Department of Pediatrics, Boston Medical Center, Boston, Massachusetts;
Department of Pediatrics, School of Medicine, Boston University, Boston, Massachusetts.
Pediatrics. 2018 Jun;141(6). doi: 10.1542/peds.2017-3608. Epub 2018 May 18.
The earned income tax credit (EITC), refundable monies for America's working poor, is associated with improved child health. Yet, 20% of eligible families do not receive it. We provided free tax preparation services in clinics serving low-income families and assessed use, financial impact, and accuracy.
Free tax preparation services ("StreetCred") were available at 4 clinics in Boston in 2016 and 2017. We surveyed a convenience sample of clients ( = 244) about experiences with StreetCred and previous tax services and of nonparticipants ( = 100; 69% response rate) and clinic staff ( = 41; 48% response rate) about acceptability and feasibility.
A total of 753 clients received $1 619 650 in federal tax refunds. StreetCred was associated with significant improvement in tax filing rates. Of surveyed clients, 21% were new filers, 47% were new users of free tax preparation, 14% reported new receipt of the EITC, and 21% reported new knowledge of the EITC. StreetCred had high client acceptability; 96% would use StreetCred again. Families with children were significantly more likely to report StreetCred made them feel more connected to their doctor ( = .02). Clinic staff viewed the program favorably (97% approval).
Free tax services in urban clinics are a promising, feasible financial intervention to increase tax filing and refunds, save fees, and link clients to the EITC. With future studies, we will assess scalability and measure impact on health. StreetCred offers an innovative approach to improving child health in primary care settings through a financial intervention.
美国为贫困劳动人口提供的应纳税所得额税收抵免（EITC）是一种可退还的款项，与改善儿童健康有关。然而，仍有 20%的符合条件的家庭无法获得该抵免。我们在为低收入家庭提供服务的诊所提供免费税务准备服务，并评估了其使用情况、经济影响和准确性。
2016 年和 2017 年，我们在波士顿的 4 家诊所提供了免费的税务准备服务（“StreetCred”）。我们对参与 StreetCred 和以前的税务服务的客户（=244）和非参与者（=100；69%的回复率）以及诊所工作人员（=41；48%的回复率）进行了调查，了解他们对服务的接受程度和可行性。
共有 753 名客户获得了 1619650 美元的联邦税收退款。StreetCred 与报税率的显著提高有关。在接受调查的客户中，21%是新报税人，47%是首次使用免费税务准备服务的人，14%报告新获得了 EITC，21%报告新了解了 EITC。StreetCred 的客户接受度很高，96%的人会再次使用 StreetCred。有孩子的家庭更有可能报告 StreetCred 让他们感觉与医生的联系更紧密（=0.02）。诊所工作人员对该项目持积极态度（97%的人表示赞成）。
城市诊所的免费税务服务是一种有前途、可行的金融干预措施，可以增加报税和退款，节省费用，并使客户获得 EITC。随着未来的研究，我们将评估其可扩展性并衡量其对健康的影响。StreetCred 通过财务干预为改善初级保健环境中的儿童健康提供了一种创新方法。
