On Feb. 17, 2026, a student lost consciousness during class at Paul Public Charter School (5800 Eighth St. NW). Despite the school’s health technician and other staff providing care, the student did not regain consciousness until emergency medical technicians arrived and began treatment. According to testimony by Kristin Yochum, executive director of operations, before the DC Council Committee on Health, “Our health tech and staff provided excellent maintenance care,” but the DCPS health technician “does not have the training to assess advanced medical needs.”
The student was transported to a hospital. “This is not an isolated incident,” Yochum added.
Weeks before students return to class, DC Health says it has filled 78% of the 201 health-suite positions planned for the coming school year. The agency is still recruiting nurses and health technicians to staff 187 participating public and public charter schools.
The vacancies add uncertainty to a system that was already providing uneven coverage. During the 2025-26 school year, only half of participating schools received 40 hours of health-suite coverage each week, while one-quarter received 24 hours or less, according to figures cited by the chair of the Committee on Health, Christina Henderson (I-At Large). A health-suite employee may be a registered nurse, a licensed practical nurse or a health technician, so even 40 hours of coverage does not necessarily mean a nurse is on campus full-time.
DC Health presented a staffing plan to a parent advisory committee on July 14 that calls for 44 clusters serving the 187 schools, an average of about four schools per cluster. At least one health-suite employee would be assigned to each campus, while a registered nurse would provide clinical guidance and support across the cluster.
The plan would add licensed nurses, shrink most clusters and restore a shorter epinephrine course for school employees. Parents who have pressed the District to place a full-time nurse in every school welcomed the changes. But DC Health has not said how many hours of care each campus will receive or how often its assigned employee will be a licensed nurse.
How the Cluster System Works
DC Health is a District agency separate from DC Public Schools (DCPS). Through its School Health Services Program, it provides and oversees health-suite staff at participating DCPS and public charter schools with approved health suites. Schools may opt out and hire their own nurses, but they remain responsible for meeting District health and immunization requirements.
DC Health introduced the cluster model in 2023 in response to a shortage of school nurses. Its original plan grouped four nearby schools, assigned each campus a full-time health-suite employee and placed two nurses and at least two health technicians within each cluster. Nurses perform clinical assessments and develop individualized health plans. Health technicians can provide first aid, administer authorized medications and perform other tasks under a nurse’s supervision, but they cannot independently assess advanced medical needs.
Most clusters later expanded to five schools under the Children’s National Hospital’s Children’s School Services (CSS) program, which then employed and managed health-suite staff through a grant from DC Health. In June 2025, DC Health brought the program in-house and began directly hiring and managing the staff. The agency told families that the change was intended to provide more consistent and direct oversight.
The transition did not immediately produce that consistency. DC Health reported an 18% vacancy rate among registered nurses and a 14% vacancy rate among licensed practical nurses and health technicians during the past school year. Director Dr. Ayanna Bennett described the first year of in-house management as tumultuous and gave the agency a B. Henderson called that grade “generous.”
Expanding clusters from four schools to five without announcing the change made supervision more difficult, Henderson said in a July 16 interview. “I think that if somebody’s managing four schools, that’s a little bit different than managing five, because you’re also starting to talk about a stronger or a longer geographic distance,” she said.
The new plan returns most clusters to roughly the size DC Health proposed in 2023. The agency’s July presentation did not explain the reason for that revision.
More Positions, but No Full-Time Promise
DC Health plans 201 health-suite positions for fiscal year 2026: 44 registered nurses, 47 licensed practical nurses and 110 health technicians. It described that as an increase from 185 positions in fiscal year 2025. However, the fiscal year 2025 categories listed in the same presentation ‒ 39 registered nurses, 32 licensed practical nurses and 104 health technicians ‒ add up to 175. DC Health had not explained the discrepancy by publication time.
As of July, the agency said 16% of the planned positions were filled by registered nurses, 15% by licensed practical nurses and 47% by health technicians. “DC Health is actively recruiting staff with the goal to have all positions hired by the start of SY26-27,” the agency said.
Even if all 201 positions are filled, the plan promises only that one health-suite employee will be assigned to each participating school. It does not guarantee 40 hours of weekly coverage or a full-time nurse at every campus.
The distinction has a complicated legal history. The DC Council passed a law in 2017 that would have required a registered nurse in every public and public charter school for at least 40 hours a week. But the requirement was contingent on funding, never took effect and was repealed in 2023. The operative District law requires at least 20 hours of registered-nurse services per week. At elementary and middle schools, licensed practical nurses may supplement registered nurses in meeting that minimum.
Robin Roesch, a practicing registered nurse and a member of Parents United for School Health, or PUSH, a volunteer parent organization that works to ensure adequate medical supervision in schools, said the cluster structure itself makes recruitment harder. “As a practicing nurse with experience in nurse recruitment, I can say clearly the current structure makes school nursing significantly less attractive,” Roesch told the council in February. Managing coverage gaps and floating between buildings, she said, “is not a sustainable model.”
Parents See Signs of Progress
Sarah Buckley, an Amidon-Bowen Elementary School parent and PUSH member, entered the July 14 meeting with DC Health frustrated by a model that reduced the number of nurses while increasing their supervisory responsibilities. “You’ve designed a system that will be driving nurses out because you are fundamentally changing the job,” she told Hill Rag before the meeting. “You’re putting nurses’ licenses at risk because they are supposed to be remotely supervising health technicians at schools miles away.”
Afterward, Buckley called the discussion “one of the most positive meetings we have had so far.” She credited Dr. Sara Beckwith, senior deputy director of DC Health’s Community Health Administration, with listening to parent concerns and trying to address them.
One concrete change is the return of an hour-long epinephrine certification course during the 2026–27 school year. DC Health previously offered a short course that allowed teachers and other school employees to recognize a severe allergic reaction and administer an EpiPen without completing the longer Administration of Medication (AOM) training. The agency discontinued the shorter course last school year.
Buckley’s son has life-threatening food allergies, and his teachers had traditionally taken the shorter course. “Taking away an EpiPen training makes my son less safe,” she testified in February. “It doesn’t increase the number of AOMs; it just increases the chance that my son and others will not have access to an adult who can identify and respond to allergic emergencies.”
District law generally requires schools to have at least two employees trained to administer medication whenever students are present, separate from health-suite personnel. Four schools had no certified Administration of Medication employees and 29 had only one when oversight data were compiled. DC Health said it was working with those schools and that some employees may still have been completing certification.
Coverage Depends on Documented Need
DC Health says it assigns staff according to health-suite use and the number of students with serious or treatment-intensive conditions, including high-risk allergies and procedures such as catheterization. That calculation depends partly on Universal Health Certificates (UCH), medication forms and other information supplied by families.
Only 28% of students had a UHC on file in fiscal year 2025, according to council oversight testimony. When families submit forms or enrollment changes, a school’s documented needs can shift, prompting DC Health to move nurses during the year. Henderson said the District needs an electronic system that reliably receives health information from medical providers.
The consequences of thin or mismatched staffing become clearest during an emergency. PUSH survey respondents described vacant health suites and a lack of trust. “My son takes medication,” one parent wrote, “and we didn’t send his second dose because I have no confidence that someone would have administered it at lunchtime.”
Other Staffing Options
Henderson does not view the cluster model as a permanent solution to staffing school health suites, although she said it may remain the District’s reality while the workforce and funding are constrained. She also stopped short of calling for a registered nurse at every campus, noting that school enrollment and student medical needs vary widely.
“I do feel like the agency needs to be doing a better job with managing this program, now that it has gone from Children’s (Children’s National Hospital’s) to in-house; it was a rocky start,” Henderson said. She called for better communication with families, public comparisons between District school-nurse salaries and those in surrounding jurisdictions and a clearer explanation of how schools qualify for nursing staff.
Sixteen schools opted to hire their own nurses during the 2025-26 school year. Some, including the SEED Public Charter School, need more hours because students board on campus. Henderson said DC Health should consider grants that would allow interested charter schools to employ nurses directly, similar to a school-based behavioral health pilot, and should publish the costs of several staffing models.
She also suggested that assigning a nurse to two nearby schools could make the cluster model less burdensome, even if the District cannot immediately fund one nurse for every campus. DC Health said it is not considering a charter-school grant pilot and raised questions about how schools would cover absences when a directly employed nurse is sick or on leave.
PUSH members worry that allowing individual schools to buy additional coverage could leave wealthier communities with full-time nurses while other students remain in a weakened cluster system. Their goal remains a full-time licensed nurse in every public and public charter school, accompanied by public staffing benchmarks and coverage data.
For now, the July plan represents movement without resolving that dispute. DC Health plans for smaller clusters, an increased number of licensed nurses and more school employees able to respond to allergic emergencies. But with the first day of school approaching, families still cannot tell from the plan how many hours their health suite will be open or whether a nurse will be in the building during an emergency.
The DC Nurses Association did not respond to requests for comment by publication time.
