Between 69 percent and 90 percent of English language learners (ELLs) in middle and high schools were born in the United States and have been in U.S. schools since kindergarten still have not achieved the academic proficiency to succeed in an all-English mainstream program. Various ELL program options are available for school districts to implement as whole-school programs or as additions to the regular curriculum. The two major models for ELLs are bilingual and monolingual programs. About two-thirds of the existing programs in K-12 schools are organized around five instructional strategies within these two programs as described here. The remaining third weave features of both the bilingual and monolingual models. As school districts choose the most effective program to meet the needs of their ELL populations, they must consider the needs and well-being of the students, their families and the communities in which they live. They also need a thorough understanding of the program options, district goals and available resources. With that knowledge, school leaders are better able to select and implement an effective education program that meets the needs of all English language learners.