GARDINER – A school-based health center proposed for Gardiner Area High School has drawn both praise and criticism in the four communities that make up Maine School Administrative District 11 and beyond. 

On Thursday, nearly four dozen people turned out to listen or have their say on a plan that has fueled controversy in the district.

Those in favor — many in the community and a majority of the school board — see it as a way to remove significant barriers for students and staff to get medical care. Those who oppose the health center, including school board member Michelle Tucker, believe the health center will provide gender-affirming care to transgender students. Still others are skeptical about how the center will run without taxpayer dollars.

The school board is in the process of negotiating a memorandum of understanding with HealthReach, the nonprofit that would run the health center. Until that legal agreement is finalized, the board said it will not have all of the answers to people’s questions.

Here’s what’s known so far.

What is a school-based health center?

A school-based health center is similar to a primary care provider located inside a school that provides healthcare services to students and staff.

If approved, Gardiner’s clinic would be the second such clinic run by HealthReach, but 16 organizations run other centers across Maine, according to a spokesperson from HealthReach. HealthReach operates 12 locations across Maine outside school settings, including the Richmond Area Health Center and Bingham Area Health & Dental Center. 

HealthReach is a nonprofit that is federally funded and already operates a school-based health center at Lawrence High School in Fairfield.

Having an appointment at a school-based health center is similar to visiting a primary care physician. Other than being inside a school, there is nothing else that sets the office apart from a traditional doctor’s office. The school-based health center would employ a primary care physician and occupy an already-empty space in the high school.

Will it cost taxpayers?

No. HealthReach covers operational, labor and equipment costs, funded through a combination of patient fees, foundation grants and private donations.

HealthReach’s most recent tax filing lists the Waterville-based company as receiving $29.6 million in revenue and $7.7 million in contributions and grants. 

Who can use a school-based health center?

All of MSAD 11’s students and staff, with or without insurance, can use the clinic. In the event a family does not have insurance, a sliding pay scale for families, similar to a co-pay, is available. If a student, or teacher, already has a primary care physician, they do not need to switch to the school center to see the doctor on site.

What services are offered?

Immunizations, sports physicals, general primary and preventive care, care for illnesses, mental health counseling and in some centers, dentistry is available.

How are parents involved?

Edward Molleo, a spokesperson for HealthReach, said the school centers follow Maine law that allows minors to consent to specific health services.

That means under Maine law, minors who are at least 16 can receive care relating to reproductive health, mental health, or prescribing medicine. 

“This is the case for any licensed healthcare provider in the state of Maine. In this regard, the school-based health center operates no differently from any other licensed primary care office in Maine,” Molleo said. 

In the event that medicine is prescribed, the school clinic would operate the same as a traditional primary care office where a patient would have that prescription filled at a pharmacy and not at the clinic, which would not dispense drugs.

How will this help Gardiner area students?

Connor Tibbetts, a Gardiner Area High School sophomore, told the Gardiner-area school board on Thursday the clinic would be beneficial to him and other students he knows, specifically, those he plays sports with.

To get his annual physical, which is required statewide to play sports, he relies on his mother to drive him to his doctor’s office in Augusta. Some families might not have the insurance or the leisure to pick up their children during the work day to drive them to doctor’s appointments.

Nora Diversi, Gardiner Area High School’s school nurse, said in October that she was encouraged to look into the possibility of hosting a school-based health center at the high school based on the need she sees on a regular basis, which includes students who do not have a primary care physician, insurance, or have to wait months to get an appointment.

Data from the U.S. Census shows that 10% of Gardiner’s 6,159 residents under the age of 65 do not have health insurance, and approximately 11% of Gardiner residents live in poverty.

“To get my physical, it took me away from my sports and school,” Tibbetts said. “It would be a lot more simple if I could just get it at school. Additionally, if someone gets hurt at school, it’s a lot easier to have the health care clinic there than to have to call an ambulance and drive them to Augusta.”

Tibbett said more students might play sports if getting their physical at school is possible.