Anchorage School District board reviews regional nursing model to prioritize care for high‑acuity students

At a June 2 Anchorage School District board work session, district leaders proposed a six‑region "regional" nursing model they say will concentrate certified nursing coverage according to student medical acuity so medically complex students receive consistent, certificated care.

Superintendent Bryant introduced the briefing and Deputy Superintendent Sven Gustoson and Kathy Bell, director of healthcare services, outlined the model and operational details. "I'd like to give the board and the public more visibility into our nursing model," Bryant said as the presentation began. Bell said the district currently counts 82.5 nurses and described a staffing structure that places nurses at an "anchor" school while allowing regionally assigned nurses to cover higher‑acuity needs across nearby schools.

Why it matters

Administrators framed the change as a response to coverage challenges on days with multiple absences and as a model the district would keep even if funding returned. "Even if we got the money back, we would still want to do this nursing model," Gustoson said, describing it as a way to ensure consistent coverage for students with daily, physician‑ordered treatments. Board members said the change matters because it affects student safety, staffing stability and union roles at individual schools.

What the district proposed

- Geography and anchors: The district described six geographic regions, each designed to include at least one high school and one middle school, with nurses assigned to a home "anchor" school where they spend most of their time. - Staffing counts (as stated in the presentation): the district said it has "a total of 82 and a half nurses," 75 nurses in non‑charter buildings, 78.5 school‑based nurse positions of which 70.5 are certificated and eight are non‑certificated healthcare services staff. Charter schools are not participating in the model. - Coverage and acuity: A regional lead will assess school acuity (defined by the presentation as the frequency and type of physician‑ordered treatments that require a nurse). Administrators outlined three coverage scenarios: A) a substitute nurse covers the shift; B) if no sub and the school is high acuity, a nurse from a lower‑acuity school or healthcare‑services staff will cover; C) if no sub and the school is low acuity, a trained unlicensed assistant personnel (UAP) — typically an AA or secretary trained in medication administration, CPR and first aid — may provide coverage for the day. - Training and SOPs: A nurse task force will develop standard operating procedures and August professional development days are planned to train nurses for inter‑school coverage and updated skill sets.

Board questions and concerns

Several board members pressed administration on student safety, evidence for the model and workforce risks. Member Blakeley recounted a personal case in which a third‑grade student developed type 1 diabetes midyear and said: "The only reason that she survived that incident was because there was immediate trained medical staff in that building." Blakeley asked how the district would ensure similar students receive immediate care if their school were classified as low acuity.

Administration replied that an anchored nurse at a school that becomes high acuity would serve that school and that the district would seek substitute coverage first, then move regional staff or healthcare‑services nurses as needed. "When somebody's out sick, they should still put in for sub coverage," Kathy Bell said, adding that healthcare‑services staff sometimes personally cover high‑acuity schools.

Members also sought evidence and context: Member Mcdana asked whether the model was driven by the $90 million shortfall or would be recommended regardless; Gustoson and Bell said the district reviewed regional practices in Alaska and the lower‑48 and would retain the model even if funding were restored, while acknowledging there was not a formal implementation study. Members suggested pursuing a formal pilot and study to measure outcomes.

Staffing, costs and retention data

Director Lang provided turnover figures: eight nurse resignations this year, 16 the previous year and 18 the year before. Lang also said the AEA range‑six addendum for regional leads would be roughly $4,000 per lead next year, about $24,000 total for six regions.

UAPs, liability and union engagement

Administrators said UAPs (AAs or secretaries) who serve in the role receive medication‑administration training and CPR/first‑aid certification; the district cited Good Samaritan protections and parent release forms for medication as mitigation for liability questions. Bell said the nurse task force was formed via an application process that included review and input from AEA union leadership.

Board members’ risk assessment

Several trustees emphasized the risks if morale or staffing worsens: if more nurses resign, the district could lack the personnel needed to implement regional coverage. Administrators acknowledged a broad nursing shortage but said they had recently hired staff and hoped to fill open positions before the school year.

Next steps

Board members asked for additional detail on the model's implementation, supporting data, and the plan for acuity reassessment after student registration (staff said acuity reviews will follow registration, with a target date around July 15). The meeting ended with a motion to move into executive session for student hearings, legal and contractual matters; the motion was moved by Member Mcdana and seconded by Member Higgins and was called on the record without opposition.

What the board did not decide

No formal policy adoption or final vote on the regional model occurred in the public session. Administrators presented the model and answered questions; board members requested more data, suggested a pilot and emphasized retention and safety concerns that staff said they would address in follow‑up materials.