NAPNAP Position Statement on School-based Health Care

School-based Health Centers (SBHCs), located on or near school campuses, provide comprehensive primary care to infants, children, and adolescents living or attending school in the local area. They are a safe and accessible source of health care for children who may not otherwise have care and provide an effective way to advocate for children. The National Association of Pediatric Nurse Practitioners (NAPNAP) supports the use of pediatric nurse practitioners (PNPs) in SBHCs to minimize access to care barriers for children by providing comprehensive primary care and management of acute and chronic illnesses and by linking these services with other community resources. PNPs, collaborating with school personnel, improve health care delivery and promote effective, timely, and accessible services for children. Early intervention provided in SBHCs is cost-effective and has been proven to improve school attendance (National Assembly on School-Based Health Care, 2005) and academics (Geierstanger & Amaral, 2005).

Major gaps exist in today's health care system for children, such as inaccessibility to health care and lack of preventive services for youth (American Academy of Pediatrics Committee on Adolescence, 2008, Brenner et al., 2007, Health services,). There is a significant lack of a stable funding source, which affects the sustainability of SBHCs (Brindis et al., 2003). SBHCs fill these gaps by providing comprehensive physical, mental, and dental health services to children in need of care at locations accessible to children (Scudder, Papa, & Brey, 2007). SBHCs do not replace an ongoing relationship a child may have with a primary provider. Rather, the centers are designed to overcome social and economic barriers to health care.

NAPNAP supports the following:

In summary, SBHCs are an important and necessary component to health care for youth, from infancy through high school. They provide a comprehensive range of services that specifically meet the needs of children and deliver health care to all children, including many who are uninsured or underinsured. The multiple models of SBHCs allow for creativity in serving the specific needs of the community-based population. The school-based health care setting provides a unique opportunity to implement a multidisciplinary team approach, utilizing integrated services to manage issues affecting a child's health, school performance, and school attendance (Scudder et al., 2007).

NAPNAP is an organization whose mission is promoting optimal health for children through leadership, practice, advocacy, education, and research.

The National Association of Pediatric Nurse Practitioners would like to acknowledge the contribution made by the following members of the NAPNAP School-based Health Care Special Interest Group (SIG) in the revision of this statement: Roberta Bavin, MN, RN, CPNP-BC, School-based Health Care SIG Chair; Renee P. McLeod, PhD, PNP, BC, CPNP-PC, Clinical Practice Chair; Bonnie Gance-Cleveland, PhD, RNC, PNP; Marjorie M. (Peg) Heinzer, PhD, PNP-BC, CRNP; Debbie Martinez, MSN, RN, PPNP; Susan Robins, MS, CFNP, PNP; Susan Rowley, MS, RN, CPNP; Esther Sikorski, MS, RN, PNP-BC; Victoria Trabucchi, MS, CPNP, SNP; Sharon Yearous, PhD(c), RN, CPNP, NCSN; and Heather Keesing, MSN, RN, FNP-BC (Staff).