School-Based Health Centers (SBHCs)

What is a school-based health center?

District employees, like occupational therapists, social workers and school nurses, often provide health services for students in their caseload. However, like an urgent care center or health department, school-based health centers (SBHCs) offer complementary primary and preventive healthcare to broader populations of students, and sometimes families.

By locating in school buildings, on campus and in other familiar locations, SBHCs improve access to necessary healthcare services, especially hard-to-reach and low-income students, who may otherwise forgo required care. SBHCs exist in all types of schools, with 81 percent located in traditional public schools.1  

Access improves health and academic outcomes

About 8 million children in the United States are uninsured and lack access to necessary healthcare services. In addition, most youth do not receive screening or preventive services at rates consistent with clinical guidelines.2  Poor student health poses a significant barrier to learning and may contribute to lower grades, as well as higher absences and dropout rates.

Each SBHC is staffed differently, though most include a primary care provider (such as a nurse practitioner or and physician assistant) and a licensed mental health professional (such as a clinical social worker, psychologist or counselor). Some schools round out the care team with case managers, nutritionists and health educators.

By ensuring access to health services, SBHCs improve students’ health outcomes, create supportive learning environments and enhance academic performance. One-third of SBHCs support students with special healthcare needs that directly affect their ability to learn or attend school. Parents and students alike consistently rate schools with SBHCs as having better learning environments than schools without SBHCs, and students report a higher level of school engagement.3

Services provided

SBHCs provide services at various levels, including at individual, small-group, classroom and school levels.4  Some of the services provided include:

  • Immunizations and vision and hearing screenings;
  • Oral and dental hygiene services;
  • Laboratory and prescription services;
  • Treatment of acute illnesses;
  • Access to mental health providers, counseling and behavioral risk assessments;
  • Medication monitoring;
  • Medical records review;
  • Implementation of Individualized Health Plans;
  • Development of Individualized Education Plans; and
  • Enrollment into public insurance programs (for eligible students and families).5

Also, 67 percent of SBHCs assist students beyond regular office hours through on-call services and referrals.6

Evidence for SBHCs

  • Access to an SBHC improves student attendance and reduces out-of-class time and early dismissal rates.7
  • SBHCs help foster positive school environments that are associated with better learning. Approximately half of SBHCs have students serve as members of health center committees, advisory councils or boards. This student involvement improves school connectedness.8
  • Schools with SBHCs have better parent engagement: nearly one-third involve parents in programs related to healthy living (nutrition, physical activity and weight management), chronic disease management (asthma, diabetes), and tobacco, alcohol and substance abuse prevention.
  • Students who receive access to mental health services from an SBHC show lower rates of depression.9
  • SBHCs provide consistent healthcare access in a safe, private and confidential environment, which is shown to improve student behavior and strengthen the relationships between staff, students and families. They also reduce hospitalizations and school absences among asthmatic students.10

Start or expand an SBHC

SBHCs have a variety of funding sources, including public and private insurance, in-kind donations and grants. For help designing a new SBHC or expanding an existing one, see the School-Based Health Alliance’s guidance and resource page.