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Rural Health Information Hub
Rural Health Information Hub

School-Based Health Centers

School-based health centers (SBHCs) provide primary healthcare and other services to students in kindergarten through 12th grade. SBHCs are often located within a school building, so services can be provided on premises, or nearby, at an offsite facility. SBHCs provide different services including:

  • Vaccinations
  • Health and mental health screenings
  • Prevention education and peer group education
  • Vision, hearing, and dental services
  • Substance use treatment and prevention services
  • Reproductive health services

Increasingly, SBHCs serve schools and communities in rural and frontier areas by using technology to provide remote healthcare visits, helping to overcome geographic barriers and a lack of transportation access. These SBHCs serve schools and communities in rural and frontier areas by using technology to provide remote healthcare visits, helping to overcome geographic barriers and a lack of transportation access.

The Community Preventive Services Task Force recommends the implementation of SBHCs in low-income communities to improve educational and health outcomes. In addition to providing healthcare services to students and families in rural communities, SBHCs can address other unmet health and social needs, improving health disparities and addressing SDOH. For example, some SBHCs address common youth behavioral health issues such as stress, personal safety, depression, and anxiety, as well as other social risk factors that can influence academic success and overall well-being.

Examples of Rural School-Based Health Centers Addressing SDOH

  • The Center for Rural Health Care Innovation in North Carolina runs a school-based telehealth program called Health-e-Schools that operates in 4 rural school districts. The program connects students with a doctor through video conferencing. Onsite school nurses connect youth with these services.
  • The Southwest Open School School-Based Health Clinic provides several types of medical services to students and community residents under the age of 21. These services include vaccinations, physical examinations, treatment of illness, and behavioral healthcare. Twice a year the SBHC provides students with dental screenings and cleanings.
  • The Hancock County Middle/High School-Based Health Center in Appalachia uses family nurse practitioners to provide primary care, urgent care, and mental health services for all family members. The SBHC is located within the school building. Students in the East Tennessee State University College of Nursing program can also complete clinical placements at this SBHC.
  • Arbor Family Health, in collaboration with four Federally Qualified Health Centers, uses SBHCs in rural Louisiana to address oral health needs among children in the community. In addition to providing medical and behavioral healthcare, the SBHCs serve as a dental home for students. Nurse practitioners received training to perform oral health assessments, apply fluoride varnishes, and make referrals to dental partners when needed.
  • In Louisiana, the Adolescent Pre-Diabetes Prevention Program functions in SBHCs across the state to identify and address the onset of prediabetes in the adolescent community. Administering the intervention through SBHCs ensured that the program had adequate resources and staffing to function sustainably.

Implementation Considerations

Implementation considerations for running and staffing a rural SBHC may be similar to considerations for other rural healthcare programs. For example, in rural areas designated as Health Professional Shortage Areas, it may be more difficult to find healthcare professionals to staff SBHCs. Technology limitations and lack of broadband access can pose challenges to implementing telehealth SBHC models. Not all SBHCs have the resources to provide telehealth services and not all areas are connected to this technology. Funding, especially for telehealth technology, is another potential challenge for rural SBHCs. In addition, programs may need to consider the impact of potential stigma youth can experience from their peers when receiving care within a school setting.

For other implementation considerations related to implementing SBHCs and other school-based health programs see the School-Based Services Integration Model in the Rural Services Integration Toolkit.