School-based health center (SBHC) common definition
The Ohio School-Based Health Alliance (Ohio Alliance) convened a statewide Advisory Group over a period of six months in 2024 to inform development of a common, standardized definition for a school-based health center (SBHC) that could be utilized in Ohio. The Advisory Group included representation from 35 organizations across all regions of the state, including SBHC operators and community healthcare providers, school districts, health plans, advocacy organizations, state agencies, and other statewide partners. Partners came together to share expertise and feedback to develop a common SBHC definition that can serve a variety of purposes, including:
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Promotion of best practices and guidelines for the development of high-quality, sustainable SBHCs
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Advancement of policy conversations around SBHC operations and sustainability
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Clarification of ambiguity around the role of SBHCs
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Creation of a stronger infrastructure for the provision of high quality, sustainable SBHCs
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The SBHC definition focuses on the following primary components: onsite school presence, comprehensive primary care, community need, system alignment, partnership, continuity of care, and compliance/consent. The definition is shared below along with defining characteristics of other ways to deliver school-based health care services.
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This initiative was contracted and funded by the Ohio Department of Health. The Ohio Alliance subcontracted with the Health Policy Insitute of Ohio to provide research, writing, and facilitation support tor this initiative.
SBHC common definition
1. A school-based health center (SBHC) is an evidence-based model of health care delivery where a center is established and operated in a school or on a school campus. SBHCs prioritize serving students in the school or district in which the SBHC is located and may also extend services to other populations including but not limited to students’ families, school personnel, and community members.
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​2. An SBHC provides comprehensive primary care services to students and may deliver additional services or work with other providers to deliver additional services based on assessed community need, including but not limited to behavioral, vision, and oral health services. Care provided by an SBHC should be responsive to the community and meet the cultural and linguistic needs of the populations served.
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​3. An SBHC has a focus on increasing access to high-quality healthcare services to improve health and education outcomes and reduce disparities. SBHCs align healthcare and education systems to support a student’s success both inside and outside of school. Care provided by an SBHC complements and supports but does not replace or duplicate existing health services provided by the school.
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​4. SBHCs are created through a collaborative partnership between the community, the school, and an entity that operates and administers the SBHC (“operator”), with students and families being central to this partnership. The SBHC operator is a: (A) federally qualified health center or federally qualified health center look-alike (B) hospital; (C) public health department; (D) nonprofit health or human services agency; or (E) other entity that can operate/administer healthcare operations. The SBHC operator and the partnering school district enter into a legally binding agreement regarding the administration and operation of the SBHC.
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​5. An SBHC provides on-site services and:
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Operates, at a minimum, during the academic day when school is in session
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Operates with regular frequency to ensure the provision of continuous and appropriate care
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Coordinates care, including a systematic follow-up and referral process for patients
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Establishes a method for the exchange of health information between the SBHC and, if applicable, a patient’s primary care provider and other existing care provider(s)
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Communicates with appropriate school personnel to ensure the provision of integrated care
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Establishes a system to connect patients to care outside of SBHC operating hours
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6. An SBHC operates in accordance with federal, state, and local laws and regulations, including those relating to licensure and certification, information sharing, and consent for treatment.
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1. Primary care services include, but are not limited to, comprehensive health assessments/well child exams, primary care mental health, diagnosis and treatment of minor, acute, and chronic medical conditions, and referrals to and follow-up for specialty care.
2. Health services provided in schools include, but are not limited to, services provided by school nurses, psychologists, counselors, social workers, health aides, etc.
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Other ways to deliver school-based health care
The Ohio Alliance and Advisory Group members acknowledged that there are other innovative ways to deliver school-based health care services being implemented across Ohio. These school-based health care delivery mechanisms vary in their evidence base, purpose, goals, outcomes, and structure. Key distinguishing characteristics of these mechanisms are described. These characteristics are not intended to serve as comprehensive definitions, but rather as a guide for understanding Ohio’s school-based health care landscape.
Mobile

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Mobile unit (i.e., bus, trailer, van) parked on a school campus
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Staffed and fully fitted with the equipment and medical supplies needed to provide clinical services to students
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Can be equipped to deliver primary care services or other specific health services, such as dental care, vision or specialty services
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Often scheduled on a school building rotation, providing notice to families when the mobile unit will be on site or pre-scheduling visits
Telehealth

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Healthcare services are provided via telehealth to a student on a school campus
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Model utilizes an adult “telepresenter” who accompanies and supports the patient during the visit with the receiving telehealth provider
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Telepresenter can be an employee of the school system or an employee of a healthcare provider who travels to or is based at the school
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Visit takes place in a private space at the site where the student is located
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Used to connect students to:
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Health care if there is no SBHC or healthcare provider on the school campus that is available to the student
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Specialists at a traditional healthcare facility located outside of the school building campus
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An SBHC site in another school building within the school district
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Portable

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Clinical provider or team travels from one school building to another, operating in spaces as designated or available
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Provider carries healthcare supplies or equipment with them
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Services may be provided on a regular or intermittent schedule

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Refers to a relationship between a school and a community healthcare provider that is located near a school building or campus but is not on-site
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Community provider may set aside appointments for students and/or the school may refer students to the provider for services
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Services delivered to students can vary depending on the provider’s capacity and the students’ needs
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School, healthcare provider, or family can arrange for transportation of the student to and from services
School-linked

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Typically, implemented as an extension of an SBHC
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SBHC is co-located in a school building or on a school campus, and students from other buildings within the district are transported to and from the SBHC site or connected via telehealth
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Provides students in other school buildings with access to the SBHC, often without relying on family members to provide transportation