School-based telebehavioral health service is increasingly important in addressing the health disparities youth in rural communities face. The study examines barriers and successes of implementation and sustainability of a rural school-based telebehavioral health program from the perspective of site coordinators or school champions informed by the Consolidated Framework for Implementation Research framework. Six coordinators participated in semi-structured interviews and completed a self-report questionnaire (organizational readiness for implementing change) to describe their experiences with telebehavioral health. The authors used thematic analysis to extract themes. The overarching themes included (1) benefits, challenges, and opportunities; (2) resources and support; and (3) work processes and challenges. Site coordinators endorsed their workplaces' commitment to telebehavioral health but shared uncertainty about the telebehavioral health program's sustainability. The emphasis coordinators place on relationships, communication, continuity, and advocacy for families and students underscores their critical role in providing high-quality telehealth services in schools and the broader community. Their perspectives are vital to ensuring these services' continued successful implementation and sustainability. Site coordinators' focus on the need for school-based champions and increased awareness of telehealth services in their communities highlights a need for outreach efforts to continue engaging relevant stakeholders.