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In three of five years, Texas anti-abortion program served fewer clients than targeted

[Editor's note: The original version of this story used incorrect data for the number of clients from fiscal year 2009. The story was updated April 1 at 3 p.m. Eastern time with the correct data.]

Since 2006, when the state started paying nonprofits to steer women toward childbirth rather than abortion, Texas’ Alternatives to Abortion Services Program failed to meet performance benchmarks for the number of clients served in three of five years, according to public records obtained by The Texas Independent. Meanwhile, state funding to the program has increased each year, as has compensation to the head of the program’s primary nonprofit contractor.

Also of note is that, while the majority of clients were between the ages of 20 and 29, most visits to providers reimbursed by the state were for clients age 19 or under. (See the graphic at the end of the story for maps of clients and visits, by county and age groups.)

In only two of the five years from 2006-2010 did the program meet its goal for number of clients served. However, overall, the program, which is administered by the Texas Health and Human Services Commission via nonprofit contractor Texas Pregnancy Care Network (TPCN), did serve about 37,600 clients — about 600 more than the goal of 37,000, exceeding it by 1.6 percent. Overall the state has spent an average of more than $300 for each of the program’s clients, for a total of $11.7 million.

The state paid about $417,000 to TPCN in fiscal year 2006; $1.95 million in 2007; $2.5 million in 2008; $2.81 million in 2009; and $4 million in 2010 — with another $4 million budgeted for the current fiscal year. The compensation paid to TPCN’s executive director similarly increased each year for which data is available.

For the executive director’s salary, the state budgeted about $52,000 for the final eight months of fiscal year 2006 (prorated from a $90,000 annual salary); $93,000 in 2007; $98,000 in 2008 and $101,000 in 2009. The executive director’s salary is not included in the current contract with TPCN for 2010-2011 that HHSC provided to The Texas Independent.

According to Internal Revenue Service documents, TPCN Executive Director Vincent Friedewald reported a total annual compensation of about $97,000 in 2007; $112,000 in 2008; and $113,000 in 2009.

Although the program has just met its overall targeted number of clients, it has greatly exceeded the targeted number of visits by clients to service providers, with each client visiting providers 4.7 times, on average (above the targeted visits-per-client ratio of 3.6). Each visit by a client to a provider cost the state about $67.

As The Texas Independent previously reported, about 78 percent of the $6.9 million in state money directed to 33 subcontractors — with 32 of them having Christian affiliations — was for reimbursement for counseling sessions.

Overall, program providers have reported nearly 175,000 visits by clients — 30 percent more than the goal of 135,000.

In three of the five years, the program did not meet its goal for number of visits to providers. Those failures, however, were more than offset by the two years where the program exceeded its goal of total visits, in 2008 and 2009. Fiscal year 2008 was the only year when the program met its goals for both number of clients and number of visits, serving about 8,000 clients during 40,000 visits (compared to targets of 6,000 clients and 18,000 visits).

In 2009, the number of clients rose to about 12,300, along with the number of visits, to more than 48,000 (compared to targets of 7,000 clients served and 21,000 visits). In 2009, each client visited providers an average of four times.

In 2010, when state funding increased to $4 million (from $2.81 million in 2009), the goal for clients served increased to 18,000 and total visits to 72,000. Providers actually served about 13,300 clients during 64,000 visits — missing targets by 26 percent and 11 percent, respectively.

The large ratio of visits-to-clients could be skewed by the fact that the state’s two largest subcontractors — San Antonio’s Seton Home and Georgetown’s Annunciation Maternity Homes — provide housing for young pregnant women and/or mothers, as The Texas Independent previously reported.

From 2006-2010, about 1,000 clients reported being from Bexar County and 330 from Williamson County — with those counties ranking 10th and 16th, respectively, out of 154 counties represented. (Only 22 of those counties had more than 100 clients.)

However, from 2006-2010, nearly 64,000 visits were from Bexar clients and more than 9,400 from Williamson — ranking first and fifth on the list of 154 counties. Bexar clients visited providers an average of 63 times, and Williamson clients visited an average of 20 times.

Further, about 61,600 of Bexar visits were from 460 clients age 19 or under — for an average of 133 visits per client. About 7,600 of the Williamson visits were from 105 clients age 19 or under — for an average of 59 visits per client. Bexar and Williamson were the top two counties for visits by clients age 19 or under.

The state’s third-largest contractor, Fifth Ward Pregnancy Help Center, is located in Houston. A total of more than 11,000 Harris County clients visited providers a total of about 17,300 times (putting Harris first and second out of the 154 counties for number of clients and visits, respectively). That’s a little more than 1.5 visits per client, on average.

Statewide, broken out by age group, 26 percent of program clients were age 19 or under; 57 percent were age 20-29; and, 16 percent were age 30 or above. However, clients age 19 or under accounted for 61 percent of total visits; clients age 20-29 for 30 percent of total visits; and clients age 30 or above for 9 percent of total visits.

About 11 percent of clients were age 17 or under, yet this youngest age group accounted for 47 percent of total visits.

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