---
kind: "section"
citation: "42 U.S.C. § 280h–5"
title: "42"
title_heading: "The Public Health and Welfare"
number: "280h–5"
heading: "School-based health centers"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/280h-5"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter II — General Powers and Duties"
  - "Part Q — Programs To Improve the Health of Children"
---

# §280h–5. School-based health centers

- (a) **Definitions; establishment of criteria—** In this section:
  - (1) **Comprehensive primary health services—** The term “comprehensive primary health [services](/usc/42/201.md?p=a)” means the [core services](/usc/42/300z–1.md?p=a-5) offered by [school](/usc/42/300j–21.md?p=6)-based health centers, which shall include the following:
    - (A) **Physical—** Comprehensive health assessments, diagnosis, and [treatment](/usc/42/11851.md?p=11) of minor, acute, and chronic medical conditions, and referrals to, and follow-up for, specialty care and oral and vision health [services](/usc/42/201.md?p=a).
    - (B) **Mental health—** Mental health and substance use disorder assessments, crisis intervention, counseling, [treatment](/usc/42/11851.md?p=11), and referral to a continuum of [services](/usc/42/201.md?p=a) including emergency psychiatric care, community support [programs](/usc/42/274l–1.md?p=4), inpatient care, and outpatient [programs](/usc/42/274l–1.md?p=4).
  - (2) **Medically underserved children and adolescents—**
    - (A) **In general—** The term “medically underserved children and [adolescents](/usc/42/300z–1.md?p=a-9)” means a population of children and [adolescents](/usc/42/300z–1.md?p=a-9) who are residents of an area designated as a medically underserved area or a health professional shortage area by the [Secretary](/usc/42/201.md?p=c).
    - (B) **Criteria—** The [Secretary](/usc/42/201.md?p=c) shall prescribe criteria for determining the specific shortages of personal health [services](/usc/42/201.md?p=a) for medically underserved children and [adolescents](/usc/42/300z–1.md?p=a-9) under [subparagraph (A)](#a-2-A) that shall—
      - (i) take into account any comments received by the [Secretary](/usc/42/201.md?p=c) from the chief executive officer of a [State](/usc/42/201.md?p=f) and local officials in a [State](/usc/42/201.md?p=f); and
      - (ii) include factors indicative of the health status of such children and [adolescents](/usc/42/300z–1.md?p=a-9) of an area, including the ability of the residents of such area to pay for health [services](/usc/42/201.md?p=a), the accessibility of such [services](/usc/42/201.md?p=a), the availability of health professionals to such children and [adolescents](/usc/42/300z–1.md?p=a-9), and other factors as determined appropriate by the [Secretary](/usc/42/201.md?p=c).
  - (3) **School-based health center—** The term “[school](/usc/42/300j–21.md?p=6)-based health center” means a health clinic that—
    - (A) meets the definition of a [school](/usc/42/300j–21.md?p=6)-based health center under [section 1397jj(c)(9)(A) of this title](/usc/42/1397jj.md?p=c-9-A) and is administered by a sponsoring facility (as defined in [section 1397jj(c)(9)(B) of this title](/usc/42/1397jj.md?p=c-9-B));
    - (B) provides, at a minimum, comprehensive primary health [services](/usc/42/201.md?p=a) during [school](/usc/42/300j–21.md?p=6) hours to children and [adolescents](/usc/42/300z–1.md?p=a-9) by health professionals in accordance with established standards, community practice, reporting laws, and other [State](/usc/42/201.md?p=f) laws, including parental consent and notification laws that are not inconsistent with Federal law; and
    - (C) does not perform abortion [services](/usc/42/201.md?p=a).
- (b) **Authority to award grants—** The [Secretary](/usc/42/201.md?p=c) shall award grants for the costs of the operation of [school](/usc/42/300j–21.md?p=6)-based health centers (referred to in this section as “SBHCs”) that meet the requirements of this section.
- (c) **Applications—** To be eligible to receive a grant under this section, an entity shall—
  - (1) be an SBHC (as defined in [subsection (a)(3)](#a-3)); and
  - (2) submit to the [Secretary](/usc/42/201.md?p=c) 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](/usc/42/201.md?p=a) to be provided by the SBHC;
    - (C) an assurance that—
      - (i) SBHC [services](/usc/42/201.md?p=a) will be provided to those children and [adolescents](/usc/42/300z–1.md?p=a-9) for whom parental or guardian consent has been obtained in cooperation with Federal, [State](/usc/42/201.md?p=f), and local laws governing health care [service](/usc/42/201.md?p=a) provision to children and [adolescents](/usc/42/300z–1.md?p=a-9);
      - (ii) the SBHC has made and will continue to make every reasonable effort to establish and maintain collaborative relationships with other [health care providers](/usc/42/300aa–33.md?p=1) in the catchment area of the SBHC;
      - (iii) the SBHC will provide on-site access during the academic day when [school](/usc/42/300j–21.md?p=6) is in session and 24-hour coverage through an on-call system and through its backup health [providers](/usc/42/299b–21.md?p=8) to ensure access to [services](/usc/42/201.md?p=a) on a year-round basis when the [school](/usc/42/300j–21.md?p=6) or the SBHC is closed;
      - (iv) the SBHC will be integrated into the [school](/usc/42/300j–21.md?p=6) environment and will coordinate health [services](/usc/42/201.md?p=a) with [school](/usc/42/300j–21.md?p=6) personnel, such as [administrators](/usc/42/4005.md?p=1), teachers, nurses, counselors, and support personnel, as well as with other community [providers](/usc/42/299b–21.md?p=8) co-located at the [school](/usc/42/300j–21.md?p=6);
      - (v) the SBHC sponsoring facility assumes all responsibility for the SBHC administration, operations, and oversight; and
      - (vi) the SBHC will comply with Federal, [State](/usc/42/201.md?p=f), and local laws concerning patient privacy and student records, including [regulations](/usc/42/201.md?p=d) promulgated under the Health Insurance Portability and Accountability Act of 1996 and [section 1232g of title 20](/usc/20/1232g.md); and
    - (D) such other information as the [Secretary](/usc/42/201.md?p=c) may require.
- (d) **Preferences and consideration—** In reviewing applications:
  - (1) The [Secretary](/usc/42/201.md?p=c) 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](/usc/42/300z–1.md?p=a-8) for children and [adolescents](/usc/42/300z–1.md?p=a-9).
    - (B) Communities with high per capita numbers of children and [adolescents](/usc/42/300z–1.md?p=a-9) who are uninsured, underinsured, or enrolled in public health insurance [programs](/usc/42/274l–1.md?p=4).
    - (C) Populations of children and [adolescents](/usc/42/300z–1.md?p=a-9) that have historically demonstrated difficulty in accessing health and mental health and substance use disorder [prevention services](/usc/42/300z–1.md?p=a-8).
  - (2) The [Secretary](/usc/42/201.md?p=c) may give consideration to whether an applicant has received a grant under [section 280h–4 of this title](/usc/42/280h–4.md).
- (e) **Waiver of requirements—** The [Secretary](/usc/42/201.md?p=c) 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](/usc/42/201.md?p=a) for a designated period of time to be determined by the [Secretary](/usc/42/201.md?p=c).
- (f) **Use of funds—**
  - (1) **Funds—** 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](/usc/42/201.md?p=a) and additional health [services](/usc/42/201.md?p=a);
      - (iii) the management and operation of health center [programs](/usc/42/274l–1.md?p=4);
      - (iv) the payment of salaries for physicians, nurses, and other personnel of the SBHC; and
    - (B) may not be used to provide abortions.
  - (2) **Construction—** The [Secretary](/usc/42/201.md?p=c) 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](/usc/42/300j–21.md?p=6) property.
  - (3) **Limitations—**
    - (A) **In general—** Any [provider](/usc/42/299b–21.md?p=8) of [services](/usc/42/201.md?p=a) that is determined by a [State](/usc/42/201.md?p=f) to be in [violation](/usc/42/2000e–16a.md?p=c) of a [State](/usc/42/201.md?p=f) law described in [subsection (a)(3)(B)](#a-3-B) with respect to activities carried out at a[^1] SBHC shall not be eligible to receive additional funding under this section.
    - (B) **No overlapping grant period—** No entity that has received funding under [section 254b of this title](/usc/42/254b.md) for a grant period shall be eligible for a grant under this section for with respect to[^1] the same grant period.
- (g) **Matching requirement—**
  - (1) **In general—** 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) **Waiver—** The [Secretary](/usc/42/201.md?p=c) may waive all or part of the matching requirement described in [paragraph (1)](#g-1) for any fiscal year for the SBHC if the [Secretary](/usc/42/201.md?p=c) 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) **Supplement, not supplant—** Grant funds provided under this section shall be used to supplement, not supplant, other Federal or [State](/usc/42/201.md?p=f) funds.
- (i) **Evaluation—** The [Secretary](/usc/42/201.md?p=c) shall develop and implement a plan for evaluating SBHCs and monitoring quality performance under the awards made under this section.
- (j) **Age appropriate services—** An eligible entity receiving funds under this section shall only provide age appropriate [services](/usc/42/201.md?p=a) through a[^1] SBHC funded under this section to an individual.
- (k) **Parental consent—** An eligible entity receiving funds under this section shall not provide [services](/usc/42/201.md?p=a) 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](/usc/42/201.md?p=f) law.
- (l) **Technical assistance—** The [Secretary](/usc/42/201.md?p=c) shall provide technical assistance by grants or contracts awarded to private, [nonprofit](/usc/42/300s–3.md?p=3) entities with demonstrated expertise related to [school](/usc/42/300j–21.md?p=6)-based health centers. Such technical assistance, taking into account local and regional differences among [school](/usc/42/300j–21.md?p=6) based[^1] health centers, shall support such entities in providing [services](/usc/42/201.md?p=a) described in [subsection (a)(1)](#a-1) pursuant to this section, including mental health and [substance use disorder services](/usc/42/290cc–34.md?p=4), and may include technical assistance relating to [program](/usc/42/274l–1.md?p=4) operations and support for the implementation of evidence-based or evidence-informed best [practices](/usc/42/17061.md?p=19) related to the provision of high quality health [care services](/usc/42/300z–1.md?p=a-7) to children and [adolescents](/usc/42/300z–1.md?p=a-9).
- (m) **Authorization of appropriations—** 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.

## Footnotes

[^1]: So in original.

## Source credit

(July 1, 1944, ch. 373, title III, § 399Z–1, as added and amended Pub. L. 111–148, title IV, § 4101(b), title X, § 10402(a), Mar. 23, 2010, 124 Stat. 547, 975; Pub. L. 116–260, div. BB, title III, § 317, Dec. 27, 2020, 134 Stat. 2932; Pub. L. 117–328, div. FF, title I, § 1401, Dec. 29, 2022, 136 Stat. 5699.)

## Notes

### 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”.