A Jefferson City lawmaker presented a bill to a House committee Monday that requires the Department of Social Services (DSS) to develop incentive programs to encourage health care clinics to open on the property of elementary and secondary schools where poverty is high.
The bill specifies the schools must have 50 percent or more students eligible for free or reduced-price lunch.
Rep. Jay Barnes, the bill's sponsor, said he's willing to increase that number to 75 percent.
"I think there's widespread agreement that there are problems in schools of high poverty," said Barnes, R-Jefferson City.
He said the the health clinics would be prohibited from performing or referring for abortion services, contraceptive drugs or devices. Services would also require the consent of a parent.
Barnes said reports have shown that wraparound services - such as the school-based health clinics - could help improve education results for children.
"This is wraparound services for those kids," he said. "It's two services at a location where the kids already are."
Barnes said he envisions individuals - who have additional education and experience a school nurse may not have - running the clinics. He also envisions the clinics catering mostly to the Medicaid population.
He said it would be up to the school districts and the health clinics to decide how the clinics are set up.
"They will have an issue on who to serve - students and siblings or students, siblings and parents," he said. "I think it could also include dental care. It would be based on the entity that decides to locate there in conjunction with the school district and DSS."
He said the school districts and clinics would also need to decide on days and hours of operation.
The bill also requires DSS to submit amendments and apply for necessary federal waivers that would allow clinics and schools to co-locate.
David Winton, a lobbyist for the Missouri Association of Rural Health Clinics, said his organization is in favor of the bill.
"These (school-based health clinics) are definitely not a new concept," Winton said. "They do work. They provide access for children in low-income areas where parents can't take them out of school. It's a level of access you don't see today in many of our rural regions."
The Missouri Department of Elementary & Secondary Education (DESE) is also in favor of the legislation.
"I think it defines a safe harbor and gives local school officials and health officials, where appropriate, the opportunity to put additional resources together to provide health care services," said Mark Van Zandt, general counsel for DESE.
Otto Fajen, legislative director of the Missouri National Education Association, said his organization has identified the health care issues school children face, but the organization is not able to provide that care.
"This bill seems to provide some leadership in moving that direction," he said. "Our first priority is that the gap in care for kids is met."
No one spoke in opposition to the bill at Monday's hearing.