A school-based health center (SBHC) is located in or adjacent to a school and typically provides medical, behavioral health, and other health care services to students. An SBHC is usually a collaboration between the community, the school, and a health care sponsor. The health care sponsor may be a community clinic or health care system, hospital, public health department, or tribal program. Under this model, the health care sponsor staffs and operates the SBHC. SBHCs typically are staffed by a primary care provider, behavioral health care provider, and clinic coordinator, although dental and other health professionals may also provide services. According to the Washington School-Based Health Alliance, there are more than 50 SBHCs throughout the state.
State law authorizes school district boards of directors to permit rental, lease, or occasional use of surplus real property if certain requirements are met. In a 1989 Office of the Attorney General (AGO) opinion, the AGO concluded school districts may lease surplus school district property to public or private entities to operate adolescent health care clinics as long as the board of directors finds this is compatible with the district's other uses for its property, and the clinic is not operated or controlled by the school district.
The Department of Health must establish a SBHC program office. The objective of the program office is to expand and sustain the availability of SBHC services to K-12 public school students with a focus on historically underserved populations.
Subject to appropriations, the program office must:
SBHC is defined as a collaboration between the community, the school, and a sponsoring agency that operates the school-based health center, which is a student-focused health center located in or adjacent to a school that provides integrated medical, behavioral health, and other health care services such as dental care.
PRO: This bill is product of a work group that identified barriers for communities to create and sustain SBHCs. SHBCs operate across the state have been in existence for over 30 years. There are over 55 SBHCs in the state. They provide youth and families with better access to health services. This bill passed with bipartisan support out of the house because of the SBHCs understand community partnerships are what is best and engage in community conversations about what makes most sense for that community. This bill will help provide funding for SBHCs during three critical stages. SBHCs are well-utilized and there has been increasing interest from communities about establishing more. Evidence shows that healthy kids learn better and often barriers to health care exist in communities of color where health disparities already exist. The COVID-19 pandemic has only made these disparities worse. SBHCs bring services to students living in medical desserts where they struggle to access medical, behavioral health and dental services. By separating the schools and the clinics, this bill will help lessen the liability concerns that some school districts have about establishing SBHCs. SBHCs work collaboratively with school nurses and guidance counselors. Most schools do not have a dedicated school nurse or counselor so many refer students to the SBHC. The majority of the students seek behavioral health services from the SBHC. SBHCs help families connect to community resources, provide both short and long-term counseling and respond to students in urgent need. SBHCs are a proven way to remove barriers to care and improve academic performance. They have been shown to decrease absenteeism, increase grades, and reduce lost instructional time. SBHCs must follow consent laws already established for health care. Students must be enrolled by their families with parental consent, minor consent laws apply to reproductive health and mental health similar to what they would access in the community. The need for SBHC services is high and funding is challenging because much of the care is uncompensated. Students often receive more time with the provider than they would in a community setting. The bill provides for local and school-district control over their SBHC.
CON: We are concerned the SBHC program will be under the Department of Health (DOH) and that DOH will take a one-size-fits all approach. This will take control away from local communities about what happens in their schools. The bill gives too much power and money to DOH. It is not transparent what processes, procedures and other requirements DOH will mandate under this program. Public funds should not be provided for a state program and should not be taken away from other local programs. No case has been made for a state office to implement this local program.