School-based health centers. Statewide quality improvement program

School-based health centers have been proposed as an avenue to provide health care for vulnerable youth. Colorado has 45 school-based health centers that provided 50,000 visits to 18,600 vulnerable youth in the 1998-1999 school year. Sustainability of the centers, however, depends on the ability to obtain an ongoing stream of revenue including managed care contracts, which in turn depend on the center's ability to meet the standard of care in the community. School-based health centers should meet standards of care similar to those of community health centers including certification, credentialing of providers, and a systematic evaluation of the outcomes of services. This article reports on a statewide quality improvement program that established certification standards for school-based health centers, verified the credentials of providers at the centers, and measured quality of care in centers across the state.