Tennessee public clinics resume offering birth control, sexual disease tests to unaccompanied teens

Tennessee teens seeking birth control or sexually transmitted infection tests can return to their local public health clinic without a parent — a partial reversal of a six-week-old state policy that has forced public health workers to turn away minors.

The restoration of family planning and infectious disease testing services for unaccompanied adolescents is outlined in an August 15 memo to clinics from the Tennessee Department of Health obtained by the Lookout.

The memo instructs clinics to provide the sexual health services to minors who cannot, or do not wish to, obtain parental consent, citing long standing Tennessee law that gives young people 14 and older the right to access confidential disease testing and birth control without having to tell their parents.

The memo noted, however, that all other primary healthcare services — once routinely offered to unaccompanied teens at Tennessee public health clinics — require the consent of a parent or guardian, including all vaccinations.

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The partial shift in policy elated some Tennessee public health providers who, for weeks, have had to turn their teenage patients away from healthcare visits that — until this summer — had been routinely available.

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

“(Tennessee Department of Health) has made the determination that parental consent is no longer required for minors seeking STI (sexually transmitted infection) or family planning services….including pregnancy testing,” the August 26 internal department email, obtained by the Lookout, said.

Beginning in July, the state department of health instructed local clinics to turn away teens who did not have a parent or guardian physically with them — or reachable by phone — for all healthcare services, citing the newly enacted Family Rights and Responsibilities Act.

The parents’ rights law, 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 healthcare sought by a minor.

The state health department initially interpreted the law to include birth control, pregnancy tests and HIV and other disease testing sought by teens at their local county clinics — often the only source of such care in rural Tennessee counties.

The Family Rights and Responsibilities Act, however, explicitly says it does not override preexisting Tennessee laws related to minors seeking healthcare. Tennessee has long had a law on its books allowing healthcare providers to treat and test teens for sexually transmitted infections without parental consent. Another preexisting law, in effect since 1971, allows doctors to prescribe contraceptives to minors without parental consent.

In early August, a group of Tennessee Democrats pressed state health department officials for an explanation about the shift in policies surrounding teens.

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In response, Tennessee Department of Health Commissioner Ralph Alvarado provided lawmakers a copy of the department’s new directive to health clinics that will allow them to continue to treat teens seeking birth control and sexually transmitted disease testing at clinics in all 95 Tennessee counties.

Neither the original guidance, barring teens seeking all healthcare services from public health clinics effective July 1, nor the revised guidance providing exceptions for teens seeking sexual health services, have been communicated to the public by the Tennessee Department of Health.

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

Rep. Aftyn Behn, among the Democratic lawmakers who signed the letter to the health department demanding clarity on their policies, said she remained concerned about the unintended consequences of the Family Rights and Responsibilities Act, which has also prevented school nurses from offering bandages or other common in-school care to students. Gov. Bill Lee has said he will consider changes to the law.

“We’re now hearing from concerned parents and school administration across the state about the unintended consequences of this legislation,” Behn said.  “Any legislation that creates an obstacle between a mature teenager and them receiving the care they need is harmful. We don’t need politicians without medical experience making decisions for our families.