Tennessee public clinics resume offering contraception and STD testing to unaccompanied youth • Tennessee Lookout

Teens in Tennessee seeking contraception or sexually transmitted disease testing can now return to their local health center without a parent, a partial reversal of a six-week-old state policy that forced public health workers to turn away minors.

An August 15 memo from the Tennessee Department of Health to clinics, obtained by Lookout, outlines the resumption of family planning and infection testing services for unaccompanied youth.

The memo directs clinics to offer sexual health services to minors who cannot or will not obtain parental consent, citing a longstanding Tennessee state law that gives teens ages 14 and older the right to confidential medical testing and contraception without telling their parents.

However, the memo noted that consent from a parent or guardian is required for all other essential health services previously routinely offered to unaccompanied youth at Tennessee public health centers, including all vaccinations.

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The partial change in policy pleased some public health providers in the US state of Tennessee, who had to turn away their teenage patients for weeks from doctor visits that had been routinely available to them until the summer.

“WONDERFUL NEWS,” read an email from Laura Varnier, nursing director at Metro Public Health Clinic in Nashville, to staff announcing the state’s new policy.

“(The Tennessee Department of Health) has determined that parental consent is no longer required for minors seeking sexually transmitted disease (STI) treatment or family planning services…including pregnancy testing,” the department's internal email dated Aug. 26, obtained by Lookout, said.

Since July, the state Department of Health has ordered local clinics to turn away youth from all health care services if no parent or guardian was present in person or available by phone, citing the newly enacted Family Rights and Responsibilities Act.

The Parental Rights Act, brought to the attention of Republican lawmakers in Tennessee and other states by the conservative Christian law firm Alliance Defense Fund, requires parental consent for any medical treatment that minors seek.

The state Department of Health had initially interpreted the law to include contraception, pregnancy testing, and tests for HIV and other diseases that adolescents want to have done at local county clinics – in rural Tennessee, this is often the only option for such care.

However, the Family Rights and Responsibilities Act specifically states that it does not override existing Tennessee state laws regarding medical care for minors. Tennessee has long had a law that allows health care providers to treat and test adolescents for sexually transmitted diseases without parental consent. Another law, in effect since 1971, allows doctors to prescribe contraception to minors without parental consent.

In early August, a group of Tennessee Democrats pressed state health department officials for an explanation of the changing policies regarding teens.

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In response, Tennessee Department of Health Commissioner Ralph Alvarado provided lawmakers with a copy of the department's new policy on health clinics, which will allow them to continue to treat youth seeking contraception and sexually transmitted disease testing at clinics in all 95 counties across the state.

The Tennessee Department of Health has not communicated to the public either the original policy prohibiting teenagers from seeking any health services at public health centers effective July 1, or the revised policy providing exceptions for teenagers seeking sexual health services.

The department also has not responded to questions from The Lookout about its policies regarding minors. Five county health centers contacted by phone confirmed the initial policy changes to The Lookout last month.

Rep. Aftyn Behn, one of the Democratic lawmakers who signed the letter to the Department of Health and Human Services demanding clarity on its policy, said she remains concerned about the unintended consequences of the Family Rights and Responsibilities Act, which also prevents school nurses from providing dressings or other common in-school care to students. Gov. Bill Lee has said he will consider changes to the law.

“We are now hearing from concerned parents and school administrators across the state about the unintended consequences of this legislation,” Behn said. “Any legislation that creates a barrier between a grown teen and necessary care is harmful. We don't need politicians with no medical experience making decisions for our families.”