In the first of its kind lawsuit, the SPLC calls gay conversion therapy a fraud. Meanwhile lawmakers try to protect crisis pregnancy centers from regulation under consumer protection laws. Are we on to something here?
“Pray away the gay” conversion therapy is a fraud and its perpetrators swindlers who should be held liable under state consumer protection statutes.
So says the Southern Poverty Law Center (SPLC), in the first-of-its kind lawsuit against a religious organization that promotes the dangerous practice. According to the SPLC, Jews Offering New Alternatives for Healing (JONAH) fraudulently claims to provide services that “convert” people from gay to straight. Previously known as Jews Offering New Alternatives for Homosexuality, the group was founded by Arthur Goldberg, a former Wall Street executive and attorney who was convicted of mail fraud and ultimately disbarred. The lawsuit, filed in state court in New Jersey, alleges that JONAH, its founder Arthur Goldberg, and counselor Alan Downing violated New Jersey’s Consumer Fraud Act by claiming that their counseling services could cure clients of being gay.
According to the lawsuit, JONAH customers typically pay a minimum of $100 for weekly individual counseling lessons and another $60 for group therapy sessions. In those therapy sessions counselors would force clients to strip naked in the group, encouraged clients to blame their parents for being gay and have them participate in violent role play exercises where they would beat effigies of their mothers. These services cost clients as much as $10,000 per year, exclusive of any fees associated with the professional treatment needed to recover from the abuse under JONAH’s care. The stories are tragic and infuriating.
The complaint, nearly thirty pages long, provides what amounts to an in-depth annotated bibliography of the medical evidence to refute “conversion therapy” as anywhere near legitimate, and pain-stakenly details how the defendants made thousands of dollars subjecting individuals to mental and physical abuse, in the name of prayer and spiritual study, and based on promises it would “cure” their homosexuality.
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Of course faulty therapies grounded in religious doctrine and used to turn a profit are the very business model of a crisis pregnancy center and it seems little can be done about it. Recent attempts to regulate CPCs by forcing them to disclosure their positions on contraception and abortion have run into First Amendment problems. Is it time to start exploring consumer fraud claims against these organizations?
Consumer fraud claims avoid the constitutional problems inherent in trying to regulate the content of commercial speech and instead provide remedies when the content of that commercial speech doesn’t live up to what is promised. In the context of CPC’s those promises would include claims of unbiased, professional medical opinions and advice relevant to the decision to terminate a pregnancy, for example. Given the fact that more and more women are being forced via informed consent laws to visit CPCs in the course of trying to access abortion care, a real need exists to effectively guard against fraud in these settings. So much so that in some states anti-choice activists are trying to forbid municipalities from regulating advertising and advice given out by CPCs, effectively shielding these organizations from claims like the ones made against JONAH. That suggest they recognize a vulnerability.
Admittedly it is an imperfect analogy, comparing conversion therapy fraud claims to similar potential claims against crisis pregnancy centers. And plenty of procedural barriers exist to make bringing such lawsuits challenging if not impossible in some instances. But if religious organizations via their for-profit enterprises are going to insist on a First Amendment right to proselytize while delivering commercial services, then as consumers we’re entitled to some way to hold those promises accountable.
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-Gazettereported 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.
“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.
California already requires CPCs to post information about free or low-cost abortion care or contraception in their facilities. The proposed ordinance would penalize licensed and unlicensed "limited service pregnancy centers" for making untrue or misleading statements in ads, online, and in publications.
Elected leaders in Oakland, California, want to crack down on crisis pregnancy centers (CPCs) with a truth-in-advertising ordinance.
A panel of some members of the city council on Tuesday took up the proposed measure during a Life Enrichment Committee meeting, arguing that many of these religiously run centers target pregnant people with deceptive billboards, websites, and search engine results for “abortion.”
California already requires CPCs to post information about free or low-cost abortion care or contraception in their facilities. The proposed ordinance would penalize licensed and unlicensed “limited service pregnancy centers” for making untrue or misleading statements in ads, online, and in publications. The ordinance also applies to statements of omission, meaning the withholding of information. Violators would be given ten days to take corrective action by the city attorney, and could face civil fines from $50 to $500. Penalties also include running new ads to correct deceptive ones.
“Crisis pregnancy centers put their ideological agenda ahead of women’s health,” Oakland Vice Mayor Annie Campbell Washington told those gathered in chambers. “They target what they call ‘abortion-minded women’ with deceptive advertising, implying they offer abortion services or referrals.”
Campbell Washington said the new “consumer protection measure” was necessary because individuals who go to CPCs are “being lied to.”
Baltimore, Maryland, was the first city in the nation to enact a similar truth-in-advertising ordinance, which has been blocked amid a court challenge. In 2011, San Francisco passed a similar ordinance. It prevailed after a protracted court battle, when a district judge said the First Amendment does not protect false and misleading commercial speech.
During public comments, Christina Malin, director of family health services for Alameda County Public Health Department, expressed support for the ordinance, noting that CPCs inflict harm by targeting low-income communities of color in particular. She described receiving a voicemail message from a CPC worker asking for help with an undocumented client with a high-risk pregnancy. Malin never learned what happened to the patient.
Malin also noted that county prenatal clinics had observed a tendency by CPCs to refer their clients to county facilities for medical care once the client reached about 24 weeks of pregnancy, when the individual “can no longer terminate easily” and abortion care, while lawful, is more expensive. These former CPC clients, Malin added, arrive without records of appropriate prenatal medical care, such as lab work.
Campbell Washington noted that CPCs are difficult for clients to vet on their own because a facility will frequently change its name.
Rewire found, for example, the state has licensed the CPC Third Box Pregnancy Clinic to operate at 400 30th Street #401 in Oakland under the legal name First Resort. But online and in Yelp reviews the facility at 400 30th Street #401 is called Support Circle Pregnancy Clinic.
First Resort, as it turns out, is the same religiously run nonprofit that challenged the San Francisco ordinance, as the San Francisco Chroniclereported. In its print and online ads in San Francisco, First Resort claimed to offer “abortion information, resources and compassionate support for women facing the crucial decisions that surround unintended pregnancies and are considering abortion,” although it did not refer clients to abortion providers or provide abortion care.
On Tuesday, Amy Everitt, state director of the advocacy group NARAL Pro-Choice California, showed those gathered in chambers how a Google search for “Oakland” and “abortion” produced results with three clinics, two of which were CPCs. She noted that a 2015 NARAL investigation found that 91 percent of CPCs in the report dispensed false information.
Google has said it would correct its inaccurate search results.
The measure now heads to the full Oakland City Council after unanimously clearing the Life Enrichment Committee.
The ordinance comes amid reports in Sacramento and Los Angeles of CPCs flouting the new state law requiring pregnancy-related centers, including CPCs, to post a brief notice about access to free and low-cost abortion care and contraception.
Officials running CPCs contend they’d rather close than comply, and say in court filings the law violates their First Amendment rights.
Alliance Defending Freedom Senior Counsel Matt Bowman, who is representing the National Institute of Family and Life Advocates in challenging the FACT Act, said in a statement earlier this month that “forcing [the centers] to promote abortion and recite the government’s messages is a clear violation of their constitutionally protected First Amendment freedoms.”