The contribution of school health programs to disease prevention among children and youth has included immunizations, screenings, referrals, and in some instances, treatment for potentially health-threatening conditions. State and community policymakers, as well as children and youth advocates, have been prompted to consider a broader role for school health services, due to poor health status of children, high risk behaviors, inadequate health insurance, poor health care utilization, and barriers to public health care. Policy planners believe that comprehensive school health programs can respond to the health information and preventive care needs unmet by society. Statistics are cited to reflect the poor health status and health-threatening behaviors of youth. The dearth of school health programs in the southern United States is attributed to inadequate funding, vocal opposition to school-based health services, and the autonomy of local school districts. States are urged to establish coherent and comprehensive state policy, support local determination of need, provide financial resources, monitor programs, evaluate programs, provide support services for school health personnel, and provide models of delivery. A table lists state regulations for health services in southern schools. Five models of state governments taking a leadership role in creating effective health services for school populations are briefly described. (JDD)