King School Parents Offered Clearer Clinic Consent Form

By KELLEY BOUCHARD Staff Writer

Portland officials are using a new parental consent and enrollment form for King Middle School’s Student Health Center to more clearly explain the reproductive health services offered there and children’s privacy rights under Maine law.

Both sparked national controversy last fall when the School Committee agreed to let the city’s Public Health Division provide prescription birth control to sexually active students who enroll at the health center.

The issue was back in the news this week when the Legislature blocked the drafting of a bill to set limits on dispensing prescription drugs to children. Earlier this year, legislative leaders blocked the introduction of a bill to require parental consent before schools could provide prescription birth control to children younger than 15.

The School Committee asked city health officials to improve the enrollment form, particularly its attached information sheet, after parents and others complained that it lacked a full description of the services offered and the legal limits to informing parents about students’ care.

Although students need written permission from parents or guardians to be treated at the health center, state law allows them to receive confidential care for reproductive health, mental health and substance-abuse issues.

"The new form addresses the concerns that parents had and makes clear what state law says on the matter," said Sarah Thompson, a School Committee member and the mother of a student at King.

The revised information sheet says the center offers "reproductive health services including risk assessment and counseling, testing and treatment of sexually transmitted infections, birth control services for sexually active students, pregnancy testing." The sheet doesn’t specify prescription birth control.

It also calls attention to the confidentiality issue and gives a Web address for a state law that "allows minors to seek services from health care providers for issues related to reproductive health, mental health or substance abuse without requiring parental notification."

The revised form was mailed in mid-December to parents of 193 students who were enrolled in the center at the end of November, said Douglas Gardner, Portland’s health and human services director.

It also was made available at a table set up during recent parent- teacher conferences, said Amanda Rowe, the school district’s head nurse.

Now, 126 students are enrolled in the center. Some were enrolled before, some are new users, and some parents declined to re-enroll their children, Rowe said.

Gardner said enrollment typically increases through the school year as students seek treatment for illnesses and get physicals they need to participate in sports.

Last year, enrollment increased from 170 at the end of September to 193 at the end of November. During the 2006-07 school year, 309 students were enrolled in the center and 134 used it for a total of 266 visits.

Gardner said the revised form will be offered to all 500 King students again in September, as it is each year.

Any student who isn’t enrolled can get regular primary care at the center if his or her parents fill out the new form. An initial visit to the center is allowed with a parent’s verbal consent, but written consent is required after that, according to the information sheet.

All Portland public school students have access to school nurses for basic health care. When there’s a medical emergency, school officials call an ambulance to bring the student to a hospital, Gardner said.

In addition, the city’s Public Health Division operates health centers at Portland High School, Deering High School, King Middle School, the West School special education program, and the Reiche and East End community schools, which are elementary schools.

The centers provide a full range of primary health care, dental care and mental health counseling. They are funded by state and foundation grants, MaineCare/Medicaid and private health insurance reimbursements.

The School Committee voted 7-2 in October to make King the first Maine middle school to make prescription birth control available to girls in grades 6, 7 and 8. King’s health center had provided condoms as part of comprehensive reproductive health care since it opened in 2000.

Advocates said the prescription birth control measure would help protect the health and futures of a few King students who are sexually active.

Five King students, ages 14 and 15, reported having sexual intercourse in 2006-07, Rowe said.

Critics said the birth control measure infringed on parents’ rights and put the city in a precarious legal position.

They asked the School Committee to include an opt-out clause in the enrollment form so parents could prevent their children from getting confidential health services. The committee declined, citing state law.

Critics included Nick McGee, chairman of Portland’s Republican City Committee, which led an unsuccessful effort to recall School Committee members who supported the measure.

McGee said the more detailed enrollment form is an improvement, but it doesn’t address concerns about parental control and providing access to birth control in a middle school.

"I still don’t like the idea of parents being taken out of the equation," McGee said. "That has more to do with state law than anything else, but there’s still the issue of providing access to children. You’re putting things in play that could put a lot of children in danger."

The revised information sheet also addresses concerns raised last fall by Cumberland County District Attorney Stephanie Anderson. She questioned whether Portland’s health care workers were reporting instances in which children younger than 14 were having sex.

Maine law prohibits having sex with a person under age 14, regardless of the age of the other person involved, she said.

The new information sheet says: "In cases where abuse or neglect is suspected, the appropriate authorities will be notified as required by law."

It also says: "In crisis situations, such as when a student is actively considering suicide, the parent will be notified and immediate crisis intervention will be sought."

Staff Writer Kelley Bouchard can be contacted at 791-6328 or at:

kbouchard@pressherald.com

[Sidebar]

ENROLLMENT CHANGES

FOR THE TEXT of changes in the enrollment form, go to the Back Page.

THE ENTIRE enrollment form, with changes highlighted, is available at pressherald.com.

ENROLLMENT FORM CHANGES

THE NEW ENROLLMENT form that more clearly explains reproductive health services offered and children’s privacy rights under Maine law makes the following changes (from the "services" section of the enrollment form):

OLD

Testing and treatment of sexually transmitted diseases

NEW

Reproductive health services including risk assessment and counseling, testing and treatment of sexually transmitted infections, birth control services for sexually active students, pregnancy testing

THE COMPLETE TEXT of the "confidentiality" section of the enrollment form:

OLD

By law, all medical, dental and mental health information kept in any student’s clinic health record is confidential and will remain locked at the Health Center site. No records or information will be released from the Student Health Center without the written consent from the parent or legal guardian. The law also allows students to seek services for issues related to reproductive health, mental health or substance abuse without requiring parental notification. Whenever possible, students are encouraged to share their health concerns and treatment information with their parents.

NEW

By law, all medical, dental and mental health information kept in any student’s clinic health record is confidential and will remain locked at the Health Center site. Health records will only be released from the Student Health Center with written consent from the parent, legal guardian or student as appropriate. Whenever possible, students are encouraged to share their health concerns and treatment information with their parents. However, please note that the law allows minors to seek services from health care providers for issues related to reproductive health, mental health or substance abuse without requiring parental notification. (22 M.R.S.A. can be found at http://janus.state.me.us/legis/statutes/22/ title22ch0sec0.html ) In cases where abuse or neglect is suspected, the appropriate authorities will be notified as required by law. In crisis situations, such as when a student is actively considering suicide, the parent will be notified and immediate crisis intervention will be sought.

KING MIDDLE SCHOOL CONTROVERSY TIMELINE

2000: Student health center opens at King Middle School, providing condoms and tests for pregnancy and sexually transmitted diseases to students who have parental permission to be treated.

Oct. 17, 2007: The Portland School Committee votes 7-2 to allow students who have parental permission to be treated at King Middle School’s health center to obtain birth control prescriptions.

Oct. 18, 2007: The School Committee’s decision attracts the interest of several national television shows, several of which feature interviews with Portland school officials. Bishop Richard Malone issues a statement expressing "shock and sadness" at the committee’s decision.

Oct. 25, 2007: The Cumberland County district attorney questions whether Portland’s public health centers have been reporting all known and suspected cases of sex between minors, as required by law. The director of Portland’s Department of Health and Human Services says the centers will do so in the future.

Nov. 26, 2007: The Portland Republican City Committee submits a petition with 550 signatures seeking a recall election for three members of the School Committee who voted in favor of the proposal to provide King Middle School students with contraceptives.

Dec. 1, 2007: The Portland city clerk begins a monthlong petition drive to determine whether at least 3,000 voters want to hold a recall election in the spring for three members of the School Committee.

Dec. 5. 2007: Members of the Portland Democratic City Committee call the recall petition a "waste of time and money" and urge voters not to sign it.

Dec. 30, 2007: The birth control controversy is voted top story of the year by readers of the Portland Press Herald/Maine Sunday Telegram.

Jan. 2, 2008: The recall petition falls short with fewer than 100 signatures.

Jan. 25, 2008: A legislative bill to require parental consent before a Maine school can provide prescription birth control to a child 14 or younger is blocked for this session.

Feb. 5, 2008: The Maine Senate votes 29-5 in favor of drafting a bill addressing whether Maine children need parental permission to obtain prescription birth control.

Feb. 7, 2008: Maine House blocks the move to draft legislation addressing the dispensing of prescription drugs to children by a vote of 75-67.

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