Anchorage School Board: 06/02/2026: School Board Work Session

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Good afternoon, everybody. Oops.

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Good evening. Afternoon. Today is Tuesday, June 2nd. This is our board work session. President Jacobs is online.

I'm covering for him in the room. Member Lessons is traveling and in the boardroom with me with Today we have Ms. Blake's, member Blakesley, member McDonough. And we're expecting member Wilson online. And then I will announce member Higgins arrival when he gets here. All right, so we have two items on, on the agenda today.

One is the nursing model. All right, Superintendent Bryant. Thank you, Madam Chair. So I'd like to give the board and the public more visibility into our nursing model. We've had quite a bit of discussions over the past year around the model, but I'm also looking ahead to FY28 and the difficult decisions that we have ahead.

So I think this is a really good inflection point for us to discuss more about the healthcare model and to answer questions from some of the experts that we have at the table. So with that, I'll hand it off to our deputy superintendent. All right, good afternoon. I'm Sven Gustafson, the deputy superintendent, and with me is Kathy Bell. She is our director of healthcare services.

And we wanted to come to you today to show you, kind of orient you to what this regional model is that we have proposed to go to for next school year. This actually came through the budget process when we worked on this. But we are committed to really having this be our model as we move forward. So just to kind of give you an idea of how many people we're talking about, we have a total of 82 and a half nurses in our school district. There's 75 nurses in our non charter buildings.

The charter schools had, have decided to not be in this model. So they have their own nurses in their schools. We have six regions. Out of the 75 non charter schools, we have 78 and a half school based nurses. Out of those 78 and a half, 70 and a half of those are certificated nurses and then the other eight are non certificated nurses out of the Healthcare services department.

So in the actual regional model, we have 75 buildings. And like AK Choice is in Inside of Ocean View or Alpine Glow. So that isn't. They utilize that nurse. So it kind of, it isn't exactly building by building or school by school.

So in our six regions, we have 13 schools in each region. Region, except for Eagle River. Eagle river has 10 in that region. This is a kind of a map. You can see with the colors how those regions are set up by proximity.

And we made sure that each of those regions has at least one high school and one middle school in those regions. So it isn't like we're asking a nurse at some point to go from South Anchorage to Eagle River. It's within the area of those regions with the region. We have Every, every nurse is assigned to a home school which we call an anchor school. And that's where they'll spend the majority of their time.

The just note three of the the three right sized the nurses from the right sizing schools. The school closure were moved to open anchor schools based on their preferences. And the other server other nurses were offered to complete a regional preference survey. And then those were respected as we we did placements and and the preferences were respected and aligned with the current placements that they had this year. And then the health core services nurses will support regions to meet the needs of students as well.

So I'm going to turn it over to Kathy.

Just a couple other things. The principal at the anchor school is the one that does the hiring help the hiring process. It will be a combination of that principal of the anchor school and Kathy's office. And then as the the principal is also the one doing the evaluation of now you're going to be kind of. You're going to see where this all kind of comes together as Kathy moves forward here with what's actually happening inside those regions.

So in addition to you need to. Turn on your mic. So in addition to the anchor nurses, each region will have a regional lead who will work with the healthcare services department and notify region nurses of any coverage needs as well as to perform ongoing acuity assessments to classify schools as low as low or high acuity.

So how will that what's. How will acuity be determined? When we're taking talking about acuity in a school, we're talking about the acuity of the students within that school. What are we placing the most weight on that when determining acuity are treatments ordered by a doctor or a medical authority. The these are scheduled and done on a day to day basis and best practices for these treatments to be performed by a nurse.

We want to acknowledge that school nurses as well as other ASD employees often perform a lot of other essential tasks within a school that aren't captured here. But they are not scheduled high acuity nurse treatments. Therefore, while we look at this for an overall acuity, they don't necessarily require daily coverage. So as you can see in that top slide, those are the items that are ordered by physicians that actually nurses should be doing within a school.

So something to keep in mind about acuity is that it can change throughout the school year. We saw it change a lot this school year. Theoretically, we will implement the regional model today. If we were going to implement it Today, we'd have 31 nurses at low acuity schools who would help provide coverage at higher acuity schools. A couple examples of this is like in the east region, there's four low acuity schools and nine high acuity schools.

I'm just picking the two biggest schools. West has seven low acuity schools and six high acuity schools.

That's looking at this year's model. It could change for next year. One of our daily challenges is covering schools when nurses are on leave. And this is where the regional model will benefit the district and students by ensuring that we have the most robust nursing coverage on a day to day basis. Here are some of the proposed leave coverage protocols that we will look at.

Scenario A, a substitute picks up the assignment. So therefore there'd be full coverage by a substitute nurse. Scenario B, no sub picks it up and the school is high acuity. So our outcome would be nurses from a low acuity school or a nurse from healthcare services will provide support to that school. Scenario 3 is no sub picks up the assignment at a low acuity school.

And the outcome could be that the UAP will provide coverage that day. And just to define a uap, it's an unlicensed assistant personnel, usually an AA or secretary, who does DEED medication administration training and is also CPR and first aid certified. The majority of our workforce is anchored in an elementary school working 7:30 to 3. So more often than not we will have an elementary school nurse at a low acuity school covering maybe for a middle school or a high school. If they're asked to cover for a middle school or high school, the gap in time will be covered through healthcare services if necessary.

Just a question. So when you say covered by health care services, is that out of the eight people, well, not assigned to schools,. There'll be, we're planning to put one of, there'll be several schools that aren't covered through the regional model. Lower acuity schools. We're starting the school year off with putting those eight nurses and that will be like five or six of them into a school.

And that will be their anchor seat until we decide otherwise. We still have four more that are based right here. Okay. District office. Okay.

And that would be helpful in covering for sick leaves because we do have a number of those at times this year. This year we had a number of days where we had actually like 17 nurses out on the same day. So we. We have to cover those. Exactly.

Before we continue, I'd like to just remember Wilson joined us at 402 and member Higgins joined us at 4:10. Thank you. Continue. So when I talk about the gap time, that's. It could be like a elementary school nurse covers a middle school and they don't get out.

Students are there till 4 o' clock and the elementary school nurse is done at 3 or 3:30. And therefore we still might have to provide coverage. So we might have to send somebody over from our office to help cover that if there's a student need during that time. Okay. All right, thanks.

So what does this mean for next year? All schools will have assigned anchor nurses. This is what I kind of just talked about a few minutes ago. Nurses will remain in their anchor school unless there is a need to provide support at a high acuity school. A nurse at a high acuity school will not be sent to another school for coverage.

They will remain in their school. Nurses in low acuity schools can also lend support to high acuity schools throughout the school year for things like health screenings, immunization compliance and data entry. Bottom line, the school district can better meet the needs of our most medically complex students at all times, regardless of what building they're in.

So we established a nurse task force that is working on developing SOP standard operating procedures that will provide guidance to nurses on how the regional model will function on a day to day basis. We're also in the process of selecting regional leads and in August, professional days, professional development days will be training all nurses on the newly di. Newly developed SOPs as well as ongoing skills trainings throughout the school year, seeing they will be moving from one school to another as a possibility if to cover absences.

So the regional lead and the Healthcare Services administration will determine anchor school assignments. As Fen mentioned, Healthcare Services is partnering with Communications to ensure transparency and clarity to the public on this. And positions will be hired specifically within a designated region.

So that is what we have and we would be willing to answer any questions as much as we could. Thank you. Questions?

Member Blake Sleep. Can you guys. Oh yeah. It's nice and loud. Yeah.

Thank you for all of these slides and I know you talked on. On slide seven. I believe I'm looking. Okay. This slide on slide seven talks about more on acuity in the statement Here it says that acuity can change right throughout the year based on where students are enrolled and if they transfer between schools.

And I think that is one of the areas that I'm most concerned about. And as an example, just like I have a family member who, when she was in elementary school, developed type 1 diabetes in the middle of the school year. Nobody saw it coming. It was the middle of the day in elementary school. She was like in the third grade and her classmates found her passed out on the bathroom floor.

And the only reason that she survived that incident was because there was immediate trained medical staff in that building that was able to respond very quickly and get her support. And had it been someone, had her school in this model, for example, been a low acuity school, and then she developed type 1 diabetes and passed out on the floor and almost died, the chances of her survival would have been significantly diminished. And so that's what I think about in one of the areas that's really hard to predict. And so, and I understand that if you have a nurse that's out, you could have a low acuity, A nurse in a low acuity school help a nurse in a higher acuity school. But in terms of how, like, how do you respond and ensure the safety of students?

If in this model what we've predicted is not actually what manifests in the school building, and you have a child in the middle of the school year who develops some high acuity need, and now there is no high nurse placed in that school permanently, how do we ensure that those children are safe? I think that, and similarly, you might have someone, even based on this slide, you might have someone that transferred in, right, that is going to what is currently deemed a low acuity school, but that student has a very significant medical need, like how do we ensure that those kids are safe? I think that that is kind of where we're coming from with this actual model, because we currently, if you have 17 nurses out and you have eight over here, you have. And we don't get enough sub nurses to cover all of our schools on any day when there's that many nurses out. So you're going to have schools uncovered on any given, on some certain days anyways.

But I think that what would end up happening is if you're in a low acuity school and then a student moves in that has diabetes or one of these areas where we need to have they turn into high acuity school and we already have an anchored that, you know, that we already have the nurse anchored at that school. So that school would then become a high acuity school. And then if you transfer it in or if somebody develops a high acuity illness, this school becomes a high acuity school. So sorry. And that means an anchor nurse is not necessarily in the building permanently.

Right. So it's just the anchor. Maybe, maybe I'm misunderstood the model. If it's a low acuity school becomes a high acuity school, then they are then taking a nurse from another school that wouldn't to be permanently staffed in that building. That, that, that low acuity school nurse will now be a high acuity school nurse.

Okay. Because there'd be a high acuity in that, in that school. Kathy responded, yes. So that nurse would. If there's a, there's going to be an anchored nurse in every school to start the school year, even though we have five schools that won't have AEA type C nurses, but we're going to use of those eight nurses we have in our department, five of them will be sitting at those schools as in their anchored seat.

So they will be covering. But that doesn't mean that someday somebody might be out sick. But when somebody's out sick, they still put in for sub coverage. If it's a high acuity school, I still hopefully will have a couple people, including myself, sometimes will cover that high acuity school. Cause diabetics, as we know, your example in elementary school, need to have a nurse there.

Yes. And all this year we had four open schools that weren't covered for a couple reasons. There was a hiring freeze and then we just didn't end up filling them. And I knew something may be changing in the, in our model, so we did have that happen this year. But we were able to cover those schools.

And that's, it's very important to me that those schools are covered. Yeah. One of the things, as a former principal of West High, of 1800 students, we had one nurse and the school right down the hill with 200 students had one nurse. We had multiple tube feedings and diabetics. And whenever our nurse was gone, if we didn't have a sub, that's when the stress level came up for me because I knew that there was a.

If there's a nurse right down the hill that doesn't have any of those tube feedings or diabetic students and stuff, and I don't have a nurse at all. This is where this model comes in to help so that we can make sure we have those really high acuity kids covered. Okay. And then I guess similarly, can I Ask a follow up another question in a similar situation, let's say it's not a high acuity student, but there is a emergent situation that happens. Something that's bigger than you fall down and scrape your knee, something that's very significant.

Right. You, I don't know, you're bombing it down a sledding hill and you crack open your head or like something very significant, you break a leg. How? I guess similarly in those situations, how do we ensure the safety of those students? The same sort of model that we're talking about.

Well, the UAPs as I talked about, they've taken the deed medication training so they can pass meds. They've also taken CPR and first aid. And even if a nurse was there, if something happened like you described, we would be calling 911. Okay. Yeah.

And we have a lot of that happen as especially in our middle and high schools, like in the afternoon and evening when they're out on the sports fields or football or wrestling meet or any of that. We don't have nurses then. And that's when a lot of our injuries occur. And then my last question, and then I'll stop asking questions so other people can talk too. This model is the transition to this model predominantly or completely based off of our lack of resources, based off of our are diminishing financial resources that if we had a world where we had all the money in the world, this would not be the recommended model.

Or is this you're saying would be the recommended model? Regardless, even if we had all of the money in the world, we, we. Would want to go to this model regardless if we had a full time nurse in any of our schools due to the coverage issues. This is going to be a big, this is going to ensure a lot more time with acuity, high acuity kids with regular nurses. So this is a model that's we you can find in different places.

It was like as we as remember you guys added a bunch of nurses to the pool after the fact and we were going to go to this model when we had a lot less nurses. We still want to be at this model because it's one of those things kind of like the thing I was talking about. 1800 Kids, lots of tube feedings, school with no high acuity students. Same, same level of nurse at each of those. So it really helps when we're having those issues of coverage.

And so we want to stay with this model even if we got say all of our nurses back. And is this model what was recommended by the Task force of nurses that was created or is the task for only created to sort of help with the logistics of implementing the model? I guess I'm wondering about the. This is the recommended plan, but I'm wondering what the recommendation is based off of. Do we have data about where this plan has been successful in other places?

Is it recommended by nursing practitioners and school nurses in other states? Is it recommended by the nurses here in our own district? Like who. Where does the recommendation come from? It wasn't really a recommendation.

We did look at what other school districts in Alaska are doing and we're still the best model there is in Alaska. Even with us moving to this regional model and having five non certified, non type C certificated nurses in a school. But we're still going to be putting anchor nurses in those schools. There would just be part of the eight nurses that are out of our office which none of those ended up being cut because those are the ones that do frequent covering of schools and are well trained. Also.

We also looked in the lower 48. I'm from Massachusetts, I have a daughter that works in Oregon. And so I had very good information from those two areas and then I went online to look at what other places are doing and we still have a very good model. Ideally, if we had all the money in the world, every school would have a nurse. But we would still keep the regional model just so that if we a couple few nurses are out and a sub isn't able to pick up those coverages for those schools, we can move somebody from a low acuity school to cover a high acuity school for a day.

Okay, that is, that's helpful to know. Yeah, it's. Yeah, it's like we would keep the regional model even with all the resources, but all the resources in the world would enable every school to have one of these nurses. And then the regional model would essentially allowed to cover. It would be supplemental.

Right. To cover those nurses when they're gone. It literally is just a way to coverage. Right. To make sure we have coverage.

To answer your first question, the task force is there to work on SOPs. It wasn't before because I mean I doubt that any nurse would say they want to be able to cut nursing different. Right. So a lot of when we had 90 million we had to make a lot of hard choices and a lot of changes to structures in our district and, and what Kathy said, I mean even the stuff that I looked at when we were, when we were going to this, that a lot of our districts in our state Actually do tele nursing. They don't have a nurse there.

They call it. Call. Yeah, we don't want to do that. That sounds terrible. Okay.

Okay, I'll stop asking questions. I thank you for the time. Can I just share with you is all the nurses are going to have their skill sets increased so. So all nurses will know how to take care of all those skills that nurses generally take care of that are ordered by a practitioner. We have several more questions, people we're going to go to member McDonough and then member Wilson online.

Before starting my questions, did want to raise to the chair a point of information. I believe in the orientation we got from the association of Alaska School Boards. They said it's called a point of personal comfort. To clarify, about five minutes ago, the deputy superintendent said this implementation plan would have been recommended without a budget shortfall. And then at the end of the testimony, he said that this plan was predicated by the $90 million shortfall.

So I would like clarification about what the rationale actually was because there's a contradictory. I can definitely clear that up for you. Member McDonough. When we had a $90 million budget shortfall, we had to look at all of our structures in this district. And nursing is one that we looked at.

And when we, when, when I might have misspoken when I said what I said. What I'm saying is, is that even if we got the money back, we would still want to do this nursing model.

We cut a lot more nurses than what we have now, and the school board has brought quite a few back. We're down to five schools without a certified nurse, but we still want, even if we got those five back, we would still want to stay in this new nursing model because it is going to help the coverages when we have nurses out.

Member McDonnell, you have a follow up? Okay, I don't have a follow up on the point, but I could ask questions to the administration. So thank you again for preparing this at the highest level. Because part of why I raised the point of information is I'm not quite sure whose direction or whose initial impetus this came from. Is it the board saying we need to find money or is it the administration saying this is an operational efficiency?

And I do believe that's somewhat more than a chicken and egg situation. So just while I'm catching myself up from a board that I didn't sit on just some high level questions, the presentation describes anchor schools. It says all schools will have an anchor nurse. Does that mean we have like, if I walk into every school in a day. I will see a nurse in every.

Assuming nobody's absent. Is. Is that what. I'm not quite sure exactly what I'm supposed to be understanding with the concept of an anchor school. When the plan was first announced in February we were told there would be many days or hours of a day in which a school would not have a nurse at all unless it's like a high acuity school.

So could you explain anchor school a little more clearly to the two of us here who are new? So the anchor school, we're only going to have five schools that are not covered by school nurse. All the school nurses stayed in the schools they were in. There has been a couple people resign, retire military. They moved away.

We have those positions open now. I'm hoping all of those positions will be filled and those will be filled by type C anchor nurses. We also have the other eight positions out of healthcare Services which will place five of those people into sit in a school as an anchor nurse. They'll probably be in the lower acuity school so they may be the ones that get moved if need be to cover a higher acuity school. Is that helpful?

I would also add in that if we have a number of absences in any given day and we don't have the subs, then you might go into low acuity school and there might not be a nurse there because that nurse is over at a high acuity school working with and making sure we're taking care of those kids that have the high acuity needs. Yeah, I can say like I appreciate the intention of a collectivist design that says there's just not enough reserves who can come to the building on. Sometimes the administrative assistant is getting a call at like 7:40 saying I woke up with the flu and I can't make it in. So I appreciate that this is looking to the students in a school whose nurse might emergency call and saying that we have a plan to get coverage from another building instead of scrambling and potentially risking the high needs students. I'm just unclear about the details.

I think maybe what would help me is what the cost savings of this actually came out to be after all the budget cycle was done. Do you guys have that figure? That would be five positions I believe right now. Isn't that right Mr. Atlas? Oh, he's not here.

Yeah, I think we were looking. So it's a five. 5.5 Is what we've been. Okay, what is the cost of the addenda pay that we're now splitting into six different regions. So range six and I don't know, will somebody help me with how much a range 6 is?

I think Amy, Marty knows that. Okay. I mean, I can look up range 6 later for my information. For 6. We can get that information.

Yeah. Okay. So it's, it's not any, it's not even equal to, I don't know, a quarter of a salaries for a nurse. I don't think. Yeah, I'd have to look up what range 6 is.

But to me, I just want to make sure because every time you can't spend money, you have to spend some other money to avoid spending money. And we, I want the board to avoid these positive feedback loops.

Has this model been tested, studied, demonstrated in any form of peer group study that I could look at as other large districts like Anchorage or an association of nurses that recommends this type of model. It has not been called the regional model. It's a very robust model compared to what many school districts are using right now in the lower 48 as well as in Alaska. It's more robust than any other nurse model in Alaska right now. And it's more robust than most nurse models in the lower 48, that I can tell you.

So I would, I would love to take the administration's word on that. And if it is, I would also encourage that the development and Grants department writes a implementation sciences grant to study this so that the rest of our peers would be able to see what is then objectively the most robust or one of the most robust models. I wish I could take the word of the administration, but I prefer the peer reviewed sciences to be able to demonstrate the model. And if that doesn't exist, I do understand the emergency that we were set with in February. Member McDonough, if I could interject, if we can go back to slide two, because I think that we're talking about two different things here.

So there's the management benefits of a regional model, which is essentially what we've been talking about. There's ease of coverage. But the reason why Ms. Bell is saying that ASD has a robust nursing model is because as you can see here, we're talking about having 82.5 nurses for having 75 buildings. So it's essentially a very generous ratio of building the health care professional. That's why it's a strong model.

It's, it's a separate point from the regional allocation of staff for coverage. There are two different things. There's the management piece and there's the fidelity of a nurse per School piece.

Thank you for that clarification. I'll move on. Just on the point of.

I'm just. I think these are. Yes, no questions. But they really help me understand the way that this board approaches management decisions and policy budgeting the way that we do our job. So I think the answer was there was not an implementation study that guided this regional model.

Is that correct? There was not. We looked at many different models that were less robust and we tried to come up with a more robust model for the Anchorage School District. And one of the reasons I wanted a more robust model to provide coverage is because when we have children in Alaska with special health care needs, many of them live in Anchorage.

Yeah, I appreciate that point. I was going to raise it too, that Anchorage is a magnet for the whole state, as you guys know. I just like to say for the record that the needs in Anchorage are much higher than any other state city in this state. So it's hard for us to compare to our peers in Anchorage. In Alaska, do we have a needs assessment that Healthcare Services uses to structure the logic of its changes?

We looked at acuities and we did that last year when we were about to do a change last year and didn't end up doing it. We're doing it again this year and we'll be looking at all the acuities again once orientation or registration is finished. And that will be, I think, July 15th. So after July 15th, we're going to start looking at all the acuities of the school because it could be a low acuity school this year. It's now a high acuity school next year.

Like you brought up, there might be a diabetic there in a second grade that would need to have a nurse in the building. So we'll be looking at that for sure. And we also did look also the board, previous board, before you two came on board, we looked at what all the other districts were doing in the state of Alaska. And this, like I said, is a very much more robust model than what the other districts are doing. If the board suddenly had a bunch more money that we all know we don't.

But I'm just hypothetically, if we did, is this a model that we could package into like a one zone region as a pilot and then the other five zones go back to status quo for the sake of stability and we invest in a pilot study where this becomes more thoroughly and methodologically assessed. Is that a realistic option? If we like, let's take money off the table and is that a realistic option if we could invest in that,. I think it's realistic too. If we could take had all the money in the world, we would have a nurse in every school.

And then some of the lower acuity schools would still help support the higher acuity schools. I gave the scenarios about what would happen if there was an absence for us. It would be a sub would pick it up. All these are still available to subs to pick up. So therefore there would still be a nurse in that school.

Secondly, we would have to move either somebody from a lower acuity school to this higher acuity school or hopefully I would have somebody still based out of my office that could go and cover that school. And then if it was a very low acuity school that doesn't even have any medications to be given during the day, maybe one. Then the UAP may have to cover and then backup would be. They would call me if there was any questions. But the goal is to try to have a nurse even at this point in every school when possible.

But even this year that didn't happen because when a lot of people are out sick and subs don't pick up the assignments, we do the best we can. There was a couple days where I covered two schools. Fortunately they were right beside each other. Two more. Is that two quick ones or real quick?

Yeah. Member, we have two more board members that wish to speak. Okay, I can make it one then. Thank you. I just want to know from the administration's perspective what has been the response from the nursing workforce.

And like I'm looking for qualitative data like surveys, testimonials and narrative input or even quantitative data like resignations and exit interviews conducted that we can review or maybe the administration has reviewed and needs to keep private. But to me is that does that data exist? As far as feedback from the team,. I can tell you the nurses that have resigned that I've talked to, there was only one nurse that said she was resigning for because of the regional model. There was a couple others who resigned for parent because of parent issues.

One's a military and they were moving out of state. But there was only one that identified verbally to lots of people that she was resigning because of the regional model. Thank you. Thank you. Member Wilson, did you still have a comment or question?

I do, yes. Thank you. You mentioned a UAP and I just want to clarify or ask you to clarify what a UAP is and typically who in the school are UAPs? Sure, they. I can look for the definition, but I can tell you off the Top of my head, they're usually the AA or the secretary.

There's somebody that the principal works with to identify who will be filling that role. It's a volunteer role they do. If they're filling it full time, I believe in their contract they're able to get some type of an addendum for that. And they are first aid and CPR trained, which they can come to our classes that we offer here at the district or go through their union to get those classes. And they also take the DEED training for medication administration and then are checked off on the medications at that school.

But like I had mentioned before, if it's a high acuity school, we will be making sure that there's a nurse in that school even if we have to move them from a low acuity school. And for the, the UAPs, then it sounds like they're, they're primarily the AA. So TOTA members, particularly at the schools where we're not intending on having a full time nurse, is there conversation with Totem to clarify their duties and responsibilities and then what they're. I just want to make sure that they're not taking on additional duties without the conversation, at least with Totem and also want to make sure that they're not accountable or they're not at higher risk, I guess we can say, for any assistance, any medical assistance they would provide because they're not going to be licensed. Well, because they are unlicensed medical providers.

Well, anyone that helps any person is covered under the new the Samaritan law. So you're just covering helping somebody out. So you're covered under that also. And as far as our documentation for giving medications, it's on the form that the parents signed saying that they released the anchor school district from any liability as long as the person had been trained on giving the medication. So there's not a liability there for that either.

Member Wilson, follow up. One additional follow up just for clarification because I just want to make sure that those AAs because the at least I would make the assumption they're going to have a lot more kids coming through with colds and, and things like that not feeling well, that there is additional conversation with Totem to make sure that they aren't overwhelmed with a second job duty or a second job essentially. So I just wanted to ensure that there's additional conversations happening particularly for those UAPS in the schools that will not have a full time nurse moving forward. I just wanted to mention too that the UAPS get an opportunity to learn or practice this job when they cover the nurse for lunch and during their planning time so they do get an opportunity to work with a nurse during a school day. We try not to leave schools unattended with just a UAP for the full day.

The goal is that a sub, like I said, would pick it up first. If a sub doesn't pick up the assignment and it's a school, a school that has high acuity, we would potentially use somebody from our office if I have staff at the available. Or we would move somebody from a lower acuity school to cover that school. So I would add that, yes. Member WILSON we'll be making sure that Totem is understands this model and what it means if they're a low acuity school and what that would look like in each of those offices.

Okay, thank you. Moving on. Member Higgins Yeah, I'll try to be reasonably brief for me. I remember back quite a while ago, used to always have halftime nurses in these schools. And I think Superintendent Como, that really wanted full time put it into special education funding to be able to justify it and kind of protect.

It kind of worked out and then later it transferred back in. But part of that issue had to do with the special ed needs in every school and what and what that's like. And this other part was being able to recruit and fill the nurse positions and keep them. The halftime, that was really impossible and that's what we were experiencing. But my concern here has to do with the special ed needs.

I look at these sort of things and say, okay, what's the goal? The goal is that we think we can operate and save some money and put it into other things that might have a more positive benefit. I think it's the goal that's right now and accept that. I just always look at the positives and negatives and one of the negatives is I listened to member Blakesley's comment about Title 1. I looked at the numbers of undiagnosed.

I had to check it out real quick of number of kids out there that might be in it. And I know that we are assigning kids, allowing kids with special education special needs to go to whatever schools in their neighborhood. We haven't said, you know, type one, we're going to transfer you to a different school or things like that. Is that a concern out there? That because there might be some kids that because of medical, you know, feeding through the stomach, all the different odds and ends, I've seen that we're looking at being reassigning or keeping kids together somewhat More than what we do today.

Well, remember Higgins, in our, in our elementary schools, when a student is like in a life skills or an in or something like that, they are in regional models. And one of the reasons why is because it is like using the term high acuity. Those, those are high acuity kiddos. And if you have that regional model with that group of kiddos at your school, that you're going to be a high acuity school. Right.

I mean, just because their special education receives special education services doesn't mean they're not a regular kid. All of our kids are regular kids. But in this particular case, we're just talking about the health issues. And usually in those elementary schools, we're talking high acuity. Now when you get in those bigger schools, like the middle and high schools, you're going to have many different types of students with high acuity.

So, you know, you're going to have a nurse in those buildings. And that's why we're going to. This is so that we make sure that we cover those, make sure we have those particular, those kids with those high acuity health issues. Yeah, I'm just looking, trying to figure out the positives and negatives. There's always both sides to each coin.

When we do it as a comment, you're going to have kids out there with undiagnosed type 1 diabetes and they may go through a crisis. You got a hundred other reasons that they might go through it. And the immediate access with the newest is a benefit to that and would be an ideal safety kind of situation that we would exist. I realize there's pros and cons because you need to do other different things with it as well, but that's all I'm looking for is just acknowledgement. You're gonna, it's gonna have a negative impact morale, it's gonna have issues with nurses, it's gonna have some concerns with parents out there that really want to make sure that their kid has any problem they're taken care of within it.

And I recognize that. And I think that's all I'm looking for. You know, when we, when we listen to the public testimony earlier this year and the parents that came out that were very adamant and very passionate about their kiddos that have really high acuity issues, diabetics, tube feedings, other types of health issues, this right here, this is what's going to help that. Because, you know, if you are a principal of a west high that has seven diabetic kids and three tube feedings and stuff, and that teacher, that nurse is gone. And we have that across up to 17 schools this year in one day.

We can't cover everything, but this model will cover those kids that have those drastic needs and so that we can make sure we have that covered. Thank you. Okay, thank you. Member Jacobs, You're on mute. Member Jacobs.

Okay. Oh, there. Yeah. Madam? Yeah, thank you.

I don't have a question this time. Thank you. Okay, thank you. All right, go. We have, it is.

We have 14 minutes left in, in the whole session.

We might go an extra 10 minutes because we have one other agenda item. Member Blakeley, you have a follow up. I do have a follow up, but if I don't want to monopolize time, I can always. It's okay. Okay.

So in, in listening to all of the, all of the conversation in I, I guess I'm. A new concern has now emerged. If, for example, I know that you said that the nurses that you've spoken to, only one of them referenced the model being the rationale for them leaving their position. I have heard like very different sort of concerns from, from people and through the grapevine of more nurses being, feeling unhappy about this model. And so we only know what we hear.

Right. And we might be hearing different things from different people. It's really hard to understand how nurses truly feel about just directly asking them. But I also know that oftentimes disgruntled employees or when morale is really low, you know, they might not always disclose to the school board or to administration how they actually feel until they resign. And then they might, they still might not disclose.

And so in the world, in a world in which nurses leave and resign because they are unhappy with this model, is there a concern or worry in our ability to fill those positions? Do we have nurses waiting to work at ASD as a full time nurse or credentialed? What, what is the. I think risk is what I'm asking about if any of those nurses in this model who are currently employed at this district who haven't resigned yet but might do. Do we have people to fill those spots in order to satisfy the plan here?

I would love to say yes, that this 100 people knocking at the door, but there isn't because it's a nursing shortage right now. There's a nursing shortage in all parts of nursing. But I did recently just hire two nurses for our office to fill two positions and it's only June 2nd, so I'm hoping that we'll be able to hire and fill the other open positions. Also last year I Went into the start of the school year with I believe, six open positions. We hired two and then, and there was a hiring freeze, so we still had four open the whole school year, which we didn't fill.

And when I mentioned about nurses leaving, there was only one nurse that was leaving that told me that. I'm sure there's many that are questioning this and nervous about it because they've been working with one nurse in one school for quite some time. I was hired, as Mr. Higgins said, when there was part time nurses in the school. And I was a part time nurse at a school on base that had two diabetics. And I was happy when Carol Como moved us all because we could afford it then to full time nurses.

I really believe this model will help us cover the schools that need to be covered for high acuity kids. Okay, thank you. Thank you. I just have a comment and then we're going to move on to our next topic. I think what's important to me is that this model, if it will, will provide coverage to any kid every day in our district with a low acuity or high acuity, even if, even if the nurse, their school nurse is unavailable or on leave and we can't find a sub.

So regardless of. I guess what I'm trying to say is regardless of.

If a kid needs. Because this is all about kids, right? I mean, I, I love our nurses and they work very, very hard. I also remember when we had either no nurse or we had a traveling nurse. I mean, that's a long way ago.

But I just need to make sure that this model is going to make sure that no matter where the kid is, it's based on their need. We will get the service to them. And this is one of, this is a model, this model will do that. It is not going to depend on, you know, if the nurse wants to go or if. I mean, I'm just trying to, I just need to focus on kids for a minute.

I don't care where the kid is, what their, what the issue is. I mean, I know as a principal, I've had to call 911 many times with the nurse, with the advice of the nurse. But I also know that there, there are kids in, in our schools that need to have pretty much round the clock care. And if the nurse is not available and if there is no substitute, will this model fill in that void for the kid? And then so I just, I just want to bring it back to kids and how this model is going to benefit the kids so the students that.

Are high acuity in a school, those would be our priority. So maybe a low acuity school may not have a nurse for part of a day or a whole day to move to a high acuity school to provide coverage for the students. But ideally, we could maybe have all the schools covered because subs would pick it up, or somebody from my office would be able to pick it up. But when we have 17 people out, nurses out, for whatever reason, it's hard to cover everything. So we have to base it on the higher acuity students.

But even in this model, there are schools where the nurse will not go anywhere because of the high acuity. And I, and I gave examples of that. Like, east has four low acuity and nine high acuity schools. Okay, so, so the lower would move to the higher level. So we're not looking at every.

Every nurse going in and out of. Well, they have the regions. We have six regions. Right. So within that region, the care for every kid in the asd, Low acuity, high acuity, or unknown.

Right. Will have care? Yes. Professional? Yes.

Care. Certificated care? Yes. They might not be placed in the school at that moment if they're a low acuity school, but they'll be placed at a school that's a high acuity school, possibly, if the need arises. Okay.

Okay, thank you. Member Bellamy. Mr. Lang has some numbers from earlier that he can give us just to. Fill in a few blanks from the conversation over the last hour that might be helpful. I don't know if this answers the question completely, but if we look at the number of resignations for nurses over the last three years, we had 8 resign this year.

The year before we had 16 resign, and the year before that we had 18. And it's difficult to draw, you know, direct conclusions about, you know, morale from those numbers alone. But the fact that we had fewer resignations for nurses this year would suggest to me that this isn't a huge driver in terms of, you know, pushing people out of the school district. The other number I wanted to share was the range six addenda question. So next year, with the addenda increase in the AEA contract, a range 6 addendum will be just under $4,000.

So for 6 regions, the total cost of that will be about $24,000 for those lead addendas. Okay, so what is the will of the board? Do we want to continue with this discussion and postpone item two, or shall. We. Extend for about maybe 15 minutes and beyond and do our second topic?

I don't believe we have enough time to do the second topic. Okay. And we need more time. And we'll need more time. Okay.

So thank you. Any other questions? We have about five minutes. Rachel. I see that question.

Go on.

And it's okay because we. You're catching up. I think this is a quick one and forgive me if it's not. I really like that this has like a looking forward task force team. Really like the word task force.

When we're talking about measuring our growth. Can you tell me how that team is filled and whether the AEA union, which is my understanding, the majority of our nurse, like the vast majority of our nurses, are certificated in the aea. Are they involved in recommending and nominating people to these task forces or do we form it ourselves in house? Actually, they. We had an application process and the applications were reviewed by myself, Diana Beltran Kali, who works out of my office, Ricardo, and one, one or both of the aea.

AEA president and then a unicerve director also looked at them and they gave input also. Okay. All right, Rach, you got a question? Three minutes. Oh, five minutes.

Okay. It's not a question. I'm just going to make a comment. I appreciated the numbers. You said it was eight that resigned this year.

So far we had 16 that resigned last year. And what was it before that was. 18 For the 23, 24 school year. Okay. So, yeah, I think I agree that when you look at those numbers, it doesn't look.

It's like, oh, well, maybe the nursing model isn't making people as upset. Except that what I hear from the public is very different. And so I guess what I worry about, again, it's more of a comment than a question. Just sort of a need to make sure that we are really reflecting about the long term consequences of decisions and not making any assumptions about how people feel or what might happen down the road based off what we're currently seeing now. Because I do think that a lot of times current staff are looking to see what might happen when we are in this sort of, will we get more money?

Will we not get more money? Will they sort of reverse course and restore some of the cuts, will they not? And they might be sort of holding on to wait and see if, if this model or, you know, it might be revised or more nurses brought back on board. And so my, again, my worry that I just see is a lot of it is sort of we need the staff that we currently have to not leave because we don't, we have a nursing shortage and we can't make an assumption that all these nurses aren't. That more aren't going to leave and that.

That we're going to retain everybody that we have now. And in. In that event, if in this nursing shortage and in a model, in a situation where we have more nurses resign because they aren't happy and whatever things that we don't know, I feel like then we're in a world of hurt of being even able to implement the model that you're describing now that might have benefits in some ways and that that impacts kids. So it's. It's like a model that very much necessitates having the people in place to facilitate even this coverage.

And anyway, I think that's just sort of. I don't want us to make assumptions about how people feel is. Is what I'm saying. Yeah. Okay.

All right. With that, I think. Thank you guys for your time and the information and putting together the report. Court. I'll entertain a motion to move into executive session for the purpose of legal, contractual and student hearings.

I'll move to executive session for the purpose of student hearings, legal updates and contractual updates. Second. Okay. Any opposition moved in? Second.

Moved by member McDonough. Second by member Higgins. Any opposition to the motion seen hearing? None. We are moving into executive session.