Family Planning Perspectives Volume 33, Number 2, March/April 2001 |
Reproductive Health Services for Adolescents |
Table 1. Number of programs with selected services and features under the State Children's Health Insurance Program (CHIP), by service or feature, according to program type | ||
Service or feature | Medicaid programs | State-designed programs |
(N=30) | (N=28) | |
REPRODUCTIVE HEALTH CARE | ||
All services listed | 21 | 20 |
Routine gynecologic exam and Pap test | 30 | 28 |
STD/HIV screening/testing | 30 | 28 |
Contraceptive services | ||
Oral contraceptives | 30 | 26 |
Injectable | 30 | 26 |
IUD | 30 | 25 |
Diaphragm | 30 | 25 |
Implant | 30 | 24 |
Natural family planning | 26 | 25 |
Emergency contraception | 21 | 22 |
Abortion* | 30 | 26 |
Pregnancy testing | 30 | 28 |
Obstetric care | 30 | 25 |
INFORMATION ON COVERAGE | ||
All services listed | 8 | 12 |
Routine gynecologic care | 11 | 17 |
STD/HIV screening/testing | 10 | 14 |
Contraceptive services | 12 | 16 |
Pregnancy testing | 10 | 15 |
Abortion | 8 | 12 |
Obstetric care | 10 | 14 |
INFORMATION ON ACCESSING CARE | ||
All services listed | 7 | 11 |
Routine gynecologic care | 10 | 15 |
STD/HIV screening/testing | 9 | 13 |
Contraceptive services | 10 | 14 |
Pregnancy testing | 9 | 13 |
Abortion | 7 | 11 |
Obstetric care | 9 | 13 |
REQUIRES CONFIDENTIALITY | ||
At all points | 9 | 8 |
Before reproductive health care | 18 | 15 |
After reproductive health care, in all cases | 11 | 10 |
After reproductive health care, only upon request | 4 | 2 |
SITES WHERE ELIGIBILITY WORKERS ARE OUTSTATIONED | ||
At any of the sites listed | 9 | 9 |
Middle schools | 4 | 3 |
High schools | 4 | 3 |
Community-based organizations serving teenagers | 3 | 5 |
Family planning clinics | 4 | 4 |
Prenatal care clinics | 8 | 6 |
STD clinics | 3 | 3 |
PRESUMPTIVE ELIGIBILITY USED AT ANY SITE | ||
All sites using | 7 | 3 |
SITES CERTIFIED AS PRESUMPTIVE ELIGIBILITY PROVIDERS | ||
Middle schools | 0 | 0 |
High schools | 0 | 0 |
Community-based organizations serving teenagers | 2 | 0 |
Family planning clinics | 3 | 1 |
Prenatal care clinics | 6 | 0 |
STD clinics | 1 | 0 |
Private physicians | 2 | 1 |
*In cases of life endangerment, rape or incest. |
Table 2. Services and features of CHIP related to contraceptive services, by state and program type | ||||||
State | Cover all five major prescription methods | Routinely inform adolescents about service | Are required not to notify parents adolescents of about repro. health care* | Guarantee access to contraceptive services from out-of-network providers | ||
Coverage of contraceptive services | Accessing contraceptive services | Before | After | |||
MEDICAID PROGRAMS | ||||||
Medicaid only | ||||||
Alaska | Yes | No | No | Yes | Yes | na |
Arkansas | Yes | No | No | No | Yes | na |
D.C. | Yes | Yes | Yes | Yes | No | Yes |
Idaho | Yes | No | No | Yes | Yes | na |
Illinois | Yes | No | No | No | No | na |
Indiana | Yes | No | No | No | No | Yes |
Louisiana | Yes | No | No | No | No | na |
Maryland | Yes | Yes | No | Yes | Yes | Yes |
Missouri | Yes | Yes | Yes | No | Yes | Yes |
Nebraska | Yes | No | No | Yes | No | Yes |
North Dakota | Yes | No | No | No | No | Yes |
Ohio | Yes | No | No | No | No | Unknown |
Oklahoma | Yes | No | No | Yes | No | Yes |
Rhode Island | Yes | Yes | Yes | Yes | Yes | No |
South Carolina | Yes | Yes | No | No | No | Yes |
Tennessee | Yes | Yes | Yes | No | No | No |
Texas | Yes | No | No | Yes | Upon request | Yes |
Wisconsin | Yes | Yes | Yes | Yes | No | Yes |
Part of combination program | ||||||
Alabama | Yes | No | No | No | No | na |
California | Yes | No | No | Yes | Upon request | Yes |
Connecticut | Yes | Yes | Yes | Yes | Upon request | Yes |
Florida | Yes | No | No | Yes | No | No |
Iowa | Yes | No | No | No | No | No |
Kentucky | Yes | No | No | Yes | Yes | Yes |
Maine | Yes | No | No | Yes | Yes | Yes |
Massachusetts | Yes | Yes | Yes | Yes | Yes | Yes |
Michigan | Yes | No | No | Yes | Yes | Yes |
Mississippi | Yes | Yes | Yes | No | No | No |
New Jersey | Yes | Yes | Yes | Yes | Upon request | Yes |
New York | Yes | Yes | Yes | Yes | Yes | na |
STATE-DESIGNED PROGRAMS | ||||||
State-designed only | ||||||
Arizona | Yes | Yes | Yes | No | No | No |
Colorado | Yes | Yes | No | Yes | Yes | No |
Delaware | Yes | No | No | No | No | No |
Georgia | Yes | No | No | No | Yes | na |
Kansas | Yes | Yes | Yes | Yes | No | No |
Montana | No | na | na | na | na | na |
Nevada | Yes | Yes | Yes | No | No | Yes |
New Hampshire | No§ | Yes | Yes | No | No | No |
North Carolina | Yes | Yes | Yes | No | No | na |
Oregon | Yes | Yes | Yes | Yes | No | Yes |
Pennsylvania | No | na | na | Yes** | No | na |
Utah | No§ | No | No | No | No | No |
Vermont | Yes | No | No | Yes | Yes | na |
Washington | Yes | Yes | Yes | Yes | Yes | Yes |
West Virginia | Yes | Yes | No | No | Upon request | na |
Wyoming | Yes | No | No | No | Yes | na |
Part of combination program | ||||||
Alabama | Yes | No | No | Yes | No | na |
California | Yes | Yes | Yes | Yes | No | Yes |
Connecticut | Yes | Yes | Yes | Yes | Yes | No |
Florida | Yes | Yes | Yes | Yes | Yes | No |
Iowa | Yes | No | No | No | No | No |
Kentucky | Yes | No | No | Yes | Yes | Yes |
Maine | Yes | No | No | Yes | Yes | Yes |
Massachusetts | Yes | Yes | Yes | Yes | Yes | Yes |
Michigan | Yes | No | No | No | No | No |
Mississippi | Yes | Yes | Yes | No | No | No |
New Jersey | Yes | Yes | Yes | Yes | Upon request | Yes |
New York | Yes | Yes | Yes | Yes | No | Yes |
*Applies to all reproductive health services, not only contraceptive services. Adolescents are never enrolled in managed care. Contraceptives are never included or are only sometimes included in managed care contracts. §New Hampshire does not cover the IUD, implant or diaphragm; Utah does not cover the implant. **The state requires that parents not be notified before reproductive health care, but the state does not cover contraception under CHIP. Notes: The survey was not applicable to the programs in Hawaii and Minnesota because of the programs' low age limits. New Mexico, South Dakota and Virginia did not respond to the survey. na=not applicable. |
Table 3. Number of programs enrolling adolescents in managed care under CHIP with selected services and managed care contract features, by program type and service | ||
Service | Medicaid | State-designed |
(N=26) | (N=22) | |
Service included in all contracts | ||
Routine gynecologic care | 25 | 22 |
STD/HIV screening/testing | 25 | 22 |
STD/HIV treatment | 25 | 22 |
Contraceptive services | 23 | 20 |
Pregnancy testing | 24 | 22 |
Abortion | 17 | 18 |
Obstetric care | 25 | 21 |
Plans required to demonstrate "reasonable access"* | ||
Routine gynecologic care | 25 | 20 |
STD/HIV screening/testing | 23 | 19 |
STD/HIV treatment | 23 | 19 |
Contraceptive services | 22 | 18 |
Pregnancy testing | 24 | 20 |
Abortion | 17 | 16 |
Obstetric care | 25 | 19 |
Plans required to allow access to out-of-network providers* | ||
Routine gynecologic care | 11 | 6 |
STD/HIV screening/testing | 17 | 8 |
STD/HIV treatment | 16 | 7 |
Contraceptive services | 17 | 9 |
Pregnancy testing | 18 | 8 |
Abortion | 7 | 5 |
Obstetric care | 9 | 5 |
*Only includes programs in which all managed care contracts offer the specified service. |
Table 4. Number of states using selected outreach activities under CHIP (N=46) | |
Type | No. |
Adolescent-specific | 27* |
Hotline | 16* |
Printed materials | 24* |
Media campaign | 22* |
Internet-based campaign | 9 |
Other | 10* |
Sites where outreach materials are provided | |
Middle schools | 42* |
High schools | 42* |
Community-based organizations serving teenagers | 42* |
Family planning clinics | 36* |
Prenatal care clinics | 37* |
STD clinics | 31* |
Shopping malls | 22* |
Fast-food outlets | 25* |
Sites where enrollment forms are provided | |
Middle schools | 33* |
High schools | 35* |
Community-based organizations serving< teenagers | 37* |
Family planning clinics | 34* |
Prenatal care clinics | 35* |
STD clinics | 28* |
Shopping malls | 12* |
Fast-food outlets | 14* |
*Includes the District of Columbia. |
© copyright 2001, The Alan Guttmacher Institute. |