Free Tax Services in Pediatric Clinics

Area of Science:

• Public Health
• Health Services Research
• Health Economics

Background:

• The Earned Income Tax Credit (EITC) is a crucial financial resource for low-income families, linked to improved child health outcomes.
• A significant portion (20%) of eligible families do not claim the EITC due to barriers in the tax filing process.
• Integrating financial services into healthcare settings presents an innovative approach to address these barriers.

Purpose of the Study:

• To evaluate the feasibility and impact of providing free tax preparation services within clinics serving low-income populations.
• To assess the uptake, financial benefits, and accuracy of tax services offered.
• To determine client and staff acceptability of this integrated financial intervention.

Main Methods:

• A "StreetCred" program offered free tax preparation at four urban clinics in Boston during 2016-2017.
• Surveys were administered to clients (n=244) who used the service and to nonparticipants (n=100) to assess experiences and outcomes.
• Clinic staff (n=41) were surveyed regarding program acceptability and feasibility.

Main Results:

• A total of 753 clients received over $1.6 million in federal tax refunds, with significant increases in tax filing rates.
• Among surveyed clients, 21% were new filers, 47% were new users of free tax preparation, and 14% newly received the EITC.
• Client acceptability was high (96% would use again), and families with children reported feeling more connected to their doctor. Staff also viewed the program favorably (97% approval).

Conclusions:

• Free, clinic-based tax services are a feasible and effective financial intervention for increasing tax filing and EITC access among low-income families.
• This model demonstrates potential for improving financial well-being and potentially child health outcomes through primary care integration.
• Further research is needed to assess scalability and long-term health impacts of such financial interventions.