Oregon SBHCs: From 1985-2010

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Contributed by Alyssa Rust

Honoring a Legacy and Advancing a Future outlines 25 years, from 1985-2010, of Oregon’s School-Based Health Center (SBHC) history and their ability to build access to health care for children. The summary below provides highlights from the report.

A Look Back

The SBHC movement first began in the late 1960s with centers opening in Massachusetts and Texas. The movement soon spread with the help of foundations and supporting practitioners. Dr. Phil Porter sparked the movement in Oregon when he spoke at a hearing at the Oregon legislature in 1985. Because of the impact that Dr. Porter saw when nurse practitioners where put in schools he testified, “Health care needs to be where students can trip over it. Adolescents do not carry appointment books, and school is the only place where they are required to spend time.”

The Courage to Begin (1985 - 1990)

This testimony, along with Dr. Porter’s research was the beginning for SBHCs in Oregon. In 1985 the first SBHC was opened at Roosevelt High School. Although there was some push back from the community about including family planning issues within the school setting, the SBHC at Roosevelt opened and thrived.
Due to the success of the Roosevelt SBHC, in 1986 the State of Oregon awarded $212,000 in grants to fund five additional SBHCs located around the state. Additional grants were awarded to Oregon City by the National Institute of Mental Health to assess teen depression and to develop resources for treatment and support. In 1990 the Portland Public Schools gained three additional centers at Grant, Madison and Parkrose.

Growing Pains (1991 - 1995)

The growth of SBHCs expanded in 1991 to 18 additional schools in nine counties. A lot of the growth and success was due to the communication among coordinators to build unity around SBHCs by creating a call to action through community outreach and policy advocacy.
In 1991, when Measure 5 was passed in Oregon that limited property taxes, SBHCs were threatened by the loss of funding. SBHCs found stable funding through insurance reimbursements. However, in their infant stage, many SBHCs did not bill for their services. Today, SBHCs are financed through a blend of resources. Because of the uncertainty of government funding year to year, SBHC coordinators initiated Advocacy Day efforts at the state capitol in order to meet with legislators and build support to fund SBHCs.

Consolidating our Voices to Build Stability (1996 - 2002)

During this period of time when there was a large amount of pressure placed on academic success, SBHCs were able to build strong partners with schools and advocate for student success. Coordinators had proved successful in gaining awareness, community acceptance, and funding for SBHCs, but as more SBHCs were beginning to open it was clear that an independent organization was necessary to help pursue political action, advocacy, and strategic communications. In 1996, the Oregon School-Based Health Care Network (presently known as the Oregon School-Based Health Alliance) established a board of directors and began to formalize the organization’s advocacy activities.

Threats and Promises (2003 - 2008)

Securing funding proved to be a constant battle for SBHCs and in 2003 many centers closed due to the lack of state grant funding resulting from budget cuts. The Network was successful at gaining at $1.5 million multiple-year grant from the WK Kellogg Foundation and was able to hire staff, create work plans to help build capacity and credibility, and prevent some centers from having to close their doors. In 2006, the Network gained IRS nonprofit status. The Network continued to work and advocate for SBHCs, along with 20 other state associations in order to share information, ensure professional development, and collaborate on policy initiatives.  

Promises and Challenge (2009- and beyond)

Even though the state was experiencing fiscal distress, Governor Kulongoski passed the Oregon Healthy Kids initiative into Oregon law establishing health insurance for all of Oregon’s children. Health Care Reform in Oregon has three main goals: (1) a healthy population, (2) extraordinary patient care for everyone and, (3) reasonable costs shared equitably. In 2010 there were 55 SBHCs operating in Oregon schools.

A Look Forward

From the first Oregon SBHC at Roosevelt High School, Oregon’s SBHCs have emerged as a vital part of the state’s health care system. Since 1985, more than 65 SBHCs have opened and have continued to evolve in order to provide primary care, preventive health, child development, and health education for all students, parents and communities. 

‚ÄčOver the past five years a lot has changed related to the advancement of SBHCs through policy, advocacy, and collaborative partnerships. The Oregon School-Based Health Alliance will be creating a new 30 year report in 2015 to highlight some of the progressive steps that have been accomplished since 2010.