School-based health centers in an era of health care reform: Building on history - Commentary

摘要

In their article, in this issue, Keeton et al. offer an expansive history and overview of the school-based health centers (SBHCs). The characteristics of SBHCs-comprehensive primary and mental health care, accessibility, collaborative practice, and prevention-are the ones that have attracted broad support from national, state, and local funders for the past 40 years. Additionally, although it is true that SBHCs face sustainability challenges, the model appears to be here to stay. According to National Assembly on School-Based Health Care's 2007-2008 census, 72% of the nation's SBHCs are 5 years or older, up from 41% in 1998. Also, more than 200 SBHCs have opened in the past 4 years. These numbers attest to continued community support of and demand for the model. We support and agree with the thoughts the authors share about implications for the future of SBHCs in the current era of health care reform, particularly the connections with medical home, the suggestion about integration with accountable care organizations, and additional research on the direct links between SBHCs and educational outcomes. However, we would like to recognize the position of strength that SBHCs currently hold and the fact that their continuous existence and growth over the past 40 years is a testament to their fortitude and sustainability.