Ray Carter | November 14, 2019
Conflicting responses given on Medicaid agency’s role in teen program
Thrive, an Oklahoma City organization that works on teen-pregnancy issues—including notifying teens that some services can be obtained without parental notification using Medicaid dollars—prominently lists the Oklahoma Health Care Authority (OHCA) as one of seven partners on its website. Planned Parenthood Great Plains, an affiliate of the nation’s largest abortion provider, is also listed as a partner alongside the OHCA.
A spokesperson for the OHCA, which manages Oklahoma’s Medicaid spending, downplayed any ties between the agency and Thrive.
“OHCA does not in any way fund or sponsor this organization,” said Shelley Zumwalt, chief communications and strategic engagement officer at the Oklahoma Health Care Authority. “The agency has a data use agreement (DUA) with the organization where we supply information from the claims we process. This is a pretty common arrangement and we share this data via an agreement with other organizations and nonprofits.”
But a spokesperson for Thrive, which describes itself as a “Sexual Health Collective for Youth,” says the OHCA has been a longtime participant in the organization’s work.
“The entire collaboration has been working with them for several years,” said Brittney Criswell, program director for Thrive OKC.
She said the OHCA’s funding has been used primarily for provider education.
“We partner with their program called ‘Focus Forward,’ which is a program from the Health Care Authority that is statewide that focuses on increasing provider knowledge about what we would call LARCs—long-acting reversible contraceptives,” Criswell said.
The website of Focus Forward Oklahoma describes its mission as working to “decrease unintended pregnancies in Oklahoma by increasing access to and utilization of long-acting reversible contraceptives (LARC).”
“In addition to time, staff, and resources provided by the Oklahoma Health Care Authority (OHCA), the Focus Forward Oklahoma program is made possible by a Children’s Health Insurance Program Health Services Initiative” and private donations, the site states.
Fast Forward Oklahoma’s “state resources” page includes a link to Planned Parenthood, although the page states that “being listed here does not imply endorsement.”
Thrive describes itself as “a public-private collaboration to reduce the teen birth rate in Central Oklahoma” and officials with Thrive have suggested a reduction in teen pregnancy from 2013 to 2018 was due in part to Thrive’s work.
Thrive’s website includes a page on minor rights that notes “teens generally cannot self-consent to contraceptive services” aside from those who are 18 or 19, but adds that “there are certain situations where teens can self-consent to these services.” Thrive reports that the situations in which a teen can self-consent to “contraceptive services” include a “minor who is insured through SoonerCare (Oklahoma Medicaid).”
That exemption includes a large share of minors in Oklahoma. According to a recent presentation from the Oklahoma Health Care Authority, there are more than 638,000 children currently on Oklahoma’s Medicaid program.
Thrive’s website adds that even in situations where a minor may see a doctor without a parent present, parents may still have access to medical or billing records.
“Although we encourage you and your parent/ guardian to communicate openly and honestly about sexual health, we understand that is not always the case,” Thrive’s website states. “If you have any concerns about the confidentiality of your visit, be sure to ask your healthcare provider who has access to your records and who will see the bill.”
Thrive’s website also advises teens, “You can get condoms for FREE without an appointment, and without a parent or guardian, at any of our teen-friendly clinic sites listed in this guide.”
Thrive’s list of “teen friendly” clinics includes Planned Parenthood Great Plains – Edmond. The website for Planned Parenthood Great Plains includes information about its facilities in Oklahoma, Kansas, Arkansas and Missouri, and lists abortion among the services it provides in the region.
Thrive’s referral guide also states, “Teens can access STI and HIV testing and treatment without a parent regardless of their age. This means that teens can self-consent to STI services, including those for HIV.” (Emphasis in original.)
The guide then adds (again, emphasis in original), “Keep in mind, some clinics have their own age restrictions. Check out the list of teen-friendly clinics on page 11 to see which ones do, or ask about self-consent when you call to make an appointment.”
Thrive’s referral guide also links to a Planned Parenthood page that informs teens, “Most doctors and nurses won’t tell anybody—including your parents—what happens during your appointment. Many states have special laws that protect your right to get private sexual health care, even if you’re under 18. But laws are different in every state. And in certain places someone from the doctor’s office might contact your parent or guardian when you’re under 18. If you’re worried about privacy, call the doctor’s office or health center to ask about their privacy policies.”
Some aspects of Thrive’s work appear to go beyond the services many people envision when they think of teen pregnancy.
Thrive’s website includes a page devoted to LBGTQ teen resources that directs youth to several Oklahoma providers. The site states that the Adolescent Medicine Roy G. Biv Program at The Children’s Hospital at OU Medical Center serves the needs for all LGBTQ youth “including those moving toward gender affirmation.”
That same page informs readers that Trust Women’s Oklahoma City clinic offers “LGBTQIA/transgender services including: hormone therapy, labs following hormonal therapy,” “assistance with changing legal documents,” and “referral to LGBTQIA-friendly behavioral health/physicians if needed.”
Thrive’s page on LBGTQ teen resources also links to the site of The Trevor Project, which states, “Most of us were taught that there are only two genders (man/masculine and woman/feminine) and two sexes (male and female). However, there is a lot more to it than that.”
The Trevor Project declares, “Gender is actually a social construct …” That message is also repeated by Thrive on its Facebook page, where Thrive officials declare, “Gender identity refers to how a person sees themselves in terms of gender. Gender is also a social construct that is greatly influenced by culture.”
Director, Center for Independent Journalism
Ray Carter is the director of OCPA’s Center for Independent Journalism. He has two decades of experience in journalism and communications. He previously served as senior Capitol reporter for The Journal Record, media director for the Oklahoma House of Representatives, and chief editorial writer at The Oklahoman. As a reporter for The Journal Record, Carter received 12 Carl Rogan Awards in four years—including awards for investigative reporting, general news reporting, feature writing, spot news reporting, business reporting, and sports reporting. While at The Oklahoman, he was the recipient of several awards, including first place in the editorial writing category of the Associated Press/Oklahoma News Executives Carl Rogan Memorial News Excellence Competition for an editorial on the history of racism in the Oklahoma legislature.