School-Based Health: Easy Access to Care

Original article written by Chris Kjolhede for Public Health Post.

Written by NY School-Based Health Foundation’s board member, Chris Kjolhede, this article outlines what services are offered by School-based health centers (SBHCs) and their impact on providing students with care. SBHCs provide primary care services including physical and mental health care, and, often, dental services. These health centers enjoy a partnership with their school sites and administrators, working collaboratively with school nurses. SBHCs are typically sponsored by hospitals, health systems, federally qualified health centers, and departments of health. Over one third of SBHCs are in rural school districts while the remainder are in urban or suburban communities. The number of SBHCs across the country is increasing, now numbering over 3,000.

Each SBHC has a nurse practitioner or physician assistant, as well as administrative staff, licensed practical nurses, and registered nurses. Most SBHCs have a mental health provider, such as a clinical social worker, who can provide short and long term, individual, and sometimes group therapy. Dental health services may be provided by dental hygienists, dental assistants, and sometimes a dentist. Some programs employ other specialists such as dieticians. Most SBHCs are led by a director and collaborating physician who is associated with the SBHC sponsor.

Improving access to health care is the primary goal of SBHCs. SBHCs provide high-quality, comprehensive and coordinated primary care for children and adolescents, particularly those who are underserved and those living in low-income communities. SBHCs can decrease geographic or transportation barriers to health care, especially in rural areas and all students who attend a school are eligible to enroll in the SBHC.

The value of SBHCs is seen through several outcomes. SBHCs can reduce health disparities and increase access to mental health services. SBHCs improve immunization rates, and provide confidential reproductive health services. Some chronic conditions such as asthma and obesity can be addressed with novel treatments by the SBHC team especially when coordinated with school health committees or committees for special education. And, importantly, by reducing barriers to health care, SBHCs reduce school absenteeism and time out of the classroom.

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