Friday, November 15, 2013

Teens, Sex and High School Health Centers

Seattle Public Schools, via our generous voters and the City's Families and Education Levy, funds a health center in every comprehensive high school in the district (and I believe one there are four at middle schools). 

Correction (I had not reviewed my notes thoroughly but the following is correct):  In Washington State, minors can consent to reproductive health services at any age without parental consent.  In addition, youth ages 13 and over can consent to their own mental health treatment.  Parental consent is needed for other health services.  (And the sheet sent home is that consent form.)

There is not an M.D. on site but there are nurses. 

And what a lot of services: routine/sports physicals, immunizations, vision/hearing screenings, dental referrals,mental health counseling, and wellness counseling.  They are hoping to offer dental services at some locations.  (Note; there is a special notification for immunization services.)  Folks, this is a great gift that voters have given SPS students, for whom some might not ever see a health care professional. 

And yes, contraceptive services are available. 

Your son or daughter has access to condoms (usually in a basket by the door, no questions asked), birth control, pregnancy testing, Plan B and abortion services.   The staff always counsels students to talk with their parents and get them involved but yes, if the authorization sheet is signed, you do not have to be contacted for your child to receive this information.  

Also new in the area of birth control is an app from Planned Parenthood (this via the NY Times).

One goal of the national Planned Parenthood organization is to be there for those young people — to, as Leslie Kantor, vice president for education at Planned Parenthood Federation of America, put it “reach them in their urgent moment of need.” Their solution was to offer live counselors able to answer questions either by text or through online chat, and their research, published in the Journal of Medical Internet Research, shows that the new program has been successful, reaching more than 250,000 people since it began in September 2010. 

On Monday to Thursday, from 9 a.m. to midnight; Friday, 9 a.m. to 10 p.m.; Saturday: 9 a.m. to 5 p.m., and Sunday, 2 p.m. to midnight (all times Eastern), 20 well-trained staff members take questions. “Our staff have to be very good at assessing the question behind the question,” Ms. Kantor said. “Frequently people present with an anxiety that may be based on misinformation. They’re assuming they’re already pregnant when the condom broke 10 minutes ago.”

One advantage of offering an expert instead of an information bank is that a staff member can ask another person questions to figure out what’s really going on, or can make sure that an anxious person really understood an answer, and can rephrase it if necessary.

12 comments:

Anonymous said...

The health center at my daughter's high school saved one of her friend's lives. I don't know the details (nor should I) but the friend was talking about harming herself and my daughter took her down to the health center and got her to talk to someone.

Also, having met in the course of my job some very desperate teen mothers, you better believe I signed the fullest range of permissions for all of my kids so that they had access to non-judgmental birth control if they needed it. These centers deserve our fullest support. Parents who are uncomfortable with the range of care they offer can always opt out, though it's some of THOSE kids who need access the most.

Grateful Mom

mirmac1 said...

I see that Student Health Centers and medical providers request access to student data and get it from SPS. My concern is the security of both the data transfer and storage. And I am unsure whether these 3rd parties obtain parental consent to release this information. Perhaps someone can comment?

Group Health Coorperative
International Community Health Services (ICHS)
Neighborcare Health
Odessa Brown Childrens Clinic
Public Health Seattle/King County
Swedish

Libby said...
This comment has been removed by the author.
Libby said...

All of the health agencies you've listed are well versed in patient rights and security measures required by HIPAA.
To clarify, they are staffed by nurse practitioners (NPs), not registered nurses (RNs).

Anonymous said...



Student health centers and drop-out rate study.

http://archpedi.jamanetwork.com/article.aspx?articleid=1107551

PSP

dw said...

Libby,

You responded to mirmac's question, but you didn't answer it. You gave the "politician's answer", which usually happens when the real answer is unpleasant or worse (illegal).

1) Do these 3rd parties get student PII without parental consent?
2) Can students under the age of 18 give consent for the transfer of this information? (presumably not legally)

There are other issues surrounding xfer, storage, retention, and who else, if anyone, can access this data; but I presume those are tied to HIPAA regulations. However, the question of whether data is transferred without parental consent stands.

Anonymous said...

I guess I just find it odd that it has to be all or nothing. If you need a separate authorization for flu shots, why can't they require separate authorizations for other things? Now, my kids aren't that age yet, but really, I will not sign a form that allows them unlimited access to free birth control etc. However, it sure would be convenient to have sports physicals or flu shots administered at the school. It would be nice it they could see the nurse if they got sick during school hours - what happens if kids are sick & the parents haven't signed the form? Why the requirement that one can't schedule some services without giving carte blanche for everything? Sounds like it is at least in part about pushing an agenda, not just providing health services.

Mom of 4

mirmac1 said...

Mom of 4,
I'm making reference to requests for access to info on the Source. Plus, possibly FRL, discipline and disability status.

This kind of info in the hands of someone who does not know the family situation, the degree of disability and its manifestations, and the reasons for discipline, the supply of this info can be inflammatory.

Anonymous said...

You guys have reminded me that I haven't yet turned in my high schoolers' health center paperwork, b/c I was troubled by the form asking for access to school records. When I asked my 11th grader about it, he said that sometimes the teen health center will work with the school mental health counseling staff. FWIW, he says that some students, for a variety of reasons, don't want their parents to know they are seeing the counselor.

Mom of 4 - some unasked for advice. Let your kids have free access to birth control at school, and then continue to have open conversations with them about sex. Hopefully, they will come to you before needing to use the free condom. But a wise mama once said to me that you should assume your kid IS going to try things - sex, drugs and rock and roll - and they will find a way around it, or worse, have sex without the condom.

High School Mama

Libby said...

Here's a link to health services that can be provided to a minor without parental consent: http://depts.washington.edu/hcsats/PDF/guidelines/Minors%20Health%20Care%20Rights%20Washington%20State.pdf.
As you can see, minors can self-consent under certain circumstances - e.g. for the treatment of STDs and birth control services. Minors over the age of 14 can access this care at school based health centers, Planned Parenthood, etc.
I visit the school based health centers in the context of my job, and my daughter is a patient at one of the middle school clinics. Both professionally and personally, I hold these health care providers in the highest regard. They have seen it all and they know what they're doing, let me tell you.
Mom of 4, if kids are sick during school they can see the school nurse. School based health center providers are entirely separate and offer different services like sports physicals and immunizations.

Anonymous said...

I agree with High School Mama—
Teens have been having sex since time began. Let's keep them safe from STDs and unwanted pregnancies. The world does not need any more teen mothers, and no teen should have to make the difficult choice of dealing with an unwanted pregnancy.
We would all love our children to wait until they are in a deep, committed relationship before having sex, but hormones are a powerful thing.
Solvay Girl

RosieReader said...

Mom of 4 - The school nurse is separate from the teen health center. If your high school student gets sick during the school day, he/she will go to the nurse. If your student wants a flu shot, to get tested for an STD, or to get a sports physical he/she would go the the Student Health Center, assuming you've authorized it.