In a 2010 special issue of New Solutions on school health and environment, Paulson and Barnett asked who is responsible for the environmental health of schools. The Massachusetts School Building Authority (MSBA), the product of liberals trying to bring organization and efficiency to school construction, is an “off-label” and only partial answer to the question. The MSBA, established in 2004, lent its ear to health and safety advocates who seized an opportunity to implement regulations, guidelines, and education reforms at the level of school construction. The MSBA's progressiveness is a model to localities and states across the United States facing the dual crisis of attacks on public education and financial inefficiency. However, the MSBA is still in its infancy. Time will tell whether the MSBA, viewed as a limited state pilot program, can survive and expand its environmental health programs or whether its initiative is only as good as its current leadership.