Texas Law Allowing Parents to Opt Kids Out of Health Services Confuses School Nurses

Texas school nurses are facing unprecedented challenges following the implementation of Senate Bill 12, a new parental consent law that has fundamentally altered how they provide care to students. The legislation, which took effect September 1, 2025, requires schools to obtain express, annual written parental consent before administering some health services. The law is still not very clear, however. 

The challenges of this legal change have been immediate. In one widely reported incident, a student was sent home still covered in vomit because the school nurse allegedly thought they couldn't provide basic cleaning and care without documented parental consent. This case highlights the practical difficulties many school nurses now face when balancing legal compliance against their professional duty to care.

About The New Law

The law stipulates that districts must treat unsigned forms as an explicit denial of consent, creating a default position where care is withheld until paperwork is processed. According to data from the Texas School Nurses Organization, approximately 40% of parents had not completed the required consent forms within the first month of the 2025-2026 school year, leaving a significant portion of students without access to routine health services at school.

Implementation challenges have been compounded by inconsistent communication strategies across districts. Some schools proactively utilized online platforms and social media to notify parents and collect consent. Others experienced significant delays in distributing the necessary forms, leaving students vulnerable during the gap period.

Main Features of The Law

Schools are required to collect annual consent forms from parents or guardians for:

• Mental health counseling or check-ins
• Participation in district or campus-sponsored clubs/organizations
• Administration of medication and non-emergency medical procedures
• School staff may not provide these services or admit students to activities without current consent on file, except in emergency situations.
• The law also incorporates “parental rights” provisions, expanding parents’ ability to opt out or exempt their children from certain instruction—especially related to human sexuality, gender identity, and diversity, equity, and inclusion (DEI) programming.
• Schools must post parental rights information prominently on their websites and have grievance procedures for families who have concerns about school practices.

According to TEA, school nurses can provide general caretaking, even without an active parental consent on file including,

• Offering a change of clothing if necessary because of illness
• Assisting with cleaning up spills or other accidents
• Feeling a child’s forehead
• Checking for swollen throat
• Applying or handing out band aids
• Helping wipe a bloody nose without an active parental consent on
  file

The Texas Education Agency (TEA) has been criticized for providing insufficient guidance on implementation details. While official communications urge "common sense" approaches, school nurses report feeling caught between this vague directive and the strict legal language that could expose them to liability if they provide unauthorized care.

Nursing practice has been dramatically affected. School nurses now spend significant time verifying consent status before any intervention, creating delays in care delivery and adding administrative burden to already stretched resources. A survey conducted by Hamshire-Fannett ISD found that nurses spent an average of 90 minutes per day on consent verification tasks during the first weeks of implementation.

For students with chronic conditions requiring regular medication or monitoring, the stakes are particularly high. Parents have expressed mixed reactions. Some appreciate the increased transparency and control over their children's healthcare at school. Others find the annual renewal requirement burdensome and worry about gaps in care when forms are delayed or misplaced.

As districts refine their processes and communication strategies, Texas school nurses remain at the frontlines of this challenging transition, working to provide the best possible care within new legal constraints that have fundamentally changed their practice.

🤔 What are your thoughts on this new law?