The National Assembly on School-Based Health Care (NASBHC) surveys state public health and Medicaid offices every three years to assess state-level public policies and activities that promote the growth and sustainability of school-based health services. The FY2011 survey found 18 states (see map below) reporting investments explicitly dedicated to school-based health centers (SBHCs). State-directed funding in FY2011 totaled $89.6M for 875 SBHCs; state general funds (67%) represent the largest funding source. Since 1996, state investments in SBHCs have grown 122% percent--despite an austere state budgetary climate in the most previous years. Several states have experienced impressive gains in the past 10 years. States that direct funds to SBHCs hold programs accountable by setting and monitoring standards, requiring certification, and collecting performance data--the most frequent indicators being tied to obesity prevention, immunizations, and mental health. Of the 18 states that fund SBHCs, 10 have enacted meaningful Medicaid policies that assure reimbursement for care delivered to Medicaid enrollees in SBHCs, including primary care prior authorization waivers and mandated managed care organization contracts. (Contains 7 tables.)