What is a School-Based Health Center?

(This article was originally published on July 24, 2014. It has been updated to include our core competencies.)


By John Schlitt, President, School-Based Health Alliance

School-Based Health Center waiting roomI’ve fielded this simple question many times—but the answer has never fully satisfied me, no matter my response. For years, Linda Juszczak, who knew a thing or two about school-based health centers (SBHCs), would tell the national office staff that it’s a magical place when executed well. Having visited many SBHCs, I understood what she meant. So it seemed necessary to struggle for the right combination of words and imagery to convey their distinctive properties, to do the model justice.

“It’s like a doctor’s office in school,” some of us were coached to say. Well-meaning marketing experts warned us that most audiences don’t have the attention span or experience to digest our overly complex and detailed descriptions. As fine as pediatric offices are, however, they aren’t the same, and that explanation never felt entirely right—in part because it discounts so much of the SBHC’s value.

The federal definition, enacted in the 2009 CHIP reauthorization, gets the mechanics right but lacks heart.

We typically draw from common characteristics to offer a definition. In most instances, SBHCs: 1) provide quality, comprehensive health care services that help students succeed in school and life; 2) are located in or near a school facility and open during school hours; 3) are organized through school, community, and health provider relationships; 4) are staffed by qualified health care professionals; and 5) are focused on the prevention, early identification, and treatment of medical and behavioral concerns that can interfere with a student’s learning.

The School-Based Health Alliance’s national census data provide a fuller picture for those craving more granularity.

Sometimes it’s easier (and effective) to say what it’s not. It’s not the school nurses office (as critical as they are to student wellness). It’s not a community health center on school property. It’s not an urgent care or retail clinic. Again, these play critical roles in the health neighborhood, but they don’t hit the mark in portraying the model’s uniqueness.

Recently a group of state and local SBHC leaders, in partnership with the Alliance, finalized a set of competencies that define the ideal expression of the model and exemplify what’s at the heart of highly-effective SBHCs. Advocates repeatedly gave voice to a handful of core values as they shaped and fine-tuned the competencies. They are, perhaps, the intangible qualities that have inspired hundreds of communities to embrace SBHCs:

  • Children and adolescents are at the heart of the mission. Other populations may be served, but they are secondary and don’t compromise student access.
  • Integration into the school is deep and seamless. The health center is a mission-critical partner, not a guest in the building. Outcomes and processes reflect school priorities.
  • Staff involve students as responsible participants in their health care, encourage the role of parents and other family members, and are accessible, confidential, culturally sensitive, and developmentally appropriate.
  • The scope of the health center’s influence extends beyond the clinic walls to the entire school, its inhabitants, climate, curriculum, and policies. The school is transformed as a hub for community health improvement.

Some of these elements are hard to codify in a definition, but you know it when you walk in the door. The magic is real.

Go to the SBHC Core Competencies
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3 Comments

  1. by gsil b gall on October 8, 2015 at 12:30 am

    Well done! Thiis is both operational and inspirational. Some additional thoughts:
    SBHC provide culturally competencent, developmentally approriate, easilty accessible high quality services to students.

  2. by Jane V Hamilton on October 9, 2015 at 12:30 pm

    Seeing is believing, a school-based health centers multiple dimensions are nearly impossible to describe.

  3. by Michael E.Bratsis on October 21, 2015 at 10:23 am

    Here’s simple, clear definition of a school-based health center: http://kidshealth.org/parent/system/doctor/school-based-health.html

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