School-Based Health Centers in Maryland


What are School-Based Health Centers (SBHCs) or School-Based Wellness Centers?

SBHCs are health centers, located in a school or on a school campus, which provide onsite comprehensive preventive and primary health services.  Services may also include mental health, oral health, ancillary, and supportive services.  You might think of a SBHC as "doctor's office in a school".  SBHCs may be staffed by one or more of the following health professionals:

• A primary care provider, such as a pediatrician, nurse practitioner, or physician assistant
• A registered nurse (RN or BSN) and/or a licensed practical nurse (LPN)
• A medical office assistant (MOA) or medical assistant (MA)
• A billing or clerical staff member
• A mental health provider, such as a psychiatrist, psychologist, social worker, or other therapist
• A substance abuse counselor
• A dentist and/or dental hygienist
• A health educator
• A nutritionist or registered dietitian
  

As of August 2007 there are 63 SBHCs in Maryland, with more being planned.  Some SBHCs serve more than one school, sharing staff between neighboring schools.  Maryland's 63 SBHCs are located in:

Where are they located?

There are SBHCs in 11 of Maryland's 24 jurisdictions (counties).

How can I locate a specific SBHC in Maryland?

Click here for a contact list for Maryland SBHCs.

What is the relationship between SBHCs and school nurses/school health services programs?

All 1,444 public schools in Maryland have school health services, usually staffed by a registered nurse.  Some large or rural schools have a full-time nurse, but most schools share a part-time nurse with one or more other schools.  School nurses provide acute care for injuries and illnesses, care for chronic health conditions under the supervision of a physician, conduct screening for health problems, and maintain up-to-date health and immunization records.  School nurses do not diagnose or treat illness; they refer children for appropriate medical care.

SBHCs serve 73 of the 1444 public schools.  (There are 63 SBHCs in Maryland, but some serve more than one school.)  SBHCs employ a primary care provider (a pediatrician, nurse practitioner, or physician assistant) who works cooperatively with the school nurse to screen, diagnose, treat, and refer children for medical conditions.  School nurses often serve as the first contact for health issues in a school.  They evaluate the problem at hand and either provide care or refer the student to the appropriate provider of care, which may be a SBHC nurse practitioner, a mental health provider, or the child's own doctor.

What is the relationship between SBHCs and the health care community/doctors?

SBHCs provide care while children are in school, and help prevent them from missing school due to illness.  They do not provide round-the-clock care or emergency coverage.  All children should have a primary care provider in the community who oversees their care.  SBHCs help make sure they have a doctor by helping parents to locate a convenient pediatrician and secure health insurance coverage.    

If all children should have their own doctor, why do we need SBHCs?

In 2004, 1 out of every 11 Maryland children under age 18 had no health insurance and 1 out of every 4 Maryland children under age 18 lived in poverty (Kids Count, Annie E. Casey Foundation Maryland data profile).  Uninsured and poor children have less access to health care and often have more chronic health problems than other children. 

SBHCs were started in Maryland in 1985 to increase children's access to health care. They have proven effective in diagnosing and treating illness, managing chronic health conditions, and increasing school attendance for children at risk of missing school due to health issues. In some parts of the United States, where SBHCs have been studied, an increase in student achievement has been noted in schools with SBHCs.

SBHCs are good for all children, though, not just the poor and the uninsured. Modern parents are busy working and taking care of other children, and it can be expensive and inconvenient to take a child to the doctor for a minor health concern. Many rural Maryland counties have few pediatricians or other child health professionals, so services provided in schools are especially important. In recent years, chronic conditions have increased in children, such as asthma, diabetes, and obesity, which benefit from daily monitoring and treatment in the school setting.