14 - Meeting Kids Where They’re At: A School-Based Health Center Initiative to Prevent School Exclusion and Advance Health Equity

Publication Number: 4013.14

Kim Hansen, University of Utah School of Medicine, Salt Lake City, UT, United States; Karen C. Manotas, University of Utah School of Medicine, Salt Lake City, UT, United States; Tristan Peterson, University of Utah School of Medicine, Salt Lake City, UT, United States; Carole H. Stipelman, University of Utah School of Medicine, Salt Lake City, UT, United States

Background: School exclusion due to vaccine non-compliance disrupts health and education, especially for underserved students who already face barriers to preventative care. School-based health centers (SBHCs) are positioned to address both immediate compliance needs and broader health inequities.

Objective: To evaluate a rapid response initiative in an urban SBHC designed to prevent disenrollment, improve immunization, screen for mental health, and connect students to ongoing primary and behavioral health care.

Design/Methods: In October 2024, a district-generated list identified 150 high-school students as non-compliant with mandated vaccines and as a result would be disenrolled from school. The West High School Clinic (WHSC), an SBHC serving a predominantly under-insured, multilingual student population, collaborated with school administrators to allow students with scheduled clinic appointments to remain enrolled. Interventions included rapid vaccination scheduling, USIIS (state immunization registry) entry and verification, physical exams with mental health screening. Outcomes included demographics, immunization initiation and completion, mental health screening results, behavioral health referrals and subsequent follow-up visits through August of 2025.

Results: Of students at risk of disenrollment, 83/150 (55%) presented to WHSC between October-December 2024 for initial visits, thereby preventing disenrollment. Of those seen in clinic, 66% were uninsured/self-pay and received no-cost Vaccines for Children immunizations; 78% required interpretation services (Table 1). Non-disenrolled students received an average of 5 vaccines each (439 total) with the majority receiving all vaccinations that were due. All received a primary care evaluation; 17 (21%) screened positive for behavioral health needs and were referred. Over the following eight months, these students generated 329 follow up visits: (191 primary care visits & 138 behavioral health) demonstrating sustained engagement in the clinic (Table 2).

Conclusion(s): This initiative highlights how SBHCs can rapidly reduce vaccine-related exclusion, expand equity in preventive care, and connect underserved students to ongoing health care.

Table 1. Student Demographics and Language Needs


Table 2. Mental Health Screening Outcomes and Follow-Up After Immunization Visits
Table 2.jpeg*Mental Health follow-up visits were seen for individual therapy or psychiatry evaluation and treatment.
**Primary care follow-up included acute and chronic care visits.