KNAPPA — The Knappa School Board has given the nod to pursue a school-based health center, a controversial step that failed to take hold in Astoria but has slowly moved forward in Jewell.
The school board voted 3-2 to apply for a $60,000 grant from the Oregon Health Authority. The money helps establish an in-house health center that can provide primary care services such as general exams, sick visits, treatment of minor injuries and vaccinations for students regardless of ability to pay.
The health centers have shown to improve attendance by providing students more convenient access to health care, especially in rural, medically underserved areas. The state provides $60,000 a year for operations.
But the health centers have stoked concerns over parental control of their children’s health care and fear that the school could offer reproductive health services, such as contraceptives. By state law, minors age 14 and older can access outpatient mental health and substance abuse services without parental permission.
The Astoria School Board, facing a backlash from some in the community, nixed the planning of a health center in 2013. The Knappa School Board bowed out of pursuing a grant last school year after the public expressed concerns ranging from the location of the health center, safety, access and quality of providers to the potential for drug deals and child abuse.
After declining to pursue the grant, the school district convened an ad-hoc committee to explore the concept. To address community concerns, Knappa would limit its health center to students and only operate during school hours. The center would not offer reproductive health services.
The school district only has a nurse four hours a day, Knappa Superintendent Paulette Johnson said, and many families are lacking basic services like dental screenings and counseling.
“I only see it as positive,” she said.
At a school board meeting Monday, Tammy Goozee, the chairwoman, and members Ed Johnson and Will Isom supported applying for the grant. Board members Craig Weaver and Cullen Bangs, the vice chairman, opposed the application.
Goozee said she heard from people in the community about the high level of need, especially among younger children, while much of the opposition seems to be about the unknowns of a health center.
“With the planning process, it will help us to define it better what’s available and what’s not,” she said. “One big concern was to not have contraceptives available.”
Weaver declined to detail the reasons he voted “no,” but said he will support the planning of the health center now that the district is moving forward. He mentioned concerns some in the community had over children over 14 seeking services without permission, and over where to put the center on campus.
Johnson said he was swayed by a survey, compiled by Jewell Superintendent Stephen Phillips to inform his school board, of 10 other rural school districts with health centers that reported increased attendance and access to health care services with minimal cost or other issues. He also liked the increased anonymity a clinic offers students over a traditional counselor for mental health treatment.
“We have a year to plan,” Johnson said. “My hope is as we work through the planning process, all the board members will participate, and we’ll end up with five people who think it’s a great idea.”
Another challenge of the health centers is finding contractors in a tight construction market to build them. Jewell, expected to start its clinic this coming school year, has been struggling to find a builder.
Mike McNickle, the county’s public health director, approached Knappa and Jewell to expand health care access for students in underserved rural areas. He is planning to approach Seaside as it builds out a new campus farther away from town, but said Astoria and Warrenton aren’t as strong of candidates for the health centers because of their proximity to other medical services.
“You really want to hit folks who are medically underserved,” he said. “That’s the goal of school-based health centers.”