Expanding Healthcare Service Delivery in South Bexar County, Texas: Development and Implementation of a School-Based Health Center

School-based health centers (SBHCs) are an important avenue for helping students receive timely clinical preventive care (screenings and immunizations). As part of an effort to redesign healthcare delivery to priority populations, University Health System, a major safety net hospital system located in South Central Texas, opened its first SBHC within Bexar County in August 2013. The Harlandale Independent School District (HISD) was the selected setting because of their large enrollment (14,000 students) and high percentage of economically disadvantaged students (88%).

Focus groups were conducted to better understand the health service needs of students. Participants included school district administrators, teachers, parents, and health service staff. Geospatial analyses of the proposed service catchment area were utilized to prioritize areas most in need of health services. Geospatial methods were also used to examine local population-level health indices, student characteristics (social and demographic), and quality of available health services.

Since the SBHC opened, it has received 1,222 care visits for immunizations (49%), acute care (37%), well-child exams (10%) and sports physicals (9%). For the first time, HISD achieved 100% completion of minimum state vaccination requirements for K-12 students.

This initiative highlights the innovative and synergistic strategy used to leverage school, community, and health services efforts to address regional disparities in child and adolescent health. Findings support the importance of complementing traditional strategic planning efforts with mix-method evaluation approaches to assess the implementation, reach, and sustainability of community-based collaborative models of care.