FREQUENTLY ASKED QUESTIONS

Real Alternatives often receives media inquiries about its work as the statewide program administrator for the award-winning Pregnancy and Parenting Support Services Program. In an effort to respond to those media inquiries, we have assembled answers to questions we have been asked in the past.

What is the purpose of the Pregnancy and Parenting Support Services Program?

The primary purpose of the Pregnancy and Parenting Support Services Program is to provide core services consisting of information, education and counseling that promotes childbirth instead of abortion and assists pregnant women in their decision regarding adoption or parenting.

The Program also provides support services including self-administered pregnancy kits, baby food, maternity and baby clothing and baby furniture, information and education, and referrals for other services for the needs of the women and newborn. The information and education provided under support services includes topics regarding infant care, adoption, parenting, or the use of abstinence to avoid unplanned and out-of-wedlock pregnancies.

The enabling legislation for the Program authorizes the Service Providers to be reimbursed for the free services they provide to women until childbirth and for up to 12 months post-partum. Services include, but are not strictly limited to:

  • Counseling
  • Pregnancy, childbirth, parenting, and abstinence classes
  • Adoption information; assistance for post delivery stress
  • Assistance with food; shelter; clothing; health care
  • Other supportive programs and services for related outreach programs.

Service Providers participating in this Program will ensure that women who are pregnant, think they are, or have a child under 12 months of age have access to the above mentioned services.

Real Alternatives, through the Service Providers, offers a comprehensive umbrella of core and support services that provide women direct support during and after the Unexpected Pregnancy. This umbrella of services also includes programs to encourage new lifestyle choices that will prevent crisis pregnancies in the future.

For those in a Unexpected Pregnancy, core services are delivered by providing direct counseling support during the parenting and adoption decision. Services include:

  • Counseling and case management in a non-judgmental atmosphere
  • Education on fetal development and the health and nutritional needs of pregnant women, through the use of books, videos, brochures, and fetal models
  • Pre- and post-natal education; pregnancy and certified childbirth classes
  • Access to information on medical care, hospital clinics, doctors, health care facilities, and other professional services; assistance with identifying drug and alcohol programs, if needed
  • Adoption service information
  • Life-skills training for parenting and nutritional needs
  • Availability of other community social services
  • Tangible aid in the form of maternity clothes
  • Referrals to maternity homes
  • Other programs for the physical and emotional needs of the women experiencing the stress of a Unexpected Pregnancy.

For women who have given birth, support services are delivered by providing direct parenting or adoption support because of their decision not to abort. Such services take the form of:

  • Parenting counseling and classes
  • Education referrals for upgrading skills or obtaining a GED
  • Child care referrals
  • Mentoring
  • Information on Women Infants and Children (WIC) programs
  • Job service and vocational training opportunities availability
  • Tangible aid in the form of baby and infant items and other needed supplies.

For those who come to our Service Providers thinking they are experiencing a Unexpected Pregnancy, self-administered pregnancy test kits are available. For those in this category who are not pregnant, support services are delivered by providing:

  • Information on the risks of sexually transmitted diseases
  • Relationship counseling
  • Decision-making education
  • Teen pregnancy prevention programs with the goal of modifying risk-taking behavior that lowers out-of-wedlock births and sexually transmitted diseases.

This umbrella of services provided by the Service Providers enables Real Alternatives to provide direct core and support services statewide so women do not feel the need to have an abortion now or in the future, and to provide support programs that effectively prevent the circumstances that might lead to an unplanned pregnancy and abortion in the first place.

With the ability to provide a wide array of services to women in need at the local level, a woman is able to make more informed choices concerning her child, as well as begin to plan for a future that will include independence and self-sufficiency. The linkage of these services over a longer period of time provides a better opportunity for counselors to help women who wish to change their status from a dependent mother to an independent mother.

How did this program come about?

Real Alternatives administers this program for the PA Department of Human Services. This revolutionary program was the brain child of PA Governor Robert Casey and State Representative Joe Pitts. They advocated funding for the program in the Commonwealth of Pennsylvania budget in 1994.  The legislature passed the budget and become a proponent. This first-of-its-kind taxpayer-funded Pennsylvania Program uses 77 Catholic Charities, pregnancy support centers, maternity homes and adoptions agencies and the hundreds of caring counselors throughout the Commonwealth to provide support services to women in unexpected pregnancies from the time they find out they are pregnant through 12 months after the birth of their baby.

These organizations have served over 341,300 women over 1.8 million times through September 2022.  Interesting to note, at every one of those 1.8 million visits, clients were informed that if they have any comments or complaints, they could call Real Alternatives. Going on 27 years, there Real Alternatives has never received a complaint!

In 2014, then IN Governor Mike Pence, sought replication of the Pennsylvania Program in Indiana.  Indiana DOH contracted with Real Alternatives to create the Indiana Pregnancy and Parenting Support Service Program.  21 Catholic Charities and pregnancy support centers in the program have served 95,800 women over 244,800 times through September 2022.

Does this Program provide abortion or abortion referrals? Why don’t you provide abortion as an option to women in a Unexpected Pregnancy?

We provide life-affirming pregnancy support services only and state such in our advertising and to our clients. This program exists to provide comprehensive support so a woman does not need to undergo an abortion. The program is prohibited by the Commonwealth of Pennsylvania and the State of Indiana from promoting, referring, or counseling for abortion.

Who are the Service Providers? What qualifications do the counselors and mentors have?

The network of Service Providers is composed of pregnancy support centers, maternity homes, social service agencies and adoption agencies. All of these groups are required to be experienced and qualified in providing core pregnancy support services that promote childbirth over abortion for a period of at least one year prior to beginning the review process towards potentially becoming a Program Service Provider. The approval process is rigorous and takes a considerable period of time prior to approval being considered. Real Alternatives analyzes all aspects of the potential Service Provider’s operations including its corporate structure and documentation, its operational policies and procedures, its staff training materials, its client education materials and programs, as well as an on-site inspection of all areas utilized in providing client services. Any deficiencies in the potential Service Provider’s operations must be corrected prior to approval being considered.

The majority of our service providers employ counselors who have bachelor’s and master’s degrees in social work or nursing. Like other state social service programs, some service providers also use trained volunteer mentors to assist our clients.

Does this Program only concern itself with the baby?

No, the stated purpose of this is a program to serve women. Because this program “promotes childbirth rather than abortion,” a common misunderstanding is that the main service reimbursed for in the Program is decision-making support, i.e., counseling as to whether to carry a pregnancy to term or to terminate (abort) a pregnancy. While decision-making support is the core service offered by all of Real Alternatives-funded service providers, the majority of reimbursable services occur after an expectant mom has made the decision to choose childbirth. This is because the period of eligibility to receive Program services extends not only throughout pregnancy, but also after the child is born.

A program-eligible client is defined as: (1) a legal U.S. and Pennsylvania, or Indiana resident female who is pregnant, possibly pregnant, or the biological parent of a child 12 months old or younger; . In other words, the mother of the infant receive services for a longer period of time when she is an expectant mother.

The scope of services that Real Alternatives reimburses for is comprehensive. Education, counseling, mentoring and classes cover many topics relevant to new and expecting parents, such as child care, financial responsibility, nutrition, healthy relationships, breast feeding, and anger management. Real Alternatives also reimburses its providers for work done on behalf of a client, including time spent making a WIC appointment or setting up a job interview for a client. On a limited basis, Real Alternatives reimburses its service providers for providing free materials assistance to their clients, such as diapers, maternity and baby clothes, and baby furniture. This is the only statewide state program that provides maternity clothes for pregnant women.

While many services are reimbursable, some are not. For example, since the program is a human services or social services program and NOT a medical program, Real Alternatives does not reimburse for ultrasound or ultrasound counseling. We also do not reimburse for post-abortion counseling, spiritual counseling or religious instruction.

How are Service Providers funded by Real Alternatives?

The Service Providers technically are not “funded” in the sense of receiving a general grant in support of their work. Rather, it’s more accurate to say that the Service Providers are “reimbursed” for very specific services delivered. This is because Real Alternatives’ relationship with each Service Provider is based on a fee-for-services contract, not a grant. Thus, Real Alternatives only pays its Service Providers for actual time spent delivering services: no more, no less.

Are the services provided under the Pennsylvania and Indiana Pregnancy and Parenting Support Services Program confidential?

There has always been a confidentiality requirement for services to clients in the Pennsylvania and Indiana Pregnancy and Parenting Support Services Programs. The PA DHS and IN DOH agreements, with Real Alternatives, covers confidentiality extensively. Confidentiality of client information is the highest priority and mandated in the agreements. Real Alternatives mandates this confidentiality policy in its service provider agreements. None of the  billing information sent by service provider counselors to Real Alternatives contains personal identification of the client. All client records and case notes are maintain securely in locked filing cabinets at the service provider site.

Some have accused “Unexpected Pregnancy centers” in other states of practices that are deceptive to or manipulative of the clients they serve. Does Real Alternatives contract with organizations like that as Service Providers?

Absolutely not. Although Real Alternatives is not familiar with centers with those kinds of practices, regardless, Real Alternatives takes measures to ensure that it only contracts with organizations that provide compassionate and caring client services. Misleading a woman in Unexpected Pregnancy about the scope of available services is not only dishonest, it is neither compassionate nor caring. Real Alternatives reviews each potential Service Provider’s phone procedures and advertisements to ensure potential clients are made aware that only life-affirming services are provided. Real Alternatives and its Service Providers would never advertise under “Abortion Services, etc.”

Real Alternatives telephone counselors explain that we do not provide abortion services nor provide referrals for abortions, but we can connect them with support services that have been received by over 350,000 women to date.

Real Alternatives believes it is neither compassionate nor caring counseling to attempt client education using graphic descriptions, images, or videos of aborted fetuses. This is why Real Alternatives disallows the use of such materials in the Program, regardless of whether the client consents to see them.

Similarly, it is neither compassionate nor caring to delay the results of a pregnancy test that only takes 5-7 minutes to complete. Accordingly, Real Alternatives reviews each potential Service Provider’s pregnancy-testing and other intake procedures to make sure nothing could contribute to the anxiety of a woman experiencing a Unexpected Pregnancy.

Does the Program have reporting requirements and oversight?

The PA Department of Human Services (DHS) and IN Department of Health (DOH) contracts with Real Alternatives specifically spell out the financial reports that Real Alternatives monthly provides to the agencies, and the performance reporting requirements that Real Alternatives files on a quarterly and end-of-year basis.  These reports include:

* Four (4) Quarterly Cash Needs Requests
* Twelve (12) Monthly Expenditure Reports
* A Final Financial Report
* An Annual A-133 Certified Public Accountant Report
* Four (4) Quarterly Service Provider Monitoring Reports
* A Service Provider non-compliance notification
* Four (4) Quarterly Administrative and Statistical Reports
* An Annual Statistical Report
* Any Budget Revisions submitted

What are Real Alternatives restrictions regarding participation in the Program by faith-based organizations?

Real Alternatives operates a completely constitutional program.

Real Alternatives reimburses its Service Providers using federal money made available pursuant to a funding stream known as TANF (Temporary Assistance for Needy Families). Under the federal Charitable Choice Act, an organization is not precluded from participating in a TANF-funded Program just because it has a faith-based mission or character. But if that organization conducts religious or spiritual activities, it must do so separately, in time or location, from the TANF-funded activities.

Real Alternatives – funded Service Providers must agree to comply with the Charitable Choice Act, but also with an additional measure to ensure that client participation in any spiritual or religious activities is completely voluntary.

Real Alternatives-funded Service Providers must agree not to conduct activities of worship, religious instruction, proselytization or other religious programs during the delivery of Program services.

They must also agree to deliver Program services using a different person than any person that delivers spiritual or religious services to a client. This “separate counselor” requirement is a unique Real Alternatives requirement, and is based on a client-centered policy to ensure a client receiving Program services never feels pressured by the person delivering those services to participate in religious or spiritual activities. If a client does want to participate in religious or spiritual activities, the Service Provider must obtain her written consent, and assure her that if at any time she chooses not to continue with the religious activities, that the Program services will still be available.

In addition, educational books or brochures that contain religious or spiritual content must not be presented to the client during the delivery of Program services, and must be housed separately (and labeled) from non-spiritual materials on bookshelves and racks, if made available to clients for browsing.

These procedures are in full compliance with the Charitable Choice Act signed into law by President Bill Clinton, the Faith-Based initiatives of President Bush and President Obama and were approved by attorneys at the PA Department of Public Welfare under Democratic Governor Ed Rendell’s administration in 2005. These same procedures are used in the Indiana and Michigan programs administered by Real Alternatives.

Does Real Alternatives reimburse for adoption placement?

No. With respect to adoption, Real Alternatives only reimburses for neutral counseling (decision-making as to whether to parent or adopt), up to the point the adoption decision is made. Thereafter, placement activities, such as parent selection, etc., are not reimbursed by Real Alternatives.

In addition, so that there is no possibility of undue pressure asserted upon a client to pursue an adoption plan, once a client chooses adoption, Service Providers must take all reasonable steps to ensure that the client receives adoption planning assistance from a person other than the counselor(s) who is providing the pregnancy support to the client before the client decides to pursue an adoption plan.

On a limited basis, Real Alternatives also reimburses for post-adoption grief counseling.

Do participating Service Providers provide medical services?

While some of Real Alternatives Service Providers may offer limited medical services, such as ultrasound or STD testing, Real Alternatives does not reimburse its providers for these services. As is typical of social service programs this Program is a counseling, mentoring and support program and not intended to be medical. Real Alternatives – funded Service Providers are no different than any other community-based, social service organizations, such as rape crisis centers or domestic violence centers that provide counseling, mentoring, education and related support to women and their families in crisis. Of course, Real Alternatives-funded Service Providers make appropriate referrals for their clients to other community resources, whether for medical services or otherwise.

The value of Real Alternatives-funded Service Providers is in no way diminished because they don’t provide medical services. On the contrary, the value of these organizations is derived from the fact that they provide unique crisis counseling and mentoring services most medical providers do not provide to women experiencing a Unexpected Pregnancy: professional peer counseling, mentoring, education classes, and materials assistance.

Do Real Alternatives-funded Service Providers do “clinic protests” or similar activities?

No. Nor does Real Alternatives reimburse for any activities that resemble political activism. Further, Real Alternatives disapproves of any client educational materials used by its Service Providers that are political, judgmental, or reflect activist sentiments, in tone or content.

Real Alternatives itself is non-political and non-partisan.

How does Real Alternatives select appropriate materials for purchase to be used with clients?

Real Alternatives only purchases educational materials that meet high quality standards. All materials must be relevant to services delivered to Real Alternatives’ target audience, which is comprised of legal U.S. and Pennsylvania or Indiana resident females who are pregnant, possibly pregnant, or the biological parent of a child 12 months old or younger;

Materials that recite health statistics and/or describe medical risks must be recently published and must include citations to legitimate authorities, such as the Centers for Disease Control, or otherwise reputable medical literature.

Finally, all publishers of the educational material guarantee the information provided in the education material is accurate and current as of the date of the order.

Real Alternatives does not purchase any materials that are political, judgmental, reflect activist sentiments, or that contain spiritual or religious content.

How do Real Alternatives’ Service Providers approach discussing some of the conflicting science and medical issues regarding abortion risks?

Real Alternatives Service Providers are encouraged to keep abreast of current developments and to stay informed regarding such matters. They must always remain ethical and honest in their dealings with their clients, and are trained and educated to recognize that providing dishonest information is not only unethical and wrong, but that it is ineffective in developing the necessary relationship of trust with the client.

Nevertheless, new developments in health and science are not hidden from the clients either as it is the philosophy of Real Alternatives that the client must be provided with all such relevant information so that she can make an educated and informed choice about her health and that of her baby. For example, some studies have shown that abortion contributes to an increased risk of developing breast cancer. While there are some studies that continue to deny that risk, a client should be told of the conflicting information so they can make the decision for herself as to how she wants to proceed, as opposed to hiding or withholding such information from her.

A 2016 report by the Pennsylvania state auditor suggested that Real Alternatives used money it received from Pennsylvania “to fund its activities in other states,” in what the auditor said was an example of the group “siphoning funds intended to benefit Pennsylvania women.” Is that report accurate?

Absolutely not. Concerning the now six-year-old “report” circulated by the former Pennsylvania Auditor General, the same allegations have been raised and dismissed countless times over the years.  It is first imperative to note that despite his attempt, the Commonwealth Court of Pennsylvania quite easily concluded that the Auditor General exceeded the scope of his authority by even trying to audit our private company, Real Alternatives, which is not a government entity.  He conducted a very limited “audit” of the Pennsylvania Department of Public Welfare (now known as the Department of Human Services “DHS”).

The claim that Real Alternatives ever used state money from Pennsylvania to unlawfully fund activities in other states, along with the accusatory implied financial wrongdoing with state money that follows, has no basis in fact or law.  Such a politically-based accusation required the Auditor General to ignore the most basic and fundamental tenets of contract law.  No such wrongdoing ever occurred.  State money Real Alternatives receives was and is spent solely on activities authorized in the grant agreement with DHS.  This has been audited four different times by different Commonwealth auditors who had no issue.

It was and is only privately raised funds that are spent in other states to start pregnancy and parenting support programs. The Pennsylvania Office of Open Records (OOR) and, on appeal, the Commonwealth Court of Pennsylvania have also agreed with Real Alternatives multiple times on this issue.

Unfortunately, some pro-abortion legislators, agenda-driven special interest groups, and journalists consistently close their eyes and ears to what has been judicially decided time and time again, and continue to raise this dead issue.