Sustainability guide for school-based health centers
October 2025
SBHCs have a proven impact on student health, well-being, and academic success. However, sustaining that impact means navigating a complex and often challenging environment marked by funding gaps, operational hurdles, shifting policy conditions, and the demands of cross-sector collaboration.
This guide outlines key challenges SBHCs face, and provides four types of sustainability strategies that SBHCs can implement:
1. Operational capacity
2. Financial model and revenue
3. Partnership and community engagement
4. Systems and accountability
This guide was developed with input and support from Ohio Alliance regional coordinators and insights from the field.
Sustainability planning tool
Sustaining an SBHC requires proactive planning. This Guide includes a Sustainability Planning Tool that is designed to support that effort. The Tool is divided into two sections: Assessment and Action plan.
The Assessment provides a structured way to assess your SBHC’s strengths and challenges across the four core sustainability categories. For each category, use the guiding questions and evaluation criteria to identify your SBHC’s key gaps, needs, and opportunities for action. The embedded sustainability tips in the Assessment section offer best practice strategies to consider as you build your action plan.
Once the assessment is complete, transition to the Action Plan to document specific next steps, responsible parties, and timelines.
Additional resources
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School-Based Health Center 101 Toolkit Ohio School-Based Health Alliance
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Quality Counts: Sustainable Business Practices QI Toolkit School-Based Health Alliance