National School-Based Health Care Census

The National School-Based Health Care Census is a triennial survey of school-based health centers (SBHCs). The School-Based Health Alliance has conducted the survey for twenty years, capturing the growth and evolution of SBHCs across the country. Our 2016-17 Census—which had a 90% response rate—collected information on SBHC locations, staffing, services provided, populations served, telehealth services, and funding.

The 2016-17 Census identified 2,584 SBHCs in 48 of 50 states, the District of Columbia, and Puerto Rico. Over the past twenty years, the number of SBHCs in the country has more than doubled—growing from 1,135 SBHCs in 1998.

We have conducted the census since 1998. Prior to the Alliance, data collection efforts were led by the Center for Population Options (now Advocates for Youth) and the Center for Health and Health Care in Schools.

This online survey provides the school-based health field with accurate, up-to-date data about SBHC demographics, staffing, services, utilization, financing, prevention activities, and clinical policies.


What’s New?

  • This year, for the first time, the Alliance matched Census data and SBHCs with data from the National Center for Education Statistics (NCES) Public Elementary/Secondary School Universe Survey to examine characteristics of students and schools with access to SBHCs. Using that data, we’ve calculated that more than 6.3 million students in the United States have access to an SBHC.
  • The latest Census data also show an expansion of telehealth technology in SBHCs. As the first national survey to describe the use of telehealth in SBHCs, our 2016-17 Census contains information about telehealth sponsorship, communities served, and provider teams.
  • You can now view your SBHC data in our redesigned Children’s Health and Education Mapping Tool. You can use this free resource to assess a community’s health, identify areas of need, examine characteristics of public schools and SBHCs, collaborate with nearby partners, and more! Click here to get started.

For even more information on our 2016-17 Census, check out:


Methodology

The School-Based Health Alliance conducts the National School-Based Health Care Census every three years to collect descriptive information about school-based health care.

Click here to read more about the census methodology.

Early versions of the Census were focused on identifying a specific model of school health care—one in which a health center and health care providers were physically located in the school. Over time, the Alliance has expanded our data collection efforts to include variations on school-based health care delivery models. The term “school-based health center” refers to one of four distinct primary care delivery models determined by the location of patients and providers.

  1. In traditional SBHCs, patients access care at a fixed site on a school campus and providers are physically onsite (though some patients also access providers using telehealth).
  2. In school-linked centers, patients access care at a fixed site near a school campus through formal or informal linkages with schools. Providers are physically onsite and may be accessed remotely.
  3. In mobile centers, patients access care at a specially equipped van or bus parked on or near a school campus. Providers are physically onsite and may be accessed remotely.
  4. In telehealth-exclusive centers, patients access care at a fixed site on a school campus and providers are available remotely for primary care services using telehealth (other services such as behavioral health, oral health care, nutrition, and vision providers and/or health educators may be available onsite or remotely).

For each of these four school health care delivery models, the Census captures data on location, staffing team, services, populations served, and funding sources.

Data from the National Center for Education Statistics (NCES) Public Elementary/Secondary School Universe Survey Data for the 2015-16 school year were used to examine characteristics of students and schools served by SBHCs. Census participants identified the specific school(s) served by the SBHC(s) by selecting from a pre-programmed list of NCES public schools. The information was used to match NCES school and student characteristics to each SBHC, including the total number of schools and students with access to the SBHC, grade levels served, students’ ethnic/racial profile and free- or reduced-price lunch program eligibility, school enrollment, and Title I program status.

Procedure and Participants: The Alliance maintains a national database of SBHCs. We continually update the database with information on SBHC openings and closures through communications with organizational and individual Alliance members and news announcements found online. In the six months prior to launching the Census, we also updated the database with contact information from state rosters of SBHCs from the Alliance’s 25 state affiliate organizations and the 17 state departments of health, public health, and education that provide funding to SBHCs. For the 2016-17 Census, the Bureau of Primary Health Care’s 2015 Uniform Data System dataset was compared with the Alliance’s database and SBHCs that were not in the Alliance database were added.

Data for the 2016-17 Census were collected from May-December 2017. Representatives from all identified SBHCs were invited to complete the Census online through a secure web-based portal. Alliance staff used mail, email, and phone calls to encourage survey completion and partnered with a survey research firm to support data collection. We asked that the survey be completed by the person(s) with the most knowledge about the care delivered by the SBHC. This person may have been a health care program director, manager, administrator, provider/clinician, or an administrative staff member.

The Census identified 2,584 sites (inclusive of the four delivery model types described above) that provided primary care—90% of which completed the Census. The final sample was comprised of the 2,317 sites that completed the Census and reported providing primary care services onsite or via telehealth by a physician, nurse practitioner, and/or physician assistant. Among these 2,317 sites, 1,894 were traditional SBHCs, 87 were school-linked, 69 were mobile, and 267 were telehealth-exclusive. We contacted non-responders by phone to confirm that they were operational and provided primary care (n=267). Programs that completed the Census but did not provide primary care (i.e., provided only behavioral health and/or oral health services) were excluded from the sample (n=217).

Data Analysis: Alliance staff analyzed the data using summary and descriptive statistics. We excluded missing data and “do not know” responses in the Census. We also excluded SBHCs that did not identify schools served or those SBHCs whose schools were not found in the NCES dataset from the school level analysis (n=51 SBHCs). The Alliance identified school grade-level types on the grades offered at the schools served by the SBHC. We defined elementary schools as those offering pre-kindergarten and/or kindergarten through fifth or sixth grade; middle schools as offering sixth and/or seventh grade through eighth and/or ninth grade; high schools as offering ninth and/or tenth grade through twelfth grade; and we defined “other” schools as those offering any other grade combinations. SBHCs that served multiple schools of different grade-level types were classified as “other” school types.


Data Sharing Policies and Procedures

The School-Based Health Alliance is committed to sharing Census data as a resource to diverse audiences; however, we do not share lists of SBHCs or their contact information.

  • We share Census data with state affiliates and state programs offices in states where 60 percent or more SBHCs complete the survey.
  • We do not share lists of SBHCs or their contact information.
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