Shereen Siewert & Damakant Jayshi

The CEO of Healthfirst Network is pushing back after the leader of a faith-based pregnancy center expressed interest in assuming a home visiting program for Marathon County.

Jack Hoogendyk, in an email to county supervisors early this month, said Hope Life Center could save taxpayer dollars by offering the program at no cost. But Healthfirst’s Jessica Scharfenberg said Hoogendyk’s numbers don’t add up, and his non accredited organization has no experience in home visiting programs.

The contrast between Healthfirst and similar organizations and those like Hope Life Center couldn’t be starker. The former say they provide “evidence-based” medicine and services based on the recommendations of regulatory and oversight state and federal agencies; the latter reach the community with the “Gospel of Jesus Christ” and cite Christian evangelical organizations such as Care Net as an oversight body.

While Hoogendyk rejects the term “religious nonprofit” for Hope Life, he also mentions the Gospel in describing the organization and names Christian groups with which his organization is affiliated to.

Hoogendyk, who is also chair of Republican Party of Marathon County, has made overtures to county supervisors on a number of occasions since 2023 budget discussions intensified in October and early November. He specifically targeted funding for Marathon County Health Department’s Start Right, a nurse visitation program, and its new version, the Nurse Family Partnership program, citing concerns over cost. He then offered the services of Hope Life, an organization he heads as its executive director.

The center is a part of a nationwide chain of crisis pregnancy centers. Critics frequently refer to them as anti-abortion “fake” clinics that attempt to “scare, shame, or pressure” women from getting abortions. Hoogendyk opposes that description, sharing an article from anti-abortion advocates rejecting that labeling of pregnancy centers.

Crisis pregnancy centers have also drawn the ire of state lawmakers. Democratic Rep. Jonathan Brostoff, who represents the 19th District in Wisconsin, issued a scathing commentary calling on lawmakers to prohibit centers from presenting false information to the public.

“(The centers) are presented to the public as though they are legitimate reproductive-health clinics often with unlicensed, non-medical staff acting and dressing as nurses and doctors,”Brostoff, of Milwaukee, said. “The true goal of a CPC is to deceive women who seek medical advice and information, so they frequently set up shop next to actual, comprehensive reproductive-health clinics to divert women from medical services.”

Some lawmakers say many of the pregnancy resource centers have a documented history of pressuring women not to have abortions and scare them away from considering an abortion.

“These so-called resource centers are designed to mislead women and to be deceptive,” says Rep. Lisa Subeck (D-Madison). “Women are tricked into entering facilities thinking they are accessing a legitimate health clinic offering services based on factually accurate medical information.”

The GOP county chair sent a note comparing Start Right and Hope Life to supervisors before they finalized the budget on Nov. 10. Speaking about the Start Right program, Hoogendyk suggested the county wasn’t seeing a return on its investment. A number of supervisors, among them who received financial support and endorsement from the Republican Party of Marathon County, also suggested NFP should be replaced by Hope Life Center.

This push for working with Hope Life drew strong opposition from residents, supervisors and other organizations, including Healthfirst and the Freedom From Religion Foundation, a national nonprofit organization based in Wisconsin that aims to protect the constitutional principle of separation between church and state.

After withering criticism, Hope Life makes another pitch

Hoogendyk sent supervisors another message on Dec. 5 and copied Wausau Pilot & Review in the joint email. In the note, he said the organization could offer “many essential services in Marathon County to women who are preparing to give birth.” He said non-profit medical and human service agencies in Wisconsin that serve pregnant women and those seeking information about their pregnancy “provided over $4.1 million in professional services and tangible supplies to over 25,000 clients, all at zero in taxpayer funds and at zero cost to the clients.” Wausau Pilot & Review has been unable to independently verify those figures.

The agency claims the services included parenting education to more than 6,200 women and their families at an average cost below $250 per client. He reiterated that “virtually all of these agencies are faith-based, working to fulfill the mission of Christ.”

However, Scharfenberg questioned Hoogendyk’s figures. In a Nov. 7 email to county supervisors that she shared with this newspaper, Healthfirst’s CEO said Hope Life’s numbers do not add up in providing clients’ healthcare with trained nurses.

“A Bachelor’s prepared nurse, including benefits is equivalent to $85,000-$100,000 annually,” her letter reads. “Is Hope going to assume the 2.4 BSN FTE – $204,000-$240,000 – without asking the county for any funding in return? Plus, an additional 1.2 FTE in administration and support to provide an evidence-based curriculum, when they have no experience in home visiting programs.”

Scharfenberg said agencies like hers save taxpayers much more than the $4.1 million that Hoogendyk mentioned.

Every dollar of public funding spent on quality reproductive health services, the community saves $7.09, she said. That resulted in a community savings of more than $21 million in the Healthfirst Network service area for 2021 alone, according to public figures.

Hope Life’s ED said their reduction in service costs are made possible “primarily because the staff and volunteers at these agencies, of which there are over 60 facilities in Wisconsin, are able to hire staff at well below market rates or as volunteers.”

But Scharfenberg questioned whether using volunteers is appropriate at all.

“Due to the nature and sensitivity of the services offered at Healthfirst, we do not use volunteers,” the Healthfirst CEO said. “We only have paid staff who have completed stringent competency trainings.”

She also challenged a claim that Hoogendyk made about his agency referring clients to WIC, the Women, Infants and Children program in Wisconsin.

“I can assure you that in the almost 7 years I have been with Healthfirst, Hope has provided zero direct referrals to the WIC program,” she said. Healthfirst is the WIC provider for Marathon County.

By contrast, the Marathon County Health Department provides referrals to WIC almost daily, she wrote. The referral and service network offered by the home visiting program would be lost if it were to be switched. Currently, by using the Health Department, clients have direct access to the childhood immunization program, breastfeeding support, Well Badger, the car seat program, and Marathon County Human Services for economic support, she added.

Scharfenberg said while Hope Life claims to offer sexually transmitted infection testing and early treatment, the organization fails to disclose that they do not provide prevention through access to condoms, one of the most recommended prevention and reinfection prevention techniques by the Centers for Disease Control and Prevention. “That would be similar to giving an individual an antibiotic, but not cleaning and dressing the wound that caused the infection,” she said.

Hoogendyk, in his response to a previous story, questioned the efficacy of condoms in preventing pregnancy.

Yet Wisconsin’s Department of Health Services lists “birth control” and emergency contraception” among the rights of those seeking reproductive health care.

Critics point to lack of licensing, regulation standards

The Wisconsin Dept. of Health Services is also critical of centers such as Hope Life.

Jennifer C. Miller from the Communications Team at DHS said these centers are not eligible for funding, even pass-through funding, from state or federal resources, “if they are not operating in accordance with existing federal and state statues, guidelines, or requirements for reproductive health care.”

Hoogendyk said Hope Life Center “adheres to all licensing requirements issued by the state if Wisconsin.” We also voluntarily comply with HIPAA regulations.”

But Scharfenberg said there is no existing accreditation or credentialing process for these centers, adding that they “are not licensed or regulated in any way because they are not healthcare facilities.”

State and local health officials point out that Hope Life is not an accredited agency, while regulated health care agencies must have accreditation.

“Furthermore, Healthfirst is a covered entity by definition from the U.S. Department of Health and Human Services,” Scharfenberg said. “That means we are regulated and monitored by HIPAA laws. CPC’s are not covered entities so they are not mandated to abide by HIPAA laws.”

But Hoogendyk says they “are in full compliance with all HIPAA provisions. Client confidentiality is paramount at our agency.”

Hoogendyk, while acknowledging that Hope Life lacks accreditation, has said the center has nurses who are “fully trained, certified and qualified to provide the services” that meet the goals of NFP program.

“We are affiliated with Care Net, a national organization that has over 1,200 pregnancy resource center members,” he told this newspaper.

Care Net is an “evangelical Christian network of crisis pregnancy centers.” On its website, Care Net describes itself as a “nonprofit organization that empowers women and men considering abortion to choose life for their unborn children and find abundant life in Christ.”

Healthfirst has an elaborate process in assisting a woman who has been sexually assaulted and they have trained Sexual Assault Nurse Examiner, or SANE nurses, available to assist in those instances.

“If the individual wanted to report the incident, we have a social worker on staff who would assist the individual through the reporting process,” Scharfenberg said. “If the individual wanted a SANE exam, we have a strong partnership with the Aspirus and Marshfield Clinic-Weston SANE programs in which we would assist the client to get to.”

Hoogendyk said Hope Life’s employees and volunteers are mandatory reporters and they comply with the law.

Hoogendyk rejected a statement from the American Society for Adolescent Health and Medicine and North American Society for Pediatric and Adolescent Psychology cautioning that crisis pregnancy centers pose a public health risk by failing to adhere to prevailing medical standards and informed consent and that they do not provide accurate or complete health information.

“The assertions made by these organizations are not based in fact,” Hoogendyk said. “I can tell you that these assertions are simply untrue for Hope Life Center.” He has also rejected the label of “religious nonprofit” and said Hope Life is “a medical clinic that provides limited services” and those services are performed by Bachelor’s of Nursing registered nurses.

Healthfirst provides evidence-based medicine, based off of best practices that is comprehensive, Scharfenberg said.

“We are a full service, comprehensive clinic offering an array of services not offered at CPCs. They offer limited ultrasounds and STI testing/treatment.” She said when clients ask for STI testing or treatment “we are going to give them access to condoms, something CPCs do not do. We take on the prevention and treatment side of healthcare. And we are not religiously affiliated.”

The American Medical Association Journal of Ethics has also expressed concerns that crisis pregnancy centers give the impression of being medical clinics or having medical expertise when they do not.

The AMA Journal of Ethics calls the crisis pregnancy centers legal but unethical.

“They strive to give the impression that they are clinical centers, offering legitimate medical services and advice, yet they are exempt from regulatory, licensure, and credentialing oversight that apply to health care facilities,” the Journal said. “Because the religious ideology of these centers’ owners and employees takes priority over the health and well-being of the women seeking care at these centers, women do not receive comprehensive, accurate, evidence-based clinical information about all available options.”

Hoogendyk said “academia” gets it wrong and the federal government recognizes pregnancy centers as reproductive health care providers.

But Scharfenberg agreed “100%” with the AMA. “CPCs are not medical clinics although they often pretend they are.”

She said that when one of her close friends went to the local CPC, “she was told that IUDs do not prevent pregnancy. That is complete misinformation and not medically accurate.”

Meanwhile, the National Service Office for Nurse-Family Partnership and Child First, a national-level Nurse-Family Partnership chain, said they require Baccalaureate prepared-registered nurses to deliver NFP services.

Speaking about the required credentials, Olivia Biggs, Public Relations Manager at NFP, said that since they require registered nurses to deliver NFP, “the RNs are required to follow all nursing practice standards established by each State’s Board of Nursing.”

Marathon County Health Dept. follows the national NFP model and requirements.

Marathon County has no plans to partner with faith-based organization on health care – yet

Unclear is why Hoogendyk reached out to the county supervisors again since he has said Hope Life Center is not requesting a contract or partnership with the county on providing services to pregnant women in our county.

And county officials say there is no path forward for Hope Life if it is trying to replace the Health Dept.’s NFP program, at least not in the near future.

Top officials from the county, both elected and appointed, have said the county has no plans to formally partner with Hope Life Center. They say a formal process is required for that to happen.

Chair of the County Board of Supervisors Kurt Gibbs has said they intend to continue with the services provided by the Health Dept.

“In this case, no request for proposal was required to be issued as the county is continuing to deliver services internally through staff at the Marathon County Health Department,” Gibbs previously told Wausau Pilot & Review. “If the county would decide to seek a new vendor for the delivery of services, it would need to do so in accordance with the County’s Procurement Code.”

County Administrator Lance Leonhard also said the county does not have plans to partner with Hope Life Center in the delivery of the NFP model.

“That said, while interacting with families in the program, our staff provide participants with information on a variety of local resources, including Hope Life Center,” he said.

Leonhard also said that NFP is an evidence-based program that will not be redesigned despite the cut in its proposed budget earlier this year.

“We will implement the NFP model as planned,” he said.

The county plans to transition from the current Start Right model to the NFP model during the first quarter of 2023.

The NFP budget for 2023 was initially reduced from  $841,507 to $220,000, a move defeated by a majority of the Board. The 38-member County Board not only reduced the proposed cut for NFP, $621,507, to $140,000 but also drastically reduced every single cut that was proposed including those for The Women’s Community and other nonprofit organizations.