The scant data available suggest there is a critical need for improving service delivery within alternative education (AE) settings for children and youth with emotional and behavioral disorders (E/BD). A promising approach for improving student outcomes in AE settings is school-wide positive behavior interventions and supports (SWPBIS), an approach that has been used successfully in many typical school environments. This case study describes school-wide practices and structures that were instituted and sustained at Centennial School of Lehigh University for the past 15 years and highlights those practices and structures associated with the universal tier. Longitudinal data are shared that illustrate the effectiveness of the practices over time positively affecting the outcomes of youth with E/BD. (Contains 4 figures.)