POULSBO — The North Kitsap School board members didn’t make a final decision on a school-based health clinic during their meeting Thursday night, but they took a step toward accepting it.

Board members directed Superintendent Gene Medina to pursue an agreement between the district and the Kitsap County Health District, which has offered to establish and fund the clinic.

Several commissioners said they supported the clinic, but all concurred that they would have to review the agreement between the two districts, school and health, before they voted.

“I’m not guaranteeing that we’ll approve it, but I want to go forward to help kids any way we can,” board member Catherine Ahl said.

The clinic, which will be housed in what is now a storage room at Spectrum, has become controversial since it was first introduced to the board in December 2002.

Several community members have spoken at each meeting since, both for and against the proposal, with opponents saying that the clinic could break down communication between children and their parents, and supporters arguing that students in the North End have a dire and sometimes urgent need for access to health care.

While a final decision was not made Thursday night, board members injected two new wrinkles into the public conversation, which has become heated and sometimes emotional during meetings.

The first is that several board members emphasized the district would not pay for the clinic.

Kitsap County Health District Director Scott Lindquist said in previous board meetings that the health district would carry the cost of the clinic, with money to come from its own funds and perhaps federal grants.

But with the economy stalled and several sources of school funds in peril, the school district has become all too familiar with how difficult it is to keep programs running.

“When the money dries up, the program ends,” Dick Endresen said.

Another new point was brought up by Medina, who had consulted with the district’s lawyer about a waiver, which Lindquist said parents would have to sign before their children could be treated at the clinic.

The clinic may not be allowed to offer that waiver under federal law, Medina said.

According to the law, anyone under the age of 18 can be required to have parent’s permission to receive primary health care: normal checkups with a physician, sports physicals, ear, nose and throat exams, etc. But minors cannot be denied other kinds of health care, including those areas that have been most controversial in school-based health clinics: reproductive health information, contraceptive information, mental health care or drug abuse care.

The district is still double-checking the legality of a waiver, Medina told the board, and has already looked into how other clinics, including those based in Seattle, deal with the issue.

That issue will be included in the language of the interagency agreement.

The board meeting was more crowded than usual and not just because the Poulsbo Junior High select girls’ choir performed a pair of songs for “Board Appreciation Month.”

As has happened at the last two meetings, several community members spoke out for and against the clinic.

Kit Foley, an Indianola resident who is a licensed counselor with experience in three school districts, said she has often seen students who have basic health-care needs that haven’t been met.

“They were held back from achieving what they could in school,” Foley said. “It isn’t that their parents don’t care… they simply couldn’t afford it.”

“I believe that healthy children make better students,” said former school board member Jean Wasson supported the clinic.

Others took a stand against the concept.

“My belief is that most options offered at the clinic are best left to parental discretion,” said 14-year-old student Jasmine Henry, who is home schooled.

Another of the clinic’s critics, Cris Shardleman, made a joke after she adjusted the microphone on the lectern.

“This is getting to be like home,” she said, sending ripples of laughter through the crowd.

Shardleman brought up several points and said that even if the district did not pay for the clinic, somebody would.

“The $50,000 is tax dollars, no matter where it comes from,” she said, referring to the approximate cost to run the clinic for one year.

Many of those who spoke about the health clinic waited through most of the three-and-a-half-hour board meeting to hear the board’s discussion.