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)

What staff must be certified in CPR and First Aid?

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.

EDUCATION CODE CHAPTER 33. SERVICE PROGRAMS AND EXTRACURRICULAR ACTIVITIES (texas.gov)

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)

Are there requirements on offering CPR and automated external defibrillator (AED) training?

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)

Are LEAs required to have AEDs?

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)

Are LEAs required to have AEDs at University Interscholastic League (UIL) athletic practices and competitions?

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.

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

Are students required to complete CPR training prior to graduation?

Does the student training have to result in certification?

Must the student training include a hands-on (psychomotor) component?

Who may instruct the CPR training for students?

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.

Does completion of the required CPR training need to be documented on the student’s transcript?

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)

Which staff are required to receive bleeding control training?

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)

Is the bleeding control training for staff an annual requirement?

Are students required to receive training on STOP the Bleed?

What bleeding controlled training courses are approved for use by the Texas Education Agency (TEA)?

Where should bleeding control stations at campuses be located?

School Health Survey

What is the School Health Survey?

Who should complete the School Health Survey?

When is the School Health Survey due?

Health Education

Is health education required in elementary school?

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)

Is health education required in middle school?

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.

Is health education a requirement in high school to graduate?

Where can a LEA find additional resources to support offering health education as a graduation requirement?

Sexual Education

What is the role of the SHAC in regards to sexual education curriculum selection?

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)

When can a SHAC review and make recommendations to the board on the district’s sexual education curriculum?

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)

Does the human sexuality instruction taught have to be abstinence based?

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.

Can a LEA distribute condoms in connection with the human sexuality instruction?

Are LEAs allowed to separate students based on sex for the human sexuality instruction?

Are LEAs required to notify parents regarding human sexuality instruction?

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)

Are parents/guardians allowed to opt their students out of participation in human sexuality instruction?

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

What is p.a.p.a. Training?

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)

What content is included in the p.a.p.a. training?

Where can I learn more information about the p.a.p.a. training program?

E-Cigarettes

Are LEAs required to provide instruction to prevent the use of e-cigarettes?

Where can a LEA find additional resources on providing instruction in schools to prevent the use of e-cigarettes?

Is smoking or the use of e-cigarettes allowed on school property?

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

Are there any requirements regarding instruction on opioid addiction?

Where can a LEA get additional information and resources on Fentanyl prevention resources?

Additional Questions

Is there a list of recommended best practice resources for school districts to utilize for mental health promotion/intervention, substance abuse prevention/intervention, and suicide prevention?

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

Were the Health Education and Physical Education Texas Essential Knowledge and Skills (TEKS) updated?

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.

Information on the new Health Education TEKS review can be found at the following web address: Health Education TEKS Review | Texas Education Agency
Information on the Physical Education TEKS review can be found at the following web address; Physical Education TEKS Review | Texas Education Agency

Health Education

Health Education FAQ

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

Bleeding Control Training (STOP the Bleed)

School Health Survey

Health Education

Sexual Education

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

E-Cigarettes

Opioid Addiction

Additional Questions

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