While the federal government has spent months proposing, discussing and debating healthcare reform, there is one group of Ballardites who have been getting free, safe, confidential primary care, regardless of insurance, for eight years.

The Teen Health Center at Ballard High School, started in partnership with Swedish Medical Center in 2002 as part of a citywide program, acts as a primary care clinic for students.

"It's more like a doctor's office than a school nurse," said Sara Rigel, manager of Patient/Family Education and Community Health at Swedish.

By providing services at no cost to students, some of whom have no insurance or are under-insured, the benefits of the Teen Health Center are huge, Rigel said.

"It's an opportunity to contribute to the greater well-being of our youth and community," she said.

The center is jointly funded by Swedish Medical Center and King County Public Health trough the Family and Education Levy.

In addition to sports physicals and vaccinations, the center provides mental health counseling and sexual health and family planning care.

There aren't any other places where teenagers can access free psychotherapy, a resource much needed in high schools, said Paul Barry, a licensed social worker and mental health therapist at the center.

Barry said teens can have a lot of mental health challenges that play out at school, where the challenges get in the way of academic success. The Teen Health Center can intervene by being where the students are, he said.

Rigel said a large part of what the center does is provide confidential services for family planning, STDs and other sexual health issues.

Janna Pekaar, the center's nurse practitioner and jack of all trades, said she talks to many students about being sexually active.

The Teen Health Center and the students it serves are lucky to be located in Washington, where laws allow teenagers access to certain health services without parental consent, Pekaar said.

In Washington, teenagers can receive family planning services, including access to contraception, at 13 without parental consent. They can be tested for STDs at 14.

Barry said young people tend to do a lot of things that fly under the radar of their parents or guardians. Confidentiality helps them to open up more, and the center has a good privacy track record with the students, he said.

The fact that students can access the center's services without needing their parents to make an appointment or drive them to the doctor's office helps with confidentiality, Rigel said.

She said the Teen Health Center's staff are employees of Swedish, not Ballard High School, which also helps with student trust.

"The reputation we have with working with the students is great," she said. "Most students self-refer."

Pekaar said the center's location next to the school's commons and lunchroom reduces the stigma students could feel walking into the center.

Students will come into the center to use the microwave and will make an appointment while they are there, she said.

Barry said teenagers are notorious for not seeking help and many have serious issues at home that prevent them from talking to their families about problems, Barry said.

He said he enjoys helping students deal with the pressures, such as relationships and college anxieties, of living in 2010. A lot of the feelings and thoughts teenagers have are brand new to them, and that gives him energy to help them, he said.

Pekaar said it is rewarding to watch students the Teen Health Center has worked with walk across the stage at graduation and know the center helped them get there.

In the eight years since it was founded, the Teen Health Center at Ballard High School has had a good deal of success.

According to center statistics, 80 percent of Ballard High School students have used the center. It receives approximately 20 visits per day and 5,000 visits every year.

Pekaar said the students have been very cooperative with the center. The center even won an award two years ago for dispensing the most HPV vaccinations, she said.

Ballard High School senior Nicole Bowns said the Teen Health Center is a great resource for students, especially for underprivileged teenagers who would not otherwise have access to the kinds of services it offers.

Bowns said she knows a lot of students who have made appoints to see Barry because they know it is safe and confidential. He has impacted a lot of lives, she said.

"I can't imagine what the school would be like if we didn't have this resource," she said.

The first Teen Health Center was started at Rainier Beach High School 20 years ago. Now, all major Seattle high schools and many middle schools have them.

The Ballard Teen Health Center is the only center funded by Swedish. The others are funded through partnerships with various providers, such as Group Health and Children's Hospital.