Frequently Asked Questions

Updated February 2009

Texas Pregnancy Care Network (TPCN) often receives inquiries about its work as the prime contractor for the Texas Alternative to Abortion Services Program (the "Program"). To help you learn more about the Program, below are TPCN's responses to the questions it most often receives.

Purpose and Scope

What is the purpose of the Program?
The purpose of the Program is to enhance and increase resources available to women facing unplanned pregnancies that promote childbirth rather than abortion.

Core services include: Counseling and mentoring; pregnancy, childbirth, and parenting education classes; adoption education; assistance with food, shelter, clothing, and medical care; and referrals to other community resources.

Services are provided by a network of non-profit organizations throughout Texas, called Service Providers. Service Providers are generally classified as pregnancy support centers, maternity homes, adoption agencies, and social service agencies.

Why an Abortion Alternatives Program?
  • Necessary. The Program does not create needs; it responds to them. Thousands of women seek alternatives to abortion every day. Public funding helps ensure continuity and availability of quality services throughout Texas.
  • Progressive. Abortion alternatives represent a refreshing and rare middle ground when it comes to abortion-related issues. Allegiance to abortion rights or restrictions is irrelevant; the only allegiance required is to helping pregnant women.
  • Smart. Eliminating the "crisis" in a crisis pregnancy is a more intelligent response than hastily eliminating the pregnancy itself. Program Service Providers help eliminate the crises, and help women understand how continuing with their pregnancy is possible.
  • Decent. A society that is decent should provide pregnant women who are alone, scared, and under pressure more than just the choice of abortion as a response to an unplanned pregnancy.


Is the Program limited to decision-making about whether or not to have a baby?
No. 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. 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. Program services are delivered until the child's first birthday.

Does the Program reimburse for medical services?
No. The Program is a typical social services program, meaning its core service is counseling and mentoring. Pregnant women need and seek out much more than what the medical community alone can provide.

Service Providers

Do Service Providers charge any fees for their services?
No. All Program services are provided free of charge to clients.

What does the typical Service Provider do for its clients?
The Program's Service Providers:

  • Educate. Many women want to continue their pregnancy, but feel internal pressure to abort. Service Providers educate women about how continuing with a pregnancy—and life beyond pregnancy—is possible.
  • Protect. A "woman's right to choose" is often exercised not by women, but by coercive boyfriends, husbands, or parents. Service Providers represent a refuge from external pressure placed on women by others during a difficult pregnancy.
  • Comfort. Like anyone in crisis, women in crisis pregnancy primarily need someone to talk to. Service Providers help relieve the despair that can lead women to rash decision-making.
  • Provide. Service Providers provide mentoring, education classes, materials assistance, referrals to community and medical resources, and adoption education.
  • Connect. Through referrals, Service Providers connect clients with community and medical resources to help them throughout their pregnancy and after their child is born.

What kind of organizations participate as Service Providers?
Participating Service Providers are diverse. All offer the core service of decision-making support in favor of childbirth rather than abortion, and all provide services free of charge. Beyond that, services vary from one provider to the next, giving the Program a comprehensive array of available specialties.

Among the Program's Service Providers are the only licensed emergency maternity shelter in Texas; licensed maternity homes and residential care facilities; social service agencies that provide long-term case management by licensed social workers; pregnancy support centers that offer crisis mentoring, education classes, and materials support both during and after pregnancy; a birth doula organization that specializes in education and support during childbirth; and licensed adoption agencies that help clients decide between parenting and adoption.

Several of the Service Providers offer more than just one service; for example, several providers are licensed as both maternity homes and adoption agencies.

Is it accurate to say the Program funding is mostly for "crisis pregnancy centers?"
While pregnancy support centers are valuable participants, historically they make up less than 40% of reimbursements. Pro-life social service agencies, adoption agencies, and maternity homes are the largest funding recipients.

Some reports have accused "crisis pregnancy centers" in other states of practices that deceive or scare the clients they serve. Do organizations like that participate in the Program?
No. And although TPCN is not familiar with centers with those practices, TPCN ensures 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.

How are Service Providers funded?
The Service Providers technically are not "funded" in the sense of receiving a general grant in support of their work. Rather, 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.

What are the Program restrictions regarding participation in the Program by faith-based organizations?
Service Providers are reimbursed 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, if an organization conducts religious or spiritual activities, it must do so separately, in time or location, from TANF-funded activities.

TPCN's Service Providers must agree to comply not only with the Charitable Choice Act, but also must 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 unique to the Program, and is based on TPCN's client-centered policy that clients receiving Program services never feel 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 first obtain her written consent.

Clients

How many clients have been served since the Program began?
As of December 2008, approximately 15,000 clients had received services since the Program's inception, making more than 75,000 visits. In the current year FY 2008-09, approximately 900 new clients receive Program services every month.

Various Program metrics are available at the Program Data portion of this website.

The Program reports "clients" served and "client visits." What's the difference?
"Client visits" identifies how many times an individual Program client returns for services. For example, if client "Emily" receives Program services on Monday, Wednesday, and Friday, that is reported as one client, three visits.

Client Education

Part of the Program's budget is for purchasing client educational materials for distribution to 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.

An example of the type of material purchased under the Program is Great Beginnings, a nutrition education curriculum published by Discovery Education for pregnant and parenting teens. A university-based study of participants who completed the Great Beginnings program demonstrated increased nutrition knowledge, significant reduction in incidences of low birth-weight and Cesarean delivery, and healthier diet quality. The findings of this research were peer-reviewed and published in the Journal of the American Dietetic Association.

TPCN does not purchase any materials that are political, judgmental, reflect activist sentiments, or that contain spiritual or religious content.

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.

Accountability

How does TPCN ensure accountability within the Program?
Accountability is ensured by a combination of high standards, ongoing monitoring, and reporting.

High standards begin with TPCN's Service Provider Selection Process.

After the Service Provider Selection Process, Service Provider staff are trained in Program compliance. This initial training is repeated during an annual, mandatory re-training of all Service Providers at the end of each fiscal year.

Once initial training is complete, TPCN ensures all Service Provider staff have undergone child abuse and criminal background checks. Service Provider staff must also certify that they have a four-year degree in a social service or nursing field of study, or otherwise have received comprehensive pregnancy counseling/mentoring skills orientation and training. Other staff certifications, including agreements to follow policies on non-discrimination, confidentiality, and limited English, are also required before staff are permitted to the bill the Program for their work.

Ongoing monitoring begins as soon as a new Service Provider begins services, and occurs in various forms on a daily, monthly, and annual basis.

On a daily basis, for example, TPCN manually inspects every invoice before submitting it to an automated system, which further scrutinizes the invoice for errors or non-compliance. A full-time staff person is dedicated to this task.

On a monthly basis, TPCN reviews Service Provider performance to detect areas of service in need of continuation Program training. This review is conducted by another full-time staff person, while another full-time position is dedicated to ongoing Program training.

On an annual basis, every Service Provider receives an in-person Site Monitoring by a TPCN representative. At the Site Monitoring, the physical facilities are again closely inspected; management is interviewed to alert TPCN to changes to corporate and organizational policies; and client files are matched with reimbursed invoices to confirm that services can be substantiated. If instances of non-compliance are found for services already reimbursed by the Program, TPCN deducts the value of those services from the Service's Provider's next-month reimbursement.

Reporting occurs on a monthly, quarterly, and annual basis.

Monthly, TPCN sends monthly Vendor and Financial Reports to the Texas Health and Human Services Commission (HHSC) detailing Program activities, milestones, and expenditures. Copies of the Monthly Vendor and Financial Reports may be obtained from HHSC, upon request.

Quarterly, TPCN reports Service Provider performance, Program outcomes, and monitoring activities to HHSC via the Quarterly Status Report. Copies of the Quarterly Status Reports may be obtained from HHSC, upon request.

Annually, TPCN undergoes a CPA audit by an independent CPA firm, as well as monitoring by representatives from HHSC. Copies of TPCN's audited financial statements may be obtained by HHSC, upon request.

Is the Program efficient?
Yes. The Program is funded by a federal funding stream called TANF. As a rule, federal TANF-funded programs have an administrative overhead cost cap of 15% of the total budget. During FY 2007-08, the Program's actual administrative cost was 12.9%.

TPCN achieves efficiency in part by modeling the Texas Program after the 14 year-old Pennsylvania Alternative to Abortion Services Program. Thus, even though the Program in Texas is only several years old, its core administrative policies and procedures benefit from years of experience gained in the Pennsylvania Program, providing immeasurable savings to Texans.

Texas Pregnancy Care Network

Has TPCN been audited for its administration of the Program?
Yes, with perfect results. For the second consecutive year, the independent CPA firm PMB Helin Donovan has again issued an unqualified (perfect) opinion to TPCN regarding its fiscal program administration for the year ending August 31, 2008.

Because TPCN manages federal funds in excess of $300,000, the audit is conducted according to the very high standards required by the U.S. Office of Management and Budget Circular A-133, Audits of States, Local Governments, and Non-Profit Organizations.

Copies of TPCN's complete audited financial statements can be obtained from the Texas Health and Human Services Commission. An unaudited summary of the audited financial statements are available at the Financials portion of this website.

What is TPCN's relationship to Real Alternatives, the Pennsylvania non-profit corporation in charge of that state's abortion-alternatives program?
The Texas Alternative to Abortion Services Program is modeled after the 14 year-old Alternatives Program in Pennsylvania, which is deemed a model of efficiency and excellence in human services administration in that state. The Pennsylvania Program was designed by Real Alternatives (RA).

TPCN and Real Alternatives are separate nonprofit corporations. Because of RA's success in administering the PA Program, TPCN has hired RA to assist TPCN achieve similar results for the Texas Program.