Center for Great Expectations

Whole recipient; conditional START maternal-health component

Research time: 3 min on GPT-6 Astra Light
  • Research — reviewed programs, finances and impact evidence.

Updated: 2026-09-14

Donate

Summary

What do they do? CGE provides residential and outpatient treatment, home-based perinatal services, childcare and supportive housing. START brings clinical, doula and peer services to pregnant and postpartum people in eight MSA counties. The estimate charges all recipient costs while pricing only finite additional maternal health from START, not complete family or portfolio return.

Why we’re interested in this organization:

  • A concrete treatment-access pathway addresses transportation and childcare barriers.

  • Original FY2023–2025 accounts support a gross resource denominator.

  • Published program counts and outcomes can anchor questions for better causal evidence.

Our main reservations:

  • Graduate surveys and national completion comparisons do not identify CGE's incremental effect.

  • The latest verified START count is historical, and funding may replace public support.

  • Residential, child, housing and training outcomes are unpriced rather than assumed worthless.

What do you get for your dollar? $147.6M per better life: ten additional quality-adjusted life years in New York City. Whole CGE annual recognized expense charged to conditional finite maternal symptom-health from START. Residential, outpatient, infant/child, housing and training benefits remain unpriced and may dominate total value. External partner resources are stress-tested, not fully measured. Not whole-portfolio return, a lower bound or a standalone comparative ranking..

Annual START participants -> additional effective care -> maternal symptom-related utility improvement, decaying with recurrence -> finite QALYs.

1. What do they do?

CGE is the full charity, EIN 22-3560158. START is its home-based perinatal program, not a separate gift recipient. Ordinary support also funds residential and outpatient treatment, childcare, housing and training. None of those costs is removed to manufacture a cheap START price. Treatment model

2. Monitoring and information sharing

The 2024 report records 53 START clients and 118,555 session minutes, up from 39 clients in 2023. These are service outputs, not successful clinical changes. The 2025 report presents graduate recovery and anxiety improvements but does not supply an appropriate untreated comparison or complete attrition denominator; its national benchmarks are not causal controls. We do not convert the reported 65% anxiety reduction into 65% more QALYs. 2024 report 2025 report

3. Qualitative assessment

START can overcome transportation and childcare barriers by bringing clinicians, peer recovery and doula care to the home. Its current 18-month service design does not guarantee 18 months of clinical benefit. The integrated-treatment review found benefits against no treatment, but did not show statistically significant superiority over non-integrated treatment on pooled substance-use measures. We therefore discount alternative care and refrain from translating an uncontrolled before/after change directly into effect. Current program Clinical evidence and limitations

4. What do you get for your dollar?

The conditional START maternal-health component costs approximately $147.6 million per 10 MSA QALYs against the entire charity's annual cost. This is not complete portfolio return, a lower bound or a direct-service ranking.

The model carries the observed 2024 scale of 53 clients forward, then assumes 60% meaningful improvement, 50% additional treatment beyond alternatives and 50% funding response. For those improved, utility rises 0.1 initially, waning at a 50% annual hazard for no more than one year, with 3% discounting. A small 0.001-QALY treatment burden per additional client is subtracted. Every clinical and response parameter is a judgment; no overdose death or lifelong recovery is added.

START's listed counties—Essex, Hudson, Hunterdon, Middlesex, Morris, Passaic, Somerset and Union—are all within the official MSA. The wider charity reports clients from 13 New Jersey counties, so this geography does not generalize to its whole portfolio. Child development, custody, housing, other treatment and training effects remain unpriced. Positive, zero and adverse alternatives are shown. Additional clinical partner costs of $5,000 per donor-attributable improvement and a separate 25% resource stress test costs omitted from the recipient accounts.

Model, assumptions and sensitivity

All CGE gross annual resources, not the START program budget. Only a maternal symptom-health component is quantified; complete family, residential and training returns are unpriced.

START's eight listed counties are all inside the official 22-county MSA, so g=1 for this component. Other CGE clients originate in 13 New Jersey counties and do not all receive local credit.

v=ln(1+d)+rho; A=(1-exp(-v*T))/v; Qall=N*a*b*(p*u*A-h); QMSA=g*Qall; price10=10*costUSD/QMSA if positive. Cost-only sensitivities hold capacity and benefit fixed.

C
8917294 USD annual gross resource expense (observed). FY2025 Part IX plus event and bad-debt expense; investment fees already retained. [return2025] [schedule2025]
N
53 historical annual START clients (observed). 2024 count of 53; carrying that historical scale forward is an explicit judgment, not a 2025 observed count. [impact24]
p
0.6 meaningful clinical improvement fraction (judgment). Explicit scenario assumption, not a measured CGE success rate or a direct meta-analysis-to-QALY conversion. [start] [clinical]
a
0.5 additional treatment fraction (judgment). Explicit scenario assumption, not a measured CGE success rate or a direct meta-analysis-to-QALY conversion. [start] [clinical]
b
0.5 funding response (judgment). Explicit scenario assumption, not a measured CGE success rate or a direct meta-analysis-to-QALY conversion. [start] [clinical]
u
0.1 health utility improvement (judgment). Explicit scenario assumption, not a measured CGE success rate or a direct meta-analysis-to-QALY conversion. [start] [clinical]
rho
0.5 annual recurrence/waning hazard (judgment). Explicit scenario assumption, not a measured CGE success rate or a direct meta-analysis-to-QALY conversion. [start] [clinical]
T
1 maximum effect years (judgment). Explicit scenario assumption, not a measured CGE success rate or a direct meta-analysis-to-QALY conversion. [start] [clinical]
h
0.001 QALY burden per additional treated person (judgment). Explicit scenario assumption, not a measured CGE success rate or a direct meta-analysis-to-QALY conversion. [start] [clinical]
g
1 MSA fraction (judgment). All eight currently listed START service counties are in the official MSA; assumes beneficiary residency follows eligibility. [start] [clinical]
d
0.03 annual discount (judgment). Explicit scenario assumption, not a measured CGE success rate or a direct meta-analysis-to-QALY conversion. [start] [clinical]

Conditional additional maternal health: Cost: $8.9M; New York City QALYs: 0.6039667239468689; all-population QALYs: 0.6039667239468689. {"C":8917294,"N":53,"p":0.6,"a":0.5,"b":0.5,"u":0.1,"rho":0.5,"T":1,"h":0.001,"g":1,"d":0.03,"numeratorCostUSD":8917294}

Mostly alternative treatment and brief improvement: Cost: $8.9M; New York City QALYs: 0.006442458927402261; all-population QALYs: 0.006442458927402261. {"C":8917294,"N":53,"p":0.3,"a":0.25,"b":0.1,"u":0.05,"rho":1,"T":0.5,"h":0.001,"g":1,"d":0.03,"numeratorCostUSD":8917294}

Strong additional access with lasting symptom relief: Cost: $8.9M; New York City QALYs: 6.023331494929441; all-population QALYs: 6.023331494929441. {"C":8917294,"N":53,"p":0.8,"a":0.75,"b":0.75,"u":0.2,"rho":0.2,"T":1.5,"h":0.001,"g":1,"d":0.03,"numeratorCostUSD":8917294}

Complete donor replacement: Cost: $8.9M; New York City QALYs: 0; all-population QALYs: 0. {"C":8917294,"N":53,"p":0.6,"a":0.5,"b":0,"u":0.1,"rho":0.5,"T":1,"h":0.001,"g":1,"d":0.03,"numeratorCostUSD":8917294}

No symptom gain with treatment burden: Cost: $8.9M; New York City QALYs: -0.1325; all-population QALYs: -0.1325. {"C":8917294,"N":53,"p":0,"a":0.5,"b":0.5,"u":0.1,"rho":0.5,"T":1,"h":0.01,"g":1,"d":0.03,"numeratorCostUSD":8917294}

Added induced partner resources: Cost: $9.0M; New York City QALYs: 0.6039667239468689; all-population QALYs: 0.6039667239468689. {"C":8917294,"N":53,"p":0.6,"a":0.5,"b":0.5,"u":0.1,"rho":0.5,"T":1,"h":0.001,"g":1,"d":0.03,"numeratorCostUSD":8957044}

Unrecognized service-resource stress: Cost: $11.1M; New York City QALYs: 0.6039667239468689; all-population QALYs: 0.6039667239468689. {"C":8917294,"N":53,"p":0.6,"a":0.5,"b":0.5,"u":0.1,"rho":0.5,"T":1,"h":0.001,"g":1,"d":0.03,"numeratorCostUSD":11146617.5}

Counterfactual: Public contracts, Medicaid and other treatment providers continue. a discounts alternative treatment; b represents ordinary-gift capacity response. No attribution of national completion-rate gaps or all observed recovery to CGE.

Attribution: N is annual clients, not completions. p translates participation into meaningful clinical improvement, a addresses alternatives, b funding response. Children and residential graduates are not added to the same clients.

Source-grounded historical reach with subjective clinical and donor priors. Finite duration and recurrence; no lifelong sobriety, avoided overdose or intergenerational QALYs inferred from a testimonial. This price is not a complete portfolio ranking. The short symptom horizon assumes survival through modeled follow-up and does not separately estimate competing death; no mortality-prevention credit is claimed. A longer clinical extrapolation would require explicit competing mortality.

Sensitivity

  • Mostly alternative treatment and brief improvement: 13841444859 USD per 10 MSA QALYs.
  • Strong additional access with lasting symptom relief: 14804588 USD per 10 MSA QALYs.
  • Complete donor replacement: no finite positive-benefit price.
  • No symptom gain with treatment burden: no finite positive-benefit price.
  • Added induced partner resources: 148303601 USD per 10 MSA QALYs.
  • Unrecognized service-resource stress: 184556815 USD per 10 MSA QALYs.

Unresolved inputs

  • Current deduplicated START enrollment, treatment intensity, attrition and recurrence.
  • Counterfactual clinical outcomes with comparable alternative care, not national unmatched rates.
  • Ordinary-gift response after public funding loss and available Medicaid capacity.
  • Health trajectories for other residential, outpatient, housing and child services.
  • Audit details on unrecognized volunteer resources and bad-debt versus resource expenditure.

5. Funding and previous grants

Latest original gross recognized expenses are $8,487,564 in 2023, $9,161,304 in 2024 and $8,917,294 in 2025. Starting with Part IX, add event costs $131,299/$158,961/$162,242 and audited bad-debt or credit-loss adjustments $880/$92,794/$14,970. Investment fees $12,698/$14,030/$21,416 are already in Part IX, not another addback. In-kind goods are also already recognized. Bad-debt losses are included conservatively in this accounting denominator, not asserted to be new clinical resources. FY2025 original Reconciliation

FY2025 reports $2,876,745 government grants and $2,937,810 program revenue, with $8,025,893 net assets including $2,734,831 restricted. The impact report describes loss of major government funding, but no verified current marginal slot commitment is available. Existing reimbursement, partner hospitals and other donors remain in the baseline; a gift might preserve rather than expand services. Current funding account Support

Expense appendix: FY2025 Part IX is $7,140,522 program, $1,168,155 management/general and $431,405 fundraising, totaling $8,740,082. Event expense $162,242 and bad-debt expense $14,970 yield $8,917,294. Investment fees are already included. The three-year recognized mean is $8,855,387.33; it includes accounting credit losses, not only newly consumed treatment resources.

Annual expenses

Organization-level spending, including programs, administration and fundraising. The research list averages three comparable, consecutive full fiscal years when available.

  • FY 2023: $8.5M; The Center for Great Expectations Inc., EIN22-3560158, 12-month period, Accrual gross recognized expense, including netted event and audited credit/bad-debt costs; investment fees and in-kind goods once.. Source
  • FY 2024: $9.2M; The Center for Great Expectations Inc., EIN22-3560158, 12-month period, Accrual gross recognized expense, including netted event and audited credit/bad-debt costs; investment fees and in-kind goods once.. Source
  • FY 2025: $8.9M; The Center for Great Expectations Inc., EIN22-3560158, 12-month period, Accrual gross recognized expense, including netted event and audited credit/bad-debt costs; investment fees and in-kind goods once.. Source

6. Sources

  1. FY2023 original IRS990. CGE / IRS. Published: not stated; retrieved: 2026-09-14.
  2. FY2023 original IRS990ScheduleD. CGE / IRS. Published: not stated; retrieved: 2026-09-14.
  3. FY2024 original IRS990. CGE / IRS. Published: not stated; retrieved: 2026-09-14.
  4. FY2024 original IRS990ScheduleD. CGE / IRS. Published: not stated; retrieved: 2026-09-14.
  5. FY2025 original IRS990. CGE / IRS. Published: not stated; retrieved: 2026-09-14.
  6. FY2025 original IRS990ScheduleD. CGE / IRS. Published: not stated; retrieved: 2026-09-14.
  7. 2024 program and outcome report. CGE. Published: not stated; retrieved: 2026-09-14.
  8. 2025 impact and funding report. CGE. Published: not stated; retrieved: 2026-09-14.
  9. Current START scope and counties. CGE. Published: not stated; retrieved: 2026-09-14.
  10. Current relational treatment model. CGE. Published: not stated; retrieved: 2026-09-14.
  11. Integrated maternal substance-use treatment review. Milligan et al.. Published: 2010-09-01; retrieved: 2026-09-14.
  12. Official support route. CGE. Published: not stated; retrieved: 2026-09-14.