Texas' new parental consent law leaves school nurses confused about
which services they can provide
[September 09, 2025]
By JADEN EDISON/The Texas Tribune
A new state law requiring schools to obtain parental consent before
administering health care services to students has triggered confusion
among campus nurses who worry they could face punishment for routine
acts like offering bandages or handing out ice packs.
The confusion is in response to Senate Bill 12, a sweeping law banning
diversity, equity and inclusion practices; instruction on sexual
orientation or gender identity; and LGBTQ+ student clubs. SB 12 comes as
part of a larger effort by Texas Republicans to shape how public schools
engage with students and their families on topics like race, racism,
gender and sex.
Incorporated into the law are what Republican lawmakers call “parental
rights” provisions, which include a requirement for Texas schools to get
written approval from parents before offering routine health assistance
and medication or conducting medical procedures. School districts are
required to take disciplinary action against any employees who provide
such services without consent.
In response, enforcement of the legislation has varied widely across the
state’s more than 1,200 school districts. Some have interpreted the law
as still allowing for regular care, like first-aid treatment and injury
evaluation. Others have indicated they will not assess or treat a
student except in life-threatening emergencies.
“When you write such a strict enforcement mechanism into a law, people
are going to take notice,” said Becca Harkleroad, executive director of
the Texas School Nurses Organization and certified school nurse. “Now
you’ve got nurses who are questioning if they can put a basket of
Band-Aids on their countertop.”
Rep. Jeff Leach, R-Allen, and Sen. Brandon Creighton, the Conroe
Republican chair of the Senate education committee, the authors of SB
12, sent a letter on Thursday to Texas Education Commissioner Mike
Morath, calling on his agency to “provide clear and consistent guidance”
to schools across the state.
“While we expect our educators to comply with the clear provisions of
the bill, we also expect them not to suspend common sense when it comes
to providing basic care for the children at their schools,” Leach wrote
in a social media post.
Neither Leach nor Creighton responded to requests for comment from The
Texas Tribune. The Texas Education Agency said in a statement that it is
revising its guidance to ensure schools receive clear direction. Updated
information will go out early next week, said Jake Kobersky, the
agency’s spokesperson.
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 As SB 12 made its way through the
legislative process earlier this year, nurses warned lawmakers that
without more specificity, the bill could have unintended
consequences. Harkleroad, the school nurse organization’s executive
director, said she recommended the law require consent for only the
activities the Legislature found most “questionable or
objectionable.” But lawmakers’ response over the course of this
year’s regular legislative session was that parents have the right
to know exactly what’s happening to their kids in school.
After the law passed and as the 2025-26 school year got closer, some
districts began preparing their consent policies. Others awaited
guidance from the Texas Association of School Boards and state
education officials, the latter of which did not arrive in their
inboxes until four days before the law took effect on Sept. 1.
The education agency’s guidance noted that parents retain the right
to make medical decisions for their children and that consent was
necessary prior to schools providing medical or health assistance,
unless it is for life-saving care.
Implementation has been inconsistent. Some district officials
provided robust consent forms to families, detailing the various
services school nurses may provide students and giving them the
option to opt in or out of each one.
Others, school nurses told the Tribune, took an all-or-nothing
approach.
“When you choose ‘no’ at that point, then we have to explain to the
parent, ‘you now know that anytime I see your child, I will have to
call you,’ then further making parents more upset, because they
don’t understand why you can do this but you can’t do that,” said
Diana Rios-Rodriguez, board president of the Texas School Nurses
Organization and director of health and wellness for the Manor
Independent School District, near Austin.
Nurses told the Tribune the confusion can be attributed to state
lawmakers not listening to the school professionals who know exactly
how their campuses function. And the solution may not be as simple
as people think.
“They want us to use common sense. Of course, we’re happy to use
common sense,” said Hollie Smith, president-elect of the nurses
organization and director of health services at North Texas’ Eagle
Mountain-Saginaw ISD. “But the question always is, is my license in
jeopardy? And that’s where a lot of, I think, our nurses are trying
to practice from right now and feeling really uneasy.”
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This story was originally published by The Texas Tribune and
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