Oregon lawmakers, educational leaders push to extend network of school-based health centers


Shane Ersland


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

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

“In all these years I’ve never seen a more troubling situation facing children and youth in our schools,” Riggs said. “The (COVID-19) pandemic, isolation, economic concerns, and social media are contributing to mental health issues that are impacting physical health (and) academic outcomes.”

The best way to respond to these challenges is with a coordinated, community-based approach that engages 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-Based Health Alliance Executive Director Maureen Hinman explained that SBHCs are primary care clinics that are located on school grounds. 

“They offer the full range of physical, behavioral, and preventive health services. They offer services to students that are youth-centered, regardless of insurance status or ability to pay. They reduce barriers to getting care. They are located all across the state.”

— Hinman

There are currently 85 SBHCs in 26 urban, rural, and frontier counties, Hinman said. They are primarily located in high schools, but several are in elementary schools, middle schools, and combined-grade campuses as well. 

“And 64 percent of them are in primary care professional health shortage areas,” Hinman said. “Only about 25 percent of school districts have SBHCs. SBHCs are effective at addressing health disparities.”

Hinman said 49 percent of SBHC school-age clients identified as persons of color, 59 percent are Medicaid members, and 21 percent have private insurance.

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

“Meeting the physical, mental, and behavioral health needs of our students, and in a lot of instances their families, is essential to children’s educational success and their family’s stability. At a time when students have suffered years of virtual education, and now some of our students are out of school due to other circumstances, it is important to ensure they always have access to mental and behavioral health resources to assist them. SBHCs provide a means by which students can begin to take agency over their own health, setting them up for more positive health outcomes through the rest of their life.”

— Dexter

Dexter said her bill will:

  • Include grants for 10 school districts to plan for the development of SBHCs 
  • Direct a study for reimbursement of mental health services in SBHCs 
  • Include a SBHC inflation adjustment for workforce 
  • 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 youths in the K-12 education system. 

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

And we know that there’s a rise in behavioral health issues. 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) addressing things before folks run through the traditional healthcare model. So we’re very supportive of this bill.”