a person in a period of human growth and development that occurs after childhood and before adulthood, from ages 10 to 19.
a person under the age of 18.
a person under the age of 24.
- When serving adolescents, special considerations are essential for high quality services.
- 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.
- 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.
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
- 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
- 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
- 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
- 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
- CDC: A Teen Friendly Reproductive Health Visit: http://www.cdc. gov/teenpregnancy/pdf/teenfriendlyclinic_8.5×11.pdf
- Advocates for Youth Parents Sex Ed Center: http://www.advocatesforyouth.org/parents-sex-ed-center-home