Chronic poverty presents components of chronic trauma with one major deficit being lack of access to needed quality health care services. Often needed therapeutic services are not available and when available, challenges exist with time or travel constraints of therapists. Students who need therapeutic services such as occupational, physical or speech therapy can fail to thrive in academic expectations if supportive therapy is not provided. Integration of mental health therapy on-site with schools via regional community health organizations has proved effective. A comparative integration of physical health care services was instituted by Helping Hands Therapy to promote access of care for students living in underserved rural poverty areas with key focus on students in special needs programs. The approach rendered benefit to both school districts and students served in modalities of occupational, physical, and speech therapy. Contextual challenges continue to present in commonality with other on-site interventions such as recruitment of therapists, management of time and travel constraints, and increase of parental and caregiver involvement. Further research is indicated for ways to meet these challenges.