The THEO office was recently contacted by Sharon Earls, school nurse for the Plemons-Stinnett-Phillips Consolidated ISD (PSPCISD) in Stinnett, Texas. Sharon called THEO’s director, Barbara James, seeking advice about an unaccompanied homeless youth who, in accordance with the McKinney-Vento Homeless Assistance Act, had been enrolled at her school without proof of state-required inoculations. The youth’s previous school, which was out-of-state, could offer only an incomplete shot record, and the documented immunizations did not comply with Texas standards. Sharon had been unable to contact a parent for assistance, and the youth did not have an adult guardian; consequently, no one was available to sign the required release form so that he could get the shots he needed to stay in school. Sharon was out of ideas as to how to provide the student with the necessary immunizations so that he could remain in school, and the call to THEO was her last hope.

Because the unaccompanied youth could not prove that he had had his immunizations and because no parent or guardian was available, Ms. Earls was uncertain what action to take. Barbara was able to help by noting that the Texas Family Code acknowledges that unaccompanied youths 16 years of age and over can sign for their own medical treatment, including inoculations:

A child may consent to medical, dental, psychological, and surgical treatment for the child by a licensed physician or dentist if the child is 16 years of age or older and resides separate and apart from the child’s parents, managing conservator, or guardian, with or without the consent of the parents, managing conservator, or guardian and regardless of the duration of the residence; and [the child is] managing the child’s own financial affairs, regardless of the source of the income;1

This provision offered Sharon some hope: by consenting to immunization, the student’s continued enrollment was ensured and the school could remain in compliance with state and federal law. However, when I followed up on the story two weeks later, Sharon told me that the student was uncooperative, refusing her request that he sign the release and get the needed shots. In spite of her best efforts, Sharon had not been able to overcome the student’s refusal. But the story doesn’t end there.

We’re all familiar with the provisions of the McKinney-Vento Homeless Assistance Act that authorize the immediate enrollment of homeless students—even in the absence of required medical records.2 When records are unavailable, the “burden of proof” falls to the homeless liaison or other school personnel who must take steps to locate and obtain such records, such as by contacting the last school that the student attended3 and/or asking the parent/guardian4 for help. Immediate enrollment is a well-intentioned mandate, ensuring that the student doesn’t miss school days while hard-to-locate records are tracked down. The law doesn’t take into account all the difficulties involved in honoring that mandate, and the uncooperative homeless youth at PSPCISD had become a challenge to Sharon’s humanitarian spirit.

However, the law once again came to the rescue. According to Texas Health and Human Services System regulations, students enrolled in a Texas public school—even those enrolled provisionally—must be immunized or show proof of having been immunized within 30 days of enrollment:

A student may be enrolled provisionally if the student has an immunization record that indicates the student has received at least one dose of each specified age-appropriate vaccine required by this rule. To remain enrolled, the student must complete the required subsequent doses in each vaccine series on schedule and as rapidly as is medically feasible and provide acceptable evidence of vaccination to the school. A school nurse or school administrator shall review the immunization status of a provisionally enrolled student every 30 days to ensure continued compliance in completing the required doses of vaccination. If, at the end of the 30-day period, a student has not received a subsequent dose of vaccine, the student is not in compliance and the school shall exclude the student from school attendance until the required dose is administered.5

An opinion issued by the Texas Attorney General in April of 2004 excludes homeless students from the provisional requirements.6 Students in homeless situations may be enrolled in school without any proof of immunization but must obtain the necessary immunizations or show proof of immunization within 30 days of enrolling in school.

For many liaisons, the feeling of being caught between the letter of the law and the unpredictability of youths whose lives have been disrupted by the loss of home and family is both familiar and disturbing. Sharon’s efforts to keep this homeless youth in school, which is perhaps the closest thing he has to a family, may not lead to a happy ending; however, the protection of the entire student body and compliance with state laws are greater concerns.

Working with the ever-increasing population of runaway and homeless youths while trying to uphold the intent of the law and maintain the spirit of service that characterizes the teaching profession has led to additional challenges for all school personnel. With so many young people enduring homeless and unspeakably tragic circumstances on a daily basis, it can be both a blessing and a curse to have a compassionate spirit. As much as we would like to, we cannot save every child from the circumstances of their lives. Some, like the youth who holds the fate of his education in his own hands, must inevitably save themselves. We must never forget compassion when working with homeless children and youth, but we also must remember the value of objectivity, differentiation, and well-intentioned laws.

1 Texas Family Code, Sec. 32.003(a)(2)(A) and (B)
2 Sec. 722(g)(3)(C)(i)
3 Sec. 722(g)(3)(C)(ii)
4 Sec. 722(g)(3)(C)(iii)
5 Summary of Changes to Immunization Requirements, Texas Department of Health, January 2005,
6 Texas Education Code, §25.002. Requirements for Enrollment. (See