Health Centers and Schools:
Uniting for Young People’s Success

School-based health care is a powerful investment in the health and academic potential of children and adolescents. This model delivers convenient, accessible, and wide-ranging primary and mental health care services to students where they already spend most of their time: in school.

At the heart of the model is the partnership between the schools and health centers* that give or support the services offered to the students. This resource explores:

–  the value of school and health center collaboration,
–  the benefits that health centers and schools get from the collaboration, and
–  the supports in place that help health centers work with their local schools. Play Video Screen shot from video

*In this document, unless otherwise noted, the term “health center” is used to refer to organizations that receive grants under the Health Center Program as authorized under section 330 of the Public Health Service Act, as amended (referred to as “grantees”) and FQHC Look-Alike organizations, which meet all the Health Center Program requirements but do not receive Health Center Program grants. It does not refer to FQHCs that are sponsored by tribal or Urban Indian Health Organizations, except for those that receive Health Center Program grants.”

Health centers are partnering with schools all over the country! Local Story: The School Health Services National Quality Initiative (NQI) charts new territory in SBHC accountability…

The School-Based Health Alliance is charting new territory with the launch of its School Health Services National Quality Initiative (NQI). The Alliance’s goal is to encourage at least 50% of SBHCs to document and report a standardized set of performance measures by 2018. SBHCs in CT, CO, NC, and WA will be the first to participate in a national learning collaborative to adopt, report, and accelerate improvements around key quality measures.

With national, state, and local partners working together to align performance measures, SBHCs will be able to compare themselves at every level, assess their strengths and areas for improvement, and provide compelling metrics to funders. Learn more.

Eastern Iowa Health Center
Cedar Rapids, IA 

Service provided: classroom-based health education 

What’s Happening: 

Situated in a county surrounded by rural areas facing severe health care provider shortages, Eastern Iowa Health Center — a federally qualified health center (FQHC) serving 7,206 patients and Title X grantees — has partnered with Cedar Rapids School District to provide sexual health education to its students. Providing this type of education in the Midwest can be challenging, but the health center rose up to that challenge. Currently, a nurse practitioner rotates through all the district schools to provide ad-hoc health education.

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Central Ozarks Medical Center, Richland, MO

photo of child being held by caregiver

Services provided: primary care, oral health, behavioral health, vaccinations, sports physicals, school health fair, and staff health education training

What’s Happening: 

Central Ozarks Medical Center is nestled in the small town of Richland, MO, and serves more than 11,000 patients. The center aims to provide comprehensive care that’s truly integrated, becoming a resource not just for the patient, but for the whole community. In keeping with that goal, they’ve partnered with several Missouri school districts to provide behavioral health services. Most services are provided in elementary schools, helping students build a good foundation for their education and handle behavioral problems before they become severe.

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Family Practice & Counseling Network, Philadelphia, PA

Services provided: reproductive health services and after-school youth development program

What’s Happening:

In West Philadelphia, the Family Practice and Counseling Network (FPCN), a group of federally qualified health centers utilizing nurse practitioners to deliver primary care, behavioral health, dental, and preventive services to more than 23,000 patients, is integrating itself into area high schools to find new ways to help adolescents access the health services they need. Since 2015, FPCN has partnered with local schools as “health resource centers.” Students can meet with FPCN staff during lunch for health resource coordination, family planning advice, and sexually-transmitted infection (STI) prevention.

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Keystone Rural Health Center, Franklin County, PA

Services provided: primary care, vaccinations, health education, and sports physicals

What’s happening:

A nun for 17 years, Nurse Joanne Cochran founded Keystone Health in rural Chambersburg, PA, 31 years ago. A federally qualified health center (FQHC) serving more than 44,500 patients since 1995, Keystone has proudly offered sexual health education and treatment to the community since 2003. In 2015, it opened a school-based health center. However, its work with students goes beyond the walls of the health center and into the classroom, as the partnership between the school and the FQHC brings sorely needed sexual health education to rural teenagers. Getting sexual health education into rural classrooms wasn’t easy. It took a lot of patience and partnership.

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Sunshine Community Health Center, Talkeetna, AK

Services provided: primary care, oral health, mental health, sports physicals, staff health education training, and a after-school youth development program

What’s happening:

Two hours north of Anchorage, AK sits Sunshine Community Health Center, a federally qualified health center (FQHC) serving 3,352 patients plus the students at two local schools. Sunshine Health knows there’s more to providing for the community than clinical care. They also run an after-school transit program that allows youth to take part in sports and other enrichment activities. They run “Parent Cafes” where parents learn about adverse childhood experiences (ACEs) and trauma-informed care. They hold an annual Color Run within the schools to raise awareness and provide education surrounding suicide and depression.

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Valle Del Sol, Phoenix, AZ

Services provided: behavioral health, Medicaid outreach and enrollment, school health fair, and staff health education training

What’s happening:

In the Phoenix Metro Area, Federally Qualified Health Center (FQHC) Valle del Sol is coordinating healthcare for more than 4500 students in six Arizona school districts. Not only does the center’s chief medical officer train and supervise the school nurses providing that care, Valle del Sol creates a care team specially tailored to the needs of each school. To ensure the team is a true collaboration between the FQHC and the school, that team always includes a teacher or staff member.

Valle del Sol doesn’t stop there. It also provides behavioral health services, sponsors health fairs, and trains teachers in how to best support students’ behavioral health needs.

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Getting Started Infographic

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Powering up a partnership in your community can seem like a big task — but it doesn’t have to be! Try out some of these ideas for ways to get started and important tips to keep in mind.

Additional Resources

Kelleher K, MD and Gardner W, PhD. Out of Sight, Out of Mind  — Behaviorial and Developmental Care for  Rural Children. The New England Journal of Medicine, April 6, 2017 (376;14). This article offers potential solutions for the health disparities facing children living in rural areas, including integrating health centers and schools.

Robinson L, PhD; Holbrook J, PhD; Bitsko R, PhD; et al. Differences in Health Care, Family, and Community Factors Associated with Mental, Behavioral, and Developmental Disorders Among Children 2-8 Years in Rural and Urban Areas — United States, 2011–2012. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. MMWR Surveill Summ, 2017; 66. This report discusses the various health disparities for children with mental, behavioral, and developmental disorders across both rural and urban communities.

Lynch, Karen. The Family Practice and Counseling Network Opt-Out Letter.The School District of Philadelphia, Office of Student Support Services, August 2017. This letter is one example of an “opt-out” policy, where students automatically have consent to participate in the health center-school partnership program, and parents can choose to “opt-out,” rather than having to “opt-in.”

National Contacts

American Academy of Pediatrics’ Council on School Health
Veda Johnson, MD
Executive Committee Member American Association of School Administrators
Kayla Jackson, MPA
Project Director, Coordinated School Health American Federation of Teachers
Shital Shah, MS
Associate Director, Education Issues Migrant Clinicians Network
Karen Mountain, MBA, MSN, RN
Chief Executive Officer National Association of Community Health Centers
Kathleen McNamara, MA, RN
Assistant Director of Clinical Affairs National Association of School Nurses
Margaret Cellucci
Director of Communications National Association of School Psychologists
Katherine Britton
Manager, Special Projects National Center for Health and Public Housing
Jose Leon, MD
Chief Medical Officer National Health Care for the Homeless Council
Juli Hishida, MS
Project Manager

Acknowledgements: This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under cooperative agreement number U30CS09738-08-00, award title “Technical Assistance to Community and Migrant Health Centers and Homeless” for $450,000. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government.

This resource was prepared by Anna Burns; Anna Mizzi; Seleena Moore, MPH; Suzanne Sellman, MA; and Andrea Shore, MPH. We gratefully acknowledge the support of the following who generously provided information for their programs:

  • Mary’s Center
  • E.L. Haynes Public Charter School
  • Central Ozarks Medical Center
  • Eastern Iowa Health Center
  • Family Practice & Counseling Network
  • Keystone Rural Health Center
  • Sunshine Community Health Center
  • Valle Del Sol

We are especially grateful to CAS Video Productions for the creation of the “Health Centers and Schools: Uniting for Young People’s Success” video and The Reinvestment Fund for contributing footage.