Association for Public Policy Analysis & Management

Recent radical expansions of health insurance coverage for children of low-income families, combined with increased funding have facilitated small but substantial increases in the use of School-Based Health Centers (SBHC) across the country. Notably, the 2010 Affordable Care Act provided $200 million for the establishment and expansion of SBHCs through competitive grants to Local Education Agencies (LEAs) and health service provider partners. SBHCs typically provide a combination of primary, mental health, nutritional, and dental services, which in many of the high need areas where grants were awarded, could help mitigate substantial barriers to school attendance or academic success. This study exploits rich longitudinal student level administrative records from North Carolina and Tennessee matched with funding records from the Health Resources and Services Administration. We estimate effects on student test scores, attendance, and disciplinary actions associated with transitioning in or out of schools served by an SBHC. Variation in student access to SBHCs results from SBHC openings, closings, and student movement across schools. The data from two diverse southern states, with SBHCs in both rural and urban communities, allows the examination of differential impacts for student subgroups that might be expected to particularly benefit from the services provided by SBHCs. Results will provide important evidence to a small but growing body of literature assessing the effectiveness of school-based health interventions in promoting improved academic performance among traditionally disadvantaged students.