Reports from Alabama: Protecting Providers, Preserving Access

Vicki Saporta

Operation Save America descended on Birmingham, Alabama this week to attempt to close the city's two abortion clinics. Vicki Saporta shares updates from National Abortion Federation staff in Birmingham.

Operation Save America (OSA), led by Flip Benham, descended on Birmingham, Alabama this week to attempt to close the city's two abortion clinics. OSA traditionally hosts these week-long events each summer in a different city in the United States. Anti-abortion extremists come from across the country to protest at clinics, federal government buildings, busy intersections, churches they perceive as liberal and adult book and video stores. In recent years their message has been not only anti-abortion but anti-gay and anti-Muslim. They host mock "funerals" for fetuses, parade through town with large, graphic signs, and burn copies of Supreme Court decisions. However, their most disruptive and troubling activity is intimidating women and clinic staff at the targeted clinics. They use bullhorns to preach and yell at women. They approach women entering the clinics and try to intimidate them from going in. In many instances, they have physically blocked the entrances. Many of the protesters have long arrest records for crimes such as criminal trespass, obstructing traffic, blockading, disobeying police orders, disorderly conduct, and even careless burning. Benham himself has been arrested over a dozen times.

This summer in Birmingham, OSA has been protesting at Planned Parenthood and the New Woman, All Women clinic. New Woman, All Women was the clinic that was bombed by convicted murderer Eric Robert Rudolph in 1998. An off duty police officer, employed as a security guard, was killed and a nurse, Emily Lyons, was brutally and permanently injured. This year the protestors also traveled approximately 60 miles to target the West Alabama Women's Center in Tuscaloosa. West Alabama Women's Center has also dealt with anti-abortion extremists in the past. In January 2006, a local man drove his car through the clinic's entrance. He was convicted of violating the Freedom of Access to Clinic Entrances (FACE) Act, which prohibits someone from using "force, threat of force or physical obstruction" to prevent someone from providing or receiving reproductive health services.

A staff member from the National Abortion Federation (NAF) is on the ground in Birmingham this week working with law enforcement and clinic staff in order to ensure that patients have safe access to abortion care and that services are unimpeded. Here is her account of Monday's events:

About 15 people demonstrated at Planned Parenthood, while about 100 gathered at the New Woman, All Women clinic. Protesters carried graphic signs and shouted at clinic staff and law enforcement. Trucks, also bearing graphic signs, drove throughout the city, provoking numerous calls from concerned citizens who complained about the trucks. The group then gathered in the Five Points neighborhood and held a rally and signing of an "emancipation proclamation for the unborn children of our land." There was a visible law enforcement presence at all the venues. Despite the disruption, both clinics remained open and cared for their patients.

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Clinics and their national organizations work before and during these protests to ensure the safety of their staffs and patients. Despite the intimidation and harassment they face during these protests, clinic staff continue to come to work and patients continue to seek the health care services they need. We work closely with local, state, and federal law enforcement agencies to ensure that they have the intelligence information that they need to prepare for and respond to the protests and to ensure that their community stays safe.

Even with a law enforcement presence, the protestors have still intimidated women and trespassed onto clinic property. OSA traveled to Tuscaloosa on Tuesday with approximately 100 protestors — many of whom were children and teenagers. Our staff member spent the day monitoring the situation and assisting the clinic:

The protesters trespassed onto clinic property, placed fliers containing the doctor's name and photograph on cars in the parking lots of the clinic and the surrounding buildings, and harassed and grabbed patients entering the clinic. In addition, two protesters even pretended to be patients and entered the clinic in order to further intimidate patients. The protesters were eventually moved to the public sidewalk where they continued their demonstration for about two to three hours, despite not having a required permit.

Although media coverage of the protest claimed the protesters "weren't allowed on the private property surrounding the Women's Center" and that they had a permit for Tuesday's demonstration, the protesters were in fact breaking the law in Tuscaloosa. While the protesters were not allowed on private property, that did not stop approximately 100 protesters from storming the clinic parking lot and positioning themselves on the clinic steps where they yelled and grabbed women in an attempt to stop them from entering the clinic. While the protesters had a permit for a protest on Wednesday, they did not have a valid permit to hold their demonstration in Tuscaloosa on Tuesday. Despite their clear violations of the law, no protesters were arrested. These facts were also not included in the news coverage of the events, which failed to present an accurate portrayal of the turbulent scene surrounding the clinic.

Many of the protesters on the clinic steps of the West Alabama Women's Center were children coached by their parents to break the law and trespass on private property in order to yell and intimidate women entering the clinic. Children are often used in protests because it is assumed that police will not arrest a child, or even if they are arrested, the penalties will be less severe for minors.

OSA is certainly proud of their "child warriors." Their website is full of pictures of children protesting in Birmingham and participating in religious rallies. It is disturbing to see so many children spreading a message of hate that they likely do not fully understand. Our experience with clinic violence and disruption has made it clear that there is nothing responsible or acceptable about teaching your children to intimidate women making private health care decisions or that violence against abortion providers is justifiable.

Fortunately, the number of participants in these types of anti-abortion events is decreasing. When Operation Rescue started in the 1980s, they were known for large-scale sieges of clinics. These blockades spurred hundreds of arrests. Today these types of events like the one being held in Birmingham only draw 100-125 people. The very visible prosecution and conviction of anti-abortion extremists like Rudolph along with the enforcement of the FACE Act have led to a decrease in major acts of violence against abortion providers in recent years. However, abortion providers still often face intimidation, threats, and picketing — sometimes even at their homes or churches. Last year our members reported 548 incidences of hate mail/harassing calls, 336 incidences of trespassing, and 13,505 incidences of picketing.

Even though major acts of violence have decreased in recent years, many anti-abortion extremists still believe that it is justifiable to murder doctors because they provide women with safe and legal abortion care. Abortion providers and clinic staff continue to face threats and potential violence every day. For more information about the types of threats they face and the frequency of incidences, visit NAF's violence statistics.

Analysis Abortion

‘Pro-Life’ Pence Transfers Money Intended for Vulnerable Households to Anti-Choice Crisis Pregnancy Centers

Jenn Stanley

Donald Trump's running mate has said that "life is winning in Indiana"—and the biggest winner is probably a chain of crisis pregnancy centers that landed a $3.5 million contract in funds originally intended for poor Hoosiers.

Much has been made of Republican Gov. Mike Pence’s record on LGBTQ issues. In 2000, when he was running for U.S. representative, Pence wrote that “Congress should oppose any effort to recognize homosexual’s [sic] as a ‘discreet and insular minority’ [sic] entitled to the protection of anti-discrimination laws similar to those extended to women and ethnic minorities.” He also said that funds meant to help people living with HIV or AIDS should no longer be given to organizations that provide HIV prevention services because they “celebrate and encourage” homosexual activity. Instead, he proposed redirecting those funds to anti-LGBTQ “conversion therapy” programs, which have been widely discredited by the medical community as being ineffective and dangerous.

Under Pence, ideology has replaced evidence in many areas of public life. In fact, Republican presidential nominee Donald Trump has just hired a running mate who, in the past year, has reallocated millions of dollars in public funds intended to provide food and health care for needy families to anti-choice crisis pregnancy centers.

Gov. Pence, who declined multiple requests for an interview with Rewire, has been outspoken about his anti-choice agenda. Currently, Indiana law requires people seeking abortions to receive in-person “counseling” and written information from a physician or other health-care provider 18 hours before the abortion begins. And thanks, in part, to other restrictive laws making it more difficult for clinics to operate, there are currently six abortion providers in Indiana, and none in the northern part of the state. Only four of Indiana’s 92 counties have an abortion provider. All this means that many people in need of abortion care are forced to take significant time off work, arrange child care, and possibly pay for a place to stay overnight in order to obtain it.

This environment is why a contract quietly signed by Pence last fall with the crisis pregnancy center umbrella organization Real Alternatives is so potentially dangerous for Indiana residents seeking abortion: State-subsidized crisis pregnancy centers not only don’t provide abortion but seek to persuade people out of seeking abortion, thus limiting their options.

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“Indiana is committed to the health, safety, and wellbeing [sic] of Hoosier families, women, and children,” reads the first line of the contract between the Indiana State Department of Health and Real Alternatives. The contract, which began on October 1, 2015, allocates $3.5 million over the course of a year for Real Alternatives to use to fund crisis pregnancy centers throughout the state.

Where Funding Comes From

The money for the Real Alternatives contract comes from Indiana’s Temporary Assistance for Needy Families (TANF) block grant, a federally funded, state-run program meant to support the most vulnerable households with children. The program was created by the 1996 Personal Responsibility and Work Opportunity Reconciliation Act signed by former President Bill Clinton. It changed welfare from a federal program that gave money directly to needy families to one that gave money, and a lot of flexibility with how to use it, to the states.

This TANF block grant is supposed to provide low-income families a monthly cash stipend that can be used for rent, child care, and food. But states have wide discretion over these funds: In general, they must use the money to serve families with children, but they can also fund programs meant, for example, to promote marriage. They can also make changes to the requirements for fund eligibility.

As of 2012, to be eligible for cash assistance in Indiana, a household’s maximum monthly earnings could not exceed $377, the fourth-lowest level of qualification of all 50 states, according to a report by the Congressional Research Service. Indiana’s program also has some of the lowest maximum payouts to recipients in the country.

Part of this is due to a 2011 work requirement that stripped eligibility from many families. Under the new work requirement, a parent or caretaker receiving assistance needs to be “engaged in work once the State determines the parent or caretaker is ready to engage in work,” or after 24 months of receiving benefits. The maximum time allowed federally for a family to receive assistance is 60 months.

“There was a TANF policy change effective November 2011 that required an up-front job search to be completed at the point of application before we would proceed in authorizing TANF benefits,” Jim Gavin, a spokesman for the state’s Family and Social Services Administration (FSSA), told Rewire. “Most [applicants] did not complete the required job search and thus applications were denied.”

Unspent money from the block grant can be carried over to following years. Indiana receives an annual block grant of $206,799,109, but the state hasn’t been using all of it thanks to those low payouts and strict eligibility requirements. The budget for the Real Alternatives contract comes from these carry-over funds.

According to the U.S. Department of Health and Human Services, TANF is explicitly meant to clothe and feed children, or to create programs that help prevent “non-marital childbearing,” and Indiana’s contract with Real Alternatives does neither. The contract stipulates that Real Alternatives and its subcontractors must “actively promote childbirth instead of abortion.” The funds, the contract says, cannot be used for organizations that will refer clients to abortion providers or promote contraceptives as a way to avoid unplanned pregnancies and sexually transmitted infections.

Parties involved in the contract defended it to Rewire by saying they provide material goods to expecting and new parents, but Rewire obtained documents that showed a much different reality.

Real Alternatives is an anti-choice organization run by Kevin Bagatta, a Pennsylvania lawyer who has no known professional experience with medical or mental health services. It helps open, finance, and refer clients to crisis pregnancy centers. The program started in Pennsylvania, where it received a $30 million, five-year grant to support a network of 40 subcontracting crisis pregnancy centers. Auditor General Eugene DePasquale called for an audit of the organization between June 2012 and June 2015 after hearing reports of mismanaged funds, and found $485,000 in inappropriate billing. According to the audit, Real Alternatives would not permit DHS to review how the organization used those funds. However, the Pittsburgh Post-Gazette reported in April that at least some of the money appears to have been designated for programs outside the state.

Real Alternatives also received an $800,000 contract in Michigan, which inspired Gov. Pence to fund a $1 million yearlong pilot program in northern Indiana in the fall of 2014.

“The widespread success [of the pilot program] and large demand for these services led to the statewide expansion of the program,” reads the current $3.5 million contract. It is unclear what measures the state used to define “success.”

 

“Every Other Baby … Starts With Women’s Care Center”

Real Alternatives has 18 subcontracting centers in Indiana; 15 of them are owned by Women’s Care Center, a chain of crisis pregnancy centers. According to its website, Women’s Care Center serves 25,000 women annually in 23 centers throughout Florida, Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin.

Women’s Care Centers in Indiana received 18 percent of their operating budget from state’s Real Alternatives program during the pilot year, October 1, 2014 through September 30, 2015, which were mostly reimbursements for counseling and classes throughout pregnancy, rather than goods and services for new parents.

In fact, instead of the dispensation of diapers and food, “the primary purpose of the [Real Alternatives] program is to provide core services consisting of information, sharing education, and counseling that promotes childbirth and assists pregnant women in their decision regarding adoption or parenting,” the most recent contract reads.

The program’s reimbursement system prioritizes these anti-choice classes and counseling sessions: The more they bill for, the more likely they are to get more funding and thus open more clinics.

“This performance driven [sic] reimbursement system rewards vendor service providers who take their program reimbursement and reinvest in their services by opening more centers and hiring more counselors to serve more women in need,” reads the contract.

Classes, which are billed as chastity classes, parenting classes, pregnancy classes, and childbirth classes, are reimbursed at $21.80 per client. Meanwhile, as per the most recent contract, counseling sessions, which are separate from the classes, are reimbursed by the state at minimum rates of $1.09 per minute.

Jenny Hunsberger, vice president of Women’s Care Center, told Rewire that half of all pregnant women in Elkhart, LaPorte, Marshall, and St. Joseph Counties, and one in four pregnant women in Allen County, are clients of their centers. To receive any material goods, such as diapers, food, and clothing, she said, all clients must receive this counseling, at no cost to them. Such counseling is billed by the minute for reimbursement.

“When every other baby born [in those counties] starts with Women’s Care Center, that’s a lot of minutes,” Hunsberger told Rewire.

Rewire was unable to verify exactly what is said in those counseling sessions, except that they are meant to encourage clients to carry their pregnancies to term and to help them decide between adoption or child rearing, according to Hunsberger. As mandated by the contract, both counseling and classes must “provide abstinence education as the best and only method of avoiding unplanned pregnancies and sexually transmitted infections.”

In the first quarter of the new contract alone, Women’s Care Center billed Real Alternatives and, in turn, the state, $239,290.97; about $150,000 of that was for counseling, according to documents obtained by Rewire. In contrast, goods like food, diapers, and other essentials for new parents made up only about 18.5 percent of Women’s Care Center’s first-quarter reimbursements.

Despite the fact that the state is paying for counseling at Women’s Care Center, Rewire was unable to find any licensing for counselors affiliated with the centers. Hunsberger told Rewire that counseling assistants and counselors complete a minimum training of 200 hours overseen by a master’s level counselor, but the counselors and assistants do not all have social work or psychology degrees. Hunsberger wrote in an email to Rewire that “a typical Women’s Care Center is staffed with one or more highly skilled counselors, MSW or equivalent.”

Rewire followed up for more information regarding what “typical” or “equivalent” meant, but Hunsberger declined to answer. A search for licenses for the known counselors at Women’s Care Center’s Indiana locations turned up nothing. The Indiana State Department of Health told Rewire that it does not monitor or regulate the staff at Real Alternatives’ subcontractors, and both Women’s Care Center and Real Alternatives were uncooperative when asked for more information regarding their counseling staff and training.

Bethany Christian Services and Heartline Pregnancy Center, Real Alternatives’ other Indiana subcontractors, billed the program $380.41 and $404.39 respectively in the first quarter. They billed only for counseling sessions, and not goods or classes.

In a 2011 interview with Philadelphia City Paper, Kevin Bagatta said that Real Alternatives counselors were not required to have a degree.

“We don’t provide medical services. We provide human services,” Bagatta told the City Paper.

There are pregnancy centers in Indiana that provide a full range of referrals for reproductive health care, including for STI testing and abortion. However, they are not eligible for reimbursement under the Real Alternatives contract because they do not maintain an anti-choice mission.

Parker Dockray is the executive director of Backline, an all-options pregnancy resource center. She told Rewire that Backline serves hundreds of Indiana residents each month, and is overwhelmed by demand for diapers and other goods, but it is ineligible for the funding because it will refer women to abortion providers if they choose not to carry a pregnancy to term.

“At a time when so many Hoosier families are struggling to make ends meet, it is irresponsible for the state to divert funds intended to support low-income women and children and give it to organizations that provide biased pregnancy counseling,” Dockray told Rewire. “We wish that Indiana would use this funding to truly support families by providing job training, child care, and other safety net services, rather than using it to promote an anti-abortion agenda.”

“Life Is Winning in Indiana”

Time and again, Bagatta and Hunsberger stressed to Rewire that their organizations do not employ deceitful tactics to get women in the door and to convince them not to have abortions. However, multiple studies have proven that crisis pregnancy centers often lie to women from the moment they search online for an abortion provider through the end of their appointments inside the center.

These studies have also shown that publicly funded crisis pregnancy centers dispense medically inaccurate information to clients. In addition to spreading lies like abortion causing infertility or breast cancer, they are known to give false hopes of miscarriages to people who are pregnant and don’t want to be. A 2015 report by NARAL Pro-Choice America found this practice to be ubiquitous in centers throughout the United States, and Rewire found that Women’s Care Center is no exception. The organization’s website says that as many as 40 percent of pregnancies end in natural miscarriage. While early pregnancy loss is common, it occurs in about 10 percent of known pregnancies, according to the American Congress of Obstetricians and Gynecologists.

Crisis pregnancy centers also tend to crop up next to abortion clinics with flashy, deceitful signs that lead many to mistakenly walk into the wrong building. Once inside, clients are encouraged not to have an abortion.

A Google search for “abortion” and “Indianapolis” turns up an ad for the Women’s Care Center as the first result. It reads: “Abortion – Indianapolis – Free Ultrasound before Abortion. Located on 86th and Georgetown. We’re Here to Help – Call Us Today: Abortion, Ultrasound, Locations, Pregnancy.”

Hunsberger denies any deceit on the part of Women’s Care Center.

“Clients who walk in the wrong door are informed that we are not the abortion clinic and that we do not provide abortions,” Hunsberger told Rewire. “Often a woman will choose to stay or return because we provide services that she feels will help her make the best decision for her, including free medical-grade pregnancy tests and ultrasounds which help determine viability and gestational age.”

Planned Parenthood of Indiana and Kentucky told Rewire that since Women’s Care Center opened on 86th and Georgetown in Indianapolis, many patients looking for its Georgetown Health Center have walked through the “wrong door.”

“We have had patients miss appointments because they went into their building and were kept there so long they missed their scheduled time,” Judi Morrison, vice president of marketing and education, told Rewire.

Sarah Bardol, director of Women’s Care Center’s Indianapolis clinic, told the Criterion Online Edition, a publication of the Archdiocese of Indianapolis, that the first day the center was open, a woman and her boyfriend did walk into the “wrong door” hoping to have an abortion.

“The staff of the new Women’s Care Center in Indianapolis, located just yards from the largest abortion provider in the state, hopes for many such ‘wrong-door’ incidents as they seek to help women choose life for their unborn babies,” reported the Criterion Online Edition.

If they submit to counseling, Hoosiers who walk into the “wrong door” and “choose life” can receive up to about $40 in goods over the course their pregnancy and the first year of that child’s life. Perhaps several years ago they may have been eligible for Temporary Assistance for Needy Families, but now with the work requirement, they may not qualify.

In a February 2016 interview with National Right to Life, one of the nation’s most prominent anti-choice groups, Gov. Pence said, “Life is winning in Indiana.” Though Pence was referring to the Real Alternatives contract, and the wave of anti-choice legislation sweeping through the state, it’s not clear what “life is winning” actually means. The state’s opioid epidemic claimed 1,172 lives in 2014, a statistically significant increase from the previous year, according to the Centers for Disease Control and Prevention. HIV infections have spread dramatically throughout the state, in part because of Pence’s unwillingness to support medically sound prevention practices. Indiana’s infant mortality rate is above the national average, and infant mortality among Black babies is even higher. And Pence has reduced access to prevention services such as those offered by Planned Parenthood through budget cuts and unnecessary regulations—while increasing spending on anti-choice crisis pregnancy centers.

Gov. Pence’s track record shows that these policies are no mistake. The medical and financial needs of his most vulnerable constituents have taken a backseat to religious ideology throughout his time in office. He has literally reallocated money for poor Hoosiers to fund anti-choice organizations. In his tenure as both a congressman and a governor, he’s proven that whether on a national or state level, he’s willing to put “pro-life” over quality-of-life for his constituents.

News Abortion

Health Insurer Kaiser Distances Itself From Employees’ Anti-Choice Activities

Nicole Knight Shine

Active since 2014, if not earlier, Kaiser for Life appears to oppose what it describes as "late-term" abortions performed at Kaiser Permanente facilities in California.

Kaiser Permanente is disavowing an anti-choice group called Kaiser for Life, telling Rewire that the $60-billion company wasn’t aware of the group, apparently comprised of Kaiser Permanente doctors and patients, and that the company is “not lending our name to it.”

The group Kaiser for Life is taking part in the July 23 summit for Californians for Life, which opposes abortion rights. Appearing on a list of “Pro-Life Doctors, Nurses, and Medical Clinics,” Kaiser for Life is described as being made up of “doctors, nurses, patients, staff, and administrators who want to end abortion, helping both women and babies THRIVE.”

Kaiser Permanente has used the word “thrive” to market itself for more than a decade.

Active since 2014, if not earlier, Kaiser for Life appears to oppose what it describes as “late-term” abortions performed at Kaiser Permanente facilities in Sacramento and elsewhere, according to Sacramento Pro-Life News.

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A representative from Kaiser for Life didn’t respond to an inquiry about the group by press time.

A Kaiser Permanente spokesperson told Rewire that the Oakland-based health-care provider’s policies permit employees to take part in political activities, as long as workers are off the clock, off premises, and avoid the appearance of representing their employer.

Asked whether participating in Kaiser for Life might violate company policy, the spokesperson would only say that the nonprofit has no immediate knowledge of the organization or contact with it.

A Kaiser Permanente logo can be seen accompanying a brief 2014 story about Kaiser for Life by Sacramento Pro-Life News.

“Kaiser Permanente is committed to providing the full range of comprehensive, integrated women’s health services for our members,” the spokesperson noted in an email.

The spokesperson said “elective” pregnancy terminations are performed at some Kaiser Permanente facilities, “usually as a result of complications or multiple fetal anomalies,” while other abortion services are provided through Planned Parenthood and Family Planning Associates.

Anti-choice advocacy by doctors and nurses isn’t unheard of, and the Californians for Life website lists participating groups like the Association of Pro-Life Physicians and California Nurses for Ethical Standards, which “promotes respect” for the “preborn.”

Conversely, anti-choice groups routinely target companies that, among other things, allow voluntary employee-donation programs to Planned Parenthood. Bank of America, as Rewire reported, was subject to an anti-choice boycott late last year.