School-based health care is a partnership between a school and a hospital, federally qualified health center, health care organization and/or health department to deliver care at a school. The school supplies the space; the health care partner supplies equipment and a medical professional to provide care. The care may be a discrete service or services, like immunization, or it may be more comprehensive, like general primary care that can be found in a pediatrician’s office.

Much of the recent focus of school-based health has been on school-based health centers. Traditionally, any health care service that is available in a pediatrician’s or primary care provider’s office is available at a school-based health center. The school-based health center may become the child’s “medical home” or regular health care provider in circumstances when the child does not have a regular doctor, but these centers also work to connect or reconnect children to community pediatricians or other medical homes. School-based clinic staff can also consult with a student’s doctor to make sure they get the best care both in and out of school.

A child who is not healthy, who must miss school for medical reasons, has increased obstacles to academic achievement. Only 54% of Ohio’s children have an established medical home—that is, a provider who has a relationship with a family and is concerned with preventive care and overall health.

Only 39% of children enrolled in Medicaid have regular well visits. Only 44.5% have dental visits. Half of kids who fail vision screenings do not get follow-up care.

School-based health brings these services to children where they are, in school. School-based care allows students to miss a minimum of class time to address health concerns that are not otherwise being addressed.

A traditional school-based health clinic typically provides the same services a pediatrician or primary care provider does, including:

• Physicals

• Blood work

• Immunizations

• Prescriptions

• Chronic disease care, such as for asthma and diabetes

• Behavioral health screening and care

School-based centers also can refer students to specialized providers, and they link families to ongoing care outside of school hours. Some school-based centers go beyond traditional primary care and offer dental, vision and other services.

The services are usually provided through a hospital, health care organization or health department that is independent of the school or school district but works in partnership with them. The individual providing the services is most often a nurse practitioner, who is licensed to treat patients and prescribe medicine.

A school-based health appointment typically occurs in a fixed space inside the school that has been converted into a medical office. Some hospitals and health systems have mobile, traveling medical offices which can travel from school to school, so that a fixed space is not needed.

School-based health services are paid for in the same ways that other medical visits are, through the billing of private insurance or Medicaid. The entire goal of school-based health is to provide care to young people who need it, and school-based health staff may be able to help connect children to Medicaid coverage and other important resources.

Grants, donors, and government agencies often help with the start-up costs of a school-based clinic.

No, but they work hand-in-hand, and a school benefits from having both.

School nurses:

• Act as the first line of triage for children who have health need

• Administer already-prescribed medication

• Provide health care education to students and staff

• Help with emergency planning for students who have a chronic health condition

• Provide state-mandated screening like those for hearing, vision and dental.

School-based health centers compliment the work of school nurses by providing primary care appointments and services, as described above.

School-based centers partner with parents and caregivers for children’s health, just as pediatricians and primary care providers do. Parents and caregivers provide consent for care for services and are welcome to attend visits either in-person or on the phone. School-based health providers also typically connect with parents both before and after the visit, through interactions on the phone and in-person, and through after-visit summaries.