NCEF Resource List: School-Based Health Facilities
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Information on school-based health facility planning, design, furnishings, and equipment, compiled by the National Clearinghouse for Educational Facilities.

References to Books and Other Media

School Health Centers. Adobe PDF
Gordon, Douglas
(National Clearinghouse for Educational Facilities, Washington, DC , Oct 2010)
Addresses the key elements for designing school health centers, the emergence of school-based health clinics, the minimum requirements these facilities should have, and the basic principles to remember when designing school health centers. Also highlighted are types of school health centers and their importance. 4p.

Guidelines for Maryland School-Based Health Centers - Facility Needs and Requirements.
(George Washington University, The Center for Health and Health Care in Schools, Washington, DC , 2007)
The "Facility Needs and Requirements" section at the end of this document discusses goals and planned usage, operational schedule, number of users, accessibility, parking, security, spatial requirements in square footage, spatial relationships, acoustical requirements, climate control, plumbing, electrical/electronic, lighting, sanitary requirements, furniture and equipment, funding. The document includes a checklist on how well the facility meets the current and projected needs and requirements of the school and the community.

Guidelines for Comprehensive School Based Health Centers in New York. Section G: Facility Requirements. Adobe PDF
(New York State Department of Health, 2006)
Pages 18 and 19 of these guidelines describe square footage requirements, as well as recommended spaces. 20p.

School-Based Health Centers Operations Tool Kit. Section A4: Facilities Management.
(National Assembly on School-Based Health Centers, Washington, D.C. , 2005)
In this extensive health center operations tool kit of reference materials, Section A4 includes information on the following: 1) ADA Accessibility; 2) Biohazard Waste; 3) Key Control Guidelines; 4) Lab Equipment/CLIA Standards; 5) OSHA Regulations; 6) Safe and Drug Free Workplace; and 7) Work Site Safety. Section A2 includes an environmental checklist and a recommended list of equipment.

Health Clinic Environments in Georgia Elementary Schools. Adobe PDF
Simpson, Susan Rogers
(University of Georgia, School Design and Planning Laboratory, Athens , 2005)
Schools seem to be the logical place to serve the health needs of students, since children spend a majority of their time there. Design standards were not available for health clinics in Georgia elementary schools; therefore, this study examined key characteristics of an elementary school clinic in order to determine the importance of each design element. Eleven design classifications and 12 specific design elements were determined through a review of related literature. Characteristics included: components (rooms), space, and size; general design elements; location; accessibility; the waiting area; the nurse's office; the treatment room; the isolation area; the restroom (toilet); security, storage, and safety elements; and furnishings/treatments. Specific design elements included: lighting; windows; integrating nature elements into design; promoting a sense of well-being for users; security and privacy/confidentiality elements; electrical/plumbing elements; doors and wayfinding (signage); walls and ceilings; acoustics; use of color; heating/ventilation/air conditioning; and flooring elements. This information was incorporated in a survey of 12 experts involved with designing, building, and managing school facilities and 104 school nurses. Establishing design guidelines for health clinics in Georgia elementary schools were recommended, and the guidelines should be written using the professional judgment of school nurses, representatives of users of the clinic, and the findings of this study. [Author's abstract] 51p.

School-Based Health Care and the District of Columbia Safety Net Adobe PDF
(21st Century School Fund, Washington, D.C. , 2004)
This report provides the results of research into the variety of health care services currently offered in the public schools in the District of Columbia, with a particular focus on school-based health centers. In a section on school-based health center practices in the U.S. there is information on facility size, design, and equipment; operating standards and guidelines; shared use agreements; and funding sources. 44p.

School Health Services: A Facility Planning and Design Guide for School Systems.
(Maryland State Department of Education, Division of Business Services, School Facilities Branch, Baltimore , Jun 2002)
This guide for Maryland schools outlines the role of school health services and proper facility design for these services. Chapter 1 provides an overview, describing coordinated school health programs, school health services programs, school health services programs in Maryland, how school health services are delivered, trends, the number of health suite visits, and school-based health centers. Chapter 2 focuses on facility design, discussing design concepts, state regulations, the facility planning process, facility design (addressing activities, users, space configuration/relationships, utilities, finishes, furniture and equipment, display, and storage), space requirements, and sample floor plans. 15p.
TO ORDER: Maryland Department of Education, School Facilities Branch, 200 W. Baltimore St., Baltimore, MD 21201; Tel: 410-767-0098

Medical and Dental Space Planning: A Comprehensive Guide to Design, Equipment, and Clinical Procedures.
Malkin, Jain
(John Wiley & Sons, 2002)
Medical and dental design for architects and interior designers. The core of the volume is a detailed analysis of 23 medical and dental specialties and their respective space planning requirements. There is information on psychological factors to be considered in health care design, plus the general parameters of medical space planning. 624p.

Guidelines for Design and Construction of Hospital and Health Care. Facilities.
(American Institute of Architects, Washington, DC, 2001)
Considered an industry standard by architects, engineers, and health care professionals, the Guidelines set minimum program, space, and equipment needs for clinical and support areas of hospitals, nursing homes, freestanding psychiatric facilities, outpatient and rehabilitation facilities, and long-term care facilities. The document also establishes minimum engineering design criteria for plumbing, medical gas, electrical, heating, ventilating, and air conditioning systems. Reflecting the most current thinking about infection control and the environment of care, the new edition also explores functional, space, and equipment requirements for acute care and psychiatric hospitals; nursing, outpatient and rehabilitation facilities; mobile health care units; and facilities for hospice care, adult day care, and assisted living.
TO ORDER: American Institute of Architects, 1735 New York Ave., NW, Washington, DC 20006

Design That Cares: Planning Health Facilities for Patients and Visitors, Second Edition.
Carpman, Janet R.
(Jossey-Bass, 2001)
After discussing current health facility design research, it includes chapters on waiting and reception rooms and diagnostic and treatment rooms that may be applicable to school health centers. 328p.

Oregon School-Based Health Center Program. Standards for Certification.
(Oregon Department of Human Services, 2000)
A SBHC facility is defined as permanent space located within a school building or on the campus used exclusively for the purpose of providing health care. Facility requirements are described on pages 4-5, including square-footage guidelines for design/remodeling. Laboratory space requirements are detailed on page 11. 24p.

Building Type Basics for Healthcare Facilities.
Bobrow, Michael ed.
(John Wiley & Sons, 2000)
This provides the essential information needed to initiate designs for acute care hospitals, clinics, long-term care facilities, and specialty centers. The book is filled with project photographs, diagrams, floor plans, sections, and details, and combines an overview of the needs and concerns of healthcare industry clients with nuts-and-bolts design guidelines. 386p.

Schools and the Health of Children: Protecting Our Future
Kronenfeld, Jennie Jacobs
( Sage Publications, Thousand Oaks, CA , 2000)
This book defines key issues in the debate over the role of schools in the health of children, outlining the history of school health programs and discussing the contemporary issue of school health care delivery. Health needs are increasingly being met by the major social institution in U.S. society that deals with the needs of children--the public school system. The book suggests that the health needs of children cannot be completely separated from the welfare needs of children. The chapters are: (1) "Introduction"; (2) "History of Child Health and School Health Programs: Background and Current Roles of School Health Programs"; (3) "Health Status of Children: Past and Present"; (4) "Models of School Health Delivery: The Growth of School-Based Clinics and Centers"; (5) "Experiences in Arizona: The Development of New Clinics in a State with a Managed-Care Medicaid System"; and (6) "The Need To Protect the Future: The Impact of Changes in Welfare and Health Policies and Linkages with School Health Issues." (Contains approximately 220 references.) 116p.
TO ORDER: Sage Publications, Inc., 2455 Teller Road, Thousand Oaks, CA 91320 Tel: 805-499-0721

Floor Plan: Edison Elementary School Clinic.
(The National Assembly on School-Based Health Care, Washington, DC, 1999)
The physical layout of a school-based health center will differ from one setting to another. Certain factors influence the final physical characteristics of a SBHC including, but not limited to, available existing space, money for remodeling or new construction, building codes, the school’s will and the means to make the changes, and the type of services being offered in the center. This webpage provides room-by-room photographs and an inventory of furnishings and equipment for selected spaces in the Edison Elementary School Clinic Kalamazoo, Michigan. Includes an open office, records/supply room, bathroom, exam room, hallway, waiting area, conference room, entrance, and dental office.

Design Details for Health: A Guide to Making the Most of Interior Design's Healing Potential.
Leibrock, Cynthia
(Wiley-Interscience, 1999)
This book showcases a range of design details and practical design solutions providing flexible, innovative design solutions in key areas such as lighting, acoustics, color, furnishings, and finishes. Includes nearly 200 images, many in full color.

Developing a School-Based Health Center: An Assistance Manual Adobe PDF
Kieltyka, Evelyn G.
(Maine State Dept. of Human Services, Bureau of Health, Augusta , 1997)
The purpose of this manual is to provide guidance to interested Maine communities, school officials, parents, students and health care providers in the development of School-Based Health Centers (SBHCs). The manual outlines the mission and goals of an SBHC and makes detailed suggestions on the structure of a community-based advisory council to guide center set-up and advocacy for community acceptance. The manual then details SBHC organizational structure and staffing, funding and operating budget, health services offered and site development, legal issues, and data collection, quality assurance, and evaluation. Includes a sample center floor plan.

The Health Clinic. School of the Future: Houston Adobe PDF
Iscoe, Louise
(The University of Texas, the Hogg Foundation for Mental Health, Austin, TX , 1995)
The Hogg Foundation for Mental Health created the School of the Future (SoF) project to enable selected Texas schools to coordinate and implement school-based social and health services on their campuses and to demonstrate the effectiveness of this method of service delivery by evaluating the project. SoF operated in four urban sites in Texas, developing services for a middle school and one or two feeder schools in Austin, Dallas, Houston, and San Antonio. A variety of services were made available through SoF funding and programming. The report describes the development and operation of the Hogg Middle School health clinic, the first such facility in Houston on a middle school campus. The many steps that were taken in establishing the clinic, the many agencies and people involved, and the daily operation of the clinic are described. The clinic grew out of the recognition that there is a causal connection between education and health. The school principal, leaders of community agencies, the school district, and the SoF coordinator came together to establish the clinic in a portable building on the school grounds. Treatment of minor illnesses and injuries, immunizations and other preventive medicine, and counseling and health education services are all provided. 31p.
TO ORDER: Education Resources Information Center (ERIC)

The Answer is at School: Bringing Health Care to Our Students.
(The George Washington University, Washington, DC, 1993)
Chapter 12 of this primer on school-based health centers briefly describes the design of a health center facility, listing the essential areas, space, and locale. The recommendations of space planners for clinical services are included for the laboratory, exam room, patient waiting area, and receptionist/records storage area.
TO ORDER: The Center for Health and Health Care In Schools,1350 Connecticut Ave., Suite 505, Washington, DC 20036; Tel: 202-466-3396

A College Health Center. Case Studies of Educational Facilities #6. Adobe PDF
Brad, Bernard
(Educational Facilities Laboratories, New York, NY , 1965)
Considers problems and solutions related to the design and establishment of college health facilities. Specific considerations include: 1) internal expansion and flexibility; 2) study and recreational facilities; and 3) supervision and space relationships. A prototype solution was developed to meet the needs of small independent liberal arts colleges. This solution consisted of a circular building with patient rooms on the perimeter and a raised central nursing station, with auxiliary waiting and treatment rooms and an attached nurses’ residence. Specifications, layouts, and elevations are given with the supporting design analysis. 36p.

References to Journal Articles

Material Health
Caldwell, Stacy
ED+C; Jun 28, 2012
Arizona State University's recent Health Services Building project focused on sustainability and the use of healthier materials to benefit the students and staff.

University Health Center Cuts Wait Time for Students
School Construction News; Jun 14, 2012
Arizona State University’s main campus in Tempe, Ariz., has unveiled its renovated Health Services Building, an energy-efficient facility where patients wait less to get help.

Key Components of a School-Located Vaccination Clinic: Lessons Learned from Fall 2009.
Herl Jenlink, Carolyn; Kuehnert, Paul; Mazyck, Donna
Journal of School Nursing; v26 n4 suppl 1 , p14S-26S ; Aug 2010
The 2009 H1N1 influenza A virus vaccination campaign focused on use of school-located vaccination (SLV) clinics because of the ability of SLV to reach targeted populations. Large numbers of children are found in schools, and schools are conveniently located throughout communities. Communities are generally familiar with and trust schools, and school facilities can generally accommodate mass vaccination clinics. School nurses are familiar with the health of individual students and may be available to assist in vaccination activities. In addition, schools have access to parental contact information, which can facilitate communications. Challenges faced by local health departments (LHDs) and schools in implementing 2009 H1N1 SLV clinics, including disruption of educational activities, locating adequate staff, tailoring immunization activities to meet the needs of each school district, and transportation and administration of vaccine, are explored.

The Relationship between School-Based Health Centers and the Learning Environment.
Strolin-Goltzman, Jessica
Journal of School Health; v80 n3 , p153-159 ; Mar 2010
This study investigates the relationship between SBHCs and the learning environment utilizing a retrospective quasi-experimental design. The findings demonstrate that the presence of a SBHC is associated with greater satisfaction in 3 out of 4 learning environment domains.

Facility Focus: Student Centers/Health Services.
College Planning and Management; v12 n7 , p40,41 ; Jul 2009
Profiles new student health and services facilities at Pennsylvania State University, and the University of Wisconsin-Madison. The respective service areas and sustainable features of these large buildings are described.

School-Located Influenza Vaccination Clinics: Local Health Department Perspectives.
Ransom, James
Journal of School Nursing; v25 n1 suppl 1 , p13S-17S ; Jan 2009
Community stakeholders need to develop and sustain new partnerships to achieve the goals of universal childhood immunization recommendations, including expanding the points of access to influenza vaccination. Schools are a key community venue for annual delivery of influenza vaccination. Over the past 2 years, the National Association of County and City Health Officials has examined local health department-school system relationships in regard to delivery of influenza vaccination to identify and document common elements of success, challenges, and key lessons learned.

2007 Architectural Portfolio: Specialized Facilities.
American School and University; v80 n3 , p194-236 ; Nov 2007
Profiles 33 outstanding new specialized school facilities selected for their innovation, sustainability, security, aesthetics, and life-cycle costs. These include art, performing arts, athletic, student health, service, K-12, science, and other facilities. Project information and photographs are included. (The URL for this citation links to the searchable database of American School and University Magazine's school design awards.)

Designer Schools: The Role of School Space and Architecture in Obesity Prevention. Adobe PDF
Obesity; v15 n11 , p2521-2530 ; Nov 2007
Discusses the link between school space and architecture and obesity prevention by reviewing and synthesizing available literature in architecture, environmental psychology, and obesity research, in an effort to propose promising ideas for school space design and redesign. The school environment is defined through 5 dimensions: physical, legal, policy, social, and cultural domains. Theories underlying environmental interventions and documented associations between the environment and health behaviors and outcomes are reviewed to illustrate how existing environmental research could translate to obesity prevention. Design strategies aimed at promoting physical activity and healthful eating are proposed, with particular emphasis on the design of cafeterias, activity spaces, connectivity with the larger community, and student health centers. Includes 52 references.

Building Blueprints: School Health Suites.
Devol, James
School Planning and Management; v46 n4 , p34,35 ; Apr 2007
Advises on the design of school health suites, presenting typical questions that should be answered by the client, and using a new middle school facility in Lincoln, Rhode Island, as an example. Keys to facility cleanliness, staff involvement in design, demographic considerations, and new expectations for parental involvement and security are covered.

Good Medicine.
McDaniel, R. Stephen
University Business; v9 n7 , p77-80 ; Jul 2006
Describes state-of-the-art health services facilities being built on higher education campuses. These are typically inviting, centrally-located facilities designed to better address the more complex physical and mental health issues of today's students. Examples at Pennsylvania State University and the University of Arkansas are detailed, as are opportunities to use the new facilities to enhance the academic program.

School Health Office Facilities: School Nurses Have Learned the Importance of Providing Input During the Planning Stages of New Construction, Renovations and Remodeling Projects.
Cooper, Leslie
School Planning and Management; v45 n3 , p44-47 ; Mar 2006
Discusses the participation of school nurses in the design process for new and renovated school facilities. Practitioner suggestions for what should be included in a well-equipped school clinic are included.

Recommended Minimal Emergency Equipment and Resources for Schools: National Consensus Group Report.
Journal of School Nursing; v19 n3 , p150-156 ; Jun 2005
Providing an environment that is responsive to emergency health needs of students is essential to creating a safe setting for children in schools. The question of what minimal essential emergency equipment and resources should be available in schools brings with it many and varied opinions, issues, and concerns. Through funding from the Emergency Medical Services for Children (EMSC), the National Association of School Nurses (NASN) was charged with the task of convening a consensus group to formulate a recommended list of minimal essential emergency equipment and resources that should be present in all schools. This article provides an overview of the issues surrounding minimal emergency equipment needs for schools, presents recommended minimal emergency equipment and resources, and recommendations for further actions. [Authors' abstract]

New Construction, Renovation and Remodeling: What School Nurses Have Learned From Planning New Health Office Facilities.
Cooper, Leslie
The Journal of School Nursing; v21 n3 , p170-175 ; Jun 2005
Many school nurses across the nation have had the opportunity to be involved with school renovation and new construction projects in their districts. Renovation and new construction projects allow school nurses the opportunity to work with facilities planners, school officials, and architects to design school health office facilities that enhance delivery of health services and accommodate all student health needs. By working with design professionals early in the process, school nurses will be able to use their expertise in planning a work space that assures optimal care, comfort, and privacy for students requiring health services during the school day. This article illustrates how school nurses who participated in the planning process for renovation or new construction of health offices gained positive experiences particularly on communication and compromise.

Recommendations for Constructing School Nurses' Offices Designed to Support School Health Services.
McKibben, Cynthia; DiPaolo, Sonja; and Bennett, J.Scott
Journal of School Nursing; v21 n3 , p164-9 ; Jun 2005
When attempting to locate guidelines for designing school nurses' offices, one finds there are minimal resources that address this need. In an effort to solve this concern, the authors were instrumental in writing an article for The Journal of School Nursing published in April 1997. The current article is an updated perspective that defines recommendations to be utilized in new construction or renovation of school nurses' offices. It encompasses information on square footage, design, utilization of space, location, and necessary equipment. Prototypes are provided that apply to elementary, middle school, and high school settings. The article outlines the importance of continued collaboration between the school nurse and key people involved in the planning and construction process, such as the school principal, administrators, and the district engineer. [Authors' abstract]

School Nurse Work Environment: Ingredients for Safe and Effective Practice.
Mosca, Nancy Walsh
Journal of School Nursing; v21 n3 , p129-31 ; Jun 2005
School nurse work environments (referred to as the ‘school clinic', ‘nurse's office', ‘health room', and ‘health office') are an essential component of a school's physical plant, yet are often an overlooked component of the building's design and utility. This describes current physical work environments, offering recommendations for state-of-the-art facilities.

School Health Clinics.
Cecil, Dan
School Planning and Management; v44 n4 , p44,45 ; Apr 2005
Describes the 1,200-sq.-ft. health clinic at Maine's Noble High School, which was designed to serve both the students and the community. The facility was thoughtfully placed close to the gymn, but with a private entrance and in a discreet location, to protect the privacy of users. Source of outside staffing and funding for the clinic, as well as the services it provides are described.

More Districts See Benefits of School-Based Health Clinics.
Chmelynski, Carol
School Board News; Nov 23, 2004
In 2004, there were about 1,500 school-based clinics in the United States, compared to just 200 in 1990, reports the Center for Health and Health Care in Schools. School-based clinics are in all but a handful of states. They are in urban, rural, and suburban communities, with the largest growth in rural areas.

Health-Care Hub.
Bowman, Darcia Harris
Education Week [free subscription required]; , p26-29 ; Feb 04, 2004
Case study of the health-care center at Broad Acres Elementary in Silver Spring, Maryland, one of 1,500 school-based health centers nationwide that bring a wide range of medical, nutritional, and mental-health care to millions of students and their families. [Free subscriber registration is required.]

Putting Health First.
Katz, Janet A.
School Planning and Management; v42 n6 , p46-48 ; Jun 2003
Describes the successful public-private partnership between the Austin Independent School District and the Children's Hospital of Austin to provide student health services.

Software Improves Student Health Services.
Mackey, Thomas A.
College Planning and Management; v5 n8 , p30-32 ; Aug 2002
Describes how electronic medical records help the staff at University of Texas Health Services to serve students efficiently and collect data on the patient population.

Student Health Clinics.
Jelliffe, James H.; Schipp, Michael K.
School Planning and Management; v41 n1 , p96-97 ; Jan 2002
Discusses important issues concerning the design of student health clinics, including convenient access, privacy and security, showers and sinks, durability and safety, and special considerations.

Ritalin Reaction
Fine, Lisa
Teacher Magazine; v12 n8 , p.11 ; May 2001
Discusses the high incidence of stolen drugs from school nurse's offices, and suggests security measures such as adding locks and limiting keys, and installing safety devices, cameras or motion detectors.

Rethinking the Health Center: Assessing Your Health Center and Setting Goals.
McMillan, Nancy S.
Camping Magazine; v74 n2 , p26-29 ; Mar-Apr 2001
Camp health center management begins with assessing the population served, camp areas impacted, and the contract of care with parents. That information is used to plan the size of the center; its location in the camp; the type of equipment; and considerations such as medication management, infectious disease control, size of in- and out-patient space, and record storage

Development of a Statewide Space Model. [Texas]
Alexander, Lynda; Lewis, Tim
Planning for Higher Education; v29 n1 , p31-38 ; Oct 2000
This article reviews development and use of a statewide (Texas) space model for long-term planning, regulating new construction, and formula appropriations for general academic and, more recently, health-related institutions. Considers the work and recommendation of a 1998 study committee on space needs of health facilities, the Commissioner's response, and the compromise decision to link space models to funding.

Interior Design for Ambulatory Care Facilities
Frasca-Beaulieu, K.
Journal of Ambulatory Care Management; v22 n1 , p67-73 ; Jan 1999
This focuses on how wayfinding, noise control, privacy, security, color and lighting, general ambience, textures, and nature can have a profound influence on patient stress, health, and well-being. Other important design issues include convenience and accessibility, accommodation to various populations, and family focus, as well as current equipment needs and future growth.

Nurse's Office, Health Office, or Clinic? The Importance of a Name and a Piece of Real Estate
Journal of School Nursing; v13 n3 , p4-5 ; Aug 1997

Promoting the Construction of an Optimal Nurse's Office Facility: One School District's Experience.
McKibben, Cynthia; DiPaolo, Sonja J.
Journal of School Nursing; v13 n2 , p22-29 ; Apr 1997
Details recommendations for updating or constructing nurses' offices based upon a descriptive study done in one midwestern school district. Suggestions are provided on size, location, and equipment needed. Also addressed is the communication process needed to persuade a board of education and school administrators that nursing facilities must be a priority in order to meet the health needs of students.

Facilities for the School Health Team.
Henshelwood, Julie; Polnay, Leon
Archives of Disease in Childhood; v70 n6 , p542-543 ; Jun 1994
Results of a questionnaire returned by 20 doctors giving information of 249 schools showed that many of the rooms made available to school health services are inadequate in terms of physical resources and privacy. A higher set of standards is recommended to enable schools and pupils to derive maximum benefit from community pediatric services.



Due to lack of funding, the National Clearinghouse for Educational Facilities is currently available only as an archived site. As of September 1, 2012 no new content will be added or updates made. We regret the need to take such steps, but should funding become available, we look forward to reinvigorating NCEF and providing this valuable resource to the educational facilities community.

If you have questions or are an organization or company wishing to support the continued operation of this industry recognized resource please contact Institute President Henry Green (, 202-289-7800).