SAN ANTONIO – School district administrators across the San Antonio area are either developing or have already established guidelines to comply with aspects of Senate Bill 12 and its so-called “parental rights” provisions.
The law, which took effect on Sept. 1, requires schools to obtain parental consent before administering certain health services to students.
If certain services are rendered without parental consent, the law requires school districts to take disciplinary action against school employees who provide health services.
The new law has generated questions and confusion among school personnel about what they can or cannot perform in the execution of their respective job duties and professional oath.
On Sept. 8, the Texas Education Agency (TEA) issued updated guidance to clarify the parental consent law. On Sept. 11, the TEA issued To the Administrator Addressed (TAA) correspondence to districts to recap the changes.
In the latest version, the TEA states that districts and charter schools must “provide to the parent of each enrolled student written notice of each health-related service and health-care service offered at the campus the student attends.”
The TEA defined the difference between health-related and health-care services:
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Health-related services require notification but consent is assumed to be provided absent a parent submitting notification of their withholding of consent. Examples of health-related services are providing first aid, like Band-Aids, or checking a student’s temperature.
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Health-care services require parents to opt-in by providing active, informed consent before the service can be administered, absent emergency care situations. Examples include psychological or psychiatric treatment and other services that involve medical treatment, medical procedures or dispensing medication.
The notice must include a statement of the parents’ right to refuse or decline service, and clarify which services require opt-in and opt-out. It must also allow parents the opportunity to provide or withhold consent for the listed services and include instructions on how to notify the school of any changes with consent.
According to the Texas Tribune, this differs from the all-or-nothing strategy some schools have reportedly adopted.
In the TAA correspondence, the agency said the Sept. 8 guidance rule text is still in draft form and may be revised before it is published as a proposed rule. At that time, there will be an opportunity for public comment.
“Because of the need for further clarity that has been expressed to TEA regarding how school systems are implementing these sections of SB 12, especially for those school systems that have established a blanket opt-in requirement for all services, TEA expects those school systems to update their forms to align with this updated guidance and the original statute as quickly as is practical,” the TAA correspondence states.
KSAT contacted 12 of the largest school districts in and around San Antonio to learn how administrators are implementing the law.
Below are the districts’ responses:
Alamo Heights ISD
“The health and safety of students is a top priority. Related to your question about Senate Bill 12 and the handling of health-related services to students, the bill requires school districts to notify parents of certain health-related services a school offers with a specific notice of their right to withhold consent or decline a service.
“We have been working through determining the most efficient and effective way to provide that notice, collect the responses, and organize it in a user-friendly reference system for our staff. The Texas Education Agency just provided guidance 9/8/25 on how to interpret this part of Senate Bill 12, so we are reviewing that guidance before proceeding.”
Northside ISD
“In Northside, parents began receiving an email the week of Sept. 8 asking them to submit their consent preference for this school year. Subsequently, the consent process will be part of the regular registration/verification process. Parents can find more information on our New Parental Forms website which hosts responses to some frequently asked questions.
“Our priority will always be the safety and well-being of our students. Health-related services not requiring parental consent include general caretaking, response to medical emergencies, immediate student safety situations, support during illness or physical symptoms at school, heat illness prevention and injury support for student athletes.
“However, parents must give consent before schools can provide routine health services, such as administration of over-the-counter medications in accordance with the law, administration of prescription medications in accordance with the law, monitoring of chronic health conditions (e.g., asthma, diabetes), vision, hearing, and scoliosis screenings, lice screening, and Acanthosis screening (Texas risk assessment for Type 2 Diabetes in children).”
North East ISD
“TEA issued new draft rules just this week, so we’re still working through the guidance. Until then, we’re continuing to provide care to students who come to the clinic ill or injured.”
Schertz-Cibolo-Universal City ISD
“SCUC ISD has been complying with Senate Bill 12 and applying it with a common-sense approach. Prior to the updated TEA guidance on September 8th, nurses had been reaching out to families who had not yet submitted consent forms to explain how consent allows us to provide basic first aid and health services.
“Our partnerships with parents are essential, and above all, students will be cared for and safe.”
Somerset ISD
“School nurses will adhere to the standards of practice outlined in their nursing licensure to ensure the physical and mental health, as well as the safety, of our students.”
Southwest ISD
“Southwest ISD understands the requirements of Texas Senate Bill 12, which now mandates parental consent for non-lifesaving medical and health-related care provided in schools. This includes health-related services, nursing care, and routine screenings.
“To be in compliance with this law, we made a districtwide effort to inform families and secure completed consent forms. Through a coordinated communication effort, we shared reminders with parents across multiple channels, including social media, text messages, the district website, and our mobile app.
“Our priority remains ensuring that every student has access to the care they need during the school day, while keeping parents fully informed and involved in those decisions.”
This article will be updated as more districts respond to KSAT’s inquiry. Parents with any additional questions can submit them to 89th@tea.texas.gov.
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