Developing Your School’s Attendance Team and Strategies: Making the Case for School Nurses, School-Based Healthcare Centers, & Telehealth Services

By: Shelneka Marsalone

May 6, 2026

School Nurses as Attendance Team Members

Chronic absenteeism can pose challenges for student success and outcomes and is often influenced by health-related issues. Students dealing with chronic conditions like asthma, diabetes, and dental issues may find it harder to attend regularly. Mental health needs or experiences of trauma can also affect attendance. These challenges tend to be more common among students from low-income backgrounds, which can add to existing educational disparities (Balfanz & Byrnes, 2012). Including school nurses as part of school attendance teams is a proven approach to help address health barriers, support better attendance, and promote overall student well-being. School nurses offer valuable direct care, help identify issues early on, and work closely with families and healthcare providers, playing an important role in supporting students and encouraging consistent attendance. 

School nurses are often the first to notice important signs such as frequent visits to the clinic, repeated reports of headaches or stomachaches and signs of stress, fatigue, or trauma. These observations can indicate underlying issues like housing challenges, mental health concerns, or unmet basic needs, all of which can affect attendance. When issues like these are identified early, they can be addressed before the student’s grades, behavior, and attendance become problematic. Nurses can help decrease instructional time loss as they provide prompt, onsite care, they administer medications and are able to triage minor health concerns. 

School nurses also support student and family engagement for their schools. They communicate with families about health concerns and link students and families to community healthcare providers. They offer a caring, safe space for students to share and feel supported and help students manage their emotions so they can comfortably return to class. School nurses can recognize when additional mental health resources might be helpful and provide them to students and families.

Data that school nurses can bring to Attendance Team meetings is vital. They can track and document health-related absences and patterns they are experiencing in their office. This data can help schools develop proactive and restorative strategies to support students and promote regular attendance. 

School-Based Healthcare Centers as a Strategy

Schools with school-based healthcare centers (SBHCs) embedded within them offer a supportive and effective way to help students attend school more consistently by providing access to essential health services right where students are…the school. When students can receive comprehensive care, including primary care, mental health support, and preventive services, it's easier for them to stay engaged and present at school. By removing common obstacles like transportation issues or costs, SBHCs make it simpler for students to get the care they need, which can lead to fewer absences due to illness or health conditions. This also means the likelihood of families/parents having to take off from work, to insure their child is being cared for, will decrease.

Research shows a positive connection between access to SBHCs and better attendance. For instance, students in schools with SBHCs tend to have lower rates of chronic absenteeism, especially in high-poverty and rural areas (Kjolhede et al., 2025). Additionally, students often see improvements in attendance shortly after visiting SBHCs, highlighting the immediate and lasting benefits of these centers (Lim et al., 2023). They are particularly helpful in managing ongoing health issues like asthma and addressing sudden health concerns early on to prevent extended absences.

SBHCs also support students' mental and behavioral health. These are important factors in attendance as they can lead to discipline issues and suspension, another aspect of chronic absence. On-site counseling and trauma-informed care help students cope with anxiety, depression, or other challenges that might keep them away from school. By working closely with school staff and using attendance data, SBHCs help identify students who need extra support and connect them to the help they need before attendance issues become more serious.

SBHCs strengthen ties between families, communities, and schools by providing a nearby, accessible place for care. This helps families save time and reduce the burden of navigating complex healthcare systems, contributing to healthier students who are better able to attend school regularly. Overall, research supports the value of SBHCs as a meaningful, equitable approach to improving student health and reducing absenteeism, making sure students are healthy, supported, and ready to learn. If your school or school district has the opportunity to partner with an organization to house an SBHC, not only will your students attend regularly, but your community becomes healthier as well. Although SBHCs are ideal, they may not be an option for many due to lack of resources.

School-Based Telehealth Services as a Strategy

Not all schools have access to a full-time school nurse or partnerships where they can build and maintain school-based healthcare centers within their walls. Telehealth services are an innovative and evidence-based approach to helping reduce chronic absences by making it easier for students to access both physical and mental healthcare within their school community. By using virtual care platforms, schools can connect students with healthcare providers conveniently, without needing them to leave campus or miss large parts of their lessons. Like SBHCs, this method is especially helpful in overcoming common obstacles to attendance, such as transportation issues, limited healthcare provider availability, cost concerns, and appointment access, particularly in rural or underserved areas. It also minimizes instructional disruptions, decreasing the likelihood of “reteaching.” Another positive to this option is that it does not take the place of the school nurse. In fact, this option supports school nurses!

Recent research shows that school-based telehealth can have positive effects on student attendance. Providing access to telemedicine clinics at schools has been linked to a reduction in chronic absenteeism by about 2.5 percentage points, which is a 29% decrease, and an overall decrease of around 10% in the number of days students are absent (Komisarow & Hemelt, 2024). Additionally, studies suggest that programs offering telehealth-only health services are associated with meaningful decreases in absences, with one study reporting a 7.7% reduction among participating students (Long et al., 2021). These findings highlight how telehealth not only improves access to healthcare but also helps improve attendance in a measurable way.

Telehealth is especially helpful in managing both urgent and ongoing health issues that can keep students out of class. It allows for quick diagnosis and treatment during the school day, helping students get back to class sooner instead of missing full days for off-site appointments. Furthermore, telehealth expands the availability of mental and behavioral health support, which are important factors influencing school attendance. Recent research on school-based teletherapy shows promising results, including improved attendance and fewer behavioral challenges, especially among students who may face additional vulnerabilities (Swaminathan et al., 2025).

In addition to providing direct health services, telehealth helps foster better coordination between schools, families, and healthcare providers. Schools can use attendance data to identify students who might need extra support and connect them with appropriate care early on. This proactive approach addresses underlying issues that can lead to absenteeism, rather than simply responding after attendance problems have become established. It is especially valuable in rural and underserved areas, where access to healthcare can be limited and absenteeism rates tend to be higher.

Overall, current evidence suggests that telehealth is a scalable, cost-effective, and equitable approach to reducing chronic absenteeism. By helping students access timely physical and mental health care, telehealth supports their ability to stay engaged and succeed academically. This strategy can act as an “or” option if a school does not have access to a full-time nurse but can definitely become an “and” option for schools that do. Teletherapy helps support school nurses by expanding their ability to care for students, easing their workload, and enhancing the quality of care. It allows nurses to work as part of a collaborative care team rather than doing everything on their own, which can lead to healthier students and improved student attendance.

Have you asked your school nurse to join your attendance team? Do you need more information about telehealth/teletherapy services? Let's chat in the chat!

Balfanz, R., & Byrnes, V. (2012). The importance of being in school: A report on absenteeism in the nation’s public schools. Johns Hopkins University Center for Social Organization of Schools. https://new.every1graduates.org/wp-content/uploads/2012/05/FINALChronicAbsenteeismReport_May16.pdf

Kjolhede, C., Brunner, W. M., & Sipple, J. W. (2025). School-based health centers and school attendance in rural areas. JAMA Network Open, 8(5), e2510083. https://doi.org/10.1001/jamanetworkopen.2025.10083

Komisarow, S., & Hemelt, S. W. (2024). School-based health care and absenteeism: Evidence from telemedicine. Education Finance and Policy, 19(2), 252–282. https://doi.org/10.1162/edfp_a_00398

Lim, C. N., Chung, P. J., Biely, C., Jackson, N. J., Puffer, M. J., Zepeda, A., Anton, P., Leifheit, K. M., & Dudovitz, R. N. (2023). School attendance following receipt of care from a school-based health center. Journal of Adolescent Health, 73(6), 1125–1131. https://doi.org/10.1016/j.jadohealth.2023.07.012

Long, M. W., Hobson, S., Dougé, J., Wagaman, K., Sadlon, R., & Acosta Price, O. (2021). Effectiveness and cost-benefit of an elementary school-based telehealth program. Journal of School Health, 91(3), 197–204. https://doi.org/10.1177/10598405211069911

Swaminathan, A., Ye, G., Weber, C., Uddanwadiker, G., Alvarado, A., & Bhushan, D. (2025). Demonstrating reduced school absenteeism through a school-based teletherapy intervention among socioeconomically vulnerable youth: A retrospective observational study. medRxiv. https://doi.org/10.1101/2025.03.11.25323793

About We Got Goals, LLC

Shelneka Marsalone is the Founder and Lead Consultant of We Got Goals, LLC (WGG). At We Got Goals, “Creating a Culture of Being Present,” means more than attendance. It means helping schools and organizations create atmospheres in which all stakeholders can show up authentically and be actively engaged. WGG supports education and organization leaders with developing multi-tiered systems of support to address attendance and engagement. Through incorporating initiatives that focus on student engagement, family engagement, and community engagement - The Triad of Engagement, data analysis, and assisting leaders with developing a strategic framework, WGG guides leaders through the mysterious void in which students disappear…chronic absenteeism.