One day last month, Lisa Sutter's 7-year-old great-granddaughter, Carmen, came home and told her she had gone to her school nurse in the Carrollton-Farmers Branch school district, but was turned away.
"She says there's some form you have to sign because they wouldn't let me stay in the nurse's office today," Sutter said. "And I'm like, what are you talking about?"
Carmen was talking about a form required under Senate Bill 12, Texas' sprawling new education law. Sutter had already signed the district's own permission slip – but the new law demanded new signatures before any student could legally receive care. Sutter hadn't signed that form yet.
Carmen has type 1 diabetes, requires insulin, and therefore already qualifies for a nurse's attention. Sutter complained to the school board during a September meeting.
"We have a district that appears to have required denial of care until a form was signed," she told trustees. "The over-lawyered interpretations are concerning.
Supporters of SB 12 call it a parental rights law. It requires, among other things, parental permission before a school employee can deliver physical or mental health care. But it's caused confusion among families like Sutter's and school nurses now worried about inadvertently breaking the law.
The National Association of School Nurses and the Texas Nurses Association said in a joint statement last month the law has "created significant and immediate challenges" for districts, families and health professionals – not because of the law itself, but because of unclear wording in a paragraph or two out of the 38-page document.
Jack Frazee, general counsel for the Texas Nurses Association, said much of the confusion revolves around the terms health care services and health related services. They may sound the same, he said, but they're not.
"There are different requirements depending on whether you're delivering a health care service or a health-related service," he said. "And it wasn't always clear what services fell into which term."
School nurses, as a result, worry they might break the new law without realizing it. Becca Harkleroad, executive director of the Texas School Nurses Organization, said it's getting in the way of caring for kids.
"The law was very clear that if you provided any services without written consent, disciplinary action was coming your way," she said. "So that gave a lot of people pause."
Some of those people include school administrators across North Texas. Wendy Eldredge is the superintendent of Carrollton-Farmers Branch ISD, where Lisa Sutter's great-granddaughter attends school.
"There has been a lot of confusion, and I don't think it was defined clearly from the beginning," Eldredge said during the September board meeting.
The bill's authors, state Rep. Jeff Leach and state Sen. Brandon Creighton, acknowledged the confusion last month. In response to "reports that some educators and school nurses are refusing to render basic first aid to children," Leach posted on X that he and Creighton expect educators "not to suspend common sense when it comes to providing basic care for the children at their schools."
Addressing her school board last month, Lisa Sutter also urged common sense.
"I don't think they're using common sense, applying this for everyday stuff," said Sutter. "I read the bill and based on everything I see, I don't believe it covers Band-Aids and ice packs. I don't believe it. Not one thing I saw in there tells me that."
But to be on the safe side, Sutter has since signed the SB12 permission form. And to clear up any ongoing confusion, the bill's authors have also asked the Texas Education Agency for "consistent and clear" guidance on how to implement the law so schools and nurses know they're in compliance; the TEA released updated guidance last month, but Jack Frazee with the Texas Nurses Association, said he's waiting for additional details from the agency.
"Those details of when do you notify and how does that happen and do you need consent beforehand?" he said. "Those were the things that even nurses were confused about based on the way the bill was written. And that's what we're trying to get clarity in."
Bill Zeeble is KERA's education reporter. Got a tip? Email Bill at bzeeble@kera.org. You can follow him on X @bzeeble.
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