Wilson County added its fourth school-based primary care clinic this year at Ralph L. Fike High School in Wilson. The Wilson Area School Health Centers (WASH) are part of a county-wide effort to increase access to healthcare and improve outcomes for students, while also filling a gap in the county’s healthcare landscape.
The WASH clinics operate like a standard community clinic for students and staff. Kristi Ferrel is the supervisor for the WASH Clinics. She handles the clinic’s operations. She ensures there’s enough flu vaccines during flu season, swabs for testing common diseases, and staff at each clinic. There is 1 full-time nurse practitioner, and 1 part-time, who see students at all the clinics.
“Usually wherever the nurse practitioner is busiest, she will see 15-20 patients in a day, but the nurses at other clinics may have patients that are just getting blood drawn or an immunization,” Ferrell said.
If the nurse practitioner is at another site, students can still receive a consultation with the provider virtually. A nurse is always present at each site. The WASH Centers differ from a school nurse’s office. At a WASH Center, a student can go in, see the nurse practitioner, receive treatment or have a prescription written, have blood drawn, or even be tested for common diseases.
“We do sick visits, so people with strep or COVID, urinary tract infections, pink eye. We also do primary care stuff, so if somebody is diabetic or has high blood pressure, then we can manage that,” Ferrell said.
They even do physicals for student athletes and the NCDOT required physicals for bus drivers. Sometimes, they even treat staff.
“The teachers would peak their head in the door and wanted to be seen, too,” Ferrell said. “If a teacher comes in with a headache or sore throat, we can see them pretty quick, and they can get back to the classroom.”
School-based health clinics like the WASH centers, have been shown to increase access to healthcare for students, especially in high-poverty and rural areas, where there’s a shortage of primary care providers. The American Academy of Pediatricians endorses school-based health clinics, citing improved health outcomes through preventative care and early intervention. School-based health clinics have also been shown to reduce absenteeism and improve academic performance: higher grades and lower dropout rates.
“It’s the convenience for students and parents,” Celita Graham said. “Because there is so many services that they can get between the hours of eight and three versus having to leave school for anywhere from an hour to three hours and not return at the end of the day.”
Graham says that’s the main selling point for the WASH centers. She is the communications manager for the Wilson County Health Department. Graham, and the department, are just a few of the many advocates for these WASH centers.
“Over time, we’ve noticed that there has been a significant decrease in the amount of primary care providers.”
The WASH centers fill a need in the county’s healthcare system. Six years in, the county has prioritized placing clinics in higher-poverty areas with the space to accommodate the clinics. Four schools now have WASH centers: Fike, Beddingfield High, Hunt High, and Forest Hills Middle School. Parents sign a form granting permission to see their student and provide care. For students, it’s an easy, welcoming introduction to the healthcare system.
“The setting is more inviting. It’s more personable for students,” Graham said.
Moving forward, Wilson County is looking to expand its services within the WASH clinics to include mental and behavioral health.
“The behavioral health piece is the biggest. Everyone knows we need it,” Graham said. “Our youth is struggling.”
Wilson County is not the only county in the state to adopt school-based health centers. Wilson modeled its WASH centers after a program in neighboring Wayne County, where it’s had in-school clinics since 1998. Buncombe County in western North Carolina opened three school-based clinics this last year, bringing the total to 90 school-based clinics in the state.
