School-Community Collaboration: A Rural District’s WISH Spurs Student Health, Academics

by Steven D. Taylor

Big dreams often start small. For the Wayne County Public Schools in eastern North Carolina, those dreams started with the vision to improve adolescent health care at school. Now seven years later, we are proud to operate five full-time school-based health centers, which have contributed to a decline in teen-age pregnancies and an increase in student performance.


Early on we recognized the need to address the long-standing issue of poor accessibility to health care in a rural, economically depressed and labor-focused county. Serving roughly 19,000 students, our school system reflects a variety of student populations.

Many students do not have adequate access to health care, and 52 percent of our students qualify for free or reduced lunch. Because our mission is to serve the needs of all children, especially those that serve as obstacles to learning, we established the Wayne Initiative for School Health, or WISH.

A Joint Commitment

Turning that wish for improved access to health care for adolescents into action was a challenge for our school system, but we have shown what collaboration between public agencies and private entities can bring about.

At the time we began to dream, state statistics showed Wayne County ranked ninth among North Carolina’s 100 counties in the number of uninsured children and young adolescents identified as receiving little to no health care services.

We recognized the need and pinpointed the solution, but to make it work we knew we needed a communitywide effort. So our administrators listened to what the community identified as the biggest health needs. In a survey, parents told us basic health care, teen-age pregnancy prevention and mental health services were the most pressing. They told us it was hard for them to obtain health care and insurance for their families because of the high costs. They also said the time spent waiting to receive services, along with their inability to take leave from work, exacerbated the problem.

With this information and a generous foundation grant, the school system worked with the local hospital, a private pediatrics practice, the local departments of health, social services and mental health and the county commissioners to form what we gave the acronym WISH.

Comprehensive Services

The first two WISH centers opened in 1997 at two of our middle schools, providing services than ranged from acute/chronic health care to mental health services, health education, nutrition education, immunizations and physical examinations.

The WISH centers’ staff includes a center director, medical director and team of registered nurses. A group of health educators, mental health counselors and dieticians split their time among the schools. The centers meet state credentialing standards, which makes us the only county in the state with five approved school-based health centers.

The school district used its own funds to remodel space to accommodate each school-based health center, which consists of exam rooms, a laboratory, reception area, medical office space, a restroom and a counseling room.

The most important part about WISH is that no student in need is ever refused service for inability to pay. WISH works with the county department of social services to help eligible parents obtain health care coverage for their children. Students without such coverage are billed on a sliding fee.

We now run health centers in four middle schools, and last fall we opened a center at one of our high schools. Our vision is to add another center at the district’s other high school. This concept provides the continuity required for comprehensive school-based health care.

The nonprofit WISH centers are governed by a community board of directors that includes one member from our school board and an additional staff member.

The district handles the maintenance services. Initial funding of $495,000 came from the Robert Wood Johnson Foundation, and the centers receive continual supplemental funding from the state. The local hospital provides physicians and nurses, providing in-kind services exceeding $275,000 annually.

Academic Payoffs

The effective schools model suggests that healthy students learn and perform better. The WISH Centers achieve this. Students who do not feel well can visit the center and return to class. Our absenteeism rate has dropped 5 percent over seven years.

More than 85 percent of the students at the schools with WISH centers are enrolled in the program. That means WISH serves close to 2,000 students a year. We believe this has contributed to higher student achievement in the years since the centers opened. A study of academic performance by those students in schools with WISH centers saw scores on the state exams increase by 11 percent over the past seven years.

In addition, adolescent pregnancies have decreased 75 percent as the centers teach students about preventive health care. The health centers reach out to students who are at high risk of teen-age pregnancy to provide one-on-one counseling and a strong abstinence message that bolsters the state-mandated abstinence education students receive in health and science class. (A state law forbids schools from distributing condoms.) Local emergency room visits for basic medical services also have declined.

Through a collaborative vision that truly is tailored to the needs of the community, the Wayne County Public Schools and our community partners are helping put all students on a healthy course to learning.

Steven Taylor is superintendent of the Wayne County Public Schools, P.O. Drawer 1797, Goldsboro, NC 27533. E-mail: His school district received the 2005 Civic Star Award, co-sponsored by Sodexho School Services and AASA.