How CompassCare and the Linear Service Model was Born

The Problem

As you may know, abortion in modern America has its roots in Western New York. Margaret Sanger, who started Planned Parenthood, the single largest abortion provider in the country, was born in Corning, NY, just 90 miles south of Rochester. New York State was the first State in the union to legalize abortion on demand on July 1st, 1970, three years before the land mark Roe V. Wade Supreme Court case. According to the history of Planned Parenthood of the Rochester/Syracuse Region, Rochester was home to the first free standing abortion clinic in the U.S. opening on July 2nd, 1970 one day after surgical abortion was legalized. In 1980, an organization was formed called the ‘Citizens for Public Morality’ which may be an oxymoron in the post-Clinton era, with morality being largely relegated to a personal level. That organization quickly realized that it wanted to focus on serving women facing unplanned pregnancy and seriously considering abortion. So the name was changed to Crisis Pregnancy Center and in some sense has become a bell weather of sorts, one of the first of many thousands of such organizations to come. As it grew it adopted a local multi-office strategy offering material assistance, lay options counseling, parenting classes, post-abortion counseling, community referrals, etc., and changed its name again to Crisis Pregnancy Services. Around the mid 1990’s, the organization began to experience a down turn in the number of women it was serving who were seriously considering abortion. In fact, by 2001, the organization served no more than a handful of at-risk women every year. To put it bluntly, if this PRC were a for-profit company that relied on paying customers as its bottom line, the organization would have been bankrupt years earlier. Its people fought with each other. It had very little money. It had been adrift and confused as to its core purpose for years. What it did have was people with passion and drive to see women at risk for abortion served such that their decision making process was not driven by the fear of the unknown but rather by information and support. At the time, we were a typical PRC offering no medical service and virtually no valid key decision-making help for the demographic of women seriously considering abortion. The focus was more on the baby we were trying to save than the woman who simply needed to be served.

Stumbling Upon A Solution

The Linear Service Model idea all started unintentionally in a staff meeting sometime around 2002 after we had added medical services and changed the name of the organization to CompassCare. We unwittingly embarked on a journey to create a new process for delivering services to women facing unplanned pregnancy. The staff began talking about a performance metric related to enhancing the number of clients the organization was able to serve: appointment no show rates. Simple math says that the more clients we can get to arrive for their appointments the more at risk women we may have a chance of serving. At that time the percentage of women who scheduled an appointment but failed to show had never been under 50%. We had a cadre of staff and volunteers who viewed themselves as phone counselors called “HelpLiners”. Their role was to ‘counsel’ any given woman who called and in many cases attempt to talk her out of having an abortion, maybe attempt to proselytize her by presenting the gospel, and if possible to schedule her to take advantage of an in-house appointment. By this time in the organization’s history, we had already been offering limited medical services, the addition of which was supposed to aid the organization’s ability to reach and serve more women seriously considering abortion. It did have a positive effect, but only provided marginal increases at reaching more women at risk for abortion and serving them in such a way that they go on to have their babies.

After poking around the data for a while, someone casually asked Val, the Director of Client Services in charge of this particular aspect of the organization, whether some HelpLiners were more effective at getting women to schedule and arrive for their appointments than others. She said, “Oh, definitely.” Not the response we thought we would get. “Would one of those people be you?” Thankfully and in all humility she said, “Yes.” We were on to something. As we pursued the conversation, it became clear that not only was Val 90% more likely to schedule a client but that client was 90% more likely to arrive for her appointment than some of the poorer performing staff and volunteers. Val was then asked if she said something similar to each of the prospective clients when they called. She intimated that in fact what she said to prospective clients on the phone was virtually identical every time. The result of this conversation was to write down exactly what Val said into a script, retrain all the HelpLiners, and have everyone begin using only that script and nothing else for the next month. The outcome was staggering. In one month the organization went from a 50% no show rate down to a 15% no show rate. We could hardly believe it. So of course the next question was, “Can we do this with everything?” Can we take the process we used in our finer moments of serving the women at highest risk for abortion, the abortion-minded, and make it standard operating protocol? The answer, of course, was a resounding, “Why not!” This was the best news we had had in years and we literally stumbled over it.

Getting Results

Armed with this new process CompassCare became quite effective at reversing the trends at the organization’s points of pain. Namely, reaching more women at risk for abortion and serving them in a way that helps them feel comfortable enough to carry their babies to term.

The number of abortion-vulnerable and abortion-minded women CompassCare served increased exponentially from 5-10 per year to over 95% of the entire client load since we embarked on this journey. And the aggregate number of those women choosing to carry their babies to term rocketed to over 80% on a consistent monthly basis. The quick, sustained, and staggering nature of the results that optimizing our services in this way did for the mission of the organization can be demonstrated in the following outcomes typically tracked in a PRC:

  1. The no-show rates dropped to a consistent low of 19%, with a 2005 average of 28%, with 198 overall at risk appointments scheduled. Assuming a 50% no show rate as a national PRC average, that demonstrates a potential 31% client load increase for a typical PRC.
  2. The number of high risk abortion-mined women increased by 53%. From 14% in 2003 (24 clients) to 41% in 2004 (59 clients) to 67% in 2005 (132 clients).
  3. The total number of “positive pregnancy test” clients increased by 25 percentage points from 60% to 85%. The following numbers demonstrate that an increasing percentage of the clients CompassCare served were “qualified leads” (i.e. clients with pregnancy tests that were positive since a woman cannot be at risk for abortion unless she is actually pregnant).

Pregnancy Tests Results– 2003

Pregnancy Tests Results – 2005

41% Negative

20% Negative

59% Positive

80% Positive

  1. The positive outcomes (i.e. clients who went on to have their babies) for the high risk abortion-minded women increased by 31% from 50% up to 81% for the time period January 2004 to December 2005.

CompassCare Training Services Is Born

News quickly spread across the country that there may be an organization that has solved the client load problem that most PRCs were facing. CompassCare began to entertain requests for consultation, training, and permission to use various aspects of the new service process. CompassCare’s President/C.E.O, Jim Harden, was even asked to become a training consultant for the national affiliate organization specializing in medical conversions called the National Institute for Family and Life Advocates (NIFLA). Some people attributed our new-found success to the fact that we added limited medical services a year earlier in the form of ultrasound pregnancy confirmation. While that did give us a bump in the number of abortion-vulnerable women we were serving, it provided very little increase in the abortion-minded category—the really hard cases that represent the bull’s-eye of our demographic target. Some people thought it was our aggressive marketing that drew the clients, but that did not account for the increased number of at risk women having their babies. Some people thought that it was the script we used to schedule clients for appointments, but that was just the first step in the service platform. Incidentally, no more than three to four minutes was spent on the phone with any one client. Others thought it was the fact that we relocated near several college campuses, but the fact that at least 50% of the client load were not in college could not alone account for our increased effectiveness. The more cynical observer maintained disbelief assuming that we had manipulated the data.

At any rate, we quickly became overwhelmed with requests for information relative to the perceived organizational needs of the enquirer. So in an effort to continue to meet the needs of not only our clients but also of organizations that had similar mission foci, we decided to create a training system. The idea was to give other PRCs the opportunity to experience the same effectiveness that CompassCare was enjoying. This proved to be more challenging than we had first thought. Be that as it may, in the end CompassCare created the first transferable PRC model in the history of the movement with demonstrated repeatability in a dozen sites from Lakeland, FL to Santa Barbara, CA; from rural to urban, from college town to boom town. The model actually worked with the same (if not better!) effectiveness in very different parts of the country serving very different types of women. Honestly, we did not know if it was going to work and so when it did, we were ecstatic.

CompassCare Open Sources the Optimization Tool

The next step has been to place this tool in the hands of more PRCs so they also may become more effective in reaching and serving women facing unplanned pregnancies and erasing the need for abortion. As a result, in 2012 CompassCare made a decision to ‘open source’ the Optimization Tool. This makes the OT Manual and related materials available, free of charge, to pregnancy centers. Optional professional services are available, including observations of currently optimized PRCs, consulting, coaching and training services, databases and reporting tools, etc. All the materials, resources, processes, and expertise are yours for FREE – no strings attached. The only requirement is that you have a desire is to become more effective in reaching and serving women at risk for abortion in a way that helps them have their babies. We want to see you be as effective as we have been.