Expanded Program Models

SBHCs | School Nurses | Behavioral Health | School-Linked Services | Telehealth | Mobile | Oral Health | Health Promotion | Community Schools 

School-Based Health Centers

School-based health centers (SBHCs), also referred to as school health centers, provide comprehensive medical and/or mental health care. Services may include physical exams, screenings, immunizations, management of chronic conditions, age-appropriate reproductive health care for adolescents, primary medical care for injuries and illness, laboratory tests, tuberculosis tests, over-the-counter medications and prescription writing, and referrals and coordination of outside services. Clinicians delivering medical care include nurse practitioners, physician assistants, physicians, residents, medical assistants and nurses. To learn more, review our Guidelines for California School Health Centers. Note that the federal definition of a school health center requires that the center provide both medical and mental health services, and many school health centers in California do provide both of these primary care services.

School Nursing Programs

School nursing programs focus on the prevention of illness and disability and the early detection and correction of health problems. As registered nurses, school nurses can assess for health problems (e.g., conduct vision and hearing screenings), deliver some health services (e.g., administer immunizations and insulin), and provide health education to students, families and staff; they often also coordinate school or district-wide health programs. Read more about the role of school nurses or visit the California School Nurses Organization website.

Student Counseling and Mental Health Programs

Student counseling and mental health programs provide assessments and interventions to support students’ mental and emotional wellbeing. These interventions may include crisis response, individual, group, or family counseling, drug or alcohol treatment, staff consultation on student behavior, classroom-based social and personal skill development, and family supports and linkages. School social workers, counselors, psychologists and other registered or licensed mental health clinicians provide these services. These programs are sometimes organized as a school wellness center. Learn more about San Francisco’s Wellness Centers. For more information about school mental health programs, visit UCLA’s Center for Mental Health in Schoolsand the California Association of School Psychologists.

School-Linked Health Services

School-linked health services or telehealth services are most appropriate when it is not feasible, or not the best use of resources, to bring clinical providers into the school. School-linked services exist when a local community health program, such as a community clinic, has a formalized, well-coordinated linkage to one or more schools. Students and families may easily access services at the community health site, and school staff know how to facilitate needed services through a close working relationship with the community health program. Read a case study of a school-linked health center in Ontario, CA.

Telehealth Services

School telehealth services connect schools to health care providers, using existing distance learning equipment and data lines (and sometimes also specialized remote medical equipment). Telehealth services allow medical providers to remotely assess an acute care problem, improve management of chronic diseases like diabetes, and increase access to mental health care, especially to psychiatrists who can prescribe and follow-up on needed medications, such as for ADHD. Read The Children’s Partnership Executive Summary ofSchool-Based Telehealth: An Innovative Approach to Meet the Health Care Needs of California’s Children.

Mobile Clinics

Mobile clinics bring health care to one or more schools using an RV-style van that’s fully equipped with exam rooms and needed medical equipment. Mobile clinics may provide comprehensive medical care, oral health care, or specialty care for conditions like asthma. Mobile health clinics increase access to needed services in rural and urban areas alike, and are usually more economical than building several school-based clinical facilities. Read a case study of a medical mobile van in Fresno County.

Oral Health Programs

Oral health programs provide oral health assessments and, sometimes, treatments to prevent or remediate dental disease. These services range from oral health education, to assessments or dental sealant programs, to actual treatment of cavities. Lead personnel may include school nurses, dental hygienists and assistants, and dentists. When required, specialized dental equipment may be brought into a school health center or onto a school campus in a mobile van; alternatively, specialized equipment may be located off-site, in which case the school facilitates transportation to treatment services as indicated. Learn more about school oral health policies at the Center for Oral Health website.

Health Promotion Programs

Health promotion programs may cover a range of topics, including healthy eating and active living (obesity prevention), drug, alcohol and tobacco use prevention, communicable disease prevention, comprehensive sexual health education,  violence prevention, and the development of positive school climate. Various staff may develop and deliver these programs, from classroom teachers to nurses to certified health education specialists. Health promotion programs can be delivered in the classroom, in a school health center, after school, or through school wide campaigns. See California’s Health Education Content Standards for more information on school health promotion programs.

Community Schools

Community School Resources

Recognizing the fact that students come to school with many diverse needs, community schools bring a variety of essential services onto campuses with the goal of providing a comprehensive set of supports — often including health services — to children and families. According to the Coalition for Community Schools, a community school is both a place and a set of partnerships between the school and other community resources.(1) Community schools are centers of the community, and they keep their doors open longer hours, including evenings, weekends, and during vacations. Please see this policy brief on how community schools address poverty and offer the supports students need to succeed in school.

Students Need A Wide Variety of Supports

To succeed, students need high-quality instructional experiences and a positive school climate. Many students,  particularly low-income students, require additional supports — supports that extend beyond the traditional responsibilities of schools and districts. In fact, recent research has identified six “out of school” factors that significantly impact the learning of children living in poverty: low birth-weight and non-genetic prenatal influences on children; inadequate medical, dental, and vision care, often a result of inadequate or no medical insurance; food insecurity; environmental pollutants; family relations and family stress; and neighborhood characteristics.(2)

Given students’ diverse needs, effective instruction must be paired with effective learning supports. These may include nutritious meals and safe places to play, high-quality health and behavioral health care, opportunities to develop autonomy and leadership skills, case management and other families services, and more. Without community schools to provide these supports, many students, particularly low-income students, are less likely to reach their potential.

Community Schools Provide Essential, Responsive Supports

Community schools are responsive to the needs and wishes of students, families, and staff, and they focus on bringing the most important community resources and services to those who need them most. As a result, no two community schools are identical. In addition, community schools evolve, starting by addressing high-priority needs and growing their offerings over time. That said, school health services and school-based health centers (SBHCs) are often among the first developed components of a community school. School health services and SBHCs meet pressing health needs, provide prevention and early intervention services, and help students get ready to learn.

Because of their integrated focus on academics, health and social services, youth and community development, and community engagement, community schools improve student learning while also building stronger families and healthier communities. A growing research base, using data from schools across the country, shows that community schools improve student behavior, attendance, and graduation rates, parent involvement, and ultimately academic achievement.(3)

Resources for Practice


The Coalition for Community Schools

The Coalition for Community Schools is a national organization advancing the community schools movement. It offers wide variety of resources, including more information about the approach and its impact, toolkits for educators and partners, and a list of organizations providing technical assistance to community school efforts.

The Center for Community School Partnerships at the University of California, Davis

The Center for Community School Partnerships (CCSP) promotes student success, youth well being, and equitable, just communities for all of California’s learners by cultivating pathways between communities and their schools. CCSP’s works on research, evaluation, and technical assistance, connecting schools and communities to support student success, youth well-being, and collaborative community-school partnerships. CCSP’s website includes description of CCSP’s services as well as links to their research and resources.

Partnership for Children and Youth

The Partnership for Children and Youth (PCY) brings together government, education, philanthropic, nonprofit, business and community leaders to support student success in California. PCY promotes the community schools approach: their website includes information and resources for those interested in community schools.

The Children’s Aid Society

Since 1992, The Children’s Aid Society has partnered with the New York City Department of Education in more than 20  community schools. The website includes a variety of resources and materials for those interested in community schools.

Examples of Community Schools Efforts

National Community Schools Models, compiled by the Coalition for Community Schools

Community Schools Across the Nation, compiled by the Coalition for Community Schools

Children’s Aid Society Community School (video), from the George Lucas Educational Foundation

Community Schools-Thriving Students Strategic Plan, Oakland Unified School District

Every Child in Every Neighborhood (video), Oakland Unified School District

Santa Clara School-Linked Services Strategic Plan, Santa Clara County

Other Resources

Community Schools: A Full Spectrum Resource

This article was published in Leadership, the magazine of the Association of California School Administrators. It provides a useful overview of the community schools approach and its impact for students.

Community Schools: Aligning Local Resources for Student Success

This paper was put together by the Partnership for Children and Youth. It explains critical funding streams and strategies for community schools.

(1) Coalition for Community Schools. What is a Community School? http://www.communityschools.org/aboutschools/what_is_a_community_school.aspx
(2) Berliner, D.C. (2009). Poverty and Potential: Out-of-School Factors and School Success. Boulder and Tempe: Education and the Public Interest Center & Education Policy Research Unit. http://epicpolicy.org/publication/poverty-and-potential.
(3) Coalition for Community Schools. Top Community Schools Research. http://www.communityschools.org/aboutschools/top_community_schools_research.aspx