Frequently Asked Questions
Texas Pregnancy Care Network (TPCN) often receives media inquiries about its work as the prime contractor for the Texas Alternative to Abortion Services Program (the "Program"). While TPCN always tries to respond to such inquiries, it cannot always do so. To help you learn more about TPCN, below are TPCN's responses to the questions it most often receives.
What is the purpose of the Texas Alternative to Abortion Services program?
The purpose of the Texas Alternative to Abortion Services Program is to enhance and increase resources available to women facing unplanned pregnancies that promote childbirth rather than abortion, regardless of her circumstances and without fee. Through a network of pregnancy support centers, maternity homes, adoption agencies, and social service agencies (known as Service Providers) that specialize in promoting childbirth rather than abortion, compassionate, trained counselors and mentors assist women and their families in developing a positive, life-affirming approach to pregnancy and parenting. Available assistance includes counseling and/or mentoring, education, materials assistance, and referrals to other appropriate community resources. By enhancing and increasing these resources throughout Texas, more women and families will feel less compelled to choose abortion out of a sense of loneliness, helplessness, and hopelessness.
What is the scope of available services? Is this Program just concerned with decision-making about whether or not to have a baby?
Because this is an "alternatives to abortion" program, a common misunderstanding is that the main service reimbursed for in the Program is decision-making support, i.e., counseling as to whether to carry a pregnancy to term or to terminate (abort) a pregnancy. While decision-making support is a core service offered by all of TPCN's Service Providers, the majority of reimbursable services occur after an expectant mom has made the decision to continue her pregnancy. This is because the period of eligibility to receive Program services extends not only throughout pregnancy, but also after the child is born. A Program-eligible client is defined as a biological parent (mother or father): (1) of an unborn child; or (2) of a child 12 months old or younger. In other words, parents of infants receive services for a longer period of time than expectant parents, and are therefore the most eligible beneficiaries of Program services.
The scope of services that TPCN reimburses for is comprehensive. Education mentoring and classes cover many topics relevant to new and expecting parents, such as child care, financial responsibility, nutrition, healthy relationships, breast feeding, and anger management. TPCN also reimburses its providers for work done on behalf of a client, including time spent making a WIC appointment or setting up a job interview for a client. On a limited basis, TPCN reimburses its Service Providers for providing free materials assistance to their clients, such as diapers, maternity and baby clothes, and baby furniture. This is the only statewide program that provides these services to pregnant women.
While many services are reimbursable, many are not. For example, TPCN does not reimburse for abstinence education; pregnancy testing; ultrasound or ultrasound counseling; post-abortion counseling; or spiritual counseling or religious instruction.
How are Service Providers funded by TPCN?
The Service Providers technically are not "funded" in the sense of receiving a general grant in support of their work. Rather, it's more accurate to say that the Service Providers earn their pay and are "reimbursed" for very specific services delivered. This is because TPCN's relationship with each Service Provider is based on a fee-for-services contract, not a grant. Thus, TPCN only pays its Service Providers for actual time spent delivering services: no more, no less.
Some reports have accused "crisis pregnancy centers" in other states of practices that are deceptive to or manipulative of the clients they serve. Does TPCN hire organizations like that as Service Providers?
No. And although TPCN is not familiar with centers with those kinds of practices, regardless, TPCN takes measures to ensure that it only hires organizations that provide compassionate and caring client services. Misleading a woman in crisis pregnancy about the scope of available services is neither compassionate nor caring; therefore, TPCN reviews each potential provider's phone procedures and advertisements to help make sure potential clients are made aware that only alternatives to abortion are provided.
Similarly, TPCN believes it is neither compassionate nor caring to attempt client education using graphic descriptions, images, or videos of aborted fetuses. This is why TPCN disallows the use of such materials in the Program, regardless of whether a client consents to see them.
Further, it is neither compassionate nor caring to require a client to view a 20-minute video or engage in other time-consuming activities while she awaits the results of a pregnancy test that only takes 5-7 minutes to complete. Accordingly, while TPCN does not reimburse for pregnancy testing, it does review each potential provider's pregnancy-testing and other intake procedures to make sure no practices occur that contribute to, or could potentially contribute to, the anxiety of a woman experiencing a crisis pregnancy.
What are TPCN's restrictions regarding participation in the Program by faith-based organizations?
TPCN reimburses its Service Providers using federal money made available to Texas pursuant to a funding stream known as TANF (Temporary Assistance for Needy Families). Under the federal Charitable Choice Act, an organization is not precluded from participating in a TANF-funded program just because it has a faith-based mission or character. But if that organization conducts religious or spiritual activities, it must do so separately, in time or location, from the TANF-funded activities.
TPCN's Service Providers must agree to comply not only with the Charitable Choice Act, but also with an additional measure required by TPCN to ensure that client participation in any spiritual or religious activities is completely voluntary.
Thus, TPCN's Service Providers must agree not to conduct activities of worship, religious instruction, proselytization or other religious programs during the delivery of Program services. They must also agree to deliver Program services using a different person than any person that delivers spiritual or religious services to a client. This "separate counselor" requirement is a unique TPCN requirement, and is based on a client-centered policy to ensure a client receiving Program services never feels pressured by the person delivering those services to participate in religious or spiritual activities. If a client does want to participate in religious or spiritual activities, the Service Provider must obtain her written consent, and assure her that if at any time she chooses not to continue with the religious activities, that the Program services will still be available.
An additional Program requirement is that educational books or brochures that contain religious or spiritual content must not be presented to the client during the delivery of Program services, and must be housed separately (and labeled) from non-spiritual materials on bookshelves and racks, if made available to clients for browsing.
Does TPCN reimburse for adoption placement?
No. With respect to adoption, TPCN only reimburses for neutral counseling (decision-making as to whether to parent or adopt), up to the point the adoption decision is made. Thereafter, placement activities, such as parent selection, etc., are not reimbursed by TPCN. On a limited basis, TPCN also reimburses for post-adoption grief counseling.
Do participating Service Providers provide medical services?
While some of TPCN's Service Providers may offer limited medical services, such as ultrasound or STD testing, TPCN does not reimburse its providers for these services. As is typical of social service programs, this Program is a mentoring and support program and is not intended to be medical. TPCN's Service Providers are no different than any other community-based, social service organizations, such as rape crisis centers, that provide counseling, mentoring, education and related support to women and their families. Of course, TPCN's Service Providers make appropriate referrals for their clients to other community resources, whether for medical services or otherwise.
The value of TPCN's Service Providers is in no way diminished because they don't provide medical services. On the contrary, the value of these organizations is derived from the fact that they provide unique crisis mentoring services most medical providers do not know how to provide: professional and peer counseling, mentoring, education classes, and materials assistance.
Do TPCN-funded Service Providers do "clinic protests" or similar activities?
No. Nor does TPCN reimburse for any activities that resemble political activism. Further, TPCN disapproves of any client educational materials used by its Service Providers that are political, judgmental, or reflect activist sentiments, in tone or content.
TPCN itself is non-political and non-partisan.
The proposal TPCN submitted in response to the Texas Health and Human Services Commission's RFP to administer this Program states that more than 200+ organizations in Texas might be eligible to become Service Providers. To date, however, far fewer organizations are participating. Why?
TPCN cannot, of course, speak for organizations that decide not to participate; that question is more properly directed at them. But even for potential providers interested in participating, the application process takes time. TPCN's standards for becoming a Service Provider are high. This does not mean the standards are preclusive; on the contrary, most organizations agree the application process improves their organization, and therefore are willing to do what's necessary to qualify. But agreeing to meet TPCN's standards, which includes understanding and agreeing to the restrictions specific to faith-based organizations, takes time for these organizations, many of which are largely volunteer-based.
Once the organization does decide to participate, the application passes through several stages that can take several weeks or more to complete, depending on the organization. The potential provider must compile and send to TPCN documentation reflecting key operating policy and practices of its organization and services. Sometimes TPCN may ask the organization to make a revision in order to ensure the best operations, and re-submit it for review. Other times, the changes TPCN requests require action by the organization's Board of Directors.
Only after TPCN is satisfied that an organization has sound corporate governance and delivers quality, compassionate client services, does TPCN make an in-person visit to all of the organization's sites where Program services would be delivered. These in-person visits are further measures taken to ensure quality. TPCN then offers a contract, executes it, and then conducts training in Program compliance for all of the provider's staff and volunteers.
To reiterate, the process takes time. More and more organizations are submitting applications and being approved every week, and early on, TPCN is already achieving good geographical coverage across Texas, from El Paso to Sherman to San Antonio.
One other note about participation: while the Program is in the second fiscal year, TPCN's contract with HHSC was not finalized until late March 2006; TPCN began receiving and reviewing its first applications from potential providers in July 2006. Considering this "late start" to the Program, which is no fault of TPCN's, the Program is making extraordinary progress in little time. This unprecedented speed in rolling out a new statewide program in such short time is mostly made possible by TPCN's decision to license the materials and methods already used by Real Alternatives.
What is TPCN's relationship to Real Alternatives, the Pennsylvania non-profit corporation in charge of that state's abortion-alternatives program?
TPCN and Real Alternatives are separate nonprofit corporations. In TPCN's winning proposal to HHSC to administer the Program, TPCN represented that it would hire Real Alternatives to assist it in its initial administration of the Program, as Real Alternatives has demonstrated great success as the prime contractor of a similar Pennsylvania program during the past 10+ years. Real Alternatives has earned the reputation in that state as a fiscally responsible and trusted custodian of public funds. Recognizing this success and reputation, TPCN has hired Real Alternatives as its consultant, and licensed its program materials and methods in order to keep startup and administrative costs to a minimum while efficiently rolling out services across Texas.
Part of TPCN's budget is for purchasing educational materials for distribution to and use by its Service Providers. How does TPCN select appropriate materials for purchase?
TPCN only purchases educational materials that meet high quality standards. All materials must be relevant to services delivered to TPCN's target audience, which is comprised of the biological parents (mother or father) of an unborn child, or of a child twelve months old or younger. Materials that recite health statistics and/or describe medical risks (general discussion only) must be recently published and must include citations to legitimate authorities, such as the Centers for Disease Control, or otherwise to articles published in peer-reviewed medical literature. Finally, all publishers of the educational material guarantee the information provided in the education material is accurate and current as of the date of the order.
TPCN does not purchase any materials that are political, judgmental, reflect activist sentiments, or that contain spiritual or religious content.
The materials TPCN has purchased for distribution to participating Service Providers in 2007 have been reviewed and approved by the Texas Health and Human Services Commission, and include brochures, booklets, and videos addressing topics such as breastfeeding, car seat safety, and prevention of shaken baby syndrome.
How do TPCN's Service Providers approach discussing some of the conflicting science and medical issues regarding abortion risks?
TPCN encourages and educates its Service Providers to follow a model of ethical informed consent when it comes to health related topics that are the subject of professional disagreement in the academic community.
For example, whether abortion contributes to an increased risk of breast cancer is a prime example of a potential abortion risk that deserves careful discussion due to conflicting science. An outline of discussion on this topic that follows a model of ethical informed consent is that generally followed by the Woman's Right to Know booklet, published by the Texas Department of State Health Services. A summary of that outline is as follows: while some studies demonstrate a link between having an abortion and an increased risk of developing breast cancer, other studies have not demonstrated the existence of such a link; accordingly, more research is needed.
Texas Pregnancy Care Network (TPCN) often receives media inquiries about its work as the prime contractor for the Texas Alternative to Abortion Services Program (the "Program"). While TPCN always tries to respond to such inquiries, it cannot always do so. To help you learn more about TPCN, below are TPCN's responses to the questions it most often receives.
What is the purpose of the Texas Alternative to Abortion Services program?
The purpose of the Texas Alternative to Abortion Services Program is to enhance and increase resources available to women facing unplanned pregnancies that promote childbirth rather than abortion, regardless of her circumstances and without fee. Through a network of pregnancy support centers, maternity homes, adoption agencies, and social service agencies (known as Service Providers) that specialize in promoting childbirth rather than abortion, compassionate, trained counselors and mentors assist women and their families in developing a positive, life-affirming approach to pregnancy and parenting. Available assistance includes counseling and/or mentoring, education, materials assistance, and referrals to other appropriate community resources. By enhancing and increasing these resources throughout Texas, more women and families will feel less compelled to choose abortion out of a sense of loneliness, helplessness, and hopelessness.
What is the scope of available services? Is this Program just concerned with decision-making about whether or not to have a baby?
Because this is an "alternatives to abortion" program, a common misunderstanding is that the main service reimbursed for in the Program is decision-making support, i.e., counseling as to whether to carry a pregnancy to term or to terminate (abort) a pregnancy. While decision-making support is a core service offered by all of TPCN's Service Providers, the majority of reimbursable services occur after an expectant mom has made the decision to continue her pregnancy. This is because the period of eligibility to receive Program services extends not only throughout pregnancy, but also after the child is born. A Program-eligible client is defined as a biological parent (mother or father): (1) of an unborn child; or (2) of a child 12 months old or younger. In other words, parents of infants receive services for a longer period of time than expectant parents, and are therefore the most eligible beneficiaries of Program services.
The scope of services that TPCN reimburses for is comprehensive. Education mentoring and classes cover many topics relevant to new and expecting parents, such as child care, financial responsibility, nutrition, healthy relationships, breast feeding, and anger management. TPCN also reimburses its providers for work done on behalf of a client, including time spent making a WIC appointment or setting up a job interview for a client. On a limited basis, TPCN reimburses its Service Providers for providing free materials assistance to their clients, such as diapers, maternity and baby clothes, and baby furniture. This is the only statewide program that provides these services to pregnant women.
While many services are reimbursable, many are not. For example, TPCN does not reimburse for abstinence education; pregnancy testing; ultrasound or ultrasound counseling; post-abortion counseling; or spiritual counseling or religious instruction.
How are Service Providers funded by TPCN?
The Service Providers technically are not "funded" in the sense of receiving a general grant in support of their work. Rather, it's more accurate to say that the Service Providers earn their pay and are "reimbursed" for very specific services delivered. This is because TPCN's relationship with each Service Provider is based on a fee-for-services contract, not a grant. Thus, TPCN only pays its Service Providers for actual time spent delivering services: no more, no less.
Some reports have accused "crisis pregnancy centers" in other states of practices that are deceptive to or manipulative of the clients they serve. Does TPCN hire organizations like that as Service Providers?
No. And although TPCN is not familiar with centers with those kinds of practices, regardless, TPCN takes measures to ensure that it only hires organizations that provide compassionate and caring client services. Misleading a woman in crisis pregnancy about the scope of available services is neither compassionate nor caring; therefore, TPCN reviews each potential provider's phone procedures and advertisements to help make sure potential clients are made aware that only alternatives to abortion are provided.
Similarly, TPCN believes it is neither compassionate nor caring to attempt client education using graphic descriptions, images, or videos of aborted fetuses. This is why TPCN disallows the use of such materials in the Program, regardless of whether a client consents to see them.
Further, it is neither compassionate nor caring to require a client to view a 20-minute video or engage in other time-consuming activities while she awaits the results of a pregnancy test that only takes 5-7 minutes to complete. Accordingly, while TPCN does not reimburse for pregnancy testing, it does review each potential provider's pregnancy-testing and other intake procedures to make sure no practices occur that contribute to, or could potentially contribute to, the anxiety of a woman experiencing a crisis pregnancy.
What are TPCN's restrictions regarding participation in the Program by faith-based organizations?
TPCN reimburses its Service Providers using federal money made available to Texas pursuant to a funding stream known as TANF (Temporary Assistance for Needy Families). Under the federal Charitable Choice Act, an organization is not precluded from participating in a TANF-funded program just because it has a faith-based mission or character. But if that organization conducts religious or spiritual activities, it must do so separately, in time or location, from the TANF-funded activities.
TPCN's Service Providers must agree to comply not only with the Charitable Choice Act, but also with an additional measure required by TPCN to ensure that client participation in any spiritual or religious activities is completely voluntary.
Thus, TPCN's Service Providers must agree not to conduct activities of worship, religious instruction, proselytization or other religious programs during the delivery of Program services. They must also agree to deliver Program services using a different person than any person that delivers spiritual or religious services to a client. This "separate counselor" requirement is a unique TPCN requirement, and is based on a client-centered policy to ensure a client receiving Program services never feels pressured by the person delivering those services to participate in religious or spiritual activities. If a client does want to participate in religious or spiritual activities, the Service Provider must obtain her written consent, and assure her that if at any time she chooses not to continue with the religious activities, that the Program services will still be available.
An additional Program requirement is that educational books or brochures that contain religious or spiritual content must not be presented to the client during the delivery of Program services, and must be housed separately (and labeled) from non-spiritual materials on bookshelves and racks, if made available to clients for browsing.
Does TPCN reimburse for adoption placement?
No. With respect to adoption, TPCN only reimburses for neutral counseling (decision-making as to whether to parent or adopt), up to the point the adoption decision is made. Thereafter, placement activities, such as parent selection, etc., are not reimbursed by TPCN. On a limited basis, TPCN also reimburses for post-adoption grief counseling.
Do participating Service Providers provide medical services?
While some of TPCN's Service Providers may offer limited medical services, such as ultrasound or STD testing, TPCN does not reimburse its providers for these services. As is typical of social service programs, this Program is a mentoring and support program and is not intended to be medical. TPCN's Service Providers are no different than any other community-based, social service organizations, such as rape crisis centers, that provide counseling, mentoring, education and related support to women and their families. Of course, TPCN's Service Providers make appropriate referrals for their clients to other community resources, whether for medical services or otherwise.
The value of TPCN's Service Providers is in no way diminished because they don't provide medical services. On the contrary, the value of these organizations is derived from the fact that they provide unique crisis mentoring services most medical providers do not know how to provide: professional and peer counseling, mentoring, education classes, and materials assistance.
Do TPCN-funded Service Providers do "clinic protests" or similar activities?
No. Nor does TPCN reimburse for any activities that resemble political activism. Further, TPCN disapproves of any client educational materials used by its Service Providers that are political, judgmental, or reflect activist sentiments, in tone or content.
TPCN itself is non-political and non-partisan.
The proposal TPCN submitted in response to the Texas Health and Human Services Commission's RFP to administer this Program states that more than 200+ organizations in Texas might be eligible to become Service Providers. To date, however, far fewer organizations are participating. Why?
TPCN cannot, of course, speak for organizations that decide not to participate; that question is more properly directed at them. But even for potential providers interested in participating, the application process takes time. TPCN's standards for becoming a Service Provider are high. This does not mean the standards are preclusive; on the contrary, most organizations agree the application process improves their organization, and therefore are willing to do what's necessary to qualify. But agreeing to meet TPCN's standards, which includes understanding and agreeing to the restrictions specific to faith-based organizations, takes time for these organizations, many of which are largely volunteer-based.
Once the organization does decide to participate, the application passes through several stages that can take several weeks or more to complete, depending on the organization. The potential provider must compile and send to TPCN documentation reflecting key operating policy and practices of its organization and services. Sometimes TPCN may ask the organization to make a revision in order to ensure the best operations, and re-submit it for review. Other times, the changes TPCN requests require action by the organization's Board of Directors.
Only after TPCN is satisfied that an organization has sound corporate governance and delivers quality, compassionate client services, does TPCN make an in-person visit to all of the organization's sites where Program services would be delivered. These in-person visits are further measures taken to ensure quality. TPCN then offers a contract, executes it, and then conducts training in Program compliance for all of the provider's staff and volunteers.
To reiterate, the process takes time. More and more organizations are submitting applications and being approved every week, and early on, TPCN is already achieving good geographical coverage across Texas, from El Paso to Sherman to San Antonio.
One other note about participation: while the Program is in the second fiscal year, TPCN's contract with HHSC was not finalized until late March 2006; TPCN began receiving and reviewing its first applications from potential providers in July 2006. Considering this "late start" to the Program, which is no fault of TPCN's, the Program is making extraordinary progress in little time. This unprecedented speed in rolling out a new statewide program in such short time is mostly made possible by TPCN's decision to license the materials and methods already used by Real Alternatives.
What is TPCN's relationship to Real Alternatives, the Pennsylvania non-profit corporation in charge of that state's abortion-alternatives program?
TPCN and Real Alternatives are separate nonprofit corporations. In TPCN's winning proposal to HHSC to administer the Program, TPCN represented that it would hire Real Alternatives to assist it in its initial administration of the Program, as Real Alternatives has demonstrated great success as the prime contractor of a similar Pennsylvania program during the past 10+ years. Real Alternatives has earned the reputation in that state as a fiscally responsible and trusted custodian of public funds. Recognizing this success and reputation, TPCN has hired Real Alternatives as its consultant, and licensed its program materials and methods in order to keep startup and administrative costs to a minimum while efficiently rolling out services across Texas.
Part of TPCN's budget is for purchasing educational materials for distribution to and use by its Service Providers. How does TPCN select appropriate materials for purchase?
TPCN only purchases educational materials that meet high quality standards. All materials must be relevant to services delivered to TPCN's target audience, which is comprised of the biological parents (mother or father) of an unborn child, or of a child twelve months old or younger. Materials that recite health statistics and/or describe medical risks (general discussion only) must be recently published and must include citations to legitimate authorities, such as the Centers for Disease Control, or otherwise to articles published in peer-reviewed medical literature. Finally, all publishers of the educational material guarantee the information provided in the education material is accurate and current as of the date of the order.
TPCN does not purchase any materials that are political, judgmental, reflect activist sentiments, or that contain spiritual or religious content.
The materials TPCN has purchased for distribution to participating Service Providers in 2007 have been reviewed and approved by the Texas Health and Human Services Commission, and include brochures, booklets, and videos addressing topics such as breastfeeding, car seat safety, and prevention of shaken baby syndrome.
How do TPCN's Service Providers approach discussing some of the conflicting science and medical issues regarding abortion risks?
TPCN encourages and educates its Service Providers to follow a model of ethical informed consent when it comes to health related topics that are the subject of professional disagreement in the academic community.
For example, whether abortion contributes to an increased risk of breast cancer is a prime example of a potential abortion risk that deserves careful discussion due to conflicting science. An outline of discussion on this topic that follows a model of ethical informed consent is that generally followed by the Woman's Right to Know booklet, published by the Texas Department of State Health Services. A summary of that outline is as follows: while some studies demonstrate a link between having an abortion and an increased risk of developing breast cancer, other studies have not demonstrated the existence of such a link; accordingly, more research is needed.
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