Under Washington State laws students at any age can get advice about reproductive services and receive birth control pills without parental consent at a teen health center at Ballard High School and other schools in King County. The health centers collaborate through partnerships between the school districts, health care providers and Seattle/King County Public Health.

Some of the laws were established nearly 20 years ago and school clinics in Seattle and Highline school districts have been operating under them for several years. It came as an unwelcome revelation for one West Seattle mother.

"These teen clinics are reproductive clinics that happen to do sports physicals," said Mary Locke, whose 13-year-old daughter attends Madison Middle School where one of the clinics is located.

Locke said she doesn't like the idea of a public institution schooling her daughter on reproductive health care.

Most centers require parents to sign a permission form to allow students to access services like sports physicals and immunizations. But for some treatments, laws authorize a minor to give their own consent.

Minors 13 or older can consent to outpatient treatment for drug/alcohol dependency and outpatient mental health treatment. Case law expands the ability of minors at any age to provide consent for abortion, birth control and reproductive functions. Washington law forbids the release of information regarding these types of treatments to the parents without the minors consent.

Providers in Washington offer these confidential contraceptive services under the 1975 Washington State Supreme Court decision State vs. Koome. This decision held that minors have the same constitutional rights as adults to receive confidential contraceptive services and prenatal care. The court said parental authority does not suddenly disappear at adulthood, but it diminishes as people mature. A person's ability to make important decisions develops at different rates in different individuals.

But Locke said public schools should not be allowed to turn into a Planned Parenthood clinic.

"You want to track what's going on with your kids," she said. "The last place I would take my child to is Planned Parenthood, but it's mandatory to take my child to school. It's like taking them to Planned Parenthood. They've stepped over a line here."

Seattle Public Schools' policy on health clinics sates that the district will furnish space in middle schools and high schools for student health clinics, provided they are funded by an outside organization and that those operators hold the district harmless from any liability. It is the district's policy that abortions not be performed at the clinics.

Currently, there are 16 health centers in King County; 14 are housed in middle schools and high schools and two are school-linked, meaning they are not on campus but serve students in the area. In the Northwest, the Ballard Teen Health Center, partnered with Swedish Medical Center, is located in Ballard High School.

Swedish employs an on-site clinic coordinator, a mental health counselor and a nurse practitioner. Visits are free and grants from health care providers and programs like Take Charge, which provides free birth control, pays for some services.

Paul Barry is a mental health psychologist at the Ballard Teen Health Center, which opened in 2002. The center operates at capacity nearly every day and students come to the clinic often for mental health issues, such as stress, depression and relationship problems, said Barry.

"It's more than teenage angst, some of them suffer from deep clinical depression," he said. The center is important because it provides help for those who can't afford it or who feel they can't go to their parents for help, he said.

Lisa Hawley is the clinic's manager. She said about 89 percent of the Ballard High student body is enrolled in the health center, which received 2,048 visits in the 2005-2006 school year.

Clinic workers try to get the word out about the clinic's services, including family planning and reproductive health services, through community outreach at neighborhood centers, parent meeting groups, middle schools and sporting events, said Hawley.

Still, Locke said she feels the schools are not forthcoming enough about what services the clinics offer.

"I go through a mountain of paperwork at the beginning of each school year that asks me to sign off on the minutest details," she said. "But not when the hot button issues come up. No one said 'this is what's happening in our clinics.'"

But Nina Hanson, clinic manager at the Madison Wellness Center in Madison Middle School, said they aren't trying to hide anything. Parents are given informational sheets about the clinic, all of its services and an explanation about the state laws at the start of the school year.

The brochure for the Ballard health center clearly states its services and laws under which it operates. When students come to the clinic looking for help, they are always asked if they want to involve their parents, said Hawley.

If a student has an unwanted pregnancy they will be counseled and given as much information as possible to make an informed decision, said Hawley. Sometimes clinic workers will help students find adoption agencies or abortion clinics and connect them with health educators who can help them plan for a baby.

"We'll sometimes make the phone call with them, and sometimes even go with them to hold their hand," said Hawley. "Many times they don't have anyone. But we don't force our opinions on anyone, we support their decisions."

Not a lot of students are willing to engage their parents in these decisions, Hawley said.

She tells parents who are upset about the clinic to get involved in policy making.

"I tell them to work on changing it," said Hawley. "The only way to change things is by getting involved. They are in a very powerful position, and if they want to influence their child's actions, the most effective thing they can do is talk to them."