By Susan Gibbs
Published: March 20, 2008

More than a decade ago, a health program was initiated here as part of a class project by University of Virginia nursing students. The goal:  to assist uninsured local children at that time and to ensure access to adequate health care.

Now that program - dubbed the Health Cottage Program (the Cottage)—could be the first expenditure the School Board is looking to cut as it prepares to work with the County Board of Supervisors to reign in costs in a tight budget year. 

Petitions have been circulating to save funding for the Cottage. More than 160 people have signed the petition already.

School board members say they do not know the origin of the petition. However, at least one member has said he thinks school employees are the most concerned about losing the benefit of the Cottage.

The petition states, in part: “(The Cottage) provides parents with the confidence of picking up children once they are seen by a health care provider. If a child is injured while at school, this also provides the child of [sic] being diagnosed before having a parent coming to pick them up.”

But Buggs Peyton, vice-chairman of the Board of Supervisors, says he has a problem with asking the County’s taxpayers to pay for the Cottage, which started long ago and might have evolved into a convenience. “Many of those same taxpayers can’t afford health insurance for themselves.”

The Cottage has an estimated operating cost of $167,000 per year, says Greene County Public Schools Business & Facilities Director Kim Powell.

School Board members say that, to their knowledge, the Cottage is the only program of its type in the state.

The Cottage was initiated in collaboration with the University of Virginia (UVa) School of Nursing in the mid-1990s, when many County children were uninsured and lacking access to adequate health care and preventable health programs.

It “was started as part of a class project by students in the masters program in public health nursing,” explains Doris Glick, associate professor at the University of Virginia’s School of Nursing.

Records made available by UVa indicate that class project, initiated in the fall of 1994, included a comprehensive community assessment of Greene County that revealed it to be “medically underserved.”

As a result, those records show, the students developed a proposal for the development of a school health clinic to serve children. Working with UVa’s School of Nursing faculty, they wrote a grant proposal and secured funding to develop the Cottage.

When the Cottage got under way in the fall of 1995, it gave Greene’s approximate 2,500 children in grades kindergarten through 12 access to preventive health services and primary health care regardless of ability to pay.

UVa records further show that the Cottage was staffed with a nurse practitioner, a school nurse and a secretary-receptionist. In addition, clinic aids staffed small clinics in three of the four schools. Twenty-four hour coverage was provided by the children’s physician and through the back-up physician for the Cottage.

In addition, clinical groups of UVa School of Nursing undergraduate and graduate students worked at the Cottage and in the schools as part of their clinical practicums to gain experience in providing health care for vulnerable populations in the community.

According to Glick, the grant that made the Cottage possible was provided by the Virginia Health Foundation and supplemented by the Department of Education and Medicaid. After three years, when funding sources dried up, Glick says, “We backed away from (the Cottage) and let the community take it over.”

That was about 10 years ago.

Though the petition states, “This is the only health care that some children in the school system are able to get,” that point can be argued.

Since the Cottage began, the state has instituted its Family Access to Medical Insurance Security (FAMIS) program to serve those who slip through Medicaid’s cracks. Martha Jefferson has set up its Greene Family Practice in Ruckersville.

But the Program has continued on, serving the School Division’s staff and students.

This current year, according to Assistant Superintendent in charge of Human Resources Deborah Brown, the Health Cottage has given “264 athletic physicals (but) the primary school and high school are the most frequent visitors … the younger kids go by there for stomach (aches), headaches … a lot of clinic assistants take them to nurse practitioner to make sure everything is okay.”

So far this year, Brown says, more than 750 “kids have been seen by the nurse practitioner.” Most, she guesses, were seen for “common colds, band-aids …”

But, as reported on January 10 in The Record, the number of students with chronic illnesses, such as diabetes, is on the rise in the School System. School medical personnel are calling for more licensed staff to help care for them.

While the Code of Virginia does not require school divisions to hire nurses to take care of their health issues, there are other laws that do require schools to provide the professionals that are needed to care for specific needs of students.

Though School Board Chairman Darcy Higgins says eliminating the Program is “not a done deal,” he adds that the School Board has voted to hire the requested licensed staff, and wonders if maintaining the Program and taking on new staff is affordable.