The recent push by the U.S. federal government to rapidly expand the use of school-based health centers (SBHCs) across the country has some critics concerned children will receive, or be pressured into receiving, unnecessary or unwanted medical interventions — including vaccines — without their parents’ knowledge or consent.
Georgia attorney Nicole Johnson, co-director of Georgia Coalition for Vaccine Choice and a consultant to the Children’s Health Defense’s (CHD) legal team, told The Defender:
“It’s scary because these health centers sound really good. In some of the rural and poor communities especially, this is going to seem like a really good way for children to get this care.
“And while there may be some conveniences, there are so many concerns with allowing medical exams and treatments at school. Parents need to be involved in all medical decisions and I fear they are being left out of the equation.”
SBHCs are intended to provide high-quality healthcare to kids by offering “primary care, mental health care, and other health services in schools,” particularly in underserved communities.
This includes services “to prevent disease, disability, and other health conditions or their progression” such as “immunizations” and “well-child care.”
According to the Centers for Disease Control and Prevention’s (CDC) Community Preventive Services Task Force, SBHCs can improve educational and health outcomes.
The CDC also considers SBHCs as integral to its Whole School, Whole Community, Whole Child model because they provide health services and mental health counseling.
But critics like Johnson worry that though there may be benefits to SBHCs, there are also downsides — including lack of regulation of the centers and the fact that parents may not be aware of the broad range of medical and behavioral services being provided in their children’s schools.
SBHCs have been linked to higher human papillomavirus (HPV) vaccination rates, according to a 2022 report by Harvard University’s Center for Health Law and Policy Innovation and the University of California Davis Comprehensive Cancer Center.
The report — written expressly to “address vaccine hesitancy” — concluded: “These results suggest SBHCs create a considerable opportunity … to implement successful school based HPV vaccination programs.”
Merck, the maker of the Gardasil HPV vaccine, is one of the funders of the School-Based Health Alliance, a large networking organization that “works on policy, standards, data, and training issues” regarding SBHCs.
Federal, state authorities pour taxpayer money into school-based health centers
The idea of running full-service health centers in public schools has been around for more than two decades, but events in 2022 caused SBHCs to catch on like wildfire.
Congress and President Joe Biden in June 2022 passed the Bipartisan Safer Communities Act, which allowed the U.S. Department of Health and Human Services (HHS) to award $50 million in grants to states “for the purpose of implementing, enhancing, or expanding the provision” of healthcare assistance through SBHCs using Medicaid or the Children’s Health Insurance Program (CHIP).
The legislation charged the Centers for Medicare & Medicaid Services (CMS) with expanding access to Medicaid healthcare services — including behavioral health services — in schools, and reducing the administrative burden for states and schools.
A CMS spokesperson told The Defender that Medicaid and CHIP now can provide reimbursement for services given in SBHCs for children and youth who are covered by those programs.
Additionally, in May 2022 HHS awarded $25 million in grants to 125 SBHCs “to improve and strengthen access to school-based health services in communities across the country.”
State public officials also are dedicating funds to expand SBHCs. For instance, the governor of Georgia in fall 2022 announced an investment of $125 million to expand school-based health services to rural communities in Georgia.
Pediatricians can ‘partner’ with schools
The American Academy of Pediatrics (AAP) supports SBHCs and said in a policy statement that pediatricians may act as “sponsors” by partnering with a school to establish the SBHC as an extension of their practice or by supervising the care given at a SBHC