• Community Schools Vs. School Based Health Centers

    September 25, 2023
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    In our mission to be more proactive in school systems and to hold school officials and school boards accountable for what goes on in our public schools, it is easy sometimes to confuse and conflate terms in our arguments. It's also easy to misunderstand labels.

    Don't feel bad if you have made a mistake in terminology or details, the public-school bureaucracy wants it that way. Like most government agencies, they use acronyms like MCAP, ELL, ESSR, SEL, CRT, etc. It's such a prevalent strategy that we used to publish a list of acronyms for new teachers and parents so they would know what all the acronyms meant.

    However, when you are speaking to education administration you HAVE to know certain information. One thing you must know is terms and what they mean. The other is history and how we got where we are today, what has been tried in the past, etc.

    We are going to tackle terms today. Two of the programs in school systems are Community Based Schools and School Based Health Centers. Honestly, neither of these terms are new. Both have been around for quite a while. They are different with different requirements and missions.

    Let's begin with Community Based Schools. The Maryland State Department of Education defines Community schools as:

    In Maryland, a community school is any school that receives Concentration of Poverty Grants. The grants are formula-based and awarded to schools on an annual basis. The determining factor for eligibility is the 4-year average of the percentage of the school’s students living in poverty (excluding 2020-2021 school year), as determined by the compensatory education enrollment. This is essentially the number of students receiving free and reduced-price meals.1

    People are often confused and think that the designation as a Community School means that a school is unsuccessful academically. While it is often true that schools in areas with high poverty may not do well academically, that is not a requirement for being a Community School.

    Some also think that being designated a Community School means that the State of Maryland will come in and take over the school. That is also not correct. While the State may become more involved in Community Schools, they do not do a "take over." The Maryland State Department of Education details what happens with a Community School:

    Wraparound Services

    Community schools work in collaboration with community partners, local governments, and other stakeholders to identify and address structural and institutional barriers to achievement. Leveraging the power of the collective allows community schools to provide resources to students and families where they need it the most—neighborhoods that have been historically underfunded and underserved. Community schools provide a wide array of wraparound services that enhance student’s ability to be successful.

    Examples of wraparound services:

    • Extended learning time
    • Extended school year
    • Safe transportation to and from school 
    • Vision and dental services 
    • Expanded school-based health center services 
    • Additional social workers, counselors, and psychologists
    • Additional mentors and restorative practice coaches
    • Healthy food in-school and out-of-school
    • Access to mental health practitioners

    There are many hoops a Community School has to jump through in order to get these services. They also cost more money to the State and local taxpayer. One of the big problems with Community Schools is that the overreach of government in these schools can easily turn into encroachment on parental rights.

    School Based Health Centers are a similar but much bigger problem. Here is the definition of School Based Health Centers in Maryland:

    The Maryland School-Based Health Center Program provides comprehensive primary, acute and preventative health services and chronic condition management to students, families, and communities in clinics physically located on a school campus. There are currently 89 active school-based health centers across 16 jurisdictions in Maryland. School-based health centers play a critical role in increasing access to health services for students in Maryland schools, especially in underserved communities. School-based health centers are known to improve both the health and educational outcomes of students. Their strength lies in their ability to innovate and integrate into the local school and broader healthcare system.​​​2

    If you look at the Community Schools list of services, you will see School Based Health Centers as one of those services. Almost 29,000 Maryland students were enrolled in these centers during 2021-2022 and they conducted 42,400 visits in that year. Centers also provide birth control and pregnancy services. The program is funded through various sources, including federal fundsgrant fundinglocal governments, and school systems.

    From the Maryland Health Department website:

    All children are eligible for the SBHC in their school. The nurse practitioner and physician prescribe medicines as needed.  Some medications may be obtained at the SBHWC; others may be purchased at your local drug store.  SBHWC staff will explain how to take the medication and answer your questions about it. With permission of a parent, children may be seen for sick care without a parent being present.  The nurse will contact the parent on the day of services.  Parents are encouraged to be present for all well child visits.

    Some districts contract these services out to private vendors while other use their county health departments. Five schools in Talbot County, Easton High School, Easton Elementary School, Easton Middle School, St. Michaels Elementary/Middle/High Schools have School Based Health Centers. Services provided are generally billed to Medicaid.

    Community Schools and School Based Health Centers are considered by many to be an intrusion on parental rights. Parents need to be aware that when they sign school enrollment forms in the beginning of the school year, they are generally signing permission for their child to be treated medically in that school. Many parents choose to opt out of having their child treated in school except in emergencies.

    The Protection of Pupil Rights Amendment allows students (via themselves or their parents) the following:

    The PPRA won't protect a child from treatment in the schools all the time, but the text can help parents back up their actions to opt their child out.

    In a time when locals are struggling to fund schools so they can fulfill their primary mission of teaching children the basic academic skills, Community Schools suck up needed funding AND distract schools from that primary mission. And, of course, they take space and extra personnel in the buildings.

    They are also an invasion into the privacy of families and a flagrant usurpation of parental rights.

    School Based Health Centers create many more problems. Aside from funding issues, they also allow the schools to be much more involved in a student and family's personal medical decisions, even those dealing with pregnancy, birth control and sexually transmitted diseases.

    As we saw during Covid, schools were not above manipulating students into getting the Covid vaccine, despite evidence of possible medical harm and over parental objections.

    Here is a story from Baltimore City where they are still coercing students as well as parents: (Watch the video!)

    City Schools holds vaccine clinics at district office (wbaltv.com)

    Baltimore City is saying that students who are not vaccinated are not in "compliance." There is no law or mandate that students in Baltimore City schools are vaccinated against Covid. They are worried about needless vaccines while neglecting their job, educating children.

    It's interesting that the claim from the State of Maryland says that School Based Health Centers are known to improve both the health and educational outcomes of students. A screen shot of a video on FOX News:

    They have School Based Health Centers in Baltimore. Based on the info above and in this video, they don't work.


    Whenever schools take their eyes off their academic mission, our students are hurt.

    Many in government claim that the Community Schools and the School Based Health Centers will help students stay healthy. The claim is that the government needs to keep students get medical care, particularly if they are poor. But, isn't that what County Health Departments are for? Don't we spend millions on Health Departments already?

    The most damning part of the Community Schools/School Based Health Centers program is that they can hide from parents treatment given to their children. Consider this headline:

    Maine Dad Says High School Clinic Sent 17-Year-Old Daughter Home with Secret Baggy of Zoloft, Sicced Child Protective Services on Him For Complaining - The Maine Wire

    The parent in this story had signed permission for his daughter to be treated. He probably, like most parents, didn't think that this would mean they would prescribe and send prescription drugs home with her in a baggie.

    When SBHC's can provide all these services without parental knowledge, they can also transition students as in another story from Maine:

    Public School Worker Who Began Secret Gender Transition on 13-Year-Old Maine Girl Has Conditional License - The Maine Wire

    And they can do this with personnel who may not even have a license to practice.

    Parents and taxpayers need to speak up about these two programs. They are the beginning of a process that takes way the rights and responsibilities of parents to make decisions that will affect the lives of their children. They are an encroachment on the privacy of families. And, like the cases above, they could be dangerous to our kids.

    But, when we do talk about them, we need to know our facts.


    1. Office of Community Schools and Expanded Learning Time (marylandpublicschools.org)
    2. Pages - About the Maryland School-Based Health Center Program


    Jan Greenhawk

    Jan Greenhawk is a former teacher and school administrator for over thirty years. She has two grown children and lives with her husband in Maryland. She also spent over twenty-five years coaching/judging gymnastics and coaching women’s softball.
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