Senator Eliot Shapleigh - El Paso, Texas

Just 166 women have been served by a nearly year-old state program that promotes childbirth as an alternative to abortion, Texas officials told state lawmakers Thursday. The state has spent $1.9 million on the program, which diverts money from the state's budget for family planning services, officials said.

"That is unacceptable," said state Rep. Dawnna Dukes, an Austin Democrat. "Almost $2 million, and maybe 166 have been served? What does that add up to?"

During a daylong meeting of House budget writers, Dukes grilled the state's top health officials on the program that was created by the Legislature last session. It diverts $2.5 million a year from the state's $54 million family planning budget to provide counseling and support, but not medical care, to pregnant women. Critics have said that because the money is diverted, each year 16,000 fewer low-income women will get medical services such as pap smears.

Anne Heiligenstein, deputy executive commissioner of the Health and Human Services Commission, told Dukes the program was expected to be more expensive at first because of startup costs such as recruiting and training providers and developing a Web site. The new nonprofit organization the state hired to run the program, the Texas Pregnancy Care Network, has met the terms of the state contract, which became effective in March, Heiligenstein said.

Vincent Friedewald, executive director of the network, who was not at the meeting, later said the program has served hundreds more women since its last required report to the state. Although 166 women had made 1,054 visits by the end of November, the program has now served 609 clients in 2,760 visits, he said. The numbers have increased significantly in the past two months because the network has more providers now and is able to see more women, he said.

The network has paid providers a total of about $146,000 for services delivered, he said.

"We actually think we're moving very fast for a program of this size that's never before been done and considering our high standards of participation," Friedewald said. "The numbers increase every month and will continue to increase every month. It's not fair to compare performance from a startup program to any other program that's been operational for years."

The problem, Dukes said, is that a startup was used in the first place.

"Why would the state want to build a network when we already have entities that provide such services at a lower rate for more women who are low-income, uninsured and underinsured?" Dukes, a newly appointed member of the House Appropriations Committee, asked state officials.

She's referring to organizations such as Planned Parenthood, which provides medical care but isn't eligible for the new program because it provides abortions. Most of the providers in the Texas Pregnancy Care Network are pregnancy resource centers, which are often faith-based organizations that provide pregnancy tests and connect pregnant women with community resources. Such centers came under fire last year from congressional Democrats for giving out information about links between breast cancer and abortion that many scientists say is not true.

"Everyone knows this is a debate over Planned Parenthood and pregnancy resource centers," said Appropriations Committee member Dan Gattis, R-Georgetown. He said that he and Dukes "have some philosophical differences" and that he's confident the program's costs will decline.

But Heather Paffe, political director of the Texas Association of Planned Parenthood affiliates, said the program "is a waste of taxpayer dollars. There are so many other uses for the money for proven and effective programs that show a good return on the dollar."

For example, a year of preventive family planning care — a pap smear and contraception — costs about $160, she said.

The nine providers in the Texas Pregnancy Care Network operate at 12 sites. Two are in Central Texas: Gabriel Project Life Center, a pregnancy resource center in Austin, and Georgetown's Annunciation Maternity Home, a residence for young pregnant women and new mothers who have left home because they were kicked out or pressured to have an abortion.