42 U.S.C. § 280h–5 — School-based health centers

(a) Definitions; establishment of criteria. (1) "Comprehensive primary health services" means the core SBHC services: (A) Physical — full health checkups, diagnosis, and treatment of minor, acute, and chronic conditions, plus referrals for specialty, oral, and vision care; and (B) Mental health — assessing mental health and substance use, crisis help, counseling, treatment, and referrals to emergency psychiatric care, community support, inpatient care, and outpatient programs. (2) "Medically underserved children and adolescents." (A) This means kids and teens living in an area the Secretary designates as medically underserved or short on health professionals. (B) The Secretary must set criteria for measuring this shortage that (i) account for comments from a state's governor and local officials, and (ii) look at the area's health status — including whether residents can pay for care, how accessible care is, how many health professionals serve the area, and other factors the Secretary picks. (3) A "school-based health center" is a clinic that (A) meets the federal definition and is run by a sponsoring facility as defined in the Social Security Act; (B) offers, at minimum, comprehensive primary health services during school hours, following standards, local practice, reporting laws, and other state laws including parental consent and notice rules consistent with federal law; and (C) does not perform abortions. (b) Authority to award grants. The Secretary must fund grants covering the operating costs of SBHCs that meet this section's rules. (c) Applications. To qualify, an entity must (1) be an SBHC as defined above, and (2) apply with (A) proof it meets all SBHC criteria; (B) proof of local need; (C) assurances that (i) services go only to kids with parental or guardian consent, consistent with relevant law; (ii) the SBHC has worked, and will keep working, to build relationships with other local health providers; (iii) the SBHC will be open during the school day and offer 24-hour, year-round coverage through an on-call system and backup providers; (iv) the SBHC will be part of the school, coordinating with staff like administrators, teachers, nurses, and counselors, and with other providers at the school; (v) the sponsoring facility takes full responsibility for running and overseeing the SBHC; and (vi) the SBHC will follow privacy laws for patients and student records, including HIPAA and the education-records law at 20 U.S.C. § 1232g; and (D) any other information the Secretary requires. (d) Preferences and consideration. In reviewing applications, (1) the Secretary may favor applicants able to serve (A) communities that have faced barriers to primary and mental health/substance-use care for youth, (B) communities with many uninsured, underinsured, or publicly insured children, and (C) groups of children who have historically struggled to access health and mental health care; and (2) the Secretary may also consider whether an applicant already got a grant under section 280h–4. (e) Waiver of requirements. The Secretary may (1) waive all or part of this subsection's requirements for up to 2 years in the right circumstances, and (2) for good cause, waive the requirement to offer every comprehensive service for a set period. (f) Use of funds. (1) Funds may (A) be used for (i) buying or leasing equipment, including loan interest, (ii) training staff to deliver required services, (iii) managing and running the health center, and (iv) paying salaries for doctors, nurses, and other SBHC staff; but (B) may not pay for abortions. (2) Construction. The Secretary may also fund expanding or modernizing buildings for use as an SBHC, including buying trailers or manufactured buildings for the school property. (3) Limitations. (A) A provider a state finds violated a state law described in (a)(3)(B) at an SBHC cannot get more funding under this section. (B) An entity already funded under section 254b for a grant period cannot also get a grant here for the same period. (g) Matching requirement. (1) Each grantee must contribute, from non-federal sources (cash or in-kind), an amount equal to 20 percent of its grant to help run the funded activities. (2) The Secretary may waive part or all of this match for a fiscal year if requiring it would cause serious hardship or stop the SBHC from doing its job. (h) Supplement, not supplant. Grant money must add to — not replace — other federal or state funding. (i) Evaluation. The Secretary must build and run a plan to evaluate SBHCs and track quality under this section's grants. (j) Age appropriate services. A grantee may only give an individual services appropriate to that person's age. (k) Parental consent. A grantee may not serve a minor (under state law) without a parent's or guardian's consent. (l) Technical assistance. The Secretary must give technical help, through grants or contracts to nonprofits experienced with SBHCs, factoring in local and regional differences, to support the services in (a)(1) — including mental health and substance-use services — and may include help with running programs and adopting evidence-based practices. (m) Authorization of appropriations. Congress authorized whatever funding was needed for fiscal years 2022 through 2026.