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House panel advances substitute for school-based health services bill after extended questions on consent and supervision
Summary
The House Education Committee on April 23 advanced a substitute for HB10-22 clarifying who may make medical decisions when school-based health services are available. Sponsors said the measure protects parental authority while ensuring licensed health professionals make assessments; members pressed authors on consent timing, age of majority and how clinics coordinate with parents and community providers.
The House Education Committee voted April 23 to report a substitute for House Bill 10-22, a bill that clarifies how medical decisions are made when school-based health centers provide care on campus. Representative Natalie Jackson, the bill’s sponsor, said the substitute limits the law to schools where clinics already exist or where districts choose to establish them and preserves parental authority through an advance consent process.
"It applies only where services already exist or if a school district decides to establish them," Representative Jackson said, adding the substitute does not expand or require school-based health centers.
The bill draws praise from providers who operate clinics in schools. Willie White, chief executive officer of David Raines Community Health Centers, told the committee his organization staffs school-based clinics with physicians, nurse practitioners, nurses and behavioral-health professionals and coordinates follow-up care with community providers. "We can assess that student, diagnose that student, and coordinate with their community provider as to any follow-up care," White said.
Committee members pressed the sponsor and witnesses on several operational points. Representative Carlson asked whether the statute allows minors under 18 to consent to treatment without parental permission; Faith Boudreaux of the Louisiana Department of Health said the department would consult its attorneys but indicated most school-based centers require parental consent and that only students who have reached the age of majority may independently consent in that setting. Representatives also asked how schools notify parents and how billing is handled; witnesses from David Raines and LDH said clinics generally obtain consent at the start of the school year, may bill insurance or Medicaid for covered services, and provide uncompensated care when families lack coverage.
Several members, including Representative Tarver, said they were still wrestling with the bill’s relationship to school authority and with operational details such as when a teacher should send a student to the clinic versus the nurse or office staff acting first. Jackson repeatedly said the goal is clarity and cooperation: "The goal here is to make sure that that student has access to that trained medical provider," she said, and offered to work with members on language tweaks.
After considerable questioning and a round of public testimony from clinic operators and advocacy groups, the committee voted to report the substitute bill for further consideration. Rep. Landry moved the substitute at the appropriate time and the motion carried with an announced roll call for subsequent action.
The committee’s action sends the substitute to the next stage of consideration; sponsors said they will file technical amendments to address members’ concerns about consent language, age thresholds and school–clinic coordination.
Votes at a glance: the committee recorded a favorable motion to report the substitute; the clerk noted the motion to report HB10-22 as substitute (see committee minutes).
