School-based Health Centers and Kids with Chronic Illness

School-based health centers (SBHCs) provide a variety of health care services to students—and often their families and/or community members. 

Located in a school building on campus, SBHCs increase health care access by removing barriers to health care that many families face. At Roberts Paideia Academy’s SBHC, Nicole DeGreg is the Nurse Practitioner who sees patients. The SBHC is also staffed with a clinic nurse and two medical assistants. Roberts Academy also has a school nurse, whose role is collaborative but separate.

The SBHC at Roberts Academy is one of 13 City of Cincinnati Primary Care centers run by the Cincinnati Health Department. “We don’t just serve the kids [who attend the school] but also those from the surrounding community,” DeGreg says.

“About 30% of the visits are well-child checks,” she says, and they offer services such as lab draws and immunizations. “We can do acute visits—which happens a lot during flu season,” she says, “and we see a lot of asthma visits in the fall and spring.”

Chronic illness and SBHCs

Asthma is a childhood chronic illness that can benefit from management at school. Kids with asthma miss more school than other kids. 

“By bringing health care to where kids are, we can follow up more closely,” says DeGreg. They offer oral steroids and nebulizer treatments in case of asthma attacks (exacerbations), as well as education about medication management. This can lead to better-managed disease and fewer absences.

The Roberts Academy SBHC addresses other common childhood chronic illnesses, such as cavities (dental caries), as well. For example, they are in the process of building a new health center that includes a dental center. “Up until now, [a mobile dentist] has come to the school twice a year to do screenings and cleanings. Those who need further help were sent to another dental center nearby,” she says. Once the center is completed, all dental treatment can happen on-site.

The importance of family involvement

DeGreg will be presenting on the importance of family involvement in SBHCs at the 2025  National School-Based Health Alliance Conference in Washington, D.C. “We’ve worked hard to get family involvement,” she says. “60% of our visits have families in attendance with the kids.”

Families consent to their child being treated by SBHCs, but DeGreg stresses that a collaborative relationship between health care provider and caregiver is paramount. “There’s only so much you can do with a child who has a chronic illness. The family has to be part of the process, too.”

She gives the example of obesity and its comorbidities, like prediabetes, fatty liver disease, and high cholesterol—all of which she has seen. “We’ve had kids as young as 10 or 11 with Type 2 diabetes.” They’ve referred kids to the HealthWorks! Physical Activity Program run by Cincinnati Children’s and collaborate with nutritionists and exercise specialists to help reduce obesity. They also provide education on obesity management. “If you get parents on board, it helps.”

SBHCs around Cincinnati

Many of SBHCs see community members as well as schoolchildren. The Growing Well website allows the public to search for SBHCs near them. DeGreg says, “It makes sense for these services to be available where kids and families have to be every day. And Cincinnati has some fantastic [SBHCs] doing truly important work.”