School-Based Health Centers Can Be Sustained Through Collaboration and Careful Site Selection

School-based health centers (SBHC) increase health care access for low-income families. They also improve patients’ health outcomes and reduce healthcare costs, according to previous research. But these centers have faced operational challenges that have led to closures. Drawing on the experiences of five SBHCs operating in Chicago Public Schools, we identify common strategies that supported their success, including collaboration and careful site selection.

What We Did

We interviewed SBHC stakeholders between 2008 and 2014 to document the implementation of Elev8 Chicago, a community school initiative that included the establishment of the five SBHCs. We also conducted follow-up interviews with SBHC stakeholders in 2018.

What We Found

Based on the information collected, the strategies that appear to have been most beneficial to sustaining the five Elev8 SBHCs include:

  • Finding common ground. The SBHCs and their host schools learned over time to limit the scope of services the centers provided to those of greatest concern to both the health providers and the school community.
  • Establishing SBHCs where demand is high. Because SBHCs rely heavily on third-party reimbursements, SBHCs in schools and communities with a large number of potential patients, including both students and community members, are more sustainable.
  • Building strong ties among health center and school staff. Keeping lines of communication among health and school staff—through regular health committee meetings or through health and school liaisons—can build trust and reduce tensions over time.

What It Means

  • Healthcare providers and schools can promote sustainability by limiting the services that SBHCs provide to those that are reimbursable through third-party payments and are of greatest concern to the school community.
  • Policymakers and healthcare providers should carefully study the potential demand for services prior to establishing SBHCs.
  • Healthcare providers and school staff should establish clear communication and planning strategies, such as health committees, to maintain trust and smooth operations over time.
    Recommended citation
    Kohm, A., & Rich, L. (2019). Sustaining school-based health centers. Chicago, IL: Chapin Hall at the University of Chicago.
SBHC_Brief One-page summary