Kate Coleman-Minahan1, Kristine Hopkins2, Kari White3. 1. College of Nursing, Anschutz Medical Campus, University of Colorado, Aurora, Colorado; University of Colorado Population Center (CUPC), University of Colorado Boulder, Boulder, Colorado. Electronic address: kate.coleman-minahan@cuanschutz.edu. 2. Population Research Center, University of Texas at Austin, Austin, Texas. 3. Population Research Center, University of Texas at Austin, Austin, Texas; Department of Sociology, University of Texas at Austin, Austin, Texas; Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas.
Abstract
PURPOSE: Texas is one of 24 states that does not explicitly allow minors to consent to contraception. We explore changes in the provision of confidential reproductive health services after the implementation of state policies that cut and reorganized public family planning funding, including Title X. METHODS: We use data from 3 waves of in-depth interviews, conducted between February 2012 and February 2015, with program administrators at publicly funded family planning organizations in Texas about changes in service delivery. We conducted a thematic analysis of transcripts from 47 organizations with segments related to the provision of services to minor teens. RESULTS: Overall, 34 of the 47 organizations received Title X funding before 2013, and 79% lost this funding during the study period. Respondents at these organizations frequently reported a decrease in teen clients, which they attributed to loss of confidential services previously guaranteed under Title X. As the number of Title X-funded sites decreased, availability of confidential services became inconsistent. Most organizations offered confidential testing for pregnancy and sexually transmitted infections, but availability of confidential contraceptive services varied across and within organizations and often depended on insurance coverage. Respondents also reported challenges clarifying parental consent requirements after the changes in Title X and state funding. CONCLUSIONS: Loss of Title X funding decreased availability of quality family planning services for teens and burdened organizations. As the new Title X regulations are implemented, family planning organizations' experiences in Texas foreshadow what might occur nationally, particularly in states that do not allow minors to consent for contraception.
PURPOSE: Texas is one of 24 states that does not explicitly allow minors to consent to contraception. We explore changes in the provision of confidential reproductive health services after the implementation of state policies that cut and reorganized public family planning funding, including Title X. METHODS: We use data from 3 waves of in-depth interviews, conducted between February 2012 and February 2015, with program administrators at publicly funded family planning organizations in Texas about changes in service delivery. We conducted a thematic analysis of transcripts from 47 organizations with segments related to the provision of services to minor teens. RESULTS: Overall, 34 of the 47 organizations received Title X funding before 2013, and 79% lost this funding during the study period. Respondents at these organizations frequently reported a decrease in teen clients, which they attributed to loss of confidential services previously guaranteed under Title X. As the number of Title X-funded sites decreased, availability of confidential services became inconsistent. Most organizations offered confidential testing for pregnancy and sexually transmitted infections, but availability of confidential contraceptive services varied across and within organizations and often depended on insurance coverage. Respondents also reported challenges clarifying parental consent requirements after the changes in Title X and state funding. CONCLUSIONS: Loss of Title X funding decreased availability of quality family planning services for teens and burdened organizations. As the new Title X regulations are implemented, family planning organizations' experiences in Texas foreshadow what might occur nationally, particularly in states that do not allow minors to consent for contraception.
Authors: Pamela J Burke; Mandy S Coles; Giuseppina Di Meglio; Erica J Gibson; Sara M Handschin; May Lau; Arik V Marcell; Kathleen P Tebb; Kim Urbach Journal: J Adolesc Health Date: 2014-04 Impact factor: 5.012
Authors: Heike Thiel de Bocanegra; Julie Cross Riedel; Mary Menz; Philip D Darney; Claire D Brindis Journal: J Womens Health (Larchmt) Date: 2014-01-09 Impact factor: 2.681
Authors: Kari White; Kristine Hopkins; Abigail R A Aiken; Amanda Stevenson; Celia Hubert; Daniel Grossman; Joseph E Potter Journal: Am J Public Health Date: 2015-03-19 Impact factor: 11.561