School-based health centers are an important avenue for students to receive timely clinical preventive care. In an effort to redesign delivery of health care to priority populations, University Health System, a major safety net hospital system located in South Central Texas, opened the first school-based health center in Bexar County, Texas. This article describes the planning process with emphasis on the community assessment as part of a strategy to promote community engagement and guide development of health services. Such synergistic efforts exemplify the importance of leveraging school, community, and health services to address regional disparities in child and adolescent health.