Not Another Free Clinic: Silver Spring's TAYA 'Non-Biased' Youth Reproductive Care

Here’s a statistic that’s uncomfortable for some adults: A majority of teens has sex. Guttmacher Institute’s February 2012 fact sheet on teen sexual health reports that 70 percent of teens in America said they had intercourse by their 19th birthday. 

Despite that, some pediatricians and parents aren’t comfortable talking to teens about sexual and reproductive health, said Molly Love, executive director of Teen and Young Adult (TAYA) Health Connection in Silver Spring. 

Tucked away on the second floor of a downtown office building, TAYA looks like a private doctor’s office. In reality it’s a nonprofit reproductive health clinic, serving teens and low-income women in the Washington, DC, area, accepting patients only between the ages of 12 and 35. Services range from pap smears to pregnancy tests to STD treatment.

Not another free clinic

Cheeky posters adorn the walls, like the one featuring a cow rocking rubber boots. “Wear your rubbers,” is the cow’s advice. Another sign, this one framed in orange, riffs on old Mastercard ads. “Condoms: $3.99. Peace of Mind: Priceless.” Free condoms are available in numerous and discrete locations.

Love talks a lot about the culture of TAYA—non-biased, welcoming and sensitive to teen and college cultures. It’s important that it not feel like “your typical free clinic,” she said. 

“A lot of people end up telling us that they feel comfortable here, that it’s a safe place,” adds Lisa Holloway, a nurse practitioner who has worked with the clinic since 2005.

There’s a reason places like TAYA, which accepts patients regardless of insurance and operates on a sliding payment scale, need to exist, according to Love.

There are barriers to access for teens to receive the kinds of services that the clinic offers: Medical practitioners may not be comfortable working with youth; teenagers don’t want to go to clinics where they might run into adults they know; teenagers don’t have their own insurance and may not want their parents to know they are having sex. Not to mention the costs associated with medical care. 

Screenings, treatment and counseling related to reproductive health may be more important for this age group than others. Guttmacher’s fact sheet said sexually active teens that don’t use contraceptives have a 90 percent chance of becoming pregnant within a year.

Non-biased care for teens

The stated goal of TAYA is to reduce teen and unplanned pregnancies and the medical staff members are people that prefer to work with youth.

Holloway says part of her job goes beyond performing exams and dispensing medicine, but connecting to a younger population that may have fewer resources. 

“Understanding our population and providing medical care in a way that makes sense to those women--I think that’s what I do on a regular basis,” she said.

“I try to understand where our patients are coming from, so not only if they want a pap smear give them a pap smear, but make sure that I’m reaching them,” Holloway continued. 

She said she wants to make sure “that that information is not going over their head, that they’re understanding what I’m saying, that they’re comfortable and that they will hopefully better their health or better their situation because of it.”

Services for Latina women 

Since opening in Takoma Park in 2000 as a part-time clinic only working with teenagers, TAYA has grown, moved to Spring Street in downtown Silver Spring and gradually increased the age range of patients it accepts. 

“We saw the need for the services grow and people that were older than teenagers wanted to receive care from us, so we expanded,” Love said. 

Along with older women, TAYA saw a swell of Spanish-speaking patients over the past decade, the result of inflation in the region’s Latino population. Teen births to Latina women in Montgomery County are triple that of other racial and ethnic groups, Love said. 

TAYA responded in kind, hiring bilingual staff and including Latino parents and youth in its outreach efforts.

“We know that we had to make the environment here comfortable and welcoming for Latina patients,” Love continued. “We had to be able to provide all of our services in English and Spanish and have that available every single appointment time.”

Health care for the uninsured 

A 22-year-old woman from College Park takes the Metro to Silver Spring a few times a year to visit TAYA. She said that she’s been going there for years, right after she switched from another clinic in Prince George’s that was free for women under 24, but made her wait for hours.

She gets the Depo-Provera birth control shot, which can run over $100 each time without insurance, she said. At TAYA she used to receive the student discount. Now that she’s graduated and working full-time, she said that she brought in her paystubs to see how much the shot would cost after the clinic factored her age and income.

Many of TAYA’s clients are uninsured, Love said. Some, like the College Park woman, have plans to get on employee-sponsored health plans at some point, but others won’t be insured in the foreseeable future. 

Love and her staff are trying to find ways to keep the clinic running in the face of a changing national healthcare strategy, she said.

“Healthcare reform presents a whole new set of challenges for us and our sustainability as the model turns into a model of health centers that provide all services in one location,” Love said. 

TAYA exists on a combination of federal funding from Title X, the money it gets from patient fees and private foundation funds. A small percentage of the budget comes from individual donors. 

“Given that a large part of our population will probably not be eligible for insurance…we will still need to subsidize care for them,” Love explained. “The question for us right now is how do we maintain what we are doing already?” 

TAYA is located at 1400 Spring Street in Silver Spring, MD. Visit the website to learn more. 

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