School-based health centers

Local governments can invest in this strategy using State and Local Fiscal Recovery Funds (SLFRF) from the American Rescue Plan Act (ARPA).

  • This strategy can help address educational disparities, promote healthy childhood environments, and improve access to health services. The U.S. Department of Treasury has indicated that strategies that help achieve these outcomes are eligible for the use of Fiscal Recovery Funds.
  • Investments in this strategy are SLFRF-eligible as long as they are made in qualified census tracts or are designed to assist populations or communities disproportionately impacted by COVID-19.

Program overview

  • Provide K–12 students with various health care services on school premises or at offsite centers linked to schools
  • In underserved communities, serve as strategic “catchment areas” for students who would not have traditionally have access to health care
  • Care often provided by teams of nurses, nurse practitioners, and physicians
  • Reproductive health services may be provided at middle and high schools (dependent on district policy and state law)
  • Often manage chronic illnesses
  • Most patients are insured by Medicaid or are without insurance

Evidence and impacts


Ranked as having the highest level of evidence by County Health Rankings and Roadmaps

  • Improved health outcomes
  • Increased academic achievement
  • Improved quality of care, fewer emergency room visits, reduced hospital utilization, and increased immunization rates
  • Improved student health behavior and possible reduction in barriers to accessing mental health services
  • Reduced absenteeism and dropout rates and increased graduation rates and connectedness to school
  • Increased access to care for minority students, students with disabilities, and underserved urban youth

Best practices in implementation

  • Note: This content is under review
  • Programs that focus on prevention as well as physical and mental health care are likely to have better outcomes
  • Routine counseling for individuals and groups strengthen preventative measures, keeping children healthy and in schools
  • Partnerships with local health care facilities and community health care workers are needed to ensure follow-up and continuity of treatment