This AttendNC Guide for District & State Leaders summarizes what the research literature says about the causes and consequences of chronic absenteeism, and provides evidence-based guidance so districts and state leaders can organize tiered, data-enabled supports that lead to measurable improvement.

Throughout this guide, you'll also find links to practical tools and resources that translate the research into concrete actions steps and consistent routines. To learn more about the research that informs this guide, visit our Review of the Research page. 

Understanding Chronic Absenteeism

Chronic absenteeism, defined in the North Carolina Student Accounting Manual (p. 35) as missing 10% or more of enrolled school days, has emerged as a national educational crisis, with rates surging in the wake of the COVID-19 pandemic. In North Carolina, nearly 400,000 students (24%), were chronically absent during the 2024–25 school year. The impact has been especially severe in high-poverty, rural, and urban districts. While chronic absenteeism rates in North Carolina have declined since their pandemic peak of 31%, and attendance bright spots can be found across the state, absenteeism levels in general remain well above pre-pandemic norms.

The research and current data suggests that chronic absenteeism is not a temporary disruption but a sustained problem that requires a systemic response, particularly for students most at risk of lost learning, disengagement, and long-term harm without targeted supports. Moreover, evidence suggests that chronic absenteeism is multi-causal and responds best to a tiered, data-enabled system that combines:

  • Tier 1: strong universal conditions for attendance (culture, belonging, predictable routines, supportive climate)
  • Tier 2: early intervention and targeted supports for emerging risk
  • Tier 3: intensive, coordinated case management for persistent barriers

To make this tiered approach effective, district and state leaders first need a clear picture of why students miss school, including the barriers and experiences that drive repeated absences, as well as the impacts these missed days have on students. 

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Why Chronic Absenteeism Should be a Strategic Priority

Missing 10% or more of instructional time creates significant learning challenges and can adversely affect student wellbeing. Research has repeatedly found that students who are chronically absent are at higher risk for:

  • Lower achievement and slower skill growth, especially in early literacy and math foundations
  • Course failure and credit accumulation problems in middle and high school
  • Lower graduation rates and weaker postsecondary transitions
  • Reduced engagement and belonging, which can further reinforce avoidance or disengagement
  • Widening opportunity gaps, because chronic absence is often concentrated among students facing the greatest structural barriers

At the school level, high rates of chronic absenteeism are associated with weaker overall performance, greater instructional disruption, and increased workload for educators who spend time catching students up or responding to crises that could have been prevented earlier. Research also suggests there can be peer effects, meaning attendance patterns can spread within friendship networks or classrooms when disengagement becomes normalized.

Policy-relevant Implication: Absenteeism is both a result of underlying challenges and a barrier to making other improvements. State and district recovery strategies, accountability systems, and improvement plans should treat attendance as a core condition for learning, not a secondary metric.

Who's at Risk (and Why)?

Research consistently shows higher rates among students who face structural barriers to attending school and students who experience weaker belonging and engagement at school. Research suggests elevated risk particularly for:

  • Students from low-income households
  • Students with disabilities
  • English learners
  • Students of color
  • Students in high-poverty communities and schools

The academic literature also suggests chronic absenteeism is multi-causal. It is rarely explained by one factor, and it often reflects several interacting conditions across a student’s life. Students miss school more often when they experience:

  • Health and wellbeing needs, including chronic illness, acute symptoms, limited access to care, and anxiety or school refusal
  • Safety, belonging, and relationships, including bullying, conflict, feeling unsafe, or weak connection to adults and peers
  • Academic struggle and disengagement, including falling behind, academic shame, low confidence, or the belief that school is not relevant
  • Family logistics and instability, including irregular work hours, caregiving responsibilities, housing moves, and difficulty navigating school systems
  • Transportation and other structural barriers, including unreliable rides, route issues, neighborhood safety, and economic stress

Absenteeism patterns often reflect how well systems identify emerging risk, respond quickly with respectful problem-solving, and connect families to practical supports. When barriers remain unresolved or disengagement becomes normalized within peer groups, absence can cluster and spread across classrooms or friendship networks.

Policy-relevant Implication: Chronic absenteeism is rarely solved through messaging or compliance alone. It requires removing structural barriers, strengthening school conditions, and ensuring supports match underlying causes.

A 90-Day Launch Plan for Districts

This 90-day launch plan is designed to help districts and state partners move from broad awareness to consistent, measurable action. It focuses on building a shared implementation infrastructure first (common definitions, dashboards, and routines), then deploying a small set of evidence-aligned Tier 1 and Tier 2 practices with clear triggers and follow-through, and finally establishing Tier 3 case management and a district learning cycle to refine and scale what works.

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Set Up Schools (and the District) for Success

Use the first month to equip schools for a strong start by standardizing shared definitions and data indicators, recommending clear meeting routine and strategies, and delivering school-ready data reports and communication templates. 

  1. Baseline district readiness and priorities. Complete the Attendance Works district self-assessment with central office staff and a small set of principals to identify gaps that districts can solve (data access, role clarity, escalation pathways, partner coordination, communication supports). Set 2–3 near-term capacity goals (for example, strengthen early warning routines, clarify Tier 3 ownership expectations, improve transportation troubleshooting pathways).
  2. Provide basic attendance guidelines for schools. Provide schools with a district attendance guidance that they can adopt and adapt, including shared definitions for chronic absenteeism and at-risk students, attendance coding expectations, decision rules or criteria for Tier 2 and Tier 3 supports, and a light-touch meeting structure and cadence that supports follow-through (weekly or biweekly early-warning check-ins plus a monthly student review).
  3. Conduct a district-level attendance review to target support. Review prior-year attendance data by school, grade band, and key student groups to identify where chronic absence concentrates and support is most needed. Use this to prioritize technical assistance, identify common friction points (for example, transportation transitions or grade-level on-ramps), and shape districtwide guidance and support.
  4. Deliver school-ready data products so schools can make evidence-informed decisions. Provide each school a start-of-year attendance package that includes prior-year chronic absence summaries (overall, by grade band, and by key student groups) and student-level flags for prior-year chronic absence with severity bands and multi-year flags where available. As data and capacity allow, include "hot spot" attendance areas that support root-cause problem solving (for example, day-of-week clustering or arrival-first period patterns).
  5. Provide districtwide family messaging and copy-ready templates that preserve a supportive tone. Prepare a short, plain-language district message for the start of the year explaining what chronic absence means, why it matters, and how families can communicate barriers early. Provide optional Tier 1–3 communication templates schools can copy and personalize, including welcome language, early outreach scripts, follow-up scripts, and Tier 3 meeting invitations, with translation-ready versions where possible so schools do not have to recreate materials.
  6. Identify and coordinate community partners to support Tier 3 interventions. Before school starts, map the partner landscape and create clear referral pathways for the most common non-academic barriers that schools cannot solve alone, such as health and behavioral health access, housing instability, transportation troubleshooting, and family support services. Confirm points of contact, eligibility boundaries, intake processes, expected response times, and what counts as a completed connection (not just a referral). Where Communities in Schools or similar partners are present, align roles so schools know when and how to engage them, and develop a simple district-level escalation route when school teams are stuck.

Data to Collect Before the School Starts

  • Prior-year attendance baselines: chronic absenteeism rate and counts overall and by school/grade/subgroup; severity bands (10–19%, 20–29%, 30%+); average days missed; persistence across years.
  • Student-level start-of-year risk flags: prior chronic absence; high absence counts; late-year declines; severe absence (20%+/30%+); mobility; recurring patterns (for example, clustered days) where available.
  • Data quality and coding checks: missing/unknown codes; excused vs unexcused distributions by school; reason-code completeness/consistency (if used); roster accuracy (enrolled vs withdrawn timing).
  • School readiness and capacity signals: named attendance lead and backup; Tier 2 cadence scheduled (weekly/biweekly) with roles assigned; Tier 3 case management process and estimated caseload; key staff coverage (counselor/social worker/nurse/family liaison).
  • Structural barrier indicators districts can act on: transportation access and route changes (as available); address instability/homelessness designation; health service need indicators where appropriate; percent of students with missing/outdated contact info.

Support Tier 1 and 2 School Routines

The first month is about prevention and catching small attendance problems early before they grow. Districts should work to clear obstacles and streamline supports so schools can act quickly and consistently.

  1. Deliver districtwide family messaging and reinforce it through the month. In the first month, pair the district message with a short set of staff-ready outreach messages and prompts that reinforce a common, supportive tone for early follow-up and reduce variation across schools. Encourage schools to document follow-up using a minimal set of fields (attempt date, barrier category, support offered, follow-up date) to strengthen continuity for families and improve district visibility into the most common needs.
  2. Establish early-warning reporting to school routines so the data are usable during weekly check-ins. Provide a school-ready weekly attendance report/dashboard with a predictable refresh cadence so teams are reviewing current data. Include students newly meeting Tier 2 trigger patterns, prior-year chronic students missing again, and other emerging risk indicators that suggest action is needed by schools and support schools in using a shared Tier 2 sequence that is simple and time-limited (e.g., student check-in, family contact, one concrete support offer, and a scheduled follow-up date).
  3. Stand up a district support pathway schools can use when barriers exceed their capacity. Create a simple attendance support request process schools can use when barriers are beyond what the school can solve, such as transportation problems, connecting families to outside services, translation needs, or data/report access issues. Make it clear how to submit a request, who will respond, and by when, and define what it means for an issue to be “resolved”
  4. Run two district pulse checks and target support where early risk is highest. At the end of Week 2 and Week 4, review early attendance patterns by school and grade (overall trends, flagged-student trends, and subgroup gaps). Use the review to identify priority schools and/or grade levels for short-cycle coaching and rapid problem-solving support. Focus district assistance on removing predictable friction points (transportation route problems, enrollment/withdrawal timing issues, incomplete contact information) and strengthening the school’s weekly check-in routines and follow-through.
  5. Close the month with a district learning review. Review outcomes alongside implementation fidelity (whether schools held check-in on schedule, completed outreach within timelines, and initiated Tier 3 plans when criteria were met). Identify what is working, what is inconsistent, and what supports are missing. Use the review to refine guidance, target additional assistance, and reduce low-value work so schools can sustain routines into months 2–3.

Data to Collect in the First 30 Days of School

  • Early attendance outcomes: daily and weekly attendance trends overall and by school/grade; early risk volume (students with 2+ absences in the first two weeks; repeated tardies; students trending toward 10–19% missed); flagged-student attendance (prior-year chronic and high-absence students); early subgroup gaps and emerging school “hot spots.”
  • Data quality and timeliness: percent of missing/late attendance entries; coding consistency across schools (absent vs tardy vs early dismissal; excused vs unexcused); stability of enrollment/withdrawal records so rates and flags are valid.
  • Tier 2 implementation: percent of schools running weekly/biweekly huddles as scheduled; percent of flagged students discussed; outreach timeliness (check-in and family contact completed within the district timeline); follow-through rate on assigned actions by the deadline.
  • Tier 3 activation and coordination: Tier 3 plan initiation rate for severe or persistent early cases; time from trigger to case lead assignment and written plan; partner referrals completed (not just attempted) for non-academic barriers.
  • District support delivery: which schools received targeted support, what supports were provided (coaching, transportation fixes, contact cleanup), and whether implementation indicators improved after support was delivered.

Establish Tier 3 and Tighten the Learning Loop

In the third month, formalize the district’s Tier 3 approach and create a routine for learning what is working, where, and why, so the system improves instead of drifting.

  1. Provide targeted coaching to a limited set of priority schools based on needs and capacity. Select a small number of schools with the highest volume of early-risk students or the greatest routine strain and offer targeted assistance focused on feasibility, follow-through, and barrier removal. Keep supports practical, short-cycle, and tied to observable improvements in team meetings, outreach timeliness, and Tier 3 activation.
  2. Establish Tier 3 case management standard and ensure role clarity. Define what Tier 3 requires (case lead, written plan, partner coordination when needed, progress monitoring timeline), specify minimum documentation fields so plans can be monitored and supported, and clarify which roles own which steps (school teams vs. central office vs. community partners). This reduces “hand-off” breakdowns and ensures the highest-need students receive coordinated support.
  3. Strengthen Tier 3 coordination, including connecting schools with community partners. Improve the district’s ability to help schools secure actual connections to services by tightening partner pathways, clarifying handoffs, and tracking whether a student and family reached the service, not merely whether a referral was attempted. Where appropriate and permissible, develop a lightweight mechanism for schools to know whether a connection occurred so plans can be adjusted quickly when supports are not landing.
  4. Hold the first district learning review that produces concrete improvements to district supports. At the end of the 90-day window, conduct a learning review focused on attendance outcomes (overall and subgroup chronic absence; persistence; school distributions) alongside implementation indicators (whether schools are smoothly running review cycles, delivering selected Tier 2 supports, initiating Tier 3 plans). Identify what to scale, what to simplify, and what to stop. Use the review to refine guidance, improve training supports, and target additional assistance where implementation is weakest. 

Measures to monitor in Days 60–90

  • Attendance trends and equity checks: Number/share of students are on track to become chronically absent (based on attendance so far); subgroup gap movement; distribution across schools; chronic absenteeism rates compared to prior year and benchmarked districts.
  • Tier 2 response: Tier 2 volume and timeliness; percent receiving a documented follow-up within the window; percent escalated using criteria.
  • Tier 3 readiness: time from Tier 3 trigger to case lead assignment and plan start; completion of partner connections (not just referrals).
  • Barrier removal throughput: transportation issues resolved; contact info gaps closed; partner connections completed.
  • Learning loop health: completion of the district learning review and the number of “district-owned” process improvements shipped to schools.

Going Deeper: Tiered Attendance Strategies

This section offers a practical set of evidence-informed attendance strategies designed for district and state leaders who are building coherent, scalable approaches to reducing chronic absenteeism. It draws on AttendNC Counts’ literature review and FutureEd’s Attendance Playbook to translate research evidence into clear actions leaders can support across schools. Organized in a tiered structure, it emphasizes how systems can strengthen universal conditions that support attendance for most students, ensure schools have clear routines and usable data to respond quickly when absences begin to accumulate, and coordinate intensive, cross-agency supports when barriers are persistent or complex. Each strategy is written for action: a plain-language description, a brief research takeaway on what works and under what conditions, a short set of first steps, and one implementation resource from sources such as Attendance Works

Tier I: Universal Prevention and System Enablers

Goal: Make regular attendance the default by setting clear expectations and strengthening the conditions that pull students to school across all schools.

Tier I at the district and state level is the set of policies, infrastructure, and supports that enable strong everyday attendance practice in classrooms and schools. These strategies focus on consistent attendance definitions and guidance, usable data and early pattern signals, supportive communications and engagement approaches, and removal of predictable barriers (e.g., transportation reliability, access to health and basic needs supports). When Tier I system supports are coherent and consistent, schools spend less time improvising and more time implementing routines well—reducing the number of students who need additional intervention.

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Districts and states can reduce burden on schools by centralizing and standardizing communication templates, translations, data pulls, and messaging schedules so high-quality outreach is consistent and equitable across schools.

Large-scale randomized studies show that personalized caregiver messaging can reduce absences at low cost, particularly when communications correct misperceptions and are repeated over time. One widely cited study found that multi-round, personalized mailers reduced absences and chronic absenteeism; effects are stronger when messages were easy to interpret, arrived on a predictable schedule, and were paired with a clear “how to get help” pathway for transportation, health, or basic needs barriers.

Getting Started:

  • Centralize templates: supportive scripts for universal norms (including translations) and early-pattern outreach
  • Automate weekly rosters: simple, reliable lists for schools (not manual spreadsheets)
  • Embed help pathways: every message includes a single, staffed route to request support

Attendance Works' Showing Up Matters for R.E.A.L. Toolkit provides a district-ready communication framework with adaptable messages and materials that can be translated, branded, and deployed on a shared calendar.

District and state systems can make Tier I stronger by ensuring schools have timely, usable attendance data and by setting minimum routines for review (e.g., weekly checks for early patterns, monthly climate/engagement monitoring), supported by training and lightweight technical assistance.

Evidence from multi-district field experiments suggests that attendance improves when schools can quickly identify emerging patterns and respond with consistent, low-friction actions, especially when families receive timely, personalized information. A recent set of randomized field experiments across multiple districts found that sending personalized attendance information reduced absences on average, reinforcing the value of reliable data pipelines and standardized “when X happens, do Y” routines that schools can execute consistently.

Getting Started:

  • Standardize definitions + thresholds: what counts as “early pattern,” “at risk,” and “chronically absent”
  • Set a minimum cadence: weekly early-warning review + monthly system check on conditions (transport, climate, engagement)
  • Make reports usable: short lists with next-step prompts, not dashboards that require interpretation training

The Early Warning and Response Systems from the Everyone Graduates Center (Johns Hopkins) offers a practical blueprint for setting indicators, thresholds, team routines, and response steps—useful for districtwide standardization and school team training.

Transportation is a common structural barrier to attendance that individual schools cannot solve alone. Districts and states can improve attendance by stabilizing routes, tightening communication about delays, and targeting transportation supports to students most affected by distance, safety, and family constraints.

Causal evidence suggests transportation eligibility can increase attendance and reduce chronic absenteeism, especially for economically disadvantaged students. In a regression discontinuity study examining walking-distance eligibility cutoffs, researchers found that transportation eligibility increased attendance and lowered chronic absenteeism, with larger effects for students facing higher structural barriers—highlighting that access, reliability, and targeted supports matter for impact.

Getting Started:

  • Diagnose “transport-driven absences”: route gaps, late buses, unsafe walk zones, long commutes
  • Create rapid fixes: backup ride protocols and a single point of contact for recurring issues
  • Target supports: prioritize students most impacted by distance, poverty, or safety constraints

The Attendance Works Transportation resource hub compiles practical strategies and examples (including transit-pass models) that districts can use to assess barriers, design solutions, and connect transportation changes to attendance improvement routines.

Districts and states can strengthen Tier I conditions by coordinating cross-agency supports (health, mental health, housing, food access) and funding roles that make “warm handoffs” real—so families actually reach services and attendance barriers are removed.

Research on community school initiatives suggests attendance benefits are most likely when schools have dedicated coordination capacity, integrated student supports, and strong implementation infrastructure. A RAND evaluation of the New York City Community Schools Initiative examined outcomes including attendance and found positive impacts in several domains, emphasizing that results depend on sustained implementation, partner integration, and clear service-delivery pathways rather than one-off referrals. 

Getting Started:

  • Fund a coordinator function: a responsible owner for partner pathways and follow-through
  • Track connection (not referrals): whether the family reached services and what happened next
  • Align incentives and metrics: shared measures across agencies so attendance barriers are addressed systematically

The Community Schools Playbook by the Coalition for Community Schools & Partnership for the Future of Learning provides a systems-oriented roadmap, implementation milestones, and examples that help districts design coordination structures and define what “integrated supports” look like in practice.

State policy can either reinforce Tier I prevention or unintentionally push systems toward punitive escalation. Strong Tier I policy alignment clarifies expectations for supportive, problem-solving steps before legal referral and ensures consistent attendance coding so districts can learn what is working and for whom.

Cross-sector public health and education guidance increasingly emphasizes that strengths-based, prevention-oriented policies that are paired with actionable data and coordinated supports are more likely to reduce chronic absence than sanction-heavy approaches alone. A recent report by John Hopkins University synthesizes evidence and recommends statewide improvements in data quality, coordinated supports, and strengths-based prevention policies as core levers for sustained attendance improvement.

Getting Started:

  • Standardize coding and guidance: reduce variation in how absences are categorized and acted on
  • Define a support-first sequence: outreach → problem-solving → barrier removal → escalation only when necessary
  • Invest in implementation support: training, TA, and monitoring so policy becomes practice

Stemming the Surge in Chronic Absence: What States Can Do policy brief by Attendance Works  synthesizes actionable state-level levers (definitions, data, capacity building, and system supports) that can be used to draft guidance, align policy, and structure SEA technical assistance.

Tier II: Targeted School Support and Rapid Response Capacity

Goal: Prevent emerging attendance problems from becoming chronic by ensuring schools can respond quickly with effective, targeted support.

Tier II at the district and state level is about building the capacity to identify schools and student groups with rising risk, then delivering timely, targeted assistance. This includes clear decision rules for when schools should intensify outreach, district-led coaching and problem-solving for priority schools, tools and training for evidence-based interventions (e.g., structured mentoring/check-ins, attendance team routines), and rapid barrier resolution supports (transportation troubleshooting, service navigation). Tier II works best when districts and states shorten response time, standardize what “good” looks like, and track whether targeted actions were implemented and improved attendance patterns.

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Districts and states can make Tier II usable by defining common thresholds, standardizing what “good response” looks like, and ensuring schools have simple reports that update weekly. The aim is to reduce variation so students get timely support regardless of school, and so leaders can see whether Tier II is happening consistently.

Rigorous studies of early warning approaches show that structured data routines can reduce chronic absence, especially when schools use clear thresholds, meet regularly, and assign owners for follow-through. In a randomized study of the Early Warning Intervention and Monitoring System (EWIMS), schools using EWIMS had a lower share of chronically absent students after one year than control schools. Impacts were achieved even though implementation was challenging, reinforcing that system leaders should invest in the routine (data access, meeting cadence, training, turnover-proof tools), not just the dashboard.

Getting Started:

  • Set common Tier II triggers: attendance thresholds + required minimum actions within a defined window
  • Provide “ready-to-run” reports: weekly lists with contact info and a place to log actions
  • Train for fidelity: short training + refreshers tied to staff turnover and principal onboarding

The American Institutes for Research EWIMS Implementation Guide provides a step-by-step, district-friendly implementation guide for building an early warning team, setting thresholds, selecting interventions, and monitoring progress.

Tier II home visiting succeeds at scale when leaders solve the operational problems: staffing models, training, compensation/time, safety protocols, coordination with partners, and a common approach to documentation and follow-up.

The evidence base suggests targeted home visits can produce meaningful attendance gains when they are voluntary, relational, and repeated—and when schools have the infrastructure to identify the right students and follow up after the first visit. In an evaluation of Connecticut’s Learner Engagement and Attendance Program (LEAP), targeted home visits for chronically absent and disengaged students were associated with measurable increases in attendance in the months following the first visit, with larger gains over time, underscoring the importance of sustained outreach and a clear process for follow-up.

Getting Started:

  • Establish who visits and how: staff/partners, pairs, scheduling rules, and language access
  • Train on a shared visit model: strengths-based conversation + clear next step + documented follow-up
  • Track “connection,” not just attempts: visits completed, barriers identified, supports delivered, attendance trends

The Connecticut State Department of Education's LEAP Website provides practical guidance that districts can adapt for staffing, training, and follow-up routines.

Districts and states can scale Tier II capacity by brokering partnerships (AmeriCorps, nonprofits, universities), standardizing training and data-sharing expectations, and making it easy for schools to launch mentoring/tutoring without building everything from scratch.

Evidence from large mentoring and tutoring initiatives suggests impacts are most likely when programs are well-structured, attendance data is used to target and monitor participation, and “dose” is protected. A Chapin Hall evaluation of City Year Chicago documents implementation and impacts including attendance outcomes, highlighting the importance of clear role design, integration with school teams, and consistent student participation. 

Getting Started:

  • Create a partner “spec”: roles, caseloads, schedule expectations, data access, and supervision
  • Target and monitor: define which students qualify and how progress is reviewed every 2–4 weeks
  • Reduce friction for schools: centralized onboarding, background checks, and templates for MOUs

Attendance Works' Mentoring: Elementary Success Mentors Toolkit includes role guidance, scripts, tracking tools, and practical tips for launching an attendance-focused mentoring model.

Tier II at the system level often means identifying a small set of priority schools (high chronic absence, sharp increases, high “near-chronic” volume) and providing rapid coaching focused on feasibility: attendance team routines, outreach timeliness, and consistent follow-through.

System-level evidence from Chicago’s ninth-grade focus shows that concentrated attention to early risk indicators when paired with school-level strategies and district supportcan improve on-track outcomes and reduce missed days over time. The Preventable Failure report documents that when high schools strengthened monitoring and supports for ninth graders, average days missed declined across cohorts, underscoring that sustained, organized focus (not one-off initiatives) matters.

Getting Started:

  • Choose a small portfolio: select priority schools and define 2–3 non-negotiable Tier II practices
  • Coach to routines: meeting cadence, outreach timelines, and action tracking (not “program adoption”)
  • Use short learning cycles: review implementation + outcomes monthly and adjust supports quickly

Preventing Dropout in Secondary Schools from the Institute of Education Sciences offers evidence-based recommendations and concrete implementation steps districts can use to structure targeted supports for at-risk secondary students.

Leaders can make Tier II more effective by ensuring students with health-related and mental health-related attendance barriers can access services quickly—through staffing models, telehealth partnerships, Medicaid strategies where applicable, and clear school-level protocols (including re-entry planning and accommodation guidance).

A study of school-based telemedicine clinics found that expanding telemedicine access can reduce chronic absenteeism, suggesting that system investments in convenient, school-day access to care can translate into real attendance gains, especially in settings with limited local health access. The underlying mechanism is straightforward: when students can be evaluated and treated quickly at school, families are less likely to keep students home for avoidable reasons such as minor illnesses, delayed appointments, or transportation challenges to off-site care.

Getting Started:

  • Map service gaps: which schools lack nursing/behavioral health capacity and what access barriers are most common
  • Standardize referral + re-entry protocols: clear roles, timelines, and documentation expectations
  • Sustain with funding: align health, mental health, and student support dollars to maintain access beyond pilots

CALDER Center's School-Based Healthcare and Absenteeism: Evidence from Telemedicine provides a clear, public summary of the model and evidence that leaders can use when designing or scaling school-based telehealth supports.

Tier III: Intensive Coordination, Cross-Agency Support, and Accountability for Connection

Goal: Address persistent or complex barriers through coordinated, individualized support systems that ensure services actually reach students and families.

Tier III at the district and state level is the infrastructure for intensive case management and cross-agency coordination when absenteeism is severe or driven by complex needs. This includes defining minimum case management standards, enabling data sharing and referral pathways where permissible, funding or aligning roles that coordinate supports, and building partnerships that can deliver mental health, housing, health, and family stabilization services. Tier III is most effective when systems monitor not only referrals made, but whether families successfully connected to services and whether barriers were reduced—so plans adapt quickly and supports don’t stall.

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Tier III works best when districts and states treat intensive attendance recovery as a coordinated service system, not a set of isolated school actions. That means common referral criteria, a shared case management standard, clear partner roles, and mechanisms to confirm whether families actually connected to available services.

Cross-agency models show stronger results when partners share timely data and operate with a single coordination point. The NYC “Attendance Matters” shelter partnership, for example, improved attendance partly because agencies had daily attendance updates, defined roles, and coordinated problem-solving across education and homelessness systems.

Getting Started:

  • Set a Tier III standard: referral triggers, minimum case management actions, and documentation expectations
  • Create MOUs and workflows: define handoffs, response times, and how “connection confirmed” will be tracked
  • Fund a coordination role: district-level lead to manage partner pathways and troubleshoot breakdowns

U.S. Department of Education's FERPA and Community-Based Organizations website offers concrete guidance for building compliant data-sharing agreements that enable coordinated supports.

Tier III systems fail when caseloads are unrealistic and coordination is treated as “extra.” Districts and states can enable success by protecting time for coordinated work and funding attendance case managers, social workers, liaisons, and partner capacity. 

Evidence from high-need populations suggests intensity matters. An evaluation of FosterEd found that intensive supports were associated with reduced enrollment gaps and total out-of-school time for participating youth, consistent with general guidance that frequent monitoring and coordinated adult action can keep students connected to school.

Getting Started:

  • Define caseload guidance: staffing ratios and role expectations aligned to Tier III complexity
  • Invest in supervision and training: motivational interviewing, trauma-informed care, and cross-system coordination routines
  • Require service tracking: not just “referral made,” but whether the student/family accessed support

Chiefs for Change's Structure referral pathways, communications, and follow-ups with community providers provides practical guidance for managing referrals, streamlining communication, and checking whether students actually accessed services.

Housing instability is a major driver of severe absenteeism, and districts/states are uniquely positioned to align schools, shelters, and housing agencies around enrollment continuity, transportation, and basic needs supports.

NYC’s shelter-based Attendance Matters program illustrates what partnership can accomplish: improved attendance and reduced school mobility when agencies coordinate using linked data and shared routines.

Getting Started:

  • Formalize partnerships: standing agreements with shelters/housing authorities for data coordination and rapid problem-solving
  • Guarantee transportation options: dedicated funds and clear procedures for students outside typical routes
  • Track stability metrics: school changes, enrollment gaps, and attendance for students in temporary housing

National Center for Homeless Education's McKinney-Vento Toolbox supports districtwide program design, compliance, and practical implementation for homeless education.

For students whose absenteeism is tied to mental health needs, Tier III requires accessible services plus coordinated re-entry planning across school staff, providers, and families. District and state levers include contracting, workforce supports, and sustainable financing (including Medicaid mechanisms where applicable).

CBT-based approaches and coordinated school-involved interventions show promise when implemented with consistency and collaboration. A study of the Back2School CBT-based model for youth with school attendance problems illustrates an approach designed to be flexible to student needs and coordinated with school supports, key features for making mental health services translate into actual attendance gains.

Getting Started:

  • Set a service pathway: clear referral routes and timelines for high-need students (school refusal/anxiety)
  • Require re-entry planning: a standardized school re-entry protocol paired with treatment supports
  • Support sustainable billing/financing: reduce “pilot-only” staffing cliffs by planning for ongoing funding

The School Refusal Assessment Scale–Revised (SRAS-R) provides a structured way to identify causes of school avoidance and refusal, and guide targeted intervention planning across school and provider teams.

State and district policy strongly shapes whether Tier III responses solve problems or deepen them. Effective modernization of truancy policies typically includes: support-first requirements before court involvement, limits on exclusionary consequences tied to truancy, and routine monitoring for disparities in unexcused absence labeling.

Evidence suggests court diversion and justice-linked approaches often do not improve attendance on their own, while unexcused absence labeling can exacerbate inequities. A quasi-experimental study found no long-term attendance improvements from a truancy diversion program, and California analyses document large disparities in unexcused absences, both pointing to the need for preventive, problem-solving, equity-aware policy design.

Getting Started:

  • Require an intervention step: mandate an absence intervention team and documented supports before any legal referral
  • Monitor disparities routinely: district/state dashboards for unexcused absences and escalation actions
  • Align incentives with learning: remove policies that deny make-up work or push students further out of school

The CSG Justice Center's Rethinking Juvenile Justice and Schools summarizes research and policy options for reducing justice involvement and improving youth outcomes.

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This page was last modified on 03/05/2026