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
Addressing students’ health needs: School-based health centers (SBHCs) provide a range of healthcare services to K-12 students either at or near their school. SBHCs aim to increase access to healthcare and improve both health outcomes and academic achievement.
Providing access to a range of services: SBHCs are typically operated by local healthcare organizations (e.g., healthcare systems, departments of health) in partnership with school districts. SBHCs may provide primary care, behavioral health services, nutrition services, oral and vision care, reproductive healthcare, and more. These services may be provided on-site, through telehealth, or via direct connections to community providers.
Target toward disadvantaged students: SBHCs vary in their staffing models, and may be operated by nurse practitioners, registered nurses, mental health providers, medical students, or other providers. Services at SBHCs are typically offered at low or no-cost and are designed to be accessible to students insured by Medicaid or without health insurance.
- Cost per Participant
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Not available
Multiple studies with rigorous designs demonstrate that school-based health centers are a well-established strategy for increasing access to healthcare and improving both health outcomes and academic achievement among K-12 students.
- This assessment is based on evidence from a 2023 systematic review.
Actively promote access to care: SBHCs aim to increase access to healthcare services, and can take a number of steps to reduce barriers to access. These may include accepting walk-ins, examining school policies (e.g., those preventing students from being excused from class), and expanding hours of operation. Conducting proactive outreach to students can also encourage uptake of services.
Take a public health approach: In addition to providing clinical care, SBHCs should identify opportunities to provide preventative services and address broader social determinants of health. For example, SBHCs may run small groups focused on relevant health issues (e.g., trauma support groups), conduct health education campaigns, or support policies that create a healthier school environment (e.g., school food policies).
Offer intensive services: Often, the students that SBHCs serve are those with the most unmet healthcare needs. As such, SBHCs should have the capacity to manage more intensive cases, such as dealing with behavioral health crises or managing chronic diseases. When this capacity cannot be provided in-house, it may be provided through a connection with a community healthcare provider.
Coordinate with educators: A key objective of SBHCs is to support students’ ability to succeed in school. As such, SBHCs should coordinate with school staff to address barriers to student success that may have a connection to health, such as absenteeism, classroom behavior, and school climate. For instance, an SBHC staff member may serve with educators on a school-wide committee focused on addressing a pressing issue facing students.
Provide integrated care: Students may have other providers outside of the healthcare system sponsoring the SBHC. To provide coordinated care, SBHCs should develop partnerships with other area healthcare systems.