Texas Lawmakers: Investigate State Contract with Anti-Choice Group (Updated)

“You can’t build a health-care network and a safety net and a robust family planning program if you’re trying to contract with people who have never done the work before and who have no experience doing it."

Planned Parenthood's clinic in Bryan, Texas, closed in the wake of deep budget cuts to the state’s family planning services made by the state legislature in 2011. The clinic saw its final patients on August 1, 2013. Shutterstock

UPDATE, October 15, 1:18 p.m.: The Texas government on Friday ended its contract with the anti-choice Heidi Group, which ran the state’s women’s health program, the Texas Observer reports. State officials in August 2017 cut the group’s funding after it failed to provide the services promised. 

Eight months after Texas officials gave an anti-choice crusader’s organization a contract to provide low-income people with access to health care, there are questions from lawmakers and advocates about the apparent failure of the organization to deliver those services.

Both Republican and Democratic state lawmakers are calling for an investigation into how a contract was awarded to The Heidi Group, an anti-choice organization that has no history of providing health care or similar services, and why taxpayer dollars are being used to promote the anti-choice pseudoscience of so-called “abortion pill reversal.”

Rep. Donna Howard (D-Austin) told Rewire she was concerned with how the state contract was approved and awarded to The Heidi Group. “Certainly in terms of transparency there are issues with how the contract was provided in the first place,” Howard said. “Now I certainly have concerns in terms of oversight and accountability.”

The Texas House General Investigating and Ethics Committee will began holding hearings in the coming weeks, and Howard told Rewire that she has talked to members of the committee who indicated there should be questions about women’s health contracts, specifically the one with The Heidi Group.

Rep. Sarah Davis (R-West University Place), chairperson of the committee, questioned state officials last week about the Heidi Group contract during a committee hearing. Davis indicated the committee will scrutinize how the Heidi Group contract was awarded, reported the Associated Press.

“It’s just not looking very good. It’s not looking promising for this provider,” Davis said. “And we’re going to be back here, and talking about contracting and procurement issues with this. I’m just predicting that.”

“You Need to Buy That Building.”

Planned Parenthood’s clinic in Bryan, Texas, closed in the wake of deep budget cuts to the state’s family planning services made by the state legislature in 2011. The clinic saw its final patients on August 1, 2013. 

The clinic had long been a target of protests by anti-choice activists, as the 40 Days for Life anti-choice protests campaign began outside the clinic’s fences. A month after the clinic closed, anti-choice activists gathered beneath a revival-style tent in celebration of what they viewed as a victory. Some saw the clinic’s closing as an opportunity.

Carol Everett, a former abortion provider turned anti-choice activist, told Pregnancy Help News that within a few days of the clinic’s closure, she called Tracy Frank, the executive director of Hope Pregnancy Center. “You need to buy that building,” Everett said.

Frank told Rewire she discussed the possibility of purchasing the clinic with Hope Pregnancy Center’s major donors and presented the proposal to the center’s board of directors. She met with Dr. Haywood Robinson and Dr. Noreen Johnson, and they told Frank that if Hope Pregnancy Center purchased the clinic they “would be interested in being tenants.”

Robinson founded Brazos Medical Associates with his wife, Johnson, both anti-choice activists and former abortion providers. Robinson was involved with the Radiance Foundation’s billboard advertising campaign in Texas to promote the idea of the anti-choice “black genocide” myth. After more than a year of deliberation, Hope Pregnancy Center announced in October 2014 that the organization had bought the former Planned Parenthood clinic.

The building was purchased on October 29, 2014, by HPCBV Properties, a limited liability company registered with the state of Texas on October 8, 2014. The purchase price of the property was not disclosed, but the appraised market value at the time of sale was $639,380, according to Brazos County property tax records.

Frank told Rewire that the purchase price and renovation of the clinic was more than $750,000. 

Robinson and Johnson relocated their practice to the building to provide health-care services, including reproductive health care, well-woman exams, weight management, and more.

The 40 Days for Life campaign relocated to the same building where the organization had once maintained a constant presence.

Hope Pregnancy Center also refers clients to Testing 4 U, which provides free sexually transmitted infection testing for chlamydia, gonorrhea, syphilis, and HIV. Both Hope Pregnancy Center and Testing 4 U are affiliates of the national network of crisis pregnancy centers, or fake clinics, known as CareNet.

There were ambitious plans for the facility.

Frank told the Bryan-College Station Eagle that the clinic would serve 750 clients a year. A year later Hope Pregnancy Center announced that Testing 4 U had provided STI testing for 425 clients.

Frank told Citizen Magazine that there were plans to expand services the clinic provided to include “post-abortive physical wellness, abortion pill reversal and counseling.”

Among the services that Brazos Medical Associates reportedly offers is so-called “abortion pill reversal.”

Dr. George Delgado, a California physician who opposes abortion rights, introduced the concept of “abortion reversal.” Delgado is the medical director of Culture of Life Family Services in Escondido, California, and the medical director of the organization’s “Abortion Pill Reversal” program. 

Delgado published an article in December 2012 in the medical journal Annals of Pharmacotherapy that documented anecdotes from Catholic physicians who attempt to reverse medication abortions. The article has been criticized for methodological and scientific flaws.

The medical community has characterized so-called abortion reversal as “junk science” and “tantamount to quackery.”

Delgado’s Abortion Pill Reversal website connects people seeking to reverse their medication abortions with what the website claims is “350 participating physicians all over the country.”

Frank told Rewire that Delgado spoke to supporters during a fundraiser for Hope Pregnancy Center in April 2015. He also “spoke to the physicians at St. Joseph Center,” a Catholic hospital system that provides services at medical clinics throughout the Brazos Valley.

Frank said Hope Pregnancy Center has not referred any clients for so-called abortion pill reversals to Brazos Medical Associates, but she is aware that Johnson offers the service.

Hope Pregnancy Center’s website states that it is “possible to reverse a medical abortion,” and directs clients to Delgado’s website for more information. The organization has promoted the abortion pill reversal service on the organization’s Facebook page, and offered referrals for the service to Brazos Medical Associates.

Brazos Medical Associates did not respond to requests by Rewire for information and interviews with Robinson and Johnson.

“I Am Really Trying to Help Those Women.”

A few years after she encouraged Frank to purchase the former Planned Parenthood clinic, Everett would secure a contract from the state of Texas that would send taxpayer dollars flowing back into the clinic.

State lawmakers in 2011 sought to exclude Planned Parenthood from the Texas Women’s Health Program, which was jointly funded through federal and state dollars. Texas launched a state-funded version in 2013, which was plagued with problems. 

Lawmakers in 2016 announced the Healthy Texas Women Program (HTWP). The HTWP is designed to help women between the ages of 18 and 44 with a household income at or below 200 percent of the federal poverty level, and includes $285 million in funding and 5,000 providers across the state.

The Heidi Group was awarded a $1.6 million contract to provide family planning services through HTWP; the former Planned Parenthood clinic site in Bryan was included in Everett’s proposal.

The Heidi Group had never before provided health care services, and has focused predominantly on supporting anti-choice crisis pregnancy centers.

Everett is a member of the Women’s Health Advisory Committee, which advises the Texas Health and Human Services Commission (HHSC) on the HTWP. Texas Health and Human Services Commission spokesperson Bryan Black told the Texas Tribune that The Heidi Group had “changed its focus.”

The Heidi Group “will now be providing women’s health and family planning services required by Healthy Texas Women, including birth control, STI screening and treatment, plus cancer screenings to women across Texas,” Black said in an email to the Tribune.

Everett told the Texas Observer that The Heidi Group will facilitate helping HTWP family planning providers reach women in rural areas. “I am really trying to help those women,” Everett said. “I am not getting paid out of this money. I’m not making any money out of this.”

However, despite Everett’s promise to reach women in rural areas, the majority of the the providers included in The Heidi Group’s Women’s Wellness Coalition are located near the urban centers of the state. In fact, more than half of the providers are located in the Dallas/Fort Worth metropolitan area. 

The Heidi Group’s application lists 20 clinics operated by 16 organizations as subcontractors, and Brazos Medical Associates was among the organizations listed as providers, according to documents obtained by the Texas Observer.

The organization projects that it would provide access to family planning services for more than 50,000 clients.

The Heidi Group also appears to be funneling taxpayer dollars to fake clinics.

Life Choices Medical Clinic would receive a $120,903 subcontract, and was projected to increase HTWP clients from 10 per month to 120 per month. Wise Choices Pregnancy Resource Center would receive $101,561 subcontract, and was projected to increase HTWP clients from 60 per month to 100 per month.

Life Choices Medical Clinic and Wise Choices Pregnancy Resource Center did not respond to requests by Rewire for information about the types of services provided and the number of clients the organizations have served.

Bryan Medical Associates, doing business as Brazos Medical Associates, was set to receive a $149,919 subcontract from The Heidi Group to provide family planning to low-income women in Brazos, Burleson, Grimes, Leon, Madison, Milam, Robertson, and Washington counties, according to The Heidi Group’s contract.

Dr. Johnson, of Brazos Medical Associates, was also listed in The Heidi Group’s application as the organization’s Medical Director, and according to the organization’s proposed budget would earn a part-time salary of $62,797.

The organization was projected by The Heidi Group to increase the number of clients seen through the Texas Healthy Women program—from 50 clients per month to 150 clients per month, 1,800 clients more than the year the contract was instituted. 

Planned Parenthood served 2,700 clients by July 2013, before the clinic closed in August that same year.

Brazos Medical Associates did not respond to a request by Rewire for information about the types of services provided and the number of clients the organizations had served.

“The Whole Thing is Nonsensical”

Eight months after the The Heidi Group was awarded the contract, the organization is “quietly sputtering” and has “little to show,” according to a report by the Associated Press.

The organization hasn’t provided the promotional services it promised with the goal of increasing public awareness, and has yet to establish a toll-free number that could assist low-income women find providers.

The Heidi Group, clinic staff, and state officials all declined to comment or provide the Associated Press with the number of clients that have been served.

Howard told Rewire that she found it “extremely frustrating” that the state has not provided information about the HTWP that was promised to lawmakers; specifically, HHSC has not disclosed data on the number of clients seen by the individual providers and the program as a whole. 

“This is very serious in light of the fact that we made decisions at the state legislature to change how these services were delivered, with the intention of eventually attempting to decrease the gaps in services,” Howard said. “And yet I have no assurance that what got put into place is actually accomplishing that.”

HHSC is required by state law to submit a biannual report to the Legislative Budget Board and the governor that includes enrollment levels of targeted women with low incomes, descriptions of outreach activities, the number of providers in the network, and the “average and median numbers of program clients per provider.”

HHSC reported 114,026 Healthy Texas Women recipients as of December 2016, and reported serving 23,484 clients in the Family Planning Program as of December 2016, according to the HHSC summary of recommendations for the senate appropriations bill.

Rewire reached out to several of the Heidi Group’s providers, and only received a response from one of the providers. Health4U, which operates clinics in Fort Worth and Arlington, said in an email to “contact Heidi for any details” on the number of clients the organization served. Health4U clinics were set to receive a $694,295 subcontract from the Heidi Group, and were projected to increase the number of clients seen through the HTWP, from 166 clients per month to 745 clients per month. 

The Heidi Group projected Health4U clinics to serve 8,940 clients over the year of the contract.

Blake Rocap, legislative counsel at NARAL Pro-Choice Texas, told Rewire the reporting by the Associated Press “confirms” the criticisms that were made about the state’s decision to approve a contract with the Heidi Group.

“You can’t build a health-care network and a safety net and a robust family planning program if you’re trying to contract with people who have never done the work before and who have no experience doing it,” Rocap said. “It shows how political the decisions at the Health and Human Services agency have become.”

Everett appeared to obfuscate responsibility for her organization’s apparent inability to provide the services promised, and told the Associated Press that some of the clinics have not cooperated with efforts to attract more clients.

“We worked on one Facebook site for three months and they didn’t want to do it. And we worked on websites and they didn’t want to do it,” Everett said. “We can’t force them. We’re not forcing them.”

Everett faulted the state for delays in a $5.1 million family planning contract, and seemed to crystallize her critics’ arguments in a comment to the Associated Press. “It’s not as easy as it looks because we are not Planned Parenthood,” Everett said.

Everett’s organization claims to coordinate “services in a statewide network of full-service medical providers” intended to increase the number of providers and increase access to reproductive health care. “There is absolutely no indication she’s doing that, and because she’s not able to do it she’s blaming the providers for not working with her,” said Howard, the state representative. “The whole thing is nonsensical.”

HHSC spokesperson Carrie Williams told the Associated Press that the agency had provided The Heidi Group with “quite a bit” of technical support and acknowledged problems with the completion of the contract. “The bottom line is that we are holding our contractors accountable, and will do everything we can to help them make themselves successful,” Williams said.

Williams appeared to downplay concerns in an emailed statement to the San Antonio Current.

“Our women’s health programs were redesigned to better serve Texas, and there is a slight learning curve for everyone,” Williams wrote. “They’re a new contractor for us … there are understandably going to be some questions.”

Rocap raised concerns about the state of Texas funding “quackery,” and criticized the decision-making process by HHSC officials.

“It shows the complete lack of oversight by the agency to look at the proposal that the Heidi Group sent, interrogate whether the providers in the proposal were ever going to provide the services they promised, and whether the providers on the list were reputable physicians that the state should be funding,” Rocap said.

Howard said the state-created family planning programs exclude abortion, and she said she found it “quite astounding” that state funds are going to a provider who is offering so-called abortion reversal services.  

“It goes against everything that this program is supposed to be about,” Howard said. “Certainly with limited funding we would want programs that actually do what the expectation is for this program.”