We launched the School-Based Health Initiative in 2020 with the dual aim of improving access to care for students and, by doing so, helping students stay in school and learn. The initiative supports partnerships between schools and health care providers to create school-based health care services in schools that need them most.

As of 2025, under the leadership of senior program officer Kelsey Gummer, the initiative has supported the startup or expansion of 82 school-based health care sites by rural health centers, tribal clinics, urban Indian organizations, federally qualified health centers, and other clinics. These sites now serve 132 of the state’s highest-need schools.

Last year, we commissioned our first statewide survey of Montana’s school-based health landscape, produced by the national School-Based Health Alliance. The landscape analysis outlined national best practices for school-based health care operations, survey findings, and recommendations for sustaining and expanding school-based health care in Montana. Key findings showed that in Montana:

• Over 47,000 visits to school-based health care sites occur annually, serving nearly 12,000 patients.
• 83% of school-based health care sites also serve populations other than students, like school staff or community members.
• 59% of school-based health care sites are sustainable, with income that meets or exceeds expenses.

One of the most important findings from the survey was that school administrators reported that having services available in schools is contributing to improved attendance and engagement. This finding validates the impact of our programming and the school-based health model.

Based on the survey findings and national best practices for school-based health care, the School-Based Health Alliance provided six recommendations to strengthen and expand school-based health care in Montana.

1. Support training and technical assistance for school-based health care excellence and sustainability.
2. Explore the impact and sustainability of existing sites at the state and site levels.
3. Identify expansion opportunities for new school-based health care sites or expanded services based on need, partnership readiness, and potential impact.
4. Convene key players and leverage community resources at the state and local levels.
5. Provide education on policies that support expanded access to and sustainability of school-based health care and community schools.
6. Invest in school-based health care sites through dedicated funding, the creation of a state office to provide oversight, and the identification of a dedicated training and technical assistance provider.

The demand for school-based services is growing quickly, and the state’s association of school administrators is an enthusiastic partner in achieving widespread implementation.

Montana’s new Rural Health Transformation Program includes plans to support startup and expansion of school-based health care sites in rural Montana, an exciting opportunity to advance this successful model of care. Through the School-Based Health Initiative, MTHF is committed to continued funding, training and technical assistance, convening school-based health leaders, and collaborating with the Montana Department of Public Health and Human Services, schools, and health care providers to identify practical policies that support the growth and sustainability of this model.