Health Education Frequently Asked Questions

General

1. Are all K-5 schools required to offer health education instruction?

Yes. According to Texas Education Code (TEC) §28.002(a)(2)(B) and Texas Administrative Codes

(TAC) §74.1(a)(2)(B) and §74.2(a), K-5 campuses must teach the Texas Essential Knowledge and

Skills (TEKS) for health education. A school district may add elements at its discretion but must

not delete or omit instruction.

2. Are all 6-8 schools required to offer health education instruction?

Yes. According to TEC §28.002(a)(2)(B) and TAC §74.1(a)(2)(B) and §74.3(a), 6-8 campuses must

teach the TEKS for health education. A school district may add elements at its discretion but

must not delete or omit instruction.

All of the TEKS for grade 6 must be taught and students must demonstrate proficiency. For grades 7-8,

all TEKS must be taught and students must demonstrate proficiency as well; however, districts

have the flexibility of when and how to offer the course in whatever instructional arrangement

they choose.

3. Is health education a requirement for high school graduation?

No. Health education is not required for high school graduation but a local school district may

offer additional opportunities for students to select health education as an elective course.

4. Are students allowed to take high school health in middle school?

Yes. The TAC §74.26(b) states that districts may offer courses designated for Grades 9-12 in

earlier grade levels. A course must be considered completed and credit must be awarded if the

student has demonstrated achievement by meeting the standard requirements of the course,

including demonstrated proficiency in the subject matter, regardless of the time the student

received instruction in the course or the grade level at which proficiency was attained.

The academic achievement record (transcript) shall reflect that students have satisfactorily

completed courses at earlier grade levels than Grades 9-12 and have been awarded state

graduation credits. The teacher must also have secondary certification in health for high school

credit to be awarded.

5. What are the required number of hours or days needed to complete elementary, middle,

and high school health education?

According to TAC §74.2(a), §74.3(a)(1), and §74.3(b)(1), a school district must ensure that

sufficient time is provided for teachers to teach and students to learn all of the TEKS for the

course. A minimum and/or maximum number of hours or days is not provided.

6. Can Health Science Technology courses be substituted for high school health courses?

Substitutions for high school health education are a local district’s decision if a district chooses

to keep health education as a local credit requirement only. For more information, you may

view the graduation requirements.

7. What are the requirements for cardiopulmonary resuscitation (CPR)?

Cardiopulmonary resuscitation (CPR) instruction must be provided to each student at least once

before graduation from high school according to TEC §28.0023 and TAC §74.38, which state a

school district or an open-enrollment charter school shall provide instruction to students in

Grades 7-12 in cardiopulmonary resuscitation (CPR).

Delivery of Instruction

 CPR instruction may be provided as a part of any course. The instruction must include

training developed by the American Heart Association or the American Red Cross, or use

nationally recognized, evidence-based guidelines for emergency cardiovascular care and

incorporate hands-on practice to support cognitive learning.

Approved Instructors

 A school district or an open-enrollment charter school may use 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 instruction and training.

Certificates of Completion

 The required CPR instruction does not have to result in certification. If the instruction is

intended to result in certification in CPR, 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.

Waivers

 A school district or an open-enrollment charter school may waive the requirement

under this section for a student, who due to a disability, is unable to complete the

requirement. The determination regarding a student's ability to complete the CPR

requirement will be made by:

 the student's admission, review, and dismissal (ARD) committee if the student receives

special education services under the Texas Education Code (TEC), Chapter 29,

Subchapter A

 the committee established for the student under Section 504, Rehabilitation Act of 1973

(29 United States Code, §794) if the student does not receive special education services

under the TEC, Chapter 29, Subchapter A, but is covered by the Rehabilitation Act of

1973.

The rule further states that this section applies to any student who entered Grade 7 in the

2010-2011 school year and thereafter.

Coordinated School Health Programs

1. What is a coordinated school health (CSH) program?

TEC §38.013 states coordinated school health (CSH) programs are programs designed to

prevent obesity, cardiovascular disease, and Type 2 diabetes in elementary school, middle

school, and junior high school students.

Each coordinated school health program must provide for coordinating: health education,

which includes oral health education, physical education (PE), physical activity (PA), nutrition

services, and parental involvement.

2. Are school districts required to implement CSH programs?

Yes. The TEC §38.014 states each school district shall participate in appropriate training for the

implementation of the approved CSH programs under TEC §38.013 and implement coordinated

school health programs in each elementary school, middle school, and junior high school in the

district.

3. Are open enrollment charter schools required to implement CSH programs?

Yes. According to TEC §12.104(2)(K), open enrollment charter schools are subject to health and

safety under Chapter 38.

4. What are the CSH programs approved by the Texas Education Agency (TEA)?

For a list of CSH programs that have been approved for elementary, middle, and junior high

school please visit

http://tea.texas.gov/Texas_Schools/Safe_and_Healthy_Schools/Coordinated_School_Health/A

pproved_Coordinated_School_Health_Programs/

School Health Advisory Councils

1. What is a school health advisory council (SHAC)?

As defined by the Texas Department of State Health Services (DSHS), a SHAC is appointed by

the school district to serve at the district level and to provide guidance to the district on

coordinated school health programming and its impact on student health and learning. The

group of individuals represent segments of the community. More information regarding school

health advisory councils can be found on the DSHS website.

2. Are schools required to have a SHAC?

Yes. According to TEC §28.004(a), the board of trustees of each school district shall establish a

local SHAC to assist the district in ensuring that local community values are reflected in the

district's health education instruction.

Open-enrollment charter schools are not required by law to have a SHAC but it would be

considered a best practice.

3. What are the required duties of a SHAC?

The local SHAC's duties include recommending:

 the number of hours of instruction to be provided in health education

 curriculum appropriate for specific grade levels designed to prevent obesity,

cardiovascular disease, Type 2 diabetes, and mental health concerns

 appropriate grade levels and methods of instruction for human sexuality instruction

 strategies for integrating the curriculum components

 if feasible, joint use agreements or strategies for collaboration between the school

district and community organizations or agencies

4. What are the membership requirements of a SHAC?

The TEC §28.004(d) states that the board of trustees shall appoint at least five members to the

local SHAC. A majority of the members must be persons who are parents of students enrolled in

the district and who are not employed by the district. One of those members shall serve as

chair or co-chair of the council. The board of trustees may also appoint one or more persons

from each of the following groups or a representative from a group not listed below

 public school teachers;

 public school administrators;

 district students;

 health care professionals;

 the business community;

 law enforcement;

 senior citizens;

 the clergy;

 nonprofit health organizations; and

 local domestic violence programs.

Human Sexuality Instruction

1. Does TEA provide a list of human sexuality instruction curricula?

No. The TEC §28.004(e) states that any course materials and instruction relating to human

sexuality, sexually transmitted diseases, or human immunodeficiency virus (HIV) or acquired

immune deficiency syndrome (AIDS) shall be selected by the board of trustees with the advice

of the local SHAC. The TEKS for health must be taught, but the local school district determines

the materials and resources used for instruction.

2. What is the human sexuality instruction requirement for middle school and high school

students?

The TAC §74.1 states that school districts offering K-12 instruction must offer an enrichment

curriculum that includes health education. Age appropriate topics related to human sexuality

instruction are components of the TEKS for middle and high school health education. A school

district may add elements at its discretion but may not delete or omit instruction in the

enrichment curriculum, including human sexuality instruction. School districts should consult

with the local SHAC for guidance on the curriculum or programs that may be selected for

human sexuality instruction.

3. What should school districts do to inform parents about the school district’s human

sexuality instruction?

The TEC §28.004(i) and (j) state the requirements for informing parents about the school

district’s human sexuality instruction. School districts must provide written notice regarding

whether human sexuality will be taught, and, if so, include a summary of the course content

and the parental rights. In addition, school districts are required to make all curriculum

materials utilized in the district's human sexuality instruction available for reasonable public

inspection and inform parents about their right to remove the student from any part of the

district's human sexuality instruction.

4. What are the appropriate notification methods when informing parents about human

sexuality instruction?

The TEC §28.004(i) states that a written notification to a parent should include the board of

trustees' decision regarding whether the district will provide human sexuality instruction to

district students. The method of written notification to parents is a local school district’s

decision. Some examples of written notification may include letters, student code of conduct,

flyers/brochures, and electronic notifications.

Parenting and Paternity Awareness

1. What are the requirements for teaching the parenting and paternity awareness (p.a.p.a.)

curriculum?

The p.a.p.a. curriculum identified in TEC §28.002(p) and TAC §74.35(a) shall be offered in all

public schools and open enrollment charter schools and incorporated in the district's middle or

junior high and high school health curriculum. At the discretion of the district, a teacher may

modify the suggested sequence and pace of the program at any grade level. A student under 14

years of age may not participate without parental permission.

2. What are the program components of the p.a.p.a. curriculum?

The TAC §74.35(a)(2) states that the p.a.p.a. program must address parenting skills and

responsibilities, including child support and other legal rights and responsibilities that come

with parenthood; address relationship skills, including money management, communication

skills, and marriage preparation; and skills relating to the prevention of family violence, only if the

school district's middle, junior high, or high schools do not have a family violence prevention program.

3. Where do school districts obtain the p.a.p.a. curriculum?

The p.a.p.a. curriculum materials and training are provided at no cost to school districts by the

Office of the Attorney General (OAG) of Texas. For additional information regarding the p.a.p.a.

curriculum and training, contact your regional education service center (ESC) Health Program

Specialist or the OAG at (512) 463-2100, or visit

https://www.texasattorneygeneral.gov/cs/parenting-and-paternity-awareness-p.a.p.a.

4. May school districts use other materials related to p.a.p.a.?

Yes. The TEC §28.002(p-2) states that a school district may develop or adopt research-based

programs and curriculum materials for use in conjunction with the requirements for p.a.p.a.

that may provide instruction in child development, parenting skills, including abuse and neglect

prevention; and assertiveness skills to prevent teenage pregnancy, abusive relationships, and

family violence.

Other Health Education Related Questions

1. What are the requirements regarding alcohol awareness instruction?

The TEC §28.002(r) and the TAC §74.35(b) both state that TEA must provide a list of evidence-

based alcohol awareness curricula. School districts and open-enrollment charter schools must

choose a program from the list to use in the middle school, junior high school, and high school

health education curriculum that is “evidence-based” for alcohol awareness instruction for

students. For a list of programs please visit

http://tea.texas.gov/Curriculum_and_Instructional_Programs/Subject_Areas/Evidence-

Based_Programs_for_Alcohol_Awareness/.

2. What is meant by an “evidence-based” alcohol awareness program?

The TEC §28.002(r) defines “evidenced -based” as a program, practice, or strategy that has

been proven to effectively prevent or delay alcohol use among students as determined by

evaluations that use valid and reliable measures and that are published in peer-reviewed

journals.

3. Do the TEKS for health education address bullying?

The TEC §28.002(s) states that the State Board of Education (SBOE), in consultation with the

Texas School Safety Center, shall adopt essential knowledge and skills for the health curriculum

that include evidence-based practices that will effectively address awareness, prevention,

identification, self-defense in response to, and resolution of and intervention in bullying and

harassment.

To view the TEKS for bullying, please visit 19 TAC, Chapter 115.