Texas Register April 10, 2026 Volume 51 Number 15

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Governor

Appointments Re:

Appointed to the Executive Council of Physical Therapy and Occupational Therapy Examiners for a term to expire February 1, 2027, Manoranjan “Mano” Mahadeva of Frisco, Texas (Mr. Mahadeva is being reappointed).

Appointed to the Advisory Committee to the Texas Board of Criminal Justice on Offenders with Medical or Mental Impairments for a term to expire February 1, 2029, Nelda T. Cacciotti of Aledo, Texas (replacing Jennifer M. “Jenn” Gonzalez, Ph.D. of Dallas who resigned).

Appointed to the Advisory Committee to the Texas Board of Criminal Justice on Offenders with Medical or Mental Impairments for a term to expire February 1, 2031, Blake R. Harris, Ph.D. of Belton, Texas (replacing James B. “Brian” Eby of Wichita Falls whose term expired).

Appointed to the Advisory Committee to the Texas Board of Criminal Justice on Offenders with Medical or Mental Impairments for a term to expire February 1, 2031, Trenton R. “Trent” Marshall of Burleson, Texas (Mr. Marshall is being reappointed).

Appointed to the Advisory Committee to the Texas Board of Criminal Justice on Offenders with Medical or Mental Impairments for a term to expire February 1, 2031, Stacey L. Mathews of Austin, Texas (replacing Justin J. “J.J.” Koch of Dallas whose term expired).

Appointed to the Advisory Committee to the Texas Board of Criminal Justice on Offenders with Medical or Mental Impairments for a term to expire February 1, 2031, Casey C. O’Neal, Ph.D. of Austin, Texas (Dr. O’Neal is being reappointed).

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Texas Higher Education Coordinating Board

Proposed Rules Re:

Repealing 19 TAC §§6.91 – 6.96, to remove duplicate administrative rules for the Texas Emergency and Trauma Care Education Partnership Program, which have been revised and relocated to Chapter 10, Subchapter H.

CHAPTER 6. HEALTH EDUCATION, TRAINING, AND RESEARCH FUNDS
SUBCHAPTER E. TEXAS EMERGENCY AND TRAUMA CARE EDUCATION PARTNERSHIP PROGRAM
19 TAC §§6.91 – 6.96

OVERVIEW

The Texas Higher Education Coordinating Board (Coordinating Board) proposes the repeal of Texas Administrative Code, Title 19, Part 1, Chapter 6, Subchapter E, §§6.91 – 6.96, concerning the Texas Emergency and Trauma Care Education Partnership Program. Specifically, this repeal will remove duplicate administrative rules that have been revised and moved to Chapter 10, Subchapter H.

Texas Education Code, Chapter 61, Subchapter HH, §§61.9801 – 61.9807, authorizes the Coordinating Board to adopt rules to administer the Texas Emergency Trauma Care Education Partnership Program.

SECTION-BY-SECTION SUMMARY

The proposed repeal of §§6.91 – 6.96 removes Purpose, Authority, Definitions, Eligibility, Selection for Funding, and General Information provisions for the Texas Emergency and Trauma Care Education Partnership Program from Chapter 6, Subchapter E. The substance of those rules has been revised and relocated to Chapter 10, Subchapter H.

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Texas Education Agency

Proposed Rules Re:

Amending 19 TAC §§89.1050, 89.1055, and 89.1096, to implement House Bill 2, Senate Bill 568, and Senate Bill 2 (89th Legislature) by updating Admission, Review, and Dismissal (ARD) committee composition and notice requirements, expanding individualized education program (IEP) content requirements including dyslexia and dysgraphia documentation, and establishing IEP eligibility criteria for the Texas Education Savings Account program for students not enrolled in public school.

CHAPTER 89. ADAPTATIONS FOR SPECIAL POPULATIONS
SUBCHAPTER AA. COMMISSIONER’S RULES CONCERNING SPECIAL EDUCATION SERVICES
DIVISION 2. CLARIFICATION OF PROVISIONS IN FEDERAL REGULATIONS
19 TAC §§89.1050, 89.1055, 89.1096

OVERVIEW

The Texas Education Agency (TEA) proposes amendments to §§89.1050, 89.1055, and 89.1096, concerning special education services. The proposed amendments would update statutory authority and clarify current program practices and requirements in accordance with House Bill (HB) 2, Senate Bill (SB) 568, and SB 2, 89th Texas Legislature, Regular Session, 2025.

BACKGROUND AND PURPOSE

Section 89.1050 defines the criteria for the admission, review, and dismissal (ARD) committee. Section 89.1055 establishes criteria for the individualized education program (IEP). Section 89.1096 establishes provisions of services for students placed by their parents in private schools or facilities.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §89.1050 aligns statutory references with HB 2 and SB 568, adds a requirement that a career and technical education (CTE) representative on the ARD committee be knowledgeable about the availability of CTE programs offered in the district, adds a cross-reference to §89.1131 for certification and licensure requirements for special education personnel, adds a provision allowing a dually certified prekindergarten teacher to represent both the general and special education teacher roles on the ARD committee, clarifies ARD committee composition requirements for students with visual impairments, hearing impairments, or deaf-blindness, updates the written notice requirement for ARD meetings from five school days to ten calendar days, clarifies the district’s obligation upon receipt of a written meeting request from a parent, and adds provisions addressing residential placements and changes in location of special education services.

The proposed amendment to §89.1055 clarifies that all elements of the rule must be followed and that IEPs must be reviewed annually within 365 days of the last annual review, adds requirements for the content of present levels of academic achievement and functional performance statements, clarifies when annual goals and short-term objectives/benchmarks are required, adds requirements for service delivery schedules, adds documentation requirements for minutes spent inside and outside the general education setting, adds progress monitoring and makeup requirements for missed specially designed instruction, adds documentation requirements for School Health and Related Services (SHARS) Medicaid reimbursement, adds documentation requirements for students identified with the specific learning disability of dyslexia or dysgraphia, clarifies IEP requirements for students ages 14, 18, and those transferring between districts, and requires that final IEPs be provided to parents within ten school days of finalization.

The proposed amendment to §89.1096 retitles the section, clarifies that parentally placed private school students do not have an individual entitlement to special education services, removes the dual enrollment provision for students ages 3 or 4, clarifies when a parent may request an individualized services plan, and adds new provisions implementing SB 2 by establishing the IEP components required to determine a student’s eligibility for the Texas Education Savings Account program under Texas Education Code §29.3615 for students not enrolled in public school.

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Amending 19 TAC §103.1209, to implement Senate Bill 57 (89th Legislature) by adding definitions related to individuals with access and functional needs and establishing requirements to ensure equal access to safety during emergency drills and incidents for students and staff with disabilities, including students with individualized education programs and Section 504 plans.

CHAPTER 103. HEALTH AND SAFETY
SUBCHAPTER CC. COMMISSIONER’S RULES CONCERNING SAFE SCHOOLS
19 TAC §103.1209

OVERVIEW

The Texas Education Agency (TEA) proposes an amendment to §103.1209, concerning mandatory school drills. The proposed amendment would implement Senate Bill (SB) 57, 89th Texas Legislature, Regular Session, 2025, by establishing requirements to ensure school systems provide equal access to safety during emergency incidents, required drills, and district-approved exercises for students and district personnel with access and functional needs.

BACKGROUND AND PURPOSE

Section 103.1209 requires that school districts and open-enrollment charter schools conduct emergency drills in accordance with Texas Education Code (TEC), §37.114.

SB 57 amended TEC, §37.1086, to require the commissioner to establish rules related to accommodations for students with an individualized education program or a Section 504 plan during a mandatory school drill required under TEC, §37.114.

SECTION-BY-SECTION SUMMARY

The proposed amendment to subsection (b) adds definitions for “individuals with access and functional needs” and “school system,” and clarifies and expands existing definitions for drill and exercise types, including a new definition distinguishing “fire drill” from “evacuation drill.”

New subsection (d) establishes equal access requirements for school systems during emergency incidents, required drills, and district-approved exercises. School systems must designate a person to review all IEPs and Section 504 plans to identify students who require accommodations to access safety and security during drills and emergencies. Accommodations must be documented locally and shared with campus-level personnel and the school system’s Safety and Security Committee. Multihazard emergency operations plans (EOPs) must account for students with access and functional needs, avoiding inclusion of personal identifying information in plans in accordance with FERPA. Equal access requirements include incorporating TEA guidelines, training staff on emergency response protocols, identifying accessible pre-evacuation sites, developing daily activity schedules that track the location of students with access needs, planning primary and secondary evacuation routes, and maintaining classroom storage of disability-related supplies. Only staff members may assist students during drills and emergency situations.

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Texas Health and Human Services Commission

Adopted Rules Re:

Adopting amendments to 26 TAC §§306.101, 306.103, 306.105, 306.107, 306.109, and 306.111, to add definitions for terms used in the subchapter, revise certification eligibility requirements for Texas Certified Community Behavioral Health Clinics (T-CCBHCs), and clarify that pharmacological management services — including those provided by nurse practitioners and physician assistants — are included within outpatient mental health treatment services.

CHAPTER 306. BEHAVIORAL HEALTH DELIVERY SYSTEM
SUBCHAPTER C. TEXAS CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINICS
26 TAC §§306.101, 306.103, 306.105, 306.107, 306.109, 306.111

OVERVIEW

The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §306.101, concerning Purpose; §306.103, concerning Application; §306.105, concerning Definitions; §306.107, concerning Certification Eligibility; §306.109, concerning Application Process; and §306.111, concerning Certification Standards.

Sections 306.105 and §306.107 are adopted with changes to the proposed text as published in the November 28, 2025, issue of the Texas Register (50 TexReg 7691). These rules will be republished. Sections 306.101, 306.103, 306.109, and 306.111 are adopted without changes.

BACKGROUND AND JUSTIFICATION

The amendments are necessary to add definitions for terms used in the subchapter and provide further clarification for certification requirements for Texas Certified Community Behavioral Health Clinics (T-CCBHCs).

SECTION-BY-SECTION SUMMARY

The adopted amendments to §306.105 add or revise definitions for terms used in the subchapter, including a revised definition of “outpatient mental health treatment services” that uses the term “pharmacological management” in place of “medication management and physician evaluation and treatment services” to ensure that nurse practitioners and physician assistants who are authorized to prescribe medication under their scope of practice may provide this service.

The adopted amendments to §306.107 update certification eligibility requirements for T-CCBHCs, including staffing, availability and accessibility of services, care coordination, scope of services, quality reporting, and organizational authority. Notable provisions include a requirement that T-CCBHCs not refuse or limit services based on a person’s address or housing status; a requirement that non-LMHA/LBHA T-CCBHCs enter into an agreement with their local LMHA or LBHA for mobile crisis outreach services; and governance board requirements including that at least 51 percent of governing board members be persons with lived experience of a mental health or substance use need or family members of people receiving behavioral health services.

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Repealing 26 TAC §§321.1, 321.3, 321.5, and 321.7, to remove outdated sections.

CHAPTER 321. SUBSTANCE USE SERVICES
SUBCHAPTER A. PREVENTION
26 TAC §§321.1, 321.3, 321.5, 321.7

OVERVIEW

The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts the repeal of §321.1, concerning Purpose; §321.3, concerning Application; §321.5, concerning Definitions; and §321.7, concerning Program Description, and new §321.1, concerning Purpose; §321.3, concerning Application; §321.5, concerning Definitions; §321.7, concerning General Program Requirements; §321.9, concerning Program Staffing; and §321.11, concerning Program Service Delivery.

Sections 321.5 and 321.7 are adopted with changes to the proposed text as published in the October 31, 2025, issue of the Texas Register (50 TexReg 7096). These rules will be republished. Sections 321.1, 321.3, 321.9, and 321.11 are adopted without changes.

BACKGROUND AND JUSTIFICATION

The repeal of the rules is necessary to replace the current rules in Title 26, Texas Administrative Code Chapter 321, Subchapter A relating to Substance Use Prevention, with new rules that clarify provider requirements related to training, staffing, written policies and procedures, screening tools, and other requirements that inform substance use prevention service delivery.

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Adopting 26 TAC §§321.1, 321.3, 321.5, 321.7, 321.9, and 321.11, to replace existing substance use prevention rules with updated provisions clarifying provider requirements related to training, staffing, written policies and procedures, screening tools, and service delivery.

CHAPTER 321. SUBSTANCE USE SERVICES
SUBCHAPTER A. PREVENTION
26 TAC §§321.1, 321.3, 321.5, 321.7, 321.9, 321.11 (New)

OVERVIEW

The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts the repeal of §321.1, concerning Purpose; §321.3, concerning Application; §321.5, concerning Definitions; and §321.7, concerning Program Description, and new §321.1, concerning Purpose; §321.3, concerning Application; §321.5, concerning Definitions; §321.7, concerning General Program Requirements; §321.9, concerning Program Staffing; and §321.11, concerning Program Service Delivery.

Sections 321.5 and 321.7 are adopted with changes to the proposed text as published in the October 31, 2025, issue of the Texas Register (50 TexReg 7096). These rules will be republished. Sections 321.1, 321.3, 321.9, and 321.11 are adopted without changes.

BACKGROUND AND JUSTIFICATION

The repeal of the rules is necessary to replace the current rules in Title 26, Texas Administrative Code Chapter 321, Subchapter A relating to Substance Use Prevention, with new rules that clarify provider requirements related to training, staffing, written policies and procedures, screening tools, and other requirements that inform substance use prevention service delivery.

SECTION-BY-SECTION SUMMARY

The new §321.5 establishes definitions for terms used in the subchapter, including adverse childhood experiences (ACE), behavioral health, Center for Substance Abuse Prevention (CSAP) strategies, evidence-based programs, non-medical drivers of health (NMDOH), primary prevention, protective factors, risk factors, and the strategic prevention framework.

The new §321.7 establishes general program requirements for providers, including a requirement to promote behavioral health and focus on preventing and delaying first use of substances. Providers must use prevention strategies that focus on risk factors including ACEs, NMDOH, unequal access to healthcare and behavioral health services, and other youth, family, and community risk factors. Providers must also use the socio-ecological model and SAMHSA’s Strategic Prevention Framework, incorporate all six CSAP strategies, and follow Culturally and Linguistically Appropriate Services (CLAS) standards. Programs must operate according to written policies and procedures. A screening tool is not required for referral to services; if one is used, it must be HHSC-approved and not used for diagnosis or treatment.

The new §321.9 establishes program staffing requirements, and the new §321.11 establishes program service delivery requirements.

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In Addition Re:

Correction of Error

The Health and Human Services Commission adopted amendments to 26 TAC §§300.100 – 300.103, 300.201 – 300.203, 300.301 – 300.303, 300.402 – 300.404, 300.501, 300.502, 300.601 – 300.606; and new §§300.204 – 300.208, 300.405 – 300.407, 300.701, and 300.702 in the March 20, 2026, issue of the Texas Register (51 TexReg 1859). Due to an error by the Texas Register, there is missing language in a response to a comment included in the preamble of the rulemaking. The corrected preamble response clarifies that DSHS does not agree that the rules should follow only food Good Manufacturing Practices, because consumable hemp products — which include food, drugs, devices, and cosmetics containing hemp or hemp-derived cannabinoids — are each subject to their own distinct regulations under HSC §431.002.

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Correction of Error

The Health and Human Services Commission proposed amendments to 26 TAC §745.115 and §745.273 in the March 27, 2026, issue of the Texas Register (51 TexReg 2006). Due to an error by the Texas Register, several items in the proposal were published incorrectly. Specifically: (1) the statutory authority and cross references to statute for both rules should include Texas Human Resources Code §42.042 and §42.041; (2) the implied subsection (a) of 26 TAC §745.115 should read that the listed programs and facilities regulated by other governmental entities are exempt from Child Care Regulation (CCR); and (3) the amendment for 26 TAC §745.273 was published with an incorrect rule number — the correct number is 26 TAC §745.273, not §749.273.

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Public Notice – Community Living Assistance and Support Services (CLASS) Waiver Amendment

The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to amend the waiver application for the Community Living Assistance and Support Services (CLASS) waiver program authorized under §1915(c) of the Social Security Act. CMS has approved the CLASS waiver through August 31, 2029. The proposed effective date for this amendment is September 1, 2026.

The amendment proposes changes to Appendices C, E, and I of the waiver application to update Texas Administrative Code (TAC) references, clarify language to align with existing TAC, update formal monitoring frequency for CLASS program providers and financial management services agencies (FMSAs) following a determination of acceptable compliance during an intermittent monitoring review, and clarify existing Electronic Visit Verification (EVV) policies.

Comments about the proposed waiver amendment must be submitted to HHSC by May 11, 2026. Written comments and requests for copies of the amendment may be submitted to Basundhara Raychaudhuri, Waiver Coordinator, by mail at Texas Health and Human Services Commission, 701 West 51st Street, Mail Code H-310, Austin, Texas 78751; by phone at (512) 438-4403; by fax at (512) 323-1905; or by email at TX_Medicaid_Waivers@hhs.texas.gov.

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Public Notice – Home and Community-Based Services (HCS) Waiver Amendment

The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to amend the waiver application for the Home and Community-based Services (HCS) waiver program authorized under §1915(c) of the Social Security Act. CMS has approved the HCS waiver through August 31, 2028. The proposed effective date for this amendment is September 1, 2026.

The amendment proposes changes to Appendices C, E, and I of the waiver application to update TAC references, update formal monitoring frequency for financial management service agencies (FMSAs) following a determination of acceptable compliance during an intermittent monitoring review, and clarify existing Electronic Visit Verification (EVV) policies.

Comments about the proposed waiver amendment must be submitted to HHSC by May 11, 2026. Written comments and requests for copies of the amendment may be submitted to Julyya Alvarez, Waiver Coordinator, by mail at Texas Health and Human Services Commission, 701 West 51st Street, Mail Code H-310, Austin, Texas 78751; by phone at (512) 438-4330; by fax at (512) 323-1905; or by email at TX_Medicaid_Waivers@hhs.texas.gov.