Title 42, The Public Health and WelfareRelease 119-73not60

§280h–5 School-based Health Centers

Title 42 › Chapter 6A— PUBLIC HEALTH SERVICE › Subchapter II— GENERAL POWERS AND DUTIES › Part Q— Programs To Improve the Health of Children › § 280h–5

Last updated Apr 5, 2026|Official source

Summary

Provides grants to run school-based health centers that give medical, mental health, and substance use disorder care to children and adolescents in need. Definitions: "comprehensive primary health services" = basic medical care, mental health and substance use services, and referrals; "medically underserved children and adolescents" = kids who live in areas labeled medically underserved or with too few health workers; "school-based health center" = a clinic run by a sponsoring facility that operates in a school, follows laws, and does not perform abortions. To get a grant an applicant must be an eligible school-based health center and apply with proof it meets the center rules, shows local need, and gives assurances such as getting parental consent, coordinating with other local providers and school staff, offering on-site services during the school day plus 24-hour on-call backup, having the sponsor take full responsibility, and following privacy laws. The Secretary may prefer projects serving communities with barriers to care or many uninsured or historically underserved children, may consider prior related grants, and may waive some rules for up to 2 years or waive some service requirements for good cause. Grant money may pay for equipment, training, operations, and staff salaries, and may be used to expand or install buildings or trailers, but may not pay for abortions. Any grantee must provide non-Federal matching funds equal to 20 percent of the grant (cash or in-kind) unless the Secretary waives it for serious hardship. Grants must add to, not replace, other Federal or State funds. The Secretary will monitor and evaluate centers, grantees must give only age-appropriate services and must obtain parent/guardian consent for minors under state law, and technical assistance grants to nonprofits are allowed. Funds are authorized as needed for fiscal years 2022 through 2026.

Full Legal Text

Title 42, §280h–5

The Public Health and Welfare, Source: USLM XML via OLRC

(a)In this section:
(1)The term “comprehensive primary health services” means the core services offered by school-based health centers, which shall include the following:
(A)Comprehensive health assessments, diagnosis, and treatment of minor, acute, and chronic medical conditions, and referrals to, and follow-up for, specialty care and oral and vision health services.
(B)Mental health and substance use disorder assessments, crisis intervention, counseling, treatment, and referral to a continuum of services including emergency psychiatric care, community support programs, inpatient care, and outpatient programs.
(2)(A)The term “medically underserved children and adolescents” means a population of children and adolescents who are residents of an area designated as a medically underserved area or a health professional shortage area by the Secretary.
(B)The Secretary shall prescribe criteria for determining the specific shortages of personal health services for medically underserved children and adolescents under subparagraph (A) that shall—
(i)take into account any comments received by the Secretary from the chief executive officer of a State and local officials in a State; and
(ii)include factors indicative of the health status of such children and adolescents of an area, including the ability of the residents of such area to pay for health services, the accessibility of such services, the availability of health professionals to such children and adolescents, and other factors as determined appropriate by the Secretary.
(3)The term “school-based health center” means a health clinic that—
(A)meets the definition of a school-based health center under section 1397jj(c)(9)(A) of this title and is administered by a sponsoring facility (as defined in section 1397jj(c)(9)(B) of this title);
(B)provides, at a minimum, comprehensive primary health services during school hours to children and adolescents by health professionals in accordance with established standards, community practice, reporting laws, and other State laws, including parental consent and notification laws that are not inconsistent with Federal law; and
(C)does not perform abortion services.
(b)The Secretary shall award grants for the costs of the operation of school-based health centers (referred to in this section as “SBHCs”) that meet the requirements of this section.
(c)To be eligible to receive a grant under this section, an entity shall—
(1)be an SBHC (as defined in subsection (a)(3)); and
(2)submit to the Secretary an application at such time, in such manner, and containing—
(A)evidence that the applicant meets all criteria necessary to be designated an SBHC;
(B)evidence of local need for the services to be provided by the SBHC;
(C)an assurance that—
(i)SBHC services will be provided to those children and adolescents for whom parental or guardian consent has been obtained in cooperation with Federal, State, and local laws governing health care service provision to children and adolescents;
(ii)the SBHC has made and will continue to make every reasonable effort to establish and maintain collaborative relationships with other health care providers in the catchment area of the SBHC;
(iii)the SBHC will provide on-site access during the academic day when school is in session and 24-hour coverage through an on-call system and through its backup health providers to ensure access to services on a year-round basis when the school or the SBHC is closed;
(iv)the SBHC will be integrated into the school environment and will coordinate health services with school personnel, such as administrators, teachers, nurses, counselors, and support personnel, as well as with other community providers co-located at the school;
(v)the SBHC sponsoring facility assumes all responsibility for the SBHC administration, operations, and oversight; and
(vi)the SBHC will comply with Federal, State, and local laws concerning patient privacy and student records, including regulations promulgated under the Health Insurance Portability and Accountability Act of 1996 and section 1232g of title 20; and
(D)such other information as the Secretary may require.
(d)In reviewing applications:
(1)The Secretary may give preference to applicants who demonstrate an ability to serve the following:
(A)Communities that have evidenced barriers to primary health care and mental health and substance use disorder prevention services for children and adolescents.
(B)Communities with high per capita numbers of children and adolescents who are uninsured, underinsured, or enrolled in public health insurance programs.
(C)Populations of children and adolescents that have historically demonstrated difficulty in accessing health and mental health and substance use disorder prevention services.
(2)The Secretary may give consideration to whether an applicant has received a grant under section 280h–4 of this title.
(e)The Secretary may—
(1)under appropriate circumstances, waive the application of all or part of the requirements of this subsection with respect to an SBHC for not to exceed 2 years; and
(2)upon a showing of good cause, waive the requirement that the SBHC provide all required comprehensive primary health services for a designated period of time to be determined by the Secretary.
(f)(1)Funds awarded under a grant under this section—
(A)may be used for—
(i)acquiring and leasing equipment (including the costs of amortizing the principle of, and paying interest on, loans for such equipment);
(ii)providing training related to the provision of required comprehensive primary health services and additional health services;
(iii)the management and operation of health center programs;
(iv)the payment of salaries for physicians, nurses, and other personnel of the SBHC; and
(B)may not be used to provide abortions.
(2)The Secretary may award grants which may be used to pay the costs associated with expanding and modernizing existing buildings for use as an SBHC, including the purchase of trailers or manufactured buildings to install on the school property.
(3)(A)Any provider of services that is determined by a State to be in violation of a State law described in subsection (a)(3)(B) with respect to activities carried out at a 11 So in original. SBHC shall not be eligible to receive additional funding under this section.
(B)No entity that has received funding under section 254b of this title for a grant period shall be eligible for a grant under this section for with respect to 1 the same grant period.
(g)(1)Each eligible entity that receives a grant under this section shall provide, from non-Federal sources, an amount equal to 20 percent of the amount of the grant (which may be provided in cash or in-kind) to carry out the activities supported by the grant.
(2)The Secretary may waive all or part of the matching requirement described in paragraph (1) for any fiscal year for the SBHC if the Secretary determines that applying the matching requirement to the SBHC would result in serious hardship or an inability to carry out the purposes of this section.
(h)Grant funds provided under this section shall be used to supplement, not supplant, other Federal or State funds.
(i)The Secretary shall develop and implement a plan for evaluating SBHCs and monitoring quality performance under the awards made under this section.
(j)An eligible entity receiving funds under this section shall only provide age appropriate services through a 1 SBHC funded under this section to an individual.
(k)An eligible entity receiving funds under this section shall not provide services through a 1 SBHC funded under this section to an individual without the consent of the parent or guardian of such individual if such individual is considered a minor under applicable State law.
(l)The Secretary shall provide technical assistance by grants or contracts awarded to private, nonprofit entities with demonstrated expertise related to school-based health centers. Such technical assistance, taking into account local and regional differences among school based 1 health centers, shall support such entities in providing services described in subsection (a)(1) pursuant to this section, including mental health and substance use disorder services, and may include technical assistance relating to program operations and support for the implementation of evidence-based or evidence-informed best practices related to the provision of high quality health care services to children and adolescents.
(m)For purposes of carrying out this section, there are authorized to be appropriated such sums as may be necessary for each of the fiscal years 2022 through 2026.

Legislative History

Notes & Related Subsidiaries

Editorial Notes

References in Text

The Health Insurance Portability and Accountability Act of 1996, referred to in subsec. (c)(2)(C)(vi), is Pub. L. 104–191, Aug. 21, 1996, 110 Stat. 1936. For complete classification of this Act to the Code, see

Short Title

of 1996

Amendments

note set out under section 201 of this title and Tables.

Amendments

2022—Subsecs. (l), (m). Pub. L. 117–328 added subsec. (l) and redesignated former subsec. (l) as (m). 2020—Subsec. (l). Pub. L. 116–260 substituted “2022 through 2026” for “2010 through 2014”. 2010—Subsec. (a)(1)(A). Pub. L. 111–148, § 10402(a), inserted “and vision” after “oral”.

Reference

Citations & Metadata

Citation

42 U.S.C. § 280h–5

Title 42, The Public Health and Welfare

Last Updated

Apr 5, 2026

Release point: 119-73not60