Anti-abortion activist Carol Everett had no experience running a family planning program when the state of Texas awarded her millions in taxpayer funds to help rebuild a network of low-income women’s health providers. The state knew that. So it should have been no surprise when Everett’s organization, the Heidi Group, failed to provide services to thousands of women after the Legislature slashed family planning funds and kicked out Planned Parenthood.
Last year, officials with the Texas Health and Human Services Commission (HHSC) acknowledged that the Heidi Group hadn’t met its contractual obligations, and the agency clawed back some of the money. But, until now, HHSC has refused to reveal how many patients Everett served, or just how much was spent on their care. Data obtained by the Observer shows that in fiscal year 2017, the Heidi Group served just over 3,300 clients, less than 5 percent of the nearly 70,000 Everett had pledged to cover. Nonetheless, the state renewed the group’s multimillion-dollar contracts for a third year.
“It’s outrageous. In what other area of state government would this kind of incompetence be rewarded over and over and over again?” said Dan Quinn, communications director at Texas Freedom Network, which called for an investigation into the Heidi Group contracts. “It’s a betrayal of taxpayers and especially of women who need these services and aren’t getting them.”
Quinn thinks state officials are giving Everett a break because of her anti-abortion views. Everett ran a Dallas-based abortion clinic until she “came to Christ” in the ’80s and wrote a memoir titled Blood Money: Getting Rich Off a Women’s Right to Choose. She’s a natural fit for conservative legislators who want to prove the state’s reproductive health safety net can survive without larger providers like Planned Parenthood and others that offer abortions.
One of Heidi Group’s contracts is for the Healthy Texas Women program, which provides family planning services and preventive screenings for poor Texans. For fiscal year 2017, Heidi was initially awarded about $1.6 million to build a network of providers — a mix of clinics, individual doctors and crisis pregnancy centers — to serve nearly 51,000 patients enrolled in Healthy Texas Women. Despite spending more than $1.3 million, Heidi Group only managed to serve 2,300 clients, according to the new data.
Through a second contract, HHSC awarded the Heidi Group $5.1 million to serve nearly 18,000 clients through the Family Planning Program, the state’s other reproductive health program. Last year, the health agency conceded that the Heidi Group was falling short and cut back its contract by just over $4 million, reducing Heidi’s proposed client totals to about 3,500 and reallocating the remaining funds to other contractors. The Heidi Group missed that mark too, spending about $605,000 to serve just over 1,000 clients.
The Heidi Group was the only contractor in either program to have funds revoked in 2017.
Quinn says this issue goes beyond contracting problems. “They know that Heidi Group is incompetent,” he said. “Yet [Heidi Group] keeps getting money from the state. At some point it becomes willful negligence on the part of state officials.”
Asked what it’s doing about contractors missing their targets, HHSC wouldn’t provide specifics. “We’re always committed to improvement when it comes to women’s health, and we’re monitoring performance and providing technical assistance to ensure success for our contractors and all program providers,” agency spokesperson Christine Mann wrote in an email.
The Heidi Group is not the only contractor to fall far below its targets. Half of the nearly 40 contractors in the Healthy Texas Women program as well as 10 Family Planning Program contractors had funds pulled in 2018 after underperforming. But the Heidi Group’s contracts are the most ambitious, with the most dramatic failures. Everett’s organization was awarded the second-highest amount in both programs in 2017, and Everett promised to serve three times more clients in Healthy Texas Women than the next highest contractor. Remarkably, the Heidi Group pledged to handle more clients in 2017 than Planned Parenthood had. Before being booted out, Planned Parenthood saw more than 40 percent of all patients in Texas’ women’s health program.
Advocates say the Heidi Group’s poor performance points to larger problems with the state’s efforts to set up a new network of women’s health providers without Planned Parenthood. Even Everett said last spring that meeting her targets is “not as easy as it looks because we are not Planned Parenthood.” (Everett declined to comment for this story. “Carol does not do interviews,” said a woman at the Heidi Group who came to the phone when I asked to speak with Everett, but who wouldn’t identify herself. She abruptly hung up.)
Yet HHSC continues to funnel taxpayer money to the group. Last summer, just days after the agency yanked back the $4 million under the Family Planning contract, HHSC quietly renewed its contract for two more years at the initial funding levels. Data obtained by the Observer shows that the agency clawed back money from the Heidi Group for a second time in fiscal year 2018, reducing its Family Planning Program grant from $5.1 million to about $2 million, and its Healthy Texas Women funding from about $1.6 million to $1.2 million, for again failing to meet its targets.
Despite these issues, HHSC recently renewed the Heidi Group’s contract for fiscal year 2019, which began a few weeks ago, at these adjusted amounts. Heidi Group is expected to serve more than 40,000 patients, still 12 times more than it was able to handle in 2017.
The ongoing logic, Mann explained, is that the agency will again adjust contracts mid-year for contractors that miss their goals. “We wanted to give our contractors the maximum opportunity to serve as many Texas women as possible,” she wrote. “That’s our whole focus.”
But women’s health advocates worry that taxpayer dollars are being squandered on inept providers, potentially reducing access to quality care.
“There are many long-standing and efficient contractors that spend every penny of their funding allocation each year serving clients, and when they run out of funds, they have to turn away new clients,” said Stacey Pogue, an analyst at the left-leaning Center for Public Policy Priorities, who previously worked on women’s health programs at HHSC. “It is critical that funding levels be based on a realistic assessment of how many women a provider can serve or actual demonstrated historical capacity.”