Civil Discourse Op-Ed: Should Lebanon Have School-Based Health Centers?

The most recent healthy argument from our Civil Discourse Program, Advised by Communications Professor Mark Urista, talks about what could be a life changing program for some. School-Based Health Centers have existed in Oregon since 1986, with Oregon Health Authority support. Take a look at our debate club’s op-ed, who will take a deeper dive into both sides of the coin.

Lebanon Should Have School-Based Health Centers

How would School-Based Health Centers (SBHC) be beneficial towards us when we have other forms of receiving medical care? Well, SBHCs have been proven to provide a variety of resources to families since they are directly located in schools. 

As a result, this makes it easier for students to access healthcare. Students don’t have to leave school to receive medical attention or burden themselves with other issues such as insurance or transportation. SBHCs will improve students’ health and help them be more successful in school.

Mental health is a serious concern for every age group, but particularly young people. The statistics are startling. One in three teens reported persistent feelings of sadness or hopelessness in 2019, and 18.8% of the same age group reported seriously considering suicide. 

Oregon has the highest rate of depression in the country.  If students have easy access to mental health support, they can learn how to manage their disorders earlier on in life and overcome them. 2017 was a particularly sad year for Lebanon with a teacher at the high school and at least four other young people dying by suicide. SBHCs would have provided these individuals with easy access to mental health care and potentially saved their lives.

SBHCs can also decrease emergency room overload and increase school attendance. Too many people use emergency rooms for basic healthcare services.  This increases wait times and financial costs. A study in 2002 found that SBHC’s caused a 41-57% decrease in emergency room visits. Despite this study being almost 20 years old, the logic makes sense.  If people have other options, the emergency room will not always be their first (and only) choice for accessing the care they need.

Concerns about cost and control over medical decision-making have come to the minds of some community members, with notable pushback. These concerns were addressed by Obria’s CEO, Debbie Tracy, in a recent Gazette-Times interview: “Obria representatives said providers will eat the cost of care for students who can’t afford care and bill insurance when they can.”  

In regards to abortion, Tracy clarified that while minors can currently seek out abortion pill access online, Obria is a “life-affirming” clinic and will be offering access only to healthcare providers who have signed a memorandum to adhere to Obria’s values that explicitly outlines the company’s intention to never provide abortions. 

With or without an SBHC, minors over the age of 15 are able to make decisions regarding their healthcare in Oregon. An SBHC just gives them the access they need to make those choices informed by medical professionals in a safe, supportive environment, so they can get back to class.
The Lebanon Community School District should allow an SBHC because it will serve the underserved, improve healthcare access, and can strengthen its community. Many have been helped by SBHCs in Oregon. Increased access to healthcare can only empower some of our most vulnerable.

By Cheyanne Rider, Moriah Rivera-Lawrence, Yahaira Suarez and The Civil Discourse Program.

Lebanon Should Not Allow School-Based Health Centers

Making sure that students have access to basic healthcare is vital to increasing academic performance. If a student is struggling with their physical and/or mental health, it’s going to be incredibly challenging for them to learn and succeed in school. 

While we recognize that school-based health centers (SBHCs) hold great potential, we also see some serious pitfalls that need to be critically examined.

First, giving minors the opportunity to take vaccinations and medication without parental supervision could result in harmful reactions unbeknownst to the student. 

According to Lebanon Local News, “a Lebanon resident who asked to remain anonymous has stated that her family has a history of medical conditions that require family members to be particularly careful. One of her grandchildren who wanted to get the vaccination was able to do so. She didn’t tell anyone and no one at the clinic knew her family history. They gave her the shot with little discretion and the result was life-threatening.” 

This case alone justifies the worries of many concerned parents. It is important for a parent to be involved in their child’s health. Healthcare decisions can be very complex and involve weighing risks and benefits. Parents should be involved in these decisions.

Second, parents should also be involved in the administration of services for mental health and drug/alcohol abuse. According to the Oregon Health Authority, although minors age 14 and older can access outpatient mental health and chemical dependency services independently, parents are expected to be involved in their treatment at some point.  

The reason for this is simple, minors are dependent on adults. They need the guidance and support of their legal guardians in order to ensure that their health improves.  Without parental involvement, many treatment plans will not be successful and the minor will suffer.

Funding is also a major concern. Many people would love health clinics available to students anonymously and for free, however getting the money to fund these services can be a daunting task.  

School Based Health Centers tend to rely on financial support from the government to keep them running. According to a recent Harvard study, “[School based health centers] need an ‘active patient population’ with high levels of insured patients—particularly students who are eligible for Medicaid or the Child Health Insurance Program (CHIP).” This makes SBHCs difficult to sustain. Any changes to Medicaid’s policies could directly impact the services SBHCs provide students.  

Funding changes can also affect SBHCs ability to pay their employees. This can make it difficult to recruit and retain high quality personnel in an increasingly competitive healthcare marketplace. Concerns about funding could also result in unethical marketing towards minors to use services they don’t need in order for the SBHCs to collect revenue.  

In conclusion, Lebanon Community Schools should not implement an SBHC at this time.  While SBHCs have the potential to help many people, these serious consequences are worth reviewing and addressing before moving forward.

By Eagle Hunt, Eliana Ortega, Jacob Pacheco and The Civil Discourse Program.