School-based and school-linked health centers are comprehensive primary care clinics providing medical and mental health screening and treatment for young people on or near school grounds. The clinics were established on a community partnership model, which has been essential to their success. Youth Health Services (YHS) collaborates with seven community health agencies to administer 14 school-based health centers in Seattle and two school-linked health centers in South King County. All of the partner agencies contribute significant resources and expertise to the clinics they operate.

All school-based and school-linked health centers:

• Provide medical care, mental health counseling, health education, and preventive services.
• Offer services to youth in a familiar and "teen-friendly" setting on or near school grounds.
• Are staffed by health professionals who are experienced and trained to work with adolescents.
• Are effective because they are designed to overcome barriers that discourage adolescents from utilizing health services (like lack of confidentiality, inconvenient appointment times, prohibitive costs, and general apprehension about discussing personal health problems).

The school-based and school-linked health centers are staffed by an integrated, multi-disciplinary team. Each site includes a nurse practitioner, mental health counselor, receptionist/patient care coordinator and either a school nurse or a Public Health Nurse. In the school-based clinics, school nurses carry out state-mandated screenings, case manage students with special health care needs, and often serve as the first point of contact for students with illnesses or injuries. The school-linked clinics use a Public Health Nurse to do outreach in the community, provide education about the clinics, and serve as the primary liaison between schools, youth, other service providers, and the clinic. Both Public Health and school nurses regularly refer students to the school-based and school-linked clinics.

The mix of services delivered at each site is tailored to the unique needs of each school community. Additional services are provided based on the needs of the health center users and the available resources at the discretion of each sponsoring agency. In addition to the health, mental health, and preventive services, school-based/linked health centers also provide:

• groups focusing on a variety of issues such as tobacco cessation and self-esteem
• health education in the classroom
• health fairs to promote healthy attitudes and behaviors
• nutrition education and cooking demonstrations
• coordination between parents, school staff, students and other health care providers

The school-based and school-linked health center model is nationally recognized as one of the best ways to provide effective, efficient, and appropriate health care services to adolescents.

The centers target adolescents who are uninsured and underinsured -- those who have no where else to go to get medical care and counseling. They also serve young people who have insurance, but who want confidential care and advice. Well utilized, school-based/linked health centers are consistently praised by students, parents, and school staff as positive places for students to receive health services.