This article was published in partnership with the Miami Herald.
To understand the problems with Florida’s oversight of anti-abortion pregnancy centers, you don’t have to look much further than Mary’s Pregnancy Resource Center, north of Miami.
The crisis pregnancy center in Broward County steered women away from abortion while providing free pregnancy tests, ultrasounds and parenting classes. Founded by Yohanka Reyes and her husband, its mission was rooted in Reyes’ own horrific history: The first time she became pregnant after she was sexually assaulted as a young girl, she had an abortion. The second time, she decided to carry her baby to term – as it turned out, the only child she would give birth to.
Mary’s “has been the greatest blessing in the world,” Reyes declared in an interview with a Spanish-language Catholic TV channel. “To be able to tell my story and to be able to save so many lives and be able to reach their souls with the word of Jesus.”
For years, Mary’s was one of the crown jewels of the Florida Pregnancy Care Network, the little-known nonprofit that administers the state-funded “alternatives to abortion” program. In April, the network’s profile grew tremendously after the Legislature approved a fivefold funding increase to $25 million a year. In October, state support grew once again after the state Department of Health quietly increased the contract to up to $29.4 million.
This year’s funding nearly matches that of the entire last decade, when the state handed out $32.5 million in taxpayer money to the anti-abortion initiative. Mary’s has been one of its biggest beneficiaries, taking in more than $2.2 million in that period.
Yet Mary’s was floundering financially for much of that time, sending up numerous red flags that the network didn’t seem to notice. For at least three years, the pregnancy center failed to file its federal Form 990s, the tax forms required for nonprofits, and other required paperwork, leading the Internal Revenue Service and the state to temporarily revoke its tax-exempt status. That should have disqualified it from receiving any public money, according to the state program’s compliance manual. But during this period, the network gave Mary’s $622,000.
The Florida Pregnancy Care Network was planning to award another $275,000 to Mary’s this year, according to documents obtained through a public records request – until journalists from Reveal from The Center for Investigative Reporting and the Miami Herald began asking questions.
Now Mary’s has dropped out of the network and faces nearly $170,000 in federal tax liens. In November, an eviction notice was posted on the front door of its two-story building alongside a sign that said, “We are moving.”
Reyes declined requests for an interview, complaining that journalists were treating her unfairly. “Why don’t you accept Jesus as Lord and Savior and that way you stop hurting people that are really trying to help others?” she wrote in an email.
A Reveal/Herald review of Florida Pregnancy Care Network records from the last three years shows that the oversight deficiencies that allowed Mary’s to collect state funds are endemic in the alternatives-to-abortion program. The network hasn’t been conducting regular reviews of nonprofit tax filings or checking for federal tax debt. Centers didn’t need to apply for funding every year because their contracts had been automatically renewed. The network isn’t required by the state to conduct frequent site visits of the crisis pregnancy centers it’s funding; it visited fewer than half of the centers it funded last year. Network employees met with Mary’s staff just twice over 18 months, once in person and once online.
And because the Florida Pregnancy Care Network is a nonprofit, it isn’t subject to the same kind of transparency required of public agencies, shielding the program from the scrutiny lawmakers and public officials would otherwise give when millions in taxpayer dollars are spent. Funneling millions in taxpayer money through a nonprofit “creates a cloud over freedom of information,” said Democratic state Rep. Anna Eskamani of Orlando. “We should have the ability to know exactly what these public dollars are doing in our state.”
Fixing the network’s oversight gaps is more urgent than ever, given its rapid state-funded growth. Republican state Rep. Jennifer Canady from Polk County, who co-sponsored the funding bill, said she contacted the Florida Pregnancy Care Network’s executive director to “ensure taxpayer dollars are used effectively” after our reporters told her about problems at Mary’s.
“There are pregnancy care centers around the state doing incredible work and doing things for women,” Canady said. “But any that are not following the rules should not be receiving state funds.”
In a written statement, Rita Gagliano, the network’s executive director, called the Mary’s situation “an isolated incident,” adding: “We do not believe the allegations made involving this one center are representative of the program, how it runs or how it will continue to run.”
The network has put in place new requirements that centers share federal tax returns, end-of-year financial reports or any information about tax debt, and annual audits will be required of any nonprofit that receives $750,000 or more in public funding. Next fiscal year, they’ll have a new contract renewal process.
But those monitoring measures are still “the very minimum,” Eskamani said.
If the state doesn’t significantly strengthen how it monitors the program and mandate that the Florida Pregnancy Care Network be more transparent about its processes, serious financial problems are bound to continue, lawmakers and experts said.
“Transparency reduces corruption,” said David Cuillier, director of the Freedom of Information Project at the University of Florida. Problems like the ones at Mary’s “happen all the time when you have a system shrouded in secrecy.”
Florida’s alternatives-to-abortion program dates back to Gov. Jeb Bush’s administration in 2005. The goal, said then-Lt. Gov. Toni Jennings, was to support women through pregnancies they might otherwise be tempted to terminate: “We want them to know that they do have a choice.” Last year, about 50 nonprofits received state money, including pregnancy centers, adoption agencies and maternity homes.
The Florida Department of Health sets the basic rules for the program. But since the beginning, responsibility for running it has been outsourced to the Florida Pregnancy Care Network, whose ties to anti-abortion conservatives and religious groups run deep. One of its founders, Tampa OB-GYN Dr. Rufus S. Armstrong, led a failed 2012 ballot campaign that sought to remove state constitutional protections for abortion.
The alternatives-to-abortion program had its first major growth spurt in 2016, when lawmakers increased funding from $2 million to $4 million a year. In 2018, they codified the network’s role as the sole conduit for distributing the taxpayer money.
The biggest chunk of that funding has gone toward parenting classes and counseling “with the goal of childbirth.” Other covered services include pregnancy tests, pregnancy loss counseling, parenting classes, testing for sexually transmitted infections and medical exams for the uninsured.
This year’s expansion was far more sweeping, and it came as Florida’s Republican lawmakers reacted to the demise of Roe v. Wade by restricting abortions. The state law banning abortion after six weeks is on hold pending a ruling from the Florida Supreme Court.
The rising profile of pregnancy centers reflects a trend that can be seen in other conservative states in the post-Roe era. For decades, the crisis pregnancy center movement concentrated on persuading “abortion vulnerable” women to choose parenting or adoption instead. Now, in conservative states with restrictive abortion laws, crisis pregnancy centers are revamping their mission – trying to fill growing gaps in access to reproductive health care by providing women’s wellness exams, sexually transmitted infection testing and even some prenatal care.
With so much new money flowing into the Florida program, many anti-abortion pregnancy centers are receiving double – and even triple – the amount of funds they received in previous years. The state is also reimbursing more for specific services – for example, reimbursement for counseling doubled to $2.50 per minute. Much of that money will go toward rent and salaries, records show.
Some of this year’s largest contracts went to Catholic dioceses that run crisis pregnancy centers.
The Catholic Charities arm of the Diocese of St. Petersburg will receive up to $800,000 this fiscal year, including for its four Foundations of Life crisis pregnancy centers in the Tampa Bay area. That’s more than triple its contract last year, and according to the operating budget it submitted to the state, the funds could nearly cover the entire budget. Foundations of Life director Laura Ramos said the new money will go toward promoting two part-time employees to full time and adding one more ultrasound technician.
“We live in a world where women are told constantly what to do, right? They tell us we cannot have children and go to school. They tell us we cannot hold jobs and have children,” Ramos said. “We are here to tell them that whatever decision they make, we will walk with them.”
The Archdiocese of Miami has seen its latest contract more than double to $350,000, enough to cover 75% of its submitted budget this year. In an interview with the Herald last spring, Angela Curatalo, director of the archdiocese’s three pregnancy centers, said volunteers, many from local churches, encourage women in state-funded counseling sessions to keep their pregnancies.
“It’s not professional counseling,” she told a Herald reporter in April. “We don’t pretend that it is.”
They tell women about services like Medicaid and food stamps, free ultrasounds and adoption. They use plastic models of first-trimester fetuses and warn about alleged long-term effects of abortion, such as post-traumatic stress disorder, suicidal ideation, and alcohol or drug abuse – information that is not supported by sound medical research.
“We let them know you don’t have to go down that route,” Curatalo said.
The Florida Pregnancy Care Network also saw a big bump in its own state funding for operational expenses, including $1 million for marketing. This type of spending is a sore point with program opponents, including Eskamani, the state representative from the Orlando area.
“Part of this $29.4 million is literally going to go towards (advertising), boosting anti-abortion rhetoric and anti-abortion stigma,” she said. “I think there should be a complete prohibition on that.”
An additional $100,000 will fund an Option Line call center run by Heartbeat International, one of the largest anti-abortion organizations in the country, to give referrals to pregnancy centers.
Florida health authorities have been given virtually no power to regulate pregnancy centers. That means the Florida Pregnancy Care Network is the only agency with a true window into the operations of pregnancy centers in the state. But that doesn’t mean it’s offering oversight.
Gagliano said the network monitors only services “that are billable to the program.” “We expect members to independently and properly maintain and keep current all other business aspects of their organizations,” she wrote, as they are “completely independent of (the network).”
The state requires pregnancy centers to have policies for addressing client complaints, file monthly invoices detailing the number of clients served and the total number of minutes spent providing services, and do background checks on employees and volunteers, according to the program’s compliance manual. The network is also required to conduct an “on-site review” of centers “in person or by Zoom every other year.” And centers must also complete training, though the manual doesn’t specify what training is required.
Once a year, pregnancy centers are also required to go through “monitoring,” a process that includes a financial audit. But the Florida Pregnancy Care Network audits information for only one month and a single financial quarter – and gives program participants 30 days’ notice about which time periods it plans to review.
Then, if a group is in compliance with these rules, the network has more or less rubber-stamped its continued participation in the program, Reveal and the Herald found.
“We need to have people visiting these centers,” said state Senate Minority Leader Lauren Book, who represents parts of Broward County, including where Mary’s was located. “People should be looking at, ‘What is our return on investment?’ ”
The state also requires that the network ensure that centers are providing “accurate and current” medical information to clients. Yet Reveal found that about a third of state-funded centers in Florida last year have posted misleading or inaccurate medical information on their websites, such as inaccurate claims about abortion causing infertility, anxiety attacks and suicidal ideation.
In October, Book filed legislation for the upcoming session that would require the Health Department to conduct annual inspections at state-funded centers and fine those distributing medical misinformation to clients.
“Your files should be up to date,” Book said. “You should be paying taxes. You should be doing all of the things that everybody else is having to do. You shouldn’t just get a free pass because you’re providing, quote, crisis pregnancy services.”
With a system that allows a nonprofit the power to distribute state money to private centers, much about the Florida Pregnancy Care Network and its operations remains hidden from the public.
Cuillier, the freedom of information expert, said outsourcing the alternatives-to-abortion program’s operations creates barriers around the public’s ability to scrutinize how taxpayer funds are spent – a practice he equated to “laundering public information through a nonprofit.” “This is kind of a gimmick used around the country to hide information,” he said. “It’s really just a blatant workaround (to promote) secrecy.”
If the Florida Department of Health directly contracted with the centers receiving state funds, individual contracts with centers and any audits would be publicly available. Currently, the only network document that’s posted online is the state’s contract with the Florida Pregnancy Care Network.
At least 17 other states award taxpayer funds to pregnancy centers and other organizations that work to deter people from having abortions. Last year, states handed out $89 million to crisis pregnancy centers and other anti-abortion organizations across the country – and that amount has been growing since Roe v. Wade was overturned.
Other states that have used the same nonprofit model have discovered problems, from a Texas pregnancy center using taxpayer money to pay for vacations to a state audit that found Oklahoma’s program spent more on administrative costs and salaries than on aid to pregnant women.
Book was among a small contingent of Democratic lawmakers who publicly opposed the Legislature’s proposal for $25 million in funding to the network this year. The lawmakers proposed reallocating the money toward other services, such as resources for domestic violence and sexual assault victims and telehealth services for a minority maternal care pilot program. Those amendments ultimately failed.
“You know how much $25 million could do for the child welfare system right now? It blows my mind,” Book said. “We talked a lot about that during the time when this bill was coming up on the floor. OK, you’re gonna give (families) bottles and cribs and car seats? Great. But that’s not child care. People can’t afford child care.”
This story was edited by Nina Martin, Kate Howard and Casey Frank and copy edited by Nikki Frick.
ABOUT THE REPORTING
To conduct this investigation, Reveal from The Center for Investigative Reporting and the Miami Herald examined Florida Pregnancy Care Network contracts, compliance manuals, center agreements and other documents for the last three fiscal years obtained through public records requests with the Florida Department of Health. Reporters also reviewed publicly available IRS Form 990 filings filed by the Florida Pregnancy Care Network and dozens of crisis pregnancy centers since 2014.