Texas School Nurses and Health Leaders Call for Urgent Clarification of SB 12 Implementation

FOR IMMEDIATE RELEASE       

Sept. 10, 2025

MEDIA CONTACT: 

Kate McDuffie
National Association of School Nurses
kmcduffie@nasn.org

Darrick Nicholas
Director of Communications
Texas Nurses Association
dnicholas@texasnurses.org   

Texas School Nurses and Health Leaders Call for Urgent Clarification of SB 12 Implementation

SILVER SPRING, MD — Texas school nurses are committed to protecting the health and safety of every student in our care. The recent implementation of Senate Bill 12 (SB 12), requiring written parental consent for all health-related services provided in schools, has created significant and immediate challenges for districts, families, and school health professionals.

SB 12 requires schools to notify parents of each health-related service offered at their child’s school and obtain written parental consent before providing any health services, administering medication, or conducting a medical procedure. The law also directs school districts to take disciplinary action against any school staff member who provides health-related services without that written consent.

We believe parents have a right to know what is happening at their child’s school, and consent is a cornerstone of healthcare in all settings. Our advocacy efforts support parental consent and parental involvement in student health. However, the language in SB 12 is excessively restrictive and unclear. It prohibits school nurses from providing care without parental consent, except in cases of emergency. That prohibition is paired with the threat of disciplinary action. For parents who are confused by these changes, it is important to know that school nurses are obligated to follow this strict prohibition or they risk discipline at the district-level as well as the professional licensing level with the Texas Board of Nursing. Nurses do not have the authority to change the laws imposed on them even in situations where they are clearly impractical.

Unfortunately, this strict prohibition’s implementation has added to the difficulty that school nurses and parents are facing. The Texas Education Agency (TEA) issued its initial guidance on August 28 with an effective September 1 date, leaving schools only one business day, before a holiday weekend, to implement the directive. For many school districts and families this was not adequate time to prepare or respond. It did not provide adequate notice to parents to process the changes and provide consent for services they would expect to be provided. Further complicating the situation, TEA revised its guidance on September 8. It would not be surprising if there are additional changes in implementation. TEA published a draft rule, which must go through a public notice and comment period before it is finalized. Based on the public’s feedback, the rule may change before it is adopted. This is a standard process under the Texas Administrative Procedures Act, however rule making is rarely caught up in situations that are this disruptive to parents’ lives. We want to provide clarity for the public and caution that we are aware of inaccurate information circulating on social media. School nurses are legally accountable to follow the law as written in SB 12 until official directives are finalized. Each district then has to implement the directives. Even the implementation process is limited in its legal authority. It must establish rules and guidance within the parameters of the law written by the Texas Legislature.

The uncertainty created by this law’s passage and implementation has left school nurses in the difficult position of being legally restricted from providing even the most basic first aid without signed parental consent. SB 12 provides no clear exemption for routine first aid or urgent but non-life-threatening situations, such as a playground injury, a bloody nose, or a sudden migraine. Parents reasonably expect immediate help in these circumstances, but without a signed form on file, that help may be delayed—through no fault of the nurse.

School nurses are allies to parents, guardians, and communities. We respect and honor parental rights, and we also know from decades of experience that students’ health needs are immediate, unpredictable, and sometimes life-threatening. The implementation of these new consent requirements has created unnecessary delays and significant risks for Texas students. Given this legal backdrop, it is important for parents to be aware of the limitations that have been placed on school nurses in the absence of parental consent.

We urge state leaders to work with educators, families, and health professionals to clarify this law and ensure that its application does not compromise timely student care in schools. Children should never be placed at risk because of procedural barriers or shifting guidance.

We call on policymakers to:

• Provide clear exemptions for emergency care and routine first aid.
• Ensure districts and families have reasonable timelines and tools for compliance.
• Engage with school nurses and healthcare professionals in shaping final guidance.

Our shared goal is safe, healthy, and ready-to-learn students. We remain committed to working with state leaders and families to uphold both parental rights and student well-being.

Signed:

Texas School Nurses Organization (TSNO)

Texas Nurses Association (TNA)

National Association of School Nurses (NASN)

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About NASN

The National Association of School Nurses (NASN) is a nonprofit specialty nursing organization, organized in 1968 and incorporated in 1977, representing school nurses exclusively. NASN has more than 18,000 members. The mission of NASN is to optimize student health and learning by advancing the practice of school nursing. To learn more about NASN, please visit us on the Web at www.nasn.org or call 866-627-6767.

About the Texas Nurses Association

The Texas Nurses Association (TNA) is a statewide membership-based professional association of licensed nurses. Founded in 1907, TNA is the most inclusive nursing association in Texas and the largest state nursing association in the country.

Our members represent all segments of nursing practice — bedside to administration, consulting to advanced practice, and education to legislation — and all practice settings, including hospital, home and community health, public health, higher education, long-term care, school health and policy. As diverse as they are, TNA members share a common purpose: Advancing excellence in nursing. Visit www.texasnurses.org.

About the Texas School Nurses Organization

The Texas School Nurses Organization is a 501(c)(6) non-profit professional association and a state affiliate of the National Association of School Nurses. As the only professional group in Texas solely representing school nurses, it serves as a unified voice for the specialty practice of school nursing in the state. TSNO partners with other organizations of similar focus to further advance its mission to enhance whole student wellness and learning by strengthening school nursing practice.