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Programs and Services » School Health and Nursing » Health Education

Health Education

Health Teachers serve an important role in our PreK-12 classrooms, educating students on concepts to support the development of healthy habits that can last a lifetime.  It is important for Health Teachers to stay up-to-date on current issues impacting the health and well-being of our youth.  In addition, as legislation changes, Health Teachers need to be aware of new mandates and requirements related to educating students on social, emotional, and physical well-being. Common questions related to Health Education are addressed below. 

 

Health Education FAQ

Cardiopulmonary Resuscitation (CPR) and Automated External Defibrillators (AEDs)

The Texas Education Code §33.086 states the following individuals must be certified in CPR and First Aid: A school district employee who serves as the head director of a school marching band or as the head coach or chief sponsor for an extracurricular athletic activity, including cheerleading, sponsored or sanctioned by a school district or the University Interscholastic League must maintain and submit to the district proof of current certification in first aid and cardiopulmonary resuscitation issued by the American Red Cross, the American Heart Association, or another organization that provides equivalent training and certification.
 
 
Additional staff at the school district may be required to maintain certification in CPR and First Aid related to health care licenses/certifications (i.e. Registered Nurse, Athletic Trainer)
The Texas Education Code §28.902 states that a school district must annually make available to district employees and volunteers instruction in CPR and the use of an AED. In addition, each school nurse, assistant school nurse, athletic coach or sponsor, physical education instructor, marching band director, cheerleading coach, and any other school employee specified by the commissioner and each student who serves as an athletic trainer must participate in the instruction in the use of an AED.  These individuals must also receive and maintain certification in the use of an AED from the American Heart Association, the American Red Cross, or a similar nationally recognized association.
 

EDUCATION CODE CHAPTER 22. SCHOOL DISTRICT EMPLOYEES AND VOLUNTEERS (texas.gov)

Yes, the Texas Education Code §38.017 requires each school district to have at least one AED available at each campus in the district. In determining the location to store the campus AED, the principal of the campus shall consider the primary location on campus where students participate in athletic activities.
 
Each LEA shall ensure the presence of at least one campus/district employee at each location at which an AED is required at any time a substantial number of district students are present at the location.
 

EDUCATION CODE CHAPTER 38. HEALTH AND SAFETY (texas.gov)

Yes, the Texas Education Code §38.017 requires a campus AED be readily available during any University Interscholastic League athletic competition held on the campus.
 
To the extent practicable, each LEA, shall make reasonable efforts to ensure that an AED is available at each UIL athletic practice held at a district campus.
 
Each LEA, shall determine the extent to which an AED must be available at each UIL athletic competition held at a location other than a district campus. The determination must be based on relevant medical information and whether emergency services personnel are present at the athletic competition under a contract with the school district.
 
Yes, The Texas Administrative Code (Title 19, Chapter 74, Subchapter C, §74.38) specifies that school districts and open-enrollment charter schools must provide instruction in cardiopulmonary resuscitation (CPR) between the grades of 7-12.
 

TAC §74.38 Texas Administrative Code (state.tx.us)

No, the CPR instruction for students is not required to result in certification. If the instruction is intended to result in CPR certification, the course instructor must be authorized to provide the instruction by the American Heart Association, the American Red Cross, or a similar nationally recognized association. TAC §74.38(d)
Yes, the training must use nationally recognized, evidence-based guidelines for emergency cardiovascular care and incorporating psychomotor skills to support the instruction. TAC §74.38(b)(2)
The TAC §74.38(c) specifies the following individuals may instruct the CPR training for students: emergency medical technicians, paramedics, police officers, firefighters, representatives of the American Heart Association or the American Red Cross, teachers, other school employees, or other similarly qualified individuals to provide CPR instruction and training under this section. Except as specified in subsection (d) of this section, an instructor of this training is not required to be certified in CPR.
Yes, the Texas Administrative Code (Title 19, Chapter 74, Subchapter A, 74.5(j)) states: A student who completes the required instruction in cardiopulmonary resuscitation (CPR) as specified in §74.38 of this title (relating to Requirements for Instruction in Cardiopulmonary Resuscitation (CPR)) in Grade 9, 10, 11, or 12 shall have completion of the CPR instruction clearly indicated on the academic achievement record.
 

TAC §74.5: Texas Administrative Code (state.tx.us)

 

Bleeding Control Training (STOP the Bleed)

The Texas Education Code, §38.030 requires that agency-approved training on the use of a bleeding control station in the event of an injury to another person be provided to the following LEA staff:
  • each school district peace officer or school security personnel employed who provides security services at the campus;
  • each school resource officer who provides law enforcement at the campus; and
  • all other district or school personnel who may be reasonably expected to use a bleeding control station
 

EDUCATION CODE CHAPTER 38. HEALTH AND SAFETY (texas.gov)

Yes, the bleeding control training is an annual training requirement for staff specified in Texas Education Code §38.030.
Each LEA is required require to annually offer instruction on the use of a bleeding control station to students enrolled at the campus in grade seven or higher.  The instruction must be provided by a school resource officer or other appropriate district or school personnel who has received the state-approved training.
The list of bleeding control training programs approved by TEA that meet all requirements outlined in the Texas Education Code §38.030 can be found on the TEA website at the following web address: Healthy and Safe School Environment of the Coordinated School Health Model | Texas Education Agency
The Texas Education Code §38.030 specifies that bleeding control stations are to be stored in easily accessible areas of the campus that are selected by the LEA's school safety, which may be areas of the campus where automated external defibrillators are stored.
 

School Health Survey

The Texas Education Code §38.0141 requires each school district and public charter school to submit information regarding school health and physical activity. The Texas Education Agency (TEA) utilizes the School Healthy Survey to collect this information from LEAs.
 
The School Health Survey gathers data regarding the School Health Advisory Council (SHAC), Physical Education, School Health, recess, Coordinated School Health programming, mental health/suicide prevention, and district policies, thus completion of the survey will require a team approach involving individuals familiar with the work done in each of these areas.
Typically, the School Health Survey is made available in January and due at the end of May. The Information is submitted electronically through an online survey.
 

Health Education

Yes, the Texas Administrative Code Rule §74.2 states that a school district that offers kindergarten through Grade 5 must provide instruction in the required curriculum as specified in §74.1 of this title (relating to Essential Knowledge and Skills). The district must ensure that sufficient time is provided for teachers to teach and for students to learn English language arts and reading, mathematics, science, social studies, fine arts, health, physical education, technology applications, and to the extent possible, languages other than English. Texas Administrative Code (state.tx.us)
 
The Texas Education Code §28.002 and Texas Administrative Code §74.1 includes as part of the required curriculum, an enrichment curriculum that includes health education.
 
The Texas Essential Knowledge and Skills for Health Education for Elementary School can be found in the Texas Administrative Code, Title 19, Part 2, Chapter 115, Subchapter A: Texas Administrative Code (state.tx.us)
Yes, the Texas Administrative Code Rule §74.3 states a school district that offers Grades 6-8 must provide instruction in the required curriculum as specified in §74.1 of this title (relating to Essential Knowledge and Skills). The district must ensure that sufficient time is provided for teachers to teach and for students to learn English language arts, mathematics, science, social studies, at least one of the four disciplines in fine arts (art, dance, music, theatre), health, physical education, technology applications, and to the extent possible, languages other than English. Texas Administrative Code (state.tx.us)
 
The Texas Education Code §28.002 and Texas Administrative Code §74.1 includes as part of the required curriculum, an enrichment curriculum that includes health education.
 
The Texas Essential Knowledge and Skills for Health Education for Middle School can be found in the Texas Administrative Code, Title 19, Part 2, Chapter 115, Subchapter B Texas Administrative Code (state.tx.us)
 
Note: The TEKS for grade 6 stand-alone and must be taught in full during grade 6. The TEKS for grades 7-8 are combined, it is a local decision as to when the during grades 7 and 8 the health TEKS will be taught.
No, there is not a state requirement for a student to take a health education course to graduate. A LEA may make health education a local graduation requirement or choose to offer health education as a high school elective course.
The Texas School Health Advisory Committee (TSHAC) created a document called: Recommendation and Research on Health Education for all Texas students, Kindergarten through 12th grade, which can be found at the following web address: School Health Advisory Committee: Recommendations (state.tx.us)
 

Sexual Education

The Texas Education Code §28.004(c)(3) specifies that the local school health advisory council's duties include recommending appropriate grade levels and methods of instruction for human sexuality instruction.
 
The Texas Education Code §28.004(e) requires that any course materials and instruction relating to human sexuality, sexually transmitted diseases, or human immunodeficiency virus or acquired immune deficiency syndrome be selected by the board of trustees with the advice of the local school health advisory council.
 

EDUCATION CODE CHAPTER 28. COURSES OF STUDY; ADVANCEMENT (texas.gov)

HB 1525 passed during the 87th legislative session and amended the Texas Education Code §28.004(e-1) requiring the school board to adopt a policy establishing a process for the adoption of sexual education curriculum. The policy must include the following:
  • The board to adopt a resolution to convene the SHAC for the purpose of making recommendations regarding curriculum materials.
  • The SHAC to hold at least two public meetings on the curriculum prior to adopting recommendations.
  • The SHAC to provide the recommendations to the board at a public-school board meeting.
  • The board take action on adoptions of the recommendations by a record vote at a public meeting.
 
A copy of HB 1525 can be found at the following web address: 87(R) HB 1525 - Enrolled version - Bill Text (texas.gov)
Yes, the Texas Education Code §28.004(e)(1-5) requires that any course materials and instruction relating to human sexuality, sexually transmitted diseases, or human immunodeficiency virus or acquired immune deficiency syndrome must:
  • present abstinence from sexual activity as the preferred choice of behavior in relationship to all sexual activity for unmarried persons of school age;
  • devote more attention to abstinence from sexual activity than to any other behavior;
  • emphasize that abstinence from sexual activity, if used consistently and correctly, is the only method that is 100 percent effective in preventing pregnancy, sexually transmitted diseases, infection with human immunodeficiency virus or acquired immune deficiency syndrome, and the emotional trauma associated with adolescent sexual activity;
  • direct adolescents to a standard of behavior in which abstinence from sexual activity before marriage is the most effective way to prevent pregnancy, sexually transmitted diseases, and infection with human immunodeficiency virus or acquired immune deficiency syndrome.
  • teach contraception and condom use in terms of human use reality rates instead of theoretical laboratory rates, if instruction on contraception and condoms is included in curriculum content.
No, the Texas Education Code §28.004(f) states a school district may not distribute condoms in connection with instruction relating to human sexuality.
Yes, The Texas Education Code §28.004(g) states a school district that provides human sexuality instruction may separate students according to sex for instructional purposes.
Yes, HB 1525 passed during the 87th legislative session amended the Texas Education Code §28.004(i) adding to the requirements for parent notification regarding human sexuality instruction.  The school district is required, before the start of each school year, to provide written notice to parents of the board of trustees' decision regarding whether the district will provide human sexuality instruction to district students.  If instruction will be provided, the notice must include:
  • A statement informing the parent of the human sexuality instruction requirements under state law;
  • A detailed description of the content of the district’s human sexuality instruction and a general schedule on which the instruction will be provided.
  • A statement of the parent's right to, at the parent’s discretion:
    • Review or purchase curriculum materials; and
    • remove the student from any part of the district's human sexuality instruction without subjecting the student to any disciplinary action, academic penalty, or other sanction imposed by the district or the student's school;
    • use the grievance procedure or the appeals process concerning a complaint or violation of this section;
  • A statement that any curriculum in the public domain must be posted on the district’s website and the website address at which the curriculum materials are located; and
  • Information describing the opportunities for parental involvement in the development of the curriculum to be used in human sexuality instruction, including information regarding the local school health advisory council.
 
Before a student may be provided with human sexuality instruction, a district must obtain the written consent of the student’s parent. The written consent may not be included with any other notification or request for consent provided to the parent and must be provided to the parent not later than the 14th day before the human sexuality instruction is scheduled to begin.
 
A copy of HB 1525 can be found at the following web address: 87(R) HB 1525 - Enrolled version - Bill Text (texas.gov)
Yes, the Texas Education Code §28.004(i)(2)(b) allows parents the right to remove their student from any part of the district's human sexuality instruction without subjecting the student to any disciplinary action, academic penalty, or other sanction imposed by the district or the student's school.
 

Parenting and Paternity Awareness (p.a.p.a.)

The Texas Education Code §28.002(p) requires the State Board of Education and the Office of the Attorney General to develop a parenting and paternity awareness program that a school district shall use in the district's high school health curriculum. The training that was developed to meet this requirement is the p.a.p.a. training program. EDUCATION CODE CHAPTER 28. COURSES OF STUDY; ADVANCEMENT (texas.gov)
The p.a.pa. training includes information over: responsible parenting, a basic overview of paternity and child support laws, healthy relationships skills, financial implications of becoming a parent, impact of father involvement, benefits of stable family relationships on children, and relationship violence prevention.
The Texas Attorney General website has additional information about the p.a.p.a. training and curriculum at the following web address: Parenting and Paternity Awareness | Office of the Attorney General (texasattorneygeneral.gov)
 

Youth Risk Behavior Survey (YRBS)

The YRBS is a federally funded survey of students used to monitor health-related behaviors that contribute to the leading causes of death and disability among youth and adults. The survey also measures the prevalence of obesity and asthma and other health-related behaviors plus sexual identity and sex of sexual contacts.  The behavior categories included in the survey are:
  • Behaviors that contribute to unintentional injuries and violence
  • Sexual behaviors related to unintended pregnancy and sexually transmitted diseases, including HIV infection
  • Alcohol and other drug use
  • Tobacco use
  • Unhealthy dietary behaviors
  • Inadequate physical activity
More information can be found on the Centers for Disease Control and Prevention Youth Risk Surveillance System website at the following web address: YRBSS | Youth Risk Behavior Surveillance System | Data | Adolescent and School Health | CDC
The YRBS is conducted biennially (every other year) in odd-numbered years (2019, 2021, 2023, etc.).
The data from the YRBS is used to track trends in student health-related behavior, monitor progress towards meeting health-related objectives, and to provide important data to identify public health problems, develop policy and interventions, and promote preventative health practices and behaviors.
No, participation in the YRBS is voluntary and not required by LEAs. If a LEA administers the survey, student participation requires parent/guardian permission and students are not required to respond to any questions they are not comfortable with answering.
The Texas Department of State Health Services has a Texas Youth Risk Behavior Surveillance System website that includes data briefs and results, the Texas YRBS calendar, and YRBSS Questionnaires. Texas Department of State Health Services, YRBS Home Page
 

E-Cigarettes

Senate Bill 489 was passed during the 85th Texas Legislative session, which added recommendations on the development of policies, procedures, strategies, and curriculum to prevent the use of e-cigarettes to the duties of the local School Health Advisory Council (SHAC). Texas Legislature Online - 85(R) Text for SB 489
The Texas School Health Advisory Committee (TSHAC) created a document called: Research and Recommendations on Instruction in Public Schools to Prevent the Use of E-Cigarettes, which can be found at the following web address: School Health Advisory Committee: Recommendations (state.tx.us)
No, the Texas Education Code §38.006 requires the board of trustees of a school district to prohibit smoking or using e-cigarettes or tobacco products at a school-related or school-sanctioned activity on or off school property; prohibit students from possessing e-cigarettes or tobacco products at a school-related or school-sanctioned activity on or off school property; and ensure that school personnel enforce the policies on school property. EDUCATION CODE CHAPTER 38. HEALTH AND SAFETY (texas.gov)
 

Opioid Addiction

Yes, the Texas Education Code 28.004(c)(6) includes as a duty of the local school health advisory council recommending appropriate grade levels and curriculum for instruction regarding opioid addiction and abuse and methods of administering an opioid antagonist. EDUCATION CODE CHAPTER 28. COURSES OF STUDY; ADVANCEMENT (texas.gov)
The Texas Education Agency has developed a resource page for LEAs on their website, which can be downloaded from the TEA website at the following web address: Fentanyl Response Communications Toolkit
 

Additional Questions

Yes, the Texas Education Code §38.351 requires the Texas Education Agency, in coordination with the Health and Human Services Commission and regional education service centers, to provide and annually update a list of recommended best practice-based programs and research-based practices for implementation in public elementary, junior high, middle, and high schools within the general education setting. Each school district may select from the list programs appropriate for implementation in the district. The list must include programs and practices in the following areas:
  • early mental health prevention and intervention;
  • building skills related to managing emotions, establishing and maintaining positive relationships, and responsible decision-making;
  • substance abuse prevention and intervention;
  • suicide prevention, intervention, and postvention;
  • grief-informed and trauma-informed practices;
  • positive school climates;
  • positive behavior interventions and supports;
  • positive youth development; and
  • safe, supportive, and positive school climate.
The list of best practice resources can be found on the TEA website at the following web address: Mental Health and Behavioral Health | Texas Education Agency
Yes, both the Health Education and Physical Education TEKS were recently reviewed, revised, and adopted by the State Board of Education. The new Health Education and Physical Education TEKs will be effective on August 1, 2022, and required to be implemented in the classroom beginning with the 2022–2023 school year. 

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