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Component 2.4

Services for Youth

Definitions

Adolescent:

a person in a period of human growth and development that occurs after childhood and before adulthood, from ages 10 to 19.

Minor:

a person under the age of 18.

Youth:

a person under the age of 24.

Strategies

  • When serving adolescents, special considerations are essential for high quality services.
    • Confidentiality
      • Ensure all clinic staff are familiar with minor rights to access and consent to health care.1
      • Schedule slightly longer visits with adolescents so they have time to ask questions and get answers to their questions.2
      • Create counseling areas that provide visual and auditory privacy.
      • Ensure examination areas provide visual and auditory privacy.

    Ensure that all patients, particularly youth, are aware of the Oregon Confidential Communication Request law. This law gives patients enrolled in a private health insurance policy the right to request that protected health information is sent directly to them instead of the person who pays for health insurance.3

    • Mandatory Reporting
      • Encourage youth to communicate with parents or other trusted family members as appropriate. If the adolescent has not talked with her/his parent(s) about sexual health, be sure that the adolescent lives in a safe environment before counseling her/him to do so.2, 4
      • Provide staff training and support on mandatory reporting.
    • Cost and Billing Transparency
      • Use billing procedures to maintain patient confidentiality. If this is not possible, advise the patient about the potential breach of confidentiality. Provide alternative billing options such as self-pay on a sliding fee scale.5
  • Quality adolescent services are patient-centered, respectful and developmentally appropriate.
    • Youth-friendly Services:
      • Ensure all clinic staff receives training in adolescent development and treating youth respectfully. Involve the adolescent in her/his own health management.2
      • Seek youth input on clinic services, such as having youth members on a clinic advisory board and/or active youth involvement in design of and feedback about programming.
      • Consider adding trained peer counselors/mentors/ instructors to team.
      • Consider offering a “teen clinic” or clinic hours that accommodate teen schedules.
      • Ensure services are “youth-friendly”: accessible, equitable, acceptable, appropriate, comprehensive, effective and efficient for youth, as recommended by the World Health Organization. Examples include youth-friendly/specific materials, effective communication skills, etc.
    • Parent/Guardian Involvement:6
      • Communicate with each patient that they may have their examination and counseling without parents or guardians present, and that their privacy is respected.
      • Inform parents and guardians of the health center’s standard procedure for the provider to spend time alone with patients to discuss their comprehensive health and wellness.
      • Give clear information to parents and guardians on the patient’s right to confidentiality, privacy and informed consent.

Resources

  1. Minor Rights: Access and Consent to Health Care, developed by the Oregon Health Authority Adolescent Health Program: https://public.health.oregon.gov/HealthyPeopleFamilies/Youth/ Documents/minor-rights.pdf
  2. Advocates for Youth, Best Practices for Youth Friendly Clinical Services: http://www.advocatesforyouth.org/publications/publications-a-z/1347–best-practices-for-youth-friendly-clinical-services
  3. Information regarding the Oregon Confidential Communication Request law: https://public.health.oregon.gov/HealthyPeopleFamilies/ReproductiveSexualHealth/Pages/Reproductive-Health-Data-and Reports.aspx. Insurance Division webpage on the law: www.patientprivacy.oregon.gov
  4. Providing Quality Family Planning Services (QFP), Recommendations of CDC and U.S. Office of Population Affairs, 2014, page 13: http://www.cdc.gov/mmwr/pdf/rr/rr6304.pdf
  5. CDC: A Teen Friendly Reproductive Health Visit: http://www.cdc. gov/teenpregnancy/pdf/teenfriendlyclinic_8.5×11.pdf
  6. Advocates for Youth Parents Sex Ed Center: http://www.advocatesforyouth.org/parents-sex-ed-center-home