Many districts around the state are considering adding School Based Health Centers (SBHCs), like the one we have in Hillsboro. Offering a full slate of health services co-located with the schools can be a useful convenience for students and their families. At first glance, there is no real downside to adding an SBHC, especially since they are primarily funded outside the school district budget. However, based on what I have observed in Hillsboro, there are some serious concerns that a school board should consider before allowing an SBHC into their district.
- An SBHC unnecessarily entangles school and health care issues. Education and health care are two major concerns for any community, but are handled by different elected bodies. There is no reason why the school board should be heavily involved in health care issues, aside from the basic ones already handled by school nurses’ offices. Such issues create a distraction and take away time and energy from a district’s primary mission. Last year, we had several board meetings that overran their schedule by hours, one going until midnight, discussing issues that really should not be in our domain.
- Children may be used as political pawns. Our SBHC started a student health council, a leadership club for students interested in health issues. This sounds like a nice extracurricular experience, and was beneficial to the participating students. But one of their “leadership” activities turned out to be busing the students to Salem, to meet with legislators and tell them about the benefits of SBHCs. As I see it, this is blatant political lobbying with public funds— and an unethical exploitation of our district’s children.
- Under Oregon laws, teens have “health care autonomy”, which includes getting all forms of birth control and transgender treatments, without parental permission or notification. This means your 8th-grade daughter could be getting birth control on school grounds, during the school day, without you ever knowing about it. Is this a good idea for the schools, or for the children? (You can see my blog article on this topic at for a discussion of the many reasons why this scares me.) You might be offered the compromise of an agreement not to provide these services, but…
- The SBHC staff will labor tirelessly to expand its scope and funding. In Hillsboro we thought we headed off the above issue by getting an agreement not to supply birth control in the SBHC. But last year we faced an intense lobbying campaign to change this agreement, and a media campaign to demonize school board members who failed to vote in favor of the change. It’s only a matter of time before this happens again, and it will probably be a repeated occurrence until either the board caves or the SBHC is closed.
Based on the above issues, I personally would not recommend adding an SBHC to any district that doesn’t already have one.
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