What are School-Based Health Centers?
Students and families across New York State face significant barriers to accessing quality, comprehensive health care. School-based health centers (SBHCs) offer a unique opportunity for school districts and communities to meet the health and mental health care needs of underserved students. SBHCs provide comprehensive primary and preventive health care. Enhancements to the basic school-based health model include on-site dental services, health education, promotion, and nutrition counseling, facilitated health insurance enrollment, family services, and community referrals. SBHCs are defined by the New York State Department of Health (NYSDOH), School Health Unit.
SBHC services are provided at no out-of-pocket cost to students/families that are enrolled. To enroll in the services offered at a SBHC, parents/guardians must sign an enrollment form which acknowledges their consent for the SBHC to treat their child. SBHCs are staffed by a multi-disciplinary team of licensed health care professionals and support staff. Currently, there are 215 approved, operating SBHCs in New York state, serving nearly 200,000 students. Approved SBHCs in New York state are located in areas with a high prevalence of unmet medical and psychological needs. >
SBHCs offer numerous health, mental health, academic and economic/financial benefits. A student’s health status plays an essential role in their ability to learn. SBHCs are on the front line – in schools – ensuring that students are healthy and ready to learn, allowing educators to focus their energy on education. Schools with SBHCs have been found to experience reduced absenteeism and improvements in graduation rates. SBHCs form an integral part of the safety net designed to support children living in underserved communities. SBHCs work in collaboration with school nurses, social workers, and psychologists. Instead of a duplication of services, SBHCs supplement the work of school health providers by offering a broad range of health care services.
The SBHC model is a marriage between a school district and a health care facility interested in providing easily accessible health care to underserved students. Each partner has a role in planning, organizing, operating, evaluating and supporting the SBHC. The SBHC sponsoring health care agency has the overall responsibility for the center’s administration, operations, and oversight. School districts assist the SBHC by providing school space for the center at no cost to the sponsoring agency.
Youth are SBHCs’ most important stakeholders. Many SBHCs organize peer health education programs and youth advisory boards for the youth in their schools to promote the development of leadership and health advocacy skills. SBHCs depend greatly on a collaborative relationship with parents, guardians, and families of enrolled students. On-going communication between providers and parents allows providers to understand the broader context of the child’s life.
SBHCs do face limitations and challenges. SBHCs greatest limitation is their lack of financial sustainability. SBHCs’ mission is to serve uninsured and medically underserved children and teens throughout the state. As a result a great deal of health and mental health care services are provided without reimbursement. In addition, school districts, in collaboration with sponsoring agencies, often have to make difficult decisions in determining which school building is most in need; limited resources make it unlikely that every building in need will get a SBHC. Additionally, school districts interested in collaborating with a sponsoring agency to open a new SBHC must gain overwhelming faculty, parent, and community support. Lastly, numerous SBHCs across the state are in need of significant contributions from foundations, individuals, and corporations to establish a SBHC given high start-up costs and limited revenue generation. Without adequate start-up costs a center will not be able to open its doors.
Advocacy has been the driving force behind SBHCs for over twenty years. SBHCs engage in advocacy to increase awareness of the SBHC model and its benefits. SBHC funding is intimately tied to community and political awareness of the SBHC model. As an effective intervention, SBHCs not only provide direct health services but also empower children, adolescents and families to overcome challenges that threaten their basic human right: quality, accessible health care. Districts can play a pivotal role in SBHC advocacy by encouraging and cultivating opportunities for youth, parents, faculty, and the community to advocate on behalf of SBHCs.
In conclusion, SBHCs offer a unique option for school districts interested in meeting the health and mental health needs of underserved students. SBHCs offer countless benefits to students, families, the school district, and the community at large. Successful SBHCs are a partnership between sponsoring agencies and school districts who share the same common vision –all children will be healthy and ready to learn.
To learn more about SBHCs in New York State please read this report which was commissioned by the Community Health Foundation of Western and Central New York (CHF) to educate school districts and charter school administrators in western and central New York on the school-based health care model in New York State. This report may be used as a model to expand SBHC awareness and knowledge in other regions of the state or country as well. Download the report (PDF)