Oregon lawmakers, education leaders push to expand network of school health centers – State of the reforms

Oregon K-12 education leaders support an initiative that would provide additional resources for students through school-based health centers (SBHCs).

Doug Riggs has been a legislative advocate with Northwest Policy Advocates since 2006. He said Oregon ranks last in the nation in mental health services available to youth during a meeting of the House Interim Committee on Health and Behavioral Health Care last week.

In all these years, I have never seen a more problematic situation that children and youth face in our schools, said Riggs. The pandemic (COVID-19), isolation, economic worries, and social media are contributing to mental health problems that affect physical health (and) academic performance.

The best way to address these challenges is through a coordinated, community-based approach that includes the local health community, school officials, students and parents, Riggs said.

That’s what our model for SBHCs does, he said. That’s why it’s been so successful for the handful of communities, both urban and rural, that have adopted the model over the past decade.

Oregon School Health Alliance Executive Director Maureen Hinman explained that SBHCs are primary care clinics located on school grounds.

They offer a full range of physical, behavioral and preventive health services. They offer youth-focused student services, regardless of insurance status or ability to pay. They reduce barriers to getting care. They are located all over the country.

Hinman

There are currently 85 SBHCs in 26 urban, rural and border counties, Hinman said. They are primarily located in high schools, but there are a few in elementary schools, high schools, and co-ed campuses.

And 64 percent of those are in areas with primary care health worker shortages, Hinman said. Only about 25 percent of school districts have SBHCs. SBHCs are effective in addressing health disparities.

Hinman said 49 percent of SBHC’s school-aged clients identify as people of color, 59 percent are Medicaid members and 21 percent have private insurance.

Rep. Makina Dekter (D-Portland) hopes to add resources and new locations to Oregon’s SBHC network through legislation. She plans to introduce a bill in 2024 that would serve as a replacement for Senate Bill 549, which failed in last year’s June legislative session.

Meeting the physical, mental, and behavioral health needs of our students, and in many cases, their families, is essential to the educational success of children and the stability of their families. At a time when students have suffered from years of virtual education, and now some of our students are out of school due to other circumstances, it is important to ensure that they always have access to mental and behavioral health resources to help them. SBHCs provide a way for students to begin taking responsibility for their own health, setting them up for more positive health outcomes throughout their lives.

Dexter

Decter said her bill will:

• Include grants to 10 school districts for SBHC development planning
• Direct a study on reimbursement for mental health services in SBHCs
• Include the SBHC inflation adjustment for labor force
• Include mental health funding for schools with and without SBHCs
• Issue bonds for the construction of SBHCs

Jeremiah Rigsby, chief of staff at CareOregon, said the initiative can help the health plan work with partners to help address the needs of youth in the K-12 education system.

“It’s really difficult in geographic areas, school district by school district, to figure out how to partner with schools,” Rigsby said. And SBHCs give us this incredible opportunity to start talking about aligning different goals. One of our biggest goals with Oregon Health Plan is for members to have access.

And we know there is an increase in behavioral health problems. If we can address these issues where these kids are in school, we have a better chance of doing the things we talk about academically, working upstream (and) solving things before people go through the traditional health care model. So they were very supportive of this law.