Youth Guide to Healthcare & Access
Contents:
It can be hard to make the time or get over a fear of accessing health care services, especially for sexual and reproductive health. Getting tested, finding out if you’re pregnant, asking for a birth control prescription, or finding places that have free condoms should be easy. It gets a lot easier when you know you’re heading somewhere that cares about and respects young people (and you know how to get there).
A “youth-friendly” clinic or other healthcare location goes out of their way to make sure you feel safe, affirmed, and respected. They know your rights to health care and can help you understand how to get the information, testing, and care you need to be healthy. When you’re ready to make an appointment, ICAH’s youth-friendly map helps you find a location with youth-friendly information, staffing, environment, and financial options.
A group of Chicago youth leaders from the Illinois Caucus for Adolescent Health have a detailed list of what makes a health care location youth-friendly. They hope these ideas can be a resource for youth and providers:
INFORMATION
Consent and confidentiality laws present and easily accessed, a clear and open part of conversation
Unbiased on the basis of sexual identity, religion, race, and other factors
Non-shaming and non-judgemental in tone, facial expressions and other body language as well as verbal language.
Complete information available on clinic services, procedures, client/youth rights, info on sexuality and resources/materials to educate
STAFFING
Staff trained in cultural competency (includes youth cultural norms and language)
Staff knowledgeable about youth development and youth rights
Someone is available to assist potentially eligible youth in obtaining public funded health insurance and public funds for other needs
Staff actively practices compassion
Staff respects patient self determination (excluding situations where a person could cause harm to self and/or others)
ENVIRONMENTAL (INTERNAL AND EXTERNAL)
Close to public transit
Accessible to those with disabilities
Has relevant posters/materials related to adolescents and their health needs
Condoms and other materials available in packaging that offers privacy
Contains areas intentionally marketed to youth
Can youth/ do youth work there? Youth presence can be inviting.
Is there a peer presence in other ways? (e.g. outreach workers, advisory council, focus groups, community service learning, internships)
Offer to follow-up/check -in via phone or email reminding folks to return for any needed services/treatment
Extra time is allocated for adolescent visits
Youth are offered an opportunity to speak alone with provider when they are accompanied for services
FINANCIAL
Offer payment plans
Transparency around free vs. paid services
Offer referrals for where to get free services if they are too costly at your location
Offer smart/indiscreet ways of getting bills to youth for privacy (utilize email)
Let’s face it. Health care can be totally confusing, especially if you’re under 18 years old. There are a lot of different rules for different kinds of procedures, and it’s hard to know what you have a right to expect from any given situation. That’s why we want to fill you in on your sexual rights—we believe that if you know your rights, you will be better informed and better able to get the health care services that you need to stay healthy.
THE MOST IMPORTANT THING YOU CAN DO IS ASK! Before getting any service, ask about how much it costs, how you will pay for it, whether you have a right to confidentiality, and what kind of information will be given to your parents or guardians, if any.
Just because there are rules in place, doesn’t mean that everyone follows them or treats youth the same way. If you don’t like how one health care provider treats you (doesn’t respect your wishes, isn’t willing to work with you to keep things confidential), you have the right to leave and go find a new health care provider!
Rights: Protections that we are given by law
State law: A written statement passed by the Illinois General Assembly and signed by the Governor
Health Care Provider: This could be a doctor, nurse practitioner, midwife, nurse, counselor, social worker, etc.
Minor: Anyone who is under 18 years old
Confidential: Something that is kept private
We always recommend that if it’s possible, you talk to trusted family member about important healthcare needs. But we understand that that’s not always possible, which is why we’re also encouraging medical providers to be more youth-friendly too.
In Illinois, you usually have a right to confidentiality when talking to a health care provider or getting a medical procedure. HOWEVER, there are a few situations when you don’t have a right to confidentiality, like when you are a danger to yourself or others. In that case, providers don’t have a choice and have to report it
The best way to make sure that your rights are respected is to ASK about what your rights are before getting a checkup.
Questions to Ask:
How much do services cost?
Is there any circumstance under which you would tell a parent what we had talked about?
How can you mail the bill so that my parents don’t see it?
What is kept confidential here? What isn’t?
If you were to tell my parent something, what information would you give them?
Unfortunately, health care services are not free. Before getting any service, always ask how much it costs, and how you can pay.
Even if you get services that are confidential, if you use your family’s insurance to pay, they will often see a bill afterward. ASK if a bill will be sent to your home, and request that it not be sent there.
Title X clinics, such as, but not limited to Planned Parenthood, will often provide many of the health services listed below, and are confidential for both adults and minors to use. Many of these clinics provide sliding-scale services, so if you think you can’t afford services, they might be able to help out!
Don’t have insurance? All Kids SCHIP Program offers health insurance to all youth. Call 1-866-ALL-KIDS to register.
Safer-sex methods include barrier methods, which can protect against STIs and pregnancy, and hormonal methods, which only prevent pregnancy. For more information about how to use these methods and how effective they are, see ICAH’s Sexual Health zine (link coming soon).
Barrier methods: Male condoms and female condoms can all be bought at your local convenience store or pharmacy no matter how old you are, even if the store keeps condoms locked up or out of reach; you can also get them for free at many community organizations and local clinics in the area. Dental dams can usually be found at local clinics.
Emergency Birth Control: (also known as Plan B or The Morning-After Pill)- Can be purchased without a prescription by anyone (male OR female!) 17 years or older. If you are under 17, only girls can get access, and they need a prescription. You can get a prescription from your doctor, or a clinic, such as Planned Parenthood.
Hormonal Birth Control: This includes the pill, the patch, the ring, the shot, the implant, and the Mirena IUD. All of these forms of birth control need a prescription or in some cases (the shot, implant, and IUD) need to be administered by a health provider at a clinic, doctor’s office, or sometimes even a school health center.
HPV Vaccine: This can protect you from getting certain strains of HPV. Though it doesn’t protect you from all strains, it can help reduce your risk of becoming infected with HPV. A teenager under 18 needs their parent’s consent to get the HPV vaccine. Parental consent is needed because the HPV vaccine, like all vaccines, is considered preventative care and not treatment.
What are STIs?
STI stands for sexually transmitted infection. Common STIs include gonorrhea, chlamydia, syphilis, HPV, and HIV (human immunodeficiency virus). Getting tested for STIs so that you know your status is an important part of maintaining your sexual health and helping the people you are sexually involved with protect themselves, too. For more information about STIs, see ICAH’s Sexual Health Zine (link).
What are your rights when it comes to STI testing?
STI testing, including HIV testing, can be available in a variety of different settings such as doctors’ offices, community health organizations, schools, campuses, etc.
In Illinois, you have the right to be tested for any STI without a parent or guardian’s permission if you are 12 years or older. However, if you are a minor (17 years old or younger), the doctor that gives you the test may legally tell your parents or guardians that you received a test, and can legally share your results with them.
When you make an appointment for STI testing, it is important that you ask if the provider will keep your results confidential, and under what circumstances, if any, they would share your information with a parent or guardian.
You do not need anyone’s permission to get a pregnancy test from a store or from a clinic. If you are pregnant in Illinois, you have full adult legal rights. What does this mean? No matter how old you are, you can access any services confidentially.
What are my options once I’m pregnant?
Parenting: Parenting involves delivering and caring for a child for any period of time from birth to young adulthood.
Adoption: Adoption is the legal act of permanently placing a child with parents who will raise them as their own. It is important to realize the child will become a legal member of the adoptive family once an adoption is finalized. In some types of adoptions, the birth parent has rights and options for contact with the child.
Abandonment: Abandonment is when someone safely leaves their child with someone else permanently. This is supported by Safe Haven Laws in Illinois, which say that as long as you don’t harm your child, you can hand your newborn (30 days old or younger) to personnel at any hospital, police station or staffed fire station for adoption with no questions asked.
Abortion: An abortion is when someone voluntarily ends a pregnancy. In Illinois, you can get an abortion no matter how old you are, and you have a right to confidentiality. You can get an abortion up until the 24th week of your pregnancy. As of August 15, 2013 you must notify your parents 48 before the procedure to receive an abortion due to the Parental Notification Act. Judicial Bypass is possible if you aren’t safe doing so. Visit (link: http://ilbypasscoordinationproject.org/)
Sexual assault is when someone is forced into a sexual act (penetration, touching, fondling, etc) and they didn’t want that to happen. Rape is forced penetration without consent. Force can be physical (hitting, using weapons, choking, etc) or it can be verbal (threats, fear, coercion, etc). These are forms of violence, and they are never the survivor’s fault.
You have a right to:
Counseling
Legal and medical advocacy: help for survivors working with police, courts, and emergency rooms
Substance Abuse treatment and rehabilitation
Go to a rape crisis center
Mental health services include counseling and therapy. You could go to a counselor if you’re feeling depressed, if you have anxiety, if you have problems with anger or addiction, or with eating, for example.
If you are 12 years old or older, you have a right to see a counselor without your parents or guardians knowing, but there are special rules. The counselor cannot tell your parent or guardian anything you say without your permission.
You can go to a total of five sessions. (After you finish those sessions, you can continue counseling, but with parental consent). Each of the sessions are 45 minutes long
If you are 17+, you can go to as many sessions as you choose without parental consent.
You have a right to admit yourself into a mental health facility without parental consent.
Illinois has a Safe Schools Law, which is an anti-harassment and nondiscrimination law that says that you cannot be discriminated against because of your sexual orientation and gender identity.
There are anti-bullying laws in Illinois that protect students based on sexual orientation and gender identity. There are also statewide anti-discrimination laws in Illinois, which include sexual orientation and gender identity. State hate crimes laws include sexual orientation but not gender identity.
At ICAH, we work with a network of healthcare providers and youth leaders who have lots of experience and advice to offer when it comes to accessing all different kinds of healthcare. Here’s what you need to know about paperwork, preparing for an appointment, speaking with a doctor, getting tested, payment, privacy, and more…
THE PAPERWORK
Identification and Insurance (I2) – Remember to bring your photo ID and proof of insurance so that you are not the reason why your visit gets cancelled, rescheduled, or delayed.
Copy of Medical Records – If you are changing providers or transferring your care to a new location, always ask for a copy of your medical records, notes, and labs to be mailed or faxed to your new place. Sometimes calling the new place at least one week before your appointment to check if your records have arrived is a good idea to make sure you have a successful visit with the doctor.
Prepare Questions – Write down all of the questions you thought about or that your friend or family member asked about your visit, and bring these questions to your appointment. It can be intimidating once you are in the office and it is normal to forget what you had questions about.
HOW TO HELP THE APPOINTMENT GO SMOOTHLY
Confidence – You are the expert of your life. The health care professional is there to learn about YOU and to serve YOU.
Knowledge – You are the expert of your body’s history, present, and future. So own your behavior, language, and attitude and be an instrument of CHANGE and THE source of INFO about you. Health is your RIGHT!
Patience – The health care system does not always allow for the provider to spend as much time with you as you expect, desire, or demand. Ask for a followup appointment to learn more about the provider AND so he/she can learn more about you.
Curiosity – Ask questions before you go and when you arrive. For instance, ask what the fee is for the appointment and what type of payment options the clinic has (debit, cash, check).
Flexibility – Sometimes things happen unexpectedly. Maybe you are running late or the provider had an emergency. If possible, are willing to change your plans and reschedule your appointment if necessary.
Time management – Are you leaving your destination early enough to arrive at least 20 minutes BEFORE for your appointment? You never know when something unexpected could happen to delay you, like a traffic accident or a long waiting line at the registration or check in desk.
Support – Meeting new people can sometimes be scary. Imagine meeting a new doctor or nurse (provider) for the first time who may be asking sensitive questions or seeing you in a different manner. You can bring someone with you to the visit that you trust and who can help make the visit more comfortable by holding your hand or keeping you company while waiting for the provider.
HOW TO SPEAK WITH A DOCTOR
Take your time. Ask questions if you do not understand the type of language or words choices the provider is using. If you still don’t understand, ask for another way of explaining the information.
Be assertive – Use direct eye, speak clearly, and in tone that your voice is heard, use “I” statements.
Try not to be too embarrassed. They have heard it all before, we promise. And if you feel as though they are rude or not listening, it is your right to ask to see another provider.
Include questions you should bring to every visit/things you should get answers to every visit such as: What is the provider’s prior history with engaging or supporting youth OUTSIDE of medicine or the clinic? Ask for examples or stories about other patients with similar questions or situations and ask how that provider supported or helped the patient AND ask how the patient responded to the provider’s help/support. Ask the provider if they know about ICAH, Healthy Teen Network, YMCA, Boys and Girls Club (link to all), or any youth affiliated organization OUTSIDE of the clinic.
PREPARE TO GET TESTED
For STI/HIV testing appointments, be prepared in these ways:
Be prepared to give a blood draw. Notify your medical provider if you have anxiety with needles or blood.
Be sure to drink water and come hydrated! You will probably be asked to submit a urine sample, so be prepared!
It may be awkward, there may be some nudity, but it is over really quickly.
ADVICE FOR GETTING TEST RESULTS
Be assertive when you ask how you will get the results, including when and how you will get them, being assertive, and preparing mentally.
Ask “What are the rules your office/clinic has about relaying test results? Is it confidential or will my guardians find out?” Your clinic should ask if they have permission to leave voicemails on your phone.
If you are called to return to the office for test results, ask if can you bring a support person with you.
If you receive test results that challenge you mentally or emotionally, ask if there is a support person that you can talk to immediately such as a Nurse, counselor, social worker, case manager, or patient educator.
If there is no to talk about how you feel at this moment, ask if there is a hotline, community organization, or group that you can visit or contact for additional support.
PREPARING FOR PREGNANCY AND PARENTING VISITS
Coming soon…
PAYMENT OPTIONS AND PRIVACY
Unfortunately, health care services are not free. Before getting any service, always ask how much it costs, and how you can pay. Here are some helpful questions to have ready:
How much do services cost?
Is there any circumstance under which you would tell a parent what we had talked about?
How can you mail the bill so that my parents don’t see it?
What is kept confidential here? What isn’t?
If you were to tell my parent something, what information would you give them?
Even if you get services that are confidential, if you use your parent’s insurance to pay, they will often see a bill afterwards. ASK if a bill will be sent to your home, and request that it not be sent there.
Title X clinics, such as, but not limited to Planned Parenthood, will often provide many of the health services listed below, and are confidential for both adults and minors to use. Many of these clinics provide sliding-scale services, so if you think you can’t afford services, they might be able to help out!
Don’t have insurance? All Kids SCHIP Program offers health insurance to all youth. Call 1-866-ALL-KIDS to register.
Are you paying up front? Ask if it is possible to pay in cash and receive a receipt immediately, so no worries about having anything mailed home.
Is insurance covering it?
First, you can ask what forms of insurance they accept. This answer will most likely come from a receptionist or triage nurse.
If you do not have insurance, ask what forms of sliding fee or payment plans are available.
If you have a government assisted insurance plan, no bill will be sent to your home.
If you have a private insurance plan, an itemized bill will be sent out listing type of visit and any services performed. This is sent directly to the address listed on the insurance card. If that’s your home address, be aware that the services you receive may appear on paperwork sent out by the insurance company.
WARNINGS
Be careful if you encounter any “Crisis Pregnancy Centers” or CPCs.
If you or someone you know is seeking an abortion, always make sure and check that the clinic you are going to is an abortion facility and not a CPC. Even if you search for abortion on Google, you are likely going to see ads for "free pregnancy tests" that are coming from CPCs right next to the ads for actual licensed abortion clinics.
These are purposefully not included because these centers do not provide scientifically accurate information but attempt to obstruct or prevent women’s access to safe reproductive care. It is common for people who work at Crisis Pregnancy Centers to warn against using condoms, using birth control, and having an abortion using manipulative tactics. Hear a recording of the kind of biased information you might hear at a Crisis Pregnancy Center, visit this article.